Addiction Science & Clinical Practice最新文献

{"title":"Innovations to the ECHO model to enhance reach and network-building among addiction clinicians in Western Canada.","authors":"Samantha Robinson, Isabella Brohman, Jenna van Draanen, Rivka Kushner, Nadia Fairbairn, Stephanie Glegg","doi":"10.1186/s13722-024-00524-z","DOIUrl":"10.1186/s13722-024-00524-z","url":null,"abstract":"<p><strong>Background: </strong>Building capacity for evidence-based treatment and support for people with substance use disorders (SUD) is an urgent priority in the context of the toxic drug poisoning crisis. We implemented the first substance use-focused Project Extension for Community Healthcare Outcomes (ECHO) in Western Canada for health care providers, to enhance their clinical addiction skills and knowledge, facilitate practice change, and foster a supportive community of practice. The aims of this article are to describe our innovations to the Project ECHO model in British Columbia (BC) and Yukon, and present key program outcomes.</p><p><strong>Methods: </strong>A pragmatic multi-methods program evaluation employed observational records of BC ECHO on Substance Use session attendance, cross-sectional and longitudinal participant surveys, and qualitative interviews with participants to assess satisfaction, relevance, and preparation to use evidence-based approaches, practice change intentions, and actual behaviours.</p><p><strong>Results: </strong>The 52 ECHO sessions (from June 2019 to July 2022) attracted 2134 unique registrants with 5089 attendances (mean 124/session), 2132 newsletter subscribers, and 5842 podcast downloads. The evaluation included 844 post-session survey respondents and 53 interview participants. The program included ECHO sessions with rolling attendance; widely accessed supplemental formats (e.g., newsletter, podcast, clinical tools, archived presentation recordings); variable, regional hub representation; and evidence-based content developed by medical writers. These features contributed to broad geographic and discipline reach, high-quality program content, and high mean session satisfaction ratings (4.2/5). Key qualitative themes emerged, related to knowledge and skill acquisition, gaining confidence in providing SUD care, facilitating shared decision-making, increasing compassion for patients, consolidating learning and applying it to practice, and reducing isolation through expanded networks.</p><p><strong>Conclusions: </strong>The ECHO model is an effective way to improve capacity in SUD care for physicians and nurse practitioners, while offering benefits for interprofessional attendees. Our findings can inform innovations in other ECHO programs to enhance reach, engagement, and impact.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"93"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856851","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":"Inpatient detoxification for alcohol and other drug use: qualitative study of patients' accounts of their relationships with staff.","authors":"Joanne Neale, Beth Cairns, Kevin Gardiner, Wulf Livingston, Trevor McCarthy, Andrew Perkins","doi":"10.1186/s13722-024-00523-0","DOIUrl":"https://doi.org/10.1186/s13722-024-00523-0","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic alliance is an important predictor of treatment outcomes but people who use alcohol and other drugs report mixed views of treatment providers. We analysed patients' accounts of inpatient detoxification staff to ascertain whether, and if so how, relationships with them, and thus the therapeutic alliance, might be improved.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted (in 2022/2023) with 20 people (14 males; 6 females) who had just completed inpatient detoxification in sixteen different facilities. Interviews were part of a larger longitudinal qualitative evaluation of an initiative to increase inpatient detoxification capacity across England.</p><p><strong>Results: </strong>Patients described how treatment was delivered by professionals with diverse roles. They rated staff highly and appreciated their personal qualities; the standard of medical care and non-medical services they provided; their willingness to provide privacy, freedom and choice; the support given at key points in the treatment journey; and the positive impact staff relationships had on their substance use and lives more generally. Criticisms of staff were infrequent, mostly related to specific individuals or events, and potentially more common when detoxification occurred within general hospitals rather than within specialist services.</p><p><strong>Conclusions: </strong>Patients' accounts of staff in this study were more positive than documented in previous literature. However, the characteristics that patients appreciated (and disliked) were consistent with earlier research. There was scope to improve in some services and patient groups not interviewed may have held more negative views of staff. Overall, the holistic and patient-centred approach that staff adopted, and patients valued, appears to contribute to a good therapeutic alliance.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"89"},"PeriodicalIF":3.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774581","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":"Pharmacy-based preventive services for opioid use disorder: a survey of U.S. pharmacists.","authors":"Li-Tzy Wu, Jacquie King, Kathryn Hefner, Mark Schactman, William John, Nicholas Hagemeier, Abigail G Matthews, Nathaniel Levitt, Paolo Mannelli","doi":"10.1186/s13722-024-00519-w","DOIUrl":"https://doi.org/10.1186/s13722-024-00519-w","url":null,"abstract":"<p><strong>Background: </strong>Pharmacists play a key role in combating the opioid-related overdose epidemic in the United States (US), but little is known about their experience and willingness to deliver preventive services for opioid use disorder (OUD).</p><p><strong>Aims: </strong>This study seeks to identify correlates of pharmacists' concerns about drug use problems (prescription drug misuse/use disorder and illicit drug use/use disorder) as well as their practice experience delivering preventive services for OUD (e.g., asked about opioid use, provided advice, made a referral) and willingness to provide services to patients with drug use problems.</p><p><strong>Design: </strong>An online survey of licensed US pharmacists was conducted. Participants were recruited from Community Pharmacy Enhanced Services Networks (CPESN) and state pharmacist associations (N = 1146).</p><p><strong>Findings: </strong>Overall, 75% of surveyed pharmacists indicated having concerns about opioid use problems, and 62% had concerns about non-opioid drug use problems at their pharmacies. Pharmacists who were White, practiced at a rural location, worked at a chain pharmacy, had not received opioid-related training in the past year, or practiced screening patients for opioid use had elevated odds of perceiving concerns about opioid use problems in their practice settings. Pharmacists who were White, practiced at a rural location, or had not received opioid-related training in the past year had elevated odds of perceiving concerns about non-opioid (illicit) drug use problems. Being male, being White, or having received opioid-related training were associated with increased odds of screening patients for opioid use problems. Being White, having practiced at a rural location (vs. an urban location), being a pharmacy owner/manager, or having received opioid-related training were associated with increased odds of delivering opioid-related advice/intervention. Being male or having received opioid-related training were associated with increased odds of making a referral to OUD treatment. Finally, being male, being White, having practiced pharmacy services for under 6 years, having received opioid-related training for 2 h in the past year, or having performed OUD-related preventive services (asked about opioid use, provided advice, or made a referral) were associated with increased levels of commitment/readiness for providing care to patients with drug use problems.</p><p><strong>Conclusions: </strong>The overall findings highlight pharmacists' involvement with OUD preventive services. It is critical to promote opioid-related preventive service training for pharmacists and provide incentives/tools to help initiate a structured practice of delivering such preventive services.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"88"},"PeriodicalIF":3.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774630","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":"Regaining control over alcohol intake but not abstinence on disulfiram medication, as a harm reduction approach: 2 case reports.","authors":"Max Schallenberg, Maximilian Pilhatsch, Johannes Petzold, Diana Vogel-Blaschka, Ulrich S Zimmermann, Maik Spreer","doi":"10.1186/s13722-024-00522-1","DOIUrl":"10.1186/s13722-024-00522-1","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) poses severe health risks, yet many affected individuals opt out of complete abstinence. Therefore, harm reduction strategies have become more prominent in treatment guidelines for AUD. Our two case reports illustrate how disulfiram, initially intended to enforce abstinence, was repurposed to support reduced drinking.</p><p><strong>Case presentations: </strong>A 41-year-old patient with a history of severe AUD successfully reduced his alcohol consumption to a low-risk level by leveraging the effects of the disulfiram-alcohol aversive reaction. Another patient, a 63-year-old woman with long histories of AUD and major depressive disorder, experienced fewer depressive episodes and hospitalizations with disulfiram therapy despite periodically intentional discontinuation of medication.</p><p><strong>Conclusion: </strong>Individualized treatment strategies are critical in optimizing outcomes for patients with AUD. Continuous disulfiram therapy, despite its limitations in directly reducing alcohol intake, might offer a new avenue for harm reduction in exceptional cases even if alcohol consumption continues. The cases suggest that maintaining therapy, aiming at reduced drinking, can enhance the therapeutic alliance and help manage comorbid conditions. Regular medical monitoring is essential for safety and efficacy, warranting further study of possible long-term consequences and psychotropic effects of elevated acetaldehyde levels related to the disulfiram-alcohol interaction.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"90"},"PeriodicalIF":3.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774707","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":"Exemplar Hospital Initiation Trial to Enhance Treatment Engagement (EXHIT ENTRE): protocol for CTN-0098 an open-label randomized comparative effectiveness trial of extended-release buprenorphine versus treatment as usual on post-hospital treatment engagement for hospitalized patients with opioid use disorder.","authors":"Gavin Bart, Kelly S Barth, Paulette Baukol, Eva Enns, Udi E Ghitza, Jacklyn Harris, Eve Jelstrom, Jane M Liebschutz, Kara M Magane, Delia Voronca, Zoe M Weinstein, P Todd Korthuis","doi":"10.1186/s13722-024-00510-5","DOIUrl":"10.1186/s13722-024-00510-5","url":null,"abstract":"<p><strong>Background: </strong>Hospitalizations involving opioid use disorder (OUD) are increasing. Addiction consultation services (ACS) initiate medications for opioid use disorder (MOUD) in hospital settings and arrange post-hospital follow-up for ongoing MOUD care. Engagement in MOUD following hospital discharge is hampered by challenges in timely access to MOUD. This protocol describes an open-label randomized comparative effectiveness trial comparing ACS treatment as usual (TAU) to a single injection of a 28-day formulation extended-release buprenorphine (XR-BUP) on MOUD engagement 34-days following hospital discharge.</p><p><strong>Methods: </strong>Six U.S. hospitals with ACS capable of prescribing all MOUD (i.e., methadone, buprenorphine, and extended-release naltrexone) recruit and randomize hospitalized patients with OUD who have not been on MOUD in the fourteen days prior to hospitalization. TAU may consist of any MOUD other than XR-BUP. Participants randomized to XR-BUP may receive any MOUD throughout their hospital stay and receive a 28-day XR-BUP injection within 72-hours of anticipated hospital discharge. There is no intervention beyond hospital stay. Participants are followed 34-, 90-, and 180-days following hospital discharge. The primary outcome is engagement in any MOUD 34-days following hospital discharge, which we hypothesize will be greater in the XR-BUP group. Randomizing 342 participants (171 per arm) provides 90% power to detect difference in the primary outcome between groups with an odds ratio of 2.1. Safety, secondary, and exploratory outcomes include: adverse events, MOUD engagement on days 90 and 180, opioid positive urine drug tests, self-reported drug use, hospital readmissions and emergency department visits, use of non-opioid drugs, fatal and non-fatal opioid overdose, all-cause mortality, quality of life, and cost-effectiveness. Data are analyzed by intention-to-treat, with pre-planned per-protocol and other secondary analyses that examine gender as an effect modifier, differences between groups, and impact of missingness.</p><p><strong>Discussion: </strong>Engagement in MOUD care following hospitalization in individuals with OUD is low. This randomized comparative effectiveness trial can inform hospital ACS in medication selection to improve MOUD engagement 34-days following hospital discharge.</p><p><strong>Trial registration: </strong>NCT04345718.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"91"},"PeriodicalIF":3.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774134","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":"Methadone clinic staff perceptions of trauma-informed and patient-centered care: the role of individual staff characteristics.","authors":"Beth E Meyerson, Linnea B Linde-Krieger, Gregory A Carter, Allison J Huff, Benjamin R Brady, Richard A Crosby, Jennifer De La Rosa, Allie Allison, Mohammad Barakat, Michael Pava, Mark Schaefer","doi":"10.1186/s13722-024-00501-6","DOIUrl":"https://doi.org/10.1186/s13722-024-00501-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;U.S. policy intervention to increase methadone treatment accommodations during COVID did not result in national adoption of the new patient-centered treatment practices. Staff-level interventions may facilitate adoption of these treatment practices, but this will depend upon knowledge about staff level characteristics and beliefs. Currently, the role of clinic staff characteristics, beliefs about patient-centeredness, and perceptions about the need for treatment practice change is unknown. This study explored the relationship between opioid treatment program staff characteristics, work roles and staff beliefs to identify opportunities for future staff-level treatment practice change interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Staff of three Arizona opioid treatment programs were surveyed (n = 40) from April 11-22, 2023 using a hybrid online survey method. The 161 survey items required less than 30 min to complete. Pearson point biserial correlation coefficients assessed the covariation between staff beliefs, staff characteristics and staff work roles. Perception of the clinic as person-centered was a potential proxy indicator for staff awareness of discontinuity between the clinic's person-centeredness and person-centered approaches to methadone treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among staff, 47.5% reported lived substance use disorder experience and 27.5% reported lived opioid use disorder experience. Most staff (70%) held at least 1 prior clinic role at the current clinic and 5% had had more than 4 prior roles. Rotation was observed with roles that did not require licensure or degrees. Staff with lived experience with substance use disorder or opioid use disorder treatment reported having more prior roles at the clinic than those without such experience. Abstinence-oriented views were significantly associated with reporting vicarious (work related) trauma symptoms. Those who rated the clinic as significantly more person-centered were staff with lived substance use disorder experience who also held abstinence-oriented views, staff with trauma exposure, and staff with lived opioid use disorder treatment experience who held harm reduction beliefs. In contrast, staff without substance use disorder experience who held harm reduction beliefs perceived the clinic as less person-centered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Staff beliefs, personal and work characteristics are likely factors in the recognition of need for clinic practice change. How these characteristics function in a clinic culture may also be influenced by clinic staffing patterns. A patient-to-provider pipeline with role cycling was observed and this staffing pattern may also influence shared beliefs of trauma-informed care or clinic person-centeredness. Vicarious trauma may also be an important factor. Larger studies should examine these relationships further to understand mechanisms associated with recognition of need for clinic practice c","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"87"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774619","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":"Survey of Massachusetts peer recovery coaches' attitudes toward the use of psychedelics to treat substance use disorders.","authors":"Veronica Szpak, Amanda Kim, Zachary Sager, Joji Suzuki","doi":"10.1186/s13722-024-00517-y","DOIUrl":"10.1186/s13722-024-00517-y","url":null,"abstract":"<p><strong>Background: </strong>There has been a growing interest in the use of psychedelics for therapeutic purposes. However, there is a lack of research on peer recovery coaches' attitudes toward the use of psychedelics for SUD treatment. Therefore, we conducted a survey of peer recovery coaches in Massachusetts to gain insight into their attitudes toward the use of psychedelics to treat SUDs.</p><p><strong>Methods: </strong>Peer recovery coaches in Massachusetts were invited to participate in an online survey between August and October 2023. The survey collected respondents' demographics, socioeconomic characteristics, personal substance use history, opinions on psychedelics for addiction treatment, and spiritual experiences.</p><p><strong>Results: </strong>146 individuals completed the survey. The mean age was 48.7 years (SD 11.2), 61% identified as female, 74% were employed as peer recovery coaches, and 43% were Certified Addiction Recovery Coaches (CARC). 70.7% reported utilizing 12-step programs, and 76% reported having a personal history of using psychedelics. The majority of participants agreed that they would feel comfortable being a coach for someone using psychedelics to treat SUDs. However, a significant number of participants expressed concerns. Those who had utilized 12-steps were more likely to express concerns about the dangers of using psychedelics to treat SUD. Conversely, participants with a personal history of psychedelic use were more likely to support the use of psychedelics for the treatment of SUDs.</p><p><strong>Conclusions: </strong>While peer recovery coaches express support for using psychedelics to treat SUD, they also voice concerns about the potential risks.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"86"},"PeriodicalIF":3.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717626","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":"Strategies for improving treatment retention for buprenorphine/naloxone for opioid use disorder: a qualitative study of issues and recommendations from prescribers.","authors":"Gary J Young, Leonard D Young, Md Noor-E-Alam","doi":"10.1186/s13722-024-00516-z","DOIUrl":"10.1186/s13722-024-00516-z","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder (OUD) remains a significant public health issue as the number of opioid-related overdose deaths continues to reach new highs each year. Buprenorphine/Naloxone is a medication that has been shown to be highly effective for the treatment of OUD. However, the clinical management of patients on this medication is challenging as many patients discontinue treatment prematurely. We conducted a qualitative study focusing on experienced prescribers of buprenorphine to learn about what they believe are key challenges in prescribing this medication to patients with OUD and related strategies for improving treatment outcomes.</p><p><strong>Methods: </strong>We conducted two rounds of interviews with 12 prescribers who were either trained as a primary care physician, nurse practitioner, or physician assistant. These prescribers were recruited from an academically-based treatment program, a community health center, and a commercial substance use disorder treatment facility. Interview data were coded and analyzed in accordance with a grounded theory approach.</p><p><strong>Results: </strong>Key findings and related recommendations emerged for patient monitoring, integration of behavioral health with prescribing, patient volume requirements, and use of telehealth.</p><p><strong>Conclusion: </strong>The interviews generated a number of recommendations for improving patient outcomes from buprenorphine treatment. Some of these recommendations can be implemented quite readily whereas others entail more substantial resources and time commitments.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"85"},"PeriodicalIF":3.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689728","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 to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study.","authors":"Elaine Hsiang, Kishan Patel, Erin C Wilson, Alexandrea Dunham, Janet Ikeda, Tim Matheson, Glenn-Milo Santos","doi":"10.1186/s13722-024-00515-0","DOIUrl":"10.1186/s13722-024-00515-0","url":null,"abstract":"<p><strong>Background: </strong>Rates of cocaine use disorder (CUD) among men who have sex with men (MSM) are high and rising. Among MSM, cocaine use is associated with negative socioeconomic, medical, and psychological outcomes. There are no FDA-approved pharmacotherapy options to treat CUD, and psychosocial interventions demonstrate limited efficacy. While there have been numerous trials evaluating possible medications for CUD, there is a scarcity of qualitative data on the barriers and facilitators of medication-assisted treatment.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 16 participants enrolled in a phase II randomized control trial evaluating extended-release lorcaserin among MSM with CUD. Participants were asked about their motivations for enrolling in the study, attitudes towards taking a medication for CUD, barriers and facilitators of study pill adherence, and their general study experience. Interviews were analyzed using an inductive and exploratory approach to thematic analysis.</p><p><strong>Results: </strong>Participants were highly motivated to reduce cocaine use and viewed pharmacotherapy as a viable and desirable treatment option. Pharmacotherapy was seen as having fewer access and adherence structural barriers compared to existing psychosocial therapies. Medication reminders facilitated pill taking, while side effects, travel, and active substance use presented barriers to study pill adherence. Disclosure of study participation within social networks was variable pointing to anticipated substance use and treatment stigma.</p><p><strong>Conclusions: </strong>Our study highlights important factors affecting the acceptability and uptake of medication-assisted treatment for CUD among a diverse sample of MSM. These findings can help guide the development and implementation of future pharmacotherapy options for CUD and other substance use disorders in this key population.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"84"},"PeriodicalIF":3.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683576","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":"Feasibility and acceptability of a web-intervention to prevent alcohol and cannabis-impaired driving among adolescents in driver education.","authors":"Katherine Nameth, Elizabeth Ueland, Elizabeth J D'Amico, Karen Chan Osilla","doi":"10.1186/s13722-024-00513-2","DOIUrl":"10.1186/s13722-024-00513-2","url":null,"abstract":"<p><strong>Background: </strong>Adolescents increasingly view cannabis as a substance with limited harm. Their propensity to engage in risky driving, combined with their relative driving inexperience, places adolescents at heightened risk for harm resulting from impaired driving. Driver education provides an opportunity to help prevent and reduce these risks, yet few interventions address cannabis-impaired driving, especially impairment from simultaneous use of both cannabis and alcohol.</p><p><strong>Methods: </strong>We adapted a single-session primary care brief intervention (CHAT) for driver education programs. First, we conducted two focus groups with adolescents aged 15-17 years (n = 6; n = 5) enrolled in driver education programs in Michigan and Colorado. Their feedback was integrated into a prototype of an online intervention called webCHAT that focuses on preventing alcohol and cannabis-impaired driving. Next, we recruited a new sample of adolescents who user tested webCHAT (n = 8) and provided qualitative and survey feedback. We analyzed qualitative data using classic content analysis and grouped themes according to the feasibility and acceptability of webCHAT.</p><p><strong>Results: </strong>Participants suggested that webCHAT should have adolescent narrators in short, informal, and interactive videos. In satisfaction surveys (n = 8), 88% of participants would recommend webCHAT to a friend and 88% reported that they learned helpful skills regarding impaired driving. General acceptability was also reflected in interviews (n = 6; 100% would recommend the intervention to a friend, 100% indicated overall positive impressions, and 67% stated it was easy to use). Participants reported that it was helpful to learn about the negative effects of both cannabis and alcohol on driving behavior, voicing that webCHAT would help adolescents make more informed decisions.</p><p><strong>Conclusions: </strong>Soliciting adolescent perspectives is critical when developing interventions targeting cannabis use because of increasingly permissive attitudes and perceptions of minimal risk associated with use. The current study highlights how feedback can help increase both the feasibility and acceptability of interventions.</p>","PeriodicalId":54223,"journal":{"name":"Addiction Science & Clinical Practice","volume":"19 1","pages":"83"},"PeriodicalIF":3.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669654","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}