Addiction Science & Clinical Practice

Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis
Xu KY, Bello JK, Buss J, Jones HE, Bierut LJ, Stwalley D, Szlyk HS, Martin CE, Kelly JC, Carter EB, Krans EE and Grucza RA
The postpartum period provides an opportunity for birthing people with opioid use disorder (OUD) to consider their future reproductive health goals. However, the relationship between the use of medication for opioid use disorder (MOUD) and contraception utilization is not well understood. We used multistate administrative claims data to compare contraception utilization rates among postpartum people with OUD initiating buprenorphine (BUP) versus no medication (psychosocial services receipt without MOUD (PSY)) in the United States (US).
Perspectives and experiences regarding pre-exposure prophylaxis (PrEP) in a community sample of Veterans with unhealthy alcohol use: overall and across sexual orientation and gender identity
Fletcher OV, Beaver K, Austin EJ, van Draanen J, Edelman EJ and Williams EC
Unhealthy alcohol use is an independent, modifiable risk factor for HIV, but limited research addresses alcohol use and HIV prevention synergistically. Groups that experience chronic stigma, discrimination, and/or other marginalization, such as sexual and gender minoritized groups, may have enhanced HIV risk related to unhealthy alcohol use. We described awareness of and experiences with pre-exposure prophylaxis (PrEP) among a community sample of Veterans reporting unhealthy alcohol use (relative to those without), overall and across self-reported sexual orientation and gender identity.
Substance use recovery needs among college students seeking recovery services: a thematic qualitative analysis
Nichols LM, Brown TB, Allmendinger A, Hennessy EA and Tanner-Smith EE
College students who are in recovery from substance use disorders face challenges related to abstaining from substance use, finding supportive social networks, and achieving their academic goals. These students may therefore seek out various recovery supports at their institutions to meet their needs and goals.
Patient centered medication treatment for opioid use disorder in rural Vermont: a qualitative study
Hichborn EG, Murray OB, Murphy EI, Gallant TE, Moore SK, McLeman BM, Saroyan J, Folland A, Mitchell M and Marsch LA
Opioid-related fatal overdoses are occurring at historically high levels and increasing each year. Accessible social and financial support are imperative to the initiation and success of treatment for Opioid Use Disorder (OUD). Medications for Opioid Use Disorder (MOUD) offer effective treatment but there are many more people with untreated OUD than receiving evidence-based medication. Patient-centered care is associated with increased care utilization for substance use disorders. This qualitative study explored the patient perspective of OUD care through a Patient-Centered Care (PCC) framework to illuminate patients' sense of engagement in care.
Rationale and design of a randomized clinical trial of integrated eHealth for PrEP and medications for opioid use disorders for women in the criminal legal system. The Athena study
Meyer JP, Brunson S, Price CR, Mulrain M, Nguyen J, Altice FL, Kyriakides TC, Cropsey K and Eaton E
Women involved in the criminal legal system have elevated rates of opioid use disorder, which is treatable, and HIV, which is preventable with pre-exposure prophylaxis (PrEP). There are significant social and structural barriers to integrated delivery of PrEP and medications for opioid use disorder (MOUD), limiting women's ability to access these life-saving interventions. In a two parallel-arm randomized controlled trial, we are assessing an innovative eHealth delivery model that integrates PrEP with MOUD and is tailored to meet the specific needs of women involved in the criminal legal system.
mHealth Incentivized Adherence Plus Patient Navigation (MIAPP): protocol for a pilot randomized controlled trial to improve linkage and retention on buprenorphine for hospitalized patients with methamphetamine use and opioid use disorder
Bhatraju EP, Kennedy DN, Gojic AJ, Iles-Shih M, Merrill JO, Samet JH, Hallgren KA and Tsui JI
Initiation of buprenorphine for treatment of opioid use disorder (OUD) in acute care settings improves access and outcomes, however patients who use methamphetamine are less likely to link to ongoing treatment. We describe the intervention and design from a pilot randomized controlled trial of an intervention to increase linkage to and retention in outpatient buprenorphine services for patients with OUD and methamphetamine use who initiate buprenorphine in the hospital.
Regaining control over alcohol intake but not abstinence on disulfiram medication, as a harm reduction approach: 2 case reports
Schallenberg M, Pilhatsch M, Petzold J, Vogel-Blaschka D, Zimmermann US and Spreer M
Alcohol use disorder (AUD) poses severe health risks, yet many affected individuals opt out of complete abstinence. Therefore, harm reduction strategies have become more prominent in treatment guidelines for AUD. Our two case reports illustrate how disulfiram, initially intended to enforce abstinence, was repurposed to support reduced drinking.
Exemplar Hospital Initiation Trial to Enhance Treatment Engagement (EXHIT ENTRE): protocol for CTN-0098 an open-label randomized comparative effectiveness trial of extended-release buprenorphine versus treatment as usual on post-hospital treatment engagement for hospitalized patients with opioid use disorder
Bart G, Barth KS, Baukol P, Enns E, Ghitza UE, Harris J, Jelstrom E, Liebschutz JM, Magane KM, Voronca D, Weinstein ZM and Korthuis PT
Hospitalizations involving opioid use disorder (OUD) are increasing. Addiction consultation services (ACS) initiate medications for opioid use disorder (MOUD) in hospital settings and arrange post-hospital follow-up for ongoing MOUD care. Engagement in MOUD following hospital discharge is hampered by challenges in timely access to MOUD. This protocol describes an open-label randomized comparative effectiveness trial comparing ACS treatment as usual (TAU) to a single injection of a 28-day formulation extended-release buprenorphine (XR-BUP) on MOUD engagement 34-days following hospital discharge.
Innovations to the ECHO model to enhance reach and network-building among addiction clinicians in Western Canada
Robinson S, Brohman I, Draanen JV, Kushner R, Fairbairn N and Glegg S
Building capacity for evidence-based treatment and support for people with substance use disorders (SUD) is an urgent priority in the context of the toxic drug poisoning crisis. We implemented the first substance use-focused Project Extension for Community Healthcare Outcomes (ECHO) in Western Canada for health care providers, to enhance their clinical addiction skills and knowledge, facilitate practice change, and foster a supportive community of practice. The aims of this article are to describe our innovations to the Project ECHO model in British Columbia (BC) and Yukon, and present key program outcomes.
Medications for opioid use disorders among incarcerated persons and those in the community supervision setting: exploration of implementation issues with key stakeholders
Kang AW, Bailey A, Surace A, Stein L, Rohsenow D and Martin RA
Receipt of medications for opioid use disorder (MOUD) critically reduces opioid-related mortality during the post-incarceration period. Optimal provision of this care to individuals on community supervision (i.e., probation) requires an understanding of this unique and complex system at the local level.
Centering autonomy and choice to support oral PrEP utilization among people who inject drugs: qualitative lessons from HPTN 094 INTEGRA
Perez-Brumer A, Schmidt R, Kennedy R, Lake JE, Villarreal YR, Bornstein S, Kuo I, Nieto O, Franks J, Denis C, El-Bassel N, Shoptaw S, Davidson P and Smith LR
Oral Pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, despite high rates of HIV risk behaviors among people who inject drugs (PWID), this population remains underserved by current HIV prevention efforts in the United States. To address this challenge, we conducted an in-depth exploration of perspectives on using oral PrEP among PWID engaged in the HIV Prevention Trials Network (HPTN) 094 INTEGRA Study.
Methadone clinic staff perceptions of trauma-informed and patient-centered care: the role of individual staff characteristics
Meyerson BE, Linde-Krieger LB, Carter GA, Huff AJ, Brady BR, Crosby RA, De La Rosa J, Allison A, Barakat M, Pava M and Schaefer M
U.S. policy intervention to increase methadone treatment accommodations during COVID did not result in national adoption of the new patient-centered treatment practices. Staff-level interventions may facilitate adoption of these treatment practices, but this will depend upon knowledge about staff level characteristics and beliefs. Currently, the role of clinic staff characteristics, beliefs about patient-centeredness, and perceptions about the need for treatment practice change is unknown. This study explored the relationship between opioid treatment program staff characteristics, work roles and staff beliefs to identify opportunities for future staff-level treatment practice change interventions.
Readiness to implement contingency management to promote PrEP initiation and adherence among people who inject drugs: results from a multi-site implementation survey
Pickering E, Viera A, Sung ML, Davidson D, Bailey G, Buchelli M, Jenkins M, Kolakowski J, Maier L, Edelman EJ and Rash CJ
Contingency management (CM), an incentive-based intervention to encourage target behaviors, effectively promotes medication adherence. However, efforts to extend CM to HIV pre-exposure prophylaxis (PrEP) have been lacking. As part of a randomized clinical trial to promote HIV Prevention among people who inject drugs (PWID), we examined the readiness of staff in community-based organizations serving PWID to implement CM for PrEP uptake and adherence in this population.
Associations of the Korean patient placement criteria matching among individuals with alcohol-related problems with treatment completion and abstinence: an observational study
Hong J, Shin SH, Kim JE, Lee SK, Oh HS, Na E, Cho HJ and Roh S
The American Society of Addiction Medicine Patient Placement Criteria (ASAM PPC) are guidelines for matching addiction patients to an optimal level of care (LOC). South Korea lacked a systematic approach to assigning alcohol use disorder patients to suitable treatment. To address this, Park et al. translated the ASAM PPC into Korean, creating the Korean Patient Placement Criteria (KPPC). We aim to assess the efficacy of the KPPC by evaluating whether receiving KPPC-matched treatment would result in longer periods of alcohol abstinence and higher number of treatment program completion.
Perceptions of family physicians in Istanbul about e-cigarettes as smoking cessation aids: a qualitative study
Selamoglu M, Onal AE, Erbas B, Karabey S, Oren MM, Ucar MT and Barton C
Family physicians (FPs) are the first point of contact for people who smoke who are seeking to quit smoking in Türkiye. We aimed to explore Turkish FPs knowledge, attitudes and perceptions of e-cigarettes as smoking cessation aids.
Inpatient detoxification for alcohol and other drug use: qualitative study of patients' accounts of their relationships with staff
Neale J, Cairns B, Gardiner K, Livingston W, McCarthy T and Perkins A
The therapeutic alliance is an important predictor of treatment outcomes but people who use alcohol and other drugs report mixed views of treatment providers. We analysed patients' accounts of inpatient detoxification staff to ascertain whether, and if so how, relationships with them, and thus the therapeutic alliance, might be improved.
Pharmacy-based preventive services for opioid use disorder: a survey of U.S. pharmacists
Wu LT, King J, Hefner K, Schactman M, John W, Hagemeier N, Matthews AG, Levitt N and Mannelli P
Pharmacists play a key role in combating the opioid-related overdose epidemic in the United States (US), but little is known about their experience and willingness to deliver preventive services for opioid use disorder (OUD).
Organization of primary care and early MOUD discontinuation
Harris RA, Kearney M, Keddem S, Calderbank T, Tomczuk L, Clapp J, Perrone J, Kranzler HR, Long JA and Mandell DS
Primary care clinic structures and operations may influence early MOUD discontinuation. Flexible scheduling can improve early MOUD retention but must be balanced with clinic efficiency. Multidisciplinary teams can improve retention but require additional resources. Addressing comorbid pain and polydrug use early in the treatment process can help prevent MOUD discontinuation.
Grayken Lessons: a patient who developed opioid use disorder after traumatic brain injury
Reed G, Lugo H, Adams RS and Walley AY
Traumatic brain injury (TBI) is common in people with substance use disorders (SUDs). TBI often results in cognitive deficits which can affect the clinical course of SUD.
Strategies for improving treatment retention for buprenorphine/naloxone for opioid use disorder: a qualitative study of issues and recommendations from prescribers
Young GJ, Young LD and Noor-E-Alam M
Opioid use disorder (OUD) remains a significant public health issue as the number of opioid-related overdose deaths continues to reach new highs each year. Buprenorphine/Naloxone is a medication that has been shown to be highly effective for the treatment of OUD. However, the clinical management of patients on this medication is challenging as many patients discontinue treatment prematurely. We conducted a qualitative study focusing on experienced prescribers of buprenorphine to learn about what they believe are key challenges in prescribing this medication to patients with OUD and related strategies for improving treatment outcomes.
Survey of Massachusetts peer recovery coaches' attitudes toward the use of psychedelics to treat substance use disorders
Szpak V, Kim A, Sager Z and Suzuki J
There has been a growing interest in the use of psychedelics for therapeutic purposes. However, there is a lack of research on peer recovery coaches' attitudes toward the use of psychedelics for SUD treatment. Therefore, we conducted a survey of peer recovery coaches in Massachusetts to gain insight into their attitudes toward the use of psychedelics to treat SUDs.