Research News Roundup: November 14, 2024

Journal: Journal of Psychosomatic Obstetrics & Gynecology, 2024, doi: 10.1080/ 0167482X.2024.2424417

Authors: Leah A. Holcomb, Rachel Mayo, Bonnie Treado, Jennifer Barkin, Kathleen Cartmell, Lori Dickes, & Lior Rennert

Abstract:

Our current understanding of postpartum people’s functioning while managing substance use disorder (SUD) recovery is limited. This study explored whether having a SUD impacts maternal functioning and examined the reliability of the Barkin Index of Maternal Functioning (BIMF) in postpartum people with SUDs. We conducted a prospective, cross-sectional survey (n = 141) by administering the BIMF and a demographic questionnaire with a sample of postpartum people with SUD (n = 48) and a comparative sample of postpartum people without SUD (n = 93). The internal reliability (Cronbach’s alpha = .86) was consistent with previous studies. SUD diagnosis was significantly associated with lower functioning, with individuals in the SUD group having an 8-point lower BIMF score compared to persons without SUDs, although both groups reported moderately high BIMF scores (>80). While not statistically significant, participants with SUDs had reduced functioning scores over time. Considering the increasing rate of overdose deaths in postpartum persons, further examination of functioning in postpartum persons with SUDs is warranted. Integration of the BIMF into SUD screening and treatment can provide a holistic view of postpartum experiences in this high-risk population and serve as a unique tool to understand the needs of new mothers navigating SUD recovery.

To read the full text of the article, please visit the publisher’s website.

Journal: International Journal Drug Policy, 2024, doi: 10.1016/j.drugpo. 2024.104587

Authors: Erin Russell, Mary Hawk, Joanne Neale, Alex S. Bennett, Corey Davis, Lucas G. Hill, … Stephen Jones

Abstract:

High dose and long-acting opioid overdose reversal drugs can precipitate withdrawal in people who are opioid dependent. Products recently brought to market for community use in the United States (US) have drawn international concern because of their increased risk of withdrawal. At the March 18-19, 2024, Compassionate Overdose Response Summit & Naloxone Dosing Meeting, a panel of harm reduction experts issued the following call to action: 1) people who use drugs should be directly involved in decisions regarding the research, development, selection, and distribution of opioid overdose reversal products; 2) regulatory agencies and pharmaceutical manufacturers should carefully consider and communicate the risk and duration of withdrawal associated with higher dose and longer-acting opioid antagonists; 3) take-home naloxone kits should include at least two doses of an intramuscular (IM) product containing 0.4 mg or an intranasal (IN) product containing ≤4 mg; 4) At this time, high dose and long-acting opioid antagonists have no use in acute opioid overdose response; and, 5) overdose response educational materials, instructions on overdose response, and training should emphasize the restoration of breathing, avoiding withdrawal, and compassionate post-overdose support and care. High dose and long-acting opioid overdose reversal drugs were approved without testing for withdrawal and are often aggressively marketed despite decades of evidence from naloxone distribution programs worldwide that the ideal dose of naloxone is one that restores breathing without inducing withdrawal. Government agencies should direct resources to harm reduction programs to make standard dose take-home naloxone products widely available among people who use drugs. Lay bystanders, people who use drugs, their families, and professional first responders can learn and apply a compassionate approach to opioid overdose response.

To read the full text of the article, please visit the publisher’s website.

Journal: medRxiv, 2024, doi: 10.1101/2024.09.24.24314320

Authors: Eduardo R. Butelman, Yuefeng Huang, Alicia McFarlane, Carolann Slattery, Rita Z. Goldstein, Nora D. Volkow, & Nelly Alia-Klein

Abstract:

Question: The opioid epidemic causes massive morbidity, and males have substantially greater overdose mortality rates than females. It is unclear whether there are sex-related disparities at different stages in the trajectory of opioid use disorders, in “real world” settings.

Goal: To determine sex disparities in non-medical opioid use (NMOU) at the end of outpatient medication-assisted treatment (MAT), using nationally representative data.

Design: Observational epidemiological study of publicly funded outpatient MAT programs in the national “Treatment episode data set-discharges” (TEDS-D) for 2019.

Participants: Persons aged ≥18 in their first treatment episode, in outpatient MAT for use of heroin or other opioids (N=11,549). The binary outcome was presence/absence of NMOU.

Results: In univariate analyses, males had significantly higher odds of NMOU, compared to females (odds ratio=1.27; Chi2 [df:1]=39.08; uncorrected p<0.0001; p=0.0041 after Bonferroni correction). A multivariable logistic regression detected a male>female odds ratio of 1.19 (95%CI=1.09-1.29; p<0.0001), adjusting for socio-demographic/clinical variables. Several specific conditions were revealed in which males had greater odds of NMOU compared to females (e.g., at ages 18-29 and 30-39; corrected p=0.012, or if they used opioids by inhalation; corrected p=0.0041).

Conclusions: This nationally representative study indicates that males have greater odds of NMOU in their first episode of MAT, indicating more unfavorable outcomes. The study reveals specific socio-demographic and clinical variables under which this sex disparity is most prominent.

To read the full text of the article, please visit the publisher’s website.