Explore the vast range of titles available.

Although federal law in the United States still prohibits the use, possession, and sale of cannabis containing more than 0.3% THC, 24 states, the District of Columbia, and three U.S. territories have legalized the recreational use of marijuana. This trend is also seen in other countries, including Canada, South Africa, and Uruguay. Studies show that the prevalence of cannabis use disorder among people who use cannabis is relatively high. As the business of cannabis—both legal and illicit—and its use continue to grow, mental health and medical professionals must be prepared to address the effects of cannabis on the mind and body. Equipping providers with the relevant information is the intention of The Other Side of Cannabis. Relying on the insights of experts from around the world, this volume examines, among many other topics: • The frequency of use and deleterious effects of cannabis on adolescents, adults, and older adults• The link between cannabis and psychosis• The relationship between cannabis and posttraumatic stress disorder and anxiety disorders• The effects of cannabis on fertility—both male and female• The mechanisms and efficacy of cannabinoids on treating chronic pain Extensively referenced, this guide is rich in figures and tables for ease of reference. Key points at the end of each chapter aid in the retention and recall of the most important information. Readers will come away with a comprehensive understanding of the detrimental impact of cannabis use and be better positioned to educate patients, the public, and policymakers.

Purpose of Review We apply the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria for substance use disorders (SUDs) to the herbal product kratom. Similarities and differences between kratom use disorder (KUD) and other SUDs are explored, along with assessment, diagnostic, and therapeutic recommendations for KUD. Recent Findings Literature reports of “kratom addiction” or KUD rarely specify the criteria by which patients were diagnosed. Individuals meeting DSM-5 KUD criteria typically do so via tolerance and withdrawal, using more than intended, and craving, not functional or ​psychosocial disruption, which occur rarely. Most clinicians who use medication to treat patients with isolated KUD select buprenorphine formulations, although there are no controlled studies showing that buprenorphine is safe or efficacious in this patient population. Summary Diagnosis and treatment decisions for KUD should be systematic. We propose an algorithm that takes into consideration whether KUD occurs with comorbid opioid use disorder.

Substance-use disorders are a public health crisis globally and carry with them significant morbidity and mortality. Stigma toward people who abuse these substances, as well as the internalization of that stigma by substance users, is widespread. In this review, we synthesized the available evidence for the role of perceived social stigma and self-stigma in people's willingness to seek treatment. While stigma may be frequently cited as a barrier to treatment in some samples, the degree of its impact on decision-making regarding treatment varied widely. More research needs to be done to standardize the definition and measurement of self- and perceived social stigma to fully determine the magnitude of their effect on treatment-seeking decisions.

By 2050, 85.7 million people in the United States are projected to be 65 or older. Older adults are especially prone to the effects of substances, and a 2021 survey showed that 4 million older adults were dealing with a substance use disorder. As the country's population ages, clinicians will inevitably have to care for a greater number of older adults with substance use disorders, but the literature on the topic—and the evidence base for treatment—is limited. In Substance Use in Older Adults, more than 20 contributors translate their real-world experience in geriatric psychiatry into an accessible, evidence-based guide to screening for and assessing substance use in older adults. Early chapters discuss not only etiology and epidemiology but also comorbidities and management and subsequent sections address the problematic use of specific substances, including • Alcohol• Tobacco• Opioids• Sedatives• Stimulants• Cannabinoids Readers will find guidance on safe prescribing practices for older patients, as well as an examination of the cultural and ethical issues that may arise when working with this patient population. Rife with case examples that illustrate key points in clinical practice, Substance Use in Older Adults also features numerous tables that can be referenced time and again with information on comorbidities, screening frameworks, and interventions for specific substances; stigma-reducing language; the pharmacological implications of physiological changes in older adults; and more. Clinicians from psychiatric professionals to primary care providers will benefit from exhaustive listings of additional resources. This guide also includes resources for patients, families, and caregivers that will help to strengthen the partnership between clinician and patient.

Introduction: In this study, we used a symptomatology checklist (SCL-90) to substantiate the hypothesis that Substance Use Disorder (SUD) has its own five-dimensional psychopathology. The aim of the present study was to test whether this psychopathology can be differentiated from other psychiatric psychopathological dimensions (such as obesity). Methods: The severity and frequency of each of the five dimensions were investigated, at univariate and multivariate levels, by comparing 972 Heroin Use Disorder (HUD) patients (83.5% male, mean age 30.12 ± 6.6, range: 16–59) and 106 obese individuals (50.0% male, mean age 37.59 ± 7.6, range: 24–52). The correlations between the Body Mass Index (BMI) of obese individuals with these psychopathological dimensions were also studied. Results: Obese individuals showed higher SCL-90 total scores, global severity index scores, number of items rated positively, and positive symptoms distress index scores than HUD patients. The severity of all psychopathological dimensions was significantly higher in obese individuals. Discriminant analysis showed that Panic-Anxiety and Violence-Suicide severity were more frequent in obese patients, sufficiently so to allow differentiation between HUD (lower severity) and obese individuals (greater severity). At the reclassification level, 70.8% of obese individuals in the sample were reclassified as HUD patients. Psychopathological subtypes characterized by Panic-Anxiety and Violence-Suicide typology were more frequent in obese patients and sufficiently so as to discriminate between groups. Of obese patients, 47.2% were reclassified as HUD patients. The severity of the Worthlessness-Being Trapped dimension was sufficient to predict the BMI of obese individuals. Conclusions: Our results suggest that the five-factor psychopathology found in HUD can discriminate between HUD and obese patients, but that there is an area of overlap between the forms of psychopathology found in SUD and those found in obese patients.

Background Substance use disorders (SUDs) have been consistently shown to exhibit moderate intergenerational continuity (1–3). While much research has examined genetic and social influences on addiction, less attention has been paid to clients’ and lay persons’ perceptions of genetic influences on the heritability of SUD (4) and implications for treatment. Methods For this qualitative study, twenty-six structured Working Model of the Child Interviews (WMCI) were conducted with mothers receiving inpatient SUD treatment. These interviews were thematically analyzed for themes related to maternal perceptions around intergenerational transmission of substance use behaviours. Results Findings show that over half of the mothers in this sample were preoccupied with their children’s risk factors for addictions. Among this group, 29% spontaneously expressed concerns about their children’s genetic risk for addiction, 54% shared worries about their children’s propensity for addiction without mentioning the word gene or genetic. Additionally, 37% had challenges in even discussing their children’s future when prompted. These concerns mapped onto internal working models of attachment in unexpected ways, with parents who were coded with balanced working models being more likely to discuss intergenerational risk factors and parents with disengaged working models displaying difficulties in discussing their child’s future. Conclusion This research suggests that the dominant discourse around the brain-disease model of addictions, in its effort to reduce stigma and self-blame, may have unintended downstream consequences for parents’ mental models about their children’s risks for future addiction. Parents receiving SUD treatment, and the staff who deliver it, may benefit from psychoeducation about the intergenerational transmission of SUD as part of treatment.

Specific treatments targeting adolescents with substance use disorders (SUDs) have been developed over the last couple of decades. Despite these developmentally tailored treatments, long-term abstinence rates remain relatively low among adolescents receiving care. Research over the last decade has increasingly focused on adolescents with comorbid substance use and psychiatric disorders, in recognition of the barriers caused by inadequate treatment of co-occurring psychiatric disorders. Treatments targeting dually diagnosed youth are now regarded as essential to improving SUD treatment outcomes, but remain underutilized. A variety of treatment modalities such as behavioral therapy, family therapy, 12-step groups, motivational interviewing, contingency management, and combinations of these interventions have been modified for adolescents. In this article, we review the research on these treatments, as they apply to dually diagnosed youth. Furthermore, we explore the evidence for various treatments targeting comorbid SUD, specific to the presence of externalizing or internalizing disorders. The current evidence base supports the importance of integrated treatment targeting both SUD and psychiatric disorders simultaneously. High-quality treatment programs offering combinations of behavioral and family therapy, particularly with motivational interviewing and contingency management, are particularly well supported. In addition, we review various psychotropic medication treatments that have also been studied in conjunction with adolescent SUD treatment. Finally, we review research on post-treatment, supportive care that has been shown to improve long-term SUD outcomes. Recently conceptualized modular treatments, which offer personalized combinations of evidence-based treatments for specific disorders, have been proposed as a means of improving outcomes. Future research on modular programs must test the efficacy of individualized treatments when applied to combinations of psychiatric and SUDs in adolescents.

Nurse practitioners (NPs) are in a key position to provide services to persons with substance use disorder and decrease marginalization and stigmatization. There is a paucity of evidence on interventions to affect NPs’ attitudes/beliefs, confidence/preparedness, concerns/barriers, and ability to treat substance use disorder. The presented research demonstrated significant positive changes (P < .05) in 33 of 44 items on the Substance Use Disorder, Knowledge, Attitudes and Beliefs Survey, after NP students were provided a targeted educational program on the treatment of opioid use disorder. The research supports educational programs positively impacting NPs’ knowledge, attitudes, and beliefs regarding persons with substance use disorder. •A need exists for substance use disorder care without marginalization or stigmatization.•Nurse practitioners are in a position to provide optimal care for substance use disorder.•Evidence is lacking on nurse practitioner skill development to address substance use disorder.•The research demonstrates significance of substance use disorder education.

A new volume in the bestselling Pocket Notebook series, Pocket Addiction Medicine delivers highly relevant coverage of this widespread and increasing health care problem in an easily portable source.Edited by physician leaders in Addiction Medicine, Drs.Sarah E.Wakeman, Joshua D.

Background The role of specific phobia as a potentially important psychopathological precursor condition to more severe mental disorders is understudied. We examined the prospective‐longitudinal association of early childhood/adolescent phobia with subsequent mental disorders and the proportion of outcome disease incidence attributable to specific phobia simultaneously for a broad range of disorders. Methods N = 2210 14‐ to 24‐year‐old community subjects were followed up for 10 years. DSM‐IV‐specific phobia as exposure and a broad range of DSM‐IV mental disorders as outcomes were assessed with the DSM‐IV/M‐CIDI. Logistic regressions, adjusting for confounders, were used to estimate the associations of specific phobia with the subsequent onset of outcome disorders. Results Baseline specific phobia predicted the subsequent first onset of anxiety disorders [panic disorder: risk ratio (RR) = 4.38, 95% confidence interval (2.34, 8.21); generalized anxiety disorder: RR = 4.10 (2.19, 7.69); posttraumatic stress disorder: RR = 2.15 (1.13, 4.10); obsessive–compulsive disorder: RR = 3.79 (1.63, 8.82)], affective disorders [major depression: RR = 1.54 (1.16, 2.03); bipolar disorder: RR = 2.20 (1.10, 4.41); dysthymia: RR = 2.75 (1.48, 5.11)], pain disorder: RR = 1.52 (1.14, 2.02), and eating disorders: RR = 2.27 (1.14, 4.51). Population attributable fractions (PAFs; i.e., proportion of outcome disease incidence in the total population attributable to specific phobia) were highest for panic disorder (PAF = 22.9), generalized anxiety disorder (PAF = 32.3), and obsessive–compulsive disorders (PAF = 30.2). Conclusion This study provides strong evidence that specific phobia is an early onset disorder predicting the subsequent onset of a range of disorders. Future studies should examine the underlying mechanisms and the potential of using specific phobia as a target for prevention of subsequent psychopathology.