Why does the need for medication become a barrier to breastfeeding? A narrative review

Problem

The need for medication during lactation can contribute to the early cessation of breastfeeding.

Study finds ‘low‐risk’ alcohol relapsers have same brain volume as abstainers

While abstinence is an option for many, requiring it also can deter patients from seeking treatment, or doom them to failure if they relapse, according to some researchers. A study published June 17 in Alcoholism: Clinical and Experimental Research has found that gray matter brain volume is the same for people who relapse to low risk levels as it is for people who stay abstinent. Furthermore, the study, “Not All Is Lost for Relapsers: Relapsers With Low WHO Risk Drinking Levels and Complete Abstainers Have Comparable Regional Gray Matter Volumes,” found that low‐risk relapsers have better cognitive performance than high‐risk relapsers.     

Psychodynamic psychotherapy: When it helps people in recovery

You have almost never read about psychoanalysis or its less intense relative, psychodynamic psychotherapy, in these pages. It's because it doesn't work to treat active substance use disorders (SUDs). But psychodynamic psychotherapy, with all of the psychoanalytic underpinnings, can be very helpful to patients in recovery, because in fact many of these patients are self‐medicating a past trauma.     

NASADAD pushes block‐grant increase for stimulus 4 bill

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) last week wrote to Sen. Patty Murray (D‐ Washington) and Sen. Roy Blunt (R‐Missouri), the Senate co‐chairs of the Labor, Health and Human Services (HHS), Education, and Related Agencies Appropriations Subcommittee, asking specifically for the $1.5 billion in supplemental funding as provided by the House in the HEROES Act for the Substance Abuse Prevention and Treatment (SAPT) block grant (see “Proposed bill for HEROES Act would give $1.5 billion to SAPT block grant,” ADAW, May 18, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32722 ).     

Effort to remove Medicaid prior authorization for bupe in NJ advances

You're a health care provider, and your patient is interested in cannabis — perhaps for pain, for anxiety, for depression or even for trying to quit drinking or using drugs. You think it could help him or her. Or, rather, it might — you really have no idea, because you didn't learn about it in medical school (except that it's illegal and addictive), but you know it's now legal in your state and you want to know how to respond to your patient's request.     

Daily,high‐potency cannabis linked to first psychosis

Daily use of marijuana (cannabis) is associated with a greater than three times increased risk of psychotic disorder compared to never users, according to a study published in Lancet Psychiatry. This risk increased to nearly five times if high‐potency cannabis was used. Across the 11 sites included in the study, if high‐potency cannabis were not available, 12.2 percent of cases of first‐episode psychosis could be prevented, rising to 30.3 percent in London and 50.3 percent in Amsterdam.     

Onslaught against 42 CFR Part 2 continues in Congress

With the opposition of the American Medical Association (AMA) last fall, any moves in Congress and the federal government to weaken the patient consent provisions of 42 CFR Part 2, the regulation protecting the confidentiality of substance use disorder (SUD) treatment records, were stopped in their tracks — and in the nick of time (see ADAW, Oct. 1, 2018; Oct. 15, 2018). But the groups promoting the complete abandonment of 42 CFR Part 2, replacing it with the Health Insurance Portability and Accountability Act, which itself is targeted for at least partial destruction (see ADAW, Jan. 21, Jan. 28, Feb. 25), are back. There's a new push to try to overhaul 42 CFR Part 2.