Drug and alcohol dependence reports最新文献

Geographic differences in buprenorphine and methadone prescribing for surgical patients with opioid use disorder 阿片类药物使用障碍手术患者丁丙诺啡和美沙酮处方的地理差异

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2025-11-26 DOI: 10.1016/j.dadr.2025.100397

Caitlin P. Coates , Margaret McGlothlin Carroll , Janelle M. Richard , Wendy Y. Craig , Aurora N. Quaye

Background

Patients with opioid use disorder (OUD) frequently present for surgery while receiving medications for OUD (MOUD), typically buprenorphine or methadone. This study evaluated MOUD use among surgical patients with OUD in a health-system spanning both urban and rural areas in Maine; a predominantly rural state with a significant opioid crisis.

Methods

We retrospectively identified adult surgical patients with OUD admitted to MaineHealth hospitals from 2014 to 2023 who were receiving MOUD prior to the day of surgery. Demographics and clinical characteristics were collected; rural designation was determined using Rural-Urban Commuting Area codes. The primary outcome was the temporal trend in proportion of surgical patients with OUD receiving methadone versus buprenorphine prior to admission. Temporal trends and geographic differences were compared using chi-square tests (p < 0.05).

Results

Of 2099 surgical patients on MOUD, 71.4 % received buprenorphine and 28.6 % methadone. Overall, rural patients were more likely to receive buprenorphine than urban patients (75.1 % vs. 68.5 %) (p < 0.001). Buprenorphine prescribing increased from 52.0 % to 84.2 % in rural areas and from 59.3 % to 72.9 % in urban areas, with corresponding declines in methadone use (both p < 0.05).

Conclusions

Temporal trends showed a significant shift in MOUD prescribing over the study period, with buprenorphine use increasing and methadone use declining in rural and urban populations. Although both medications are considered safe in hospitalized and surgical patients, perioperative management remains inconsistent. Further work is needed to evaluate how these prescribing trends influence clinical outcomes and ensure perioperative protocols support continuity of care for patients with OUD.

背景阿片类药物使用障碍（OUD）患者在接受OUD （mod）药物治疗时经常出现手术，通常是丁丙诺啡或美沙酮。本研究评估了缅因州城市和农村地区的医疗系统中手术OUD患者的使用情况；一个以农村为主的州，存在严重的阿片类药物危机。方法回顾性分析2014年至2023年在缅因州卫生医院接受手术治疗的成年OUD手术患者，这些患者在手术当日接受了mod。收集人口统计学和临床特征；使用城乡通勤区域代码确定农村名称。主要结局是入院前接受美沙酮和丁丙诺啡治疗的OUD手术患者比例的时间趋势。采用卡方检验比较时间趋势和地理差异（p < 0.05）。结果2099例mod手术患者中，71.4%接受丁丙诺啡治疗，28.6%接受美沙酮治疗。总体而言，农村患者比城市患者更有可能接受丁丙诺啡（75.1%比68.5%）（p < 0.001）。丁丙诺啡的处方在农村地区从52.0%增加到84.2%，在城市地区从59.3%增加到72.9%，美沙酮的使用也相应下降（p < 0.05）。结论在研究期间，农村和城市人群中丁丙诺啡的使用增加，美沙酮的使用减少，这一趋势在全国范围内发生了显著变化。尽管这两种药物在住院和手术患者中被认为是安全的，但围手术期的管理仍然不一致。需要进一步的工作来评估这些处方趋势如何影响临床结果，并确保围手术期方案支持OUD患者护理的连续性。

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引用次数: 0

Corrigendum to “The experience of individuals living with alcohol use disorder within palliative care and end of life services: A scoping review” [Drug Alcohol Depend. 17 (2025) 100383] “在姑息治疗和临终服务中患有酒精使用障碍的个人的经历：范围审查”的勘误表[药物酒精依赖，17 (2025)100383]

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-03-11 DOI: 10.1016/j.dadr.2025.100401

Amélie Deschamps , Andrée-Anne Légaré , Anne-Marie Auger , Natalia Muñoz Gómez , Magaly Brodeur

引用次数: 0

Hallucinogen use in the United States, 2021–2023: Diverging trends and subgroup patterns 致幻剂在美国的使用，2021-2023：不同的趋势和亚组模式

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-01-19 DOI: 10.1016/j.dadr.2026.100410

Jing-Jer Chen , Carla J. Berg , Y. Tony Yang

Background

While interest in the therapeutic and recreational use of hallucinogens has increased, national surveillance often reports use in aggregate, potentially masking shifting trends among pharmacologically distinct substances. This study assessed trends in specific hallucinogens from 2021 to 2023 and identified correlates of use, with particular attention to subgroup patterns in populations commonly prioritized for prevention and access-focused interventions.

Methods

Using nationally representative NSDUH data (2021–2023; ages ≥12), we estimated annual past-year prevalence of LSD, PCP, ecstasy (MDMA), ketamine, Salvia divinorum, and tryptamines (including DMT). We fit survey-weighted logistic regression models with year (continuous) to assess trends and pooled multivariable models to examine demographic correlates.

Results

Although overall past-year hallucinogen use was stable (2.83 % [95 % CI: 2.52–3.14] in 2021; 2.82 % [2.52–3.12] in 2023), substance-specific trends diverged. LSD declined (aOR per year=0.83, 95 % CI: 0.75–0.93), from 0.88 % (0.72–1.04) in 2021–0.58 % (0.47–0.68) in 2023. Ketamine increased (aOR=1.11, 95 % CI: 1.02–1.21), from 1.61 % (1.42–1.80) to 1.91 % (1.67–2.16). Ecstasy/MDMA and tryptamines were stable, and PCP and Salvia remained rare. Use concentrated among young adults and males; adjusted models indicated higher odds among uninsured respondents and those below the federal poverty level.

Conclusions

Despite stable overall hallucinogen prevalence, significant increases were observed for ketamine alongside declines for LSD, suggesting a shifting landscape of hallucinogen use. Substance-specific monitoring may better inform screening, prevention, and harm-reduction efforts than aggregate hallucinogen indicators, especially as ketamine’s medical availability expands and disparities in access to mental health treatment persist.

虽然对致幻剂治疗和娱乐用途的兴趣有所增加，但国家监测经常报告总体使用情况，可能掩盖了药理学上不同物质之间的变化趋势。本研究评估了2021年至2023年特定致幻剂的趋势，并确定了使用的相关性，特别关注通常优先考虑预防和以获取为重点的干预措施的人群中的亚组模式。方法使用具有全国代表性的NSDUH数据（2021-2023年，年龄≥12岁），我们估计了过去一年LSD、PCP、摇头丸（MDMA）、氯胺酮、鼠尾草和色胺（包括DMT）的年度患病率。我们拟合调查加权逻辑回归模型与年份（连续）来评估趋势，并合并多变量模型来检查人口统计学相关性。结果尽管过去一年致幻剂的总体使用情况稳定（2021年为2.83% [95% CI: 2.52-3.14]； 2023年为2.82%[2.52-3.12]），但具体药物的使用趋势存在差异。LSD下降（aOR每年=0.83,95% CI: 0.75-0.93），从2021年的0.88%（0.72-1.04）下降到2023年的0.58%（0.47-0.68）。氯胺酮增加（aOR=1.11, 95% CI: 1.02 ~ 1.21），从1.61%（1.42 ~ 1.80）增加到1.91%（1.67 ~ 2.16）。摇头丸/MDMA和色胺稳定，PCP和鼠尾草仍然罕见。使用集中在年轻人和男性中；调整后的模型显示，未投保的受访者和低于联邦贫困线的受访者的患病几率更高。结论：尽管致幻剂的总体使用率稳定，但氯胺酮的使用率显著上升，LSD的使用率下降，这表明致幻剂的使用正在发生变化。与综合致幻剂指标相比，特定物质的监测可能更好地为筛查、预防和减少危害的努力提供信息，特别是在氯胺酮的医疗可用性扩大和精神健康治疗方面的差距持续存在的情况下。

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引用次数: 0

The relationship between injection status, cocaine use, overdose, and drug-related behaviors among people who use opioids 阿片类药物使用者注射状态、可卡因使用、过量和药物相关行为之间的关系

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.dadr.2025.100398

Carl A. Latkin , Lauren Dayton , Haley Bonneau , Melissa A. Davey-Rothwell , Grace Tian Yi , Kaori Suga , Oluwaseun Falade-Nwulia

Background

The co-use of opioids and stimulants is associated with elevated health risks. This study examined patterns of injection drug use and cocaine use frequency among people who use opioids.

Methods

Cross-sectional data were collected from community-recruited adults who use opioids in Baltimore, Maryland, between December 7, 2022 and January 26, 2025. Participants were categorized into four groups based on injection status and cocaine use frequency. Multinomial logistic regression examined factors associated with group membership, calculating relative risk ratios (RRR) and adjusted relative risk ratios (aRRR) with 95 % confidence intervals.

Results

Of 777 participants (60.7 % male, 71.6 % Black, median age 52), 29.2 % reported past-month injection drug use. Daily/almost daily use was reported for heroin/fentanyl (79.5 %), crack cocaine (43.2 %), and powder cocaine (9.3 %). Four distinct drug use patterns emerged: not inject/lower frequency cocaine use (42.0 %), inject/lower frequency cocaine use (9.3 %), not inject/higher frequency cocaine use (28.8 %), and inject/higher frequency cocaine use (19.9 %). Factors significantly associated with injecting and higher frequency cocaine use group membership included: overdose history (aRRR=2.58, 95 % CI=1.52–4.38), withdrawal behavior with high overdose risk (aRRR=1.29, 95 % CI=1.14–1.46), and using in multiple locations (aRRR=1.09, 95 % CI=1.02–1.18).

Conclusions

Nearly one-fifth of people who use opioids reported both injection drug use and high-frequency cocaine use, and greater frequency of cocaine use was associated with higher overdose risk. Targeted interventions addressing polysubstance use patterns, social networks, and environmental factors are urgently needed to reduce harm among this high-risk population.

阿片类药物和兴奋剂的共同使用与健康风险升高有关。这项研究调查了阿片类药物使用者的注射毒品使用模式和可卡因使用频率。方法收集2022年12月7日至2025年1月26日期间在马里兰州巴尔的摩社区招募的使用阿片类药物的成年人的横断面数据。参与者根据注射状态和可卡因使用频率分为四组。多项逻辑回归检查与群体成员相关的因素，计算相对风险比（RRR），并以95%的置信区间调整相对风险比（aRRR）。结果在777名参与者中（60.7%为男性，71.6%为黑人，中位年龄52岁），29.2%报告过去一个月使用过注射药物。据报道，海洛因/芬太尼（79.5%）、快克可卡因（43.2%）和粉末可卡因（9.3%）每天或几乎每天使用。出现了四种不同的吸毒模式：不注射/使用频率较低的可卡因（42.0%）、注射/使用频率较低的可卡因（9.3%）、不注射/使用频率较高的可卡因（28.8%）和注射/使用频率较高的可卡因（19.9%）。与注射和高频率可卡因使用组成员显著相关的因素包括：过量使用史（aRRR=2.58, 95% CI= 1.52-4.38）、高过量使用风险的戒断行为（aRRR=1.29, 95% CI= 1.14-1.46）、多地点使用（aRRR=1.09, 95% CI= 1.02-1.18）。结论：近五分之一的阿片类药物使用者报告有注射用药和高频率可卡因使用，高频率可卡因使用与高过量风险相关。迫切需要针对多种物质使用模式、社会网络和环境因素的有针对性的干预措施，以减少对这一高危人群的伤害。

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引用次数: 0

A short communication of pain outcomes following a pharmacist-delivered alcohol and opioid use reduction intervention 药剂师提供的减少酒精和阿片类药物使用干预后疼痛结果的简短交流

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-02-27 DOI: 10.1016/j.dadr.2026.100418

Gerald Cochran , Grace Broussard , Yingjia Wei , Craig Field , Adam J. Gordon , Kenneth C. Hohmeier

Background

Co-use of alcohol and opioid medications increases risk for sedation, respiratory depression, and overdose, yet remains common among patients prescribed opioids. The Alcohol Brief Intervention–Medication Therapy Management (ABI-MTM) intervention was developed for delivery by community pharmacists and demonstrated feasibility, acceptability, and preliminary reductions in co-use. Given possible pain-related motives for co-use, this exploratory secondary analysis assessed whether ABI-MTM affected pain symptomatology.

Methods

This study utilized data from a randomized trial of 44 community pharmacy patients from 25 pharmacies prescribed opioids and who reported alcohol co-use. Participants were randomized to ABI-MTM or standard medication counseling (SMC). Pain intensity/interference were assessed at baseline, 2-, and 3-months using the Brief Pain Inventory–Short Form. Analyses included descriptive statistics, Cohen’s d effect sizes, and mixed-effects models comparing pain across conditions and timepoints.

Results

Pain scores did not differ between groups (p > 0.05). For pain intensity, ABI-MTM and SMC showed similar baseline means (4.31 vs. 5.05), decreased modestly at 2-months (2.80 vs. 3.74), and returned to baseline levels at 3-months (4.21 vs. 4.83). Pain interference followed a comparable pattern, with ABI-MTM and SMC starting similarly (4.83 vs. 5.07), decreasing modestly at 2-months (3.19 vs. 3.87), and returning near baseline at 3-months (4.92 vs. 4.42). Effect sizes between group differences were small (Cohen’s d≤0.33). Mixed-model analyses showed no significant treatment effects on pain intensity/interference across time (p > 0.05).

Conclusions

This underpowered study found no evidence of pain differences between ABI-MTM and SMC, tentatively suggesting possible alcohol-opioid co-use improvements associated with the intervention without worsening pain.

背景：酒精和阿片类药物的共同使用增加了镇静、呼吸抑制和过量的风险，但在处方阿片类药物的患者中仍然很常见。酒精简短干预-药物治疗管理（ABI-MTM）干预被开发出来，由社区药剂师提供，并证明了可行性、可接受性和共同使用的初步减少。考虑到可能与疼痛相关的共同使用动机，本探索性二次分析评估了ABI-MTM是否影响疼痛症状。方法本研究利用来自25家药店的44名社区药房患者的随机试验数据，这些患者开了阿片类药物并报告了饮酒。参与者随机接受ABI-MTM或标准药物咨询（SMC）。疼痛强度/干扰在基线、2个月和3个月时使用简短疼痛量表进行评估。分析包括描述性统计、科恩效应大小和混合效应模型，比较不同条件和时间点的疼痛。结果西班牙评分组间差异无统计学意义（p > 0.05）。对于疼痛强度，ABI-MTM和SMC显示相似的基线平均值（4.31比5.05），在2个月时略有下降（2.80比3.74），并在3个月时恢复到基线水平（4.21比4.83）。疼痛干扰遵循类似的模式，ABI-MTM和SMC开始相似（4.83对5.07），在2个月时适度下降（3.19对3.87），并在3个月时恢复到接近基线（4.92对4.42）。组间差异效应量较小（Cohen’s d≤0.33）。混合模型分析显示，治疗对疼痛强度/干扰无显著影响（p > 0.05）。结论：这项研究没有发现ABI-MTM和SMC之间疼痛差异的证据，初步提示酒精-阿片类药物联合使用可能与干预有关，但不会加重疼痛。

{"title":"A short communication of pain outcomes following a pharmacist-delivered alcohol and opioid use reduction intervention","authors":"Gerald Cochran , Grace Broussard , Yingjia Wei , Craig Field , Adam J. Gordon , Kenneth C. Hohmeier","doi":"10.1016/j.dadr.2026.100418","DOIUrl":"10.1016/j.dadr.2026.100418","url":null,"abstract":"<div><h3>Background</h3><div>Co-use of alcohol and opioid medications increases risk for sedation, respiratory depression, and overdose, yet remains common among patients prescribed opioids. The Alcohol Brief Intervention–Medication Therapy Management (ABI-MTM) intervention was developed for delivery by community pharmacists and demonstrated feasibility, acceptability, and preliminary reductions in co-use. Given possible pain-related motives for co-use, this exploratory secondary analysis assessed whether ABI-MTM affected pain symptomatology.</div></div><div><h3>Methods</h3><div>This study utilized data from a randomized trial of 44 community pharmacy patients from 25 pharmacies prescribed opioids and who reported alcohol co-use. Participants were randomized to ABI-MTM or standard medication counseling (SMC). Pain intensity/interference were assessed at baseline, 2-, and 3-months using the Brief Pain Inventory–Short Form. Analyses included descriptive statistics, Cohen’s d effect sizes, and mixed-effects models comparing pain across conditions and timepoints.</div></div><div><h3>Results</h3><div>Pain scores did not differ between groups (p > 0.05). For pain intensity, ABI-MTM and SMC showed similar baseline means (4.31 vs. 5.05), decreased modestly at 2-months (2.80 vs. 3.74), and returned to baseline levels at 3-months (4.21 vs. 4.83). Pain interference followed a comparable pattern, with ABI-MTM and SMC starting similarly (4.83 vs. 5.07), decreasing modestly at 2-months (3.19 vs. 3.87), and returning near baseline at 3-months (4.92 vs. 4.42). Effect sizes between group differences were small (Cohen’s d≤0.33). Mixed-model analyses showed no significant treatment effects on pain intensity/interference across time (p > 0.05).</div></div><div><h3>Conclusions</h3><div>This underpowered study found no evidence of pain differences between ABI-MTM and SMC, tentatively suggesting possible alcohol-opioid co-use improvements associated with the intervention without worsening pain.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100418"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395468","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}

引用次数: 0

Clinicians’ experiences of delivering online Community Reinforcement and Family Training (CRAFT) for families affected by substance use in rural Australia 临床医生为澳大利亚农村受药物使用影响的家庭提供在线社区强化和家庭培训（CRAFT）的经验。

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-02-12 DOI: 10.1016/j.dadr.2026.100416

Subash Thapa , Heidi Gray , Nicole Snowdon , Brian Serna , Brianna Jacobson , Julaine Allan

Background

Interventions that support family members or concerned significant others (CSOs) of people with alcohol or drug dependence can enhance recovery, strengthen family functioning, and reduce recurrence rates. Yet factors influencing successful implementation of CSO-focused online programs, especially in rural Australia remain poorly understood. This study explored the implementation experiences of clinicians delivering online Community Reinforcement and Family Training (CRAFT).

Methods

This exploratory descriptive qualitative study involved semi-structured interviews with seven clinicians who delivered CRAFT. Data were analysed thematically using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.

Results

CRAFT was perceived as well-structured, feasible, and compatible with routine clinical practice, enhancing clinicians’ confidence and enabling CSOs to develop skills in self-care, positive communication, problem-solving, and supporting healthy behaviours among loved ones. Successful implementation depended on clinician enthusiasm, flexible delivery modes (online as well as in-person), tailored content, and ongoing feedback, while challenges included CSO emotional overwhelm, competing responsibilities, limited digital literacy, and insufficient alcohol and drug services for loved ones. Socio-cultural factors, including reluctance to discuss alcohol or substance dependence, also limited engagement. Clinicians intended to retain key program components in practice but time constraints, telehealth limitations, and rural service gaps hindered sustained integration. Suggested improvements included cultural adaptation and structured opportunities for family–service collaboration.

Conclusions

Online CRAFT is a promising, practice-ready intervention for supporting and empowering rural families affected by alcohol and drug use. Its integration into health services will depend on addressing workforce capacity, digital access, and rural service inequities, alongside policy-level commitment to family-focused programs.

Clinical trial registration

ACTRN12623000796684 (registered 26 July 2023)

背景：支持酒精或药物依赖者的家庭成员或相关重要他人（cso）的干预措施可以促进康复，加强家庭功能，并降低复发率。然而，影响以公民社会组织为重点的在线课程成功实施的因素，特别是在澳大利亚农村，仍然知之甚少。本研究探讨了临床医生提供在线社区强化和家庭培训（CRAFT）的实施经验。方法：这项探索性描述性定性研究包括对7名实施CRAFT的临床医生进行半结构化访谈。使用RE-AIM （Reach, Effectiveness, Adoption, Implementation, Maintenance）框架对数据进行了主题分析。结果：CRAFT被认为结构良好，可行，与常规临床实践相兼容，增强了临床医生的信心，使cso能够发展自我护理，积极沟通，解决问题和支持亲人健康行为的技能。成功的实施取决于临床医生的热情、灵活的交付模式（在线和面对面）、量身定制的内容和持续的反馈，而挑战包括CSO的情绪压力、相互竞争的责任、有限的数字素养以及为亲人提供的酒精和药物服务不足。社会文化因素，包括不愿讨论酒精或物质依赖，也限制了参与。临床医生打算在实践中保留关键的方案组成部分，但时间限制、远程医疗限制和农村服务差距阻碍了持续整合。建议的改进包括文化适应和家庭服务合作的结构性机会。结论：在线CRAFT是一种有希望的、可付诸实践的干预措施，可为受酒精和药物使用影响的农村家庭提供支持和赋权。将其纳入卫生服务将取决于解决劳动力能力、数字获取和农村服务不平等问题，以及政策层面对以家庭为重点的规划的承诺。临床试验注册：ACTRN12623000796684（2023年7月26日注册）。

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引用次数: 0

Rural community peer partnerships for improving methamphetamine -associated heart failure screening and engagement in cardiology care (PEER-Heart): Study protocol 农村社区同伴伙伴关系改善甲基苯丙胺相关心力衰竭筛查和参与心脏病学护理（peer - heart）：研究方案。

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.dadr.2026.100411

Maria Alias-Ferri , Cooper B. Kersey , Evan F. Shalen , Ryan Cook , Devin Gregoire , Kim Hoffman , Michelle Beam , Ximena A. Levander , Kellie Pertl , Alexis Stensby , Paul Gonzales , Shanna Smith , Tabetha Evernden , Chris T. Longenecker , P. Todd Korthuis , Brian Chan

Background

Methamphetamine-associated heart failure (MAHF) is increasingly prevalent in rural communities, where limited specialty care and barriers to healthcare engagement hinder early diagnosis and treatment. Peer-led screening with brain natriuretic peptide (BNP) testing, supported by telemedicine, may enhance early detection and linkage to cardiology care.

Aim

PEER-Heart is a hybrid type 1 effectiveness-implementation trial to evaluate the feasibility, acceptability, and effectiveness of a peer-assisted point-of-care screening protocol and telecardiology intervention for MAHF in rural Oregon.

Methods

We will recruit 122 adults reporting methamphetamine use within the past 30 days from two rural Oregon counties. Individuals will be screened for MAHF by peers using a symptom questionnaire, brain natriuretic peptide (BNP) testing, and a mobile electrocardiogram. Individuals who screen positive will be randomized to a peer-facilitated telecardiology intervention or enhanced usual care (EUC). Primary outcome is linkage to heart failure treatment at 2 months. Secondary outcomes include changes in symptom severity, knowledge, and engagement in guideline-directed medical therapy. Implementation barriers and facilitators will be assessed through interviews and focus groups using thematic analysis and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. We hypothesize that peer-assisted telecardiology will result in higher linkage to care. The study will assess the feasibility and acceptability of peer-delivered cardiovascular screening and telecardiology in high-risk populations.

Conclusion

PEER-Heart addresses a critical gap in early detection and management of heart failure for people who use methamphetamine in rural settings. Findings will inform efforts to scale peer-integrated telemedicine programs for underserved populations with complex needs.

背景：甲基苯丙胺相关心力衰竭（MAHF）在农村社区越来越普遍，在那里，有限的专科护理和医疗保健参与障碍阻碍了早期诊断和治疗。在远程医疗的支持下，同伴主导的脑利钠肽（BNP）检测筛查可以增强早期发现和与心脏病学护理的联系。目的：PEER-Heart是一项混合1型有效性实施试验，旨在评估俄勒冈州农村MAHF的同伴辅助点护理筛查方案和心脏远端学干预的可行性、可接受性和有效性。方法：我们将从俄勒冈州两个农村县招募122名报告在过去30天内使用甲基苯丙胺的成年人。个体将由同伴使用症状问卷、脑钠肽（BNP）测试和移动心电图筛查MAHF。筛查呈阳性的个体将被随机分配到同侪促进的心电学干预或增强常规护理（EUC）组。主要结局是与2个月心力衰竭治疗的联系。次要结局包括症状严重程度、知识和参与指南指导的药物治疗的变化。实施障碍和促进因素将通过访谈和焦点小组进行评估，采用专题分析和覆盖、有效性、采用、实施、维护（RE-AIM）框架。我们假设，同侪协助的心电学将导致更高的联系护理。该研究将评估在高危人群中同伴传递的心血管筛查和心脏远端学的可行性和可接受性。结论：PEER-Heart解决了农村地区甲基苯丙胺使用者心力衰竭早期发现和管理的关键问题。研究结果将为为有复杂需求的未得到充分服务的人群提供规模对等综合远程医疗项目的努力提供信息。

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引用次数: 0

Statewide trends in access to medications for opioid use disorder (moud) among adolescents with opioid use disorders in Indiana 印第安纳州阿片类药物使用障碍青少年获得阿片类药物使用障碍（mod）的全州趋势。

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.dadr.2026.100417

Sumedha Gupta , Katherine Schwartz , Lauren Arnold Bell , Nicole Siegal , Matthew C. Aalsma

Purpose

Opioid use disorder (OUD) and related harms have risen among adolescents, yet access to medications for OUD (MOUD) remains limited, particularly among Medicaid-enrolled youth. This study examines trends in OUD diagnosis and MOUD receipt among Indiana Medicaid adolescents and differences by race, ethnicity, and age.

Design

Setting, and participants Retrospective cross-sectional study of 2019–2023 Indiana Medicaid claims for adolescents aged 12–17.

Main outcomes and measures Outcomes were initial OUD diagnosis, MOUD receipt conditional on diagnosis, and MOUD initiation delay, examined at beneficiary and population levels. Analyses were stratified by demographics, with linear regression assessing predictors.

Results

Of 420,361 Medicaid adolescents, 871 (0.2 %) had an OUD diagnosis and 73 (8.4 %) among them received MOUD. Diagnosis rates increased 67 % between 2019 and 2023, with higher rates among males and White adolescents. Black and Hispanic adolescents were less likely than White peers to be diagnosed (–11 % and –7 %, respectively); among those diagnosed, Black youth were far less likely to receive MOUD (–89 %), while Hispanic youth had the highest treatment rate (15.8 %). Delays in MOUD initiation was longest for Black adolescents (781 days), followed by White (665 days) and Hispanic (588 days) youth. Younger teens (12–14) were less likely to be diagnosed (–20 %) and treated (–56 %) than older peers.

Conclusions

AND RELEVANCE MOUD access among Indiana Medicaid adolescents remains low, with persistent racial and ethnic differences in diagnosis and treatment rates. Targeted policies are needed to expand equitable access, particularly for Black and younger adolescents.

目的：阿片类药物使用障碍（OUD）及其相关危害在青少年中有所上升，但获得OUD （mod）药物的途径仍然有限，特别是在参加医疗补助的青少年中。本研究考察了印第安纳州接受医疗补助的青少年中OUD诊断和mod接收的趋势以及种族、民族和年龄的差异。2019-2023年印第安纳州12-17岁青少年医疗补助申请的回顾性横断面研究。主要结果和测量结果是在受益人和人群水平上进行的首次OUD诊断，诊断条件下的mod接收和mod启动延迟。分析按人口统计学分层，用线性回归评估预测因子。结果：在420,361名接受医疗补助的青少年中，871名（0.2%）被诊断患有OUD，其中73名（8.4%）接受了mod治疗。2019年至2023年期间，诊断率增加了67%，男性和白人青少年的诊断率更高。黑人和西班牙裔青少年被确诊的可能性低于白人（分别为- 11%和- 7%）；在确诊的人群中，黑人青年接受mod治疗的可能性要小得多（- 89%），而西班牙裔青年的治疗率最高（15.8%）。黑人青少年的mod启动延迟时间最长（781天），其次是白人（665天）和西班牙裔（588天）青少年。年龄较小的青少年（12-14岁）被诊断和治疗的可能性（- 20%）低于年龄较大的同龄人（- 56%）。结论：在印第安纳州接受医疗补助的青少年中，mod的使用率仍然很低，在诊断率和治疗率方面存在持续的种族和民族差异。需要有针对性的政策来扩大公平获取机会，特别是对黑人和青少年。

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引用次数: 0

Barriers and facilitators to methadone dispensing for opioid use disorder in community pharmacies: A scoping review 社区药房阿片类药物使用障碍美沙酮调剂的障碍和促进因素：范围审查

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.dadr.2026.100413

Caroline Shubel , Mary Ava Nunnery , Grace Marley , Bayla Ostrach , Delesha M. Carpenter

Background

Methadone, an evidence-based medication for opioid use disorder (MOUD), is available through prescription at community pharmacies in countries like Canada, Australia, and the United Kingdom, but not in the United States (U.S.). The objective of this scoping review was to summarize barriers and facilitators related to dispensing methadone in community pharmacies to inform future implementation efforts in the U.S.

Methods

A scoping review was conducted using PubMed, Embase, SCOPUS, and CINAHL. Original research articles related to barriers and/or facilitators around community pharmacy-based methadone dispensing were included. No search limits (year of publication, geographic boundaries) were applied to the search strategy. Two independent researchers screened all articles for eligibility, extracted data, and met to reach consensus. Data were extracted on 12 items, with a particular focus on barriers and facilitators to dispensing methadone in community pharmacies.

Results

Forty-one articles were included in the review. The most common barriers to methadone dispensing were workload (n = 14), safety concerns for staff and property (n = 13), concern about patient behavior and interactions (n = 12), financial hardship (for pharmacists and patients) (n = 11), and stigma and discrimination towards patients (n = 11). The most common facilitators were pharmacist training and education (n = 14), positive pharmacist-patient relationships (n = 14), and privacy (n = 10).

Conclusions

The findings from this review can be used to address barriers and incorporate known facilitators into future protocols or practice of pharmacy-based methadone dispensing. Further research is needed to identify U.S. and state-specific anticipated needs for pharmacy-based methadone dispensing.

美沙酮是一种治疗阿片类药物使用障碍（mod）的循证药物，在加拿大、澳大利亚和英国等国家的社区药店可以通过处方获得，但在美国则不行。本综述的目的是总结与社区药房配药美沙酮相关的障碍和促进因素，为美国未来的实施工作提供信息。方法综述使用PubMed、Embase、SCOPUS和CINAHL进行。纳入了与社区药房美沙酮分配障碍和/或促进因素相关的原创研究文章。没有搜索限制（出版年份，地理边界）应用于搜索策略。两名独立研究人员筛选所有文章的合格性，提取数据，并会面达成共识。提取了12个项目的数据，特别侧重于在社区药房分发美沙酮的障碍和促进因素。结果共纳入41篇文献。最常见的障碍是工作量（n = 14），对工作人员和财产的安全担忧（n = 13），对患者行为和互动的担忧（n = 12），经济困难（药剂师和患者）（n = 11），以及对患者的羞辱和歧视（n = 11）。最常见的促进因素是药师培训和教育（n = 14）、积极的药师-患者关系（n = 14）和隐私（n = 10）。结论本综述的发现可用于解决障碍，并将已知的促进因素纳入未来基于药物的美沙酮分配方案或实践中。需要进一步的研究来确定美国和各州对基于药物的美沙酮分配的预期需求。

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引用次数: 0

Characteristics and comorbidities of patients on opioid agonist therapy in Switzerland: A descriptive analysis of the nationwide SAMMSU cohort 瑞士阿片类激动剂治疗患者的特征和合并症：对全国SAMMSU队列的描述性分析

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-03-01 Epub Date: 2025-12-16 DOI: 10.1016/j.dadr.2025.100404

Michael Lütolf , Andrea Bregenzer , Philip Bruggmann , Alberto Moriggia , Claude Scheidegger , Katharina Hensel-Koch , Erika Castro Batänjer , Maria Christine Thurnheer , Pascale Della Santa , Oliver Senn , Thomas Grischott

Background

Opioid agonist therapy (OAT) is the gold standard of treatment for opioid dependence and a cornerstone of Swiss drug policy. The Swiss Association for the Medical Management in Substance Users (SAMMSU) cohort was established to monitor health trends and improve care for OAT patients across Switzerland.

Methods

Baseline and follow-up data collected from eight centres between 2014 and 2024 were analysed descriptively, including demographic and psychosocial characteristics, substance use history, prescribed OAT, co-medications, and somatic and psychiatric comorbidities.

Results

During the study, the SAMMSU cohort included 1 502 participants. Median individual age at registration was 44.3 years, rising to a cohort median of 50.9 years by the end of 2024; 75.7 % of participants were male. Lifetime heroin use was reported by 97.2 %, with 73.2 % having a history of intravenous drug use. Ongoing illicit and intravenous drug use declined over time, while prescribed OAT shifted from methadone to long-acting morphine and diacetylmorphine. The most prevalent lifetime somatic comorbidities were hepatitis C (56.5 %), (pre)hypertension (18.6 %), musculoskeletal disorders (13.8 %), and needle abscesses (13.7 %). Psychiatric disorders – primarily affective (34.8 %), personality (23.2 %), and anxiety disorders (18.0 %) – contributed to multimorbidity and a high prevalence of polypharmacy (49.2 %). There were 120 deaths, mainly from malignancy, overdose, and liver failure, with a median age at death of 51.6 years.

Conclusion

SAMMSU cohort trends corroborate the effectiveness of OAT in reducing illicit drug use and underscore the need for OAT services to evolve from an addiction-focused model to comprehensive chronic care for an ageing and highly vulnerable population.

阿片类药物激动剂治疗（OAT）是治疗阿片类药物依赖的黄金标准，也是瑞士药物政策的基石。瑞士药物使用者医疗管理协会（SAMMSU）队列的建立是为了监测瑞士各地OAT患者的健康趋势和改善护理。方法对2014年至2024年8个中心收集的基线和随访数据进行描述性分析，包括人口统计学和社会心理特征、药物使用史、处方OAT、联合用药以及躯体和精神合并症。结果在研究期间，SAMMSU队列包括1 502名参与者。个人登记年龄中位数为44.3岁，到2024年底将上升到50.9岁；75.7%的参与者为男性。97.2%的人终生使用海洛因，其中73.2%的人有静脉吸毒史。持续的非法和静脉注射药物的使用随着时间的推移而下降，而处方OAT从美沙酮转向长效吗啡和二乙酰吗啡。最常见的终生躯体合并症是丙型肝炎（56.5%）、高血压（18.6%）、肌肉骨骼疾病（13.8%）和针脓肿（13.7%）。精神障碍——主要是情感性障碍（34.8%）、人格障碍（23.2%）和焦虑症（18.0%）——导致多重发病和多重用药的高患病率（49.2%）。有120例死亡，主要死于恶性肿瘤、用药过量和肝功能衰竭，死亡时的中位年龄为51.6岁。结论：sammsu队列趋势证实了OAT在减少非法药物使用方面的有效性，并强调了OAT服务需要从以成瘾为重点的模式发展为针对老龄化和高度脆弱人群的综合慢性护理。

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引用次数: 0