Drug and alcohol dependence reports最新文献

{"title":"Sociodemographic and patient reported outcomes by racial and ethnicity status among participants in a randomized controlled trial for methamphetamine use disorder","authors":"Chukwuemeka N. Okafor ,&nbsp;Thomas Carmody ,&nbsp;Angela L. Stotts ,&nbsp;Gavin Bart ,&nbsp;Taryn L. Mayes ,&nbsp;Tara Karns-Wright ,&nbsp;Madhukar Trivedi ,&nbsp;Steve Shoptaw ,&nbsp;Jennifer S. Potter","doi":"10.1016/j.dadr.2024.100230","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100230","url":null,"abstract":"<div><h3>Background</h3><p>There has been a significant increase in methamphetamine use and methamphetamine use disorder (Meth UD) in the United States, with evolving racial and ethnic differences.</p></div><div><h3>Objectives</h3><p>This secondary analysis explored racial and ethnic differences in baseline sociodemographic and clinical characteristics as well as treatment effects on a measure of substance use recovery, depression symptoms, and methamphetamine craving among participants in a pharmacotherapy trial for Meth UD.</p></div><div><h3>Methods</h3><p>The ADAPT-2 trial (ClinicalTrials.gov number, NCT03078075; N=403; 69% male) was a multisite, 12-week randomized, double-blind, trial that employed a two-stage sequential parallel design to evaluate the efficacy of combination naltrexone (NTX) and oral bupropion (BUP) vs. placebo for Meth UD. Treatment effect was calculated as the <em>weighted mean change</em> in outcomes in the NTX-BUP minus placebo group across the two stages of treatment.</p></div><div><h3>Results</h3><p>Of the 403 participants in the ADAPT-2 trial, the majority (65%) reported non-Hispanic White, while 14%, 11% and 10% reported Hispanic, non-Hispanic Black, and non-Hispanic other racial and ethnic categories respectively. At baseline non-Hispanic Black participants reported less severe indicators of methamphetamine use than non-Hispanic White. Treatment effects for recovery, depression symptoms and methamphetamine cravings did not significantly differ by race and ethnicity.</p></div><div><h3>Conclusions</h3><p>Although we found racial and ethnic differences at baseline, our findings did not show racial and ethnic differences in treatment effects of NTX-BUP on recovery, depression symptoms and methamphetamine cravings. However, our findings also highlight the need to expand representation of racial and ethnic minority groups in future trials.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000143/pdfft?md5=4c29f016fcfc08541f57db78887e5579&pid=1-s2.0-S2772724624000143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140606818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediational pathways among drug use initiation, use-related consequences, and quit attempts","authors":"Adura Sogbesan ,&nbsp;Danielle Lenz ,&nbsp;Jamey J. Lister ,&nbsp;Leslie H. Lundahl ,&nbsp;Mark K. Greenwald ,&nbsp;Eric A. Woodcock","doi":"10.1016/j.dadr.2024.100229","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100229","url":null,"abstract":"<div><h3>Background</h3><p>Factors that predict attempts to discontinue drug use are clinically relevant and may inform treatment. This study investigated drug use-related consequences as a predictor of drug quit attempts and treatment seeking among two cohorts of persons who use drugs.</p></div><div><h3>Methods</h3><p>Drug use and clinical characteristics were assessed among persons who use cocaine (N=176; urine-verified; ‘Cocaine Cohort’) and among those who use heroin (N=166; urine-verified; ‘Heroin Cohort’). Mediation analyses assessed relationships among age at initial drug use, adverse drug-specific use-related consequences, and drug-specific quit attempts, separately for each cohort. Forward conditional logistic regression models evaluated drug use and clinical symptom scores as predictors of drug-specific treatment seeking.</p></div><div><h3>Results</h3><p>Controlling for age, mediation models showed that drug use consequences <em>fully mediated</em> the relationship between age at initial drug use and number of drug-specific quit attempts for the ‘Cocaine Cohort’ and ‘Heroin Cohort’ (<em>R</em>²=0.30, <em>p</em>&lt;.001; <em>R</em>²=0.17, <em>p</em>&lt;.001; respectively). Reporting more consequences predicted more quit attempts in each cohort, accounting for duration of use (<em>p</em>s&lt;.001). Reporting more consequences also predicted greater likelihood of seeking drug use treatment (<em>p</em>s&lt;.001) and was associated with more severe clinical symptoms in each cohort (<em>p</em>s&lt;.05).</p></div><div><h3>Conclusions</h3><p>Using a parallel analysis design, we showed that reporting more drug-specific use-related consequences predicted more drug-specific quit attempts and greater likelihood to seek treatment in two cohorts: persons who use cocaine and those who use heroin. Our findings suggest that experiencing more drug use consequences predicts more attempts to seek drug abstinence and that assessment of consequences may be informative for treatment.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000131/pdfft?md5=c07a0ae9e317ae24bb85b6eb9554b3ac&pid=1-s2.0-S2772724624000131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140547132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cigarettes and e-cigarettes use among US adults with multimorbidity","authors":"Olatokunbo Osibogun ,&nbsp;Wei Li ,&nbsp;Rime Jebai ,&nbsp;Mohammad Ebrahimi Kalan","doi":"10.1016/j.dadr.2024.100231","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100231","url":null,"abstract":"<div><h3>Background</h3><p>Tobacco use leads to multiple illnesses. Yet, the effects of different categories of tobacco use on multimorbidity remain understudied. We investigated the associations between tobacco use categories and multimorbidity and the potential moderating effects of age, sex, or race/ethnicity among adults in the United States.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional analysis using pooled data from the Behavioral Risk Factor Surveillance System for the years 2020–2022. Multimorbidity was ascertained through self-reported ≥2 chronic health conditions. We categorized tobacco use into nine derived from nonuse (did not use e-cigarettes or cigarettes), former cigarette or e-cigarette use, current (used on some days/everyday) cigarette use or e-cigarette use, or both (dual use). We used multinomial logistic regression to investigate the associations while accounting for potential confounding factors.</p></div><div><h3>Results</h3><p>Within the sample (N=1,080,257), 28.2% reported multimorbidity. For the categories examined (former exclusive e-cigarette, exclusive e-cigarette, former exclusive cigarette, former dual, former cigarette/current e-cigarette, exclusive cigarette, current cigarette/former e-cigarette and dual use), all reported higher odds of having multimorbidity compared to those who reported nonuse of both e-cigarettes and cigarettes. We found significant interactions for age, sex and race/ethnicity with the tobacco use categories for multimorbidity (p&lt;0.01), where stronger associations were observed among younger adults, females and non-Hispanic Multiracial for current dual use (p&lt;0.05).</p></div><div><h3>Conclusions</h3><p>The use of cigarettes, e-cigarettes, or both was associated with multimorbidity among adults, which was more pronounced among younger adults, females and non-Hispanic Multiracial. These findings underscore the importance of implementing targeted public health interventions to mitigate the health risks associated with using both products, particularly among specific demographics, to reduce the prevalence of multimorbidity.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000155/pdfft?md5=85fe99b1029310713af94796dd105f31&pid=1-s2.0-S2772724624000155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140606817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives regarding cannabis use: Results from a qualitative study of individuals engaged in substance use treatment in Georgia and Connecticut","authors":"Charles A. Warnock ,&nbsp;Ashlin R. Ondrusek ,&nbsp;E. Jennifer Edelman ,&nbsp;Trace Kershaw ,&nbsp;Jessica L. Muilenburg","doi":"10.1016/j.dadr.2024.100228","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100228","url":null,"abstract":"<div><h3>Objective</h3><p>Cannabis use is increasingly pervasive throughout the U.S. People in treatment for substance use disorders (SUD) may be especially at-risk of harm due to this changing context of cannabis in the U.S. This study’s objective was to qualitatively describe experiences and beliefs around cannabis among people who had entered treatment for any SUD in the past 12-months.</p></div><div><h3>Methods</h3><p>From May to November of 2022, we conducted 27 semi-structured interviews (n=16 in Georgia, n=11 in Connecticut) with individuals in treatment for SUD in Georgia and Connecticut. Interviews were recorded, transcribed, and thematically analyzed using an emergent approach.</p></div><div><h3>Results</h3><p>All participants had used cannabis in the past. Four themes emerged from the interviews. Participants: (1) perceived cannabis as an important contributor to non-cannabis substance use initiation in adolescence; (2) viewed cannabis as a substance with the potential to improve health with fewer side effects than prescription medications; (3) expressed conflicting opinions regarding cannabis as a trigger or tool to manage cravings for other non-cannabis substances currently; and 4) described concerns related to negative legal, social service, and treatment-related consequences as well as negative peer perception relating to the use of cannabis.</p></div><div><h3>Conclusion</h3><p>Although participants described cannabis’s important role as an initiatory drug in adolescence and young adulthood, many felt that cannabis was a medicinal substance for a range of health challenges. These findings suggest SUD treatment clinicians should address medicinal beliefs related to cannabis among their clients and emphasizes the need for research on cannabis use and SUD treatment outcomes.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277272462400012X/pdfft?md5=58888d82046f6622081bec8675a149dc&pid=1-s2.0-S277272462400012X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for harmonization of randomized trials testing the addition of behavioral therapy to buprenorphine for opioid use disorder","authors":"R. Kathryn McHugh ,&nbsp;Allen J. Bailey ,&nbsp;Roger D. Weiss ,&nbsp;Garrett M. Fitzmaurice","doi":"10.1016/j.dadr.2024.100226","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100226","url":null,"abstract":"<div><h3>Background</h3><p>Although buprenorphine is an effective treatment for opioid use disorder (OUD), much remains to be understood about treatment non-response and methods for improving treatment retention. The addition of behavioral therapies to buprenorphine has not yielded consistent benefits for opioid outcomes, on average. However, several studies suggest that certain subgroups may benefit from the combination of buprenorphine and behavioral therapy, highlighting the potential for personalized approaches to treatment. Furthermore, little is known about whether behavioral therapies improve buprenorphine retention or non-opioid (e.g., functional) outcomes.</p></div><div><h3>Methods</h3><p>The objective of this project is to harmonize four previously conducted clinical trials testing the addition of behavioral therapy to buprenorphine maintenance for OUD and to use this larger dataset to answer critical clinical questions about the role of behavioral therapy in this population. Study aims include identifying potential moderators of the effect of the addition of behavioral therapy and quantifying the effect of behavioral therapy on buprenorphine retention and functional outcomes.</p></div><div><h3>Results</h3><p>Analyses will consider outcomes of weeks of opioid use, weeks of retention in buprenorphine treatment, and functional outcomes as measured by the Addiction Severity Index. Analyses will include an indicator for each study to account for heterogeneity of samples and design.</p></div><div><h3>Conclusion</h3><p>Results will help to inform clinical and research efforts to optimize the use of behavioral therapies in the treatment of OUD.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000106/pdfft?md5=69863a469c33d1c3b9199e2fa387a883&pid=1-s2.0-S2772724624000106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas","authors":"Natalie D. Bayrakdarian ,&nbsp;Erin E. Bonar ,&nbsp;Isabelle Duguid ,&nbsp;Lauren Hellman ,&nbsp;Sarah Salino ,&nbsp;Chelsea Wilkins ,&nbsp;Mary Jannausch ,&nbsp;James R. McKay ,&nbsp;Michele Staton ,&nbsp;Katherine Dollard ,&nbsp;Inbal Nahum-Shani ,&nbsp;Maureen A. Walton ,&nbsp;Frederic C. Blow ,&nbsp;Lara N. Coughlin","doi":"10.1016/j.dadr.2024.100225","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100225","url":null,"abstract":"<div><h3>Background</h3><p>At-risk alcohol use is associated with increased adverse health consequences, yet is undertreated in healthcare settings. People residing in rural areas need improved access to services; however, few interventions are designed to meet the needs of rural populations. Mobile interventions can provide feasible, low-cost, and scalable means for reaching this population and improving health, and behavioral economic approaches are promising.</p></div><div><h3>Methods</h3><p>We conducted a pilot randomized controlled trial focused on acceptability and feasibility of a mobile behavioral economic intervention for 75 rural-residing adults with at-risk alcohol use. We recruited participants from a large healthcare system and randomized them to one of four virtually-delivered conditions reflecting behavioral economic approaches: episodic future thinking (EFT), volitional choice (VC), both EFT and VC, or enhanced usual care control (EUC). The intervention included a telephone-delivered induction session followed by two weeks of condition-consistent ecological momentary interventions (EMIs; 2x/day) and ecological momentary assessments (EMAs; 1x/day). Participants completed assessments at baseline, post-intervention, and two-month follow-up, and provided intervention feedback.</p></div><div><h3>Results</h3><p>All participants completed the telephone-delivered session and elected to receive EMI messages. Average completion rate of EMAs across conditions was 92.9%. Among participants in active intervention conditions, 89.3% reported the induction session was helpful and 80.0% reported it influenced their future drinking. We also report initial alcohol use outcomes.</p></div><div><h3>Discussion</h3><p>The behavioral economic intervention components and trial procedures evaluated here appear to be feasible and acceptable. Next steps include determination of their efficacy to reduce alcohol use and public health harms.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277272462400009X/pdfft?md5=18116295feff4d7536afc70fdfe496cf&pid=1-s2.0-S277272462400009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A telemedicine bridge clinic improves access and reduces cost for opioid use disorder care","authors":"Michael J. Lynch ,&nbsp;Dominic Vargas ,&nbsp;Mary E. Winger ,&nbsp;Justin Kanter ,&nbsp;Jessica Meyers ,&nbsp;James Schuster ,&nbsp;Donald M. Yealy","doi":"10.1016/j.dadr.2024.100227","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100227","url":null,"abstract":"<div><h3>Objective</h3><p>We evaluated the impact of a telemedicine bridge clinic on treatment outcomes and cost for patients with opioid use disorder. Telemedicine bridge clinics deliver low-barrier rapid assessment of patients with opioid use disorder via audio-only and audiovisual telemedicine to facilitate induction on medication therapy and connection to ongoing care.</p></div><div><h3>Methods</h3><p>A pre-post analysis of UPMC Health Plan member claims was performed to evaluate the impact of this intervention on the trajectory of care for patients with continuous coverage before and after bridge clinic visit(s).</p></div><div><h3>Results</h3><p>Analysis included 150 UPMC Health Plan members evaluated at the bridge clinic between April 2020 and October 2021. At least one buprenorphine prescription was filled within 30 days by 91% of patients; median proportion of days covered by buprenorphine was 73.3%, 54.4%, and 50.6% at 30, 90, and 180 days after an initial visit compared to median of no buprenorphine claims 30 days prior among the same patients. Patients had an 18% decline in unplanned care utilization 30 days after initial Bridge Clinic visit, with a 62% reduction in unplanned care cost per member per month (PMPM), 38% reduction in medical cost PMPM, and 10% reduction in total PMPM (medical + pharmacy cost) at 180 days. Primary care, outpatient behavioral health, and laboratory costs increased while emergency department, urgent care, and inpatient costs declined.</p></div><div><h3>Conclusion</h3><p>Utilization of a telemedicine bridge clinic was associated with buprenorphine initiation, linkage to ongoing care with retention including medication treatment, reduced unplanned care cost, and overall savings.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000118/pdfft?md5=ab947eccf1748161d1d84da065041dd1&pid=1-s2.0-S2772724624000118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of peer recovery services for substance use disorder in Minnesota: Impact of peer recovery initiation on SUD treatment and recovery","authors":"Cody R. Tuttle,&nbsp;Aaron T. Berger,&nbsp;Sean L. Barton,&nbsp;Ben Nguyen,&nbsp;Weston Merrick","doi":"10.1016/j.dadr.2024.100224","DOIUrl":"10.1016/j.dadr.2024.100224","url":null,"abstract":"<div><p>Substance use disorder (SUD) remains one of the most persistent public health challenges across the nation and in Minnesota. One intervention to help people with SUD is peer recovery services (PRS). PRS is a form on non-clinical support where trained individuals who are more established in recovery come alongside people currently in the recovery journey and provide guidance in the treatment process, help in accessing resources, and offer an empathetic ear. In combination with other services in the continuum of care, PRS seeks to reduce harm from disordered use. In 2018, Minnesota made PRS for SUD a Medicaid reimbursable service. While prior literature demonstrates promising effects of PRS for SUD, especially in treatment retention and participant experience, most studies evaluated PRS in limited settings, rather than in a large-scale implementation. Our retrospective, matched-cohort study used administrative data to estimate the impact of initiating Medicaid-reimbursable PRS for SUD on treatment, overdose, and mortality. Our results align, in some dimensions, with prior literature evaluating smaller-scale programs with positive impacts on treatment completion. We also find, however, that PRS at scale did not produce other positive outcomes that past studies have documented, particularly around overdose and inpatient treatment. This suggests that PRS follows a common challenge of implementing promising ideas at scale.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"11 ","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000088/pdfft?md5=45c71cbf5abed5695a70f557a8fe48d8&pid=1-s2.0-S2772724624000088-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140084106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging prescription monitoring program data to evaluate the implementation of buprenorphine telehealth flexibilities: An interrupted time series analysis in Texas","authors":"Whanhui Chi ,&nbsp;Chijioke Okeke ,&nbsp;Douglas Thornton ,&nbsp;Hua Chen ,&nbsp;Abofazl Sadeghi ,&nbsp;Tyler J. Varisco","doi":"10.1016/j.dadr.2024.100222","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100222","url":null,"abstract":"<div><h3>Background</h3><p>In March 2020, policy changes by the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration aimed to maintain access to office-based opioid treatment services by easing telehealth buprenorphine prescribing restrictions. However, the effectiveness of these changes remains largely unmeasured. The objective of this study was to measure the effectiveness of COVID-19-related telehealth flexibilities in an all-payer cohort from the Texas Prescription Monitoring Program.</p></div><div><h3>Methods</h3><p>Using Texas Prescription Monitoring Program data, we identified oral buprenorphine and buprenorphine/naloxone prescriptions dispensed in Texas between September 1, 2019, and September 26, 2020. Weekly counts of prescriptions, prescribing physicians, and dispensing pharmacies were analyzed. An autoregressive integrated moving average (ARIMA) model estimated changes in prescription volume between pre-implementation (September 1, 2019 - February 15, 2020) and post-implementation (April 12, 2020 - September 26, 2020) periods.</p></div><div><h3>Results</h3><p>Pre-flexibility, an average of 8898 (SD: 342) buprenorphine prescriptions were dispensed to 7829 (SD: 326) patients weekly. This declined to 8360 (SD: 247) prescriptions and 7661 (SD: 229) patients post-flexibility. Adjusted for seasonality, this represented a statistically significant average decline of −257.27 (95% CI: −426.06, −88.49) patients and −647.01 (95% CI: −856.67, −437.36) prescriptions per week.</p></div><div><h3>Discussion</h3><p>Our results suggest a modest decline in buprenorphine dispensing volume early in the COVID-19 pandemic. While difficult to assess its significance, it can be assumed that telehealth flexibilities mitigated a potentially larger decline. Future research should explore system and individual-level barriers to telehealth utilization.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"10 ","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000064/pdfft?md5=a15f08a93dc2493b844584d1fe3f5917&pid=1-s2.0-S2772724624000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychostimulant drug co-ingestion in non-fatal opioid overdose","authors":"Siri Shastry ,&nbsp;Joshua Shulman ,&nbsp;Kim Aldy ,&nbsp;Jeffrey Brent ,&nbsp;Paul Wax ,&nbsp;Alex F. Manini ,&nbsp;On behalf of the Toxicology Investigators Consortium Fentalog Study Group","doi":"10.1016/j.dadr.2024.100223","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100223","url":null,"abstract":"<div><h3>Introduction</h3><p>In 2019, there were over 16,000 deaths from psychostimulant overdose with 53.5% also involving an opioid. Given the substantial mortality stemming from opioid and psychostimulant co-exposure, evaluation of clinical management in this population is critical but remains understudied. This study aims to characterize and compare clinical management and outcomes in emergency department (ED) overdose patients with analytically confirmed exposure to both opioids and psychostimulants with those exposed to opioids alone.</p></div><div><h3>Methods</h3><p>This was a secondary analysis of a prospective consecutive cohort of ED patients age 18+ with opioid overdose at 9 hospital sites from September 21, 2020 to August 17, 2021. Toxicologic analysis was performed using liquid chromatography quadrupole time-of-flight mass spectrometry. Patients were divided into opioid-only (OO) and opioid plus psychostimulants (OS) groups. The primary outcome was total naloxone bolus dose administered. Secondary outcomes included endotracheal intubation, cardiac arrest, troponin elevation, and abnormal presenting vital signs. We employed t-tests, chi-squared analyses and multivariable regression models to compare outcomes between OO and OS groups.</p></div><div><h3>Results</h3><p>Of 378 enrollees with confirmed opioid overdose, 207 (54.8%) had psychostimulants present. OO patients were significantly older (mean 45.2 versus 40.6 years, p &lt; 0.01). OS patients had significantly higher total naloxone requirements (mean total dose 2.79<!--> <!-->mg versus 2.12<!--> <!-->mg, p = 0.009). There were no significant differences in secondary outcomes.</p></div><div><h3>Conclusion</h3><p>Approximately half of ED patients with confirmed opioid exposures were also positive for psychostimulants. Patients in the OS group required significantly higher naloxone doses, suggesting potential greater overdose severity.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"10 ","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000076/pdfft?md5=230eef3f4634794a426ac5f3a4c7d669&pid=1-s2.0-S2772724624000076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}