Adverse childhood experiences predict opioid relapse during treatment among rural adults

Derefinko, Karen J.; García, Francisco I. Salgado; Talley, Kevin M.; Bursac, Zoran; Johnson, Karen C.; Murphy, James G.; McDevitt-Murphy, Meghan E.; Andrasik, Frank; Sumrok, Daniel D.

doi:10.1016/j.addbeh.2019.05.008

Cited by 40 publications

(41 citation statements)

References 22 publications

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“…People with ACE scores 4, or higher, are at increased risks for comorbid conditions including depression, obesity, and cardiovascular diseases ( Campbell et al, 2016 ). ACE scores might also be associated with compromised medication non-adherence and therapy outcomes ( Derefinko et al, 2019 ; Korhonen et al, 2015 ). Another subset of factors which can affect therapy outcomes comprises atmospheric conditions (air pollution, wildfires, floods, extreme weather like high temperatures) ( Stewart et al, 2017 ), and unpredictable circumstances, such as the COVID-19 pandemic.…”

Section: Precision Digital Interventions For Epilepsy Pain Depression and Cancermentioning

confidence: 99%

From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

et al. 2021

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To improve long-term outcomes of therapies for chronic diseases, health promotion and lifestyle modifications are the most promising and sustainable strategies. In addition, advances in digital technologies provide new opportunities to address limitations of drug-based treatments, such as medication non-adherence, adverse effects, toxicity, drug resistance, drug shortages, affordability, and accessibility. Pharmaceutical drugs and biologics can be combined with digital health technologies, including mobile medical apps (digital therapeutics), which offer additional clinical benefits and cost-effectiveness. Promises of drug+digital combination therapies are recognized by pharmaceutical and digital health companies, opening opportunities for integrating pharmacotherapies with non-pharmacological interventions (metapharmacology). Herein we present unique features of digital health technologies which can deliver personalized self-care modalities such as breathing exercises, mindfulness meditation, yoga, physical activity, adequate sleep, listening to preferred music, forgiveness and gratitude. Clinical studies reveal how aforementioned complimentary practices may support treatments of epilepsy, chronic pain, depression, cancer, and other chronic diseases. This article also describes how digital therapies delivering “medicinal” self-care and other non-pharmacological interventions can also be personalized by accounting for: 1) genetic risks for comorbidities, 2) adverse childhood experiences, 3) increased risks for viral infections such as seasonal influenza, or COVID-19, and 4) just-in-time stressful and traumatic circumstances. Development and implementation of personalized pharmacological-behavioral combination therapies (precision metapharmacology) require aligning priorities of key stakeholders including patients, research communities, healthcare industry, regulatory and funding agencies. In conclusion, digital technologies enable integration of pharmacotherapies with self-care, lifestyle interventions and patient empowerment, while concurrently advancing patient-centered care, integrative medicine and digital health ecosystems.

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Section: Precision Digital Interventions For Epilepsy Pain Depression and Cancermentioning

confidence: 99%

From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

et al. 2021

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“…Possible: neglect, financial strain, abuse, violence, food insecurity, less employment, more injuries to children, greater safety risk in home, lack of access to medical care, parental mental health challenges, increased incarceration, possible disordered attachment, possible increased risk of child SUD, increased foster care rates, overdose mortalities increasing (Brundage & Levine, 2019;Cole et al, 2005;Derefinko et al, 2019;Stulac et al, 2019;Welby, 2019) Trauma experienced by child could be:…”

Section: Opioid Use Disordermentioning

confidence: 99%

“…Possible: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned; add community ACEs experiencing racism, witnessing violence, living in an unsafe neighborhood, experiencing bullying, and a having a history of living in foster care (Cronholm et al, 2015;Derefinko et al, 2019;Felitti et al, 1998)…”

Section: Adverse Childhood Experiences (Aces)mentioning

confidence: 99%

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Secondary Traumatic Stress in Teachers and School Communities Impacted by the Opioid Epidemic

Steketee¹

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Secondary Traumatic Stress in Teachers and School Communities Impacted by the Opioid Epidemic by Anne Steketee People who support others who have experienced trauma, like nurses, doctors, social workers, or first responders can sometimes be affected by a type of stress called secondary traumatic stress (STS). Although the effect of STS has been studied in helpers like social workers and medical professionals, the prevalence and characteristics of STS in teachers have not been studied extensively and are less understood. Schools in our communities impacted by the opioid epidemic also report additional stressors from issues like addiction, overdose, crime, neglect, rise in foster care, increased medical care, and death. This dissertation investigates STS in K-12 public school teachers in the United States, in areas of varying opioid impact. Specifically, K-12 teachers (n = 450), in 26 states and Washington, D. C., were surveyed utilizing a validated instrument for secondary traumatic stress (Secondary Traumatic Stress Scale; Bride, Robinson, Yegidis, & Figley, 2004), along with demographic questions and open-ended questions. Teachers were also asked about adverse childhood experiences of their students, using the PHL-ACE categories (Health Federation of Philadelphia and Philadelphia ACE Research and Data Committee, 2012). The prevalence and extent of teacher STS were explored in communities of low-, medium-, and high-opioid impact levels as defined by the National Institute of Health epidemiology parameters. I used descriptive statistics and correlations (Spearman's Rho) to determine the prevalence of STS in the sample of teachers and to determine if this prevalence had any relationship to the opioid mortality rate in communities. Over half of the teachers in the VII study (59.56%) experienced STS at a moderate or higher level. Teachers in high opioid zones reported the highest mean STSS scores (M = 43.78, SD = 16.00), with 62.67% scoring at 38 or higher. Over 85% of teachers endorsed intrusion symptoms at a diagnostic level. Between 91-93% of all teachers surveyed endorsed adverse events experienced by their students. Using Spearman's Rho correlation, I did not find a relationship between the environment of the opioid zone or the demographic characteristics of the teachers. Additional findings and implications are discussed and support the need to continue teacher STS research in all communities. VIII

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“…People with ACE scores 4, or higher, are at increased risks for comorbid conditions including depression, obesity, and cardiovascular diseases (Campbell et al, 2016). ACE scores might also be associated with compromised medication nonadherence and therapy outcomes (Derefinko et al, 2019;Korhonen et al, 2015). Another subset of factors which can affect therapy outcomes comprises atmospheric conditions (air pollution, wildfires, floods, extreme weather like high temperatures) (Stewart et al, 2017), and unpredictable circumstances, such as the COVID-19 pandemic.…”

Section: Examples Of Clinical Benefitsmentioning

confidence: 99%

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Adverse childhood experiences predict opioid relapse during treatment among rural adults

Cited by 40 publications

References 22 publications

From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

Secondary Traumatic Stress in Teachers and School Communities Impacted by the Opioid Epidemic

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