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.

Co-Occurring Substance Use Disorder And Mental Illness In Criminal Offenders, Jayme M. Reisler

Jayme M Reisler

The high rate of comorbid substance use disorder and other mental illness (“dual diagnosis”) poses an enormous obstacle to public policy and sentencing in criminal cases. It is estimated that almost half of all Federal, State, and jail inmates suffer from dual diagnosis – a significantly higher prevalence than in the general population. Yet such inmates lack access to proper and effective treatments for their conditions. Several etiological theories have been put forth to explain the occurrence of dual diagnosis in general. However, virtually no studies have explored possible etiological reasons for the higher prevalence of dual diagnosis specifically in …

Harm Reduction: Compassionate Care For Persons With Addiction, Robin Bartlett, Laura Brown, Mona Shattell, Thelma Wright, Lynne Lawallen

Mona Shattell

No abstract provided.

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 …

U.S. Cultural Involvement And Its Association With Co-Occurring Substance Abuse And Sexual Risk Behaviors Among Youth In The Dominican Republic, Elián P. Cabrera-Nguyen, Juan B. Peña

Elián P. Cabrera-Nguyen

We examined the relationship of US cultural involvement with substance abuse and sexual risk behavior profiles from our nationally representative sample of public high school students in the Dominican Republic. Using a novel methodological approach to control for selection bias, we examined explanations for the so-called Latino or Hispanic immigrant paradox. A latent class regression analysis with manifest and latent covariates found that US cultural involvement indicators were independent and robust predictors of increased risk of co-ocurring substance abuse and sexual risk behaviors. Implications for prevention efforts targeting risk behaviors among Latino/a adolescents in the US and abroad are considered.

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

Intercountry Prevalences And Practices Of Betel-Quid Use In South, Southeast And Eastern Asia Regions And Associated Oral Preneoplastic Disorders: An International Collaborative Study By Asian Betel-Quid Consortium Of South And East Asia, Lee C. H., Ko A. M. S., Warnakulasuriya S., Yin B. L., Rosnah Binti Zain, Ibrahim S. O., Liu Z. W., Li W. H., Zhang S. S., Utomo B., Rajapakse P. S., Warusavithana S. A., Abdul Razak I., Abdullah N., Shrestha P., Kwan A. L., Shieh T. Y., Chen M. K., Ko Y. C.

Prof. Dr. Rosnah Binti Zain

Health risks stemming from betel-quid (BQ) chewing are frequently overlooked by people. Updated epidemiological data on the increased BQ use among Asian populations using comparable data collection methods have not been widely available. To investigate the prevalence, patterns of practice and associated types of oral preneoplastic disorders, an intercountry Asian Betel-quid Consortium study (the ABC study) was conducted for Taiwan, Mainland China, Malaysia, Indonesia, Nepal and Sri Lanka. A random sample of 8,922 subjects was recruited, and the data were analyzed using survey-data modules adjusted for the complex survey design. Chewing rates among men (10.7-43.6%) were significantly higher than women …

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.

Men's Health And Psychosocial Issues Affecting Men, Sandra Thomas

Sandra Thomas

Contemporary scholars are calling on men to rethink "the male deal." As Samuels describes it, "In the male deal, the little boy, at around the age of 3 or 4. strikes a bargain with the social world in which he lives. If he will turn away from soft things, feminine things, maternal things...then the world will reward his gender certainty by giving him all the goodies in its possession." But the "deal" can have damaging effects, as shown in the studies reviewed in this article. Clinicians can help men to rethink the restrictions of the "male deal" so that they …