Journal of Addiction Medicine最新文献

{"title":"Statewide Trends in Medications for Opioid Use Disorder Utilization in Rhode Island, United States, 2017-2023.","authors":"Leah C Shaw, Benjamin D Hallowell, Taylor Paiva, Christina T Schulz, Mackenzie Daly, Samantha K Borden, Jamieson Goulet, Elizabeth A Samuels, Magdalena Cerdá, Brandon D L Marshall","doi":"10.1097/ADM.0000000000001411","DOIUrl":"10.1097/ADM.0000000000001411","url":null,"abstract":"<p><strong>Background: </strong>Buprenorphine and methadone are US Food and Drug Administration-approved medications for opioid use disorder (MOUD). Although utilization of MOUD was increasing pre-COVID-19, it is not well understood how this trend shifted during and \"after\" the COVID-19 pandemic in Rhode Island. This analysis will consider the differential utilization of MOUD over time and by key demographic factors.</p><p><strong>Methods: </strong>We utilized two of Rhode Island's statewide databases to examine aggregate counts of dispensed buprenorphine and methadone from January 1, 2017, to December 31, 2023. Data were stratified by age group, sex assigned at birth, and race/ethnicity (where available). Counts were stratified into pre-COVID-19 (Q1 2017-Q1 2020), COVID-19 (Q2 2020-Q4 2022), and endemic COVID-19 (2023) eras. Averages and annualized percent change for each period were calculated to understand how utilization changed over time.</p><p><strong>Results: </strong>Before COVID-19, buprenorphine and methadone utilization were increasing annually. During COVID-19, utilization declined annually by 0.40% and 0.43%, respectively. In the endemic COVID-19 time period, buprenorphine and methadone utilization declined more rapidly at 2.59% and 1.77%, respectively. Declines were more dramatic for adults aged 18-34.</p><p><strong>Conclusions: </strong>We observed a decline in MOUD utilization during and after COVID-19 in Rhode Island, primarily driven by substantial decreases in MOUD use among the youngest group of adult residents. Interventions specifically tailored to youth, such as school-based or primary healthcare-based programs, may be particularly effective in engaging with youth in substance use disorder treatment.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"281-289"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728875","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}

{"title":"Too Early to Define Treatment-Refractory Addiction.","authors":"Nicholaus J Christian","doi":"10.1097/ADM.0000000000001415","DOIUrl":"10.1097/ADM.0000000000001415","url":null,"abstract":"","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"343-344"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769092","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}

{"title":"Response to: Gorelick.","authors":"Katherine Hill, Oliver Grundmann, Kirsten E Smith, Corneliu N Stanciu","doi":"10.1097/ADM.0000000000001418","DOIUrl":"10.1097/ADM.0000000000001418","url":null,"abstract":"","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"345"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769065","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}

{"title":"Response to: Christian.","authors":"Eric C Strain","doi":"10.1097/ADM.0000000000001414","DOIUrl":"10.1097/ADM.0000000000001414","url":null,"abstract":"","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"344"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769078","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}

{"title":"Development and Evaluation of the Global Appraisal of Individual Needs Quick Version 4 (GAIN-Q4) for ASAM Dimension Ratings and Placement Recommendations for Adolescents and Adults.","authors":"Michael L Dennis, Siara I Sitar, Kathryn C Modisette, Barbara D Estrada, Justine W Welsh","doi":"10.1097/ADM.0000000000001413","DOIUrl":"10.1097/ADM.0000000000001413","url":null,"abstract":"<p><strong>Objectives: </strong>This article describes the development and evaluation of the Global Appraisal of Individual Needs Quick Version 4 (GAIN-Q4) for the American Society of Addiction Medicine (ASAM) 4th edition patient placement dimension ratings and level of care placement recommendations. The research questions are as follows: (1) Can the GAIN-Q4 replicate recommendations from the prior longer instrument within adolescents and adults? (2) What are the substantive differences in the results by age?</p><p><strong>Methods: </strong>The 35- to 45-minute GAIN-Q4 was developed through modification of the GAIN-Q3 and evaluated in terms of its ability to predict ASAM dimensional ratings and level of care placement recommendations from the 60- to 120-minute GAIN-I instrument. Data were obtained from participants who are adolescents aged 12 to 17 years (n = 101,897) and adults 18 years and older (n = 204,711) interviewed between 2002 and 2018 across 530 US sites. Reliability between measures was assessed with Cohen's κ statistic within age group; substantive differences by age were evaluated with logistic regression and χ 2 .</p><p><strong>Results: </strong>The ability of the 35- to 45-minute GAIN-Q4 measure to predict ASAM 6 dimensional ratings from the 60- to 120-minute GAIN-I was excellent ( κ  > 0.8) for 4 dimensions, good (0.6-0.79) for 1, and fair for 1 (0.4-0.59) - both for adolescents and young adults. κ for general level of care placement to ASAM levels of care was excellent for both adolescents and young adults.</p><p><strong>Conclusions: </strong>The GAIN-Q4 demonstrates the ability to predict ASAM dimensional ratings and general level of care placement reliably when compared to the lengthier GAIN-I measure. These results highlight that clinicians using the GAIN-Q4 measure will be equipped to evaluate patients from a wide variety of sources with an accurate and reliable screening tool.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"298-305"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769030","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}

{"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":"331-333"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","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}

{"title":"New Alcohol-related Condition Diagnoses Are Associated With Opioid Tapers Among Patients Receiving Long-term Opioid Therapy.","authors":"Jarratt D Pytell, Komal J Narwaney, Anh P Nguyen, Jason M Glanz, Ingrid A Binswanger","doi":"10.1097/ADM.0000000000001412","DOIUrl":"10.1097/ADM.0000000000001412","url":null,"abstract":"<p><strong>Objectives: </strong>The study sought to describe the association between alcohol-related conditions (ARCs) and long-term opioid therapy (LTOT) dose trajectories among patients with chronic pain. We explored if ARCs moderated the association between LTOT tapers and mortality.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 3912 patients receiving LTOT. The association of ARCs before initiating LTOT with subsequent LTOT dose trajectories (increasing, decreasing, stable) was assessed using multinomial regression models. The association of LTOT trajectories with subsequently diagnosed new (incident) ARC was assessed using competing risks regression models. Lastly, we explored whether ARCs moderated the association between LTOT trajectories and all-cause mortality using Cox-proportional hazards models.</p><p><strong>Results: </strong>Overall, 6.2% (n = 244) of patients receiving LTOT were diagnosed with an ARC prior to initiating LTOT. There was no association between an ARC prior to LTOT initiation with subsequent LTOT trajectory. Among patients without an ARC diagnosis before initiating LTOT, newly diagnosed ARCs were made in 1.3% (n = 50) of patients. Patients in the decreasing LTOT trajectory were twice as likely to be diagnosed with new ARCs compared to those in the stable LTOT trajectory (adjusted hazard ratio, 2.23 [95% CI, 1.15-4.29]). The presence of ARCs did not significantly moderate the relationship between LTOT trajectories and mortality risk.</p><p><strong>Conclusions: </strong>Patients in the decreasing LTOT trajectory are at a higher risk of developing a new ARC. Implementing routine alcohol use screening among patients with LTOT taper would enable early identification for alcohol use. Interventions to reduce alcohol use may mitigate harms associated with LTOT taper.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"290-297"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728865","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}

{"title":"Promoting Race and Ethnic Diversity in a Hospital-Based Randomized Clinical Trial to Address Untreated Alcohol Use Disorder: Initial Lessons Learned.","authors":"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","doi":"10.1097/ADM.0000000000001400","DOIUrl":"10.1097/ADM.0000000000001400","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe initial experiences and lessons learned conducting a trial focused on recruiting racially and ethnically diverse hospitalized patients with untreated alcohol use disorder (AUD).</p><p><strong>Methods: </strong>The parent trial is comparing the effectiveness of strategies including Brief Negotiation Interview (BNI), facilitated initiation of medications for AUD, and computer-based training for cognitive behavioral therapy (CBT4CBT) on AUD treatment engagement post-hospitalization. Guided by the Framework for Reporting Adaptations and Modifications-Enhanced, we catalogued protocol changes and evaluated outcomes using study and electronic medical record data during the first 18 months of recruitment.</p><p><strong>Results: </strong>Recipients : (1) Selected entry criterion to intentionally include individuals most likely impacted by structural racism, (2) developed multipronged recruitment approaches, and (3) selected bilingual, multicultural, and ethnically diverse research staff. Intervention : (1) Added scripts in the BNI to consider how cultural factors influence and how racism may impact, alcohol use, and AUD treatment engagement, (2) offered tablets as a compensation alternative with support for CBT4CBT initiation (as relevant), and (3) anticipate and troubleshoot internet access challenges. Setting : (1) Identified community-based AUD treatment options with Spanish-speaking services and (2) identified resources to address social determinants of health. Study : (1) Audited data to monitor whether diverse enrollment is occurring. Among n = 132 randomized as of March 1, 2024, 25% endorsed Black, 24% endorsed Latine, 58% endorsed White, 1% endorsed Indigenous, and 15% endorsed race not listed or declined to disclose. We observed no difference by race or ethnicity in recruitment or retention experiences.</p><p><strong>Conclusions: </strong>Multilevel practices within a hospital-based AUD-focused trial can promote recruitment and retention of a racially and ethnically diverse sample.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"334-337"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602069","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}

{"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":"274-280"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086258/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-induced Liver Injury Due to Medications for Alcohol Use Disorder: Results From the DILIN Prospective Study.","authors":"Harish Gopalakrishna, Marwan Ghabril, Jiezhun Gu, Yi Ju Li, Robert J Fontana, David E Kleiner, Christopher Koh, Naga Chalasani","doi":"10.1097/ADM.0000000000001421","DOIUrl":"10.1097/ADM.0000000000001421","url":null,"abstract":"<p><strong>Objectives: </strong>Concerns about drug-induced liver injury (DILI) may deter physicians from prescribing medications for alcohol use disorder (MAUD). We aim to explore DILI due to MAUD in Drug-Induced Liver Injury Network (DILIN) prospective study.</p><p><strong>Methods: </strong>High-confidence DILI cases (ie, definite, highly likely, or probable) due to MAUD in DILIN prospective study (2004-2024) were included. Demographic, clinical, laboratory data, and 6-month outcomes were analyzed. HLA allele frequency (AF) of disulfiram cases was compared to matched controls with DILI due to non-MAUD (DILI controls).</p><p><strong>Results: </strong>Among 1975 high-confidence cases, 13 were attributed to MAUD (11 disulfiram; 1 naltrexone and 1 baclofen; and none from acamprosate). Median age was 45 years, with 77% female and 85% White. All had hepatocellular injury. In disulfiram group, the median time for DILI occurrence was 34 days. Eight patients developed jaundice, with 3 fatal or near-fatal cases (2 liver transplantation and 1 liver-related death). Five (71%) patients with severe or fatal disulfiram DILI had underlying liver disease. AF for HLA-C*01:02 (OR, 6.29; P  = 0.02) and DRB1*09:01 (OR, 10.16; P  = 0.02) were significantly higher in disulfiram cases than in DILI controls. DILI from baclofen and naltrexone was mild and self-limited with no chronic DILI.</p><p><strong>Conclusions: </strong>Disulfiram is the leading cause of DILI among MAUD and is most common in women. Disulfiram can cause severe DILI and is associated with HLA-C*01:02 and DRB1*09:01. Baclofen and naltrexone can cause mild to moderate self-limited DILI. There were no cases of acamprosate. These findings suggest DILI due to MAUD are less frequent.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"314-321"},"PeriodicalIF":4.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800691","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}