Email UpdatesLiterature Collection
Collection Insights
10K+
References
9K+
Articles
1400+
Grey Literature
4500+
Opioids & SU
The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
10858 Results
5743
Management of kratom dependence with buprenorphine/naloxone in a veteran population
Type: Journal Article
Year: 2021
Publication Place: United States
Abstract: Background: Kratom is a substance that when ingested produces an opioid-like effect. As kratom continues to gain popularity, increasing numbers of cases of addiction, dependence, and adverse events have been reported, as well as an increase in mortality associated with its use. George E. Wahlen Department of Veterans Affairs Medical Center has been using buprenorphine/naloxone for the treatment of kratom withdrawal and dependence in both primary care and specialty addiction treatment settings in the Veteran population. Cases: We present three cases that describe the use of buprenorphine/naloxone for kratom dependence. For each case, we describe the withdrawal symptoms from kratom, induction and long-term maintenance on buprenorphine/naloxone in kratom dependence, the impact of polysubstance use disorders in management of kratom dependence, and the use of urine drug screens for kratom alkaloids during treatment. Discussion: This case series demonstrates that patients with kratom dependence can effectively be treated with buprenorphine/naloxone. It appears that it is safe to induce buprenorphine/naloxone as early as eight hours after last kratom use and maintenance dosing for kratom use was similar to maintenance doses used in opioid use disorder. Prolonged and continued withdrawal symptoms were reported despite treatment with buprenorphine/naloxone and multiple daily doses of up to 24mg per day may be beneficial for prolonged withdrawal symptoms and for cooccurring pain. Polysubstance use with kratom dependence may require higher levels of care and higher doses of buprenorphine/naloxone. Urine drug screens may be best practice for monitoring kratom alkaloids concentrations and facilities that utilize buprenorphine/naloxone to treat kratom dependence should have testing available. Further research is needed on the impact and the treatment of kratom dependence.
Topic(s):
Opioids & Substance Use
See topic collection
, Healthcare Disparities
See topic collection
Reference Links: 
View the DOI record for Management of kratom dependence with buprenorphine/naloxone in a veteran population
View DOI Record
View the PubMed citation for Management of kratom dependence with buprenorphine/naloxone in a veteran population5744
Management of mental health problems by general practitioners in Quebec
Type: Journal Article
Year: 2012
Publication Place: Canada
Abstract: OBJECTIVE: To document the management of mental health problems (MHPs) by general practitioners. DESIGN: A mixed-method study consisting of a self-administered questionnaire and qualitative interviews. An analysis was also performed of Regie de l'assurance maladie du Quebec administrative data on medical procedures. SETTING: Quebec. PARTICIPANTS: Overall, 1415 general practitioners from different practice settings were invited to complete a questionnaire; 970 general practitioners were contacted. A subgroup of 60 general practitioners were contacted to participate in interviews. MAIN OUTCOME MEASURES: The annual frequency of consultations over MHPs, either common (CMHPs) or serious (SMHPs), clinical practices, collaborative practices, factors that either support or interfere with the management of MHPs, and recommendations for improving the health care system. RESULTS: The response rate was 41% (n = 398 general practitioners) for the survey and 63% (n = 60) for the interviews. Approximately 25% of visits to general practitioners are related to MHPs. Nearly all general practitioners manage CMHPs and believed themselves competent to do so; however, the reverse is true for the management of SMHPs. Nearly 20% of patients with CMHPs are referred (mainly to psychosocial professionals), whereas nearly 75% of patients with SMHPs are referred (mostly to psychiatrists and emergency departments). More than 50% of general practitioners say that they do not have any contact with resources in the mental health field. Numerous factors influence the management of MHPs: patients' profiles (the complexity of the MHP, concomitant disorders); individual characteristics of the general practitioner (informal network, training); the professional culture (working in isolation, formal clinical mechanisms); the institutional setting (multidisciplinarity, staff or consultant); organization of services (resources, formal coordination); and environment (policies). CONCLUSION: The key role played by general practitioners and their support of the management of MHPs were evident, especially for CMHPs. For more optimal management of primary mental health care, multicomponent strategies, such as shared care, should be used more often.
Topic(s):
Education & Workforce
See topic collection
View the PubMed citation for Management of mental health problems by general practitioners in Quebec
Reference Links: View the PubMed citation for Management of mental health problems by general practitioners in Quebec
5745
Management of mood and anxiety disorders in patients receiving opioid agonist therapy: Review and meta-analysis
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Management of mood and anxiety disorders in patients receiving opioid agonist therapy: Review and meta-analysis
View DOI Record
View the PubMed citation for Management of mood and anxiety disorders in patients receiving opioid agonist therapy: Review and meta-analysis5748
Management of opioid painkiller dependence in primary care: Ongoing recovery with buprenorphine/naloxone
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: Opioid painkiller dependence is a growing problem and best-practice management is not well defined. We report a case of a young woman exhibiting dependence on codeine, originally prescribed for myalgic encephalopathy, after escalating use over a 10-year period. In 2012, a consultation with a new general practitioner, who had extensive experience of patients with substance abuse, revealed the underlying dependence. After building trust for 6 months, she was able to admit to medication abuse, and was referred to the community drug and alcohol team. On presentation to the team, the patient had no pain issues and the dihydrocodeine use--600 tablets/week--solely reflected her dependence. The patient successfully underwent rapid induction with buprenorphine/naloxone as opioid substitution treatment over 2 days. She is currently stable, engaged with recovery support services and psychosocial counselling, and has just returned to work. She is maintained on a therapeutic dose of buprenorphine 10 mg/naloxone 2.5 mg.
Topic(s):
Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Management of opioid painkiller dependence in primary care: Ongoing recovery with buprenorphine/naloxone
View DOI Record
View the PubMed citation for Management of opioid painkiller dependence in primary care: Ongoing recovery with buprenorphine/naloxone5749
Management of Opioid Use Disorder Treatment: An Overview
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Opioids & Substance Use
See topic collection
, Education & Workforce
See topic collection
, Measures
See topic collection
Reference Links: View the PubMed citation for Management of Opioid Use Disorder Treatment: An Overview
5751
Management of patients with issues related to opioid safety, efficacy and/or misuse: a case series from an integrated, interdisciplinary clinic
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: BACKGROUND: Patients, providers, communities and health systems have struggled to achieve balance between access to opioid treatment for chronic pain and its potential harmful consequences: especially misuse, addiction and overdose. We developed an interdisciplinary clinic embedded within primary care (the Opioid Reassessment Clinic-ORC) with the goal of improving the quality of care of patients with co-occurring chronic pain and issues related to opioid safety, efficacy and/or misuse. CASE DESCRIPTIONS: We present three cases referred to the ORC that highlight complex clinical scenarios related to assessment and treatment of patients with chronic pain and issues related to opioid safety, efficacy and misuse. DISCUSSION AND EVALUATION: In the context of the three cases, with respect to assessment, we discuss: making the diagnosis of opioid use disorder; allowing the patient space to endorse lack of efficacy; identification of co-occurring hazardous alcohol use; and recognizing barriers to multimodal pain care. With respect to treatment, we discuss: making a change in treatment with which the patient may not agree; effectiveness of buprenorphine/naloxone for the treatment of chronic pain; responding to low efficacy; and making continued opioid therapy contingent on engagement with substance abuse treatment. CONCLUSIONS: The core components of our approach-biopsychosocial assessment and multimodal treatment planning with an emphasis on promoting functional goals and safety using clear communication and a patient-centered stance-should guide providers in the management of similar clinical scenarios. More evidence is needed to definitively guide specific interventions and points of clinical equipoise.
Topic(s):
Opioids & Substance Use
See topic collection
, Education & Workforce
See topic collection
5752
Management of postnatal depression in primary care: A window of opportunity
Type: Journal Article
Year: 2010
Publication Place: England
Topic(s):
Education & Workforce
See topic collection
Reference Links:
View the DOI record for Management of postnatal depression in primary care: A window of opportunity
View DOI Record
View the PubMed citation for Management of postnatal depression in primary care: A window of opportunity5756
Managing alcohol use in primary care
Type: Journal Article
Year: 2020
Publication Place: England
Topic(s):
Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Managing alcohol use in primary care
View DOI Record
View the PubMed citation for Managing alcohol use in primary care5757
Managing behavioral health needs of veterans with Traumatic brain injury (TBI) in primary care
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: Traumatic brain injury (TBI) is a frequent occurrence in the United States, and has been given particular attention in the veteran population. Recent accounts have estimated TBI incidence rates as high as 20 % among US veterans who served in Afghanistan or Iraq, and many of these veterans experience a host of co-morbid concerns, including psychiatric complaints (such as depression and post-traumatic stress disorder), sleep disturbance, and substance abuse which may warrant referral to behavioral health specialists working in primary care settings. This paper reviews many common behavioral health concerns co-morbid with TBI, and suggests areas in which behavioral health specialists may assess, intervene, and help to facilitate holistic patient care beyond the acute phase of injury. The primary focus is on sequelae common to mild and moderate TBI which may more readily present in primary care clinics.
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for Managing behavioral health needs of veterans with Traumatic brain injury (TBI) in primary care
View DOI Record
View the PubMed citation for Managing behavioral health needs of veterans with Traumatic brain injury (TBI) in primary care5758
Managing Bipolar Disorder in the Primary Care Setting: A Perspective for Mental Health Professionals
Type: Journal Article
Year: 2011
Abstract: Bipolar disorder affects between 1.3 percent and 1.6 percent of the general population. According to available evidence, prevalence rates appear to be even higher in primary care settings. The diagnosis and management of patients with bipolar disorder are potentially complicated by a number of factors, including underdiagnosis due to the predominance of depressive symptoms; high levels of psychiatric comorbidity; a comparatively high suicide rate; continuing controversies in the pharmacological management of the disorder; and a potentially elevated cost-of-care contributed by the prescription of brand-name medications as well as laboratory monitoring at baseline and intermittently for lithium and atypical antipsychotics and serum levels for lithium and some anticonvulsants. All of these factors seem to result in an understandable hesitancy on the behalf of primary care clinicians to diagnose and assume care for these complex patients. Mental health professionals need to remain mindful of these issues when arranging dispositions for patients.
Topic(s):
Education & Workforce
See topic collection
, Financing & Sustainability
See topic collection
Reference Links: View the PubMed citation for Managing Bipolar Disorder in the Primary Care Setting: A Perspective for Mental Health Professionals
5759
Managing borderline personality disorder and substance use - an integrated approach
Type: Journal Article
Year: 2011
Publication Place: Australia
Abstract: BACKGROUND Although substance use is a common feature of borderline personality disorder, regular use is associated with greater levels of psychosocial impairment, psychopathology, self harm and suicidal behaviour and leads to poorer treatment outcomes. Management of co-occurring substance use disorder and borderline personality disorder within primary care is further compounded by negative attitudes and practices in responding to people with these conditions, which can lead to a fractured patient-doctor relationship. OBJECTIVE This article provides an overview of how the general practitioner can provide effective support for patients with co-occurring borderline personality disorder and substance use disorder, including approaches to assessment and treatment, the therapeutic relationship, referral pathways and managing risk and chronic suicidality. DISCUSSION Despite the complexities associated with this population, GPs are ideally placed to engage patients with co-occurring borderline personality disorder and substance use disorder in a long term therapeutic relationship, while also ensuring timely referral to other key services and health professionals. To provide the most effective responses to this patient group, GPs need to understand borderline personality disorder and its relationship to substance use, develop an 'explanatory framework' for challenging behaviours, implement mechanisms for reflective practice to manage negative countertransference, as well as learn skills to respond adequately to behaviours which jeopardise treatment retention.
Topic(s):
General Literature
See topic collection
Reference Links: View the PubMed citation for Managing borderline personality disorder and substance use - an integrated approach