2013 Update in addiction medicine for the generalist

Addiction Science & Clinical Practice

Alexander Y Walley⁶  Jeanette M Tetrault¹  Joanna L Starrels²  Jennifer McNeely⁴  Nicolas Bertholet³  Adam J Gordon⁵ 

[1]Yale University School of Medicine, New Haven, CT, USA

[2]Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA

[3]Lausanne University Hospital, Lausanne, Switzerland

[4]New York University School of Medicine, New York, NY, USA

[5]VA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA, USA

[6]Boston University School of Medicine, Boston, MA, USA

关键词: Integration of addiction treatment and medical care;    Use of pharmacotherapy for addiction treatment in primary care;    Screening and brief intervention;    Substance-related disorders;    Drug abuse;    Addictive behavior;    Alcoholism;    Primary care;   

Others  :  789284
DOI  :  10.1186/1940-0640-8-18

 received in 2013-09-26, accepted in 2013-10-28,  发布年份 2013

【 摘 要 】

Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and medical care. The authors discuss each selected articles’ merits, limitations, conclusions, and implication to advancing addiction screening, assessment, and treatment of addiction in generalist physician practice environments.

【 授权许可】

   
2013 Gordon et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 2.

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