Doctors and Nurses with Addictions

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As I’ve said before, doctors get addicted to alcohol and other drugs. They also get different treatment and outcomes from their patients. But what about nurses? If you are a nurse or a doctor with a substance problem and it comes to the attention of your employer, then what happens to you in the UK […]

Is addiction a brain disease? Does it matter?

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Is addiction a brain disease? It’s an interesting question. Researchers asked over 1,200 members of the public in Australia what their views were. Their paper, published in Drug & Alcohol Review, starts by laying out the challenges of finding consensus: In the USA, directors of the National Institute on Drug Abuse have argued that addiction is a […]

Faith in pharmacology

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Holy grails are few and far between. Pharmaceutical holy grails are no different. They are as rare as a moderate position in the Scottish independence debate. We have a few prescription drugs licensed to treat addiction and some make things significantly better, some have modest impacts, and some appear to have little impact. Regardless of […]

Recovery in Primary Care – best practice

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Most opioid replacement prescribing takes place in primary care settings and the GP is powerfully placed to be a catalyst in the recovery journey. What if we placed prescribing at the heart of a fully recovery-oriented system of care? SMMGP highlights the Public Health England guidance, a supplement to previous guidance, which calls on all treatment providers to […]

Gabapentin abuse

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Gabapentin can be addictive. Search for gabapentin abuse or pregabalin abuse on Google Scholar and you’ll turn up 18,000 entries in less than a second. Pubmed is a little more specific finding 249 papers related to the subject. Vaults of Erowid has over 100 gabapentin and pregabalin ‘experiences’ detailed by users. I wrote a while back […]

Do AA & NA fit with methadone maintenance?

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  Given the dearth of research on NA populations this study from Bill White and colleagues is welcome. Knowing what we do already from the research on mutual aid groups, the researchers made the reasonable assumption that clients on ORT (opiate replacement therapy) attending 12-step mutual aid were likely to achieve to higher levels of abstinence (no […]

Do opioids work for chronic pain? Sorry, we haven’t a clue

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Jason Schwartz highlights a Keith Humphreys post on the challenges of assessing opioids for long term non-cancer pain. With millions of people in the UK prescribed regular opiates on repeat prescriptions for chronic pain and these drugs fraught with dependence dangers, you’d think there would have to be a solid evidence base that they work. Not a bit […]

Doctors with addictions: double standards?

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Doctors get addicted to alcohol and other drugs; there’s plenty of evidence of that. My question is: Do doctors with addictions get the same kind of treatment and outcomes as their patients?  The British Medical Association estimates that there are 10,000 to 13,000 addicted doctors in the UK. Most of them will be in practice. What […]

The wise do recover from addiction

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Wisdom’s not a very scientific term is it? We sort of know what it means, but it’s vague and not really something to value or measure in scientific literature – right? It’s a bit like spirituality; you might get a dozen different definitions depending on whom you talk to. That hasn’t stopped researchers exploring what […]

Pain management in drug addiction & recovery

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“Pain is inevitable; suffering is optional.” So starts a paper on managing chronic pain in patients with opioid dependence. It’s a dilemma, or is it really? It’s actually less of a dilemma because the evidence for opioids in chronic pain is pretty ropey in everybody, never mind in addicted populations. When you balance potential benefits up against the risks […]