Medicine and Health Sciences Commons^™

Representation And Recommendations: Participation Of People Who Use Drugs In Un-Level Policy-Making, Lily Knudsen

Independent Study Project (ISP) Collection

Although participation in health policy-making is a popular topic in the literature and a stated priority of the United Nations, very little research has been published examining the full spectrum of participation by people who use drugs (PWUD) at the UN level. This study aims to describe and evaluate this participation through a combination of a literature review that looks at academic sources, UN publications, and publications by organizations of PWUD, and a series of interviews with representatives of organizations of PWUD who have participated in UN level policy-making.

Data collected demonstrates that there is no comprehensive system for the …

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

S5e2: How Can We Address Mental Health Needs In Rural Maine?, Ron Lisnet, Jeff Hecker, Sandy Butler, Emily Haigh

The Maine Question

Many people nationwide are experiencing a decline in their mental health. Rates of anxiety, depression, and substance abuse are rising, more so in rural areas. Ten out of 16 Maine counties have a shortage of mental health professionals. Only about half of the state population receives the services they need.

At UMaine, a major effort is underway to recruit more mental health care providers to serve in rural areas. Using federal funding, researchers from the Psychology Department and School of Social Work are working with other experts to increase the number of psychologists, social workers and substance abuse professionals in …

Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas

Sociology Faculty Articles and Research

Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012–2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors …

Emergency Medicine Shift Factors Causing The Most Stress Among Emergency Medicine Residents, Mohamad Moussa, Kristen Hayden, Chia-Hao Shih, Sadik Khuder, Zayd Safadi, Connor Parsell

Journal of Wellness

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses.

Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance …

A Decarceral Cadence: Neurologic Music Therapy As An Abolitionist Project, Mallori D. Thompson, Richard A. Kirby

Connecticut Law Review

Because police and prison abolition must be approached while simultaneously improving quality of life, and thus reducing harm, abolitionist discourse should include health policies that regard the (de)regulation, use, and culture of addictive substances. This Essay calls for research into neurologic music therapy as a response to addiction, improving quality of life and paving the way for police and prison abolition.

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Relationship Between Sexual Activity, Contraceptive Utilization And Biopsychosocial Characteristics Among Homeless Shelter Adolescents., Brittney A Gaudet, Nina Liu, Allison N Kayne, Taylor L Jarvill, Cecilia Zemanek, Jeffrey M Downen, Hoonani M Cuadrado, Amy B Smith, Marna R Greenberg, Jessica L Jacoby, Joanne N Quinones

Department of Emergency Medicine

Objective: To determine whether biopsychosocial factors are associated with sexual activity and contraceptive utilization among homeless shelter adolescents. Methods: A retrospective study of 440 adolescents at a shelter in Pennsylvania between February 2015 and September 2019 was conducted. The cohort was evaluated to determine what relationship age, gender identity, substance use, and trauma history have with sexual activity and contraceptive utilization. Results: Sexual activity was significantly related to age (mean 15.8+1.4 years in sexually active vs. 14.7+1.6 years in abstinent youth, p<0.001); remote history of self-harm behavior (relative risk ratio (RR) 1.23 [95% CI 1.03-1.46]; p=0.02), history of aggressive behavior (RR 1.21 [95% CI 1.01-1.46]; p=0.04), history of trauma (RR 1.24 [95% CI 1.04-1.48]; p=0.03), and substance use (RR 2.27 [95%CI 1.86-2.77]; p<0.001). There were 55.7% sexually active females vs. 42.50% males reporting contraception use (p=0.01). After adjustment, older age and substance use remained significantly associated with sexual activity (adjusted odds ratio (AOR) 1.58 [95% CI 1.36-1.83]; p<0.001 and AOR 5.18 [95% CI 3.28-8.18]; p<0.001, respectively). Conclusions: Females self-reported sexual activity using contraception more than males. After adjustment, older age and substance use were associated with sexual activity. By better understanding the impact these factors can have on contraceptive utilization, informed policy and practice interventions can be developed and implemented to help increase safe sex practices in spaces where homeless adolescents access healthcare.

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Opioid Abuse: Are Doctors Creating The Problem?, Nguyen Tran

Symposium of Student Scholars

Opioid abuse and overdose are serious health problems in the United States. Current research has concentrated on the treatment and prevention of opioid abuse. Using data from the Controlled Substance Utilization Review and Evaluation System (CURES) for California zip codes, my research focuses on the causes of opioid overdose by considering the relationships between the following variables within each zip code: population size, average number of prescriptions per doctor, percentage of people who receive opioid prescriptions, percentage of people receiving the same prescription drug from 3 or more doctors, average number of opioid pills per prescription and number of people …

Accidental Overdoses: Insights To Aid In Prevention, Annabel Nganga

Symposium of Student Scholars

Having lost a friend six years ago to an accidental cocaine overdose, I am very passionate about spreading awareness of accidental drug overdoses that have affected thousands of families countrywide. According to past research, deaths resulting from opiates specifically have been on the rise, and a significant number of deaths in the United States for those below fifty years are caused by drug overdoses. Data exists indicating which states have more overdoses. The data set I will be using includes variables on race, sex, age, drug with which person overdosed, location of the overdose, ultimate cause of death and year …

County And Demographic Differences In Drug Arrests And Controlled Substance Use In Maine, Trajan F. Hyde, Amadea D. Bekoe-Tabiri, Amalie K. Kropp Lopez, Luis G. Devia, Belsy D. Gutierrez, Matthew C. Lara, Anthony R. Soto, Daniel E. Kaufman, Matthew T. Moran, Kevin J. Simpson, Dipam T. Shah, Michelle Foster, Clare E. Desrosiers, John Hebert, Stephanie D. Nichols, Kenneth Lee Mccall, Brian J. Piper

Journal of Maine Medical Center

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Introduction: The Diversion Alert Program (DAP) was established to curb misuse of drugs and help identify people who may need treatment for substance use disorder (SUD). Law enforcement compiled arrest data into a database accessible by health care providers. Our objectives were to identify regional and demographic differences in drug use and misuse in Maine.

Methods: All arrests (N = 11 234) reported to the DAP from 2013 to 2018 were examined by county and arrestee demographics, and classified into families (opioids, stimulants, sedatives). The Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) tracks the distribution …

Increased Incidence Of Substance Use And Substance Use Disorders Among Mexicans That Have Migrated To The United States, Emily Hock

Honors Theses

The United States is becoming increasingly older and more racially and ethnically diverse, with Mexican Americans adults aged 65 and over becoming the frontrunners in population growth. Substance use disorders are high among this particular population, with alcohol and tobacco being the most common culprits. Previous research suggests that the prevalence of drinking and smoking among Mexican Americans is increased compared to Mexicans living in Mexico, and substance use rates are highest in those most accustomed to United States culture. While acculturation may initially increase exposure to healthcare options, Mexican Americans are disproportionally uneducated and have lower socioeconomic status than …

Mindfulness-Based Intervention And Relapse Rates In Adults With A History Of Substance Use Disorder, Tamieko Ross-Anyaso

Student Scholarly Projects

Practice Problem: Substance abuse disorder (SUD) has become an increasingly prevalent community health problem worldwide, affecting individuals in all geographical regions regardless of age, race, sex, and socioeconomic status, despite decades of efforts to find a solution (Bowen et al., 2014). A lack of treatment engagement and substance‐misuse crisis calls attention to the effectiveness of relapse‐sensitive care and treatments.

PICOT: The question addressed in this evidence-based project was “ In adults over 18 years of age with substance use disorder (P), how does the effect of mindfulness-based treatment (I), compared with no mindfulness-based treatment (C), reduce the risk of relapse …

The Development And Implementation Of A Culturally Safe Survey For Measuring Knowledge, Attitudes And Values Around Fasd And Alcohol Use During Pregnancy In A Remote Australian Aboriginal Community Setting, Martyn Symons, David Tucker, Kaashifah Bruce, Annalee Stearne, Annette Kogolo, Maureen Carter, June Oscar, Glenn Pearson, James P. Fitzpatrick

Australian Indigenous HealthBulletin

Fetal Alcohol Spectrum Disorder (FASD) describes a lifelong neurodevelopmental disability caused by prenatal alcohol exposure that has a devastating impact on individuals, families and communities. The prevalence of FASD is high in some Indigenous communities around the World and the only active case ascertainment prevalence study conducted in Australia found a rate of 19.44 per 100 children in the remote Fitzroy Valley region of Western Australia. Following this study community led FASD prevention activities were implemented under the Marulu (“Worth Nurturing”) Strategy in the Fitzroy Valley.

A Knowledge, Attitudes and Practices survey was designed to assess the impact of the …

Syndemic Of Opioid Crisis And Covid-19 Pandemic: A Call To Invest In Solutions, Manoj Sharma, Kavita Batra

Social & Behavioral Health Faculty Publications

Preliminary data by the Centers for Disease Control and Prevention [CDC, 2020] indicated a significant surge in the number of opioid involved deaths amidst COVID-19 pandemic and these trends are concerning, which warrant a collective investment in finding the solutions (Baumgartner & Radley, 2021; Becker & Fiellin, 2020). [...]this editorial aims to reflect on the interaction of the COVID-19 pandemic with the existing opioid crisis and its role in widening the gap of the pre-existing disparities, and discusses implications of practice to protect the health of vulnerable drug-users. Recently, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed take-home …

Alcohol Use In Women: Resources And Recommendations For Counselors, Samantha Haling

Educational Specialist, 2020-current

The research shows that alcohol use is rising rapidly among women, resulting in devastating consequences that have not been sufficiently explored in counselor education and training. This paper aims to address this by providing a review of the literature which shows that women are more vulnerable to many of the physical and mental health consequences of alcohol use than men, and that they have unique treatment needs and face gender-specific risk factors and barriers to treatment. The review examines the interaction between gender and alcohol use, summarizes the existing research on the physical and behavioral health consequences of alcohol use …

"Going It Alone": Following The Male Cohort Of Survivors Of Sex Trafficking Of The Chab Dai Butterfly Longitudinal Research Project, Jarrett D. Davis, James Havey, Glenn M. Miles, Nhanh Channtha, Sreang Phally, Lim Vanntheary

Dignity: A Journal of Analysis of Exploitation and Violence

Over the past ten years, the Butterfly Longitudinal Research Project has followed 128 survivors of trafficking through their experiences in aftercare, reintegration, and beyond to better understand the recovery and reintegration of trafficking survivors within a Cambodian context. This paper focuses on the 19 males who were available to interview. Despite the project’s wealth of data and analysis, there are notable gaps regarding the male cohort. In response, this paper examines this cohort holistically, considering their statements and broader narratives, merging them with previous collective observations of the Butterfly Project. Throughout this paper, data indicates a pattern of violence among …

Contraception Choice And Compliance Among Mothers With Opioid Addiction: Identifying Barriers To Care, Robert C. Bowers, Catherine Waldron, Jennie Yoost, Hayley Weese, Amy Roy

Marshall Journal of Medicine

Introduction

West Virginia leads the nation in substance abuse deaths per capita. This epidemic has given rise to a novel population of high-risk, obstetric patients with opiate abuse. Appropriate education, counseling, and implementation of contraception are of extreme importance among this population, due to the risks of unintended pregnancy.

Methods

This study was a retrospective chart review to determine compliance and uptake of contraceptive methods by patients in a maternal buprenorphine maintenance program prior to and following implementation of standardized contraception education and Medicaid coverage of immediate postpartum long-acting reversible contraceptives (LARC). Rates of planned contraception and rates of actual …

Translation And Examination Of The Reliability And Validity Of The Spanish Version Of The Smoking Self-Efficacy Questionnaire Among Latino Smokers., Francisco Cartujano-Barrera, Scott Mcintosh, Lisa Sanderson Cox, Evelyn Arana-Chicas, Delwyn Catley, Edward F Ellerbeck, Deborah J Ossip, Ana Paula Cupertino

Manuscripts, Articles, Book Chapters and Other Papers

The 12-item Smoking Self-Efficacy Questionnaire (SEQ-12) is a valid and reliable instrument to assess confidence in one's ability to refrain from smoking in a variety of different situations. This study evaluated the psychometric properties of the Spanish version of the 12-item Smoking Self-Efficacy Questionnaire (SEQ-12) among a sample of Spanish-speaking Latino smokers engaged in a smoking cessation research study. A forward-backward translation procedure guided the translation of the SEQ-12 into Spanish. The Spanish version of the SEQ-12 showed promising internal consistency reliability and construct validity among Latino smokers, with potential applications in both research and clinical settings.

Temporal Trends In Smoking And Nicotine Dependence In Relation To Co-Occurring Substance Use In The United States, 2005-2016, Yun Wang, Ying Liu, Mary Waldron, Alexandra N. Houston-Ludlam, Vivia V. Mccutcheon, Michael T. Lynskey, Pamela A. F. Madden, Kathleen K. Bucholz, Andrew C. Heath, Min Lian

Pharmacy Faculty Articles and Research

Background
Despite an overall decline in tobacco use in the United States, secular trends of smoking and nicotine dependence with co-occurring substance use are not well characterized.

Methods
We examined self-reported tobacco and other substance use in 22,245 participants age 21–59 in the United States from six waves of the National Health and Nutrition Examination Survey (NHANES). Using Joinpoint regression, we assessed secular trends of smoking and nicotine dependence as a function of co-occurring use of alcohol, prescription opioids, marijuana/hashish, cocaine/heroin/methamphetamine, or other injection drug use. Multivariable logistic regressions were fitted to identify the potential risk factors.

Results
During 2005–2016, …

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

Disability Injustice: A Latino’S Creative Autoethnographic Testimonio On The Organizational Culture Of Higher Education, Leonel A. Diaz Jr.

Organization, Information and Learning Sciences ETDs

Using creative autoethnographic testimonio (CAT), a story is told about the injustices within the learning environment and work environment of higher education toward a person with disabilities: sleep apnea, learning disabilities, negative mental health. The author explores the health difficulties of addressing sleep deprivation while attending graduate school and working full-time as a professional. With sleep apnea impacting his health, his mental health declines. As his health declines, there is an increase in discrimination, hostility, oppression, bullying, and toxic masculinity. Initially, the medical system dismisses his declining health and refuses to look further into it. Once he receives medical care …

The Relationship Between Emotion Regulation And Substance Use Treatment Attrition, Melanie Ruth Roys

LSU Doctoral Dissertations

Severe substance use disorders are characterized by chronic cycles of relapse; however, individuals who complete substance use treatment are less likely to experience relapse. Research has focused on trying to identify factors that predict treatment dropout to help improve treatment outcomes. Most of this research has focused on examining demographic and patient-specific factors, with little success in reliably predicting treatment attrition. There has been less focus on investigating transdiagnostic factors that span across discrete psychological diagnoses and demographics. The present study sought to determine if self-report and behavioral measures related to emotion regulation predicted inpatient substance use treatment dropout above …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Clinicians' Use Of Mhealth Applications In Interventions For Substance Use Disorders, James Daniel Bender

Dissertations

The purpose of the study was to examine how clinicians are identifying, evaluating, and utilizing mHealth apps as treatment adjuncts with their clients who have a substance use disorder. A sample of 93 participants (20 males, 72 females, and 1 not listed) completed measures of demographics and inquiries about their use and evaluation of mHealth apps in their practices. Clinicians who work at mental health centers and private practicing clinicians were recruited. The majority of the sample (71%) reported that they had not utilized mHealth apps with their clients who have a substance use disorder diagnosis. Participants who have attended …

Investigating Social Support As A Moderator Of The Association Between Adverse Childhood Experiences And Alcohol Use And Problems, Sterling Mckenzie Hubbard

Masters Theses & Specialist Projects

Unresolved childhood trauma, known as adverse childhood experiences (ACES), have been found previously to lead to a plethora of health disparities and increase the risk for problematic substance use, particularly alcohol use. However, protective factors, such as social support have been found to buffer against these consequences. The goal of this study was to highlight the connection between ACES and problematic alcohol use. Additionally, the aim was to investigate perceived social support as a moderator between ACES and problematic alcohol use and to examine the domains of social support and how they individually moderate the association between ACES and social …

An Investigation Of Occupational Therapy Utilizing Sensory Modulation To Manage Co-Morbid Chronic Pain And Substance Use In Order To Promote Occupational Performance And Recovery, Claire Ruth

Student Capstone Papers

Background: Those with chronic pain have worse drug and alcohol treatment outcomes and higher rates of relapse compared to those without pain or with reduced pain (Ilgen et al., 2020).

Methods: A descriptive study was employed with the aim of determining what are the sensory processing pattens of those with co-morbid chronic pain and in recovery for substance use. All participants completed the Adolescent and Adult Sensory Profile, the Brief Pain Inventory, and the Personal Recovery Outcome Measure (PROM).

Results: From the preliminary findings, individuals with co-morbid chronic pain and substance use may have atypical sensory processing …

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.

Understanding The Stigma And Feasibility Of Opening A Safe Injection Facility In Baltimore City: A Qualitative Case Study, Timothy Dupree, Caroline I. Wood, Andrea M. Brace

The Qualitative Report

Supervised injection facilities (SIFs) are medically supervised facilities designed to provide a hygienic environment in which drug users can consume illicit drugs intravenously. SIFs can be cost saving, help to reduce transmission of disease, and decrease drug overdoses. There are no SIFs in the United States. In this study we used a multiple case study design to understand the stigma surrounding the use of a SIF and the feasibility of implementing the drug prevention strategy in Baltimore City by comparing experiences with opening a SIF in Sydney, Australia. We interviewed one healthcare worker at the Sydney SIF and ten community …