Pub Date : 2022-04-18DOI: 10.1080/08897077.2022.2060429
William L. Swann, Terri L Schreiber, Serena Y Kim, Heidi McNeely, Jake H. Hong
Background: US local health departments (LHDs) have faced the COVID-19 pandemic and the opioid epidemic simultaneously. This article investigates the perceived impact of COVID-19 on the continuation of locally available services for addressing opioid use disorder (OUD). Methods: A national survey of US LHDs was conducted from November to December 2020. The survey asked key personnel in LHDs about the availability of OUD services in their jurisdiction, and how COVID-19 impacted such availability (i.e., whether terminated or continued at a reduced, the same, or an increased level after the arrival of COVID-19). Proportions for each impact category were estimated for prevention, treatment, harm reduction, and recovery services. Logistic regression tested for rural-urban and regional differences in perceived service impact. Results: An 11.4% (214 out of 1873) response rate was attained. Of the returned surveys, 187 were used in the analysis. Reported terminations were generally low, especially for treatment services. School-based prevention initiatives had the highest termination rate (17.2%, 95% CI = 11.4–25.1%). Prevention services had the highest proportions for continuing at a reduced level, except for recovery mutual help programs (53.9%, 95% CI = 45.2–62.4%). LHDs reported continuing services at an increased level at a higher frequency than terminating. Notably, 72.2% (95% CI = 62.7–80.0%) continued telehealth/telemedicine options for OUD at an increased level, and 23.8% (95% CI = 17.8–31.1%) and 10.0% (95% CI = 5.7–16.7%) reported doing the same for naloxone distribution and medications for opioid use disorder (MOUD), respectively. More harm reduction services were continued at the same versus at a reduced level. Service continuation differed little between rural-urban LHDs or by region. Conclusions: The impacts of COVID-19 on OUD service availability in LHD jurisdictions may depend on the specific area of opioid response while the long-term consequences of these changes remain unknown.
{"title":"Perceived Impact of Covid-19 on Prevention, Treatment, Harm Reduction, and Recovery Services for Opioid Use Disorder: National Survey of Local Health Departments","authors":"William L. Swann, Terri L Schreiber, Serena Y Kim, Heidi McNeely, Jake H. Hong","doi":"10.1080/08897077.2022.2060429","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060429","url":null,"abstract":"Background: US local health departments (LHDs) have faced the COVID-19 pandemic and the opioid epidemic simultaneously. This article investigates the perceived impact of COVID-19 on the continuation of locally available services for addressing opioid use disorder (OUD). Methods: A national survey of US LHDs was conducted from November to December 2020. The survey asked key personnel in LHDs about the availability of OUD services in their jurisdiction, and how COVID-19 impacted such availability (i.e., whether terminated or continued at a reduced, the same, or an increased level after the arrival of COVID-19). Proportions for each impact category were estimated for prevention, treatment, harm reduction, and recovery services. Logistic regression tested for rural-urban and regional differences in perceived service impact. Results: An 11.4% (214 out of 1873) response rate was attained. Of the returned surveys, 187 were used in the analysis. Reported terminations were generally low, especially for treatment services. School-based prevention initiatives had the highest termination rate (17.2%, 95% CI = 11.4–25.1%). Prevention services had the highest proportions for continuing at a reduced level, except for recovery mutual help programs (53.9%, 95% CI = 45.2–62.4%). LHDs reported continuing services at an increased level at a higher frequency than terminating. Notably, 72.2% (95% CI = 62.7–80.0%) continued telehealth/telemedicine options for OUD at an increased level, and 23.8% (95% CI = 17.8–31.1%) and 10.0% (95% CI = 5.7–16.7%) reported doing the same for naloxone distribution and medications for opioid use disorder (MOUD), respectively. More harm reduction services were continued at the same versus at a reduced level. Service continuation differed little between rural-urban LHDs or by region. Conclusions: The impacts of COVID-19 on OUD service availability in LHD jurisdictions may depend on the specific area of opioid response while the long-term consequences of these changes remain unknown.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"993 - 998"},"PeriodicalIF":3.5,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46428573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-18DOI: 10.1080/08897077.2022.2060430
Rachel E. Barenie, Brian L. Winbigler, R. Heidel, James S. Wheeler
Background: Opioid use disorder affects millions of Americans, but only a fraction receive treatment. This may be due in part to inaccurate information available about buprenorphine waivered practitioners (waivered practitioners) and Opioid Treatment Programs (OTPs) on public, federally-sponsored locator databases. We aimed to assess the accuracy of publicly-listed locator information for waivered practitioners and OTPs across the US. Methods: Using a cross-sectional study design, we randomly sampled waivered practitioners (n = 253; 0.5%) and licensed OTPs (n = 165; 10%) that were publicly-listed on a federally-sponsored database. We used a three-pronged approach to assess the accuracy of the information available by concurrently administering a phone survey (making up to 3 attempts to contact), conducting online searches, and reviewing provider information on state board websites (practitioners only) between August and November 2020. We used descriptive analyses and inferential statitistics to analyze the data. Results: Among n = 418 waivered practitioners and OTPs sampled, many were located in the South and in an urban area. For the phone survey, researchers were able to reach OTPs nearly twice as often as waivered practitioners. Of those reached, n = 19 waivered practitioners and n = 40 OTPs agreed to participate, and we found most had up-to-date contact information. OTPs yielded significantly more online search results and matching contact information than waivered practitioners (p < 0.001). Most waivered practitioners were located on state licensing board websites, but few had contact information listed, and only one listed the practitioner's waiver status. Conclusions: Waivered practitioners and OTPs were difficult to reach via phone but easier to find online and on state licensing board websites; when they were reached via phone, their contact information was very accurate. Whether challenges locating a waivered practitioner or OTP is associated with lower treatment utilization should be evaluated.
{"title":"Accuracy of Publicly-Listed Locator Information for Buprenorphine Waivered Practitioners and Opioid Treatment Programs in the Us, 2020","authors":"Rachel E. Barenie, Brian L. Winbigler, R. Heidel, James S. Wheeler","doi":"10.1080/08897077.2022.2060430","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060430","url":null,"abstract":"Background: Opioid use disorder affects millions of Americans, but only a fraction receive treatment. This may be due in part to inaccurate information available about buprenorphine waivered practitioners (waivered practitioners) and Opioid Treatment Programs (OTPs) on public, federally-sponsored locator databases. We aimed to assess the accuracy of publicly-listed locator information for waivered practitioners and OTPs across the US. Methods: Using a cross-sectional study design, we randomly sampled waivered practitioners (n = 253; 0.5%) and licensed OTPs (n = 165; 10%) that were publicly-listed on a federally-sponsored database. We used a three-pronged approach to assess the accuracy of the information available by concurrently administering a phone survey (making up to 3 attempts to contact), conducting online searches, and reviewing provider information on state board websites (practitioners only) between August and November 2020. We used descriptive analyses and inferential statitistics to analyze the data. Results: Among n = 418 waivered practitioners and OTPs sampled, many were located in the South and in an urban area. For the phone survey, researchers were able to reach OTPs nearly twice as often as waivered practitioners. Of those reached, n = 19 waivered practitioners and n = 40 OTPs agreed to participate, and we found most had up-to-date contact information. OTPs yielded significantly more online search results and matching contact information than waivered practitioners (p < 0.001). Most waivered practitioners were located on state licensing board websites, but few had contact information listed, and only one listed the practitioner's waiver status. Conclusions: Waivered practitioners and OTPs were difficult to reach via phone but easier to find online and on state licensing board websites; when they were reached via phone, their contact information was very accurate. Whether challenges locating a waivered practitioner or OTP is associated with lower treatment utilization should be evaluated.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"999 - 1003"},"PeriodicalIF":3.5,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45004968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-18DOI: 10.1080/08897077.2022.2060436
D. Lardier, Kristen Gilmore Powell, N. Peterson, Suzanne Borys, Donald K. Hallcom
Background: Epidemiological research has indicated higher polysubstance use among individuals who misuse opioids in the United States. Polysubstance use is also associated with multiple emergency department (ED) engagements in intervention services. Less is known about polysubstance use among individuals who use opioids or were engaged in an ED setting as part of an opioid recovery intervention program. Examining emerging patterns of polysubstance use among individuals who use opioids may help shape policy and practice around developing drug markets and social norms. The objective of this study was to understand subpopulations who demonstrated distinct patterns of polysubstance use among participants in an ED Opioid Overdose Recovery Program (OORP) in New Jersey. Method: This study investigated patterns of polysubstance use among participants in a New Jersey OORP using latent class analysis (LCA; N = 1690; 70.2% male; 84.7% White non-Hispanic; meanage = 35.72 ± 11.95). Multinomial logistic regression analyses examined latent class (LC) membership based on clinically relevant indicators. Results: Five latent classes were identified (Model fit: L2 = 33.76, BIC = 4482.69, AIC = 4245.01, and the bootstrap L2p-value =0.27; standard R2 value of 0.85). Multinomial logistic regression analyses showed that subgroups with the greatest odds of prior OORP engagement related to those participants in subgroups with heroin and polysubstance use. Conclusion: It is critical to examine the heterogeneity among people engaging in prescription opioid use and polysubstance use in the United States. This study represents an important contribution in identifying polysubstance use LC membership groups and associations with clinically relevant indicators among those engaged in an opioid recovery program. Results can be valuable in understanding the nature of the larger epidemic and how it can be addressed.
{"title":"Polysubstance Use Latent Class Membership in New Jersey: Association with Prior Overdoses, Prior Emergency Department Peer Recovery Engagement, and Mental Health Diagnosis among Participants in An Opioid Overdose Recovery Program","authors":"D. Lardier, Kristen Gilmore Powell, N. Peterson, Suzanne Borys, Donald K. Hallcom","doi":"10.1080/08897077.2022.2060436","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060436","url":null,"abstract":"Background: Epidemiological research has indicated higher polysubstance use among individuals who misuse opioids in the United States. Polysubstance use is also associated with multiple emergency department (ED) engagements in intervention services. Less is known about polysubstance use among individuals who use opioids or were engaged in an ED setting as part of an opioid recovery intervention program. Examining emerging patterns of polysubstance use among individuals who use opioids may help shape policy and practice around developing drug markets and social norms. The objective of this study was to understand subpopulations who demonstrated distinct patterns of polysubstance use among participants in an ED Opioid Overdose Recovery Program (OORP) in New Jersey. Method: This study investigated patterns of polysubstance use among participants in a New Jersey OORP using latent class analysis (LCA; N = 1690; 70.2% male; 84.7% White non-Hispanic; meanage = 35.72 ± 11.95). Multinomial logistic regression analyses examined latent class (LC) membership based on clinically relevant indicators. Results: Five latent classes were identified (Model fit: L2 = 33.76, BIC = 4482.69, AIC = 4245.01, and the bootstrap L2p-value =0.27; standard R2 value of 0.85). Multinomial logistic regression analyses showed that subgroups with the greatest odds of prior OORP engagement related to those participants in subgroups with heroin and polysubstance use. Conclusion: It is critical to examine the heterogeneity among people engaging in prescription opioid use and polysubstance use in the United States. This study represents an important contribution in identifying polysubstance use LC membership groups and associations with clinically relevant indicators among those engaged in an opioid recovery program. Results can be valuable in understanding the nature of the larger epidemic and how it can be addressed.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"1011 - 1022"},"PeriodicalIF":3.5,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49251370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-18DOI: 10.1080/08897077.2022.2060426
Terence M. Hughes, Alexander V Kalicki, Zina Huxley-Reicher, Wilma Toribio, Don L Samuels, J. Weiss, Michael Herscher, Linda Wang
Background: The co-occurrence of the COVID-19 pandemic and opioid epidemic has increased the risk of overdose and death for patients with opioid use disorder (OUD). COVID-19 has also exacerbated already limited access to opioid overdose education and naloxone distribution (OEND). In this context, we aim to increase access to OEND for patients at risk for opioid overdose. Methods: Medical student volunteers were trained to conduct telephone-based OEND, and subsequently contacted all patients at a NYC primary care clinic for people who use drugs as well as those presenting to the hospital with OUD or a history of opioid overdose. Interested patients who completed the training received naloxone kits via mail or at hospital discharge. Results: OEND provision was converted to a remote-only model from May to June 2020. During this time, eight pre-clinical medical students called a total of 503 high-risk patients. Of these patients, 165 were reached, with 90 (55%) accepting telephone-based OEND. Comparing across populations, 51% of primary care patients versus 76% of ED/hospitalized patients accepted opioid overdose education. Eighty-four total patients received naloxone. Conclusions: We have outlined a scalable, adaptable model by which clinics and hospitals with affiliated medical schools can provide OEND by telephone. Medical student-driven, telephone-based OEND efforts can effectively reach at-risk patients and increase naloxone access.
{"title":"A Medical Student-Led Model for Telephone-Based Opioid Overdose Education and Naloxone Distribution during the Covid-19 Pandemic","authors":"Terence M. Hughes, Alexander V Kalicki, Zina Huxley-Reicher, Wilma Toribio, Don L Samuels, J. Weiss, Michael Herscher, Linda Wang","doi":"10.1080/08897077.2022.2060426","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060426","url":null,"abstract":"Background: The co-occurrence of the COVID-19 pandemic and opioid epidemic has increased the risk of overdose and death for patients with opioid use disorder (OUD). COVID-19 has also exacerbated already limited access to opioid overdose education and naloxone distribution (OEND). In this context, we aim to increase access to OEND for patients at risk for opioid overdose. Methods: Medical student volunteers were trained to conduct telephone-based OEND, and subsequently contacted all patients at a NYC primary care clinic for people who use drugs as well as those presenting to the hospital with OUD or a history of opioid overdose. Interested patients who completed the training received naloxone kits via mail or at hospital discharge. Results: OEND provision was converted to a remote-only model from May to June 2020. During this time, eight pre-clinical medical students called a total of 503 high-risk patients. Of these patients, 165 were reached, with 90 (55%) accepting telephone-based OEND. Comparing across populations, 51% of primary care patients versus 76% of ED/hospitalized patients accepted opioid overdose education. Eighty-four total patients received naloxone. Conclusions: We have outlined a scalable, adaptable model by which clinics and hospitals with affiliated medical schools can provide OEND by telephone. Medical student-driven, telephone-based OEND efforts can effectively reach at-risk patients and increase naloxone access.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"988 - 992"},"PeriodicalIF":3.5,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48042126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-18DOI: 10.1080/08897077.2022.2060449
Amy Werremeyer, M. Strand, Heidi N. Eukel, Elizabeth Skoy, J. Steig, Oliver C. Frenzel
Background: Pharmacist stigma via examination of social distance preference and negative attitudes toward persons who misuse opioids is prevalent and may lower the quality of care provided to patients. Few studies have previously extended beyond the immediate post-intervention period to examine stigma change. Methods: This longitudinal cohort study utilized a pre-survey administered before the training program, a post-survey immediately upon completion of the training program, and a delayed post-survey, administered 12 months after the training program. Co-primary outcomes were changes in social distance scale (SDS) total score from baseline to post-survey and from baseline to 12 months. Secondary outcomes included change in SDS question scores and change in negative attitudes. One hundred eighty-seven of the 1211 eligible pharmacists in the state completed the training. Matched responses of forty-four pharmacists who completed all three surveys were examined. Results: The mean total SDS score was significantly lower in the immediate post-training survey than the pre-training mean (14.75 vs. 16.57, p = .000). The 12 months mean total SDS score was also significantly lower than the pre-training mean (15.32 vs. 16.57, p = .017). Significant changes in negative attitudes from baseline to post-survey and from baseline to 12 months were seen. Conclusion: Stigma reduction components integrated into opioid training decreased pharmacist social distance preference and negative attitudes toward patients who misuse opioids immediately after the training and, most notably, were sustained for 12 months.
{"title":"Longitudinal Evaluation of Pharmacists’ Social Distance Preference and Attitudes toward Patients with Opioid Misuse following An Educational Training Program","authors":"Amy Werremeyer, M. Strand, Heidi N. Eukel, Elizabeth Skoy, J. Steig, Oliver C. Frenzel","doi":"10.1080/08897077.2022.2060449","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060449","url":null,"abstract":"Background: Pharmacist stigma via examination of social distance preference and negative attitudes toward persons who misuse opioids is prevalent and may lower the quality of care provided to patients. Few studies have previously extended beyond the immediate post-intervention period to examine stigma change. Methods: This longitudinal cohort study utilized a pre-survey administered before the training program, a post-survey immediately upon completion of the training program, and a delayed post-survey, administered 12 months after the training program. Co-primary outcomes were changes in social distance scale (SDS) total score from baseline to post-survey and from baseline to 12 months. Secondary outcomes included change in SDS question scores and change in negative attitudes. One hundred eighty-seven of the 1211 eligible pharmacists in the state completed the training. Matched responses of forty-four pharmacists who completed all three surveys were examined. Results: The mean total SDS score was significantly lower in the immediate post-training survey than the pre-training mean (14.75 vs. 16.57, p = .000). The 12 months mean total SDS score was also significantly lower than the pre-training mean (15.32 vs. 16.57, p = .017). Significant changes in negative attitudes from baseline to post-survey and from baseline to 12 months were seen. Conclusion: Stigma reduction components integrated into opioid training decreased pharmacist social distance preference and negative attitudes toward patients who misuse opioids immediately after the training and, most notably, were sustained for 12 months.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"1051 - 1056"},"PeriodicalIF":3.5,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47870979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-14DOI: 10.1080/08897077.2022.2060425
Y. Maricich, E. Nunes, A. Campbell, J. Botbyl, Hilary F Luderer
Background: Traditional treatments for substance use disorders (SUDs) rely heavily on face-to-face interactions, which pose substantial limitations for patients. A clinical trial of a digital therapeutic (DT), delivering behavioral therapy demonstrated safety and efficacy in a population including patients with opioid use disorder (OUD) not treated with buprenorphine, which is not a guideline-recommended approach. This study re-analyzed the data excluding patients with OUD to more closely approximate real-world patient populations. Methods: Secondary analysis of patients with substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (n = 399, patients with OUD excluded) from a previously-published randomized controlled trial. Patients received 12-weeks of outpatient treatment-as-usual (TAU; n = 193) or TAU with reduced counseling plus a DT (n = 206) providing computerized cognitive behavioral therapy and contingency management. Primary outcomes were abstinence in weeks 9–12 and retention in treatment. Results: The 399 patients in this analysis (206 in the DT group and 193 in the TAU group) reported substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (e.g., methamphetamines). Demographic and baseline characteristics including age, sex, race, education, and reported primary substance use disorder were balanced between treatment groups. Abstinence was significantly higher in the DT group compared to TAU (40.3 vs. 17.6%; p < 0.001) as was retention in therapy (76.2 vs. 63.2%, p = 0.004). Intergroup adverse event rates were not significantly different (p = 0.68). Conclusions: The results demonstrate that use of a DT safely increased abstinence (reduced substance use) and retention in treatment among patients with substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (including methamphetamines).
{"title":"Safety and Efficacy of A Digital Therapeutic for Substance Use Disorder: Secondary Analysis of Data from A Nida Clinical Trials Network Study","authors":"Y. Maricich, E. Nunes, A. Campbell, J. Botbyl, Hilary F Luderer","doi":"10.1080/08897077.2022.2060425","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060425","url":null,"abstract":"Background: Traditional treatments for substance use disorders (SUDs) rely heavily on face-to-face interactions, which pose substantial limitations for patients. A clinical trial of a digital therapeutic (DT), delivering behavioral therapy demonstrated safety and efficacy in a population including patients with opioid use disorder (OUD) not treated with buprenorphine, which is not a guideline-recommended approach. This study re-analyzed the data excluding patients with OUD to more closely approximate real-world patient populations. Methods: Secondary analysis of patients with substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (n = 399, patients with OUD excluded) from a previously-published randomized controlled trial. Patients received 12-weeks of outpatient treatment-as-usual (TAU; n = 193) or TAU with reduced counseling plus a DT (n = 206) providing computerized cognitive behavioral therapy and contingency management. Primary outcomes were abstinence in weeks 9–12 and retention in treatment. Results: The 399 patients in this analysis (206 in the DT group and 193 in the TAU group) reported substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (e.g., methamphetamines). Demographic and baseline characteristics including age, sex, race, education, and reported primary substance use disorder were balanced between treatment groups. Abstinence was significantly higher in the DT group compared to TAU (40.3 vs. 17.6%; p < 0.001) as was retention in therapy (76.2 vs. 63.2%, p = 0.004). Intergroup adverse event rates were not significantly different (p = 0.68). Conclusions: The results demonstrate that use of a DT safely increased abstinence (reduced substance use) and retention in treatment among patients with substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (including methamphetamines).","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"937 - 942"},"PeriodicalIF":3.5,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41820912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-14DOI: 10.1080/08897077.2022.2060437
S. Lines, Aliya Marroquin, Steve Corbett, Julie Sergeant, Won Choi, B. Faseru
Background: In the U.S., excessive drinking accounts for one in 10 deaths among adults aged 20–64 years old. Binge drinking is a common form of excessive alcohol consumption that contributes to this chilling statistic. Binge drinking is defined as women consuming four or more drinks or men consuming five or more drinks within a 2-h time span. Examining existing data on risk factors for binge drinking can inform strategies to prevent this deadly practice. Methods: The 2019 Kansas Behavioral Risk Factor Surveillance System (BRFSS) dataset consists of data collected from 11,368 non-institutionalized adults aged 18 years and older with landline or cell phones. The dependent variable in this study was binge drinking status. The independent variables included several sociodemographic variables and risk factors. Data were analyzed using descriptive statistics, bivariate analysis, single logistic regression, and multivariable logistic regression. Results: In the population, 1,447 (17.4%) were reported to be binge drinkers. Significant factors associated with binge drinking in the final model included sex (aOR = 0.53 (0.45–0.63)), age (18–24 years old aOR = 8.77 (6.02–12.79); 25–34 years old aOR = 7.10 (5.35–9.42); 35–44 years old aOR = 6.23 (4.73–8.19); 45–54 years old aOR = 3.87 (2.92–5.14); and 55–64 years old aOR = 2.58 (1.96–3.38)), income ($15,000–$24,999 aOR = 1.00 (0.63–1.58); $25,000–$34,999 aOR = 1.61 (1.04–2.50); $35,000-$49,999 aOR = 1.69 (1.13–2.55); ≥$50,000 aOR = 1.97 (1.34–2.89)), smokeless tobacco use (aOR = 2.09 (1.55–2.82)), and smoking/e-cigarette use (Cigarette user only aOR = 2.11 (1.69–2.65); E-cigarette user only aOR = 2.67 (1.62–3.17); dual cigarette and e-cigarette user = 3.43 (2.21–5.33)). Conclusion: Developing interventions that take into account elevated risk for binge drinking amongst demographic characteristics (i.e., age, sex, income) and lifestyle factors (i.e., smokeless tobacco use, and smoking/e-cigarette use) is crucial to lowering morbidity and mortality related to this form of excessive alcohol consumption.
{"title":"Factors Associated with Binge Drinking—Findings from 2019 Kansas Behavioral Risk Factor Surveillance System","authors":"S. Lines, Aliya Marroquin, Steve Corbett, Julie Sergeant, Won Choi, B. Faseru","doi":"10.1080/08897077.2022.2060437","DOIUrl":"https://doi.org/10.1080/08897077.2022.2060437","url":null,"abstract":"Background: In the U.S., excessive drinking accounts for one in 10 deaths among adults aged 20–64 years old. Binge drinking is a common form of excessive alcohol consumption that contributes to this chilling statistic. Binge drinking is defined as women consuming four or more drinks or men consuming five or more drinks within a 2-h time span. Examining existing data on risk factors for binge drinking can inform strategies to prevent this deadly practice. Methods: The 2019 Kansas Behavioral Risk Factor Surveillance System (BRFSS) dataset consists of data collected from 11,368 non-institutionalized adults aged 18 years and older with landline or cell phones. The dependent variable in this study was binge drinking status. The independent variables included several sociodemographic variables and risk factors. Data were analyzed using descriptive statistics, bivariate analysis, single logistic regression, and multivariable logistic regression. Results: In the population, 1,447 (17.4%) were reported to be binge drinkers. Significant factors associated with binge drinking in the final model included sex (aOR = 0.53 (0.45–0.63)), age (18–24 years old aOR = 8.77 (6.02–12.79); 25–34 years old aOR = 7.10 (5.35–9.42); 35–44 years old aOR = 6.23 (4.73–8.19); 45–54 years old aOR = 3.87 (2.92–5.14); and 55–64 years old aOR = 2.58 (1.96–3.38)), income ($15,000–$24,999 aOR = 1.00 (0.63–1.58); $25,000–$34,999 aOR = 1.61 (1.04–2.50); $35,000-$49,999 aOR = 1.69 (1.13–2.55); ≥$50,000 aOR = 1.97 (1.34–2.89)), smokeless tobacco use (aOR = 2.09 (1.55–2.82)), and smoking/e-cigarette use (Cigarette user only aOR = 2.11 (1.69–2.65); E-cigarette user only aOR = 2.67 (1.62–3.17); dual cigarette and e-cigarette user = 3.43 (2.21–5.33)). Conclusion: Developing interventions that take into account elevated risk for binge drinking amongst demographic characteristics (i.e., age, sex, income) and lifestyle factors (i.e., smokeless tobacco use, and smoking/e-cigarette use) is crucial to lowering morbidity and mortality related to this form of excessive alcohol consumption.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"949 - 955"},"PeriodicalIF":3.5,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48130658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.1080/08897077.2022.2056934
K. Robinson, J. Marwaha, Chris J. Kennedy, B. Beaulieu-Jones, A. Fleishman, Justin Yu, L. Nathanson, G. Brat
Background:Since 2017, states, insurers, and pharmacies have placed blanket limits on the duration and quantity of opioid prescriptions. In many states, overlapping duration and daily dose limits yield maximum prescription limits of 150–350 morphine milligram equivalents (MMEs). There is limited knowledge of how these restrictions compare with actual patient opioid consumption; while changes in prescription patterns and opioid misuse rates have been studied, these are, at best, weak proxies for actual pain control consumption. We sought to determine how patients undergoing surgery would be affected by opioid prescribing restrictions using actual patient opioid consumption data. Methods: We constructed a prospective database of post-discharge opioid consumption: patients undergoing surgery at one institution were called after discharge to collect opioid consumption data. Patients whose opioid consumption exceeded 150 and 350 MME were identified. Results: Two thousand nine hundred and seventy-one patients undergoing 54 common surgical procedures were included in our study. Twenty-one percent of patients consumed more than the 150 MME limit. Only 7% of patients consumed above the 350 MME limit. Typical (non-outlier) opioid consumption, defined as less than the 75th percentile of consumption for any given procedure, exceeded the 150 MME and 350 MME limits for 41 and 7% of procedures, respectively. Orthopedic, spinal/neurosurgical, and complex abdominal procedures most commonly exceeded these limits. Conclusions: While most patients undergoing surgery are unaffected by recent blanket prescribing limits, those undergoing a specific subset of procedures are likely to require more opioids than the restrictions permit; providers should be aware that these patients may require a refill to adequately control post-surgical pain. Real consumption data should be used to guide these restrictions and inform future interventions so the risk of worsened pain control (and its troublesome effects on opioid misuse) is minimized. Procedure-specific prescribing limits may be one approach to prevent misuse, while also optimizing post-operative pain control.
{"title":"Evaluation of U.S. State Opioid Prescribing Restrictions Using Patient Opioid Consumption Patterns from A Single, Urban, Academic Institution","authors":"K. Robinson, J. Marwaha, Chris J. Kennedy, B. Beaulieu-Jones, A. Fleishman, Justin Yu, L. Nathanson, G. Brat","doi":"10.1080/08897077.2022.2056934","DOIUrl":"https://doi.org/10.1080/08897077.2022.2056934","url":null,"abstract":"Background:Since 2017, states, insurers, and pharmacies have placed blanket limits on the duration and quantity of opioid prescriptions. In many states, overlapping duration and daily dose limits yield maximum prescription limits of 150–350 morphine milligram equivalents (MMEs). There is limited knowledge of how these restrictions compare with actual patient opioid consumption; while changes in prescription patterns and opioid misuse rates have been studied, these are, at best, weak proxies for actual pain control consumption. We sought to determine how patients undergoing surgery would be affected by opioid prescribing restrictions using actual patient opioid consumption data. Methods: We constructed a prospective database of post-discharge opioid consumption: patients undergoing surgery at one institution were called after discharge to collect opioid consumption data. Patients whose opioid consumption exceeded 150 and 350 MME were identified. Results: Two thousand nine hundred and seventy-one patients undergoing 54 common surgical procedures were included in our study. Twenty-one percent of patients consumed more than the 150 MME limit. Only 7% of patients consumed above the 350 MME limit. Typical (non-outlier) opioid consumption, defined as less than the 75th percentile of consumption for any given procedure, exceeded the 150 MME and 350 MME limits for 41 and 7% of procedures, respectively. Orthopedic, spinal/neurosurgical, and complex abdominal procedures most commonly exceeded these limits. Conclusions: While most patients undergoing surgery are unaffected by recent blanket prescribing limits, those undergoing a specific subset of procedures are likely to require more opioids than the restrictions permit; providers should be aware that these patients may require a refill to adequately control post-surgical pain. Real consumption data should be used to guide these restrictions and inform future interventions so the risk of worsened pain control (and its troublesome effects on opioid misuse) is minimized. Procedure-specific prescribing limits may be one approach to prevent misuse, while also optimizing post-operative pain control.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"932 - 936"},"PeriodicalIF":3.5,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42143256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Successful implementation of group-based appointments can increase capacity to treat patients, reduce costs, and improve productivity. We sought to understand the acceptability of group-based appointments for opioid use disorder (OUD) in an urban clinical setting that treats predominantly ethnic minority populations. Methods: A survey collecting data on demographics, substance use, co-morbid psychiatric conditions, and satisfaction with group-based opioid treatment (GBOT) was conducted among patients 18 years and older with OUD attending an urban buprenorphine clinic between December 2019 and February 2020. Results: Thirty-nine patient surveys were completed. Among participants, 64.1% identified as Black/African American and 76.9% identified as male. The mean age was 51.2 years. Participants reported overall high levels of satisfaction with group-based appointments though GBOT was not strongly preferred over individual visits. On a 5-point Likert scale, 69.2% of participants agreed or strongly agreed that their medical needs were met during group-based appointments. A majority of participants agreed or strongly agreed that medical information received from the clinical team (97.4%) and other patients (82.1%) were valuable. Most participants (82.1%) reported adherence to treatment plans became easier since attending GBOT. Age and self-identified employment status as disabled or retired were positively associated with total satisfaction scores. Conclusions: Patients in a predominantly Black/African American and Hispanic/Latinx community with co-occurring mental health disorders and other substance use reported overall satisfaction with GBOT and would recommend this modality to other patients.
{"title":"Satisfaction with Group-Based Appointments among Patients with Opioid Use Disorder in An Urban Buprenorphine Clinic","authors":"Serra Akyar, Amesika N. Nyaku, Kristyn Lao, Stephanie Ruthberg, Erin Zerbo","doi":"10.1080/08897077.2021.2010258","DOIUrl":"https://doi.org/10.1080/08897077.2021.2010258","url":null,"abstract":"Background: Successful implementation of group-based appointments can increase capacity to treat patients, reduce costs, and improve productivity. We sought to understand the acceptability of group-based appointments for opioid use disorder (OUD) in an urban clinical setting that treats predominantly ethnic minority populations. Methods: A survey collecting data on demographics, substance use, co-morbid psychiatric conditions, and satisfaction with group-based opioid treatment (GBOT) was conducted among patients 18 years and older with OUD attending an urban buprenorphine clinic between December 2019 and February 2020. Results: Thirty-nine patient surveys were completed. Among participants, 64.1% identified as Black/African American and 76.9% identified as male. The mean age was 51.2 years. Participants reported overall high levels of satisfaction with group-based appointments though GBOT was not strongly preferred over individual visits. On a 5-point Likert scale, 69.2% of participants agreed or strongly agreed that their medical needs were met during group-based appointments. A majority of participants agreed or strongly agreed that medical information received from the clinical team (97.4%) and other patients (82.1%) were valuable. Most participants (82.1%) reported adherence to treatment plans became easier since attending GBOT. Age and self-identified employment status as disabled or retired were positively associated with total satisfaction scores. Conclusions: Patients in a predominantly Black/African American and Hispanic/Latinx community with co-occurring mental health disorders and other substance use reported overall satisfaction with GBOT and would recommend this modality to other patients.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"913 - 916"},"PeriodicalIF":3.5,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48497017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-28DOI: 10.1080/08897077.2021.2010261
M. Hartwell, Nicholas B. Sajjadi, Samuel Shepard, John Whelan, Jamie N. Roberts, A. Ford, J. Beaman, M. Vassar
Objective:With approximately 15 million individuals in the United States meeting criteria for Alcohol Use Disorder (AUD), advancing effective medication-assisted treatment options is crucial. This advancement stems from the publication of clinical trial (CT) results. The primary objective of this study was to assess the rates of discontinuation and non-publication of results in CTs focused on the pharmacologic treatment of AUD and to assess associated factors. Design: A cross-sectional study was completed after acquiring trials focused on AUD within the ClinicalTrials.gov database. Inclusion criteria for CTs were the use of a pharmaceutical intervention with an outcome measure of alcohol intake or craving, conducted between October 2008 through September 2018. The primary outcome measures were the frequency of trial discontinuation and non-publication. Discontinuation was assessed as the listed status on ClinicalTrials.gov. Publications were identified through verification of listings on ClinicalTrials.gov, or via searches of PubMed, Embase, and Google Scholar. If publications were not found, correspondence to trial contacts were sent. Data analysis occurred on December 5th, 2020. Results: Of 235 trials returned from the search, 87 met inclusion criteria. Our study found that 12.6% (11) of CTs involving pharmaceutical treatments for AUD were prematurely terminated, and 39.1% (34) had no published results. Recruitment and lower cutoff of targeted age groups were significantly associated with discontinuation and non-publication, respectively. Conclusions: Scientific evidence advances faster when all results are known—furthering the progress of positive studies, while avoiding duplicative efforts to test the same hypotheses with the same methods, thereby reducing scientific waste. Given the number of unpublished AUD trials, potentially useful information regarding treatment for individuals with AUD may be inaccessible to clinicians while also adding to the abundance of research waste. Key points Question: What are the rates of discontinuation or non-publication of clinical trials for pharmacological treatments for AUD and associated factors? Findings: Among 87 trials, 11 (12.6%) were prematurely terminated and 34 (39.1%) did not reach publication, with trials that included participants 21 years and older more likely to reach publication than those with younger participants. Meaning: Low publication rates of CTs for pharmacological treatments of AUD may (1) stunt the advancement of AUD research, (2) decrease the value in funding AUD research from government entities, and (3) needlessly expose participants to potentially harmful interventions.
{"title":"Rates of Discontinuation and Non-Publication of Trials for the Pharmacologic Treatment of Alcohol Use Disorder","authors":"M. Hartwell, Nicholas B. Sajjadi, Samuel Shepard, John Whelan, Jamie N. Roberts, A. Ford, J. Beaman, M. Vassar","doi":"10.1080/08897077.2021.2010261","DOIUrl":"https://doi.org/10.1080/08897077.2021.2010261","url":null,"abstract":"Objective:With approximately 15 million individuals in the United States meeting criteria for Alcohol Use Disorder (AUD), advancing effective medication-assisted treatment options is crucial. This advancement stems from the publication of clinical trial (CT) results. The primary objective of this study was to assess the rates of discontinuation and non-publication of results in CTs focused on the pharmacologic treatment of AUD and to assess associated factors. Design: A cross-sectional study was completed after acquiring trials focused on AUD within the ClinicalTrials.gov database. Inclusion criteria for CTs were the use of a pharmaceutical intervention with an outcome measure of alcohol intake or craving, conducted between October 2008 through September 2018. The primary outcome measures were the frequency of trial discontinuation and non-publication. Discontinuation was assessed as the listed status on ClinicalTrials.gov. Publications were identified through verification of listings on ClinicalTrials.gov, or via searches of PubMed, Embase, and Google Scholar. If publications were not found, correspondence to trial contacts were sent. Data analysis occurred on December 5th, 2020. Results: Of 235 trials returned from the search, 87 met inclusion criteria. Our study found that 12.6% (11) of CTs involving pharmaceutical treatments for AUD were prematurely terminated, and 39.1% (34) had no published results. Recruitment and lower cutoff of targeted age groups were significantly associated with discontinuation and non-publication, respectively. Conclusions: Scientific evidence advances faster when all results are known—furthering the progress of positive studies, while avoiding duplicative efforts to test the same hypotheses with the same methods, thereby reducing scientific waste. Given the number of unpublished AUD trials, potentially useful information regarding treatment for individuals with AUD may be inaccessible to clinicians while also adding to the abundance of research waste. Key points Question: What are the rates of discontinuation or non-publication of clinical trials for pharmacological treatments for AUD and associated factors? Findings: Among 87 trials, 11 (12.6%) were prematurely terminated and 34 (39.1%) did not reach publication, with trials that included participants 21 years and older more likely to reach publication than those with younger participants. Meaning: Low publication rates of CTs for pharmacological treatments of AUD may (1) stunt the advancement of AUD research, (2) decrease the value in funding AUD research from government entities, and (3) needlessly expose participants to potentially harmful interventions.","PeriodicalId":22108,"journal":{"name":"Substance abuse","volume":"43 1","pages":"906 - 912"},"PeriodicalIF":3.5,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47659542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：