DNP, Otterbein University, 2025, Nursing

Opioids have highly addictive properties that allow for high levels of misuse. Since the early 1990s, the misuse and deaths rates related to narcotics have steadily risen in the United States. Efforts to identify individuals using opioids prior to surgery have proven difficult. The number of patients misusing opioids and reporting for surgery can only be estimated due to under-reporting related to fear and self-stigma. With 50 million surgeries in the U.S. annually and 3.32 million people misusing opioids monthly, the chances of a patient with Opioid Use Disorder (OUD) presenting for anesthesia are exceptionally high. Moreover, patients who rate pain higher throughout their hospital stay are more likely to have longer stays and be readmitted for pain issues. Notably, the average readmission cost is $15,200 for the patient. Issues with anesthetizing patients who chronically misuse opioids include cardiac dysrhythmias, respiratory complications, death from acute intoxication, higher opioid requirements postoperatively, prolonged hospital stays and increased readmission rates. The project serves to evaluate current literature to provide direct guidelines for implementation for OUD. The providers will be given a set of guidelines for adaption into practice. The success of the project will be measured by the outcomes of amount of opioids used, the length of stay, and readmission rates.

Committee: Brian Garrett (Advisor); Amy Bishop (Committee Member); Deanna Batross (Committee Member) Subjects: Medicine; Nursing

Master of Arts, University of Toledo, 2021, Psychology - Clinical

Suicide-related behaviors and opioid misuse are co-occurring major public health problems that are responsible for decreased life expectancy. Despite advances using public health data on understanding the prevalence of both behaviors' co-occurrence, there is a lack of research explicating why opioid use is associated with heightened suicide and suicide attempt risk. Contemporary models of self-injurious behavior suggest several variables predictive of suicidal behavior that may have relevance for opioid misuse: increased negative self-appraisal, decreased social norm espousal, fearlessness about death, pain habituation, and practical capability, or knowledge and familiarity with lethal means. Given that prior research has associated opioid misuse with elevated levels of these risk factors, they may explain the association between opioid misuse and suicide-related behavior. Further, to distinguish if any observed association is unique to opioid misuse, it is important to compare associations with other substances robustly associated with suicide risk, such as alcohol. To address this research gap, a community sample of participants with lifetime suicide ideation (N=283) was recruited across three groups: those with opioid misuse (n=99; Opioid group), alcohol misuse (n=80; Alcohol Group) and no problematic substance use (n=104; No Substance Misuse group). Participants completed self-report measures assessing characteristics of suicide risk (e.g., suicide ideation, planning and attempt) and assessing the above risk factors hypothesized to account for the link between opioid misuse and suicidal thoughts and behaviors. All examined factors except pain tolerance were associated with suicide risk characteristics. Only increased negative self-appraisal (measured by self-criticism and self-hate), and practical capability were statistically different across groups, such that Opioid group participants reported: (1) significantly less self-criticism than Alcohol group pa (open full item for complete abstract)

Committee: Matthew Tull PhD (Committee Chair) Subjects: Clinical Psychology

PhD, University of Cincinnati, 2020, Education, Criminal Justice, and Human Services: Health Education

Study One Abstract: Factors Influencing Physicians' Perceived Knowledge and Attitudes of the Prescription Drug Monitoring Program. Introduction: Due to the impact of opioid use disorder and overdose deaths on the U.S. healthcare system, leaders and politicians have provided support and pressure for the creation of opioid specific prescribing guidelines, Prescription Drug Monitoring Programs (PDMPs), and numerous additional policies and programs to prevent prescription drug misuse, and addiction. The present study investigated whether the level of physicians' perceived knowledge and utilization of a PDMP differed based on perceived helpfulness of OARRs use and physician characteristics among Ohio physicians. We also assessed whether physician characteristics differed based on continuing education training. Methods: This study included a convenience sample of practicing physicians based in the state of Ohio (N = 151) aged 27-72 years. Physicians were invited to participate via email listservs and social media outlets including LinkedIn and Twitter, by the Ohio Medical Association. Data were collected using Qualtrics, and all results were anonymously recorded. Independent samples t-tests and chi-square tests were conducted. This study was approved by the University of Cincinnati's (UC) Institutional Review Board (#2019-0091). Results: Over half of female (51.0%) and male (53.7%) physicians reported they had an in-depth knowledge level of OARRS. here was a gradual increase in percent of physicians who reported they had an in-depth knowledge level of OARRS by career level with 44.5% of young professionals reporting in-depth knowledge and higher rates among mid-level professionals (51.4%) and advanced professionals (62.8%). Regarding level of perceived knowledge, on the five-question assessment of knowledge on OARRS policy and practice, the mean score was 2.3 out of 5.0. There was no significant difference between level of perceived knowledge and physician career le (open full item for complete abstract)

Committee: Ashley Merianos Ph.D. (Committee Chair); Keith King Ph.D. (Committee Member); Rebecca Vidourek Ph.D. (Committee Member) Subjects: Health Education

PHD, Kent State University, 2017, College of Public Health

This study evaluates the acceptability of pharmacy based opioid misuse and abuse interventions by surveying practicing pharmacists and patients in treatment for substance use disorders. The survey instrument examines five specific pharmacy-based interventions using a Likert scale to measure acceptability: (1) Pharmacists counseling patients on the risks associated with opioid misuse and abuse, (2) pharmacists referring patients to drug treatment programs within the community, (3) pharmacists utilizing Prescription Drug Monitoring Programs (PDMPs) to validate prescriptions, (4) pharmacists providing emergency opioid overdose treatments such as naloxone with opioid prescriptions, and (5) pharmacists providing naloxone without a prescription. The goal of this study is to answer three research questions: which interventions are most acceptable to pharmacists, which interventions are most acceptable to patients, and which interventions produce statistically significant agreement on acceptability when both pharmacist and patient attitudes are compared. These data are used to identify a subset of interventions with high acceptability within and across the two groups. These findings are, in turn, used as an indication of professional and patient receptivity to specific interventions. The interventions with the greatest acceptability within each group and the strongest agreement across groups are identified, and changes to State regulations, organizational policy, and professional training that foster these interventions, as supported by the literature, are proposed.

Committee: Sonia Alemagno PhD (Committee Chair); VanGeest Jonathan PhD (Committee Member); Phillips Lynette PhD (Committee Member); Deric Kenne PhD (Committee Member); Mark James PhD (Other) Subjects: Pharmacy Sciences; Public Health Education; Public Policy