Perinatal women in substance use disorder treatment: Interest in partnering with family and friends to support recovery needs.

Background: Perinatal women treated for substance use disorder (SUD) face considerable barriers to recovery that might be ameliorated through activation of community support.

Objectives: This descriptive study evaluated the presence of drug-free family and friends in the social networks of perinatal women treated for SUD. It also assessed the interest of these women to partner with network members to mobilize support across several recovery needs.

Pilot investigation of an electronic pillbox at a community opioid treatment program.

Opioid treatment programs (OTPs) permit patients to ingest daily methadone doses unsupervised and away from the clinic, a strategy that enhances treatment access and convenience but has the potential for mismanagement. This retrospective review, conducted during the COVID-19 pandemic (5/2020-1/2022), evaluates the feasibility and acceptability of a commercially available electronic pillbox to safely administer methadone take-home tablets in a large community-based OTP (census >500 people). Study participants ( = 24; 54% male, 46% female; M age = 63 years) had recently received more take-homes per visit to support national social distancing directives, and were instructed that they could maintain these privileges by agreeing to use the pillbox.

Feasibility and preliminary efficacy of a community support intervention for people with opioid use disorder.

Background And Objectives: People receiving agonist treatment for opioid use disorder often have family or friends who do not use illicit substances and could be mobilized to support recovery efforts. The present study evaluates the feasibility and preliminary efficacy of a community support intervention (CSI) designed to increase drug-free social support and expand drug-free network support.

Methods: Participants receiving methadone treatment and using illicit drugs (n = 33) were randomly assigned to a weekly CSI or education group for 12 weeks.

The Impact of Child Protective Services Involvement on Pregnant and Postpartum Women in Substance Use Disorder Treatment.

: Pregnant women with substance use disorder often fail to complete treatment. Treatment retention can be influenced by many factors, including CPS involvement. This study evaluates the relationship, if any, between active CPS involvement while in treatment and treatment outcomes.

Economic, social, and clinic influences on opioid treatment program retention in Dar es Salaam, Tanzania: a qualitative study.

Background: Medications for opioid use disorder (MOUD) are associated with positive health outcomes. People remaining on MOUD have a reduced likelihood of drug overdose and mortality. Tanzania supports a national opioid treatment program (OTP) offering MOUD, but retention is a continual challenge.

Drug-Free Community Support in Inpatients with Co-occurring Psychiatric Disorders and Substance Use Problems.

This study evaluated the presence of drug-free family and friends in the social networks of patients treated in an inpatient setting for co-occurring psychiatric disorders and substance use problems. Social network interviews were conducted with inpatients at the Johns Hopkins Bayview Acute Psychiatric Unit with co-occurring psychiatric disorders and substance use problems ( = 90). Participants reported about five social network members, of which four were drug-free.

Opioid treatment program prescribing of methadone with community pharmacy dispensing: Pilot study of feasibility and acceptability.

Access to methadone for opioid use disorder (OUD) in the United States remains limited to regulated and certified Opioid Treatment Programs (OTPs). Collaboration between OTPs and community pharmacies would increase access to and potentially satisfaction with methadone delivery. While it remains illegal for prescribers to write, and pharmacies to dispense, methadone when the indication is OUD, the present pilot study evaluates the feasibility, acceptability, and outcomes of using community pharmacies to dispense methadone prescribed by OTP physicians (in tablet formulation) to a subset of clinically stable OTP patients; all other treatment services were delivered within the OTP.

HIV Stigma, HIV status disclosure, and ART adherence in the context of an integrated opioid use disorder and HIV treatment setting in Dar es Salaam, Tanzania.

Little is known about social factors, including stigma, that affect antiretroviral therapy (ART) adherence among people enrolled in opioid use disorder treatment (OUDT) in the context of integrated OUDT and HIV treatment models. We qualitatively examined the relationship between HIV stigma, HIV status disclosure, and ART adherence among clients living with HIV at an OUDT clinic with integrated HIV services in Tanzania. We conducted in-depth interviews with 25 clients receiving HIV care at an OUDT clinic in Dar es Salaam, Tanzania between January and April 2020.

The impact of social network dynamics on engagement in drug use reduction programs among men and women who use drugs.

Background: Cross-sectional studies have shown strong relationships between social network characteristics and substance use disorder (SUD) treatment engagement. The current study examined associations between longitudinal changes in egocentric social networks of male and female people who use drugs (PWUD) and engagement in drug use reduction programs, broadly defined as either formal SUD treatment or self-help groups.

Method: Using data from an HIV prevention and care study in Baltimore, MD, this study categorized PWUD into those who engaged and did not engage in any drug use reduction programs over two follow-ups during a one-year observation window.

Use of an electronic pillbox to increase number of methadone take-home doses during the COVID-19 pandemic.

This study describes use of the commercially available Medminder electronic pillbox at a community substance use disorder treatment program to safely increase the number of methadone take-home doses administered during the COVID-19 pandemic. The pillbox contains 28 cells that lock independently and can be opened only during preprogrammed time windows. This study provided patients (n = 42) deemed vulnerable to take-home mismanagement or more severe symptoms from COVID-19 infection the pillbox and observed them for 11 weeks.

Sexual-risk reduction following the referral of syringe exchange registrants to methadone maintenance: Impact of gender and drug use.

This study evaluates the impact of enrolling syringe exchange registrants in methadone maintenance on change in sexual-risk behaviors. Baltimore Needle Exchange Program (BNEP) registrants (n = 210) participated in a parent study evaluating strategies for initiating methadone maintenance treatment and the study followed them for six months. Study staff administered the Risk Assessment Battery (RAB; Metzger, 1993) monthly throughout treatment.

Reducing Risky Drug Use Behaviors by Enrolling Syringe Exchange Registrants in Methadone Maintenance.

Referral of syringe exchange registrants with opioid use disorder to agonist treatment provides a pathway to further reduce drug use risk behaviors. : This study evaluates the drug use risk reduction benefits of enrolling syringe exchange registrants in methadone maintenance, and the impact of continued illicit drug use on risk reduction. : Baltimore Needle Exchange Program (BNEP) registrants ( = 210) participated in a parent study evaluating treatment initiation strategies for methadone maintenance and were followed for six months.

Developing a community-supported risk reduction intervention for syringe exchange registrants and their drug-free family or friends: a pilot study.

Background: People engaged in injection opioid use often have drug-free family or friends that could be mobilized to support risk reduction and treatment seeking.

Objective: This pilot study evaluated the feasibility and preliminary efficacy of a 6-week community-supported risk reduction group intervention for syringe exchange program (SEP) registrants and drug-free network members.

Method: The group provided risk reduction and treatment readiness education, with weekly assignments for participants to engage together in community activities designed to meet other drug-free people.

Impact of Personality Disorder on the Treatment of Psychiatric Disorders in People Receiving Methadone-Assisted Treatment.

This study evaluates personality disorder as a moderator of psychiatric treatment response in people receiving methadone-assisted treatment. Participants ( = 125) were enrolled in a 12-week parent study that evaluated the impact of incentives on attendance to psychiatric care. All participants had a current Axis I disorder and were classified based on presence of an Axis II disorder: Axis I-only ( = 46) versus Axis I + II ( = 79).

Prefrontal cortex response to drug cues, craving, and current depressive symptoms are associated with treatment outcomes in methadone-maintained patients.

Methadone maintenance is an effective treatment for opioid use disorder, yet many methadone-maintained patients (MMPs) continue to struggle with chronic relapse. The current study evaluated whether functional near-infrared spectroscopy (fNIRS) could identify prefrontal cortex (PFC) markers of ongoing opioid use in MMPs, and whether clinical measures of depression and self-report measures of craving would also be associated with opioid use. MMPs (n = 29) underwent a drug cue reactivity paradigm during fNIRS measurements of PFC reactivity.

Psychiatric and Substance Use Comorbidity in Treatment-Seeking Injection Opioid Users Referred From Syringe Exchange.

Objective: The present study evaluated rates of co-occurring current psychiatric and substance use disorders in a sample of opioid-dependent treatment-seeking injection drug users referred from syringe exchange.

Methods: Participants (N = 208) completed the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-R to assess current (within the past year) psychiatric and substance use disorders and the two most commonly diagnosed personality disorders (antisocial and borderline personality disorders).

Results: Forty-eight percent of the sample had a current Axis I psychiatric disorder, and 67% had a co-occurring current substance use disorder.

Mobilizing community support in people receiving opioid-agonist treatment: A group approach.

This descriptive study evaluates a novel group intervention designed to help opioid-dependent patients in medication-assisted treatment identify and recruit drug-free individuals to support recovery efforts. The Social Network Activation Group works with patients who are actively using drugs and resistant to including drug-free family or friends in treatment. The group encourages patients to attend structured recovery, religious, or recreational activities in the community to find recovery support.

Treatment initiation strategies for syringe exchange referrals to methadone maintenance: A randomized clinical trial.

This randomized clinical trial evaluated the efficacy of three treatment initiation strategies for improving retention to methadone maintenance for opioid-dependent individuals referred from a syringe exchange program (SEP). New admissions (n = 212) were randomly assigned to one of three 3-month initiation strategies: 1) Low Threshold (LTI), 2) Voucher Reinforcement (VRI), or 3) Standard Care (SCI). LTI was modeled on interim methadone maintenance to transition SEP admissions to the structure of medication-assisted treatment while maximizing exposure to methadone pharmacotherapy.

Incentivizing attendance to prolonged exposure for PTSD with opioid use disorder patients: A randomized controlled trial.

Objective: To determine whether contingent monetary incentives increase opioid use disorder patients' attendance to Prolonged Exposure (PE) therapy and whether attendance is associated with improvement in posttraumatic stress disorder (PTSD) and substance use disorder (SUD) outcomes.

Method: Patients (N = 58) with PTSD were offered PE or PE with incentives (PE + I; max $480) to attend PE sessions. Participants were assessed at baseline and weeks 6, 12, and 24 postrandomization.

Presence of Drug-Free Family and Friends in the Personal Social Networks of People Receiving Treatment for Opioid Use Disorder.

The present study evaluated the presence of drug-free family and friends in the personal social networks of individuals seeking treatment for opioid use disorder, and the willingness of patients to bring these individuals to the treatment program to support recovery efforts. Patients at a community medication-assisted treatment program (n=355) completed a clinical survey to identify drug-free social network members. Results showed that almost all patients (98%) reported having at least one drug-free family or friend in their personal network (M=3.

Effect of traumatic event reexposure and PTSD on substance use disorder treatment response.

Background: A remarkably high rate of traumatic event reexposure has been demonstrated in community-based substance users which negatively impacts their substance use disorder (SUD). The rate and effect of such reexposure in treatment is unknown. Despite increasing evidence that a diagnosis of posttraumatic stress disorder (PTSD) has little influence on long-term SUD treatment outcomes, it is possible that PTSD symptom fluctuations could have effects.

Substance use and response to psychiatric treatment in methadone-treated outpatients with comorbid psychiatric disorder.

The psychiatric care of opioid users receiving agonist therapies is often complicated by high rates of illicit drug use (Brooner et al., 2013). The present study evaluates if illicit drug use (i.

Challenges and outcomes of parallel care for patients with co-occurring psychiatric disorder in methadone maintenance treatment.

Objective: Most opioid users seeking treatment in community-based substance abuse treatment programs have at least one co-occurring psychiatric disorder, and the presence of psychiatric comorbidity in this population is associated with increased psychological distress, poorer quality of life, and reduced response to substance abuse treatment. This observational study describes clinical outcomes of referring patients receiving methadone maintenance with at least one co-occurring psychiatric disorder to a community psychiatry program located on the same hospital campus.

Methods: Participants (n = 156) were offered priority referrals to a community psychiatry program that included regularly scheduled psychiatrist appointments, individual and group therapy, and enhanced access to psychiatric medications for 1 year.

A randomized trial of Web-based videoconferencing for substance abuse counseling.

Web-based videoconferencing can improve access to substance abuse treatment by allowing patients to receive counseling services in their homes. This randomized clinical trial evaluates the feasibility and acceptability of Web-based videoconferencing in community opioid treatment program (OTP) participants. Participants that reported computer and Internet access (n=85) were randomly assigned to receive 12weeks of weekly individual counseling in-person or via eGetgoing, a Web-based videoconferencing platform.