Substance Abuse and Addiction Commons^™

Deconstructing Drugs: Addressing The Stigma, Harm Reduction, And Policy Solutions, Charlotte Theriault

Themis: Research Journal of Justice Studies and Forensic Science

Black and homeless people who struggle with substance use disorder (SUD), especially opioid use disorder (OUD), have experienced unique obstacles due to inequalities relating to their social determinants of health (SDOH). Historical context and peer-reviewed research were used to evaluate racial bias and expand upon the factors that contributed to the opioid crisis, the effects of COVID-19 on drug overdoses, and the presence of fentanyl in illicit drug supplies. Various studies combat the stigma surrounding substance use disorder (SUD) by acknowledging the disease as a chronic health condition. Research showed that the most effective way to combat these inequalities and …

Dance/Movement Therapy: A Novel Approach For Latino Males With Incarceration Histories In Sud Treatment, Aletia Egipciaco

Expressive Therapies Capstone Theses

This paper investigates how open clients would be to participating and engaging in Dance/Movement Therapy (DMT) sessions at a residential SUD facility. The questions asked were (1) What level of engagement would clients have and (2) How would they engage in DMT group sessions at a residential substance use disorder facility? A program lasting 8 weeks, aimed at facilitating DMT group sessions, was conducted at a residential SUD facility twice a week. The objective was to assess participant engagement levels and observe their involvement in the DMT sessions. Residents of the facility were invited voluntarily to attend the DMT groups. …

States’ Covid-19 Restrictions Were Associated With Increases In Drug Overdose Deaths In 2020, Douglas A. Wolf, Shannon M. Monnat, Jennifer Karas Montez, Emily E. Wiemers, Elyse Grossman

Center for Policy Research

Drug overdoses surged in the U.S. during the COVID-19 pandemic. Public health experts raised concerns in the pandemic’s early months about how the pandemic and the policies enacted to stem it might increase overdose risk. This brief summarizes the findings of a paper that used national data to identify how states’ COVID-19 policies affected drug overdose rates among U.S. adults ages 25-64 during the first year of the pandemic. Results show that counties located in states that adopted more aggressive in-person activity restrictions experienced larger increases in 2020 than counties located in states with fewer limitations. State economic support policies …

Psilocybin Utilization In Alcohol Use Disorder, Hannah Hall, Sarah Turske, Hannah Blake, Abigail Carter, Connor Dains, Haylee Whyde, Brianna Lu, Joshua Honaker, Lindsey Peters

Pharmacy and Wellness Review

Alcohol use disorder (AUD) is a medical condition that arises from the inability to control alcohol consumption regardless of negative consequences. Over 10% of the US population met the diagnostic criteria for having AUD in 2022.1 Each individual presents with symptoms of AUD differently and may therefore need more personalized treatment. Research has shown that using a combination of currently available pharmacological and non-pharmacological treatment options provides the best results for patients with AUD. However, there still remains a pressing need for the development of newer treatment options. Psilocybin, a naturally occurring psychedelic compound, is currently under investigation due to …

Standard Rodent Diets Differentially Impact Alcohol Consumption, Preference, And Gut Microbiome Diversity, Aline Zaparte, Evan Dore, Selby White, Franciely Paliarin, Cameron Gabriel, Katherine Copenhaver, Samhita Basavanhalli, Emily Garcia, Rishith Vaddavalli, Meng Luo, Christopher M. Taylor, David Allen Welsh, Rajani Maiya

School of Graduate Studies Faculty Publications

Alcohol use disorder (AUD) is a complex and widespread disease with limited pharmacotherapies. Preclinical animal models of AUD use a variety of voluntary alcohol consumption procedures to recapitulate different phases of AUD, including binge alcohol consumption and dependence. However, voluntary alcohol consumption in mice is widely variable, making it difficult to reproduce results across labs. Accumulating evidence indicates that different brands of commercially available rodent chow can profoundly influence alcohol intake. In this study, we investigated the effects of three commercially available and widely used rodent diet formulations on alcohol consumption and preference in C57BL/6 J mice using the 24 …

Trends In Substance Use And Mental Health Among Adolescents In Georgia, 2002-2022, Saumya S. Palipudi, Bangaru Talli Palipudi, Murty Komanduri

Georgia Public Health Association Annual Meeting & Conference

Background: While substance use and absence of mental health disorders among youth in the United States (US) have declined over the past two decades, post COVID-19 pandemic, these conditions have increased significantly with notable disparities, and witnessed a crisis in public health. In 2022, 24.7% or 6.1 million adolescents aged 12 to 17 in the US had either Major Depressive Episodes (MDE) or Substance Use Disorder (SUD) and 3.7 percent had both in the prior year². Increased stress, lack of peer connections, parental abuse, and poor mental health conditions were attributed to this increase in substance use^{3-7 …}

How Financial Beliefs And Behaviors Influence The Financial Health Of Individuals Struggling With Opioid Use Disorder, James R Langabeer, Francine R Vega, Marylou Cardenas-Turanzas, A Sarah Cohen, Karima Lalani, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

The surge in opioid use disorder (OUD) over the past decade escalated opioid overdoses to a leading cause of death in the United States. With adverse effects on cognition, risk-taking, and decision-making, OUD may negatively influence financial well-being. This study examined the financial health of individuals diagnosed with OUD by reviewing financial beliefs and financial behaviors. We evaluated quality of life, perceptions of financial condition during active use and recovery, and total debt. We distributed a 20-item survey to 150 individuals in an outpatient treatment program for OUD in a large metropolitan area, yielding a 56% response rate. The results …

Role Of Dunc-13 Isoforms In Alcohol Sensitivity In Drosophila, Makenzie Havard

Honors Theses

Functional alcohol tolerance is an adaptation made by the nervous system to high doses of alcohol, and is seen by a significant reduction in sensitivity to this drug. This tolerance is a significant contributing factor in the progression to Alcohol Use Disorders. A major goal of alcohol research is to understand how alcohol induces this tolerance. Dunc13 is a presynaptic active zone protein essential in synaptic vesicle docking and priming. Alcohol binds to the C1 domain of Dunc13 at physiological concentrations, which inhibits Dunc13 from binding Diacylglycerol. This inhibition is predicted to reduce Dunc13 activity and presynaptic activity. Yet, genetically …

Student Pharmacists Educating Patients On Proper Disposal Of Unused Opioid Medications, Ashley Ann Uy, Jessica Cao, Anthony Esposito, Colleen Carrigan, Siddharth Pant, Ashley Kim, Kaylen Louie, Efrain Santiago, Richard Pacitti, Pharmd, Mba, Fashp, Joseph Stavish, Pharmd, Msph, Nicholas Leon, Pharmd, Bcacp, Fcpp

Health Equity and Quality Improvement (HEQI) Summit

Background

• The opioid epidemic is a public health crisis characterized by illicit drug abuse like heroin, fentanyl, and opioid medications (oxycodone and morphine)
• Improper disposal of unused opioids contribute to the opioid epidemic
• Jefferson Health places high importance on opioid stewardship to mitigate the public health risks associated with unused opioids.

Viral Hepatitis And Hiv Screening Amongst Inpatients With Substance Use Disorder, Christine Papastamelos, Md, Elizabeth Novick, Md, Carolyn Kramer, Md, John Zurlo,Md, Nikhil Seval, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• ~67,000 individuals in Philadelphia county are estimated to be living with opioid use disorder (OUD).¹
• Persons who inject drugs (PWID) are at disproportionately greater risk of acquiring HIV and viral hepatitis compared to the general public.²
• PWID are less likely to receive timely HIV and viral hepatitis screening in the outpatient setting given complex biopsychosocial barriers, including homelessness, mental illness, lack of insurance, incarceration, and stigma.^3,4

Protection Or Punishment? Reimagining The Hospital Care Environment For People Who Use Drugs, Natalina Contoreggi, Md, Jillian Zavodnick, Md, Kathleen Mechler, Md, Helene Dailey, Dnp, Rn, Ccrn, Ccctm, Rebecca Jaffe, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem: Jefferson serves a large population of patients who use drugs (PWUD). As the opioid epidemic has evolved, our practice has adapted. Examples of Jefferson's dynamic response include hospital-wide guidelines for withdrawal management and medications for opioid use disorder, establishment of a bridge clinic, and the JAMS service. However, there is little consensus on how to best support this population in the hospital, particularly if they are using or suspected of using non-prescribed substances during their admission.

Aim: Development of accessible guidelines to manage and support PWUD in thehospital.

Patient Safety Case Review: Inpatient Use Of Recreational Opiates, Duncan Kilpatrick, Md, Tammy Tran, Md, Hayley Barker, Md, Gine Urban, Rn, Timothy Kuchera, Md

Health Equity and Quality Improvement (HEQI) Summit

Background of Case

• Patient with active substance use (reported snorting 8-10 bags of fentanyl/day) not initially interested in MOUD admitted to TJUH for severe sepsis due to empyema
• Placed on hydromorphone PCA with scheduled oxycodone for pain control and withdrawal, found to have diverted prescribed opiates and used recreational fentanyl while inpatient

Project Aim

1. Perform root cause analysis of safety event
2. Develop solutions to prevent similar instances in future given growing opiate epidemic in Philadelphia

Limited Education And Training For Inpatient Nurses Caring For Pregnant Women With Opioid Use Disorder, Jaime Tsao, Bs, Stephen Didonato, Phd, Lpc, Abby Adamczyk, Mlis, Ahip, Meghan Gannon, Phd Msph

Health Equity and Quality Improvement (HEQI) Summit

Background

• The opioid epidemic continues as a public health emergency
• Pregnant women with OUD face multiple forms of marginalization and stigma based on the complex interplay of their various social identities
• OUD education and training among healthcare providers, particularly nurses, who are frontline clinicians in treating perinatal OUD, are lacking and leave the workforce unprepared and under-resourced to effectively support pregnant persons with OUD

Public And Community Perceptions Of Safe Injection Sites, Bahram Pashaee, Mph, Gary Kaplan, Mslis, Amy Leader, Drph, Mph

Health Equity and Quality Improvement (HEQI) Summit

Background

• The opioid epidemic began in 1999 and the number of deaths from overdoses has since quadrupled by 2019
• 50,000 deaths in the US in 2019 from opioid overdoses and the numbers increase each year
• Research Question: What are the public’s and communities' perceptions of safe injection sites?

Back From Baclofen: A Case Report Of Baclofen Overdose, Alexis M. Dunn, Andrew M. Vasta, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 45-year-old female who presented with intentional Baclofen overdose. The patient was lethargic and then quickly unresponsive and hypotensive, intubated by EMS in the field. By the time the patient was admitted to the Intensive Care Unit (ICU), the patient was clinically brain dead. After several days of supportive care, patient slowly, and miraculously, regained full neurologic functioning and was admitted to the Psychiatric Unit.

Over The Counter Overdose: A Case Of Tylenol Toxicity, Swet M. Patel, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 51-year-old man presenting to the Emergency Department (ED) with suicidal ideations (SI) endorsing an intentional overdose of acetaminophen. Just as important is the clinical presentation; it is equally important to obtain a detailed history of patient's presentation leading to the ED visit when evaluating a suicide attempt. Tylenol (acetaminophen) is a common over the counter (OTC) medication available to the public. Management of Tylenol overdose follows a standard outline of things to observe and intervene on. In this case, we discuss how Tylenol overdose is managed in a clinical setting through a patient who …

Opioid Prescription Rates Before And After Alto Program And Various Factors Affecting Emergency Department Opioid Prescription Rates, Neel B. Patel, James F. Baird

Rowan-Virtua Research Day

Opioid prescription rates vary between patient population, diagnosis, location, and emergency department characteristics. High prescription rates offer an avenue for potential opioid addiction and overdoses. Alternatives to opioids (ALTO) is a new program already implemented in certain emergency departments to help change opioid prescription rates by introducing new protocols for first line treatments for pain management. With current trends still showing that South Jersey opioids prescription rates are the highest in the state of New Jersey, ALTO was introduced at Inspira Health Network located in South Jersey. This study retrospectively analyzed opioids prescription rates for abdominal pain, renal colic, migraines, …

Review Of Missing Data Elements For Client Enrollment In The Minority Aids Initiative For High-Risk Men Of Nj, Vrushank Shah

Rowan-Virtua Research Day

The Minority AIDS Initiative study funded in NMI seeks to enhance healthcare outcomes for underserved individuals. Implementing outreach programs, the initiative provides healthcare and post-treatment follow-up to this demographic. The proposed project, a component of this study, concentrates on individuals with substance abuse disorder, specifically targeting those who have been onboarded but subsequently lost to follow-up. In the United States, approximately 20 million people are diagnosed with substance abuse disorder, yet in 2016, only 3.8 million received treatment. Within this cohort, between 20% and 70% of individuals undergoing residential substance abuse treatment disengage before completion. Various factors hinder the sustained …

Fos Expression In Lateral Hypothalamus/Perifornical Area Is Correlated With Psychosocial Stress-Induced Cocaine-Seeking Behavior In A Sex-Specific Manner, Milena Sudarikov, Nicole M. Hinds, Ireneusz D. Wojtas, Desta M. Pulley, Daniel F. Manvich

Rowan-Virtua Research Day

Cocaine Use Disorder persists as a significant public health concern in the United States. Recent epidemiological data indicate that rates of cocaine-involved overdose deaths are rising, and treatment of Cocaine Use Disorder is challenging due to a lack of FDA-approved medications to help patients achieve abstinence and avoid relapse. Stress can precipitate cocaine craving and trigger relapse episodes, however the underlying neural circuitry by which stressors drive cocaine seeking is not completely understood. Our laboratory has recently identified the potential involvement of the rostrolateral aspect of the periaqueductal gray (rlPAG) in psychosocial stress-induced cocaine-seeking behavior using a rodent model of …

Efficacy Of Psilocybin In The Treatment Of Substance And Alcohol Use Disorders, Hanna Brancaccio

Rowan-Virtua Research Day

Introduction: Substance use disorder (SUD) and alcohol use disorder (AUD) are major public health crises, affecting millions of Americans. Current treatment options include behavioral therapies and medications. In this review, we explored psilocybin’s efficacy in treating SUD and AUD.

Methods: Key terms were used to search databases to identify articles that addressed psilocybin in the treatment of SUD. Included in the review were indexed, peer-reviewed, primary sources that were published within the last 10 years. Excluded studies were non-peer reviewed, not relevant to the thesis, and did not have an English translation.

Results: The psychodynamic antidepressant effects of psilocybin mark …