Psychology

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Subject: search.filters.subject.Substance use

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Now showing 1 - 7 of 7
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    Experiences of substance use and medication for opioid use disorder stigmas in an underserved, rural community
    (2024) Anvari, Morgan; Magidson, Jessica F; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Overdose rates related to opioid and stimulant use have been steadily increasing in underserved, rural areas of the U.S. for over 10 years. Access to and retention in medication for opioid use disorder (MOUD) care are persistent challenges nationally and in underserved rural communities. Stigma around substance use (SU) and MOUD specifically are barriers to engagement in opioid use disorder and MOUD care. However, little is known regarding how SU and MOUD stigmas manifest and affect patients in rural settings. Given their shared lived experiences, peer recovery specialists (PRSs), individuals with lived substance use and recovery experience who are formally trained to support others’ recovery, may be unique resources to shifting stigma barriers. Yet, few studies have examined if and how PRS engagement shifts stigma, particularly in underserved, rural communities. This qualitative study sought to understand: 1) how substance use and MOUD stigmas manifest in a low-resource, rural community; 2) how these stigmas influence patients’ treatment experiences and preferences; 3) if and how PRS-delivered intervention may shift these stigmas and improve MOUD outcomes. Patients (n = 25) and staff (n = 5) at a telemedicine-mobile treatment unit (MTU) in an underserved, rural community completed semi-structured qualitative interviews. Transcripts were analyzed using thematic analysis, guided by the interview guide and Stigma Mechanisms Framework. Study findings demonstrated the pervasive role of multiple forms of stigma in a rural community, negatively impacting substance use treatment outcomes. Experiences of these stigmas were found to be uniquely influenced by rural living conditions. Additionally, results revealed that PRS-delivered interventions have potential in shifting these stigmas and improving MOUD outcomes by leveraging PRSs’ shared lived experiences. Identifying and understanding patient experiences of substance use and MOUD stigmas are vital in developing innovative solutions to target stigma reduction and support recovery. Future research may continue to develop and evaluate how PRS interventions can reduce stigma and support positive recovery outcomes.
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    “It’s more than just the act of not using. It's a feeling of finally completing something.”: Patient-centered definitions of successful treatment outcomes in methadone treatment in Baltimore City
    (2024) Bradley, Valerie Diane; Magidson, Jessica F.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Background. Successful outcomes in substance use disorder treatment are often narrowly defined as retention in care, substance use cessation, and the prevention of recurrent substance use. These widely utilized benchmarks may overlook key patient-centered indicators of success. Few studies have sought patient perspectives to establish a representative definition of successful treatment outcomes for opioid use disorder (OUD), with historically marginalized individuals facing the least representation and the largest inequities in care. With overdose-related deaths increasing to over 112,000 in the 12 months preceding May 2023 and a disproportionate impact on racially minoritized populations, understanding comprehensive patient-centered definitions of successful treatment in minoritized populations is an imperative endeavor for research, treatment planning, and policy. This study aimed to understand how patients and providers at an outpatient methadone treatment program in Baltimore City describe patient-centered successful treatment outcomes.Methods. We conducted qualitative interviews and focus groups with 32 patients, staff, and peer recovery specialists (PRSs) at a Baltimore-based outpatient methadone treatment program predominantly serving low-income, racially minoritized individuals with OUD. Semi-structured interview guides prompted patients (n=20) to describe success in methadone treatment and staff and PRSs (n=12) to describe their observations of patients' success in treatment. Qualitative data were transcribed, coded, and analyzed using thematic analysis. We utilized the Health Equity Implementation Framework to contextualize findings across multiple domains and explore potential influences on equitable outcomes of treatment success. Results. Five key themes emerged to demonstrate how patients and their providers define patient-centered successful methadone treatment outcomes, including (1) improvements in general health, (2) productivity and accomplishment, (3) social improvements, (4) substance use changes, and (5) treatment engagement. Patients and providers were generally in agreement on these five overarching themes. Conclusion: Findings suggest patient-centered definitions of success in methadone treatment span psychosocial, environmental, behavioral, health-related, and other factors beyond the traditionally measured outcomes of treatment retention and substance use abstinence. Working toward a more representative definition of methadone treatment success—integrating patient perspectives, particularly minoritized individuals who often face the greatest obstacles in care—may have significant clinical, research, and policy implications for improving the patient experience and outcomes in methadone treatment.
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    Sleep, Alcohol, and Cannabis Use in College Student Drinkers with and without ADHD
    (2022) Marsh, Nicholas Patrick; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Background: Heavy drinking college students are at risk for experiencing poor sleep and negative alcohol-and cannabis-related consequences. College students with attention-deficit/hyperactivity disorder (ADHD) are uniquely vulnerable to both poor sleep and negative consequences from alcohol and cannabis use. Thus, it is critical to consider relations between ADHD, sleep and alcohol-related negative consequences together in a single study. In the present study, we examined: (1) the associations among ADHD status, sleep and alcohol- and cannabis-related consequences; (2) the independent and interactive effects of sleep and ADHD on negative alcohol-related consequences. Finally, we explored the independent and interactive effects of sleep and ADHD on negative cannabis-related consequences. Method: College student drinkers with (n=51) and without (n=50) ADHD completed a 2-hour assessment that included measures of sleep quality, alcohol and cannabis use, and alcohol/cannabis-related negative consequences. Analyses utilized a series of hierarchical linear regression models to examine study aims. Results: College student drinkers with ADHD reported significantly worse sleep quality relative to non-ADHD student drinkers. Students with ADHD also experienced more negative alcohol-related consequences, relative to student drinkers without ADHD. When ADHD and sleep quality were included in the model together, ADHD—but not sleep quality—was independently associated with negative alcohol consequences, but not negative cannabis consequences. There were no moderating effects of ADHD on the associations among sleep and negative consequences resulting from either alcohol or cannabis use. Conclusion: This is the first study to examine sleep quality in college students with and without ADHD engaging in heavy drinking, as well as the first to examine the independent and interactive effects of sleep and ADHD on alcohol- and cannabis-related consequences. Results demonstrated that college drinkers with ADHD are particularly vulnerable to experiencing poor sleep and negative consequences from their alcohol and cannabis use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk.
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    Project Khanya: a randomized, hybrid effectiveness-implementation trial of a peer-delivered behavioral intervention for ART adherence and substance use in Cape Town, South Africa
    (Springer Nature, 2020-03-04) Magidson, Jessica F.; Joska, John A.; Myers, Bronwyn; Belus, Jennifer M.; Regenauer, Kristen S.; Andersen, Lena S.; Majokweni, Sybil; O’Cleirigh, Conall; Safren, Steven A.
    Substance use is prevalent in South Africa and associated with poor HIV treatment outcomes, yet, it is largely unaddressed in HIV care. Implementing an evidence-based, task-shared intervention for antiretroviral therapy (ART) adherence and substance use integrated into HIV care may be a feasible and effective way to improve HIV treatment outcomes and reduce substance use in this population.
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    The Relation between Substance Use and Medication Adherence among HIV Positive Substance Users in Residential Treatment
    (2015) Hoffman, Elana Michelle; MacPherson, Laura; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Poor medication adherence is problematic among HIV positive, low-income African-American substance users. Substance use has been shown to be associated with poor medication adherence, though we do not know the mechanism that underlies this relationship. Lack of positive environmental rewards and the propensity to discount delayed rewards may be possible mechanisms to explain this relationship. Using baseline data from a randomized controlled trial, we examined the relationships between substance use and medication adherence, testing both environmental rewards and delay discounting as independent mediators. There was a main effect of substance use on adherence, such that high frequency of substance use predicted poor adherence. There was also a main effect of environmental rewards on adherence, such that a lack of environmental reinforcement predicted poor adherence. This study shed light on the processes that contribute to low adherence, namely substance use and lack of environmental contingencies, and suggests important targets for intervention.
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    Discrepancy between how children perceive their own alcohol risk and how they perceive alcohol risk for other children longitudinally predicts alcohol use
    (2010-12) De Los Reyes, Andres; Reynolds, Elizabeth K.; Wang, Frances; MacPherson, Laura; Lejuez, C.W.
    This paper examined discrepancies between children's self-perceptions of the riskiness of alcohol use versus their perceptions of the riskiness of alcohol use for other children, and whether these discrepancies predicted children's future alcohol use. Participants included 234 children (M=11 years, 45.3% female) who completed baseline and one-year follow-up assessments on self-perceived riskiness of alcohol use, perceived riskiness of alcohol use for other same-age children, and own past year alcohol use. When considering child age and gender, baseline alcohol use, and the individual reports of the riskiness of alcohol use, the interaction between alcohol use riskiness reports prospectively predicted greater odds of alcohol use. The highest percentage of childhood alcohol use at one-year follow-up came from those children with both low self-perceived riskiness of alcohol use and high perceived riskiness of alcohol use for other children. Children's perceptions of multiple people's risk from alcohol use result in identifying important subgroups of children at risk for early-onset alcohol use.
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    Discrepancy between how children perceive their own alcohol risk and how they perceive alcohol risk for other children longitudinally predicts alcohol use
    (2010) De Los Reyes, Andres; Reynolds, Elizabeth K.; Wang, Frances; MacPherson, Laura; Lejuez, C.W.
    This paper examined discrepancies between children's self-perceptions of the riskiness of alcohol use versus their perceptions of the riskiness of alcohol use for other children, and whether these discrepancies predicted children's future alcohol use. Participants included 234 children (M=11 years, 45.3% female) who completed baseline and one-year follow-up assessments on self-perceived riskiness of alcohol use, perceived riskiness of alcohol use for other same-age children, and own past year alcohol use. When considering child age and gender, baseline alcohol use, and the individual reports of the riskiness of alcohol use, the interaction between alcohol use riskiness reports prospectively predicted greater odds of alcohol use. The highest percentage of childhood alcohol use at one-year follow-up came from those children with both low self-perceived riskiness of alcohol use and high perceived riskiness of alcohol use for other children. Children's perceptions of multiple people's risk from alcohol use result in identifying important subgroups of children at risk for early-onset alcohol use.