Drug and alcohol dependence
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Drug Alcohol Depend · Apr 2021
ReviewThe phenomics and genetics of addictive and affective comorbidity in opioid use disorder.
Opioid use disorder (OUD) creates significant public health and economic burdens worldwide. Therefore, understanding the risk factors that lead to the development of OUD is fundamental to reducing both its prevalence and its impact. ⋯ In this review, we describe the prevalence and clinical significance of addictive and affective comorbidities as risk factors for OUD development as a basis for rational opioid prescribing and OUD treatment and to improve efforts to prevent the disorder. We also review the genetic variants that have been associated with OUD and other addictive and affective disorders to highlight targets for future study and risk assessment protocols.
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Drug Alcohol Depend · Dec 2020
ReviewAddressing opioid overdose deaths: The vision for the HEALing communities study.
The United States is facing two devastating public health crises- the opioid epidemic and the COVID-19 pandemic. Within this context, one of the most ambitious implementation studies in addiction research is moving forward. ⋯ The goal for this research was to reduce opioid overdose deaths by 40 % in three years by enhancing and integrating the delivery of multiple evidence-based practices (EBPs) with proven effectiveness in reducing opioid overdose deaths across health care, justice, and community settings. This paper describes the initial vision, goals, and objectives of this initiative; the impact of COVID-19; and the potential for knowledge to be generated from HCS at the intersection of an unrelenting epidemic of opioid misuse and overdoses and the ravishing COVID-19 pandemic.
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Drug Alcohol Depend · Nov 2020
Meta AnalysisA systematic review and meta-analysis of medications for stimulant use disorders in patients with co-occurring opioid use disorders.
Stimulant (cocaine and/or methamphetamine) use has increased among people with opioid use disorder. We conducted a systematic review of medications for stimulant use disorders in this population. ⋯ Co-occurring stimulant/opioid use disorder is an important problem for targeting future research. Medication trials for methamphetamine use disorder are lacking in this population. Most of the medications studied for cocaine use were ineffective, although psychostimulants warrant further study.
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Drug Alcohol Depend · May 2020
ReviewA systematic review of opioid overdose interventions delivered within emergency departments.
People with opioid use disorders are at higher risk of fatal opioid overdose and attend emergency departments (ED) more frequently compared to the general population. This review aimed to synthesise evidence on the ED-based delivery of opioid overdose prevention interventions. ⋯ ED provision of a range of opioid overdose prevention interventions is feasible, acceptable to patients and ED personnel. Interventions require adequate staffing/role responsibility for sustainable implementation. Most evidence was for THN, with an emerging evidence base for other intervention types reducing opioid-overdose risks in ED settings. Further research on implementation and sustainability may assist in translation of effective interventions into the ED setting.
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Drug Alcohol Depend · Mar 2020
ReviewAssessment of the completeness of intervention reporting of randomized clinical trials for alcohol use disorders: Effect of the TIDieR checklist and guide.
Properly designed randomized controlled trials (RCTs) are the gold standard in patient-centered clinical research. Incomplete intervention reporting affects the readers' ability to evaluate treatment efficacy. Previous studies show that detailed descriptions of trial interventions remains insufficient for reliable replication. Understanding reporting areas in need of improvement can improve the quality of intervention reporting. ⋯ We found the reporting of interventions to be inadequate in our sample of AUD-related RCTs. Fundamental details were often not reported, hampering both clinical and research reproducibility. Moving forward, it may be necessary to consider additional mechanisms to either improve TIDieR uptake or to find other solutions to improve intervention reporting.