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The Carlat Addiction Treatment Report

Emerging Risks for Old Medications (May/June) | 2020

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CME Post-Test - Emerging Risks for Old Medications, CATR, May/June 2020

June 10, 2020

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits. Read More

Gabapentin for Alcohol Use Disorder, Redux

June 10, 2020

Rehan Aziz, MD.

Which patients with alcohol use disorder might benefit from gabapentin most? This randomized controlled trial focused on gabapentin’s impact on alcohol use among patients with alcohol use disorder and who had also had alcohol withdrawal symptoms in the past. Read More

Does Baclofen Titrated to High Doses Reduce Alcohol Use?

June 10, 2020

Thomas Jordan, MD.

Previous trials of baclofen for alcohol use disorder have used fixed or rather low doses, and the results have been mixed. This was the first randomized trial to allow up-titration of the dose depending on the patient’s response. Read More

Amphetamines and Topiramate for Cocaine Use Disorder

June 10, 2020

Rehan Aziz, MD.

Small studies have shown promise for treating cocaine use disorder with combination amphetamine salts/topiramate. In this larger trial, the combination was tested against a placebo. Read More

E-Cigarettes vs Nicotine Replacement for Smoking Cessation

June 10, 2020

Jason Mallo, DO

Quitting smoking remains extremely difficult. This multicenter randomized controlled trial evaluates the efficacy of using e-cigarettes compared to nicotine replacement among adults (average age 41) seeking help to quit smoking. Read More

Benzodiazepines: Old Medicines, New Concerns

June 10, 2020

Kenneth Morford, MD

Benzodiazepine use is on the rise, and is implicated with a significant portion of opioid-related overdose deaths. Dr. Morford gives the latest on benzodiazepine prevalence and suggests strategies to employ in addiction treatment settings when working with patients who use benzodiazepines. Read More

Muscle Relaxants: Sedatives Often Under the Radar

June 10, 2020

Michael Weaver, MD, FASAM.

Muscle relaxants encompass medications with different mechanisms of action—many of which have been used for decades. Yet most are sedating, can have significant side effects, and can interact with opioids and other substances to worsen CNS and respiratory depression. Read More

SAMHSA Relaxes Regulations on Methadone and Buprenorphine During COVID-19 Emergency

June 10, 2020

Benjamin Oldfield

In the context of a pandemic, how can and should our practices change to continue to meet the needs of patients with opioid use disorder? We summarize recent changes to the regulations surrounding medications for opioid use disorder: buprenorphine and methadone. Read More

Gabapentin Misuse and Diversion

June 10, 2020

Rachel Vickers-Smith, PhD, MPH

Clinicians are increasingly turning to gabapentinoids as non-opioid alternatives for pain treatment. Yet we may be inadvertently introducing new risks in so doing. Dr. Vickers-Smith reviews current epidemiology of gabapentinoid use and offers some clues regarding how to turn the tide on gabapentin misuse. Read More

The “Z-Drugs”: Safety Issues and Misuse Potential

June 10, 2020

Rehan Aziz, MD.

Once heralded for their relative safety compared to benzodiazepines, the “Z-drugs” are now known to be one of the most common causes of adverse drug events. Here we review the risks of Z-drugs and highlight updated dosing recommendations for zolpidem. Read More

Note From the Editor-in-Chief

June 10, 2020

Benjamin Oldfield

The expansion of telemedicine—which health systems had been slow to adopt and payers had been reluctant to reimburse for years—has zoomed ahead in recent weeks. Sure, it’s not perfect: The video connections can be finicky, and learning new digital platforms can pose challenges for both patients and providers. But with... Read More