AMERSA, Author at AMERSA

The Authors’ Own Words: Heterogeneity of State Medical Marijuana Laws and Adolescent Recent Use of Alcohol and Marijuana: Analysis of 45 States, 1991-2011

Jan 11, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Heterogeneity of State Medical Marijuana Laws and Adolescent Recent Use of Alcohol and Marijuana: Analysis of 45 States, 1991-2011

Julie K. Johnson PhD; Renee M. Johnson PhD; Dominic Hodgkin PhD; Abenaa A. Jones PhD; Ann Marie Matteucci PhD; & Sion K. Harris PhD

Substance Abuse Vol. 39, Iss. 2, 2018

“This study examined whether Medical Marijuana Laws (MMLs) and their restrictiveness affect varying current adolescent alcohol and marijuana use behaviors using Youth Risk Behavioral Surveillance System data from 45 states between 1991-2011, including 12 of the 16 states that enacted MML on or previous to 2011, representing the most liberalized categorization of marijuana laws prior to the wave of recreational marijuana legalization laws that began in 2012. It is not well known how MMLs affect alcohol use behaviors, even less so for the adolescent cohort. This study found that states that enacted a MML, and having a less restrictive policy, were associated with lowered odds of current adolescent alcohol use. A unique feature of this study is the analysis of not only the effect of having any MML on these outcomes, but also the effect of state MML restrictiveness, using policy taxonomy scores. The alcohol findings are not as surprising given that Monitoring in the Future, a national surveillance of youth substance use, reports steadily annual declining alcohol use rates among youth from 1991 to 2011. By contrast, prevalence of marijuana use has remained steady from 1994 to 2014, despite a changing marijuana reform landscape.”

The Authors’ Own Words: High Dosage Opioid Prior Authorization Policy on Prescription Opioid Use, Misuse, and Overdose Outcomes

Jan 10, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

High Dosage Opioid Prior Authorization Policy on Prescription Opioid Use, Misuse, and Overdose Outcomes

Daniel M. Hartung PharmD, MPH; Hyunjee Kim PhD; Sharia M. Ahmed MPH; Luke Middleton BS; Shellie Keast PhD, PharmD, MS; Richard A. Deyo MD, MPH; Kun Zhang PhD; & K. John McConnell PhD

Substance Abuse Vol. 39, Iss. 2, 2018

“This paper evaluates the impact of Medicaid prior authorization policy for high dose opioid prescriptions. Results show the policy was associated with a substantial reduction in opioid prescriptions above a daily dose of 120 morphine milligram equivalents, increases in lower dose opioid prescriptions and drugs for neuropathic pain, but had no significant impact on opioid-related ED visits or hospitalizations. As insurers and healthcare payers align reimbursement strategies and benefit designs to influence opioid prescribing, it is important to characterize both intended an unintended effects of these policy changes.”

The Authors’ Own Words: Knowledge of the 911 Good Samaritan Law and 911-calling behavior of overdose witnesses

Jan 10, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Knowledge of the 911 Good Samaritan Law and 911-calling behavior of overdose witnesses

Andrea Jakubowski MD; Hillary V. Kunins MD, MPH; Zina Huxley-Reicher BA; & Anne Siegler DrPH

Substance Abuse Vol. 39, Iss. 2, 2018

“We hope that our finding that knowledge of the 911 Good Samaritan Law is associated with bystanders calling 911 in response to witnessed overdose will encourage states to pass legislation that protects drug overdose victims and witnesses seeking help from arrest and prosecution for drug related charges. It is also noteworthy that participant knowledge of the Good Samaritan Law increased with repeated education, suggesting that overdose prevention refresher trainings and public information campaigns about the law may be important strategies to achieving widespread knowledge of it. Finally, our finding that lay-person naloxone administration was not associated with a reduction in the rate of bystanders calling 911 should allay concerns that naloxone distribution deters use of emergency medical services.”

The Authors’ Own Words: Lessons learned from the implementation of a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential addiction treatment

Jan 9, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Lessons learned from the implementation of a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential addiction treatment

Honora Englander MD; Talitha Wilson BS; Devin Collins MA; Elena Phoutrides MD, MPH; Melissa Weimer DO, MCR; P. Todd Korthuis MD, MPH; Jessica Calcagni CADC I, MA; & Christina Nicolaidis MD, MPH

Substance Abuse Vol. 39, Iss. 2, 2018

Our study is a mixed-methods study evaluating a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential substance use disorder (SUD) treatment for hospitalized adults. MERT had low recruitment and retention, and ended after 6 months. We used a mixed-methods approach to describe limited feasibility and acceptability of MERT, and to explore and explain reasons why MERT failed.
Our study has several key implications. First, the finding that hospitalized patients declined residential treatment is important and suggests the need for flexible, patient-centered post-acute care models that can engage patients who range from pre-contemplative to action stages of change. Low recruitment also raises questions as to the necessity of stringent residential requirements (e.g. the 30-day blackout period and intensive group attendance), and underscores the need to integrate pain management and other physical healthcare into an SUD treatment setting for this population. Findings that patients with complex medical illness (including PICC lines) and medications for addiction treatment (MAT) “stood out” in residential suggests a need for increased medical support and staff training in residential treatment settings. Finally, though MERT was developed based on a patient needs assessment and broad stakeholder input, our experience raises the question of whether a more iterative design process that included ongoing feedback from adults with SUD and residential staff may have led to a more successful intervention. While a single solution to this widespread national problem is unlikely, we aim to demonstrate lessons that are likely to be applicable across future models.
Our study is a mixed-methods study evaluating a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential substance use disorder (SUD) treatment for hospitalized adults. MERT had low recruitment and retention, and ended after 6 months. We used a mixed-methods approach to describe limited feasibility and acceptability of MERT, and to explore and explain reasons why MERT failed.
Our study has several key implications. First, the finding that hospitalized patients declined residential treatment is important and suggests the need for flexible, patient-centered post-acute care models that can engage patients who range from pre-contemplative to action stages of change. Low recruitment also raises questions as to the necessity of stringent residential requirements (e.g. the 30-day blackout period and intensive group attendance), and underscores the need to integrate pain management and other physical healthcare into an SUD treatment setting for this population. Findings that patients with complex medical illness (including PICC lines) and medications for addiction treatment (MAT) “stood out” in residential suggests a need for increased medical support and staff training in residential treatment settings. Finally, though MERT was developed based on a patient needs assessment and broad stakeholder input, our experience raises the question of whether a more iterative design process that included ongoing feedback from adults with SUD and residential staff may have led to a more successful intervention. While a single solution to this widespread national problem is unlikely, we aim to demonstrate lessons that are likely to be applicable across future models.
Our study is a mixed-methods study evaluating a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential substance use disorder (SUD) treatment for hospitalized adults. MERT had low recruitment and retention, and ended after 6 months. We used a mixed-methods approach to describe limited feasibility and acceptability of MERT, and to explore and explain reasons why MERT failed.
Our study has several key implications. First, the finding that hospitalized patients declined residential treatment is important and suggests the need for flexible, patient-centered post-acute care models that can engage patients who range from pre-contemplative to action stages of change. Low recruitment also raises questions as to the necessity of stringent residential requirements (e.g. the 30-day blackout period and intensive group attendance), and underscores the need to integrate pain management and other physical healthcare into an SUD treatment setting for this population. Findings that patients with complex medical illness (including PICC lines) and medications for addiction treatment (MAT) “stood out” in residential suggests a need for increased medical support and staff training in residential treatment settings. Finally, though MERT was developed based on a patient needs assessment and broad stakeholder input, our experience raises the question of whether a more iterative design process that included ongoing feedback from adults with SUD and residential staff may have led to a more successful intervention. While a single solution to this widespread national problem is unlikely, we aim to demonstrate lessons that are likely to be applicable across future models.
Our study is a mixed-methods study evaluating a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential substance use disorder (SUD) treatment for hospitalized adults. MERT had low recruitment and retention, and ended after 6 months. We used a mixed-methods approach to describe limited feasibility and acceptability of MERT, and to explore and explain reasons why MERT failed.
Our study has several key implications. First, the finding that hospitalized patients declined residential treatment is important and suggests the need for flexible, patient-centered post-acute care models that can engage patients who range from pre-contemplative to action stages of change. Low recruitment also raises questions as to the necessity of stringent residential requirements (e.g. the 30-day blackout period and intensive group attendance), and underscores the need to integrate pain management and other physical healthcare into an SUD treatment setting for this population. Findings that patients with complex medical illness (including PICC lines) and medications for addiction treatment (MAT) “stood out” in residential suggests a need for increased medical support and staff training in residential treatment settings. Finally, though MERT was developed based on a patient needs assessment and broad stakeholder input, our experience raises the question of whether a more iterative design process that included ongoing feedback from adults with SUD and residential staff may have led to a more successful intervention. While a single solution to this widespread national problem is unlikely, we aim to demonstrate lessons that are likely to be applicable across future models.”