Pediatrics Psychiatry | Substance Use
Inappropriate Use of Controlled Drugs by Teens
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This is the AAP’s most recent clinical report on nonmedical prescription drug use (NMPDU) among adolescents and young adults. The report summarizes epidemiology, driving factors, risk and protective factors, morbidity and mortality, and prevention of NMPDU.
Source
Nonmedical Use of Controlled Medications by Adolescents and Young Adults: Clinical Report. Pediatrics. 2024 Dec 1;154(6):e2024069298. doi: 10.1542/peds.2024-069298. PMID: 39552240
Pediatrics Pharmacy/Pharmacology Psychiatry | Substance Use
Clonidine for Neonatal Opioid Withdrawal Syndrome?
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Infants who received clonidine, as opposed to morphine, for treatment of neonatal opioid withdrawal syndrome (NOWS) have similar length of treatment and neurodevelopmental outcomes, but are more likely to require an adjunct medication during treatment.
Source
Clonidine as Monotherapy for Neonatal Opioid Withdrawal Syndrome: A Randomized Trial. Pediatrics. 2024 Nov 1;154(5):e2023065610. doi: 10.1542/peds.2023-065610. PMID: 39403061
Internal Medicine-Primary Care Psychiatry | Substance Use
What Reduces Alcohol Withdrawal Bouncebacks?
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In a retrospective study of alcohol withdrawal interventions on Veterans Affairs hospital inpatients, only discharge to residential treatment centers was associated with improved outcomes.
Source
Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study. J Hosp Med. 2024 Dec;19(12):1122-1130. doi: 10.1002/jhm.13458. Epub 2024 Jul 19. PMID: 39031461
Critical Care Emergency Medicine Ethics Health Policy Psychiatry | Substance Use
“I Can’t Breathe” Means EMERGENCY – Avoiding Restraint Deaths
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Restraint in the prone position is commonly used by law enforcement officers, but this technique impairs effective ventilation and increases the risk of death for restrained individuals. Take “I can’t breathe” statements seriously in this population.
Source
Handcuffs and Unexpected Deaths – “I Can’t Breathe” as a Medical Emergency. N Engl J Med. 2024 Nov 30. doi: 10.1056/NEJMp2407162. Epub ahead of print. PMID: 39620456
Pediatric Emergency Pediatrics Psychiatry | Substance Use
Adverse Childhood Experiences Highly Prevalent
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This systematic review of studies on adverse childhood experiences (ACEs) showed that ACEs remain prevalent — 58% of children had experienced at least 1 ACE before the age of 18.
Source
Prevalence of Adverse Childhood Experiences in Child Population Samples: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2024 Nov 11:e244385. doi: 10.1001/jamapediatrics.2024.4385. Epub ahead of print. PMID: 39527072
Internal Medicine-Primary Care Psychiatry | Substance Use
How to Reduce Suicide in Primary Care
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A cluster randomized implementation trial integrating suicide care same-day strategies into a primary care clinic reduced 90-day suicide attempts by 25% in patients with frequent thoughts of self harm.
Source
Effectiveness of Integrating Suicide Care in Primary Care : Secondary Analysis of a Stepped-Wedge, Cluster Randomized Implementation Trial. Ann Intern Med. 2024 Nov;177(11):1471-1481. doi: 10.7326/M24-0024. Epub 2024 Oct 1. PMID: 39348695
Pediatrics Psychiatry | Substance Use Technology
Tablet to Tantrum to Tablet Again – Screen Time Cycle
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There is a correlation between tablet time and emotional dysregulation and between emotional dysregulation and tablet time, suggesting a cyclical effect between screen time, emotional dysregulation, with more screen time to regulate a child’s emotions.
Source
Early-Childhood Tablet Use and Outbursts of Anger. JAMA Pediatr. 2024 Oct 1;178(10):1035-1040. doi: 10.1001/jamapediatrics.2024.2511.
Pediatrics Psychiatry | Substance Use Toxicology
Let’s Be Blunt About Teen Cannabis Use
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Cannabis use in adolescents and young adults is associated with lower grades, decreased high school and university completion rates, increased absenteeism, and increased dropout rates.
Source
Cannabis Use During Adolescence and Young Adulthood and Academic Achievement: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2024 Oct 7:e243674. doi: 10.1001/jamapediatrics.2024.3674. Epub ahead of print. PMID: 39374005
Emergency Medicine EMS Pharmacy/Pharmacology Psychiatry | Substance Use
Prehospital Ketamine or Midazolam for Dangerous Agitation?
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For prehospital acute behavioral disturbance, there was no association with worse outcomes when giving midazolam versus ketamine in the field.
Source
A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting. Ann Emerg Med. 2024 Oct 21:S0196-0644(24)01069-2. doi: 10.1016/j.annemergmed.2024.09.003. Epub ahead of print. PMID: 39436328
Emergency Medicine Pediatric Emergency Pediatrics Psychiatry | Substance Use
Opioids for Kids – New AAP Prescribing Guideline
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The American Academy of Pediatrics has released their first clinical practice guideline on opioid prescribing in children and adolescents. The 12 evidence-based key action statements outline safe practices for prescribing opioids for acute pain in the outpatient setting.
Source
Opioid Prescribing for Acute Pain Management in Children and Adolescents in Outpatient Settings: Clinical Practice Guideline. Pediatrics. 2024 Sep 30:e2024068752. doi: 10.1542/peds.2024-068752. Epub ahead of print. PMID: 39344439