Journal of substance use and addiction treatment最新文献

{"title":"Barriers and enablers of addiction recovery amongst people experiencing homelessness in Dublin, Ireland: A proposed conceptual framework adapted from the REC-CAP","authors":"Carolyn Ingram,&nbsp;Conor Buggy,&nbsp;Carla Perrotta","doi":"10.1016/j.josat.2025.209669","DOIUrl":"10.1016/j.josat.2025.209669","url":null,"abstract":"<div><h3>Background</h3><div>Worsening health disparities amongst individuals experiencing co-occurring homelessness and addiction underline a need to examine potential pathways towards recovery. This study consists of a secondary analysis to identify barriers and enablers of addiction recovery amongst people experiencing homelessness (PEH) in Dublin, Ireland, and to propose a conceptual framework adapted from the Recovery Capital Assessment &amp; Recovery Planning Tool (REC-CAP).</div></div><div><h3>Methods</h3><div>The analysis drew on two data sources collected between September 2022 and April 2023 as part of a qualitative, community health needs assessment: in-depth interviews with 19 providers working with PEH in Dublin, and ethnographic fieldwork conducted with 40 homeless clients attending a primary care and addiction services clinic in the city.</div></div><div><h3>Results</h3><div>In addition to widely reported barriers to recovery such as limited access to housing<em>,</em> clients' recovery progress was blocked by unaddressed physical and psychological health conditions, and by harmful attitudes and beliefs about themselves, their substance use, and their treatment options. Societal stigma perpetuated those harmful beliefs and unfair access to recovery resources. Despite these barriers, once an individual found sufficient motivation to recover and reached a minimum threshold of physiological health and stability in their substance use, key elements of personal, social and community capital intersected and built upon each other to aid in recovery.</div></div><div><h3>Conclusion</h3><div>Key elements of recovery capital for PEH include a combination of self-confidence and self-efficacy, autonomy and freedom of choice, meaningful activities, social support, and access to satisfactory mental health, addiction, family, primary care, and housing supports. Though not essential for starting recovery, a safe and stable home is crucial for sustaining it.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209669"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577998","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":"Implementing a pre-exposure prophylaxis (PrEP) promotion intervention among persons who inject drugs: Perspectives from community and research implementation partners","authors":"Charles A. Warnock ,&nbsp;Colleen Mistler ,&nbsp;Adam Viera ,&nbsp;Dini Harsono ,&nbsp;June Weiss ,&nbsp;Daniel Davidson ,&nbsp;Genie L. Bailey ,&nbsp;Marianne Buchelli ,&nbsp;Kathy Eggert ,&nbsp;River Rose ,&nbsp;Joanne Montgomery ,&nbsp;Portia Robinson ,&nbsp;Oscar F. Rojas Perez ,&nbsp;Ellie Pickering ,&nbsp;Carla J. Rash ,&nbsp;E. Jennifer Edelman","doi":"10.1016/j.josat.2025.209667","DOIUrl":"10.1016/j.josat.2025.209667","url":null,"abstract":"<div><h3>Background</h3><div>Clinical guidelines recommend pre-exposure prophylaxis (PrEP) to prevent HIV among persons who inject drugs (PWID), yet few are reached by this evidence-based intervention. To address this challenge, we are conducting a clinical trial to evaluate the impact of contingency management (CM) with stepped care to PrEP adherence and support services (PASS) among PWID. We sought to elicit perspectives from community- and research-based implementation partners on barriers and facilitators to implementing this intervention package as well as describe perspectives around evidence-based research practices in general.</div></div><div><h3>Methods</h3><div>In October 2023, we conducted three focus groups with community-based site staff (n = 8), site leadership (n = 6), and research coordinators (n = 6) involved in delivering and implementing the intervention. The Promoting Action on Research Implementation in Health Service (PARIHS) implementation science framework construct (<em>evidence, context</em>, and <em>facilitation</em> opportunities) informed qualitative data collection and analysis.</div></div><div><h3>Results</h3><div>Regarding <em>evidence</em>, focus group participants had a mix of previous experience or backgrounds in behavioral and interventional research with pre-existing research experience and embedded research infrastructure described as implementation facilitators. Participants described initially mixed views towards CM but became more positive as participants engaged in trial implementation. Regarding <em>context</em> within the community-based setting, focus group participants acknowledged challenges in promoting PrEP among PWID given competing social needs as well as individual and service priorities. Participants described turnover and burnout among staff delivering the intervention in addition to providing regular day-to-day services as major barriers to implementation. Regarding future intervention <em>facilitation</em> opportunities, participants suggested integrating interventional activities into off-site services like outreach as well as increasing the number of CM sessions. To facilitate site engagement and localized practice improvement, site leadership emphasized the need for consistent research team presence and detailed correspondence of results at the conclusion of research.</div></div><div><h3>Conclusion</h3><div>Focus group participants identified barriers and facilitators to implementing and sustaining CM-based PrEP promotion interventions within community-based settings. Efforts should be made to anticipate and address staff capacity and turnover when implementing HIV prevention interventions within community settings. Additionally, integrating CM-based PrEP promotion programs into off-site services and operations to reach PWID could be an opportunity to increase reach.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209667"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588624","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":"Promoting substance use stigma resistance through an automated text message intervention (project RESTART): Outcomes of a pilot feasibility trial","authors":"Adams L. Sibley ,&nbsp;Kathryn E. Muessig ,&nbsp;Seth M. Noar ,&nbsp;Nisha Gottfredson O'Shea ,&nbsp;William C. Miller ,&nbsp;Vivian F. Go","doi":"10.1016/j.josat.2025.209671","DOIUrl":"10.1016/j.josat.2025.209671","url":null,"abstract":"<div><h3>Background</h3><div>Stigma in people who use drugs predicts treatment engagement, psychosocial health, and overdose, yet there are few evidence-based interventions to support people who use drugs in managing and coping with substance-related stigma and even fewer for people in active use. mHealth is one option to engage this hard-to-reach population.</div></div><div><h3>Methods</h3><div>Premised on the theory of stigma resistance, this mixed-methods study explored the feasibility, acceptability, and preliminary effectiveness of Project RESTART, a four-week, automated text message intervention for rural-dwelling people who use drugs (<em>n</em> = 30) using a one-group pre-post design. The study recruited participants from syringe service programs and by word-of-mouth.</div></div><div><h3>Results</h3><div>Key outcomes included high retention (90 %), message engagement (median responses: 4, interquartile range: 1–17), acceptability (mean item score: 3.55, standard deviation: 0.34, range: 1–4), and preliminary effectiveness in the main outcomes (Cohen's d: stigma resistance (0.56), self-stigma (0.50)). Results were corroborated in sub-sample follow-up interviews (<em>n</em> = 13).</div></div><div><h3>Conclusion</h3><div>These promising findings suggest text messaging is a feasible and acceptable modality for delivering stigma education and coping resources. Effectiveness should be established in a full-scale randomized controlled trial. This trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> on February 20, 2024 (<span><span>NCT06281548</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209671"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562733","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":"Women and men veterans' initiation, engagement, and retention in treatment for substance use disorders: A cross-sectional investigation using VHA administrative data","authors":"Tracy L. Simpson ,&nbsp;Yoanna E. McDowell ,&nbsp;Nicholas A. Livingston ,&nbsp;Emma I. Brett ,&nbsp;Katherine J. Hoggatt ,&nbsp;Elena R. Stein ,&nbsp;Carol A. Malte","doi":"10.1016/j.josat.2025.209673","DOIUrl":"10.1016/j.josat.2025.209673","url":null,"abstract":"<div><h3>Introduction</h3><div>More men have substance use disorders (SUD) in the US compared to women; however, the gender gap is closing, including among US veterans. Little information is available about gender differences in patterns of SUD treatment receipt. The current study evaluated gender differences in SUD outpatient, residential, and medication treatment receipt to address critical gaps in the literature.</div></div><div><h3>Methods</h3><div>Veterans Health Administration patients with SUD diagnoses between 10/01/2014 and 9/30/2018 were included (women = 40,841, men = 615,002). The study tracks treatment initiation, engagement, retention, and treatment transitions for 12 months following study entry. Unadjusted Chi-square tests and logistic regressions, adjusted for race/ethnicity, age study entry year, and facility complexity test for gender differences.</div></div><div><h3>Results</h3><div>Women had higher initiation, engagement, and retention than men in outpatient and residential settings in unadjusted comparisons. However, after adjustment, women were less likely to initiate, engage, and retain. Post-hoc analyses indicate findings were driven by age and race/ethnicity; specifically, women under 60 and non-Hispanic White and Black women were less likely to initiate or retain in SUD care than men. Women were also less likely to transition through outpatient treatment and utilize opioid use medication; however, women were more likely to transition through residential treatment and utilize alcohol use medication.</div></div><div><h3>Conclusions</h3><div>Women were found to have lower outpatient and residential SUD treatment receipt and opioid medication utilization but greater alcohol use medication utilization compared to men. Future research is needed to better understand factors leading to these gender differences and to develop tailored treatment approaches to address gender disparities.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209673"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577999","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":"Understanding parents' experience navigating substance use treatment and the child welfare system","authors":"Allyson L. Dir ,&nbsp;Brielle L. Batch ,&nbsp;Matthew C. Aalsma","doi":"10.1016/j.josat.2025.209672","DOIUrl":"10.1016/j.josat.2025.209672","url":null,"abstract":"<div><h3>Introduction</h3><div>Substance use is a common reason for involvement in the child welfare system and associated with poor outcomes for families, such as repeat maltreatment and loss of parental rights; however, rates of substance use treatment engagement among parents in child welfare are low. The current study examines the role and impact of substance use on parents' experiences with the child welfare system and substance use treatment.</div></div><div><h3>Methods</h3><div>The study conducted semi-structured interviews with parents currently or recently involved in child welfare and substance use treatment (N = 29; 86.2 % female; 75.9 % White).</div></div><div><h3>Results</h3><div>Themes from qualitative analyses related to (1) the role of substance use in child welfare cases, (2) the challenges of managing substance use treatment and child welfare requirements, and (3) perspectives on the role of parenting in substance use treatment and recovery.</div></div><div><h3>Conclusions</h3><div>Parents with substance use involved in child welfare face unique challenges when addressing substance use and child welfare requirements. Findings underscore the importance of involving those with lived experience in policy and decision-making; ensuring evidence-based practices specifically targeting parents with substance use are available; and ensuring child welfare personnel receive training and education in addiction and substance use.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209672"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588407","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":"“You just want to kill the pain and get numb:” A mixed methods study investigating the lived experiences of individuals experiencing homelessness enrolled in outpatient methadone treatment","authors":"Marina Gaeta Gazzola ,&nbsp;Emma Thompson ,&nbsp;Kim Hoffman ,&nbsp;Gul Saeed ,&nbsp;Colin Baylen ,&nbsp;Lynn M. Madden ,&nbsp;Kathryn F. Eggert ,&nbsp;Mark Beitel ,&nbsp;Declan T. Barry","doi":"10.1016/j.josat.2025.209668","DOIUrl":"10.1016/j.josat.2025.209668","url":null,"abstract":"<div><h3>Background</h3><div>People experiencing homelessness (PEH) with opioid use disorder (OUD) are at high risk of overdose yet less likely to enroll and stay engaged in standard-of-care treatment for OUD, opioid agonist medication for OUD (MOUD), particularly methadone treatment. Engaging this group in treatment is a public health priority, yet little is known about the experiences of PEH enrolled in MOUD. We sought to understand the housing experiences and perspectives of PEH engaged in methadone treatment using mixed quantitative and qualitative methods.</div></div><div><h3>Methods</h3><div>We recruited individuals with past or present experiences of homelessness who were engaged in methadone treatment at a low-barrier opioid treatment program (OTP) in Connecticut between December 2022 and May 2023. Participants completed surveys about their demographics, resource needs, and housing and healthcare experiences. One-to-one qualitative interviews using a semi-structured interview guide queried participants' experiences with homelessness. Descriptive statistics summarize study variables using Python. The interviews were transcribed and analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Of 50 participants (19 women, 31 men, mean age 44 years), 80 % reported experiencing homelessness for over a year. Participants reported experiencing a mean of 56.6 months without permanent, stable housing and a mean of 2.4 periods of homelessness in the past 3 years. Thematic analysis yielded three primary themes that described the intersectional identity of an individual with OUD and experiencing homelessness: 1) Challenges created by homelessness (e.g., transportation barriers limiting access to the OTP); 2) Personal barriers to exiting homelessness (e.g., struggling with continued substance use); and 3) Structural barriers to exiting homelessness (e.g., difficulty navigating the housing system).</div></div><div><h3>Conclusions</h3><div>PEH enrolled in methadone treatment face substantial barriers related to their OUD and housing status as well as many structural, social, and health-related vulnerabilities. Future efforts to address these vulnerabilities in clinical settings may enhance treatment engagement and should be examined to potentially attenuate the very high risk of overdose that PEH face. Challenges created by homelessness, personal barriers to exiting homelessness, and structural barriers to exiting homelessness are potential targets for methadone treatment programs to better tailor treatment and improve engagement and outcomes.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209668"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588597","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":"Barriers and facilitators to buprenorphine delivery: Results from a qualitative study of syringe services provider experiences","authors":"Sarah M. Philbrick ,&nbsp;Jessica Smith ,&nbsp;Lynn D. Wenger ,&nbsp;Christopher F. Akiba ,&nbsp;Sara Hairgrove ,&nbsp;Hansel Tookes ,&nbsp;Alex H. Kral ,&nbsp;Barrot H. Lambdin ,&nbsp;Sheila V. Patel","doi":"10.1016/j.josat.2025.209670","DOIUrl":"10.1016/j.josat.2025.209670","url":null,"abstract":"<div><h3>Background</h3><div>Access to medications for opioid use disorder (MOUD) is essential for the 6.1 million Americans with OUD. However, only one in five adults with past-year OUD received MOUD. Syringe services programs (SSPs) have existing and trusting relationships with people who use drugs and are an alternative service provider to traditional healthcare settings. SSPs are uniquely positioned to facilitate buprenorphine inductions and increase overall MOUD access. We aimed to understand models for implementing buprenorphine and barriers and facilitators SSPs encounter.</div></div><div><h3>Methods</h3><div>We interviewed 23 SSP representatives across the U.S. Interviews sought to explore emerging issues, including whether and how SSPs facilitate access to buprenorphine. We used purposive sampling to include programs varying by region, organizational type, and legal status to understand a range of perspectives. We coded transcripts using a blended inductive and deductive, content analysis approach, met weekly to capture emerging themes, and developed analytic memos using the Health Equity Implementation Framework.</div></div><div><h3>Results</h3><div>Of the 23 representatives interviewed, 20 reported that their SSP facilitated buprenorphine access. We identified four models for implementing buprenorphine. For all models, stigma, policy, and funding systems dictate SSPs' ability to be involved in buprenorphine induction. In turn, these determinants impact the patient–provider buprenorphine induction experience, which could perpetuate low service provision and participant uptake.</div></div><div><h3>Conclusions</h3><div>SSPs need various approaches to improve the patient–provider buprenorphine induction experience. SSPs can select the best fit buprenorphine model(s) by examining their inner and outer contexts. In doing so, SSPs leverage their position as trusted allies to improve care and outcomes for people with OUD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209670"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577892","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":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(25)00026-8","DOIUrl":"10.1016/S2949-8759(25)00026-8","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209647"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534105","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":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(25)00025-6","DOIUrl":"10.1016/S2949-8759(25)00025-6","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209646"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534104","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":"JSAT Editorial Fellow Call 2025","authors":"","doi":"10.1016/S2949-8759(25)00030-X","DOIUrl":"10.1016/S2949-8759(25)00030-X","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209651"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534106","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}