The last e-weekly discussed the opioid epidemic. This article will discuss more about assessing for opioid use disorders and appropriate treatments. A person is diagnosed as having an opioid use disorder if he develops symptoms of tolerance and withdrawal to opioids as well as at least two other symptoms in the same year. Tolerance is […]

The opioid epidemic has become a national emergency. Opioid related deaths have increased ~300% from 2001 to 2016. It is known that overdoses are a leading cause of accidental death in the United States, and the number has been increasing yearly from 2002 to present time. Drug overdoses cause more deaths than car accidents and […]

Alcohol Use Disorder (AUD) is very common and can lead to medical, occupational, social and legal impairments for affected individuals and their families. Despite the high prevalence of AUD and its significant public health consequences, patients with this disorder continue to be under-identified and undertreated. The American Psychiatric Association has recently come out with practice […]

It is not uncommon for a patient with depression to also suffer from chronic pain. Some antidepressants are known to be helpful for depression and anxiety disorders as well as some chronic pain conditions. They have been shown to be helpful in pain states that are a result of neural sensitization rather than somatic or […]

There is a complexity when it comes to cannabis – it can be safe and benign, it can have medicinal components, and it can be harmful and dangerous. These are all true. As regulations around cannabis continue to loosen, it is imperative that providers understand that cannabis use will probably increase. It is therefore important […]

30-50% of adults report transient concerns with insomnia and about 5-10% of adults have chronic problems with insomnia. Insomnia is defined as a subjective difficulty with initiating or maintaining sleep that results in daytime impairment. It can occur as a primary disorder or as a secondary disorder related to another medical condition, medication side effect, […]

It is common for children and families to present to their primary care providers with concerns about behavioral problems and/or wanting to rule out ADHD. The typical presenting problem is severe temper tantrums or disruptive behavior in school. In some of these cases, the appropriate diagnosis is ADHD or another disruptive behavior disorder and treatment […]

While migraines are a medical and not a psychological condition, it is well known that psychological factors can impact a patient’s experience with migraines. It is widely known that migraines can be triggered by psychological stressors. Factors such as work stress, home stress, relationship difficulties, anxiety, depression and other issues can trigger headaches, maintain them, […]

Case Study: Patient Presenting with Mood and Psychotic Symptoms This article is based on a recent SmartCare consultation with a primary care provider. Case: 36 yo male who is a new patient presents with depressive symptoms since age 14 and previous suicide attempt at age 18. Additionally, he reports voices telling him negative things about […]

Patients will frequently present in the primary care setting asking for an assessment for a mental health or behavioral concern. It can be confusing to know which direction to send a family in and/or what type of assessment to refer for. There are some clarifying questions that a primary care provider can ask to better […]