Abstract：
:Recovery coaches, trained peers with a history of substance use disorder (SUD) who are formally embedded in the health care team, may be a cost-effective approach to support outpatient management of SUD treatment. Although recovery coach programs are scaling nationwide, limited data exist to support their impact on costs or clinical outcomes. This study aimed to evaluate the integration of peer recovery coaches in general medical settings. Staff hired and trained nine recovery coaches as a part of a health system-wide effort to redesign SUD care. We examined reductions in acute care utilization and increases in outpatient treatment utilization among patients connected to a recovery coach. Additionally, we examined buprenorphine treatment engagement and opioid abstinence among a subset of patients who initiated buprenorphine prior to or within 30 days of their first recovery coach contact. We hypothesized recovery coach contact would strengthen outpatient SUD treatment and be associated with reductions in SUD severity and preventable acute care utilization. We included patients with an initial recovery coach contact between January 2015 and September 2017 in the main analyses (N = 1171). We assessed utilization outcomes via medical records over one year, comparing the six months before and after first recovery coach contact. We used chart review to extract toxicology results and buprenorphine treatment engagement for the subset of patients initiated on buprenorphine (n = 135). In the six months following recovery coach contact, there was a 44% decrease in patients hospitalized and a 9% decrease in patients with an ED visit. There was a 66% increase in outpatient utilization across primary care, community health center visits, mental health, and laboratory visits. Among patients who initiated buprenorphine, current recovery coach contact was associated with significantly increased odds of buprenorphine treatment engagement (OR = 1.89; 95% CI: 1.49-2.39; p < 0.001) and opioid abstinence (OR = 1.32; 95% CI: 1.02-1.70; p < 0.001). Recovery coaches may be an impactful and potentially cost-effective addition to an SUD care team, but future research is needed that uses a matched comparison condition.
journal_name
J Subst Abuse Treatjournal_title
Journal of substance abuse treatmentauthors
Magidson JF,Regan S,Powell E,Jack HE,Herman GE,Zaro C,Kane MT,Wakeman SEdoi
10.1016/j.jsat.2020.108248subject
Has Abstractpub_date
2021-03-01 00:00:00pages
108248eissn
0740-5472issn
1873-6483pii
S0740-5472(20)30505-5journal_volume
122pub_type
杂志文章abstract：INTRODUCTION:Prescription opioid misuse is a risk factor for opioid use disorder (OUD). Patients who misuse prescribed opioids and those who misuse illicit opioids are demographically and medically distinct groups, and research has shown there is heterogeneity in treatment response between these groups. The objective o...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2020.108073
更新日期：2020-10-01 00:00:00
abstract：:This article examines variables that predicted outpatient treatment entry within 6 months of residential detoxification. Patient data were collected from 632 injection drug users enrolled in a randomized trial conducted at eight detoxification programs within the National Drug Abuse Treatment Clinical Trials Network (...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2009.12.012
更新日期：2010-06-01 00:00:00
abstract：:In 2006, the Medicare program covered 37 million elderly persons and 7 million persons younger than 65 years, but little is known about substance abuse (SA) service utilization. Using the 5% Sample of Medicare claims data, the study examines individuals who used SA detoxification ("detox") and/or rehabilitation ("reha...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2008.08.007
更新日期：2009-06-01 00:00:00
abstract：:Progress continues to be made in clarifying neurobiological factors in alcoholism and other chemical dependencies. Research in animal behavioral genetics and human genetics has revealed substantial genetic predispositions for some cases of alcoholism. Studies of neurotransmitters suggest that some alcoholics may have ...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章,评审
doi：10.1016/0740-5472(88)90043-8
更新日期：1988-01-01 00:00:00
abstract：:We review the problems unique to the diagnosis and treatment of patients who suffer both major mental illness and alcohol/drug abuse. We describe the experience and the approach evolved in the Special Treatment Team, a State Hospital unit that has specialized in this work. We discuss in detail the assessment and stabi...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章,评审
doi：10.1016/0740-5472(88)90044-x
更新日期：1988-01-01 00:00:00
abstract：:Sixty-nine cocaine-dependent outpatients were exposed to cocaine-related stimuli and to non-drug events on separate days. Cocaine cue sessions were always followed by a meeting with a trained clinician designed to eliminate any craving that remained following cue presentations. Urine samples were collected before each...
journal_title：Journal of substance abuse treatment
pub_type： 临床试验,杂志文章
doi：10.1016/s0740-5472(97)00290-0
更新日期：1998-09-01 00:00:00
abstract：:Practitioners and researchers across disciplines have been interested in identifying variables that act as indicators of treatment success or failure and one straightforward approach to measuring treatment success is to assess client satisfaction with treatment. Existing measures of treatment satisfaction do not addre...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jsat.2016.04.007
更新日期：2016-08-01 00:00:00
abstract：:Research has not consistently supported an association between stage of change and substance abuse treatment retention. This study examined whether social desirability response bias could help explain why. Participants (N = 200) recruited from an outpatient program completed the University of Rhode Island Change Asses...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2011.09.013
更新日期：2012-06-01 00:00:00
abstract：:Incorporation of very low doses of phenobarbital into a methadone linctus has enabled us to monitor the compliance of 7 patients receiving a reducing dose of methadone (detoxification) for treatment for opioid addiction. By measuring both plasma phenobarbital and methadone we detected 4 patients who consumed extra ill...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/0740-5472(93)90006-n
更新日期：1993-09-01 00:00:00
abstract：:This qualitative study describes social support that female sex workers who inject drugs (FSW-IDUs) receive and recovery efforts in the context of relationships with family and intimate partners. We conducted thematic analysis of in-depth interviews with 47 FSW-IDUs enrolled in an intervention study to reduce injectio...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jsat.2012.12.009
更新日期：2013-07-01 00:00:00
abstract：:Parents who use opioids and are involved in the child welfare system are less likely to retain custody of their children than parents who use other drugs. No previous studies have described medication-assisted treatment (MAT) utilization and child permanency outcomes for this population. The Sobriety Treatment and Rec...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2016.09.006
更新日期：2016-12-01 00:00:00
abstract：:Poverty is common among people who have substance use disorder. The therapeutic workplace addresses some of the interrelated and chronic problems of poverty, such as unemployment, lack of education and job skills, and drug use. A prior controlled trial showed that the therapeutic workplace was effective in promoting d...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2020.108160
更新日期：2021-01-01 00:00:00
abstract：:The objective of this study was to identify migration patterns from an open illicit drug scene (the Downtown Eastside [DTES] neighborhood) and describe factors associated with these migration patterns. Data were derived from three cohorts of people who use illicit drugs in Vancouver, Canada. Defined using latent class...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2019.09.006
更新日期：2019-12-01 00:00:00
abstract：:In the present study, 36 specialized substance abuse treatment programs for women and their children were identified and chosen for review. These programs provide a wide range of services including substance abuse, mental health and medical treatment, life skills training (i.e. vocational and parenting training), and ...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/s0740-5472(00)00123-9
更新日期：2000-12-01 00:00:00
abstract：:Marijuana and tobacco co-use is common among young adults, and findings are mixed regarding the association between marijuana use and smoking cessation outcomes. This study examined the longitudinal relationships between marijuana use and smoking cessation outcomes among young adults (aged 18-25 years; N = 500) enroll...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2018.08.010
更新日期：2018-11-01 00:00:00
abstract：:The turnover of substance use disorder (SUD) treatment staff has been assumed to adversely impact treatment effectiveness, yet only limited research has empirically examined this assumption. Representing an extension of prior organizational-level analyses of the impact of staff turnover on client outcomes, this study ...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2012.09.004
更新日期：2013-04-01 00:00:00
abstract：:This study examined whether homelessness predicted earlier resumption of substance use after detoxification, and sought evidence concerning the impact of post-detoxification stabilization programs among homeless and nonhomeless individuals. Kaplan-Meier plots and proportional hazards models were used to determine the ...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/s0740-5472(03)00026-6
更新日期：2003-04-01 00:00:00
abstract：BACKGROUND:Co-use of tobacco and cannabis has been associated with greater dependence on and lower quit rates for both substances. Tobacco/cannabis co-use among individuals with substance use disorders (SUDs), a population with high rates of cigarette smoking, may hinder the effectiveness of smoking cessation intervent...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2020.108064
更新日期：2020-09-01 00:00:00
abstract：INTRODUCTION:Chronic polysubstance abuse (SUD) is associated with neurophysiological and neuroanatomical changes. Neurocognitive impairment tends to affect quality of life, occupational functioning, and the ability to benefit from therapy. Neurocognitive assessment is thus of importance, but costly and not widely avail...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2016.02.010
更新日期：2016-07-01 00:00:00
abstract：:We examined the relationship of sleep disturbance and demographic, mental health, drug use and other factors among 225 methadone-maintained individuals. The cohort was 78% Caucasian and 54% male with a mean age of 41 years. Sleep disturbance was measured using the Pittsburgh Sleep Quality Index (PSQI) with a score >5 ...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/S0740-5472(03)00191-0
更新日期：2004-04-01 00:00:00
abstract：:Emerging adults (roughly 18-29years) with substance use disorders can benefit from participation in twelve-step mutual-help organizations (TSMHO), however their attendance and participation in such groups is relatively low. Twelve-step facilitation therapies, such as the Stimulant Abuser Groups to Engage in 12-Step (S...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2017.10.012
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:The National Drug Abuse Treatment Clinical Trials Network (CTN) multisite comparative-effectiveness study ("X:BOT") by Lee et al. (2018) found that, once initiated, extended-release naltrexone (XR-NTX) is as similarly safe and effective as sublingual buprenorphine-naloxone (BUP-NX) for the treatment of opioi...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2020.108183
更新日期：2021-03-01 00:00:00
abstract：:The 12-month posttreatment outcome results for a randomized clinical trial that tested the effectiveness of various combinations of 4-month psychosocial treatment interventions are reported for 184 clients who used cocaine. Clients primarily used crack (93%), and the majority were African American (95%). Overall, clie...
journal_title：Journal of substance abuse treatment
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0740-5472(95)02020-9
更新日期：1996-01-01 00:00:00
abstract：:The comorbidity of attention deficit hyperactivity disorder (ADHD) is frequently not well recognized in substance abuse treatment institutions in The Netherlands. As a consequence, patients with substance use disorder (SUD) and ADHD often receive suboptimal treatment. To prevent every treatment center from having to i...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2005.12.004
更新日期：2006-04-01 00:00:00
abstract：:Research found that therapeutic communities and other types of residential programs are effective in reducing drug use, unemployment, and criminal behavior and that length of time spent in treatment is an important predictor of client outcomes from programs. Studies vary considerably, however, in terms of the amount o...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/0740-5472(94)90061-2
更新日期：1994-01-01 00:00:00
abstract：:The association of physical and sexual abuse with substance abuse has frequently been noted among chemically dependent women. Without diagnosis and treatment of the trauma, female substance abusers are vulnerable to relapse and/or revictimization. This paper describes a model for education and preliminary treatment of...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/0740-5472(90)90003-9
更新日期：1990-01-01 00:00:00
abstract：:Consecutive intakes (N = 419) between ages 13 and 18 years to chemical dependency (CD) programs in a large private health plan were interviewed. The prevalence of six HIV risk behaviors was measured and categorized into zero, one, and multiple risk groups. The relationships between both demographic characteristics and...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2005.03.003
更新日期：2005-07-01 00:00:00
abstract：INTRODUCTION:Rapid HIV testing (RHT) greatly increases the proportion of clients who learn their test results. However, existing studies have not examined the adoption and implementation of RHT in programs treating persons with substance use disorders, one of the population groups at higher risk for HIV infection. MET...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章
doi：10.1016/j.jsat.2015.12.001
更新日期：2016-04-01 00:00:00
abstract：:Alcohol use--and abuse--has always been more prevalent among males than among females. The sex role prescription for men to affirm their masculinity by drinking is a major determinant of this sex difference. This paper reviews the intricate interrelationship between masculinity and both social and alcoholic drinking. ...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章,评审
doi：10.1016/0740-5472(89)90045-7
更新日期：1989-01-01 00:00:00
abstract：:Greater impulsivity, assessed by the Barratt Impulsiveness Scale-11 (BIS-11) and Stroop interference scores, has been associated with treatment completion in cocaine-dependent patients. This study evaluated the relationships among impulsivity, stimulant-dependence diagnosis, and treatment completion. Six sites evaluat...
journal_title：Journal of substance abuse treatment
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jsat.2012.12.005
更新日期：2013-05-01 00:00:00
