Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review

2021 ◽  
pp. 107839032110501
Author(s):  
Karen Werder ◽  
Alexa Curtis ◽  
Stephanie Reynolds ◽  
Jason Satterfield
Keyword(s):  
Health Care ◽  
Treatment Outcomes ◽  
Health Care Professionals ◽  
Treatment Method ◽  
Opioid Use Disorder ◽  
Narrative Review ◽  
Intentional Stance ◽  
Review Of The Literature ◽  
Opioid Use ◽  
Education Practice

BACKGROUND: Despite an increase in access to medications for opioid use disorder, less than 20% of individuals with opioid use disorder (OUD) receive treatment. Stigmatizing language has been identified as a potential trigger for explicit and implicit biases that may adversely affect treatment enrollment and quality of care for persons with OUD. AIMS: To conduct a narrative review of the literature on stigmatizing language and OUD, examine how treatment outcomes are affected, and present strategies to reduce bias and promote OUD treatment. METHOD: A narrative review of the literature between 2010 and 2019 was conducted using CINAHL, PubMed, and PsycINFO. Key search terms were opioid use disorder (or substance use disorder), stigma, and language. Fifty-two articles were screened for inclusion, and 17 articles were included in this review. RESULTS: The articles reviewed provide consensus that stigmatizing language toward persons with OUD fosters explicit and implicit bias and impedes engagement in treatment. Four themes emerged: (1) stigma and language, (2) stigma and language used by health care professionals, (3) stigma and language used by the general public, and (4) stigma and language used by people with OUD. CONCLUSIONS: Stigmatizing language is dehumanizing and plays a pivotal role in bias and discrimination that may contribute to unsatisfactory treatment outcomes among persons with OUD. Health care professionals, nursing in particular, must assume an intentional stance against stigma perpetuated toward persons with OUD through advocacy in education, practice, policy, and the media.

scholarly journals The impact of project ECHO on physician preparedness to treat opioid use disorder: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hunter M. Puckett ◽  
Jenny S. Bossaller ◽  
Lincoln R. Sheets
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Underserved Populations ◽  
Medical Condition ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Project Echo ◽  
The Impact

AbstractOpioid use disorder (OUD) is a medical condition that has evolved into a serious and deadly epidemic in the United States. Both medical and psychological interventions are called for to end this growing epidemic, but too few health care professionals are trained to treat OUD. One proven model of training physicians and cross-disciplinary teams in treating a variety of disorders is exemplified by Project ECHO (Extension for Community Healthcare Outcomes), a collaborative tele-mentoring program in which specialists train health-care workers to treat medical conditions, especially those that affect underserved populations. This systematic review found that Project ECHO has the potential to effectively extend current services to patients suffering from OUD, but that there is also a gap in knowledge regarding this type of training. The articles that we reviewed all presented evidence that Project ECHO improves healthcare provider preparedness to treat OUD, especially in regard to improving knowledge and self-efficacy.

scholarly journals Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Sheryl L. Chow ◽  
Comilla Sasson ◽  
Ivor J. Benjamin ◽  
Robert M. Califf ◽  
Wilson M. Compton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Health Care Professionals ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Brain Health

The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strategic tools and therapeutic approaches for recognition of opioid use disorder and safe opioid use are available for health care professionals who manage patients with cardiovascular disease and stroke, high-quality evidence does not currently exist. Therefore, there is an urgent need for more research to identify the most effective approaches to improve care for these patients.

Birth Plans: A Narrative Review of the Literature

2016 ◽  
Vol 6 (3) ◽  
pp. 157-172 ◽  
Author(s):  
Bernie Divall ◽  
Helen Spiby ◽  
Julie Roberts ◽  
Denis Walsh
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Research Agenda ◽  
Narrative Review ◽  
Obstetric Outcomes ◽  
Review Of The Literature ◽  
Comprehensive Overview ◽  
Women's Experiences ◽  
The Subject ◽  
The Impact

OBJECTIVE: To describe and summarize the current body of evidence on the subject of birth plans to develop a research agenda.METHOD: A narrative review was undertaken to offer a comprehensive overview of themes emerging from previous research in this area.FINDINGS: Thirty-five papers from 33 studies were retrieved and grouped into three main themes: the impact of birth plans on obstetric outcomes, women’s experiences and opinions of completing and using birth plans, and health care professionals’ beliefs about and experiences of the use of birth plans. Key findings relate to beliefs about the benefits and challenges of birth plans, as described by women and health care professionals and the impact of birth plans on a range of obstetric outcomes.CONCLUSION: This review brings together a range of studies around birth plans and synthesizes key themes. Little homogeneity was seen in the studies identified, and a wide variety of care contexts and childbirth philosophies were represented. Findings suggest the need for further research into whether there are ideal circumstances and environments for the completion of birth plans antenatally and whether disparities between expectations described in women’s plans and experiences in labor and birth can be reduced.

Well-Being of Health Care Professionals Treating Opioid Use Disorder During the COVID-19 Pandemic: Results From a National Survey

2021 ◽  
pp. appi.ps.2021000
Author(s):  
Derek Blevins ◽  
Brandy F. Henry ◽  
Minhee Sung ◽  
E. Jennifer Edelman ◽  
Anne C. Black ◽  
...  
Keyword(s):  
Health Care ◽  
National Survey ◽  
Health Care Professionals ◽  
Well Being ◽  
Opioid Use Disorder ◽  
Opioid Use

Treatment Outcomes in Individuals Diagnosed with Comorbid Opioid Use Disorder and Posttraumatic Stress Disorder: A Review

2021 ◽  
pp. 107026
Author(s):  
Sarah Meshberg-Cohen ◽  
R. Ross MacLean ◽  
Ashley M. Schnakenberg Martin ◽  
Mehmet Sofuoglu ◽  
Ismene L. Petrakis
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Opioid Use Disorder ◽  
Opioid Use

The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes

2021 ◽  
Author(s):  
R. Ross MacLean ◽  
Suzanne Spinola ◽  
Gabriella Garcia-Vassallo ◽  
Mehmet Sofuoglu
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Disorder Treatment ◽  
The Impact

Safety culture in health care teams: A narrative review of the literature

2019 ◽  
Vol 27 (5) ◽  
pp. 871-883 ◽  
Author(s):  
Roisin O’Donovan ◽  
Marie Ward ◽  
Aoife De Brún ◽  
Eilish McAuliffe
Keyword(s):  
Health Care ◽  
Safety Culture ◽  
Narrative Review ◽  
Review Of The Literature ◽  
Health Care Teams

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.

Treatment Persistence Among Insured Patients Newly Starting Buprenorphine/Naloxone for Opioid Use Disorder

2018 ◽  
Vol 52 (5) ◽  
pp. 405-414 ◽  
Author(s):  
Natalia Shcherbakova ◽  
Gary Tereso ◽  
Jacqueline Spain ◽  
Robert J. Roose
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Care Providers ◽  
Opioid Use ◽  
Treatment Persistence ◽  
Factors Associated ◽  
Insured Patients

Background: Persistence with medication-assisted therapy among patients with opioid use disorder has been associated with reduced likelihood of illicit opioid use. Objective: We aimed to describe treatment persistence and identify factors associated with 1-year persistence among insured patients newly initiating buprenorphine-containing pharmacotherapy. Methods: The retrospective observational cohort included employer-sponsored and managed Medicaid patients newly started on buprenorphine-containing therapy between June 30, 2010, and January 1, 2015. Persistence was measured as both a continuous and dichotomous variable (proportion of patients persistent for 1 year). Multivariable logistic regression analysis was used to identify factors associated with 1-year persistence. Results: A total of 302 patients met inclusion criteria. The median [range] number of treatment episodes was 1 [1-4]. Mean number of days on therapy during the first episode was 206 (SD = 152) days, with 40.4% (n = 122) of patients persisting for 1 year. Presence of concomitant fills of prescription opioid analgesics (odds ratio [OR] = 0.25; 95% CI = 0.12-0.51), being in care of an addiction specialist (OR = 0.40; 95% CI = 0.21-0.76), and Medicaid insurance coverage (OR = 0.33; 95% CI = 0.13-0.84) were significantly and negatively associated with 1-year persistence. There was also a strong inverse relationship between persistence and inpatient hospitalization (OR = 0.30; 95% CI = 0.12-0.76). Conclusions: Several health care delivery and use variables were significantly associated with nonpersistence. Concomitant use of prescription opioids is the most easily modifiable risk factor that health care providers and policy makers may act on to improve treatment continuation.

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