Presenter:
Bryce Mayo
People with opioid use disorder (PWOUD) are over-represented in the criminal legal system and are vulnerable to overdose-related deaths post-release. People with opioid use disorder leaving the carceral system are often not connected to, or retained in, medication treatment for OUD (MOUD), despite evidence that MOUD reduces overdose risk. The Transitions Clinic Network (TCN) aims to improve health outcomes for people leaving incarceration by providing targeted healthcare, social services, and addiction treatment in collaboration with community clinics. This analysis reports qualitative findings from a parent study evaluating the implementation and effectiveness of the TCN intervention on OUD treatment outcomes for PWOUD leaving incarceration compared to referrals to standard primary care in four states (NC, CT, NY, and MN) and Puerto Rico. Between November 2024 and March 2025, we conducted 24 semi-structured qualitative interviews with key stakeholders in clinical, carceral, and community settings. We developed a codebook using deductive themes from the interview guides, and revised the codebook collaboratively via three rounds of consensus coding to include inductive and deductive themes. Once strong inter-coder reliability was reached (≥80% agreement), we conducted a thematic analysis of the code "Social and Political factors concerning rules regarding MOUD" to identify key rules and policies that stakeholders view as affecting access to MOUD after incarceration. We identified 3 major themes: 1) Methadone-specific regulations which restrict availability to only specialized clinics, thus limiting patients' ability to continue or receive methadone; 2) Local and organizational policies that limit post-release communication and continuity of treatment between clinics and courts/correctional facilities; and 3) Treatment discontinuation due to the type of offense or post-release conditions, such as housing. Our findings suggest multiple types of rules regarding MOUD limit accessible care for PWOUD. Addressing these barriers will require buy- in from multiple stakeholder groups, including policy-makers, carceral facilities, and treatment providers. Cannabis Use Factors and Quality of Life in Treatment-Seeking Individuals with Cannabis Use Disorder at Baseline
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Presenter: Bryce Mayo
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Cannabis is the most commonly used illicit drug in the United States, with 3 in 10 cannabis users developing cannabis use disorder (CUD). Increased legalization of cannabis for medical and recreational purposes has contributed to a rise in use. Many individuals use cannabis due to its mood-enhancing effects, but misconceptions about its addictive qualities, potential withdrawal symptoms, and long-term health consequences highlight a need for further research. In particular, there is limited information on which specific factors of cannabis use relate to Quality of Life (QoL), a subjective concept that measures individuals' satisfaction. Understanding this relationship is critical in developing treatments targeting cannabis users' mental health and well-being. This project aims to identify baseline cannabis use factors related to QoL in individuals with cannabis use disorder. We explored several variables to examine their relationship with patients' Quality of Life scores. Data was analyzed from double-blind, randomized controlled trial with a sample of 20 treatment-seeking individuals with CUD. Spearman's Rank-Order Correlations were run between participants' raw scores on the Quality of Life, Enjoyment, and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) and the Pittsburgh Sleep Quality Index (PSQI), Marijuana Problem Scale (MPS), Quick Inventory of Depressive Symptomatology (QIDS), and Generalized Anxiety Disorder-7 (GAD-7) at baseline. Independent Samples t-tests were run to assess differences in QoL, Age of Onset, and Age of Regular Use between median-split age groups. No statistically significant correlations were found. QoL did not differ by Age of Regular use (t(18) = 1.373, p = .186), but the effect size (Cohen's d = .614) indicates potential clinical significance. Quality of Life as an outcome measure for cannabis use disorder requires further exploration with larger sample sizes. Prospective studies, with self-reports conducted at multiple timepoints, are needed to determine a causal relationship between cannabis use and Quality of Life.
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Duke University / 2025
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Presenter: Bryce Mayo