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Opioids & SU
The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
677 Results
101
Can urban methadone patients complete health utility assessments?
Type: Journal Article
Year: 2008
Publication Place: Ireland
Abstract: OBJECTIVE: To assess the ability of methadone maintenance treatment (MMT) patients to use two standardized health assessment tools to value health states related to chronic hepatitis C virus (HCV) infection and HCV treatment-associated side effects. An estimated 65-90% of MMT patients are chronically infected with HCV. METHODS: We employed qualitative methods to explore how patients completed computerized rating scale assessments and standard gamble utility assessments by (1) having them discuss their responses in a think-aloud interview immediately after each health state assessment, and (2) allowing them the opportunity to recalibrate prior responses after considering subsequent health states. RESULTS: MMT patients used the rating scale boundaries appropriately and used the standard gamble to rank the health states in an a priori logical order. A guided assessment approach that allowed recalibration provided additional insight into values assigned to the health states presented. CONCLUSION: MMT patients are able to perform the tasks associated with rating scale assessments and standard gamble utility assessments of HCV health states. PRACTICE IMPLICATIONS: These assessment methods should be considered as a means to elicit MMT patients' values for HCV treatment, since the treatment outcome is uncertain but it is likely that side effects will adversely affect current health.
Topic(s):
Opioids & Substance Use
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, Measures
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View the DOI record for Can urban methadone patients complete health utility assessments?
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View the PubMed citation for Can urban methadone patients complete health utility assessments?102
Can we predict addiction to opioid analgesics? A possible tool to estimate the risk of opioid addiction in patients with pain
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: BACKGROUND: The use of opioid analgesics in the treatment of chronic pain conditions has long been controversial. They have been reported to be relatively safe when prescribed with caution, but a brief and valid instrument to estimate a person's risk of addiction is still missing. OBJECTIVE: The aim of this study was to investigate a self-rating questionnaire allowing an estimation of a person's risk of addiction to opioid analgesics. STUDY DESIGN: Retrospective review. SETTING: Four Austrian hospitals. METHODS: Seven hundred forty-one patients were interviewed. Of these, 634 patients were affected with chronic pain while 107 patients had a history of opioid addiction. Patients were interviewed about alcohol and nicotine consumption and family history of psychiatric disorders. Attitudes towards medication and the origin of pain were examined. We asked patients with an opioid addiction and patients suffering from chronic pain to complete a short questionnaire intended to help screen for addiction potential. RESULTS: Compared to the patients suffering from chronic pain, patients with an opioid addiction significantly more often had alcohol- and nicotine-related pathologies and psychiatric comorbidity. A family history of mental illness and developmental problems were significantly more frequent in this group. Compared to those not addicted, those with an opioid addiction had significantly higher expectations concerning the potential of medication to change one's mental state; they thought that psychological factors might contribute to the pain they feel. LIMITATIONS: The main limitation of this study is the use of a self-rating instrument which reduces objectivity and introduces the possibility of misreporting. Also, the 2 groups differ in number and are not homogenous. CONCLUSION: We found differences in questionnaire responses between patients with an opioid addiction and patients suffering from chronic pain to be dependent upon the prevalence of current or former addiction, psychiatric history, attitudes towards medication, and ideas about the origin of pain. We believe these factors have predictive value in estimating a patient with pain's risk of addiction.
Topic(s):
Opioids & Substance Use
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, Measures
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103
Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada
Type: Journal Article
Year: 2021
Abstract:
BACKGROUND: As the legalization of recreational cannabis becomes more widespread, its impact on individuals with substance use disorders must be studied. Amidst an ongoing opioid crisis, Canada's legalization of recreational cannabis in October 2018 provides an important setting for investigation. We examined changes to cannabis use patterns in patients receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) following legalization. METHODS: This study includes cross-sectional data from 602 participants recruited 6 months pre-legalization and 788 participants recruited 6 months post-legalization, providing information on cannabis use. Regression analysis was used to estimate the association between legalization and cannabis use patterns. We collected longitudinal urine drug screens (UDSs) detecting cannabis-metabolites for 199 participants recruited pre-legalization and followed prospectively post-legalization. Conditional logistic regression was used to assess the association between legalization and UDS results. RESULTS: Past-month cannabis use was self-reported by 54.8 and 52.3% of participants recruited pre- and post-legalization, respectively. Legalization was not associated with changes in any measured cannabis characteristics: cannabis use (OR 0.91, 95% CI 0.73-1.13), days of use/month (B -0.42, 95% CI - 2.05-1.21), money spent, or cannabis source. There was no association between legalization and prevalence of cannabis use on UDS (OR 1.67, 95% CI 0.93-2.99) or percentage of cannabis-positive UDSs (OR 1.00, 95% CI 0.99-1.01). Participants overwhelmingly reported that legalization would have no impact on their cannabis use (85.7%). CONCLUSIONS: Amongst patients treated for OUD, no significant change in cannabis use was observed following legalization; however, high rates of cannabis use are noted.
Topic(s):
Measures
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, Opioids & Substance Use
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View the DOI record for Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada
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View the PubMed citation for Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada105
Case finding and screening clinical utility of the Patient Health Questionnaire (PHQ-9 and PHQ-2) for depression in primary care: a diagnostic meta-analysis of 40 studies
Type: Journal Article
Year: 2016
Publication Place: England
Topic(s):
Measures
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106
Casting a wider net in behavioral health screening in primary care: a preliminary study of the Outcome Rating Scale
Type: Journal Article
Year: 2017
Publication Place: England
Abstract: Introduction The integration of behavioral health services into primary care has led to enhanced use of brief screening measures to identify mental health problems. Although useful, such instruments are largely symptom based and diagnosis specific. This narrow focus can potentially limit the identification of broader social or relational distress in patients that affect medical outcomes, as well as present feasibility challenges using a multi-measure approach in identifying mental health comorbidities. METHOD: This exploratory study of adult primary care patients compared an ultra-brief, and widely used measure of global distress across life functioning, the Outcome Rating Scale (ORS), with the Patient Health Questionnaire (PHQ-9 and PHQ-2). RESULTS: Correlations between the ORS and the PHQ-9 and PHQ-2 indicated agreement between the measures in classifying patients, and the ORS identified significantly more patients in the clinical range. Discussion Although results are preliminary, the ORS may cast a wider net in identifying patients with significant distress in primary care.
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View the DOI record for Casting a wider net in behavioral health screening in primary care: a preliminary study of the Outcome Rating Scale
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View the PubMed citation for Casting a wider net in behavioral health screening in primary care: a preliminary study of the Outcome Rating Scale108
Changes in quality of life (WHOQOL-BREF) and addiction severity index (ASI) among participants in opioid substitution treatment (OST) in low and middle income countries: an international systematic review
Type: Journal Article
Year: 2014
Publication Place: Ireland
Topic(s):
Opioids & Substance Use
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, Measures
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109
Changing Nurse Practitioner Students' Attitudes and Beliefs About Caring for Those With Opioid Use Disorders
Type: Journal Article
Year: 2021
Publication Place: United States
Topic(s):
Education & Workforce
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, Measures
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, Opioids & Substance Use
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View the DOI record for Changing Nurse Practitioner Students' Attitudes and Beliefs About Caring for Those With Opioid Use Disorders
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View the PubMed citation for Changing Nurse Practitioner Students' Attitudes and Beliefs About Caring for Those With Opioid Use Disorders110
Characteristics of chronic noncancer pain patients assessed with the opioid risk tool in a Canadian tertiary care pain clinic
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: BACKGROUND: The Opioid Risk Tool (ORT) is a screening instrument for assessing the risk of opioid-related aberrant behavior in chronic noncancer pain (CNCP) patients. OBJECTIVE: This study aims to compare patient characteristics documented in the original ORT study with those identified in CNCP patients assessed using a physician-administered ORT in a tertiary care pain clinic in Toronto, Canada. METHODOLOGY: This was a descriptive cross-sectional study of 322 consecutive new patients referred over 12 months. Data extraction included ORT scores, demographics, pain ratings, opioid, and other medication use at point of entry, diagnosis, and other variables. Characteristics were compared with those described in the original ORT study. RESULTS: The total mean ORT scores of patients in this study were related to several demographic (gender, age, marital status, and country of birth) and nondemographic variables (employment status, cigarette smoking, and contribution of biomedical and/or psychological factors to presentation). Prevalence of characteristics noted in this patient sample differed substantially from that found in Webster and Webster as the basis for ORT scores. CONCLUSION: Significant differences existed between this study population and the patient sample from which the ORT was derived. Limitations of this study are discussed. We concur with the authors of the original study that the ORT may not be applicable in different pain populations and settings. Based on our findings, we encourage caution in interpreting the ORT in general CNCP settings until further studies are performed.
Topic(s):
Opioids & Substance Use
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, Measures
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112
Characteristics, management, and depression outcomes of primary care patients who endorse thoughts of death or suicide on the PHQ-9
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: BACKGROUND: With increasing emphasis on integrating behavioral health services, primary care providers play an important role in managing patients with suicidal thoughts. OBJECTIVE: To evaluate whether Patient Health Questionnaire-9 (PHQ-9) Item 9 scores are associated with patient characteristics, management, and depression outcomes in a primary care-based mental health program. DESIGN: Observational analysis of data collected from a patient registry. PARTICIPANTS: Eleven thousand fifteen adults enrolled in the Mental Health Integration Program (MHIP). INTERVENTIONS: MHIP provides integrated mental health services for safety-net populations in over 100 community health centers across Washington State. Key elements of the team-based model include: a disease registry; integrated care management; and organized psychiatric case review. MAIN MEASURES: The independent variable, suicidal ideation (SI), was assessed by PHQ-9 Item 9. Depression severity was assessed with the PHQ-8. Outcomes included four indicators of depression treatment process (care manager contact, psychiatric case review, psychotropic medications, and specialty mental health referral), and two indicators of depression outcomes (50 % reduction in PHQ-9 score and PHQ-9 score < 10). KEY RESULTS: SI was common (45.2 %) at baseline, with significantly higher rates among men and patients with greater psychopathology. Few patients with SI (5.4 %) lacked substantial current depressive symptoms. After adjusting for age, gender, and severity of psychopathology, patients with SI received follow-up earlier (care manager contact HR = 1.05, p < 0.001; psychiatric review HR = 1.02, p < 0.05), and were more likely to receive psychotropic medications (OR = 1.11, p = 0.001) and specialty referral (OR = 1.23, p < 0.001), yet were less likely to achieve a PHQ-9 score < 10 (HR = 0.87, p < 0.001). CONCLUSIONS: Suicidal thoughts are common among safety-net patients referred by primary care providers for behavioral health care. Scores on Item 9 of the PHQ-9 are easily obtainable in primary care, may help providers initiate conversations about suicidality, and serve as useful markers of psychiatric complexity and treatment-resistance. Patients with positive scores should receive timely and comprehensive psychiatric evaluation and follow-up.
Topic(s):
Measures
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113
Characterization of diverted buprenorphine use among adults entering corrections-based drug treatment in Kentucky
Type: Journal Article
Year: 2020
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Measures
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, Opioids & Substance Use
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View the DOI record for Characterization of diverted buprenorphine use among adults entering corrections-based drug treatment in Kentucky
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View the PubMed citation for Characterization of diverted buprenorphine use among adults entering corrections-based drug treatment in Kentucky117
Chronic obstructive pulmonary disease (COPD) among opioid-dependent patients in agonist treatment. A diagnostic study
Type: Journal Article
Year: 2019
Publication Place: England
Topic(s):
Measures
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, Opioids & Substance Use
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View the DOI record for Chronic obstructive pulmonary disease (COPD) among opioid-dependent patients in agonist treatment. A diagnostic study
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View the PubMed citation for Chronic obstructive pulmonary disease (COPD) among opioid-dependent patients in agonist treatment. A diagnostic study118
Chronic pain and depression among primary care patients treated with buprenorphine
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: BACKGROUND: Pain and depression are each prevalent among opioid dependent patients receiving maintenance buprenorphine, but their interaction has not been studied in primary care patients. OBJECTIVE: We set out to examine the relationship between chronic pain, depression, and ongoing substance use, among persons maintained on buprenorphine in primary care settings. DESIGN: Between September 2012 and December 2013, we interviewed buprenorphine patients at three practice sites. PARTICIPANTS: Opioid dependent persons at two private internal medicine offices and a federally qualified health center participated in the study. MAIN MEASURES: Pain was measured in terms of chronicity, with chronic pain being defined as pain lasting at least 6 months; and in terms of severity, as measured by self-reported pain in the past week, measured on a 0-100 scale. We defined mild chronic pain as pain severity between 0 and 39 and lasting at least 6 months, and moderate/severe chronic pain as severity >/= 40 and lasting at least 6 months. To assess depression, we used the Center for Epidemiologic Studies Depression (CESD) ten-item symptom scale and the two-item Patient Health Questionnaire (PHQ-2). KEY RESULTS: Among 328 participants, 169 reported no chronic pain, 56 reported mild chronic pain, and 103 reported moderate/severe chronic pain. Participants with moderate/severe chronic pain commonly used non-opioid pain medications (56.3%) and antidepressants (44.7%), yet also used marijuana, alcohol, or cocaine (40.8%) to help relieve pain. Mean CESD scores were 7.1 (+/-6.8), 8.3 (+/-6.0), and 13.6 (+/-7.6) in the no chronic, mild, and moderate/severe pain groups, respectively. Controlling for covariates, higher CESD scores were associated with a higher likelihood of moderate/severe chronic pain relative to both no chronic pain (OR = 1.09, p < 0.001) and mild chronic pain (OR = 1.06, p = 0.04). CONCLUSION: Many buprenorphine patients are receiving over-the-counter or prescribed pain medications, as well as antidepressants, and yet continue to have significant and disabling pain and depressive symptoms. There is a clear need to address the pain-depression nexus in novel ways.
Topic(s):
Opioids & Substance Use
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, Measures
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View the DOI record for Chronic pain and depression among primary care patients treated with buprenorphine
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View the PubMed citation for Chronic pain and depression among primary care patients treated with buprenorphine119
Chronic pain severity in opioid-dependent patients
Type: Journal Article
Year: 2008
Publication Place: England
Abstract: Treatment-seeking opioid-dependent patients present frequently with chronic pain (CP). This pilot study examined the feasibility and utility of a single-item rapid screening tool for identifying CP with implications for substance use disorder (SUD) treatment in a sample of patients presenting for inpatient opioid detoxification (n = 110). Most respondents (91.2%) reported pain in the past week. Forty-seven (42.8%) had CP. Individuals with severe CP had significantly greater depressive symptom severity, pain-related functional interference, and were more likely to be on disability than individuals with mild to moderate CP or no CP. The relationships were supported in a multivariate model. The results suggest it is feasible and important to assess for CP severity in SUD treatment settings.
Topic(s):
Measures
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, Opioids & Substance Use
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