AMERSA, Author at AMERSA

The Authors’ Own Words: Breastfeeding and Methadone Therapy: The Maternal Experience

Apr 18, 2016 by AMERSA

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.

Breastfeeding and Methadone Therapy: The Maternal Experience
Jill R. Demirci , Debra L. Bogen , Yael Klionsky
Substance Abuse
Vol. 36, Iss. 2, 2015

The breastfeeding challenges faced by women prescribed methadone are often inferred, but these assertions have not been substantiated from the maternal perspective. In this study, we found that women taking methadone and intending to breastfeed face additional barriers to breastfeeding establishment compared to the general population (e.g., poor support, concern about methadone transfer through breast milk); yet, awareness of the protective effects of breastfeeding against neonatal abstinence syndrome is a highly motivating factor to persevere through these challenges. Our research exposes the shortcomings of the healthcare community in educating women about the safety and benefits of breastfeeding while taking methadone, but also highlights the opportunities clinicians and researchers have to correct misinformation, promote maternal breastfeeding confidence, and develop support systems to improve breastfeeding outcomes in this population.

The Authors’ Own Words: Exploring the Concepts of Abstinence and Recovery Through the Experiences of Long-Term Opiate Substitution Clients

Apr 14, 2016 by AMERSA

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.

Exploring the Concepts of Abstinence and Recovery Through the Experiences of Long-Term Opiate Substitution Clients
Caitlin Notley , Annie Blyth , Vivienne Maskrey , Hayley Pinto , Richard Holland
Substance Abuse
Vol. 36, Iss. 2, 2015

This study aimed to explore the client experience of long term opiate substitution treatment (OST). Participants experienced long term OST as a transition between illicit drug use and recovery. Recovery was seen as a process rather than a fixed goal, confirming that there is a need for services to negotiate individualised recovery goals, spanning harm minimisation and abstinence oriented treatment approaches. Decisions about the length or components of treatment should be based on an understanding of the meaning of treatment and the consequent balance of risk and benefits for that individual.

The Authors’ Own Words: Advanced Practice Nurses: Increasing Access to Opioid Treatment by Expanding the Pool of Qualified Buprenorphine Prescribers

Apr 4, 2016 by AMERSA

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.

Advanced Practice Nurses: Increasing Access to Opioid Treatment by Expanding the Pool of Qualified Buprenorphine Prescribers
Matthew Tierney , Deborah S. Finnell , Madeline A. Naegle , Colleen LaBelle , Adam J. Gordon
Substance Abuse
Vol. 36, Iss. 4, 2015This editorial is noteworthy for appealing to a broad audience to promote Advanced Practice Registered Nurses (APRNs) to prescribe buprenorphine to treat opioid use disorders. This significant change in practice would require a change to current federal law that currently grants only physicians the authority to prescribe buprenorphine for opioid use disorder. The authors join other stakeholders, including professional organizations and communities throughout the US represented by numerous senators, by calling for APRNs to join the insufficient number of physicians now prescribing buprenophine in order to increase access to care in the context of ever-increasing morbidities and mortality associated with opioid use. APRNs are already involved in all other aspects of care for patients with opioid use disorder, and are known to be safe providers who are interested in providing this evidence-based treatment.

The Authors’ Own Words: Project ECHO (Extension for Community Healthcare Outcomes): A new model for educating primary care providers about treatment of substance use disorders

Apr 1, 2016 by AMERSA

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.

Project ECHO (Extension for Community Healthcare Outcomes): A new model for educating primary care providers about treatment of substance use disorders
Miriam Komaromy, Dan Duhigg, Adam Metcalf, Cristina Carlson, Summers Kalishman, Leslie Hayes, Tom Burke, Karla Thornton, Sanjeev Arora
Substance Abuse
Vol. 37, Iss. 1, 2016

The ECHO model is gaining recognition nationally and internationally as a model for ongoing telementoring and guided practice that can help primary care providers to hone their skills and increase their confidence in caring for patients with complex diseases. The current epidemic in opioid overdose deaths has created a need for PCPs to become comfortable identifying and treating substance use disorders, and yet graduate and undergraduate medical education typically do not focus on the skills and knowledge needed to treat SUDs effectively. This manuscript describes a teleECHO clinic that has operated for the past decade in NM with a focus on training and supporting PCPs to address SUDs. The manuscript also describes use of the ECHO network to recruit providers to participate in training to receive the buprenorphine waiver. Over the past decade NM has seen a rapid rise in the number of providers in traditionally underserved areas who have obtained the waiver to prescribe buprenorphine. ECHO may provide an effective model to train and support PCPs to address SUDs, and may also expand access to SUD treatment in traditionally-underserved areas.

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Our newly released issue is now online —> January-March 2016.
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The Authors’ Own Words: Screening and evaluation of hepatitis C virus infection in pregnant women on opioid maintenance therapy: A retrospective cohort study

Mar 31, 2016 by AMERSA

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.

Screening and evaluation of hepatitis C virus infection in pregnant women on opioid maintenance therapy: A retrospective cohort study
Elizabeth E. Krans , Susan L. Zickmund , Vinod K. Rustgi , Seo Young Park , Shannon L. Dunn , Eleanor B. Schwarz
Substance Abuse
Vol. 37, Iss. 1, 2016

This large study of prenatal screening and evaluation of HCV infection at a leading academic medical center found many missed opportunities to identify and evaluate women with opioid use disorders for HCV infection during pregnancy. Our results indicate that one-third of patients receive the diagnosis of HCV for the first time during pregnancy, emphasizing the importance of pregnancy as a critical period for HCV evaluation. However, prenatal care approaches to HCV infection remain inconsistent and the majority of patients diagnosed with HCV infection during pregnancy do not receive treatment after delivery. Future research should be devoted to efforts to improve care coordination and inter-provider dialogue among substance abuse treatment providers, prenatal care providers and hepatologists to improve the efficiency and effectiveness of screening for common medical co-morbidities such as HCV infection as well as to the development of interventions designed to increase the number of patients enrolled in HCV treatment following delivery. As a new era in HCV treatment unfolds, prenatal care clinical recommendations and practice patterns must keep pace.

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Our newly released issue is now online —> January-March 2016.
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