Substance Abuse: Research and Treatment最新文献

{"title":"Prior Periods of Abstinence Among Adults With an Alcohol Use Disorder: A Qualitative Template Analysis.","authors":"Orrin D Ware, Breanna Labos, Daniella Hudgins, Nathan A Irvin, Megan E Buresh, Cecilia L Bergeria, Mary M Sweeney","doi":"10.1177/11782218231162468","DOIUrl":"10.1177/11782218231162468","url":null,"abstract":"<p><p>Abstaining from substance use is a goal of many people with alcohol use disorder (AUD). Understanding patient perspectives of a period of abstinence may assist persons with AUD in achieving this goal. We accessed the electronic health records of adults with AUD entering an emergency department in Baltimore, Maryland, who received a brief peer support intervention for substance use. Data contained open-ended text entered by staff after a patient indicated ever having a sustained period of substance abstinence. Using qualitative template analysis methodology, we identified codes and themes from these open-ended responses from N = 153 adults with AUD. The sample was primarily male (n = 109, 71.2%) and White (n = 98, 64.1%) with an average age of 43.8 years (SD = 11.2). Themes identified included the abstinence length, abstinence reason, relapse, triggers, time of relapse, and treatment. The most common code for abstinence length was \"between 1 and 5 years\" (n = 55, 35.9%). Other abstinence length codes included \"less than 1 year\" and \"more than 5 years.\" Relapse triggers included \"family (non-death),\" \"death of a loved one,\" \"social,\" \"economic,\" and \"treatment-related\" reasons. Findings from this study could be used to inform strategies for peer support interventions to assist patients with substance abstinence.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231162468"},"PeriodicalIF":2.4,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/9b/10.1177_11782218231162468.PMC10034338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9560579","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":"Association Between Buprenorphine Dose and the Urine \"Norbuprenorphine\" to \"Creatinine\" Ratio: Revised.","authors":"Hiroko Furo,&nbsp;Timothy Wiegand,&nbsp;Meenakshi Rani,&nbsp;Diane G Schwartz,&nbsp;Ross W Sullivan,&nbsp;Peter L Elkin","doi":"10.1177/11782218231153748","DOIUrl":"10.1177/11782218231153748","url":null,"abstract":"<p><strong>Background: </strong>Utilizing a 1-year chart review as the data, Furo et al. conducted a research study on an association between buprenorphine dose and the urine \"norbuprenorphine\" to \"creatinine\" ratio and found significant differences in the ratio among 8-, 12-, and 16-mg/day groups with an analysis of variance (ANOVA) test. This study expands the data for a 2-year chart review and is intended to delineate an association between buprenorphine dose and the urine \"norbuprenorphine\" to \"creatinine\" ratio with a higher statistical power.</p><p><strong>Methods: </strong>This study performed a 2-year chart review of data for the patients living in a halfway house setting, where their drug administration was closely monitored. The patients were on buprenorphine prescribed at an outpatient clinic for opioid use disorder (OUD), and their buprenorphine prescription and dispensing information were confirmed by the New York Prescription Drug Monitoring Program (PDMP). Urine test results in the electronic health record (EHR) were reviewed, focusing on the \"buprenorphine,\" \"norbuprenorphine,\" and \"creatinine\" levels. The Kruskal-Wallis <i>H</i> and Mann-Whitney <i>U</i> tests were performed to examine an association between buprenorphine dose and the \"norbuprenorphine\" to \"creatinine\" ratio.</p><p><strong>Results: </strong>This study included 371 urine samples from 61 consecutive patients and analyzed the data in a manner similar to that described in the study by Furo et al. This study had similar findings with the following exceptions: (1) a mean buprenorphine dose of 11.0 ± 3.8 mg/day with a range of 2 to 20 mg/day; (2) exclusion of 6 urine samples with \"creatinine\" level <20 mg/dL; (3) minimum \"norbuprenorphine\" to \"creatinine\" ratios in the 8-, 12-, and 16-mg/day groups of 0.44 × 10^-4 (n = 68), 0.1 × 10^-4 (n = 133), and 1.37 × 10^-4 (n = 82), respectively; however, after removing the 2 lowest outliers, the minimum \"norbuprenorphine\" to \"creatinine\" ratio in the 12-mg/day group was 1.6 × 10^-4, similar to the findings in the previous study; and (4) a significant association between buprenorphine dose and the urine \"norbuprenorphine\" to \"creatinine\" ratios from the Kruskal-Wallis test (<i>P</i> < .01). In addition, the median \"norbuprenorphine\" to \"creatinine\" ratio had a strong association with buprenorphine dose, and this association could be formulated as: [y = 2.266 ln(<i>x</i>) + 0.8211]. In other words, the median ratios in 8-, 12-, and 16-mg/day groups were 5.53 × 10^-4, 6.45 × 10^-4, and 7.10 × 10^-4, respectively. Therefore, any of the following features should alert providers to further investigate patient treatment compliance: (1) inappropriate substance(s) in urine sample; (2) \"creatinine\" level <20 mg/dL; (3) \"buprenorphine\" to \"norbuprenorphine\" ratio >50:1; (4) buprenorphine dose >24 mg/day; or (5) \"norbuprenorphine\" to \"creatinine\" ratios <0.5 × 10<sup>-4</","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231153748"},"PeriodicalIF":2.1,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/88/10.1177_11782218231153748.PMC10014968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499456","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":"A Systematic Approach to Standardizing Drinking Outcomes From Timeline Followback Data.","authors":"Christina Marini, Nicole S Northover, Noah D Gold, Ursula K Rogers, Kelley C O'Donnell, Babak Tofighi, Stephen Ross, Michael P Bogenschutz","doi":"10.1177/11782218231157558","DOIUrl":"10.1177/11782218231157558","url":null,"abstract":"<p><strong>Objective: </strong>The timeline followback (TLFB) interview is the gold standard for the quantitative assessment of alcohol use. However, self-reported \"drinks\" can vary in alcohol content. If this variability is not accounted for, it can compromise the reliability and validity of TLFB data. To improve the precision of the TLFB data, we developed a detailed standard operating procedure (SOP) to calculate standard drinks more accurately from participant reports.</p><p><strong>Method: </strong>For the new SOP, the volume and alcohol content by volume (ABV) of distinct types of alcoholic beverages were determined based on product websites and other reliable sources. Recipes for specific cocktails were constructed based on recipes from bartending education websites. One standard drink was defined as 0.6 oz (14 g) of absolute alcohol. Standard drink totals were contrasted for the new SOP approach and the standard procedure, which generally assumed that one self-reported drink was equivalent to one standard drink.</p><p><strong>Results: </strong>Relative to the standard TLFB procedure, higher numbers of standard drinks were reported after implementing the TLFB SOP.</p><p><strong>Conclusions: </strong>Variability in procedures for conversion of self-reported alcohol consumption to standard drinks can confound the interpretation of TLFB data. The use and reporting of a detailed SOP can significantly reduce the potential for such inconsistencies. Detailed and consistent procedures for calculation of standard drinks can enhance the quality of TLFB drinking data.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231157558"},"PeriodicalIF":2.4,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/61/71/10.1177_11782218231157558.PMC10009017.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491459","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":"Psychoactive Substance Use Disorder in HIV-Infected Adolescents in Botswana: A Comparison Between the Congenitally Infected and Behaviorally Infected Adolescents.","authors":"Anthony A Olashore, Saeeda Paruk, Merrian Brooks, Bonginkosi Chiliza","doi":"10.1177/11782218231152818","DOIUrl":"10.1177/11782218231152818","url":null,"abstract":"<p><p>Substance use is a major obstacle to preventing and managing HIV among adolescents, who account for 30% of new infections in many parts of the world, including Botswana. Unfortunately, there is a paucity of data on adolescent substance use, especially in the region. Therefore, this study aimed to determine the pattern of psychoactive substance use in adolescents living with HIV (ALWHIV). It also aimed to compare and explore the pattern of substance use disorders and associated factors between congenitally infected adolescents (CIAs) and behaviorally infected adolescents (BIAs). Six hundred and thirty-four ALWHIV were interviewed using a sociodemographic questionnaire, the WHO drug questionnaire, and DSM-5 criteria for substance use disorder. The participants' mean age (SD) was 17.69 (1.6) years, with a male predominance (n = 336, 53%), and the majority (n = 411, 64.8%) were CIAs. Alcohol was the most used substance among the participants, with 15.8% admitting to its current use. The BIAs were more likely to have SUD (χ² = 17.2, <i>P</i> < .01), use more than one substance (χ² = 20.3, <i>P</i> < .01), and more likely to use all psychoactive substances except for inhalants. In the CIAs, regular participation in religious activities was negatively associated with SUD (AOR = 0.36; 95% CI: 0.17-0.77), while struggling with HIV status acceptance was positively associated with SUD (AOR = 2.54; 95% CI: 1.15-5.61) in the BIAs. This study showed a huge burden and similar pattern of substance use disorders among the ALWHIV in Botswana, as reported elsewhere. It also identified the dissimilarities between the BIAs and CIAs regarding substance-related issues and suggested the need for differentiated care.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231152818"},"PeriodicalIF":2.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/4a/10.1177_11782218231152818.PMC9974603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395929","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":"Habits and Routines of Adults in Early Recovery From Substance Use Disorder: Clinical and Research Implications From a Mixed Methodology Exploratory Study.","authors":"Robert H Kitzinger, Jennifer A Gardner, Mariann Moran, Carly Celkos, Nicole Fasano, Eric Linares, Joyce Muthee, Gabby Royzner","doi":"10.1177/11782218231153843","DOIUrl":"10.1177/11782218231153843","url":null,"abstract":"<p><p>The purpose of this exploratory, non-experimental mixed methods study was to analyze the habits and routines of adults in early recovery (>3 months) from substance use disorder (SUD). Participants (N = 14) were recruited from an intensive outpatient treatment (IOP) program for substance use disorders. Data collection consisted of a demographic survey, a researcher developed Daily Occupational Questionnaire (DOQ), and follow-up semi-structured interviews with 5 randomly selected participants. Quantitative results indicate rest as the most frequently engaged in activity on the most busy (31.0%) and least busy day (36.6%). There was no significant difference, t(13) = 0.117, P = .909, between newly established activities on the most busy and least busy day. Qualitative themes included <i>1. The most difficult time of day is often related to patterns of unused time. 2. When there is a lack of structure or unoccupied time, they return to their previously established positive supports. 3. There is a need for consistency and structure for developing anticipated/perceived routines</i>. Implications for all healthcare and clinical providers working with this population, as well as research suggestions, are outlined.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231153843"},"PeriodicalIF":2.0,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/b6/10.1177_11782218231153843.PMC9926005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10731203","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":"Revealing the Meaning of Cannabis Use as an Occupation: A Scoping Review.","authors":"Emma Guyonnet, Katherine E Stewart, Jane A Davis","doi":"10.1177/11782218221150113","DOIUrl":"10.1177/11782218221150113","url":null,"abstract":"<p><strong>Background: </strong>Occupational science and occupational therapy typically perceive occupations as promoting health and well-being. However, this perspective overlooks the many occupations that are viewed as illegal, unhealthy, or risky, such as drug use. Due to its negative association with health, drug use is perceived as not holding significance or meaning in people's lives.</p><p><strong>Objective: </strong>This study explores how individuals perceive and describe the meaning of their cannabis use in the context of their lives, from an occupational perspective.</p><p><strong>Methods: </strong>A scoping review was conducted using Levac et al.' modifications to Arksey and O'Malley's framework. To examine the peer-reviewed literature, 7 databases were searched using terms related to cannabis and meaning. Descriptive statistics were used to describe the selected studies, and reflexive thematic analysis identified cross-study themes.</p><p><strong>Results: </strong>Fourteen studies were selected. Most studies have been published since 2008, with 5 published in the last 2 years. Four themes were identified across the studies: (a) preserving life; (b) navigating the routines of everyday life; (c) understanding the self, identity, and belonging; and (d) expanding the view of the world.</p><p><strong>Conclusions: </strong>Cannabis use was revealed in this study as a support for navigating occupational routines and enhancing occupational repertoires and engagement, feelings of belonging, and collective user identities. As such, substance abuse treatment practices, including those provided by occupational therapists, should recognize the potential significance of cannabis use within people's lives. Using a harm reduction approach, occupational therapists can acknowledge the ways in which clients use cannabis to manage their daily routines, while also focusing on supporting clients to reduce the ill-effects of cannabis. As individuals become more engaged in occupations that are significant in their lives, their need for and meaning of cannabis use may change leading to a possible reduction in its use and a shift in their identity construction.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218221150113"},"PeriodicalIF":2.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/45/10.1177_11782218221150113.PMC9853873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9147159","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 Stigma of Substance Use and Addiction Among Filipino Immigrants and in the Philippines.","authors":"Rowalt Alibudbud","doi":"10.1177/11782218231166805","DOIUrl":"https://doi.org/10.1177/11782218231166805","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Substance Abuse: Research and Treatment Volume 17: 1–2 © The Author(s) 2023 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1 782218 3 166805","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231166805"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/a5/10.1177_11782218231166805.PMC10084525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304499","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":"Normative Misperceptions About Cannabis Use in a Sample of Risky Cannabis Users.","authors":"John A Cunningham,&nbsp;Christina Schell,&nbsp;Nicolas Bertholet,&nbsp;Jeffrey D Wardell,&nbsp;Lena C Quilty,&nbsp;Alexandra Godinho","doi":"10.1177/11782218231166809","DOIUrl":"https://doi.org/10.1177/11782218231166809","url":null,"abstract":"<p><strong>Introduction: </strong>This study examines normative misperceptions in a sample of participants recruited for a brief intervention trial targeting risky cannabis use.</p><p><strong>Methods: </strong>Participants who were concerned about their own risky cannabis use were recruited to help develop and evaluate intervention materials. At baseline, participants reported on their own cannabis use and provided estimates of how often others their gender and age used cannabis in the past 3 months. Comparisons were made between participants estimates of others cannabis use with reports of cannabis use obtained from a general population survey conducted during a similar time period.</p><p><strong>Results: </strong>Participants (N = 744, mean age = 35.8, 56.2% identified as female) largely reported daily or almost daily cannabis use (82.4%). Roughly half (55.3%) of participants estimated that others their age and gender used cannabis weekly or more often in the past 3 months, whereas the majority of people in the general population reported not using cannabis at all.</p><p><strong>Conclusions: </strong>Normative misperceptions about cannabis use were common in this sample of people with risky cannabis use. Limitations and possible future directions of this research are discussed, as well as the potential for targeting these misperceptions in interventions designed to motivate reductions in cannabis use.</p><p><strong>Clinicaltrialsorg number: </strong>NCT04060602.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231166809"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309676","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":"Tobacco Use in Adolescents With Disabilities: A Literature Review.","authors":"Melissa Beck Wells","doi":"10.1177/11782218231179599","DOIUrl":"https://doi.org/10.1177/11782218231179599","url":null,"abstract":"<p><p>The use of tobacco products by adolescents has greatly increased in recent years. Adolescents with disabilities have demonstrated higher instances of e-cigarette and tobacco use in relation to their peers without disabilities. Repercussions for e-cigarette and tobacco use increase negative physical and health implications and financial which ultimately will further the gap for individuals with disabilities over time. It is argued that adolescents with disabilities are more susceptible to begin using tobacco and remain using tobacco which can lead to further use of addictive substances. In this paper, the researcher explained the use of tobacco within the adolescent population, specifically for individuals with disabilities, the impact of tobacco use for individuals with disabilities, reviewed previous studies on tobacco use for adolescents with disabilities, points to the need for educational policy reform, and stated certain recommendations for mitigating tobacco use in adolescents with disabilities, which may result in positive future outcomes. The literature review indicated that the targeted interventions in schools or peer groups reduces tobacco use in adolescents with disabilities.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231179599"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/6a/10.1177_11782218231179599.PMC10326458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812006","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":"Ethical Dilemmas Facing Substance Use Counselors During the COVID-19 Pandemic.","authors":"Caravella McCuistian,&nbsp;J Konadu Fokuo,&nbsp;Jaime Dumoit Smith,&nbsp;James L Sorensen,&nbsp;Emily A Arnold","doi":"10.1177/11782218231158338","DOIUrl":"https://doi.org/10.1177/11782218231158338","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, substance use disorder (SUD) treatment settings experienced several abrupt changes, including decreased admissions, reduction in services, and modified requirements for medication for substance use disorder. While these changes were implemented to facilitate the maintenance of important treatment options, the ethical consequences of such changes remained unknown. The current study aimed to explore ethical issues related to COVID-19-related changes reported by counselors in SUD treatment facilities.</p><p><strong>Method: </strong>From May to August 2020, we conducted 60 to 90 minutes in-depth interviews with 18 front-line staff in 1 residential and 1 outpatient treatment program, exploring issues drawn from the ethical principles of the national organization representing SUD counselors. Counselors volunteered to participate via phone or email, and participation was confidential. Interviews were conducted via videoconferencing. Topics included day-to-day experiences of ethical dilemmas in the workplace, particularly during the COVID-19 era. Interviews were recorded, transcribed, and checked for accuracy and a trained team of analysts then coded transcripts using thematic analysis.</p><p><strong>Results: </strong>As a result of the COVID-19 pandemic, SUD treatment programs quickly modified procedures to adhere to public health mandates while also continuing to offer care to clients. SUD counselors reported several ways their programs adapted new and creative procedures to reduce the risk of COVID-19 transmission. SUD counselors also identified several novel ethical dilemmas that occurred during the COVID-19 pandemic, often resulting from the counselor balancing the needs for responding to public health mandates with providing services to clients. There were several ways that COVID-19 related changes resulted in therapeutic challenges for some clients, and the SUD counselors highlighted ways that changes resulted in more flexible services for other clients.</p><p><strong>Conclusions: </strong>This study highlights the quick response to COVID-19 that occurred within SUD treatment. While these changes resulted in novel ethical dilemmas, they also offered more flexible and client-centered approaches to treatment.</p>","PeriodicalId":22185,"journal":{"name":"Substance Abuse: Research and Treatment","volume":"17 ","pages":"11782218231158338"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/4e/10.1177_11782218231158338.PMC10008725.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9621682","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}