Abstract:
AIMS:Deaths attributed to fentanyl have increased in the United States. However, little is known about fentanyl use among substance abuse treatment clients. To fill this gap, we assessed prevalence of fentanyl exposure, characteristics of clients testing positive for fentanyl, other substances detected concurrently or simultaneously with fentanyl, and clients' perception of how many people are actively seeking to use fentanyl. METHODS:A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan. Urine drug screens (UDS) including fentanyl (and its metabolite norfentanyl) were conducted clinically. To obtain additional data, 113 clients in this clinic subsequently completed an anonymous survey. RESULTS:Of 368 unique clients with UDS, 38.0% had at least one and 26.1% had ≥2 fentanyl-positive UDS results. None had a fentanyl prescription. Clients ever testing positive for fentanyl were significantly (p<0.05) more likely to use cocaine, have multiple treatment admissions to the clinic, and leave treatment sooner. Fentanyl-positive UDS results coincided most commonly with metabolites of cocaine- and heroin-positive UDS results. Of the anonymously surveyed clients, most (67.3%) reported they did not know anyone seeking fentanyl, a proportion significantly higher than for heroin, cocaine, alprazolam, hydrocodone and morphine. CONCLUSIONS:Fentanyl was commonly detected during this period with some clients having multiple fentanyl-positive UDS. Most clients did not know anyone seeking to obtain fentanyl. Regardless, the high exposure underscores that naloxone training and distribution is needed.
journal_name
J Subst Abuse Treatjournal_title
Journal of substance abuse treatmentauthors
Arfken CL,Suchanek J,Greenwald MKdoi
10.1016/j.jsat.2017.01.004subject
Has Abstractpub_date
2017-04-01 00:00:00pages
17-21eissn
0740-5472issn
1873-6483pii
S0740-5472(16)30473-1journal_volume
75pub_type
杂志文章abstract::Although the psychological treatment of addiction is premised on the notion that addictive behavior is learned behavior, addiction workers have been slow to exploit the capacity of the computer to promote new learning. The best computer-assisted learning programs are fully adaptive; their design anticipates the respon...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/0740-5472(90)90008-e
更新日期:1990-01-01 00:00:00
abstract::The purpose of this study was to describe a novel approach to calculating service use costs across multiple domains of service for homeless populations. A randomly-selected sample of homeless persons was interviewed in St. Louis, MO and followed for 2 years. Service- and cost-related data were collected from homeless ...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2013.12.002
更新日期:2014-04-01 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::Opioid medication treatment access is a public health priority aimed to improve opioid use treatment outcomes. However, Medicaid does not cover all forms of MOUD, particularly methadone, in many states. We examined associations between medication for opioid use disorder (MOUD) plans and substance use treatment dischar...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2020.108028
更新日期:2020-07-01 00:00:00
abstract::Many drug abusers have repeated exposure to treatment, yet little is known about the reasons some individuals re-enter treatment following relapse to drug use. This paper examines the predictors of treatment re-entry among cocaine abusers who relapsed to cocaine use (N = 347) within 5 years following their index treat...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章,多中心研究
doi:10.1016/s0740-5472(03)00128-4
更新日期:2003-10-01 00:00:00
abstract::In view of their role in licensing opioid treatment programs (OTPs), state opioid treatment authorities (SOTAs) are in a unique position to influence how OTPs address their patients' alcohol abuse. Using data from a telephone survey of SOTAs from the District of Columbia and states that have at least one OTP (n = 46),...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2010.03.010
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:The United States is in the middle of an opioid overdose epidemic, and experts are calling for improved detection of opioid use disorders (OUDs) and treatment with buprenorphine or extended release (XR) injectable naltrexone, which can be prescribed in general medical settings. To better understand the magni...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2020.02.001
更新日期:2020-03-01 00:00:00
abstract::We studied a modified therapeutic community designed for the treatment of patients with combined substance abuse and psychiatric disorders. This model has been ap117117plied on a limited basis in clinical practice, and little is known about the characteristics of patients who are likely to complete the prescribed stay...
journal_title:Journal of substance abuse treatment
pub_type: 临床试验,杂志文章
doi:10.1016/s0740-5472(97)00136-0
更新日期:1998-03-01 00:00:00
abstract::Despite aggressive efforts to recruit into treatment cocaine users 21 years and younger, we obtained only 12 such clients over a period of 9 months, while recruiting 122 adult cocaine clients during a comparable time frame. An examination of admissions data for the city, state, and nation indicated that our experience...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/0740-5472(89)90013-5
更新日期:1989-01-01 00:00:00
abstract::Although the literature on dual diagnosis has grown considerably over the last several years, report describing inpatient treatment models are less common. We describe some of the major treatment concerns in the dural diagnosis literature, such as using 12-step self-help programs like Alcoholics Anonymous (AA) or Narc...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/0740-5472(94)00060-5
更新日期:1995-03-01 00:00:00
abstract::Inpatient detoxification is frequently used to treat substance use disorders, despite consistent findings that drug use soon after detoxification is the norm. A number of lines of evidence suggest the most rational means of improving outcomes after detoxification is to improve postdetoxification treatment entry. This ...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2008.11.003
更新日期:2009-09-01 00:00:00
abstract::Medication-assisted treatment (MAT) with methadone or buprenorphine has been shown to be more effective at reducing the use of illicit opioids, the risk of drug-related overdose, and overall healthcare costs, on average, compared to abstinence-based addiction treatments for individuals with an opioid use disorder (OUD...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2019.05.015
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Remission from alcohol problems in the absence of treatment is common, yet there are wide ranging estimates of the extent to which this occurs, depending on method. A systematic review of the literature on untreated remission from alcohol problems was conducted to analyse the ways different definitions and s...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2019.04.004
更新日期:2019-07-01 00:00:00
abstract::Widespread adoption of empirically-supported treatment innovations has the potential to improve effectiveness of treatment received by individuals with substance use disorders. However, the process of disseminating such innovations has been complex, slow, and difficult. We empirically describe the dissemination and ad...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2015.04.003
更新日期:2015-10-01 00:00:00
abstract::Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identifi...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2009.05.009
更新日期:2010-01-01 00:00:00
abstract::This study examined the effects of specific services provided in therapeutic communities (TCs) to treatment outcomes. Findings are compared to prior analyses of treatment outcomes from the District of Columbia Treatment Initiative (DCI) that did not utilize the treatment service information. A subsample of DCI clients...
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/s0740-5472(00)00170-7
更新日期:2001-03-01 00:00:00
abstract::There has been a rise in illicit drug smoking in the United States. "Shotgunning" drugs (or "doing a shotgun") refers to the practice of inhaling smoke and then exhaling it into another individual's mouth, a practice with the potential for the efficient transmission of respiratory pathogens. Three hundred fifty-four d...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/s0740-5472(96)00182-1
更新日期:1997-01-01 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::Despite consensus about the value of substance abuse treatment for delinquent youth, information about its prevalence and availability is inadequate and inconsistent. This article presents findings about treatment and other correctional service provision from a national survey of directors of 141 juvenile institutiona...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2006.12.018
更新日期:2007-04-01 00:00:00
abstract::Recidivism among recovering ex-offenders is usually conceptualized as an outcome of the interplay between personal traits and treatment interventions. This focus on the individual, to the exclusion of the sociolegal context in which recovery and reintegration take place, has limited extant policy initiatives. Recidivi...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2006.05.010
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Early treatment motivation is a meaningful predictor of clinical outcomes in the context of methamphetamine dependence (MD). Cognitive deficits associated with MD can have a significant impact on motivational fluctuations during early treatment. We specifically examined if sustained attention and effort-base...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2018.09.007
更新日期:2018-12-01 00:00:00
abstract::This study's purpose is to gain a current perspective on the substance abuse treatment field's workforce. The data are from the Retrospective Study of treatment professionals designed to document how the Treatment Improvement Protocols published by the Center for Substance Abuse Treatment have influenced the implement...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/s0740-5472(02)00322-7
更新日期:2003-01-01 00:00:00
abstract::Previous research has found an association between childhood and adult physical and sexual abuse and substance abuse, but has not examined or compared specific dimensions of the abuse experience, such as its age of onset or the type, severity, or frequency. Women receiving perinatal care (N = 1189) at an inner-city ho...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/s0740-5472(97)00198-0
更新日期:1998-07-01 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::The goal of this study was to compare the effects of 1, 3 and 8 mg per day doses of buprenorphine in the maintenance treatment of opium-dependent subjects in Iran over a treatment period of 12 months. Participants were randomized to three equal groups (171 subjects per group) of opium-dependent individuals who met the...
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/s0740-5472(03)00141-7
更新日期:2004-01-01 00:00:00
abstract::Comorbidity of substance abuse disorders (SUD) and psychiatric disorders is one of the most important areas of investigation in contemporary drug abuse treatment research. This study examined the impact of psychiatric comorbidity on the treatment of 182 adolescent drug abusers in a randomized clinical trial comparing ...
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/S0740-5472(03)00166-1
更新日期:2004-03-01 00:00:00
abstract::The design and implementation of a personality assessment system for severely substance-dependent men in a therapeutic community (TC) are described. The system was designed from a treatment utility perspective (Hayes, Nelson, & Jarrett, 1987) and uses the Personality Research Form E (Jackson, 1984) to provide each pat...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/0740-5472(96)00030-x
更新日期:1996-03-01 00:00:00
abstract::The majority of adults seeking substance use disorder treatment also smoke. Smoking is associated with greater substance use disorder severity, poorer treatment outcome, and increased mortality among those with substance use disorders. Yet, engaging this population in smoking cessation treatment is a significant chall...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2016.12.008
更新日期:2017-03-01 00:00:00
abstract::Drug treatment services of varying types have been scaled up in China over the past decade. Yet, barriers to treatment remain among the population of drug users in China. In this paper, we use a person-centered approach to examine external barriers to drug treatment among a sample of Chinese drug users. Specifically, ...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2013.05.004
更新日期:2013-10-01 00:00:00
abstract::We examine the prevalence of screening for student alcohol misuse/abuse among 333 U.S. colleges via a survey of campus leaders. We also use latent class modeling to identify classes of colleges based on screening practices. We found that most colleges conduct screening after a student is involved in an alcohol-related...
journal_title:Journal of substance abuse treatment
pub_type: 杂志文章
doi:10.1016/j.jsat.2012.01.001
更新日期:2012-10-01 00:00:00