scholarly journals 1134. Substance Use Disorder Patients’ Perspectives of a Multidisciplinary Antimicrobial Infusion Service

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S596-S596
Author(s):  
Joy J Juskowich ◽  
Clinton G Cooper ◽  
Ruchi Bhandari ◽  
Stephanie S Boyd ◽  
Neil Reece ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Substance Use ◽  
Infectious Diseases ◽  
Substance Use Disorder ◽  
Antimicrobial Therapy ◽  
Addiction Treatment ◽  
Healthcare Providers ◽  
Injection Drugs ◽  
Addiction Therapy

Abstract Background Injection drug use is associated with infectious diseases such as endocarditis and osteomyelitis requiring prolonged intravenous (IV) antimicrobial therapy. Few programs offer simultaneous inpatient infectious disease and addiction treatment. WVU Medicine implemented a multidisciplinary Infusion Service (IS) to provide IV antimicrobial therapy while treating substance use disorder. From 2017 through 2019, IS cared for over 840 patients. The aim of this study was to evaluate IS by assessing patients’ perspectives of overall experience, interactions with healthcare providers, and preparation for continued recovery from substance use. Methods Adults ≥ 18 and < 90 years-old with substance use disorder on IS between November 2019 and May 2020 were eligible. Demographic, substance use, and infectious diseases data were obtained by chart review. Confidential surveys with questions about overall experience, interactions with healthcare providers, and preparation for continued recovery were administered during the first week after transfer to IS and again the week of discharge. Results Forty-two patients completed 39 initial and 12 follow up surveys. All used injection drugs, 85.7% (36/42) used opioids and 66.7% (28/42) used methamphetamine. Endocarditis was most common infection (61.9% (26/42)), with Staphylococcus aureus most often isolated (59.5% (25/42)). IS experience and care for infection were excellent or good in 97.4% (38/39) initial and 100% (12/12) follow up surveys. During IS, patients did not perceive being treated differently due to substance use in 94.9% (37/39) initial and 83.3% (10/12) follow up surveys. Before IS, patients perceived being treated differently in 84.6% (33/39) initial and 100% (12/12) follow up surveys. Patients felt IS would help with continued recovery in 84.6% (33/39) initial and 100% (12/12) follow up surveys. Conclusion According to patients’ perspectives, IS is effective in creating a positive overall healthcare experience, reducing stigma associated with substance use, and preparing patients for continued recovery after discharge. This study supports combining inpatient infectious disease and addiction therapy. Infectious diseases providers should be educated about this multidisciplinary approach. Disclosures All Authors: No reported disclosures

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

scholarly journals Patient-centred care for addiction treatment: a scoping review protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024588 ◽  
Author(s):  
Kirsten Marchand ◽  
Scott Beaumont ◽  
Jordan Westfall ◽  
Scott MacDonald ◽  
Scott Harrison ◽  
...  
Keyword(s):  
Substance Use ◽  
Scoping Review ◽  
Addiction Treatment ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Open Science ◽  
Patient Centred Care ◽  
Healthcare Settings ◽  
Problematic Substance Use ◽  
Problematic Substance

IntroductionSubstance use disorders are chronic conditions that require a multidimensional treatment approach. Despite ongoing efforts to diversify such treatments, evidence continues to illuminate modest rates of treatment engagement and perceived barriers to treatment. Patient-centred care (PCC) is one approach that may strengthen the responsiveness of treatments for people with problematic substance use. The aim of this scoping review is to explore how the principles of PCC have been implemented and operationalised in healthcare settings for people with problematic substance use.Methods and analysisThis scoping review follows the iterative stages of the Arksey and O’Malley framework. Both empirical (from Medline, Embase, PsycINFO, CINAHL and ISI Web of Science) and grey literature references will be considered if they focused on populations with problematic substance use and described or measured PCC or one of its principles in a health-oriented context. Two reviewers will independently screen references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria. A descriptive overview, tabular and/or graphical summaries, and a directed content analysis will be carried out on extracted data. This scoping review has been registered with Open Science Framework (https://osf.io/5swvd/).Ethics and disseminationThis review will systematically examine the extent and nature of existing evidence of PCC in addiction research and clinical practice. Such evidence will contribute to the operationalisation of PCC for people with problematic substance use. A multidisciplinary team has been gathered to represent the needs of people with problematic substance use, healthcare providers and decision-makers. The team’s knowledge users will be engaged throughout this review and will participate in dissemination activities (eg, workshops, presentations, publications, reports).

scholarly journals Rural Clients’ Continuity Into Follow‐Up Substance Use Disorder Treatment: Impacts of Travel Time, Incentives, and Alerts

2020 ◽  
Vol 36 (2) ◽  
pp. 196-207
Author(s):  
Deborah W. Garnick ◽  
Constance M. Horgan ◽  
Andrea Acevedo ◽  
Margaret T. Lee ◽  
Lee Panas ◽  
...  
Keyword(s):  
Substance Use ◽  
Travel Time ◽  
Substance Use Disorder ◽  
Substance Use Disorder Treatment ◽  
Rural Clients ◽  
Disorder Treatment

Specialized assertive community treatment intervention for homeless youth with first episode psychosis and substance use disorder: A 2‐year follow‐up study

2019 ◽  
Vol 14 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Virginie Doré‐Gauthier ◽  
Jean‐Philippe Miron ◽  
Dider Jutras‐Aswad ◽  
Clairélaine Ouellet‐Plamondon ◽  
Amal Abdel‐Baki
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Homeless Youth ◽  
First Episode Psychosis ◽  
Community Treatment ◽  
First Episode ◽  
Treatment Intervention ◽  
Follow Up Study ◽  
Episode Psychosis

scholarly journals An Educational Forum to Engage Infectious Diseases and Microbiology Residents in Resource Stewardship Modelled after the Choosing Wisely Campaign

2015 ◽  
Vol 26 (5) ◽  
pp. 231-233 ◽  
Author(s):  
Derek R MacFadden ◽  
Wayne L Gold ◽  
Ibrahim Al-Busaidi ◽  
Jeffrey D Craig ◽  
Dan Petrescu ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Care Delivery ◽  
Daily Practice ◽  
Choosing Wisely ◽  
Delphi Panel ◽  
Potential Harm ◽  
Modified Delphi ◽  
Five Practices

BACKGROUND: Rising costs present a major threat to the sustainability of health care delivery. Resource stewardship is increasingly becoming an expected competency of physicians. The Choosing Wisely framework was used to introduce resource stewardship at a national educational retreat for infectious disease and microbiology residents.METHODS: During the 2014 Annual Canadian Infectious Disease and Microbiology Resident Retreat in Toronto, Ontario, infectious disease (n=50) and microbiology (n=17) residents representing 11 Canadian universities from six provinces, were invited to participate in a modified Delphi panel. Participants were asked, in advance of the retreat, to submit up to five practices that infectious disease and microbiology specialists should not routinely perform due to lack of proven benefit(s) and/or potential harm to patients. Submissions were discussed in small and large group forums using an iterative approach involving electronic polling until consensus was reached for five practices. A finalized list was created for both educational purposes and for residents to consider enacting; however, it was not intended to replace formal society-endorsed statements. A follow-up survey at two-months was conducted.RESULTS: Consensus was reached by the residents regarding five low-value practices within the purview of infectious diseases and microbiology physicians. After the retreat, 20 participants (32%) completed the follow-up survey. The majority of respondents (75%) believed that the session was at least as relevant as other sessions they attended at the retreat, including 95% indicating that at least some of the material discussed was new to them. Since returning to their home institutions, nine (45%) respondents have incorporated what they learned into their daily practice; four (20%) reported that they have considered initiating a project related to the session; and one (5%) reported having initiated a project.CONCLUSIONS: The present educational forum demonstrated that trainees can become actively engaged in the identification and discussion of low-value practices. Embedding residence training programs with resource stewardship education will be necessary to improve the value of care offered by the future members of our profession.

scholarly journals Young adults’ reasons for dropout from residential substance use disorder treatment

2016 ◽  
Vol 17 (1) ◽  
pp. 24-40 ◽  
Author(s):  
Kristoffer Nordheim ◽  
Espen Walderhaug ◽  
Ståle Alstadius ◽  
Ann Kern-Godal ◽  
Espen Arnevik ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Social Work Practice ◽  
University Hospital ◽  
Personal Contact ◽  
User Perspective ◽  
Substance Use Disorder Treatment ◽  
Drug Craving ◽  
Disorder Treatment

Dropout from substance use disorder treatment is usually investigated and understood from a perspective of quantitative patient-related factors. Patients’ own perspectives (user perspective) are rarely reported. This study, therefore, aimed to explore patients’ own understanding of their dropout from residential substance use disorder treatment. The participants were 15 males and females, aged 19–29 years, who had dropped out of residential substance use disorder treatment at the Department of Addiction Treatment, Oslo University Hospital, Norway. Qualitative methodology with semistructured interviews was used to explore how the participants described their dropout and their reasons for doing so. Thematic analysis was used as the framework for analyzing the data derived from the interviews. Dropout had different meanings for different participants. It was understood as a break from treatment, as an end to treatment, or as a means of reduced treatment intensity. Against that background, four main themes for dropout were found: drug craving, negative emotions, personal contact, and activity. Patient and treatment factors seem to interact when participants explore reasons for their dropout. A complex pattern of variables is involved. As remedies, participants suggested that substance use disorder treatment should provide more focus on drug craving and training to understand and tolerate emotional discomfort. They also wanted closer contact with the staff during treatment, more activities, and rigorous posttreatment follow-up. These findings from the user perspective have important implications for substance use disorder treatment, clinical and social work practice, management, and research.

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

scholarly journals A Motion-Activated Video Game for Prevention of Substance Use Disorder Relapse in Youth: Pilot Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Lorien C Abroms ◽  
Marc Fishman ◽  
Hoa Vo ◽  
Shawn C Chiang ◽  
Victoria Somerville ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Video Game ◽  
Addiction Treatment ◽  
Intervention Group ◽  
Body Motion ◽  
Control Group ◽  
Inpatient Setting ◽  
Game Play ◽  
Treatment As Usual

BACKGROUND Body motion-activated video games are a promising strategy for promoting engagement in and adherence to addiction treatment among youth. OBJECTIVE This pilot randomized trial (N=80) investigated the feasibility of a body motion–activated video game prototype, Recovery Warrior 2.0, targeting relapse prevention in the context of a community inpatient care program for youth. METHODS Participants aged 15-25 years were recruited from an inpatient drug treatment program and randomized to receive treatment as usual (control) or game play with treatment as usual (intervention). Assessments were conducted at baseline, prior to discharge, and at 4 and 8 weeks postdischarge. RESULTS The provision of the game play intervention was found to be feasible in the inpatient setting. On an average, participants in the intervention group played for 36.6 minutes and on 3.6 different days. Participants in the intervention group mostly agreed that they would use the refusal skills taught by the game. Participants in the intervention group reported attending more outpatient counseling sessions than those in the control group (10.8 versus 4.8), but the difference was not significant (P=.32). The game had no effect on drug use at 4 or 8 weeks postdischarge, with the exception of a benefit reported at the 4-week follow-up among participants receiving treatment for marijuana addiction (P=.04). CONCLUSIONS Preliminary evidence indicates that a motion-activated video game for addiction recovery appears to be feasible and acceptable for youth within the context of inpatient treatment, but not outpatient treatment. With further development, such games hold promise as a tool for the treatment of youth substance use disorder. CLINICALTRIAL ClinicalTrials.gov NCT03957798; https://clinicaltrials.gov/show/NCT03957798 (Archived by WebCite at http://www.webcitation.org/78XU6ENB4)

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