Addiction Science & Clinical Practice最新文献

{"title":"Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study.","authors":"Emily G Hichborn, Owen B Murray, Eilis I Murphy, Tess E Gallant, Sarah K Moore, Bethany M McLeman, John Saroyan, Anthony Folland, Megan Mitchell, Lisa A Marsch","doi":"10.1186/s13722-024-00529-8","DOIUrl":"https://doi.org/10.1186/s13722-024-00529-8","url":null,"abstract":"<p><strong>Background: </strong>Opioid-related fatal overdoses are occurring at historically high levels and increasing each year. Accessible social and financial support are imperative to the initiation and success of treatment for Opioid Use Disorder (OUD). Medications for Opioid Use Disorder (MOUD) offer effective treatment but there are many more people with untreated OUD than receiving evidence-based medication. Patient-centered care is associated with increased care utilization for substance use disorders. This qualitative study explored the patient perspective of OUD care through a Patient-Centered Care (PCC) framework to illuminate patients' sense of engagement in care.</p><p><strong>Methods: </strong>Fifteen semi-structured telephone interviews were conducted from August through November of 2021 regarding patient experiences receiving MOUD in 13 Vermont Hub and Spoke clinics. Emergent themes were deductively mapped to PCC domains of Therapeutic Alliance, Individualized Care, Shared Decision-Making, and Holistic Care.</p><p><strong>Results: </strong>Participants indicated that PCC fostered engagement and often characterized MOUD clinics they no longer attended as lacking in PCC. Themes related to Therapeutic Alliance were the most prevalent and suggest pathways to retention. Individualizing care through flexible appointment scheduling was strongly valued, while inflexible scheduling fostered fear of not getting medication. Some participants indicated they were less likely to remain in care when providers did not include them in decisions about medication type, dose, or formulation. Participants also appreciated holistic biopsychosocial care and care referrals.</p><p><strong>Conclusions: </strong>Patient-centered MOUD care was important to participants and encouraged engagement in care. Prioritizing alliance with patients, adapting care to patient needs and preferences particularly when scheduling, including patients in medication decisions, and biopsychosocial attention to patients are congruent with patient perception of desirable MOUD care. Having this understanding of an established, leading MOUD treatment system may serve to benefit states looking to implement this model, or for states who are looking to improve the model they already have in place, potentially leading to higher treatment and retention rates.</p><p><strong>Trial registration: </strong>This was not a clinical trial involving an intervention, and therefore registration was not required.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"3"},"PeriodicalIF":3.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance use recovery needs among college students seeking recovery services: a thematic qualitative analysis.","authors":"Lindsey M Nichols, Tiffany B Brown, Angela Allmendinger, Emily A Hennessy, Emily E Tanner-Smith","doi":"10.1186/s13722-024-00518-x","DOIUrl":"https://doi.org/10.1186/s13722-024-00518-x","url":null,"abstract":"<p><strong>Background: </strong>College students who are in recovery from substance use disorders face challenges related to abstaining from substance use, finding supportive social networks, and achieving their academic goals. These students may therefore seek out various recovery supports at their institutions to meet their needs and goals.</p><p><strong>Methods: </strong>This study analyzed previously collected data to explore themes related to students' experiences of recovery, including their recovery needs and challenges while also attending college. We conducted qualitative thematic analysis of written responses to open-ended prompts posed to 92 college students from one university (47% female; M age = 21.5 years, SD = 5.6) who participated in a larger parent study of Collegiate Recovery Programs in the United States. We used a phenomenological approach to guide the current study, to characterize the meaning and experience within the shared phenomenon of recovery processes among college students.</p><p><strong>Results: </strong>Two broad categories emerged, representing nine total themes that were coded: (a) intrapersonal factors: recovery-specific challenges, self-care and coping, mental and behavioral health, life challenges, and personal motivations and attributes; and (b) interpersonal/social factors: 12-step recovery supports, external supports and community, college environment, and relationships with others.</p><p><strong>Conclusions: </strong>Findings offer insight into barriers and facilitators to recovery among colleges students and are discussed in terms of their implications for primary stakeholders at institutions of higher education to support college students in substance use recovery.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"2"},"PeriodicalIF":3.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis.","authors":"Kevin Y Xu, Jennifer K Bello, Joanna Buss, Hendrée E Jones, Laura J Bierut, Dustin Stwalley, Hannah S Szlyk, Caitlin E Martin, Jeannie C Kelly, Ebony B Carter, Elizabeth E Krans, Richard A Grucza","doi":"10.1186/s13722-024-00530-1","DOIUrl":"https://doi.org/10.1186/s13722-024-00530-1","url":null,"abstract":"<p><strong>Background: </strong>The postpartum period provides an opportunity for birthing people with opioid use disorder (OUD) to consider their future reproductive health goals. However, the relationship between the use of medication for opioid use disorder (MOUD) and contraception utilization is not well understood. We used multistate administrative claims data to compare contraception utilization rates among postpartum people with OUD initiating buprenorphine (BUP) versus no medication (psychosocial services receipt without MOUD (PSY)) in the United States (US).</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed data from the Merative™ MarketScan^® Multi-State Medicaid Databases 2016-2021 among postpartum women with OUD who did and did not initiate BUP during pregnancy. Our primary outcome was the receipt of prescribed highly-effective or effective contraception by 90 days postpartum. Highly-effective contraception was defined as female sterilization and long-acting reversible contraception [LARC]). Effective contraception was defined as oral contraceptive pills [OCPs], the contraceptive patch, ring, or injection. We used multivariable Poisson regression models, adjusting for sociodemographic and clinical characteristics, to measure the association of BUP (vs. PSY) on postpartum contraception utilization.</p><p><strong>Results: </strong>Our sample consisted of 11,118 postpartum people with OUD. Among those, 3,443 initiated BUP and 7,675 received PSY. By 90 days postpartum, 22.4% (n = 2,487) of the cohort were prescribed contraception (21.5% PSY vs. 24.3% BUP). Among these participants, most received LARC (41.0%), followed by female sterilization (27.3%), the contraceptive injection (17.3%), pills (8.6%), ring (4.7%), and patch (1.0%), Compared to people engaged in PSY, BUP receipt was associated with a greater use of prescribed contraceptive use by 90 days postpartum (adjusted relative risk [aRR] = 1.17[1.07-1.28]), including a modestly greater use of the patch, ring, and pills, (aRR = 1.13[1.08-1.18]), but a modestly lesser use of injection contraception (aRR = 0.95[0.91-0.99]). There was no relationship observed between BUP and LARC use (aRR = 1.00[0.95-1.04]) and female sterilization (aRR = 1.01[0.98-1.06]).</p><p><strong>Conclusions: </strong>Only 22% of pregnant people with OUD in our cohort used effective or highly-effective postpartum contraception. BUP receipt during pregnancy, relative to PSY, was associated with modestly greater use of prescribed effective contraceptive methods but was not associated with greater use of provider-administered contraceptive methods, such as the contraceptive injection, LARC and female sterilization.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"1"},"PeriodicalIF":3.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of family physicians in Istanbul about e-cigarettes as smoking cessation aids: a qualitative study.","authors":"Melis Selamoglu, Ayse Emel Onal, Bircan Erbas, Selma Karabey, Meryem Merve Oren, Mahmut Talha Ucar, Chris Barton","doi":"10.1186/s13722-024-00532-z","DOIUrl":"10.1186/s13722-024-00532-z","url":null,"abstract":"<p><strong>Background: </strong>Family physicians (FPs) are the first point of contact for people who smoke who are seeking to quit smoking in Türkiye. We aimed to explore Turkish FPs knowledge, attitudes and perceptions of e-cigarettes as smoking cessation aids.</p><p><strong>Methods: </strong>Eleven in-depth semi-structured interviews were conducted with FPs in Istanbul, Türkiye. Participants were recruited through purposeful sampling from respondents to a previous survey study completed with 243 participants in 2022. The survey explored the knowledge, attitudes and recommendations of FPs in Istanbul about e-cigarettes as smoking cessation aids. Participants indicated availability for a follow up qualitative interview. FPs were interviewed and audio files were transcribed verbatim. QSR NVivo was used to aid coding, thematic analysis and retrieval of quotes.</p><p><strong>Results: </strong>FPs expressed they had little knowledge about e-cigarettes and this impacted their confidence to discuss these with their patients. They held a range of views on the harms of e-cigarettes and the potential for a gateway effect and dual use with tobacco cigarettes. FPs stated they would not recommend e-cigarettes as smoking cessation aids and half were not keen on a prescription model for e-cigarettes. FPs did not feel comfortable or have the confidence to answer patient questions about e-cigarettes if asked. They were keen to learn more about e-cigarettes and receive training and education to be able to better inform their patients about e-cigarettes as smoking cessation aids.</p><p><strong>Conclusion: </strong>FPs in Türkiye require more understanding of e-cigarettes if they are to answer patient questions about using e-cigarettes to support smoking cessation. They perceived to be lack of evidence and research on the harms of vaping and as such were not currently willing to recommend them to patients. FPs desired more information and resources from trusted sources to support them to learn about e-cigarettes in order to discuss them with patients. Providing evidence-based information and upskilling FPs on e-cigarettes may increase their knowledge and confidence to have discussions about e-cigarettes for smoking cessation.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"99"},"PeriodicalIF":3.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the Korean patient placement criteria matching among individuals with alcohol-related problems with treatment completion and abstinence: an observational study.","authors":"Jiyoung Hong, Seon-Hi Shin, Ji Eun Kim, Sang Kyu Lee, Hong Seok Oh, Euihyeon Na, Hyun Ji Cho, Sungwon Roh","doi":"10.1186/s13722-024-00521-2","DOIUrl":"10.1186/s13722-024-00521-2","url":null,"abstract":"<p><strong>Background: </strong>The American Society of Addiction Medicine Patient Placement Criteria (ASAM PPC) are guidelines for matching addiction patients to an optimal level of care (LOC). South Korea lacked a systematic approach to assigning alcohol use disorder patients to suitable treatment. To address this, Park et al. translated the ASAM PPC into Korean, creating the Korean Patient Placement Criteria (KPPC). We aim to assess the efficacy of the KPPC by evaluating whether receiving KPPC-matched treatment would result in longer periods of alcohol abstinence and higher number of treatment program completion.</p><p><strong>Methods: </strong>This is an observational, multi-site study of 225 individuals with hazardous alcohol use or alcohol dependence, defined by Alcohol Use Disorder Identification Test score of 10 or more for men, and 6 or more for women. We evaluated patients using KPPC at baseline and one-month follow-up visits and recommended a LOC at every visit. Patients freely chose to receive KPPC-matched treatment or not. We examined the duration of alcohol abstinence and number of one-month treatment program completion within a three-month period.</p><p><strong>Results: </strong>Of the 225 participants, 47 never pursued their matched level of care treatment, 54 pursued it once, and 124 pursued it twice. Individuals who received KPPC-matched treatment once had significantly higher odds of achieving alcohol abstinence (OR = 2.23), with greater odds when they received KPPC-matched treatments twice (OR = 2.88). The association was also significant for treatment completion, with greater odds of completing treatment program for one KPPC-matched treatment (OR = 3.28) and two KPPC-matched treatments (OR = 3.19).</p><p><strong>Conclusions: </strong>Individuals who followed the KPPC matched level of care had longer periods of alcohol abstinence and better treatment completion. Our results should encourage community addiction management centers and hospitals to adopt KPPC for classifying treatment settings for alcohol use disorder patients. Further research is warranted to maximize the potential benefits of KPPC.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"98"},"PeriodicalIF":3.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readiness to implement contingency management to promote PrEP initiation and adherence among people who inject drugs: results from a multi-site implementation survey.","authors":"Eleanor Pickering, Adam Viera, Minhee L Sung, Daniel Davidson, Genie Bailey, Marianne Buchelli, Mark Jenkins, Jennifer Kolakowski, Leah Maier, E Jennifer Edelman, Carla J Rash","doi":"10.1186/s13722-024-00503-4","DOIUrl":"10.1186/s13722-024-00503-4","url":null,"abstract":"<p><strong>Background: </strong>Contingency management (CM), an incentive-based intervention to encourage target behaviors, effectively promotes medication adherence. However, efforts to extend CM to HIV pre-exposure prophylaxis (PrEP) have been lacking. As part of a randomized clinical trial to promote HIV Prevention among people who inject drugs (PWID), we examined the readiness of staff in community-based organizations serving PWID to implement CM for PrEP uptake and adherence in this population.</p><p><strong>Methods: </strong>From April to August 2022, we conducted a survey of staff from four community-based organizations providing HIV testing, harm reduction, and outreach services in the northeastern United States. We assessed knowledge and attitudes regarding PrEP for PWID on five-point Likert scales (e.g., Poor to Excellent, Not at all to Extremely). Using a modified version of the Contingency Management Beliefs Questionnaire, we assessed the degree to which attitudes about CM for HIV prevention influenced interest in its adoption on a scale from \"1-No influence at all\" to \"5-Very strong influence\". We explored endorsement patterns, along with average values of individual items and subscale scores.</p><p><strong>Results: </strong>Among 271 staff invitations, 123 (45.4%) responded. The majority (88.6%) of respondents reported prior PrEP awareness, with a mean self-rated knowledge of 2.98 out of 5 (SD = 1.1). Attitudes towards PrEP, including its relevance to and importance for clients (both means = 4.3), efficacy (mean = 4.5), and safety (mean = 4.2), were positive. Items related to practicality and confidence in providing PrEP-related care had relatively lower ratings. Respondents endorsed influential generalized (mean = 2.1) and training-related (mean = 2.5) CM implementation barriers less frequently than positive attitudes towards CM (mean = 3.6). Staff favored adding CM to existing services (mean = 3.8), and highly endorsed it as \"useful for targeting HIV prevention with PrEP\" (mean = 3.7).</p><p><strong>Conclusions: </strong>Respondents generally supported the use of CM to promote HIV prevention among PWID and favored adding it to their existing services. Though respondents understood the value of both PrEP and CM to support HIV prevention activities, findings corroborate research citing relative lack of knowledge and confidence regarding PrEP management among clients, potentially detracting from implementation readiness.</p><p><strong>Trial registration number: </strong>NCT04738825.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"97"},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organization of primary care and early MOUD discontinuation.","authors":"Rebecca Arden Harris, Matthew Kearney, Shimrit Keddem, Tara Calderbank, Liza Tomczuk, Justin Clapp, Jeanmarie Perrone, Henry R Kranzler, Judith A Long, David S Mandell","doi":"10.1186/s13722-024-00527-w","DOIUrl":"10.1186/s13722-024-00527-w","url":null,"abstract":"","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"96"},"PeriodicalIF":3.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medications for opioid use disorders among incarcerated persons and those in the community supervision setting: exploration of implementation issues with key stakeholders.","authors":"Augustine W Kang, Amelia Bailey, Anthony Surace, Lynda Stein, Damaris Rohsenow, Rosemarie A Martin","doi":"10.1186/s13722-024-00528-9","DOIUrl":"10.1186/s13722-024-00528-9","url":null,"abstract":"<p><strong>Introduction: </strong>Receipt of medications for opioid use disorder (MOUD) critically reduces opioid-related mortality during the post-incarceration period. Optimal provision of this care to individuals on community supervision (i.e., probation) requires an understanding of this unique and complex system at the local level.</p><p><strong>Methods: </strong>We conducted in-depth individual interviews with key treatment providers and probation staff (n = 10) involved with the provision of MOUD to individuals on community supervision in the Northeast. Interviews explored perspectives on the provision of MOUD and support services during the community supervision period. Thematic analysis was conducted to describe inductive and deductive codes, subcodes, and themes.</p><p><strong>Results: </strong>Stakeholders shared diverse attitudes about the benefits and drawbacks of MOUD utilization. The provision of MOUD during the community supervision period was perceived to be influenced by both treatment and probation organizational characteristics, including the structures and values of the agencies. As such, the specific context of the community supervision setting facilitated and impeded MOUD delivery. Persistent challenges to enhancing MOUD delivery to this population remain including widespread MOUD stigma, inter-agency communication issues, and structural barriers to healthcare (i.e., transportation, finances).</p><p><strong>Conclusions: </strong>There are opportunities to enhance access to evidence-based OUD treatment for persons on community supervision by engaging probation agencies and community treatment staff in systems change.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"95"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centering autonomy and choice to support oral PrEP utilization among people who inject drugs: qualitative lessons from HPTN 094 INTEGRA.","authors":"Amaya Perez-Brumer, Rose Schmidt, Rebecca Kennedy, Jordan E Lake, Yolanda R Villarreal, Sydney Bornstein, Irene Kuo, Omar Nieto, Julie Franks, Cecile Denis, Nabila El-Bassel, Steve Shoptaw, Peter Davidson, Laramie R Smith","doi":"10.1186/s13722-024-00520-3","DOIUrl":"10.1186/s13722-024-00520-3","url":null,"abstract":"<p><strong>Background: </strong>Oral Pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, despite high rates of HIV risk behaviors among people who inject drugs (PWID), this population remains underserved by current HIV prevention efforts in the United States. To address this challenge, we conducted an in-depth exploration of perspectives on using oral PrEP among PWID engaged in the HIV Prevention Trials Network (HPTN) 094 INTEGRA Study.</p><p><strong>Methods: </strong>Guided by the Practical, Robust, Implementation, and Sustainability Model (PRISM), our qualitative study drew on semi-structured interviews conducted as part of the embedded implementation science evaluation of HPTN 094 INTEGRA. Seventy-seven PWID participants from five sites across New York City, Houston, Los Angeles, Philadelphia, and Washington DC were interviewed to assess intervention delivery, care access, and engagement sustainability. Audio files were transcribed verbatim and analyzed via an inductive and deductive thematic approach.</p><p><strong>Results: </strong>Most participants (n = 46, 59.7%) discussed oral PrEP during their interview, though not directly prompted. Participants discussing PrEP had a mean age of 41.6 years and were predominantly white (54.3%) and cisgender men (60.9%). Among these, 15 participants described using PrEP. All participants had facilitated access to oral PrEP. Yet, the choice to use PrEP was influenced by personal risk perceptions, (mis)information about PrEP, and external factors (i.e. housing, financial security), which, for some, limited the autonomy to use PrEP. Two key themes emerged among participants using PrEP: ease of access and perceptions of high HIV risk. Those not using PrEP described two themes: low risk perception and prioritizing more urgent needs. Among participants not using PrEP a subgroup commonly described ambivalent interest, PrEP knowledge gaps, and PrEP readiness (i.e., contemplation).</p><p><strong>Conclusions: </strong>Qualitative findings highlight that facilitated PrEP access was insufficient to motivate use for many participants. Rather, PrEP decision-making process (i.e., choice) was linked to risk perception and individuals' capability to leverage PrEP as a resource based on their circumstances (i.e., autonomy). Participants' descriptions of the centrality of choice and autonomy for PrEP use underscore that ease of access is a necessary pre-condition, but person-centered interventions should also address housing, financial stability, and urgent medical conditions to promote PrEP utilization among PWID.</p><p><strong>Clinical trial registration: </strong>NCT04804027.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"92"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grayken Lessons: a patient who developed opioid use disorder after traumatic brain injury.","authors":"Gabriela Reed, Hansel Lugo, Rachel Sayko Adams, Alexander Y Walley","doi":"10.1186/s13722-024-00525-y","DOIUrl":"10.1186/s13722-024-00525-y","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is common in people with substance use disorders (SUDs). TBI often results in cognitive deficits which can affect the clinical course of SUD.</p><p><strong>Case presentation: </strong>Here we present the case of a 34-year-old Spanish-speaking man with severe opioid use disorder and two prior TBIs affecting his cognitive abilities. He was linked to outpatient addiction specialty care at a community health center. After identification of his TBI history, his care team, which included a language-concordant physician and peer recovery coach, worked to develop a treatment plan that accounted for his unique cognitive deficits and behavioral challenges. He was also connected with community resources including a rehabilitation program designed for people with TBI. These individualized aspects of treatment helped to better engage and retain the patient in quality care for his SUD.</p><p><strong>Conclusions: </strong>By identifying TBI history in people with SUDs, the treatment plan can be tailored to accommodate TBI-related deficits. An effective care plan should incorporate not only medical providers, but also resources such as peer recovery supports and TBI-focused rehabilitation programs when and where they are available, with an emphasis on improving functional capacity.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"94"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}