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Patient Characteristics From Norway's First Heroin-Assisted Treatment Clinics. 挪威首家海洛因辅助治疗诊所的患者特征。
Substance use & addiction journal Pub Date : 2024-09-23 DOI: 10.1177/29767342241271991
Francesca Melis, Thomas Clausen, Charlotte Castel, Omid Dadras, Silvana De Pirro, Lars Henrik Myklebust, Ann Oldervoll, Linda Elise Wüsthoff, Desiree Eide
{"title":"Patient Characteristics From Norway's First Heroin-Assisted Treatment Clinics.","authors":"Francesca Melis, Thomas Clausen, Charlotte Castel, Omid Dadras, Silvana De Pirro, Lars Henrik Myklebust, Ann Oldervoll, Linda Elise Wüsthoff, Desiree Eide","doi":"10.1177/29767342241271991","DOIUrl":"https://doi.org/10.1177/29767342241271991","url":null,"abstract":"<p><strong>Background: </strong>Heroin-assisted treatment (HAT) is an evidence-based treatment option for opioid use disorder (OUD), available in a limited number of countries. Norway implemented a 5-year HAT project in 2022, aiming to assess its effectiveness and its potential integration into the country's OUD treatment system. This study describes and compares patients' baseline characteristics from the Oslo and Bergen HAT clinics, providing a comprehensive picture of the unique population and the real-world application of HAT.</p><p><strong>Methods: </strong>This cross-sectional study examines the baseline characteristics of consenting HAT patients within the first 2 years of operation (<i>n</i> = 86). Self-reported questionnaires gathered sociodemographics, previous treatment experiences, self-reported crime, and substance use, as well as motivations and expectations for treatment. Comparisons between the clinics were carried out using <i>t</i>-tests, Mann-Whitney <i>U</i> tests, Chi-square, and Fisher's exact test.</p><p><strong>Results: </strong>The majority of the patients were enrolled at the Oslo clinic (76%) and were male (80%). At admission, the average age was 45.9, with a significantly younger group in Bergen (42.5 vs 47.3, <i>P</i> < .05). While no patients reported being unhoused, 17% noted unstable housing within the preceding month. Unemployment was prevalent (91%) alongside previous treatment experiences (95%), with a median of 2 prior medication types. In the 3 months preceding HAT initiation, 78% of patients reported being victims of crime, and 44% committed at least one crime. Over their lifetime, 2 in 5 participants (41%) had experienced an unwanted overdose and 43% had shared syringes and equipment.</p><p><strong>Conclusion: </strong>This study reveals a cohort experiencing societal marginalization, including unstable housing, unsatisfactory prior OUD treatment, high-risk behaviors, and frequent interactions with criminal activities, predominantly as victims. While the Oslo and Bergen clinics serve a similar patient profile, notable differences emerged in the reasons for discontinuing past OUD treatment and crime-related factors.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305691","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}
引用次数: 0
Using Planned and Unplanned Adaptation to Implement Universal Alcohol Screening and Brief Intervention to Prevent Alcohol-Exposed Pregnancies in Four Primary Care Health Systems. 利用计划内和计划外的调整,在四个初级医疗保健系统中实施普遍酒精筛查和简短干预,以预防暴露于酒精的妊娠。
Substance use & addiction journal Pub Date : 2024-09-20 DOI: 10.1177/29767342241271404
Diane K King, Steven J Ondersma, Bonnie G McRee, Jacqueline S German, Amy M Loree, Amy Harlowe, Daniel P Alford, Robyn N M Sedotto, Mary Kate Weber
{"title":"Using Planned and Unplanned Adaptation to Implement Universal Alcohol Screening and Brief Intervention to Prevent Alcohol-Exposed Pregnancies in Four Primary Care Health Systems.","authors":"Diane K King, Steven J Ondersma, Bonnie G McRee, Jacqueline S German, Amy M Loree, Amy Harlowe, Daniel P Alford, Robyn N M Sedotto, Mary Kate Weber","doi":"10.1177/29767342241271404","DOIUrl":"https://doi.org/10.1177/29767342241271404","url":null,"abstract":"<p><strong>Background: </strong>The United States Preventive Services Task Force recommends annual alcohol screening and brief behavioral intervention (alcohol SBI) with general adult and pregnant populations. Implementation of alcohol SBI in primary care has encountered numerous barriers to adapting procedures and infrastructure to support its routine delivery. This collection of case studies describes the implementation strategies used by 4 academic health system teams that were funded by the Centers for Disease Control and Prevention to implement alcohol SBI within healthcare systems to prevent alcohol-exposed pregnancies.</p><p><strong>Methods: </strong>We used constructs from the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to describe planned and unplanned adaptations to implementation strategies, and the SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix to identify key questions, challenges, and recommendations for improving alcohol SBI implementation. Participating systems were 2 regional affiliates of a national reproductive healthcare organization, an integrated non-profit healthcare system, and an urban medical center and its affiliated network of community health centers.</p><p><strong>Results: </strong>Planned adaptations included expanding the target population for brief interventions to include patients drinking at low levels who could become pregnant, modifying workflows and systems to support routine screening, and customizing training content and logistics. Unplanned adaptations included varying site recruitment and pre-implementation awareness-building strategies to enhance local receptivity of systems with decentralized management, and pivoting from in-person to virtual training during the COVID-19 pandemic. Fewer unplanned adaptations were observed for health systems with centralized management structures and practice teams that were fully engaged in implementation planning, training, roll-out, and problem-solving.</p><p><strong>Conclusions: </strong>Unplanned adaptations were observed across the 4 cases and emphasized the importance of flexible, adaptive designs when implementing evidence-based practice in dynamic settings. Participation of the health system in planning, including decisions to modify electronic health records and workflows, supported adapting to unplanned circumstances to achieve implementation goals.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305692","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}
引用次数: 0
Adverse Events at 1 Month Following Medication Initiation for Opioid Use Disorder Among Adolescents and Young Adults. 青少年和年轻成年人阿片类药物使用障碍用药 1 个月后的不良事件。
Substance use & addiction journal Pub Date : 2024-09-19 DOI: 10.1177/29767342241275738
Mishka Terplan, Kevin E O'Grady, Laura B Monico, Robert P Schwartz, Jan Gryczynski, Marc J Fishman, Shannon Gwin Mitchell
{"title":"Adverse Events at 1 Month Following Medication Initiation for Opioid Use Disorder Among Adolescents and Young Adults.","authors":"Mishka Terplan, Kevin E O'Grady, Laura B Monico, Robert P Schwartz, Jan Gryczynski, Marc J Fishman, Shannon Gwin Mitchell","doi":"10.1177/29767342241275738","DOIUrl":"https://doi.org/10.1177/29767342241275738","url":null,"abstract":"<p><strong>Background: </strong>We assess adverse events (AEs) following medication initiation for adolescents and young adults with opioid use disorder (OUD).</p><p><strong>Methods: </strong>This is a secondary analysis of a clinical trial of long-acting injectable naltrexone (LAI-naltrexone) among youth with OUD aged 15 to 21 years. Participants were recruited from residential treatment and placed into 1 of 3 treatment groups based on medication receipt at time of discharge (no medication, sublingual buprenorphine-naloxone [buprenorphine], or LAI-naltrexone). Frequencies and percentages of AEs by body system were compared by medication group at the 1-month follow-up visit. Logistic regression was used to compare groups on their likelihood of reporting an AE, overall and excluding injection site reactions.</p><p><strong>Results: </strong>Of 199 participants, 71 (36%) received no medication, 59 (30%) buprenorphine, and 69 (35%) LAI-naltrexone at discharge. Participants who received LAI-naltrexone experienced more AEs, primarily due to injection site reactions (62%, accounting for 43% of all AEs among participants who received LAI-naltrexone). There were 6 reports of nonlethal overdose, 5 in the no medication, 1 in the buprenorphine, and none in the LAI-naltrexone group. Participants receiving LAI-naltrexone were more likely to report an AE compared to the other groups (<i>P</i> = .04), but this difference was no longer significant when excluding injection site reactions (<i>P</i> = .82).</p><p><strong>Conclusions: </strong>Excluding injection site reactions, there were no significant differences in the likelihood of reporting an AE 1 month after receiving LAI-NTX, buprenorphine, and no medications. LAI-naltrexone should be among the medications offered for the treatment of OUD in youth.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305687","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}
引用次数: 0
National Addiction Workshop: A Virtual Adaptation to Support Competency Development in Opioid Use Disorder Management. 国家成瘾问题研讨会:支持阿片类药物使用障碍管理能力发展的虚拟改编。
Substance use & addiction journal Pub Date : 2024-09-19 DOI: 10.1177/29767342241273423
Gabriela Garcia-Vassallo, Noel B Quinn, Brent A Moore, Sara Chaudhry, David T Moore, Sarah T Sorenson, Shawn Braddock, Ellen L Edens
{"title":"National Addiction Workshop: A Virtual Adaptation to Support Competency Development in Opioid Use Disorder Management.","authors":"Gabriela Garcia-Vassallo, Noel B Quinn, Brent A Moore, Sara Chaudhry, David T Moore, Sarah T Sorenson, Shawn Braddock, Ellen L Edens","doi":"10.1177/29767342241273423","DOIUrl":"https://doi.org/10.1177/29767342241273423","url":null,"abstract":"<p><strong>Background: </strong>Accessible, manualized, skill-based training ready for wide dissemination is needed to prepare healthcare staff to meet the needs of people impacted by the opioid epidemic.</p><p><strong>Methods: </strong>A 2-day workshop and simulation training was designed by an interprofessional substance use disorder (SUD) specialty care team, adapted to a virtual platform, manualized, and offered to healthcare staff and trainees from a large healthcare system. The workshop was offered 6 times over the course of 10 months with a total of 177 participants from across the United States enrolled in the training. Interactive experiential learning strategies including games designed to test knowledge, small-group case discussions, video demonstrations of skills, patient panels, and 3 simulations of a patient with chronic pain who developed opioid use disorder in the context of long-term opioid therapy were utilized in efforts to build skills and confidence managing SUDs in primary care and general mental health settings.</p><p><strong>Results: </strong>Of those who completed the post-workshop survey, most found both content and training structure useful, particularly content related to medication management, stigma, and collaborative care. In addition, overall confidence scores in assessing, diagnosing, and treating SUD increased. Skill building exercises, such as interprofessional team simulations, were highlighted as most beneficial. The workshop received national attention leading to a partnership with the healthcare system's simulation center for wider dissemination.</p><p><strong>Conclusion: </strong>Expanding access to SUD treatment requires training healthcare staff to effectively change attitudes, increase knowledge, and improve key skills. This 2-day interprofessional workshop was well-received by participants who reported high acceptability and satisfaction scores and demonstrated improved confidence in the management of SUDs. This type of manualized, collaborative, skill-based learning experience can foster staff preparedness and willingness to conceptualize SUD as a chronic condition amenable to treatment in different healthcare settings.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305690","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}
引用次数: 0
Multi-Level Approaches to Fetal Alcohol Spectrum Disorders Prevention Education and Training for Health Professionals. 胎儿酒精中毒综合症预防教育和卫生专业人员培训的多层次方法。
Substance use & addiction journal Pub Date : 2024-09-16 DOI: 10.1177/29767342241273397
Faith Ozer Green, Amy K Harlowe, Alexandra Edwards, Daniel P Alford, Hetal Choxi, Jacqueline S German, Diana Ling, Iwona Pawlukiewicz, Reshana Peterson, Kirk von Sternberg, Mary M Velasquez
{"title":"Multi-Level Approaches to Fetal Alcohol Spectrum Disorders Prevention Education and Training for Health Professionals.","authors":"Faith Ozer Green, Amy K Harlowe, Alexandra Edwards, Daniel P Alford, Hetal Choxi, Jacqueline S German, Diana Ling, Iwona Pawlukiewicz, Reshana Peterson, Kirk von Sternberg, Mary M Velasquez","doi":"10.1177/29767342241273397","DOIUrl":"https://doi.org/10.1177/29767342241273397","url":null,"abstract":"<p><strong>Background: </strong>Alcohol-exposed pregnancies, which can lead to fetal alcohol spectrum disorders (FASDs), is one of the most common preventable causes of lifelong intellectual and developmental disabilities in the U.S. Healthcare teams can play a critical role in preventing FASDs; however, they are currently unprepared to do so. Training can remediate this problem. This article explores the different approaches to the education and training of healthcare providers around FASD prevention used by six Centers for Disease Control (CDC)-funded programs, and how they have been adapted to (1) the specific needs of the healthcare professionals and/or the clinical setting and (2) the challenges posed by the COVID-19 pandemic.</p><p><strong>Methods: </strong>This article offers an in-depth description and comparison of the models utilized by the programs described, detailing the challenges of each model as well as the adaptations made. Interdisciplinary collaboration and review highlights these models and offers a variety of solutions and lessons learned that can be implemented in similar practice settings and/or educational initiatives.</p><p><strong>Results: </strong>Based on organizational structure (i.e., national organization, educational institution, and clinical settings) and program purpose, different methods were employed for FASD education. Some programs were focused on FASD prevention through staff training and alcohol screening and brief intervention/clinical intervention and others were focused on broadscale professional education and awareness. Improvements were made on an ongoing basis as challenges related to COVID-19, staff shortages, and patient and clinician discomfort were identified, resulting in modifications to content and delivery modality (e.g., online forums and use of social media).</p><p><strong>Conclusion: </strong>FASD prevention education is wrought with a variety of challenges related to stigma, discomfort, and misinformation, which these programs encountered in a variety of ways.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305689","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}
引用次数: 0
Driving Under the Influence of Alcohol and Cannabis by Sexual Identity, Race, Ethnicity, and Gender: A Nationwide Analysis Using the 2016 to 2019 National Survey on Drug Use and Health. 按性别身份、种族、民族和性别分列的在酒精和大麻影响下驾车情况:利用 2016 至 2019 年全国毒品使用和健康调查进行的全国性分析》。
Substance use & addiction journal Pub Date : 2024-09-16 DOI: 10.1177/29767342241273419
Raymond L Moody, Sarah Gutkind, Priscila D Gonçalves, Morgan Philbin, Dustin T Duncan, Silvia S Martins
{"title":"Driving Under the Influence of Alcohol and Cannabis by Sexual Identity, Race, Ethnicity, and Gender: A Nationwide Analysis Using the 2016 to 2019 National Survey on Drug Use and Health.","authors":"Raymond L Moody, Sarah Gutkind, Priscila D Gonçalves, Morgan Philbin, Dustin T Duncan, Silvia S Martins","doi":"10.1177/29767342241273419","DOIUrl":"https://doi.org/10.1177/29767342241273419","url":null,"abstract":"<p><strong>Background: </strong>Sexual minority populations experience higher rates of substance use and related problems, but little is known about their specific involvement in driving under the influence (DUI) of alcohol (DUIA) and cannabis (DUIC) incidents.</p><p><strong>Methods: </strong>Using data from the 2016 to 2019 National Survey on Drug Use and Health, we used logistic regression models to estimate the interactive effects of sexual identity, race/ethnicity, and gender on past-year DUIA among adults who used alcohol and DUIC among adults who used cannabis, accounting for covariates. Using model estimates and linear combinations, we calculated the predicted probabilities of each outcome and compared sexual identity differences within and across race/ethnicity and gender.</p><p><strong>Results: </strong>With few exceptions, the predicted probabilities of DUIA and DUIC were significantly higher among sexual minority women than heterosexual women of similar race/ethnicity. The results were more variable among men with the probabilities of DUIA and DUIC being significantly higher for some groups of sexual minority men and some groups having probabilities equal to or lower than similar heterosexual men. Some of the largest sexual minority gaps in DUIA and DUIC were observed among Hispanic and Other lesbian women and Black gay men.</p><p><strong>Conclusions: </strong>Sexual minority individuals are more likely to report DUI than their heterosexual counterparts; however, the risk of DUI among sexual minority populations varies by racial/ethnic and gender subgroup. Our findings indicate the importance of applying an intersectional framework when addressing substance-use-related disparities and when designing effective DUI prevention interventions for sexual minority populations.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305688","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}
引用次数: 0
Facilitators and Barriers to Implementing HIV Testing and Pre-Exposure Prophylaxis in Substance Use Treatment Programs: Perspectives of Non-medical Staff. 在药物使用治疗项目中实施 HIV 检测和暴露前预防的促进因素和障碍:非医务人员的观点。
Substance use & addiction journal Pub Date : 2024-09-05 DOI: 10.1177/29767342241274077
Maria Christina Herrera, Anjali Mahajan, Stephen Bonett, Shoshana Aronowitz, Jose Bauermeister, Daniel Teixeira da Silva
{"title":"Facilitators and Barriers to Implementing HIV Testing and Pre-Exposure Prophylaxis in Substance Use Treatment Programs: Perspectives of Non-medical Staff.","authors":"Maria Christina Herrera, Anjali Mahajan, Stephen Bonett, Shoshana Aronowitz, Jose Bauermeister, Daniel Teixeira da Silva","doi":"10.1177/29767342241274077","DOIUrl":"https://doi.org/10.1177/29767342241274077","url":null,"abstract":"<p><strong>Background: </strong>People with substance use disorder (SUD) are at increased risk of HIV infection. HIV testing and pre-exposure prophylaxis (PrEP) are evidence-based practices to prevent HIV infection, yet these approaches are not regularly provided in SUD treatment programs. To address this evidence-to-practice gap, this study aimed to identify facilitators and barriers to implementing PrEP services in SUD treatment programs from the perspective of non-medical staff and administrators.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted from February to June 2022 with non-medical staff (N = 10) and administrators (N = 11) from 3 academic and 8 community-based SUD treatment programs in Philadelphia. Interview guides were developed using the Consolidated Framework for Implementation Research (CFIR). Qualitative descriptive techniques were used to examine interview data and identify key facilitators and barriers, which were grouped within CFIR domains and constructs.</p><p><strong>Results: </strong>Of the 11 SUD treatment programs, 5 provided PrEP services. Most interviewees at programs without PrEP services reported high levels of receptivity to implementing PrEP and identified leadership engagement as a key determinant, but several lacked comfort with PrEP counseling. Inner setting facilitators included compatibility with workflows (eg, intake assessments), alignment with cultures of holistic care, and programs' longstanding community trust. Inner setting barriers included limited time to discuss PrEP, insufficient resources and staff (eg, phlebotomy), perception of clients' HIV risk, and lower prioritization of HIV prevention versus other services. Intervention facilitators included robust evidence and addressing costs through grants and drug pricing programs, and barriers included the time needed to initiate PrEP, loss to follow-up, and HIV stigma.</p><p><strong>Conclusions: </strong>Successful implementation of HIV testing and PrEP in SUD treatment programs requires addressing multi-level barriers. Including perspectives of non-medical staff and administrators is important for implementation. Potential strategies include supporting organizational networks, leveraging peer specialists' expertise, and packaging PrEP to better meet client priorities and needs.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134994","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}
引用次数: 0
Racial Differences in Medications for Opioid Use Disorder Initiation in a Carceral Setting. 在囚禁环境中,阿片类药物使用障碍的初始用药种族差异。
Substance use & addiction journal Pub Date : 2024-09-02 DOI: 10.1177/29767342241273417
Justin Berk, Jessica Brar, Ariel Hoadley, Rosemarie Martin
{"title":"Racial Differences in Medications for Opioid Use Disorder Initiation in a Carceral Setting.","authors":"Justin Berk, Jessica Brar, Ariel Hoadley, Rosemarie Martin","doi":"10.1177/29767342241273417","DOIUrl":"https://doi.org/10.1177/29767342241273417","url":null,"abstract":"<p><strong>Background: </strong>The opioid overdose crisis significantly affects marginalized communities, with people of color experiencing higher rates of overdose and barriers to treatment. The syndemic of opioid use disorder and mass incarceration exacerbates racial health disparities. Some carceral facilities offer medication for addiction treatment, though no significant research explores differences in type of treatment uptake by race in these settings. This study focuses on the racial differences in medications for opioid use disorder (MOUD) preferences among incarcerated individuals.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at the Rhode Island Department of Corrections (RIDOC), examining MOUD-type preferences (buprenorphine or methadone) among incarcerated individuals. The study utilized RIDOC electronic medical records from January 1, 2017 to December 31, 2022, involving 3533 unique incarceration events. Participants were categorized by race (White vs non-White) and MOUD status (new initiation vs community continuation), with logistic regression models.</p><p><strong>Results: </strong>The study found no direct racial disparity in preferences for MOUD type. However, an interaction between race and MOUD initiation status significantly influenced MOUD-type preference. Among those initiating MOUD during incarceration, non-White individuals were more likely to choose buprenorphine compared to their White counterparts.</p><p><strong>Conclusions: </strong>This research provides new insights into the intersection of race, incarceration, and MOUD preferences. While direct racial disparities in MOUD type were not observed, the analysis uncovered a notable interaction effect: race influences the relationship between MOUD initiation status and the selected MOUD treatment during incarceration. Specifically, data demonstrate that the likelihood of choosing buprenorphine varies significantly based on both racial background and whether the treatment was initiated during incarceration or in the community. Further research is needed in different geographic settings to understand the broader implications to help guide equitable healthcare delivery in jails and prisons.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116770","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}
引用次数: 0
In Support of the Decriminalization of Personal Drug and Paraphernalia Use and Possession: Position Statement of AMERSA, Inc (Association for Multidisciplinary Education, Research, Substance Use and Addiction). 支持个人使用和持有毒品及用具非刑罪化:AMERSA 公司(多学科教育、研究、物质使用和成瘾协会)的立场声明。
Substance use & addiction journal Pub Date : 2024-08-31 DOI: 10.1177/29767342241277619
Katherine Hill, Katherine Dunham, Kristin Doneski, Kimberly L Sue, Kinna Thakarar, Jenna Butner
{"title":"In Support of the Decriminalization of Personal Drug and Paraphernalia Use and Possession: Position Statement of AMERSA, Inc (Association for Multidisciplinary Education, Research, Substance Use and Addiction).","authors":"Katherine Hill, Katherine Dunham, Kristin Doneski, Kimberly L Sue, Kinna Thakarar, Jenna Butner","doi":"10.1177/29767342241277619","DOIUrl":"https://doi.org/10.1177/29767342241277619","url":null,"abstract":"<p><p>More than 25% of all arrests made nationwide are related to drug offenses, affecting almost 1.2 million people and their social networks. Furthermore, roughly 20% of people in jails and prisons across the United States are incarcerated for a drug offense and millions more are under community supervision for these charges. This criminalization of drug use has negatively affected the health and well-being of people who use drugs (PWUD) and their communities. Decriminalization-a process of removing criminal sanctions for a previously criminalized behavior-of drug use is central to harm reduction as it mitigates these negative consequences of drug use and supports the health of PWUD. As such, AMERSA supports the decriminalization of drug and paraphernalia possession for personal use for all currently illicit drugs and all associated equipment. AMERSA continues to strongly advocate for the funding of harm reduction strategies and addiction services to improve the health and well-being of PWUD since decriminalization without complementary funding for harm reduction services, addiction treatment services, and social safety nets will be incomplete.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116769","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}
引用次数: 0
Answering a Call to Action: Reducing Fetal Alcohol Spectrum Disorders Using a Healthcare Champion Model. 响应行动号召:利用医疗保健冠军模式减少胎儿酒精紊乱。
Substance use & addiction journal Pub Date : 2024-08-23 DOI: 10.1177/29767342241271361
Courtney Townsel, Vincent C Smith, Hemalatha Senthilkumar, Lily R Bastian, Miranks Sanks, Diana Ling, Joshua Benke, Alexandra Edwards, Nancy Roget, Kimberly Prokosch, Mary M Velasquez, Kimi Yonamine, Kirk von Sternberg, Tonya McFadden, Antoinette Abou Haidar, Karen E Harris
{"title":"Answering a Call to Action: Reducing Fetal Alcohol Spectrum Disorders Using a Healthcare Champion Model.","authors":"Courtney Townsel, Vincent C Smith, Hemalatha Senthilkumar, Lily R Bastian, Miranks Sanks, Diana Ling, Joshua Benke, Alexandra Edwards, Nancy Roget, Kimberly Prokosch, Mary M Velasquez, Kimi Yonamine, Kirk von Sternberg, Tonya McFadden, Antoinette Abou Haidar, Karen E Harris","doi":"10.1177/29767342241271361","DOIUrl":"https://doi.org/10.1177/29767342241271361","url":null,"abstract":"<p><p>Prenatal alcohol exposure and fetal alcohol spectrum disorders (FASDs) remain critical public health issues. Alcohol use in pregnancy is a leading preventable cause of birth defects, developmental disabilities, and learning disabilities. Alcohol screening and brief intervention (SBI) is effective at reducing excessive alcohol use. However, this clinical preventive service remains critically underutilized in primary care. In 2014, the Centers for Disease Control and Prevention called for the creation of FASD Champion programs to promote clinician education about FASDs. Six professional health organizations and groups providing reproductive and child health services set out to create FASD Champion programs. The American College of Obstetricians and Gynecologists FASDs Prevention Program was created to focus on reducing alcohol-exposed pregnancies. The American Academy of Pediatrics' Champion program maintains the goal of improving health outcomes for children with FASDs by improving pediatricians' diagnostic capacity. The American Academy of Family Physicians has prioritized training family physician champions to improve the delivery of alcohol SBI among adult patients. The University of Alaska Anchorage has partnered with the National Association of Nurse Practitioners in Women's Health, the American College of Nurse-Midwives, and the Association of Women's Health, Obstetric, and Neonatal Nurses to assure advanced practice registered nurses and midwives have the knowledge and skills to prevent alcohol-exposed pregnancies and FASDs. The American Association of Medical Assistants has prioritized expanding the knowledge and skills of medical assistants related to promoting alcohol-free pregnancies. Finally, the Champions program at the University of Texas at Austin was established to train health social workers in alcohol SBI. Through the advocacy, education, and mission of these 6 health sectors in collaboration with national organizations and educational institutions, the evidence-based approach of alcohol SBI is being disseminated throughout the United States to reduce the harmful effects of prenatal alcohol exposure.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038685","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}
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