Susanne A. Fogger

Mobile Apps for Psychiatric Nurses

Many health care professionals, including psychiatric nurses, are faced with increasing questions from patients about mobile applications (apps). The purpose of this article is to give psychiatric-mental health nurses (PMHNs) an overview of the world of mobile health and medical apps to answer their own questions as well as those of their patients. Mobile apps will continue to evolve; thus, this article will serve as a base for PMHNs to build knowledge and understanding to help their patients.

Update on Energy Drinks and Youth

Energy drinks are attractive and readily available in every grocery store and gas station. While most youth verbalize an understanding that too much caffeine is bad for ones health, at an age of multiple demands, an over-the-counter offer of increased energy and alertness is hard to ignore. What makes energy drinks different from regular coffee? Although the heavily caffeinated drinks promise increased energy and stamina and are loaded with healthy natural ingredients, excessive consumption is of concern on many levels. This article will discuss some of the effects of excessive caffeine, as well as risks associated with energy drinks mixed with alcohol.

Adolescents at Risk: Pain Pills to Heroin: Part II

Casually exposing adolescents to prescription opioid agents may escalate to daily use. A trend exists for adolescents using prescription opioid agents to substitute heroin because it is significantly cheaper than pills (approximately half of the cost) and is often more readily available. Additionally, it is more potent than most prescription opioid agents and carries increased risks of overdose and death. Although treatment for substance use disorders has traditionally centered on total abstinence, opioid replacement therapy (ORT) is an option that saves lives and prevents overdose deaths. In the United States, ORT is based on two medicines: methadone and buprenorphine. These drugs can be substituted for other opiate agents and have much lower overdose risks. Nursing implications and web-based resources for teaching are presented.

Nurse Practitioner Prescriptive Authority for Buprenorphine: From DATA 2000 to CARA 2016

Abstract The aim of this Policy Watch column is to provide an update on a much anticipated legislation, enacted in 2016, which enabled office-based opioid treatment (OBOT) with buprenorphine prescribing for the treatment of opioid addiction by nurse practitioners (as well as physician assistants). First, an overview of the Drug Addiction Treatment Act of 2000, which only permitted OBOT prescribing by physicians, will be described. It will be followed by a summary of the Recovery Enhancement for Addiction Treatment Act of 2015–2016. Finally, a review of the Comprehensive Addiction Recovery Act of 2016 will be provided, which includes information about important changes to OBOT regulations that enable NP prescribing of buprenorphine for the treatment of opioid addiction.

Improving Quality Outcomes in Veteran-Centric Care.

The University of Alabama at Birmingham (UAB) School of Nursing and the Birmingham Veterans Affairs Medical Center (BVAMC) created a Psychiatric-Mental Health Nurse Practitioner (PMHNP) Residency Continuity Clinic tasked with providing Veteran-centric mental health outpatient treatment informed by measurement-based care (MBC) to provide quality outcomes. Approved by the BVAMC, the UAB Institutional Review Board also approved and exempted the project as quality improvement. PMHNP residents administered the Patient Stress Questionnaire (PSQ)-an MBC tool that incorporates validated tools for assessing depression, anxiety, posttraumatic stress, alcohol use, and pain-to each Veteran from March to August 2016. Patient outcomes focused on depression and anxiety. PSQ scores were reviewed retrospectively via descriptive statistics, paired t tests, and Wilcoxon signed ranks tests. Analysis showed improvement in depression and anxiety that approached significance, and in several national Veterans Affairs mental health performance measures, reinforcing the importance of using MBC in psychiatric assessment. [Journal of Psychosocial Nursing and Mental Health Services, 55(1), 37-44.].

Update on ecstasy.

After years of declining use in the United States, youth consumption of ecstasy has increased significantly. Although ecstasy (3, 4-methylenedioxymethamphetamine) is known to be a drug with detrimental effects, users view the drug as a safe and attractive social lubricant. To update and clarify misperceptions, this article reviews current evidence regarding ecstasys side effects and risks and encourages honest discussion focusing on risk-reduction behaviors.

Echoes of the Past: Recognizing Co-occurring Alcohol Use Disorder and Posttraumatic Stress Disorder in the American Veteran Population

Purpose The aim of this editorial is to explore and highlight the importance of identifying both the alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) in the veteran population. Review Determining if the patient has military experience can assist in both an accurate and complete assessment. Being aware of the patient’s military service time can help better understand some of the presenting physical and mental complaints that may incorrectly be attributed to substances. Although not all veterans had trauma exposure while in the military, asking about PTSD may help identify additional issues needing attention. Having a PTSD diagnosis increases the likelihood that there is an underlying substance use disorder. Veterans with PTSD have a 65% likely comorbidity with alcohol use (Smith, Goldstein, & Grant, 2016). Conclusion Recognition of PTSD as a co-occurring disorder with AUD can begin the dialogue to address treatment of both disorders to optimize recovery.

Recovery Beyond Buprenorphine: Nurse-Led Group Therapy

Abstract It has taken the tragedy of swelling opioid overdoses to raise addictions to national attention. This past year, a new law called the Comprehensive Addictions Recovery Act has helped to open doors for nurse practitioners and physician assistants to prescribe buprenorphine. Although this medication can assist those dependent on opioids in finding needed stability, medication-assisted treatment is only the beginning. Addiction and psychiatric nurses must play a larger role in providing various therapies that coincide with medication-assisted treatment to support ongoing recovery. One treatment option is group therapy, which is effective for individuals with substance use as well as other co-occurring disorders to develop needed skills to remain in recovery. The purpose of this review is to explore the nursing role in group therapy for substance use as well as encourage addictions and psychiatric nurse practitioners to offer recovery-focused group therapy to this population.