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Substance Abuse rehabilitation

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101. 2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN Key Data Elements and Definitions for Peripheral Atherosclerotic Vascular Disease

) Treatment for alcohol dependency For patients with alcohol dependency, note treatment for dependency, cessation of use, or continued use. Illicit drug use Indicate history of current, recent, or remote abuse of any illicit drug (eg, cocaine, methamphetamine, marijuana) or controlled substance. Choose 1 of the following: ? Yes ? No Evidence of Atherosclerosis History of MI The term myocardial infarction should be used when there is evidence of myocardial necrosis in a clinical setting consistent (...) 2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN Key Data Elements and Definitions for Peripheral Atherosclerotic Vascular Disease A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Peripheral Atherosclerotic Vascular Disease) Developed in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation, American Academy of Neurology, American Association

2012 Society for Cardiovascular Angiography and Interventions

102. Management of Chronic Pain in Survivors of Adult Cancers

should be assessed. Clinicians should clearly understand terminology such as tolerance, dependence, abuse, and addiction as it relates to the use of opioids and should incorporate universal precautions to minimize abuse, addiction, and adverse consequences. Additional information is available at and . INTRODUCTION Section: As a result of extraordinary advancements in diagnosis and treatment, approximately 14 million individuals with a history of cancer (excluding nonmelanomatous skin cancers (...) factors) and captures information about cancer treatment history and comorbid conditions, psychosocial and psychiatric history (including substance use), and prior treatments for the pain. The assessment should characterize the pain, clarify its cause, and make inferences about pathophysiology. A physical examination should accompany the history, and diagnostic testing should be performed when warranted. (Informal consensus; benefits outweigh harms; evidence quality: insufficient strength

2016 American Society of Clinical Oncology Guidelines

104. A consensus document for the selection of lung transplant candidates: 2014 - An update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation

associated with the inability to cooperate with the medical/allied health care team and/or adhere with complex medical therapy. • Absence of an adequate or reliable social support system. • Severely limited functional status with poor rehabilitation potential. • Substance abuse or dependence (e.g., alcohol, tobacco, marijuana, or other illicit substances). In many cases, convincing evidence of risk reduction behaviors, such as meaningful and/or long-term participation in therapy for substance abuse (...) and/or dependence, should be required before offering lung transplantation. Serial blood and urine testing can be used to verify abstinence from substances that are of concern. Relative contraindications • Age >65 years in association with low physiologic reserve and/or other relative contraindications. Although there cannot be endorsement of an upper age limit as an absolute contraindication, adults >75 years old are unlikely to be candidates for lung transplantation in most cases. Although age by itself

2015 International Society for Heart and Lung Transplantation

105. The Management of Chronic Multisymptom Illness

., abuse history), and occupational/environmental (e.g., chemical exposure). The categories of diagnostic technologies considered under this CPG include biomarkers (biological markers and neuroimaging studies), neuropsychological test batteries, and sleep studies. Some of the management approaches considered include team-based approaches, core competencies of the treatment team, patient-provider communication styles, the role of occupational and other rehabilitative services, behavioral health services (...) of 89 orientation to time, orientation to place, memorizing and repeating three non-related items, and spelling “world” backwards). [11] A psychosocial assessment is also critical in evaluating the patient with multisymptom illness and should include a screening for suicidal ideation and substance use disorders. The Patient Health Questionnaire (PHQ) is an excellent screening tool for assessing the presence of the most common psychiatric conditions associated with complaints of fatigue: depression

2014 VA/DoD Clinical Practice Guidelines

106. Treatment and recommendations for homeless people with Opioid Use Disorders

the plan of care; implement strategies to minimize risk of diversion/ misuse (random drug tests, alternate day dosing, prescription monitoring program, directly observed therapy). Balance overall benefits of continuing MAT with potential harms. FOLLOW-UP ? Determine frequency of follow-up based on stability of the patient and his/her living situation and risk of diversion/ misuse/ abuse of medications used for treatment of opioid use disorders or other substances. ? At each visit, assess for behaviors (...) condition does not necessarily cause the other, but each can exacerbate problems associated with the other. Substance abuse can be both a precipitating factor and a consequence of homelessness.” (Zerger 2002) Barriers to treatment for homeless people with opioid use disorders Limited access to addiction treatment and fragmented health care delivery systems present significant obstacles to medical care for homeless people with substance use disorders, many of whom have serious co-occurring disorders

2014 National Health Care for the Homeless Council

107. Management of Concussion-mild Traumatic Brain Injury (mTBI)

of Injury. The Centers for Disease Control and Prevention (CDC) estimate that approximately 2.2 million emergency department visits and 50,000 deaths occur annually due to TBI.[2] In the 2014 CDC Report to Congress “Traumatic Brain Injury In the United States: Epidemiology and Rehabilitation,” according to data from the DoD, 235,046 Service Members (or 4.2% of the 5,603,720 who served in the Army, Air Force, Navy, and Marine Corps) were diagnosed with a TBI between 2000 and 2011.[2] Similarly (...) that are important and relevant to the management of mTBI, from which Work Group members were recruited. The specialties and clinical areas of interest included: blind rehabilitation, family medicine, occupational therapy (OT), language neurology, nursing, pharmacy, physical medicine and rehabilitation (PM&R), physical therapy (PT), polytrauma care, primary care, psychiatry, psychology, and speech-language pathology. The guideline development process for the 2016 CPG update consisted of the following steps: 1

2016 VA/DoD Clinical Practice Guidelines

108. Obesity Prevention and Management

supervised weight loss program for a minimum of six months (including monthly documentation of weight, dietary, exercise and lifestyle modifications at each visit) without achieving significant weight loss. The supervised weight loss program usually should have occurred within the past 2 years, although some insurance companies will include the past 4 years. Absolute contraindications to bariatric surgery include pregnancy, lactation, active substance abuse, end-stage cardiovascular disease, severe (...) for patients with severe obesity and making little/limited progress Registered dietitian for help with dietary modifications Endocrine specialist for adult patients with BMI > 30 whose excess weight may be due to an endocrine disorder. Physical Medicine and Rehabilitation for patients with arthritis, joint, or mobility concerns Social work and mental health for issues regarding personal resources and emotional concerns Surgeon for consideration of bariatric surgery (see requirements of patients, listed

2016 University of Michigan Health System

109. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians

anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence). (Grade: strong recommendation) Recommendation 2: For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant (...) low back pain, radicular low back pain, or symptomatic spinal stenosis. The review evaluated pharmacologic (acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, skeletal muscle relaxants [SMRs], benzodiazepines, antidepressants, antiseizure medications, and systemic corticosteroids) and nonpharmacologic (psychological therapies, multidisciplinary rehabilitation, spinal manipulation, acupuncture, massage, exercise and related therapies, and various physical modalities) treatments

2017 American College of Physicians

110. Management of Posttraumatic Stress Disorder and Acute Stress Reaction

, in person, the event(s) as it occurred to others 3. Learning that the event(s) occurred to a close family member or close friend Note: In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, police officers repeatedly exposed to details of child abuse) Note: This does not apply to exposure through (...) for at least three days and up to a month is needed to meet disorder criteria. Criterion D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion E. The disturbance is not attributable to the physiological effects of a substance (e.g., medication or alcohol) or another medical condition (e.g., mild traumatic brain injury) and is not better explained by brief psychotic disorder. *Reprinted with permission

2017 VA/DoD Clinical Practice Guidelines

111. Diagnosis and Treatment of Low Back Pain

or interdisciplinary rehabilitation program which should include at least one physical component and at least one other component of the biopsychosocial model (psychological, social, occupational) used in an explicitly coordinated manner. Weak for Reviewed, New-replaced *For additional information, please refer to Grading Recommendations. †For additional information, please refer to Recommendation Categorization and Appendix A. VA/DoD Clinical Practice Guideline for Diagnosis and Treatment of Low Back Pain (...) research questions on which to base an SR about the diagnosis and treatment of LBP. The group also identified a list of clinical specialties and areas of expertise that were important and relevant to the diagnosis and treatment of LBP, from which Work Group members were recruited. The specialties and clinical areas of interest included: chiropractic care, integrative medicine, neurology, nursing, pain medicine, pharmacy, physical medicine and rehabilitation, physical therapy, primary care, radiology

2017 VA/DoD Clinical Practice Guidelines

112. Management of Opioid Therapy (OT) for Chronic Pain

(acute and chronic) in the U.S., as well as the disability and morbidity associated with pain.[26] Government agencies, including the VA, DoD, and Substance Abuse and Mental Health Services Administration (SAMHSA), have also launched initiatives to improve the study and treatment of pain and adverse events associated with opioid analgesics such as OUD and overdose.[27] By August 2013, the VA deployed the Opioid Safety Initiative (OSI) requirements to all Veterans Integrated Service Networks (VISNs (...) ), assessment for opioid use disorder, and consideration for tapering when risks exceed benefits (see Recommendation 14). Strong for Reviewed, New- replaced 4. a) We recommend against long-term opioid therapy for pain in patients with untreated substance use disorder. b) For patients currently on long-term opioid therapy with evidence of untreated substance use disorder, we recommend close monitoring, including engagement in substance use disorder treatment, and discontinuation of opioid therapy for pain

2017 VA/DoD Clinical Practice Guidelines

113. Attention-Deficit Hyperactivity Disorder

). ? School interventions: children with ADHD may qualify for a 504 education plan or special education services with individualized education plan (IEP) [ID] (see Appendices A3 & A4). Special Populations or Circumstances Special considerations apply to: 3-5 year olds, adolescents and adults, head-injured, intellectually disabled/autistic, fetal alcohol syndrome, and substance-abusing patients (see Appendix B3). Controversial Areas Common myths. Several common beliefs related to ADHD are untrue, e.g (...) to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events

2013 University of Michigan Health System

114. Professional Practice Guidelines for the Psychological Practice with Boys and Men

problems (e.g., cardiovascular problems), public health concerns (e.g., violence, substance abuse, incarceration, and early mortality), and a wide variety of other quality-of-life issues (e.g., relational problems, family well-being; for comprehensive reviews, see Levant & Richmond, 2007; Moore & Stuart, 2005; O’Neil, 2015). Additionally, many men do not seek help when they need it, and many report distinc- tive barriers to receiving gender-sensitive psychological treatment (Mahalik, Good, Tager (...) may be more likely to be diagnosed with externalizing disorders (e.g., con- duct disorder and substance use disorders) (Cochran & Rabinowitz, 2000). Indeed, therapists’ gender role stereotypes about boys’ externalizing behaviors may explain why boys are dispropor- tionately diagnosed with ADHD compared to girls (Bruchmüller, Margaf, & Schneider, 2012). Other investigations have identified systemic gender bias toward adult men in psychotherapy (Mahalik et al., 2012) and in other helping services

2019 American Psychological Association

115. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence

intervention compared with standard care? 38 4.5 For people with moderate and severe alcohol dependence who have significant comorbid problems, is an intensive residential rehabilitation programme clinically and cost effective when compared with intensive community-based care? 39 4.6 For people with alcohol dependence, which medication is most likely to improve adherence and thereby promote abstinence and prevent relapse? 40 5 Other versions of this guideline 41 5.1 Full guideline 41 5.2 Information (...) contact with family or friends) or or complex physical or psychiatric comorbidities or or not responded to initial community-based interventions (see 1.3.1.2). 1.3.1.4 For people with alcohol dependence who are homeless, consider offering residential rehabilitation for a maximum of 3 months. Help the service user find stable accommodation before discharge. 1.3.1.5 All interventions for people who misuse alcohol should be delivered by appropriately trained and competent staff. Pharmacological

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

116. Looked-after children and young people

be in place to ensure other permanence arrangements are available. When deciding whether rehabilitation with birth parents is a possibility especially for young children or babies, give particular attention to the reasons why any siblings have been placed in care or been adopted. This is to gather evidence on the willingness and ability of parents to change and sustain their behaviour after concerns were raised about this particular child. Ensure the voice of the child or young person is heard at every

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

117. Antisocial personality disorder: prevention and management

, coping strategies, strengths and vulnerabilities comorbid mental disorders (including depression and anxiety, drug or alcohol misuse, post-traumatic stress disorder and other personality disorders) the need for psychological treatment, social care and support, and occupational rehabilitation or development domestic violence and abuse. 1.3.1.2 Staff involved in the assessment of antisocial personality disorder in secondary and specialist services should use structured assessment methods whenever (...) and forensic healthcare. This guideline is concerned with the treatment of people with antisocial personality disorder across a wide range of services including those provided within mental health (including substance misuse) services, social care and the criminal justice system. People with antisocial personality disorder exhibit traits of impulsivity, high negative emotionality, low conscientiousness and associated behaviours including irresponsible and exploitative behaviour, recklessness

2009 National Institute for Health and Clinical Excellence - Clinical Guidelines

118. Autism in adults: diagnosis and management

) to be involved in their care: give the family, partner or carer(s) verbal and written information about who they can contact if they are concerned about the person's care bear in mind that people with autism may be ambivalent or negative towards their family or partner. This may be for many different reasons, including a coexisting mental disorder or prior experience of violence or abuse. 1.2 Identification and assessment Principles for the effectiv Principles for the effective assessment of autism e (...) or a moderate or severe learning disability) rapid escalation of problems harm to others self-neglect breakdown of family or residential support exploitation or abuse by others. Develop a risk management plan if needed. 1.2.13 Develop a care plan based on the comprehensive assessment, incorporating the risk management plan and including any particular needs (such as adaptations to the social or physical environment), and also taking into account the needs of the family, partner or carer(s). 1.2.14 Provide

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

119. Drug misuse in over 16s: opioid detoxification

Addiction Treatment Service. Journal of Substance Abuse Treatment 28: 57–65. Kirby KC, Benishek LA, Dugosh KL, et al.(2006) Substance abuse treatment providers' beliefs and objections regarding contingency management: implications for dissemination. Drug and Alcohol Dependence 85:19–27. McGovern MP , Fox TS, Xie H, et al. (2004) A survey of clinical practices and readiness to adopt evidence-based practices: dissemination research in an addiction treatment system. Journal of Substance Abuse Treatment 26 (...) detoxification should be assessed to establish the presence and severity of opioid dependence, as well as misuse of and/or dependence on other substances, including alcohol, benzodiazepines and stimulants. As part of the assessment, healthcare professionals should: use urinalysis to aid identification of the use of opioids and other substances; consideration may also be given to other near-patient testing methods such as oral fluid and/or breath testing clinically assess signs of opioid withdrawal where

2007 National Institute for Health and Clinical Excellence - Clinical Guidelines

120. Perinatal Cocaine Use: Care of the Mother

arrhythmias. 2) Sinus tachycardia and bradycardia. 3) Myocardial ischemia and infarction. 4) Seizures. 5) Stroke. 6) Lung damage, "crack lung" and asthma. 7) Sexually transmitted diseases. 8) Rhabdomyolysis (muscle breakdown that can lead to renal failure). 9) Psychosis. 10) Placental abruption. 11) Spontaneous abortion. 12) Death. FETAL / NEONATAL RISKS OF COCAINE EXPOSURE (See Substance Use Guideline 5B: Perinatal Cocaine Exposure, Care of the Newborn) Most women who abuse substances in pregnancy use (...) , 1998; Center for Substance Abuse Treatments, 1995). Perinatal Cocaine Use, Care of the Mother * BCRCP * November,1999 Page 4 of 6 I ANTENATAL HOSPITAL ADMSISSION Cocaine abuse or dependence constitutes a high risk pregnancy. A woman having a problem with cocaine should be offered shelter in a residential setting (e.g. hospital) for several reasons: 1) Cocaine craving and use are very environmentally cued so withdrawal in the home setting may be difficult. 2) Often there has been little prenatal

1999 British Columbia Perinatal Health Program

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