Suchergebnisse

Movement toward legalization of cannabis grows in the United States yet little is known about long‐term use effects. This study was an initial step in the instrument development of a patient registry questionnaire of cannabis users who will be followed over time. Cannabis‐using patients (12 females, 10 males) aged 20–64, were sampled from a Portland, Oregon primary care health center. Respondents completed semi­structured qualitative interviews describing methods of cannabis use, motivations for use, and perceptions of risks and benefits. Qualitative analysis used a content analysis approach to assess and extract salient themes. Patients smoked, inhaled, ingested, and applied a wide variety of cannabis products. All participants but one reported using cannabis for perceived physiological or psychological pain and several used cannabis to alleviate cravings for opioid medications. Other motivations included relief from suicidal thoughts and depression, anxiety, migraines, and neuropathic pain. Relatively few perceived risks as compared to benefits were reported. This study provides relevant insight into how and why these primary care patients use cannabis. Results will be used to construct a quantitative questionnaire for a patient registry that can provide critical information about long‐term use effects.

There is an urgent need for strategies to address the US epidemic of prescription opioid, heroin and fentanyl-related overdoses, misuse, addiction, and diversion. Evidence-based treatment such as medications for opioid use disorder (MOUD) are available but lack numbers of providers offering these services to meet the demands. Availability of electronic health record (EHR) systems has greatly increased and led to innovative quality improvement initiatives but this has not yet been optimized to address the opioid epidemic or to treat opioid use disorder (OUD). This report from a clinical decision support (CDS) working group convened by the NIDA Center for the Clinical Trials Network aims to converge electronic technology in the EHR with the urgent need to improve screening, identification, and treatment of OUD in primary care settings through the development of a CDS algorithm that could be implemented as a tool in the EHR. This aim is consistent with federal, state and local government and private sector efforts to improve access and quality of MOUD treatment for OUD, existing clinical quality and HEDIS measures for OUD or drug and alcohol use disorders, and with a recent draft grade B recommendation from the US Preventative Services Task Force (USPSTF) for screening for illicit drug use in adults when appropriate diagnosis, treatment and care services can be offered or referred. Through a face-to-face expert panel meeting and multiple follow-up conference calls, the working group drafted CDS algorithms for clinical care felt to be essential for screening, diagnosis, and management of OUD in primary care. The CDS algorithm was reviewed by addiction specialists and primary care providers and revised based on their input. A clinical decision support tool for OUD screening, assessment, and treatment within primary care systems may help improve healthcare delivery to help address the current epidemic of opioid misuse and overdose that has outpaced the capacity of specialized treatment settings. A semi-structured ...