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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).
12255 Results
10981
The OCHIN community information network: bringing together community health centers, information technology, and data to support a patient-centered medical village
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Creating integrated, comprehensive care practices requires access to data and informatics expertise. Information technology (IT) resources are not readily available to individual practices. One model of shared IT resources and learning is a "patient-centered medical village." We describe the OCHIN Community Health Information Network as an example of this model; community practices have come together collectively to form an organization that leverages shared IT expertise, resources, and data, providing members with the means to fully capitalize on new technologies that support improved care. This collaborative facilitates the identification of "problem sheds" through surveillance of network-wide data, enables shared learning regarding best practices, and provides a "community laboratory" for practice-based research. As an example of a community of solution, OCHIN uses health IT and data-sharing innovations to enhance partnerships between public health leaders, clinicians in community health centers, informatics experts, and policy makers. OCHIN community partners benefit from the shared IT resource (eg, a linked electronic health record, centralized data warehouse, informatics, and improvement expertise). This patient-centered medical village provides (1) the collective mechanism to build community-tailored IT solutions, (2) "neighbors" to share data and improvement strategies, and (3) infrastructure to support innovations based on electronic health records across communities, using experimental approaches.
Topic(s):
HIT & Telehealth
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10983
The opiate dosage adequacy scale for identification of the right methadone dose--a prospective cohort study
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: BACKGROUND: Opioid maintenance treatment with methadone is regarded as gold standard in the therapy of opioid dependence. Identification of the 'right' methadone dose, however, remains challenging. We wanted to explore if the Opiate Dosage Adequacy Scale (ODAS) is a helpful instrument in methadone titration. METHODS: Within this 12-months prospective naturalistic cohort study patients in stable maintenance treatment with methadone (Eptadone(R)) were included. Sociodemographic and clinical data were gathered at baseline, and months 3, 6, and 12. At the same points in time, the instruments ODAS, European Addiction Severity Index (EuropASI), and Derogatis Interview for Sexual Functioning-Self Report (DISF-SR) were applied. RESULTS: Five hundred fifteen patients were enrolled, 129 patients prematurely terminated substitution treatment (treatment failure), in 108 patients substitution medication was changed, likely due to bitter taste of Eptadone(R). Complete longitudinal ODAS and EuropASI data sets were available for 229 patients. The frequency of adequate methadone doses (ODAS) increased (60.9 % at baseline, 85.3 % at month 12) as well as the average daily methadone dose (63.8 (+/-30.8) mg/day at baseline to 69.6 (+/-36.0) mg/day at month 12). Inadequacy of methadone dose was not associated with treatment failure (RR 1.019; CI 95 % 0.756-1.374). Addiction severity decreased statistically significantly. Compared to adequately dosed patients, inadequately dosed patients benefited more, in that they showed greater improvements in ODAS scores, had higher increases in methadone dose, and partially experienced more advanced sexual functioning. CONCLUSION: Application of ODAS was associated with improved methadone dose adequacy and addiction severity parameters as well as increased methadone doses. Its usefulness should be corroborated in a controlled trial.
Topic(s):
Opioids & Substance Use
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, Measures
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Reference Links: 
View the DOI record for The opiate dosage adequacy scale for identification of the right methadone dose--a prospective cohort study
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View the PubMed citation for The opiate dosage adequacy scale for identification of the right methadone dose--a prospective cohort study10985
The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases
Type: Journal Article
Year: 2020
Abstract: Background/aims: To examine trends in rural Appalachian opioid and related drug epidemics during the past 10 years, including at-risk populations, substance use shifts and correlates, and associated infections. Methods: We conducted this review in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Seven databases were searched for quantitative studies, published between January 2006 and December 2017, of drug use, drug-related mortality, or associated infections in rural Appalachia. Results: Drug-related deaths increased in study states, and a high incidence of polydrug toxicity was noted. Rural substance use was most common among young, white males, with low education levels. A history of depression/anxiety was common among study populations. Prescription opioids were most commonly used, often in conjunction with sedatives. Women emerged as a distinct user subpopulation, with different routes of drug use initiation and drug sources. Injection drug use was accompanied by risky injection behaviors and was associated with hepatitis C. Conclusions: This review can help to inform substance use intervention development and implementation in rural Appalachian populations. Those at highest risk are young, white males who often engage in polysubstance use and have a history of mental health issues. Differences in risk factors among other groups and characteristics of drug use in rural Appalachian populations that are conducive to human immunodeficiency virus (HIV) spread also warrant consideration.
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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10986
The Opioid Crisis in America: Too much, too little, too late
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for The Opioid Crisis in America: Too much, too little, too late
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View the PubMed citation for The Opioid Crisis in America: Too much, too little, too late10987
The opioid crisis in Canada: a national perspective
Type: Journal Article
Year: 2018
Publication Place: Canada
Topic(s):
Opioids & Substance Use
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10990
The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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Reference Links:
View the DOI record for The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care
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View the PubMed citation for The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care10992
The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey
Type: Journal Article
Year: 2022
Publication Place: England
Abstract:
Background: The opioid epidemic is a public health crisis. Among initiatives surrounding treatment and prevention, opioid use disorder (OUD) stigma has emerged as a subject for intervention. Objectives: This study examines overall results and demographic differences of three subscales of a public stigma survey instrument: general attitudes, social distance, and treatment availability and effectiveness. Methods: A statewide sample of Pennsylvanian adults (N = 1033) completed an online survey about the opioid epidemic. Weighted percentage level of agreement was reported for each item. To determine significant differences in responding across demographic groups (gender, race, and urban/rural status), multiple one-way ANOVAs were analyzed. Significant differences in the level of agreement and disagreement (p < .05) were reported. Results: The majority of respondents agreed that the opioid epidemic is a problem and that anyone can become addicted to opioids; however, many Pennsylvanians still disagree that OUD is a medical disorder and continue to endorse social distance beliefs of people with OUD. Most participants agreed that there are effective treatments available, and that recovery was possible; however, a large portion of participants were unsure whether specific treatments are effective. Subscale mean differences were significant for gender and age. Conclusions/Importance: Findings highlight that stigmatized attitudes, behaviors, and beliefs about individuals who use opioids are still prevalent and that uncertainty remains about the effectiveness of OUD treatment. OUD interventions should use targeted messaging in order to impact the ongoing opioid crisis.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey
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View the PubMed citation for The Opioid Epidemic and the State of Stigma: A Pennsylvania Statewide Survey10993
The Opioid Epidemic in NC: Progress, Challenges, and Opportunities
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for The Opioid Epidemic in NC: Progress, Challenges, and Opportunities
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View the PubMed citation for The Opioid Epidemic in NC: Progress, Challenges, and Opportunities10994
The opioid epidemic in rural northern New England: An approach to epidemiologic, policy, and legal surveillance
Type: Journal Article
Year: 2019
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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Reference Links:
View the DOI record for The opioid epidemic in rural northern New England: An approach to epidemiologic, policy, and legal surveillance
View DOI Record
View the PubMed citation for The opioid epidemic in rural northern New England: An approach to epidemiologic, policy, and legal surveillance10995
The Opioid Epidemic in the United States
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for The Opioid Epidemic in the United States
View DOI Record
View the PubMed citation for The Opioid Epidemic in the United States10997
The Opioid Epidemic: What Does it Mean for Nurses?
Type: Journal Article
Year: 2017
Publication Place: United States
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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10998
The opioid renewal clinic: a primary care, managed approach to opioid therapy in chronic pain patients at risk for substance abuse
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: OBJECTIVE: To measure the impact of a structured opioid renewal program for chronic pain run by a nurse practitioner (NP) and clinical pharmacist in a primary care setting. PATIENTS AND SETTING: Patients with chronic noncancer pain managed with opioid therapy in a primary care clinic staffed by 19 providers serving 50,000 patients at an urban academic Veterans hospital. DESIGN: Naturalistic prospective outcome study. INTERVENTION: Based on published opioid prescribing guidelines and focus groups with primary care providers (PCPs), a structured program, the Opioid Renewal Clinic (ORC), was designed to support PCPs managing patients with chronic noncancer pain requiring opioids. After training in the use of opioid treatment agreements (OTAs) and random urine drug testing (UDT), PCPs worked with a pharmacist-run prescription management clinic supported by an onsite pain NP who was backed by a multi-specialty Pain Team. After 2 years, the program was evaluated for its impact on PCP practice and satisfaction, patient adherence, and pharmacy cost. RESULTS: A total of 335 patients were referred to the ORC. Of the 171 (51%) with documented aberrant behaviors, 77 (45%) adhered to the OTA and resolved their aberrant behaviors, 65 (38%) self-discharged, 22 (13%) were referred for addiction treatment, and seven (4%) with consistently negative UDT were weaned from opioids. The 164 (49%) who were referred for complexity including history of substance abuse or need for opioid rotation or titration, with no documented aberrant drug-related behaviors, continued to adhere to the OTA. Use of UDT and OTAs by PCPs increased. Significant pharmacy cost savings were demonstrated. CONCLUSION: An NP/clinical pharmacist-run clinic, supported by a multi-specialty team, can successfully support a primary care practice in managing opioids in complex chronic pain patients.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
See topic collection