behavior, addictive

Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain - Quarterly Progress Report: December 2020

Author/s: 
McDonagh, M. S., Wagner, J., Ahmed, A. Y., Morasco, B., Kansagara, D., Chou, R.

This is the first progress report for an ongoing living systematic review on plant-based
treatments for chronic pain. The systematic review will synthesize evidence on the benefits and
harms of plant-based compounds (PBCs) such as cannabinoids and kratom used to treat chronic
pain, addressing concerns about severe adverse effects, abuse, misuse, dependence, and
addiction.
The purpose of this progress report is to describe the body of literature identified thus far.
This report will be periodically updated with new studies as they are published and identified,
culminating in a systematic review that provides a synthesis of the accumulated evidence.

Helping Patients Who Drink Too Much: A Clinician's Guide

Author/s: 
National Institute on Alcohol Abuse and Alcoholism

Why screen for heavy drinking?

  • At-risk drinking and alcohol problems are common. About 3 in 10 U.S. adults drink at levels that elevate their risk for physical, mental health, and social problems. Of these heavy drinkers, about 1 in 4 currently has alcohol abuse or dependence.All heavy drinkers have a greater risk of hypertension, gastro - intestinal bleeding, sleep disorders, major depression, hemorrhagic stroke, cirrhosis of the liver, and several cancers. 
  • Heavy drinking often goes undetected. In a recent study of primary care practices, for example, patients with alcohol dependence received the recommended quality of care, including assessment and referral to treatment, only about 10 percent of the time.
  • Patients are likely to be more receptive, open, and ready to change than you expect. Most patients don’t object to being screened for alcohol use by clinicians and are open to hearing advice afterward. In addition, most primary care patients who screen positive for heavy drinking or alcohol use disorders show some motivational readiness to change, with those who have the most severe symptoms being the most ready.
  • You’re in a prime position to make a difference. Clinical trials have demonstrated that brief interventions can promote significant, lasting reductions in drinking levels in at-risk drinkers who aren’t alcohol dependent.8 Some drinkers who are dependent will accept referral to addiction treatment programs. Even for patients who don’t accept a referral, repeated alcohol-focused visits with a health care provider can lead to significant improvement.
  • If you’re not already doing so, we encourage you to incorporate alcohol screening and intervention into your practice. With this Guide, you have what you need to begin.
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