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Article ; Online: Feasibility and Acceptability of Digital Behavioral Interventions Among Black and Hispanic Patients With Inflammatory Bowel Disease: A Randomized Pilot Study.

Greywoode, Ruby / Nahvi, Shadi / Ullman, Thomas / Keefer, Laurie

2024

Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1340971-2
ISSN	1536-4844 ; 1078-0998
ISSN (online)	1536-4844
ISSN	1078-0998
DOI	10.1093/ibd/izae034
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Zs.A 4530: Show issues

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Article ; Online: Off-White: decentring Whiteness in tobacco science.

Lee, Juliet P / Maddox, Raglan / Kennedy, Michelle / Nahvi, Shadi / Guy, Mignonne C

Tobacco control

2023 Volume 32, Issue 5, Page(s) 537–539

MeSH term(s)	Humans ; Racial Groups
Language	English
Publishing date	2023-08-17
Publishing country	England
Document type	Editorial ; Research Support, N.I.H., Extramural
ZDB-ID	1146554-2
ISSN	1468-3318 ; 0964-4563
ISSN (online)	1468-3318
ISSN	0964-4563
DOI	10.1136/tc-2023-057998
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Zs.A 3651: Show issues

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Article ; Online: The Impact of Cigarette Relighting on Nicotine Dependence and Smoking Cessation Treatment Outcome Measures Among Adults With Mood Disorders.

Minami, Haruka / Selva Kumar, Danusha / Nahvi, Shadi

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

2022 Volume 24, Issue 8, Page(s) 1310–1314

Abstract: Introduction: The number of cigarettes smoked per day (CPD) is a component of commonly used nicotine dependence measures and often used as a smoking cessation treatment outcome. Yet relighting (ie, smoking used cigarette butts) is not usually considered ...

Abstract	Introduction: The number of cigarettes smoked per day (CPD) is a component of commonly used nicotine dependence measures and often used as a smoking cessation treatment outcome. Yet relighting (ie, smoking used cigarette butts) is not usually considered when CPD is assessed, which may underestimate nicotine dependence and result in an inaccurate picture of smoking behaviors. Aims and methods: Data from a randomized controlled trial of a smoking cessation intervention were used. Fagerström Test for Cigarette Dependence (FTCD), CPD, and the frequency of smoking (number of smoking episodes/day) assessed at baseline and 3-month follow-up were used. Results: Participants were 49 adults with mood disorders who smoke daily receiving outpatient psychiatric treatment. At baseline, 27 (55.1%) participants reported relighting cigarettes, and 6 (27.3%) of those who did not report relighting at baseline reported relighting at 3-month follow-up. Replacing CPD with the frequency of smoking to recalculate the total FTCD score increased the score for 21 participants (43%). The mean FTCD scores increased from 4.61 to 5.16, from a classification of low to medium dependence, and 16 participants (33%) moved up in the dependence classification. Of the 31 participants who reported a >=50% reduction in CPD at 3-month follow-up, 5 (16%) did not achieve the outcome of >=50% reduction in the frequency of smoking per day. Conclusions: In this sample of adults with mood disorders who smoke, over half reported relighting cigarettes. Results underscore the importance of incorporating the frequency of smoking/relighting when assessing nicotine dependence and patterns of smoking behaviors in high-risk populations. Implications: This is the first study to investigate the patterns of relighting behavior and its impact on nicotine dependence and smoking cessation treatment outcome measures among treatment-seeking adults with mood disorders who smoke. The majority were relighting, and over a quarter of those who did not report relighting at baseline subsequently reported relighting in the context of a quit attempt. The findings demonstrate that overlooking relighting may underestimate nicotine dependence and overestimate the rates of those who have made meaningful changes in smoking behavior. Incorporating the frequency of smoking/relighting may help to more accurately capture nicotine dependence and patterns of smoking behavior among high-risk populations.
MeSH term(s)	Adult ; Humans ; Mood Disorders/therapy ; Nicotine ; Smoking Cessation/methods ; Nicotiana ; Tobacco Products ; Tobacco Use Disorder/psychology ; Tobacco Use Disorder/therapy ; Treatment Outcome
Chemical Substances	Nicotine (6M3C89ZY6R)
Language	English
Publishing date	2022-05-19
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	1452315-2
ISSN	1469-994X ; 1462-2203
ISSN (online)	1469-994X
ISSN	1462-2203
DOI	10.1093/ntr/ntac061
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Zs.A 5789: Show issues

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Article ; Online: Adapting methadone inductions to the fentanyl era.

Buresh, Megan / Nahvi, Shadi / Steiger, Scott / Weinstein, Zoe M

Journal of substance abuse treatment

2022 Volume 141, Page(s) 108832

Abstract: Since 2013, fentanyl and fentanyl analogs, which are significantly more potent than heroin, have been increasingly prevalent in the opioid drug supply. A need exists to adapt methadone dosing from opioid treatment programs (OTPs) in this era. Current ... ...

Abstract	Since 2013, fentanyl and fentanyl analogs, which are significantly more potent than heroin, have been increasingly prevalent in the opioid drug supply. A need exists to adapt methadone dosing from opioid treatment programs (OTPs) in this era. Current methadone protocols at many clinics in the United States are based on expert consensus documents that were created prior to the introduction of fentanyl into the drug supply and are relatively conservative. To date, most OTP reform efforts have focused on relaxation of regulations for take-homes and have not addressed the need to adapt methadone induction schedules to be more rapid in the fentanyl era, as allowed by current regulations. Written by OTP and inpatient consult service addiction medicine physicians with expertise in OUD treatment from across the United States, the aims of the perspective piece are to: 1) highlight the need to improve OTP care by adapting methadone inductions to the fentanyl era, 2) cite emerging evidence for and examples of experiences of OTPs using more aggressive methadone inductions, and 3) call for research and updated guidelines on safety and best practices for methadone induction.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Fentanyl ; Heroin ; Humans ; Methadone/therapeutic use ; Opiate Substitution Treatment/methods ; Opioid-Related Disorders/drug therapy ; United States
Chemical Substances	Analgesics, Opioid ; Heroin (70D95007SX) ; Methadone (UC6VBE7V1Z) ; Fentanyl (UF599785JZ)
Language	English
Publishing date	2022-06-27
Publishing country	United States
Document type	Letter
ZDB-ID	605923-5
ISSN	1873-6483 ; 0740-5472
ISSN (online)	1873-6483
ISSN	0740-5472
DOI	10.1016/j.jsat.2022.108832
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Zs.A 2017: Show issues

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Article ; Online: Missed opportunities to test the neuropsychiatric safety--and efficacy--of varenicline among smokers with substance use disorders.

Nahvi, Shadi / Arnsten, Julia H

Drug and alcohol dependence

2018 Volume 185, Page(s) 245–247

Language	English
Publishing date	2018-02-22
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	519918-9
ISSN	1879-0046 ; 0376-8716
ISSN (online)	1879-0046
ISSN	0376-8716
DOI	10.1016/j.drugalcdep.2018.02.001
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Zs.A 1310: Show issues

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Article ; Online: Achieving Smoking Cessation Among Persons with Opioid Use Disorder.

Vlad, Cynthia / Arnsten, Julia H / Nahvi, Shadi

CNS drugs

2020 Volume 34, Issue 4, Page(s) 367–387

Abstract: While prevalence of tobacco use in the US general population is declining, prevalence among those with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco ... ...

Abstract	While prevalence of tobacco use in the US general population is declining, prevalence among those with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco cessation rates are negligible without treatment. However, both low-intensity behavioral interventions and more intensive motivational interventions yield negligible cessation rates. While contingency management has potent short-term cessation effects, effects are not maintained at post-intervention follow-up. Evidence-based smoking cessation pharmacotherapies, such as nicotine replacement therapy, bupropion, and varenicline, result in very modest cessation rates among smokers with OUD. Intensification of pharmacotherapy, such as high-dose and combination nicotine replacement therapy or extended medication treatment, has failed to improve cessation outcomes compared with standard treatment regimens. Targeting the unique challenges faced by smokers with OUD, including nicotine-opioid interactions and poor medication adherence, has potential to improve cessation outcomes, but further research is needed to optimize intervention efficacy among smokers with OUD.
MeSH term(s)	Animals ; Humans ; Opioid-Related Disorders/physiopathology ; Smoking/adverse effects ; Smoking Cessation ; Tobacco Use Cessation Devices
Language	English
Publishing date	2020-02-27
Publishing country	New Zealand
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1203800-3
ISSN	1179-1934 ; 1172-7047
ISSN (online)	1179-1934
ISSN	1172-7047
DOI	10.1007/s40263-020-00701-z
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Zs.A 4083: Show issues

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Article ; Online: Hospital-based clinicians lack knowledge and comfort in initiating medications for opioid use disorder: opportunities for training innovation.

Jakubowski, Andrea / Singh-Tan, Sumeet / Torres-Lockhart, Kristine / Nahvi, Shadi / Stein, Melissa / Fox, Aaron D / Lu, Tiffany

Addiction science & clinical practice

2023 Volume 18, Issue 1, Page(s) 31

Abstract: Background: Hospital-based clinicians infrequently initiate medications for opioid use disorder (MOUD) for hospitalized patients. Our objective was to understand hospital-based clinicians' knowledge, comfort, attitudes, and motivations regarding MOUD ... ...

Abstract	Background: Hospital-based clinicians infrequently initiate medications for opioid use disorder (MOUD) for hospitalized patients. Our objective was to understand hospital-based clinicians' knowledge, comfort, attitudes, and motivations regarding MOUD initiation to target quality improvement initiatives. Methods: General medicine attending physicians and physician assistants at an academic medical center completed questionnaires eliciting barriers to MOUD initiation, including knowledge, comfort, attitudes and motivations regarding MOUD. We explored whether clinicians who had initiated MOUD in the prior 12 months differed in knowledge, comfort, attitudes, and motivations from those who had not. Results: One-hundred forty-three clinicians completed the survey with 55% reporting having initiated MOUD for a hospitalized patient during the prior 12 months. Common barriers to MOUD initiation were: (1) Not enough experience (86%); (2) Not enough training (82%); (3) Need for more addiction specialist support (76%). Overall, knowledge of and comfort with MOUD was low, but motivation to address OUD was high. Compared to MOUD non-initiators, a greater proportion of MOUD initiators answered knowledge questions correctly, agreed or strongly agreed that they wanted to treat OUD (86% vs. 68%, p = 0.009), and agreed or strongly agreed that treatment of OUD with medication was more effective than without medication (90% vs. 75%, p = 0.022). Conclusions: Hospital-based clinicians had favorable attitudes toward MOUD and are motivated to initiate MOUD, but they lacked knowledge of and comfort with MOUD initiation. To increase MOUD initiation for hospitalized patients, clinicians will need additional training and specialist support.
MeSH term(s)	Humans ; Academic Medical Centers ; Behavior, Addictive ; Hospitals ; Motivation ; Opioid-Related Disorders/drug therapy ; Buprenorphine/therapeutic use
Chemical Substances	Buprenorphine (40D3SCR4GZ)
Language	English
Publishing date	2023-05-18
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2492632-2
ISSN	1940-0640 ; 1940-0640
ISSN (online)	1940-0640
ISSN	1940-0640
DOI	10.1186/s13722-023-00386-x
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Article ; Online: Loss, liberation, and agency: Patient experiences of methadone treatment at opioid treatment programs during the COVID-19 pandemic.

López-Castro, Teresa / Jakubowski, Andrea / Masyukova, Mariya / Peterson, Meghan / Pierz, Amanda / Kodali, Sruthi / Arnsten, Julia H / Starrels, Joanna L / Nahvi, Shadi

Journal of substance use and addiction treatment

2023 Volume 157, Page(s) 209235

Abstract: Background: Despite its safety and effectiveness, methadone treatment for opioid use disorder (OUD) remains highly stigmatized, and stringent opioid treatment program (OTP) attendance requirements create barriers to retention for many patients. The ... ...

Abstract	Background: Despite its safety and effectiveness, methadone treatment for opioid use disorder (OUD) remains highly stigmatized, and stringent opioid treatment program (OTP) attendance requirements create barriers to retention for many patients. The COVID-19 pandemic prompted a shift in federal regulations governing methadone, including a blanket exemption permitting increased take-home doses of methadone. We studied the impact of these changes upon established patients' experiences of OTP care. Method: We conducted semi-structured qualitative interviews with 18 OTP patients who met our criteria of having established OTP care (i.e., enrolled at the OTP for at least 12 weeks) and were administered methadone three to six days weekly prior to the March 2020 blanket exemption. Interviews centered on how COVID-19 had affected their experiences of receiving treatment at an OTP. Results: We identified three interconnected themes relevant to transformation of OTP care by the COVID-19 pandemic. Participants described mourning therapeutic OTP relationships and structure (1. loss), yet feeling more satisfaction with fewer in-person OTP visits (2. liberation), and appreciating more opportunities to self-direct their OUD care (3. agency). Discussion: Structural changes made to OTP care early in the COVID-19 pandemic resulted in loss of community and structure. Increasing the availability of take-home methadone also improved patient experience and sense of agency. Our findings join a diverse body of converging evidence in support of policy changes allowing for more flexible dosing and individualized OTP care.
MeSH term(s)	Humans ; Analgesics, Opioid/therapeutic use ; Opiate Substitution Treatment/methods ; Pandemics ; COVID-19 ; Methadone/therapeutic use ; Opioid-Related Disorders/drug therapy ; Patient Outcome Assessment
Chemical Substances	Analgesics, Opioid ; Methadone (UC6VBE7V1Z)
Language	English
Publishing date	2023-12-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2023.209235
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Article ; Online: More intensive hepatitis C virus care models promote adherence among people who inject drugs with active drug use: The PREVAIL study.

Heo, Moonseong / Pericot-Valverde, Irene / Niu, Jiajing / Norton, Brianna L / Akiyama, Matthew J / Nahvi, Shadi / Arnsten, Julia H / Litwin, Alain H

Journal of viral hepatitis

2022 Volume 30, Issue 2, Page(s) 172–175

MeSH term(s)	Humans ; Hepacivirus ; Drug Users ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Antiviral Agents/therapeutic use ; Substance-Related Disorders ; Substance Abuse, Intravenous/complications ; Substance Abuse, Intravenous/drug therapy ; Hepatitis C, Chronic/drug therapy
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2022-10-12
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1212497-7
ISSN	1365-2893 ; 1352-0504
ISSN (online)	1365-2893
ISSN	1352-0504
DOI	10.1111/jvh.13756
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Zs.A 4119: Show issues

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Article ; Online: The impact of menthol cigarette use on quit attempts and abstinence among smokers with opioid use disorder.

Selva Kumar, Danusha / Peterson, Meghan / Zhang, Chenshu / Fagan, Pebbles / Nahvi, Shadi

Addictive behaviors

2021 Volume 118, Page(s) 106880

Abstract: An exceedingly high proportion of persons with opioid use disorder (OUD) smoke cigarettes. Smokers with OUD face multiple barriers to smoking cessation. While menthol cigarette use has been associated with low cessation rates, research has not explored ... ...

Abstract	An exceedingly high proportion of persons with opioid use disorder (OUD) smoke cigarettes. Smokers with OUD face multiple barriers to smoking cessation. While menthol cigarette use has been associated with low cessation rates, research has not explored the impact of menthol cigarette use on tobacco use outcomes among smokers with OUD. Participants were current smokers, in methadone treatment for OUD, participating in randomized controlled trials of smoking cessation therapies. We examined the use of menthol cigarettes, and the association between menthol cigarette use and achieving 24-hour quit attempts and seven-day point prevalence abstinence. Of 268 participants, 237 (88.4%) reported menthol use. A similar proportion of menthol and non-menthol smokers achieved a 24-hour quit attempt (83.1% vs. 83.8%, p = 0.92). Though fewer menthol smokers (vs. non-menthol smokers) achieved abstinence (12.7% vs. 22.6%), this did not reach statistical significance (p = 0.14). In this sample of smokers with OUD, menthol smoking was nearly ubiquitous. Menthol smoking was not associated with differences in quit attempts, but was associated with differences in cessation that were not statistically significant. Menthol smoking may contribute to the challenges in achieving abstinence among smokers with OUD.
MeSH term(s)	Humans ; Menthol/therapeutic use ; Opioid-Related Disorders ; Smokers ; Smoking Cessation ; Tobacco Products
Chemical Substances	Menthol (1490-04-6)
Language	English
Publishing date	2021-02-23
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	197618-7
ISSN	1873-6327 ; 0306-4603
ISSN (online)	1873-6327
ISSN	0306-4603
DOI	10.1016/j.addbeh.2021.106880
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