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Journal of Addiction Medicine

Richard Saitz
No abstract text is available yet for this article.
January 14, 2019: Journal of Addiction Medicine
Jessica L Moreno, Sarah E Wakeman, Matthew S Duprey, Russell J Roberts, Jared S Jacobson, John W Devlin
OBJECTIVES: To identify the incidence, characteristics, and predictors for 30 and 90-day readmission among acutely hospitalized patients with opioid use disorder (OUD). METHODS: This retrospective, cohort study evaluated consecutive adults with OUD admitted to an academic medical center over a 5-year period (10/1/11 to 9/30/16). Multivariable logistic regression was used to determine independent predictors for 30 and 90-day readmissions based on pertinent admission, hospital, and discharge variables collected via chart review and found to be different (with a P < 0...
January 8, 2019: Journal of Addiction Medicine
Bao-Liang Zhong, Yan-Min Xu, Wu-Xiang Xie, Jin Lu, Wen-Bo Yu, Jun Yan
OBJECTIVES: Unhealthy alcohol use is associated with negative health outcomes in clients attending methadone maintenance therapy (MMT) programs. However, debates exist regarding the methadone dose of drinkers, and little is known about the health outcomes of drinkers with other types of alcohol use. This study examined the drinking pattern and its association with methadone dose, and depressive and anxiety symptoms in Chinese clients undergoing MMT. METHODS: A secondary data analysis was conducted with data from a large-scale cross-sectional survey of 549 clients of 3 MMT clinics in Wuhan, China...
January 4, 2019: Journal of Addiction Medicine
Vivian Braithwaite, Seonaid Nolan
: Substance use disorders account for a significant burden of disease and place an enormous strain on the health care system in the United States and beyond. Despite death tolls climbing, a myriad of evidence-based medications exist to effectively treat many substance use disorders including nicotine, alcohol, and opioid use disorders. To date, hospitals have largely been overlooked as a setting ripe for the delivery of specialized addiction care. This occurs despite a high lifetime prevalence of a substance use disorder (50%) occurring among hospitalized individuals...
January 4, 2019: Journal of Addiction Medicine
Kaitlyn R Hay, Andrew S Huhn, David Andrew Tompkins, Kelly E Dunn
BACKGROUND: While most opioid use disorder (OUD) treatment providers consider opioid abstinence to be the preferred outcome, little is known about the treatment preferences of the larger population of individuals who engage in nonmedical opioid use and have not yet sought treatment. This study sought to descriptively quantify the proportion of out-of-treatment individuals with nonmedical opioid use that have abstinent and nonabstinent recovery goals. METHODS: Participants (N = 235) who engage in nonmedical opioid use and met self-reported criteria for OUD were recruited online and participated in a cross-sectional survey on recovery goals and treatment perceptions...
January 4, 2019: Journal of Addiction Medicine
Kelsey C Priest, Dennis McCarty
OBJECTIVE: The aim of the study was to explore and describe the structure and design elements of addiction medicine consult (AMC) services within selected US hospitals. METHODS: As part of a larger mixed methods study, 10 qualitative semi-structured telephone interviews were completed with board-certified addiction medicine physicians affiliated with the Addiction Medicine Foundation's Addiction Medicine Fellowship Programs at 9 US hospitals. Interviews were transcribed, coded, and analyzed using a directed content analysis...
December 28, 2018: Journal of Addiction Medicine
Honora Englander, Stacey Mahoney, Kimberly Brandt, Jessica Brown, Claire Dorfman, Alexander Nydahl, Melissa Weimer, Jessica Gregg
: Hospitals are increasingly filled with people admitted for medical and surgical complications of substance use disorder (SUD). Hospitalization can be a reachable moment to engage and initiate SUD care. Yet most hospitals do not have systems in place to adequately address addiction, and most providers have little to no addiction training. There is widespread need for protocols and tools to implement hospital-based SUD care. We share best practices from our hospital-based Improving Addiction Care Team (IMPACT)...
December 28, 2018: Journal of Addiction Medicine
Ivana Lúcia Damásio Moutinho, Alessandra Lamas Granero Lucchetti, Oscarina da Silva Ezequiel, Giancarlo Lucchetti
OBJECTIVES: Although there are a number of studies about substance use by medical students, the majority are still cross-sectional. We aimed to investigate prevalence, 2-year incidence, and factors associated with substance use during medical training. METHODS: This longitudinal study included medical students in 4 different waves (with each wave equaling 1 semester). Socio-demographic data, Duke Religion Index (DUREL), DASS-21, and the "Alcohol, Smoking and Substance Involvement Screening Test" (ASSIST) were used...
December 27, 2018: Journal of Addiction Medicine
A J Lowik, Rod Knight
: Epidemiological and clinical evidence clearly indicates that binge and/or heavy alcohol use while pregnant can be dangerous for the fetus. As such, there is a large body of research evaluating interventions to address harms associated with alcohol use during pregnancy. Unfortunately, based on our assessment of the scientific literature in this area, including a reading of three high-impact systematic reviews, there are several key areas where the language being used is hindering efforts to address alcohol harms during pregnancy in nonjudgmental and gender-inclusive ways...
December 27, 2018: Journal of Addiction Medicine
Babak Tofighi, Noelle Leonard, Peter Greco, Aboozar Hadavand, Michelle C Acosta, Joshua D Lee
BACKGROUND: Technology-based interventions offer a practical, low-cost, and scalable approach to optimize the treatment of substance use disorders (SUDs) and related comorbidities (HIV, hepatitis C infection). This study assessed technology use patterns (mobile phones, desktop computers, internet, social media) among adults enrolled in inpatient detoxification treatment. METHODS: A 49-item, quantitative and qualitative semi-structured survey assessed for demographic characteristics, technology use patterns (ie, mobile phone, text messaging [TM], smart phone applications, desktop computer, internet, and social media use), privacy concerns, and barriers to technology use...
December 20, 2018: Journal of Addiction Medicine
Rachel L Graves, Elena Andreyeva, Jeanmarie Perrone, Frances S Shofer, Raina M Merchant, Zachary F Meisel
OBJECTIVE: To assess the availability and price of naloxone as well as pharmacy staff knowledge of the standing order for naloxone in Pennsylvania pharmacies. METHODS: We conducted a telephone audit study from December 2016 to April 2017 in which staff from Pennsylvania pharmacies were surveyed to evaluate naloxone availability, staff understanding of the naloxone standing order, and out-of-pocket cost of naloxone. RESULTS: Responses were obtained from 682 of 758 contacted pharmacies (90% response rate)...
December 18, 2018: Journal of Addiction Medicine
Bayla Ostrach, Catherine Leiner
OBJECTIVES: The objectives of this article are to present findings from recent qualitative research with patients in a combined perinatal substance use treatment program in Central Appalachia, and to describe and analyze participants' ambivalence about medication-assisted treatment for opioid use disorder (OUD), in the context of widespread societal stigma and judgement. METHODS: We conducted research in a comprehensive outpatient perinatal substance use treatment program housed in a larger obstetric practice serving a large rural, Central Appalachian region...
December 17, 2018: Journal of Addiction Medicine
Andrew H Rogers, Jafar Bakhshaie, Julia D Buckner, Michael F Orr, Daniel J Paulus, Joseph W Ditre, Michael J Zvolensky
OBJECTIVES: Opioid misuse constitutes a significant public health problem and is associated with a host of negative outcomes. Despite efforts to curb this increasing epidemic, opioids remain the most widely prescribed class of medications. Prescription opioids are often used to treat chronic pain despite the risks associated with use, and chronic pain remains an important factor in understanding this epidemic. Cannabis is another substance that has recently garnered attention in the chronic pain literature, as increasing numbers of individuals use cannabis to manage chronic pain...
December 13, 2018: Journal of Addiction Medicine
Paul Trowbridge, Alexander Y Walley
: Tianeptine is an atypical antidepressant which exerts an opioid-like effect on the μ-opioid receptor. There is well documented intentional misuse and addiction to tianeptine in Europe, and this is increasingly being seen in the United States. We presented a case of buprenorphine/naloxone successfully being used to aid in cessation and subsequent abstinence from tianeptine after years of use. An additional consideration with tianeptine use is the potential for the development or re-emergence of depression and anxiety on cessation...
December 13, 2018: Journal of Addiction Medicine
Marian Jarlenski, Sarah Minney, Caroline Hogan, Judy C Chang
OBJECTIVE: In many states, health care providers are legally required to report pregnant women who use substances, or infants affected by prenatal substance use, to child welfare authorities. The objective of this study was to characterize obstetric and pediatric providers' perceptions of and experiences with policies requiring mandatory reporting of prenatal substance use to child welfare authorities. METHODS: We conducted a qualitative interview study among 20 obstetric and pediatric providers to elicit participants' perspectives about and experience with current policy requiring mandatory reporting of prenatal substance use...
December 13, 2018: Journal of Addiction Medicine
Sarah E Wakeman, Yuchiao Chang, Susan Regan, Liyang Yu, James Flood, Joshua Metlay, Nancy Rigotti
OBJECTIVES: There has been a rapid increase in the presence of illicitly manufactured fentanyl in the heroin drug supply. Buprenorphine is an effective treatment for heroin and prescription opioid use disorder; however, little is known about treatment outcomes among people using fentanyl. We compared 6-month treatment retention and opioid abstinence among people initiating buprenorphine treatment who had toxicology positive for heroin compared to fentanyl at baseline. METHODS: Retrospective cohort study of 251 adult patients initiating office-based buprenorphine treatment who had available toxicology testing across an academic health system between August 2016 and July 2017...
December 13, 2018: Journal of Addiction Medicine
Joseph K Eibl, Andrew S Wilton, Alexandra M Franklyn, Paul Kurdyak, David C Marsh
OBJECTIVES: Benzodiazepine (BZD) use is common in patients who are engaged in methadone as a treatment for opioid use disorder. BZD prescribing is generally discouraged for this patient population due to the increased risk of BZD dependence and BZD use disorder, medication-assisted treatment (MAT) discontinuation, and opioid-overdose death. However, some patients have concurrent mental health disorders, where BZD use may be clinically indicated. This study evaluates the impact of prescribed BZD on MAT outcomes...
December 12, 2018: Journal of Addiction Medicine
Giselle Castaneira, Kelley Rojas, Yehuda Galili, Zachary Field, Ariel Perez-Perez, Mario Madruga, Steve J Carlan
: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder defined as low platelet count with normal bone marrow in the absence of other causes of thrombocytopenia. It is caused by autoantibodies binding to several platelet surface antigens which lead to premature destruction of the platelet by the reticuloendothelial system. ITP can be primary or secondary, and it is known to be associated with various infections and drugs. K2/Spice, or synthetic marijuana, acts on cannabinoid receptors CB1 (cannabinoid type-1) and CB2 (cannabinoid type-2) with increased binding capacity compared to marijuana...
November 29, 2018: Journal of Addiction Medicine
Marc Fishman, Carlos Tirado, Danesh Alam, Kristen Gullo, Thomas Clinch, Charles W Gorodetzky
OBJECTIVES: To investigate the safety and efficacy of lofexidine for treating opioid withdrawal syndrome (OWS) and facilitating completion of opioid withdrawal. METHODS: A multicenter, double-blind, placebo-controlled study was conducted at 18 US centers from June 2013 to December 2014. Participants (n = 603) aged ≥18 years, dependent on short-acting opioids, and seeking withdrawal treatment, randomized 3:3:2 to receive lofexidine 2.88 mg/d (n = 222), lofexidine 2...
November 29, 2018: Journal of Addiction Medicine
David N Juurlink
No abstract text is available yet for this article.
November 29, 2018: Journal of Addiction Medicine
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