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Lewis Nelson
Emergency Medicine, Medical Toxicology, Addiction Medicine. Pain Medicine. The dose makes the poison.
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Lewis Nelson 8h
Its all about the nocebo effect...what the officers experience feels real (though its not poisoning).
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Lewis Nelson Oct 21
US overdose deaths appear to rise amid coronavirus pandemic
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A6: More brief objective scales such as Richmond Agitation Sedation Scale (RASS) or Brief Alcohol Withdrawal Scale (BAWS) are recommended. Learn more
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A6: Clinical Institute Withdrawal Assessment, Revised (CIWA) is hard to use given its subjective nature in patients with altered mental status.
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A5: Don’t forget to check carefully for comorbid conditions that caused the patient to stop drinking. Pneumonia, pancreatitis, GI bleed, trauma are common among many other often covert diseases
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A5: In addition to the physiological effects such as tremulousness and hypertension, acute alcohol withdrawal results in cognitive changes such as impaired judgment or delirium.
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Lewis Nelson retweeted
NIAAA News Oct 20
Replying to @TreatmentWeek
A4: There are 3 medications approved by the FDA for AUD: acamprosate, disulfiram & naltrexone – the latter is available as daily oral pills & monthly intramuscular injections. 3/5
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A4: Evidence-based treatments, including behavioral therapy, medications, and support groups, for AUD are effective. All have a role. Treatment plan should be built with the individual in mind. Each one of us is different.
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Lewis Nelson retweeted
NIAAA News Oct 20
Replying to @TreatmentWeek
A3: Resources like NIAAA’s Rethinking Drinking can be useful for helping patients evaluate their relationship with alcohol and take steps to make a change. 3/4
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A3: We can develop and provide guidance on harm reduction. This can be done on a policy, population, group focused, or individual level.
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A3: Absolutely, treatment can begin in the ED. Clinicians in the ED can provide patient resources, referral to addiction medicine specialist and outline evidence-treatments that are available including naltrexone for treating AUD.
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A1: The cost of excessive alcohol use in the US reached $249 billion in 2010, or about $2.05 per drink. The cost has most certainly not gone down since! Most (77%) of these costs were due to binge drinking.
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Lewis Nelson retweeted
TreatmentWeek Oct 20
Replying to @TreatmentWeek
A1: Est. 88,000 people (approx. 62,000 men; 26,000 women) die from alcohol-related causes annually, making alcohol the 3rd leading preventable cause of death in the US. 1st is tobacco & 2nd is poor diet & physical inactivity.
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Lewis Nelson retweeted
ASAM Oct 20
Join the conversation with . We’re getting started!
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Lewis Nelson retweeted
Andrew Stolbach, MD, MPH Oct 14
We recommend remote buprenorphine inductions, pausing drug screens for stabilized patients, and other modifications for treating OUD in the pandemic. , , , , , ,
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Lewis Nelson Sep 30
Very thoughtful and balanced approach to prehospital ketamine use for severely agitated patients. Law enforcement purposes is NOT an appropriate indication.
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Lewis Nelson Sep 24
Nice effort to shine light on the misrepresentation of fentanyl risks from casual exposure. See:
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Lewis Nelson Sep 24
An important safety update, though not breaking news to most. It may be hard to believe....but the current labeling only has a boxed warning for concomitant use with opioids.
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Lewis Nelson Sep 16
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Lewis Nelson Sep 14
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