Drug Treatment Providers Research Articles

The effects of race and class on community-level stigmatization of opioid use and policy preferences.

With opioid use and overdose rates continuing to plague minority communities in the U.S., we explored whether a geographic community's racial composition and social class affect how opioid use in the community is stigmatized and what policy preferences arise in response. We use case vignettes in a randomized, between-subjects study (N=1478) with a nation-wide survey. The vignettes describe a community where opioids are harmfully used, varying whether the community was (1) wealthy or poor, (2) predominantly Black or White and (3) facing prevalent use of painkillers or heroin. We tested how these variables affect public stigmatization of opioid use (measured with ratings of responsibility, dangerousness, sympathy, concern, anger, and disappointment) preferred levels of social distance from communities with opioid use (measured with responses to questions about living, working, and interacting in the community), and policy preferences for responding to opioid use (measured with levels of support for providing a safe-consumption site in the community, treating drug use in the community punitively, treating drug use in the community as an illness, and funding drug treatment in the community through income redistribution). Compared to wealthy communities with opioid use, poor communities with opioid use were less stigmatized in terms of responsibility, sympathy, concern, anger, and disappointment; they were also met with less support for punitiveness, more support for treating drug use as an illness, and preferences for greater social distance. Compared to White communities with opioid use, Black communities with opioid use were less stigmatized in terms of responsibility, and they were met with stronger preferences to not live and work there and with reduced support for using income redistribution to provide drug treatment for people in the community. Poor-Black communities with opioid use were also perceived to be more dangerous than both poor-White and wealthy-Black communities with opioid use. These results point to class- and race-based territorial stigma affecting how communities with opioid use are judged and whether policies for providing communities with treatment are supported.

Immunogenic landscape and risk score prediction based on unfolded protein response (UPR)-related molecular subtypes in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is the most common type of cancer and causes a significant number of cancer-related deaths worldwide. The molecular mechanisms underlying the development of HCC are complex, and the heterogeneity of HCC has led to a lack of effective prognostic indicators and drug targets for clinical treatment of HCC. Previous studies have indicated that the unfolded protein response (UPR), a fundamental pathway for maintaining endoplasmic reticulum homeostasis, is involved in the formation of malignant characteristics such as tumor cell invasiveness and treatment resistance. The aims of our study are to identify new prognostic indicators and provide drug treatment targets for HCC in clinical treatment based on UPR-related genes (URGs). Gene expression profiles and clinical information were downloaded from the TCGA, ICGC and GEO databases. Consensus cluster analysis was performed to classify the molecular subtypes of URGs in HCC patients. Univariate Cox regression and machine learning LASSO algorithm were used to establish a risk prognosis model. Kaplan-Meier and ROC analyses were used to evaluate the clinical prognosis of URGs. TIMER and XCell algorithms were applied to analyze the relationships between URGs and immune cell infiltration. Real time-PCR was performed to analyze the effect of sorafenib on the expression levels of four URGs. Most URGs were upregulated in HCC samples. According to the expression pattern of URGs, HCC patients were divided into two independent clusters. Cluster 1 had a higher expression level, worse prognosis, and higher expression of immunosuppressive factors than cluster 2. Patients in cluster 1 were more prone to immune escape during immunotherapy, and were more sensitive to chemotherapeutic drugs. Four key UPR genes (ATF4, GOSR2, PDIA6 and SRPRB) were established in the prognostic model and HCC patients with high risk score had a worse clinical prognosis. Additionally, patients with high expression of four URGs are more sensitive to sorafenib. Moreover, ATF4 was upregulated, while GOSR2, PDIA6 and SRPRB were downregulated in sorafenib-treated HCC cells. The UPR-related prognostic signature containing four URGs exhibits high potential application value and performs well in the evaluation of effects of chemotherapy/immunotherapy and clinical prognosis.

An observational study on drug interactions caused by proton pump inhibitors

Proton pump inhibitors (PPIs) are widely used to treat gastric acid-related diseases worldwide and in our country. The high reliability of PPIs also allows long-term use for appropriate indications in chronic diseases, which increases the possibility of drug-drug interactions. Therefore, it is clear that the usage of PPIs should be monitored in terms of drug-drug interactions to provide drug treatment success and patient safety. The ability of pharmacists, the closest health consultants, to identify these interactions during prescription fulfillment will significantly contribute to treatment success. Although many studies deal with the rational use of PPIs and drug interactions, the number of studies revealing observational drug interactions is minimal. This research aims to determine drug-drug interactions frequently encountered in community pharmacies for PPIs, which interact with many drug groups and are commonly prescribed. For this purpose, approximately 1700 prescriptions supplied by a selected community pharmacy, serving in Van, were examined. One hundred sixty-four of the prescriptions were evaluated by considering the study’s limitations. Drug-drug interactions were checked by three different electronic database. It was determined that 73 of 164 prescriptions had interactions in at least one of the three databases. In 73 prescriptions, 86 drug interactions were observed. 34% of the interactions detected in the study were caused by lansoprazole.

An Immunological Perspective on the Mechanism of Drug Induced Liver Injury: Focused on Drugs for Treatment of Hepatocellular Carcinoma and Liver Transplantation.

The liver is frequently exposed to potentially toxic materials, and it is the primary site of clearance of foreign agents, along with many innate and adaptive immune cells. Subsequently, drug induced liver injury (DILI), which is caused by medications, herbs, and dietary supplements, often occurs and has become an important issue in liver diseases. Reactive metabolites or drug-protein complexes induce DILI via the activation of various innate and adaptive immune cells. There has been a revolutionary development of treatment drugs for hepatocellular carcinoma (HCC) and liver transplantation (LT), including immune checkpoint inhibitors (ICIs), that show high efficacy in patients with advanced HCC. Along with the high efficacy of novel drugs, DILI has become a pivotal issue in the use of new drugs, including ICIs. This review demonstrates the immunological mechanism of DILI, including the innate and adaptive immune systems. Moreover, it aims to provide drug treatment targets, describe the mechanisms of DILI, and detail the management of DILI caused by drugs for HCC and LT.

Increased solitary drug use during COVID-19: An unintended consequence of social distancing.

During the COVID-19 pandemic, overdose rates substantially increased in the United States. One possible contributor to this phenomenon may be solitary drug use resulting from social distancing efforts to prevent COVID-19 transmission. We surveyed 458 people who use drugs (PWUD) who were recruited from harm reduction and drug treatment providers located in nine states and the District of Columbia. We assessed if solitary drug use had increased since the start of COVID-19. Associations between increased solitary drug use and sociodemographic characteristics, drug use characteristics, and COVID-19 prevention behaviors were examined using multiple logistic regression. Half the sample identified as men (52.7%), White (49.7%), and single (49.3%). The average age was 43.2 (SD:11.8) years. Two-thirds (66.8%) recently injected drugs. 44% reported increased solitary drug use since COVID-19. Significant correlates of increased solitary drug use included being single (adjusted Odds Ratio [aOR]=1.99, 95% Confidence Interval [CI]: 1.33, 2.98), increasing drug use (aOR=2.74, 95% CI: 1.72, 4.37), using more in private locations (aOR=1.91, 95% CI: 1.34, 2.72), and social distancing behaviors (aOR=1.31, 95% CI: 1.11, 1.54). Experiencing homelessness (aOR=0.45, 95% CI: 0.31, 0.65) and identifying as a sexual minority (aOR=0.53, 95% CI: 0.31, 0.93) were associated with being less likely to increase solitary drug use. Solitary drug use increased during the COVID-19 pandemic. Increases in solitary drug use, in the context of a drug market increasingly permeated by fentanyl, indicates an urgent need for comprehensive harm reduction interventions to reduce overdose mortality.

Challenges in the pharmacological treatment of patients under suspicion of chronic traumatic encephalopathy: A review

Chronic traumatic encephalopathy (CTE) is caused by progressive neurodegeneration associated with repetitive head impacts. This disease is more common in professionals who practice contact sports, resulting in a concussion and subconcussive trauma. CTE is characterized by the accumulation of hyperphosphorylated tau protein in neurons, astrocytes, and frontotemporal lobe degeneration. Symptoms are usually nonspecific and overlap with other neurodegenerative diseases, such as Alzheimer's disease and frontotemporal dementia, making it difficult to provide drug treatment for patients with this comorbidity. Therefore, the objective of this article is to present an updated review of the pharmacological treatment of chronic traumatic encephalopathy and its challenges.

Reducing the drivers of drug demand in English towns by understanding risk and resilience in the community and developing a framework for partnership action: a mixed methods analysis

BackgroundSubstance misuse has extensive effects on individuals and communities, ranging from the poor health of people who use drugs to the pressure placed on health care, social services, and the criminal justice system. Strategies to curtail the supply and demand of drugs and reduce these effects typically focus on supply, with less emphasis placed on the drivers of demand. We piloted and evaluated a public health approach for understanding the drivers and effects of substance misuse in a local area, and how these might be targeted for prevention through multi-agency partnership action. MethodsA cross-sectional mixed methods analysis was conducted, using multi-agency data. 3 years of data provided by criminal justice agencies (police, youth justice, and probation), drug treatment services, social care, education, and hospitals were used to profile the local demand and effect of drugs on individuals and communities in a coastal town in southern England. The experiences of local professionals who support people who misuse drugs, or people affected by drug misuse, were collected via an online survey that was disseminated to relevant partnership organisations, including homelessness charities and drug treatment providers. A public health framework identifying relevant risk and resilience factors in the community was developed by combining the multi-agency data and survey responses The methodological efficacy of this approach to inform partnership action was evaluated via a survey with the project's stakeholders. FindingsCommunity housing, mental health, and cycles entrenching substance misuse were identified as risk factors that increase individual-level, interpersonal-level, and community-level vulnerabilities to the harms of drug misuse, violence, and exploitation. Evaluation found this mixed-methods analysis for understanding risk and resilience to be a valuable approach to enable public health and community safety leaders to develop a framework for partnership action to reduce the negative effects of drug demand in the community. InterpretationAnalysis of multi-agency data helped to further a shared understanding in local partners of the drivers and effects of drug demand at a local level; and, through a public health lens, clearly identified the role that local organisations can play in minimising the harms of substance misuse and exploitation. FundingNo funding received.

Pharmacist-led review sessions with medical students and their impact

The Institute of Medicine (IOM) called for a new emphasis on interprofessional approaches to medical education suggesting the ever challenging and complex needs of patients can best be addresses by healthcare professionals communicating and working together as members of an interprofessional healthcare team. A number of different articles are published on the effects a pharmacist can have on medical education in the clinical years. Few articles detail the effect pharmacists could have on medical students in their pre-clinical years. The purpose of this study was to determine if an interprofessional educational approach, defined as having a pharmacist-led pharmacology review session(s), can impact medical student attitudes towards pharmacists. A pre-post survey design using a reliable and validated tool was performed. This study supports, using trending data, the premise that interprofessional education can impact attitudes of healthcare students towards each other. Pharmacist educating medical students in pre-clinical years was shown to have an impact of medical students’ attitudes towards the role of pharmacist, especially in providing drug treatment decisions.

A qualitative study exploring the impact of the COVID-19 pandemic on People Who Inject Drugs (PWID) and drug service provision in the UK: PWID and service provider perspectives.

BackgroundPeople Who Inject Drugs (PWID) are subject to distinct socio-structural inequalities that can expose them to high risks of COVID-19 transmission and related health and social complications. In response to COVID-19 mitigation strategies, these vulnerabilities are being experienced in the context of adapted drug treatment service provision, including reduced in-person support and increased regulatory flexibility in opioid substitution therapy (OST) guidelines. This study aimed to explore the longer-term impact of the pandemic on the health and wellbeing of PWID in the UK, including provider and client experiences of treatment changes.MethodsInterviews were conducted with 19 PWID and 17 drug treatment providers between May and September 2021, recruited from drug and homelessness charities providing treatment services and healthcare in the UK. Data were analysed using reflexive thematic analysis.ResultsMost participants expressed ongoing fears of COVID-19 transmission, although socio-structural inequalities limited the contexts in which physical distancing could be practised. In addition, virus mitigation strategies altered the risk environment for PWID, resulting in ongoing physical (e.g. changing drug use patterns, including transitions to crack cocaine, benzodiazepine and pregabalin use) and socio-economic harms (e.g. limited opportunities for sex work engagement and income generation). Finally, whilst clients reported some favourable experiences from service adaptations prompted by COVID-19, including increased regulatory flexibility in OST guidelines, there was continued scepticism and caution among providers toward sustaining any treatment changes beyond the pandemic period.ConclusionsWhilst our findings emphasize the importance of accessible harm reduction measures attending to changing indices of drug-related harm during this period, there is a need for additional structural supports to ensure pre-existing disparities and harms impacting PWID are not exacerbated further by the conditions of the pandemic. In addition, any sustained policy and service delivery adaptations prompted by COVID-19 will require further attention if they are to be acceptable to both service users and providers.

Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder.

BackgroundCognitive dysfunction is disproportionately prevalent among persons with opioid use disorder (OUD). Specific domains of cognitive dysfunction (attention, executive functioning, memory, and information processing) may significantly impede treatment outcomes among patients on medication for OUD (MOUD). This limits patient's ability to learn, retain, and apply information conveyed in behavioral intervention sessions. Evidence-based accommodation strategies have been integrated into behavioral interventions for other patient populations with similar cognitive profiles as persons with OUD; however, the feasibility and efficacy of these strategies have not yet been tested among patients on MOUD in a drug treatment setting.MethodsWe conducted a series of focus groups with 25 key informants (10 drug treatment providers and 15 patients on MOUD) in a drug treatment program in New Haven, CT. Using an inductive approach, we examined how cognitive dysfunction impedes participant's ability to retain, recall, and utilize HIV prevention information in the context of drug treatment.ResultsTwo main themes capture the overall responses of the key informants: (1) cognitive dysfunction issues and (2) accommodation strategy suggestions. Subthemes of accommodation strategies involved suggestions about particular evidence-based strategies that should be integrated into behavioral interventions for persons on MOUD. Specific accommodation strategies included: use of a written agenda, mindfulness meditation, multi-modal presentation of information, hands-on demonstrations, and a formal closure/summary of sessions.ConclusionsAccommodation strategies to compensate for cognitive dysfunction were endorsed by both treatment providers and patients on MOUD. These accommodation strategies have the potential to enhance the efficacy of behavioral interventions to reduce HIV transmission among persons on MOUD as well as addiction severity, and overdose.

In Case You Haven't Heard…

North Carolina received more than $16 million in funding to deal with the opioid crisis, and $10 million of it went to one organization — Hope Alive — for a new treatment center. The organization, according to a report in WRAL, has no record of ever providing drug treatment, is run by a pastor and is connected to the lawmaker in charge of doling out the money. “We really didn't have a whole lot of other options out there locally for folks that were willing to do this,” said Sen. Danny Britt (R‐Robeson). “Hope Alive ministries was — but we needed them to work with people who have had clinically proven methods.” Hope Alive was founded in July 2020 and has the same address as “a church in a strip mall off of Interstate 95 in Lumberton, called Greater Hope International Church — a nondenominational institution run by senior pastor Ronald Barnes,” according to the WRAL report. Also according to the report, Barnes pleaded guilty to at least seven counts of embezzlement, serving time for them. Britt told WRAL he wasn't aware of that criminal history but supported giving the money to him anyway. For the report, go to https://www.wral.com/church‐nonprofit‐with‐zero‐track‐record‐of‐providing‐drug‐treatment‐awarded‐10‐mil‐from‐state‐to‐combat‐opioid‐crisis/20072234/.

"You're Not Supposed to be on it Forever": Medications to Treat Opioid Use Disorder (MOUD) Related Stigma Among Drug Treatment Providers and People who Use Opioids.

Opioid use disorder (OUD) through prescription opioid misuse, heroin, and illicitly manufactured fentanyl use has increased dramatically in the past 20 years. Medications to treat opioid use disorder (MOUD) is considered the gold standard for treating opioid use disorders but uptake remains low. Recently, Madden has argued that in addition to the stigma assigned to substance use and people with SUD, MOUDs also are stigmatized, a process she labels intervention stigma to distinguish it from condition stigma (ie, stigma of SUD) . In this paper, we examine MOUD related stigma from the perspective of people who use opioids (PWUO) and key informants who play some role in providing or referring people to drug treatment. Providers and PWOU often viewed MOUD as one drug replacing another which discouraged providers from recommending and PWUO from accepting MOUD. MOUD stigma was also expressed by providers’ exaggerated fear of MOUD diversion. The extent to which MOUD was accepted as a legitimate treatment varied and influenced treatment providers’ perceptions of the goals of drug treatment and the length of time that MOUD should be used with many feeling that MOUD should only be used as a temporary tool while PWOU work on other treatment goals. This led to tapering off of MOUD after some time in treatment. Some providers also expressed mistrust of MOUD stemming from their previous experiences with the over-prescription of opioids for pain which led to the current crisis. Results from this study suggest that the proportion of PWUO on MOUD is unlikely to increase without addressing MOUD stigma among drug treatment providers and PWUO seeking treatment.

Addressing opioid misuse: Hero Help as a recovery and behavioural health response

Increases in opioid-related overdoses have required law enforcement and public health officials to collectively develop new approaches that treat substance use disorders and save lives. This essay describes the Hero Help recovery and behavioural health assistance program, a Delaware-based initiative providing drug treatment to qualifying adults who contact the police and ask for treatment, or to individuals in lieu of an arrest or upon recommendation by a police officer. Led by the New Castle County Division of Police, this collaborative project has brought together stakeholders from public health and criminal justice to coordinate treatment for people suffering from a substance use disorder and/or mental health problems. This essay describes the goals, evolution, and key activities of the program. It further highlights lessons learned, including improving credibility through concerted community outreach, finding ways to overcome the stigma associated with participating in a law enforcement–based program, gaining officer buy-in, and using data to inform treatment responses. Effectively, this essay seeks to disseminate emerging lessons in creating programming responsive to substance use disorder and mental illness among police departments and their community partners.

Factors influencing engagement and utilisation of opium tincture-assisted treatment for opioid use disorder: A qualitative study in Tehran, Iran.

In response to a high burden of opioid use disorder (OUD), Iran established a network of opioid agonist treatment (OAT) centres beginning in 2002. To increase treatment diversity, particularly for patients who use opium as their drug of choice, opium tincture (OT)-assisted treatment was introduced to the network. This study aimed to explore factors influencing OT-assisted treatment selection for OUD in Tehran, Iran. We conducted 54 in-depth interviews with patients with OUD (n= 33), family members of patients (n= 9) and drug treatment providers (n= 12). Participants were recruited from 12 drug treatment centres across Tehran, between September and November 2019. All interviews were audio-recorded, transcribed and coded in OpenCode 4.02 software and analysed using thematic analysis. Study participants more commonly reported individual-level factors as facilitators (e.g. to reduce harms associated with illicit opioid use, achieve recovery through a gradual dose reduction regimen combined with Congress 60 recovery program) and structural level factors (e.g. low adoption by OAT system and lack of familiarity of treatment providers) as barriers for utilisation of OT-assisted treatment regimens. OT was perceived to produce lower levels of physiological dependence than methadone, but the requirement for twice supervised dosing was restrictive. Low familial and community acceptance were also seen as barriers to access. This research identified a range of perceived benefits for OT-assisted treatment ranging from harm reduction to an intermediate step to achieve recovery. However, several structural-, individual-, familial- and community-level barriers impede its availability and acceptability.

A comparison of structural features and vulnerability between government and nongovernment alcohol and other drug (AOD) treatment providers

ObjectiveBoth public (government-run), and not-for-profit (nongovernment) service providers provide alcohol and other drug (AOD) treatment services. Research has rarely studied the structural features of these providers, such as workforce characteristics, procurement arrangements, and funding security. The study reported here sought to document and analyze the differences between these two AOD treatment provider types in Australia. MethodsThe study administered an online survey instrument targeted at managers of AOD treatment sites. The survey comprised three sections: (1) the service (e.g., treatment types); (2) workforce (e.g., total number of staff); and (3) funding and procurement arrangements (e.g., contract length). The study completed a total of 207 site surveys. The studied compared government and nongovernment services on structural features that may create a more or less sustainable or vulnerable service (funding arrangements, payment mechanisms, and contract length). ResultsGovernment providers were more likely to provide medically oriented treatment types such as withdrawal management and pharmacotherapy, whereas nongovernment organization (NGO) providers were more likely to offer rehabilitation. Consistent with this, government services were more likely to employ medical professionals and nurses, indicative of a more medically oriented workforce, while NGO services were more likely to employ AOD workers, youth workers, peer workers, and counselors. Our data illustrate that NGO services were more likely to be subject to competitive tendering and to have shorter contract lengths, compared with government services, and overall to be more structurally vulnerable. ConclusionDespite the reliance on NGOs to provide the majority of specialist care (71% of all treatment episodes in Australia), these services are more vulnerable than their government counterparts. To ensure that a comprehensive suite of treatment services is available, procurement arrangements that support stability and security in nongovernment service providers and government service providers are essential.

The correlates and extent of prescribing of medications for alcohol relapse prevention in England.

To determine the pattern and extent of prescribing of medications for alcohol relapse prevention (ARP) in England. Cross-sectional. Specialist drug and alcohol treatment providers in England reporting to the National Drug Treatment Monitoring System. Service users aged 18+, with alcohol the primary substance of dependence, completing a treatment journey between April 2013 and March 2016 (n=188 152). Prescription of medications for ARP during a treatment journey. Data on service users' demographics, treatment and clinical characteristics were extracted. The rate of prescribing medications for ARP was 2.1% in 2013/14, 6.8% in 2014/15 and 7.8% in 2015/16. A greater likelihood of prescription was associated with treatment journey year [2014/15; adjusted odds ratio (aOR)=3.269, 95% confidence intervals (CI)=3.044-3.510, 2015/16; aOR=3.823, CI=3.560-4.106], age (25-34; aOR=1.622, CI=1.380-1.907, 35-54; aOR=1.901, CI=1.628-2.220 or 55+; aOR=1.700, CI=1.446-1.999), female gender (aOR=1.129, CI=1.077-1.184), white ethnicity (aOR=1.219, CI=1.077-1.380), regional prevalence of alcohol dependence (middle rate; aOR=1.121, CI=1.024-1.228), severity of alcohol dependence (moderate dependence without complex needs; aOR=1.329, CI=1.244-1.419, severe dependence without complex needs; aOR=1.308, CI=1.188-1.441, moderate/severe dependence with complex needs; aOR=1.131, CI=1.020-1.255), treatment setting (inpatient; aOR=10.512, CI=9.950-11.104, primary care; aOR=2.264, CI=2.050-2.500, residential; aOR=3.216, CI=2.807-3.685), prior treatment for alcohol dependence (aOR=1.242, CI=1.183-1.304), longer treatment journey (aOR=1.002, CI=1.002-1.002), more drinking days in the prior 28days (aOR=1.021, CI=1.018-1.024) and drinking a higher number of alcohol units in the prior 28days (aOR=1.002 CI=1.001-1.004). Living in a region of England with the lowest alcohol prevalence was associated with a lower likelihood of prescription of medication for aRP (AOR=0.491, CI=0.436-0.552). In England, medications for alcohol relapse prevention are rarely prescribed (e.g. 7.8% in 2015/16) and those prescriptions appear to be associated with specific service user demographics, treatment and clinical characteristics.

History and modern problems of providing dispensary drug treatment

The article presents an analysis of the history of development and identified problems in the system of outpatient drug treatment. The main issues of providing drug treatment to the population and possible prospects for the development of the system of outpatient drug treatment are considered.

Pharmacists can provide drug treatment for hypertension, WHO guideline says

Pharmacists can provide drug treatment for hypertension, WHO guideline says

Therapeutic Discipline: Drug Courts, Foucault, and the Power of the Normalizing Gaze

Drug treatment courts represent a paradigm shift in the American criminal justice system. By focusing on providing drug treatment services to low-level offenders with severe use disorders rather than sentencing them to a term of incarceration, drug courts represent a return to a more rehabilitative model for dealing with individuals ensnared by the criminal justice system and away from the retributive model that dictated punishment in the latter half of the twentieth century. The existing scholarship exploring how drug treatment courts function has been largely atheoretical, and past attempts to harmonize theory to drug treatment courts fail to demonstrate how these institutions normalize offenders prior to reintegration into society. Relying on Michel Foucault’s notion of governmentality together with his concepts of “technologies of power” and “technologies of the self,” I develop the analytical framework of “therapeutic discipline” as a more robust lens through which to understand the operation of drug treatment courts nationwide. My contribution of “therapeutic discipline” to the existing literature is bolstered by representative examples of qualitative data taken from a long-term, ethnographic study of one adult drug treatment court.

Nutritional implications of opioid use disorder: A guide for drug treatment providers.

The number of Americans seeking treatment for opioid use disorder (OUD) continues to increase. However, there are important nutritional implications of having OUD that often get overlooked by drug treatment providers. OUDs can cause metabolic changes, constipation, and weight loss, or lead to a lifestyle that results in inadequate food intake and unhealthy eating patterns. Nutritional factors associated with OUD can also hinder treatment outcomes and recovery. Addiction providers tend to give little attention to the nutritional implications of OUD, and this knowledge is rarely incorporated into treatment plans. The goal of this article, therefore, is to summarize the existing literature on the connection between OUD and nutrition to help guide treatment programs. This article (a) describes the nutritional consequences associated with misusing opioids, (b) discusses the role that nutrition can play in OUD treatment and recovery, (c) summarizes the nutritional implications of medication treatment for OUD, and (d) recommends nutritional interventions that might aid in the treatment of OUD. This article directly fills a gap in the OUD literature and has the potential to serve as a guide for drug treatment providers to make more informed nutritional recommendations to their clients. Treatment programs may wish to consider the issues raised in this paper before launching nutritional programs at their facility. (PsycInfo Database Record (c) 2020 APA, all rights reserved).