Pub Date : 2024-03-03Epub Date: 2023-11-27DOI: 10.1080/00952990.2023.2266117
Fangfang Duan, Chen Liu, Chunyan Chang, Shanshan Song, Hang Zhai, Jun Cheng, Song Yang
Background: Optimal treatments for severe alcoholic hepatitis (SAH) remain controversial. Previous network meta-analysis showed that corticosteroid (CS) combined with N-acetylcysteine (NAC) was superior in reducing short-term mortality of patients with SAH. Recently, granulocyte colony-stimulating factor (G-CSF) treatments for SAH yielded promising results.Objectives: To determine how currently available treatments affect the survival and complications of patients with SAH.Methods: The study was conducted following the guidelines of PRISMA. The data from PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov to October 2022 were searched, and patients with SAH with pharmacotherapy were included in our study. The primary outcome was short-term survival, and the other outcomes were medium- (3/6 months) or long-term (12 months) survival and complications after treatment. R software was used to establish network meta-analysis models and the result was expressed by the odd ratio (OR) value and 95% credible interval (Crls).Results: A total of 31 randomized controlled trials, including 19 treatment regimens, were enrolled in our study. As the primary outcome, G-CSF+ pentoxifylline (PTX) ranked first in one-month survival and showed significant superiority when compared with the placebo (OR 8.60, 95% Crls 1.92-45.10) and CS (OR 4.95, 95% Crls 1.11-25.53). Also, G-CSF+PTX ranked first in improving three-month survival and reducing the occurrence of infection. PTX+MTD ranked first in six-month survival, and G-CSF ranked first in twelve-month survival. CS+MTD ranked first in the occurrence of gastrointestinal bleeding and hepatorenal syndrome.Conclusions: The combination of G-CSF and PTX showed a significant benefit in improving the short-term survival of SAH patients.
{"title":"Granulocyte colony-stimulating factor plus pentoxifylline increases short-term survival in patients with severe alcoholic hepatitis: a network meta-analysis.","authors":"Fangfang Duan, Chen Liu, Chunyan Chang, Shanshan Song, Hang Zhai, Jun Cheng, Song Yang","doi":"10.1080/00952990.2023.2266117","DOIUrl":"10.1080/00952990.2023.2266117","url":null,"abstract":"<p><p><i>Background:</i> Optimal treatments for severe alcoholic hepatitis (SAH) remain controversial. Previous network meta-analysis showed that corticosteroid (CS) combined with N-acetylcysteine (NAC) was superior in reducing short-term mortality of patients with SAH. Recently, granulocyte colony-stimulating factor (G-CSF) treatments for SAH yielded promising results.<i>Objectives:</i> To determine how currently available treatments affect the survival and complications of patients with SAH.<i>Methods:</i> The study was conducted following the guidelines of PRISMA. The data from PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov to October 2022 were searched, and patients with SAH with pharmacotherapy were included in our study. The primary outcome was short-term survival, and the other outcomes were medium- (3/6 months) or long-term (12 months) survival and complications after treatment. R software was used to establish network meta-analysis models and the result was expressed by the odd ratio (OR) value and 95% credible interval (Crls).<i>Results:</i> A total of 31 randomized controlled trials, including 19 treatment regimens, were enrolled in our study. As the primary outcome, G-CSF+ pentoxifylline (PTX) ranked first in one-month survival and showed significant superiority when compared with the placebo (OR 8.60, 95% Crls 1.92-45.10) and CS (OR 4.95, 95% Crls 1.11-25.53). Also, G-CSF+PTX ranked first in improving three-month survival and reducing the occurrence of infection. PTX+MTD ranked first in six-month survival, and G-CSF ranked first in twelve-month survival. CS+MTD ranked first in the occurrence of gastrointestinal bleeding and hepatorenal syndrome.<i>Conclusions:</i> The combination of G-CSF and PTX showed a significant benefit in improving the short-term survival of SAH patients.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446731","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 : 2024-03-03Epub Date: 2024-01-29DOI: 10.1080/00952990.2023.2299922
Darby J E Lowe, Maryam Sorkhou, Tony P George
Background: The use of cannabis is highly prevalent during adolescence compared to the general adult population. In addition to the high comorbidity between cannabis use and anxiety disorders, early evidence suggests that cannabis may precede the development of anxiety. Moreover, adolescence represents a major developmental period for both neurobiological and psychological processes, placing these individuals at a heightened vulnerability to the influence of cannabis.Objectives: This systematic review and meta-analysis examined the prospective associations between adolescent cannabis use and subsequent anxiety outcomes (i.e. anxiety disorders and/or symptoms).Methods: Following PRISMA guidelines, a systematic review and meta-analysis were conducted encompassing data from articles published between database inception and September 2022.Results: Six longitudinal studies were identified for quantitative analysis, while twelve non-overlapping longitudinal studies were identified for qualitative review (total N = 18; 33380 subjects). Meta-analytical findings supported an association between adolescent cannabis use and the development of a subsequent anxiety disorder (Odds Ratio = 2.14, 95% CI: 1.37-3.36, p < .01). These findings were consistent with our qualitative synthesis where nine of the twelve longitudinal studies observed a significant relationship between adolescent cannabis use and exacerbation of anxiety symptoms later in life, irrespective of an anxiety disorder diagnosis.Discussion: In summary, the current evidence suggests a prospective association between adolescent cannabis use and later anxiety symptoms and disorders. These findings underscore the importance of refining research methodologies, considering sex-based differences and controlling for confounding factors, as well as implementing educational initiatives and developing clinical interventions to address the mental health risks associated with cannabis use among adolescents.
背景:与普通成年人相比,青少年时期吸食大麻的情况非常普遍。除了大麻使用与焦虑症之间的高度共存性之外,早期证据还表明,大麻可能先于焦虑症的发生。此外,青春期是神经生物学和心理过程的重要发育期,使这些人更容易受到大麻的影响:本系统综述和荟萃分析研究了青少年使用大麻与后续焦虑结果(即焦虑症和/或症状)之间的前瞻性关联:按照PRISMA指南,对数据库建立至2022年9月期间发表的文章数据进行了系统综述和荟萃分析:结果:确定了六项纵向研究进行定量分析,同时确定了十二项非重叠纵向研究进行定性审查(总人数=18;33380 名受试者)。元分析结果表明,青少年吸食大麻与随后出现焦虑症之间存在关联(Odds Ratio = 2.14,95% CI:1.37-3.36,p 讨论):总之,目前的证据表明,青少年吸食大麻与日后的焦虑症状和焦虑症之间存在前瞻性关联。这些发现强调了改进研究方法、考虑性别差异和控制混杂因素的重要性,以及实施教育计划和制定临床干预措施以应对青少年吸食大麻带来的心理健康风险的重要性。
{"title":"Cannabis use in adolescents and anxiety symptoms and disorders: a systematic review and meta-analysis.","authors":"Darby J E Lowe, Maryam Sorkhou, Tony P George","doi":"10.1080/00952990.2023.2299922","DOIUrl":"10.1080/00952990.2023.2299922","url":null,"abstract":"<p><p><i>Background:</i> The use of cannabis is highly prevalent during adolescence compared to the general adult population. In addition to the high comorbidity between cannabis use and anxiety disorders, early evidence suggests that cannabis may precede the development of anxiety. Moreover, adolescence represents a major developmental period for both neurobiological and psychological processes, placing these individuals at a heightened vulnerability to the influence of cannabis.<i>Objectives:</i> This systematic review and meta-analysis examined the prospective associations between adolescent cannabis use and subsequent anxiety outcomes (i.e. anxiety disorders and/or symptoms).<i>Methods:</i> Following PRISMA guidelines, a systematic review and meta-analysis were conducted encompassing data from articles published between database inception and September 2022.<i>Results:</i> Six longitudinal studies were identified for quantitative analysis, while twelve non-overlapping longitudinal studies were identified for qualitative review (total <i>N</i> = 18; 33380 subjects). Meta-analytical findings supported an association between adolescent cannabis use and the development of a subsequent anxiety disorder (Odds Ratio = 2.14, 95% CI: 1.37-3.36, <i>p</i> < .01). These findings were consistent with our qualitative synthesis where nine of the twelve longitudinal studies observed a significant relationship between adolescent cannabis use and exacerbation of anxiety symptoms later in life, irrespective of an anxiety disorder diagnosis.<i>Discussion:</i> In summary, the current evidence suggests a prospective association between adolescent cannabis use and later anxiety symptoms and disorders. These findings underscore the importance of refining research methodologies, considering sex-based differences and controlling for confounding factors, as well as implementing educational initiatives and developing clinical interventions to address the mental health risks associated with cannabis use among adolescents.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571591","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 : 2024-03-03Epub Date: 2024-02-22DOI: 10.1080/00952990.2024.2302500
Emily Carter, Daniel Schatz, Noah Isaacs, Juan Garcia, Brandy Henry, Noa Krawczyk, Arthur Robin Williams
Background: Over the past decade, hospitals and health systems have increasingly adopted interventions to address the needs of patients with substance use disorders. The Opioid Use Disorder (OUD) Cascade of Care provides a framework for organizing and tracking patient health milestones over time and can assist health systems in identifying areas of intervention to maximize the impact of evidence-based services. However, detailed protocols are needed to guide health systems in how to operationalize the OUD Cascade and track outcomes using electronic health records.Objective: In this paper, we describe the process of operationalizing and applying the OUD Cascade in a large, urban, public hospital system.Methods: Through this case example, we describe the technical processes around data mining, as well as the decision-making processes, challenges encountered, lessons learned from compiling preliminary patient data and defining stages and outcome measures for the OUD Cascade of Care, and preliminary dataResults: We identified 33,616 (26.17% female) individuals with an OUD diagnosis. Almost half (48%) engaged with addiction services, while only 10.7% initiated medication-based treatment in an outpatient setting, 6.7% had timely follow-up, and 3.5% were retained for a minimum of 6 months.Conclusion: The current paper serves as a primer for other health systems seeking to implement data-informed approaches to guide more efficient care and improved substance use-related outcomes. An OUD Cascade of Care must be tailored to local systems based on inherent data limitations and services design with an emphasis on early stages wherein drop-off is the greatest.
{"title":"Application of an opioid use disorder cascade of care in a large public health system.","authors":"Emily Carter, Daniel Schatz, Noah Isaacs, Juan Garcia, Brandy Henry, Noa Krawczyk, Arthur Robin Williams","doi":"10.1080/00952990.2024.2302500","DOIUrl":"10.1080/00952990.2024.2302500","url":null,"abstract":"<p><p><i>Background:</i> Over the past decade, hospitals and health systems have increasingly adopted interventions to address the needs of patients with substance use disorders. The Opioid Use Disorder (OUD) Cascade of Care provides a framework for organizing and tracking patient health milestones over time and can assist health systems in identifying areas of intervention to maximize the impact of evidence-based services. However, detailed protocols are needed to guide health systems in how to operationalize the OUD Cascade and track outcomes using electronic health records.<i>Objective:</i> In this paper, we describe the process of operationalizing and applying the OUD Cascade in a large, urban, public hospital system.<i>Methods:</i> Through this case example, we describe the technical processes around data mining, as well as the decision-making processes, challenges encountered, lessons learned from compiling preliminary patient data and defining stages and outcome measures for the OUD Cascade of Care, and preliminary data<i>Results:</i> We identified 33,616 (26.17% female) individuals with an OUD diagnosis. Almost half (48%) engaged with addiction services, while only 10.7% initiated medication-based treatment in an outpatient setting, 6.7% had timely follow-up, and 3.5% were retained for a minimum of 6 months.<i>Conclusion:</i> The current paper serves as a primer for other health systems seeking to implement data-informed approaches to guide more efficient care and improved substance use-related outcomes. An OUD Cascade of Care must be tailored to local systems based on inherent data limitations and services design with an emphasis on early stages wherein drop-off is the greatest.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933749","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 : 2024-03-03Epub Date: 2024-01-29DOI: 10.1080/00952990.2023.2283691
Julianne D Jett, Rachael Beck, Diana Tyutyunnyk, Jesus Sanchez, Douglas L Weeks, Martin A Javors, Nathalie Hill-Kapturczak, Marisa Lopez-Cruzan, Liat Kriegel, Brett C Ginsburg, Leopoldo Cabassa, Michael G McDonell
Background: Phosphatidylethanol (PEth) is a blood-based biomarker for alcohol consumption that can be self-collected and has high sensitivity, specificity, and a longer detection window compared to other alcohol biomarkers.Objectives: We evaluated the feasibility and acceptability of a telehealth-based contingency management (CM) intervention for alcohol use disorder (AUD) using the blood-based biomarker PEth to assess alcohol consumption.Methods: Sixteen adults (7 female, 9 male) with AUD were randomized to Control or CM conditions. Control participants received reinforcers regardless of their PEth levels. CM participants received reinforcers for week-to-week decreases in PEth (Phase 1) or maintenance of PEth consistent with abstinence (<20 ng/mL, Phase 2). Blood samples were self-collected using the TASSO-M20 device. Acceptability was assessed by retention in weeks. Satisfaction was assessed with the Client Satisfaction Questionnaire (CSQ-8) and qualitative interviews. The primary efficacy outcome was PEth-defined abstinence. Secondary outcomes included the proportion of visits with PEth-defined heavy alcohol consumption, negative urine ethyl glucuronide results, and self-reported alcohol use.Results: Retention averaged 18.6 ± 8.8 weeks for CM participants. CM participants reported high levels of satisfaction (CSQ-8, Mean = 30.3 ± 1.5). Interview themes included intervention positives, such as staff support, quality of life improvement, and accountability. 72% of PEth samples from CM participants were consistent with abstinence versus 34% for Control participants (OR = 5.0, p = 0.007). PEth-defined heavy alcohol consumption was detected in 28% of CM samples and 52% of Control samples (OR = 0.36, p = 0.159). CM participants averaged 1.9 ± 1.7 drinks/day versus 4.2 ± 6.3 for Control participants (p = 0.304).Conclusion: Results support the acceptability and satisfaction of a telehealth PEth-based CM intervention, though a larger study is needed to assess its efficacy [NCT04038021].
{"title":"Feasibility of a telehealth-based contingency management intervention for alcohol use disorders using the phosphatidylethanol (PEth) 16:0/18:1 alcohol biomarker: a pilot randomized trial.","authors":"Julianne D Jett, Rachael Beck, Diana Tyutyunnyk, Jesus Sanchez, Douglas L Weeks, Martin A Javors, Nathalie Hill-Kapturczak, Marisa Lopez-Cruzan, Liat Kriegel, Brett C Ginsburg, Leopoldo Cabassa, Michael G McDonell","doi":"10.1080/00952990.2023.2283691","DOIUrl":"10.1080/00952990.2023.2283691","url":null,"abstract":"<p><p><i>Background:</i> Phosphatidylethanol (PEth) is a blood-based biomarker for alcohol consumption that can be self-collected and has high sensitivity, specificity, and a longer detection window compared to other alcohol biomarkers.<i>Objectives:</i> We evaluated the feasibility and acceptability of a telehealth-based contingency management (CM) intervention for alcohol use disorder (AUD) using the blood-based biomarker PEth to assess alcohol consumption.<i>Methods:</i> Sixteen adults (7 female, 9 male) with AUD were randomized to Control or CM conditions. Control participants received reinforcers regardless of their PEth levels. CM participants received reinforcers for week-to-week decreases in PEth (Phase 1) or maintenance of PEth consistent with abstinence (<20 ng/mL, Phase 2). Blood samples were self-collected using the TASSO-M20 device. Acceptability was assessed by retention in weeks. Satisfaction was assessed with the Client Satisfaction Questionnaire (CSQ-8) and qualitative interviews. The primary efficacy outcome was PEth-defined abstinence. Secondary outcomes included the proportion of visits with PEth-defined heavy alcohol consumption, negative urine ethyl glucuronide results, and self-reported alcohol use.<i>Results:</i> Retention averaged 18.6 ± 8.8 weeks for CM participants. CM participants reported high levels of satisfaction (CSQ-8, Mean = 30.3 ± 1.5). Interview themes included intervention positives, such as staff support, quality of life improvement, and accountability. 72% of PEth samples from CM participants were consistent with abstinence versus 34% for Control participants (OR = 5.0, <i>p</i> = 0.007). PEth-defined heavy alcohol consumption was detected in 28% of CM samples and 52% of Control samples (OR = 0.36, <i>p</i> = 0.159). CM participants averaged 1.9 ± 1.7 drinks/day versus 4.2 ± 6.3 for Control participants (<i>p</i> = 0.304).<i>Conclusion:</i> Results support the acceptability and satisfaction of a telehealth PEth-based CM intervention, though a larger study is needed to assess its efficacy [NCT04038021].</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11228813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-02Epub Date: 2024-01-31DOI: 10.1080/00952990.2023.2296860
Shaelyn Ward, Josh Autaubo, Philo Waters, Elizabeth Garrett, Kelsi Batioja, Reece Anderson, Debra Furr-Holden, Matt Vassar
Background: Alcohol Use Disorder (AUD) poses a significant health burden on individuals. The burden occurs more frequently in the medically underserved, as well as racial and sexual minority populations. Ameliorating health inequities is vital to improving patient-centered care.Objectives: The objective of this scoping review is to chart the existing evidence on health inequities related to AUD and identify existing knowledge gaps to guide future equity-centered research.Methods: We performed a literature search using the Ovid (Embase) and MEDLINE (PubMed) databases for articles on AUD that were published in the 5-year period spanning from 2017 to 2021 and written in English. The frequencies of each health inequity examined were analyzed, and findings from each included study were summarized.Results: Our sample consisted of 55 studies for analysis. The most common inequity examined was by race/ethnicity followed by sex or gender. The least reported inequities examined were rural under-resourced areas and occupational status. Our findings indicate that significant research gaps exist in education, rural under-resourced populations, and LGBTQ+ communities with AUD.Conclusions: This scoping review highlights the gaps in research on inequities in AUD. To bridge the current gaps, we recommend research on the following: 1) triage screening tools and the use of telemedicine for rural, under-resourced populations; 2) interventions to increase treatment engagement and retention for women; and 3) community-based participatory methodologies for the LGBTQ+ communities.
{"title":"A scoping review of health inequities in alcohol use disorder.","authors":"Shaelyn Ward, Josh Autaubo, Philo Waters, Elizabeth Garrett, Kelsi Batioja, Reece Anderson, Debra Furr-Holden, Matt Vassar","doi":"10.1080/00952990.2023.2296860","DOIUrl":"10.1080/00952990.2023.2296860","url":null,"abstract":"<p><p><i>Background:</i> Alcohol Use Disorder (AUD) poses a significant health burden on individuals. The burden occurs more frequently in the medically underserved, as well as racial and sexual minority populations. Ameliorating health inequities is vital to improving patient-centered care.<i>Objectives:</i> The objective of this scoping review is to chart the existing evidence on health inequities related to AUD and identify existing knowledge gaps to guide future equity-centered research.<i>Methods:</i> We performed a literature search using the Ovid (Embase) and MEDLINE (PubMed) databases for articles on AUD that were published in the 5-year period spanning from 2017 to 2021 and written in English. The frequencies of each health inequity examined were analyzed, and findings from each included study were summarized.<i>Results:</i> Our sample consisted of 55 studies for analysis. The most common inequity examined was by race/ethnicity followed by sex or gender. The least reported inequities examined were rural under-resourced areas and occupational status. Our findings indicate that significant research gaps exist in education, rural under-resourced populations, and LGBTQ+ communities with AUD.<i>Conclusions:</i> This scoping review highlights the gaps in research on inequities in AUD. To bridge the current gaps, we recommend research on the following: 1) triage screening tools and the use of telemedicine for rural, under-resourced populations; 2) interventions to increase treatment engagement and retention for women; and 3) community-based participatory methodologies for the LGBTQ+ communities.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651985","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 : 2024-01-02Epub Date: 2024-01-31DOI: 10.1080/00952990.2023.2291748
Joy D Scheidell, Maya Pitre, Barbara Andraka-Christou
Background: Research describes inequities in substance use treatment, but few studies focus specifically on racial and ethnic disparities in a range of aspects of substance use treatment among women with opioid use disorder (OUD).Objective: To examine whether substance use treatment (i.e. receipt, sources, barriers) differs by race and ethnicity among women with opioid use disorder (OUD) and to identify factors associated with treatment gap (i.e. needing treatment but not receiving it).Methods: We performed cross-sectional analyses using National Survey on Drug Use and Health 2015-2019 data, restricted to non-Hispanic Black, non-Hispanic White, and Hispanic women with past-year OUD (unweighted n = 1089). We estimated the prevalence of aspects of treatment among racial and ethnic groups, and used modified Poisson regression to estimate correlates of reported treatment gap.Results: Approximately 68% of White versus 87% of Black and 81% of Hispanic women with OUD had a treatment gap (p-value 0.0034). Commonly reported barriers to treatment included prioritization, affordability, and stigma. Older age was associated with lower prevalence of treatment gap among all women [prevalence ratio (PR) = 0.83, and 95% confidence interval (CI): 0.76, 0.92], while criminal legal involvement and healthcare coverage was associated with a lower prevalence of treatment gap among Hispanic and White women only (past year arrest: Hispanic women PR = 0.38, 95% CI: 0.17, 0.86; White women PR = 0.62, 95% CI: 0.47, 0.82).Conclusions: Receipt of treatment is low among women with OUD, especially Black and Hispanic women. Intersectional intervention approaches are needed to increase access and reduce inequities.
{"title":"Racial and ethnic inequities in substance use treatment among women with opioid use disorder.","authors":"Joy D Scheidell, Maya Pitre, Barbara Andraka-Christou","doi":"10.1080/00952990.2023.2291748","DOIUrl":"10.1080/00952990.2023.2291748","url":null,"abstract":"<p><p><i>Background:</i> Research describes inequities in substance use treatment, but few studies focus specifically on racial and ethnic disparities in a range of aspects of substance use treatment among women with opioid use disorder (OUD).<i>Objective:</i> To examine whether substance use treatment (i.e. receipt, sources, barriers) differs by race and ethnicity among women with opioid use disorder (OUD) and to identify factors associated with treatment gap (i.e. needing treatment but not receiving it).<i>Methods:</i> We performed cross-sectional analyses using National Survey on Drug Use and Health 2015-2019 data, restricted to non-Hispanic Black, non-Hispanic White, and Hispanic women with past-year OUD (unweighted <i>n</i> = 1089). We estimated the prevalence of aspects of treatment among racial and ethnic groups, and used modified Poisson regression to estimate correlates of reported treatment gap.<i>Results:</i> Approximately 68% of White versus 87% of Black and 81% of Hispanic women with OUD had a treatment gap (p-value 0.0034). Commonly reported barriers to treatment included prioritization, affordability, and stigma. Older age was associated with lower prevalence of treatment gap among all women [prevalence ratio (PR) = 0.83, and 95% confidence interval (CI): 0.76, 0.92], while criminal legal involvement and healthcare coverage was associated with a lower prevalence of treatment gap among Hispanic and White women only (past year arrest: Hispanic women PR = 0.38, 95% CI: 0.17, 0.86; White women PR = 0.62, 95% CI: 0.47, 0.82).<i>Conclusions:</i> Receipt of treatment is low among women with OUD, especially Black and Hispanic women. Intersectional intervention approaches are needed to increase access and reduce inequities.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651989","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 : 2024-01-02Epub Date: 2024-01-11DOI: 10.1080/00952990.2023.2286585
Nicholas M G Friedman, Matthew J Bivens
Emergency medical services (EMS) can be an invaluable ally of addiction medicine clinicians, but the potential role of EMS in combating the opioid epidemic has been under-realized. EMS has historically focused on emergency response and resuscitation in cases of overdose; however, EMS is also well-positioned to build rapport with persons who use drugs (PWUD), provide harm reduction services, and connect PWUD with additional treatment services and resources. A select number of EMS organizations have begun to offer substance-related programming that extends beyond resuscitation, but these offerings remain limited in scope and impact. This perspective argues that addiction medicine clinicians can bolster the ability of EMS to provide high quality substance-related services by engaging in prehospital care education, program development and research, and clinical care. This perspective shares practical strategies for addiction medicine clinicians to partner with EMS and considers several potential barriers that must be overcome, including bureaucratic challenges, variability in the scope of practice of EMS providers across different locations, and limited funding.
{"title":"Expanding access to substance misuse services through emergency medical services: envisioning a novel partnership for addiction medicine clinicians.","authors":"Nicholas M G Friedman, Matthew J Bivens","doi":"10.1080/00952990.2023.2286585","DOIUrl":"10.1080/00952990.2023.2286585","url":null,"abstract":"<p><p>Emergency medical services (EMS) can be an invaluable ally of addiction medicine clinicians, but the potential role of EMS in combating the opioid epidemic has been under-realized. EMS has historically focused on emergency response and resuscitation in cases of overdose; however, EMS is also well-positioned to build rapport with persons who use drugs (PWUD), provide harm reduction services, and connect PWUD with additional treatment services and resources. A select number of EMS organizations have begun to offer substance-related programming that extends beyond resuscitation, but these offerings remain limited in scope and impact. This perspective argues that addiction medicine clinicians can bolster the ability of EMS to provide high quality substance-related services by engaging in prehospital care education, program development and research, and clinical care. This perspective shares practical strategies for addiction medicine clinicians to partner with EMS and considers several potential barriers that must be overcome, including bureaucratic challenges, variability in the scope of practice of EMS providers across different locations, and limited funding.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425757","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 : 2024-01-02Epub Date: 2024-01-22DOI: 10.1080/00952990.2023.2292011
Raluca Isenberg
{"title":"Opioid overdose after extended-release buprenorphine injection: a case report.","authors":"Raluca Isenberg","doi":"10.1080/00952990.2023.2292011","DOIUrl":"10.1080/00952990.2023.2292011","url":null,"abstract":"","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520390","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 : 2024-01-02Epub Date: 2024-01-12DOI: 10.1080/00952990.2023.2292010
Samantha Johnstone, Maryam Sorkhou, Molly Zhang, Sarah S Dermody, Rachel A Rabin, Tony P George
Clinical trial name: Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) on Cannabis Use and Cognitive Outcomes in SchizophreniaURL: www.clinicaltrials.gov; Registration Number: NCT03189810.
{"title":"Cannabis cravings predict cigarette use in schizophrenia: a secondary analysis from two cannabis abstinence studies.","authors":"Samantha Johnstone, Maryam Sorkhou, Molly Zhang, Sarah S Dermody, Rachel A Rabin, Tony P George","doi":"10.1080/00952990.2023.2292010","DOIUrl":"10.1080/00952990.2023.2292010","url":null,"abstract":"<p><strong>Clinical trial name: </strong>Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) on Cannabis Use and Cognitive Outcomes in SchizophreniaURL: www.clinicaltrials.gov; Registration Number: NCT03189810.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425756","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 : 2024-01-02Epub Date: 2024-01-31DOI: 10.1080/00952990.2023.2297661
Kai-Ting Chen, Ming-Chyi Huang, Chun Lin, Hu-Ming Chang, Chung-Feng Kao
Background: Methamphetamine use disorder (MUD) is a worldwide health concern. The hypothalamic orexin system regulates stress response and addictive behaviors. The genetic variation in the hypocretin receptor 2 (HCRTR2), rs2653349, is associated with substance use disorder.Objectives: We explored the gene-environment (GxE) interaction of rs2653349 and adverse childhood experiences (ACEs) associated with MUD susceptibility.Methods: Four hundred and one individuals (336 males, 65 females) with MUD and 348 healthy controls (288 males, 60 females) completed a self-report questionnaire evaluating ACEs, encompassing childhood abuse and household dysfunction categories, and were genotyped for SNP rs2653349. Methamphetamine use variables were collected using the Diagnostic Interview for Genetic Studies. We used regression analyses to assess the GxE effect on MUD risk.Results: The MUD group had a comparable genotypic distribution for rs2653349 to the control group, albeit with a higher prevalence and number of types of ACEs, correlating with an increased MUD risk (p < .05). No significant genetic impact of rs2653349 on MUD risk was found. However, we observed a GxE interaction effect between the minor allele of rs2653349 and the number of childhood abuse or household dysfunction types, correlating with a reduced MUD risk (OR = -0.71, p = .04, Benjamini-Hochberg adjusted p = .08 and OR = -0.59, p = .045, Benjamini-Hochberg adjusted p = .09, respectively).Conclusion: HCRTR2 SNP rs2653349 has no significant impact on MUD risk, but ACEs may increase this risk. GxE results suggest that rs2653349 could offer protection against developing MUD in individuals experiencing multiple types of ACEs.
{"title":"GxE interaction effects of <i>HCRTR2</i> single nucleotide polymorphism and adverse childhood experiences on methamphetamine use disorder.","authors":"Kai-Ting Chen, Ming-Chyi Huang, Chun Lin, Hu-Ming Chang, Chung-Feng Kao","doi":"10.1080/00952990.2023.2297661","DOIUrl":"10.1080/00952990.2023.2297661","url":null,"abstract":"<p><p><i>Background:</i> Methamphetamine use disorder (MUD) is a worldwide health concern. The hypothalamic orexin system regulates stress response and addictive behaviors. The genetic variation in the hypocretin receptor 2 (HCRTR2), rs2653349, is associated with substance use disorder.<i>Objectives:</i> We explored the gene-environment (GxE) interaction of rs2653349 and adverse childhood experiences (ACEs) associated with MUD susceptibility.<i>Methods:</i> Four hundred and one individuals (336 males, 65 females) with MUD and 348 healthy controls (288 males, 60 females) completed a self-report questionnaire evaluating ACEs, encompassing childhood abuse and household dysfunction categories, and were genotyped for SNP rs2653349. Methamphetamine use variables were collected using the Diagnostic Interview for Genetic Studies. We used regression analyses to assess the GxE effect on MUD risk.<i>Results:</i> The MUD group had a comparable genotypic distribution for rs2653349 to the control group, albeit with a higher prevalence and number of types of ACEs, correlating with an increased MUD risk (<i>p</i> < .05). No significant genetic impact of rs2653349 on MUD risk was found. However, we observed a GxE interaction effect between the minor allele of rs2653349 and the number of childhood abuse or household dysfunction types, correlating with a reduced MUD risk (OR = -0.71, <i>p</i> = .04, Benjamini-Hochberg adjusted <i>p</i> = .08 and OR = -0.59, <i>p</i> = .045, Benjamini-Hochberg adjusted <i>p</i> = .09, respectively).<i>Conclusion:</i> HCRTR2 SNP rs2653349 has no significant impact on MUD risk, but ACEs may increase this risk. GxE results suggest that rs2653349 could offer protection against developing MUD in individuals experiencing multiple types of ACEs.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651987","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}