Journal of substance use and addiction treatment最新文献

{"title":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(24)00307-2","DOIUrl":"10.1016/S2949-8759(24)00307-2","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209595"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163596","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":"Redefining low-threshold buprenorphine access in an integrated mobile clinic program: Factors associated with treatment retention","authors":"Robert Harris ,&nbsp;Norberth Stracker ,&nbsp;Molly Rice ,&nbsp;Anne St. Clair ,&nbsp;Kathleen Page ,&nbsp;Amanda Rosecrans","doi":"10.1016/j.josat.2024.209586","DOIUrl":"10.1016/j.josat.2024.209586","url":null,"abstract":"<div><h3>Introduction</h3><div>The Spot mobile clinic provides low-threshold buprenorphine integrated with clinical and social services in Baltimore City, MD. In 2021, The Spot modified practices to improve engagement including providing extended prescriptions, reducing frequency of toxicology testing, giving up to six months to stabilize on medication, offering maximum doses (up to 32 mg total) daily, and utilizing telemedicine. This study characterizes care retention by examining both the total time in care and the percentage of time with buprenorphine prescription coverage during these practice changes, and examines factors associated with retention.</div></div><div><h3>Methods</h3><div>This retrospective cohort study includes patients (<em>n</em> = 341) who received a buprenorphine prescription who initiated care on The Spot mobile clinic from September 2021 to October 2022, with follow-up through October 2023. We utilized the Cox proportional hazards model and Kaplan-Meier survival analyses to assess differences in care retention by the factors of patient demographics and clinical characteristics. Additionally, we performed sensitivity analyses using Poisson regression to examine differences between patients with 80 % or greater time with active prescription coverage versus &lt;80 % of time with active prescription coverage.</div></div><div><h3>Results</h3><div>After practice setting changes, retention in care at 90 days was 60 %. Patients whose maximum daily buprenorphine dose was 28 to 32 mg were 80 % less likely to discontinue treatment over the study period than those prescribed ≤16 mg (adjusted hazard ratio of discontinuation: 0.2 [95 % CI: 0.1–0.3]). Engaging in wound care or hepatitis C treatment was associated with higher retention in care, and individuals experiencing homelessness remained engaged at rates comparable to stably housed patients.</div></div><div><h3>Conclusion</h3><div>Practice changes aimed to improve access to patient-centered, low-threshold buprenorphine treatment may increase retention in care. Notably, higher doses of buprenorphine and integrated treatment with wound care and hepatitis C treatment were associated with increased retention. Due to gaps in patient care, retention metrics should incorporate total time in care as well as percentage of time with an active buprenorphine prescription.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209586"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775069","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 of medications for opioid use disorder in U.S. emergency departments: A systematic review","authors":"Sarah E. Philbin ,&nbsp;Alexandra Harris ,&nbsp;Salva Balbale ,&nbsp;Lucy Bilaver ,&nbsp;Molly Beestrum ,&nbsp;Megan McHugh","doi":"10.1016/j.josat.2024.209600","DOIUrl":"10.1016/j.josat.2024.209600","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with opioid use disorder (OUD) experiencing withdrawal or nonfatal overdose often present to emergency departments (EDs). While professional societies endorse the initiation of evidence-based medications for OUD (MOUD) in the ED, low uptake persists. The purpose of this systematic review is to synthesize what is known about implementation of MOUD in EDs and to identify potential strategies to improve the uptake of MOUD in the ED.</div></div><div><h3>Methods</h3><div>We reviewed articles that examined implementation outcomes (acceptability, adoption, appropriateness, feasibility, fidelity, penetration, sustainability, and cost) of MOUD in United States EDs. Peer-reviewed studies that used quantitative, qualitative, or mixed methods approaches were eligible for inclusion.</div></div><div><h3>Results</h3><div>Twenty-seven articles met the inclusion criteria for one or more implementation outcomes. Forty-four percent (<em>n</em> = 11) reported on acceptability, 78 % (<em>n</em> = 21) reported on adoption, 26 % (<em>n</em> = 7) reported on appropriateness, and 15 % (<em>n</em> = 4) reported on feasibility. Eleven percent (<em>n</em> = 3) reported on fidelity, 7 % (n = 2) reported on penetration, and 7 % (n = 2) reported on sustainability. No articles reported on implementation cost. While physicians found MOUD acceptable, their comfort levels with the intervention varied. Rates of MOUD adoption were often low, but uptake may be facilitated by implementation strategies. MOUD may constrain ED time resources and exacerbate overcrowding, hindering appropriateness.</div></div><div><h3>Conclusion</h3><div>Results suggest that ED physicians and administrators have encountered barriers to the initiation of MOUD. There may be opportunities to overcome these implementation barriers using multi-component strategies consisting of educational interventions that address safety and monitoring and process interventions, such as clinical decision support systems.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209600"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824970","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":"Corrigendum to “Development and validation of a community-level social determinants of health index for drug overdose deaths in the HEALing Communities Study” [Journal of Substance Use and Addiction Treatment (2024) 209186]","authors":"Nina Cesare ,&nbsp;Lisa M. Lines ,&nbsp;Redonna Chandler ,&nbsp;Erin B. Gibson ,&nbsp;Rachel Vickers-Smith ,&nbsp;Rebecca Jackson ,&nbsp;Angela R. Bazzi ,&nbsp;Dawn Goddard-Eckrich ,&nbsp;Nasim Sabounchi ,&nbsp;Deena J. Chisolm ,&nbsp;Nathan Vandergrift ,&nbsp;Emmanuel Oga","doi":"10.1016/j.josat.2024.209452","DOIUrl":"10.1016/j.josat.2024.209452","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209452"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602337","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":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(24)00306-0","DOIUrl":"10.1016/S2949-8759(24)00306-0","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209594"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129935","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":"An initial randomized controlled trial of a Combined Medication and Behavioral Activation Treatment (CoMBAT) for people with opioid use disorder","authors":"Jaclyn M.W. Hughto ,&nbsp;Landon D. Hughes ,&nbsp;Kimberly M. Nelson ,&nbsp;Nicholas S. Perry ,&nbsp;Matthew J. Mimiaga ,&nbsp;Katie B. Biello ,&nbsp;Amelia Bailey ,&nbsp;David W. Pantalone","doi":"10.1016/j.josat.2024.209602","DOIUrl":"10.1016/j.josat.2024.209602","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid use disorder is a chronic, relapsing disease and a major source of morbidity and mortality in the U.S. Medications for opioid use disorder (MOUD) have been shown to reduce opioid use; however, MOUD maintenance is often suboptimal. Depression is a well-documented risk factor for MOUD treatment disengagement; thus, behavioral interventions to address depression and support ongoing MOUD use in community settings are warranted.</div></div><div><h3>Methods</h3><div>We evaluated the feasibility, acceptability, and preliminary efficacy of the CoMBAT (Combined Medication and Behavioral Activation Treatment) intervention via a pilot randomized controlled trial. We hypothesized that the CoMBAT intervention, which uses behavioral activation, motivational interviewing, and problem-solving techniques, would be feasible and acceptable to participants and decrease depression, increase goal-directed activity, improve MOUD care engagement, and reduce opioid use among adults with depressive symptoms who had a missed dose or clinical MOUD visit in the past 30 days. We enrolled 32 participants prescribed methadone or buprenorphine in the community; each received 2 health navigation and substance use counseling sessions (HN_SUC) before being randomized into (a) the 8-session CoMBAT intervention + HN_SUC + treatment as usual or (b) HN_SUC + treatment as usual only. The primary outcomes were intervention feasibility and acceptability. Preliminary efficacy measures included self-reported past-30-day MOUD doses and clinical visits, depressive symptoms, behavioral activation; and opioid-positive urinalysis; each assessed at baseline and 3- and 6-month follow-up visits.</div></div><div><h3>Results</h3><div>The intervention was feasible (88 % of intervention sessions completed; 100 % retention at 6 months) and acceptable (86 % of intervention participants were satisfied/very satisfied with the intervention at 3-months; and intervention participants had a high level of alliance with their counselor at the mid-point: mean = 5.7 out of 7 [SD = 1.3] and end of their treatment: mean = 5.5 out of 7 [SD = 1.1]. At 6-months, intervention participants reported fewer missed MOUD doses and visits, less depressive symptoms, greater behavioral activation scores, and a lower percentage of opioid-positive toxicology screens relative to the control condition.</div></div><div><h3>Conclusion</h3><div>Findings provide evidence of intervention feasibility and acceptability and demonstrate initial efficacy for ongoing MOUD care engagement, depressive symptom reduction, increased behavioral activity, and reduced opioid use. Future intervention testing in a fully-powered efficacy trial is warranted.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209602"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822739","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":"Siyakhana: A hybrid type 2 effectiveness-implementation stepped-wedge trial to reduce stigma towards substance use and depression among community health workers in HIV/TB care in South Africa","authors":"Jessica F. Magidson ,&nbsp;Kristen S. Regenauer ,&nbsp;Kim Johnson ,&nbsp;Tianzhou Ma ,&nbsp;Jennifer M. Belus ,&nbsp;Alexandra L. Rose ,&nbsp;Imani Brown ,&nbsp;Nonceba Ciya ,&nbsp;Sibabalwe Ndamase ,&nbsp;Caroline Sacko ,&nbsp;John Joska ,&nbsp;Goodman Sibeko ,&nbsp;Ingrid V. Bassett ,&nbsp;Bronwyn Myers","doi":"10.1016/j.josat.2025.209634","DOIUrl":"10.1016/j.josat.2025.209634","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Substance use (SU) and other mental health conditions, such as depression, contribute to poor engagement in HIV and TB care in South Africa, a country with the highest global prevalence of HIV and a significant TB burden. Yet, community health workers (CHWs)—frontline lay health workers who play a central role in re-engaging patients in HIV/TB care—receive little-to-no training on supporting patients with SU or other mental health concerns. CHWs also display stigma towards patients with SU and depression, which may contribute to HIV/TB care disengagement. We developed and tested a CHW training (&lt;em&gt;“Siyakhana”&lt;/em&gt;) to reduce CHW stigma towards SU and depression in HIV/TB care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A cluster randomized, stepped-wedge hybrid type 2 effectiveness-implementation trial (&lt;em&gt;N&lt;/em&gt; = 82 CHWs) evaluated &lt;em&gt;Siyakhana&lt;/em&gt; across six clinics in a low-resource area of Cape Town, SA. The three-day &lt;em&gt;Siyakhana&lt;/em&gt; training included psychoeducation, self-care strategies, non-judgmental communication, problem solving, and contact-based stigma reduction using lived experience narratives. Pre-training and three- and six-month post-training assessments were conducted. Primary effectiveness outcomes were CHW stigma towards SU and depression, assessed using the Social Distance Scale. Primary implementation outcomes were guided by Proctor's model, including fidelity, acceptability, appropriateness, and feasibility, assessed using structured coding of role plays and a validated quantitative measure for assessing implementation outcomes in low- and middle-income countries.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Participants were on average 46.8 years old (&lt;em&gt;SD&lt;/em&gt; = 8.9), 99% female, and 100% Black African. Ninety-five percent of CHWs completed the &lt;em&gt;Siyakhana&lt;/em&gt; training, with approximately 90% retention over six months. A linear mixed effects model showed a significant effect of the &lt;em&gt;Siyakhana&lt;/em&gt; training on reducing SU stigma over six months after adjusting for time (β = −1.46, &lt;em&gt;SE&lt;/em&gt; = 0.67, &lt;em&gt;p&lt;/em&gt; &lt; 0.05), but no effect on depression stigma (β = −0.20, &lt;em&gt;SE&lt;/em&gt; = 0.57, &lt;em&gt;p&lt;/em&gt; &gt; 0.05). CHW fidelity was 89.4% (&lt;em&gt;SD&lt;/em&gt; = 11.3%) at six-months. Quantitative implementation outcomes indicated high acceptability (&lt;em&gt;M&lt;/em&gt; = 2.85, &lt;em&gt;SD&lt;/em&gt; = 0.27), appropriateness (&lt;em&gt;M&lt;/em&gt; = 2.77, &lt;em&gt;SD&lt;/em&gt; = 0.31), and feasibility (&lt;em&gt;M&lt;/em&gt; = 2.41, &lt;em&gt;SD&lt;/em&gt; = 0.38).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;&lt;em&gt;Siyakhana&lt;/em&gt; was associated with reductions in CHW SU stigma in the context of HIV/TB care, with promising implementation outcomes. Findings will inform a larger randomized trial evaluating the effectiveness and implementation of &lt;em&gt;Siyakhana&lt;/em&gt; and examine whether shifting CHW stigma improves patient-level health outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial registration&lt;/h3&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;: &lt;span&gt;&lt;span&gt;NCT0528","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209634"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076726","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":"What are the risk factors of non-fatal overdose among persons who use opioids? A systematic review and meta-analysis","authors":"Neil Dunne,&nbsp;Maire-Brid Casey,&nbsp;Jo-Hanna Ivers","doi":"10.1016/j.josat.2025.209630","DOIUrl":"10.1016/j.josat.2025.209630","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-fatal opioid overdose (NFOD) is a concerning public health issue that is a risk factor for subsequent fatal overdose.</div></div><div><h3>Methods</h3><div>This systematic review aimed to evaluate all the previous literature using a self-report method to investigate the risk factors of NFOD. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRSIMA) and its 27-item checklist guided the conduct and reporting of this systematic review. The review used the population, risk factor, and outcome (PRO) framework. The population was studies with a majority of participants that regularly used opioids. Risk factors were demographic, medical, and behavioral characteristics. The outcomes were self-reported recent (&lt;12 months) or lifetime presence of NFOD. The study explored seven databases: PubMed, Embase, Cochrane Library, PsycINFO, CINAHL, ProQuest, and Web of Science and used Google Scholar to search for grey literature. A risk of bias assessment was carried out using ROBANS-E and meta-analysis was performed using STATA.</div></div><div><h3>Results</h3><div>The review discovered 53 studies using the self-report experience of persons who use opioids assessing different factors associated with NFOD. Involvement in the sex trade, having a lower than typical education, previous incarceration, experiencing homelessness, unemployment, psychiatric co-morbidity, suicidal ideation or behavior, polysubstance use, especially benzodiazepine use and problematic alcohol use, needing help injecting, former opioid agonist therapy (OAT) engagement, previous treatment experiences, and a hepatitis-C diagnosis were associated with an increased likelihood of NFOD. Current engagement in OAT was protective against NFOD. Gender, relationship status, needle exchange use, symptoms of anxiety, and being HIV positive were not strongly associated with a difference in NFOD likelihood.</div></div><div><h3>Conclusion</h3><div>Using the findings from above to identify the individuals who are at high risk for NFOD, particularly those using opioids, will enable a targeted approach to outreach and education programs based on the identified risk factors- such as polysubstance use, socioeconomic associations, and psychiatric co-morbidities, which can help reduce the occurrence of NFOD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209630"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076727","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":"What apps and websites do those in treatment for substance-related problems use to help them in their recovery? A cross-sectional study of products and use patterns","authors":"Tyler B. Wray ,&nbsp;Gage Reitzel ,&nbsp;Chanda Phelan ,&nbsp;Jennifer E. Merrill ,&nbsp;Kristina M. Jackson","doi":"10.1016/j.josat.2025.209631","DOIUrl":"10.1016/j.josat.2025.209631","url":null,"abstract":"<div><h3>Background</h3><div>Given the global burden of substance use disorders (SUD), innovations in methods to achieve sustained recovery are critical. Digital health products (e.g., websites, smartphone apps) can complement and enhance existing SUD treatments or provide some assistance to those who cannot access formal treatment. One goal of the present study was to obtain descriptive information regarding the use of digital health products during SUD recovery. We also examined demographic and SUD-related correlates (e.g., severity, duration) of digital health product use and whether patterns of app use were related to perceived utility of the apps.</div></div><div><h3>Methods</h3><div>A sample of 255 participants (45 % female, <em>M</em>_age = 41.4 [9.6]) recruited at several outpatient addictions treatment facilities in the northeastern US completed an online survey.</div></div><div><h3>Results</h3><div>Forty-five percent of participants reported having used some kind of app or website to help them in recovery during their lifetimes. The most common motivations participants reported for using an app alongside treatment were to increase knowledge about addiction, hear advice from others in recovery, and to find motivation to stay sober. Those in most older age groups (35–40, 50+) had significantly lower odds of having used an app relative to 18–35 year-olds, and odds of reporting having used an app were 90 % higher among female participants versus others. Increased frequency of app use and using an app/website over a longer period of time were associated with higher ratings of perceived app helpfulness.</div></div><div><h3>Conclusion</h3><div>Future research is needed to determine whether using these products provides clinically meaningful benefits for patients, both in the presence and absence of traditional treatment.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209631"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070078","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":"The impact of buprenorphine prescriber data on geospatial access to treatment in HEALing Communities Study communities, 2022","authors":"Daniel R. Harris ,&nbsp;Shikhar Shrestha ,&nbsp;Peter Rock ,&nbsp;Anita Silwal ,&nbsp;Gia Barboza-Salerno ,&nbsp;Olivia Lewis ,&nbsp;Sumeeta Srinivasan ,&nbsp;Thomas J. Stopka","doi":"10.1016/j.josat.2025.209625","DOIUrl":"10.1016/j.josat.2025.209625","url":null,"abstract":"<div><h3>Introduction</h3><div>The location of buprenorphine treatment providers in the United States is pivotal to the understanding of regional factors associated with prescription and uptake. We evaluated how distinct data sources of treatment providers and their associated locations contribute to the differences observed when measuring buprenorphine accessibility.</div></div><div><h3>Methods</h3><div>We compared buprenorphine treatment provider data from the Drug Enforcement Administration (DEA) and data from the behavioral health treatment locator from the Substance Abuse and Mental Health Services Administration (SAMHSA) for July 2022. Both DEA and SAMHSA data, while similar in spirit, vary substantially in how and why each data set is collected. DEA registration was required by law, while SAMHSA data was an opt-in registry of provider-submitted details. Analyzing the underlying semantics of the data is important for understanding the contextual factors driving observable differences in analytical outputs. We measured accessibility using enhanced two-step floating catchment area (E2SFCA) analysis in three states participating in the HEALing Communities Study (Kentucky, Ohio, Massachusetts). Within communities, we compared decile rankings of accessibility per census tract using each data source. We linked prescribing data from Kentucky's prescription drug monitoring program (PDMP) to measure accessibility using providers prescribing buprenorphine. We explored the significance of localized rank exchanges using neighbor set local indicators of mobility association (LIMA).</div></div><div><h3>Results</h3><div>The number and rate of providers per capita differed substantially at the community level between data sources in the three states. These differences were less impactful in the spatial context of buprenorphine accessibility, which required both supply and demand in regions smaller than our intervention communities. Shifts did occur when measuring the intercommunity decile ranking of accessibility of census tracts, but LIMA results indicated that these rank exchanges were not significant.</div></div><div><h3>Conclusions</h3><div>When analyzing accessibility within a community using E2SFCA analyses, either DEA or SAMHSA data sources are acceptable; linkage to Kentucky's PDMP demonstrated that SAMHSA provider data is equally suitable to PDMP data for research studies involving spatial relationships with providers while being both significantly easier to obtain and less sensitive. When analyzing treatment provider rates per capita, results may vary substantially across these different data sources. Therefore, context must be considered when choosing an appropriate data source to use.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209625"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070077","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}