Mobile Clinics Tested as a Way to Treat Substance Use Disorders

Mobile Clinics Tested as a Way to Treat Substance Use Disorders

Mobile health units may be able to help manage HIV infections and opioid use disorder. A clinical trial, funded by the National Institute of Allergy and Infectious Diseases and the National Institute on Drug Abuse, aims to determine mobile clinics’ effectiveness and usefulness in opioid use disorder treatment. The clinical trial will have 860 participants, for 26 weeks and in five cities—Los Angeles, New York, Houston, Philadelphia and Washington, DC.  Researchers will evaluate whether these mobile health units will help people to treat opioid use disorder and prevent or receive care for HIV/AIDS.

“If they have HIV/AIDS, it can then be transferred to another person,” said Anton C. Bizzell, MD, a physician who advocates for addressing healthcare disparities and the chief executive order of the Bizzell Group, tells Verywell. “It’s also important to know that we can decrease the incidence of substance abuse, as well as infections that can occur.” People may be reluctant to access appropriate health care due to stigma and cost. Dr. Bizzell states that if you take the mobile clinics to where people live and work, they are more likely to receive care.

Read more: NIH-Funded Study Tests Mobile Clinics as a Way to Treat Substance Abuse

Image Source: Métraux, J. (2021). Verywell/LifeLineMobile [Online Picture]. Verywell Health. https://www.verywellhealth.com/study-investigates-if-mobile-clinics-will-help-people-with-opioid-use-disorder-5190855

Bizzell Supports NIDA in the Launch of Innovative Learning Tools to Help Manage Opioid Treatment

Bizzell Supports NIDA in the Launch of Innovative Learning Tools to Help Manage Opioid Treatment

In conjunction with the National Institute on Drug Abuse-Clinical Trials Network (NIDA-CTN), Bizzell announces the availability of three educational videos for healthcare providers managing opioid use disorder (OUD). The first two videos are animations that discuss overdose prevention. The third video is an interactive tool used to educate healthcare providers on OUD in an emergency setting.

Video 1Overdose Prevention Education for Clinicians Treating Patients with Opioids for Chronic Pain is an animated video that focuses on four key strategies: Reducing Risk for Development of OUD and Avoidance of Misuse, Identification of Risk Factors, Safety Planning, and Overdose Rescue Preparation.

Video 2: Overdose Prevention Education for Clinicians Treating Patients for an Opioid Use Disorder is an animated video that highlights three key strategies: Identifying Overdose Risk Factors, Developing a Safety Plan, and Overdose Rescue Preparation.

“These teachings are done in a simple, non-judgmental fashion offering the viewer clear and memorable points in assessing and managing opioid overdoses,” says Douglas L. Gourlay, M.D., MSc., FRCPC, FASAM, Former Director of the Pain and Chemical Dependency division of the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto, a reviewer of the video.

Video 3:  Buprenorphine Initiation for Opioid Use Disorders in Emergency Departments: Interactive Case Vignettes is a branching video, which is an interactive educational tool. It allows participants to select a healthcare track which results in varying outcomes. The American College of Emergency Physicians (ACEP) is providing Continuing Medical Education (CME) credit and access to the tool will require the creation of a free ACEP account. Throughout the course, guidance is provided on the clinical management of OUD with a focus on screening, enlisting the patient’s input into their treatment, buprenorphine initiation, and referral to ongoing treatment.

After watching these videos, participants will be able to apply a patient-centered, shared decision-making approach while discussing the prevalence of overdose and the process of introducing buprenorphine in the ED for treatment of OUD. Participants will also be able to discuss chances for recovery as research suggests that patients are twice as likely to enter addiction treatment and remain in treatment at 30 days if medication is initiated in the ED.

The targeted audiences for the buprenorphine initiation video include: Emergency Physicians, Emergency Nurses, Nurse Practitioners, Residents, Medical Students, Physician Assistants, Emergency Department Medical Directors, Hospital Administrators, EMTs/Paramedics, and other healthcare providers engaged in the practice of emergency medicine.

“This branching video effectively and quickly walks users through the most high-yield information in the most engaging way possible. Providers around the country should see this video before their next shift caring for patients with opioid addiction,” says video reviewer, Alister Martin MD, MPP, Faculty – Center for Social Justice and Health Equity, Harvard Medical School, Massachusetts General Hospital Emergency Department.

All of the above mentioned videos were funded in part with federal funds from the National Institute on Drug Abuse, Center for the Clinical Trials Network Dissemination Initiative (contract # HHSN271201700059C). The content for the videos was developed by researchers and experts and does not necessarily reflect the official position of the National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. These training resources should not be considered as a substitute for individualized patient care and treatment decisions.

  • This activity has been planned and implemented in accordance with the accreditation requirements and policies of The Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Emergency Physicians, NIDA, The Bizzell Group, and Modern Epic. The American College of Emergency Physicians is accredited by the ACCME to provide continuing medical education for physicians.
  • The  American College of Emergency Physicians designates this enduring material activity for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate .with the extent of their participation in the activity.
  • Approved by the American College of Emergency Physicians for 1 hour of ACEP Category I credit.

ABOUT BIZZELL

Established in 2010, The Bizzell Group (Bizzell) is a U.S. Small Business Administration (SBA) 8(a) certified strategy, consulting, and technology firm that specializes in program management, administrative support, communications and outreach, conference management and logistical support, health services and research, technical assistance, and training and development. Bizzell’s expert staff and consultants work on health, scientific, education, environmental, research, and information technology projects that advance national priorities. Under the leadership and vision of founder, Anton C. Bizzell, MD, the company has grown from a staff of two in one small office, to a thriving firm with three offices in Lanham, MD, Rockville, MD, and Atlanta, GA, with ongoing projects around the world. Learn more about how we develop data- driven, research-informed, innovative solutions to complex-real-world challenges: www.BizzellUS.com.

ABOUT THE NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. Fact sheets on the health effects of drugs and information on   NIDA research and   other   activities   can be found at www.drugabuse.gov, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA’s DrugPubs research dissemination center at 1-877- NIDA-NIH or 240-645-0228 (TDD) or email requests to drugpubs@nida.nih.gov. Online ordering is available at drugpubs.drugabuse.gov. NIDA’s media guide can be found at www.drugabuse.gov/publications/media-guide/dear-journalist.

Alcohol Use Disorder: Hope for Recovery

Alcohol Use Disorder: Hope for Recovery

Written by: Anton Bizzell, MD

Alcohol use disorder (AUD) is often referred to as the hidden substance use disorder (SUD). With alcohol use legal and socially acceptable in many settings, the symptoms of AUD may initially go unnoticed. Yet individuals with AUD may experience significant difficulties in their relationships, work, and health.

In a newly released analysis, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) found that over 70 percent of the adult population drank alcohol in 2017. Alcohol-related deaths more than doubled from 1999 to 2017. Overdoses of alcohol alone or in combination with other drugs accounted for 18 percent of the deaths in 2017; 31 percent of the deaths resulted from alcohol-related liver disease. Researchers note that the since this study examined only death certificate data, the actual number of lives lost may be significantly higher.

The death rates increased higher for women than for men, and gender differences persist in risks for alcohol-related cardiovascular disease, liver disease, and cancer. In addition, while prevalence of alcohol use and binge drinking remained stable for men, the prevalence of alcohol use increased by over 10 percent for women and binge drinking increased by over 23 percent among women.

The NIAAA screening tool for AUD includes questions a provider can use to diagnose whether an individual may have an AUD. Individuals who are struggling with their drinking, or families and friends concerned about their loved ones, can start by considering the following questions.

In the past year, have you:

  •  Tried to cut down or stop drinking more than once, but couldn’t?
  •  Found that drinking or being sick from drinking got in the way of you taking care of your home or your family, or caused problems at work or school?
  •  More than once gotten into situations while drinking that could be dangerous, such as driving, having unsafe sex, using machinery, walking in an unsafe neighborhood; or had a memory blackout?
  •  Kept drinking even though it was making you depressed or anxious, or adding to other health problems?
  •  Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating?

In addition to peer-led support models such as Alcoholics Anonymous, there are many options for professionally-led treatment. Treatment for AUD often involves a combination of talk therapy and medication. Therapy can be for individuals, groups, or families, under the direction of a licensed counselor trained in substance use disorders. Medication to help individuals stop drinking and avoid relapse can be administered under the care of a licensed primary care provider or a board-certified addiction medicine physician. In addition, different levels of care and care settings are available to meet the needs of each situation, including outpatient, partial hospitalization, residential, or intensive inpatient.

Although the consequences of AUD can be devastating, hope for recovery is possible with evidence-based, timely intervention.

About Bizzell

The Bizzell Group (Bizzell) was founded by CEO Anton Bizzell, M.D., a substance use disorders expert and former Medical Officer at NIAAA. Our recent work includes systematic, integrated approaches designed to effect lasting change in the field of substance use disorders through projects with the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI), the Food and Drug Administration (FDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the United States Chamber of Commerce Foundation (USCCF). Learn more about how Bizzell advances data-driven, research-informed, innovative solutions to solve complex, real-world challenges. www.BizzellUS.com

Reference:

White, A. M., Castle, I. J. P., Hingson, R. W., & Powell, P. A. (2020). Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017. Alcoholism: Clinical and Experimental Research.

National Alcohol Screening Day

National Alcohol Screening Day

National Alcohol Screening Day (NASD) is an initiative first launched in 1999 by the National Institutes of Health (NIH).  NASD is held annually on the first Thursday of the first full week of April. The purpose of this event is to increase public awareness that alcohol abuse and alcoholism are recognized disorders which can be treated. During this day, members of the public are encouraged to visit screening centers and asked to complete written self-assessments about their alcohol use.

According to The Community Guide, there are 2,000 alcohol poisoning deaths in the U.S. each year and alcohol abuse is higher in college students, who do tend to frequently drink in large volumes.  Excessive, fast consumption of alcohol is known as ‘binge drinking’, and this kind of alcohol abuse can lead to many recognized health problems such as anxiety, depression or sexual problems.  The long-term effects of alcohol abuse include an increased risk of developing certain cancers, liver cirrhosis, high blood pressure and heart problems.
National Alcohol Screening Day awareness continues to grow nationally, and the U.S. government is supporting programs and policies to reduce binge drinking and expand access through the Affordable Care Act to new health insurance plans to cover alcohol screening and brief counseling. The National Institute on Drug Abuse (NIDA) has launched two online screening tools that providers can use to assess for substance use disorder (SUD) risk among adolescents 12-17 years old.

Two Screening Options: Providers can select the tool that makes sense for their clinical practice.

CAGE Questionnaire  

The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.

The questionnaire takes less than one minute to administer and is often used in the primary care of other general settings as a quick screening tool rather than as an in-depth interview for those who have alcoholism.  The CAGE questionnaire does not have a specific intended population and is meant to find those who drink excessively and need treatment. The CAGE questionnaire is reliable and valid for assessment of alcohol abuse; however, it is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE questionnaire have been frequently implemented for such a purpose.

AUDIT-C Overview 

The Alcohol Use Disorders Identification Test (AUDIT) can detect alcohol problems experienced in the last year. A score of 8+ on the AUDIT generally indicates harmful or hazardous drinking. Questions 1–8 = 0, 1, 2, 3, or 4 points. Questions 9 and 10 are scored 0, 2, or 4 only. The Audit-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence). The AUDIT-C is a modified version of the question AUDIT instrument.