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Biomedical subjects

J T Mulry

Publications and source records attributed to J T Mulry.

7 recordsLinked to original sources

Drug use in the chemically dependent. How to avoid relapse to addiction.

Unsupervised use of intoxicating drugs almost certainly causes relapse to addiction in persons who have been chemically dependent. Other drugs may predispose some persons to failure in their attempt to remain drug-free. Studies have shown that the chemically dependent are addicted to intoxication, not to one particular chemical, so these persons must be guided away from psychoactive drugs that have any risk of producing intoxication. In some cases, such as during hospitalization, relapse-producing agents may be necessary. With close attention from the physician and the patient's acceptance of his or her addiction and active participation in a self-help group, relapse can usually be avoided. Benefits that are gained from counseling are often underrecognized. The physician who takes time to intervene in this way probably has fewer relapses among his or her chemically dependent patients than the physician who orders a prescription. Prescribing any drugs to these patients must be done with caution. In general, all intoxicating substances are contraindicated outside the hospital. The patient's use of any over-the-counter agent to produce weight loss, excitement, or sleep should serve as a warning signal to both the patient and physician.

Drug Therapy↗

Nicotine gum dependency: a positive addiction.

Prolonged nicotine gum dependency may provide a therapeutic interlude for the compulsive or addictive patient during the transition from smoking to a tobacco-free state. We present a case report of an addicted man with asthma who successfully converted his tobacco dependency to the daily use of nicotine gum for four years. No adverse effects were seen. Nicotine gum has potential as substitution therapy for prolonged treatment in a highly addictive, compulsive patient.

Adult↗

Codependency: a family addiction.

Codependency is a common and treatable family-system illness that develops in reaction to the stress of addiction or another "shameful secret" in a family member. This stressful environment induces emotional changes in each family member and creates a variety of pathologic family roles. For the family physician, brief therapy for the codependent family can be visibly effective when combined with follow-up and referral to resources such as Al-Anon family groups.

Alcoholics Anonymous↗

Guanabenz therapy for opiate withdrawal.

A 29-year-old man used codeine approximately 1000 mg/d for seven years prior to detoxification. He developed dose-related clonidine side effects of dizziness, sedation, and dysphoria during standard clonidine detoxification; however, opiate withdrawal symptoms persisted. Conversion to guanabenz, a clonidine-like alpha 2 agonist, promptly relieved the opiate withdrawal symptoms without side effect recurrence. Guanabenz shows promise as an opiate withdrawal agent.

Adult↗

Chemical dependency: a unified illness.

Chemical dependency is now recognized as a unified illness that includes alcoholism and other substance abuse syndromes. The chemically dependent person's primary relationship is with the experience of intoxication. The general course is loss of control, social disaster, denial and ethical deterioration. Treatment is best initiated at a resource that also offers a family treatment program. The denial system must be penetrated. Abstinence and group support, such as through Alcoholics Anonymous, facilitate ongoing recovery. An aftercare process is essential.

Alcoholism↗

The effect of an inpatient chemical dependency rotation on residents' clinical behavior.

The effect of a rotation in a chemical dependency unit on subsequent resident diagnoses in the family practice clinic was investigated by clinic audit. A significant increase in diagnoses of alcoholism (56 vs. 18, P less than .05) and chemical dependency (114 vs. 49, P less than .001) was found in the year following initiation of the rotation. An inpatient rotation immediately increases resident recognition of addictive illness in the model clinic.

Alcoholism↗