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Nock NL, Hernandez E, Robinson D, Hoffer L, Wachholtz A. Barriers, perceived benefits and preferences to exercise in adults with an opioid use disorder in the U.S. Prev Med Rep 2023; 36:102393. [PMID: 37753380 PMCID: PMC10518576 DOI: 10.1016/j.pmedr.2023.102393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/07/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Over 10 million Americans misuse opioids and more than 5 million have been diagnosed with an opioid use disorder (OUD). In 2021, over 100,000 Americans died of a drug overdose and more than 75% of these deaths involved an opioid. Exercise has been shown to increase abstinence and decrease anxiety and depression in people with a substance use disorder. However, only a few small trials have focused on persons with OUD who often experience additional challenges including chronic pain, mental health disorders and cardio-metabolic abnormalities. Methods We aimed to describe the barriers, perceived benefits and preferences to exercise in adults with OUD in residential treatment in the U.S. as part of a larger study. We conducted 33 individually administered, semi-structured interviews and transcribed audiotapes verbatim, conducted coding and thematic analysis using NVivo v12 software (QSR International Inc.). Results Our sample had nearly equal representation of males and females and, was predominantly Caucasian (88%) with a mean of age of 34.5 (s.d. 7.5) years old. Participants stated that exercise helps to reduce drug cravings, anxiety, depression and pain and improve mood, physical health and build "normalcy". Barriers included lack of time, access to resources, fear of poor health and triggering pain. Participants preferred moderate intensity exercise 3 times/week and 30-60 min sessions. Conclusions Our findings indicate that adults with OUD believe exercise is a valuable tool to use in their recovery but they encounter several barriers. Many barriers, however, could be overcome with structured programs offered by residential treatment centers.
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Affiliation(s)
- Nora L. Nock
- Departments of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Cleveland, OH, USA
| | | | - Dallas Robinson
- Department of Psychology, University of Colorado at Denver, Denver, CO, USA
| | - Lee Hoffer
- Anthropology, Case Western Reserve University, Cleveland, OH, USA
| | - Amy Wachholtz
- Department of Psychology, University of Colorado at Denver, Denver, CO, USA
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Kaguelidou F, Valtuille Z, Durrieu G, Delorme R, Peyre H, Treluyer JM, Montastruc F, Chouchana L. Weight Gain During Antipsychotic Treatment in Children, Adolescents, and Adults: A Disproportionality Analysis in the Global Pharmacovigilance Database, Vigibase ®. Drug Saf 2023; 46:77-85. [PMID: 36459374 DOI: 10.1007/s40264-022-01252-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION While antipsychotic-induced weight gain has been widely described in adults, it has yet to be better characterized in children and adolescents. OBJECTIVE The aim of this study was to assess antipsychotic-induced weight-gain reporting in children and adolescents as compared to adults, and according to the type of antipsychotic. METHODS The study is an observational, case-non-case study using individual case safety reports from the WHO global pharmacovigilance database VigiBase® from 1 January 2000 to 2 June 2021. Disproportionality in antipsychotic-related weight-gain reporting in children and adolescents compared to adults was evaluated based on reporting odds ratios (RORs) with corresponding 95% confidence intervals (CIs) through multivariate logistic regression modeling. Analysis was adjusted for sex, region of reporting, year of notification, reporter qualification, concomitant use of antidepressants, and use of more than one antipsychotic. RESULTS Among 282,224 antipsychotic-related spontaneous reports included in this analysis, we identified 16,881 (6.0%) weight-gain cases. Disproportionality in weight-gain reporting was found in children (adjusted ROR (aROR) 3.6; 95% CI 3.3-3.8) and in adolescents (aROR 2.3; 95% CI 2.2-2.4) compared to adults. Use of risperidone was associated with the highest increase in weight-gain reporting in children (aROR 4.9; 95% CI 3.9-6.1) and adolescents (aROR 3.6; 95% CI 3.1-4.1). CONCLUSIONS Compared to adults, weight-gain reporting with antipsychotics was disproportionally higher in the pediatric population, especially in children under 12 years of age. Considering the impact of weight gain on global morbidity and mortality, physicians should closely monitor weight gain in young patients, especially children on risperidone.
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Affiliation(s)
- Florentia Kaguelidou
- Department of Pediatric Pharmacology, APHP.Nord, Robert Debre Hospital, Paris Cité University, Paris, France. .,Clinical Investigations Center, Inserm CIC1426, Hôpital Robert Debré, 48 boulevard Sérurier, 75019, Paris, France. .,EA7323 "Therapeutic Assessment, and Perinatal and Pediatric Pharmacology", Paris Cité University, Paris, France.
| | - Zaba Valtuille
- Department of Pediatric Pharmacology, APHP.Nord, Robert Debre Hospital, Paris Cité University, Paris, France.,Clinical Investigations Center, Inserm CIC1426, Hôpital Robert Debré, 48 boulevard Sérurier, 75019, Paris, France
| | - Geneviève Durrieu
- Department of Medical and Clinical Pharmacology, Centre of Pharmacovigilance and Pharmacoepidemiology, Faculty of Medicine, Toulouse University Hospital (CHU), Toulouse, France.,CIC 1436, Team PEPSS (Pharmacologie En Population cohorteS et biobanqueS), Toulouse University Hospital, Toulouse, France
| | - Richard Delorme
- Department of Child and Adolescent Psychiatry, Robert Debre Hospital, APHP Nord, Paris Cité University, Paris, France.,Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Hugo Peyre
- Department of Child and Adolescent Psychiatry, Robert Debre Hospital, APHP Nord, Paris Cité University, Paris, France.,Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Jean-Marc Treluyer
- EA7323 "Therapeutic Assessment, and Perinatal and Pediatric Pharmacology", Paris Cité University, Paris, France.,Department of Pharmacology, Regional Center of Pharmacovigilance, Cochin Hospital, AP-HP Centre-Paris Cité University, Paris, France
| | - François Montastruc
- Department of Medical and Clinical Pharmacology, Centre of Pharmacovigilance and Pharmacoepidemiology, Faculty of Medicine, Toulouse University Hospital (CHU), Toulouse, France.,CIC 1436, Team PEPSS (Pharmacologie En Population cohorteS et biobanqueS), Toulouse University Hospital, Toulouse, France
| | - Laurent Chouchana
- EA7323 "Therapeutic Assessment, and Perinatal and Pediatric Pharmacology", Paris Cité University, Paris, France.,Department of Pharmacology, Regional Center of Pharmacovigilance, Cochin Hospital, AP-HP Centre-Paris Cité University, Paris, France
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Choi J, Alexis J, Gosev I, Zimbrean P, Nickels M. Management of Substance Use Disorders in a Patient With Left Ventricular Assist Device. J Acad Consult Liaison Psychiatry 2021:S2667-2960(21)00140-3. [PMID: 34391977 DOI: 10.1016/j.jaclp.2021.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/28/2021] [Accepted: 07/31/2021] [Indexed: 11/23/2022]
Abstract
We present a case of common challenges in assessment and treatment of substance use disorders in patients with advanced heart failure requiring left ventricular assist device (LVAD). Top experts in the field of consultation-liaison psychiatry, cardiology, and cardiac surgery provide guidance for this commonly encountered clinical case based on their experience and review of the available literature. Key teaching topics include the role of LVAD in heart failure management, the impact of substance use disorder on heart failure and LVAD patient outcomes, and recommendations for assessment and management of substance use disorder in a patient with LVAD. Specifically, we highlight the challenges of assessing for substance use disorder in LVAD candidates and the limited literature available to guide treatment in this challenging patient population.
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Affiliation(s)
- Lindsay McCormack
- Boston Health Care for the Homeless Program, Boston, Massachusetts
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts
- University of Massachusetts Medical School, Worcester, Massachusetts
| | - Joseph Ponce
- Boston Health Care for the Homeless Program, Boston, Massachusetts
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts
| | - Avik Chatterjee
- Boston Health Care for the Homeless Program, Boston, Massachusetts
- Boston University School of Medicine, Department of Internal Medicine, Boston, Massachusetts
| | - Jennifer K. Tan
- Boston Health Care for the Homeless Program, Boston, Massachusetts
- Massachusetts General Hospital, Department of Dermatology, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Correspondence to: Jennifer K. Tan, MD, Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Suite 200, Boston, MA 02114.
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