Journal of substance abuse treatment
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J Subst Abuse Treat · Dec 2018
Multicenter StudyRisk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
Recent U.S. trends demonstrate sharp rises in adverse opioid-related health outcomes, including opioid use disorder (OUD), overdose, and death. Yet few affected people receive treatment for OUD and a minority of those who receive treatment are effectively retained in care. The purpose of this study was to examine duration of buprenorphine treatment for OUD following treatment initiation to identify risk factors for early discontinuation. ⋯ For Medicaid beneficiaries with OUD treated with buprenorphine, there is a need to implement treatment models that more effectively address barriers to treatment retention. These barriers are particularly challenging for minorities, younger individuals, and those with additional substance use disorders.
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J Subst Abuse Treat · Nov 2018
Factors associated with methadone maintenance therapy discontinuation among people who inject drugs.
Methadone maintenance therapy (MMT) continues to be a key treatment for opioid use disorder, although premature discontinuation of MMT can increase risk for overdose and other severe harms. We examined sociodemographic characteristics, substance use patterns and social-structural exposures associated with MMT discontinuation among a cohort of people who use drugs (PWUD) in Vancouver, Canada. ⋯ Discontinuation of MMT in this urban setting was associated with recent homelessness and incarceration, not accessing social income assistance, as well as daily prescription opioid use and daily heroin injection drug use. These findings underscore a need to reduce potential barriers to MMT retention by providing access to stable housing and preventing treatment interruptions during transitions between community and custodial settings.
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J Subst Abuse Treat · Nov 2018
Multicenter Study Comparative StudyBuprenorphine treatment formulations: Preferences among persons in opioid withdrawal management.
In the current study, we examined factors predicting willingness to receive buprenorphine treatment and preferences for various buprenorphine formulations (oral, injection, implant) among persons in opioid withdrawal management. ⋯ Past buprenorphine prescription does not predict future willingness to restart. Among those willing to use buprenorphine, newer formulations of buprenorphine appealed to more than half of the participants.
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J Subst Abuse Treat · Nov 2018
Variations in prescription drug monitoring program use by prescriber specialty.
Although prescription drug monitoring programs (PDMPs) have been widely implemented to potentially reduce abuse of prescription opioids, there is limited data on variations in PDMP use by prescriber specialty. Such knowledge may guide targeted interventions to improve PDMP use. ⋯ A minority of opioid prescribers to Medicaid beneficiaries used the PDMP. We identified variations in PDMP use by prescriber specialty. Interventions to increase PDMP queries should target both PDMP registration and PDMP use after registration, as well as specialties with current low use rates.
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J Subst Abuse Treat · Nov 2018
Associations between marijuana use and tobacco cessation outcomes in young adults.
Marijuana and tobacco co-use is common among young adults, and findings are mixed regarding the association between marijuana use and smoking cessation outcomes. This study examined the longitudinal relationships between marijuana use and smoking cessation outcomes among young adults (aged 18-25 years; N = 500) enrolled in a 3-month smoking cessation intervention on Facebook. At baseline and 3, 6, and 12 months, participants reported their marijuana use and their smoking behaviors (seven-day point prevalence abstinence from smoking, cigarettes per day, quit attempts) and readiness to quit. ⋯ Use of marijuana was not significantly associated with perceptions of or engagement in the smoking cessation intervention, stage of change for quitting smoking, or tobacco quit attempts (all p's > 0.08). Study findings indicate that while marijuana use is unrelated to motivation to quit tobacco and engage in cessation interventions, marijuana use is associated with less success in reducing and abstaining from tobacco. Additional support and targeted tobacco cessation strategies to address challenges associated with marijuana co-use may be needed.