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Horne IMT, Veggeland F, Bååthe F, Drewes C, Rø KI. Understanding peer support: a qualitative interview study of doctors one year after seeking support. BMC Health Serv Res 2023; 23:324. [PMID: 37004074 PMCID: PMC10066008 DOI: 10.1186/s12913-023-09312-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Doctors' health is of importance for the quality and development of health care and to doctors themselves. As doctors are hesitant to seek medical treatment, peer support services, with an alleged lower threshold for seeking help, is provided in many countries. Peer support services may be the first place to which doctors turn when they search for support and advice relating to their own health and private or professional well-being. This paper explores how doctors perceive the peer support service and how it can meet their needs. MATERIALS AND METHODS Twelve doctors were interviewed a year after attending a peer support service which is accessible to all doctors in Norway. The qualitative, semi-structured interviews took place by on-line video meetings or over the phone (due to the COVID-19 pandemic) during 2020 and were audiotaped. Analysis was data-driven, and systematic text condensation was used as strategy for the qualitative analysis. The empirical material was further interpreted with the use of theories of organizational culture by Edgar Schein. RESULTS The doctors sought peer support due to a range of different needs including both occupational and personal challenges. They attended peer support to engage in dialogue with a fellow doctor outside of the workplace, some were in search of a combination of dialogue and mental health care. The doctors wanted peer support to have a different quality from that of a regular doctor/patient appointment. The doctors expressed they needed and got psychological safety and an open conversation in a flexible and informal setting. Some of these qualities are related to the formal structure of the service, whereas others are based on the way the service is practised. CONCLUSIONS Peer support seems to provide psychological safety through its flexible, informal, and confidential characteristics. The service thus offers doctors in need of support a valued and suitable space that is clearly distinct from a doctor/patient relationship. The doctors' needs are met to a high extent by the peer-support service, through such conditions that the doctors experience as beneficial.
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Affiliation(s)
- Ingrid Marie Taxt Horne
- Research Institute Modum Bad, Postbox 33, Vikersund, 3371, Norway.
- Institute for Studies of the Medical Profession, Oslo, Norway.
| | - Frode Veggeland
- Department of Organisation, Leadership and Management, Inland Norway University of Applied Sciences (HINN), Lillehammer, Norway
| | - Fredrik Bååthe
- Institute for Studies of the Medical Profession, Oslo, Norway
| | - Christina Drewes
- Health Department, County Governor of Trøndelag, Trondheim, Norway
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Dwarakanath M, Klipp S. "Helping the Helpers"-Making Access to Buprenorphine the New Standard of Care for Physicians in State Monitoring Programs. J Addict Med 2023; 17:4-6. [PMID: 35802756 DOI: 10.1097/adm.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This commentary argues that the Federation of State Medical Board's (FSMB) recommendations concerning the use of buprenorphine for physicians in their state-affiliated monitoring programs falls short of effectively permitting an evidence-based treatment for opioid use disorder. Although the FSMB acknowledges the benefits of medications for opioid use disorder and recommends that physicians who elect to start on buprenorphine receive treatment safely and privately, the FSMB is opposed to health care professionals practicing while on buprenorphine. Their rationale is based on the notion that physicians are exceptional in their ability to remain in recovery without medications for opioid use disorder and the unsupported assumption that buprenorphine causes significant cognitive impairment. This commentary contends that FSMB policy recommendations should work to destigmatize and indeed support evidence-based treatments for physicians with substance use disorders.
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Affiliation(s)
- Megana Dwarakanath
- From the Children's Hospital of Pittsburgh, Department of Adolescent Medicine, Pittsburgh, PA (MD, SK)
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3
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Merlo LJ, Campbell MD, Shea C, White W, Skipper GE, Sutton JA, DuPont RL. Essential components of physician health program monitoring for substance use disorder: A survey of participants 5 years post successful program completion. Am J Addict 2022; 31:115-122. [PMID: 35037334 PMCID: PMC9303734 DOI: 10.1111/ajad.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/14/2021] [Accepted: 12/26/2021] [Indexed: 11/28/2022] Open
Abstract
Background and Objectives Physician health programs (PHPs) have demonstrated efficacy, but their mechanism of influence is unclear. This study sought to identify essential components of PHP care management for substance use disorder (SUD), and to assess whether positive outcomes are sustained over time. Methods Physicians with DSM‐IV diagnoses of Substance Dependence and/or Substance Abuse who had successfully completed a PHP monitoring agreement at least 5 years before the study (N = 343) were identified as eligible. Of the 143 (42%) that could be reached by phone, 93% (n = 133; 86% male) completed the anonymous online survey. Results Virtually all PHP program components were rated as being at least “somewhat helpful” in promoting recovery, with the plurality of respondents rating almost all components as “extremely helpful.” The top‐rated components were: signing a PHP monitoring agreement, participation in the PHP, formal SUD treatment, and attending 12‐step meetings, with each receiving a mean rating of at least 6.2 out of 7. Notably, 88% of respondents endorsed continued participation in 12‐step fellowships. Despite the significant financial burden of PHP participation, 85% of respondents reported they believed the total financial cost of PHP participation was “money well spent.” Discussion and Conclusions Components of PHP monitoring were viewed as acceptable and helpful to physicians who completed the program, and outcomes were generally sustained over 5 years. More studies are needed to confirm these preliminary findings. Scientific Significance This study documents the perceived cost‐benefit of participation in a PHP among a small sample of program completers.
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Affiliation(s)
- Lisa J Merlo
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA
| | | | - Corinne Shea
- Institute for Behavior and Health, Inc., Rockville, Maryland, USA
| | | | | | - Jill A Sutton
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA
| | - Robert L DuPont
- Institute for Behavior and Health, Inc., Rockville, Maryland, USA
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Moe FD, Moltu C, McKay JR, Nesvåg S, Bjornestad J. Is the relapse concept in studies of substance use disorders a 'one size fits all' concept? A systematic review of relapse operationalisations. Drug Alcohol Rev 2021; 41:743-758. [PMID: 34792839 DOI: 10.1111/dar.13401] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
ISSUES Relapse is a theoretical construct and empirical object of inquiry. It is unclear how relapse is operationalised with regard to the various phases in substance use disorders (SUD). The aim was to investigate relapse operationalisations in SUDs studies after short- and long-term abstinence and remission, recovery and slip/lapse. APPROACH Systematic review using the following databases: Epistemonikos, Cochrane Central Register of Controlled Trials (CENTRAL and DARE), MEDLINE, EMBASE, Google Scholar, CINAHL, Web of Science and PsycINFO. Search returned 3426 articles, with 276 meeting the following inclusion criteria: empirical study published in English in a peer-reviewed journal; samples meet diagnostic criteria for dependence syndrome or moderate-severe drug use disorder or alcohol use disorder; reports relapse, abstinence, recovery, remission, slip or lapse. Review protocol registration: PROSPERO (CRD42020154062). KEY FINDINGS Thirty-two percent of the studies had no definition of 'relapse'. Most relapse operationalisations were defined according to measure (26%), time (17%), use (26%) and amount and frequency (27%). Of the 16 studies with a follow-up duration of up to 2 years, one (6%) contained a definition of 'long-term abstinence'. Of the 64 studies with a follow-up duration of more than 2 years, four (6%) contained a definition of 'long-term abstinence'. Of those, one (2%) mentioned 'early relapse' and one (2%) mentioned 'late relapse'. IMPLICATIONS Future research is needed to explore the possible difference between early and late relapse. Moreover, working to increase consensus on relapse operationalisations in SUD research is warranted. CONCLUSIONS We identified no consensus on relapse operationalisations nor agreement on the differentiation between early and late relapse. The clinical utility of current relapse operationalisations seems low and may compromise knowledge accumulation about relapse and implementation of research into treatment.
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Affiliation(s)
- Fredrik D Moe
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - James R McKay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.,Philadelphia VA Medical Center, Philadelphia, USA.,Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Nesvåg
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Jone Bjornestad
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.,Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,TIPS-Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
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Simpson K, Ashworth M, Roberts-Lewis S, Ayis S. Evaluation of NHS Practitioner Health: capturing mental health outcomes using five instruments. BJPsych Open 2021; 7:e106. [PMID: 34059169 PMCID: PMC8220854 DOI: 10.1192/bjo.2021.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND NHS Practitioner Health is the England wide programme providing mental health and addiction healthcare to doctors and dentists. Outcomes are assessed using five measures. AIMS To contribute to a service evaluation of NHS Practitioner Health. To determine responsiveness to change and compare outcome measures. METHOD Measures were completed at baseline and 6 months: Generalized Anxiety Disorder Assessment (GAD-7), Perceived Stress Scale (PSS), Patient Health Questionaire-9 (PHQ-9), Warwick-Edinburgh Mental Wellbeing scale (WEMWBS), Psychological Outcome Profiles (PSYCHLOPS). Responsiveness to change was determined using effect size with improvement threshold ≥0.80. Instruments were compared using Bland-Altman plots. RESULTS Our sample, n = 402; with 14 (3.5%) excluded for missing data; final sample, n = 388. All measures showed strong mean effect sizes: PSYCHLOPS 1.86 (95%CI 1.73-1.99), 75.8% ≥0.80; PSS 1.48 (1.34-1.62), 64.4% ≥0.80; WEMWBS 1.24 (1.13-1.35), 58.2% ≥0.80; GAD-7 1.07 (0.96-1.18), 52.8% ≥0.80; PHQ-9 0.86 (0.76-0.96), 52.8% ≥0.80. Findings were largely unchanged after stratification by diagnosis, presenting problem or therapy type. Fifty (12.9%) participants did not reach the threshold for improvement on any instrument. Bland-Altman plots indicated generally strong agreement between measures; combining PSYCHLOPS with WEMWBS maximised capture of improvement with only 3.6% of patients lying outside limits of agreement; GAD-7 was most likely to duplicate recovery scores of other measures. CONCLUSIONS Patients attending the NHS Practitioner Health service demonstrated high levels of improvement in mental health scores. The patient-generated instrument produced higher change scores than standardised instruments. Combining PSYCHLOPS and WEMWBS captured 96% of patients with above threshold improvement; GAD-7 added little to overall recovery measurement.
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Affiliation(s)
- Kieran Simpson
- School of Population Health and Environmental Sciences, King's College London, UK
| | - Mark Ashworth
- School of Population Health and Environmental Sciences, King's College London, UK
| | - Sarah Roberts-Lewis
- School of Population Health and Environmental Sciences, King's College London, UK
| | - Salma Ayis
- School of Population Health and Environmental Sciences, King's College London, UK
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Madden EF, Prevedel S, Light T, Sulzer SH. Intervention Stigma toward Medications for Opioid Use Disorder: A Systematic Review. Subst Use Misuse 2021; 56:2181-2201. [PMID: 34538213 DOI: 10.1080/10826084.2021.1975749] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Medications for opioid use disorder (MOUD) are evidence-based treatments, yet can be controversial among some populations. This study provides a systematic review of prejudice and discrimination toward MOUD, a form of "intervention stigma," or stigma associated with a particular medical treatment. A systematic search strategy was used in PsychInfo and PubMed to identify studies published between 1998 and 2018. Studies that empirically examined stigma toward MOUD were included if the manuscript was of moderate or high quality. Studies were analyzed using thematic synthesis. The search yielded 972 studies, of which 28 were included. Most studies utilized qualitative methods to examine intervention stigma toward methadone or buprenorphine, with one including naltrexone. Studies demonstrated that intervention stigma among healthcare providers was influenced by lack of training and abstinent treatment preferences. Providers equated MOUD with illicit substance use and at times refused to care for MOUD patients. Stigma among peer patients seeking treatment was also influenced by abstinent treatment preferences, and among the general public stigma was influenced by lack of MOUD knowledge. Intervention stigma was also driven at the policy level by high regulation of methadone, which fueled diversion and hindered social functioning among patients. Few studies indicated how to reduce intervention stigma toward MOUD. Intervention stigma affects both provision and perceptions of methadone and buprenorphine, decreasing access and utilization of MOUD. Future research should further develop and test MOUD stigma reduction interventions in a variety of social contexts to improve access to care and reduce patient barriers.
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Affiliation(s)
- Erin Fanning Madden
- Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Suzanne Prevedel
- Utah State University Extension, Utah State University, Logan, Utah, USA
| | - Timothy Light
- College of Osteopathic Medicine, Rocky Vista University-Southern Utah, Ivins, Utah, USA
| | - Sandra H Sulzer
- Utah State University Extension, Utah State University, Logan, Utah, USA
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Griffith SA, Chastain K, Kiefer SA, Privette KG. A Description of Participants in North Carolina’s Alternative-to-Discipline Program for Licensed Nurses Diagnosed With Opioid Use Disorder. JOURNAL OF NURSING REGULATION 2021. [DOI: 10.1016/s2155-8256(20)30173-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Polles AG, Williams MK, Phalin BR, Teitelbaum S, Merlo LJ. Neuropsychological impairment associated with substance use by physicians. J Neurol Sci 2020; 411:116714. [DOI: 10.1016/j.jns.2020.116714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/05/2019] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
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Goldenberg M, Miotto K, Skipper GE, Sanford J. Outcomes of Physicians with Substance Use Disorders in State Physician Health Programs: A Narrative Review. J Psychoactive Drugs 2020; 52:195-202. [PMID: 32156222 DOI: 10.1080/02791072.2020.1734696] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The prevalence rate of addiction among physicians is similar to the general population, with approximately 10% to 12% of U.S.-based physicians developing substance use disorders (SUDs) during their lifetimes. To address this public health concern, physician health programs (PHPs) have been created to facilitate the early identification, evaluation, treatment, and monitoring of physicians. Although a number of published studies provide outcome information from PHPs, there has been no comprehensive review of the related literature. The objective of this narrative review is to summarize the treatment outcomes, including treatment types, rates of relapse, rates of contract completion or extension, as well as licensure and work status rates of a nationally representative physician cohort and related subpopulations from a single dataset. Based on the studies included in this review, our findings reveal that physicians who completed their PHP contracts have more favorable treatment outcomes than members of the general population who receive mainstream treatment. In addition, our review describes unique features of physician rehabilitation facilitated by PHPs. However, further prospective research is needed to ensure a standardized and comparable dataset and facilitate performance improvement.
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Affiliation(s)
- Matthew Goldenberg
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center , Los Angeles, CA, USA
| | - Karen Miotto
- Department of Psychiatry and Biobehavioral Sciences, UCLA , Los Angeles, CA, USA
| | | | - Jesse Sanford
- Department of Psychiatry and Biobehavioral Sciences, UCLA , Los Angeles, CA, USA
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10
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Affiliation(s)
- Chris Bundy
- Federation of State Physician Health Programs, Seattle, WA
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11
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Timko C, Han X, Woodhead E, Shelley A, Cucciare MA. Polysubstance Use by Stimulant Users: Health Outcomes Over Three Years. J Stud Alcohol Drugs 2019. [PMID: 30422794 DOI: 10.15288/jsad.2018.79.799] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Studies show that stimulant users have varied substance use patterns and that polysubstance use is associated with poorer past or concurrent medical, mental health, and substance use outcomes. This study examined outcomes of substance use patterns prospectively. METHOD A latent class analysis was conducted to examine substance use patterns among adults using stimulants (n = 710; 38.6% women) at baseline, and the health and treatment utilization outcomes of different use patterns over the subsequent 3 years. To examine associations between latent class membership and outcomes, generalized estimating equation modeling was conducted. RESULTS Four classes of substance use patterns at baseline were identified, involving high use of (a) methamphetamine and marijuana (23%); (b) crack cocaine and alcohol (25%); (c) powder cocaine, alcohol, and marijuana (23%); and (d) nonprescribed opioids, alcohol, marijuana, crack cocaine, and powder cocaine (i.e., polysubstance [29%]). Polysubstance class members had poorer physical health and mental health status, and more severe substance use, over the subsequent 3-year period, than other class members. Regarding treatment utilization, polysubstance class members had more medical care utilization than crack cocaine class members, and more substance use treatment utilization than powder cocaine class members. The methamphetamine, crack cocaine, and powder cocaine classes did not differ from each other on any health or treatment utilization outcome. CONCLUSIONS People using stimulants commonly use other substances, and those whose polysubstance use includes nonprescribed opioids have especially poor health outcomes.
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Affiliation(s)
- Christine Timko
- Center for Innovation to Implementation, Veterans Affairs (VA) Health Care System, Menlo Park, California.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Xiaotong Han
- Division of Health Services Research, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.,VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas
| | - Erin Woodhead
- Department of Psychology, San Jose State University, San Jose, California
| | - Alexandra Shelley
- Center for Innovation to Implementation, Veterans Affairs (VA) Health Care System, Menlo Park, California
| | - Michael A Cucciare
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.,VA South Central (VISN 16) Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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12
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DuPont RL. The opioid epidemic is an historic opportunity to improve both prevention and treatment. Brain Res Bull 2018. [DOI: 10.1016/j.brainresbull.2017.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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13
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Grigson PS. Addiction: A multi-determined chronic disease. Brain Res Bull 2018; 138:1-4. [DOI: 10.1016/j.brainresbull.2017.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Srivastava AB, Gold MS. Beyond Supply: How We Must Tackle the Opioid Epidemic. Mayo Clin Proc 2018; 93:269-272. [PMID: 29502558 DOI: 10.1016/j.mayocp.2018.01.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 10/17/2022]
Affiliation(s)
| | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO
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Huhn AS, Tompkins DA, Dunn KE. The relationship between treatment accessibility and preference amongst out-of-treatment individuals who engage in non-medical prescription opioid use. Drug Alcohol Depend 2017; 180:279-285. [PMID: 28942031 PMCID: PMC5648596 DOI: 10.1016/j.drugalcdep.2017.08.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/17/2017] [Accepted: 08/18/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Relatively little is known regarding the perception of medication-assisted treatments (MATs) and other treatment options amongst individuals that engage in non-medical prescription opioid use. This study surveyed out-of-treatment individuals that misuse opioids to better understand how perceived access to treatment shapes treatment preference. METHODS Participants (n=357) were out-of-treatment adults registered as workers on the Amazon Mechanical Turk platform who reported current non-medical prescription opioid use. Participants were surveyed regarding demographics, insurance status, attitudes toward opioid use disorder (OUD) treatments, and self-reported symptoms of OUD. RESULTS Participants who were male, did not have health insurance, and knew that counseling-type services were locally available were most likely to first attempt counseling/detox treatments (χ2(6)=30.19, p<0.001). Participants who met criteria for severe OUD, used heroin in the last 30days, knew their insurance covered MAT, and knew of locally available MAT providers were most likely to first attempt MAT (χ2(4)=26.85, p<0.001). Participants with insurance and who knew of locally available physicians were most likely to attempt physician visits without the expressed purpose of MAT (χ2(3)=24.75, p<0.001). CONCLUSION Out-of-treatment opioid users were particularly interested in counseling-based services and medical care that could be attained from a primary-care physician. Results suggest that insurance coverage and perceived access to OUD treatment modalities influences where out-of-treatment opioid users might first seek treatment; understanding the factors that shape treatment preference is critical in designing early interventions to effectively reach this population.
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White W, Galanter M, Humphreys K, Kelly J. The Paucity of Attention to Narcotics Anonymous in Current Public, Professional, and Policy Responses to Rising Opioid Addiction. ALCOHOLISM TREATMENT QUARTERLY 2016. [DOI: 10.1080/07347324.2016.1217712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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