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Substance Abuse

Noah Berland, Daniel Lugassy, Aaron Fox, Keith Goldfeld, So-Young Oh, Babak Tofighi, Kathleen Hanley
PURPOSE: In response to the opioid epidemic and efforts to expand substance use education in medical school, the authors introduced opioid overdose prevention training (OOPT) with naloxone for all first-year medical students (MS1s) as an adjunct to required basic life support training (BLST). The authors previously demonstrated improved knowledge and preparedness following in-person OOPT with BLST; however, it remains unclear whether online-administered OOPT would produce comparable results...
February 15, 2019: Substance Abuse
Bonnie K Lind, Dennis McCarty, Yifan Gu, Robin Baker, K John McConnell
BACKGROUND: It is important to understand patterns and predictors of initiation and engagement in treatment for Medicaid-covered individuals with substance use disorders because Medicaid is a major source of payment for addiction treatment in the United States. Our analysis examined similarities and differences in predictors between adults and adolescents. METHODS: An analysis of Oregon Medicaid claims data for the time period January 2010 through June 2015 assessed rates of substance use and of treatment initiation and engagement using the Healthcare Effectiveness Data and Information Set (HEDIS) definitions...
February 13, 2019: Substance Abuse
Joshua D Cockroft, Susie M Adams, Kemberlee Bonnet, Deondria Matlock, Jessica McMillan, David Schlundt
BACKGROUND: Trust in health care has been shown to influence health care utilization, perceptions of fair treatment, and health outcomes in the general population. The literature on trust in health care in individuals with a history of substance use disorder (SUD) is more limited, primarily examining the patient-provider relationship. Women seeking substance abuse treatment in community-based programs have higher rates of prior trauma and health disparities compared with male counterparts and the general population...
February 13, 2019: Substance Abuse
Michael P Girouard, Hilary Goldhammer, Alex S Keuroghlian
Although little is known about the specific burden of the opioid epidemic on lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, there is evidence to suggest that opioid use disorders are disproportionately prevalent in the LGBTQ community. In this commentary, we present an overview of the current state of evidence on opioid use and misuse among LGBTQ-identified people in the United States and suggest ways to adapt behavioral health interventions to the specific needs of this population. Programs that integrate behavioral health with primary care, address minority stress, and use a trauma-informed approach have the most potential to produce effective, long-term benefits for LGBTQ-identified people with opioid use disorders...
February 13, 2019: Substance Abuse
Julia M Shi, Susan P Henry, Stephanie L Dwy, Skye A Orazietti, Kathleen M Carroll
BACKGROUND: Despite the clear success of office-based buprenorphine treatment in increasing availability of effective treatment for opioid use disorder, constraints on its effectiveness include high attrition and limited high-quality behavioral care in many areas. Web-based interventions may be a novel strategy for providing evidence-based behavioral care to individuals receiving office-based buprenorphine maintenance. This report describes modification and initial pilot testing of Web-based training in cognitive-behavioral therapy (CBT4CBT) specifically for use with individuals in office-based buprenorphine...
February 4, 2019: Substance Abuse
Andrea H Kline-Simon, Scott P Stumbo, Cynthia I Campbell, Ingrid A Binswanger, Constance Weisner, Irina V Haller, Rulin C Hechter, Brian K Ahmedani, Gwen T Lapham, Amy M Loree, Stacy A Sterling, Bobbi Jo H Yarborough
BACKGROUND: Treatment initiation and engagement rates for alcohol and other drug (AOD) use disorders differ depending on where the AOD use disorder was identified. Emergency department (ED) and primary care (PC) are 2 common settings where patients are identified; however, it is unknown whether characteristics of patients who initiate and engage in treatment differ between these settings. METHODS: Patients identified with an AOD disorder in ED or PC settings were drawn from a larger study that examined Healthcare Effectiveness Data and Information Set (HEDIS) AOD treatment initiation and engagement measures across 7 health systems using electronic health record data (n = 54,321)...
January 31, 2019: Substance Abuse
Lauren Gorfinkel, Jan Klimas, Breanne Reel, Huiru Dong, Keith Ahamad, Christopher Fairgrieve, Mark McLean, Annabel Mead, Seonaid Nolan, Will Small, Walter Cullen, Evan Wood, Nadia Fairbairn
BACKGROUND: Hospital-based clinical addiction medicine training can improve knowledge of clinical care for substance-using populations. However, application of structured, self-assessment tools to evaluate differences in knowledge gained by learners who participate in such training has not yet been addressed. METHODS: Participants (n = 142) of an elective with the hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada, responded to an online self-evaluation survey before and immediately after the structured elective...
January 28, 2019: Substance Abuse
Amy M Loree, Hsueh-Han Yeh, Derek D Satre, Andrea H Kline-Simon, Bobbi Jo H Yarborough, Irina V Haller, Cynthia I Campbell, Gwen T Lapham, Rulin C Hechter, Ingrid A Binswanger, Constance Weisner, Brian K Ahmedani
BACKGROUND: Psychiatric comorbidity is common among patients with alcohol and other drug (AOD) use disorders. To better understand how psychiatric comorbidity influences AOD treatment access in health care systems, the present study examined treatment initiation and engagement among a large, diverse sample of patients with comorbid psychiatric and AOD use disorders. METHODS: This study utilized data from a multisite observational study examining Healthcare Effectiveness Data and Information Set (HEDIS) measures of initiation and engagement in treatment (IET) among patients with AOD use disorders from 7 health care systems...
January 25, 2019: Substance Abuse
Cynthia I Campbell, Constance Weisner, Ingrid A Binswanger, Gwen T Lapham, Brian K Ahmedani, Bobbi Jo H Yarborough, Irina V Haller, Andrea Altschuler, Rulin C Hechter, Amy M Loree, Andrea H Kline-Simon
BACKGROUND: The prevalence of opioid use disorder (OUD) has increased rapidly in the United States and improving treatment access is critical. Among patients with OUD, we examined factors associated with the Healthcare Effectiveness Data and Information Set (HEDIS) performance measures of alcohol and other drug (AOD) treatment initiation and engagement. METHODS: Electronic health record and claims data between October 1, 2014, and August 15, 2015, from 7 health systems were used to identify patients (n = 11,490) with a new index OUD diagnosis (no AOD diagnosis prior <60 days) based on International Classification of Diseases (ICD)-9 codes...
January 24, 2019: Substance Abuse
Constance Weisner, Cynthia I Campbell, Andrea Altschuler, Bobbi Jo H Yarborough, Gwen T Lapham, Ingrid A Binswanger, Rulin C Hechter, Brian K Ahmedani, Irina V Haller, Stacy A Sterling, Dennis McCarty, Derek D Satre, Andrea H Kline-Simon
BACKGROUND: Only 10% of patients with alcohol and other drug (AOD) disorders receive treatment. The AOD Initiation and Engagement in Treatment (AOD-IET) measure was added to the national Healthcare Effectiveness Data and Information Set (HEDIS) to improve access to care. This study identifies factors related to improving AOD-IET rates. METHODS: We include data from 7 health systems with differing geographic, patient demographic, and organizational characteristics; all used a common Virtual Data Warehouse containing electronic health records and insurance claims data...
January 24, 2019: Substance Abuse
Ingrid A Binswanger, Nikki M Carroll, Brian K Ahmedani, Cynthia I Campbell, Irina V Haller, Rulin C Hechter, Jennifer McNeely, Bobbi Jo H Yarborough, Andrea H Kline-Simon, Derek D Satre, Constance Weisner, Gwen T Lapham
BACKGROUND: Medical comorbidity may influence treatment initiation and engagement for alcohol and other drug (AOD) use disorders. We examined the association between medical comorbidity and Healthcare Effectiveness Data and Information Set (HEDIS) treatment initiation and engagement measures. METHODS: We used electronic health record and insurance claims data from 7 US health care systems to identify patients with AOD use disorders between October 1, 2014, and August 15, 2015 (N = 86,565)...
January 24, 2019: Substance Abuse
Gwen Lapham, Cynthia I Campbell, Bobbi Jo H Yarborough, Rulin C Hechter, Brian K Ahmedani, Irina Haller, Andrea H Kline-Simon, Derek D Satre, Amy M Loree, Constance Weisner, Ingrid A Binswanger
BACKGROUND: Cannabis use disorders (CUDs) have increased with more individuals using cannabis, yet few receive treatment. Health systems have adopted the Healthcare Effectiveness Data and Information Set (HEDIS) quality measures of initiation and engagement in alcohol and other drug (AOD) dependence treatment, but little is known about the performance of these among patients with CUDs. METHODS: This cohort study utilized electronic health records and claims data from 7 health care systems to identify patients with documentation of a new index CUD diagnosis (no AOD diagnosis ≤60 days prior) from International Classification of Diseases, Ninth revision, codes (October 1, 2014, to August 31, 2015)...
January 18, 2019: Substance Abuse
Taeko Minegishi, Austin B Frakt, Melissa M Garrido, Walid F Gellad, Leslie R M Hausmann, Eleanor T Lewis, Steven D Pizer, Jodie A Trafton, Elizabeth M Oliva
The United States is facing an opioid crisis in which overdose is the leading cause of injury death-misuse of opioids constitutes the vast majority of those deaths. In 2016 alone, over 42,000 people died from opioid overdose, an increase of 27% from the prior year. Deployment of the Stratification Tool for Opioid Risk Mitigation (STORM), a clinical decision support tool to improve opioid safety, is one response by the Veterans Health Administration (VHA) to the opioid crisis. STORM identifies VHA patients at very high risk of opioid-related adverse events and lists potential risk mitigation strategies...
January 8, 2019: Substance Abuse
Idan Barak, Miriam Adelson, Anat Sason, Yuval Livnat, Shaul Schreiber, Einat Peles
BACKGROUND: The aim of this study was to characterize human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related knowledge and stigma among methadone maintenance treatment (MMT) patients and evaluate the contribution of an educational lecture in reducing risky behavior and unjustified overprotective behavior due to fear and stigma among MMT patients. METHODS: Patients from an MMT clinic within a tertiary medical center were invited to an educational lecture on HIV/AIDS...
December 4, 2018: Substance Abuse
Ashley N Linden-Carmichael, Deborah D Kloska, Rebecca Evans-Polce, Stephanie T Lanza, Megan E Patrick
BACKGROUND: Age of first marijuana use is a key predictor of later educational outcomes, but limited work has identified demographic factors that impact this association across continuous ages of first use. The purpose of this study was threefold: (1) to identify the age-varying prevalence of later college degree attainment as a function of age of first marijuana use; (2) to examine the age-varying association of gender and college degree attainment as a function of age of first use; and (3) to examine the age-varying association of parent education and college degree attainment as a function of age of first use...
November 26, 2018: Substance Abuse
Andrea Jakubowski, Alexander Pappas, Lee Isaacsohn, Felipe Castillo, Mariya Masyukova, Richard Silvera, Louisa Holaday, Evan Rausch, Sameen Farooq, Keith T Veltri, Chinazo O Cunningham, Marcus A Bachhuber
BACKGROUND: Overdose education and naloxone distribution (OEND) to people at risk of witnessing or experiencing an opioid overdose has traditionally been provided through harm reduction agencies. Expanding OEND to inpatient general medical settings may reach at-risk individuals who do not access harm reduction services and have not been trained. An OEND program targeting inpatients was developed, piloted, and evaluated on 2 general medicine floors at Montefiore Medical Center, a large urban academic medical center in Bronx, New York...
November 26, 2018: Substance Abuse
Kirsten Elin Smith, Michele Staton
BACKGROUND: Over the past decade, availability and use of novel psychoactive substances such as synthetic cannabinoid receptor agonists (SCRA) have proliferated globally. However, the prevalence of SCRAs use remains uncertain, as does the degree to which individuals reporting SCRA use prefer SCRA to other drugs. METHODS: In April 2017, a total of 500 anonymous surveys were completed by clients enrolled in a residential drug recovery program. Chi-square and t tests were used to examine significant differences between those who had ever used SCRA and those who had not...
November 20, 2018: Substance Abuse
Stephanie Lake, Andrew Gaddis, Kenneth W Tupper, Ekaterina Nosova, Kora DeBeck
BACKGROUND: Despite the popularity of 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) among young people across North America and Europe, MDMA is rarely explored in studies of young people at high risk of injecting drugs. We conducted a study among street-involved youth who use illicit drugs in Vancouver, Canada, to understand if use of MDMA is associated with initiation of injection drugs. METHODS: We followed injection-naïve participants in the At-Risk Youth Study (ARYS), an ongoing prospective cohort of street-involved youth aged 14-26 who use illicit drugs...
November 20, 2018: Substance Abuse
Frank P Deane, Russell Blackman, Peter J Kelly
BACKGROUND: Routine outcome monitoring (ROM) is an important component of service provision and qualitity assurance procedures. However, a major logistical and financial challenge for organizations is successfully following up participants once they have left residential alcohol and other drug treatment. The aim of the current study was to assess the impact and effectiveness of an "early" follow-up contact and brief interview on subsequent 3-month ROM follow-up success. METHODS: Participants were 800 clients attending specialist residential alcohol and other drug treatment provided by The Salvation Army...
November 20, 2018: Substance Abuse
Jasleen Salwan
No abstract text is available yet for this article.
November 1, 2018: Substance Abuse
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