Meditation shows promise as an additional therapy to help prevent relapse in people recovering from alcohol dependence. In a 16-week study of 19 adults who had completed an intensive outpatient program, 15 completed an 8-week meditation course plus home practice and standard care. On average, participants meditated about 4.6 days per week and were abstinent on 94.5% of study days; 47% remained completely abstinent, while 47% had at least one heavy drinking day. Depression, anxiety, stress, and craving decreased, and mindfulness increased. Participants rated the course highly as a relapse prevention tool. A biomarker of inflammation, interleukin-6, also decreased. No adverse events occurred.
A 32-year-old man with no prior mental health problems amputated both of his testicles by hand after his first use of LSD combined with alcohol. Six months later, he had not developed any psychiatric disorder. This case shows that even a single first use of LSD with alcohol can lead to severe intoxication and extreme self-harm.
Transitioning from high-dose methadone to buprenorphine for opioid use disorder risks precipitated withdrawal because buprenorphine is a high-affinity partial agonist that can displace methadone. A 6-day microdosing protocol using sublingual buprenorphine was tested in a patient on 100 mg methadone, followed by 20 days of monitoring. The patient tolerated the protocol with supportive medications, peaking at a withdrawal score of 6 on the Clinical Opiate Withdrawal Scale, with the most severe symptoms occurring several days after microdosing ended. The case shows feasibility of this approach in a medically monitored intensive inpatient setting.