Pub Date : 2025-08-05DOI: 10.1016/S2949-8759(25)00137-7
{"title":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(25)00137-7","DOIUrl":"10.1016/S2949-8759(25)00137-7","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209758"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781021","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 : 2025-08-05DOI: 10.1016/S2949-8759(25)00136-5
{"title":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(25)00136-5","DOIUrl":"10.1016/S2949-8759(25)00136-5","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209757"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780776","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 : 2025-08-04DOI: 10.1016/j.josat.2025.209774
Hannah S. Szlyk , Devin E. Banks , Nathaniel A. Dell , William D. Hutson , Lucy Meigs
In this commentary, we draw upon the care ethics framework to discuss why and how substance use researchers should re-evaluate traditional best practices for participant compensation. We encourage researchers to have conversations with community partners and potential participants alike on how compensation can convey appreciation, whether the participants have a need for the specific type of compensation, and if participants are able to capably and conveniently use it. When planned poorly, compensation can cause harm to participants and communities and undermine research efforts. Three case examples are provided to illustrate these points. Lastly, we urge researchers to update their respective institutions about barriers to equitable compensation that may be embedded within the research infrastructure. Overall, compensation has the potential to strengthen collaborations between researchers and community members and provide a strong foundation for rigorous and impactful substance use recovery research.
{"title":"Something does not add up: Rethinking how we compensate for research participation among people who use drugs","authors":"Hannah S. Szlyk , Devin E. Banks , Nathaniel A. Dell , William D. Hutson , Lucy Meigs","doi":"10.1016/j.josat.2025.209774","DOIUrl":"10.1016/j.josat.2025.209774","url":null,"abstract":"<div><div>In this commentary, we draw upon the care ethics framework to discuss why and how substance use researchers should re-evaluate traditional best practices for participant compensation. We encourage researchers to have conversations with community partners and potential participants alike on how compensation can convey appreciation, whether the participants have a need for the specific type of compensation, and if participants are able to capably and conveniently use it. When planned poorly, compensation can cause harm to participants and communities and undermine research efforts. Three case examples are provided to illustrate these points. Lastly, we urge researchers to update their respective institutions about barriers to equitable compensation that may be embedded within the research infrastructure. Overall, compensation has the potential to strengthen collaborations between researchers and community members and provide a strong foundation for rigorous and impactful substance use recovery research.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209774"},"PeriodicalIF":1.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767143","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 : 2025-08-02DOI: 10.1016/j.josat.2025.209773
Sarah Petelinsek
{"title":"The ethics we abandon – A medical student perspective on a familiar face","authors":"Sarah Petelinsek","doi":"10.1016/j.josat.2025.209773","DOIUrl":"10.1016/j.josat.2025.209773","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209773"},"PeriodicalIF":1.9,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757672","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 : 2025-07-31DOI: 10.1016/j.josat.2025.209766
Miriam T.H. Harris , Megan Hall , Sylvia Ellison , JaNae Holloway , Carly Bridden , Sarah M. Bagley , Mackenzie Bullard , Deborah Chassler , Avik Chatterjee , Anindita Dasgupta , Mari-Lynn Drainoni , Dawn E. Gruss , Elizabeth Jadovich , Rachel Katz , Christine Mayotte , Jessica L. Neufeld , Emmanuel Oga , LaShawn Glasgow
Introduction
Pregnant and postpartum women (PPW) face substantial barriers to opioid use disorder (OUD) care despite overdose being a leading cause of maternal mortality in the United States. In this study, we leveraged data from the Helping End Addictions Long Term (HEALing) Communities Study (HCS), a community-engaged implementation trial aimed at reducing opioid overdose deaths, to 1) describe evidence-based practice (EBP) strategies designed to reach PPW and 2) review implementation determinants.
Methods
We analyzed data from 50 communities across Massachusetts, New York, and Ohio that implemented the Communities That HEAL intervention from January 2020 through December 2023. HCS community coalitions used the HCS Opioid-overdose Reduction Continuum of Care Approach (ORCCA) menu to inform the selection of overdose education naloxone distribution (OEND) and medication for OUD (MOUD) EBP strategies. We used the ORCCA tracker, an HCS tool documenting strategy selection and implementation details, to identify and summarize strategies designed for PPW. We reviewed written community action and implementation plans to analyze and summarize implementation determinants.
Results
The 50 communities included in this analysis selected 29 EBP strategies designed to reach PPW, and 21 (72.4 %) of the selected strategies were implemented, accounting for 3.5 % of all implemented strategies. Most (85.7 %) focused on MOUD, 31.0 % were based in rural communities, and 66.7 %, 23.8 %, and 9.5 % were delivered in healthcare sectors, behavioral health sectors, and criminal legal sectors, respectively. Barriers to implementing OUD strategies intended for PPW included a lack of staff or services with adequate experience, and stigma preventing delivery and engagement. Facilitators included leveraging existing services and community expertise to expand OUD care.
Conclusion
Our findings indicate a need for greater awareness of OUD among PPW and research on implementation approaches for EBPs that effectively reach this group. Leveraging existing community programs that serve PPW with substance use disorders could help expand tailored services.
{"title":"Tailored strategies to reduce opioid overdose deaths for pregnant and postpartum women: Examples and lessons learned from the HEALing Communities Study","authors":"Miriam T.H. Harris , Megan Hall , Sylvia Ellison , JaNae Holloway , Carly Bridden , Sarah M. Bagley , Mackenzie Bullard , Deborah Chassler , Avik Chatterjee , Anindita Dasgupta , Mari-Lynn Drainoni , Dawn E. Gruss , Elizabeth Jadovich , Rachel Katz , Christine Mayotte , Jessica L. Neufeld , Emmanuel Oga , LaShawn Glasgow","doi":"10.1016/j.josat.2025.209766","DOIUrl":"10.1016/j.josat.2025.209766","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnant and postpartum women (PPW) face substantial barriers to opioid use disorder (OUD) care despite overdose being a leading cause of maternal mortality in the United States. In this study, we leveraged data from the Helping End Addictions Long Term (HEALing) Communities Study (HCS), a community-engaged implementation trial aimed at reducing opioid overdose deaths, to 1) describe evidence-based practice (EBP) strategies designed to reach PPW and 2) review implementation determinants.</div></div><div><h3>Methods</h3><div>We analyzed data from 50 communities across Massachusetts, New York, and Ohio that implemented the Communities That HEAL intervention from January 2020 through December 2023. HCS community coalitions used the HCS Opioid-overdose Reduction Continuum of Care Approach (ORCCA) menu to inform the selection of overdose education naloxone distribution (OEND) and medication for OUD (MOUD) EBP strategies. We used the ORCCA tracker, an HCS tool documenting strategy selection and implementation details, to identify and summarize strategies designed for PPW. We reviewed written community action and implementation plans to analyze and summarize implementation determinants.</div></div><div><h3>Results</h3><div>The 50 communities included in this analysis selected 29 EBP strategies designed to reach PPW, and 21 (72.4 %) of the selected strategies were implemented, accounting for 3.5 % of all implemented strategies. Most (85.7 %) focused on MOUD, 31.0 % were based in rural communities, and 66.7 %, 23.8 %, and 9.5 % were delivered in healthcare sectors, behavioral health sectors, and criminal legal sectors, respectively. Barriers to implementing OUD strategies intended for PPW included a lack of staff or services with adequate experience, and stigma preventing delivery and engagement. Facilitators included leveraging existing services and community expertise to expand OUD care.</div></div><div><h3>Conclusion</h3><div>Our findings indicate a need for greater awareness of OUD among PPW and research on implementation approaches for EBPs that effectively reach this group. Leveraging existing community programs that serve PPW with substance use disorders could help expand tailored services.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209766"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748826","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 : 2025-07-31DOI: 10.1016/j.josat.2025.209763
Tyler G. Erath , Rosalie LaCroix , Erin O'Keefe , Michael DeSarno , Stephen T. Higgins , Richard A. Rawson
Introduction
Expanding access to effective treatment for stimulant use disorder (StimUD) is increasingly urgent as US fatal drug poisonings involving stimulants have rapidly increased. Limited information is available regarding interest in StimUD treatment among syringe service program (SSP) participants including interest in contingency management (CM).
Methods
We surveyed SSP participants in Burlington, Vermont regarding their interests in reducing and stopping stimulant use, participating in CM, and examined associations between sociodemographics, drug use, and health/treatment variables with interest in reducing and stopping stimulant use using multivariable logistic regression.
Results
Among 139 participants, 64.6 % reported interest in reducing and 59.7 % in stopping stimulant use. Overall, 82.8 % of participants reported interest in CM to reduce or stop stimulant use. Interest in reducing use was greater (odds ratio[95 % CI]) among participants currently receiving substance use disorder (SUD) treatment (3.84[1.61–9.14], p < .01), without Hepatitis C viral (HCV) infection (2.61[1.14–5.98], p = .02), and being somewhat (19.29[2.25–165.65], p = .01) or very (19.65[2.34–164.84], p = .01) concerned about anxiety. Interest in stopping use was greater among participants currently receiving SUD treatment (4.98[1.97–12.62], p < .01), without HCV infection (2.87[1.22–6.74], p = .02), participants whose primary drug was opioids compared to both stimulants and opioids (28.13[2.95–267.93], p < .01), and participants whose primary drug was stimulants compared to both stimulants and opioids (12.81[1.45–113.43], p = .02).
Conclusions
Results demonstrate interest in stimulant use treatment among this sample of SSP participants, with strong interest in CM. As community-based programs with high social acceptability for their non-judgmental services, SSPs are a novel setting to examine providing evidence-based CM for StimUD.
{"title":"Interest in contingency management and reducing stimulant use among syringe service program participants","authors":"Tyler G. Erath , Rosalie LaCroix , Erin O'Keefe , Michael DeSarno , Stephen T. Higgins , Richard A. Rawson","doi":"10.1016/j.josat.2025.209763","DOIUrl":"10.1016/j.josat.2025.209763","url":null,"abstract":"<div><h3>Introduction</h3><div>Expanding access to effective treatment for stimulant use disorder (StimUD) is increasingly urgent as US fatal drug poisonings involving stimulants have rapidly increased. Limited information is available regarding interest in StimUD treatment among syringe service program (SSP) participants including interest in contingency management (CM).</div></div><div><h3>Methods</h3><div>We surveyed SSP participants in Burlington, Vermont regarding their interests in reducing and stopping stimulant use, participating in CM, and examined associations between sociodemographics, drug use, and health/treatment variables with interest in reducing and stopping stimulant use using multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among 139 participants, 64.6 % reported interest in reducing and 59.7 % in stopping stimulant use. Overall, 82.8 % of participants reported interest in CM to reduce or stop stimulant use. Interest in reducing use was greater (odds ratio[95 % CI]) among participants currently receiving substance use disorder (SUD) treatment (3.84[1.61–9.14], <em>p</em> < .01), without Hepatitis C viral (HCV) infection (2.61[1.14–5.98], <em>p</em> = .02), and being somewhat (19.29[2.25–165.65], <em>p</em> = .01) or very (19.65[2.34–164.84], <em>p</em> = .01) concerned about anxiety. Interest in stopping use was greater among participants currently receiving SUD treatment (4.98[1.97–12.62], <em>p</em> < .01), without HCV infection (2.87[1.22–6.74], <em>p</em> = .02), participants whose primary drug was opioids compared to both stimulants and opioids (28.13[2.95–267.93], <em>p</em> < .01), and participants whose primary drug was stimulants compared to both stimulants and opioids (12.81[1.45–113.43], <em>p</em> = .02).</div></div><div><h3>Conclusions</h3><div>Results demonstrate interest in stimulant use treatment among this sample of SSP participants, with strong interest in CM. As community-based programs with high social acceptability for their non-judgmental services, SSPs are a novel setting to examine providing evidence-based CM for StimUD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209763"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757671","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 : 2025-07-31DOI: 10.1016/j.josat.2025.209772
Coleen Leung , Christina Marel , Maree Teesson , Jack Wilson , Shane Darke , Paul S. Haber , Katherine L. Mills
Introduction
Cross-sectional studies have shown a well-established relationship between post-traumatic stress disorder (PTSD) and substance use disorders, particularly, heroin dependence. The present study examines the prevalence, correlates and predictors of PTSD over the longer term among people with a history of heroin dependence.
Method
This study explored PTSD outcomes at the 18–20-year follow-up of the Australian Treatment Outcomes Study, a prospective longitudinal study of 615 people with heroin dependence recruited from Sydney, Australia in 2001–2002. Structured interviews asked participants about demographic characteristics, drug use history and dependence, mental health and patterns of treatment seeking for heroin dependence. Group comparisons between those with and without PTSD were conducted to identify correlates of PTSD at 18–20-years. Logistic regression with backwards stepwise elimination was conducted to identify baseline predictors of PTSD at 18–20-years follow-up.
Results
Of the 615 people assessed at baseline, 393 provided complete PTSD data at 18–20-year follow-up. Of those, 16% met diagnostic criteria for current PTSD. Individuals with PTSD had increased odds of meeting criteria for cannabis dependence, being in current opiate treatment, experiencing a major depressive episode in the past month and lifetime suicide attempt (ORs range 1.85–4.32). Baseline predictors of PTSD at 18–20-year follow-up included female sex, a history of incarceration and current PTSD diagnosis.
Conclusions
This study showed PTSD remained prevalent among a cohort of people with a history of heroin dependence, and was associated with poorer long-term clinical outcomes across substance use and mental health domains. Additionally, individuals with PTSD demonstrated poorer occupational functioning and greater treatment utilisation. The finding that baseline PTSD diagnosis was a predictor of PTSD at 18–20-years stresses the need to provide effective and immediate evidence-based treatment for those with co-occurring PTSD and heroin dependence.
{"title":"Correlates and predictors of PTSD among people with heroin dependence: Findings from the 18–20-year follow-up of the Australian Treatment Outcomes Study (ATOS)","authors":"Coleen Leung , Christina Marel , Maree Teesson , Jack Wilson , Shane Darke , Paul S. Haber , Katherine L. Mills","doi":"10.1016/j.josat.2025.209772","DOIUrl":"10.1016/j.josat.2025.209772","url":null,"abstract":"<div><h3>Introduction</h3><div>Cross-sectional studies have shown a well-established relationship between post-traumatic stress disorder (PTSD) and substance use disorders, particularly, heroin dependence. The present study examines the prevalence, correlates and predictors of PTSD over the longer term among people with a history of heroin dependence.</div></div><div><h3>Method</h3><div>This study explored PTSD outcomes at the 18–20-year follow-up of the Australian Treatment Outcomes Study, a prospective longitudinal study of 615 people with heroin dependence recruited from Sydney, Australia in 2001–2002. Structured interviews asked participants about demographic characteristics, drug use history and dependence, mental health and patterns of treatment seeking for heroin dependence. Group comparisons between those with and without PTSD were conducted to identify correlates of PTSD at 18–20-years. Logistic regression with backwards stepwise elimination was conducted to identify baseline predictors of PTSD at 18–20-years follow-up.</div></div><div><h3>Results</h3><div>Of the 615 people assessed at baseline, 393 provided complete PTSD data at 18–20-year follow-up. Of those, 16% met diagnostic criteria for current PTSD. Individuals with PTSD had increased odds of meeting criteria for cannabis dependence, being in current opiate treatment, experiencing a major depressive episode in the past month and lifetime suicide attempt (ORs range 1.85–4.32). Baseline predictors of PTSD at 18–20-year follow-up included female sex, a history of incarceration and current PTSD diagnosis.</div></div><div><h3>Conclusions</h3><div>This study showed PTSD remained prevalent among a cohort of people with a history of heroin dependence, and was associated with poorer long-term clinical outcomes across substance use and mental health domains. Additionally, individuals with PTSD demonstrated poorer occupational functioning and greater treatment utilisation. The finding that baseline PTSD diagnosis was a predictor of PTSD at 18–20-years stresses the need to provide effective and immediate evidence-based treatment for those with co-occurring PTSD and heroin dependence.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209772"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767144","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 : 2025-07-31DOI: 10.1016/j.josat.2025.209771
Michael Hsu , Talia Panadero , Nisha Choothakan , Mikayla O. Castellon , Gregory Gee , Edwin Jacobo , Erin P. Finley , James R. McKay , Peter Capone-Newton , Larissa J. Mooney , Sonya Gabrielian
Background
Stimulant use disorder (StUD) is a leading cause of overdose and death among homeless-experienced Veterans (HEVs). Contingency management (CM), a behavioral intervention offering rewards for stimulant abstinence, is the most effective psychosocial treatment for StUD. However, CM remains underutilized and understudied in homeless service settings. We piloted CM at a novel transitional pallet shelter community for HEVs and assessed the intervention's feasibility and acceptability.
Methods
We implemented a 12-week, on-site CM program at a pallet shelter community—comprised of locked, private “tiny homes” alongside on-site case management and health services—at the Veterans Affairs Greater Los Angeles. Veterans with a history of StUD were eligible to participate in twice-weekly urine drug screening (UDS), with voucher-based rewards for stimulant-negative results. Mixed methods were used to evaluate CM's feasibility and acceptability, including quantitative measures of attendance and abstinence and qualitative interviews with participating Veterans (n = 10) and staff (n = 6).
Results
Among 26 enrolled Veterans, average session attendance was 32 % and 49 % of UDS samples were negative for stimulants. Qualitative findings identified several factors that supported CM's acceptability, including perceptions that CM was accessible, structured, and supportive; helped meet immediate needs through monetary rewards; and enhanced engagement with health services. Reported barriers included concerns about privacy, stigma, and perceptions of insufficient rewards.
Conclusion
This pilot showed initial Veteran engagement and positive Veteran and staff attitudes toward implementing CM at CTRS, though feasibility and acceptability may be enhanced by addressing concerns regarding privacy, stigma, accessibility, rewards, and integrated psychotherapeutic support.
{"title":"Feasibility and acceptability of a contingency management program for stimulant use disorder in a pallet shelter community for homeless-experienced veterans","authors":"Michael Hsu , Talia Panadero , Nisha Choothakan , Mikayla O. Castellon , Gregory Gee , Edwin Jacobo , Erin P. Finley , James R. McKay , Peter Capone-Newton , Larissa J. Mooney , Sonya Gabrielian","doi":"10.1016/j.josat.2025.209771","DOIUrl":"10.1016/j.josat.2025.209771","url":null,"abstract":"<div><h3>Background</h3><div>Stimulant use disorder (StUD) is a leading cause of overdose and death among homeless-experienced Veterans (HEVs). Contingency management (CM), a behavioral intervention offering rewards for stimulant abstinence, is the most effective psychosocial treatment for StUD. However, CM remains underutilized and understudied in homeless service settings. We piloted CM at a novel transitional pallet shelter community for HEVs and assessed the intervention's feasibility and acceptability.</div></div><div><h3>Methods</h3><div>We implemented a 12-week, on-site CM program at a pallet shelter community—comprised of locked, private “tiny homes” alongside on-site case management and health services—at the Veterans Affairs Greater Los Angeles. Veterans with a history of StUD were eligible to participate in twice-weekly urine drug screening (UDS), with voucher-based rewards for stimulant-negative results. Mixed methods were used to evaluate CM's feasibility and acceptability, including quantitative measures of attendance and abstinence and qualitative interviews with participating Veterans (n = 10) and staff (n = 6).</div></div><div><h3>Results</h3><div>Among 26 enrolled Veterans, average session attendance was 32 % and 49 % of UDS samples were negative for stimulants. Qualitative findings identified several factors that supported CM's acceptability, including perceptions that CM was accessible, structured, and supportive; helped meet immediate needs through monetary rewards; and enhanced engagement with health services. Reported barriers included concerns about privacy, stigma, and perceptions of insufficient rewards.</div></div><div><h3>Conclusion</h3><div>This pilot showed initial Veteran engagement and positive Veteran and staff attitudes toward implementing CM at CTRS, though feasibility and acceptability may be enhanced by addressing concerns regarding privacy, stigma, accessibility, rewards, and integrated psychotherapeutic support.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209771"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757673","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 : 2025-07-31DOI: 10.1016/j.josat.2025.209767
Leonardo Dominguez Gomez , Ashly E. Jordan , Izza Zaidi , Hannah Helmy , Alex Harocopos
Introduction
Skin and soft tissue infections (SSTI) and severe injection-related infections (SIRI) cause serious morbidity among people who inject drugs (PWID). Data suggest that specific injection practices associate with a higher risk of developing SSTI/SIRI, and that a brief screening tool may help identify at-risk individuals. This study examines injection drug use behaviors and SSTI/SIRI experiences among a sample of PWID in New York City (NYC). In particular, the analysis explores the potential utility of the bacterial infections risk scale for injection drug use (BIRSI) in identifying people at risk for developing SSTI/SIRI in a non-hospitalized population of PWID.
Methods
This study examines associations between sociodemographic factors, healthcare system usage, injection practices, and the seven-item BIRSI instrument in relation to reported past 90-day SSTI/SIRI among a subset of respondents who reported past 90-day injection drug use (146 total respondents). Each respondent received a composite score for the BIRSI instrument by adding a point for each reported behavior. Analyses examine the association between select factors and reporting ≥1 SSTI/SIRI in the past 90 days.
Results
Among participants, 55.5 % identified as Hispanic and 30.1 % as female. The mean age was 44.6 years and 32.2 % had stable housing. The prevalence of reported past 90-day SSTI/SIRI was 24.7 %. Unadjusted univariate models showed age (prevalence ratio, PR: 0.97, 95 % CI: 0.94, 0.99), receptive syringe sharing (RSS) (PR: 2.91, 95 % CI: 1.69, 4.88) or using other people's previously used (non-syringe) injection equipment (PR: 2.61, 95 % CI: 1.53, 4.45), and a higher BIRSI composite score (PR: 1.33, 95 % CI, 1.34, 1.56) to associate with reporting of past 90-day SSTI/SIRI. Further modeling showed that a higher BIRSI score, exclusive of other injection related behaviors, was associated with self-reported SSTI/SIRI (adjusted PR: 1.35, 95 % CI: 1.13, 1.62) when controlling for age, sex, race, and housing status.
Conclusion
Findings suggest the BIRSI instrument may be a useful, brief tool to identify individuals at higher risk of developing SSTI/SIRI among non-hospitalized PWID. Using the BIRSI instrument can help programs and staff serving PWID to implement strategies to reduce SSTI/SIRI risk among their participants, such as wound prevention and care interventions.
{"title":"Bacterial infections risk scale for injection drug use: A brief screener to identify skin and soft tissue infection risk for people who inject drugs","authors":"Leonardo Dominguez Gomez , Ashly E. Jordan , Izza Zaidi , Hannah Helmy , Alex Harocopos","doi":"10.1016/j.josat.2025.209767","DOIUrl":"10.1016/j.josat.2025.209767","url":null,"abstract":"<div><h3>Introduction</h3><div>Skin and soft tissue infections (SSTI) and severe injection-related infections (SIRI) cause serious morbidity among people who inject drugs (PWID). Data suggest that specific injection practices associate with a higher risk of developing SSTI/SIRI, and that a brief screening tool may help identify at-risk individuals. This study examines injection drug use behaviors and SSTI/SIRI experiences among a sample of PWID in New York City (NYC). In particular, the analysis explores the potential utility of the bacterial infections risk scale for injection drug use (BIRSI) in identifying people at risk for developing SSTI/SIRI in a non-hospitalized population of PWID.</div></div><div><h3>Methods</h3><div>This study examines associations between sociodemographic factors, healthcare system usage, injection practices, and the seven-item BIRSI instrument in relation to reported past 90-day SSTI/SIRI among a subset of respondents who reported past 90-day injection drug use (146 total respondents). Each respondent received a composite score for the BIRSI instrument by adding a point for each reported behavior. Analyses examine the association between select factors and reporting ≥1 SSTI/SIRI in the past 90 days.</div></div><div><h3>Results</h3><div>Among participants, 55.5 % identified as Hispanic and 30.1 % as female. The mean age was 44.6 years and 32.2 % had stable housing. The prevalence of reported past 90-day SSTI/SIRI was 24.7 %. Unadjusted univariate models showed age (prevalence ratio, PR: 0.97, 95 % CI: 0.94, 0.99), receptive syringe sharing (RSS) (PR: 2.91, 95 % CI: 1.69, 4.88) or using other people's previously used (non-syringe) injection equipment (PR: 2.61, 95 % CI: 1.53, 4.45), and a higher BIRSI composite score (PR: 1.33, 95 % CI, 1.34, 1.56) to associate with reporting of past 90-day SSTI/SIRI. Further modeling showed that a higher BIRSI score, exclusive of other injection related behaviors, was associated with self-reported SSTI/SIRI (adjusted PR: 1.35, 95 % CI: 1.13, 1.62) when controlling for age, sex, race, and housing status.</div></div><div><h3>Conclusion</h3><div>Findings suggest the BIRSI instrument may be a useful, brief tool to identify individuals at higher risk of developing SSTI/SIRI among non-hospitalized PWID. Using the BIRSI instrument can help programs and staff serving PWID to implement strategies to reduce SSTI/SIRI risk among their participants, such as wound prevention and care interventions.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"178 ","pages":"Article 209767"},"PeriodicalIF":1.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769429","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 : 2025-07-30DOI: 10.1016/j.josat.2025.209765
Kevin A. Hallgren , Elizabeth Speaker , Elenore P. Bhatraju , Matthew Iles-Shih , Devin N. Kennedy , Alexander J. Gojic , Charissa Fotinos , Joseph O. Merrill , Judith I. Tsui
Background
Many hospitals initiate medications for opioid use disorder (MOUD), which are associated with reduced opioid use and fewer readmissions. Among people who use opioids, co-occurring methamphetamine use is increasingly prevalent and is associated with worse health and treatment outcomes. This study evaluated the frequency of hospital readmissions and emergency department (ED) encounters over a 6-month period after MOUD was initiated in a hospital setting. It was hypothesized that methamphetamine use within the 30 days prior to hospital admission would be associated with increased risk for hospital readmissions and ED encounters.
Methods
The sample included patients aged 18–64 with Title XIX Medicaid coverage who were admitted to a large, urban, public, university-affiliated hospital and initiated on MOUD by an addiction consult service between May 2019 and December 2021. Hospital readmissions and ED encounters were identified over 6 months after the index hospitalization using Medicaid claims. Patients self-reported past 30-day methamphetamine use during structured interviews. Cox proportional hazards models tested whether time to first readmission or first ED encounter differed for patients with and without recent methamphetamine use, adjusting for demographics and clinical covariates.
Results
Of 690 hospitalized patients initiating MOUD, 404 met study inclusion criteria (41 % unhoused, 56 % with methamphetamine use). Within 6 months after the index hospitalization, 35 % of patients had at least one hospital readmission and 54 % had at least one ED encounter. Hospitalization and ED incidence risks and event rates did not significantly differ for patients with and without methamphetamine use. In survival analyses, methamphetamine use was not associated with earlier hospital readmission (aHR = 0.98, 95 % CI: 0.70–1.35) or ED encounter (aHR = 0.90, 95 % CI: 0.67–1.20). Among patients with methamphetamine use, receiving buprenorphine (vs. methadone) was associated with earlier time to first ED encounter (aHR = 1.64, 95 % CI: 1.13–2.40, p = 0.01).
Conclusions
This study did not observe a significant association between methamphetamine use and risk of hospital readmission or ED encounters up to 6 months after initiation of MOUD in the hospital. Frequent hospital readmissions and ED encounters after discharge highlight the need for research on drivers of acute care utilization and interventions that better serve patients who initiate MOUD in hospital settings.
{"title":"Hospital readmissions and emergency department encounters among patients who initiate medications for opioid use disorder during hospitalization: Comparison of patients with and without co-occurring methamphetamine use","authors":"Kevin A. Hallgren , Elizabeth Speaker , Elenore P. Bhatraju , Matthew Iles-Shih , Devin N. Kennedy , Alexander J. Gojic , Charissa Fotinos , Joseph O. Merrill , Judith I. Tsui","doi":"10.1016/j.josat.2025.209765","DOIUrl":"10.1016/j.josat.2025.209765","url":null,"abstract":"<div><h3>Background</h3><div>Many hospitals initiate medications for opioid use disorder (MOUD), which are associated with reduced opioid use and fewer readmissions. Among people who use opioids, co-occurring methamphetamine use is increasingly prevalent and is associated with worse health and treatment outcomes. This study evaluated the frequency of hospital readmissions and emergency department (ED) encounters over a 6-month period after MOUD was initiated in a hospital setting. It was hypothesized that methamphetamine use within the 30 days prior to hospital admission would be associated with increased risk for hospital readmissions and ED encounters.</div></div><div><h3>Methods</h3><div>The sample included patients aged 18–64 with Title XIX Medicaid coverage who were admitted to a large, urban, public, university-affiliated hospital and initiated on MOUD by an addiction consult service between May 2019 and December 2021. Hospital readmissions and ED encounters were identified over 6 months after the index hospitalization using Medicaid claims. Patients self-reported past 30-day methamphetamine use during structured interviews. Cox proportional hazards models tested whether time to first readmission or first ED encounter differed for patients with and without recent methamphetamine use, adjusting for demographics and clinical covariates.</div></div><div><h3>Results</h3><div>Of 690 hospitalized patients initiating MOUD, 404 met study inclusion criteria (41 % unhoused, 56 % with methamphetamine use). Within 6 months after the index hospitalization, 35 % of patients had at least one hospital readmission and 54 % had at least one ED encounter. Hospitalization and ED incidence risks and event rates did not significantly differ for patients with and without methamphetamine use. In survival analyses, methamphetamine use was not associated with earlier hospital readmission (aHR = 0.98, 95 % CI: 0.70–1.35) or ED encounter (aHR = 0.90, 95 % CI: 0.67–1.20). Among patients with methamphetamine use, receiving buprenorphine (vs. methadone) was associated with earlier time to first ED encounter (aHR = 1.64, 95 % CI: 1.13–2.40, <em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>This study did not observe a significant association between methamphetamine use and risk of hospital readmission or ED encounters up to 6 months after initiation of MOUD in the hospital. Frequent hospital readmissions and ED encounters after discharge highlight the need for research on drivers of acute care utilization and interventions that better serve patients who initiate MOUD in hospital settings.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"177 ","pages":"Article 209765"},"PeriodicalIF":1.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765874","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号