Substance use treatment services for older adults in five states in the Southern United States: a state-by-state comparison of available treatment services.

Objectives: Substance use disorders (SUD) among older adults have become a serious public health concern. The purpose of this study was to assess which states in the Southern U.S. are more responsive to SUD treatment needs of older adults.Methods: This study is a secondary data analysis of the N-SSATS-2019 dataset.Results: There were 1,215 substance treatment facilities in the five states. Kentucky had the highest number of substance use treatment facilities (n = 449, 37%), followed by Georgia (357, 29%), Alabama (153, 13%), Louisiana (146, 12%) and then Mississippi (110, 9%). Out of the 1,215 facilities, only 20% (n = 244) indicated that they had programs specifically tailored for older adults. Kentucky had the largest number of facilities per 1 million older adults while Mississippi had the highest number of facilities per 1 million older adults offering detoxification services. Alabama had the lowest number of services per 1 million adults in all categories examined.Conclusion: Across the U.S., most adults with SUD do not have access to substance use treatment; in the southeastern region of the country, higher rates of poverty, rural geography and stigma, and lack of treatment availability may further complicate individuals' ability to access substance use-related medical care.

Adult Age Differences in Sensitivity to Semantic Satiation.

OBJECTIVE: In this study, we investigated age differences in sensitivity to semantic satiation.Semantic satiation was conceptualized as occurring within a semantic activation framework. METHOD: A prime or to-be-satiated word (e.g., ANIMAL) was presented repeatedly for an average of 2.5, 12.5, or 22.5 times. Afterward, a word triad comprised of two related words (e.g., PURPLE, YELLOW) and one unrelated word (e.g., DOG) was presented. The two related words were designated as nontargets or context words in the display and the unrelated word was the target. Participants were instructed to indicate as quickly and as accurately as possible which of the words in the triad was the unrelated word by pressing a key which was spatially compatible to the position of the stimulus on the CRt. RESULTS: For young but not older adults, there was an attenuation of priming effects in the response latency data as repetition of the prime increased. CONCLUSION: These results were interpreted as evidence that older adults are less sensitive to the semantic satiation phenomenon than young adults.

Abortion at 12 or more weeks' gestation and travel for later abortion care among Mississippi residents.

OBJECTIVE: To assess the association between indicators of economic disadvantage and geographic accessibility of reproductive health services and abortions ≥ 12 weeks' gestation in Mississippi. STUDY DESIGN: This cross-sectional study used data on Mississippi residents who obtained abortion care from 12 of 14 facilities in Mississippi, Alabama, Louisiana, and Tennessee in 2018. We estimated logistic regression models to assess the association between levels of county deprivation, the number of obstetrician and/or gynecologists per 10,000 women, and one way distance to the nearest facility with having an abortion ≥ 12 weeks' gestation. We compared the median one-way distance to the facility where patients < 12 weeks', 12-15 weeks', and ≥ 16 weeks' gestation received care, using Kruskal-Wallis tests. RESULTS: Of the 4,455 Mississippi residents who obtained abortions, 73% were Black, 59% lived ≥ 50 miles from a facility, and 60% obtained care in Mississippi. Overall, 764 (17.2%) abortions were performed ≥ 12 weeks' gestation. In adjusted models, those in counties with moderate (OR, 1.47; 95% CI: 1.15-1.90) and high (OR: 1.36, 95% CI: 1.01-1.83) (vs low) levels of economic deprivation and counties with 0.1-1.4 (vs ≥ 2.5) obstetrician/gynecologists per 10,000 women (OR: 1.55; 95% CI: 1.06-2.27) had higher odds of obtaining an abortion ≥12 weeks' gestation. Mississippi residents who obtained abortions ≥ 16 weeks' gestation traveled a median 143 miles one way to the facility where they received care, compared to 69 miles and 60 miles traveled by those < 12 weeks' and 12-15 weeks' gestation, respectively (p < .001). CONCLUSIONS: Many Mississippi residents obtained abortion care ≥ 12 weeks' gestation, which is related to greater economic constraints and limited geographic access to reproductive health services. IMPLICATIONS: People's need for abortions ≥ 12 weeks' gestation may be higher in communities with limited access to reproductive health services and among those living in areas with greater economic disadvantage. State laws that narrow gestational limits would increase long-distance travel for later abortion care, and disproportionately affect those with fewer resources.

Effects of Unemployment on Opioid Use Treatment Trajectories: Impact of the COVID-19 Pandemic.

ABSTRACT: Living with an opioid use disorder (OUD) can make finding and sustaining employment a significant challenge and is only expected to get worse in the COVID-19 environment. For most individuals in OUD treatment, being employed is an important part of their recovery journey. Employment has several benefits, including reductions in preoccupation with symptoms, social isolation, risk of suicide, hopelessness, and economic instability, which if not addressed often result in homelessness. Therefore, employment is an important social determinant of health, especially among those with OUD. Employment success and OUD, however, may vary based on race, age, gender, and socioeconomic status. Return to work support as states begin to reopen will be critically important to improve treatment outcomes for individuals with OUD in a post-COVID-19 environment, requiring utilizations of evidence-based interventions. Nurses, particularly psychiatric mental health and addiction nurses, should routinely screen for employment needs of their patients with OUD and connect them to the necessary support services. Finally, nurses should advocate for regulatory reform that allows for employment support services to be billable and integrated in psychiatric and behavioral health services just like other mental health services.