Journal of substance use and addiction treatment最新文献

{"title":"Quit attempts, use of smoking cessation treatments and quitting intention among treatment seekers in rural areas","authors":"Weijia Li ,&nbsp;Christine L. Paul ,&nbsp;Amanda L. Baker ,&nbsp;Judith Byaruhanga ,&nbsp;Jason Dizon ,&nbsp;Simon Chiu ,&nbsp;Flora Tzelepis","doi":"10.1016/j.josat.2024.209603","DOIUrl":"10.1016/j.josat.2024.209603","url":null,"abstract":"<div><h3>Introduction</h3><div>Rural populations have higher rates of tobacco use but are less likely to use evidence-based smoking cessation treatments than urban residents. There is limited evidence on the use of smoking cessation treatments and the factors associated with their use in rural populations. This study explored quit attempts, use of smoking cessation treatments, quitting intention and associated factors among rural residents seeking smoking cessation treatment.</div></div><div><h3>Methods</h3><div>Participants were adult rural or remote residents of New South Wales, Australia who enrolled in a randomized trial of smoking cessation treatment (<em>n</em> = 1244). Participants completed an online baseline survey assessing quit attempts, quitting intention, and prior use of smoking cessation treatments. Multivariable logistic regressions that adjusted for other variables examined associations and derived odds ratios.</div></div><div><h3>Results</h3><div>Almost half (48.3 %) of participants made a quit attempt in the last 12 months, and 44.6 % intended to quit in the next 30 days. Women (OR = 0.74, 95 % CI 0.56–0.99), Australian-born participants (OR = 0.67, 95 % CI 0.45–0.99) and those with moderate (OR = 0.53, 95 % CI 0.40–0.71) or high (OR = 0.42, 95 % CI 0.28–0.63) nicotine dependence had significantly lower odds of making a quit attempt in the last 12 months. Among participants who had ever made a quit attempt, most had used pharmacotherapies (82.2 %) or behavioral interventions (68.3 %) during any quit attempt. Participants with moderate (OR = 1.96, 95 % CI 1.37–2.79) or high (OR = 3.27, 95 % CI 1.66–6.45) nicotine dependence and chronic conditions (OR = 1.45, 95 % CI 1.00–2.11) had significantly greater odds of pharmacotherapy use while those who drank alcohol daily or almost daily (OR = 0.46, 95 % CI 0.26–0.81) had significantly lower odds of pharmacotherapy use. Those with moderate (OR = 1.38, 95 % CI 1.02–1.87) or high (OR = 3.31, 95 % CI 1.94–5.66) nicotine dependence, university education (OR = 1.47, 95 % CI 1.04–2.07), moderate (OR = 1.63, 95 % CI 1.19–2.22) or high (OR = 1.73, 95 % CI 1.12–2.68) financial stress, and anxiety (OR = 1.61, 95 % CI 1.16–2.22) had significantly greater odds of using behavioral treatments whereas those with depression (OR = 0.66, 95 % CI 0.47–0.92) had significantly lower odds.</div></div><div><h3>Conclusions</h3><div>Some sub-groups had lower odds of using smoking cessation treatments. Understanding if particular barriers hinder use of smoking cessation treatments among certain sub-groups of rural residents is needed.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209603"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822688","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":"Just an unfair score: Perceptions of gender inequity in the treatment of substance use disorders among women involved in the criminal legal system","authors":"A.A. Jones ,&nbsp;K. Brant ,&nbsp;R.E. Bishop ,&nbsp;S. Strong-Jones ,&nbsp;D.A. Kreager","doi":"10.1016/j.josat.2024.209587","DOIUrl":"10.1016/j.josat.2024.209587","url":null,"abstract":"<div><h3>Introduction</h3><div>Increasing overdose deaths and criminal legal involvement among women necessitate women-specific solutions to curb the adverse consequences of substance use disorders (SUDs). The current study is the pre-implementation phase of an implementation science study that works with various stakeholders—affected women, criminal legal professionals, and SUD treatment professionals—to identify and address high-priority needs for criminal-legal involved women with SUDs.</div></div><div><h3>Methods</h3><div>This study uses semi-structured interviews (<em>N</em> = 42) administered in 2022 to women with a history of SUD and criminal legal involvement (<em>n</em> = 20), SUD treatment professionals (<em>n</em> = 12), and criminal legal professionals (<em>n</em> = 10). Interviews focused on participants' history of substance use and criminal legal involvement, facilitators and barriers to initiating and completing treatment, and gender-specific issues encountered during treatment and criminal legal involvement. Drawing on the social ecological model of health, analyses identified gender-specific challenges impacting criminal-legal involved women's treatment and recovery processes.</div></div><div><h3>Results</h3><div>Participants identified five gender-specific challenges impacting women across social ecological levels. At the relational level, challenges stemmed from women's roles as mothers and from victimization within healthcare and criminal legal settings; at the community level, from unequal resource allocation for treatment; and at the societal level, from stigma associated with certain intersectional identities and cultural norms that constrict job opportunities. Participants noted that providing women with effective care coordination and women-specific guidelines and spaces within the criminal-legal system could mitigate some of these challenges.</div></div><div><h3>Discussion</h3><div>Findings highlight the need to consider gender-specific challenges faced across relational, community, and societal levels when implementing medical interventions and criminal legal proceedings for women. Given these findings and extant literature, the authors are developing an all-female, trauma-informed intervention that includes case management with female certified recovery specialists who are in recovery and have navigated the criminal legal system. By reducing some of the gender-specific barriers identified in this study, this future intervention aims to improve the substance use and criminal legal outcomes of participating women.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209587"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775039","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":"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":"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":"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":"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":"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}