Journal of substance use and addiction treatment最新文献

{"title":"Patient experiences in outpatient substance use disorder treatment: A qualitative study exploring both clinical and non-clinical contexts","authors":"Sugy Choi ,&nbsp;Jasmin Choi ,&nbsp;Megan O'Grady ,&nbsp;Diego Renteria ,&nbsp;Crissy Oueles ,&nbsp;Eddie Liebmann ,&nbsp;Pat Lincourt ,&nbsp;Ashly E. Jordan ,&nbsp;Charles J. Neighbors","doi":"10.1016/j.josat.2024.209581","DOIUrl":"10.1016/j.josat.2024.209581","url":null,"abstract":"<div><h3>Background</h3><div>Addressing the persistent treatment gap in substance use disorder (SUD) remains a critical challenge, with only 13 % of Americans with SUDs receiving necessary treatment. We explored the complexities of engaging in SUD treatment from patients' perspectives and aims to provide a comprehensive understanding of their treatment experiences.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with 34 patients who had been attending outpatient SUD clinics in New York State for 6 or less months. Participants were recruited from seven clinics using purposive sampling. Interviews were conducted between June and August 2022. We conducted thematic analysis of coded data to explore patients' experiences and preferences while navigating their treatment journeys.</div></div><div><h3>Results</h3><div>Critical elements for a positive treatment experience included cultural humility, confidentiality, consistency, trust, peer counselors with SUD experience, a strong sense of connection, and addressing needs beyond clinical settings. These included assistance with housing and employment, participation in external clinic events, and access to amenities like coffee and snacks. Participants favored holistic treatment approaches integrating mental health and involving peer recovery counselors. However, participants also identified ineffective aspects, including rigid and generic approaches, stigmatizing attitudes, and challenges related to communities and environmental influences.</div></div><div><h3>Conclusion</h3><div>The study highlights the multifaceted nature of outpatient SUD treatment, emphasizing the integration of patient-centered, holistic, and culturally competent approaches. Tailoring interventions to individual circumstances and acknowledging the diverse needs of patients are imperative for effective healthcare practices.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209581"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669869","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}

{"title":"Evaluating public health vending machine rollout and utilization in criminal-legal settings","authors":"Rosemarie Martin ,&nbsp;Alyssa DaCunha ,&nbsp;Amelia Bailey ,&nbsp;Raynald Joseph ,&nbsp;Kimberly Kane","doi":"10.1016/j.josat.2024.209584","DOIUrl":"10.1016/j.josat.2024.209584","url":null,"abstract":"<div><h3>Introduction</h3><div>Harm reduction resources for people who are involved in the criminal-legal system should be easily accessible. The Rhode Island Department of Corrections (DOC) used funding from a state opioid stewardship fund created through the Rhode Island Opioid Stewardship Act (legislation passed in 2019) to implement five custom-designed vending machines for community corrections offices and state awaiting trial carceral facilities. The vending machines provide resources for overdose prevention, infection prevention, basic needs, and nicotine replacement therapy (NRT). We aim to describe the development and rollout of the vending machines and present data about items taken most frequently by setting.</div></div><div><h3>Methods</h3><div>Research and design experts, with DOC and community stakeholders, developed and tailored the public-facing design of the vending machines. Before implementation, the researchers from the development team conducted meetings with staff at each location to discuss harm reduction and their role in addressing the opioid crisis in this high-risk population. The machines were manufactured in 2022 and installed in early 2023 (dates varied by location). The community support and advocacy organization tracks and maintains inventory (items taken and replaced) by month. No individual-level client data is collected.</div></div><div><h3>Results</h3><div>There were 3720 items dispensed from May 2022 to February 2024 across five locations. Overall, hygiene kits were the most frequently accessed item (28.3 %, <em>n</em> = 1051), followed by NRT (19.0 %, <em>n</em> = 706) and ponchos (16.6 %, <em>n</em> = 616). The fentanyl tests (<em>n</em> = 230), wound care kits (<em>n</em> = 248), resource guide (<em>n</em> = 253), naloxone (<em>n</em> = 221), and safer sex kits (<em>n</em> = 218) each made up between 5.9 % and 6.8 % of items accessed. The pregnancy test was the least accessed at 4.8 % (<em>n</em> = 177). There were statistically significant differences in the monthly number of items distributed by location for the basic needs items, excluding NRT, with 39 items per month at the three Probation/Parole locations compared to 21 per month for the two DOC facilities.</div></div><div><h3>Conclusions</h3><div>The utilization patterns demonstrate the demand for basic supplies and support related to harm reduction. Monitoring and summarizing utilization ensures that the vending machines remain useful to the community and facilitates transparency and communication with stakeholders.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209584"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649766","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}

{"title":"The phenotype of recovery XII: A reinforcer pathology perspective on associations between delay discounting and pain catastrophizing in substance use disorder recovery","authors":"Candice L. Dwyer ,&nbsp;William H. Craft ,&nbsp;Yu-Hua Yeh ,&nbsp;Daniel A.R. Cabral ,&nbsp;Liqa N. Athamneh ,&nbsp;Allison N. Tegge ,&nbsp;Jeffrey S. Stein ,&nbsp;Warren K. Bickel","doi":"10.1016/j.josat.2024.209573","DOIUrl":"10.1016/j.josat.2024.209573","url":null,"abstract":"<div><h3>Background</h3><div>Substance use disorder (SUD) and pain are highly comorbid conditions and several pain indices (e.g., pain intensity) are associated with an increased risk of relapse. However, the cognitive-emotional experience of pain (i.e., pain catastrophizing) is understudied in SUD recovery. Further, how the association between pain catastrophizing and delay discounting - a posited biomarker of addiction, impacts multidimensional aspects of SUD recovery, including remission and quality of life (QOL), has yet to be examined.</div></div><div><h3>Methods</h3><div>Individuals (<em>n</em> = 170) in SUD recovery reporting pain were asked about their chronic pain status, completed the Brief Pain Inventory, the Pain Catastrophizing Scale, an Adjusting Amount Delay Discounting Task, and the World Health Organization QOL-BREF scale. Univariate logistic and linear regressions examined associations between delay discounting and several pain indices with remission and QOL. Mediation analyses were investigated whether pain catastrophizing mediates the relationship between delay discounting and 1) sustained remission and 2) QOL.</div></div><div><h3>Results</h3><div>Significant negative associations were found between delay discounting (<em>p</em> &lt; .001) and pain catastrophizing (<em>p</em> = .001) with sustained remission. Pain catastrophizing significantly mediated the relationship between delay discounting and physical QOL (<em>p</em> = .044), psychological QOL (<em>p</em> = .009), social (<em>p</em> = .018), and environmental QOL (<em>p</em> = .014). Pain catastrophizing did not mediate the relationship between DD and sustained remission.</div></div><div><h3>Conclusion</h3><div>Individuals with greater DD exhibited greater pain catastrophizing, contributing to poorer QOL in SUD recovery. Our findings support that a Reinforcer Pathology framework is useful to understanding the cognitive-emotional experience of pain within the context of SUD recovery. Interventions that target both delay discounting and maladaptive cognitive and emotional responses to pain may lessen the negative impact of pain on SUD recovery and improve SUD outcomes.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209573"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634209","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}

{"title":"Certified peer recovery support specialists and substance use related emergency department visits: A mixed methods study of the patient experience","authors":"Mia Rae Kirk ,&nbsp;Haley Etchart ,&nbsp;Jon Soske ,&nbsp;Robert W. Harding ,&nbsp;Elizabeth A. Samuels ,&nbsp;Stephanie Woodard ,&nbsp;Roy F. Oman ,&nbsp;Karla D. Wagner","doi":"10.1016/j.josat.2024.209563","DOIUrl":"10.1016/j.josat.2024.209563","url":null,"abstract":"<div><h3>Introduction</h3><div>Emergency department (ED) peer-delivered interventions have been implemented across the country to improve outcomes for people who use drugs. In this study we describe what elements patients believe led to a positive interaction with a certified peer recovery support specialist (CPRSS) in the ED and discuss implications when those elements were missing.</div></div><div><h3>Methods</h3><div>This is a qualitatively driven mixed methods study embedded within a larger longitudinal study. Using a close and open-ended question interview guide, we interviewed 26 participants from 2018 to 2023 who met with a CPRSS in a Nevada ED for a substance use related concern. Interviews were recorded and transcribed verbatim. Thematic analysis was used to code the transcripts and generate themes. Quantitative data (satisfaction, therapeutic alliance, and social support) were analyzed using student-t, Fisher's exact, and one-way ANOVA tests.</div></div><div><h3>Results</h3><div>Participants described numerous elements that they believed contributed to being satisfied with their CPRSS interaction, which we grouped into three categories: 1) how the CPRSS interaction felt, 2) how the CPRSS services were delivered, and 3) patient factors that influenced the interaction with a CPRSS. Elements that contributed to their satisfaction, including whether the CPRSS adapted to their current circumstances, if they received personalized referrals, and how their own mental and physical state impacted their receptivity to services.</div></div><div><h3>Conclusions</h3><div>Our findings highlight areas to optimize implementation and increase program uptake for future ED-based CPRSS-delivered interventions, including training CPRSS in the philosophy of harm reduction, following up with the patient post-ED, and tailoring services to the patients' immediate needs.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209563"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634170","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}

{"title":"Cost and cost-effectiveness of abstinence-contingent wage supplements for adults experiencing homelessness and alcohol use disorder","authors":"Stephen Orme ,&nbsp;Gary A. Zarkin ,&nbsp;Laura J. Dunlap ,&nbsp;Jackson Luckey ,&nbsp;Forrest Toegel ,&nbsp;Matthew D. Novak ,&nbsp;August F. Holtyn ,&nbsp;Kenneth Silverman","doi":"10.1016/j.josat.2024.209569","DOIUrl":"10.1016/j.josat.2024.209569","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol use disorder, unemployment, and risk of homelessness are linked and often co-occurring, but most interventions do not address both alcohol use disorder and unemployment. The Abstinence-Contingent Wage Supplement (ACWS) model of the Therapeutic Workplace offers participants stipends or wage supplements contingent on both their abstaining from alcohol and engaging with an employment specialist or working in a community job. Wearable biosensors continuously tracked alcohol use.</div></div><div><h3>Methods and data</h3><div>The study randomized participants to Usual Care (UC) (<em>n</em> = 57) and ACWS (<em>n</em> = 62). We used micro-costing methods to identify the resources and costs of the 6-month ACWS intervention. The study team tracked the cost of incentives for wearing biosensors, stipends, and wage supplements. We used 6-month cost and effectiveness data to calculate incremental cost-effectiveness ratios and cost-effectiveness acceptability curves.</div></div><div><h3>Results</h3><div>Over the 6-month study period, average intervention costs per participant were $7282, with contingent stipends and wage supplements accounting for 50 % of intervention costs. We also reported average per participant costs for healthcare (UC: $17,785; ACWS: $26,734), justice system (UC: $131; ACWS: $153), and public welfare (UC: $1107; ACWS: $1275). The incremental cost-effectiveness ratios (ICERs) at 6 months were $80,911 for an additional participant abstinent, $3894 for an additional drinking free day, $22,756 for an additional participant employed, and $1514 for an additional day worked.</div></div><div><h3>Conclusions</h3><div>The ACWS intervention for adults with an alcohol use disorder and experiencing homelessness increased costs and improved alcohol use and employment outcomes compared with Usual Care. For policymakers seeking a solution to alcohol use and unemployment with populations experiencing homelessness, ACWS may be a cost-effective solution.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209569"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634175","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}

{"title":"Development of a brief stigma and perceptions questionnaire for pharmacists: An exploratory factor analysis approach in New York state counties enrolled in the healing communities study","authors":"Dawn Goddard-Eckrich ,&nbsp;Kyle Grealis ,&nbsp;Nabila El-Bassel ,&nbsp;David W. Lounsbury ,&nbsp;Nishita Dsouza ,&nbsp;Jennifer Bhuiyan ,&nbsp;Melissa Cervantes ,&nbsp;Angelo Angerame ,&nbsp;Daniel J. Feaster ,&nbsp;Erin Kim ,&nbsp;Terry T.K. Huang ,&nbsp;Nasim S. Sabounchi ,&nbsp;Louisa Gilbert ,&nbsp;Frances R. Levin ,&nbsp;Kevonyah Edwards ,&nbsp;Ohshue S. Gatanaga ,&nbsp;Tara McCrimmon ,&nbsp;James L. David ,&nbsp;Timothy Hunt ,&nbsp;Edward V. Nunes ,&nbsp;Raymond Balise","doi":"10.1016/j.josat.2024.209566","DOIUrl":"10.1016/j.josat.2024.209566","url":null,"abstract":"<div><h3>Introduction</h3><div>Little is known about how pharmacists' attitudes and stigma toward naloxone and Medication for opioid use disorder (MOUD) influence effective linkage to treatment. We examine the psychometrics of a new Pharmacist Opioid Use Disorder Perceptions Questionnaire (P-OUDP-Q), a multidimensional measure to examine pharmacists' stigma and perceptions related to MOUD in the New York State (NYS) site of the HEALing Communities Study.</div></div><div><h3>Methods</h3><div>The study recruited a sample of 324 pharmacists from 16 counties in NYS between January and June 2022. A 74-item questionnaire assessed pharmacists' familiarity with opioid-related medications, protocols, policies and attitudes regarding their role, confidence, and beliefs centered around delivery of MOUD and naloxone in the community. Exploratory factor analysis assessed individual and community-level factors associated with four underlying constructs. Factor scores were compared across the demographic predictors. Variables factor loadings &lt;0.4 were eliminated from the factor analysis and the process was reiterated.</div></div><div><h3>Results</h3><div>Eighty-six percent (<em>n</em> = 280) of the pharmacists were white. A little over half, 57 % (<em>n</em> = 186), were female, 35 % (<em>n</em> = 113) were 30–35 years old. The mean number of years practicing (SD) was 18 (SD: 13). Exploratory factor analysis identified four underlying constructs: (1) practice confidence, (2) practice familiarity, (3) practice attitudes, and (4) methadone attitudes. Statistically significant (<em>p</em> &lt; .05) mean factor scale score differences by race were observed for practice familiarity (white reporting higher than non-white); by pharmacy size for practice familiarity (across all groups; non-significant Tukey post-hoc) and practice attitudes (hospital/clinic greater than big chain pharmacies); by gender (males greater than females) for practice familiarity and methadone attitudes; by poverty quartile for practice attitudes (lowest less than highest quartile); and urban versus rural pharmacist county setting for practice familiarity (rural greater than urban).</div></div><div><h3>Conclusions</h3><div>Findings show the P-OUDP-Q is a concise measure of pharmacists' perceptions of their role in dispensing MOUD and naloxone, including distinct “stigma” dimensions, which is valuable for use with pharmacists in communities highly impacted by the opioid epidemic. The development and validation of a reliable measure to assess pharmacists' perceptions of stigma and barriers represents a valuable contribution to the field, to inform the design/implementation of targeted interventions and support systems.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209566"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634177","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}

{"title":"Clinician perspectives on barriers and facilitators to the treatment of adolescent cannabis use: A qualitative study","authors":"Maha N. Mian ,&nbsp;Jay Annam ,&nbsp;Andrea Altschuler ,&nbsp;Monique B. Does ,&nbsp;Stacy A. Sterling ,&nbsp;Derek D. Satre ,&nbsp;Cynthia I. Campbell ,&nbsp;Asma H. Asyyed ,&nbsp;Lynn D. Silver ,&nbsp;Sarah F. Cunningham ,&nbsp;Kelly C. Young-Wolff","doi":"10.1016/j.josat.2024.209559","DOIUrl":"10.1016/j.josat.2024.209559","url":null,"abstract":"<div><h3>Introduction</h3><div>Cannabis use among adolescents is prevalent, and clinicians who work with adolescents have unique insights about how to treat cannabis use in this population.</div></div><div><h3>Methods</h3><div>This qualitative study interviewed 32 clinicians from addiction medicine recovery services (AMRS), the emergency department (ED), mental health (MH), and pediatrics in an integrated healthcare system to understand their perspectives and experiences regarding barriers and facilitators to treating adolescent cannabis use. The analysis was developed using thematic analysis of interviews.</div></div><div><h3>Results</h3><div>Thirty-two clinicians (Mean age = 45.9, SD =7.6; 56.3 % Female; 56.3 % White) were recruited from AMRS (<em>n</em> = 13; 41.6 %), the ED (<em>n</em> = 7; 21.9 %), MH (n = 7; 21.9 %) and pediatrics (<em>n</em> = 5; 15.6 %). Clinicians discussed several key barriers and facilitators of treating adolescent cannabis use. Facilitators include the use of multiple screening tools for adolescent cannabis use (i.e., self-report and toxicology testing) which provide more comprehensive information; patient-centered treatment approaches; and discussing cannabis use in the context of adolescents' mental health. Barriers discussed included adolescents' and parents' minimization of adolescent cannabis use risks. Several factors were discussed as potential facilitators or barriers, depending on context, including the influence of peers, virtual treatment, and parental involvement or lack thereof in treatment.</div></div><div><h3>Conclusions</h3><div>Interviews with clinicians who work with adolescents across settings highlighted factors that serve as barriers and facilitators to treating adolescent cannabis use. These findings have important implications for guiding future research and intervention efforts, including the inclusion of universal screening practices, addressing stigma, reducing adolescents' and parents' minimization of cannabis use-related harms, and improving adolescent and parent engagement in treatment.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209559"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634172","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}

{"title":"Medications for opioid use disorder and other evidence-based service offerings in faith-affiliated treatment centers: Implications for implementation partnerships","authors":"Kim Gannon ,&nbsp;Charles A. Warnock","doi":"10.1016/j.josat.2024.209572","DOIUrl":"10.1016/j.josat.2024.209572","url":null,"abstract":"<div><h3>Introduction</h3><div>Amidst an ongoing surge of opioid use disorder (OUD) incidence, clinicians and policymakers are seeking partnerships with faith communities – including with faith-affiliated treatment centers (FATCs) – to expand access to evidence-based OUD treatment. However, little is known whether FATCs differentially offer such evidence-based treatment services, particularly medications for opioid use disorder (MOUD) and co-occurring mental health care.</div></div><div><h3>Methods</h3><div>We use the 2021 National Substance Use and Mental Health Services Survey (N-SUMHSS) to examine differences in provision of several OUD services, including MOUD, psychological treatments, mental health services, medical services, recovery support services, and services related to treatment accessibility, between self-identified FATCs and non-FATCs. We also explored differences in characteristics related to insurance, licensure, and accreditation.</div></div><div><h3>Results</h3><div>FATCs were less likely than non-FATCs to offer almost all measure of MOUD and more likely to refuse to accept clients who use MOUD. They were also less likely to report using telemedicine. However, they were more likely to offer residential treatment, Twelve Step facilitation, and transitional housing. We find little evidence that FATCs offer co-occurring mental health treatments at different rates than non-FATCs.</div></div><div><h3>Conclusion</h3><div>More research is needed to examine the factors that drive these differences, especially in MOUD and transitional housing. When partnering with FATCs, clinicians and policymakers should seek common ground with FATCs and recognize the philosophies, values, and concerns that may potentially be driving these differences.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209572"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634185","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}

{"title":"Exploring the potential of Self-Management and Recovery Training (SMART Recovery) mutual-help groups for supporting people who use methamphetamine: A qualitative study examining participant experience of initiation and engagement","authors":"Alison K. Beck ,&nbsp;Briony Larance ,&nbsp;Victoria Manning ,&nbsp;Frank P. Deane ,&nbsp;Amanda L. Baker ,&nbsp;Leanne Hides ,&nbsp;Anthony Shakeshaft ,&nbsp;Angela Argent ,&nbsp;Peter J. Kelly","doi":"10.1016/j.josat.2024.209570","DOIUrl":"10.1016/j.josat.2024.209570","url":null,"abstract":"<div><h3>Introduction</h3><div>Improving support options for people who use methamphetamine is of critical national and global importance. The role of mutual-help groups within the treatment-seeking journey of people who use methamphetamine is unclear. Self-Management and Recovery Training (‘SMART Recovery’) mutual-help groups are led by a trained facilitator and support participants to work on individual goals, including, but not limited to abstinence. This study examined how people who use methamphetamine came to be involved in SMART Recovery mutual-help groups and factors associated with engagement.</div></div><div><h3>Methods</h3><div>A sample of Australian SMART Recovery participants who self-reported using methamphetamine in the preceding 12-months (n = 18) discussed their history of substance use and experience of service provision in a semi-structured telephone interview. Interviews were audio-recorded, transcribed, and analysed using iterative categorization.</div></div><div><h3>Results</h3><div>Participant initiation of SMART Recovery groups was described across two themes: i) delayed attendance and ii) use as an adjunct to other services. Factors associated with engagement were discussed in terms of: i) the ‘fit’ of SMART Recovery mutual-help groups; ii) coping and tolerance of discomfort; iii) the power of shared lived experience; iv) choice and autonomy; and v) short-term goal setting supports self-efficacy and the possibility of change.</div></div><div><h3>Discussion and conclusions</h3><div>SMART Recovery mutual-help groups show promise for engaging people who use methamphetamine. There is a clear need to improve awareness of mutual-help group options amongst service users, providers and the general community. Offering choice over mutual-help groups may help to engage people earlier and support improved linkage between services.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209570"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interrupted time series analysis of fentanyl, naloxone, and opioid-involved deaths in five counties in Eastern Missouri","authors":"Schyler T. Newman ,&nbsp;Ian A. McNamara ,&nbsp;Kaytryn D. Campbell ,&nbsp;Brandon Park ,&nbsp;Ryan W. Carpenter ,&nbsp;Brittany A. Blanchard ,&nbsp;Paul Thater ,&nbsp;Lauren Green ,&nbsp;Rachel P. Winograd","doi":"10.1016/j.josat.2024.209564","DOIUrl":"10.1016/j.josat.2024.209564","url":null,"abstract":"<div><h3>Introduction</h3><div>Rates of opioid overdose deaths (OOD) have increased since the introduction of illicitly manufactured fentanyl in the U.S. drug supply. Though community-based naloxone distribution efforts have been found to effectively reduce OOD, no studies to date have examined their effects during the fentanyl era, nor in the epicenter of a state's overdose crisis. Thus, the current study assessed the impacts of both fentanyl and of subsequent grant-funded community-based naloxone distribution on OOD across Missouri's St. Louis region.</div></div><div><h3>Methods</h3><div>Medical examiner data includes individuals who died within one of the five study counties (St. Louis City, St. Louis County, and Franklin, Jefferson, St. Charles counties [combined as “Collar Counties”]) between 2011 and 2022 due to an opioid overdose (<em>N</em> = 6,799). Naloxone distribution date and location data came from Missouri's university-based naloxone distribution team. We conducted a controlled interrupted time series using an autoregressive model via proc ARIMA to examine changes over time in the rate of OOD associated with the introduction of fentanyl (defined to be present in 25% of opioid overdose deaths; June 2015) and the start of naloxone distribution for each location (August 2017, October 2017, and January 2018, respectively).</div></div><div><h3>Results</h3><div>The introduction of fentanyl into the drug supply of St. Louis City was associated with an increased rate of OOD over time (<em>p</em> &lt; .001). Naloxone distribution in the City was associated with an immediate decrease in OOD (<em>p</em> &lt; .001) followed by a slowed increase in OOD (<em>p</em> &lt; .001). These findings were not replicated in St. Louis County nor the Collar Counties.</div></div><div><h3>Conclusions</h3><div>The effects of fentanyl and naloxone on OOD varied by region in Eastern Missouri. Specifically, fentanyl and naloxone effects were only found in a high-need urban area with existing harm reduction and street outreach programs, but not in surrounding suburban or rural areas. State-level naloxone distribution decision-makers should prioritize funding harm reduction services in both urban and non-urban settings to help increase targeted naloxone distribution to those actively using drugs. Additionally, interventions tailored for people who engage in solitary drug use - such as safe consumption spaces and overdose detection technologies - should receive increased investment and implementation, particularly in rural areas where harm reduction infrastructure is more scarce.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209564"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}