ADHD and fetal alcohol spectrum disorders (FASD).

This multi-author book will discuss the history and clinical presentation of Foetal Alcohol Spectrum Disorders(FASD) i.e Fetal Alcohol Syndrome (FAS) and Alcohol Related Neurodevelopmental Disorder (ARND). These developmental neuropsychiatric disorders result from prenatal exposure to alcohol during any gestational period of pregnancy. The book will particularly address the co-occurring presence of ADHD in patients with FASD. ADHD is the most frequent neuropsychiatric presentation of FASD throughout the lifespan and it is particularly difficult to manage because the underlying pathophysiology is related to prenatal neurotoxic brain injury. Although prenatal alcohol exposure , and the resulting FASD, is recognised as the commonest preventable cause of intellectual disability, many clinicians and educators are not aware that 75 to 80% of the patients with FASD have I.Q.s over 70. Thus, the neuropsychiatric presentation of FASD can often be unrecognised or misunderstood. FASD are the true clinical ' masqueraders' and ADHD is their most likely disguise! The authors are all experienced professionals from a wide range of disciplines working throughout the USA and Canada. They have been involved in the diagnosis, research and management of FASD for many years and this book will bring their collective knowledge regarding management from infancy to adulthood to an inter-professional audienceThis resource was contributed by The National Documentation Centre on Drug Use.

Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults.

Attention Deficit Hyperactivity Disorder (ADHD) is a childhood onset psychiatric disorder that can persist into adulthood in up to 50% of patients. From a clinical point of view, ADHD is characterized by hyperactivity, mood instability, irritability, difficulties in maintaining attention, lack of organization and impulsive behaviours. The presence of other disorders occurring at the the same time is also common, especially mood disorders and substance abuse. It seems that amphetamines could reverse the underlying neurological problems that feature in ADHD, and so improve ADHD symptoms. We found seven studies, which enrolled 1091 patients. These studies compared amphetamines to placebo and three of them also compared amphetamines with other drugs: guanfacine, modafinil and paroxetine. Three amphetamine derivatives were investigated: dexamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS). Treatment length ranged from two to 20 weeks. All amphetamines improved ADHD symptoms but overall they did not make people more likely to stay in treatment and were associated with a higher risk of treatment ending early due to adverse events. One type of amphetamine, mixed amphetamine salts, did, however, increase retention in treatment. We found no evidence that higher doses worked better than lower ones. We did not find any difference in effectiveness between immediate-release and sustained-release formulations. Therefore, it appears that short-term treatment with amphetamines reduces ADHD symptoms, but studies assessing the effects of amphetamines for longer periods of time are needed.This resource was contributed by The National Documentation Centre on Drug Use.

International ADHD in substance use disorders prevalence study.

Dr Van Hout has been invited by the ICASA network and IASP research team [Drs Geurt van de Glind; Trimbos Institute, The Netherlands; Dr Pieter-Jan Carpentier, ICASA; Josep Antoni Ramos-Quiroga, University of Barcelona, Spain, Professor Dr Frances Levin, University of Columbia, New York, USA and Professor Dr. Wim van den Brink, University of Amsterdam, The Netherlands] to undertake the research protocol for Ireland as part of this European study of the prevalence of ADHD in adult patients referred for treatment of addiction problems. The research team at Waterford Institute of Technology, School of Health Sciences will undertake this national study as part of the International Collaboration on ADHD and Substance Abuse [ICASA] â?~International ADHD in Substance Use Disorders Prevalence Studyâ?T [IASP study]. The International Collaboration on ADHD and Substance Abuse [ICASA] will provide Dr Van Hout and her team with full support from ICASA of the measurement instruments available and a central database at the University of Amsterdam, and will undergo training for procedures for data capture from Dr van de Glind, Trimbos Institute, The Netherlands. Eight European countries (Norway, Sweden, the Netherlands, Belgium, France, Spain, Switzerland and Hungary) USA and Australia have already participated in the first phase of the IASP study, which will close in September 2011. Over 2500 Substance Use Disorder [SUD] patients were sampled with approximately 38% scoring positive on the ADHD screener (ASRS). Of these 2500 patients over 1000 patients were evaluated on ADHD, Depression, Bipolar Disorder, Anti-Social Personality and Borderline Personality Disorder. A preliminary estimate of the prevalence of ADHD in SUD treatment seeking patients was recorded at 20 %. The second phase of study [IASP 2011] will commence in September 2011 for countries including Ireland, South Africa, Egypt and Brazil. Dr Van Hout has also been invited to partake in a systematic review paper on the risk factors for development of SUD in children/adolescents with ADHD in collaboration with the ICASA foundation.This resource was contributed by The National Documentation Centre on Drug Use.

Substance abuse treatment for persons with co-occurring disorders.

This TIP, Substance Abuse Treatment for Persons With Co-Occurring Disorders, revises TIP 9, Assessment and Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug Abuse. The revised TIP provides information about new developments in the rapidly growing field of co-occurring substance use and mental disorders and captures the state-of-the-art in the treatment of people with co-occurring disorders. The TIP focuses on what the substance abuse treatment clinician needs to know and provides that information in an accessible manner. The TIP synthesizes knowledge and grounds it in the practical realities of clinical cases and real situations so the reader will come away with increased knowledge, encouragement, and resourcefulness in working with clients with co-occurring disorders. Contents: Executive Summary â?¢ 1 Introduction  2 Definitions, Terms, and Classification Systems for Co-Occurring Disorders  3 Keys to Successful Programming  4 Assessment  5 Strategies for Working With Clients With Co-Occurring Disorders  6 Traditional Settings and Models  7 Special Settings and Specific Populations  8 A Brief Overview of Specific Mental Disorders and Cross-Cutting Issues 9 Substance-Induced Disorders Appendix A: Bibliography Appendix B: Acronyms  Appendix C: Glossary of Terms Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor  Appendix E: Emerging Models â?¢ Appendix F: Common Medications for Disorders  Appendix G: Screening and Assessment Instruments  Appendix H: Screening Instruments  Appendix I: Selected Sources of Training  Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Consumers and Providers  Appendix K: Confidentiality  Appendix L: Resource Panel  Appendix M: Cultural Competency and Diversity Network Participants Appendix N: Field ReviewersThis resource was contributed by The National Documentation Centre on Drug Use.

Mental health and growing up factsheet. Drugs and alcohol - what parents need to know.

Information about drugs and alcohol - what parents need to know: information for parents, carers and anyone who works with young people. About this leaflet This is one in a series of leaflets for parents, teachers and young people entitled Mental Health and Growing Up. These leaflets aim to provide practical, up-to-date information about mental health problems (emotional, behavioural and psychiatric disorders) that can affect children and young people. This leaflet offers practical advice for parents, teachers and carers who are worried that a young person is misusing drugs or alcohol. Why do I need to know about a young person using drugs or alcohol? Many young people smoke, drink alcohol and may try drugs. It is important you are aware of this and do not ignore it as a time when they are just having fun or experimenting. It doesnââ,‰"¢t take much for the young people to soon lose control and to need help to recover from this problem. How common is it? By the age of 16, up to half of young people have tried an illegal drug. Young people are trying drugs earlier and more are drinking alcohol. What are the different types of drugs which cause problems? The most commonly used, readily available and strongly addictive drugs are tobacco and alcohol. There are numerous others that can be addictive. Alcohol and cannabis are sometimes seen as ââ,¬Ëogatewayââ,‰"¢ drugs that lead to the world of other drugs like cocaine and heroin. Drugs are also classed as ââ,¬Ëolegalââ,‰"¢ andââ,¬Ëoillegalââ,‰"¢. The obviously illegal drugs include cannabis (hash), speed (amphetamines), ecstasy (E), cocaine and heroin. Using ââ,¬Ëolegalââ,‰"¢ drugs (like cigarettes, alcohol, petrol, glue) does not mean they are safe or allowed to be misused. It just means they may be bought or sold for specific purposes and are limited to use by specific age groups. There are clear laws regarding alcohol and young people. For more detailed information on various drugs, their side-effects and the law, see ââ,¬ËoFurther Informationââ,‰"¢ at the end of the factsheet. Why do young people use drugs or alcohol? Young people may try or use drugs or alcohol for various reasons. They may do it for fun, because they are curious, or to be like their friends. Some are experimenting with the feeling of intoxication. Sometimes they use it to cope with difficult situations or feelings of worry and low mood. A young person is more likely to try or use drugs or alcohol if they hang out or stay with friends or family who use them. What can be the problems related to using drugs or alcohol? Drugs and alcohol can have different effects on different people. In young people especially the effects can be unpredictable and potentially dangerous. Even medications for sleep or painkillers can be addictive and harmful if not used the way they are prescribed by a doctor. Drugs and alcohol can damage health. Sharing needles or equipment can cause serious infections, such as HIV and hepatitis. Accidents, arguments and fights are more likely after drinking and drug use. Young people are more likely to engage in unprotected sex when using drugs. Using drugs can lead to serious mental illnesses, such as psychosis and depression. When does it become addiction or problem? It is very difficult to know when exactly using drugs or alcohol is more than just ââ,¬Ëocasualââ,‰"¢. Addiction becomes more obvious when the young person spends most of their time thinking about, looking for or using drugs. Drugs or alcohol then become the focus of the young personââ,‰"¢s life. They ignore their usual work, such as not doing their schoolwork, or stop doing their usual hobbies/sports such as dancing or football. How do I know if there is a problem or addiction? Occasional use can be very difficult to detect. If the young person is using on a regular basis, their behaviour often changes. Look for signs such as: ïâ?s§ unexplained moodiness ïâ?s§ behaviour that is ââ,¬Ëoout of character' ïâ?s§ loss of interest in school or friends ïâ?s§ unexplained loss of clothes or money ïâ?s§ unusual smells and items like silver foil, needle covers. Remember, the above changes can also mean other problems, such as depression, rather than using drugs. What do I do if I am worried? If you suspect young person is using drugs, remember some general rules. ïâ?s§ Pay attention to what the child is doing, including schoolwork, friends and leisure time. ïâ?s§ Learn about the effects of alcohol and drugs (see websites listed below). ïâ?s§ Listen to what the child says about alcohol and drugs, and talk about it with them. ïâ?s§ Encourage the young person to be informed and responsible about drugs and alcohol. ïâ?s§ Talk to other parents, friends or teachers about drugs - the facts and your fears and seek help. If someone in the family or close friend is using drugs or alcohol, it is important that they seek help too. It may be hard to expect the young person to give up, especially if a parent or carer is using it too. My child is abusing drugs. What do I do? ïâ?s§ If your child is using drugs or alcohol, seek help. ïâ?s§ Do stay calm and make sure of facts. ïâ?s§ Don't give up on them, get into long debates or arguments when they are drunk, stoned or high. ïâ?s§ Donââ,‰"¢t be angry or blame themââ,‰?othey need your help and trust to make journey of recovery. Where can I get help? You can talk in confidence to a professional like your GP or practice nurse, a local drug project or your local child and adolescent mental health. They can refer your child to relevant services and they will be able to offer you advice and support. You may also be able to seek help through a school nurse, teacher or social worker. You can find this information from your local area telephone book or council website, or ask for the address from your health centre. [For the full factsheet, click on the link above]This resource was contributed by The National Documentation Centre on Drug Use.

Medication use in patients with end of life dementia:Presentations

CARDI recently launched a new report (Friday 6 July 2012) which finds considerable uncertainty and variation in the medicines doctors say they would prescribe for patients with dementia at the end of life when presented with clinical scenarios. The all-Ireland research, led by a team at QUB, finds evidence that GPs and hospital physicians indicate they would continue with dementia medications and statins and actively prescribe antibiotics when there is limited evidence of benefits to patients with dementia at end of life.Links to presentations are below:Assessment of factors which influence decision-making regarding medication use in patients with dementia at the end of life: Prof Carmel HughesMedication use in patients with end of life dementia: Dr Shaun O'Keefe

Regional Guidelines for the Search of Patients, their Belongings and the Environment of Care within Adult Mental Health and Learning Disability Inpatient Settings

The overarching purpose of these guidelines is to ensure the safety and promote the protection of patients, staff and visitors by ensuring that dangerous items or hazardous substances are not brought into the in-patient setting, including illicit substances, prescribed / over the counter medications, dangerous items and alcohol or any other hazardous or potentially hazardous item or substance.

Stopping smoking made easier (English and translations)

This booklet takes smokers through the stages of stopping smoking:preparing to stopstoppingstaying stoppedIt also provides advice on the various forms of nicotine replacement therapy (NRT) and non-nicotine medications available, as well as a list of contacts for advice and support.Note: translations are of the 2009 leaflet, which will have lower costs for packets of cigarettes.

Smoking: know the facts

This leaflet outlines the health and financial benefits of stopping smoking. It provides key facts on the health dangers associated with smoking, information on second-hand smoke, information on the dangers of smoking to babies, and contact details for help and support available. It also lists the various forms of nicotine replacement therapy (NRT) and non-nicotine medications available.This poster highlights some of the main health and financial benefits of stopping smoking. An associated A5 leaflet goes into detail on these areas.

Alcohol, drugs and older people

This�booklet is for older people (defined as those aged 55 or over) who are worried about their use of alcohol, illegal drugs and /or prescribed/over the counter medications.Alcohol guidelines changed on 8 January 2016. Please see the latest advice from the four UK Chief Medical Officers on www.knowyourlimits.info