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Background: Overcoming addiction is characterized by a long-term recovery process and a high rate of relapse. This study aimed to identify factors associated with relapse and long-term abstinence in patients with substance use disorders or behavioral addictions (SUDs/BA) five years after completing the inpatient addiction treatment based on the Apolinar model. Methods: In this 5-year prospective cohort study, 366 (female 32.5%) patients with diagnosed SUDs/BA (ICD-10) who were treated between March 2004 and April 2008 in Czechia were studied. Data were collected using a non-standardized questionnaire and structured telephone interviews. Outcome measures were (i) relapse and (ii) long-term abstinence (at least one full year of continuous abstinence). Logistic regression was used to assess the effect of socio-demographic and treatment-related characteristics on outcome measures. Results: In a 5-year follow-up period, 70.2% of patients relapsed, while 46.7% relapsed within the first six months after completing the baseline treatment. Long-term abstinence was observed in 63.9% of patients. Of the treatment-related factors, early discontinuation of treatment, shorter treatment duration, and absence of early aftercare services predicted relapse in patients. A positive effect of early aftercare attendance on long-term abstinence was found. Conclusions: These findings support the importance of treatment compliance and aftercare to prevent relapse in addiction-treated patients. [ABSTRACT FROM AUTHOR]

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Although American Indian and Alaska Native (AI/AN) people have high rates of abstinence from alcohol and other drugs, there also is evidence of greater rates of substance use disorders (SUDs) in Native communities. Health disparities associated with substance use are compounded by inadequate access to evidence-based treatments (EBTs). Lack of mental health providers is one notable barrier to EBT implementation in rural AI reservation communities. Our Indigenous Recovery Planning (IRP) intervention merges cultural lessons and culturally adapted relapse prevention strategies to facilitate SUD recovery in the reservation environment. One key implementation strategy is training non-specialist community-based facilitators to deliver IRP, thereby increasing its acceptability and sustainability. This manuscript reports the facilitator training, supervision, and fidelity monitoring procedures used in our ongoing clinical trial of IRP. The study recruited four AI non-specialist providers from the community to serve as IRP facilitators. Initial training involved an introductory motivational interviewing workshop followed by a 2-day workshop in the IRP curriculum. Then we conducted an open trial of the 6-week intervention with weekly supervision meetings as part of the facilitator training process. During the open trial we also assessed participant and facilitator receptivity to the IRP intervention and pilot tested our fidelity monitoring protocol. The initial training workshops provided facilitators with information they needed to understand the rationale behind IRP and determine whether the facilitator role was a good fit; however, additional training and supervision during the open trial was needed to ensure proper treatment delivery. Although participant and facilitator feedback ratings were positive, the open trial helped us identify revisions needed to improve our approach to facilitator training, supervision, and fidelity monitoring. We revised these procedures, and also developed a protocol to train new facilitators who join the study midstream. The open trial was an important aspect of the facilitator training process and helped our team identify several areas of improvement. Our approach to training, supervising, and monitoring community member facilitators may serve as an example of how to overcome one barrier to implementing evidence-based SUD treatments in rural reservation communities with few mental health professionals. • American Indian (AI) community members were trained to deliver addiction treatment. • An open trial was conducted as part of the facilitator training process. • The open trial suggested revisions needed to the training and study protocols. • We revised our procedures for training, supervision, and fidelity monitoring. • Community-based providers can help expand treatment access in AI communities. [ABSTRACT FROM AUTHOR]

In addiction treatment, harm reduction is a philosophy that aims to reduce the harms from ongoing alcohol and other drug use. Although abstinence may be the 'gold standard' in reducing harm from ongoing alcohol and other drug use, harm reduction recognises that abstinence may not be achievable for certain individuals. Accordingly, harm reduction is used to enable medical or mental health treatment for individuals who continue to use alcohol and other drugs, providing a form of care which meets individuals where they present to healthcare facilities. Harm reduction accepts ongoing alcohol and other drug use, while providing a traditionally marginalised cohort of individuals access to healthcare services. In this perspective paper, we argue that the role of nurses in promoting and utilising harm reduction as part of their regular practice is essential to both reducing harm from alcohol and other drug use, engaging individuals who use alcohol and other drugs in healthcare services, and providing a means to accept individuals as they are to build trust and rapport for engagement in addiction treatment when they are ready, and at their own pace. Nurses, by virtue of their role and number in the healthcare landscape (approximately 28 million globally), are ideally placed to implement harm reduction in their practice to achieve better outcomes for individuals who use alcohol and other drugs., (© 2024 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Introduction: Alcohol use disorders (AUD) are under-treated, particularly among older adults. Using data from national treatment registers can expand knowledge on the AUD treatment rate among older adults and on potential biases in treatment receipt. The aim of this paper was to determine the AUD treatment prevalence rate and to investigate sociodemographic, health-related and substance use-related correlates of AUD treatment receipt among older adults with different degrees of problematic alcohol use., Methods: The study sample (n = 13,403; inclusion criteria: age 55-80 years, positive CAGE-C) is a subsample from the representative cross-sectional 2017 Danish National Health Survey. It was enriched with data from Danish National Registers, including the National Alcohol Treatment Database. Weighted 12-month AUD treatment prevalence rates were determined. Logistic regression analysis was applied to identify correlates of treatment receipt. All analyses were conducted among: (i) the study sample; (ii) the 28.9% with a positive original CAGE (n = 3725); and (iii) the 6.1% endorsing the CAGE's E-criterion (n = 692)., Results: The 12-month AUD treatment prevalence was 0.5% in the study sample, 1.6% in the CAGE-, and 3.8% in the E-criterion subsample. Not being married or partnered, loneliness and contacts with health care providers were positively associated with AUD treatment receipt in all three samples., Discussion and Conclusions: Even in the subsample with putative alcohol withdrawal, the AUD treatment rate did not reach 5%. This finding suggests that putative AUD is significantly undertreated in older adults. Contacts with other health care providers may facilitate AUD treatment entry in this age group., (© 2025 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

From the 1830s onward, Euro-American medicine began addressing opium addiction among the Chinese population. Drawing upon records from medical missionaries, medical journals, and related Chinese sources, this article examines the transformation of opium addiction treatment in late Qing China (1830-1910). Despite their pioneering efforts, medical missionaries encountered various challenges in gaining cooperation from patients and Chinese authorities. In contrast, Chinese medical practitioners, particularly elite scholar-physicians, enjoyed favor with the Qing government throughout much of the nineteenth century. By the turn of the twentieth century, the scientific knowledge introduced by the missionaries had gained greater acceptance in the country. By creatively translating this knowledge, Chinese medical practitioners began to recognize new theories for addressing the opium problem., (© The Author(s) 2025. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Emergency department (ED) visits are an opportunity to provide prevention services to people at high risk of overdose. Considering patients' resources to initiate and sustain recovery ("recovery capital") may be useful for tailoring ED services, although its relevance in this population is unknown., Methods: This secondary analysis used data from ED patients at high risk of opioid overdose enrolled in a randomized controlled trial in Rhode Island (2018-2021). We assessed baseline recovery capital using the Brief Assessment of Recovery Capital (BARC-10), dichotomized as a total score <47 versus ≥47. Post-discharge addiction treatment engagement within 30 days and non-fatal opioid overdose and fatal overdose within 18 months were assessed using statewide administrative data. We used modified Poisson regression and Cox proportional hazards models to estimate the association between recovery capital and (1) treatment engagement and (2) overdose risk, respectively, adjusting for potential confounders., Results: Among 543 participants, 32.2% had a baseline BARC-10 total score of ≥47, 32.6% engaged in treatment within 30 days, and 25.6% had a non-fatal opioid overdose and 4.2% had a fatal overdose within 18 months. BARC-10 total score was not associated with treatment engagement within 30 days (adjusted relative risk = 0.79, 95% confidence interval [CI] = 0.60-1.05) or non-fatal opioid overdose (adjusted hazard ratio [aHR] = 0.83, 95%CI = 0.57-1.20) or fatal overdose (aHR = 0.45, 95%CI = 0.14-1.40) within 18 months., Conclusion: The majority of ED patients at high risk of opioid overdose had a BARC-10 total score of <47, suggesting low recovery capital. BARC-10 total score was not associated with post-discharge treatment engagement or overdose risk.