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Substance Abuse

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https://www.readbyqxmd.com/read/29161228/homelessness-predicts-attrition-but-not-alcohol-abstinence-in-outpatients-experiencing-co-occurring-alcohol-dependence-and-serious-mental-illness
#1
Emily Leickly, Jordan Skalisky, Oladunni Oluwoye, Sterling M McPherson, Debra Srebnik, John M Roll, Richard K Ries, Michael G McDonell
BACKGROUND: Adults experiencing homelessness and serious mental illnesses (SMI) are at an increased risk for poor mental health and treatment outcomes compared to stably housed adults with SMI. The additional problem of alcohol misuse further complicates the difficulties of those living with homelessness and SMI. In this secondary data analysis, we investigated the impact of homelessness on attrition and alcohol use in a contingency management (CM) intervention that rewarded alcohol abstinence in outpatients with SMI...
November 21, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29058572/lifetime-marijuana-and-alcohol-use-and-cognitive-dysfunction-in-people-with-human-immunodeficiency-virus-infection
#2
Sara A Lorkiewicz, Alicia S Ventura, Timothy C Heeren, Michael R Winter, Alexander Y Walley, Meg Sullivan, Jeffrey H Samet, Richard Saitz
BACKGROUND: Substance use is common among people with HIV infection. Alcohol, marijuana, and HIV can have negative effects on cognition. We examined associations between current and lifetime marijuana and alcohol use, and cognitive dysfunction in people with HIV infection. METHODS: We studied a cohort of 215 HIV-infected adults with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance dependence or ever injection drug use. In adjusted cross-sectional regression analyses we tested the associations between current marijuana use, current heavy alcohol use, lifetime marijuana use, lifetime alcohol use, duration of heavy alcohol use (the independent variables), and three measures of cognitive dysfunction (dependent variables): both the i) memory and ii) attention domains from the Montreal Cognitive Assessment (MoCA), and iii) the 4-item cognitive function scale (CF4) from the Medical Outcomes Study HIV Health Survey (MOS-HIV)...
October 23, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29043947/outpatient-continuing-care-after-residential-substance-use-disorder-treatment-in-the-u-s-veterans-health-administration-facilitators-and-challenges
#3
Anna D Rubinsky, Laura S Ellerbe, Shalini Gupta, Tyler E Phelps, Thomas Bowe, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Veterans Health Administration (VHA), residential treatment programs are an important part of the continuum of care for patients with substance use disorders (SUDs). Outpatient continuing care after residential treatment helps maintain early recovery and treatment gains. Knowing more about the drivers of variation in continuing care practices and performance across residential programs might inform quality improvement efforts. METHODS: We operationalized measures of continuing care and calculated these metrics for each of VHA's 63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs) and 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track in fiscal year 2012...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29043922/barriers-and-facilitators-to-dispensing-of-intranasal-naloxone-by-pharmacists
#4
Ludmila N Bakhireva, Adriana Bautista, Sandra Cano, Shikhar Shrestha, Amy M Bachyrycz, Theresa H Cruz
BACKGROUND: While misuse of prescription opioids has reached epidemic proportions, pharmacy-based preventive services to combat this epidemic are limited. The aims of this study were to identify barriers and facilitators to the dispensing of intranasal naloxone (INN) by pharmacists in New Mexico. METHODS: For this mixed methods study, a qualitative component (focus group) informed the development of a quantitative component (electronic survey) distributed to all pharmacists registered with the New Mexico Board of Pharmacy and practicing in the state...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29043918/-being-able-to-speak-what-individuals-in-jail-perceived-as-helpful-about-participating-in-alcohol-related-brief-interventions
#5
Mandy D Owens, Megan Kirouac, Kylee Hagler, Lauren N Rowell, Emily C Williams
BACKGROUND: A significant proportion of individuals within the criminal justice system meet criteria for a substance use disorder. Treatments for individuals who are incarcerated with substance use disorders show minimal to no benefit on post-release outcomes, suggesting a need to improve their effectiveness, particularly those that can be delivered in a brief format. The purpose of this study was to describe what individuals in jail with substance use disorders perceived as being helpful about two brief alcohol-focused interventions, which can be used to inform future treatments with this population...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29016245/effect-of-a-high-dosage-opioid-prior-authorization-policy-on-prescription-opioid-use-misuse-and-overdose-outcomes
#6
Daniel M Hartung, Hyunjee Kim, Sharia M Ahmed, Luke Middleton, Shellie Keast, Richard A Deyo, Kun Zhang, K John McConnell
High dosage opioid use is a risk factor for opioid-related overdose commonly cited in guidelines, recommendations, and policies. In 2012, the Oregon Medicaid program developed a prior authorization policy for opioid prescriptions above 120 mg per day morphine equivalent dose (MED). This study aimed to evaluate the effects of that policy on utilization, prescribing patterns, and health outcomes. Methods: Using administrative claims data from Oregon and a control state (Colorado) between 2011 and 2013, we used difference-in-differences analyses to examine changes in utilization, measures of high risk opioid use, and overdose after introduction of the policy...
October 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28991522/heterogeneity-of-state-medical-marijuana-laws-and-adolescent-recent-use-of-alcohol-and-marijuana-analysis-of-45-states-1991-2011
#7
Julie K Johnson, Renee M Johnson, Dominic Hodgkin, Abenaa A Jones, Ann Marie Matteucci, Sion K Harris
OBJECTIVE: To assess associations between enactment of state medical marijuana laws (MMLs), MML restrictiveness, and past-30-day youth alcohol use overall, and in relation to marijuana use. METHOD: This quasi-experimental difference-in-difference designed study used state-level Youth Risk Behavior Survey data of 9th-12th grade students in 45 states from 1991-2011 (N = 715,014). We conducted bivariate (unadjusted) and multivariable (adjusted for state, year, individual characteristics) logistic regression analyses to examine the effect of MML enactment (yes/no) and less restrictive vs...
October 9, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28991520/mortality-risk-in-a-sample-of-emergency-department-patients-who-use-cocaine-with-alcohol-and-or-cannabis
#8
Devin Gilmore, Jennifer Zorland, Joanna Akin, J Aaron Johnson, James G Emshoff, Gabriel P Kuperminc
BACKGROUND: Illicit drug use is common among emergency department (ED) patients, yet the association between drug use and subsequent mortality is not well understood. This study examines 36-month mortality rates for a sample of ED patients based on reported use of alcohol, cannabis, and cocaine, both individually and in combination. METHODS: Patients (N = 1669) from 2 urban EDs were surveyed at the time of the visit. The patient survey included the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) and information on physical and mental health, health care utilization, and risk factors associated with substance use...
October 9, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28991519/association-between-binge-drug-use-and-suicide-attempt-among-people-who-inject-drugs
#9
Charles Fournier, Maykel Farag Ghabrash, Adelina Artenie, Elise Roy, Geng Zang, Julie Bruneau, Didier Jutras Aswad
BACKGROUND: People who inject drugs (PWID) have an elevated risk of suicide attempt. Although different substances are associated with suicide attempt, the overall risk posed by binge behavior, a high-risk pattern of drug use, remains unclear. The objective of this study is to assess the association between binge drug use and suicide attempt in a prospective cohort of PWID in Montreal, Canada. METHODS: Participants answered a biannual interviewer-administered questionnaire compiling information on sociodemographics, pattern of substance use (cocaine, amphetamine, opioids, sedative-hypnotics, alcohol, and cannabis), and psychosocial stressors and related markers...
October 9, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28991516/addressing-substance-use-disorder-in-primary-care-the-role-integration-and-impact-of-recovery-coaches
#10
Helen E Jack, Devin Oller, John Kelly, Jessica F Magidson, Sarah E Wakeman
BACKGROUND: Only 10% of people with substance use disorder (SUD) receive treatment, partially due to inadequate access to specialty SUD care and limited management within primary care. "Recovery coaches" (RCs), peers sharing the lived experience of addiction and recovery, are increasingly being integrated into primary care to help reach and treat people experiencing SUD, yet little is known about how their role should be defined or about their clinical integration and impact. METHODS: Semistructured interviews with RCs (n = 5) and their patients (n = 16) were used to explore patient and RC perspectives on the RC role...
October 9, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28972445/knowledge-of-the-911-good-samaritan-law-and-911-calling-behavior-of-overdose-witnesses
#11
Andrea Jakubowski, Hillary V Kunins, Zina Huxley-Reicher, Anne Siegler
BACKGROUND: Overdose deaths tripled between 1999 and 2014. Most fatal overdoses are witnessed, offering an opportunity for bystanders to call 911. However, fear of arrest may prevent them from calling authorities. Many states have passed 911 Good Samaritan laws that protects the 911 caller and overdose victim from prosecution for drug possession. Little is known, however, about whether the law affects 911-calling behavior of overdose witnesses. This study investigated the relationship between knowledge of a 911 Good Samaritan Law (GSL) and 911-calling behavior of study participants trained in opioid overdose rescue...
October 3, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28901836/the-overlap-of-sleep-disturbance-and-depression-in-primary-care-patients-treated-with-buprenorphine
#12
Sarah L Garnaat, Risa B Weisberg, Lisa A Uebelacker, Debra S Herman, Genie L Bailey, Bradley J Anderson, Katherine M Sharkey, Michael D Stein
BACKGROUND: Sleep disturbance is common among patients receiving long-term opioid therapies, such as methadone maintenance. However, little is known about sleep disturbances in patients receiving medication treatment with buprenorphine. We sought to determine the frequency of subjective sleep disturbance in a sample of patients receiving medication treatment and to examine clinical factors related to sleep disturbance. METHODS: Participants were 328 persons receiving buprenorphine at 3 primary care sites...
October 2017: Substance Abuse
https://www.readbyqxmd.com/read/28715290/trainees-knowledge-attitudes-and-practices-towards-caring-for-the-substance-exposed-mother-infant-dyad
#13
Davida M Schiff, Barry Zuckerman, Elisha M Wachman, Megan Bair-Merritt
BACKGROUND: As rates of substance use disorder during pregnancy rise, pediatric trainees are increasingly caring for infants with neonatal abstinence syndrome (NAS). This study evaluated the knowledge, attitudes, and practices of trainees caring for substance-exposed newborns and their families, comparing differences by level and type of training, and personal experience with addiction or trauma. METHODS: A cross-sectional survey of medical students and pediatric, medicine/pediatric, and family medicine residents in 2015-2106...
October 2017: Substance Abuse
https://www.readbyqxmd.com/read/28699845/development-and-implementation-of-an-alcohol-withdrawal-protocol-using-a-5-item-scale-the-brief-alcohol-withdrawal-scale-baws
#14
Darius A Rastegar, Dinah Applewhite, Anika A H Alvanzo, Christopher Welsh, Timothy Niessen, Edward S Chen
BACKGROUND: The standard of care for management of alcohol withdrawal is symptom-triggered treatment using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). Many items of this 10-question scale rely on subjective assessments of withdrawal symptoms, making it time-consuming and cumbersome to use. Therefore, there is interest in shorter and more objective methods to assess alcohol withdrawal symptoms. METHODS: A 6-item withdrawal scale developed at another institution was piloted...
October 2017: Substance Abuse
https://www.readbyqxmd.com/read/28622099/energy-drinks-and-alcohol-related-risk-among-young-adults
#15
Celeste M Caviness, Bradley J Anderson, Michael D Stein
BACKGROUND: Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. METHODS: The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours")...
October 2017: Substance Abuse
https://www.readbyqxmd.com/read/28934063/openness-to-adopting-evidence-based-practice-in-public-substance-use-treatment-in-south-africa-using-task-shifting-caseload-size-matters
#16
Jessica F Magidson, Jasper S Lee, Kim Johnson, Warren Burnhams, J Randy Koch, Ron Manderscheid, Bronwyn Myers
BACKGROUND: In response to the lack of coverage for substance use treatment in the Western Cape province of South Africa, the local government expanded funding for evidence-based practices (EBPs) for treating substance use. Yet, little is known about provider and staff attitudes towards adopting EBPs in this setting, which is particularly relevant in this context where task shifting clinical care increases demands on paraprofessional providers. This study aimed to (1) assess attitudes towards adopting EBPs among a range of staff working in substance use treatment in Cape Town using a task shifting model; and (2) evaluate factors associated with openness towards adopting EBPs in this setting...
September 21, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28929914/the-conundrum-of-opioid-tapering-in-long-term-opioid-therapy-for-chronic-pain-a-commentary
#17
Ajay Manhapra, Albert A Arias, Jane C Ballantyne
BACKGROUND: In response to the opioid epidemic and new guidelines, many patients on high-dose long term opioid therapy (LTOT) for chronic pain are getting tapered off opioids. As a result, a unique clinical challenge is emerging: while many on LTOT have poor pain control, functional decline, psychiatric instability, aberrancies and misuse, these issues may often worsen with opioid tapering. Currently, a clear explanation and practical guidance on how to manage this perplexing clinical scenario is lacking...
September 20, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28910591/the-denial-of-the-association-between-youth-cannabis-and-opiate-use-a-split-brain-syndrome
#18
Yifrah Kaminer
No abstract text is available yet for this article.
September 14, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28895809/screening-brief-intervention-and-referral-to-treatment-sbirt-curriculum-integration-and-sustainability-social-work-and-nursing-faculty-perspectives
#19
M Nicole Belfiore, Marcela D Blinka, Karlynn BrintzenhofeSzoc, Joseph Shields
BACKGROUND: The Substance Abuse and Mental Health Services Administration (SAMHSA) has funded grants to universities to provide training and conduct research on the dissemination of screening, brief intervention, and referral to treatment (SBIRT) to health care professionals. However, when it comes to integrating SBIRT content into an existing curriculum, difficulties can arise. When there is so much content already in the curriculum, adding more can be challenging. Additionally, some faculty believe that course curricula should be driven by the expertise and knowledge of faculty, not by opportunities afforded because of grant funding...
September 12, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28873050/randomized-pilot-trial-measuring-knowledge-acquisition-of-opioid-education-in-emergency-department-patients-using-a-novel-media-platform
#20
Bharath Chakravarthy, Shashank Somasundaram, Jennifer Mogi, Roshan Burns, Wirachin Hoonpongsimanont, Warren Wiechmann, Shahram Lotfipour
BACKGROUND: The number of active opioid analgesic prescriptions has risen steadily, causing increases in nonmedical opioid use, addiction, and overdose. Insufficient focus on patient discharge instructions has contributed to lack of patient awareness regarding dangers of opioids. This study examines whether an educational Khan Academy-style animation discharge instruction on the dangers and safe usage of opioid analgesics elicits higher knowledge acquisition than current standard of care...
September 5, 2017: Substance Abuse
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