Browsing by Subject "substance use disorder"
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Item Compassion Fatigue in Staff at LGBTQ+ Substance Use Recovery Center(2023-05-01) Nickel, Allison; Van Antwerp, Leah; Department of Occupational Therapy, School of Health and Human Sciences; Connaughty, ToddIndividuals working in recovery from substance use disorders (SUD) have a high risk for developing compassion fatigue (CF) due to high job demands and frequent exposure to client trauma. Pride Institute, an LGBTQ+ SUD recovery facility reported to have a high level of compassion fatigue. This was further explored with a screening measure, the Professional Quality of Life Scale (ProQOL 5), to measure levels of compassion satisfaction (CS), secondary traumatic stress (STS), and burnout in staff. Between the surveys, staff received educational resources and had the opportunity to participate in a weekly group session to practice coping strategies. The ProQOL 5 was used as an outcome measure for intervention effectiveness, along with qualitative questions about perceived helpfulness and meaningfulness of the project. A significant decrease in STS occurred between the initial and final surveys (p = .02). Findings were inconclusive on whether the improvement was due to education and weekly groups due to their being a significantly lower level of STS in non-participants compared to participants (p = .05). However, the qualitative survey responses demonstrate promise towards their effectiveness, and the higher participant level of STS may be due to interventions reaching the staff members most in need. Further research is warranted to determine best practice for long-term programs toward CF resiliency.Item Implementation of a Wellness Exploration Group for Women with Substance Use Disorder(2024-05) Mathieu, Hannah; Belkiewitz, Johnna; Department of Occupational Therapy, School of Health and Human Sciences; Young, NikoleIndividuals with substance use disorders are heavily impacted in participation and performance of their daily activities due to the neurobiology, occupational deprivation, and occupational balance barriers. In the theory of addiction as occupation, individuals with substance use disorder are more likely to relapse if their addiction is not recognized as an occupation (Wasmuth et al., 2014). When addiction is removed from their daily routines an occupational deprivation is created and must be addressed for success in recovery (Wasmuth et al., 2014). The capstone student implemented a wellness exploration group focused on meeting adult female residents at a recovery house where they were at with their recovery process. Wellness exploration groups concentrated on resident-identified leisure, social participation, and self-care activities on a weekly basis. The intent of group meetings was to improve quality of life, well-being, and occupational balance while also addressing occupational deprivation with occupational replacement of healthy lifestyle activities. Outcome data was collected through a survey composed with the PROMIS database. The survey was administered before group implementation and after group implementation in aggregate. The results of this project indicated an improvement in quality of life, well-being, and occupational balance through survey dissemination and verbal comments. This further demonstrated the important role that occupational therapy can play in treatment for substance use disorder.Item Innovations in Opioid Law and Policy Interventions Workshop: Summary of Proceedings(Indiana University, 2018-08-31) Terry, Nicolas P.; Silverman, Ross D.; Hoss, Aila; Beukema, EmilyIn 2017, Indiana University, in cooperation with Indiana Governor Eric Holcomb and community partners, launched the Grand Challenge: Responding to the Addictions Crisis initiative, a university-wide effort to advance interdisciplinary research and interventions in response to the substance abuse crisis affecting Indiana and the nation. The “Legal and Policy Best Practices in Response to the Substance Abuse Crisis” project is one of sixteen funded under Phase 1 of the Grand Challenge. In July 2018, and as part of this project, the research team convened a group of national experts to discuss legal and policy innovations to respond to the opioid use disorder (OUD) crisis. This report summarizes the proceedings of this workshop and updates some of the recommendations made by the team in their March 2018 Preliminary Report. During the workshop, experts answered targeted questions relating to the challenges in implementing law and policy recommendations to respond to the addiction crisis, as well as identified gaps in the current research. Participants provided examples of innovative interventions to respond to this crisis across four primary topic categories: (1) Criminalization; (2) Public Health; (3) Treatment; and (4) Effectuating Change.Item Intervention Development for Camp Mariposa Aaron’s Place: Increasing Functioning in Families Impacted by Substance Use Disorder(2021-05-06) Solesky, Allison; Wilburn, Victoria; Department of Occupational Therapy, School of Health and Human Sciences; Wilburn, VictoriaSubstance use disorder (SUD) has negatively impacted many children and families across the state of Indiana. Camp Mariposa Aaron’s Place was recently established in the Indianapolis community and serves children aged nine to twelve along with their families to mitigate the harmful impacts that SUD has placed in their lives. This camp offers family and group interventions to instill and equip each individual with the skills needed to navigate relationships and conflicts within the family as they arise. By giving families impacted by SUD a safe space to participate in evidence-based, occupation-driven, and trauma-informed activities, the camp will be able to promote resiliency and enhance communication within the families to increase functioning within the home.Item Long-term Prescription Opioid Utilization, Substance Use Disorders, and Opioid Overdoses after Adolescent Trauma(Wolters Kluwer, 2019-03) Bell, Teresa M.; Raymond, Jodi; Vetor, Ashley; Mongalo, Alejandro; Adams, Zachary; Rouse, Thomas; Carroll, Aaron; Surgery, School of MedicineBACKGROUND Injured adolescents have a 56% increased risk of developing a substance use disorder (SUD) within 3 years of their injury. The transition from medical prescription opioid use to nonmedical use in adolescent trauma patients has not been longitudinally studied long-term. The aim of this study is to describe 5-year patterns of opioid use in a cohort of injured adolescents as well as the proportion of patients experiencing overdose and SUD diagnoses. METHODS Our retrospective cohort study consisted of 736 patients 12-18 years old who were admitted for trauma from 2011-2013. We examined up to 5 years of regional health information exchange data containing information on prescription fills as well as diagnoses from inpatient, outpatient, and emergency department encounters. RESULTS At 1 year, over 20% of adolescents filled more than 2 opioid prescriptions after being discharged for their injury; and at 4 years, over 13% had received more than 8 opioid fills. Over the 5 year period, 11% received an opioid antagonist injection, 14% received an SUD diagnosis, and 8% had an overdose diagnosis. Relatively few patients had diagnoses for other mental health conditions including depression (5.5%), post-traumatic stress disorder (PTSD) (2.1%), and chronic pain (3.6%). CONCLUSIONS Opioid usage remains high for multiple years in a subset of the adolescent trauma population. Mental health diagnosis rates were substantially lower in injured adolescents than what has been reported in adults. However, overdose and SUD diagnoses occur in over 1 in 10 adolescents within 5 years of their injury.Item Neonatal Abstinence Syndrome Screening for Newborn Girl with Prenatal Maternal History of Substance Use Disorder(2020-03) Arnaudo, Camila; Chiu, Megan; Essex, Amanda; D'Arnaud, LindseyBackground: Neonatal Abstinence Syndrome (NAS) is a drug withdrawal syndrome of newborns with prenatal exposure to opioids and other substances. Incidence of NAS has increased significantly in the last decade and remains a current issue. Untreated NAS can lead to adverse outcomes including infant death. All newborns with known opioid exposure are screened for NAS using the Finnegan Scoring System or now more popular Eat Sleep Console (ESC) method. Treatment ranges from supportive care to pharmacological management, dependent on assessment scoring and clinical signs. Case: A 3.48kg female newborn was born at 40-week,2-day gestation from spontaneous vaginal delivery with no meconium and Apgar scores of 8 and 9. Prenatal maternal history was significant for hepatitis C, heroin use and buprenorphine (BUP) mono-product as medication assisted treatment (MAT) and maternal urine drug screen positive for BUP and benzodiazepines at delivery. The newborn’s urine drug screen was positive only for BUP. During her 4-day hospital course, she was eating and voiding well with some need for caregiver support for consoling and no need for pharmacological intervention per ESC. She was discharged home with mother and supportive extended family and has been developing well without major complications. Clinical Significance: Several barriers (social stigma, provider bias and legal policies) discourage mothers from seeking prenatal care and MAT, thus precluding NAS screening and treatment. Studies show that increased access and earlier initiation to maternal MAT improves outcomes for both mother and baby. Decreasing stigma and bias, implementing non-punitive policies and using ESC have also been shown to improve outcomes. This case provides a positive example of early initiation maternal MAT and use of ESC for a newborn with concern for NAS. We hope these cases will continue to help decrease stigma and help us advocate for non-punitive state policies regarding substance use during pregnancy.Item Promoting Family Engagement in a Community Setting for Children Impacted by the Substance Use Disorder of a Family Member(2024-05) Greenwell, Conner; Belkiewitz, Johnna; Department of Occupational Therapy, School of Health and Human Sciences; McFadden, RachelIndividuals caring for children impacted by the substance use disorder of a family member are often less able to participate in valued occupations, specifically social participation, and they lack a community in which they feel supported and understood. The capstone student collaborated with Camp Mariposa Aaron’s Place in Indianapolis, IN and Mitchell, IN, with the purpose of promoting family and peer engagement for caregivers of children who attend this program. The student identified a gap in current research on how to best support caregivers of children affected by the substance use disorder of a family member. The main component of this project was evaluation and further development of Camp Village Council, a support program for family members of children who attend Camp Mariposa Aaron’s Place. The student created an intervention binder, educational modules, and educational handouts to promote connectedness between group members and to provide caregivers with an improved ability to carry over what kids are learning at camp into the home. Another component of this project was supplemental programming of family events to promote family engagement. Overall, results suggest that groups facilitated by the student and materials created by the student had a positive impact on the Camp Village Council participants and program as a whole. Results were mixed on the impact of supplemental programming.Item Quantifying Behavioral Sensation Seeking With the Aroma Choice Task(SAGE, 2019-07-27) Oberlin, Brandon G.; Ramer, Nolan E.; Bates, Sage M.; Shen, Yitong I.; Myslinski, Jeremy S.; Kareken, David A.; Cyders, Melissa A.; Psychiatry, School of MedicineOur goal was to develop a behavioral measure of sensation seeking (SS). The Aroma Choice Task (ACT) assesses preference for an intense, novel, varied, and risky (exciting) option versus a mild, safe (boring) option using real-time odorant delivery. A total of 147 healthy young adults completed 40 binary choice trials. We examined (1) intensity and pleasantness of odorants, (2) stability of responding, (3) association with SS self-report, and (4) association with self-reported illicit drug use. Participants’ preference for the “exciting” option versus the safe option was significantly associated with self-reported SS (p < .001) and illicit drug use (p = .041). Odorant ratings comported with their intended intensity. The ACT showed good internal, convergent, and criterion validity. We propose that the ACT might permit more objective SS assessment for investigating the biological bases of psychiatric conditions marked by high SS, particularly addiction. The ACT measures SS behaviorally, mitigating some self-report challenges and enabling real-time assessment, for example, for functional magnetic resonance imaging (fMRI).Item Social Network Decay as Potential Recovery from Homelessness: A Mixed Methods Study in Housing First Programming(MDPI, 2017-09) Golembiewski, Elizabeth; Watson, Dennis P.; Robison, Lisa; Coberg, John W.; Social and Behavioral Sciences, School of Public HealthThe positive relationship between social support and mental health has been well documented, but individuals experiencing chronic homelessness face serious disruptions to their social networks. Housing First (HF) programming has been shown to improve health and stability of formerly chronically homeless individuals. However, researchers are only just starting to understand the impact HF has on residents’ individual social integration. The purpose of the current study was to describe and understand changes in social networks of residents living in a HF program. Researchers employed a longitudinal, convergent parallel mixed method design, collecting quantitative social network data through structured interviews (n = 13) and qualitative data through semi-structured interviews (n = 20). Quantitative results demonstrated a reduction in network size over the course of one year. However, increases in both network density and frequency of contact with network members increased. Qualitative interviews demonstrated a strengthening in the quality of relationships with family and housing providers and a shedding of burdensome and abusive relationships. These results suggest network decay is a possible indicator of participants’ recovery process as they discontinued negative relationships and strengthened positive ones.Item Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees(BMC, 2021) Magee, Lauren A.; Fortenberry, J. Dennis; Rosenman, Marc; Aalsma, Matthew C.; Gharbi, Sami; Wiehe, Sarah E.; School of Public and Environmental AffairsBackground Individuals with mental illness and co-occurring substance use disorders often rapidly cycle through the justice system with multiple arrests. Therefore, is it imperative to examine the prevalence of mental health and substance use diagnoses among arrestees and repeat arrestees to identify opportunities for intervention. Methods We linked police arrest and clinical care data at the individual level to conduct a retrospective cohort study of all individuals arrested in 2016 in Indianapolis, Indiana. We classified arrestees into three levels: 1 arrest, 2 arrests, or 3 or more arrests. We included data on clinical diagnoses between January 1, 2014 and December 31, 2015 and classified mental health diagnoses and substance use disorder (SUD) based on DSM categories using ICD9/10 diagnoses codes. Results Of those arrested in 2016, 18,236 (79.5%) were arrested once, 3167 (13.8%) were arrested twice, and 1536 (6.7%) were arrested three or more times. In the 2 years before the arrest, nearly one-third (31.3%) of arrestees had a mental health diagnosis, and over a quarter (27.7%) of arrestees had an SUD diagnosis. Most of those with a mental health or SUD diagnosis had both (22.5% of all arrestees). Arrestees with multiple mental health (OR 2.68, 95% CI 2.23, 3.23), SUD diagnoses (OR 1.59, 95% CI 1.38, 1,82), or co-occurring conditions (1.72, 95% CI 1.48, 2.01) in the preceding 2 years had higher odds of repeat arrest. Conclusions Our findings show that linked clinical and criminal justice data systems identify individuals at risk of repeat arrest and inform opportunities for interventions aimed at low-level offenders with behavioral health needs.