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Drug

Treatment and Support for Substance Use Disorder

  • Posted Apr 16, 2019
  • hchadmin

Are you concerned that you, a family member or friend may have a substance use disorder (SUD)? SUDs occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. It's necessary that you educate yourself about the support that may be available to you or that you may need to provide to others in order to achieve a sustained recovery.

The National Institute on Drug Abuse (NIDA) offers the following information if you think you might have an addiction:

•It's important to know that addiction can be successfully treated. Contact your primary care physician who can help coordinate your care and refer you to a specialist, if needed. If you don’t have a primary care physician, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions. Or, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website for more information and resources.

•It takes a lot of courage to seek help because there is a lot of hard work ahead. However, treatment can work, and people recover every day.

•Your treatment approach must be tailored to address your specific substance misuse pattern and also your substance-related medical, psychiatric and social needs.

•There are different kinds of addiction specialists who will be involved in your care, including doctors, nurses, therapists, social workers, and others.

•Behavioral treatment (also known as "talk therapy") can help you engage in the treatment process, change your attitude and behaviors related to substance misuse, and increase your healthier life skills.

•Medications are available to treat addictions to alcohol and opioids (heroin and pain relievers). Other medications are available to treat possible mental health conditions.

•Self-help groups can extend the effects of professional treatment. These groups can be particularly helpful during recovery, as they are a source of ongoing communal support.

If you have an adult family member or friend who is struggling with the misuse of alcohol and/or drugs, NIDA offers the following tips:

•Recognize that you can't fix the problem by yourself. If someone you care about has asked for help, he or she has taken an important first step. If that person is resistant to help, perhaps you can at least convince him or her to get an evaluation from a doctor.

•You can always take steps to locate an appropriate physician or health professional, and leave the information with your friend or family member.

•Emphasize to your friend or loved one that it takes a lot of courage to seek help for a drug or alcohol problem because there is a lot of hard work ahead. But assure them that you will be supportive in their courageous efforts.

•The pressure of family and friends sometimes compels people to enter treatment. However, it's better that you focus on creating incentives to at least get the person to a doctor.

•If your friend or loved one was previously treated and then relapsed, they have already learned many of the skills needed to recover from addiction and should try it again. 

•People being treated or recovering from SUDs relapse about as often as do people with other chronic diseases such as hypertension and diabetes. Treatment of any chronic disease involves changing deeply imbedded behaviors, and relapse sometimes goes with the territory.

•Encourage your loved one to participate in a self-help group during and after formal treatment. These groups can be particularly helpful during recovery, as they are a source of ongoing communal support.

You may also consider contacting your site Employee Assistance Program (EAP).  Your EAP is a confidential resource that provides counseling, information and referral services to help address personal, family or work-related concerns. These services are provided to you and your family members free-of-charge as one of your employee benefits.

As your trusted health partnerf or life, Holy Cross Hospital is committed to providing resources that promote well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.


[Disclaimer: Trinity Health is a Catholic health care facility that is firmly committed to maintaining fidelity to its Catholic identity by closely conforming to the Ethical and Religious Directives for Catholic Health Care Services (ERDs). The links provided here are independent sites and have no obligation to provide information that is always congruent with the ERDs. Trinity Health cannot guarantee their content and ask for your discretion when using information from these sites]

 

Awareness is Key to Addressing Chemical Dependency

  • Posted Apr 17, 2018
  • hchadmin

 pile of coloful pills

The numbers are sobering. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported that, in 2016, approximately 20.1 million people aged 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year, including 15.1 million people who had an alcohol use disorder and 7.4 million people who had an illicit drug use disorder. Additionally, according to the Centers for Disease Control and Prevention (CDC), in 2016, more than 64,000 Americans died from overdosing on illicit drugs and prescription opioids. This number has nearly doubled in a decade.

SUDs occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school or home. Addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.

Awareness about the scope of chemical abuse and dependency and the physical, mental, emotional and spiritual toll it takes is one component, along with prevention and treatment to improving the lives of affected individuals.

There is good news regarding prevention. National Institute on Drug Abuse (NIDA)-funded research has shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction.

Treatment for chemical dependency generally isn’t a cure. However, addiction is treatable and can be successfully managed. According to NIDA, treatment should be ongoing and should be adjusted based on how the patient responds. Treatment plans need to be reviewed often and modified to fit the patient’s changing needs.

If you or a loved one is struggling with chemical dependency, don’t hesitate to reach out. Help is available. Contact your PCP who can help coordinate your care and refer you to a specialist, if needed. If you don’t have a PCP, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross is committed to providing resources that promote well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.

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What really helps? Or, How I learned to accept why we do what we do and stop worrying. (Part One)

  • Posted Dec 14, 2010
  • Alan Niederman, MD, FACC, FACP

As readers of this blog know, I am fascinated by the disconnect that often goes on in the practice of medicine.  That disconnect is most powerfully felt in why there are so many people under the curve.

The curve I am talking about is described as follows.  You take two large groups and give one a drug and another a placebo and then you get an answer...say a ten percent difference. That may be statistically important and the drug is approved.  What happened to the other 90%?  Why do only some people in the treatment group receive a benefit?  This is often expressed in the “number to treat”.  What this means is you need to treat so many patients to get one result.

A favorite example of mine is the relationship of aspirin and Plavix.  Plavix was approved on the basis of a 20% reduction in cardiovascular events.  What were the “real” numbers?  The treatment effect of Plavix in the group tested was 0.5%.  That’s right, that small.  You need to treat 200 patients to get a treatment effect, yet that is how Plavix got approved.  This does not have anything to do with why we use Plavix now, which is to protect against stent closure.  The drug was approved and we migrated to it as a better alternative than Ticlid, which was a nightmare.  If we still had to use Ticlid, stenting would never have remained a viable technology.  Was there ever a study?  No, we just did it.

This is not a new topic but one that has gained much attention lately in both the cardiology community and in the lay publications.  What is most surprising is what the numbers actually show and that most doctors don’t even get this little right.  As published in JACC 2006;48:434 a partial account is as follows:

Drug         Condition     No. of patients     RRR      Absolute reduction
Aspirin                 MI                     9,302                   30%            3.8%
Thrombolysis   MI                   58,000                  18%             1.8%
Beta Blocker      MI                   28,970                  13%             1.3%
ACE-I                   MI                    98,496                   7%              0.5%
Statins       2nd Prevention    20,536                  13%             1.8%

Mind you, this is mortality we are talking about.  The ultimate benefit but as you can see 200 patients need to take an ACE-I (ace inhibitor like lisinopril) so 1 less death occurs.  Even my beloved statins require many patients to be exposed so a few benefit.

In the same issue of JACC, by the way, is the Meta Analysis  of statins showing high dose statins do a much better job of providing benefit than low dose, albeit not mortality.    In over 100,000 patient years of study, those who took high dose statins achieved a benefit of 16% reduction of events such as myocardial infarction or stroke. To put it in a more striking way, if you treat 1,000,000 patients for five years, 35,000 events can be prevented including 14,000 deaths.  Crazy but true.  Why would you want to do this?  It’s the best we have.  Why don’t more people benefit?  No one knows, but the work is ongoing and the expectation is that one day we will do better at targeting a drug to a patient using genomics or your gene type.  Until then this is the best we have.

Now what if I told you that we have a treatment that provides a 50% reduction in mortality and that you need to only treat 5 patients to achieve a benefit.  Interested?  More next time.

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About Holy Cross Hospital

Holy Cross Hospital is a nonprofit, Catholic hospital in Fort Lauderdale, Florida, dedicated to innovative, high quality and compassionate care. For nearly six decades, Holy Cross has continuously expanded its services to provide leading-edge care for their patients in Florida and for those from elsewhere in the United States. Holy Cross also offers an International Services program to ensure that patients from outside the U.S. receive the care they need.

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