Substance use : research and treatment最新文献

{"title":"Exploring Socio-Ecological and Structural Factors Among Black Men in Rural South Carolina to Inform Substance Use Disorder Interventions: A Qualitative Study.","authors":"Serge R Wandji, Jean E Davis, Monica H Swahn, Mohan Madisetti, Charlene Pope","doi":"10.1177/29768357251349918","DOIUrl":"10.1177/29768357251349918","url":null,"abstract":"<p><strong>Objective: </strong>This formative study aimed to explore socio-ecological and structural determinants that influence substance use disorders (SUD) among Black men in rural areas of South Carolina (USA) and inform the design of culturally relevant community-based interventions.</p><p><strong>Methods: </strong>Black adult men (N = 15; ages 33-66 years) with known SUD were recruited from outpatient treatment centers, homeless shelters, and via community outreach initiatives within rural areas of South Carolina. Written informed consent was obtained, and interviews were conducted using a structured interview guide. Interview data was audio-recorded, coded and analyzed until consensus was reached on emergent themes. Data were collected between June 2023 and May 2024.</p><p><strong>Results: </strong>Five primary themes emerged: perceptions and experiences with substance use, contributing factors to substance use, determinants of treatment acceptance, and relapse triggers. Findings from this work highlight barriers such as financial constraints, peer influence, social dynamics, and systemic inequalities that hinder SUD treatment engagement for Black men in the rural South. Facilitators such as community and familial support, cultural considerations, and self-awareness were identified as critically important for encouraging treatment acceptance.</p><p><strong>Conclusion: </strong>This exploratory study provides insight into the socio-cultural and structural complexities faced by Black men in rural South Carolina (USA) regarding SUD treatment and relapse prevention. Our findings support the call for culturally sensitive, community-driven research and interventions that address both personal and systemic challenges. Larger and interdisciplinary studies are needed to address urgent prevention and treatment gaps, and pervasive disparities in SUD treatment outcomes for Black men in medically underserved rural communities.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251349918"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736513","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":"Alcohol Consumption Impacts Liver Fibrosis Progression in Minority of Patients Screened for Hepatitis C at Drug Treatment Centers.","authors":"Alberto Hernández-Bustabad, Dalia Morales-Arraez, Ruth Ramos, Luz Goretti Santiago Gutiérrez, María Jesús Medina Alonso, Zaida Ramos-Marrero, Victor Pérez Pérez, Eva Molina Carballo, Felicitas Diaz-Flores, Julia Nazco, Fernando Gutiérrez, Manuel Hernández-Guerra","doi":"10.1177/29768357251347821","DOIUrl":"10.1177/29768357251347821","url":null,"abstract":"<p><strong>Background & aims: </strong>Hepatitis C virus (HCV) infection is a prevalent disease at drug treatment centers (DTC). Alcohol abuse may also contribute to liver fibrosis at DTC, which may affect the prescription of HCV therapy. This study evaluated the risk of alcohol intake and other predictive factors for fibrosis progression.</p><p><strong>Methods: </strong>An on-site dried-blood-spot (DBS) testing program for hepatitis C care at DTC from 2017 to 2019 was used to identify patients with previous HCV-antibody testing and fibrosis score data. Patients were grouped based on RNA status, alcohol intake and advanced liver disease (ALD ⩾ F3). Fibrosis progression was assessed using APRI and FIB-4. Kaplan-Meier and Cox-regression analyses were performed.</p><p><strong>Results: </strong>Positive HCV RNA patients (n = 138) exhibited a higher rate of ALD (11% vs 2.2%, <i>P</i> < .001) and a higher risk of fibrosis progression during follow-up (HR = 3.14, 95% CI: 1.2-8.2) than patients who did not have an infection (n = 230). Overall, 25% (n = 84) reported high-risk alcohol consumption, which was associated with an increased risk of ALD in patients with RNA positivity (HR = 3.2; 95% CI: 1.1-9.1). Alcohol consumption at any dose regardless of HCV infection status was not associated with ALD. Age, high-risk alcohol consumption, and RNA positivity were independent factors for progression to ALD.</p><p><strong>Conclusions: </strong>Patients with active HCV infections at DTC have an increased risk for ALD compared to patients without HCV. High-risk alcohol consumption is present in a minority of patients aggravating fibrosis. These results suggest that HCV treatment should not be delayed at DTC regardless of alcohol consumption.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251347821"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593388","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":"How Much Treatment are Adolescents Receiving in Specialised Substance Use Healthcare in Sweden? Age and Cohort Trends.","authors":"Patrik Karlsson, Mats Ekendahl, Philip Lindner","doi":"10.1177/29768357251351758","DOIUrl":"10.1177/29768357251351758","url":null,"abstract":"<p><strong>Background: </strong>There is little systematic research on what adolescents are provided within specialised substance use treatment. This study explored trends in treatment received (number of outpatient treatment visits and inpatient treatment episodes) according to year and age at first contact among adolescents who were enrolled at Sweden's largest treatment provider, the Maria Ungdom Clinic in Stockholm, between 2011 and 2021.</p><p><strong>Methods: </strong>The data were derived from electronic health records for all patients (n = 29 967) who were in contact with Maria Ungdom Stockholm between 2011 and 2021. Negative binomial regressions estimated the association between year cohort and age at first contact and number of outpatient visits respective number of inpatient episodes. We also tested whether trends according to year cohort and age at first contact were moderated by sex and treatment type.</p><p><strong>Results: </strong>Patients in earlier cohorts and those who were younger at first contact had more outpatient visits. A similar association with age at first contact was observed for inpatient treatment, but was less evident for year cohort. Differences in outpatient visits according to year cohort and age at first contact were mainly observed in patients enrolled in both outpatient and inpatient treatment, and the same held true for differences in number of inpatient episodes according to age at first contact. Regression models that adjusted for potential different exposure time found a higher treatment rate among later cohorts and patients who were older at first contact.</p><p><strong>Conclusion: </strong>Patients in the earlier year cohorts and who were at younger age at first contact with Maria Ungdom received most treatment. However, later cohorts and patients who were at an older age at first contact with Maria Ungdom had a higher treatment rate, suggesting that these groups were provided with a more intensive treatment.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251351758"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577549","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":"Exploring Nicotine Dependence Among People Using Methamphetamine During Methadone Maintenance Treatment in Vietnam.","authors":"Nguyen Truong Giang, Nguyen Bich Diep, Nguyen Thu Trang, Pham Thanh Luan, Hoang Thi Hai Van, Do Van Dung, Michael Li, Chunqing Lin, Li Li, Steve Shoptaw, Le Minh Giang","doi":"10.1177/29768357251347819","DOIUrl":"10.1177/29768357251347819","url":null,"abstract":"<p><strong>Introduction: </strong>Cigarette smoking is common among individuals with substance use disorders and those undergoing addiction treatment. Cigarette use is highly comorbid with methamphetamine use, and among individuals who co-use methamphetamine and opioids, nicotine dependence may further complicate smoking cessation efforts. This study examines nicotine dependence levels and associated factors among people who use methamphetamine undergoing methadone maintenance treatment (MMT) in Vietnam.</p><p><strong>Methods: </strong>This cross-sectional analysis utilized baseline data from 667 participants enrolled in a randomized controlled trial designed to evaluate the effectiveness of various combinations of behavioral evidence-based interventions for methamphetamine use among patients on MMT in Vietnam (STAR-OM R01DA050486). Data on levels of nicotine dependence and other covariates including demographic, health status, treatment characteristics and substance use were collected. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence, with a score of 6 or higher indicating high dependence. Logistic regression estimated the association between nicotine dependence and various psychosocial and behavioral factors.</p><p><strong>Results: </strong>Overall, 96.7% of the participants were current smokers with 247 of them (38.3%) exhibiting high nicotine dependence. Greater severity of methamphetamine withdrawal symptoms (OR: 1.03; 95% CI: 1.01-1.05) and a high risk of depression, anxiety or stress (OR: 1.76; 95% CI: 1.14-2.72) were associated with increased odds of high nicotine dependence. Conversely, older age at onset of methamphetamine use was associated with lower odds of high nicotine dependence.</p><p><strong>Conclusions: </strong>Cigarette smoking was highly prevalent among individuals using methamphetamine during MMT, with many exhibiting high nicotine dependence. Providing smoking cessation support with efforts to manage methamphetamine withdrawal symptoms, could help improve cessation outcomes.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251347819"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500081","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":"A Qualitative Study to Explore Feasibility of Implementing Seeking Safety and Trauma-Sensitive Yoga.","authors":"Teresa Naseba Marsh, Farah Tahsin, Kristen A Morin, Tammy Linekar, Harry Jones, David C Marsh","doi":"10.1177/29768357251350869","DOIUrl":"10.1177/29768357251350869","url":null,"abstract":"<p><strong>Background: </strong>Seeking Safety (SS) is an evidence-based intervention that benefits patients living with co-occurring PTSD and SUD. Trauma Sensitive Yoga (TSY) has been found to be another beneficial treatment for this patient population. In this study, we examine the feasibility of implementing both SS and TSY within a residential addiction treatment program to support this patient population.</p><p><strong>Methods: </strong>We conducted a qualitative prospective evaluation at the Jubilee Treatment Centre in Timmins Ontario from March 2023 to October 2023. Staff members of this center delivered the SS intervention and the TSY was delivered virtually by a certified yoga teacher to the participants. The data sources included patient data, focus groups, and treatment satisfaction surveys to evaluate the effect of this blended intervention on study participants and program staff. A descriptive statistical analysis as well a thematic analysis was conducted to analyze both quantitative and qualitative data, respectively.</p><p><strong>Results: </strong>A total of 45 individuals, participated in this 6-month-long intervention. The average age of the participants was 37.88. 84.44% of participants experienced mental health problems in the last 90 days, and 80% used substances in the last 90 days. The paired <i>t</i>-test analysis indicated a significant difference in Trauma Symptoms Checklist 40 scores before and after the intervention.</p><p><strong>Conclusion: </strong>This study provided valuable insights into participants' experiences of participating in this innovative intervention. The finding can benefit future researchers who seek to implement similar programs to support individuals with PTSD and SUD.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251350869"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500080","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":"Pain Management Strategies for Patients Receiving Extended-Release Buprenorphine for Opioid Use Disorder: A Scoping Review.","authors":"Pouya Azar, Jane J Kim, Farbod Azarmju, Koviya Sirohi, Jessica Machado, Anthony Lau, Jacky Siu, Martha J Ignaszewski, Julio S G Montaner, Michael Krausz","doi":"10.1177/29768357251343612","DOIUrl":"10.1177/29768357251343612","url":null,"abstract":"<p><strong>Objective: </strong>Pain is a significant clinical challenge among patients with opioid use disorder (OUD), and management strategies remain diverse and controversial. This scoping review aimed to describe and evaluate the different types of pharmacologic pain management strategies for patients who are prescribed extended-release buprenorphine (BUP-XR) for OUD and experiencing pain.</p><p><strong>Methods: </strong>The databases Ovid Medline, EMBASE, CINAHL, Web of Science, and PsycInfo were searched from their inception to February 2025 for relevant articles. All articles that discuss the treatment of acute or chronic pain among patients receiving BUP-XR were included. Data on the key outcomes of pain severity, related functioning, patient satisfaction, and adverse events were extracted and study quality was rated independently by the authors.</p><p><strong>Results: </strong>The initial search yielded 980 articles. Of those, 56 were assessed for full-text review and a total of 6 articles met inclusion criteria for the study. The overall strength of the evidence was poor, consisting mainly of case series and case reports. Most studies achieved adequate pain control through the continuation of BUP-XR and the combination of full opioid agonists and non-opioid adjuncts, adjunct use of nonsteroidal anti-inflammatory drugs, conversion to sublingual buprenorphine, or performing surgery at trough serum buprenorphine concentration. No cases of respiratory depression or toxicity were observed.</p><p><strong>Conclusions: </strong>This review confirmed that clear guidelines on how to support pain management in BUP-XR treatment have yet to be identified. The majority of clinicians favored a multimodal analgesic approach combining opioids, non-opioid analgesics, and regional anesthesia. Further studies, including high-quality evidence through randomized controlled trials, are needed to find and evaluate optimal adjunctive medications and define overall strategies.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251343612"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319144","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":"Promoting Health Equity Among People With Opioid Use Disorder and Serious Mental Illness Through the Chronic Disease Self-Management Program.","authors":"Elizabeth Siantz, Leopoldo J Cabassa, Adam J Gordon","doi":"10.1177/29768357251342749","DOIUrl":"10.1177/29768357251342749","url":null,"abstract":"<p><p>People with opioid use disorder (OUD) experience higher prevalence of serious mental illness (e.g., schizophrenia and bipolar disorder) and chronic disease (e.g., diabetes) relative to the general population, less access to high quality health care, and limited access to evidence-based treatments that promote self-management of chronic health conditions. The Chronic Disease Self-Management Program is a widely used patient education intervention that imparts disease knowledge and self-management skills to people with a range of medical conditions. In this Perspective Column, a multidisciplinary team of community-based researchers representing the fields of social work and addiction medicine argue that implementing the Chronic Disease Self-Management Program in a primary care environment is a promising way to build the self-management skills of people with OUD and co-occurring mental illness and chronic disease.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251342749"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201286","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":"Stimulant-Involved Cardiovascular Disease Mortality and Life Years Lost, 2014 to 2023.","authors":"Rebecca Arden Harris, Sameed Ahmed M Khatana, Dana A Glei, Judith A Long","doi":"10.1177/29768357251342744","DOIUrl":"10.1177/29768357251342744","url":null,"abstract":"<p><strong>Background: </strong>Cocaine and methamphetamine, highly cardiotoxic stimulants, are associated with increased risks of hypertension, coronary artery disease, arrhythmias, cardiomyopathy, and stroke.</p><p><strong>Objectives: </strong>This study examines trends in stimulant-involved cardiovascular disease (CVD) mortality in the U.S. from 2014 to 2023, analyzing CVD subtypes, stimulant type, population characteristics, and years of life lost (YLL).</p><p><strong>Design: </strong>Trend analysis of age-adjusted mortality rates using serial cross-section mortality data from 2014 to 2023.</p><p><strong>Methods: </strong>Using National Vital Statistics System data, we analyzed age-adjusted mortality rates (AAMRs) where CVD was the underlying cause of death and stimulants were contributing factors. We used Joinpoint regression to estimate average annual percent change (AAPC) and compare trends across groups. We calculated YLL based on age at death and demographic-specific life expectancies.</p><p><strong>Results: </strong>From 2014 to 2023, stimulant-involved CVD mortality rose sharply (AAPC: 10.1%), contrasting with stable rates of overall CVD mortality (AAPC: 0.2%). Methamphetamine-involved deaths increased faster (AAPC: 13.8%) than cocaine-involved deaths (AAPC: 6.5%). Among CVD subtypes, cerebrovascular disease showed the steepest rise (AAPC: 15.9%), followed by hypertensive (12.1%) and ischemic heart diseases (7.9%). Older adults (⩾65 years) exhibited the most pronounced increase in stimulant-involved CVD mortality (AAPC: 20.2%), while non-Hispanic American Indian/Alaska Native populations experienced the highest AAPC among racial/ethnic groups (18.1%). Stimulant-involved CVD caused nearly 1 million years of YLL, predominantly among middle-aged males (687 430 YLL) and non-Hispanic White individuals (511 120 YLL). Methamphetamine involvement (580 570 YLL) exceeded that of cocaine (423 528 YLL). Within CVD types, ischemic heart disease was the leading cause (406 248 YLL).</p><p><strong>Conclusions: </strong>Stimulant-involved CVD mortality has surged, especially among non-Hispanic American Indian/Alaska Native and non-Hispanic White populations and older adults, with cerebrovascular disease showing the largest increase among CVD subtypes. The findings reveal the importance of targeted prevention, screening, and intervention.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251342744"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164401","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":"A Latent Class Analysis of Psychopathology Among Adults in Residential Substance Use Treatment: Associations With Craving and Treatment Dropout.","authors":"Evan J Basting, Alyssa M Medenblik, Samantha Schlachta, Alisa R Garner, Ryan C Shorey, Gregory L Stuart","doi":"10.1177/29768357251337850","DOIUrl":"10.1177/29768357251337850","url":null,"abstract":"<p><strong>Objective: </strong>Adults receiving residential treatment for substance use disorders (SUDs) who have comorbid psychopathology face unique challenges, including an increased risk of substance use craving and treatment dropout against medical advice (AMA). Prior studies have investigated associations between specific forms of psychopathology and these outcomes. However, psychological disorders often co-occur and may cluster together to amplify risk for craving and treatment dropout AMA.</p><p><strong>Methods: </strong>This study used latent class analysis to identify patterns of psychopathology in 1046 adult patients receiving residential treatment for SUDs (73.7% men; <i>M_age</i>  = 42.31, SD = 12.13). We tested whether psychopathology classes differed in alcohol and drug cravings and treatment dropout AMA. We identified 4 latent classes: (1) high psychopathology, (2) moderate anxiety/depression, (3) illness anxiety/somatic problems, (4) low psychopathology.</p><p><strong>Results: </strong>The high psychopathology class reported significantly more alcohol and drug cravings than all other classes. The moderate anxiety/depression class also reported more alcohol cravings than the low psychopathology class. Additionally, the high psychopathology, illness anxiety/somatic problems, and moderate anxiety/depression classes had higher proportions of patients who dropped out of treatment AMA compared to the low psychopathology class.</p><p><strong>Conclusion: </strong>These findings suggest that comorbid psychopathology significantly impacts treatment outcomes in residential SUD treatment programs. Targeted interventions that address comorbid psychopathology may help reduce craving and improve treatment retention.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251337850"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096161","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":"Dropout from Substance Use Disorder Treatment at a Swedish Private Care Institution and Its Associated Risk Factors.","authors":"Kent Ehliasson, Johannes Eriksson, Riccardo LoMartire","doi":"10.1177/29768357251332827","DOIUrl":"https://doi.org/10.1177/29768357251332827","url":null,"abstract":"<p><strong>Background and objectives: </strong>The drop-out rate for inpatient treatment for substance use disorder continues to be a significant issue. To increase the knowledge about drop out in different settings, this study's objective was to quantify the association for the previously identified risk factors of age, sex, and time in treatment at a private care institution offering substance use disorder treatment in Sweden.</p><p><strong>Design and methods: </strong>This retrospective cohort study of clinical record data included all 1334 adult clients who were discharged from substance use disorder treatment between 1 January 2014, to 30 June 2022, at one privately operated treatment institution. Drop out was defined as treatment terminated before the planned end. The association between three potential risk factors and drop out was analysed in a multivariable logistic regression model. Estimates were reported as marginal risk ratios (95% confidence intervals).</p><p><strong>Results: </strong>Of 1334 discharged clients, 34% dropped out, corresponding to 38% of females and 33% of males. Approximately 52% of clients dropped out within 30 days, 42% dropped out between 30 and 89 days, and around 15% from 90 days and onwards. In the multivariable model, both time in treatment (3.08 [2.34, 3.83] for 30 to 89 days vs 90 days and 3.55 [2.72, 4.39] for <30 days vs ⩾90 days) and age (1.19 [1.14, 1.23] for one decade) showed a strong inverse association with drop out. The results did not support an association between sex and drop out (1.05 [0.89, 1.22]).</p><p><strong>Conclusion: </strong>The risk for drop out is higher earlier in the treatment and for younger clients, so to reduce the drop out at private institutional care it is important to implement extensive interventions early in the treatment programme to increase the motivation for clients, particularly younger ones, to remain in treatment.</p>","PeriodicalId":517405,"journal":{"name":"Substance use : research and treatment","volume":"19 ","pages":"29768357251332827"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037223","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}