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Substance Abuse

Jasleen Salwan
No abstract text is available yet for this article.
November 1, 2018: Substance Abuse
Sydney S Kelpin, Steven J Ondersma, Michael Weaver, Dace S Svikis
BACKGROUND: The extent to which participants in randomized clinical trials (RCTs) resemble their broader target groups is of particular concern when studying stigmatized conditions such as substance use disorders (SUDs). The present study compared patients who enrolled in a 4-arm clinical trial of SBIRT (screening, brief intervention, and referral to treatment) with eligible patients who declined study participation. METHODS: Participants (N = 1338) were primary care patients who anonymously completed a computer-delivered health survey and screened positive for heavy/problem alcohol or drug use...
October 29, 2018: Substance Abuse
Oluwakemi Odukoya, Babalola Faseru, Nkolika Uguru, Mustapha Jamda, Olanrewaju Onigbogi, Oluwafunmilola James, Scott Leischow, Olalekan Ayo-Yusuf
BACKGROUND: Physician-led smoking cessation services are suboptimal in Nigeria. OBJECTIVES: This study evaluated a text messaging intervention designed to increase the knowledge and practices of physicians in Nigeria to help smokers quit. METHODS: Using a pre-post study design, all physicians (N = 946) in 3 tertiary care hospitals located in 3 geopolitical zones in Nigeria were sent 2-3 text messages weekly over a 13-week period to create awareness and improve cessation practices using the "Ask, Advise and Refer" (AAR) model...
October 29, 2018: Substance Abuse
Helen Valenstein-Mah, Hildi Hagedorn, Chad L Kay, Melissa L Christopher, Adam J Gordon
BACKGROUND: Opioid use disorder (OUD) is a critical concern among US veterans. The Veterans Health Administration (VHA) recommends buprenorphine as a first-line treatment for OUD; however, only 35% of veterans with an OUD currently receive medication treatment. Practical barriers, including the capacity of providers to prescribe, may affect delivery of buprenorphine. We examined the current state of buprenorphine treatment within the VHA. METHODS: National VHA administrative databases were queried to identify all providers credentialed to prescribe buprenorphine as of January 2018...
October 16, 2018: Substance Abuse
Desiree Madah-Amiri, Arne Kristian Skulberg, Anne-Cathrine Braarud, Ola Dale, Fridtjof Heyerdahl, Philipp Lobmaier, Thomas Clausen
BACKGROUND: Although the United States and numerous other countries are amidst an opioid overdose crisis, access to safe injection facilities remains limited. METHODS: We used prospective data from ambulance journals in Oslo, Norway, to describe the patterns, severity, and outcomes of opioid overdoses and compared these characteristics among various overdose locations. We also examined what role a safe injection facility may have had on these overdoses. RESULTS: Based on 48,825 ambulance calls, 1054 were for opioid overdoses from 465 individuals during 2014 and 2015...
October 10, 2018: Substance Abuse
Stephen W Patrick, Melinda B Buntin, Peter R Martin, Theresa A Scott, William Dupont, Michael Richards, William O Cooper
BACKGROUND AND AIMS: Opioid agonist therapies (OATs) are highly effective treatments for opioid use disorders (OUDs), especially for pregnant women; thus, improving access to OAT is an urgent public policy goal. Our objective was to determine if insurance and pregnancy status were barriers to obtaining access to OAT in 4 Appalachian states disproportionately impacted by the opioid epidemic. METHODS: Between April and May 2017, we conducted phone surveys of OAT providers, opioid treatment programs (OTPs), and outpatient buprenorphine providers, in Kentucky, North Carolina, Tennessee, and West Virginia...
October 9, 2018: Substance Abuse
Michael B Madson, Margo C Villarosa-Hurlocker, Julie A Schumacher, Daniel C Williams, Jami M Gauthier
BACKGROUND: Through evaluations of training programs, systematic reviews, and meta-analyses, advances in identifying best practices for disseminating motivational interviewing (MI) have emerged. To advance this work further, inclusion of thorough descriptions of the following is needed in research publications: study (design, trainee characteristics, setting characteristics), training and coaching methods (if applicable), trainer qualifications, and evaluation of MI skills. METHODS: The purpose of this study was to systematically evaluate the research on MI training of substance use treatment professionals for the inclusion of such descriptions...
October 9, 2018: Substance Abuse
Kathleen Hanley, Sewit Bereket, Ellen Tuchman, Frederick G More, Madeline A Naegle, Adina Kalet, Keith Goldfeld, Marc N Gourevitch
BACKGROUND: We developed and implemented the Substance Abuse Research Education and Training (SARET) program for medical, dental, nursing, and social work students to address the dearth of health professionals pursuing research and careers in substance use disorders (SUD). SARET has 2 main components: (1) a novel online curriculum addressing core SUD research topics, to reach a large number of students; (2) a mentored summer research experience for in-depth exposure. METHODS: Modules were integrated into the curricula of the lead institution, and of 5 external schools...
October 8, 2018: Substance Abuse
Jessica H Jun, Nadia Fairbairn
BACKGROUND: A substantial proportion of individuals involved with the North American criminal justice system are convicted for drug-related activities. Drug treatment court (DTC) programs were developed as an alternative to incarceration for drug-related offences and aim to prioritize addiction treatment and improve health and social outcomes; however, only a fraction of DTC participants have access to first-line medications for opioid use disorder (OUD). Further, despite emerging evidence for the efficacy of injectable opioid agonist therapy (OAT) in treating individuals with severe OUD where past treatment attempts with first-line therapies have been unsuccessful, this treatment has never, to our knowledge, been implemented in correctional settings...
October 2, 2018: Substance Abuse
Samantha Young, Evan Wood, M-J Milloy, Kora DeBeck, Sabina Dobrer, Ekaterina Nosova, Thomas Kerr, Kanna Hayashi PhD
BACKGROUND: People who inject drugs (PWID) have high rates of hepatitis C virus (HCV) infection. Little is known about the rates of diagnosis and treatment for HCV among PWID. Therefore, this study aims to characterize the cascade of care in Vancouver, Canada, to improve HCV treatment access and delivery for PWID. METHODS: Data were derived from 3 prospective cohort studies of PWID in Vancouver, Canada, between December 2005 and May 2015. The progression of participants was identified through 5 steps in the cascade of care: (1) chronic HCV; (2) linkage to HCV care; (3) liver disease assessment; (4) initiation of treatment; and (5) completion of treatment...
October 2, 2018: Substance Abuse
Abdul-Kareem Abdul-Rahman, Timothy R Card, Matthew J Grainge, Kate M Fleming
BACKGROUND: Although alcohol use disorders (AUDs) are known to increase the relative risk of all-cause and some cause-specific mortality, the absolute mortality rates of the AUD population are unknown. Such knowledge would benefit planners of the provision of services for this population, including in prioritizing the identification and/or treatment of diseases likely to cause their death. METHODS: We conducted a systematic review of studies in English, reporting the cause-specific mortality rates among people treated for AUDs...
September 20, 2018: Substance Abuse
Cynthia J Price, Elaine A Thompson, Sheila E Crowell, Kenneth Pike, Sunny C Cheng, Sara Parent, Carole Hooven
BACKGROUND: Sensory information gained through interoceptive awareness may play an important role in affective behavior and successful inhibition of drug use. This study examined the immediate pre-post effects of the mind-body intervention Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to women's substance use disorder (SUD) treatment. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation. METHODS: Women in intensive outpatient treatment (IOP) for chemical dependency (N = 217) at 3 community clinics in the Pacific Northwest of the United States were recruited and randomly assigned to one of 3 study conditions: MABT + treatment as usual (TAU), women's health education (WHE) +TAU (active control condition), and TAU only...
September 20, 2018: Substance Abuse
Bradley D Stein, Andrew W Dick, Mark Sorbero, Adam J Gordon, Rachel M Burns, Douglas L Leslie, Rosalie Liccardo Pacula
BACKGROUND: Medication treatment (MT) with methadone and buprenorphine are effective treatments for opioid use disorders, but little information is available regarding the extent to which buprenorphine's approval resulted in more individuals receiving MT nor to what extent receipt of such treatment was equitable across communities. METHODS: To examine changes in MT utilization and the association between MT utilization and county-level indicators of poverty, race/ethnicity, and urbanicity, we used Medicaid claims of non-dually eligible Medicaid enrollees aged 18-64 from 14 states for 2002-2009...
June 22, 2018: Substance Abuse
Joji Suzuki, Stephanie Garayalde, Martekuor Dodoo, Claudia Rodriguez
BACKGROUND: Prior studies have suggested that physicians and residents may not have sufficient knowledge to appropriately interpret urine drug tests (UDTs) in patients who are prescribed opioids or using illicit substances. Therefore, the aim of this study was to survey psychiatry residents and fellows about their confidence and knowledge in interpreting UDTs in patients with chronic pain or receiving office-based opioid treatment. METHODS: All psychiatry residency and fellowship program directors in the New England states were approached to recruit their trainees to participate in an anonymous online survey including a 7-item knowledge test...
April 26, 2018: Substance Abuse
Joseph J Palamar, Alberto Salomone, Charles M Cleland, Scott Sherman
BACKGROUND: Nondisclosure of drug use on surveys is common, and many drug users unknowingly ingest adulterant or replacement drugs, which leads to underreporting of use of these drugs. Biological testing can complement survey research, and hair testing is an appealing method, as many drugs are detectable for months post-use. We examined willingness to donate a hair sample to be tested among those surveyed in a population at high risk for consuming adulterated drugs-electronic dance music (EDM) party attendees...
April 25, 2018: Substance Abuse
Joshua Eloge, T Celeste Napier, Bezalel Dantz
Substance use disorders (SUDs) are pervasive in the United States, with 20.1 million cases in 2016, of which only 19% receive treatment. SUDs permeate all medical specialties and should be considered in the differential diagnosis of every chief complaint. Acknowledging the salience of SUDs provides a unique opportunity for early identification and intervention. Thus, SUDs should be reflected prominently in the history of the present illness rather than in the social history. To this effect, we propose the inclusion of Use (U) in the history of present illness and incorporating "U" into the pedagogical mnemonic of OPQRST that is commonly used in medical training...
April 25, 2018: Substance Abuse
Mary Jo Larson, Cheryl Browne, Ruslan V Nikitin, Nikki R Wooten, Sarah Ball, Rachel Sayko Adams, Kelly Barth
BACKGROUND: This study evaluated an educational intervention intended to increase physician use of patient prescription history information from the state prescription monitoring program (PMP) and their adoption of clinical behaviors consistent with opioid prescription guidelines to reduce patient risk. METHODS: Physician volunteers (N = 87) in community practices and Veterans Administration medical settings in South Carolina received an office-based, individualized, educational intervention (academic detailing) from a trained pharmacist who promoted 3 key messages about safer opioid prescribing...
April 2, 2018: Substance Abuse
Sharon Levy, Shannon Mountain-Ray, Jason Reynolds, Steven J Mendes, Jonas Bromberg
BACKGROUND: Medication treatment for opioid use disorder is effective, and is recommended for adolescents, although very few adolescents with opioid use disorder ever receive medications. Reasons include lack of trained medication prescribers for this age group and difficulty in identifying adolescents with substance use disorders. This paper examines a novel implementation model of identifying and providing treatment for substance use disorders, including opioid use disorder, in a pediatric primary care practice...
March 29, 2018: Substance Abuse
Tauheed Zaman, Tessa L Rife, Steven L Batki, David L Pennington
BACKGROUND: Co-prescribing opioids and benzodiazepines increases overdose risk. A paucity of literature exists evaluating strategies to improve safety of co-prescribing. This study evaluated an electronic intervention to improve safety for patients co-prescribed chronic opioids for pain and benzodiazepines at 3 and 6 months. METHODS: A prospective cohort study was conducted from December 2015 through May 2016 at San Francisco Veterans Affairs Health Care System...
March 29, 2018: Substance Abuse
Sara J Becker, Lourah M Kelly, Augustine W Kang, Katherine I Escobar, Daniel D Squires
BACKGROUND: Contingency management (CM) is an evidence-based behavioral intervention for opioid use disorders (OUDs); however, CM adoption in OUD treatment centers remains low due to barriers at patient, provider, and organizational levels. In a recent trial, OUD treatment providers who received the Science to Service Laboratory (SSL), a multilevel implementation strategy developed by a federally funded addiction training center, had significantly greater odds of CM adoption than providers who received training as usual...
March 29, 2018: Substance Abuse
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