• Riley Ladegaard posted an update 6 days, 10 hours ago

    BACKGROUND There are several relatively safe and effective FDA-approved medications for Opioid Use Disorder (OUD). Despite the existence of these medications, the rate of returning to opioid use after treatment is relatively high, underscoring the need for continued enhancement of treatments. Adjunctive psychosocial interventions paired with medication have been shown to improve OUD treatment outcomes. However, studies have yet to conclusively examine the distinct effects of the most widely utilized psychosocial treatment modalities. The current study will investigate the relationship between individual counseling, group therapy, and 12-Step participation and illicit opioid abstinence at the end of treatment, 1 and 3 months after treatment. METHOD A secondary analysis was conducted with data from a sample of 570 individuals diagnosed with OUD who were recruited from eight substance abuse treatment centers in the United States. Participants were enrolled in a two-group randomized, controlled trial testing bupr2-Step participation may be beneficial for individuals receiving medication treatment for OUD. AIMS Methamphetamine Use Disorder is prevalent in South Africa. This analysis uses data from a contingency management (CM) pilot study in South Africa to replicate and expand on a U.S.-based study showing that CM voucher spending was associated with drug abstinence behavior. DESIGN Participants with methamphetamine-use disorder were enrolled in an 8-week CM trial requiring thrice weekly visits and received cash vouchers in exchange for stimulant-negative urines at each visit. PARTICIPANTS Participants were 33 treatment-seeking individuals with methamphetamine use disorder including 22 men (66.7%) and 11 women (33.3%) with a mean age of 34 years (S.D. = 7.7). Participants reported using methamphetamine for a mean of 11.7 years (S.D. = 4.9). SETTING All study procedures took place in South Africa between August 2016 and May 2018. MEASUREMENTS A time-lagged counting process Cox Proportional Hazards model for recurrent event survival analysis examined the relationship between frequency of and participant-categorimine abstinence. Qualitative results suggest spending CM vouchers may support social reintegration over the course of the trial. CONCLUSIONS Abstinence outcomes are a function of CM spending in both the U.S. and South Africa. Findings of a significant relationship between contingency management spending and subsequent stimulant-negative urine samples across geographic locations provide guidance toward future work in optimizing CM efficacy. Justice-involved youth (JIY) in the US have high rates of substance use (SU) problems, yet 50%-80% of these youth do not receive necessary services. There has been no systematic exploration of the use of treatment services for JIY that examines viewpoints across stakeholders in justice- and treatment-systems as well as the families. We conducted qualitative interviews and focus groups with n = 58, youth, their caregivers, SU treatment providers and probation officers in a Northeastern state. Interviews explored how families, staff- and system-level factors influence uptake of and retention in SU treatment services in youth on probation. We conducted a thematic analysis of all interview texts. Caregiver engagement is essential for youth treatment uptake and retention. selleck Difficulties achieving caregiver engagement and agreement that treatment was necessary stemmed from distrust in the “system”; denial or minimization of youth’s SU problem; relational barriers; and overburden and chaos within the family system. Structural barriers to service uptake were lack of available treatment options, SU agency practices and policies, and interagency collaboration between SU treatment agencies and probation. Enhancing family engagement at the point of referral to SU treatment is essential. Improvements in interagency collaboration and communication between SU treatment and probation agencies are necessary. Implications for policy and intervention are discussed. BACKGROUND Inpatient treatment for substance use disorders is a collection of strategies ranging from short term detoxification to longer term residential treatment. How those with opioid use disorder (OUD) navigate this inpatient treatment system after an encounter for detoxification and subsequent risk of opioid-related overdose is not well understood. METHODS We used a comprehensive Massachusetts database to characterize the movement of people with OUD through inpatient care from 2013 to 2015, identifying admissions to inpatient detoxification, subsequent inpatient care, and opioid overdose while navigating treatment. We measured the person-years accumulated during each transition period to calculate rates of opioid-related overdose, and investigated how overdose differed in select populations. RESULTS Sixty-one percent of inpatient detoxification admissions resulted in a subsequent inpatient detoxification admission without progressing to further inpatient care. Overall, there were 287 fatal and 7337 non-fatal overdoses. Persons exiting treatment after detoxification had the greatest risk of overdose (17.3 per 100 person-years) compared to those who exited after subsequent inpatient care (ranging from 5.9 to 6.6 overdoses per 100 person-years). Non-Hispanic whites were most at risk for opioid related overdose with 16 overdoses per 100 person-years and non-Hispanic blacks had the lowest risk with 5 overdoses per 100 person-years. CONCLUSIONS The majority of inpatient detoxification admissions do not progress to further inpatient care. Recurrent inpatient detoxification admission is common, likely signifying relapse. Rather than functioning as the first step to inpatient care, inpatient detoxification might be more effective as a venue for implementing strategies to expand addiction services or treatment such as medications for opioid use disorder. Smoking remains more prevalent among non-college educated and racial/ethnic minority young adults in the U.S. These smokers are less likely than their college educated/non-Hispanic white counterparts to use cessation treatments approved by the U.S. Food and Drug Administration (FDA). Alternative cessation methods (e.g., e-cigarettes) have also grown in popularity among smokers. Therefore, we conducted a focus group study to explore perceptions and beliefs about various cessation treatments among, racially/ethnically diverse, non-college educated young adult smokers. Seventy-five 18-29-year-old current smokers without a 4-year college education were recruited from the U.S. Washington, D.C. metropolitan area and attended one of twelve focus groups to discuss their awareness, beliefs, experiences, and intention for future use of cessation treatments. Focus groups were stratified by race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic) and educational attainment (≤ high school vs. some college without obtaining a bachelor’s degree).