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Opioid Use Disorder: Medical Treatment Options - American Family Physician

Oct 1, 2019 - Opioid use disorder is highly prevalent and can be fatal. At least 2.1 million Americans 12 years and older had opioid use disorder in 2016, and approximately 47,000 Americans died from opioid overdoses in 2017. Opioid use disorder is a chronic relapsing condition, the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p416.html

Primary Care for Persons Who Inject Drugs - American Family Physician

Jan 15, 2019 - More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p109.html

Stimulant and Designer Drug Use: Primary Care Management - American Family Physician

Jul 15, 2018 - Approximately 10% of the U.S. population 12 years and older reported using illicit substances in 2015. This article reviews the clinical effects and treatment of persons who use cocaine, methamphetamines, 3,4-methylenedioxymethamphetamine (MDMA), synthetic cannabinoids, and synthetic ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0715/p85.html

Autism Spectrum Disorder: Primary Care Principles - American Family Physician

Dec 15, 2016 - Autism spectrum disorder is characterized by difficulty with social communication and restricted, repetitive patterns of behavior, interest, or activities. The Diagnostic and Statistical Manual of Mental Disorders, 5th ed., created an umbrella diagnosis that includes several previously ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p972.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Identification and Management of Peripartum Depression - American Family Physician

May 15, 2016 - Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. A history of depression is the strongest risk factor for developing peripartum depression. The U.S. Preventive Services Task Force recommends screening...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p852.html

Nonpharmacologic Management of Chronic Insomnia - American Family Physician

Dec 15, 2015 - Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1058.html

Common Questions About the Pharmacologic Management of Depression in Adults - American ...

Jul 15, 2015 - One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p94.html

Recognition and Differential Diagnosis of Psychosis in Primary Care - American Family ...

Jun 15, 2015 - Psychosis is a symptom complex that may include hallucinations, delusions, disorders of thought, and disorganized speech or behavior. Acute psychosis is primary if it is symptomatic of a psychiatric disorder, or secondary if caused by a specific medical condition. Patients with primary ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p856.html

Delirium in Older Persons: Evaluation and Management - American Family Physician

Aug 1, 2014 - Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p150.html

Common Sleep Disorders in Children - American Family Physician

Mar 1, 2014 - Up to 50% of children will experience a sleep problem. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, irritability, behavioral problems, learning difficulties, motor vehicle crashes in teenagers, and poor academic performance. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p368.html

Outpatient Management of Alcohol Withdrawal Syndrome - American Family Physician

Nov 1, 2013 - Approximately 2% to 9% of patients seen in a family physician’s office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome if they abruptly abstain from alcohol use. Alcohol withdrawal syndrome begins six to 24 hours after the last intake of ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p589.html

Care of the College Student - American Family Physician

Nov 1, 2013 - There are approximately 20 million students in U.S. colleges and universities. Although this population is characterized as having good health, 600,000 students report some form of disability or some type of medical problem, including attention-deficit/hyperactivity disorder, learning ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p596.html

Management of Common Sleep Disorders - American Family Physician

Aug 15, 2013 - Sleep disorders are common and affect sleep quality and quantity, leading to increased morbidity. Patients with sleep disorders can be categorized as those who cannot sleep, those who will not sleep, those with excessive daytime sleepiness, and those with increased movements during ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0815/p231.html

A Primary Care Approach to Substance Misuse - American Family Physician

Jul 15, 2013 - Substance misuse is common among patients in primary care settings. Although it has a substantial health impact, physicians report low levels of preparedness to identify and assist patients with substance use disorders. An effective approach to office-based treatment includes a coherent...

American Family Physician : Article

https://www.aafp.org/afp/2013/0715/p113.html

Managing Difficult Encounters: Understanding Physician, Patient, and Situational ...

Mar 15, 2013 - Family physicians commonly find themselves in difficult clinical encounters. These encounters often leave the physician feeling frustrated. The patient may also be dissatisfied with these encounters because of unmet needs, unfulfilled expectations, and unresolved medical issues. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0315/p419.html

Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults - ...

May 1, 2012 - Attention-deficit/hyperactivity disorder in childhood can persist into adulthood in at least 30 percent of patients, with 3 to 4 percent of adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., diagnostic criteria. A number of conditions, such as thyroid ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0501/p890.html

Clinical Vignettes in Geriatric Depression - American Family Physician

Nov 15, 2011 - The diagnosis of depression in older patients is often complicated by comorbid conditions, such as cerebrovascular disease or dementia. Tools specific for this age group, such as the Geriatric Depression Scale or the Cornell Scale for Depression in Dementia, may assist in making the ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1149.html

Postpartum Major Depression - American Family Physician

Oct 15, 2010 - Postpartum major depression is a disorder that is often unrecognized and must be distinguished from baby blues. Antenatal depressive symptoms, a history of major depressive disorder, or previous postpartum major depression significantly increase the risk of postpartum major depression. ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1015/p926.html

Prevention, Recognition, and Management of Serotonin Syndrome - American Family Physician

May 1, 2010 - Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. Most reported cases of serotonin syndrome are in patients...

American Family Physician : Article

https://www.aafp.org/afp/2010/0501/p1139.html

Evaluation and Management of Delirium in Hospitalized Older Patients - American Family ...

Dec 1, 2008 - Delirium is common in hospitalized older patients and may be a symptom of a medical emergency, such as hypoxia or hypoglycemia. It is characterized by an acute change in cognition and attention, although the symptoms may be subtle and usually fluctuate throughout the day. This ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1265.html

Pharmacologic Management of Adult Depression - American Family Physician

Mar 15, 2008 - Major depression is a common and treatable disease. Many patients benefit from pharmacologic treatment and, because there is little variation in antidepressant effectiveness, medication choices should be made based on patient characteristics, safety, and anticipated side effects. Most ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0315/p785.html

Treating Eating Disorders in Primary Care - American Family Physician

Jan 15, 2008 - Binge-eating disorder, bulimia nervosa, and anorexia nervosa are potentially life-threatening disorders that involve complex psychosocial issues. A strong therapeutic relationship between the physician and patient is necessary for assessing the psychosocial and medical factors used to ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0115/p187.html

Methamphetamine Abuse - American Family Physician

Oct 15, 2007 - Methamphetamine is a stimulant commonly abused in many parts of the United States. Most methamphetamine users are white men 18 to 25 years of age, but the highest usage rates have been found in native Hawaiians, persons of more than one race, Native Americans, and men who have sex with ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1015/p1169.html

Disaster-Related Physical and Mental Health: A Role for the Family Physician - American...

Mar 15, 2007 - Natural disasters, technologic disasters, and mass violence impact millions of persons each year. The use of primary health care services typically increases for 12 or more months following major disasters. A conceptual framework for assisting disaster victims involves understanding the...

American Family Physician : Article

https://www.aafp.org/afp/2007/0315/p841.html

Managing Opioid Addiction with Buprenorphine - American Family Physician

May 1, 2006 - Legislation has enabled physicians to treat opioid-dependent patients with an office-based maintenance program using buprenorphine, a partial mu-opioid receptor agonist. Clinical studies indicate buprenorphine effectively manages opioid addiction. Buprenorphine is more effective than ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0501/p1573.html

Management of the Difficult Patient - American Family Physician

Nov 15, 2005 - All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Difficulties may be traced to patient, physician, or health care system factors. Patient factors include psychiatric disorders, personality ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2063.html

Medications for Treating Alcohol Dependence - American Family Physician

Nov 1, 2005 - Medications for treating alcohol dependence primarily have been adjunctive interventions, and only three medications--disulfiram, naltrexone, and acamprosate--are approved for this indication by the U.S. Food and Drug Administration. Disulfiram, an aversive agent that has been used for ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1775.html

Ambulatory Detoxification of Patients with Alcohol Dependence - American Family Physician

Feb 1, 2005 - Detoxification from alcohol can be undertaken in ambulatory settings with patients who are alcohol-dependent and show signs of mild to moderate withdrawal when they are not drinking. An appropriate candidate for outpatient detoxification should have arrangements to start an alcohol ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0201/p495.html

Club Drugs: MDMA, Gamma-Hydroxybutyrate (GHB), Rohypnol, and Ketamine - American Family...

Jun 1, 2004 - Club drugs are substances commonly used at nightclubs, music festivals, raves, and dance parties to enhance social intimacy and sensory stimulation. The most widely used club drugs are 3,4-methylenedioxymethamphetamine (MDMA), also known as ecstasy; gamma-hydroxybutyrate (GHB); ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2619.html

Depression in Later Life: A Diagnostic and Therapeutic Challenge - American Family ...

May 15, 2004 - Depression in elderly persons is widespread, often undiagnosed, and usually untreated. The current system of care is fragmented and inadequate, and staff at residential and other facilities often are ill-equipped to recognize and treat patients with depression. Because there is no ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0515/p2375.html

Alcohol Withdrawal Syndrome - American Family Physician

Mar 15, 2004 - The spectrum of alcohol withdrawal symptoms ranges from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens. Although the history and physical examination usually are sufficient to diagnose alcohol withdrawal ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0315/p1443.html

Recognition of Alcohol and Substance Abuse - American Family Physician

Apr 1, 2003 - Ten percent of the population abuses drugs or alcohol, and 20 percent of patients seen by family physicians have substance-abuse problems, excluding tobacco use. These patients can be identified by relying on regular screening or a high index of suspicion based on

American Family Physician : Article

https://www.aafp.org/afp/2003/0401/p1529.html

Smoking Cessation: Integration of Behavioral and Drug Therapies - American Family ...

Mar 15, 2002 - Family physicians should take advantage of each contact with smokers to encourage and support smoking cessation. Once a patient is identified as a smoker, tools are available to assess readiness for change. Using motivational interviewing techniques, the physician can help the patient ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0315/p1107.html

Evaluation and Treatment of ADHD - American Family Physician

Sep 1, 2001 - Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder. The recommended evaluation also includes documenting the ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0901/p817.html

Assessment and Treatment of Depression Following Myocardial Infarction - American ...

Aug 15, 2001 - Approximately 65 percent of patients with acute myocardial infarction report experiencing symptoms of depression. Major depression is present in 15 to 22 percent of these patients. Depression is an independent risk factor in the development of and mortality associated with ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0815/p641.html

The Child With ADHD: Using the AAP Clinical Practice Guideline - American Family Physician

May 1, 2001 - The American Academy of Pediatrics developed an evidence-based clinical practice guideline that provides recommendations for the assessment and diagnosis of school-aged children with attention-deficit/hyperactivity disorder (ADHD). This guideline, the first of two guidelines to provide ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0501/p1803.html

Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for ...

Jan 1, 2001 - The relationship between spirituality and medicine has been the focus of considerable interest in recent years. Studies suggest that many patients believe spirituality plays an important role in their lives, that there is a positive correlation between a patient's spirituality or ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0101/p81.html

Adult ADHD: Evaluation and Treatment in Family Medicine - American Family Physician

Nov 1, 2000 - Attention-deficit/hyperactivity disorder (ADHD) affects 30 to 50 percent of adults who had ADHD in childhood. Accurate diagnosis of ADHD in adults is challenging and requires attention to early development and symptoms of inattention, distractibility, impulsivity and emotional lability....

American Family Physician : Article

https://www.aafp.org/afp/2000/1101/p2077.html

Generalized Anxiety Disorder - American Family Physician

Oct 1, 2000 - Patients with generalized anxiety disorder experience worry or anxiety and a number of physical and psychologic symptoms. The disorder is frequently difficult to diagnose because of the variety of presentations and the common occurrence of comorbid medical or psychiatric conditions. The...

American Family Physician : Article

https://www.aafp.org/afp/2000/1001/p1591.html

Alcoholism in the Elderly - American Family Physician

Mar 15, 2000 - Alcohol abuse and alcoholism are common but underrecognized problems among older adults. One third of older alcoholic persons develop a problem with alcohol in later life, while the other two thirds grow older with the medical and psychosocial sequelae of early-onset alcoholism. The ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1710.html

Depression Without Sadness: Alternative Presentations of Depression in Late Life - ...

Sep 1, 1999 - Older adults often deny feeling sad while exhibiting other characteristics of depression. Elderly patients with depression who do not present with sadness often have unexplained somatic complaints and exhibit a sense of hopelessness. Anxiety and anhedonia (a general loss of ability to ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0901/p820.html

Postpartum Major Depression: Detection and Treatment - American Family Physician

Apr 15, 1999 - Postpartum major depression occurs in approximately one of 10 childbearing women and is considerably underdiagnosed. If left untreated, the disorder can have serious adverse effects on the mother and her relationship with significant others, and on the child's emotional and psychologic ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2247.html

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