A5051552117- Opioid Use Disorder Treatment
- Substance Abuse Treatment and Outcomes
- Pain Management and Opioid Use
- Prenatal Substance Exposure Effects
- Forensic Toxicology and Drug Analysis
- Health Policy Implementation Science
- Pharmaceutical Practices and Patient Outcomes
- Healthcare professionals’ stress and burnout
- Digital Mental Health Interventions
- HIV, Drug Use, Sexual Risk
- COVID-19 and Mental Health
- Medication Adherence and Compliance
- Mobile Health and mHealth Applications
- Pediatric Pain Management Techniques
- Anesthesia and Pain Management
- Primary Care and Health Outcomes
University of Vermont
2013-2024
Substance Abuse and Mental Health Services Administration
2021
Vermont Department of Health
2021
JSW Group (India)
2020
National Institute of General Medical Sciences
2017
National Institutes of Health
2017
Dartmouth Psychiatric Research Center
2016
John Brown University
1988
Opioid use disorders (OUDs) are reaching epidemic proportions in the United States, and many geographic areas struggle with a persistent shortage availability of opioid agonist treatment. Over past 5 years, Vermont addiction medicine physicians public health leaders have responded to these challenges by developing an integrated hub-and-spoke treatment network.In present report, we review development, implementation, impact this novel model for expanding OUD Vermont.Vermont's system has been...
The prevalence of heroin and other opioid use has markedly increased among adolescents in the last decade; however, virtually no research been conducted to identify effective treatments for this population.To evaluate relative efficacy 2 pharmacotherapies, partial agonist buprenorphine hydrochloride centrally active alpha(2)-adrenergic blocker clonidine hydrochloride, detoxification opioid-dependent adolescents.A double-blind, double-dummy, parallel-groups randomized controlled trial a...
<h3>Importance</h3> Although abuse of prescription opioids (POs) is a significant public health problem, few experimental studies have investigated the treatment needs this growing population. <h3>Objective</h3> To evaluate, following brief stabilization with combination buprenorphine hydrochloride and naloxone dihydrate, relative efficacy 1-, 2-, 4-week tapering regimens subsequent naltrexone therapy in PO-dependent outpatients. <h3>Design, Setting, Participants</h3> A double-blind, 12-week...
Rapidly escalating rates of heroin and prescription opioid use have been widely observed in rural areas across the United States. Although US Food Drug Administration-approved medications for disorders exist, they are not routinely accessible to patients. One medication, buprenorphine, can be prescribed by waivered physicians office-based practice settings, but patterns vary widely. This study explored a learning collaborative method improve provision buprenorphine state Vermont.We initiated...
People with opioid use disorder (OUD) are overrepresented in US correctional facilities and experience disproportionately high risk for overdose after release. Medications OUD (MOUD) highly efficacious but not available to most incarcerated individuals. In 2018, Vermont began providing MOUD all individuals statewide. 2020, the COVID-19 state of emergency began. We assessed impact both events on utilization treatment outcomes.
Introduction The prevalence of high-potency synthetic opioids (HPSOs), such as fentanyl and its analogs, present significant treatment challenges to current strategies for Emergency Department (ED) medication opioid use disorder (MOUD). While most EDs traditionally buprenorphine MOUD, effectiveness can be limited in patients exposed HPSOs due risk precipitated withdrawal or inadequate control symptoms. Methadone, a full agonist, is an alternative MOUD agent that addresses the severe symptoms...
Background Medications for opioid use disorder (MOUD) significantly reduce morbidity and mortality from (OUD). To prescribe MOUD, physicians must obtain a DEA waiver through requirements outlined in the Drug Addiction Treatment Act of 2000 (DATA 2000). We developed an Medicine curriculum that features DATA training at Robert Larner, MD College (LCOM). Methods All third-year medical students completed virtual commencement clinical clerkships. conducted needs assessment followed by pre-...
It is crucial that future physicians understand the nature of opioid use disorder (OUD). We designed a pilot Observed Structured Clinical Examination (OSCE) using simulated patients (SPs) experiencing OUD with concurrent chronic pain. The case was piloted in 2021 and 2022 during multi-station OSCE all medical school clerkship students take at end their third year school. A total 111 completed 93 2022. authors developed description an assessment instrument for SP to evaluate student's...
Introduction: Overdose deaths from high-potency synthetic opioids, including fentanyl and its analogs, continue to rise along with emergency department (ED) visits for complications of opioid use disorder (OUD). Fentanyl accumulates in adipose tissue; although rare, this increases the risk precipitated withdrawal patients upon buprenorphine initiation. Many EDs have implemented medication (MOUD) programs using buprenorphine. However, few offer methadone, a proven therapy without associated...
Objectives Distance and travel costs to opioid treatment programs (OTPs), especially in rural communities, are barriers for use disorder. Retention rates at 12 months our OTP 55% (range 53%–61%).We piloted a novel platform utilizing video directly observed therapy (VDOT) smartphone app secure medication dispenser support adherence with take-home doses of methadone or buprenorphine while enabling patients maintain prosocial activities, reduce time cost travel, increase retention. Methods...
Treatment of opioid use disorder with methadone is highly effective. Methadone dispensed from treatment programs under regulated circumstances. However, diversion take-home doses can occur and difficult to detect. We wanted test the application a handheld ultraviolet light absorption spectrometer detect concentration in bottles that were suspected being altered by patient.Standardized dilutions hydrochloride oral concentrate used calibrate wavelengths then compared take homes unsuspected see...
Substance abuse is a problem among college student populations. In spite of continued efforts to educate students about the dangers substance abuse, preventive measures have been met with resistance. Reluctance respond these messages may arise from psychological defense mechanisms. However, unique properties university life and role are seen contribute more significantly this The processes individuation, emotional development, socialization, group membership appear be stabilized by use drugs...