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Substance Abuse

Disa Dahlman, Anders Håkansson, Alex H Kral, Lynn Wenger, Elizabeth K Ball, Scott P Novak
BACKGROUND: People who inject drugs (PWID) are at increased risk for bacterial skin and soft tissue infections (SSTIs). While SSTIs pose significant health risks, little is known about their prevalence and characteristics in the population of PWID in the United States. This study investigates whether behavioral factors related to skin and equipment hygiene and tissue-damaging injection practices are associated with recent SSTIs among PWID. METHODS: Active PWID were recruited using targeted sampling in San Francisco in 2011-2013...
November 29, 2016: Substance Abuse
Matthew A Spinelli, Claudia Ponath, Lina Tieu, Emily E Hurstak, David Guzman, Margot Kushel
BACKGROUND: The median age of the single adult homeless population is 50 and rising. While the prevalence of substance use decreases as individuals age, older adults now have a higher prevalence of substance use than older adults did ten years ago. Homeless individuals have a higher prevalence of substance use disorders than the general population. However, little is known about substance use in older homeless adults. METHODS: We examined prevalence of and factors associated with substance use in a population-based sample (n = 350) of homeless individuals aged 50 and older in Oakland, CA...
November 29, 2016: Substance Abuse
Sara L Doorley, Cheryl J Ho, Elizabeth Echeverria, Charles Preston, Huy Ngo, Ahmad Kamal, Chinazo O Cunningham
BACKGROUND: Opioid misuse and dependence are prevalent and rising problems in the United States. Treatment with buprenorphine is a successful treatment option for individuals with opioid dependence. We describe and preliminarily evaluate a unique delivery system that provides buprenorphine treatment via a shared medical appointment. METHODS: We conducted a retrospective medical record review on all 77 opioid-dependent patients referred for a buprenorphine shared medical appointment in a homeless clinic from 2010-2012...
November 29, 2016: Substance Abuse
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
Alanna Stone, Maria Wamsley, Patricia O'Sullivan, Jason Satterfield, Derek D Satre, Katherine Julian
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching...
November 29, 2016: Substance Abuse
Kimber P Richter, Jamie J Hunt, A Paula Cupertino, Byron J Gajewski, Yu Jiang, Janet Marquis, Peter D Friedmann
BACKGROUND: Although people with mental illness, including substance use disorders, consume 44% of cigarettes in the U.S., few facilities provide tobacco treatment. This study assesses staff- and facility-level drivers of tobacco treatment in substance use treatment. METHODS: We administered surveys to 405 clinic directors selected from a comprehensive inventory of 3,800 U.S. outpatient facilities. The main outcome was the validated 7-item Index of Tobacco Treatment Quality...
November 29, 2016: Substance Abuse
Tammy Chung, Feifei Ye, Alison E Hipwell, Stephanie D Stepp, Elizabeth Miller, Sonya Borrero, Mary Hawk
BACKGROUND: Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. We tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females. METHODS: The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions...
November 29, 2016: Substance Abuse
Lauren M Papp, Chrystyna D Kouros
BACKGROUND: Mounting evidence based on retrospective and global assessments has established associations between prescription drug misuse and illicit drug use, alcohol abuse, mental health problems, risky sexual behaviors, and overdose deaths. However, there is a notable absence of identified risk and protective factors for an individual's likelihood of engaging in misuse in real-world environments. METHODS: Using an experience sampling approach, we collected repeated moments of young adults' (n = 95 participants drawn from 49 romantic couples) prescription drug misuse instances in daily life, and tested multiple factors associated with the misuse...
November 29, 2016: Substance Abuse
Christine E Spadola, Eric F Wagner, Veronica H Accornero, Denise C Vidot, Nestor de la Cruz-Munoz, Sarah E Messiah
BACKGROUND: Research suggests that young adults and racial/ethnic minorities are at an increased risk for problematic alcohol use. Recent studies have also documented patterns of problematic alcohol use among a subset of weight loss surgery (WLS) patients. However, to date, there are no published studies investigating the intersection of these demographic and clinical characteristics. METHODS: This study used descriptive and inferential analyses to examine alcohol use patterns, prevalence of pre and post-WLS alcohol use disorders (AUDs), and predictors of increased alcohol use and problematic alcohol use post-WLS among young adult (mean age 26...
November 22, 2016: Substance Abuse
Stefan G Kertesz
The US opioid epidemic has changed profoundly in the last 3 years, in ways that require substantial recalibration of the US policy response. This report summarizes the changing nature of overdose deaths in Jefferson County (home to Birmingham, Alabama) using data updated through June 30, 2016. Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, while opioids commonly obtained by prescription play a minor role, accounting for no more than 15% of reported deaths in 2015...
November 18, 2016: Substance Abuse
Nicki Jackson, Simon Denny, Janie Sheridan, Terry Fleming, Terryann Clark, Roshini Peiris-John, Shanthi Ameratunga
BACKGROUND: Many Western countries have reported declines in adolescent alcohol use. This study examined changes in adolescent alcohol use in New Zealand between 2007 and 2012 and explored variations across socio-demographic strata. METHODS: Data from two nationally-representative, cross-sectional high school surveys conducted in 2007 (n = 7,709) and 2012 (n = 7,266) were examined. Changes in the prevalence of drinking in the past 4 weeks were examined among the total sample, as well as the frequency of drinking in the past 4 weeks and typical drinking-occasion quantity among drinkers...
October 26, 2016: Substance Abuse
Magdalena Greene, J Aaron Johnson, J Paul Seale, Allen Tindol, Kristy B Le, Diana D Clemow, Ann H Barham, David P Miller
BACKGROUND: Over one-quarter of American adults binge drink, resulting in significant alcohol-related morbidity and mortality. Though brief interventions can decrease patients' alcohol use, many physicians in training do not provide this service. This study examines the prevalence of binge drinking among primary care residents, and the association of resident drinking behaviors with addressing patients' hazardous alcohol use. METHODS: Between July 2013 and August 2014, the authors surveyed all trainees in six primary care residency programs...
September 20, 2016: Substance Abuse
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October 2016: Substance Abuse
Corey S Davis, Scott Burris, Leo Beletsky, Ingrid Binswanger
The opioid overdose epidemic claims the lives of tens of thousands of Americans every year. Opioid overdose is reversible by the administration of naloxone, a pure antagonist now available in formulations specifically designed and labeled for layperson use. Despite broad support for layperson access to naloxone from professional organizations, health officials, and clinical experts, qualitative studies suggest that some providers have concerns about legal risks associated with naloxone prescribing, particularly co-prescribing naloxone to pain patients...
October 2016: Substance Abuse
Arthi K Narayanan, John D Harding, Shaddy K Saba, James Conley, Adam J Gordon
The United States faces an addiction health crisis. Presidential election cycles in the United States are cause for creation of political party platforms. These platforms provide general stances and specific policies on a variety of issues. We undertook a review of the addiction policies of the 2016 Republican and Democratic platforms. Despite differences in focus, we found more similarities than differences between the two. We call upon those in political power to use every evidence-based policy at their disposal to promote addiction treatment and prevention...
October 2016: Substance Abuse
Traci M Schwinn, Steven P Schinke, Jessica Hopkins, Bridgette Thom
BACKGROUND: Despite overall reductions in teenage substance use, adolescent girls' rates of substance use remain unacceptably high. This article examines whether girls' substance use is associated with general risk and protective factors (goal setting, problem solving, refusal skills, peer use, and self-efficacy) and gender-specific risk and protective factors (communication style, coping skills, self-esteem, body image, perceived stress, anxiety, and depression). METHODS: Cross-sectional data were collected in 2013 via online surveys from a nationwide sample of adolescent girls (N = 788), aged 13 and 14 years, who were recruited through Facebook...
October 2016: Substance Abuse
Traci Rieckmann, John Muench, Mary Ann McBurnie, Michael C Leo, Phillip Crawford, Daren Ford, Jennifer Stubbs, Conall O'Cleirigh, Kenneth H Mayer, Kevin Fiscella, Nicole Wright, Maya Doe-Simkins, Matthew Cuddeback, Elizabeth Salisbury-Afshar, Christine Nelson
BACKGROUND: The Affordable Care Act increases access to treatment services for people who suffer from substance use disorders (SUDs), including alcohol use disorders (AUDs) and opioid use disorders (OUDs). This increased access to treatment has broad implications for delivering health services and creates a dramatic need for transformation in clinical care, service lines, and collaborative care models. Medication-assisted treatments (MAT) are effective for helping SUD patients reach better outcomes...
October 2016: Substance Abuse
Jeremy Mennis, Michael Mason
BACKGROUND: This study investigates whether residential exposure to tobacco outlets (i.e., convenience stores and other stores selling tobacco) is associated with attitudes towards smoking among a sample of urban, primarily African American, adolescent smokers. METHODS: Cross-sectional survey data for 197 adolescents were integrated with spatial data on tobacco outlets via subject home addresses. Ordinal regression was employed to test hypotheses that closer proximity to, and higher concentrations of, tobacco outlets are associated with higher measures of intention to continue to smoke in the future, weaker self-efficacy related to stopping smoking, and more accepting social norms related to smoking, while controlling for characteristics of age, gender, family and peer smoking contexts, and level of nicotine dependence...
October 2016: Substance Abuse
Sarah E Wakeman, Genevieve Pham-Kanter, Karen Donelan
BACKGROUND: Previous research demonstrates that most primary care physicians feel unprepared to diagnose and treat substance use disorder (SUD). Confidence in SUD management has been associated with improved clinical practices. METHODS: A cross-sectional survey of 290 inpatient and outpatient general internists in an academic medical center evaluating attitudes, preparedness, and clinical practice related to SUD. RESULTS: 149 general internists responded, a response rate of 51%...
October 2016: Substance Abuse
Laura Brandt, Patrick Swoboda, Gabriele Fischer, Annemarie Unger
BACKGROUND: Prior studies have reported on the pregnancies and outcomes of in vitro fertilization (IVF) in special subpopulations; however, there is a lack of studies on opioid-exposed IVF-conceived neonates. CASE PRESENTATION: A young adult IVF-pregnant woman was maintained on buprenorphine throughout pregnancy and received follow-up from the addiction clinic from estimated gestational week 32. She delivered healthy dichorionic twins via cesarean section at 38 weeks gestational age (buprenorphine dose at time of delivery: 16 mg)...
October 2016: Substance Abuse
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