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Trends and Barriers of Medication Treatment for Opioid Use Disorders: A Systematic Review and Meta-Analysis 阿片类药物使用障碍药物治疗的趋势和障碍:系统回顾和荟萃分析
4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-11 DOI: 10.1177/00220426231204841
Morica Hutchison, Beth S. Russell, Abigail Leander, Nathaniel Rickles, Derek Aguiar, Xiaomei S. Cong, Ofer Harel, Adrian V. Hernandez
Adherence to and retention in Medication Treatment for Opioid Use Disorders (MOUD) persist. We systematically reviewed trends of USA MOUD adherence, retention, and barriers from 2011–2021. Primary outcomes were adherence to and retention in MOUD, abstinence, adverse events, and treatment barriers. Effects of inverse variance random meta-analyses were examined using proportions and 95% CIs. 28 studies (102,318 patients), 78.1% male. Adherence was 56% across all studies, highest for methadone (73%). Retention by study design was heterogeneous: case series (57%), cohorts (47%), and RCTs (70%). The most common barriers were younger age, comorbid diagnoses, daily attendance, no insurance, and transportation. Abstinence was 72%, and adverse events was 5%. There was high heterogeneity in MOUD across drug types and study designs. Our findings extend the knowledge base of MOUD treatment to describe barriers that underpin the focus on retention in care above adherence given its focus to harm reduction principles.
阿片类药物使用障碍(mod)药物治疗的依从性和保留性持续存在。我们系统地回顾了2011-2021年美国mod依从性、保留率和障碍的趋势。主要结局是mod的坚持和保留、戒断、不良事件和治疗障碍。使用比例和95% ci检验反方差随机荟萃分析的效果。28项研究(102318例患者),78.1%为男性。所有研究的依从性为56%,美沙酮最高(73%)。研究设计的保留是异质的:病例系列(57%)、队列(47%)和随机对照试验(70%)。最常见的障碍是年龄较小、合并症诊断、每日就诊、无保险和交通。禁欲率为72%,不良事件发生率为5%。在不同的药物类型和研究设计中,mod具有高度的异质性。我们的研究结果扩展了mod治疗的知识基础,描述了基于减少伤害原则的坚持治疗而不是依从性的障碍。
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引用次数: 1
Entry Mechanisms into the Belgian Synthetic Drugs Market 进入比利时合成药物市场的机制
4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-10 DOI: 10.1177/00220426231205523
Sophia De Seranno, Charlotte Colman
Organised crime groups prefer existing ties, such as family and friendship, to maximise trust. However, they might also win from a certain degree of heterogeneity. External individuals might add value in the form of skills, expertise or money. Accordingly, including suitable co-offenders is an important activity for the organised crime group. This article studies the entry mechanisms of individuals into the synthetic drugs market in Belgium, namely by gaining insight into the factors and mechanisms introducing people into this market. Interviews with 29 inmates detained for their involvement in the production and/or trafficking of synthetic drugs in Belgium revealed that: (1) poly drug supply markets exist in Belgium; (2) financial reasons to enter the market are common; and (3) there are six different entry mechanisms, in which trust is crucial, namely criminal family ties, criminal friends, drug use, earlier time in prison, outlaw motorcycle gang membership, and criminal professional ties.
有组织犯罪集团更喜欢现有的关系,如家庭和友谊,以最大化信任。然而,他们也可能从一定程度的异质性中获胜。外部个人可能会以技能、专业知识或金钱的形式增加价值。因此,纳入合适的共犯是有组织犯罪集团的一项重要活动。本文研究个人进入比利时合成药物市场的进入机制,即通过洞察人们进入这个市场的因素和机制。对29名在比利时因参与生产和/或贩运合成毒品而被拘留的囚犯的访谈显示:(1)比利时存在多种毒品供应市场;(2)进入市场的财务原因比较普遍;(3)有六种不同的进入机制,其中信任是至关重要的,即犯罪家庭关系、犯罪朋友、吸毒、较早入狱时间、非法摩托车团伙成员和犯罪职业关系。
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引用次数: 0
Factors Influencing Attitudes Towards Safer Supply Programs for People Who Use Drugs: Findings From an Atlantic Canadian Province 影响对吸毒者安全供应计划态度的因素:来自加拿大大西洋省的调查结果
4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-05 DOI: 10.1177/00220426231205520
Adrienne N. Thornton, Amy L. MacQuarrie, Caroline Brunelle
Safer supply programs (SSPs) are harm reduction services where people who use drugs can access regulated pharmaceutical drugs (e.g., hydromorphone). Public attitudes, and factors that influence attitudes towards SSPs must be considered as they impact policy and funding decisions. A total of 384 participants were recruited from the community ( n = 160, 41.7%) and an Atlantic Canadian University ( n = 224, 58.3%) to complete an online survey. The majority of the sample was supportive of SSPs ( n = 316, 82.3%). Being of European origin, a younger age, identifying as female, displaying higher levels of Openness to Experience, and reporting less stigma towards people who use drugs were predictive of more positive attitudes towards SSPs. Openness to Experience mediated the relationship between stigma levels and attitudes towards SSPs. The findings of the current study suggest that when developing public awareness campaigns, considering the impact of demographic and psychological factors is important.
安全供应规划(ssp)是减少危害的服务,使吸毒者能够获得受管制的药品(例如氢吗啡酮)。公众的态度以及影响对可持续发展战略计划态度的因素影响到政策和供资决定,因此必须加以考虑。共从社区(n = 160, 41.7%)和加拿大大西洋大学(n = 224, 58.3%)招募384名参与者完成在线调查。大多数样本支持ssp (n = 316, 82.3%)。欧洲血统、年龄较年轻、自认为是女性、表现出更高水平的经验开放性、对吸毒者较少的耻辱感,预示着对ssp的态度更积极。对经验的开放性介导了耻感水平与对ssp的态度之间的关系。目前的研究结果表明,在开展公众意识运动时,考虑人口和心理因素的影响是很重要的。
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引用次数: 0
Assessing Determinants of Shifting Attitudes on Drug Policy Reform in Maine 评估缅因州毒品政策改革态度转变的决定因素
4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-04 DOI: 10.1177/00220426231205797
Robert W. Glover, Karyn Sporer
There is growing recognition that our decades-long “war on drugs” has not only been a policy failure but has made our societal drug crisis worse. This is painfully evident in our response to the opioid epidemic. Efforts at comprehensive policy reform are likely to emerge first at the state and local levels. We collaborated with policy advocates and practitioners to study policy perspectives of registered Maine voters, and to investigate determinants of receptivity to drug policy reforms rooted in decriminalization and harm reduction. Our results suggest that while political ideology still impacts one’s perspective on these issues, increased exposure to those with substance use disorder reduces stigma, resulting in increasingly broad, bipartisan support for policy reform. We conclude with a discussion on how policymakers addressing overdose and substance use disorder at the state and local level should consider implementing and funding evidence-based alternative approaches such as decriminalization and harm reduction.
越来越多的人认识到,我们长达数十年的“禁毒战争”不仅是政策上的失败,而且使我们的社会毒品危机更加严重。这在我们对阿片类药物流行的反应中令人痛苦地显而易见。全面政策改革的努力可能首先出现在州和地方层面。我们与政策倡导者和实践者合作,研究缅因州注册选民的政策观点,并调查基于非刑事化和减少伤害的毒品政策改革的接受程度的决定因素。我们的研究结果表明,虽然政治意识形态仍然会影响一个人对这些问题的看法,但增加对物质使用障碍患者的接触会减少耻辱感,从而导致政策改革得到越来越广泛的两党支持。最后,我们讨论了政策制定者如何在州和地方层面解决药物过量和药物使用障碍问题,应考虑实施和资助基于证据的替代方法,如非刑事化和减少危害。
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引用次数: 0
Examining Gender Differences in the Relationship Between School Bonding and Opioid Misuse Among Justice-Involved Adolescents. 司法参与青少年学校关系与阿片类药物滥用关系的性别差异研究
IF 1.2 4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-01 Epub Date: 2022-11-12 DOI: 10.1177/00220426221139423
Enya B Vroom, Micah E Johnson, Zahra Akbari, Zachary Frederick, Skye C Bristol

Justice-involved adolescents (JIAs) have an increased risk for opioid use disorder and overdose related to opioid misuse (OM). Consequences of untreated OM include recidivism and poor educational outcomes, which can be harsher for female JIA. Therefore, identifying relevant factors and settings that reduce the risk for OM is critical. Schools are a central institution in adolescent development. Drawing on social control theory, JIA with higher levels of school bonding was hypothesized to attenuate risk for OM. Cross-sectional data on 79,960 JIA from the Florida Department of Juvenile Justice were examined. Multivariate and stratified logistic regression analyses were employed. On average, for every one-unit increase in school bonding, JIA had 22%, female JIA had 23%, and male JIA had 22% lower odds of OM. Results suggest school bonding and the school context should be considered in treatment and how this setting may impact OM intervention outcomes among JIA.

参与司法的青少年(JIAs)发生阿片类药物使用障碍和与阿片类药物滥用(OM)相关的过量使用的风险增加。未经治疗的OM的后果包括再犯和不良的教育成果,这对女性JIA来说可能更严重。因此,确定降低OM风险的相关因素和环境至关重要。学校是青少年发展的中心机构。根据社会控制理论,我们假设具有较高学校联系水平的JIA可以降低OM的风险。对来自佛罗里达州少年司法部门的79,960名JIA的横断面数据进行了检查。采用多变量和分层逻辑回归分析。平均而言,每增加一个单位的学校关系,JIA的发生率降低22%,女性JIA的发生率降低23%,男性JIA的发生率降低22%。结果表明,在治疗中应考虑学校关系和学校环境,以及这种环境如何影响JIA的OM干预结果。
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引用次数: 0
Local Prohibitions on Marijuana Businesses With On-Site Consumption: Evidence from New York State 当地禁止现场吸食大麻的企业:来自纽约州的证据
IF 1.7 4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-01 DOI: 10.1177/00220426221138229
David M. Yaskewich
As several US states have legalized recreational marijuana over the past decade, local approval of commercial marijuana activities has faced opposition in a non-negligible share of communities. A common provision in state laws often grants local governments the authority to prohibit marijuana businesses from locating within their jurisdictions. This paper analyzed determinants of local government policies in New York State following the legalization of recreational marijuana in 2021. A key feature of New York’s law authorized municipal governments to pass an “opt-out” ordinance prohibiting marijuana retail stores, on-site consumption establishments, or both. Based on results from multilevel logistic regression models, the likelihood of allowing commercial marijuana activities was higher for local governments representing communities with larger Black populations, fewer evangelical Protestants, and lower levels of household income. While slightly more municipalities prohibited on-site consumption, determinants of opt-out decisions were similar for both retail and consumption businesses.
在过去十年中,随着美国几个州将娱乐性大麻合法化,当地对商业大麻活动的批准在不可忽视的社区中遭到了反对。州法律中的一项常见条款通常授予地方政府禁止大麻企业在其管辖范围内经营的权力。本文分析了2021年娱乐性大麻合法化后纽约州地方政府政策的决定因素。纽约法律的一个关键特征授权市政府通过一项“选择退出”法令,禁止大麻零售店、现场消费场所或两者兼而有之。根据多层次逻辑回归模型的结果,代表黑人人口较多、福音派新教徒较少、家庭收入水平较低的社区的地方政府允许商业大麻活动的可能性更高。虽然略多于城市禁止现场消费,但零售和消费企业选择退出决定的决定因素相似。
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引用次数: 0
Prevalence and Predictors of Substance Use Support Programming Among U.S. Religious Congregations. 美国宗教团体药物使用支持计划的流行率和预测因素。
IF 1.2 4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-10-01 Epub Date: 2022-11-08 DOI: 10.1177/00220426221138479
Vanessa N Torres, Brad R Fulton, Eunice C Wong, Kathryn P Derose
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引用次数: 0
Assessing the Relevance of Exposure to Violence as a Predictor of Cocaine/Crack Use: Delineating Witnessed Violence and Direct Victimization and Testing for Developmental Differences 评估暴露于暴力作为可卡因/快克使用预测因子的相关性:描述目击暴力和直接受害以及对发展差异的测试
4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-09-29 DOI: 10.1177/00220426231204840
Thomas Wojciechowski
Exposure to violence has been found to predict cocaine use, but evidence is limited in terms of how different forms of exposure to violence impact use and how the relevance of these relationships may vary across adolescence and emerging adulthood. This study tested for differential salience of witnessed violence and direct victimization predictors of cocaine use during adolescence and emerging adulthood. The present study analyzed data from all waves of the Pathways to Desistance study. Mixed effects logistic regression was used to assess whether either form of exposure to violence influenced cocaine use and whether that influence was more or less salient in adolescence versus emerging adulthood. Results indicated that only direct victimization significantly influenced cocaine use. This effect demonstrated a quadratic growth pattern; first diminishing in salience in its impact on cocaine use when experienced throughout adolescence and then becoming more salient when experienced during emerging adulthood.
已经发现,接触暴力可以预测可卡因的使用,但在不同形式的暴力接触如何影响使用以及这些关系的相关性在青春期和成年初期如何变化方面,证据有限。本研究测试了在青春期和成年初期可卡因使用的目击暴力和直接受害预测因素的差异显著性。本研究分析了阻力通路研究的所有波的数据。使用混合效应逻辑回归来评估暴力暴露是否会影响可卡因的使用,以及这种影响在青春期和成年初期是否更显著。结果表明,只有直接受害对可卡因使用有显著影响。这种效应表现为二次增长模式;在整个青少年时期,它对可卡因使用的影响首先减弱,然后在成年初期变得更加明显。
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引用次数: 0
Fun in the Workplace and Employee Substance Use: A Double-Edged Sword? 职场乐趣与员工物质使用:一把双刃剑?
4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-09-19 DOI: 10.1177/00220426231187284
Michael J. Tews, Heyao Yu, Sydney T. Pons
While fun in the workplace has been demonstrated to favorably influence a variety of attitudinal and behavioral outcomes in previous research (Michel et al., 2019), the present study demonstrates that fun bears a complex relationship with employee alcohol and marijuana use. With a sample of 378 individuals employed in the hospitality and retail industries, manager support for fun and fun activities were negatively related to after-work employee substance use through subjective stress. In addition, both aspects of fun in the workplace were positively related to substance use through coworker socializing. In this light, fun in the workplace may be a double-edged sword in the context of human resource management. These findings are discussed, along with opportunities for future research.
虽然在之前的研究中,工作场所的乐趣已被证明对各种态度和行为结果产生有利影响(Michel et al., 2019),但本研究表明,乐趣与员工饮酒和吸食大麻有着复杂的关系。以378名在酒店和零售行业工作的个人为样本,通过主观压力,经理对娱乐和娱乐活动的支持与员工下班后的物质使用呈负相关。此外,工作场所乐趣的两个方面都与同事社交中的物质使用呈正相关。这样看来,在人力资源管理的背景下,工作场所的乐趣可能是一把双刃剑。讨论了这些发现,以及未来研究的机会。
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引用次数: 0
Spiking Versus Speculation? Perceived Prevalence, Probability, and Fear of Drink and Needle Spiking 飙升还是投机?感知流行,概率和恐惧的饮料和针刺
IF 1.7 4区 社会学 Q4 SUBSTANCE ABUSE Pub Date : 2023-08-24 DOI: 10.1177/00220426231197826
A. Bendau, Twyla Michnevich, M. Petzold, Andrea Piest, Rüdiger Schmolke, Daniel Jakobson, Katharin Ahrend, Thale Reitz, Lukas Roediger, F. Betzler
Contrasting widespread speculation in the media and public debate about spiking (administration of a substance to a person without their knowledge/consent), empirical evidence on the subject is lacking. This study aimed to investigate the assumed prevalence, perceived likelihood, and fear of drink-versus needle-spiking, and associated mental strain. Data from a cross-sectional online-survey (November 2022 – January 2023) of 1916 adults connected to Berlin’s nightlife-scene were analyzed. Almost a quarter reported having experienced drink-spiking, but only a small fraction sought medical or police attention; about 1% suspected needle-spiking. Presumptive victims of drink-spiking rated the likelihood and fear of spiking significantly higher and exhibited more symptoms of depression and anxiety. Considering toxicological and police findings, the reported prevalence and perceived likelihood of spiking seem to be highly overestimated. This, in conjunction with associated mental strain, highlights the importance of adequately addressing the issue of spiking through psychoeducation, prevention, and interprofessional investigation.
与媒体广泛猜测和公众辩论相比,在这个问题上缺乏经验证据(在不知情/不同意的情况下给人服用某种物质)。本研究旨在调查假定的患病率、感知的可能性、饮酒与针刺的恐惧以及相关的精神压力。一项横断面在线调查(2022年11月至2023年1月)对1916名与柏林夜生活有关的成年人进行了数据分析。近四分之一的人报告说他们经历过醉酒,但只有一小部分人寻求医疗或警察的关注;大约1%怀疑是针刺。假定的酗酒受害者对酗酒的可能性和恐惧程度的评估要高得多,并且表现出更多的抑郁和焦虑症状。考虑到毒理学和警方的调查结果,报告的流行率和感知到的峰值可能性似乎被高度高估了。这一点,连同相关的精神紧张,强调了通过心理教育、预防和跨专业调查充分解决尖峰问题的重要性。
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引用次数: 0
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Journal of Drug Issues
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