scholarly journals How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study

2019 ◽  
Vol 13 ◽  
pp. 117822181983337 ◽  
Author(s):  
Henning Pettersen ◽  
Anne Landheim ◽  
Ivar Skeie ◽  
Stian Biong ◽  
Morten Brodahl ◽  
...  
Keyword(s):  
Substance Use ◽  
Social Relationships ◽  
Substance Use Disorder ◽  
Service Providers ◽  
Treatment Strategies ◽  
Support Network ◽  
Structured Interviews ◽  
Narrative Study ◽  
Study Planning ◽  
Caring Relationship

Individuals with a substance use disorder (SUD) often have fewer social support network resources than those without SUDs. This qualitative study examined the role of social relationships in achieving and maintaining stable recovery after many years of SUD. Semi-structured interviews were conducted with 18 participants, each of whom had been diagnosed with a SUD and each of whom had been abstinent for at least 5 years. A resource group of peer consultants in long-term recovery from SUDs contributed to the study planning, preparation, and initial analyses. The relationship that most participants described as helpful for initiating abstinence was recognition by a peer or a caring relationship with a service provider or sibling. These findings suggest that, to reach and maintain abstinence, it is important to maintain positive relationships and to engage self-agency to protect oneself from the influences of negative relationships. Substance use disorder service providers should increase the extent to which they involve the social networks of clients when designing new treatment approaches. Service providers should also focus more on individualizing services to meet their clients on a personal level, without neglecting professionalism or treatment strategies.

scholarly journals Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Erika L. Crable ◽  
Allyn Benintendi ◽  
David K. Jones ◽  
Alexander Y. Walley ◽  
Jacqueline Milton Hicks ◽  
...  
Keyword(s):  
Substance Use ◽  
Policy Implementation ◽  
Substance Use Disorder ◽  
Service Providers ◽  
Implementation Strategies ◽  
Local Context ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Addiction Medicine ◽  
Us States

Abstract Background Despite the important upstream impact policy has on population health outcomes, few studies in implementation science in health have examined implementation processes and strategies used to translate state and federal policies into accessible services in the community. This study examines the policy implementation strategies and experiences of Medicaid programs in three US states that responded to a federal prompt to improve access to evidence-based practice (EBP) substance use disorder (SUD) treatment. Methods Three US state Medicaid programs implementing American Society of Addiction Medicine (ASAM) Criteria-driven SUD services under Section 1115 waiver authority were used as cases. We conducted 44 semi-structured interviews with Medicaid staff, providers and health systems partners in California, Virginia, and West Virginia. Interviews were triangulated with document review of state readiness and implementation plans. The Exploration, Preparation, Implementation, Sustainment Framework (EPIS) guided qualitative theme analysis. The Expert Recommendations for Implementing Change and Specify It criteria were used to create a taxonomy of policy implementation strategies used by policymakers to promote providers’ uptake of statewide EBP SUD care continuums. Results Four themes describe states’ experiences and outcomes implementing a complex EBP SUD treatment policy directive: (1) Medicaid agencies adapted their inner/outer contexts to align with EBPs and adapted EBPs to fit their local context; (2) enhanced financial reimbursement arrangements were inadequate bridging factors to achieve statewide adoption of new SUD services; (3) despite trainings, service providers and managed care organizations demonstrated poor fidelity to the ASAM Criteria; and (4) successful policy adoption at the state level did not guarantee service providers’ uptake of EBPs. States used 29 implementation strategies to implement EBP SUD care continuums. Implementation strategies were used in the Exploration (n=6), Preparation (n=10), Implementation (n=19), and Sustainment (n=6) phases, and primarily focused on developing stakeholder interrelationships, evaluative and iterative approaches, and financing. Conclusions This study enhances our understanding of statewide policy implementation outcomes in low-resource, public healthcare settings. Themes highlight the need for additional pre-implementation and sustainment focused implementation strategies. The taxonomy of detailed policy implementation strategies employed by policymakers across states should be tested in future policy implementation research.

scholarly journals Helpful Ingredients in the Treatment of Long-Term Substance Use Disorders: A Collaborative Narrative Study

2019 ◽  
Vol 13 ◽  
pp. 117822181984499 ◽  
Author(s):  
Henning Pettersen ◽  
Anne Landheim ◽  
Ivar Skeie ◽  
Stian Biong ◽  
Morten Brodahl ◽  
...  
Keyword(s):  
Substance Use ◽  
Term Treatment ◽  
Structured Interviews ◽  
Narrative Study ◽  
Treatment Services ◽  
Study Planning ◽  
Long Term Treatment ◽  
Care Models ◽  
Resource Group

Relatively few individuals with a substance use disorder (SUD) seek or receive treatment, and knowledge about the effective ingredients in SUD treatment, from the perspective of those who receive it, is scarce. Our study purpose was to explore the experiences of those with long-term SUDs and the aspects they found helpful during treatment and long-term recovery. Semi-structured interviews were conducted with 18 participants, each of whom had been diagnosed with a long-term SUD, and who had been abstinent for at least 5 years. A resource group of peer consultants in long-term recovery from SUDs contributed to study planning, preparation, and initial analyses. Participants preferred individualized, long-term treatment, and support from both therapists and other clients. They further acknowledged the importance of their own sense of responsibility for their treatment and recovery success. Greater focus should be placed on viewing long-term SUD as a long-term condition, similar to somatic diseases, and SUD treatment services should place greater emphasis on developing partnership care models, long-term monitoring and support, and actively engaging recovered clients in the care of others in SUD treatment.

scholarly journals The impact of COVID-19 on substance use disorder treatment in California: Service providers' perspectives

2021 ◽  
pp. 108544
Author(s):  
Chunqing Lin ◽  
Sarah E. Clingan ◽  
Sarah J. Cousins ◽  
Jonathan Valdez ◽  
Larissa J. Mooney ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Service Providers ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment ◽  
The Impact

Tolerability and side effects of an extended-release injectable suspension of aripripazole in a series of inpatients in a dual diagnosis unit

2016 ◽  
Vol 33 (S1) ◽  
pp. S539-S539
Author(s):  
A. Farre ◽  
A. Palma ◽  
G. Mateu ◽  
J.L. Perez de Heredia ◽  
R. Martinez ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Use ◽  
Side Effects ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Extended Release ◽  
Treatment Strategies ◽  
Clinical Global Impression Scale ◽  
Clinical Scales ◽  
Competing Interest

IntroductionThe integrated care in dual diagnosis units involves selecting pharmacological treatment strategies for both substance use disorder and the non-addictive psychiatric disorder. It is recommended to choose drugs with a favorable balance between efficacy/tolerability, an adequate side effects profile and the minimal drug interactions.Objectives and aimsTo evaluate the tolerability and side effects after first administration-first dose of an extended-release injectable suspension of aripiprazole in a group of patients admitted to an acute dual diagnosis unit.MethodsThe study included a series of patients admitted in our unit from May to August 2015 that received the first dose of the aripiprazole preparation (400 mg). Evaluations included different scales for side effects (SAS, ESRS, UKU) and the clinical global impression scale (CGI).ResultsA total of 9 patients were included and evaluated (all men, mean age: 39-years-old). Diagnoses were: bipolar disorder (5/9), schizophrenia (2/9), schizoaffective disorder (1/9) and delusional disorder (1/9) with concomitant substance use disorder (6 cannabis, 2 alcohol, 1 cocaine). All of them without outpatient control and treatment at admission. The results of the clinical scales conclude that none of them had significant side effects, including extrapyramidal, with an improvement in the ICG scale.ConclusionTolerability of extended-release injectable suspension of aripiprazole was good in all cases. In the future, new cases should be included to extend the sample and to evaluate other aspects such as the craving for substances.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Use of Telehealth in Substance Use Disorder (SUD) Services During and After COVID-19 (Preprint)

2020 ◽  
Author(s):  
Todd Molfenter ◽  
Nancy Roget ◽  
Michael Chaple ◽  
Stephanie Behlman ◽  
Olivia Cody ◽  
...  
Keyword(s):  
Substance Use ◽  
Technology Acceptance ◽  
Substance Use Disorder ◽  
Service Providers ◽  
Controlled Trial ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Intention To Use ◽  
Use Of Technology ◽  
Intent To Use

BACKGROUND COVID-19 social distancing guidelines caused a rapid transition to telephone and video technologies for the delivery of substance use disorder (SUD) treatment. The study examined: a) adoption of these technologies across the SUD service continuum; b) acceptance of these technologies by service providers; and c) intention of providers to use these technologies following the pandemic. An additional analysis used the validated Technology Acceptance Model (TAM) to test the rigor of the intent to use the technology post-pandemic. OBJECTIVE Specific hypotheses were that over 50% of organizations would use telephone and video technologies, that organizations would report statistically significant odds of increasing their use of technology after the COVID-19 pandemic, and that perceived usefulness of telephone and video technologies would mediate the effect of ease of use on intention to use. METHODS An on-line survey distributed between May and August, 2020 measured current use of telephone and video services, assessed perceived organizational readiness to use these services, and gauged intent to use telephone and video applications post-COVID-19. Seven of the 10 Regional Addiction Technology Transfer Centers (ATTCs), representing 43 states, distributed the survey. The unit of analysis was the organization. RESULTS Four hundred and fifty-seven organizations responded. Overall, there was widespread use of technology; greater than 70% of organizations reported using telephone or video for most services. For all but two services (residential and buprenorphine services by telephone), organizations reported significantly greater odds (mean OR = 3.79; range from 1.87 to 6.98) of intending to use technology to deliver services post COVID-19. Clinical users regarded video more favorably than telephone for all but two services. Readiness for telephone and video use was high across numerous factors, though telephone services were viewed as being more accessible. Consistent with the TAM, perceived usefulness and ease of use influenced intention to use both telephone and video technologies. CONCLUSIONS The overall perceived ease of use and usefulness of telephone and video-based services provide a promising outlook for use of these services post the COVID-19 pandemic. Future studies should continue to review the acceptance of these services and their comparative impact on care outcomes. CLINICALTRIAL This trial is not currently registered since it was not an randomized controlled trial.

Social Connectedness, Self-Efficacy, and Mental Health Outcomes Among Homeless Youth

2016 ◽  
Vol 50 (7) ◽  
pp. 989-1014 ◽  
Author(s):  
Stephanie Begun ◽  
Kimberly A. Bender ◽  
Samantha M. Brown ◽  
Anamika Barman-Adhikari ◽  
Kristin Ferguson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Health Outcomes ◽  
Protective Factors ◽  
Substance Use Disorder ◽  
Self Efficacy ◽  
Social Connectedness ◽  
Homeless Youth ◽  
Service Providers ◽  
Mental Health Outcomes

Homeless youth frequently meet diagnosis criteria for depressive and/or substance use disorder(s). Although prior research has established that both social connectedness and self-efficacy buffer vulnerable youth’s adverse health outcomes, few studies have compared the potential of these protective factors on homeless youth’s mental well-being. The current study analyzes comparative effects of social connectedness and self-efficacy on meeting criteria for major depressive disorder, substance use disorder, and the co-occurrence of both disorders among a sample of 601 service-seeking homeless youth in Austin, Denver, and Los Angeles. Hierarchical logistic regressions indicate that while both social connectedness and self-efficacy constructs are valuable protective factors, social connectedness may offer greater utility, particularly in buffering against more complex mental health outcomes, such as the co-occurrence of depressive and substance use disorders. Accordingly, resource-strapped homeless youth service providers and researchers may benefit from tailoring mental health intervention strategies to further emphasize social connectedness in future efforts.

scholarly journals Virtual Nature as an Intervention for Reducing Stress and Improving Mood in People with Substance Use Disorder

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Lori Reynolds ◽  
Oaklee Rogers ◽  
Andrew Benford ◽  
Ammie Ingwaldson ◽  
Bethany Vu ◽  
...  
Keyword(s):  
Heart Rate ◽  
Substance Use ◽  
Negative Affect ◽  
Substance Use Disorder ◽  
Rating Scale ◽  
Treatment Strategies ◽  
Recovery Process ◽  
The United States ◽  
Cost Effective Treatment ◽  
Nature Scene

Substance use disorder (SUD) afflicts a large percentage of the United States population, with negative implications that cost more than $420 billion annually. This population often experiences negative emotions throughout the recovery process, including anxiety, depression, stress, and negative affect. Currently, evidence-based treatment strategies for SUD include cognitive behavioral therapy, motivational interviewing, 12-step programs, and mindfulness-based treatment. One intervention that has not been studied at length among individuals with SUD is use of the natural environment as treatment. Among other patient populations, nature has been shown to reduce stress and anxiety by regulating autonomic nervous system function, reducing symptoms of depression, and improving mood. The purpose of this study was to investigate whether viewing nature videos could similarly reduce stress and improve mood in individuals with SUD. A crossover design was used to compare viewing a nature scene and practicing mindfulness-based activities for women with SUD at a residential treatment facility. Over four weeks, participants engaged in the two activities for the first 10 minutes of their daily program. Immediately before and after each 10 minute session, measures were taken for heart rate, in beats per minute (BPM); affect, using the Positive and Negative Affect Scale (PANAS); and overall mood, using a 10-point rating scale from “very unpleasant” to “pleasant.” Thirty-six women completed the study. For viewing a nature scene and practicing the mindfulness-based activities, there were statistically significant reductions in mean negative affect scores (p=0.001) and heart rate (p≤0.001). In addition, for participants in both conditions, overall mood improved significantly (p=0.030). The results from this study provide initial evidence that viewing nature has similar benefits to MBT in the treatment of stress and negative mood associated with the SUD recovery process and may be an additional, cost-effective treatment strategy for individuals with SUD.

scholarly journals Women Trading Sex in a U.S.-Mexico Border City: A Qualitative Study of the Barriers and Facilitators to Finding Community and Voice

Sexes ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 1-18
Author(s):  
Claudia Gonzalez ◽  
Kimberly C. Brouwer ◽  
Elizabeth Reed ◽  
Melanie J. Nicholls ◽  
Jessica Kim ◽  
...  
Keyword(s):  
Substance Use ◽  
Human Trafficking ◽  
Social Services ◽  
Partner Violence ◽  
Service Providers ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Or Education ◽  
Sex Trade ◽  
Structural Support

Poverty and income inequality can increase a woman’s decision to engage in risky transactional sex, and may lead to unimaginable harms, such as violence, substance use, and human trafficking. This study examines the facilitators and barriers to finding community and voice among women trading sex in Tijuana, Mexico, and what factors, such as socio-structural support, violence, and substance use, may impact their potential to engage with others, including human service providers. Sixty qualitative in-depth interviews were conducted with women trading sex in Tijuana, Mexico. Researchers met with participants for in-depth-face-to-face structured interviews. Data were coded using ATLAS.ti. Participants were aged 19–73 (mean: 37), 98% were of Mexican nationality, 90% reported trading sex independent of the control of others, with 58% identified as independent and street-based. Thirty percent of women trading sex reported substance use (excluding marijuana) and 20% reported injection drug use within 30 days. The majority reported no involvement in mobilization activities, but 85% expressed interest. However, barriers included stigma, cultural gender norms, partner violence, and privacy in regards to disclosure of sex trade involvement, moral conflict (revealing one’s involvement in sex trade), involvement in substance use, human trafficking, and feeling powerless. Facilitators were having a safe space to meet, peer support, self-esteem, feeling heard, knowledge of rights, economic need to support families, and staying healthy. Findings imply the potential to go beyond mobilizing limited groups of women in the sex trade and instead involve whole community mobilization; that is, to reach and include the more vulnerable women (substance use, trafficked) in supportive services (social services, exit strategies, better healthcare opportunities, and/or education for healthcare providers to help break societal stigmas regarding women in the sex trade) and to change the status of women in society in general.

scholarly journals Understanding the impact of the SARS-COV-2 pandemic on hospitalized patients with substance use disorder

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247951
Author(s):  
Caroline King ◽  
Taylor Vega ◽  
Dana Button ◽  
Christina Nicolaidis ◽  
Jessica Gregg ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Transitions ◽  
Hospitalized Patients ◽  
Structured Interviews ◽  
Hospital Policy ◽  
Semantic Level ◽  
The Impact

Background The SARS-COV-2 pandemic rapidly shifted dynamics around hospitalization for many communities. This study aimed to evaluate how the pandemic altered the experience of healthcare, acute illness, and care transitions among hospitalized patients with substance use disorder (SUD). Methods We performed a qualitative study at an academic medical center in Portland, Oregon, in Spring 2020. We conducted semi-structured interviews, and conducted a thematic analysis, using an inductive approach, at a semantic level. Results We enrolled 27 participants, and identified four main themes: 1) shuttered community resources threatened patients’ basic survival adaptations; 2) changes in outpatient care increased reliance on hospitals as safety nets; 3) hospital policy changes made staying in the hospital harder than usual; and, 4) care transitions out of the hospital were highly uncertain. Discussion Hospitalized adults with SUD were further marginalized during the SARS-COV-2 pandemic. Systems must address the needs of marginalized patients in future disruptive events.

scholarly journals Reported Barriers to Hepatitis C Treatment among Pregnant and Early-Parenting Mothers Undergoing Substance Use Disorder Treatment in One U.S. State

2021 ◽  
Vol 14 (1) ◽  
pp. 1-11
Author(s):  
Ayooluwatomiwa Deborah Adekunle ◽  
Kathi L. Harp ◽  
Zaynab G. Al-Abdali ◽  
Agatha S. Critchfield ◽  
Sheila Barnhart ◽  
...  
Keyword(s):  
Substance Use ◽  
Hepatitis C ◽  
Substance Use Disorder ◽  
Substance Use Treatment ◽  
Structured Interviews ◽  
Hcv Treatment ◽  
Direct Acting Antiviral ◽  
Early Parenting ◽  
Treatment Uptake ◽  
Eligibility Requirements

Nationwide, the prevalence of the hepatitis C virus (HCV) has risen in recent years. At least 90% of infected persons must be treated to achieve global elimination targets. The current study aimed to explore barriers to, and facilitators of, direct-acting antiviral (DAA) HCV treatment uptake amongst pregnant and early-parenting women undergoing comprehensive substance use treatment. Twenty participants with documented HCV antibody positivity were recruited from two substance use treatment centers in central Kentucky. Semi-structured interviews were conducted to explore knowledge about HCV, previous experiences, and intentions to seek care. Themes were extracted using an inductive analytical approach. Most participants were aware of the dangers posed by HCV infection. However, there was a high degree of misinformation about transmission mechanisms and treatment eligibility requirements. Low priority for HCV treatment also surfaced as a barrier to treatment uptake. Participants reported being unable to seek care due to time and resource limitations in the presence of a highly demanding treatment process. Findings from the current study suggest that more work is needed to eliminate residual barriers that limit access to HCV treatment among pregnant and early-parenting women in treatment for substance use disorder.

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