Journal of Addiction Medicine最新文献

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The Associations of Kratom (Mitragynine), Opioids, Other Substances, and Sociodemographic Variables to Drug Intoxication-related Mortality. Kratom (Mitragynine)、阿片类药物、其他物质和社会人口变量与药物中毒相关死亡率的关系。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-19 DOI: 10.1097/ADM.0000000000001417
Armiel A Suriaga, Ruth M Tappen, Christopher R McCurdy, David Newman, Oliver Grundmann, John F Kelly
{"title":"The Associations of Kratom (Mitragynine), Opioids, Other Substances, and Sociodemographic Variables to Drug Intoxication-related Mortality.","authors":"Armiel A Suriaga, Ruth M Tappen, Christopher R McCurdy, David Newman, Oliver Grundmann, John F Kelly","doi":"10.1097/ADM.0000000000001417","DOIUrl":"10.1097/ADM.0000000000001417","url":null,"abstract":"<p><strong>Introduction: </strong>The US age-adjusted drug overdose rate increased by 298%, with fentanyl being the main contributor to drug overdose deaths. The contribution of kratom to drug overdoses or intoxication is seldom reported despite its increasing use and detection among overdose decedents.</p><p><strong>Methods: </strong>Our cross-sectional study utilized deidentified data from the Florida Department of Law Enforcement, 2020-2021 (N = 30,845). The medical examiners ascertained the exposures of interest (kratom, opioids, and other substances) and the outcome variable of drug intoxication-related mortality (DIRM) through autopsies and toxicology results. DIRM refers to any death from a substance identified as drug toxicity or intoxication. We used regression modeling to examine the association of exposure with DIRM.</p><p><strong>Results: </strong>Five hundred fifty-one cases were confirmed kratom (mitragynine) exposures. More males died of DIRM (81.5%), primarily White (95.1%) and 35-44 years old (40.5%). Among mitragynine exposures, 484 (87.8%) died of DIRM; 36 decedents (6.5%) used kratom as the sole substance, and 515 (93%) used multiple substances; 437 (79.3%) used at least 1 opioid. The odds of dying of DIRM were 7.6 times higher among those mitragynine exposed compared with non-mitragynine exposed (univariate model) and 5.6 times higher after adjusting for confounders (multivariate model) (adjusted odds ratio = 5.6; 95% confidence interval, 4.1-7; P < 0.001). Opioid use increased the odds of dying of DIRM (adjusted odds ratio = 11.7; 95% confidence interval, 10.9-12.7; P < 0.001).</p><p><strong>Conclusion: </strong>Our results indicate that dozens of decedents died of kratom (mitragynine) exposures alone, which has safety implications. Co-using opioids with kratom further increased the odds of dying of DIRM, indicating that kratom may not always work as a harm-reduction agent.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Telehealth on Buprenorphine Prescribing at a Large Federally Qualified Health Center during COVID-19. 在 COVID-19 期间,远程医疗对一家大型联邦合格医疗中心丁丙诺啡处方的影响。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-19 DOI: 10.1097/ADM.0000000000001397
Ann Winters, Eve Walter
{"title":"The Impact of Telehealth on Buprenorphine Prescribing at a Large Federally Qualified Health Center during COVID-19.","authors":"Ann Winters, Eve Walter","doi":"10.1097/ADM.0000000000001397","DOIUrl":"10.1097/ADM.0000000000001397","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the impact of telehealth on buprenorphine prescribing and retention in care for patients with opioid use disorder (OUD) seen at a large federally qualified health center (FQHC) the year prior to and following the start of the COVID-19 pandemic.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with OUD and at least one medical visit to the FQHC between March 1, 2019, and February 28, 2021. This study utilized March 1, 2020, to delineate the beginning of COVID as the FQHC widely instituted telehealth during the month in response to the pandemic. We examined buprenorphine prescribing before and during year 1 of the pandemic; we applied logistic regression to estimate the association between telehealth and buprenorphine prescribing and we assessed buprenorphine retention through survival analysis.</p><p><strong>Results: </strong>In the year before COVID, 24% of patients (502/2090) received buprenorphine compared with 31% (656/2110) during the first year of COVID (P < 0.01). Patients with at least one telehealth visit were three times more likely to receive buprenorphine compared to those without telehealth (odds ratio: 3.2, confidence interval: 2.1-5.0). Among those who received buprenorphine, those with at least one telehealth visit were retained in buprenorphine care longer (hazard ratio: 2.7, confidence interval: 1.8-3.9).</p><p><strong>Conclusions: </strong>During the first year of COVID, telehealth was associated with increased likelihood that patients received buprenorphine; those who had telehealth remained in buprenorphine care longer compared to those who only had office-based visits. Increasing buprenorphine access through telehealth can play a significant role in retention in care for OUD.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recommendations for the Design and Implementation of Alcohol Pharmacotherapy Trials: Perspectives of Women With HIV Participating in the WHAT-IF Study. 酒精药物治疗试验的设计和实施建议:参与 WHAT-IF 研究的女性艾滋病感染者的观点。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-19 DOI: 10.1097/ADM.0000000000001410
Rebecca J Fisk-Hoffman, Sashaun Ranger, Abigail Gracy, Nanyangwe Siuluta, Christina E Parisi, Isaac Payton, Robert L Cook, Shantrel Canidate
{"title":"Recommendations for the Design and Implementation of Alcohol Pharmacotherapy Trials: Perspectives of Women With HIV Participating in the WHAT-IF Study.","authors":"Rebecca J Fisk-Hoffman, Sashaun Ranger, Abigail Gracy, Nanyangwe Siuluta, Christina E Parisi, Isaac Payton, Robert L Cook, Shantrel Canidate","doi":"10.1097/ADM.0000000000001410","DOIUrl":"10.1097/ADM.0000000000001410","url":null,"abstract":"<p><strong>Objectives: </strong>Naltrexone for alcohol reduction has been poorly studied in women with HIV (WWH), for whom heavy alcohol use is associated with negative HIV outcomes. This study offers recommendations for researchers conducting alcohol pharmacotherapy trials among PWH as suggested by WWH who participated in an alcohol pharmacotherapy trial in Florida.</p><p><strong>Methods: </strong>The WHAT-IF? Study enrolled WWH with a history of heavy alcohol use in Miami, Florida, into a clinical trial where participants were randomized to receive naltrexone or placebo to assess effectiveness among WWH. Twenty participants (mean age, 49 years; 85% Black/African American) completed interviews that included questions about barriers to participation and recommendations for future researchers and WWH. Interviews were analyzed using a reflexive thematic approach.</p><p><strong>Results: </strong>We identified six recommendations: 1) increasing opportunities for study engagement, 2) fostering positive relationships to support change, 3) addressing medication concerns, 4) considering structural barriers to participation, 5) improving alcohol-related education, and 6) preventing fraudulent participation. Positive relationships included both study staff and external support. Medication concerns included cost, accessibility, and adherence. Structural barriers included transportation, substance use, and mental health conditions. Better education included information on the risks of alcohol use and encouraging women to quit. Overall, women reported having positive experiences in the WHAT-IF? trial, and many recommended that the study continue.</p><p><strong>Conclusion: </strong>Future alcohol pharmacotherapy studies could consider these recommendations when working with women from underserved communities, including WWH. Additionally, these recommendations could be applied to increase alcohol pharmacotherapy uptake and adherence in clinical practice.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing Individuals Who Elect and Decline Opioid Overdose Education and Naloxone Distribution to Tailor Programs and Expand Impact. 确定选择和拒绝阿片类药物过量教育和纳洛酮发放的个人特征,以调整计划并扩大影响。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001407
Michelle L Sisson, Andres Azuero, Elizabeth Hawes, Keith R Chichester, Matthew J Carpenter, Michael S Businelle, Richard C Shelton, Karen L Cropsey
{"title":"Characterizing Individuals Who Elect and Decline Opioid Overdose Education and Naloxone Distribution to Tailor Programs and Expand Impact.","authors":"Michelle L Sisson, Andres Azuero, Elizabeth Hawes, Keith R Chichester, Matthew J Carpenter, Michael S Businelle, Richard C Shelton, Karen L Cropsey","doi":"10.1097/ADM.0000000000001407","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001407","url":null,"abstract":"<p><strong>Background: </strong>In response to the opioid epidemic, federal agencies have stressed the importance of targeted naloxone distribution through avenues such as Opioid Overdose Education and Naloxone Distribution (OEND). OEND effectively reduces mortality by training laypersons to respond to overdose situations. Despite demonstrated effectiveness, OEND remains underutilized. This project aimed to characterize those who illicitly use opioids to determine avenues for future tailoring of OEND programs.</p><p><strong>Methods: </strong>Individuals who illicitly used opioids within the past 6 months were recruited via online social media. Participants completed an online questionnaire that assessed history of opioid use and were given the option to receive opioid overdose and naloxone administration training. Those who elected training (n = 111) and those who declined (n = 193) were compared on opioid use, severity of use, and overdose experiences.</p><p><strong>Results: </strong>Participants (N = 304) were 47% male and 83% White. Tests of between group differences with measures of effect size were used for analyses. Those who elected training endorsed greater intravenous administration (χ2 = 4.18, P = 0.041, Cramer's V = 0.12). Individuals who declined training reported more frequent nonprescribed methadone use (χ2 = 7.51, P = 0.006, Cramer's V = 0.16), overdose hospitalizations (t(298) = 2.13, P = 0.034, Cohen's d = 0.26), and observed overdoses (t(300) = 3.01, P = 0.003, Cohen's d = 0.36). After adjusting for multiple comparisons, only the differences in nonprescribed methadone use and observed overdoses remained statistically significant.</p><p><strong>Conclusions: </strong>Individuals who declined training were more likely to report ever use of nonprescribed methadone and having witnessed others overdose. They may have had greater exposure to naloxone, hence decreasing perceived need for training. Understanding characteristics of those who elect and refuse training could inform structuring of programs and recruitment approaches.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Urgent Need to Promote Equitable Buprenorphine Administration for Opioid Use Disorder in the Emergency Department. 急需在急诊科推广平等的丁丙诺啡治疗阿片类药物使用障碍。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001409
Edouard Coupet, E Jennifer Edelman
{"title":"An Urgent Need to Promote Equitable Buprenorphine Administration for Opioid Use Disorder in the Emergency Department.","authors":"Edouard Coupet, E Jennifer Edelman","doi":"10.1097/ADM.0000000000001409","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001409","url":null,"abstract":"<p><strong>Abstract: </strong>In recent years, there has been a marked surge in opioid overdose deaths among Black, Latino, and Native American populations. The emergency department (ED) represents a crucial opportunity to address these racial and ethnic inequities by initiating buprenorphine and providing referral for ongoing addiction treatment. Yet Black, Latino, and Native American populations encounter substantial inequities in ED-based addiction treatment access. Within this context, Koeber et al conducted their cross-sectional study of ED patients who screened positive for opioid misuse to evaluate inequities in buprenorphine administration. The authors found that Black ED patients were less likely (odds ratio, 0.56; 95% confidence interval, 0.35-0.88) to receive buprenorphine. There is an urgent need for mixed methods research to understand the drivers of these inequities and interventions to address the multilevel factors across the opioid use disorder care continuum to promote equitable, accessible, person-centered opioid use disorder treatment.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Xylazine Positivity in Opioid-Positive Drug Screens on an Inpatient Labor Unit. 住院产科阿片阳性药物筛查中的异丙嗪阳性反应。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001396
Cassandra Trammel, Vahid Azimi, Bridgit Crews, Stephen Roper, Nandini Raghuraman, Ebony B Carter, Antonina Frolova, Anthony O Odibo, Megan Lawlor, Jeannie C Kelly
{"title":"Xylazine Positivity in Opioid-Positive Drug Screens on an Inpatient Labor Unit.","authors":"Cassandra Trammel, Vahid Azimi, Bridgit Crews, Stephen Roper, Nandini Raghuraman, Ebony B Carter, Antonina Frolova, Anthony O Odibo, Megan Lawlor, Jeannie C Kelly","doi":"10.1097/ADM.0000000000001396","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001396","url":null,"abstract":"<p><strong>Objective: </strong>Untreated opioid use disorder (OUD) is associated with significant morbidity in pregnancy. Recent reports have highlighted the rise of xylazine in the nonprescribed fentanyl supply. The frequency with which pregnant people with OUD are exposed to xylazine has not been characterized. We sought to describe the rate of xylazine detection in urine drug screens (UDS) from pregnant people admitted to a labor unit.</p><p><strong>Methods: </strong>We performed a cross sectional study of all UDS results from an inpatient obstetric unit at an urban tertiary care center from December 2022, when xylazine was added to the detection panel, through July 2023. We perform universal verbal drug screening, with subsequent urine drug screening only performed after a positive verbal screen and consent. The trend of opioid-positive urine drug screens also positive for xylazine from December to July was measured with the Cochran-Armitage test.</p><p><strong>Results: </strong>Of 5662 people admitted to Labor and Delivery during the study period, 138 UDS were sent for 123 unique individuals. Ninety-eight (71%) of UDS were positive for nonprescribed substances. Of positive UDS, 36 (37%) were positive for nonprescribed opioids, and of these, 17 (47.2%) were positive for xylazine among 14 pregnant people. The trend of UDS positive for opioids that were also positive for xylazine increased significantly over time (P = 0.030), from 0% in December 2022 to 100% in July 2023.</p><p><strong>Conclusions: </strong>Over 8 months, xylazine positivity significantly increased in UDSs positive for nonprescribed opioids in an urban Midwestern hospital. These results underscore the critical need to study the impact of xylazine on obstetric outcomes.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leveraging Implementation Factors and Policy to Improve the Effectiveness of Naloxone. 利用实施因素和政策提高纳洛酮的有效性。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001406
Ashly E Jordan, Mary Brewster, Pamela Mund, Grace Hennessy, Chinazo O Cunningham
{"title":"Leveraging Implementation Factors and Policy to Improve the Effectiveness of Naloxone.","authors":"Ashly E Jordan, Mary Brewster, Pamela Mund, Grace Hennessy, Chinazo O Cunningham","doi":"10.1097/ADM.0000000000001406","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001406","url":null,"abstract":"<p><strong>Abstract: </strong>More than 50 years of high-quality data demonstrate that naloxone is an efficacious and cost-effective overdose reversal agent. Intranasal naloxone is now available in the United States as an over-the-counter and generic medication for the first time since the start of the overdose crisis more than 20 years ago. As the overdose crisis continues to contribute to substantial loss of life, there is an historic opportunity for jurisdictions to expand equitable and sustained access to intranasal naloxone. Further, through simultaneously enacting and expanding effective Naloxone Access and Good Samaritan laws, and equitably implementing these laws, there is the potential to maximize the population-level effectiveness of naloxone to sustainably reduce overdose mortality.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systematic Review of Obstetric and Child Outcomes of Prenatal Exposure to Inhalants in the Context of a Use Disorder. 产前接触吸入剂导致使用障碍的产科和儿童结果的系统性回顾。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001382
Emily Southida Kounlavong, Charles W Schauberger, Jamie L Conklin, Hendree E Jones
{"title":"Systematic Review of Obstetric and Child Outcomes of Prenatal Exposure to Inhalants in the Context of a Use Disorder.","authors":"Emily Southida Kounlavong, Charles W Schauberger, Jamie L Conklin, Hendree E Jones","doi":"10.1097/ADM.0000000000001382","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001382","url":null,"abstract":"<p><strong>Objectives: </strong>Inhalants are often used for their psychoactive effects, producing feelings of euphoria. Inhalant and solvent use is a serious public health concern, yet little is known about their effects on perinatal, fetal, and child outcomes. The aim of our review is to evaluate the impact of inhalant use by pregnant people on maternal, fetal, neonatal, and early childhood outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted on March 1, 2023, in 6 databases using relevant keywords. Bias assessment was performed using JBI Critical Appraisal Tools. Studies were included if they described a prenatal exposure to an inhalant; focused on maternal, fetal, neonatal, or early childhood outcomes; and were published as peer-reviewed reports in English.</p><p><strong>Results: </strong>The search yielded 1101 unique references with 22 studies meeting eligibility criteria and representing 205 pregnancies and 171 infants.The most common symptom of inhalant use reported in pregnant people was altered mentation, followed by renal tubular acidosis (RTA) reported with toluene use. Most common fetal outcomes included fetal growth restriction and preterm delivery (<37 weeks), while neonatal outcomes were withdrawal symptoms, such as jitteriness, trouble feeding, and dystonia. Child outcomes included developmental delays, including cognitive and speech impairments, and postnatal growth restriction, including microcephaly.</p><p><strong>Conclusion: </strong>Perinatal, fetal, and child outcomes associated with inhalant use among pregnant individuals are largely based on case reports and series. Prospective studies are needed to better characterize these outcomes, reduce stigma, increase equitable access to treatment, and identify potential interventions to reduce use and potential harm.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Buprenorphine Administration and Prescribing at Emergency Departments: A National Analysis from 2014-2021. 急诊科的丁丙诺啡管理和处方:2014-2021 年全国分析。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001402
Christine Ramdin, Tanner McGowan, Jeanmarie Perrone, Maryann Mazer-Amirshahi, Lewis S Nelson
{"title":"Buprenorphine Administration and Prescribing at Emergency Departments: A National Analysis from 2014-2021.","authors":"Christine Ramdin, Tanner McGowan, Jeanmarie Perrone, Maryann Mazer-Amirshahi, Lewis S Nelson","doi":"10.1097/ADM.0000000000001402","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001402","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED)-initiated buprenorphine provides a low barrier access point and safety net to mitigate opioid overdose risk and increase treatment engagement. We sought to describe trends and patterns of buprenorphine utilization from the ED using national data.</p><p><strong>Methods: </strong>This is a retrospective review of the National Hospital Ambulatory Medical Care Survey between 2014 and 2021. Our primary outcomes were trends in ED buprenorphine utilization. We described patient demographics, visit characteristics, and conducted trend analyses. We utilized logistic regression to determine predictors of buprenorphine prescribing.</p><p><strong>Results: </strong>Between 2014 and 2021, there were 341,875 ED visits in which buprenorphine was administered, with no change over time (P = 0.08). There were 392,031 visits where buprenorphine was prescribed at ED discharge, with an increase over time (P = 0.01). The largest rise in rate for discharge prescriptions occurred between 2019 and 2020 (37,737 [0.03%] visits vs 126,041 [0.10%]) (233% increase in rate, P < 0.0001).</p><p><strong>Conclusions: </strong>Although there was an increase in buprenorphine prescribing at ED discharge, there was no increase in administration. The acceleration in prescribing between 2019 and 2020 suggests that the ED may have been a safety net for patients who lost access to addiction care during COVID-19. Future studies should explore reasons for disparities and barriers to buprenorphine utilization.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Promoting Race and Ethnic Diversity in a Hospital-Based Randomized Clinical Trial to Address Untreated Alcohol Use Disorder: Initial Lessons Learned. 在以医院为基础的随机临床试验中促进种族和民族多样性,以解决未经治疗的酒精使用障碍:初步经验教训。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-11-08 DOI: 10.1097/ADM.0000000000001400
E Jennifer Edelman, Tami Frankforter, Oscar F Rojas-Perez, Karen Ablondi, Carla Castro, Joanne Corvino, Isabel Garcia, Derrick M Gordon, Yudilyn Jaramillo, Natrina L Johnson, Ayana Jordan, Charla Nich, Manuel Paris, David Pagano, Melissa B Weimer, Emily C Williams, Brian D Kiluk
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