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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).
11202 Results
2341
Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy
Type: Journal Article
Year: 2017
Abstract: Despite the high burden and poor rates of treatment associated with mental illness and substance use disorders, public support for allocating resources to improving treatment for these disorders is low. A growing body of research suggests that effective policy communication strategies can increase public support for policies benefiting people with these conditions. In October 2015, the Center for Mental Health and Addiction Policy Research at Johns Hopkins University convened an expert forum to identify what is currently known about the effectiveness of such policy communication strategies and produce recommendations for future research. One of the key conclusions of the forum was that communication strategies using personal narratives to engage audiences have the potential to increase public support for policies benefiting persons with mental illness or substance use disorders. Specifically, narratives combining personal stories with depictions of structural barriers to mental illness and substance use disorder treatment can increase the public's willingness to invest in the treatment system. Depictions of mental illness and violence significantly increase public stigma toward people with mental illness and are no more effective in increasing willingness to invest in mental health services than nonstigmatizing messages about structural barriers to treatment. Future research should prioritize development and evaluation of communication strategies to increase public support for evidence-based substance use disorder policies, including harm reduction policies-such as needle exchange programs-and policies expanding treatment.
Topic(s):
Healthcare Policy
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Reference Links: 
View the DOI record for Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy
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View the PubMed citation for Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy2342
Community Attitudes Toward Opioid Use Disorder and Medication for Opioid Use Disorder in a Rural Appalachian County
Type: Journal Article
Year: 2021
Publication Place: England
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Community Attitudes Toward Opioid Use Disorder and Medication for Opioid Use Disorder in a Rural Appalachian County
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View the PubMed citation for Community Attitudes Toward Opioid Use Disorder and Medication for Opioid Use Disorder in a Rural Appalachian County2343
Community based buprenorphine micro-induction in the context of methadone maintenance treatment and fentanyl - Case report
Type: Journal Article
Year: 2022
Publication Place: England
Abstract:
INTRODUCTION: The micro-induction method of initiating buprenorphine is becoming a popular method for initiating buprenorphine in patients with Opioid Use Disorder, who are on full opioid agonists, either prescribed or non-prescribed, in order to avoid precipitated withdrawal. Given the rising concerns around illicit fentanyl use, this method of initiating buprenorphine has become another tool for clinicians to help patients with Opioid Use Disorder, even when multiple full opioid agonists are involved. While the process for initiating buprenorphine through this process is well studied, the characteristics of patients who are able to tolerate this initiation method in an outpatient setting is not. CASE(S): We present the cases of two patients with Opioid Use Disorder in a community-based methadone maintenance program in whom micro-induction methods were used to initiate buprenorphine without lowering the methadone dose. Both patients successfully transitioned to buprenorphine without precipitated withdrawal. One of the patients was also using fentanyl at the time of induction and was able to abstain from fentanyl use following the induction process. CONCLUSION: Initiating Buprenorphine using micro-induction strategies in a community based outpatient clinic in patients who are already on full opioid agonists is feasible, in these particular cases, the methadone dose or concurrent fentanyl use did not affect the outcome. We present the characteristics of the patient and the community clinic hoping that this helps more clinicians in replicating this induction strategy.
Topic(s):
Opioids & Substance Use
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2344
Community Case Study of Naloxone Distribution by Hospital-Based Harm Reduction Program for People Who Use Drugs in New York City
Type: Journal Article
Year: 2021
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
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2347
Community correctional agents' views of medication-assisted treatment: Examining their influence on treatment referrals and community supervision practices
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: BACKGROUND: Alcohol and opioid use disorders are common among adults under community supervision. Although several medications (medication-assisted treatment or MAT) are Food and Drug Administration (FDA)-approved to treat such disorders, they are underutilized with this population despite established effectiveness at decreasing substance use. This paper examines how community correctional agents' understanding of addiction and views of MAT influence their professional actions regarding addiction medications. METHODS: A total of 118 semistructured qualitative interviews were conducted with community correctional agents taking part in the CJ-DATS MATICCE implementation study across 20 parole/probation offices in 9 US states. Using grounded theory methodology and an iterative analytic approach, issues of role perception, views of MAT, current treatment referral, and community supervision practices were explored. RESULTS: Agents often had limited autonomy to make direct treatment referrals, regardless of their views of MAT, as they were required to follow court orders and their organization's policies and procedures. Within some organizations, community correctional agents held sufficient autonomy to make direct treatment referrals, with agents struggling to reconcile their desire to support their clients who needed MAT with concerns about the abuse potential of opioid agonist medications. Viewing MAT as a "treatment of last resort" was counterbalanced by the view that it was an effective evidence-based practice. Agents described how MAT impacted their ability to supervise clients and how their knowledge and understanding of MAT was directly influenced by watching their clients who were successful or unsuccessful on MAT. Even those agents who were more accepting of MAT were largely unsupportive of it long-term use. CONCLUSIONS: Community correctional agents' views of MAT were influenced by their understanding of addiction as well as their experiences supervising clients receiving treatment with medications, but whether or not MAT referrals were made was not always within their control.
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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2348
Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups
Type: Journal Article
Year: 2014
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups
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View the PubMed citation for Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups2351
Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
Type: Journal Article
Year: 2018
Publication Place: Netherlands
Abstract: The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. However, the PCMH model puts downward pressure on the panel sizes of primary care providers, increasing the average fixed costs of care at the practice level. While the I-PaCS model layers an additional cost of the CHWs into the primary care cost structure, that additional costs is relatively small. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The costs and cost offsets of the model were estimated at the clinic practice level. The studies which find the largest cost savings are for high-risk, paneled patients and therefore do not represent the effects of the PCMH model on moderate-utilizing patients or practice-level effects. We modeled a 12.6% decrease in the inpatient hospital, outpatient hospital and emergency department costs of high and moderate risk patients. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
Topic(s):
Financing & Sustainability
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, Medical Home
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Reference Links:
View the DOI record for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
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View the PubMed citation for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes2352
Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
Type: Journal Article
Year: 2018
Publication Place: Netherlands
Abstract: The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. However, the PCMH model puts downward pressure on the panel sizes of primary care providers, increasing the average fixed costs of care at the practice level. While the I-PaCS model layers an additional cost of the CHWs into the primary care cost structure, that additional costs is relatively small. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The costs and cost offsets of the model were estimated at the clinic practice level. The studies which find the largest cost savings are for high-risk, paneled patients and therefore do not represent the effects of the PCMH model on moderate-utilizing patients or practice-level effects. We modeled a 12.6% decrease in the inpatient hospital, outpatient hospital and emergency department costs of high and moderate risk patients. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
View DOI Record
View the PubMed citation for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes2353
Community integration of transition-age individuals: views of young with mental health disorders
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: This qualitative study examines the perceptions of young adults with mental health disorders of community integration. Fifty-nine young men and women participated in 12 focus groups whose aim was to gain understanding of what community integration means to them. Focus group questions also explored barriers and supports for their community integration, as well as their goals for the future and advice to others facing similar challenges. Themes that emerged were reported within the multiple domains that participants used to describe their experiences of community integration (or the lack thereof). This study highlights the desires of these young people to achieve goals in education and employment and to have friendships. Participants identified a pervasive lack of understanding of mental health and prevalent stigmatizing attitudes as resulting in challenges to their community integration. Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Community integration of transition-age individuals: views of young with mental health disorders
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View the PubMed citation for Community integration of transition-age individuals: views of young with mental health disorders2354
Community interventions against depression
Type: Journal Article
Year: 2007
Publication Place: India
Abstract: Depression appears to be the common psychiatric dosorder in any given community. Depression in different forms may affect 10% of the population at any given time. The paucity of mental health power has made people to ignore the presence of depression and its impact on individual's capacity of functioning. If we have to plan community based interventions some strategies are to be adopted. In primary healthcare systems short training of all categories of personnel in PHC and regular supply of free medicines are essential. With the experiences of general practitioners and their involvement, patients with depression can be approached for help. So also school and college teachers, trained counselors, religious and spiritual leaders can be involved in the processes. Family members can take care of patients. Stress management techniques, helpline, crisis intervention can be other methods to help the patients suffering from depression.
Topic(s):
Education & Workforce
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2356
Community Mental Health Center Integrated Care Outcomes
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Community Mental Health Center Integrated Care Outcomes
2357
Community mental health nursing: Keeping pace with care delivery?
Type: Journal Article
Year: 2008
Publication Place: Australia
Abstract: The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Community mental health nursing: Keeping pace with care delivery?
View DOI Record
View the PubMed citation for Community mental health nursing: Keeping pace with care delivery?