A Proposal for Addiction and Infectious Diseases Specialist Collaboration to Improve Care for Patients With Opioid Use Disorder and Injection Drug Use-Associated Infective Endocarditis
Patients with injection drug use-associated infective endocarditis and opioid use disorder often receive treatment for the infection that fails to address its underlying cause. People who inject drugs (PWID) and develop serious infections also face disparities in antibiotic management, particularly with regards to use of outpatient parenteral antimicrobial therapy (OPAT). We highlight literature on OPAT in PWID challenging the notion that PWID cannot be managed with OPAT. Given that OPAT use amongst PWID and non-PWID yields similar outcomes, we argue that a bias against OPAT use in PWID is unwarranted and may reflect stigm...
Source: Journal of Addiction Medicine - July 1, 2022 Category: Addiction Tags: Commentary and Debate Source Type: research
A Plea From People Who Use Drugs to Clinicians: New Ways to Initiate Buprenorphine Are Urgently Needed in the Fentanyl Era
With the worst opioid overdose death crisis in the United States history, urgent new approaches to assist people who use drugs onto medication for opioid use disorder are necessary. In this commentary, addiction medicine clinicians and drug user union representatives align to argue that conventional ways of buprenorphine initiation that require periods of withdrawal must be augmented with additional novel approaches to initiation. In the fentanyl era, members of the New England Users Union and Portland Users Union report encountering precipitated withdrawal, being unable to stop using full agonist opioids for a required pe...
Source: Journal of Addiction Medicine - July 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
Moving Away From a “One Size Fits All” Model: Ensuring Opioid Stewardship Includes People Who Use Drugs
The opioid-driven overdose crisis has had devastating effects across North America, resulting from a complex interplay between individual, social-structural, and environmental factors. Changing approaches to pain management, increased heroin use, and potent synthetic opioids infiltrating the drug supply are compounded by both lack of access to opioid use disorder treatment and surrounding stigma. Inappropriate opioid prescribing practices in healthcare settings have played a central role, and in recent years, there has been increasing interest in implementing hospital-based opioid stewardship programs aimed at improving sa...
Source: Journal of Addiction Medicine - July 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
Commentary on Ajazi et al (2021) Re-analysis of the X:BOT Trial
No abstract available (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - July 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
One Fictional Opioid Overdose in Eighteenth-century England and One Attempted Opioid Overdose in Nineteenth-century America
In today’s epidemic of opioid misuse, overdoses are not infrequent and can end in death. A fatal overdose is the culmination of a series of events that can be difficult to understand. Overdoses are not new, as is illustrated by two case reports from the past of overdoses on laudanum, a mixture of alcohol and opium. One was fictional and one was attempted, but they show how even 200 to 300 years ago people overdosed on opioids (or what they thought were opioids) when they found themselves in unbearable situations. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - July 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
The Need for Multidisciplinary Hospital Teams for Injection Drug Use-related Infective Endocarditis
We describe the format and structure of a team called the Multidisciplinary Endocarditis Evaluation Team (MEET) whose purpose is to optimize, formalize, and standardize the care of patients with IDUIE. Given the complexity of IDU-IE, MEET is comprised of addiction medicine, anesthesia, cardiology, cardiac surgery, infectious disease, case management, nursing, and social work. MEET strived to be acceptable to patients and families to support their preferences and values. MEET focused treatment of IDU-IE on the patient’s medical and surgical needs with attention to the patients’ underlying substance use disorder as an es...
Source: Journal of Addiction Medicine - July 1, 2022 Category: Addiction Tags: Commentaries Source Type: research
A Low-threshold Comprehensive Shared Medical Appointment Program for Perinatal Substance Use in an Underserved Population
Conclusions
A low-threshold, comprehensive perinatal shared medical appointment program had high retention rates, increased access to evidence-based MOUD, and high rates of opioid-negative urine toxicology. Participants enrolled after wraparound services began had a lower hazard of disengagement. Future research in perinatal substance use should evaluate the most optimal and cost-effective components of comprehensive programs to inform standard of care. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Opting into the Public List of DATA-Waivered Practitioners: Variations by Specialty, Treatment Capacity, and Practitioner Characteristics
Objectives
Although increased access to buprenorphine treatment for opioid use disorder is a central policy objective in addressing the US opioid overdose crisis, insufficient capacity for buprenorphine treatment exists relative to treatment need. Little is known about the characteristics of practitioners who opt into the public listing, an online list of Drug Addiction Treatment Act (DATA)-waivered practitioners provided by the US government, as compared to those who do not. In this cross-sectional study, we examined the association of public listing with practitioner demographic data, specialty, and treatment capacit...
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Differential Gateways, Facilitators, and Barriers to Substance Use Disorder Treatment for Pregnant Women and Mothers: A Scoping Systematic Review
Conclusions
There has been progress in implementing different types of interventions and treatments for that were attentive to pregnant women and mothers’ needs. We developed a conceptual model that characterized women’s pathways to treatment by deciphering women’s potential engagement in gateway settings. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Changes in Rates of Hospitalizations due to Cannabis Harms in Ontario, Canada Before the Legalization of Nonmedical Cannabis: Retrospective Population-level Study Between 2003 and 2017
Conclusions
There are distinct patterns of hospitalizations due to cannabis harms in different priority populations. Young women aged 15 to 24 are a key demographic that is disproportionately burdened with a rapid increase in hospitalizations due to cannabis harms. Jurisdictions considering new approaches to cannabis control policy and addiction services should consider the rising burden of harms faced by youth and young adults when planning interventions. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
“Nobody Knows How You’re Supposed to Interpret it:” End-user Perspectives on Prescription Drug Monitoring Program in Massachusetts
Conclusions
User insights must inform design, programmatic, and policy reform to maximize PDMP benefits while minimizing harm. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Sex Differences in Injection Drug Risk Behaviors Among Hospitalized Persons
Objectives
As opioid use increases, it remains important to assess factors that contribute to injection drug risk behaviors, as sharing needles and other drug use equipment contributes to the spread of human immunodeficiency virus and hepatitis C virus. Such risks may differ by sex and injecting with others. The current study examined factors that contribute to increased injection drug risk separately for men and women.
Methods
People who inject drugs were recruited at an academic safety-net hospital that reported recent injection drug use. Two main injection outcomes were assessed: (1) human immunodeficiency vi...
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Effectiveness of and Access to Medications for Opioid Use Disorder for Adolescents and Young Adults: A Scoping Review
Conclusions
MOUD therapies reduce opioid use among adolescent and young adults but few receive MOUD. MOUD services for adolescents and young adults should be developed and tested. Randomized clinical trials are necessary to develop appropriate clinical guidelines for using MOUD with adolescents and young adults. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Anhedonia and Substance Use Disorders by Type, Severity, and With Mental Health Disorders
Conclusions
People with OUD or a lifetime history of mood disorder or PTSD may be most likely to present to SUD treatment with anhedonia. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
Exercise Addiction Stability and Health Effects. A 6-Month Follow-up Postcompetition Study in Amateur Endurance Cyclists
Conclusions
Exercise addiction had a marked transitory component at 6-month postcompetition with associated health benefits in amateur endurance cyclists. (Source: Journal of Addiction Medicine)
Source: Journal of Addiction Medicine - May 1, 2022 Category: Addiction Tags: Original Research Source Type: research
