A Substance Use DIsorder Educational Session: Influence on Nurse Anesthesia Care Providers Addiction Attitudes and Perceived Self-Efficacy to Recognize Chemical Impairment

2021 ◽  
Author(s):  
Ferne Michele Cohen
2020 ◽  
Author(s):  
Naim Naim ◽  
Laura Dunlap

BACKGROUND Access to behavioral health services, particularly substance use disorder (SUD) treatment services, is challenging in rural and other underserved areas. Some of the reasons for these challenges include local primary care providers without experience in behavioral health treatment, few specialty providers, and concerns over stigma and lack of privacy for individuals from smaller communities. Telehealth can ease these challenges and support behavioral health, specifically SUD treatment, in a variety of ways, including direct patient care, patient engagement, and provider education. Telehealth is particularly relevant for the growing opioid epidemic, which has profoundly affected rural areas. OBJECTIVE We sought to understand how telehealth is used to support behavioral health and SUDs, with a particular focus on implications for medication-assisted treatment for opioid use disorders. The intent was to understand telehealth implementation and use, financing and sustainability, and impact in the field. The results of this work can be used to inform future policy and practice. METHODS We reviewed literature and interviewed telehealth stakeholders and end users in the field. The team identified a diverse set of participants, including clinical staff, administrators, telehealth coordinators, and information technology staff. We analyzed research notes to extract themes from participant experiences to answer the study questions. RESULTS Organizations varied in how they implemented telehealth services and the services they offered. Common themes arose in implementation, such as planning for technical and organizational impacts of telehealth, the importance of leadership support, and tailoring programs to community needs. CONCLUSIONS Telehealth is used in a variety of ways to expand access to services and extend service delivery. As the policy and reimbursement landscape continues to evolve, there may be corresponding changes in telehealth uptake and services provided. CLINICALTRIAL NA


2014 ◽  
Vol 44 (6) ◽  
pp. 698-709 ◽  
Author(s):  
Ewa K. Czyz ◽  
Amy S. B. Bohnert ◽  
Cheryl A. King ◽  
Amanda M. Price ◽  
Felicia Kleinberg ◽  
...  

2020 ◽  
Vol 103 (6) ◽  
pp. 1125-1133 ◽  
Author(s):  
Yan Liu ◽  
Rachel Kornfield ◽  
Bret R. Shaw ◽  
Dhavan V. Shah ◽  
Fiona McTavish ◽  
...  

2019 ◽  
Vol 199 ◽  
pp. 76-84
Author(s):  
Mary A. Hatch-Maillette ◽  
Robin Harwick ◽  
John S. Baer ◽  
Elizabeth A. Wells ◽  
Tatiana Masters ◽  
...  

2021 ◽  
pp. 351-363
Author(s):  
Hunter Woodall

Palliative care providers, including physician assistants, frequently encounter substance use disorder (SUD) in patients or their families. Many of these patients with SUD remain undiagnosed at the time of palliative care referral, with most patients with these issues having preexisting conditions. Management of these patients requires proper screening and diagnosis, and teams must establish clear expectations. This chapter teaches palliative care teams to detect SUD and differentiate addiction behaviors from incompletely managed symptoms; diagnose and manage associated psychosocial issues; communicate clear expectations regarding treatment; safely prescribe controlled medications; manage intoxication or withdrawal; and develop plans to deal with drug diversion. Ongoing timely multidisciplinary communication is paramount in managing these challenging illnesses.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Dexter L. Louie ◽  
Mehret T. Assefa ◽  
Mark P. McGovern

Abstract Background The opioid epidemic is a major public health issue associated with significant overdose deaths. Effective treatments exist, such as the medication buprenorphine, but are not widely available. This narrative review examines the attitudes of primary care providers (PCPs) toward prescribing buprenorphine. Methods Narrative review of 20 articles published after the year 2000, using the Consolidated Framework for Implementation Research (CFIR) to organize the findings. Results Three of the five CFIR domains (“Intervention Characteristics,” “Outer Setting,” “Inner Setting”) were strongly represented in our analysis. Providers were concerned about the clientele associated with buprenorphine, diversion, and their self-efficacy in prescribing the medication. Some believed that buprenorphine does not belong in the discipline of primary care. Other barriers included philosophical objections and stigma toward substance use disorders. Notably, two studies reported a shift in attitudes once physicians prescribed buprenorphine to actual patients. Conclusions Negative attitudes toward buprenorphine encompassed multi-layered concerns, ranging from skepticism about the medication itself, the behaviors of patients with opioid use disorders, and beliefs regarding substance use disorders more generally. We speculate, however, that negative attitudes may be improved by tailoring support strategies that address providers’ self-efficacy and level of knowledge.


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