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A 35-year-old physician with opioid dependence / J. R. KNIGHT
Titre : A 35-year-old physician with opioid dependence Titre traduit : (Un médecin de 35 ans dépendant des opioïdes) Type de document : Périodique Auteurs : J. R. KNIGHT Année de publication : 2004 Importance : 1351-1357 Note générale : JAMA - Journal of the American Medical Association, 2004, 292, (11), 1351-7
Article accompagné de lettres à l'éditeur et de la réponse de l'auteur publiées dans JAMA 2005;293(3):294.
Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
MEDECIN ; DEPENDANCE ; AUTOMEDICATION ; OPIOIDES ; TEMOIGNAGE ; TRAITEMENT
Discipline : PRO Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods Résumé : FRANÇAIS :
Communiqué à une conférence d'un médecin dépendant de l'hydrocone qui a suivi un programme de traitement résidentiel. Il décrit son expérience de la dépendance et soulève la question de la particularité des médecins face à la dépendance : combien de médecins aux Etats Unis pratiquent leur métier en étant dépendant, à partir de quel moment un médecin est-il considéré comme incapable d'exercer son activité, comment peut-il être aidé ? Il présente également les possibilités de traitement.
Dr L is a specialist physician in practice for several years who became addicted to hydrocodone. Dr L lives with his wife, who is also a physician, and his 2 young children.
Dr L was well until several years ago, when he was grieving after a stressful life event. He began taking antidepressant medication from the sample closet in his office. He stopped taking the medications after several months because he had no relief from his symptoms. Gradually, most of his grief symptoms resolved.
Some time later, Dr L became ill with an upper respiratory tract infection. Again, he self-treated his symptoms, this time with a cough syrup containing hydrocodone that he obtained from his office sample closet. The hydrocodone improved not only his cough but also his mood, and he began to take it regularly to get through the day, even after his cough resolved. [Extract]
Domaine : Drogues illicites / Illicit drugs Affiliation : Center for Adolescent Substance Abuse Res., Children's Hosp. Boston, 300 Longwood Ave., Boston, MA 02115. Etats-Unis. United States. Numéro Toxibase : 207892 Centre Emetteur : 13 OFDT Cote : A01958 Permalink : 50-Year trends in smoking-related mortality in the United States / M. J. THUN ; B. D. CARTER ; D. FESKANICH ; N. D. FREEDMAN ; R. PRENTICE ; A. LOPEZ ; P. HARTGE ; S. M. GAPSTUR in New England Journal of Medicine, Vol.368, n°4 (January 24, 2013)
Titre : 50-Year trends in smoking-related mortality in the United States Type de document : Périodique Auteurs : M. J. THUN ; B. D. CARTER ; D. FESKANICH ; N. D. FREEDMAN ; R. PRENTICE ; A. LOPEZ ; P. HARTGE ; S. M. GAPSTUR Année de publication : 2013 Article en page(s) : 351-364 Note générale : Editorial: New evidence that cigarette smoking remains the most important health hazard. Schroeder S.A., p. 389-390.
Correspondence: Smoking-Related Mortality in the United States. Lippi G., Mattiuzzi C., Cerimele J.M., Halperin A.C., Blum A., Thun M.J., Lopez A.D., Hartge P., Schroeder S., NEJM 2013;368(18), p. 1752-1754.
Langues : Anglais (eng) Mots-clés : Thésaurus Géographique
TABAC ; MORTALITE ; EVOLUTION ; COHORTE ; FACTEUR DE RISQUE ; CAUSE DE DECES ; SEXE ; AGE
Discipline : EPI Epidémiologie / Epidemiology Résumé : Background: The disease risks from cigarette smoking increased in the United States over most of the 20th century, first among male smokers and later among female smokers. Whether these risks have continued to increase during the past 20 years is unclear. Methods: We measured temporal trends in mortality across three time periods (1959-1965, 1982-1988, and 2000-2010), comparing absolute and relative risks according to sex and self-reported smoking status in two historical cohort studies and in five pooled contemporary cohort studies, among participants who became 55 years of age or older during follow-up.
Results: For women who were current smokers, as compared with women who had never smoked, the relative risks of death from lung cancer were 2.73, 12.65, and 25.66 in the 1960s, 1980s, and contemporary cohorts, respectively; corresponding relative risks for male current smokers, as compared with men who had never smoked, were 12.22, 23.81, and 24.97. In the contemporary cohorts, male and female current smokers also had similar relative risks for death from chronic obstructive pulmonary disease (COPD) (25.61 for men and 22.35 for women), ischemic heart disease (2.50 for men and 2.86 for women), any type of stroke (1.92 for men and 2.10 for women), and all causes combined (2.80 for men and 2.76 for women). Mortality from COPD among male smokers continued to increase in the contemporary cohorts in nearly all the age groups represented in the study and within each stratum of duration and intensity of smoking. Among men 55 to 74 years of age and women 60 to 74 years of age, all-cause mortality was at least three times as high among current smokers as among those who had never smoked. Smoking cessation at any age dramatically reduced death rates.
Conclusions: The risk of death from cigarette smoking continues to increase among women and the increased risks are now nearly identical for men and women, as compared with persons who have never smoked. Among men, the risks associated with smoking have plateaued at the high levels seen in the 1980s, except for a continuing, unexplained increase in mortality from COPD.
Domaine : Tabac / Tobacco Refs biblio. : 36 Affiliation : Department of Epidemiology, American Cancer Society, Atlanta, GA, USA Lien : http://dx.doi.org/10.1056/NEJMsa1211127 Permalink :
in New England Journal of Medicine > Vol.368, n°4 (January 24, 2013) . - 351-364[article]Absinthe, absinthism and thujone: new insight into the spirit's impact on public health / D. W. LACHENMEIER ; D. NATHAN-MAISTER ; T. A. BREAUX ; J. P. LUAUTE ; J. EMMERT in Open Addiction Journal, Vol.3 (2010)
Titre : Absinthe, absinthism and thujone: new insight into the spirit's impact on public health Type de document : Périodique Auteurs : D. W. LACHENMEIER ; D. NATHAN-MAISTER ; T. A. BREAUX ; J. P. LUAUTE ; J. EMMERT Année de publication : 2010 Article en page(s) : 32-38 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
ALCOOL ; HISTOIRE ; ANALYSE CHIMIQUE ; EFFET SECONDAIRE ; LEGISLATION ; MESURES QUANTITATIVES
FRANCE ; EUROPE ; ETATS-UNIS
Mots-clés : Absinthe Discipline : PRO Produits, mode d'action, méthode de dépistage / Substances, action mode, screening methods Résumé : Absinthe, a strong alcoholic aperitif, is notorious for containing the compound ‘thujone’, which has been commonly regarded as its ‘active ingredient’. It has been widely theorized that the thujone content of vintage absinthe made it harmful to public health, and caused the distinct syndrome absinthism, which was extensively described in the literature prior to the spirit’s ban in 1915. The interdisciplinary research presented in this paper shows that 1) absinthism cannot be distinguished from common alcoholism in the medical research literature of the time, and that 2) due to the physical chemistry of the distillation process, the thujone content of vintage absinthe was considerably lower than previously estimated and corresponds to levels generally recognized as safe, as proven by analyses of absinthes from the pre-ban era. Due to the re-legalization of absinthe in the European Union and more recently in the United States, potential public health concerns have re-emerged, not expressly based on worries about thujone content or absinthism, but on alcohol-related harm and youth protection issues, exacerbated by marketing strategies promoting absinthe using false and discredited claims pertaining to thujone and stubbornly persistant myths. [Review's abstract] Domaine : Alcool / Alcohol Refs biblio. : 31 Affiliation : Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Karlsruhe, Germany Lien : http://dx.doi.org/10.2174/1874941001003010032 Permalink :
in Open Addiction Journal > Vol.3 (2010) . - 32-38[article]Abstinence rates following behavioral treatments for marijuana dependence / R. M. KADDEN ; M. D. LITT ; E. KABELA-CORMIER ; N. M. PETRY in Addictive Behaviors, Vol.32, n°6 (June 2007)
Titre : Abstinence rates following behavioral treatments for marijuana dependence Type de document : Périodique Auteurs : R. M. KADDEN ; M. D. LITT ; E. KABELA-CORMIER ; N. M. PETRY Année de publication : 2007 Article en page(s) : 1220-1236 Langues : Anglais (eng) Mots-clés : Thésaurus Géographique
CANNABIS ; THERAPIE COMPORTEMENTALE ; DEPENDANCE ; ABSTINENCE ; MOTIVATION
Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : Previous studies have noted particular difficulty in achieving abstinence among those who are marijuana dependent. The present study employed a dismantling design to determine whether adding contingency management (ContM) to motivational enhancement therapy plus cognitive behavioral therapy (MET+CBT), an intervention used in prior studies of treatment for marijuana dependence, would enhance abstinence outcomes. 240 marijuana dependent participants were recruited via advertisements and assigned to either MET+CBT, ContM-only, MET+CBT+ContM, or to a case-management control condition. All interventions involved 9 weekly 1-h sessions, except for the ContM-only condition whose sessions lasted about 15 min. ContM provided reinforcement for marijuana-free urine specimens, in the form of vouchers redeemable for goods or services. Follow-up data were collected at posttreatment and at 3-month intervals for 1 year. The two ContM conditions had superior abstinence outcomes: ContM-only had the highest abstinence rates at posttreatment, and the MET+CBT+ContM combination had the highest rates at later follow-ups. The roles of contingency management and coping skills training in the treatment of marijuana dependence are discussed. Domaine : Drogues illicites / Illicit drugs Affiliation : Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030-3944, USA Permalink :
in Addictive Behaviors > Vol.32, n°6 (June 2007) . - 1220-1236[article]Abstinence trajectories among treated crack cocaine users / H. A. SIEGAL
Titre : Abstinence trajectories among treated crack cocaine users Titre traduit : (Trajectoires d'abstinence parmi des patients traités pour usage de crack et de cocaïne) Type de document : Périodique Auteurs : H. A. SIEGAL ; L. LI ; R. C. RAPP Année de publication : 2002 Importance : 437-449 Présentation : graph. ; tabl. Note générale : Addictive Behaviors, 2002, 27, (3), 437-449 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE
TRAITEMENT ; ABSTINENCE ; CRACK ; COCAINE ; TRAJECTOIRE ; COMPARAISON
Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : This article reports findings from a study that investigated treatment outcomes among crack/cocaine users over a 18-month period. From a cohort of 229 subjects, three groups emerged: (1) those who had reported ongoing, stable abstinence from crack/cocaine; (2) those who had consistently used during the period; and (3) those who reported cycling between abstinence and use during the follow-up period. Analyses of variance (ANOVA) were conducted to compare the three groups in terms of intake characteristics, including demographic profile, previous treatment, motivational factors, and functioning in seven Addiction Severity Index (ASI) domains. Length of time involved in aftercare and Twelve Step participation after treatment were also contrasted among the three groups. Results showed that subjects who achieved sustained abstinence from crack/cocaine also did better in other domains such as employment, family, legal, and psychiatric than others. Stable abstinence was also significantly associated with a longer period of aftercare and frequent attendance at Twelve Step programs. Logistic regression analyses further estimated the significant impact of the posttreatment factors on the achievement of sustained abstinence. The implications of these findings for treatment services research are discussed. (Editor's abstract.) Domaine : Drogues illicites / Illicit drugs Refs biblio. : 34 Affiliation : Ctr. Interventions, Treatment, Addictions Res., Wright State Univ. Sch. Med, 216 Med. Sciences Building, Dayton, OH 45435.
Etats-Unis. United States.
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