Journal of Addictions Nursing最新文献

Abstract: Emergency departments (EDs) serve as the front line when patients encounter the hospital system. Limited data are available of patients' alcohol habits collected during Danish ED visits, and no studies have, to our knowledge, examined frontline staffs' (registered nurses and medical secretaries) acceptability to deliver anonymous alcohol surveys to patients. We aimed at examining the proportion of survey respondents and the prevalence of patients' alcohol habits and also exploring frontline staff acceptability of the distribution of an anonymous survey regarding patients' alcohol habits in EDs. Intendedly, all eligible patients ≥18 years old entering two EDs in March 2019 should receive a survey based on the Alcohol Use Disorder Identification Test. The study was an explanatory, sequential, mixed methods design, and results were analyzed with descriptive statistics and a deductive content analysis based on the theoretical framework of acceptability. In total, 15% (n = 1,305) of the total 8,679 patients in the EDs returned the survey. Qualitative analysis of interviews (n = 31) with staff showed that they had been reluctant to distribute the survey primarily because of ethical concerns of anonymity, freedom of choice, and being nonjudgmental toward patients. Hence, patients with no obvious alcohol problems were more likely to receive the survey. Still, we found that 23% of the respondents had an Alcohol Use Disorder Identification Test score ≥ 8. Results indicate that frontline staffs' recognition of patients' alcohol use is inadequate, and findings show a low degree of acceptability among staff to deliver an anonymous survey, which is in line with earlier described barriers toward screening activities in EDs.

Purpose of the study: Buprenorphine and methadone, when used as maintenance therapy in opioid use disorder (OUD), can significantly reduce the risk of death after an opioid overdose. Despite the many benefits, medication for OUD (MOUD) remains controversial and underutilized. The aim of this study was to (a) identify studies that explicate the lived experience of MOUD, (b) conduct a methodologically sound critical quality assessment, (c) conduct a metasynthesis of identified qualitative studies, and (d) analyze the results through the lenses of critical social justice, feminist standpoint, and social theories to inform a more culturally responsive, effective, and holistic approach to treatment to increase the utilization of and receptivity to MOUD in the treatment of OUDs.

Design and methods: Metasynthesis is the deliberate process of synthesizing data from multiple qualitative studies to create a new interpretation of previously published research. Our metasynthesis focused on forming a new interpretation of the lived experience of MOUD. Of the 292 studies identified, eight met inclusion criteria. The overall quality of the studies was variable. The study population included adults aged ≥ 18 years with OUD or dependency.

Results: Metasynthesis produced three overarching themes: (a) The duplexity of MOUD creates ambivalence in how a person experiences MOUD; (b) the structure of treatment and systemic influences matter, and (c) MOUD as a stepping-stone with multiple meanings in recovery.

Implications: Understanding experiential dualities allows professionals to see from other perspectives and can inform interventions and treatment structures as well as serve as a backdrop for social change. The synthesized new meaning of MOUD was an ambivalent experience influenced by intersectionality.

Abstract: Support within the nursing community for those coping with substance misuse has been lacking for over a hundred years. A review of the history of substance use disorders in nursing reveals that nurses still encounter similar risks, stigma, and punishments today. Kristin, a nurse for over 30 years, tells her story of trials, tribulations, and triumphs with substance use. She shares how having to face early recovery on her own sparked the development of the Wisconsin Peer Alliance for Nurses (WisPAN). WisPAN offers a community for nurses in recovery to provide peer support to those taking their first steps on the journey toward recovery.

Abstract: Nonmedical prescription stimulants are used to reduce symptoms of inattention, impulsivity, and hyperactivity in children and adults with attention-deficit hyperactivity/disorder. They are Schedule II controlled substances because of their high potential for dependence, and individuals who misuse them without a valid prescription are subject to criminal charges. Stimulant medications are also associated with common side effects (e.g., insomnia) as well as more serious but less common side effects (e.g., arrhythmias). Despite the potential health and legal consequences, misuse of prescription stimulants has become a public health crisis on college campuses in the United States. Neurocognitive enhancement is the primary reason that college students report misusing prescription stimulants, despite no enhancement of cognitive functioning when taken by healthy adults. Nursing students may be at risk for misuse because of their high levels of academic and clinical demands and because many start misusing in nursing school. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the databases PubMed, Science Direct, EBSCOhost, and Academic OneFile were systematically searched to investigate the (a) percentage of prescription stimulant misuse studies that have included nursing students, (b) prevalence of prescription stimulant misuse among nursing students, (c) motivations for prescription stimulant misuse among nursing students, and (d) demographic factors associated with increased use among nursing students. Results revealed that of the 197 studies conducted within the past decade (2010-2021), only 1.02% (two) included nursing students. Future studies must investigate the prevalence and nature of prescription stimulant misuse among nursing students.

Purpose: This quality improvement project was introduced at an addiction treatment center to implement the Centers for Disease Control and Prevention's (CDC's) hepatitis C virus (HCV) treatment guidelines and offer anticraving medications to patients to improve standards of care of patients with substance use disorders.

Literature review: Patients with opioid use disorders are at the highest risk of contracting HCV. More than 80% of people in the United States with opioid use disorders who use intravenous drugs have contracted HCV. Despite the high prevalence of HCV, patients at treatment centers are being screened only for HCV antibodies (HCV-AB) and are not receiving the CDC's HCV treatment guidelines. The CDC has treatment recommendations of hepatitis panels, full STD testing, and early follow-up care.

Method: This quality improvement project utilized the Plan-Do-Study-Act tool. With the application of Plan-Do-Study-Act, for patients identified with HCV-AB, the established CDC HCV treatment guidelines were followed, and the clinical progress of the implementation of the guidelines was monitored. Chart reviews comparing compliance of guidelines before and after the study were implemented.

Participants: A convenience sample of 125 patients were collected, and of these, 32 patients were found to be HCV-AB+.

Findings: The findings revealed that 18.75% of patients followed the CDC's HCV recommendations after the quality improvement project compared with 6.25% of patients before the intervention. The number of HIV testing offered increased by 40.00% as a result of the implementation of the project.

Objective: The aim of this study was to examine the factors associated with alcohol consumption among Thai people by gender using the social determinants of health theoretical framework.

Method: Participants were Thai people aged 15 years or older. A total of 25,758 Thai people were selected through a stratified random sampling method. The study was a secondary analysis of a national cross-sectional study using the data from the Thailand Smoking and Drinking Behavior Survey 2014.

Results: Thai people were regular drinkers (13.69%). Regarding gender, 26.54% of men and 2.72% of women were regular drinkers. The risk factors for regular drinking among Thai men included family members and close friends consuming alcohol, being aged 25-44 years, living in Northern Thailand, being a skilled or unskilled worker, smoking, and income of 10,001-30,000 Thai baht/month (31 Thai Baht (THB)/U.S. dollars). Protective factors against alcohol consumption were living in Southern Thailand and being unemployed/a student. For women, the risk factors for regular drinking were family members and close friends drinking as well as smoking. Being married, living in a nonmunicipal area, holding a diploma or bachelor's degree, and being unemployed/a student were protective factors against alcohol drinking among women.Factors associated with alcohol consumption among Thai people vary by gender. Therefore, solving the drinking problems should consider both the risk and protective factors for men and women separately.

Background: Changes in patterns of drug use and population needs necessitate the adoption of new technologies. Despite high failure rates in adopting new technologies acquired in training, little is known about the process that can support successful change. This study explores the impact that staff and service characteristics have on the process of training adoption in Irish opiate substitution therapy services, with a specific focus on the concept of organizational readiness to change.

Methods: A cross-sectional survey was conducted on a convenience sample of 132 staff members across 12 services in Ireland. The relationship between staff demographics, their perceptions of organizational readiness to change, burnout, and a four-stage process of training adoption were considered.

Results: Discipline, job tenure, and educational levels are important predictors of engagement in the adoption process. Staff in services with higher institutional needs, greater pressures for change, and poorer resources were less likely to be exposed to, or adopt, training. Having lower levels of stress and more influence with peers was associated with better adoption of training.

Conclusions: Planners and service managers need to carefully consider the composition or dynamics of services when initiating change. Organizational readiness to change and staff characteristics as measured by instruments used in this study are important determinants of the process of innovation or training adoption and provide a good basis for developing further understanding of how treatment services work. This article expands on results from previous studies conducted in the United States to a European context.

Objective: The aim of this study was to explore client experiences in a community-based injectable opioid agonist therapy (iOAT) program.

Study setting: The study occurred across two cities in Alberta, Canada.

Study design: The research team conducted secondary interpretive description analysis on qualitative interview transcripts.

Data collection: Twenty-three iOAT clients were interviewed as part of a prior quality improvement initiative. Using secondary analysis of the transcripts, interviews were analyzed for themes, to create an understanding of clients' experiences.

Principal findings: Participants accessed iOAT through other health services, for treatment of opioid use disorder. Participants reported that building trusting and supportive relationships with nurses was crucial to their success in the program. Through these relationships, participants experienced stopping and starting. They stopped behaviors such as illicit drug use, having withdrawal symptoms and anxiety, and prohibited income generation activities. They started taking care of themselves, accessing housing, increasing financial stability, receiving primary care, and connecting with friends and family. The global experience of iOAT was one of positive change for participants.

Conclusions: The findings of this study are largely consistent with other published examples-iOAT programs create benefits for both clients and their communities. Although clients may join the program to access the hydromorphone, the relationships between staff and clients are the key driver of success.

Purpose: Although gender differences in adolescent substance use are complex and substance use accompanies mental health problems, most previous studies have focused on gender-specific association between single substance use and mental health. This study aimed to investigate gender-specific substance use patterns and to examine their association with mental health characteristics.

Methods: Nationally representative data from the Korea Youth Risk Behavior Survey collected in 2018 were analyzed. To identify substance use patterns among male adolescents (n = 30,463) and female adolescents (n = 29,577), multiple-group latent class analysis was conducted using eight substance use indicators. In addition, we conducted a latent class analysis with covariates to examine the association between substance use patterns and mental health characteristics.

Results: Among both gender samples, the four-class model best fit the data: nonusers (86.4%), frequent smokers (2.9%), risky drinkers (7.1%), and heavy tobacco and alcohol users with lifetime heated tobacco product use (3.6%) for male adolescents, and nonusers (89.8%), frequent smokers (0.5%), risky drinkers (8.0%), and heavy tobacco and alcohol users with a drunkenness episode (1.7%) for female adolescents. Depression, suicidal plans, and suicidal attempts predicted the latent class model for both genders. In addition, stress level predicted the latent class model for female adolescents.

Conclusions: The findings indicate that homogeneous patterns of substance use by gender are differentially associated with mental health problems. Therefore, health professionals should develop interventions tailored to gender-specific substance use patterns, taking into account the mental health characteristics of each pattern.