The Psychiatric Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Harm Reduction
This article provides an overview of harm reduction and its application to alcohol, tobacco, and drug use. It discusses the importance of integrating harm reduction principles and services with traditional psychiatric, medical, and addiction treatment programs. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: Avinash Ramprashad, Gregory Malik Burnett, Christopher Welsh Source Type: research

Individual Paths to Recovery from Substance Use Disorder (SUD)
Although the research base around 12-step effectiveness has been grown markedly in recent years, there has also been growth in the broader evidence base around recovery models, and this article reviews three key components: the transition to a social model of recovery; the emergence of a metric of recovery progress, recovery capital focused on building strengths; and multiple pathways to recovery, involving mutual aid groups, recovery community organizations, and access to jobs, friends, and housing. We conclude with an overview of the practical implications for addiction treatment and sustaining the gains made in speciali...
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: David Best, Mulka Nisic Source Type: research

Technological Addictions
This article provides an overview of the more common TAs including their evaluation and treatment techniques. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: James Sherer, Petros Levounis Source Type: research

Policy Ahead of the Science
Forty-one US jurisdictions (37 states) have legalized comprehensive medical cannabis programs since 1996. The number of qualifying conditions per jurisdiction varies from 5 to 29. Five (12%) of 42 qualifying conditions have conclusive or substantial evidence of efficacy and are listed in more than half of all jurisdictions. Half (50%) of qualifying conditions have no or insufficient scientific evidence of benefit from medical cannabis; 9% of qualifying conditions have limited evidence of harm from medical cannabis. The mean number of qualifying conditions per jurisdiction and the proportion of conditions with and without e...
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: Gregory Malik Burnett, David A. Gorelick, Kevin P. Hill Source Type: research

Important Drug-Drug Interactions for the Addiction Psychiatrist
The misuse of illicit substances, prescribed medications, and alcohol poses obvious health risks to afflicted individuals. When addressing these health risks, the overarching concerns generally relate to the direct effects that various substances can have on the functioning of multiple organ systems: cardiac, pulmonary, central nervous system, and others. What is not always evident, but potentially equally or even more dire, are the risks arising from drug-drug interactions involving illicit drugs and alcohol, whether with each other, or with prescribed medications. This review provides some basics that enable the reader t...
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: Neil Sandson Source Type: research

The Protective Wall of Human Community
Mutual-help organizations (MHOs) such as alcoholics anonymous (AA) are the most commonly sought source of help for alcohol and other drug (AOD) problems in the United States. Popularity, however, is not commensurate with efficacy; hence, following a call for more rigorous research on AA and 12-step treatments from the Institute of Medicine in 1990 a flurry of clinical trials, cost-effectiveness analyses, and mechanisms studies, have been published during the past 30  years. This body of work has now revealed the true clinical and public health utility attributable to these freely available resources in aiding addiction re...
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: John F. Kelly Source Type: research

Attention-Deficit Hyperactivity Disorder and Therapeutic Cannabis Use Motives
This article explores motivations for cannabis use in ADHD populations. Research on the neural correlates and therapeutic potential of cannabis use are reviewed. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - August 1, 2022 Category: Psychiatry Authors: Mariely Hernandez, Frances R. Levin Source Type: research

Pharmacotherapy of Opioid Use Disorder —Update and Current Challenges
The incidence of opioid use disorder (OUD) and overdose deaths is rising yearly within the United States. Many cases are associated with illicitly manufactured fentanyl use. In addition to offering patients medications for OUD (methadone, buprenorphine, and naltrexone), the approach to this epidemic should involve increasing provider awareness and education about substance use disorders, expanding urine toxicology screens to test for fentanyl, and using low-threshold treatment approaches. (Source: The Psychiatric Clinics of North America)
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: Savitha Racha, Megan Buresh, Michael Fingerhood Source Type: research

Kratom: Substance of Abuse or Therapeutic Plant?
Kratom is the common term for Mitragyna speciosa and its products. Its major active compounds are mitragynine and 7-hydroxymitragynine. An estimated 2.1 million US residents used kratom in 2020, as a “legal high” and self-medication for pain, opioid withdrawal, and other conditions. Up to 20% of US kratom users report symptoms consistent with kratom use disorder. Kratom use is associated with medical toxicity and death. Causality is difficult to prove as almost all cases involve other psycho active substances. Daily, high-dose use may result in kratom use disorder and opioid-like withdrawal on cessation of use. These a...
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: David A. Gorelick Source Type: research

Nicotine Addiction
Addressing nicotine addiction has been given a low priority, compared with other substance use disorders (SUDs), by the addiction treatment field. Persons with nicotine addiction are reluctant to attempt to stop using nicotine products —despite recognizing it to be a problem—because they are feeling discouraged by multiple past unsuccessful attempts at quitting. By understanding that discouragement is a frequent reason that these people are in Precontemplation and by using traditional clinical interventions applied to other SU Ds, clinicians could achieve better overall treatment outcomes. (Source: The Psychiatric Clin...
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: George Kolodner, Carlo C. DiClemente, Michael M. Miller Source Type: research

Update on Gambling Disorder
Gambling disorder (GD) is estimated to be experienced by about 0.5% of the adult population in the United States. The etiology of GD is complex and includes genetic and environmental factors. Specific populations appear particularly vulnerable to GD. GD often goes unrecognized and untreated. GD often co-occurs with other conditions, particularly psychiatric disorders. Behavioral interventions are supported in the treatment of GD. No medications have a formal indication for the GD, although clinical trials suggest some may be helpful. Noninvasive neuromodulation is being explored as a possible treatment. Improved identifica...
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: Elina A. Stefanovics, Marc N. Potenza Source Type: research

Neuropsychiatric Model of Addiction Simplified
While substance experimentation typically begins in adolescence, substance use disorders (SUDs) usually develop in late teens or early adulthood, often in individuals who are vulnerable because of biological and socioeconomic risk factors. Severe SUDs —synonymous with addiction—involve changes in limbic and prefrontal brain areas after chronic drug exposure. These changes involve learned associations between drug reward and cues that trigger the anticipation of that reward (known as incentive salience), as well as heightened dysphoria during withdrawal and weakened prefrontal circuits needed for inhibiting habitual res...
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: Wilson M. Compton, Eric M. Wargo, Nora D. Volkow Source Type: research

Substance Use Disorders in Postacute and Long-Term Care Settings
Substance use disorders (SUDs) have not been rigorously studied in postacute and long-term care (PALTC) populations. SUDs are among the fastest growing disorders in the community dwelling older population. Untreated SUDs often lead to overdose deaths, emergency department visits, and hospitalizations due to SUD-related adverse effects, especially exacerbation of comorbid physical and mental health conditions. Primary care providers (PCPs) working in PALTC settings can and should play a key role in its prevention and treatment. This clinical review identifies several practical strategies that PCPs can incorporate in their d...
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: Abhilash Desai, George Grossberg Source Type: research

Practical Technology for Expanding and Improving Substance Use Disorder Treatment
The US opioid crisis and the COVID-19 pandemic have sparked innovation in substance use disorder (SUD) treatment such that telehealth, remote monitoring, and digital health interventions are increasingly feasible and effective. These technologies can increase SUD treatment access and acceptability, even for nontreatment seeking, remote, and underserved populations, and can be used to reduce health disparities. Overall, digital tools will likely overcome many barriers to delivery of evidence-based behavioral treatments such as cognitive behavioral therapy and contingency management, that, along with appropriate medications,...
Source: The Psychiatric Clinics of North America - July 31, 2022 Category: Psychiatry Authors: Mary M. Sweeney, August F. Holtyn, Maxine L. Stitzer, David R. Gastfriend Source Type: research

The Impact of Severe Acute Respiratory Syndrome-Coronavirus-2 Infection and Pandemic on Mental Health and Brain Function in the Elderly
This review discusses the evolving evidence base and clinical considerations for examining the direct and indirect effects of the coronavirus disease (COVID-19) pandemic on the mental health of elderly individuals. It briefly addresses the cognitive and psychiatric outcomes in older adults who have survived COVID-19 infections and the complexity of appraising them during different stages of the pandemic. Indirect effects of the COVID-19 pandemic on the mental health of the geriatric population are also explored, including those influenced by quarantine, media campaigns, discrimination, and difficulties in accessing support...
Source: The Psychiatric Clinics of North America - July 6, 2022 Category: Psychiatry Authors: Angela Wang, Caitlin Lawrence Source Type: research