scholarly journals Negative Affect–Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e127-e138 ◽  
Author(s):  
Gadi Gilam ◽  
John A Sturgeon ◽  
Dokyoung S You ◽  
Ajay D Wasan ◽  
Beth D Darnall ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Negative Affect ◽  
Substance Use Disorders ◽  
Opioid Misuse ◽  
Related Factors ◽  
Opioid Prescription ◽  
Increased Risk ◽  
Patient Reported ◽  
Opioid Medications

Abstract Objective Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors. Methods A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect–related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders. Results Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity–worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04). Conclusions Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.

The Role of Negative Affect in the Course of Substance Use Disorders

2018 ◽  
Author(s):  
Elizabeth D. Reese ◽  
Jennifer Y. Yi ◽  
Ryan P. Bell ◽  
Stacey B. Daughters
Keyword(s):  
Substance Use ◽  
Negative Affect ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Theoretical Models ◽  
Central Mechanism ◽  
Substance Use Treatment ◽  
Increased Risk ◽  
The Impact

Negative affect (NA) plays a prominent role in theoretical models characterizing the course of substance use disorders and is thus considered a central mechanism contributing to maintenance of symptoms and increased risk for relapse. This chapter overviews theoretical models of substance use, highlighting the impact of NA within the addiction cycle. In this context, it examines the evidence linking NA to substance use disorder (SUD) development, maintenance, and relapse, highlighting the association between NA and addiction-specific processes including withdrawal and craving. It concludes with a discussion of current substance use treatment approaches that target NA, including promising new pharmacological and neurobiological treatments.

scholarly journals Mental health and opioid addiction comorbidities among chronic pain patients

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Kevin Cevasco ◽  
Bill Saunders
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Opioid Addiction ◽  
Screening Tools ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients

ObjectiveAssessing mental health and opioid addiction comorbidities among chronic pain patients using a large longitudinal clinical, operational, and laboratory data set.IntroductionThe National Institute for Drug Abuse Report, Common Comorbidities with Substance Use Disorders, states there are “many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa.”(1) Prescription opioids are amongst the most commonly used drugs that lead to illicit drug use.(2)Much of the data about the starting point of the prescription opioid addiction is in the patient health history and is recorded within the provider electronic health record and administrative systems.DescriptionThere are a variety of addiction and misuse risk screening tools available and selecting appropriate tools screening can be confusing for providers. Examples of common screening tools: Opioid Abuse Risk Screener (OARS), Opioid Risk Tool (ORT), Screener and Opioid Assessment for Patients with Pain (SOAPP), Current Opioid Misuse Measure (COMM), Diagnosis, Intractability, Risk, and Efficacy (DIRE). These opioid risk screening tools are interview based and vary in how they survey for psychosocial factors. The screening tools are useful, but are meant only to alert the provider to conduct further investigation.(3)Understanding how the comorbidities recorded in the patient’s clinical interactions may help improve risk assessment investigations and ongoing monitoring programs. Studying the chronic pain patients’ longitudinal clinical, operational, and laboratory records provides the basis for better study controls than those using population based on emergency department admission and mortality events.MethodsThe analysis leverages IBM's Explorys electronic health record (EHR) data, a large integrated source of real world clinical, operational and lab data across 39 large integrated delivery networks that span the continuum of care. In addition to demographic characteristics of drug abusers, we will describe common comorbidities of selected mental health diagnoses, examine coding-related issues, distinguish chronic and episodic addiction and look for regional differences due to state/local level prescribing training and provider addiction awareness.How the Moderator Intends to Engage the Audience in Discussions on the TopicPromote the event through interatction with the @ISDS twitter account and #ISDS19 hashtag.Solicit question for presenters-panelists through social media before the briefing, and meet with presenters before the event to tune the presenations to areas of interest.Conduct a demographic poll of the audience to get them engaged. Ask audience to stand to show their organization-role. e.g. state-local public health, provider, vendor. This helps the presenters adapt to the audience profile.After each panelist speaks, have the panelist ask a question to the audience about a lingering question that arose during the research. Limit the audience to ~1 minute to answer. Allow panelists to ask a few more questions if the process is working, but limit to overall event time schedule.Finish with Q&A from the audience.References1. Abuse NI on D. Part 1: The Connection Between Substance Use Disorders and Mental Illness [Internet]. [cited 2018 Sep 29]. Available from: https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness2. Lankenau SE, Teti M, Silva K, Bloom JJ, Harocopos A, Treese M. Initiation into prescription opioid misuse amongst young injection drug users. Int J Drug Policy. 2012 Jan 1;23(1):37–44.3. Hudspeth RS. Safe Opioid Prescribing for Adults by Nurse Practitioners: Part 1. Patient History and Assessment Standards and Techniques. J Nurse Pract. 2016 Mar;12(3):141–8. 

scholarly journals Quality of life and its related factors in women with substance use disorders referring to substance abuse treatment centers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Majid Barati ◽  
Khadijeh Bandehelahi ◽  
Tahereh Nopasandasil ◽  
Hanieh Jormand ◽  
Amir Keshavarzi
Keyword(s):  
Quality Of Life ◽  
Substance Abuse ◽  
Substance Use ◽  
Substance Abuse Treatment ◽  
Substance Use Disorders ◽  
Related Factors ◽  
Substance Abuse Treatment Centers ◽  
The Mean ◽  
Abuse Treatment

Abstract Background Substance-Related Disorders are among the most common social problems caused by using legal and illegal substances. Therefore, this study aimed at determining the quality of life (QoL) and its related factors among women with substance use disorders referring to substance abuse treatment centers in Hamadan, west of Iran. Methods This cross-sectional study was carried out on 120 Iranian female substance users recruited through the census sampling method in 2018. Data collection tools consisted of demographic characteristics and QoL assessment (SF-36). Data were analyzed using SPSS-16 via one-way analysis of variance (ANOVA) and chi-square tests. Results The mean age of the participants was 33.2 ± 12.1 years and the mean score of their total QoL was 35.35 ± 13.5. The results of multiple linear regression analysis indicated that using methamphetamine (β =  − 6.62) was the predictor of QoL in women. Moreover, there was a significant association between QoL and age (p < 0.001), educational level (p = 0.011), and age at first use (p < 0.001). Conclusion According to the results, the participants’ QoL was found to be at an unsatisfactory level. So, it is essential to implement educational help-seeking behavior for treatment and effectiveness educational, as well as holding mental health intervention, school-based substance abuse prevention, and harm reduction programs of substance use. This is especially important in adolescents, young, low-educated, early drug use, and methamphetamine user women, as it may increase the QoL

Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Sarah C Snow ◽  
Gregg C Fonarow ◽  
Joseph A Ladapo ◽  
Donna L Washington ◽  
Katherine Hoggatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Substance Use ◽  
Native American ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Opioid Use ◽  
Drug Use Disorders ◽  
Increased Risk ◽  
Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

scholarly journals Using polygenic scores for identifying individuals at increased risk of substance use disorders in clinical and population samples

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Peter B. Barr ◽  
Albert Ksinan ◽  
Jinni Su ◽  
Emma C. Johnson ◽  
Jacquelyn L. Meyers ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Increased Risk ◽  
Polygenic Scores

Brain Development and the Risk for Substance Abuse

2013 ◽  
pp. 706-715
Author(s):  
Kristina Caudle ◽  
B.J. Casey
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Brain Development ◽  
Substance Use Disorders ◽  
Animal Studies ◽  
Substance Abuse Problem ◽  
Increased Risk ◽  
Drug And Alcohol ◽  
The Brain ◽  
Developmental Window

Drug and alcohol dependence affects millions each year. Adolescence is a period of increased risk for substance use disorders. Understanding how the brain is changing during this developmental window relative to childhood and adulthood and how these changes vary across individuals is critical for predicting risk of later substance abuse and dependence. This chapter provides an overview of recent human imaging and animal studies of brain development focusing on changes in corticostriatal circuitry that has been implicated in addiction. Behavioral, clinical, and neurobiological evidence is provided to help elucidate who may be most at risk for developing a substance abuse problem and whenthey may be most vulnerable.

scholarly journals Clinical impact of COVID-19 on people with substance use disorders

2020 ◽  
Author(s):  
G Vallecillo ◽  
R Perelló ◽  
R Güerri ◽  
F Fonseca ◽  
M Torrens
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Severe Pneumonia ◽  
Epidemiological Studies ◽  
Urban Hospital ◽  
Increased Risk ◽  
Disorder Treatment ◽  
Low Incidence ◽  
The Impact ◽  
Larger Sample

Abstract Background People with substance use disorders are considered at increased risk of COVID-19 and its more serious complications, however data on the impact of COVID-19 are lacking. The study aimed to describe the clinical characteristics and outcomes of COVID-19 on people with substance use disorders. Methods an observational study was carried out including patients aged ≥ years with COVID-19 pneumonia admitted to an urban hospital during March 12 to June 21,2020. Results Among 2078 patients admitted, 27 (1.3%) were people with substance use disorders: 23(85.2%) were men with a median age of 56.1 + 10.3 years and. The main SUD were alcohol in 18(66.7%) patients, heroine in 6(22.2%) and cocaine in 3(11.1%) and 24(88.8%) patients were on ongoing substance use disorder treatment. One or more comorbidities associated to COVID-19 risk were observed in 18(66.6%) of patients. During a median length of stay of 10 days (IQR:7-19), severe pneumonia developed in 7(25.9%) patients, acute respiratory distress syndrome in 5 (18.5%) and none died. Conclusion Larger sample sizes and sero-epidemiological studies are needed to confirm the low incidence of severe COVID-19 on patients with SUD.

Associations between Childhood Abuse and Chronic Pain in Adults with Substance Use Disorders

2020 ◽  
pp. 1-6
Author(s):  
Nadine R. Taghian ◽  
R. Kathryn McHugh ◽  
Margaret L. Griffin ◽  
Alexandra R. Chase ◽  
Shelly F. Greenfield ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Childhood Abuse ◽  
Substance Use Disorders
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