Impact of a pharmacist-led substance use disorder transitions of care clinic on postdischarge medication treatment retention

2021 ◽  
pp. 108440
Author(s):  
Austin Smith ◽  
Jamie Hansen ◽  
Michelle Colvard
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Treatment Retention ◽  
Transitions Of Care ◽  
Care Clinic ◽  
Medication Treatment

Preclinical Models of Substance Use Disorder

2020 ◽  
pp. 45-64
Author(s):  
Kathryn L. Schwienteck ◽  
Matthew L. Banks
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Drug Discrimination ◽  
Substance Use Disorder ◽  
Treatment Effects ◽  
Abuse Liability ◽  
Self Administration ◽  
Medication Treatment ◽  
Medication Effects ◽  
Repeated Dosing

The foundational premise for all preclinical biomedical research is that results generated from nonhumans would be predictive of and consistent with results generated in humans. Preclinical procedures have been developed to model various aspects of substance use disorder (SUD) in almost every nonhuman species, but the predominant species utilized are mice, rats, and nonhuman primates. Three common preclinical procedures that have been utilized to determine the abuse liability of novel or emerging psychoactive compounds include intracranial self-stimulation (ICSS), drug discrimination, and drug self-administration. Although all three procedures model slightly different aspects of substance abuse, all three have shown good translational concordance to predicting substance abuse potential in humans. Where these three preclinical procedures differentiate is in their utility to evaluate candidate medications for the treatment of SUDs, and preclinical drug self-administration procedures have shown to be more predictive of candidate medication treatment effects than drug discrimination endpoints. Candidate medication treatment effects on ICSS have only recently been published. Two preclinical experimental design attributes that enhance translational concordance with clinical evaluation of candidate pharmacotherapies for SUD include repeated dosing of the candidate medication over several days and assessment of behavioral selectivity for candidate medication effects to decrease drug-maintained behavior and increase behavior maintained by nondrug reinforcers such as food.

scholarly journals Examination of Referral Source and Retention Among Women in Residential Substance Use Disorder Treatment: A Prospective Follow-Up Study

2020 ◽  
Author(s):  
Dean Rivera ◽  
Donna Dueker ◽  
Hortensia Amaro
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Mental Health Disorder ◽  
Treatment Retention ◽  
Future Research ◽  
Referral Source ◽  
Protective Services ◽  
Court Mandated ◽  
The Impact

Abstract Background: Court-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women’s residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear. Purpose: This study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or certain mental health characteristics (increased stress, depression, anxiety, and PTSD symptomology) contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women. Methods: Multivariate regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N = 141, Black: N = 50, White: N = 50) mandated or nonmandated (CJ: N = 114, CPS: N = 82, nonmandated: N = 49) into residential SUD treatment to determine each group’s treatment retention outcomes. Results: Women mandated to SUD residential treatment regardless of source (CPS or CJ) remained in treatment significantly longer (CPS: M = 116.59 days, SD = 65.59, p = .023; CJ: M = 133.86 days, SD = 79.43, p = .028), compared to women not mandated (M = 96.11 days, SD = 72.09), representing a 34.4% and 31.6% increase, respectively. Findings further revealed a corresponding 2.3% decrease in retention (p = .024) for each one-unit increase in a patient’s stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention (p < .001). Conclusions: This study highlights the importance of future research that examines the impact of referral source, co-occurring mental disorders, and stress on women’s residential SUD treatment retention.Further research is needed examining the variability in external motivation among referral sources compounded by dynamic intersections of risk associated with having a co-occurring disorder and stress on treatment retention.ClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648

scholarly journals More than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy

2016 ◽  
Vol 10 ◽  
pp. SART.S40475 ◽  
Author(s):  
Ann Kern-Godal ◽  
Ida Halvorsen Brenna ◽  
Espen Ajo Arnevik ◽  
Edle Ravndal
Keyword(s):  
Substance Use ◽  
Qualitative Study ◽  
Substance Use Disorder ◽  
Thematic Analysis ◽  
Treatment Retention ◽  
Social Constructionist ◽  
Treatment Practices ◽  
Stable Environment ◽  
Usual Treatment ◽  
Patients Experience

Inclusion of horse-assisted therapy (HAT) in substance use disorder (SUD) treatment is rarely reported. Our previous studies show improved treatment retention and the importance of the patient–horse relationship. This qualitative study used thematic analysis, within a social constructionist framework, to explore how eight patients experienced contextual aspects of HAT's contribution to their SUD treatment. Participants described HAT as a “break from usual treatment”. However, four interrelated aspects of this experience, namely “change of focus”, “activity”, “identity”, and “motivation,” suggest HAT is more than just a break from usual SUD treatment. The stable environment is portrayed as a context where participants could construct a positive self: one which is useful, responsible, and accepted; more fundamentally, a different self from the “patient/self” receiving treatment for a problem. The implications extend well beyond animal-assisted or other adjunct therapies. Their relevance to broader SUD policy and treatment practices warrants further study.

scholarly journals Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study

2021 ◽  
Author(s):  
Dean Rivera ◽  
Donna Dueker ◽  
Hortensia Amaro
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Mental Health Disorder ◽  
Treatment Retention ◽  
Service Needs ◽  
Management Support ◽  
Protective Services ◽  
Unit Increase ◽  
Court Mandated

Abstract Background: Court-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women’s residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear. Purpose: This study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or increased stress, depression, anxiety, and PTSD symptomology contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women. Methods: Multiple regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N = 141, Black: N = 50, White: N = 50) mandated or nonmandated (CJ: N = 114, CPS: N = 82, nonmandated: N = 49) into residential SUD treatment to determine each group’s treatment retention outcomes. Results: Women mandated to SUD residential treatment by the CPS system remained in treatment significantly longer ( p = .046), compared to women not mandated, representing a 34.4% increase in retention. Findings further revealed a corresponding 2.3% decrease in retention ( p = .048) for each one-unit increase in a patient’s stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention ( p < .001). Conclusions: Policy and clinical considerations include (a) increasing case management support and wraparound services that meet the multiple service needs of women who are nonmandated to residential SUD treatment, and (b) incorporating a more nuanced treatment approach that manages mental health disorders and stress symptomology early in treatment when women are most vulnerable to relapse and treatment dropout. ClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648

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