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Marcus Turan posted an update 9 days ago
An investigation into the influence of COVID-19 on recovery was conducted through a machine learning method, the classification and regression tree analysis, utilizing 28 variables, including demographic data, substance use history, and psychosocial variables. Ten-fold cross-validation was carefully chosen to overcome the potential for overfitting.
In the study sample, 26% of respondents reported that COVID-19 recovery was noticeably or substantially harder. Past-month opioid use prevalence was considerably higher in the group reporting a harder recovery than in the group who reported an easier recovery (51% vs 24%, respectively; P < 0.0001). The classification tree, ultimately, demonstrating 80% accuracy overall, discovered the Beck Depression Inventory (BDI-II) to be the major independent risk factor connected to the reporting of the impact of COVID-19. A BDI-II score of 10 or above was linked to a substantial 645-fold increase in the likelihood of adverse impacts (95% confidence interval: 329-1330), as opposed to those with scores lower than 10. Where individuals displayed elevated BDI-II scores, a slower trajectory in substance use management and OUD treatment over the last two to three years was similarly connected to adverse outcomes.
These results strongly suggest the necessity of continuous observation of depressive symptoms and perceived progress in substance use management for individuals recovering from OUD, especially during periods of major crises.
By illustrating the impact on recovery from OUD, these findings stress the importance of constant monitoring of depressive symptoms and progress in managing substance use, particularly throughout large-magnitude crises.
A co-occurring substance use disorder (SUD) is often associated with a lower probability of opioid use disorder (OUD) patients receiving opioid use disorder treatment medications (MOUD). Undoubtedly, the precise association between distinct co-occurring substance use disorders and medication-assisted treatment (MOUD) receipt is not evident. The national Veterans Health Administration (VA) study explored how different concurrent substance use disorders (SUDs) influenced the start and ongoing use of medication-assisted treatment (MOUD) in opioid use disorder (OUD) patients.
Extracted data originated from the electronic health records of outpatients suffering from opioid use disorder (OUD), who received care spanning the period from August 1, 2016, to July 31, 2017. Distinct analyses were carried out on patients with and without prior-year MOUD receipt to examine initiation and continuation. The use of diagnostic codes provided the measurements of SUDs; the counting of prescription fills/clinic visits was employed to record the number of MOUD receipts. By using adjusted regression models, the probability of receiving MOUD in the following year was assessed for patients with a co-occurring SUD relative to those without.
The following year, a twelve percent portion of the 23,990 patients, who did not receive MOUD the previous year, began treatment. A negative association was observed between initiation and alcohol use disorder (aIRR = 0.80, 95% CI = 0.72-0.90) as well as cannabis use disorder (aIRR = 0.78, 95% CI = 0.70-0.87). The following year, 83% of the 11,854 patients who had received MOUD in the prior year continued their use of MOUD. Individuals with alcohol use disorder (aIRR 0.94; 95% CI 0.91-0.97), amphetamine/other stimulant use disorder (aIRR 0.94; 95% CI 0.90-0.99), and cannabis use disorder (aIRR 0.95; 95% CI 0.93-0.98) demonstrated a negative correlation with continued involvement.
In a research investigation encompassing national VA outpatients with opioid use disorder (OUD), a pattern emerged whereby patients with co-occurring substance use disorders (SUDs) showed lower participation in or adherence to medication-assisted opioid use disorder treatment (MOUD). More in-depth research is needed to pinpoint the obstacles linked to specific co-occurring substance use disorders.
This research, examining national VA outpatients with opioid use disorder (OUD), identified a lower rate of medication-assisted treatment (MOUD) initiation or continuation among those with concurrent substance use disorders (SUDs). A more comprehensive analysis is needed to identify impediments related to specific co-occurring substance use disorders.
Patient experience surveys, or PESs, are a vital element in the assessment of health care quality. A critical gap in information exists regarding PES data, which prevents individuals from locating superior substance use disorder treatment providers. Our project’s solution involved the creation of a PES for substance use disorder treatment providers, with the goal of public dissemination of PES information.
Six states’ addiction service providers were collectively documented in a population frame we created. Myc signal A survey invitation letter, containing a link to an online survey, was sent to patients by providers. There was no exchange of personally identifiable information. A survey comprising 10 questions was developed, drawing upon the characteristics of superior addiction treatment programs identified by the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the Substance Abuse and Mental Health Services Administration (SAMHSA).
Among the facilities, 19% took part; within the participating group, 9627 patients finalized the survey. Facility-specific patient experiences differed substantially, with the percentage of patients responding with the most positive sentiment exhibiting substantial variations. The reliability metrics between facilities with a minimum of 20 responding patients are estimated to reach or surpass 0.80. Our investigation, though thorough, yielded no proof of data falsification.
This economical survey protocol is a minimal burden on both providers and patients, due to its cost-efficiency. The results demonstrate notable differences in care quality amongst facilities, and facility-specific data are critical for informing consumer evaluations of patient-reported facility quality. Population statistics are not obtainable from these data. The rising volume of participating facilities and the corresponding increase in patient counts will make public PES data significantly more effective for consumers in comparing and selecting healthcare providers.
This cost-effective survey protocol is a burden-light solution for providers and patients. Significant differences in the quality of care across facilities, as suggested by the results, underscore the importance of facility-level data for consumers assessing relative patient-reported quality. The data’s design does not accommodate the calculation of population-wide statistics. More participating facilities and patients will result in a higher value proposition of public PES data for consumers making comparisons and selections of healthcare facilities.
A novel intervention for opioid use disorder (OUD), injectable opioid agonist treatment (iOAT), is usually reserved for treatment-experienced persons who inject drugs (PWID) with a lengthy history of opioid use disorder. This research examined the prior opioid use disorder treatment histories of people who inject drugs (PWID) and their views concerning injectable opioid-assisted treatment (iOAT) with hydromorphone.
This cross-sectional study in New York City focused on recruiting syringe services program users with opioid use disorder. Participants detailed their prior experiences with opioid use disorder care, encompassing detoxification, outpatient treatment, inpatient care, medication treatment, and involvement in mutual aid groups. Their current interest in hydromorphone-assisted overdose prevention training (iOAT) was evaluated using a four-point scale, with a score of three or four indicating interest. Treatment-experienced individuals were characterized by having incurred two or more episodes of treatment within the previous five years. The impact of past care episode occurrences on interest in iOAT was studied.
The 108 participants who inject drugs were predominantly male (68.5%) and Hispanic (68.5%), exhibiting a mean age of 43 years. Practically all (981%) patients experienced severe opioid use disorder (OUD) and had previously received OUD care (963%), with an average of 174 care episodes (standard deviation, 159). The overwhelming majority of participants (598 percent) were repeat treatment recipients. Despite a considerable (648%) interest in iOAT with hydromorphone, no significant link was found between the total number of previous care episodes and expressing interest in this intervention (odds ratio 102; 95% confidence interval 0.99–1.05).
Participants who had received a significant amount of treatment expressed a strong interest in iOAT, independent of their past OUD treatment. Individuals who inject drugs (PWID) whose opioid use disorder (OUD) has proven resistant to conventional therapies may find improved outcomes through innovative treatments, such as iOAT coupled with hydromorphone.
Participants, having undergone extensive prior treatment, demonstrated a significant interest in iOAT, irrespective of their previous OUD treatment history. Incorporating hydromorphone in iOAT could offer a new pathway to OUD recovery for PWIDs who haven’t responded to standard treatments, in the same way as other PWIDs.
Widely acknowledged as a risk factor for substance use disorders, childhood maltreatment (CM) is typically assessed through the use of the Childhood Trauma Questionnaire (CTQ). Retrospective accounts, however, are potentially prone to bias. With a focus on the impact of SUD, we used a unique patient cohort with prospectively documented CM to analyze the CTQ’s performance.
One hundred four individuals were used in the foundation of the analysis. In Linköping, Sweden, a specialized childhood trauma unit identified subjects with prospectively tracked childhood trauma experiences (n = 55; 31 with substance use disorders, 61% female; 24 without substance use disorders, 71% female). SUD was observed in clinical controls, but CM was absent. Twenty-five participants, with 48% females, were included in this group. Control subjects classified as healthy had neither SUD nor CM (n = 24; 54% female).
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