Telehealth Services for Substance Use Disorders: A 3-month Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices During the COVID-19 Pandemic (Preprint)

2022 ◽  
Author(s):  
Kate Gliske ◽  
Justine Welsh ◽  
Jacqueline E. Braughton ◽  
Lance A. Waller ◽  
Quyen M. Ngo
Keyword(s):  
Substance Use ◽  
Data Collection ◽  
Addiction Treatment ◽  
Well Being ◽  
The United States ◽  
Treatment Center ◽  
Post Discharge ◽  
Health Crisis ◽  
Outcome Monitoring ◽  
Intensive Outpatient

BACKGROUND The onset of the COVID-19 pandemic necessitated the rapid transition of many types of substance use disorder (SUD) treatment to telehealth formats, despite limited information about what makes treatment effective in this novel format. OBJECTIVE To examine the feasibility and effectiveness of virtual intensive outpatient program (IOP) treatment for SUD in the context of a global pandemic, while considering the unique challenges posed to data collection during an unprecedented public health crisis. METHODS The study is based on a longitudinal study with a baseline sample of 3,642 patients who enrolled in intensive outpatient addiction treatment (in-person, hybrid, or virtual) from January 2020 to March 2021 at a large substance use treatment center in the United States. The analytical sample consisted of patients who completed the 3-month post-discharge outcome survey as part of routine outcome monitoring (n = 1,060) (response rate = 29%). RESULTS No significant differences were detected by delivery format in continuous abstinence (χ2 = 0.42, P = .81), overall quality of life (F(2,826) = 2.06, P = .13), financial well-being (F(2,767) = 2.30, P = .10), psychological well-being (F(2,918) = 0.72, P = .49), and confidence in one’s ability to stay sober (F(2,941) = 0.21, P = .81). Individuals in hybrid programming were more likely to report a higher level of general health than those in virtual IOP (F(2,917) = 4.19, P = .01). CONCLUSIONS Virtual outpatient care for the treatment of SUDs is a feasible alternative to in-person only programming leading to similar self-reported outcomes at 3-months post-discharge. Given the many obstacles presented throughout data collection during a pandemic, further research is needed to better understand under what conditions telehealth is an acceptable alternative to in-person care.

scholarly journals Within-treatment changes in a novel addiction treatment program using traditional Amazonian medicine

2021 ◽  
Vol 11 ◽  
pp. 204512532098663
Author(s):  
David M. O’Shaughnessy ◽  
Ilana Berlowitz ◽  
Robin Rodd ◽  
Zoltán Sarnyai ◽  
Frances Quirk
Keyword(s):  
Repeated Measures ◽  
Addiction Treatment ◽  
Emotional Health ◽  
Neuropsychological Functioning ◽  
Well Being ◽  
Treatment Center ◽  
Therapeutic Effects ◽  
Spiritual Well Being ◽  
Treatment Safety ◽  
Addiction Treatment Program

Aims: The therapeutic use of psychedelics is regaining scientific momentum, but similarly psychoactive ethnobotanical substances have a long history of medical (and other) uses in indigenous contexts. Here we aimed to evaluate patient outcomes in a residential addiction treatment center that employs a novel combination of Western and traditional Amazonian methods. Methods: The study was observational, with repeated measures applied throughout treatment. All tests were administered in the center, which is located in Tarapoto, Peru. Data were collected between 2014 and 2015, and the study sample consisted of 36 male inpatients who were motivated to seek treatment and who entered into treatment voluntarily. Around 58% of the sample was from South America, 28% from Europe, and the remaining 14% from North America. We primarily employed repeated measures on a psychological test battery administered throughout treatment, measuring perceived stress, craving frequency, mental illness symptoms, spiritual well-being, and physical and emotional health. Addiction severity was measured on intake, and neuropsychological performance was assessed in a subsample from intake to at least 2 months into treatment. Results: Statistically significant and clinically positive changes were found across all repeated measures. These changes appeared early in the treatment and were maintained over time. Significant improvements were also found for neuropsychological functioning. Conclusion: These results provide evidence for treatment safety in a highly novel addiction treatment setting, while also suggesting positive therapeutic effects.

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

Aging, Vulnerability and Managing Type 2 Diabetes During a Pandemic

2020 ◽  
Vol 7 (6) ◽  
pp. 106-111
Author(s):  
Jasmin Tahmaseb McConatha
Keyword(s):  
United States ◽  
Type 2 Diabetes ◽  
Black Women ◽  
Well Being ◽  
Immigrant Woman ◽  
The United States ◽  
Health Crisis ◽  
Men And Women ◽  
Class Differences

Older men and women have been found to be more vulnerable to negative outcomes should they contract Covid19, particularly if they also have comorbid conditions such as type 2 diabetes. Cultural, racial, ethnic, and social class differences exist in vulnerability to Covid19 and in the prevalence of type 2 diabetes. In the United States, for example, diabetes rates for minority and immigrant populations are higher than for non-Hispanic whites. During the a social health crisis, it is helpful to explore the ways that illness management and associated vulnerability influences the ways that minority elders attempt to maintain and promote their well-being. This paper presents a case study example of an older immigrant woman, diagnosed with type 2 diabetes, and her struggle to manage her illness during a pandemic. The risk of developing diabetes in the United States is 3 to 1 and risks increase with age (American Diabetes Association, 2020).  Almost 50 % of black women as well as Hispanic men and women will develop diabetes in their lifetime (CDC, 2019). Disparities such as these have their origin in intersecting risk factors such as health care and lifestyle factors such as tress, poverty, weight, diet, and exercise patterns. Being a member of an ethnic minority and being overweight are the two significant factors associated with the onset of type 2 diabetes. During the coronavirus epidemic, these same factors also increase the risk for infection and for greater complications, even death as a result of infection (Society for Women’s Health Research, 2020). This essay illustrates the increased vulnerability and challenges including loneliness facing older women with type 2 diabetes during pandemic isolation.    

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

scholarly journals 454. Impact of Covid-19 on Infectious Disease Fellows in the United States: A National Survey to Identify Targets for Intervention

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S328-S330
Author(s):  
Shuba Balan ◽  
Shweta Anjan ◽  
Alison Ohringer ◽  
Jose Gonzales-Zamora ◽  
Deborah Jones Weiss ◽  
...  
Keyword(s):  
Infectious Disease ◽  
National Survey ◽  
Medical Training ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
The United States ◽  
Educational Activities ◽  
Health Crisis ◽  
The Impact ◽  
Severe Anxiety

Abstract Background The Coronavirus disease of 2019 (COVID-19) global health crisis has resulted in an unprecedented strain on healthcare systems, reorganization of medical training programs and disruption in professional and personal lives of medical trainees. The impact of COVID-19 on infectious disease (ID) fellows, who are frontline healthcare professionals, has not been assessed. Methods We conducted a national survey of adult and pediatric ID fellows to assess impact on educational activities, availability of personal protective equipment (PPE), well-being, and career prospects. Anxiety and burnout were assessed by 7-item generalized anxiety disorder scale and abbreviated Maslach burnout inventory respectively. Invitations to participate in the survey were sent via email to all ID fellows through Accreditation Council for Graduate Medical Education (ACGME) fellowship directors. Survey responses collected from August 1 to September 30, 2020 have been reported. Results 136 fellows completed the survey (Table 1). 84% reported their institution had provided evidence-based didactics for management of COVID-19 and 53% indicated their general ID didactics were affected by the pandemic. 86% of fellows were involved in care of patients with COVID-19, and 31% reported a shortage of PPE affecting their clinical duties. Those living in highly impacted states (CA, FL, NY, TX) at the time of the survey were 1.70 times as likely to experience moderate to severe anxiety (vs. minimal to moderate) than those in other states; similarly, those who saw ≥11 COVID-19 patients weekly and reported PPE shortages were 2.5 and 2.0 times as likely, respectively, to experience moderate to severe anxiety compared to their peers who took care of 10 or fewer COVID-19 patients and did not experience PPE shortages. Burnout scores were not significant (Table 2). Table 1. Demographics, Responses to Personal Exposure, Educational Activities and Career Prospects Table 2. Stress, Burnout, Anxiety , Sleep and Quality of Life Among Survey Participants. Conclusion It is imperative that ID fellows feel adequately protected and supported during this pandemic. Pandemic preparedness should be included in the ID fellowship curriculum. Interventions for anxiety and burnout reduction should be implemented. ID fellowship programs should continue to accept feedback from fellows to ensure their ongoing safety, well-being, and education as we navigate this pandemic. Disclosures All Authors: No reported disclosures

scholarly journals Resilience, mood, and mental health outcomes during the first wave of the COVID-19 pandemic in Bulgaria

2021 ◽  
Author(s):  
Elena Psederska ◽  
Georgi Vasilev ◽  
Briana DeAngelis ◽  
Kiril Bozgunov ◽  
Dimitar Nedelchev ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Protective Factor ◽  
Negative Mood ◽  
Well Being ◽  
Emotional States ◽  
Depression And Anxiety ◽  
Health Crisis ◽  
The Face ◽  
Low Prevalence

Background: The fundamental challenges of the COVID-19 pandemic may have lasting negative effects on the quality of mental health worldwide. Resilience is considered an important protective factor in reducing the risk of psychopathology in the face of various adverse events, such as the ongoing health crisis. The aims of the current study were to: (1) evaluate the predictive utility of resilience in accounting for positive and negative moods, substance use, depression and anxiety; and (2) compare negative and positive moods experienced before the pandemic to emotions reported during the first wave of the COVID-19 pandemic in Bulgaria, when the country still had low prevalence of infections and fatalities. Methods: 179 Bulgarian participants completed the international online Minnesota Global Survey on Stress and Resilience in the Face of the Novel Coronavirus (COVID-19), which included measures of resilience, depression and anxiety, substance use, positive and negative moods experienced both before and during the COVID-19 outbreak. Results: Resilience predicted higher levels of positive affect and lower anxiety, depression, and negative mood during the first wave of the COVID-19 outbreak in Bulgaria. A significant increase was found in negative mood and a corresponding decrease in positive mood in the time since COVID-19 began spreading compared to before the pandemic.Conclusions: Results suggest that the initial wave of the COVID-19 crisis impacted individuals’ well-being, even in countries with relatively low prevalence of COVID-19 and associated fatalities. In this challenging global setting, resilience may serve as a buffer against negative emotional states and psychological distress.

scholarly journals Community-Engaged Research (CER) as the Avenue to Promoting Well-being and Recovery in Drug Court

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
John Robert Gallagher ◽  
Anne Nordberg ◽  
Raychel Minasian ◽  
Sydney Szymanowski ◽  
Jesse Carlton ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Support Groups ◽  
Drug Court ◽  
Well Being ◽  
The United States ◽  
Drug Courts ◽  
Recidivism Rate ◽  
Criminal Recidivism ◽  
Community Engaged Research

Drug courts are an alternative to incarceration for individuals who have substance use disorders and have been arrested for drug-related crimes (e.g. possession of a controlled substance). The first drug court began in 1989 in Florida and it is estimated that there are over 3,000 drug courts now operating throughout the United States.  This community-engaged research (CER) evaluated the St. Joseph County (Indiana) drug court by identifying who was most likely to graduate, who was most likely to recidivate, and whether drug court or probation was more effective at reducing criminal recidivism.  Furthermore, although drug courts are found in many communities, research rarely describes the process used to develop and implement CER.  Therefore, this article also highlights the collaborative process used in this drug court evaluation.   The findings from this study suggest that the St. Joseph County (Indiana) drug court is an effective program at reducing criminal recidivism and a valuable resource for individuals who have substance use disorders, the community, and other stakeholders. Drug court participants were less likely to recidivate than probationers, and a lower recidivism rate clearly equates to many benefits to the community.  The article concludes with community-based implications, such as starting recovery support groups that are welcoming to individuals who receive medication-assisted treatment (MAT), marketing drug court to racial and ethnic minorities to increase their representation in drug court, and disseminating research findings throughout the community via local news stories and public lectures.

Performance-Based Practice: Clinical Dashboards for Addiction Treatment Retention

2020 ◽  
pp. 104973152097279
Author(s):  
David A. Patterson Silver Wolf ◽  
Autumn Asher BlackDeer ◽  
Sara Beeler-Stinn ◽  
Ken Zheng ◽  
Kristin Stazrad
Keyword(s):  
Substance Use ◽  
Pilot Study ◽  
Substance Use Disorders ◽  
Addiction Treatment ◽  
Treatment Retention ◽  
Treatment Center ◽  
Health Improvement ◽  
Evidence Based ◽  
Treatment Needs ◽  
The Impact

Purpose: Substance use disorders (SUDs) are on the rise, particularly concerning opioids, and existing services are still not adequately meeting treatment needs. Most treatment dropouts occur within the first few weeks of treatment, indicating health improvement is likely not occurring. In this study, a clinical dashboard tool has shown promising utility with increasing retention in SUD treatment. Method: This pilot study was designed to measure the effects of implementing a performance-based practice clinical dashboard tool and having a process for monitoring patients’ recovery in a Midwestern SUD treatment center. Results: The results demonstrated the efficacy of a clinical dashboard tool that complements therapists’ monitoring and measuring of their patients’ performance. Discussion: Results support a building knowledge base about the impact of real-time, evidence-based tools on the retention and support of clients seeking SUD treatment.

scholarly journals Creating Community During COVID-19: A Virtual Art Gallery to Address Social Isolation During a Pandemic

2021 ◽  
pp. 152483992110646
Author(s):  
Sara E. Baumann ◽  
Jessica G. Burke
Keyword(s):  
Social Isolation ◽  
Social Cohesion ◽  
Well Being ◽  
The United States ◽  
Public University ◽  
Positive Health ◽  
Art Gallery ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Health And Well Being

The COVID-19 pandemic, a public health crisis, significantly impacted millions of people around the world. “Creating Community During COVID-19” is a community-engaged virtual art gallery that explores resilience, social cohesion, and creativity during the onset of the pandemic in the United States. It aimed to address social isolation and encourage inclusion at a large public university in the early days of the pandemic. The community was invited to submit artworks that reflected how they are staying connected during the pandemic. The artworks were then qualitatively analyzed and highlighted three key themes: (1) reflecting (turning inward), (2) advocating (turning outward), and (3) engaging (coming together). This arts-based project demonstrates promise as a creative approach for promoting social cohesion and positive health and well-being, especially in times of uncertainty.

scholarly journals Co -occurring Mental Disorders among In-patients in a Substance use Disorder Treatment Center in Plateau State, Nigeria

2020 ◽  
Vol 3 (1) ◽  
pp. 223-229
Author(s):  
D M Makput
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Addiction Treatment ◽  
Treatment Center ◽  
Post Traumatic Stress ◽  
Functional Abnormality ◽  
Plateau State

Patients with psychoactive substance use disorders (SUD) often have co- occurring medical and mental disorders. This occurs as a result of a number of factors, for instance, drug abuse may facilitate the full expression of a latent psychiatric disorder; mental disorder may lead to SUD (drugs used for self- medication; or both SUD and mental disorders are caused by the same underlying brain deficit such as genetic vulnerability, neurotransmitter abnormality, structural or functional abnormality, and so on. After obtaining ethical clearance, the case notes of all patients who were admitted in the Centre for Addiction Treatment and Research, (CATR) Vom, Plateau state throughout the first quarter of year 2019 were traced. A systematic random sample of every third consecutive patient was selected beginning with the first patient admitted and relevant data were collected and analyzed. A total of fourty- eight (48) in-patients were analyzed. Ninety -four percent (94%) of the patients were males, the mean age of 23.6 + 5 years with 46% being below 25 years of age. Fourty-six percent (46%) had cannabis as their primary drug followed by alcohol (32%) and opioids (28%). Only 1 % had a history of injecting drug use. Twenty-nine percent (29%) of the SUD patients had co-occurring depression, nine percent (8%) had anxiety disorder, and five percent (4%) had Post Traumatic Stress Disorder (PTSD) in addition to their substance use disorder. In line with sustainable development goals (SDG) goal 3.5 which seeks to “strengthen prevention and treatment of substance abuse including narcotics drug abuse and harmful use of alcohol”; identifying co-occurring mental disorders among patients with substance use disorders is one way of moving closer towards achieving this SDG.

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