Addiction Science & Clinical Practice最新文献

{"title":"Inpatient addiction care is associated with increased vaccinations, medication for opioid use disorder and naloxone prescribing among patients with infective endocarditis in a rural state.","authors":"Eva J Farkas, Victoria Molina, Brittany Mohoney, Wendy Craig, Jessie Schaumberg, Amy McAuliffe, Kinna Thakarar","doi":"10.1186/s13722-025-00614-6","DOIUrl":"10.1186/s13722-025-00614-6","url":null,"abstract":"<p><strong>Background: </strong>Rural states have experienced increasing injection drug use (IDU)-associated infective endocarditis (IE). Inpatient addiction consult services can reduce morbidity associated with substance use and other infectious complications, such as IDU-IE. However data on the impact of such services on healthcare utilization are limited, particularly in rural communities.</p><p><strong>Methods: </strong>This retrospective study assesses clinical and health service utilization data from index hospitalizations for IDU-IE before and after the implementation of the Integrated Medication for Addiction Treatment (IMAT) program at a tertiary care center in a rural state. We summarized data descriptively, stratified by both pre- and post-IMAT program implementation and IDU-IE and non-IDU IE. We also performed exploratory multivariable analyses assessing the association between IMAT program implementation and various outcomes. The primary outcomes were: 1) 90-day emergency department (ED) visits and 2) 30-day hospital readmissions post-discharge. Secondary outcomes included prescriptions at time of discharge for medication for opioid use disorder (MOUD), naloxone and key vaccinations.</p><p><strong>Results: </strong>We identified n = 99 patients with IDU-IE. Comparing pre- and post-IMAT implementation, 30-day readmissions trended lower post-IMAT (18%) versus pre-IMAT (22%), although the difference was not significant (p = 0.7). 90-day ED visits remained stable (37%, p > 0.9). The proportion of MOUD prescribing (24% versus 80%), hepatitis B vaccination (29% versus 51%), and Tdap vaccination (7.3% versus 41%) increased significantly following IMAT implementation (p < 0.001, p = 0.037 and p < 0.001, respectively). In a regression analysis controlling for age, housing status, primary care provider, age, hepatitis C, cardiac device, Duke's criteria, valve affected, alcohol use disorder, payer, and vascular or infectious complications, the IMAT program was not significantly associated with the primary outcomes or with hepatitis B vaccination. However, the IMAT program was associated with increased MOUD prescribing (aOR: 110; CI:16-1500), naloxone prescribing (aOR 18; CI: 1.1-1600) hepatitis A vaccination (aOR: 5.3; CI: 1.2-32), and Tdap vaccination (aOR: 9.2; CI: 2.0-59).</p><p><strong>Conclusions: </strong>Inpatient addiction services were associated with increased prescribing of MOUD, naloxone and key vaccinations, though the incidence of acute healthcare utilization did not change. These results highlight hospitalization as an opportunity to connect patients with IDU-IE to MOUD and preventative care, particularly in rural areas where access to such services may be limited.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"82"},"PeriodicalIF":3.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309855","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":"Barriers and facilitators of opioid treatment among Indigenous Syringe Services Program clients.","authors":"Jordan Stipek, Jennifer J Mootz, Frank L Johnson, Kevin A Hallgren, Atasha L Brown, Alexandra Perron, Clinton Alexander, Brenna L Greenfield","doi":"10.1186/s13722-025-00604-8","DOIUrl":"10.1186/s13722-025-00604-8","url":null,"abstract":"<p><strong>Introduction: </strong>American Indian and Alaska Native individuals are disproportionately impacted by the opioid epidemic, partially due to structural racism. Tribal nations and communities are finding innovative ways to provide opioid use disorder (OUD) treatment, but barriers to medications for opioid use disorder (MOUD) remain. This study surveyed Indigenous clients at a Syringe Services Program about barriers and facilitators to OUD treatment.</p><p><strong>Methods: </strong>Interviews were conducted with 27 Indigenous individuals who had used opioids in the past month and were receiving opioid harm reduction services from a tribally-run Anishinaabe Syringe Services Program (rural Minnesota). Participants were asked five questions in interview style format about their experiences with opioid use disorder care with a focus on barriers and facilitators. The coding team analyzed interviews utilizing the Collaborative Story Analysis method to highlight overall impressions of participants' narratives.</p><p><strong>Results: </strong>There were 27 participants: 48% male and 52% female. The main themes of barriers and facilitators were connection to others, flexibility of treatment services, and ensuring individual needs were met. Having a positive relationship with providers (e.g. non-judgmental), access to MOUD and Harm Reduction services, and minimizing assessment requirements prior to starting treatment were some of the most frequently identified facilitators to care. Lack of transportation, prioritizing care for others, and turbulent relationships with providers and certain aspects of care services were identified as barriers.</p><p><strong>Conclusions: </strong>Study participants cited clear barriers and facilitators to accessing OUD treatment in a rural Anishinaabe Tribal Nation in Minnesota. The Tribal Nation has already implemented several strategies to improve access to MOUD care (e.g., hiring additional drivers to help with transportation, facilitating immediate MOUD care prior to an intake, if needed, and giving take home MOUD doses). Tailoring services to address identified barriers and leverage facilitators of connection and flexibility will enhance care.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"81"},"PeriodicalIF":3.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309896","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":"GamblingLess: In-The-Moment: a mixed-methods acceptability and engagement evaluation of a gambling just-in-time adaptive intervention.","authors":"N A Dowling, S S Merkouris, C J Greenwood, G J Youssef, A C Thomas, C O Hawker, D I Lubman, S N Rodda","doi":"10.1186/s13722-025-00608-4","DOIUrl":"10.1186/s13722-025-00608-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mobile health interventions, particularly dynamic Just-In-Time Adaptive Interventions (JITAIs), can overcome barriers to gambling treatment by offering timely, accessible support in people's everyday lives. GamblingLess: In-The-Moment is a theoretically-informed and evidence-based app-delivered JITAI to people who want to quit or reduce their gambling. The JITAI aims to reduce gambling symptom severity through short-term reductions in the likelihood of gambling episodes by improving cognitive vulnerability (craving intensity, self-efficacy, or positive outcome expectancies). It administers three daily ecological momentary assessments (EMAs) to deliver tailored interventions in moments of cognitive vulnerability. Given that intervention acceptability and engagement are likely to improve clinical outcomes, this study aimed to comprehensively examine these constructs for GamblingLess: In-The-Moment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 28-day micro-randomised trial (MRT) was conducted, with a supplementary six-month within-group follow-up evaluation and a mixed-methods acceptability/engagement evaluation. The acceptability/engagement evaluation included: (1) app use and engagement indices across the MRT (n = 192; 66% male; age&lt;sub&gt;median&lt;/sub&gt;=35 years); (2) app acceptability measures administered at post-intervention (n = 161; 84% completion rate), and (3) semi-structured interviews (n = 11).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;App use and engagement indices indicated that the JITAI was an attractive option for gambling support. Participants completed 5,116 EMAs (compliance rate = 32%, averaging 27 EMAs), spent an average of 30 min in the app, and completed an average of nine intervention activities from a pool of 53 activities they could repeatedly access. Subjective quality and perceived impact scores well exceeded minimally acceptable standards but 77% of participants preferred a hybrid push-pull approach and many endorsed less frequent EMAs (52%) but a longer program (58%). Participants also endorsed additional features, such as in-person support, motivational messages, gambling feedback, saving favourite activities, online discussion boards, virtual computer coaches, and in-app rewards. Interviews revealed two distinct themes: (1) facilitation of gambling reductions through check-ins/availability, personal tailoring, seamless and holistic support, and treatment experience suitability; and (2) promoting behaviour change through enhanced awareness, goal-setting, skill-building, and positive habit formation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;GamblingLess: In-The-Moment was highly accepted and was generally perceived as effective in supporting reductions in gambling behaviour. The findings underscore the iterative process for JITAI development and highlight several avenues for its optimisation, particularly in relation to enhancing user engagement and reducing user fatigue.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The ","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"80"},"PeriodicalIF":3.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294403","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":"Young people's perspectives on integrating physical activity interventions into youth substance use treatment practice: a mixed-methods study.","authors":"Lisa Klamert, Melinda Craike, Gillinder Bedi, Susan Kidd, Alice Sweeting, Alexandra G Parker","doi":"10.1186/s13722-025-00607-5","DOIUrl":"10.1186/s13722-025-00607-5","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) interventions may benefit youth with problematic substance use (SU); however, the acceptability of these interventions in young people is poorly understood. In this mixed-methods study, predictors and correlates of treatment acceptability of PA interventions as part of SU treatment were investigated, and young people's perspectives on PA intervention (e.g., perceived barriers and service-related needs) were explored.</p><p><strong>Methods: </strong>Young people aged 16-25 years (n=145) with problematic SU completed a quantitative online survey on substance use, PA engagement, treatment acceptability, and perceived barriers and benefits of PA. Data were analysed using data mining and modelling approaches. Four participants aged 18-25 years participated in a subsequent, semi-structured focus group; data were analysed using qualitative content analysis. Quantitative and qualitative findings were integrated using an established model of behaviour change (COM-B).</p><p><strong>Results: </strong>Generalised additive modelling identified perceived PA barriers to be a predictor of treatment acceptability (p≤.001). Decision tree analyses confirmed that lower psychological distress (1^st partition, p<.001) and higher PA levels (2^nd partition, p=.03) predicted lower perceived PA barriers. Latent class analysis suggested a 2-class model differentiating young people at moderate substance-related risk, reporting low psychological distress and perceived PA barriers (class 1) from young people at severe substance-related risk, reporting higher psychological distress and perceived barriers. Qualitative findings revealed substantial barriers to PA, including substance-related, mental health, access, and social barriers. Together, findings illustrated complex interactions between different dimensions related to behaviour change and areas where clinical services may increase young people's capability, opportunity and motivation to prompt behaviour change.</p><p><strong>Conclusions: </strong>PA levels and psychological distress predict perceived barriers to PA in young people with problematic SU. PA barriers predict treatment acceptability of PA interventions. Knowledge of such predictors may inform treatment decisions by clinicians. Young people's insights should be integrated into PA intervention research to inform intervention and understand the unique barriers, preferences and needs of youth affected by problematic SU. Integration of young people's perspectives may increase behaviour change, as well as motivation, engagement and positive feelings in young people participating in PA interventions within substance use treatment.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"79"},"PeriodicalIF":3.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259857","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":"Cost of implementing evidence-based practices to reduce opioid overdose fatalities in New York State communities.","authors":"Jazmine M Li, Dawn Gruss, Timothy Hunt, James David, Emma Rodgers, Nabila El-Bassel, Bruce R Schackman, Laura E Starbird","doi":"10.1186/s13722-025-00606-6","DOIUrl":"10.1186/s13722-025-00606-6","url":null,"abstract":"<p><strong>Background: </strong>The HEALing Communities Study was a multi-site cluster randomized waitlist-controlled trial evaluating a community-engaged, data-driven intervention to select and deploy evidence-based practices (EBPs) including overdose education and naloxone distribution (OEND), medication for opioid use disorder (MOUD), and safer opioid prescribing. The trial was conducted in 67 highly impacted communities in 4 states, including 8 Rural and 8 urban communities in New York State (NYS). To inform future community-level decision making, we estimated the implementation costs of the EBPs selected by NYS communities.</p><p><strong>Methods: </strong>The study was implemented between January 2020-June 2022 (Wave 1, 30 months duration including the peak COVID-19 emergency period) and July 2022-December 2023 (Wave 2, 18 months); each wave included 4 Rural and 4 urban NYS communities. We collected cost data prospectively using invoices, administrative records, and interviews with program staff and stakeholders. We then conducted a micro-costing analysis from the community perspective and compared costs from Waves 1 and 2.</p><p><strong>Results: </strong>In both Waves, each community deployed on average 15 EBPs (range 8-25). EBP costs averaged $705,000 (range $320,000-$1.3 million) and $312,000 (range $39,200-$686,300) in Waves 1 and 2, respectively. In Wave 1, 25% of costs were allocated for OEND, 71% for MOUD, and 4% for safer prescribing, compared to 38% for OEND, 60% for MOUD, and 2% for safer prescribing in Wave 2. Average EBP costs per community were $147,600 (range $20,900-$374,000) for those in the OEND category, $345,400 (range $4,100-$1.1 million) for MOUD, and $16,400 (range $360-$105,500) for safer prescribing. Total EBP cost per capita in urban communities was $0.32 compared to $2.65 in Rural communities in Wave 1, and $0.41 urban communities compared to $0.65 in Rural communities in Wave 2.</p><p><strong>Conclusions: </strong>The lower EBP costs in Wave 2 resulted from differences in EBP categories and specific EBPs selected and may also reflect differences in the duration of the intervention and the impact of the COVID-19 pandemic over time. Higher per capita costs in rural communities indicate that many costs were not directly related to the number of individuals served.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"77"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208248","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":"Design of a cluster-randomized, hybrid type 1 effectiveness-implementation trial of a care navigation intervention to increase substance use disorder treatment engagement: study protocol.","authors":"Theresa E Matson, Mia A Navarro, Abisola Idu, Jennifer F Bobb, Briana M Patrick, Rebecca Phillips, Tyler D Barrett, Fernanda S Rossi, Noa Krawczyk, Rachael Doud, Kristine Rogers, Chayna J Davis, Ryan Caldeiro, Joseph E Glass","doi":"10.1186/s13722-025-00605-7","DOIUrl":"10.1186/s13722-025-00605-7","url":null,"abstract":"<p><strong>Background: </strong>Practical and motivational barriers can deter people from engaging in substance use disorder (SUD) treatment, even those who seek treatment. Care navigation is a psychosocial intervention that seeks to facilitate patients' timely access to care by identifying and intervening upon barriers. Few trials have tested the effectiveness of care navigation when embedding in real-world healthcare, and no trials have studied the process of implementing care navigation into clinical practice. This protocol describes a study that will evaluate whether care navigation can increase treatment engagement among patients seeking SUD treatment.</p><p><strong>Methods: </strong>The Addressing Barriers to Care for Substance Use Disorder (ABC-SUD) study is a hybrid type I cluster-randomized effectiveness-implementation trial. It is conducted in a mental health access center of an integrated healthcare system in Washington state. Within this center, licensed mental health clinicians assess patient needs and use shared decision-making to establish SUD treatment plans for patients (usual care). This study tests whether an added care navigation intervention can improve patient engagement in SUD treatment. Care navigation begins after a treatment plan is made and provides up to 7 weeks of support focused on enhancing patient motivation to initiate and engage in treatment, problem-solving barriers (e.g., transportation logistics), and accommodating patient preferences (e.g., preferred language of care, cultural preferences). This trial uses a two period, two sequence crossover design. Clinicians are randomized to offer care navigation to patients during the first or second study period (i.e., clinicians are assigned to an initial study condition and switch conditions halfway through the trial). Care navigation is implemented with several strategies: leadership engagement, clinical workflow specifications, electronic health record (EHR) tools, training, performance improvement, and electronic learning collaborative. The primary outcome-obtained from EHRs and insurance claims-is engagement in SUD treatment, defined as ≥3 SUD treatment visits within 48 days of a treatment plan. This study uses standardized measures of implementation climate and outcomes to examine mechanisms with which the intervention strategies exert their impact on implementation and effectiveness outcomes.</p><p><strong>Discussion: </strong>The ABC-SUD study will test whether care navigation improves SUD treatment engagement while concurrently generating information about its implementation in healthcare.</p><p><strong>Trial registration: </strong>This study was prospectively registered at www.</p><p><strong>Clinicaltrials: </strong>gov (NCT06729957) on December 9, 2024.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"78"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208350","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":"Creation of a telehealth addiction consultation service at a rural hospital: a case study.","authors":"Rachel Katz, Tiarra Fisher, Talia Singer-Clark, William Soares Iii, Jane Carpenter, Nadia Schuessler, Henry Stadler, Andrea Sahovey, Ann Scheck McAlearney, Jeffrey H Samet, Avik Chatterjee","doi":"10.1186/s13722-025-00596-5","DOIUrl":"10.1186/s13722-025-00596-5","url":null,"abstract":"<p><strong>Background: </strong>Rural communities face significant barriers to accessing substance use disorder (SUD) treatment, resulting in gaps in care and increased rates of opioid-related overdose deaths. Hospital-based Addiction Consult Services (ACS) improve outcomes for patients with SUD, but rural hospitals often lack these services.</p><p><strong>Case presentation: </strong>The Community Addiction Consult (CAC) service was established at a rural hospital in western Massachusetts to address this gap. CAC was designed by a community coalition comprised of a diverse cross-section of the community in which the hospital is based, using opioid-overdose data from the region to inform their decisions. Using a telehealth model, the CAC provided evidence-based treatments to support hospital staff treating patients with opioid use disorder (OUD) or requiring addiction-related care. From April 2023 through December 2023, the CAC provided 36 consults, facilitating increased access to medications for opioid use disorder (MOUD), and enhancing provider confidence in treating people who use drugs (PWUD) and initiating MOUD. An average of 22 patients received MOUD as inpatients monthly, and 11 emergency department patients received MOUD monthly. The CAC team also implemented training sessions, and an anti-stigma campaign to familiarize hospital staff with harm reduction principles and person-centered care strategies to foster a more supportive treatment environment for PWUD.</p><p><strong>Conclusions: </strong>The Community Addiction Consult service demonstrates the feasibility and efficacy of a telehealth Addiction Consult Service model. Paired with staff trainings, such a model can bridge the gaps in rural addiction care. By leveraging local expertise and data-driven approaches, this model offers a scalable, equitable solution to improving access to substance use disorder treatment in rural settings.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"76"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180267","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":"Hepatitis C care delivery practices among buprenorphine prescribers and non-prescribers: results from a survey of Washington state primary care providers.","authors":"Jocelyn R James, Amelia M Mohabir, Claire B Simon, Allison Cole, Emalie Huriaux, Jon Stockton, Julien Rouvere, Judith I Tsui","doi":"10.1186/s13722-025-00603-9","DOIUrl":"10.1186/s13722-025-00603-9","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C infection (HCV) and opioid use disorder (OUD) are syndemic in the U.S., thus primary care providers (PCPs) who treat OUD by prescribing buprenorphine can play key roles to advance HCV elimination targets. We compared HCV screening and treatment among PCPs who do and do not prescribe buprenorphine in Washington (WA) State.</p><p><strong>Methods: </strong>This study utilized a cross-sectional survey of PCPs in WA State, designed to characterize HCV care delivery practices and experiences/attitudes toward HCV. In this study, the independent variable was self-reported buprenorphine prescribing, and the main outcomes were (1) guideline-concordant HCV screening and (2) directly providing treatment for HCV. We used descriptive statistics to describe respondent characteristics. We used logistic regression to assess the association between buprenorphine prescribing status and HCV screening and treatment outcomes.</p><p><strong>Results: </strong>Our sample included 73 PCPs, of whom 55% prescribe buprenorphine. We found that 25% of buprenorphine prescribers directly treated HCV. There was over a 2x greater relative odds that buprenorphine prescribers would correctly screen for HCV relative to non-prescribers (OR = 2.24; 95% CI: 0.67-8.18, p = .20) and a nearly 2.5x greater relative odds that they would treat HCV relative to non-prescribers (OR = 2.42; 0.72-9.61; p = .17), although both findings were not statistically significant.</p><p><strong>Conclusion: </strong>In a sample of PCPs in WA state, buprenorphine prescribers compared to non-prescribers appear more likely to screen for and directly treat HCV, yet only a minority treat HCV. Interventions are needed to enhance HCV guideline-concordant care among these and all PCPs on the frontlines of caring for persons with OUD.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"75"},"PeriodicalIF":3.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139328","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":"\"Bupe by the book\": A study protocol for a pilot randomized controlled trial of library-facilitated telehealth to increase buprenorphine treatment among individuals experiencing homelessness.","authors":"Lianne A Urada, Carla Marienfeld, Megan Partch, Richard S Garfein, Steffanie A Strathdee, Melanie J Nicholls, Ashley Weitensteiner, María Luisa Zúñiga, Peter Davidson, Eileen V Pitpitan","doi":"10.1186/s13722-025-00599-2","DOIUrl":"10.1186/s13722-025-00599-2","url":null,"abstract":"<p><strong>Background: </strong>Accessing opioid use disorder (OUD) treatment is difficult for individuals with unstable housing. This population often uses public libraries for computer and internet access, which could provide telehealth access to OUD treatment. Therefore, we developed a novel 12-week library-facilitated telehealth intervention study called \"Bupe by the Book\" (BBB) that uses library resources to facilitate initiation and retention in OUD treatment with buprenorphine.</p><p><strong>Methods: </strong>The study is a partnership between the San Diego Public Library and a federally qualified healthcare center attached to a homeless shelter (Father Joe's Villages (FJV) Village Health Center). We co-designed a pilot randomized controlled trial to assess the feasibility and acceptability of a library-facilitated telehealth intervention in San Diego, California. The intervention is being evaluated for its feasibility and acceptability (library tele-buprenorphine uptake) by obtaining an estimate of the effect of the library telehealth arm of the intervention on buprenorphine treatment outcomes (primary outcome: buprenorphine uptake, i.e., a pharmacy pickup and taking the prescription 1 + times) and adherence (i.e., > 1 buprenorphine positive screens, ideally for 8 + weeks), compared to the control (standard care at the clinic) intervention. Individuals reporting homelessness and OUD (with or without other substance use) are eligible. Forty library patrons will be recruited via flyers, screened for eligibility, and referred to FJV Health Center for in-person initial buprenorphine treatment intake visits. Participants who complete intake are enrolled and randomized to the library-facilitated telehealth condition, which involves using library internet and computer resources for follow-up buprenorphine treatment appointments with the medical provider via library telehealth. In the control condition, participants do not use library telehealth for their buprenorphine care follow up appointments, but rather they go in-person to the clinic or per usual standard care protocols. Feasibility and acceptability of the library telehealth intervention and conduct of the randomized controlled trial are determined by the participants' use of the library telehealth intervention for buprenorphine treatment, and quantitative and qualitative measures assessing their perceptions of the library telehealth intervention, collected over a 12-week period.</p><p><strong>Discussion: </strong>The design of this pilot study may support the adoption of library-facilitated telehealth treatment as a feasible and acceptable strategy to engage and retain people experiencing homelessness with OUD in buprenorphine treatment.</p><p><strong>Trial registration: </strong>This trial was registered prospectively at ClinicalTrials.gov (registration number NCT05872386) on May 24, 2023.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"74"},"PeriodicalIF":3.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076542","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":"Rural providers' attitudes toward integrating harm reduction strategies and PrEP prescribing into rural primary care settings in the US. Southeast and Midwest.","authors":"Phillip L Marotta, Miryam Biaid, Robert Heimer, Debbie Humphries, Katie Wang, Nithya Narayanan, Zach Lynch, Virginia McKay, Hilary Reno, Rachel Winograd, Dawn Goddard-Eckrich, Lindsey Filiatreau, Kristi Stringer, Kaileigh Backes, Patricia Cavazos-Rehg","doi":"10.1186/s13722-025-00584-9","DOIUrl":"10.1186/s13722-025-00584-9","url":null,"abstract":"<p><strong>Background: </strong>People with opioid use disorders (OUD) living in the South and Midwest are under-prescribed pre-exposure prophylaxis (PrEP) despite an increasing number of providers writing PrEP prescriptions in other regions of the United States. Greater research is needed into attitudes toward integrating harm reduction strategies into primary care and PrEP prescribing among prescribers working in rural primary care settings. The objective of this paper was to examine relationships between providers' attitudes toward buprenorphine and methadone, comprehensive harm reduction (e.g., fentanyl test strips) and self-reported PrEP prescribing in the past year.</p><p><strong>Methods: </strong>Relationships were examined between attitudes toward buprenorphine and harm reduction services, and PrEP prescribing among 409 rural primary health care providers (PCPs) treating at least one person with OUD or HIV in several EHE priority states. A Qualtrics panel survey was administered to primary care providers residing in the U.S. South and Midwest and worked in a Federally Qualified Health Center, Rural Health Clinic or other HRSA-eligible health center. Chi-square tests were used to explore significant differences between PrEP prescribers and non-Prescribers on attitudes toward integrating MOUD, drug-related harm reduction into primary care.</p><p><strong>Results: </strong>Overall, 62.1% (n = 254) of the sample of providers reported writing at least one prescription for PrEP in the past year. Providers who believed that reforming buprenorphine waiver laws made their jobs easier or who expressed interest in integrating naloxone distribution and syringe exchange into primary care were more likely to write prescriptions for PrEP compared to providers who did not have these beliefs. Providers who were from larger facilities and who had specialty training in infectious diseases were more likely to write prescriptions for PrEP.</p><p><strong>Conclusions: </strong>Findings from this study suggest that providers who are more open to integrating harm reduction services into primary care are more likely to prescribe PrEP in the past year. PCPs with more positive attitudes toward naloxone, syringe exchange, and buprenorphine were more likely to prescribe PrEP in the past year. Combination interventions may be a promising avenue of reducing the harms of drug use including overdose and HIV infection among populations of people who use drugs.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"20 1","pages":"73"},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056192","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}