The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

Abstract Background It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. Methods Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. Results Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. Conclusion Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. Trial registration ISRCTN88025085, date of registration: 29.08.2016, retrospectively registered.

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Substance use disorders and psychological trauma

Psychiatric Bulletin ◽

10.1192/pb.bp.108.019554 ◽

2009 ◽

Vol 33 (7) ◽

pp. 257-260

Author(s):

Shaheen Shora ◽

Elizabeth Stone ◽

Keron Fletcher

Keyword(s):

Substance Use ◽

Alcohol Dependence ◽

Life Events ◽

Substance Use Disorders ◽

Best Practice ◽

Clinical Course ◽

Traumatic Events ◽

Psychological Trauma ◽

Clinical Implications ◽

The Impact

Aims and MethodThe Impact of Events Scale was administered to 104 in-patients detoxing from alcohol or opiates to determine the prevalence of psychological trauma, the severity of its symptoms and the types of trauma responsible for symptoms.ResultsOut of the 104 in-patients undergoing detoxification, 75 had symptoms of psychological trauma; in 60 patients the symptoms were in the treatable range. Patients with alcohol-dependence were more severely affected. ‘Life events’ traumatised a higher proportion of individuals than ‘traumatic events’.Clinical ImplicationsPsychological trauma requiring treatment is commonly found in substance misusers. This is rarely addressed despite the cormorbid disorder running a complicated clinical course. There are conflicting opinions about best practice, but consideration should be given to providing patients with accessible treatments for psychological trauma.

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The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders

Journal of Anxiety Disorders ◽

10.1016/j.janxdis.2016.03.003 ◽

2016 ◽

Vol 41 ◽

pp. 73-81 ◽

Cited By ~ 34

Author(s):

Anne N. Banducci ◽

Sarah J. Bujarski ◽

Marcel O. Bonn-Miller ◽

Amee Patel ◽

Kevin M. Connolly

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Emotional Distress ◽

The Impact

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Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.11.suppl_1.228 ◽

2018 ◽

Vol 11 (suppl_1) ◽

Author(s):

Sarah C Snow ◽

Gregg C Fonarow ◽

Joseph A Ladapo ◽

Donna L Washington ◽

Katherine Hoggatt ◽

...

Keyword(s):

Heart Failure ◽

Substance Use ◽

Native American ◽

Drug Use ◽

Substance Use Disorders ◽

Age Groups ◽

Opioid Use ◽

Drug Use Disorders ◽

Increased Risk ◽

Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

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A review of recent literature on the impact of parental substance use disorders on children and the provision of effective services

Current Opinion in Psychiatry ◽

10.1097/yco.0000000000000421 ◽

2018 ◽

Vol 31 (4) ◽

pp. 363-367 ◽

Cited By ~ 6

Author(s):

Shulamith L.A. Straussner ◽

Christine H. Fewell

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Recent Literature ◽

Parental Substance Use ◽

The Impact

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“Turning the tide” in Treatment of substance use: A nursing response

Journal of Nursing Education and Practice ◽

10.5430/jnep.v8n2p116 ◽

2017 ◽

Vol 8 (2) ◽

pp. 116 ◽

Cited By ~ 2

Author(s):

Julie Worley ◽

Kathleen R. Delaney

Keyword(s):

Substance Use ◽

Healthcare Provider ◽

Substance Use Disorders ◽

Evidence Based ◽

Review Of Literature ◽

Evidence Based Treatment ◽

The Impact

Objective: To analyze science and practice surrounding nursing approaches to substance use disorders (SUDs) and make recommendations for the future.Methods: A review of literature and topics related to healthcare provider stigma, science surrounding SUDs, nursing approaches to SUDs in education and practice and evidence based treatment was conducted, analyzed and synthesized.Results: Stigma is embedded in nursing approach to SUDs, up to date information regarding SUDs is not widely disseminated or practiced in nursing.Conclusions: To reduce the impact of stigma and to bring nurses into the “turning the Tide” movement requires an understanding of how beliefs root stigma, building knowledge related to SUDs as an illness, and expansion of nurses' skill when intervening with individuals dealing with SUDs.

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Substance use Treatment and Harm Reduction Services for Migrants and Refugees in the COVID-19 Pandemic: Findings from a Global Survey

10.21203/rs.3.rs-123740/v1 ◽

2020 ◽

Author(s):

Cornelis De Jong ◽

Ali Farhoudian ◽

Mehrnoosh Vahidi ◽

Mohsen Ebrahimi ◽

Hamed Ekhtiari ◽

...

Keyword(s):

Substance Use ◽

Harm Reduction ◽

Substance Use Disorders ◽

Mental Health Problems ◽

World Health ◽

Substance Use Treatment ◽

Second Phase ◽

Addiction Medicine ◽

Global Survey ◽

The Impact

Abstract Migrants and refugees are considered vulnerable to mental health problems and substance use disorders; and may be particularly affected by service disruptions associated with the COVID-19 pandemic The International Society of Addiction Medicine (ISAM) ran a multi-phased global survey among clinicians and health professional that are actively working in the field of addiction medicine to investigate the impact of the COVID-19 pandemic on substance use and related services. In March 2020, the first month after the announcement of the pandemic by the World Health Organization, 177 informants from 77 countries took part in the global survey, and only 12.9% of them reported their countries’ substance use treatment and harm reduction services for the migrants and refugees with substance use disorders continued as usual. In May 2020, 11.7% of respondents of the second phase reported that the services for refugees and migrants improved in comparison to March 2020; 11.7% reported that these services in their country discontinued. Results suggest that refugee and migrants access to treatment and harm reduction services has been reduced as a result of COVID-19. It can be concluded that it is crucial to improve the visibility of migrants’ needs and exploit appropriate interventions for those with substance use disorders.

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The Impact of Training Indigenous Facilitators for a Two-Eyed Seeing Research Treatment Intervention for Intergenerational Trauma and Addiction

International Indigenous Policy Journal ◽

10.18584/iipj.2020.11.4.8623 ◽

2020 ◽

Vol 11 (4) ◽

pp. 1-20

Author(s):

Teresa Naseba Marsh ◽

David C. Marsh ◽

Lisa M. Najavits

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Research Effort ◽

Traditional Healers ◽

Traditional Healing ◽

Intergenerational Trauma ◽

Seeking Safety ◽

Traditional Healing Practices ◽

The Impact ◽

Sharing Circles

Intergenerational trauma in Indigenous Peoples was not the result of a targeted event, but rather political and governmental policies inflicted upon entire generations. The resultant effects of these traumas and multiple losses include addiction, depression, anxiety, violence, self-destructive behaviors, and suicide, to name but a few. Traditional healers, Elders, and Indigenous facilitators agree that the reclamation of traditional healing practices combined with conventional interventions could be effective in addressing intergenerational trauma and substance use disorders. Recent research has shown that the blending of Indigenous traditional healing practices and the Western treatment model Seeking Safety resulted in a reduction of intergenerational trauma (IGT) symptoms and substance use disorders (SUD). This article focuses on the Indigenous facilitators who were recruited and trained to conduct the sharing circles as part of the research effort. We describe the six-day training, which focused on the implementation of the Indigenous Healing and Seeking Safety model, as well as the impact the training had on the facilitators. Through the viewpoints and voices of the facilitators, we explore the growth and changes the training brought about for them, as well as their perception of how their changes impacted their clients.

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The Impact of Alcohol and Other Substance Use Disorders on Mortality in Patients With Eating Disorders: A Nationwide Register-Based Retrospective Cohort Study

American Journal of Psychiatry ◽

10.1176/appi.ajp.2021.21030274 ◽

2022 ◽

Vol 179 (1) ◽

pp. 46-57 ◽

Cited By ~ 2

Author(s):

Angelina Isabella Mellentin ◽

Anna Mejldal ◽

Maria Mercedes Guala ◽

René Klinkby Støving ◽

Lene Stryhn Eriksen ◽

...

Keyword(s):

Eating Disorders ◽

Substance Use ◽

Cohort Study ◽

Substance Use Disorders ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

The Impact

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Screening, Assessment, and Diagnosis of Substance Use Disorders among Emerging Adults

Emerging Adults and Substance Use Disorder Treatment ◽

10.1093/med-psych/9780190490782.003.0003 ◽

2017 ◽

pp. 38-70 ◽

Cited By ~ 1

Author(s):

Douglas C. Smith ◽

Kyle M. Bennett ◽

Michael L. Dennis ◽

Rodney Funk

Keyword(s):

Substance Use ◽

Emerging Adults ◽

Substance Use Disorders ◽

Emerging Adult ◽

Assessment Instruments ◽

Specific Research ◽

Dsm 5 ◽

Administration Time ◽

Symptom Patterns ◽

Using Data

Several challenges may hinder accurate screening for and assessment of substance use disorders among emerging adults ages 18–29. This chapter discusses emerging adult–specific research on diagnosing substance use disorders and several empirically supported screeners and assessments that may be useful to those working with emerging adults. First, emerging adult–specific research supporting changes to the most recent version of the Diagnostic and Statistical Manual for Mental Disorders, the DSM-5, is reviewed, and nuances in using the DSM-5 with emerging adults are discussed. The chapter highlights idiosyncrasies in emerging adult symptom patterns using data from large national surveys. Finally, a practice-friendly review of screening and assessment instruments commonly used with emerging adults is provided. For screening instruments, administration time, the instrument’s ability to discern which emerging adults exhibit substance use problems, and emerging adult–specific cutoff points in the literature are addressed. For assessment tools, comprehensiveness of the instrument, administration time, and contexts in which the instrument has been used with emerging adults are discussed.

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