Opioid Use Disorder
New Hampshire ranks in the top five states with the highest rates of drug overdose deaths (1), with close to ninety percent due to opioid misuse (2). In New England, 8% of pregnancies are impacted by opioid use disorder. Researchers at Dartmouth collaborate with entities regionally and nationally to inform trends in opioid use for vulnerable populations, and promote best-practices for opioid misuse prevention, intervention, and treatment.
Improving Safety & Quality of Care for Pregnant Women with Opioid Use Disorder
Although evidence based guidelines for the care of substance affected pregnancies are available, gaps in quality and safety for this patient population persist. A toolkit is being developed to facilitate the delivery of comprehensive services for pregnant women with substance use disorder. It will address two major issues
- Lack of knowledge among maternity care providers about evidence based management of perinatal substance use disorders
- Inconsistent coordination between maternity providers and addiction treatment providers
- Currently being tested in NH, VT, and ME
Integrated Behavioral Health Care for Patients with Co-Occurring Mental Heath and Substance Use Disorder
1 in 5 adults in America experience a mental illness (3) and approximately 10.2 million adults have co-occurring mental health and addiction disorders (4). An interdisciplinary team at Dartmouth-Hitchcock has developed a model of integrated behavioral healthcare to serve patients with co-occurring mental health and substance use issues in the primary care setting.
- The goal of the Integrated Behavioral Health Care pilot at DH-Nashua is to offer person-centered services and support in primary care to people who suffer from mental illness and substance use regardless of social and economic circumstances.
- Involves the use of a novel technology to to motivate patients towards meeting their behavioral health goals.
Coproduction of Nutrition in the Perinatal Addiction Treatment Program
Pregnant women and new mothers engaged in opioid replacement therapy face significant barriers in meeting their daily nutritional requirements. This student-led project involved interviews with participants in the Dartmouth-Hitchcock Perinatal Addiction Program. Findings included:
- Addressing barriers with practical solutions and mom-to-mom knowledge is an effective strategy
- Recipes must address the realities of newborn care, be low on time-investment and high in energy impact
Prescription Opioid Use in Older Adults with Arthritis
Opioids are the most frequently used prescription drug in adults 65 years and older (5). Our researchers are investigating trends in prescription opioid use high-risk older adults with arthritis and/or depressive symptoms using a nationally representative data set. This study will:
- Identify sociodemographic characteristics associated with opioid use, such as co-morbid medical conditions, sedentary behavior, and smoking.
- This research will offer guidance, and suggest mechanisms of action for opioid misuse prevention & intervention programs for older adults with arthritis.
1. Centers for Disease Control and Prevention; available from https://www.cdc.gov/drugoverdose/data/statedeaths.html. (2016). Drug Overdose Data, State Deaths.
2. NH Health Wisdom, New Hampshire Department of Health and Human Services, Division of Public Health Services; available from https://wisdom.dhhs.nh.gov/wisdom/#main (2015). Misuse of Alcohol and Drugs: Opioid Use.
3. Any Mental Illness (AMI) Among Adults. (n.d.); available from http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-adults.shtml
4. Substance Abuse and Mental Health Services Administration, Results from the 2014 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration. (2015); available from http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
5. Steinman MA, Komaiko KD, Fung KZ, Ritchie CS. Use of opioids and other analgesics by older adults in the United States, 1999-2010. Pain Med. 2015 Feb; 16(2): 319-327.