Characteristics and current clinical practices of opioid treatment programs in the United States

This study examined commuting patterns among 23,141 methadone patients enrolling in 84 opioid treatment programs (OTPs) in the United States. Patients completed an anonymous one-page survey. A linear mixed model analysis was used to predict distance traveled to the OTP. More than half (60%) the patients traveled <10 miles and 6% travelled between 50 and 200 miles to attend an OTP; 8% travelled across a state border to attend an OTP. In the multivariate model (n=17,792), factors significantly (P<.05) associated with distance were, residing in the Southeast or Midwest, low urbanicity, area of the patient's ZIP code, younger age, non-Hispanic white race/ethnicity, prescription opioid abuse, and no heroin use. A significant number of OTP patients travel considerable distances to access treatment. To reduce obstacles to OTP access, policy makers and treatment providers should be alert to patients' commuting patterns and to factors associated with them.

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Overview of Opioid Treatment Programs within the United States: 2008

PsycEXTRA Dataset ◽

10.1037/e513532010-001 ◽

2010 ◽

Keyword(s):

United States ◽

The United States ◽

Treatment Programs ◽

Opioid Treatment

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1068. Large-Scale Migration and the Changing Viral Hepatitis Prevalences in North America: A modeling approach

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1254 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S563-S563

Author(s):

Kenneth A Valles ◽

Lewis R Roberts

Keyword(s):

United States ◽

Viral Hepatitis ◽

Large Scale ◽

Country Of Origin ◽

Human Movement ◽

High Volume ◽

The United States ◽

The Philippines ◽

Outcome Data ◽

Treatment Programs

Abstract Background Infection by hepatitis B and C viruses causes inflammation of the liver and can lead to cirrhosis, liver failure, and hepatocellular carcinoma. The WHO’s ambition to eliminate viral hepatitis by 2030 requires strategies specific to the dynamic disease profiles each nation faces. Large-scale human movement from high-prevalence nations to the United States and Canada have altered the disease landscape, likely warranting adjustments to present elimination approaches. However, the nature and magnitude of the new disease burden remains unknown. This study aims to generate a modeled estimate of recent HBV and HCV prevalence changes to the United States and Canada due to migration. Methods Total migrant populations from 2010-2019 were obtained from United Nations Migrant Stock database. Country-of-origin HBV and HCV prevalences were obtained for the select 40 country-of-origin nations from the Polaris Observatory and systematic reviews. A standard pivot table was used to evaluate the disease contribution from and to each nation. Disease progression estimates were generated using the American Association for the Study of the Liver guidelines and outcome data. Results Between 2010 and 2019, 7,676,937 documented migrants arrived in US and Canada from the selected high-volume nations. Primary migrant source regions were East Asia and Latin America. Combined, an estimated 878,995 migrants were HBV positive, and 226,428 HCV positive. The majority of both migrants (6,477,506) and new viral hepatitis cases (HBV=840,315 and HCV=215,359) were found in the United States. The largest source of HBV cases stemmed from the Philippines, and HCV cases from El Salvador. Conclusion Massive human movement has significantly changed HBV and HCV disease burdens in both the US and Canada over the past decade and the long-term outcomes of cirrhosis and HCC are also expected to increase. These increases are likely to disproportionally impact individuals of the migrant and refugee communities and screening and treatment programs must be strategically adjusted in order to reduce morbidity, mortality, and healthcare expenses. Disclosures All Authors: No reported disclosures

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Multicultural Perspectives in Music Therapy: An Examination of the Literature, Educational Curricula, and Clinical Practices in Culturally Diverse Cities of the United States

Music Therapy Perspectives ◽

10.1093/mtp/16.1.27 ◽

1998 ◽

Vol 16 (1) ◽

pp. 27-32 ◽

Cited By ~ 7

Author(s):

A.-A. Darrow ◽

D. Molloy

Keyword(s):

United States ◽

Music Therapy ◽

Culturally Diverse ◽

The United States ◽

Clinical Practices ◽

Multicultural Perspectives

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Methadone Distribution Trends from 2017-2019 in the United States

10.1101/2020.11.07.20227496 ◽

2020 ◽

Author(s):

John A. Furst ◽

Nicholas J. Mynarski ◽

Kenneth L. McCall ◽

Brian J. Piper

Keyword(s):

United States ◽

Rhode Island ◽

Distribution Patterns ◽

The United States ◽

Opioid Use Disorder ◽

Primary Objective ◽

Treatment Programs ◽

Opioid Use ◽

Drug Enforcement ◽

The Us

AbstractObjectiveMethadone is an evidence based treatment for opioid use disorder and is also employed for acute pain. The primary objective of this study was to explore methadone distribution patterns between the years 2017 and 2019 across the United States (US). This study builds upon previous literature that has analyzed prior years of US distribution patterns, and further outlines regional and state specific methadone trends.MethodsThe Drug Enforcement Administration’s Automated Reports and Consolidated Ordering System (ARCOS) was used to acquire the number of narcotic treatment programs (NTPs) per state and methadone distribution weight in grams. Methadone distribution by weight, corrected for state populations, and number of NTPs were compared from 2017 to 2019 between states, within regions, and nationally.ResultsBetween 2017 and 2019, the national distribution of methadone increased 12.30% for NTPs but decreased 34.57% for pain, for a total increase of 2.66%. While all states saw a decrease in distribution for pain, when compared regionally, the Northeast showed a significantly smaller decrease than all other regions. Additionally, the majority of states experienced an increase in distribution for NTPs and most states demonstrated a relatively stable or increasing number of NTPs, with an 11.49% increase in NTPs nationally. The number of NTPs per 100K in 2019 ranged from 2.08 in Rhode Island to 0.00 in Wyoming.ConclusionAlthough methadone distribution for OUD was increasing in the US, there were pronounced regional disparities.

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Deep in the Brain: Identity and Authenticity in Pediatric Gender Transition

Cultural Anthropology ◽

10.14506/ca34.1.10 ◽

2019 ◽

Vol 34 (1) ◽

pp. 103-129 ◽

Cited By ~ 1

Author(s):

Sahar Sadjadi

Keyword(s):

United States ◽

Cultural History ◽

The United States ◽

Clinical Practices ◽

Gender Transition ◽

Gender Nonconforming ◽

Scientific Substantiation ◽

Contemporary United States ◽

Cultural Attachment ◽

The Brain

Based on an ethnography of clinical practices around gender-nonconforming and transgender children in the United States, this article explores the cultural and scientific notions of identity that shape this field. It examines the practice of diagnosing true gender identity in the clinic and situates the search for the foundation of identity in the inner depths of the self, and in children as harbingers of authenticity, as part of a broader cultural history. It addresses the scientific substantiation of the faith in innateness (“born this way”) and interiority (“from within”) of identity, as well as their political appeal. This article challenges the often taken-for-granted association of science with materialism—and the distribution of matter-idea along the nature–culture axis—by demonstrating the idealism that drives the siting of identity in the brain. Finally, it questions the assumption that it is the appeal of nature and biology that underlies the cultural attachment to entities such as the gene and the brain as locations for the origin of identity in the contemporary United States. Rather than the nature–culture dyad, this article argues that the internal-external dyad more accurately captures and explains this cultural attachment.

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