[Mechanism of Action of Disulfiram and Treatment Optimization in Prevention of Recurrent Alcoholism].

[Mechanism of action of disulfiram and treatment optimization in prevention of recurrent alcoholism].

Praxis (Bern 1994). 2013 Jan 30; 102(3): 139-46
Mutschler J, Kiefer F

The current frequent use of disulfiram in alcohol relapse prevention, and the possible extension of the indication (cocaine addiction, pathological gambling) make in-depth knowledge about therapeutic effects, interactions, contraindications, and side effects of disulfiram in alcohol relapse prevention the psychological-psychotherapeutic and supportive effects are perhaps more important than the pharmacological effects. The efficacy and safety of supervised disulfiram treatment is verified in a number of studies (also in co-morbid psychiatric patients). In addition, in this review options were presented, which can improve the safety of the treatment with disulfiram (e.g. Ethylglucuoronide and pharmacogenetics). Given the high prevalence of alcohol dependence in our view disulfiram is used very little, although the use of disulfiram in the context of structured, multi-modal outpatient treatment programs are considered to be safe. HubMed – addiction rehab

Organizational stressors associated with job stress and burnout in correctional officers: a systematic review.

BMC Public Health. 2013; 13: 82
Finney C, Stergiopoulos E, Hensel J, Bonato S, Dewa CS

In adult correctional facilities, correctional officers (COs) are responsible for the safety and security of the facility in addition to aiding in offender rehabilitation and preventing recidivism. COs experience higher rates of job stress and burnout that stem from organizational stressors, leading to negative outcomes for not only the CO but the organization as well. Effective interventions could aim at targeting organizational stressors in order to reduce these negative outcomes as well as COs’ job stress and burnout. This paper fills a gap in the organizational stress literature among COs by systematically reviewing the relationship between organizational stressors and CO stress and burnout in adult correctional facilities. In doing so, the present review identifies areas that organizational interventions can target in order to reduce CO job stress and burnout.A systematic search of the literature was conducted using Medline, PsycINFO, Criminal Justice Abstracts, and Sociological Abstracts. All retrieved articles were independently screened based on criteria developed a priori. All included articles underwent quality assessment. Organizational stressors were categorized according to Cooper and Marshall’s (1976) model of job stress.The systematic review yielded 8 studies that met all inclusion and quality assessment criteria. The five categories of organizational stressors among correctional officers are: stressors intrinsic to the job, role in the organization, rewards at work, supervisory relationships at work and the organizational structure and climate. The organizational structure and climate was demonstrated to have the most consistent relationship with CO job stress and burnout.The results of this review indicate that the organizational structure and climate of correctional institutions has the most consistent relationship with COs’ job stress and burnout. Limitations of the studies reviewed include the cross-sectional design and the use of varying measures for organizational stressors. The results of this review indicate that interventions should aim to improve the organizational structure and climate of the correctional facility by improving communication between management and COs. HubMed – addiction rehab

Evolution of opioid risk management and review of the classwide REMS for extended-release/long-acting opioids.

Phys Sportsmed. 2012 Nov; 40(4): 12-20
Stanos S

In 2007, the Food and Drug Administration Amendments Act (FDAAA) afforded the US Food and Drug Administration (FDA) the ability to enforce postmarketing risk management strategies for prescription medicines. Under this policy, certain medications with known or potential risks could be required to have a Risk Evaluation and Mitigation Strategy (REMS), a risk management program designed to ensure that a product’s therapeutic benefit outweighs its risks. Prescription opioid analgesics, particularly extended-release (ER)/long-acting (LA) formulations, have undergone scrutiny in recent years due to the serious risks associated with their use, especially when they are prescribed improperly, misused, or abused. In July 2012, the FDA approved a classwide REMS for ER and LA opioids. This ER/LA opioid REMS program is designed to improve prescriber education and patient awareness about safe opioid use to minimize the risks of addiction, unintentional overdose, and death. Because clinicians often encounter patients with moderate-to-severe chronic, noncancer pain who are in need of around-the-clock opioid analgesia, knowledge of the conditions of this classwide REMS may become essential to continue prescribing ER/LA opioids. This article briefly describes the changes in US risk management policies that have shaped today’s regulatory environment and provides an overview of the requirements for the classwide ER/LA opioid REMS. HubMed – addiction rehab

Coping with the urge to smoke: A real-time analysis.

Res Nurs Health. 2013 Feb; 36(1): 3-15
Merchant G, Pulvers K, Brooks RD, Edwards J

Successfully coping with the urge to smoke is important to achieve smoking cessation. Nicotine-dependent smokers (N?=?123) were placed in a tempting setting in a laboratory, and the effectiveness of various coping strategies for resisting the urge to smoke were evaluated in real time. Latency (time between exposure to lit cigarettes and report of need to smoke) was the primary-dependent variable, and coping strategies listed by participants after the smoking encounter served as predictors. There was a small positive relationship between cognitive-specific strategies, such as using positive self-talk, and latency (r?=?.19, p?HubMed – addiction rehab