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  • Urine Drug Screens to Monitor Opioid Use for Managing Chronic Pain

    Abstract Full Text
    JAMA. 2017; 318(11):1061-1062. doi: 10.1001/jama.2017.10593

    A 53-year-old woman with chronic low back pain presented for a prescription refill of hydrocodone/acetaminophen. She had partial paralysis from a thoracic spinal cord infarction secondary to aortic dissection from prior cocaine use and reported taking hydrocodone on that day but no recent illicit drug use. Urine immunoassay drug screen results were negative overall but positive for cocaine. How would you proceed?

  • CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016

    Abstract Full Text
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    JAMA. 2016; 315(15):1624-1645. doi: 10.1001/jama.2016.1464

    This guideline from the Centers for Disease Control and Prevention makes 12 recommendations to improve communication about opioids for chronic pain, to improve the safety and effectiveness of pain treatment, and to reduce risks associated with long-term opioid therapy.

  • JAMA April 14, 2015

    Figure 3: Forest Plot Showing Association Between Various Monitoring Strategies and Patient Adherence to Dabigatran

    Adherence to dabigatran was defined as the proportion of days covered as being at least 80%. The dotted line represents no effect. All observations to the right of the vertical line signify a positive association with dabigatran adherence. The error bars represent 95% CIs. Variables included in the model were age, sex, race (white), congestive heart failure, hypertension, diabetes, stroke or transient ischemic attack, chronic kidney disease, bleeding, myocardial infarction, liver disease, depression, alcohol, drug abuse, region, patients per hospital, median income in hospital’s county, proportion of urban to rural patients at hospital, education, selection, and follow-up.
  • Alcohol Combined With Drug Abuse Leads to More Overdoses and Deaths

    Abstract Full Text
    JAMA. 2014; 312(23):2482-2482. doi: 10.1001/jama.2014.16135
  • JAMA August 20, 2014

    Figure 1: Smoking Cessation Study Participation Diagram

    aPatients may have had more than 1 reason for exclusion.bInclusion criteria were age of 18 years or older, daily smoker, plans to quit smoking, and willingness to accept cessation medication after discharge.cRefers to illicit drug use (except marijuana) or alcohol use during past year or drug overdose as reason for current admission.dThe numbers of patients who withdrew and died are cumulative.
  • Screening and Brief Intervention for Drug Use in Primary Care: The ASPIRE Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2014; 312(5):502-513. doi: 10.1001/jama.2014.7862

    Saitz and coauthors tested the efficacy of 2 brief interventions among 528 adults with unhealthy drug use identified by screening in primary care. They compared a brief negotiated interview and an intervention based on motivational interviewing with no brief intervention. In an Editorial, Hingson and Compton discuss the importance of exploring drug use with patients in primary care.

  • Street Children and Drug Abuse

    Abstract Full Text
    JAMA. 2013; 310(11):1113-1113. doi: 10.1001/jama.2013.278239
  • WHO Documents Worldwide Need for Better Drug Abuse Treatment—and Access to It

    Abstract Full Text
    JAMA. 2012; 308(5):442-443. doi: 10.1001/jama.2012.8882
  • Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery

    Abstract Full Text
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    JAMA. 2012; 307(23):2516-2525. doi: 10.1001/jama.2012.6147
    King and coauthors conducted a prospective cohort study of adults who underwent bariatric surgery at 10 US hospitals to assess the prevalence of alcohol use disorders before and after surgery.
  • JAMA May 23, 2012

    Figure 1: Participant Flow

    Only those patients excluded in the allocation process were excluded from the analysis. Discontinuation of intervention was more frequent in the control group, in which patients were excluded because of somnolence (n = 7), change to continuous positive airway pressure (CPAP) (n = 5), hypertension (n = 2), drug abuse (n = 1), pregnancy (n = 1), or other cause (n = 1).
  • Illicit Drug Use Creates Opportunities for Microbes

    Abstract Full Text
    JAMA. 2011; 305(13):1289-1289. doi: 10.1001/jama.2011.379
  • JAMA May 26, 2010

    Figure 1: Treatment Failure for Early Antibiotic Treatment vs Late or No Treatment

    Subgroup analyses are presented according to whether patients had a sputum test or arterial blood gas measurement on hospital day 1 or 2 and also by risk tertile for treatment failure. aCovariates include age group, sex, insurance, respiratory failure as a principle diagnosis, attending physician specialty, admission source, prior year admissions for acute exacerbation chronic obstructive pulmonary disease, region, chronic pulmonary heart disease, hypertension, heart failure, pulmonary circulation disease, metastatic cancer, arthritis, obesity, weight loss, deficiency anemia, hypothyroid, depression, psychoses, alcohol abuse, and day 1 or 2 initiation of long-acting β2 agonists, bilevel positive airway pressure or continuous positive airway pressure, methylxanthine bronchodilators, oral or intravenous steroids, morphine, loop diuretics, arterial blood gas measurements, brain natriuretic peptide, pulmonary function tests, and selected interaction terms.bCovariates include race, insurance status, respiratory failure as principal diagnosis, attending physician specialty, region, population served, chronic pulmonary heart disease, heart failure, diabetes, hypothyroid, renal failure, drug abuse, and day 1 or 2 initiation of anticholinergic or short-acting β2 agonists, long-acting β2 agonists, methylxanthine bronchodilators, bilevel positive airway pressure or continuous positive airway pressure, oral or intravenous steroids, morphine, loop diuretics, mucolytic medications, arterial blood gases, brain natriuretic peptide, and pulmonary function tests. cRisk of treatment failure tertiles are first: 0.008-0.059; second: 0.060-0.102; third: 0.103-0.838.
  • Treatment Given High Priority in New White House Drug Control Policy

    Abstract Full Text
    JAMA. 2010; 303(9):821-822. doi: 10.1001/jama.2010.210
  • Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety

    Abstract Full Text
    JAMA. 2009; 301(2):183-190. doi: 10.1001/jama.2008.976
  • House Committee Change

    Abstract Full Text
    JAMA. 2009; 301(2):152-152. doi: 10.1001/jama.2008.879
  • Integrated Care Needed for Patients With HIV, Drug Abuse, and Mental Illness

    Abstract Full Text
    JAMA. 2008; 300(5):494-495. doi: 10.1001/jama.300.5.494
  • Prescription Abuse High

    Abstract Full Text
    JAMA. 2008; 299(4):399-399. doi: 10.1001/jama.2008.5
  • Prescription Drug Abuse Rises Globally

    Abstract Full Text
    JAMA. 2007; 297(12):1306-1306. doi: 10.1001/jama.297.12.1306
  • Limit Lifted

    Abstract Full Text
    JAMA. 2005; 294(14):1752-1752. doi: 10.1001/jama.294.14.1752-c
  • Drug Abuse “Propaganda”

    Abstract Full Text
    JAMA. 2005; 293(6):668-668. doi: 10.1001/jama.293.6.668-c