Substance Abuse and Addiction Commons^™

An Assessment Of Maine's Capacity To Support Transitions Of Care Through The Substance Use Disorder Continuum, Mary Lindsey Smith Phd, Sarah Mclaughlin Mph, Rachel M. Gallo Mph

Substance Use Research & Evaluation

This report evaluates Maine's capacity to support effective transitions of care across the substance use disorder (SUD) treatment continuum. Using data collected from a statewide survey of 65 SUD providers, conducted from February to April 2025, the study examines organizational practices, inter-provider communication, and coordination strategies related to transitions between levels of care: medically supervised withdrawal, inpatient, and outpatient treatment programs. Key findings reveal strong intra-organizational communication, widespread understanding of ASAM criteria, and a general commitment to patient-centered care. However, gaps persist in coordination between care levels, particularly in withdrawal management programs, which rarely conduct follow-ups or collaborate with outpatient …

Withdrawal Management In Maine: Capacity Challenges And Opportunities For Improvement, Mary Lindsey Smith Phd, Katie Rosingana Ba, Tyler Egeland Ba, Sarah Mclaughlin Mph

Substance Use Research & Evaluation

This summary report presents findings from healthcare provider interviews conducted in 2024 to assess the current landscape of withdrawal management (WM) services in Maine. Sixteen providers, across eight counties and representing a range of substance use disorder (SUD) service types, were interviewed to evaluate capacity, challenges, and opportunities for improvement across the continuum of care. Thematic analysis identified widespread gaps in withdrawal management capacity, especially in ASAM Levels 1.7 to 4.0, with critical shortages in ambulatory and low-intensity residential services. Key barriers included geographic inequities, insufficient infrastructure, long waitlists, inadequate reimbursement, and workforce shortages exacerbated by stigma and provider discomfort. …

Feedback On Withdrawal Management Services In Maine From Persons With Lived Experience, Mary Lindsey Smith Phd, Katie Rosingana Ba

Substance Use Research & Evaluation

This summary report presents findings from interviews with twelve persons with lived experience of substance use disorder (PWLE). The interviews asked persons in recovery about their experiences accessing withdrawal management and broader substance use treatment services across Maine. Participants identified key barriers to treatment including high costs, limited bed availability, long wait times, geographic inaccessibility, and lack of centralized information. Gaps in service infrastructure, particularly for opioid withdrawal management, long-term treatment, and transition supports post-detox, were widely reported. Participants emphasized the critical need for more localized and individualized services, particularly for parents, rural residents, and low-income individuals. Recommendations include expanding …

Assessing The Relationship Between Combat Exposure, Wartime Service, And Barriers To Substance Use Disorder Treatment In Post 9/11 Veterans., Robert Near

Dissertations

Substance use disorders (SUDs) represent a critical public health concern, particularly within military and veteran populations. The complex interplay of mental health challenges, combat exposure, and the unique stressors associated with military service contribute to a heightened vulnerability among veterans. Research from the United States Department of Veterans Affairs (USDVA) underscores the prevalence of these issues, indicating that approximately 1 in 10 veterans from the Iraq or Afghanistan wars treated by the VA are diagnosed with a SUD (Veterans Affairs, 2023). Additionally, veterans from all eras show a higher propensity for binge drinking when compared to the general population, further …

Opioid Use Patterns After Nonsurgical Management Of Distal Radius Fractures: A Call For Opioid Stewardship, Sina Ramtin, Sara Khan, Vijay Chhabra, Wali Pirzada, Mohammad Khak, Asif M. Ilyas

Rothman Institute Papers

PURPOSE: While most opioid research focuses on postoperative use, limited data exist on prescribing patterns in nonsurgical management of common injuries such as distal radius fractures (DRFs). This study aimed to assess opioid prescribing trends and identify factors linked to prolonged use in nonsurgically treated DRFs.

METHODS: A retrospective cohort study of 591 patients aged 18-50 with nonsurgically managed DRFs between 2018 and 2024 was conducted. Opioid use was classified as prior opioid use (POU), fracture-related opioid use (FxOU), or delayed opioid use (DOU). Prescription data were obtained from the Prescription Drug Monitoring Program and analyzed for morphine milligram equivalents, …

Health Care In Women’S Carceral Spaces, Kate Gouveia Pereira

Culture, Society, and Praxis

Canada has had a long history of mistreating incarcerated women in their jails. The carceral system was built to fit around the needs of men, neglecting to consider the various health issues that only women face. For many years. federally imprisoned women were held in one deteriorated prison, the Prison for Women (P4W), and were held in abhorrent conditions and experienced many acts of violence. Despite the opening of five more prisons and funding for various programs for women, incarcerated women continue to experience violence and health crises, leaving imprisoned women extremely vulnerable to mental and physical distress. In particular, …

Intersection Of Alcohol Use, Pain Symptoms, And Negative Affect In Total Knee Arthroplasty Patients And People With Hiv, Taylor Fitzpatrick-Schmidt, Vinod Dasa, Claudia Leonardi, Tekeda F. Ferguson, David A. Welsh, Patricia E. Molina, Martin J.J. Ronis, Scott Edwards

School of Medicine Faculty Publications

Alcohol is a well-known analgesic, although excessive alcohol use can lead to hyperalgesia and heightened negative affect. This cross-sectional study examined associations between alcohol use, self-reported pain, and negative affective symptoms in two distinct cohorts of patients vulnerable to chronic pain: individuals undergoing total knee arthroplasty (TKA) surgery and a cohort of people with HIV (PWH). Participants were enrolled in two clinical studies: a retrospective study of patients undergoing TKA and a longitudinal study of PWH, the New Orleans Alcohol Use in HIV (NOAH) cohort. Based on the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) score, participants in both …

Misused And Misunderstood: Examining The Inappropriate Use Of Stimulant Medications, Connor Dains, Madilyn Paphanchith, Makayla Eversole, Chaehyeon Jin, Minhwan Yang, Joshua Honaker, Samantha Mccord, Kayla Petkus

Pharmacy and Wellness Review

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsivity. The American Academy of Pediatrics (AAP) endorses stimulant medications as the first-line treatment option. When combined with behavioral therapy, this pharmacologic class can improve focus, executive functioning, and the overall quality of life. While stimulant prescriptions can have a positive effect when used as directed, there is concern for the potential of provider overprescription and patient misuse related to these medications. Consequently, the Food and Drug Administration (FDA) revised the boxed warning and prescribing information for stimulant medications. Healthcare providers must educate …

Viral Hepatitis And Hiv Screening Amongst Inpatients With Substance Use Disorder: An Initial Pdsa Cycle Analysis, Christine Papastamelos, Md, Elizabeth Novick, Md, Carolyn Kramer, Md, John Zurlo, Md, Nikhil Seval, Md, Mollie Tucker, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• ~67,000 individuals in Philadelphia county are estimated to be living with substance use disorder (SUD).¹
• Persons who inject drugs (PWID) are at disproportionately higher risk of acquiring HIV and viral hepatitis compared to the general public.² 
• A 3-month retrospective chart review (11/6/23-1/22/24) of 160 inpatient SUD encounters with an Infectious Disease (ID) consult showed that 35%-42% of HIV and hepatitis C screening opportunities were missed.

Recommendations For Telesupervision: Promoting Ethical, Legal, And Effective University And Clinical Supervision Using Technology, Madeleine M. Stevens, Yegan Pillay, Edisa Music, Elena Shahen

Journal of Counselor Preparation and Supervision

The expansion of the use of technology in counseling has implicated counseling professionals in considering how to legally and ethically incorporate it into all facets of practice, including university and clinical supervision settings. In this article, we provide scholarship-backed recommendations for doing so as well as provide suggestions for incorporating psychodynamic and cognitive-behavioral (CBT) supervision models into telesupervision.

Exploring Race In Addiction Treatment And The Need For An Anti-Racist Approach, Jackie D. Dell, Mei Tang

Journal of Counselor Preparation and Supervision

Extensive literature documents that Black people, Indigenous people, and People of Color (BIPOC) have been historically and systematically discriminated in addiction and substance use disorder treatment and services. This systemic oppression is the result of the creation and intersection of multiple systems that are rooted in White supremacy, which continue to fail to recognize racism as a critical factor in health disparities. The complexities of the structural factors that contribute to these racial health disparities, and opportunities to better address these disparities were reviewed to discuss their impact on BIPOC clients and the necessity for anti-racist approaches to addressing addiction …

Culturally-Affirming Service-Learning For Counselors-In-Training: Child-Parent Relationship Therapy Training With Spanish-Speaking Families, Karen M. Roller, Szu-Yu Chen, Katrina Volante

Journal of Counselor Preparation and Supervision

The Spanish-speaking community is the largest underserved language group in the United States. To advance social justice advocacy and multicultural humility for this language group, the field of counselor education needs to create pedagogical scaffolding for non-Spanish-speaking counselors-in-training to work with interpreters to support Spanish-speaking families, while also enhancing language-concordant training for Spanish-English bilingual counselors-in-training. We utilized a critical race research design to explore six counselors-in-training’s experience participating in service-learning through online facilitation of Child-Parent Relationship Therapy with Spanish-speaking families. Interpretative phenomenological analysis of qualitative data yielded four major themes: (a) collaboration, (b) improved awareness, (c) growth and strength, and …

Investigating Undergraduate Conditioned Place Preference Utilizing Virtual Alcohol Stimuli, Nikole A. Rodriguez Torres, Robert Astur, Jeffrey Divino

Honors Scholar Theses

Alcohol use remains a major concern among college students, with binge drinking linked to serious physical and mental health problems. But how much does the environment influence these addictive behaviors? The relationship between environmental cues and alcohol related behaviors is a critical area of study, particularly understanding reward and motivation mechanisms. Binge drinking, common among college students, is associated with a range of negative outcomes such as physical harm, legal issues, poorer overall health, sleep problems, depression, anxiety, and severe thoughts of suicide. In our study, college undergraduates were exposed to two VR rooms: one with alcohol-related stimuli and one …

Clinician Comfort, Attitudes, And Practices With Provision Of Harm Reduction Supplies To Patients Who Use Drugs, Amanda Cahn, Melissa Calica, Erin Mooz, Malia Haddock, Wendy Craig, Tania Strout, Kinna Thakarar

Costas T. Lambrew Research Retreat 2025

Over 100,000 individuals in the United States died from drug overdose in 2022, over 80,000 of which involved opioids. Overdose deaths from psychostimulants (cocaine, methamphetamine) have also been on the rise.

There has also been an increase in substance-related emergency department visits and hospitalizations. People who use drugs (PWUD) often have longer hospital stays, higher self-discharge, and readmission rates.

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

Addiction In The Prison System: Recidivism And Alternatives, Daniel R. Bowers

Undergraduate Honors Theses

The United States criminal justice system has the highest number of incarcerated individuals in the world, with nearly 2 million people currently being behind bars, and around 7.5 million arrests per year according to the most recent available statistics. A key factor in this is addiction, specifically substance use disorders. Between 58% to 68% of adults arrested are addicted to one or more substances, with 68% of drug involved individuals being rearrested within three years of being released. This recidivism rate is incredibly high, and when combined with current prison and jail overcrowding, has created massive problems for the United …

The Impact Of Quality Of Life And Recovery Capital On Inhibitory Control In Patients On Medication For Opioid Use Disorder, Caroline K. Jeffries

All Theses

The opioid crisis persists as a global health challenge, necessitating a comprehensive understanding of the complex interplay between psychological factors and neurocognitive responses among individuals with opioid use disorder (OUD). Two such psychological factors include recovery capital, an individual's internal and external resources to supporting recovery, and quality of life. Past work suggests that positive levels of recovery capital and quality of life may enhance individuals’ ability to regulate emotions and manage cravings. However, it is unclear how these variables are affected when buprenorphine is taken. This study investigates the influence of recovery capital and quality of life on inhibitory …

Kratom As A Therapeutic Option For Opioid Use Disorder​: A Comprehensive Review​, Harmann Singh, Abdullah Noory, Akash M. Patel, Kush C. Patel, Simran Gandhi

Rowan-Virtua Research Day

Kratom (Mitragyna speciosa) has gained significant attention for its potential role in managing opioid use disorder (OUD). This review examines kratom’s pharmacology, safety profile, addiction potential, and ethical considerations in research, while exploring its future as a therapeutic option. Kratom’s primary alkaloids, mitragynine and 7-hydroxymitragynine, act as partial mu-opioid receptor agonists, producing analgesic and sedative effects at higher doses and stimulant-like effects at lower doses. Preclinical and observational studies suggest kratom may alleviate opioid withdrawal symptoms and cravings, but concerns remain regarding its dependency potential and adverse effects, including gastrointestinal distress, hepatotoxicity, and withdrawal symptoms upon cessation. While kratom carries …

Symptomatic Treatment Of Cannabis Withdrawal Syndrome: A Review Of The Existing Literature, Aria Sen, Dale Shober

Rowan-Virtua Research Day

Despite its public reputation as a recreational substance that does not cause physical withdrawal symptoms, cannabis withdrawal syndrome (CWS) was added to the DSM-5 in 2013. Existing research would suggest that almost half of regular cannabis users will experience symptoms such as mood symptoms, insomnia, and gastrointestinal distress. For more than 20 years, the rates of cannabis use have continued to trend upward due to expanding legislation on the recreational use of marijuana. Currently, there are no FDA approved treatments for CWS. Considering this trend, the lack of a well-formed treatment protocol for CWS will have a growing impact on …

Is The Vaping Epidemic Linked To Neurologic Changes And Mental Health Diagnoses Amongst Us Adolescents?, Tracy Lin, Victoria Shwe

Rowan-Virtua Research Day

Vaping has significantly increased among U.S. adolescents, driven by the rise of e-cigarettes and flavored pods. Nicotine exposure during brain development is linked to changes in the limbic-dopaminergic system, white matter integrity, and increased risk of emotional and behavioral dysregulation. Higher rates of depression, anxiety, and suicidality are reported among adolescent users, with greater symptom severity seen in those with high vaping dependence. Though studies show correlation rather than causation, findings suggest vaping may contribute to rising mental health diagnoses. Addressing vaping’s neurological and psychological impact is critical to guiding prevention efforts, regulatory policies, and support for at-risk youth.