Addiction Center Research Articles

A Descriptive Study to Assess the Level of Depression among Alcoholic Patients Admitted in De Addiction Center at Selected Settings

A Descriptive Study to Assess the Level of Depression among Alcoholic Patients Admitted in De Addiction Center at Selected Settings

Evaluation of an Educational Intervention Based on Theory of Planned Behavior to Reduce Suicidal Ideation and Attempts in Drug Addicts Receiving Methadone: A Quasi-Experimental Study

Background Drug addiction can lead to suicidal ideation or suicide attempt so that half of those who attempt suicide have a history of substance abuse. The purpose of this study was to investigate the effect of educational intervention based on Theory of Planned Behavior (TPB) on reducing suicidal ideation and suicide attempt of addicts. Methods A longitudinal quasi-experimental educational intervention was conducted on 200 methadone-treated addicts with suicidal ideation under the auspices of government addiction centers of Shiraz city from 2021 to 2022. Baseline data on demographic characteristics, suicidal ideation, and TPB questionnaire were collected from two groups at the beginning of the study and then three months after the intervention. The experiment group received educational intervention including sessions of individual and group counseling, training and organizational supports. The questionnaire was completed by both the experimental and control groups before the educational intervention and three months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, Chi-square and paired t-test (p = 0.05). Results The mean age of addicts in the experimental and control groups was 38.80 ± 11.64 and 39.41 ± 11.18 years, respectively (p = 0.206). 22% of the experimental group and 18% of the control group had a history of suicide. According to the results, there was no significant difference between the experimental and control groups in terms of knowledge, attitude, subjective norms and perceived behavioral control before the educational intervention, however, the mentioned variables increased significantly in the experimental group three months after the educational intervention. There was no significant difference in suicide attempt and suicidal ideation between the experimental and control groups before the educational intervention, however, there was a significant change in the experimental group after the educational intervention. Conclusion The results of the present study showed the effect of educational intervention on the knowledge, attitude, subjective norms, perceived behavioral control, suicidal ideation and suicidal attempt of addicts, thus confirming the effectiveness of the TPB-based intervention on reducing suicide of addicts.

Comparison of hepatitis B and SARS-CoV2 vaccination rates in people who attended Drugs and Addiction Centres.

Persons with substance use disorder are at increased risk for hepatitis B virus (HBV) infection. Although most of them are attached to social health centers, the vaccination rate in this group is low. In this context, we designed a study to evaluate the prevalence of users of drug addiction centers (DAC) not immunized against hepatitis B and to compare the rate of vaccination against hepatitis B with the rate of immunization against SARS-Cov-2 in 2 years of follow-up. Retrospective study that included individuals attended at DAC. Patients were screened at baseline (June 2020-January 2021) for HBV immunization. Individuals with HBsAb < 10 IU/mL were recommended to receive hepatitis B vaccine, during follow-up (January 2021-October 2022). At the end of follow-up, the HBV vaccination rate among candidates was determined and compared with the vaccination rate against SARS-Cov-2 in this population in the same period. A total of 325 subjects were surveyed and tested. At baseline, the 65% (211/325) of were candidates to initiate vaccination and were advisor to HBV vaccination. During the follow-up 15 individuals received at least one dose of HBV vaccine, supposing a vaccination rate of 7.2%. In the same period, 186 individuals received at least one dose against SARS-Cov-2, representing a vaccination rate of 83%. The comparison between vaccination rates reached statistically significant (p < 0.001). Our study manifests a low rate of immunization against HBV in DAC users, despite a high level of immunization for SARS-Cov-2 during the same period in the same population. Consequently, the lack of immunization against HVB in this population might be related with health policy issue more than to individuals linked to care and awareness. A similar approach for vaccination intended for SARS-CoV2 should be applied in high-risk population to warrant the success of immunization program against other preventable diseases such as HBV.

Re-examining provider perceptions of best pre-war practices: what elements can help opiate agonist therapy programs in Ukraine successfully survive the crisis?

This paper seeks to explore and understand what constitutes successful opioid agonist therapy (OAT) programs from the views of Ukrainian OAT providers in their context-specific accounts. Prior to the ongoing war the Ukrainian addiction treatment system made great strides to expand its OAT program and increase the number of patients. Since the beginning of the war there has been much alarm that those hard-earned successes will be destroyed. However, emerging evidence suggests that the Ukrainian OAT programs have shown signs of resilience in the face of adversity albeit at great cost. What aspects of the OAT programs developed prior to the crisis have been helpful to allow them to weather the storm? Using the data from 24 addiction treatment providers, this paper describes the essential elements of the OAT programs that preceded the current crisis which made them robust over time. By examining the narratives of the participants interviewed pre-war and pre-COVID-19 the paper reveals structural and cultural elements of the OAT programs before the perfect storm that are likely to endure. To the best of our knowledge, no one else has investigated OAT providers perspectives in Ukraine prior to the crisis which makes this paper extremely salient to understand both the robustness and the vulnerability of MAT programs in Ukraine during the war and going forward. The data come from qualitative semi-structured interviews with 24 OAT providers throughout 5 regions of Ukraine. Participants included front-line clinicians, head narcologists, and chief doctors from TB clinics, district hospitals and drug addiction centers. Using a coding scheme of 103 inductively developed categories we explored participants' perceptions of their OAT program. In the stories shared by clinicians pre crisis, three major interconnected themes focused on economic uncertainty at the institutional level (leading to under-staffing), structural capacity of the program, and clinicians' professional identity, shaping differing views on application of rules for administrative discharge, take-home dosing, and the potential for scale-up. Knowing the data collection was completely unbiased to the current crisis, interpreting the findings helps us understand that OAT clinicians have had "years" of training under conditions of duress in Ukraine to overcome barriers, find creative solutions and form a support network that became indispensable in surviving the current humanitarian catastrophe. In the discussion we point out that the current crisis magnified the pre-existing challenges as the providers approach toward overcoming them was already largely present before the crisis (just on a different scale). The underlying fragility of resources was a constant since OAT inception in Ukraine. Historically, providers in Ukraine operated in a system that was under-funded in the absence of solid governmental funding for OAT programs, yet they came up with solutions which required ingenuity that they took pride in. This gives hope that addiction treatment in Ukraine and OAT programs will not be casualties of this humanitarian crisis and providers and their patients will persevere.

The Impact of Psychological, Social, Societal, and Economic Factors Leading to Relapse in Patients Recovered from Addiction

Abstract Background: The problem of using psychotropic substances and addiction has become one of the major problems in the world. Despite the significant increase in treatment programs of addiction, many studies indicate that the rate of relapse globally is very high, especially when treatment is limited to the medical side only. Aims: The study aims to determine the percentage of influence of psychological, societal, social, economic, and other factors that lead to relapse when recovering from addiction. Methods: This study conducted in two main hospitals for the treatment of substance use disorders in Baghdad (Ibn Rushud Teaching Hospital for Psychiatry and Al-Ataa Center for Addiction Treatment) through the period from January 10, 2023, to June 10, 2023. All (300 inpatient) who are suffering from relapse to addiction after recovery were included in the study. The scale was prepared for the psychological, social, therapeutic, environmental, and economic factors, which was used by a group of senior doctors working in the field of treatment of addiction and rehabilitation centers, who unanimously agreed with their expertise on these factors. Results: This study revealed that the most important factor for relapse is the availability of addictive substances (91%); other factors include psychological, social pressures that the addict is exposed to in his social environment, in addition to the loss of social support (76%). The pressure of friends or peers with a rate of (78%) and the weakness of family control (44%) in addition to the influence of other factors that were examined in this study. Conclusion: There are many factors affecting the return of those recovering from addiction to addiction again, and the most prominent of these factors is the abundance or ease of access to psychoactive substances in addition to other factors, which include (psychological, social, societal, and economic factors). Society must realize that the responsibility for preventing addiction should not be borne by the medical treatment alone, because it is a problem that must be dealt with collectively by all parties to enable recovered patients from addiction to build their lives with confidence.

Psychosocial factors as potential predictors of sustained recovery amongst individuals with substance use disorder

ABSTRACT Purposes The present study investigated the contributory role of psychosocial capital specifically quality of life, social support and intellectual wellness as potential predictors of sustained recovery among individuals diagnosed with substance use disorders. Design/methodology The study included 180 individuals with 95% being male and, age between 17–60 years. Participants were recruited from various addiction and rehabilitation centers located in Pakistani cities, such as Karachi, Islamabad, Lahore and Murree. To assess sustain recovery, quality of life, social support, and intellectual wellness, the Recovery Assessment Scale, Multidimensional Scale of Perceived Social Support, World Health Organization (WHO) quality of Life BREF, and Intellectual Wellness Scale respectively, were used. Findings Results of the current study showed that quality of life, social support and intellectual wellness positively predicted sustained recovery. Furthermore, the demographic variables were also found to be significant predictors. Conclusion The study examined the contributory role of psychosocial capital such as quality of life, social support and intellectual wellness, in predicting sustained recovery among individuals with substance use disorders. The finding revealed that these factors positively predict sustained recovery, and helpful in the developing early intervention in clinical practices.

An overview of tobacco use in France: Observed trends and new challenges

This article reports changes in tobacco and vaping consumption in France over the last thirty years and the issues they raise for public authorities in terms of prevention and management of the social and health consequences. This report is the result of a joint analysis by Santé publique France (SpF) and the French Monitoring Center for Drugs and Drug Addiction (OFDT). It shows that there has been a “generational shift” in tobacco consumption and social representations of cigarettes since the mid-2010s, with a sharp decline in tobacco initiation among adolescents, which has become less common and reported at an older age, which was one of the objectives of the national tobacco reduction plans. However, smoking remains fairly stable among adults, predominantly among men, with gaps between men and women persisting since the early 2000s. Beyond the gender gap, social disparities in consumption remain significant, both among youth and adults. However, while the prevalence of smoking is no longer increasing, the prevalence of vaping is rising, which is a public health concern since some of these practices involve nicotine consumption. This also entails the risk of a “renormalization” of the act of smoking, a matter of concern for health authorities in France as in other European countries. The analysis concludes that the statistical information system and qualitative surveys need to be adapted to ensure a reliable monitoring of the situation, taking into account the rapid transformations of the market.

Excellent hepatitis C virus cure rates despite increasing complexity of people who use drugs: Integrated-Test-stage Treat study final outcomes.

Achieving hepatitic C virus (HCV) elimination requires linking people who use drugs (PWUD) into care. We report final direct-acting antivirals (DAAs)-based outcomes from the Integrated-Test-stage -Treat (ITTREAT) study. Project ITTREAT (2013-2021), based at an addiction centre, was a 'one-stop' service with innovative linkage to care strategies. Primary outcome was sustained virological response (SVR12) (intention to treat ITT) including whether individuals were recruited in first (period 1) versus last four (period 2 included the COVID-19 pandemic) years of the study. Number recruited were n = 765, mean age 40.9 ± 10.1 years, 78% males, history of current/past injecting drug use (IDU) and alcohol use being 77% and 90%, respectively. Prevalence of a positive HCV PCR was 84% with 19% having cirrhosis. Comparing those recruited in period 2 versus period 1, there was increasing prevalence of IDU, 90% versus 72% (p < .001); homelessness, 67% versus 50% (p < .001); psychiatric diagnosis, 84% versus 50% (p < .001); overdose history 71% versus 31% (p < .001), receiving opioid agonist treatment (OAT) 75% versus 52% (p < .001) and comorbidity 44% versus 25% (p < .001). Of those treated with DAAs (n = 272), ITT SVR rates were 86% (95% CI: 81%-90%), being similar in period 2 versus period 1. Predictors of non-SVR were receiving OAT (OR 0.33, 95% CI: 0.12-0.87, p = .025) and ≥80% adherence (OR 0.01, 95% CI: 0.003-0.041, p < .001). Reinfection rates period 2 versus period 1 (per 100 person-years) were 1.84 versus 1.70, respectively. In the treated cohort, mortality was 15%, being mostly drug-related. Despite increasing complexity of PWUD, high SVR12 rates are achievable with use of OAT and good adherence.

Study will use OTP to look at methadone reform

A new study funded by the National Institute on Drug Abuse (NIDA) and headed by researchers interested in changing the way methadone for opioid use disorder is utilized will use Community Medical Services treatment staff and patients as research subjects. Community Medical Services operates more than 60 opioid treatment programs in 11 states, and is the first OTP, or methadone clinic, to be open around the clock in some areas, with head Nicholas Stavros incorporating novel ways to reach out to patients. The MPACT (Methadone Patient Access to Collaborative Treatment) study will develop and test a medical intervention using a $1 million NIDA grant. Researchers at the University of Arizona Health Sciences, under the direction of Beth Meyerson, Ph.D., will test a “patient‐empowered, trauma‐informed” treatment using methadone in Arizona. Meyerson is a professor, and director of the Harm Reduction Research Lab in the University of Arizona College of Medicine at Tucson. The study will take two years. “Improving methadone treatment is critical because one person dies from an opioid overdose every five minutes in this country,” said Meyerson, who is also director of policy for the University of Arizona Health Sciences Comprehensive Pain and Addiction Center. “Access to methadone has been found to reduce opioid overdoses by 80%, but it is currently being delivered in ways that can create suboptimal patient outcomes, where only 30% of patients complete treatment and over 30% experience significant treatment interruptions.” The protocol will be used to focus on how to make treatment more acceptable to patients and includes a staff‐focused intervention to reduce trauma related to actually working in the OTP. “Vicarious trauma has been found to impact both patient care and staff recognition of the need to adopt treatment and practice innovations,” Meyerson said, adding, “This study is the crucial first step in assessing MPACT's feasibility, acceptability and preliminary effects on patient and staff outcomes. Once our established milestones are reached from the pilot program, the second phase of funding will enable us to expand the study of MPACT among 30 clinics with 600 patients and 450 staff members across the U.S.” Kristen Rundell, M.D., professor and chair of the Department of Family and Community Medicine at the University of Arizona, where Meyerson's harm reduction lab is based, said the study “is a prime example of our department's emphasis of social justice through medicine.”

Characterization and evaluation of nine Cannabis sativa chloroplast SNP markers for crop type determination and biogeographical origin on European samples

Cannabis sativa can be classified in two main types, according to psychotropic cannabinoid ∆9-tetrahydrocannabinol (∆9-THC) content: the drug-type and the fiber-type. According to the European Monitoring Center for Drugs and Drug Addiction, most of the European Union countries consider the possession of cannabis, for personal use, a minor offense with possibility of incarceration. Despite of the model of legal supply (i.e., Spanish cannabis clubs, Netherlands coffee shops) or medical use (i.e., Italy), cannabis remains the most used and trafficked illicit plant in the European Union. Differentiating cannabis crops or tracing the biogeographical origin is crucial for law enforcement purposes. Chloroplast DNA (cpDNA) markers may assist to determine biogeographic origin and to differentiate hemp from marijuana. This research aims: to identify and to evaluate nine C. sativa cpDNA polymorphic SNP sites to differentiate crop type and to provide information about its biogeographical origin. Five SNaPshot™ assays for nine chloroplast markers were developed and conducted in marijuana samples seized in Chile, the USA-Mexico border and Spain, and hemp samples grown in Spain and in Italy. The SNapShot™ assays were tested on 122 cannabis samples, which included 16 blind samples, and were able to differentiate marijuana crop type from hemp crop type in all samples. Using phylogenetic analysis, genetic differences were observed between marijuana and hemp samples. Moreover, principal component analysis (PCA) supported the relationship among hemp samples, as well as for USA-Mexico border, Spanish, and Chilean marijuana samples. Genetic differences between groups based on the biogeographical origin and their crop type were observed. Increasing the number of genetic markers, including the most recently studied ones, and expanding the sample database will provide more accurate information about crop differentiation and biogeographical origin.

Neurobehavioral and Social Sequelae Of “Maajoune Illicit Drug” Use by Young Individuals

Background: Maajoune is a dough prepared using hemp resin and certain plants known for their aphrodisiac effects. This drug is manufactured in North African countries. Objectives: The goal of this study was to seek the neurocognitive effects of the Maâjoune among children and young individuals. Methods: This randomized case-control study was conducted in three addiction centers and four schools in Morocco’s central region. The neurocognitive evaluation was performed by the Bells Test (visual attention deficits, unilateral spatial neglect, memory, and executive functions). SPSS software (version 20) was used to perform statistical analysis consisting of descriptive and qualitative analyses. Results: This study was conducted on 115 participants aged between 10 and 18 years. The subjects were divided into two groups, namely 55 subjects (48%) (G1) addicted to Maajoune and 60 subjects (52%) (G2) as non-consumers (control group). The results showed the omission of 6 items for 73% and 42% in G1 and G2, respectively (P &lt; 0.05). Hemianopsia was detected as bilateral visuospatial neglect (BVN) for 36% (G1) and 17% (G2) (P &lt; 0.05) and right visuospatial neglect for 24% (G1) and 13% (G2) (P &lt; 0.05). The addicted group score was significant regarding attention disorder (P = 0.001‡) and memory troubles (P &lt; 0.000001‡). Conclusions: The study results confirmed that Maajoune consumption significantly affected attention, executive function, and memory in young individuals. These findings highlight the urgent need for research that elucidates the neurobiological changes caused by Maajoune consumption in human health.

Maximising the potential of administrative data to examine homelessness in Northern Ireland

ObjectivesHomelessness is a growing public health concern in Northern Ireland. Our study intends to measure the scale of homelessness in Northern Ireland and identify the potential of using linked administrative data to understand the complex needs of people who experience homelessness (PEH) and contribute to policy and service development.&#x0D; MethodsAll formal applications for homelessness go to one central body the Northern Ireland Housing Executive (NIHE). However, it is possible that a proportion might remain unknown to local housing authorities due to personal circumstances, changes in legislation or eligibility criteria etc, which might mean that formal applications underestimate the true scale of homelessness. In this study of the interplay of homelessness health and exposure to social services, we can identify emergency accommodation centres by using ArcGIS, a geographic information system that allows users to analyse maps and spatial data to identify individuals who have been residing at hostels, addiction centres or women's refuges.&#x0D; ResultsWe identified 115 emergency accommodation centres. We plan to use this information to quantify the scale of homelessness in NI and compare the demographic profiles of those who may not be registered with local housing authorities. It is likely these individuals may represent a highly vulnerable population with complex needs and need tailored support packages.&#x0D; ConclusionWe will discuss some of the limitations of housing-administrative data and the methodologies we explored to help identify those people who may not be known to local authorities that are experiencing homelessness. Our findings can be used to inform policy on providing continuity of care and support for all people experiencing homelessness and reduce barriers to timely access of this support.

Implementing One-at-a-Time Therapy in community addiction and mental health centres: a retrospective exploration of the implementation process and initial outcomes

BackgroundThe Department of Health of the Government of New Brunswick and Regional Health Authorities elected to implement Stepped Care 2.0 (SC2.0) in 2021, and began with One-at-a-Time (OAAT) therapy in Community Addiction and Mental Health Centres (CAMHCs) to facilitate rapid access to addiction and mental healthcare. This study: 1) explicated the process of implementing OAAT therapy as it aligned to evidence-based implementation frameworks and strategies; 2) assessed readiness for change among providers during the implementation; and 3) evaluated initial client and system outcomes.MethodsThe process of implementing OAAT therapy within CAMHCs was documented and retrospectively aligned with the Active Implementation Frameworks-Stages of Implementation, Consolidated Framework for Implementation Research, and incorporated strategies endorsed by the Expert Recommendations for Implementing Change. Providers working in CAMHCs completed online asynchronous courses in OAAT therapy and SC2.0, and were recruited to participate in research on perceptions of organizational readiness. Initial outcomes of the implementation were evaluated through client satisfaction surveys administered in CAMHCs and system performance indicators.ResultsAligning with implementation stages, key strategies included: 1) continuously monitoring readiness and soliciting stakeholder feedback for iterative improvement; 2) building a representative implementation team with engaged leaders; 3) creating a comprehensive implementation plan on staff training, communication, and system changes; and 4) supporting sustainability. Providers who participated in research (N = 170, ~ 50% response rate) agreed that their organization was ready for implementation, and that OAAT therapy delivered within a SC2.0 framework was acceptable, appropriate, and feasible. More than 3,600 OAAT therapy sessions were delivered during the initial implementation stage, and waitlists were reduced by 64.1%. The majority of clients who completed surveys (N = 1240, ~ 35% response rate) reported that their OAAT therapy session was helpful, with a minority reporting that additional intervention was needed.ConclusionsThoughtful planning and execution, aligned with evidence-based implementation frameworks and strategies, played an important role in this provincial change initiative. Implementation steps outlined can help inform others looking to enact large-scale change.

Adherence to SARS-CoV-2 Vaccination Recommendations among Patients with Substance Use Disorders: A Cross-Sectional Study in Rome, Italy.

Adherence to vaccination recommendations is a challenge for national immunization programs. We quantified adherence to COVID-19 vaccination recommendations in people with substance use disorders (SUDs) attending an outpatient addiction center in Rome, Italy; we investigated the determinants of adherence, and also analyzed patient risk perception and compliance with preventive measures. A multivariable logistic regression model identified predictors of adherence to vaccination recommendations, with statistical validity tested by estimating adjusted odds ratios (aORs) and 95% confidence intervals (CIs). From December 2021 to January 2022, 200 SUD patients completed a questionnaire, 80% of whom reported being vaccinated against SARS-CoV-2 (minimum one dose). Negative predictors of vaccine uptake included being non-Italian (aOR: 0.36, 95% CI: 0.13-0.97), having coexisting comorbidities (aOR: 0.35, 95% CI: 0.13-0.95), and previous use of heroin (aOR: 0.24, 95% CI: 0.08-0.71). No difference was found for cocaine use, demographic characteristics, previous COVID-19 infection, methadone therapy, or compliance with preventive measures. Major reasons for non-adherence to vaccination recommendations were fear of side effects, insufficient recognition of the importance of vaccination, bureaucratic issues, and lack of trust in the authorities. Given their vulnerability, additional efforts are needed to facilitate access to vaccination for people with SUDs, and to limit disinformation around vaccines..

Community-based respondent-driven sampling as a strategy for drug use surveillance in a large French urban area

BackgroundUnderstanding drug use and behavior within the PWUD population is crucial to adapt harm reduction and prevention strategies, and provide improved addiction and medical treatment. However, in most countries such as France, the knowledge of drug use behaviors is likely biased as it originates from addiction centers which are attended by only an unknown proportion of PWUD. The objectives of this study were to describe drug use behavior in a population of active PWUD in the urban area of Montpellier, South of France.MethodsWe implemented a community-based respondent-driven sampling survey (RDSS), a validated strategy to obtain a representative sample of a population, to recruit PWUD in the city. Adult individuals reporting frequent psychoactive drug use other than cannabis, with confirmation by urine test, were eligible. Beside HCV and HIV testing, trained peers interviewed participants on their drug consumption and behavior using standardized questionnaires. Fifteen seeds launched the RDSS.ResultsDuring the 11 weeks of the RDSS, 554 actives PWUD were consecutively included. They were mostly men (78.8%), had a median age of 39 years, and only 25.6% had a stable living place. On average, participants consumed 4.7 (± 3.1) different drugs, and 42.6% smoked free-base cocaine. Unexpectedly, heroin and methamphetamine were consumed by 46.8% and 21.5% of participants, respectively. Among the 194 participants injecting drugs, 33% declared sharing their equipment.ConclusionThis RDSS highlighted a high consumption of heroin, crack and methamphetamine in this PWUD population. These unexpected results can be explained by low attendance to addiction centers, the source of drug use reports. Despite free care and risk reduction equipment in the city, sharing was very frequent among injectors, challenging the current program of harm reduction.

FRI-156 - Effectiveness of a direct care action strategy at the drug addiction center (test and treat in point of care) for the detection and treatment of hepatitis C in drug users on opioid agonist substitution therapy

FRI-156 - Effectiveness of a direct care action strategy at the drug addiction center (test and treat in point of care) for the detection and treatment of hepatitis C in drug users on opioid agonist substitution therapy

Problemas ligados ao álcool em centros de emergência (PLACE)-People experiencing homelessness with alcohol-related problems in Lisbon's emergency shelters during the COVID-19 pandemic: a description and analysis of a harm reduction intervention.

Alcohol-related problems disproportionally affect people experiencing homelessness. As the first wave of the COVID-2019 pandemic spread in 2020, a number of emergency shelters were opened in Lisbon. Increased difficulties in obtaining alcohol could have led to an increased incidence of alcohol withdrawal. Therefore, a low-threshold harm reduction intervention was introduced to these emergency shelters. This consisted of a fixed medication treatment, made available immediately for those with specific conditions, without the need for a medical evaluation or abstinence from alcohol, together with an offer of subsequent access to specialized addiction centers. The Problemas Ligados ao Álcool em Centros de Emergência (PLACE) study (alcohol-related problems in emergency shelters) is a retrospective mixed-methods observational study. It describes the demographic, health, and social characteristics of shelter users participating in the program and aims to evaluate the intervention as well as the experience of the patients, professionals, and decision-makers involved. A total of 69 people using shelters self-reported alcohol-related problems. Among them, 36.2% of the people accepted a pharmacological intervention, and 23.2% selected an addiction appointment. The take-up of the intervention was associated with better housing outcomes. A description of an individual's trajectory after leaving the shelter is provided. This study suggests that non-abstinence-focused interventions can be useful and well-tolerated in treating addiction in this population.

The Impact of Child Protective Services Involvement on Pregnant and Postpartum Women in Substance Use Disorder Treatment

Background: Pregnant women with substance use disorder often fail to complete treatment. Treatment retention can be influenced by many factors, including CPS involvement. This study evaluates the relationship, if any, between active CPS involvement while in treatment and treatment outcomes. Methods: This study is a retrospective analysis of data from 127 patients from the Center for Addiction and Pregnancy at the Johns Hopkins Bayview Medical Center in Baltimore, MD. The sample included 92 women with active CPS cases and 35 individuals without current CPS involvement. A log binomial regression with robust variance was used to estimate the relative risks of treatment completion and time spent in treatment (≥90 days vs. <90 days) between the active CPS-involved and uninvolved groups. Statistical significance was noted at a level of p < 0.05. Results: Women with active CPS involvement during their admission were significantly more likely to spend at least 90 days in treatment (OR = 1.78, CI = [1.09, 2.93]). The active CPS group also trended toward higher rates of treatment completion (RR = 1.41, CI = [0.78, 2.57]), although this finding was not statistically significant. Conclusions: In this real-world clinical sample, active CPS involvement was not associated with early SUD treatment discontinuation, however this did not translate to significant differences in rates of treatment completion. Additionally, prospective research to evaluate how the potential for CPS involvement may affect enrollment in SUD treatment would also help direct patient counseling.

Perceived Aetiology of Addiction and Stigmatizing Attitudes of Mental Health Professionals towards Substance Use Disorders Patients

Purpose: The study aimed to investigate the relationship between aetiological beliefs and stigmatizing attitudes of mental health professionals towards substance use patients. It was hypothesized that bio-genetic causal attributions would have a positive relationship with stigmatizing attitudes whereas psycho- social causal attributions would have a negative relationship with stigmatizing attitudes. Method: Correlational research design and purposive sampling strategy was used to collect a sample of 100 mental health professionals (MHPs) both from government hospitals and private addiction centres. Results: Results showed that Bio- genetic causal attributions had a positive relationship with stereotypic attitudes, treatment pessimism and non- permissiveness, however, no significant relationship was observed with moralism and treatment intervention. Also, psycho- social causal attributions had a positive relationship with stereotypic attitudes and moralism whereas no significant relationship was present with treatment pessimism, non- permissiveness and treatment intervention. Conclusion: The study highlights the multifaceted nature of stigma therefore the importance of combined aetiological information in anti- stigma interventions and empirically informed curriculum to reduce stigmatizing attitudes of mental health professionals. Keywords: Perceived Aetiology, Therapeutic Attitudes, Stigmatizing Attitudes, Substance Use Disorders

Widespread Mistreatment of Patients at Addiction Centers

Biomedical Safety & Standards 53(7):p 55, April 15, 2023. | DOI: 10.1097/01.BMSAS.0000924628.36781.23