Substance Abuse and Addiction Commons^™

The Efficacy Of Meditation-Based Treatments In Relapse Prevention For Persons With Substance Use Disorders, Florence C. Bates

Honors Undergraduate Theses

Substance abuse is a global problem that has contributed to a variety of societal, financial, health, and familial strains. An increasing prevalence of illicit drug, prescription opioids, and alcohol abuse has created a need for re-evaluation of recovery and relapse treatments. This literature review examines the efficacy of meditation-based treatments for relapse prevention in persons recovering from Substance Use Disorders (SUDs). A comparative analysis of Mindfulness Based Relapse Programs (MBRP), an adapted MBRP-W program, and a Transcendental Meditation (TM) intervention was used to examine the success of meditation-based interventions. Research supports improvements associated with the meditation-based interventions including significant reductions …

Anxiety-Like Behavior In Adolescent Rats Following Maternal Separation And Chronic Cocaine Exposure, Jonathan Handy

Behavioral Neuroscience Honors Papers

Cocaine is one of the most widely used illicit substances in the world and has an addiction rate comparable to opioids. Early Life Stress (ELS) has been shown to have a profound influence on the development of an individual, showing strong correlations to the development of psychiatric disorders and psychostimulant abuse. Adolescents in particular are at a high risk for the abuse of psychostimulants such as cocaine. Previous studies have individually described the correlation between cocaine addiction and anxiety, and the correlation between ELS and cocaine addiction. Rats who have experienced some form of ELS have shown a higher levels …

Effects Of Naltrexone On Alcohol And Nicotine Use In Female P Rats, Usman Z. Hamid, Sarah E. Maggio, Meredith A. Saunders, Kimberly Nixon, Mark A. Prendergast, Richard L. Bell, Michael T. Bardo

Posters-at-the-Capitol Presentations

The objective of the present study was to determine the effectiveness of the opioid antagonist naltrexone at reducing the consumption of EtOH and nicotine in female alcohol-preferring (P) rats. P rats have been selectively bred to have a genetic predisposition for alcohol abuse, which allows them to be used as an animal model of alcoholism. P rats readily self-administer i.v nicotine (Le et al., 2016), have EtOH consumption during adolescence that is similar to that seen in adulthood, and operantly respond for EtOH until they are impaired/intoxicated (Bell et al., 2006). Thus, P rats are a useful model for studying …

Understanding Structure-Activity Relationship Of Synthetic Cathinones (Bath Salts) Utilizing Methylphenidate, Barkha J. Yadav

Theses and Dissertations

Synthetic cathinones are stimulant drugs of abuse that act at monoamine transporters e.g. the dopamine transporter (DAT) as releasing agents or as reuptake inhibitors. More than >150 new synthetic cathinones have emerged on the clandestine market and have attracted considerable attention from the medical and law enforcement communities.

threo-Methylphenidate (tMP) is an FDA approved drug for the treatment of ADHD and narcolepsy, which also acts as a DAT reuptake inhibitor and is widely abused. tMP and synthetic cathinones share some structural similarities and extensive structure-activity relationship (SAR) studies on tMP have been conducted. However, much less is known about the …

Daily Factors Driving Daily Substance Use And Chronic Pain Among Older Adults With Hiv: A Study Using Ecological Momentary Assessment, Alexis Kuerbis, M. Carrington Reid, Jordan Lake, Suzanne Glasner-Edwards, Jessica Jenkins, Diana Liao, Jury Candelario, Alison A. Moore

Publications and Research

Background: Adults 50 and older make up approximately 50% of persons living with HIV. Multiple co-morbidities are common among this group, including chronic pain and substance abuse, yet little is known about the daily factors that either enhance or inhibit these experiences or behaviors. This study explored daily drivers of substance use, pain, and relief from pain among older adults living with HIV utilizing ecological momentary assessment (EMA). Method: Participants (N=55), ages 49–71, completed seven consecutive days of daily EMA online surveys prior to treatment initiation within a randomized controlled trial. Multilevel modeling tested predictors of pain, substance use, and …

Developing A Workflow To Evaluate Medications For Repurposing Using Health Claims Data: Application To Substance Use Disorders, Emily Ruth Hankosky

Theses and Dissertations--Pharmacy

Healthcare big data are a growing source of real-world data with which to identify and validate medications with repurposing potential. Previously, we developed a claims-based workflow to evaluate medications with potential to treat stimulant use disorders. In order to test the workflow, the framework was applied in the context of opioid use disorders (OUDs), for which there are medications with known efficacy. Using the Truven Marketscan Commercial Claims Database, a nested case-control analysis was conducted to determine the association between OUD medications (buprenorphine, naltrexone) and remission. Cases were defined as enrollees with a remission diagnosis and matched (1:4) to controls …

A Pilot Study Of A Multiple Health Behavior Change Intervention For Smokers, Srihari Seshadri

Theses and Dissertations--Clinical and Translational Science

Background: Being both obese and a smoker increases the probability of developing type 2 diabetes, cardiovascular disease, and cancer, diseases that impact Kentucky residents disproportionately. Kentucky (KY) has a high incidence of obesity (34.2%) and smoking (24.5 %). Weight gain associated with smoking cessation also can undermine health benefits of quitting, and may lead to smoking relapse.

Aim: The aim of the pilot study was to implement and evaluate a Multiple Health Behavioral Change (MHBC) program that combines Cooper Clayton Method to Stop Smoking (CCMSS) and the Diabetes Prevention Program (DPP) for weight control.

Method: A 15-week intervention was administered …

Impact Of Prescription Opioid Access Restrictions On Alcohol-Induced Mortality In Kentucky, Changwe Park

MPA/MPP/MPFM Capstone Projects

Prescription drug monitoring programs (PDMPs) are state policy tools to combat risky opioid prescribing. Since 2012, several states began to mandate PDMP use. As mandating use laws have settled down, evaluating potential adverse events becomes possible.

In this study, I focus on alcohol-induced mortality as a potential unintended consequence via substituting alcohol for prescription opioids, since alcohol and opioids are often concurrently misused as a part of pain self-management. Therefore, the aim of this study is to analyze the unintended consequences of prescription opioid access restrictions on alcohol-induced mortality.

I compare the alcohol-induced mortality among adults during pre- and post-revision …

Examining Motivational Interviewing's Effect On Confidence And Commitment Using Daily Data, Alexis Kuerbis, Kevin Lynch, Sijing Shao, Jon Morgenstern

Publications and Research

Mechanisms of behavior change (MOBC) within Motivational Interviewing (MI) are thought to operate via both relational and technical elements. These elements are hypothesized to increase client motivation and self-efficacy for change and subsequently decrease drinking. Only partial support for this causal chain exists, particularly when using within-session change talk as the primary intervening variable. This study explored whether commitment to moderate or abstain from drinking and confidence to moderate drinking in the next day measured via ecological momentary assessment (EMA) provided alternative support for the theory. Data were from a pilot randomized controlled trial testing active ingredients of MI. Problem …

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; …

Impacts Of An Opioid Overdose Prevention Intervention Delivered Subsequent To Acute Care, Caleb J. Banta-Green, Phillip O. Coffin, Joseph O. Merrill, Jeanne M. Sears, Chris Dunn, Norbert D. Yanez, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.

Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting …

Trace Amine-Associated Receptor Gene Polymorphism Increases Drug Craving In Individuals With Methamphetamine Dependence, Jennifer M. Loftis, Michael Lasarev, Xiao Shi, Jodi Lapidus, Aaron Janowsky, William Hoffman, Marilyn Huckans

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Methamphetamine (MA) is a potent agonist at the trace amine-associated receptor 1 (TAAR1). This study evaluated a common variant (CV) in the human TAAR1 gene, synonymous single nucleotide polymorphism (SNP) V288V, to determine the involvement of TAAR1 in MA dependence.

Methods: Participants (n = 106) with active MA dependence (MA-ACT), in remission from MA dependence (MA-REM), with active polysubstance dependence, in remission from polysubstance dependence, and with no history of substance dependence completed neuropsychiatric symptom questionnaires and provided blood samples. In vitro expression and function of CV and wild type TAAR1 receptors were also measured.

Results: The V288V polymorphism …

Is Acupuncture Effective In Reducing Opioid Cravings In Detoxifying Opioid Abusing Adults?, Sarah Kish

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is acupuncture effective in reducing opioid cravings in detoxifying opioid abusing adults?”

STUDY DESIGN: A review of three RCTs published in English, each of which was published in 2009, 2013 and 2014 respectively.

DATA SOURCES: Three randomized controlled trials (RCTs) published in peer-reviewed journals that evaluate the effectiveness of acupuncture to reduce opioid cravings found via PubMed and ScienceDirect.

OUTCOMES MEASURED: Opioid cravings via 100 millimeter analog scale score, the Maudsely craving score consisting of five-point Likert scales and withdraw symptoms as measured by a 4-point …

Is Gabapentin Effective In Reducing Heavy Drinking And Alcohol Related Insomnia In Alcohol Dependent Patients?, Benjamin Michalsky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is gabapentin effective in reducing heavy drinking and alcohol related insomnia in alcohol dependent patients?”

STUDY DESIGN: Review of three English language primary studies, one published in 2008 and two others in 2013.

DATA STUDIES: Three double blind, randomized controlled trials (RCTs) analyzing the effects of gabapentin therapy in attempting to reduce heavy drinking and alcohol related insomnia in alcohol dependent patients were found via PubMed and Cochrane databases.

OUTCOMES MEASURED: The reduction in alcohol consumption and improvement in alcohol related insomnia were measured through the …

Is Acupuncture A Beneficial Therapy For The Treatment Of Alcohol Dependence?, Jamie E. Mcginn

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is a beneficial therapy for the treatment of alcohol dependence.

STUDY DESIGN: Review of three randomized controlled trails (RCTs) which were published in 2007, 2015, and 2016.

DATA SOURCES: All articles were presented in English and taken from peer reviewed journals found on PubMed.

OUTCOMES: The various symptoms of alcohol dependence; from withdrawal, cravings, and use were assessed through various methods. Alcohol withdrawal symptoms were assed using the alcohol-withdrawal syndrome scale, alcohol craving was assed using a Visual Analogue Scale, and alcohol use was measured …

Is Sublingual Buprenorphine Treatment Effective And Efficient When Compared To Traditional Neonatal Opium Solution (Morphine) In Treating Newborns With Neonatal Abstinence Syndrome?, Abigail G. Stefanides

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether sublingual buprenorphine treatment is effective and efficient when compared to traditional neonatal opium solution (morphine) in treating newborns with neonatal abstinence syndrome (NAS).

Study Design: Review of one randomized active-control clinical trial, one randomized doubleblind, double-dummy clinical trial, and one retrospective cohort analysis.

Data Sources: All articles were published in English between the years of 2011 and 2017. Articles were obtained from peer-reviewed journals and databases using PubMed and Embase.

Outcomes: Outcomes measured were length of stay using the neonates birth date and hospital discharge date as well …

Polysubstance Opioid Use In A Justice-Involved Population: An Analysis Of Patterns And Reentry Outcomes, Amanda Marie Bunting

Theses and Dissertations--Sociology

The public health crisis surrounding opioid use is pronounced among justice-involved populations, who face high rates of overdose mortality as well as HIV, and hepatitis C due to injection drug use. The majority of opioid-related overdoses are due to polysubstance use (PSU), and a better understanding of the prevalence and patterns of PSU are necessary in order to inform interventions. This dissertation project has three aims: (1) understand the patterns of opioid PSU among a justice-involved population, (2) identify PSU patterns most at-risk for post-release relapse, and (3) examine engagement in post-release health service utilization. Post-release aims are guided by …

Evaluating The Impact Of An Intervention To Promote Empathy For Patients With Substance Use Disorder In A Rural Emergency Department, Theresa Poling

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background

Negative attitudes of health professionals towards patients with SUD are common and contribute to suboptimal health care for this marginalized group of patients (Van-Boekel, Brouwers, Van-Weeghel & Garretson, 2013).

Objectives

Promoting empathy in the Emergency Department (ED) has the potential to increase nursing staff’s awareness of their attitudes and perceptions toward patients with SUD, thereby decreasing the stigma associated with addiction and improving patient care and patient outcomes. The rationale for implementing this project was to evaluate a tool to promote empathy. This tool was developed by the student researcher based on a literature search and analysis.

Design

This …

Differences In Sexual Delay Discounting Among In-Treatment Adults With Opioid Use Disorder, Jonathan J.K. Stoltman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Previous research has found impulsive decision-making to be a core component of addiction (Moody, Franck, Hatz, & Bickel, 2016). One way to measure impulsive choice is through the use of a delay discounting task. The delay discounting task provides a way to measure choice of immediate, smaller rewards compared to delayed, larger rewards (Odum, 2011b). An emerging area of research in addiction science is the intersection of addiction and sexual health. Previous sexual delay discounting research has focused on whether attractiveness or STD risk can shift the likelihood of waiting until a condom was available (Johnson & Bruner, 2012). This …

The Effect Of Narrative Medicine Combined With Medication Assisted Treatment On Decreasing The Desire To Use Intravenous Substances In Hospitalized Patients With Infective Endocarditis, Paula Works

DNP Projects

Substance abuse is a significant problem that spans the nation. Of particular concern is the growing population of patients at UK HealthCare who have endocarditis as a complication from IV substance abuse.

PURPOSE: The aims of this study were

1. To assess the effect of narrative medicine combined with MAT, compared to MAT alone, on desire to use in hospitalized patients with a history of IV substance use
2. To examine the changes in quality of life before and after the introduction of narrative medicine in hospitalized patients with a history of IV substance abuse using The Quality of Life Scale (QOLS). …