Medicine and Health Sciences Commons^™

Listening To Voices In Appalachia: Gathering Wisdom From The Field About Substance-Abuse Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

New qualitative data collected through six regional community-based listening sessions and community meetings are presented that describe elements of the Appalachian Regional Commission’s Recovery Ecosystem Model. These data informed the Model, which was used in formulating the new ARC Recovery-to-Work initiative. Input was intentionally solicited from multiple sectors, including persons recovering from substance abuse disorder, treatment and recovery service providers, workforce development agencies, employers, and community advocacy groups.

Responding To Appalachian Voices: Steps In Developing Substance-Use Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

A description is presented of the four-step process used by the Appalachian Regional Commission to develop a new Recovery to Work initiative. The Commission identified, defined, and described issues facing individuals who complete substance abuse disorder treatment and who seek reentry into the workforce. Key elements were identified for resources and supports to develop and maintain community-based substance abuse recovery ecosystems. The steps included conceptualization, data collection, analysis, and review to formulate recommendations for program and policy development. The full process of development was accomplished in twelve months.

Co-Prescription Network Reveals Social Dynamics Of Opioid Doctor Shopping, Brea L. Perry, Kai Cheng Yang, Patrick Kaminski, Meltem Odabas, Jaehyuk Park, Michelle M. Martel, Carrie B. Oser, Patricia R. Freeman, Yong-Yeol Ahn, Jeffery C. Talbert

Psychology Faculty Publications

This paper examines network prominence in a co-prescription network as an indicator of opioid doctor shopping (i.e., fraudulent solicitation of opioids from multiple prescribers). Using longitudinal data from a large commercially insured population, we construct a network where a tie between patients is weighted by the number of shared opioid prescribers. Given prior research suggesting that doctor shopping may be a social process, we hypothesize that active doctor shoppers will occupy central structural positions in this network. We show that network prominence, operationalized using PageRank, is associated with more opioid prescriptions, higher predicted risk for dangerous morphine dosage, opioid overdose, …

A Qualitative Analysis Of Gabapentin Misuse And Diversion Among People Who Use Drugs In Appalachian Kentucky, Rachel Vickers Smith, Elaine M. Boland, April M. Young, Michelle R. Lofwall, Alexa Quiroz, Michele Staton, Jennifer R. Havens

Center on Drug and Alcohol Research Faculty Publications

Gabapentin, an anticonvulsant and analgesic for postherpetic neuralgia, has been thought to have no abuse potential despite numerous published reports to the contrary. Gabapentin has been linked with impaired driving and opioid use, highlighting the need to more fully understand its risk profile. Thirty-three individuals reporting recent nonmedical use of gabapentin were recruited from two ongoing longitudinal studies of drug users in Appalachian Kentucky to participate in focus groups. Four sessions were held (two in the community and two in jail settings), during which participants responded to questions regarding their personal experiences with gabapentin misuse. Focus group participants were similar …

Accuracy Of Name And Age Data Provided About Network Members In A Social Network Study Of People Who Use Drugs: Implications For Constructing Sociometric Networks, April M. Young, Abby E. Rudolph, Amanda E. Su, Lee King, Susan Jent, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Purpose—Network analysis has become increasingly popular in epidemiologic research, but the accuracy of data key to constructing risk networks is largely unknown. Using network data from people who use drugs (PWUD), the study examined how accurately PWUD reported their network members’ (i.e., alters’) names and ages.

Methods—Data were collected from 2008 to 2010 from 503 PWUD residing in rural Appalachia. Network ties (n=897) involved recent (past 6 months) sex, drug co-usage, and/or social support. Participants provided alters’ names, ages, and relationship-level characteristics; these data were cross-referenced to that of other participants to identify participant-participant relationships and to determine …

Plant Expression Of Cocaine Hydrolase-Fc Fusion Protein For Treatment Of Cocaine Abuse, Guojun Wang, Ting Zhang, Haifeng Huang, Shurong Hou, Xiabin Chen, Fang Zheng, Chang-Guo Zhan

Molecular Modeling and Biopharmaceutical Center Faculty Publications

BACKGROUND: A recently reported cocaine hydrolase (CocH3) fused with fragment crystallizable (Fc) region of human immunoglobulin G1, denoted as CocH3-Fc, is known as a promising therapeutic candidate for the treatment of cocaine overdose and addiction. A challenge for practical therapeutic use of this enzyme exists in the large-scale protein production and, therefore, it is interesting to identify a low-cost and feasible, sustainable source of CocH3-Fc production.

RESULTS: CocH3-Fc was transiently expressed in plant Nicotiana benthamiana leaves. The plant-expressed protein, denoted as pCocH3-Fc, was as active as that expressed in mammalian cells both in vitro and in vivo. However, compared to …

Estimated Probability Of Becoming A Case Of Drug Dependence In Relation To Duration Of Drug-Taking Experience: A Function Approach, Olga A. Vsevolozhskaya, James C. Anthony

Olga A. Vsevolozhskaya

Measured as elapsed time from first use to dependence syndrome onset, the estimated 'induction interval' for cocaine clearly is short relative to the cannabis interval, but little is known about risk of becoming dependent when use persists. Published estimates for this facet of drug dependence epidemiology are from life histories elicited years after first use. To improve estimation, we turn to new data from nationally representative samples of newly incident drug users identified via probability sampling and confidential computer-assisted self-interviews for the National Surveys on Drug Use and Health, 2004-2013. Standardized modules assess first and most recent use, and dependence …

Confidence Interval Estimation In R-Das, Olga A. Vsevolozhskaya, James C. Anthony

Olga A. Vsevolozhskaya

Background

Roughly 25 years ago, the United States National Institute on Drug Abuse (US NIDA) initiated the creation of public use datasets for its National Household Survey on Drug Abuse, since re-named the National Survey on Drug Use and Health (NSDUH). The Substance Abuse and Mental Health Services Administration (SAMHSA), which assumed responsibility for the survey in 1992, has continued and expanded this effort to make the survey data available to researchers. During 2012, SAMHSA created a “Restricted-Use Data Analysis System” (R-DAS) to provide researchers with the capability to create tabulations using restricted NSDUH variables not otherwise available on the …

From Drug Use To Dependence: A Multiparametric Approach, Olga A. Vsevolozhskaya, James C. Anthony

Olga A. Vsevolozhskaya

One of the hallmarks of a drug dependence (DD) process is an escalation in rate of drug self-administration (DSA). We seek to extend current biostatistical approaches for epidemiological research on drug dependence processes via an investigation of a four-parameter dose-effect curve (DEC).

Confidence Interval Estimation In R-Das: State-Level Estimates For Extra-Medical Use Of Prescription Pain Relievers, Olga A. Vsevolozhskaya, James C. Anthony

Olga A. Vsevolozhskaya

The specific methodological aims of our research are: 1) to clarify statistical inference procedures used by R-DAS to produce confidence interval estimates; 2) to review a simple solution to some of the research questions not currently addressed by R-DAS (i.e., with respect to tests of significance); and 3) to describe how in certain situations the percentages and the corresponding standard errors, which are suppressed from the R-DAS output due to the confidentiality concerns can be estimated “by hand”.

High-Activity Mutants Of Human Butyrylcholinesterase For Cocaine Abuse Treatment, Liu Xue

Theses and Dissertations--Pharmacy

Cocaine is a widely abused drug without an FDA-approved medication. It has been recognized as an ideal anti-cocaine medication to accelerate cocaine metabolism producing biologically inactive metabolites via a route similar to the primary cocaine-metabolizing pathway, i.e. butyrylcholinesterase (BChE)-catalyzed hydrolysis. However, the native BChE has a low catalytic activity against cocaine. We recently designed and discovered a set of BChE mutants with a high catalytic activity specifically for cocaine. An ideal, therapeutically valuable mutant of human BChE should have not only a significantly improved catalytic activity against cocaine, but also certain selectivity for cocaine over neurotransmitter acetylcholine (ACh) such …

Student-Athletes And Drug Abuse Policies: A Study Of Drug Abuse Policies Of Athletics Departments In A Major Intercollegiate Athletics Conference, Jennifer Hale

MPA/MPP/MPFM Capstone Projects

No executive summary.

Influence Of Prescription Drug Monitoring Programs On Acetaminophen-Related Liver Toxicity, Aaron Barcelo

MPA/MPP/MPFM Capstone Projects

No executive summary.