Substance Abuse and Addiction Commons^™

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

Honors Theses and Capstones

Introduction: Nursing education prepares students to care for patient populations by enhancing knowledge of clinical pathophysiology and applying foundational nursing skills to tailor to the unique care requirements of each patient. When analyzing the nursing course curriculums as guides for what is included in nursing education, it is essential to consider relevant patient populations to ensure adequate representation in lectures. Inclusivity of relevant patient populations within curriculums equips students to encounter a variety of patients in a clinical setting. Perinatal substance use has prevalence in the local community of this university, with 6% of all births in New Hampshire in …

Stress And Reward Interactions In Substance Use Disorder: An Evolutionary Mismatch Framework, Nicholas L. Castrucci

Honors Theses and Capstones

Substance use disorder (SUD) is a major public health concern characterized by compulsive substance use despite adverse consequences. While contemporary models emphasize biological, psychological, and environmental contributors, stress- and reward-related systems are often examined in isolation. This review integrates these systems within an evolutionary mismatch framework to examine how chronic stress exposure and repeated substance use increase vulnerability to addiction. Stress and reward systems are evolutionarily conserved but may become chronically dysregulated under modern conditions characterized by persistent psychosocial stressors and highly potent rewarding stimuli. This is associated with converging neuroadaptations across stress and reward circuitry, resulting in altered affective …

Enhancing Nursing Education To Improve Care For Women Experiencing A Substance Use Disorder During Pregnancy, Sadie Caddell

UNH URC Open (2026 and after)

Enhancing Nursing Education to Improve Care for Women Experiencing a Substance Use Disorder During Pregnancy

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 …

Utilizing Outpatient Telehealth As A Treatment Approach For Patients With Substance Use Disorder: A Quality Improvement Project, Veronica Kwegyir-Afful

DNP Scholarly Projects

Background: The issue of substance use disorder (SUD) has demonstrated a growing prevalence both in the United States (U.S.) and globally. Effective treatment modalities have been devised for individuals afflicted by SUD, thereby enabling their post-treatment prognosis to be parallel to that of patients with other chronic diseases, such as diabetes. However, several factors or barriers impede individuals with SUD from assessing treatment. These barriers encompass financial constraints stemming from inadequate insurance coverage and high cost, the stigma surrounding SUD, which results in patient's hesitancy to seek treatment treat, adverse societal attitudes, collateral social percussions like work hour losses and …

Mindfulness And Pain Regulation: The Role Of Acceptance And Commitment Therapy For Individuals With Chronic Pain, Ariana C. White

Honors Theses and Capstones

Chronic pain is a significant and widely prevalent health condition which requires comprehensive care to address the many facets contributing to symptomatology. In 2016, 20% of American adults (about 50 million) reported experiencing chronic pain, of which 7.4% indicated that chronic pain frequently limited their life and participation in activities within the past 3 months (CDC, 2018). As a result, many individuals with chronic pain turn to opioid-based medication for pain relief, but long-term use of opioids actually increases pain sensation (Tobin, 2019). Moreover, opioid medication is unable to target underlying mental health components which emerge as part of chronic …

Optimizing The Effectiveness Of Naloxone Distribution In The State Of New Hampshire: A Program Evaluation, Lisa M. Armes

DNP Scholarly Projects

In order to develop an understanding of the state-funded community naloxone distribution program in New Hampshire, a program evaluation was conducted. The project collected data on distributed naloxone and opioid overdose deaths between the years of 2014-2018 but focused primarily on comparing data from 2017 and 2018. There were 409 opioid deaths in 2017 and 399 opioid overdose deaths in 2018 in New Hampshire. Between 2017 and 2018, naloxone supply was increased by 38%-493%, varying widely across New Hampshire counties. Statistically significant increases in naloxone distributed to target users occurred only in Hillsborough and Strafford counties. Significant changes in death …

A Pilot Of Emergency Department-Initiated Buprenorphine For Opioid Withdrawal And Opioid Use Disorder: A Quality Improvement Project, Jason Lucey

DNP Scholarly Projects

Background: Emergency department (ED) visits for opioid related visits have increased dramatically during the opioid epidemic. Buprenorphine is an evidence-based therapy for treating opioid use disorder (OUD) and withdrawal. Unfortunately, lack of access to pharmacotherapy for OUD, including buprenorphine, remains a challenge. Research supports ED-initiated buprenorphine as a practical, cost-effective strategy which engages patients in treatment better than non-pharmacologic alternatives.

Purpose: The aims of this improvement project were to 1) develop a pilot process in an ED for providing buprenorphine to patients in opioid withdrawal or for OUD; 2) recruit and train a cohort of ED staff on the process; …

Peer Support For Addiction In The Inpatient Setting, Rebecca Sweeney

DNP Scholarly Projects

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered …

Substance Use Disorder Treatment Confidentiality Boot Camp, Lucy C. Hodder, Stephanie Cameron, Marcy Doyle, Christina Muñiz, Jeanne Ryer Edd

Law Faculty Scholarship

[Excerpt]: "INTRODUCTION: The Health Law and Policy Programs at UNH School of Law, Institute for Health Policy and Practice, and the NH Citizens Health Initiative have contracted with several of the New Hampshire Building Capacity for Transformation Delivery System Reform Incentive Payment (DSRIP) Integrated Delivery Networks (IDN) to provide technical assistance to the IDNs as they develop confidentiality tools related to substance use disorder services projects.

A UNH Team assisted the IDNs by providing an educational summary of federal and state confidentiality requirements, focusing on 42 CFR Part 2, and hosting IDN interdisciplinary teams in three Substance Use Disorder (SUD) …

Empathy, Casey Golomski

Anthropology

A short poem about suicidal ideation and alcoholism in the United States.

Drugs, Alcohol, And Suicide Represent Growing Share Of U.S. Mortality, Shannon M. Monnat

Carsey Publications

In this brief, author Shannon Monnat identifies trends in mortality rates from drugs, alcohol, and suicide by race and sex for adults aged 25 to 54, from the years 2000 to 2014. She reports that—nationwide--the mortality rate from deaths involving drugs, alcohol, and suicide rose 52 percent from 2000 to 2014. Drug, alcohol, and suicide mortality rates are highest among middle-aged non-Hispanic white males and are growing fastest among non-Hispanic white females. Nearly half of all young white male deaths are caused by drugs, alcohol, or suicide. A little over a quarter of young Hispanic male deaths and 13 percent …

Associations Of Suicidal Ideation With Opioid/Prescription Drug Use, Violence, Food Insecurity, And Community Factors Among New Hampshire High School Students, Emily R. Carbonara, Semra Aytur

Honors Theses and Capstones

Purpose: Suicide is the second leading cause of death for New Hampshire (NH) youth. Evidence-based public health emphasizes the use of data for translating research into practice/policy. We utilized data from the Youth Risk Behavior Survey (YRBS) to support community-academic partnerships and inform suicide prevention interventions. Methods: Data from the 2011 NH YRBS, a cross-sectional survey of 9th-12th grade students, were analyzed. Gender-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models (SAS 9.4, ProcSuveylogistic) to evaluate associations between suicidal ideation (seriously considering attempting suicide within the past 12 months), violence (e.g., physical bullying, …

Teen Stress And Substance Use Problems In Coös: Survey Shows Strong Community Attachment Can Offset Risk, Karen T. Van Gundy, Meghan L. Mills

Carsey Publications

This brief explores how social stress and community attachment are related to problem alcohol and drug use for girls and boys in Coös County, New Hampshire. The brief uses survey data from the Coös Youth Study, which includes self-reported information from 564 Coös youth who were in seventh and eleventh grades in 2008, and who were surveyed again one year later (in 2009) when they were in eighth and twelfth grades. Nearly one-fourth of youth in Coös County (22 percent of boys and 23 percent of girls) reported at least one alcohol or drug use related problem. The authors note …

Pledge Your Body For Your Bread: Welfare, Drug Testing, And The Inferior Fourth Amendment, Jordan C. Budd

Law Faculty Scholarship

Proposals to subject welfare recipients to periodic drug testing have emerged over the last three years as a significant legislative trend across the United States. Since 2007, over half of the states have considered bills requiring aid recipients to submit to invasive extraction procedures as an ongoing condition of public assistance. The vast majority of the legislation imposes testing without regard to suspected drug use, reflecting the implicit assumption that the poor are inherently predisposed to culpable conduct and thus may be subject to class-based intrusions that would be inarguably impermissible if inflicted on the less destitute. These proposals are …

Too Much Free Time: Coos County Youth Who Are Least Involved In Out-Of-School Activities Are Most Likely To Use Drugs And Alcohol, Erin H. Sharp

Carsey Publications

Carsey Institute researchers are seeing links between the self-reported substance use and involvement in out-of-school activities. As part of a ten-year tracking survey of high school students in Coos County, New Hampshire, this brief finds that those most involved with constructive activities report the least amount of substance abuse.

Help In A Haystack: Youth Substance Abuse And Mental Health Services In The North Country, Meghan L. Mills

Carsey Publications

A new brief from Nordblom Fellow Meghan Mills at the Carsey Institute finds that youth in New Hampshire's North Country have challenges in accessing support for substance abuse and mental health issues. Mills also finds that the providers face unique challenges, from getting referrals to hiring professionals, all while working without a functional network.

College Athletes Having More Than Just A Sip, Lia M. Barros

Inquiry Journal 2008

No abstract provided.

Performance Indicator Analysis Of Proficiency Criteria In The Drug-Testing-Laboratory Certification Process Of The Dhhs, John M. Gleason, Darold T. Barnum

RISK: Health, Safety & Environment (1990-2002)

The authors highlight and propose remedies for problems in the proficiency criteria used in certifying laboratories for drug testing federal employees in the United States.

Unspeakable Suspicions: Challenging The Racist Consensual Encounter, Peter Schoenburg, Risa Evans

Law Faculty Scholarship

[Excerpt] "In recent years, law enforcement officials have honed a new technique for fighting the "War on Drugs:" the suspicionless police sweep of stations and vehicles involved in interstate mass transportation. Single officers or groups of officers approach unfortunate individuals in busses, trains, stations and airline terminals. A targeted traveller is requested to show identification and tickets, explain the purpose of his or her travels, and finally, at times, to consent to a luggage search. As long as "a reasonable person would understand that he or she could refuse to cooperate," the encounter between the law-enforcement official and the traveller …

The Supreme Court As Risk Manager: An Analysis Of Skinner, Todd F. Volyn, James F. Mogan, Lisa M. White

RISK: Health, Safety & Environment (1990-2002)

Examining a recent case in which the U.S. Supreme Court approved the collection of blood and urine samples from railroad employees, the authors conclude that, in attempting to improve railroad safety, both majority and minority opinions reflected undue emphasis on technical issues and inadequate attention to the intangible social values underlying traditional Constitutional rights to privacy.

Book Review, Jennifer L. Frizzell

RISK: Health, Safety & Environment (1990-2002)

Review of the following: THOMAS SZASZ, OUR RIGHT TO DRUGS: THE CASE FOR A FREE MARKET. (Praeger 1992) [164 pp.] Notes, bibliography, name index, notes, preface, subject index. LC: 91-30378; ISBN: 0-275-94216-3. [Cloth $19.95. P.O. Box 5007, Westwood CT 06881-9990.]

Book Review, John M. Gleason

RISK: Health, Safety & Environment (1990-2002)

Review of the following book: ROBERT THOMPSON, JR., SUBSTANCE ABUSE AND EMPLOYEE REHABILITATION (BNA Books 1990) [485 pp.] Appendices, bibliography, index, table of cases. LC-90-2629; ISBN 0-87179-649-X

Predictive Probabilities In Employee Drug-Testing, John M. Gleason, Darold T. Barnum

RISK: Health, Safety & Environment (1990-2002)

Substance abuse in the U.S. has been estimated to cost $99 billion annually through lower productivity. Yet the authors urge caution in attempting to reduce these costs and health and safety Risks. In doing so, they cite commonly high frequencies of false negatives and false positives in employee drug tests - the latter having the potential to do great injustice to many drug-free employees.