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Opioids & SU
The Literature Collection contains over 11,000 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).
12780 Results
2222
Challenges and opportunities during the COVID-19 pandemic: Treating patients for substance use disorders during the perinatal period
Type: Journal Article
Year: 2021
Topic(s):
Healthcare Disparities
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, HIT & Telehealth
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, Opioids & Substance Use
See topic collection
2223
Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: BACKGROUND: Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. METHODS: A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. RESULTS: The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. CONCLUSIONS: The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care.
Topic(s):
General Literature
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2225
Challenges and Opportunities for the Use of Medications to Treat Opioid Addiction in the United States and Other Nations of the World
Type: Journal Article
Year: 2015
Publication Place: England
Abstract: There has been a well documented increase in the use and abuse of prescription opioids and heroin in the United States and other parts of the world. There has also been an increasing focus to increase access to the use of medications (methadone, buprenorphine, Naltrexone/Vivitrol) for opioid addicted individuals under legal supervision. As policymakers engage in strategic initiatives to better prevent and effectively treat chronic opioid addiction, both in the United States and other countries, there are a number of unintended consequences, complicating how best to increase access to effective treatment.
Topic(s):
Opioids & Substance Use
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2228
Challenges applying alcohol brief intervention in diverse practice settings: Populations, outcomes, and costs
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: This article summarizes the proceedings of a symposium at the 2005 Research Society on Alcoholism, Santa Barbara, California. The purpose of the symposium was to address challenges that arise in translating evidence for efficacy of alcohol brief intervention (BI) into diverse clinical settings and populations by reviewing the literature and describing 4 research studies. Dr. Saitz reviewed the limitations in evidence for efficacy of BIs and then described results of a randomized clinical trial of brief motivational intervention for medical inpatients drinking risky amounts. Dr. Svikis presented alternative methods for identifying pregnant women in prenatal care at risk for alcohol and drug problems (including nicotine and caffeine) and BIs to reduce or eliminate use. Dr. D'Onofrio discussed results of a randomized trial of the brief negotiated interview in emergency department patients. Dr. Kraemer presented results of a decision analytic and computer-simulation model regarding the cost-effectiveness of alcohol screening and intervention in primary care settings. Finally, Dr. Perl discussed the salient issues and suggested future directions for work in the area of alcohol BI.
Topic(s):
Financing & Sustainability
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Reference Links: 
View the DOI record for Challenges applying alcohol brief intervention in diverse practice settings: Populations, outcomes, and costs
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View the PubMed citation for Challenges applying alcohol brief intervention in diverse practice settings: Populations, outcomes, and costs2232
Challenges in Referral Communication Between VHA Primary Care and Specialty Care
Type: Journal Article
Year: 2014
Abstract: BACKGROUND: Poor communication between primary care providers (PCPs) and specialists is a significant problem and a detriment to effective care coordination. Inconsistency in the quality of primary-specialty communication persists even in environments with integrated delivery systems and electronic medical records (EMRs), such as the Veterans Health Administration (VHA). OBJECTIVE: The purpose of this study was to measure ease of communication and to characterize communication challenges perceived by PCPs and primary care personnel in the VHA, with a particular focus on challenges associated with referral communication. DESIGN: The study utilized a convergent mixed-methods design: online cross-sectional survey measuring PCP-reported ease of communication with specialists, and semi-structured interviews characterizing primary-specialty communication challenges. PARTICIPANTS: 191 VHA PCPs from one regional network were surveyed (54 % response rate), and 41 VHA PCPs and primary care staff were interviewed. MAIN MEASURES/APPROACH: PCP-reported ease of communication mean score (survey) and recurring themes in participant descriptions of primary-specialty referral communication (interviews) were analyzed. KEY RESULTS: Among PCPs, ease-of-communication ratings were highest for women's health and mental health (mean score of 2.3 on a scale of 1-3 in both), and lowest for cardiothoracic surgery and neurology (mean scores of 1.3 and 1.6, respectively). Primary care personnel experienced challenges communicating with specialists via the EMR system, including difficulty in communicating special requests for appointments within a certain time frame and frequent rejection of referral requests due to rigid informational requirements. When faced with these challenges, PCPs reported using strategies such as telephone and e-mail contact with specialists with whom they had established relationships, as well as the use of an EMR-based referral innovation called "eConsults" as an alternative to a traditional referral. CONCLUSIONS: Primary-specialty communication is a continuing challenge that varies by specialty and may be associated with the likelihood of an established connection already in place between specialty and primary care. Improvement in EMR systems is needed, with more flexibility for the communication of special requests. Building relationships between PCPs and specialists may also facilitate referral communication.
Topic(s):
Education & Workforce
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, HIT & Telehealth
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Reference Links:
View the DOI record for Challenges in Referral Communication Between VHA Primary Care and Specialty Care
View DOI Record
View the PubMed citation for Challenges in Referral Communication Between VHA Primary Care and Specialty Care2235
Challenges of addressing opioid use disorder in rural settings: A state perspective
Type: Journal Article
Year: 2021
Publication Place: United States
Abstract:
Rural states and communities continue to face significant challenges as they work to address the ongoing opioid epidemic and to implement specific strategies for prevention and treatment of opioid use disorder (OUD) and other substance use disorders (SUDs). While a growing number of innovative strategies have been identified that can offer promise for rural communities, state and clinical leaders from rural communities will need to identify evidence-based approaches that can work best in their communities, and ways to tailor options to meet their unique needs. This article identifies a set of five considerations for rural states and communities as they continue their work to identify solutions to this deadly epidemic.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Challenges of addressing opioid use disorder in rural settings: A state perspective
View DOI Record
View the PubMed citation for Challenges of addressing opioid use disorder in rural settings: A state perspective