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Processing abnormalities in monetary outcome evaluations among male individuals with opioid use disorder: evidence from feedback-related negativity. 男性阿片类药物使用障碍患者在货币结果评估中的处理异常:反馈相关否定性的证据。
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-03-03 Epub Date: 2024-02-22 DOI: 10.1080/00952990.2024.2304036
Ling Yang, ZhiChen Chen, LiJuan Qi, HanBing Yang, Yang Zhang

Background: Numerous studies have highlighted the pivotal role of alterations in the monetary reward system in the development and maintenance of substance use disorder (SUD). Although these alterations have been well documented in various forms of SUD, the electrophysiological mechanisms specific to opioid use disorder (OUD) remain underexplored. Understanding these mechanisms is critical for developing targeted interventions and advancing theories of addiction specific to opioid use.Objectives: To explore abnormalities in monetary reward outcome processing in males with OUD. We hypothesized that control individuals would show higher feedback-related negativity (FRN) to losses, unlike those in the OUD group, where FRN to losses and gains would not differ significantly.Methods: Fifty-seven participants (29 male individuals with OUD [heroin] and 28 male controls) were evaluated. A combination of the monetary incentive delay task (MIDT) and event-related potential (ERP) technology was used to investigate electrophysiological differences in monetary reward feedback processing between the OUD and healthy control groups.Results: We observed a significant interaction between group (control vs. OUD) and monetary outcome (loss vs. gain), indicated by p < .05 and η2p = 0.116. Specifically, control participants showed stronger negative FRN to losses than gains (p < .05), unlike the OUD group (p > .05).Conclusion: This study's FRN data indicate that males with OUD show altered processing of monetary rewards, marked by reduced sensitivity to loss. These findings offer electrophysiological insights into why males with OUD may pursue drugs despite potential economic downsides.

背景:大量研究强调了货币奖赏系统的改变在药物使用障碍(SUD)的发展和维持中的关键作用。虽然这些改变在各种形式的药物使用障碍中都有充分的记录,但阿片类药物使用障碍(OUD)特有的电生理机制仍未得到充分探索。了解这些机制对于制定有针对性的干预措施和推进阿片类药物使用成瘾理论至关重要:目的:探讨患有 OUD 的男性在金钱奖赏结果处理方面的异常。我们假设,对照组的个体会对损失表现出更高的反馈相关负性(FRN),而 OUD 组的个体则不同,他们对损失和收益的 FRN 不会有显著差异:对 57 名参与者(29 名男性 OUD [海洛因] 患者和 28 名男性对照组)进行了评估。方法:对 57 名参与者(29 名男性 OUD 患者[海洛因]和 28 名男性对照组)进行评估,结合货币激励延迟任务(MIDT)和事件相关电位(ERP)技术,研究 OUD 组和健康对照组在货币奖励反馈处理方面的电生理差异:我们观察到组别(对照组 vs. OUD)和货币结果(损失 vs. 收益)之间存在明显的交互作用,p η2p = 0.116。具体来说,对照组参与者对损失的负 FRN 比对收益的负 FRN 更强(p p > .05):本研究的 FRN 数据表明,患有 OUD 的男性对金钱奖励的处理发生了改变,对损失的敏感性降低。这些发现从电生理学角度揭示了为什么患有 OUD 的男性可能会不顾潜在的经济损失而追求毒品。
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引用次数: 0
Medicinal cannabis use among young adults during California's transition from legalized medical use to adult-use: a longitudinal analysis. 加利福尼亚州从合法化医疗使用向成人使用过渡期间年轻成人的药用大麻使用情况:纵向分析。
IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-03 Epub Date: 2024-02-26 DOI: 10.1080/00952990.2024.2308098
Janna Ataiants, Carolyn F Wong, Omolola A Odejimi, Ekaterina V Fedorova, Bridgid M Conn, Stephen E Lankenau

Background: In 2016, California transitioned from legalized medical cannabis use to adult-use. Little is known about how this policy change affected medicinal cannabis use among young adults.Objectives: To identify longitudinal groups of medicinal cannabis users and concurrent changes in health- and cannabis use-related characteristics among young adults in Los Angeles between 2014 and 2021.Methods: Cannabis users (210 patients and 156 non-patients; 34% female; ages 18-26 at baseline) were surveyed annually across six waves. Longitudinal latent class analysis derived groups from two factors - cannabis patient status and self-reported medicinal use. Trajectories of health symptoms, cannabis use motives, and cannabis use (daily/near daily use, concentrate use, and problematic use) were estimated across groups.Results: Three longitudinal latent classes emerged: Recreational Users (39.3%) - low self-reported medicinal use and low-to-decreasing patient status; Recreational Patients (40.4%) - low self-reported medicinal use and high-to-decreasing patient status; Medicinal Patients (20.3%) - high self-reported medicinal use and high-to-decreasing patient status. At baseline, Medicinal Patients had higher levels of physical health symptoms and motives than recreational groups (p < .05); both patient groups reported higher level of daily/near daily and concentrate use (p < .01). Over time, mental health symptoms increased in recreational groups (p < .05) and problematic cannabis use increased among Recreational Patients (p < .01).Conclusions: During the transition to legalized adult-use, patterns of medicinal cannabis use varied among young adults. Clinicians should monitor increases in mental health symptoms and cannabis-related problems among young adults who report recreational - but not medicinal - cannabis use.

背景:2016 年,加利福尼亚州从合法使用医用大麻过渡到成人使用。人们对这一政策变化如何影响年轻人使用药用大麻知之甚少:确定 2014 年至 2021 年期间洛杉矶年轻成年人中的医用大麻使用者纵向群体以及健康和大麻使用相关特征的并发变化:每年对大麻使用者(210 名患者和 156 名非患者;34% 为女性;基线年龄为 18-26 岁)进行六次调查。纵向潜类分析从两个因素--大麻患者身份和自我报告的药物使用情况--得出群体。对各组的健康症状、大麻使用动机和大麻使用(每日/接近每日使用、集中使用和问题使用)轨迹进行了估计:出现了三个纵向潜在类别:娱乐使用者(39.3%)--自我报告的医疗使用率低,患者身份从低到低;娱乐患者(40.4%)--自我报告的医疗使用率低,患者身份从高到低;医疗患者(20.3%)--自我报告的医疗使用率高,患者身份从高到低。基线时,药用患者的身体健康症状和动机水平高于娱乐组(p p p p 结论):在向成人使用大麻合法化过渡的过程中,年轻成年人使用药用大麻的模式各不相同。临床医生应监测报告使用娱乐性大麻而非药用大麻的年轻人中精神健康症状和大麻相关问题的增加情况。
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引用次数: 0
Cannabis use in adolescents and anxiety symptoms and disorders: a systematic review and meta-analysis. 青少年吸食大麻与焦虑症状和焦虑症:系统回顾和荟萃分析。
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-03-03 Epub Date: 2024-01-29 DOI: 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。
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引用次数: 0
Granulocyte colony-stimulating factor plus pentoxifylline increases short-term survival in patients with severe alcoholic hepatitis: a network meta-analysis. 粒细胞集落刺激因子加己酮茶碱增加严重酒精性肝炎患者的短期生存:一项网络荟萃分析
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-03-03 Epub Date: 2023-11-27 DOI: 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.

背景:重度酒精性肝炎(SAH)的最佳治疗方法仍存在争议。先前的网络荟萃分析显示,皮质类固醇(CS)联合n -乙酰半胱氨酸(NAC)在降低SAH患者的短期死亡率方面具有优势。最近,粒细胞集落刺激因子(G-CSF)治疗SAH取得了可喜的结果。目的:确定目前可用的治疗方法如何影响SAH患者的生存和并发症。方法:本研究遵循PRISMA指南进行。检索PubMed、Embase、MEDLINE、Cochrane Library和clinicaltrials.gov截至2022年10月的数据,并将接受药物治疗的SAH患者纳入我们的研究。主要结局是短期生存,其他结局是中期(3/6个月)或长期(12个月)生存和治疗后并发症。采用R软件建立网络元分析模型,结果用奇比(OR)值和95%可信区间(Crls)表示。结果:本研究共纳入31项随机对照试验,包括19个治疗方案。作为主要终点,G-CSF+ pentoxifylline (PTX)在1个月生存率中排名第一,与安慰剂(OR 8.60, 95% Crls 1.92-45.10)和CS (OR 4.95, 95% Crls 1.11-25.53)相比具有显著优势。此外,G-CSF+PTX在提高3个月生存率和减少感染发生率方面排名第一。PTX+MTD在6个月生存率中排名第一,G-CSF在12个月生存率中排名第一。CS+MTD组胃肠道出血及肝肾综合征发生率居首位。结论:G-CSF联合PTX对改善SAH患者的短期生存有显著的益处。
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引用次数: 0
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. 利用磷脂酰乙醇(PEth)16:0/18:1 酒精生物标志物对酒精使用障碍进行基于远程医疗的应急管理干预的可行性:试点随机试验。
IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-03 Epub Date: 2024-01-29 DOI: 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].

背景:磷脂酰乙醇(PEth)是一种基于血液的酒精消费生物标志物,可自行采集,与其他酒精生物标志物相比,具有高灵敏度、特异性和更长的检测窗口期:我们评估了基于远程医疗的应急管理(CM)干预措施的可行性和可接受性,该干预措施使用血液生物标志物 PEth 来评估酒精消耗量:16名患有AUD的成年人(7名女性,9名男性)被随机分配到对照组或CM组。对照组参与者无论其 PEth 水平如何都会获得强化物。CM参与者在PEth逐周下降(第1阶段)或PEth维持在与戒酒一致的水平时接受强化物(结果:CM参与者的PEth平均为18.6%,而CM参与者的PEth平均为18.6%:CM 参与者平均戒断时间为 18.6 ± 8.8 周。CM 参与者的满意度很高(CSQ-8,平均值 = 30.3 ± 1.5)。访谈主题包括干预的积极意义,如工作人员的支持、生活质量的提高和责任感。在 CM 参与者的 PEth 样本中,72% 符合戒酒要求,而对照组参与者中只有 34% 符合戒酒要求(OR = 5.0,p = 0.007)。在 28% 的 CM 样本和 52% 的对照组样本中发现了 PEth 定义的大量饮酒(OR = 0.36,p = 0.159)。CM参与者平均每天饮酒1.9 ± 1.7杯,而对照组参与者平均每天饮酒4.2 ± 6.3杯(p = 0.304):研究结果表明,基于 PEth 的远程保健 CM 干预具有可接受性和满意度,但还需要更大规模的研究来评估其疗效 [NCT04038021]。
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引用次数: 0
Application of an opioid use disorder cascade of care in a large public health system. 在大型公共卫生系统中应用阿片类药物使用障碍级联护理。
IF 2.7 3区 医学 Q2 PSYCHOLOGY, CLINICAL Pub Date : 2024-03-03 Epub Date: 2024-02-22 DOI: 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.

背景:在过去十年中,医院和医疗系统越来越多地采用干预措施来满足药物使用障碍患者的需求。阿片类药物使用失调(OUD)级联护理提供了一个组织和跟踪患者随时间推移的健康里程碑的框架,可帮助医疗系统确定干预领域,以最大限度地发挥循证服务的影响。然而,还需要详细的协议来指导医疗系统如何使用电子健康记录来操作 OUD 分级护理和跟踪结果:在本文中,我们描述了在一个大型城市公立医院系统中操作和应用 OUD Cascade 的过程:通过这个案例,我们描述了数据挖掘的技术过程、决策过程、遇到的挑战、从汇编初步患者数据、确定 OUD 分级护理的阶段和结果衡量标准以及初步数据中汲取的经验教训:我们确定了 33,616 名(26.17% 为女性)确诊为 OUD 的患者。近一半(48%)的患者接受了戒毒服务,只有 10.7% 的患者在门诊接受了药物治疗,6.7% 的患者得到了及时随访,3.5% 的患者至少接受了 6 个月的治疗:本文可作为其他医疗系统的入门指南,帮助其实施以数据为依据的方法,以指导更有效的治疗并改善药物使用的相关结果。必须根据固有的数据局限性和服务设计,为当地系统量身定制 "OUD 分级护理",并将重点放在辍学率最高的早期阶段。
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引用次数: 0
A scoping review of health inequities in alcohol use disorder. 对酒精使用障碍中的健康不平等现象进行范围界定。
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-01-02 Epub Date: 2024-01-31 DOI: 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.

背景:酒精使用障碍(AUD)对个人健康造成了巨大的负担。这种负担更多地发生在医疗服务不足的人群以及少数种族和性别人群中。改善健康不平等对于改善以患者为中心的护理至关重要:本范围综述的目的是梳理与 AUD 相关的健康不公平现象的现有证据,并确定现有的知识差距,以指导未来以公平为中心的研究:我们使用Ovid(Embase)和MEDLINE(PubMed)数据库对2017年至2021年5年间发表的有关AUD的英文文章进行了文献检索。我们分析了每种健康不公平现象的发生频率,并总结了每项纳入研究的结果:我们的分析样本包括 55 项研究。最常见的不公平现象是种族/族裔,其次是性别。报告最少的不公平现象是农村资源不足地区和职业状况。我们的研究结果表明,在教育、资源不足的农村人口以及患有澳大拉伤的 LGBTQ+ 群体方面存在着巨大的研究差距:本范围界定综述强调了有关 AUD 不平等现象研究方面的差距。为了弥补目前的差距,我们建议对以下方面进行研究:1) 针对农村、资源不足人群的分流筛查工具和远程医疗的使用;2) 提高妇女治疗参与度和保留率的干预措施;3) 针对 LGBTQ+ 群体的社区参与方法。
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引用次数: 0
Racial and ethnic inequities in substance use treatment among women with opioid use disorder. 患有阿片类药物使用障碍的妇女在药物使用治疗方面的种族和民族不平等。
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-01-02 Epub Date: 2024-01-31 DOI: 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.

背景:研究描述了药物使用治疗中的不公平现象,但很少有研究专门关注患有阿片类药物使用障碍(OUD)的女性在药物使用治疗的一系列方面存在的种族和民族差异:研究患有阿片类药物使用障碍(OUD)的女性在药物使用治疗(即接受、来源、障碍)方面是否存在种族和民族差异,并确定与治疗差距(即需要治疗但未接受治疗)相关的因素:我们使用《2015-2019 年全国药物使用和健康调查》数据进行了横截面分析,仅限于非西班牙裔黑人、非西班牙裔白人和西班牙裔女性上一年的 OUD 患者(未加权 n = 1089)。我们估算了种族和民族群体中治疗方面的流行率,并使用修正的泊松回归估算了报告治疗差距的相关因素:约 68% 的白人、87% 的黑人和 81% 的西班牙裔女性 OUD 患者存在治疗差距(P 值为 0.0034)。常见的治疗障碍包括优先级、经济承受能力和耻辱感。在所有女性中,年龄越大,治疗差距发生率越低[患病率比(PR)= 0.83,95% 置信区间(CI):0.76, 0.92],而仅在西班牙裔女性和白人女性中,刑事法律介入和医疗保健覆盖率与治疗差距发生率较低有关(过去一年被捕的西班牙裔女性:PR = 0.83,95% 置信区间(CI):0.76, 0.92):西班牙裔女性 PR = 0.38,95% CI:0.17,0.86;白人女性 PR = 0.62,95% CI:0.47,0.82):患有 OUD 的妇女接受治疗的比例较低,尤其是黑人和西班牙裔妇女。需要采取跨部门干预方法来增加治疗机会并减少不平等现象。
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引用次数: 0
Expanding access to substance misuse services through emergency medical services: envisioning a novel partnership for addiction medicine clinicians. 通过紧急医疗服务扩大药物滥用服务的可及性:为成瘾医学临床医生设想一种新型合作关系。
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-01-02 Epub Date: 2024-01-11 DOI: 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.

急救医疗服务(EMS)可以成为成瘾医学临床医生的宝贵盟友,但急救医疗服务在抗击阿片类药物流行方面的潜在作用尚未得到充分认识。急救医疗服务(EMS)历来侧重于用药过量情况下的应急响应和复苏;然而,急救医疗服务(EMS)在与吸毒者(PWUD)建立友好关系、提供减低伤害服务以及将吸毒者与其他治疗服务和资源联系起来方面也处于有利地位。一些选定的急救医疗组织已经开始提供与药物相关的项目,这些项目不仅限于复苏,但这些项目的范围和影响仍然有限。本观点认为,成瘾医学临床医生可以通过参与院前护理教育、项目开发和研究以及临床护理,提高急救医疗服务提供高质量药物相关服务的能力。本观点分享了成瘾医学临床医生与急救医疗服务合作的实用策略,并考虑了必须克服的几个潜在障碍,包括官僚主义挑战、不同地区急救医疗服务提供者执业范围的差异性以及有限的资金。
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引用次数: 0
Opioid overdose after extended-release buprenorphine injection: a case report. 注射缓释丁丙诺啡后阿片类药物过量:病例报告。
IF 2.7 3区 医学 Q1 Psychology Pub Date : 2024-01-02 Epub Date: 2024-01-22 DOI: 10.1080/00952990.2023.2292011
Raluca Isenberg
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引用次数: 0
期刊
American Journal of Drug and Alcohol Abuse
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