scholarly journals Predicting Dropout from Inpatient Substance Use Disorder Treatment: A Prospective Validation Study of the OQ-Analyst

2019 ◽  
Vol 13 ◽  
pp. 117822181986618
Author(s):  
Hanne H Brorson ◽  
Espen Ajo Arnevik ◽  
Kim Rand
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Substance Use Disorder ◽  
Bayes Factor ◽  
Predictive Accuracy ◽  
Predictive Ability ◽  
Random Intercept ◽  
Icd 10 ◽  
Patients At Risk ◽  
Prospective Longitudinal

Background and Aims: There is an urgent need for tools allowing therapists to identify patients at risk of dropout. The OQ-Analyst, an increasingly popular computer-based system, is used to track patient progress and predict dropout. However, we have been unable to find empirical documentation regarding the ability of OQ-Analyst to predict dropout. The aim of the present study was to perform the first direct test of the ability of the OQ-Analyst to predict dropout. Design: Patients were consecutively enlisted in a naturalistic, prospective, longitudinal clinical trial. As interventions based on feedback from the OQ-Analyst could alter the outcome and potentially render the prediction wrong, feedback was withheld from patients and therapists. Setting: The study was carried out during 2011–2013 in an inpatient substance use disorder clinic in Oslo, Norway. Participants: Patients aged 18 to 28 years who met criteria for a principal diagnosis of mental or behavioural disorder due to psychoactive substance use (ICD 10; F10.2–F19.2). Measurements: Red signal (predictions of high risk) from the Norwegian version of the OQ-Analyst were compared with dropouts identified using patient medical records as the standard for predictive accuracy. Findings: A total of 40 patients completed 647 OQ assessments resulting in 46 red signals. There were 27 observed dropouts, only one of which followed after a red signal. Patients indicated by the OQ-Analyst as being at high risk of dropping out were no more likely to do so than those indicated as being at low risk. Random intercept logistic regression predicting dropout from a red signal was statistically nonsignificant. Bayes factor supports no association. Conclusions: The study does not support the predictive ability of the OQ-Analyst for the present patient population. In the absence of empirical evidence of predictive ability, it may be better not to assume such ability.

Foster Care Factors and Permanency for Children With Substance-Related Removals

2020 ◽  
pp. 104438942094722
Author(s):  
Margaret H. Lloyd Sieger
Keyword(s):  
Substance Use ◽  
Foster Care ◽  
Child Welfare ◽  
High Risk ◽  
Substance Use Disorder ◽  
Care Setting ◽  
Foster Parent ◽  
Vulnerable Group ◽  
Children In Foster Care ◽  
Socioeconomic Risk

Children in foster care due to parental substance use disorder are at high risk for delayed permanency. Understudied is the effect of foster care factors on these children’s exits from care. This study analyzed 10 years of federal child welfare data to understand the effect of foster care placement, provider, and support factors for this vulnerable group. Results revealed that several foster care variables influenced time to, and likelihood of, permanency for children with substance-related removals. Foster care setting, foster parent age and race, and several types of federal supports affected permanency trajectories. Children in homes receiving more federal supports were less likely to achieve permanency, suggesting the insufficiency of these supports to counteract the effects of socioeconomic risk on permanency.

Assessment and Management of the High-Risk Dental Patient with Active Substance Use Disorder

2020 ◽  
Vol 64 (3) ◽  
pp. 547-558
Author(s):  
Archana Viswanath ◽  
Antje M. Barreveld ◽  
Matthew Fortino
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Substance Use Disorder ◽  
Active Substance ◽  
Dental Patient

Prevalence of Psychiatric Disorder in a Methadone Maintenance Population

2001 ◽  
Vol 35 (5) ◽  
pp. 601-605 ◽  
Author(s):  
Tom Callaly ◽  
Tom Trauer ◽  
Leigh Munro ◽  
Greg Whelan
Keyword(s):  
Substance Use ◽  
Anxiety Disorder ◽  
Psychiatric Disorder ◽  
Affective Disorder ◽  
Diagnostic Criteria ◽  
Substance Use Disorder ◽  
Psychiatric Illness ◽  
Methadone Maintenance ◽  
Service Planning ◽  
Icd 10

Objective: The objective of this study was to examine the prevalence of psychiatric disorders in a group of patients who had recently entered a methadone maintenance programme. Method: A total of 62 patients were interviewed using the Composite International Diagnostic Interview (CIDI) within 6 months of commencing methadone maintenance. The CIDI was used to establish symptoms of psychiatric illness at interview and in the 12 months prior. Results: In the 12 months prior to interview, 76% of the sample fulfilled ICD-10 criteria for a psychiatric disorder other than substance-use disorder. Over half of the group interviewed fulfilled ICD-10 criteria for an affective disorder, two-thirds fulfilled criteria for an anxiety disorder and just under half fulfilled diagnostic criteria for both an affective disorder and an anxiety disorder in the 12 months prior to interview. At the time of interview, 19% fulfilled ICD-10 diagnostic criteria for a moderate or severe affective disorder. Seventy per cent of males and 89% of females interviewed had a comorbid psychiatric illness. In 71% of the group who had a comorbid psychiatric illness, the onset of psychiatric symptomatology was reported to predate the use of heroin. Conclusion: The prevalence of psychiatric disorder is up to 10 times higher in the population on methadone maintenance than in the general population and is two to three times higher than that found in community surveys of those with a substance-use disorder. These results are consistent with earlier findings and have implications for service planning.

Substance use disorder and the baby boomers: Does German outpatient addiction care face a change?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Specht ◽  
B Braun-Michl ◽  
L Schwarzkopf ◽  
D Piontek ◽  
N Seitz ◽  
...  
Keyword(s):  
Substance Use ◽  
Baby Boomers ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Age Groups ◽  
Random Intercept ◽  
Sustained Change ◽  
Using Data ◽  
Addiction Care ◽  
Primary Substance

Abstract Background The aging of baby boomers is expected to confront addiction care with new challenges. This study aims to investigate if German addiction care is confronted with a sustained change in its clientele that was initiated by the baby boomers. Methods Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an older (n = 6524) as well as a younger cohort (n = 15677). To isolate cohort effects, two-level random-intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each other cohort. Results Compared to the older cohort, alcohol use disorder lost importance while illicit substances use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the older cohort. Comparing baby boomers with the younger cohort, these relationships pointed in the opposite direction. Conclusions Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. The addiction care system ought to adapt its services to address the changing needs of its clientele. Key messages Baby boomers differed in comparison to the older cohort regarding type of substance use disorder and comorbid substance use disorders. The changes set off by the baby boomers continued in the younger cohort.

Takotsubo cardiomyopathy in children

2020 ◽  
Vol 30 (11) ◽  
pp. 1711-1715
Author(s):  
Prithvi Sendi ◽  
Paul Martinez ◽  
Madhuradhar Chegondi ◽  
Balagangadhar R. Totapally
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Takotsubo Cardiomyopathy ◽  
International Classification Of Diseases ◽  
Interquartile Range ◽  
Anoxic Injury ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Multivariable Regression

AbstractObjective:To explore the epidemiology and outcomes of takotsubo cardiomyopathy in children.Methods:A retrospective analysis of the Healthcare Cost and Utilization 2012 and 2016 Kids’ Inpatient Database was performed. Patients admitted with the diagnosis of takotsubo cardiomyopathy in the age group of 1 month–20 years were identified using International Classification of Diseases (ICD)-9 code 429.83 and ICD-10 code I51.81.Results:Among a total of 4,860,859 discharges, there were 153 with the diagnosis of takotsubo cardiomyopathy (3.1 per 100,000 discharges). Among patients with takotsubo cardiomyopathy, 55.0% were male, 62.4% were white, and 16.7% were black. Eighty-nine percent of patients were between 12 and 20 years. Psychiatric diagnosis was documented in 46% and substance use disorder in 36.2%. Sepsis was documented in 22.8% of patients. The median length of stay was 5 days (interquartile range: 2.7–15), and median total charges were $75,080 (interquartile range: 32,176–198,336). The overall mortality for takotsubo cardiomyopathy was 7%. On multivariable regression analysis, mortality was higher in the presence of anoxic injury (odds ratio = 34.42, 95% confidence interval: 4.85–320.11, p = 0.00).Conclusions:Takotsubo cardiomyopathy is uncommon in children and carries a mortality rate of 7%. Most children with takotsubo cardiomyopathy are adolescent males, many of whom have psychiatric disorder or substance use disorder or both. Takotsubo cardiomyopathy should be considered in the differential diagnosis for patients who present with cardiac dysfunction and have underlying psychiatric disorders or drug abuse.

scholarly journals A missed opportunity: underutilization of inpatient behavioral health services to reduce injection drug use sequelae in Florida

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Austin E. Coye ◽  
Mackenzie T. Jones ◽  
Kasha J. Bornstein ◽  
Hansel E. Tookes ◽  
Joan E. St. Onge
Keyword(s):  
Substance Use ◽  
Health Services ◽  
Behavioral Health ◽  
Substance Use Disorder ◽  
Hospital Admissions ◽  
Inpatient Setting ◽  
High Morbidity ◽  
Coding System ◽  
Behavioral Health Services ◽  
Icd 10

Abstract Background People who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI). The inpatient setting is an ideal opportunity to treat underlying substance use disorder (SUD), but it is unclear how often this occurs. Objectives To quantify the utilization of behavioral health services for PWID during inpatient admissions for IRI. Methods Data for all hospital admissions in Florida in FY2017 were obtained from the Agency for Healthcare Administration. Hospitalization for IRI were obtained using a validated ICD-10 algorithm and treatment for substance use disorder was quantified using ICD-10-Procedure Coding System (ICD-10-PCS) codes. Result Among the 20,001 IRI admissions, there were 230 patients who received behavioral health services as defined by ICD-10-PCS SAT codes for treatment for SUD. Conclusions In a state with a large number of IRI, only a very small portion of admissions received behavioral health services. Increased efforts should be directed to studying referral patterns among physicians and other providers caring for this population and increasing utilization of behavioral health services.

The misuse of alcohol and drugs

2012 ◽  
pp. 441-484
Author(s):  
Philip Cowen ◽  
Paul Harrison ◽  
Tom Burns
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Alcohol Use Disorders ◽  
Psychoactive Drug ◽  
Psychoactive Drugs ◽  
Alcohol And Drugs ◽  
Icd 10 ◽  
Dsm Iv

The phrases substance use disorder (DSM-IV) or disorders due to psychoactive drug use (ICD-10) are used to refer to conditions arising from the misuse of alcohol, psychoactive drugs, or other chemicals such as volatile substances. In this chapter, problems related to alcohol will be discussed first under the general heading of alcohol use disorders. Problems related to drugs and other chemicals will then be discussed under the general heading of other substance use disorders.

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