Drug and alcohol dependence reports最新文献

{"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}

{"title":"Community-based substance use treatment programs for reentering justice-involved adults: A scoping review","authors":"Brian D. Graves ,&nbsp;Michael Fendrich","doi":"10.1016/j.dadr.2024.100221","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100221","url":null,"abstract":"<div><h3>Introduction</h3><p>For adults involved with the criminal justice system who are reentering their communities post-incarceration, there is a large need for community-based substance use treatment. Little is known, however, about the types, availability, and benefits of programs targeting the reentry population in community settings that operate independently from the criminal justice system.</p></div><div><h3>Methods</h3><p>We conducted a scoping review of community-based treatment programs for substance use among reentering justice-involved adults to examine the contemporary state of literature and identify research gaps. We searched four databases for peer-reviewed articles conducted in the United States and published between 2017 and 2021.</p></div><div><h3>Results</h3><p>The final sample included 58 articles. Interventions varied, but the two most prominent were medications for opioid use disorder (35%) and peer support or social support interventions (22.4%). Studies were more likely to show positive impact on substance use outcomes than criminal justice outcomes. Themes were identified around participant characteristics, treatment delivery, and treatment benefits.</p></div><div><h3>Conclusions</h3><p>Findings from this scoping review suggest that the range of evidence-based strategies for substance use treatment targeting the reentry population is growing, but there is a need for additional research that examines implementation, cost effectiveness, and racial/ethnic disparities.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"10 ","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000052/pdfft?md5=914655981d87acebd402d0ac2d9acc05&pid=1-s2.0-S2772724624000052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935652","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":"Opioid use disorder (OUD) and treatment for opioid problems among OUD symptom subtypes in individuals misusing opioids","authors":"Emily A. Miller ,&nbsp;Angela M. DeVeaugh-Geiss ,&nbsp;Howard D. Chilcoat","doi":"10.1016/j.dadr.2024.100220","DOIUrl":"10.1016/j.dadr.2024.100220","url":null,"abstract":"<div><h3>Background</h3><p>In 2021, approximately 60 million individuals worldwide and 9 million individuals in the United States (US) reported opioid misuse. In the US, 2.5 million have OUD, of which only about a third receive any substance abuse treatment. OUD is often regarded as a monolithic disorder but different opioid problem subtypes may exist beyond DSM-IV/5 criteria. Understanding the characteristics of these subtypes could be useful for informing treatment and intervention strategies.</p></div><div><h3>Methods</h3><p>Latent class analysis was used to identify OUD symptom subtypes among persons in the US who reported misusing prescription opioids or heroin in the 2015–2018 National Survey on Drug Use and Health (n=10,928). Regression analyses were utilized to determine associations between class membership and treatment receipt, as well as demographic characteristics and other comorbid conditions.</p></div><div><h3>Results</h3><p>Five classes were identified with unique OUD symptom patterns: <em>Class 1: Asymptomatic</em> (71.6%), <em>Class 2: Tolerance/Time</em> (14.5%), <em>Class 3: Loss of Control/Pharmacological</em> (<em>LOC/Pharmacol</em>) (5.7%), <em>Class 4: Social Impairment</em> (2.6%), and <em>Class 5: Pervasive</em> (5.6%). Nearly all persons in the <em>LOC/Pharmacol, Social Impairment,</em> and <em>Pervasive</em> classes met criteria for OUD (98–100%); however, they differed in receipt of past-year treatment for substance use (28%, 28%, 49%, respectively). Age, race, education, insurance status, and criminal activity were also associated with treatment receipt.</p></div><div><h3>Conclusions</h3><p>There were considerable differences in OUD symptom patterns and substance use treatment among individuals who misused opioids. The findings indicate a substantial unmet need for OUD treatment and point to patterns of heterogeneity within OUD that can inform development of treatment programs.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"10 ","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000040/pdfft?md5=887609fb37221c3b126519bf2c3405b7&pid=1-s2.0-S2772724624000040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139822333","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":"Characteristics and co-morbidities associated with hospital discharges for opioid and methamphetamine co-use, United States 2016–2019","authors":"Riley D. Shearer ,&nbsp;Nathan D. Shippee ,&nbsp;Beth A. Virnig ,&nbsp;Timothy J. Beebe ,&nbsp;Tyler N.A. Winkelman","doi":"10.1016/j.dadr.2024.100219","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100219","url":null,"abstract":"<div><h3>Introduction</h3><p>The US overdose crisis is increasingly characterized by opioid and methamphetamine co-use. Hospitalization is an important opportunity to engage patients in substance use treatment. Understanding characteristics of co-use-related hospital stays can inform the development of services to better support this growing patient population.</p></div><div><h3>Methods</h3><p>We used 2016–2019 National Inpatient Sample data to conduct a cross sectional analysis of hospitalizations involving use of opioids, methamphetamine, or both. We used bivariate analysis to compare patient demographics. We then used multinomial logistic regressions to compare the proportion of hospital stays which indicated co-morbid diagnosis. To account for correlated data, we used generalized linear models to compare outcomes in hospital mortality, patient-directed discharge, and length of stay.</p></div><div><h3>Results</h3><p>Co-use-related stays had a higher proportion of co-morbid mental health (60.7%; 95% CI: 59.9–61.4%) and infectious diseases (41.5%; 95% CI: 40.8–42.2%), than opioid- or methamphetamine-related stays. Co-use-related stays increased between 2016 and 2019 and were associated with a higher proportion of patient directed discharge (10.7%; 95% CI: 10.4–11.0%) and longer length of stay (6.3 days; 95% CI: 6.2–6.4 days) compared to opioid (8.1%; 95% CI: 7.9–8.3% and 5.8 days; 95% CI: 5.8–5.9 days) and methamphetamine-related stays (6.5%; 95% CI: 6.3–6.6% and 5.5 days; 95% CI: 5.4–5.5 days).</p></div><div><h3>Conclusion</h3><p>Patients discharged with co-use differ from patients with opioid or methamphetamine use alone, representing a range of challenges and opportunities. In addition to offering treatment for both substance use disorders, hospital-based services that address co-occurring conditions may better support patients with co-use through targeted and tailored approaches.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"10 ","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000039/pdfft?md5=2442186d3cbec826bdc8304a8adac2e3&pid=1-s2.0-S2772724624000039-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709482","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":"County-level neonatal opioid withdrawal syndrome rates and real-world access to buprenorphine during pregnancy: An audit (“secret shopper”) study in Missouri","authors":"Bronwyn S. Bedrick ,&nbsp;Caroline Cary ,&nbsp;Carly O'Donnell ,&nbsp;Christine Marx ,&nbsp;Hayley Friedman ,&nbsp;Ebony B. Carter ,&nbsp;Nandini Raghuraman ,&nbsp;Molly J. Stout ,&nbsp;Benson S. Ku ,&nbsp;Kevin Y Xu ,&nbsp;Jeannie C. Kelly","doi":"10.1016/j.dadr.2024.100218","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100218","url":null,"abstract":"<div><h3>Background</h3><p>Amid rising rates of neonatal opioid withdrawal syndrome (NOWS) worldwide and in many regions of the USA, we conducted an audit study (“secret shopper study”) to evaluate the influence of county-level buprenorphine capacity and rurality on county-level NOWS rates.</p></div><div><h3>Methods</h3><p>In 2019, up to three phone calls were made to buprenorphine prescribers in the state of Missouri (USA). County-level buprenorphine capacity was defined as the number of clinicians (across all specialties) accepting pregnant people divided by the number of births. Multivariable negative binomial regression models estimated associations between buprenorphine capacity, rurality, and county-level NOWS rates, controlling for potential confounders (i.e., poverty, unemployment, and physician shortages) that may correspond to higher rates of NOWS and lower rates of buprenorphine prescribing. Analyses were stratified using tertiles of county-level overdose rates (top, middle, and lowest 1/3 of overdose rates).</p></div><div><h3>Results</h3><p>Of 115 Missouri counties, 81(70 %) had no buprenorphine capacity, 17(15 %) were low-capacity (&lt;0.5-clinicians/1,000 births), and 17(15 %) were high-capacity (≥0.5/1,000 births). The mean NOWS rate was 6.5/1,000 births. In Missouri counties with both the highest and lowest opioid overdose rates, higher buprenorphine capacity did not correspond to decreases in NOWS rates (incidence rate ratio[IRR]=1.23[95 %-confidence-interval[CI]=0.65–2.32] and IRR=1.57[1.21–2.03] respectively). Rurality did not correspond to greater NOWS burden in both Missouri counties with highest and lowest opioid overdose rates.</p></div><div><h3>Conclusions</h3><p>The vast majority of counties in Missouri have no capacity for buprenorphine prescribing during pregnancy. Rurality and lower buprenorphine capacity did not significantly predict elevated rates of NOWS.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"10 ","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000027/pdfft?md5=5e45e02782104a2cc8834850e0eeb072&pid=1-s2.0-S2772724624000027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139731584","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":"Opioid Use Disorder (OUD) and Treatment for Opioid Problems Among OUD Symptom Subtypes in Individuals Misusing Opioids","authors":"Emily A. Miller, A. DeVeaugh-Geiss, H. Chilcoat","doi":"10.1016/j.dadr.2024.100220","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100220","url":null,"abstract":"","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"26 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139882128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}