Pub Date : 2022-01-01DOI: 10.1177/11782218221138335
Tabitha E Moses, Gary L Rhodes, Emytis Tavakoli, Carl W Christensen, Alireza Amirsadri, Mark K Greenwald
Background: Many patients in methadone treatment have difficulty achieving or maintaining drug abstinence, and many clinics have policies that lead to discharging these patients. We designed a pilot "Second Chance" (SC) program for patients scheduled to be discharged from other local methadone clinics to be transferred to our clinic.
Aim: Determine whether SC patients' retention and opioid use is related to physical or mental health conditions, non-opioid substance use, or treatment features.
Methods: From December 2012 to December 2014, this program enrolled 70 patients who were discharged from other clinics in the area; we were their last remaining option for methadone treatment. Unlike the clinic's standard policies, the treatment focus for SC patients was retention rather than abstinence. This program focused on connection to care (eg, psychiatric services) and enabled patients to continue receiving services despite ongoing substance use. Each patient was assessed at treatment entry and followed until June 2016 to evaluate outcomes.
Results: SC patients receiving disability benefits (n = 37) vs. non-disabled (n = 33) had significantly (P < .05) higher rates of current DSM-IV Axis I psychiatric diagnosis (97% vs 70%), prescriptions for opioids (84% vs 55%) and benzodiazepines (65% vs 27%), and higher methadone doses at admission (58 vs 46 mg) but did not differ significantly in rates of 6-month or 1-year retention (77% and 56%, respectively) or all-drug use (39% positive urine drug screens). Methadone doses >65 mg predicted significantly longer retention and less opioid use, but these effects were not moderated by baseline characteristics.
Conclusions: Patients in methadone treatment struggling to achieve abstinence may benefit from retention-oriented harm-reduction programs. Higher methadone doses can improve retention and opioid abstinence despite psychiatric comorbidities. Further work is needed to improve program implementation and outcomes in this complex population.
{"title":"Predictors of Retention and Drug Use Among Patients With Opioid Use Disorder Transferred to a Specialty \"Second Chance\" Methadone Program.","authors":"Tabitha E Moses, Gary L Rhodes, Emytis Tavakoli, Carl W Christensen, Alireza Amirsadri, Mark K Greenwald","doi":"10.1177/11782218221138335","DOIUrl":"https://doi.org/10.1177/11782218221138335","url":null,"abstract":"<p><strong>Background: </strong>Many patients in methadone treatment have difficulty achieving or maintaining drug abstinence, and many clinics have policies that lead to discharging these patients. We designed a pilot \"Second Chance\" (SC) program for patients scheduled to be discharged from other local methadone clinics to be transferred to our clinic.</p><p><strong>Aim: </strong>Determine whether SC patients' retention and opioid use is related to physical or mental health conditions, non-opioid substance use, or treatment features.</p><p><strong>Methods: </strong>From December 2012 to December 2014, this program enrolled 70 patients who were discharged from other clinics in the area; we were their last remaining option for methadone treatment. Unlike the clinic's standard policies, the treatment focus for SC patients was retention rather than abstinence. This program focused on connection to care (eg, psychiatric services) and enabled patients to continue receiving services despite ongoing substance use. Each patient was assessed at treatment entry and followed until June 2016 to evaluate outcomes.</p><p><strong>Results: </strong>SC patients receiving disability benefits (n = 37) vs. non-disabled (n = 33) had significantly (<i>P</i> < .05) higher rates of current DSM-IV Axis I psychiatric diagnosis (97% vs 70%), prescriptions for opioids (84% vs 55%) and benzodiazepines (65% vs 27%), and higher methadone doses at admission (58 vs 46 mg) but did not differ significantly in rates of 6-month or 1-year retention (77% and 56%, respectively) or all-drug use (39% positive urine drug screens). Methadone doses >65 mg predicted significantly longer retention and less opioid use, but these effects were not moderated by baseline characteristics.</p><p><strong>Conclusions: </strong>Patients in methadone treatment struggling to achieve abstinence may benefit from retention-oriented harm-reduction programs. Higher methadone doses can improve retention and opioid abstinence despite psychiatric comorbidities. Further work is needed to improve program implementation and outcomes in this complex population.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"16 ","pages":"11782218221138335"},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/54/10.1177_11782218221138335.PMC9669697.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10741726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221088875
Bonnie K Lee, Samuel M Ofori Dei
Purpose: Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants (N = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU).
Method: Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU (n = 17) and CCT (n = 21) were analyzed.
Results: Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran's Q = 5.429, P = .066) or TAU (Cochran's Q = 2.800, P = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group.
Conclusion: Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.
{"title":"Changes in Work Status, Couple Adjustment, and Recovery Capital: Secondary Analysis of Data From a Congruence Couple Therapy Randomized Controlled Trial.","authors":"Bonnie K Lee, Samuel M Ofori Dei","doi":"10.1177/11782218221088875","DOIUrl":"https://doi.org/10.1177/11782218221088875","url":null,"abstract":"<p><strong>Purpose: </strong>Employment and family/social relationships are 2 of the highest priorities among those in substance use recovery. This study examined the relationship of work status with couple adjustment and other recovery capital treatment outcomes among symptomatic alcohol, substance use, and gambling participants (<i>N</i> = 38) using data collected in a randomized trial comparing a systemic Congruence Couple Therapy (CCT) and individual-based Treatment-as-Usual (TAU).</p><p><strong>Method: </strong>Change scores and associations between work status and couple adjustment together with 8 other recovery outcome variables at post-treatment (5 months from baseline) and follow-up (8 months from baseline) in TAU (<i>n</i> = 17) and CCT (<i>n</i> = 21) were analyzed.</p><p><strong>Results: </strong>Number of those working increased with both CCT and TAU but without reaching significance in either CCT (Cochran's <i>Q</i> = 5.429, <i>P</i> = .066) or TAU (Cochran's <i>Q</i> = 2.800, <i>P</i> = .247). Relative to those not working in the combined sample, those working showed significantly improved scores in post-treatment and follow-up in addictive symptoms, couple adjustment, psychiatric symptoms, depression, and life stress. Separating the CCT and TAU groups, similar trend was found in the CCT group but was inconsistent in the TAU group.</p><p><strong>Conclusion: </strong>Significantly greater improvement in addictive symptoms and recovery capital of couple adjustment, mental health, and life stress was found in the working vs not-working group. Compared to individual-based TAU, exploratory findings indicate that the systemic treatment of CCT showed a clearer and more consistent difference in improved working days, addictive symptoms and recovery capital. Replication with larger samples is needed to generalize these results.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"16 ","pages":"11782218221088875"},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/0c/10.1177_11782218221088875.PMC9130820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10252622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221086653
Tran Quang Duc, Le Thi Kim Anh, V. T. Chi, Nguyễn Thị Thu Hương, Phan Ngoc Quang
Background: Second-hand smoking (SHS) is associated with many health problems. However, its prevalence in the community population aged 15 years and older in Vietnam is unknown. Objectives: To quantify the prevalence of SHS in Vietnamese communities aged 15 and above. Methods: This is a meta-analysis that reviewed studies of the prevalence of SHS in Vietnam published in MEDLINE, Scopus, Pubmed and the WHO library database between 1 January 2010 and 31 December 2019. MedCalc was used to perform all the analyses, and publication bias was determined using funnel plots and Egger regression asymmetry tests. Q-test and I2 statistic were used to identify heterogeneity across studies. Results: There were 7 articles that met our inclusion criteria 2 surveys at the national level, 3 Cross-sectional studies and 2 Case-control studies) involving 184 921 participants. According to the meta-analysis, the overall random-effects pooled prevalence of SHS was 54.6% (95% CIs: 44.900-64.154) with a high level of heterogeneity (P = .0001, Q = 2245.60, I2 = 99.73%). It is noteworthy that the pooled prevalence of SHS rose throughout the course of the survey years. Our research found no evidence of publication bias. Conclusions: Vietnam has ratified the implementation the WHO Framework Convention on Tobacco Control (FCTC) in 2004, there are still a large number of people who are adversely impacted by SHS. Given the tremendous cost that SHS imposes on health systems, our results underscore the critical need for the Vietnamese government to expedite an implementation of a set of stronger tobacco control practices, thus reducing the incidence of smoking-related illnesses and fatalities.
{"title":"Second-Hand Smoking Prevalence in Vietnamese Population Aged 15 and older: A Systematic Review and Meta-Analysis","authors":"Tran Quang Duc, Le Thi Kim Anh, V. T. Chi, Nguyễn Thị Thu Hương, Phan Ngoc Quang","doi":"10.1177/11782218221086653","DOIUrl":"https://doi.org/10.1177/11782218221086653","url":null,"abstract":"Background: Second-hand smoking (SHS) is associated with many health problems. However, its prevalence in the community population aged 15 years and older in Vietnam is unknown. Objectives: To quantify the prevalence of SHS in Vietnamese communities aged 15 and above. Methods: This is a meta-analysis that reviewed studies of the prevalence of SHS in Vietnam published in MEDLINE, Scopus, Pubmed and the WHO library database between 1 January 2010 and 31 December 2019. MedCalc was used to perform all the analyses, and publication bias was determined using funnel plots and Egger regression asymmetry tests. Q-test and I2 statistic were used to identify heterogeneity across studies. Results: There were 7 articles that met our inclusion criteria 2 surveys at the national level, 3 Cross-sectional studies and 2 Case-control studies) involving 184 921 participants. According to the meta-analysis, the overall random-effects pooled prevalence of SHS was 54.6% (95% CIs: 44.900-64.154) with a high level of heterogeneity (P = .0001, Q = 2245.60, I2 = 99.73%). It is noteworthy that the pooled prevalence of SHS rose throughout the course of the survey years. Our research found no evidence of publication bias. Conclusions: Vietnam has ratified the implementation the WHO Framework Convention on Tobacco Control (FCTC) in 2004, there are still a large number of people who are adversely impacted by SHS. Given the tremendous cost that SHS imposes on health systems, our results underscore the critical need for the Vietnamese government to expedite an implementation of a set of stronger tobacco control practices, thus reducing the incidence of smoking-related illnesses and fatalities.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48341685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221097390
C. De Kock
Despite mounting evidence of disparities in health service provision for migrants and ethnic minorities (MEM) across EU countries, there has been limited research into how services (meso) and policy (macro) can contribute to reducing these disparities. In Flemish (Belgian) substance use treatment (SUT) policy making, no systematic attention is given to MEM. Nevertheless, preliminary studies have identified some disparities, especially among non-Belgian MEM. For this paper we studied the factors related to these disparities and ways forward based on 21 semi-structured interviews with SUT coordinators and experts. The low representation of MEM populations in psychiatric hospitals due to language exclusion criteria stands out as the main disparity. Moreover, respondents indicated that exclusion may be anticipated by general practitioners in the referral process, causing additional disparities. The exclusion of MEM from policy making processes, waiting lists and the structure of the federalized Belgian health system are identified as indirect macro contributors to disparities. Respondents specified four main ways to reduce disparities in SUT among MEM: targeted treatment and policy making, installing diversity policies in SUT services, enhancing training and education, and community-based treatment.
{"title":"Equitable Substance Use Treatment for Migrants and Ethnic Minorities in Flanders, Belgium: Service Coordinator and Expert Perspectives","authors":"C. De Kock","doi":"10.1177/11782218221097390","DOIUrl":"https://doi.org/10.1177/11782218221097390","url":null,"abstract":"Despite mounting evidence of disparities in health service provision for migrants and ethnic minorities (MEM) across EU countries, there has been limited research into how services (meso) and policy (macro) can contribute to reducing these disparities. In Flemish (Belgian) substance use treatment (SUT) policy making, no systematic attention is given to MEM. Nevertheless, preliminary studies have identified some disparities, especially among non-Belgian MEM. For this paper we studied the factors related to these disparities and ways forward based on 21 semi-structured interviews with SUT coordinators and experts. The low representation of MEM populations in psychiatric hospitals due to language exclusion criteria stands out as the main disparity. Moreover, respondents indicated that exclusion may be anticipated by general practitioners in the referral process, causing additional disparities. The exclusion of MEM from policy making processes, waiting lists and the structure of the federalized Belgian health system are identified as indirect macro contributors to disparities. Respondents specified four main ways to reduce disparities in SUT among MEM: targeted treatment and policy making, installing diversity policies in SUT services, enhancing training and education, and community-based treatment.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41526976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221095871
Rinat Lasmanovich, O. Shaked, A. Sivan, Idan Barak, Mor Nahari, O. Mor, H. Katchman
Background: Hepatitis C virus (HCV) infection is a primary health concern among people who use drugs (PWUDs). Homeless PWUDs that constitute a key population for HCV transmission remain underrepresented in many surveys. Objectives: We performed a proactive street outreach to evaluate HCV infection prevalence among homeless PWUDs in Tel Aviv, identify risk factors associated with HCV infection, awareness of disease status and linkage to care rate. Results: Thirty-eight percent of approached PWUD were willing to participate in the study. Out of 53 subjects who got tested for anti HCV by rapid test, 29 (54.72%) had a positive result, 20 of 29 anti-HCV positive (69%) patients had positive HCV PCR. Risk factors were investigated using structured questionnaires. Heroin use was reported significantly more frequently in the HCV-positive group (P = .05, CI 95%), whereas other established risk factors did not reach significance in our cohort. While 21 of 29 (72%) HCV-positive participants were aware of their condition, only 4 of 21 (19%) received treatment in the past, and 2 of 4 (50%) failed to achieve treatment goals, as assessed by HCV PCR. Conclusions: Our data indicate a high prevalence of HCV infection among homeless PWUDs. Importantly, despite relatively high awareness of HCV status in this population, we found strikingly low access to care. These findings motivate novel interventional approaches targeted at improving patient access, and compliance among homeless PWUDs, in an effort to reduce HCV transmission.
背景:丙型肝炎病毒(HCV)感染是吸毒者(pwud)的主要健康问题。在许多调查中，无家可归的pwud是HCV传播的关键人群，但他们的代表性仍然不足。目的:我们进行了一项前瞻性的街道外展，以评估特拉维夫无家可归的pwud中HCV感染的流行情况，确定与HCV感染相关的危险因素，疾病状态的认识以及与护理率的联系。结果:38%的PWUD患者愿意参加研究。53例抗HCV快速检测阳性29例(54.72%)，29例抗HCV阳性20例(69%)PCR阳性。采用结构化问卷调查危险因素。海洛因使用在丙型肝炎病毒阳性组中更为频繁(P =。05, CI 95%)，而其他已确定的危险因素在我们的队列中没有显著性。虽然29名HCV阳性参与者中有21名(72%)知道自己的病情，但根据HCV PCR评估，21名参与者中只有4名(19%)过去接受过治疗，4名参与者中有2名(50%)未能达到治疗目标。结论:我们的数据表明，无家可归的pwud人群中HCV感染率很高。重要的是，尽管这一人群对丙型肝炎病毒状况的认识相对较高，但我们发现获得护理的机会非常低。这些发现激发了新的干预方法，旨在改善无家可归的pwud患者的可及性和依从性，以减少HCV传播。
{"title":"Hepatitis C Virus Prevalence, Medical Status Awareness and Treatment Engagement among Homeless People Who use Drugs: Results of a Street Outreach Study","authors":"Rinat Lasmanovich, O. Shaked, A. Sivan, Idan Barak, Mor Nahari, O. Mor, H. Katchman","doi":"10.1177/11782218221095871","DOIUrl":"https://doi.org/10.1177/11782218221095871","url":null,"abstract":"Background: Hepatitis C virus (HCV) infection is a primary health concern among people who use drugs (PWUDs). Homeless PWUDs that constitute a key population for HCV transmission remain underrepresented in many surveys. Objectives: We performed a proactive street outreach to evaluate HCV infection prevalence among homeless PWUDs in Tel Aviv, identify risk factors associated with HCV infection, awareness of disease status and linkage to care rate. Results: Thirty-eight percent of approached PWUD were willing to participate in the study. Out of 53 subjects who got tested for anti HCV by rapid test, 29 (54.72%) had a positive result, 20 of 29 anti-HCV positive (69%) patients had positive HCV PCR. Risk factors were investigated using structured questionnaires. Heroin use was reported significantly more frequently in the HCV-positive group (P = .05, CI 95%), whereas other established risk factors did not reach significance in our cohort. While 21 of 29 (72%) HCV-positive participants were aware of their condition, only 4 of 21 (19%) received treatment in the past, and 2 of 4 (50%) failed to achieve treatment goals, as assessed by HCV PCR. Conclusions: Our data indicate a high prevalence of HCV infection among homeless PWUDs. Importantly, despite relatively high awareness of HCV status in this population, we found strikingly low access to care. These findings motivate novel interventional approaches targeted at improving patient access, and compliance among homeless PWUDs, in an effort to reduce HCV transmission.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43770305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221080772
G. Umeta, Sanyi Daba Regasa, Getu Melesie Taye, H. Ayeno, Gosaye Mekonen Tefera
Introduction: Internet addiction (IA) is causing academic failure, decreased concentration ability, and a negative affective state. In Ethiopia, studies conducted on IA were limited; therefore, this study aimed to assess its prevalence and risk factors among medicine and health science (MHS) students of Ambo University. Materials and Methods: This study was a cross-sectional study and included MHS students of Ambo University from July 15 to August 15, 2021. Data were collected using a self-administered questionnaire after receiving informed consent from study participants. The results were analyzed using the statistical software for social sciences version 24. Bivariate and multivariate logistic regressions were performed to explore the relationship between IA and dependent variables. Results: Of the 253 participants who participated in the study, 201 (79%) were found to have an IA. Having one’s own computer, Internet access at home and an email account were 2 times more risky to develop IA compared to their counterparts with AOR = 2.615 (95% CI = 1.118-5.956) with a P value of .022, AOR = 2.154 (95% CI = 1.054-4.405) with a P value of .35 and (=2.154 (95% CI = 1.054-4.405 with a P value of .035 respectively. Additionally, those who use the Internet for news were 2.5 times more likely to develop IA compared to those who do not (AOR = 2.551 (95% CI = 1.225-5.349) with a P-value of .013). The use of the Internet for scientific research and education reduces IA by 0.7 times (AOR = 0.323 (95% CI = 0.120-0.868) with a P value of .025). Conclusions: The prevalence of IA was found to be high in this study. Therefore, strategies are needed to minimize the prevalence of this problem.
{"title":"Prevalence of Internet Addiction and its Correlates Among Regular Undergraduate Medicine and Health Science Students at Ambo University. Cross-Sectional Study","authors":"G. Umeta, Sanyi Daba Regasa, Getu Melesie Taye, H. Ayeno, Gosaye Mekonen Tefera","doi":"10.1177/11782218221080772","DOIUrl":"https://doi.org/10.1177/11782218221080772","url":null,"abstract":"Introduction: Internet addiction (IA) is causing academic failure, decreased concentration ability, and a negative affective state. In Ethiopia, studies conducted on IA were limited; therefore, this study aimed to assess its prevalence and risk factors among medicine and health science (MHS) students of Ambo University. Materials and Methods: This study was a cross-sectional study and included MHS students of Ambo University from July 15 to August 15, 2021. Data were collected using a self-administered questionnaire after receiving informed consent from study participants. The results were analyzed using the statistical software for social sciences version 24. Bivariate and multivariate logistic regressions were performed to explore the relationship between IA and dependent variables. Results: Of the 253 participants who participated in the study, 201 (79%) were found to have an IA. Having one’s own computer, Internet access at home and an email account were 2 times more risky to develop IA compared to their counterparts with AOR = 2.615 (95% CI = 1.118-5.956) with a P value of .022, AOR = 2.154 (95% CI = 1.054-4.405) with a P value of .35 and (=2.154 (95% CI = 1.054-4.405 with a P value of .035 respectively. Additionally, those who use the Internet for news were 2.5 times more likely to develop IA compared to those who do not (AOR = 2.551 (95% CI = 1.225-5.349) with a P-value of .013). The use of the Internet for scientific research and education reduces IA by 0.7 times (AOR = 0.323 (95% CI = 0.120-0.868) with a P value of .025). Conclusions: The prevalence of IA was found to be high in this study. Therefore, strategies are needed to minimize the prevalence of this problem.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45539545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221095873
C. Striley, C. Hoeflich, Andrew T Viegas, Lindsey A Berkowitz, Emily G Matthews, Leyla P Akin, Chidinma Iheanyi-Okeahialam, Urmeen Mansoor, Christopher R. McCurdy
Background: Kratom (Mitragyna speciosa) consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices. Methods: The objective of this narrative review was to elucidate selected health effects associated with using kratom—either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described. Results: Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate’s risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions. Conclusions: Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom.
{"title":"Health Effects Associated With Kratom (Mitragyna speciosa) and Polysubstance Use: A Narrative Review","authors":"C. Striley, C. Hoeflich, Andrew T Viegas, Lindsey A Berkowitz, Emily G Matthews, Leyla P Akin, Chidinma Iheanyi-Okeahialam, Urmeen Mansoor, Christopher R. McCurdy","doi":"10.1177/11782218221095873","DOIUrl":"https://doi.org/10.1177/11782218221095873","url":null,"abstract":"Background: Kratom (Mitragyna speciosa) consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices. Methods: The objective of this narrative review was to elucidate selected health effects associated with using kratom—either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described. Results: Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate’s risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions. Conclusions: Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46665551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221095872
Devon Meadowcroft, W. Davis
Background: The COVID-19 pandemic has led to disruptions in the provision of care at substance use disorder (SUD) treatment facilities. Stresses associated with the pandemic could also negatively impact treatment outcomes for clients. The aim of this study is to evaluate how SUD treatment facilities in Mississippi changed their operations following the start of the pandemic. The change in client success rates at the facilities is also assessed. Methods: An online survey was completed by 12 SUD treatment facilities in Mississippi between February and May 2021. Results: Generally, the facilities’ capacity to provide treatment to clientele was moderately affected by the pandemic. Facilities in the sample also adapted a variety of policies to limit the spread of COVID-19. Changes in the services provided by facilities was observed in the survey responses. For client success rates reported by the facilities, there was a decrease in the number of facilities stating that more than 80% of their clients completed treatment across the pre- and post-pandemic periods. However, the number of facilities with more than 80% of their clients successfully finishing treatment has increased in recent months. Conclusions: To continue serving their clientele during the pandemic, facilities enacted COVID-19-related policies and began offering new services such as telehealth. Although client success rates decreased at the beginning of the pandemic, they have returned to pre-pandemic levels in recent months. Our results indicate that SUD treatment facilities and clients have improved in terms of giving and receiving care as the pandemic has progressed.
{"title":"Understanding the Effect of the COVID-19 Pandemic on Substance Use Disorder Treatment Facility Operations and Patient Success: Evidence From Mississippi","authors":"Devon Meadowcroft, W. Davis","doi":"10.1177/11782218221095872","DOIUrl":"https://doi.org/10.1177/11782218221095872","url":null,"abstract":"Background: The COVID-19 pandemic has led to disruptions in the provision of care at substance use disorder (SUD) treatment facilities. Stresses associated with the pandemic could also negatively impact treatment outcomes for clients. The aim of this study is to evaluate how SUD treatment facilities in Mississippi changed their operations following the start of the pandemic. The change in client success rates at the facilities is also assessed. Methods: An online survey was completed by 12 SUD treatment facilities in Mississippi between February and May 2021. Results: Generally, the facilities’ capacity to provide treatment to clientele was moderately affected by the pandemic. Facilities in the sample also adapted a variety of policies to limit the spread of COVID-19. Changes in the services provided by facilities was observed in the survey responses. For client success rates reported by the facilities, there was a decrease in the number of facilities stating that more than 80% of their clients completed treatment across the pre- and post-pandemic periods. However, the number of facilities with more than 80% of their clients successfully finishing treatment has increased in recent months. Conclusions: To continue serving their clientele during the pandemic, facilities enacted COVID-19-related policies and began offering new services such as telehealth. Although client success rates decreased at the beginning of the pandemic, they have returned to pre-pandemic levels in recent months. Our results indicate that SUD treatment facilities and clients have improved in terms of giving and receiving care as the pandemic has progressed.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41997699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11782218221085599
Sharon JN Walhout, J. V. Zanten, L. DeFuentes-Merillas, C. Sonneborn, M. Bosma
Background: The prevalence of substance use disorders (SUD) in individuals with autism spectrum disorders (ASD) appears to be higher than previously described. Attention has been drawn to developing new treatment approaches for this patient population, as they appear to do less well with traditional addiction treatment. There is very little research addressing treatment outcome. This study aims to introduce and evaluate a manualized group treatment intervention developed specifically for patients with ASD and co-occurring SUD. Methods: We developed a group treatment based on cognitive behavioural therapy (CBT) and evaluated outcome measures at the end of treatment and 3-month follow-up. Fifty-seven patients with ASD and co-occurring SUD were included of which 30 completed the group intervention, 27 of them also participated at 3-month follow-up. Results: The findings suggest that group treatment can work for patients with ASD and co-occurring SUD. Lower levels of alcohol use (t = 3.61, P = .002, d = 0.75), craving (t = 2.65, P = .013, d = 0.51), passive coping styles (t = 2.32, P = .030, d = 0.48), depression (t = 3.48, P = .002, d = 0.67), anxiety (t = 3.02, P = .006, d = 0.58), and stress (t = 2.62, P = .015, d = 0.51) symptoms were reported after completing the group intervention, with even stronger effects at 3 months follow-up. Conclusions: The present study shows promising results of a tailor-made group intervention in a heterogeneous patient population with ASD and co-occurring SUD with positive effects on both symptoms of ASD and SUD.
背景:自闭症谱系障碍(ASD)患者中物质使用障碍(SUD)的患病率似乎高于先前的描述。由于传统的成瘾治疗似乎效果不佳，因此人们开始关注为这类患者开发新的治疗方法。关于治疗结果的研究很少。本研究旨在介绍和评估一种专门针对ASD合并SUD患者的手动组治疗干预措施。方法:我们开发了一种基于认知行为疗法(CBT)的群体治疗，并在治疗结束和3个月随访时评估结果措施。纳入57例ASD合并SUD患者，其中30例完成组干预，27例随访3个月。结果:小组治疗对ASD合并SUD患者有效。较低的酒精使用水平(t = 3.61, P =。002, d = 0.75)，渴望(t = 2.65, P =。013年,d = 0.51),被动应对方式(t = 2.32, P =。030, d = 0.48)，抑郁(t = 3.48, P =。002, d = 0.67)，焦虑(t = 3.02, P = 0.67)。006, d = 0.58)，应力(t = 2.62, P =。015, d = 0.51)，完成组干预后出现症状，随访3个月效果更明显。结论:目前的研究显示，针对ASD和并发SUD的异质患者群体进行量身定制的群体干预，对ASD和SUD的症状均有积极作用，结果令人鼓舞。
{"title":"Patients With Autism Spectrum Disorder and Co-occurring Substance Use Disorder: A Clinical Intervention Study","authors":"Sharon JN Walhout, J. V. Zanten, L. DeFuentes-Merillas, C. Sonneborn, M. Bosma","doi":"10.1177/11782218221085599","DOIUrl":"https://doi.org/10.1177/11782218221085599","url":null,"abstract":"Background: The prevalence of substance use disorders (SUD) in individuals with autism spectrum disorders (ASD) appears to be higher than previously described. Attention has been drawn to developing new treatment approaches for this patient population, as they appear to do less well with traditional addiction treatment. There is very little research addressing treatment outcome. This study aims to introduce and evaluate a manualized group treatment intervention developed specifically for patients with ASD and co-occurring SUD. Methods: We developed a group treatment based on cognitive behavioural therapy (CBT) and evaluated outcome measures at the end of treatment and 3-month follow-up. Fifty-seven patients with ASD and co-occurring SUD were included of which 30 completed the group intervention, 27 of them also participated at 3-month follow-up. Results: The findings suggest that group treatment can work for patients with ASD and co-occurring SUD. Lower levels of alcohol use (t = 3.61, P = .002, d = 0.75), craving (t = 2.65, P = .013, d = 0.51), passive coping styles (t = 2.32, P = .030, d = 0.48), depression (t = 3.48, P = .002, d = 0.67), anxiety (t = 3.02, P = .006, d = 0.58), and stress (t = 2.62, P = .015, d = 0.51) symptoms were reported after completing the group intervention, with even stronger effects at 3 months follow-up. Conclusions: The present study shows promising results of a tailor-made group intervention in a heterogeneous patient population with ASD and co-occurring SUD with positive effects on both symptoms of ASD and SUD.","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42213953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-06eCollection Date: 2021-01-01DOI: 10.1177/11782218211061746
Molly Carlyle, Janni Leung, Zoe C Walter, Jennifer Juckel, Caroline Salom, Catherine A Quinn, Lily Davidson, Rhiannon Ellem, Grace Newland, Leanne Hides
Background: Alcohol and other drug (AOD) use patterns have altered as a result of the coronavirus (COVID-19) pandemic restrictions. This study aimed to: (i) determine the impact of the pandemic on patterns of AOD use among individuals seeking treatment, (ii) identify which mental health and resilience factors were associated with changes in patterns of AOD use and (iii) evaluate changes in the contextual factors (eg, motivations) associated with use.
Methods: Cross-sectional surveys were completed by clients (n = 325) who had sought AOD treatment from January 2020 onwards. We measured quantity and frequency of AOD use now compared to before the pandemic, mental health (depression, anxiety, trauma exposure), resilience and contextual factors related to AOD use.
Results: Quantity of tobacco and cannabis use increased post-pandemic, while methamphetamine and alcohol did not change. Depression was associated with more frequent alcohol use now compared to before the pandemic, while anxiety and lower resilience were associated with less frequent cannabis use now. Lower resilience was associated changes in methamphetamine use. Depression was associated with using more frequently for enjoyment and to alleviate loneliness following the pandemic, and anxiety was associated with using earlier in the day and to alleviate boredom.
Conclusions: The pandemic has led to increased frequency of AOD use for a subset of individuals seeking treatment. Depression, anxiety and resilience are important factors associated with altered AOD use, and changes in the motivations and control surrounding use. Special consideration of this should be considered during AOD treatment through the pandemic.
{"title":"Changes in Substance Use Among People Seeking Alcohol and Other Drug Treatment During the COVID-19 Pandemic: Evaluating Mental Health Outcomes and Resilience.","authors":"Molly Carlyle, Janni Leung, Zoe C Walter, Jennifer Juckel, Caroline Salom, Catherine A Quinn, Lily Davidson, Rhiannon Ellem, Grace Newland, Leanne Hides","doi":"10.1177/11782218211061746","DOIUrl":"https://doi.org/10.1177/11782218211061746","url":null,"abstract":"<p><strong>Background: </strong>Alcohol and other drug (AOD) use patterns have altered as a result of the coronavirus (COVID-19) pandemic restrictions. This study aimed to: (i) determine the impact of the pandemic on patterns of AOD use among individuals seeking treatment, (ii) identify which mental health and resilience factors were associated with changes in patterns of AOD use and (iii) evaluate changes in the contextual factors (eg, motivations) associated with use.</p><p><strong>Methods: </strong>Cross-sectional surveys were completed by clients (n = 325) who had sought AOD treatment from January 2020 onwards. We measured quantity and frequency of AOD use now compared to before the pandemic, mental health (depression, anxiety, trauma exposure), resilience and contextual factors related to AOD use.</p><p><strong>Results: </strong>Quantity of tobacco and cannabis use increased post-pandemic, while methamphetamine and alcohol did not change. Depression was associated with more frequent alcohol use now compared to before the pandemic, while anxiety and lower resilience were associated with less frequent cannabis use now. Lower resilience was associated changes in methamphetamine use. Depression was associated with using more frequently for enjoyment and to alleviate loneliness following the pandemic, and anxiety was associated with using earlier in the day and to alleviate boredom.</p><p><strong>Conclusions: </strong>The pandemic has led to increased frequency of AOD use for a subset of individuals seeking treatment. Depression, anxiety and resilience are important factors associated with altered AOD use, and changes in the motivations and control surrounding use. Special consideration of this should be considered during AOD treatment through the pandemic.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":" ","pages":"11782218211061746"},"PeriodicalIF":2.1,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/0e/10.1177_11782218211061746.PMC8655460.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39718304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号