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CLINICAL Q&A

Using Motivational Interviewing in Your Practice

June 1, 2016
David Rosengren, PhD

David Rosengren, PhD. President of Prevention Research Institute, Inc.
Dr. Rosengren has disclosed that he receives book royalties from Guilford Press. Dr. Carlat has reviewed this article and found no evidence of bias in this educational activity.

At its most basic, motivational interviewing is a conversation in which you are trying to help someone deal with ambivalence that prevents them from acting on a problematic behavior. At a more complex level, it has to do with things like paying attention to how the patient talks and what kind of language they’re using. In this interview, Dr. Rosengren discusses the language and process of motivational interviewing.
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RESEARCH UPDATE

Psychedelic Mushrooms May Help Treatment Resistant Depression

June 1, 2016
Bret A. Moore, PsyD, ABPP
Bret A. Moore, PsyD, ABPP

Board-Certified Clinical Psychologist, San Antonio, TX

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Psilocybin, a naturally occurring and psychedelic compound of the Psilocybe species of mushrooms, has garnered the most attention.
Psilocybin is essentially a serotonin 2A agonist. Theoretically, this action should mediate depressive symptoms, but we don’t know for sure because no available antidepressants are direct agonists of this receptor. Researchers from the United Kingdom set out to see if this is indeed the case.
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RESEARCH UPDATE

Good News for Smoking Cessation Drugs: Not as Scary as Once Thought

June 1, 2016
Bret A. Moore, PsyD, ABPP

Bret A. Moore, PsyD, ABPP                                    

Board-Certified Clinical Psychologist, San Antonio, TX.                                       

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Both varenicline (Chantix) and bupropion (Zyban) are effective anti-smoking agents, but over the years we’ve heard about potential neuropsychiatric side effects, especially related to varenicline. These include depression, suicidal thoughts, psychosis, and nightmares.
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CLINICAL UPDATE

Medication Treatment of Anxiety Disorders in Substance Abusers

May 1, 2016
Daniel Carlat, MD
Daniel Carlat, MD  

Editor-in-Chief, Publisher, The Carlat Report.

Dr. Carlat has disclosed that he has no relevant relationships or financial interests in any commercial company pertaining to this educational activity.

While benzodiazepines are effective anti-anxiety workhorses for many patients, most guidelines tell us to avoid prescribing them to substance abusers. The concern is that the benzo high will remind patients of their substances of choice, and that benzo withdrawal symptoms will lead to old substance abuse habits.
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EXPERT Q&A

Benzodiazepines: Dependence, Tolerance, and Addiction

May 1, 2016
Alex Stalcup, MD

DrStalcup_headshot.jpgAlex Stalcup, MD
Medical director of the New Leaf Treatment Center in Lafayette, CA.
Dr. Stalcup has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this
educational activity.

One good way to think of benzodiazepines is that they are literally, physiologically anyway, alcohol in a pill. Especially the fast-onset/fast-offset benzodiazepines like alprazolam (Xanax) have a very similar pharmacologic profile to alcohol. This discussion with Dr. Alex Stalcum covers strategies of using benzodiazepines as anxiety treatments for substance-abusing patients.
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RESEARCH UPDATE

Synthetic THC and Antihypertensive Provide Little Benefit for Cannabis Dependence

May 1, 2016
Bret A. Moore, PsyD, ABPP
Bret A. Moore, PsyD, ABPP. Board-Certified Clinical Psychologist, San Antonio,.

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Second only to alcohol, marijuana is the most common reason people enter substance abuse treatment. And unlike alcohol dependence, there are virtually no effective medications available for those addicted to it. It’s not from a lack of trying. A recent review of 14 drug studies for cannabis dependence revealed little benefit from antidepressants, anticonvulsants, or anxiolytics.
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RESEARCH UPDATE

When Physicians Become Addicted: How Well Do Treatment Programs Work?

May 1, 2016
Bret A. Moore, PsyD, ABPP
Bret A. Moore, PsyD, ABPP. Board-Certified Clinical Psychologist, San Antonio, TX.

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
When physicians are diagnosed with opioid or other drug dependence, they are required to receive treatment from special physician health programs (PHP) if they want to keep their medical licenses. Unlike treatment programs for the general population, PHPs do not use opiate agonists, such as methadone or buprenorphine.
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How to Treat Opiate Use Disorders

March 1, 2016
Michael Weaver, MD, FASAM
Michael Weaver, MD, FASAM.

Professor and medical director at the Center for Neurobehavioral Research on Addictions at the University of Texas Medical School.

Dr. Weaver has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Opiate use disorder is increasingly common, and it is important to develop a systematic approach for treating it. In this article, I will discuss some of the more important elements of treatment, starting with the need to address patients’ denial and moving on to some of the nitty gritty aspects of medication-assisted treatment.
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