Substance Abuse and Addiction Commons^™

Data-Driven Analysis Of Drug And Substance Abuse Rates Across The Varying Regions In The United States Of America, Reem Saleh

University Honors Theses

Drugs and substance abuse is one of the leading causes of death for adolescents in the United States. The consequences of using these drugs are profound and can cause both damage to one's physical and psychological health. The rates of drug abuse in the United States continue to increase over the years. This paper analyzes the trends in rates of drug abuse in the four regions in the United States. It looks at the rates in cocaine, cigarettes, marijuana, and tobacco. A preliminary analysis was done to look at the trend in rates followed by an ARIMA time series model …

2022 Community Needs Assessment Of Klamath County Residential Services And Housing Needs, Karen Cellarius, Aliza Tuttle, Jennifer Blakeslee

Regional Research Institute for Human Services

The PSU Regional Research Institute for Human Services (RRI) was asked by Klamath Basin Behavioral Health (KBBH) and the Oregon Health Authority (OHA) to conduct a community-wide needs assessment focusing on residential services and housing needs for populations that (1) Have behavioral health needs, and (2) Identify with a community experiencing inequities in access to health care resources.

The assessment was conducted in collaboration with KBBH and other community partners. Data sources included key informant interviews, written surveys of individuals impacted by mental health challenges and/or housing needs, and focus groups with representatives from underserved communities in Klamath County, Oregon. …

Tools For Addressing Intimate Partner Violence And Suicide Risk: Lessons Learned From Oha’S Covid-19 Emergency Response For Suicide Prevention Grant, Karen Cellarius, Aliza Tuttle, Lea Sevey

Regional Research Institute for Human Services

In August 2020, the Oregon Coalition Against Domestic and Sexual Violence (OCADSV), the Oregon Health Authority (OHA), and Portland State University’s Regional Research Institute for Human Services (PSU RRI) began an 18-month collaboration to strengthen support for domestic violence and mental health agencies during COVID-19. As part of this grant, six domestic violence advocacy organizations around Oregon were able to place co-located advocates with their mental health partner agencies for services and cross-training. The content of this booklet is another product of this collaboration.

Predictors Of Opioid And Alcohol Pharmacotherapy Initiation At Hospital Discharge Among Patients Seen By An Inpatient Addiction Consult Service, Honora Englander, Caroline King, Christina Nicolaidis, Devin Collins, Alisa Patten, Jessica Gregg, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

Background:

Medications for opioid use disorder (MOUD) and alcohol use disorder (MAUD) are effective and under-prescribed. Hospital-based addiction consult services can engage out-of-treatment adults in addictions care. Understanding which patients are most likely to initiate MOUD and MAUD can inform interventions and deepen understanding of hospitals’ role in addressing substance use disorders (SUD).

Objective:

Determine patient- and consult-service level characteristics associated with MOUD/MAUD initiation during hospitalization.

Methods:

We analyzed data from a study of the Improving Addiction Care Team (IMPACT), an interprofessional hospital-based addiction consult service at an academic medical center. Researchers collected patient surveys and clinical data from September …

Take Control: A Proposed Mental Health Treatment Program To Be Implemented In Youth Correctional Facilities Around Oregon Based On The Evidence-Based Target Program, Zoey S. Rochefort

OHSU-PSU School of Public Health Annual Conference

70% of youth in state and local juvenile justice systems exhibit symptoms of one or more mental health disorders and are not receiving adequate treatment. Currently, in Oregon, there is no mental health-screening requirement for youth admitted into detention centers or correctional facilities. Though this doesn’t mean kids never get diagnosed, it does mean there is a large delay in time before treatment begins where they could be receiving care. The Take Control program is working to mitigate wasted time and improve mental health treatment for youth inmates through a seven-step treatment program that provides youth with steps and strategies …

Hospital-Based Services For Opioid Use Disorder: A Study Of Supply-Side Attributes, Kelsey Caroline Priest

Dissertations and Theses

The United States (U.S.) is in the midst of an opioid overdose epidemic. In the U.S., overdose deaths related to opioid exposure are the leading cause of accidental death, yet life-saving treatments, such as methadone or buprenorphine (opioid agonist therapy [OAT]), are underused. OAT underused is due, in part, to complex regulatory and health services delivery environments. Public health officials and policymakers have focused on expanding OAT access in the community (e.g. office-based buprenorphine treatment, and opioid treatment programs); however, an often-overlooked component of the treatment pathway is the acute care delivery setting, in particular hospitals.

Opioid use disorder (OUD)-related …

Impacts Of An Opioid Overdose Prevention Intervention Delivered Subsequent To Acute Care, Caleb J. Banta-Green, Phillip O. Coffin, Joseph O. Merrill, Jeanne M. Sears, Chris Dunn, Norbert D. Yanez, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.

Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting …

Trace Amine-Associated Receptor Gene Polymorphism Increases Drug Craving In Individuals With Methamphetamine Dependence, Jennifer M. Loftis, Michael Lasarev, Xiao Shi, Jodi Lapidus, Aaron Janowsky, William Hoffman, Marilyn Huckans

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Methamphetamine (MA) is a potent agonist at the trace amine-associated receptor 1 (TAAR1). This study evaluated a common variant (CV) in the human TAAR1 gene, synonymous single nucleotide polymorphism (SNP) V288V, to determine the involvement of TAAR1 in MA dependence.

Methods: Participants (n = 106) with active MA dependence (MA-ACT), in remission from MA dependence (MA-REM), with active polysubstance dependence, in remission from polysubstance dependence, and with no history of substance dependence completed neuropsychiatric symptom questionnaires and provided blood samples. In vitro expression and function of CV and wild type TAAR1 receptors were also measured.

Results: The V288V polymorphism …

Exploring The Association Of Victimization And Alcohol And Marijuana Use Among American Indian Youth Living On Or Near Reservations: A Mixed Methods Study, Lindsay Nicole Merritt

Dissertations and Theses

Adolescent substance use research has yet to consider victimization as a potential risk factor contributing to alcohol and marijuana use among American Indian youth living on or near reservations, despite the presence of traumatic experiences, childhood adverse events, racism, and discrimination. Contribution to this lack of attention may be due to little being known about American Indian youth victimization. Even less is known about its association with alcohol and marijuana use in general and for those youth living on or near reservations in particular.

This study utilizes mixed methods with a nationally representative sample of American Indian youth living on …

Lessons Learned From The Implementation Of A Medically Enhanced Residential Treatment (Mert) Model Integrating Intravenous Antibiotics And Residential Addiction Treatment, Talitha Wilson, Devin Collins, Elena Phoutrides, Melissa B. Weimer, P. Todd Korthuis, Jessica Calcagni, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

BACKGROUND: Hospitalizations for severe infections associated with substance use disorder (SUD) are increasing. People with SUD often remain hospitalized for many weeks instead of completing intravenous antibiotics at home; often, they are denied skilled nursing facility admission. Residential SUD treatment facilities are not equipped to administer intravenous antibiotics. We developed a medically enhanced residential treatment (MERT) model integrating residential SUD treatment and long-term IV antibiotics as part of a broader hospital-based addiction medicine service. MERT had low recruitment and retention, and ended after six months. The goal of this study was to describe the feasibility and acceptability of MERT, to …

Gender And Prescription Painkiller Misuse: Findings From The 2011 National Survey On Drug Use And Health, Robin Jo Clough

Dissertations and Theses

This study examines the effects of gender and social bonds on the experience of prescription painkiller misuse for men and women. The theoretical framework for the project is Travis Hirschi's social control theory (1969), and the social bond elements of attachment, commitment, involvement, and belief, which emphasizes the importance of these bonds in creating a "stake in conformity" for the individual, leading to acceptance of social norms and desistence from deviance. This theory, however, is relatively silent with regard to gender differences and was developed to examine delinquency in an all male sample of adolescents. The elements of this theory …

Strengthening A Social Justice Lens For Addictions Practice: Exploration, Reflections, Possibilities And A Challenge To Our Shared Work To Promote Recovery Among The Most Vulnerable, Laura Burney Nissen

School of Social Work Faculty Publications and Presentations

Addiction is commonly conceptualized as a personal problem, a family problem, a neighborhood problem, a community problem, and even a social problem. But how might addiction be understood as a social justice problem?

Substance abuse problems, addictions, and addiction treatment and the related preparation of professionals to fill its treatment ranks exist within an ideological and political infrastructure. Issues of social justice are often conspicuously absent as a primary consideration of the experience of people seeking treatment (acknowledging the treatment gap that impacts some people more than others), for communities ravaged by addiction (acknowledging that some communities are affected more …

Decreases In Self-Reported Alcohol Consumption Following Hiv Counseling And Testing At Mulago Hospital, Kampala, Uganda, Judith A. Hahn, Robin Fatch, Rhoda K. Wanyenze, Steven Baveewo, Moses R. Kamya, David Bangsberg, Thomas J. Coates

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT.

Methods: We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at …

Trauma-Informed Research And Planning: Understanding Government And Urban Native Community Partnerships To Addressing Substance-Exposed Pregnancies In Portland, Or, Amanda Mercier

Dissertations and Theses

In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given …

Alcohol And Drug Prevention, Intervention, And Treatment Literature: A Bibliography For Best Practices, Laura Burney Nissen

School of Social Work Faculty Publications and Presentations

Addictions remain a persistent challenge to mental health practice. There is a need for mental health educators, students, and practitioners to be aware of, critique, contribute to, and, where relevant, utilize emerging scholarly literature to inform their intervention strategies. This comprehensive addictions bibliography draws from a wide variety of sources, perspectives, and ideologies to hasten the rate at which academics and practitioners can more meaningfully participate in this rapidly developing field of practice.

Patient And Provider Comfort Discussing Substance Use, Moira Ray, Mary Catherine Beach, Christina Nicolaidis, Dongseok Choi, Somnath Saha, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: Substance use is a prevalent issue in primary care with wide-reaching implications, particularly for the care of HIV-infected patients. This analysis identified patient and provider characteristics associated with high comfort discussing substance use in HIV primary care clinics using multivariable logistic regression.

METHODS: A total of 413 patients and 44 providers completed surveys on their comfort discussing substance use. Additional independent variables from surveys included demographics, drug and alcohol use, self-efficacy, and activation for patients. Providerlevel data included demographics, training, practice descriptors, and stress levels.

RESULTS: The majority of patients (76%) and providers (73%) reported high comfort. …

System Dynamics Modeling Of Prescription Opioid Pain Reliever Abuse, Alexandra Nielsen

Systems Science Friday Noon Seminar Series

The nonmedical use of prescription opioid pain relievers and associated overdose deaths have been labeled an epidemic by the Centers of Disease Control and Prevention. While these medicines play an important role in the treatment of pain, the benefits of opioids for the treatment of pain need to be balanced against these very real risks. Alex has been working closely with Professor Wayne Wakeland, Teresa Schmidt, and Dr. Dennis McCarty (OHSU) to create a dynamic systems-level model of opioid use, abuse, and diversion in order to give context to current research in this area and to provide a better understanding …

Oral Health Knowledge, Attitudes, And Behaviors: Investigation Of An Educational Intervention Strategy With At-Risk Females, Susan Romano Rustvold

Dissertations and Theses

A self-perpetuating cycle of poor health literacy and poor oral health knowledge and behavior affects approximately 90 million people in the United States, most especially those from low-income groups and other at-risk populations such as those with addiction. Poor oral health can result from lack of access to regular preventive dental appointments, lack of access to restorative care when dental diseases are treatable, and low oral health knowledge that leads to poor oral health self-care behaviors. In addition, patients' dental anxiety can impede care, because highly anxious people often avoid dental appointments. To address these issues, this inquiry examined oral …

Reducing Overdose Deaths Associated With Pharmaceutical Opioid Treatment Of Chronic Pain: Analyzing Interventions With A System Dynamics Model, Wayne Wakeland

Systems Science Friday Noon Seminar Series

A dramatic rise in the use pharmaceutical opioids to treat pain, and the associated opioid abuse and addiction, has created a substantial public health problem in the United States. Effective tools and interventions are needed to identify policies to reduce opioid abuse, addiction, and overdose deaths. A system dynamics model is used to identify policy interventions that will reduce the prevalence of adverse outcomes attributed to pharmaceutical opioids. Results suggest that it will be difficult to minimize negative outcomes without adversely affecting the degree to which chronic pain patients can access pharmaceutical treatment, and also indicate the importance of the …

Adolescent Daily Cigarette Smoking: Is Rural Residency A Risk Factor?, M. Nawal Lutfiyya, K. K. Shah, M. Johnson, R. W. Bales, I. Cha, C. Mcgrath, L. Serpa, Martin S. Lipsky

Community Health Faculty Publications and Presentations

Introduction: Daily cigarette smoking among US adolescents remains a significant public health problem. Understanding risk is important in order to develop strategies to reduce this type of tobacco use. Purpose: The primary objective of this research was to examine whether rural residency is an independent risk factor for being a daily smoker among adolescents ages 12 to 18 years.

Methods: This is a cross-sectional study where univariate, bivariate, and multivariate analyses were performed on a merged 1997- 2003 Youth Risk Behavior Surveillance System dataset to determine whether rural residence was a significant risk factor for daily cigarette smoking, after adjusting …

Toward Predicting Completion Of Substance Abuse Treatment, Rebecca Lee Bragg

Dissertations and Theses

This investigation attempts to identify factors which influence whether or not someone is likely to drop out of a chemical dependency treatment program. Dropping out is defined as someone who leaves treatment against medical advice.

The subjects were patients from a private, non-profit, medically based, residential program. Nine demographic characteristics were abstracted from the charts on file for the patients at the treatment center. Two groups of 45 patients each were selected from the inpatient population. One group, the Completed Treatment group, comprised patients who had completed the 28 day program. The second group, the AMA Discharge group, comprised patients …

A Study Of The Identification And Referral Components Of Substance Abuse Intervention Programs In Washington State's Public High Schools, Todd C. Herberg

Dissertations and Theses

This multiple-case study investigated the characteristics of successful high school substance abuse intervention programs.

The unit of analysis for this multiple-case study is the public high school substance abuse intervention program of twelve selected Washington State high schools. Sub-units of analysis within the multiple-case study include the various components and attributes of a substance abuse intervention program. Examples of these sub-units include: formal drug education policies; staff training on substance abuse issues and intervention skills; formal curriculum and student instruction; central office administration and building administration support for the program; community support for the program, staff time to administer the …

Adolescent Chemical Substance Use And Abuse : Environmental And Personal Determinants, And A Proposed Model For Group Intervention, Lindy Louise Low Lecoq

Dissertations and Theses

The purpose of the literature review is to identify consistent patterns regarding adolescent use and abuse of chemical substances, especially alcohol and marijuana. Acute physical, cognitive and social effects of alcohol and marijuana use are outlined, and environmental and personal determinants of drug use and abuse are examined. Methods of prevention and intervention are discussed and, from the research findings, a model group counseling program designed for the school setting is proposed. Adolescent use of both marijuana and alcohol is found to be modal by age 16-17. The physical, cognitive and social effects are pervasive and especially damaging to chronic …

The Portland, Oregon Asap : An Evaluation Of Treatment Effectiveness, Joan M. Wildebush Berry, Stefani K. Cuda, Judi L. Edwards, Mary E. Ericson, Emilie Ford Frisbee, Steve Ernest Hand, Mary Anne Hannibal, Laurel M. Myers, Sharon Lee Perry, Loree Richards, Barbara Burns Schmidtke, Stephen Walker Voris, Barbara M. Westby

Dissertations and Theses

The Alcohol Safety Action Program (ASAP), in accordance with its goals and directives, determined, in 1980, the need for an evaluation of its services. In response to that need, the present study was conducted between April and October, 1980.

The initial step in this evaluation is a review of the relevant literature. The review includes literature in the areas of: treatment evaluation methodology, follow-up studies of alcohol treatment, and management of drunken drivers. In addition, the history and current organization of the Portland ASAP are discussed.

The study employs a one group pretest-posttest design and utilizes the Oregon Quality of …

Lifespring's Basic Seminar: An Evaluation Study, Patricia A. Percival

Dissertations and Theses

This was a three part study designed to evaluate the effectiveness of the Basic Seminar, a five-day personal growth training designed and presented by Lifespring, Inc. The instrument used in this study was the Personal Orientation Inventory (POI) published in 1963 by Everett L. Shostrom and copyrighted by Edits Publishing Co., San Diego, CA. This inventory consists of 150 two-choice comparative value and behavior judgments. Two basic scales measure personal orientation, inner directed support and time competence. Ten subscales measure different conceptually important elements of self-actualizing. The items are scored twice, once for the two basic scales and second for …

Marital Status As A Discriminator And Treatment Variable Among Female Alcoholics, James C. Knapp

Dissertations and Theses

In this study marital status and the alcoholism or non-alcoholism of the spouse are hypothesized to be important factors affecting the female alcoholic's personality and treatability.

The Application And Evaluation Of Goal Attainment Scaling To The Janis Drug Treatment Program, Steven W. Kilber, Carol E. Swanson

Dissertations and Theses

Janis is a residential drug treatment program for drug abusers between the ages of twelve and eighteen deigned to rehabilitate the participants. Five homes, each staffed by two trained residential coordinators and one student accommodate a total of thirty patients at a time. The treatment program consists of daily house meetings led by the residential coordinators, one group therapy session per week led by a psychiatric social worker, and individual therapy sessions with a psychiatrist as needed, as well as regular consultation with a psychologist and psychiatrist. The adolescents enrolled in the program are referred from a variety of agencies, …