Linkage to methadone treatment from acute opiate detoxification treatment

Zaller, Nickolas; Thurmond, Portia; Brett, Jon; Carleton, James C; Rich, Josiah D.

doi:10.5055/jom.2006.0050

Cited by 7 publications

(5 citation statements)

References 23 publications

(24 reference statements)

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“…It was born out of research investigating how to engage patients in SUD treatment after medical treatment related to substance misuse (Carroll et al , 2009). This approach may include providers familiarizing patients with the SUD treatment program they will subsequently enter (eg, medical clinic staff escort patients on a shuttle bus to a treatment program where, together, they meet with a treatment counselor) (Chutuape et al , 2001), in addition to the provision of ongoing, face-to-face intensive case management (McLellan et al , 2005; Zaller et al , 2006). Indeed, medical patients in an escort condition were more likely to enter SUD treatment than were those in usual care (76% versus 24%).…”

Section: Resultsmentioning

confidence: 99%

A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature

Cucciare

Coleman

Timko

2014

Prim Health Care Res Dev

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We conducted a narrative review that occurred in three stages: literature review of health care transition models, identification of conceptual domains common across care transition models, and identification of SUD-specific model elements. Findings The conceptual model presented describes patient, provider, and system-level facilitators and barriers to the transition process, and includes intervention strategies that can be utilized by primary care clinics to potentially improve the process of transitioning patients from primary care to SUD care. Recognizing that primary care clinics vary in available resources, we present three examples of care practices along an intensity continuum from low (counseling and referral) to moderate (telephone monitoring) to high (intensive case management) resource demands for adoption. We also provide a list of common outcomes clinics might consider when evaluating the impact of care transition practices in this patient population; these include process outcomes such as patients' increased knowledge of available treatment resources, and health outcomes such as patients' reduced substance use and better quality of life.

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Section: Resultsmentioning

confidence: 99%

A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature

Cucciare

Coleman

Timko

2014

Prim Health Care Res Dev

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“…Detoxification inpatients in an accompanied condition were more likely to enter treatment than those in usual care (76% vs. 24%; Chutuape et al, 2001). Compared to usual care, intensive case management of repeat detoxification inpatients showed a 70% increase in treatment entry and significantly longer treatment stays (McLellan et al, 2005;Zaller et al, 2006).…”

Section: Treatment and Outcomes Among Detoxification Inpatientsmentioning

confidence: 98%

“…Studies have examined how to engage detoxification patients in subsequent treatment to reduce the occurrence of repeated detoxification episodes and increase beneficial outcomes (Carroll et al, 2009). Strategies include detoxification staff familiarizing patients, during the detoxification episode, with the addiction treatment program patients will later enter (e.g., staff accompany patients on a shuttle bus to meet treatment counselors), and providing ongoing, in-person intensive case management (Chutuape et al, 2001;McLellan Weinstein, Shen, Kendig, & Levine, 2005;Zaller, Thurmond, Brett, Carleton, & Rich, 2006). Detoxification inpatients in an accompanied condition were more likely to enter treatment than those in usual care (76% vs. 24%; Chutuape et al, 2001).…”

Section: Treatment and Outcomes Among Detoxification Inpatientsmentioning

confidence: 99%

Randomized controlled trial of enhanced telephone monitoring with detoxification patients: 3- and 6-month outcomes

Timko

Below

Vittorio

et al. 2019

Journal of Substance Abuse Treatment

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Telehealth interventions have the potential to deter repeated detoxification episodes and improve outcomes. Using a sample of 298 detoxification inpatients, this randomized controlled trial compared Enhanced Telephone Monitoring (ETM) to usual care (UC) on the primary outcome of reducing subsequent detoxification, and secondary outcomes of linking patients to addiction treatment and mutual-help, and patients' experience of improved substance use and mental health outcomes. At the 3-month follow-up (i.e., at the end of the ETM intervention), compared to UC patients, ETM patients were significantly less likely to have received additional inpatient detoxification, but no more likely to have participated in 12-step groups or received outpatient addiction treatment. Even so, ETM patients had better alcohol, drug, and mental health outcomes. In contrast, at the 6-month follow-up, patients in ETM and UC generally did not differ on primary or secondary outcomes. Findings suggest that ETM deters additional detoxification episodes while the intervention is ongoing, but not after the intervention ends. Because telephone monitoring is low-intensity and low-cost, its extension over time may help reduce repeated detoxifications.

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“…Enrollment of a partner, particularly when from the parental family, in an extended training program to assist the partner in using behavioral principles to increase the patient's treatment retention and reduce their drug use, may have a substantial effect on improving retention 114 . Even providing a personal escort plus a financial incentive may substantially increase the success of transition from a detoxification unit to aftercare 115 as many patients with addiction harbor misconceptions that may deter them for entering MAT programs 116 and they may not have the transportation required.…”

Section: Rehabilitation Of People With Addictionmentioning

confidence: 99%

The Two Opioid Crises Problems, Causes, and Potential Solutions: An Analytic Review

Nadeau,

Lawhern

2023

MRAJ

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Introduction: The United States currently faces two opioid crises, an evolved crisis currently manifesting as widespread abuse of illicit opioids, and a crisis in pain management largely manufactured by the Centers for Disease Control and Prevention 2016 Guideline. Our goal in this paper is to identify root causes, trace the trajectory of forces unleashed over time, and define potential solutions to these crises. Methods: Analytic review of the scientific, socioeconomic, and historical literature. Results: The evolved crisis reflects a socioeconomic rift in American society that began in the 1970s and has resulted in disintegration of lives and rising levels of desperation, particularly among the under-educated, rendering them susceptible to the lure of illicit opioids. Present manifestations of that crisis reflect a complex series of events starting with a consensus in the late1990s that opioids were fully acceptable in the management of chronic noncancer pain. This was followed by vast opportunism by pill mills, drug distributors, and the manufacturers that supplied them; aggressive actions by state governments to rein in the pill mills; and ultimately, the development of an enormous black market in heroin and fentanyl. The manufactured crisis reflects intrusion into the medical care of patients in chronic pain by the Centers for Disease Control that had been politicized decades earlier and that, in 2016, issued a Guideline that reflected serious mis-construal of the causes of the opioid crisis. We trace this history and review the literature on treatment of addiction, including medically assisted therapy, treatment of depression, psychosocial interventions, 12-step programs, programs that seek to address the causes of desperation, supervised injection facilities, decriminalization, legalization, and the impact of the comprehensive approach taken by Portugal. We also analyze the problems affecting the Centers for Disease Control that led to the publication of its ill-advised 2016 Guideline. Discussion: We conclude that many approaches currently being taken to treat addiction are well supported by scientific evidence but that the overall efficacy of treatment programs is not optimal and only a small fraction of all patients actually enter such programs. We also conclude that the Centers for Disease Control should have no future role in the regulation of patient care.

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Linkage to methadone treatment from acute opiate detoxification treatment

Cited by 7 publications

References 23 publications

A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature

A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature

Randomized controlled trial of enhanced telephone monitoring with detoxification patients: 3- and 6-month outcomes

The Two Opioid Crises Problems, Causes, and Potential Solutions: An Analytic Review

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