Tobacco use disorders (TUDs) continue to be overly represented in patients treated in mental health and addiction treatment settings. It is the most common substance use disorder (SUD) and the leading cause of health disparities and increased morbidity/mortality amongst individuals with a psychiatric disorder. There are seven Food and Drug Administration (FDA) approved medications and excellent evidence-based psychosocial treatment interventions to use in TUD treatment. In the past few years, access to and use of other tobacco or nicotine emerging products are on the rise, including the highly publicized electronic cigarette (e-cigarette). There has also been a proliferation of technology-based interventions to support standard TUD treatment, including mobile apps and web-based interventions. These tools are easily accessed 24/7 to support outpatient treatment. This update will review the emerging products and counter-measure intervention technologies, including how clinicians can integrate these tools and other community-based resources into their practice.
Meditation is gaining popularity as an effective means of managing and attenuating pain and has been particularly effective for migraines. Meditation additionally addresses the negative emotional states known to exist with migraines. The purpose of this study was to evaluate the effectiveness of meditation as an immediate intervention for reducing migraine pain as well as alleviating emotional tension, examined herein as a negative affect hypothesized to be correlated with pain. Twenty-seven migraineurs, with two to ten migraines per month, reported migraine-related pain and emotional tension ratings on a Likert scale (ranging from 0 to 10) before and after exposure to a brief meditation-based treatment. All participants were meditation-naïve, and attended one 20-minute guided meditation session based on the Buddhist “loving kindness” approach. After the session, participants reported a 33% decrease in pain and a 43% decrease in emotional tension. The data suggest that a single exposure to a brief meditative technique can significantly reduce pain and tension, as well as offer several clinical implications. It can be concluded that single exposure to a meditative technique can significantly reduce pain and tension. The effectiveness and immediacy of this intervention offers several implications for nurses.
Persons with severe mental illness and addiction are at higher risk for early morbidity and mortality than the general population, and are less likely to receive primary care and preventive health services. Primary and behavioral integrated care programs aim to reduce these health disparities by providing comprehensive health and wellness services. Gender in particular may play a significant role in individuals' engagement and outcomes in such programs. Hence, this study examines the salient characteristics of behavioral health consumers accessing an integrated care program at a large community mental health center. Baseline gender differences in consumer demographics, substance use, psychological distress and functioning, physical health indicators, and risk factors for serious medical conditions are examined. Our results demonstrate that key gender differences exist and may warrant distinct treatment needs for men and women receiving integrated care.
Tobacco use disorder is the most common substance use disorder among ind1v1duals with any other psychiatric disorder, resulting 1n enormous health disparities. shorter lifespan. increased suicide risk. and reduced quality of life compared with others. due in part to general medical conditions caused or worsened by tobacc o use. Tobacco use can have financial, employment. relationship. and other personal consequences. Mental health and addiction treatment settings have historically ignored tobacco use; however. psychiatrists and others have recently recognized their crucial role in helping patients to quit. A culture change 1s needed that values addressing tobacco use in behavioral treatment settings to support the integration of evidence-based practices for assessing and treating tobacco use disorder. This clinically focused article provides up-to-date information for practicing psychiatnsts on how to increase screening, assessment. and treatment of tobacco use disorder Clinical tools. such as the carbon monoxide meter. can easily be integrated into practice to assess patients and motivate quitting. Other aids to help patients recover from tobacco use disorder include nicotine replacement therapy med1cat1ons. simple and effective brief psychosocial interventions. and free community resources. Psychiatrists must not only be aware of the changes 1n common psychiatric med1cat1on blood levels that occur when patients change their smoking status but also know the amounts of nicotine in tobacco products, including emerging tobacco products and e-c1garettes. Mounting evidence supports the mental and physical health benefits of quitting tobacco use and the effectiveness of using trad1t1onal tobacco use disorder treatments in helping people with psychiatric disorders quit use.
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