SAj Blog Archives - Page 49 of 88

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.”

The Authors’ Own Words: Experiences of burnout among drug counselors in a large opioid treatment program: A qualitative investigation

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.

Experiences of burnout among drug counselors in a large opioid treatment program: A qualitative investigation

Mark Beitel PhD; Lindsay Oberleitner PhD; Dharushana Muthulingam MD, MSc; David Oberleitner PhD; Lynn M. Madden PhD, MPA; Ruthanne Marcus PhD, MPH; Anthony Eller BS; Madeline H. Bono; & Declan T. Barry, PhD

Substance Abuse Vol. 39, Iss. 2, 2018

“The scale-up of medication-assisted treatment is crucial for addressing the current opioid treatment gap in the US. One barrier to scale-up is concern about the impact on staff of increased patient volume. Finding from this quality improvement study of drug counselors, employed at large opioid treatment programs whose capacities were expanding, yielded lower than expected rates of burnout. Participants reported a variety of onsite (e.g., taking breaks) and offsite (e.g., taking an exercise class) coping strategies to prevent burnout. Many strategies were low-cost and transportable to other settings. Overall, our findings suggest that drug counselor burnout is not inevitable, and opioid treatment programs might benefit from routinely seeking counselor feedback on burnout and implementing practical recommendations to enhance staff engagement and reduce burnout.”

The Authors’ Own Words: Implementation and Evaluation of an Opioid Overdose Education and Naloxone Distribution (OEND) Program at a Veterans Affairs Medical Center (VAMC)

Jan 7, 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.

Implementation and Evaluation of an Opioid Overdose Education and Naloxone Distribution (OEND) Program at a Veterans Affairs Medical Center (VAMC)

Julienne B. Pauly PharmD, BCPP; Christine M. Vartan PharmD, BCPS; & Abigail T. Brooks PharmD, BCPS

Substance Abuse Vol. 39, Iss. 2, 2018

“Being that accidental opioid overdose has become a national epidemic, it is important to educate all individuals who utilize opioids on risk mitigation strategy. Patients on chronic prescribed opioid therapy were referred to participate in this VAMC OEND programming; many were surprised to learn that despite being on an opioid regimen long-term, accidental overdose can still occur. Participants were encouraged to bring a significant other/friend to the education or identify someone to teach, as the bystander will likely be applying this life-saving information. The project authors also calculated the risk index for overdose (RIOSORD) and serious opioid induced respiratory depression (OIRD) score on all OEND participants. The RIOSORD/ORID is a novel tool that can be utilized by facilities seeking to target patients for OEND or similar programming. The findings and failures of this project can be utilized by other facilities who desire to allocate resources to OEND programming.”

The Authors’ Own Words: Integration of a Clinical Pharmacy Specialist into a Substance Use Disorder Training drug addiction counselors to deliver a brief psychosocial psychoeducational intervention for chronic pain among patients in opioid agonist treatment: A pilot investigation.

Jan 7, 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.

Integration of a Clinical Pharmacy Specialist into a Substance Use Disorder Training drug addiction counselors to deliver a brief psychosocial psychoeducational intervention for chronic pain among patients in opioid agonist treatment: A pilot investigation.

Jenna L. Butner MD; Curtis Bone MD; Caridad C. Ponce Martinez MD; Grace Kwon MD; Mark Beitel PhD; Lynn M. Madden PhD; Madeline H. Bono; Anthony Eller BS; & Declan T. Barry PhD

Substance Abuse Vol. 39, Iss. 2, 2018

“Initiatives to reduce providers’ perceived inability, reported discomfort, and lack of interest in managing chronic pain have centered on enhancing curricula at medical and professional schools. This approach has met with mixed success; it appears that training providers on a biomedical model of pain management emphasizing pathophysiology, pharmacotherapy, and surgical interventions does not automatically enhance perceived ability to manage chronic pain. Findings from this pilot study suggest that it is both feasible and acceptable to train front-line opioid agonist treatment drug counselors with an inexpensive, brief, onsite psychoeducational intervention for assessing and addressing chronic pain; on average attendees continued to perceive a beneficial effect on their clinical work with patients six months later. These findings underscore the importance of conducting further research on training providers, including those in opioid agonist treatment settings, on the biopsychosocial model of chronic pain, and targeting strategies that might enhance their clinical management of patients with chronic pain.”