Drug and alcohol dependence
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Drug Alcohol Depend · Dec 2019
Multicenter Study Pragmatic Clinical TrialLong-term naturalistic follow-up of chronic pain in adults with prescription opioid use disorder.
Chronic pain is common in patients with prescription opioid use disorder (OUD), and pain severity has been shown to predict opioid use for those with chronic pain. However, recent research suggests that focusing on pain status (i.e., the presence or absence of chronic pain) at treatment initiation may not reflect the clinical significance of pain over the long-term course of OUD. Reports of variability in chronic pain and its clinical significance over time have yet to be investigated in patients with prescription OUD. The present study examined variability in chronic pain status from entry into prescription OUD treatment through 3.5-year follow-up. Additionally, we examined the association between concurrent chronic pain and opioid use at three follow-up time points. ⋯ Chronic pain status may vary over time in those with prescription OUD, and chronic pain appears to be associated with concurrent opioid use. The present findings highlight the importance of assessing chronic pain throughout the course of prescription OUD.
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Drug Alcohol Depend · Dec 2019
Social norms towards smoking and vaping and associations with product use among youth in England, Canada, and the US.
This study assesses differences in social norms towards smoking and vaping among youth across countries (England, Canada, US) and smoking and vaping status. ⋯ Youth had more positive vaping than smoking norms. English youth reported the most pro-smoking but least pro-vaping norms in adjusted models; this was unexpected given country differences in regulatory environments. Norms towards both products were associated with use, with some evidence of cross-product associations between norms and behaviours.
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Drug Alcohol Depend · Dec 2019
A mixed-methods assessment of the impact of the opioid epidemic on first responder burnout.
First responders have demanding jobs and report experiencing burnout. The opioid epidemic has added to first responder workloads, which could contribute to increased burnout. This mixed-methods study examined burnout among first responders by: 1) describing burnout among first responders specifically related to workload demands associated with the opioid epidemic; 2) exploring first responder perspectives on how the opioid epidemic has affected their profession; and 3) conducting exploratory analyses to examine how burnout and perspectives on the effect of the opioid epidemic differ across first responder professions. ⋯ First responders reported experiencing burnout, increased workloads, and negative emotional effects related to their role in responding to the opioid epidemic. Despite this, first responders view responding to community opioid misuse as part of their professional role for which they have received specialized training. Future research should continue to explore the impact of the opioid epidemic on first responders, including how to prevent or address burnout.
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Drug Alcohol Depend · Dec 2019
Trends in and factors associated with the adoption of digital aids for smoking cessation and alcohol reduction: A population survey in England.
Digital smoking cessation and alcohol reduction aids are widely available in England. To estimate their public health impact, researchers need to consider their adoption in the target population. We assessed adoption rates, and characteristics of adopters, of digital smoking cessation and alcohol reduction aids in England. ⋯ Digital smoking cessation and alcohol reduction aids are rarely used by smokers or high-risk drinkers attempting to quit/cut down in England, indicating that most of the target population is not being reached. Despite overall digital access improving, adoption rates remained similarly low between 2015-2018.
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Drug Alcohol Depend · Dec 2019
Overlapping prescriptions of opioids, benzodiazepines, and carisoprodol: "Holy Trinity" prescribing in the state of Florida.
High-risk combinations of controlled medications, such as those involving opioid analgesics, are under increased scrutiny because of their contribution to the opioid epidemic in the United States. Responsible prescribing guidelines indicate that the triple drug combination--opioids, benzodiazepines and skeletal muscle relaxants, especially carisoprodol--should not be concurrently prescribed. ⋯ These findings raise important questions as to how frequently prescribers are checking prescription drug monitoring programs, following US Centers for Disease Control and Prevention opioid prescribing guidelines, and/or handling the clinical challenges associated with pharmaceutical management of patients with complex, painful health conditions.