Medicine and Health Sciences Commons^™

What Is The Risk Of “Captagon” And Other Pill-Pressed Stimulants In Tennessee?, Jeremy C. Kourvelas Mph

SMART Policy Briefs

• The U.S. is the world’s largest market for amphetamine-type stimulants. While “ice” methamphetamine is the predominant type seized in Tennessee, amphetamine powder, cocaine, designer stimulants like MDMA, and diverted pharmaceuticals are also encountered. In fact, non-medical use of pharmaceutical amphetamines is the most predominant type of amphetamine use in the U.S.

• The ongoing shortage of prescription stimulants like Adderall puts college-aged youth and other vulnerable populations at particular risk of encountering counterfeit prescription stimulants. Fentanyl-laced counterfeit Adderall has already been discovered on college campuses, for example.

• One potential threat is “Captagon,” which was banned in the 1980s but has since …

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Expansion Of Osteopathic Medicine Practitioner Education On Substance Use Disorders, Joanna Petrides, Stuti Jha, Alexander Kowalski, Suzanna Hosein, Philip B Collins, Joshua Coren

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

CONTEXT: Medical school graduates are generally not well prepared to treat patients with substance use disorders (SUDs), even though opioid overdose deaths in the United States have increased in recent years. When it comes to training in SUDs, osteopathic medicine lags far behind allopathic medicine. It was only in 2019 that the American Osteopathic Association approved Board Certification in Addiction Medicine to help combat the opioid epidemic. Few articles have been published in the literature pertaining to substance use education for osteopathic students and trainees.

OBJECTIVES: The goal of this study was to expand the education of osteopathic medical students …

The Effect Of Focused Client Education On Case Management & Readmission Rates In Homeless Individuals With Co-Occurring Disorders Admitted To A Jail Diversion Program, Pallavi Rao, Mary Johnson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Individuals with both mental illness(es) (MI) and substance use disorder (SUD) occurring simultaneously are known as having co-occurring disorders (COD). The rates of COD found among homeless individuals (H-COD) are higher than in the general population. The presence of both conditions prevents H-COD individuals from overcoming their hardships and places them at a higher risk of being involved in the criminal justice system.

Local Problem: Jail diversion programs (JDPs) admit a high rate of H-COD clients nationally and locally at the project site in Knoxville (JDP-K). The Office on Homelessness reported about 80% of those admitted to JDP-K are …

Neonatal Abstinence Syndrome (Nas): What You Need To Know, Maren Wright Wright Voss, Amelia Van Komen, Emily Hamilton, Aarica Cleveland, Jaclyn Miller

All Current Publications

National overdose deaths continue to rise, with 2021 marking the first time U.S. overdose deaths topped 100,000 in a 12-month timeframe. Substance use, such as alcohol, cocaine, opioids, and marijuana, during pregnancy is also increasing. As the U.S. struggles with harmful substance use, a growing number of infants are born with neonatal abstinence syndrome (NAS), a harmful outcome of fetal exposure to substances. This fact sheet will talk about why and what to do, with recommendations for safe treatment and support during pregnancy.

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson

Doctor of Nursing Practice (DNP) Projects

Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between …

Examining The Perspectives And Experiences Of Nutrition Educators Working With Clients In Substance Use Recovery Settings, Cora Teets, Paula Plonski, Omolola Adedokun, Heather Norman-Burgdolf

Dietetics and Human Nutrition Faculty Publications

Substance use disorder (SUD) is one of the most detrimental health, social, and economic problems in the United States. Limited studies suggest providing tailored nutrition education during SUD treatment correlates with positive recovery outcomes. The University of Kentucky Nutrition Education Program conducted two focus group sessions to explore and determine educators’ instructional and programmatic needs who deliver nutrition education to clients in substance use recovery throughout Kentucky. The study team identified four emerging themes and several subthemes related to Nutrition Education Program educators working with clientele in recovery. The four emerging themes included: (1) current experiences working with the audience, …

R.A.C.E. To Recovery Year 1 Evaluation Summary Report, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

Through a collaborative effort led by the Healthy Community Coalition, the multi-sector Rural Addiction Care Expansion (R.A.C.E.) to Recovery initiative consortium is utilizing evidence-based, community-wide response to impact and reduce the effects of the opioid epidemic in the Western Maine Public Health District/ Greater Franklin County. To assess and evaluate the implementation, successes, and challenges of the RACE to Recovery project, the Cutler Institute is collecting and analyzing data for both process and outcomes of the initiative.

In the first year of the initiative, the Cutler evaluation team utilized both primary and secondary data to assess RACE to Recovery program …

Support For Me: Provider Focus Group Summary, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Karen Pearson Mlis, Ma, Mark Richards Bs

Substance Use Research & Evaluation

This summary highlights feedback from focus groups with providers across Maine who currently address the needs of persons with substance use disorder (SUD). These providers represent individuals working in the following organizations: Health Systems, Behavioral Health Agencies, Residential Treatment, Community Recovery Programs, Opioid Treatment Programs (OTP), Emergency Medical Services (EMS), First Responders (EMT, fire, police), and law enforcement (e.g., Sheriff’s Office, Corrections). This summary report is designed to provide feedback to the Office of MaineCare Services to help inform their strategic planning process to increase statewide capacity for SUD treatment and recovery service capacity to better meet the needs of …

Pregnancy And Substance Use, Elise Withers, Krista Thompson, Emily Hamilton, Maren Wright Voss

All Current Publications

The use of alcohol and other harmful substances, such as cocaine, opioids, and marijuana during pregnancy has increased over the last decades (Sebastiani et al., 2018). Using these substances can be very harmful to the unborn baby and mother (Viteri et al., 2015). This fact sheet covers (1) the consequences of substance use and (2) the current recommendations for substance use during pregnancy.

Support For Me: Key Stakeholder Interview Summary, Katie Rosingana Ba, Mary Lindsey Smith Phd, Karen Pearson Mlis, Ma, Evelyn Ali Bs, Tyler Egeland Ba, Mark Richards Bs

Substance Use Research & Evaluation

This summary feedback report is organized to inform the Office of MaineCare Services goal of addressing barriers and finding new and/or improved ways to increase capacity in Maine for people who seek treatment and recovery services for substance use disorder. Interview protocols were designed to assess critical domains of interest for the state, which include: current and potential provider capacity, access to care & service delivery provider willingness, and financial/ administrative policies.

Key Highlights from the stakeholder interviews indicated that:

• While there have been improvements in the integration of care for persons with behavioral health (BH) diagnoses, this integration has …

A Crisis Of Her Own: Fatal Opioid Overdose, Opioid Use Disorder, And Intimate Partner Violence Among Rural Utah Women, Timothy Light, Erin Fanning Madden, Debasree Das Gupta, Hilary Disch, Katie Zaman, Suzanne Prevedel, Sandra H. Sulzer

All Current Publications

The Centers for Disease Control report that the rate of overdose deaths among women is rapidly increasing, with women experiencing a 532% increase in fatal opioid overdose deaths between 1999 and 2017, compared to a 355% increase for men. Among women, those in rural areas have disproportionately higher drug overdose death rates than women in urban areas (Mazure & Fiellin, 2018), indicating an opportunity for targeted rural public health interventions to slow overdose fatality increases among women. This fact sheet reviews Utah trends, potential factors increasing fatal opioid overdose, intimate partner violence and substance use disorders, and provides resources for …

Opioid-Related Visits To Rural Emergency Departments, Erika C. Ziller Phd, Jean A. Talbot Phd, Deborah Thayer Mba, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Increased rates of acute opioid poisoning and related emergency department (ED) visits in the United States have occurred at the same time as rural EDs face a number of resource constraints. Researchers at the Maine Rural Health Research Center conducted this study to gain insight about rural ED visits for acute opioid poisoning and how they compare with urban ED visits. The authors used data from the 2006 and 2013 Nationwide Emergency Department Sample to examine rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these ED visits (treatment and release, inpatient …

Same Day Transportation For Opioid Use Disorder: Impact Of The Crisis Addiction Recovery Transportation (Cart) Program, Katherine Palmer Loveluck, Andrew King

Medical Student Research Symposium

Patients with opioid use disorder (OUD) frequently present to the emergency department (ED). Delays or barriers in referral to recovery programs from the ED may decrease successful linkage to ongoing care. Immediately following discharge is a particularly high-risk time for OUD patients as studies have shown that immediately following a non-fatal overdose there is an increase in death rates¹. To attempt to combat this gap in care The Detroit Medical Center (DMC) partnered with a community program, Team Wellness (TW), to offer direct transportation 18 hours per day to the TW facility. This crisis addiction recovery transportation (CART) …

Self-Esteem And Long-Term Recovery From Substance Use Disorders, Mariah Brennan Nanni, Austin Mcneill Brown

Population Health Research Brief Series

This brief describes how self-esteem and other strength-based measures of personal growth are better indicators of recovery progress.

Historical Trauma Response Scores As A Function Of Unresolved Grief And Substance Use Disorder In American Indian Populations, Andrew R. Saunders

Undergraduate Research Symposium

Abstract

Researchers are interested in the outcomes of interventions, specifically, measuring historical trauma (HT) among American Indian/Alaska Native communities and the long-term distress and substance abuse as a result of historical trauma response (HTR). Previous literature has implicated limitations in the clinical conceptualization of the relationship between intergenerational transfer of HTR and substance abuse. The aim of the current study is to examine treatment efficacy of 50 homosexual, American Indian males randomized to a culturally-adapted juxtaposition of (1) Group Interpersonal Psychotherapy (IPT), (2) Cognitive Processing Therapy (CPT), and (3) Historical Trauma and Unresolved Grief Intervention (HTUG), or (4) waitlisted on …

Diet, Nutrition, And Substance Use Disorder, Mateja R. Savoie-Roskos, Ashley Yaugher, Alise Williams Condie, Gabriela Murza, Maren Wright Voss, Kandice Atisme

All Current Publications

Consuming a healthy diet can benefit everyone—especially individuals with substance use disorder (SUD), a disorder that occurs when frequent use of drugs or alcohol causes impairment, health issues, and difficulties with managing daily responsibilities (Substance Abuse and Mental Health Services Administration [SAMHSA], 2020). Although often overlooked, nutrition can play a key role in the treatment and recovery process for individuals with SUD, and should be included as part of a holistic approach toward recovery. In this fact sheet we will review how diet and nutrition are impacted during an active addiction, and the influence nutrition can have on treatment and …

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.

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, …

Timely Linkage Of Individuals To Substance Use Disorder Treatment: Development, Implementation, And Evaluation Of Findhelpnowky.Org, Terry Lee Bunn, Dana Quesinberry, Tyler Jennings, Amber Kizewski, Heather Jackson, Sarah Mckee, Sarah Eustice

Kentucky Injury Prevention and Research Center Faculty Publications

Background: Substance use disorders (SUD) have steadily increased over the last two decades. Seeking SUD treatment involves searching SUD treatment facility types (inpatient, outpatient and intensive outpatient, residential and family residential, and detoxification facilities) that offer specialized SUD treatment depending on individual needs and preferences. Referrals to SUD treatment require innovative strategies that rapidly link individuals to SUD treatment when they are at the critical stage of readiness. The aim of this study was to develop, implement, and evaluate a user-friendly SUD treatment facility opening availability website called FindHelpNowKY.org. The objectives of the study were to 1) recruit SUD treatment …

Intensive Referral To Mutual-Help Groups: A Field Trial Of Adaptations For Rural Veterans, Kathleen M. Grant, Lance Brendan Young, Kimberly A. Tyler, Jamie L. Simpson, R. Dario Pulido, Christine Timko

Department of Sociology: Faculty Publications

Objective: A multisite field trial testing whether improved outcomes associated with intensive referral to mutual help groups (MHGs) could be maintained after the intervention was adapted for the circumstances and needs of rural veterans in treatment for substance use disorder (SUD). Methods: In three Veterans Affairs treatment programs in the Midwest, patients (N = 195) received standard referral (SR) or rural-adapted intensive referral (RAIR) and were measured at baseline and 6-month follow-up. Results: Both groups reported significant improvement at 6 months but no significant differences between SR and RAIR groups in MHG participation, substance use, addiction severity, and posttraumatic stress …

Prevention Of Drug Use And Treatment Of Drug Use Disorders In Rural Settings, John A. Gale Ms

Mental Health / Substance Use Disorders

This Guide on Prevention of Drug Use and Treatment of Drug Use Disorders in Rural Settings was prepared by the United Nations Office on Drugs and Crime (UNODC) Drug Prevention and Health Branch (DHB), in the context of the global project Treatnet II: OFID-UNODC Programme to prevent HIV/AIDS through Treatnet Phase II, with the aim of providing an awareness-raising tool and guidance for policymakers, public health officials, local authorities and other stakeholders in dealing with substance use issues in rural settings in their respective countries. This Guide will serve as an awareness-raising tool and guidance for policymakers, public health officials, …

Impact Of Cannabis Use On Treatment Outcomes Among Adults Receiving Cognitive-Behavioral Treatment For Ptsd And Substance Use Disorders, Lesia M. Ruglass, Alina Shevorykin, Vanja Radoncic, Kathryn M. Z. Smith, Philip H. Smith, Isaac R. Galatzer-Levy, Santiago Papini, Denise A. Hien

Publications and Research

Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary …

A Pilot Test Of A Mobile App For Drug Court Participants, Kimberly Johnson, Stephanie Richards, Ming-Yuan Chih, Tae Joon Moon, Hilary Curtis, David H. Gustafson

Health and Clinical Sciences Faculty Publications

The U.S. criminal justice system refers more people to substance abuse treatment than any other system. Low treatment completion rates and high relapse rates among addicted offenders highlight the need for better substance use disorder treatment and recovery tools. Mobile health applications (apps) may fill that need by providing continuous support. In this pilot test, 30 participants in a Massachusetts drug court program used A-CHESS, a mobile app for recovery support and relapse prevention, over a four-month period. Over the course of the study period, participants opened A-CHESS on average of 62% of the days that they had the app. …

Behavioral Couples Treatment For Substance Use Disorder: Secondary Effects On The Reduction Of Risk For Child Abuse, Michelle L. Kelley, Adrian J. Bravo, Abby L. Braitman, Adrienne K. Lawless, Hannah R. Lawrence

Psychology Faculty Publications

Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6 month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For …