Health Insurance And Moud: Predicting Oud Treatment Success, Amy S. White, Jennifer I. Manuel

Publications and Research

Background

Opioid use disorder (OUD) is a chronic condition with low rates of treatment success; use of medication for OUD (MOUD) is inconsistent across treatment settings. The purpose of this study was to examine the independent and interactive associations of MOUD and health insurance status with successful treatment completion across residential and outpatient treatment settings.

Methods

We conducted multilevel random-effects logistic regression analyses of the 2022 Treatment Episode Dataset–Discharge (TEDS-D) to estimate associations among MOUD receipt, insurance status (Medicaid, Medicare, private insurance, uninsured), and treatment completion. Models adjusted for demographic and clinical characteristics and stratified by treatment setting. The sample …

Financial Recovery Capital: Exploring The Role Of Extension Education In Promoting Substance Use Recovery, Alex Elswick, Nichole L Huff, Omolola A. Adedokun, Leslie Workman

Journal of Extension

Substance use is a widespread and complex public health challenge. Financial stress (e.g., unemployment, inadequate housing, transportation access, poor financial literacy) is pervasive among people with substance use disorder (SUD). However, few educational interventions exist to address financial stress for this group. Through the theoretical lens of recovery capital (an asset-based approach that describes the totality of resources that support SUD recovery), we summarize the association between financial stress and substance use, offering implications for Extension educators by highlighting PROFIT, an exemplary program that leverages Extension education as a tool to promote financial recovery capital among people with SUD.

Responding To Medetomidine In Philadelphia: Narrative Summary Of The Public Health Response To A New Psychoactive Substance, Tareva Warrick-Stone, Serge-Emile Simpson, Phil Durney, Dennis Goodstein, Catherine Abrams, Raymond Bobb, Kory London, Daniel Teixeira Da Silva

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Despite the emergence of medetomidine as the dominant adulterant in Philadelphia's illicit opioid supply, coordinated public health responses are limited or non-existent in the literature. Thus, we summarize a recent Summit in Philadelphia of outpatient and inpatient service providers who specialize in the care of persons who use drugs to discuss medetomidine response readiness and building ongoing community readiness for potential destabilizing drug supply changes.

PURPOSE: Describe a public health intervention that distributed information about practices across health care settings and mobilized key informants to identify and address barriers to treatment.

METHODS: Descriptive summary of the in-person Summit organized …

Nicotine Pouches: Harm Reduction Or Initiation Pathway? A Pharmacy-Focused Review, Emmanuel Fashesin Souza, Keykavous Parang

Pharmacy Faculty Articles and Research

Background

Nicotine pouches (NPs) are a rapidly growing category of tobacco-free oral nicotine products increasingly available in the community, including pharmacies. Whether NPs primarily function as harm-reduction tools for existing tobacco users or as a novel initiation pathway into nicotine and tobacco use, particularly among youth, remains a critical and unresolved clinical and public health question.

Objectives

To synthesize current evidence on the pharmacology, harm-reduction potential, and initiation risk of NPs; to compare NPs with U.S. Food and Drug Administration-approved nicotine replacement therapy and combustible cigarettes; and to identify implications and counseling priorities for pharmacy practice.

Methods

A narrative evidence …

Breaking The Cycle: From Victimization To Offending Through The Lens Of Human Services, Colette R. Penalosa

Master of Arts in Human Services

The victim-offender overlap challenges the common view that victims and offenders are separately labeled by recognizing that both groups have experienced significant childhood trauma, physical, emotional, and psychological abuse, neglect, and other adverse childhood experiences (ACEs). Current research implies these experiences can increase the risk of offending as they all influence cognitive and behavioral development while leaving criminal behavior undetermined. The purpose of this capstone is to analyze the relationship between childhood victimization and offending from a human service perspective; analyzing the pathways a victim takes on the road to offending. Research conducted will focus on exploring the victim-offender overlap, …

Sober Curious: A Treatment Manual For A Semi-Structured Interpersonal Process Group Targeting Substance Misuse In Emerging Adults, Annalise G. Floody

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper presents Sober Curious, an original treatment manual for an eight-session, semi-structured interpersonal process group for emerging adults ages 18–25 with mild-to-moderate substance misuse concerns. This group is designed for university counseling centers and outpatient treatment settings, particularly for individuals who experience substance-related distress, impairment, risk, or ambivalence but may not identify with abstinence-based recovery or formal diagnostic substance use disorder (SUD) language. The manual is grounded in epidemiological data, established substance use treatment guidelines, meta-analytic findings on group psychotherapy and substance use interventions, and the developmental theory of emerging adulthood. Key intervention elements include motivational interviewing (MI) to …

Trauma Processing And Sleep Inconsistencies In Firefighters: A Proposed Program To Bridge Gaps And Set Heroes Up For Success, Megan Griffin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This doctoral paper presents a comprehensive review of the literature supporting the need for an integrated training program addressing sleep disruption, trauma exposure and processing, and substance use as a self-medication strategy among firefighter populations. Drawing on empirical research, the paper examines the prevalence and interaction of posttraumatic stress disorder (PTSD), moral injury, sleep disturbances, and substance use within this occupational group. The introduction provides operational definitions of PTSD and moral injury and synthesizes existing research on trauma exposure, sleep impairment, and substance use functions among firefighters. The literature review also highlights evidence-based, exposure informed interventions to facilitate adaptive trauma …

The Safe Fishbowl Model: Psychological Safety By Design In Counseling Skills Training, Mike Mariska

Journal of Counselor Preparation and Supervision

Skills training in counselor education can be constrained by performance anxiety, which may reduce participation, limit deliberate practice repetitions, and shift demonstrations to the instructor. This applied-practice manuscript introduces the SAFE (Structured Avatar and Feedback Experience) Fishbowl model, a simulation architecture designed to address performance anxiety while scaling participation. SAFE Fishbowl integrates rotating counselor roles, a real-time coaching loop, structured observation grounded in experiential learning theory, and purposeful debriefing. An implementation example for group counseling leadership skills is provided, along with adaptation guidance across multiple skill domains and delivery modalities. Descriptive course-evaluation feedback illustrates feasibility and perceived usefulness. Implications include …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

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 …

Essays On Opioid Prescription Limit Policy Diffusion, Evaluation, And Opioid Use Disorder Treatment Utilization, Md Ashiqur Rab

All Dissertations

The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive …

Sicker Americans Are More Likely To Misuse Prescription Medications, Esther Oshaji, Andrew S. London

Population Health Research Brief Series

Prescription medication misuse is a long-term population health problem in the United States. This data slice uses data from the National Wellbeing Survey (N=32,789, 2021–2025) of U.S. adults ages 18–64 to examine how the number of chronic health conditions a person has is related to their misuse of prescription opioids, tranquilizers, sedatives, or stimulants in the past 12 months. The authors find a dose-response pattern: misuse rises from 2.8% among those with no chronic conditions to 11.7% among those with three or more conditions. Mental health conditions show stronger associations with misuse than physical health conditions.

Using In-Home Air Quality Monitoring To Reduce Cannabis Secondhand Smoke Exposure In Children: Quantitative Pilot Feasibility Study, Vincent Berardi, Bradley N. Collins, Laura M. Glynn, Eusabeia Silfanus, Darby G. Lyons, Stephen J. Lepore

Psychology Faculty Articles and Research

Background: An estimated 5 to 8 million US children live with a parent who uses cannabis, and most cannabis users report smoking cannabis inside their homes, placing children at risk for cannabis secondhand smoke (cSHS) exposure. Indoor air quality (IAQ) monitoring provides real-time feedback on airborne pollutants and has shown promise in reducing in-home tobacco secondhand smoke exposure, suggesting its potential as an effective harm reduction strategy for cSHS.

Objective: This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of using low-cost, off-the-shelf IAQ monitors to increase caregivers’ awareness of children’s cSHS exposure risk and to change …

Extraction Of Key Themes In Online Health Discourse Using Unsupervised Learning And Large Language Models, Miranda G. Scully

Computer Science Senior Theses

Health online discussion boards are a modern platform that allow patients to interact with each other and the healthcare system as a whole, making them valuable sources of information for clinicians seeking to better anticipate treatment experiences and barriers. This study focuses on one such community, r/suboxone, a subreddit where patients using Suboxone share their experiences and ask questions. Our analysis is motivated by previous work that proposes event-based classification systems for such posts which buckets posts from r/suboxone into one or more of five high-level labels (Access Logistics, Co-Occurring Drug Usage, Medication for Opioid Use Disorder Administration, Psychophysical Effects, …

The Cannabis Motivation Spectrum: Comparing Medical, Recreational And Dual Intent Users, Addyson Domian, Jacob Borodovsky

Wetterhahn Science Symposium Posters

There is a lack of a standardized definition of “medical” cannabis use in the healthcare industry, which has led to an informal, user-reported definition of medical use. Consequently, individuals who use cannabis for both medical and recreational reasons (dual intent) are not always differentiated from pure medical or pure recreational users. This study compares self-defined medical only and dual intent motivational groups relative to recreational only users to better understand how these groups differ by analyzing sociodemographic and use patterns, clinically relevant factors, and claimed cannabis-related benefits. Using data from the Qualtrics Cannabis Exposure Index survey instrument of 8836 adult …

Enhancing Primary Care Provider’S Knowledge And Use Of Long-Acting And Oral Naltrexone In The Management Of Opioid And Alcohol Use Disorder, Ariana Juarez-Moncada

Doctor of Nursing Practice Final Manuscripts

Abstract

Objective: This evidence-based project aimed to enhance primary care provider knowledge and prescription rates of naltrexone and long-acting injectable (LAI) naltrexone in a community healthcare setting.

Background: Naltrexone and LAI naltrexone pharmacotherapy is shown to reduce use of alcohol and opioids and improve client retention in patients with alcohol use disorder (AUD) and opioid use disorder (OUD) (Bahji et al., 2020; Morley et al., 2024; Murphy et al., 2022).

Methods: A 30-minute in-service was provided to 14 family practice providers at the clinic. The prescription rate of naltrexone and LAI naltrexone was evaluated for the baseline period of February …

Empowering Recovery: Implementing Ace Screenings To Enhance Care For Patients With Substance Use Disorders, Joshua Wolf

Doctor of Nursing Practice Final Manuscripts

Objective: This evidence-based practice project evaluated the impact of implementing adverse childhood experience (ACE) screenings for patients with substance use disorders (SUDs) in an outpatient community behavioral health clinic.

Background: ACEs are strongly associated with an increased risk of developing SUDs, chronic medical comorbidities, and negative treatment outcomes. Despite consistent evidence supporting the need for identification of ACEs and implementing trauma-informed care, standardized ACE screening is not routinely incorporated into outpatient SUD treatment, potentially limiting the identification of the need for education and referrals.

Methods: The ACE Questionnaire for Adults was implemented during routine psychiatric visits for patients diagnosed with …

Disney Princess Films Representation Of Food And Their Effects On Teenage Girls' Eating Norms, Addison Benninghoff

InnovateHER Meeting 2026

Media portrayal obviously have some profound impacts on our society. The problem at hand is that there have been and will continue to be body image and eating habits linked to the media in teenage girls' lives. A mainstream example of this can be seen early on in young girls' lives when they are first exposed to princess films, which have representations of both femininity and the idealized female form. Disney maintains these body ideals whether the heroine is Asian, Scottish, African-American, or Native American.  How are these body ideals broadcast through eating habits? What messages about normative eating might …

Rhythms Of Hippocampal Function And Memory After Moderate Prenatal Alcohol Exposure, Lilliana May Sanchez

Psychology ETDs

Fetal Alcohol Spectrum Disorders involve morphologic and neurobiological abnormalities in offspring subjected to prenatal alcohol exposure. Although not as well studied as high exposure, moderate prenatal alcohol exposure represents the most common and undetected form in humans. While learning and memory deficits have been well characterized at the behavioral level in humans with Fetal Alcohol Spectrum Disorders and in animal models of moderate prenatal alcohol exposure, few studies have determined the circuit or systems level mechanisms of the behavioral deficits. A complete understanding of the neural bases of memory deficits after moderate prenatal alcohol exposure is needed to ultimately identify …