Medicine and Health Sciences Commons^™

Augmenting Project Echo For Opioid Use Disorder With Data-Informed Quality Improvement, Owen B. Murray, Marcy A. Doyle, Bethany M. Mcleman, Lisa A. Marsch, Elizabeth C. Saunders, Katherine Cox, Delitha Watts, Jeanne Ryer

Faculty Publications

Background

National opioid-related overdose fatalities totaled 650,000 from 1999 to 2021. Some of the highest rates occurred in New Hampshire, where 40% of the population lives rurally. Medications for opioid use disorder (MOUD; methadone, buprenorphine, and naltrexone) have demonstrated effectiveness in reducing opioid overdose and mortality. Methadone access barriers disproportionally impact rural areas and naltrexone uptake has been limited. Buprenorphine availability has increased and relaxed regulations reduces barriers in general medical settings common in rural areas. Barriers to prescribing buprenorphine include lack of confidence, inadequate training, and lack of access to experts. To address these barriers, learning collaboratives have trained …

Ethnic/Racial Differences In Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?, P. Priscilla Lui, Savannah M. Krantz, Michael B. Madson

Faculty Publications

Introduction: College students—including those of Hispanic backgrounds—are at risk for hazardous drinking. Research has shown robust group differences between Hispanic and White individuals in alcohol use outcomes. The ability to resist alcohol consumption can be leveraged to reduce hazardous drinking; however, little research has examined Hispanic-White differences and whether drinking refusal self-efficacy accounts for group differences in hazardous drinking. Considering Hispanic individuals make up the largest ethnic/racial minority group in the United States, it is important to identify malleable psychological factors that prevent and reduce drinking problems. Method: Hispanic and White college students at two predominantly White institutions …

Post-Traumatic Stress And Marijuana Outcomes: The Mediating Role Of Marijuana Protective Behavioral Strategies, Hallie R. Jordan, Michael B. Madson, Adrian J. Bravo, Matthew R. Pearson

Faculty Publications

Background: The present study investigated the mediating role of protective behavioral strategies for marijuana (PBSM) on the relationship between posttraumatic stress disorder (PTSD) and marijuana outcomes (i.e. marijuana use frequency, marijuana use quantity, cannabis use disorder (CUD) symptoms, and marijuana-related problems).

Methods: Participants were 1,107 traditional age college students (M_age = 20.26, SD = 3.32; 66.5% White, non-Hispanic; 68.8% female), who reported consuming marijuana at least once in the last 30 days and completed measures of PTSD symptoms, PBSM, and marijuana-related outcomes.

Results: PBSM significantly mediated the positive relationships between PTSD symptoms and both CUD symptoms and marijuana-related …

2020 County Health Rankings Tennessee Data And Updated Substance Abuse 2005-2019, Kelsey L. Grabeel, Jenny Moore

Faculty Publications

No abstract provided.

The Relationship Between Social Anxiety And Alcohol And Marijuana Use Outcomes Among Concurrent Users: A Motivational Model Of Substance Use, Margo C. Villarosa-Hurlocker, Adrian J. Bravo, Matthew R. Pearson, Protective Strategies Study Team

Faculty Publications

Background: College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample …

Comparing Substance Use And Mental Health Outcomes Among Sexual Minority And Heterosexual Women In Probability And Non-Probability Samples, Laurie Drabble, Karen Trocki, Rachael Korcha, Jamie Klinger, Cindy Veldhuis, Tonda Hughes

Faculty Publications

Objective To examine similarities and differences in demographics and key substance use and mental health outcomes in a probability sample of heterosexual women and two samples of sexual minority women (SMW), one recruited using probability and the other using non-probability methods. Methods Using data from four waves of the National Alcohol Survey (NAS; n = 315 SMW; 10,523 heterosexual women) and Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW; n = 688 SMW) study, we examined hazardous drinking, drug use, tobacco use, depression, and help-seeking for alcohol or other drug problems. Results Compared to SMW …

When Your Spouse Is Addicted: How To Avoid Enabling And Get To Reality, Jason B. Whiting

Faculty Publications

Addiction manifests in a variety of ways, from the most severe heroin junkie, to the compulsive spender. It can include drug or alcohol dependence, compulsive pornography use, gambling, obsessive eating, lying, toxic relationships, or even Netflix. When does a habit become an addiction? Any behavior can begin as pleasure or escape, but in the case of addiction, the actions become demands. Addictions are secretive habits the person has unsuccessfully tried to stop, and that have disrupted work and home. An addiction takes an outsized role in the addict’s life and affects those they love.

Relationship Of Religiosity And Spirituality To Hazardous Drinking, Drug Use, And Depression Among Sexual Minority Women, Laurie Drabble, Cindy Veldhuis, Barth Riley, Sharon Rostosky, Tonda Hughes

Faculty Publications

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. …

Conducting Qualitative Interviews By Telephone: Lessons Learned From A Study Of Alcohol Use Among Sexual Minority And Heterosexual Women, Laurie Drabble, Karen Trocki, Brenda Salcedo, Patricia Walker, Rachael Korcha

Faculty Publications

This study explored effective interviewer strategies and lessons learned based on collection of narrative data by telephone with a subsample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: (1) cultivating rapport and maintaining connection; (2) demonstrating responsiveness to interviewee content, concerns; and (3) …

Brief Intervention For Truant Youth Sexual Risk Behavior And Marijuana Use, Richard Dembo, Rhissa Briones-Robinson, Kimberly Barrett, Rocio Ungaro, Ken C. Winters, Steven Belenko, Lora M. Karas, Laura Gulledge, Jennifer Wareham

Faculty Publications

Substance use and sexual risk behaviors are common among adolescents, but research has focused attention on alcohol use. Much less is known about the relationship of marijuana use and sexual risk behavior among high-risk, especially truant, youths. We report interim findings from a NIDA-funded experimental, brief intervention (BI) study involving truant youths and their parents/guardians. Longitudinal data were analyzed to study (1) the relationships between the youths' marijuana use and sexual risk behavior and (2) the effects of a substance use BI on their marijuana use and sexual risk behavior. A growth model analysis for parallel processes was conducted to …

Brief Intervention For Truant Youth Sexual Risk Behavior And Alcohol Use: A Parallel Process Growth Model Analysis, Richard Dembo, Rhissa Briones-Robinson, Rocio Ungaro, Kimberly Barrett, Laura Gulledge, Ken C. Winters, Steven Belenko, Lora M. Karas, Jennifer Wareham

Faculty Publications

Truant youths frequently experience family problems, emotional/psychological issues, substance misuse, and delinquency. They are likely engaging in alcohol use and sexual risk behavior at a higher rate than the general youth population. Early intervention services would benefit them, their families, and society. We present interim findings from an ongoing, National Institute on Drug Abuse-funded, experimental, brief intervention (BI) study involving truant youths and their parent/guardians. Baseline, 3-, 6-, and 12-month follow-up data were analyzed to determine whether alcohol use and sexual risk behaviors were longitudinally related, to examine the effects of the BI on alcohol use and sexual risk behaviors, …

State Responses To Alcohol Use And Pregnancy: Findings From The Alcohol Policy Information System, Laurie Drabble, Sue Thomas, Lisa O'Connor, Sarah Roberts

Faculty Publications

This article describes U.S. state policies related to alcohol use during pregnancy, using data from the National Institute on Alcohol Abuse and Alcoholism Alcohol Policy Information System. Specifically, this study examines trends in policies enacted by states over time and types of policies enacted across states in the United States, with a focus on whether laws were supportive or punitive toward women. Findings revealed substantial variability in characteristics of policies (19 primarily supportive, 12 primarily punitive, 12 with a mixed approach, and 8 with no policies). Findings underscore the need to examine possible consequences of policies, especially of punitive policies …

Alcohol In The Life Narratives Of Women: Commonalities And Differences By Sexual Orientation, Laurie A. Drabble, K. Trocki

Faculty Publications

Aim: The aim of this study was to explore social representations of alcohol use among women, with a focus on possible differences between sexual minority and heterosexual women. Methods: This qualitative study was part of a larger study examining mediators of heavier drinking among sexual minority women (lesbian identified, bisexual identified, and heterosexual identified with same sex partners) compared to heterosexual women based on the National Alcohol Survey. Qualitative in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey, including respondents representing different sexual orientation groups. Questions explored the …

Advancing Trauma-Informed Systems Change In A Family Drug Treatment Court Context, Laurie Drabble, Shelby Jones, Vivian Brown

Faculty Publications

A growing body of literature documents the importance of trauma-informed and trauma-specific services and systems change in both addiction treatment and child welfare fields. The overall aim of this qualitative study was to explore barriers, benefits, and facilitating factors associated with a trauma-informed systems assessment and improvement initiative conducted in the context of a family drug treatment court (FDTC). Semistructured in-depth interviews with 12 key informants and historical analyses of project documents over a 4-year time span were conducted. Results underscore the relevance of trauma-informed systems change in collaborative contexts designed to address the complex needs of children and families.

Lines In The Sand: Social Representations Of Substance Use Boundaries In Life Narratives, K. F. Trocki, L. O. Michalak, Laurie A. Drabble

Faculty Publications

This study identifies social representations in interviews about alcohol and substance use in the discourse of 129 young adults, who were interviewed for 2.5 to 3.5 hr each for their life histories and use or nonuse of alcoholic beverages and drugs. Respondents spontaneously delineated their substance use boundaries, creating a continuum of behaviors with boundary points separating acceptable from unacceptable behaviors. They used signaling expressions to indicate go and stop signs and movement along the substance use continuum and reported negotiating substance use boundaries both internally and with peers. A ubiquitous narrative element was the cautionary tale, in which a …

Drug Treatment Program Ownership, Medicaid Acceptance, And Service Provision., Duane C. Mcbride, J. Chriqui, Y. Terry-Mcelrath, M Mulatu

Faculty Publications

The Institute of Medicine noted that effective substance abuse treatment (SAT) programs integrate individual therapeutic approaches with transitional/ancillary services. In addition, research suggests that type of ownership impacts SAT services offered and that Medicaid plays a key role in SAT access. Data from the National Survey of Substance Abuse Treatment Services for the years 2000 and 2002–2006 were used to examine relationships among SAT program Medicaid acceptance, program ownership, and transitional/ancillary service accessibility. Multivariate logistic regression models controlling for state- and program-level contextual factors were used to analyze the data. Nonprofit SAT programs were significantly more likely to offer transitional/ancillary …

Differences In Substance-Related Risk Behavior Between Dual And Triple Diagnosed Severely Mentally Ill Adults, Michelle Hampton, Linda Chafetz, Carmen Portillo

Faculty Publications

The purpose of this study was to determine whether differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of human immunodeficiency virus/hepatitis C virus. When compared to the dual diagnosis group, subjects …

State Methamphetamine Precursor Policies And Changes In Small Toxic Lab Methamphetamine Production, Duane C. Mcbride, Yvonne Terry-Mcelrath, Jamie Chriqui, Jean O'Connor, Curtis Vanderwaal, Karen Mattson

Faculty Publications

Domestic production of methamphetamine in small toxic labs (STLs) results in significant community safety and health consequences. This paper examines the effects of state-level policies implemented in the middle of the last decade in reaction to a rapid increase in STL labs. These policies focused on controlling access to the methamphetamine precursor chemicals ephedrine and pseudoephedrine and the relationship of such policies with actual STL seizure rates. Data include (a) primary legal research on state laws/regulations in all 50 states in effect as of October 1, 2005; and (b) STL seizure counts for 2004–2006. Results from random effects cross-sectional time-series …

In Memoriam: James A. Inciardi, Professor Of Sociology & Criminal Justice And Director Of The Center For Drug & Alcohol Studies At The University Of Delaware, Wendee Wechsberg, Duane C. Mcbride, Hilary Surratt

Faculty Publications

No abstract provided.

State Policies Matter: The Case Of Outpatient Drug Treatment Program Practices, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, D Eidson

Faculty Publications

This study examined relationships between state policy requirements governing outpatient substance abuse treatment services and reported outpatient treatment program practices. State policies effective as of February 1, 2003, and February 1, 2004, were collected and analyzed via primary legal research; data were validated by state officials (88% response rate; > 90% validation rate). Treatment practice data were obtained from the National Survey of Substance Abuse Treatment Services for the years 2003 and 2004. Multivariate analyses clustered by state were conducted, controlling for state, program, and state-aggregated client admission characteristics. Results indicated that treatment programs located in states with requirements for comprehensive …

Does State Certification Or Licensure Influence Outpatient Substance Abuse Treatment Program Practices?, Jamie Chriqui, Yvonne Terry-Mcelrath, Duane C. Mcbride, S Eidson, Curtis Vanderwaal

Faculty Publications

In the United States, state governments legally authorize outpatient substance abuse treatment programs. In some states, programs are certified or accredited (ideal standards). Other states license programs (minimal standards). Additionally, some states authorize programs through "deemed status", which is afforded to programs attaining accreditation from a national accrediting body. Primary legal research and the National Survey of Substance Abuse Treatment Services' (N-SSATS) data were used to examine the relationships between state authorization type (certification/accreditation vs licensure with and without deemed status) and outpatient treatment program practices. Programs in certification/accreditation (vs licensure) states had significantly higher odds of offering wrap-around and …

Developing Healthy Kids In Healthy Communities: Eight Evidence-Based Strategies For Preventing High-Risk Behaviour., Gary L. Hopkins, Duane Mcbride, Helen H. Marshak, Kiti Freier, John V. Stevens, Wendi Kannenberg, James B. Weaver, Stephanie L. Sargent Weaver, Peter N. Landless, Jonathan Duffy

Faculty Publications

Australian youth engage in behaviour that threatens their health and wellbeing. National surveys report that about a third of young Australians have tried an illicit drug. High rates of substance use and risky sexual behaviour among young Australians suggest that effective prevention efforts based on empirical evidence need to be expanded. Church-associated organisations are an untapped resource that could be used to improve the health and welfare of young people. We describe eight evidence-based elements to consider in designing strategies to prevent high-risk behaviour in young people.

Community And School Drug Prevention Strategy Prevalence: Differential Effects By Setting And Substance, Curtis J. Vanderwaal, Lisa M. Powell, Yvonne M. Terry-Mcelrath, Yanjun Bao, Brian R. Flay

Faculty Publications

This study used key informant interviews and student survey data in 508 U.S. communities to examine relationships between the prevalence of community and non-classroom-based school substance prevention strategies and teen substance use rates. After controlling for covariates, analyses indicated that: (1) adult-supervised after-school activities were significantly related to lower past 30-day cigarette smoking and both past 30-day alcohol use and binge drinking; (2) unsupervised after-school recreational facilities were significantly associated with both lower past 30-day cigarette smoking and current daily smoking; (3) community activities to reduce substance use were significantly related to lower binge drinking; and (4) student organizations to …

Alcohol, Tobacco, And Pharmaceutical Industry Funding: Considerations For Organizations Serving Lesbian, Gay, Bisexual And Transgender Communities, Laurie A. Drabble

Faculty Publications

Emerging research suggests that alcohol, tobacco and drug-related problems may be higher in lesbian and gay communities than in the population as a whole. At the same time, alcohol, tobacco and pharmaceutical industries have increased marketing strategies that are targeted specifically to lesbian and gay communities. Lesbian, Gay, Bisexual and Transgender (LGBT) and HTV/AIDS organizations, often marginalized and under-funded, have frequently faced significant challenges in funding programs and special events. These organizations are often the very same groups needed to promote and support effective substance abuse countermeasures in LGBT communities. Agency leaders, community members, and substance abuse prevention advocates all …

Compliance To Bleach Disinfection Protocols Among Injecting Drug Users In Miami, Clyde B. Mccoy, James E. Rivers, H. V. Mccoy, Paul Shapshak, Norman L. Weatherby, Dale D. Chitwood, J. Bryan Page, James A. Inciardi, Duane C. Mcbride

Faculty Publications

Bleach cleansing of injection equipment has been recommended to reduce the risk of human immunodeficiency virus (HIV) transmission associated with the reuse of injection equipment by injecting drug users (IDUs). We evaluated the recall and performance of the most commonly recommended bleach cleansing procedure of two complete fillings of the syringe with bleach, followed by two complete fillings with rinse water, and not putting used bleach and water back into source containers. IDUs were taught this procedure on enrollment in an HIV prevention demonstration project in Dade County, Florida. During follow-up session 6-12 months after initial training, the knowledge and …