Drug and alcohol dependence
-
Drug Alcohol Depend · Jun 2019
Effects of mandatory prescription drug monitoring program (PDMP) use laws on prescriber registration and use and on risky prescribing.
Comprehensive mandatory use laws for prescription drug monitoring programs (PDMPs) have been implemented in a number of states to help address the opioid overdose epidemic. These laws may reduce opioid-related overdose deaths by increasing prescribers' use of PDMPs and reducing high-risk prescribing behaviors. ⋯ These findings indicate that PDMP mandates have the potential to reduce risky opioid prescribing practices. Variation in the laws may explain why the effectiveness varied between states.
-
Drug Alcohol Depend · Jun 2019
Randomized Controlled Trial Comparative StudyVeterans with PTSD and comorbid substance use disorders: Does single versus poly-substance use disorder affect treatment outcomes?
Substance use disorders (SUD) frequently co-occur with posttraumatic stress disorder (PTSD). Little is known, however, about how individuals with a single SUD diagnosis (relating to only one substance) compare to individuals with poly-SUD diagnoses (relating to more than one substance) on substance use and PTSD treatment outcomes. To address this gap in the literature, we utilized data from a larger study investigating a 12-week integrated, exposure-based treatment (i.e., Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure, or COPE) to examine treatment outcomes by single vs. poly-SUD status. ⋯ The findings from this exploratory study suggest that Veterans with PTSD and co-occurring poly-SUD, as compared to a single-SUD, may experience greater improvement in substance use but less improvement in PTSD symptoms during integrated treatment. Future research should identify ways to enhance treatment outcomes for individuals with poly-SUD, and to better understand mechanisms of change for this population.
-
Drug Alcohol Depend · Apr 2019
Comparative StudyPrescription opioid misuse among African-American adults: A rural-urban comparison of prevalence and risk.
Prescription opioid misuse (POM) remains a public health concern in the United States. Although the problem has been studied extensively, little research attention is paid to POM among African-Americans (AAs), and even fewer studies consider rural status in their analysis. The goal of this study, therefore, was to identify and compare prevalence and predictors of POM among rural and urban AA adults using data from a nationally representative sample. ⋯ Results indicate that AA nonmedical prescription opioid users are not a monolith and have distinct demographic, clinical, and psychosocial profiles based on geographic region. Because AAs have been virtually ignored in the POM literature, our findings are an important step towards understanding POM among this understudied group. These results invite additional investigation into AA POM and encourage researchers to consider rural status in their analysis of POM among AAs.
-
Drug Alcohol Depend · Apr 2019
Co-occurring substance use and mental disorders among adults with opioid use disorder.
Co-occurring substance use and mental disorders among people with opioid use disorder (OUD) increase risk for morbidity and mortality. Addressing these co-occurring conditions is critical for improving treatment and health outcomes. There is limited recent research on the prevalence of co-occurring disorders, demographic characteristics associated with co-occurring disorders, and receipt of mental health and substance use treatment services among those with OUD. This limits the development of targeted and resourced policies and clinical interventions. ⋯ Co-occurring substance use and mental disorders are common among adults with OUD. Expanding access to comprehensive service delivery models that address the substance use and mental health co-morbidities of this population is urgently needed.
-
Drug Alcohol Depend · Apr 2019
Randomized Controlled TrialVery-low-nicotine-content cigarettes and dependence among non-daily smokers.
The US Food and Drug Administration is considering reductions in the nicotine content of cigarettes to reduce smoking and tobacco dependence. A randomized study showed that even non-daily, intermittent smokers (ITS) reduced their cigarette consumption when switched to very-low-nicotine-content cigarettes (VLNCCs). This paper assesses whether switching ITS to VLNCCs results in decreased dependence and whether subsequent cigarette consumption is mediated by decreased dependence. ⋯ Among ITS, switching to VLNCCs results in reduced tobacco dependence. However, the reductions in dependence appear to be secondary to effects on cigarette consumption, and do not appear to be an independent predictor or cause of reduced cigarette consumption.