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McCuistian C, Lisha NE, Campbell B, Cheng C, Le J, Guydish J. Reducing tobacco use in substance use treatment: The California tobacco free initiative. Addict Behav 2024; 155:108025. [PMID: 38593596 DOI: 10.1016/j.addbeh.2024.108025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND People in substance use disorder (SUD) treatment have a smoking prevalence that is five times higher than the national average. California funded the Tobacco Free for Recovery Initiative, designed to support programs in implementing tobacco-free grounds and increasing smoking cessation services. In the first cohort of the initiative (2018-2020) client smoking prevalence decreased from 54.2% to 26.6%. The current study examined whether similar findings would be replicated with a later cohort of programs (2020-2022). METHOD Cross-sectional survey data were collected from clients in 11 residential SUD treatment programs at baseline (n = 185) and at post intervention (n = 227). Multivariate logistic regression assessed change over time in smoking prevalence, tobacco use behaviors, and receipt of cessation services across the two timepoints. RESULTS Client smoking prevalence decreased from 60.3 % to 40.5 % (Adjusted Odds Ratio [AOR] = 0.46, 95 % CI = 0.27, 0.78; p = 0.004). Current smokers and those who quit while in treatment reported an increase in nicotine replacement therapy (NRT)/pharmacotherapy from baseline to post intervention (31.9 % vs 45.6 %; AOR = 2.22, 95 % CI = 1.08, 4.58; p = 0.031). CONCLUSIONS Like the first cohort, the Tobacco Free for Recovery initiative was associated with decreased client smoking prevalence and an increase in NRT/pharmacotherapy. These findings strengthen the evidence that similar initiatives may be effective in reducing smoking prevalence among people in SUD treatment.
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Affiliation(s)
- Caravella McCuistian
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco 1001 Potrero Ave, San Francisco, CA 94110, United States.
| | - Nadra E Lisha
- Division of General Internal Medicine, School of Medicine University of California, San Francisco 530 Parnassus Ave, San Francisco, CA 94143, United States
| | - Barbara Campbell
- Division of General Internal Medicine & Geriatrics, Oregon Health and Science University 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, United States
| | - Christine Cheng
- Smoking Cessation Leadership Center, University of California, San Francisco 490 Illinois Street, 9216, San Francisco, CA 94158, United States
| | - Jennifer Le
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco 1001 Potrero Ave, San Francisco, CA 94110, United States
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., Floor 7, San Francisco, CA 94158, United States
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Nwanaji-Enwerem U, Beitel M, Oberleitner DE, Gaeta Gazzola M, Eggert KF, Oberleitner LMS, Jegede O, Zheng X, Redeker NS, Madden LM, Barry DT. Correlates of Perceived Discrimination Related to Substance Use Disorders Among Patients in Methadone Maintenance Treatment. J Psychoactive Drugs 2023:1-11. [PMID: 37399330 PMCID: PMC10761588 DOI: 10.1080/02791072.2023.2230571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 07/05/2023]
Abstract
This study sought to examine demographic, treatment-related, and diagnosis-related correlates of substance use disorder (SUD)-related perceived discrimination among patients receiving methadone maintenance treatment (MMT). Participants were 164 patients at nonprofit, low-barrier-to-treatment-access MMT programs. Participants completed measures of demographics, diagnosis-related characteristics (Brief Symptom Inventory (BSI-18) and Depressive Experiences Questionnaire (DEQ)), and treatment-related characteristics. Perceived discrimination was measured on a seven-point Likert-type scale ranging from 1 ("Not at all") to 7 ("Extremely") in response to the item: "I often feel discriminated against because of my substance abuse." Given the variable's distribution, a median split was used to categorize participants into "high" and "low" discrimination groups. Correlates of high and low discrimination were analyzed with bivariate and logistic regression models. Ninety-four participants (57%) reported high SUD-related perceived discrimination. Bivariate analyses identified six statistically significant correlates of SUD-related perceived discrimination (P < .05): age, race, age of onset of opioid use disorder, BSI-18 Depression, DEQ Dependency, and DEQ Self-Criticism. In the final logistic regression model, those with high (versus low) SUD-related perceived discrimination were more likely to report depressive symptoms and be self-critical. Patients in MMT with high compared to low SUD-related perceived discrimination may be more likely to report being depressed and self-critical.
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Affiliation(s)
| | - Mark Beitel
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
| | - David E Oberleitner
- Department of Research, APT Foundation, New Haven, CT, USA
- Psychology Department, University of Bridgeport, Bridgeport, CT, USA
| | - Marina Gaeta Gazzola
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
| | | | - Lindsay M S Oberleitner
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Oluwole Jegede
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
| | - Xiaoying Zheng
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
| | | | - Lynn M Madden
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
| | - Declan T Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Research, APT Foundation, New Haven, CT, USA
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Qeadan F, Nicolson A, Barbeau WA, Azagba S, English K. The association between dual use of electronic nicotine products and illicit drugs with adverse cardiovascular and respiratory outcomes in a longitudinal analysis using the Population Assessment of Tobacco and Health (PATH) survey. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100166. [PMID: 37228861 PMCID: PMC10205457 DOI: 10.1016/j.dadr.2023.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/16/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023]
Abstract
Background Drug use and electronic nicotine delivery systems (ENDS) are independently associated with increased risk of cardiovascular and respiratory outcomes. Literature on the association between the dual use of these key substances and potential health outcomes is limited. Methods We examined the association between dual use of ENDs and drugs (including heroin, methamphetamine, cocaine, painkillers, and misused stimulant medications) with adverse cardiovascular and respiratory outcomes in a longitudinal analysis using waves 1-5 from the Population Assessment of Tobacco and Health survey (2014-2018). Multivariable logistic regression with Generalized Estimating Equations was utilized. Results About 0.9% (n = 368) of respondents at wave 2 used both ENDS and drugs, 5.1% (n = 1,985) exclusively used ENDS, and 5.9% (n = 1,318) used drugs. Compared with people who do not use drugs, both those who used only ENDS (Adjusted Odds Ratio (AOR) 1.11 [95% CI 0.99-1.23], P = 0.07758) and those who used only drugs (AOR 1.36 [95% CI 1.15-1.60], P = 0.00027) were more likely to experience adverse respiratory conditions. Individuals who used drugs and ENDS compared to people who did not use drugs or ENDS had the largest odds of respiratory problems among all drug use category comparisons (AOR 1.52 [95% CI 1.20-1.93], P = 0.00054). Individuals who only used drugs had elevated odds of cardiovascular ailments compared to people who did not use drugs or ENDS (AOR 1.24 [95% CI 1.08-1.42], P = 0.00214) and compared to people who only used ENDS (AOR 1.22 [95% CI 1.04-1.42], P = 0.0117). Conclusions Inhaling electronic nicotine delivery systems and other substances may negatively affect the users' respiratory health.
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Affiliation(s)
- Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Alexander Nicolson
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - William A. Barbeau
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Sunday Azagba
- Nese College of Nursing, Penn State University, University Park, PA, USA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, NM, USA
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Scheidell JD, Townsend T, Ban KF, Caniglia EC, Charles D, Edelman EJ, Marshall BDL, Gordon AJ, Justice AC, Braithwaite RS, Khan MR. Cessation of self-reported opioid use and impacts on co-occurring health conditions. Drug Alcohol Depend 2023; 242:109712. [PMID: 36469994 PMCID: PMC10108375 DOI: 10.1016/j.drugalcdep.2022.109712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/31/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Among veterans in care reporting opioid use, we investigated the association between ceasing opioid use on subsequent reduction in report of other substance use and improvements in pain, anxiety, and depression. METHODS Using Veterans Aging Cohort Study survey data collected between 2003 and 2012, we emulated a hypothetical randomized trial (target trial) of ceasing self-reported use of prescription opioids and/or heroin, and outcomes including unhealthy alcohol use, smoking, cannabis use, cocaine use, pain, and anxiety and depressive symptoms. Among those with baseline opioid use, we compared participants who stopped reporting opioid use at the first follow-up (approximately 1 year after baseline) with those who did not. We fit logistic regression models to estimate associations with change in each outcome at the second follow-up (approximately 2 years after baseline) among participants with that condition at baseline. We examined two sets of adjusted models that varied temporality assumptions. RESULTS Among 2473 participants reporting opioid use, 872 did not report use, 606 reported use, and 995 were missing data on use at the first follow-up. Ceasing opioid use was associated with no longer reporting cannabis (adjusted odds ratio [AOR]=1.82, 95% confidence interval [CI] 1.10, 3.03) and cocaine use (AOR=1.93, 95% CI 1.16, 3.20), and improvements in pain (AOR=1.53, 95% CI 1.05, 2.24) and anxiety (AOR=1.56, 95% CI 1.01, 2.41) symptoms. CONCLUSION Cessation of opioid misuse may be associated with subsequent cessation of other substances and reduction in pain and anxiety symptoms, which supports efforts to screen and provide evidence-based intervention where appropriate.
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Affiliation(s)
- Joy D Scheidell
- NYU Grossman School of Medicine, Department of Population Health, 227 E 30th Street, Sixth Floor, New York, NY 10016, USA.
| | - Tarlise Townsend
- NYU Grossman School of Medicine, Department of Population Health, 227 E 30th Street, Sixth Floor, New York, NY 10016, USA
| | - Kaoon Francois Ban
- NYU Grossman School of Medicine, Department of Population Health, 227 E 30th Street, Sixth Floor, New York, NY 10016, USA
| | - Ellen C Caniglia
- University of Pennsylvania Perelman School of Medicine, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA, USA
| | - Dyanna Charles
- NYU Grossman School of Medicine, Department of Population Health, 227 E 30th Street, Sixth Floor, New York, NY 10016, USA
| | - E Jennifer Edelman
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Adam J Gordon
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, USA; Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), University of Utah School of Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Amy C Justice
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - R Scott Braithwaite
- NYU Grossman School of Medicine, Department of Population Health, 227 E 30th Street, Sixth Floor, New York, NY 10016, USA
| | - Maria R Khan
- NYU Grossman School of Medicine, Department of Population Health, 227 E 30th Street, Sixth Floor, New York, NY 10016, USA
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Parker MA, Byers JE, Villanti AC. Effect of brief nicotine corrective messaging on nicotine beliefs in persons who use opioids. Exp Clin Psychopharmacol 2022; 30:1008-1015. [PMID: 34291993 PMCID: PMC8782917 DOI: 10.1037/pha0000497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This pilot study tested the effect of a brief nicotine education messaging exposure on beliefs about nicotine, nicotine-replacement therapy (NRT), and e-cigarettes. Participants ages 18 and older were recruited via Amazon Mechanical Turk to complete a 20-min online survey in April/May 2020 to assess relationships between opioid use, smoking, and other behaviors. Participants with past-month extra-medical opioid use completed questions on background characteristics and literacy and then were randomized in a 2:1 ratio of two conditions: nicotine education (n = 362) or no message control (n = 181). Beliefs about nicotine, NRT, and e-cigarettes were asked of all participants; this occurred after message exposure for the nicotine education condition. Bivariate and multivariable analyses examined differences in beliefs by study condition. Brief nicotine messaging increased the probability of a correct response to "Nicotine is a cause of cancer" (false, 63% vs. 36%) and reduced the probability of a don't know response (9% vs. 17%) compared to the no message control condition. Nicotine education also reduced false beliefs about harms of long-term NRT use compared to cigarettes (p < .05). In adjusted models, participants in the nicotine education group had lower mean false beliefs about nicotine (p < .001) and to a lesser extent NRT (p = .053) compared with the control group; there was no difference in mean false beliefs about e-cigarettes (p = .547) between groups. A brief education intervention produced similar changes in nicotine beliefs in adults with past-month extra-medical opioid use as in a general adult sample. Findings support the potential for impact of nicotine public education messaging in vulnerable populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Maria A. Parker
- Indiana University School of Public Health, Department of Epidemiology & Biostatistics, Bloomington, IN, United States
| | - Jodi E. Byers
- Indiana University School of Public Health, Department of Applied Health Science, Bloomington, IN, United States
| | - Andrea C. Villanti
- Vermont Center on Behavior & Health, University of Vermont, Burlington, VT, United States
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Tehrani H, Rajabi A, Ghelichi- Ghojogh M, Nejatian M, Jafari A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health 2022; 80:240. [DOI: 10.1186/s13690-022-00998-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Abstract
Background
The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping.
Method
The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author.
Results
In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively.
Conclusions
Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.
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Streck JM, Regan S, Neil J, Kalkhoran S, Gupta PS, Bearnot B, Coker FK, Kalagher KM, Park ER, Wakeman S, Rigotti NA. Interest in Electronic Cigarettes for Smoking Cessation Among Adults With Opioid Use Disorder in Buprenorphine Treatment: A Mixed-Methods Investigation. Nicotine Tob Res 2022; 24:1134-1138. [PMID: 34915581 PMCID: PMC9199932 DOI: 10.1093/ntr/ntab259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/13/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Individuals in treatment for opioid use disorder (OUD) have high smoking rates and limited success with Food and Drug Administration (FDA)-approved cessation aids, suggesting need for novel approaches. Electronic cigarettes (e-cigarettes) might benefit this population, but e-cigarettes' acceptability for tobacco reduction or cessation among smokers in OUD treatment is not known. METHODS A cross-sectional mixed-methods study of 222 adults in OUD treatment with buprenorphine in the Boston, Massachusetts metropolitan area was conducted in 2020. We used quantitative and qualitative data to investigate individuals' experience with and interest in e-cigarettes and other methods for smoking cessation and assessed factors associated with interest in e-cigarette use. RESULTS One hundred sixty (72%) of the 222 participants were past 30-day cigarette smokers. They most frequently reported having ever used nicotine replacement therapy (NRT; 83%) and e-cigarettes (71%) for smoking cessation and most often indicated interest in using NRT (71%) and e-cigarettes (44%) for future smoking cessation. In multiple logistic regression analysis, interest in using e-cigarettes for future smoking cessation was independently associated with having ever used e-cigarettes for smoking cessation, current e-cigarette use, and perceiving e-cigarettes to be less harmful than cigarettes (ps < .05). In qualitative data, many current vapers/former smokers reported that e-cigarettes had been helpful for quitting cigarettes. For current smokers who currently or formerly vaped, frequently reported challenges in switching to e-cigarettes were concerns about replacing one addiction with another and e-cigarettes not adequately substituting for cigarettes. CONCLUSIONS E-cigarettes had a moderate level of acceptability for smoking cessation among cigarette smokers in OUD treatment. More research is warranted to test the efficacy of this approach. IMPLICATIONS Individuals in treatment for opioid use disorder (OUD) have high smoking rates and limited success with existing smoking cessation tools, suggesting a need for novel cessation treatment approaches. In this mixed-methods study of individuals receiving medication treatment for OUD with buprenorphine in Massachusetts in 2020, we found a moderate level of acceptability of e-cigarettes for smoking cessation.
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Affiliation(s)
- Joanna M Streck
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Susan Regan
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Jordan Neil
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Sara Kalkhoran
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Priya S Gupta
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Benjamin Bearnot
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Faith K Coker
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Kelly M Kalagher
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Elyse R Park
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Wakeman
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston MA, USA
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Pemathilaka RL, Alimoradi N, Reynolds DE, Hashemi NN. Transport of Maternally Administered Pharmaceutical Agents Across the Placental Barrier In Vitro. ACS APPLIED BIO MATERIALS 2022; 5:2273-2284. [PMID: 35380796 PMCID: PMC9116385 DOI: 10.1021/acsabm.2c00121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To understand the transport of pharmaceutical agents and their effects on developing fetus, we have created a placental microsystem that mimics structural phenotypes and physiological characteristic of a placental barrier. We have shown the formation of a continuous network of epithelial adherens junctions and endothelial cell-cell junctions confirming the integrity of the placental barrier. More importantly, the formation of elongated microvilli under dynamic flow condition is demonstrated. Fluid shear stress acts as a mechanical cue triggering the microvilli formation. Pharmaceutical agents were administered to the maternal channel, and the concentration of pharmaceutical agents in fetal channel for coculture and control models were evaluated. In fetal channel, the coculture model exhibited about 2.5 and 2.2% of the maternal initial concentration for naltrexone and 6β-naltrexol, respectively. In acellular model, fetal channel showed about 10.5 and 10.3% of the maternal initial concentration for naltrexone and 6β-naltrexol, respectively. Gene expressions of epithelial cells after direct administration of naltrexone and 6β-naltrexol to the maternal channel and endothelial cells after exposure due to transport through placental barrier are also reported.
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Affiliation(s)
- Rajeendra L Pemathilaka
- Department of Mechanical Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Nima Alimoradi
- Department of Mechanical Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - David E Reynolds
- Department of Mechanical Engineering, Iowa State University, Ames, Iowa 50011, United States
| | - Nicole N Hashemi
- Department of Mechanical Engineering, Iowa State University, Ames, Iowa 50011, United States.,Department of Mechanical Engineering, Stanford University, Stanford, California 94305, United States
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melody Wu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Larry Davidson
- Department of Psychiatry, School of Medicine at Yale University, New Haven, CT, USA
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10
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Masson CL, Le T, Hosakote S, Fokuo JK, Gubner NR, Shingle M, Guydish J. Correlates of e-cigarette use for smoking cessation among clients in residential substance use disorder treatment. Addict Behav 2021; 119:106947. [PMID: 33892312 DOI: 10.1016/j.addbeh.2021.106947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/07/2021] [Accepted: 04/05/2021] [Indexed: 11/28/2022]
Abstract
Little is known about e-cigarette use among persons in substance use disorder (SUD) treatment, or their use of e-cigarettes for smoking cessation. Prevalence of e-cigarette use and correlates of e-cigarette use for smoking cessation were examined among clients in SUD treatment. Participants (n = 332) were current cigarette smokers recruited from 20 residential SUD programs in California. We used multivariable logistic regression to identify correlates of using e-cigarettes for quitting smoking. Almost half (45.2%) of the sample had ever used e-cigarettes for smoking cessation, and 34% had used e-cigarettes in the past 30 days. Smokers who had used e-cigarettes for smoking cessation, compared to those who had not, were younger (adjusted odds ratio [AOR] = 0.94, 95% confidence interval [CI] = 0.91, 0.96), had more than a high school education (AOR = 1.69, 95% CI = 1.07, 2.68), sought treatment for both SUD and mental health disorder (AOR = 2.62, 95% CI = 1.38, 5.00), wanted help quitting smoking (AOR = 1.90, 95% CI = 1.03, 3.50) and perceived e-cigarettes as equally harmful (AOR = 3.03, 95% CI = 1.10, 8.33) or less harmful than tobacco cigarettes (AOR = 2.82, 95% CI = 1.02, 7.77). Black/African American and Hispanic/Latino participants were less likely to use e-cigarettes for smoking cessation than participants who identify as White. E-cigarettes were favorably perceived by clients in residential SUD treatment as a quit smoking aid. Treatment programs should consider how to advise clients with respect to the use of e-cigarettes for smoking cessation.
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Affiliation(s)
- Carmen L Masson
- University of California San Francisco, Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, Building 20, Suite 2100, San Francisco, CA 94941, United States.
| | - Thao Le
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
| | - Sindhushree Hosakote
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
| | - J Konadu Fokuo
- University of California San Francisco, Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, Building 20, Suite 2100, San Francisco, CA 94941, United States.
| | - Noah R Gubner
- Department of Psychiatry and Behavioral Sciences, University of Washington, School of Medicine, United States.
| | - Mallory Shingle
- University of California San Francisco, Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, Building 20, Suite 2100, San Francisco, CA 94941, United States
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St., Ste. 265, San Francisco, CA 94118, United States.
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Montgomery L, Winhusen T, Scodes J, Pavlicova M, Twitty D, Campbell ANC, Wang AL, Nunes EV, Rotrosen J. Reductions in tobacco use in naltrexone, relative to buprenorphine-maintained individuals with opioid use disorder: Secondary analysis from the National Drug Abuse Treatment Clinical Trials Network. J Subst Abuse Treat 2021; 130:108489. [PMID: 34118716 DOI: 10.1016/j.jsat.2021.108489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/10/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Smoking prevalence in individuals with opioid use disorder (OUD) is over 80%. Research suggests that opioid use significantly increases smoking, which could account for the strikingly low smoking-cessation rates observed in both methadone- and buprenorphine-maintained patients, even with the use of first-line smoking-cessation interventions. If opioids present a barrier to smoking-cessation, then better smoking outcomes should be observed in OUD patients treated with extended-release naltrexone (XR-NTX, an opioid antagonist) compared to those receiving buprenorphine (BUP-NX, a partial opioid agonist). METHODS The current study is a secondary analysis of a 24-week, multi-site, open-label, randomized clinical trial conducted within the National Drug Abuse Treatment Clinical Trials Network comparing the effectiveness of XR-NTX vs. BUP-NX for adults with OUD. Longitudinal mixed effects models were used to determine if there was a significant reduction in cigarette use among daily smokers successfully inducted to treatment (n = 373) and a subset of those who completed treatment (n = 169). RESULTS Among daily smokers inducted onto OUD medication, those in the XR-NTX group smoked fewer cigarettes per day (M = 11.36, SE = 0.62) relative to smokers in the BUP-NX group (M = 13.33, SE = 0.58) across all study visits, (b (SE) = -1.97 (0.55), p < .01). Results were similar for the treatment completers. CONCLUSIONS OUD patients treated with XR-NTX reduced cigarette use more than those treated with BUP-NX, suggesting that XR-NTX in combination with other smoking cessation interventions might be a better choice for OUD smokers interested in reducing their tobacco use.
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Affiliation(s)
- LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA.
| | - Theresa Winhusen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
| | - Jennifer Scodes
- Division of Mental Health Data Science, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Martina Pavlicova
- Department of Biostatistics, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA
| | - Dylanne Twitty
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
| | - Aimee N C Campbell
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA
| | - An Li Wang
- Addiction Institute of Addiction of Mount Sinai, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1399 Park Ave, New York, NY 10029, USA
| | - Edward V Nunes
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA
| | - John Rotrosen
- Department of Psychiatry, NYU Grossman School of Medicine, One Park Avenue, New York, NY 10016, USA
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Correlates of sleep quality and excessive daytime sleepiness in people with opioid use disorder receiving methadone treatment. Sleep Breath 2020; 24:1729-1737. [PMID: 32556918 DOI: 10.1007/s11325-020-02123-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/30/2020] [Accepted: 06/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to evaluate the prevalence and clinical correlates of impaired sleep quality and excessive daytime sleepiness among patients receiving methadone for opioid use disorder (OUD). METHODS Patients receiving methadone (n = 164) completed surveys assessing sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and related comorbidities. We used bivariate and multivariable linear regression models to evaluate correlates of sleep quality and daytime sleepiness. RESULTS Ninety percent of patients had poor sleep quality (PSQI >5), and the mean PSQI was high (11.0 ±4). Forty-six percent reported excessive daytime sleepiness (ESS > 10). In multivariable analyses, higher PSQI (worse sleep quality) was significantly associated with pain interference (coefficient = 0.40; 95% CI = 0.18-0.62; β = 0.31), somatization (coefficient = 2.2; 95% CI = 0.75-3.6; β = 0.26), and negatively associated with employment (coefficient = - 2.6; 95% CI = - 4.9 to - 0.19; β = - 0.17). Greater sleepiness was significantly associated with body mass index (coefficient = 0.32; 95% CI = 0.18-0.46; β = 0.33), and there was a non-significant association between sleepiness and current chronic pain (coefficient = 1.6; 95% CI = 0.26-3.5; β = 0.13; p value = 0.09). CONCLUSIONS Poor sleep quality and excessive daytime sleepiness are common in patients receiving methadone for OUD. Chronic pain, somatization, employment status, and obesity are potentially modifiable risk factors for sleep problems for individuals maintained on methadone. People with OUD receiving methadone should be routinely and promptly evaluated and treated for sleep disorders.
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13
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Abstract
While prevalence of tobacco use in the US general population is declining, prevalence among those with opioid use disorder (OUD) remains high and results in excessive tobacco-related disease and premature mortality. Among smokers with OUD, tobacco cessation rates are negligible without treatment. However, both low-intensity behavioral interventions and more intensive motivational interventions yield negligible cessation rates. While contingency management has potent short-term cessation effects, effects are not maintained at post-intervention follow-up. Evidence-based smoking cessation pharmacotherapies, such as nicotine replacement therapy, bupropion, and varenicline, result in very modest cessation rates among smokers with OUD. Intensification of pharmacotherapy, such as high-dose and combination nicotine replacement therapy or extended medication treatment, has failed to improve cessation outcomes compared with standard treatment regimens. Targeting the unique challenges faced by smokers with OUD, including nicotine-opioid interactions and poor medication adherence, has potential to improve cessation outcomes, but further research is needed to optimize intervention efficacy among smokers with OUD.
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