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Category Archives: Drug and Substance Abuse

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Post-traumatic stress disorder and opioid use

Posted on August 11, 2015 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Mental Health Issues

Urine drug screening

Posted on July 28, 2015 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Formulary & Pharmacy Issues, Medical Practice

Get ready for powdered alcohol

Posted on June 16, 2015 by RMoore

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 →

Posted in Drug and Substance Abuse, Health Care Reform & Health Policy, Social and Societal Aspects of Medicine

Does ADHD in adults start in childhood?

Posted on June 11, 2015 by RMoore

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 →

Posted in Drug and Substance Abuse, Formulary & Pharmacy Issues, Medical Practice, Mental Health Issues

Patient confidentiality in mental health and substance abuse treatment vs. integration of care

Posted on April 22, 2015 by RMoore

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 →

Posted in Drug and Substance Abuse, Mental Health Issues

How do mental health problems and problem drinking interact?

Posted on April 15, 2015 by RMoore

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 →

Posted in Drug and Substance Abuse, Mental Health Issues

How often do acute opioids become chronic opioids?

Posted on February 16, 2015 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Medical Practice

One clinician’s perspective on how to get past denial in identifying alcohol abuse and dependence

Posted on February 2, 2015 by RMoore

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 →

Posted in Drug and Substance Abuse

Sensible drinking

Posted on January 5, 2015 by RMoore

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 →

Posted in Drug and Substance Abuse, Medical Practice

Methadone – a complex tool for pain management

Posted on December 22, 2014 by RMoore

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 →

Posted in Chronic Pain, Drug and Substance Abuse, Formulary & Pharmacy Issues, Medical Practice

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