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Understanding Cannabinoid Designer Drugs

Understanding Cannabinoid Designer Drugs

Over the last few years, research has shown that abuse of synthetic drugs is becoming more common throughout the country. In response to this, the United States Drug Enforcement Agency has listed an increasing number of synthetic cannabinoids (SC) as Schedule 1 substances, and Congress has passed the Synthetic Drug Abuse Prevention Act. “SC products have received substantial media attention for being sold as legal highs,” explains Patrick M. Lank, MD. Common SCs include “Spice” and “K2,” and these drugs are often packaged as incense. Tough Spot for EDs Complications from SC use have led to an increase in hospital visits, particularly for EDs. “The initial growth of SC use in the U.S. was sparked by reports that they had effects similar to marijuana,” says Dr. Lank. “An added advantage was that they were thought to be undetectable on routine urine drug screens and were widely available by legal public consumer means. We have learned over time that the clinical effects of SCs are quite different from those caused by smoking marijuana.” There is growing concern for the potential of long-term immunologic, neurologic, and psychiatric complications with SC use, specifically in adolescents. Dr. Lank says emergency physicians (EPs) are in a particularly difficult position as the use of new synthetic drugs increases in popularity. “EPs often must treat patients who abuse SCs despite having relatively little knowledge of these substances,” he says. “Considering the increasing popularity of SCs, it’s important to assess EP knowledge of these designer drugs and explore ways to optimize care for patients presenting to EDs after exposure to these drugs.” New Data & Insights In...
Taking a Closer Look at Attending Rounds

Taking a Closer Look at Attending Rounds

Attending rounds has been a long-standing practice for internal medicine physicians, residents, and medical students to direct patient care, communicate with patients and families, and advance their medical education. The model of having senior physicians, trainees, and patients interact has existed for decades, but the features of these rounds have evolved dramatically in more recent years, explains Chad Stickrath, MD. “The format has shifted away from being conducted mostly at the bedside to taking place more frequently in conference rooms and hallways.” The Accreditation Council for Graduate Medical Education (ACGME) program requires that patient-based teaching include direct interaction between residents and attending physicians, bedside teaching, discussion of pathophysiology, and the use of current evidence in diagnostic and therapeutic decisions. The ACGME does not, however, provide additional specific guidelines on how to accomplish these requirements. The structure and content of contemporary attending rounds has not been well described in studies. “Some educators have expressed concerns about how patient communication and physical examination skills are being deemphasized,” adds Dr. Stickrath. Are Patient Rounds Meeting Goals? In a study published in JAMA Internal Medicine, Dr. Stickrath and colleagues sought to determine if current methods of patient rounds are meeting patient care and educational goals. The cross-sectional observational analysis was conducted at four teaching hospitals, involving 56 attending physicians and 279 trainees who treated 807 general medicine inpatients. The study group performed detailed observations of 90 rounds over a course of nearly 2 years.   According to results, most rounds consisted of an attending physician and several resident and student trainees, speaking with a median of nine patients during the course of about...
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