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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
10181
Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: The treatment of depression in low-income older adults who live in poverty is complicated by several factors. Poor access to resources, disability, and mild cognitive impairment are the main factors that moderate treatment effects in this population. Interventions that not only address the depressive syndrome but also manage social adversity are sorely needed to help this patient population recover from depression. METHODS: This paper is a literature review of correlates of depression in late life. In the review we propose a treatment model that combines case management (CM) to address social adversity with problem solving treatment (PST) to address the depressive syndrome. RESULTS: We present the case of Mr Z, an older gentleman living in poverty who is also depressed and physically disabled. In this case we illustrate how the combination of CM and PST can work together to ameliorate depression. CONCLUSIONS: The combination of age, disability, and social adversity complicates the management and treatment of depression. CM and PST are interventions that work synergistically to overcome depression and manage social problems.
Topic(s):
General Literature
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View the DOI record for Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care
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View the PubMed citation for Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care10184
Treating depressive symptoms among veterans in primary care: A multi-site RCT of brief behavioral activation
Type: Journal Article
Year: 2021
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Treating depressive symptoms among veterans in primary care: A multi-site RCT of brief behavioral activation
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View the PubMed citation for Treating depressive symptoms among veterans in primary care: A multi-site RCT of brief behavioral activation10187
Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: To increase the sustainability of cognitive behavior therapy (CBT) in primary care for late-life anxiety, we incorporated nonexpert counselors, options for telephone meetings, and integration with primary care clinicians. This open trial examines the feasibility, satisfaction, and clinical outcomes of CBT delivered by experienced and nonexperienced counselors for older adults with generalized anxiety disorder (GAD). Clinical outcomes assessed worry (Penn State Worry Questionnaire), GAD (Generalized Anxiety Disorder Severity Scale), and anxiety (Beck Anxiety Inventory and Structured Interview Guide for Hamilton Anxiety Scale). After 3 months of treatment, Cohen's d effect sizes for worry and anxiety ranged from 0.48 to 0.78. Patients treated by experienced and nonexperienced counselors had similar reductions in worry and anxiety, although treatment outcomes were more improved on the Beck Anxiety Inventory for experienced therapists. Preliminary results suggest that adapted CBT can effectively reduce worry. The piloted modifications can provide acceptable and feasible evidence-based care.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links:
View the DOI record for Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study
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View the PubMed citation for Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study10192
Treating opioid addiction with buprenorphine-naloxone in community-based primary care settings
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: PURPOSE: Office-based treatment of opioid addiction with a combination of buprenorphine and naloxone was approved in 2002. Efficacy of this treatment in non-research clinical settings has not been studied. We examined the efficacy and practicality of buprenorphine-naloxone treatment in primary care settings. METHODS: We studied a cohort of 99 consecutive patients enrolled in buprenorphine-naloxone treatment for opioid dependence at 2 urban primary care practices: a hospital-based primary care clinic, and a primary care practice in a free-standing neighborhood health center. The primary outcome measure was sobriety at 6 months as judged by the treating physician based on periodic urine drug tests, as well as frequent physical examinations and questioning of the patients about substance use. RESULTS: Fifty-four percent of patients were sober at 6 months. There was no significant correlation between sobriety and site of care, drug of choice, neighborhood poverty level, or dose of buprenorphine-naloxone. Sobriety was correlated with private insurance status, older age, length of treatment, and attending self-help meetings. CONCLUSIONS: Opioid-addicted patients can be safely and effectively treated in non-research primary care settings with limited on-site resources. Our findings suggest that greater numbers of patients should have access to buprenorphine-naloxone treatment in nonspecialized settings.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Treating opioid addiction with buprenorphine-naloxone in community-based primary care settings
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View the PubMed citation for Treating opioid addiction with buprenorphine-naloxone in community-based primary care settings10193
Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: Research has examined the safety, efficacy, feasibility, and cost-effectiveness of buprenorphine for the treatment of opioid dependence, but few studies have examined patient and provider experiences, especially in community health centers. Using de-identified electronic health record system (EHRS) data from 70 OCHIN community health centers (n = 1825), this cross-sectional analysis compared the demographics, comorbidities, and service utilization of patients receiving buprenorphine to those not receiving medication-assisted treatment (MAT). Compared to non-MAT patients, buprenorphine patients were younger and less likely to be Hispanic or live in poverty. Buprenorphine patients were less likely to have Medicaid insurance coverage, more likely to self-pay, and have private insurance coverage. Buprenorphine patients were less likely to have problem medical comorbidities or be coprescribed high-risk medications. It is important for providers, clinic administrators, and patients to understand the clinical application of medications for opioid dependence to ensure safe and effective care within safety net clinics.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data
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View the PubMed citation for Treating Opioid Dependence with Buprenorphine in the Safety Net: Critical Learning from Clinical Data10195
Treating Opioid Use Disorder in Puerto Rico During the COVID-19 Pandemic: Providers' Leadership Efforts in Unprecedented Times
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
: Opioid use disorder (OUD) is an unprecedented medical and public health issue both in Puerto Rico (PR) and the greater US with an increase incidence of opioid use every year. Unprecedented and compounded emergencies in PR such as those caused by hurricanes, earthquakes, and the COVID-19 pandemic coupled with limited national and local governmental support, has forced most clinics in PR to take action to be able to continue providing care. This commentary summarizes the leadership and clinical initiatives of 3 community organizations in PR to maintain services for people with OUD during the COVID-19 pandemic. Local legislation that supported the continuity of OUD care is summarized, along with unique experiences specific to each organization. In addition, the vulnerability of economically disadvantaged people or experiencing homelessness as well as those affected by these compounded events in PR is discussed, with an emphasis on how some challenges were addressed and future directions for continuity of care as our country adjusts to new demands caused by the COVID-19 pandemic.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Healthcare Policy
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, Opioids & Substance Use
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10197
Treating pain in addicted patients: recommendations from an expert panel
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: Clinicians may face pragmatic, ethical, and legal issues when treating addicted patients. Equal pressures exist for clinicians to always address the health care needs of these patients in addition to their addiction. Although controversial, mainly because of the lack of evidence regarding their long-term efficacy, the use of opioids for the treatment of chronic pain management is widespread. Their use for pain management in the addicted population can present even more challenges, especially when evaluating the likelihood of drug-seeking behavior. As the misuse and abuse of opioids continues to burgeon, clinicians must be particularly vigilant when prescribing chronic opioid therapy. The purpose of this article is to summarize recommendations from a recent meeting of experts convened to recommend how primary care physicians should approach treatment of chronic pain for addicted patients when an addiction specialist is not available for a referral. As there is a significant gap in guidelines and recommendations in this specific area of care, this article serves to create a foundation for expanding chronic pain guidelines in the area of treating the addicted population. This summary is designed to be a practical how-to guide for primary care physicians, discussing risk assessment, patient stratification, and recommended therapeutic approaches.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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Reference Links:
View the DOI record for Treating pain in addicted patients: recommendations from an expert panel
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View the PubMed citation for Treating pain in addicted patients: recommendations from an expert panel10198
Treating Pain in an Established Patient: Sifting Through the Guidelines
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The CDC Guideline for Prescribing Opioids for Chronic Pain, published last March, provided major steps toward bringing the medical community together to address the opioid epidemic in the U.S. However, the Guideline focuses primarily on treatment of new inductions into opioid therapy for pain. Physicians may have difficulty figuring out how to apply the CDC's recommendations to patients who are already receiving opioid maintenance therapy for chronic pain. Patients already maintained on opioids for chronic pain should not be subjected to abrupt cessation or rapid tapers, and the CDC's Guideline confirms this. Physicians should not balk from treating opioid-dependent patients with chronic pain, and the CDC's recommendations do contain helpful information if one reads through them carefully. This article attempts to distill the major points from the Guideline for the treatment of chronic-pain patients already on long-term opioid therapy.[Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
Topic(s):
Opioids & Substance Use
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View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
Reference Links: View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
10199
Treating Pain in an Established Patient: Sifting Through the Guidelines
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The CDC Guideline for Prescribing Opioids for Chronic Pain, published last March, provided major steps toward bringing the medical community together to address the opioid epidemic in the U.S. However, the Guideline focuses primarily on treatment of new inductions into opioid therapy for pain. Physicians may have difficulty figuring out how to apply the CDC's recommendations to patients who are already receiving opioid maintenance therapy for chronic pain. Patients already maintained on opioids for chronic pain should not be subjected to abrupt cessation or rapid tapers, and the CDC's Guideline confirms this. Physicians should not balk from treating opioid-dependent patients with chronic pain, and the CDC's recommendations do contain helpful information if one reads through them carefully. This article attempts to distill the major points from the Guideline for the treatment of chronic-pain patients already on long-term opioid therapy.[Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].
Topic(s):
Opioids & Substance Use
See topic collection
View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
Reference Links: View the PubMed citation for Treating Pain in an Established Patient: Sifting Through the Guidelines
10200
Treating pain in primary care: Optimizing an integrated psychological intervention based on perspectives of psychologists, primary care providers, and patients
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
General Literature
See topic collection