Le top 10 des articles sur la dépendance en 2014

Au classement de l'American Society of Addiction Medicine (ASAM) pour l'année 2014, voici la liste des 10 articles sur la dépendance les plus percutants (voir ci-dessous). Un de ces articles, qui a été publié dans le Journal of the American Medical Association (JAMA), indique que la hausse inquiétante de la consommation de substances fera en sorte que la médecine des toxicomanies sera éventuellement intégrée à la médecine en général(mainstream medicine).

Comparison of Effectiveness of Methadone and Two Sublingual Formulations of Buprenorphine on Maintenance Treatment Outcomes

Experimental and Clinical Psychopharmacology

This study sought to compare the effectiveness of the 3 most commonly prescribed maintenance medications in the United States indicated for the treatment of opioid dependence in reducing illicit drug use and retaining patients in treatment. The 6-month prevalence rates of positive urinalysis drug screen findings for both opioids and nonopioid substances were similar across medication groups...

Lire la suite: http://www.ncbi.nlm.nih.gov/pubmed/25069011

'MATs Replace One Addiction with Another' – NIDA Head Takes on Debate

The New England Journal of Medicine

A number of barriers contribute to low access to and utilization of medication-assisted therapies (MATs), including a paucity of trained prescribers and negative attitudes and misunderstandings about addiction medications held by the public, providers, and patients. For decades, a common concern has been that MATs merely replace one addiction with another. Many treatment-facility managers and staff favor an abstinence model, and provider skepticism may contribute to low adoption of MATs...

Lire la suite : http://www.nejm.org/doi/full/10.1056/NEJMp1402780

Just Released! WHO Guidelines: Substance Use and Pregnancy

World Health Organization

These evidence-based, consensus guidelines have been developed to enable professionals to assist pregnant women who use alcohol or drugs or with substance use disorders to achieve healthy outcomes. Until now, there were no global guidelines providing evidence-based recommendations for identifying and managing substance use an substance use disorders in pregnancy.  

Lire la suite : http://apps.who.int/iris/bitstream/10665/107130/1/9789241548731_eng.pdf

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010

JAMA Internal Medicine

Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. Medical cannabis laws are associated with significantly lower state-level opioid overdose mortality rates. Further investigation is required to determine how medical cannabis laws may interact with policies aimed at preventing opioid analgesic overdose.

Lire la suite : http://archinte.jamanetwork.com/article.aspx?articleid=1898878

Editorial: Is Marijuana Safer Than Alcohol?

Richard G. Soper, MD, FASAM, DABAM, Editor-in-Chief

Are we talking about direct effects of alcohol vs. marijuana? Are we talking about alcohol-associated vs. marijuana-associated disease? Auto injuries and fatalities associated with driving? Short-term or infrequent use relative to long-term use? Or about how use of either drug leads to incarceration, and how race is superimposed by law enforcement?      

Lire la suite : http://www.asam.org/magazine/read/article/2014/02/13/is-marijuana-safer-than-alcohol]

Addiction Medicine: The Birth of a New Discipline

JAMA Internal Medicine

Substance use is highly prevalent, a substantial cause of morbidity and mortality and accounts for over $500 billion in economic costs in the United States annually. The 2012 National Survey on Drug Use and Health (NSDUH) reported that 32% binge drink and nearly 7% reported heavy drinking over the past 30 days. With these alarming figures and more, it seems clear that the path has been paved for addiction medicine to become an integrated part of mainstream medicine.

Lire la suite : http://archinte.jamanetwork.com/article.aspx?articleid=1901120

A Comprehensive Federal Strategy for Addressing America's Prescription Drug and Heroin Epidemic

Ed Markey

In response to the dramatic increase in prescription opiate and heroin overdose deaths, US Senator Markey has introduced a comprehensive bill Recovery Enhancement for Addiction Treatment Act (TREAT), to expand the ability of medical professionals to address this.      

Lire la suite : http://www.markey.senate.gov/imo/media/doc/2014-10-14_Markey_OpiodReport_Overdosed.pdf

Alternative Models of Addiction

Frontiers in Psychiatry

Historically, perceptions of addiction were polarized between two models; the first attributing this phenomenon as a moral failure, the second as a specific brain disease caused by neurobiological adaptations...    

Lire la suite : http://journal.frontiersin.org/ResearchTopic/1036

Addicted Doctors: Prevention Strategies

Addictive Disorders and Their Treatment

Studies have noted all doctors to be at risk of developing addictive disorders, irrespective of their grade, sex, and specialty. Early detection and treatment are beneficial in reducing the impact that an addictive disorder can have on the doctors' career and family life...

Lire la suite : http://journals.lww.com/addictiondisorders/Abstract/2014/03000/Addicted_Doctors___Prevention_Strategies.4.aspx

US State by State Ranking of Mental Health Services

Mental Health America

The lack of data on disability status during ACA enrollment means that for the mental health community, there is no way to know exactly how many people with mental illness gained access to insurance. This lack of data, coupled with the complexity of the mental health system as whole, results in more questions than answers. These challenges led MHA to investigate national survey data to answer questions about the impact of the ACA on individuals with mental health problems. A primer on the ACA and the complexity of mental health insurance can be found on page 43 in the section entitled "Insuring Individuals with Mental Illness."  

Lire la suite : http://www.mentalhealthamerica.net/sites/default/files/Parity