scholarly journals Is residential treatment effective for opioid use disorders? A longitudinal comparison of treatment outcomes among opioid dependent, opioid misusing, and non-opioid using emerging adults with substance use disorder

2014 ◽  
Vol 144 ◽  
pp. 178-185 ◽  
Author(s):  
Zev Schuman-Olivier ◽  
M. Claire Greene ◽  
Brandon G. Bergman ◽  
John F. Kelly
Keyword(s):  
Substance Use ◽  
Residential Treatment ◽  
Treatment Outcomes ◽  
Emerging Adults ◽  
Substance Use Disorder ◽  
Opioid Use ◽  
Opioid Use Disorders ◽  
Longitudinal Comparison

Substance Use Disorders

2019 ◽  
Author(s):  
Erik A. Levinsohn ◽  
Kevin P. Hill
Keyword(s):  
Substance Use ◽  
General Population ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
General Framework ◽  
Opioid Use ◽  
Diagnosis And Management ◽  
Conceptual Background ◽  
Opioid Use Disorders

Given the incredible scope of substance use disorders, this chapter will primarily focus on alcohol and opioid use disorders, while also discussing substance use broadly. Furthermore, this chapter does not provide detailed guidelines for managing patients with a substance use disorder. Instead, this review aims to provide the reader with conceptual background of the biology of addiction as well as a general framework for its diagnosis and management. While this chapter primarily focuses on physicians in the role of caregiver, it is important to note that physicians also struggle with SUDs, at a rate near that of the general population.25 This review contains 3 tables and 25 references.

Barriers and Facilitators of Using Telehealth to Identify and Manage Behavioral Health and Substance Use Disorder Conditions in Rural Areas: An Environmental Scan (Preprint)

2020 ◽  
Author(s):  
Naim Naim ◽  
Laura Dunlap
Keyword(s):  
Substance Use ◽  
Behavioral Health ◽  
Substance Use Disorder ◽  
Rural Areas ◽  
Primary Care Providers ◽  
Care Patient ◽  
Direct Patient Care ◽  
Care Providers ◽  
Provider Education ◽  
Opioid Use

BACKGROUND Access to behavioral health services, particularly substance use disorder (SUD) treatment services, is challenging in rural and other underserved areas. Some of the reasons for these challenges include local primary care providers without experience in behavioral health treatment, few specialty providers, and concerns over stigma and lack of privacy for individuals from smaller communities. Telehealth can ease these challenges and support behavioral health, specifically SUD treatment, in a variety of ways, including direct patient care, patient engagement, and provider education. Telehealth is particularly relevant for the growing opioid epidemic, which has profoundly affected rural areas. OBJECTIVE We sought to understand how telehealth is used to support behavioral health and SUDs, with a particular focus on implications for medication-assisted treatment for opioid use disorders. The intent was to understand telehealth implementation and use, financing and sustainability, and impact in the field. The results of this work can be used to inform future policy and practice. METHODS We reviewed literature and interviewed telehealth stakeholders and end users in the field. The team identified a diverse set of participants, including clinical staff, administrators, telehealth coordinators, and information technology staff. We analyzed research notes to extract themes from participant experiences to answer the study questions. RESULTS Organizations varied in how they implemented telehealth services and the services they offered. Common themes arose in implementation, such as planning for technical and organizational impacts of telehealth, the importance of leadership support, and tailoring programs to community needs. CONCLUSIONS Telehealth is used in a variety of ways to expand access to services and extend service delivery. As the policy and reimbursement landscape continues to evolve, there may be corresponding changes in telehealth uptake and services provided. CLINICALTRIAL NA

scholarly journals Characteristics of Neuropsychiatric Mobile Health Trials: Cross-Sectional Analysis of Studies Registered on ClinicalTrials.gov

10.2196/16180 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e16180
Author(s):  
Mia Tova Minen ◽  
Julia Frederica Reichel ◽  
Pallavi Pemmireddy ◽  
Elizabeth Loder ◽  
John Torous
Keyword(s):  
Substance Use ◽  
Major Depressive Disorder ◽  
Alzheimer Disease ◽  
Depressive Disorder ◽  
Alcohol Use Disorders ◽  
Opioid Use ◽  
Major Depressive ◽  
High Burden ◽  
Opioid Use Disorders ◽  
Neuropsychiatric Conditions

Background The development of mobile health (mHealth) technologies is progressing at a faster pace than that of the science to evaluate their validity and efficacy. Under the International Committee of Journal Medical Editors (ICMJE) guidelines, clinical trials that prospectively assign people to interventions should be registered with a database before the initiation of the study. Objective The aim of this study was to better understand the smartphone mHealth trials for high-burden neuropsychiatric conditions registered on ClinicalTrials.gov through November 2018, including the number, types, and characteristics of the studies being conducted; the frequency and timing of any outcome changes; and the reporting of results. Methods We conducted a systematic search of ClinicalTrials.gov for the top 10 most disabling neuropsychiatric conditions and prespecified terms related to mHealth. According to the 2016 World Health Organization Global Burden of Disease Study, the top 10 most disabling neuropsychiatric conditions are (1) stroke, (2) migraine, (3) major depressive disorder, (4) Alzheimer disease and other dementias, (5) anxiety disorders, (6) alcohol use disorders, (7) opioid use disorders, (8) epilepsy, (9) schizophrenia, and (10) other mental and substance use disorders. There were no date, location, or status restrictions. Results Our search identified 135 studies. A total of 28.9% (39/135) of studies evaluated interventions for major depressive disorder, 14.1% (19/135) of studies evaluated interventions for alcohol use disorders, 12.6% (17/135) of studies evaluated interventions for stroke, 11.1% (15/135) of studies evaluated interventions for schizophrenia, 8.1% (11/135) of studies evaluated interventions for anxiety disorders, 8.1% (11/135) of studies evaluated interventions for other mental and substance use disorders, 7.4% (10/135) of studies evaluated interventions for opioid use disorders, 3.7% (5/135) of studies evaluated interventions for Alzheimer disease or other dementias, 3.0% (4/135) of studies evaluated interventions for epilepsy, and 3.0% (4/135) of studies evaluated interventions for migraine. The studies were first registered in 2008; more than half of the studies were registered from 2016 to 2018. A total of 18.5% (25/135) of trials had results reported in some publicly accessible location. Across all the studies, the mean estimated enrollment (reported by the study) was 1078, although the median was only 100. In addition, across all the studies, the actual reported enrollment was lower, with a mean of 249 and a median of 80. Only about a quarter of the studies (35/135, 25.9%) were funded by the National Institutes of Health. Conclusions Despite the increasing use of health-based technologies, this analysis of ClinicalTrials.gov suggests that only a few apps for high-burden neuropsychiatric conditions are being clinically evaluated in trials.

Treatments for Substance Use Disorders

2020 ◽  
pp. 267-324
Author(s):  
Arash Ansari ◽  
David N. Osser
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Clinical Characteristics ◽  
Black Box ◽  
Brand Names ◽  
Opioid Use ◽  
Childbearing Age ◽  
Black Box Warnings ◽  
Amphetamine Use ◽  
Opioid Use Disorders

The chapter on treatments for substance use disorders discusses and reviews the use of medication-assisted treatments with (a) methadone, buprenorphine/naloxone, and naltrexone for opioid use disorders; (b) disulfiram, acamprosate, naltrexone, and several off-label medications for alcohol use disorders; and (c) nicotine replacement therapies, bupropion, and varenicline for tobacco use disorders. The chapter reviews the mechanisms of action, clinical characteristics, potential medication interactions, and adverse effects of these medications, followed by an in-depth discussion of their clinical use in these disorders. The chapter also briefly reviews several non-Food and Drug Administration (FDA)-approved medicines studied for cocaine, cannabis, and amphetamine use disorders. It also briefly discusses complementary and alternative pharmacotherapies, such as the use of cannabinoids. It also discusses the use of these medicines in women of childbearing age, notably for pregnancy and breastfeeding considerations. Finally, the chapter includes a table of approved substance use disorder medicines that includes each medicine’s generic and brand names, usual adult doses, pertinent clinical comments, black box warnings, and FDA indications.

Substance Use Disorder Treatments

2017 ◽  
pp. 96-118 ◽  
Author(s):  
Liliane Cambraia Windsor ◽  
Douglas C. Smith ◽  
Kyle M. Bennett ◽  
Frederick X. Gibbons
Keyword(s):  
Substance Use ◽  
Emerging Adults ◽  
Substance Use Disorder ◽  
The United States ◽  
Drug Misuse ◽  
Future Research ◽  
Cultural Groups ◽  
Treatment Access ◽  
Effective Interventions ◽  
Diverse Groups

Today’s emerging adults belong to one of the most diverse generations in the United States and show the highest rates of alcohol and illicit drug misuse, facing significant health risks. Thus it is critical to develop effective interventions to reduce alcohol and illicit substance misuse and its related harms among this diverse group. This chapter examines the current literature on the development and effectiveness of existing culturally relevant substance use disorder treatments and makes recommendations for future research and best practices. We argue that given their unique needs, the severity of their substance use, and the low rates of treatment engagement among this population, it is critical that treatment efforts focus on increasing effective treatment access to all emerging adults. We further encourage substance use disorder treatment researchers and practitioners to move beyond addressing culture-bound intervention targets focused on specific cultural groups. The chapter advocates for the development, testing, and adoption of interventions that are responsive to cultural contexts and that (1) target social determinants of health, (2) are equally effective with privileged and marginalized emerging adults, and (3) prepare therapists to effectively deliver interventions to diverse groups and demonstrate cultural competence.

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