The Impact of 9/11 on Patients in New York City's Substance Abuse Treatment Programs

Dewart, Tracey; Frank, Blanche; Schmeidler, James

doi:10.1080/00952990600919435

Cited by 30 publications

(29 citation statements)

References 8 publications

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“…However, this contrasts with a larger sample study of methadone patients that found a 34% increase in relapse to heroin [16]. A home supply of buprenorphine may allow patients to cope more effectively in the event of service disruption compared to methadone, which requires frequent clinic visits for directly observed dosing.…”

Section: Discussionmentioning

confidence: 91%

Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy

Tofighi

Grossman

Williams

et al. 2014

Addict Sci Clin Pract

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BackgroundThe extent of damage in New York City following Hurricane Sandy in October 2012 was unprecedented. Bellevue Hospital Center (BHC), a tertiary public hospital, was evacuated and temporarily closed as a result of hurricane-related damages. BHC’s large primary care office-based buprenorphine clinic was relocated to an affiliate public hospital for three weeks. The extent of environmental damage and ensuing service disruption effects on rates of illicit drug, tobacco, and alcohol misuse, buprenorphine medication supply disruptions, or direct resource losses among office-based buprenorphine patients is to date unknown.MethodsA quantitative and qualitative semi-structured survey was administered to patients in BHC’s primary care buprenorphine program starting one month after the hurricane. Survey domains included: housing and employment disruptions; social and economic support; treatment outcomes (buprenorphine adherence and ability to get care), and tobacco, alcohol, and drug use. Open-ended questions probed general patient experiences related to the storm, coping strategies, and associated disruptions.ResultsThere were 132 patients enrolled in the clinic at the time of the storm; of those, 91 patients were recruited to the survey, and 89 completed (98% of those invited). Illicit opioid misuse was rare, with 7 respondents reporting increased heroin or illicit prescription opioid use following Sandy. Roughly half of respondents reported disruption of their buprenorphine-naloxone medication supply post-event, and self-lowering of daily doses to prolong supply was common. Additional buprenorphine was obtained through unscheduled telephone or written refills from relocated Bellevue providers, informally from friends and family, and, more rarely, from drug dealers.ConclusionsThe findings highlight the relative adaptability of public sector office-based buprenorphine treatment during and after a significant natural disaster. Only minimal increases in self-reported substance use were reported despite many disruptions to regular buprenorphine supplies and previous daily doses. Informal supplies of substitute buprenorphine from family and friends was common. Remote telephone refill support and a temporary back-up location that provided written prescription refills and medication dispensing for uninsured patients enabled some patients to maintain an adequate medication supply. Such adaptive strategies to ensure medication maintenance continuity pre/post natural disasters likely minimize poor treatment outcomes.

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Section: Discussionmentioning

confidence: 91%

Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy

Tofighi

Grossman

Williams

et al. 2014

Addict Sci Clin Pract

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show abstract

“…In clinical studies, life stress has been identified as an important contributing factor to increased rates of drug and alcohol use and as a trigger for relapse to drug use (Brown et al 1995;Dewart et al 2006;Kosten et al 1986;Ludwig and Wikler 1974;McFall et al 1992;McKay et al 1995;Ouimette et al 2007). In the past decade, these primarily correlational reports have been verified by controlled laboratory studies carried out in both human and nonhuman animal subjects.…”

mentioning

confidence: 97%

Footshock stress reinstates cocaine seeking in rats after extended post-stress delays

Brown

Erb

2007

Psychopharmacology

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Within a limited time window, footshock is effective in reinstating cocaine seeking, when testing is delayed after termination of the stressor. Together with previous work from this laboratory, the findings are consistent with the idea that stress can induce the reinstatement of drug seeking by conditioning excitation to the context in which it is administered and that this conditioned excitation can overcome the inhibitory processes maintaining extinction responding, even after a post-stress delay.

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“…One pioneering research study conducted by Dewart, Frank, and Schmeidler (2006) assessed the impact of the 9=11 attack in New York City on drug use, relapse, and mental health. The findings indicated that one-half of the patients in drug-free outpatient programs and 37% of methadone patients reported using illicit drugs during that stressful time.…”

mentioning

confidence: 99%

Anxiety Symptoms and Need for Help Among Israeli Methadone Patients in a War Zone

Schiff

Levit

Schori

et al. 2011

Journal of Loss and Trauma

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The Impact of 9/11 on Patients in New York City's Substance Abuse Treatment Programs

Abstract: The attacks on 9/11 may have contributed to relapse among drug users and exacerbated existing mental health problems among patients with a history of concurrent drug use and mental illness.

Cited by 30 publications

References 8 publications

Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy

Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy

Footshock stress reinstates cocaine seeking in rats after extended post-stress delays

Anxiety Symptoms and Need for Help Among Israeli Methadone Patients in a War Zone

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