Drug and alcohol dependence
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Drug Alcohol Depend · Jul 2018
Controlled Clinical TrialEffects of electronic cigarette liquid solvents propylene glycol and vegetable glycerin on user nicotine delivery, heart rate, subjective effects, and puff topography.
Electronic cigarettes (ECIGs) are a class of tobacco products that produce different effects (e.g., nicotine delivery), depending on the device, liquid, and behavioral factors. However, the influence of the two primary ECIG liquid solvents, propylene glycol (PG) and vegetable glycerin (VG), on ECIG acute effects is unknown. ⋯ PG:VG ratio influenced nicotine delivery, some subjective effects, and puff topography. Lower overall product satisfaction associated with the 100PG liquid suggests factors other than nicotine delivery (e.g., aerosol visibility) may play a role in maintaining ECIG use. Regulating ECIG acute effects such as nicotine delivery and subjective effects may require simultaneous attention to liquid PG:VG ratio as well as device, liquid, and behavioral factors known to influence these outcomes.
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Drug Alcohol Depend · Jul 2018
Predicting pharmacy naloxone stocking and dispensing following a statewide standing order, Indiana 2016.
While naloxone, the overdose reversal medication, has been available for decades, factors associated with its availability through pharmacies remain unclear. Studies suggest that policy and pharmacist beliefs may impact availability. Indiana passed a standing order law for naloxone in 2015 to increase access to naloxone. ⋯ Pharmacies with larger capacity took advantage of the naloxone standing order. Predictors of pharmacist naloxone dispensing should continue to be explored to maximize naloxone access.
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Drug Alcohol Depend · Jul 2018
Exploring opioid use disorder, its impact, and treatment among individuals experiencing homelessness as part of a family.
Opioid Use Disorder (OUD) causes significant morbidity and mortality among people experiencing homelessness. We aimed to explore the unique way in which OUD impacts individuals experiencing homelessness as part of a family. ⋯ According to a sample of adults experiencing OUD in the context of family homelessness, an ideal OUD treatment program would overcome logistical barriers, provide comprehensive treatment for comorbidities, support employment and housing needs, and focus care on the family. Future work should explore the generalizability and financial feasibility of this model.
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Drug Alcohol Depend · Jun 2018
Prevalence, patterns, and correlates of multiple substance use disorders among adult primary care patients.
Addressing multiple substance use disorders (SUDs) in primary care-based screening and intervention may improve SUD treatment access, engagement, and outcomes. To inform such efforts, research is needed on the prevalence and patterns of multiple SUDs among primary care patients. ⋯ Findings suggest that primary care physicians should be aware of multiple SUDs when planning treatment, especially among adults who are male, younger, less educated, or unemployed. Interventions that target multiple SUDs warrant future investigation.
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Drug Alcohol Depend · Jun 2018
Randomized Controlled Trial Multicenter StudyOutpatient transition to extended-release injectable naltrexone for patients with opioid use disorder: A phase 3 randomized trial.
Injectable extended-release naltrexone (XR-NTX), approved to prevent relapse to opioid dependence, requires initial abstinence. This multisite outpatient clinical trial examined the efficacy and safety of low-dose oral naltrexone (NTX), combined with a brief buprenorphine (BUP) taper and standing ancillary medications, for detoxification and induction onto XR-NTX. ⋯ A 7-day detoxification protocol with NTX alone or NTX + BUP provided similar rates of induction to XR-NTX as placebo. For those inducted onto XR-NTX, management of opioid withdrawal symptoms prior to induction was achieved in a structured outpatient setting using a well-tolerated, fixed-dose ancillary medication regimen common to all three groups.