Scroll to top
Tag: opioids

There’s Medicine to Quiet His Opioid Cravings. Getting It Can Be Hard

Article Excerpt: Hargrove’s story illustrates the challenges often faced by those struggling with opioid addiction — especially people of color — in receiving buprenorphine, a medication that public health experts believe should play a critical role in curbing an addiction-and-overdose crisis fueled by fentanyl. His overdose happened this month as a newly published national study from the Harvard T.H. Chan School of Public Health showed that White patients are up to 80 percent more likely to receive buprenorphine than Black patients, and that Black patients receive a more limited supply.

Full Article:

Article Source: The Washington Post


Augmenting project ECHO for opioid use disorder with data‑informed quality improvement

Murray OB, Doyle M, McLeman BM, Marsch LA, Saunders EC, Cox KM, Watts D, Ryder J. Augmenting project ECHO for opioid use disorder with data-informed quality improvement. Addict Sci Clin Pract 18, 24 (2023).

Learning collaboratives can address barriers to medication for opioid use disorder availability by training clinic staff on best-practice performance data collection and quality improvement (QI). Project ECHO is an evidence-based method using teleconferencing to link experts with community-based providers to enhance opioid use disorder (OUD) care. This study examined the feasibility of training of 18 clinics in New Hampshire using an additional component, ECHO-AMPLIFI, to collect and review performance data and develop QI initiatives for best practice of OUD care. Feasibility was assessed descriptively through each clinic’s participation in training sessions, data collection, and QI initiatives. At the end of the project, clinic staff completed surveys on their perspectives of usability and acceptability of the project. Five of the 18 clinics joined the ECHO-AMPLIFI project for 8 months and met the minimum engagement requirements (completed at least one training session, at least one month of performance data, and at least one QI initiative). Results from staff surveys showed the training and data collection was useful. However, there were several problems identified with data collection, including lack of staff time and lack of standardization of documentation in electronic health records. Findings indicate that implementing performance data-informed QI as a supplement to Project ECHO has potential to inform best practices, but challenges to collecting consistent performance data must be addressed. Future assessments could provide further information on the utility of performance data in helping clinics.


When Naloxone Isn’t Enough: How Technology Can Save Lives when People Use Drugs Alone

Article Excerpt: Researchers from Brown and Rhode Island Hospital are working with Rhode Island community members to understand how apps, monitors and other emerging technologies can help prevent opioid overdose deaths.

Full Article:

Article Source: News from Brown

Text Messages Exchanged Between Individuals With Opioid Use Disorder and Their mHealth e-Coaches: Content Analysis Study

Ranjit Y, Davis W, Fentem A, Riordan R, Roscoe R, Cavazos-Rehg P. Text Messages Exchanged Between Individuals With Opioid Use Disorder and Their mHealth e-Coaches: Content Analysis Study. JMIR Hum Factors 2023;10:e37351 DOI: 10.2196/37351

The aim of this study was to understand the text messaging communication between persons undergoing opioid use disorder (OUD) recovery and their e-coaches. The study was part of a larger mHealth intervention study called “uMAT-R”, which is a support mobile app to improve OUD treatment adherence and recovery. The uMAT-R app provides instant in-app messaging with a recovery support e-coach. Participants were recruited from various OUD recovery programs in St. Louis and were eligible if they had a formal OUD diagnosis and were currently receiving treatment. For this content analysis, messages from 70 participants were coded for emotional support, informational support, and material support (services and resources that help solve practical issues). Messages were also coded for treatment and recovery domains and problems related to mobile app usage. On average, the number of messages exchanged between participants and e-coaches was 17 (SD=16.05) and 90% of conversations were initiated by e-coaches. Emotional support was most commonly identified in conversations (196 occurrences), followed by material support (110 occurrences). For OUD treatment content, messages about OUD recovery and opioid use risk factors occurred the most (N=72), followed by motivation to avoid drug use (N=47). Depression was significantly associated with social support related messages (r=0.27, p=0.02). Overall, findings demonstrate that people in OUD recovery seek social support and relapse prevention support when provided online communication with their health care providers. Due to the need for continuous interpersonal support as part of addiction care, instant two-way text messaging could be a cost-effective and sustainable tool to support OUD recovery.


Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain

Anderson Goodell EM, Nordeck C, Finan PH, Vandrey R, Dunn KE, & Thrul J. (2021). Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain. Internet Interventions: the Application of Information Technology in Mental and Behavioural Health, 26, 100460–100460.

This paper described the feasibility and acceptability of a smartphone-based Ecological Momentary Assessment (EMA) data collection tool among people who use multiple substances and suffer from chronic pain. Forty-six participants were recruited through targeted Facebook and Instagram advertisements and completed screening via the link in the ads. Eligible participants had an opioid medication prescription, current opioid use, a pain disorder, and a referral for medical cannabis. Participants completed prompted EMA surveys on a mobile app for 30 days. Surveys included questions about opioid medication use, medical cannabis use, and pain symptoms. Participants were prompted to respond to four randomly timed surveys (assessing the past hour) and one daily diary per day. A subsample of 10 participants completed qualitative interviews. On average, participants responded to 70% of past-hour surveys and 92% of daily diaries. During qualitative interviews, participants reported an overall positive experience, but identified some issues related to smartphone notifications, redundant questions, or being prompted to complete assessments when they do not feel well. Findings demonstrate the feasibility and general acceptability of using this methodology for examining patterns of medical cannabis and prescription opioid medication use among individuals with chronic pain. Engagement with the digital tool over the 30-day duration was comparable to previous work. This study has implications for informing larger-scale epidemiology studies, interventions, and assessments on a wider geographic scale.


“I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums

Meacham MC, Nobles AL, Tompkins DA, Thrul J (2022) “I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums. PLoS ONE 17(2): e0263583.

This study investigated cannabis-related posts in two online communities on the Reddit platform to compare naturalistic cannabis use by people actively using opioids versus people in recovery from opioid misuse. Researchers extracted all posts mentioning keywords related to cannabis from an opioid use subreddit and opioid recovery subreddit on Reddit from December 2015 to August 2019. Cannabis-related posts were analyzed using qualitative content analysis to identify the most frequently used phrases and then compared between the two subreddits. Cannabis-related posts were twice as prevalent in the recovery subreddit (N=908, 5% of posts) than the active opioid use subreddit (N=4224, 2.6% of posts). The most frequent phrases in the recovery subreddit referred to time without opioid use and using cannabis as treatment. The opioid use subreddit most frequently referred to concurrent use of cannabis and opioids. The primary reason for cannabis use among persons in recovery was to manage opioid withdrawal symptoms and among active opioid users to achieve the “high” in conjunction with opioids. This study of naturalistic cannabis use reported on an online community platform provides insight into the motivation behind cannabis use among people who actively or previously used opioids. Findings have implications for cannabis policy and its potential impact on opioid use in the context of unmet treatment needs for opioid use disorder. Future research is needed to understand the role of cannabis for treating opioid withdrawal symptoms.


Use of telemedicine for opioid use disorder treatment – Perceptions and experiences of opioid use disorder clinicians

Riedel L, Uscher-Pines L, Mehrotra A, Busch AB, Barnett ML, Raja P, & Huskamp HA. (2021). Use of telemedicine for opioid use disorder treatment – Perceptions and experiences of opioid use disorder clinicians. Drug and Alcohol Dependence, 228, 108999–108999.

Researchers conducted a national online survey to assess clinician use of and perspectives about telemedicine for opioid use disorder (OUD) during the COVID-19 pandemic. Clinicians, including psychiatrists, nurse practitioners, primary care providers, and physician assistants, were recruited from WebMD/Medscape’s online panel (N=602). The survey focused on the use of telemedicine to treat OUD in the last month. Questions included clinician training, patient population served, OUD visit delivery, barriers to telemedicine, and opinions on effectiveness of telemedicine. Findings showed that on average 57% of visits were via telemedicine. The majority of clinicians (63%) reported telemedicine was as effective as in-person care. Ninety percent said they were comfortable using video for clinically stable patients and 49% said the same for clinically unstable patients. Seventy percent of clinicians preferred to return to in-person care following the pandemic, but 95% wanted to continue to offer telemedicine in some form. Significantly higher comfort levels were found among clinicians with at least 30% of their patient caseload composed of those with OUD compared to clinicians with fewer patients with OUD. Further, clinicians with at least 60% Medicaid and uninsured patients were significantly more likely to have conducted visits via audio-only methods and also preferred to continue using telemedicine after the pandemic compared to those with fewer Medicaid patients. These findings could inform how telemedicine is used for OUD treatment moving forward; however, there remains uncertainty about the use of audio-only visits and reimbursement levels.


Technology-Assisted Opioid Education for Out-of-Treatment Adults With Opioid Use Disorder

Toegel F, Novak MD, Rodewald AM, Leoutsakos JM, Silverman K & Holtyn AF. (2022). Technology-assisted opioid education for out-of-treatment adults with opioid use disorder. Psychology of Addictive Behaviors, 36(5), 555–564.

This pre-post study evaluated the feasibility and preliminary efficacy of a technology-assisted education program for adults at higher risk of opioid overdose. The education program was self-paced and included three courses: 1) introduction to opioids, 2) preventing, detecting, and responding to an opioid overdose, and 3) opioid use disorder medications. Each course presented information and then prompted the user to complete a multiple-choice quiz to assess mastery of course material; incorrect answers produced feedback and participants were required to answer the question again to be able to advance to the next course. Forty adult participants with opioid use disorder who were not currently in treatment and who were living in Baltimore, Maryland were referred from community agencies and enrolled in the study. The education program took on average 91 minutes to complete and most participants completed the program in a single day. The mean score for the baseline test was 85% accuracy, indicating that participants already had prior knowledge of opioids, opioid overdoses, and medications. After completion of the program, participants showed significant improvement in test scores across all three courses (increase of 9.1%, 5.8%, and 10.1% respectively; p<.001); this was independent of education, employment, and poverty status. Participants with less than 12 years of education had significantly lower scores than those with 12 or more years of education. The computerized opioid education program demonstrated preliminary feasibility and efficacy in an uncontrolled trial among at-risk adults. Mobile technology allows for the potential to disseminate widely.


WSU Study Finds Smart Home Technology Could Help Those Recovering from Opioid Use Disorder

Article Excerpt: Disrupted sleep is a common complaint for people actively trying to quit highly addictive opioids. According to a release from WSU, methadone is effective at reducing cravings and withdrawal, but it is often prescribed once daily and adjusting for the proper dosage can take time. Before a patient and doctor can get the dosage right, treatments can wear off during the night, returning withdrawal symptoms and pain – which increases the risk of resuming drug use and accidental overdose. The study, published in the journal Pain Management Nursing, found home sensors matched other sleep monitoring methods 89% of the time.

Full Article:

Article Source: Fox 28