Medical Comorbidities

Clinical Update

Primer: Physical Examination in Addiction Practice

Topics: Addiction | Medical Comorbidities | Prevention | Substance Use | Substance use disorders

Patients with substance use disorders (SUD) often have unaddressed medical issues. As addiction providers, we may be a patient’s only line of contact with health care personnel. Thus, keeping an eye out for medical problems could help reduce associated complications and even save a life. This article will take you through the sections of a basic physi

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Expert Q&A

Screening and Prophylaxis of Infectious Diseases in Addiction Practice

Topics: Addiction | Addiction Treatment | Hepatitis | HIV | Medical Comorbidities | Prevention | Substance Use | Substance use disorders

CATR: Can you tell us about your background? Dr. Springer: I’m an infectious disease doctor who is addiction medicine board certified as well. My background clinically is treating HIV and infectious diseases, as well as opioid use disorder (OUD) and alcohol use disorder (AUD). My research is about how to best integrate infectious disease and OUD trea

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Clinical Update

PrEP: Introduction to the Basics

Topics: Addiction | Addiction Treatment | HIV | Medical Comorbidities | Medication | Pharmacology | Prevention | Substance Use | Substance use disorders

Great strides have been made in HIV treatment and prevention during the last 2 decades, resulting in falling numbers of new HIV infections during that time span. But since 2013, the rate of new infections has mostly plateaued at just under 40,000 new infections per year (www.hiv.gov). Those at highest risk of infection remain men who have sex with men,

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Expert Q&A

Perioperative Management of Patients on Buprenorphine Maintenance

Topics: Addiction | Addiction Treatment | Buprenorphine | Medical Comorbidities | Medication | Opioid epidemic | Opioid Use Disorder | Opioids | Pain | Pharmacology | Suboxone | Substance Use | Substance use disorders

CATR: Can you tell us about your background? Dr. Acampora: I used to work as a cardiac anesthesiologist. Later, my interest turned to addiction medicine, and I trained in psychiatry and addiction psychiatry. I currently work in a pain clinic where I helped develop a strategy for managing buprenorphine in the perioperative period. CATR: Where does th

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Research Update

Mood Stabilizers and Stroke Risk in Bipolar Disorder

Topics: Bipolar Disorder | Lithium | Medical Comorbidities | Mood Stabilizers | Pharmacology

Review of: Chen PH et al, Br J Psychiatry 2018;1–6. doi:10.1192/bjp.2018.203 Study Type: Case-crossover study People living with bipolar disorder already have a decreased life expectancy of 10+ years compared to the general population (Crump C et al, JAMA Psychiatry 2013;70:931–939). Most of these years of lost life have been attributed to cardiov

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Expert Q&A

Distinguishing Between Medical and Psychiatric Conditions

Topics: Laboratory Testing in Psychiatry | Medical Comorbidities | Practice Tools and Tips | Psychopharmacology Tips

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Article

Traumatic Brain Injury in Psychiatric Practice

Topics: Medical Comorbidities

A casual glance at front-page headlines and scientific publications has probably raised your awareness of traumatic brain injury (TBI) and the TBI-related symptoms that might bring a patient to your office. In the popular press, reports often focus on injuries from combat and sports—such as those resulting from improvised explosive devices (IEDs) or h

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Article

Chronic Pain, Comorbidity, and Treatment Complexity

Topics: Medical Comorbidities

Chronic pain is typically defined as pain lasting longer than three months, resulting from either a disease process or bodily injury that has not resolved as expected. It is a major and complex public health reality for almost one-third of the US population. More than 116 million Americans have chronic pain conditions, contributing to healthcare costs a

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Article

Fatigue: Causes and Treatments

Topics: Medical Comorbidities

How often are you faced with patients who come to you with “I’m exhausted,” “I have no energy,” “I’m dragging,” or “I can’t stay awake”? If you’re like most psychiatrists, you see this often, and at times simply giving a sleep aid is an unsatisfying or ineffective solution. Up to one half of the general population, and one of

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Article

Drugs in the Pipeline: ALKS–5461

Topics: Medical Comorbidities

Since our feature article on “New Antidepressants” in the May 2012 TCPR, you may have heard some buzz about yet another new antidepressant undergoing clinical trials, this one with the less-than-sexy name ALKS-5461. Some news outlets have promoted it as “revolutionary.” What exactly is it? While most current antidepressants act on the monoami

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Expert Q&A

Integrating Primary Care and Mental Health Care

Topics: Medical Comorbidities

TCPR: Dr. Gardner, you are the head of psychiatry at an integrated health clinic. Please tell us why it important for psychiatric services to be integrated into primary care settings. Dr. Gardner: Integration destigmatizes and defragments care for providers and patients. For example, people with severe mental illness have a life expectancy 25 years s

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