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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).
11196 Results
6101
Medically unexplained symptoms: the need for effective communication and an integrated care strategy
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: Much is already known about medically unexplained symptoms (MUS) in terms of incidence, presentation and current treatment. What needs to be urgently addressed is a strategy for dealing with patients and their conditions, particularly when they do not fall neatly into medical frameworks or pathologies where the syndrome can be easily explained. This article will consider the provision of health and social care support for patients with MUS within an interprofessional education context. The author will contend that a sensitive and valued service for this large client group is dependent upon services without professional boundaries and practitioners with a clinical interest that can work together and agree an appropriate way forward in terms of care, support and strategic service provision. The article will support the idea that clear guidelines through the National Institute for Health and Care Excellence can offer clear clinical direction for practitioners working in primary and secondary care settings to work together interprofessionally to ensure a seamless and sensitive service for people with this condition.
Topic(s):
Education & Workforce
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, Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Medically unexplained symptoms: the need for effective communication and an integrated care strategy
6104
Medicare Payment for Behavioral Health Integration
Type: Journal Article
Year: 2017
Publication Place: United States
Topic(s):
Financing & Sustainability
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6108
Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder
Type: Journal Article
Year: 2015
Publication Place: Ireland
Abstract: BACKGROUND: Increasing use of opioids has led to an increase in the number of pregnant and postpartum women in medication assisted treatment (MAT) for opioid use disorder. METHODS: We (1) conducted a systematic review of published literature on MAT discontinuation (methadone and buprenorphine) in pregnant and postpartum women and (2) determined methadone discontinuation rates in a retrospective cohort (2006-2013) of pregnant and postpartum women in a university affiliated methadone clinic. RESULTS: We found limited generalizable literature reports of discontinuation rates, with a range of prenatal discontinuation rates from 0 to 33% and rates which spanned various prenatal and postnatal periods from 26 to 64%. In our cohort of 229 women, 251 pregnancies were reported, with a prenatal methadone discontinuation rate of 11.0%. Based on a Cox proportional hazards model controlling for age, pregnancy outcome, and duration of treatment prior to delivery, the probability of methadone discontinuation at or before 6 months postpartum was 56.0%. Duration of methadone treatment prior to delivery was inversely associated with risk for postpartum discontinuation of treatment (HR = 0.98, 95% CI (0.96, 0.99)). CONCLUSIONS: We conclude that the postpartum period is a time of increased risk for discontinuation of MAT. More accurate assessment of rates of pre- and postpartum MAT discontinuation, as well as further investigation of factors affecting these rates, is warranted. Development and testing of interventions to encourage early prenatal enrollment in MAT and improve postnatal retention in MAT would benefit pregnant women and new mothers with opioid use disorder.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder
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View the PubMed citation for Medication assisted treatment discontinuation in pregnant and postpartum women with opioid use disorder6111
Medication Assisted Treatment for Opioid Use Disorders. Final rule
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: This final rule increases access to medication-assisted treatment (MAT) with buprenorphine and the combination buprenorphine/naloxone (hereinafter referred to as buprenorphine) in the office-based setting as authorized under the United States Code. Section 303(g)(2) of the Controlled Substances Act (CSA) allows individual practitioners to dispense or prescribe Schedule III, IV, or V controlled substances that have been approved by the Food and Drug Administration (FDA). Section 303(g)(2)(B)(iii) of the CSA allows qualified practitioners who file an initial notification of intent (NOI) to treat a maximum of 30 patients at a time. After 1 year, the practitioner may file a second NOI indicating his/her intent to treat up to 100 patients at a time. This final rule will expand access to MAT by allowing eligible practitioners to request approval to treat up to 275 patients under section 303(g)(2) of the CSA. The final rule also includes requirements to ensure that patients receive the full array of services that comprise evidence-based MAT and minimize the risk that the medications provided for treatment are misused or diverted.
Topic(s):
Grey Literature
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, Opioids & Substance Use
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, Education & Workforce
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Reference Links: View the PubMed citation for Medication Assisted Treatment for Opioid Use Disorders. Final rule
6112
Medication Assisted Treatment for Substance Use Disorders within a National Community Health Center Research Network
Type: Journal Article
Year: 2016
Abstract: BACKGROUND: The Affordable Care Act increases access to treatment services for people who suffer from substance use disorders (SUDs), including alcohol use disorders (AUDs) and opioid use disorders (OUDs). This increased access to treatment has broad implications for delivering health services and creates a dramatic need for transformation in clinical care, service lines, and collaborative care models. Medication assisted treatments (MAT) are effective for helping SUD patients reach better outcomes. This manuscript uses electronic health record (EHR) data to examine the prevalence of EHR-documented SUD, patient characteristics, and patterns of MAT prescribing and screening for patients within the Community Health Applied Research Network (CHARN), a national network of 17 community health centers that facilitates patient-centered outcomes research among underserved populations. METHODS: Hierarchical generalized linear models examined patient characteristics, SUD occurrence rates, MAT prescription, and HIV and Hepatitis Virus C screening for patients with AUDs or OUDs. RESULTS: Among 572,582 CHARN adult patients, 16,947 (3.0%) had a documented AUD diagnosis and 6,080 (1.1%) an OUD diagnosis. Alcohol MAT prescriptions were documented for 547 AUD patients (3.2%) and opioid MAT for 1,764 OUD patients (29.0%). Among OUD patients, opioid MAT was significantly associated with HIV screening (OR = 1.31, p<.001) in OUD patients as was alcohol MAT among AUD patients (OR = 1.30, p = .013). CONCLUSIONS: Our findings suggest that effective opioid and alcohol MAT may be substantially under-prescribed among safety-net patients identified as having OUD or AUD.
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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, HIT & Telehealth
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, Healthcare Policy
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Reference Links:
View the DOI record for Medication Assisted Treatment for Substance Use Disorders within a National Community Health Center Research Network
View DOI Record
View the PubMed citation for Medication Assisted Treatment for Substance Use Disorders within a National Community Health Center Research Network6114
Medication assisted treatment of drug abuse and dependence: Global availability and utilization
Type: Journal Article
Year: 2007
Publication Place: Netherlands
Abstract: Clinical trials and clinical studies, using patented drugs and drugs off patent, provide data that impact the best treatment practices for substance abuse and dependence. In the United States, medications have been approved for use in the treatment of both alcohol and opioid dependence. Medications are used in the detoxification from drug abuse and dependence in the symptomatic relief of withdrawal. For long term treatment or medical maintenance treatment, medications eliminate the physiological effects of drug use by blocking drug-receptor binding in the brain. Therefore, patented drugs showing interactions with neurotransmitters in the brain, are attractive candidates for treatment efficacy trials. An effective long term treatment paradigm for reducing drug dependence is the combinatorial use of medications that block the effects of drug use with behavior change counseling and psychotherapy. Medications used for the long term treatment of opioid dependence are methadone, buprenorphine, and naltrexone. Pharmacotherapies used in the treatment of alcohol dependence include acamprosate, antabuse and naltrexone. A reliable indicator for successful treatment of drug dependence is time in treatment. Patients remain in long term treatment when they perceive that their health care environment is supportive and non-stigmatizing and with a good patient-provider relationship where their needs are identified and met. Additional medications are needed for individual comprehensive substance abuse treatment plans, particularly for individuals who abuse stimulants. Patented drugs remain an important source of candidate pharmacotherapies comprising medication assistant treatment, part of a comprehensive treatment plan for drug dependence that addresses the medical, social, and psychological needs of the patient. Adapting this drug treatment paradigm globally requires identifying and testing new drug candidates while building and changing programs to patient centered treatment programs that promote access to care and treatment and integrate medical, psychological, and social services.
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Medication assisted treatment of drug abuse and dependence: Global availability and utilization
6118
Medication for Addiction Treatment and Postpartum Health Care Utilization Among Pregnant Persons With Opioid Use Disorder
Type: Journal Article
Year: 2021
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, Opioids & Substance Use
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6120
Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort Study
Type: Journal Article
Year: 2018
Abstract: BACKGROUND: Opioid overdose survivors have an increased risk for death. Whether use of medications for opioid use disorder (MOUD) after overdose is associated with mortality is not known. OBJECTIVE: To identify MOUD use after opioid overdose and its association with all-cause and opioid-related mortality. DESIGN: Retrospective cohort study. SETTING: 7 individually linked data sets from Massachusetts government agencies. PARTICIPANTS: 17 568 Massachusetts adults without cancer who survived an opioid overdose between 2012 and 2014. MEASUREMENTS: Three types of MOUD were examined: methadone maintenance treatment (MMT), buprenorphine, and naltrexone. Exposure to MOUD was identified at monthly intervals, and persons were considered exposed through the month after last receipt. A multivariable Cox proportional hazards model was used to examine MOUD as a monthly time-varying exposure variable to predict time to all-cause and opioid-related mortality. RESULTS: In the 12 months after a nonfatal overdose, 2040 persons (11%) enrolled in MMT for a median of 5 months (interquartile range, 2 to 9 months), 3022 persons (17%) received buprenorphine for a median of 4 months (interquartile range, 2 to 8 months), and 1099 persons (6%) received naltrexone for a median of 1 month (interquartile range, 1 to 2 months). Among the entire cohort, all-cause mortality was 4.7 deaths (95% CI, 4.4 to 5.0 deaths) per 100 person-years and opioid-related mortality was 2.1 deaths (CI, 1.9 to 2.4 deaths) per 100 person-years. Compared with no MOUD, MMT was associated with decreased all-cause mortality (adjusted hazard ratio [AHR], 0.47 [CI, 0.32 to 0.71]) and opioid-related mortality (AHR, 0.41 [CI, 0.24 to 0.70]). Buprenorphine was associated with decreased all-cause mortality (AHR, 0.63 [CI, 0.46 to 0.87]) and opioid-related mortality (AHR, 0.62 [CI, 0.41 to 0.92]). No associations between naltrexone and all-cause mortality (AHR, 1.44 [CI, 0.84 to 2.46]) or opioid-related mortality (AHR, 1.42 [CI, 0.73 to 2.79]) were identified. LIMITATION: Few events among naltrexone recipients preclude confident conclusions. CONCLUSION: A minority of opioid overdose survivors received MOUD. Buprenorphine and MMT were associated with reduced all-cause and opioid-related mortality. PRIMARY FUNDING SOURCE:National Center for Advancing Translational Sciences of the National Institutes of Health.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort Study
View DOI Record
View the PubMed citation for Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association With Mortality: A Cohort Study