Substance use & addiction journal最新文献

{"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":"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":" ","pages":"421-429"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","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}

{"title":"Practice Changes 6 Months Following a Physical Therapist Training Program Regarding Opioid Use and Misuse Screening and Assessment: A Qualitative Study.","authors":"John Magel, Elizabeth Siantz, Priscilla Blosser, Julie M Fritz, Paul Hartman, Jason M Beneciuk, Adam J Gordon","doi":"10.1177/29767342241292259","DOIUrl":"10.1177/29767342241292259","url":null,"abstract":"<p><strong>Background: </strong>The U.S. Preventive Services Task Force recommends that all healthcare providers be trained to screen for misuse and/or opioid use disorder. An opioid misuse training program for physical therapists was developed and implemented. The purposes of this research were to (1) understand whether the participants found the training useful, (2) understand if they instituted practice changes that resulted from the training, and (3) understand barriers to implementing the skills learned in the training.</p><p><strong>Methods: </strong>Four separate 30-minute virtual training sessions were provided (1 session every 2 weeks). The topics included an introduction to the opioid crisis, screening, assessing, and communicating with patients and with the healthcare team about opioid misuse. A final training manual was distributed after the final training session at which time participants were asked to implement what they learned in the training. Semi-structured interviews were conducted with all training program participants (n = 13) approximately 6 months after the final training session. Rapid content analysis was used to understand the perceptions of and barriers to implementing what the physical therapists learned in the training.</p><p><strong>Results: </strong>Generally, the participants found the training important and useful and strengthened their perceptions of physical therapists' role in screening for opioid misuse. Compared to the opioid misuse-related content of the training, most found it easier to implement general opioid-related content such as asking whether their patients were taking an opioid. Few participants screened any of their patients for opioid misuse. Barriers to implementation included concerns about how the patient might respond to being asked about their opioid use.</p><p><strong>Conclusion: </strong>These findings provide insight into physical therapists' perceptions of an opioid misuse training program and the challenges with implementing what they learned in the program. Future training could incorporate activities such as role-playing to improve participants' comfort with screening for opioid misuse.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"337-346"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635731","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":"Impact of a Web-Based Curriculum on Internal Medicine Resident Use of Stigmatizing Language for Substance Use Disorder.","authors":"Diana Samberg, Sara Spinella, Scott Rothenberger, Jeanette M Tetrault, Julie Childers","doi":"10.1177/29767342241298057","DOIUrl":"10.1177/29767342241298057","url":null,"abstract":"<p><strong>Background: </strong>Addiction is a chronic, treatable disorder, yet it carries considerable stigma. Stigmatizing language biases how clinicians view patients with substance use disorders (SUDs) and negatively affects patient care. While national medical organizations have recommended educational initiatives to reduce the stigma associated with SUDs, studies of initiatives are lacking. We aimed to improve documentation of SUDs and reduce measured stigma by teaching standardized, non-stigmatizing language.</p><p><strong>Methods: </strong>We created an online, 25-minute interactive curriculum about vocabulary for addiction and why language matters. Before and 8 weeks after completing the curriculum, internal medicine residents viewed a video encounter between a physician and a \"challenging\" simulated patient with opioid use disorder, then completed a case write-up and a SUD stigma survey. We analyzed the frequency of usage of stigmatizing terms and quantified participants' stigma levels.</p><p><strong>Results: </strong>During the fall of 2020, UPMC Internal Medicine residents completed the curriculum. In all, 98 participants (out of ~150) completed the pre-curriculum assessment, and 39 completed the entire course. In pre-curriculum write-ups, stigmatizing terminology was used 4 times more often than clinical terminology (30 terms per 100 write-ups versus 7.6, <i>P</i> = .032). Clinical terminology was used 134% more often post-curriculum than pre-curriculum (24 terms per 100 write-ups vs 7.6), but this result was not significant. There was no difference between measured stigma levels pre- and post-curriculum. In total, 34/45 (75.6%) participants who completed the post-curriculum survey said that they learned new information, and 32/45 (71.1%) would recommend it to others.</p><p><strong>Conclusions: </strong>There were trends toward improvement in language, including decreased use of stigmatizing terminology and increased usage of clinical terminology, though not statistically significant. The curriculum was well-received, but the study was limited in participation by the COVID-19 pandemic. However, the simple design of the curriculum-a short, web-based module-allows for easy delivery to workers across the healthcare sector.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"313-319"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848806","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":"A Hospital-Based Intervention to Improve Access to Buprenorphine for Patients with Opioid Use Disorder.","authors":"Matthew Fine, Leeza Hirt Wilner, Cameron K Ormiston, Linda Wang, Trevor G Lee, Michael Herscher","doi":"10.1177/29767342241292416","DOIUrl":"10.1177/29767342241292416","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) is often under-addressed in hospitalized patients. In the absence of formal addiction consult services, volunteer physician-led models can increase access to inpatient OUD treatment. This paper describes a novel, volunteer physician-led interprofessional approach to identifying patients with OUD, initiating buprenorphine, and linking to office-based opioid treatment.</p><p><strong>Methods: </strong>The intervention took place from April 2018 to August 2020 at a large, urban, tertiary care center and teaching hospital in New York, NY that does not have an addiction consult service. Hospitalized patients with OUD were identified by provider-driven referrals or an automated daily patient list generated by a bioinformatics search algorithm. Eligible patients with OUD were started on buprenorphine during their hospitalization and linked to primary care-based buprenorphine treatment. Patients were followed longitudinally via chart review to assess follow-up clinic rates at >30 days, >60 days, >90 days, >6 months, >12 months, and >24 months after discharge.</p><p><strong>Results: </strong>Over a 2-year period, 178 patients were evaluated, 88 were eligible for inpatient buprenorphine, and 47 were started on buprenorphine while hospitalized. Sixty-seven patients were referred to a post-discharge visit at a primary care practice, 29 (43%) of whom attended an appointment at least 30 days after discharge. Of these, 22 (76%) returned at >60 days and 20 (69%) at 6 months. At the 1-year time point, 16 of a possible 17 patients (94%) and 15 of a possible 16 patients (94%) were still engaged in care at 2 years.</p><p><strong>Conclusion: </strong>This intervention represents a proof of principle, adaptable model for identifying patients with OUD and engaging patients in primary care-based buprenorphine treatment. Limitations to consider include the sustainability of a volunteer-based initiative and that retention rates for 1 to 2 years post-discharge may be more indicative of the strengths of office-based opioid treatment itself as opposed to in-hospital engagement and the intervention.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"377-383"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650109","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":"One Third of Alcohol Use Disorder Diagnoses are Missed by ICD Coding.","authors":"Laura Mercurio, Augusto Garcia, Stephanie Ruest, Susan J Duffy, Carsten Eickhoff","doi":"10.1177/29767342241288112","DOIUrl":"10.1177/29767342241288112","url":null,"abstract":"<p><strong>Background/significance: </strong>Alcohol use carries significant morbidity and mortality, yet accurate identification of alcohol use disorder (AUD) remains a multi-layered problem for both researchers and clinicians.</p><p><strong>Objective: </strong>To fine-tune a language model to AUD in the clinical narrative and to detect AUDs not accounted for by ICD-9 coding in the MIMIC-III database.</p><p><strong>Materials and methods: </strong>We applied clinicalBERT to unique patient discharge summaries. For classification, patients were divided into nonoverlapping groups stratified by the presence/absence of AUD ICD diagnosis for model training (80%), validation (10%), and testing (10%). For detection, the model was trained (80%) and validated (20%) on 1:1 positive/negative patients, then applied to remaining negative patient population. Physicians adjudicated 600 samples from the full model confidence spectrum to confirm AUD by Diagnostic and Statistical Manual of Mental Disorders-V criteria.</p><p><strong>Results: </strong>The model exhibited the following characteristics (mean, standard deviation): precision (0.9, 0.02), recall (0.65, 0.03), F-1 (0.75, 0.02), area under the receiver operating curve (0.97, 0.01), and area under the precision-recall curve (0.86, 0.01). Adjudication produced an estimated 4% under-documentation rate for the total study population. As model confidence increased, AUD under-documentation rate rose to 30% of the number of patients identified as positive by ICD-9 coding.</p><p><strong>Conclusion: </strong>Our model improves the identification of patients meeting AUD criteria, outperforming ICD codes in detecting cases of AUD. Detection discrepancy between ICD and free-text highlights clinician <i>under documentation</i>, not under recognition. Adjudication revealed model over-sensitivity to language around substance use, withdrawal, and chronic liver disease; future study requires application to a broader set of patient age and acuity. This model has the potential to improve rapid identification of patients with AUD and enhance treatment allocation.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"328-336"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607931","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":"Mandated Substance Use Disorder Treatment in Qatar: An Innovative Model of Care.","authors":"Majid Alabdulla, Shuja Mohd Reagu, Nirvana Chandrappa, Zeeshan Sheikh, Ahmad Alater, Suhair Yousuf, Nimesh Samarasinghe","doi":"10.1177/29767342241288433","DOIUrl":"10.1177/29767342241288433","url":null,"abstract":"<p><strong>Background: </strong>Qatar has struggled with substance use disorders among its population. Qatar has maintained a relative political and social stability, which has informed a dramatic restructuring of its health and social care services with emphasis on being led by international best practice and primacy of patient rights. However, the rehabilitative model for substance use, which Qatar has placed emphasis on so far, has been based upon voluntary engagement of people who use substances. This has led to lack of provision of care to a significant proportion of patients with substance use disorders in addition to system-wide disagreements around models of care.</p><p><strong>Methods: </strong>This study employed a retrospective patient record review of 163 patients admitted to the Umm Slal Treatment and Rehabilitation Center between January 2022 and October 2023. The data were systematically analyzed to evaluate the effectiveness of the innovative Recovery Journey model.</p><p><strong>Results: </strong>The majority of patients (61.3%) were aged 20 to 29, with 54% unemployed or students. Methamphetamine (77.3%) and cannabis (76.1%) were the most commonly used substances. Notable comorbidities included drug-induced psychosis (29.4%) and depression (19.5%). Most patients (90%) had previous treatment encounters. The Recovery Journey model, consisting court-mandated detoxification and stabilization, residential rehabilitation, and community-based continuing care, facilitated treatment completion for 91 out of 149 patients advancing from detoxification to rehabilitation. Challenges included managing complex co-occurring disorders and aligning multidisciplinary team working efforts.</p><p><strong>Conclusion: </strong>The innovative Recovery Journey model at the Umm Slal Treatment and Rehabilitation Center demonstrated promising results in treating individuals with substance use disorders. While initial outcomes are encouraging, challenges related to stakeholder engagement, treatment adherence, and post-discharge care remain. This model emphasizes the importance of balancing directed care with patient autonomy and may serve as a framework for similar initiatives in the region. Further research into and adaptation of cultural contexts are essential for optimizing treatment outcomes.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"405-412"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684039","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":"Pointing Fingers: Who US Adults Blame for the Opioid Overdose Epidemic.","authors":"Yoonsang Kim, Alex Kresovich, Kai MacLean, Phoebe Lamuda, Marie Ngobo-Ekamby, Cedasia McQueen, John Schneider, Harold A Pollack, Bruce G Taylor","doi":"10.1177/29767342241262556","DOIUrl":"10.1177/29767342241262556","url":null,"abstract":"<p><strong>Background: </strong>Over 3 million Americans have an opioid use disorder (OUD), and only a fraction receive treatment. Public opinion is crucial in enacting evidence-based policies. Few studies have examined the public's perception of blame for the ongoing opioid overdose epidemic directed at distinct groups. We assessed US adults' perceived blameworthiness for the epidemic and examined factors that may influence the perceived blameworthiness.</p><p><strong>Methods: </strong>We conducted a national survey in 2022 using the AmeriSpeak® panel to assess US adults' perception of blame toward individuals with an OUD and external contributors. Of the 3335 eligible panel members invited to participate, 1233 (37%) completed the survey. We developed a measure of knowledge and understanding of OUD, with a higher value indicating a greater understanding of the nature of OUD and recovery-including knowledge and beliefs on evidence-based treatment and relapse. We analyzed the relationships between sources of blame, knowledge, and understanding of OUD, and individual-level correlates.</p><p><strong>Results: </strong>Higher score of knowledge and understanding of OUD was associated with lower odds of blaming individuals with OUD (odds ratio [OR] = 0.73, 95% confidence interval [CI] = [0.51, 1.05]) and greater odds of blaming external contributors: healthcare providers (OR = 1.49, 95% CI = [1.05, 2.12]), pharmaceutical companies (OR = 2.17, 95% CI = [1.50, 3.15]), and health insurance companies (OR = 1.42, 95% CI = [0.97, 2.09]). Those who are female, non-Hispanic White, Democrat, have higher education, or have friends or family who misused opioids tended to score higher in knowledge and understanding of OUD.</p><p><strong>Conclusions: </strong>Perceived blameworthiness for the opioid overdose epidemic is related to knowledge and understanding of OUD. Public health campaigns with a bipartisan agenda to increase evidence-informed knowledge about OUD targeting people of color and with lower education may help reduce the blame toward people with an OUD, which in turn may increase support for evidence-informed policies.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"220-230"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794491","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":"Naloxone Distribution Models in the United States: A Scoping Review.","authors":"Nina Vadiei, David R Axon, Becka Eckert","doi":"10.1177/29767342241289008","DOIUrl":"10.1177/29767342241289008","url":null,"abstract":"<p><strong>Background: </strong>Increasing naloxone distribution is a high priority means to mitigating opioid overdose rates in the United States. Since a variety of naloxone distribution models exist, with differences in infrastructure and funding between states and health-systems, it is important to review their differences and understand the strengths and barriers to widespread implementation of each model.</p><p><strong>Methods: </strong>The following 4 databases were searched for articles reporting on naloxone distribution models: (1) PubMed/Medline (National Library of Medicine), (2) Embase (Elsevier), (3) Scopus (Elsevier), and (4) the Cochrane library. Reports from all years written in English that discussed naloxone distribution models in the United States were included, as were all study designs.</p><p><strong>Results: </strong>Of 5825 articles initially identified, 173 were selected for full text review. Of these, 49 met full criteria and were included for data extraction and analysis. Most distribution models occurred in community-based opioid education and naloxone distribution programs and in community pharmacies via a standing order/statewide protocol. Most programs reported strengths related to feasibility, but frequently reported cost as a limitation. Fewer studies described distribution models in ambulatory care or hospital settings, though these studies also highlighted strengths related to feasibility, particularly with support from working partners, and when utilizing an interprofessional care approach. Few studies reported health/economic outcomes data associated with naloxone distribution, such as changes in the number of patient/layperson access, the number of opioid overdose reversals, or cost-savings.</p><p><strong>Conclusions: </strong>This review outlines the many ways in which naloxone is distributed in the United States and emphasizes a need for improved outcomes data collecting/reporting in the various settings where naloxone is distributed. This would allow for future studies to evaluate which distribution model factors are associated with improvements in health outcomes, such as increased layperson access, and lower opioid overdose/mortality rates.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"391-404"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515898","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":"Exploring Xylazine Awareness, Health Impacts, and Harm Reduction Strategies: Findings From a Multimethods Study in Lowell, Massachusetts.","authors":"Shikhar Shrestha, Kevin Cyr, Grace Hajinazarian, Jaime Dillon, Takkyung Oh, Jennifer Pustz, Thomas J Stopka","doi":"10.1177/29767342241265181","DOIUrl":"10.1177/29767342241265181","url":null,"abstract":"<p><strong>Background: </strong>Xylazine, an adulterant in local drug supplies, has been detected in approximately 30% of opioid samples submitted for testing in Massachusetts. A better understanding of local risks, harms, and use preferences is needed to combat xylazine-related impacts on local communities.</p><p><strong>Methods: </strong>Through the STOP-OD Lowell study, we aimed to assess local xylazine awareness through in-depth interviews with local community stakeholders (n = 15) and local people who use drugs (PWUD; n = 15) and surveys with local PWUD (n = 94). The qualitative interviews focused on the current drug landscape and knowledge of adulterants in Lowell, and the results informed subsequent survey design. Through our survey, we examined whether PWUD were aware of xylazine and their willingness to use xylazine test strips.</p><p><strong>Results: </strong>Most community stakeholders and PWUD had limited awareness about the presence and impact of xylazine as an adulterant. Forty-seven (50%) survey respondents were aware of xylazine. When provided with more information about xylazine, 65% of all respondents expressed a willingness to use xylazine test strips. PWUD who had received naloxone training, reported using with others, and using tester shots were more willing to use xylazine test strips.</p><p><strong>Conclusion: </strong>Our findings are congruent with existing literature that indicates that there is limited awareness of xylazine among PWUD, and they consider xylazine an unwanted adulterant. We also found that PWUD who use other harm reduction measures are more willing to use xylazine test strips. The increase in xylazine warrants additional community-level interventions such as wound management and local testing infrastructure. Further research is needed to understand better the impacts associated with xylazine use, effective harm reduction techniques, and perceptions of xylazine test strips.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"291-301"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891512","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":"A Case-Based Curriculum on Buprenorphine for Treatment of Opioid Use Disorder Among Internal Medicine Residents.","authors":"Minaliza Shahlapour, Alyssa F Peterkin, Jessica L Taylor, Sebastian Suarez","doi":"10.1177/29767342241261612","DOIUrl":"10.1177/29767342241261612","url":null,"abstract":"<p><strong>Background: </strong>As the mandatory X-waiver requirements for prescribing buprenorphine have recently been lifted, general practitioners are being relied on to fill the treatment gap in prescribing medications for opioid use disorder (MOUD). However, insufficient clinician education remains a major barrier to prescribing MOUD in both inpatient and outpatient settings.</p><p><strong>Objective: </strong>To evaluate the impact of a new MOUD curriculum on internal medicine (IM) residents' attitudes, comfort, and knowledge of buprenorphine in the inpatient and outpatient settings.</p><p><strong>Methods: </strong>All second-year IM residents (n = 46) participated in a 90-minute curricular session between July and October 2022 during scheduled mandatory didactic blocks. The curriculum was structured as a small group, case-based session focused on how to initiate sublingual buprenorphine (traditional and low-dose initiation). Residents completed identical and anonymous pre- and post-session surveys. A Wilcoxon signed rank test was used to analyze the data.</p><p><strong>Results: </strong>Thirty-nine (84.4%) second-year IM residents participated in the evaluation. Residents reported increased importance of independently initiating buprenorphine for hospitalized patients with opioid withdrawal (<i>P</i> < .001). Residents were significantly more likely to endorse confidence in discussing MOUD with patients (<i>P</i> < .001), initiating buprenorphine in inpatient and outpatient settings (<i>P</i> < .001), and identifying patients who would benefit from low-dose buprenorphine initiation (<i>P</i> = .002). There was a significant increase in the correct number of knowledge-based questions after the session (before = 1.55/4 vs after = 3.33/4; <i>P</i> value < .001).</p><p><strong>Conclusions: </strong>A 90-minute buprenorphine training improved residents' attitudes toward, perceptions of competency, and knowledge of buprenorphine delivery to patients with OUD in the inpatient and outpatient setting.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":"46 2","pages":"231-237"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635067","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}