Substance use disorder (SUD)-and more specifically opioid use disorder-is a national epidemic. With the increasing amounts of people suffering from SUD, all healthcare professionals should be educated to identify substance abuse, provide a brief intervention, and refer patients for treatment when indicated.

The approach of nursing department students who will practice the nursing profession in the future, which they adopt for individuals with addiction, bears importance. This study was conducted to evaluate the changes in stigmatizing attitudes of nursing students who took the addiction course toward individuals with substance use disorder.

The use of electronic nicotine delivery systems (ENDS) has increased rapidly in recent years, particularly among young adults. There is a dearth of research on the cognitive factors that contribute to ENDS use. One of the possible cognitive mechanisms involved with addictive behavior is attentional bias (AB). AB can manifest as either facilitated attention engagement toward or delayed attention disengagement from a relevant stimulus. The purpose of this study was to examine the difference in AB toward ENDS-related cues between ENDS users and non-ENDS users. ENDS users (n = 29) and nonusers (n = 24) between the ages of 18 and 29 years participated in the dot-probe and eye-tracking picture-viewing tasks. The results showed that there was a significant difference in the variance of AB between the two groups. In the eye-tracking task, ENDS users displayed significantly greater net dwell time and fixation time at time frames of 6-9, 9-12, and 12-15 seconds, compared to nonusers. It is noteworthy that ENDS users exhibited attentional fluctuation toward ENDS cues as well as difficulties disengaging attention from ENDS cues. The current findings offer insight into the nature of attentional processes associated with ENDS cues and provide useful data to guide the development of a nurse-led cognitive intervention focusing on biased attentional processing related to ENDS cues.

People who inject drugs are likely to end up admitted to a hospital due to complications associated with substance use. While in hospital, many of these patients will continue the self-administration of nonprescribed drugs. When implemented without a harm reduction approach, self-administration can lead to an increase in the acquisition of infectious diseases, injection-related infections, and fatal and nonfatal overdoses. Often, administrators and providers use punitive approaches to manage this behavior among patients and providers. This abstinence-based approach has, and continues to, disproportionally impact structurally vulnerable communities. To mobilize the Truth and Reconciliation Commission's Calls to Action, Canadian hospitals must respond transparently and urgently to Indigenous peoples, patients, and communities. For example, First Nations, Inuit, and Metis people and communities living in Canada are significantly affected by the opioid epidemic, which can be traced back to the legacy of and continued colonialism and systemic discrimination in health care. Colonial policies and systems manifest as Indigenous populations experiencing a high prevalence of socioeconomic disadvantage and poor access to quality health and social services, on- and off-reserve. Clinicians must understand and receive cultural safety training to adequately care for Indigenous patient populations, as well as other structurally vulnerable populations. Additionally, Canadian hospitals should acknowledge and measure intravenous drug use in their organizations and take a harm reduction approach to mitigate associated adverse outcomes. Finally, hospitals should work with academic institutions to train, recruit, and retain Indigenous clinicians from diverse sociocultural backgrounds.

Women physicians and nurses are health professionals with significant differences in their role, but they share common social and occupational stressors. This study compares the outcomes of female physicians and nurses in treatment in a highly specialized program for health professionals with substance use disorders. This was a 9-year, survival, observational, cohort study, conducted with data from medical e-records of female nurses (n = 58) and physicians (n = 50) in treatment for addictions. The most common drug of abuse was alcohol (62% of physicians and 75.9% of nurses) followed by sedatives (16% vs. 12.1%). The median time in treatment was similar (49.1 and 46.4 months for physicians and nurses, respectively). Abstinence rates of physicians (76%) were higher than those of nurses (61.4%) as well as their median time to first lapse (15.5 and 7.6 months, respectively). However, after multivariate analyses, differences did not remain statistically significant neither for their abstinence rates nor for their survival time. To have an alcohol use disorder emerged as a risk factor of relapse for all (Hazard Ratio = 3.41, p = .03). More knowledge is needed to ascertain the common and differential factors related to the treatment response of women physicians and nurses with addictions and particularly to improve alcohol use disorder outcomes in these populations.

Patients experiencing alcohol withdrawal often receive care on inpatient mental health units. Registered nurses on one such unit had several concerns and questions about the existing alcohol withdrawal symptom management order set. To address these issues, a multidisciplinary team including nurses, psychiatrists, and pharmacists was formed.

Persons experiencing homelessness have higher rates of substance abuse, poorer overall health, and higher mortality from opioid overdose than the general population. Measuring progress throughout the addictions recovery process in these populations is challenging, given the multitude of factors that impact the recovery journey among persons experiencing homelessness. Despite these challenges, outcome assessment is essential for informing the continued improvement of recovery programs and validating effectiveness of evidence-based interventions. To better track and monitor progress throughout a 1-year residential faith-based addictions recovery program, the leadership of a large homeless service and residential recovery organization adapted the Progress to Life Transformation Model, a model based upon self-sufficiency, to measure improvements in self-sufficiency and stability across a diverse range of life domains. The purpose of this paper was to describe the experience of a homeless provider organization as it attempted to measure the impact of its programs on the self-sufficiency of persons experiencing homelessness as they work through the addiction recovery process. This case study of an evidence-based best practice may be used to inform public health nursing practice when working with organizations seeking to measure progress in serving persons experiencing homelessness who are in recovery from chemical addictions.

Substance use disorder is a major public health problem, and its treatment is one of the most challenging issues facing clinical professionals. This clinical trial study investigated the effects of the dialectical behavior therapy (DBT) on cognitive and executive functions in patients under methadone maintenance treatment (MMT). Participants included 50 people under MMT who referred to addiction treatment clinics in Kashan in 2018. They were randomly assigned to intervention (DBT + MMT) and control (MMT) groups. Participants in the intervention group received twelve 90-minute sessions of the DBT skills. The used assessments included Structured Clinical Interview for DSM-5 Axis I Disorders, Iowa Gambling Task, Wisconsin Card Sorting Task, and Tower of London Task. The results showed that DBT improved cognitive and executive function. Risky decision making (F = 4.1, p = 0.04), attention (F = 18.2, p = 0.001), cognitive flexibility (F = 18.5, p = 0.001), problem-solving (F = 18.5, p = 0.001), and planning (F = 14.10, p = 0.003) showed improvement in the intervention group following DBT. Therefore, it can be said that DBT alongside the MMT can be useful for patients under MMT.

Clients with substance use disorders (SUDs) have a substantial risk of developing Type 2 diabetes mellitus (T2DM). The connection between SUD and DM stems from rapid cell damage, pancreatic beta-cell dysfunction, and glucose dysregulation due to increased oxidative stress and decreased antioxidant activity. This study aims to reduce the risk of T2DM among individuals undergoing SUD recovery treatments.

Six high-fidelity simulations were developed to promote empathetic, evidence-based care devoid of stigma for individuals with opioid use disorder (OUD). Study aim was to validate simulation scenario and content for accuracy and clinical relevance.

Opioid use disorder is a national epidemic that has killed over one million United States residents since 1999. Randolph County, North Carolina (NC) has a significantly higher rate of drug overdose and emergency-department-related visits than the NC state average. Primary care providers are well positioned to intervene and offer screening, referral, and treatment of opioid use disorder, yet this does not often occur.

Opioid use disorder (OUD) research is essential to inform evidence-based responses to the OUD crisis in the United States. Individuals with OUD, their caregivers, and support group leaders are historically difficult to recruit for research studies. The purpose of this study was to describe barriers and facilitators in recruitment during the implementation of a qualitative study that sought to explore stigma, barriers, and facilitators to healthcare.

Stress indicators, including perceived discrimination and depression, have been linked with chronic diseases. Studies have also linked persistent prescription opioid use (PPOU) with depression. With increasing numbers of opioid overdose deaths among Hispanics (predominantly Puerto Rican) in Massachusetts, investigating how perceived discrimination and depression affect PPOU is relevant to public health efforts to address the opioid crisis. This study examined the effect of depression on PPOU and whether depression mediated the association between perceived discrimination and PPOU among Puerto Rican adults.

The opioid overdose crisis has continued to worsen, with a concomitant increase in serious injection-related infections, such as endocarditis and osteomyelitis. Usual care of these infections involves long-term intravenous antibiotics, typically administered via a peripherally inserted central venous catheter (PICC) at home. In patients with a history of opioid use disorder who inject drugs, a PICC has long been viewed as a high-risk intervention that may contribute to illicit substance use due to ease of venous access; thus, providers are often uncomfortable discharging these patients home to complete their antibiotics. As a result, many patients remain hospitalized or are discharge to skilled nursing facilities (SNFs) in order to complete their antibiotics. Challenges to this model include difficulty finding SNFs that will accept these patients, inability for these SNFs to continue their medication for opioid use disorder (MOUD), and inability to coordinate care with outpatient MOUD providers at SNF discharge. This quality improvement project sought to increase linkage to outpatient MOUD on SNF discharge via a telephone intervention. A total of 11 patients qualified for this intervention. Although patients were still in an SNF, 4/7 (57.1%) of patients were successfully contacted. Once they were discharged from the SNF, only 3/10 (30.0%) of patients were successfully reached. Of those 30.0% who were contacted, all of them had attended their outpatient MOUD appointment. We suggest that future linkage interventions in this population may benefit from utilizing existing care team members to facilitate linkage, to maximize the rapport built during an inpatient stay.

Simulation-enhanced interprofessional education is widely viewed as an effective teaching pedagogy to foster effective communication and teamwork for healthcare students. Pharmacists and registered nurses must learn to work collaboratively during their educational programs in order to be prepared for the complexities of modern healthcare. This study evaluated prelicensure pharmacy and prelicensure nursing students' perceptions of professional collaboration before and after caring for a standardized patient exhibiting opioid dependence secondary to inappropriate use of an opioid analgesic. Statistically significant gains in communication, collaboration, roles and responsibilities, patient-centered care, conflict management, and team functioning were measured for both pharmacy and nursing students after the interprofessional simulation. This study adds to the existing evidence that suggests simulation-enhanced interprofessional education is an effective teaching strategy; however, this study demonstrates its usefulness for students learning about safer opioid analgesic practices.

The purpose of this study was to examine sex-stratified independent predictors of patient-initiated discharge from an inpatient withdrawal management service and to determine whether those predictors differed by sex.