Substance Abuse and Addiction Commons^™

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operations Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

The Social Cost Of Pain: Rejection Sensitivity, Social Rejection, And Cannabis Use In Young Adults, Naomi Dambreville

Dissertations, Theses, and Capstone Projects

Cannabis has been implicated in relieving distress and social pain, an important area of research in young adult samples, given the saliency of peer and social networks to addiction. Cannabis, via opioid pathways, has been shown to reduce, or potentially buffer, the effects of social pain and rejection. Thus, cannabis may be protective against the painful feelings of social stress, particularly for heavier or more frequent users. However, findings are not wholly positive, as other research indicates cannabis may blunt affective responses and impair social processing. The effects of cannabis use in young adults are understudied, as well as its …

Frontal Alpha Asymmetry And Inhibitory Control Among Individuals With Cannabis Use Disorders, Alina Shevorykin, Lesia M. Ruglass, Robert D. Melara

Publications and Research

To better understand the biopsychosocial mechanisms associated with development and maintenance of cannabis use disorder (CUD), we examined frontal alpha asymmetry (FAA) as a measure of approach bias and inhibitory control in cannabis users versus healthy nonusers. We investigated: (1) whether FAA could distinguish cannabis users from healthy controls; (2) whether there are cue-specific FAA effects in cannabis users versus controls; and (3) the time course of cue-specific approach motivation and inhibitory control processes. EEG data were analyzed from forty participants (CUD (n = 20) and controls (n = 20)) who completed a modified visual attention task. Results showed controls …

Recent Trends, Current Research In Cyberpsychology: A Literature Review, Amarjit Kumar Singh, Pawan Kumar Singh

Library Philosophy and Practice (e-journal)

Cyberpsychology refers to the study of the mind and behavior in the context of interactions with technology. It is an emerging branch, which has focused on the psychological aspects connected to the increasing presence and usages of technology in modern lives. This paper traces recent advancement and trends of Cyberpsychology is an emerging domain of knowledge and goes on the give a literature review of the same. An analysis of the recent research and literature covering 300 most relevant research papers from the period of 2012 to 15, August 2019 was conducted to determine and shape the research pattern based …

Visualization Of Global Opioid Use Disorder Rates Based On Harm Reduction Availability, Soyol Enkh-Amgalan

The Journal of Purdue Undergraduate Research

No abstract provided.

"The Traps Started During My Childhood": The Role Of Substance Abuse In Women's Responses To Adverse Childhood Experiences (Aces), Breanna Boppre, Cassandra Boyer

Criminal Justice Faculty Research

The gendered pathways perspective seeks to identify the biological, psychological, and social realities that lead to women’s law-breaking behavior. Prior research in this area demonstrates the link between women’s adverse childhood experiences (ACEs) and involvement in the criminal justice system later in life. The current study fills an important gap in the literature by providing a phenomenological description of the impacts ACEs had upon 19 community supervised women’s lives. Their stories illuminate the need to consider multiple forms of ACEs, from physical and sexual abuse to the death of a loved one. Interviewees’ most prevalent response to ACEs was substance …

Psychopathology And Hypersexuality Among Veterans With And Without Histories Of Alcohol‐Use Disorders, Jonathan Moisson, Marc N. Potenza, Steven D. Shirk, Rani A. Hoff, Crystal L. Park, Shane W. Kraus

Psychology Faculty Research

Background and Objectives: Little research has examined the clinical characteristics of U.S. post‐9/11 military veterans coping with alcohol problems. Specifically, we examined psychopathology and hypersexuality among male and female post‐9/11 veterans with and without a lifetime history of alcohol‐use disorders (AUDs). Methods: Using data from a baseline telephone interview and follow‐up web‐based survey, we examined frequencies of AUDs, mental health and addictive disorders, sexual behaviors, hypersexuality, and problematic use of pornography in a national convenience sample of 283 U.S. veterans. Results: Many (39.1%) veterans met lifetime criteria for AUDs. Bivariate associations revealed that veterans with lifetime AUDs met clinically significant …

Characterizing Participation And Perceived Engagement Benefits In An Integrated Digital Behavioral Health Recovery Community For Women: A Cross-Sectional Survey, Brenda Curtis, Brandon Bergman, Austin Brown, Jessica Mcdaniel

Faculty Articles

Background: Research suggests that digital recovery support services (D-RSSs) may help support individual recovery and augment the availability of in-person supports. Previous studies highlight the use of D-RSSs in supporting individuals in recovery from substance use but have yet to examine the use of D-RSSs in supporting a combination of behavioral health disorders, including substance use, mental health, and trauma. Similarly, few studies on D-RSSs have evaluated gender-specific supports or integrated communities, which may be helpful to women and individuals recovering from behavioral health disorders. Objective: The goal of this study was to evaluate the SHE RECOVERS (SR) recovery community, …

Driving While High, Page D. Dobbs, Michael Smith, David T. Rolfe

All Faculty Scholarship for the College of Education and Professional Studies

As of May 2019, ten U.S. states and Washington DC have legalized non-medical/recreational use of cannabis. With increased access to legal marijuana across the country, some have raised concerns regarding unintended implications of these policies, such as the risk of motor vehicle crashes, which is the leading cause of mortality and injury among youth and young adults. Driving under the influence of marijuana is particularly concerning among young adults and college students, due to the increased level of substance use reported during the transition from high school to post-high school environments, such as college.

The Impact Of Mother And Adolescent Offspring Distress Reduction Training On Maternal Anxiety And Alcohol Related Behaviors Following Conflict, Sarah Ann Bilsky

Graduate Theses and Dissertations

Nearly half of people suffering from psychopathology meet criteria for more than one disorder. Scholars have focused on understanding factors that may simultaneously maintain multiple psychiatric problems. Elevated distress during interpersonal conflict is likely to maintain both alcohol use and anxiety psychopathology. Reducing distress elicited by normative mother-adolescent conflict holds particular promise. Conflict is common in families with problematic drinking and anxiety disorders and the affective impact of parent-offspring conflict is malleable. Distress reduction skills, such as cognitive reappraisal, are effective in reducing distress during conflict. The current study examined the unique and combined effects of training mothers and adolescents …

Comorbidity Profile Of Head And Neck Cancer Patients With And Without Depression, Michaela Frenzel

Capstone Experience: Master of Public Health

This population-based retrospective study used SEER-Medicare data from 2002-2010 to assess depression, comorbidity, and substance use in the elderly head and neck cancer population. Out of 3,533 head and neck cancer patients, 10.6% had depression diagnoses two years prior to cancer diagnosis, 8.9% were newly diagnosed with depression within one year after cancer diagnosis, and 44.5% of those with preexisting depression had an additional depression diagnosis within one year following cancer diagnosis. Comorbid conditions (p<0.0001) and substance use (p=0.0017) showed associations with depression prior to cancer diagnosis yet, no significant associations with incidence of depression in this head and neck cancer population. This study affirms the need for continual depression screenings in head and neck cancer patients and suggests the need for increased research into the burden of comorbid conditions and substance use within the head and neck cancer population.

"Every Day I Think About Your Messages": Assessing Text Messaging Engagement Among Latino Smokers In A Mobile Cessation Program., Francisco Cartujano-Barrera, Evelyn Arana-Chicas, Mariana Ramírez-Mantilla, Jaime Perales, Lisa Sanderson Cox, Edward F. Ellerbeck, Delwyn Catley, Ana Paula Cupertino

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Mobile health interventions are a promising mode to address tobacco-related disparities among Latinos, the largest minority group and the highest users of text messaging technology. The purpose of this pilot study was to assess engagement in a smoking cessation intervention delivered via text message (Kick Buts) among Latino smokers.

Methods: We relied on a community-based recruitment strategy to enroll 20 Latino smokers in Kick Buts. Outcome measures included biochemically verified abstinence at 12 weeks, participant text messaging interactivity with the program, and satisfaction.

Results: Participants' mean age was 40.7 years old (SD=14.6). Most of the participants were male (70%), …

Nicotine Replacement Therapies To Decrease Withdrawal Symptoms And Improve Patient Experience, Cheryl Pawloski, Holly Stewart, Devon Gillis, Dena Whitesell, Maya Bulman, Christopher Racine, Raymond Serrano, Leslie Gatcombe-Hynes, Elizabeth Mullany, Amy Mcauliffe, Jayne Weisberg, Amy Sparks, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Operations Transformation

Smoking is one the leading causes of preventable death in the United States. Patient centered care revolves around encouraging patients to reduce their chances of preventable disease and death. To that end, nicotine replacement therapy (NRT) prescribed within 24 hours of hospital admission increases the chance of quitting and decreases the chance of nicotine withdrawal.

A pilot performance improvement project was initiated on two cardiac units at an academic tertiary medical center. The goal the project was to have NRT ordered within 24 hours of admission 100% of the time. Baseline metrics demonstrated admission NRT orders were below acceptable levels …

Understanding Opioid Users’ Views On Fentanyl Could Help Reduce Overdoses, Kate Mclean, Shannon M. Monnat, Khary Rigg, Glenn Sterner, Ashton Verdery

Population Health Research Brief Series

The opioid overdose crisis is a national public health emergency, made much worse in recent years by the widespread emergence of fentanyl – a highly potent synthetic opioid. This research brief summarizes the findings from their research conducted in southwestern Pennsylvania in 2017 and 2018. Results show that the majority of interviewees who use opioids are fearful of and want to avoid fentanyl and would utilize harm reduction strategies such as fentanyl test strips if they were made more widely available.

Subtypes In Patients With Opioid Misuse: A Prognostic Enrichment Strategy Using Electronic Health Record Data In Hospitalized Patients, Majid Afshar, Cara Joyce, Dmitriy Dligach, Brihat Sharma, Robert Kania, Meng Xie, Kristin Swope, Elizabeth Salisbury-Afshar, Niranjan S. Karnik

Biostatistics Collaborative Core: Faculty Publications and Other Works

Background: Approaches are needed to better delineate the continuum of opioid misuse that occurs in hospitalized patients. A prognostic enrichment strategy with latent class analysis (LCA) may facilitate treatment strategies in subtypes of opioid misuse. We aim to identify subtypes of patients with opioid misuse and examine the distinctions between the subtypes by examining patient characteristics, topic models from clinical notes, and clinical outcomes.

Methods: This was an observational study of inpatient hospitalizations at a tertiary care center between 2007 and 2017. Patients with opioid misuse were identified using an operational definition applied to all inpatient encounters. LCA with eight …

The Bidirectionality Of Impulsivity And Alcohol Use: An Ecological Momentary Examination Among Emerging Adults, Amy L. Stamates

Psychology Theses & Dissertations

Impulsivity is a robust risk factor for alcohol use among emerging adults (i.e., 18 to 25), but significant gaps remain in our understanding of the way that impulsivity relates to alcohol harms. Most prior research has been limited to between-level differences; thus, within-person variability in impulsivity at the momentary level and its bidirectional association with alcohol use has not been examined. Consequently, the present research used a 14-day ecological momentary assessment (EMA) design to: (1) determine momentary impulsivity as a predictor of subsequent alcohol use and problems; (2) examine the influence of alcohol use on subsequent impulsivity; (3) test socio-cognitive …

There Are Multiple And Geographically Distinct Opioid Crises In The U.S., Shannon M. Monnat

Population Health Research Brief Series

Rates of fatal drug overdose increased 250% in the U.S. between 1999 and 2017, due in large part to a massive surge in overdoses involving opioids. However, there is substantial geographic variation in fatal opioid overdoses, and prescription opioids, heroin, and fentanyl are differentially responsible for high overdose rates across different parts of the U.S. This research brief summarizes the findings from a study just published in the American Journal of Public Health. The study shows that there are at least four geographically distinct opioid overdose crises in the U.S.

Association Of Naloxone Coprescription Laws With Naloxone Prescription Dispensing In The United States, Minji Sohn, Jeffery C. Talbert, Zhengyan Huang, Michelle R. Lofwall, Patricia R. Freeman

Institute for Pharmaceutical Outcomes and Policy Faculty Publications

Importance: To mitigate the opioid overdose crisis, states have implemented a variety of legal interventions aimed at increasing access to the opioid antagonist naloxone. Recently, Virginia and Vermont mandated the coprescription of naloxone for potentially at-risk patients.

Objective: To assess the association between naloxone coprescription legal mandates and naloxone dispensing in retail pharmacies.

Design, Setting, and Participants: This was a population-based, state-level cohort study. The sample included all prescriptions dispensed for naloxone in the retail pharmacy setting contained in IQVIA's national prescription audit, which represents 90% of all retail pharmacies in the United States. The unit of observation was state-month …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …