We report the results of a survey of second-year medical students concerning attitudes and basic knowledge of electroconvulsive therapy (ECT). It appeared that there were significant negative biases against ECT in a portion of the group. Forty percent of the students who participated felt that psychiatrists often misused ECT, while 31% actually thought ECT was used to punish violent or uncooperative patients. Few students knew the typical frequency or duration of treatment or even that it was done under general anesthesia. It was interesting that the group describing themselves as highly knowledgeable about psychiatric illness had a greater bias against ECT. Students in the negative group did not differ in the sources of their information about ECT. The most common sources of this information about ECT were movies or college classes. The results document the need for appropriate coverage of ECT in medical school curriculum.

Epidemiologic, level IV.

BackgroundSubstance use disorders are a leading cause of morbidity and mortality in the United States, with opioid use disorder representing a growing public health concern and economic burden. Veterans within the Veterans Health Administration are impacted by opioid use disorder.SignificanceA common medication-assisted treatment is sublingual Suboxone (buprenorphine/naloxone) used in combination with behavior modification therapy. Missed Suboxone doses may lead to withdrawal and potential drug diversion. Sublocade (buprenorphine extended-release) is an alternative once-monthly subcutaneous injection administered by a healthcare provider. The purpose of this quality improvement project was to examine the effects of Sublocade on cravings in veterans with opioid use disorder.MethodsVeterans were considered for Sublocade monthly injections if they were enrolled in the Suboxone program, not taking Suboxone as prescribed, and disenrolled from the Suboxone program more than 2 times. Cravings were measured before and after Sublocade program enrollment.ResultsFifteen veterans were enrolled in the Sublocade program over a 12-month timeframe. Most were male (93%) with a median (range) age of 42 (33–62) years. The following were the primary opioids used before enrollment in the substance use disorder program: hydrocodone (47%), oxycodone (20%), and heroin (20%). Sublocade significantly reduced cravings (p = .001). In this small group, cravings were fully eliminated.DiscussionRecent studies have shown Sublocade effectively blocks the effects of other opioids and minimizes the risk of medication diversion that occurs with Suboxone. For these reasons, Sublocade is an alternative medication-assisted treatment for veterans with opioid use disorder.

No abstract