Psychiatric comorbidity and substance use outcomes in an office-based buprenorphine program six months following hurricane sandy

Babak Tofighi, Ellie Grossman, Keith S. Goldfeld, Arthur Robinson Williams, John Rotrosen, Joshua Lee

Research output: Contribution to journalArticle

Abstract

Background: On October 2012, Hurricane Sandy struck New York City, resulting in unprecedented damages, including the temporary closure of Bellevue Hospital Center and its primary care office-based buprenorphine program. Objectives: At 6 months, we assessed factors associated with higher rates of substance use in buprenorphine program participants that completed a baseline survey one month post-Sandy (i.e. shorter length of time in treatment, exposure to storm losses, a pre-storm history of positive opiate urine drug screens, and post-disaster psychiatric symptoms). Methodology: Risk factors of interest extracted from the electronic medical records included pre-disaster diagnosis of Axis I and/or II disorders and length of treatment up to the disaster. Factors collected from the baseline survey conducted approximately one month post-Sandy included self-reported buprenorphine supply disruption, health insurance status, disaster exposure, and post-Sandy screenings for PTSD and depression. Outcome variables reviewed 6 months post-Sandy included missed appointments, urine drug results for opioids, cocaine, and benzodiazepines. Results: 129 (98%) patients remained in treatment at 6 months, and had no sustained increases in opioid-, cocaine-, and benzodiazepine-positive urine drug tests in any sub-groups with elevated substance use in the baseline survey. Contrary to our initial hypothesis, diagnosis of Axis I and/or II disorders pre-Sandy were associated with significantly less opioid-positive urine drug findings in the 6 months following Sandy compared to the rest of the clinic population. Conclusion: These findings demonstrate the adaptability of a safety net buprenorphine program to ensure positive treatment outcomes despite disaster-related factors.

Original languageEnglish (US)
Pages (from-to)1571-1578
Number of pages8
JournalSubstance Use and Misuse
Volume50
Issue number12
DOIs
StatePublished - Oct 15 2015

Fingerprint

Cyclonic Storms
Buprenorphine
Disasters
comorbidity
Psychiatry
Comorbidity
disaster
Urine
Opioid Analgesics
drug
Benzodiazepines
Cocaine
Pharmaceutical Preparations
Opiate Alkaloids
Health Facility Closure
Insurance Coverage
Electronic Health Records
prehistory
Health Insurance
Post-Traumatic Stress Disorders

Keywords

  • buprenorphine
  • cyclonic storm
  • disaster planning
  • disasters
  • hurricane
  • opioid replacement therapy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Psychiatric comorbidity and substance use outcomes in an office-based buprenorphine program six months following hurricane sandy. / Tofighi, Babak; Grossman, Ellie; Goldfeld, Keith S.; Williams, Arthur Robinson; Rotrosen, John; Lee, Joshua.

In: Substance Use and Misuse, Vol. 50, No. 12, 15.10.2015, p. 1571-1578.

Research output: Contribution to journalArticle

Tofighi, Babak ; Grossman, Ellie ; Goldfeld, Keith S. ; Williams, Arthur Robinson ; Rotrosen, John ; Lee, Joshua. / Psychiatric comorbidity and substance use outcomes in an office-based buprenorphine program six months following hurricane sandy. In: Substance Use and Misuse. 2015 ; Vol. 50, No. 12. pp. 1571-1578.
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