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Background: Increases in fatal synthetic opioid overdoses over the past 8 years have left states scrambling for effective means to curtail these deaths. Many states have implemented policies and increased service capacity to address this rise. To better understand the effectiveness of policy level interventions we estimated the impact of the presence of naloxone access laws (NALs) on synthetic opioid fatalities at the state level. Methods: A multivariable longitudinal linear mixed model with a random intercept was used to determine the relationship between the presence of NALs and synthetic opioid overdose death rates, while controlling for, Good Samaritan laws, opioid prescription rate, and capacity for medication for opioid use disorder (MOUD), utilizing a quadratic time trajectory. Data for the study was collected from the National Vital Statistics System using multiple cause-of-death mortality files linked to drug overdose deaths. Results: The presence of an NAL had a significant (univariate P -value =.013; multivariable p-value =.010) negative relationship to fentanyl overdose death rates. Other significant controlling variables were quadratic time (univariate and multivariable P -value <.001), MOUD (univariate P -value <.001; multivariable P -value =.009), and Good Samaritan Law (univariate P -value =.033; multivariable P -value =.018). Conclusion: Naloxone standing orders are strongly related to fatal synthetic opioid overdose reduction. The effect of NALs, MOUD treatment capacity, and Good Samaritan laws all significantly influenced the synthetic opioid overdose death rate. The use of naloxone should be a central part of any state strategy to reduce overdose death rate. [ABSTRACT FROM AUTHOR]

The past decade has seen a marked increase in the illicit use of opioids, as well as a doubling of the percentage of individuals seeking treatment for opioid use disorders. However, little is known about the differences between opioid users and nonopioid users in residential treatment. Further, no studies have been published that compare opioid users and nonopioid users in treatment for co-occurring substance use and mental disorders. To address this gap, this study examined differences between opioid and nonopioid substance users in residential treatment for co-occurring disorders. Data was drawn from 1,972 individuals treated between 2009 and 2011 at one of three private residential treatment centers that provide integrated treatment for co-occurring substance use and mental disorders. Data was collected at program intake, and 1- and 6-month postdischarge using the Addiction Severity Index and the University of Rhode Island Change Assessment. To examine within-group changes in substance use, addiction severity, and mental health across time, linear mixed-model analyses were conducted with facility, year, age, gender, and race included as covariates. The authors found more similarities than differences between the two groups on baseline characteristics, treatment motivation, length of stay, and outcomes on measures of substance use, addiction severity, and mental health. The results demonstrate that though opioid users entered treatment with higher levels of substance use–related impairment, they were just as successful in treatment outcomes as their non-opioid-using peers. [ABSTRACT FROM PUBLISHER]

Like many areas of the country, the state of Tennessee is experiencing a recent and growing rise in the rate of methamphetamine use, particularly in rural areas of the state. While substance use is a known risk factor for contracting HIV/AIDS, there is limited information regarding the risk behaviors of rural methamphetamine users. This paper seeks to document the existence of known HIV risk behaviors as they relate to rural southern methamphetamine use. Qualitative interviews with ninety-seven current and former methamphetamine users from the Cumberland Plateau area, a rural mountainous region in the state of Tennessee, suggest that methamphetamine users are putting themselves at risk for contracting HIV/AIDS and other blood-borne diseases through high-risk injection and sexual behaviors. Additionally, the results present the perceptions of respondents regarding the impact of methamphetamine use on rural communities and related service needs. [ABSTRACT FROM AUTHOR]

The article presents an analysis of literature on substance abuse among U.S. Latinos. High fertility and high immigration rates have made Latinos the largest minority in the U.S. Therefore, alcohol and illicit drug use within this population give reason for concern. Beginning in early adolescence, Latinos and native Americans lead the nation in alcohol and illicit drug use. They also have a high need for alcohol and illicit drug treatment compared to Whites and African-Americans. Even though family and peers have been shown to play an important role in the etiology of substance abuse across ethnic groups, research indicates that important differences exist within ethnic groups on these and other factors. In the article, research concerning ethnic differences has been reviewed in order to gain an understanding of the patterns and trajectories of substance use within the Latino community. Prevention and treatment interventions specific to Latinos have been described, and gaps in the literature are noted. Finally, implications of the current research findings for social workers and recommendations for future research have been discussed.

The purpose of this article is to present the Harm Reduction Model and its potential as a framework from which to provide prevention services for adolescents. While it may be uncomfortable for service providers to acknowledge, the vast majority of adolescents in the United States will have used mood-altering substances sometime during their teen years. While non-abstinence-based prevention services have existed for some time, they are not without controversy. This article proposes Harm Reduction as a complimentary or alternative perspective for work with adolescents for whom abstinence may not be immediately possible and/or may not be a realistic outcome for services. This article outlines the abstinence-oriented and Harm Reduction perspectives, as well as the Stages of Change model; utilizing empirical support, it then discusses how these perspectives can work together in social work practice in the adolescent substance abuse prevention arena. [ABSTRACT FROM PUBLISHER]