Delivering opioid maintenance treatment in rural and remote settings

2015 ◽  
Vol 23 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Lynda Berends ◽  
Andrew Larner ◽  
Dan I. Lubman
Keyword(s):  
Maintenance Treatment ◽  
Rural And Remote ◽  
Opioid Maintenance Treatment

scholarly journals The “black box” of treatment: Patients’ perspective on what works in opioid maintenance treatment for opioid dependence

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Teresa C. Silva ◽  
Fredrik B. Andersson
Keyword(s):  
Opioid Dependence ◽  
Maintenance Treatment ◽  
Treatment Plan ◽  
Black Box ◽  
Opioid Maintenance Treatment ◽  
Convenience Sample ◽  
Problematic Use ◽  
Treatment Stage ◽  
Pre Treatment ◽  
Patients Perspective

Abstract Background A lack of conceptual modeling of how the components of opioid maintenance treatment (OMT) for opioid dependence (OD) work causes it to occasionally be labeled the “black-box” of treatment. This study had a two-fold objective: First, to analyze which factors related to OMT for OD contribute to the abstinence of problematic use of non-prescribed opioids and sustain recovery, from the patients’ perspective; second, to understand which changes OMT produced in the individuals’ lives might significantly contribute to relapse prevention. Methods We used qualitative methods of design, inquiry, and analysis from a convenience sample of 19 individuals in a Swedish treatment setting. Results All the participants reported previous cycles of problematic use of non-prescribed opioids and other non-prescribed psychoactive substances, treatment, abstinence, recovery, and relapse before starting the current OMT program. During the pre-treatment stage, specific events, internal processes, and social environments enhanced motivation toward abstinence and seeking treatment. During the treatment stage, participants perceived the quality of the human relationships established with primary social groups as important as medication and the individual plan of care in sustaining recovery. From the participants’ perspective, OMT was a turning point in their life course, allowing them a sense of self-fulfillment and the reconstruction of personal and social identity. However, they still struggled with the stigmatization produced by a society that values abstinence-oriented over medication-assisted treatments. Conclusion OMT is not an isolated event in individuals’ lives but rather a process occurring within a specific social context. Structural factors and the sense of acceptance and belonging are essential in supporting the transformation. Treatment achievements and the risk for relapse vary over time, so the objectives of the treatment plan must account for characteristics of the pre-treatment stage and the availability and capacity of individuals to restructure their social network, besides the opioid maintenance treatment and institutional social care.

Effects of social exclusion and physical pain in chronic opioid maintenance treatment: fMRI correlates

2019 ◽  
Vol 29 (2) ◽  
pp. 291-305 ◽  
Author(s):  
Patrick Bach ◽  
Ulrich Frischknecht ◽  
Melanie Bungert ◽  
Damian Karl ◽  
Christian Vollmert ◽  
...  
Keyword(s):  
Social Exclusion ◽  
Maintenance Treatment ◽  
Physical Pain ◽  
Opioid Maintenance Treatment

scholarly journals A Longitudinal Study on Substance Use and Related Problems in Women in Opioid Maintenance Treatment from Pregnancy to Four Years after Giving Birth

2014 ◽  
Vol 8 ◽  
pp. SART.S15055 ◽  
Author(s):  
Ingunn O. Lund ◽  
Håvar Brendryen ◽  
Edle Ravndal
Keyword(s):  
Substance Use ◽  
Maintenance Treatment ◽  
Positive Impact ◽  
Child Protective Services ◽  
Severity Index ◽  
Psychological Problems ◽  
Opioid Maintenance Treatment ◽  
Protective Services ◽  
One Year

Background Women in opioid maintenance treatment (OMT) have a past characterized by drug abuse, which is a challenging start for parenthood. Studies of mothers in OMT are typically limited to pregnancy and early infancy. Knowledge about how they cope with substance use and related problems in the years following birth is therefore important. The aims of the study were to examine changes in mothers’ substance use, psychological problems, and other challenges; from one to four years after their children were born, and describe kindergarten attendance and prevalence and type of child protective services involvement when the children were four years old. Method A four-year prospective cohort study of mothers in OMT. The European severity index was used to map substance use and related problems during the third trimester of pregnancy, one and four years after birth. Results At the four-year follow-up, use of illegal substances remained low (4%) and use of legal substances (39%) was similar to the one-year follow-up. The proportion of women with psychological problems was significantly higher than at one-year follow-up (69 vs. 39%, P = .009). At age four, most children (89%) attended kindergarten, and the child protective services were following 73% of the families, mostly with voluntary measures. Conclusion Mothers in OMT cope well with substance use over time, given access to sufficient support. The findings imply that a preventive governmental strategy with close support of mother and child, have a positive impact contributing to making OMT and motherhood more compatible.

scholarly journals Benzodiazepine Use in Opioid Maintenance Treatment Programme: Risks and Clinical Outcomes

2021 ◽  
Vol 34 (3) ◽  
pp. 209
Author(s):  
Catarina Oliveira ◽  
Rita Filipe ◽  
João Meira ◽  
Lara Sampaio ◽  
Leonor Teixeira ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Clinical Outcomes ◽  
Maintenance Treatment ◽  
Treatment Effectiveness ◽  
Multivariable Analysis ◽  
High Rate ◽  
Opioid Maintenance Treatment ◽  
Cross Sectional ◽  
Increased Risk ◽  
Benzodiazepine Use

Introduction: The co-association of benzodiazepines and opioids is associated with an increased risk of overdose, death, and poorer psychosocial prognosis. The aim of this study is to characterize the prevalence, pattern of use, and primary clinical outcomes in benzodiazepines users in a public opioid maintenance treatment unit.Material and Methods: We conducted a cross-sectional study involving 236 patients treated with opioid substitutes (methadone and buprenorphine). We conducted a descriptive, bivariable, and multivariable analysis to determine clinical differences between benzodiazepines users and non-users.Results: The prevalence of consumption of benzodiazepines was 25.4% (60). The benzodiazepines were obtained with a medical prescription (49.8%) or on the black market (42.6%). The most prescribed benzodiazepine was diazepam (29.1%), and the main reasons were to relieve insomnia (27.7%) or anxiety (26.9%) and to enhance the psychoactive effects of other drugs (19.7%). Regarding the clinical outcomes, we highlight: a very high prevalence of hepatitis C (51.7%); severe ongoing consumption of psychoactive drugs (73.7%); and a high rate of depression and anxiety (> 60%), significantly higher in the benzodiazepines-user group. In the multivariable analysis of benzodiazepine use, we found alcohol consumption (OR 0.482; IC 95% 0.247, 0.238) had a negative association and having hepatitis C (OR 2.544, IC 95% 1.273, 5.084) or anxiety symptoms (OR 5.591; IC 95% 2.345, 13.326) had positive associations.Discussion: Our results suggest the BZD users had a complex drug addiction problem and underline the importance of adequately addressing BZD use, contemplating psychological and psychiatric approach in this particular population.Conclusion: Past or current use of benzodiazepines is associated with poor clinical and psychiatric outcomes. A multidisciplinary approach with a focus on infectious diseases and mental health is critical in order to enhance the treatment effectiveness and overall prognosis.

A history of sexual, emotional, or physical abuse predicts adjustment during opioid maintenance treatment

2008 ◽  
Vol 34 (2) ◽  
pp. 208-214 ◽  
Author(s):  
Steven A. Branstetter ◽  
Emily H. Bower ◽  
Jonathan Kamien ◽  
Leslie Amass
Keyword(s):  
Physical Abuse ◽  
Maintenance Treatment ◽  
Opioid Maintenance Treatment ◽  
History Of

Pain management in opioid maintenance treatment

2019 ◽  
Vol 20 (16) ◽  
pp. 1993-2005
Author(s):  
Gabi Koller ◽  
Andreas Schwarzer ◽  
Kathrin Halfter ◽  
Michael Soyka
Keyword(s):  
Pain Management ◽  
Maintenance Treatment ◽  
Opioid Maintenance Treatment
Sign in / Sign up

Export Citation Format

Share Document