BestBETs
|
 Source: bestbets.org |
| Clinical Resource: Evidence Based Answers to Clinical Questions |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
The Cochrane Collaboration
Cochrane Reviews - Tobacco, Drugs and Alcohol
The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.
| Source: cochrane.org |
| Clinical Resource: Systematic Reviews |
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| Last Checked: 13/07/15 | Link Error: Report It |
In these pages are collected the stories from Bandolier relating to drug abuse.
| Source: bandolier.org.uk |
| Clinical Resource: Evidence Based Abstracts |
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| Last Checked: 13/06/17 | Link Error: Report It |
Royal College of General Practitioners Substance Misuse Unit
Royal College of General Practitioners Sex, Drugs & HIV Task Group
Substance Misuse Management in General Practice
Hepatitis C Trust
UK Hepatitis C Resource Centre
Release
This guidance has been produced to aid medical practitioners and others in the management of hepatitis C infection in primary care.
| Source: rcgp.org.uk |
| Clinical Resource: Guidance |
| Register to Access Content: No |
| Last Checked: 02/12/16 | Link Error: Report It |
This booklet provides up-to-date information about hepatitis C and injecting drug use. It has been designed for professionals working with injecting drug users (IDUs).
| Source: britishlivertrust.org.uk |
| Clinical Resource: Publication |
| Register to Access Content: No |
| Last Checked: 22/11/13 | Link Error: Report It |
| Source: nice.org.uk |
| Clinical Resource: Guidance |
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| Last Checked: 10/11/17 | Link Error: Report It |
Royal College of General Practitioners Substance Misuse & Associated Health
Substance Misuse Unit
Royal College of General Practitioners Sex, Drugs and HIV Group
Substance Misuse Management in General Practice
The Alliance
This guidance is to aid primary care clinicians and others in the use of substitute medication for opioid dependence when prescribing for maintenance or detoxification.
| Source: rcgp.org.uk |
| Clinical Resource: Guidance |
| Register to Access Content: No |
| Last Checked: 02/12/16 | Link Error: Report It |
The Buprenorphine/Naloxone for Opioid Dependence: Clinical Practice Guideline provides clinical recommendations for the initiation, maintenance and discontinuation of buprenorphine/ naloxone maintenance treatment in patients with opioid dependence in Ontario. The guideline will help educate practitioners in opioid prescribing, improve access to treatment for opioid dependence and lead to the safer prescribing and dispensing of buprenorphine/ naloxone.
| Source: knowledgex.camh.net |
| Clinical Resource: Guideline |
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| Last Checked: 08/07/13 | Link Error: Report It |
This book provides a comprehensive background on the history, research, pharmacology and legal aspects of methadone prescribing. It focuses on this single substance in practical aspects of assessment, treatment aims, dosages and detoxification and should be a valuable reference for workers in the field.
| Source: drugtext.org |
| Clinical Resource: Book |
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| Last Checked: 08/07/13 | Link Error: Report It |
This paper examines evidence-based principles and expert opinions regarding “best practice” approaches. Such information can help shape clinical intuition allowing practitioners to reliably prescribe more adequate and safe doses of methadone for better patient care and achieving favorable treatment outcomes.
| Source: atforum.com |
| Clinical Resource: Paper |
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| Last Checked: 19/10/15 | Link Error: Report It |
Traditionally, methadone has been used for the treatment of opioid dependence. It is now being used with increased frequency as an analgesic due to its low cost, long half-life, rapid onset, and safety in chronic renal failure and stable liver failure. Methadone’s use as an analgesic is controversial because of its variable kinetics, potential toxicities, and a recent increase in the number of fatalities associated with use in this setting.
| Source: utah.edu |
| Clinical Resource: Poison Control Centre Newsletter |
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| Last Checked: 21/08/15 | Link Error: Report It |
This paper briefly summarizes the published research concerning methadone affects on cardiac repolarization and TdP. Clinical suggestions are offered in identifying individual patient cardiac risk factors and for optimizing cardiac safety during MMT.
| Source: atforum.com |
| Clinical Resource: Paper |
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| Last Checked: 21/08/15 | Link Error: Report It |
This booklet can be considered as a combination of a short review of the scientific evidence and the experience in clinical practice with regard to buprenorphine substitute treatment. The booklet is divided into two main parts.
In Part 1, opioid dependence is discussed and questions are addressed such as: What is addiction? What is substitution treatment? How many people are addicted world-wide and what sort of treatment do they get?
In Part 2, the critical questions are examined, which were raised in the audit amongst experts in the field. This part is divided into three chapters: part 2.1 addresses clinical issues, part 2.2 non-clinical issues and in part 2.3 some patient perspectives are discussed.
| Source: q4q.nl |
| Clinical Resource: Booklet |
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| Last Checked: 08/07/13 | Link Error: Report It |
Providers' Clinical Support System Guidance: Transfer from Methadone to Buprenorphine
| Source: pcssmat.org |
| Clinical Resource: Guidance |
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| Last Checked: 20/08/15 | Link Error: Report It |
In situations where a woman is pregnant and taking opioids, opioids cross the placenta. Therefore, withdrawal has the same physical effects on the fetus as it does on the woman.
| Source: knowledgex.camh.net |
| Clinical Resource: Advice |
| Register to Access Content: No |
| Last Checked: 20/03/13 | Link Error: Report It |
Providers' Clinical Support System Guidance: Pregnancy and Buprenorphine Treatment
| Source: pcssmat.org |
| Clinical Resource: Guidance |
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| Last Checked: 20/08/14 | Link Error: Report It |
Buprenorphine is a partial opioid agonist analgesic that exhibits high affinity for mu receptors and causes blockade of other opioid agonists. Some of its properties are summarised in Box 1. It can be prescribed on alternate days.
| Source: rcpsych.org |
| Clinical Resource: Journal Article |
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| Last Checked: 08/07/13 | Link Error: Report It |
Section Contents
Understanding Methadone Metabolism & Drug Interactions
Table 1: Drugs That Are Contraindicated with Methadone (May Precipitate Opioid Withdrawal)
Table 2: Drugs That May Result in Altered Metabolism or Unpredictable Interactions with Methadone
Table 3: Drugs That May Lower SML and/or Decrease Methadone Effects
Table 4: Drugs That May Raise SML and/or Increase Methadone Effects
Table 5: Methadone-Drug Interactions: Alphabetical Listing by Generic & Brand Names
| Source: atforum.com |
| Clinical Resource: Document |
| Register to Access Content: No |
| Last Checked: 21/08/15 | Link Error: Report It |
A consensus statement prepared by The British Pain Society in collaboration with The Royal College of Psychiatrists, The Royal College of General Practitioners and The Advisory Council on the Misuse of Drugs
This document aims to identify elements of good practice in the management of pain and in the prescription of opioid drugs. It provides non-specialists with appropriate information to assess the needs of and manage pain in patients who are or have previously been substance misusers. The document also gives guidance on models of collaborative working among relevant healthcare professionals involved in the care of patients with pain who are using, or are at risk of using, drugs inappropriately. It therefore aims to improve practice in managing this group of patients with complex needs.
| Source: britishpainsociety.org |
| Clinical Resource: Consensus Statement |
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| Last Checked: 17/07/15 | Link Error: Report It |
A consensus statement prepared on behalf of the British Pain Society, the Faculty of Pain Medicine of the Royal College of Anaesthetists, the Royal College of General Practitioners and the Faculty of Addictions of the Royal College of Psychiatrists
This guidance has been written for all healthcare professionals who manage patients with persistent pain, to help their understanding of the role of opioids in pain management. The document outlines good practice regarding decision making in relation to opioid therapy, ongoing monitoring of treatment and identification and management of problems related to opioid use.
| Source: britishpainsociety.org |
| Clinical Resource: Consensus Statement |
| Register to Access Content: No |
| Last Checked: 17/07/15 | Link Error: Report It |
The intent of this book is to help clinicians make practical sense of the varied and often conflicting issues (pharmacological, clinical, and regulatory) surrounding opioid pharmacotherapy, in order to promote the most healthful outcomes possible for patients in pain. The aim is to improve knowledge and skills related to both the principles of prescribing and the management of risk. In this way, healthcare professionals and those they serve may benefit increasingly from the unique therapeutic potential of this drug class, and fear less the undeniable, yet manageable, potential for harm.
| Source: stoppain.org |
| Clinical Resource: Book |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
We provide an opioid conversion table for commonly used opioid preparations to help clinicians better understand the relationship between these agents and methadone. Conversion must take into consideration clinical issues that affect translation of equivalents to and from methadone.
| Source: nih.gov |
| Clinical Resource: Journal Article |
| Register to Access Content: No |
| Last Checked: 28/11/16 | Link Error: Report It |
| Source: pcssmat.org |
| Clinical Resource: Guidance |
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| Last Checked: 20/08/15 | Link Error: Report It |
Royal College of General Practitioners Drug & Alcohol Misuse Training Programme
Royal College of General Practitioners Sex, Drugs and HIV Task Group
Substance Misuse Management in General Practice
The guidance is aimed at all those involved in primary care working with adults using cocaine, including GPs and other team members. It will also be useful to all working in the community with drug users.
| Source: rcgp.org.uk |
| Clinical Resource: Guidance |
| Register to Access Content: No |
| Last Checked: 02/12/16 | Link Error: Report It |
This monograph contains information about the effects that benzodiazepines have on the brain and body and how these actions are exerted. Detailed suggestions on how to withdraw after long-term use and individual tapering schedules for different benzodiazepines are provided. Withdrawal symptoms, acute and protracted, are described along with an explanation of why they may occur and how to cope with them.
| Source: benzo.org.uk |
| Clinical Resource: Manual |
| Register to Access Content: No |
| Last Checked: 20/06/13 | Link Error: Report It |
This information is designed to assist doctors in the management of patients ceasing benzodiazepine use, and is to be read in conjunction with the patient resource called ‘Benzodiazepines: Reasons to stop and stopping use.
| Source: sahealth.sa.gov.au |
| Clinical Resource: Material |
| Register to Access Content: No |
| Last Checked: 28/01/14 | Link Error: Report It |
| Source: sahealth.sa.gov.au |
| Clinical Resource: Conversion Chart |
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| Last Checked: 28/11/16 | Link Error: Report It |
Calculating equivalent doses of oral benzodiazepines
Benzodiazepines are the most commonly used anxiolytics and hypnotics. There are major differences in potency between different benzodiazepines and this difference in potency is important when switching from one benzodiazepine to another.
| Source: sussexpartnership.nhs.uk |
| Clinical Resource: Document |
| Register to Access Content: No |
| Last Checked: 28/11/16 | Link Error: Report It |
This review aims to answer key questions relating to cannabis and the risks associated with its use. It was commissioned by the Australian National Council on Drugs (ANCD) for an audience including the media, key decision makers and their advisers, the alcohol and other drug sector, and interested members of the community.
This review of the current research and clinical literature reflects the status of the evidence up to the end of 2004 and involved the review of around 700 papers in international peer-reviewed journals and high quality reports. In addition, several international experts reviewed this document and commended it as an accurate synthesis, reflecting complex evidence.
| Source: atoda.org.au |
| Clinical Resource: Research Paper |
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| Last Checked: 19/10/15 | Link Error: Report It |
Comprehensive Urine Drug Test (UDT)
| Source: paineducation.vcu.edu |
| Clinical Resource: Table |
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| Last Checked: 13/03/14 | Link Error: Report It |
Immunoassay Urine Drug Test (UDT)
| Source: paineducation.vcu.edu |
| Clinical Resource: Table |
| Register to Access Content: No |
| Last Checked: 13/03/14 | Link Error: Report It |
Drugs of Abuse: Approximate Detection Times Table
| Source: mayomedicallaboratories.com |
| Clinical Resource: Table |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
Drugs of Abuse Detection Period
| Source: paml.com |
| Clinical Resource: Table |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
Toxicology screening is a tool frequently used in the initial evaluation of poisoned patients. It is also commonly used in the community setting by employers and in courtmandated drug testing programs.
| Source: utah.edu |
| Clinical Resource: Poison Control Center Newsletter |
| Register to Access Content: No |
| Last Checked: 13/03/14 | Link Error: Report It |
False-positive reports on urine drug screens by immunoassay are rare (strength of recommendation [SOR]: C, small controlled-exposure studies, small case series). Nonsteroidal anti-inflammatory drugs, fluoroquinolones, and Vicks Inhaler are most frequently implicated.
| Source: jfponline.com |
| Clinical Resource: Evidence Based Answer to Clinical Question |
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| Last Checked: 13/03/14 | Link Error: Report It |
What drugs are likely to interfere with urine drug screens?
| Source: uic.edu |
| Clinical Resource: Frequently Asked Question |
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| Last Checked: 04/12/15 | Link Error: Report It |
Interpretation of Urine Drug Test (UDT) based on Opioid Prescribed
| Source: paineducation.vcu.edu |
| Clinical Resource: Table |
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| Last Checked: 13/03/14 | Link Error: Report It |
| Source: nice.org.uk |
| Clinical Resource: Guidance |
| Register to Access Content: No |
| Last Checked: 18/05/15 | Link Error: Report It |
| Source: nice.org.uk |
| Clinical Resource: Guidance |
| Register to Access Content: No |
| Last Checked: 18/05/15 | Link Error: Report It |
This review covers the published international research literature on alcohol interventions and treatment.
| Source: nta.nhs.uk |
| Clinical Resource: Publication |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
The Alcohol Identification and Brief Advice e-learning project (Alcohol IBA) helps professionals with identifying those individuals whose drinking might be impacting on their health and delivering simple, structured advice. It has been developed in partnership with the Department of Health's Alcohol Policy Team and e-Learning for Healthcare.
We have developed three e-learning coursed to date. You are encouraged to visit the e-learning course that is most appropriate to your profession.
| Source: alcohollearningcentre.org.uk |
| Clinical Resource: CE / CPD / Learning |
| Register to Access Content: Yes - registration is FREE |
| Last Checked: 08/07/13 | Link Error: Report It |
| Source: surgicalcriticalcare.net |
| Clinical Resource: Guideline |
| Register to Access Content: No |
| Last Checked: 21/08/15 | Link Error: Report It |
When hazardous or harmful drinking is first identified in primary care or the hospital setting, patients should be offered brief intervention.
| Source: nih.gov |
| Clinical Resource: Journal Article |
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| Last Checked: 08/07/13 | Link Error: Report It |
This paper reviews the scope of the problem, the neurochemistry of alcoholism, the available agents, and how physicians can help.
| Source: mdedge.com |
| Clinical Resource: Journal Article |
| Register to Access Content: Yes - registration is FREE |
| Last Checked: 19/06/17 | Link Error: Report It |
Acamprosate, a medication that has been used in Europe for years, is the newest drug to be approved by the US Federal Drug Administration for the treatment of alcohol dependence. It has been shown to assist in the maintenance of abstinence in recently detoxified alcohol-dependent individuals. The following review delineates the proposed mechanism of action and pharmacokinetics of the drug. Findings of clinical trials are outlined and topics such as cost effectiveness, comparison with other medications used for the treatment of alcohol dependences as well as combination pharmacotherapy are discussed.
| Source: nih.gov |
| Clinical Resource: Journal Article |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
Have you ever wondered which of your patients continue to drink alcohol during pregnancy? Have you deliberated about how to best educate the pregnant alcohol-dependent women who presents to your practice without prenatal care? Have you been concerned about the risk of suicide or of a psychiatric illness in one of your patients who is pregnant and drinking alcohol?
If you have, then the following questions and answers should serve as a stimulus for the management of the psychiatric aspects of alcohol use during pregnancy and the postpartum period for mother and the neonate.
| Source: nih.gov |
| Clinical Resource: Journal Article |
| Register to Access Content: No |
| Last Checked: 07/04/14 | Link Error: Report It |
The content for this series of physician training materials on alcohol use and pregnancy was developed in partnership with:
• Motherisk • Centre for Addiction and Mental Health • City of Hamilton Social & Public Health Services • Health Canada, Population and Public Health Branch, Ontario Region • Breaking the Cycle • FASworld Canada • AWARE • FOCUS Resource Centre • Equay wuk • and concerned physicians
This guide, designed as part of a training module, informs physicians about alcohol use and abuse in pregnancy and to support physicians in appropriate screening and assessment of their pregnant patients and provides tools and resources.
| Source: beststart.org |
| Clinical Resource: Handbook |
| Register to Access Content: No |
| Last Checked: 07/05/14 | Link Error: Report It |
Tool for health care providers to assess and inform pregnant patients about the risk of alcohol use in pregnancy and includes a table that illustrates the time clearance of alcohol from breast milk of women, according to mother's weight, amount of alcohol consumed and hours since consumption.
| Source: beststart.org |
| Clinical Resource: Tool |
| Register to Access Content: No |
| Last Checked: 07/05/14 | Link Error: Report It |
The following table provides information on the potential for interaction between alcohol and common medications.
| Source: usask.ca |
| Clinical Resource: Drug Information Services Newsletter |
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| Last Checked: 19/10/15 | Link Error: Report It |
There are a number of classes of drugs that can potentially interact with alcohol (e.g., antibiotics, antidepressants, sedative/hypnotics, opioids, anticoagulants, etc). The included chart summarizes common alcohol-medication interactions including precautions and recommendations for alcohol consumption.
| Source: hamsnetwork.org |
| Clinical Resource: Detail Document |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
This guidance applies to general psychiatry units, but may not be suitable for application on specialist units caring for patients who are known alcohol abusers or are alcohol dependent.
| Source: sussexpartnership.nhs.uk |
| Clinical Resource: Guidance |
| Register to Access Content: No |
| Last Checked: 02/09/15 | Link Error: Report It |
Patients often express concerns about interactions between their medicines and alcohol and any illicit drugs that they may consume. Doctors and pharmacists are also often asked about interactions, especially short courses of antibiotics, which might reduce the efficacy of oral contraceptives.
| Source: nps.org.au |
| Clinical Resource: Journal Article |
| Register to Access Content: No |
| Last Checked: 08/08/16 | Link Error: Report It |
Many medications can interact with alcohol, leading to increased risk of illness, injury, or death. For example, it is estimated that alcohol medication interactions may be a factor in at least 25 per cent of all emergency room admissions. An unknown number of less serious interactions may go unrecognized or unrecorded. This Beyond the ABCs notes some of the most significant alcohol-drug interactions. (Although alcohol can interact with illicit drugs as well, the term “drugs” is used here to refer exclusively to medications, whether prescription or non-prescription.)
| Source: albertahealthservices.ca |
| Clinical Resource: Publication |
| Register to Access Content: No |
| Last Checked: 08/07/13 | Link Error: Report It |
This educational guide is intended to provide advice that may reduce harm to patients who use substances such as the drugs cocaine, LSD, Marijuana, etc. and there effects on the human mind and body
| Source: nynjaetc.org |
| Clinical Resource: Guide |
| Register to Access Content: No |
| Last Checked: 20/05/14 | Link Error: Report It |
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