RT Book, Section
A1 Roy, Raymond C.
A2 Longnecker, David E.
A2 Mackey, Sean C.
A2 Newman, Mark F.
A2 Sandberg, Warren S.
A2 Zapol, Warren M.
SR Print(0)
ID 1144138391
T1 Substance Dependence and Abuse in Anesthesia Care Providers
T2 Anesthesiology, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071848817
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144138391
RD 2024/04/19
AB KEY  POINTSThe  incidence  of  opioid  abuse  among  anesthesia  trainees  is  1%.Addiction  is  a  chronic,  relapsing  disease  with  a  genetic  predisposition.The  brain  changes  associated  with  addiction  are  the  same  for  all  drugs  of  abuse.The  brain  lesion  associated  with  substance  use  disorders  manifests  a  greater  number  of  dopamine  D1  receptors  and  fewer  dopamine  D2  receptors  in  specific  brain  regions,  including  the  nucleus  accumbens,  amygdala,  and  prefrontal  cortex.The  craving  and  compulsive  behavior  associated  with  addiction  is  associated  with  impaired  glutamate  homeostasis  in  the  nucleus  accumbens.Substance  use  disorders  among  anesthesia  providers  are  most  commonly  detected  through  observed  behavioral  changes.  Interventions  should  be  based  on  concern  over  wellness  because  substance  use  disorder  is  only  one  of  several  potential  diagnoses  that  threaten  wellness.Intervention  at  an  early  stage  of  addiction  is  associated  with  greater  treatment  success  than  intervention  at  later  stages.Antagonist  therapy  with  naltrexone  reduces  relapse  rates.Most  addicts  have  psychiatric  comorbidities  that  must  be  treated  concurrently  to  prevent  relapse.Reentry  requires  a  contract  between  abstinent  colleagues  and  their  employers.