scholarly journals Medicated-Assisted Treatment and 12-Step Programs: Evaluating the Referral Process

2021 ◽  
Author(s):  
Candace Brown ◽  
Chudney Williams ◽  
Ryan Stephens ◽  
Jacqueline Sharp ◽  
Bobby Bellflower ◽  
...  
Keyword(s):  
Medication Management ◽  
Drop Out ◽  
Twelve Step ◽  
Missed Appointments ◽  
Twelve Step Programs ◽  
Face To Face ◽  
Urine Drug ◽  
Virtual Visits ◽  
Low Incidence ◽  
Step Program

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT. Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected from a database before project implementation. Eligible participants were diagnosed with OUD, receiving buprenorphine (opiate agonist), and at least 18. Participants were provided with temporary sponsors to attend Narcotics Anonymous, Alcoholics Anonymous, and Medication-Assisted Recovery meetings together. The primary endpoint was the change in positive opiate urine drug screens over 6 months between participants and controls. Results Between March 29, 2021, and April 16, 2021, 166 patients were scheduled at the clinic. Of those scheduled, 146 were established patients, and 123 were scheduled for face-to-face visits. Of these, 64 appeared for the appointment, 6 were screened, and 3 were enrolled. None of the participants attended a 12-step meeting. Enrollment barriers included excluding new patients and those attending virtual visits, the high percentage of patients who missed appointments, and lack of staff referrals. The low incidence of referrals was due to time constraints by both staff and patients. Implications for Nursing Practice Low enrollment limited our ability to determine whether combining medication management with a 12-step program improves abstinence. Failure to keep appointments is common among patients with OUD, and virtual meetings are becoming more prevalent post-COVID. Although these factors are unlikely to be controllable, developing strategies to expedite the enrollment process for staff and patients could hasten recruitment.

scholarly journals Using Qualitative Methods to Inform Scale Development

2015 ◽  
Author(s):  
Noell Rowan ◽  
Dan Wulff
Keyword(s):  
Scale Development ◽  
Qualitative Methods ◽  
Mixed Method ◽  
Twelve Step ◽  
Twelve Step Programs ◽  
Qualitative Interviewing ◽  
Recovery Programs ◽  
Twelve Step Program ◽  
Analytical Approaches ◽  
Step Program

This article describes the process by which one study utilized qualitative methods to create items for a multi dimensional scale to measure twelve step program affiliation. The process included interviewing fourteen addicted persons while in twelve step focused treatment about specific “pros” (things they like or would miss out on by not being involved in twelve-step programs) and “cons” (things they dislike or would benefit from if they did not engage in twelve-step programs). The triangular process used in qualitative research is described, which generated items for the subsequent instrument to measure ambivalence toward recovery programs. Mixed-method strategies included qualitative interviewing to inform scale development and three analytical approaches to produce specific codes, themes, and domains.

scholarly journals Physician requirements for adoption of telehealth following the SARS-CoV-2 pandemic

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Michael Hodgkins ◽  
Meg Barron ◽  
Shireesha Jevaji ◽  
Stacy Lloyd
Keyword(s):  
Care Delivery ◽  
Virtual Technology ◽  
Privacy Concerns ◽  
Face To Face ◽  
House Calls ◽  
Care Delivery Model ◽  
Virtual Visits ◽  
Similar Survey ◽  
Remote Care

AbstractIt took the advent of SARS-CoV-2, a “black swan event”, to widely introduce telehealth, remote care, and virtual house calls. Prior to the epidemic (2019), the American Medical Association (AMA) conducted a routine study to compare physicians’ adoption of emerging technologies to a similar survey in 2016. Most notable was a doubling in the adoption of telehealth/virtual technology to 28% and increases in the use of remote monitoring and management for improved care (13–22%). These results may now seem insignificant when compared to the unprecedented surge in telehealth visits because of SARS-CoV-2. Even as this surge levels off and begins to decline, many observers believe we will continue to see a persistent increase in the use of virtual visits compared to face-to-face care. The requirements for adoption communicated by physicians in both the 2016 and 2019 surveys are now more relevant than ever: Is remote care as effective as in-person care and how best to determine when to use these modalities? How do I safeguard my patients and my practice from liability and privacy concerns? How do I optimize using these technologies in my practice and, especially integration with my EHR and workflows to improve efficiency? And how will a mix of virtual and in-person visits affect practice revenue and sustainability? Consumers have also expressed concerns about payment for virtual visits as well as privacy and quality of care. If telehealth and remote care are here to stay, continuing to track their impact during the current public health emergency is critically important to address so that policymakers and insurers will take necessary steps to ensure that the “new normal” will reflect a health care delivery model that can provide comparable or improved results today and into the future.

scholarly journals Working the Self: Truth-Telling in the Practice of Alcoholics Anonymous

Human Studies ◽  
2021 ◽  
Author(s):  
Fredrik Palm
Keyword(s):  
Alcoholics Anonymous ◽  
The Self ◽  
Twelve Step ◽  
Truth Telling ◽  
Twelve Step Programs ◽  
Critical Studies ◽  
Self Help ◽  
Close Study ◽  
Care Of Self

AbstractThis article interrogates twelve step practice within Alcoholics Anonymous (AA) from the perspective of Foucault’s later work on governance, truth-telling and subjectivity. Recent critical studies of addiction tend to view self-help cultures like that of AA and related twelve step programs as integral parts of contemporary power/knowledge complexes, and thus as agents of the modern “will to knowledge” that Foucault often engages with. In line with the widespread Foucauldian critique of governmentality, addiction self-help culture is thus conceived as one that primarily reproduces abstract, neoliberal norms on health and subjectivity. The argument put forward in this article aims to upset this framework attending to a number of features of twelve step practice that, arguably, bear striking resemblances to Foucault’s later discussions of ethics, care of self and truth-telling. In this, it is suggested that a close study of AA practices, might interrupt assumptions about contemporary addiction discourse and its relationship to issues of truth and power often reproduced in Foucauldian critiques.

Substance-Related Cravings and Relapses: Clinical Implications

1998 ◽  
Vol 43 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Nady el-Guebaly ◽  
David Hodgins
Keyword(s):  
Family Involvement ◽  
Relapse Prevention ◽  
Management Strategies ◽  
Clinical Implications ◽  
Twelve Step ◽  
Twelve Step Programs ◽  
Treatment Techniques ◽  
Substance Dependent ◽  
Cue Exposure Treatment ◽  
Relapse Patterns

Objective: To review the implications of current research on clinical practice. Method: An examination of the literature over the last 10 years and the data from our own study group. Results: A synopsis of current psychobiological and psychological conceptual underpinnings of the nature and process of cravings and relapses among substance-dependent individuals is presented. The biopsychosocial dimensions of the clinical assessment of craving components, relapse patterns, and predictors, including relevant instruments, are explored. The panoply of management strategies for cravings and relapses encompasses cue exposure treatment techniques, relapse prevention approaches, anticraving and psychotropic medication, family involvement, and twelve-step programs. Conclusion: A clinician's familiarity with these strategies should contribute significantly to the transformation of the sense of failure engendered by a patient's relapse into a constructive challenge and opportunity.

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