Drug and alcohol dependence
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Drug Alcohol Depend · Oct 2018
Improved treatment-retention for patients receiving methadone dosing within the clinic providing physician and other health services (onsite) versus dosing at community (offsite) pharmacies.
Opioid-use disorder has been declared a public health crisis across North America. One of the most common treatments for opioid-use disorder is opioid agonist therapy, including MMT. This study examined the impact of methadone dispensing in clinic (onsite) pharmacies versus community (offsite) pharmacies on treatment retention for patients initiating MMT. ⋯ The results of this study suggest that clinic (onsite) pharmacy methadone dosing results in a greater likelihood of retention in MMT compared to community (offsite) pharmacy dosing. The study highlights the importance of coordinating delivery of care across patient, physician, and pharmacist in delivery of treatment services.
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Drug Alcohol Depend · Oct 2018
The association between physical pain and cannabis use in daily life: An experience sampling method.
Previous research shows that between individuals there is a positive association between medically motivated use and cannabis use frequency and quantity. While between-subjects' analyses are useful for understanding shared vulnerabilities, research has so far not examined within-subjects' relationships which are closer to evaluating functional relationships (i.e., do individuals tend to use cannabis more heavily subsequent to elevations in pain experiences?). To better understand the association between experiences of pain and cannabis use, the current paper examines whether there is a functional within-subjects association between experiences of pain and heavy cannabis use. ⋯ Experiences of pain are not associated with decisions about whether or not to use cannabis. Once cannabis users are in cannabis-using situations, they tend to use larger amounts when they are experiencing elevated levels of pain. This may have implications for cannabis abuse treatment as pain may make it more difficult for users to reduce their consumption.
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Drug Alcohol Depend · Oct 2018
Cognitive reappraisal moderates the relationship between PTSD symptoms and alcohol use over time in post-9/11 U.S. military veterans.
Rates of comorbid alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are increasing among post-9/11 veterans, and emotion regulation problems have been identified as a feature of both disorders. However, no studies to date have explored how individual differences in emotion regulation may moderate the relationship between PTSD symptoms and alcohol use. We evaluated how two core emotion regulation strategies - one adaptive (i.e., cognitive reappraisal) and one maladaptive (i.e., expressive suppression) are related to PTSD symptoms and alcohol use over one-year. ⋯ Findings from the present study suggest that baseline individual differences in cognitive reappraisal influence the relation between PTSD symptoms and alcohol use. For post-9/11 veterans, high levels of cognitive reappraisal may serve as a protective factor against ongoing alcohol use.
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Drug Alcohol Depend · Oct 2018
Comparing state, regional, and local variation in concurrent opioid and benzodiazepine use.
Concurrent opioid and benzodiazepine use is associated with a three-fold increase in the risk of opioid-related overdose. No study has evaluated geographic variation in the concurrent use of opioids and benzodiazepines in US Medicare. We compared state, hospital-referral region (HRR), and county-level variation in concurrent opioid and benzodiazepine use among US Medicare opioid users and examined the heterogeneity in concurrent use within states. ⋯ Large variation in concurrent use of opioids and benzodiazepines exists across the US. State variation masks substantial local variation, which beckons for polices to monitor concurrent opioid and benzodiazepine use at the county level.
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Drug Alcohol Depend · Oct 2018
ReviewPharmacotherapy for amphetamine dependence: A systematic review.
Demand for treatment for amphetamine use is increasing internationally. Establishing effective pharmacotherapy provides broader treatment options for people who are dependent on amphetamine and may encourage engagement in evidence-based behavioral treatment. This study aimed to identify medicines that have potential in improving treatment outcomes for people who are dependent on amphetamines. ⋯ No medicine has as yet demonstrated sufficient, consistent evidence of effectiveness to support its use in routine treatment. High study drop-out and poor medication adherence limits the strength of evidence and raises important clinical questions about how to improve treatment engagement and outcomes.