Improving Intranasal Naloxone Prescribing Through EMR Modification and Automation
Conclusions:
Our findings suggest that a clinical decision support system can be an effective way to increase hospital-wide naloxone prescribing rates. We were able to increase prescribing rates by more than three-fold, significantly increasing the availability of a rescue medication to individuals at high-risk for overdose. Intranasal naloxone prescribing increased with the implementation of a visual reminder and a more intuitive ordering experience while preserving provider autonomy. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2021 Category: Addiction Tags: Original Research Source Type: research
Pathways to Heroin Use: Commentary on McCabe et al.
Rates and patterns of transition from opioid analgesic to illicit opioid (ie, heroin) use is of great clinical significance. Exposure to opioid analgesics, and whether use is therapeutic or outside a doctor's orders, may have overlapping yet different patterns of transition to heroin use. Yet, this topic is rarely examined in longitudinal studies. With data from the landmark Monitoring the Future (MTF) study, McCabe and colleagues have now studied the transition from adolescent use of opioid analgesics (both medical and nonmedical) to heroin over a seventeen year follow up for adolescents first recruited from 1975 to 2000....
Source: Journal of Addiction Medicine - May 1, 2021 Category: Addiction Tags: Commentary Source Type: research
Letter in Reply
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Letters to the Editor Source Type: research
Response to Do Patients Require Emergency Department Interventions After Prehospital Naloxone?
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Letters to the Editor Source Type: research
Objective Outcome Measures in Randomized Clinical Trials of Interventions to Reduce Risk of Opioid Overdose Following Discharge From the Emergency Department: Utility of Administrative Data Linkage
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Letters to the Editor Source Type: research
Temporal Trends in Online Posts About Vaping of Cannabis Products
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Letters to the Editor Source Type: research
Treatment of Kratom Withdrawal and Dependence With Buprenorphine/Naloxone: A Case Series and Systematic Literature Review
Conclusions:
Based on our analysis, patients using 40 g/d could be initiated with 12/3 mg-16/4 mg of buprenorphine-naloxone/day. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Case Reports Source Type: research
Hospital Initiated Injectable Opioid Agonist Therapy for the Treatment of Severe Opioid Use Disorder: A Case Series
Background:
Across North America, there is an unprecedented opioid overdose epidemic. Approximately 15% of individuals with severe opioid use disorder (OUD) do not benefit from opioid agonist therapy (OAT) such as buprenorphine/naloxone or methadone and are considered treatment refractory. Of those who inject, injectable OAT (iOAT), with hydromorphone or diacetylmorphine, offered in community settings has demonstrated improved retention to treatment and decreased nonprescription opioid use. This case series seeks to describe iOAT initiation and titration in a hospital setting for treatment refractory individuals with O...
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Case Reports Source Type: research
Associations Between Polysubstance Use Patterns and Receipt of Medications for Opioid Use Disorder Among Adults in Treatment for Opioid Use Disorder
Conclusions:
Opioid/methamphetamine and opioid/benzodiazepine increased substantially between 1992 and 2017. Co-use of other substances with opioids was associated with significantly lower receipt of MOUD. Treatment facilities should increase access to MOUD for individuals who co-use opioids with other substances. This change would extend evidence-based treatment to thousands of individuals and save lives. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Brief Reports Source Type: research
Medications for Opioid use Disorder Associated With Less Against Medical Advice Discharge Among Persons Who Inject Drugs Hospitalized With an Invasive Infection
Conclusions:
Among patients with OUD and serious injection related infections, inpatient initiation of MOUD is associated with decreased risk of AMA discharge. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Brief Reports Source Type: research
Non-prescription Fentanyl Positive Toxicology: Prevalence, Positive Predictive Value of Fentanyl Immunoassay Screening, and Description of Co-substance Use
Conclusions:
At an urban safety-net hospital, nonprescription fentanyl use was common and was associated with greater use of other substances favoring routine fentanyl testing. Although the positive predictive value of the screening test was high, confirmation testing detected substantial numbers of false positives, especially in older patients. Therefore, fentanyl confirmation testing should be used when results will change treatment approach and patient education. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Original Research Source Type: research
Disparities in Access to Medications for Opioid Use Disorder in the Veterans Health Administration
Conclusions:
Quality improvement efforts targeted at vulnerable populations are needed at the VHA to ensure these groups receive the same quality of substance use disorder treatment as other veterans. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Original Research Source Type: research
How Patient Centered Are Addiction Treatment Intake Processes?
Conclusions:
This evidence is encouraging for the SUD treatment field, especially considering that many Medicaid programs are adopting ASAM or similar patient placement criteria and multidimensional assessments. Future research should consider whether increases in the patient-centeredness of assessments are associated with increased retention in SUD treatment and other positive treatment outcomes. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Original Research Source Type: research
Patterns of Prescription Opioid Use Prior to Self-reported Heroin Initiation
Objectives:
To determine the association between self-reported heroin initiation and patterns of prescription opioid use.
Methods:
Using linked Oregon Medicaid, prescription drug monitoring program, and Treatment Episodes Data Set data, we conducted a case-control study of individuals reporting heroin initiation between 2015 and 2017 during treatment intake. Prescription drug monitoring program data provided prescription opioid use patterns, including long-term prescription opioid therapy, in the year before self-reported heroin initiation. Four controls were matched to each case on aggregate prescription opioid...
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Original Research Source Type: research
Feasibility and Acceptability of Mobile Phone Self-monitoring and Automated Feedback to Enhance Telephone Coaching for People With Risky Substance Use: The QUIT-Mobile Pilot Study
Conclusions:
Results are consistent with prior similar research suggesting that mobile phone self-monitoring of drug use and related factors is feasible and acceptable among diverse adults with risky drug use. Findings also suggest the potential benefits of integrating electronic self-monitoring and feedback into substance use reduction interventions such as QUIT to enhance patient self-management and coaching or counseling intervention components. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - March 1, 2021 Category: Addiction Tags: Original Research Source Type: research
