Evaluating the Impact of the Bridge Clinic in Patients With Opioid Use Disorder

2019 ◽  
Author(s):  
Keyword(s):  
Opioid Use Disorder ◽  
Opioid Use ◽  
The Impact

scholarly journals Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans

2020 ◽  
Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman
Keyword(s):  
Multivariate Analysis ◽  
Hospital Admission ◽  
Intervention Group ◽  
Opioid Use Disorder ◽  
Control Group ◽  
Opioid Use ◽  
Motivation To Change ◽  
Heroin Use ◽  
Ed Visits ◽  
The Impact

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (>45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P < 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.

scholarly journals Conceptualizing the effects of the COVID-19 pandemic on people with opioid use disorder: an application of the social ecological model

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ethan Cowan ◽  
Maria R. Khan ◽  
Siri Shastry ◽  
E. Jennifer Edelman
Keyword(s):  
Structural Changes ◽  
Ecological Model ◽  
Disease Incidence ◽  
Opioid Use Disorder ◽  
Social Ecological Model ◽  
Physical And Mental Health ◽  
Opioid Use ◽  
Social Ecological ◽  
The Social ◽  
The Impact

AbstractThe COVID-19 pandemic has resulted in unparalleled societal disruption with wide ranging effects on individual liberties, the economy, and physical and mental health. While no social strata or population has been spared, the pandemic has posed unique and poorly characterized challenges for individuals with opioid use disorder (OUD). Given the pandemic’s broad effects, it is helpful to organize the risks posed to specific populations using theoretical models. These models can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations. Such models are not unidirectional, in that actions of individuals, networks, communities and structural changes can also affect overall disease incidence and prevalence. In this commentary, we describe how the social ecological model (SEM) may be applied to describe the theoretical effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD). This model can provide a necessary framework to systematically guide time-sensitive research and implementation of individual-, community-, and policy-level interventions to mitigate the impact of the COVID-19 pandemic on individuals with OUD.

The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes

2021 ◽  
Author(s):  
R. Ross MacLean ◽  
Suzanne Spinola ◽  
Gabriella Garcia-Vassallo ◽  
Mehmet Sofuoglu
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Disorder Treatment ◽  
The Impact

scholarly journals 213. A Comparison of Medication Assisted Therapy Treatment Strategies for Opioid Use Disorder in Persons who Inject Drugs and are Hospitalized with Serious Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S126-S126
Author(s):  
Laura Marks ◽  
Evan Schwarz ◽  
David Liss ◽  
Munigala Satish ◽  
David K Warren ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Hospital Readmissions ◽  
Treatment Strategies ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Readmission Rates ◽  
Persons Who Inject Drugs ◽  
Increased Risk ◽  
Hospital Patients ◽  
The Impact

Abstract Background Persons who inject drugs (PWID) with opioid use disorder (OUD) are at increased risk of invasive bacterial and fungal infections, which warrant prolonged, inpatient parenteral antimicrobial therapy. Such admissions are complicated by opioid cravings and withdrawal. Comparisons of medications for OUD during prolonged admissions for these patients have not been previously reported. The aim of this study was to evaluate the impact of different OUD treatment strategies in this population, and their impact on ED and hospital readmissions. Methods We retrospectively analyzed consecutive admissions for invasive bacterial or fungal infections in PWID, admitted between January 2016 and January 2019 at Barnes-Jewish Hospital. Patients in our cohort were required to receive an infectious diseases consult, and an anticipated antibiotic treatment duration of >2 weeks. We collected data on demographics, comorbidities, length of stay, microbiologic data, medications prescribed for OUD, mortality, and readmission rates. We compared 90-day readmission rates by OUD treatment strategies using Kaplan–Meier curves. Results In our cohort of 237 patients, treatment of OUD was buprenorphine (17.5%), methadone (25.3%), or none (56.2%). Among patients receiving OUD treatment, 30% had methadone tapers and/or methadone discontinued upon discharge. Patient demographics were similar for each OUD treatment strategy. Infection with HIV (2.8%), and hepatitis B (3%), and hepatitis C (67%) were similar between groups. Continuation of medications for OUD was associated with increased completion of parenteral antibiotics (odds ratio 2.11; 95% confidence interval 1.70–2.63). When comparing medications for OUD strategies, methadone had the lowest readmission rates, followed by buprenorphine, and no treatment (P = 0.0013) (figure). Discontinuation of methadone during the admission or upon discharge was associated with the highest readmission rates. Conclusion Continuation of OUD treatment without tapering, was associated with improved completion of parenteral antimicrobials in PWID with invasive bacterial or fungal infections lower readmission rates. Tapering OUD treatment during admission was associated with higher readmission rates. Disclosures All authors: No reported disclosures.

scholarly journals Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study

2020 ◽  
pp. 102841
Author(s):  
Alexandria Macmadu ◽  
Joëlla W. Adams ◽  
S.E. Bessey ◽  
Lauren Brinkley-Rubinstein ◽  
Rosemarie A. Martin ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Opioid Use ◽  
Microsimulation Modeling ◽  
The Impact ◽  
Modeling Study ◽  
Release From Prison

scholarly journals Effects of Selective Dopamine D2 or D3 Receptor Antagonism on Morphine-Induced Locomotion in Mice

2020 ◽  
Author(s):  
Christian A. Botz-Zapp ◽  
Stephanie L. Foster ◽  
Amy H. Newman ◽  
David Weinshenker ◽  
Daniel F. Manvich
Keyword(s):  
Locomotor Activity ◽  
Inhibitory Effect ◽  
Opioid Use Disorder ◽  
Locomotor Sensitization ◽  
Opioid Use ◽  
R And D ◽  
Morphine Administration ◽  
Additional Support ◽  
The Impact ◽  
Selective Dopamine

AbstractRationaleThe dopamine D3 receptor (D3R) has garnered interest as a pharmacotherapeutic target for the treatment of opioid use disorder (OUD). Recent evidence suggests that D2R and D3R antagonism oppositely affect the locomotor-activating effects of cocaine, but whether this pattern extends to opioid-induced hyperactivity remains unresolved.ObjectiveThis study compared the impact of selective D2R vs. D3R antagonists on the locomotor-activating effects of acute and repeated morphine administration in mice. Catalepsy following D2R vs. D3R antagonism alone or in combination with morphine was also assessed.MethodsC57Bl/6J mice were pretreated with either the highly-selective D3R antagonist PG01037 (vehicle, 10.0 mg/kg) or the selective D2R antagonist L-741,626 (vehicle, 10.0 mg/kg) and tested for 1) locomotor activity induced by acute morphine administration (10.0 – 56.0 mg/kg), 2) locomotor sensitization following repeated morphine administration (56.0 mg/kg), or 3) catalepsy after administration of either antagonist alone or in combination with morphine (10.0 – 56.0 mg/kg).ResultsIn locomotion studies, both PG01037 and L-741,626 shifted the acute morphine dose-response function rightward/downward, although the inhibitory effect of L-741,626 pretreatment was more robust. Likewise, PG01037 pretreatment partially attenuated, while L-741,626 pretreatment fully abolished, morphine-induced locomotor sensitization. L-741,626 produced catalepsy that was blunted by morphine, whereas PG01037 did not induce catalepsy under any conditions.ConclusionsD2R or D3R antagonism attenuates morphine-induced locomotor activity and sensitization. D2R antagonism produces a stronger suppression of these effects, but also induced modest cataleptic effects which were not observed following D3R antagonism. The results lend additional support to the investigation of selective D3R antagonists as treatments for OUD.

scholarly journals Designing and validating a Markov model for hospital-based addiction consult service impact on 12-month drug and non-drug related mortality

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256793
Author(s):  
Caroline A. King ◽  
Honora Englander ◽  
P. Todd Korthuis ◽  
Joshua A. Barocas ◽  
K. John McConnell ◽  
...  
Keyword(s):  
Markov Model ◽  
Opioid Use Disorder ◽  
Hospitalized Patients ◽  
Opioid Use ◽  
Post Discharge ◽  
Logistic Regression Models ◽  
Improve Patient Survival ◽  
Bayesian Logistic Regression ◽  
The Impact ◽  
Related Mortality

Introduction Addiction consult services (ACS) engage hospitalized patients with opioid use disorder (OUD) in care and help meet their goals for substance use treatment. Little is known about how ACS affect mortality for patients with OUD. The objective of this study was to design and validate a model that estimates the impact of ACS care on 12-month mortality among hospitalized patients with OUD. Methods We developed a Markov model of referral to an ACS, post-discharge engagement in SUD care, and 12-month drug-related and non-drug related mortality among hospitalized patients with OUD. We populated our model using Oregon Medicaid data and validated it using international modeling standards. Results There were 6,654 patients with OUD hospitalized from April 2015 through December 2017. There were 114 (1.7%) drug-related deaths and 408 (6.1%) non-drug related deaths at 12 months. Bayesian logistic regression models estimated four percent (4%, 95% CI = 2%, 6%) of patients were referred to an ACS. Of those, 47% (95% CI = 37%, 57%) engaged in post-discharge OUD care, versus 20% not referred to an ACS (95% CI = 16%, 24%). The risk of drug-related death at 12 months among patients in post-discharge OUD care was 3% (95% CI = 0%, 7%) versus 6% not in care (95% CI = 2%, 10%). The risk of non-drug related death was 7% (95% CI = 1%, 13%) among patients in post-discharge OUD treatment, versus 9% not in care (95% CI = 5%, 13%). We validated our model by evaluating its predictive, external, internal, face and cross validity. Discussion Our novel Markov model reflects trajectories of care and survival for patients hospitalized with OUD. This model can be used to evaluate the impact of other clinical and policy changes to improve patient survival.

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