Substance Abuse and Addiction Commons^™

The Efficacy Of Transversus Abdominis Plane Block As An Adjunct To Spinal Anesthesia For Cesarean Delivery: An Evidence Synthesis And Implementation Toolkit, Alyssa Hebert, Alex Potts, Gabriela Robertson

Graduate Theses, Dissertations, and Capstones

Postoperative pain hinders cesarean delivery recovery and overall patient experience. Although spinal anesthesia with intrathecal opioids remains the standard of practice, associated side effects and concerns regarding opioid exposure highlight the need for effective opioid-sparing strategies. Anesthesia providers play a critical role in advancing postoperative pain management through evidence-based protocol development, provider education, and interdisciplinary collaboration to optimize maternal outcomes. The transversus abdominis plane (TAP) block provides somatic analgesia to the anterior abdominal wall by targeting the thoracolumbar nerves (T6–L1) and has increasingly been incorporated into multimodal postoperative pain management strategies for abdominal surgery. Nevertheless, a gap remains in obstetric …

Non-Metropolitan Vs. Metropolitan Variations In Alcohol, Illicit Drug, And Prescription Therapeutic Drug Misuse, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

Alcohol Use. The prevalence of past year and past 30-day drinking was lower among non-metropolitan (non-metro) than metropolitan (metro) residents. However, non-metro drinkers engaged in more frequent binge drinking than metro drinkers. Drinking 3-5, 6-19, and 20-30 days over the past 30 days were higher among non-metro than metro residents.

Illicit Drug Use. Hallucinogens were the mostly commonly used illicit drugs among non-metro as well as metro residents. Methamphetamine use was significantly higher among non-metro than metro residents.

Prescription Pain Reliever Use. The misuse of prescription pain killers, primarily prescription opioids, was higher among non-metro than …

Alcohol Awareness, Prevention, And Education In Greek Life, Vivian J. Mcmechen, Kara Ann Lasater, Page Dobbs

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Alcohol consumption is normalized in Greek Life culture, and this social standard can lead to risky health behaviors and overconsumption. At the University of Arkansas, approximately one-third of students are members of Greek Life; there is a need for prevention methods that understand students’ lived experiences. Purpose: The purpose of this study is to examine students’ experiences with alcohol prevention, awareness, and education as current members of Greek Life at the University of Arkansas. Through student interviews and surveys, this project aims to inform and provide recommendations for relatable and student-centered alcohol prevention and education efforts. Methodology: This study …

Governing Addiction: An Anthropological Comparison Of Care In The United States And The Netherlands, Kiren K. Bagga

Bates College Journal of Political Studies

This article examines addiction care as a form of moral governance through a comparative anthropological analysis of the United States and the Netherlands. Drawing on a Foucauldian theory of biopolitics alongside this study argues that approaches to addiction treatment reveal how states differentially value life, citizenship, and vulnerability. Joan Tronto's relational definition of ethical care is used to move beyond a solely moral context, towards an ethical understanding of both caretakers and those who require care. In the United States, addiction policy has historically functioned as a punitive and moralizing project, shaped by racialized drug criminalization, neoliberal ideals of individual …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

Health Data And Policy Related To Methamphetamine-Use Suicide In Mississippi, Mary C. Drane

Honors Theses

The purpose of this research is to investigate how methamphetamine use in Mississippi, especially in its rural areas, intersects with public health, policy, and suicide outcomes in the state. Mississippi's methamphetamine crisis has evolved significantly, shifting from locally produced drugs to cartel-supplied crystal methamphetamine, while state and federal policies have struggled to keep pace with the scale and complexity of the problem. Using a convergent parallel mixed-methods design, this research analyzed CDC Wonder multiple causes of death data and SAMHSA Treatment Episode Data Set Admissions (TEDS-A) data from 2018 to 2024 alongside four qualitative key informant interviews with stakeholders across …

Fact Sheet: Kratom, Cadence Johnnie, Ashley Yaugher, Aaron Hunt, Cara Murray, Timothy Keady

All Current Publications

There are many common myths and misunderstandings associated with kratom. Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia. In recent years, kratom use has grown in the United States. It is sold in various forms, including capsules, powders, and most commonly as liquid extracts or “shots." These kratom products are promoted as health supplements, advertised for benefits such as boosting energy, enhancing mood, or producing opioid-like effects. However, most users may not fully understand what they are consuming or the potential risks it carries. Commercial kratom products vary widely in their chemical composition. Synthetic (human-made) or …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Prevalence And Factors Associated With Alcohol And Illicit Drug Use Among Brazilian Youth: A Multicenter Cross-Sectional Study, Emerson Brito, Marina Bessel, Natalia Luiza Kops, Lucas Albrechet-Souza, Flavia Moreno, Alexis Koskan, Thayane Martins Dornelles, Ben Hur Graboski Pinheiro, Suelen Basgalupp, Eliana Wendland

School of Medicine Faculty Publications

This study examined alcohol and illicit drug use among Brazilian youth aged 16 to 25 during the transition to adulthood. A multicenter, cross-sectional survey was conducted between Sep-2016 and Dec-2017 across all 26 Brazilian state capitals and the Federal District. A total of 8,581 participants completed structured interviews on substance use and sociodemographic characteristics. Lifetime prevalence was 71.6% for alcohol and 30% for illicit drugs. Frequent alcohol use was more common among males, while the most used illicit substances were cannabis (27.4%) and cocaine (9.9%). Participants without a partner had higher rates of alcohol and hallucinogen use, while those with …

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

The Use Of Glp-1 Agonists In Alcohol Use Disorder And Reducing Alcohol Consumption: A Scoping Review, Alec Birnbaum, Yashas Sattur, Akash Patel

Rowan-Virtua Research Day

Alcohol use disorder (AUD) reigns as one of the most pressing issues in the United States with high rates of complications, morbidity, and mortality. Recent studies have exhibited the potential for Glucagon-Like Peptide-1 (GLP-1) agonists to decrease alcohol cravings or alcohol-related adverse events through human and animal studies via reward and satiety signaling pathways. To investigate the ability of GLP-1 agonists to decrease alcohol use, alcohol cravings, and alcohol-related adverse events, this study conducted a scoping review of the current literature to uncover the potential benefit of GLP-1 agonists in patients with AUD. A systematic search across 6 databases was …

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

Staying Safe When Taking Prescription Opioids, Aaron Hunt, Gabriela Murza, Amy May, Jenna Hawks, Alyssa Ferrin

All Current Publications

Prescription opioids, such as oxycodone, morphine, codeine, and hydrocodone, are often used for short-term pain management, and it is important to know how to keep yourself safe when taking opioids prescribed by a doctor. This fact sheet reviews what opioids are, how they work in the body, and how people become dependent on or overdose on opioids. It also offers how to limit your risk of dependence and suggests alternative pain management options.

Evaluating Engagement In Health Care And Substance Use Disorder Services Among People Who Use Drugs, Tiffany Mckenney, Kevin Cobty, Divya Boorle, Julie Gleason-Comstock

Medical Student Research Symposium

An urban community-based organization conducted a study to examine demographics of individuals who use drugs and their approaches to risk reduction. A substantial proportion reported encountering significant barriers to accessing substance use disorder (SUD) services.

In collaboration with a state survey, the community organization recruited a convenience sample of individuals who actively used drugs, examining substance use patterns, healthcare access, and barriers to SUD services. Community health workers facilitated outreach efforts, focusing on harm reduction engagement, and healthcare access.

Data were collected from 55 individuals. 51% identified as male, 48% as female, and 2% as LGBTQIA+. 67% identified as White/Caucasian, …

Investigating The Impact Of Tirzepatide Treatment On Alcohol And Cigarette Consumption, Yvannia Gray, Benjamin Latey, Hayden Mcaffee, Karissa Mccown, Seth Maki, Victoria Nguyen, Andrew Payne

Annual Research Symposium

No abstract provided.

Impaired Driving Among Rural Appalachian Women In The Year Following Incarceration, J. Matthew Webster, Megan F. Dickson, Shawn M. Jamison, Michele Staton

Journal of Appalachian Health

Introduction: Despite the known risks associated with substance use following incarceration, no studies have examined substance-impaired driving as a post-incarceration health risk behavior in rural Appalachia.

Purpose: The present study examined differences by impaired driving following incarceration and identified predictors of impaired driving in sample of rural Appalachian women with a history of drug use and risky sex.

Methods: Women (N=340) from three rural Appalachian jails completed a baseline interview in jail and follow-up interviews at six and 12 months post-release. Interview questions included demographic characteristics and information on substance use risk, mental health, criminal legal system involvement, and impaired …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Opioid Knowledge And Experiences In Nebraska College Students, Natalie Holding

Theses/Capstones/Creative Projects

This study investigated opioid-related knowledge and experiences among 83 Nebraska college students, with an emphasis on awareness, perceived risks, and educational needs regarding opioids and the overdose-reversing drug, naloxone. For participants who have used opioids outside of a doctor’s orders, questions were asked regarding motivations, comorbidities, coping mechanisms, and treatment experiences. Data were collected via an anonymous survey featuring closed- and open-ended questions. Results showed that 41% of participants reported feeling moderately knowledgeable about opioid risks, while 34% felt only slightly knowledgeable. Although 80.7% of participants were aware of naloxone, most were uncertain either about (22.9%) or did not know …

Increasing Referrals To Local Resources For The Treatment Of Aud By Increasing Audit-C Usage By Increasing Awareness Of Aud Through Use Of Educational Materials ​, David Ortiz, Gerardo Munoz Monaco

Research Colloquium

Background: One in nine people will suffer from alcohol use disorder, if of legal drinking age. One in nine of our patients might suffer from AUD. Among those suffering from AUD, only 1.6% were found to be treated with evidence-based medications for treatment of AUD. Underdiagnosing may be a reality.

Methods: Evaluate physicians-in-training knowledge regarding AUD at time zero and after 3 months after an educational presentation is giving containing information on AUD diagnosis, treatment, and available local resources. This repeated cross-sectional data analysis aims to increase screening using the AUDIT-C tool, as well as referral/utilization to local resources. Patients …

Past-Year Hiv Testing, Current Antiretroviral Therapy Use, And Participation In Services For People Who Inject Drugs, Itunu Sokale, Johnny Wilkerson, Paige Wermuth, Folefac Atem, Janet Burnett, Cyprian Wejnert, Salma Khuwaja, Catherine Troisi

Faculty, Staff and Student Publications

Evaluating routine HIV testing and treatment and use of services for people who inject drugs (PWID) is critical to curb the ongoing HIV epidemic. We analyzed data from the 2018 National HIV Behavioral Surveillance of PWID aged 18 years or older, recruited using respondent-driven sampling and offered anonymous HIV testing after survey. We performed bivariate and multivariable analyses with log-linked Poisson regression of the generalized linear models to examine the associations between demographics and PWID service use, past-year HIV testing, and current antiretroviral therapy (ART) use. Among 10,311 HIV-negative PWID, 56% reported past-year HIV testing, and of the 553 HIV-positive …

Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow

University Honors Theses

Harm reduction (HR) is a movement focused on reducing the harms of the opioid overdose crisis through education, advocacy, and community engagement. A key component of HR is naloxone, a medication which reverses opioid overdoses when administered. Due to increased fentanyl contamination, opioid overdose deaths have been on the rise among adolescents in the U.S and HR practices are crucially important at this point in time. In recent years, alternative curricula of HR education have included a neuroscience-based approach to the topic of substance use. While both traditional and alternative programs have had success increasing substance use literacy among adolescents, …

The Frequency And Predictive Factors Of Change In Alcohol Consumption During The Covid-19 Pandemic: Results From A Multi-Country Longitudinal Study, Carolien Verhei, Nadja Alexandrov, Erica I. Lubetkin, Gouke J. Bonsel, John N. Yfantopoulos, Mathieu F. Janssen, Stephanie C.E. Schuit, Suzanne Polinder, Pleunie P.M. Rood, Juanita A. Haagsma

Publications and Research

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries. Methods: Longitudinal study design with 4999 participants (47% male; aged 18–75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US). Measurements: Three web-based surveys at …

What Do Extension And Public Health Educators Need To Address Substance Misuse?, Lisa Washburn, Karen Franck

Journal of Extension

Limited organizational capacity has hindered Extension’s ability to address substance misuse in communities. To inform capacity-building efforts, we obtained Extension educator and health educator feedback on opportunities, challenges and resource needs using the Delphi technique. Opportunities included collaboration and partnerships with local entities. Stigma, inadequate resources, and limited knowledge and skills of educators were challenges. Top resource needs were updated youth curricula, funding, and clear guidance on what educators can do and what should be referred externally. Findings provide insights to educator perceptions and suggest additional training and resources needed to implement evidence-based approaches to address substance misuse.

Biofeedback Gaming For Substance Use Disorder, Rebecca L. Chevrel

University Honors Theses

Substance Use Disorder (SUD) and stress are often predictive of one another, bidirectionally causal, and mutually intensifying. This thesis describes the bi-directional connection between physiological stress-modulating systems and Substance Use Disorder, and explores some emerging biofeedback stress-reduction gaming technology as a potential adjunct to recovery treatments. Improving autonomic balance, often described by Heart Rate Variability, has been shown to be beneficial for physical and psychological recovery, as well as improving self-control. For this reason, regular biofeedback for stress relief could be helpful in augmenting SUD treatment and preventing relapse. This exploration found that presenting it through a gaming lens may …

Opioid-Related Emergency Department Visits Before And During Covid-19: Association With Community-Level Factors, Timothy F. Page, Weiwei Chen, François Sainfort, Julie A. Jacko

HCA Healthcare Journal of Medicine

Background

The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits.

Methods

We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations …

Polygenic Scores For Tobacco Use Provide Insights Into Systemic Health Risks In A Diverse Ehr-Linked Biobank In Los Angeles, Vidhya Venkateswaran, Kristin Boulier, Yi Ding, Ruth Johnson, Arjun Bhattacharya, Bogdan Pasaniuc

Faculty, Staff and Student Publications

Tobacco use is a major risk factor for many diseases and is heavily influenced by environmental factors with significant underlying genetic contributions. Here, we evaluated the predictive performance, risk stratification, and potential systemic health effects of tobacco use disorder (TUD) predisposing germline variants using a European- ancestry-derived polygenic score (PGS) in 24,202 participants from the multi-ancestry, hospital-based UCLA ATLAS biobank. Among genetically inferred ancestry groups (GIAs), TUD-PGS was significantly associated with TUD in European American (EA) (OR: 1.20, CI: [1.16, 1.24]), Hispanic/Latin American (HL) (OR:1.19, CI: [1.11, 1.28]), and East Asian American (EAA) (OR: 1.18, CI: [1.06, 1.31]) GIAs but …