Drug and alcohol dependence
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Drug Alcohol Depend · Dec 2019
A mixed-methods assessment of the impact of the opioid epidemic on first responder burnout.
First responders have demanding jobs and report experiencing burnout. The opioid epidemic has added to first responder workloads, which could contribute to increased burnout. This mixed-methods study examined burnout among first responders by: 1) describing burnout among first responders specifically related to workload demands associated with the opioid epidemic; 2) exploring first responder perspectives on how the opioid epidemic has affected their profession; and 3) conducting exploratory analyses to examine how burnout and perspectives on the effect of the opioid epidemic differ across first responder professions. ⋯ First responders reported experiencing burnout, increased workloads, and negative emotional effects related to their role in responding to the opioid epidemic. Despite this, first responders view responding to community opioid misuse as part of their professional role for which they have received specialized training. Future research should continue to explore the impact of the opioid epidemic on first responders, including how to prevent or address burnout.
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Drug Alcohol Depend · Dec 2019
Gestational buprenorphine exposure: Effects on pregnancy, development, neonatal opioid withdrawal syndrome, and behavior in a translational rodent model.
The opioid crisis has led to an increased number of pregnant opioid-dependent women receiving opioid-maintenance therapy (e.g. buprenorphine, BUP), but little is known about the consequences of gestational BUP exposure on pregnancy outcomes, maternal care, or offspring development. ⋯ These results demonstrate that the therapeutic BUP-LD in rats was relatively safe with subtle effects on maternal care and rodent offspring. However, overexposure BUP-HD in rats produced NOWS and compromised maternal caregiving as well as rodent offspring survival. More research is critical to validate the translational implication of these findings for human opioid-dependent mothers maintained on BUP-maintenance therapy.
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The subjective experience of drug craving is a prominent and common clinical phenomenon for many individuals diagnosed with opioid use disorder (OUD), and could be a valuable clinical endpoint in medication development studies. The purpose of this scoping review is to provide an overview and critical analysis of opioid craving assessments located in the published literature examining OUD. ⋯ This review identified a variety of opioid craving assessments, but few had been evaluated for their psychometric properties making it difficult to ascertain whether craving is being assessed optimally in studies of OUD. Thus, the development of a reliable and valid opioid craving assessment would be worthwhile and could be guided by recently published Food and Drug Administration Clinical Outcome Assessment (COA) guidelines. Importantly, a COA focused on opioid craving could be a valuable addition to research studies designed to evaluate novel treatments for OUD.
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Drug Alcohol Depend · Dec 2019
Randomized Controlled TrialAcute and residual effects of smoked cannabis: Impact on driving speed and lateral control, heart rate, and self-reported drug effects.
Although driving under the influence of cannabis is increasingly common among young adults, little is known about residual effects on driver behavior. This study examined acute and residual effects of smoked cannabis on simulated driving performance of young cannabis users. ⋯ Acutely, cannabis caused decreased speed, increased heart rate, and increases in VAS drug effect and drug high. There was no evidence of residual effects on these measures over the two days following cannabis administration.
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Drug Alcohol Depend · Dec 2019
Randomized Controlled TrialA randomized controlled trial evaluating integrated versus phased application of evidence-based psychotherapies for military veterans with comorbid PTSD and substance use disorders.
Recent clinical practice guidelines recommend the delivery of evidence-based psychotherapies for both substance use disorder (SUD) and posttraumatic stress disorder (PTSD) within the same treatment episode for patients with SUD/PTSD comorbidity. This randomized clinical trial evaluated the comparative effectiveness of integrating versus phasing evidence-based psychotherapies for SUD and PTSD among veterans with co-occurring SUD/ PTSD. ⋯ Our hypothesis that integrated MET/PE would result in better outcomes than phased MET/PE across a range of PTSD and SUD measures was not supported; both strategies for combining two single-disorder treatments for co-occurring SUD/PTSD yielded significant symptom reduction.