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Perceptions of Overdose Response Hotlines and Phone Application Services Among Women and Gender-diverse Individuals Who Use Drugs in Canada: A Qualitative Study. 加拿大女性和不同性别吸毒者对用药过量应对热线和电话申请服务的看法:定性研究。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI: 10.1097/ADM.0000000000001325
Amanda Lee, Farah Jafri, Dylan Viste, Boogyung Seo, Darci Skiber, Marguerite Medwid, S Monty Ghosh
{"title":"Perceptions of Overdose Response Hotlines and Phone Application Services Among Women and Gender-diverse Individuals Who Use Drugs in Canada: A Qualitative Study.","authors":"Amanda Lee, Farah Jafri, Dylan Viste, Boogyung Seo, Darci Skiber, Marguerite Medwid, S Monty Ghosh","doi":"10.1097/ADM.0000000000001325","DOIUrl":"10.1097/ADM.0000000000001325","url":null,"abstract":"<p><strong>Objectives: </strong>In 2021, opioid-related deaths have increased by 96% and continue to be higher than prepandemic levels. In particular, women and gender-diverse individuals face numerous challenges when assessing harm reduction supports, including physical supervised consumption sites, compared with male counterparts. Mobile overdose response services (MORSs) including overdose response hotlines and phone-based overdose response applications are novel virtual overdose response technologies that may help mitigate this issue. This study aims to explore how women and gender-diverse individuals engage with and perceive these services.</p><p><strong>Methods: </strong>A qualitative study using grounded theory was conducted. Using existing peer networks and purposive and snowball sampling between March and July 2023, 19 semistructured interviews were conducted with women and gender-diverse individuals in Canada who have lived experience using substances. NVivo was used for thematic analysis, which continued until saturation was reached.</p><p><strong>Results: </strong>The interviews elucidated the following 5 themes: Overdose response hotlines and applications were generally preferred over supervised consumption sites due to (1) perceived gender-based safety; (2) better accommodation for mothers concerned with stigma, childcare, and child welfare systems; and (3) eased accessibility for those involved in sex work. It was also noted that (4) judgment-free spaces and trauma-informed care provided by staff with lived experiences were invaluable, and (5) decriminalization of illicit substances will encourage uptake of these harm reduction services.</p><p><strong>Conclusion: </strong>This study found that women and gender-diverse individuals felt positively toward overdose response hotlines and applications with the potential to fill a need in providing harm reduction services that create feelings of safety, support roles of motherhood and sex work, and generate nonstigmatizing spaces.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087383","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 Pharmacological Management of Ketamine Use Disorder: A Systematic Review. 氯胺酮使用障碍的药物治疗:系统性综述。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI: 10.1097/ADM.0000000000001340
Emmert Roberts, Elizabeth Sanderson, Irene Guerrini
{"title":"The Pharmacological Management of Ketamine Use Disorder: A Systematic Review.","authors":"Emmert Roberts, Elizabeth Sanderson, Irene Guerrini","doi":"10.1097/ADM.0000000000001340","DOIUrl":"10.1097/ADM.0000000000001340","url":null,"abstract":"<p><strong>Objectives: </strong>There has been limited evidence synthesis examining treatment of ketamine use disorder. We aimed to conduct a systematic review to assess the efficacy and tolerability of pharmacological interventions in the management of ketamine use disorder.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, PsychINFO, and CENTRAL (Cochrane Central Register of Controlled Trials) from database inception to November 14, 2023, for studies of any design that reported on any pharmacological intervention in the management of ketamine use disorder. We extracted any reported measure of efficacy or tolerability and assessed outcome quality using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. We planned to combine outcomes using random-effects meta-analysis, where this was not possible results were reported narratively.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria reporting on 368 participants. These comprised 1 controlled trial, 2 retrospective case series, and 9 case reports. Two studies reported on ketamine intoxication, 6 on withdrawal, and 4 on craving/relapse prevention. All studies reported only descriptive outcomes, and all evidence was of very low quality. Benzodiazepine regimens and haloperidol were reported to have potential utility in intoxication and withdrawal, whereas naltrexone, lamotrigine, and a combination of paliperidone palmitate and bupropion were reported to have potential utility in craving/relapse prevention.</p><p><strong>Conclusions: </strong>There is a paucity of research into pharmacological management of ketamine use disorder. The limited very low-quality evidence suggests benzodiazepine regimens may be most salient for future exploration in management of ketamine intoxication and withdrawal, whereas case reports suggest naltrexone, lamotrigine, and paliperidone palmitate plus bupropion may potentially merit further investigation with regard to craving/relapse prevention.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450501","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 Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients: A Scoping Review. GLP-1 激动剂治疗药物滥用障碍患者的疗效:范围综述》。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-08-01 DOI: 10.1097/ADM.0000000000001347
Mary R Shen, Kwadwo Owusu-Boaitey, Laura M Holsen, Joji Suzuki
{"title":"The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients: A Scoping Review.","authors":"Mary R Shen, Kwadwo Owusu-Boaitey, Laura M Holsen, Joji Suzuki","doi":"10.1097/ADM.0000000000001347","DOIUrl":"10.1097/ADM.0000000000001347","url":null,"abstract":"<p><strong>Abstract: </strong>Substance use disorder (SUD) continues to be a leading cause of morbidity and mortality with limited treatments. There is interest in expanding the use of GLP-1 agonists in treating SUD. However, evidence for safety and efficacy in humans is limited. This review aims to bridge the existing knowledge gap by establishing a baseline of literature in this area to inform future trials and clinical practice. Our inclusion criteria were English peer-reviewed manuscripts reporting on use of GLP-1, GIP, and/or glucagon receptor agonists in treatment of SUDs, excluding case studies. The literature search was performed in accordance to PRISMA guidelines. Five studies were included in this review examining the use of this medication in tobacco use disorder, alcohol use disorder, and cocaine use disorder. No studies regarding substance withdrawal syndrome were identified. The included studies varied widely in terms of patient selection, dose/formulation of GLP-1 agonists, and follow-up. The results of this scoping review are mixed, with 3 studies demonstrating positive results and 2 studies finding no efficacy of this medication on SUD outcomes. It is premature to prescribe this medication off-label to patients. Further research is needed to determine the efficacy of GLP-1 agonists in treating SUD.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874833","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 Concept of Treatment-Refractory Addiction: A Call to the Field. 难治性成瘾的概念:对该领域的呼吁。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-08-10 DOI: 10.1097/ADM.0000000000001349
Eric C Strain
{"title":"The Concept of Treatment-Refractory Addiction: A Call to the Field.","authors":"Eric C Strain","doi":"10.1097/ADM.0000000000001349","DOIUrl":"10.1097/ADM.0000000000001349","url":null,"abstract":"<p><strong>Abstract: </strong>Not all patients respond to effective and approved treatment interventions, and there has been growing recognition in the medical field of these \"resistant\" or refractory illnesses (eg, treatment-resistant depression, resistant hypertension). In the field of substance use disorders, there has not been an explicit acknowledgement of treatment-refractory addiction (TRA) despite substantial evidence that many patients do not respond to standard-of-care treatment interventions. This article provides a justification for TRA as a critically important condition to recognize and define. TRA is not conceptualized as a diagnosis, but as a signal that a current treatment approach has not worked. The article addresses areas in need of research and consensus in order to ensure the approach to TRA is uniform, thoughtfully addressed, and data-driven. By explicitly acknowledging TRA, clinicians, researchers, and patients and their families can begin to explore the unique features of this population and find ways in which substance use disorders for persons with TRA can be more effectively addressed, which in turn will help to expand remission for persons who suffer from these devastating conditions.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365277","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 High-Potency Synthetic Opioids on Pharmacotherapies for Opioid Use Disorder: A Scoping Review. 高能合成类阿片对阿片类药物使用障碍药物疗法的影响:范围综述》。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-08-10 DOI: 10.1097/ADM.0000000000001356
Oluwole Jegede, Joao P De Aquino, Connie Hsaio, Ebony Caldwell, Melissa C Funaro, Ismene Petrakis, Srinivas B Muvvala
{"title":"The Impact of High-Potency Synthetic Opioids on Pharmacotherapies for Opioid Use Disorder: A Scoping Review.","authors":"Oluwole Jegede, Joao P De Aquino, Connie Hsaio, Ebony Caldwell, Melissa C Funaro, Ismene Petrakis, Srinivas B Muvvala","doi":"10.1097/ADM.0000000000001356","DOIUrl":"10.1097/ADM.0000000000001356","url":null,"abstract":"<p><strong>Background: </strong>The clinical implications of high potency synthetic opioids (HPSO) on medications for opioid use disorder (MOUDs) are not well understood. Although pharmacological interactions are plausible, the clinical significance of such interaction has not been systematically elucidated. This scoping review investigates the relationship between HPSO exposure and various MOUD treatment outcomes.</p><p><strong>Methods: </strong>We followed PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews) for scoping reviews with extensive a priori search strategy of databases: MEDLINE, EMBASE, PsycINFO, Web of Science, CINAHL, and Cochrane.</p><p><strong>Results: </strong>From 9149 studies, 34 fulfilled the inclusion criteria. Synthesized data reveal several critical insights: First, there is a variable but high occurrence (38%-80%) of HPSO usage among individuals with MOUDs. Second, MOUDs are linked to a decreased risk of overdoses and deaths associated with HPSO. Third, HPSO consumption is correlated with the risk of precipitated withdrawal when starting buprenorphine. Fourth, low-dose buprenorphine is being recognized as one method to avoid moderate withdrawal symptoms prior to treatment. Lastly, significant gaps exist in human experimental data concerning the effects of HPSO on key factors critical for treating OUD-craving, withdrawal symptoms, and pain.</p><p><strong>Conclusions: </strong>Current evidence supports MOUD safety and effectiveness in reducing nonmedical opioid use. Further research is needed to explore HPSO's influence on the acute factors preceding nonmedical opioid use, such as cravings, withdrawal symptoms, and pain. This research could inform the optimization of MOUD dosing strategies. Achieving consensus and harmonizing data across clinical and research protocols could diminish variability, enhancing our understanding of HPSOs effect on MOUD treatment outcomes.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Isolated Kratom Use Disorder Treated With Extended-Release Buprenorphine Taper. 用缓释丁丙诺啡减量治疗孤立的 Kratom 使用障碍。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-22 DOI: 10.1097/ADM.0000000000001328
Benjamin B Swart, Charles Reznikoff, Katie Steen
{"title":"Isolated Kratom Use Disorder Treated With Extended-Release Buprenorphine Taper.","authors":"Benjamin B Swart, Charles Reznikoff, Katie Steen","doi":"10.1097/ADM.0000000000001328","DOIUrl":"10.1097/ADM.0000000000001328","url":null,"abstract":"<p><strong>Abstract: </strong>This case report highlights a 36-year-old male without history of psychiatric disease, chronic pain, or substance use disorder who developed severe substance use disorder per Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition criteria to kratom. He was successfully treated with sublingual buprenorphine after a 3-year period of intermittent withdrawal management and trials of oral and extended-release injectable naltrexone. After a period of abstinence from kratom, he was tapered from buprenorphine using 2 monthly injections of 100 mg extended-release buprenorphine. His case underscores some of the current uncertainties around kratom use disorder diagnosis and treatment.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081366","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
Barriers and Facilitators to Accessing Opioid Agonist Therapy for Street-involved Adolescents and Young Adults in Vancouver. 温哥华街头青少年获得阿片类激动剂治疗的障碍和促进因素。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-08-27 DOI: 10.1097/ADM.0000000000001361
Kat Gallant, Preety Nijjar, Kora DeBeck, Michelle Cui, Thomas Kerr
{"title":"Barriers and Facilitators to Accessing Opioid Agonist Therapy for Street-involved Adolescents and Young Adults in Vancouver.","authors":"Kat Gallant, Preety Nijjar, Kora DeBeck, Michelle Cui, Thomas Kerr","doi":"10.1097/ADM.0000000000001361","DOIUrl":"10.1097/ADM.0000000000001361","url":null,"abstract":"<p><strong>Objective: </strong>Opioid agonist therapy (OAT) remains the first-line therapy for people with opioid use disorder. Whereas overdose rates among adolescents and young adults (AYAs) remain high, little is known about their access to OAT. Therefore, we sought to evaluate factors that shape access to OAT among AYAs aged 14 to 26 years.</p><p><strong>Methods: </strong>Data were derived from the At-Risk Youth Study, a prospective cohort study that involves street-involved AYAs who use illicit substances in Vancouver, Canada. Generalized estimating equations were used to identify factors associated with OAT enrollment from September 2005 to October 2021.</p><p><strong>Results: </strong>A total of 759 AYAs reported at least weekly opioid or OAT use, with a median age of 23 years and 65.7% self-identifying as male. At baseline, 147 participants (19.4%) were on OAT, and another 199 (26.2%) initiated OAT during study follow-up (median number of follow-up visits, 5 [Q1-Q3, 2.5-8]). In a multivariable analysis, being <19 years old (adjusted odds ratio [AOR], 0.40; 95% confidence interval [CI], 0.23-0.71), Indigenous ancestry (OR, 0.72; 95% CI, 0.52-1.00), homelessness (AOR, 0.65; 95% CI, 0.54-0.77), drug dealing (AOR, 0.73; 95% CI, 0.61-0.87), daily opioid use (AOR, 0.47; 95% CI, 0.40-0.55), and nonfatal overdose (AOR, 0.73; 95% CI, 0.60-0.89) were negatively associated with OAT use.</p><p><strong>Conclusions: </strong>This study identified a low rate of OAT access among AYAs. Adolescents and young adults were less likely to be on OAT if they were <19 years old, Indigenous, and possessed certain risk markers. These findings highlight the need for mitigation strategies to facilitate OAT access for this population and for additional harm reduction measures to support AYAs who do not want to use OAT.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107574","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
A Brief Intervention on Alcohol Use Disorder Is Associated With Treatment Access for Inpatients With Alcohol-Associated Liver Disease. 对酒精相关肝病住院患者进行酒精使用障碍简短干预与获得治疗有关。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-08-16 DOI: 10.1097/ADM.0000000000001371
Patrick A Twohig, Alena Balasanova, Lauren Cooper, Michelle Le, Nathalie Khoury, Wuittporn Manatsathit, Marco Olivera, Thoetchai Bee Peeraphatdit
{"title":"A Brief Intervention on Alcohol Use Disorder Is Associated With Treatment Access for Inpatients With Alcohol-Associated Liver Disease.","authors":"Patrick A Twohig, Alena Balasanova, Lauren Cooper, Michelle Le, Nathalie Khoury, Wuittporn Manatsathit, Marco Olivera, Thoetchai Bee Peeraphatdit","doi":"10.1097/ADM.0000000000001371","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001371","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>Alcohol-associated liver disease (ALD) is the most common indication for liver transplantation in the United States. Alcohol use disorder (AUD) treatment is recommended in all patients with ALD and AUD, but it remains underutilized.</p><p><strong>Aims: </strong>To identify predictors of AUD treatment and to assess 30-day readmission, return to drinking, and 1-year transplant-free survival.</p><p><strong>Methods: </strong>Retrospective single-center cohort study of consecutive patients hospitalized with ALD and AUD between 2018 and 2020. Patients who died or were lost to follow-up at 90 days after hospitalization were excluded. AUD treatment was defined as receiving medication or participating in residential, outpatient, or support groups within 90 days of discharge.</p><p><strong>Results: </strong>One hundred nine patients were included. Mean age was 51.7 years, and 63% were male. Fifty-six (51%) patients received AUD treatment, and 23 (21%) patients received more than one treatment. Predictors of AUD treatment were younger age (OR, 1.07 [95% CI, 1.04-1.12]; P < 0.001), gastroenterology/hepatology consult (AOR, 8.54 [95% CI, 2.55-39.50]; P = 0.0002), addiction psychiatry consult (AOR, 2.77 [95% CI, 1.16-6.84]; P = 0.02), and a brief AUD intervention (AOR, 18.19 [95% CI, 3.36-339.07]; P = 0.0001). Cirrhosis decompensation, MELD-Na score, and insurance status were not associated with treatment. Thirty-one patients (28.4%) were readmitted, and 29 (26.6%) remained abstinent 30 days from discharge. Patients who received treatment had improved transplant-free survival (HR, 0.44, P = 0.04).</p><p><strong>Conclusion: </strong>A brief intervention on AUD had the strongest association with receiving AUD treatment in our cohort. Further efforts to incorporate brief interventions when offering AUD treatment to patients with ALD may be beneficial.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987992","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
Medications for Opioid Use Disorder after Entering Residential Treatment: Evidence from Louisiana Medicaid. 进入住院治疗后阿片类药物使用障碍的药物治疗:路易斯安那州医疗补助的证据。
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-08-16 DOI: 10.1097/ADM.0000000000001373
Wenshu Li, Matthew Eisenberg, Minna Song, Alene Kennedy-Hendricks, Brendan Saloner
{"title":"Medications for Opioid Use Disorder after Entering Residential Treatment: Evidence from Louisiana Medicaid.","authors":"Wenshu Li, Matthew Eisenberg, Minna Song, Alene Kennedy-Hendricks, Brendan Saloner","doi":"10.1097/ADM.0000000000001373","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001373","url":null,"abstract":"<p><strong>Objective: </strong>Policies have attempted to increase the use of medication for opioid use disorder (MOUD) during an admission to a residential treatment program, but little is known about the association of residential admission with subsequent MOUD use.</p><p><strong>Methods: </strong>In a cohort study of Louisiana Medicaid beneficiaries age 18-64 with diagnosed opioid use disorder (OUD), weekly MOUD use and overdose for 20 weeks before and after an admission to residential treatment was analyzed using comparative interrupted time series regression. Participants with residential treatment admission between January 1, 2018, and December 31, 2020 (N = 12,222) were compared against a demographically similar group of people with OUD without residential treatment during the study period.</p><p><strong>Results: </strong>The samples with residential treatment were largely male (61.9%), White (47.2%), and aged 30 to 39 years (41.4%). At baseline, people admitted to residential treatment were much less likely to use MOUD than the comparison group (4.2% lower, CI: 3.8%, 4.5%, P < 0.01). After admission, use of any MOUD initially increased by 3.1% (P < 0.01) relative to the comparison group, which reverted to the counterfactual trend by 20 weeks. Post-admission MOUD use differed widely by medication. Overdose incidence was highest in the weeks right before admission, but otherwise, it did not change during the study period.</p><p><strong>Conclusions: </strong>Admission to residential treatment for OUD was associated with a temporary increase in MOUD use. Policy initiatives should focus on both boosting use of MOUD during residential treatment and sustaining access to MOUD in outpatient care in the weeks following discharge.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987995","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
Association between Smoking Abstinence and Depression and Anxiety Symptoms After Hospital Discharge: The Helping HAND 4 Trial. 出院后戒烟与抑郁和焦虑症状之间的关系:Helping HAND 4 试验
IF 4.2 3区 医学
Journal of Addiction Medicine Pub Date : 2024-08-08 DOI: 10.1097/ADM.0000000000001358
Catherine S Nagawa, Nancy A Rigotti, Yuchiao Chang, Douglas E Levy, Joanna M Streck, Thomas Ylioja, Scott S Lee, Hilary A Tindle
{"title":"Association between Smoking Abstinence and Depression and Anxiety Symptoms After Hospital Discharge: The Helping HAND 4 Trial.","authors":"Catherine S Nagawa, Nancy A Rigotti, Yuchiao Chang, Douglas E Levy, Joanna M Streck, Thomas Ylioja, Scott S Lee, Hilary A Tindle","doi":"10.1097/ADM.0000000000001358","DOIUrl":"10.1097/ADM.0000000000001358","url":null,"abstract":"<p><strong>Objectives: </strong>Some people who stop smoking experience improved mood, but few studies have examined this relationship after hospitalization or accounted for concomitant substance use and psychological factors. We examined associations between smoking abstinence after a hospital discharge and change in depression and anxiety symptoms.</p><p><strong>Methods: </strong>We conducted a secondary analysis of data from the Helping HAND 4 smoking cessation trial, which enrolled people who used tobacco when admitted to three academic medical center general hospitals. Participants (n = 986) were categorized as continuously abstinent (CA) or not. We used linear and logistic regression to model continuous and binary measures of depression (Patient Health Questionnaire [PHQ-8] ≥/<10), and anxiety (Generalized Anxiety Disorder Assessment [GAD-7], ≥/<8) over 6 months, adjusting for baseline mood, psychological factors, and substance use. Binary outcomes were defined using established clinical thresholds to aid in the clinical interpretation of the results.</p><p><strong>Results: </strong>Mean age was 52.3 years, 56.5% were female, and the baseline mean cigarettes/day was 16.2 (SD: 3.2). In the adjusted analyses, depression and anxiety scores improved more in CA than non-CA participants over 6 months (difference-in-improvement, 2.43 [95% CI: 1.50-3.36] for PHQ-8; 3.04 [95% CI: 2.16-3.93] for GAD-7). At 6 months, CA participants were more likely to have a PHQ-8 score <10 (aOR = 2.07 [95% CI: 1.36-3.16]) and a GAD-7 score <8 (aOR = 2.90 [95% CI: 1.91-4.39]).</p><p><strong>Conclusions: </strong>Individuals who were CA, compared to those who were not, had fewer depression and anxiety symptoms at 6 months, and were twice as likely to score below the population screening thresholds for major depression and anxiety disorders. Clinicians should emphasize the association between continuous abstinence and improved mood symptoms after hospital discharge.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901819","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
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