Traumatic stress is common in American life. 80% of adult Americans will experience one or more traumatic events in their lifetimes. Of these, 13% of women and 6% of men will develop post-traumatic stress disorder. Think of trauma as any event where one is Continue reading
Category Archives: Drug and Substance Abuse
Urine drug screening
Urine drug screens (UDS) are a valuable tool in our management of patients on chronic opioid therapy. However, the results can be misleading and clinical judgment is needed in interpreting results. Continue reading
Get ready for powdered alcohol
Call me naïve, but I was surprised a few days ago to learn that powdered alcohol will start being sold this summer. I guess I missed that memo. This new product will initially come in five flavors: rum, vodka, cosmo, margarita, and lemon drop Just mix the Continue reading
Does ADHD in adults start in childhood?
I will open this post with the bottom line. No one has the definitive answer to this question. Yet. But interesting information can be found in a study published last month in The American Journal of Psychiatry. This study suggests that ADHD in adults does Continue reading
Patient confidentiality in mental health and substance abuse treatment vs. integration of care
With health care pushing in the direction of integration of care and Partnership’s interest in integration as we implement the new Medi-Cal mild-to-moderate mental health benefit and our Managing Pain Safely initiative, a significant bone of contention involves protecting the Continue reading
How do mental health problems and problem drinking interact?
People with unhealthy patterns of alcohol intake often have concomitant mental health problems. Whether one factor is the more dominant influence in this dialectic is a subject of ongoing debate. Is it the heavy drinking which leads to mental health problems? Or is it Continue reading
How often do acute opioids become chronic opioids?
Each individual who uses chronic opioids was at some point started for the first time on a prescription opioid. Often the problem was an episode of acute pain, such as a twisted ankle. Opioids may also have been newly started for a chronic pain problem, such as Continue reading
One clinician’s perspective on how to get past denial in identifying alcohol abuse and dependence
Throughout my forty years as a practicing psychologist, I witnessed many shifts in opinion around assessing alcoholism, both in the therapy setting and in medicine in general. Back in the earliest days of my career in the 1970s, issues around alcoholism were rarely if Continue reading
On the first Monday of each month, my local newspaper publishes a list of local DUI convictions for the previous month (which of course, I scan carefully for people I may know). Along with the list is a guideline for avoiding a DUI: “if you weigh 150-169 pounds, Continue reading
Methadone – a complex tool for pain management
Methadone is a valuable tool for patients with chronic benign pain, but it is a medication with a complex pharmacology and potential dangers in prescribing. It is often used for patients who require a long acting pain medication when they have failed or have side Continue reading