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Book: The assessment and treatment of addiction

Danovitch, Itai / Mooney, Larissa J.

best practices and new frontiers

2019

Author's details	edited by Itai Danovitch, Larissa J. Mooney
Language	English
Size	xii, 240 Seiten, Illustrationen
Publisher	Elsevier Mosby
Publishing place	St. Louis, Missouri
Publishing country	United States
Document type	Book
HBZ-ID	HT019986903
ISBN	978-0-3235-4856-4 ; 0-3235-4856-3
Database	Catalogue ZB MED Medicine, Health

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2019 A 375	available for loan (reading room)	Lesesaal EG

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Article ; Online: Medication Treatment for Opioid Use Disorder Reduces Suicide Risk.

Mooney, Larissa J

The American journal of psychiatry

2022 Volume 179, Issue 4, Page(s) 262–263

MeSH term(s)	Buprenorphine/therapeutic use ; Humans ; Opioid-Related Disorders/drug therapy ; Suicide/prevention & control
Chemical Substances	Buprenorphine (40D3SCR4GZ)
Language	English
Publishing date	2022-03-11
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	280045-7
ISSN	1535-7228 ; 0002-953X
ISSN (online)	1535-7228
ISSN	0002-953X
DOI	10.1176/appi.ajp.20220173
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Article ; Online: Medication-based treatment among rural, primary care patients diagnosed with opioid use disorder and alcohol use disorder.

Kan, Emily / Baldwin, Laura-Mae / Mooney, Larissa J / Saxon, Andrew J / Zhu, Yuhui / Hser, Yih-Ing

Journal of substance use and addiction treatment

2024 , Page(s) 209339

Abstract: Introduction: Opioid and alcohol use disorders are increasingly being addressed in primary care, yet how medications to treat these disorders are prescribed in rural regions is unknown.: Methods: We determined prevalence, types, and duration of ... ...

Abstract	Introduction: Opioid and alcohol use disorders are increasingly being addressed in primary care, yet how medications to treat these disorders are prescribed in rural regions is unknown. Methods: We determined prevalence, types, and duration of medication prescription for opioid and/or alcohol use disorder among adult patients in rural primary clinics. The sample included 1874 adult patients who visited one of six rural primary care sites in the Northeastern and Northwestern United States at least once from October 2019 to January 2021 and had a diagnosis code for opioid use disorder (OUD), alcohol use disorder (AUD), or co-occurring opioid and alcohol use disorder (OUD + AUD) during that time. Results: Patients with OUD + AUD were more likely to be prescribed medication for at least one of these disorders (85.3 %) than patients with OUD only (63.7 %) or AUD only (10.3 %). Further, the OUD + AUD group had the highest number of days on medication (M = 264.7), followed by OUD only (M = 220.5), then the AUD only group (M = 62.5). Only 8.8 % of patients with OUD + AUD were prescribed naltrexone or medication for OUD + AUD to treat both substance use disorders. Conclusions: Medications for treating AUD as well as OUD are available, but few patients with OUD + AUD and even fewer with AUD received pharmacological treatment for AUD. The current work highlights the need for rural clinicians to consider medications for AUD as an important treatment method for patients with AUD only or OUD + AUD.
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Journal Article
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2024.209339
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Article ; Online: Integrating Telemedicine for Medication Treatment for Opioid Use Disorder in Rural Primary Care: Beyond the COVID Pandemic.

Hser, Yih-Ing / Mooney, Larissa J

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

2020 Volume 37, Issue 1, Page(s) 246–248

MeSH term(s)	COVID-19/epidemiology ; Humans ; Medication Therapy Management/organization & administration ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/epidemiology ; Pandemics ; Primary Health Care/organization & administration ; Rural Health Services/organization & administration ; SARS-CoV-2 ; Telemedicine/organization & administration ; United States/epidemiology ; Videoconferencing/organization & administration
Keywords	covid19
Language	English
Publishing date	2020-07-02
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639160-6
ISSN	1748-0361 ; 0890-765X
ISSN (online)	1748-0361
ISSN	0890-765X
DOI	10.1111/jrh.12489
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Article ; Online: Referral of patients from rural primary care clinics to telemedicine vendors for opioid use disorder treatment: A mixed-methods study.

Lin, Chunqing / Zhu, Yuhui / Mooney, Larissa J / Ober, Allison / Clingan, Sarah E / Baldwin, Laura-Mae / Calhoun, Stacy / Hser, Yih-Ing

Journal of telemedicine and telecare

2024 , Page(s) 1357633X231226261

Abstract: Introduction: Rural primary care clinics can expand their medication treatment for opioid use disorder (MOUD) capacity by coordinating care with external telemedicine (TM) vendors specializing in addiction medicine. This study used mixed methods to ... ...

Abstract	Introduction: Rural primary care clinics can expand their medication treatment for opioid use disorder (MOUD) capacity by coordinating care with external telemedicine (TM) vendors specializing in addiction medicine. This study used mixed methods to identify factors that influence patient referrals from rural primary care clinics to TM vendors for MOUD. Methods: Between July/August 2020 and January/February 2021, 582 patients with OUD were identified across six primary care sites; that included 68 referred to an external TM vendor to receive MOUD. Mixed effects logistic regression identified individual and site-level factors associated with being referred to the TM vendor. Clinic providers and staff participated in in-depth interviews and focus groups to discuss their considerations for referring patients to the TM vendor. Results: Patient referrals were positively associated with local household broadband coverage (OR = 2.55, p < 0.001) and negatively associated with local population density (OR = 0.01, p = 0.003) and the number of buprenorphine prescribers in the county (OR = 0.85, p < 0.001). Clinic personnel expressed appreciation for psychiatric expertise and the flexibility to access MOUD brought by the TM vendor. Perceived concerns about TM referral included a lack of trust with external providers, uncertainty about TM service quality, workflow delays, and patients' technological and insurance challenges. Conclusion: This study revealed several clinic-level factors that may potentially influence patient referral to TM vendor services for MOUD. To facilitate the referral process and utilization of TM vendors, efforts should be made to foster open communication and trust between clinic providers and TM vendors, streamline workflows, and improve Internet access for patients.
Language	English
Publishing date	2024-01-22
Publishing country	England
Document type	Journal Article
ZDB-ID	1340281-x
ISSN	1758-1109 ; 1357-633X
ISSN (online)	1758-1109
ISSN	1357-633X
DOI	10.1177/1357633X231226261
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Article ; Online: Social Determinants of Health and Continuity of Medications for Opioid Use Disorder Among Patients Receiving Treatment in Rural Primary Care Settings.

Pham, Huyen / Ober, Allison / Baldwin, Laura-Mae / Mooney, Larissa J / Zhu, Yuhui / Fei, Zhe / Hser, Yih-Ing

Journal of addiction medicine

2024

Abstract: Objectives: Factors associated with treatment retention on medications for opioid use disorder (MOUD) in rural settings are poorly understood. This study examines associations between social determinants of health (SDoH) and MOUD retention among ... ...

Abstract	Objectives: Factors associated with treatment retention on medications for opioid use disorder (MOUD) in rural settings are poorly understood. This study examines associations between social determinants of health (SDoH) and MOUD retention among patients with opioid use disorder (OUD) in rural primary care settings. Methods: We analyzed patient electronic health records from 6 rural clinics. Participants (N = 575) were adult patients with OUD and had any prescription for MOUD from October 2019 to April 2020. MOUD retention was measured by MOUD days and continuity defined as continuous 180 MOUD days with no more than a 7-day gap. Mixed-effect regressions assessed associations between the outcomes and SDoH (Medicaid insurance, social deprivation index [SDI], driving time from home to the clinic), telehealth use, and other covariates. Results: Mean patient MOUD days were 127 days (SD = 50.7 days). Living in more disadvantaged areas (based on SDI) (adjusted relative risk [aRR]: 0.98; 95% confidence interval [CI], 0.98-0.99) and having more than an hour (compared with an hour or less) driving time from home to clinic (aRR: 0.95; 95% CI, 0.93-0.97) were associated with fewer MOUD days. Using telehealth was associated with more MOUD days (aRR: 1.23; 95% CI, 1.21-1.26). In this cohort, 21.7% of the participants were retained on MOUD for at least 180 days. SDoH and use of telehealth were not associated with having continuity of MOUD. Conclusions: Addressing SDoH (eg, SDI) and providing telehealth (eg, improvements in public transportation, internet access) may improve MOUD days in rural settings.
Language	English
Publishing date	2024-02-05
Publishing country	Netherlands
Document type	Journal Article
ISSN	1935-3227
ISSN (online)	1935-3227
DOI	10.1097/ADM.0000000000001274
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Article ; Online: Alcohol Use Among Treatment-Seeking Individuals With Opioid Use Disorder.

Baskerville, Wave-Ananda / Grodin, Erica N / Lin, Johnny / Miotto, Karen / Mooney, Larissa J / Ray, Lara A

Journal of studies on alcohol and drugs

2023 Volume 84, Issue 4, Page(s) 579–584

Abstract: Objective: Individuals in the United States with opioid use disorder (OUD) have high rates of co-occurring alcohol use disorder. However, there is limited research on co-use patterns among opioid and alcohol use. The present study examined the ... ...

Abstract	Objective: Individuals in the United States with opioid use disorder (OUD) have high rates of co-occurring alcohol use disorder. However, there is limited research on co-use patterns among opioid and alcohol use. The present study examined the relationship between alcohol and opioid use in treatment-seeking individuals with an OUD. Method: The study used baseline assessment data from a multisite, comparative effectiveness trial. Participants with an OUD who had used nonprescribed opioids in the last 30 days ( Results: The likelihood of same-day opioid use was significantly lower on days in which participants drank any alcohol ( Conclusions: These findings suggest that alcohol or binge alcohol use is associated with significantly lower odds of opioid use on a given day, which was not related to gender or age. The prevalence of opioid use remained high on both alcohol use and non-alcohol use days. In line with a substitution model of alcohol and opioid co-use, alcohol may be used to treat symptoms of opioid withdrawal and possibly play a secondary and substitutive role in individuals with OUD substance use patterns.
MeSH term(s)	Male ; Humans ; Female ; United States/epidemiology ; Analgesics, Opioid/therapeutic use ; Opioid-Related Disorders/epidemiology ; Opioid-Related Disorders/drug therapy ; Alcohol Drinking/epidemiology ; Alcoholism/drug therapy ; Substance Withdrawal Syndrome ; Ethanol
Chemical Substances	Analgesics, Opioid ; Ethanol (3K9958V90M)
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2266450-6
ISSN	1938-4114 ; 1934-2683 ; 1937-1888 ; 0096-882X
ISSN (online)	1938-4114 ; 1934-2683
ISSN	1937-1888 ; 0096-882X
DOI	10.15288/jsad.22-00176
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Article ; Online: Medication treatment for opioid use disorder among rural primary care patients.

Hser, Yih-Ing / Zhu, Yuhui / Baldwin, Laura-Mae / Mooney, Larissa J / Saxon, Andrew J

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

2023 Volume 40, Issue 1, Page(s) 195–199

Abstract: Purpose: To investigate the prevalence of opioid use disorder (OUD) and medication treatment for OUD (MOUD) receipt in rural primary care settings and identify characteristics associated with MOUD among patients with OUD.: Methods: Secondary analyses ...

Abstract	Purpose: To investigate the prevalence of opioid use disorder (OUD) and medication treatment for OUD (MOUD) receipt in rural primary care settings and identify characteristics associated with MOUD among patients with OUD. Methods: Secondary analyses based on electronic health records of all adult patients who visited 1 of the 6 rural primary care clinic sites from October 2019 to January 2021. Mixed effects logistic regression was conducted to assess MOUD receipt (Y/N) in relation to patient characteristics (eg, demographics, other substance use disorders [SUDs], mental health disorders, and chronic pain) and the number of MOUD prescribers per clinic. Findings: The prevalence of OUD varied from 0.7% to 8.2% (Mean [SD] = 3.3% [95% CI: 0.4, 6.1]) among 36,762 primary care patients across 6 clinic sites. Among 1,164 patients with OUD, on average 50.1% received MOUD (95% CI: 28.0, 72.3). Patients in clinics with more than 3 MOUD prescribers had more than 3 times the odds of receiving MOUD (OR = 3.42; 95% CI, 1.22-9.62) as those in clinics with fewer than 3 prescribers. MOUD was positively associated with younger age (18-30 [OR = 6.97; 95% CI, 3.37-14.42], 31-64 [OR = 5.03; 95% CI, 2.64-9.57], relative to those 65 and older), having other co-occurring SUDs (OR = 3.77; 95% CI, 2.57-5.52), being male (OR = 1.50; 95% CI, 1.12-2.01), and negatively associated with having chronic pain disorders (OR = 0.69; 95% CI, 0.50-0.94). Conclusions: The prevalence of OUD and MOUD are high but vary considerably across rural primary care clinics; primary care MOUD prescribers play a key role on MOUD access in rural settings.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Chronic Pain/drug therapy ; Chronic Pain/epidemiology ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/epidemiology ; Ambulatory Care Facilities ; Electronic Health Records ; Primary Health Care
Language	English
Publishing date	2023-07-26
Publishing country	England
Document type	Journal Article
ZDB-ID	639160-6
ISSN	1748-0361 ; 0890-765X
ISSN (online)	1748-0361
ISSN	0890-765X
DOI	10.1111/jrh.12785
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Article ; Online: Psychosis among individuals with methamphetamine use disorder is associated with elevated rates of hospitalizations and emergency department visits across an academic health care system.

Zito, Michael F / Fei, Zhe / Zhu, Yuhui / Clingan, Sarah E / Marder, Stephen R / Mooney, Larissa J

Journal of substance use and addiction treatment

2023 Volume 151, Page(s) 209033

Abstract: Introduction: Methamphetamine (MA) is increasingly available in the United States and manufactured with increasing potency. Although psychosis is a known harm related to MA use, we know little about the clinical outcomes and prognosis of individuals who ...

Abstract	Introduction: Methamphetamine (MA) is increasingly available in the United States and manufactured with increasing potency. Although psychosis is a known harm related to MA use, we know little about the clinical outcomes and prognosis of individuals who use MA and experience psychosis. Some evidence exists that psychosis among people who use methamphetamine leads to a high utilization of emergency and acute inpatient services, but the extent of this use is unclear. Methods: Using an electronic health record (EHR) database, this study assessed acute care visits of individuals receiving diagnostic codes of the following disorders: methamphetamine use disorder with undifferentiated psychosis (MUDp), schizophrenia (MUDs) and no history of psychosis (MUD) in addition to individuals without MUD diagnosis but with diagnoses of either undifferentiated psychosis (Psy) or schizophrenia (Scz) from 2006 to 2019. The study explored potential clinical risk factors associated with rate of acute care visits. Results: Receiving diagnoses of psychotic disorders and MUD were both associated with high rates of acute care utilization. The incidence rate ratio (IRR) was highest in the MUDp group 6.30 (95% CI: 5.73, 6.93) followed by the MUDs group 4.03 (95% CI: 3.87, 4.20), the Psy group 3.77 (95% CI: 3.45, 4.11), the Scz group 3.11 (95% CI: 2.99, 3.23), and the MUD group 2.17 (95% CI: 2.09, 2.25). Receiving another SUD diagnosis was identified as a risk factor for acute care visits in the MUDp group, and mood and anxiety disorder diagnoses were a risk factor in the MUDs group. Conclusions: In a general health care system, individuals receiving diagnoses of MUD and co-occurring psychotic disorders were observed to have particularly high rates of acute care service utilization, suggesting a high degree of disease burden and the need for development of targeted treatment interventions with both MUD and psychosis.
MeSH term(s)	Humans ; United States ; Methamphetamine/adverse effects ; Psychotic Disorders/diagnosis ; Hospitalization ; Delivery of Health Care ; Emergency Service, Hospital
Chemical Substances	Methamphetamine (44RAL3456C)
Language	English
Publishing date	2023-04-01
Publishing country	United States
Document type	Journal Article
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2023.209033
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Article ; Online: Co-occurring substance use disorders among patients with opioid use disorder in rural primary care clinics.

Zhu, Yuhui / Baldwin, Laura-Mae / Mooney, Larissa J / Saxon, Andrew J / Kan, Emily / Hser, Yih-Ing

Journal of substance use and addiction treatment

2023 Volume 158, Page(s) 209269

Abstract: Background: Co-occurring substance use disorders (SUDs) among individuals with opioid use disorder (OUD) are associated with additional impairment, overdose, and death. This study examined characteristics of patients who have OUD with and without co- ... ...

Abstract	Background: Co-occurring substance use disorders (SUDs) among individuals with opioid use disorder (OUD) are associated with additional impairment, overdose, and death. This study examined characteristics of patients who have OUD with and without co-occurring SUDs in rural primary care clinics. Methods: Secondary analysis used electronic health record (EHR) data from six rural primary care clinics, including demographics, diagnoses, encounters, and prescriptions of medication for OUD (MOUD), as well as EHR data from an external telemedicine vendor that provided MOUD to some clinic patients. The study population included all adult patients who had a visit to the participating clinics from October 2019 to January 2021. Results: We identified 1164 patients with OUD; 72.6 % had OUD only, 11.5 % had OUD and stimulant use disorder (OUD + StUD), and 15.9 % had OUD and other non-stimulant substance use disorder (OUD + Other). The OUD + StUD group had the highest rates of hepatitis C virus (25.4 % for OUD + StUD, 17.8 % for OUD + Other, and 7.5 % for OUD Only; p < 0.001) and the highest rates of mental health disorders (78.4 %, 69.7 %, and 59.9 %, respectively; p < 0.001). Compared to the OUD Only group, patients in the OUD + StUD and OUD + Other groups were more likely to receive telehealth services provided by clinic staff, in-clinic behavioral health services, and in-clinic MOUD. The OUD + StUD group had the highest proportion of referrals to the external telemedicine vendor. Conclusions: More than 27 % of patients with OUD in rural primary care clinics had other co-occurring SUDs, and these patients received more healthcare services than those with OUD only. Future studies should examine variations in outcomes associated with these other services among patients with OUD and co-occurring SUDs.
MeSH term(s)	Adult ; Humans ; Drug Overdose ; Ambulatory Care Facilities ; Hepacivirus ; Opioid-Related Disorders/epidemiology ; Primary Health Care
Language	English
Publishing date	2023-12-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2023.209269
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