Screening and Brief Intervention for Substance Misuse Among Older Adults: The Florida BRITE Project

Schonfeld, Lawrence; King‐Kallimanis, Bellinda L.; Duchene, Darran M.; Etheridge, Roy L.; Herrera, Julio R.; Barry, Kristen L.; Lynn, Nancy

doi:10.2105/ajph.2008.149534

Cited by 169 publications

(119 citation statements)

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“…4 Prior studies indicate that groups at greatest risk to abuse or overdose on prescription pain relievers are men, middle-aged adults, people in rural counties, whites and American Indian or Alaska Natives, those suffering from mental disorders, and those with a history of alcohol abuse or illicit substance use. [4][5][6][7][8][9][10][11] However, more can be learned about the characteristics of and circumstances surrounding those most likely to abuse and overdose on prescription pain relievers.…”

Section: Introductionmentioning

confidence: 99%

Unintentional Prescription Opioid-Related Overdose Deaths: Description of Decedents by Next of Kin or Best Contact, Utah, 2008–2009

et al. 2012

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BACKGROUND:Little is known about the characteristics that may predispose an individual to being at risk for fatal overdose from prescription opioids. OBJECTIVE: To identify characteristics related to unintentional prescription opioid overdose deaths in Utah. DESIGN: Interviews were conducted (October 2008-October 2009) with a relative or friend most knowledgeable about the decedent's life. SUBJECTS: Analyses involved 254 decedents aged 18 or older, where cause of death included overdose on at least one prescription opioid. KEY RESULTS: Decedents were more likely to be middle-aged, Caucasian, non-Hispanic/Latino, less educated, not married, or reside in rural areas than the general adult population in Utah. In the year prior to death, 87.4 % were prescribed prescription pain medication. Reported potential misuse prescription pain medication in the year prior to their death was high (e.g., taken more often than prescribed [52.9 %], obtained from more than one doctor during the previous year [31.6 %], and used for reasons other than treating pain [29.8 %, almost half of which "to get high"]). Compared with the general population, decedents were more likely to experience financial problems, unemployment, physical disability, mental illness (primarily depression), and to smoke cigarettes, drink alcohol, and use illicit drugs. The primary source of prescription pain medication was from a healthcare provider (91.8 %), but other sources (not mutually exclusive) included: for free from a friend or relative (24 %); from someone without their knowledge (18.2 %); purchase from a friend, relative, or acquaintance (16.4 %); and purchase from a dealer (not a pharmacy) (11.6 %). CONCLUSIONS:The large majority of decedents were prescribed opioids for management of chronic pain and many exhibited behaviors indicative of prescribed medication misuse. Financial problems, unemployment, physical disability, depression, and substance use (including illegal drugs) were also common.

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Section: Introductionmentioning

confidence: 99%

Unintentional Prescription Opioid-Related Overdose Deaths: Description of Decedents by Next of Kin or Best Contact, Utah, 2008–2009

et al. 2012

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“…Participants were recruited from the Florida BRITE (Brief Intervention and Treatment for Elders) Program (40), a statewide program providing outreach, screening, and brief interventions for substance misuse (alcohol, illicit drugs, medications). BRITE providers do not provide treatment for depression, but screen for depression and suicide risk as possible signs of undetected substance use.…”

Section: Methodsmentioning

confidence: 99%

“…For cases with positive depression screens (i.e., ≥ 5 on the Short-Geriatric Depression Scale [S-GDS]; 41) in the absence of substance misuse (i.e., ≥ 3 drinks/week; 2 ≥ drinks/1 day; or any illicit substance use), BRITE providers refer them to local mental health services. These individuals were recruited for the current study at the five original BRITE sites (Broward, Duval, Hillsborough, Orange, and Pinellas Counties) and the local University of South Florida research site, using similar methods in community and medical settings (40). Screening personnel were instructed to approach all individuals ineligible for BRITE services for the current study.…”

Section: Methodsmentioning

confidence: 99%

Six-Month Longitudinal Patterns of Mental Health Treatment Utilization by Older Adults With Depressive Symptoms

Gum¹,

Iser²,

King‐Kallimanis³

et al. 2011

Psychiatric Services

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OBJECTIVE For community-dwelling older adults with depressive symptoms, aims were to: describe behavioral health service utilization patterns over a six-month period; and identify factors associated with service use, guided by a multidimensional, comprehensive theoretical model emphasizing the dynamic nature of service use patterns over time and social context. METHODS 144 participants with depressive symptoms completed an in-person baseline interview and six monthly telephone follow-up interviews. Outcomes included use of antidepressants or counseling at each follow-up. Covariates included individual (demographic, need, prior treatment experience, intentions) and social context (stigma, advice) variables. RESULTS Approximately half of participants received no formal service (antidepressant or counseling; n = 70, 48%). Service use or non-use did not change for most participants. More participants with severe symptoms received antidepressants (25–37%) than those with milder symptoms (10–14%), although more of the milder cases started (62% vs. 49%) and stopped antidepressants (77% vs. 26%) at least once. Fewer individuals received counseling overall, with no clear patterns by symptom severity. In multivariate longitudinal analyses, service use at follow-up was independently associated with younger age, current major depressive episode, baseline use of antidepressant, intention to begin a new service at baseline, and receipt of advice to use services over follow-up. CONCLUSIONS Over a six-month period, the majority of older adults with depressive symptoms in this study continued use or non-use of mental health services. Demographic, need, attitudinal and social variables were related to service use over time. Addressing intentions and providing advice may facilitate uptake of services.

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“…부정적 정서는 우울, 불안, 불쾌, 혐오, 두 려움, 분노, 고립감, 슬픔 등을 포함하고 있으며, 부정적 정서가 클 수록 약물오용이 증가하는 것으로 나타났고 [21], 특히, 우울이나 고 립감은 약물오용행위의 주요한 영향요인으로 보고되었다 [9]. 또한 복용하는 처방약물 수 및 비처방약물 수가 많을수록 약물오용행위 가 유의하게 증가하는 것으로 나타났다 [7,22] (Table 4).…”

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A Prediction Model of Drug Misuse Behaviors in Community-Dwelling Older Adults

Hong

Yoo

2016

J Korean Acad Nurs

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This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium. Purpose: This study was designed to construct a model which explains drug misuse behaviors in community-dwelling older adults. Methods:The design of this research is a cross-sectional study using structure equation modeling. The hypothetical model consisted of two types of variables: the exogenous variables of health status, cognitive ability, and negative emotion, and the endogenous variables of number of drugs, and drug misuse behaviors. The data collection was conducted from September 2 to September 21, 2013 through self-report questionnaires. Participants were 320 community-dwelling adults over the age of 65 living in J city. Data were analyzed with SPSS 21.0 program and Amos 18.0 program. Results: The results of the model fitness analysis were satisfied. The predictor variables for the hypothetical model explained 62.3% of variance regarding drug misuse behaviors. Drug misuse behaviors were directly affected by health status, cognitive ability, negative emotion and number of drugs and indirectly affected by health status, and negative emotion through number of drugs. Conclusion:These findings indicate factors that should be used in developing effective nursing interventions for safe and proper drug use and the prevention of drug misuse behaviors in community-dwelling older adults.

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Screening and Brief Intervention for Substance Misuse Among Older Adults: The Florida BRITE Project

Abstract: The BRITE program effectively shaped state policy by responding to legislative mandates to address the needs of an increasing, but underserved, elder population. The pilot paved the way for obtaining a federally funded grant to expand BRITE to 27 sites in 17 counties in Florida.

Cited by 169 publications

References 11 publications

Unintentional Prescription Opioid-Related Overdose Deaths: Description of Decedents by Next of Kin or Best Contact, Utah, 2008–2009

Unintentional Prescription Opioid-Related Overdose Deaths: Description of Decedents by Next of Kin or Best Contact, Utah, 2008–2009

Six-Month Longitudinal Patterns of Mental Health Treatment Utilization by Older Adults With Depressive Symptoms

A Prediction Model of Drug Misuse Behaviors in Community-Dwelling Older Adults

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