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.

Age of Initiation, Psychopathology and Other Substance Use Are Associated with Time to Use Disorder Diagnosis in Persons using Opioids Nonmedically

Ty S. Schepis, PhD & Jahn K. Hakes, PhD

Substance Abuse Vol. 38, Iss. 4, 2017

“This study was the among first to look at factors associated with the time involved in the transition from initial opioid use to opioid use disorder in adults engaged in nonmedical opioid use.  We found that age of nonmedical opioid use initiation was a key factor in both the development of dependence, with younger initiation raising odds of developing a use disorder, and in the time to develop dependence.  In contrast to development of dependence, time to dependence was longer in individuals who initiated nonmedical opioid use at younger ages. Presence of an alcohol use disorder diagnosis was associated with more rapid development of opioid use disorder, while a depressive disorder diagnosis was associated with slower development of opioid use disorder. These results highlight the need to prevention efforts and screening of younger individuals in school and medical settings for initiation of nonmedical opioid use, as such early initiation is associated with greater odds of later opioid use disorder; in contrast, screening in university or vocational settings should aim to identify those initiating opioid nonmedical use at a later age and prevent acceleration of such use, as those initiating at older ages are at risk for more rapid development of an opioid use disorder.”

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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.

ASI profile of persons who re-enter treatment for substance use disorders

Hélène Simoneau, PhD & Serge Brochu, PhD

Substance Abuse Vol. 38, Iss. 4, 2017

“The results of this study, using a large sample, support what the clinicians feel: the persons who re-enter treatment show a more severe clinical profile than those who come for the first time. They have several needs that must be identified by an in-depth evaluation. To fulfill these needs, the treatment centers should consider the relevance of offering a more intensive and comprehensive treatment to the persons who re-enter treatment than the usual treatment offered to everyone.”

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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.

Feasibility and Acceptability of Using an App Help Identify Psychomotor Function Impairments During Drinking Occasions

Brian Suffoletto, MD; Akash Goyal; Juan Carlos Puyana; & Tammy Chung, PhD

Substance Abuse Vol. 38, Iss. 4, 2017

“Behavioral interventions delivered through mobile phone communication technologies show promise in reducing alcohol consumption in young adults, but current designs may not be optimized. One way to improve effectiveness is to deliver behavioral support when an individual is drinking to both influence self-regulation of alcohol consumption and prevent risky behaviors. To achieve this goal, methods are needed to efficiently identify impairments related to drinking as they occur in real-time and optimally influence individuals to limit drinking and/or avoid risky behaviors once drinking has been initiated. This paper describes the feasibility and potential utility of a mobile app that measures psychomotor impairments during drinking occasions. Preliminary findings generally support the concept of using these mobile games to identify alcohol-related impairments in young adults that they may not be aware of, but highlights difficulties in achieving high sustained engagement.”

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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.

Trainees knowledge, attitudes, and practices towards caring for the substance-exposed mother-infant dyad

Davida M. Schiff, MD; Barry Zuckerman, MD; Elisha M. Wachman, MD; & Megan Bair-Merritt, MD, MSCE

Substance Abuse Vol. 38, Iss. 4, 2017

“This study evaluates the knowledge, attitudes, and practices of trainees who care for substance exposed infants and their families. Categorical pediatric residents were significantly less comfortable than their colleagues training in family medicine or internal medicine/pediatrics discussing issues related to addiction and trauma. In the setting of rising cases of neonatal abstinence syndrome where pediatric residents are on the front lines caring for infants and families, trainees may benefit from educational interventions about opioid use disorder and trauma-informed care to improve outcomes for the mother-infant dyad.”

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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.

Development and Implementation of an Alcohol Withdrawal Protocol Using a 5-item Brief Alcohol Withdrawal Scale (BAWS)

Darius A. Rastegar, MD; Dinah Applewhite, MD; Anika A. H. Alvanzo, MD, MS; Christopher Welsh, MD; Timothy Niessen, MD, MPH; & Edward S. Chen, MD

Substance Abuse Vol. 38, Iss. 4, 2017

“Treatment of alcohol withdrawal requires assessment of the severity to guide the administration of medication.  The most commonly used instrument (CIWA-Ar) is cumbersome to use.  Our study shows that a simple protocol using symptom-triggered dosing of benzodiazepines guided by a 5-item scale (BAWS) is effective in the setting of a dedicated unit treating patients with mild-moderate withdrawal.  Its use on other units, with patients with more severe withdrawal and concurrent active/unstable medical and psychiatric co-morbidities needs to be studied further.”

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