Substance Abuse and Addiction Commons^™

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 …

Addiction In The Prison System: Recidivism And Alternatives, Daniel R. Bowers

Undergraduate Honors Theses

The United States criminal justice system has the highest number of incarcerated individuals in the world, with nearly 2 million people currently being behind bars, and around 7.5 million arrests per year according to the most recent available statistics. A key factor in this is addiction, specifically substance use disorders. Between 58% to 68% of adults arrested are addicted to one or more substances, with 68% of drug involved individuals being rearrested within three years of being released. This recidivism rate is incredibly high, and when combined with current prison and jail overcrowding, has created massive problems for the United …

Investigating The Role Of The Hypocretin/Orexin System In A Novel Model Of Polysubstance Dependence, Tyler Zarin

Electronic Theses and Dissertations

Substance use disorders (SUD) in the United States are steadily increasing. Potent and dangerous substances such as methamphetamine (MA) and fentanyl (FEN) are often co-used as a polysubstance (POLY), either intentionally or unknowingly as FEN is a common adulterant. SUD is characterized by physiological and psychological dependence involving the negative reinforcement of anhedonia and withdrawal which drive hypermotivated drug-taking behaviors. Current theory suggests that recruitment of hypocretin/orexin (HCRT) neuropeptide in reward and stress associated brain regions contributes to drug dependence. Despite strong evidence for HCRT’s role in mono-drug dependence, a relevant model for POLY dependence has yet to be developed, …

Stigma Reduction And Resiliency Training For First Responders (Srrt-Fr): A Feasibility And Initial Efficacy Evaluation, Thalia P. Nicholson

Electronic Theses and Dissertations

First responders, especially law enforcement, frequently encounter individuals experiencing substance use concerns. Previous research has documented that a greater understanding of substance use disorders promotes a decrease in stigmatizing perspectives. We present a novel approach to training law enforcement officers to improve their interactions with community members exhibiting substance use disorders, while also promoting their professional well-being. The present study sought to evaluate the feasibility and acceptability of the Stigma Reduction and Resiliency Training for First Responders (SRRT-FR) in a sample of law enforcement officers, as well as its efficacy in decreasing stigmatizing perspectives towards substance use disorders and increasing …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

Validation Of A Novel Heritable Rodent Model Of Drug Abuse Vulnerability In Psychosis And Investigation Of Therapeutic Targets, Loren D. Peeters

Electronic Theses and Dissertations

Schizophrenia is a severe neuropsychiatric disorder of largely unknown etiology that is often accompanied by high rates of cigarette smoking, reduced quit success, and high relapse rates. Dysregulated dopamine signaling and aberrant synaptic plasticity in the mesocorticolimbic pathway are implicated in the pathophysiology of schizophrenia and conferred substance abuse disorder and relapse vulnerability. Genetic factors are presumed to play a significant role in the development of schizophrenia, with a 40-50% concordance rate for monozygotic twins, although genetic markers are inconsistent. As such, epigenetic factors have instead been implicated. Specifically, there is strong evidence to suggest DNA methylation at several candidate …

Familial Sex Trafficking In East Tennessee, Mary K. Brannock

Electronic Theses and Dissertations

This dissertation was completed in partial fulfillment of the Doctor of Public Health program at East Tennessee State University. The dissertation follows the Manuscript Format which includes three manuscripts, these manuscripts regard familial sex trafficking and are as follows, a scoping review, an empirical study on regional familial sex trafficking, and a policy implications paper on criminal record relief for survivors of familial sex trafficking.

The scoping review includes eight peer reviewed studies on familial sex trafficking and a summary of grey literature. Thematic analysis was used to map the existing literature onto the Three Ps of human trafficking: Prevention, …

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

The Journey From Drug Addiction To Drug Withdrawal: A Christian Gospel Rehabilitation Program In Taiwan, Pi-Ming Yeh

ETSU Faculty Works

Background

World Drug Report estimates the number of opioid users at 53 million and identifies opioids as responsible for two thirds of the 585,000 people who died as a result of drug use in 2017.

Purpose

The purpose of this study was to analyze the testimonies of 30 people regarding their journeys from drug addiction to drug withdrawal in Taiwan.

Methods

This was a qualitative research design. The sample inclusion criteria were as follows: (a) being a drug abuser, (b) completed the Christian Gospel Drug Withdrawal Program or church-sponsored program, and (c) shared their related testimony on the Good TV …

Prevention And Education In Medication Assisted Treatment Facilities, Lindsey Mccartt

Epsilon Sigma at-Large Research Conference

Introduction and Background: Between 1999 and 2014 the number of patients in the labor and delivery that were on medication for opioid use disorder (MOUD) quadrupled. The rate of unintended pregnancies in pregnant patients of mOUD is at a tremendous high due to inconsistencies in the use of reliable contraception in this population.

Purpose Statement: To reduce the number of unintended pregnancies and infants born with neonatal abstinence syndrome there is a need for prevention and required education for men and women in medication-assisted facilities.

Literature Review: Twenty research studies were reviewed and evaluated. These articles were …

The Impact Of Covid-19 On The Opioid Epidemic, Hailey Stewart

Undergraduate Honors Theses

The COVID-19 pandemic adversely affected the lives of most Americans. People with Substance Use Disorder (SUD) were particularly vulnerable to the negative effects brought on by the pandemic. This study explored the increase in deaths due to opioid overdose during the pandemic exacerbated by factors such as increased stress, decrease in treatment options due to social distancing requirements and facility closures, social isolation, and an increase in spare time. Access to treatment for opioid use disorder (OUD) was interrupted by the measures meant to mitigate the spread of COVID-19. Through a systematic review of current literature, it was demonstrated that …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Lgbt Community And Mental Health, Danielle Schleeter

Epsilon Sigma at-Large Research Conference

Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities.

Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health.

Literature Review: This literature review utilized search engines …

A Comparative Study Of Recovery Ecosystems For Opioid Use Disorder In Portugal And Appalachia, Jonathan David Mullins

Undergraduate Honors Theses

A comparison of the structure and effectiveness of recovery ecosystems for opioid use disorder in Portugal and Appalachia, with a focus on identifying areas for improvement within the Appalachian region.

Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, Parker Miller

Undergraduate Honors Theses

Neonatal Abstinence Syndrome (NAS) remains an ever-growing public health issue and a continued avenue for future research. The research question for this retrospective study was whether polysubstance exposure is related to the dose of medication the infant received or to the number of opioid-medications required to treat the infants’ withdrawal symptoms? The hypothesis for the retrospective study was there will be a significant relationship between polysubstance exposure and the dose of medication the infant received as well as the number of opioid-medications required to treat the infants’ withdrawal symptoms. A bivariate correlational indicated that there was not a significant association …

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

ETSU Faculty Works

No abstract provided.

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

ETSU Faculty Works

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

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

ETSU Faculty Works

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

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

Addressing Intimate Partner Violence: Development Of A Trauma Informed Workforce, Andrea D. Clements, Becky Haas, Randi G. Bastian, Natalie Cyphers

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

The Relationship Between Breastfeeding Practices And Postpartum Depressive Symptoms In Appalachian Women, Rose Stephens, Andrea D. Clements, Valerie M. Hoots, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

The Surrender To God Scale: Psychometric Validation And Psychological Correlates, Kelley Pugh, Andrea D. Clements, Jameson K. Hirsch

ETSU Faculty Works

(1) Surrender to God (STG), is a construct which quantifies the extent to which an individual willingly relinquishes control to God. (2) An STG scale has been developed, yet remains unvalidated, as it relates to psychological constructs. (3) Utilizing undergraduate participants (N=249), we conducted a psychometric validation of the STG scale, and examined its potential relation with depression, anxiety, stress, and suicide risk

Antidepressant-Like Actions Of Inhibitors Of Poly(Adp-Ribose) Polymerase In Rodent Models, Gregory A. Ordway, Attila Szebeni, Liza J. Hernandez, Jessica D. Crawford, Katalin Szebeni, Michelle J. Chandley, Katherine C. Burgess, Corwin Miller, Erol Bakkalbasi, Russell W. Brown

ETSU Faculty Works

Many patients suffering from depressive disorders are refractory to treatment with currently available antidepressant medications, while many more exhibit only a partial response. These factors drive research to discover new pharmacological approaches to treat depression. Numerous studies demonstrate evidence of inflammation and elevated oxidative stress in major depression. Recently, major depression has been shown to be associated with elevated levels of DNA oxidation in brain cells, accompanied by increased gene expression of the nuclear base excision repair enzyme, poly(ADP-ribose) polymerase-1. Given these findings and evidence that drugs that inhibit poly(ADP-ribose) polymerase-1 activity have antiinflammatory and neuroprotective properties, the present study …

An Update On The Opioid Epidemic: Perception Vs. Reality, Nicholas E. Hagemeier

ETSU Faculty Works

No abstract provided.

Prevalence Of Communication Disorders In Children With Neonatal Abstinence Syndrome On School Speech-Language Pathology Caseloads: A National Survey, Brittany V. Ratliff

Electronic Theses and Dissertations

There is concern about the recently increasing number of infants born with Neonatal Abstinence Syndrome (NAS), yet little is known about its long-term neurodevelopmental effects. School-based speech-language pathologists (SLPs) are in a unique position to comment on potential long-term consequences of NAS because their caseloads include children with a variety of communication disorders and comorbidities. School-based SLPs across the United States (N = 258) responded to a survey about the presence of children with NAS on their caseloads and their perceptions of the children’s communication disorders and comorbidities. Results revealed that children with NAS currently are being treated by …

The Use Of Vital Statistics Data For Research Of Consequence: Birth Outcomes And Population Health In A Rural Region, Claudia Kozinetz, Shimin Zheng, Eunice Mogusu

ETSU Faculty Works

Objective: The Affordable Care Act (ACA) has influenced increasing interests in population health and population health outcomes. The purpose of this study was to exemplify the importance of using existing vital statistics data for understanding and monitoring health outcomes and consequentially health disparities at the population level. Data from birth records for two geographic regions from 2009-2014 were compared; low birth weight (LBW) and preterm delivery (PD) were used as surrogates for population health outcomes.

Methods: A population-based, multi-year, cross-sectional study design using a pooled dataset of birth records from Tennessee (TN) was the framework for the analyses. …

The Relationship Between Religiosity And Health-Promoting Behaviors In Pregnant Women, Natalie A. Cyphers, Andrea D. Clements, Glenda Lindseth

ETSU Faculty Works

Pender’s health promotion model guided this descriptive/correlational study exploring the relationship between religiosity and health-promoting behaviors of pregnant women at Pregnancy Resource Centers (PRCs). A consecutive sample included women who knew they were pregnant at least 2 months, could read/write English, and visited PRCs in eastern Pennsylvania. Participants completed self-report surveys that examined religiosity, demographics, pregnancy-related variables, services received at PRCs, and health-promoting behaviors. Women reported they “sometimes” or “often” engaged in health-promoting behaviors, Hispanic women reported fewer health-promoting behaviors than non-Hispanic women, and women who attended classes at the centers reported more frequent health-promoting behaviors than those who did …

Prescription Drug Abuse Communication: A Qualitative Analysis Of Prescriber And Pharmacist Perceptions And Behaviors, Nicholas E. Hagemeier, Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Angela Hagaman, Robert P. Pack

ETSU Faculty Works

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods: Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central …

Predictors Of Neonatal Abstinence Syndrome In Buprenorphine Exposed Newborn: Can Cord Blood Buprenorphine Metabolite Levels Help?, Darshan Shah, Stacy Brown, Nick Hagemeier, Shimin Zheng, Amy Kyle, Jason Pryor, Nilesh Dankhara, Piyuesh Singh

ETSU Faculty Works

Background

Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns.

Methods

Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and …

Church Attendance And Intrinsic Religiosity Predict A Lower Likelihood Of Hypertension In 18 To 60 Year Olds, Andrea D. Clements, Natalie Cyphers

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

The Relationship Between Religiosity And Health-Promoting Behaviors In Pregnant Women At Pregnancy Resource Centers, Natalie Cyphers, Andrea D. Clements, Jody L. Ralph

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.