Substance Abuse Treatment, Prevention, and Policy最新文献

{"title":"Community pharmacist-administered injectable naltrexone for individuals who were formerly incarcerated: a review of Wisconsin legislation and regulations.","authors":"Jason S Chladek, Michelle A Chui","doi":"10.1186/s13011-025-00647-9","DOIUrl":"10.1186/s13011-025-00647-9","url":null,"abstract":"<p><p>Opioid use disorder (OUD) is highly prevalent among jail and prison populations in the United States, including in Wisconsin. Medications for opioid use disorder (MOUD), including long-acting injectable naltrexone, are crucial in the treatment of OUD. These medications are especially important for individuals transitioning out of jail or prison and back into the community. Unfortunately, few individuals who were formerly incarcerated continue MOUD after reentry due to a variety of barriers. Wisconsin community pharmacists are highly accessible and uniquely positioned to provide care for this population, specifically by administering injectable naltrexone. However, community pharmacist-administered injectable naltrexone for individuals who were formerly incarcerated has not been previously explored. As a first step, this legislative and regulatory review aimed to identify Wisconsin statutes and administrative codes that may impact these services for this population. Two legal databases were searched to identify relevant Wisconsin statute and administrative code subsections. Overall, 24 statute subsections (from 7 chapters) and 31 administrative code subsections (from 12 chapters) were identified that (1) highlighted a need or potential role of community pharmacist-administered injectable naltrexone for individuals who were formerly incarcerated or (2) served as a potential barrier or facilitator to the availability, access, or use of these services. Future work should focus on helping community pharmacists leverage available resources and overcome existing legal barriers to providing or supporting MOUD services. Importantly, work should be done to ensure that individuals who were formerly incarcerated can be linked to these services upon reentry.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"17"},"PeriodicalIF":3.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789032","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":"Mapping Colombians' positions on national policies to control tobacco and marijuana consumption: a pilot study.","authors":"Daniel Del Rio Forero, Claudia Pineda Marín, María Teresa Muñoz Sastre, Lonzozou Kpanake, Etienne Mullet","doi":"10.1186/s13011-025-00646-w","DOIUrl":"10.1186/s13011-025-00646-w","url":null,"abstract":"<p><strong>Background: </strong>Public authorities use a variety of control policies, with varying degrees of severity, to reduce the prevalence of health-damaging habits. Since these policies can only succeed if people understand and approve of them, this study mapped Colombians' positions on policies to control tobacco and marijuana consumption.</p><p><strong>Method: </strong>A sample of 147 adults was presented with 32 vignettes illustrating a control policy. Each vignette contained four items of information: the behavior targeted (smoking tobacco or using marijuana), the nature of preventive measures (e.g., information campaigns), the degree of regulatory measures (e.g., prohibition of use by minors) and the severity of penalties (e.g., imprisonment).</p><p><strong>Results: </strong>Through cluster analysis, three qualitatively different positions were found in relation to control policies for each substance: Generally unfavorable, irrespective of policy (22% and 17%), Depends on regulation (18% and 22%), and Always favorable, irrespective of policy (23% and 25%). A substantial minority of participants (37% and 36%) expressed no opinion at all.</p><p><strong>Conclusion: </strong>While qualitatively different positions on the acceptability of national policies to control tobacco and marijuana consumption were indeed observed among Colombian participants, the most frequent response seemed to be indifference (or indeterminacy), with other positions reflecting little more than systematic opposition or blind acquiescence. It would therefore be useful to make citizens aware that their opinions count, that their relative indifference to these issues is in itself a problem, and that it is by taking their perspectives into account that one can truly define and make effective public health policies that are understood and accepted by as many people as possible.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"16"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781035","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":"Barriers and facilitators to scaling up medications for opioid use disorder in Kentucky: qualitative perspectives of treatment organization staff.","authors":"Hannah K Knudsen, Shaquita Andrews-Higgins, Sandra Back-Haddix, Michelle R Lofwall, Laura Fanucchi, Sharon L Walsh","doi":"10.1186/s13011-025-00644-y","DOIUrl":"10.1186/s13011-025-00644-y","url":null,"abstract":"<p><strong>Background: </strong>Underutilization of medications for opioid use disorder (MOUD) remains a persistent obstacle to addressing the opioid epidemic. This study explores MOUD agency experiences with patient census growth as well as multi-level barriers and facilitators to expanding MOUD from the perspectives of agency staff.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted with 66 employees representing 30 MOUD agencies in eight Kentucky counties in the United States from December 2022 to June 2023 as part of the HEALing (Helping to End Addiction Long-term®) Communities Study in Kentucky (HCS-KY). Interviews were conducted prior to the development of partnerships to implement strategies focused on expanding MOUD census and increasing MOUD retention. Facility administrators/directors, prescribers, and clinicians were prioritized for recruitment, but agencies could identify other staff to participate. Interviews were recorded and transcribed. A consensus-based approach to coding and thematic analysis was used.</p><p><strong>Results: </strong>Although some agencies had a fairly static number of patients, most described recent experiences with modest growth in MOUD census and the ability to provide same day/next day MOUD. Multi-level factors, including organizational, patient, and community factors, were perceived to impact MOUD census. Organizational characteristics impacting growth included the physical space of the clinic and staffing. Organizational policies in some agencies constrained treatment retention, while other agencies implemented innovations to better meet patients' needs. Patients often encountered numerous obstacles to treatment initiation and retention, including limited access to transportation, technology, stable housing, and childcare. These patient-level barriers often reflected community characteristics, while community stigma also impeded MOUD growth.</p><p><strong>Conclusions: </strong>Although some degree of growth in MOUD has occurred, multiple barriers are impeding further increases in treatment initiation and retention. Overcoming some barriers would likely require policy changes related to financing and regulation, while other barriers would require community-level efforts to decrease stigma and greater community investment in infrastructure, such as transportation and housing.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT04111939. Registered 30 September 2019, https://clinicaltrials.gov/ct2/show/NCT04111939 .</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"15"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773106","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":"Rumination and drug craving scores in Chinese male patients with methamphetamine and heroin use disorders: a cross-sectional study.","authors":"Yinxue Mao, Deyang Li, Dongmei Wang, Yang Tian, Jiajing Chen, Lianglun Jia, Xiaotao Wang, Xiang-Yang Zhang","doi":"10.1186/s13011-025-00643-z","DOIUrl":"10.1186/s13011-025-00643-z","url":null,"abstract":"<p><strong>Background: </strong>Rumination is an essential trans-diagnostic process associated with substance use disorders (SUDs) in psychopathology. In China, methamphetamine and heroin have become major illegal drugs, but the role of rumination in their use remains unclear. The objective of this study was to investigate the relationship between rumination subtypes and drug craving in patients with methamphetamine use disorder (MAUD) and 81 patients with heroin use disorder (HUD).</p><p><strong>Methods: </strong>A total of 489 participants, including 408 patients with MAUD and 81 patients with HUD, were recruited from a rehabilitation center. Participants were screened for inclusion criteria, and the Obsessive Compulsive Drug Use Scale (OCDUS) was used to assess drug craving. Rumination was assessed using the Ruminative Responses Scale (RRS), categorized into three dimensions: symptom rumination, brooding, and reflective pondering. Correlational and multiple regression analyses were conducted to examine associations between rumination and craving.</p><p><strong>Results: </strong>Compared to patients with MAUD, patients with HUD had significantly higher RRS and OCDUS total score (42.51 vs 39.71 and 25.99 vs 20.95, both p < 0.01). In patients with MAUD, the OCDUS total score was positively correlated with the total score (r = 0.298, p < 0.01) and all subscale scores of the RRS (for reflective pondering, r = 0.180; for brooding, r = 0.230; for symptom rumination, r = 0.325; all p < 0.01). However, in patients with HUD, only symptom rumination was positively associated with the OCDUS total score (r = 0.247, p < 0.05). Multiple regression showed symptom rumination was independently associated with OCDUS total score in both groups (for patients with MAUD, β = 0.324, p < 0.001; for patients with HUD, β = 0.252, p < 0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that rumination shows different effects on craving in male patients with MAUD and HUD. Moreover, symptom rumination may have a significant influence on the connection between rumination and craving in individuals with MAUD and HUD.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"14"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720716","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":"Perceived impacts of North Americas first de-medicalized safer supply program.","authors":"Jeremy Kalicum, Eris Nyx, Mary Clare Kennedy, Thomas Kerr","doi":"10.1186/s13011-025-00642-0","DOIUrl":"10.1186/s13011-025-00642-0","url":null,"abstract":"<p><strong>Background: </strong>The Drug User Liberation Front led an evaluation of a non-medicalized model of safer supply known as a \"Compassion Club.\" This club sourced, rigorously tested, packaged, and accurately labeled certain illicit substances and then provided them to club members at cost in order to investigate the effects and feasibility of a non-medical model of safer supply. Operating for 14 months, the club provided low-cost, quality-controlled illicit substances to individuals at risk of fatal overdose in Vancouver, Canada's Downtown Eastside neighbourhood. This study was undertaken to explore perceived impacts of the Compassion Club among its participants, as well as their perceptions regarding how the Club could be improved.</p><p><strong>Methods: </strong>At the one-year time point of club operations 43 participants from the club's membership completed an interviewer-administered survey which is utilized in this cross sectional analysis. Descriptive statistics were employed to assess the perceived influence of club membership on various factors, including drug use patterns, harm reduction practices, financial outcomes, housing stability, and overall well-being.</p><p><strong>Results: </strong>Applicable responses reported benefits from membership in the Compassion Club, including reduced drug use (64.3%), decreased reliance on illicit markets (86.7%), lowered risk of overdose (90.0%), and increased likelihood of using sterile equipment (84.6%). Mental health (74.2%), physical health (63.3%), and overall well-being (70.0%) were also noted improvements. Suggestions for club improvement included extended operating hours, broader substance selection, and improved accessibility.</p><p><strong>Conclusion: </strong>The reported reductions in drug use and improved adherence to harm reduction practices described herein underscore the perceived benefits of this unique program. Compassion Clubs represent a distinct strategy to mitigate overdose risk and enhance the well-being of drug users. These insights advance ongoing dialogues on overdose prevention strategies, urging further research to refine non-medicalized approaches within the evolving landscape of interventions.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"11"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597947","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 repeatable battery for the assessment of neuropsychological status (RBANS) and substance use disorders: a systematic review.","authors":"Kristoffer Høiland, Rune Raudeberg, Jens Egeland","doi":"10.1186/s13011-025-00640-2","DOIUrl":"10.1186/s13011-025-00640-2","url":null,"abstract":"<p><strong>Background: </strong>Cognitive deficits are prevalent among substance use disorder (SUD) patients and affect treatment retention and outcome. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a well-researched instrument in diverse patient groups and has the potential to serve as an effective and accurate method for identifying cognitive impairment in SUD patients. This systematic review examines the RBANS' ability to detect cognitive impairment in SUD patients. Limitations of knowledge and the need for further research are discussed.</p><p><strong>Methods: </strong>We conducted a systematic search using PsycINFO, Medline, and Cochrane databases to identify relevant studies and articles on applying RBANS in SUD. No time limits were imposed on the search. Search words were RBANS, substance use disorder, drug use disorder, and alcohol use disorder, and the most common specific types of drugs (e.g., opiates, cannabis, and methamphetamine).</p><p><strong>Results: </strong>A systematic search identified 232 articles, of which 17 were found eligible and included in the review. Most studies examined patient groups using either alcohol, methamphetamine, or opioids. The results are presented in the form of a narrative review. We identified some evidence that the RBANS can detect group differences between SUD patients and healthy controls, but the findings were somewhat inconsistent. The literature search revealed little information about cognitive profiles, reliability, factor structure, and construct and criterion validity.</p><p><strong>Conclusions: </strong>The evidence concerning the validity and usefulness of the RBANS in SUD populations is scarce. Future research should investigate cognitive profiles, reliability, factor structure, and construct and criterion validity.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"12"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597862","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":"Global scientific research landscape on binge drinking: a comprehensive bibliometric and visualization analysis of trends, collaborations, and future directions.","authors":"Sa'ed H Zyoud","doi":"10.1186/s13011-025-00641-1","DOIUrl":"10.1186/s13011-025-00641-1","url":null,"abstract":"<p><strong>Background: </strong>Binge drinking constitutes a significant public health concern. Defined as the consumption of five or more alcoholic beverages on a single occasion, binge drinking leads to acute cognitive and motor impairments and is associated with a multitude of detrimental health consequences. Therefore, the aim of this study was to analyse globally published peer-reviewed literature on binge drinking.</p><p><strong>Methods: </strong>A thorough search of the Scopus database was conducted to gather all the relevant research. Keywords related to binge drinking were used to locate a wide range of studies. Specific criteria were subsequently applied to narrow the results, ensuring the inclusion of only the most relevant articles. This process yielded a collection of 2,763 research papers. Finally, a software program called VOSviewer was utilized to analyse and visualize the connections between these studies.</p><p><strong>Results: </strong>A bibliometric analysis was performed to investigate trends in binge drinking research literature published between 1980 and 2024. The findings revealed a significant increase in publications (R²=0.916; p < 0.001), with a peak in 2018 (191 articles). The majority (89.65%, n = 2,477) were research articles, followed by review articles (4.74%, n = 131). Authors from 139 countries contributed to binge-drinking research, with the USA (n = 1,550; 56.1%) and the UK (n = 216; 7.82%) leading in the volume of publications. The National Institute on Alcohol Abuse and Alcoholism (n = 65; 2.35%) and the University of North Carolina at Chapel Hill (n = 63; 2.28%) emerged as the main institutional contributors. The National Institute on Alcohol Abuse and Alcoholism in the United States was the main funding source, supporting 599 articles (21.68%), followed by the National Institutes of Health in the United States, with 544 articles (19.69%). In particular, the post-2016 period witnessed a shift in research themes toward mechanistic investigations alongside studies on societal interventions, reflecting a growing focus on mitigating the broader social impact of binge drinking.</p><p><strong>Conclusions: </strong>This study is the first comprehensive analysis of trends in binge drinking research. Over the past decade, binge drinking has increased dramatically, led by the United States, the UK, and Spain. Initially, focused on social and cultural factors, research shifted after 2016 to mechanistic and animal models, shaping future research directions and strategies.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"13"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597850","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":"Alcohol use disorder among people diagnosed with tuberculosis in a large urban case-finding project in central Uganda: prevalence, associated factors and challenges to treatment adherence.","authors":"Josephine Bayigga, Ilona Kakai, Eva Agnes Laker Odongpiny, Ahmed Ddungu, Lynn Semakula, Martha Nansereko, Christine Sekaggya Wiltshire, Turyahabwe Stavia, Stella Zawedde-Muyanja","doi":"10.1186/s13011-024-00629-3","DOIUrl":"10.1186/s13011-024-00629-3","url":null,"abstract":"<p><strong>Background: </strong>Heavy consumption of alcohol increases the risk of developing active tuberculosis (TB), contributes to delayed diagnosis and affects adherence to treatment. Within a large urban case-finding project, we aimed to determine the prevalence of and factors associated with alcohol use disorder (AUD) and to understand the challenges that people with AUD face while seeking for TB services and adhering to TB treatment.</p><p><strong>Methods: </strong>We carried out an explanatory sequential study in two large urban districts in Uganda. We collected quantitative data on the prevalence of alcohol use disorder using the Cut, Annoyed, Guilty, Eye opener (CAGE) tool. We used a Poisson regression model with robust variance to examine factors associated with AUD. Both the crude and adjusted prevalence risk ratios with 95% confidence intervals were presented. We then conducted two focus group discussions with persons diagnosed with both TB and AUD. Focus group discussions (FGDs) were transcribed, data were analysed inductively and coded into themes using NVIVO version 12 software.</p><p><strong>Results: </strong>Out of 325 people with TB people interviewed, 62 (18.7% 95% confidence interval [CI] 18-31%) screened positive for AUD. Majority 82.3% (51/62) were male. Being male aPR 2.32 (95% CI 1.19, 4.49) and living in an urban area aOR 1.79 (95% CI: 1.10, 2.92) were significantly associated with a positive screen. Among people who screened positive for AUD, there was a tendency towards suboptimal TB treatment outcomes, although this did not reach significance aPR 1.65 (95% CI: 0.95, 2.85). Fourteen people (eight male and six female) who screened positive for AUD attended two FGDs. These respondents often did not disclose alcohol use during TB treatment and missed clinic refill appointments due to lack of transport fares to the clinic.</p><p><strong>Conclusion: </strong>A significant proportion of people with TB screened positive for AUD but did not disclose alcohol use to their healthcare workers. These patients experienced several challenges while on TB treatment. Therefore, TB care programs need to design interventions that actively assess for AUD and in order to address related challenges.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"10"},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568202","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":"Using illicit drugs alone in Vancouver, Canada: a gender-based analysis.","authors":"Kat Gallant, Kanna Hayashi, Eric C Sayre, JinCheol Choi, Manal Mansoor, Thomas Kerr","doi":"10.1186/s13011-025-00637-x","DOIUrl":"10.1186/s13011-025-00637-x","url":null,"abstract":"<p><strong>Objectives: </strong>Canada continues to experience an epidemic of toxic drug-related overdose deaths. Public health messaging emphasizes the dangers of using drugs alone as it restricts timely overdose response or renders it impossible, yet this practice remains prevalent among people who use drugs. While drug use practices and associated harms are known to be highly gendered, little is known about how factors shaping solitary drug use may differ across genders (including cisgender men, cisgender women, transgender women, Two-Spirit people and gender diverse people). Thus, we sought to explore solitary drug use practices according to gender in Vancouver, Canada.</p><p><strong>Methods: </strong>Data were collected through Vancouver Injection Drug Users Study, a prospective cohort study between June 2019 and May 2023. We used gender-stratified multivariable generalized estimating equation models to identify factors associated with using drugs alone.</p><p><strong>Results: </strong>Among the 697 participants, 297 (42.6%) reported using drugs alone in the previous 6 months at baseline. In multivariable analyses, we found that being in a relationship was negatively associated with using alone for both cisgender men and cisgender women (adjusted odds ratio [AOR] = 0.25 and 0.34, respectively), while homelessness was negatively associated for cisgender men only (AOR = 0.45). Factors positively associated for cisgender men included daily illicit stimulant use (AOR = 1.90), and binge drug use (AOR = 2.18). For cisgender women, only depression was positively associated with using drugs alone (AOR = 2.16). All p-values < 0.05. While unable to conduct a multivariable analysis on transgender, Two-Spirit and gender diverse people due to small sample sizes, bivariate analyses showed larger impact of depression on using alone for Two-Spirit (OR = 8.00) and gender diverse people (OR = 5.05) compared to others, and only gender diverse people's risk was impacted by experiences of violence (OR = 9.63). All p-values < 0.05.</p><p><strong>Conclusion: </strong>The findings of this study suggest significant heterogeneity in gender-specific factors associated with using drugs alone. Factors exclusively impacting cisgender men's risk included homelessness and daily stimulant use, and depression having a significant impact on cisgender women's, but not cisgender men's, risk. Ultimately, gender-specific factors must be recognized in public health messaging, and in developing policies and harm reduction measures to address the risks associated with using alone.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"9"},"PeriodicalIF":3.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477116","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":"Overcoming barriers to traditional care delivery and pharmacy challenges: a qualitative study of buprenorphine, telehealth, and a digital therapeutic for opioid use disorder.","authors":"Laura B Monico, Megan Eastlick, Darcy Michero, Peyton Pielsticker, Suzette Glasner","doi":"10.1186/s13011-024-00631-9","DOIUrl":"10.1186/s13011-024-00631-9","url":null,"abstract":"<p><strong>Background: </strong>The opioid epidemic contributes to increasing morbidity and mortality due to drug overdoses in the US, but barriers to traditional opioid use disorder (OUD) treatment prevent a vast majority of patients from accessing quality care and medications for opioid use disorder (MOUDs). Public Health Emergency (PHE) provisions during the COVID-19 pandemic relaxed in-person evaluation requirements for buprenorphine inductions, allowing for the expansion of telehealth care to OUD populations. This qualitative study explores patients' experiences with a novel digital therapeutic telehealth program with buprenorphine for OUD.</p><p><strong>Method: </strong>Semi-structured qualitative interviews were conducted with a sub-sample (n = 15) of participants from a larger feasibility and acceptability pilot. Interviews explored participants' opioid use, OUD treatment history, previous MOUD experience, barriers to previous treatment attempts, medication adherence, counseling experience, treatment satisfaction, and comparisons between current and previous treatments.</p><p><strong>Results: </strong>Barriers to care in previous OUD treatment episodes included logistical and program related inconveniences (program attendance requirements, commute distances, transportation, appointment wait times, and clinic patient volumes), financial strain, unreliable access to prescribers, residential program experiences, and the availability of detox-only based treatments. Participants with previous treatment experiences contrasted these barriers with the virtual delivery study setting and reported that the characteristics of telehealth OUD care facilitated improved engagement and retention by overcoming many of these barriers through: no transportation requirements, open and flexible appointment scheduling, appointment times confined to care team meetings only, absence of provider availability concerns, and the ability to receive buprenorphine maintenance care from home. The primary barrier noted for virtual care delivery was the fulfillment of buprenorphine prescriptions from local pharmacies.</p><p><strong>Conclusion: </strong>A novel digital therapeutic telehealth program was reported to overcome almost all of the barriers encountered by participants during previous traditional OUD treatment episodes, contributing to a growing body of evidence supporting the permanency of current PHE expansions for OUD telehealth care. Findings also emphasize the importance of coming to workable policy solutions for buprenorphine supply threshold constraints on local pharmacies that unintentionally constrict access for telehealth and other OUD patients.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"8"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450374","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}