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Substance Abuse

John A Cunningham, Michael Chaiton
BACKGROUND: To assess whether there has been an increase over time in the proportion of people who drink in a risky fashion, who receive expressions of concern about their drinking or advice to cut down. METHODS: Secondary analysis of the CAMH Monitor population survey, conducted annually in Ontario (participants 18 or older) and with relevant data available from 1998 to 2015 (N = 48,124). The proportion of participants who drank above weekly low risk drinking levels (approximated as 15 or more drinks for males and 11 or more for females) who reported receiving expressions of concern about their drinking or advice to cut down were compared between the time periods 1998-2004, 2005-2010, and 2011-2015...
March 13, 2018: Substance Abuse
Gerod Hall, Sarah Walters, Hannah Gould, Sungwoo Lim
BACKGROUND: Homeless persons with substance use disorders (SUD) have high disease risk, poor access to healthcare, and are frequent users of Medicaid and other social services. Low-demand supportive housing with no prerequisites for treatment or sobriety has been shown to improve housing stability and decrease public service use for chronically homeless persons with serious mental illness (SMI) and chronic medical conditions. The impact of low-demand housing on individuals with SUD but without co-occurring SMI has been little studied...
March 12, 2018: Substance Abuse
Mark Beitel, Lindsay Oberleitner, Dharushana Muthulingam, David Oberleitner, Lynn M Madden, Ruthanne Marcus, Anthony Eller, Madeline H Bono, Declan T Barry
BACKGROUND: Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. METHODS: Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory...
March 9, 2018: Substance Abuse
Jenna L Butner, Curtis Bone, Caridad C Ponce Martinez, Grace Kwon, Mark Beitel, Lynn M Madden, Madeline H Bono, Anthony Eller, Declan T Barry
BACKGROUND: Despite high rates of chronic pain among their patients, opioid agonist treatment (OAT) counselors report an absence of training to manage chronic pain. METHODS: A multidisciplinary team developed a tailored training for counselors to screen and address chronic pain via a brief psychosocial intervention, and implemented it with 52 addiction counselors. Data on knowledge (9 true-false items) as well as attitudes, interest, and perceived ability (scored on 5-point Likert-type scales) were collected from counselors before (pre-test), after (post-test) training, and after 6 months (follow-up)...
March 9, 2018: Substance Abuse
Hao Yu, John Engberg, Deborah Scharf
BACKGROUND: To determine the relative impact of each of the three state-level tobacco control policies (cigarette taxation, tobacco control spending, and smoke-free air (SFA) laws) on adult smoking rate overall and separately for adult subgroups in the U.S. METHODS: We conducted a difference-in-differences analysis with generalized propensity scores. We merged state-level policies with the individual-level Behavioral Risk Factor Surveillance System in 1995-2009...
March 7, 2018: Substance Abuse
Lello Tesema, Jeffrey Marshall, Rachel Hathaway, Christina Pham, Camille Clarke, Genevieve Bergeron, James Yeh, Michael Soliman, Danny McCormick
BACKGROUND: The prevalence of opioid use disorder (OUD) has increased sharply. Office-based opioid treatment with buprenorphine (OBOT) is effective but often underutilized because of physicians' lack of experience prescribing this therapy. Little is known about US residency training programs provision of OBOT and addiction medicine training. METHODS: We conducted a survey of residency program directors (RPD) at all U.S. residency programs in internal medicine, family medicine and psychiatry to assess the frequency with which their residents provide care for OUD, presence and features of curricula in OBOT and addiction medicine, RPD's beliefs about OBOT and potential barriers to providing OBOT training...
March 7, 2018: Substance Abuse
Bonnie M Vest, Rachel A Hoopsick, D Lynn Homish, Rachel C Daws, Gregory G Homish
BACKGROUND: The goal of this work was to examine associations among childhood trauma, combat trauma and substance use (alcohol problems, frequent heavy drinking (FHD), current cigarette smoking, and current/lifetime drug use) and the interaction effects of childhood trauma and combat exposure on those associations among National Guard/Reserve soldiers. METHODS: Participants (n = 248) completed an electronic survey asking questions about their military experiences, physical and mental health, and substance use...
February 27, 2018: Substance Abuse
Chia-Kuei Lee, Colleen Corte, Karen F Stein
BACKGROUND: Drinking and smoking commonly co-occur in undergraduate students. Although an identity as a drinker is a known predictor of alcohol use and alcohol problems, and early evidence suggests that it also predicts smoking, the role of these behaviors in the development of an identity as a drinker is unknown. In this study, we conceptualized a drinker identity as an enduring memory structure referred to as a self-schema, and conducted a preliminary investigation of the relationships between early drinking experiences, drinker self-schema, and alcohol and tobacco use in undergraduate students...
February 23, 2018: Substance Abuse
Marcus A Bachhuber, Cole Thompson, Ann Prybylowski, José Benitez, Silvana Mazzella, David Barclay
BACKGROUND: Syringe exchange programs are uniquely positioned to offer treatment services to interested clients. Prevention Point Philadelphia recently expanded to offer buprenorphine maintenance treatment through its Stabilization, Treatment, and Engagement Program (STEP). OBJECTIVE: To describe the STEP model of care and report treatment outcomes. METHODS: Retrospective chart review of patients enrolled in STEP (October 2011-August 2014)...
February 23, 2018: Substance Abuse
John R Marshall, Stephen F Gassner, Craig L Anderson, Richelle J Cooper, Shahram Lotfipour, Bharath Chakravarthy
Background Reports indicate a geographic effect of socioeconomic inequalities on the occurrence of opioid-related fatal overdoses. We aim to (1) estimate the rates of opioid-related overdoses, (2) estimate the association of benzodiazepine co-ingestion with opioid-related deaths, (3) estimate associations between socioeconomic indicators and opioid-related deaths, and (4) map the distribution of fatal overdoses, in Orange County (OC), California. Methods We conducted an ecologic study of all opioid related deaths (1205 total) obtained from the OC Coroner Division database from 2010-2014 (1065 OC residents, 55 non-residents, 85 OC homeless) (analyzed 2016-2017)...
February 21, 2018: Substance Abuse
Melissa L Anderson, Bei-Hung Chang, Nisha Kini
BACKGROUND: Within the field of behavioral health research, one of the most understudied populations is the U.S. Deaf and hard-of-hearing (D/HH) population - a diverse group of individuals with hearing loss that have varied language and communication preferences, community affiliations, and sociocultural norms. Recent research identified concerning behavioral health disparities experienced by the D/HH population; yet, little research has been conducted to extend these findings to the topic of substance use disorder...
February 16, 2018: Substance Abuse
Martin T Hall, Diana Ball, Jeanelle Sears, George E Higgins, T K Logan, Seana Golder
BACKGROUND: Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems, and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. METHODS: This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012...
February 16, 2018: Substance Abuse
Daniel P Alford, Brittany L Carney, Angela H Jackson, Belle Brett, Carly Bridden, Michael Winter, Jeffrey H Samet
BACKGROUND: Generalist physicians should play a vital role in identifying and managing individuals with substance use but are inadequately trained to do so. METHODS: This 5 year (2008-2012) controlled educational study assessed whether internal medicine and family medicine chief residents' (CRs) addiction medicine teaching increased by co-training with faculty mentors at a Chief Resident Immersion Training (CRIT) program in addiction medicine. All CRIT CR attendees identified a residency program faculty mentor to support addiction medicine teaching after CRIT through functional mentoring with a focus on developing and implementing an Addiction Medicine Teaching Project ("Teaching Project")...
February 16, 2018: Substance Abuse
Giulia A Aldi, Giuly Bertoli, Francesca Ferraro, Aldo Pezzuto, Fiammetta Cosci
BACKGROUND: Smokers with major depressive disorder (MDD) or depressive symptoms (DS) represent a subgroup in need of attention since they have specific clinical features and prognosis. METHODS: A systematic review of the literature (Cochrane, MEDLINE, ScienceDirect, Web Of Science databases from inception to June 2017) of randomized clinical trials assessing the effectiveness of pharmacological, psychological or combined interventions for smoking cessation in subjects with current or past MDD/DS without medical or comorbid psychiatric disorder(s) was run following the PRISMA guidelines...
February 13, 2018: Substance Abuse
Noa Krawczyk, Tianna Negron, Maia Nieto, Deborah Agus, Michael I Fingerhood
BACKGROUND: Treatment for opioid use disorder involving opioid-based pharmacotherapies is considered most effective when accompanied by psychosocial interventions. Peer-led support groups are widely available and have been described by many as fundamental to the recovery process. However, some individuals using medications face stigma in these settings, which can be contradictory and counterproductive to their recovery. METHODS: This article describes the development of the Ability, Inspiration and Motivation or "AIM" group, an alternative peer support group that aims to remove medication stigma from peer-recovery...
February 12, 2018: Substance Abuse
Carl A Latkin, Catie Edwards, Melissa A Davey-Rothwell, Cui Yang, Karin E Tobin
BACKGROUND: There has been a dramatic increase in drug overdose deaths in the US. In the current study, we examined factors associated with witnessing a drug overdose. METHODS: A sample of 450 substance users in Baltimore, Maryland, US were recruited for a behavioral intervention and were administered a survey. Multinomial logistic regression models were used to compare participants who never witnessed a drug overdose to those who witnessed one in the prior six months and those who witnessed an overdose over six months ago...
February 12, 2018: Substance Abuse
Anita N Jacobson, Jeffrey P Bratberg, Miranda Monk, John Ferrentino
BACKGROUND: Overdose education and naloxone training was recently implemented into the required curriculum of the College of Pharmacy at the University of Rhode Island. The objective of this study was to compare the retention of knowledge between student pharmacists who received a didactic lecture only versus student pharmacists who received the same lecture plus a skills-based objective structured clinical examination (OSCE) with a standardized patient actor. METHODS: Students in their first-professional year (P1) of the Doctor of Pharmacy program (n = 129) and students in their second-professional (P2) year (n = 123) attended a required lecture on opioid overdose, including detailed naloxone training...
February 12, 2018: Substance Abuse
Jessica Lee Taylor, Alison B Rapoport, Christopher F Rowley, Kenneth J Mukamal, Wendy Stead
BACKGROUND: Despite escalating opioid overdose death rates, addiction medicine is underrepresented in residency curricula. Providing naloxone to at-risk patients, relatives, and first responders reduces overdose deaths, but rates of naloxone prescribing remain low. The goal of this study is to examine the impact of a brief curricular intervention for internal medicine residents on naloxone prescribing rates, knowledge, and attitudes. METHODS: Internal medicine residents (n = 160) at an urban, tertiary care medical center received two one-hour didactic sessions addressing overdose prevention, including intranasal naloxone...
February 12, 2018: Substance Abuse
Lindsay R Duncan, Kimberly D Hieftje, Tyra M Pendergrass, Benjamin G Sawyer, Lynn E Fiellin
BACKGROUND: Videogames are becoming increasingly popular to deliver health interventions; however, their role in the primary prevention of cigarette and marijuana use has not yet been evaluated. The purpose of this study was to conduct a preliminary test of the efficacy of a role-playing videogame prototype, smokeSCREEN, aimed at developing knowledge and behavioral skills associated with primary prevention of cigarette and marijuana use. We also explored participants' gameplay experience...
February 9, 2018: Substance Abuse
Zila M Sanchez, Adriana Sanudo
BACKGROUND: This study aimed to test the effectiveness of a web-based intervention in preventing alcohol abuse among nightclub patrons. METHODS: A probabilistic sample of the patrons of 31 nightclubs in São Paulo, Brazil, was invited to participate in an online screening using the Alcohol Use Disorders Identification Test (AUDIT). A total of 1057 patrons met the inclusion criteria to participate in the randomized controlled trial, with data collection at 0, 3, 6 and 12 months...
February 9, 2018: Substance Abuse
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