Medicine and Health Sciences Commons^™

Reducing Postoperative Opioids After Minimally Invasive Hysterectomy With Enhanced Recovery, Kevin D. White, Shirin Azadi, Amanda Pauley, Dr. Brenda L Mitchell,, Nadim Bou Zgheib

Amanda Pauley

I

Introduction:

We evaluated the efficacy of various strategies utilized for the control of postoperative pain after minimally invasive hysterectomy. The primary enhanced recovery after surgery (ERAS) protocol of interest utilized premedication (acetaminophen, celecoxib and pregabalin), then intraoperative subcutaneous liposomal bupivacaine followed by scheduled oral acetaminophen and ibuprofen postoperatively. Patients also had tramadol and oxycodone as needed for moderate or severe breakthrough pain, respectively.

Materials and Methods:

We conducted a retrospective cohort study that included all patients who underwent minimally invasive hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for both benign and oncologic indications over a 2-year period. We …

How Substance Abuse Impacts Pain Management In Acute Care, Dawn Dunn, Janette Neuman

Janette S. Jones

Article includes a review of evidence-based interventions useful for assessing and managing pain in patients with histories of substance abuse.

Substance-Using Hispanic Youth And Their Families: Review Of Engagement And Treatment Strategies, Edward Cannon, Marielle Levy

Edward Cannon

A growing population of Hispanic immigrants to the United States means that helping professionals need to gain knowledge about specific issues affecting these groups. Stresses related to the immigration experience and minority status can influence the use of alcohol and illegal substances by Hispanic adolescents. Because the family is considered the preferred unit of treatment for this population, studies addressing approaches to engagement and treatment are reviewed, and two promising models are highlighted: the strategic structural systems engagement approach and the brief strategic family therapy model.

Gender Disparities: A Medical Detoxification Program, Alberto Coustasse, Karan P. Singh, Sue G. Lurie, Yu-Sheng Lin, Claudia S. Coggin, Fernando Trevino

Alberto Coustasse, DrPH, MD, MBA, MPH

Significant gaps exist in health care regarding gender in the United States. Health status, social roles, culturally patterned behavior and access to health care can be influenced by gender. Women have been the primary users of health care and minority women usually have received poorer quality care than Non-Hispanic White (NHW) females. The objectives of this study were to identify gender, racial and ethnic disparities in access to substance abuse treatment in a Texas hospital. Secondary data collected on 1,309 subjects who underwent detoxification were studied. Gender, race/ethnicity, drug of abuse, relapse and financial classification were included in the analysis. …

Brief Screening For Co-Occurring Disorders Among Women Entering Substance Abuse Treatment, Alisa K. Lincoln, Jane M. Liebschutz, Miriam Chernoff, Dana Nguyen, Hortensia Amaro (1950-)

Alisa Lincoln

BackgroundDespite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential …

State-Level Influences On Buprenorphine Utilization: Variations In Opioid Addiction Treatment, Lisa M. Lines Mph, Robin E. Clark Phd

Lisa M. Lines

Research Objective: Buprenorphine is a medication used to treat opioid addiction. Physicians are required to have special Drug Enforcement Agency certification to prescribe buprenorphine. Although it is more accessible and potentially safer than methadone, the leading opioid addiction treatment modality, there appear to be state-to-state variations in rates of buprenorphine adoption and use. The purpose of this study was to identify state-level influences on the volume of buprenorphine prescribed, using a limited set of supply and demand measures. Study Design: We developed a database using data on buprenorphine prescribing and factors hypothesized to influence variations in prescribing obtained from the …

Brief Screening For Co-Occurring Disorders Among Women Entering Substance Abuse Treatment, Alisa K. Lincoln, Jane M. Liebschutz, Miriam Chernoff, Dana Nguyen, Hortensia Amaro (1950-)

Hortensia Amaro

BackgroundDespite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential …

Mr. Atod’S Wild Ride: What Do Alcohol, Tobacco, And Other Drugs Have In Common?, David T. Courtwright

David T. Courtwright

All researchers agree that individuals can become intoxicated by and dependent on alcohol, tobacco, and other psychoactive drugs. But they have disagreed over whether, and to what extent, drug pathologies comprise a unitary medical problem. Most critically, does addiction have a biological common denominator? Consensus on this question has shifted back and forth. In the late nineteenth and early twentieth centuries, physicians often studied and treated various drug addictions together, working under the “inebriety” paradigm. By the mid-twentieth century the inebriety paradigm had collapsed. Tobacco and alcohol had split off, both in the medical research community and in western popular …

Substance Abuse Treatment Utilization Among Adults Living With Hiv/Aids And Alcohol Or Drug Problems, John Orwat, Richard Saitz, Christopher Tompkins, Debbie Cheng, Michael Dentato, Jeffrey Samet

Michael P. Dentato, PhD, MSW

Trajectories Of Ptsd And Substance Use Disorders In A Longitudinal Study Of Personality Disorders, Meghan E. Mcdevitt-Murphy, Gilbert R. Parra, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Andrew E. Skodol, John C. Markowitz

Charles A. Sanislow, Ph.D.