Substance use & addiction journal最新文献

{"title":"Linkage to Care Outcomes Following Treatment in A Low-Threshold Substance Use Disorder Bridge Clinic.","authors":"Sarah K Casey, Sydney Howard, Susan Regan, Alison Romero, Elizabeth A Powell, Laura Kehoe, Martha T Kane, Sarah E Wakeman","doi":"10.1177/29767342241261609","DOIUrl":"10.1177/29767342241261609","url":null,"abstract":"<p><strong>Background: </strong>Treatment for substance use disorders (SUD) remains low in the United States. To better meet needs of people who use alcohol and other drugs, low threshold bridge clinics which offer treatment without barrier and harm reduction services have gained prevalence. Bridge clinics work to surmount barriers to care by providing same day medication and treatment for SUD and eventually transitioning patients to community-based treatment providers. In this study, we examine SUD treatment outcomes among patients who transitioned out of a bridge clinic.</p><p><strong>Methods: </strong>This is a retrospective cohort study of posttreatment outcomes of patients seen at an urban medical center's bridge clinic between 2017 and 2022. The primary outcome was being in care anywhere at time of follow-up. We also examined the proportion of patients who completed each step of the cascade of care following transfer: connection to transfer clinic, completion of a clinic visit, retention in care, and medication use among those remaining in care at the transfer clinic. We examined the association of different bridge clinic services with still being in care anywhere and the association between successful transfer with being in care and taking medication at follow-up.</p><p><strong>Results: </strong>Of 209 eligible participants, 63 were surveyed. Sixty-five percent of participants identified as male, 74% as white, 12% as Hispanic, 6% as Black, and 16% were unhoused. Most participants (78%) reported being connected to SUD treatment from the Bridge Clinic, and 37% remained in care at the same facility at the time of survey. Eighty-four percent reported being in treatment anywhere and 68% reported taking medication for SUD at follow-up, with most participants reporting taking buprenorphine (46%).</p><p><strong>Conclusion: </strong>Of those participants who transitioned out of a bridge clinic into community-based SUD care, 78% were successfully connected to ongoing care and 84% were still in care at follow-up.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"247-255"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444021","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":"Association Between Length of Buprenorphine or Methadone Use and Nonprescribed Opioid Use Among Individuals with Opioid Use Disorder: A Cohort Study.","authors":"Xinyi Jiang, Gery P Guy, Jill A Dever, John S Richardson, Laura J Dunlap, Didier Turcios, Sara Beth Wolicki, Mark J Edlund, Jan L Losby","doi":"10.1177/29767342241266038","DOIUrl":"10.1177/29767342241266038","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) affects millions of individuals each year in the United States. Patient retention in medications for opioid use disorder (MOUD) treatment is suboptimal. This study examines and quantifies the associations between each additional month of buprenorphine or methadone use and nonprescribed opioid use.</p><p><strong>Methods: </strong>Data were obtained from an 18-month longitudinal, observational cohort study of patients (age ≥ 18 years) treated for OUD. Patients completed a baseline self-reported questionnaire between March 2018 and December 2019 and were asked to complete follow-up questionnaires at approximately 3-, 6-, 12-, and 18-months post-baseline until May 2021. Patients treated with buprenorphine or methadone, without taking other MOUD at least 12 months prior to baseline, were included. Outcomes included past 30-day use of prescription opioids nonmedically, heroin, or illegally made fentanyl. A multivariable, multilevel regression model with a binomial distribution and a logit link was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>This study included 353 patients taking buprenorphine (mean [standard deviation, SD] age 39 [11] years; 226 [64%] female), and 785 patients taking methadone (mean [SD] age 42 [12] years; 392 [50%] female). Each additional month of MOUD treatment was associated with a 25% decrease in the odds of past 30-day nonprescribed opioid use for patients taking buprenorphine (aOR [95% CI] = 0.75 [0.68-0.83]), and a 17% decrease for patients taking methadone (aOR = 0.83 [0.79-0.87]). The COVID-19 pandemic (aOR = 9.29 [2.96-29.17]; aOR = 3.19 [1.74-5.86]) and MOUD adverse reaction experiences (aOR = 3.07 [1.11-8.48]; aOR = 2.51 [1.01-6.22]) were significantly associated with higher odds of nonprescribed opioid use among buprenorphine and methadone groups.</p><p><strong>Conclusion: </strong>Among patients treated with buprenorphine or methadone, with each additional treatment month since baseline, those who continued with treatment appeared to be more likely to report 17% to 25% decreased odds of past 30-day nonprescribed opioid use. Our findings can be used by clinicians in the shared decision-making process with patients, emphasizing the value of sustained retention in MOUD.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"266-279"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977549","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":"Cross-Site Evaluation of Alcohol Screening and Brief Intervention Implementation Programs in Healthcare Systems Serving Individuals of Reproductive Age.","authors":"Janice Vendetti, Candice Bangham, Melissa Riba, Corrie Whitmore, Karen Steinberg Gallucci, Bridget L Hanson, Jacey A Greece","doi":"10.1177/29767342241267074","DOIUrl":"10.1177/29767342241267074","url":null,"abstract":"<p><strong>Background: </strong>With US Centers for Disease Control and Prevention funding, from 2018 to 2022, 4 large healthcare systems (n = 53 health centers across 7 states) serving people of reproductive age trained staff and provided implementation support for alcohol screening and brief intervention (SBI). This cross-site evaluation explores each healthcare system's implementation approach to implement SBI, reduce excessive alcohol use, and prevent prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders.</p><p><strong>Methods: </strong>The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework.</p><p><strong>Results: </strong>Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI.</p><p><strong>Conclusions: </strong>Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"461-475"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977550","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":"Non-Inferiority of Online Compared With In-Person Opioid Overdose Prevention Training in Medical Students.","authors":"Noah Berland, Aaron D Fox, Keith Goldfeld, Andrea Greene, Daniel Lugassy, Kathleen Hanley, Ian S deSouza","doi":"10.1177/29767342251328755","DOIUrl":"https://doi.org/10.1177/29767342251328755","url":null,"abstract":"<p><strong>Background: </strong>Drug overdose deaths have increased fivefold over the last 20 years, primarily fueled by synthetic opioids, which led the Centers for Disease Control and Prevention to declare an opioid overdose epidemic. Responding to this epidemic, we designed and implemented opioid overdose prevention (OOP) training for medical students to help promote effective naloxone usage. Previously, we compared online and in-person versions of OOP training over 2 years of training. To better establish the evidence for online training, we performed a randomized controlled non-inferiority trial comparing in-person with online opioid prevention training.</p><p><strong>Methods: </strong>Third-year medical students were randomized into groups to receive either in-person or online training in preparation for clinical rotations. Students randomized to receive online training were provided a link to the training modules. Students randomized to receive in-person training were trained in an in-person setting. We performed a non-inferiority per-protocol analysis with the primary outcome of knowledge using a non-inferiority margin of a -9.1% difference between groups.</p><p><strong>Results: </strong>A total of 205 students were randomized, 103 students to in-person training and 102 to online training. Eighty-three in-person students and 104 online students were included. The online group had a higher post-training knowledge score compared to the in-person group by 0.44 points (0-11 point scale) with a 95% CI of (-0.04, 0.93) that did not cross the margin of non-inferiority.</p><p><strong>Conclusions: </strong>Online training for OOP was effective and non-inferior to in-person training. Online OOP training may be considered an alternative to in-person training.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251328755"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757235","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":"Weighing Risks and Benefits: Patient Perceptions on Using Medications for Opioid Use Disorder During and After Pregnancy.","authors":"Anna E Eitel, Christin Mujica, Marie A Hayes, Constance Guille, Aimee McRae-Clark, Sara M Witcraft","doi":"10.1177/29767342251326344","DOIUrl":"https://doi.org/10.1177/29767342251326344","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) among pregnant and postpartum persons has increased in the last 20 years and poses risks to both birthing parent and fetus/child. Medication for opioid use disorder (MOUD) can reduce these risks, yet engagement is limited among pregnant and postpartum persons with over half discontinuing in the postpartum year. Little research has explored pregnant and postpartum persons' reasons for using MOUD in pregnancy and decisions around (dis)continuing after childbirth. We sought to gain a deeper understanding of the reasons pregnant and postpartum persons use MOUD in pregnancy and motivations for continued use or discontinuation postpartum.</p><p><strong>Methods: </strong>Individual interviews (n = 4) and focus groups (2 focus groups with total n = 6) were conducted with 10 participants with OUD aged 18 to 45 years who were currently pregnant (50%) or postpartum (50%) and had been treated with MOUD. Interviews and focus groups were transcribed, and a codebook was iteratively created using thematic analysis.</p><p><strong>Results: </strong>Five themes and 7 subthemes emerged within 2 domains representing experiences with MOUD during pregnancy (domain 1) and postpartum (domain 2). Participants were highly motivated toward MOUD in pregnancy for the benefits to themselves and their unborn children but acknowledged several drawbacks including the possibility of fetal/neonatal withdrawal. Reasons for MOUD use postpartum shifted toward improving maternal mental health and parenting. Several participants anticipated eventually tapering MOUD within the postpartum year as they no longer saw a distinct need for it.</p><p><strong>Conclusion: </strong>Despite perceived risks, pregnant and postpartum persons with OUD have many motivations to use MOUD during pregnancy that may shift in the postpartum period. Our findings underscore the importance of education and shared decision-making and emphasize the need for leveraging pre- and postnatal motivation for MOUD during these conversations and throughout course of treatment.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251326344"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660216","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":"Employment Trajectories of Recently Certified Peer Support Specialists: A Longitudinal Qualitative Analysis.","authors":"Elizabeth Siantz, Morgan Pelot, Laysha Ostrow","doi":"10.1177/29767342251322243","DOIUrl":"https://doi.org/10.1177/29767342251322243","url":null,"abstract":"<p><strong>Background: </strong>Recent work has highlighted the challenges and benefits that certified peer specialists (CPSs) experience in the workforce. While their work can lead to personal fulfillment and financial independence for CPSs, and improved mental health and substance use recovery outcomes for their clients, little is known about CPS employment trajectories or the circumstances that impact their early-career workforce involvement over time.</p><p><strong>Methods: </strong>This study used within- and across-case analyses of longitudinal data from qualitative interviews with 13 CPS that participated in a multistate, 3 year observational prospective cohort study of CPS graduates to explore employment changes and circumstances that led to these transitions. Qualitative results were organized according to whether cases were \"employed as a CPS at follow-up\" (N = 5) or \"not employed as CPS at follow-up\" (N = 8).</p><p><strong>Results: </strong>Participants \"employed as a CPS\" at follow-up held various positions following certification, and they shared a sense of optimism about their future work. At the second interview, most remained in the same positions they held at baseline and described personal fulfillment and a supportive work environment as reasons for remaining. Participants who were \"not employed as a CPS\" at follow-up were also not employed as a CPS at their baseline interview but aspired to pursue future CPS work. At their second interview, many remained unemployed due to poor health and disability, or described past traumatic experiences, stress, and burnout related to being a CPS as reasons for leaving the CPS work force. All participants were challenged to find work as a CPS at various moments in their trajectories.</p><p><strong>Conclusion: </strong>Results indicate that securing employment as a CPS was challenging for participants. Findings are discussed with implications for supporting CPS job seeking, well-being, and workforce retention.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251322243"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618070","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 Plant-Based Nutrition for Patients with Substance Use Disorders: A Scoping Review of Dietary Intake and Potential Applications.","authors":"Joshua E Lewis, Kelly Georgestone, Chiedza Mutindori, Ernst J Nicanord","doi":"10.1177/29767342251323361","DOIUrl":"https://doi.org/10.1177/29767342251323361","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorders (SUDs) represent a significant global public health challenge, with affected individuals often exhibiting poor dietary habits, nutritional deficiencies, and compromised mental and physical health. This scoping review evaluates existing literature on dietary intake in individuals with SUDs, focusing on the potential benefits of plant-based dietary interventions for improving nutritional status and supporting recovery.</p><p><strong>Methods: </strong>A scoping review was conducted following PRISMA guidelines. Four databases were searched using PICO-based terms, targeting studies assessing dietary intake in patients with SUD, particularly plant-based interventions. Inclusion criteria were studies reporting macro- and micronutrient intake among patients with SUD, while studies lacking direct dietary intake data were excluded. Study quality was appraised using the STROBE checklist.</p><p><strong>Results: </strong>The search yielded 1142 potential articles, with 6 meeting inclusion criteria (4 from the United States and 2 from Iran). Patients with SUD exhibited significant deficiencies in iron (-16.8%, <i>P</i> = .04), folate (-15.0%, <i>P</i> = .04), and vitamins E and A, alongside diets high in simple carbohydrates and unhealthy processed foods. Plant-based dietary interventions were associated with improved Healthy Eating Index scores (<i>P</i> < .001), increased resilience (+31%, <i>P</i> = .031), and enhanced self-esteem (<i>P</i> = .043). High energy intake and low multivitamin use were reported among methadone-treated patients, emphasizing the need for dietary interventions to address nutrient gaps and support recovery.</p><p><strong>Conclusion: </strong>Plant-based dietary interventions may offer a promising strategy to address nutrient deficiencies and improve mental health outcomes in patients with SUD. However, studies are limited, with small sample sizes and variability in dietary assessments. Future research, including randomized controlled trials, is needed to establish the efficacy and feasibility of integrating plant-based nutrition into SUD treatment programs. Addressing barriers such as socioeconomic challenges and food access is also crucial for implementing effective dietary interventions.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251323361"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618135","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":"Empowering Change: From Evidence to Action in Addiction Care and Research-Overview and Proceedings of the AMERSA 2024 Conference.","authors":"Elizabeth Salisbury-Afshar, Megan Buresh, Bradley M Buchheit, Rachel McCart, Deborah S Finnell","doi":"10.1177/29767342251320201","DOIUrl":"https://doi.org/10.1177/29767342251320201","url":null,"abstract":"<p><p>This commentary provides an overview of the 2024 Association of Multidisciplinary Education and Research in Substance Use and Addiction annual conference: Empowering Change: From Evidence to Action in Addiction Care and Research, held from November 14 to 16, 2024, in Chicago. The conference featured 16 interactive workshops, 166 oral abstract presentations, and 120 poster presentations. From the preconference workshop to plenary sessions, paper, and poster presentations, there was a focus on practical approaches to implementing evidence-based practices in a variety of settings.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251320201"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538242","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":"Insights Into Recovery: A Qualitative Analysis of Primary Care Provider Perspectives on Treating Veterans With Opioid Use Disorder in the VA Primary Care Setting.","authors":"Krista L Scorsone, Mary Ava Nunnery, Spencer Calder, Anissa Danner, Eric J Hawkins, Adam J Gordon, Joseph W Frank","doi":"10.1177/29767342251320450","DOIUrl":"https://doi.org/10.1177/29767342251320450","url":null,"abstract":"<p><strong>Background: </strong>The Veterans Health Administration (VA) has prioritized addressing opioid use disorder (OUD) due to rising opioid overdose rates among Veterans, aiming to expand evidence-based OUD treatment in primary care. The purpose of this project was to (1) examine VA provider perspectives regarding OUD treatment in primary care, and (2) explore provider perceptions about stigma related to OUD.</p><p><strong>Methods: </strong>From September 2021 to June 2022, we held 6 semi-structured focus groups with multidisciplinary VA primary care providers (n = 91 participants) via Microsoft Teams and in person. Each group, comprising 13 to 24 providers, engaged in interviews lasting 50 to 80 minutes. We employed qualitative interviewing techniques to collect feedback on provider perspectives concerning OUD treatment within VA primary care. Participants viewed 2 to 3 short videos from the <i>Insights Into Recovery</i> series. Focus group interviews were recorded, transcribed, and checked for accuracy. Directed content analysis was used to identify themes and patterns.</p><p><strong>Results: </strong>Participants identified several barriers to treating OUD in primary care. Patient-level challenges reported by providers included establishing clinician-patient trust and differing views on OUD diagnoses. Provider-level barriers included limited experience, discomfort with treatment, and managing complex care needs. System-level obstacles involved time constraints, administrative burdens, and stigma, which affected attitudes toward OUD and opioid medication use. Facilitators of OUD care included satisfaction with patient success, training in buprenorphine prescribing, and the use of motivational interviewing (MI) techniques tailored to the patient's level of readiness.</p><p><strong>Conclusions: </strong>Providers identified barriers to OUD care, including patient trust issues, limited provider experience, lack of support, and stigma from both patients and providers. Facilitators included enhanced training in buprenorphine prescribing and MI. To strengthen OUD care, 3 key strategies are recommended: addressing provider stigma, prioritizing OUD-specific training, and integrating MI. These initiatives could enhance OUD care in primary care settings within the VA, benefiting Veterans with chronic pain and OUD.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251320450"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532033","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 Scoping Review of Community Harm Reduction Strategies for Maternal and Fetal Opioid Impacts: Implications for Policy.","authors":"Maren Wright Voss, Marcela C Smid, Julie C Herrick, Aarica Cleveland, Amelia Van Komen, Joli Johanson, Matthew Huntington","doi":"10.1177/29767342241312486","DOIUrl":"https://doi.org/10.1177/29767342241312486","url":null,"abstract":"<p><strong>Background: </strong>Community-based harm reduction for opioid use may be crucial for mitigating maternal and fetal harms by reducing information bias, fostering trust, and connecting individuals to essential treatment and services. This scoping review examines community-based harm reduction strategies and policies addressing maternal opioid use occurring in nonclinical settings, including stigma reduction, public health education, service access, and integration. The objectives of this scoping review are to 1) delineate community-based harm reduction approaches; 2) contextualize findings; 3) identify policy gaps; and 4) synthesize insights for policy.</p><p><strong>Methods: </strong>A systematic selection of articles was conducted using predefined inclusion and exclusion criteria. Three search domains (mother-child dyad, opioid misuse, and harm reduction) were used from PubMed, PsychINFO, and Scopus databases from 2013 onward. Articles were screened using title and abstract review, full-text analysis, and cross-referencing to ensure relevance. Articles focusing on policy related to community-based harm reduction strategies for pregnant individuals experiencing opioid misuse were included in the final review.</p><p><strong>Results: </strong>Initial search yielded 548 articles with 45 articles identified as domain relevant. After full-text review, 26 articles were included in final scoping review. Number of publications increased over time (2013-2017, <i>n</i> = 6; 2018-2021, <i>n</i> = 20). Twenty articles (77%) addressed multisystem level interventions, defined as coordinated strategies across multiple sectors (e.g., healthcare, education, and social services) and favored supportive (over punitive) harm reduction methods. Identified needs included addressing socioeconomic disparities and ensuring equitable access to care. Literature gaps highlight an oversimplification of outcomes such as narrow definitions of neonatal abstinence syndrome that do not account for overall harm reduction.</p><p><strong>Conclusions: </strong>Policy review favored systemic interventions over individual-level criminalization or remediation. Community-based, comprehensive, integrated, and supportive care received less attention than medication-based treatment. These results underscore urgent need for consideration of evidence-based community-level harm reduction strategies to effectively address maternal opioid use and its associated challenges.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342241312486"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525943","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}