Executive Summary of the American Society of Addiction Medicine (ASAM) Clinical Practice Guideline on Alcohol Withdrawal Management.

: The American Society of Addiction Medicine (ASAM) Clinical Practice Guideline on Alcohol Withdrawal Management provides guidance on the identification and management of alcohol withdrawal in adults with varying degrees of syndrome severity. The guideline addresses both ambulatory and inpatient care and considers special patient populations. The Guideline was primarily developed following the RAND/UCLA Appropriateness Method (RAM), a process to determine the appropriateness of a set of clinical procedures.

Executive Summary of the Focused Update of the ASAM National Practice Guideline for the Treatment of Opioid Use Disorder.

: A Focused Update of the ASAM National Practice Guideline for the Treatment of Opioid Use Disorder is published in the current issue of the Journal of Addiction Medicine. The focused update included a search of Medline's PubMed database from January 1, 2014 to September 27, 2018, as well as a search of the grey literature (archives of the Clinical Guideline Clearinghouse, and key agency and society websites) for new practice guidelines and relevant systematic reviews addressing the use of medications and psychosocial treatments in the treatment of opioid use disorder, including within special populations. The search identified 11 practice guidelines and 35 systematic reviews that informed the subsequent RAND/UCLA Appropriateness Method (RAM) process employed to facilitate the focused update by a National Guideline Committee of addiction experts.

Applying American Society of Addiction Medicine Performance Measures in Commercial Health Insurance and Services Data.

Objectives: ASAM's Standards of Care for the Addiction Specialist established appropriate care for the treatment of substance use disorders. ASAM identified three high priority performance measures for specification and testing for feasibility in various systems using administrative claims: use of pharmacotherapy for alcohol use disorder (AUD); use of pharmacotherapy for opioid use disorder (OUD); and continuity of care after withdrawal management services. This study adds to the initial testing of these measures in the Veteran's Health Administration (VHA) by testing the feasibility of specifications in commercial insurance data (Cigna).

Male gender identity in complete androgen insensitivity syndrome.

Women and girls with complete androgen insensitivity syndrome (CAIS) invariably have a female typical core gender identity. In this case report, we describe the first case of male gender identity in a CAIS individual raised female leading to complete sex reassignment involving both androgen treatment and phalloplasty. CAIS was diagnosed at age 17, based on an unambiguously female phenotype, a 46,XY karyotype, and a 2660delT androgen receptor (AR) gene mutation, leading to a premature stop in codon 807.

Interferon-based hepatitis C treatment in patients with pre-existing severe mental illness and substance use disorders.

Hepatitis C infection in patients with mental illness and drug addiction is highly prevalent and infrequently treated. Over the past 5 years, a wealth of studies specifically focused on these groups have demonstrated comparable rates of sustained virological response, compliance and adverse events. Optimization of psychotropic and opioid-replacement therapy with integrated psychiatric/addiction treatment prior to and during IFN-alpha initiation produces optimal results.

Antimicrobial stewardship stabilizes resistance patterns in a behavioral health setting.

Background: Connecticut Valley Hospital, an inpatient tertiary care psychiatric hospital, identified a significant increase in the antimicrobial resistance of E. coli to multiple antibiotics including quinolones.

Objectives: To improve the resistance profile of E.

Addiction and chronic pain: diagnostic and treatment dilemmas.

Chronic pain and addictive disorders present significant medical and public health problems; both are underdiagnosed and inadequately treated. The cooccurrence of pain and addiction adds complexity to the assessment and treatment of both disorders. Research on the link between pain and substance use disorders (SUDs) has focused on the bidirectional relationship between chronic pain and opioid dependence.