Substance use & misuse
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Substance use & misuse · Jan 2020
Adolescents' Willingness to Commit to Safe Use and Disposal of Prescription Opioids.
Introduction and aims: Leftover pills from prescriptions written in emergency departments are a key source of misused opioids among adolescents. Recently, the AMA has proposed emphasizing safe use and disposal of opioids, but patient perceptions on this proposed solution are largely unknown. In this study, we evaluate the willingness of adolescents to commit to pill security and safe opioid use in a clinical setting. ⋯ Overall 29.7% of adolescents had received a prescription for opioids and 40.7% had leftover pills. 87.9% were willing to commit to take opioids only as prescribed and 83.5% were willing to commit to disposing leftover opioids. Willingness did not vary by previous exposure to prescription opioids or attitudes toward recreational opioid use. Discussion and conclusions: Adolescents are highly willing to commit to safe opioid use and disposal regardless of previous exposure to opioids or attitude toward opioid misuse.
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Substance use & misuse · Jan 2020
Provider beliefs on the Barriers and Facilitators to Prescription Monitoring Programs and Mandated Use.
Background: Underutilization of Prescription monitoring programs (PMP), especially in states where participation is voluntary could limit their impact against opioid epidemic. Objectives: To (1) examine PMP use among Iowa healthcare providers (HCPs); (2) identify factors prompting and impeding PMP use, and (3) assess beliefs toward mandating PMP use. Methods: A cross-sectional survey of Iowa HCPs was conducted using a 12-item questionnaire. ⋯ Discussion: HCPs displayed variation in PMP use. EMR integration appears to be a strategy for increasing PMP use. There was resistance to mandating PMP use for all controlled substances prescribed and dispensed, with some interest in mandates for new patients only or new controlled substance prescriptions only.
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Substance use & misuse · Jan 2020
CBD (Cannabidiol) Product Attitudes, Knowledge, and Use Among Young Adults.
Background: Cannabidiol (CBD), a non-psychoactive component of cannabis is marketed as a potential treatment for many conditions and widely available to purchase as a dietary supplement. In 2017, sales of CBD exceeded 820 million dollars despite many unconfirmed health claims, murky legality, and limited product efficacy and safety testing. Purpose/Objectives: This study aims to explore cannabidiol (CBD) knowledge, attitudes, and use among young adults. ⋯ Many respondents reported using guesswork to determine dosage, and over half of respondents reported at least one unanticipated side effect. Conclusions/Importance: This study revealed that many users are not responsibly using CBD products, many believe CBD products provide health benefits that are not yet scientifically proven, and they are not knowledgeable about legal and regulatory issues. Until CBD use is more thoroughly researched and has more comprehensive regulation, public health professionals should address alternative stress and anxiety treatment methods.
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Substance use & misuse · Jan 2020
Urine Drug Testing among Opioid-Naïve and Long-Term Opioid Nevada Medicaid Beneficiaries.
Current guidelines recommend that, when prescribing opioids, providers use urine drug testing (UDT) for harm reduction. Objective: To identify whether Medicaid beneficiaries in Nevada at increased risk for opioid misuse received UDT. Methods: We used Nevada Medicaid claims data (2017-2018) to describe UDT among three samples: opioid naïve patients (N = 11,326), opioid naïve patients with a second follow-up prescription (N = 8,910), and long-term opioid patients (N = 19,173). ⋯ Adults with alcohol disorders and other substance use disorders had the highest PP of UDT, among both the naïve (alcohol related disorder: 3.1%; other substance use disorder: 7.7%) and the naïve with a second follow-up prescription (alcohol related disorder: 4.1%; other substance use disorder: 11.7%) samples. Among the long-term sample, similar predictors were significant. Conclusions: Although there was an association between having risk factors for opioid misuse (e.g. past alchohol disorders and other substance use disorder diagnoses) and receiving UDT, the percentage of patients who received UDT was unexpectedly low, pointing to the need to increase guideline adherence and implementation among providers who prescribe opioids.