Lower Risk Of Abuse Research Articles

Review of long-acting stimulants in the treatment of attention deficit hyperactivity disorder

A number of long-acting medications for the treatment of attention deficit hyperactivity disorder (ADHD) have recently been developed and approved for use in the US. These compounds are intended to optimize and maintain ADHD symptom control throughout the day, while eliminating problems associated with short-acting medications, such as the need for in-school, midday or multiple daily doses. Recent reports confirm that the safety and tolerability of long-acting medications are similar to those of short-acting medications, although long-acting medications appear to have a lower risk of abuse and diversion and may be associated with significant improvements in medication adherence. Distinctions can be made among the long-acting medications with regard to the onset, magnitude and duration of their clinical effects. Recognition of these differences is important for individualizing treatment for patients with ADHD.

Effects of WIC and Food Stamp Program participation on child outcomes

This study examines the relationship between WIC and Food Stamp Program participation and young children's health and maltreatment outcomes, utilizing a unique individual-level longitudinal database linking administrative datasets on WIC and Food Stamp Program (FSP) participation, Medicaid enrollment and claims, and child abuse and neglect reports in Illinois. Using Ordinary Least Square (OLS) methods, the data show that any of the three program participation types (joint WIC and FSP, WIC only, and FSP only) is associated with a lower risk of abuse and neglect reports, and of diagnosis of several nutrition related health problems such as anemia, failure to thrive, and nutritional deficiency. When we control for the possible selection bias using sibling fixed-effects models, the results were essentially unchanged suggesting no evidence of selection bias in the OLS results. The findings are significant indicators of the benefits of WIC and FSP participation among low-income young children. Furthermore, the findings about the lower risk of abuse and neglect is significant because it offers some evidence that participation in programs such as WIC and FSP that offer family supports not directly aimed at preventing child abuse and neglect may protect children.

Evidence for and against the use of opioid analgesics for chronic nonmalignant low back pain: a review.

Opioid analgesics are very effective for treating pain, but their chronic use in nonmalignant conditions is controversial. Low back pain is a common condition, and chronic low back pain (CLBP) is the most frequent regional pain syndrome in the United States. This article reviews the evidence for and against the use of chronic opioid analgesic therapy (COAT) for patients with CLBP unrelated to cancer. A literature review was conducted looking for reports of oral or transdermal opioid analgesic therapy for CLBP. There are very few randomized controlled trials of COAT for CLBP. The scant evidence that is available suggests that over the short-term, COAT is helpful with patients with CLBP. In the published reports, most of which are brief in duration, COAT is associated with moderate side effects but a low risk of abuse or drug addiction. COAT was not associated with adverse long-term sequelae. Longer-acting opioid analgesics may be preferable to shorter-acting agents. Patient selection and close follow-up are critical to good outcomes. There is a place for the use of chronic oral or transdermal opioid analgesics in the treatment of some patients with CLBP.

Elder abuse: a call to action.

An estimated 2 million people a year are victims of elder abuse, which ranges from neglect and mistreatment to physical abuse. By the year 2020, a full 22% of the population will be aged 65 or older. This demographic explosion demands that we identify and protect those at risk. To investigate the incidence of elder abuse or neglect (EAN) and to determine clinician awareness of associated risk factors, we conducted a 1-year retrospective review of thermally injured patients aged 60 or older. Data included age, total body surface area burned, mechanism of injury, length of hospital stay, mortality, abuse or neglect risk factors, and referral to the appropriate social agency. We found that our elderly patients (n = 28) were poorly screened for EAN. While 64% to 96% of patients were screened for cognitive impairment, overall health, and financial resources, none were screened for risk factors of emotional isolation. None of the patient's caregivers, including any spouses, roommates, or guardians, were screened for risk factors of substance abuse, familial violence, dependency needs, or external stresses. With the use of available data, we were able to place 11 patients on the following levels of abuse or neglect: 1) low risk for abuse; 2) self-neglect; 3) neglect; and 4) abuse. By this scale, 7 patients (64%) were victims of self-neglect, 3 patients (27%) were victims of neglect, and 1 patient (9%) was a victim of abuse. Adult Protective Services intervened in 2 cases. Recognizing that all cases of EAN should be preventable, we cannot accept the socioeconomic impact of this entity. The 11 patients identified as victims of neglect, self-neglect, or abuse accounted for 135 hospital days and 8 fatalities. Before we can address EAN, health care personnel must be made aware of the problem and routine screening for risk factors must be implemented. The true incidence of EAN is likely underestimated because health care providers have difficulty recognizing its features. A standard assessment tool to screen for neglect or abuse should be used for each older adult admission.

Child Maltreatment: A Test of Sociobiological Theory

Five hypotheses regarding child maltreatment were derived from sociobiological theory and tested using data on 69,119 families and 113,748 abused children. It was predicted that: I) nonbiological parents would engage. in more severe types of abuse than would biological parents; 2) in two-biological-parent households, biological fathers would maltreat their progeny more than would biological mothers; 3) biological parents would abuse their progeny while their children were very young, whereas nonbiological parents would not show a predictable age-related pattern of abuse; 4) when biological parents from poorer families abused their progeny, the victims would tend to be male, whereas when biological parents from more affluent families abused their progeny, the victims would tend to be female; and 5) children Ii vino with female relatives who were past their reproductive prime would be at low risk for abuse. Only two of these hypotheses were supported: biological parents abused younger rather than older children, whereas nonbiological parents did not show a predictable age-related pattern of abuse; and female relatives past their reproductive prime tended to commit less severe types of abuse than did female relatives still reproductively capable.