Substance use & misuse
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Substance use & misuse · Jan 2019
Readmissions Following Inpatient Treatment for Opioid-Related Conditions.
Previous research suggests that relatively few hospitalized patients with opioid-related conditions receive substance use treatment during their inpatient stay. Without treatment, these individuals may be more likely to have subsequent hospitalizations for continued opioid use disorder. ⋯ A relatively small percentage (19.4%) of patients with identified opioid-related conditions received treatment for drug use during their hospital inpatient stay. Patients who received drug rehabilitation, but not drug detoxification, during an opioid-related index hospitalization had lower odds of an opioid-related readmission within 90 days of discharge (odds ratio = 0.60, 95% confidence interval = 0.54-0.67) compared with patients with no inpatient drug detoxification or rehabilitation. Conclusions/Importance: A low percentage of patients receive inpatient services for drug use during an index stay involving an opioid-related diagnosis. Our findings indicate that receipt of drug rehabilitation services in acute care hospitals is associated with a lower 90-day readmission rate. Further research is needed to understand factors associated with the receipt of inpatient services and readmissions.
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Substance use & misuse · Jan 2019
Intention to Try Tobacco Among Middle School Students in a Predominantly Rural Environment of Central Appalachia.
Disparities in tobacco use exist across regions in the United States. The Central Appalachian region carries some of the very high rates of tobacco use prevalence but research on tobacco use initiation is sparse. ⋯ This study suggests that individual, interpersonal, and community level factors influence intention to try tobacco in this environment where tobacco pre-emption laws impede development of local tobacco control policies and regulations. Thus, efforts should focus on tobacco use initiation preventive programs, including school-based tobacco control programs.
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Substance use & misuse · Jan 2019
Perceived Unintended Consequences of Prescription Drug Monitoring Programs.
Opioid-related injuries and deaths continue to present challenges for public health practitioners. Prescription Drug Monitoring Programs (PDMPs) are a prevalent policy option intended to address problematic opioid pain reliever (OPR) prescribing, but previous research has not thoroughly characterized their unintended consequences. ⋯ We identified six themes from the interviews. Perceived negative unintended consequences included: access barriers for those with medical needs, heroin use as OPR substitute and related deaths, and need for adequate PDMP security infrastructure and management. Perceived positive unintended consequences were: community formation and problem awareness, proactive population-level OPR monitoring, and increased knowledge about population-level drug diversion. Conclusions/Importance: State actors perceive a range of both negative and positive unintended consequences of PDMPs. Our findings suggest that there may be unintended risks of PDMPs that states should address, but also opportunities to maximize certain benefits.
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Substance use & misuse · Jan 2019
Overdose Risk and Client Characteristics Associated With the Injection of Buprenorphine at a Medically Supervised Injecting Center in Sydney, Australia.
Background: Buprenorphine and buprenorphine/naloxone (BNX) were developed to improve the safety profile of opioid substitution treatment (OST) and reduce diversion and injection, yet continue to be injected, despite the risk of harm. Previous studies examining injection of these substances have relied on self-reported injection and overdose. Using data from the Uniting Medically Supervised Injecting Center (MSIC) in Sydney, this study aimed to assess the overdose risk associated with the use of buprenorphine and BNX and identify factors associated with injecting. ⋯ Conclusions: Buprenorphine and BNX continue to be injected, albeit in small numbers. This is the first study to report on injection and overdose risk using direct observation, and has confirmed the lower overdose risk. MSIC clients who inject buprenorphine and BNX tend to be marginalized and may benefit from targeted harm reduction measures.
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Substance use & misuse · Jan 2019
Understanding Public Attitudes Toward Cannabis Legalization: Qualitative Findings From a Statewide Survey.
Cannabis policy is rapidly evolving in the United States as more states legalize medical and non-medical marijuana. Public opinion has shifted dramatically in favor of marijuana legalization. ⋯ 48.1% of the sample supported cannabis legalization, 41.9% were opposed to legalization, and 10% were unsure. Harms associated with marijuana use were the most commonly given reasons for opposing legalization. Those who supported legalization were most likely to state that marijuana is less dangerous than other substances and has medical benefits. They also cited criminal justice reform and the potential for tax revenue as potential benefits of legalization. Reasons for supporting and opposing legalization differed based on gender, age, and recent marijuana use. Conclusions/Importance: Findings highlight nuances in public attitudes toward cannabis legalization. Many who support cannabis legalization recognize some potential negative consequences of these policy changes. Understanding views of cannabis is important as policies for marijuana use and sales become less restrictive.