Recognizing and Reducing the Impact of Trauma of Hospitalization: Considerations for Persons Who Use Drugs
Amidst the ongoing opioid crisis, the number of individuals with substance use disorders being hospitalized for acute medical illnesses has increased. There is now a growing recognition that these events may be psychologically traumatic, leading to the development of acute stress reactions, and post-traumatic stress disorder. Patients who use drugs may be particularly susceptible to being traumatized due to their underlying psychiatric comorbidities, prior trauma histories, inadequate treatment of the underlying substance use disorders, and stigmatization. Interventions such as early identification and screening, trauma-in...
Source: Journal of Addiction Medicine - January 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
Prescribing the Buprenorphine Monoproduct for Adverse Effects of Buprenorphine-Naloxone
Buprenorphine-naloxone (BNX) reduces the risk of mortality from untreated opioid use disorder by 50% or more. However, adverse effects of BNX can be a cause of inconsistent use or discontinuation. The buprenorphine monoproduct (BUP) is effective and is sometimes tolerated better, but practice guidelines and insurance restrictions discourage its prescription due to concerns about diversion and injection.
An idiopathic reaction of bilateral flank pain reported by three patients is used as an example to show how to assess the success of a BUP trial. Sublingual absorption of naloxone is discussed as a potential cause of adv...
Source: Journal of Addiction Medicine - January 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
Take-Home Naloxone and the Need for a Publicly Funded Naloxone Supply
The opioid crisis continues to exact a heavy toll on the United States, and overdose deaths have only increased during the current global pandemic. One effective intervention to reduce overdose deaths is to distribute the opioid antagonist naloxone directly to persons actively using opioids (ie, “take-home naloxone”), especially at touchpoints with the potential for significant impact such as emergency departments and jails. A number of hospital emergency departments have recently sought to implement individual take-home naloxone programs; however, programmatic success has been inconsistent due primarily to the inabili...
Source: Journal of Addiction Medicine - January 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
Letter of Appreciation to Richard Saitz, MD, MPH, DFASAM, Editor-in-Chief
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - January 1, 2022 Category: Addiction Tags: Editorial Source Type: research
Letter in Reply
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Letters to the Editor Source Type: research
Initiation of Medications for Opioid Use Disorder Shortly Before Release From Prison to Promote Treatment Retention: Strong Evidence but Compromised Policy
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Letters to the Editor Source Type: research
Sildenafil Misuse for its Psychoactive Properties? A Case Report
We report a case of a 38-year-old male with opioid and sedative use disorder who self-administered sildenafil orally in a dose of up to 2000 mg per day for its psychoactive effects (primarily) for 10 years before seeking treatment and discuss the literature relevant to the case. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Case Reports Source Type: research
Hospital-based Buprenorphine/Naloxone Initiation in a Patient With Limited Communication Abilities: A Case Report
North America's opioid crisis highlights the profound need for low-barrier access to opioid agonist therapy (OAT) for the treatment of opioid use disorder (OUD). This case describes a 33-year-old female with a history of opioid and stimulant use disorder admitted to hospital after a left middle cerebral artery ischemic stroke with resulting aphasia. After medical stabilization, she consented to buprenorphine/naloxone through limited verbal and written communication. After 14 days of titration, she was stabilized on 14 to 3.5 milligrams of buprenorphine/naloxone daily. Buprenorphine/naloxone initiation and titration is pati...
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Case Reports Source Type: research
Reduction in Oregon's Medication Dosing Visits After the SARS-CoV-2 Relaxation of Restrictions on Take-home Medication
To slow the spread of SARS-CoV-2 in opioid treatment programs (OTPs), SAMHSA notified State Opioid Treatment Authorities that stable patients could receive up to 27 days of take-homes, less stable patients could receive up to 13 days with fewer take-homes for other patients. An analysis assessed how the relaxed standards affected the number of patient dosing visits and the amount of take-home medications dispensed in Oregon's 20 public, nonprofit, and for-profit OTPs.
OTPs reported the number of patients receiving take homes pre and post federal policy change at 3 time points: pre SARS-CoV-2 (February or first half ...
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Brief Reports Source Type: research
COVID-19 Social Distancing and Online Mutual Help Engagement for Alcohol Use Recovery
Conclusions:
Relatively low activity on StopDrinking may signal broader population trends of problematic alcohol use and recovery disengagement during the initial COVID-19 social distancing timeframe. Continued investigation of online MHGs is needed to understand their potential for monitoring population health trends and to understand how such groups might support alcohol use recovery in contexts of crisis and isolation. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Brief Reports Source Type: research
Low Uptake of Secure Messaging Among Veterans With Experiences of Homelessness and Substance Use Disorders
We examined secure messaging use among veterans with experiences of homelessness (VEHs), and determined factors associated with messaging use.
Methods:
We conducted a cross-sectional analysis of responses to a national survey of VEHs, administered by mail from March to October 2018 (response rate = 40.2%). One item assessed secure messaging use and satisfaction. We used multivariable logistic regressions to model secure messaging use, controlling for sociodemographics, medical conditions, housing indicators, and mental health and SUD diagnoses.
Results:
Of 5072 VEHs, 21% had ever used secure messaging and...
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Brief Reports Source Type: research
Co-occurring Substance Use Disorders Identified Among Delivery Hospitalizations in the United States
Conclusions:
Co-occurring substance use disorders are common among women with any substance use disorder in pregnancy. Findings support the need for public health efforts to monitor and address multiple, concurrent use of substances in pregnancy. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Brief Reports Source Type: research
Understanding Contraceptive Needs of Women Who Inject Drugs in Orange County: A Qualitative Study
Conclusions:
Our findings highlight several causative factors for the unmet contraceptive need among women who use injection drugs, and suggest that syringe exchange programs represent a unique access point for the provision of contraceptive care for this population. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Original Research Source Type: research
Perceptions of Signs of Addiction Among Opioid Naive Patients Prescribed Opioids in the Emergency Department
Conclusions:
Signs of addiction identified by opioid naive patients were similar to concepts identified in medical definitions. However, participants’ understanding also included misconceptions, omissions, and conflated misuse behaviors with signs of addiction. Identifying these differences will help inform patient-provider risk communication, providing an opportunity for counseling and prevention. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Original Research Source Type: research
Cannabis Use During the COVID-19 Pandemic in Canada: A Repeated Cross-sectional Study
Conclusions:
A large proportion of those who used cannabis have increased cannabis use during the pandemic, suggesting a need for interventions to limit increased cannabis use, policy measures to address cannabis-attributable harms, and continued monitoring of cannabis use during and after the pandemic. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - November 1, 2021 Category: Addiction Tags: Original Research Source Type: research
