Journal of substance use and addiction treatment最新文献

{"title":"A qualitative inquiry into music consumption at drug treatment centers with and without music therapy sessions – challenges, dangers, and successes","authors":"Jeffrey Lozon,&nbsp;Moshe Bensimon","doi":"10.1016/j.josat.2025.209641","DOIUrl":"10.1016/j.josat.2025.209641","url":null,"abstract":"<div><h3>Introduction</h3><div>Music therapy supports individuals with substance use disorders (SUD) in their recovery. Although robust quantitative research exists on the topic, research on subjective experiences of people with SUD is scarce. This qualitative study offers a retrospective perspective on clients with SUD at treatment centers, exploring the impact of music consumption and music therapy on their recovery process, examining the varying experiences of participants from treatment centers providing music therapy and participants from treatment centers not providing music therapy.</div></div><div><h3>Methods</h3><div>This phenomenological study included semi-structured interviews with 23 clients with SUD from treatment centers in Israel. Six participants came from treatment centers providing music therapy. Participants from treatment centers without music therapy consisted of two groups: those from treatment centers with a policy prohibiting all music (<em>n</em> = 4), and those from treatment centers allowing all types of music (<em>n</em> = 13).</div></div><div><h3>Results</h3><div>Content analysis revealed that at treatment centers providing music therapy, participants completed a 4-stage process: 1) developing awareness of problematic music as a trigger to possible relapse; 2) avoiding problematic music; 3) finding alternative music genres to enjoy; 4) developing tolerance to problematic music. At treatment centers without music therapy and having a policy prohibiting all music, participants developed anxiety towards music, and consequently one person relapsed. At treatment centers not providing music therapy but allowing all types of music, some participants achieved stages 1 to 3, some did not, and two participants relapsed.</div></div><div><h3>Conclusions</h3><div>At treatment centers providing music therapy, participants completed a four-stage process in which they developed tolerance to problematic music. At treatment centers not providing music therapy, participants failed to develop tolerance and some relapsed. The ability to develop tolerance to musical triggers seems crucial for rehabilitation, as music is fundamental for human life and cannot be completely avoided outside treatment. The current study calls policy makers in the field of treating clients with SUD to incorporate music therapy in treatment programs.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209641"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473376","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":"Medicaid expansion is not associated with prescription opioid and benzodiazepine misuse among people who inject drugs: A serial cross-sectional observational study using generalized difference-in-differences models","authors":"Danielle F. Haley ,&nbsp;Stephanie Beane ,&nbsp;Courtney R. Yarbrough ,&nbsp;Janet Cummings ,&nbsp;Sabriya Linton ,&nbsp;Umed Ibragimov ,&nbsp;Regine Haardörfer ,&nbsp;Catlainn Sionean ,&nbsp;Rashunda Lewis ,&nbsp;Hannah L.F. Cooper ,&nbsp;For the NHBS Study Group","doi":"10.1016/j.josat.2025.209639","DOIUrl":"10.1016/j.josat.2025.209639","url":null,"abstract":"<div><h3>Background</h3><div>While evidence suggests Medicaid expansion can reduce overdose, some expressed concern expansion fueled the US opioid overdose crisis by increasing access to low-cost prescription opioids diverted for non-prescribed use. Ecologic studies find a protective relationship or no relationship between expansion and area-level opioid prescribing. Little is known about the relationship between expansion and opioid use among people experiencing poverty who inject drugs (PWID), a population at heightened risk of overdose likely to benefit from Medicaid expansion. We examined whether expansion was associated with prescription opioid and benzodiazepine misuse among PWID experiencing poverty and whether associations varied by race/ethnicity and HIV status.</div></div><div><h3>Methods</h3><div>This serial cross-sectional observational study used generalized difference-in-differences models to analyze data (2012, 2015, 2018) from 19,728 PWID aged 18–64 with income ≤138 % of federal poverty line from 13 states in the CDC's National HIV Behavioral Surveillance. Outcomes included past 12-month non-injection and injection prescription opioid misuse and benzodiazepine misuse.</div></div><div><h3>Results</h3><div>The sample (<em>N</em> = 19,728) was 40 % non-Latinx Black persons and 22 % Latinx persons. Past 12-month non-injection prescription opioid misuse was 33 %, injection prescription opioid misuse was 16 %, and benzodiazepine use was 40 %. Across all models, there was no association between expansion and prescription opioid misuse (confidence intervals included 0) or prescription benzodiazepine misuse (confidence intervals included 0). Associations did not vary by race/ethnicity or HIV status.</div></div><div><h3>Conclusions</h3><div>We found no association between Medicaid expansion and opioid or benzodiazepine misuse overall, by race/ethnicity, or HIV status among a large, geographically diverse sample of PWID. These findings provide empirical evidence that expansion is not associated with prescription opioid or benzodiazepine misuse in a population likely to benefit from expansion.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209639"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437041","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":"Development and validation of the compulsive substance use questionnaire: Attending to substance use automaticity, craving, and continued use despite negative consequences","authors":"Nadine R. Taghian,&nbsp;E. Marie Parsons,&nbsp;Michael W. Otto","doi":"10.1016/j.josat.2025.209638","DOIUrl":"10.1016/j.josat.2025.209638","url":null,"abstract":"<div><h3>Background</h3><div>Compulsivity characterizes an important subtype of substance use disorders (SUDs), but there has been variability in how compulsive substance use is defined and measured. The current study was designed to (1) develop a new measure of substance use compulsivity, (2) validate this scale in a community sample of adults who drink alcohol, and (3) evaluate the association between this new measure of compulsivity and substance use severity. We hypothesize that compulsivity will be characterized by automaticity, craving and insensitivity to negative consequences, and greater substance use severity will be associated with higher levels of substance use compulsivity.</div></div><div><h3>Methods</h3><div>A preliminary set of items were generated for the novel Compulsive Substance Use Questionnaire (CSUQ) to reflect three conceptual aspects of substance use compulsivity: automaticity, craving, and disregarding negative consequences. The study recruited a total of 253 adults who drink alcohol, with a range of severity. Participants answered online surveys on compulsivity, frequency of alcohol use, craving, and negative consequences of alcohol use.</div></div><div><h3>Results</h3><div>We obtained a single-factor solution with 22 items that included 3 automaticity items, 10 craving items, and 9 disregarding negative consequences items. The resulting measure had excellent internal consistency (α = 0.96). The CSUQ was associated with substance use severity; specifically, greater compulsivity was associated with heavy alcohol use and higher frequency of negative consequences associated with alcohol use.</div></div><div><h3>Conclusions</h3><div>The current study supports the validity of a new measure of substance use compulsivity, composed of items that closely hew to the concept of substance use compulsivity. Future work investigating compulsivity in other substance use populations with varying levels of severity will further our understanding of compulsive substance use and SUD subtypes.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209638"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442832","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 difference-making role of staff support in implementing nurse care management for opioid use disorder treatment: A configurational analysis","authors":"Theresa E. Matson ,&nbsp;Amy K. Lee ,&nbsp;Edward J. Miech ,&nbsp;Paige D. Wartko ,&nbsp;Rebecca C. Phillps ,&nbsp;Mary Shea ,&nbsp;Andrea Altschuler ,&nbsp;Aimee N.C. Campbell ,&nbsp;Colleen T. Labelle ,&nbsp;Julia H. Arnsten ,&nbsp;Jordan M. Braciszewski ,&nbsp;Joseph E. Glass ,&nbsp;Viviana E. Horigian ,&nbsp;Mark T. Murphy ,&nbsp;Mohammad Zare-Mehrjerdi ,&nbsp;Katharine A. Bradley","doi":"10.1016/j.josat.2025.209642","DOIUrl":"10.1016/j.josat.2025.209642","url":null,"abstract":"<div><h3>Introduction</h3><div>Understanding conditions in which interventions succeed or fail is critical. The PRimary care Opioid Use Disorders treatment (PROUD) trial, a cluster-randomized hybrid study, tested whether implementation of office-based addiction treatment supported by a nurse increased medication of OUD. Six health systems each provided two primary care (PC) clinics that were randomly assigned to implement the intervention or usual care. This secondary, exploratory study used an innovative mixed methods approach to understand contextual factors that consistently distinguished intervention clinics that increased OUD treatment from those that did not.</div></div><div><h3>Methods</h3><div>The study collected contextual information through field notes, health system debriefs, and nurse interviews. Rapid qualitative analysis using a template based on the Practical, Robust Implementation and Sustainability Model identified themes reflecting the external environment, recipients, and implementation infrastructure. The study used qualitative themes to create binary factors reflecting barriers and facilitators potentially critical to implementation success and assigned clinics a factor value of 1 if present and 0 if absent. Two clinic-level outcomes were defined: 1) significant increase in patient-years of OUD treatment from baseline to two-year follow-up; and 2) high rate of OUD treatment at two-year follow-up (≥20 per 10,000 patient-years). Coincidence analysis, a cross-case configurational method, identified difference-makers for both OUD outcomes across intervention clinics.</div></div><div><h3>Results</h3><div>Qualitative analysis yielded 11 themes which were dichotomized and consolidated into 9 factors. Two factor values perfectly distinguished between intervention clinics with and without increased OUD treatment (outcome #1): (a) presence of strong support from PC staff and providers and (b) lack of OUD treatment in the community. Intervention clinics increased OUD treatment when either factor value was present; when both were absent, clinics did not increase treatment. Strong support from PC staff and providers was independently sufficient to achieve high rates of OUD treatment (outcome #2) while the absence of support explained low rates of treatment. Importantly, strong support from leadership was not sufficient for either outcome.</div></div><div><h3>Conclusion</h3><div>Strong support from staff and providers consistently differentiated between clinics with increased OUD treatment across both outcomes in the PROUD trial from those without. OUD programs should consider increasing support across clinic roles.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"172 ","pages":"Article 209642"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442835","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":"Introduction to the special issue on legislative-driven responses to the opioid crisis: Expanding research and implementation through federal and state funding","authors":"Dennis P. Watson ,&nbsp;Barbara Andraka-Christou","doi":"10.1016/j.josat.2025.209636","DOIUrl":"10.1016/j.josat.2025.209636","url":null,"abstract":"<div><div>This special issue focuses on legislative-driven responses to the opioid crisis in the United States, emphasizing the expansion of research and implementation through federal and state funding. Since 2017, federal, state, and local initiatives have allocated billions of dollars to combat the opioid epidemic. This issue comprises 10 articles that collectively demonstrate the critical role of federal and state funding in enhancing opioid-related prevention, treatment, and recovery services. They also bring to light ongoing challenges such as funding sustainability and equitable service access that can guide future funding initiatives.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209636"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434474","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":"Enhancing access to medication-assisted treatment in tribally-operated health and behavioral health systems: A qualitative study","authors":"Sierra Quintana ,&nbsp;Gregory Aarons ,&nbsp;Ashleigh Coser ,&nbsp;Terrence Kominsky ,&nbsp;Laura Martin ,&nbsp;Sasha Tsurnos ,&nbsp;Douglas Novins","doi":"10.1016/j.josat.2025.209635","DOIUrl":"10.1016/j.josat.2025.209635","url":null,"abstract":"<div><h3>Background</h3><div>American Indian and Alaska Native (AI/AN) communities' resiliency perseveres despite the disproportionate impact of the opioid crisis. Medication-assisted treatment (MAT) combines traditional psychosocial therapy with pharmacotherapies and has emerged as the standard of care for individuals with alcohol and opioid misuse. Combining traditional healing, evidence-based practices, and medications for the treatment of substance misuse to create a form of MAT that is culturally appropriate for AI/AN communities has proven challenging. This study explores how AI/AN culture and community perceptions impact the acceptability and feasibly of MAT and insights into what intervention components would support its provision.</div></div><div><h3>Methods</h3><div>Two health and human service care systems serving primarily AI/AN populations participated in the study. An Advisory Board consisting of clinical providers, program administrators, evaluation specialists, tribal members, and researchers led this project following community-based participatory research principles. Qualitative data was obtained over two waves of data collection, the first wave focusing on describing the cultural, community, systems, and clinical contexts for MAT implementation. The second wave gathered feedback on the feasibility and acceptability of intervention components developed from findings from the first wave. Participants in focus groups and key informant interviews (<em>N</em> = 41 with 29 participating in both waves of data collection) were at least 18 years of age and involved in substance misuse treatment services. Analysis involved extracting themes following principles of grounded theory to identify perspectives within and across each participating community.</div></div><div><h3>Results</h3><div>In the first wave of data collection, major themes included regulatory issues, procedural issues, clinical issues and the availability of consultation to therapists and counselors regarding MAT. In the second wave of data collection, participants reported that tribal, state, and federal resources for prescribing providers in response to the opioid crisis were robust and the gap was in supporting patients, their families, and therapists.</div></div><div><h3>Conclusions</h3><div>These results supported the Advisory Board in identifying the following intervention components to improve access to MAT: 1) the provision of patient and family educational materials and 2) education and clinical consultation opportunities for therapists and counselors to support them in discussing MAT as a treatment option for their patients.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"171 ","pages":"Article 209635"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257581","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 the implementation of screening and intervention for co-use of opioid medications and alcohol among community pharmacy patients","authors":"Grace Broussard ,&nbsp;Kenneth C. Hohmeier ,&nbsp;Craig Field ,&nbsp;Adam J. Gordon ,&nbsp;Kristi Carlston ,&nbsp;Alina Cernasev ,&nbsp;Melissa Tyszko ,&nbsp;Ashley M. Snyder ,&nbsp;Gerald Cochran","doi":"10.1016/j.josat.2024.209606","DOIUrl":"10.1016/j.josat.2024.209606","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;A significant risk for overdose among patients prescribed opioid medications is co-use of alcohol. Community pharmacies are underutilized as a resource to prevent and address co-use. The barriers and facilitators that promote or impede the adoption of universal alcohol screening and intervention at point of opioid medication dispensing are unknown. We assessed community pharmacy leaders, pharmacists, and technician's perceptions towards the implementation of a pharmacy-based screening/intervention for the co-use of opioids and alcohol among patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a multi-method study that included one-time key informant interviews combined with a close-ended survey to inform our understanding of pharmacy system/practice-level barriers and facilitators for universal screening and intervention. Participants were recruited from Utah and Tennessee and were required to have active employment as pharmacy leaders, pharmacists, or technicians, be English-speaking, and believe they could provide feedback regarding co-use screening and intervention within community pharmacies. Interviews used the Consolidated Framework for Implementation Research and the Organizational Readiness for Implementing Change assessment. Qualitative analysis included both inductive and deductive coding. Themes followed a cycle of open, initial coding whereby codes were derived inductively from the data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Themes from interviews (&lt;em&gt;N&lt;/em&gt; = 68) included a) emphasizing a need to overcome the stigma associated with patients who engage in co-use and a mindset shift to treat the challenges and risks associated, b) need for corporate-level support, management buy-in, and c) appropriate technology to support the workflow including system-wide changes to support the integration of medication therapy management services within community pharmacies. However, barriers were offset by pharmacists eager to understand their role in screening patients and reiterated a focus on patient-centered care to achieve this goal.&lt;/div&gt;&lt;div&gt;From the ORIC assessment, 75 % (&lt;em&gt;n&lt;/em&gt; = 51) of respondents reported that community pharmacy staff wanted to implement the screening and intervention, and 69.1 % (&lt;em&gt;n&lt;/em&gt; = 47) reported motivation to implement the screening and intervention. Finally, 67.6 % (&lt;em&gt;n&lt;/em&gt; = 46) felt that community pharmacies are committed to implementing the screening and intervention, but only 10.3 % (&lt;em&gt;n&lt;/em&gt; = 7) expressed strong support to do “whatever it takes” to implement the screening and intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;These results provide critical insights into implementation strategies for the adoption of brief intervention by community pharmacists. These data are foundational to developing strategies for a powered trial and possible future system/practice-level implementation of universal alcohol screening and intervention for co-use.&lt;/div&gt;&lt;/d","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209606"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822574","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":"Early implementation of an electronic measurement-based care tool in substance use disorder treatment clinics","authors":"Megan A. O'Grady ,&nbsp;Patricia Lincourt ,&nbsp;Sueun Hong ,&nbsp;Shazia Hussain ,&nbsp;Charles J. Neighbors","doi":"10.1016/j.josat.2024.209605","DOIUrl":"10.1016/j.josat.2024.209605","url":null,"abstract":"<div><h3>Background</h3><div>Measurement-based care (MBC), routinely measuring and reviewing treatment progress with a standardized tool, can inform clinical decision making and improve patient outcomes. Despite potential benefits, implementation of MBC in SUD treatment settings has been limited and little is known about its implementation in SUD settings. The goal of this convergent parallel mixed methods study was to understand staff experiences during early implementation of MBC in SUD treatment clinics.</div></div><div><h3>Methods</h3><div>The Treatment Progress Assessment-8 (TPA8) is an 8-item measure that supports MBC with an electronic system (eTPA8) allowing client completion on electronic devices and providing staff reports. The study introduced the eTPA8 into 13 clinics using external practice facilitation and implementation teams. Quantitative data examining implementation included eTPA8 system data (1672 administrations) and staff surveys (<em>n</em> = 70) using feasibility, acceptability, and appropriateness measures. Semi-structured interviews (<em>n</em> = 34) were conducted with clinic staff. To analyze data, we classified clinics into adopters, non-adopters, and sustainers using eTPA8 system data. One-way ANOVA compared these classifications on the three implementation outcome measures. Rapid qualitative analysis was used for the interviews.</div></div><div><h3>Results</h3><div>There were significant differences between staff in sustainer (<em>M</em> = 3.90) and non-adopter (<em>M</em> = 3.21) clinics on the feasibility measure (<em>F</em>(2, 68) = [4.28], <em>p</em> = 0.018). SUD program staff found the eTPA8 to be user-friendly, appropriate, and acceptable. There was some variation in perceived feasibility of regular use of the eTPA8, especially given competing demands and time constraints. Staff found the eTPA8 useful to support clinical interactions but varied in embracing new technology and the overall MBC concept. The inner and outer contexts influenced implementation and required attention by clinic champions and implementation teams. External practice facilitators were key to addressing barriers in an ongoing and flexible manner.</div></div><div><h3>Conclusions</h3><div>Implementing MBC using the eTPA8 showed promise. Staff felt the TPA8 was generally clinically useful, appropriate, and acceptable; yet feasibility was variable. Adoption of MBC faced barriers (e.g., competing demands). Implementation required relatively intensive implementation supports that were dynamic, proactive, and responsive. Findings have implications for guiding development and refinement of responsive, theory-driven implementation strategies to support MBC in SUD treatment settings, with a particular focus on addressing feasibility.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209605"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822581","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":"Treatment completion among Australians attending publicly-funded specialist alcohol and other drug treatment services","authors":"Amanda Roxburgh ,&nbsp;Joseph Van Buskirk ,&nbsp;Darren M. Roberts ,&nbsp;Mark Stoove ,&nbsp;Jacques Raubenheimer ,&nbsp;Paul Dietze ,&nbsp;Sharon Reid ,&nbsp;Paul S. Haber ,&nbsp;Carolyn A. Day","doi":"10.1016/j.josat.2024.209588","DOIUrl":"10.1016/j.josat.2024.209588","url":null,"abstract":"<div><h3>Introduction</h3><div>Completion of alcohol and other drug (AOD) treatment is associated with improved health and social outcomes. Previous research has largely focused on individual (e.g. demographic) or service-level (e.g. treatment modality/setting) factors related to treatment completion in isolation. This study investigates the relationship between treatment completion and service-level and substance related factors, after controlling for demographics.</div></div><div><h3>Study design</h3><div>Retrospective cohort of 53,430 people engaging in government funded specialist AOD treatment across New South Wales, Australia, between 1 January 2015–31 December 2018.</div></div><div><h3>Methods</h3><div>Generalised linear mixed models were used to analyse factors associated with treatment completion, accounting for repeated measures across treatment episodes.</div></div><div><h3>Results</h3><div>Approximately two-thirds (69.8 %, n = 37,330) of the cohort completed treatment at least once during the study period, 42.3 % (22,605) on a single, and 27.5 % (14,725) on multiple occasions. After controlling for demographics, treatment episodes for amphetamines were least likely to be recorded as complete (52.5 %), while those for MDMA were 1.9 (95 % CI: 1.49, 2.45) times more likely (67 %) than amphetamine episodes to be completed. Treatment episodes mandated through criminal justice/child protection agencies were 1.25 (95 % CI: 1.20, 1.30) times more likely to be completed compared to those originating from self-referral. There were no differences in treatment completion between self or health professional referrals (aOR: 0.98, 95 % CI: 0.95, 1.02). Episodes involving involuntary AOD treatment modalities and residential withdrawal were 6.67 times (95% CI: 4.53, 9.81) and 5.02 times (95 % CI: 4.46, 5.64) more likely respectively to be completed compared to those for community rehabilitation. Case management episodes were also more likely (aOR: 2.43, 95 % CI: 2.16, 2.73) to be completed. Episodes of longer treatment duration (≥90 days) were 1.89 times (95 % CI: 1.82, 1.97) more likely to be completed compared to shorter (≤30 days) treatment episodes.</div></div><div><h3>Conclusions</h3><div>Treatment completion was moderated by a range of factors including drug type, treatment modality and duration, and referral source. Low rates of amphetamine treatment completion across treatment modalities confirms the urgent need for further research investigating more effective treatment options for amphetamine use disorders.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209588"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792893","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":"“There was no services that I could access so I just stayed on the street…using until I went into labour.”: A qualitative study of accessibility and cultural safety of services for perinatal substance use in British Columbia, Canada","authors":"S. Joyce ,&nbsp;M. Piske ,&nbsp;C. Norris (Eagle Spirit Woman) ,&nbsp;B. Barker ,&nbsp;R. David ,&nbsp;U. Malhotra ,&nbsp;B. Nosyk","doi":"10.1016/j.josat.2024.209604","DOIUrl":"10.1016/j.josat.2024.209604","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal substance use is a critical public health challenge, impacting both mother and fetus. Its prevalence has increased in British Columbia, Canada, disproportionately impacting First Nations people. For specialized perinatal substance use services to be effective, they must be accessible and safe. This study aimed to explore the accessibility and cultural safety of health services for perinatal substance use from the perspective of service users.</div></div><div><h3>Methods</h3><div>We conducted a qualitative study from six focus group discussions, consisting of five in-person sharing circles for people with lived/living experience of pregnancy and substance use and one virtual focus group with inreach workers, for a total of 55 participants including 48 people with lived experience and seven inreach workers across the five health delivery regions in British Columbia. We interpreted results using thematic analysis and narrative inquiry to explore inductively and deductively derived themes.</div></div><div><h3>Results</h3><div>Participants identified a lack of perinatal substance use specific services, particularly supportive housing facilities and wrap-around community centres in the province but highlighted that community-based services they were able to access made participants feel safe and respected. Thematic analysis identified six themes related to accessibility and cultural safety: geographic disparities in access to care, importance of Indigenous culture for Indigenous client's healing, transitions as critical moments in service accessibility, safe services protect the mother-infant dyad, inconsistent access to opioid agonist treatment, and relationality as a crucial element of safe service delivery.</div></div><div><h3>Conclusion</h3><div>This study suggests that services that preserve the mother-infant dyad, incorporate wholistic care including Indigenous culture, and are relationship-based are experienced as accessible and safe, and those that do not are often mistrusted and avoided. This study highlights needed improvements, particularly of acute care services, through supporting instead of reporting birthing parents with substance use, ensuring continuous access to opioid agonist treatment for pregnant people with opioid use disorder, and suffusing the client-provider relationship with empathy, respect, and connection.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"169 ","pages":"Article 209604"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823042","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}