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A Qualitative Exploration of Attitudes Toward Global Positioning System Tracking and Ecological Momentary Assessment Among Individuals in Substance Use Treatment

Jun 7, 2024 by AMERSA

The article, “A Qualitative Exploration of Attitudes Toward Global Positioning System Tracking and Ecological Momentary Assessment Among Individuals in Substance Use Treatment” has been published in SAj.

In this article, the authors detail their findings from qualitative interviews with 30 individuals in substance use treatment programs regarding their opinions on participating in a study that involved GPS tracking and ecological momentary assessment to better understand place-based, environmental factors that may predict substance use. The authors relay the concerns and benefits as described by participants and the resulting implications for this type of research. 

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Few previous studies have used global positioning system (GPS) tracking in concert with ecological momentary assessment (ie, the use of mobile devices to administer frequent surveys on real-world experiences) to measure the real-time exposure to such triggers or their subsequent effects on return to use. This combination of tracking technology provides an opportunity to look at the duration and frequency of exposure to triggers and other aspects of the “environmental context” on recovery and return to use.6”

“To our knowledge, researchers have not explored in depth the attitudes and perceptions of people in SUD treatment on the use of such tracking technology, especially GPS tracking, for research purposes. Charron et al16 recently found high levels of acceptability for different sensing technologies, but did not examine attitudes toward more active methodologies (ie, ecological momentary assessment).”

Filed Under: SAj Blog

Providers’ Experiences and Perspectives in Treating Patients With Co-Occurring Opioid and Stimulant Use Disorders in the Hospital

May 29, 2024 by AMERSA

The article, “Providers’ Experiences and Perspectives in Treating Patients With Co-Occurring Opioid and Stimulant Use Disorders in the Hospital,” has been published in SAj.

In this article, the authors detail their findings from qualitative interviews with 20 hospital-based providers with a focus on treating patients who co-use opioids and stimulants. Based on the interviews, the authors identified and discussed ways in which opioid and stimulant co-use creates challenges for substance use treatment. The article also outlines provider-level and system-level opportunities to improve treatment of co-occurring opioid and stimulant use disorders among patients in the hospital setting. 

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Qualitative research can support the development and implementation of hospital-based care for patients with substance use disorders (SUDs). For example, qualitative research findings supported the development of hospital addiction consult services (ACS)8 and identified key barriers and facilitators to adoption at other hospitals.9 Similarly, a deeper understanding of physician perspectives, available through qualitative inquiry, has informed practice facilitation strategies to implement Emergency Department-based MOUD prescribing.10,11”

“Despite a 13.4% increase in hospitalizations involving co-use between 2016 and 2018,3 and lower rates of treatment with MOUD,21,22 to our knowledge, there are no hospital care pathways specifically tailored for patients with co-use. A recent qualitative study of Veterans Affairs primary care providers’ experiences and perspectives treating patients with multiple SUDs identified barriers at the patient (e.g., life instability, stigma), provider (e.g., lack of knowledge or clear guidelines), and system levels (e.g., low accessibility to specialty SUD clinics providing MOUD).23 However, patient presentations and healthcare delivery in the hospital may be substantially different than outpatient settings. Therefore, a deeper understanding of hospital providers’ experiences and perspectives is needed to inform the development and implementation of targeted services for hospitalized patients with co-use.”

Filed Under: SAj Blog

Xylazine-Associated Wounds and Related Health Concerns Among People Who Use Drugs: Reports From Front-Line Health Workers in 7 US States

May 22, 2024 by AMERSA

The article, “Xylazine-Associated Wounds and Related Health Concerns Among People Who Use Drugs: Reports From Front-Line Health Workers in 7 US States,” has been published in SAj.

In this article, the author acknowledges the increasing prevalence of xylazine in the US drug supply and provides insight from front-line harm reduction and health care professionals on risk, recognition, and care of xylazine-associated wounds. The article also documents the health implications of xylazine exposure experienced by people who use drugs. Additionally, the author relates recommended priorities for xylazine-related research as identified by front-line professionals. 

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Harm reduction organizations have been actively documenting and sharing lessons learned through direct service to people impacted by xylazine exposure, including knowledge related to xylazine withdrawal and xylazine-associated wounds.26,27 Though this expert knowledge is insufficient to guide public health efforts alone, it is one of the 3 pillars of evidence-based practice alongside high-quality scientific evidence and meaningful input from directly impacted people.28,29 Service providers who work for or with harm reduction organizations, therefore, represent an available, necessary, and largely untapped source of knowledge about the harms of xylazine exposure, the challenges those harms pose to patients and providers, and the most urgent priorities for xylazine-related scientific research.”

“As xylazine becomes more pervasive in the US drug supply, xylazine-associated wounds and related harms are being observed by front-line harm reduction professionals with increasing frequency. Conservative wound care strategies have been developed by front-line wound care providers, but more research into risk factors for these wounds, the biologic mechanisms of these wounds, and strategies for their prevention and treatment is urgently needed. Efforts to improve the management of xylazine withdrawal and reduce stigma against people who use drugs by incorporating harm reduction professionals into healthcare settings may also improve opportunities for engagement with many forms of care.”

Filed Under: SAj Blog

Relationships Between Stigma, Risk Tolerance, and Buprenorphine Dispensing Intentions Among Community-Based Pharmacists: Results From a National Sample

May 8, 2024 by agalloway

The article, “Relationships Between Stigma, Risk Tolerance, and Buprenorphine Dispensing Intentions Among Community-Based Pharmacists: Results From a National Sample,” has been published in SAj.

In this commentary, the authors state that concerns have been raised that pharmacists sometimes act as barriers to patients with opioid use disorder (OUD) accessing buprenorphine treatment. The present research explores how community pharmacists’ endorsement (vs non-endorsement) of stigmatizing beliefs about patients taking buprenorphine relate to intentions, comfort, and decisions regarding dispensing buprenorphine for OUD. In addition, the authors assessed attitudes toward risk in pharmacy practice as a novel correlate of dispensing intentions and decisions.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“In the context of existing stigma and knowledge deficits, the concept of risk aversion related to controlled substance dispensing has been identified among pharmacists. Risk aversion, defined as a preference for certain outcomes over uncertain outcomes, is a pervasive cognitive bias, at times leading to disadvantageous decision-making to avoid uncertainty around potential negative outcomes.

In the present research, we explore 2 factors that may influence pharmacists’ dispensing behavior—stigma toward patients taking buprenorphine for OUD and risk tolerance in the domain of pharmacy practice. In addition to measuring levels of stigma toward buprenorphine patients and risk avoidance, the present research explored how these key variables relate to (1) general intentions to dispense buprenorphine and (2) decision-making in buprenorphine dispensing vignettes. Specifically, we hypothesized that stigma and risk tolerance would impact more proximal cognitions like behavioral intentions and comfort with dispensing a specific prescription to influence decision-making. We tested our hypotheses using a variety of statistical methods, including mediation models.”

“Buprenorphine is an effective treatment for OUD with the potential to reduce mortality, but patients may encounter barriers to access in pharmacy settings. Our data suggest that stigmatizing beliefs and concerns about risk among community pharmacists may contribute to these barriers. Education and training efforts and regulatory reform should incorporate attempts to reduce stigma and broaden the scope of risks considered in pharmacy practice to include negative outcomes of choosing not to fill a valid prescription.”

Filed Under: SAj Blog, Uncategorized

The Cost of Safe Injection: Insights on Nonprescription Syringe Price Variability From Systematic Secret Shopping

May 1, 2024 by agalloway

The article, “The Cost of Safe Injection: Insights on Nonprescription Syringe Price Variability From Systematic Secret Shopping,” has been published in SAj.

In this commentary, the authors state that although the sale of nonprescription syringes in pharmacies is legal in most states, people who inject drugs (PWID) continue to face obstacles to syringe purchase like stigma, prohibitive costs, restrictive policies, and stocking issues. The authors examined the consistency of syringe pricing as another possible barrier.

In the AUTHORS’ OWN WORDS, they relate the importance of their work:

“Pharmacists are among the most accessible healthcare providers and therefore are uniquely positioned to provide harm-reduction services. Pharmacies can contribute to community infection prevention by stocking and dispensing medications for opioid use disorder and NPS, as well as providing universal, on-site, and portable syringe disposal services. Pharmacies can also act as critical sources of the opioid antagonist, naloxone, which is a medication proven to reduce opioid overdose mortality. At the same time, pharmacies can only provide effective harm-reduction services if syringes are consistently stocked and distributed at low- or no-cost. The purpose of this study is to examine the variability of syringe prices across 2 retail chain pharmacy businesses and 4 states—Massachusetts, New Hampshire, Oregon, and Washington—and to explore the determinants of syringe prices.”

“Inconsistency in syringe price is yet another barrier to accessing sterile syringe equipment from community pharmacies. While professional education is needed to reduce stigma at pharmacy counter interactions, system-level changes are critically needed to improve transparency, streamline syringe purchases, eliminate the taxation of exempt syringes, and reduce the variation in syringe prices if equitable, consistent access to these essential public health tools is to be realized for consumers.”

Filed Under: SAj Blog, Uncategorized

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