Assessing pain among people with OUD is challenging, because ongoing opioid use brings changes in pain responses and most pain assessment tools have not been validated for this population. In this narrative review, we discuss the fundamentals of pain assessment for populations with OUD. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study evaluates the time course of pain and craving and objective experience of pain as a function of the last methadone dose. Preliminary findings highlight the potential for increased risks after even a short delay in receiving a methadone dose. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
This study compares by occurrence-era and age-group how opioid-related deaths (ORDs) and their counterpart evolved in Scotland versus England and Wales during 2006-2020. Open access article - no login required.
This systematic review investigates behaviour change techniques in interventions promoting physical activity for young people aged 12–25 years at heightened risk of problematic substance use, and the effect of these techniques on physical activity participation and substance use outcomes.
A strong cooperative bond between the patient and provider (“therapeutic alliance”) is robustly associated with better alcohol use disorder (AUD) treatment outcomes. Although digital treatments for AUD have significant potential, the function of the alliance during digital programs is unclear. We compared the validity of patient-reported measures of the alliance with a digital treatment (“digital alliance”) for AUD and the alliance with their clinician (“clinician alliance”). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Medication for opioid use disorder (MOUD) improves treatment retention and reduces illicit opioid use. A-CHESS is an evidence-based smartphone intervention shown to improve addiction-related behaviors. The authors tested the efficacy of MOUD alone versus MOUD plus A-CHESS to determine whether the combination further improved outcomes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
The clear implication for practice from this research is that when it comes to retaining individuals in treatment, methadone has the edge over buprenorphine. However, time alone is not enough. It is just as important to consider client rather than clinician preference as to which they would like.
Effective pharmacologic treatments for comorbid alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) are lacking. Kappa (κ) opioid receptor antagonists may address this unmet need. Buprenorphine is a κ-opioid antagonist and a partial agonist of mu (μ) opioid receptors, and naltrexone blocks all μ-mediated effects, thus, yielding a pharmacological net effect of a κ-opioid receptor antagonist. This combination was tested in this proof-of-concept study since no specific κ-opioid receptor antagonist was available. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Concerns regarding symptom severity and the risk of relapse among people seeking recovery from alcohol use disorder (AUD) have been raised since the onset of the COVID-19 pandemic. Owing to preventive measures implemented during the pandemic (social distancing or lockdown), self-help group (SHG) meetings were restricted. However, the impact of deprivation of onsite recovery meetings on drinking behavior and risk among SHG members with AUD remains unclear. We aimed to identify the proportion of SHG members who reported drinking and their reasons for drinking during the early stages of the pandemic and to examine the effect of non-attendance at onsite recovery meetings on drinking behavior during the early pandemic period, stratified by gender. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Alcohol is regularly consumed throughout most of the world, including by nearly half the U.S. population age 12 or older. Heavy drinking, which is also common, contributes to multiple adverse medical, psychiatric, and social outcomes and more than 140,000 deaths annually in the United States. It is the major risk factor for alcohol use disorder (AUD), whose current U.S. prevalence is 11%. However, AUD is undertreated, with less than 15% of individuals with a lifetime diagnosis receiving any treatment. Risk of AUD is nearly equally genetic and environmental. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Cannabis has been associated with poorer mental health, but little is known of the effect of synthetic cannabinoids or cannabidiol (often referred to as CBD). To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Recently, early maladaptive schemas have been increasingly focused as the underlying factor of several psychopathologies. The primary objective is to systematically review and meta-analytically analyse the evidence on the relationship between early maladaptive schemas and types of addictive behaviours. Additionally, the secondary objective was to examine potential moderators of the effect sizes. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Youth ages 12–24 account for approximately 20% of overdoses and yet are poorly reached by opioid agonist treatment (OAT), the most widely recommended treatment for opioid use disorder (OUD). This study contributes to understanding this critical gap by describing youths' patterns of OAT engagement at a novel integrated youth-specific OAT program.
Chronic heavy alcohol use impacts all major neurotransmitter systems and is associated with multiple medical, psychiatric, and social problems. Available evidence-based medications to treat alcohol use disorder (AUD) are underutilized in clinical practice. These medications promote abstinence or reduce alcohol consumption, though there are questions regarding their optimal dosage, length of treatment, and utility in combination with one another. Pharmacogenetic approaches, which use a patient's genetic make-up to inform medication selection, have garnered great interest but have yet to yield results robust enough to incorporate them in routine clinical care. This narrative review summarizes the evidence both for medications approved by the Food and Drug Administration (disulfiram, oral naltrexone, acamprosate, and extended-release naltrexone) and those commonly used off-label (e.g., gabapentin, baclofen, and topiramate) for AUD treatment. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
One obvious piece of intelligence for practice is the clear link between social deprivation and risky alcohol consumption. As with other aspects of health, it is those that have the least that pay the greatest price including mortality. Knowing that alcohol consumption is elevated in this group could help target resources locally as practitioners and teams will have the knowledge of where these individuals are and aim to make access to treatment as easy as possible. However, given the continuing real-term decrease in treatment budgets, that could prove to be an ambition rather than the reality.
To examine the association between alcohol consumption and mental health during the COVID-19 pandemic. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
While clinical consequences of thiamine deficiency in alcohol use disorder (AUD) are severe, evidence-based recommendations on dosage, type of administration and duration of thiamine substitution (TS), and its’ target levels remain sparse. This study aimed to compare the effect of two best practice TS regimens on thiamine blood levels (i.e. thiamine pyrophosphate, TPP) and cognitive function. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.
Alcohol withdrawal syndrome (AWS) is a frequent and potentially life-threatening condition experienced in alcohol use disorder. Since hypomagnesemia is involved in AWS’s severity, we conducted a multicenter double-blind randomized placebo-controlled trial to examine the efficacy of oral magnesium supplementation as an adjuvant therapy of AWS. To read the full article, choose Open Athens “Institutional Login” and search for “Midlands Partnership”.