Pain is a universal experience across people of all genders. How do we know when something hurts inside? It keeps coming back; first, it disrupts, then colors all aspects of everyday life. There are many shades of emotional hurt that can be emotionally crippling. Anger, grief and jealousy – are all hurtful emotional states. They are experienced and can be a part of our life for years. How we manage these painful experiences as men can be a challenge. While recent studies suggest sexes don’t feel pain the same way, the evidence on sex differences in pain is mixed and potential biopsychosocial factors may play a role. To read the full text please visit Dr Matt Modrcin’s blog
Researchers recently found that many people with co-occurring mental health and substance use disorders are admitted to inpatient psychiatric units. According to a 2019 report from the Boston’s Institute for Healthcare Improvement and The Grayken Center, “hospitals have the opportunity to make a major impact in reducing morbidity and mortality related to opioid use.” The present study, therefore, looked at patients admitted to an acute care hospital in Vancouver, British Columbia. It sought to improve our understanding of this population and the care provided so that we can improve patients’ outcomes and care experiences.
Updating Cochrane systematic reviews makes them most useful and fresh for readers. We updated our review on concurrent alcohol and drug problems again.
Which new studies we found?
We found seven studies that examined 825 people with drug problems. Six of the studies were funded by the National Institutes for Health or by the Health Research Board; one study did not report its funding source.
One study focused on the way people think and act versus an approach based on Alcoholics Anonymous. It aimed to motivate the person to develop a desire to stop using drugs or alcohol.
Three studies looked at a counselling style for helping people to explore and resolve doubts about changing their behaviour (group, individual and intensive formats). Their controls were education, or less intensive counselling, or assessment-only.
Two Irish studies and one Swiss study looked at practices that aimed to identify an alcohol problem and motivate the person to do something about it versus usual treatment.
This study has been made into a podcast available at Cochrane.org news item at https://www.cochrane.org/news/podcast-which-talking-therapies-work-people-who-use-drugs-and-also-have-alcohol-problems
and a Network news item https://mhn.cochrane.org/news/podcast-which-talking-therapies-work-people-who-use-drugs-and-also-have-alcohol-problems Listen to the podcast below:
Updating Cochrane Review – Key results
The Swiss and Irish studies were directly compared. They took place in general practices (one trial) or methadone clinics (two trials). They included 170 participants with a mean age of 37 years. All participants had positive alcohol screening test upon entry to the trial. At the end, the scores between groups were similar (average difference in scores: -0.6, 1.7 and -2, respectively).
One study found that a brief motivational intervention led to a reduction of alcohol use (by seven or more days in the past month at 6 months).
It remains uncertain whether talking therapies affect drinking and drug-using in people who have problems with both alcohol and other drugs. We lack high quality studies.
Cited cochrane review: Klimas J, Fairgrieve C, Tobin H, Field C-A, O’Gorman CSM, Glynn LG, Keenan E, Saunders J, Bury G, Dunne C, Cullen W. Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users. Cochrane Database of Systematic Reviews 2018, Issue 11
Read a summary of the previous version of this review here
New research from the BC Centre on Substance Use (BCCSU) suggests applying easy and effective tool to identify patients at high risk of going into withdrawal, in efforts to modernize alcohol detox. In a study published in the August issue of the peer-reviewed Journal of American Medical Association, BCCSU researchers used data from approximately 71,295 persons taking part in 14 scientific studies to predict which patient will develop serious complications, including seizures and delirium.
Which patient will go into severe alcohol withdrawal?
From the press release by British Columbia Centre on Substance Use (Aug 28, 2018):
(Text taken from http://www.bccsu.ca/news-releases/)
From: Will This Hospitalized Patient develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review. JAMA (In Press) JAMA Network: jama.jamanetwork.com
If you’re interested in alcohol, read more about my alcohol research here.
For more information about the study or to schedule an interview, please contact:
Kevin Hollett, BC Centre on Substance Use