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  • 1
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    Online Resource
    Placement of chronically homeless into different types of permanent supportive housing before and after a coordinated entry system: The influence of severe mental illness, substance use disorder, and dual diagnosis on housing configuration and intensity of services
    Wiley ; 2020
    In:  Journal of Community Psychology Vol. 48, No. 7 ( 2020-09), p. 2410-2427
    Details
    In: Journal of Community Psychology, Wiley, Vol. 48, No. 7 ( 2020-09), p. 2410-2427
    Abstract: Permanent supportive housing (PSH) is designed to house people who experience chronic homelessness with one or more of the following: serious mental illness (SMI), substance use disorders (SUD) or human immunodeficiency virus. The Department of Housing and Urban Development has required major metropolitan areas to develop a coordinated entry system (CES) to prioritize access to PSH to those who need it the most. The aim of this paper is to determine whether PSH residents with SMI, SUD, or dual diagnosis were more likely to be housed after implementation of CES and were more likely to be housed in housing models with more intensive services provided. Methods A cross‐sectional survey with 855 residents of different PSH models. Results Those with SMI, SUD, or dual diagnosis were not more likely to be housed using the CES but were more likely to be housed in higher intensity service programs. Conclusions Those with SMI are more likely to be housed in PSH with high‐intensity services.
    Type of Medium: Online Resource
    ISSN: 0090-4392 , 1520-6629
    URL: Issue
    URL: Article
    DOI: 10.1002/jcop.v48.7
    DOI: 10.1002/jcop.22428
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1491194-2
    SSG: 5,2
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  • 2
    Online Resource
    Online Resource
    Barriers to drug treatment in police diversion programs and drug courts: A qualitative analysis.
    American Psychological Association (APA) ; 2022
    In:  American Journal of Orthopsychiatry Vol. 92, No. 6 ( 2022), p. 692-701
    Details
    In: American Journal of Orthopsychiatry, American Psychological Association (APA), Vol. 92, No. 6 ( 2022), p. 692-701
    Type of Medium: Online Resource
    ISSN: 1939-0025 , 0002-9432
    URL: Article
    DOI: 10.1037/ort0000643
    RVK:
    CL 1000
    Language: English
    Publisher: American Psychological Association (APA)
    Publication Date: 2022
    detail.hit.zdb_id: 2065804-7
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  • 3
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    Online Resource
    The effects of opioid policy changes on transitions from prescription opioids to heroin, fentanyl and injection drug use: a qualitative analysis
    Springer Science and Business Media LLC ; 2022
    In:  Substance Abuse Treatment, Prevention, and Policy Vol. 17, No. 1 ( 2022-07-21)
    Details
    In: Substance Abuse Treatment, Prevention, and Policy, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2022-07-21)
    Abstract: Beginning in the 1990s, nonmedical use of prescription opioids (POs) became a major public health crisis. In response to rising rates of opioid dependence and fatal poisonings, measures were instituted to decrease the prescription, diversion, and nonmedical use of POs including prescription drug monitoring programs (PDMPs), pain clinic laws, prescription duration limits, disciplining doctors who prescribed an excessive number of POs, and the advent of abuse deterrent formulations of POs. This paper explores the unintended effects of these policies in the descriptions of why people who use opioids transitioned from PO to injection or heroin/fentanyl use. Methods We conducted 148 in-depth-interviews with people who use prescription opioids nonmedically, fentanyl or heroin from a rural, urban and suburban area in three states, Connecticut, Kentucky and Wisconsin. Interviews with people who use opioids (PWUO) focused on how they initiated their opioid use and any transitions they made from PO use to heroin, fentanyl or injection drug use. Results The majority of participants reported initiating use with POs, which they used for medical or nonmedical purposes. They described needing to take more POs or switched to heroin or fentanyl as their tolerance increased. As more policies were passed to limit opioid prescribing, participants noticed that doctors were less likely to prescribe or refill POs. This led to scarcity of POs on the street which accelerated the switch to heroin or fentanyl. These transitions likely increased risk of overdose and HIV/HCV infection. Conclusions A careful analysis of how and why people say they transitioned from PO to heroin or fentanyl reveals many unintended harms of policy changes to prevent overprescribing and diversion. Results highlight the importance of mitigating harms that resulted from policy changes.
    Type of Medium: Online Resource
    ISSN: 1747-597X
    URL: Article
    DOI: 10.1186/s13011-022-00480-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2222956-5
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  • 4
    Online Resource
    Online Resource
    Signaling through L-Selectin Mediates Enhanced Chemotaxis of Lymphocyte Subsets to Secondary Lymphoid Tissue Chemokine
    The American Association of Immunologists ; 2012
    In:  The Journal of Immunology Vol. 188, No. 7 ( 2012-04-01), p. 3223-3236
    Details
    In: The Journal of Immunology, The American Association of Immunologists, Vol. 188, No. 7 ( 2012-04-01), p. 3223-3236
    Abstract: L-selectin functions as an important adhesion molecule that mediates tethering and rolling of lymphocytes by binding to high endothelial venule (HEV)-expressed ligands during recirculation. Subsequent lymphocyte arrest and transmigration require activation through binding of HEV-decorated homeostatic chemokines such as secondary lymphoid tissue chemokine (SLC; CCL21) to its counterreceptor, CCR7. Importantly, L-selectin also functions as a signaling molecule. In this study, signaling induced by ligation of L-selectin using mAb or endothelial cell-expressed ligand significantly enhanced the chemotaxis of murine T cells and B cells to SLC but not to other homeostatic chemokines. Consistent with the expression levels of L-selectin in different lymphocyte subsets, L-selectin–mediated enhancement of chemotaxis to SLC was observed for all naive lymphocytes and effector/memory CD8+ T cells, whereas only a subpopulation of effector/memory CD4+ T cells responded. During in vivo mesenteric lymph node migration assays, the absence of L-selectin on lymphocytes significantly attenuated both their ability to migrate out of the HEV and their chemotaxis away from the vessel wall. Notably, ligation of L-selectin and/or CCR7 did not result in increased CCR7 expression levels, internalization, or re-expression. Pharmacologic inhibitor studies showed that L-selectin–mediated enhanced chemotaxis to SLC required intact intracellular kinase function. Furthermore, treatment of lymphocytes with the spleen tyrosine kinase family inhibitor piceatannol reduced their ability to migrate across the HEV in peripheral lymph nodes. Therefore, these results suggest that “cross-talk” in the signaling pathways initiated by L-selectin and CCR7 provides a novel mechanism for functional synergy between these two molecules during lymphocyte migration.
    Type of Medium: Online Resource
    ISSN: 0022-1767 , 1550-6606
    URL: Article
    DOI: 10.4049/jimmunol.1101032
    RVK:
    XA 54100
    RVK:
    XA 10000
    Language: English
    Publisher: The American Association of Immunologists
    Publication Date: 2012
    detail.hit.zdb_id: 1475085-5
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  • 5
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    Online Resource
    Effects of Implementation and Enforcement Differences in Prescription Drug Monitoring Programs in 3 States: Connecticut, Kentucky, and Wisconsin
    SAGE Publications ; 2021
    In:  Substance Abuse: Research and Treatment Vol. 15 ( 2021-01), p. 117822182199234-
    Details
    In: Substance Abuse: Research and Treatment, SAGE Publications, Vol. 15 ( 2021-01), p. 117822182199234-
    Abstract: Prescription Drug Monitoring Programs (PDMPs) were designed to curb opioid misuse and diversion by tracking scheduled medications prescribed by medical providers and dispensed by pharmacies. The effects of PDMPs on opioid prescription, misuse and overdose rates have been mixed due in part to variability in states’ PDMPs and difficulties measuring this complexity, and a lack of attention to implementation and enforcement of PDMP components. The current study uses qualitative interviews with key informants from 3 states with different PDMPs, Connecticut, Kentucky and Wisconsin to explore differences in the characteristics of the PDMPs in each state; how they are implemented, monitored and enforced; and unintended negative consequences of these programs. Methods: We conducted in-depth interviews with key informants from each state representing the following sectors: PDMP and pain clinic regulation agencies, Medicaid programs, state licensing boards, pharmacies, emergency medicine departments, pain management clinics, first responders, drug courts, drug treatment programs, medication assisted treatment (MAT) providers, and harm reduction organizations. Interview guides explored participants’ experiences with and opinions of PDMPs according to their roles. Data analysis was conducted using a collaborative, constant comparison method. Results: While all 3 states had mandated registration and reporting requirements, the states differed in the implementation and enforcement of these and the extent to which provider prescribing was monitored. These, in turn, influenced how medical providers perceived the PDMP and changed how providers prescribed opioids. Unintended consequences of state PDMPs included under-prescribing for pain and “dumping” patients who were long term users of opioids or who had developed opioid use disorders and may explain the increase in illicit heroin or opioid use. Conclusion: State PDMPs with similar mandates may differ greatly in implementation and enforcement. These differences are important to consider when determining the effects of PDMPs on opioid misuse and overdose.
    Type of Medium: Online Resource
    ISSN: 1178-2218 , 1178-2218
    URL: Article
    DOI: 10.1177/1178221821992349
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2517768-0
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