Drug and alcohol dependence reports最新文献

{"title":"Youth and young adult knowledge of and access to opioid harm reduction policies and interventions in North Carolina","authors":"Kathleen L. Egan ,&nbsp;Thomas P. McCoy ,&nbsp;Renata Yassa ,&nbsp;Jonna Daniel ,&nbsp;Kimberly G. Wagoner ,&nbsp;Melinda M. Pankratz ,&nbsp;Justin B. Moore ,&nbsp;Jennifer Cornacchione Ross ,&nbsp;Parissa J. Ballard ,&nbsp;Scott D. Rhodes","doi":"10.1016/j.dadr.2024.100265","DOIUrl":"10.1016/j.dadr.2024.100265","url":null,"abstract":"<div><h3>Introduction</h3><p>From 2019–2021, overdose deaths among youth and young adults ages 10–19 years of age residing in the United States increased by 109 %. We sought to examine the extent to which youth and young adults who have experience with substance use are aware of the harm reduction policies and interventions, including the statewide Good Samaritan Law (GSL), naloxone, and fentanyl test strips, and have access to naloxone and fentanyl test strips.</p></div><div><h3>Methods</h3><p>From December 2022 to February 2023, we conducted a cross-sectional telephone survey of individuals ages 12–25 years who resided in North Carolina (NC) (N=15,000). We assessed awareness of and access to harm reduction policies and interventions among participants who reported ever using heroin/fentanyl, diverted prescription medication, cocaine, methamphetamine, and hallucinogens (<em>n</em>=539). Logistic regression models were used to identify factors associated with awareness of and access to these policies and interventions.</p></div><div><h3>Results</h3><p>We found that 81.5 % of the sample of youth and young adults who reported ever use of substances were aware of NC’s GSL, 80.0 % were aware of naloxone, 43.0 % perceived they had access to naloxone, 74.4 % were aware of fentanyl test strips, and 21.9 % perceived they had access to fentanyl test strips. There were individual and community-level characteristics associated with awareness of and perceived access to these harm reduction policies and interventions.</p></div><div><h3>Conclusions</h3><p>Efforts are needed to improve access to harm reduction interventions among youth and young adults as they are experiencing an increased risk of dying from opioid-involved overdoses.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100265"},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000490/pdfft?md5=7fd6b4dc4804292ce311aa0ecdcc4d49&pid=1-s2.0-S2772724624000490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951151","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":"Changing patterns of hospitalization for sedative misuse among youth aged 10–24 years in Quebec, Canada","authors":"Nathalie Auger ,&nbsp;Jessica Healy-Profitós ,&nbsp;Gabriel Côté-Corriveau","doi":"10.1016/j.dadr.2024.100264","DOIUrl":"10.1016/j.dadr.2024.100264","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess trends in hospitalization for sedative misuse among youth.</p></div><div><h3>Methods</h3><p>Using a serial cross-sectional design, we computed hospitalization rates for sedative-related suicide attempts, sedative use disorders, and other sedative poisonings within individuals aged 5–24 years in Quebec, Canada. We computed sedative-related hospitalization rates in 2006–2011, 2012–2017, and 2018–2023, and examined differences according to age, sex, polysubstance use, mental health comorbidity, and social vulnerability using rate ratios (RR) and 95 % confidence intervals (CI) comparing the last time period relative to the first.</p></div><div><h3>Results</h3><p>Sedative-related hospitalization rates more than doubled during the study. Suicide attempts using sedatives increased from 50.5 per 100,000 youth in 2006–2011, to 82.2 in 2012–2017 and 114.4 in 2018–2023 (RR 2.26, 95 % CI 1.63–3.15), while sedative use disorders increased from 13.1 to 21.8 and 60.5 per 100,000 in these same time periods (RR 4.62, 95 % CI 2.54–8.40). Rates increased for 10–24 year-olds and in both sexes, particularly among youth with polysubstance use, anxiety and attention disorders, and social vulnerability.</p></div><div><h3>Discussion</h3><p>Sedative misuse requiring hospitalization appears to be a growing issue among youth.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100264"},"PeriodicalIF":0.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000489/pdfft?md5=e8f14f5940ff0ec4ee6a3439f14d2cb4&pid=1-s2.0-S2772724624000489-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840065","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":"“Smoking weed it gets you over the hump”: Cannabis co-use as a facilitator of decreased opioid use among people who inject drugs in Los Angeles, California","authors":"Siddhi S. Ganesh ,&nbsp;Erin E. Gould ,&nbsp;Bradley T. Conner ,&nbsp;Jimi Huh ,&nbsp;Rachel Carmen Ceasar ,&nbsp;Ricky N. Bluthenthal","doi":"10.1016/j.dadr.2024.100257","DOIUrl":"10.1016/j.dadr.2024.100257","url":null,"abstract":"<div><h3>Introduction</h3><p>Opioid overdose mortality rates have surged dramatically in the last decade due largely to fentanyl in the illicit US drug supply. As of June 2024, 38 states, three territories, namely US Virgin Islands, Guam and the Northern Mariana Islands, and the District of Columbia, allow the medical use of cannabis products. However, there remains limited qualitative community-based evidence on the role of cannabis co-use among opioid using and injecting populations. In this study, we present data from people who inject drugs (PWID)’s co-use of cannabis-opioid.</p></div><div><h3>Methods</h3><p>We conducted 30 one-on-one semi-structured interviews with PWID from July 2021 to April 2022 at two community sites in Los Angeles, CA, near a syringe service program and a methadone clinic. Interviews were recorded and transcribed. We used constructivist grounded theory methods for identifying and comparing the emerging themes that appeared across transcripts to construct a conceptual explanation of how PWID co-used cannabis and opioids. Participant inclusion criteria included injection drug use, opioid and cannabis use, English fluency, and age 18+ years.</p></div><div><h3>Results</h3><p>PWID described that cannabis co-use assisted in developing patterns of reduced opioid use in a number of ways: 1) maintain opioid cessation and/or adhere to opioid use disorder treatment by managing cessation-specific symptoms, 2) manage symptoms of opioid withdrawal episodically and, 3) decrease opioid use due to low barrier accessibility of cannabis.</p></div><div><h3>Discussion</h3><p>Participants reported myriad benefits of opioid and cannabis co-use for reducing patterns of opioid use. These findings have two major harm reduction implications for PWID: 1) the distribution of cannabis via low threshold peer programming and interventions can facilitate changes in opioid use patterns and 2) access to cannabis co-use, potentially alongside existing Medication for Opioid Use Disorder, in treatment settings may improve efficacy of uptake and treatment outcomes and goals for individual PWID.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100257"},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000416/pdfft?md5=cad8fb086601cef0ce6ab1e31de44917&pid=1-s2.0-S2772724624000416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852083","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":"Healthcare expenditures for people with substance use disorders in drug courts compared to their peers in traditional courts","authors":"Barrett Wallace Montgomery ,&nbsp;Arnie Aldridge ,&nbsp;Dara Drawbridge ,&nbsp;Ira Packer ,&nbsp;Gina M. Vincent ,&nbsp;Rosa Rodriguez-Monguio","doi":"10.1016/j.dadr.2024.100258","DOIUrl":"10.1016/j.dadr.2024.100258","url":null,"abstract":"<div><p>Individuals within the criminal justice system are at greater risk of substance use–related morbidity and mortality and have substantial healthcare needs. In this quasi-experimental study, we assessed utilization patterns of Massachusetts Medicaid Program (MassHealth) services and associated expenditures among drug court probationers compared to a propensity score–matched sample of traditional court probationers. Risk of reoffending, employment status, age, and living arrangement data were used to calculate propensity scores and match probationers between the two court types, producing a final sample of 271 in each court (N=542). Utilization of services and associated expenditures were analyzed using a two-part model to address the skewed distribution of the data and to control for residual differences after matching from the perspective of the payer (i.e., MassHealth). The largest categories of MassHealth spending were prescription pharmaceuticals, hospital inpatient visits, and physician visits. In the unadjusted analysis, drug court probationers exhibited greater MassHealth services utilization and expenditures than traditional court probationers. However, drug courts enrolled more females, more people at higher risk of reoffending, and more people with opioid use disorders. After controlling for differences between the two court types, the difference in MassHealth services utilization and associated expenditures did not reach statistical significance. Drug court probationers were more likely to engage with healthcare services but did not incur significantly greater expenditures than traditional court probationers after controlling for differences between the samples.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000428/pdfft?md5=b42e2a32e91ba5663a369a09d3871013&pid=1-s2.0-S2772724624000428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849540","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":"Extended-release buprenorphine induction in opioid non-tolerant incarcerated individuals","authors":"Michael S. Gordon ,&nbsp;Thomas R. Blue ,&nbsp;Frank J. Vocci ,&nbsp;Shannon G. Mitchell ,&nbsp;Kevin R. Wenzel ,&nbsp;Marc Fishman","doi":"10.1016/j.dadr.2024.100261","DOIUrl":"10.1016/j.dadr.2024.100261","url":null,"abstract":"<div><h3>Background</h3><p>Buprenorphine maintenance treatment remains unavailable in most jails in the US. We provide data on a four-day rapid sublingual buprenorphine (SL-B) induction strategy followed by a weekly dose of extended-release injectable buprenorphine (XR-B) with incarcerated individuals with opioid use disorder (OUD) ho were not opioid tolerant.</p></div><div><h3>Methods</h3><p>Between October 2020 to April 2024, <em>N</em> = 65 individuals with an opioid use disorder in jails participating in a larger randomized, controlled trial received SL-B and XR-B prior to release. Primary outcomes included completing the proposed dose induction and any reported adverse events (AEs).</p></div><div><h3>Results</h3><p>Sixty-five individuals received SL-B dose induction from our team’s medical staff, 53 (81.5 %) completed the four-day SL-B dose induction and received their first weekly XR‑B injection on day 5. Of the 65 individuals, 10 (15.38 %) participants reported AEs during the dosing period and/or in the week following the dosing period. All but one of the AE’s were rated as mild. One participant experienced a serious adverse event in the week following dose induction. The study medical team determined that this was unlikely to be related to the intervention.</p></div><div><h3>Discussion</h3><p>Overall, our study findings demonstrate the feasibility of implementing a four-day sublingual dose induction followed by a weekly XR-B injection with incarcerated individuals who are not opioid tolerant. This study provides important data to illustrate a dose induction strategy that might assist in reducing illicit diversion in jails, which is a main barrier to buprenorphine delivery cited by correctional administrators.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000453/pdfft?md5=6711d8e5a7274d4200164e1988df0887&pid=1-s2.0-S2772724624000453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847557","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":"Quality of participants’ relationships to peer recovery support specialists as a function of perceived similarities: An exploratory analysis","authors":"Martha Tillson ,&nbsp;Alexander H. Lewis","doi":"10.1016/j.dadr.2024.100263","DOIUrl":"10.1016/j.dadr.2024.100263","url":null,"abstract":"<div><h3>Background</h3><p>A growing evidence base supports the value of peer recovery support specialists (PRSS), particularly due to shared lived experience with participants (recipients of PRSS services). However, little research has examined whether congruence on certain aspects of “peerness” (e.g., demographics, experiences) matters for PRSS-participant relationships.</p></div><div><h3>Methods</h3><p>Through a pilot study under the NIDA-funded Initiative for Justice and Emerging Adult Populations (JEAP), adults who had recently received PRSS services (<em>N</em>=100) were interviewed. Participants completed a modified version of the Scales for Participant Alliance with Recovery Coach (SPARC), a measure of PRSS-participant relationship quality, and rated themselves as different/similar to their PRSS in several domains using a six-point scale.</p></div><div><h3>Results</h3><p>Participants had met with their PRSS for a median of 10 sessions over two months. SPARC scores were unrelated to participant demographics or lived experiences. However, better-quality relationships were reported by participants who believed their PRSS was similar to them in relationships with family (<em>p</em>=.004), spirituality/religion (<em>p</em>=.001), age (<em>p</em>&lt;.001), and overall recovery pathway (<em>p</em>&lt;.001). Total SPARC scores were not significantly correlated with perceived PRSS-participant similarities on gender, race/ethnicity, substances of choice, and history of incarceration or substance use treatment.</p></div><div><h3>Discussion</h3><p>Results from this pilot study suggest that PRSS-participant alignment on past experiences (e.g., prior incarceration, choice of drugs) may not be needed to establish good-quality working relationships. However, similarities on factors related to current life stage (e.g., age, family relationships) and/or recovery process (e.g., overall pathway, spirituality) may be more important. Future research should employ mixed-methods approaches to elucidate these unique findings.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000477/pdfft?md5=5218e71078ae54dc2f7ddcadad887ea7&pid=1-s2.0-S2772724624000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840274","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":"Simulating the effects of medicaid expansion on the opioid epidemic in North Carolina","authors":"Anthony Berghammer,&nbsp;Joella W. Adams,&nbsp;Sazid Khan,&nbsp;Georgiy Bobashev","doi":"10.1016/j.dadr.2024.100262","DOIUrl":"10.1016/j.dadr.2024.100262","url":null,"abstract":"<div><p>Expanding Medicaid plays a large role in ensuring that people across the United States have access to health care services. Although North Carolina recently moved toward Medicaid expansion, the impact of expansion on overdoses and overdose mortality may vary based on the type of treatment (offering medications for opioid use disorder [MOUD] vs. offering inpatient medically managed withdrawal without linkage to further MOUD treatment or non–MOUD-based treatment) accessed by individuals newly eligible for treatment through expansion. Based on official North Carolina statistics and published peer-reviewed literature, we developed a simulation model that forecasts opioid overdose and mortality under different scenarios for type of treatment accessed (MOUD-based vs. non–MOUD-based) and Medicaid coverage levels. An optimistic scenario assuming 70 % of individuals newly eligible for treatment would enter treatment during the first year of expansion estimated that 332 (Simulation Interval: 246–412) overdose deaths would be averted. A scenario more in line with recent historical trends assuming 38 % of individuals newly eligible for treatment would enter treatment resulted in 213 (Simulation Interval: 157–263) averted overdose deaths. In all scenarios, MOUD-based treatment approaches increased the number of lives saved compared with approaches expanding opioid treatment through non–MOUD-based treatment. Our study emphasized the need to ensure access to MOUD-based treatment for individuals newly covered by the Medicaid expansion.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100262"},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000465/pdfft?md5=aa309dbf2154369a42edff042e47fc11&pid=1-s2.0-S2772724624000465-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852402","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":"Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings","authors":"Leah K. Hamilton ,&nbsp;Katharine A. Bradley ,&nbsp;Theresa E. Matson ,&nbsp;Gwen T. Lapham","doi":"10.1016/j.dadr.2024.100260","DOIUrl":"10.1016/j.dadr.2024.100260","url":null,"abstract":"<div><h3>Background</h3><p>The prevalence of cannabis use disorder (CUD) is increasing in the US and primary care providers need tools to identify patients with moderate-severe CUD to facilitate treatment. A single-item screen for cannabis (SIS-C) has outstanding discriminative validity for CUD. However, because the prevalence of moderate-severe CUD is typically low, the probability that an average patient who screens positive for daily cannabis has moderate-severe cannabis use disorder is low, making follow-up assessment important.</p></div><div><h3>Methods</h3><p>This study reports the discriminative validity of a DSM-5 Substance Use Symptom Checklist (“Checklist”) for moderate-severe CUD among 498 primary care patients who reported daily cannabis use on the SIS-C. We evaluated the performance of the Checklist (score 0–11) completed during routine care, compared to ≥4 DSM-5 CUD symptoms (moderate-severe CUD) on the Composite International Diagnostic Interview <em>Substance Abuse Module</em> from a confidential survey (reference standard). We estimated areas under receiver operating curve (AUROC), sensitivities, specificities, and post-test probabilities.</p></div><div><h3>Results</h3><p>Of 498 eligible patients, 17 % met diagnostic criteria for moderate-severe CUD. The Checklist’s AUROC for moderate-severe CUD was 0.77 (95 % CI: 0.71–0.83), and Checklist scores of 1–2 balanced sensitivity and specificity. Among patients from a population with average prevalence of CUD before screening (~6 % prevalence) and daily use on the SIS-C, a Checklist score of 3 indicated a post-test probability of 82.1 %.</p></div><div><h3>Conclusion</h3><p>Overall performance of the Checklist was good and the high specificity made it useful for identifying patients likely to have moderate-severe CUD among those at average risk.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000441/pdfft?md5=468e165c6ff5e4b110eb7e7271a87843&pid=1-s2.0-S2772724624000441-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714396","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":"Perceptions of structural and provider-based substance use stigma interventions among primary care professionals","authors":"Erin Fanning Madden ,&nbsp;Felicia Frabis ,&nbsp;Jonathan Cohn ,&nbsp;Fares Qeadan ,&nbsp;Christopher RC Mann ,&nbsp;Mark K. Greenwald","doi":"10.1016/j.dadr.2024.100259","DOIUrl":"10.1016/j.dadr.2024.100259","url":null,"abstract":"<div><h3>Background</h3><p>Stigma enacted in primary care settings remains a barrier to care for people who use drugs (PWUD). Little is known about the acceptability of potential stigma interventions to target structural drivers of stigma affecting the organizational- or provider-level.</p></div><div><h3>Methods</h3><p>In-depth interview data were collected from 21 individuals working in Michigan primary care facilities. Participants included clinical (e.g., physicians, nurses) and non-clinical (e.g., administrators, receptionists) staff. Interviews explored perceptions of stigma toward PWUD and the acceptability of interventions to mitigate such stigma. Thematic analysis was used to identify stigma themes.</p></div><div><h3>Results</h3><p>Participants largely reported substance-use stigma as a matter of individual attitudes or knowledge limitations and described such stigma as rarely occurring during interpersonal interactions. Participants were still acutely aware of upstream societal and organizational factors creating structural barriers to care and/or worsening outcomes among PWUD, but seldom labeled these as stigma. Some provider and structural stigma reduction interventions were enthusiastically supported because they address participant ideas of substance-use stigma drivers (e.g., lack of knowledge) or provide resources that could improve care quality or provide resources for PWUD. Conversely, participants opposed some potential stigma interventions, e.g., less-frequent urine drug testing and increasing clinical visit time, deemed infeasible because of outside forces like insurers or regulators.</p></div><div><h3>Conclusions</h3><p>Although most participants conceptualized substance-use stigma as an individual or interpersonal process best addressed with training, their awareness of social determinants of health seemed to fuel an openness to some structural interventions to reduce organizational and provider stigma toward PWUD in primary care settings.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277272462400043X/pdfft?md5=5e843f9030f109a6474fbef140b3be8b&pid=1-s2.0-S277272462400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630538","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":"Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies","authors":"Kyle J. Moon ,&nbsp;Sabriya L. Linton ,&nbsp;Neda J. Kazerouni ,&nbsp;Ximena A. Levander ,&nbsp;Adriane N. Irwin ,&nbsp;Daniel M. Hartung","doi":"10.1016/j.dadr.2024.100255","DOIUrl":"10.1016/j.dadr.2024.100255","url":null,"abstract":"<div><h3>Background</h3><p>Timely and reliable dispensing of buprenorphine is critical to accessing treatment for opioid use disorder (OUD). Racial and ethnic inequities in OUD treatment access are well described, but it remains unclear if inequities persist at the point of dispensing.</p></div><div><h3>Methods</h3><p>We analyzed data from a U.S. telephone audit that measured restricted buprenorphine dispensing in community pharmacies, defined as inability to fill a buprenorphine prescription requested by a “secret shopper.” Using the Index of Concentration at the Extremes (ICE), we constructed county-level measures of racial, ethnic, economic, and racialized economic (joint racial and economic segregation) segregation. Logistic regression models evaluated the association of ICE measures and restricted buprenorphine dispensing, adjusting for county type (urban vs. rural) and pharmacy type (chain vs. independent).</p></div><div><h3>Results</h3><p>Among 858 pharmacies surveyed in 473 counties, pharmacies in the most ethnically segregated and economically deprived counties had 2.66 times the odds (95 % CI: 1.41, 5.17) of restricting buprenorphine dispensing, compared to pharmacies in the most privileged counties after adjustment. Pharmacies in counties with high racialized economic segregation (quintile 2 and 3) also had higher odds of restricting buprenorphine dispensing (aOR 3.09 [95 % CI 1.7, 5.59]; aOR 2.11 [95 % CI 1.17, 3.98]). Similar associations were observed for economic segregation (aOR: 2.18 [95 % CI: 1.21, 3.99]), but not ethnic (0.59 [0.34, 1.05]) or racial (0.61 [0.35, 1.07]) segregation alone.</p></div><div><h3>Conclusions</h3><p>Restricted buprenorphine dispensing was most pronounced in socially and economically disadvantaged communities, potentially exacerbating gaps in OUD treatment access. Policy interventions should target both prescribing and dispensing capacity to advance pharmacoequity.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000398/pdfft?md5=36e0c271c0d6d4c2e784e8baa8ac8011&pid=1-s2.0-S2772724624000398-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630539","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}