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Oesterle TS, Bormann NL, Ochal DA, Arndt S, Breitinger SA. Transitioning Virtual-Only Group Therapy for Substance Use Disorder Patients to a Hybrid Model. Subst Abuse Rehabil 2024; 15:73-78. [PMID: 38681859 PMCID: PMC11055515 DOI: 10.2147/sar.s460024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/20/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose Telehealth is associated with a myriad of benefits; however, little is known regarding substance use disorder (SUD) treatment outcomes when participants join group therapy sessions in a combination in-person and virtual setting (hybrid model). We sought to determine if treatment completion rates differed. Patients and Methods Policy changes caused by the COVID-19 pandemic created a naturalistic, observational cohort study at seven intensive outpatient (IOP) programs in rural Minnesota. Virtual-only delivery occurred 6/1/2020-6/30/2021, while hybrid groups occurred 7/1/2021-7/31/2022. Data was evaluated retrospectively for participants who initiated and discharged treatment during the study period. Participants were IOP group members 18 years and older who had a SUD diagnosis that both entered and discharged treatment during the 26-month period. A consecutive sample of 1502 participants (181-255 per site) was available, with 644 removed: 576 discharged after the study conclusion, 49 were missing either enrollment or discharge data, 14 transferred sites during treatment, and 5 initiated treatment before the study initiation. Helmert contrasts evaluated the impact of hybrid group exposure. Results A total of 858 individuals were included. Data was not from the medical chart and was deidentified preventing specific demographics; however, the overall IOP sample for 2020-2022, from which the sample was derived, was 29.8% female, and 64.1% were 18-40 years of age. For completed treatment, hybrid group exposure relative to virtual-only had a univariate odds ratio of 1.88 (95% CI: 1.50-2.41, p < 0.001). No significant difference was seen across IOP sites. Conclusion These results describe a novel hybrid group approach to virtual care for SUDs with outcome data not previously documented in the literature. While virtual treatment delivery can increase access, these results suggest a benefit is derived from including an in-person option. Further research is needed to identify how an in-person component may change dynamics and if it can be replicated in virtual-only models.
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Affiliation(s)
- Tyler S Oesterle
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nicholas L Bormann
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Stephan Arndt
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Scott A Breitinger
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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Bahji A. Navigating the Complex Intersection of Substance Use and Psychiatric Disorders: A Comprehensive Review. J Clin Med 2024; 13:999. [PMID: 38398311 PMCID: PMC10889170 DOI: 10.3390/jcm13040999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
The co-occurrence of substance use disorders (SUDs) and psychiatric conditions, often referred to as comorbidity or concurrent disorders, presents intricate challenges in both diagnosis and treatment. This comprehensive narrative review aims to synthesize and critically evaluate the existing evidence surrounding the management of individuals with comorbid SUDs and psychiatric disorders. Comorbidity in these domains carries profound implications for clinical practice, research, and policymaking, emphasizing the need for a holistic understanding of the intricate dynamics that arise when these conditions coexist. This review explores recent research findings, evidence-based guidelines, and emerging trends within the field, offering valuable insights for clinicians, researchers, and policymakers seeking to navigate the complex terrain of comorbidity in substance use and psychiatric disorders.
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Affiliation(s)
- Anees Bahji
- Departments of Psychiatry and Community Health Sciences & Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2R 1N4, Canada
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Suwanchatchai C, Buaphan S, Khuancharee K. Determinants and prevalence of relapse among patients with substance use disorder in a rural population: A retrospective observational study. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209244. [PMID: 38056631 DOI: 10.1016/j.josat.2023.209244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/04/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Substance use relapse after successful detoxication and rehabilitation is one of the most important aspects of addiction worldwide. This study aims to examine the current prevalence of relapse and to determine the factors associated with relapse among patients with substance use disorder (SUD) in a rural population. METHODS This single-centered retrospective observational study enrolled a total of 915 patients with SUD who visited Banna hospital, Nakhon Nayok province, Thailand, from January 1, 2019, to December 31, 2021. Multiple logistic regression models determined the factors associated with relapse among the patients with SUD. RESULTS The substance use relapse rate in this rural Thai population was 24 % (95%CI 21.16-26.70). Multivariate analysis revealed that being over 40 years of age, single, and unemployed, and having no legal history were associated with relapse among the patients with SUD. Furthermore, family disputes, addicted friends, and addicted close relatives resulted in a major significant increase in the risk of substance use relapse. CONCLUSIONS The current study confirmed that family disputes, addicted friends, and addicted close relatives were the main associations with addiction relapse. Therefore, addiction rehabilitation programs based on the findings of the current study may reduce and contribute to preventing the risk of substance use relapse.
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Affiliation(s)
- Chawin Suwanchatchai
- Department of Preventive and Community Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok 26120, Thailand
| | | | - Kitsarawut Khuancharee
- Department of Preventive and Community Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok 26120, Thailand.
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Ghaderi A, Khoshakhlagh AH, Gruszecka-Kosowska A, Alemi F, Hazegh P, Aghaei Z, Molavi N, Mahdavi M, Vahed N, Dehkohneh SG, Ostadmohammady F, Das D. Blood-lead level in humans and drug addiction: a comprehensive study in Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:112071-112085. [PMID: 37828260 DOI: 10.1007/s11356-023-30179-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
Drug abuse has a high prevalence worldwide and causes many health-related disorders. There are limited human exposure studies on establishing lead exposure levels and their propensity for drug addiction. In the present study, blood samples were tested for lead (Pb) concentrations in illicit drug users together with the related symptoms in comparison with control group of non-drug users. The study was performed on 250 volunteers divided equally in four drug groups, namely, opioids, hashish, methadone, and methamphetamine, and one control group of non-drug users. Participants were recruited from drug addiction clinics and camps in Kashan city, Iran, who were using drugs continuously for more than 1 year. Control group was recruited from companions of the patients with no drug use history. In the investigated groups of drug users, the highest blood-lead level (BLL) concentrations were observed in the opioid group (mean 37.57 µg/dL) with almost 3.7 times higher than in the control group (mean 3.39 µg/dL). In the methamphetamine group, type of occupation had the significant association with BLL concentrations. The positive correlation was revealed in the opioid and methadone groups for BLL concentrations and the duration of drug usage. In the opioid group, the highest BLL concentrations were observed among users who used both methods of drug use: smoking and eating. Also, several behavioral and life-style factors were identified which influence the blood-lead concentration in the drug users. The results of our study revealed that the BLL concentrations in investigated drug users' groups were significantly higher than in the control group (P < 0.001). That can be related with the Pb contents in illicitly used drugs. Apart other adverse health effects, long-term illicit drug use might cause to lead poisoning.
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Affiliation(s)
- Amir Ghaderi
- Department of Addiction Studies, School of Medical and Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Hossein Khoshakhlagh
- Department of Occupational Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
| | - Agnieszka Gruszecka-Kosowska
- Department of Environmental Protection, Faculty of Geology, Geophysics and Environmental Protection, AGH University of Krakow, Al. Mickiewicza 30, 30-059, Krakow, Poland
| | - Fatemeh Alemi
- Department of Toxicology and Pharmacology, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pooya Hazegh
- Department of Psychiatry, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Aghaei
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Nader Molavi
- Department of Addiction Studies, School of Medical and Clinical Research Development Unit-Matini/Kargarnejad Hospital, Kashan University of Medical Sciences, Kashan, Iran
| | - Mojtaba Mahdavi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Neda Vahed
- Department of Addiction Studies, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Ghadami Dehkohneh
- Department of Pharmacy, Acharya BM Ready College of Pharmacy, Rajive Gandhi University of Health Sciences, Bangalore, Karnataka, India
| | | | - Darpan Das
- Department of Environment and Geography, University of York, York, UK
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Karsinti E, Vorspan F, Therribout N, Icick R, Bloch V, Fortias M, Piani K, Romo L. A specific cognitive behavioral group therapy program for stimulant use disorder. Front Psychiatry 2022; 13:1031067. [PMID: 36532161 PMCID: PMC9748415 DOI: 10.3389/fpsyt.2022.1031067] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/02/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Stimulant use is an important health issue. In the US in 2018, 2.8% of males and 1.5% of females older than 18 had used cocaine in the preceding 12 months. OBJECTIVE To intervene in a specific targeted group of Stimulant Use Disorder (SUD) patients according to CBT and relapse prevention theories, and to determine the program's feasibility and attendance. METHOD Stimulant Use Disorder patients in addiction care were evaluated for addictive, psychological and psychiatric dimensions at baseline and conclusion in a 9-session CBT group program with several themes: define SUD, enhance motivation, involve close companions, cope with craving, decline a proposal, solve problems, invite expert patients, invest time and money, and review content. RESULTS In total, 41 patients attended at least one session. They were mainly poly dependent, primarily cocaine users. Sixty percent of the population also suffered from another psychiatric comorbidity. Median attendance for participants was 7/9 sessions. CONCLUSION A specific targeted CBT group for stimulant dependent highly comorbid patients is feasible. These findings suggest that peers should be included in addiction care services.
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Affiliation(s)
- Emily Karsinti
- Clinique Psychanalyse Développement, Unités de Formation et de Recherche Sciences Psychologiques et Sciences de l'Education, Université Paris Nanterre, Nanterre, France.,Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France.,INSERM U1144 Variabilité de Réponse aux Psychotropes, Paris, France.,FHU Network of Research in Substance Use Disorders, Paris, France
| | - Florence Vorspan
- Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France.,INSERM U1144 Variabilité de Réponse aux Psychotropes, Paris, France.,FHU Network of Research in Substance Use Disorders, Paris, France.,Université Sorbonne Paris Cité, Paris, France
| | - Norman Therribout
- Clinique Psychanalyse Développement, Unités de Formation et de Recherche Sciences Psychologiques et Sciences de l'Education, Université Paris Nanterre, Nanterre, France.,Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France.,INSERM U1144 Variabilité de Réponse aux Psychotropes, Paris, France.,FHU Network of Research in Substance Use Disorders, Paris, France
| | - Romain Icick
- Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France.,INSERM U1144 Variabilité de Réponse aux Psychotropes, Paris, France.,FHU Network of Research in Substance Use Disorders, Paris, France.,Université Sorbonne Paris Cité, Paris, France
| | - Vanessa Bloch
- Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France.,INSERM U1144 Variabilité de Réponse aux Psychotropes, Paris, France.,FHU Network of Research in Substance Use Disorders, Paris, France.,Université Sorbonne Paris Cité, Paris, France
| | - Maeva Fortias
- Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France.,INSERM U1144 Variabilité de Réponse aux Psychotropes, Paris, France.,FHU Network of Research in Substance Use Disorders, Paris, France
| | - Kristel Piani
- Hôpital Fernand Widal, Département Universitaire de Psychiatrie et d'Addictologie, Paris, France
| | - Lucia Romo
- Clinique Psychanalyse Développement, Unités de Formation et de Recherche Sciences Psychologiques et Sciences de l'Education, Université Paris Nanterre, Nanterre, France.,Hôpital Raymond-Poincaré, Garches, France
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