Prevalence of Cannabis Use Disorder and Reasons for Use Among Adults in a US State Where Recreational Cannabis Use Is Legal

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(8), P. e2328934 - e2328934

Published: Aug. 29, 2023

Medical and nonmedical cannabis use disorders (CUD) have increased with increasing legalization. However, the prevalence of CUD among primary care patients who for medical or reasons is unknown in states legal recreational use.To estimate severity report only, both a state use.This cross-sectional survey study took place at an integrated health system Washington State. Among 108 950 adult completed routine screening from March 2019 to September 2019, 5000 were selected confidential using stratified random sampling frequency past-year race ethnicity. 1688 respondents, 1463 reporting past 30-day included study.Patient survey-reported reason 30 days: reasons.Patient responses Composite International Diagnostic Interview-Substance Abuse Module CUD, corresponding Statistical Manual Mental Disorders, Fifth Edition (0-11 symptoms) categorized as any (≥2 moderate severe (≥4 symptoms). Adjusted analyses weighted stratification nonresponse population estimates compared across use.Of (weighted mean [SD] age, 47.4 [16.8] years; 748 [weighted proportion, 61.9%] female) used cannabis, 42.4% (95% CI, 31.2%-54.3%) reported 25.1% 17.8%-34.2%) 32.5% 25.3%-40.8%) use. The was 21.3% 15.4%-28.6%) did not vary groups. 6.5% 5.0%-8.6%) differed groups: 1.3% 0.0%-2.8%) use, 7.2% 3.9%-10.4%) 7.5% 5.7%-9.4%) (P = .01).In this common cannabis. Moderate more prevalent These results underscore importance assessing patient symptoms settings.

Language: Английский

---

Test-retest reliability of DSM-5 substance use symptom checklists used in primary care and mental health care settings

Drug and Alcohol Dependence, Journal Year: 2024, Volume and Issue: 256, P. 111108 - 111108

Published: Jan. 24, 2024

Language: Английский

---

Evidence-Based Assessment of Substance Use Disorder

Assessment, Journal Year: 2023, Volume and Issue: 31(1), P. 168 - 190

Published: June 15, 2023

The current review describes updated information on the evidence-based assessment of substance use disorder. We offer an overview state science for substance-related targets, instruments (screening, diagnosis, outcome and treatment monitoring, psychosocial functioning wellbeing) processes (relational technical) as well recommendations each these three components. encourage assessors to reflect their own biases, beliefs, values, including how those relate people that substances, view individual a whole person. It is important consider person’s profile symptoms inclusive strengths, comorbidities, social cultural determinants. Collaborating with patient select target best fits goals integration in holistic manner critical. conclude by providing instruments, comprehensive disorder assessment, describe future directions research.

Language: Английский

---

Using digitally delivered measurement-based care in substance use disorder treatment: qualitative analysis of patients’ perspectives

The American Journal of Drug and Alcohol Abuse, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 11

Published: Feb. 24, 2025

Background: Measurement-based care (MBC) is a clinical practice where patients complete standardized outcome measures throughout treatment to monitor progress and inform decision-making. However, MBC rarely adopted in routine substance use disorder (SUD) treatment. We developed digital system pilot tested it an outpatient adult community SUD setting.

Language: Английский

---

Tools to implement measurement-based care (MBC) in the treatment of opioid use disorder (OUD): toward a consensus

Addiction Science & Clinical Practice, Journal Year: 2024, Volume and Issue: 19(1)

Published: Feb. 28, 2024

Abstract Background The prevalence and associated overdose death rates from opioid use disorder (OUD) have dramatically increased in the last decade. Despite more available treatments than 20 years ago, treatment access high discontinuation are challenges, as personalized medication dosing making timely changes when fail. In other fields such depression, brief measures to address these tasks combined with an action plan—so-called measurement-based care (MBC)—have been better outcomes. This workgroup aimed determine whether can be identified for using MBC optimizing or informing decisions OUD. Methods National Institute on Drug Abuse Center Clinical Trials Network (NIDA CCTN) 2022 convened a small develop consensus about clinically usable improve quality of delivery methods Two clinical were addressed: (1) identify optimal dose medications OUD each patient (2) estimate effectiveness particular once implemented, granular fashion binary categories early sustained remission no found Diagnostic Statistical Manual Mental Disorders, fifth edition (DSM-5). Discussion Five parameters recommended personalize adjustment: withdrawal symptoms, use, magnitude (severity duration) subjective effects opioids used, craving, side effects. A rating OUD-specific parameter adjust global assessment verbal question side-effects was viewed sufficient. Whether ratings produce outcomes (e.g., engagement retention) practice deserves study. There that core signs symptoms based some 5 DSM-5 domains withdrawal) should basis assessing outcome. No existing measure meet all recommendations. Next steps would select, adapt de novo items/brief scales inform decision-making effectiveness. Psychometric testing, acceptability produces symptom control, life (QoL), daily function prognosis compared usual investigation.

Language: Английский

---

Equivalence of alcohol use disorder symptom assessments in routine clinical care when completed remotely via online patient portals versus in-clinic via paper questionnaires: Psychometric evaluation (Preprint)

Journal of Medical Internet Research, Journal Year: 2024, Volume and Issue: 26, P. e52101 - e52101

Published: June 7, 2024

Background The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends the paper-based or computerized Symptom Checklist to assess alcohol use disorder (AUD) symptoms in routine care when patients report high-risk drinking. However, it is unknown whether response characteristics differ administered online (eg, remotely via an electronic health record [EHR] patient portal before appointment) versus clinic paper after appointment check-in). Objective This study evaluated psychometric performance of completed during clinical care. Methods cross-sectional, obtained EHR data from by adult integrated system Washington state. sample included who had a primary visit 2021 at 1 32 practices, were due for annual behavioral screening, reported drinking screen (Alcohol Use Disorder Identification Test–Consumption score ≥7). After with typically asked complete Checklist—an 11-item questionnaire which self-report they experienced each 11 AUD criteria listed Diagnostic Statistical Manual Mental Disorders, Fifth Edition (DSM-5) over past-year timeframe. Patients could computer, smartphone, tablet any location) as part rooming process appointments). We examined measurement conducted differential item functioning analyses using theory examine consistency across these 2 assessment modalities. Results Among 3243 meeting eligibility this secondary analysis (2313/3243, 71% male; 2271/3243, 70% White; 2014/3243, 62% non-Hispanic), 1640 (51%) while 1603 (49%) clinic. Approximately 46% (752/1640) 48% (764/1603) ≥2 (the threshold diagnosis) (P=.37), respectively. A small degree was observed 4 items. produced only minimal impact total scores used clinically severity, affecting count maximum 0.13 (on scale ranging 0 11). Conclusions Completing online, prior check-in, performed similarly in-clinic modality medical assistant time appointment. Findings have implications symptom assessments streamline workflows, reduce staff burden, stigma, potentially do not receive in-person Whether DSM-5 differentially impacts treatment unknown.

Language: Английский

---

Feasibility, Engagement, and Usability of a Remote, Smartphone-Based Contingency Management Program as a Treatment Add-On for Patients Who Use Methamphetamine: Single-Arm Pilot Study

JMIR Formative Research, Journal Year: 2023, Volume and Issue: 7, P. e47516 - e47516

Published: May 29, 2023

Background In the United States, methamphetamine-related overdoses have tripled from 2015 to 2020 and continue rise. However, efficacious treatments such as contingency management (CM) are often unavailable in health systems. Objective We conducted a single-arm pilot study evaluate feasibility, engagement, usability of fully remotely delivered mobile CM program offered adult outpatients who used methamphetamine were receiving care within large university system. Methods Participants referred by primary or behavioral clinicians between September 2021 July 2022. Eligibility criteria screening was telephone included self-reported use on ≥5 out past 30 days goal reducing abstaining use. Eligible participants agreed take part then completed an initial welcome phase that 2 videoconference calls register for learn about “practice” saliva-based substance tests prompted smartphone app. these activities could receive intervention 12 consecutive weeks. The approximately 24 randomly scheduled alerts requesting video recording themselves taking test verify recent abstinence, weekly with guide, 35 self-paced cognitive therapy modules, multiple surveys. Financial incentives disbursed via reloadable debit cards. An questionnaire at midpoint. Results Overall, 37 patients screenings, 28 (76%) meeting eligibility consenting participate. Most baseline (21/24, 88%) symptoms consistent severe disorder, most had other co-occurring non-methamphetamine disorders (22/28, 79%) mental (25/28, 89%) according existing electronic records. 54% (15/28) successfully able intervention. Among participants, engagement testing, guides, modules varied. Rates verified abstinence testing generally low but varied considerably across participants. reported positive opinions intervention’s ease satisfaction Conclusions Fully remote can be feasibly settings lacking programs. Although delivery may help reduce barriers treatment access, many struggle engage onboarding. High rates psychiatric conditions patient population also contribute uptake challenges. Future efforts leverage greater human-to-human connection, more streamlined onboarding procedures, larger incentives, longer durations, incentivization non–abstinence-based recovery goals increase health–based CM.

Language: Английский

---

Considerations when prescribing opioid agonist therapies for people living with HIV

Expert Review of Clinical Pharmacology, Journal Year: 2024, Volume and Issue: 17(7), P. 549 - 564

Published: July 1, 2024

Introduction Medications for opioid use disorder (MOUD) include agonist therapies (OAT) (buprenorphine and methadone), antagonists (extended-release naltrexone). All forms of MOUD improve (OUD) HIV outcomes. However, the integration services OUD remains inadequate. Persistent barriers to accessing underscore immediate necessity addressing pharmacoequity in treatment persons with (PWH).

Language: Английский

---

Assessing Substance Use Disorder Symptoms with a Checklist among Primary Care Patients with Opioid Use Disorder and/or Long-Term Opioid Treatment: An Observational Study

Journal of General Internal Medicine, Journal Year: 2024, Volume and Issue: 39(12), P. 2169 - 2178

Published: July 1, 2024

Language: Английский

---

Association between cannabis use disorder symptom severity and probability of clinically-documented diagnosis and treatment in a primary care sample

Drug and Alcohol Dependence, Journal Year: 2023, Volume and Issue: 251, P. 110946 - 110946

Published: Aug. 23, 2023

Language: Английский

---