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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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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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.

Evaluation of knowledge and confidence following opioid overdose prevention training: A comparison of types of training participants and naloxone administration methods
Lisham Ashrafioun , Stephanie Gamble , Michele Herrmann , Gloria Baciewicz
Substance Abuse
Vol. 37, Iss. 1, 2016

In this study, we assess the effectiveness of naloxone training on enhancing knowledge about opioid overdose and confidence to recognize and respond to an opioid overdose situation as a function of route of naloxone administration and training participant type.  Opioid overdose trainings are effective in increasing knowledge and confidence related to opioid overdose situations. Findings suggest that trainees are more confident administering naloxone via intranasal spray compared to injection.  This training is a relatively brief, easily transferrable and understandable training that appears to be effective in increasing participants’ knowledge and confidence to respond appropriately in opioid overdose situations.  Training on injection administration of naloxone should consider additional content aimed at decreasing potential concerns surrounding its administration and/or consider more skills training in order to increase confidence.

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

Optimizing psychosocial support during office-based buprenorphine treatment in primary care: Patients’ experiences and preferences
Aaron D. Fox , Mariya Masyukova , Chinazo O. Cunningham
Substance Abuse
Vol. 37, Iss. 1, 2016

We conducted a qualitative study with buprenorphine treatment-experienced patients to inquire about the supportive aspects of treatment that they received and valued. Providers, policy makers, or health insurers may require buprenorphine-treated patients to participate in individual or group counseling outside of buprenorphine provider visits, but more intensive psychosocial interventions have not consistently demonstrated improved buprenorphine outcomes in studies. We found that participants derived psychosocial support from their prescribing physician, but were also open to collaborative or group-based models of care, as long as they were voluntary and confidential. The implications are that some buprenorphine patient may receive adequate psychosocial support from an effective physician provider, while other patients may desire peer support or more intensive counseling and would be open to collaborative care or group counseling. We believe that our findings call for tailored, patient-centered treatment plans, not universal mandates for buprenorphine patients, but group-based treatment models appear to be acceptable.

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Our newly released issue is now online —> January-March 2016.
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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 comparative study of screening instruments and biomarkers for the detection of cannabis use
Paulien Meersseman , Simon Vanhoutte , Joris Van Damme , Lea Maes , Gilbert Lemmens , Gunter Heylens , Alain G. Verstraete
Substance Abuse
Vol. 37, Iss. 1, 2016

Questionnaires and biomarkers are used to estimate the extent of cannabis use within a designated population, but, it is not clear what screening instruments or biomarkers should be the option of choice. This study compares three screening questionnaires with two different biomarkers in order to investigate their usefulness in the detection of cannabis use. This study shows that the CAGE-AID and ProbCannabis-DT are two valid screening questionnaires in the detection of cannabis use compared to biomarkers in hair and plasma. Based on our results, biomarker analyses detect much fewer cannabis users than questionnaires.

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