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Reflective practice in health care and how to reflect effectively
Koshy K, Limb C et al. International Journal of Surgical Oncology. 2017 2:e20
Special interest: Addiction
Clinical reviews on addiction
Chronic use of prescription opioids and initiation of injecting drug use
24 Feb 2022
The risk of initiating injecting drug use is eight times higher for patients who receive long-term prescription opioid medication for non-cancer pain compared with that of opioid naïve patients, a large retrospective cohort study from Canada has found. However, the five-year cumulative probability of injecting drug use initiation in this group was only 4%.
Naltrexone lowers hospital admissions in alcohol use disorder
27 Oct 2021
The risk of hospitalisation for an alcohol-related or other cause is lower when patients with alcohol use disorder are treated with naltrexone alone or in combination with disulfiram or acamprosate, a nationwide Swedish study has found. However, acamprosate monotherapy was associated with an increased risk of hospital admission for an alcohol-related cause.
Increased risk of attempted suicide in young problem gamblers
21 Feb 2021
Men and women, under the age of 25, with problem gambling are at increased risk of trying to take their own lives, a UK study has found.
Which treatments are effective for maintaining abstinence from alcohol in primary care?
25 Jan 2021
Acamprosate was the only intervention with evidence that it was better than placebo in maintaining alcohol abstinence for up to 12 months, following detoxification, in a network meta-analysis.
Engagement with HCV therapy linked to lower deaths from all causes in injecting drug users
27 Oct 2020
Engagement with hepatitis C treatment by people who inject drugs is associated with a lower risk of all-cause mortality and drug-related death, a study set in Scotland has found.
Patient safety incidents in opioid substitution therapy analysed
24 Jul 2020
Errors in prescribing, supervised or non-supervised dispensing, and monitoring and communication were responsible for patient safety incidents in opioid substitution treatment, a study from England and Wales has shown.
Increased risk of fatal overdose or suicide associated with stopping opioids
25 May 2020
Ceasing treatment with opioids is associated with an increased risk of death from overdose and suicide, an observational study from the United States has found.
Most deaths in patients on methadone are not drug related
23 Jan 2020
Non drug-related morbidities are the most common cause of death as methadone-treated opioid dependent patients age, a study from Scotland has found. The study authors used information from the Community Health Index and data on methadone prescriptions held within the Scottish National Prescribing Information System for 36,606 patients who had received one or more methadone prescriptions between 2009 and 2015.
Tramadol associated with longer use of opioids after surgery
24 Jun 2019
A study from the United States has found that patients prescribed tramadol for postoperative pain have a higher risk of prolonged opioid use relative to those given other short-acting opioids.
Alcohol use disorder affects offspring’s behaviour in adulthood
25 Mar 2019
Parental alcohol use disorder is associated with an increased likelihood of marriage to a spouse with alcohol use disorder, a Swedish population-based study has found. In particular, daughters of affected mothers were more likely to have an affected spouse.
Deaths associated with opioid overdose increase
22 Feb 2019
A study from Ontario, Canada, has found that prescribed, diverted and illicit opioids all play an important role in the recent increase in opioid-related deaths.
Childhood trauma raises risk of drug misuse later on
23 Jan 2019
Individuals who suffer abuse as children are more likely to use marijuana or cocaine later in life, a study from the United States has found.
Patients prescribed opioids for analgesia at risk of dependence
25 Jul 2018
A systematic review and meta-analysis has estimated that the incidence of iatrogenic opioid dependence or abuse in patients prescribed opioids for pain is almost 1 in 20.
Marked regional variations identified in primary care opioid prescribing
23 Apr 2018
Opioid prescribing rates are increasing and show notable geographical variations across England. They are highest in the North and in areas of social deprivation, a study on primary care prescribing has shown. Virtually all the low prescribing areas were in the south of England and nine of the ten highest prescribing areas were northern clinical commissioning groups (CCGs).
Benzodiazepines and Z-drugs are being widely used long term
23 Jan 2018
A UK primary care survey has found that many patients are taking benzodiazepines or Z-drugs, recommended for short-term use, for at least a year.
Are differing emotional responses to alcohol associated with choice of drink?
20 Dec 2017
Emotional responses to drinking appear to vary according to the type of drink imbibed and differ between men and women, an analysis of data from the Global Drug Survey (GDS) has found.
Mortality risk raised during induction with methadone in opioid substitution therapy
23 Nov 2017
Patients undergoing opioid substitution treatment have an increased mortality risk during the induction phase with methadone but not with buprenorphine, a meta-analysis has found. Mortality risk is also raised in the period immediately after leaving treatment with both drugs.
Gambling linked to mental health problems
22 Jun 2017
Patients with depression and those who drink at risky levels are more than twice as likely to report gambling problems, a UK primary care study has shown.
Benzodiazepine and opioid co-prescribing raises risk of opioid overdose
24 Apr 2017
Stopping concurrent benzodiazepine and opioid prescribing could reduce the risk of inpatient admissions for opioid overdose and attendance at emergency departments by 15%, a study from the US has found.
Smoking cessation
E-cigarettes fail to help smokers quit
24 Feb 2022
Using e-cigarettes for smoking cessation neither improved the chance of quitting successfully nor helped to improve relapse rates, in a large nationally representative cohort study from the USA.
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Evaluating interventions to help smokers quit
09 Aug 2021
Varenicline and a combination of pharmacological and behavioural interventions were the two most effective methods for smoking cessation, a systematic review by the US Preventive Services Task Force has found. Data on the effectiveness and safety of e-cigarettes for smoking cessation in adults were limited and study results inconsistent.
Even smoking some days increases risk of premature death
25 Jun 2021
Individuals who do not smoke every day have a significantly higher risk of all-cause mortality compared with those who have never smoked. For those who smoke daily, the mortality risk increases as the number of cigarettes smoked increases, a large study from the USA has found.
Smokers’ dependence on cigarettes has decreased over the past decade
24 Nov 2020
Between 2008 and 2017 smokers appear to have become less dependent on cigarettes but also less likely to try to quit or cut down. For those who tried to quit, fewer used behavioural support and more used pharmacological support, a study has found.
Nausea may affect adherence to varenicline
24 Sep 2020
Nausea during the first few weeks of varenicline therapy may reduce adherence, a study from North America has found. The authors analysed data on 870 adults receiving varenicline in two smoking cessation trials conducted at multiple sites in Canada and the USA.
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Smokeless tobacco cessation: South Asian communities overview