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The Carlat Addiction Treatment Report

Addiction in Pregnancy (July/August) | 2021

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Learning Objectives, Addiction in Pregnancy, CATR, July/August 2021

July 3, 2021

After reading these articles, you should be able to… Read More

Does CBT Enhance Pharmacotherapy for Addiction?

July 3, 2021

Jedidiah Perdue, MD, MPH

Psychotherapy has had a mixed track record of efficacy for substance use disorders. This meta-analysis suggests that CBT is only modestly effective when combined with medications and likely no better than any other form of therapy. Although it’s unlikely be a magic bullet, CBT is very low risk, and reasonable to offer alongside other more established treatments. Read More

Starting Buprenorphine: Is Timing Everything?

July 3, 2021

John O’Neal, MD

When is an optimal time to start buprenorphine in order to keep patients in treatment? In this retrospective study, researchers compared treatment retention as a function of whether or not buprenorphine was prescribed on the day of initial evaluation. Same day prescription trended non-significantly towards improved retention. Read More

Cannabidiol for Crack-Cocaine Craving: Negative Findings

July 3, 2021

David Moltz, MD

Cocaine use disorder is notoriously difficult to treat. The authors of this study asked, might cannabidiol be helpful in treating the cravings that prompt cocaine use? While this might seem like an unusual question at first, there is some supportive preclinical data that makes the premise plausible. Unfortunately, the results were negative in this small study. Read More

Nicotine Patch for Cannabis Withdrawal?

July 3, 2021

John O’Neal, MD.

As cannabis use becomes more widespread, treaters will inevitably see increases in patients reporting symptoms of cannabis withdrawal. Researchers in this study investigated whether a nicotine patch might help mitigate some of these symptoms. Results were not particularly promising, and should only be considered for patients who also use tobacco. Read More

Breastfeeding and Addiction

July 3, 2021

Pochu Ho, MD.

Addictive substances and medications alike can find their way into the breastmilk of lactating women, however the effect these substances have on breastfeeding babies can vary. We provide guidance on how best to manage addiction in women who are actively breastfeeding. Read More

The Pregnant Patient With Substance Use Disorder

July 3, 2021

Ariadna Forray, MD

Dr. Forray gives readers a comprehensive refresher on fetal effects of alcohol, tobacco, opioid, cannabis, and stimulant use during pregnancy. She then lays out the current evidence for various treatments and provides recommendations for how to treat pregnant patients with addiction. Read More

Naloxone Prescribing

July 3, 2021

Phillip Coffin, MD

Dr. Coffin provides our readers with everything there is to know about the nuts and bolts of naloxone prescribing for opioid use disorder. He tells us how patients can get their hands on naloxone, reviews the pros, cons, and costs of various naloxone formulations, and covers current naloxone laws. Read More

A New High-Dose Naloxone: Life Saver or Punishment?

July 3, 2021

Noah Capurso, MD

The FDA recently approved a nasal spray formulation of naloxone. Called Kloxxado, each spray delivers 8mg, twice as much as the most widely used formulation, Narcan. Whether or not this higher dose is necessary, is debatable. Read More