26 research outputs found
Ariel - Volume 8 Number 3
Executive Editor
James W. Lockard, Jr.
Business Manager
Neeraj K. Kanwal
University News
Richard J . Perry
World News
Doug Hiller
Opinions
Elizabeth A. McGuire
Features
Patrick P. Sokas
Sports Desk
Shahab S. Minassian
Managing Editor
Edward H. Jasper
Managing Associate
Brenda Peterson
Photography Editor
Robert D. Lehman. Jr.
Graphics
Christine M. Kuhnl
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Extended-release Naltrexone for Alcohol and Opioid Dependence : A Meta-Analysis of Healthcare Utilization Studies
Through improved adherence, once-monthly injectable extended-release naltrexone (XR-NTX)
may provide an advantage over other oral agents approved for alcohol and opioid dependence
treatment. The objective of this study was to evaluate cost and utilization outcomes between
XR-NTX and other pharmacotherapies for treatment of alcohol and opioid dependence.
Published studies were identified through comprehensive search of two electronic databases.
Studies were included if they compared XR-NTX to other approved medicines and reported
economic and healthcare utilization outcomes in patients with opioid or alcohol dependence. We
identified five observational studies comparing 1,565 patients using XR-NTX to other therapies
over six months. Alcohol dependent XR-NTX patients had longer medication refill persistence
versus acamprosate and oral naltrexone. Healthcare utilization and costs was generally lower or
as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid
dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other
agents and $8170 lower total cost versus methadone
Decreased olfactory discrimination is associated with impulsivity in healthy volunteers
In clinical populations, olfactory abilities parallel executive function, implicating shared
neuroanatomical substrates within the ventral prefrontal cortex. In healthy individuals, the relationship
between olfaction and personality traits or certain cognitive and behavioural characteristics remains
unexplored. We therefore tested if olfactory function is associated with trait and behavioural impulsivity
in nonclinical individuals. Eighty-three healthy volunteers (50 females) underwent quantitative
assessment of olfactory function (odour detection threshold, discrimination, and identifcation). Each
participant was rated for trait impulsivity index using the Barratt Impulsiveness Scale and performed
a battery of tasks to assess behavioural impulsivity (Stop Signal Task, SST; Information Sampling
Task, IST; Delay Discounting). Lower odour discrimination predicted high ratings in non-planning
impulsivity (Barratt Non-Planning impulsivity subscale); both, lower odour discrimination and detection
threshold predicted low inhibitory control (SST; increased motor impulsivity). These fndings extend
clinical observations to support the hypothesis that defcits in olfactory ability are linked to impulsive
tendencies within the healthy population. In particular, the relationship between olfactory abilities and
behavioural inhibitory control (in the SST) reinforces evidence for functional overlap between neural
networks involved in both processes. These fndings may usefully inform the stratifcation of people at
risk of impulse-control-related problems and support planning early clinical interventions
Practical technology for expanding and improving substance use disorder treatment: telehealth, remote monitoring, and digital health interventions.
The US opioid crisis and the COVID-19 pandemic have sparked innovation in substance use disorder (SUD) treatment such that telehealth, remote monitoring, and digital health interventions are increasingly feasible and effective. These technologies can increase SUD treatment access and acceptability, even for nontreatment seeking, remote, and underserved populations, and can be used to reduce health disparities. Overall, digital tools will likely overcome many barriers to delivery of evidence-based behavioral treatments such as cognitive behavioral therapy and contingency management, that, along with appropriate medications, constitute the foundation of treatment of SUDs
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HIV risk reduction in the National Institute on Drug Abuse Cocaine Collaborative Treatment Study
HIV risk was evaluated among 487 cocaine-dependent patients recruited from five treatment programs in a trial that examined the efficacy of four outpatient-based psychosocial treatments. Treatments were offered two to three times per week for 6 months and consisted of group drug counseling (GDC) or group counseling plus individual drug counseling (IDC), cognitive therapy (CT), or supportive-expressive therapy (SE). The average patient had used cocaine for 7 years, with 10 days of use in the last month. Crack smoking was the main route in 79%, and HIV risk was mainly due to multiple partners and unprotected sex. Treatment was associated with a decrease in cocaine use from an average of 10 days per month at baseline to 1 day per month at 6 months. Reduction in cocaine use was associated with an average 40% decrease in HIV risk across all treatment, gender, and ethnic groups, mainly as a result of fewer sexual partners and less unprotected sex. The combination of IDC and GDC was associated with an equal or even greater reduction in HIV risk than the other treatment conditions and thus shows promise as an effective HIV prevention strategy, at least for some patients
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