scholarly journals Primary Care Recognition and Treatment of Methamphetamine Use Disorder

2020 ◽  
pp. 22-26
Author(s):  
Ricahrd Terry ◽  
Leslie Dally ◽  
Constantantino Lambroussis
Keyword(s):  
Primary Care ◽  
Behavioral Therapy ◽  
The United States ◽  
Drug Abusers ◽  
Methamphetamine Use ◽  
Fda Approval ◽  
Proven Efficacy ◽  
Drug Abuse Screening Test ◽  
Promising Treatment ◽  
Methamphetamine Use Disorder

Methamphetamine addiction remains one of the most common substance use disorders encountered by physicians and is often unrecognized in the current opioid epidemic. Methamphetamine remains widely available in the United States despite laws designed to limit illicit production. Physical signs of methamphetamine abuse are not always recognized in the primary care setting. The utilization of the Drug Abuse Screening Test (DAST) has helped in the identification of drug abusers in this setting. The mainstay of treatment remains cognitive behavioral therapy. Though various medications have been tried, none have gained FDA approval because of the lack of proven efficacy. The most promising treatment modality on the horizon appears to be immunotherapy. Treatment, while not necessarily efficacious in the long term, is widely available today.

scholarly journals Pharmacotherapy treatment of stimulant use disorder

2021 ◽  
Vol 11 (6) ◽  
pp. 347-357
Author(s):  
Mei T. Liu
Keyword(s):  
Public Health ◽  
Behavioral Therapy ◽  
Contingency Management ◽  
Public Health Problem ◽  
Psychosocial Interventions ◽  
The United States ◽  
Stimulant Use ◽  
Methamphetamine Use ◽  
Methamphetamine Use Disorder ◽  
Selection Of

Abstract Stimulant use disorder (SUD) is a public health problem in the United States that is associated with increased morbidity and mortality. Psychosocial interventions, such as cognitive behavioral therapy and contingency management, are the main treatment modality for SUDs and no pharmacotherapy is currently FDA approved for this indication. Although some medications show promising data for the treatment of SUD, the evidence remains inconsistent, and the clinical application is limited due to the heterogenicity of the population and the lack of studies in patients with various comorbidities. Selection of pharmacotherapy treatment for methamphetamine intoxication, persistent methamphetamine-associated psychosis with methamphetamine use disorder, and cocaine use disorder in patients with co-occurring OUD are discussed in 3 patient cases.

scholarly journals Buprenorphine Added on Brief Cognitive Behavioral Therapy for Treatment of Methamphetamine Use Disorder

2018 ◽  
Vol 12 (2) ◽  
Author(s):  
Schwann Shariatirad ◽  
Alireza Mahjoub ◽  
Ashraf Haqiqi ◽  
Mohsen Rezaei Hemami ◽  
Babak Tofighi ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Methamphetamine Use ◽  
Methamphetamine Use Disorder

Prior HIV testing behaviour is associated with HIV testing results among men, trans women and trans men who have sex with men in the United States

2020 ◽  
pp. jech-2019-213493
Author(s):  
Christian Grov ◽  
Drew Westmoreland ◽  
Sarit A Golub ◽  
Denis Nash
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
The United States ◽  
Hiv Positive ◽  
Methamphetamine Use ◽  
Trans Men ◽  
Negative Results ◽  
Sex With Men ◽  
Positive Results ◽  
Hiv Negative

BackgroundAmong those at high risk for HIV, it is important to examine the ways in which someone who has recently tested for HIV might differ from someone who has not.MethodsIn 2017–2018, a total of 5001 men, trans women and trans men who have sex with men from across the United States completed an online survey about their recent testing behaviour as well as self-collected oral samples for HIV testing.ResultsIn total, 3.8% tested HIV-positive and—among those with positive results—35% were recent HIV infections (ie, self-reported an HIV-negative test result within the 12 months prior to enrollment). Those with HIV-positive results—regardless of how recent their HIV test was prior to enrollment—differed from those with negative results in ways that are known to be associated with HIV risk: racial and income disparities, housing instability, recent transactional sex and recent methamphetamine use. Among those with HIV-positive results at enrollment, only having a primary care physician distinguished those who recently tested negative prior to enrollment versus not. Among those with HIV-negative results, there were numerous differences between those who had recently tested for HIV prior to enrollment, versus not, such that those who had not recently tested were significantly more likely to report being at higher risk for HIV.ConclusionStrategies aimed at improving more frequent HIV testing among HIV-negative persons at high risk for HIV should address other needs including stable housing, transactional sex, access to a primary care provider and methamphetamine use.

scholarly journals Building a Viable Weight Management Program in a Patient-Centered Medical Home

2020 ◽  
Vol 52 (6) ◽  
pp. 427-431
Author(s):  
Stephanie B. Wilhoit-Reeves ◽  
Laurel A.G. Sisler ◽  
Shannon E. Aymes ◽  
Shiara M. Ortiz-Pujols ◽  
Deborah S. Porterfield ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Weight Management ◽  
Behavioral Therapy ◽  
Blood Pressure Reduction ◽  
The United States ◽  
Management Program ◽  
Average Weight ◽  
Weight Management Program ◽  
Eligibility Criteria

Background and Objectives: The growing prevalence of obesity in the United States and globally highlights the need for innovative strategies to provide obesity treatment in primary care settings. This report describes and evaluates the Weight Management Program (WMP), an interprofessional program in an academic family medicine clinic delivering intensive behavioral therapy (IBT) following evidenced-based guidelines. Methods: We extracted WMP participant health data from the electronic health record and evaluated retrospectively. Eligible participants completed at least four WMP visits and had a baseline weight, blood pressure, and hemoglobin A1c (HbA1c) recorded within 1 year prior to their first visit. Paired t tests were used to assess changes in, weight, HbA1c and systolic and diastolic blood pressures from baseline. Results: WMP counseled 673 patients over 3,895 visits from September 2015 to June 2019. Of these, 186 met eligibility criteria (at least four visits), with a median of eight visits (mean=11.3, SD=8.1). Participants saw an average weight decrease during program participation of 9.7 lbs (P<.001), an average decrease in HbA1c of 0.2 points (P=.004), and an average blood pressure reduction of 2.8 mmHg systolic (P=.002) and 1.9 mmHg diastolic (P=.03). One-third of participants (n=60) achieved clinically significant weight loss (>5%) at 18 months. The program has become financially sustainable through billing for preventive counseling services and a $125 out-of-pocket enrollment fee. Conclusions: WMP provides one model for primary care practices to develop a financially sustainable and evidence-based behavioral therapy weight management program for their patients with obesity. Future work will include assessment of longer-term program benefits, quality metrics, and health care costs.

scholarly journals Effect of Acceptance and Commitment Therapy on Impulsivity of Patients With Methamphetamine Use Disorder

2020 ◽  
Vol 21 (3) ◽  
pp. 406-421
Author(s):  
Mahdi Yousefi ◽  
◽  
Seyyed Jalal Younesi ◽  
Ali Farhoudian ◽  
Mohammad Hadi Safi ◽  
...  
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Control Group ◽  
Control Group Design ◽  
Methamphetamine Use ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Methamphetamine Use Disorder

Objective: Executive functions and impulse control ability are severely impaired in people with amphetamine use disorders. In this regard the study aims to decrease impulsivity in patients with Methamphetamine use disorder by using Acceptance and Commitment Therapy (ACT). Materials & Methods: The study is a quasi-experimental study with a pretest-posttest control group design. The study population included all men under treatment with Methamphetamine use disorder in 2019 in Yazd city. The sampling method was purposive sampling. Among those who scored higher than the cut-point according to Bart's Impulsivity Questionnaire (1994), 12 were randomly assigned to the experimental group and 12 randomly assigned to the control group. Descriptive and inferential statistical methods including covariance analysis were used to analyze the data. Results: The results showed that the value of the parameter (F) belonging to the pretest variable was 4.9 and it was significant. Therefore, there was a significant difference between the mean scores of impulsivity of the control and experimental groups in the posttest after the pretest effect was gone in patients with treated methamphetamine use disorder. Conclusion: Finally based on the results of this study, it can be concluded that the ACT as a new and emerging treatment of the third wave of behavioral therapy is a useful intervention for patients with methamphetamine use disorder to reduce their impulsive behaviors.

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

Electronic cigarettes: How confident and effective are allergists, pulmonologists, and primary care physicians in their practice behavior?

2020 ◽  
Vol 41 (3) ◽  
pp. 192-197
Author(s):  
Sherry S. Zhou ◽  
Alan P. Baptist
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Electronic Cigarettes ◽  
The United States ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Knowledge And Beliefs ◽  
Tobacco Cigarette ◽  
Number Of Patients ◽  
Personal Use

Background: There has been a striking increase in electronic cigarette (EC) use in the United States. The beliefs and practices toward ECs among physicians are unknown. Objective: The purpose of this study was to investigate EC practice patterns among allergists, pulmonologists, and primary care physicians. Methods: An anonymous survey was sent to physicians. The survey contained 32 questions and addressed issues related to demographics, cessation counseling behaviors, personal use, and knowledge and beliefs about ECs. Statistical analysis was performed by using analysis of variance, the Pearson χ2 test, Fisher exact test, and logistic regression. Results: A total of 291 physicians completed the survey (222 primary care physicians, 33 pulmonologists, and 36 allergists) for a response rate of 46%. The allergists asked about tobacco cigarette use as frequently as did the pulmonologists and more than the primary care physicians (p < 0.001), but they rarely asked about EC use. The pulmonologists scored highest on self-reported knowledge on ECs, although all the groups answered <40% of the questions correctly. The allergists did not feel as comfortable about providing EC cessation counseling as did the pulmonologists and primary care physicians (p < 0.001). All three groups were equally unlikely to recommend ECs as a cessation tool for tobacco cigarette users. Conclusion: Allergists lacked knowledge and confidence in providing education and cessation counseling for EC users. As the number of patients who use these products continues to increase, there is an urgent need for all physicians to be comfortable and knowledgeable with counseling about ECs.

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