Exposure to Violence and Posttreatment Substance Use Among Patients With Opioid Use Disorder

Exposure to violence can lead to a dramatic increase in the likelihood of the development of a substance use disorder (SUD). Given the overlap between the two, substance use for survivors of violence, then, can be a coping mechanism to manage the traumatic effects of abuse and persistent use can evolve into a diagnosable SUD. This study was designed to examine the posttreatment substance use among adults who have a history of exposure to violence and sought treatment for opioid use disorder. Data for this study were drawn from the Comprehensive Addiction Treatment Outcome Research system. Among the 13,105 patients included in the study, 444 (3.4%) received a formal diagnosis for opioid use disorder. Female victims of violence are at a greater risk of suffering injuries related to violence, resulting in increased levels of medical care utilization , which may prompt the initiation and prolonged use of prescription pain relief medication. Related to this important finding is another indicating that exposure to violence at multiple points in the past was associated with more severe indicators of substance use. These data show that there is a relationship between exposure to violence, SUDs, and relapse among patients seeking treatment. Not only must patients and treatment providers address these past violent experiences as important psychological factors in recovery, but in the context of opioid use disorder, physical injuries contributing to chronic pain may also trigger persistent substance use.

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Medication for Addiction Treatment and Postpartum Health Care Utilization Among Pregnant Persons With Opioid Use Disorder

Journal of Addiction Medicine ◽

10.1097/adm.0000000000000827 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Katherine A. Ahrens ◽

Carole A. McBride ◽

Alane O’Connor ◽

Marjorie C. Meyer

Keyword(s):

Health Care ◽

Health Care Utilization ◽

Addiction Treatment ◽

Opioid Use Disorder ◽

Care Utilization ◽

Opioid Use ◽

Postpartum Health

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Designing an “Ideal” Substance Use Disorder Treatment Center: Perspectives of People Who Have Utilized Medications for Opioid Use Disorder

Qualitative Health Research ◽

10.1177/1049732320971231 ◽

2020 ◽

pp. 104973232097123

Author(s):

Barbara Andraka-Christou ◽

Olivia Randall-Kosich ◽

Rachel Totaram

Keyword(s):

Substance Use ◽

Harm Reduction ◽

Substance Use Disorder ◽

Professional Education ◽

Opioid Use Disorder ◽

Treatment Center ◽

Opioid Use ◽

Substance Use Disorder Treatment ◽

History Of ◽

Disorder Treatment

Treatment preferences of people with opioid use disorder (OUD) have been underexplored, especially among those with a history of utilizing medications for opioid use disorder (MOUD). Therefore, we sought to understand preferred characteristics of substance use disorder treatment centers among people recovering from OUD with a history of MOUD utilization. We recruited 30 individuals from eight states through snowball sampling initiated at three syringe exchange programs. Telephone interviews were audio-recorded and transcribed in 2018–2019. Inductive thematic analysis in Dedoose software occurred iteratively with recruitment. The following were “ideal” treatment center themes: a menu of treatment options, including MOUD and nonspiritual peer support groups; an integrated system with multiple care levels (e.g., outpatient, residential); a harm reduction approach, including for goal setting and success measures; adjunctive support services (e.g., housing); and employees with recovery experience and professional education. Many preferences directly related to core principles of person-centered care and harm reduction.

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LO91: Opioid poisoning and opioid use disorder in older trauma patients

CJEM ◽

10.1017/cem.2020.145 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S40-S41

Author(s):

R. Daoust ◽

J. Paquet ◽

L. Moore ◽

A. Cournoyer ◽

M. Emond ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorder ◽

Proportional Hazards ◽

Opioid Use Disorder ◽

Cox Proportional Hazards ◽

Trauma Patients ◽

Opioid Use ◽

Multicenter Cohort Study ◽

Opioid Prescription ◽

History Of

Introduction: Patients hospitalized following a trauma will be frequently treated with opioids during their stay and after discharge. We examined the relationship between acute phase (< 3 months) opioid use after discharge and the risk of opioid poisoning (OP) or opioid use disorder (OUD) in older trauma patients Methods: In a retrospective multicenter cohort study conducted on registry data, we included all patients aged 65 years and older admitted (hospital stay >2 days) for injury in 57 trauma centers in the province of Quebec (Canada) between 2004 and 2014. We searched for OP and OUD from ICD-9 and ICD-10 code diagnosis that resulted in a hospitalization or a medical consultation after their initial injury. Patients that filled an opioid prescription within a 3-month period after sustaining the trauma were compared to those who did not fill an opioid prescription during that period using Cox proportional hazards regressions. Results: A total of 70,314 participants were retained for analysis; median age was 82 years (IQR: 75-87), 68% were women, and 34% of the patients filled an opioid prescription within 3-months of the initial trauma. During a median follow-up of 2.6 years (IQR: 1-5), 192 participants (0.30%; 95%CI: 0.25%-0.35%) were hospitalized for OP and 73 (0.10%; 95%CI: 0.07%-0.13%) were diagnosed with OUD. Having filled an opioid prescription within 3-months of injury was associated with an increased hazard ratio of OP (2.6; 95%CI: 1.9-3.5) and OUD (4.0; 95%CI: 2.3-7.0). However, history of OP (2.7; 95%CI: 1.2-6.1), of substance use disorder (4.3; 95%CI: 2.4-7.9), or of opioid prescription filled (2.7; 95%CI: 2.1-3.5) before trauma were also related to OP or OUD. Conclusion: Opioid poisoning and opioid use disorder are rare events after hospitalization for trauma in older patients. However, opioids should be used cautiously in patients with history of substance use disorder, opioid poisoning or opioid use during the past year.

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Suicidology and Substance abuse in Adolescence

European Psychiatry ◽

10.1016/s0924-9338(09)70524-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

N. Werner ◽

J.-P. Kahn

Keyword(s):

Substance Use ◽

Childhood Abuse ◽

Substance Use Disorder ◽

Suicidal Behaviour ◽

Treatment Protocol ◽

Opioid Use Disorder ◽

Integrated Treatment ◽

Opioid Use ◽

Treatment And Prevention ◽

History Of

Adolescence is a critical period for suicidal risk. Suicide currently ranks as the second or third leading cause of mortality among adolescents in developped countries. It has been shown that a history of suicidal act, of depressive disorder and of a substance use disorder (SUD), alcohol and drugs, are the most prominent risk factors for suicidal behaviour among adolescents.Data on alcohol and drug use disorders and suicide consisted primarily of reports on alcohol use disorders and, to a lesser extent, opioid use disorder. The magnitude of the association with other drugs is still unclear.The relationships between substance use disorder and suicidal behaviour are multiple: In the long term, SUD may be associated with increases in stress and co-occuring psychopathology (poor self esteem, feeling of worthlessness, isolation).These elements may reach a level where a suicide attempt is viewed as a means to cope with perceived unsolvable difficulties. During life crises, SUD can also be responsible for inhibiting adaptative coping and desinhibiting suicidal behaviour. Finally, SUD and suicidal behaviour share common vulnerability factors: history of childhood abuse, genetically determined dimensions such as impulsivity or psychiatric disorders, particularly unipolar depressive and bipolar disorder.Given the comorbidity between SUD and suicide, it is essential for treatment and prevention that all suicidal adolescents be screened for SUD and vice versa. Ideally, adolescents who receive diagnosis of SUD and co-occuring suicidality should follow an integrated treatment protocol that addresses both conditions.

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Four single nucleotide polymorphisms in genes involved in neuronal signaling are associated with opioid use disorder in West Virginia

Journal of Opioid Management ◽

10.5055/jom.2019.0491 ◽

2019 ◽

Vol 15 (2) ◽

pp. 103-109 ◽

Cited By ~ 1

Author(s):

Shane W. Kaski, BS, MD/PhD ◽

Stephan Brooks, MPH ◽

Sijin Wen, PhD ◽

Marc W. Haut, PhD ◽

David P. Siderovski, PhD ◽

...

Keyword(s):

Substance Use ◽

Pilot Study ◽

General Population ◽

Single Nucleotide Polymorphisms ◽

West Virginia ◽

Addiction Treatment ◽

Opioid Use Disorder ◽

Nucleotide Polymorphisms ◽

Opioid Use ◽

Single Nucleotide

Objective: Pilot study to assess utility in opioid use disorder (OUD) of a panel of single nucleotide polymorphisms (SNPs) in genes previously related to substance use disorder (SUD) and/or phenotypes that predispose individuals to OUD/SUD. Design: Genetic association study.Setting: West Virginia University’s Chestnut Ridge Center Comprehensive Opioid Addiction Treatment (COAT) clinic for individuals diagnosed with OUD. Patients: Sixty patients 18 years of age or older with OUD undergoing medication (buprenorphine/naloxone)-assisted treatment; all 60 patients recruited contributed samples for genetic analysis.Outcome measure(s): Minor allele frequencies for SNPs.Results: Four of the 14 SNPs examined were present at frequencies that are statistically significantly different than in a demographically matched general population. Conclusions: For the purposes of testing WV individuals via genetic means for predisposition to OUD, at least four SNPs in three genes are likely to have utility in predicting susceptibility. Additional studies with larger populations will need to be conducted to confirm these results before use in a clinical setting.

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Levels of Impulsivity, Hyperactivity, and Inattention and the Association with Mental Health and Substance Use Severity in Opioid-Dependent Patients Seeking Treatment with Extended-Release Naltrexone

Journal of Clinical Medicine ◽

10.3390/jcm10194558 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4558

Author(s):

Ann Tarja Karlsson ◽

John-Kåre Vederhus ◽

Thomas Clausen ◽

Bente Weimand ◽

Kristin Klemmetsby Solli ◽

...

Keyword(s):

Substance Use ◽

Adult Adhd ◽

Extended Release ◽

Mental Distress ◽

Opioid Use Disorder ◽

Self Report ◽

Opioid Antagonist ◽

Opioid Use ◽

History Of ◽

Amphetamine Use

The level of impulsivity, hyperactivity, and inattention (IHI) is higher among patients with substance use disorder (SUD) than in the general population. However, the prevalence of such symptoms in patients seeking treatment with an opioid antagonist, such as extended-release naltrexone (XR-NTX), is unknown. We screened 162 patients with opioid use disorder (OUD) seeking treatment with XR-NTX in Norway using the Adult ADHD Self-Report Scale (ASRS) to estimate the prevalence of IHI alongside an assessment of mental and physical health and substance use. Sixty-six patients scored above the clinical cut-off on the ASRS. Higher levels of IHI were significantly associated with a longer history of frequent amphetamine use, current alcohol use, and greater mental distress. Mental distress was the strongest factor associated with higher levels of IHI. The introduction of screening for IHI and mental distress in opioid maintenance treatment and XR-NTX would likely improve the quality of care and enable clinicians to tailor interventions to the needs of patients with high levels of IHI to prevent treatment discontinuation.

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Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116163 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6163

Author(s):

Rosemarie Martin ◽

Augustine W. Kang ◽

Audrey A. DeBritz ◽

Mary R. Walton ◽

Ariel Hoadley ◽

...

Keyword(s):

Substance Use ◽

Mixed Methods ◽

Telephone Counseling ◽

Opioid Use Disorder ◽

Appropriate Technology ◽

Counseling Services ◽

Opioid Use ◽

Qualitative Evidence ◽

Positive Experiences ◽

Anxiety Depression

Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era.

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