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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The eight articles in this special issue on anxiety sensitivity (AS) and substance abuse provide provocative new information on the relationships, or lack of relationships, between AS and several types of substance use and abuse. The eight articles provide data that extend our understanding of the role of AS in substance abuse with younger people, people who use substances other than alcohol, people who have disorders comorbid with substance use disorders, and people who experience chronic headaches. In addition, one of the articles attempts to determine how AS develops in relationship to parental substance abuse. Finally, several of the studies show that the three Anxiety Sensitivity Index (ASI) subscales (physical concerns, social concerns, and psychological concerns) are uniquely associated with different aspects of substance use/abuse. Each of the articles is discussed as to its merits and potential domains that may require additional research. Finally, several general suggestions are provided for new directions that research on the relations of AS and substance use/abuse should take.
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PMID:Substance use/abuse and anxiety sensitivity: what are the relationships? 1176 53

It is estimated that 40% to 50% of patients with metastatic disease and 90% of patients with terminal cancer experience unrelieved pain. Furthermore, inadequate treatment of cancer pain is a greater possibility if the patient is a substance abuser. In this paper, we will explore pertinent conceptual and clinical aspects of addiction that can assist in improving the identification and treatment of patients with substance use disorders.
Curr Pain Headache Rep 2002 Jun
PMID:Substance abuse issues in cancer pain. 1200 88

This article reviews current research on medication-overuse headache (MOH), and provides clinical suggestions for effective treatment programs. Epidemiological research has identified reliance on analgesics as a predictive factor in headache chronicity. MOH can be distinguished as simple (Type I) or complex (Type II). Simple cases involve relatively short-term drug overuse, relatively modest amounts of overused medications, minimal psychiatric contribution, and no history of relapse after drug withdrawal. In contrast, complex cases often present with multiple psychiatric comorbidities and a history of relapse. Although limited, current research suggests that comorbid psychiatric disorders are more prevalent in MOH than in control headache conditions, and may precede the onset of MOH. There appears to be an elevated risk of family history of substance use disorders in MOH patients, and an increased risk of MOH in patients with diagnosed personality disorders. Current studies suggest a high rate of relapse at 3 to 4 years after drug withdrawal and pharmacological treatment, with most relapse occurring during the first year of treatment. Relapse is a greater problem with analgesics than ergots or triptans. The addition of behavioral treatment to prophylactic medication may significantly reduce the risk of relapse over a period of several years. Clinical recommendations include assessment and modification of psychological factors that may underlie MOH, provision of detailed educational information, and combining behavioral treatment with the current standard of drug withdrawal and use of prophylactic pharmacotherapy.
Headache 2006 Oct
PMID:Medication overuse headache: biobehavioral issues and solutions. 1703 3

Using data from the National Comorbidity Survey--Replication, this study examined the timing of onset of self-report comorbid chronic nonarthritis pain and substance use disorders (SUDs) and characteristics associated with different onset patterns. Most individuals (58.2%; N = 351/632) report that the SUD preceded the onset of pain. Relative to those with SUDs prior to the onset of chronic pain, those experiencing pain first were less likely to have a drug use disorder, more likely to have head pain, to be younger at the onset of the first condition, and to have a shorter duration between condition onsets.
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PMID:The timing of onset of pain and substance use disorders. 2071 3

Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. This study explored the pattern of chronic medical conditions in a sample of adult detainees in psychiatric treatment in a large urban jail to develop a clinical profile encompassing the full range of medical conditions. A total of 431 male and female detainees were sampled with certainty from admissions to a residential psychiatric treatment program (overall recruitment rate = 67%). Interviews used the World Mental Health version of the Composite International Diagnostic Interview to assess psychiatric and substance use disorders per DSM-IV criteria and chronic medical conditions. Latent class analysis was conducted using 17 medical conditions as class indicators, yielding a 3-class model composed of: a latent class with a high to intermediate probability of multiple medical conditions (HMC; 12.5% of the sample); an intermediate class with a lower probability of having a smaller number of medical conditions (MMC; 43.2%); and a class with a low probability of any medical condition (44.3%). Those in the HMC class were more likely to report respiratory problems, severe headaches, musculoskeletal pain, hypertension, and arthritis, have greater functional impairment, and have a higher number of co-occurring psychiatric disorders. Being older (50+ years) and female were associated with higher odds of being in the HMC or MMC classes. The policy implications for providing medical care to incarcerates with complex mixtures of medical conditions and psychiatric disorders are considered.
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PMID:Chronic medical conditions among jail detainees in residential psychiatric treatment: a latent class analysis. 2139 59

A history of mild traumatic brain injury (mTBI) is common among military members who served in Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND). We completed a systematic review to describe the cognitive, mental health, physical health, functional, social, and cost consequences of mTBI in Veteran and military personnel. Of 2668 reviewed abstracts, the 31 included studies provided very low strength evidence for the questions of interest. Cognitive, physical, and mental health symptoms were commonly reported by Veterans/military members with a history of mTBI. On average, these symptoms were not significantly more common in those with a history of mTBI than in those without, although a lack of significant mean differences does not preclude the possibility that some individuals could experience substantial effects related to mTBI history. Evidence of potential risk or protective factors moderating mTBI outcomes was unclear. Although the overall strength of evidence is very low due to methodological limitations of included studies, our findings are consistent with civilian studies. Appropriate re-integration services are needed to address common comorbid conditions, such as treatment for post-traumatic stress disorder, substance use disorders, headaches, and other difficulties that Veterans and members of the military may experience after deployment regardless of mTBI history. (JINS, 2014, 20, 1-13).
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PMID:Factors Associated with Mild Traumatic Brain Injury in Veterans and Military Personnel: A Systematic Review. 2449 7

Gabapentin is effective for the treatment of alcohol dependence and can be used for treating anxiety, insomnia, headaches, and/or pain in patients who have comorbid substance use disorders (SUDs) or who are at high risk of substance abuse. Deaths from unintentional drug overdoses are increasing, are the leading cause of injury death in the United States, and are mostly attributable to prescription drugs, in particular opioid agents. Compared to other psychotropic drugs, gabapentin is not especially harmful or lethal. Gabapentin misuse is possible, similar to other medications not typically considered drugs of abuse, but it should be considered safe and appropriate for use in patients with all types of SUDs, including patients who take opioid drugs.
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PMID:Gabapentin for Substance Use Disorders: Is it Safe and Appropriate? 2454 70

A history of mild traumatic brain injury (mTBI) is common among military members who served in Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND). We completed a systematic review to describe the cognitive, mental health, physical health, functional, social, and cost consequences of mTBI in Veteran and military personnel. Of 2668 reviewed abstracts, the 31 included studies provided very low strength evidence for the questions of interest. Cognitive, physical, and mental health symptoms were commonly reported by Veterans/military members with a history of mTBI. On average, these symptoms were not significantly more common in those with a history of mTBI than in those without, although a lack of significant mean differences does not preclude the possibility that some individuals could experience substantial effects related to mTBI history. Evidence of potential risk or protective factors moderating mTBI outcomes was unclear. Although the overall strength of evidence is very low due to methodological limitations of included studies, our findings are consistent with civilian studies. Appropriate re-integration services are needed to address common comorbid conditions, such as treatment for post-traumatic stress disorder, substance use disorders, headaches, and other difficulties that Veterans and members of the military may experience after deployment regardless of mTBI history.
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PMID:Factors associated with mild traumatic brain injury in veterans and military personnel: a systematic review. 2462 5

Chronic pain has long been considered an important risk factor for suicidal behavior. Less well understood are the factors associated with the increased risk for suicide death within chronic pain populations. The purpose of this review is to examine recent research with regard to rates of and risk factors for suicide mortality in patients with chronic musculoskeletal pain. We conclude that patients with a number of chronic pain states are at increased risk for suicide death, and that this risk appears to be due, at least in part, to other well-known correlates of pain such as depression and substance use disorders. However, in all likelihood, there are aspects of chronic pain itself that add uniquely to an individual's suicide risk profile. Lastly, we address a theoretical perspective and offer recommendations for clinical practice.
Curr Pain Headache Rep 2014
PMID:The risk of suicide mortality in chronic pain patients. 2495 8

Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society.
Curr Pain Headache Rep 2016 Dec
PMID:Challenges to Treatment of Chronic Pain and Addiction During the "Opioid Crisis". 2787 21


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