Alcohol Abuse

In clinical terms, one of the most distinguishing diagnostic features of addictive disorders is that those affected continually and repeatedly revert to their addictive behaviors, despite the devastating negative and adverse consequences.

This brief communication highlights clinically applicable information and take-home points presented at the American Academy of Addiction Psychiatry Annual Meeting.

This brief communication highlights the importance of genetic predictors and moderators of treatment research in the field of substance use.

Maltreatment at an early age casts a very long shadow. Here: a look at the long-term effects of early childhood trauma.

Severe alcohol dependence and frequent relapses in this patient prompts his son to produce a durable power of attorney for health care. He demands that the physicians declare his father to lack decision-making capacity. More in this ethics case report.

An overview of special coverage on advances in the treatment of alcohol use disorders.

Very few heavy drinkers receive treatment and fewer still are prescribed medications with demonstrated efficacy. Here, a summary of current research, key takeaways, and highlights from a study on topiramate treatment for heavy drinkers by the lead author of that study.

In addition to the approval of novel medications for alcohol use disorders, the past several years have been marked by an emphasis on development, standardization, and dissemination of new behavioral therapies, including computer-based interventions.

There is increasing evidence and support for medications for alcohol use disorders to be used in regular clinical practice, and not to be limited to specialty substance abuse settings. Here, special considerations for pharmacological management.

Clinicians will be drawn in by author Charles R. Cross's personal experience documenting, Here We Are Now: The Lasting Impact of Kurt Cobain. Cobain, lead singer of Nirvana, committed suicide 20 years ago this month.

Alcohol misuse in older adults is often underdiagnosed in medical practice. This age group is rapidly moving into the treatment realm of the practicing general, geriatric, and addiction psychiatrist.

Substance abuse and addiction are commonly associated with an increased risk of suicide. Alcohol abuse plays a key role in suicide attempts and completions; prescription drugs are a close second. The causes of suicide for men and women are different but the suicide rates are equally staggering.

Why do so many die as a consequence of addiction? Sadly-and in some cases disastrously-affected individuals are never offered alternative approaches after one option fails. More in this commentary.

The frayed dignity of the patient described in this poem, his intelligence matched by the inexplicable intransigence of his alcoholism, moved this VA psychiatrist to describe the clinical encounter, apropos for April, Alcohol Awareness Month.

What medications are FDA approved for alcohol dependence? Take the quiz and learn more.

The challenges of identifying patients at risk for alcohol withdrawal have been found to be mitigated by the development of a Risk Stratification Questionnaire, now being adopted by the VA regionally throughout New England. More in this video.

For patients with hepatic disease, benzodiazepines that are conjugated and renally cleared (eg, lorazepam) should be used instead of those metabolized by the liver. Take the quiz and learn more.

As we accumulate a greater war chest of patient experiences, we can better apply our skills as physicians to fill a space once occupied with alcohol-lubricated decision-making with smooth yet sober coping strategies.

In a new study, "as needed" use of an opioid antagonist for heightened alcohol craving appeared to reduce the number of heavy drinking days and total amount of alcohol consumed.

"Psychiatric diagnosis is certainly imperfect -- but so is much of diagnosis throughout medicine. And whatever the current limitations, psychiatric diagnosis is useful and essential. There are no 'paradigm shifts possible til we learn a lot more. To imply otherwise is misleading and confusing to patients."

A panel of experts at the APA Annual Meeting discussed how changes in DSM-5 may affect clinical practice. Highlights here.

A clinician’s notes and clinical records should document and defend treatment decisions, and are the best defense in court. Here: 3 key things every patient record should include.

While it is true that the intense grief of bereavement and major depressive disorder often share some features-for example, tearfulness, insomnia, low mood, and decreased appetite-there are many substantive differences.

Psychiatrists vary in their eagerness to share therapeutic decisions with patients: some believe that adherence is paramount and paternalism is often necessary to prevent loss of insight with consequent impaired judgment and functional decline. These authors argue in favor of a radically more collaborative style.

Because the aftermath of sexual violence can result in suicidal feelings, depression, PTSD, and other mental disorders, clinicians play an important role in treating both victims and perpetrators and helping to prevent further damage.

Historically, there has been conflict between psychiatry and religion.

Less common but still important syndromes connected with Alzheimer disease include traumatic brain injury, infectious and inflammatory disorders, alcohol-induced dementia.

Cognitive decline feels as though a little man is inside the elderly patient's head, with darkness all around him. To the front, some light seeps in through the eyes. Sounds come from a distance, muted, like in a heavy fog.

After each violent tragedy, the politicians hypocritically mourn and harrumph, but wind up buckling under pressure from the NRA, fiscal constraints, and the prison and gun lobbies. Repeated dramatic events can shake the complacency and cowardice of a stalemated Congress and state legislatures.

According to the CDC's latest published report, there were 38,364 suicides in the US in 2010-an average of 105 each day. Globally, an estimated 1 million suicides occur annually.