SUD Archives - AMERSA

SAj Flashback: Inhalant Use and Risky Behavior Correlates in a Sample of Rural Middle School Students

Oct 14, 2022 by AMERSA

In this SAj Flashback, we take it all the way back to 2008 with “Inhalant Use and Risky Behavior Correlates in a Sample of Rural Middle School Students” from authors Jessica Legge Muilenburg, PhD and William D. Johnson, PhD.

At the time, this study found 20.4% of children attending a middle school located in rural Mississippi had used inhalants to “get high,” a figure that is much larger than the national average. Many (3.4%) students reported they had used inhalants on 10 or more occasions. Inhalant use was most associated with being younger, ever smoking, riding with a driver who had been drinking, and being involved in a fight. Nearly twice as many younger students reported usage in our sample compared to other studies. Longitudinal studies need to be conducted to investigate whether use of inhalants is a precursor to other risky behaviors, and subsequent progression to alcohol abuse or illicit drug use.

You can still read this article in SAj Volume 27, Issue 4 or online.

New in SAj: Transforming an educational ecosystem for substance use disorders: A multi-modal model for continuous curricular improvement and institutional change

Oct 13, 2022 by AMERSA

In “Transforming an educational ecosystem for substance use disorders: A multi-modal model for continuous curricular improvement and institutional change” authors elaborate the construct and process of “educational ecosystem transformation” as a tool for the evolution of the educational ecosystem and its situated curriculum that will eventually drive the enrichment of the healthcare workforce. Drawing from traditional models of curriculum development, recent work on transforming the hidden curriculum, the clinical learning environment, and change management strategies, this new approach uses a health equity and structural competence lens to interrogate and deconstruct a learning system in order to identify opportunities to change, strengthen, and deepen a learner’s experience around a specific topic.

This commentary comes from Jason M. Satterfield, PhD; Karen Werder , PhD, PMHNP-BC; Stephanie Reynolds, MPH; Irina Kryzhanovskaya, MD; and Alexa Colgrove Curtis, PhD, MPH, FNP, PMHNP.

This commentary is new to SAj, published September 2, 2022. You can read it now in SAj Volume 43, Issue 1 or online.

The Authors’ Own Words: A Call for Training Graduate Medical Students on Harm Reduction for People Who Inject Drugs

Oct 12, 2022 by AMERSA

In this letter to the editor, authors share that there is a lack of standardized education on topic of harm reduction for graduate medical students. In order to fill this curricular gap, we delivered a two-hour pilot training introducing local community harm reduction organizations and harm reduction ideology and strategies for people who inject drugs to graduate medical students at Boston University.

Raagini Jawa, MD, MPH; Nivetha Saravanan, BA; Shana A. B. Burrowes, MPH, PhD; and Lindsay Demers, PhD share with SAj, “due to the ongoing opioid epidemic, the prevalence of people who inject drugs (PWID) continues to increase, and it is critical for medical trainees and providers to be exposed to, and familiar with, community harm reduction resources and strategies, which are often siloed outside of medical curricula. Even though nearly three-fourths of our respondents had prior classroom didactics on substance use disorders, our stand-alone introductory training was effective in increasing graduate medical students comfort and knowledge of harm reduction ideology, safer injection techniques, and naloxone administration- all practical risk mitigation tools they can utilize later in their clinical careers. Our findings serve as an example that introducing harm reduction education early within medical training ought to be explored and inclusion of community harm reduction organizations during trainings may serve as a future model to facilitate integrated care delivery for PWID.”

You can read this letter now in SAj Volume 42, Issue 3 or online.

SAj Flashback: Research priorities for expanding access to methadone treatment for opioid use disorder in the United States: A National Institute on Drug Abuse Center for Clinical Trials Network Task Force report

Oct 11, 2022 by AMERSA

In this SAj Flashback, we look back to “A National Institute on Drug Abuse Center for Clinical Trials Network Task Force report” from SAj Volume 42, Issue 3. This commentary comes from authors Paul J. Joudrey, MD, MPH; Gavin Bart, MD, PhD; Robert K. Brooner, PhD; Lawrence Brown, MD, MPH; Julie Dickson-Gomez, PhD; Adam Gordon, MD, MPH; Sarah S. Kawasaki, MD; Jane M. Liebschutz, MD MPH; Edward Nunes, MD; Dennis McCarty, PhD; Robert P. Schwartz, MD; José Szapocnik, PhD; Madhukar Trivedi, MD; Judith I. Tsui, MD MPH; Arthur Williams, MD; Li-Tzy Wu, DSc; and David A. Fiellin, MD.

In the US, methadone treatment can only be provided to patients with opioid use disorder (OUD) through federal and state-regulated opioid treatment programs (OTPs). There is a shortage of OTPs, and racial and geographic inequities exist in access to methadone treatment. The National Institute on Drug Abuse Clinical Trials Network convened the Methadone Access Research Task Force to develop a research agenda to expand and create more equitable access to methadone treatment for OUD. This research agenda included mechanisms that are available within and outside the current regulations. The task force identified 6 areas where research is needed: (1) access to methadone in general medical and other outpatient settings; (2) the impact of methadone treatment setting on patient outcomes; (3) impact of treatment structure on outcomes in patients receiving methadone; (4) comparative effectiveness of different medications to treat OUD; (5) optimal educational and support structure for provision of methadone by medical providers; and (6) benefits and harms of expanded methadone access. In addition to outlining these research priorities, the task force identified important cross-cutting issues, including the impact of patient characteristics, treatment, and treatment system characteristics such as methadone formulation and dose, concurrent behavioral treatment, frequency of dispensing, urine or oral fluid testing, and methods of measuring clinical outcomes. Together, the research priorities and cross-cutting issues represent a compelling research agenda to expand access to methadone in the US.

Read this commentary now in SAj Volume 42, Issue 3 or online.

The Authors’ Own Words: National trauma and substance use disorders: A slippery slope in Lebanon

Oct 9, 2022 by AMERSA

Lebanon, a small middle-income nation in western Asia, has been crippled by decades of political turmoil and armed conflict. A “quadruple crisis” hit the country over the past years, starting with the protracted humanitarian Syrian refugee crisis, followed by a severe socioeconomic collapse, the global COVID-19 pandemic, and lastly the Beirut port catastrophic blast. With the exposure to repetitive traumatic events and associated organic brain injury, the Lebanese population has become at a higher risk of addiction, among other psychiatric comorbidities. With the scarce statistics about the topic and limited addiction services in the country, collaborative local efforts and international help are urgently needed to fight the upcoming substance use epidemic. Raising awareness, providing adequate training, and securing resources for the management of both addiction and trauma are of utmost importance.

Authors Maya Bizri, MD, MPH; Samer El Hayek , MD; Hadi Beaini, BS; Firas Kobeissy, PhD; and Farid Talih, MD share, “in this letter, we discuss the potential exacerbation of substance use disorders in Lebanon in the context of the country’s quadruple crises. The limitations of addiction treatment services in Lebanon are highlighted and we discuss the need for a multidisciplinary comprehensive national plan to improve services and outcomes. Lessons from the Lebanese crisis may help other countries develop mental health contingency plans that can be implemented in times of national crisis and trauma.”

You can read this Letter to the Editor now in SAj Volume 42, Issue 3 or online.