How Can We Help? A Guide to Substance Use Disorders, Stigma, and Harm Reduction

For people with a substance use disorder, stigma is a major barrier to recovery. When someone discloses their struggles with substance use, they risk being stigmatized by their families, friends, and even health care providers. Some treatment strategies, including harm reduction, are also stigmatized, making it difficult for people to access resources. Harm reduction is a set of strategies based on the core value of respect for the rights of people who use drugs. The goal of harm reduction is to help people stay safe while using substances and to connect them with medical professionals who offer evidence-based treatment for substance use disorders. Because harm reduction strategies do not require abstinence from substance use, they are often misunderstood as enabling drug use. This guide is meant to help people understand the role of stigma in preventing people from accessing recovery resources. It provides an overview of harm reduction strategies and explains the research on best practices for supporting people with substance use disorders to use substances more safely, and to help them consider options for treatment and recovery. The guide is in graphic novel format, and follows Erin, Hilary and Leo the Chihuahua as they travel to beautiful destinations in Utah and talk about these topics.https://digitalcommons.usu.edu/harmreductioncomics/1002/thumbnail.jp

The Ever-Shifting Internet Population

Presents findings from surveys conducted between March and May 2002. Takes a new look at Internet access and the digital divide. Explores factors of cost, lack of technology skills, and physical access (particularly for persons with disabilities)

Screening Prevalence and Incidence of Colorectal Cancer Among American Indian/Alaskan Natives in the Indian Health Service

BackgroundStudies on colorectal cancer (CRC) screening and incidence among American Indian/Alaska Natives (AI/AN) are few.AimsOur aim was to determine CRC screening prevalence and to calculate CRC incidence among AI/AN receiving care within the Indian Health Service (IHS).MethodsA retrospective cohort study of AI/AN who utilized IHS from 1996 to 2004. AI/AN who were average-risk for CRC and received primary care within IHS were identified by searching the IHS Resource Patient Management System for selected ICD-9/CPT codes (n = 142,051). CRC screening prevalence was calculated and predictors of screening were determined for this group. CRC incidence rates were ascertained for the entire AI/AN population ages 50-80 who received IHS medical care between 1996 and 2004 (n = 283,717).ResultsCRC screening was performed in 4.0% of average-risk AI/AN. CRC screening was more common among women than men (RR = 1.6, 95% CI 1.4-1.7) and among AI/AN living in the Alaska region compared to the Pacific Coast region (RR = 2.5, 95% CI 2.2-2.8) while patients living in the Northern Plains (RR = 0.4, 95% CI 0.3-0.4) were less likely to have been screened. CRC screening was less common among patients with a greater number of primary care visits. The age-adjusted CRC incidence among AI/AN ages 50-80 was 227 cancers per 100,000 person-years.ConclusionsCRC was common among AI/AN receiving medical care within IHS. However, CRC screening prevalence was far lower than has been reported for the U.S. population

The Urban/Rural Divide in Access to Medication-Assisted Treatment for Opioid Use Disorder in Utah

Death by drug poisoning is the leading cause of death due to injury in the state of Utah (UDOH, 2014). From 2013-2015, Utah ranked seventh in the nation for drug overdose deaths, the majority of which were opioid-related (CDC, 2018a). In 2017, the age-adjusted mortality rate from drug overdose in Utah was 15.5 per 100,000, putting the state above the national average of 14.9 per 100,000 (CDC, 2018b). Opioid overdose death rates in most of rural Utah far exceeds rates across the urban counties of the state. The higher rates of deaths in rural Utah is indeed concerning. Evidence indicates that rural areas are particularly hard hit due to limited access to care and resources (USDA, 2019). Three kinds of medication-assisted treatment (MAT) approved for treatment of opioid use disorder (OUD) include: methadone, buprenorphine, and naltrexone (SAMHSA, 2019a). These medications block the euphoric effect of drugs, relieve cravings, and stabilize brain chemistry without the negative side effects of the previously abused drug (SAMHSA, 2019b). This fact sheet gives details about MAT for opioid use disorder

Increases in ROPS Pricing from 2006-2012 and the Impact on ROPS Demand

In 2006, a social marketing campaign was developed to increase the installation of rollover protective structures (ROPS) on unprotected New York tractors. Using data gathered from the program\u27s hotline, the impact of price increases on farmers\u27 interest in ROPS is examined. Pricing data were obtained for all rigid ROPS kits commercially available in the U.S. since 2006. These data were stratified into two groups of ROPS suppliers: (1) tractor manufacturers that sell ROPS for their own tractors, referred to in this study as original equipment manufacturers (OEMs), and (2) aftermarket (AM) ROPS suppliers. The trend in price increases was contrasted with the change in the consumer price index (CPI), the probability of retrofitting within quintiles of cost was estimated, and the increase in ROPS prices over time was plotted The average price increase for a ROPS kit (excluding shipping and installation) over the six years of the study was 23.3% for OEM versus 60.5% for AM (p \u3c 0.0001). Out-of-pocket expenses held steady for OEM versus a six-year increase of $203 for AM (p = 0.098). The probability of a farmer retrofitting dropped monotonically from 66.9% in the lowest ROPS cost quintile to 23% in the highest. If these trends continue, the proportion of inquiries resulting in a ROPS retrofit will fall below 20% by 2020 for AM ROPS. Based on other trends identified in the literature, it is reasonable to assume that decreases in ROPS installation are likely to affect the tractor owners who are most likely to need these safety devices

Examination of Anger Prevalence in NCAA Division I Student-Athletes

Purpose: Anger associated with sports participation may affect inability to acutely process anger, may decrease performance and increase the likelihood of risk-taking behavior in collegiate athletes. Therefore, the purpose was to examine the prevalence of anger in collegiate student-athletes across sex, academic status, and sport type. Methods: A cross sectional study over a three-year period examined 759 NCAA Division I student-athletes at one institution (age=20±1 years; males: n=259; females: n=500) completed an optional pre-participation behavioral health screening questionnaire, personal demographic information and the Anger Index Self-Test. Results: Overall, 37.2% (n=282/759; males=127/259, 49.0%; females=155/500, 31.0%) of participants were at high-risk for anger. We identified a significant difference between the anger and sex [Χ2(2, N=759) =28.1, P≤0.01]. We also identified a significant difference between the anger and sport type [Χ2(8, N=759)=32.1, P≤0.01] with 55.2% (n=419/759) at moderate risk for anger despite sport type; with the highest percentages presenting high-risk for anger within power sports (n= 64/116, 55.2%) and ball sports (n=98/240, 40.8%). No significant differences were identified for anger risk and academic status (P=0.66). Conclusions: Female collegiate student-athletes demonstrated a higher prevalence of anger than male collegiate student-athletes, yet more males were high-risk. Most student-athletes displayed moderate-risk for anger across different sports. Anger across academic status was not significantly different implying that anger management and coping skills may need to be taught during their student-athlete tenure to mitigate the identified risk. A collegiate student-athlete’s inability to process anger may affect sports performance and have negative consequences on their personal and social life. A primary prevention mechanism exists to explore proper coping mechanisms for anger during sport before the onset of mental health conditions that could exacerbate the experience for the individual

Professional Education to Reduce Provider Stigma Toward Harm Reduction and Pharmacotherapy

Aims: A novel professional training was developed to reduce stigma toward harm reduction and pharmacotherapy for substance use disorders. Methods: The training was delivered over three sessions to n = 147 health professionals in Utah between 2019 and 2020, including n = 40 substance use disorder treatment professionals. Pre and post-training survey measures provided evaluation information on knowledge, attitudes, and planned action regarding harm reduction and pharmacotherapy. Items were grouped into a stigma score, and multilevel modeling, regression analyses, and McNemar tests were used to quantify changes in overall stigma toward harm reduction interventions both before and after the training. Results: The training significantly decreased the total stigma score toward harm reduction (b = -0.09, p \u3c .001, β = -0.34). At the individual item level, 6 of the 22 items showed significant change in reduced stigma (all p \u3c .047), and all items moved in the direction of decreased stigma. These items include both attitudes and planned action aspects of the total stigma score. Conclusions: This study suggests that education targeting prejudice and discriminatory actions against harm reduction and pharmacotherapy interventions among healthcare professionals may contribute to stigma reduction. These results provide a basis for intervention effectiveness, addressing preconceived ideas, and show community need for such substance use interventions, as a component of future stigma reduction efforts

Opioid Use Disorder (OUD) and Pregnancy in Utah

Over the past twenty years, opioid use during pregnancy has become much more common (Haight et al., 2018). Opioids may be prescribed for pain management or the treatment of an opioid use disorder (OUD). For example, methadone or buprenorphine are medications recommended for pregnant women with OUD. Opioid use may also include misusing prescription painkillers or using illicit drugs such as heroin. Regardless of the nature of opioid use, it is important for pregnant women to know how opioid use can impact their pregnancy and what treatment options are available

A Crisis of Her Own: Fatal Opioid Overdose, Opioid Use Disorder, and Intimate Partner Violence Among Rural Utah Women

The Centers for Disease Control report that the rate of overdose deaths among women is rapidly increasing, with women experiencing a 532% increase in fatal opioid overdose deaths between 1999 and 2017, compared to a 355% increase for men. Among women, those in rural areas have disproportionately higher drug overdose death rates than women in urban areas (Mazure & Fiellin, 2018), indicating an opportunity for targeted rural public health interventions to slow overdose fatality increases among women. This fact sheet reviews Utah trends, potential factors increasing fatal opioid overdose, intimate partner violence and substance use disorders, and provides resources for getting help