Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative.
Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative.
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预防参与法律系统的青少年中阿片类药物的使用和紊乱：由 NIDA HEAL 倡议资助的四项研究的创新和实施。
DOI：
10.1007/s11121-023-01566-6
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Tolou-Shams,Marina
中科院分区：
文献类型：
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作者：
Ahrens,Kym;Blackburn,Natalie;Aalsma,Matthew;Haggerty,Kevin;Kelleher,Kelly;Knight,DanicaK;Joseph,Elizabeth;Mulford,Carrie;Ryle,Ted;Tolou-Shams,Marina
参与法律制度的青年的阿片类药物和物质使用障碍(OUD/SUD)和过量用药的比率远远高于普通人群。尽管有迫切的需求，而且现有的方案侧重于治疗YILS的这些问题，但关于阿片类药物启动和OUD预防的研究，包括可行性和可持续性，都受到严重限制。我们提出了四项研究，测试干预措施，虽然不一定是新的作为SUD治疗，测试新的结构和人际策略，以逆转阿片类药物的启动/OUD前体：(1)适应(临床试验编号。NCT04499079)使用基于社区的治疗信息系统数据提供实时反馈，以创建更有效的精神健康和SUD治疗级联，以防止阿片类药物的使用；(2)HOME(临床试验NO.NCT04135703)作为一项阿片类药物启动预防战略，为包括YILS在内的无家可归青年提供了在没有先决条件的情况下独立生活的直接避难所；(3)LESA(临床试验编号：NCT04678960)使用基于信任的关系干预®，使YILS及其照顾者在从安全监禁过渡到减少阿片类药物启动/重新启动期间具备自我调节和沟通技能；以及(4)POST(临床试验编号。NCT04901312)测试了两种干预措施，将人际/饮酒和拒绝毒品技能、病例管理和目标设定作为阿片类药物启动预防战略，在YILS中作为阿片类药物启动预防战略过渡到安全拘留状态。我们讨论了早期实施的障碍和促进者，包括与YILS进行预防研究的复杂性，以及由于新冠肺炎的适应。最后，我们描述了预期的最终产品，包括实施有效的预防干预措施和整合来自多个项目的数据，以解决更大的、多地点的研究问题。
Youth involved in the legal system (YILS) experience rates of opioid and substance use disorders (OUD/SUDs) and overdose that is well above those in the general population. Despite the dire need, and the existing programs that focus on treatment of these problems in YILS, research on opioid initiation, and OUDprevention, including feasibility and sustainability, are severely limited. We present four studies testing interventions that, while not necessarily novel as SUDtreatments, test novel structural and interpersonal strategies topreventopioid initiation/OUD precursors: (1) ADAPT (Clinical Trial No. NCT04499079) provides real-time feedback using community-based treatment information system data to create a more effective mental health and SUD treatment cascade to prevent opioid use; (2) HOME (Clinical Trial No. NCT04135703) provides youth experiencing homelessness, including YILS, with direct access to shelter in independent living without prerequisites as an opioid initiation prevention strategy; (3) LeSA (Clinical Trial No. NCT04678960) uses the Trust-Based Relational Intervention®to equip YILS and their caregivers with self-regulatory and communication skills during the transition from secure confinement to reduce opioid initiation/re-initiation; and (4) POST (Clinical Trial No. NCT04901312) tests two interventions integrating interpersonal/drinking and drug refusal skills, case management, and goal setting among YILS in transitioning out of secure detention as opioid initiation prevention strategies. We discuss early implementation barriers and facilitators, including complexities of prevention research with YILS and adaptations due to COVID-19. We conclude by describing anticipated end products, including implementation of effective prevention interventions and integration of data from multiple projects to address larger, multi-site research questions.