Sören Kuitunen-Paul, PhD, Veit Roessner, Lukas A. Basedow, MSc, and Yulia Golub, PhD, MD, authors of “Beyond the tip of the iceberg: A narrative review to identify research gaps on comorbid psychiatric disorders in adolescents with methamphetamine use disorder or chronic methamphetamine use” share their own insights on their SAj article.

“To our knowledge this is the first review on comorbid disorders specifically in adolescents with methamphetamine use disorder. Readers interested in basic research on SUD development will find a number of identified research goals that are both relevant to the field and under-researched in adolescent samples (see chapter 5.3 Future Directions, section Testing associations deducted from adult studies). For readers interested in therapy research, we provide an overview of studies that underline the therapeutic relevance of treating comorbidities already during SUD treatment (see Table 3 Summary of onset patterns and treatment recommendations for selected comorbidities of MUD in adolescents, and chapter 5.3 Future Directions, section Integrated therapy programs and their evaluation).”

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Summer 2021 has come to a close, with those high temps dropping (finally) and days feeling shorter and shorter. We hope that you enjoyed reading all of the articles that were published in SAj this summer. Just a few of the articles included “Project ECHO and primary care buprenorphine treatment for opioid use disorder: Implementation and clinical outcomes” that highlighted research increasing clinicians waivered to prescribe buprenorphine for treatment of opioid use disorder. In “The role of spirituality in addiction medicine: a position statement from the spirituality interest group of the international society of addiction medicine” authors described the role of spirituality and how it can serve as recovery capital for those with a substance use disorder. These are just two of the great articles that SAj had the privilege of publishing the last couple of months.

As we step into fall, we are looking forward to all the research to come! We have just recently released our first fall articles, such as “Physical therapists should play a greater role in managing patients with opioid use and opioid misuse” which aims to increase physical therapists’ knowledge and skills related to managing patients taking prescription opioid medications for pain. There is also “Health professionals’ attitudes toward medications for opioid use disorder” that advocates for an increase in knowledge about MOUD and foster interprofessional communication related to MOUD, especially between prescribers and behavioral health providers. We are excited for the rest of the articles we have planned for publication this fall to drop!

You can stay up to date with all of our articles as soon as they hit the web at Taylor & Francis. Follow us on twitter to stay up to date with everything we have coming your way this fall – stay tuned!

“We’ll be able to take care of ourselves” – A qualitative study of client attitudes toward implementing buprenorphine treatment at syringe services programs

Taeko Frost, DrPH, MPH, Sarah Deutsch, MPH, Shoshana Brown, LMSW, Ellen Lemien, MPH, Chinazo O. Cunningham, MD, MS & Aaron D. Fox, MD, MS

NEW! Published March 24, 2021

Syringe services programs (SSPs) complement substance use disorder treatment in providing services that improve the health of people who use drugs (PWUD). Buprenorphine treatment is an effective underutilized opioid use disorder treatment. Regulations allow buprenorphine prescribing from office-based settings, potentially including SSPs although few studies have examined this approach. Our objective was to assess the attitudes among PWUD toward the potential introduction of buprenorphine treatment in an SSP. Methods: In this qualitative study, we recruited 34 participants who were enrolled at a New York City-based SSP to participate in one of seven focus group sessions. The focus group facilitators prompted participants to share their thoughts in five domains: attitudes toward (1) medical clinics; (2) harm reduction in general; (3) SSP-based buprenorphine treatment; (4) potential challenges of SSP-based treatment; and (5) logistical considerations of an SSP-based buprenorphine treatment program. Four researchers analyzed focus group transcripts using thematic analysis. Results: Of the 34 participants, most were white (68%), over the age of 40 years old (56%), and had previously tried buprenorphine (89%). Common themes were: 1) The SSP is a supportive community for people who use drugs; 2) Participants felt less stigmatized at the SSP than in general medical settings; 3) Offering buprenorphine treatment could change the SSP’s culture; and 4) SSP participants receiving buprenorphine may be tempted to divert their medication. Participants offered suggestions for a slow intentional introduction of buprenorphine treatment at the SSP including structured appointments, training medical providers in harm reduction, and program eligibility criteria. Conclusion: Overall, participants expressed enthusiasm for onsite buprenorphine treatment at SSPs. Research on SSP-based buprenorphine treatment should investigate standard buprenorphine treatment outcomes but also any effects on the program itself and medication diversion. Implementation should consider cultural and environmental aspects of the SSP and consult program staff and participants.

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Balancing need and risk, supply and demand: Developing a tool to prioritize naloxone distribution

Claire A. Wood, PhD, Lauren Greena, MSW, Anna La Manna, MPH, Sarah Phillips, MS, Kimberly B. Werner, PhD, Rachel P. Winograd, PhD & Angie Stuckenschneider, BS

NEW! Published March 24, 2021

Background: Opioid overdose deaths continue to rise nationally. The demand for naloxone, the opioid overdose antidote, is outpacing the supply. With increasing naloxone requests, tools to prioritize distribution are critical to ensure available supplies will reach those at highest risk of overdose. Methods: We developed a standardized “Naloxone Request Form” (NRF) and corresponding weighted prioritization algorithm to serve as decisional aid to better enable grant staff to prioritize naloxone distribution in a data-driven manner. The algorithm computed raw priority scores for each agency, which were then separated into the predetermined quintiles. Historical naloxone distribution decisions were compared with agencies’ prioritization quintile. Results: Results demonstrated that the NRF and corresponding algorithm was successful at prioritizing agencies based on potential impact. Although, overall, naloxone was distributed more heavily to the agencies deemed highest priority, our algorithm identified significant shortcomings of the “first come, first served” method of distribution we had initially deployed. Conclusions: This work has laid the foundation to use this tool prospectively to allow for data-driven decision-making for naloxone distribution. Our tool is flexible and can be customized to best fit the needs of a variety of programs and locations to ensure the distribution of limited supplies of naloxone have the greatest impact.

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An international consultation on case reports in addiction medicine

Rouhollah Qurishi, MD, Joost P. H. Drenth, MD, PhD, Alexander Baldacchino, MD, MPhil, PhD, Barbara Broers, MD, MSc, PhD, Victor J. A. Buwalda, MD, PhD & Cornelis A. J. De Jong, MD, PhD

NEW! Published March 22, 2021

A Case Report (CR) is a scientific documentation of a single clinical observation which serves to inform but also to educate the reader. Case reports help to compliment clinical critical thinking in Addiction Medicine (AM) when there is limited evidence base. Aim: This study aims to analyze how international clinical and research leaders in Addiction Medicine view Case Reports and their relevance to bridge the gap between evidence and practice. Methods: A semi-structured, audio-recorded interviews were conducted with 12 international Addiction Medicine scholars. Thematic content analysis was used to code the transcribed interview data. Results: Interviewees showed a positive view toward publishing Case Reports in Addiction Medicine. They found that medical students and clinicians working in the field of Addiction Medicine should be encouraged to share and record cases of clinical interaction. To aid this process (1) formal supervised training in case reporting within an academic environment must be facilitated. And (2) journals should also offer a place to publish Case Reports. Conclusion: The international scholars agree that Case Reports are important for the development of Addiction Medicine and that they can contribute to a better understanding of patients with substance use disorder.

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