Drug and alcohol dependence
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Drug Alcohol Depend · Nov 2019
Preference for drugs containing fentanyl from a cross-sectional survey of people who use illicit opioids in three United States cities.
Death from fentanyl-related overdose is now a leading cause of mortality among US adults. We sought to characterize fentanyl preference among street-based people who use drugs (PWUD). ⋯ In three cities with high levels of opioid use and overdose, a quarter of street based PWUD reported preferring fentanyl. An opioid use age cohort effect and disproportionate access to prescription opioids by race could be contributing to preference. Frequency of opioid use, not route of administration, was associated with preference. Our data demonstrate the need to consider preferences for fentanyl when targeting services and interventions for PWUD.
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Drug Alcohol Depend · Nov 2019
"You can see those concentric rings going out": Emergency personnel's experiences treating overdose and perspectives on policy-level responses to the opioid crisis in New Hampshire.
In parallel to a substantial increase in opioid overdose deaths in New Hampshire (NH), emergency personnel experienced an increase in opioid-related encounters. To inform public health responses to this crisis, insights into the experiences and perspectives of those emergency personnel who treat opioid-related overdoses are warranted. ⋯ Findings suggest that interventions addressing trauma and burnout are necessary to support emergency personnel, while expanded harm reduction and treatment access are critical to support those who experience opioid overdose in NH.
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Drug Alcohol Depend · Nov 2019
Correlation between interleukin-6 levels and methadone maintenance therapy outcomes.
The outcome of methadone maintenance therapy (MMT) varies in each patient with opioid use disorder (OUD). Opioid abuse activates proinflammatory processes by increasing cytokine production and impairing neurotrophic factor expression, and possibly leads to a vicious cycle that hinders recovery. Therefore, we investigated whether markers of inflammation and neurotrophic expression correlate with the MMT outcomes in OUD patients. ⋯ Higher IL-6 levels were associated with poor MMT outcomes. Additional studies on regulating IL-6 expression to improve treatment outcomes in OUD patients might be warranted.
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Drug Alcohol Depend · Nov 2019
Adolescents' awareness of the nicotine strength and e-cigarette status of JUUL e-cigarettes.
JUUL e-cigarettes are popular among youth. However, it is unknown whether adolescents understand that 5% JUUL pods contain a high nicotine concentration or consider JUULs to be e-cigarettes. ⋯ Most students were unaware of JUUL's high nicotine concentration, with more believing that JUULs contain low or medium nicotine concentrations when informed JUULs contain 5% nicotine. Thus, youth may misinterpret the nicotine concentration printed on JUUL pod packaging, raising concerns about inadvertent exposure to high nicotine levels and dependence risk. Further, 39% of adolescents believed JUULs are not e-cigarettes or were unsure. Regulatory efforts are needed to establish understandable nicotine concentration labels, require products to be labeled accordingly, and clarify what products constitute e-cigarettes.
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Drug Alcohol Depend · Nov 2019
Predictors of availability of long-acting medication for opioid use disorder.
The U.S. Food and Drug Administration has approved three long-acting medications for opioid use disorder (MOUD): extended-release naltrexone (XR-NTX) in 2010, a subdermal buprenorphine implant in 2016, and a depot buprenorphine injection in 2017. Long-acting MOUD options may improve adherence while reducing diversion, but their availability compared to daily-dosing MOUD has not been well-characterized. The objective of this analysis was to characterize the availability of long-acting MOUD in substance use disorder treatment settings in the United States. ⋯ In 2017, XR-NTX was available at most of the minority of facilities offering MOUD, but the buprenorphine implant was not. Increasing the availability of MOUD, including long-acting options, is necessary to address unmet need for opioid use disorder treatment.