The Authors' Own Words Archives - Page 19 of 38

The Authors’ Own Words: ‘A Scarlet Letter:’ Stigma and Other Factors Affecting Trust in the Healthcare System for Women Seeking Substance Abuse Treatment in a Community Setting

Nov 16, 2019 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.

‘A Scarlet Letter:’ Stigma and Other Factors Affecting Trust in the Healthcare System for Women Seeking Substance Abuse Treatment in a Community Setting

Joshua D. Cockroft, BA; Susie M. Adams, PhD, RN, PMHNP; Kemberlee Bonnet, MA; Deondria Matlock, MS; Jessica McMillan, DNP, RN, PMHNP; & David Schlundt , PhD

Substance Abuse Vol. 40, Iss. 2, 2019

“Though derived from a small sample size, the findings of this study demonstrate multiple factors that influence trust of the healthcare system for women who seek substance abuse treatment in a community setting. Efforts should be made to address components of healthcare organizations that predispose to stigma, poor quality of care, negatively aligned payment structure and reimbursement, ensuring patients’ rights and protections, and mediating the healthcare system’s potential role in causing or influencing an individual’s substance use disorder (SUD). These findings suggest that public health or institutional interventions to improve treatment for women with a history of SUD may require direct engagement with experiential and structural factors that influence trust and healthcare entry and engagement in order to be effective.“

The Authors’ Own Words: Synthetic cannabinoid use among a sample of individuals enrolled in community-based recovery programs: Are synthetic cannabinoids actually preferred to other drugs?

Nov 16, 2019 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.

Synthetic cannabinoid use among a sample of individuals enrolled in community-based recovery programs: Are synthetic cannabinoids actually preferred to other drugs?

Kirsten Elin Smith, MSW & Michele Staton, PhD

Substance Abuse Vol. 40, Iss. 2, 2019

“A majority of individuals (68%) enrolled in peer-led residential recovery programs who reported synthetic cannabinoid receptor agonist (SCRA) use were more likely to be younger, White, and to have been arrested and experienced homelessness in the past year compared to those who had not used SCRA. Though this group reported versatile substance use patterns, including use of other novel psychoactive drugs, they did not prefer SCRA to other drugs. Rather, heroin, non-prescribed opioids, and amphetamines were preferred. One reason may be that several adverse side effects were attributed to SCRA use. This latter finding is particularly concerning in that individuals using SCRA to circumnavigate drug monitoring, such as some in this clinical sample reported, may be motivated not to disclose use or seek medical treatment for SCRA-related effects. Indeed, few individuals who reported adverse SCRA side effects also reported seeking medical care. Given that SCRA are typically undetectable via standard drug screens, clinicians should consider alternative assessment methods and remain mindful of how psychiatric symptoms may be influenced by SCRA use. These findings indicate that only a minority of individuals who reported lifetime SCRA use prefer SCRA and intend to use it in the future, perhaps indicating that use of some SCRA compounds will not endure long-term.“

The Authors’ Own Words: Demystifying buprenorphine misuse: Has fear of diversion gotten in the way of addressing the opioid crisis?

Nov 15, 2019 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.

Demystifying buprenorphine misuse: Has fear of diversion gotten in the way of addressing the opioid crisis?

Molly Doernberg BA; Noa Krawczyk BA; Deborah Agus JD; & Michael Fingerhood MD

Substance Abuse Vol. 40, Iss. 2, 2019

“Buprenorphine is proven to be a safe and highly effective medication treatment for opioid disorder, yet a misguided perception that it is prone to diversion results in increased stigma and an overly restrictive regulatory climate. The limitations placed on access to treatment can have dangerous and even fatal consequences. This manuscript reviews literature showing that illicit buprenorphine is often used for self-treatment among persons who are not accessing formal care and argues that we should work to make it more accessible, especially among criminal justice populations that are often denied any medication treatment. It is intended that this manuscript will encourage clinicians, treatment programs, funding agencies, and criminal justice bodies to focus on lowering barriers to legal buprenorphine and to improving quality of care, thus reducing the burden of overdose death in our communities.“

The Authors’ Own Words: Person First and Patient First: Tailoring Language to Individual Patient Needs

Nov 15, 2019 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.

Person First and Patient First: Tailoring Language to Individual Patient Needs

Jasleen Salwan, MD, MPH

Substance Abuse Vol. 40, Iss. 2, 2019

“The Commentary, Person First and Patient First: Tailoring Language to Individual Patient Needs, aims to foster dialogue on patient-centered language in addiction. Person-first language, which positions the person literally before the disease, has been shown to humanize and empower people living with addiction. Many experts have called for the exclusive use of person-first language and have argued that terms like “addict” or “alcoholic” should be removed from the provider’s lexicon. However, confusion can arise when individuals use these terms to describe themselves, or when groups such as Alcoholics Anonymous encourage members to own certain identities as a part of their healing process. It is the author’s hope that this commentary will stir conversation on the nuances of patient-centered language.“

The Authors’ Own Words: The Problem of Pain: Additive Analgesic Effect of Tramadol and Buprenorphine in a Patient with Opioid Use Disorder

Nov 14, 2019 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.

The Problem of Pain: Additive Analgesic Effect of Tramadol and Buprenorphine in a Patient with Opioid Use Disorder

Cristina Montalvo, MD, MBS; Nicolas Genovese, BA; & John Renner, MD

Substance Abuse Vol. 40, Iss. 2, 2019

“The treatment of severe pain in patients on long term buprenorphine therapy for opioid dependence remains an ongoing challenge for clinicians across the country. When non-pharmacological and non-opioid treatments prove ineffective, additional opioid medication is often the last remaining option for these patients. However, due to the traditional understanding of buprenorphine’s pharmacokinetics and its strong affinity for analgesic opioid receptors, the efficacy of any additional opioid medication chosen by clinicians would expectedly be reduced. Coupled with the dearth of academic literature examining appropriate adjuvant medication for those on buprenorphine treatment, this decision facing many clinicians begins to seem insurmountable. In this manuscript, we show that our patient had a significant decrease in his pain and an improvement in his daily functioning with the addition of tramadol to his medication regiment while maintained on his opioid agonist therapy, and it highlights a novel and effective treatment option available to clinicians in the management of pain for those on buprenorphine therapy. Further, our manuscript creates a paradigm for future studies to compare tramadol’s efficacy in pain management compared to other opioid and non-opioid analgesics for those on long-term buprenorphine therapy.“