Co-occurring mental illness and addiction is very common and results in worse treatment outcomes compared to singly diagnosed addicted individuals. Integrated treatment for co-occurring disorders is associated with better treatment outcomes; however there is a wide range of what is included in integrated treatment. Due to patient and staff interests, integrated treatment often includes complementary and alternative therapies, including music and art therapy. There is a need to study how these approaches effect treatment engagement, retention, and outcome. This study was a prospective naturalistic non-randomized pilot study without a control group that sought to evaluate how participation in a music therapy program affected treatment outcomes for individuals with co-occurring mental illness and addiction. In summary, music therapy appears to be a novel motivational tool in a severely impaired inpatient sample of patients with co-occurring disorders. Future studies of music therapy in integrated co-occurring disorder setting should include a control group.

Thailand, where influenza viruses circulate year‐round, is one of 22 WHO‐designated high‐burden countries for tuberculosis (TB). Surveillance for hospitalized respiratory illness between 2003 and 2011 revealed 23 (<1% of 7180 tested) with concurrent influenza and TB. Only two persons were previously known to have TB suggesting that acute respiratory illness may bring patients to medical attention and lead to TB diagnosis. Influenza/TB was not associated with higher disease severity or mortality.

Background: To provide Centers for Disease Control and Prevention (CDC) guideline-recommended practices for patients on long-term opioid therapy (LTOT) including individualized decisions about opioid dose reduction, we developed the Power Over Pain (POP) Clinic.Objective: To describe frequency and reasons for opioid dose reduction and pre–post adherence to CDC guideline-recommended practices.Design: Retrospective chart review with qualitative and pre–post analysis.Patients and setting: Patients at an urban internal medicine teaching practice-prescribed LTOT were seen at POP Clinic at least once.Methods: Opioid dose reduction was defined by reduction in morphine-equivalent daily dose (MEDD) at 6 and 12 months after the first POP Clinic visit compared to baseline using paired t-tests. Among patients with a dose reduction, reasons documented in POP Clinic notes were qualitatively examined. Dichotomous measures of receiving four CDC guideline-recommended practices (controlled substance agreement [CSA], urine drug testing [UDT], prescription monitoring program review, and naloxone dispensing) at baseline versus 6 and 12 months were compared using McNemar's tests.Results: Of the 70 patients, most were female (66 percent) and Hispanic (54 percent). Forty-three patients (61 percent) had an opioid dose reduction in 12 months after the first POP Clinic visit. The most frequent reason was low or unclear benefit of continuing the current dose (49 percent). Mean MEDD was reduced from 69 mg to 57 mg at 6 months (p 0.01) and to 56 mg at 12 months (p 0.01). Completing a CSA, UDT, and naloxone distribution increased at 6 and 12 months (p 0.01). Conclusions: Individualized risk assessment in a primary care-based opioid management clinic is feasible and can result in opioid dose reduction and guideline adherence.

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The Bronx, New York, is the poorest congressional district in the United States and has the highest COVID‐19 infection rate in New York City. COVID‐19 has led to major changes in our healthcare system, including heightened infection‐control practices, novel staffing patterns and widespread social distancing. In this article, we describe how our experience with inpatient care has changed in the wake of COVID‐19.