Pain in Critically Ill Patients With Substance Use Disorder or Long-term Opioid Use for Chronic Pain

2011 ◽  
Vol 22 (3) ◽  
pp. 238-254 ◽  
Author(s):  
Debra J. Drew ◽  
Barbara J. St. Marie
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Critical Care ◽  
Substance Use Disorder ◽  
Care Setting ◽  
Opioid Use ◽  
Care Nurse ◽  
Complex Patients ◽  
Opioid Induced Hyperalgesia

Opioid tolerance resulting from long-term opioid consumption for chronic pain or from substance use disorder adds a layer of complexity to managing pain in the critical care setting. This article discusses similarities and differences of these 2 conditions. The phenomenon of tolerance and opioid-induced hyperalgesia are presented. Prevention of opioid withdrawal, when patients are on methadone or buprenorphine, is described. An overview of the neurophysiology of pain and substance use disorder is presented. Practical clinical suggestions are given to assist the critical care nurse in caring for these complex patients.

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

2020 ◽  
Vol 17 (4) ◽  
pp. 472-482
Author(s):  
Danielle E. Baker ◽  
Keith A. Edmonds ◽  
Maegan L. Calvert ◽  
Sarah M. Sanders ◽  
Ana J. Bridges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Modifiable Risk Factors ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

Barriers and Facilitators of Using Telehealth to Identify and Manage Behavioral Health and Substance Use Disorder Conditions in Rural Areas: An Environmental Scan (Preprint)

2020 ◽  
Author(s):  
Naim Naim ◽  
Laura Dunlap
Keyword(s):  
Substance Use ◽  
Behavioral Health ◽  
Substance Use Disorder ◽  
Rural Areas ◽  
Primary Care Providers ◽  
Care Patient ◽  
Direct Patient Care ◽  
Care Providers ◽  
Provider Education ◽  
Opioid Use

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

scholarly journals Development and Preliminary Evaluation of an Integrated Cognitive-Behavior Treatment for Chronic Pain and Substance Use Disorder in Patients with the Hepatitis C Virus

Pain Medicine ◽  
2016 ◽  
Vol 17 (12) ◽  
pp. 2280-2290 ◽  
Author(s):  
Benjamin J. Morasco ◽  
David W. Greaves ◽  
Travis I. Lovejoy ◽  
Dennis C. Turk ◽  
Steven K. Dobscha ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Substance Use Disorder ◽  
Cognitive Behavior ◽  
Preliminary Evaluation

Foster Care Factors and Permanency for Children With Substance-Related Removals

2020 ◽  
pp. 104438942094722
Author(s):  
Margaret H. Lloyd Sieger
Keyword(s):  
Substance Use ◽  
Foster Care ◽  
Child Welfare ◽  
High Risk ◽  
Substance Use Disorder ◽  
Care Setting ◽  
Foster Parent ◽  
Vulnerable Group ◽  
Children In Foster Care ◽  
Socioeconomic Risk

Children in foster care due to parental substance use disorder are at high risk for delayed permanency. Understudied is the effect of foster care factors on these children’s exits from care. This study analyzed 10 years of federal child welfare data to understand the effect of foster care placement, provider, and support factors for this vulnerable group. Results revealed that several foster care variables influenced time to, and likelihood of, permanency for children with substance-related removals. Foster care setting, foster parent age and race, and several types of federal supports affected permanency trajectories. Children in homes receiving more federal supports were less likely to achieve permanency, suggesting the insufficiency of these supports to counteract the effects of socioeconomic risk on permanency.

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