Medicine and Health Sciences Commons^™

Children’S Cancer Pain In A World Of The Opioid Epidemic: Challenges And Opportunities, Michelle Fortier, Sun Yang, Michael T. Phan, Daniel Tomaszewski, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

The opioid crisis in the United States has grown at an alarming rate. Children with cancer are at high risk for pain, and opioids are a first‐line treatment in this population. Accordingly, there is an urgent need to optimize pain management in children with cancer without contributing to the opioid crisis. This report details opportunities for this optimization, including clinical practice guidelines, comprehensive approaches to pain management, mobile health, and telemedicine. It is vital to balance appropriate use of analgesics with efforts to prevent misuse in order to reduce unnecessary suffering and minimize unintended harms.

A Systematic Review Of Gambling-Related Findings From The National Epidemiologic Survey On Alcohol And Related Conditions, Jasmine M.Y. Loo, Shane W. Kraus, Marc N. Potenza

Psychology Faculty Research

Background and aims: This systematic review analyzes and summarizes gambling-related findings from the nationally representative US National Epidemiological Survey on Alcohol and Related Conditions (NESARC) data. Methods: Systematic literature searches in accordance with PRISMA guidelines found 51 eligible studies that met inclusion criteria. Eight studies utilized both Waves 1 and 2 NESARC data, and selection of sample sizes varied from 185 to 43,093 individuals, consistent with specified research objectives of each study. Results: The prevalence of lifetime pathological gambling was 0.42% (0.64% among men, 0.23% among women), while past-year prevalence was 0.16%. Pathological gambling rates were generally higher in populations …

Downeast Maine Mat Expansion Project: Year 1 Data Summary, Mary Lindsey Smith Phd, Olivia Dooley Mpa, Evelyn Ali Bs

Substance Use Research & Evaluation

This report summarizes the Year 1 activities of the Healthy Acadia Downeast Maine MAT Expansion Project. Through a collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network and Downeast Substance Use Response Coalition, the project utilized multiple evidence-based strategies to combat opioid use disorder (OUD) in Downeast Maine.

Key findings focused on:

• capacity building,
• stakeholder engagement,
• organizational and peer support,
• payment and reimbursement issues,
• the creation of low-barrier access to MAT,
• barriers, including stigma, to MAT
• patient-centered approaches
• auxiliary recovery supports

For more information, please contact M. LIndsey Smith, PhD at m.lindsey.smith@maine.edu

We Need To Change The Language We Use To Describe Individuals With Substance Use Issues, Austin Mcneill Brown

Population Health Research Brief Series

People with substance use disorders (SUDs) are highly stigmatized worldwide. This research brief describes the results from several studies on unconscious bias and negative language used to describe individuals with SUDs.

Trends And Associated Factors Of Use Of Opioid, Heroin, And Cannabis Among Patients For Emergency Department Visits In Nevada: 2009–2017, Pearl C. Kim, Ji Won Yoo, Chris R. Cochran, Seong Min Park, Sungyoun Chun, Yong-Jae Lee, Jay J. Shen

School of Medicine Faculty Publications

To examine trends and contributing factors of opioid, heroin, and cannabis-associated emergency department (ED) visits in Nevada. The 2009 to 2017 Nevada State ED database (n = 7,950,554 ED visits) were used. Use of opioid, heroin, and cannabis, respectively, was identified by the International Classification of Diseases, 9th & 10th Revisions. Three multivariable models, one for each of the 3 dependent variables, were conducted. Independent variables included year, insurance status, race/ethnicity, use of other substance, and mental health conditions. The number of individuals with opioid, heroin, cannabis-associated ED visits increased 3%, 10%, and 23% annually from 2009 to 2015, particularly …

Post-Overdose Interventions Triggered By Calling 911: Centering The Perspectives Of People Who Use Drugs (Pwuds), Karla D. Wagner, Robert W. Harding, Richard Kelley, Brian Labus, Silvia R. Verdugo, Elizabeth Copulsky, Jeanette M. Bowles, Maria Luisa Mittal, Peter J. Davidson

Environmental & Occupational Health Faculty Publications

Background Opioid overdose deaths have increased exponentially in the United States. Bystander response to opioid overdose ideally involves administering naloxone, providing rescue breathing, and calling 911 to summon emergency medical assistance. Recently in the US, public health and public safety agencies have begun seeking to use 911 calls as a method to identify and deliver post-overdose interventions to opioid overdose patients. Little is known about the opinions of PWUDs about the barriers, benefits, or potential harms of post-overdose interventions linked to the 911 system. We sought to understand the perspectives of PWUDs about a method for using 911 data to …

Enhancing Timeliness Of Drug Overdose Mortality Surveillance: A Machine Learning Approach, Patrick J. Ward, Peter J. Rock, Svetla Slavova, April M. Young, Terry L. Bunn, Ramakanth Kavuluru

Kentucky Injury Prevention and Research Center Faculty Publications

BACKGROUND: Timely data is key to effective public health responses to epidemics. Drug overdose deaths are identified in surveillance systems through ICD-10 codes present on death certificates. ICD-10 coding takes time, but free-text information is available on death certificates prior to ICD-10 coding. The objective of this study was to develop a machine learning method to classify free-text death certificates as drug overdoses to provide faster drug overdose mortality surveillance.

METHODS: Using 2017–2018 Kentucky death certificate data, free-text fields were tokenized and features were created from these tokens using natural language processing (NLP). Word, bigram, and trigram features were created …

There Are Costs From Spending Too Much Time On Social Media, Sean Withington, Alexandra Punch

Population Health Research Brief Series

Ninety percent of young adults in the U.S. are on social media, with the majority using these sites at least once a day. This issue brief explores how excessive use of social media can lead to addiction, loneliness, depression, decreased self-esteem, and unfulfilling relationships.

The Importance Of Shared Language In Rural Behavioral Health Interventions: An Exploratory Linguistic Analysis, Michele Staton, Jennifer Cramer, Robert Walker, Claire Snell-Rood, Athena Kheibari

Behavioral Science Faculty Publications

A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. …

Employer Perceptions Of Addiction Recovery And Hiring Decisions, Haley Henderson, Valerie Hoots, Joseph Barnet, Andrea D. Clements

ETSU Faculty Works

Abstract Addiction to drugs and alcohol is a widespread, and ever-growing problem in American society today. Individuals who undergo treatment for their addiction often find it difficult to gain employment due to employers' negative perceptions of addiction. Previous research has found that many employers have a stigma of those in addiction recovery. However, little research has been done to determine if these stigmas affect hiring decisions. Drug and alcohol misuse are prominent in the Appalachian area, which presents an issue for employers in the area who maintain a drug-free work place or who have a stigma of those in addiction …

Identifying Intimate Partner Violence: A Review Of Three Measures For Implementation In Primary Care Settings, Matthew W. Henninger, Andrea D. Clements

ETSU Faculty Works

No abstract provided.

Adverse Effects Of Opioid Dependency On Central And Peripheral Aspects Of The Neuromuscular System, Cindy Yang

Student Publications

Prevalence of chronic pain and health care costs have caused an escalation of opioid dependency. The current national crisis involving opioid dependency and drug overdose are growing problems that need to be addressed. Since 2000, there has been an increased awareness of pain relief; more people are looking at alternative ways to induce pain relief and stricter guidelines in prescription of addictive opioid medications (Manchikanti et al., 2012). Despite growing efforts, opioid use and dependency has risen dramatically in the past few years; since 1999, there has been an increase in the number of opioids sold and opioid-related deaths in …

Examining The Effect Of A Hypothetical Safe Injection Facility On Hiv And Hcv Transmission Rates In Kent County, Michigan, Trevor Ditmar

McNair Scholars Manuscripts

Previous literature has established that increases in prescription opioid misuse has resulted in similar increases in injection drug use (IDU), collectively referred to as the “opioid epidemic” in the US. Due to this surge in IDU, incidence of Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) are on the rise in many regions. Research conducted in Canada and elsewhere has supported the use of Safe Injection Facilities (SIFs) and Needle Syringe Programs (NSPs) to mollify disease incidence, but only NSPs are operating in the US despite SIFs having been in use in Canada for several decades. As little research has …

Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy

Independent Study Project (ISP) Collection

Research question – What is the current landscape of drug abuse in Chile and how has the state attempted to address this problem?

Objectives – The objectives of the paper were to characterize drug use patterns in Chile since 1994, revise drug abuse services, and offer possible improvements for the system of drug abuse treatment.

Background – Chile, despite being one of the most well economically-developed countries in South America, has some of the worst mental health indicators, one of these being drug abuse. Since 1994, use of alcohol and marihuana has increased, while use of cocaine products has remained …

Response To: How Should We Respond To Pregnancy And Substance Use?, Frank E. E. Vandervort, Vincent J. Palusci

Articles

We begin our reply by asking the reader to consider this typical case taken from Professor Vandervort’s current practice. It is one of several similar cases currently being handled by the clinic he works in and similar to many dozens—perhaps hundreds—of cases handled over the past 30 years.

To Protect And Provide For Children, Prenatal Substance Use Must Be Considered Abuse., Frank E. E. Vandervort, Vincent J. Palusci

Articles

The use of drugs and alcohol during pregnancy is harmful to the developing child. When children are born having been exposed to these substances, children’s protective services should uniformly substantiate child maltreatment in order to ensure that the child’s parent(s) and the child receive the treatment and services necessary to address the child’s immediate safety, protect the government’s compelling interest in the child’s welfare, and ensure the best long-term outcome for the child.

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operations Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

Frontal Alpha Asymmetry And Inhibitory Control Among Individuals With Cannabis Use Disorders, Alina Shevorykin, Lesia M. Ruglass, Robert D. Melara

Publications and Research

To better understand the biopsychosocial mechanisms associated with development and maintenance of cannabis use disorder (CUD), we examined frontal alpha asymmetry (FAA) as a measure of approach bias and inhibitory control in cannabis users versus healthy nonusers. We investigated: (1) whether FAA could distinguish cannabis users from healthy controls; (2) whether there are cue-specific FAA effects in cannabis users versus controls; and (3) the time course of cue-specific approach motivation and inhibitory control processes. EEG data were analyzed from forty participants (CUD (n = 20) and controls (n = 20)) who completed a modified visual attention task. Results showed controls …

Recent Trends, Current Research In Cyberpsychology: A Literature Review, Amarjit Kumar Singh, Pawan Kumar Singh

Library Philosophy and Practice (e-journal)

Cyberpsychology refers to the study of the mind and behavior in the context of interactions with technology. It is an emerging branch, which has focused on the psychological aspects connected to the increasing presence and usages of technology in modern lives. This paper traces recent advancement and trends of Cyberpsychology is an emerging domain of knowledge and goes on the give a literature review of the same. An analysis of the recent research and literature covering 300 most relevant research papers from the period of 2012 to 15, August 2019 was conducted to determine and shape the research pattern based …

"The Traps Started During My Childhood": The Role Of Substance Abuse In Women's Responses To Adverse Childhood Experiences (Aces), Breanna Boppre, Cassandra Boyer

Criminal Justice Faculty Publications

The gendered pathways perspective seeks to identify the biological, psychological, and social realities that lead to women’s law-breaking behavior. Prior research in this area demonstrates the link between women’s adverse childhood experiences (ACEs) and involvement in the criminal justice system later in life. The current study fills an important gap in the literature by providing a phenomenological description of the impacts ACEs had upon 19 community supervised women’s lives. Their stories illuminate the need to consider multiple forms of ACEs, from physical and sexual abuse to the death of a loved one. Interviewees’ most prevalent response to ACEs was substance …

Psychopathology And Hypersexuality Among Veterans With And Without Histories Of Alcohol‐Use Disorders, Jonathan Moisson, Marc N. Potenza, Steven D. Shirk, Rani A. Hoff, Crystal L. Park, Shane W. Kraus

Psychology Faculty Research

Background and Objectives: Little research has examined the clinical characteristics of U.S. post‐9/11 military veterans coping with alcohol problems. Specifically, we examined psychopathology and hypersexuality among male and female post‐9/11 veterans with and without a lifetime history of alcohol‐use disorders (AUDs). Methods: Using data from a baseline telephone interview and follow‐up web‐based survey, we examined frequencies of AUDs, mental health and addictive disorders, sexual behaviors, hypersexuality, and problematic use of pornography in a national convenience sample of 283 U.S. veterans. Results: Many (39.1%) veterans met lifetime criteria for AUDs. Bivariate associations revealed that veterans with lifetime AUDs met clinically significant …

Characterizing Participation And Perceived Engagement Benefits In An Integrated Digital Behavioral Health Recovery Community For Women: A Cross-Sectional Survey, Brenda Curtis, Brandon Bergman, Austin Brown, Jessica Mcdaniel

Faculty and Research Publications

Background: Research suggests that digital recovery support services (D-RSSs) may help support individual recovery and augment the availability of in-person supports. Previous studies highlight the use of D-RSSs in supporting individuals in recovery from substance use but have yet to examine the use of D-RSSs in supporting a combination of behavioral health disorders, including substance use, mental health, and trauma. Similarly, few studies on D-RSSs have evaluated gender-specific supports or integrated communities, which may be helpful to women and individuals recovering from behavioral health disorders. Objective: The goal of this study was to evaluate the SHE RECOVERS (SR) recovery community, …

Driving While High, Page D. Dobbs, Michael Smith, David T. Rolfe

All Faculty Scholarship for the College of Education and Professional Studies

As of May 2019, ten U.S. states and Washington DC have legalized non-medical/recreational use of cannabis. With increased access to legal marijuana across the country, some have raised concerns regarding unintended implications of these policies, such as the risk of motor vehicle crashes, which is the leading cause of mortality and injury among youth and young adults. Driving under the influence of marijuana is particularly concerning among young adults and college students, due to the increased level of substance use reported during the transition from high school to post-high school environments, such as college.

"Every Day I Think About Your Messages": Assessing Text Messaging Engagement Among Latino Smokers In A Mobile Cessation Program., Francisco Cartujano-Barrera, Evelyn Arana-Chicas, Mariana Ramírez-Mantilla, Jaime Perales, Lisa Sanderson Cox, Edward F. Ellerbeck, Delwyn Catley, Ana Paula Cupertino

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Mobile health interventions are a promising mode to address tobacco-related disparities among Latinos, the largest minority group and the highest users of text messaging technology. The purpose of this pilot study was to assess engagement in a smoking cessation intervention delivered via text message (Kick Buts) among Latino smokers.

Methods: We relied on a community-based recruitment strategy to enroll 20 Latino smokers in Kick Buts. Outcome measures included biochemically verified abstinence at 12 weeks, participant text messaging interactivity with the program, and satisfaction.

Results: Participants' mean age was 40.7 years old (SD=14.6). Most of the participants were male (70%), …

Nicotine Replacement Therapies To Decrease Withdrawal Symptoms And Improve Patient Experience, Cheryl Pawloski, Holly Stewart, Devon Gillis, Dena Whitesell, Maya Bulman, Christopher Racine, Raymond Serrano, Leslie Gatcombe-Hynes, Elizabeth Mullany, Amy Mcauliffe, Jayne Weisberg, Amy Sparks, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Operations Transformation

Smoking is one the leading causes of preventable death in the United States. Patient centered care revolves around encouraging patients to reduce their chances of preventable disease and death. To that end, nicotine replacement therapy (NRT) prescribed within 24 hours of hospital admission increases the chance of quitting and decreases the chance of nicotine withdrawal.

A pilot performance improvement project was initiated on two cardiac units at an academic tertiary medical center. The goal the project was to have NRT ordered within 24 hours of admission 100% of the time. Baseline metrics demonstrated admission NRT orders were below acceptable levels …

Understanding Opioid Users’ Views On Fentanyl Could Help Reduce Overdoses, Kate Mclean, Shannon M. Monnat, Khary Rigg, Glenn Sterner, Ashton Verdery

Population Health Research Brief Series

The opioid overdose crisis is a national public health emergency, made much worse in recent years by the widespread emergence of fentanyl – a highly potent synthetic opioid. This research brief summarizes the findings from their research conducted in southwestern Pennsylvania in 2017 and 2018. Results show that the majority of interviewees who use opioids are fearful of and want to avoid fentanyl and would utilize harm reduction strategies such as fentanyl test strips if they were made more widely available.

There Are Multiple And Geographically Distinct Opioid Crises In The U.S., Shannon M. Monnat

Population Health Research Brief Series

Rates of fatal drug overdose increased 250% in the U.S. between 1999 and 2017, due in large part to a massive surge in overdoses involving opioids. However, there is substantial geographic variation in fatal opioid overdoses, and prescription opioids, heroin, and fentanyl are differentially responsible for high overdose rates across different parts of the U.S. This research brief summarizes the findings from a study just published in the American Journal of Public Health. The study shows that there are at least four geographically distinct opioid overdose crises in the U.S.

Association Of Naloxone Coprescription Laws With Naloxone Prescription Dispensing In The United States, Minji Sohn, Jeffery C. Talbert, Zhengyan Huang, Michelle R. Lofwall, Patricia R. Freeman

Institute for Pharmaceutical Outcomes and Policy Faculty Publications

Importance: To mitigate the opioid overdose crisis, states have implemented a variety of legal interventions aimed at increasing access to the opioid antagonist naloxone. Recently, Virginia and Vermont mandated the coprescription of naloxone for potentially at-risk patients.

Objective: To assess the association between naloxone coprescription legal mandates and naloxone dispensing in retail pharmacies.

Design, Setting, and Participants: This was a population-based, state-level cohort study. The sample included all prescriptions dispensed for naloxone in the retail pharmacy setting contained in IQVIA's national prescription audit, which represents 90% of all retail pharmacies in the United States. The unit of observation was state-month …

Psychosocial Well-Being And Efforts To Quit Smoking In Pregnant Women Of South-Central Appalachia, Brittney Stubbs, Valerie Hoots, Andrea D. Clements, Beth Bailey

ETSU Faculty Works

Introduction: Psychosocial well-being variables from the Tennessee Intervention for Pregnant Smokers (TIPS) study, a longitudinal smoking cessation study in South-Central Appalachia, were investigated as potential predictors of smoking status.

Methods: A sample of 1031 pregnant women participated in an expanded 5A's (Ask, Advise, Assess, Assist, Arrange) program, from 2008 to 2011. Measures of stress, self-esteem, depressive symptoms, and disordered eating collected by interview during the first trimester, or during the third trimester in a combined interview if participants began prenatal care late, were hypothesized to differ among three groups of participants: pregnant women who never smoked, pregnant women who smoked …