Journal of addictions nursing最新文献

Abstract: Stress experienced by family caregivers of individuals with opioid use disorder (OUD) contributes to caregiver burden. To understand the stressors experienced by family caregivers of individuals with OUD and the factors that influence their personal resiliency, data were collected from a convenience sample of family caregivers who answered two open-ended questions about sources of stress and factors that affect their personal resilience as part of an online survey. Yin's thematic analysis revealed five objective and two subjective burden themes and four resilience themes. Results indicate OUD places significant burden on families and may contribute to decreased physical and mental well-being in caregivers. Caregivers who perceived adequate support were able to use their experience and innate knowledge to cope and emerge with more resilience. Results of this study support the need for translational research to increase resilience and coping in this population of caregivers.

Abstract: Substance abuse stigma is a social phenomenon that negatively impacts individuals who use illicit substances or alcohol. This stigma includes the derogatory terms used to describe people who use substances; perceptions that individuals with alcohol and substance use disorder are dangerous, immoral, and of weak character; and the public blaming of the addicted people for their addiction. Substance abuse took the life of over 100,000 Americans between 2020 and 2021, and one identified barrier to treatment is the stigma associated with substance abuse. When someone is ashamed, they are less likely to seek treatment, and when someone is seeking help and is greeted with negative preconceptions, they are again deterred from treatment. The stigma exists in multiple layers of society including the general public, policy makers, the police, doctors, and nurses and within the person using the substance. The purpose of this article is to define substance abuse stigma in multiple contexts and explore its effects on treatment.

Abstract: Patients with substance use disorder (SUD) encounter many barriers to healthcare, including negative attitudes of healthcare personnel. Compared with other healthcare professions, nurses have been reported as having less tolerant attitudes toward patients with SUD. Knowledge acquisition combined with role support has been shown to improve therapeutic attitudes of nurses toward patients with SUD. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based educational intervention aimed to improve the outcomes of patients at risk and with SUD. SBIRT education has been shown as an effective educational tool with licensed nurses. Therefore, the aim of this study was to evaluate whether a 2-hour educational session on SBIRT (Mitchell et al., 2013) improved the therapeutic attitudes of nurses toward patients with SUD. Peplau's theory of interpersonal relations guided this study with an emphasis on the nurse-patient relationship. A quasi-experimental pretest/posttest design was used to evaluate nurses' attitudes pre and post a 2-hour educational session. Participants included 65 registered nurses employed in a 247-bed teaching hospital in New England. Attitudes were measured before and after the educational session using the 20-item, five-subscale Drug and Drug Problems Perceptions Questionnaire. A paired t test was performed, showing statistically significant improvements in attitudes postintervention. Prior education on SUD significantly correlated with baseline attitudes. A standard regression model, with practice setting, family history of SUD, and prior education as dependent variables, was not predictive of baseline attitudes. The results suggest conducting SBIRT should be considered a mandatory nursing competency, both in undergraduate curriculum and among licensed nurses.

Abstract: Opioids are a leading cause of drug overdose deaths in the United States. Methadone used as medication for opioid use disorder (MOUD) reduces drug cravings and promotes abstinence. However, individuals in methadone-based MOUD treatment commonly report subjective sleep complaints and are at risk for respiratory depression from opioids. We investigated nighttime sleep and respiratory function in eight individuals (six women, two men; ages 31-68 years) in their first 90 days of methadone-based MOUD treatment. Participants underwent overnight cardiorespiratory polysomnography. Sleep and respiratory variables were characterized with descriptive statistics for comparison to reference data from similarly aged healthy adults. Although participants spent 8.1 ± 0.3 hours (mean ± SD ) in bed, their total sleep time was only 6.8 ± 1.3 hours. They exhibited longer sleep latency and intermittent wakefulness. Sleep structure was irregular, with disrupted sleep cycles. Participants also displayed a decreased amount of N1 sleep and an increased amount of N3 sleep, compared with reference data. Participants showed respiratory depression, with an average apnea-hypopnea index of 16.5 ± 8.9 events per hour. Central sleep apneas comprised 69.1% ± 20.9% of the respiratory events. A Cheyne-Stokes-like breathing pattern, consisting of 30-second cycles of three central sleep apneas, was observed in 75% of participants. Our results suggest that individuals early in methadone-based MOUD treatment experience disordered sleep and respiratory disturbances. Such nighttime physiological changes may have serious long-term health consequences and contribute to unintended overdose rates. Identifying and treating MOUD individuals with sleep apnea could reduce risk of death.

Background: The internet is the main channel for electronic nicotine delivery systems sales that the media uses to publicize electronic cigarettes (e-cigarettes). Once e-cigarettes entered the market, they quickly became widely available online and in retail stores in many countries and regions around the world. This systematic review aims to explore the online marketing strategies for e-cigarette retail websites including the design of e-cigarette retail websites and how the information of retail websites was exposed to the public.

Method: Studies were searched in five databases: Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science, Communication & Mass Media Complete, and PubMed. Included studies were published between 2007 and 2019.

Results: Eight studies were included in this review. Topics covered included smoking cessation claims, nicotine content claims, health or harmful substance exposure claims, age restriction/verification, membership and discounts, and media and celebrity effect. Most of the claims included information about the benefits of e-cigarettes, such as helping to quit smoking, being more environmentally friendly than traditional paper cigarettes, and not containing nicotine. Common marketing techniques included celebrity endorsements, showing discounts or membership offers, or getting a link to buy from the media.

Conclusions: The marketing of e-cigarettes is complex, and the authenticity of the information presented on the websites needs to be thoroughly understood. Such information will undoubtedly increase the interest and desire of potential buyers for e-cigarettes. Therefore, it is critical to establish necessary regulations regarding e-cigarette product information.

Background: There is limited research investigating sexual-orientation-related differences in older adults and their relationship with alcohol use.

Objective: The purpose of this study was to determine if sexual minority status moderates the relationship between psychological distress and alcohol drinking patterns.

Methods: This study was a secondary analysis of data from the 2017-2018 National Survey on Drug Use and Health. Health outcomes among lesbian, gay, and bisexual (LGB) older adults (N = 462) aged 50 years or older were compared with heterosexual (N = 16,856) peers using univariate analyses and logistic regressions. Interaction terms evaluated the influence of sexual orientation on psychological distress and alcohol consumption.

Results: Sexual orientation was a predictor of alcohol use in the past year, past month, and at any time (p < .001) but was not a predictor of alcohol dependence or misuse, binge drinking, or heavy drinking. Heterosexual older adults were less likely to consume alcohol than those who identified as LGB. Respondents not reporting psychological distress were less likely to engage in problematic drinking. However, there was no evidence that sexual minority status moderates the relationship between psychological distress and alcohol use.

Conclusion: Limited evidence supports higher rates of alcohol use and alcohol-related problems among sexual minority persons than heterosexuals. Prediction models for alcohol use were not improved by using sexual orientation and psychological distress as interaction terms. Future research should examine the underlying causes of impaired health in the older LGB population. Those findings should be used to research methods of preventing and minimizing alcohol misuse.

Abstract: This study aimed to analyze the differences in sleep quality according to drinking patterns and identify factors associated with poor sleepers among Korean male adults younger than 65 years. Data from 68,711 male participants from the Korean Community Health Survey collected in Korea in 2018 were analyzed. After dividing them into binge drinking and nonbinge drinking groups, each group was further categorized into three subgroups according to the frequency of drinking: less than occasionally, frequent, and very frequent. The quality of sleep and depression were assessed through face-to-face interviews using the Pittsburgh Sleep Quality Index and the Patient Health Questionnaire-9, respectively. Total sleep quality was the lowest in the group that participated in "very frequent" binge drinking; the groups that participated in "frequent" binge drinking and "very frequent" nonbinge drinking had similar levels of sleep quality. Poisson regression with robust variance analysis revealed an almost 50% higher prevalence of poor sleep in the "very frequent" binge drinking group (prevalence ratio = 1.49, p < .001) compared with the reference group (nonbinge drinking, less than occasionally) after controlling for confounding variables. Significantly higher prevalence ratios of poor sleep were found in the "frequent" and "very frequent" drinking groups compared with the reference group. Health policies could emphasize the importance of reducing one's frequency and amount of drinking. In addition, it is also necessary for healthcare professionals to assess drinking patterns when caring for people experiencing poor quality sleep and support them in correcting such drinking behaviors.