Twitter

JACC: Journal of the American College of Cardiology - Key Summary

• Patients aged ≤50 years presenting with their first myocardial infarction were retrospectively analyzed to evaluate the prevalence of cocaine and marijuana use and the impact on clinical outcomes. The prevalence of the use of cocaine and/or marijuana was 10.7%. Compared with patients without a history substance use, those using cocaine and/or marijuana had…a significantly higher rate of tobacco use. There was a significant association between the use of cocaine and/or marijuana and elevated cardiovascular and all-cause mortality risk.
• Approximately 10% of patients presenting with myocardial infarction at age ≤50 years are cocaine and/or marijuana users, and this substance use is associated with an increased mortality risk. Young adults presenting with a first myocardial infarction should be screened for substance use to allow intervention in order to prevent future cardiac events

For more

Twitter

Abstract – Mayo Clinic

The opioid crisis that exists today developed over the past 30 years. The reasons for this are many. Good intentions to improve pain and suffering led to increased prescribing of opioids, which contributed to misuse of opioids and even death. Following the publication of a short letter to the editor in a major medical journal declaring that those with chronic pain who received opioids rarely became addicted, prescriber attitude toward opioid use changed. Opioids were no longer reserved for treatment of acute pain or terminal pain conditions but now were used to treat any pain condition. Governing agencies began to evaluate doctors and hospitals on their control of patients' pain. Ultimately, reimbursement became tied to patients' perception of pain control. As a result, increasing amounts of opioids were prescribed, which led to dependence. When this occurred, patients sought more in the form of opioid prescriptions from providers or from illegal sources. Illegal, unregulated sources of opioids are now a factor in the increasing death rate from opioid overdoses. Stopping the opioid crisis will require the engagement of all, including health care providers, hospitals, the pharmaceutical industry, and federal and state government agencies.

For complete article

Twitter

“A complementary and necessary approach is to target the “demand” side of opioid use, namely, implementation of preventive measures, educating physicians, requiring physician continuing education for opioid prescribing licensure, and addressing why patients use opioids in the first place. Indeed, prevention of initiation of use is the only 100% safeguard against addiction; however, millions of patients remain addicted, and they need comprehensive, rather than perfunctory, treatment. Rummans and colleagues are absolutely correct in their delineation of the unwitting consequences of a focus on pain, given that a perceived undertreatment of pain fuelled the opioid epidemic in the first place. They are correct to point out how effective pain evaluation and treatment are much more than prescribing and should routinely include psychotherapy, interventional procedures, and nonopioid therapies. In addition, we have described the crossroads between pain and addiction as well as successful strategies to manage patients with both chronic pain syndromes and addiction.”

Download PDF

Twitter

CONCLUSIONS AND RELEVANCE: In this study, our findings indicate that while individuals who

use cannabis or cigarettes during adolescence have an increased risk of subsequent psychotic

experiences, epidemiological evidence is substantively more robust for cannabis use than it is

for tobacco use.

For complete study see PDF