“Who’s gonna love a junkie? But he does”: Exploring couples’ identity negotiations and dyadic coping in the context of opioid use disorder

2020 ◽  
Vol 37 (5) ◽  
pp. 1634-1652
Author(s):  
Jenny L. Crowley ◽  
Laura E. Miller
Keyword(s):  
Communication Theory ◽  
Romantic Partners ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Structured Interviews ◽  
Theoretical Understanding ◽  
Communication Theory Of Identity ◽  
Identity Negotiations ◽  
Identity Gaps

Opioid use disorder (OUD) is a leading cause of accidental death in the U.S., and people with OUD may rely on romantic partners to dyadically cope with their illness. Guided by the communication theory of identity, this study examines the identity tensions experienced by couples managing OUD and how identity negotiations contribute to couples’ efforts to dyadically cope with OUD. Semi-structured interviews were conducted with 19 dyads and 6 individuals ( N = 44), all of whom were in relationships in which at least one partner was managing OUD. Analyses revealed that couples managing OUD experience three types of identity gaps: personal–relational, relational–enacted, and relational–communal identity gaps. These gaps coalesced around a central theme of couple identity paradoxes, which demonstrated the opportunities and potential downsides of dyadically coping with OUD. Findings deepen theoretical understanding of identity negotiation in couples and the role of relational identities in managing illness.

scholarly journals Syringe service program-based telemedicine linkage to opioid use disorder treatment: protocol for the STAMINA randomized control trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dennis P. Watson ◽  
James A. Swartz ◽  
Lisa Robison-Taylor ◽  
Mary Ellen Mackesy-Amiti ◽  
Kim Erwin ◽  
...  
Keyword(s):  
Study Protocol ◽  
Randomized Control Trial ◽  
Treatment Protocol ◽  
Opioid Use Disorder ◽  
Additional Treatment ◽  
Initial Assessment ◽  
Opioid Use ◽  
Structured Interviews ◽  
Randomized Control ◽  
Opioid Users

Abstract Background A key strategy for mitigating the current opioid epidemic is expanded access to medications for treating opioid use disorder (MOUD). However, interventions developed to expand MOUD access have limited ability to engage opioid users at higher levels of overdose risk, such as those who inject opioids. This paper describes the study protocol for testing STAMINA (Syringe Service Telemedicine Access for Medication-assisted Intervention through NAvigation), an intervention that engages high-risk opioid users at community-based syringe service programs (SSP) and quickly links them to MOUD using a telemedicine platform. Methods This randomized control trial will be conducted at three SSP sites in Chicago. All participants will complete an initial assessment with a provider from a Federally Qualified Health Center who can prescribe or refer MOUD services as appropriate. The control arm will receive standard referral to treatment and the intervention arm will receive immediate telemedicine linkage to the provider and (depending on the type of MOUD prescribed) provided transportation to pick up their induction prescription (for buprenorphine or naltrexone) or attend their intake appointment (for methadone). We aim to recruit a total of 273 participants over two years to provide enough power to detect a difference in our primary outcome of MOUD treatment linkage. Secondary outcomes include treatment engagement, treatment retention, and non-MOUD opioid use. Data will be collected using structured interviews and saliva drug tests delivered at baseline, three months, and six months. Fixed and mixed effects generalized linear regression analyses and survival analysis will be conducted to compare the probabilities of a successful treatment linkage between the two arms, days retained in treatment, and post-baseline opioid and other drug use. Discussion If successful, STAMINA’s telemedicine approach will significantly reduce the amount of time between SSP clients’ initial indication of interest in the medication and treatment initiation. Facilitating this process will likely lead to stronger additional treatment- and recovery-oriented outcomes. This study is also timely given the need for more rigorous testing of telemedicine interventions in light of temporary regulatory changes that have occurred during the COVID-19 pandemic. Trial registration ClinicalTrials.gov (Clinical Trials ID: NCT04575324 and Protocol Number: 1138–0420). Registered 29 September 2020. The study protocol is also registered on the Open Science Framework (DOI 10.17605/OSF.IO/4853 M).

Association of Medication-Assisted Treatment and Age With Treatment Completion Among Veterans Seeking Non-VA Treatment for Opioid use Disorder at Non-Veterans Health Administration Facilities

2021 ◽  
Author(s):  
Joseph G Pickard ◽  
Carissa van den Berk-Clark ◽  
Monica M Matthieu
Keyword(s):  
Positive Impact ◽  
Treatment Completion ◽  
Armed Forces ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Health Administration ◽  
Opioid Use ◽  
Data Set ◽  
Medication Assisted Treatment

ABSTRACT Background Medication-assisted treatment has been shown to be effective in treating opioid use disorder among both older adults and veterans of U.S. Armed Forces. However, limited evidence exists on MAT’s differential effect on treatment completion across age groups. This study aims to ascertain the role of MAT and age in treatment completion among veterans seeking treatment in non–Department of Veterans Affairs healthcare facilities for opioid use disorder. Methods We used the Treatment Episode Data Set—Discharges (TEDS-D; 2006-2017) to examine trends in treatment and MAT usage over time and TEDS-2017 to determine the role of age and MAT in treatment completion. We examined a subset of those who self-identified as veterans and who sought treatment for an opioid use disorder. Results Veterans presented in treatment more often as heroin users than prescription opioid users, and older veterans were more likely to get MAT than younger veterans. We found that before propensity score matching, MAT initially appeared to be associated with a lower likelihood of treatment completion in inpatient ($\beta $ = −1.47, 95% CI −1.56 to −1.39) and outpatient ($\beta $ = −1.40, 95% CI −2.21 to −0.58) settings, and age (50+ years) appeared to mediate the effect of MAT on treatment completion ($\beta $ = −0.54, 95% CI −0.87 to −0.21). After matching, older veterans were more likely to complete substance use disorder treatment ($\beta $ = 0.21, 95% CI 0.01-0.42), while age no longer mediated the effect of MAT, and MAT had a significant positive impact on treatment completion in detox settings ($\beta $ = 1.36, 95% CI 1.15-1.50) and inpatient settings ($\beta $ = 1.54, 95% CI 1.37 -1.71). Conclusion The results show that age plays an important role in outpatient treatment completion, while MAT plays an important role in inpatient treatment completion. Implications for veterans are discussed.

A review of the evidence to explain pharmacological basis of injection (ab)use of buprenorphine–naloxone tablets

2021 ◽  
Vol 17 (7) ◽  
pp. 141-152
Author(s):  
Tamoud Modak, MD, DM ◽  
Siddharth Sarkar, MD, MRCPsych ◽  
Yatan Pal Singh Balhara, MD
Keyword(s):  
Public Health Problem ◽  
Opioid Use Disorder ◽  
Critical Examination ◽  
Evidence Based ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Evidence Based Treatment ◽  
Opioid Replacement Therapy ◽  
Pharmacological Basis

Opioid use disorder is a major public health problem, and opioid replacement therapy with buprenorphine (BPN) is a clinically effective and evidence-based treatment for it. To deter misuse of the tablet through the injecting route, BPN coformulated with naloxone (BNX) in 4:1 ratio is available in many countries. Despite this, significant diversion and injecting use of the BNX combination has been reported from across the world. In this article, the pharmacological properties of BPN and BNX and the evidence for their diversion are reviewed. Also, a critical examination is made of the evidence supporting the role of naloxone in reducing the agonist effects of BPN when used through the injecting route. Based on this evidence, a hypothesis explaining the continued diversion of BNX has been proposed.

scholarly journals The role of social network support in treatment outcomes for medication for opioid use disorder: a systematic review

2020 ◽  
Author(s):  
Navin Kumar ◽  
William Oles ◽  
Benjamin A. Howell ◽  
Kamila Janmohamed ◽  
Selena T. Lee ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Social Connections ◽  
Opioid Use ◽  
Network Support ◽  
Social Network Support ◽  
Partner Relationships

AbstractBackgroundSocial connections can lead to contagion of healthy behaviors. Successful treatment of patients with opioid use disorder, as well as recovery of their communities from the opioid epidemic, may lay in rebuilding social networks. Strong social networks of support can reinforce the benefits of medication treatments that are the current standard of care and the most effective tool physicians have to fight the opioid epidemic.MethodsWe conducted a systematic review of electronic research databases, specialist journals and grey literature up to August 2020 to identify experimental and observational studies of social network support in patient populations receiving medication for opioid use disorder (MOUD). We place the studies into a conceptual framework of dynamic social networks, examining the role of networks before MOUD treatment is initiated, during the treatment, and in the long-term following the treatment. We analyze the results across three sources of social network support: partner relationships, family, and peer networks. We also consider the impact of negative social connections.ResultsOf 5193 articles screened, 46 studies were identified as meeting inclusion criteria (12 were experimental and 34 were observational). 39 studies indicated that social network support, or lack thereof, had a statistically significant relationship with improved MOUD treatment outcomes. We find the strongest support for the positive impact of family and partner relationships when integrated into treatment attempts. We also identify strong evidence for a negative impact of maintaining contacts with the drug-using network on treatment outcomes.ConclusionsSocial networks significantly shape effectiveness of opioid use disorder treatments. While negative social ties reinforce addiction, positive social support networks can amplify the benefits of medication treatments. Targeted interventions to reconstruct social networks can be designed as a part of medication treatment with their effects evaluated in improving patients’ odds of recovery from opioid use disorder and reversing the rising trend in opioid deaths.

The Role of Hospitalists in Treating Opioid Use Disorder

2020 ◽  
Vol 14 (2) ◽  
pp. 178
Author(s):  
Richard Bottner ◽  
Christopher Moriates ◽  
Carlos Tirado
Keyword(s):  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals Business to business digital content marketing: marketers’ perceptions of best practice

2014 ◽  
Vol 8 (4) ◽  
pp. 269-293 ◽  
Author(s):  
Geraint Holliman ◽  
Jennifer Rowley
Keyword(s):  
Information Needs ◽  
Good Practice ◽  
Digital Content ◽  
Structured Interviews ◽  
Theoretical Understanding ◽  
Content Type ◽  
Inbound Marketing ◽  
Business To Business ◽  
Content Marketing

Purpose – This paper aims to draw attention to the emerging phenomenon of business to business (B2B) digital content marketing, offers a range of insights and reflections on good practice and contributes to theoretical understanding of the role of digital content in marketing. B2B digital content marketing is an inbound marketing technique and hence offers a solution to the declining effectiveness of traditional interruptive marketing techniques. Design/methodology/approach – Semi-structured interviews were conducted with 15 key informants involved in B2B content marketing in the USA, UK and France, in five industry sectors. Findings – B2B digital content marketing is an inbound marketing technique, effected through web page, social media and value-add content, and is perceived to be a useful tool for achieving and sustaining trusted brand status. Creating content that is valuable to B2B audiences requires brands to take a “publishing” approach, which involves developing an understanding of the audience’s information needs, and their purchase consideration cycle. Valuable content is described as being useful, relevant, compelling and timely. Content marketing requires a cultural change from “selling” to “helping”, which in turn requires different marketing objectives, tactics, metrics and skills to those associated with more traditional marketing approaches. The article concludes with a theoretical discussion on the role of digital content in marketing, thereby contextualising the findings from this study within a broader exploration of the role of digital content in marketing and relational exchanges. Originality/value – As the first research study to explore the use of digital content marketing in B2B contexts, this research positions digital content marketing with regard to prior theory, and provides both an agenda for further research, and suggestions for practice.

The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder

2020 ◽  
Author(s):  
Zhenhao Shi ◽  
Kanchana Jagannathan ◽  
James H. Padley ◽  
An‐Li Wang ◽  
Victoria P. Fairchild ◽  
...  
Keyword(s):  
Cue Reactivity ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Drug Cue
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