Pharmacology Carlat Reports | Carlat Publishing

Clinical Update

From The Carlat Addiction Treatment Report, Medical Issues in Addiction Practice

Great strides have been made in HIV treatment and prevention during the last 2 decades, resulting in falling numbers of new HIV infections during that time span. But since 2013, the rate of new infections has mostly plateaued at just under 40,000 new infections per year (www.hiv.gov). Those at highest risk of infection remain men who have sex with men,

Expert Q&A

Perioperative Management of Patients on Buprenorphine Maintenance

From The Carlat Addiction Treatment Report, Medical Issues in Addiction Practice

CATR: Can you tell us about your background? Dr. Acampora: I used to work as a cardiac anesthesiologist. Later, my interest turned to addiction medicine, and I trained in psychiatry and addiction psychiatry. I currently work in a pain clinic where I helped develop a strategy for managing buprenorphine in the perioperative period. CATR: Where does th

Research Update

Varenicline and Bupropion: Soaring Again With EAGLES?

From The Carlat Addiction Treatment Report, Medical Issues in Addiction Practice

Topics: | | | | | | | | | | | | | | | | | | | | Addiction Addiction Treatment Bupropion Chantix Co-occurring disorders Dual diagnosis FDA Warnings Medication Pharmacology Research Research Update Side Effects Smoking Cessation Smoking Cessation Agents Substance Use Substance use disorders Suicidality Suicide Tobacco Varenicline Wellbutrin

Review of: Anthenelli RM et al, Lancet 2016;387(10037):2507–2520 Varenicline (Chantix) and bupropion (Zyban and others) are effective treatments for tobacco use disorder, but their use (and sales) took a big hit in 2009 when the FDA slapped both with black box warnings linking them to psychiatric complications, including suicidal ideation. Although

Research Update

The COMBINE Study: A Core Paper in the Treatment of AUD

From The Carlat Addiction Treatment Report, Medical Issues in Addiction Practice

Review of: Anton RF et al, JAMA 2006;295(17):2003–2017 Conducted from 2001 to 2004 and published in 2006, the COMBINE study was the largest pharmacotherapy study that assessed the treatment of alcohol use disorder (AUD). Although there were significant data on the use of naltrexone and acamprosate (both had been FDA approved), widespread use had no

Clinical Update

“What About the Implant, Doc?” Appraising Various Formulations of Buprenorphine

From The Carlat Addiction Treatment Report, Opioid Use Disorder Treatment

With other epidemics in the world dominating our attention, let’s not forget the epidemic of opioid-related deaths. Unlike the current viral epidemic, the opioid epidemic is eminently treatable. The figure on page 3 shows the reduction in heroin overdoses in Baltimore, MD, as increasing numbers of patients received opioid agonist treatment (Schwartz R

Clinical Update

Updated Guidelines for Treating Opioid Use Disorder

From The Carlat Addiction Treatment Report, Opioid Use Disorder Treatment

Before the COVID-19 pandemic, America was in the grip of an opioid crisis. Now, the medical community is sounding alarms that shelter-in-place orders may have triggered drug and alcohol relapses (Silva MJ et al, Am J Manag Care 2020;26(7):1–3). The American Medical Association has noted that at least 30 states have reported increases in opioid-related

Research Update

A Possible Option in Opioid-Related Harm Reduction

From The Carlat Addiction Treatment Report, Opioid Use Disorder Treatment

Topics: Harm reduction | Heroin | Opioid epidemic | Opioid Use Disorder | Pharmacology

REVIEW OF: Oviedo-Joekes E et al, JAMA Psychiatry 2016;73(5):447–455 We have effective FDA-approved medications for opioid use disorder (OUD): buprenorphine, methadone, and injectable naltrexone. Yet some patients with severe OUD decline these options. Many other countries offer a more controversial treatment—medically supervised IV administratio

Research Update

Efficacy and Acceptability of Varenicline for Alcohol Use Disorder

From The Carlat Addiction Treatment Report, Opioid Use Disorder Treatment

Topics: Alcohol | Alcohol use disorder | Pharmacology | Tobacco use disorder | Varenicline

REVIEW OF: Oon-Arom A et al, Drug Alcohol Depend 2019;205:1–9 Varenicline, a partial agonist of one of the nicotinic receptors, is approved for the treatment of tobacco use disorder and has also been found to decrease alcohol use in some individuals who smoke. Naltrexone, acamprosate, and disulfiram are FDA approved and effective for alcohol use di

Clinical Update

The “Z-Drugs”: Safety Issues and Misuse Potential