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Substance Abuse : Research and Treatment
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  This is an Open Access Journal Open Access journal
ISSN (Print) 1178-2218
Published by Sage Publications Homepage  [1175 journals]
  • Effects of VHA Policy Directive 1163 on Acceptance and Employment Rates
           for Veterans with Substance Use Disorders Referred to VHA Vocational
           Rehabilitation

    • Authors: Matthew E Sprong, Heaven Hollender, Ashley A Pechek, Kellie Forziat-Pytel, Frank D Buono
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Introduction:Research has shown that Veterans with Substance/Alcohol Use Disorders (SUDs/AUDs) are at a greater risk for employment-related issues (eg, lower labor force participation rates), and interventions such as Vocational Rehabilitation (VR) have been used as a tool to reduce employment obtainment and maintenance. The purpose of the current study was to evaluate acceptance rates and employment rates at closure for Veterans with SUDs/AUDs prior to the implementation of VHA Policy Directive 1163 (mandated that Veterans are not refused services based on prior or current SUD/AUDs). SUD/AUDs were coded to reflect DSM 5-TR criteria of active use and in-remission.Methods:Data from a VHA Vocational Rehabilitation program in the Veterans Integrated Service Network 12 network were obtained for the purpose of the current study.Results:Findings showed that Veterans with AUDs were less likely to be accepted for VR services prior and after implementation of VHA Policy Directive 1163.Conclusions:When examining active and inactive SUDs/AUDs, findings showed that implementation of VHA Policy Directive 1163 was not effective for Veterans with AUDs. One factor that was not explored but could explain disparities in program acceptance rates is duration of program entry. If a Veteran has a consult placed for VHA Vocational Rehabilitation services, and their program entry date (date accepted) is a significant duration, then perhaps Veterans with active AUDs start drinking again given that they are waiting for vocational assistance. Thus, it would be important to assist Veterans with active AUDs into services in a timely manner (perhaps prior them being discharged from SUD treatment).
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-11-26T08:43:09Z
      DOI: 10.1177/11782218221132397
      Issue No: Vol. 16 (2022)
       
  • Predictors of Retention and Drug Use Among Patients With Opioid Use
           

    • Authors: Tabitha E Moses, Gary L Rhodes, Emytis Tavakoli, Carl W Christensen, Alireza Amirsadri, Mark K Greenwald
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Many patients in methadone treatment have difficulty achieving or maintaining drug abstinence, and many clinics have policies that lead to discharging these patients. We designed a pilot “Second Chance” (SC) program for patients scheduled to be discharged from other local methadone clinics to be transferred to our clinic.Aim:Determine whether SC patients’ retention and opioid use is related to physical or mental health conditions, non-opioid substance use, or treatment features.Methods:From December 2012 to December 2014, this program enrolled 70 patients who were discharged from other clinics in the area; we were their last remaining option for methadone treatment. Unlike the clinic’s standard policies, the treatment focus for SC patients was retention rather than abstinence. This program focused on connection to care (eg, psychiatric services) and enabled patients to continue receiving services despite ongoing substance use. Each patient was assessed at treatment entry and followed until June 2016 to evaluate outcomes.Results:SC patients receiving disability benefits (n = 37) vs. non-disabled (n = 33) had significantly (P 65 mg predicted significantly longer retention and less opioid use, but these effects were not moderated by baseline characteristics.Conclusions:Patients in methadone treatment struggling to achieve abstinence may benefit from retention-oriented harm-reduction programs. Higher methadone doses can improve retention and opioid abstinence despite psychiatric comorbidities. Further work is needed to improve program implementation and outcomes in this complex population.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-11-16T06:45:31Z
      DOI: 10.1177/11782218221138335
      Issue No: Vol. 16 (2022)
       
  • Surveying Over the Counter and Prescription Only Medication Misuse in
           Treatment Services During COVID-19

    • Authors: Rosalind Gittins, Roya Vaziri, Ian Maidment
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment.Aim:To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England.Methods:In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables.Results:Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed.Conclusion:OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-11-09T06:51:17Z
      DOI: 10.1177/11782218221135875
      Issue No: Vol. 16 (2022)
       
  • Denial and Diagnosis of Methamphetamine Dependence Severity

    • Authors: Myra Rice, Andy C Dean, Jaymee Suh, Edythe D London
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Introduction:Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence.Methods:This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the University of Rhode Island Change Assessment Scale (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc t-tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis.Results:SCID summary scores were negatively correlated with URICA Precontemplation scores (P = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems (t = 3.066, P = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, r = .26; P = .01).Conclusions:The findings highlight the importance of a patient’s insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-11-09T06:41:57Z
      DOI: 10.1177/11782218221135721
      Issue No: Vol. 16 (2022)
       
  • Characterizing Clinical Heterogeneity in a Large Inpatient Addiction
           Treatment Sample: Confirmatory Latent Profile Analysis and Differential
           Levels of Craving and Impulsivity

    • Authors: Meenu Minhas, Alysha Cooper, Sarah Sousa, Mary Jean Costello, James MacKillop
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Individuals with substance use disorders (SUDs) have highly heterogeneous presentations and identifying more homogeneous subgroups may foster more personalized treatment. This study used SUD and other psychiatric indicators to characterize latent subgroups of patients in a large inpatient addiction treatment program. The resulting subgroups were then analyzed with respect to differences on clinically informative motivational mechanisms.Methods:Patients (n = 803) were assessed for severity of SUD (ie, alcohol use disorder, drug use disorder), post-traumatic stress disorder, anxiety disorders, and major depressive disorder. Confirmatory latent profile analysis (CLPA) was used to identify latent subgroups, hypothesizing 4 subgroups. Subgroups were then characterized with respect to multiple indicators of impulsivity (ie, delay discounting and impulsive personality traits via the UPPS-P) and craving.Results:The CLPA confirmed the hypothesized 4-profile solution according to all indicators (eg, entropy = 0.90, all posterior probabilities ⩾.92). Profile 1 (n = 229 [32.2%], 24.9% female, median age in range of 45-49) reflected individuals with high alcohol severity and low psychiatric severity (HAlc/LPsy). Profile 2 (n = 193 [27.1%], 29.3% female, median age in range of 35-39) reflected individuals with high drug and psychiatric severity (HDrug/HPsy). Profile 3 (n = 160 [22.5%], 37.6% female, median age in range of 45-49) reflected individuals with high alcohol severity and psychiatric severity (HAlc/HPsy). Profile 4 (n = 130 [18.3%], 19.4% female, median age in range of 35-39) reflected individuals with high drug severity and low psychiatric severity (HDrug/LPsy). Both high comorbid psychiatric severity subgroups exhibited significantly higher craving and facets of impulsivity.Conclusions:The results provide further evidence of 4 latent subgroups among inpatients receiving addiction treatment, varying by alcohol versus other drugs and low versus high psychiatric comorbidity. Furthermore, they reveal the highest craving and impulsivity in the high psychiatric comorbidity groups, suggesting targets for more intensive clinical intervention in these patients.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-11-09T06:37:19Z
      DOI: 10.1177/11782218221126977
      Issue No: Vol. 16 (2022)
       
  • Perceptions and Knowledge Around Substance Use Disorders and the Role of
           Occupational Therapy: A Survey of Clinicians

    • Authors: Amy M Mattila, Gabriella Santacecilia, Rebecca LaCroix
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Today’s healthcare system requires practitioners to acquire a level of confidence, knowledge, and personal desire that enables them to treat a growing clientele with substance use disorders (SUDs). Although SUDs impact millions of Americans, there are many barriers to receiving treatment. It is important to understand how occupational therapy (OT) practitioners’ perceptions of working with clients who experience SUDs relate to the knowledge and skills required to identify and provide treatment.Method:Two surveys, the Medical Regard Scale and modified Drug Problems Perceptions Scale, were utilized to analyze participants attitudes, perceptions, and knowledge around working with individuals with SUDs. Data was collected from 116 practitioners with a variety of experience, practice settings, and backgrounds in understanding SUDs.Results:The majority of respondents reported no formal training in treating clients with SUDs (72.4%). In terms of attitudes around working with this population, a fraction reported a preference not to work with patients experiencing SUDs (16.0%) or finding them “irritating” to work with (12.9%), while 62.0% reported they felt especially compassionate toward this population. The majority of respondents felt that insurance plans should cover patients like this to the same degree that they cover patients with other conditions; however, only 48.3% had a clear idea of their responsibilities in helping individuals with SUDs. In regard to knowledge around working with SUDs, just over half of respondents reported a true working knowledge of SUDs and SUDs related problems (53.4%).Conclusion:Occupational therapy practitioners would benefit from additional training, resources, and support related to provision of services to individuals with SUD. In addition, training to continue to reduce stigma within the profession can potentially increase access to care.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-10-29T06:45:14Z
      DOI: 10.1177/11782218221130921
      Issue No: Vol. 16 (2022)
       
  • Recreational Drug Use During the Amsterdam Dance Event: Impact on
           Emergency Services

    • Authors: Femke MJ Gresnigt, Pedram Ghaem Maghami, Pieternel van Exter, Annelieke Noordhoff, Tobias van Dijk, Ronald van Litsenburg, Frits Holleman, Mark HH Kramer, Prabath WB Nanayakkara
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Recreational drug use is common at large-scale dance events such as the Amsterdam Dance Event (ADE) and severe drug-related complications and deaths occur. Increasing concentrations of cocaine, amphetamine and MDMA have been observed in samples from dance events. Therefore, large dance events are expected to cause an increasing amount of recreational drug related complaints (RDRC) and an increased demand on emergency medical services.Aim:To evaluate the impact of recreational drug related complaints (RDRC) during ADE 2016, compared to regular weeks, and to evaluate the requirement for additional medical personnel.Methods:For this prospective, observational cohort study, patients>12 years old presenting with RDRC at first aid stations (FAS), ambulance service (AA) and ED during ADE, between October 19th and October 24th 2016 were included. From 2 EDs and AA, the RDRC 2 weeks before and after ADE were also collected.Results:An estimated 375.000 people attended ADE. The number of patients with RDRC was 459 at the FAS, 113 at AA and 81 at the ED, and increased significantly during ADE with 225% at AA and with 236% at OLVG ED. Eight patients were admitted. A higher percentage of poly-drug use among ED patients (58%) was found, compared to FAS patients (25%). Also, the proportion of tourists in ED’s (51%) was higher compared to FAS (30%).Conclusions:During ADE 2016, the number of intoxicated patients increased significantly. Eight patients were admitted to the hospital, without any deaths. The absolute number of patients stayed within normal range of emergency medical services capacity.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-10-19T01:49:28Z
      DOI: 10.1177/11782218221114965
      Issue No: Vol. 16 (2022)
       
  • Associations Between Copays, Coverage Limits for Naloxone, and Prescribing
           in Medicaid

    • Authors: John C Messinger, Aaron S Kesselheim, Seanna M Vine, Michael A Fischer, Rachel E Barenie
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Aims:To describe naloxone dispensing in Medicaid fee-for-service (FFS) and examine relationships between copays and coverage limits for naloxone and its dispensing rates.Methods:Cross-sectional study using Medicaid FFS State Drug Utilization Data to quantify the use of naloxone in 2018. The primary outcomes of this study were the proportion of naloxone prescriptions relative to all prescriptions and all opioid prescriptions dispensed in each state. We obtained drug benefit design information from the Medicaid Behavioral Health Services Database. The primary analysis examined the influence of copays (yes/no), copay amounts, and coverage limits on medication dispensing using simple linear regression, excluding states with no measurable use or less than 5% Medicaid FFS.Results:We found substantial variability across 50 states and DC in the proportion of prescriptions dispensed for Narcan and generic naloxone. We found a positive relationship between copay and copay amount and dispensing of generic naloxone. However, a sensitivity analysis including the broadest possible cohort of states failed to confirm this relationship. We found no other relationships between copays or coverage limits and dispensing of any naloxone formulation.Conclusions:Substantial variation exists between the rates of naloxone dispensing across the US for Medicaid patients, but we did not find a meaningful relationship between plan design and dispensing. Whether drug benefit designs in Medicaid influence naloxone use requires further evaluation to avoid limiting access to this life-saving medication.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-09-29T01:18:11Z
      DOI: 10.1177/11782218221126972
      Issue No: Vol. 16 (2022)
       
  • Engaging Community Partners to Understand and Respond to Substance Use and
           Addiction Crisis Facing Families in Prince Albert, Saskatchewan

    • Authors: Geoffrey Maina, Marcella Ogenchuk, Jordan Sherstobitoff, Robert Bratvold, Barbara Robinson
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Substance use is a persisting health care crisis that has led to residents’ addiction to diverse substances in Prince Albert, Saskatchewan. This public health issue affects not only those with a substance use disorder but also those within their circle of family and friends. This paper aims to outline the community engagement processes that we undertook to identify community priorities for addressing the substance use and addiction issues facing them. We began the community engagement using a patient-oriented research process, which led to the development of a grant application. Following the awarding of this grant application by the Saskatchewan Health Research Foundation and Saskatchewan Centre for Patient-Oriented Research, we conducted interviews with family members affected by addiction in the city. The study provided us with significant insight into the impacts of substance use disorders on family members. The importance of collaboration among people with lived experience, health care providers, and community partners helped us to identify our research questions. Community members also actively participated in the data collection, analysis, and presentation of the findings where priorities for the interventions were identified. The conversations we had because of the community’s engagement and participation in the research process enhanced our understanding of the realities of caring for people with substance use disorders and the importance of family involvement throughout the process. We also learned lessons regarding community engagement and participation in research on a stigmatizing and complex topic.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-09-28T01:21:09Z
      DOI: 10.1177/11782218221126881
      Issue No: Vol. 16 (2022)
       
  • For Better or Worse: Self-reported Changes in Kratom and Other Substance
           Use as a Result of the COVID-19 Pandemic

    • Authors: Jeffrey M Rogers, Kirsten E Smith, Destiny Schriefer, David H Epstein
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Kratom is taken to self-treat pain and symptoms of psychiatric disorders, including substance-use disorders (SUDs) and opioid withdrawal. Before COVID-19, kratom use was increasing in the US, however, there are few published data on whether that trend continued during the COVID-19 pandemic, which could have affected kratom use in multiple ways.Aim:To examine COVID-19-related changes in kratom use and how these changes were experienced, relative to changes in other commonly used substances.Methods:Using Amazon Mechanical Turk, 2615 evaluable surveys were completed between September 2020 and March 2021. Responses from past-month and past-year kratom-using adults (N = 174) indicating changes for the better or worse were examined using generalized linear mixed effects models, and relevant open-text responses (n = 85) were thematically coded.Results:For kratom 33% (n = 58) reported a Covid-related increase and 24% (n = 42) reported a Covid-related decrease. Controlling for changes in amount used, alcohol (OR = 5.02), tobacco (OR = 4.72), and nonmedical opioid use (OR = 3.42) were all more likely to have changed for the worse, compared with kratom use. Relative to decreases in kratom use, decreases in alcohol (OR = 3.21) and tobacco (OR = 6.18) use were more likely to be changes for the better. Cannabis use was the only substance to display a probability lower than 50% of being a decrease for the better, and of the increases, cannabis use displayed the highest probability of being for the better.Conclusions:Increases in kratom and cannabis use were less likely than alcohol and tobacco to be reported as changes for the worse, and decreases in kratom and cannabis use were more likely than alcohol and tobacco to be reported as changes for the better. These findings indicate that people differently conceptualize their relationships with kratom and cannabis, compared to their relationships with alcohol and tobacco.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-09-28T01:18:22Z
      DOI: 10.1177/11782218221123977
      Issue No: Vol. 16 (2022)
       
  • Feasibility and Acceptability of a Digital Health Intervention to Promote
           Continued Engagement in Medication for Opioid Use Disorder Following
           Release From Jail/Prison

    • Authors: Kirsten J Langdon, Paola Jiménez Muñoz, Amanda Block, Caroline Scherzer, Susan Ramsey
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Despite the extensive benefits of implementing Medications for Opioid Use Disorder (MOUD) in jail/prison, criminal justice-involved populations face significant challenges when transitioning back to the community following a period of incarceration. These risk factors are associated with increased drug use and discontinuation of evidence-based care. Novel intervention strategies are needed to support this high-risk period of transition. The primary objective of this protocol was to gather perspectives from the target population to optimize feasibility and acceptability of a combined in-person and text message-delivered intervention designed to support community reentry and continuation of MOUD.Methods:Participants (n = 8), who had prior experience engaging in MOUD while in jail/prison, were recruited from an outpatient primary care clinic in Rhode Island. A semi-structured interview was conducted to assess barriers/facilitators to technology following release, experiences of community reentry and OUD treatment, perceptions of continuum of care, and feasibility/acceptability of the intervention. All interviews were coded independently by 2 research assistants.Results:Participants reacted positively toward an intervention designed to support the transition to community-based care. Most participants denied any apprehension about using this type of platform. Obtaining a cell phone following release was endorsed as generally viable; however, special consideration must be paid to the consistency of cell phone service as well as digital literacy. Participants readily agreed on the utility of structured, daily text messages that provide motivational reminders and distress tolerance skill suggestions as well as the opportunity to access “on-demand” support.Conclusion:Overall, individuals engaged in MOUD while in jail/prison were receptive to a motivational- and distress tolerance-based digital health intervention to support recovery. Incorporating thematic results on suggested structural changes may increase the usability of this intervention to promote continuation of MOUD following release from jail/prison.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-09-27T09:58:00Z
      DOI: 10.1177/11782218221127111
      Issue No: Vol. 16 (2022)
       
  • The Pandemic Experience for People with Depressive Symptoms: Substance
           Use, Finances, Access to Treatment, and Trusted Sources of Information

    • Authors: Katherine Sanchez, Briget da Graca, Lauren R Hall, Monica M Bennett, Mark B Powers, Ann Marie Warren
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Mental health impacts of the COVID-19 pandemic are well recognized, but little is known about the pandemic experience among people experiencing mental health symptoms.Methods:In June 2020, a national sample of 5023 U.S. adults, including 785 scoring ⩾10 on the PHQ-8 for symptoms of depression, completed survey measures related to their pandemic experience.Results:After adjusting for sociodemographic characteristics, aspects of the COVID-19 pandemic experience for which participants scoring PHQ-8 ⩾ 10 had the greatest increase in odds of reporting moderate/severe negative impacts included: mental health treatment access (odds ratio [OR], 95% confidence interval [CI] = 8.81, 6.70-11.57), family stress/discord (OR, 95% CI = 5.21, 4.24-6.42), food access (OR, 95% CI = 3.76, 2.97-4.77), and income/employment (OR, 95% CI = 3.19, 2.66-3.83). They were also significantly more likely to report increased use of prescription painkillers (OR, 95% CI = 8.46, 4.50-15.92) and other drugs (OR, 95% CI = 4.43, 2.85-6.89), and less trust in healthcare authorities/providers, family/friends, and employers, and more trust in websites/blogs/social media, for COVID-19 information (P-values 
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-09-27T09:56:13Z
      DOI: 10.1177/11782218221126973
      Issue No: Vol. 16 (2022)
       
  • Barriers and Facilitators to Substance Use Disorder Treatment: An Overview
           of Systematic Reviews

    • Authors: Ali Farhoudian, Emran Razaghi, Zahra Hooshyari, Alireza Noroozi, Azam Pilevari, Azarakhsh Mokri, Mohammad Reza Mohammadi, Mohsen Malekinejad
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      objective:This investigation explored the barriers and facilitators to substance use disorder (SUD) treatment in the integrated paradigm.methods:A search technique for barriers and facilitators of SUD treatment was applied to the PubMed and Web of Science databases to identify relevant systematic reviews. The eligibility criteria included systematic review (SR) or SR plus meta-analysis (MA) articles published before the end of 2021, human research, and the English language. Each of the 12 relevant review articles met the inclusion criteria. AMSTAR was utilised to evaluate the methodological quality of the systematic reviews.results:Two authors analysed 12 SR/SR-MA articles to identify barriers or facilitators of SUD treatment. The cumulative summary results of these 12 evaluations revealed that barriers and facilitators may be classified into 3 levels: individual, social and structural. By analysing these review papers, 37 structural barriers, 21 individual barriers and 19 social barriers were uncovered, along with 15 structural facilitators, 9 social facilitators and 3 individual facilitators.conclusions:The majority of barriers indicated in the review articles included in this analysis are structural, as are the majority of facilitators. Consequently, the design of macro models for the treatment of substance use disorders may yield various outcomes and potentially affect society and individual levels.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-29T08:59:35Z
      DOI: 10.1177/11782218221118462
      Issue No: Vol. 16 (2022)
       
  • Adolescents’ Perceptions of Substance Use Harms are Contingent on Mode
           of Administration and Type of Substance

    • Authors: Kevin Cummins, Yang Lu
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Early vaping research often did not differentiate between substances vaped. The present study investigates risk perceptions for vaped nicotine and vaped cannabis. A school-based census of 9th and 11th graders yielded 431 responses to the California Healthy Kids Survey. Differences in harm perceptions were evaluated using multilevel mixed-effects models. Students were more likely to report nicotine vaping as great-moderate risk in comparison to cannabis vaping. Additionally, vaped cannabis was viewed as riskier than traditional administration. These results indicate that differences in harm perceptions may need to be addressed when targeting specific classes of substance use in investigations and interventions.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-24T10:41:08Z
      DOI: 10.1177/11782218221119584
      Issue No: Vol. 16 (2022)
       
  • Getting High or Getting By' An Examination of Cannabis Motives,
           Cannabis Misuse, and Concurrent Psychopathology in a Sample of General
           Community Adults

    • Authors: Molly L Scarfe, Candice Muir, Karen Rowa, Iris Balodis, James MacKillop
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      OBJECTIVE:Few studies have examined cannabis motives in adults and, although associations between cannabis use and psychiatric conditions are well documented, there has been limited investigation of the intersection of cannabis use, cannabis motives, and psychopathology. In a sample of community adults, the present study examined cannabis motives in relation to cannabis misuse, and investigated whether motives linked cannabis misuse with concurrent psychiatric symptoms.METHOD:Participants (N = 395; Mage = 34.8; %F = 47.6; % White = 81.3%) completed assessments related to cannabis misuse, cannabis use motives, and symptoms of depression, anxiety, PTSD, and somatic experiences. Bivariate correlations, hierarchical regressions, and indirect effect analyses were performed to examine associations between motives and cannabis misuse and to investigate mechanistic relationships between psychiatric symptoms and cannabis misuse.RESULTS:Regressions revealed significant associations between cannabis misuse and social (β = .13, P 
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-23T10:58:13Z
      DOI: 10.1177/11782218221119070
      Issue No: Vol. 16 (2022)
       
  • Impact of an Accelerated Pretreatment Evaluation on Linkage-to-Care for
           Hepatitis C-infected Persons Who Inject Drugs

    • Authors: Valérie Martel-Laferrière, Suzanne Brissette, Claire Wartelle-Bladou, Louis-Christophe Juteau, Maria Popa, Marie-Ève Goyer, Julie Bruneau
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Historically, hepatitis C virus (HCV) pretreatment evaluation has required multiple visits, frequently resulting in loss to follow-up and a delayed initiation of treatment. New technologies can accelerate this process. We investigated the feasibility of a single-day evaluation program and its impact on evaluation completion, treatment eligibility awareness, and treatment initiation among people who inject drugs (PWIDs).Methods:HCV-infected PWID who were unaware if they were eligible for treatment were recruited in a prospective evaluation of an accelerated model of care between 2017 and 2019 and compared to a historical cohort. The patients underwent a medical evaluation, rapid HCV viral load testing, and transient elastography during a single visit, at the end of which they were informed whether they were eligible for treatment. A historical cohort of patients fulfilling the same inclusion criteria and evaluated with the usual standard of care spanning several visits who were examined at the addiction medicine clinic from 2014 to 2016 served as the comparison group.Results:The accelerated and historical cohorts included 99 and 76 patients, respectively. The cohorts did not differ significantly by age and gender, but more patients in the historical cohort were undergoing opioid agonist therapy, while more patients in the accelerated cohort injected drugs in the last month. An accelerated evaluation resulted in a higher rate of evaluation completion (100% vs 67.1%; P 
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-12T10:05:56Z
      DOI: 10.1177/11782218221119068
      Issue No: Vol. 16 (2022)
       
  • Examining Internalizing Mental Health Correlates of Addiction Severity in
           Patients Hospitalized With Medical Complications From Substance Use
           Disorder

    • Authors: Bryana N Baginski, Kaileigh A Byrne, Lauren Demosthenes, Prerana J Roth
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Comorbidities between Substance Use Disorder (SUD) and mental health disorders are highly prevalent, yet there remains a lack of information regarding how mental health conditions may affect addiction severity. Consequently, this study sought to investigate the relationship between internalizing disorders (anxiety and mood disorders) and addiction severity in patients hospitalized for SUD-related medical complications. Individual difference predictors and history of prior treatment for SUD were also examined.Methods:Participants (N = 200) were hospitalized patients who consented to receive peer-based recovery support services for their SUD. To be eligible for the study, participants needed to have a SUD diagnosis due to alcohol, opioids, methamphetamine, cocaine, or a combination of these substances (polysubstance use). Participants completed self-report questionnaires regarding demographics, mental health history, prior SUD treatment, and addiction severity (Drug and Alcohol Screening Test; DAST-10) during their hospitalization.Results:Results showed that patients with Generalized Anxiety Disorder (GAD) (M = 6.68, SD = 2.97) had greater addiction severity compared to those without GAD (M = 5.41, SD = 3.34), P = .016. Addiction severity results stratified by SUD type showed that the relationship was significant among patients with Alcohol Use Disorder (P = .014), but not among those with other SUD types (Ps > .27). Major Depressive Disorder (MDD) and Post-Traumatic Stress Disorder (PTSD) were not linked to addiction severity. Among those with GAD, 81.4% had previously been to treatment compared to only 53.1% of those without GAD, P = .010. The only participant characteristic linked with addiction severity was insurance status.Conclusions:GAD may represent a risk factor for advanced alcohol addiction trajectories, including greater addiction severity and severe health complications requiring inpatient hospitalization.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-12T10:03:34Z
      DOI: 10.1177/11782218221115583
      Issue No: Vol. 16 (2022)
       
  • Hospitalizations for Alcohol and Opioid Use Disorders in Older Adults:
           Trends, Comorbidities, and Differences by Gender, Race, and Ethnicity

    • Authors: Andrea Acevedo, Ivette Rodriguez Borja, Tania M Alarcon Falconi, Nicole Carzo, Elena Naumova
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:The prevalence of substance use disorders (SUDs) among adults ages 65 and older has been increasing at a notably high rate in recent years, yet little information exists on hospitalizations for SUDs among this age group. In this study we examined trends in hospitalizations for alcohol use disorders (AUDs) and opioid use disorders (OUDs) among adults 65 and older in the United States, including differences by gender and race/ethnicity.Methods:We used Medicare claims data for years 2007-2014 from beneficiaries ages 65 and older. We abstracted hospitalization records with an ICD-9 diagnostic code for an AUD or OUD. Hospitalization rates were calculated using population estimates from the United States Census. We examined trends in quarterly hospitalization rates for hospitalizations with AUD/OUD as primary diagnoses, and separately for those with these disorders as secondary diagnoses. We also examined comorbidities for those with a primary diagnosis of AUD/OUD. Analyses were conducted for all hospitalizations with AUD/OUD diagnoses, and separately by gender and race/ethnicity.Results:Between the last quarter of 2007 and the third quarter of 2014, AUD hospitalization rates increased from 485 to 579 per million (19%), and OUD hospitalization rates from 46 to 101 per million (120%) and varied by gender (for AUD) and race/ethnicity (for both AUD and OUD). Hospitalization rates were particularly high for Black older adults, as was the increase in hospitalization rates. The increase in hospitalization rates was substantially higher for hospitalizations with AUD (84%) and OUD (269%) as secondary diagnoses.Conclusions:Hospitalizations for AUDs and OUDs among older adults increased at an alarming rate during the observation period, and disparities existed in hospitalization rates for these conditions. Interventions focusing on the needs of older adults with AUD and/or OUD are needed, particularly to address the needs of a growing racially/ethnically diverse older adult population.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-10T12:11:06Z
      DOI: 10.1177/11782218221116733
      Issue No: Vol. 16 (2022)
       
  • Early Age of Cannabis Initiation and Its Association With Suicidal
           Behaviors

    • Authors: Manik Ahuja, Manul Awasthi, Suzanna Gim, Kathie Records, Johanna Cimilluca, Kawther Al-Ksir, Johnathan Tremblay, Riddhi P Doshi, Thiveya Sathiyasaleen, Praveen Fernandopulle
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Suicide rates in the U.S. have continued to rise over the last 2 decades. The increased availability and broader legalization of cannabis is a public health concern, particularly among adolescents. The objective of this study was to examine the association between the age of cannabis initiation and lifetime suicidal ideations and attempts in a sample of adults aged 18 or older.Methods:Data are from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001 to 2003 (N = 15 238). The primary objective of the CPES was to collect data about the prevalence of mental disorders, impairments associated with these disorders, and their treatment patterns from representative samples of majority and minority adult populations in the U.S. Logistic regression analyses were conducted to test the association between cannabis initiation age (early ⩽14 years old; later>14 years old) and outcomes of lifetime suicide ideation and attempts. Cigarette use, cannabis use, gender, income, race, education, and age were controlled for the analyses.Results:Overall, 12.5% of participants reported suicide ideation, while 4.2% reported attempt. Early cannabis use was associated with a higher risk of suicide ideation (AOR = 3.32, 95% CI [2.75, 3.80]) than later cannabis use (AOR = 2.15, 95% CI [1.92, 2.39]). Early cannabis use was associated with a higher risk of suicide attempt (AOR = 4.38, 95% CI [3.48, 5.52]) than later cannabis use (AOR = 2.56, 95% CI [2.14, 3.06]). Wald chi-squared tests revealed significant differences between the early and late initiation for both ideation (χ2 = 26.99; P 
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-10T12:07:45Z
      DOI: 10.1177/11782218221116731
      Issue No: Vol. 16 (2022)
       
  • An Assessment of the Psychosocial Evaluation for Early Liver
           Transplantation in Patients With Acute Alcoholic Hepatitis in the Context
           of Alcohol Use Disorder, a Case-Control Study

    • Authors: Aryeh Dienstag, Penina Dienstag, Kanwal Mohan, Omar Mirza, Elizabeth Schubert, Laura Ford, Margot Edelman, Gene Im, Akhil Shenoy
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Severe acute alcoholic hepatitis (AAH) has an extremely poor prognosis with a high short term mortality rate. As a result, many centers, including our own, have allowed transplant patients to be listed for transplantation prior to achieving 6-months of sobriety. Several scoring systems, designed to target patients with a minimal period of sobriety, have been proposed to identify patients with alcohol use disorder (AUD), who would be predisposed to relapse after liver transplantation. We investigated whether these scoring systems corroborated the results of the non-structured selection criteria used by our center regarding decision to list for transplant.Methods:We conducted a retrospective case-control study of 11 patients who underwent early liver transplantation for AAH matched with 11 controls who were declined secondary to low insight into AUD. Blinded raters confirmed the severity of the diagnosis of DSM-5 and scored the patients on a variety of structured psychometric scales used to predict alcohol relapse. These included the High Risk for Alcohol Relapse Scale (HRAR), Stanford Integrated Psychosocial Assessment Tool (SIPAT), Alcohol Relapse Risk Assessment (ARRA), Hopkins Psychosocial Scale (HPSS), Michigan Alcoholism Prognosis Score (MAPS), Alcohol Use Disorders Identification Test -Consumption (AUDIT-C), and Sustained Alcohol Use Post-Liver Transplant (SALT) scales. All patients who underwent transplantation were followed for harmful and non-harmful drinking until the end of the study period.Results:The transplant recipients had significantly favorable MAPS, HRAR, SIPAT, ARRA, and HPSS scores with cutoffs that matched their previous research. The SALT and AUDIT-C scores were not predictive of our selection of patients for transplantation. Despite an expedited evaluation and no significant period of sobriety, our case cohort had a 30% relapse to harmful drinking after an average of 6.6 years (5-8.5 years) of follow-up.Discussion:Despite the rapid assessment and the short to no period of sobriety, the patient cohort demonstrated a 30% relapse to harmful drinking, consistent with the 20% to 30% relapse to drinking rate reported after liver transplantation for all forms of alcoholic liver disease. Average scores from MAPS, HRAR, SIPAT, ARRA, and HPSS corroborated our current stratification procedures, with lower mean risk scores found in the transplanted group.Conclusion:Patients with AUD and severe AAH who obtain new insight into their disease and posses other favorable psychosocial factors have low rates of AUD relapse post-liver-transplantation. The psychosocial selection criteria for patients with alcoholic hepatitis in our institution are consistent with 4 of the 5 scoring systems investigated in their prediction of sobriety post-transplant.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-08-10T12:05:46Z
      DOI: 10.1177/11782218221115659
      Issue No: Vol. 16 (2022)
       
  • Cue Reactivity to Electronic Cigarettes: A Systematic Review

    • Authors: Merel Keijsers, Maria Cecilia Vega-Corredor, Simon Hoermann, Melanie Tomintz
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Cue reactivity to Electronic Nicotine Delivery Systems (ENDS) has been studied by several researchers, yet the variability in user types (smokers, former smokers, dual users, exclusive ENDS users) and ENDS designs used between the studies may have undermined consistent results. This systematic review aims to give an overview of ENDS cue reactivity and how smoking status and device design may moderate this. A systematic search of Medline, Embase, Web of Science, PubMed and Cochrane was completed. All studies which reported findings on reactivity to ENDS cues in the form of craving or desire for ENDS or cigarettes, attention to cue, delay of gratification or economic decisions were included. Exclusion criteria were non-human subjects, non-adult participants or participants with comorbidities. Literature selection was carried out by 2 independent reviewers. The risk of bias and study quality were assessed using tools developed by Cochrane, BMJ and NHLBI. A total of 711 papers were screened and 22 studies were included in the current review. Study design, research question(s), population of interest, number of participants, dependent variable(s), ENDS generation and nicotine content used and study results were extracted. ENDS cues reliably induced ENDS craving, with no clear moderation by smoking status and no apparent moderation by device generation. In about half of the studies, ENDS cues induced craving for conventional cigarettes. Most studies used a smoker sample, thus limiting the conclusions that can be drawn on the moderation of cue reactivity by smoking status. The quality varied among studies but comparing the findings against the outcomes of only high-quality studies did not yield any different results. The results of this review support the notion of cue reactivity to ENDS, identifies gaps in current research on different user types and implies that ENDS design iterations have little impact on cue reactivity.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-28T10:49:57Z
      DOI: 10.1177/11782218221114971
      Issue No: Vol. 16 (2022)
       
  • Problematic Opioid Use: A Scoping Literature Review of Profiles

    • Authors: Léonie Archambault, Karine Bertrand, Michel Perreault
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background and Objectives:Problematic opioid use can be defined as opioid use behaviors leading to social, medical, or psychological consequences. In some instances, people presenting problematic opioid use can also meet criteria for an opioid use disorder. A growing body of literature highlights different types of people who use opioids, with contrasting characteristics and initiation patterns. In recent years, dynamic trends in opioid use have been documented and studies have demonstrated a shift in profiles.Methods:A scoping literature review was conducted to identify profiles of people presenting problematic opioid use, in order to support the development of tailored interventions and services.Results:Nine articles met the inclusion criteria. Five classifications emerge from the literature reviewed to distinguish types of people presenting problematic opioid use, according to: (1) the type of opioids used, (2) the route of opioid administration, (3) the level of quality of life, (4) patterns of other drugs used, and (5) dependence severity. While samples, concepts, and measurement tools vary between studies, the most salient finding might be the distinct profile of people presenting problematic use of pharmaceutical-type opioids.Discussion and Conclusions:This scoping review highlights that few studies address distinctive profiles of people presenting problematic opioid use. Geographical and chronological differences suggest that local timely assessments may be needed to tailor the service offer to specific needs.Scientific Significance:Future studies should focus on providing a deep understanding of distinct experiential perspectives and service needs, through exploratory quantitative and qualitative designs.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-28T10:48:22Z
      DOI: 10.1177/11782218221103581
      Issue No: Vol. 16 (2022)
       
  • Comparison of Lapse Rate in Drug Dependent Patients in 2 Methods of
           Methadone Maintenance Treatment and Buprenorphine Maintenance Treatment

    • Authors: Mohammadreza Vafaeinasab, Hamidreza Zare, Ali Dehghani, Seyedehzahra Malek, Maryam Dehghani-Tafti, Mohammadtaghi Sarebanhassanabadi
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Lapse has been one of the major challenges in the treatment of drug dependence sometimes leading to its relapse.Objectives:The aim of this study was to determine the lapse rate in drug dependent patients as for the 2 methods of methadone maintenance treatment (MMT) and buprenorphine maintenance treatment (BMT) in Yazd city.Methods:In this cross-sectional study, 626 female and male patients who had referred to 5 SUD treatment centers in Yazd and had been treated with methadone and buprenorphine maintenance were studied. Participants were divided into 2 groups of MMT and BMT and were evaluated based on lapse within 6 months.Results:In this study, 60.9% of patients were treated with methadone but the rest were treated with buprenorphine. Overall, 33.1% of patients lapsed (35.2% for methadone and 29.8%for buprenorphine). Lapse in methadone treatment was correlated with age, occupational status, and duration of treatment (P  .05). Lapse rate in buprenorphine treatment was also related to marital status and the drug used (P  .05). The results demonstrated that given the low dose, lapse stood higher in the buprenorphine group than the methadone group; however, as to high dose, the buprenorphine group showed lower lapse than the other group.Conclusions:In regard with the high rate of lapse, it is recommended to consider the factors related to the 2 methods of treatments, and provide counseling and training programs to lower lapse in the patients.Ethics Committee (REC) approval code: IR.SSU.REC.1394.158.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-22T11:35:22Z
      DOI: 10.1177/11782218221112502
      Issue No: Vol. 16 (2022)
       
  • Rethinking Unhealthy Alcohol Use in the United States: A Structured Review

    • Authors: Joseph R Volpicelli, Percy Menzies
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Greater than moderate alcohol use spans a continuum that includes high levels of total alcohol consumed per period (heavy drinking) as well as episodes of intense drinking (binges) and can give rise to alcohol use disorder (AUD) when associated with an inability to control alcohol use despite negative consequences. Although moderate drinking and AUD have standard, operable definitions in the United States (US), a significant “gray area” remains in which an individual may exceed recommended drinking guidelines but does not meet the criteria for AUD (hereafter referred to as unhealthy alcohol use). To address this need, we conducted a structured literature search to evaluate how this gray area is defined and assess its burden within the US. For purposes of this review, we will refer to this gray area as “unhealthy alcohol use.” Although numerous terms are used to describe various unsafe drinking practices, our review did not find any studies in which the specific prevalence and/or burden of unhealthy alcohol use was evaluated. That is, we found no studies that focus exclusively on individuals who exceed moderate drinking guidelines but do not meet AUD criteria. Furthermore, we did not discover an established framework for identifying individuals with unhealthy alcohol use. The lack of a consistent framework for identifying unhealthy alcohol users has significant implications for patient management and disease burden assessment. Therefore, we propose the following framework in which unhealthy alcohol use comprises 2 distinct subpopulations: those at risk of experiencing alcohol-related consequences and those who have subthreshold problems associated with use. The former, termed “risky drinkers,” are defined by exceeding recommended guidelines for moderate drinking (⩽1 or 2 drinks per day for women and men, respectively). People with subthreshold problems associated with use, defined as exhibiting exactly 1 AUD symptom, would be classified as “problematic drinkers” within this proposed framework. These definitions would help bring the core elements of unhealthy alcohol use into focus, which in turn would help identify and provide management strategies sooner to those affected and reduce the overall burden of unhealthy alcohol use.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-22T11:33:49Z
      DOI: 10.1177/11782218221111832
      Issue No: Vol. 16 (2022)
       
  • Association Between Interorganizational Collaboration in Opioid Response
           and Treatment Capacity for Opioid Use Disorder in Counties of Five States:
           A Cross-Sectional Study

    • Authors: William L Swann, Michael DiNardi, Terri L Schreiber
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Local governments on the front lines of the opioid epidemic often collaborate across organizations to achieve a more comprehensive opioid response. Collaboration is especially important in rural communities, which can lack capacity for addressing health crises, yet little is known about how local collaboration in opioid response relates to key outputs like treatment capacity.Purpose:This cross-sectional study examined the association between local governments’ interorganizational collaboration activity and agonist treatment capacity for opioid use disorder (OUD), and whether this association was stronger for rural than for metropolitan communities.Methods:Data on the location of facilities providing buprenorphine and methadone were merged with a 2019 survey of all 358 counties in 5 states (CO, NC, OH, PA, and WA) that inquired about their collaboration activity for opioid response. Regression analysis was used to estimate the effect of a collaboration activity index and its constituent items on the capacity to provide buprenorphine or methadone in a county and whether this differed by urbanicity.Results:A response rate of 47.8% yielded an analytic sample of n = 171 counties, including 77 metropolitan, 50 micropolitan, and 44 rural counties. Controlling for covariates, a 1-unit increase in the collaboration activity index was associated with 0.155 (95% CI = 0.005, 0.304) more methadone facilities, ie, opioid treatment programs (OTPs), per 100 000 population. An interaction model indicated this association was stronger for rural (average marginal effect = 0.354, 95% CI = 0.110, 0.599) than for non-rural counties. Separate models revealed intergovernmental data and information sharing, formal agreements, and organizational reforms were driving the above associations. Collaboration activity did not vary with the capacity to provide buprenorphine at non-OTP facilities. Spatial models used to account for spatial dependence occurring with OUD treatment capacity showed similar results.Conclusion:Rural communities may be able to leverage collaborations in opioid response to expand treatment capacity through OTPs.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-13T12:22:04Z
      DOI: 10.1177/11782218221111949
      Issue No: Vol. 16 (2022)
       
  • Predictors of Pain Reliever Misuse Among Respondents of the United States
           2017 National Survey on Drug Use and Health

    • Authors: Marissa S Matta, Timothy P Janikowski
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      The risk factors for potential opioid misuse and abuse in patients receiving long-term opioid pain treatment have been a topic of interest in research for many years. There are differences among patients who receive long-term opioid pain treatment. These differences may or may not lead to opioid misuse. This study analyzes the different characteristics and predictors of prescription pain reliever misuse among respondents of the United States 2017 National Survey on Drug Use and Health. It examines the relationships of age, gender, income, perception of risk and availability of heroin, past substance use and alcohol use, the source of the pain relievers, and motivation to misuse pain relievers to pain reliever misuse and if these variables significantly predict pain reliever misuse. Data used in this study were analyzed through sequential multiple linear regression analyses. The significant positive predictors of prescription pain reliever misuse were being 26 or older, perceiving heroin as easily obtainable, and past methamphetamine use. The significant negative predictors of prescription pain reliever misuse were being 12 to 25 years old, perceiving heroin as a great risk, past alcohol use, and obtaining pain relievers from a friend or relative. The goal of this study was to increase the amount of knowledge regarding predictors of prescription opioid misuse to identify those who are at risk and decrease prescription opioid misuse and overdose rates in the United States.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-12T07:04:44Z
      DOI: 10.1177/11782218221111843
      Issue No: Vol. 16 (2022)
       
  • The Role of Physical Activity in Opioid Substitution Therapy: A Systematic
           Review of Interventional and Observational Studies

    • Authors: Silvia Eiken Alpers, Einar Furulund, Ståle Pallesen, Asgeir Mamen, Sindre M Dyrstad, Lars Thore Fadnes
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Use of physical activity in the treatment and follow-up of people receiving opioid substitution therapy is an understudied area of research. Therefore, the objective of this systematic review was to synthesize the currently available research on the role of physical activity in opioid substitution therapy and proper adaptions for the group.Methods:A systematic search was performed on PsycINFO, EMBASE, MEDLINE, CINAHL, and Web of Science until September 2021 (PROSPERO-reg.no: CRD42020109873). The inclusion criteria were studies involving physical activity interventions for opioid substitution patients. Reference lists of relevant studies were screened to identify additional relevant studies. Data extracted were compiled into tables and descriptively presented.Results:The search yielded 2105 unique records. A total of 10 studies were included, whose methodological quality ranged from satisfactory to very good. Study quality was assessed using a 7-/8-point quality score. The agreement between the reviewers, assessed with Cohen’s kappa, was 0.91. Overall, the results suggest that physical activity increases physical fitness of patients in opioid substitution therapy and decreases substance use. The minority of studies in this field are of high quality with sufficient power.Conclusions:The findings of this systematic review suggest beneficial effects of physical activity on physical fitness, substance use, and mental health for patients in opioid substitution therapy. Although the findings are quite consistent across studies, high-quality studies and sufficiently powered clinical trials are needed to confirm and validate the findings and to conclude on the degree of impact.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-12T07:02:03Z
      DOI: 10.1177/11782218221111840
      Issue No: Vol. 16 (2022)
       
  • Barriers to Implementing a Cannabis Focused SBIRT in Adolescent Primary
           Care

    • Authors: Allison N Kristman-Valente, Carolyn A McCarty, Denise D Walker, Leslie Walker-Harding
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Introduction:The current study investigated providers’ perceived barriers, supports, and need for adopting a screening, brief intervention, and referral to treatment model (SBIRT) intervention related to cannabis reduction into their community based primary care clinics.Methods:Eleven pediatric primary care providers from regional community-based clinics participated in focus groups discussing a proposed adolescent cannabis use SBIRT reduction intervention, perceived need, and potential barriers to implementation within their clinic.Results:Seven primary themes emerged regarding barriers to implementing a cannabis reduction SBIRT in primary care including provider ambivalence to adolescent cannabis use.Conclusion:Further research is needed to understand evolving provider perceptions of adolescent cannabis use and how these views impact the adoption of SBIRT for the reduction of cannabis use among their adolescent patients.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-12T06:59:23Z
      DOI: 10.1177/11782218221111837
      Issue No: Vol. 16 (2022)
       
  • Misuse of Over the Counter and Prescription Only Medication by Adults
           Accessing Specialist Treatment Services in the UK: A Narrative Synthesis

    • Authors: Rosalind Gittins, Louise Missen, Ian Maidment
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Concerns about the misuse of over the counter (OTC) and prescription only medication (POM) are due to their impact upon physical/mental wellbeing, drug interactions and drug-related deaths. Improving an understanding of the pattern of use by people accessing specialist substance misuse services (SMSs) should enable improvements to treatment provision.Aim:To review the literature on the misuse of OTC/POM among adults accessing SMS, including the pattern of use, types of medication and associated characteristics.Methods:This review is reported in line with PRISMA. The protocol has been registered on PROSPERO (CRD42020135216) and separately published. A search of Cochrane, OVID Medline, Pubmed, Scopus and Web of Science databases and grey literature was undertaken. Only English language publications outlining OTC/POM misuse by adults in receipt of psychological/pharmacological interventions for substance misuse were included. Two reviewers conducted the title, abstract and full-text reviews using predetermined selection criteria and a piloted data extraction form to ensure a consistent approach. A third reviewer resolved disagreements and the Mixed Methods Appraisal Tool assessed for bias. Ethical approval was not required.Results:Thirteen studies with notable heterogeneity were included in the narrative synthesis after non-UK-based and ineligible publications were excluded, from the 143 potentially relevant papers. To reduce bias all studies were included in the analysis and GRADE-CERQual was applied. ‘High confidence’ was identified for all review findings, despite moderate methodological limitations. Antihistamine, benzodiazepine and opioid misuse was mentioned most frequently. Usage patterns and supply sources varied. Adverse consequences and polypharmacy are concerning. Withdrawal symptoms perpetuated misuse, often alongside illicit substance use, comorbid psychiatric/pain disorders and street drug shortages.Conclusion:OTC/POM misuse is common amongst adults accessing SMS. A renewed approach to withdrawal management is required. The limited number of studies may impact on generalisability but allowed for a more detailed review. Restricting to UK studies improved relevance due to drug market variations and availability of medicines in different countries. Further UK-based research on OTC/POM misuse in SMS is needed to build upon the current paucity in the published literature.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-07-12T06:57:46Z
      DOI: 10.1177/11782218221111833
      Issue No: Vol. 16 (2022)
       
  • Association of Cardiac Arrest With Opioid Overdose in Transport

    • Authors: Marissa L Ritter, Adam D Bohr, Matthew B McQueen
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Introduction:Drug overdose is the leading cause of injury-related death in the United States. It has been linked to respiratory depression and cardiac toxicity, both of which can lead to cardiac arrest. Despite this potential association, few studies have examined this relationship, particularly in transport to the hospital. The purpose of this research was to determine if there was a relationship between opioid overdose and cardiac arrest in transport.Methods:A sample (n = 1 000 000) was utilized from the National EMS Information System (NEMSIS) from the year 2019. A logistic regression model was used to predict cardiac arrest from dispatch reason with gender, race, and age included as controls.Results:Overdose-related dispatch reason was associated with an increased likelihood of cardiac arrest in transport (Odds Ratio = 1.65, 95% Confidence Interval: [1.22, 2.22]).Conclusions:Opioid overdose is associated with an increased incidence of cardiac arrest in transport in the United States.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-30T11:26:26Z
      DOI: 10.1177/11782218221103582
      Issue No: Vol. 16 (2022)
       
  • Is There an Association Between Salivary Cortisol and Dropping Out of
           Inpatient Substance Addiction Treatments' A Prospective Repeated
           Measures Study

    • Authors: Kari Bøhle, Eli Otterholt, Stål Bjørkly
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Several studies have found an association between salivary cortisol levels and dropping out of inpatient substance addiction treatment programs. The results are mixed due to variations in the study design and the lack of standardized routines for cortisol assessment. The aim of this study was to investigate whether there was (1) an association between salivary cortisol levels and dropping out from inpatient substance addiction treatments; (2) higher predictive validity for dropout in one of the cortisol indexes: Area Under the Curve with respect to ground (AUCG) or Daily Cortisol Slope (DCS); (3) an interaction effect with time for each cortisol index; and (4) different dropout rates for sex and patients in short-term versus long-term treatment programs. This was a prospective, repeated-measures observational study. Patients (n = 173) were recruited from 2 inpatient facilities in the central region of Norway between 2018 and 2021. Salivary cortisol was measured 4 times during the treatment period, with 8 samples collected over 2 consecutive days at each time point. Cortisol levels were calculated using the cortisol indices AUCG and DCS. Dropout was used as the outcome measure at each time point. Associations were calculated using a logistic linear regression. The results suggest a main effect of AUCG, whereby higher levels reduce dropout risk (OR = 0.92, P = .047). An interaction with time in treatment also revealed a higher dropout risk (OR = 1.09, P = .044) during week 4 of the treatment, depending on the AUCG. These results support using AUCG as the recommended index when assessing cortisol, and that the relationship between cortisol levels and length of treatment should be further investigated.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-30T06:40:31Z
      DOI: 10.1177/11782218221106797
      Issue No: Vol. 16 (2022)
       
  • “You’re Not Supposed to be on it Forever”: Medications to Treat
           Opioid Use Disorder (MOUD) Related Stigma Among Drug Treatment Providers
           and People who Use Opioids

    • Authors: Julia Dickson-Gomez, Antoinette Spector, Margaret Weeks, Carol Galletly, Madelyn McDonald, Helena Danielle Green Montaque
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Opioid use disorder (OUD) through prescription opioid misuse, heroin, and illicitly manufactured fentanyl use has increased dramatically in the past 20 years. Medications to treat opioid use disorder (MOUD) is considered the gold standard for treating opioid use disorders but uptake remains low. Recently, Madden has argued that in addition to the stigma assigned to substance use and people with SUD, MOUDs also are stigmatized, a process she labels intervention stigma to distinguish it from condition stigma (ie, stigma of SUD) . In this paper, we examine MOUD related stigma from the perspective of people who use opioids (PWUO) and key informants who play some role in providing or referring people to drug treatment. Providers and PWOU often viewed MOUD as one drug replacing another which discouraged providers from recommending and PWUO from accepting MOUD. MOUD stigma was also expressed by providers’ exaggerated fear of MOUD diversion. The extent to which MOUD was accepted as a legitimate treatment varied and influenced treatment providers’ perceptions of the goals of drug treatment and the length of time that MOUD should be used with many feeling that MOUD should only be used as a temporary tool while PWOU work on other treatment goals. This led to tapering off of MOUD after some time in treatment. Some providers also expressed mistrust of MOUD stemming from their previous experiences with the over-prescription of opioids for pain which led to the current crisis. Results from this study suggest that the proportion of PWUO on MOUD is unlikely to increase without addressing MOUD stigma among drug treatment providers and PWUO seeking treatment.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-27T10:09:04Z
      DOI: 10.1177/11782218221103859
      Issue No: Vol. 16 (2022)
       
  • Factors Associated With Increased Alcohol Consumption During Physical and
           Social Distancing Measures During the COVID-19 Pandemic in a University in
           Brazil

    • Authors: Cremildo João Baptista, Guilherme Oliveira de Arruda, Wilson Rayzel Barroso, Verusca Soares de Souza
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Objective:To report alcohol consumption during the first month of social home-isolation and physical distancing measures during the COVID-19 pandemic in an public University in Mid-West Brazil.Methods:We designed an online observational study. Initial data of 2166 participants was obtained between April and May, 2020, less than a month after University’s measures of social distancing with remote work and classes. We used Poisson regression model with robust variance to identify the significant factors associated with self-reported increase in alcohol consumption during social and physical distancing measures.Results:Increased alcohol consumption during social and physical distancing was reported by 22.9% of 1371 alcohol drinkers. Factors associated with reporting increased alcoholic consumption during University’s physical and social distancing measures were: not professing any religion (1.52, 95% CI 1.25-1.83), having signs/symptom suggesting SARS-COV-2 infection (1.56, 95% CI 1.26-1.93), missing social interaction with peers carried out without any mediating technology (1.57, 95% CI 1.13-2.20), experiencing financial distress/hardship (1.25, 95% CI 1.02-1.54), perceiving duration of social isolation as long (1.62, 95% CI 1.10-2.41), reporting worsening of emotional/mental wellbeing (1.76, 95% CI 1.34-2.33), and previous psychological disorders (1.25, 95% CI 1.03-1.52).Conclusions:This study highlights several individual, psychological, and social determinants of increase in consumption of alcoholic beverages during physical and social distancing measures due to the pandemic and the results may reflect the presence of emotional changes due to the COVID-19 pandemic. It urges that sanitary authorities adopt measures to avoid excessive alcohol consumption during social distancing measures.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-21T12:38:15Z
      DOI: 10.1177/11782218211061140
      Issue No: Vol. 16 (2022)
       
  • Peripartum and Postpartum Analgesia and Pain in Women Prescribed
           Buprenorphine for Opioid Use Disorder Who Deliver by Cesarean Section

    • Authors: Alane B O’Connor, Joel Smith, Liam M O’Brien, Kaitlyn Lamarche, Nadine Byers, Stephanie D Nichols
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Aim:Little is known about whether pain can be effectively managed in pregnant women with opioid use disorder (OUD) during delivery hospitalization, particularly those undergoing surgery and taking buprenorphine as medication for OUD (MOUD). To address this question, we compared pain scores and opioid analgesic utilization during delivery hospitalization in women taking their pre-hospital dose of buprenorphine who delivered by cesarean section to matched controls. To inform future research efforts, we also began to explore opioid analgesic utilization and pain scores by type of anesthesia as this variable is often not included in related literature.Methods:Retrospective matched cohort study of 46 women prescribed buprenorphine during pregnancy who delivered by cesarean section during a 7-year period.Results:When compared to matched controls, women taking their pre-hospital dose of buprenorphine undergoing cesarean section utilized more opioid analgesics as measured by morphine milligram equivalents (MME) (mean MME first 48 hours 153.0 mg vs 175.1 mg, respectively, P 
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-21T10:32:06Z
      DOI: 10.1177/11782218221107936
      Issue No: Vol. 16 (2022)
       
  • Patients’ Perspectives on Coming Off Opioid Agonist Treatment: A
           Qualitative Study

    • Authors: Christina Nehlin, Josefin Bäckström, Charlotte Wollert Brander, Caisa Öster
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Aims:Opioid agonist treatment (OAT) programs are life-saving, as they reduce opioid use, overdoses, and criminal activities. Disadvantages reported with long-term OAT include side effects of the medication, especially on cognitive ability and sexual function, which may discourage potential participants. Many of those who participate in OAT have a desire to come off treatment. The aims of this study were to explore patients’ thoughts about coming off OAT and to investigate their perceptions of what support they would need in order to realize a planned withdrawal from OAT.Methods:A qualitative interview study with semi-structured interviews, using applied thematic analysis. Persons with experiences of participating in OAT were invited from Swedish programs and a private Facebook community.Results:Fifteen persons, with a mean of 9.6 (±6.4) years of treatment experience, were included. The participants underlined the need for a patient-centered focus within the treatment. They wanted to be regarded as capable of deciding if, when, and how a planned ending was to take place. They also called for staff to be supportive in making such decisions. Participants recommended staff to be sensitive to the needs of the specific patient and to have strategies for coming off OAT that could be adjusted for the single person.Conclusions:OAT programs need to be continually updated and adapted to the persons who can benefit from them. Applying a person-centered, holistic perspective would enhance the quality of the treatment by emanating from individual goals. Regulatory guidelines need to take into account research on patient experiences and perspectives on coming off.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-21T10:30:48Z
      DOI: 10.1177/11782218221107021
      Issue No: Vol. 16 (2022)
       
  • Equitable Substance Use Treatment for Migrants and Ethnic Minorities in
           Flanders, Belgium: Service Coordinator and Expert Perspectives

    • Authors: Charlotte De Kock
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Despite mounting evidence of disparities in health service provision for migrants and ethnic minorities (MEM) across EU countries, there has been limited research into how services (meso) and policy (macro) can contribute to reducing these disparities. In Flemish (Belgian) substance use treatment (SUT) policy making, no systematic attention is given to MEM. Nevertheless, preliminary studies have identified some disparities, especially among non-Belgian MEM. For this paper we studied the factors related to these disparities and ways forward based on 21 semi-structured interviews with SUT coordinators and experts. The low representation of MEM populations in psychiatric hospitals due to language exclusion criteria stands out as the main disparity. Moreover, respondents indicated that exclusion may be anticipated by general practitioners in the referral process, causing additional disparities. The exclusion of MEM from policy making processes, waiting lists and the structure of the federalized Belgian health system are identified as indirect macro contributors to disparities. Respondents specified four main ways to reduce disparities in SUT among MEM: targeted treatment and policy making, installing diversity policies in SUT services, enhancing training and education, and community-based treatment.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-20T07:25:27Z
      DOI: 10.1177/11782218221097390
      Issue No: Vol. 16 (2022)
       
  • Associations of Cannabis Use across Adolescence and Early Adulthood With
           Health and Psychosocial Adjustment in Early Adulthood and Midadulthood in
           Men

    • Authors: Deborah M Capaldi, Stacey S Tiberio, David CR Kerr, Lee D Owen
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Associations between men’s prior cannabis use and their physical and psychosocial adjustment were examined using prospective data across adolescence (ages 13-20 years), early adulthood (ages 20-30 years), and midadulthood (ages 30-38 years). The theoretical framework was based in developmental-contextual and lifespan approaches.Method:Models were tested using men in the Oregon Youth Study who had been studied since ages 9 to 10 years and who, in childhood, lived in neighborhoods with higher than average rates of delinquency. Cannabis use in adolescence was used to predict early adult outcomes (and early adult use to midadult outcomes). In addition, a set of covariates was added to the models, including childhood risk factors assessed at age 9 years (ie, family socioeconomic status; externalizing behaviors; and if available, the childhood proxy for the outcome [eg, age 9 intelligence scale]) and alcohol use in adolescence (or early adulthood). physical health outcomes included accidental injuries, problems resulting from a prior injury, body mass index, self-report health, and also pain and cardiovascular risk (blood pressure and pulse rate) in midadulthood. Psychosocial outcomes included income, housing insecurity, intelligence, depressive symptoms, psychosis symptoms, hostility/aggression, social problems, and attention problems.Results:Whereas there was almost no prediction from prior cannabis use to the physical health outcomes, there were comprehensive associations of cannabis use from the prior developmental period and psychosocial outcomes in both early adulthood and midadulthood.Conclusion:Cannabis use in prior developmental periods was associated with a broad range of types of poor psychosocial adjustment in adulthood.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-06-03T11:59:03Z
      DOI: 10.1177/11782218221096154
      Issue No: Vol. 16 (2022)
       
  • Relentless Stigma: A Qualitative Analysis of a Substance Use Recovery
           Needs Assessment

    • Authors: Stephany Medina, Anna Van Deelen, Robyn Tomaszewski, Keri Hager, Nathaniel Chen, Laura Palombi
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Substance use disorders (SUD) pose emotional, mental, and physical threats to persons worldwide. There is a paucity of research focused on capturing individual perspectives on supports and barriers to recovery from a SUD. This need has been identified in areas of Minnesota where a gap in evidence-based substance use support exists. A team of interdisciplinary professionals distributed a qualitative survey assessing supports and barriers to SUD recovery within recovery circles in order to inform the efforts of local organizations. This paper and online access survey was adapted from an existing survey created by Faces and Voices of Recovery. The online survey was accessed by a link and distributed to persons in recovery across Minnesota over 7 months. Data from this survey were analyzed through a consensual qualitative research (CQR) coding method. Notable themes emerged in the following domains: healthcare, environment, individual, and community. Community-wide stigma was an overarching concern, and the study yielded unique insights into stigma within healthcare and the community at-large. Barriers and support to recovery were reported. Barriers included experiencing high levels of stigma and identifying a need for community education on SUDs and recovery. Support included local recovery groups, peer recovery support, and access to healthcare and medication. Our findings illuminate the needs of the recovery community from the perspective of individuals with lived experience and will inform local organizations in specifying resources to help meet the identified needs. This survey may also be adapted and used around the world to inform substance use prevention, treatment, and recovery programing.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-31T06:20:56Z
      DOI: 10.1177/11782218221097396
      Issue No: Vol. 16 (2022)
       
  • Hepatitis C Virus Prevalence, Medical Status Awareness and Treatment
           Engagement among Homeless People Who use Drugs: Results of a Street
           Outreach Study

    • Authors: Rinat Lasmanovich, Or Shaked, Ayelet Sivan, Idan Barak, Mor Nahari, Orna Mor, Helena Katchman
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Hepatitis C virus (HCV) infection is a primary health concern among people who use drugs (PWUDs). Homeless PWUDs that constitute a key population for HCV transmission remain underrepresented in many surveys.Objectives:We performed a proactive street outreach to evaluate HCV infection prevalence among homeless PWUDs in Tel Aviv, identify risk factors associated with HCV infection, awareness of disease status and linkage to care rate.Results:Thirty-eight percent of approached PWUD were willing to participate in the study. Out of 53 subjects who got tested for anti HCV by rapid test, 29 (54.72%) had a positive result, 20 of 29 anti-HCV positive (69%) patients had positive HCV PCR. Risk factors were investigated using structured questionnaires. Heroin use was reported significantly more frequently in the HCV-positive group (P = .05, CI 95%), whereas other established risk factors did not reach significance in our cohort. While 21 of 29 (72%) HCV-positive participants were aware of their condition, only 4 of 21 (19%) received treatment in the past, and 2 of 4 (50%) failed to achieve treatment goals, as assessed by HCV PCR.Conclusions:Our data indicate a high prevalence of HCV infection among homeless PWUDs. Importantly, despite relatively high awareness of HCV status in this population, we found strikingly low access to care. These findings motivate novel interventional approaches targeted at improving patient access, and compliance among homeless PWUDs, in an effort to reduce HCV transmission.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-27T05:23:08Z
      DOI: 10.1177/11782218221095871
      Issue No: Vol. 16 (2022)
       
  • Poor Sleep Quality and Other Risk Factors for Unemployment Among Patients
           on Opioid Agonist Treatment

    • Authors: Margo Huffman, Marianne Cloeren, Orrin D Ware, Jodi J Frey, Aaron D Greenblatt, Amanda Mosby, Marc Oliver, Rachel Imboden, Alicia Bazell, Jean Clement, Montserrat Diaz-Abad
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Purpose:Patients with opioid use disorder (OUD) face high rates of unemployment, putting them at higher risk of treatment nonadherence and poor outcomes, including overdose death. The objective of this study was to investigate sleep quality and its association with other biopsychosocial risk factors for unemployment in patients receiving opioid agonist treatment (OAT) for OUD.Methods:Using a cross-sectional survey design, participants from 3 OAT programs for OUD completed questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]); pain disability; catastrophic thinking; injustice experience; quality of life; and self-assessed disability. Spearman’s rank correlation was used to test for associations between sleep quality and other study variables.Results:Thirty-eight participants completed the study, with mean age 45.6 ± 10.9 years, 27 (71.1%) males, and 16 (42.1%) reporting a high school diploma/equivalent certification as the highest level of academic attainment. Poor sleep quality (defined as PSQI > 5) was identified in 29 participants (76.3%) and was positively correlated with pain disability (r = 0.657, P 
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-21T12:39:42Z
      DOI: 10.1177/11782218221098418
      Issue No: Vol. 16 (2022)
       
  • Changes in Work Status, Couple Adjustment, and Recovery Capital: Secondary
           Analysis of Data From a Congruence Couple Therapy Randomized Controlled
           Trial

    • Authors: Bonnie K Lee, Samuel M Ofori Dei
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Purpose:Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants (N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU).Method:Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU (n = 17) and CCT (n = 21) were analyzed.Results:Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran’s Q = 5.429, P = .066) or TAU (Cochran’s Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group.Conclusion:Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-21T12:37:47Z
      DOI: 10.1177/11782218221088875
      Issue No: Vol. 16 (2022)
       
  • Prevalence and Associated Factors of Substance Use Male Population in East
           African Countries: A Multilevel Analysis of Recent Demographic and Health
           Surveys From 2015 to 2019

    • Authors: Kenaw Derebe Fentaw, Setegn Muche Fenta, Hailegebrael Birhan Biresaw
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:East Africa is still home to one of the world’s highest rates of substance user. Substance use is primarily associated with male behavior and is becoming one of the region’s most public health issues.Methods:The study included data from 11 East African countries’ Demographic and Health Surveys. About 55 307 men were enrolled in the study and multilevel logistic regression model was appliedResult:East African countries had a 43.70% prevalence of substance abuse coverage. Education level, age, current working status, marital status, wealth index, media exposure, residence, and nation were all found to be statistically associated with substance use of males.Conclusion:In East African countries, the prevalence of substance abuse among men was high. As a result, substance control programs should focus on the poor, not (least) educated, rural people, and adult age groups, who are the region’s most vulnerable social groups.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-20T11:12:49Z
      DOI: 10.1177/11782218221101011
      Issue No: Vol. 16 (2022)
       
  • The Pattern of Substance Use and Characteristics of the Individuals
           Enrolled in Residential Treatment at Selected Rehabilitation Centers in
           Sri Lanka: A Descriptive Cross-Sectional Study

    • Authors: Akila R Jayamaha, Nishadi D Dharmarathna, Nimesha DM Herath, Nadeeka DK Ranadeva, Medhavi M Fernando, Kerstin L Samarasinghe, Priyangi N Amarabandu, Badhrani Senanayake, Thamara Darshana, Nilani Renuka, Iyanthimala H Rajapakse, Chinthika P Gunasekara, Lalitha Meegoda, Neluka Fernando
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Introduction:Substance use becomes censorious when it leads to harmful effects on individuals, their families, and the community. The nature of substance use in Sri Lankan context is poorly understood and empirical evidences are sparse. The study aimed to describe patterns of substance use and characteristics of the individuals enrolled in residential treatment at selected rehabilitation centers in Sri Lanka.Material and methods:A descriptive cross-sectional study was conducted among 205 individuals enrolled in selected rehabilitation centers. Pretested interviewer-administered questionnaire was used to collect data. Data were analyzed using descriptive statistics.Results:Most of the individuals who enrolled in residential treatment at selected rehabilitation centers were unmarried (n = 124, 60.5%), Sinhala (n = 186, 90.7%), Buddhist (n = 166, 81.0%), males (n = 202, 98.5%) and belonged to the young adult age (18-35 years) category (n = 178, 86.8%). All the participants were poly-drug users and cannabis was the most commonly used (n = 183, 89.3%) illicit drug followed by heroin (n = 172, 83.9%), methamphetamine (n = 150, 73.2%) and cocaine (n = 78, 38%). The most (n = 152, 74.1%) problematic substance for life was heroin. Most of the participants (n = 149, 72.7%) had used drugs several times per day. The mean duration of substance use was 7 ± 5 years. Participants (n = 177, 86.3%) reported that the substances were available in their residential areas and their friends (n = 197, 96.1%) were also using the substances.Conclusions:Pattern of substance use and characteristics of the individuals were unique in Sri Lanka and need to be considered when implementing and strengthening the programs for drug prevention and rehabilitation.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-20T11:09:46Z
      DOI: 10.1177/11782218221100823
      Issue No: Vol. 16 (2022)
       
  • Health Effects Associated With Kratom (Mitragyna speciosa) and
           Polysubstance Use: A Narrative Review

    • Authors: Catherine W Striley, Carolin C Hoeflich, Andrew T Viegas, Lindsey A Berkowitz, Emily G Matthews, Leyla P Akin, Chidinma Iheanyi-Okeahialam, Urmeen Mansoor, Christopher R McCurdy
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Kratom (Mitragyna speciosa) consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices.Methods:The objective of this narrative review was to elucidate selected health effects associated with using kratom—either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described.Results:Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate’s risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions.Conclusions:Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-20T11:07:27Z
      DOI: 10.1177/11782218221095873
      Issue No: Vol. 16 (2022)
       
  • Understanding the Effect of the COVID-19 Pandemic on Substance Use
           Disorder Treatment Facility Operations and Patient Success: Evidence From
           Mississippi

    • Authors: Devon Meadowcroft, Will Davis
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:The COVID-19 pandemic has led to disruptions in the provision of care at substance use disorder (SUD) treatment facilities. Stresses associated with the pandemic could also negatively impact treatment outcomes for clients. The aim of this study is to evaluate how SUD treatment facilities in Mississippi changed their operations following the start of the pandemic. The change in client success rates at the facilities is also assessed.Methods:An online survey was completed by 12 SUD treatment facilities in Mississippi between February and May 2021.Results:Generally, the facilities’ capacity to provide treatment to clientele was moderately affected by the pandemic. Facilities in the sample also adapted a variety of policies to limit the spread of COVID-19. Changes in the services provided by facilities was observed in the survey responses. For client success rates reported by the facilities, there was a decrease in the number of facilities stating that more than 80% of their clients completed treatment across the pre- and post-pandemic periods. However, the number of facilities with more than 80% of their clients successfully finishing treatment has increased in recent months.Conclusions:To continue serving their clientele during the pandemic, facilities enacted COVID-19-related policies and began offering new services such as telehealth. Although client success rates decreased at the beginning of the pandemic, they have returned to pre-pandemic levels in recent months. Our results indicate that SUD treatment facilities and clients have improved in terms of giving and receiving care as the pandemic has progressed.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-05-13T07:26:50Z
      DOI: 10.1177/11782218221095872
      Issue No: Vol. 16 (2022)
       
  • COVID 19 and the Opioid Epidemic: An Analysis of Clinical Outcomes During
           COVID 19

    • Authors: Chiemeka Ezie, Ryan Badolato, Mary Rockas, Rayek Nafiz, Brian Sands, Adam Wolkin, Pantea Farahmand
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background and Objectives:Here we aimed to characterize clinical outcomes in those receiving treatment at a Veterans Health Administration (VHA) methadone maintenance treatment program (MMT) during the COVID 19 pandemic in which SAMSHA regulations for MMTs were changed to provide a greater number of methadone allotments and decreased clinic-visit frequency.Methods:We report results of a single-site, pre-post cohort study of urine drug screen data 3 months before and after an increase in allotments of take-home medication from the methadone clinic. One hundred twenty-nine patients met inclusion criteria for this study. The study was reviewed by the NYHHS IRB committee and granted final approval by the Research and Development Committee.Results:The sample was predominately male, average age 66years and average years in most recent treatment is 4.1 years. No statistical significance was found between period 1 and period 2 in the positive test detection for nonprescribed opiates, methadone and illicit substances (P > .05), number of new medical illnesses or overdoses. We controlled for participant age, substance use disorder diagnosis, psychiatric disorder diagnosis, and number of years in treatment.Discussion/Conclusions:The results of the study illustrate the relative safety of the changes made at this particular MMT during the pandemic. Additionally, there was continued adherence to methadone treatment with minimal change in illicit substance use during period 1 and period 2.Scientific Significance:To these authors’ knowledge this paper is one of the first to examine clinical outcomes in those with opioid addiction prescribed methadone from MMTs during the COVID 19 pandemic.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-04-23T06:14:38Z
      DOI: 10.1177/11782218221085590
      Issue No: Vol. 16 (2022)
       
  • Patients With Autism Spectrum Disorder and Co-occurring Substance Use
           Disorder: A Clinical Intervention Study

    • Authors: Sharon JN Walhout, Johan van Zanten, Laura DeFuentes-Merillas, Christina KME Sonneborn, Marc Bosma
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:The prevalence of substance use disorders (SUD) in individuals with autism spectrum disorders (ASD) appears to be higher than previously described. Attention has been drawn to developing new treatment approaches for this patient population, as they appear to do less well with traditional addiction treatment. There is very little research addressing treatment outcome. This study aims to introduce and evaluate a manualized group treatment intervention developed specifically for patients with ASD and co-occurring SUD.Methods:We developed a group treatment based on cognitive behavioural therapy (CBT) and evaluated outcome measures at the end of treatment and 3-month follow-up. Fifty-seven patients with ASD and co-occurring SUD were included of which 30 completed the group intervention, 27 of them also participated at 3-month follow-up.Results:The findings suggest that group treatment can work for patients with ASD and co-occurring SUD. Lower levels of alcohol use (t = 3.61, P = .002, d = 0.75), craving (t = 2.65, P = .013, d = 0.51), passive coping styles (t = 2.32, P = .030, d = 0.48), depression (t = 3.48, P = .002, d = 0.67), anxiety (t = 3.02, P = .006, d = 0.58), and stress (t = 2.62, P = .015, d = 0.51) symptoms were reported after completing the group intervention, with even stronger effects at 3 months follow-up.Conclusions:The present study shows promising results of a tailor-made group intervention in a heterogeneous patient population with ASD and co-occurring SUD with positive effects on both symptoms of ASD and SUD.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-04-18T06:49:07Z
      DOI: 10.1177/11782218221085599
      Issue No: Vol. 16 (2022)
       
  • Second-Hand Smoking Prevalence in Vietnamese Population Aged 15 and older:
           A Systematic Review and Meta-Analysis

    • Authors: Tran Quang Duc, Le Thi Kim Anh, Vu Thi Quynh Chi, Nguyen Thi Thanh Huong, Phan Ngoc Quang
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Second-hand smoking (SHS) is associated with many health problems. However, its prevalence in the community population aged 15 years and older in Vietnam is unknown.Objectives:To quantify the prevalence of SHS in Vietnamese communities aged 15 and above.Methods:This is a meta-analysis that reviewed studies of the prevalence of SHS in Vietnam published in MEDLINE, Scopus, Pubmed and the WHO library database between 1 January 2010 and 31 December 2019. MedCalc was used to perform all the analyses, and publication bias was determined using funnel plots and Egger regression asymmetry tests. Q-test and I2 statistic were used to identify heterogeneity across studies.Results:There were 7 articles that met our inclusion criteria 2 surveys at the national level, 3 Cross-sectional studies and 2 Case-control studies) involving 184 921 participants. According to the meta-analysis, the overall random-effects pooled prevalence of SHS was 54.6% (95% CIs: 44.900-64.154) with a high level of heterogeneity (P = .0001, Q = 2245.60, I2 = 99.73%). It is noteworthy that the pooled prevalence of SHS rose throughout the course of the survey years. Our research found no evidence of publication bias.Conclusions:Vietnam has ratified the implementation the WHO Framework Convention on Tobacco Control (FCTC) in 2004, there are still a large number of people who are adversely impacted by SHS. Given the tremendous cost that SHS imposes on health systems, our results underscore the critical need for the Vietnamese government to expedite an implementation of a set of stronger tobacco control practices, thus reducing the incidence of smoking-related illnesses and fatalities.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-03-31T06:02:17Z
      DOI: 10.1177/11782218221086653
      Issue No: Vol. 16 (2022)
       
  • Substance Use in Healthcare Professionals During the COVID-19 Pandemic in
           Latin America: A Systematic Review and a Call for Reports

    • Authors: Jeel Moya-Salazar, Elizabeth Nuñez, Alexis Jaime-Quispe, Nahomi Zuñiga, Isabel L Loaiza-Barboza, Edison A Balabarca, Karina Chicoma-Flores, Betsy Cañari, Hans Contreras-Pulache
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:The COVID-19 pandemic has generated a remarkable change in the behaviour of Healthcare workers (HCWs) around the world. However, there is a lack of evidence on substance use among HCWs in Latin America. Therefore, this study aimed to determine the current frequency of substance use among Latin American among HCWs.Methods:We searched 8 databases (PubMed, Scopus, ScientDirect, Web of Science, Cochrane, Scielo, LILACS and Latindex), 4 public prepublication servers (SocArXiv, medRxiv, bioRxiv and Preprints) and Google scholar from 1/9/2019 to 11/1/2021. We determined the frequency of each study based on original studies, scientific letters, and clinical trials in English, Spanish and Portuguese.Results:A total of 17 175 study articles were identified from electronic databases and preprints, and 2 cross-sectional studies conducted in 2020 were included in the qualitative analysis. Both studies included HCWs but did not perform a differential analysis. The first was developed by the Pan-American Health Organization and included interviewees from 35 countries, while the second was conducted with 1145 Brazilian participants. Both studies showed increases in substance use during the pandemic, with alcohol being the most commonly used substance (30%), but PAHO’s study reported a 13.8% increase in self-reported heavy-episodic drinking, with differences among genders (males, 15.4%), age groups (highest increase in the 40-49 age group, 16.5%) and area of residence (urban with 14%). The second study showed that 21 32% of participants reported initiating psychoactive substance use, 29.3% added some substance to their initial use and 4% of them had to replace the substance, mainly due to difficulty of access. Other substances of abuse that showed significant increases were tobacco (0.5%) and marijuana (0.3%).Conclusion:Overall, despite the analysis of the 2 studies, the results provided are not a conclusive description of the frequency of substance use by HCWs in Latin America during the COVID-19 pandemic. Further research is required to understand the impact of the pandemic on drug abuse in the region.Protocol Registration:The protocol has been registered on 30 November 2021 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CRD420212919700.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-03-29T09:57:38Z
      DOI: 10.1177/11782218221085592
      Issue No: Vol. 16 (2022)
       
  • A Mixed-Methods Evaluation of the Feasibility of a Medical
           Management-Based Text Messaging Intervention Combined With Buprenorphine
           in Primary Care

    • Authors: Babak Tofighi, Meghan Durr, Christina Marini, Crystal F Lewis, Joshua D Lee
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Mobile health (mHealth) tools offer an effective and personalized approach to enhance chronic disease management and may partially offset provider-level barriers to increasing buprenorphine prescribing in primary care. This study assessed the feasibility of integrating a text messaging-based medical management tool (TeMeS) in primary care among patients initiating buprenorphine.Methods:TeMeS messages are categorized per the medical management model, programed in a HIPAA-compliant texting software (Apptoto©), and delivered in a tiered fashion over 8-weeks to patients. This mixed-methods evaluation of TeMeS utilized key stakeholder feedback (patients, physicians, administrators, nursing), text messaging software process measures, thematic analysis of patient participant text message content, and electronic administrative data (eg, appointment adherence, treatment retention) at 2-months.Results:The study team approached 65 patients and n = 14 (21%) were ineligible or declined to participate in the study. Most eligible participants owned a smartphone (90%), responded to at least one text query (88%) over an average of 24 days, and few requested to stop receiving texts (6%). Participant text replies included responses to cognitive behavioral therapy-based queries (13.8%), confirming or rescheduling appointments (6.1%), and insurance, pharmacy, or clinical issues pertaining to buprenorphine dispensation or dosing (2%). Suggestions for design modifications included personalizing message content and adjusting message frequency per patient risk of illicit opioid reuse, use of video-based informational content, and real-time provider and staff support for emergent issues.Conclusion:Our findings highlight the acceptability, feasibility, and high rates of engagement of utilizing text messaging to enhance self-management among patients initiating buprenorphine treatment.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-03-26T04:38:05Z
      DOI: 10.1177/11782218221078253
      Issue No: Vol. 16 (2022)
       
  • Employment Stress and Couple Adjustment among Clients With Disorders of
           Gambling and Alcohol Use: Themes of Transfers in Congruence Couple Therapy
           

    • Authors: Bonnie K Lee, Noor-Khanu Merali
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background:Individuals with problematic gambling, alcohol and substance use commonly report lower employment rates and more employment-related problems such as job loss, work conflicts and poor performance.Method:A thematic qualitative analysis was conducted to extract employment-related themes from 21 sets of addiction counselors’ case notes of couple therapy sessions (average 10 sessions per case) from a randomized controlled trial of Congruence Couple Therapy (CCT). Case notes were examined for the types of employment issues to answer the research question: What are the interconnections of employment, couple adjustment and addictive behaviors as revealed in the CCT counselors’ case notes'Results:Five key areas of employment-related stress were identified: (1) unemployment, (2) financial concerns, (3) history of crime, (4) overworking and workaholism, and (5) workplace conflict. These themes interacted negatively with couple adjustment and addictive behaviors. Using CCT as an intervention, clients gained skills in 4 areas transferred to employment: (1) awareness of self, other and family of origin, (2) congruent communication, (3) work-family balance, and (4) enlisting spousal support. These themes intersected with enhanced work functioning and reduced stress, alcohol use and gambling.Conclusion:Employment problems negatively impacted addictive behaviors, couple adjustment and well-being of partners and clients. Skills and awareness gained in CCT promoted changes in addicted clients’ employment functioning and coping with employment stress. The domains of work and couple adjustment are mutually influential in increasing or reducing stress with implications for addiction recovery. CCT as a viable intervention for enhancing employment function should be further studied.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-03-22T10:30:07Z
      DOI: 10.1177/11782218221080773
      Issue No: Vol. 16 (2022)
       
  • Prevalence of Internet Addiction and its Correlates Among Regular
           Undergraduate Medicine and Health Science Students at Ambo University.
           Cross-Sectional Study

    • Authors: Gurmu Tesfaye Umeta, Sanyi Daba Regasa, Getu Melesie Taye, Hunduma Dinsa Ayeno, Gosaye Mekonen Tefera
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Introduction:Internet addiction (IA) is causing academic failure, decreased concentration ability, and a negative affective state. In Ethiopia, studies conducted on IA were limited; therefore, this study aimed to assess its prevalence and risk factors among medicine and health science (MHS) students of Ambo University.Materials and Methods:This study was a cross-sectional study and included MHS students of Ambo University from July 15 to August 15, 2021. Data were collected using a self-administered questionnaire after receiving informed consent from study participants. The results were analyzed using the statistical software for social sciences version 24. Bivariate and multivariate logistic regressions were performed to explore the relationship between IA and dependent variables.Results:Of the 253 participants who participated in the study, 201 (79%) were found to have an IA. Having one’s own computer, Internet access at home and an email account were 2 times more risky to develop IA compared to their counterparts with AOR = 2.615 (95% CI = 1.118-5.956) with a P value of .022, AOR = 2.154 (95% CI = 1.054-4.405) with a P value of .35 and (=2.154 (95% CI = 1.054-4.405 with a P value of .035 respectively. Additionally, those who use the Internet for news were 2.5 times more likely to develop IA compared to those who do not (AOR = 2.551 (95% CI = 1.225-5.349) with a P-value of .013). The use of the Internet for scientific research and education reduces IA by 0.7 times (AOR = 0.323 (95% CI = 0.120-0.868) with a P value of .025).Conclusions:The prevalence of IA was found to be high in this study. Therefore, strategies are needed to minimize the prevalence of this problem.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-02-28T09:55:11Z
      DOI: 10.1177/11782218221080772
      Issue No: Vol. 16 (2022)
       
  • Results of a Hepatitis C Micro-Elimination Program in Two Addiction
           Centers Among Subjects With Substance Use Disorder

    • Authors: Pablo Vega-Astudillo, Ignacio Basurte-Villamor, Inés De Ema López, Ruth Olmos Espinos, Beatriz Mesías-Pérez, Nestor Szerman
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Objectives:We aimed to evaluate a hepatitis C (HCV) micro-elimination program in 2 addiction centers among subjects with substance use disorders (SUD).Methods:The program was based on simplifying the diagnosis of HCV infections by avoiding referral to primary care for the diagnosis and performing the necessary tests at the point of care (ie, the addition center) and simplifying the patient pathway by directly referring patients to the specialized care for treatment. Descriptive and multivariate analyses are presented.Results:Of the 1497 subjects included in the program, 327 reported that they were anti-HCV-positive. Among the 1170 patients who were offered the HCV rapid antibody test, 180 (15.4%) did not perform the test. Performing the HCV rapid antibody test only contributed ten patients (3%) to the 337 who were anti-HCV-positive. A high proportion (147 out of 327 [45%]) of subjects who reported being anti-HCV-positive also reported that they had not been treated for HCV. Among the 67 subjects who were HCV-RNA-positive and were referred for treatment, 53 (79%) ultimately received and completed antiviral treatment. Unfortunately, we did not find any factors associated with not performing dry blood testing, and the factors associated with not performing the HCV rapid antibody test were difficult to interpret, and the model showed low goodness of fit.Conclusions:Our results suggest that a micro-elimination program focused on patients with SUD attending an addiction center is not effective for screening the presence of hepatitis C but is successful for linking patients with hepatitis C to antiviral treatment.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-02-08T11:51:40Z
      DOI: 10.1177/11782218221075058
      Issue No: Vol. 16 (2022)
       
  • Effects of a New York Medicaid Care Management Program on Substance Use
           Disorder Treatment Services and Medicaid Spending: Implications for
           Defining the Target Population

    • Authors: Charles J Neighbors, Rajeev Yerneni, Yi Sun, Sugy Choi, Constance Burke, Megan A O’Grady, Rebecca McDonald, Jon Morgenstern
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Aims:We examined the effects of a statewide New York (NY) care management (CM) program for substance use disorder (SUD), Managed Addiction Treatment Services (MATS), on SUD treatment services’ utilization and spending among patients with a recent history of high Medicaid spending and among those for whom a predictive algorithm indicates a higher probability of outlier spending in the following year.Methods:We applied difference-in-difference analyses with propensity score matching using NY Medicaid claims data and a state registry of SUD-treatment episodes from 2006 to 2009. A total of 1263 CM enrollees with high SUD treatment spending (>$10K) in the prior year and a matched comparison group were included in the analysis. Crisis care utilization for SUD (detoxification and hospitalizations), outpatient SUD treatment, and Medicaid spending were examined over 12 months among both groups. CM effects among predicted high-future-spending patients (HFS) were also analyzed.Results:CM increased outpatient SUD treatment visits by approximately 10.5 days (95% CI = 0.9, 20.0). CM crisis care and spending outcomes were not statistically different from comparison since both conditions had comparable pre-post declines. Conversely, CM significantly reduced SUD treatment spending by approximately $955 (95% CI = −1518, −391) and reduced days of detox utilization by about 1.0 days (95% CI = −1.9, −0.1) among HFS.Conclusion:Findings suggest that CM can reduce SUD treatment spending and utilization when targeted at patients with a greater likelihood of high future spending, indicating the potential value of predictive models to select CM patients.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-01-31T06:10:36Z
      DOI: 10.1177/11782218221075041
      Issue No: Vol. 16 (2022)
       
  • Examining the Attitudes of Non-Psychiatric Practicing Healthcare Workers
           Towards Patients With Alcohol Problems in General Hospital Setting

    • Authors: Ho Teck Tan, Yit Shiang Lui, Lai Huat Peh, Rasaiah Munidasa Winslow, Song Guo
      Abstract: Substance Abuse: Research and Treatment, Volume 16, Issue , January-December 2022.
      Background and objectives:Problematic alcohol-use affect the physical and mental well-being of hospitalised individuals and may receive screening and brief-intervention during treatment. Non-psychiatric doctors and nurses might respond inadequately due to negative attitudes and beliefs. This study aimed to examine these attitudes of non-psychiatric workers in the medical and surgical wards.Methods:A total of 457 doctors and 1643 nurses were recruited from the medical, surgical and orthopaedic disciplines over a period of 4 months. Three questionnaires were administered: demographics, Alcohol & Alcohol-Problems Perceptions Questionnaire (AAPPQ) and Staff Perception of Alcohol Treatment Resources.Results:About 128 doctors and 785 nurses responded. Around 75.5% doctors and 51.9% nurses endorsed role-legitimacy in the AAPPQ. Both the doctor (86.7%) and nurse (77.6%) groups agreed on the importance to initiate intervention for patients with problematic alcohol-use in daily work. Both groups were sceptical and negative towards these patients endorsing low-level role-adequacy (41.2%), role-support (36.9%), motivation (36.5%), task-specific self-esteem (25.1) as well as work satisfaction (20.5%).Conclusion/discussion:Doctors and nurses demonstrated low levels of therapeutic commitments towards patients with problematic alcohol-use thereby necessitating the introduction of in-house programmes to educate, empower and emphasise the importance of therapeutic contact with patients for alcohol intervention.Scientific significance:The prompt identification and treatment of patients with alcohol problems are contingent on the workers’ attitudes towards them. This study’s results should spark a nation-wide interest to improve the training and recognition of such patients and providing adequate educational resources.
      Citation: Substance Abuse: Research and Treatment
      PubDate: 2022-01-08T12:53:18Z
      DOI: 10.1177/11782218211065755
      Issue No: Vol. 16 (2022)
       
 
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