Drug and alcohol dependence
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Drug Alcohol Depend · Sep 2017
Multicenter Study Observational StudyA retrospective review of unintentional opioid overdose risk and mitigating factors among acutely injured trauma patients.
Opioid medication to treat acutely injured patients is usual care in trauma settings. A higher prevalence of alcohol and other substance misuse in this population compared to the general population increases the vulnerability of such patients to both misuse of their prescribed opioids, and also unintentional opioid overdose. The primary purpose of this study was to assess the prevalence of substance use and unintentional opioid overdose risk among acutely injured trauma patients, and to examine the frequency and predictors of high opioid dose at discharge. ⋯ Our results indicate that despite the high rates of substance misuse, the potential for misuse, dependence and unintentional overdose risk from prescribed opioid medications are prevalent among acutely injured trauma patients. Prescribing after acute trauma care should address these risk factors.
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Drug Alcohol Depend · Sep 2017
ReviewTwenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids-Conception and maturation.
Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy. ⋯ Framed as a public health tool for harm reduction, THN has overcome social, clinical, and legal barriers in many jurisdictions. Nonetheless, the rising death toll of opioid overdose illustrates that current THN coverage is insufficient, and greater public investment in overdose prevention will be required if THN is to achieve its full potential impact.
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Drug Alcohol Depend · Sep 2017
Cross-validation of short forms of the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R).
The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a 24-item assessment designed to assist in the prediction of aberrant drug-related behavior (ADB) among patients with chronic pain. Recent work has created shorter versions of the SOAPP-R, including a static 12-item short form and two computer-based methods (curtailment and stochastic curtailment) that monitor assessments in progress. The purpose of this study was to cross-validate these shorter versions in two new populations. ⋯ Curtailment, stochastic curtailment, and the 12-item short form have potential to enhance the efficiency of the SOAPP-R.
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Drug Alcohol Depend · Sep 2017
The Experimental Tobacco Marketplace II: Substitutability and sex effects in dual electronic cigarette and conventional cigarette users.
The aim of the current study was to evaluate tobacco product purchasing in the Experimental: Tobacco Marketplace (ETM) among male and female smokers who also use e-cigarettes. We hypothesized a high substitution profile for e-cigarettes and that males would purchase more Snus than females. ⋯ This study suggests that the user profile of cigarette smokers is associated with behavioral economic measures of alternative product substitution and indicates that the evaluation of nicotine replacement products should be considered for both males and females separately.
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Drug Alcohol Depend · Sep 2017
Intentions to quit tobacco smoking in 14 low- and middle-income countries based on the transtheoretical model.
Over 80% of the world's one billion tobacco smokers reside in low- and middle-income countries (LMICs); therefore, it is important to understand factors that promote intention to quit smoking in these countries. This study evaluated factors associated with three stages of intention to quit tobacco smoking among adults in LMICs. ⋯ The results suggest that anti-smoking media campaigns and smoke-free policies may promote intention to quit smoking in LMICs. While these suggest the need for implementation of comprehensive anti-smoking campaigns and smoke-free policies, longitudinal studies are required to confirm these findings and to evaluate how intention to quit translates into quit attempts in LMICs.