Journal of substance use and addiction treatment最新文献

{"title":"Classes of outpatient quality of care among individuals with substance-related disorders, based on a survey and health insurance registry","authors":"Marie-Josée Fleury ,&nbsp;Zhirong Cao ,&nbsp;Guy Grenier ,&nbsp;Christophe Huỳnh ,&nbsp;Xianghei Meng","doi":"10.1016/j.josat.2024.209619","DOIUrl":"10.1016/j.josat.2024.209619","url":null,"abstract":"<div><h3>Objectives</h3><div>Improving quality of care for individuals with substance-related disorders (SRD) should be a priority considering SRD are associated with high morbidity. This study aimed to identify classes of individuals with SRD based on their clinical characteristics and the quality of outpatient care they received, and to verify whether better quality of care was associated with other respondent characteristics and more favorable subsequent outcomes.</div></div><div><h3>Methods</h3><div>Data came from the 2013–14 and 2015–16 Canadian Community Health Survey (<em>N</em> = 42,099), merged with administrative data from Quebec's health insurance registry. Investigating a cohort of 1473 individuals with SRD, we conducted Latent class analysis based on the respondents' diagnoses and outpatient quality of care indicators such as access, diversity, continuity and regularity of care received in the 12 months preceding interview. Chi-Square, Fisher's exact tests or <em>t</em>-tests, and logistic regression associate classes with sociodemographic and health behavior (e.g., suicidal behaviors) correlates, and outcomes (repeated emergency department use, hospitalization, quality of life) over the three months following interview, respectively.</div></div><div><h3>Results</h3><div>The study identified four classes: (1) Individuals with polysubstance-related disorders and other health disorders, receiving high diversity and moderate regularity of care (6 % of sample); (2) Individuals with alcohol-related disorders, receiving low quality of care (41 %); (3) Individuals with drug-related disorders, receiving high overall quality of care (9 %); and (4) Individuals with alcohol-related disorders, receiving high continuity of family doctor care (44 %). Classes 2 and 4 showed better social conditions (e.g., higher education), health behaviors, and subsequent outcomes than Classes 1 and 3, despite receiving lower quality of care – especially mental healthcare.</div></div><div><h3>Conclusion</h3><div>Study outcomes related more to health and social conditions than to the quality of outpatient care received, especially as outpatient care alone might not meet needs of Classes 1 and 3 individuals having important health and social issues, unmet care needs and worse outcomes. Results suggest that interventions like assertive community treatment or intensive case management with integrated SRD-mental health disorders treatment could better respond to the needs of Classes 1 and 3. Overall, enhanced care, including peer support, might benefit all individuals with SRD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209619"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928837","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":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(24)00287-X","DOIUrl":"10.1016/S2949-8759(24)00287-X","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"168 ","pages":"Article 209575"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163170","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":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(24)00288-1","DOIUrl":"10.1016/S2949-8759(24)00288-1","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"168 ","pages":"Article 209576"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163171","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":"Description of implementing a mail-based overdose education and naloxone distribution program in community supervision settings during COVID-19","authors":"Carrie B. Oser ,&nbsp;Margaret McGladrey ,&nbsp;Douglas R. Oyler ,&nbsp;Hannah K. Knudsen ,&nbsp;Sharon L. Walsh ,&nbsp;Susannah Stitzer ,&nbsp;Michael Goetz ,&nbsp;Marisa Booty ,&nbsp;Erica Hargis ,&nbsp;Sarah Johnson ,&nbsp;Michele Staton ,&nbsp;Patricia R. Freeman","doi":"10.1016/j.josat.2024.209618","DOIUrl":"10.1016/j.josat.2024.209618","url":null,"abstract":"<div><h3>Introduction</h3><div>This study uses the <em>Exploration, Preparation, Implementation</em>, and <em>Sustainment</em> (EPIS) model to retrospectively describe the mail-based overdose education and naloxone distribution (OEND) program developed in collaboration with the Kentucky Department of Corrections (DOC) for use in the HEALing Communities Study in Kentucky (HCS-KY) and details the reach of this innovative delivery model.</div></div><div><h3>Methods</h3><div>HCS-KY is a community-engaged cluster-randomized trial assessing the effects of implementing evidence-based practices, including OEND, on overdose death reduction across 16 communities highly impacted by the opioid epidemic in Kentucky.⁶ The study launch coincided with the COVID-19 pandemic. All coalitions in the 16 HCS-KY counties selected OEND implementation in community supervision offices; however, pandemic limitations on in-person reporting made face-to-face OEND unfeasible. This study uses the EPIS phases to understand how the unique inner and outer contextual factors of the pandemic drove innovation, including five implementation strategies to promote the mail-based OEND program. Internal study management trackers data measured implementation reach.</div></div><div><h3>Results</h3><div>Implementation occurred in all 16 counties. All promotional strategies used in the first 8 counties (Wave 1) were carried over to the second 8 counties (Wave 2), except letters were not sent to community supervision clients in Wave 2 counties. Across both waves, 1759 people accessed the Typeform™ website to receive overdose education, complete a brief demographic survey, and 1696 had naloxone shipped to their homes. Greater reach occurred in Wave 1 and in rural counties. Of the participants, 81.13 % were white, 61.17 % were female, 51.79 % were between the ages of 35–54, 18.82 % had previously experienced an overdose, and 69.07 % had witnessed an overdose. Sites sustained three of the five implementation strategies for publicizing the OEND website at the study's end but not letters and texting.</div></div><div><h3>Conclusions</h3><div>Mail-based OEND programs are an appropriate delivery method for ensuring access to life-saving medication for people on community supervision and may encourage treatment. Strategies to promote the OEND program that were high-effort for agency and study staff, such as letters, or high-cost, such as texting, were not sustainable. Implications for OEND best practices, including innovative technology use within community supervision settings are addressed.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209618"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916631","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":"Association between Comprehensive Primary Care Plus and opioid prescribing and prescription fills among Medicare beneficiaries","authors":"Jelena Zurovac ,&nbsp;Eunhae Shin ,&nbsp;Joel Earlywine ,&nbsp;Arkadipta Ghosh ,&nbsp;Jonathan Brown","doi":"10.1016/j.josat.2024.209621","DOIUrl":"10.1016/j.josat.2024.209621","url":null,"abstract":"<div><h3>Introduction</h3><div>To examine if Medicare beneficiaries attributed to Comprehensive Primary Care Plus (CPC+) practices had a greater decrease in the potential overuse of prescription opioids relative to beneficiaries attributed to other primary care practices. Primary care practices that participated in CPC+ received enhanced Medicare payment to support five functions: access and continuity of care, care management, comprehensiveness and coordination, patient and caregiver engagement, and planned care and population health. CPC+ practices participated within two tracks starting in 2017; Track 2 practices received larger payments to support more enhanced care delivery than Track 1 practices.</div></div><div><h3>Methods</h3><div>Employing difference-in-differences, we used Medicare claims and Part D data to examine changes in potential opioid overuse between 2016 (baseline) and 2021 (the fifth program year). Our measure of potential opioid overuse measure relies on specifications for an existing quality measure of the same name that is defined as filling opioid prescriptions at a daily dosage of 90 morphine milligram equivalents or more among beneficiaries who use opioids for at least 90 days of supply per year. A total of 40,219 Medicare fee-for-service beneficiaries used opioids long term and were attributed to 2888 CPC+ practices; 129,178 beneficiaries used opioids long term and were attributed to 6921 comparison practices.</div></div><div><h3>Results</h3><div>Across the combined treatment and comparison groups, potential opioid overuse decreased from 19 % in 2016 to 12 % in 2021. Relative to the comparison group, beneficiaries attributed to Track 1 CPC+ practices experienced an 0.8 percentage point greater decrease in potential opioid overuse (95 % CI = −1.4, −0.2) in the third program year compared to baseline. These findings persisted in the fourth and fifth years and were similar in magnitude to those in the third year. Track 2 results were similar to Track 1 results. The findings were likely driven by changes in CPC+ clinicians' prescribing behaviors: clinicians in CPC+ practices reduced the average dosage and the number of days' supply of prescription opioids more than clinicians in comparison practices.</div></div><div><h3>Conclusions</h3><div>A large-scale primary care delivery transformation initiative was associated with reduced potential opioid overuse among Medicare beneficiaries.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209621"},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908076","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":"Text message-delivered cannabis use disorder treatment with young adults: A large randomized clinical trial","authors":"Michael J. Mason ,&nbsp;J. Douglas Coatsworth ,&nbsp;Nathaniel R. Riggs ,&nbsp;Michael Russell ,&nbsp;Jeremy Mennis ,&nbsp;Nikola Zaharakis ,&nbsp;Aaron Brown","doi":"10.1016/j.josat.2024.209611","DOIUrl":"10.1016/j.josat.2024.209611","url":null,"abstract":"<div><h3>Background</h3><div>Two scientific and clinical challenges for treating cannabis use disorder (CUD) are developing efficacious treatments with high likelihood of uptake and scalability, and testing the clinical mechanisms by which treatments work. Because young adults experience more CUD than other age groups, a need exists to test the efficacy and hypothesized causal pathways of novel treatments for CUD. Text-delivered treatments have the potential to reach young adults by increasing access and perceived privacy.</div></div><div><h3>Methods</h3><div>We conducted a randomized clinical trial (<em>n</em> = 1078) of a 4-week CUD treatment with U.S. young adults from Colorado and Tennessee. Participants were allocated to Peer Network Counseling-text (PNC-txt), a text-message delivered brief motivational interviewing informed treatment, or a wait-list control condition, and followed for 6 months.</div></div><div><h3>Results</h3><div>No significant direct treatment effects on cannabis use were found between experimental conditions. However, significant treatment effects were identified on hypothesized mediators: readiness to change and protective behavioral strategies. Tests of indirect effects using latent change score mediation modeling showed the treatment group (PNC-txt) increased in readiness to change and protective behavioral strategies at the 1-month follow-up period, which led to decreases in the number of days participants used cannabis from baseline to 6-months, compared to controls.</div></div><div><h3>Conclusions</h3><div>While no direct treatment effects were identified, PNC-txt appears successful in reducing cannabis use relative to controls indirectly by activating participants' motivation to change and through teaching harm reduction strategies. Results suggest targeting readiness to change and protective behavioral strategies as modifiable clinical mechanisms when treating CUD in young adults.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209611"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900973","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":"Institutional variation of smoking cessation success in Taiwan: A multi-level analysis of the National Second-Generation Tobacco Cessation Program Data","authors":"Mei-Tzu Huang ,&nbsp;Jia-Ling Wu ,&nbsp;Shang-Chi Lee ,&nbsp;Chin-Wei Kuo ,&nbsp;Chuan-Yu Chen ,&nbsp;Esther Ching-Lan Lin ,&nbsp;Ya-Hui Chang ,&nbsp;Shu-Ying Lo ,&nbsp;Santi Martin ,&nbsp;Arief Hargono ,&nbsp;Tung-Yao Tsai ,&nbsp;Chung-Yi Li","doi":"10.1016/j.josat.2024.209615","DOIUrl":"10.1016/j.josat.2024.209615","url":null,"abstract":"<div><h3>Introduction</h3><div>Although the relationships between personal factors and smoking abstinence are well-documented, institutional variation in smoking abstinence remains underexplored. This study investigates institutional variation in the six-month smoking abstinence prevalence among institutions participating in Taiwan's Second-Generation Tobacco Cessation Program (SGTCP) and examines institutional characteristics associated with smoking cessation success.</div></div><div><h3>Methods</h3><div>The analysis included 304,757 pharmacotherapy and health education sessions from 160,336 participants who received smoking cessation services across 2420 institutions under the SGTCP between 2000 and June 2022. Institutional characteristics analyzed included type of institution, number of healthcare professionals, proportion of sessions with high utilization, and service volume. Binary logistic regression models with generalized estimation equations were used to assess associations with six-month smoking abstinence status.</div></div><div><h3>Results</h3><div>Substantial institutional variation was observed in six-month smoking cessation success, with prevalence ranging from 0.0 % to 100.0 % (mean = 37.84 %, SD = 25.74 %). After adjusting for ecological and personal factors, regional hospitals demonstrated the highest adjusted odds ratio (aOR) for success at 1.202 (95 % confidence interval [CI] = 1.159–1.246). Higher session utilization was positively associated with better outcomes, while institutions with a greater number of participating healthcare professionals showed reduced aORs.</div></div><div><h3>Conclusions</h3><div>Structural characteristics, such as healthcare setting type and resource availability, and process factors, including methodologies that enhance utilization, are critical determinants of the effectiveness of smoking cessation interventions.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209615"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900969","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":"“I still can feel the sickness”: Withdrawal experiences of people on methadone maintenance treatment","authors":"David Frank ,&nbsp;Alex S. Bennett ,&nbsp;Charles M. Cleland ,&nbsp;Beth E. Meyerson ,&nbsp;Danielle M. Russell ,&nbsp;Suzan M. Walters ,&nbsp;Caty Simon ,&nbsp;Joy D. Scheidell ,&nbsp;Luther Elliott","doi":"10.1016/j.josat.2024.209616","DOIUrl":"10.1016/j.josat.2024.209616","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid withdrawal is a regular occurrence for many people who use illicit opioids (PWUIO) involving acute physical and psychological pain. Yet, there is very little data on the withdrawal experience of people in methadone maintenance treatment (MMT) and almost none from the patients' experience. Learning more about patients' withdrawal experiences can help to inform policies and practices that are better suited to address withdrawal and may improve patient satisfaction as well as uptake and retention.</div></div><div><h3>Methods</h3><div>This article is based on 29 semi-structured interviews with people who use illicit opioids who reported recent withdrawal experience. The study conducted interviews remotely via Zoom between April and August 2022 and later transcribed them professionally. The study team then coded data thematically using Atlas.ti, based on a combination of inductive and deductive coding strategies and informed by the literature and study aims.</div></div><div><h3>Results</h3><div>Participants described withdrawal as a significant issue that negatively impacts their treatment experience and increases the likelihood of treatment cessation. Their accounts of withdrawal were complex and often involved multiple factors; however, feeling underdosed and missing clinic dosing hours were seen as important vectors that led to their withdrawal experiences. Importantly, participants framed feeling underdosed and missing clinic dosing hours as institutional problems, resulting primarily from clinic policies, practices, and culture rather than from patients' decisions or individual behavior. Specifically, they cited restricted access to take-home doses, limited hours of operation, and a punitive focus on complete abstinence as factors that made withdrawal difficult to avoid.</div></div><div><h3>Conclusions</h3><div>Patients' accounts demonstrate a disconnect between providers' focus on promoting complete abstinence and patients, who were often using MMT for more pragmatic reasons that did not include complete abstinence from all drugs. These findings support growing calls for the integration of MMT into the mainstream healthcare system by making it available via prescription from office-based medical settings and dispensed through pharmacies.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209616"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900966","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":"Affect-laden risk profiles derived from two days of EMA predict substance use and quality of life three- and six-months after SUD treatment","authors":"Samuel W. Stull,&nbsp;Stephanie T. Lanza","doi":"10.1016/j.josat.2024.209613","DOIUrl":"10.1016/j.josat.2024.209613","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209613"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883765","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":"State-level actions targeting unethical substance use disorder treatment practices: A qualitative study","authors":"Melissa Davoust ,&nbsp;PhiYen Nguyen ,&nbsp;Michael Adelberg ,&nbsp;Austin Frakt ,&nbsp;Melissa M. Garrido","doi":"10.1016/j.josat.2024.209609","DOIUrl":"10.1016/j.josat.2024.209609","url":null,"abstract":"<div><h3>Introduction</h3><div>There has been increasing recognition of unethical practices occurring in substance use disorder (SUD) treatment, such as patient brokering and deceptive marketing. We conducted a qualitative study with key informants to characterize state actions that have been undertaken to target unethical practices and the context surrounding state-level actions, including barriers and facilitators to their implementation.</div></div><div><h3>Methods</h3><div>We recruited key informants at the state-level, as well as those from national organizations engaged in improving SUD treatment quality, who could provide perspectives on the scope of unethical practices in the field and ways in which states have sought to prevent unethical practices and improve the quality of SUD treatment. We conducted semi-structured interviews via videoconference with 15 key informants from 11 organizations, including four national advocacy organizations, four state-level advocacy organizations, one local advocacy organization, and two SUD task forces, with both civilian and law enforcement perspectives represented.</div></div><div><h3>Results</h3><div>Key informants described the scope of unethical substance use disorder treatment practices as encompassing patient brokering, deceptive marketing, unethical billing and insurance fraud, and harmful practices in recovery housing. They discussed state-level legislative and non-legislative activities (e.g., licensing and certification efforts, task forces) that have been undertaken to target unethical practices, but they emphasized the need for improved regulation and enforcement. Adequate funding and clear authority were seen as key to success, but without the ability to coordinate across state boundaries, key informants also felt state-level actions alone would be insufficient in combatting unethical actors and practices in substance use disorder treatment and recovery housing spaces.</div></div><div><h3>Conclusions</h3><div>Lessons from states that have enacted legislation and other activities targeting unethical SUD treatment practices may help other states decide which policy approaches are most appropriate for their circumstances. However, our results also suggest that without additional resources or the ability to coordinate across state boundaries, state-level actions intended to combat unethical SUD treatment practices may be unlikely to have the desired effect.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209609"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883686","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}