Literature Collection

8461

Safe opioid prescribing: A community-based approach

Type: Journal Article

Authors: Sal Volpe, Joseph Conte

Year: 2021

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8462

Safety and danger: Perceptions of the implementation of harm reduction programs in two communities in Nova Scotia, Canada

Type: Journal Article

Authors: L. A. Jackson, M. Dechman, H. Mathias, J. Gahagan, K. Morrison

Year: 2022

Publication Place: England

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8463

Safety and danger: Perceptions of the implementation of harm reduction programs in two communities in Nova Scotia, Canada

Type: Journal Article

Authors: Lois A. Jackson, Margaret Dechman, Holly Mathias, Jacqueline Gahagan, Kirk Morrison

Year: 2021

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8464

Safety and Efficacy of Buprenorphine-Naloxone in Pregnancy: A Systematic Review of the Literature

Type: Journal Article

Authors: A. Ordean, M. Tubman-Broeren

Year: 2023

Abstract:

The prevalence of opioid use among pregnant people has been increasing over the past few decades, with a parallel increase in the rate of neonatal abstinence syndrome. Opioid agonist treatment (OAT) including methadone and buprenorphine is the recommended management method for opioid use disorders during pregnancy. Methadone has been extensively studied during pregnancy; however, buprenorphine was introduced in the early 2000s with limited data on the use of different preparations during pregnancy. Buprenorphine-naloxone has been incorporated into routine practice; however, only a few studies have investigated the use of this medication during pregnancy. To determine the safety and efficacy of this medication, we conducted a systematic review of maternal and neonatal outcomes among buprenorphine-naloxone-exposed pregnancies. The primary outcomes of interest were birth parameters, congenital anomalies, and severity of neonatal abstinence syndrome. Secondary maternal outcomes included the OAT dose and substance use at delivery. Seven studies met the inclusion criteria. Buprenorphine-naloxone doses ranged between 8 and 20 mg, and there was an associated reduction of opioid use during pregnancy. There were no significant differences in gestational age at delivery, birth parameters, or prevalence of congenital anomalies between buprenorphine-naloxone-exposed neonates and those exposed to methadone, buprenorphine monotherapy, illicit opioids, or no opioids. In studies comparing buprenorphine-naloxone to methadone, there were reduced rates of neonatal abstinence syndrome requiring pharmacotherapy. These studies demonstrate that buprenorphine-naloxone is a safe and effective opioid agonist treatment for pregnant people with OUD. Further large-scale, prospective data collection is required to confirm these findings. Patients and clinicians may be reassured about the use of buprenorphine-naloxone during pregnancy.

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8465

Safety and Efficacy of Exposure-Based Risk Reduction Through Family Therapy for Co-occurring Substance Use Problems and Posttraumatic Stress Disorder Symptoms Among Adolescents: A Randomized Clinical Trial

Type: Journal Article

Authors: C. K. Danielson, Z. Adams, M. R. McCart, J. E. Chapman, A. J. Sheidow, J. Walker, A. Smalling, M. A. de Arellano

Year: 2020

Abstract: IMPORTANCE: No empirically supported treatments have been evaluated to address co-occurring substance use problems (SUP) and posttraumatic stress disorder (PTSD) symptoms among adolescents in an integrative fashion. This lack is partially owing to untested clinical lore suggesting that delivery of exposure-based PTSD treatments to youth with SUP might be iatrogenic. OBJECTIVE: To determine whether an exposure-based, integrative intervention for adolescents with SUP and PTSD symptoms-risk reduction through family therapy (RRFT)-resulted in improved outcomes relative to a treatment-as-usual (TAU) control condition consisting primarily of trauma-focused cognitive behavioral therapy. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial enrolled 124 participants who were recruited from November 1, 2012, through January 30, 2017. Adolescents (aged 13-18 years) who engaged in nontobacco substance use at least once during the past 90 days, experienced at least 1 interpersonal traumatic event, and reported 5 or more PTSD symptoms were enrolled. Blinded assessments were collected at baseline and at 3, 6, 12, and 18 months after baseline. Recruitment and treatment took place in community-based child advocacy centers in the Southeastern United States. Data were analyzed from August 2 through October 4, 2018, and were based on intention to treat. INTERVENTIONS: Participants were randomized to receive RRFT (n = 61) or TAU (n = 63). MAIN OUTCOMES AND MEASURES: Primary outcomes focused on number of nontobacco substance-using days measured with the timeline follow-back method and PTSD symptom severity using the UCLA (University of California, Los Angeles) PTSD Reaction Index for DSM-IV completed by adolescents and caregivers. Secondary outcomes focused on marijuana, alcohol, and polysubstance use and PTSD criterion standard (re-experiencing, avoidance, and hyperarousal) symptom severity. RESULTS: In all, 124 adolescents (mean [SD] age, 15.4 [1.3] years; 108 female [87.1%]) were randomized. For primary outcomes relative to TAU, RRFT yielded significantly greater reductions in substance-using days from baseline to month 12 (event rate [ER], 0.28; 95% CI, 0.12-0.65) and month 18 (ER, 0.10; 95% CI, 0.04-0.24). Significant reductions in PTSD symptoms were observed within groups for RRFT from baseline to months 3 (β = -9.25; 95% CI, -12.95 to -5.55), 6 (β = -16.63; 95% CI = -20.40 to -12.87), 12 (β = -17.51; 95% CI, -21.62 to -13.40), and 18 (β = -19.02; 95% CI, -23.07 to -14.96) and for TAU from baseline to months 3 (β = -9.62; 95% CI, -13.16 to -6.08), 6 (β = -13.73; 95% CI, -17.43 to -10.03), 12 (β = -15.53; 95% CI, -19.52 to -11.55), and 18 (β = -13.88; 95% CI, -17.69 to -10.09); however, between-group differences were not observed. CONCLUSIONS AND RELEVANCE: In this study, RRFT and TAU demonstrated within-group improvements in SUP and PTSD symptoms, with greater improvement for substance use and PTSD avoidance and hyperarousal symptoms among adolescents randomized to RRFT compared with TAU. No evidence of the worsening of SUP was observed in either condition. These results suggest that this exposure-based treatment is safe, feasibly delivered by community-based clinicians, and offers an effective approach to inform clinical practice. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01751035.

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8466

Safety and efficacy of long-term buprenorphine maintenance treatment.

Type: Journal Article

Authors: Ayman Fareed, Sreedevi Vayalapalli, Johnita Byrd-Sellers, Jennifer Casarella, Karen Drexler

Year: 2011

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8467

Safety of a Rapidly Dissolving Buprenorphine/Naloxone Sublingual Tablet (BNX-RDT) for Treatment of Opioid Dependence: A Multicenter, Open-label Extension Study

Type: Journal Article

Authors: K. Hoffman, M. L. Peyton, M. Sumner

Year: 2017

Publication Place: United States

Abstract: OBJECTIVE: To assess the safety of rapidly dissolving buprenorphine/naloxone sublingual tablets (BNX-RDT) in opioid-dependent patients. METHODS: This open-label, 24-week extension study enrolled patients who completed primary trials of BNX-RDT. Daily tablet doses ranged from 5.7 to 17.1 mg. The primary endpoint was safety; secondary assessments included opioid cravings, addiction severity, health-related quality of life (QOL), and workplace productivity at screening (final day of the primary trials) through study end, with changes measured from baseline of the primary trials. RESULTS: In all, 665 patients received treatment; 292 (43.9%) completed the study. A total of 258 patients (38.8%) reported 557 treatment-emergent adverse events, most commonly headache (3.2%) and constipation (3.0%). Craving scores showed continued improvement on 100-mm visual analog scale (mean change from primary trial baseline, -52.8 at screening; mean change from extension trial baseline, -60.5 at week 24). Reductions in addiction severity from baseline of both the primary and extension trial were maintained through week 24 on multiple assessments, as were improvements in QOL on Short Form 36. Employment increased by 15% and mean (SD) hours worked per week increased by 4.6 (20.1) from baseline to study end. Mean (SD) scores for impact of opioid dependence on work productivity improved from 4.7 (3.0) at baseline to 0.9 (1.8) at study end (11-point scale). CONCLUSIONS: Extended treatment with BNX-RDT demonstrated a safety profile similar to other BNX formulations, reduced opioid cravings, and improved both QOL and work productivity. Continued treatment may enable patients to advance in recovery and return to normal functioning.

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8468

Safety of a Rapidly Dissolving Buprenorphine/Naloxone Sublingual Tablet (BNX-RDT) for Treatment of Opioid Dependence: A Multicenter, Open-label Extension Study

Type: Journal Article

Authors: K. Hoffman, M. L. Peyton, M. Sumner

Year: 2017

Publication Place: United States

Abstract: OBJECTIVE: To assess the safety of rapidly dissolving buprenorphine/naloxone sublingual tablets (BNX-RDT) in opioid-dependent patients. METHODS: This open-label, 24-week extension study enrolled patients who completed primary trials of BNX-RDT. Daily tablet doses ranged from 5.7 to 17.1 mg. The primary endpoint was safety; secondary assessments included opioid cravings, addiction severity, health-related quality of life (QOL), and workplace productivity at screening (final day of the primary trials) through study end, with changes measured from baseline of the primary trials. RESULTS: In all, 665 patients received treatment; 292 (43.9%) completed the study. A total of 258 patients (38.8%) reported 557 treatment-emergent adverse events, most commonly headache (3.2%) and constipation (3.0%). Craving scores showed continued improvement on 100-mm visual analog scale (mean change from primary trial baseline, -52.8 at screening; mean change from extension trial baseline, -60.5 at week 24). Reductions in addiction severity from baseline of both the primary and extension trial were maintained through week 24 on multiple assessments, as were improvements in QOL on Short Form 36. Employment increased by 15% and mean (SD) hours worked per week increased by 4.6 (20.1) from baseline to study end. Mean (SD) scores for impact of opioid dependence on work productivity improved from 4.7 (3.0) at baseline to 0.9 (1.8) at study end (11-point scale). CONCLUSIONS: Extended treatment with BNX-RDT demonstrated a safety profile similar to other BNX formulations, reduced opioid cravings, and improved both QOL and work productivity. Continued treatment may enable patients to advance in recovery and return to normal functioning.

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8469

Safety profile of injectable hydromorphone and diacetylmorphine for long-term severe opioid use disorder

Type: Journal Article

Authors: Eugenia Oviedo-Joekes, Suzanne Brissette, Scott MacDonald, Daphne Guh, Kirsten Marchand, Salima Jutha, Scott Harrison, Amin Janmohamed, Derek Z. Zhang, Aslam H. Anis, Michael Krausz, David C. Marsh, Martin T. Schechter

Year: 2017

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8470

Safety-Net Providers In Some US Communities Have Increasingly Embraced Coordinated Care Models

Type: Journal Article

Authors: P. Cunningham, L. Felland, L. Stark

Year: 2012

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8471

SAGE & THYME: A model for training health and social care professionals in patient-focussed support

Type: Journal Article

Authors: M. Connolly, J. Perryman, Y. McKenna, J. Orford, L. Thomson, J. Shuttleworth, S. Cocksedge

Year: 2010

Publication Place: Ireland

Abstract: OBJECTIVE: To develop a model for addressing the emotional concerns of patients or their caregivers; to teach the model in a three-hour workshop and to assess the impact of that training on a wide range of health and social care staff. METHODS: A multi-specialty team, including a cancer patient, developed a model based on the evidence relating to emotional support and communication skills. The model (SAGE & THYME) consists of nine steps (see Box 1). The purpose of the model is to enable staff of all grades and roles to fulfil the most important objectives of support: enabling patients to describe their concerns and emotions if they wish to do so, holding and respecting those concerns; identifying the patients' support structures; exploring the patients' own ideas and solutions before offering advice or information. Over 800 health and social care staff of all grades and students have participated in the three-hour SAGE & THYME training workshops. RESULTS: Analysis from 412 participants suggests that the workshops had a significant positive effect on self-confidence (p<.0005), self-perception of competence (p<.0005) and willingness to explore the emotional concerns of patients (p<.0005). 95% felt that the workshop would be very likely to have an impact on their practice. CONCLUSIONS: The workshops have been successful in increasing the self-perceptions of confidence, competence and willingness to explore the emotional concerns of patients. The model 'SAGE & THYME' has been welcomed by participants. PRACTICE IMPLICATIONS: Staff groups will require training for patients or their caregivers to have their concerns heard without interruption and to be allowed to explore their own resolutions. The three-hour SAGE & THYME training may go some way towards helping patients and staff form sound partnerships which assist patients to participate constructively in their own care.

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8472

Same-Day Integrated Mental Health Care and PTSD Diagnosis and Treatment Among VHA Primary Care Patients With Positive PTSD Screens

Type: Journal Article

Authors: K. M. Bohnert, R. K. Sripada, J. Mach, J. F. McCarthy

Year: 2016

Publication Place: United States

Abstract: OBJECTIVE: The study examined whether same-day integrated mental health services are associated with increased diagnosis and treatment initiation among primary care patients with positive posttraumatic stress disorder (PTSD) screens. METHODS: Data were from a national sample of Veterans Health Administration (VHA) primary care patients with a positive PTSD screen (N=21,427). Patients were assessed for PTSD diagnosis and treatment initiation on the screening day and

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8473

Same-day vs. delayed buprenorphine prescribing and patient retention in an office-based buprenorphine treatment program

Type: Journal Article

Authors: A. Jakubowski, T. Lu, F. DiRenno, B. Jadow, A. Giovanniello, S. Nahvi, C. Cunningham, A. Fox

Year: 2020

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8474

SAMHSA Opioid Overdose Prevention Toolkit: Facts for Community Members, Five Essential Steps for First Responders, Information for Prescribers, Safety Advice for Patients & Family Members, Recovering From Opioid Overdose

Type: Government Report

Authors: Substance Abuse and Mental Health Services Administration

Year: 2016

Publication Place: Rockville, MD

Topic(s):

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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.

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8475

SAMHSA-HRSA Center for Integrated Health Solutions

Type: Web Resource

Authors: Substance Abuse and Mental Health Services Administration

Year: 2013

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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.

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8476

SAMHSA's 2018 National Survey on Drug Use and Health (NSDUH) Report Data Findings

Type: Government Report

Authors: Substance Abuse and Mental Health Services Administration

Year: 2018

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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.

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8477

SAMHSA's National Model Standards for Peer Support Certification

Type: Web Resource

Authors: Substance Abuse and Mental Health Services Administration

Year: 2023

Publication Place: Rockville, MD

Topic(s):

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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.

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8478

SAMHSA's Working Definition of Recovery

Type: Government Report

Authors: Substance Abuse and Mental Health Services Administration

Year: 2012

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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.

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8479

San Bernardino County Youth Opioid Response: Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder

Type: Journal Article

Authors: M. M. Neeki, F. Dong, B. Archambeau, M. Cerda, S. Ratliff, A. Goff, K. Roloff, L. Tran

Year: 2020

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8480

San Francisco Department of Public Health Low Barrier Buprenorphine Pilot Program

Type: Government Report

Authors: Barry Zevin

Year: 2019

Publication Place: San Francisco, CA

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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.

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