Drug and alcohol dependence
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Drug Alcohol Depend · Apr 2019
Co-occurring substance use and mental disorders among adults with opioid use disorder.
Co-occurring substance use and mental disorders among people with opioid use disorder (OUD) increase risk for morbidity and mortality. Addressing these co-occurring conditions is critical for improving treatment and health outcomes. There is limited recent research on the prevalence of co-occurring disorders, demographic characteristics associated with co-occurring disorders, and receipt of mental health and substance use treatment services among those with OUD. This limits the development of targeted and resourced policies and clinical interventions. ⋯ Co-occurring substance use and mental disorders are common among adults with OUD. Expanding access to comprehensive service delivery models that address the substance use and mental health co-morbidities of this population is urgently needed.
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Drug Alcohol Depend · Apr 2019
Randomized Controlled TrialIntegrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial.
Attention Deficit Hyperactivity Disorder (ADHD) frequently co-occurs with Substance Use Disorders (SUDs). Standard ADHD pharmacotherapies are not effective in patients with this comorbidity and cognitive behavioral therapy (CBT) has not been tested in this population. This RCT aimed to compare the efficacy of Integrated CBT (CBT/Integrated) directed at adult ADHD and SUD with CBT directed at SUD only (CBT/SUD) in patients with SUD and ADHD (SUD + ADHD). ⋯ Compared to regular SUD cognitive behavioral therapy, integrated cognitive behavioral therapy resulted in a significant extra improvement in ADHD symptoms in SUD + ADHD patients.
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Drug Alcohol Depend · Apr 2019
Internalizing and externalizing factors on the pathway from adverse experiences in childhood to non-medical prescription opioid use in adulthood.
Research demonstrates strong associations between adverse childhood experiences (ACEs) and non-medical prescription opioid use (NMPO), but pathways are not understood, hindering prevention and treatment responses. ⋯ Internalizing and externalizing factors partially explained the pathway from ACEs to NMPO. Substance abuse may be more difficult to treat with co-occurring psychopathologies and maladaptive behaviors, highlighting the need to address trauma early in life.
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Drug Alcohol Depend · Apr 2019
Comparative StudyPrescription opioid misuse among African-American adults: A rural-urban comparison of prevalence and risk.
Prescription opioid misuse (POM) remains a public health concern in the United States. Although the problem has been studied extensively, little research attention is paid to POM among African-Americans (AAs), and even fewer studies consider rural status in their analysis. The goal of this study, therefore, was to identify and compare prevalence and predictors of POM among rural and urban AA adults using data from a nationally representative sample. ⋯ Results indicate that AA nonmedical prescription opioid users are not a monolith and have distinct demographic, clinical, and psychosocial profiles based on geographic region. Because AAs have been virtually ignored in the POM literature, our findings are an important step towards understanding POM among this understudied group. These results invite additional investigation into AA POM and encourage researchers to consider rural status in their analysis of POM among AAs.
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Drug Alcohol Depend · Feb 2019
Pregnant women with opioid use disorder and their infants in three state Medicaid programs in 2013-2016.
Maternal opioid use disorder (OUD) has serious consequences for maternal and infant health. Analysis of Medicaid enrollee data is critical, since Medicaid bears a disproportionate share of costs. ⋯ There is an urgent need for comprehensive, evidence-based OUD treatment integrated with maternity care. To fill critical gaps in care, workforce and infrastructure innovations can facilitate delivery of preventive and treatment services coordinated across settings.