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Book: Harm Reduction Treatment for Substance Use

Collins, Susan E. / Clifasefi, Seema L.

(Advances in Psychotherapy - Evidence-Based Practice ; 49)

2023

Series title	Advances in Psychotherapy - Evidence-Based Practice ; 49
Keywords	Addiction ; Harm reduction approaches ; drug use ; evidence-based therapy
Language	English
Size	116 p.
Edition	1
Publisher	Hogrefe Publishing
Document type	Book
Note	PDA Manuell_23
Format	176 x 250 x 11
ISBN	9780889375079 ; 0889375070
Database	PDA

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Article ; Online: Impact of Harm Reduction Treatment with or without Pharmacotherapy on Polysubstance Use among People Experiencing Homelessness and Alcohol Use Disorder.

Mostofi, Nicole / Collins, Susan E

Journal of addiction medicine

2023 Volume 17, Issue 5, Page(s) 574–579

Abstract: Objectives: A prior randomized controlled trial showed behavioral harm reduction treatment for alcohol use disorder (AUD), or HaRT-A, was effective in improving alcohol outcomes and quality of life for people experiencing homelessness and AUD when ... ...

Abstract	Objectives: A prior randomized controlled trial showed behavioral harm reduction treatment for alcohol use disorder (AUD), or HaRT-A, was effective in improving alcohol outcomes and quality of life for people experiencing homelessness and AUD when provided with or without pharmacotherapy (ie, extended-release naltrexone). Because nearly 80% of the sample also reported baseline polysubstance use, this secondary study tested whether HaRT-A also positively impacted other substance use. Methods: In the parent study, 308 adults with AUD and homelessness were randomized to receive HaRT-A plus intramuscular injections of 380-mg extended-release naltrexone (HaRT-A + extended-release naltrexone), HaRT-A plus placebo (HaRT-A + placebo), HaRT-A alone, or community-based services as usual (control). In this secondary study, we used random intercept models to detect changes in other substance use after exposure to any of the HaRT-A conditions. For less prevalent behaviors, outcomes included past-month use (cocaine, amphetamines/methamphetamines, opioids). For more prevalent behaviors (polysubstance, cannabis), outcomes were past-month use frequency. Results: Compared with controls, participants who received HaRT-A showed significantly reduced 30-day frequency of cannabis use (incident rate ratio = 0.59, 95% CI = 0.40-0.86, P = 0.006) and polysubstance use (incident rate ratio = 0.65, 95% CI = 0.43-0.98, P = 0.040). No other significant changes were detected. Conclusions: Compared with services as usual, HaRT-A is associated with reduced cannabis and polysubstance use frequency. The benefits of HaRT-A may thus extend beyond its impact on alcohol and quality of life outcomes to positively reshape overall substance use patterns. A randomized controlled trial is needed to further investigate the efficacy of such combined pharmacobehavioral harm reduction treatment for polysubstance use.
MeSH term(s)	Adult ; Humans ; Alcoholism/drug therapy ; Alcoholism/epidemiology ; Harm Reduction ; Naltrexone/therapeutic use ; Quality of Life ; Ill-Housed Persons ; Substance-Related Disorders/therapy
Chemical Substances	Naltrexone (5S6W795CQM)
Language	English
Publishing date	2023-05-30
Publishing country	Netherlands
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ISSN	1935-3227
ISSN (online)	1935-3227
DOI	10.1097/ADM.0000000000001182
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Commentary: Similarities and Differences Between Harm-Reduction and Substitute Addiction-- Implications for the Health Professions.

Sussman, Steve / Sinclair, Deborah L / Clifasefi, Seema L / Collins, Susan E

Evaluation & the health professions

2024 Volume 47, Issue 1, Page(s) 75–80

Abstract: Substitute addiction" refers to the process of achieving abstinence or resolution of one addictive behavior and subsequently engaging in one or more additional addictive behaviors in its place. Substitute addiction, a concept in the abstinence-based ... ...

Abstract	"Substitute addiction" refers to the process of achieving abstinence or resolution of one addictive behavior and subsequently engaging in one or more additional addictive behaviors in its place. Substitute addiction, a concept in the abstinence-based recovery field for decades, is viewed as a cause for concern because resolving one addictive behavior might not fully remove harm or ensure recovery. Conversely, "harm-reduction treatment" refers to a counseling orientation that focuses on helping service users reduce substance-related harm and improve their quality of life without necessarily requiring abstinence or use reduction. Harm-reduction treatment assesses a constellation of addictive behaviors in the larger context of a person's life to holistically reduce harm in that constellation. In this commentary, we define and compare both constructs and point out their implications for addictions treatment.
MeSH term(s)	Humans ; Quality of Life ; Behavior, Addictive/therapy ; Health Occupations ; Substance-Related Disorders/therapy ; Substance-Related Disorders/psychology
Language	English
Publishing date	2024-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	603792-6
ISSN	1552-3918 ; 0163-2787
ISSN (online)	1552-3918
ISSN	0163-2787
DOI	10.1177/01632787241227225
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Article ; Online: A systematic meta-epidemiologic review on nonabstinence-inclusive interventions for substance use: inclusion of race/ethnicity and sex assigned at birth/gender.

Goldstein, Silvi C / Newberger, Noam G / Schick, Melissa R / Ferguson, Jewelia J / Collins, Susan E / Haeny, Angela M / Weiss, Nicole H

The American journal of drug and alcohol abuse

2024 , Page(s) 1–15

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	193086-2
ISSN	1097-9891 ; 0095-2990
ISSN (online)	1097-9891
ISSN	0095-2990
DOI	10.1080/00952990.2024.2308087
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Article ; Online: A command centre implementation before and during the COVID-19 pandemic in a community hospital.

Grosman-Rimon, Liza / Wegier, Pete / Rodriguez, Ruben / Casey, Jane / Tory, Susan / Solanki, Jhanvi / Collins, Barbara E

BMC medical informatics and decision making

2024 Volume 24, Issue 1, Page(s) 14

Abstract: Introduction: The objective of the study was to assess the effects of high-reliability system by implementing a command centre (CC) on clinical outcomes in a community hospital before and during COVID-19 pandemic from the year 2016 to 2021.: Methods: ...

Abstract	Introduction: The objective of the study was to assess the effects of high-reliability system by implementing a command centre (CC) on clinical outcomes in a community hospital before and during COVID-19 pandemic from the year 2016 to 2021. Methods: A descriptive, retrospective study was conducted at an acute care community hospital. The administrative data included monthly average admissions, intensive care unit (ICU) admissions, average length of stay, total ICU length of stay, and in-hospital mortality. In-hospital acquired events were recorded and defined as one of the following: cardiac arrest, cerebral infarction, respiratory arrest, or sepsis after hospital admissions. A subgroup statistical analysis of patients with in-hospital acquired events was performed. In addition, a subgroup statistical analysis was performed for the department of medicine. Results: The rates of in-hospital acquired events and in-hospital mortality among all admitted patients did not change significantly throughout the years 2016 to 2021. In the subgroup of patients with in-hospital acquired events, the in-hospital mortality rate also did not change during the years of the study, despite the increase in the ICU admissions during the COVID-19 pandemic.Although the in-hospital mortality rate did not increase for all admitted patients, the in-hospital mortality rate increased in the department of medicine. Conclusion: Implementation of CC and centralized management systems has the potential to improve quality of care by supporting early identification and real-time management of patients at risk of harm and clinical deterioration, including COVID-19 patients.
MeSH term(s)	Humans ; Hospitals, Community ; COVID-19/epidemiology ; Pandemics ; Reproducibility of Results ; Retrospective Studies
Language	English
Publishing date	2024-01-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2046490-3
ISSN	1472-6947 ; 1472-6947
ISSN (online)	1472-6947
ISSN	1472-6947
DOI	10.1186/s12911-023-02394-y
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Article: Associations Between Socioeconomic Factors and Alcohol Outcomes.

Collins, Susan E

Alcohol research : current reviews

2016 Volume 38, Issue 1, Page(s) 83–94

Abstract: Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, ... ...

Abstract	Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. These associations are further complicated by a variety of moderating factors, such as race, ethnicity, and gender. Thus, among individuals with lower SES, members of further marginalized communities, such as racial and ethnic minorities and homeless individuals, experience greater alcohol-related consequences. Future studies are needed to more fully explore the underlying mechanisms of the relationship between SES and alcohol outcomes. This knowledge should be applied toward the development of multilevel interventions that address not only individual-level risks but also economic disparities that have precipitated and maintained a disproportionate level of alcohol-related consequences among more marginalized and vulnerable populations.
MeSH term(s)	Alcohol Drinking/epidemiology ; Alcoholism/epidemiology ; Educational Status ; Employment/statistics & numerical data ; Ethnic Groups/statistics & numerical data ; Homeless Persons/statistics & numerical data ; Housing/statistics & numerical data ; Humans ; Income/statistics & numerical data ; Minority Groups/statistics & numerical data ; Poverty/statistics & numerical data ; Risk Factors ; Social Class ; Socioeconomic Factors ; Unemployment/statistics & numerical data ; United States
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ISSN	2168-3492
ISSN	2168-3492
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A command centre implementation before and during the COVID-19 pandemic in a community hospital

Liza Grosman-Rimon / Pete Wegier / Ruben Rodriguez / Jane Casey / Susan Tory / Jhanvi Solanki / Barbara E. Collins

BMC Medical Informatics and Decision Making, Vol 24, Iss 1, Pp 1-

2024 Volume 10

Abstract: Abstract Introduction The objective of the study was to assess the effects of high-reliability system by implementing a command centre (CC) on clinical outcomes in a community hospital before and during COVID-19 pandemic from the year 2016 to 2021. ... ...

Abstract	Abstract Introduction The objective of the study was to assess the effects of high-reliability system by implementing a command centre (CC) on clinical outcomes in a community hospital before and during COVID-19 pandemic from the year 2016 to 2021. Methods A descriptive, retrospective study was conducted at an acute care community hospital. The administrative data included monthly average admissions, intensive care unit (ICU) admissions, average length of stay, total ICU length of stay, and in-hospital mortality. In-hospital acquired events were recorded and defined as one of the following: cardiac arrest, cerebral infarction, respiratory arrest, or sepsis after hospital admissions. A subgroup statistical analysis of patients with in-hospital acquired events was performed. In addition, a subgroup statistical analysis was performed for the department of medicine. Results The rates of in-hospital acquired events and in-hospital mortality among all admitted patients did not change significantly throughout the years 2016 to 2021. In the subgroup of patients with in-hospital acquired events, the in-hospital mortality rate also did not change during the years of the study, despite the increase in the ICU admissions during the COVID-19 pandemic.Although the in-hospital mortality rate did not increase for all admitted patients, the in-hospital mortality rate increased in the department of medicine. Conclusion Implementation of CC and centralized management systems has the potential to improve quality of care by supporting early identification and real-time management of patients at risk of harm and clinical deterioration, including COVID-19 patients.
Keywords	Command Centre ; COVID-19 Pandemic ; Community Hospital ; In-Hospital Acquired Events ; In-Hospital Mortality ; Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	360
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The life-enhancing alcohol-management program: Results from a 6-month nonrandomized controlled pilot study assessing a community based participatory research program in housing first.

Clifasefi, Seema L / Collins, Susan E

Journal of community psychology

2019 Volume 48, Issue 3, Page(s) 763–776

Abstract: ... effectiveness of the Life Enhancing Alcohol-management Program (LEAP) as an adjunct to Housing First (HF; e.g ...

Abstract	A 2-arm, 6-month, nonrandomized controlled pilot trial was conducted to test the initial effectiveness of the Life Enhancing Alcohol-management Program (LEAP) as an adjunct to Housing First (HF; e.g., permanent supportive housing) on alcohol and quality-of-life (QoL) outcomes. The LEAP entails resident-driven leadership opportunities, meaningful activities, and pathways to recovery aimed at reducing alcohol-related harm and improving QoL. Data analyses were conducted to test between- and within-subjects effects of the LEAP on self-reported alcohol and QoL outcomes among HF residents. At the 6-month follow up, between groups analysis revealed nonsignificant findings for alcohol quantity or alcohol-related harm (ps > 0.06); however, LEAP participants reported significantly more engagement in meaningful activities than control participants (p < .001), and within-subjects analyses indicated that high levels of LEAP programming engagement predicted significant reductions in alcohol quantity and alcohol-related harm (ps < 0.01). The LEAP was associated with increased engagement in meaningful activities, and greater involvement in the LEAP programming was associated with reduced alcohol use and alcohol-related harm. Planning is underway for a future, large-scale randomized controlled trial to establish the efficacy of this approach, its generalizability across HF programs, and potential mechanisms of action.
MeSH term(s)	Adult ; Alcoholism/therapy ; Community-Based Participatory Research ; Female ; Harm Reduction ; Housing/organization & administration ; Humans ; Male ; Middle Aged ; Non-Randomized Controlled Trials as Topic ; Pilot Projects ; Quality of Life ; Substance Abuse Treatment Centers/organization & administration
Language	English
Publishing date	2019-11-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1491194-2
ISSN	1520-6629 ; 0090-4392
ISSN (online)	1520-6629
ISSN	0090-4392
DOI	10.1002/jcop.22291
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Article: Micronutrients and respiratory infections: the biological rationale and current state of clinical evaluation.

Rowe, Sam / Collins, Patrick D / Stacey, Susan E / Carr, Anitra C

British journal of hospital medicine (London, England : 2005)

2021 Volume 82, Issue 4, Page(s) 1–8

Abstract: ... of vitamin A, the B vitamins, vitamin C, vitamin D, eicosapentaenoic acid, vitamin E, selenium, zinc and ...

Abstract	A range of nutrients has been studied or proposed for use in preventing respiratory tract infections and reducing their severity. This article gives a narrative review of the existing literature, biological rationales and current state of clinical evaluation for micronutrient therapies. The importance of vitamin A, the B vitamins, vitamin C, vitamin D, eicosapentaenoic acid, vitamin E, selenium, zinc and a range of combination therapies are discussed, looking at their effects on reducing rates of infection, reducing severity of infection and improved recovery from infection. Further discussion regarding the level of evidence required for nutritional interventions is included.
Language	English
Publishing date	2021-04-27
Publishing country	England
Document type	Journal Article
ISSN	1750-8460
ISSN	1750-8460
DOI	10.12968/hmed.2020.0730
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Article ; Online: Content Analysis of Health Concerns among Housing First Residents with a History of Alcohol Use Disorder.

Mackelprang, Jessica L / Clifasefi, Seema L / Grazioli, Ronique S / Collins, Susan E

Journal of health care for the poor and underserved

2021 Volume 32, Issue 1, Page(s) 463–486

Abstract: Previous research has utilized survey and administrative data to document health problems among Housing First (HF) residents; however, little is known about residents' personal perspectives on their health. The purpose of this study was to utilize ... ...

Abstract	Previous research has utilized survey and administrative data to document health problems among Housing First (HF) residents; however, little is known about residents' personal perspectives on their health. The purpose of this study was to utilize conventional content analysis to analyze health-related concerns among HF residents with histories of alcohol use disorder. Between June and December 2013, we interviewed 44 adults who had histories of chronic homelessness and alcohol use disorder and were residing in single-site HF in Seattle, Washington. Responses centered on five primary topics: alcohol-related harm, perceived health vulnerability, concern for fellow residents' health, end of life, and health and safety promotion. HF residents experience complex alcohol-exacerbated health difficulties and existing health services may not meet the needs of those whose health is particularly compromised. Considering that HF facilitates aging in place, end-of-life care and grief counseling should be integrated into HF services.
MeSH term(s)	Adult ; Aged ; Alcoholism/epidemiology ; Ill-Housed Persons ; Housing ; Humans ; Independent Living ; Social Problems
Language	English
Publishing date	2021-10-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1142637-8
ISSN	1548-6869 ; 1049-2089
ISSN (online)	1548-6869
ISSN	1049-2089
DOI	10.1353/hpu.2021.0035
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