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A Pragmatic, Person-Centered View of Cannabis in the United States: Pursuing Care That Transcends Beliefs. Subst. Abus. (IF 3.5) Pub Date : 2023-10-30 Hannah G Bosley,Juan M Peña,Andrew D Penn,James L Sorensen,Matthew Tierney,Annesa Flentje
BACKGROUND Rates of cannabis use are increasing in the United States, likely as a result of changes in societal attitudes and expanding legalization. Although many patients report wanting to discuss the risks and benefits of cannabis use with their clinical providers, many providers hold conflicting beliefs regarding cannabis use and often do not engage patients in discussion about cannabis. This dilemma
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Association of MOUD ECHO Participation on Expansion of Buprenorphine Prescribing in Rural Primary Care. Subst. Abus. (IF 3.5) Pub Date : 2023-10-30 Julie G Salvador,Orrin B Myers,Snehal R Bhatt,Vanessa Jacobsohn,Larissa Lindsey,Rana S Alkhafaji,Heidi Rishel Brakey,Andrew L Sussman
BACKGROUND Lack of access to buprenorphine to treat Opioid Use Disorder is profound in rural areas where over half of small and remote rural counties have no buprenorphine prescriber. To increase prescribing, an online, Medication of Opioid Use Disorder (MOUD) Extensions for Community Healthcare Outcomes (ECHO) was developed that addressed known barriers to the startup and expansion of treatment. The
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Research Priorities for Expansion of Opioid Use Disorder Treatment in the Community Pharmacy. Subst. Abus. (IF 3.5) Pub Date : 2023-10-30 Jennie B Jarrett,Jeffrey Bratberg,Anne L Burns,Gerald Cochran,Bethany A DiPaula,Anna Legreid Dopp,Abigail Elmes,Traci C Green,Lucas G Hill,Felicity Homsted,Stephanie L Hsia,Michele L Matthews,Udi E Ghitza,Li-Tzy Wu,Gavin Bart
In the last decade, the U.S. opioid overdose crisis has magnified, particularly since the introduction of synthetic opioids, including fentanyl. Despite the benefits of medications for opioid use disorder (MOUD), only about a fifth of people with opioid use disorder (OUD) in the U.S. receive MOUD. The ubiquity of pharmacists, along with their extensive education and training, represents great potential
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Advancing Proficiencies for Health Professionals in the Treatment of Tobacco Use Among Marginalized Communities: Development of a Competency-Based Curriculum and Virtual Workshop. Subst. Abus. (IF 3.5) Pub Date : 2023-10-16 Christine E Sheffer,Alina Shevorykin,Roberta Freitas-Lemos,Darian Vantucci,Ellen Carl,Lindsey Bensch,Matthew Marion,Deborah O Erwin,Philip H Smith,Jill M Williams,Jamie S Ostroff
BACKGROUND Tobacco-related disparities are a leading contributor to health inequities among marginalized communities. Lack of support from health professionals is one of the most cited barriers to tobacco cessation reported by these communities. Improving the proficiencies with which health professionals incorporate social and cultural influences into therapeutic interactions has the potential to address
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Treatment Initiation, Substance Use Trajectories, and the Social Determinants of Health in Persons Living With HIV Seeking Medication for Opioid Use Disorder. Subst. Abus. (IF 3.5) Pub Date : 2023-10-16 Ryan R Cook,Erin N Jaworski,Kim A Hoffman,Elizabeth N Waddell,Renae Myers,P Todd Korthuis,Pamela Vergara-Rodriguez
BACKGROUND People living with HIV and opioid use disorder (OUD) are disproportionally affected by adverse socio-structural exposures negatively affecting health, which have shown inconsistent associations with uptake of medications for OUD (MOUD). This study aimed to determine whether social determinants of health (SDOH) were associated with MOUD uptake and trajectories of substance use in a clinical
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Care Practices of Mental Health Clinical Pharmacist Practitioners Within an Interdisciplinary Primary Care Model for Patients With Substance Use Disorders. Subst. Abus. (IF 3.5) Pub Date : 2023-10-15 Annette Percy,A Taylor Kelley,Natalie Valentino,Amy Butz,Jacob D Baylis,Ying Suo,Adam J Gordon,Audrey L Jones
BACKGROUND Clinical pharmacist practitioners (CPPs) play an increasingly important role in interdisciplinary care for patients with substance use disorders (SUDs). However, CPPs' scope of practice varies substantially across clinics and settings. OBJECTIVES We sought to describe CPP practices and activities within an interdisciplinary, team-based primary care clinic dedicated to treat Veterans with
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Improving DEIB in Addiction Medicine Training Through Interdisciplinary Collaboration and Program Evaluation. Subst. Abus. (IF 3.5) Pub Date : 2023-10-13 Sophia M Ly,Amanda M Fitzpatrick,Jules Canfield,Amaya Powis,Kaku So-Armah,Emily E Hurstak
Developing a diverse Addiction Medicine (AM) workforce will improve medical and public health responses to the increasing health risks created by substance use disorders (SUDs). A workforce that embraces diversity, equity, inclusion, and belonging (DEIB) principles may foster novel responses to address the disparities in treatment and outcomes experienced by Black, Indigenous, and People of Color (BIPOC)
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Impact of Mandated Case Review Policy on Opioid Discontinuation and Mortality Among High-Risk Long-Term Opioid Therapy Patients: The STORM Stepped-Wedge Cluster Randomized Controlled Trial. Subst. Abus. (IF 3.5) Pub Date : 2023-10-13 Yufei Li,Kyle D Barr,Jodie A Trafton,Elizabeth M Oliva,Melissa M Garrido,Austin B Frakt,Kiersten L Strombotne
BACKGROUND Although long-term opioid therapy (LTOT) has its own risks, opioid discontinuation could pose harm for high-risk Veterans Health Administration (VHA) patients receiving LTOT. There is limited information on the impact of a mandate requiring providers to perform case reviews on high-risk patients with an active opioid prescription (ie, mandated case review policy) on opioid discontinuation
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Cocaine Use is Associated With Increased LVMI in Unstably Housed Women With Polysubstance Use. Subst. Abus. (IF 3.5) Pub Date : 2023-10-13 Akshay Ravi,Eric Vittinghoff,Alan H B Wu,Leslie W Suen,Phillip O Coffin,Priscilla Hsue,Kara L Lynch,Sithu Win,Dhruv S Kazi,Elise D Riley
BACKGROUND While substance use is known to influence cardiovascular health, most prior studies only consider one substance at a time. We examined associations between the concurrent use of multiple substances and left ventricular mass index (LVMI) in unhoused and unstably housed women. METHODS Between 2016 and 2019, we conducted a cohort study of unstably housed women in which measurements included
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Harms Versus Harms: Rethinking Treatment for Patients on Long-Term Opioids. Subst. Abus. (IF 3.5) Pub Date : 2023-09-22 Pooja Lagisetty,Stefan Kertesz
In 2022, the CDC revised its and encourage clinicians to weight the risks versus harms of continued therapy and empathetically engage patients in patient-centered discussions around continued therapy while avoiding patient abandonment. This commentary discusses how the emphasis on "benefit" will almost always lead to discordance between the patient and provider since many clinicians find little benefit
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Effects of Smoking Marijuana on the Respiratory System: A Systematic Review. Subst. Abus. (IF 3.5) Pub Date : 2023-09-20 Jorge Vásconez-González,Karen Delgado-Moreira,Belén López-Molina,Juan S Izquierdo-Condoy,Esteban Gámez-Rivera,Esteban Ortiz-Prado
BACKGROUND The prevalence of marijuana use and its derivatives has surged over the past century, largely due to increasing legalization globally. Despite arguments advocating its benefits, marijuana smoking exposes the lungs to harmful combustion byproducts, leading to various respiratory issues such as asthma, pneumonia, emphysema, and chronic obstructive pulmonary disease. METHODS We embarked on
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Low Dose Buprenorphine Initiation: A Guide for the Inpatient Clinician. Subst. Abus. (IF 3.5) Pub Date : 2023-09-20 Cara Zimmerman,Seth Clark,Michael E Guerra,Jeffrey Bratberg,Kathleen K Adams
Low dose buprenorphine initiation (LDBI) is a dosing strategy used to transition patients from full opioid agonists to buprenorphine. The purpose of LDBI is to circumvent obstacles associated with disruption in analgesia, precipitated withdrawal, and prerequisite opioid withdrawal prior to initiating buprenorphine, as not all patients are able to tolerate physical withdrawal symptoms recommended by
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Evaluating a Video-Based Addiction Curriculum at a Safety Net Academic Medical Center. Subst. Abus. (IF 3.5) Pub Date : 2023-09-20 Alyssa F Peterkin,Marielle Baldwin,Lindsay Demers,Katherine Gergen Barnett
BACKGROUND Since 2019, the United States (US) has witnessed an unprecedented increase in drug overdose and alcohol-related deaths. Despite this rise in morbidity and mortality, treatment rates for substance use disorder remain inadequate. Insufficient training in addiction along with a dearth of addiction providers are key barriers to addressing the current addiction epidemic. Addiction-related clinical
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Rapid Methadone Induction in a General Hospital Setting: A Retrospective, Observational Analysis. Subst. Abus. (IF 3.5) Pub Date : 2023-09-20 Sarah Casey,Susan Regan,Evan Gale,Zoe M Adams,Eugene Lambert,Faith O Omede,Sarah E Wakeman
BACKGROUND Outpatient methadone guidelines recommend starting at a low dose and titrating slowly. As fentanyl prevalence and opioid-related mortality increases, there is a need for individuals to rapidly achieve a therapeutic methadone dose. Hospitalization offers a monitored setting for methadone initiation, however dosing practices and safety are not well described. METHODS Retrospective, observational
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Starting the Discussion: A Call to Enhance Care for People With Stimulant Use Disorder. Subst. Abus. (IF 3.5) Pub Date : 2023-09-20 Justin Alves,Victoria Rust,Marielle Baldwin,Logan Puleikis,Ann Claude,Meghan Brett,Colleen T LaBelle,Alicia S Ventura
Stimulant use disorder (StUD) significantly contributes to substance-related morbidity and mortality in the United States. Overshadowed by the country's focus on opioid-related overdose deaths, stimulant and stimulant/opioid overdose deaths have increased dramatically over the last decade. Many individuals who use stimulants illicitly or have StUD have multiple, intersecting stigmatized characteristics
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Co-use of Opioid Medications and Alcohol Prevention Study (COAPS). Subst. Abus. (IF 3.5) Pub Date : 2023-09-20 Alina Cernasev,Kenneth Hohmeier,Craig Field,Adam J Gordon,Stacy Elliott,Kristi Carlston,Grace Broussard,Gerald Cochran
While there is limited research in the field regarding the various dimensions of co-use of alcohol and opioid medication, particularly related to co-use and levels of severity, our research has shown 20% to 30% of community pharmacy patients receiving opioid pain medications are engaged in co-use. Co-use of alcohol and opioid medications is a significant risk factor for opioid-related overdose. Community
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Associations Between Patient-Reported Experiences with Opioid Use Disorder Treatment and Unmet Treatment Needs and Discontinuation Among Virginia Medicaid Members. Subst. Abus. (IF 3.5) Pub Date : 2023-09-14 Sarah J Marks,Huyen Pham,Neil McCray,Jennifer Palazzolo,Ashley Harrell,Jason Lowe,Chethan Bachireddy,Lauren Guerra,Peter J Cunningham,Andrew J Barnes
BACKGROUND Many payers, including Medicaid, the largest payer of opioid use disorder (OUD) treatment, are pursuing treatment-related quality improvement initiatives. Yet, how patient-reported experiences with OUD treatment relate to patient-centered outcomes remains poorly understood. AIM To examine associations between Medicaid members' OUD treatment experiences, outpatient treatment settings, demographic
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Dispensary Staff Perceptions About the Benefits, Risks, and Safety of Cannabis for Medical Purposes. Subst. Abus. (IF 3.5) Pub Date : 2023-09-14 Hailey W Bulls,Andrew D Althouse,Robert Feldman,Julia H Arnsten,Jane M Liebschutz,Shannon M Nugent,Steven R Orris,Rebecca Rohac,Deepika E Slawek,Joanna L Starrels,Benjamin J Morasco,Devan Kansagara,Jessica S Merlin
BACKGROUND Therapeutic use of cannabis is common in the United States (up to 18.7% of Americans aged ≥12), and dispensaries in the US are proliferating rapidly. However, the efficacy profile of medical cannabis is unclear, and customers often rely on dispensary staff for purchasing decisions. The objective was to describe cannabis dispensary staff perceptions of medical cannabis benefits and risks
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Factors Associated with Nurses' Motivation to Provide Care for Patients with Alcohol Use and Alcohol Use-Related Problems. Subst. Abus. (IF 3.5) Pub Date : 2023-09-13 Khadejah F Mahmoud,Deborah S Finnell,Susan M Sereika,Dawn Lindsay,Janet Cipkala-Gaffin,Ann M Mitchell
BACKGROUND There is a high human and economic cost associated with alcohol use and alcohol use-related problems. Nurses have a pivotal role in addressing the needs of this patient population. Purpose: The study aimed to examine the correlation between nurses' demographics/background characteristics, personal attitudes, professional attitudes, and their motivation to provide care to patients with alcohol
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Outcomes of State Targeted/Opioid Response Grants and the Medication First Approach: Evidence of Racial Inequities in Improved Treatment Access and Retention. Subst. Abus. (IF 3.5) Pub Date : 2023-09-13 Rachel Winograd,Zach Budesa,Devin Banks,Ryan Carpenter,Claire A Wood,Alex Duello,Paul Thater,Christine Smith
BACKGROUND Since 2017, Missouri has increased access to medication for opioid use disorder (OUD) within the State's publicly-funded substance use specialty treatment system through a "Medication First" approach. Results from a statewide assessment of the first year of State Targeted Response implementation showed increases and improvements in overall treatment admissions, medication utilization, and
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Association Between Opioid Dose Reduction Rates and Overdose Among Patients Prescribed Long-Term Opioid Therapy. Subst. Abus. (IF 3.5) Pub Date : 2023-09-13 Jason M Glanz,Stanley Xu,Komal J Narwaney,David L McClure,Deborah J Rinehart,Morgan A Ford,Anh P Nguyen,Ingrid A Binswanger
BACKGROUND Tapering long-term opioid therapy is an increasingly common practice, yet rapid opioid dose reductions may increase the risk of overdose. The objective of this study was to compare overdose risk following opioid dose reduction rates of ≤10%, 11% to 20%, 21% to 30%, and >30% per month to stable dosing. METHODS We conducted a retrospective cohort study in three health systems in Colorado and
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Leveraging National Data and Regional Innovations to Right-Size Tobacco Treatment Policy for Behavioral Health in a Midwestern State. Subst. Abus. (IF 3.5) Pub Date : 2023-09-07 Nathalia Munck Machado,Rick Cagan,Babalola Faseru,Won S Choi,Andrew Brown,Ginny Chadwick,Ja'net Jackson,Kevin D Everett,Tristi Bond,Kimber Richter
BACKGROUND People with mental health (MH) and substance use disorders (SUD) have high rates of tobacco use and tobacco-related mortality. They want to stop smoking and studies have shown they can quit, but few behavioral health facilities provide tobacco treatment. The purpose of this paper is to describe how a midwestern statewide behavioral health collaboration used regional data to pinpoint strengths
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Evaluation of a Primary Care-Based Multidisciplinary Transition Clinic for Patients Newly Initiated on Buprenorphine in the Emergency Department. Subst. Abus. (IF 3.5) Pub Date : 2023-09-07 Michael A Incze,Sonia L Sehgal,Annika Hansen,Luke Garcia,Laura Stolebarger
BACKGROUND Care transitions represent vulnerable events for patients newly initiating medications for opioid use disorder (MOUD). Multidisciplinary primary care-based transition clinics may improve care linkage and retention in MOUD treatment. Additionally, these interventions may help primary care clinicians (PCPs) overcome barriers to adopting MOUD into practice. In this evaluation, we assessed the
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Will the End of the X-Waiver Expand Access to Buprenorphine Treatment? Achieving the Full Potential of the 2023 Consolidated Appropriations Act. Subst. Abus. (IF 3.5) Pub Date : 2023-09-07 Brendan Saloner,Barbara Andraka-Christou,Bradley D Stein,Adam J Gordon
The 2023 Consolidated Appropriations Act repealed the special waiver for prescribing buprenorphine to patients with opioid use disorder, a bipartisan goal long sought by advocates. The change has symbolic importance in recognizing that buprenorphine is a mainstream medical treatment. We argue that the maximum potential of the law can be achieved by addressing three bottlenecks. First, it is important
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Exploring the Association of State Policies and the Trajectories of Buprenorphine Prescriber Patient Caseloads. Subst. Abus. (IF 3.5) Pub Date : 2023-07-04 Beth Ann Griffin,Irineo Cabreros,Brendan Saloner,Adam J Gordon,Rose Kerber,Bradley D Stein
BACKGROUND Increasing buprenorphine access is critical to facilitating effective opioid use disorder treatment. Buprenorphine prescriber numbers have increased substantially, but most clinicians who start prescribing buprenorphine stop within a year, and most active prescribers treat very few individuals. Little research has examined state policies' association with the evolution of buprenorphine prescribing
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Evaluation of the New England Office Based Addiction Treatment ECHO: A Tool for Strengthening the Addiction Workforce. Subst. Abus. (IF 3.5) Pub Date : 2023-06-07 Matthew R Heerema,Alicia S Ventura,Samantha C Blakemore,Ivan D Montoya,Danna E Gobel,Mathew V Kiang,Colleen T LaBelle,Angela R Bazzi
INTRODUCTION Reducing substance-related morbidity requires an educated and well-supported workforce. The New England Office Based Addiction Treatment Extension for Community Healthcare Outcomes (NE OBAT ECHO) began in 2019 to support community-based addiction care teams through virtual mentoring and case-based learning. We sought to characterize the program's impact on the knowledge and attitudes of
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National Trends in Buprenorphine Treatment for Opioid Use Disorder From 2007 to 2018. Subst. Abus. (IF 3.5) Pub Date : 2023-06-06 Megan S Schuler,Brendan Saloner,Adam J Gordon,Andrew W Dick,Bradley D Stein
BACKGROUND Buprenorphine is a key medication to treat opioid use disorder (OUD). Since its approval in 2002, buprenorphine access has grown markedly, spurred by major federal and state policy changes. This study characterizes buprenorphine treatment episodes during 2007 to 2018 with respect to payer, provider specialty, and patient demographics. METHODS In this observational cohort study, IQVIA Real
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Sociodemographic Differences in Menthol Cigarette Use in the United States. Subst. Abus. (IF 3.5) Pub Date : 2023-05-13 Rajesh Talluri,Sanjay Shete
BACKGROUND Menthol cigarette use is associated with higher smoking initiation and reduced smoking cessation. We investigated sociodemographic differences in menthol and nonmenthol cigarette use in the United States. METHODS We used the most recent available data from the May 2019 wave of the nationally-representative Tobacco Use Supplement to the Current Population Survey. The survey weights were used
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Implementation and Evaluation of Primary Care Team Participation in Opioid Use Disorder Learning Sessions. Subst. Abus. (IF 3.5) Pub Date : 2023-05-11 Cory Lutgen,Elisabeth Callen,Elise Robertson,Tarin Clay,Melissa K Filippi
INTRODUCTION Previous studies show that some primary care clinicians do not feel equipped to treat patients with opioid use disorder (OUD). This study addressed the gaps in confidence and knowledge of primary care physicians and other participants (i.e., participants who were not physicians) in diagnosing, treating, prescribing, and educating patients with OUD through interactive learning sessions
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Examining Systems, Substance Use, and Disenfranchisement: Overview and Proceedings of the 2022 AMERSA Conference. Subst. Abus. (IF 3.5) Pub Date : 2023-05-08 Sarah M Bagley,Rebecca Northup,Kristin Wason,Jeffrey Bratberg,Adam J Gordon,Elizabeth Oliva
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The Creation of an Addiction Nursing Fellowship Program for Registered Nurses: A Unique Approach to Enhancing the Addiction-Treatment Workforce. Subst. Abus. (IF 3.5) Pub Date : 2023-05-08 Jason M Fox,Kristin Wason,Donna Beers,Maggie Faulds,Nicole Lincoln,Mary Tomanovich,Nancy W Gaden,Miriam Komaromy Md
In 2020, Boston Medical Center and the Grayken Center for Addiction launched an addiction nursing fellowship to enhance registered nurses' knowledge and skills related to the care of patients with substance use disorders and to improve patient experience and outcomes. This paper describes the development and essential components of this innovative fellowship, to our knowledge the first of its kind
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"I'm Clean and Sober, But Not Necessarily Free": Perceptions of Buprenorphine Among Patients in Long-Term Treatment. Subst. Abus. (IF 3.5) Pub Date : 2023-05-03 Jessica J Wyse,Travis I Lovejoy,Adam J Gordon,Katherine Mackey,Anders Herreid-O'Neill,Benjamin J Morasco
BACKGROUND Patients receiving buprenorphine for the treatment of opioid use disorder (OUD) experience a roughly 50% reduction in mortality risk relative to those not receiving medication. Longer periods of treatment are also associated with improved clinical outcomes. Despite this, patients often express desires to discontinue treatment and some view taper as treatment success. Little is known about
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Patients' Perceptions of Physical Therapists Addressing Opioid Misuse. Subst. Abus. (IF 3.5) Pub Date : 2023-05-03 John Magel,Paul Hartman,Julie M Fritz,Nicholas N Koch,Hannah Dostal,Nicholas Vollmer,Natalie L Ferguson,Jennifer Tapken,Kim Cohee,Gerald Cochran,Adam J Gordon
INTRODUCTION In the US, rising numbers of patients who misuse illicit or prescribed opioids provides opportunities for physical therapists (PTs) to be engaged in their care. Prior to this engagement, it is necessary to understand the perceptions of patients who access physical therapy services about their PTs playing such a role. This project examined patients' perceptions of PTs addressing opioid
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A National Study of Homelessness, Social Determinants of Health, and Treatment Engagement Among Outpatient Medication for Opioid Use Disorder-Seeking Individuals in the United States. Subst. Abus. (IF 3.5) Pub Date : 2023-05-03 Marina Gaeta Gazzola,Iain D Carmichael,Nicholaus J Christian,Xiaoying Zheng,Lynn M Madden,Declan T Barry
BACKGROUND Homelessness is an important social determinant of health (SDOH), impacting health outcomes for many medical conditions. Although homelessness is common among people with opioid use disorder (OUD), few studies systematically evaluate homelessness and other SDOH among people enrolled in standard of care treatment for OUD, medication for opioid use disorder (MOUD), or examine whether homelessness
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More Effective Communication During Inpatient Addiction Treatment. Subst. Abus. (IF 3.5) Pub Date : 2023-05-03 David E Marcovitz,Kristopher A Kast
In this commentary, the authors argue that historical approaches to inpatient addiction treatment favoring more confrontational, expert-centric, or paternalistic undercurrents continue to permeate the hidden curriculum in medical training. These older approaches unfortunately continue to inform how many trainees learn to approach inpatient addiction treatment. The authors go on to provide several examples
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The Association of Vaping With Social/Emotional Health and Attitudes Toward COVID-19 Mitigation Measures in Adolescent and Young Adult Cohorts During the COVID-19 Pandemic. Subst. Abus. (IF 3.5) Pub Date : 2023-04-26 Alicia L Oliver,Joe Kossowsky,Machiko Minegishi,Sharon Levy,Elissa R Weitzman
BACKGROUND Vaping is a major health risk behavior which often occurs socially. Limited social activity during the COVID-19 pandemic contributed to worsening social and emotional health. We investigated associations among youth vaping, and reports of worsening mental health, loneliness, and relationships with friends and romantic partners (ie, social health), as well as perceived attitudes toward COVID-19
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Training Providers of People Who Use Drugs to Offer Hepatitis C Treatment: A Washington State Initiative. Subst. Abus. (IF 3.5) Pub Date : 2023-04-26 Jocelyn R James,Judith I Tsui
To address hepatitis C infection (HCV) treatment gaps among people who use drugs (PWUD), a statewide initiative trained buprenorphine waiver trainers to offer an optional HCV treatment module to waiver trainees. Five of twelve trained buprenorphine trainers went on to conduct HCV sessions at waiver trainings, reaching 57 trainees. Word-of-mouth led to multiple additional presentations by the project
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Perioperative Management of Extended-Release Buprenorphine: A Narrative Review and Case Series. Subst. Abus. (IF 3.5) Pub Date : 2023-04-26 Thomas R Hickey,Thomas Meeks,Heather Oxentine,Dong Chan Park,Audrey Abelleira,Ellen Edens,Adam J Gordon,Gregory Acampora
BACKGROUND Perioperative management of formulations of buprenorphine used for the treatment of opioid use disorder and/or pain are common clinical challenges. Care strategies are increasingly recommending continuation of buprenorphine while administering multimodal analgesia including full agonist opioids. While this "simultaneous strategy" is relatively simple for the shorter-acting sublingual buprenorphine
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Buprenorphine Prescribing and Dosing Limits: Evidence and Policy Goals. Subst. Abus. (IF 3.5) Pub Date : 2023-04-26 David Tyler Coyle,Stephanie Stewart,Cole Bortz,Jane Manalo,Alexis Ritvo,Martin Krsak
The opioid misuse epidemic is a serious public health crisis. Opioid-involved deaths continue to rise and the potency of illicitly manufactured synthetic opioids has increased, creating challenges for the healthcare system to provide multifaceted specialized care. Elements of the regulation around buprenorphine, 1 of 3 drugs approved to treat opioid use disorder (OUD), constrain treatment options for
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Defining and supporting high-quality telehealth for patients with opioid use disorder: The promise and potential pitfalls of telehealth expansion Subst. Abus. (IF 3.5) Pub Date : 2022-10-12 Christopher J. Frank, Lewei (Allison) Lin
Abstract Many patients with opioid use disorders do not receive evidence-based treatment. The COVID-19 pandemic expanded the use of telehealth for prescribing medications for opioid use disorder (OUD). The uptake of telehealth has been variable, and this uneven expansion has created natural experiments to test assumptions and answer key questions about what improves outcomes for patients with OUD.
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Substance use–related continuing education course objectives: Alignment with professional competencies Subst. Abus. (IF 3.5) Pub Date : 2022-09-12 Deborah S. Finnell, Victoria Soltis-Jarrett, Jeffrey Bratberg, Andrew Muzyk, Yifei Liu, Ellen Edens, J. Paul Seale, Jill Mattingly, Kristen Schnurman, Victoria Osborne-Leute, Allen Zweben, Ann Cary, Brent A. Moore
Abstract Background: Novel educational efforts are needed to prepare the current and future interprofessional health care workforce to address the range of substance use–related health problems. A 6-module massive open online course (MOOC) was developed to provide education to health professionals of various disciplines on the fundamentals of substance use–related treatment. The purpose of this project
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Transforming an educational ecosystem for substance use disorders: A multi-modal model for continuous curricular improvement and institutional change Subst. Abus. (IF 3.5) Pub Date : 2022-09-02 Jason M. Satterfield, Karen Werder, Stephanie Reynolds, Irina Kryzhanovskaya, Alexa Colgrove Curtis
Abstract Health professions curricula are created to prepare learners to effectively address health issues affecting individ uals and their communities. Ideally, curricula emphasize the predominant biopsychosocial influences impacting the health of diverse populations. However, despite decades of investment and advances in educational research and design, we have failed to create a health professional
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Association of multidisciplinary education and research in substance use and addiction’s (AMERSA) 2021 transforming care through evidence and policy conference: Tackling stigma and giving voice to lived experience Subst. Abus. (IF 3.5) Pub Date : 2022-08-31 Elizabeth M. Oliva, Sarah M. Bagley, Richard Bottner, Rebecca Northup, Doreen MacLane-Baeder
Abstract This commentary provides an overview of the Association of Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) 2021 annual conference: Transforming Care Through Evidence and Policy. The topics covered during the conference were especially critical given the unprecedented rise in drug overdose deaths and continued impact of the COVID-19 pandemic on substance use
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Evaluating ACGME-accredited addiction psychiatry fellowship online content: A critical analysis of addiction psychiatry fellowship program websites in the US Subst. Abus. (IF 3.5) Pub Date : 2022-08-31 Matthew P. Abrams, Elle Lett, Danielle S. Jackson, Anne E. Kohler, Ayana Jordan
Abstract Introduction: There is an extreme shortage of addiction psychiatrists and a lack of representation of addiction psychiatry (ADP) fellows from racial/ethnic minoritized backgrounds. ADP fellowship websites are integral in engaging potential applicants. It is therefore critical to understand the quality of engagement that trainees are having with ADP fellowship websites. The aim of this study
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Reward sensitivity and hazardous alcohol consumption in women: The parallel mediation effect of self-control and impulsivity traits Subst. Abus. (IF 3.5) Pub Date : 2022-08-29 Cristina Martín-Pérez, Esperanza Vergara-Moragues, Juan José Fernández-Muñoz, Juan Manuel García-González, Luis Miguel García-Moreno
Abstract Introduction: Little research has been carried out on the associations between several individual factors and hazardous alcohol use in women. The aim of this study was first, to study the relationship between reward sensitivity (RS) and alcohol use in both women with and without hazardous drinking separately. Second, to explore the potential mediating roles of the impulsivity and self-control
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Peer providers and linkage with buprenorphine care after hospitalization: A retrospective cohort study Subst. Abus. (IF 3.5) Pub Date : 2022-07-27 Helen E. Jack, Eric D. Denisiuk, Brett A. Collins, Dan Stephens, Kendra L. Blalock, Jared W. Klein, Elenore P. Bhatraju, Joseph O. Merrill, Kevin A. Hallgren, Judith I. Tsui
Abstract Background: People with opioid use disorder (OUD) are increasingly started on buprenorphine in the hospital, yet many patients do not attend outpatient buprenorphine care after discharge. Peer providers, people in recovery themselves, are a growing part of addiction care. We examine whether patients who received a low-intensity, peer-delivered intervention during hospitalization had a greater
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Trends in buprenorphine treatment disparities during the COVID pandemic in Massachusetts Subst. Abus. (IF 3.5) Pub Date : 2022-07-27 Sarah E. Wakeman, Eugene Lambert, Sunny Kung, Nicholas M. Brisbon, Aleta D. Carroll, Thu-Trang Hickman, Charles Covahey, Thomas D. Sequist, Scott G. Weiner
Abstract Background: Racial, sex, and age disparities in buprenorphine treatment have previously been demonstrated. We evaluated trends in buprenorphine treatment disparities before and after the onset of the COVID pandemic in Massachusetts. Methods: This cross-sectional study used data from an integrated health system comparing 12-months before and after the March 2020 Massachusetts COVID state of
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Coverage of the opioid crisis in national network television news from 2000–2020: A content analysis Subst. Abus. (IF 3.5) Pub Date : 2022-07-27 Jessica Jay, Amy Chan, George Gayed, Julie Patterson
Abstract Background: News coverage has both negatively and positively influenced public awareness and perceptions surrounding the opioid crisis. This study aimed to describe and analyze national network television news framing of the scope and impact of the opioid crisis in the United States. Methods: We performed a retrospective content analysis on national network television evening news segments
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Use of electronic cigarettes among U.S. Military service members – prevalence and associated risk factors Subst. Abus. (IF 3.5) Pub Date : 2022-07-25 Abegail A. Gill, Brandi Alford, Jennylynn Balmer, Eric A. Lutz, Frederic D. Glogower, COL Keith Palm
Abstract Background Decreased physical fitness, loss of vision and hearing, and increased risk of chronic diseases are significant primary and secondary implications associated with the health of U.S. Military Service members who use tobacco, including electronic cigarettes. Despite the medical and non-medical costs to the U.S. Department of Defense and potential adverse health effects to Service members
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Caregivers of people with substance use or mental health disorders in the US Subst. Abus. (IF 3.5) Pub Date : 2022-07-18 Christine Timko, Mai Chee Lor, Fernanda Rossi, Amber Peake, Michael A. Cucciare
Abstract Background: Caregiving for persons with substance use and/or mental health disorders (SU/MHD) and other conditions places significant strains on caregivers. Methods: The present study used Behavioral Risk Factor Surveillance System (a US health survey) data to (1) compare caregivers of recipients with SU/MHD to those of recipients with other conditions on demographic and caregiving characteristics
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Is it all in the family? Sexual identity differences in DSM-5 alcohol and other drug use disorders and associations with alcohol and other drug misuse history among parents, offspring, and other relatives Subst. Abus. (IF 3.5) Pub Date : 2022-07-18 Sean Esteban McCabe, Tonda L. Hughes, Jessica N. Fish, Sebastian Hoak, Luisa Kcomt, Rebecca J. Evans-Polce, Curtiss Engstrom, Kate Leary, Philip Veliz, Brady T. West, Vita V. McCabe, Carol J. Boyd
Abstract Background: The objectives of this study were to: (1) estimate the prevalence of family history of alcohol and other drug (AOD) misuse (positive family history [FH+]) in first- and second-degree relatives across sexual identity subgroups (i.e., lesbian, gay, bisexual, heterosexual); (2) compare AOD misuse among offspring of sexual minority and heterosexual parents; and (3) examine the relationships
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Patient-centered quality measurement for opioid use disorder: Development of a taxonomy to address gaps in research and practice Subst. Abus. (IF 3.5) Pub Date : 2022-07-18 A. Taylor Kelley, Michael A. Incze, Jacob D. Baylis, Spencer G. Calder, Saul J. Weiner, Susan L. Zickmund, Audrey L. Jones, Megan E. Vanneman, Molly B. Conroy, Adam J. Gordon, John F.P. Bridges
Abstract Background: Evidence-based treatment is provided infrequently and inconsistently to patients with opioid use disorder (OUD). Treatment guidelines call for high-quality, patient-centered care that meets individual preferences and needs, but it is unclear whether current quality measures address individualized aspects of care and whether measures of patient-centered OUD care are supported by
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Cannabis and cocaine use, drinking outcomes, and quality of life in general hospital inpatients with alcohol use disorder Subst. Abus. (IF 3.5) Pub Date : 2022-06-07 Esperanza Romero-Rodríguez, Clara A. Chen, Kimberly A. Dukes, Kaitlin Hartlage, Tibor P. Palfai, Kara M. Magane, Jeffrey H. Samet, Richard Saitz
Abstract Background: While associations between cannabis and cocaine use, and heavy drinking and quality of life (QOL), are well-established in the general population, it is unclear whether they are present in hospital inpatients with alcohol use disorder (AUD). The aim of the study was to assess associations between cannabis and cocaine use and two outcomes [heavy drinking days (HDDs) and QOL] among
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Smartphone-based alcohol interventions: A systematic review on the role of notifications in changing behaviors toward alcohol Subst. Abus. (IF 3.5) Pub Date : 2022-06-07 Charlotte Williamson, Katie White, Roberto J. Rona, Amos Simms, Nicola T. Fear, Laura Goodwin, Dominic Murphy, Daniel Leightley
Abstract Background: Smartphone-based interventions are increasingly being used to facilitate positive behavior change, including reducing alcohol consumption. However, less is known about the effects of notifications to support this change, including intervention engagement and adherence. The aim of this review was to assess the role of notifications in smartphone-based interventions designed to support
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Perceptions of prescription opioid use among rural farming and ranching communities: Preliminary implications for outreach and treatment Subst. Abus. (IF 3.5) Pub Date : 2022-06-07 Kristine Ramsay-Seaner, Amber Letcher, Meagan Scott Hoffman, Emily Anderson, Charlotte Heckmann
Abstract Background: In 2017, 45% of rural adults reported being directly impacted by the opioid epidemic. While research on the experiences of those using prescription opioids in rural communities is increasing, less is known about a unique sub-population who may have high rates of exposure: rural agricultural workers. The purpose of this study was to explore the prevalence and perceptions related
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Differences in the delivery of medications for opioid use disorder during hospitalization by racial categories: A retrospective cohort analysis Subst. Abus. (IF 3.5) Pub Date : 2022-06-07 Kelsey C. Priest, Caroline A. King, Honora Englander, Travis I. Lovejoy, Dennis McCarty
Abstract Background: As the drug-related overdose crisis and COVID-19 pandemic continue, communities need increased access to medications for opioid use disorder (MOUD) (i.e., buprenorphine and methadone). Disparities in the type of MOUD prescribed or administered by racial and ethnic categories are well described in the outpatient clinical environment. It is unknown, however, if these disparities
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Predictors of substance use disorder treatment initiation and engagement among adolescents enrolled in Medicaid Subst. Abus. (IF 3.5) Pub Date : 2022-06-07 Laura J. Chavez, Danielle L. Steelesmith, Jeffrey A. Bridge, Cynthia A. Fontanella
Abstract Background: Adolescents with substance use disorders (SUD) should receive timely access to treatment to improve lifelong outcomes. The Healthcare Effectiveness Data and Information Set (HEDIS) initiation and engagement in treatment (IET) performance measure was intended to promote quality improvement for patients with SUD. Yet, few studies have assessed predictors of measure performance among
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Barriers and facilitators to changing drinking and receiving alcohol-related care: Interviews with Veterans Health Administration primary care patients who indicated interest but did not enroll in an alcohol care management intervention trial Subst. Abus. (IF 3.5) Pub Date : 2022-06-03 Madeline C. Frost, Theresa E. Matson, Julie E. Richards, Amy K. Lee, Carol E. Achtmeyer, Katharine A. Bradley, Emily C. Williams
Abstract Background: Most people with alcohol use disorder do not receive treatment, and primary care (PC)-based management of alcohol use disorder is a key strategy to close this gap. Understanding PC patients’ perspectives on changing drinking and receiving alcohol-related care is important for this goal, particularly among those who decline alcohol-related care. This study examined perspectives
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Opioid use disorder Cascade of care framework design: A roadmap Subst. Abus. (IF 3.5) Pub Date : 2022-06-03 Arthur Robin Williams, Kimberly A. Johnson, Cindy Parks Thomas, Sharon Reif, Eugenia M. Socías, Brandy F. Henry, Charles Neighbors, Adam J. Gordon, Constance Horgan, Bohdan Nosyk, Karen Drexler, Noa Krawczyk, Gregg S. Gonsalves, Scott E. Hadland, Bradley D. Stein, Marc Fishman, A. Taylor Kelley, Harold A. Pincus, Mark Olfson
Abstract Unintentional overdose deaths, most involving opioids, have eclipsed all other causes of US deaths for individuals less than 50 years of age. An estimated 2.4 to 5 million individuals have opioid use disorder (OUD) yet a minority receive treatment in a given year. Medications for OUD (MOUD) are the gold standard treatment for OUD however early dropout remains a major challenge for improving