Substance Abuse and Rehabilitation最新文献

{"title":"Not Two Sides of the Same Coin: A Qualitative Comparative Analysis of Post-Treatment Abstinence and Relapse.","authors":"Esther Pars, Fadi Hirzalla, Joanne E L VanDerNagel, Boukje A G Dijkstra, Arnt F A Schellekens","doi":"10.2147/SAR.S447560","DOIUrl":"10.2147/SAR.S447560","url":null,"abstract":"<p><strong>Purpose: </strong>Substance use disorder (SUD) can be a chronic relapsing condition with poor treatment outcomes. Studies exploring factors associated with abstinence or relapse after treatment are often quantitative in nature, applying linear statistical approaches, while abstinence and relapse result from non-linear, complex, dynamic and synergistic processes. This study aims to explore these underlying dynamics using qualitative comparative analysis (QCA) as a mixed methods approach to further our understanding of factors contributing to post-treatment abstinence and relapse.</p><p><strong>Patients and methods: </strong>In a prospective study, we gathered both qualitative and quantitative data pertaining to post-treatment substance use and the factors linked to substance use outcomes. These factors encompassed psychiatric comorbidity, intellectual disability, social disintegration, post-treatment support, and engagement in activities among patients who had undergone inpatient treatment for severe SUD (n = 58). QCA, a set-theoretic approach that considers the complex interplay of multiple conditions, was applied to discern which factors were necessary or sufficient for the occurrence of either abstinence or relapse.</p><p><strong>Results: </strong>We found two solutions predicting abstinence, and five for relapse. Post-treatment conditions (support and engagement in activities) were important for retaining abstinence. For relapse, individual baseline characteristics (intellectual disability, social disintegration, psychiatric comorbidity) combined with (post-)treatment factors (post-treatment support, activities) were important.</p><p><strong>Conclusion: </strong>Although abstinence and relapse represent opposing outcomes, they each exhibit distinct dynamics. To gain a comprehensive understanding of these dynamics, it is advisable to examine them as separate outcomes. For clinical practice, it can be worthwhile to recognize that fostering the conditions conducive to abstinence may differ from preventing the factors that trigger relapse.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"15 ","pages":"9-19"},"PeriodicalIF":1.8,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State and Service Estimates of Substance Use Treatment Facilities That Receive Public Funds in the United States","authors":"Orrin D. Ware","doi":"10.2147/sar.s438706","DOIUrl":"https://doi.org/10.2147/sar.s438706","url":null,"abstract":"","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"26 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Alternate Measures of Readiness to Quit Smoking: Stages of Change and the Contemplation Ladder","authors":"Kelsey Miskimins, Amanda Kaufmann, David Haaga","doi":"10.2147/SAR.S440691","DOIUrl":"https://doi.org/10.2147/SAR.S440691","url":null,"abstract":"Purpose Two methods of operationalizing readiness to quit smoking have been used extensively in prior research. An algorithm derived from the transtheoretical model classifies current smokers in distinct stages of precontemplation (not intending to quit in next 6 months), contemplation (serious intent to quit within 6 months), and preparation (serious intent to quit within 30 days). The Contemplation Ladder (CL) is a single-item continuous (0–10) rating. The current study, a secondary analysis of a clinical trial testing a method of inducing quit attempts, examined the convergent validity, one-month retest reliability, and predictive validity (for quit attempts) of the CL and the stages of change algorithm. Patients and Methods Adult daily smokers (≥10 cigarettes/day; N = 278) completed the CL and stage of change algorithm measures and underwent an experimental manipulation intended to induce quit attempts. Four weeks later they completed the same measures and reported on whether they had attempted to quit smoking in the interim. Results The CL and the staging algorithm showed strong convergent validity, with intercorrelations of 0.50 and 0.51 at baseline and follow-up assessments. Retest reliability was similar for each measure (CL r = 0.52; stage of change r = 0.57). Each showed predictive validity in that smokers who went on to make a quit attempt had scored significantly higher at baseline in readiness to quit. Conclusion Researchers and clinicians can reasonably choose either measure of readiness to quit smoking with confidence that the results would parallel what would have been obtained with the other.","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":" 23","pages":"167 - 171"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobiology and the Treatment of Alcohol Use Disorder: A Review of the Evidence Base.","authors":"Suzanna Donato, Lara A Ray","doi":"10.2147/SAR.S409943","DOIUrl":"https://doi.org/10.2147/SAR.S409943","url":null,"abstract":"<p><p>Alcohol use disorder (AUD) is a significant public health concern, accounting for a majority of substance use disorder cases in the United States. Treatment for AUD is complex, with multiple intervention points that may be further complicated by genotype and phenotype, resulting in diverse outcomes. In order to better understand the current landscape of AUD treatment, the present review considers different etiological models of AUD and assesses the evidence base of current treatment options. The first section of this review summarizes various etiological models of AUD and presents different approaches to classifying the disorder. Various theories, including neurobiological models, are discussed. The second section presents a comprehensive analysis of available treatment options for AUD, encompassing behavioral and pharmacological interventions and their current evidence base. Finally, this review discusses the ongoing treatment gap and significant factors contributing to low treatment utilization. Together, this review provides an overview of different etiological processes and mechanisms of AUD, as well as summarizes the literature on key treatment approaches. By integrating historical, theoretical, and empirical data, this review aims to inform both researchers and providers with valuable insights to advance AUD treatment approaches and narrow the treatment gap.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"14 ","pages":"157-166"},"PeriodicalIF":1.8,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting, Implementing, and Maintaining a Group Cognitive Behavioral Therapy Program at an Inpatient Addiction Treatment Facility.","authors":"Jessica L Bourdon, Sidney Judson, Gabriella Caporaso, Monica F Wright, Taylor Fields, Nehal P Vadhan, Jon Morgenstern","doi":"10.2147/SAR.S433523","DOIUrl":"10.2147/SAR.S433523","url":null,"abstract":"<p><strong>Background: </strong>Quality training is an oft-cited barrier to effective implementation and ongoing delivery of high-quality evidence-based practice (EBP) across fields. This is especially true in the addiction field, but there is little cited evidence for optimal methods to improve EBP in inpatient addiction facilities with minimal resources.</p><p><strong>Objective: </strong>The current paper focuses on evaluating the state of our facility's group CBT manual and clinical training on the manual in a \"realistic\" (ie, non-RCT, non-grant-funded) inpatient addiction treatment setting.</p><p><strong>Methods: </strong>Five full-time clinicians volunteered to take part in the study (woman = 60%; <i>M_age</i> = 36.20 years). The study involved a mix of semi-structured interviews and surveys designed to measure seven outcomes (barriers, feasibility, useability, appropriateness, acceptability, burden, trialability).</p><p><strong>Results: </strong>Three themes emerged from the data that impacted the group CBT manual: training, timing, and functionality. Addressing these themes allowed for a new, optimal manual and training procedure to be put into place.</p><p><strong>Conclusion: </strong>The current study highlights that under-resourced inpatient addiction facilities can still methodically utilize implementation approaches to study their EBP, namely CBT. Such an approach will ensure that the highest quality care is being delivered to patients and actively addresses known training barriers that prevent proper EBP delivery.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"14 ","pages":"119-130"},"PeriodicalIF":1.8,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10637231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Injectable Opioid Agonist Treatment (iOAT) on Involvement in Criminalized Activities: A Secondary Analysis from a Clinical Trial in Vancouver, BC","authors":"Sophia Dobischok, Daphne Guh, Kirsten Marchand, Scott MacDonald, Kurt Lock, Scott Harrison, Julie Lajeunesse, Martin Schechter, Eugenia Oviedo-Joekes","doi":"10.2147/sar.s438451","DOIUrl":"https://doi.org/10.2147/sar.s438451","url":null,"abstract":"Purpose: A significant portion of the economic consequences of untreated Opioid Use Disorder (OUD) relate to individuals’ involvement in the criminal justice system. The present study uncovers if treatment with iOAT is related to the number of criminal charges amongst participants, what type of crime participants were involved in, and the frequency with which participants were victims of crime. This study contributes to the body of research on the effectiveness of iOAT reducing criminal involvement. Patients and Methods: This is a secondary analysis of police record data obtained from the Vancouver Police Department over a three-year period during the Study to Assess Longer-term Opioid Medication Effectiveness clinical trial. The data was obtained from participants (N = 192) enrolled in the trial through a release of information form. Results: During the three-year period, most charges (45.6%) were property offences, and 25.5% of participants were victims of crime. Participants with no treatment prior to randomization into the SALOME trial were 2.61 (95% CI = 1.64– 4.14) more likely to have been charged with a crime than during the iOAT state. Conclusion: IOAT can reduce individuals’ involvement with the criminal justice system and is thus a crucial part of the continuum of care. Addiction should be conceptualized as a healthcare rather than criminal issue. Keywords: heroin assisted treatment, diacetylmorphine, hydromorphone, crime, charges, police","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"17 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying and Treating Incarcerated Women Experiencing Substance Use Disorders: A Review","authors":"Michele Staton, Martha Tillson, Mary Levi, Megan Dickson, Matt Webster, Carl Leukefeld","doi":"10.2147/sar.s409944","DOIUrl":"https://doi.org/10.2147/sar.s409944","url":null,"abstract":"Abstract While research on substance use disorder (SUD) treatment among justice-involved populations has grown in recent years, the majority of corrections-based SUD studies have predominantly included incarcerated men or men on community supervision. This review 1) highlights special considerations for incarcerated women that may serve as facilitating factors or barriers to SUD treatment; 2) describes selected evidence-based practices for women along the cascade of care for SUD including screening and assessment, treatment and intervention strategies, and referral to services during community re-entry; and 3) discusses conclusions and implications for SUD treatment for incarcerated women.","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"29 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery Capital Gains May Precede Craving Reduction in Opioid Use Disorder.","authors":"Nicholas L Bormann, Andrea N Weber, Benjamin Miskle, Stephan Arndt, Alison C Lynch","doi":"10.2147/SAR.S433350","DOIUrl":"10.2147/SAR.S433350","url":null,"abstract":"<p><strong>Purpose: </strong>Cravings for drugs and alcohol have been significantly associated with worse treatment outcomes. We investigated if improvements in recovery capital (RC) (eg, a measure of social capital/network, financial resources, education, and cultural factors) over time were associated with decreased reported cravings.</p><p><strong>Patients and methods: </strong>The original cohort consisted of 133 participants (63 females) with opioid use disorder seeking outpatient treatment, who completed the Assessment of Recovery Capital (ARC) (range 0 to 50) and the Brief Addiction Monitor (BAM) thrice over the 6-month study. Intervention was medication and case management. Analysis included one-way mixed models testing change over time for ARC total scores and single question craving rating (5-point Likert scale). Cross-lagged panel estimates used structural equation models with variables z-scored, allowing for path coefficient evaluation as standard deviations (sd).</p><p><strong>Results: </strong>Total ARC significantly increased over the study (χ2 = 33.77, df = 2, p < 0.0001), with baseline of 36.6 (n = 114, sd = 11.1) and 6-month of 41.2 (n = 107, sd = 9.5). Craving also changed significantly (χ2 = 8.51, df = 2, p < 0.015), with baseline of 1.1 (n = 101, sd = 1.2) and 6-month of 0.9 (n = 107, sd = 1.1). The cross-lag from baseline RC to 3-month craving was significant (β = -0.28, SE = 0.11, z = -2.53, p < 0.011). The converse was not true; baseline craving did not affect later RC. Results were similarly significant when comparing 3-month to 6-month. The majority of sample was on buprenorphine.</p><p><strong>Conclusion: </strong>As RC improves, the reported cravings at both 3- and 6-month study time points are significantly reduced. When evaluated inversely, there was not a significant association with baseline cravings and follow-up RC. Significant path coefficients provide an estimation of a directional effect from increased RC towards craving reduction.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"14 ","pages":"113-118"},"PeriodicalIF":1.8,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/4f/sar-14-113.PMC10561754.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41213546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to Support Engagement in Addiction Care Postpartum: Principles and Pitfalls.","authors":"Shayna Mazel, Karen Alexander, Camille Cioffi, Mishka Terplan","doi":"10.2147/SAR.S375652","DOIUrl":"10.2147/SAR.S375652","url":null,"abstract":"<p><p>There is a fundamental disconnect between the optimal management of addiction in general and care delivery in pregnancy and postpartum. Addiction is a chronic condition requiring some degree of management across the life course. Yet, in the US, reproductive care is episodic and centers more on pregnancy than at other stages of the reproductive life course. Pregnancy is prioritized in access to insurance as almost all pregnant people are Medicaid eligible but access ends at varying points postpartum. This results in a structural mismatch: the episodic management of the chronic condition of addiction only within gestational periods. Though people with substance use disorder (SUD) may access care in pregnancy, treatment attrition is common postpartum. Postpartum is a time of increased vulnerabilities where insurance churn and newborn caretaking responsibilities collide in a context of care withdrawal from the health system and health providers. In part in consequence, return to use, SUD recurrence, overdose, and overdose death are more common postpartum than in pregnancy, and drug deaths have become a leading cause of maternal deaths in the US. This review addresses interventions to support engagement in addiction care postpartum. We begin with a scoping review of model programs and evidence-informed interventions that have been shown to increase continuation of care postpartum. We then explore the realities of contemporary care through a review of clinical and ethical principles, with particular attention to harm reduction. We conclude with suggestions of strategies (clinical, research, and policy) to improve care postpartum and highlight potential pitfalls in the uptake of evidence-based and person-centered services.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"14 ","pages":"49-59"},"PeriodicalIF":5.1,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/18/sar-14-49.PMC10327918.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Factors Associated with Alcohol Consumption Among Secondary School Students in Nekemte, Ethiopia: A Cross-Sectional Study.","authors":"Tesfaye Shibiru,&nbsp;Anthonisamy Arulandhu,&nbsp;Ashenafi Belete,&nbsp;Jiregna Etana,&nbsp;Wakjira Amanu","doi":"10.2147/SAR.S408736","DOIUrl":"10.2147/SAR.S408736","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption is a major public health concern among adolescents and young adults. Adolescence is an important period of human growth. Alcohol consumption during this age will lead to a variety of problems: health, social, economic, etc. Further, research studies have shown that alcohol consumption, both at normal and above normal levels, will lead to a wide range of health problems. The purpose of this study is to evaluate the prevalence and associated factors for alcohol consumption among secondary school students in Nekemte town, East Wollega Zone, Ethiopia, in 2022.</p><p><strong>Methods: </strong>A school-based cross-sectional research design approach is used. The data is collected using a structured and self-administered questionnaire. Through systematic random sampling, 291 out of 15,798 students ranging from 9 through 12 grades are chosen. The students selected from each school are proportional to their total strength.</p><p><strong>Results: </strong>The study is conducted on 291 participants with a mean age of 17.5 ± 1.5 years. Of them, 49.8% are males, and the remaining 50.2% are females. It revealed that 27.84% of participants consume alcohol: 30.3% males and 25.3% females. Age (AOR: 2.755, 95% CI: 1.307-5.809), Urban location (AOR: 1.674, 95% CI: 0.962-2.914), Smoking (AOR: 0.426, 95% CI: 0.104-1.740), Chewing Khat (AOR: 2.185, 95% CI: 0.539-8.855), Having friends who drink (AOR: 1.740, 95% CI: 0.918-3.300), and having a family member who drinks alcohol. All these categories are significantly (p<0.05) associated with alcohol use.</p><p><strong>Conclusion: </strong>The effects of alcohol consumption and its risks of mental illness, chronic illness, and social problems in adulthood are not completely understood by school students. Alcoholism can be eradicated using educational, preventive, and motivating measures. Special attention should be given to young people and their coping mechanisms against alcohol use.</p>","PeriodicalId":22060,"journal":{"name":"Substance Abuse and Rehabilitation","volume":"14 ","pages":"35-47"},"PeriodicalIF":1.8,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/cb/sar-14-35.PMC10187642.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9495914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}