Journal of Substance Abuse Treatment最新文献

{"title":"Influence of a national transgender health care directive on receipt of alcohol-related care among transgender Veteran Health Administration patients with unhealthy alcohol use","authors":"Theresa E. Matson ,&nbsp;Alex H.S. Harris ,&nbsp;Jessica A. Chen ,&nbsp;Amy T. Edmonds ,&nbsp;Madeline C. Frost ,&nbsp;Anna D. Rubinsky ,&nbsp;John R. Blosnich ,&nbsp;Emily C. Williams","doi":"10.1016/j.jsat.2022.108808","DOIUrl":"10.1016/j.jsat.2022.108808","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Transgender persons are vulnerable to under-receipt of recommended health care due to chronic exposure to systemic stressors (e.g., discriminatory laws and </span>health system<span> practices). Scant information exists on receipt of alcohol-related care for transgender populations, and whether structural interventions to reduce transgender discrimination in health care improve receipt of recommended treatment. This study evaluated the effect of the Veteran Health Administration (VA) Transgender Healthcare Directive—a national policy to reduce structural discrimination—on receipt of evidence-based alcohol-related care for transgender VA patients with unhealthy alcohol use.</span></p></div><div><h3>Methods</h3><p><span>The study used an interrupted time series with control design to compare monthly receipt of alcohol-related care among transgender patients with unhealthy alcohol use (Alcohol Use Disorders Identification Test Consumption ≥5) documented in their electronic health record before (10/1/2009–5/31/2011) and after (7/1/2011–7/31/2017) implementation of VA's Transgender Healthcare Directive. A propensity-score matched sample of non-transgender patients with unhealthy alcohol use served as a comparison group to control for concurrent secular trends. Mixed effects segmented </span>logistic regression models estimated changes in level and slope (i.e., rate of change) in receipt of any evidence-based alcohol-related care, including brief intervention, specialty addictions treatment, and alcohol use disorder medications.</p></div><div><h3>Results</h3><p>The matched sample (mean age = 47.5 [SD = 15.0]; 75% non-Hispanic White race/ethnicity) included 2074 positive alcohol screens completed by 1377 transgender patients and 6,l99 positive alcohol screens completed by 6185 non-transgender patients. Receipt of alcohol-related care increased for transgender patients from 78.5% (95% CI: 71.3%–85.6%) at the start of study to 83.0% (75.9%–90.1%) immediately before the directive and decreased slightly from 81.6% (77.4%–85.9%) immediately after the directive to 80.1% (76.8–85.4) at the end of the study. Changes in level and slope comparing periods before and after the directive were not statistically significant, nor were they statistically significantly different from the matched sample of non-transgender patients.</p></div><div><h3>Conclusions</h3><p>Health systems must urgently employ and evaluate policies to address structural stigma that produces and reproduces disparities in health and health care. Although VA's directive was not associated with increased receipt of alcohol-related care, that receipt of alcohol-related care among transgender patients is comparable to non-transgender patients is promising.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108808"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10520319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC (update)","authors":"","doi":"10.1016/S0740-5472(22)00186-6","DOIUrl":"https://doi.org/10.1016/S0740-5472(22)00186-6","url":null,"abstract":"","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108904"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0740547222001866/pdfft?md5=87186ef2b496839d04de97fe09ac7e53&pid=1-s2.0-S0740547222001866-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72075419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between prescription and illicit stimulant and opioid use in the United States, 2015–2020","authors":"Riley D. Shearer ,&nbsp;Abenaa Jones ,&nbsp;Benjamin A. Howell ,&nbsp;Joel E. Segel ,&nbsp;Tyler N.A. Winkelman","doi":"10.1016/j.jsat.2022.108894","DOIUrl":"10.1016/j.jsat.2022.108894","url":null,"abstract":"<div><h3>Introduction</h3><p>Overdose deaths involving opioids and stimulants continue to reach unprecedented levels in the United States. Although significant attention has been paid to the relationship between prescription and illicit opioid use, little work has focused on the association between prescription and illicit stimulant use. Thus, this study explores characteristics of those who use or misuse prescription stimulants and/or opioids and associations with use of cocaine, methamphetamine, and heroin.</p></div><div><h3>Methods</h3><p>We used 2015–2020 data from the National Survey on Drug Use and Health. Using adjusted multivariable logistic regression, we estimated the associations between past year prescription stimulant or prescription opioid prescribed use and misuse; various demographic characteristics; and past-year cocaine, methamphetamine, or heroin use.</p></div><div><h3>Results</h3><p>From 2015 to 2020, 4.9 and 9.8 million US adults annually reported misusing prescription stimulants and opioids, respectively. Individuals who misused prescription stimulants were more likely to be ages 18–25 (45.8 %; 95 % CI: 44.0–47.5) than individuals who misused prescription opioids (21.7 %; 95 % CI: 20.7–22.7). We observed higher rates of cocaine use among individuals reporting prescription stimulant misuse (12.0 %; 95 % CI: 11.0–12.9) compared to those reporting prescription opioid misuse (5.7 %; 95 % CI: 5.1–6.3, p &lt; 0.001). Heroin use was more common among individuals with prescription opioid misuse (2.1 %; 95 % CI: 1.7–2.2) than prescription stimulant misuse (0.6 %; 95 % CI: 0.4–0.7, p &lt; 0.001). However, rates of methamphetamine use among individuals with prescription stimulant misuse (2.4 %; 95 % CI: 1.9–3.0) did not differ from individuals with prescription opioid misuse (2.1 %; 95 % CI: 1.7–2.5, p = 0.67).</p></div><div><h3>Conclusions</h3><p>Prescription stimulant misuse, compared to prescription opioid misuse, was associated with higher levels of cocaine use but not methamphetamine use. Treatment providers should consider screening for other substance use disorders among people who report prescription stimulant use or misuse. Additional research should seek to understand the mechanism underlying the different associations between prescription stimulant misuse and cocaine or methamphetamine use.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108894"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10830464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability, feasibility, and outcomes of a clinical pilot program for video observation of methadone take-home dosing during the COVID-19 pandemic","authors":"Kevin A. Hallgren ,&nbsp;James Darnton ,&nbsp;Sean Soth ,&nbsp;Kendra L. Blalock ,&nbsp;Alyssa Michaels ,&nbsp;Paul Grekin ,&nbsp;Andrew J. Saxon ,&nbsp;Steve Woolworth ,&nbsp;Judith I. Tsui","doi":"10.1016/j.jsat.2022.108896","DOIUrl":"10.1016/j.jsat.2022.108896","url":null,"abstract":"<div><h3>Background</h3><p>Methadone is one of the most utilized treatments for opioid use disorder. However, requirements for observing methadone dosing can impose barriers to patients and increase risk for respiratory illness transmission (e.g., COVID-19). Video observation of methadone dosing at home could allow opioid treatment programs (OTPs) to offer more take-home doses while ensuring patient safety through remote observation of ingestion.</p></div><div><h3>Methods</h3><p>Between April and August 2020, a clinical pilot program of video observation of methadone take-home dosing via smartphone was conducted within a multisite OTP agency. Participating patients completed a COVID-19 symptom screener and submitted video recordings of themselves ingesting all methadone take-home doses. Patients who followed these procedures for a two-week trial period could continue participating in the full pilot program and potentially receive more take-home doses. This retrospective observational study characterizes patient engagement and compares clinical outcomes with matched controls.</p></div><div><h3>Results</h3><p>Of 44 patients who initiated the two-week trial, 33 (75 %) were successful and continued participating in the full pilot program. Twenty full pilot participants (61 %) received increased take-home doses. Full pilot participants had more days with observed dosing over a 60-day period than matched controls (mean = 53.2 vs. 16.6 days, respectively). Clinical outcomes were similar between pilot participants and matched controls.</p></div><div><h3>Conclusions</h3><p>Video observation of methadone take-home dosing implemented during the COVID-19 pandemic was feasible. This model has the potential to enhance safety by increasing rates of observed methadone dosing and reducing infection risks and barriers associated with relying solely on face-to-face observation of methadone dosing.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108896"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9331943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the cost and impact of injectable opioid agonist therapy on overdose and overdose deaths","authors":"Wai Chung Tse ,&nbsp;Nick Scott ,&nbsp;Paul Dietze ,&nbsp;Suzanne Nielsen","doi":"10.1016/j.jsat.2022.108871","DOIUrl":"10.1016/j.jsat.2022.108871","url":null,"abstract":"<div><h3>Aims</h3><p>Unsupervised injectable opioid agonist<span> therapy (iOAT) may decrease the unmet treatment needs for people who inject opioids. We aimed to model whether unsupervised iOAT may be effective in reducing fatal and non–fatal overdose, and estimate the cost per life saved.</span></p></div><div><h3>Methods</h3><p>The study used a decision tree model based on Australian and international parameters for overdose risk in people who inject opioids who are: not on OAT; new/stable to methadone/buprenorphine treatment; on iOAT; or on unsupervised iOAT. We modeled scenarios of (1) current OAT only (status quo), or current OAT plus either (2) 5% supervised iOAT, (3) 5% supervised or 5.69% unsupervised iOAT (based on willingness to enroll), OR (4) 1.2% supervised and 10% unsupervised iOAT (the same cost as scenario 2). The study measured overdoses (fatal and nonfatal) and treatment costs per 10,000 people who inject opioids per annum, and cost-per deaths averted on implementation of iOAT.</p></div><div><h3>Results</h3><p>With current OAT, the study found an estimated 1655.5 (1552.7–1705.3) overdoses, 19.3 (17.9–20.3) overdose deaths and AUD 23,335,081 in treatment costs per 10,000 people per annum. Implementation of 5% enrollment in supervised iOAT costs an additional AUD 14,807,855 and showed a reduction of 122.9 (95% UI 114.2–130.5) overdoses and 2.0 (1.8–2.0) overdose deaths per 10,000 people per annum ($7,774,172 [7,283,182–8,146,989] per death averted). For the same treatment costs, additional coverage of 10% unsupervised iOAT and 1.2% supervised iOAT could be achieved, which the study estimated to prevent 269.0 (95% UI 250.0–278.7) overdoses and 4.0 (3.7–4.2) overdose deaths per 10,000 people per annum ($3,723,340 (3,385,878–3,894,379) per death averted), alongside further benefits of treatment unaccounted for in this study.</p></div><div><h3>Conclusion</h3><p>An implementation scenario with greater unsupervised iOAT compared to supervised iOAT allows for an increased reduction in overdose and overdose deaths per annum at the same cost, with the additional benefit of increased treatment coverage among people who inject opioids.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108871"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10813606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Service providers' perspectives on substance use and treatment needs among human trafficking survivors","authors":"Erica Koegler ,&nbsp;Claire A. Wood ,&nbsp;Sharon D. Johnson ,&nbsp;Lilly Bahlinger","doi":"10.1016/j.jsat.2022.108897","DOIUrl":"10.1016/j.jsat.2022.108897","url":null,"abstract":"<div><h3>Introduction</h3><p>Understanding substance use and treatment needs for survivors of human trafficking remains an underdeveloped area in the field of substance use treatment. This study assessed the nature of substance use among survivors of all types of human trafficking and identified treatment barriers and needs, as reported by human trafficking service providers in one Midwest major metropolitan area.</p></div><div><h3>Methods</h3><p>Participants were purposively selected from agencies that served foreign-born and domestic-born survivors of human trafficking. The study interviewed fifteen key informants across 13 agencies directly serving survivors of trafficking.</p></div><div><h3>Results</h3><p>Providers highlighted frequent use of alcohol and marijuana, as well as polysubstance use. They noted survivors' significant use of opioids, associated concerns regarding fentanyl-related deaths, and increased frequency of stimulant use. Barriers for addressing substance use problems with survivors included low self-perceptions of need, lack of available residential or inpatient treatment options, and prioritizing basic needs such as housing over substance use treatment.</p></div><div><h3>Conclusions</h3><p>Results underscore how broader trends in substance use and overdose in a region can mirror substance use patterns and treatment needs of human trafficking survivors. Further, a need exists for broader substance use screening and low-barrier referral services to address emergent needs of survivors of trafficking.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108897"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10464501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of race, gender, and heroin use on opioid addiction stigma","authors":"Kimberly Goodyear ,&nbsp;Jasjit Ahluwalia ,&nbsp;David Chavanne","doi":"10.1016/j.jsat.2022.108872","DOIUrl":"10.1016/j.jsat.2022.108872","url":null,"abstract":"<div><h3>Introduction</h3><p>Stigmatization of an opioid addiction<span> acts as a barrier to those seeking substance use treatment. As opioid use and overdoses continue to rise and affect minority populations, understanding the impact that race and other identities have on stigma is pertinent.</span></p></div><div><h3>Methods</h3><p>This study aimed to examine the degree to which race and other identity markers (i.e., gender and type of opioid used) interact and drive the stigmatization of an opioid addiction. To assess public perceptions of stigma, this research team conducted a randomized, between-subjects case vignette study (<em>N</em> = 1833) with a nation-wide survey. Participants rated a hypothetical individual who became addicted to opioids on four stigma indices (responsibility, dangerousness, positive affect, and negative affect) based on race (White or Black), gender (male or female), and end point (an individual who transitioned to using heroin or who continued using prescription painkillers).</p></div><div><h3>Results</h3><p>Our results first showed that the White individual had higher stigma ratings compared to the Black individual (range of partial η² = 0.002–0.004). An interaction effect demonstrated that a White female was rated with higher responsibility for opioid use than a Black female (Cohen's <em>d</em> = 0.21) and a Black male was rated with higher responsibility for opioid use than a Black female (Cohen's <em>d</em> = 0.26). Last, we showed that a male and an individual who transitioned to heroin had higher stigma than a female and an individual who continued to use prescription opioids (range of partial η² = 0.004–0.007). Conclusion: This study provides evidence that information about multiple identities can impact stigmatizing attitudes, which can provide deeper knowledge on the development of health inequities for individuals with an opioid addiction.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108872"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10469090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal associations between pain and substance use disorder treatment outcomes","authors":"Erin Ferguson ,&nbsp;Ben Lewis ,&nbsp;Scott Teitelbaum ,&nbsp;Gary Reisfield ,&nbsp;Michael Robinson ,&nbsp;Jeff Boissoneault","doi":"10.1016/j.jsat.2022.108892","DOIUrl":"10.1016/j.jsat.2022.108892","url":null,"abstract":"<div><h3>Introduction</h3><p>Pain is commonly reported among those in treatment for substance use disorders (SUD) and is associated with poorer SUD treatment outcomes. The current study examined the trajectory of pain over the course of SUD treatment and associations with substance use outcomes.</p></div><div><h3>Methods</h3><p>This observational study included adults seeking treatment for alcohol, cannabis, or opioid use disorders (N = 811). Participants completed a battery of assessments at treatment admission, 30 days post admission, and at discharge, including measures of demographics, pain, quality of life, abstinence self-efficacy, and craving.</p></div><div><h3>Results</h3><p>Analyses indicated linear reductions in pain intensity and interference over time. Significant interactive effects were observed for opioid use disorder (OUD) and time, such that participants with OUD had greater reductions in pain intensity and interference over time compared to those without OUD. Elevated pain intensity was associated with negative treatment outcomes, including reduced quality of life and abstinence self-efficacy, and greater craving and negative affect.</p></div><div><h3>Conclusions</h3><p>Reductions in pain occur over the course of SUD treatment, particularly for those with OUD. Greater pain was also associated with adverse SUD treatment outcomes. Results suggest that treatment and associated abstinence may be beneficial for those with co-occurring pain and SUD, highlighting an additional benefit of improving access to SUD treatment for patients and health care systems. Future research should replicate these findings among diverse samples and further characterize the trajectory of pain during and after SUD treatment.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108892"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10469132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance use and criminogenic thinking: Longitudinal latent class analysis of veterans with criminal histories","authors":"Christine Timko ,&nbsp;Noel Vest ,&nbsp;Michael A. Cucciare ,&nbsp;David Smelson ,&nbsp;Daniel Blonigen","doi":"10.1016/j.jsat.2022.108893","DOIUrl":"10.1016/j.jsat.2022.108893","url":null,"abstract":"<div><h3>Introduction</h3><p>The objective of this study was to inform clinical practice by identifying distinct subgroups of US veterans with criminal histories in residential mental health<span> treatment. The study characterized veteran patients on their alcohol and drug use and criminogenic thinking. We also examined predictors and outcomes of subgroup membership.</span></p></div><div><h3>Methods</h3><p>Participants were 341 veterans with a criminal history in residential mental health care. A parallel latent growth trajectory model characterized participants' alcohol and drug use and criminogenic thinking at treatment entry and at 6- and 12-month follow-ups.</p></div><div><h3>Results</h3><p>The study identified four distinct classes: 53 % Normative Improvement, 27 % High Criminogenic Thinking, 11 % High Recurrence (of substance use), and 9 % High Drug Use. Compared to the Normative Improvement class, prior to treatment entry, patients in the High Recurrence class were less likely to be on parole or probation, and patients in the High Criminogenic Thinking class were more likely to be chronically homeless. Compared to the Normative Improvement class, at follow-ups, patients in the High Drug Use and High Criminogenic Thinking classes were more likely to recidivate, and patients in the High Drug Use class were more likely to report unstable housing. Depression scores were higher (nearly double) in the High Drug Use, High Recurrence, and High Criminogenic Thinking classes at follow-ups compared to the Normative Improvement class.</p></div><div><h3>Conclusions</h3><p>That the Normative Improvement class entered mental health residential treatment with relatively low alcohol and drug use and criminogenic thinking, and sustained these low levels, suggests that treatment does not need to be broadened or intensified to improve these domains for these patients with criminal histories. In contrast, findings for the High Drug Use, High Recurrence, and High Criminogenic Thinking classes, which composed 47 % of the sample, suggest that more integrated and sustained treatment may be needed to reduce recidivism, depression, and homelessness among these patients.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108893"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10733896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polysubstance use before and during treatment with medication for opioid use disorder: Prevalence and association with treatment outcomes","authors":"Amanda M. Bunting ,&nbsp;Noa Krawczyk ,&nbsp;Tse-Hwei Choo ,&nbsp;Martina Pavlicova ,&nbsp;Jennifer McNeely ,&nbsp;Babak Tofighi ,&nbsp;John Rotrosen ,&nbsp;Edward Nunes ,&nbsp;Joshua D. Lee","doi":"10.1016/j.jsat.2022.108830","DOIUrl":"10.1016/j.jsat.2022.108830","url":null,"abstract":"<div><h3>Objective</h3><p>Polysubstance use may complicate treatment outcomes for individuals who use opioids. This research aimed to examine the prevalence of polysubstance use in an opioid use disorder treatment trial population and polysubstance use's association with opioid relapse and craving.</p></div><div><h3>Methods</h3><p><span>This study is a secondary data analysis of individuals with opioid use disorder who received at least one dose of medication (n = 474) as part of a 24-week, multi-site, open label, randomized Clinical Trials Network study (CTN0051, X:BOT) comparing the effectiveness of extended-release </span>naltrexone<span> versus buprenorphine. Models examined pretreatment polysubstance use and polysubstance use during the initial 4 weeks of treatment on outcomes of relapse by week 24 of the treatment trial and opioid craving.</span></p></div><div><h3>Results</h3><p>Polysubstance use was generally not associated with treatment outcomes of opioid relapse and craving. Proportion of days of pretreatment sedative use was associated with increased likelihood of opioid relapse (OR: 1.01, 95 % CI: 1.00–1.02). Proportion of days of cocaine use during the initial 4 weeks of treatment was associated with increased likelihood of opioid relapse (OR: 1.05, 95 % CI: 1.01–1.09) but this effect was no longer significant once the potential of confounding by opioid use was considered. Sedative use during initial 4 weeks of treatment was associated with increased opioid craving (b: 0.77, 95 % CI: 0.01–1.52). The study found no other significant relationships.</p></div><div><h3>Conclusions</h3><p>In the current study population, polysubstance use was only marginally associated with 24-week treatment outcomes.</p></div>","PeriodicalId":17148,"journal":{"name":"Journal of Substance Abuse Treatment","volume":"143 ","pages":"Article 108830"},"PeriodicalIF":3.9,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9107651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}