Substance use : research and treatment最新文献

{"title":"Insights into the Experiences of Persons with Substance Use Disorders During COVID-19 Lockdown in Lagos, Nigeria: A Qualitative Investigation.","authors":"Samuel Ojima Adejoh, Peter Osazuwa, Sofiat Busari-Akinbode, Rosilyn Gborogen, Abolaji Awodein, Waziri Adisa, Titi Tade, Fatai Adesina Badru","doi":"10.1177/29768357241307752","DOIUrl":"https://doi.org/10.1177/29768357241307752","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the impact of COVID-19 lockdown on the consumption of illicit drugs among Persons with Substance Use Disorders in Lagos, Nigeria.</p><p><strong>Methods: </strong>Using convenience sampling, 25 participants, who use different substances consented to participate in the study. Data was collected using in-depth interview guide and thematically analysed using NVivo 12 Plus.</p><p><strong>Findings: </strong>The findings show that activities of celebrities on social media were motivation for use. There was an increase in the consumption of illicit drugs during the COVID-19 lockdown period among the participants. Participants were able to purchase illicit drugs from street vendors despite the lockdown restriction, while others bought from online retailers - the social media platforms. Participants reported an increase in the price of substances and a reduction in their quantity and quality during the lockdown which may likely account for the increase in consumption reported.</p><p><strong>Conclusion: </strong>The lockdown, though used in curtailing the spread of COVID-19, had an unintended increase in the consumption of illicit drugs suggesting that drug markets can be resilient and adaptive during global crises.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241307752"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848808","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":"Seizure Susceptibility in E-cigarette Users: Navigating the Clinical Management and Public Health Considerations.","authors":"Soyemi Toluwalashe, Olusola Aremu, Olabode Ekerin, Abdulqudus Lawal, Faniyi Oluwatobi, Victor Adebayo, Adewunmi Akingbola, Simon Olaniyan, Agboola Progress, Abdullahi Tunde Aborode","doi":"10.1177/29768357241304298","DOIUrl":"https://doi.org/10.1177/29768357241304298","url":null,"abstract":"<p><p>E-cigarettes gained popularity globally through the promotion of e-cigarettes as a risk-free way to stop traditional smoking. However, new evidence suggests that they may have a detrimental effect on the nervous system and ultimately adverse neurological manifestations. Seizures have been reported among both new and experienced e-cigarette users. In several cases, the seizure presented immediately after its use, while others reported continuous use for weeks before seizures occurred. This review presents a deeper insight into the clinical management, implications, and public health considerations of seizure susceptibility in e-cigarette users. Using recent case reports, epidemiological studies, and experimental research, we highlight the role of likely etiological mechanisms such as how nicotine's convulsive effects are linked to α7- nicotinic acetylcholine receptors (nAChRs), the varied clinical presentations, and the potential nicotine toxicity linked to seizures. Furthermore, we discuss the existing debates and controversies, diagnostic directions, and potential role in individual susceptibility to e-cigarette-associated seizures. Importantly, we address how seizures may be accompanied by both physical and psychological sequelae, which may impair the quality of life for individuals presenting for emergency care. We also address the limitations and challenges in the etiology of e-cigarette-associated seizures and the non-criteria for defining seizures caused by e-cigarettes. The review concludes with an insight into public health considerations and policy recommendations by highlighting the importance of mass awareness and clinical considerations that could guide patient management.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241304298"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776287","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":"Factors Related to Receipt of Help for Alcohol Use: Extending the Focus of Treatment to the Continuum of Unhealthy Alcohol Use.","authors":"Lina Tieu, Nadereh Pourat, Elizabeth Bromley, Rajat Simhan, Roshan Bastani, Beth Glenn","doi":"10.1177/29768357241301990","DOIUrl":"10.1177/29768357241301990","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy alcohol use is one of the leading preventable causes of mortality in the U.S. Despite evidence of the growing burden of alcohol-associated mortality and disease, treatment is severely underutilized. Prior literature has often focused on assessing treatment among patients with severe alcohol use.</p><p><strong>Objectives: </strong>Assess factors associated with uptake of treatment for alcohol use among a broad population of those regularly exceeding U.S. guidelines for alcohol use.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Using data from the National Epidemiologic Survey on Alcohol and Related Conditions - Wave III (NESARC-III) collected April 2012 to June 2013, weighted descriptive statistics were used to describe the U.S. population who self-reported regularly exceeding U.S. guidelines for moderate alcohol use at least monthly. Weighted multivariable regression was used to assess the association of individual-level factors with receipt of help for unhealthy alcohol use.</p><p><strong>Results: </strong>In weighted analyses of 6467 NESARC-III participants, 17% of the U.S. population reported regular engagement in unhealthy alcohol use (76% use exceeding guidelines, 14% binge drinking, 11% heavy drinking) and were predominantly male (62%), below age 65 (93%), non-Hispanic White (65%), and had lower levels of education and income. Half (53%) met criteria for alcohol use disorder. Only 5% reported receipt of help for their alcohol use. Compared to non-Hispanic White individuals, non-Hispanic Asian/Native Hawaiian or Other Pacific Islander (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.18-0.90) and non-Hispanic Black (OR 0.68, 95% CI 0.48-0.96) individuals were less likely to receive help for alcohol use. Factors associated with greater receipt of help included being older, educational attainment, Medicaid insurance, concomitant drug use, liver disease, acute healthcare utilization, and greater alcohol-related problems.</p><p><strong>Conclusion: </strong>Identification of the factors associated with receipt of alcohol-related treatment, including race and ethnicity, age, education, insurance, and drug use can inform interventions to increase treatment receipt.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241301990"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the COVID-19 Pandemic on Recovery From Substance Use Disorder: Findings From a Qualitative Study.","authors":"Connie Hassett-Walker","doi":"10.1177/29768357241287405","DOIUrl":"10.1177/29768357241287405","url":null,"abstract":"<p><strong>Background: </strong>This study considers how the COVID-19 pandemic impacted individuals recovering from a substance use disorder (SUD).</p><p><strong>Method: </strong>Fifty individuals recovering from SUD in Vermont, a rural New England state (U.S.), were recruited for an interview from 12-step recovery meetings (Alcoholics Anonymous, Narcotics Anonymous) as well as via word-of-mouth. Interviews were transcribed and coded, and qualitative analyses were performed.</p><p><strong>Results: </strong>Many of the participants who were in recovery prior to the pandemic starting remained substance-free and in recovery throughout the pandemic period. Some individuals used substances during the pandemic period, although not typically in the context of a relapse caused by negative emotions (eg, distress over a loved one contracting COVID-19). The majority of those individuals indicated that the risk of catching COVID-19 did not alter their substance use.</p><p><strong>Conclusions: </strong>Many individuals already in SUD recovery before COVID-19 remained in recovery despite the challenges of pandemic era. The role of peer support in recovering individuals managing negative emotions caused by COVID-19 is considered.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241287405"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485266","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":"Examining Homeless-Experienced Adults' Smoking Cessation Treatment Use Pre- and Post-Entry into Permanent Supportive Housing.","authors":"Taylor Harris, Talia Panadero, Lauren Hoffmann, Ann Elizabeth Montgomery, Jack Tsai, Lillian Gelberg, Sonya Gabrielian","doi":"10.1177/29768357241271567","DOIUrl":"https://doi.org/10.1177/29768357241271567","url":null,"abstract":"<p><strong>Background: </strong>Homeless-experienced adults smoke at rates 5 times that of the general adult population, and often have limited access to cessation treatments while homeless. Permanent Supportive Housing (PSH) can be a catalyst for cessation treatment utilization, yet little is known about use of these treatments following PSH entry, or how to tailor and implement cessation care that meets homeless-experienced adults' vulnerabilities.</p><p><strong>Methods: </strong>Using Department of Veterans Affairs (VA) administrative data, we assessed smoking status (ie, current, former, non/never) among a cohort of homeless-experienced Veterans (HEVs) housed in Los Angeles-based PSH. We compared cessation treatment use rates (ie, nicotine replacement therapies, cessation medications, psychosocial counseling) pre- and post-housing using Chi-square tests. Predisposing (ie, demographics), enabling (eg, primary care, benefits), and need characteristics (ie, health, mental health, substance use diagnoses) were examined as correlates of cessation treatment utilization pre- and post-housing in univariable and multivariable logistic regression models.</p><p><strong>Results: </strong>Across HEVs (N = 2933), 48.6% were identified as currently-smoking, 17.7% as formerly-smoking, and 14.0% as non/never smoking. Among currently- and formerly-smoking HEVs (n = 1944), rates of cessation treatment use post-housing were significantly lower, compared to pre-housing, across all treatment types. Health, mental health, and substance use was more prevalent among currently- and formerly-smoking HEVs compared to non/never-smoking HEVs, and most diagnoses were positively associated with utilization univariably. However, in multivariable models, cessation clinic referrals and primary care engagement were the only significant (<i>P</i> < .001) predictors of pre-housing and post-housing cessation treatment utilization.</p><p><strong>Conclusion: </strong>Among HEVs, we found high smoking rates and low cessation treatment utilization pre- and post-PSH entry. Efforts to educate providers about this population's desire to quit smoking, support primary care engagement, and increase cessation clinic referrals may bolster their utilization. For homeless-experienced adults, optimizing cessation treatment accessibility by embedding cessation services within PSH and homeless service settings may reduce utilization impediments.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241271567"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Patient-Level Factors and Positive Treatment Response Among Individuals With a Psychostimulant Use Disorder: A Cross-Sectional Study.","authors":"Dana Abulez, Clare C Brown, Michael A Cucciare, Corey J Hayes","doi":"10.1177/29768357241274483","DOIUrl":"https://doi.org/10.1177/29768357241274483","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to provide insights into which patient-level characteristics are associated with a positive treatment response among patients whose primary drug of choice was a psychostimulant with a particular emphasis on understanding the impact of age at first use and co-occurring psychiatric comorbidities.</p><p><strong>Methods: </strong>We used a cross-sectional study design and the 2019 US Treatment Episode Data Set: Discharges (n = 167 802) to identify outpatient treatment episodes for which the primary drug of choice was a psychostimulant. We defined a positive treatment response as (1) a reduction in drug use between treatment admission and discharge or (2) no use at both admission and discharge. Multivariable logistic regression was conducted, overall and stratified by presence of psychiatric comorbidity, to identify demographic, clinical, and treatment-level factors associated with positive treatment response.</p><p><strong>Results: </strong>Treatment episodes among patients 11 years and under at the time of first use had a 22% higher odds of having a positive response to treatment as compared to those treatment episodes in which the person was 30 years or older at the time of first use. The presence of psychiatric comorbidity resulted in substantial differences in direction and magnitude of the relationships between treatment response and covariates. Positive response to treatment was less likely for episodes among Non-Hispanic Black/African American persons, in detoxification settings, for unemployed individuals, or for individuals living in the South, but a positive response was more likely for episodes occurring in rehabilitation/residential settings.</p><p><strong>Conclusions: </strong>Race/ethnicity, geographic region, treatment setting, and employment status were the strongest predictors of response to treatment. Treatment programs should maximize treatment of psychiatric conditions, intensify support for persons of color seeking treatment in detoxification settings, and increase efforts to find adequate employment for patients.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241274483"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Relationship Quality on Couples With an Incarcerated Partner With Co-Occurring Mental Health and Substance Use Issues.","authors":"Eman Tadros, Anh-Khoi Nguyen Le, Alexis Gregorash","doi":"10.1177/29768357241284097","DOIUrl":"https://doi.org/10.1177/29768357241284097","url":null,"abstract":"<p><strong>Objective: </strong>In 2020, approximately 1.7 million people were incarcerated in the United States, with nearly half of the general population being related to, or romantically involved with, an incarcerated individual. Over 70% of these incarcerated individuals met the criteria for a co-occurring mental health and substance use diagnoses. Individuals with co-occurring disorders often experience high rates of recidivism, which negatively impacts their non-incarcerated partners. This study aimed to examine the impact of incarcerated individuals with co-occurring ADHD and depression on their relationship quality, focusing on the roles of substance use, substance use treatment, and self-efficacy.</p><p><strong>Methods: </strong>The study analyzed the effects of substance use, substance use treatment, and self-efficacy on the relationship quality of couples where one partner was incarcerated and diagnosed with co-occurring ADHD and depression. The direct and indirect influences of these factors on relationship quality were assessed.</p><p><strong>Results: </strong>The findings indicated that higher levels of substance use and depressive symptoms, along with lower levels of self-efficacy and substance use treatment, were associated with lower relationship quality. ADHD indirectly affected relationship quality via substance use (β = -.015, 95% CI [-0.023, -0.008]) and self-efficacy (β = -.027, 95% CI [-0.039, -0.016]). Depression had both direct effects on relationship quality (β = -.180, 95% CI [-0.224, -0.138]) and indirect effects via substance use (β = -.023, 95% CI [-0.033, -0.015]), self-efficacy (β = -.040, 95% CI [-0.056, -0.025]), and through substance use and substance treatment (β = -.002, 95% CI [0.001, 0.005]).</p><p><strong>Conclusion: </strong>These findings highlight the need for further research to explore combined substance use and mental health treatment programs. Such interventions could potentially reduce recidivism rates, and promote the quality and maintenance of relationships among incarcerated individuals and their partners.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241284097"},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396611","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":"'You Can Die With Me But I Won't Let You Live With Me', Exploring Social Influences on the Continuation of Heroin Use in Men Who Use Heroin.","authors":"Ben Houghton, Christos Kouimtsidis, Theodora Duka, Yannis Paloyelis, Alexis Bailey, Caitlin Notley","doi":"10.1177/29768357241276320","DOIUrl":"10.1177/29768357241276320","url":null,"abstract":"<p><strong>Background: </strong>Heroin is a substance with a unique social profile in that it is commonly used by individuals alone but there is a paucity of qualitative research exploring how social influences impact the continuation of heroin use, particularly when people are trying to stop using heroin. This study explored social determinants which influence the continuation of heroin use in males in UK community treatment who use illicit heroin alongside opioid replacement therapy.</p><p><strong>Design: </strong>Participants were self-selecting from an initial purposively recruited sample. Using Janis (1972) 8 symptoms of Groupthink as an a priori framework for analysis, the study method utilised qualitative interviews with fourteen males. The discussions were digitally-recorded, transcribed verbatim, and analysed thematically.</p><p><strong>Findings: </strong>Contrasting with the evidence base, the sample included people who transitioned from recreational drug use to dependent heroin use without experiencing trauma of any kind. Far from becoming socially isolated when actively using heroin, interviews identified a shift in social networks from networks built on shared moments to networks underpinned by transactional exchange. Components of Groupthink were identified when participants described belonging to heroin using networks and continued to use heroin whilst trying to abstain though individual accountability was central to the decision to continue to use heroin.</p><p><strong>Conclusions: </strong>The conflict between the individual goal of abstinence and the group goal of continuation suggests that social network interventions could be more successful if delivered to cohorts of people who buy heroin together.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241276320"},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373990","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":"Treatment Journey and Healthcare Resource Use Among Patients With Alcohol Use Disorder Who Initiated Extended-Release Naltrexone: An Analysis of Veterans Affairs Data.","authors":"Regina Grebla, Jieruo Liu, Amy K O'Sullivan, Sherry Shi, Elyse Swallow, Angela Lax, Maria A Sullivan, Shuqian Liu, Lizheng Shi, Katie Witkiewitz, Karen Drexler","doi":"10.1177/29768357241280713","DOIUrl":"https://doi.org/10.1177/29768357241280713","url":null,"abstract":"<p><strong>Background: </strong>The US Department of Veterans Affairs, Department of Defense (VA/DoD) clinical guidelines recommend extended-release naltrexone (XR-NTX) as a treatment option for moderate-to-severe alcohol use disorder (AUD); however, contemporary real-world outcomes related to this guideline are lacking. This retrospective, observational, descriptive study examined treatment patterns and healthcare resource use (HCRU) among veterans with an AUD diagnosis who initiated XR-NTX.</p><p><strong>Methods: </strong>Veterans with incident AUD who initiated XR-NTX between 8/2014 and 11/2018 were identified. Treatment patterns and HCRU were assessed during the 1-year baseline period before and following XR-NTX initiation (the index date).</p><p><strong>Results: </strong>Of the 3665 VA patients (mean [SD] age: 46 [12.5] years; male: 89.7%; White: 76.9%) included in the study, time from AUD diagnosis to XR-NTX initiation was highly variable (mean [range]: 13.6 [0-50.5 months]). Patients received a mean [SD] of 6.8 [6.1] XR-NTX administrations; 44.4% received ⩾6. Mean [SD] time to XR-NTX discontinuation was 93.4 [75.7] days, and 31.3% of discontinuing patients resumed XR-NTX therapy. Of those who received other subsequent medications for AUD, 38.6% (acamprosate) to 47.8% (disulfiram) re-initiated XR-NTX. The proportion of patients with ⩾1 inpatient admissions decreased during follow-up compared with baseline (all-cause: 61.5% to 37.8%; AUD-related: 58.0%-35.4%); with a smaller decrease observed in emergency department (ED) visits. In contrast, more patients had ⩾1 outpatient visits during follow-up (all-cause: 97.5%-99.7%; AUD-related: 84.4%-92.7%). Compared with baseline, mean number of inpatient admissions and ED visits decreased during follow-up, while the number of outpatient visits increased for both all-cause and AUD-related care.</p><p><strong>Conclusions: </strong>Among VA patients with AUD who initiated XR-NTX, we observed reductions in all-cause and AUD-related acute care, and increases in outpatient care. This finding demonstrates a possible transition from acute, inpatient treatment to long-term, outpatient care that may reflect a reduction in disease severity. Additional research is warranted.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241280713"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Perspective of an Inpatient Addiction Medicine Unit Implemented in an Urban Northern Acute Care Hospital in Ontario, Canada.","authors":"Kristen A Morin, Adele Bodson, Karla Ghartey, Krysten A Patrick, Shannon Knowlan, David C Marsh, Natalie Aubin, Tara Leary","doi":"10.1177/29768357241280579","DOIUrl":"https://doi.org/10.1177/29768357241280579","url":null,"abstract":"<p><strong>Background: </strong>An Addiction Medicine Unit (AMU) represents a promising approach to enhancing hospital care for individuals who use substances, but there is limited research to understand patients' perspectives on AMUs. Therefore, the study objectives involved exploring patients' experiences with the AMU.</p><p><strong>Methods: </strong>Qualitative semi-structured interviews were conducted with 17 patients to gather their perspectives about the AMU. The AMU offers specialized inpatient addiction support, integrating medical and psychosocial interventions while facilitating connections to community supports to stabilize patients and manage addiction-related issues using a harm reduction philosophy.</p><p><strong>Results: </strong>Factors identified by patients that lead to positive experiences with the AMU included: efficient access to high-quality acute medical care, specialized addiction care, and additional support for non-medical needs. Patients emphasized the benefits of having peer support workers on staff, the overall positive interactions with staff, and how different these experiences were from their hospital admissions outside of the AMU. Factors identified by patients that should be considered in an AMU included: the ease of access to substances, negative interactions with other patients, and self-stigma/internalized discrimination. Also, the patient perspective reflected varied views on harm reduction. Patients' perception of the impact of an AMU overall reflected that the AMU is an effective way to deliver comprehensive treatment, to address the needs of PWUS, both medical and substance-use-related issues. They identified that the unit's intentional harm reduction philosophy facilitated access to care and positive patient-staff interactions, emphasizing the unit's progress in reducing fear and judgment and rebuilding trust in the healthcare system.</p><p><strong>Conclusion: </strong>The introduction of a new AMU in a Northern urban acute care hospital in Ontario has yielded positive patient experiences. The AMU model shows potential to re-establish trust between patients and providers, but ongoing efforts are needed to address underlying stigma to be more effective.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"18 ","pages":"29768357241280579"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11388301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305619","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}