Journal of substance use and addiction treatment最新文献

{"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}

{"title":"Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.","authors":"Wiley D. Jenkins ,&nbsp;Lauren B. Beach ,&nbsp;John Schneider ,&nbsp;Samuel R. Friedman ,&nbsp;Mai T. Pho ,&nbsp;Suzan Walters ,&nbsp;Jerel Ezell ,&nbsp;April M. Young ,&nbsp;Caitie Hennessy ,&nbsp;William C. Miller ,&nbsp;Vivian F. Go ,&nbsp;Christina Sun ,&nbsp;David W. Seal ,&nbsp;Ryan P. Westergaard ,&nbsp;Heidi M. Crane ,&nbsp;Rob J. Fredericksen ,&nbsp;Stephanie A. Ruderman ,&nbsp;Scott Fletcher ,&nbsp;Jimmy Ma ,&nbsp;J.A. Delaney ,&nbsp;Mike Winer","doi":"10.1016/j.josat.2025.209629","DOIUrl":"10.1016/j.josat.2025.209629","url":null,"abstract":"<div><h3>Introduction</h3><div>People who use drugs (PWUD) are at risk of HIV infection, but the frequency and distribution of transmission-associated behaviors within rural communities is not well understood. Further, while interventions designed to more explicitly affirm individuals' sexual orientation and behaviors may be more effective, descriptions of behavior variability by orientation are lacking. We sought to describe how disease transmission behaviors and overdose risk vary by sexual orientation and activity among rural PWUD.</div></div><div><h3>Methods</h3><div>From 01/2018–03/2020, rural PWUD participating in the Rural Opioid Initiative were surveyed across 8 sites. Collected data included: demographics; experiences with drug use, overdose, and healthcare; stigma; gender identity; and sexual orientation and partners. Participants were categorized as: monosexual by orientation and behavior (Mono-only), monosexual by orientation but behaviorally bisexual (Mono/Bi), and bisexual by orientation (Bi+). Analyses included descriptive summaries, bivariate examination (chi-square), and logistic regression (relative risk [RR] and 95 % confidence interval [CI]).</div></div><div><h3>Results</h3><div>The 1455 participants were 84.8 % Mono-only, 3.2 % Mono/Bi, and 12.0 % Bi+. Compared to Mono-only men, Mono/Bi and Bi+ men had greater risk of transactional sex (RR = 9.71, CI = 6.66–14.2 and RR = 5.09, CI = 2.79–9.27, respectively) and sharing syringes for injection (RR = 1.58, CI = 1.06–2.35 and RR = 1.85, CI = 1.38–2.47). Compared to Mono-only women, Mono-Bi and Bi+ women had greater risk of transactional sex (RR = 4.47, CI = 2.68–7.47 and RR = 2.63, CI = 1.81–3.81); and Bi+ women had greater risk of sharing syringes for injection (RR = 1.49, CI = 1.23–1.81), sharing syringes to mix drugs (RR = 1.44, CI = 1.23–1.69), and experiencing an overdose (RR = 1.32, CI = 1.12–1.56). Bi+ men and women both more frequently reported selling sex as a source of income (versus Mono-only, both <em>p</em> &lt; 0.050) and measures of perceived stigma (all p &lt; 0.050).</div></div><div><h3>Conclusions</h3><div>Rural PWUD who are bisexual by orientation or behavior are significantly more likely to engage in behaviors associated with infectious disease transmission and to experience stigma and drug overdose. Given the growing recognition of bisexuality as a distinct orientation that warrants individualized consideration, interventions that are specifically acknowledging and affirming to the circumstances of this group are needed.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209629"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061622","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":"Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN): Study protocol for a type 2 hybrid effectiveness-implementation trial","authors":"Claire B. Simon ,&nbsp;Jacqueline B. Britz ,&nbsp;Brennan Keiser ,&nbsp;E. Marshall Brooks ,&nbsp;Alex H. Krist ,&nbsp;Nicholas Franko ,&nbsp;Benjamin Webel ,&nbsp;Mary A. Hatch ,&nbsp;Judith I. Tsui ,&nbsp;Kari A. Stephens ,&nbsp;Sebastian T. Tong","doi":"10.1016/j.josat.2025.209626","DOIUrl":"10.1016/j.josat.2025.209626","url":null,"abstract":"<div><h3>Background</h3><div>Unhealthy substance use (USU) is common and ranges from use above guideline-recommended levels to severe substance use disorder. USU results in substantial morbidity and mortality yet primary care practices rarely systematically screen, diagnose, and treat USU. Supporting Unhealthy Substance use care Through a whole person Approach and user centered INtegration into primary care (SUSTAIN) tests whether the implementation of a co-designed change package for USU improves patient function. The protocol for SUSTAIN is presented here.</div></div><div><h3>Methods</h3><div>SUSTAIN is a cluster randomized controlled implementation trial of a customized approach to identify and treat USU in primary care. The sample includes 24 primary care clinics in two practice-based research networks (PBRNs). In phase one, primary care practice champions and patients with lived USU experience co-design a change package to identify and treat USU. In phase two, we test the effectiveness of the change package versus usual care and evaluate the implementation of the change package. Data will be collected from 24 clinics (50 patients per clinic for total of 1200 patients) through patient surveys and the electronic health record. Patients surveyed must be 18 or older and screen positive for USU using the Tobacco, Alcohol, Prescription medication and other Substance use part one (TAPS-1) tool. Primary outcomes include mental and physical health patient function scales measured using Patient Reported Outcomes Measurement Information System (PROMIS-29-v2). Secondary outcomes are prevalence of USU, recovery, health care utilization, USU screening rates, provision/referral to behavioral health services and prescription of appropriate medications. We will also evaluate implementation outcomes by surveying 96 practice representatives (4 at each clinic) and conduct qualitative interviews with 20 patients and 20 practice leaders to assess their experience with the intervention and its implementation.</div></div><div><h3>Conclusions</h3><div>The SUSTAIN trial creates and tests an implementation package approach to address USU in diverse primary care settings. The SUSTAIN change package aims to transform how primary care practices care for individuals with USU to improve patient outcomes and enhance community well-being.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209626"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054428","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":"Impacto — A single-arm open-label pilot trial of a digital-based integrated smoking cessation program for Spanish-speaking Hispanic individuals who smoke: Development, feasibility, engagement, and clinical outcomes","authors":"Michael J. Zvolensky ,&nbsp;Richard A. Brown ,&nbsp;Justin M. Shepherd ,&nbsp;Jason T. Brown ,&nbsp;Brooke Y. Redmond ,&nbsp;Sergio Alcocer","doi":"10.1016/j.josat.2025.209632","DOIUrl":"10.1016/j.josat.2025.209632","url":null,"abstract":"<div><h3>Introduction</h3><div>Hispanic/Latinx (hereafter Hispanic) individuals who smoke have challenges in quitting and a disproportionate risk of smoking-related health problems when compared to the general population. The smoking inequalities among the Hispanic population are influenced by limited treatment access and chronic stress exposure (e.g., racial/ethnic discrimination). The present study sought to culturally adapt and initially test a novel, Spanish-language mobile intervention entitled Impacto. Impacto helps address aversive psychosomatic stress (e.g., bodily symptoms, negative affect states) that can maintain smoking by targeting individual differences in anxiety sensitivity during the cessation process.</div></div><div><h3>Methods</h3><div>The current study utilized a single-arm open-label pilot trial of an integrated, anxiety sensitivity and smoking cessation Spanish language mobile health application for the Android platform, Impacto. Participants were 30 adults who engaged in daily combustible cigarette use (females <em>n</em> = 15, <em>M</em>_<em>age</em> = 40.2 years, <em>SD</em> = 11.1). The study evaluated effects of Impacto on 7-day point-prevalence smoking abstinence, cigarettes smoked per day, and anxiety sensitivity and examined feasibility, acceptability, and engagement.</div></div><div><h3>Results</h3><div>Results indicated that Impacto had a positive impact on smoking abstinence with over half of the sample (65.4 %) reporting smoking abstinence 4-weeks post-quit. Moreover, rates of cigarettes smoked per day and anxiety sensitivity levels significantly decreased from baseline through 4-weeks post-quit. High rates of feasibility, acceptability, and engagement were also observed.</div></div><div><h3>Conclusions</h3><div>Impacto represents a promising new smoking cessation intervention for Hispanic individuals with elevated psychosomatic symptoms who smoke.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209632"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049052","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":"Internet-based cognitive behavioral therapy for alcohol use disorder: A systematic review of evidence and future potential","authors":"Fernanda Gushken ,&nbsp;Gabriel P.A. Costa ,&nbsp;Anderson de Paula Souza ,&nbsp;Daniel Heringer ,&nbsp;Akhil Anand","doi":"10.1016/j.josat.2025.209627","DOIUrl":"10.1016/j.josat.2025.209627","url":null,"abstract":"<div><h3>Introduction</h3><div>While cognitive behavioral therapy (CBT) remains a highly effective psychotherapy approach for managing Alcohol Use Disorder (AUD), its potential is hindered by workforce shortages and access barriers. In response to these challenges, Internet-Based Cognitive Behavioral Therapy (iCBT) has emerged as an innovative solution that integrates the core CBT structure with technology. In iCBT, educational materials, therapist communication and progress dashboards can be centralized in a digital format, and delivered in a self-guided, therapist-guided or blended approach.</div></div><div><h3>Methods</h3><div>In this systematic review we aimed to summarize the current evidence of iCBT for AUD. The study performed a comprehensive literature search on PubMed, Embase, Cochrane, Web of Science, and Scopus in August 2023.</div></div><div><h3>Results</h3><div>Out of 497 studies that met our search criteria, five high-quality studies met our inclusion criteria. The studies presented a wide variation in the choice of outcomes and in the definition of controls or treatment as usual. When compared to treatment as usual, studies reported non-inferior to superior abstinence results of iCBT for AUD. Overall, most studies favor iCBT use as an adjunct to AUD treatment due to feasibility and access advantages. However, there were limitations identified in recruitment and implementation processes that warrant further studies. The review also showcases how studies on iCBT for AUD often neglect crucial variables such as insurance coverage, digital literacy and health equity. Clinical trials' investigators need to account for economic feasibility and external validity since the method design phase.</div></div><div><h3>Conclusion</h3><div>iCBT may be an effective adjunct treatment for AUD. However, further research is required. Research in the field should entail larger trials with standard controls and outcome measures. It is also important to actively recruit participants from diverse ethnic and cultural backgrounds and adapt iCBT materials to different languages. This will allow a wider population to benefit from the treatment and address existing health disparities.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209627"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054426","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 moral voice in addiction and the self","authors":"Sarel Ohayon,&nbsp;Natti Ronel","doi":"10.1016/j.josat.2025.209624","DOIUrl":"10.1016/j.josat.2025.209624","url":null,"abstract":"<div><h3>Background</h3><div>The robust literature on moral psychology research has often overlooked people struggling with addiction, partly due to social, theoretical, and methodological biases. This has created a gap in understanding the role of moral thinking and its influence on addiction and recovery. To address this, our hermeneutic phenomenological study, the first in a series, explores the moral voice of individuals contending with addiction.</div></div><div><h3>Methods</h3><div>The study interviewed 34 male participants from various ethnical backgrounds and ages with substance and behavioral addictions using semi-structured methods, focusing on factors shaping their moral thinking and behavior.</div></div><div><h3>Results</h3><div>The findings highlight that moral thinking is central to individuals with addiction, yet it fails to regulate behavior due to conflicting addictive drives, and its presence during active addiction can hinder recovery efforts. This misalignment often leads to tormenting internal conflict and a detrimental effect on both self and others. Participants attempted to establish a modus vivendi (a manner of living) but often failed, resulting in covert moral schemas that complicate their psychological states. This phenomenon, described as a moral spin, illustrates the complex interplay between addiction and morality.</div></div><div><h3>Conclusion</h3><div>To address rebuilding moral identity and recovery, we may support framing egocentrism positively through a self-compassionate moral inventory.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209624"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049168","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":"Different forms of stigma and rural primary care professionals' willingness to prescribe buprenorphine","authors":"Berkeley Franz ,&nbsp;Lindsay Y. Dhanani ,&nbsp;Sean Bogart ,&nbsp;Cheyenne Fenstemaker ,&nbsp;William C. Miller ,&nbsp;O. Trent Hall ,&nbsp;Daniel Brook ,&nbsp;Vivian Go","doi":"10.1016/j.josat.2025.209633","DOIUrl":"10.1016/j.josat.2025.209633","url":null,"abstract":"<div><h3>Introduction</h3><div>Buprenorphine and other medications for opioid use disorder (MOUD) are highly effective but substantially under prescribed in the rural United States. Among the most cited barriers to buprenorphine prescribing is stigma, yet little progress has been made in developing successful strategies to reduce stigma and increase access to life-saving medication. One of the key challenges to developing successful implementation strategies is understanding the different types of stigma that limit implementation.</div></div><div><h3>Methods</h3><div>This study draws from qualitative interviews with 23 primary care professionals (PCPs) in rural Ohio. We conducted semi-structured interviews focused on prior experiences with buprenorphine, willingness to prescribe it, prior buprenorphine training, and barriers to prescribing. Thematic analysis resulted in 3 forms of stigma that must be addressed to improve implementation.</div></div><div><h3>Results</h3><div>PCPs discussed 3 key forms of stigma that limit buprenorphine prescribing in rural areas: 1) stigma towards patients—PCPs feared being harmed by patients with opioid use disorder (OUD) if they began prescribing buprenorphine; 2) stigma towards providers—PCPs believed their clinics would be stigmatized if they began treating addiction; and 3) stigma towards buprenorphine—PCPs worried they might unintentionally harm patients through prescribing a partial opioid agonist.</div></div><div><h3>Conclusions</h3><div>Stigma remains a critical barrier to buprenorphine prescribing among rural PCPs but is not limited to negative attitudes towards people with OUD. Buprenorphine is also stigmatized and PCPs fear becoming stigmatized if they prescribe the medication. Implementation research is urgently needed to test whether multicomponent stigma-reduction strategies increase access to buprenorphine in rural communities.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209633"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049132","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":"Perceived organizational support for the treatment of opioid use disorder and its association with primary care provider treatment willingness and medication prescribing","authors":"Lindsay Y. Dhanani ,&nbsp;William C. Miller ,&nbsp;Vivian Go ,&nbsp;Janet E. Simon ,&nbsp;Berkeley Franz","doi":"10.1016/j.josat.2025.209623","DOIUrl":"10.1016/j.josat.2025.209623","url":null,"abstract":"<div><h3>Introduction</h3><div>Buprenorphine is a highly effective medication for opioid use disorder (MOUD; OUD), which can be prescribed alongside naloxone in the primary care setting as part of a harm reduction approach to OUD. Despite this potential, implementation challenges have limited adoption of MOUD. To address barriers at the organizational level, we need better tools to measure perceived organizational support for the treatment of OUD and use of MOUD in the primary care setting. In this study, we developed an OUDSUPPORT measure to assess the relationship between organizational culture and critical treatment attitudes and behaviors in primary care.</div></div><div><h3>Methods</h3><div>We conducted a statewide survey of 404 primary care-aligned health professionals (PCPs) in Ohio. We analyzed the survey data using descriptive and bivariate statistics. Additionally, three stepwise multivariable regression models assess the relationship between organizational support and three primary outcomes: willingness to treat OUD; receipt of the X-waiver, which was previously required to prescribe buprenorphine; and naloxone prescribing, independent of individual and county-level predictors.</div></div><div><h3>Results</h3><div>The OUDSUPPORT measure demonstrated satisfactory psychometric properties, and was associated with meaningful treatment outcomes. PCPs perceived the strongest organizational support for a shared mission of providing care to people with OUD. The least commonly endorsed form of organizational support was for prescribing buprenorphine. Perceived organizational support was associated with increased willingness to treat OUD (b = 0.26; 95 % CI: 0.17, 0.35); higher odds of having received the X-waiver (OR = 1.63; 95 % CI: 1.26, 2.12); and higher odds of naloxone prescribing (OR = 1.71; 95 % CI: 1.30, 2.25).</div></div><div><h3>Conclusions</h3><div>OUDSUPPORT is a multidimensional measure of perceived organizational support for the treatment of OUD, which was associated with treatment willingness, receipt of buprenorphine prescribing training, and naloxone prescribing among PCPs. Implementation strategies to increase buprenorphine prescribing in the primary care setting must include efforts to decrease stigma, and address hesitance related to MOUD and harm reduction at the administrative level, in addition to addressing well known barriers at the individual prescriber level.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209623"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049080","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":"Feasibility and acceptability of the delivery of a group telehealth intervention for support persons of patients receiving buprenorphine for opioid use disorder","authors":"Elizabeth Ueland ,&nbsp;Katherine Nameth ,&nbsp;Jennifer K. Manuel ,&nbsp;Karen Chan Osilla","doi":"10.1016/j.josat.2025.209628","DOIUrl":"10.1016/j.josat.2025.209628","url":null,"abstract":"<div><h3>Background</h3><div>Opioid-related overdoses increased substantially during the COVID-19 pandemic, eliciting an urgent demand for accessible treatment for individuals with opioid use disorder (OUD) and those who support them (support persons). Support persons can improve treatment initiation and retention in their individuals with OUD. Additionally, support persons may have their own mental health needs related to their loved one's OUD. Unfortunately, few treatment options exist for support persons of individuals with an OUD. A support person-focused group telehealth intervention (referred to as eINSPIRE) that is accessible and feasible could help fill the treatment gap for support persons and bolster outcomes for individuals with OUD.</div></div><div><h3>Methods</h3><div>The study interviewed patients receiving buprenorphine (n = 9), their support persons (n = 12), and clinic staff members (n = 6) about their perceptions on a group telehealth intervention designed for support persons. Patient and support person dyads were recruited from two community health clinics to participate in a qualitative interview and/or focus group. Using classic content analysis, we then analyzed this data to evaluate the feasibility, acceptability, and usability of a group telehealth intervention for support persons.</div></div><div><h3>Results</h3><div>The eINSPIRE intervention was deemed generally acceptable, feasible, and usable. All support persons (n = 12) agreed that group telehealth was acceptable and those who completed an eINSPIRE demo session found it usable (IUS = 72.5). Patients indicated that eINSPIRE would be beneficial for support persons, and could provide services that are unattainable to them in their immediate community, but that groups sometimes lacked intimacy. Participants also found group telehealth to be more accessible than in-person alternatives and suggested how to improve the delivery of the intervention.</div></div><div><h3>Conclusions</h3><div>Group telehealth may be a feasible and acceptable option for delivering an intervention to support persons and could reduce barriers to treatment that this population often experiences due to competing demands. However, due to sample size limitations, more participant perspectives and future research are needed.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209628"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043508","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":"A qualitative study exploring the feasibility and acceptability of embedding an overdose prevention sites in a U.S. hospital","authors":"Rachel French ,&nbsp;Rachal McFadden ,&nbsp;Margaret Lowenstein ,&nbsp;Nicole O'Donnell ,&nbsp;Jeanmarie Perrone ,&nbsp;Shoshana Aronowitz ,&nbsp;Ashish P. Thakrar ,&nbsp;Allison Schachter ,&nbsp;Eleanor Turi ,&nbsp;Peggy Compton","doi":"10.1016/j.josat.2024.209620","DOIUrl":"10.1016/j.josat.2024.209620","url":null,"abstract":"<div><h3>Introduction</h3><div>Community-based overdose prevention sites (OPS) are recognized for reducing overdose deaths and the spread of HIV and hepatitis C among people who use drugs (PWUD). While some hospitals in Europe and Canada have successfully integrated OPS into their facilities, such integration remains illegal in the United States. This study explores the feasibility and acceptability of implementing an OPS at the Hospital of the University of Pennsylvania (HUP), situated in an urban area with high rates of overdose.</div></div><div><h3>Methods</h3><div>Using semi-structured interviews, we engaged 28 stakeholders, including clinicians, hospital leadership, security personnel, and PWUD. The study presented participants with a hypothetical scenario depicting a PWUD hospitalized multiple times for injection-related endocarditis to elicit nuanced responses.</div></div><div><h3>Results</h3><div>Thematic analysis of the qualitative data revealed a complex landscape of perceived benefits and challenges associated with embedding an OPS at HUP. Stakeholders acknowledged potential advantages, such as harm reduction, including patient and community safety, education, and stigma reduction. However, concerns were raised regarding acceptability among PWUD, hospital staff, leadership, and the broader Philadelphia community. Hesitancy stemmed from uncertainties about trust-building, safety protocols, clinician stigma, and institutional support. Feasibility concerns, including patient eligibility criteria, drug policy, staffing, and suitable location, were also highlighted.</div></div><div><h3>Conclusions</h3><div>Despite political and cultural barriers, participants proposed strategies to garner support for a hospital-based OPS, emphasizing clinical education, anti-stigma training, and community engagement. They discussed a vision for an OPS at HUP that could serve as a haven for PWUD during hospitalization, potentially reducing patient-directed discharges and improving adherence to medical treatments, thus decreasing morbidity and readmissions. This study underscores the need to address multifaceted concerns before implementing OPS within hospital settings. Once legal and cultural impediments are addressed, insights from this research can inform the design and operation of OPS at HUP and similar institutions, contributing to enhanced patient outcomes and community well-being.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"170 ","pages":"Article 209620"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980887","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}