https://www.thecarlatreport.com/rss en-us After reading these articles, you should be able to…

]]> http://www.thecarlatreport.com/articles/5923 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/5923-learning-objectives-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/5913 Wed, 01 Apr 2026 01:00:00 -0400 https://www.thecarlatreport.com/articles/5913-copy-of-cme-post-test-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 Medication misuse in correctional settings reveals how prescribing practices intersect with diversion risk. Dr. Holoyda discusses high demand agents such as gabapentin and bupropion, system level strategies like crush and float, and how to balance safety with adequate treatment. The lessons extend beyond jails to hospitals and outpatient units.

]]> http://www.thecarlatreport.com/articles/5919 Wed, 01 Apr 2026 00:00:08 -0400 https://www.thecarlatreport.com/articles/5919-prescription-drug-misuse-and-diversion-in-correctional-settings Inhalant misuse is often missed in routine practice, especially when drug screens are negative. This update reviews common products, acute risks such as sudden sniffing death, long-term neurologic injury, and nitrous oxide related B12 deficiency. Learn practical screening questions, red flags, and management strategies relevant to both adolescents and adults.

]]> http://www.thecarlatreport.com/articles/5922 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5922-what-psychiatrists-should-know-about-inhalants CATR_AprMayJun2026.jpg Illicit fentanyl now dominates the opioid supply and is often mixed with other dangerous drugs. Dr. Palamar reviews many of these drugs including xylazine, medetomidine, nitazenes, and even industrial chemicals. He explains how these additives alter risk, why geography matters, and how clinicians can stay current using regional alerts and drug checking data.

]]> http://www.thecarlatreport.com/articles/5921 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5921-trends-in-illicit-drug-use CATR_QA1 Joseph Palamar_photo_sm.png Addiction affects entire families, yet family members often receive little guidance. This article reviews evidence for behavioral couples therapy, community reinforcement, and peer led groups such as Al Anon and SMART Recovery Family and Friends. Learn how to present these options in ways that validate stress and strengthen engagement.

]]> http://www.thecarlatreport.com/articles/5920 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5920-family-support-in-substance-use-disorders In hospitalized patients with alcohol use disorder, both oral and extended-release injectable naltrexone significantly reduced heavy drinking days at three months, with no meaningful difference between groups. Initiating treatment before discharge may help reduce gaps in care.

]]> http://www.thecarlatreport.com/articles/5918 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5918-oral-vs-injectable-naltrexone-for-hospitalized-patients-with-aud A large cohort study found a clear dose response relationship between higher early buprenorphine dosing and reduced mortality. Patients receiving more than 16 mg daily in the first month had substantially lower overdose and all cause death rates compared to lower dose groups.

]]> http://www.thecarlatreport.com/articles/5917 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5917-higher-buprenorphine-doses-lower-death-rates-in-the-fentanyl-era Two large cohort studies compared retention and ongoing opioid use among patients receiving methadone versus buprenorphine. Methadone showed slightly higher retention, while both medications reduced illicit opioid use effectively. Choosing between them remains a patient centered clinical decision.

]]> http://www.thecarlatreport.com/articles/5916 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5916-methadone-vs-buprenorphine-naloxone-real-world-comparisons A secondary analysis of the X:BOT trial found lower cannabis use among patients treated with buprenorphine compared to extended-release naltrexone. While opioid outcomes were similar once treatment was initiated, this research suggests that buprenorphine may have an edge for patients with comorbid cannabis use disorder.

]]> http://www.thecarlatreport.com/articles/5915 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5915-cannabis-use-in-oud-does-medication-type-make-a-difference Two recent studies examine starting long-acting injectable buprenorphine before significant withdrawal develops using a so-called "Direct-to-Inject" approach. Precipitated withdrawal rates were low, and early engagement in care was encouraging. This review outlines the protocols, tolerability, and practical implications for emergency and outpatient settings.

]]> http://www.thecarlatreport.com/articles/5914 Wed, 01 Apr 2026 00:00:00 -0400 https://www.thecarlatreport.com/articles/5914-early-and-injectable-only-buprenorphine-induction-can-you-skip-withdrawal By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/5846 Thu, 01 Jan 2026 23:00:00 -0500 https://www.thecarlatreport.com/articles/5846-cme-post-test-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 After reading these articles, you should be able to…

]]> http://www.thecarlatreport.com/articles/5852 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5852-learning-objectives-outpatient-treatment-of-substance-use-disorder-catr-january-february-march-2026 Street psychiatry brings mental health and addiction care directly to unhoused individuals through proactive outreach and long-term trust-building. Dr. Lo describes the importance of collaborating with other providers, applying harm reduction principles, engagement strategies, and how reversing traditional power dynamics helps reach vulnerable “non-utilizers” who rarely access clinics or hospitals.

]]> http://www.thecarlatreport.com/articles/5851 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5851-lessons-from-street-psychiatry CATR_QA1_Emma Lo_photo_sm.png Twelve-step programs remain widely used yet poorly understood in clinical practice. This article outlines the twelve steps, demystifies what happens in meetings, how sponsorship and “90 in 90” support recovery, and how clinicians can address common reservations to make referrals more effective and patient-centered.

]]> http://www.thecarlatreport.com/articles/5850 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5850-understanding-12-step-programs-a-guide-for-clinicians Dextromethorphan misuse is common, especially among young people, yet can easily be overlooked by family and healthcare providers alike. This article reviews recognition of toxicity across the four “plateaus,” psychiatric and medical complications, and supportive management strategies—including when to consider benzodiazepines, antipsychotics, or naloxone.

]]> http://www.thecarlatreport.com/articles/5848 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5848-dextromethorphan-misuse Compared with counseling alone, e-cigarettes significantly improved six-month smoking abstinence, though many participants continued vaping and did not achieve full nicotine cessation. This study supports e-cigarettes as a valuable tool for smokers who struggle with standard cessation medications.

]]> http://www.thecarlatreport.com/articles/5847 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5847-e-cigarettes-for-smoking-cessation-efficacy-and-safety A large prospective cohort study finds no evidence that take-home naloxone increases risky drug use behaviors. Injection frequency, opioid use, benzodiazepine use, and using alone remained unchanged—reinforcing naloxone’s role as a lifesaving harm-reduction tool without unintended risk compensation.

]]> http://www.thecarlatreport.com/articles/5845 Thu, 01 Jan 2026 00:00:00 -0500 https://www.thecarlatreport.com/articles/5845-does-take-home-naloxone-lead-to-riskier-drug-use Psychiatry Practice Boosters, Fifth Edition (2026) - 4 SA / 10 CME Course

]]> http://www.thecarlatreport.com/articles/5813 Sun, 28 Dec 2025 14:59:34 -0500 https://www.thecarlatreport.com/articles/5813-psychiatry-practice-boosters-fifth-edition-2026-4-sa-10-cme Psychiatry Practice Boosters, Fifth Edition (2026) - 4 SA / 10 CME Course

]]> http://www.thecarlatreport.com/articles/5812 Sun, 28 Dec 2025 14:50:07 -0500 https://www.thecarlatreport.com/articles/5812-psychiatry-practice-boosters-fifth-edition-2026-4-sa-10-cme Here are the 10 most visited clinical topics across all Carlat Report newsletters in 2025 with links to relevant articles.]]> http://www.thecarlatreport.com/blogs/1/post/5801 Thu, 18 Dec 2025 00:00:00 -0500 https://www.thecarlatreport.com/blogs/1-the-carlat-psychiatry-blog/post/5801-top-10-clinical-topics-of-2025-all-newsletters Topics_Most_Read.png Dr. Nisavic explains how phenobarbital offers advantages over benzodiazepines for alcohol withdrawal management, particularly in patients with benzodiazepine resistance. He details weight-based loading protocols, monitoring strategies, and the dual GABA/glutamate mechanism that may make phenobarbital superior for severe withdrawal cases.

]]> http://www.thecarlatreport.com/articles/5648 Mon, 17 Nov 2025 17:47:24 -0500 https://www.thecarlatreport.com/articles/5648-phenobarbital-for-inpatient-treatment-of-alcohol-withdrawal CATR QA1_Mladen Nisavic_image2_sm.png Dr. Gunderson provides expert guidance on recognizing and managing delirium tremens, challenging conventional wisdom about withdrawal timelines and offering practical approaches to risk stratification. He details his treatment approach for patients at high risk of developing withdrawal complications and discusses the differential diagnosis of delirium in hospitalized patients with alcohol use disorder.

]]> http://www.thecarlatreport.com/articles/5647 Mon, 17 Nov 2025 17:47:24 -0500 https://www.thecarlatreport.com/articles/5647-delirium-tremens-recognition-risk-and-practical-management CATR_QA2_Craig Gunderson_photo_sm.png This page has links and instructions for downloading your PDF and eBook copies of Psychiatry Practice Boosters, Fifth Edition (2026) and completing the 10 CME Post-Test.

]]> http://www.thecarlatreport.com/articles/5576 Mon, 03 Nov 2025 11:36:45 -0500 https://www.thecarlatreport.com/articles/5576-psychiatry-practice-boosters-fifth-edition-2026 PB5e_eBook_Cover.png New rapid induction strategies are allowing clinicians to start buprenorphine in acute care settings.

]]> http://www.thecarlatreport.com/articles/5649 Sat, 01 Nov 2025 00:00:00 -0400 https://www.thecarlatreport.com/articles/5649-rapid-induction-of-buprenorphine-in-acute-care-settings When bipolar disorder and substance use disorders co-occur patients can be difficult to diagnose and treat, particularly because they often present with mixed states rather than classic mood episodes. This article reviews evidence-based treatment approaches for specific substance combinations, including valproate for alcohol use, citicoline for stimulant use, and considerations for managing this complex dual diagnosis.

]]> http://www.thecarlatreport.com/articles/5646 Sat, 01 Nov 2025 00:00:00 -0400 https://www.thecarlatreport.com/articles/5646-bipolar-disorder-and-addiction-untangling-a-complex-overlap A massive meta-analysis of over one million participants provides the most comprehensive real-world comparison to date of methadone versus buprenorphine for opioid use disorder. While both medications are effective, methadone shows superior treatment retention at 3, 6, and 12 months, though the medications are largely comparable in other outcomes.

]]> http://www.thecarlatreport.com/articles/5645 Sat, 01 Nov 2025 00:00:00 -0400 https://www.thecarlatreport.com/articles/5645-methadone-vs-buprenorphine-a-meta-analysis The first randomized controlled trial testing varenicline for e-cigarette cessation shows encouraging results. With 45% of participants achieving 7-day abstinence at week eight compared to 30% on placebo, this study provides preliminary evidence that varenicline may be effective for helping patients quit vaping, expanding its utility beyond traditional tobacco cessation.

]]> http://www.thecarlatreport.com/articles/5644 Sat, 01 Nov 2025 00:00:00 -0400 https://www.thecarlatreport.com/articles/5644-varenicline-shows-promise-for-vaping-cessation By successfully completing the test you will be awarded a certificate for 2 CME credits.

]]> http://www.thecarlatreport.com/articles/5643 Sat, 01 Nov 2025 00:00:00 -0400 https://www.thecarlatreport.com/articles/5643-cme-post-test-substance-use-disorder-on-the-inpatient-unit-catr-october-november-december-2025 Alcohol use disorder (AUD) is notoriously difficult to treat, with pharmacological options often underutilized or only modestly effective. But what if a medication already used for diabetes and obesity could help?

]]> http://www.thecarlatreport.com/articles/5581 Sat, 01 Nov 2025 00:00:00 -0400 https://www.thecarlatreport.com/articles/5581-repurposing-semaglutide-and-liraglutide-for-alcohol-use-disorder