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Opioids & SU
The Literature Collection contains over 10,000 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).
10858 Results
8006
Public Safety is Public Health; Public Health is Public Safety: Adult Correction's Response to the Opioid Epidemic in North Carolina
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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8007
Public sector low threshold office-based buprenorphine treatment: outcomes at year 7
Type: Journal Article
Year: 2017
Publication Place: England
Abstract: BACKGROUND: Buprenorphine maintenance for opioid dependence remains of limited availability among underserved populations, despite increases in US opioid misuse and overdose deaths. Low threshold primary care treatment models including the use of unobserved, "home," buprenorphine induction may simplify initiation of care and improve access. Unobserved induction and long-term treatment outcomes have not been reported recently among large, naturalistic cohorts treated in low threshold safety net primary care settings. METHODS: This prospective clinical registry cohort design estimated rates of induction-related adverse events, treatment retention, and urine opioid results for opioid dependent adults offered buprenorphine maintenance in a New York City public hospital primary care office-based practice from 2006 to 2013. This clinic relied on typical ambulatory care individual provider-patient visits, prescribed unobserved induction exclusively, saw patients no more than weekly, and did not require additional psychosocial treatment. Unobserved induction consisted of an in-person screening and diagnostic visit followed by a 1-week buprenorphine written prescription, with pamphlet, and telephone support. Primary outcomes analyzed were rates of induction-related adverse events (AE), week 1 drop-out, and long-term treatment retention. Factors associated with treatment retention were examined using a Cox proportional hazard model among inductions and all patients. Secondary outcomes included overall clinic retention, buprenorphine dosages, and urine sample results. RESULTS: Of the 485 total patients in our registry, 306 were inducted, and 179 were transfers already on buprenorphine. Post-induction (n = 306), week 1 drop-out was 17%. Rates of any induction-related AE were 12%; serious adverse events, 0%; precipitated withdrawal, 3%; prolonged withdrawal, 4%. Treatment retention was a median 38 weeks (range 0-320) for inductions, compared to 110 (0-354) weeks for transfers and 57 for the entire clinic population. Older age, later years of first clinic visit (vs. 2006-2007), and baseline heroin abstinence were associated with increased treatment retention overall. CONCLUSIONS: Unobserved "home" buprenorphine induction in a public sector primary care setting appeared a feasible and safe clinical practice. Post-induction treatment retention of a median 38 weeks was in line with previous naturalistic studies of real-world office-based opioid treatment. Low threshold treatment protocols, as compared to national guidelines, may compliment recently increased prescriber patient limits and expand access to buprenorphine among public sector opioid use disorder patients.
Topic(s):
Opioids & Substance Use
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Reference Links: 
View the DOI record for Public sector low threshold office-based buprenorphine treatment: outcomes at year 7
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View the PubMed citation for Public sector low threshold office-based buprenorphine treatment: outcomes at year 78010
Public-academic partnerships: the Beck Initiative: A partnership to implement cognitive therapy in a community behavioral health system
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: The Beck Initiative is a partnership between researchers and clinicians at a large university and an urban behavioral health managed care system. Both partners share a commitment to ensuring that consumers in the community have access to competently delivered, individualized, evidence-based mental health care and that the providers who serve them have the support they need to deliver high-quality evidence-based treatments. Central features of the program are individualized training and consultation in cognitive therapy for each provider agency and policies to promote the sustainability of the initiative and its continuing evolution to meet the needs of providers and consumers.
Topic(s):
Education & Workforce
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8011
Puentes clinic: An integrated model for the primary care of vulnerable populations
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: Traditional primary care models for medically vulnerable populations such as the homeless and injection-drug users do not deliver optimal and efficient medical care. We propose an integrated model for the delivery of primary care to a vulnerable population emphasizing open access, outreach, groups, and a team approach to care.Methods: We monitored the health care use patterns of a group of 408 injection-drug users during a five-year period at Puentes Clinic, an integrated primary care site within a larger county health care system, Santa Clara Valley Health and Hospital System of California. We specifically compared use patterns before and after the inception of this new primary care site.Results: Emergency Department and urgent care visit rates decreased from 3.8 visits in the 18 months prior to the clinic's opening to 0.8 visits in the first 18 months of the clinic's operation. Simultaneously, primary care visits increased from 2.8 visits per 18 months prior to the clinic's operation to a current use rate of 5.9 visits per 18 months.Conclusion: This changing health care use pattern after the implementation of an integrated primary care model suggests that a "medical home" for a vulnerable population can influence the way that populations interact with a larger health care system.
Topic(s):
Medical Home
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Reference Links: View the PubMed citation for Puentes clinic: An integrated model for the primary care of vulnerable populations
8012
Put prevention into practice (PPIP): evaluating PPIP in two family practice residency sites
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: BACKGROUND AND OBJECTIVES: The Put Prevention Into Practice (PPIP) office system is a set of office tools designed to address physician, patient, and system barriers to the provision of clinical preventive services. This study evaluated the effect of using PPIP on the delivery of clinical preventive services at two family practice residency sites. METHODS: After a careful planning process at each clinic, a 1-year trial was conducted with implementation of PPIP at two residency sites compared to two control residency sites. The subjects included adults age 19 and older Data were collected via chart extraction on 300 randomly selected patients per clinic for the following three outcomes: health risk factor assessment (for limited physical activity, poor nutrition habits, and tobacco use), health promotion/counseling (for nutrition, physical activity, and tobacco use), and screening rates (clinical breast exam, cholesterol, fecal occult blood test, mammography, and Pap smear). RESULTS: Only inconsistent or sporadic differences in risk factor assessment, health promotion counseling, and screening were seen when comparing implementation and control sites. CONCLUSIONS: PPIP had little effect on the delivery of clinical preventive services. Future research should include a careful analysis of the users of PPIP and the environments in which they practice.
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for Put prevention into practice (PPIP): evaluating PPIP in two family practice residency sites
8013
Putting patients at the centre of health care in the US
Type: Journal Article
Year: 2011
Publication Place: England
Topic(s):
Key & Foundational
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Reference Links: View the PubMed citation for Putting patients at the centre of health care in the US
8015
QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: In an effort to enhance patient safety in opioid treatment programs, the Substance Abuse and Mental Health Saervices Administration convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members (Appendix A) reviewed the literature, regulatory actions, professional guidances, and opioid treatment program experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every opioid treatment program should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, electrocardiogram assessment, risk stratification, and prevention of drug interactions) for all patients and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining electrocardiograms as indicated by a particular patient's risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events. The Panel also suggested specific modifications to informed consent documents, patient education, staff education, and methadone protocols.
Topic(s):
Education & Workforce
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, Key & Foundational
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, Opioids & Substance Use
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Reference Links:
View the DOI record for QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel
View DOI Record
View the PubMed citation for QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel8020
Qualitative understandings of access to primary care services for consumers who use methamphetamine
Type: Journal Article
Year: 2021
Publication Place: Australia
Abstract:
BACKGROUND AND OBJECTIVES: General practice is the most common source of healthcare for people who use methamphetamine. The aim of this study was to explore primary care providers' understandings of access to and service utilisation by this group. METHOD: Semi-structured interviews were conducted with general practitioners, practice nurses and alcohol and other drug service providers from two large towns in rural Victoria. RESULTS: Participants (n = 8) reported that availability (workforce shortages, time, complex clinician-client relationships), acceptability (stigma) and appropriateness of care (skill mix, referral networks, models of care) were associated with access to care for this population. Affordability of care was not perceived to be of concern. DISCUSSION: Availability of care is not enough to ensure utilisation and improved health outcomes among consumers who use methamphetamine. Provision of services to this group and to other substance-using populations requires the right 'skill mix' across and within healthcare organisations.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Qualitative understandings of access to primary care services for consumers who use methamphetamine
View DOI Record
View the PubMed citation for Qualitative understandings of access to primary care services for consumers who use methamphetamine