Drug and alcohol dependence
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Drug Alcohol Depend · Dec 2019
Characteristics and current clinical practices of opioid treatment programs in the United States.
Given rising rates of opioid use disorder (OUD) and related consequences, opioid treatment programs (OTPs) can play a pivotal role in the U.S. opioid crisis. There is a paucity of recent research to guide how best to leverage OTPs in the opioid response. ⋯ Efforts are needed to increase availability of all medications approved to treat OUD in OTPs, integrate infectious disease-related services, and expand the reach of OTPs in the U.S.
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Drug Alcohol Depend · Nov 2019
Adolescents' awareness of the nicotine strength and e-cigarette status of JUUL e-cigarettes.
JUUL e-cigarettes are popular among youth. However, it is unknown whether adolescents understand that 5% JUUL pods contain a high nicotine concentration or consider JUULs to be e-cigarettes. ⋯ Most students were unaware of JUUL's high nicotine concentration, with more believing that JUULs contain low or medium nicotine concentrations when informed JUULs contain 5% nicotine. Thus, youth may misinterpret the nicotine concentration printed on JUUL pod packaging, raising concerns about inadvertent exposure to high nicotine levels and dependence risk. Further, 39% of adolescents believed JUULs are not e-cigarettes or were unsure. Regulatory efforts are needed to establish understandable nicotine concentration labels, require products to be labeled accordingly, and clarify what products constitute e-cigarettes.
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Drug Alcohol Depend · Nov 2019
U.S. trends in the supply of providers with a waiver to prescribe buprenorphine for opioid use disorder in 2016 and 2018.
Healthcare providers can receive waivers to prescribe buprenorphine for opioid use disorder, an evidence-based medication. The United States federal government has undertaken numerous recent efforts to expand access to waivers. This study describes national trends in the U.S. in 2016 and 2018, geospatial characteristics of waivered providers, and the association of county characteristics with patient treatment capacity. ⋯ The availability of waivered providers to prescribe buprenorphine increased from 2016 to 2018, while disparities persisted. More research is needed to understand how changes in availability of waivered prescribers impact population health.
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Drug Alcohol Depend · Nov 2019
Pain severity and prescription opioid misuse among individuals with chronic pain: The moderating role of alcohol use severity.
Chronic pain is a public health problem associated with opioid misuse. Yet, it is important to understand factors underlying opioid misuse in the context of pain. Alcohol use is one factor to consider given past work documenting use of alcohol to manage pain. However, it is unknown whether alcohol use severity exacerbates the relation between pain and opioid misuse. This study sought to examine relations between pain and prescription opioid misuse and the moderating role of alcohol use severity in two online survey studies of individuals with chronic pain. ⋯ In two online samples, there was evidence of a novel interaction of pain severity and alcohol use severity in relation to opioid misuse. Although cross-sectional, results replicated in two studies. Pain severity was related to opioid misuse among those with higher but not lower alcohol use. Those who use alcohol, even below suggested cut-offs, may be more likely to misuse opioids when in pain.
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Drug Alcohol Depend · Nov 2019
Predictors of availability of long-acting medication for opioid use disorder.
The U.S. Food and Drug Administration has approved three long-acting medications for opioid use disorder (MOUD): extended-release naltrexone (XR-NTX) in 2010, a subdermal buprenorphine implant in 2016, and a depot buprenorphine injection in 2017. Long-acting MOUD options may improve adherence while reducing diversion, but their availability compared to daily-dosing MOUD has not been well-characterized. The objective of this analysis was to characterize the availability of long-acting MOUD in substance use disorder treatment settings in the United States. ⋯ In 2017, XR-NTX was available at most of the minority of facilities offering MOUD, but the buprenorphine implant was not. Increasing the availability of MOUD, including long-acting options, is necessary to address unmet need for opioid use disorder treatment.