The lived experience of Australian opioid replacement therapy recipients in a community‐based program in regional Victoria

2019 ◽  
Vol 38 (6) ◽  
pp. 656-663 ◽  
Author(s):  
Tejaswini Patil Vishwanath ◽  
Penelope Cash ◽  
Robyn Cant ◽  
Jane Mummery ◽  
Wendy Penney
Keyword(s):  
Replacement Therapy ◽  
Lived Experience ◽  
Community Based ◽  
Opioid Replacement Therapy

scholarly journals Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

2021 ◽  
pp. 1-10
Author(s):  
Stephanie Paula Elisabeth Guillery ◽  
Rainer Hellweg ◽  
Golo Kronenberg ◽  
Ulrich Bohr ◽  
Hagen Kunte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Replacement Therapy ◽  
Psychological Functioning ◽  
Treatment Options ◽  
Chronically Ill ◽  
Cross Sectional ◽  
Life Improvement ◽  
Methadone Patients ◽  
Opioid Replacement Therapy

<b><i>Background:</i></b> Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. <b><i>Objectives:</i></b> Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (<i>n</i> = 126), diamorphine (<i>n</i> = 85), or buprenorphine (<i>n</i> = 37) were recruited in 6 German therapy centers. <b><i>Methods:</i></b> Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the <i>Profile of the Quality of Life in the Chronically Ill</i> (PLC) questionnaire. <b><i>Results:</i></b> Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (<i>p</i> &#x3c; 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (<i>p</i> &#x3c; 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.141). Diamorphine patients reported a higher psychological functioning (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.078) and overall life improvement (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.060) compared to methadone, but not compared to buprenorphine patients (both <i>p</i> &#x3e; 0.25). <b><i>Conclusion:</i></b> Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

Maternal and neonatal characteristics of a Canadian urban cohort receiving treatment for opioid use disorder during pregnancy

2018 ◽  
Vol 10 (1) ◽  
pp. 132-137 ◽  
Author(s):  
C. Miller ◽  
D. Grynspan ◽  
L. Gaudet ◽  
E. Ferretti ◽  
S. Lawrence ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Retrospective Chart Review ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Maternal Characteristics ◽  
Ottawa Hospital ◽  
Increased Risk ◽  
Opioid Replacement Therapy ◽  
In Pregnancy

AbstractThe epidemic of prescription and non-prescription opioid misuse is of particular importance in pregnancy. The Society of Obstetricians and Gynaecologists of Canada currently recommends opioid replacement therapy with methadone or buprenorphine for opioid-dependent women during pregnancy. This vulnerable segment of the population has been shown to be at increased risk of blood-borne infectious diseases, nutritional insecurity and stress. The objective of this study was to describe an urban cohort of pregnant women on opioid replacement therapy and to evaluate potential effects on the fetus. A retrospective chart review of all women on opioid replacement therapy and their infants who delivered at The Ottawa Hospital General and Civic campuses between January 1, 2013 and March 24, 2017 was conducted. Data were collected on maternal characteristics, pregnancy outcomes, neonatal outcomes and corresponding placental pathology. Maternal comorbidities identified included high rates of infection, tobacco use and illicit substance use, as well as increased rates of placental abruption compared with national averages. Compared with national baseline averages, the mean neonatal birth weight was low, and the incidence of small for gestational age infants and congenital anomalies was high. The incidence of NAS was comparable with estimates from other studies of similar cohorts. Findings support existing literature that calls for a comprehensive interdisciplinary risk reduction approach including dietary, social, domestic, psychological and other supports to care for opioid-dependent women in pregnancy.

Dental Plaque Concentrations of Methadone, Morphine and Their Metabolites in Opioid Replacement Therapy and in Post-Mortem Cases

2021 ◽  
Author(s):  
Kerstin Henkel ◽  
Miriam Klima ◽  
Volker Auwärter ◽  
Markus J Altenburger ◽  
Merja A Neukamm
Keyword(s):  
Oral Cavity ◽  
Replacement Therapy ◽  
Dental Plaque ◽  
Oral Intake ◽  
Study Groups ◽  
Post Mortem ◽  
Dental Biofilm ◽  
Intravenous Application ◽  
Drug Concentrations ◽  
Opioid Replacement Therapy

Abstract Non-mineralized dental biofilm (plaque) has potential as novel alternative matrix in forensic toxicology to prove drug use. The incorporation of illicit and medicinal drugs in dental plaque could take place through direct contact after oral or nasal intake, which can lead to high drug levels in the oral cavity, or indirectly via the secretion of drug-containing saliva, e.g. after intravenous application. Therefore, plaque samples from patients in opioid replacement therapy (ORT) and post-mortem plaque samples were analyzed and the drug concentrations were compared. The study comprised 26 plaque samples from ORT patients with different daily doses which were analyzed for methadone, morphine and their respective metabolites. Plaque samples were taken directly before the oral administration of the regular daily dose. Seventeen post-mortem plaque samples were analyzed, either from cases of lethal drug intoxications or after pain therapy with morphine. Plaque analysis was performed using LC-MS/MS after liquid extraction with acetonitrile. Plaque concentrations in ORT for methadone and its metabolite EDDP ranged from 42 to approx. 49,000 pg/mg (median 1,300 pg/mg) and from below 10 to 610 pg/mg (median 31 pg/mg), respectively. Morphine plaque concentrations in ORT ranged from 120 to 480 pg/mg (median 400 pg/mg). In lethal intoxication cases plaque concentrations were generally at least one order of magnitude higher than in the study groups with therapeutic substance use. This data will help to interpret drug findings in plaque. Additionally, the EDDP/methadone concentration ratio in plaque was lower after oral intake with contamination of the oral cavity (e.g. syrup) compared to cases with suspected intravenous application of methadone and could therefore indicate the drug administration route.

Portraits of Joy: The Lived Experiences of Young Adults With Autism Expressed Through Photovoice

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512505155p1-7512505155p1
Author(s):  
Paula J. Thompson-Costello ◽  
Mackenzie Traub ◽  
Eleanor Sweeney ◽  
Mallory Schrier ◽  
Hannah R. Dau
Keyword(s):  
Young Adults ◽  
Lived Experience ◽  
Social Relationships ◽  
Living Arrangements ◽  
Independent Living ◽  
Employment Status ◽  
Community Based ◽  
Adults With Autism ◽  
Challenges And Opportunities ◽  
Young Adults With Autism

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. For young adults and adults with autism, the outcomes related to independence, social relationships, employment status, and living arrangements have been poor. This session will share research using PhotoVoice to explore the lived experience of young adults with autism in a community-based independent-living residence. Challenges and opportunities for independence as seen through photos and reflections on the OT role will be shared. Primary Author and Speaker: Paula J. Thompson-Costello Additional Authors and Speakers: Mackenzie Traub, Eleanor Sweeney, Mallory Schrier, and Hannah R. Dau

Patients’ Perceptions of Opioid Replacement Therapy: a Comparison of Diamorphine and Methadone/Levomethadone

2020 ◽  
Author(s):  
Stephanie Paula Elisabeth Guillery ◽  
Rainer Hellweg ◽  
Sören Enge ◽  
Ulrich Bohr ◽  
Hagen Kunte ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Opioid Replacement Therapy

scholarly journals COOL Music: a ‘bottom-up’ music intervention for hard-to-reach young people in Scotland

2019 ◽  
Vol 37 (1) ◽  
pp. 87-98 ◽  
Author(s):  
Stephen R. Millar ◽  
Artur Steiner ◽  
Francesca Caló ◽  
Simon Teasdale
Keyword(s):  
Young People ◽  
Lived Experience ◽  
Self Esteem ◽  
Small Scale ◽  
Music Intervention ◽  
Community Based ◽  
Collaborative Project ◽  
Music Making ◽  
Participatory Music

AbstractCommunity Orientated and Opportunity Learning (COOL) Music was a 12-month collaborative project between researchers at Glasgow Caledonian University and practitioners at the Edinburgh-based social enterprise Heavy Sound. The project began in October 2017 and involved 16 sessions of participatory music making with 32 ‘hard-to-reach’ young people (aged 12–17) aimed at increasing confidence and self-esteem and improving social skills. Using COOL Music as a case study, this article explores some of the challenges faced by community-based arts organisations tasked with delivering such interventions, contrasting COOL Music’s small-scale, targeted, community-based approach with prevailing top-down music interventions in Scotland. We argue that such programmes are particularly suitable in engaging those at the margins of society, reaching them on their own terms through music that resonates with their own lived experience. However, we acknowledge the short-term and transitory nature of such projects may prove problematic for some hard-to-reach groups who require more stability in their lives and may also lead to staff fatigue and burnout. We call for further research in these areas, and greater policy attention to be paid to the sustainability of such projects.

Coalescent Communities: Settlement Aggregation and Social Integration in Iroquoian Ontario

2012 ◽  
Vol 77 (4) ◽  
pp. 646-670 ◽  
Author(s):  
Jennifer Birch
Keyword(s):  
Social Integration ◽  
Lived Experience ◽  
Fifteenth Century ◽  
Small Scale ◽  
Community Based ◽  
Small Communities ◽  
Cultural Perspectives ◽  
South Central ◽  
New Community ◽  
Regional Settlement

AbstractThis paper explores processes of settlement aggregation among ancestral Huron-Wendat populations in south-central Ontario, Canada. During the fifteenth century A.D., numerous small communities came together, forming large, fortified village aggregates. In order to understand these processes a multiscalar analytical approach was combined with a conceptual framework emphasizing cross-cultural perspectives on coalescent societies, the archaeology of communities, and historical trajectories of societal change. Regional settlement data are presented to illustrate the movement and increasing size of settlements. In order to determine how individual coalescent communities were formed and maintained, a single village relocation sequence is examined in detail. This sequence illustrates how people constructed, inhabited, and negotiated domestic and public spaces in these new community aggregates. Detailed analyses of the occupational histories of these sites point to the creation of new community-based identities, corporate decision-making structures, and increasing social integration over time. The results of this study demonstrate that while settlement aggregation can be documented at the regional level, only detailed intrasite analyses can identify the small-scale changes in practice that reflect the lived experience of coalescence.

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