RESUMO
BACKGROUND: Substance use disorder (SUD) is a persistent problem within society and an issue of increasing community awareness and concern. SUD is often comorbid with significant mental health challenges, trauma and negative social determinants of health. SUDs contribute to increased burden of chronic disease and can lead to increased mortality and shorter life expectancy, not just through overdose but also through increased rates of mental and physical chronic disease. OBJECTIVE: The aim of this article is to explore the evidence regarding lifestyle interventions as either primary interventions or adjuncts to existing treatments for individuals with SUD. DISCUSSION: Lifestyle interventions can play a significant part in the management of people with SUD. These interventions play a part in SUD treatment and relapse prevention as well as improving physical and mental health and quality of life. These interventions ideally can be instituted and managed through community services and primary care.
Assuntos
Qualidade de Vida , Transtornos Relacionados ao Uso de Substâncias , Comorbidade , Humanos , Estilo de Vida , Saúde Mental , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
BACKGROUND: High-dose opioid prescribing is associated with an increased risk of harms, including death. OBJECTIVE: The aim of this article is to discuss the concept of high-risk opioid prescribing, as well as relevant management strategies for patients on >100 mg oral morphine equivalent daily dose (OMEDD). The six 'Rs' approach to managing high-risk opioid prescribing (Rotation of opioids; Reduction; Replacement pharmacotherapy; Reversal with naloxone; Referral; Restriction of supply) is discussed. DISCUSSION: The six Rs is an aide-memoire that summarises the management options available to mitigate the risk of high OMEDDs. However, an effective therapeutic alliance between clinician and patient remains the foundation of all risk mitigation strategies.