Overview of Substance Use Disorder Treatment

2020 ◽  
pp. 29-42
Author(s):  
Darius A. Rastegar
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Behavioral Therapy ◽  
Psychosocial Treatment ◽  
Addiction Medicine ◽  
Patient Centered ◽  
Therapeutic Modalities ◽  
Disorder Treatment ◽  
American Society ◽  
Self Help Groups

Treatment of substance use disorders (SUD) has traditionally been program-centered, but patient-centered models hold the promise of care that is more ethical and effective. Most SUD treatments can be roughly divided into two types of modalities: psychosocial treatment, which includes brief interventions, self-help groups, counseling, cognitive–behavioral therapy, and analytic psychotherapy; and pharmacotherapy, which includes drug antagonists or agonists and other agents. These treatments are not mutually exclusive, and the best approach in many cases is a combination of therapeutic modalities. The American Society of Addiction Medicine has developed placement criteria to help determine the optimal treatment setting. Harm reduction is an approach that focuses on reducing the harms of drug use without necessarily targeting drug use itself.

scholarly journals Inpatient Addiction Medicine Consultation and Post-Hospital Substance Use Disorder Treatment Engagement: a Propensity-Matched Analysis

2019 ◽  
Vol 34 (12) ◽  
pp. 2796-2803 ◽  
Author(s):  
Honora Englander ◽  
Konrad Dobbertin ◽  
Bonnie K. Lind ◽  
Christina Nicolaidis ◽  
Peter Graven ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Treatment Engagement ◽  
Addiction Medicine ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

Does screening and brief intervention for drug use in primary care increase receipt of substance use disorder treatment?

2015 ◽  
Vol 156 ◽  
pp. e111-e112
Author(s):  
Theresa W. Kim ◽  
Judith Bernstein ◽  
Debbie M. Cheng ◽  
Jeffrey Samet ◽  
Christine Lloyd-Travaglini ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Drug Use ◽  
Substance Use Disorder ◽  
Brief Intervention ◽  
Screening And Brief Intervention ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

scholarly journals Patient-centered care's relationship with substance use disorder treatment utilization

2020 ◽  
Vol 118 ◽  
pp. 108125
Author(s):  
Sunggeun (Ethan) Park ◽  
Jennifer E. Mosley ◽  
Colleen M. Grogan ◽  
Harold A. Pollack ◽  
Keith Humphreys ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Treatment Utilization ◽  
Patient Centered ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

Critical Care Medicine

2016 ◽  
pp. 719-728
Author(s):  
Cassie C. Kennedy
Keyword(s):  
Substance Use ◽  
Critical Care ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Psychosocial Treatment ◽  
Racial Groups ◽  
Self Help ◽  
Self Help Groups ◽  
Alcohol And Other Drugs ◽  
Pharmacologic Agents

Alcohol and other substance use disorders are a major concern in all age groups and across all ethnic, socioeconomic, and racial groups. Despite high lifetime prevalence (up to 20%), less than 10% of persons with substance use disorders are involved in treatment (either self-help groups or professional care). Several pharmacologic agents are available to help diminish the craving for alcohol and other drugs or to deter relapse. Although several medications, including disulfiram, acamprosate, and naltrexone, may help prevent relapse, they are adjunctive and not a substitute for comprehensive psychosocial treatment.

Recognition and Management of Iatrogenically Induced Opioid Dependence and Withdrawal in Children

2018 ◽  
pp. 109-112
Author(s):  
Jeffrey Galinkin ◽  
Jeffrey Lee Koh
Keyword(s):  
Substance Use ◽  
Pain Relief ◽  
Opioid Dependence ◽  
Pediatric Population ◽  
Single Source ◽  
Pain Medicine ◽  
Addiction Medicine ◽  
Or Management ◽  
Acute Injuries ◽  
American Society

Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. According to a 2001 Consensus Paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as “a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.” Although the experience of many children undergoing iatrogenically induced withdrawal may be mild or goes unreported, there is currently no guidance for recognition or management of withdrawal for this population. Guidance on this subject is available only for adults and primarily for adults with substance use disorders. The guideline will summarize existing literature and provide readers with information currently not available in any single source specific for this vulnerable pediatric population.

scholarly journals A state-level study of opioid use disorder treatment access and neonatal abstinence syndrome

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth R. Wolf ◽  
Sebastian T. Tong ◽  
Roy T. Sabo ◽  
Steven H. Woolf ◽  
Kassie Abbinanti ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Illicit Drug ◽  
State Level ◽  
Opioid Use Disorder ◽  
Neonatal Abstinence Syndrome ◽  
Abstinence Syndrome ◽  
Opioid Use ◽  
Treatment Access ◽  
Disorder Treatment

Abstract Background Adult opioid use and neonatal abstinence syndrome (NAS) are growing public health problems in the United States (U.S.). Our objective was to determine how opioid use disorder treatment access impacts the relationship between adult opioid use and NAS. Methods We conducted a cross-sectional state-level ecologic study using 36 states with available Healthcare Cost and Utilization Project State Inpatient Databases in 2014. Opioid use disorder treatment access was determined by the: 1) proportion of people needing but not receiving substance use treatment, 2) density of buprenorphine-waivered physicians, and 3) proportion of individuals in outpatient treatment programs (OTPs). The incidence of NAS was defined as ICD-9 code 779.5 (drug withdrawal syndrome in newborn) from any discharge diagnosis field per 1000 live births in that state. Results Unmet need for substance use disorder treatment correlated with NAS (r = 0.54, 95% CI: 0.26–0.73). The correlation between adult illicit drug use/dependence and NAS was higher in states with a lower density of buprenorphine-waivered physicians and individuals in OTPs. Conclusions Measures of opioid use disorder treatment access dampened the correlation between illicit drug use/dependence and NAS. Future studies using community- or individual-level data may be better poised to answer the question of whether or not opioid use disorder treatment access improves NAS relative to adult opioid use.

scholarly journals Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Kirsten Marchand ◽  
Scott Beaumont ◽  
Jordan Westfall ◽  
Scott MacDonald ◽  
Scott Harrison ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Scoping Review ◽  
Treatment Engagement ◽  
Shared Decision ◽  
Patient Centered ◽  
Substance Use Disorder Treatment ◽  
Centered Care ◽  
Disorder Treatment ◽  
Substance Related Disorders

Abstract Background Despite ongoing efforts aimed to improve treatment engagement for people with substance-related disorders, evidence shows modest rates of utilization as well as client-perceived barriers to care. Patient-centered care (PCC) is one widely recognized approach that has been recommended as an evidence-based practice to improve the quality of substance use disorder treatment. PCC includes four core principles: a holistic and individualized focus to care, shared decision-making and enhanced therapeutic alliance. Aims This scoping review aimed to explore which PCC principles have been described and how they have defined and measured among people with substance-related disorders. Methods Following the iterative stages of the Arksey and O’Malley scoping review methodology, empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references were eligible if they focused on people accessing treatment for substance-related disorders and described PCC. Two reviewers independently screened the title/abstract and full-texts of references. Descriptive analyses and a directed content analysis were performed on extracted data. Findings One-hundred and forty-nine references met inclusion from the 2951 de-duplicated references screened. Therapeutic alliance was the most frequent principle of PCC described by references (72%); this was consistently defined by characteristics of empathy and non-judgment. Shared decision-making was identified in 36% of references and was primarily defined by client and provider strategies of negotiation in the treatment planning process. Individualized care was described by 30% of references and included individualized assessment and treatment delivery efforts. Holistic care was identified in 23% of references; it included an integrated delivery of substance use, health and psychosocial services via comprehensive care settings or coordination. Substance use and treatment engagement outcomes were most frequently described, regardless of PCC principle. Conclusions This review represents a necessary first step to explore how PCC has been defined and measured for people accessing substance use disorder treatment. The directed content analysis revealed population and context-specific evidence regarding the defining characteristics of PCC-principles that can be used to further support the implementation of PCC.

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