Addiction Treatment

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Tips on the Doubts about Ketamine/Esketamine

By: zdavis | August 19th , 2020 | The Carlat Psychiatry Blog| 0 Comment

Ketamine and esketamine have been shown to provide rapid relief of suicidality, however, many lingering doubts have been raised about these medicines. In a previous article from The Carlat Psychiatry Report, Nolan Williams, M.D., discusses the potential negative consequences of ketamine/esketamine treatment. Here are some of Dr. Williams’s tips: It

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Helping Patients Maintain Recovery

By: jives | July 2nd , 2019 | The Carlat Psychiatry Blog| 0 Comment

Excerpted from a past issue of The Carlat Addiction Treatment Report, Matthew Goldenberg, DO, Founder of Professionals Health Solutions and assistant professor of psychiatry at Cedars-Sinai Medical Center, offers the following advice: Enhance your patients’ courage. Many people with SUDs may not think of themselves as brave, but it takes guts to fa

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Tips for Better Motivational Interviewing

By: jives | June 27th , 2019 | The Carlat Psychiatry Blog| 0 Comment

In The Carlat Addiction Treatment Report, David Rosengren, PhD, President of the Prevention Research Institute, gives the following tips on how to conduct motivational interviewing: Be curious, not an expert. Training and expertise can get in the way of our really hearing the client’s story. For example, a client says, “I don’t think my drinki

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Safe Use of Gabapentin with Patients

By: jives | June 19th , 2019 | The Carlat Psychiatry Blog| 0 Comment

Although there’s been a lot of discussion about gabapentin’s abuse potential, gabapentin substance use disorders are pretty rare, with one study finding that only 2% of 44,148 patients using gabapentin alone met criteria for sustained overuse (Peckham et al, Pharmacotherapy, in press). The one area where you should show caution, however, is when pat

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Strategies for Getting Patients to Quit Smoking

By: jives | June 21st , 2019 | The Carlat Psychiatry Blog| 0 Comment

For patients who smoke intermittently, you should start with nicotine replacement therapies, such as nicotine lozenges or gum, which can be used on a PRN basis. Patients who smoke more frequently, such as several times per day, will need consistent nicotine replacement from a patch to prevent the peaks and troughs associated with nicotine cravings. S

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Tips on Marijuana Use Disorder

By: jives | March 20th , 2019 | The Carlat Psychiatry Blog| 0 Comment

Regardless of where you practice, you'll increasingly hear patients acknowledging regular marijuana (MJ) use, sometimes as a "medical treatment" for conditions ranging from back pain to ADHD. You might want to remind your patients that, whether legal or not, marijuana is still a drug with potential negative consequences. Here are some quick MJ bullet po

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Is your patient hooked on Vicodin? Try this

By: jives | March 19th , 2019 | The Carlat Psychiatry Blog| 0 Comment

I don't specialize in addiction treatment, but occasionally I do have patients who tell me they've been overusing prescription narcotics. For example, I once treated a woman for depression who was dependent on Vicodin that was originally prescribed after surgery by her OB/GYN. Over the years she had tried quitting on her own, unsuccessfully. Her PCP

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Alcohol-Induced Blackouts

By: jives | October 4th , 2018 | The Carlat Psychiatry Blog| 0 Comment

The recent Senate hearings regarding Supreme Court nominee Brett Kavanaugh have brought up the topic of alcohol overuse, and especially the issue of the alcoholic blackout. This post covers what alcohol-induced blackouts are and aren’t, and how to differentiate them from simply passing out from too much alcohol. Alcohol is a potent CNS depressant,

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Screening Adolescent Patients for Substance Use

By: jives | July 19th , 2018 | The Carlat Psychiatry Blog| 0 Comment

Adolescents are generally healthy, and they don’t tend to present with pancreatitis or other adult diseases that can be possible clues to a substance use issue. A lot of times adolescents with SUDs don’t hit the surface until they have a legal or a school consequence. The following is some advice on screening adolescents for SUDs from Joanna Quig

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