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 Substance use, Unlike Dolutegravir, is Associated with Mood Symptoms in People Living with HIV

2021 ◽  
Author(s):  
Lisa Van de Wijer ◽  
Wouter van der Heijden ◽  
Mike van Verseveld ◽  
Mihai Netea ◽  
Quirijn de Mast ◽  
...  
Keyword(s):  
Substance Use ◽  
Term Treatment ◽  
Assessment Tools ◽  
Self Report ◽  
People Living With Hiv ◽  
Antiretroviral Drug ◽  
Long Term Treatment ◽  
Living With Hiv ◽  
Neuropsychiatric Side Effects

AbstractContradictory data have been reported concerning neuropsychiatric side effects of the first-line antiretroviral drug dolutegravir, which may be partly due to lack of control groups or psychiatric assessment tools. Using validated self-report questionnaires, we compared mood and anxiety (DASS-42), impulsivity (BIS-11), and substance use (MATE-Q) between dolutegravir-treated and dolutegravir-naive people living with HIV (PLHIV). We analyzed 194, mostly male, PLHIV on long-term treatment of whom 82/194 (42.3%) used dolutegravir for a median (IQR) of 280 (258) days. Overall, 51/194 (26.3%) participants reported DASS-42 scores above the normal cut-off, 27/194 (13.5%) were classified as highly impulsive, and 58/194 (29.9%) regularly used recreational drugs. Regular substance use was positively associated with depression (p = 0.012) and stress scores (p = 0.045). We observed no differences between dolutegravir-treated and dolutegravir-naive PLHIV. Our data show that depressed and anxious moods and impulsivity are common in PLHIV and associate with substance use and not with dolutegravir use.

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.

Pharmacotherapy for substance use disorders within correctional facilities

2015 ◽  
Author(s):  
Sarah E. Wakeman ◽  
Josiah D. Rich
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Interventions ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Term Treatment ◽  
Opiate Dependence ◽  
Opioid Use ◽  
Long Term Treatment

Drug addiction treatment is increasingly complex. Only 5% of prisons and 34% of jails offer any detoxification services, and only 1% of jails offer methadone for opioid withdrawal. Even fewer facilities offer medication assisted therapy (MAT) for alcohol or substance use disorders despite the tremendous evidence base supporting the use of medications to treat addiction. Untreated opioid dependence both within corrections and in the community is associated with HIV, Hepatitis C, crime, and death by overdose. Substantial evidence argues that these risks are reduced through long-term treatment with agonist medications such as methadone and buprenorphine. Only a minority of prisoners receive any addiction treatment while incarcerated. Those that do are usually offered behavioral interventions, which when used alone have extremely poor outcomes. Although there are limited studies on the outcomes of drug treatment during incarceration, there are nearly 50 years of evidence documenting the efficacy of methadone given in the community in reducing opioid use, drug-related health complications, overdose, death, criminal activity, and recidivism. Buprenorphine is similarly an effective, safe, and cost-effective long-term treatment for opioid dependence that reduces other opioid use and improves health and quality of life outcomes. There is a growing role for MAT in jails, and to a lesser degree in prisons for the treatment of alcohol and opiate dependence. This chapter presents the current state of evidence based practice in correctional MAT models.

scholarly journals Oral Valproate Sodium as an Alternative to Benzodiazepine in the Treatment of Catatonia- A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Jacob Maier ◽  
Daniel Rapport ◽  
Alex McCormick ◽  
Chandani Lewis
Keyword(s):  
Substance Use ◽  
Case Report ◽  
Sodium Valproate ◽  
Term Treatment ◽  
Alternative Therapies ◽  
Long Term Treatment ◽  
History Of ◽  
Polysubstance Abuse ◽  
Oral Sodium

Alternative therapies are necessary to treat catatonia in patients with comorbidities that are not amenable to therapy with benzodiazepines or ECT. This is a patient with schizophrenia with catatonic features and a history of polysubstance abuse. Consequently, he was not a candidate for treatment with benzodiazepines, so an alternative needed to be found. GABAergic medications have been used previously as alternatives to benzodiazepines and ECT. In this case we chose sodium valproate, due to its cross-reaction with GABAergic systems. There are five reported cases using sodium valproate. Three of which were treated with intravenous valproate, while the remaining two do not specify the route of administration. We present a case where oral sodium valproate was used successfully for both acute and long-term catatonic treatment. To our knowledge, no other report has looked at both acute and long-term treatment with sodium valproate. Oral sodium valproate can be considered for patients with substance use disorders like COPD, sleep apnea or myasthenia gravis in which benzodiazepines are contraindicated and where ECT is not an option for treatment.

Addressing Community Trauma and Building Community Resilience to Prevent Opioid Misuse and Addiction

2019 ◽  
pp. 199-210
Author(s):  
Sheila Savannah ◽  
Dana Fields-Johnson ◽  
Ruben Cantu ◽  
Sana Chehimi ◽  
Alexis Captanian ◽  
...  
Keyword(s):  
Substance Use ◽  
Primary Prevention ◽  
Term Treatment ◽  
Opioid Epidemic ◽  
Long Term Treatment ◽  
Trauma Informed ◽  
Building Community ◽  
Community Trauma

Any strategy to end the opioid epidemic must include recognizing and addressing the role of widespread individual and community trauma and the need for solutions that build protective factors and agency within communities while supporting long-term treatment and recovery for those experiencing substance use disorders. In this chapter, the authors describe how a community trauma–informed approach can be applied to address and mitigate the exposures, behaviors, and high levels of hopelessness that are fueling the opioid crisis. Further, the chapter explores how primary prevention strategies can complement opioid treatment and long-term recovery interventions and address other conditions that co-occur in communities experiencing trauma.

Pharmacotherapy for substance use disorders within correctional facilities

2017 ◽  
Author(s):  
Sarah E. Wakeman ◽  
Josiah D. Rich
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Interventions ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Term Treatment ◽  
Opiate Dependence ◽  
Opioid Use ◽  
Long Term Treatment

Drug addiction treatment is increasingly complex. Only 5% of prisons and 34% of jails offer any detoxification services, and only 1% of jails offer methadone for opioid withdrawal. Even fewer facilities offer medication assisted therapy (MAT) for alcohol or substance use disorders despite the tremendous evidence base supporting the use of medications to treat addiction. Untreated opioid dependence both within corrections and in the community is associated with HIV, Hepatitis C, crime, and death by overdose. Substantial evidence argues that these risks are reduced through long-term treatment with agonist medications such as methadone and buprenorphine. Only a minority of prisoners receive any addiction treatment while incarcerated. Those that do are usually offered behavioral interventions, which when used alone have extremely poor outcomes. Although there are limited studies on the outcomes of drug treatment during incarceration, there are nearly 50 years of evidence documenting the efficacy of methadone given in the community in reducing opioid use, drug-related health complications, overdose, death, criminal activity, and recidivism. Buprenorphine is similarly an effective, safe, and cost-effective long-term treatment for opioid dependence that reduces other opioid use and improves health and quality of life outcomes. There is a growing role for MAT in jails, and to a lesser degree in prisons for the treatment of alcohol and opiate dependence. This chapter presents the current state of evidence based practice in correctional MAT models.

Psychiatric factors affecting recovery after a long term treatment program for substance use disorder

2019 ◽  
Vol 276 ◽  
pp. 283-289 ◽  
Author(s):  
Constanza Daigre ◽  
Marta Perea-Ortueta ◽  
Marta Berenguer ◽  
Oriol Esculies ◽  
Marta Sorribes-Puertas ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Treatment Program ◽  
Term Treatment ◽  
Factors Affecting ◽  
Long Term Treatment

Achieving Remission and Favorable Outcomes in Patients with Depression/Anxiety and Substance use Disorders

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S6) ◽  
pp. 10-12 ◽  
Author(s):  
Alan F. Schatzberg
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Dependence ◽  
Psychiatric Symptoms ◽  
Term Treatment ◽  
Multiple Sources ◽  
Long Term Treatment ◽  
History Of ◽  
Relationship Of

Given the frequency with which patients with substance use disorders (SUDs) and those with psychiatric disorders, such as major depressive disorder (MDD) and generalized anxiety disorder (GAD), suffer relapses and recurrences, the issue of long-term treatment for SUDs warrants special attention. Faced with recommending long-term treatment, the clinician must discern the primacy of disorder, which may have been only obliquely addressed at the time of the patient's presentation and then solved by concurrent treatment. Establishing primacy relies on determining whether the psychiatric symptoms were induced by SUD or the psychiatric disorder emerged first and substance use was a means of coping with it. A third possibility exists—that the two disorders developed independently of each other, albeit becoming intermingled over time and serving to exacerbate each other. Clues to the temporal relationship of the disorders can be deduced from a meticulous history obtained from multiple sources, the effects that acute treatment has had on either condition, and the patient's willingness to remain abstinent from the addictive substance. Hasin and colleagues demonstrated the importance that a history of depression has on long-term remission and relapse outcomes in substance dependence (Slide 1).

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