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Drazdowski TK, Castedo de Martell S, Sheidow AJ, Chapman JE, McCart MR. Leveraging Parents and Peer Recovery Supports to Increase Recovery Capital in Emerging Adults With Polysubstance Use: Protocol for a Feasibility, Acceptability, and Appropriateness Study of Launch. JMIR Res Protoc 2024; 13:e60671. [PMID: 39037768 DOI: 10.2196/60671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Emerging adults (aged 18-26 years) are the most at-risk yet underserved age group among people with substance use disorder, especially rural emerging adults, and polysubstance use is common. Recovery capital is lower among emerging adults than older adults, and evidence-based treatments are typically unavailable or not developmentally tailored, especially in rural areas. Both supportive parents (or parental figures) and peer recovery support services (PRSS) can be leveraged to better support these emerging adults. Previous research indicates parents can be engaged to deliver contingency management (CM), an extensively researched evidence-based intervention for substance use. OBJECTIVE This protocol describes a funded pilot of Launch, a novel, scalable service package that pairs web-based coaching for parents to deliver CM for emerging adults (CM-EA) at home and in-person PRSS with educational and vocational goal setting. Specifically, this protocol describes feasibility, acceptability, and appropriateness testing (implementation-related outcomes) and steps taken to prepare for a future large-scale trial of Launch. METHODS Upon the recruitment of 48 emerging adult and parent pairs from sites serving primarily rural clients, participants will be randomized into 1 of 3 conditions for this randomized controlled trial: virtual parent coaching to deliver CM-EA, in-person PRSS for emerging adults, or both sets of services. Emerging adult eligibility includes polysubstance use, a substance use disorder, and availability of a consenting parent. Emerging adults will be interviewed at baseline and 6 months about substance use, quality of life, recovery capital, parental relationship, and Launch implementation-related outcomes (6-month follow-up only). Parents, peer workers delivering PRSS, and parent CM-EA coaches will be interviewed about implementation-related outcomes at the end of the study period. Peer workers and CM-EA coaches will be asked to complete checklists of services delivered after each session. Finally, payers and providers will be interviewed for additional insights into Launch implementation and to identify key outcomes of Launch. Data analysis for emerging adult outcomes will be primarily descriptive, but parent CM-EA training adherence will be assessed using nested mixed-effects regression models of repeated measures. RESULTS Launch is currently ongoing, with funding received in August 2023, and is expected to end in September 2025, with data analysis and results in December 2026. Participants are expected to begin enrolling in June 2024. CONCLUSIONS While this pilot is limited by the small sample size and restriction to emerging adults with an involved parent, this is mitigated by the study's strengths and is appropriate for the pilot stage. Launch uses an innovative combination of existing strategies to generate better outcomes for emerging adults while remaining scalable. This pilot will provide insights into the feasibility and acceptability of Launch from the perspectives of service recipients, providers, and payers to inform a larger-scale effectiveness trial. TRIAL REGISTRATION ClinicalTrials.gov NCT06414993; https://clinicaltrials.gov/study/NCT06414993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/60671.
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Affiliation(s)
- Tess K Drazdowski
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | | | - Ashli J Sheidow
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
| | - Jason E Chapman
- Lighthouse Institute, Chestnut Health Systems, Bloomington, IL, United States
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Wisdom A, Haddad S, Govindu M, Higgins F, Filion N, Sullivan K, Rooks-Peck C. Overdose prevention activities led by local public health departments, 2019-2023. Subst Abuse Treat Prev Policy 2024; 19:29. [PMID: 38831453 PMCID: PMC11149216 DOI: 10.1186/s13011-024-00612-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Drug overdose deaths in the United States increased to historic levels in recent years, with provisional estimates indicating more than 111,000 deaths in the 12 months ending July 2023. In 2019, the Centers for Disease Control and Prevention's Division of Overdose Prevention in collaboration with the National Association of City and County Health Officials, funded local health departments (LHDs) to work on overdose prevention activities. This paper aims to: 1) describe the overdose prevention activities that LHDs implemented during the four eighteen-month funding cycles; 2) identify programmatic successes and areas of opportunity for LHDs to consider when implementing future overdose prevention activities; and to 3) inform policy considerations and future overdose prevention programming at the local level. METHODS We used programmatic data to identify overdose prevention activities implemented by 45 LHDs. Activities were double-coded according to the social-ecological model and the U.S. Department of Health and Human Services Overdose Prevention Strategies and Guiding Principles. We analyzed final codes to identify distribution and overlap of the Strategies and Guiding Principles across the social ecological model co-occurrences. RESULTS Approximately 55.9% (n=123) of the 220 overdose prevention activities that were coded took place at the community level, 32.3% (n=71) at the individual level, 8.6% (n=19) at the relationship level, and 3.2% (n=7) at the policy level. Most of the activities were coded as coordination, collaboration, and integration (n=52, 23.6%), harm reduction (n=51, 23.1%), data and evidence (n=47, 21.4%) or reducing stigma (n=24, 10.9%). Few activities were related to primary prevention (n=14, 6.4%), equity (n=14, 6.4%), recovery support (n=11, 5.0%), and evidence-based treatment (n=7, 3.2%). CONCLUSIONS Localities have primarily implemented activities focused on the community and individual levels, with most of these centered around coordination, collaboration, and integration; harm reduction; or data and evidence. This study identified gaps in overdose prevention for LHDs related to treatment and health equity and that more interventions should be implemented at the relationship and policy levels. Continuing these efforts is important as LHDs explore opportunities to enhance and expand their work in various strategy areas across the social ecology. Findings from this study may be used to inform localities as they design and implement future overdose prevention activities.
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Affiliation(s)
- April Wisdom
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway NE, MS S106-8, Chamblee, GA, 30341-3717, USA.
| | - Stephanie Haddad
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway NE, MS S106-8, Chamblee, GA, 30341-3717, USA
| | - Madhumita Govindu
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway NE, MS S106-8, Chamblee, GA, 30341-3717, USA
| | - Francis Higgins
- National Association of City and County Health Officials, Washington, D.C, USA
| | | | - Kate Sullivan
- New York City Department of Health and Mental Hygiene, New York, USA
| | - Cherie Rooks-Peck
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway NE, MS S106-8, Chamblee, GA, 30341-3717, USA
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Giggie M, Boudreaux M, Harper E. Characteristics of a Southern Intensive Trauma- and Psychiatric-Focused Recovery Program. South Med J 2023; 116:776-781. [PMID: 37657788 DOI: 10.14423/smj.0000000000001598] [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: 09/03/2023]
Abstract
OBJECTIVES Treatment of substance use disorders (SUDs) is complex, involving biological, psychological, and social factors to be considered when designing effective programs. Trauma-informed psychiatric care integrated with a developmentally appropriate intensive 12-step approach is being used at A Reprieve for Women (Reprieve), a long-term intensive residential recovery program for female emerging adults with SUDs located in Tuscaloosa, Alabama. The Reprieve treatment philosophy focuses on long-term intensive care, treatment of coexisting trauma and psychiatric disorders, and development of life skills. The purpose of this article is to outline Reprieve's programmatic features and report Reprieve's 1- and 2-year sobriety rates for women who completed the 6-month residential program and compare it with national sobriety rates for other residential SUD treatment programs. METHODS Reprieve provided 1- and 2-year sobriety rates and duration of treatment from 110 deidentified participants who completed Reprieve's 6-month residential program between September 2016 and November 2020. The researchers defined sobriety as complete abstinence from any addictive substances. Reprieve staff contacted program graduates to determine sobriety status following completion of the program. This research, approved by the University of Alabama's institutional review board, involved usable data points from 68 of the 110 participants. RESULTS We determined that Reprieve has a 75% 1-year sobriety rate and a 63% 2-year sobriety rate. The national average sobriety rate for people completing SUD treatment in residential programs is 40%. CONCLUSIONS Reprieve's higher-than-national sobriety rates make it a valuable program to study. Its emphasis on the treatment of coexisting psychiatric problems and past traumas, development of life skills, and the unique needs of female emerging adults may contribute to the program's success. It is hoped that this program description and preliminary analysis of outcomes will provide valuable information for future SUD treatment program development. More rigorous study is needed to delineate the effects of specific programmatic features on sobriety.
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Affiliation(s)
- Marisa Giggie
- From the College of Community Health Sciences, University of Alabama-Tuscaloosa, Tuscaloosa
| | - Madison Boudreaux
- From the College of Community Health Sciences, University of Alabama-Tuscaloosa, Tuscaloosa
| | - Emma Harper
- From the College of Community Health Sciences, University of Alabama-Tuscaloosa, Tuscaloosa
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Harrison A, Folk J, Rodriguez C, Wallace A, Tolou-Shams M. Using Social Media to Engage Justice-Involved Young Adults in Digital Health Interventions for Substance Use: A Pilot Feasibility Study (Preprint). JMIR Form Res 2022; 6:e37609. [DOI: 10.2196/37609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/30/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
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Vigdal MI, Moltu C, Bjornestad J, Selseng LB. Social recovery in substance use disorder: A metasynthesis of qualitative studies. Drug Alcohol Rev 2022; 41:974-987. [PMID: 35104369 PMCID: PMC9306622 DOI: 10.1111/dar.13434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/15/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
Issues In substance use disorder, connection to social communities plays a significant role in the recovery process. The aim here has been to identify and synthesise the qualitative research examining the process of social recovery from a first‐person perspective and how social communities assist in this process. Approach Metasynthesis using the following databases: CINAHL, Embase, MEDLINE, PsycINFO, Scopus, SocIndex and Web of Science. The search returned 6913 original articles, of which 18 met the following criteria: examining the experience of social recovery from a first‐person perspective and how social communities support this process, age of 18+, recovery of at least 12 months, in an English‐language peer‐reviewed journal. Review protocol registration: PROSPERO (CRD42020190159). Key Findings The persons in recovery emphasised communities that they perceived as being safe and non‐stigmatising. These are qualities that contributed to positive self‐change, and these communities were perceived as suitable arenas in which to confront responsibility and trust. Additionally, participants found that their relationship skills were improving due to the new social bonds forged in these communities. A sense of citizenship was gained along with a regaining of social dignity through voluntary work and giving back to society. Implications The pivotal role of the social community identified in this review underscores the importance of recognising and supporting persons in recovery's needs when connecting with such communities Conclusion We propose a four‐stage model to guide research into social recovery from a first‐person perspective and how social communities support this process.
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Affiliation(s)
- Mariann Iren Vigdal
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Christian Moltu
- District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Science, Førde, Norway
| | - Jone Bjornestad
- District General Hospital of Førde, Førde, Norway.,Department of Social Studies, University of Stavanger, Stavanger, Norway
| | - Lillian Bruland Selseng
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway
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Naji L, Dennis B, Morgan RL, Sanger N, Worster A, Paul J, Thabane L, Samaan Z. Investigating and addressing the immediate and long-term consequences of the COVID-19 pandemic on patients with substance use disorders: a scoping review and evidence map protocol. BMJ Open 2021; 11:e045946. [PMID: 34493506 PMCID: PMC8424417 DOI: 10.1136/bmjopen-2020-045946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 08/09/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has driven unprecedented social and economic reform in efforts to curb the impact of disease. Governments worldwide have legislated non-essential service shutdowns and adapted essential service provision in order to minimise face-to-face contact. We anticipate major consequences resulting from such policies, with marginalised populations expected to bear the greatest burden of such measures, especially those with substance use disorders (SUDs). METHODS AND ANALYSIS We aim to conduct (1) a scoping review to summarise the available evidence evaluating the impact of the COVID-19 pandemic on patients with SUDs, and (2) an evidence map to visually plot and categorise the current available evidence evaluating the impact of COVID-19 on patients with SUDs to identify gaps in addressing high-risk populations. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review as we plan to review publicly available data. This is part of a multistep project, whereby we intend to use the findings generated from this review in combination with data from an ongoing prospective cohort study our team is leading, encompassing over 2000 patients with SUDs receiving medication-assisted therapy in Ontario prior to and during the COVID-19 pandemic.
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Affiliation(s)
- Leen Naji
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brittany Dennis
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nitika Sanger
- Medical Science Gradaute Program, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Worster
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - James Paul
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Research Institute at St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Blount TN, LaGuardia AC, Fitzpatrick DC. African American Women's Substance Use Recovery Experiences: A Phenomenological Inquiry. COUNSELING AND VALUES 2021. [DOI: 10.1002/cvj.12146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Piecing Together the Puzzle of Success: Attending to the Developmental Needs of Emerging Adults in Substance Use Disorder Programming. CANADIAN JOURNAL OF ADDICTION 2020. [DOI: 10.1097/cxa.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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“One Out of Ten Ain’t Going to Make It”: An Analysis of Recovery Capital in the Rural Upper Midwest. JOURNAL OF DRUG ISSUES 2019. [DOI: 10.1177/0022042619859309] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Substance use and associated fatalities are disproportionately experienced by rural communities. This study used consensual qualitative research methodology to analyze focus group data from individuals in short- and long-term recovery in rural Michigan and Minnesota. Coding was conducted within a recovery capital framework to improve understanding of the resources and barriers participants experienced in their recovery. Key findings included barriers related to transportation, as well as access to and availability of sober meetings and sober living activities. Participants perceived connections to culturally appropriate treatment as particularly important. A reconstruction of social networks from those promoting addiction to those supporting recovery was also prominently emphasized. Recovery capital appears to be a useful framework for assessing how rural communities are experiencing substance use crises, in addition to identifying areas of low capital and high need in supporting long-term recovery.
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