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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).

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12780 Results
2701
Committee Opinion No. 711: Opioid Use and Opioid Use Disorder in Pregnancy
Type: Journal Article
Authors: Committee on Obstetric Practice
Year: 2017
Publication Place: United States
Abstract: Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal. Screening for substance use should be a part of comprehensive obstetric care and should be done at the first prenatal visit in partnership with the pregnant woman. Patients who use opioids during pregnancy represent a diverse group, and it is important to recognize and differentiate between opioid use in the context of medical care, opioid misuse, and untreated opioid use disorder. Multidisciplinary long-term follow-up should include medical, developmental, and social support. Infants born to women who used opioids during pregnancy should be monitored for neonatal abstinence syndrome by a pediatric care provider. Early universal screening, brief intervention (such as engaging a patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes. In general, a coordinated multidisciplinary approach without criminal sanctions has the best chance of helping infants and families.
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
2702
Committee Opinion No. 711: Opioid Use and Opioid Use Disorder in Pregnancy
Type: Journal Article
Authors: Committee on Obstetric Practice
Year: 2017
Publication Place: United States
Abstract: Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal. Screening for substance use should be a part of comprehensive obstetric care and should be done at the first prenatal visit in partnership with the pregnant woman. Patients who use opioids during pregnancy represent a diverse group, and it is important to recognize and differentiate between opioid use in the context of medical care, opioid misuse, and untreated opioid use disorder. Multidisciplinary long-term follow-up should include medical, developmental, and social support. Infants born to women who used opioids during pregnancy should be monitored for neonatal abstinence syndrome by a pediatric care provider. Early universal screening, brief intervention (such as engaging a patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes. In general, a coordinated multidisciplinary approach without criminal sanctions has the best chance of helping infants and families.
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
2703
Common behavioral and cognitive interventions in primary care: Moving out of the specialty mental health clinic
Type: Book Chapter
Authors: Christopher L. Hunter, Jeffrey L. Goodie, Mark S. Oordt, Anne C. Dobmeyer
Year: 2017
Topic(s):
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

2704
Common Comorbidities With Substance Use Disorders
Type: Government Report
Authors: National Institute on Drug Abuse
Year: 2018
Topic(s):
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

2705
Common health problems in safety‐net primary care: Modeling the roles of trauma history and mental health
Type: Journal Article
Authors: Allison B. Williams, Erin R. Smith, Michael A. Trujillo, Paul B. Perrin, Sarah Griffin, Bruce Rybarczyk
Year: 2019
Topic(s):
Healthcare Disparities See topic collection
2706
Common mental disorders in primary health care: differences between Latin American-born and Spanish-born residents in Madrid, Spain
Type: Journal Article
Authors: M. A. Salinero-Fort, R. Jimenez-Garcia, C. de Burgos-Lunar, R. M. Chico-Moraleja, P. Gomez-Campelo
Year: 2014
Abstract: PURPOSE: Our main objective was to estimate and compare the prevalence of the most common mental disorders between Latin American-born and Spanish-born patients in Madrid, Spain. We also analyzed sociodemographic factors associated with these disorders and the role of the length of residency for Latin American-born patients. METHODS: We performed a cross-sectional study to compare Latin American-born (n = 691) and Spanish-born outpatients (n = 903) from 15 primary health care centers in Madrid, Spain. The Primary Care Evaluation of Mental Disorders was used to diagnose common mental disorders. Sociodemographic, psychosocial, and migration data were collected. RESULTS: We detected common mental disorders in 49.9 % (95 % CI = 47.4-52.3 %) of the total sample. Values were higher in Latin American-born patients than in Spanish-born patients for any disorder (57.8 % vs. 43.9 %, p < 0.001), mood disorders (40.1 % vs. 34.8 %, p = 0.030), anxiety disorders (20.5 % vs. 15.3 %, p = 0.006), and somatoform disorders (18.1 % vs. 6.6 %, p < 0.001). There were no statistically significant differences in prevalence between Latin American-born patients with less than 5 years of residency and Latin American-born residents with 5 or more years of residency. Finally, multivariate analysis shows that gender, having/not having children, monthly income, geographic origin, and social support were significantly associated with several disorders. LIMITATIONS: The sample was neither population-based nor representative of the general immigrant or autochthonous populations. CONCLUSIONS: The study provides further evidence of the high prevalence of common mental disorders in Latin American-born patients in Spain compared with Spanish-born patients.
Topic(s):
Healthcare Disparities See topic collection
2707
Common mental health disorders in children and adolescents in primary care: A survey of knowledge, skills and attitudes among general practitioners in a newly developed European country
Type: Journal Article
Authors: Kurt Buhagiar, Joseph R. Cassar
Year: 2012
Publication Place: Spain
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
2708
Common mental health problems in immigrants and refugees: general approach in primary care
Type: Journal Article
Authors: L. J. Kirmayer, L. Narasiah, M. Munoz, M. Rashid, A. G. Ryder, J. Guzder, G. Hassan, C. Rousseau, K. Pottie, Canadian Collaboration for Immigrant and Refugee Health
Year: 2011
Publication Place: Canada
Abstract: BACKGROUND: Recognizing and appropriately treating mental health problems among new immigrants and refugees in primary care poses a challenge because of differences in language and culture and because of specific stressors associated with migration and resettlement. We aimed to identify risk factors and strategies in the approach to mental health assessment and to prevention and treatment of common mental health problems for immigrants in primary care. METHODS: We searched and compiled literature on prevalence and risk factors for common mental health problems related to migration, the effect of cultural influences on health and illness, and clinical strategies to improve mental health care for immigrants and refugees. Publications were selected on the basis of relevance, use of recent data and quality in consultation with experts in immigrant and refugee mental health. RESULTS: The migration trajectory can be divided into three components: premigration, migration and postmigration resettlement. Each phase is associated with specific risks and exposures. The prevalence of specific types of mental health problems is influenced by the nature of the migration experience, in terms of adversity experienced before, during and after resettlement. Specific challenges in migrant mental health include communication difficulties because of language and cultural differences; the effect of cultural shaping of symptoms and illness behaviour on diagnosis, coping and treatment; differences in family structure and process affecting adaptation, acculturation and intergenerational conflict; and aspects of acceptance by the receiving society that affect employment, social status and integration. These issues can be addressed through specific inquiry, the use of trained interpreters and culture brokers, meetings with families, and consultation with community organizations. INTERPRETATION: Systematic inquiry into patients' migration trajectory and subsequent follow-up on culturally appropriate indicators of social, vocational and family functioning over time will allow clinicians to recognize problems in adaptation and undertake mental health promotion, disease prevention or treatment interventions in a timely way.
Topic(s):
Healthcare Disparities See topic collection
2709
Common symptoms in ambulatory care: Incidence, evaluation, therapy, and outcome
Type: Journal Article
Authors: K. Kroenke, A. D. Mangelsdorff
Year: 1989
Publication Place: UNITED STATES
Abstract: PURPOSE AND PATIENTS AND METHODS: Many symptoms in outpatient practice are poorly understood. To determine the incidence, diagnostic findings, and outcome of 14 common symptoms, we reviewed the records of 1,000 patients followed by house staff in an internal medicine clinic over a three-year period. The following data were abstracted for each symptom: patient characteristics, symptom duration, evaluation, suspected etiology of the symptom, treatment prescribed, and outcome of the symptom. Cost estimates for diagnostic evaluation were calculated by means of the schedule of prevailing rates for Texas employed by the Civilian Health and Medical Program of the Uniformed Services for physician reimbursement. RESULTS: A total of 567 new complaints of chest pain, fatigue, dizziness, headache, edema, back pain, dyspnea, insomnia, abdominal pain, numbness, impotence, weight loss, cough, and constipation were noted, with 38 percent of the patients reporting at least one symptom. Although diagnostic testing was performed in more than two thirds of the cases, an organic etiology was demonstrated in only 16 percent. The cost of discovering an organic diagnosis was high, particularly for certain symptoms, such as headache ($7,778) and back pain ($7,263). Treatment was provided for only 55 percent of the symptoms and was often ineffective. Where outcome was documented, 164 (53 percent) of 307 symptoms improved. Three favorable prognostic factors were an organic etiology (p = 0.006), a symptom duration of less than four months (p = 0.009), and a history of two or fewer symptoms (p = 0.001). CONCLUSION: The classification, evaluation, and management of common symptoms need to be refined. Diagnostic strategies emphasizing organic causes may be inadequate.
Topic(s):
Financing & Sustainability See topic collection
,
Key & Foundational See topic collection
2710
Common themes in early state policy responses to substance use disorder treatment during covid-19
Type: Journal Article
Authors: Barbara Andraka-Christou, Kathryn Bouskill, Rebecca L. Haffajee, Olivia Randall-Kosich, Matthew Golan, Rachel Totaram, Adam J. Gordon, Bradley D. Stein
Year: 2021
Topic(s):
Healthcare Policy See topic collection
,
HIT & Telehealth See topic collection
,
Opioids & Substance Use See topic collection
2711
Commonality of 25 component themes of integrated care for children: rapid review of 170 models
Type: Journal Article
Authors: E. Stepanova, F. Hillier-Brown, E. Owen-Boukra, S. Hope, S. Scott, D. Hargreaves, D. Nicholls, R. M. Viner, C. Summerbell
Year: 2025
Abstract:

INTRODUCTION: The components of integrated care for children, young people and families (CYPF) listed across existing authoritative guidance is generally consistent; the guidance suggests a list of components that should ideally be considered for implementation. Local system managers report specific challenges around integrating system-wide funding, trusted workforce relationships, and CYPF engagement. We aimed to systematically generate a list of components of integrated care from existing systems and models for CYPF, assess their commonality, intended target(s) of impact, and compare these findings with guidance and local system managers' concerns. METHODS: PubMed, CINHAL and Cochrane CENTRAL were systematically searched (01/01/2016 to 31/12/2023) for studies of any design, conducted in high-income countries, describing components of an integrated care system or model for CYPF. Following data extraction, individual components within studies were coded a) using the framework method to generate Component Themes b) for their intended target(s) of impact; system (S), users (U) and/or workforce (W). Simple analytic methods were used to rank and map the commonality of Component Themes and their intended target(s) of impact. Subgroup analysis was conducted for four public health priorities: mental health, learning disabilities and autism, obesity, and early years. RESULTS: From 170 studies, 1057 components nested in one or more 25 Component Themes of integration were identified. None of the studies identified all Component Themes (median 5, range 1-16). Most commonly identified were 'shared professional responsibility and practices' (in 58% of studies; intended targets of impact S and W), 'stronger connections and partnerships' (52%; SUW), 'empowerment of service users' (36%; U), 'early detection and prevention' (32%; SUW) and 'training of parents' (32%; SUW). Those not commonly identified were 'finance/budgeting' (8%; S), 'family engagement' (12%; U), 'leadership' (11%; W), 'empowering staff' (8%; SUW), and 'role of language and culture' (5%; SW). The commonality of Component Themes for all studies combined and for each of the four subgroups was very similar and is described in visual representations. Alignment with guidance and local system managers' concerns is discussed. CONCLUSION: We suggest this list of Component Themes and their intended target(s) of impact be considered when updating guidance on integrated care for CYPF. Existing guidance may benefit from additional implementation support around the integration of finance across the system; leadership, empowerment, language and culture across the workforce; and embedding meaningful CYPF engagement.

Topic(s):
Healthcare Disparities See topic collection
2712
Communicating evidence for participatory decision making
Type: Journal Article
Authors: R. Epstein, B. Alper, T. Quill
Year: 2004
Abstract: CONTEXT: Informed patients are more likely to actively participate in their care, make wiser decisions, come to a common understanding with their physicians, and adhere more fully to treatment; however, currently there are no evidence-based guidelines for discussing clinical evidence with patients in the process of making medical decisions.OBJECTIVE: To identify ways to communicate evidence that improve patient understanding, involvement in decisions, and outcomes. DATA SOURCES AND STUDY SELECTION: Systematic review of MEDLINE for the period 1966-2003 and review of reference lists of retrieved articles to identify original research dealing with communication between clinicians and patients and directly addressing methods of presenting clinical evidence to patients. DATA EXTRACTION: Two investigators and a research assistant screened 367 abstracts and 2 investigators reviewed 51 full-text articles, yielding 8 potentially relevant articles. DATA SYNTHESIS: Methods for communicating clinical evidence to patients include nonquantitative general terms, numerical translation of clinical evidence, graphical representations, and decision aids. Focus-group data suggest presenting options and/or equipoise before asking patients about preferred decision-making roles or formats for presenting details. Relative risk reductions may be misleading; absolute risk is preferred. Order of information presented and time-frame of outcomes can bias patient understanding. Limited evidence supports use of human stick figure graphics or faces for single probabilities and vertical bar graphs for comparative information. Less-educated and older patients preferred proportions to percentages and did not appreciate confidence intervals. Studies of decision aids rarely addressed patient-physician communication directly. No studies addressed clinical outcomes of discussions of clinical evidence. CONCLUSIONS: There is a paucity of evidence to guide how physicians can most effectively share clinical evidence with patients facing decisions; however, basing our recommendations largely on related studies and expert opinion, we describe means of accomplishing 5 communication tasks to address in framing and communicating clinical evidence: understanding the patient's (and family members') experience and expectations; building partnership; providing evidence, including a balanced discussion of uncertainties; presenting recommendations informed by clinical judgment and patient preferences; and checking for understanding and agreement.
Topic(s):
Education & Workforce See topic collection
2713
Communicating genetic information: A difficult challenge for future pediatricians
Type: Journal Article
Authors: E. Rosas-Blum, P. Shirsat, M. Leiner
Year: 2007
Publication Place: England
Abstract: BACKGROUND: The role of the pediatrician as genetic counselor is ideal because pediatricians have medical knowledge and experience with genetic disorders (e.g. Down syndrome). Moreover, pediatricians can provide comprehensive care in a medical home to patients with genetic disorders. However, changes in the curriculum of the pediatric resident are necessary to address the future challenges of effectively communicating genetic information to patients. The objective of this study was to explore these challenges and make recommendations for training to adequately prepare pediatricians for their future role as genetic counselors. METHODS: Three reviewers independently searched PubMed, OVID, and Medline databases to identify articles describing the challenges of communicating genetic information to patients, published from 1960 to December 2005. After the publications were identified and reviewed, four major areas of interest were identified in order to categorize the findings. RESULTS: Twenty-five publications were identified during the literature search. From the review, the following categories were selected to organize the findings: (1) Inherent difficulties of communicating and comprehending genetic information; (2) Comprehension of genetic information by pediatricians; (3) Genetics training in residency programs; and (4) The effect of genetic information on the future role of pediatricians and potential legal implications. CONCLUSION: Pediatricians and residents lack essential knowledge of genetics and communication skills for effective counseling of patients. The review indicated that successful communication of genetic information involves a number of important skills and considerations. It is likely that these skills and considerations are universally required for the communication of most complex specialized medical information. In the past, communication skills have not been considered a priority. Today, these skills have become a demanding professional and even legal obligation. However, the challenges involved in communicating complex medical information cannot be successfully addressed with universal, one-size-fits-all recommendations. Residency training programs require changes to adequately prepare future pediatricians for the growing challenge of communicating genetic information. Four important skills should be considered in the training of residents to improve the communication of complex information to patients. These skills are (1) discriminating, (2) understanding, (3) simplifying, and (4) explaining information.
Topic(s):
Education & Workforce See topic collection
,
Medical Home See topic collection
2714
Communicating with pediatricians: developing social work practice in primary care
Type: Journal Article
Authors: S. Lynch, T. Franke
Year: 2013
Publication Place: United States
Abstract: While social work models of interdisciplinary collaboration suggest that communication is important, the research literature on social worker-physician collaboration infrequently considers work with pediatricians or practice outside the hospital setting. A cross-sectional survey was sent to a stratified random sample of social workers to assess their communication satisfaction with pediatricians. The study found that social workers in health settings were more satisfied than those in mental health settings. The implications of this finding for the development of colocated, collaborative care models are discussed.
Topic(s):
Education & Workforce See topic collection
2715
Communication and Collaboration With Schools: Pediatricians' Perspectives
Type: Journal Article
Authors: Kathy L. Bradley-Klug, Ashley N. Sundman, Joshua Nadeau, Jennifer Cunningham, Julia Ogg
Year: 2010
Publication Place: United States
Topic(s):
General Literature See topic collection
2716
Communication between community mental health services and primary care
Type: Journal Article
Authors: Vincent I. O. Agyapong, Olorunfemi Ahmodu, Allys Guerandel
Year: 2011
Publication Place: Ireland: MedMedia
Topic(s):
General Literature See topic collection
2717
Communication between psychosomatic C-L consultants and general practitioners in a German health care system
Type: Journal Article
Authors: W. de Cruppe, C. Hennch, C. Buchholz, A. Muller, W. Eich, W. Herzog
Year: 2005
Publication Place: United States
Abstract: A randomized and prospective study examined the effects of intensive communication between treatment providers on physician behavior and patient care using a representative sample of patients referred to a German psychosomatic consultation-liaison (C-L) service (1998-1999). Sixty-seven patients were grouped (ICD-10) and randomized into intervention (n=33) and control groups (n=34). In the control group (CG), only the inpatient referring physicians were informed of consultation findings, as is standard practice in Germany. In the IG, the consultant directly reported the consultation findings to the general practitioner (GP). Patients were examined at 6-month (T2) and 3.5-year (T3) follow-up. Physician feedback and requests regarding the nature of communication were also assessed at T2. A significant reduction in symptoms was revealed at both follow-ups for the IG and CG. No significant group differences were found for acceptance of psychotherapy (59.1% IG and 42.3% CG at T3). The utilization of medical services remained stable across time. Patients who began psychotherapy were shown to have greater baseline symptom levels and "openness for new experiences" (NEO Five-Factor Inventory, NEO-FFi). Regular GP integration of psychosocial aspects into primary care differed between IG (44.0%) and CG (25.0%). Ninety-one percent of the GPs requested the option for a telephone conversation with the consultant or a case conference involving the patient at either their practice (37.7%) or the clinic (24.5%). We conclude that GPs are interested in a differentiated and more intensive cooperation concerning the integration of psychosocial aspects in their outpatient treatment. The patient's acceptance to follow a recommendation for psychotherapy, however, is related to the level of symptom severity and openness for new experiences.
Topic(s):
Medically Unexplained Symptoms See topic collection
2718
Communication Disorders and Mental Health Outcomes in Children and Adolescents: A Scoping Review
Type: Journal Article
Authors: L. Xue, Y. Gong, S. Pill, W. Han
Year: 2025
Abstract:

Background/Objectives: Communication disorders in childhood, including expressive, receptive, pragmatic, and fluency impairments, have been consistently linked to mental health challenges such as anxiety, depression, and behavioural difficulties. However, existing research remains fragmented across diagnostic categories and developmental stages. This scoping review aimed to synthesise empirical evidence on the relationship between communication disorders and mental health outcomes in children and adolescents and to identify key patterns and implications for practice and policy. Methods: Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O'Malley's framework, this review included empirical studies published in English between 2000 and 2024. Five databases were searched, and ten studies met the inclusion criteria. Data were charted and thematically analysed to explore associations across communication profiles and emotional-behavioural outcomes. Results: Four interconnected themes were identified: (1) emotional and behavioural manifestations of communication disorders; (2) social burden linked to pragmatic and expressive difficulties; (3) family and environmental stressors exacerbating child-level challenges; and (4) a lack of integrated care models addressing both communication and mental health needs. The findings highlight that communication disorders frequently co-occur with emotional difficulties, often embedded within broader social and systemic contexts. Conclusions: This review underscores the need for developmentally informed, culturally responsive, and interdisciplinary service models that address both communication and mental health in children. Early identification, family-centred care, and policy reforms are critical to reducing inequities and improving outcomes for this underserved population.

Topic(s):
Healthcare Disparities See topic collection
2719
Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy
Type: Journal Article
Authors: E. McGinty, B. Pescosolido, A. Kennedy-Hendricks, C. L. Barry
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 See topic collection