Below are links to the MANY articles on this website about SUBSTANCE-RELATED AND ADDICTIVE DISORDERS. , which is the title of the relevant chapter in the DSM-5-TR®.
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Urine drug screen
Urine Drug Screening—General Articles
Which urine drug screen (UDS) should we specifically order?
Which urine drug screen do most workplaces require?
For how long are substances detected in a urine drug screen (UDS)?
“Fingerprint” metabolites that uniquely identify substances in a urine drug screen
How to check for possible tampering of urine samples for drug testing
Urine Drug Screening—False Positives
Urine Drug Screening—False Negatives
Which opioids will not show up in the urine drug screen?
Can you figure out this “puzzling” case of oxycodone overdose with a negative UDS?
Standard urine drug screens can be false-negative for some benzodiazepines
Will zolpidem be detected on a standard urine drug screen?
Urine Drug Screening—Fentanyl
Alcohol
Alcohol use—Basic facts
Three key statistics about alcohol use: Bad, worse, and worst news
What is a “standard” drink?
How much alcohol intake is “normal”?
Alcohol, not marijuana, is the real gateway drug
Alcohol use—Screening
How to screen for alcohol use disorder
AUDIT-C: A practical guide
Let’s stop using the CAGE questionnaire
Real-life examples: How to identify recent alcohol use in urine and blood tests
Why, who, and how to monitor for increased alcohol use after bariatric surgery
Alcohol use—Laboratory tests
How to use laboratory testing for alcohol use
Phosphatidylethanol (PEth) testing to identify recent alcohol use
How do PEth and CDT tests compare for identifying recent alcohol use?
Abstinence from alcohol can be monitored by a urine screening test
Tips about hepatic function tests
Real-life examples: How to identify recent alcohol use in urine and blood tests
Can thrombocytopenia be due to alcohol use?
Why and how to calculate the FIB-4 score in asymptomatic alcohol-associated liver disease
Alcohol withdrawal
Understanding the DSM-5-TR diagnostic criteria for alcohol withdrawal
Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar)
Which benzodiazepines for alcohol withdrawal syndrome (AWS)?
Alcohol withdrawal syndrome: Benzodiazepine regimens
How exactly to prescribe thiamine for the prevention of Wernicke-Korsakoff syndrome
Non-Alcoholic or Alcohol-Free Beer
What are “non-alcoholic,” “alcohol-free,” “low alcohol,” and “reduced alcohol” beverages?
Non-alcoholic or alcohol-free beer in patients with past alcohol use disorder?
Is non-alcoholic beer safe in patients on monoamine oxidase (MAO) inhibitors?
Will non-alcoholic beer show up in breath or urine tests?
Where to find/ buy non-alcoholic or alcohol-free beer
Great options for “alcohol-removed” red, white, rosé, or sparkling wines
Alcohol use disorder—Treatment
APA Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder
How exactly to prescribe thiamine for the prevention of Wernicke-Korsakoff syndrome
Tips on using naltrexone for alcohol use disorder
How high can we go with naltrexone for alcohol use disorder?
Tips on using naltrexone extended-release injectable (Vivitrol®)
How to order, store, and administer naltrexone extended-release injection (Vivitrol®)
Find a Vivitrol® prescriber
Could extended-release naltrexone injection work for alcohol use disorder even if oral naltrexone did not?
Naltrexone (Revia®, Vivitrol®): Basic information
Tips on using acamprosate (Campral®) for alcohol use disorder
Disulfiram: A shortcut to sobriety?
How to use disulfiram to help with alcoholism
Should we consider gabapentin for alcohol use disorder?
Tips on treating alcohol use disorder in persons with a bipolar disorder
Should we tell people with alcoholism to avoid drinking kombucha?
Tips on how to avoid alcohol in social settings
What to tell patients with alcohol use disorder about taking acetaminophen (paracetamol)
Caffeine
Caffeine and mental health
How much caffeine is too much?
Key things clinicians should know about caffeine withdrawal
Minimizing caffeine may be helpful in bipolar disorder
Caffeine can significantly change serum clozapine levels
Interactions that can significantly affect caffeine metabolism
Should those with migraine not consume caffeine?
Caffeine content of coffee and tea
Should we recommend decaffeinated coffee?
Caffeine content of soft drinks
Caffeine content of “energy” drinks
Drug interactions with caffeine
Caffeine can significantly change serum clozapine levels
Let’s wake up to how much caffeine our patients are taking
Cannabis
Cannabis—General articles
Cannabis (“Marijuana”): Terminology
Acute effects of cannabis that we should warn patients about
Why and how to routinely ask and counsel patients about driving after cannabis use
“Blunts”: Why they are a particularly worrisome way of smoking cannabis
What are cannabis joints and spliffs or mulled cigarettes?
Why using cannabis concentrates in vapes or by “dabbing” is dangerous
Cannabis or cannabinoids for PTSD?
Cannabis or cannabinoids for dementia?
Only the minimum about cannabigerol (CBG)
Why we must learn about delta-8-tetrahydrocannabinol (delta-8-THC)
Cannabis Use During Pregnancy and Lactation: Key Facts and Recommendations
How reliable is the labeled THC content at cannabis dispensaries?
Cannabis—Drug interactions
Which psychotropic medications does cannabis affect?
Cannabidiol (CBD): Drug interactions
Pharmacokinetics of cannabis or cannabinoids
Cannabidiol (CBD)
What is cannabidiol (CBD)?
What is the dose of cannabidiol (CBD) for anxiety disorders?
Cannabidiol (CBD): Clinical experience
Cannabidiol for schizophrenia or other psychotic disorders? An overview
What did randomized, double-blind clinical trials of cannabidiol in schizophrenia find?
What side effects can cannabidiol (CBD) cause in our patients?
Cannabidiol (CBD): Drug interactions
Cannabigerol (CBG)
Cannabis use disorder
Which medications work for cannabis use disorder?
Tips for managing the abuse potential of medications for ADHD
Does lisdexamfetamine really have lower abuse potential?
Key facts about ADHD and cannabis use (and their practical implications)
How should ADHD be treated when cannabis use is also present?
Stimulants for ADHD with a history of a substance use disorder?
Should stimulant medications be avoided in ADHD patients who use cannabis?
Cannabis withdrawal
Cannabinoid hyperemesis syndrome
Hypnotics
Non-addictive sleep medications
Will zolpidem be detected on a standard urine drug screen?
My best tip for reducing (or stopping) benzodiazepines and hypnotics
Kratom
Opioids
Opioid use disorder
Opioid use disorder is a VERY serious condition
Clinical pearls on prescribing buprenorphine (Suboxone®)
Clinical pearls about prescribing buprenorphine: Part Two
Buprenorphine (Subutex®, Suboxone®)
Buprenorphine extended-release injection (Sublocade®)
Opioids in the urine drug screen
Tips for our opioid-dependent patients
Naltrexone (Revia®, Vivitrol®): Basic information
Tips on using naltrexone extended-release injectable (Vivitrol®)
Naltrexone extended-release injection (Vivitrol®): The how to
Fentanyl
Why we MUST know about fentanyl and fentanyl analogs
Fentanyl analogs and why they are so important
An overview of fentanyl opioid use disorder (addiction)
Special points in the management of fentanyl opioid use disorder (addiction)
Special tests are needed to identify fentanyl in the urine
Use and recommend an FDA-cleared over-the-counter fentanyl urine test
Why and how to use fentanyl test strips
For how long can fentanyl be detected in the urine?
Special issues in using naloxone for overdoses involving fentanyl
Miscellaneous
Loperamide abuse: Tips for mental health clinicians
NeuroStim System-2 (NSS-2) BRIDGE
Psychedelics
Considerable beneficial effects are reported by psilocybin users
What side effects can occur with psilocybin
Is psilocybin addictive?
Can psilocybin lead to suicide or other self-harm?
What we need to know about hallucinogen persisting perception disorder (HPPD)
Can psychedelics cause serotonin toxicity (syndrome)?
Can a psychedelic be taken along with lithium?
Stimulants
Prescription stimulant medications
Eight tips for reducing the risk of abuse/diversion of stimulants
Does lisdexamfetamine really have lower abuse potential?
Methamphetamine
Methamphetamine use: What, Who, How, and Why
What harms can result from methamphetamine use?
Three scenarios in which psychosis can occur in a methamphetamine user
How to treat methamphetamine use disorder
Other stimulants
What is khat, and why is it important in mental health?
Tobacco/ Nicotine
Tobacco/ Nicotine Use Disorder—General Articles
Are you evaluating and treating tobacco use disorder in your patients?
High-yield tips for evaluating patients who use tobacco
A primer on tobacco-free oral nicotine pouches
Drug interactions with tobacco smoking
Smoking and psychotropic medications
Time course of decrease in CYP1A2 activity after smoking cessation
Tobacco/ Nicotine Use Disorder—Management
A practical guide to the management of tobacco use disorder
A simple questionnaire to help guide tobacco cessation treatment
Should we ask former or current smokers if they have been screened for lung cancer?
Nicotine Replacement Therapy (NRT)
A practical guide to nicotine replacement therapy (NRT)
Guide patients in obtaining reliable and affordable nicotine patches
How exactly should nicotine patches be used?
Detailed instructions for correctly using nicotine patches
How exactly should nicotine gum be used?
How exactly should nicotine lozenges be used?
How exactly should nicotine oral inhalers be used?
How exactly should nicotine nasal spray be used?
Don’t miss nicotine as a cause of the increase in pulse rate or blood pressure
Monitor pulse rate and blood pressure when bupropion and nicotine are combined
Varenicline
Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders?
Varenicline (Chantix®): Basic Information
A practical guide to using varenicline (Chantix®) for tobacco (smoking) cessation
What are the potential side effects of varenicline (Chantix®)?
Clarification about the potential neuropsychiatric side effects of varenicline (Chantix®)
Can varenicline (Chantix®) be stopped abruptly or should it be tapered off?
Electronic Cigarettes (E-cigarettes)
What are electronic cigarettes (e-cigarettes)?
Do electronic cigarettes (e-cigarettes) work for smoking cessation?
What “authorities” say about e-cigarettes for tobacco use disorder
Finding treatment for addictions
How to find a certified addiction psychiatrist
How to find treatment facilities for substance use disorders (addiction)
SAMHSA National Helpline (Treatment Referral Routing Service)
How to find a detoxification (detox) center
How to choose a rehab
Private facilities for the treatment of substance use disorders
Substance use and Bipolar disorders
How common is the comorbidity of bipolar disorders and substance use disorders?
Bipolar disorder or substance use? Tips on resolving the diagnostic confusion
Tips on treating patients with BOTH a bipolar disorder AND a substance use disorder
Substance use—Miscellaneous articles
Tips on dealing with “slips” in recovery
Never crave alone
What happened to polysubstance dependence?
Practice guidelines for substance-related and addictive disorders
Monitor carefully even AFTER substance/medication-induced psychosis subsides
How can we know that a patient’s psychotic symptoms may be substance- or medication-induced?
How to learn addiction psychiatry
Also see: Anti-Addiction Medications at Other Psychiatric Medications (Main Menu)
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