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El-Helaly M. Artificial Intelligence and Occupational Health and Safety, Benefits and Drawbacks. LA MEDICINA DEL LAVORO 2024; 115:e2024014. [PMID: 38686574 PMCID: PMC11181216 DOI: 10.23749/mdl.v115i2.15835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024]
Abstract
This paper discusses the impact of artificial intelligence (AI) on occupational health and safety. Although the integration of AI into the field of occupational health and safety is still in its early stages, it has numerous applications in the workplace. Some of these applications offer numerous benefits for the health and safety of workers, such as continuous monitoring of workers' health and safety and the workplace environment through wearable devices and sensors. However, AI might have negative impacts in the workplace, such as ethical worries and data privacy concerns. To maximize the benefits and minimize the drawbacks of AI in the workplace, certain measures should be applied, such as training for both employers and employees and setting policies and guidelines regulating the integration of AI in the workplace.
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Affiliation(s)
- Mohamed El-Helaly
- Occupational and Environmental Medicine, Faculty of Medicine, Mansoura University, Mansoura City, Egypt
- Faculty of Medicine, New Mansoura University, New Mansoura City, Egypt
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Assayag N, Bar-Shalita T, Rand D. The Functional-Cognitive and Sensory Treatment (F-CaST) to improve rehabilitation outcomes of individuals with substance use disorder: a study protocol for a mixed-method randomized controlled trial. Addict Sci Clin Pract 2024; 19:28. [PMID: 38594737 PMCID: PMC11003090 DOI: 10.1186/s13722-024-00449-7] [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: 08/17/2023] [Accepted: 03/07/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Substance use disorder (SUD) is associated with executive function (EF) deficits and sensory modulation dysfunction (SMD). Yet, these deficits are not addressed therapeutically. This study aims to examine the effectiveness of the Functional-Cognitive and Sensory Treatment (F-CaST) compared to standard care to improve everyday performance and behavior and length of stay at the therapeutic community (TC) in individuals with SUD. In addition, to assess the improvement in EF, sensory modulation, participation, self-efficacy, life satisfaction, and use of strategies within and between groups. Satisfaction with F-CaST will also be assessed. METHODS Forty-eight participants from a community of men in a TC, aged 18-45 years will be randomly allocated to (i) F-CaST-(experimental group) providing sensory and EF strategies for improving daily function; (ii) standard care (control group) as provided in the TC. Assessments will be conducted by assessors blind to group allocation at 4 time points: T1- pre-intervention; T2- post-intervention; T3- 1-month follow-up; and T4- 3-month follow-up. Primary outcome measures will be everyday performance, assessed by the Canadian Occupational Performance Measure (COPM), behavior and length of stay in the TC; secondary outcome measures will assess EF, SMD. Semi-structured in-depth qualitative interviews will be conducted at T1, T2 and T4. DISCUSSION We hypothesize that F-CaST will lead to improved everyday performance and longer length of stay in the TC, compared to the control group. If F-CaST will prove to be effective, cognitive and sensory strategies may be incorporated as an adjunctive intervention in SUD rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov NCT05647863 Registered on 13 December 2022, https://classic. CLINICALTRIALS gov/ct2/show/NCT05647863 .
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Affiliation(s)
- Naama Assayag
- Department of Occupational Therapy, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - Debbie Rand
- Department of Occupational Therapy, School of Health Professions, Faculty of Medical and Health Sciences, Tel Aviv University, 6997801, Tel Aviv, Israel
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Thornton JD, Varisco T, Prachet B, Olateju O, Shrestha M, Shen C. Productivity Loss Among Opioid and Benzodiazepine Users in the United States: A Medical Expenditure Panel Survey From 2010 to 2019. J Occup Environ Med 2024; 66:226-233. [PMID: 38151973 PMCID: PMC10922134 DOI: 10.1097/jom.0000000000003029] [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] [Indexed: 12/29/2023]
Abstract
OBJECTIVE The aim of the study is to estimate the association between productivity losses and the use of prescription opioids and benzodiazepines among employed US adults with painful conditions. METHODS Using Medical Expenditures Panel Survey (2010-2019), we used two-part (logistic regression and generalized linear model with zero-truncated negative binomial link) model to compare missed workdays due to illness or injury among employed adults with a painful condition. RESULTS Of the eligible sample of 57,413 working US individuals, 14.65% were prescription opioid users, 2.95% were benzodiazepine users, and 1.59% were both opioid and benzodiazepine users. The predicted missed workdays were 5.75 (95% Confidence Limit [CL]: 5.58-5.92) days for benzodiazepine users, 13.06 (95% CL: 12.88-13.23) days among opioid users, and 15.18 (95% CL: 14.46-15.90) days for opioid and benzodiazepine concomitant users. CONCLUSIONS Concomitant use of prescription opioids and benzodiazepines was significantly associated with having more missed workdays among employed adults with documented painful conditions.
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Affiliation(s)
- J. Douglas Thornton
- Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, Houston, Texas, USA
- Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Tyler Varisco
- Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, Houston, Texas, USA
- Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Bhatt Prachet
- Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, Houston, Texas, USA
- Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Olajumoke Olateju
- Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, Houston, Texas, USA
- Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Mina Shrestha
- Prescription Drug Misuse Education and Research Center, College of Pharmacy, University of Houston, Houston, Texas, USA
- Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, Texas, USA
| | - Chan Shen
- Division of Outcomes Research and Quality, College of Medicine, Pennsylvania State University, Hershey, PA, USA
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Taylor S, Lavalley CA, Hakimi N, Stewart JL, Ironside M, Zheng H, White E, Guinjoan S, Paulus MP, Smith R. Active learning impairments in substance use disorders when resolving the explore-exploit dilemma: A replication and extension of previous computational modeling results. Drug Alcohol Depend 2023; 252:110945. [PMID: 37717307 PMCID: PMC10635739 DOI: 10.1016/j.drugalcdep.2023.110945] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Substance use disorders (SUDs) represent a major public health risk. Yet, our understanding of the mechanisms that maintain these disorders remains incomplete. In a recent computational modeling study, we found initial evidence that SUDs are associated with slower learning rates from negative outcomes and less value-sensitive choice (low "action precision"), which could help explain continued substance use despite harmful consequences. METHODS Here we aimed to replicate and extend these results in a pre-registered study with a new sample of 168 individuals with SUDs and 99 healthy comparisons (HCs). We performed the same computational modeling and group comparisons as in our prior report (doi: 10.1016/j.drugalcdep.2020.108208) to confirm previously observed effects. After completing all pre-registered replication analyses, we then combined the previous and current datasets (N = 468) to assess whether differences were transdiagnostic or driven by specific disorders. RESULTS Replicating prior results, SUDs showed slower learning rates for negative outcomes in both Bayesian and frequentist analyses (partial η2=.02). Previously observed differences in action precision were not confirmed. Learning rates for positive outcomes were also similar between groups. Logistic regressions including all computational parameters as predictors in the combined datasets could differentiate several specific disorders from HCs, but could not differentiate most disorders from each other. CONCLUSIONS These results provide robust evidence that individuals with SUDs adjust behavior more slowly in the face of negative outcomes than HCs. They also suggest this effect is common across several different SUDs. Future research should examine its neural basis and whether learning rates could represent a new treatment target or moderator of treatment outcome.
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Affiliation(s)
- Samuel Taylor
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Navid Hakimi
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Evan White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, USA.
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Fields M, Longley J, Martinez JA, Weizman S, LaBelle R. Recovery Ready Workplaces: A key strategy for reducing overdoses and sustaining recovery from substance use disorder. J Opioid Manag 2023; 19:45-52. [PMID: 37879659 DOI: 10.5055/jom.2023.0798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
In 2021, overdose deaths surpassed the 100,000 mark for the first time in the United States' history, and alcohol-related deaths continue to surpass 140,000 each year. Regulatory and societal barriers to effective treatment and prevention of substance use disorder (SUD) persist. Innovative strategies and approaches to support long-term recovery can help re-duce morbidity and mortality associated with SUD. Improving access to quality treatment and the availability of a broad range of policies and programs to support recovery and address social determinants of health, including employment supports, are key to curbing the overdose epidemic and rebuilding stronger communities. This article outlines the role Recovery Ready Workplaces can play in reducing overdoses and helping individuals sustain recovery from SUD, as well as in strengthening communities. This article describes how congressional and state legisla-tive action, Americans with Disabilities Act (ADA) enforcement and expansion, and other programmatic and fiscal policy changes at the state and federal levels will accelerate the adoption of Recovery Ready Workplaces as an element of a comprehensive response to SUD. The article also identifies existing state models and proposes specific federal- and state-level solutions to address some of the current limitations. Recovery Ready Workplaces benefit employees, employers, and the nation's economy. Recovery Ready Workplaces are a supportive tool and policy strategy to help those with SUD thrive in recovery and to bolster communities and the econ-omy as a whole.
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Affiliation(s)
- Madison Fields
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
| | - Joseph Longley
- Addiction and Public Policy Initiative, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
| | - Jennifer A Martinez
- Addiction and Public Policy Initiative, O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
| | - Shelly Weizman
- Addiction and Public Policy Initiative, O'Neill Institute for National and Global Health Law; Adjunct Professor of Law, Georgetown University Law Center, Washington, DC
| | - Regina LaBelle
- Addiction and Public Policy Initiative, O'Neill Institute for National and Global Health Law; Director, Master of Science in Addiction Policy and Practice, Georgetown University, Washington, DC. ORCID: https://orcid.org/0000-0003-1475-3217
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Sinelnikov S, Prentice EA, Bryant CS. Supervisor Training: A Promising Approach to Addressing Impairment in the Workplace. J Occup Environ Med 2023; 65:858-867. [PMID: 37621022 PMCID: PMC10581438 DOI: 10.1097/jom.0000000000002924] [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] [Indexed: 08/26/2023]
Abstract
OBJECTIVE This study presents a pilot evaluation of a new online training program created to improve supervisors' ability to protect worker safety by recognizing and responding to signs of impairment from diverse causes. METHODS The study design relied on a mixed-methods approach with two waves of surveys and interviews immediately after training completion and after 3 months to gauge changes in participants' perceived knowledge and competencies. RESULTS Participants had a positive reaction to training and found it relevant to their job responsibilities and aligned with existing organizational safety programs, practices, and policies. There was statistically significant improvement in perceived impairment knowledge and competencies. The study also provided early indications of training transfer. CONCLUSIONS The study offers encouraging results that may be used to improve the impairment recognition and response training for supervisors and support future investigations of its impact.
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Weinhouse S, Merlo LJ, Bundy CC, Bresnahan LR, Staffa SJ, Fitzsimons MG, Rockoff MA, Vinson AE. Barriers to recovery for medical professionals: Assessing financial support through a survey of Physician Health Programs. Am J Addict 2023; 32:385-392. [PMID: 36883286 DOI: 10.1111/ajad.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is increasing focus on physician burnout, psychiatric problems, and substance use disorders. Costs of recovery for physicians enrolled in Physician Health Programs (PHPs) remain unexamined with little known regarding funding resources. We sought to elucidate perceived costs of recovery from impairing conditions and highlight resources for financial strain. METHODS This survey study was distributed by the Federation of State Physician Health Organizations via e-mail to 50 PHPs in 2021. Questions assessed perceptions of costs and ability to pay for recommended evaluation, treatment, and monitoring. Questions also assessed limitation of engagement due to financial concerns, and availability of financial resources. RESULTS Complete responses were received from 40 of 50 eligible PHPs. The majority (78%) of responding PHPs assessed ability to pay at initial intake evaluation. There is notable financial strain on physicians, particularly those earliest in training, to pay for services. DISCUSSION AND CONCLUSIONS PHPs are vital to physicians, especially physicians-in-training, as "safe haven programs." Methods to financially assist through PHPs included fee deferrals, sliding scale fees, and fee forgiveness. Health insurance, medical schools, and hospitals were able to provide additional assistance. SCIENTIFIC SIGNIFICANCE Because burnout, mental health, and substance use disorders are high stakes amongst physicians, it is critical that access to PHPs is available, destigmatized, and affordable. Our paper focuses specifically on the financial cost of recovery, the financial burden placed on PHP participants, a topic lacking in the literature, and highlights remedies and vulnerable populations.
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Affiliation(s)
- Samuel Weinhouse
- Department of Cardiothoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lisa J Merlo
- Department of Psychiatry, University of Florida, Gainesville, Florida, USA
| | - Chris C Bundy
- Washington Physicians Health Program, Seattle, Washington, USA
- University of Washington School of Medicine, Seattle, Washington, USA
- Washington State University, Elson S Floyd College of Medicine, Seattle, Washington, USA
| | - Linda R Bresnahan
- Federation of State Physician Health Programs, Wilmington, Massachusetts, USA
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Michael G Fitzsimons
- Department of Anesthesia, Critical Care, and Pain Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark A Rockoff
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Amy E Vinson
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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Chigangaidze RK, Noel Garikai M, Samuel Lisenga S. How deep is the cancerous cut of substance use disorders on human rights? The effects of substance use disorders from a human rights perspective: The thinking of Developmental Clinical Social Work. SOCIAL WORK IN HEALTH CARE 2023:1-15. [PMID: 37276187 DOI: 10.1080/00981389.2023.2221706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/01/2023] [Indexed: 06/07/2023]
Abstract
Developmental Clinical Social Work (DCSW) involves the integration of social development approaches to the prevention, assessment, diagnosis, and treatment of psychological, behavioral, emotional, and medical disorders through social work methods. In doing so, it also covers the predispositions that occur over time in one's life course. Utilising the thinking of Developmental Clinical Social Work, the paper explores the effects of substance use disorders from a human rights perspective. The human rights to health, adequate housing, food and nutrition, development, clean and healthy environment, occupational health and safety, education, parental and children rights have been discussed considering the effects of substance use disorders. The article stimulates the realization that investment in the prevention of substance use disorders advances for the attainment and enjoyment of the above-mentioned human rights. To its end, the paper contradicts with the notion that the use of drugs is a "human right". It justifies the need for court sanctioned substance use disorder treatment facilities that are evidence-based and adhere to human rights. It should be noted that this is a conceptual reflection of three academics, two of whom have taught on the advanced substance use and treatment course and one has taught on developmental social work courses.
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Affiliation(s)
- Robert K Chigangaidze
- School of Health, Science and Wellbeing (Staffordshire University), Stoke-on-Trent, UK
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Taylor S, Lavalley CA, Hakimi N, Stewart JL, Ironside M, Zheng H, White E, Guinjoan S, Paulus MP, Smith R. Active learning impairments in substance use disorders when resolving the explore-exploit dilemma: A replication and extension of previous computational modeling results. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.03.23288037. [PMID: 37066197 PMCID: PMC10104213 DOI: 10.1101/2023.04.03.23288037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Background Substance use disorders (SUDs) represent a major public health risk. Yet, our understanding of the mechanisms that maintain these disorders remains incomplete. In a recent computational modeling study, we found initial evidence that SUDs are associated with slower learning rates from negative outcomes and less value-sensitive choice (low "action precision"), which could help explain continued substance use despite harmful consequences. Methods Here we aimed to replicate and extend these results in a pre-registered study with a new sample of 168 individuals with SUDs and 99 healthy comparisons (HCs). We performed the same computational modeling and group comparisons as in our prior report (doi: 10.1016/j.drugalcdep.2020.108208) to confirm previously observed effects. After completing all pre-registered replication analyses, we then combined the previous and current datasets (N = 468) to assess whether differences were transdiagnostic or driven by specific disorders. Results Replicating prior results, SUDs showed slower learning rates for negative outcomes in both Bayesian and frequentist analyses (η 2 =.02). Previously observed differences in action precision were not confirmed. Logistic regressions including all computational parameters as predictors in the combined datasets could differentiate several specific disorders from HCs, but could not differentiate most disorders from each other. Conclusions These results provide robust evidence that individuals with SUDs have more difficulty adjusting behavior in the face of negative outcomes than HCs. They also suggest this effect is common across several different SUDs. Future research should examine its neural basis and whether learning rates could represent a new treatment target or moderator of treatment outcome.
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Affiliation(s)
- Samuel Taylor
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Navid Hakimi
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Haixia Zheng
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Evan White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, USA
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Ahmadi S, Vojdani P, MortezaBagi HR. The study of nurses' knowledge and attitudes regarding pain management and control in emergency departments. BMC Emerg Med 2023; 23:26. [PMID: 36907850 PMCID: PMC10009925 DOI: 10.1186/s12873-023-00793-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 02/21/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Given the importance and pivotal role of nurses in pain management and control, this study was conducted to determine the nurses' knowledge and attitudes toward in emergency departments. METHODS This study was designed and conducted as a descriptive-analytical cross-sectional study. Nurses' attitude and knowledge towards pain management and control and relationship between their demographic characteristics have been assessed. Nurse Attitude Survey (NAS) and Pain management and control principles assessment Test (PMPAT) questionnaires were used. RESULTS Totally 400 volunteers, including 148 (37.2%) male and 250 (62.8%) female nurses recruited from 23 hospitals in East Azerbaijan, Iran, with a mean age of 30.88 years (± 6.04 SD) and age range between 22 and 53 years old. The crude mean score of participants' knowledge of pain management and control was 12.51 (± 2.77 SD), and standardized mean score was 40.34 (± 8.92 SD), which was low at 84.8% and moderate in 15.3% of the participants. Older nurses and nurses who previously participated in pain retraining courses had significantly less knowledge about pain management and control (r= -0.104, P = 0.038), and (r= -0.148, P = 0.003) respectively. The crude mean score of participants' attitudes toward pain control and management was 15.22 (± 2.56 SD), and standardized mean score was 60.87 (± 10.26 SD). Nurses' attitudes have become more negative with the increase of their work experience (r = -0.168, P = 0.001), and previously participation in pain retraining courses (r =-0.207, P < 0.001). Older nurses and highly educated nurses had significantly more negative attitudes towards pain control and management (r = -0.153, P = 0.002), and (r= -0.126, P = 0.005), respectively. CONCLUSIONS The current study revealed that pain management and control knowledge in most emergency nurses was low, and most of them had a moderate attitude. We need more scientific and comprehensive pain management and control training courses to improve knowledge and attitude among health workers and nurses.
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Affiliation(s)
- Sajjad Ahmadi
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parya Vojdani
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
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Obuobi-Donkor G, Shalaby R, Vuong W, Agyapong B, Hrabok M, Gusnowski A, Surood S, Greenshaw AJ, Agyapong VI. Effects of Text4Hope-Addiction Support Program on Cravings and Mental Health Symptoms: Results of a Longitudinal Cross-sectional Study. JMIR Form Res 2023; 7:e40440. [PMID: 36857114 PMCID: PMC10018381 DOI: 10.2196/40440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/23/2022] [Accepted: 11/11/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Drug misuse is complex, and various treatment modalities are emerging. Providing supportive text messages to individuals with substance use disorder offers the prospect of managing and improving symptoms of drug misuse and associated comorbidities. OBJECTIVE This study evaluated the impact of the daily supportive text message program (Text4Hope-Addiction Support) in mitigating cravings and mental health symptoms in subscribers and quantify user satisfaction with the Text4Hope-Addiction Support program. METHODS Subscribers to the Text4Hope-Addiction Support program received daily supportive text messages for 3 months; the messages were crafted based on addiction counseling and cognitive behavioral therapy principles. Participants completed an anonymous web-based questionnaire to assess cravings, anxiety, and depressive symptoms using the Brief Substance Craving Scale (BSCS), Generalized Anxiety Disorder-7 (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale at enrollment (baseline), after 6 weeks, and after 3 months. Likert scale satisfaction responses were used to assess various aspects of the Text4Hope-Addiction program. RESULTS In total, 408 people subscribed to the program, and 110 of 408 (26.9%) subscribers completed the surveys at least at one time point. There were significant differences between the mean baseline and 3-month BSCS scores P=.01 (-2.17, 95% CI -0.62 to 3.72), PHQ-9 scores, P=.004 (-5.08, 95% CI -1.65 to -8.51), and GAD-7 scores, P=.02 (-3.02, 95% CI -0.48 to -5.56). Participants who received the supportive text messages reported a reduced desire to use drugs and a longer time interval between substance use, which are reflected in 41.1% and 32.5% decrease, respectively, from baseline score. Approximately 89% (23/26) of the participants agreed that Text4Hope-Addiction program helped them cope with addiction-related stress, and 81% (21/25) of the participants reported that the messages assisted them in dealing with anxiety. Overall, 69% (18/26) of the participants agreed that it helped them cope with depression related to addiction; 85% (22/26) of the participants felt connected to a support system; 77% (20/26) of the participants were hopeful of their ability to manage addiction issues; and 73% (19/26) of the participants felt that their overall mental well-being was improved. Most of the participants agreed that the interventions were always positive and affirmative (19/26, 73%), and succinct (17/26, 65%). Furthermore, 88% (21/24) of the participants always read the messages; 83% (20/24) of the participants took positive or beneficial actions after reading; and no participant took a negative action after reading the messages. In addition, most participants agreed to recommend other diverse technology-based services as an adjunctive treatment for their mental and physical health disorders. CONCLUSIONS Subscribers of Text4Hope-Addiction Support program experienced improved mental health and addiction symptoms. Addiction care practitioners and policy makers can implement supportive text-based strategies to complement conventional treatments for addiction, given that mobile devices are widely used.
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Marianne Hrabok
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | | | | | | | - Vincent Io Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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Oh S. Workplace alcohol and other drug policy and support services in the United States, 2015-2019. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 112:103935. [PMID: 36641817 DOI: 10.1016/j.drugpo.2022.103935] [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: 05/11/2022] [Revised: 11/22/2022] [Accepted: 12/09/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Despite their growing popularity, the extent and nature of workplace alcohol and other drug (AOD) policy and support services in the United States remain unclear. The present study examined the availability of AOD policies and support services in workplaces. Also, the associations between a combination of these workplace measures and the current AOD consumption (focusing on binge drinking, use of marijuana and other illicit drugs, and nonmedical use of prescription drugs) were assessed. METHODS Pooled Data from the 2015-2019 National Survey on Drug Use and Health (NSDUH) were utilized to examine a nationally representative sample of 131,751 employed adults. First, the rates of those who reported having a written AOD policy at their workplaces among the total sample and subpopulations across socioeconomic status, and those who reported an employee assistance program or other counseling services for substance use problems were estimated. Then the associations between a combination of the two workplace measures and individuals' current AOD consumption were tested using multinomial logistic regression analyses. RESULTS Although 77.2% of employed individuals reported having a written AOD policy at their workplaces, only 50% of the sample had access to support services for substance use problems. The limited access to support services was most notable among traditionally disadvantaged groups (e.g., females, Hispanics, and individuals with limited English proficiency). The models suggest that having both a workplace AOD policy and support services was associated with significantly lower rates of marijuana and other illicit drug use compared to having neither of the two measures or only support services. CONCLUSION Regardless of workplace AOD policies, the limited availability of support services, especially for disadvantaged workers, raises concerns. While further investigation is needed to understand the effectiveness of the comprehensive prevention approaches at workplaces, it is also important to advocate for the potential benefits of having employee assistance or other services available along with AOD policies.
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Affiliation(s)
- Sehun Oh
- College of Social Work, The Ohio State University, Columbus, OH 43210, United States.
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Park D, Minnick D. Workplace Context to Prevent Substance Misuse in the United States: Associations Between workplace Policies and Employee Substance Use Disorders. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231152913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Workplace policies are important because employee rates of alcohol and drug misuse can be associated with work-related risk factors in the United States. To explore the associations, this study analyzed the 2010–2014 National Survey on Drug Use and Health datasets. The overall sample size was 130,726, and the SUD outcome variables included alcohol, marijuana, pain reliever, and illicit drug use disorders. 20% of participants reported no substance use policies in their workplace. Significant associations were identified between all four measured SUD outcome variables, the presence of specific substance use workplace policies, and individual employment sectors. Specifically, comprehensive policies out of six policies were significantly associated with decreased SUDs in nearly every employment sector. The results of this study suggest that workplace substance use policies are important to prevent the development of employee SUDs and comprehensive policies in place can be most effective.
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Affiliation(s)
- Daejun Park
- Department of Social Work, Ohio University, Athens, OH, USA
| | - Dane Minnick
- Department of Social Work, Ball State University, Muncie, IN, USA
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14
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Li M, Peterson C, Xu L, Mikosz CA, Luo F. Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population. JAMA Netw Open 2023; 6:e2252378. [PMID: 36692881 PMCID: PMC9972180 DOI: 10.1001/jamanetworkopen.2022.52378] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Direct costs of substance use disorders (SUDs) in the United States are incurred primarily among the working-age population. Quantifying the medical cost of SUDs in the employer-sponsored insurance (ESI) population can improve understanding of how SUDs are affecting workplaces and inform decision-making on the value of prevention strategies. OBJECTIVE To estimate the annual attributable medical cost of SUDs in the ESI population from the health care payer perspective. DESIGN, SETTING, AND PARTICIPANTS In this economic evaluation, Merative MarketScan 2018 databases were weighted to represent the non-Medicare eligible ESI population. Regression and mathematical modeling of medical expenditures controlled for insurance enrollee demographic, clinical, and insurance factors to compare enrollees with and without an SUD diagnosis to identify the annual attributable medical cost of SUDs. Data analysis was conducted from January to March 2022. EXPOSURES International Statistical Classification of Diseases, Tenth Revision, Clinical Modification SUD diagnoses on inpatient or outpatient medical records according to Clinical Classifications Software categories (alcohol-, cannabis-, hallucinogen-, inhalant-, opioid-, sedative-, stimulant-, and other substance-related disorders). MAIN OUTCOMES AND MEASURES Annual SUD medical cost in the ESI population overall and by substance type (eg, alcohol). Number of enrollees with an SUD diagnosis and the annual mean cost per affected enrollee of SUD diagnosis (any and by substance type) are also reported. RESULTS Among 162 million ESI enrollees, 2.3 million (1.4%) had an SUD diagnosis in 2018. The regression analysis sample included 210 225 individuals with an SUD diagnosis (121 357 [57.7%] male individuals; 68 325 [32.5%] aged 25-44 years) and 1 049 539 individuals with no SUD diagnosis. The mean annual medical cost attributable to SUD diagnosis per affected enrollee was $15 640 (95% CI, $15 340-$15 940), and the total annual medical cost in the ESI population was $35.3 billion (2018 USD). Alcohol use disorder ($10.2 billion) and opioid use disorder ($7.3 billion) were the most costly. CONCLUSIONS AND RELEVANCE In this economic evaluation of medical expenditures in the ESI population, the per-person and total medical costs of SUDs were substantial. Strategies to support employees and their health insurance dependents to prevent and treat SUDs can be considered in terms of potentially offsetting the existing high medical cost of SUDs. Medical expenditures for SUDs represent the minimum direct cost that employers and health insurers face because not all people with SUDs have a diagnosis, and costs related to absenteeism, presenteeism, job retention, and mortality are not addressed.
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Affiliation(s)
- Mengyao Li
- National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cora Peterson
- National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Likang Xu
- National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina A Mikosz
- National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Feijun Luo
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Frone MR, Casey Chosewood L, Osborne JC, Howard JJ. Workplace Supported Recovery from Substance Use Disorders: Defining the Construct, Developing a Model, and Proposing an Agenda for Future Research. OCCUPATIONAL HEALTH SCIENCE 2022; 6:475-511. [PMID: 37206918 PMCID: PMC10193449 DOI: 10.1007/s41542-022-00123-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 05/21/2023]
Abstract
Substance use disorders (SUDs) represent a critical public and occupational health issue. Therefore, understanding the process of SUD recovery has become an issue of growing importance among substance use and recovery professionals. Nonetheless, despite the acknowledged importance of employment for SUD recovery, little conceptual or empirical work exists on how the workplace might support or undermine SUD recovery. In this article, we address this limitation in several ways. First, to promote a better understanding of SUD recovery for occupational health researchers, we provide a brief overview of the nature of a SUD, prior definitions of SUD recovery, and general themes associated with the recovery process. Second, we develop a working definition of workplace supported recovery. Third, we present a heuristic conceptual model showing how the workplace might impact the SUD recovery process. Fourth, using this model and research from the substance use and occupational health literatures, we develop a series of general research propositions. These propositions highlight broad directions requiring more detailed conceptualization and empirical research to understand better how work conditions may support or undermine the process of employee SUD recovery. Our overarching goal is to motivate innovative conceptualization and research on workplace supported recovery from SUDs. Such research may inform the development and evaluation of workplace interventions and policies supporting SUD recovery and highlight the benefits of workplace supported SUD recovery for employees, employers, and communities. Research on this issue may allow occupational health researchers to impact a significant societal and occupational health issue.
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Affiliation(s)
- Michael R. Frone
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - L. Casey Chosewood
- Office of the Director, Office for Total Worker Health®, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA, United States
| | - Jamie C. Osborne
- Office of the Director, Office for Policy, Planning and Evaluation, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA, United States
| | - John J. Howard
- Office of the Director, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC, United States
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16
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Morse AK, Askovic M, Sercombe J, Dean K, Fisher A, Marel C, Chatterton ML, Kay-Lambkin F, Barrett E, Sunderland M, Harvey L, Peach N, Teesson M, Mills KL. A systematic review of the efficacy, effectiveness and cost-effectiveness of workplace-based interventions for the prevention and treatment of problematic substance use. Front Public Health 2022; 10:1051119. [PMID: 36419993 PMCID: PMC9676969 DOI: 10.3389/fpubh.2022.1051119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227598, PROSPERO [CRD42021227598].
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Affiliation(s)
- Ashleigh K. Morse
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Mina Askovic
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jayden Sercombe
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Kate Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Alana Fisher
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
- eCentre Clinic, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | | | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Logan Harvey
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Natalie Peach
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Katherine L. Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
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Morgan JR, Murphy SM, Assoumou SA, Linas BP. Estimating Absenteeism Related to Nonalcohol Substance Use in a US National Cohort of Full-Time Employees. J Occup Environ Med 2022; 64:899-904. [PMID: 35901222 PMCID: PMC9637773 DOI: 10.1097/jom.0000000000002612] [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] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We aimed to estimate absenteeism due to substance use disorder among full-time employees. METHODS We used the 2018 National Survey on Drug Use and Health to identify a sample of individuals employed full time. We used a survey-weighted multivariable negative binomial model to evaluate the association between absenteeism and type of substance use disorder controlling for available demographic information. RESULTS In the adjusted model, we estimated that opioid use without a disorder had the highest absenteeism for use, and polysubstance use disorder had the highest absenteeism among use disorders. In a hypothetical firm of 10,000 employees, we estimate $232,000 of lost wage value annually. CONCLUSIONS Substance use is associated with absenteeism and presents a compelling argument for employers to promote programs that support treatment for employees and reduce downstream costs associated with absenteeism and turnover.
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Affiliation(s)
- Jake R Morgan
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts (Dr Morgan); Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (Dr Murphy); Department of Medicine, Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (Dr Assoumou, Dr Linas); Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts (Dr Assoumou, Dr Linas); and Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts (Dr Linas)
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18
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Edwards CV, Sheikh AR, Dennis MJ, Hunter A, Mackay ZP, Catudal EC, Elias R, Cabral HJ, Sarosiek SR, Tapan U. The impact of substance use on health care utilization, treatment, and outcomes in patients with non-small cell lung cancer. J Thorac Dis 2022; 14:3865-3875. [PMID: 36389291 PMCID: PMC9641327 DOI: 10.21037/jtd-21-1992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/19/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Mortality from non-small cell lung cancer (NSCLC) has improved with screening and novel treatments. The substance use epidemic has threatened health outcomes in a variety of diseases, but little is known about how it is associated with NSCLC outcomes. METHODS We performed a retrospective cohort study of 211 patients with NSCLC treated at a safety-net hospital. Sociodemographic data and clinical outcomes were extracted via review of electronic medical records. Patients were stratified based on substance use status. Comparative and multivariable analyses were performed to evaluate baseline characteristics and lung cancer outcomes including survival. RESULTS Among 193 patients (91.5%) with information available on substance use, 24.9% reported substance use; specifically, alcohol, marijuana, and illicit substances. Patients with substance use were more likely to have increased health care utilization and poor social determinants of health, including safe housing, stable employment, and social support. There were no significant differences in treatment adherence. Only 6.3% of patients with substance use did not receive guideline concordant care (GCC) compared to 24.8% of patients without substance use; due to poor performance status, increased comorbidities, or loss to follow up. On univariable analysis, patients with substance use experienced inferior median overall survival (OS) if they had metastatic disease (0.40 vs. 1.03 years, P=0.01). However, in the multivariable analysis, substance use did not predict for survival. Independent predictors of mortality were sex (male HR, 1.67; 95% CI: 1.04-2.68; P=0.04), smoking status (current smoking HR, 2.63; 95% CI: 1.14-6.08; P=0.02), and stage (stage IV HR, 14.96; 95% CI: 6.28-35.63; P=0.008). CONCLUSIONS Substance use is associated with poor social determinants of health and increased health care utilization. On multivariable analysis, substance use was not independently associated with OS once guideline-concordant care was used. Future studies should focus on improving our understanding of these associations, delineating potential mechanisms, and developing evidence-based strategies to reduce health care utilization and overcome challenges related to poor social determinants of health.
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Affiliation(s)
- Camille V. Edwards
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA;,Boston University School of Medicine, Boston, MA, USA
| | - Ayesha R. Sheikh
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA;,Saint Vincent Medical Group, Worcester, MA, USA
| | - Michael J. Dennis
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - Andrew Hunter
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - Zoe P. Mackay
- Boston University School of Medicine, Boston, MA, USA
| | | | - Rawad Elias
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA;,Department of Medical Oncology, Hartford Hospital/Hartford Healthcare Cancer Institute, Hartford, CT, USA
| | | | - Shayna R. Sarosiek
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA;,Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Umit Tapan
- Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA;,Boston University School of Medicine, Boston, MA, USA
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19
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Bedene A, Dahan A, Rosendaal FR, van Dorp ELA. Opioid epidemic: lessons learned and updated recommendations for misuse involving prescription versus non-prescription opioids. Expert Rev Clin Pharmacol 2022; 15:1081-1094. [PMID: 36068971 DOI: 10.1080/17512433.2022.2114898] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In the past decades, the opioid crisis has heavily impacted parts of the US society and has been followed by an increase in the use of opioids worldwide. It is of paramount importance that we explore the origins of the US opioid epidemic to develop best practices to tackle the rising tide of opioid overdoses. AREAS COVERED In this expert review, we discuss opioid (over)prescription, change in perception of pain, and false advertisement of opioid safety as the leading causes of the US opioid epidemic. Then, we review the evidence about opioid dependence and addiction potential and provide current knowledge about predictors of aberrant opioid-related behavior. Lastly, we discuss different approaches that were considered or undertaken to combat the rising tide of opioid-related deaths by regulatory bodies, pharmaceutical companies, and health-care professionals. For this expert review, we considered published articles relevant to the topic under investigation that we retrieved from Medline or Google scholar electronic database. EXPERT OPINION The opioid epidemic is a dynamic process with many underlying mechanisms. Therefore, no single approach may be best suited to combat it. In our opinion, the best way forward is to employ multiple strategies to tackle different underlying mechanisms.
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Affiliation(s)
- Ajda Bedene
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eveline L A van Dorp
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
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20
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Abstract
PURPOSE OF REVIEW Substance use disorders account for a tremendous burden to society, yet despite substantial progress in basic studies, our understanding of the brain-basis of these disorders is still emerging. This review summarizes the recent findings of neuroimaging studies with substance use disorder individuals. RECENT FINDINGS Resting-state functional connectivity studies support for some but not all substances of abuse and disruption in executive control. Structural neuroimaging findings point towards reduced subcortical volumes, which may emerge as an interaction between preexisting factors and recent substance use. Longitudinal studies implicate some of the same core brain structures and their functional role that have also been identified via case-control studies. Finally, meta-analyses support the idea of dysregulation of cortical control over subcortical salience processing. SUMMARY Although progress has been made and there is both structural and functional imaging evidence of an imbalance between brain structures involved in executive control and salience processing, there is emerging evidence that brain-behaviour relationships, which are core to discovering the neural processes that lead to and maintain substance use, are small and require larger consortia that prospectively examine individuals with substance use disorder.
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21
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Parsley IC, Dale AM, Fisher SL, Mintz CM, Hartz SM, Evanoff BA, Bierut LJ. Association Between Workplace Absenteeism and Alcohol Use Disorder From the National Survey on Drug Use and Health, 2015-2019. JAMA Netw Open 2022; 5:e222954. [PMID: 35297970 PMCID: PMC8931561 DOI: 10.1001/jamanetworkopen.2022.2954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
IMPORTANCE Alcohol use disorder (AUD) is common and associated with increased morbidity. The degree to which AUD currently factors into workplace absenteeism needs further characterization in the US. OBJECTIVE To examine the association between AUD and workplace absenteeism in a nationally representative sample. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from a nationally representative sample of noninstitutionalized US residents from the 2015-2019 National Survey on Drug Use and Health to examine the association of AUD with workplace absenteeism. Eligible respondents were aged 18 years and older who reported full-time employment. Data were analyzed from March to September 2021. MAIN OUTCOMES AND MEASURES Primary outcomes were markers of workplace absenteeism as defined by the number of days missed from work because of illness or injury and days skipped from work in the last 30 days. Descriptive statistics, prevalence ratios, and logistic regression analyses were performed to assess the association between AUD and absenteeism. RESULTS A total of 110 701 adults aged 18 years and older reported current full-time employment (58 948 [53.2%] men, 51 753 [46.8%] women; 12 776 [11.5%] Black, 18 096 [16.3%] Hispanic, and 69 506 [62.8%] White respondents). Weighted prevalence of AUD in this sample of working adults was 9.3% (95% CI, 9.0%-9.5%); 6.2% (95% CI, 6.0%-6.4%) of respondents met criteria for mild AUD, 1.9% (95% CI, 1.7%-2.0%) for moderate AUD, and 1.2% (95% CI, 1.1%-1.3%) for severe AUD. Mean days missed from work annually increased in a stepwise fashion with increasing AUD severity (no AUD, 13.0 days; 95% CI, 12.7-13.2 days; mild AUD, 17.7 days; 95% CI, 16.4-19.1 days; moderate AUD, 23.6 days; 95% CI, 21.5-25.7 days; severe AUD, 32.3 days; 95% CI, 27.5-37.0 days). People with AUD represented 9.3% of the full-time workforce and contributed to 14.1% of total reported workplace absences. CONCLUSIONS AND RELEVANCE In this cross-sectional study, AUD was disproportionately associated with an increased prevalence of workplace absenteeism, with individuals with AUD contributing over 232 million missed workdays annually. These results provide economic incentive for increased investment in AUD prevention and treatment, both for employers and policy makers.
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Affiliation(s)
- Ian C. Parsley
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Ann Marie Dale
- Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Sherri L. Fisher
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Carrie M. Mintz
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Sarah M. Hartz
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Bradley A. Evanoff
- Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Laura J. Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
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22
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Occupational Stressors and Access to COVID-19 Resources among Commuting and Residential Hispanic/Latino Farmworkers in a US-Mexico Border Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020763. [PMID: 35055585 PMCID: PMC8775392 DOI: 10.3390/ijerph19020763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 12/01/2022]
Abstract
Hispanic/Latino and migrant workers experience high degrees of occupational stress, constitute most of California’s agricultural workforce, and were among the most impacted populations by the COVID-19 pandemic. However, relatively little is known about the occupational stress experienced by farmworkers who commute daily between the US and Mexico. Occupational stress is considered an imbalance between the demands at work and the capabilities to respond in the context of the workforce. The goal of this study is to determine the type and severity of stressors in daytime and resident farmworkers and how COVID-19 vaccination status contributes to these stressors. Interviews containing the Migrant Farmworker Stress Inventory (MSWSI) were administered to a sample of 199 Hispanic/Latino farmworkers in Imperial County, a multi-billion-dollar agriculture sector in the US. Principal factor analysis differentiated latent factors in the MFSWI. Simple linear regression models and correlations identified associations between MFWSI scores and sample characteristics. The MFWSI reduced to five stressor domains: Health and Well-Being Vulnerabilities, Inadequate Standards of Living/Unknown Conditions of Living, Working Conditions, Working Environment, and Language Barriers. Approximately 40 percent of the respondents reported significant stress levels, with foreign-born (p = 0.014) and older respondents (p = 0.0415) being more likely to experience elevated stress regardless of their nighttime residence. We found that Spanish-language COVID-19 outreach might have been particularly effective for workers who reported high stress from English-language communication (p = 0.001). Moreover, our findings point to the importance of worker and human rights to mitigate the high-stress foreign-born workers who live in Mexico and the US experience.
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23
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Graham DP, Harding MJ, Nielsen DA. Pharmacogenetics of Addiction Therapy. Methods Mol Biol 2022; 2547:437-490. [PMID: 36068473 DOI: 10.1007/978-1-0716-2573-6_16] [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] [Indexed: 06/15/2023]
Abstract
Drug addiction is a serious relapsing disease that has high costs to society and to the individual addicts. Treatment of these addictions is still in its nascency, with only a few examples of successful therapies. Therapeutic response depends upon genetic, biological, social, and environmental components. A role for genetic makeup in the response to treatment has been shown for several addiction pharmacotherapies with response to treatment based on individual genetic makeup. In this chapter, we will discuss the role of genetics in pharmacotherapies, specifically for cocaine, alcohol, and opioid dependences. The continued elucidation of the role of genetics should aid in the development of new treatments and increase the efficacy of existing treatments.
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Affiliation(s)
- David P Graham
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Mark J Harding
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David A Nielsen
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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24
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Le AB, Rosen JD. It Is Time to Implement Primary Prevention in the Workplace to Ameliorate the Ongoing U.S. Opioid Epidemic. New Solut 2021; 31:210-218. [PMID: 34431383 PMCID: PMC8505780 DOI: 10.1177/10482911211039880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The United States' opioid public health crisis continues having disastrous consequences on communities, including workers and employers. From May 2019 to May 2020, the largest number of drug overdose deaths was recorded over a twelve-month period. The "twindemics" of COVID-19 and opioids underscore the urgent need to address workers' physical and mental health. Although much has been written about the negative impacts of the opioid epidemic on the workplace, few initiatives have focused on primary prevention, addressing work-related root causes of opioid use disorders (e.g., injury, stress) that may lead to prescription or illicit opioid use. We suggest primary prevention efforts to address the connection between workplace hazards and opioid misuse, dependence, and addiction such as examining patterns of work injury and stress with records of opioid prescription. Government funding should be expanded to support primary prevention and research efforts to strengthen the evidence-base to support workplace primary prevention endeavors.
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Affiliation(s)
- Aurora B. Le
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jonathan D. Rosen
- National Clearinghouse for Worker Safety and Health Training, Schenectady, NY, USA
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25
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Campbell SM, Rosen J. The Intersectionality of Activism and Public Health in New York State: Can Labor/Health and Safety Move Addiction Recovery Forward? New Solut 2021; 31:330-339. [PMID: 34554010 DOI: 10.1177/10482911211046267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People affected by overdose deaths are advocating for prevention and increased access to treatment. Activist coalitions challenged the deadly impact of stigma, discrimination, and inadequate access to life-saving substance use disorder (SUD) and mental health care. Advocacy by coalitions resulted in federal and state funding and legislation, improving access to care. New York State is a model for these reforms. Occupational safety and health activists have largely been absent from this critical policy work even though 70% of people who are struggling with substance use are working. Antiquated workplace policies discipline workers who have substance use problems, silencing those who need support. Pain related to hazardous and stressful work are drivers of the crisis. Prevention and recovery-friendly workplace programs are part of the solution. Partnerships among employers, unions and safety and health activists with the recovery movement can prevent SUD and help affected workers build and sustain their recovery.
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Affiliation(s)
- Stephanie M Campbell
- NYS Office of the Ombudsman, NYS Office of Addiction Services and Supports, Albany, USA
| | - Jonathan Rosen
- 6857National Institute of Environmental Health Sciences, Schenectady, USA
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Abstract
The workplace is a key environment to impact employees, families, and communities to prevent further opioid and substance misuse, addiction, and overdose. However, it is often overlooked as an ideal location to launch a prevention intervention or support strategy. Employees in recovery, seeking treatment, and dealing with mental distress require employer support. Supports should consider the diversity of the work force and be culturally appropriate. Several data sources, tools, and other resources exist to aid employers in supporting their employees and addressing the opioid epidemic; a few from the National Safety Council are discussed. As well as suitable strategies to strengthen workplace prevention interventions and treatment access, in light of the opioid epidemic, coronavirus pandemic, and workplace disparities.
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A Public Health Approach to Protecting Workers from Opioid Use Disorder and Overdose Related to Occupational Exposure, Injury, and Stress : APHA Policy Statement Number 202012, Issued October 24, 2020. New Solut 2021; 31:373-383. [PMID: 34228552 DOI: 10.1177/10482911211031012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Opioid overdose mortality, in combination with increased deaths from alcohol and suicide, is having a profound impact on American workplaces, compromising occupational health and safety and increasing workers' compensation and health insurance costs, absenteeism, and lost productivity. The President's Council of Economic Advisers estimates that more than 1 million workers are out of the workforce due to the opioid crisis. The impact on workers is equally profound, including job loss, divorce and family disruption, and potentially imprisonment, injury, illness, and death. Pain from occupational injuries and illnesses and stress are important pathways to opioid use disorder. Effective workplace programs that incorporate the public health approach to prevention offer a significant opportunity to prevent and respond to the opioid crisis. To date, the nation's efforts at combating the crisis have not included the necessary policy reforms to transform the workplace from a pathway to opioid misuse to a pathway to prevention, including education of workers, unions, employers, and health care providers and treatment and recovery of affected workers. Several key policy interventions are recommended to address this disconnect, including prevention of workplace injury, illness, and emotional distress; worker education and training; and replacement of stigmatizing, punitive workplace substance use programs with supportive programs. Increasing access to alternative pain treatment and preventing opioid misuse in workers' compensation systems are other key policy recommendations.
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Akanbi MO, Iroz CB, O'Dwyer LC, Rivera AS, McHugh MC. A systematic review of the effectiveness of employer-led interventions for drug misuse. J Occup Health 2021; 62:e12133. [PMID: 32533807 PMCID: PMC7293184 DOI: 10.1002/1348-9585.12133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/02/2020] [Accepted: 05/12/2020] [Indexed: 01/29/2023] Open
Abstract
Aims Employers in the United States incur substantial costs associated with substance use disorders. Our goal was to examine the effectiveness of employer‐led interventions to reduce the adverse effects of drug misuse in the workplace. Methods We conducted a systematic review of studies that evaluated the effectiveness of recommended workplace interventions for opioids and related drugs: employee education, drug testing, employee assistance programs, supervisor training, written workplace drug‐free policy, and restructuring employee health benefit plans. We searched PubMed MEDLINE, EMBASE (embase.com), PsycINFO (Ebsco), ABI Inform Global, Business Source Premier, EconLit, CENTRAL, Web of Science (Thomson Reuters), Scopus (Elsevier), Proquest Dissertations, and Epistemonikos from inception through May 8, 2019, with no date or language restrictions. We included randomized controlled trials, quasi‐experimental studies, and cross‐sectional studies with no language or date restrictions. The Downs and Black questionnaire was used to assess the quality of included studies. The results were reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. Results In all, 27 studies met our inclusion criteria and were included in the systematic review. Results were mixed, with each intervention shown to be effective in at least one study, but none showing effectiveness in over 50% of studies. Studies examining the impact of interventions on workplace injuries or accidents were more commonly reported to be effective. Although four studies were randomized controlled trials, the quality of all included studies was “fair” or “poor.” Conclusions Despite the opioid epidemic, high‐quality studies evaluating the effectiveness of employer‐led interventions to prevent or reduce the adverse effects of substance use are lacking. Higher quality and mixed methods studies are needed to determine whether any of the interventions are generalizable and whether contextual adaptations are needed. In the meantime, there is a reason to believe that commonly recommended, employer‐led interventions may be effective in some environments.
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Affiliation(s)
- Maxwell O Akanbi
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Cassandra B Iroz
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Linda C O'Dwyer
- Galter Health Sciences Library and Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Adovich S Rivera
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Megan Colleen McHugh
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA.,Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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29
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Bassiony MM, Ibrahim EF, Youssef UM. Association Between Dual Diagnosis and Drug-Related Problems in Workplace in Egypt: A Case-Control Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-019-00170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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30
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Health Risk Calculator: An Online, Interactive Tool to Estimate how Health Impacts Workers' Compensation Claim Incidence and Cost. J Occup Environ Med 2020; 61:597-604. [PMID: 31022100 DOI: 10.1097/jom.0000000000001619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this paper is to describe and evaluate a web-based, educational Health Risk Calculator that communicates the value of investing in employee health and well-being for the prevention of work-related injuries, illnesses, and fatalities. METHODS We developed and evaluated the calculator following the RE-AIM framework. We assessed effectiveness via focus groups (n = 15) and a post-use survey (n = 33) and reach via website analytics. RESULTS We observed evidence for the calculator's usability, educational benefit, and encouragement of action to improve worker health and safety. Website analytics data demonstrated that we reached over 300 users equally in urban and rural areas within 3 months after launch. CONCLUSION We urge researchers to consider the ways in which they can communicate their empirical research findings to their key stakeholders and to evaluate their communication efforts.
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Bottema AJ, Telep CW. Examining Views of Police Chiefs and College Students Regarding Drug Disqualifiers for the Hiring of Police Officers in Arizona. JOURNAL OF DRUG ISSUES 2020. [DOI: 10.1177/0022042620959331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Police applicant disqualification due to prior illegal drug use is a contributing factor to major recruitment and hiring challenges currently facing many American policing agencies. This article explores how chief executives of law enforcement agencies and college students enrolled in criminology courses in Arizona view current statewide police hiring standards related to prior drug use. We use surveys conducted in cooperation with the Arizona Peace Officer Standards and Training Board to examine respondent opinions regarding the preemployment use of marijuana and illicit use of prescription drugs. Generally, we find significant differences between the chief executive and student views. Students, who represent potential policing applicants, typically are in favor of harsher treatment of prior drug use than chief executives, although students are also more open to forgiving marijuana use under certain circumstances. We discuss the implications of these findings for police hiring and suggest potential areas of policy change.
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32
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Musculoskeletal Disorders and Prescription Opioid Use Among U.S. Construction Workers. J Occup Environ Med 2020; 62:973-979. [DOI: 10.1097/jom.0000000000002017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Assayag N, Bonneh Y, Parush S, Mell H, Kaplan Neeman R, Bar-Shalita T. Perceived Sensitivity to Pain and Responsiveness to Non-noxious Sensation in Substance Use Disorder. PAIN MEDICINE 2020; 21:1902-1912. [PMID: 31782772 DOI: 10.1093/pm/pnz292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD. METHODS Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)-Revised. RESULTS The SUD group scored higher on the PSQ (P < 0.0001), BAS-R aversiveness (P < 0.0001), BAS-R-unpleasantness (P < 0.0001), and on the aftersensation of auditory aversiveness (P < 0.0001) and unpleasantness (P < 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P < 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ. CONCLUSIONS This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.
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Affiliation(s)
- Naama Assayag
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Yoram Bonneh
- School of Optometry and Vision Science, Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Shula Parush
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Haim Mell
- Yezreel Valley College, Afula, Israel
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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34
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Choi B. Opioid use disorder, job strain, and high physical job demands in US workers. Int Arch Occup Environ Health 2020; 93:577-588. [PMID: 31919662 DOI: 10.1007/s00420-019-01514-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/27/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Little is known about the work environmental risk factors for opioid use disorder (OUD) in working populations. The purpose of this study is to examine whether adverse physical and psychosocial working conditions are associated with OUD in a working population of the United States (US). METHODS Among the participants of the National Survey of Midlife Development in the United States (MIDUS) II Study (2004-2006), 2134 workers (1059 men and 1075 women; mean age, 51 years) were chosen for this study. OUD was measured with self-administered questions in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSD-5). Physical demands (physical efforts, heavy lifting, and crouching/stooping/kneeling) and psychosocial work stressors (skill discretion, decision authority, job control, psychological job demands, supervisor and coworker support at work, job insecurity, and work hours) were measured with a standard questionnaire. RESULTS The prevalence of OUD was 3.8%. In multivariate analyses, low skill discretion, high psychological job demands, job strain (a combination of low control and high demands), and high physical job demands were significantly associated with OUD. The multivariate prevalence ratios for OUD by job strain and frequent heavy lifting were 1.98 (1.27-3.10) and 2.23 (1.22-4.10), respectively. Job strain was more strongly associated with OUD in men, while high physical job demands were more strongly associated with OUD in women. CONCLUSION This study implies that adverse physical and psychosocial working conditions may be important risk factors for OUD in US working populations. Future longitudinal and mechanistic studies are urgently warranted.
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Affiliation(s)
- BongKyoo Choi
- Department of Medicine and Program in Public Health, University of California Irvine, 100 Theory, Suite 100, Irvine, CA, 92617, USA.
- Center for Work and Health Research, Irvine, CA, USA.
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Tiu RB, Teng-Calleja M, Hechanova MRM, Go JFC. A social cognitive approach to understanding employee substance use: An example from the Philippines. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2019. [DOI: 10.1080/15555240.2019.1646658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Reniel B. Tiu
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | | | | | - Jaimee Felice C. Go
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
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36
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Aoun EG, Appelbaum PS. Ten Years After the ADA Amendment Act (2008): The Relationship Between ADA Employment Discrimination and Substance Use Disorders. Psychiatr Serv 2019; 70:596-603. [PMID: 30991909 DOI: 10.1176/appi.ps.201800574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Title I of the Americans with Disabilities Act (ADA) provides protection against discrimination on the basis of disability. This article explores how the courts have dealt with provisions limiting these protections for persons with substance use disorders. Specifically, the ADA allows employees with substance use disorders to be held to the same standards as other employees, suggesting that employers may not be required to provide reasonable accommodations. Moreover, employees "currently engaging in the illegal use of drugs" are excluded from ADA coverage. METHODS This article reviewed all published federal appellate court opinions involving cases in which a substance use disorder was the basis for a claim of employment-related discrimination in violation of the ADA. RESULTS In 26 cases identified, the lower courts ruled in favor of the employer 25 times, and the appellate courts reversed four of these rulings. The cases highlight three important limitations of ADA protections for persons with substance use disorders: the dilemma of needing to prove that one's substance use disorder limits major life activities while simultaneously arguing that one is qualified for the job; expansive interpretations of "current" drug use and the period of sobriety needed to qualify for ADA protections; and restrictions on the extent to which a qualifying disability can serve as a legal excuse for substance use-related misconduct. CONCLUSIONS The protections afforded by the ADA for individuals with substance use disorders are restricted by what appears to be the statute's moralizing on drug and alcohol use and those who use these substances.
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Affiliation(s)
- Elie G Aoun
- Division of Law, Ethics, and Psychiatry (Aoun and Appelbaum) and Center for Research on Ethical, Legal, and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics (Appelbaum), Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York
| | - Paul S Appelbaum
- Division of Law, Ethics, and Psychiatry (Aoun and Appelbaum) and Center for Research on Ethical, Legal, and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics (Appelbaum), Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York
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37
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Kuzma EK, Boucher N, Gray B, Burmester K, Ploutz-Snyder R, Strobbe S. Preparing Advanced Practice Registered Nursing Students to Deliver Adolescent SBIRT for Substance Use. J Nurs Educ 2018; 57:736-741. [DOI: 10.3928/01484834-20181119-06] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/17/2018] [Indexed: 11/20/2022]
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38
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Higgins SA, Simons J. The Opioid Epidemic and the Role of the Occupational Health Nurse. Workplace Health Saf 2018; 67:36-45. [PMID: 30305006 DOI: 10.1177/2165079918796242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The opioid epidemic is a national public health crisis. It began with the misuse of commonly used prescription opioid pain relievers and has led to the increased use of heroin and illicit fentanyl. Large-scale initiatives have begun on the federal and state level and place an emphasis on improved opioid prescribing, which have important implications for the workplace. Treatment of work injury may initiate the use of prescription opioids and result in misuse and possible overdose. Prescription drug abuse affects all aspects of society so potentially any workplace could be affected. A multifaceted approach is needed to reduce opioid morbidity and mortality and the occupational health nurse should be actively involved. The intent of this article is to provide an overview of the epidemic and its impact on health, the challenges for the workplace, and recommended strategies for the occupational health nurse to impact the problem.
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