scholarly journals Three-month outcomes from a patient-centered program to treat opioid use disorder in Iowa, USA

2021 ◽  
Author(s):  
Alison C. Lynch ◽  
Andrea N. Weber ◽  
Suzy Hedden ◽  
Sayeh Sabbagh ◽  
Stephan Arndt ◽  
...  
Keyword(s):  
Drug Use ◽  
Retention Rate ◽  
Opioid Use Disorder ◽  
Illegal Drug ◽  
Treatment Retention ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Patient Centered ◽  
Illegal Drug Use ◽  
Recovery Capital

Abstract Background: Opioid use disorder (OUD), a chronic disease, is a major public health problem. Despite availability of effective treatment, too few people receive it and treatment retention is low. Understanding barriers and facilitators of treatment access and retention is needed to improve outcomes for people with OUD.Objectives: To assess 3-month outcomes pilot data from a patient-centered OUD treatment program in Iowa, USA, that utilized flexible treatment requirements and prioritized engagement over compliance. Methods: Forty patients (62.5% female: mean age was 35.7 years, SD 9.5) receiving medication, either buprenorphine or naltrexone, to treat OUD were enrolled in an observational study. Patients could select or decline case management, counseling, and peer recovery groups. Substance use, risk and protective factors, and recovery capital were measured at intake and 3 months. Results: Most participants reported increased recovery capital. The median Assessment of Recovery Capital (ARC) score went from 37 at enrollment to 43 (p<0.01). Illegal drug use decreased, with the median days using illegal drugs in the past month dropping from 10 to 0 (p<0.001). Cravings improved: 29.2% reported no cravings at intake and 58.3% reported no cravings at 3 months (p<0.001). Retention rate was 92.5% at 3 months. Retention rate for participants who were not on probation/parole was higher (96.9%) than for those on probation/parole (62.5%, p=0.021). Conclusion: This study shows preliminary evidence that a care model based on easy and flexible access and strategies to improve treatment retention improves recovery capital, reduces illegal drug use and cravings, and retains people in treatment.

scholarly journals Three-month outcomes from a patient-centered program to treat opioid use disorder in Iowa, USA

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Alison C. Lynch ◽  
Andrea N. Weber ◽  
Suzy Hedden ◽  
Sayeh Sabbagh ◽  
Stephan Arndt ◽  
...  
Keyword(s):  
Drug Use ◽  
Retention Rate ◽  
Opioid Use Disorder ◽  
Illegal Drug ◽  
Treatment Retention ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Patient Centered ◽  
Illegal Drug Use ◽  
Recovery Capital

Abstract Background Opioid use disorder (OUD), a chronic disease, is a major public health problem. Despite availability of effective treatment, too few people receive it and treatment retention is low. Understanding barriers and facilitators of treatment access and retention is needed to improve outcomes for people with OUD. Objectives To assess 3-month outcomes pilot data from a patient-centered OUD treatment program in Iowa, USA, that utilized flexible treatment requirements and prioritized engagement over compliance. Methods Forty patients (62.5% female: mean age was 35.7 years, SD 9.5) receiving medication, either buprenorphine or naltrexone, to treat OUD were enrolled in an observational study. Patients could select or decline case management, counseling, and peer recovery groups. Substance use, risk and protective factors, and recovery capital were measured at intake and 3 months. Results Most participants reported increased recovery capital. The median Assessment of Recovery Capital (ARC) score went from 37 at enrollment to 43 (p < 0.01). Illegal drug use decreased, with the median days using illegal drugs in the past month dropping from 10 to 0 (p < 0.001). Cravings improved: 29.2% reported no cravings at intake and 58.3% reported no cravings at 3 months (p < 0.001). Retention rate was 92.5% at 3 months. Retention rate for participants who were not on probation/parole was higher (96.9%) than for those on probation/parole (62.5%, p = 0.021). Conclusion This study shows preliminary evidence that a care model based on easy and flexible access and strategies to improve treatment retention improves recovery capital, reduces illegal drug use and cravings, and retains people in treatment.

scholarly journals Three-Month Outcomes from a Patient-Centered Program to Treat Opioid use Disorder

2020 ◽  
Author(s):  
Alison Lynch ◽  
Andrea N Weber ◽  
Suzy Hedden ◽  
Sayeh Sabbagh ◽  
Stephan Arndt ◽  
...  
Keyword(s):  
Drug Use ◽  
Retention Rate ◽  
Opioid Use Disorder ◽  
Illegal Drug ◽  
Treatment Retention ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Patient Centered ◽  
Illegal Drug Use ◽  
Recovery Capital

Abstract Background: Opioid use disorder (OUD), a chronic disease, is a major public health problem. Despite availability of effective treatment, too few people receive it and treatment retention is low. Understanding barriers and facilitators of treatment access and retention is needed to improve outcomes for people with OUD.Objectives: To assess 3-month outcomes pilot data from a patient-centered OUD treatment program that utilized flexible treatment requirements and prioritized engagement over compliance. Methods: Forty patients (62.5% female) receiving medication to treat OUD at all levels of care were enrolled in an observational study. Patients could select or decline case management, counseling, and peer recovery groups. Substance use, risk and protective factors, and recovery capital were measured at intake and 3 months. Results: Most participants reported increased recovery capital. The median Assessment of Recovery Capital (ARC) score went from 37 at enrollment to 43 (p<0.01). Illegal drug use decreased, with the median days using illegal drugs in the past month dropping from 10 to 0 (p<0.001). Cravings improved: 29.2% reported no cravings at intake and 58.3% reported no cravings at 3 months (p<0.001). Retention rate was 92.5% at 3 months. Retention rate for participants who were not on probation/parole was higher (96.9%) than for those on probation/parole (62.5%, p=0.021). Conclusion: This study shows preliminary evidence that a care model based on low-barrier access and strategies to improve treatment retention improves recovery capital, reduces illegal drug use and cravings, and retains people in treatment.

Prescription Opioids in Adolescence and Future Opioid Misuse

2018 ◽  
pp. 49-57
Author(s):  
Richard Miech ◽  
Lloyd Johnston ◽  
Patrick M. O’Malley ◽  
Katherine M. Keyes ◽  
Kennon Heard
Keyword(s):  
High School ◽  
Drug Use ◽  
Illegal Drug ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Illegal Drug Use ◽  
12Th Grade ◽  
History Of ◽  
Monitoring The Future ◽  
Nationally Representative

BACKGROUND AND OBJECTIVE Legitimate opioid use is associated with an increased risk of long-term opioid use and possibly misuse in adults. The objective of this study was to estimate the risk of future opioid misuse among adolescents who have not yet graduated from high school. METHODS Prospective, panel data come from the Monitoring the Future study. The analysis uses a nationally representative sample of 6220 individuals surveyed in school in 12th grade and then followed up through age 23. Analyses are stratified by predicted future opioid misuse as measured in 12th grade on the basis of known risk factors. The main outcome is nonmedical use of a prescription opioid at ages 19 to 23. Predictors include use of a legitimate prescription by 12th grade, as well as baseline history of drug use and baseline attitudes toward illegal drug use. RESULTS Legitimate opioid use before high school graduation is independently associated with a 33% increase in the risk of future opioid misuse after high school. This association is concentrated among individuals who have little to no history of drug use and, as well, strong disapproval of illegal drug use at baseline. CONCLUSIONS Use of prescribed opioids before the 12th grade is independently associated with future opioid misuse among patients with little drug experience and who disapprove of illegal drug use. Clinic-based education and prevention efforts have substantial potential to reduce future opioid misuse among these individuals, who begin opioid use with strong attitudes against illegal drug use.

Why use group visits for opioid use disorder treatment in primary care? A patient-centered qualitative study

2017 ◽  
Vol 39 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Randi Sokol ◽  
Chiara Albanese ◽  
Deviney Chaponis ◽  
Jessica Early ◽  
George Maxted ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Patient Centered ◽  
Group Visits ◽  
Disorder Treatment

Illegal drug use

1985 ◽  
Vol 3 (3) ◽  
pp. 239-240
Author(s):  
Richard Rogers ◽  
James L. Cavanaugh
Keyword(s):  
Drug Use ◽  
Illegal Drug ◽  
Illegal Drug Use

A review of the evidence to explain pharmacological basis of injection (ab)use of buprenorphine–naloxone tablets

2021 ◽  
Vol 17 (7) ◽  
pp. 141-152
Author(s):  
Tamoud Modak, MD, DM ◽  
Siddharth Sarkar, MD, MRCPsych ◽  
Yatan Pal Singh Balhara, MD
Keyword(s):  
Public Health Problem ◽  
Opioid Use Disorder ◽  
Critical Examination ◽  
Evidence Based ◽  
Major Public Health Problem ◽  
Opioid Use ◽  
Evidence Based Treatment ◽  
Opioid Replacement Therapy ◽  
Pharmacological Basis

Opioid use disorder is a major public health problem, and opioid replacement therapy with buprenorphine (BPN) is a clinically effective and evidence-based treatment for it. To deter misuse of the tablet through the injecting route, BPN coformulated with naloxone (BNX) in 4:1 ratio is available in many countries. Despite this, significant diversion and injecting use of the BNX combination has been reported from across the world. In this article, the pharmacological properties of BPN and BNX and the evidence for their diversion are reviewed. Also, a critical examination is made of the evidence supporting the role of naloxone in reducing the agonist effects of BPN when used through the injecting route. Based on this evidence, a hypothesis explaining the continued diversion of BNX has been proposed.

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