Good news in NSDUH: New heroin use down

New users of heroin were down in 2017 from the previous year, according to the National Survey on Drug Use and Health (NSDUH) released Sept. 14. The decline is dramatic: from 170,000 new heroin users in 2016, to 81,000 in 2017. But there are concerns about increasing cocaine and methamphetamine use, a continuing increase in widespread use of marijuana, and increased substance use in the “transitional‐age” (18–25‐year‐olds) population and pregnant women.     

Toward an effective treatment system for adolescents with substance use disorders: The role of the states

A 2002 national expert panel found that the treatment system for adolescents with substance use disorders was inadequate and underdeveloped. The panel recommended immediate improvement in five areas: youth-serving agency collaboration, treatment system financing, workforce development, the implementation of evidence-based practices, and family involvement in all aspects of treatment. In 2004, the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA), designed the State Adolescent Substance Abuse Treatment Coordination Grant program (SAC) and implemented it in 2005 to address the critical need in the field. This paper reviews the adolescent substance use disorders treatment system, discusses selected drivers for change and the design of the SAC grant program, and summarizes some of the program's results. Both quantitative and qualitative data analysis document that substantive systems development occurred within each of the sixteen grantees and that federal–state partnerships are useful in creating systemic change.     

Using cannabis to mitigate symptoms of opioid use disorder

Results of a study published this month in Psychiatric Services suggest that if states want to ensure greater provision of evidence‐based care for opioid use disorder (OUD), expanding Medicaid offers an effective strategy for doing so. At the same time, the study data indicate that Medicaid expansion alone is not sufficient for making agonist therapies accessible in dramatic numbers.     

Alcohol and substance use disorders as predictors of child to adult sexual revictimization in a sample of community women

Alcohol- and substance-related diagnoses were examined as factors in child to adult sexual revictimization. Three hundred community women completed interviews and self-report instruments to obtain information regarding victimization and to diagnose substance use disorders (alcohol and substance abuse/dependence). Childhood sexual abuse (CSA) survivors were more likely than nonvictims to meet criteria for both substance use disorders and to report rape (e.g., unwanted intercourse due to threat or use of force, or due to the inability to consent due to the respondent's alcohol or drug use) and coerced intercourse (e.g., unwanted intercourse due to verbal coercion or misuse of authority by the perpetrator) by acquaintances, strangers, and husbands. In general, both CSA and substance use disorders were predictive of adult sexual victimization, but there were no significant interactions between these factors. Overall, substance use disorders were related to rape for all women; this relationship was not unique to CSA survivors. Alcohol- and substance-related diagnoses predicted rape by all three types of perpetrators, but CSA was predictive of rape only by acquaintances and strangers and not husbands. In contrast, CSA predicted coerced intercourse by all three perpetrators, while alcohol- and substance-related diagnoses predicted coerced intercourse by acquaintances and strangers, but not husbands. Results highlight the need to continue the study of revictimization of CSA survivors, including examination of both rape and sexually coercive experiences by different types of perpetrators. Findings support continued research of substance use disorders as risk factors for sexual victimization among all women.     

Substance use disorders and COVID-19: the role of telehealth in treatment and research

ABSTRACT

Telehealth, or the use of telecommunications and virtual technology to deliver health care and engage with patients outside of traditional health-care facilities, can play an important role in addressing the treatment and study of substance use disorders (SUDs) during the ongoing COVID-19 crisis. COVID-19 and related safety restrictions have thrust healthcare workers and researchers into a new reality of healthcare that relies heavily, or even exclusively, on telehealth methods. These changes have forced treatment providers and researchers to be agile in adopting these methods in order to maintain continuity of patient care and data collection. There are unique considerations that should be taken into account as telehealth practices continue to augment SUD care and research, even when restrictions have been lifted. Overall, we propose that telehealth can support innovation in treatment and research focused on SUDs and should be an integral part of our work, beyond COVID-19.