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Addiction Science & Clinical Practice

Brian Chan, Samuel T Edwards, Meg Devoe, Richard Gil, Matthew Mitchell, Honora Englander, Christina Nicolaidis, Devan Kansagara, Somnath Saha, P Todd Korthuis
BACKGROUND: Medically complex urban patients experiencing homelessness comprise a disproportionate number of high-cost, high-need patients. There are few studies of interventions to improve care for these populations; their social complexity makes them difficult to study and requires clinical and research collaboration. We present a protocol for a trial of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) team, an ambulatory ICU (A-ICU) intervention to improve utilization and patient experience that uses control populations to address limitations of prior research...
December 14, 2018: Addiction Science & Clinical Practice
Sarah M Bagley, Howard Cabral, Kelley Saia, Alyssa Brown, Christine Lloyd-Travaglini, Alexander Y Walley, Ruth Rose-Jacobs
BACKGROUND: Little is known about opioid overdose or naloxone access among pregnant women. OBJECTIVES: The objectives of this study were to determine the prevalence of non-fatal overdose, risk factors for overdose, and naloxone access among third trimester women in treatment for opioid use disorder. METHODS: We collected baseline data from a case management parental-support intervention study. To explore the association of variables with past year overdose, we used Wilcoxon rank-sum test, Chi square or Fisher's exact tests...
December 14, 2018: Addiction Science & Clinical Practice
Hildi Hagedorn, Marie Kenny, Adam J Gordon, Princess E Ackland, Siamak Noorbaloochi, Wei Yu, Alex H S Harris
BACKGROUND: In the US, emergency room visits and overdoses related to prescription opioids have soared and the rates of illicit opioid use, including heroin and fentanyl, are increasing. Opioid use disorder (OUD) is associated with higher morbidity and mortality, higher HIV and HCV infection rates, and criminal behavior. Opioid agonist therapy (OAT; methadone and buprenorphine) is proven to be effective in treating OUD and decreasing its negative consequences. While the efficacy of OAT has been established, too few providers prescribe OAT to patients with OUD due to patient, provider, or system factors...
December 13, 2018: Addiction Science & Clinical Practice
Bryan Borg, Ivor S Douglas, Madelyne Hull, Angela Keniston, Marc Moss, Brendan J Clark
PURPOSE: Patients with alcohol misuse are less likely to receive preventive health services but more likely to utilize emergency health services. However, the association between alcohol misuse and outpatient follow-up after hospitalization is unknown and may depend on whether a patient experiences a critical illness. We sought to determine whether alcohol misuse was associated with lower rates of outpatient follow-up after hospital discharge and whether the magnitude of this association differed in patients who experienced a critical illness...
December 4, 2018: Addiction Science & Clinical Practice
Amanda M Bunting, Carrie B Oser, Michele Staton, Katherine S Eddens, Hannah Knudsen
BACKGROUND: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia...
December 3, 2018: Addiction Science & Clinical Practice
Matthew A Miclette, Jared A Leff, Isabella Cuan, Jeffrey H Samet, Brendan Saloner, Gary Mendell, Yuhua Bao, Michael A Ashburn, Marcus A Bachhuber, Bruce R Schackman, Daniel E Polsky, Zachary F Meisel
Drug overdose deaths involving opioids have surged in recent years and the economic cost of the opioid epidemic is estimated to be over $500 billion annually. In the midst of calls for declaring a national emergency, health policy decision makers are considering the best ways to allocate resources to curb the epidemic. On June 9, 2017, 116 invited health researchers, clinicians, policymakers, health system leaders, and other stakeholders met at the University of Pennsylvania to discuss approaches to address the gaps in evidence-based substance use disorder policy and practice, with an emphasis on the opioid epidemic...
November 13, 2018: Addiction Science & Clinical Practice
Zev Schuman-Olivier, Jacob T Borodovsky, Jackson Steinkamp, Qays Munir, Kyle Butler, Mary Ann Greene, Jonah Goldblatt, Hai Yi Xie, Lisa A Marsch
BACKGROUND: While buprenorphine/naloxone (B/N) is approved for opioid use disorder treatment, effective delivery of B/N comes with significant challenges. Most notably, many patients do not take medication daily as prescribed; this non-adherence worsens treatment outcomes, increases healthcare costs, and leads to persistent worries of diversion among providers and policymakers. The present study examines the feasibility, usability, and acceptability of MySafeRx-a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing designed to address the challenges of office-based opioid treatment (OBOT) with B/N...
September 24, 2018: Addiction Science & Clinical Practice
Mandy D Owens, Jessica A Chen, Tracy L Simpson, Christine Timko, Emily C Williams
BACKGROUND: Addiction treatment improves substance use and criminal recidivism outcomes among justice-involved individuals with substance use disorders, but is underutilized. Although information exists regarding barriers to addiction treatment among individuals with substance use disorders more generally, less is known about barriers among individuals with previous justice involvement. The purpose of this pilot study was to describe barriers to addiction treatment in a sample of adults with a substance use disorder who participated in a pilot trial of brief interventions and were recently released from jail...
August 21, 2018: Addiction Science & Clinical Practice
Kathryn Hawk, Gail D'Onofrio
The emergency department (ED) has long been recognized as providing critical access to the health care system for many, yet only in the past few decades has the ED visit been recognized as an opportunity to identify and link patients to care for substance use disorders (SUDs). This review explores the evidence for ED-based screening, psychosocial and pharmacological interventions, and linkage to treatment for the spectrum of SUDs including high risk alcohol use and alcohol, opioid, tobacco and other SUDs. Despite knowledge gaps, methodological challenges and some inconsistency across interventions studied, opportunities for EDs to improve the care of patients across the spectrum of SUDs are robust...
August 6, 2018: Addiction Science & Clinical Practice
David C Hodgins, Jonathan N Stea
BACKGROUND: Increasing understanding of the pathways and processes of recovery from cannabis use disorder may help in designing effective and attractive interventions to promote recovery. We report insights from individuals who had successfully recovered from cannabis use disorder with a variety of pathways. Recovered individuals describe their perceptions of why they developed the problem, why they were successful in recovering, and the advice they would offer to individuals with similar problems...
July 30, 2018: Addiction Science & Clinical Practice
Isra Y Mizher, Shahd I Fawaqa, Waleed M Sweileh
BACKGROUND: Little is known about tobacco smoking behaviors of healthcare professionals in the Middle East where stress conditions are high and tobacco smoking regulations are either absent or loose. The objective of this study was to identify the prevalence of and attitudes toward tobacco smoking among healthcare professionals. METHODS: Trained senior medical students conducted a cross-sectional survey study in all governmental and non-governmental hospitals in Nablus city (Palestine) using a self-administered questionnaire containing both open-and closed-ended questions...
July 27, 2018: Addiction Science & Clinical Practice
Scott E Hadland, Tae Woo Park, Sarah M Bagley
BACKGROUND: Opioid-related overdose deaths have risen sharply among young adults. Despite this increase, access to evidence-based medication for opioid agonist treatment (OAT) for youth remains low. Among older adults, barriers to OAT include the paucity of buprenorphine-waivered prescribers and low rates of prescribing among waivered physicians. We have increasingly found in our clinical practice significant stigma related to using OAT to treat addiction for young adults. In this series, we describe three cases of young adults who faced significant stigma related to their treatment...
May 7, 2018: Addiction Science & Clinical Practice
Stephen A Martin, Jordon Bosse, Amanda Wilson, Phyllis Losikoff, Lisa Chiodo
For over a decade, the vast majority of new hepatitis C virus (HCV) infections have been among young people who inject drugs (PWID). Well-characterized gaps in chronic HCV diagnosis, evaluation, and treatment have resulted in fewer than 5% of PWID receiving HCV treatment. While interferon-based treatment may have intentionally been foregone during part of this time in anticipation of improved oral therapies, the overall pattern points to deficiencies and treatment exclusions in the health care system. Treatment for HCV with all-oral, highly effective direct-acting antiviral medication for 12 weeks or less is now the standard of care, putting renewed focus on effective delivery of care...
April 25, 2018: Addiction Science & Clinical Practice
Eric L Garland, Matthew O Howard
Contemporary advances in addiction neuroscience have paralleled increasing interest in the ancient mental training practice of mindfulness meditation as a potential therapy for addiction. In the past decade, mindfulness-based interventions (MBIs) have been studied as a treatment for an array addictive behaviors, including drinking, smoking, opioid misuse, and use of illicit substances like cocaine and heroin. This article reviews current research evaluating MBIs as a treatment for addiction, with a focus on findings pertaining to clinical outcomes and biobehavioral mechanisms...
April 18, 2018: Addiction Science & Clinical Practice
Jennifer McNeely, Pritika C Kumar, Traci Rieckmann, Erica Sedlander, Sarah Farkas, Christine Chollak, Joseph L Kannry, Aida Vega, Eva A Waite, Lauren A Peccoralo, Richard N Rosenthal, Dennis McCarty, John Rotrosen
BACKGROUND: Alcohol and drug use are leading causes of morbidity and mortality that frequently go unidentified in medical settings. As part of a multi-phase study to implement electronic health record-integrated substance use screening in primary care clinics, we interviewed key clinical stakeholders to identify current substance use screening practices, barriers to screening, and recommendations for its implementation. METHODS: Focus groups and individual interviews were conducted with 67 stakeholders, including patients, primary care providers (faculty and resident physicians), nurses, and medical assistants, in two urban academic health systems...
April 9, 2018: Addiction Science & Clinical Practice
Kasey Claborn, Sara Becker, Don Operario, Steve Safren, Josiah D Rich, Susan Ramsey
BACKGROUND: HIV-infected people who use drugs (PWUD) exhibit the highest rates of non-adherence to antiretroviral therapy (ART) among people living with HIV. This contributes to poor treatment outcomes, increased morbidity and mortality, and HIV transmission. However, current interventions fail to address the unique barriers to adherence faced by this population. Life Steps is a brief, single session intervention that demonstrated increased ART adherence among HIV-infected individuals...
April 2, 2018: Addiction Science & Clinical Practice
M Mofizul Islam, Helen T Oni, K S Kylie Lee, Noel Hayman, Scott Wilson, Kristie Harrison, Beth Hummerston, Rowena Ivers, Katherine M Conigrave
INTRODUCTION AND AIMS: Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHSs) around Australia have been asked to standardise screening for unhealthy drinking. Accordingly, screening with the 3-item AUDIT-C (Alcohol Use Disorders Identification Test-Consumption) tool has become a national key performance indicator. Here we provide an overview of suitability of AUDIT-C and other brief alcohol screening tools for use in ACCHSs. METHODS: All peer-reviewed literature providing original data on validity, acceptability or feasibility of alcohol screening tools among Indigenous Australians was reviewed...
March 29, 2018: Addiction Science & Clinical Practice
Michael M Neeki, Fanglong Dong, Lidia Liang, Jake Toy, Braeden Carrico, Nina Jabourian, Arnold Sin, Farabi Hussain, Sharon Brown, Keyvan Safdari, Rodney Borger, David Wong
BACKGROUND: This study investigates the impact of methamphetamine use on trauma patient outcomes. METHODS: This retrospective study analyzed patients between 18 and 55 years old presenting to a single trauma center in San Bernardino County, CA who sustained traumatic injury during the 10-year study period (January 1st, 2005 to December 31st, 2015). Routine serum ethanol levels and urine drug screens (UDS) were completed on all trauma patients. Exclusion criteria included patients with an elevated serum ethanol level (> 0 mg/dL)...
March 29, 2018: Addiction Science & Clinical Practice
Christina Nehlin, Margareta Wennberg, Caisa Öster
BACKGROUND: Research has identified drinking motives as the final common pathway to alcohol use, and associations between specific drinking motives and drinking patterns have consistently been demonstrated. Data on drinking motives can be used for research, in the planning of prevention strategies and for treatment purposes. The Drinking Motives Questionnaire-Revised (DMQ-R) has become the most used measure of drinking motives. So far, the questionnaire has not been investigated with qualitative methods...
March 14, 2018: Addiction Science & Clinical Practice
P Todd Korthuis, E Jennifer Edelman
No abstract text is available yet for this article.
March 12, 2018: Addiction Science & Clinical Practice
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