Pub Date : 2025-09-13DOI: 10.1016/j.josat.2025.209801
Megan S. Patterson , Yunlin Zhou , Anjorin E. Adeyemi , Shuai Ma , Linlin Luo , Allison N. Francis , Zhenning Kang , Katie M. Heinrich , Tyler Prochnow
Introduction
Addiction is a complex and pervasive condition which affects physical, social, and mental health. Research consistently shows that social support and social networks are key to the addiction recovery process (defined as a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential) and recovery communities available outside of or in conjunction to formal treatment are effective in providing such support. This study investigated social networks and psychological distress among members of The Phoenix, a sober active community that incorporates group-based exercise (e.g., CrossFit) into the recovery process.
Methods
Using Social Network Analysis (SNA), we analyzed relationships within The Phoenix CrossFit programs in Denver, Colorado (N = 35) and Wichita, Kansas (N = 42). Linear Network Autocorrelation Models (LNAMs) assessed whether social network positions and connections related to psychological distress among members, and Exponential Random Graph Models (ERGMs) explored factors that explained the presence of supportive relationships between Phoenix members.
Results
Network centrality, such as being identified as a source of support (i.e., in-degree), was associated with lower psychological distress, while peripheral positions correlated with higher psychological distress in both networks. Additionally, individuals experiencing higher psychological distress tended to seek more supportive connections, whereas those with lower distress were more frequently nominated as supportive figures.
Conclusions
These results highlight the potential of community-based recovery resources like The Phoenix to foster social networks that promote mental well-being.
{"title":"Exploring social connections and mental well-being among members of a sober active community: A social network analysis","authors":"Megan S. Patterson , Yunlin Zhou , Anjorin E. Adeyemi , Shuai Ma , Linlin Luo , Allison N. Francis , Zhenning Kang , Katie M. Heinrich , Tyler Prochnow","doi":"10.1016/j.josat.2025.209801","DOIUrl":"10.1016/j.josat.2025.209801","url":null,"abstract":"<div><h3>Introduction</h3><div>Addiction is a complex and pervasive condition which affects physical, social, and mental health. Research consistently shows that social support and social networks are key to the addiction recovery process (defined as a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential) and recovery communities available outside of or in conjunction to formal treatment are effective in providing such support. This study investigated social networks and psychological distress among members of <em>The Phoenix</em>, a sober active community that incorporates group-based exercise (e.g., CrossFit) into the recovery process.</div></div><div><h3>Methods</h3><div>Using Social Network Analysis (SNA), we analyzed relationships within <em>The Phoenix</em> CrossFit programs in Denver, Colorado (N = 35) and Wichita, Kansas (N = 42). Linear Network Autocorrelation Models (LNAMs) assessed whether social network positions and connections related to psychological distress among members, and Exponential Random Graph Models (ERGMs) explored factors that explained the presence of supportive relationships between <em>Phoenix</em> members.</div></div><div><h3>Results</h3><div>Network centrality, such as being identified as a source of support (i.e., in-degree), was associated with lower psychological distress, while peripheral positions correlated with higher psychological distress in both networks. Additionally, individuals experiencing higher psychological distress tended to seek more supportive connections, whereas those with lower distress were more frequently nominated as supportive figures.</div></div><div><h3>Conclusions</h3><div>These results highlight the potential of community-based recovery resources like <em>The Phoenix</em> to foster social networks that promote mental well-being.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"179 ","pages":"Article 209801"},"PeriodicalIF":1.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066599","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}
Pub Date : 2025-09-12DOI: 10.1016/j.josat.2025.209798
Kelsey Hills-Dunlap , Christopher E. Knoepke , Daniel D. Matlock , Ellen L. Burnham , Marc Moss , Sarah E. Jolley , Caroline K. Tietbohl
Introduction
Alcohol use disorder (AUD) is a common and serious medical condition with substantial global public health impact, and it is prevalent among patients admitted to intensive care units (ICUs) in the United States. Many ICU survivors with AUD report motivation to change their drinking, however, few receive alcohol treatment. We sought to understand the decision support needs of ICU survivors with AUD when faced with choices about alcohol treatment options.
Methods
In this qualitative study, we completed 17 semi-structured interviews with hospitalized patients with AUD recruited from two urban hospitals in the United States after an alcohol-related ICU admission. We used a reflexive thematic analysis and a deductive and inductive coding approach, with a-priori codes developed from the Ottawa Decision Support Framework.
Results
Participants described any prior experience with alcohol treatment decisions and their current decision-making process regarding engagement with alcohol treatment after ICU admission. In our analysis, we developed four themes and associated subthemes: (1) Decisional needs included knowledge of alcohol's impact on health issues, awareness of treatment options, and trust in the recovery process; (2) Priorities regarding treatment options centered on cost, lifestyle integration, and personal experiences with addiction among treatment program staff; (3) Values regarding the decision making process included a sense of autonomy, relatedness to information providers, and productive involvement of social supports; (4) Decision aids should incorporate video formats to deliver transparent information regarding alcohol treatment options.
Conclusions
Decisional needs of ICU survivors with AUD who are considering alcohol treatment reflect the importance of patient-centered information and consideration of patient preferences and values in alcohol treatment decisions. These findings will inform the development of an alcohol treatment decision aid to address these decisional needs and facilitate engagement with alcohol treatment for ICU survivors with AUD.
{"title":"Decisional needs of intensive care unit survivors with alcohol use disorder considering alcohol treatment: A qualitative study","authors":"Kelsey Hills-Dunlap , Christopher E. Knoepke , Daniel D. Matlock , Ellen L. Burnham , Marc Moss , Sarah E. Jolley , Caroline K. Tietbohl","doi":"10.1016/j.josat.2025.209798","DOIUrl":"10.1016/j.josat.2025.209798","url":null,"abstract":"<div><h3>Introduction</h3><div>Alcohol use disorder (AUD) is a common and serious medical condition with substantial global public health impact, and it is prevalent among patients admitted to intensive care units (ICUs) in the United States. Many ICU survivors with AUD report motivation to change their drinking, however, few receive alcohol treatment. We sought to understand the decision support needs of ICU survivors with AUD when faced with choices about alcohol treatment options.</div></div><div><h3>Methods</h3><div>In this qualitative study, we completed 17 semi-structured interviews with hospitalized patients with AUD recruited from two urban hospitals in the United States after an alcohol-related ICU admission. We used a reflexive thematic analysis and a deductive and inductive coding approach, with a-priori codes developed from the Ottawa Decision Support Framework.</div></div><div><h3>Results</h3><div>Participants described any prior experience with alcohol treatment decisions and their current decision-making process regarding engagement with alcohol treatment after ICU admission. In our analysis, we developed four themes and associated subthemes: (1) Decisional needs included knowledge of alcohol's impact on health issues, awareness of treatment options, and trust in the recovery process; (2) Priorities regarding treatment options centered on cost, lifestyle integration, and personal experiences with addiction among treatment program staff; (3) Values regarding the decision making process included a sense of autonomy, relatedness to information providers, and productive involvement of social supports; (4) Decision aids should incorporate video formats to deliver transparent information regarding alcohol treatment options.</div></div><div><h3>Conclusions</h3><div>Decisional needs of ICU survivors with AUD who are considering alcohol treatment reflect the importance of patient-centered information and consideration of patient preferences and values in alcohol treatment decisions. These findings will inform the development of an alcohol treatment decision aid to address these decisional needs and facilitate engagement with alcohol treatment for ICU survivors with AUD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"179 ","pages":"Article 209798"},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066658","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}
Pub Date : 2025-09-10DOI: 10.1016/j.josat.2025.209799
Alexander Y. Walley , Jiayi Wang , C. To , MaryKate Duska , Stephen Murray , Moriah Wiggins , Andrew Rolles , Shapei Yan , Sarah Kosakowski , Sarah M. Bagley , Ziming Xuan , Justeen Hyde , Scott W. Formica
Purpose
To describe the characteristics of Massachusetts post-overdose outreach programs before and after the onset of the COVID-19 pandemic and identify program adaptations and practices.
Methods
We surveyed Massachusetts post-overdose programs about programming onset, funding, outreach encounters, naloxone distribution, medication for opioid use disorder (MOUD) referrals, and program practices before and after the onset of the COVID-19 pandemic. We calculated frequencies and summary statistics for program characteristics and practices. We compared programs that started before and after the onset of the COVID-19 pandemic using Pearson Chi-squared and Fisher's Exact tests.
Results
As of July 2022, we identified 256 programs active in 242 (69 %) of Massachusetts' 351 municipalities. Before March 2020, 160 “pre-pandemic onset” programs were active. After March 2020, 96 “post-pandemic onset” programs started. In 2022, most were grant funded (89 % (227/256)). Initial survivor contact was attempted via phone (79 % (201/256)) and text (47 % (120/256)), most commonly by a recovery coach (77 % (196/256)). Most programs offered fentanyl test strips and naloxone. Some programs, more commonly pre-pandemic onset, offered safer smoking and injecting supplies. Among the 160 pre-pandemic onset programs, new practices included recommending virtual spotting (44 % (70/160)), facilitating MOUD telemedicine (24 % (39/160)), outreach for people using cocaine and methamphetamine (42 % (67/160)), and referring to race and ethnicity congruent services (31 % (50/160)).
Conclusion
Massachusetts post-overdose outreach programs expanded following the COVID-19 pandemic onset. Services and innovations included resources to reduce harms from the unregulated drug supply (e.g., fentanyl test strips) and more inclusive outreach (e.g., include people using stimulants and race and ethnicity congruent services).
{"title":"Post-overdose outreach programs in Massachusetts before and after the onset of the COVID-19 pandemic","authors":"Alexander Y. Walley , Jiayi Wang , C. To , MaryKate Duska , Stephen Murray , Moriah Wiggins , Andrew Rolles , Shapei Yan , Sarah Kosakowski , Sarah M. Bagley , Ziming Xuan , Justeen Hyde , Scott W. Formica","doi":"10.1016/j.josat.2025.209799","DOIUrl":"10.1016/j.josat.2025.209799","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the characteristics of Massachusetts post-overdose outreach programs before and after the onset of the COVID-19 pandemic and identify program adaptations and practices.</div></div><div><h3>Methods</h3><div>We surveyed Massachusetts post-overdose programs about programming onset, funding, outreach encounters, naloxone distribution, medication for opioid use disorder (MOUD) referrals, and program practices before and after the onset of the COVID-19 pandemic. We calculated frequencies and summary statistics for program characteristics and practices. We compared programs that started before and after the onset of the COVID-19 pandemic using Pearson Chi-squared and Fisher's Exact tests.</div></div><div><h3>Results</h3><div>As of July 2022, we identified 256 programs active in 242 (69 %) of Massachusetts' 351 municipalities. Before March 2020, 160 “pre-pandemic onset” programs were active. After March 2020, 96 “post-pandemic onset” programs started. In 2022, most were grant funded (89 % (227/256)). Initial survivor contact was attempted via phone (79 % (201/256)) and text (47 % (120/256)), most commonly by a recovery coach (77 % (196/256)). Most programs offered fentanyl test strips and naloxone. Some programs, more commonly pre-pandemic onset, offered safer smoking and injecting supplies. Among the 160 pre-pandemic onset programs, new practices included recommending virtual spotting (44 % (70/160)), facilitating MOUD telemedicine (24 % (39/160)), outreach for people using cocaine and methamphetamine (42 % (67/160)), and referring to race and ethnicity congruent services (31 % (50/160)).</div></div><div><h3>Conclusion</h3><div>Massachusetts post-overdose outreach programs expanded following the COVID-19 pandemic onset. Services and innovations included resources to reduce harms from the unregulated drug supply (e.g., fentanyl test strips) and more inclusive outreach (e.g., include people using stimulants and race and ethnicity congruent services).</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"179 ","pages":"Article 209799"},"PeriodicalIF":1.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056394","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}
Pub Date : 2025-09-06DOI: 10.1016/j.josat.2025.209800
Victor Roy , Michele J. Buonora , Cristina Murray-Krezan , Anthony Fabio , Paul J. Joudrey
Background
Historically, federal regulations limited take-home methadone doses largely due to concerns about methadone-related overdose. In response to the COVID-19 pandemic, an emergency federal policy in March 2020 permitted states to expand take-home methadone doses. Our objective was to utilize state-level variation in take-home expansion to compare changes in methadone related overdose death rates among states that opted into and then out of expanded take-home dosing with states that opted into and continued the policy.
Methods
We used an extended two-way fixed effects difference-in-differences (DID) approach. The intervention group included states that initially opted into and then out of expanded take-home dosing, while the comparison group included states that opted into and continued the policy. Our primary outcome was the average treatment effect on the treated states (ATET) using quarterly rate of methadone-related overdose deaths per 100,000 persons from April 2020 to December 2022. Data sources included a state policy review, CDC WONDER, and U.S. Census Bureau.
Results
The intervention group included three states that opted out of expanded take-home dosing, while the comparison group comprised 16 states maintaining the policy. We found no significant association between opting out of expanded take-home dosing and methadone-related overdose death rates [ATET = 0.02, 95 % CI = (−0.03, 0.47), p = 0.47]. Adjustments for non-methadone-related overdose variables yielded similar results.
Conclusion
States who continued expanded take-home methadone dosing did not subsequently experience a detectable increase in methadone-related overdose deaths relative to states that opted out of the policy. This evidence suggests that policies expanding methadone take-homes are safe at a population level, which can inform deliberations within states that currently maintain strict restrictions.
背景：历史上，联邦法规限制带回家的美沙酮剂量主要是由于担心美沙酮过量。为了应对COVID-19大流行，2020年3月的一项紧急联邦政策允许各州扩大美沙酮的带回家剂量。我们的目标是利用州层面上的变化来比较选择加入和退出扩大的带回家剂量的州与选择加入并继续该政策的州之间美沙酮相关的过量死亡率的变化。方法：采用扩展的双向固定效应差分法（DID）。干预组包括最初选择加入然后退出扩大的带回家剂量的州，而对照组包括选择加入并继续执行该政策的州。我们的主要结局是使用2020年4月至2022年12月每10万人中美沙酮相关过量死亡的季度率对治疗状态（ATET）的平均治疗效果。数据来源包括州政策审查、CDC WONDER和美国人口普查局。结果：干预组包括三个选择退出扩大带回家剂量的州，而对照组包括16个维持政策的州。我们发现选择退出扩大的带回家剂量与美沙酮相关的过量死亡率之间没有显著关联[ATET = 0.02,95 % CI = （-0.03,0.47），p = 0.47]。对与美沙酮无关的用药过量变量进行调整，也得到了类似的结果。结论：与退出政策的州相比，继续扩大美沙酮带回家剂量的州随后并未出现美沙酮相关过量死亡的可检测到的增加。这一证据表明，扩大美沙酮带回家的政策在人口水平上是安全的，这可以为目前保持严格限制的州的审议提供信息。
{"title":"U.S. states opting out of expanded methadone take-home policies and associated mortality","authors":"Victor Roy , Michele J. Buonora , Cristina Murray-Krezan , Anthony Fabio , Paul J. Joudrey","doi":"10.1016/j.josat.2025.209800","DOIUrl":"10.1016/j.josat.2025.209800","url":null,"abstract":"<div><h3>Background</h3><div>Historically, federal regulations limited take-home methadone doses largely due to concerns about methadone-related overdose. In response to the COVID-19 pandemic, an emergency federal policy in March 2020 permitted states to expand take-home methadone doses. Our objective was to utilize state-level variation in take-home expansion to compare changes in methadone related overdose death rates among states that opted into and then out of expanded take-home dosing with states that opted into and continued the policy.</div></div><div><h3>Methods</h3><div>We used an extended two-way fixed effects difference-in-differences (DID) approach. The intervention group included states that initially opted into and then out of expanded take-home dosing, while the comparison group included states that opted into and continued the policy. Our primary outcome was the average treatment effect on the treated states (ATET) using quarterly rate of methadone-related overdose deaths per 100,000 persons from April 2020 to December 2022. Data sources included a state policy review, CDC WONDER, and U.S. Census Bureau.</div></div><div><h3>Results</h3><div>The intervention group included three states that opted out of expanded take-home dosing, while the comparison group comprised 16 states maintaining the policy. We found no significant association between opting out of expanded take-home dosing and methadone-related overdose death rates [ATET = 0.02, 95 % CI = (−0.03, 0.47), <em>p</em> = 0.47]. Adjustments for non-methadone-related overdose variables yielded similar results.</div></div><div><h3>Conclusion</h3><div>States who continued expanded take-home methadone dosing did not subsequently experience a detectable increase in methadone-related overdose deaths relative to states that opted out of the policy. This evidence suggests that policies expanding methadone take-homes are safe at a population level, which can inform deliberations within states that currently maintain strict restrictions.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"179 ","pages":"Article 209800"},"PeriodicalIF":1.9,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024860","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}
Pub Date : 2025-08-26DOI: 10.1016/j.josat.2025.209794
Mohammad Yaseliani , Youngsuhk Jo , Lake Lindo , Jabed Al Faysal , Md Mahmudul Hasan
Importance
Attention-deficit/hyperactivity disorder (ADHD) is a condition often comorbid with substance use disorders. With the increase in opioid and stimulant overdoses, there remains concern regarding the appropriateness of psychostimulants for patients on maintenance therapy for opioid use disorder (OUD) with co-occurring ADHD.
Objectives
To assess the impact of psychostimulant use on outcomes of OUD maintenance therapy with buprenorphine based on rates of (1) treatment discontinuation and (2) opioid-related hospitalization.
Design, setting, and participants
This present investigation used a retrospective cohort study design consisting of a secondary analysis of data collected from IBM MarketScan Commercial claims from 2011 to 2021. Individuals were aged 12 to 64 with concurrent ADHD and OUD diagnosis receiving buprenorphine treatment.
Exposures
Presence of psychostimulant prescriptions.
Main outcomes and measures
Primary outcomes were buprenorphine discontinuation and opioid-related hospitalization.
Results
Study sample included 10,712 individuals with comorbid ADHD and OUD (mean age of 31.7 years, SD 10.9) who initiated buprenorphine maintenance therapy. 5190 individuals received psychostimulant prescriptions while 5522 individuals did not. Individuals who received psychostimulants demonstrated lower odds of buprenorphine discontinuation (OR = 0.669, 95 % CI = 0.610, 0.734) and hospitalization (OR = 0.493, 95 % CI = 0.418, 0.581). A one-unit increase in the psychostimulant fill count (IRR = 0.580, 95 % CI = 0.493, 0.683) was associated with a lower incidence rate of hospitalization.
Conclusions
In patients with a dual diagnosis of ADHD and OUD on buprenorphine therapy, treatment of ADHD with prescription psychostimulants is associated with improved adherence to buprenorphine and lower odds of opioid-related hospitalization.
重要性：注意缺陷和多动障碍（ADHD）通常与物质使用障碍共病。随着阿片类药物和兴奋剂过量使用的增加，人们仍然关注阿片类药物使用障碍（OUD）并发ADHD患者维持治疗的适当性。目的：基于(1)治疗停药率和(2)阿片类药物相关住院率，评估精神兴奋剂使用对丁丙诺啡维持OUD治疗结果的影响。设计、环境和参与者：本研究采用回顾性队列研究设计，包括对2011年至2021年从IBM MarketScan商业索赔中收集的数据进行二次分析。12至64岁同时患有ADHD和OUD诊断的个体接受丁丙诺啡治疗。暴露：存在精神兴奋剂处方。主要结局和措施：主要结局是丁丙诺啡停药和阿片类药物相关住院。结果：研究样本包括10,712例ADHD和OUD合并症患者（平均年龄32.2 岁，SD 11.2），他们开始了丁丙诺啡维持治疗。5190人服用了精神兴奋剂处方，5522人没有服用。接受精神兴奋剂的个体显示丁丙诺啡停药（OR 0.669(95 % CI 0.610至0.734)）和住院(OR 0.493（95 % CI 0.418至0.581）的几率较低。精神兴奋剂填充计数增加1个单位（IRR = 0.580,95 % CI = 0.493,0.683）与住院率降低相关。结论：在接受丁丙诺啡治疗的ADHD和OUD双重诊断的患者中，处方精神兴奋剂治疗ADHD与改善对丁丙诺啡的依从性和降低阿片类药物相关住院的几率相关。
{"title":"The effects of psychostimulant prescription on opioid use disorder among people with co-occurring ADHD","authors":"Mohammad Yaseliani , Youngsuhk Jo , Lake Lindo , Jabed Al Faysal , Md Mahmudul Hasan","doi":"10.1016/j.josat.2025.209794","DOIUrl":"10.1016/j.josat.2025.209794","url":null,"abstract":"<div><h3>Importance</h3><div>Attention-deficit/hyperactivity disorder (ADHD) is a condition often comorbid with substance use disorders. With the increase in opioid and stimulant overdoses, there remains concern regarding the appropriateness of psychostimulants for patients on maintenance therapy for opioid use disorder (OUD) with co-occurring ADHD.</div></div><div><h3>Objectives</h3><div>To assess the impact of psychostimulant use on outcomes of OUD maintenance therapy with buprenorphine based on rates of (1) treatment discontinuation and (2) opioid-related hospitalization.</div></div><div><h3>Design, setting, and participants</h3><div>This present investigation used a retrospective cohort study design consisting of a secondary analysis of data collected from IBM MarketScan Commercial claims from 2011 to 2021. Individuals were aged 12 to 64 with concurrent ADHD and OUD diagnosis receiving buprenorphine treatment.</div></div><div><h3>Exposures</h3><div>Presence of psychostimulant prescriptions.</div></div><div><h3>Main outcomes and measures</h3><div>Primary outcomes were buprenorphine discontinuation and opioid-related hospitalization.</div></div><div><h3>Results</h3><div>Study sample included 10,712 individuals with comorbid ADHD and OUD (mean age of 31.7 years, SD 10.9) who initiated buprenorphine maintenance therapy. 5190 individuals received psychostimulant prescriptions while 5522 individuals did not. Individuals who received psychostimulants demonstrated lower odds of buprenorphine discontinuation (OR = 0.669, 95 % CI = 0.610, 0.734) and hospitalization (OR = 0.493, 95 % CI = 0.418, 0.581). A one-unit increase in the psychostimulant fill count (IRR = 0.580, 95 % CI = 0.493, 0.683) was associated with a lower incidence rate of hospitalization.</div></div><div><h3>Conclusions</h3><div>In patients with a dual diagnosis of ADHD and OUD on buprenorphine therapy, treatment of ADHD with prescription psychostimulants is associated with improved adherence to buprenorphine and lower odds of opioid-related hospitalization.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"179 ","pages":"Article 209794"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981287","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}
Pub Date : 2025-08-26DOI: 10.1016/j.josat.2025.209791
So Bi Kim , Maja Lindegaard Moensted , Bethany White , Jillian Roberts , Katerina Lagios , Carolyn A. Day
Introduction
Pregnant women with substance use histories face many challenges during incarceration, leading to potentially harmful outcomes for both maternal and infant health. However, research on how to address these challenges is limited. Early disclosure of substance use is crucial for engaging in and receiving timely, appropriate intervention and follow-up care post-release. Current evidence suggests women under-report their substance use when pregnant due to stigma and fear of losing child custody. Whilst these factors are likely exacerbated in the prison environment, specific underlying factors that influence women's decisions to withhold disclosure of their substance use in the context of prison reception are unknown.
Methods
We conducted qualitative interviews to explore the viewpoint of currently or recently pregnant women (n = 31) with a history of substance use currently incarcerated in two adult women's prisons in New South Wales, Australia, between April and October 2022. Thematic analysis was used with line-by-line coding. Goffman's theory of total institution, mortification, and stigma was used to examine the experiences and underlying factors influencing pregnant women to disclose their substance use during the prison reception process.
Findings
Several unique barriers to disclosing in prison settings were identified. Barriers included tension surrounds the reception process itself (e.g. long waits, hunger, fatigue, and lack of privacy), frustration due to repeated requests for recounting substance use history, fear of negative consequences following disclosure (e.g., possible extension of incarceration or impacting on child custody post-release), and perceived a lack of benefit of disclosing, including insufficient treatment options, particularly for methamphetamine use disorder, or being housed longer in a restricted high-security cell.
Conclusions
Findings highlighted the underlying dynamics and contextual factors that influence the decision of pregnant women to disclose their substance use at prison reception. Understanding these factors and addressing gaps in clinical practice is crucial to enhancing open disclosure of substance use, leading to timely and appropriate intervention, thereby reducing potential harm for both mother and foetus.
{"title":"“What's the point of telling them?”: Unspoken struggles of pregnant women with substance use history in Australian prisons","authors":"So Bi Kim , Maja Lindegaard Moensted , Bethany White , Jillian Roberts , Katerina Lagios , Carolyn A. Day","doi":"10.1016/j.josat.2025.209791","DOIUrl":"10.1016/j.josat.2025.209791","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnant women with substance use histories face many challenges during incarceration, leading to potentially harmful outcomes for both maternal and infant health. However, research on how to address these challenges is limited. Early disclosure of substance use is crucial for engaging in and receiving timely, appropriate intervention and follow-up care post-release. Current evidence suggests women under-report their substance use when pregnant due to stigma and fear of losing child custody. Whilst these factors are likely exacerbated in the prison environment, specific underlying factors that influence women's decisions to withhold disclosure of their substance use in the context of prison reception are unknown.</div></div><div><h3>Methods</h3><div>We conducted qualitative interviews to explore the viewpoint of currently or recently pregnant women (<em>n</em> = 31) with a history of substance use currently incarcerated in two adult women's prisons in New South Wales, Australia, between April and October 2022. Thematic analysis was used with line-by-line coding. Goffman's theory of total institution, mortification, and stigma was used to examine the experiences and underlying factors influencing pregnant women to disclose their substance use during the prison reception process.</div></div><div><h3>Findings</h3><div>Several unique barriers to disclosing in prison settings were identified. Barriers included tension surrounds the reception process itself (e.g. long waits, hunger, fatigue, and lack of privacy), frustration due to repeated requests for recounting substance use history, fear of negative consequences following disclosure (e.g., possible extension of incarceration or impacting on child custody post-release), and perceived a lack of benefit of disclosing, including insufficient treatment options, particularly for methamphetamine use disorder, or being housed longer in a restricted high-security cell.</div></div><div><h3>Conclusions</h3><div>Findings highlighted the underlying dynamics and contextual factors that influence the decision of pregnant women to disclose their substance use at prison reception. Understanding these factors and addressing gaps in clinical practice is crucial to enhancing open disclosure of substance use, leading to timely and appropriate intervention, thereby reducing potential harm for both mother and foetus.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"178 ","pages":"Article 209791"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913074","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}
Pub Date : 2025-08-25DOI: 10.1016/j.josat.2025.209797
Michael A Incze, Sophia Huebler, Jacob D Baylis, Andrea Stofko, A Taylor Kelley, Ingrid A Binswanger, Gavin Bart, Andrew J Saxon, Ajay Manhapra, Adam J Gordon
Introduction: Hospitalizations are common among people with opioid use disorder (OUD). While hospitalizations represent opportunities to engage patients and offer treatment, they are also destabilizing events associated with an increased risk of death in the post-hospitalization period.
Methods: We conducted a retrospective cohort study within the Veterans Health Administration including all Veterans with OUD who experienced at least one medical hospitalization between January 2011 and December 2021. We examined which patient-level clinical and demographic factors were associated with all-cause and opioid-related mortality within 0-30 and 0-365 days following an index medical hospitalization.
Results: The cohort included 90,920 Veterans with OUD who experienced one or more medical hospitalizations during the study period. Median age was 58 years, and 93 % were male. Older age (adjusted Odds Ratio [aOR] range 30d: 1.50-2.66; 1y: 1.58-3.28), higher medical complexity (aOR range 30d: 2.11-6.23; 1y: 1.96-7.34), multiple substance use disorders (SUD; aOR 30d: 1.81 (95 % CI 1.44, 2.27) 1y: 1.48 [95 % CI 1.36, 1.62]), and length of hospitalization (aOR 30d: 6.78 [95 % CI 4.85, 9.47] 1y: 3.45 [95 % CI 2.96, 4.01]) were associated with increased all-cause mortality following hospitalization. Homelessness (aOR 30d: 0.75 [95 % CI 0.63, 0.90]; 1y: 0.85 [95 % CI 0.80, 0.91]), depression (aOR 1y: 0.89 [95 % CI 0.84, 0.95]), bipolar disorder (aOR 1y: 0.88 [95 % CI 0.82, 0.94]), buprenorphine receipt (aOR 1y: 0.79 [95 % CI 0.69, 0.91]), and service connection (aOR 30d: 0.76 [95 % CI 0.60, 0.97] 1y: 0.64 [95 % CI 0.59, 0.70]) were associated with reduced all-cause mortality. Younger age (aOR range 30d: 3.21-5.24; 1y: 2.71-2.38), homelessness (aOR 1y: 1.40 [95 % CI 1.20, 1.63]), and multiple SUD (aOR 1y: 1.78 [95 % CI 1.33, 2.38]) were among factors associated with increased opioid-related mortality after hospitalization. Black race (aOR 1y: 0.61 [95 % CI 0.50, 0.74]) and higher service connection (aOR 30d: 0.41 [95 % CI 0.21, 0.81]; 1y: 0.53 [95 % CI 0.43-0.66]) were associated with reduced opioid-related mortality after hospitalization.
Conclusions: Several patient-level factors were associated with increased all-cause mortality (e.g., length of hospital stay), reduced all-cause mortality (e.g., homelessness), increased opioid-related mortality (e.g., multiple SUD), and reduced opioid-related mortality (e.g., service connection) after hospitalization. This information provides a roadmap for future development and study of tailored supports and risk stratification tools to enhance post-hospitalization transitional care for patients with OUD.
住院治疗在阿片类药物使用障碍（OUD）患者中很常见。虽然住院是与患者接触并提供治疗的机会，但它们也是与住院后死亡风险增加相关的不稳定事件。方法：我们在退伍军人健康管理局进行了一项回顾性队列研究，包括2011年1月至2021年12月期间至少住院一次的所有OUD退伍军人。我们检查了哪些患者水平的临床和人口因素与全因死亡率和阿片类药物相关死亡率在指数医疗住院后0-30天和0-365 天内相关。结果：该队列包括90,920名在研究期间经历过一次或多次医疗住院治疗的OUD退伍军人。中位年龄为58 岁，93% 为男性。年龄较大（调整比值比[aOR]范围30d: 1.50-2.66; 1y: 1.58-3.28）、较高的医疗复杂性（aOR范围30d: 2.11-6.23; 1y: 1.96-7.34）、多种物质使用障碍（SUD; aOR 30d: 1.81(95 % CI 1.44, 2.27) 1y: 1.48[95 % CI 1.36, 1.62]）和住院时间（aOR 30d: 6.78[95 % CI 4.85, 9.47] 1y: 3.45[95 % CI 2.96, 4.01]）与住院后全因死亡率增加相关。无家可归（aOR 30d: 0.75[95 % CI 0.63, 0.90]; aOR: 0.85[95 % CI 0.80, 0.91]）、抑郁（aOR: 0.89[95 % CI 0.84, 0.95]）、双相情感障碍（aOR: 0.88[95 % CI 0.82, 0.94]）、丁丙诺啡接受（aOR: 0.79[95 % CI 0.69, 0.91]）和服务联系（aOR 30d: 0.76[95 % CI 0.60, 0.97] aOR: 0.64[95 % CI 0.59, 0.70]）与全因死亡率降低相关。年龄较小（aOR范围30d: 3.21-5.24; 1y: 2.71-2.38）、无家可归（aOR: 1.40[95 % CI 1.20, 1.63]）和多重SUD （aOR: 1.78[95 % CI 1.33, 2.38]）是住院后阿片类药物相关死亡率增加的相关因素。黑人（aOR: 0.61[95 % CI 0.50, 0.74]）和较高的服务连接（aOR: 0.41[95 % CI 0.21, 0.81]; aOR: 0.53[95 % CI 0.43-0.66]）与住院后阿片类药物相关死亡率降低相关。结论：几个患者层面的因素与住院后全因死亡率增加（例如，住院时间）、全因死亡率降低（例如，无家可归）、阿片类药物相关死亡率增加（例如，多发SUD）以及阿片类药物相关死亡率降低（例如，服务连接）有关。这一信息为未来开发和研究量身定制的支持和风险分层工具提供了路线图，以加强对OUD患者的住院后过渡护理。
{"title":"Factors associated with mortality following hospitalization among veterans with opioid use disorder.","authors":"Michael A Incze, Sophia Huebler, Jacob D Baylis, Andrea Stofko, A Taylor Kelley, Ingrid A Binswanger, Gavin Bart, Andrew J Saxon, Ajay Manhapra, Adam J Gordon","doi":"10.1016/j.josat.2025.209797","DOIUrl":"10.1016/j.josat.2025.209797","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitalizations are common among people with opioid use disorder (OUD). While hospitalizations represent opportunities to engage patients and offer treatment, they are also destabilizing events associated with an increased risk of death in the post-hospitalization period.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study within the Veterans Health Administration including all Veterans with OUD who experienced at least one medical hospitalization between January 2011 and December 2021. We examined which patient-level clinical and demographic factors were associated with all-cause and opioid-related mortality within 0-30 and 0-365 days following an index medical hospitalization.</p><p><strong>Results: </strong>The cohort included 90,920 Veterans with OUD who experienced one or more medical hospitalizations during the study period. Median age was 58 years, and 93 % were male. Older age (adjusted Odds Ratio [aOR] range 30d: 1.50-2.66; 1y: 1.58-3.28), higher medical complexity (aOR range 30d: 2.11-6.23; 1y: 1.96-7.34), multiple substance use disorders (SUD; aOR 30d: 1.81 (95 % CI 1.44, 2.27) 1y: 1.48 [95 % CI 1.36, 1.62]), and length of hospitalization (aOR 30d: 6.78 [95 % CI 4.85, 9.47] 1y: 3.45 [95 % CI 2.96, 4.01]) were associated with increased all-cause mortality following hospitalization. Homelessness (aOR 30d: 0.75 [95 % CI 0.63, 0.90]; 1y: 0.85 [95 % CI 0.80, 0.91]), depression (aOR 1y: 0.89 [95 % CI 0.84, 0.95]), bipolar disorder (aOR 1y: 0.88 [95 % CI 0.82, 0.94]), buprenorphine receipt (aOR 1y: 0.79 [95 % CI 0.69, 0.91]), and service connection (aOR 30d: 0.76 [95 % CI 0.60, 0.97] 1y: 0.64 [95 % CI 0.59, 0.70]) were associated with reduced all-cause mortality. Younger age (aOR range 30d: 3.21-5.24; 1y: 2.71-2.38), homelessness (aOR 1y: 1.40 [95 % CI 1.20, 1.63]), and multiple SUD (aOR 1y: 1.78 [95 % CI 1.33, 2.38]) were among factors associated with increased opioid-related mortality after hospitalization. Black race (aOR 1y: 0.61 [95 % CI 0.50, 0.74]) and higher service connection (aOR 30d: 0.41 [95 % CI 0.21, 0.81]; 1y: 0.53 [95 % CI 0.43-0.66]) were associated with reduced opioid-related mortality after hospitalization.</p><p><strong>Conclusions: </strong>Several patient-level factors were associated with increased all-cause mortality (e.g., length of hospital stay), reduced all-cause mortality (e.g., homelessness), increased opioid-related mortality (e.g., multiple SUD), and reduced opioid-related mortality (e.g., service connection) after hospitalization. This information provides a roadmap for future development and study of tailored supports and risk stratification tools to enhance post-hospitalization transitional care for patients with OUD.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209797"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981270","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}
Pub Date : 2025-08-25DOI: 10.1016/j.josat.2025.209796
Liba Blumberger , Guodong Liu , William Calo , Daniel Mallinson , Douglas Leslie
Introduction
There is increased effort among states to enhance access to pharmacological treatment, a best practice for those diagnosed with opioid use disorder (OUD), within carceral settings to lower risk of overdose fatalities after release. This study examines trends in OUD and medications for opioid use disorder (MOUD) received by individuals released from state correctional institutions (SCIs) in Pennsylvania.
Methods
Using prison data, this retrospective cohort study analyzes annual rates of substance use disorder by sub-type, focusing specifically on OUD and subsequent treatments, among adults (≥18 years) released between 2014 and 2022 (n = 134,781). Changes in rates were evaluated using Cochran-Armitage tests, while logistic regression models identified predictive factors for OUD and treatment received before release.
Results
From 2014 to 2022, the prevalence of OUD in Pennsylvania SCIs increased from 16.6 % to 25.2 % (p < .0001) and pharmacological engagement rose from 0.0% to 22.6% (p < .0001), especially for buprenorphine (0.0% to 15.7%; p < .0001). This occurred alongside reduced rates of behavioral health services, which dropped from 69.6 % to 41.9 % (p < .0001), and a decline in OUD prevalence in later years. Predictive factors for OUD and MOUD included being female, white, released in later years, and being younger, specifically in late 20s or early 30s.
Conclusion
The use of pharmacological treatment, particularly buprenorphine, has increased, while behavioral health services have declined for those released from PA SCIs with an OUD, with varying levels of OUD presence and demographic variations in its provision. This highlights the progress of MOUD expansions and reveals too that further improvements are necessary to meet treatment need to assist in recovery and reintegration into society.
{"title":"Changing patterns and predictors of opioid use disorder and treatment of adults released from state detention in Pennsylvania","authors":"Liba Blumberger , Guodong Liu , William Calo , Daniel Mallinson , Douglas Leslie","doi":"10.1016/j.josat.2025.209796","DOIUrl":"10.1016/j.josat.2025.209796","url":null,"abstract":"<div><h3>Introduction</h3><div>There is increased effort among states to enhance access to pharmacological treatment, a best practice for those diagnosed with opioid use disorder (OUD), within carceral settings to lower risk of overdose fatalities after release. This study examines trends in OUD and medications for opioid use disorder (MOUD) received by individuals released from state correctional institutions (SCIs) in Pennsylvania.</div></div><div><h3>Methods</h3><div>Using prison data, this retrospective cohort study analyzes annual rates of substance use disorder by sub-type, focusing specifically on OUD and subsequent treatments, among adults (≥18 years) released between 2014 and 2022 (<em>n</em> = 134,781). Changes in rates were evaluated using Cochran-Armitage tests, while logistic regression models identified predictive factors for OUD and treatment received before release.</div></div><div><h3>Results</h3><div>From 2014 to 2022, the prevalence of OUD in Pennsylvania SCIs increased from 16.6 % to 25.2 % (<em>p</em> < .0001) and pharmacological engagement rose from 0.0% to 22.6% (p < .0001), especially for buprenorphine (0.0% to 15.7%; p < .0001). This occurred alongside reduced rates of behavioral health services, which dropped from 69.6 % to 41.9 % (p < .0001), and a decline in OUD prevalence in later years. Predictive factors for OUD and MOUD included being female, white, released in later years, and being younger, specifically in late 20s or early 30s.</div></div><div><h3>Conclusion</h3><div>The use of pharmacological treatment, particularly buprenorphine, has increased, while behavioral health services have declined for those released from PA SCIs with an OUD, with varying levels of OUD presence and demographic variations in its provision. This highlights the progress of MOUD expansions and reveals too that further improvements are necessary to meet treatment need to assist in recovery and reintegration into society.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"179 ","pages":"Article 209796"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981336","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}
Pub Date : 2025-08-24DOI: 10.1016/j.josat.2025.209795
Laura Rodger , Kathleen Ann Sheehan , Andrew Pinto
Introduction
Addiction consultation services are hospital-based specialist programs designed to support the care of patients with substance use disorders (SUDs). This study aimed to: (1) describe service volumes and patient demographics for a pilot addiction consultation program, (2) compare clinical outcomes between patients seen prior to and after program implementation, and (3) explore provider perceptions, referral patterns, and clinical practice.
Methods
Using the RE-AIM framework, we conducted a formative multi-method evaluation at a tertiary care hospital. Quantitative data about the uptake of the pilot program and clinical descriptions of three patient groups (consult patients, pre-program baseline patients, post-program non-consult patients) was collected through chart review. A provider survey with closed and open-ended questions was used to explore provider practice patterns, perceived needs, roles, and challenges.
Results
Most consult requests were from General Internal Medicine (136/181, 75.1 %). Consult orders were usually placed during service hours (169/181 93.4 %), with a median time between admission and consult request of 1 day (IQR 0–2). Consultation was linked to higher odds of receiving a pharmacotherapy prescription compared to baseline (OR 5.82 [95 % CI 3.05–11.99], p < 0.001) and patients not receiving consultation (OR 6.78 [95 % CI 2.76–20.75], p < 0.001). Survey findings highlighted non-addiction specialist providers' lack of confidence with substance use pharmacotherapy and consultation for counselling, resource navigation, and harm reduction.
Conclusions
The consult program demonstrated consistent uptake and was associated with increased access to pharmacotherapy for hospitalized patients, supporting improved inpatient addiction care. Non-addiction providers identified value in the consult program beyond pharmacotherapy and identified challenges with this patient population.
成瘾咨询服务是基于医院的专家项目，旨在支持对物质使用障碍（sud）患者的护理。本研究旨在：(1)描述一个试点成瘾咨询项目的服务量和患者人口统计数据；(2)比较项目实施前后患者的临床结果；(3)探索提供者的看法、转诊模式和临床实践。方法采用RE-AIM框架，对某三级医院进行形成性多方法评价。通过图表回顾收集了三组患者（会诊患者、会诊前基线患者、会诊后非会诊患者）对试点方案的接受情况和临床描述的定量数据。一项包含封闭式和开放式问题的提供者调查用于探索提供者实践模式、感知需求、角色和挑战。结果内科医师咨询最多（136/181,75.1%）；咨询订单通常在服务时间下达（169/181 93.4%），入院和咨询请求之间的中位数时间为1天（IQR 0-2）。与基线相比，会诊与接受药物治疗处方的几率较高（OR 5.82 [95% CI 3.05-11.99], p < 0.001）和未接受会诊的患者（OR 6.78 [95% CI 2.76-20.75], p < 0.001）相关。调查结果强调，非成瘾专家提供者对药物使用药物治疗和咨询、资源导航和减少危害缺乏信心。结论：咨询项目显示出持续的吸收，并与住院患者获得药物治疗的机会增加有关，支持改善住院患者成瘾护理。非成瘾提供者确定了咨询项目在药物治疗之外的价值，并确定了这一患者群体的挑战。
{"title":"Multi-method evaluation of a physician-led pilot addiction consult service","authors":"Laura Rodger , Kathleen Ann Sheehan , Andrew Pinto","doi":"10.1016/j.josat.2025.209795","DOIUrl":"10.1016/j.josat.2025.209795","url":null,"abstract":"<div><h3>Introduction</h3><div>Addiction consultation services are hospital-based specialist programs designed to support the care of patients with substance use disorders (SUDs). This study aimed to: (1) describe service volumes and patient demographics for a pilot addiction consultation program, (2) compare clinical outcomes between patients seen prior to and after program implementation, and (3) explore provider perceptions, referral patterns, and clinical practice.</div></div><div><h3>Methods</h3><div>Using the RE-AIM framework, we conducted a formative multi-method evaluation at a tertiary care hospital. Quantitative data about the uptake of the pilot program and clinical descriptions of three patient groups (consult patients, pre-program baseline patients, post-program non-consult patients) was collected through chart review. A provider survey with closed and open-ended questions was used to explore provider practice patterns, perceived needs, roles, and challenges.</div></div><div><h3>Results</h3><div>Most consult requests were from General Internal Medicine (136/181, 75.1 %). Consult orders were usually placed during service hours (169/181 93.4 %), with a median time between admission and consult request of 1 day (IQR 0–2). Consultation was linked to higher odds of receiving a pharmacotherapy prescription compared to baseline (OR 5.82 [95 % CI 3.05–11.99], <em>p</em> < 0.001) and patients not receiving consultation (OR 6.78 [95 % CI 2.76–20.75], p < 0.001). Survey findings highlighted non-addiction specialist providers' lack of confidence with substance use pharmacotherapy and consultation for counselling, resource navigation, and harm reduction.</div></div><div><h3>Conclusions</h3><div>The consult program demonstrated consistent uptake and was associated with increased access to pharmacotherapy for hospitalized patients, supporting improved inpatient addiction care. Non-addiction providers identified value in the consult program beyond pharmacotherapy and identified challenges with this patient population.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"178 ","pages":"Article 209795"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906898","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}
Quality of life (QoL) measures are increasingly used as outcome indicators in both pharmacological and non-pharmacological intervention trials for alcohol use disorder (AUD). However, there is no current and comprehensive review to inform standardization and utilization of psychometrically sound measures adapted to an AUD population. Therefore, this systematic review aims to identify QoL assessment instruments used in clinical trials targeting AUD and provide an overview of the psychometric properties of the most frequently used instruments.
Methods
A systematic search was conducted in PubMed, EMBASE, and PsycINFO up to July 20th, 2023. Studies were included if they were original controlled trials assessing QoL in adults with AUD. Data extraction included study characteristics and details of QoL assessment instruments. Psychometric properties of frequently used instruments were analyzed.
Results
Out of 3751 studies, 61 met inclusion criteria. Across these, 19 different QoL instruments were identified, with the SF-36 being the most frequently used. Our findings indicate that while several generic and health-related QoL instruments were employed, more than half of the instruments were applied in only one study, and generally few studies report on the psychometric properties specific to AUD populations.
Conclusions
The findings underscore a lack of standardized practice and utilization of the most empirically sound QoL assessment instruments in clinical trials targeting AUD. This review provides an updated and more comprehensive synthesis than previous reviews, highlights the need for validated, AUD-specific QoL measures, and suggests directions for future research, including the development of core outcome sets.
{"title":"Quality of life assessment instruments used in clinical trials for alcohol use disorder: A systematic review","authors":"Jeppe Sig Juelsgaard Tryggedsson , Kjeld Andersen , Anette Søgaard Nielsen , Camilla Dahl Haislund Olsen , Angelina Isabella Mellentin","doi":"10.1016/j.josat.2025.209793","DOIUrl":"10.1016/j.josat.2025.209793","url":null,"abstract":"<div><h3>Background</h3><div>Quality of life (QoL) measures are increasingly used as outcome indicators in both pharmacological and non-pharmacological intervention trials for alcohol use disorder (AUD). However, there is no current and comprehensive review to inform standardization and utilization of psychometrically sound measures adapted to an AUD population. Therefore, this systematic review aims to identify QoL assessment instruments used in clinical trials targeting AUD and provide an overview of the psychometric properties of the most frequently used instruments.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, EMBASE, and PsycINFO up to July 20th, 2023. Studies were included if they were original controlled trials assessing QoL in adults with AUD. Data extraction included study characteristics and details of QoL assessment instruments. Psychometric properties of frequently used instruments were analyzed.</div></div><div><h3>Results</h3><div>Out of 3751 studies, 61 met inclusion criteria. Across these, 19 different QoL instruments were identified, with the SF-36 being the most frequently used. Our findings indicate that while several generic and health-related QoL instruments were employed, more than half of the instruments were applied in only one study, and generally few studies report on the psychometric properties specific to AUD populations.</div></div><div><h3>Conclusions</h3><div>The findings underscore a lack of standardized practice and utilization of the most empirically sound QoL assessment instruments in clinical trials targeting AUD. This review provides an updated and more comprehensive synthesis than previous reviews, highlights the need for validated, AUD-specific QoL measures, and suggests directions for future research, including the development of core outcome sets.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"178 ","pages":"Article 209793"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902132","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}
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