Increasing preoperative sleep reduces postoperative pain and analgesic use

s / Drug and Alcohol Dependence 140 (2014) e169–e251 e187 Conclusions: Ourfindings indicate that access toMAT increased over the ten-year study period in the sample of privately funded-treatment programs. Results also indicate that specific organizational factors continues to play a critical role in successful adoption of medication in SUD treatment. Efforts to enhance access to MAT for patients with SUDs may require interventions that address provider and organizational capacities and preparation. Financial support: This work was supported by the NIDA, Award K23DA021225 and NIDA Grant R01DA13110. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.522 Increasing preoperative sleep reduces postoperative pain and analgesic use Timothy Roehrs1,2, S. Randall 1, T. Roth1,2 1 Sleep Disorders & Research Center, Henry Ford Health System, Detroit, MI, United States 2 Psychiatry & Behavioral Neuroscience, Wayne State University, Detroit, MI, United States Aims: Suboptimal management of postoperative pain increases the risk of chronic pain and opiate abuse. Given the bidirectional relation of sleep and pain, we hypothesized that post operative pain and analgesic use could be reduced in joint replacement “short sleepers” who increased bedtime pre operatively vs. those remaining on their habitual sleep schedule. Methods: Twelve patients, 3men, 9women, 50.3±12.5 yrs old, who were scheduled for joint replacement (6 knee and 6 hip) and reported <7h nightly sleep participated. Sevenwere randomized to a nightly extension (1–2h) of their habitual bedtime (EXT: 4 knee, 3 hip) and five remained on their habitual (HAB: 2 knee, 3 hip) schedule during the week before surgery. They were monitored by actigraphy. The outcome measures were the postoperative daily dose of opiates (converted to morphine mg equivalents) and the daily pain ratings (5–6 times daily on a 0–10 scale: 0 =no pain and 10=worst pain experienced) over the 1–3 day in-hospital recovery. Results:Onaoneweeksleepdiarybefore thepreoperativeweek those in the EXT group reported 6.8 (0.4) h and the HAB group 6.6 (0.9) h of time in bed nightly. During the one week preoperative sleep manipulation, compared to the HAB group the EXT group spent significantly more time in bed nightly (8.0h vs. 6.9h, p<0.03), which resulted in significantly more sleep time (6.8h vs. 5.8h, p<0.04). On the 1–3 day postoperative in-patient recovery the EXT group reported significantly less daily pain (4.2 vs. 5.5, p<0.01) than the HAB group, despite a trend (p<0.06) for less daily morphine mg intake (25.2mg vs. 46.5mg). Conclusions: These data demonstrate prophylactic preoperative improvement of sleep reduces post operative pain and opiate use. It demonstrates the analgesic potential for preoperative sleep extension and consolidation in patients with other sleep disorders. Financial support: Supported by the Fund for Henry Ford Hospital B10914. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.523 Training undergraduate students in addiction-related topics using in-person and online instructional formats: Implications for preparing the behavioral health workforce N.A. Roget1, Joyce A. Hartje1, W.W. Woods1, M.L. Shadley1, T.E. Freese2 1 Center for the Application of Substance Abuse Technologies, University of Nevada Reno, Reno, NV, United States 2 UCLA, Los Angeles, CA, United States Aims:Health reform implementationwill help drive integration of physical and behavioral health. It is essential to expose allied health students to addiction-related education early in their academic careers significant since studies have shown that nurses, social workers, physicians, healthcare workers, and psychologists report feeling unprepared to intervene with patients with SUDs. Currently, there are 345 universities/colleges with addiction programs with most courses taught in-person. In 2011 over a third of all college students reported taking an online academic course. Existing data demonstrate the efficacy of online courses. However, limited data exist comparing the effectiveness of in-person vs. online instruction for addiction-related courses. This study compared the effectiveness and student satisfaction of in-person vs. online undergraduate generalist addiction courses. Methods: An in-person introductory undergraduate generalist addiction course at the University of Nevada Reno was originally developed in 1998. Course faculty later developed anonline version ensuring that course content, assignments, and testing/grading methods/criteria were equivalent. Both courses are offered during each semester. Results: During the Spring 2011 through Fall 2012 semesters, the in-person course was completed by 762 students; 435 completed the online version of the course. The total average satisfaction and usefulness scores were 4.47 and 4.35 respectively for the in-person course, and 4.45 and 4.65 for the online course (5-point Likert scale). Complete item analysis will be presented. Conclusions: To adequately prepare the behavioral health workforce for health reform, access to undergraduate addiction courses must be expanded. Based on this study, expansion may be achieved by offering equivalent online and in-person addiction courses as student ratingswere high for both instructional formats. Financial support: Funded by SAMHSA/CSAT: Mountain West and Pacific Southwest ATTCs. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.524 The effects of menthol cigarette use on treatment outcomes in an intervention for weight-concerned smokers Alana M. Rojewski1, B.A. Toll 1,2,3, S.S. O’Malley1,2 1 Yale University School of Medicine, New Haven, CT, United States 2 Yale Cancer Center, New Haven, CT, United States 3 Smilow Cancer Hospital at Yale-New Haven, New Haven, CT, United States Aims: Several studies have shown that individuals who smoke menthol cigarettes are less likely to quit smoking andmore likely to relapse during a quit attempt. The current study investigatedmenthol cigarette use as a potential moderator of smoking cessation outcomes in a predominately white sample of treatment-seeking smokers.