We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.
Opioid Crisis Message from the US Surgeon General
Dear Colleague,
Today, the U.S. Surgeon General is taking historic action by sending a personal letter to more than 2.3 million health care practitioners and public health leaders. He is seeking our help to address the prescription opioid crisis. I want to make sure you see his letter, a copy of which I have included below. Please take a moment to read it. Then go to www.TurnTheTideRx.org/join to join with clinicians from across the country in a simple but powerful movement to end this epidemic.
Read the letter. Take the pledge. And spread the word.
Together, we can save countless lives. We can lead the way. We can #TurnTheTide.
UNITED STATES SURGEON GENERAL
Vivek H. Murthy, M.D., M.B.A.
August 2016
Dear Colleague,
I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic. Everywhere I travel, I see communities devastated by opioid overdoses. I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure.
It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.
The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.
I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.
That is why I am asking you to pledge your commitment to turn the tide on the opioid crisis. Please take the pledge. Together, we will build a national movement of clinicians to do three things:
First, we will educate ourselves to treat pain safely and effectively. A good place to start is this pocket guide with the CDC Opioid Prescribing Guideline. Second, we will screen our patients for opioid use disorder and provide or connect them with evidence-based treatment. Third, we can shape how the rest of the country sees addiction by talking about and treating it as a chronic illness, not a moral failing.
Years from now, I want us to look back and know that, in the face of a crisis that threatened our nation, it was our profession that stepped up and led the way. I know we can succeed because health care is more than an occupation to us. It is a calling rooted in empathy, science, and service to humanity. These values unite us. They remain our greatest strength.
Thank you for your leadership.
Vivek H. Murthy, M.D., M.B.A.
The Authors’ Own Words: Journalists and substance use: A systematic literature review
We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.
Journalists and substance use: A systematic literature review
Jasmine B. MacDonald, Anthony J. Saliba, and Gene Hodgins
Substance Abuse Vol. 37 , Iss. 3, 2016
In recent years there has been increased focus on the psychological risks of journalistic work, with research in trauma and related pathologies receiving funding from organisation such as the DART center. This systematic review is a valuable addition to the literature in that it synthesises the published empirical knowledge acquired to date concerning the experience of substance use amongst journalists. The authors are aware of no other review covering substance use in journalists. As such, future work assessing trauma or other pathologies in journalist samples will cite this review to develop hypotheses about the variables that are likely to be associated with psychological health and with distress, not only in substance use but also in other areas of psychology and organisational management.
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Our newly released issue is now online —> July-September 2016.
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The Authors’ Own Words: Medication-assisted treatment for opioid dependence in Twelve Step–oriented residential rehabilitation settings
We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.
Medication-assisted treatment for opioid dependence in Twelve Step–oriented residential rehabilitation settings
Marc Galanter, Marvin Seppala, and Audrey Klein
Substance Abuse Vol. 37 , Iss. 3,2016
There are 3,450 residential programs in the USA that are colloquially referred to as “rehabs.” They treat a large portion of people with severe substance use disorders, often with little input regarding contemporary therapeutic techniques developed within the biomedical community. It is important for expert clinicians to be aware of this potential deficit, both in choice of facility, to which they may refer patients, and to the clinical issues they may confront when asked to follow up when a patient is discharged from residential treatment.
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Our newly released issue is now online —> July-September 2016.
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The Authors’ Own Words: Characteristics of methadone maintenance treatment patients prescribed opioid analgesics
We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.
Characteristics of methadone maintenance treatment patients prescribed opioid analgesics
Matthew C. Glenn, Nancy L. Sohler, Joanna L. Starrels, Jeronimo Maradiaga, John J. Jost, Julia H. Arnsten, and Chinazo O. Cunningham
Substance Abuse Vol. 37 , Iss. 3,2016
Despite the potential iatrogenic hazards of concurrent methadone treatment and opioid analgesic prescription, the published literature has focused on illicit opioid use amongst MMT patients. Our novel findings suggest high prevalence of prescription opioid overuse amongst opioid analgesic-prescribed MMT patients, higher prevalence of HIV infection and chronic pain when compared to MMT patients not prescribed opioid analgesics, and similarly high rates of illicit substance use across all MMT patients, regardless of opioid analgesic prescription. Thus, the opioid analgesic-prescribed MMT population represents a very high risk group due to the potential for overdose. These findings highlight the complex challenges facing physicians treating patients with comorbid chronic pain and opioid dependence and adds to the body of literature calling for coordinated and integrated strategies to treating these patients.
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Our newly released issue is now online —> July-September 2016.
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