Browsing by Subject "medication-assisted treatment"

Now showing 1 - 4 of 4
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    Art Therapy in Opiate Use Disorder: Moving Toward an Integrated Treatment Framework
    (2021-05) Sentir, Alena; Misluk, Eileen
    Drug addiction is a major public health concern resulting in deleterious consequences to individuals and society. Yet, addiction is a recoverable disease with the right support. Although evidence-based treatments exist for opiate use disorder, many individuals remain treatment refractory and die from overdoses. These individuals often present to treatment with dual diagnosis and polysubstance use, which are conditions that increase client complexity and barriers to recovery. An integrative systematic literature review was conducted to examine how art therapy has been used in these populations and ways that it could be incorporated into current addiction neuroscience treatment. The culmination is a six-session proposal with the goal of increasing treatment retention in refractory populations. Through the framework of the Expressive Therapies Continuum and modern addiction neuroscience treatment, the proposal is theorized to integrate limbic to cortical functioning, stimulate motivation, increase empowerment, and support clients during recovery. Though the proposal gives special consideration to those with opiate use disorder in medication-assisted treatment, it inclusive of other substance use disorders and accounts for various client complexities, as well as being easily adaptable by an art therapist to different treatment settings.
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    Characterizing variability in state-level regulations governing opioid treatment programs
    (Journal of Substance Abuse Treatment, 2020-04-24) Jackson, Joanna R.; Harle, Christopher A.; Silverman, Ross D.; Simon, Kosali; Menachemi, Nir
    Abstract Introduction: The opioid use crisis has left nearly 1 million people in need of treatment. States have focused primarily on policies aimed at decreasing the prevalence of opioid use disorder. However, opioid treatment programs (OTPs), an evidence-based modality which can prevent and decrease opioid-related mortality and morbidity, remain highly complex with variation in treatment by state. A focus on evidence-based state-level regulation of OTPs may help improve the unmet need for treatment. This study characterized the variability in state laws that regulate OTPs and examines how this variability is associated with state characteristics. These data provides an opportunity for policymakers to consider regulations that increase access to care and retention in OTPs, which could improve population health. Materials and Methods: Utilizing legal mapping techniques, we identified all regulations governing OTPs in effect on January 1, 2017 and determined whether the most common regulations were consistent with best practices. We then examined how the number and type of regulations were associated with state characteristics. All legal mapping research was conducted between November 2017 and March 2019. Results: We identified 89 different regulations, the most common of which exists in fewer than half of all states; and most exist in less than 25% of states. Eighteen of the 30 most common regulations were inconsistent with best practice recommendations. Overall, variability in the number and type of OTP regulations was related to geographic location as opposed to state size or political leanings. Conclusions: Wide-ranging variability in the regulations of OTPs exists across the U.S. The majority of state OTP regulations are not congruent with best practices.
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    Court personnel attitudes towards medication-assisted treatment: A state-wide survey
    (Elsevier, 2019-09) Andraka-Christou, Barbara; Gabriel, Meghan; Madeira, Jody; Silverman, Ross D.; Health Policy and Management, School of Public Health
    Background Despite its efficacy, medication-assisted treatment (MAT) is rarely available in the criminal justice system in the United States, including in problem-solving courts or diversionary settings. Previous studies have demonstrated criminal justice administrators' hostility towards MAT, especially in prisons and jails. Yet, few studies have examined attitudes among court personnel or compared beliefs among different types of personnel. Also, few studies have explored the relationship between MAT education/training and attitudes. Finally, few studies have directly compared attitudes towards methadone, oral buprenorphine, and extended-release naltrexone in the criminal justice system. Methods We modified a survey by Matusow et al. (2013) to explore justice professionals' MAT attitudes, including associations with demographic variables, court role, and previous MAT education/training. After piloting the survey, we distributed it to a convenience sample of justice professionals registered for an educational summit held in Indiana in 2018. Data was analyzed using descriptive and inferential statistical methods. Results 231 Indiana court employees who had registered for a state MAT educational summit completed the survey prior to the summit, including judges, probation officers, law enforcement personnel, attorneys, probation officers, program directors, counselors, and case managers. Overall, participants had significantly more positive attitudes towards extended-release naltrexone than towards other medications ( p value <0.01). Court employee average attitudes towards methadone were significantly more negative than average attitudes towards oral buprenorphine; and average attitudes towards oral buprenorphine were significantly more negative than average attitudes towards extended-release naltrexone ( p value <0.01). Employment as a prosecutor or law enforcement officer was associated with more negative attitudes towards oral buprenorphine and methadone ( p value <0.05). Exposure to previous MAT training was associated with more positive attitudes for all medications ( p value <0.05). Compared to participants with graduate degrees, participants with less education had significantly more negative attitudes towards extended-release naltrexone ( p < 0.05). Gender, age, rurality, and personal/family recovery history were not associated with differences in attitudes. Conclusion As expected, court employees' attitudes significantly differ by medication, with average attitudes towards agonist medications being more negative than attitudes towards extended-release naltrexone. Despite a larger evidence base for the efficacy of methadone and oral buprenorphine, justice personnel may have more positive attitudes towards extended-release naltrexone due to targeted marketing by the pharmaceutical manufacturer, fears about diversion or misuse of agonist medications, and historic criminal justice hostility towards agonist medications. Importantly, previous education/training regarding MAT is associated with more positive attitudes, suggesting that more awareness-raising or capacity building educational interventions are needed, especially for prosecutors and law enforcement personnel.
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    Treating Opioid Use Disorders in Drug Court: Participants’ Views on Using Medication-Assisted Treatments (MATs) to Support Recovery
    (Sage, 2019-09) Gallagher, John R.; Wahler, Elizabeth A.; Minasian, Raychel M.; Edwards, Abigail; School of Social Work
    Drug courts began in 1989 in Miami-Dade County, FL. Due to their success in treating substance use disorders and reducing criminal recidivism, they have expanded globally and are currently operating in countries such as Australia, Canada, and Scotland, to name a few. Drug courts can be a key intervention in addressing the opioid epidemic. This is the first known qualitative study to ask drug court participants (n = 38) who have opioid use disorders questions related to their lived experiences in drug court, as well as direct questions related to the use of medication-assisted treatments (MATs) in drug court. Overall, drug court participants felt that MATs were helpful for treating their opioid use disorders; however, some participants reported using other drugs while on MATs and they viewed their recovery through a harm reduction lens. Additionally, participants emphasized the importance of using MATs in combination with counseling that used cognitive and behavioral therapies. Implications for drug court practice and future research are discussed.