Journal of substance use and addiction treatment最新文献

{"title":"Preliminary evidence that self-incentives uniquely promote smoking cessation in incarcerated populations: A pilot randomized controlled trial","authors":"Emma M. Brown ,&nbsp;Debbie M. Smith ,&nbsp;Christopher J. Armitage","doi":"10.1016/j.josat.2024.209610","DOIUrl":"10.1016/j.josat.2024.209610","url":null,"abstract":"<div><h3>Introduction</h3><div>Smoking prevalence rates in prison are typically four times higher than the rates found within community-based settings, increasing premature mortality. Encouraging smokers to self-administer incentives contingent on abstinence (i.e., self-incentivize) are effective in community-based settings and have the potential to work in an incarcerated population. The present study aims to: gauge the feasibility of- and assess possible effects associated with- encouraging smokers to self-incentivize to increase smoking abstinence.</div></div><div><h3>Methods</h3><div>The study recruited 25 smokers from a UK prison who were attending the prison-based stop smoking service. Participants were randomized to one of three conditions, either: (a) an active control, asked to form a plan to quit smoking (<em>n</em>=5); or to self-incentivize if they had not smoked at all by the end of (b) the week (<em>n</em>=7); or (c) the month (<em>n</em>=13). The study gave no specific options to participants in choosing a self-incentive for a number of reasons (e.g., to enable choice of a self-incentive of sufficient rewarding value within a restrictive setting). Participant eligibility included: (a) aged 18 years or over, (b) able to understand written English, (c) competent to provide informed consent, and (d) were tobacco smokers, smoking on a daily basis. Acceptance and completion assessed feasibility. Chi-square analysis assessed possible effect of the intervention.</div></div><div><h3>Results</h3><div>Twenty five out of 27 smokers who were approached, welcomed the opportunity of further support and completed the baseline questionnaire. At 3-month follow-up, no participants (0/5) in the control condition abstained from smoking. In contrast, three (out of seven, d=1.12) participants who self-incentivized on a weekly basis abstained, and five (out of 13, d=0.83) participants who self-incentivized on a monthly basis abstained at the 3-month follow-up time point. Abstaining is defined as no cigarette smoked within at least the last 28-days via self-report and supported by biochemical verification from a sub-sample of participants (68%; 17/25).</div></div><div><h3>Conclusions</h3><div>Use of self-incentives alongside behavioral support and cessation medication is feasible and can be delivered at low-cost. Furthermore, the promise seen in this trial suggests a fully powered randomized controlled trial has the potential to increase smoking abstinence in an incarcerated population.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209610"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878822","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":"Screening, treatment, and referral for substance use disorder in Medicaid health homes: Results of a national pilot study","authors":"Olivia M. Hinds,&nbsp;Melissa A. Westlake,&nbsp;Sophia N.D. Negaro,&nbsp;Christina M. Andrews","doi":"10.1016/j.josat.2024.209608","DOIUrl":"10.1016/j.josat.2024.209608","url":null,"abstract":"<div><h3>Introduction</h3><div>Established under the Affordable Care Act, Medicaid health homes are designed to provide comprehensive health care for enrollees with chronic health conditions. Given high rates of substance use disorder (SUD) in Medicaid, health homes have the potential to enhance SUD identification and treatment. Yet little is known about the extent to which they engage in these activities. In this study, we assessed the proportion of health homes that screen, treat, and refer for SUD; health homes compliance with state plan requirements for SUD screening and treatment; and the extent to which these trends differ among health homes focusing on physical versus mental health and SUD.</div></div><div><h3>Methods</h3><div>We administered a pilot survey in 2022 to all health care providers participating in active Medicaid health home models. Health home models were categorized as physical-, mental health-, or SUD-focused. We estimated the percentage of health homes engaged in SUD screening, treatment, and referral, and the percentage of health homes that complied with state requirements in each domain.</div></div><div><h3>Results</h3><div>Our sample included 113 Medicaid health homes in 15 states and the District of Columbia. Physical health-focused health homes were more likely to screen for SUD than mental health-focused and SUD-focused health homes (81.0 % versus 63.4 % and 55.0 % respectively). Most health homes referred out at least some SUD treatment (84.1 %). Among those that did refer, fewer than 20 % had a formal contractual agreement with an SUD treatment program. The majority of health homes complied with state requirements for referral. However, among health homes required by their state to offer SUD screening, 38.5 % of physical health-, 10.0 % of mental health-, and 25.0 % of SUD-focused health homes failed to do so. Similarly, 5.9 % of physical health-, 67.9 % of mental health- and 45.0 % of SUD-focused health homes did not offer onsite SUD treatment, even when required to do so.</div></div><div><h3>Conclusions</h3><div>While Medicaid health home plans were established to promote care coordination and integration, relatively few health homes in this study reported doing so in the case of SUD. A concerning number of health homes did not comply with state plan requirements for SUD screening and treatment.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209608"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878831","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}

{"title":"Advancing peer support workforce research: Insights and recommendations through the lens of professionalization","authors":"Justin S. Bell ,&nbsp;Angela Hagaman ,&nbsp;Justin Beattey ,&nbsp;Gina Fears ,&nbsp;William L. White ,&nbsp;Dennis P. Watson","doi":"10.1016/j.josat.2024.209612","DOIUrl":"10.1016/j.josat.2024.209612","url":null,"abstract":"<div><div>Over the past two decades, peer support providers have increasingly formalized their roles in the addiction treatment workforce through credentialing and professionalization efforts. Despite these advancements, misconceptions regarding their professional identity persist and contribute to challenges such as burnout and high turnover. This commentary underscores the importance of viewing the peer workforce as an emerging profession using a lens that has previously been applied to other healthcare service roles. We outline key milestones in the peer workforce's professional development and ongoing labor advocacy efforts by state and national organizations. We call for a comprehensive research agenda that addresses workforce outcomes, workplace dynamics, and role competencies. Such efforts are crucial for advancing the recognition and support of peers as an integral component of the behavioral healthcare workforce.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209612"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878819","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}

{"title":"Using state opioid response grant funding to disseminate contingency management for substance use disorder treatment in Indiana","authors":"Michael P. Smoker ,&nbsp;Jeremiah Weinstock ,&nbsp;Brigid R. Marriott ,&nbsp;Matthew C. Aalsma ,&nbsp;Zachary W. Adams","doi":"10.1016/j.josat.2024.209589","DOIUrl":"10.1016/j.josat.2024.209589","url":null,"abstract":"<div><h3>Introduction</h3><div>Contingency management (CM) is an efficacious psychosocial intervention for substance use disorders with over 25-years of empirical support, yet CM adoption in SUD treatment settings is limited. In 2020, SAMHSA's State Opioid Response Grant (SOR) initiative included CM as an allowable activity to “treat stimulant use disorder and concurrent substance misuse, and to improve retention in care.” This policy-driven funding mechanism has significant potential to expand CM implementation nationally. This study describes an SOR-funded program to disseminate CM in Indiana.</div></div><div><h3>Methods</h3><div>Indiana government and university partners developed a multi-component, statewide CM dissemination and implementation plan, including 1) statewide promotion, 2) detailed application process for interested SUD treatment agencies, 3) live, expert-led CM workshop, 4) technical assistance (TA) sessions for participating agencies, and 5) agency-level start-up funds to offset CM-related expenses. The study collected data on provider/staff characteristics, CM knowledge and attitudes, readiness, perceived barriers, and CM implementation at pre- and post-training workshop and at 3- and 6-month follow-up. In Year 2, the study collected client-reported quality assurance data.</div></div><div><h3>Results</h3><div>Staff (<em>N</em> = 72) from 12 selected agencies (13 sites) attended the CM workshop. About half (57 %) had some familiarity with CM, but only 14 % had any prior CM experience or training. Post workshop, participants reported increased CM knowledge and increased confidence in ability to implement CM. Sites completed 3–7 CM TA sessions and developed a tailored CM program. By 6 months, 9 sites had begun CM implementation. These sites averaged 57 days of implementation (range = 25–122), engagement of 23 clients (range = 4–77), delivery of 208 CM reinforcers (gift card codes; range = 8–366), and per-client payouts of $33.77 (range = $11.25–$49.48). Identified barriers to CM implementation included lack of time, client referrals, and resources (administrative, economic). Client-level quality assurance data indicated provider adherence to CM.</div></div><div><h3>Conclusions</h3><div>A multi-component training model funded by SOR yielded several new CM programs that operated successfully within SAMHSA's guidelines. Organizational barriers related to readiness/capacity, turnover, and buy-in remained for some sites and warrant attention in future CM dissemination and implementation efforts. This work illustrates the promise of applying SAMHSA SOR awards to disseminate CM in community agencies.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209589"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759218","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}

{"title":"Implementation strategies to support recovery support workers serving criminal legal involved people who use drugs","authors":"Mai T. Pho ,&nbsp;Alida Bouris ,&nbsp;Erin D. Carreon ,&nbsp;MoDena Stinnette ,&nbsp;Maggie Kaufmann ,&nbsp;Valery Shuman ,&nbsp;Dennis P. Watson ,&nbsp;Antonio D. Jimenez ,&nbsp;Borris Powell ,&nbsp;Charlie Kaplan ,&nbsp;Stacy Zawacki ,&nbsp;Stefanie Morris ,&nbsp;Julio Garcia ,&nbsp;Ashley Hafertepe ,&nbsp;Katy Hafertepe ,&nbsp;Harold A. Pollack ,&nbsp;John A. Schneider ,&nbsp;Basmattee Boodram","doi":"10.1016/j.josat.2024.209583","DOIUrl":"10.1016/j.josat.2024.209583","url":null,"abstract":"<div><h3>Introduction</h3><div>Recovery support workers (RSWs) who provide social support interventions for people who use drugs (PWUD) often face challenges that can jeopardize the well-being, efficacy and sustainability of this essential workforce. To date, little has been reported on the types of implementation strategies used to support RSWs. We describe and evaluate a multifaceted implementation strategy package to support Reducing Opioid Mortality in Illinois (ROMI), a paired peer recovery coach and case manager (PRC-CM) intervention for PWUD with recent criminal-legal involvement in urban and rural settings.</div></div><div><h3>Methods</h3><div>ROMI utilized a remote, hub and spoke-administered multifaceted implementation strategy package to support PRCs-CMs to deliver evidence-based services to PWUD with criminal-legal involvement. The core strategies included: (a) comprehensive training; (b) individual clinical supervision; (c) group consultation; and (d) centralized technical assistance. We evaluated the implementation strategy package using a mixed-methods design including qualitative interviews with the intervention staff to explore their experiences with each strategy component, as well as a quantitative coding of topics discussed during supervision and group consultation meetings to estimate prioritization of issues and balance of topics between strategy type.</div></div><div><h3>Results</h3><div>Between January 2019 and January 2024, the study interviewed 8 PRC-CMs and quantitatively coded 568 sessions (79 group consultations and 489 individual supervisory) for discussion themes. The hub-and-spoke model allowed for centralized access to highly skilled supervisory staff as well as knowledge sharing across geographically remote teams. The therapeutic space to process feelings and emotional support provided during individual supervision was noted to be an essential resource by PRC-CMs. Group consultation facilitated camaraderie, mutual support and continual learning through dynamic and responsive trainings. Frustrations around resource limitations and systemic barriers facing their clients remained a dominant concern for PRCs-CMs, and was incompletely addressed by the technical assistance strategy.</div></div><div><h3>Conclusion</h3><div>Understanding the practical components and individual strengths of the implementation strategies required to support the implementers of complex interventions such as social support and navigation for PWUD with criminal-legal involvement elucidates the organizational and professional capacities that may be required for real world implementation.</div></div><div><h3>Trial registration</h3><div><span><span>NCT04925427</span><svg><path></path></svg></span></div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209583"},"PeriodicalIF":0.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717970","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}

{"title":"Feasibility and outcomes of a trauma-informed model of care in residential treatment for substance use","authors":"Z.C. Walter ,&nbsp;M. Carlyle ,&nbsp;V. Mefodeva ,&nbsp;S. Glasgow ,&nbsp;G. Newland ,&nbsp;R.D.V. Nixon ,&nbsp;V.E. Cobham ,&nbsp;L. Hides","doi":"10.1016/j.josat.2024.209571","DOIUrl":"10.1016/j.josat.2024.209571","url":null,"abstract":"<div><h3>Introduction</h3><div>History of trauma and PTSD are both common among individuals with substance use disorder (SUD) and associated with poorer SUD treatment retention and outcomes. Recommended trauma-informed care (TIC) approaches in SUD treatment have been underutilized in residential substance use treatment services.</div></div><div><h3>Methods</h3><div>This study conducted a single-armed, phase 1 feasibility and outcomes trial for a novel TIC model developed and delivered in a young adult (18–35 years) residential substance use treatment service in Australia. Measures of client acceptability, staff acceptability, and treatment fidelity assessed feasibility. The study collected client substance use (global substance use and alcohol, methamphetamine, and cannabis use involvement) and mental health outcomes (depression, anxiety, and PTSD symptoms) at service entry, and 3, 6, and 12 months later. Staff professional quality of life, and perceptions and confidence in delivering TIC were collected at baseline (prior to staff training in TIC), and at 3, 6, 12 and 18 months following training in the model.</div></div><div><h3>Results</h3><div>The program was delivered as per the TIC model approximately 88 % of the time, where 48 % of clients completed the full 6-week treatment program. Mixed effect models showed significant reductions in substance involvement, particularly for substance use at 3 months (<em>d</em> = 0.67). Improvements in depression, anxiety, and PTSD were also found (<em>p</em>s &lt; .01). Staff levels of support and self-efficacy to implement TIC remained high over the duration of the evaluation, and trauma knowledge scores were higher at follow-up time points. Staff professional quality of life also remained high across the study.</div></div><div><h3>Conclusion</h3><div>The novel TIC model was acceptable for residential clients and staff and was associated with improved mental and substance use outcomes. These findings support TIC as feasible in residential service, with likely benefits for staff and clients.</div></div><div><h3>Ethics</h3><div>The study received ethical approval by the University of Queensland (Approval number: 2020000949).</div></div><div><h3>Trial registration number</h3><div>ACTRN12621000492853.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209571"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683726","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":"“Someone is there with you through this [pregnancy] that isn't seeing you through a negative lens”: Considerations for integrating doula referrals into opioid treatment programs","authors":"Meghan Gannon ,&nbsp;Dennis Hand ,&nbsp;Vanessa L. Short ,&nbsp;Taylor Carrubba ,&nbsp;Grace Thiele ,&nbsp;Sam Pancoe ,&nbsp;Sarah Lawson ,&nbsp;Nadia Haerizadeh-Yazdi ,&nbsp;Scott W. Keith ,&nbsp;Diane Abatemarco","doi":"10.1016/j.josat.2024.209585","DOIUrl":"10.1016/j.josat.2024.209585","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy-associated mortality involving opioids represents a significant public health issue. Limited social support is a known factor, contributing to a more complex recovery and a greater risk for relapse and overdose. Community-based doulas have been used in other marginalized populations yet are under-studied among pregnant and parenting persons with Opioid Use Disorder (OUD). Therefore, we aimed to investigate the perspectives of Opioid Treatment Program (OTP) clinical staff and community doulas about doula support for persons with perinatal OUD to 1) describe the perceived utility of doula support and 2) identify structural considerations for integrating doula support at an OTP.</div></div><div><h3>Methods</h3><div>This study conducted focus groups and utilized domains of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Purposive sampling recruited 10 participants (5 doulas, 5 OTP staff: 1 clinical director, two counselors, one nurse, and one Community Health Worker) from an OTP program and a Philadelphia Department of Public Health Community Doula Support Program (CDSP). One focus group was held for doula staff, and two focus groups were held for OTP clinical staff. Thematic analytic procedures were used to analyze data using NVivo and an interdisciplinary coding team.</div></div><div><h3>Results</h3><div>Five key themes were identified from the focus group data: 1) Role of advocacy in the court system, 2) Need for collaborative care, 3) Use of doulas to de-stigmatize healthcare experiences, 4) Impact of doula support on recovery, 5) Considerations to integrating doula referrals into OTPs.</div></div><div><h3>Conclusion</h3><div>Perinatal doula support among persons with OUD is perceived as beneficial by critical stakeholders to advocate in healthcare and legal systems, de-stigmatize healthcare experiences, and promote recovery engagement. The implementation recommendations outlined may guide other OTPs looking to integrate doula support to improve maternal outcomes associated with opioid use.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209585"},"PeriodicalIF":0.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649762","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}

{"title":"Testing the feasibility, acceptability, and preliminary efficacy of integrating accommodation strategies into an HIV prevention intervention for people who inject drugs with cognitive dysfunction","authors":"Colleen B. Mistler ,&nbsp;Roman Shrestha ,&nbsp;Michael M. Copenhaver","doi":"10.1016/j.josat.2024.209582","DOIUrl":"10.1016/j.josat.2024.209582","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive profiles of individuals with opioid use disorder (OUD) limit patients' ability to learn, retain, and recall HIV prevention information. It also limits adherence to medications, such as pre-exposure prophylaxis (PrEP). Cognitive dysfunction accommodation strategies have shown promise at reducing HIV-related risk behaviors among individuals with OUD and increasing adherence to PrEP. This study investigated the feasibility, acceptability, and preliminary efficacy of integrating accommodation strategies into a behavioral HIV prevention intervention.</div></div><div><h3>Methods</h3><div>This 2-arm single blind study provided 50 people who inject drugs (PWID) with OUD linkage to PrEP services and randomized them to a 4-week HIV prevention intervention condition. The active control condition received the HIV prevention intervention as treatment per usual, while the experimental condition received the enhanced HIV prevention intervention with added accommodation strategies. Participants completed acceptability ratings of intervention content and accommodation strategies post-intervention; feasibility was measured via participant recruitment and retention. HIV risk reduction information, motivation, and behavior (IMB) assessments and HIV risk reduction skills assessments were completed pre/post-intervention. Participants also completed weekly PrEP adherence assessments.</div></div><div><h3>Results</h3><div>The intervention content received a high acceptability rating (89 %). Intervention feasibility was deemed acceptable, with 80 % of participants completing all study protocols. The accommodation strategies integrated into the HIV prevention sessions were also endorsed by 92 % of participants. Participants in the experimental condition had significant increases in retention and recall of how to perform HIV risk reduction skills including how to properly clean a syringe (<em>p</em> = 0.048) and how to accurately apply a female condom (<em>p</em> = 0.025), compared to the control condition. Weekly PrEP adherence was reported by the three (7.5 %) participants who indicated taking PrEP throughout the study. All three participants reported missing doses throughout each of the 4 weeks.</div></div><div><h3>Conclusions</h3><div>Results from this study highlight the potential for integrating accommodation strategies into behavioral HIV prevention interventions to reduce the risk of HIV among PWID. Future research is needed to evaluate the use of such strategies by larger and diverse samples of PWID, as well as whether accommodation strategies enable the retention and recall of HIV prevention information and HIV prevention skills over longer periods of time.</div></div><div><h3>Trial registration</h3><div>This trial has been retrospectively registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> on June 12, 2023. (<span><span>NCT05912374</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209582"},"PeriodicalIF":0.0,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649770","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}

{"title":"Patient experiences in outpatient substance use disorder treatment: A qualitative study exploring both clinical and non-clinical contexts","authors":"Sugy Choi ,&nbsp;Jasmin Choi ,&nbsp;Megan O'Grady ,&nbsp;Diego Renteria ,&nbsp;Crissy Oueles ,&nbsp;Eddie Liebmann ,&nbsp;Pat Lincourt ,&nbsp;Ashly E. Jordan ,&nbsp;Charles J. Neighbors","doi":"10.1016/j.josat.2024.209581","DOIUrl":"10.1016/j.josat.2024.209581","url":null,"abstract":"<div><h3>Background</h3><div>Addressing the persistent treatment gap in substance use disorder (SUD) remains a critical challenge, with only 13 % of Americans with SUDs receiving necessary treatment. We explored the complexities of engaging in SUD treatment from patients' perspectives and aims to provide a comprehensive understanding of their treatment experiences.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with 34 patients who had been attending outpatient SUD clinics in New York State for 6 or less months. Participants were recruited from seven clinics using purposive sampling. Interviews were conducted between June and August 2022. We conducted thematic analysis of coded data to explore patients' experiences and preferences while navigating their treatment journeys.</div></div><div><h3>Results</h3><div>Critical elements for a positive treatment experience included cultural humility, confidentiality, consistency, trust, peer counselors with SUD experience, a strong sense of connection, and addressing needs beyond clinical settings. These included assistance with housing and employment, participation in external clinic events, and access to amenities like coffee and snacks. Participants favored holistic treatment approaches integrating mental health and involving peer recovery counselors. However, participants also identified ineffective aspects, including rigid and generic approaches, stigmatizing attitudes, and challenges related to communities and environmental influences.</div></div><div><h3>Conclusion</h3><div>The study highlights the multifaceted nature of outpatient SUD treatment, emphasizing the integration of patient-centered, holistic, and culturally competent approaches. Tailoring interventions to individual circumstances and acknowledging the diverse needs of patients are imperative for effective healthcare practices.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209581"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669869","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}

{"title":"Evaluating public health vending machine rollout and utilization in criminal-legal settings","authors":"Rosemarie Martin ,&nbsp;Alyssa DaCunha ,&nbsp;Amelia Bailey ,&nbsp;Raynald Joseph ,&nbsp;Kimberly Kane","doi":"10.1016/j.josat.2024.209584","DOIUrl":"10.1016/j.josat.2024.209584","url":null,"abstract":"<div><h3>Introduction</h3><div>Harm reduction resources for people who are involved in the criminal-legal system should be easily accessible. The Rhode Island Department of Corrections (DOC) used funding from a state opioid stewardship fund created through the Rhode Island Opioid Stewardship Act (legislation passed in 2019) to implement five custom-designed vending machines for community corrections offices and state awaiting trial carceral facilities. The vending machines provide resources for overdose prevention, infection prevention, basic needs, and nicotine replacement therapy (NRT). We aim to describe the development and rollout of the vending machines and present data about items taken most frequently by setting.</div></div><div><h3>Methods</h3><div>Research and design experts, with DOC and community stakeholders, developed and tailored the public-facing design of the vending machines. Before implementation, the researchers from the development team conducted meetings with staff at each location to discuss harm reduction and their role in addressing the opioid crisis in this high-risk population. The machines were manufactured in 2022 and installed in early 2023 (dates varied by location). The community support and advocacy organization tracks and maintains inventory (items taken and replaced) by month. No individual-level client data is collected.</div></div><div><h3>Results</h3><div>There were 3720 items dispensed from May 2022 to February 2024 across five locations. Overall, hygiene kits were the most frequently accessed item (28.3 %, <em>n</em> = 1051), followed by NRT (19.0 %, <em>n</em> = 706) and ponchos (16.6 %, <em>n</em> = 616). The fentanyl tests (<em>n</em> = 230), wound care kits (<em>n</em> = 248), resource guide (<em>n</em> = 253), naloxone (<em>n</em> = 221), and safer sex kits (<em>n</em> = 218) each made up between 5.9 % and 6.8 % of items accessed. The pregnancy test was the least accessed at 4.8 % (<em>n</em> = 177). There were statistically significant differences in the monthly number of items distributed by location for the basic needs items, excluding NRT, with 39 items per month at the three Probation/Parole locations compared to 21 per month for the two DOC facilities.</div></div><div><h3>Conclusions</h3><div>The utilization patterns demonstrate the demand for basic supplies and support related to harm reduction. Monitoring and summarizing utilization ensures that the vending machines remain useful to the community and facilitates transparency and communication with stakeholders.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209584"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649766","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}