Drug and alcohol dependence
-
Drug Alcohol Depend · Oct 2020
Trajectories of cannabis use and risk for opioid misuse in a young adult urban cohort.
Although much of the attention surrounding the opioid epidemic has focused on rural and suburban Whites and prescription opioids, heroin overdoses among urban Blacks are on the rise. While some argue that legalization of cannabis will combat the epidemic, there are concerns it ignores the shift in the epidemic and could increase vulnerability to opioid misuse. The goal of this study is to examine the association between cannabis use from adolescence to young adulthood with opioid misuse in a primarily urban Black cohort. ⋯ Adolescent onset cannabis use is associated with opioid misuse in young adulthood among urban Blacks even after adjustment for socioecological factors associated with opioid misuse.
-
Drug Alcohol Depend · Oct 2020
Successful engagement in buprenorphine treatment among hospitalized patients with opioid use disorder and trauma.
The opioid epidemic continues to cause significant morbidity and mortality. Although there are effective medications for opioid use disorder (OUD), a minority of patients receive these treatments. OUD is common among patients hospitalized for traumatic injury and hospitalization could be an opportunity to initiate medications and link to ongoing buprenorphine care. ⋯ Among hospitalized patients with OUD who initiate buprenorphine, those who were hospitalized for trauma were at least as likely to link to out-patient treatment. Trauma admissions represent an important opportunity for diagnosing and linking patients with OUD to buprenorphine treatment.
-
Drug Alcohol Depend · Sep 2020
Medications for opioid use disorder in pregnancy in a state women's prison facility.
Medication for opioid use disorder (MOUD) improves both maternal and neonatal outcomes for pregnant women with opioid use disorder (OUD). Although correctional policies often state that incarcerated pregnant women with OUD should receive MOUD, implementation data is scant. Our aims were to 1) quantify the extent to which pregnant women in a Southeastern prison received MOUD during their incarceration; 2) to describe the medications and doses used during incarceration and frequency of MOUD referral after incarceration; and 3) identify associations between maternal characteristics and receipt of MOUD in order to identify points of intervention for clinical policy change. ⋯ There was significant unmet need for MOUD and MOUD referral among pregnant women imprisoned in North Carolina from 2016-2018. Our findings suggest that the initial assessment for MOUD and referral to a community MOUD provider may represent opportunities to improve MOUD access for this population.
-
Drug Alcohol Depend · Sep 2020
Signal of increased opioid overdose during COVID-19 from emergency medical services data.
Individuals with opioid use disorder may be at heightened risk of opioid overdose during the COVID-19 period of social isolation, economic distress, and disrupted treatment services delivery. This study evaluated changes in daily number of Kentucky emergency medical services (EMS) runs for opioid overdose between January 14, 2020 and April 26, 2020. ⋯ This Kentucky-specific study provides empirical evidence for concerns that opioid overdoses are rising during the COVID-19 pandemic and calls for sharing of observations and analyses from different regions and surveillance systems with timely data collection (e.g., EMS data, syndromic surveillance data for ED visits) to improve our understanding of the situation, inform proactive response, and prevent another big wave of opioid overdoses in our communities.
-
Drug Alcohol Depend · Sep 2020
Pain-related anxiety, sex, and co-use of alcohol and prescription opioids among adults with chronic low back pain.
Both alcohol and prescription opioid use/misuse are highly prevalent among individuals with chronic pain. Co-use of alcohol and prescription opioids is also common, despite contraindications due to increased risk of negative health effects and mortality. There is evidence that pain-related anxiety (i.e., the tendency to respond to pain with anxiety or fear) may be associated with heavier drinking and prescription opioid use/co-use, and that these associations may be especially salient among men. ⋯ These findings contribute to a growing literature suggesting that pain-related anxiety is an important transdiagnostic factor in pain and alcohol and prescription opioid use/co-use, perhaps especially among males.