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8% for opioids at least once; 48.5% were court-ordered to substance use treatment. Of those referred, 67% had history of completing at least one treatment episode; black youth (OR=0.54, p<.01) were less likely to have history of completing substance use treatment.
Our results underscore the need to utilize objective measures as well as validated self-reports of substance use history in both research and justice system decision-making to aid in identifying youth in need of services. Additional research should identify barriers to substance use treatment completion among this population.
Our results underscore the need to utilize objective measures as well as validated self-reports of substance use history in both research and justice system decision-making to aid in identifying youth in need of services. ex229 datasheet Additional research should identify barriers to substance use treatment completion among this population.A large and growing body of literature supports the association between cocaine addiction and impulsivity. The aim of the study was to test whether pretreatment screening for adult ADHD, and self-report and behavioral measures of impulsivity have prognostic utility in clinical practice with cocaine users. We enrolled a cohort of N = 86 treatment-seeking cocaine users, assisted by a public addiction service, in a 24 week study. At baseline, we performed screening for adult ADHD, assessed the presence of co-occurring mental disorders, and applied measures of drug use severity, trait-like impulsivity (Barratt Impulsiveness Scale; BIS-11), decision-making (Iowa Gambling Task; IGT), risk-taking (Balloon Analogue Risk Task; BART), and ability to inhibit cognitive interference (Stroop Color Word Test; SCWT). Patients positive to the screening for ADHD showed a higher level of self-reported impulsivity and a longer history of drug use, but did not differ from those without ADHD in adherence to psychosocial treatments and number of negative urines for cocaine during the 24 weeks. Among all of the self-report and behavioral measures used, only IGT BIS-11 was associated with cocaine abstention. The small effect size and the problematic direction of the associations found do not give strong support to the routine use of self-regulation measures to guide clinical decisions in public addiction treatment settings.
Polysubstance use is common and contributes to morbidity and mortality of hospitalized patients, and yet little is known about patterns of substance use among hospitalized patients, or how an addiction consult service (ACS) might impact polysubstance use after discharge. The objective of this study was to identify patterns of substance use at admission and after discharge among hospitalized patients with substance use disorders who saw an ACS.
Prospective cohort study. We used latent transition analysis of substance use scores at the time of hospital admission and 30 to 90days posthospitalization.
Single, academic health center with an ACS in Portland, Oregon, from 2015 to 2018.
Patients were eligible if they received a consult to the inpatient ACS.
We used Addiction Severity Index-Lite scores to capture self-reported substance use at baseline and follow-up for heroin, other opioid, alcohol, amphetamine, and cocaine.
From 2015 to 2018, 486 individuals consented to participate. More than half of paon in hospitalized patients with substance use disorders and identifying patterns of polysubstance use can guide clinical management. Hospital providers should prepare to manage polysubstance use during hospitalization and hospitals should broaden care beyond interventions for opioid use disorder.In response to the novel coronavirus 2019 (Covid-19) pandemic, many people experiencing homelessness and substance use disorders entered respite and recuperation facilities for care and to isolate and prevent subsequent SARS-CoV-2 transmission. However, because drug use was officially prohibited in these facilities, we observed people who use substances leaving isolation temporarily or prematurely. The initial Covid-19 surge magnified the need for harm reduction access for those who use substances to ensure their safety and well-being and that of their local communities. In this commentary, we argue that expanding harm reduction access is crucial for subsequent waves of SARS-CoV-2 infection and also for patients who use substances and are hospitalized for other reasons.
Opioid use disorder (OUD) and methadone treatment are increasing among women ages 18-44years old, a population with unique healthcare needs. Despite this increase, there is little research on the healthcare experiences of women with OUD, particularly experiences with reproductive healthcare.
We designed a sequential, mixed-methods study in three Los Angeles methadone clinics. In the first phase, we conducted in-depth interviews with women in methadone treatment (n=22) (September-December 2016). After thematic coding and analysis, we designed and administered a survey to understand patterns in women's experiences and reproductive health knowledge, attitudes, and behavior (n=50) (January-April 2018). We conducted descriptive statistics, then integrated the quantitative and qualitative findings to contextualize and understand perceptions and experiences with healthcare providers among women in methadone treatment.
We found that women experienced and anticipated that providers would treat them poorly when tmental communication that intentionally alleviates stigma. Additionally, healthcare providers should understand medical guidelines and laws/policies around methadone during pregnancy and communicate this understanding to all patients who may wish to become pregnant or who are at risk for unintended pregnancy.The alcohol treatment literature has established in-session client speech as a mechanism of change that therapist behavior can influence and that can predict drinking outcomes. This study aimed to explore temporal patterns of in-session speech in Alcohol Behavioral Couple Therapy (ABCT), including the unique interplay between client and partner speech and the role of speech trajectories in predicting client drinking outcomes. Participants were 165 heterosexual couples receiving ABCT in one of four clinical trials. We coded client speech on an utterance-by-utterance basis using the System for Coding Couples' Interactions in Therapy-Alcohol. We focused on individual-level speech codes of change talk and sustain talk and couple-level variables of positive and negative interactions. We segmented the initial and midtreatment sessions into quartiles to conduct path analyses and latent growth curve models. Path analyses suggested that clients and partners may not have been aligned in terms of treatment goals at the start of the therapy.