Substance Abuse Treatment, Prevention, and Policy最新文献

Purpose: Professionals providing substance use treatment services often report poor workplace well-being. Moreover, professionals' beliefs about addiction may influence their view of clients, treatment delivery and their well-being at work. Most research has been undertaken in Western countries, hence this study investigated workplace well-being and addiction beliefs of substance use (SU) professionals in Singapore.

Methods: A mixed-methods design was employed. Fifteen participants completed questionnaires related to their well-being at work and addiction beliefs, before participating in a semi-structured interview.

Results: Descriptive analyses revealed that most participants experienced a moderate level of satisfaction with their work and moderate burnout. Reflexive thematic analysis generated four themes: (1) deriving and maintaining meaningfulness; (2) clarity of role and support for effective performance; (3) holding a multidimensional and nuanced view of addiction promotes satisfaction and motivation; and (4) navigating systemic challenges. Workplace well-being was negatively impacted by perceptions of organisational and systemic challenges.

Conclusions: SU professionals derived satisfaction and stayed motivated by crafting their work to re-align with their personal values and beliefs, finding role-clarity, adopting a multidimensional and flexible model of addiction and having external support. Implications highlight the role that organisational training, supervision and career development can play in supporting SU professionals.

Background: The present study aimed to identify opportunities for earlier intervention of non-medical prescription opioid use (NMPOU) among youth (aged 12-24) by characterizing the multidimensional social ecological needs of youth reporting NMPOU and their service utilization patterns in an expanding integrated youth services network.

Methods: The sample (n = 6181) included youth who accessed a novel integrated youth services (IYS) network in British Columbia, Canada, which delivers five core service streams for youth health and well-being through coordinated services. Analyses were conducted on routinely collected data drawn from youths' self-reported demographic and health measures and service provider-reported service utilization data. Multivariable logistic regression identified factors associated with past 30-day NMPOU and multivariable Poisson regression was used to compare service utilization outcomes between youth with and without NMPOU.

Results: A total of 248 (4%) youth reported past 30-day NMPOU. Multidimensional factors independently associated with NMPOU included poor self-rated physical health compared to excellent/very good physical health (adjusted odds ratio (aOR) = 2.51, 95% Confidence Interval (95% CI) = 1.39, 4.56), high likelihood of externalizing mental health disorders compared to low likelihood (aOR = 1.72, 95% CI = 1.03, 2.86), past 30-day illicit polydrug use compared to none (aOR = 10.00, 95% CI = 5.89, 16.99), and past 3-month exposure to violence compared to none (aOR = 2.18, 95% CI = 1.62, 2.92). Rates of service utilization were similar between youth with and without NMPOU (adjusted relative rate = 1.02, 95% CI = 0.95, 1.32).

Conclusions: These findings indicate that youth with NMPOU present to IYS with several individual, interpersonal, and community-related social ecological needs. Integrated care models may be beneficial to address these multidimensional needs and reduce barriers to service utilization, thereby providing opportunity for earlier intervention of NMPOU among youth. Future research should examine the extent to which IYS reduce the incidence of NMPOU and improve opioid-related health and social outcomes among youth.

Objective: To examine patterns of abstinence from nicotine vaping and cannabis use among adolescent and young adult (YA) e-cigarette users in two text message vaping cessation trials.

Methods: Among adolescents with complete 7-month data (n = 1,016) at baseline, 25.4% were Exclusive E-cigarette Users (no past 30-day cannabis use) and 74.6% were Dual Users (past 30-day cannabis use). Among YAs with complete 7-month data (n = 1,829), 40.8% were Exclusive E-cigarette Users and 59.2% were Dual Users at baseline. Primary analyses examined the proportion of participants who were Dual Abstinent at 7-months by treatment arm differences. We also examined for interaction effects between baseline product use and vaping status at 7 months on cannabis use outcomes.

Results: At 7-months, adolescent categories of use were: Dual Abstinent, 31.7% (95% CI: 28.8, 34.6); Exclusive E-cigarette Users, 18.2% (95% CI: 15.9, 20.7); Exclusive Cannabis Users, 15.1% (95% CI: 12.9, 17.4); Dual Users, 35.0% (95% CI: 32.1, 38.1). Among YAs: Dual Abstinent, 15.6% (95% CI: 13.9, 17.3); Exclusive E-cigarette Users, 29.4% (95% CI: 27.3, 31.6); Exclusive Cannabis Users, 12.8% (95% CI: 11.3, 14.5); Dual Users, 42.2% (95% CI: 39.9, 44.5). Intervention outperformed Control in promoting rates of Dual Abstinence among adolescents (38.5% vs. 25.0%, p < 0.0001) and YAs (17.9% vs. 13.3%, p = 0.007). A higher proportion of Exclusive E-cigarette Users compared to Dual Users were Dual Abstinent at follow-up (adolescents: 37.6% vs. 29.7%, p = 0.019; YAs: 25.8% vs. 8.5%, p < 0.001).

Conclusion: A text message nicotine vaping cessation intervention promoted dual abstinence from e-cigarettes and cannabis among adolescents and YAs. Dual abstinence rates were higher among exclusive vapers than dual users, signaling the need to optimize cessation programs for dual users.

Trial registration: Studies included were registered on ClinicalTrials.gov (NCT04251273, registered on January 31, 2020; NCT04919590, registered on June 9, 2021).

Background: Non-medical use of tramadol has emerged as a significant public health concern in Ghana, particularly among young commercial drivers. Despite its growing prevalence, there is a lack of mixed-methods research exploring both the quantitative patterns and underlying motivations for the inappropriate use of tramadol. This study adopts a concurrent triangulation mixed-methods design to investigate the key factors driving tramadol use among young commercial drivers in the Tamale Metropolis.

Methods: A total of 434 participants were recruited through convenience sampling for the quantitative component, while 50 individuals who use tramadol participated in seven focus group discussions using snowball sampling. The study examined patterns of tramadol use, reasons for consumption, modes of intake, and sources of supply among young commercial drivers.

Results: The findings indicate that 60.1% of participants used tramadol for non-medical purposes, with 41.5% consuming it daily. The primary motivation for use was to enhance physical performance (39.2%), followed by pain relief (19.4%). Regarding the mode of consumption, 43.5% mixed tramadol powder with energy drinks, while 31.6% swallowed the tablets with water. On average, participants consumed 155 mg of tramadol daily, often in unauthorized high-dose formulations. Alarmingly, 72.8% of users sourced tramadol from the black market.

Conclusion: The study highlights the widespread misuse of high-dose, non-prescribed tramadol among commercial drivers in the Tamale Metropolis. The illicit supply chain and unregulated distribution exacerbate the crisis. Addressing this issue requires stringent regulation of drug importation and distribution, alongside targeted awareness campaigns to educate young drivers about the risks associated with the inappropriate use of tramadol.

Clinical trial number: Not applicable.

Background: The opioid epidemic continues to pose significant challenges in the United States, with over 75% of nearly 107,000 drug overdose deaths in 2022 involving opioids. Recently, efforts to curb the epidemic have made strides. Beginning in the early 2000s, local and state governments filed a series of lawsuits against opioid manufacturers and distributors. The lawsuits held that manufacturers and distributors knew about the potential addictive nature of these painkillers and withheld this information from providers, leading to overprescription and overdose. The current settlement funds allotted to Pennsylvania amount to approximately 2 billion USD, can be spent over the next 18 years, and are distributed at the county level. This paper investigates the early perceptions of local government officials and substance use service providers in Pennsylvania regarding the rollout of settlement funds and their decisions about how to use them.

Methods: This paper draws on 66 semi-structured interviews and 6 focus groups conducted in 2023 across six Pennsylvania counties. Interviews were audio-recorded, transcribed and inductively coded using NVivo software.

Results: Findings reveal an initial sense of confusion among participants about navigating the funding process, exacerbated by unclear guidelines and insufficient support from state-level officials. Despite these challenges, participants express optimism about the potential for innovative, locally focused projects to effectively address the impacts of the epidemic. Emphasizing the importance of community involvement and transparency, the study highlights a collective commitment to ensuring that funds reach those most affected by the crisis. Yet still, some participants recognized the limits of the settlement funds in addressing the deep trauma that their communities have experienced.

Conclusions: The recommendations underscore the necessity for better systems to outline funding processes, promote best practices, and enhance inter-county collaboration. This research contributes valuable insights into the decision-making dynamics surrounding opioid settlement funds and lays the groundwork for future investigations into their long-term impacts and efficacy.

Background: Smoking is more common in lower socioeconomic position (SEP) groups, but smoking cessation interventions are less effective for these groups. StopCoach, an mHealth intervention, supports people with lower SEP in quitting smoking. A non-randomized controlled trial found that adding StopCoach to accredited smoking cessation counselling (SCC) led to higher abstinence rates immediately after and one year after SCC, compared to SCC alone. Users also rated its usability, acceptability, and practicality positively. Recent studies show a dose-response relationship, where more mHealth use improves smoking cessation outcomes. Since adherence is a challenge and often underreported, understanding adherence factors is crucial in evaluating eHealth intervention effectiveness.

Aim: This study aims to assess the association between participant characteristics and StopCoach app adherence, as well as the association between app adherence and (short- and long-term) abstinence.

Methods: Main outcomes are app adherence and abstinence. All participants (N = 132) were enrolled in group-based SCC. The association between user characteristics and adherence was estimated with logistic regression models. Chi-square tests were performed to test the association between app adherence and self-reported smoking abstinence. Short-term and long-term abstinence were defined as 4 weeks and 1 year after the quit date, respectively. App adherence was defined as the number of steps completed by a participant in the app.

Results: Older users and those who had attended all SCC meetings were significantly more likely to be adherent to the app. More app-adherent participants were significantly more likely to be abstinent 1 year after the quit date. This association was non-significant at 4 weeks.

Conclusion: The results indicate that mHealth interventions such as StopCoach may increase the effectiveness of traditional SCC programs. Users could benefit from further integration of StopCoach in SCC programs, as this could motivate them to be more adherent to StopCoach, resulting in them quitting successfully.