The COVID-19 public health emergency, declared by the federal government in March 2020, led federal agencies to significantly modify regulations, in keeping with the guidelines for social distancing and smaller gatherings, in order to enhance access to medications for opioid use disorder (MOUD) treatment. These adjustments permitted patients initiating treatment to receive multiple days' supply of take-home medications (THM) and to utilize remote technology for treatment sessions, which were previously only accessible to stable patients with established treatment duration and adherence. Nevertheless, the consequences of these modifications for low-income, underrepresented patients—often the most reliant on opioid treatment programs (OTPs) for addiction care—remain poorly understood. The study's objective was to explore the lived experiences of patients undergoing treatment prior to the introduction of COVID-19 OTP regulations, thereby understanding how these subsequent changes influenced their perception of treatment.
The research methodology incorporated semistructured, qualitative interviews with a group of 28 patients. A purposeful sampling approach was implemented to enroll individuals actively participating in treatment plans immediately preceding COVID-19-related policy changes, who also continued treatment for several months thereafter. For a diversified representation of experiences, we interviewed individuals who experienced either successful or challenging methadone adherence from March 24, 2021 to June 8, 2021, approximately 12-15 months after COVID-19's initial impact. Using thematic analysis, the interviews were subsequently transcribed and coded.
Male participants (57%) and Black/African American participants (57%) predominated the study group, with a mean age of 501 years and a standard deviation of 93 years. The 50% THM recipient rate prior to COVID-19 evolved into a 93% figure during the widespread pandemic, a stark demonstration of societal shifts. The COVID-19 program's modifications engendered a spectrum of effects on both the treatment and recovery experiences. The choice of THM was significantly influenced by factors including convenience, safety, and employment. Medication management and storage presented significant hurdles, compounded by the isolation experienced and the worry surrounding potential relapse. Additionally, participants indicated that the tele-mental health encounters appeared to be less personalized.
A patient-centric approach to methadone dosage, ensuring safety, flexibility, and accommodation for diverse patient needs, necessitates consideration of patients' perspectives by policymakers. Support for OTPs, offering technical assistance, is needed to uphold interpersonal connections within the patient-provider relationship post-pandemic.
To cultivate a safer, more adaptable, and inclusive methadone dosing strategy, policymakers should prioritize patient input and perspectives, thereby creating a patient-centered approach that caters to the diverse needs of the patient population. In addition, OTPs should receive technical support to keep the interpersonal connections strong between patients and providers, a connection that should outlast the pandemic.

Through the Buddhist-inspired Recovery Dharma (RD) peer support program for addiction, mindfulness and meditation are interwoven into meetings, program materials, and the recovery process, offering a unique opportunity to investigate these concepts within a peer support environment. Recovery capital, a positive indicator of recovery outcomes, is positively influenced by mindfulness and meditation practices, though the precise nature of this connection remains largely unknown. We investigated recovery capital, using mindfulness and meditation (average session duration and weekly frequency) as potential predictors, and explored the link between perceived support and recovery capital.
The online survey, seeking to measure recovery capital, mindfulness, perceived support, and meditation practices (including frequency and duration), recruited 209 participants via the RD website, newsletter, and social media. The average age of participants was 4668 years (standard deviation = 1221), with 45% identifying as female, 57% as non-binary, and a representation of 268% from the LGBTQ2S+ community. A mean recovery time of 745 years was observed, with a standard deviation of 1037 years. To pinpoint significant predictors of recovery capital, the study fit both univariate and multivariate linear regression models.
Mindfulness (β = 0.31, p < 0.001), meditation frequency (β = 0.26, p < 0.001), and perceived support from the RD (β = 0.50, p < 0.001) emerged as significant predictors of recovery capital in multivariate linear regression models, controlling for age and spirituality, as expected. Although recovery time was longer than anticipated and meditation sessions were of average duration, recovery capital did not manifest as predicted.
Recovery capital's enhancement, according to the findings, is best facilitated by a regular meditation practice, not by infrequent, extended sessions. find more Previous research, highlighting the benefits of mindfulness and meditation for those recovering, is further substantiated by these findings. Beyond that, there exists a connection between peer support and a superior recovery capital among RD members. The current study marks the initial investigation into the correlation of mindfulness, meditation, peer support, and recovery capital in recovering individuals. The exploration of these variables' relationship to positive outcomes, both within the RD program and other recovery pathways, is paved by these findings.
Results show that consistent meditation, not infrequent extended periods, is key to fostering recovery capital. This study's results reinforce earlier findings, which demonstrate the positive impact of mindfulness and meditation on positive recovery outcomes for individuals. Additionally, higher recovery capital in RD members is observed alongside the presence of peer support. This study represents the first comprehensive examination of the relationship between mindfulness, meditation, peer support, and recovery capital among individuals in recovery. Future exploration of these variables, concerning their connection to favorable outcomes within both the RD program and other recovery avenues, is warranted by these findings.

Federal, state, and health system responses to the prescription opioid crisis resulted in guidelines and policies designed to reduce opioid misuse, a crucial part of which was the use of presumptive urine drug testing (UDT). This study investigates the disparity in UDT utilization across various primary care medical license types.
Using Nevada Medicaid pharmacy and professional claims data from January 2017 to April 2018, this study investigated presumptive UDTs. A study of the connections between UDTs and clinician attributes (medical license type, urban/rural classification, and practice setting) was performed in conjunction with analysis of clinician-level characteristics of patient caseloads, including the proportion of patients with behavioral health diagnoses and the rate of early refills. Data from logistic regression, with a binomial distribution, demonstrate the adjusted odds ratios (AORs) and calculated predicted probabilities (PPs). International Medicine Primary care clinicians, including medical doctors (MDs), physician assistants (PAs), and nurse practitioners (NPs), numbered 677 in the analysis.
In the analysis of the study participants, 851 percent of clinicians refrained from ordering any presumptive UDTs. NPs displayed the largest percentage increase in UDT use, with a figure of 212% compared to the overall average. PAs followed, utilizing UDTs 200% more frequently than the average, and MDs demonstrated the lowest percentage increase, using UDTs 114% more often. Further analyses revealed a statistically significant association between physician assistant (PA) or nurse practitioner (NP) status and a higher likelihood of UDT, compared to medical doctors (MDs). Specifically, PAs exhibited a considerably elevated risk (adjusted odds ratio [AOR] 36; 95% confidence interval [CI] 31-41), while NPs displayed a substantial increase in odds (AOR 25; 95% CI 22-28). Among all professionals, PAs demonstrated the greatest proportion (21%, 95% CI 05%-84%) in ordering UDTs. When analyzing UDT usage among ordering clinicians, those in mid-level roles (physician assistants and nurse practitioners) displayed a significantly higher average and median usage than medical doctors. The mean UDT usage for PAs and NPs was 243% compared to 194% for MDs, and the median UDT usage for PAs and NPs was 177% contrasted with 125% for MDs.
In Nevada's Medicaid program, UDTs are heavily concentrated amongst 15% of primary care physicians, many of whom are not medical doctors. When evaluating clinician variation in mitigating opioid misuse, researchers should consider incorporating the contributions of Physician Assistants and Nurse Practitioners.
Among Nevada Medicaid's primary care physicians, 15% of whom are not MDs, a substantial portion of UDTs (unspecified diagnostic tests?) are concentrated. Expanded program of immunization When evaluating the diverse approaches of clinicians in addressing opioid misuse, future research should include the crucial roles played by physician assistants and nurse practitioners.

Racial and ethnic disparities in opioid use disorder (OUD) outcomes are becoming more apparent as the overdose crisis intensifies. Virginia, similar to its neighboring states, has experienced a sharp rise in fatal overdoses. Further research is required to understand the effects of the overdose crisis on the pregnant and postpartum Virginian population. Our research analyzed the proportion of hospitalizations due to opioid use disorder (OUD) among Virginia Medicaid members in the postpartum year one, before the COVID-19 pandemic. Postpartum hospitalizations for opioid use disorder (OUD) are examined in relation to prior prenatal OUD treatment, in a secondary analysis.
This retrospective cohort study, at the population level, utilized Virginia Medicaid claims data for live infant deliveries from July 2016 to June 2019. Hospitalizations linked to opioid use disorder (OUD) prominently featured events such as overdoses, visits to the emergency department, and periods of intensive care.