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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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12581 Results
3541
Disparities in years of potential life lost to drug-involved overdose deaths in South Carolina
Type: Journal Article
Authors: Suzanne Lane, Angela Moreland, Sazid Khan, Karen Hartwell, Louise Haynes, Kathleen Brady
Year: 2022
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
3542
Disparity in use of psychotherapy offered in primary care between older african-american and white adults: Results from a practice-based depression intervention trial
Type: Journal Article
Authors: J. H. Joo, K. H. Morales, H. F. de Vries, J. J. Gallo
Year: 2010
Publication Place: United States
Abstract: The purpose of this study was to assess ethnic differences in use of psychotherapy (having met at least once with a psychotherapist) for late-life depression in primary care. Participants were identified through a two-stage, age-stratified (60-74, > or =75) depression screening of randomly sampled patients from 20 practices in New York City, Philadelphia, and Pittsburgh in a practice-randomized trial. Practices were randomly assigned to usual care or to an intervention with a depression care manager who worked with primary care physicians to provide algorithm-based care. Depression status based on clinical interview and any use of psychotherapy within the 2-year follow-up interval were the primary dependent variables under study. The focus was on 582 persons with complete data. Participants were sorted into major depression (n=385, 112 African American and 273 white) and clinically significant minor depression (n=197, 51 African American and 146 white) based on clinical diagnostic assessment. Persons who self-identified as African American were less likely than whites to use interpersonal therapy (IPT) if they had minor depression, even after adjusting for potentially influential variables including age, cognitive functioning, and whether the dose of antidepressant was adequate (adjusted odds ratio (AOR)=0.22, 95% confidence interval (CI)=0.06-0.80). Ethnicity was not significantly associated with IPT use in persons with major depression (AOR=0.71, 95% CI=0.37-1.37). Older African Americans with minor depression were less likely than whites to use psychotherapy. Targeted strategies are needed to mitigate the disparity in use of psychotherapy.
Topic(s):
Healthcare Disparities See topic collection
3543
Dispensing opioid substitution treatment: Practices, attitudes and intentions of community-based pharmacists
Type: Journal Article
Authors: Peter Lawrinson, Ann Roche, Hiroe Terao, Phuong-Phi Le
Year: 2008
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
3544
Disrupted profiles of interoception and mental health in youths: a systematic review
Type: Journal Article
Authors: H. Mayer-Benarous, X. Benarous, M. Robin
Year: 2025
Abstract:

Although sensory integration impairment and atypical bodily perception were long-lasting described in youths with psychopathology, the contribution of interoceptive deficits in pediatric mental health problems remains poorly understood. A systematic search of PubMed, Medline, Cochrane, Psycinfo, and reference lists of the included studies was conducted for articles up to November 2024. Attention was paid to distinguishing objective performance on behavioral tests (i.e., interoceptive accuracy, IAc), subjective self-assessment of competence (i.e., interoceptive sensibility, ISe), the congruence level between objective performance and subjective self-assessment (i.e., interoceptive awareness, IAw) and beliefs on interoception (interoceptive metacognition, IMe). The quality of studies was assessed using a modified version of the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. Of the 761 citations initially identified, 24 studies were finally included. IAc appeared reduced in youths with neurodevelopmental disorders, with mitigated findings regarding anxiety symptoms. ISe were positively correlated with the severity of anxiety and depressive symptoms in pediatric samples. The domain of IMe was particularly impaired among youths with eating disorder symptoms. The review identified few and highly heterogeneous studies. Such preliminary findings support the importance of accounting for different constructs related to interoception and including a trans-nosographical framework of psychopathology to explore these relations.

Topic(s):
Healthcare Disparities See topic collection
,
Medically Unexplained Symptoms See topic collection
3545
Disrupting the Adverse Interplay Between Psychiatric and Medical Illnesses
Type: Journal Article
Authors: R. N. Golden
Year: 2016
Publication Place: United States
Abstract: Psychiatric illnesses increase the morbidity and mortality of comorbid medical disease, and current research targets the identification of specific mechanisms that account for this association. Psychotic illness complicates the management of chronic diseases where self-care activities often play a major role, such as in the regulation of blood glucose levels in diabetes. In this issue, Wykes et al. describe an interactive relationship between cognitive functioning and negative symptoms, self-efficacy, and diabetic control in patients with psychotic illnesses and Type 1 diabetes. Although high self-efficacy was associated with better hemoglobin A1C levels in patients with mild negative symptoms and higher cognitive function, in patients with more severe negative symptoms and lower cognitive function, high-self-efficacy was linked to higher A1C levels. These findings point to the need for designing diabetes management plans based on careful assessments of specific psychiatric symptomatology in this population. Severe mental illness is also associated with poor general physical health and higher rates of somatic complaints. Madan and colleagues describe in this issue an integrated model of psychiatric and medical care that substantially reduced physical symptoms in patients with severe mental illness during an 8-week hospitalization, with striking improvements in those presenting with substance abuse and sleep disorders. If these findings are shown to persist after discharge, then accountable care organizations should be encouraged to incorporate this more aggressive approach to caring for this vulnerable population. Such targeted approaches are likely to result in decreased utilization of outpatient medical services and improved long-term outcomes.
Topic(s):
Education & Workforce See topic collection
3546
Disrupting the System: An Innovative Model of Comprehensive Care
Type: Journal Article
Year: 2021
Publication Place: Philadelphia
Topic(s):
Education & Workforce See topic collection
,
Financing & Sustainability See topic collection
3547
Disrupting the System: An Innovative Model of Comprehensive Care
Type: Journal Article
Authors: Virginia M. Conley, Teresa Judge-Ellis
Year: 2021
Publication Place: Philadelphia, Pennsylvania
Topic(s):
Education & Workforce See topic collection
,
Financing & Sustainability See topic collection
3548
Disruptive innovation: The future of healthcare?
Type: Journal Article
Authors: Peter Yellowlees, Alberto Odor, Kesha Patrice, Michelle Burke Parish, Najia Nafiz, Ana-Maria Iosif, Donald Hilty
Year: 2011
Publication Place: US
Topic(s):
HIT & Telehealth See topic collection
3550
Disseminating contingency management: impacts of staff training and implementation at an opiate treatment program
Type: Journal Article
Authors: B. Hartzler, T. R. Jackson, B. E. Jones, B. Beadnell, D. A. Calsyn
Year: 2014
Publication Place: United States
Abstract: Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (intervention cost, feasibility, and sustainability) were assessed at study conclusion in a qualitative interview with OTP management. Intervention effectiveness was also assessed via independent chart review of trial CM implementation vs. a historical control period. Results included: 1) robust, durable increases in delivery skill, knowledge, and adoption readiness among trained staff; 2) positive managerial perspectives of intervention cost, feasibility, and sustainability; and 3) significant clinical impacts on targeted patient indices. Collective results offer support for the study's collaborative intervention design and the applied, skills-based focus of staff training processes. Implications for CM dissemination are discussed.
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
,
Financing & Sustainability See topic collection
3551
Disseminating treatment for anxiety disorders step 2: Peer recommendations to seek help
Type: Journal Article
Authors: Jessica R. Schubert, Meredith E. Coles, Richard G. Heimberg, Barry D. Weiss
Year: 2014
Publication Place: New York
Topic(s):
Healthcare Disparities See topic collection
3552
Dissemination and adoption of the advanced primary care model in the Maryland multi-payer patient centered medical home program.
Type: Journal Article
Authors: Niharika Khanna, Fadia Shaya, Viktor Chirikov, Ben Steffen, David Sharp
Year: 2014
Topic(s):
Medical Home See topic collection
,
Financing & Sustainability See topic collection
,
Education & Workforce See topic collection
,
HIT & Telehealth See topic collection
3553
Dissemination of Contingency Management for the Treatment of Opioid Use Disorder
Type: Journal Article
Authors: A. DeFulio
Year: 2023
Topic(s):
Opioids & Substance Use See topic collection
,
Financing & Sustainability See topic collection
,
Healthcare Policy See topic collection
3554
Distance to OTPs in hard‐hit regions makes case for pharmacy‐based service
Type: Journal Article
Authors: Gary Enos
Year: 2020
Publication Place: Hoboken, New Jersey
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
3555
Distinctive and shared health needs of minority communities by immigrant status
Type: Journal Article
Authors: Erin An, Damian Crow, Nhat Minh Ho, Leslie Omeire, Charles Yang, Jacob Luddington, Jessica Jones, Mathivarshini Sivachidambaram, Robert Ferrer, Robert Wood, Jasmine Rodriguez, Rosemary Williams, Melanie Stone, Fozia Ali, Elena Jimenez Gutierrez
Year: 2025
Topic(s):
Healthcare Disparities See topic collection
3556
Distinctive patterns of medical care utilization in patients who somatize
Type: Journal Article
Authors: A. J. Barsky, E. J. Orav, D. W. Bates
Year: 2006
Publication Place: URL
Abstract: BACKGROUND: Somatizing patients have maladaptive and increased rates of medical care utilization. If there were a way of routinely identifying such patients, one that did not require intensive, case-by-case review, they could be targeted for specific interventions to improve their use of medical care. OBJECTIVE: We sought to identify patterns of medical care utilization that would distinguish somatizing and nonsomatizing medical outpatients with acceptable sensitivity and specificity. DESIGN: Subjects completed questionnaires assessing somatization and sociodemographic characteristics. Their medical care utilization was obtained for the 12 months preceding the index visit. We then used multivariable logistic regression and recursive partitioning to identify patients with a provisional diagnosis of somatoform disorder. These exploratory models used various patterns of medical care utilization and sociodemographic characteristics as the independent variables. SUBJECTS: We studied consecutive adults attending 2 primary care practices on randomly chosen days. MEASURES: The provisional diagnosis of a somatoform disorder was assessed with a 15-item self-report questionnaire. The number of primary care visits, specialty visits, mental health visits, emergency visits, and inpatient and outpatient costs were obtained for the 12 months preceding the index visit from our hospital's automated medical records, which also provided a rating of aggregate medical morbidity. Self-reported utilization outside our hospital system was obtained from a subsample of patients. RESULTS: Complete data were obtained on 1440 patients. Somatizing patients had more specialty care than primary care visits, higher outpatient than inpatient costs, and more emergency visits than nonsomatizing patients. A regression model containing 7 measures of utilization and 4 sociodemographic characteristics distinguished somatizing and nonsomatizing patients with a c-statistic = 0.73. Recursive partitioning identified 10 terminal nodes with a very high specificity (99%) but a very low sensitivity (15%). CONCLUSIONS: We identified 7 discrete patterns of medical care utilization that distinguished somatizing and nonsomatizing patients. However, they did so with only modest specificity and sensitivity. This algorithm might be used effectively as the first step in a 2-step screening procedure whose second step would entail more intensive screening or individual, case-by-case review to identify somatizing patients in primary care practice.
Topic(s):
Financing & Sustainability See topic collection
,
Medically Unexplained Symptoms See topic collection
3557
Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States
Type: Journal Article
Authors: T. C. Green, R. Heimer, L. E. Grau
Year: 2008
Publication Place: England
Abstract: AIMS: This study assessed overdose and naloxone administration knowledge among current or former opioid abusers trained and untrained in overdose-response in the United States. DESIGN AND PARTICIPANTS: Ten individuals, divided equally between those trained or not trained in overdose recognition and response, were recruited from each of six sites (n = 62). SETTING: US-based overdose training and naloxone distribution programs in Baltimore, San Francisco, Chicago, New York and New Mexico. MEASUREMENTS: Participants completed a brief questionnaire on overdose knowledge that included the task of rating 16 putative overdose scenarios for: (i) whether an overdose was occurring and (ii) if naloxone was indicated. Bivariate and multivariable analyses compared results for those trained to untrained. Responses were also compared to those of 11 medical experts using weighted and unweighted kappa statistics. FINDINGS: Respondents were primarily male (72.6%); 45.8% had experienced an overdose and 72% had ever witnessed an overdose. Trained participants recognized more opioid overdose scenarios accurately (t(60) = 3.76, P < 0.001) and instances where naloxone was indicated (t(59) = 2.2, P < 0.05) than did untrained participants. Receipt of training and higher perceived competency in recognizing signs of an opioid overdose were associated independently with higher overdose recognition scores. Trained respondents were as skilled as medical experts in recognizing opioid overdose situations (weighted kappa = 0.85) and when naloxone was indicated (kappa = 1.0). CONCLUSIONS: Results suggest that naloxone training programs in the United States improve participants' ability to recognize and respond to opioid overdoses in the community. Drug users with overdose training and confidence in their abilities to respond may effectively prevent overdose mortality.
Topic(s):
Opioids & Substance Use See topic collection
3558
Distinguishing symptoms of ADHD from other psychiatric disorders in the adult primary care setting
Type: Journal Article
Authors: C. B. Montano, R. Weisler
Year: 2011
Publication Place: United States
Abstract: Attention-deficit/hyperactivity disorder (ADHD) is frequently misdiagnosed or undiagnosed in adults. Owing to the relatively recent recognition of adult ADHD as a valid mental disorder and its overlapping symptomatology with other conditions, primary care physicians often fail to screen for ADHD in patients who present with inattention, impulsivity, and hyperactivity. A substantial proportion of adults with ADHD also have psychiatric comorbidities. Physicians need to recognize the ways in which ADHD symptoms are expressed in adults and distinguish them from symptoms of other disorders, including mood, anxiety, and substance abuse disorders.
Topic(s):
General Literature See topic collection
3559
Diversion of methadone and buprenorphine by patients in opioid substitution treatment in Sweden: Prevalence estimates and risk factors
Type: Journal Article
Authors: Bjorn Johnson, Torkel Richert
Year: 2015
Topic(s):
Opioids & Substance Use See topic collection