Recognition and Management of Iatrogenically Induced Opioid Dependence and Withdrawal in Children

2018 ◽  
pp. 109-112
Author(s):  
Jeffrey Galinkin ◽  
Jeffrey Lee Koh
Keyword(s):  
Substance Use ◽  
Pain Relief ◽  
Opioid Dependence ◽  
Pediatric Population ◽  
Single Source ◽  
Pain Medicine ◽  
Addiction Medicine ◽  
Or Management ◽  
Acute Injuries ◽  
American Society

Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. According to a 2001 Consensus Paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as “a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.” Although the experience of many children undergoing iatrogenically induced withdrawal may be mild or goes unreported, there is currently no guidance for recognition or management of withdrawal for this population. Guidance on this subject is available only for adults and primarily for adults with substance use disorders. The guideline will summarize existing literature and provide readers with information currently not available in any single source specific for this vulnerable pediatric population.

scholarly journals Buprenorphine: Not a silver bullet, and still controversial

2021 ◽  
Vol 17 (7) ◽  
pp. 9-10
Author(s):  
Sudheer Potru, DO, FASAM ◽  
Michael Sprintz, DO, DFASAM ◽  
Antje M. Barreveld, MD ◽  
Lynn Kohan, MD
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Working Group ◽  
Ad Hoc ◽  
Hospital Setting ◽  
Outpatient Setting ◽  
Pain Medicine ◽  
Appropriate Use ◽  
Addiction Medicine ◽  
Silver Bullet

We are practitioners of pain medicine and addiction medicine and also four of the seven members of the Multi-Society Ad Hoc Substance Use Disorder (SUD) Working Group comprised of representatives from anesthesia, pain, pharmacy, and addiction medicine societies. We are finalizing “tip sheets” and a consensus-based manuscript to provide guidance on the appropriate use and initiation of buprenorphine in the hospital setting by anesthesiologists, and in the outpatient setting by pain clinicians.

The Language of Pain and Addiction (DRAFT)

2018 ◽  
Author(s):  
Michael M. Miller
Keyword(s):  
Substance Use ◽  
Treatment Plan ◽  
Improve Patient Care ◽  
Practice Research ◽  
Prescription Medications ◽  
Pain Medicine ◽  
Addiction Medicine ◽  
Research And Education ◽  
Monitoring Treatment ◽  
Improve Patient

The language employed in managing coexisting pain and addiction affects the management itself. Clinicians working with such patients may not realize that the two disorders share a terminology that can be confusing, imprecise, overlapping and/or stigmatizing. This chapter has two components:1. A description of Pain Medicine as a specialized area of practice, research, and education, whose leaders try to clarify concepts and terminology to improve patient care, professional standards, and public policy.2. The language of Addiction Medicine; arguably, even more complex than that of pain medicine because of the emotions, stigma, and discrimination attached to substance use disorders labels.All physicians’ concern must be that the patient adheres to the treatment plan by using prescription medications in only safe and healthy ways. This requires counseling, and monitoring treatment adherence and the safety of prescriptions, even in the absence of a diagnosable substance use disorder.

Overview of Substance Use Disorder Treatment

2020 ◽  
pp. 29-42
Author(s):  
Darius A. Rastegar
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Behavioral Therapy ◽  
Psychosocial Treatment ◽  
Addiction Medicine ◽  
Patient Centered ◽  
Therapeutic Modalities ◽  
Disorder Treatment ◽  
American Society ◽  
Self Help Groups

Treatment of substance use disorders (SUD) has traditionally been program-centered, but patient-centered models hold the promise of care that is more ethical and effective. Most SUD treatments can be roughly divided into two types of modalities: psychosocial treatment, which includes brief interventions, self-help groups, counseling, cognitive–behavioral therapy, and analytic psychotherapy; and pharmacotherapy, which includes drug antagonists or agonists and other agents. These treatments are not mutually exclusive, and the best approach in many cases is a combination of therapeutic modalities. The American Society of Addiction Medicine has developed placement criteria to help determine the optimal treatment setting. Harm reduction is an approach that focuses on reducing the harms of drug use without necessarily targeting drug use itself.

Treatment Settings for Substance Use Problems

2019 ◽  
pp. 25-32
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Substance Use ◽  
Outpatient Treatment ◽  
Inpatient Treatment ◽  
Treatment Level ◽  
Addiction Medicine ◽  
Levels Of Care ◽  
Substance Use Problems ◽  
Care Approach ◽  
Professional Treatment ◽  
American Society

The American Society of Addiction Medicine (ASAM) outlines levels of care for alcohol or other drug problems in a stepped care approach. The ASAM levels, from least to most restrictive, are Level 1: outpatient treatment; Level 2: intensive outpatient treatment and partial hospitalization; Level 3: medically monitored intensive inpatient treatment (residential); and Level 4: medically managed intensive inpatient treatment (hospital). Clients should use the least restrictive level of professional treatment possible unless they have serious medical complications, such as liver disease or gastritis, or serious psychiatric complications, such as feeling suicidal, persistently depressed, or paranoid. The goals of this chapter are to learn about the different types of professional treatments for substance use problems and for clients to work closely with their therapist or counselor to figure out their specific goals and what steps they can take to reach them.

scholarly journals Substance Use and Cumulative Exposure to American Society: Findings From Both Sides of the US–Mexico Border Region

2016 ◽  
Vol 106 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Guilherme Borges ◽  
Cheryl J. Cherpitel ◽  
Ricardo Orozco ◽  
Sarah E. Zemore ◽  
Lynn Wallisch ◽  
...  
Keyword(s):  
Substance Use ◽  
Border Region ◽  
Cumulative Exposure ◽  
The Us ◽  
Mexico Border ◽  
American Society ◽  
Us Mexico Border

Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration

2016 ◽  
Vol 124 (3) ◽  
pp. 535-552 ◽  
Keyword(s):  
Respiratory Depression ◽  
Regional Anesthesia ◽  
Practice Guidelines ◽  
Task Force ◽  
Digital Content ◽  
Pain Medicine ◽  
Practice Parameters ◽  
Opioid Administration ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract The American Society of Anesthesiologists Committee on Standards and Practice Parameters and the Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine present an updated report of the Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration. Supplemental Digital Content is available in the text.

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