Substance use & addiction journal最新文献

{"title":"Post-Overdose Extended-Release Buprenorphine Initiation Facilitated by a Partnership Between Emergency Medical Services and an Outpatient Substance Use Disorder Observation Unit.","authors":"Jessica L Taylor, Jacqueline Gott, Karrin Weisenthal, Paige Colicchio, Sophia Dyer, Miriam S Komaromy","doi":"10.1177/29767342241249386","DOIUrl":"10.1177/29767342241249386","url":null,"abstract":"<p><strong>Background: </strong>People who experience a nonfatal opioid overdose and receive naloxone are at high risk of subsequent overdose death but experience gaps in access to medications for opioid use disorder. The immediate post-naloxone period offers an opportunity for buprenorphine initiation. Limited data indicate that buprenorphine administration by emergency medical services (EMS) after naloxone overdose reversal is safe and feasible. We describe a case in which a partnership between a low-barrier substance use disorder (SUD) observation unit and EMS allowed for buprenorphine initiation with extended-release injectable buprenorphine after naloxone overdose reversal.</p><p><strong>Case: </strong>A man in his 40's with severe opioid use disorder and numerous prior opioid overdoses experienced overdose in the community. EMS was activated and he was successfully resuscitated with intranasal naloxone, administered by bystanders and EMS. He declined emergency department (ED) transport and consented to transport to a 24/7 SUD observation unit. The patient elected to start buprenorphine due to barriers attending opioid treatment programs daily. His largest barrier was unsheltered homelessness. His severe opioid withdrawal symptoms were successfully treated with 16/4 mg sublingual buprenorphine/naloxone and 300 mg extended-release injectable buprenorphine (XR-buprenorphine), without precipitated withdrawal. Two weeks later, he reported no interval fentanyl use.</p><p><strong>Discussion: </strong>We describe the case of a patient successfully initiated onto XR-buprenorphine in the immediate post-naloxone period via a partnership between an outpatient low-barrier addiction programs and EMS. Such partnerships offer promise in expanding buprenorphine access and medication choice, particularly for the high-risk population of patients who decline ED transport.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"771-776"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913658","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":"Stress Exposure and PTSD in a Cross-Sectional Residential Substance Use Treatment Sample.","authors":"Rebecca L Schacht, Laurel E Meyer, Kevin R Wenzel, Meghan E Mette, Samantha K Berg, Christa R Lewis, Jennifer L Carrano, Marc Fishman","doi":"10.1177/29767342241248978","DOIUrl":"10.1177/29767342241248978","url":null,"abstract":"<p><strong>Background: </strong>Aim 1 of this cross-sectional, observational study with people in residential treatment for substance use disorders (SUDs) was to document stress exposure. Aim 2 was to assess potential sociodemographic and health differences based on probable posttraumatic stress disorder (PTSD) status. Aim 3 was to assess relative contributions of Diagnostic and Statistical Manual (DSM)-congruent versus DSM-incongruent stressors (Criterion A vs non-Criterion A) to mental and physical health. We hypothesized that both types of stressors would significantly contribute to impairment across indicators and that DSM-congruent stressor exposure would be more strongly associated with impairment than DSM-incongruent exposure.</p><p><strong>Methods: </strong>We assessed exposure to DSM-congruent traumatic stressors and DSM-incongruent life stressors, PTSD and depressive symptoms, emotion regulation difficulties, substance use recovery capital, and physical/mental health-related quality of life among 136 people in residential SUD treatment who were 64% men, 36% women; 49% white, 41% Black, 11% multiracial/another race; 18% lesbian, gay, or bisexual (LGB+); mean age = 39.82 (standard deviation = 12.24) years.</p><p><strong>Results: </strong>Participants reported experiencing a mean of 9.76 (SD = 6.11) DSM-congruent events. Those with probable PTSD were younger and more likely to be LGB+ than those without probable PTSD (<i>P</i> < .05). Experiencing higher numbers of DSM-congruent events was associated with more severe PTSD and depressive symptoms, emotion regulation difficulties, and lower physical health-related quality of life (<i>P</i> < .05). DSM-incongruent stressor exposure was not independently associated with any indicators. Recovery capital was not associated with either type of stress exposure.</p><p><strong>Conclusions: </strong>Stressful event exposure among people in residential SUD treatment is very high. Those who are younger or LGB+ in residential SUD treatment may be at greater risk of developing PTSD. DSM-congruent stressors are more consistently associated with mental health indicators than are DSM-incongruent stressors. Prioritizing treatment targets and identifying implementable treatment strategies can be challenging with this complex population.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"664-673"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878387","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 of Food and Housing Insecurity on Outcomes in Pregnant Patients With Substance Use Disorder.","authors":"Pranaya Chilukuri, Neil Patel, Cynthia Cockerham, Leon Su, Arnold Stromberg, John O'Brien, Barbara Parilla","doi":"10.1177/29767342241254587","DOIUrl":"10.1177/29767342241254587","url":null,"abstract":"<p><strong>Objectives: </strong>Food insecurity (FI) may be associated with worsened neonatal abstinence syndrome severity in infants born to individuals with substance use disorder. This study evaluates FI and housing insecurity (HI) influence on maternal and neonatal outcomes.</p><p><strong>Methods: </strong>This was a cohort study of patients receiving obstetric care through a multispecialty program in Kentucky from 2015 to 2023. Inclusion criteria were: (1) program participants over age 18 consenting to observational research, (2) delivering at University of Kentucky, and (3) not withdrawing from research at any time. Initially, a subset of patients for whom FI and HI concerns were heightened were screened. In 2019, FI and HI screening became standard of care at the clinic. Housing was assessed on enrollment. A validated 2-question Hunger Vital Sign FI screen was utilized for a subset of patients. Maternal and neonatal outcomes, including adverse delivery outcomes, maternal comorbidities, and birth complications, were observed. Fisher's exact and 2 sample <i>t</i> tests were performed.</p><p><strong>Results: </strong>Of 494 participants, 188 (38%) identified at risk for HI. At enrollment, 221 (45%) individuals reported owning their primary residence, 85 (17%) were in group residential treatment, 34 (6.9%) had no housing, and 134 (27%) lived at another's residence. Disposition of a child to a relative or not the patient's own care was greater with HI, 51% versus 47%. Of 155 respondents, 96 (62%) reported FI, associated with increased neonatal intensive care unit (NICU) admission, 86% versus 74%. Using the validated tool, Abuse Assessment Screen, abuse was significantly greater with FI, 76% versus 58%. Edinburgh Postpartum Depression Scales >12 indicating depression were more common with FI, 63% versus 32%, <i>P</i> < .05. Anxiety scores were also higher with FI, <i>P</i> < .05. Patients with FI were more likely to experience abuse.</p><p><strong>Conclusions: </strong>FI and HI were health-related needs associated with increased anxiety, depression, infant NICU admission, and loss of child custody.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"645-652"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289080","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":"U.S. Healthcare Workers' Perspective of Outpatient Provision of Methadone: A Scoping Review.","authors":"Sara E Hernandez, Aaron M Gilson, Te-Lien Ku, Michele Gassman, James H Ford","doi":"10.1177/29767342241262115","DOIUrl":"10.1177/29767342241262115","url":null,"abstract":"<p><strong>Background: </strong>A recent National Institute on Drug Addiction Call to Action focused on expanding methadone treatment access for individuals with opioid use disorder (OUD). One research priority identified was optimal educational and support structures, including training to provide methadone across multiple healthcare settings (e.g., primary care, opioid treatment programs [OTPs], pharmacies) and healthcare workers (HCWs) (e.g., providers, pharmacists). This scoping review sought to better understand HCWs' knowledge, attitudes, and stigma as it relates to methadone provision.</p><p><strong>Methods: </strong>Four databases (PubMed, PsycInfo, CINAHL, Web of Science) were searched for publications between 2010 and 2022 using keywords-methadone, HCW, outpatient setting, knowledge, attitudes, and stigma, focusing on HCWs in general and pharmacists specifically.</p><p><strong>Results: </strong>A total of 2,747 articles were identified and 14 met inclusion criteria for review. Settings included OTPs (n = 4), specialty addiction treatment clinics (n = 3), community pharmacies (n = 2), and multiple settings (n = 5). All articles (n = 14) examined methadone-related attitudes. Despite approval of methadone in 1972 to treat OUD, four articles illustrated continued methadone-related stigma held by HCWs. In response to COVID-19-related policy changes allowing methadone take-home flexibility, OTP clinicians expressed a range of attitudes concerning patient risk and potential program liability around diversion and misuse. One article assessing knowledge suggested that, even when most pharmacists correctly answered knowledge questions, a significant minority had misunderstandings that could undermine effective treatment.</p><p><strong>Conclusions: </strong>Given the current imbalance between methadone treatment demand and availability, there is a critical need to expand outpatient methadone services. Pharmacists partnering with OTPs represent a logical but underutilized access point. We identified key areas to improve HCWs methadone-related knowledge, attitudes, and stigma. Future research should explore the impact of outpatient pharmacy-OTP and other expansion services, and systematic training, education, and evaluation of methadone-related understanding, including assessment tools to measure knowledge, attitudes, and stigma.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"753-764"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790816","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":"Perception and Correlates of Opioid Overdose Risk Among Overdose Survivors Who Use Nonprescribed Opioids in San Francisco and Boston.","authors":"Yi-Shin Grace Chang, Vanessa M McMahan, Xochitl Luna Marti, Emily Pope, Shae Wolfe, Adam Majeski, Gabriela Reed, Alexander Y Walley, Phillip O Coffin","doi":"10.1177/29767342241237202","DOIUrl":"10.1177/29767342241237202","url":null,"abstract":"<p><strong>Background: </strong>Understanding opioid overdose risk perception may inform overdose prevention strategies.</p><p><strong>Methods: </strong>We used baseline data from a randomized overdose prevention trial, in San Francisco, CA, and Boston, MA, among people who used nonprescribed opioids, survived an overdose in the past 3 years, and had received naloxone. Participants were asked how likely they were to overdose in the next 4 months. We combined \"extremely likely\" and \"likely\" (higher risk perception) and \"neutral,\" \"unlikely,\" and \"extremely unlikely\" (lower risk perception). We performed bivariate analyses and separate multivariable logistic regression models of risk perception across (1) sociodemographic, (2) substance use, and (3) overdose risk behavior measures. Covariates were selected <i>a priori</i> or significant in bivariate analyses.</p><p><strong>Results: </strong>Among 268 participants, 88% reported at least 1 overdose risk behavior; however, only 21% reported higher risk perception. The adjusted odds ratio (AOR) of higher risk perception was 2.41 (95% confidence interval [CI]: 1.10-5.30) among those unhoused in the past 4 months, 2.06 (95% CI: 1.05-4.05) among those using opioids in a new place, and 5.61 (95% CI: 2.82-11.16) among those who had overdosed in the past 4 months. Living in Boston was associated with higher risk perception in all 3 models (AOR = 2.00-2.46, 95% CI: 1.04-4.88).</p><p><strong>Conclusions: </strong>Despite prevalent risk behaviors, a minority of participants perceived themselves to be at higher risk of overdose. Nonetheless, some known risk factors for overdose were appropriately associated with risk perception. Fentanyl has been prevalent in Boston for longer than San Francisco, which may explain the higher risk perception there.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"559-567"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061702","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":"\"They Ask Questions, But They Don't Want the Answers\"-Perceptions of Clinical Communication Among Veterans Discontinuing Buprenorphine for the Treatment of Opioid Use Disorder.","authors":"Alison Eckhardt, Dylan E Waller, Sarah Shull, Travis I Lovejoy, Benjamin J Morasco, Adam J Gordon, Jessica J Wyse","doi":"10.1177/29767342241251761","DOIUrl":"10.1177/29767342241251761","url":null,"abstract":"<p><strong>Background: </strong>Many patients with opioid use disorder (OUD) discontinue treatment prematurely, increasing their risk of opioid-related overdose and death. While patient-centered care is considered the gold standard in treating chronic illness, it may be practiced less frequently in the context of OUD care. Patient-provider communication can influence patients' care experiences, potentially having an impact on treatment retention and care decision-making.</p><p><strong>Methods: </strong>This study was conducted at the VA Portland Health Care System from March 2021 to April 2022. We conducted qualitive interviews with patients who had discontinued buprenorphine for the treatment of OUD within the past year. Coding and analysis were guided by inductive qualitative content analysis. Retrospective medical record review identified clinical and demographic characteristics of participants.</p><p><strong>Results: </strong>Twenty patients completed an interview. Participant age ranged from 28 to 74 years (median 63 years). Ninety percent of participants were white and 90% male. Many participants expressed frustration and feelings of disempowerment in OUD care processes. Patients with a history of long-term prescribed opioid use frequently expressed stigmatizing views of OUD, and perceptions of disagreement with providers over diagnosis and care choices. Elderly patients and those with multiple comorbidities expressed confusion over significant aspects of their care, as well as difficulty navigating treatment logistics like appointment requirements and medication dose changes. Some patients reported later restarting buprenorphine in new settings, and described feeling respected and involved in care decisions as a facilitator for continuing treatment.</p><p><strong>Conclusions: </strong>Prioritizing patient-centered communication in OUD treatment could improve the patient experience and potentially support treatment retention. Subgroups of OUD patients, such as those with a history of long-term prescribed opioid use, elderly patients with multiple comorbidities, or those who express stigmatizing medication views, could particularly benefit from tailored communication strategies that address their individual concerns.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"674-681"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State Policies Targeting Patient Brokering and Deceptive Marketing of Substance Use Disorder Treatment.","authors":"Melissa M Garrido, Kiersten Strombotne, PhiYen Nguyen, Steven D Pizer, Austin B Frakt","doi":"10.1177/29767342241279194","DOIUrl":"https://doi.org/10.1177/29767342241279194","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize state laws targeting patient brokering and deceptive marketing of substance use disorder (SUD) treatment.</p><p><strong>Background: </strong>Patient brokering and deceptive marketing of SUD treatment leads to poor outcomes for individuals with SUD, including relapse- or overdose-related hospitalizations, ED visits, or death. In response, several states within the United States have passed laws targeting unethical practices of SUD treatment in recent years. The context in which these laws were passed has not been previously described. The extent to which states engaged in recovery residence regulation that also pass patient brokering and deceptive marketing laws is unknown.</p><p><strong>Methods: </strong>We conducted a descriptive study and identified state laws relating to patient brokering and deceptive marketing that were enacted and effective as of December 31, 2022. Using a model state law for addressing unethical SUD treatment practices as a guide, we developed a taxonomy to describe the laws' elements, including covered entities, prohibited activities, and penalties. We used descriptive statistics to characterize variation across current laws.</p><p><strong>Results: </strong>All patient brokering laws explicitly mention referrals to SUD treatment facilities, and most specify that both individuals and facilities are prohibited from paying, receiving, or soliciting referrals in exchange for fees or commissions. All deceptive marketing laws prohibit making false or misleading statements about the nature of services provided. Beyond these common features, there is wide variability in the degree to which states specifically prohibit other patient brokering and deceptive marketing activities (e.g., indirect offerings, lead generation, or kickback schemes involving laboratories).</p><p><strong>Conclusions: </strong>State policies targeting patient brokering and deceptive marketing may be useful for preventing instances of unethical SUD treatment practices. We constructed a taxonomy to characterize elements of patient brokering and deceptive marketing laws and facilitate future evaluations of their effectiveness.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342241279194"},"PeriodicalIF":0.0,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336010","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":"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":" ","pages":"29767342241271404"},"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}

{"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":" ","pages":"29767342241273397"},"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}

{"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":" ","pages":"29767342241271361"},"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}