scholarly journals Evaluation of Femoral Ultrasonography as a Tool for Promoting Cessation of Groin-Injecting Behaviour

2015 ◽  
Vol 21 (4) ◽  
pp. 204-210 ◽  
Author(s):  
Richard Senbanjo ◽  
John Strang
Keyword(s):  
Femoral Vein ◽  
Group Differences ◽  
Number Needed To Treat ◽  
Single Session ◽  
Opioid Substitution Treatment ◽  
Novel Approach ◽  
Time In Treatment ◽  
History Of ◽  
The Impact ◽  
Opioid Substitution

Aim: To assess the impact of femoral ultrasonography accompanied by explanation of the findings (UFV) on groin-injecting behaviour. Methods: 348 heroin-addicted groin injectors (GIs) on opioid substitution treatment (OST) were included in the study: 174 received UFV (cases), 174 did not (controls). Injecting behaviour among cases and matched controls were compared for both ‘persistent GIs' (patients who had injected via the femoral vein in the 28-day period preceding the baseline) and ‘former GIs' (patients with a history of previous groin injecting). Findings: There were no significant between-group differences in gender, mean age, time in treatment, substitute medication and mean dose at baseline or injecting behaviour prior to baseline. After baseline, reduction by a third in the proportion still groin injecting was immediately evident among UFV cases versus controls (number needed to treat: 3, 95% CI: 2, 8; p < 0.001). Marked reduction in groin-injecting behaviour among UFV cases was maintained over 12 months, including fewer relapses among ‘former GIs' (number needed to treat: 5, 95% CI: 4, 9; p < 0.001). Conclusion: Single-session UFV may promote cessation of groin-injecting behaviour among patients receiving OST. This benefit appears to be evident 12 months later. Further evaluation of this novel approach to the management of groin injecting, a particularly harmful behaviour, is now warranted.

scholarly journals Polluting pharmaceutical atmospheres: Compulsion, resistance, and symbolism of buprenorphine in Norway

2018 ◽  
Vol 36 (3) ◽  
pp. 267-285
Author(s):  
Aleksandra Bartoszko
Keyword(s):  
Social History ◽  
Opioid Substitution Treatment ◽  
Ethnographic Fieldwork ◽  
Ethnographic Studies ◽  
Counter Narrative ◽  
The Social ◽  
Institutional Forces ◽  
History Of ◽  
Insight Into ◽  
Opioid Substitution

This article offers a counter narrative to the current ethnographic studies on treatment with buprenorphine, in which notions of promised and experienced normality dominate. In some countries, introduction of buprenorphine led to a perceived “normalisation” of opioid substitution treatment, and this new modality was well received. However, in Norway the response has been almost the opposite: patients have reacted with feelings of disenfranchisement, failure, and mistrust. Based on ethnographic fieldwork in Norway, this article offers comparative insight into local experiences and subjectivities in the context of the globalisation of buprenorphine. By outlining the ethnographic description of the pharmaceutical atmosphere of forced transfers to buprenorphine-naloxone, I show that the social history of the medication is as significant as its pharmacological qualities for various treatment effects. An analysis of the reactions to this treatment modality highlights the reciprocal shaping of lived experiences and institutional forces surrounding pharmaceutical use in general and opioids in particular.

scholarly journals The shifting roles of medical stakeholders in opioid substitution treatment: a comparison between Denmark and the UK

2015 ◽  
Vol 15 (4) ◽  
pp. 216-230 ◽  
Author(s):  
Bagga Bjerge ◽  
Karen Duke ◽  
Vibeke Asmussen Frank
Keyword(s):  
Medical Professionals ◽  
Substitution Treatment ◽  
Policy And Practice ◽  
Opioid Substitution Treatment ◽  
Content Type ◽  
Recovery Movement ◽  
Drug Policies ◽  
History Of ◽  
The Uk ◽  
Opioid Substitution

Purpose – The purpose of this paper is to examine the shifting roles of medical professionals as stakeholders in opioid substitution treatment (OST) policies and practices in Denmark and the UK within the past 15 years. Design/methodology/approach – The paper is based on literature reviews, documentary analyses and key informant interviews with a range of stakeholders involved in OST and policy in Denmark and UK. The study is part of the EU-funded project: Addictions and Lifestyles in Contemporary Europe: Reframing Addictions Project. Findings – Denmark and the UK are amongst those few European countries that have long traditions and elaborate systems for providing OST to heroin users. The UK has a history of dominance of medical professionals in drugs treatment, although this has been recently challenged by the recovery movement. In Denmark, a social problem approach has historically dominated the field, but a recent trend towards medicalisation can be traced. As in all kinds of policy changes, multiple factors are at play when shifts occur. We examine how both countries’ developments around drugs treatment policy and practice relate to broader societal, economic and political changes, how such divergent developments emerge and how medical professionals as stakeholders enhanced their roles as experts in the field through a variety of tactics, including the production and use of “evidence”, which became a key tool to promote specific stakeholder’s perspectives in these processes. Originality/value – The paper contributes to current policy and practice debates by providing comparative analyses of drug policies and examination of stakeholder influences on policy processes.

scholarly journals Assessing the economics of animal trypanosomosis in Africa - history and current perspectives : vector-borne diseases : trypanosomosis

2009 ◽  
Vol 76 (1) ◽  
Author(s):  
A.P.M. Shaw
Keyword(s):  
Farming Systems ◽  
Vector Borne Diseases ◽  
Novel Approach ◽  
History Of ◽  
Animal Trypanosomosis ◽  
Livestock Productivity ◽  
Economic Analyses ◽  
Cost Implications ◽  
The Cost ◽  
The Impact

Finding appropriate ways of dealing with the problem of tsetse and trypanosomosis will be an important component of efforts to alleviate poverty in Africa. This article reviews the history of economic analyses of the problem, starting with the use of cost to guide choice of technique for tsetse control in the 1950s, followed by work in the 1970s and 1980s linking these to the impact of the disease on livestock productivity, and in the 1990s to its wider impact. In the current situation, with limited resources and a range of techniques for controlling or eliminating tsetse, the cost implications of choosing one technique or another are important and a recent study reviewed these costs. A novel approach to assessing the potential benefits from removing trypanosomosis by creating 'money maps' showed that high losses from animal trypanosomosis currently occur in areas with high cattle population densities on the margins of the tsetse distribution and where animal traction is an important component of farming systems. Given the importance of the decisions to be made in the next decade, when prioritising and choosing techniques for dealing with tsetse and trypanosomosis, more work needs to be done underpinning such mapping exercises and estimating the true cost and likely impact of planned interventions.

scholarly journals Patient Dropout from Opioid Substitution Treatment

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Opioid Dependence ◽  
Dropout Rate ◽  
Substitution Treatment ◽  
Opioid Substitution Treatment ◽  
Exact Test ◽  
Factors Associated ◽  
Patient Dropout ◽  
Key Indicator ◽  
History Of ◽  
Opioid Substitution

Opioid Substitution Treatment (OST) is an established treatment for opioid dependence. In New Zealand, OST programs are regulated by the Ministry of Health (2014) and Methadone and Buprenorphine/Naloxone (Suboxone) are the primary medications. Retention on OST is a key indicator for stabilisation of patients with opioid dependence. The purpose of the present research was to study dropout rates and identify factors associated with the dropout of patients from OST at the Community Alcohol and Drug Service (CADS), Hamilton, from 1st January 2013 to 30th April 2014. A retrospective clinical audit of patients on OST was conducted. There were 150 patients on OST in Hamilton under the CADS team during the period of study. Nine patients dropped out during the study period. Sixty-four patients were randomly selected from the remaining 141 patients who remained on treatment as a comparison group and for the study sample to be approximately half of the overall population of 150 patients. File review was conducted and potential predictors of dropout were identified. Thirty-five independent variables were selected and dropout was the dependent variable. The statistical programme SPSS22 was used to analyse the data. Fisher’s exact test was used and four variables were identified as being associated with dropout: history of intravenous drug use; (Fisher’s exact p = 0.05); history of lifetime imprisonment (Fisher’s exact p =0.05); other medications prescribed, (Fisher’s exact p = 0.04); and opioid type prescribed during the study, i.e. methadone or Suboxone. Patients on Suboxone dropped out more than those on methadone, (Fisher’s exact p = 0.00). The overall dropout rate was 6%, which was less than the rates of 15-85% found in previous studies. The limitations of the study were that it was retrospective and the number of dropouts was small. Furthermore, only patient factors associated with dropout were included in the study and service factors were not included.

scholarly journals Patients' knowledge about treatment for opiate dependence

2011 ◽  
Vol 35 (12) ◽  
pp. 448-453 ◽  
Author(s):  
Paula Alves ◽  
Adam Winstock
Keyword(s):  
Opioid Dependence ◽  
Information Provision ◽  
Opiate Dependence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Opioid Substitution Treatment ◽  
Written Information ◽  
History Of ◽  
Study Participants ◽  
Opioid Substitution

Aims and methodA cross-sectional survey was conducted to assess patient knowledge and information provision about opioid substitution treatment among individuals with opiate dependence receiving treatment at four treatment centres in South London.ResultsIn total 118 people were recruited to the study. Participants answered a mean of 14 out of 34 questions assessing a range of factors such as medication, blood-borne viruses and overdose correctly. Participants overestimated their performance on average by almost 40%. Individuals with a history of previous treatments scored significantly higher than those in their first treatment episode. The majority reported having been given written information on most of the topics assessed.Clinical implicationsThe results of this study highlight the need to improve education about opioid dependence and its treatment. Poorly informed patients are unlikely to make optimal treatment choices. Improving patients' knowledge and understanding about treatment may lead to better engagement, retention, treatment adherence and, ultimately, better health outcomes.

scholarly journals Journal of Behavioral Finance in retrospect

2019 ◽  
Vol 11 (4) ◽  
pp. 468-476
Author(s):  
Angelito Calma
Keyword(s):  
Behavioral Finance ◽  
Design Methodology ◽  
Web Of Science ◽  
Journal Articles ◽  
Content Type ◽  
Publication History ◽  
Novel Approach ◽  
The Usa ◽  
History Of ◽  
The Impact

Purpose The purpose of this paper is to examine the impact and contribution of the Journal of Behavioral Finance (JBF). Design/methodology/approach It uses the metadata from 328 journal articles (2004–2017) extracted from Scopus and Web of Science. The data included 2,602 author-submitted keywords, 1,825 index keywords and 310 abstracts. Findings Results indicate that JBF is still a young journal with 196 academic articles cited by 372 documents. Most citations come from JBF itself and the Journal of Behavioral and Experimental Finance. Mesly and Seiler are the most published, University of Gothenberg has more contributions than any other institution while the USA, Australia and UK represent nearly half of those citations. Investment policy is the most used author keyword next to behavioural finance, while risk is the most used index keyword. The most commonly used words in abstracts are investor or investors. The implications of and for JBF are discussed. Originality/value It is a unique and novel approach to analysing almost the entire publication history of the journal by using citation analysis.

scholarly journals Risk of PTSD Due to the COVID-19 Pandemic Among Patients in Opioid Substitution Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Isabella Fuchs-Leitner ◽  
Kurosch Yazdi ◽  
Nikolas W. Gerstgrasser ◽  
Matthias G. Tholen ◽  
Sophie-Therés Graffius ◽  
...  
Keyword(s):  
High Risk ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Opioid Substitution Treatment ◽  
Post Traumatic ◽  
The Impact ◽  
Ptsd Group ◽  
Opioid Substitution

Background: The impact of the COVID-19 pandemic on the mental health of patients suffering from addictive disorders is of major concern. This study aimed to explore the presence and potential increase in post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety since the beginning of the pandemic for patients in opioid substitution therapy (OST).Methods: This cross-sectional survey study evaluated a clinical sample of patients in OST (N = 123). Symptoms of post-traumatic stress disorder (PTSD) due to the COVID-19 pandemic were assessed by an adapted version of the impact of event scale (IES-R), resulting in two subgroups of low and high risk for PTSD. The depression, anxiety, and stress scale (DASS-21) was applied to collect data on the respective symptoms, and changes since the onset of the pandemic were reported on separate scales. Sociodemographic and COVID-19 related factors, as well as data on craving, consumption patterns, concomitant use, and the drug market were further assessed.Results: A binary logistic regression analysis confirmed the impact of self-perceived higher burden by psychological and economic factors on the elevated risk for PTSD due to the pandemic. The high-risk PTSD group also showed higher levels of depression, anxiety and stress, as well as a more pronounced deterioration in these symptoms since the pandemic. While reported levels of craving did not differ between the two groups, the high-risk PTSD group indicated a significantly higher increase in craving since the crisis, when compared to the low-risk group.Discussion: Our findings demonstrate elevated levels of clinical symptoms among patients in OST, with more than a quarter of patients found at risk for PTSD due to the COVID-19 pandemic. Furthermore, about 30–50% of our patients reported concerning levels of depression, anxiety, or stress. Special attention should be drawn to these findings, and potential deterioration of the situation should be addressed by health care facilities. Particularly, psychological, and financial burden due to the crisis were identified as factors increasing the risk for PTSD. These factors can easily be evaluated during routine anamneses, and might be a valuable source of information, when special attention is needed.

scholarly journals Opioid substitution treatment uptake among people who inject drugs: The findings of two consecutive bio-behavioral surveillance surveys in Iran

2020 ◽  
Author(s):  
Mehran Nakhaeizadeh ◽  
Zahra Abdolahiniya ◽  
Hamid Sharifi ◽  
Ali Mirzazadeh ◽  
Mohammad Karamouzian ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Substitution Treatment ◽  
Urban Centers ◽  
Opioid Substitution Treatment ◽  
Behavioral Surveillance ◽  
Opioid Drugs ◽  
History Of ◽  
Opioid Substitution

Abstract Background Opioid substitution treatment (OST) uptake has been associated with multiple positive health outcomes among people who inject drugs (PWID). This study evaluated the pattern of OST uptake among PWID in two consecutive national bio-behavioral surveillance surveys (2010 and 2014) in Iran. Methods Data were obtained from two national bio-behavioral surveillance surveys (N2010 = 1,783 and N2014 = 2,166) implemented using convenience sampling at the harm reduction facilities and street venues in 10 geographically diverse urban centers across Iran. Multivariable logistic regression model was used to determine the correlates of OST uptake for 2014 survey and adjusted odds ratios (AORs) and 95% confidence intervals (CI) were reported. Results The prevalence of OST uptake decreased from 49.2% in 2010 to 45.8% in 2014 (P-value = 0.033). OST uptake varied across the studied cities ranging from 0.0%-69.3% in the 2010 survey and 3.2%-75.5% in the 2014 survey. Ever being married (AOR = 1.40; 95% CI: 1.12, 1.75), having a history of incarceration (AOR = 1.56; 95% CI: 1.16, 2.09), and human immunodeficiency virus (HIV) sero-positivity (AOR = 1.63; 95% CI: 1.08, 2.5) were associated with OST uptake. Conversely, PWID who reported using only non-opioid drugs (AOR = 0.43; 95% CI: 0.26, 0.71) and those who reported concurrent use of opioid and non-opioid drugs (AOR = 0.66; 95% CI: 0. 0.51, 0.86) were less likely to uptake OST. Conclusions Although OST uptake among PWID in Iran is above the 40% threshold defined by the World Health Organization, there remains significant disparities across urban centers in Iran. Importantly, the OST services appear to be serving high risk PWID including those living with HIV and those with a history of incarceration. Evaluating service integration including mental health, HIV and hepatitis C virus care, and other harm reduction services may support the optimization of health outcomes of opioid substitution treatment across Iran.

scholarly journals The Impact of Misuse and Diversion of Opioid Substitution Treatment Medicines: Evidence Review and Expert Consensus

2015 ◽  
Vol 22 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Jens Reimer ◽  
Nat Wright ◽  
Lorenzo Somaini ◽  
Carlos Roncero ◽  
Icro Maremmani ◽  
...  
Keyword(s):  
Criminal Behavior ◽  
Opioid Dependence ◽  
Direct Impact ◽  
Substitution Treatment ◽  
Negative Effects ◽  
Opioid Substitution Treatment ◽  
Controlled Drugs ◽  
The Individual ◽  
The Impact ◽  
Opioid Substitution

Background/Aims: Opioid substitution treatment (OST) improves outcomes in opioid dependence. However, controlled drugs used in treatment may be misused or diverted, resulting in negative treatment outcomes. This review defines a framework to assess the impact of misuse and diversion. Methods: A systematic review of published studies of misuse and diversion of OST medicines was completed; this evidence was paired with expert real-world experience to better understand the impact of misuse and diversion on the individual and on society. Results: Direct impact to the individual includes failure to progress in recovery and negative effects on health (overdose, health risks associated with injecting behaviour). Diversion of OST has impacts on a community that is beyond the intended OST recipient. The direct impact includes risk to others (unsupervised use; unintended exposure of children to diverted medication) and drug-related criminal behavior. The indirect impact includes the economic costs of untreated opioid dependence, crime and loss of productivity. Conclusion: While treatment for opioid dependence is essential and must be supported, it is vital to reduce misuse and diversion while ensuring the best possible care. Understanding the impact of OST misuse and diversion is key to defining strategies to address these issues.

scholarly journals Changes in opioid-related deaths following increased access to opioid substitution treatment

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisa Andersson ◽  
Anders Håkansson ◽  
Jonas Berge ◽  
Björn Johnson
Keyword(s):  
Policy Change ◽  
National Level ◽  
Patient Choice ◽  
Mortality Data ◽  
Substitution Treatment ◽  
Opioid Substitution Treatment ◽  
Level Data ◽  
The Impact ◽  
Overdose Deaths ◽  
Opioid Substitution

Abstract Background Opioid-related mortality is high and increasing in the Western world, and interventions aimed at reducing opioid-related deaths represent an important area of study. In Skåne County, Sweden, a patient choice reform resulted in increased access to opioid substitution treatment (OST). In addition, a gradual shift towards less restrictive terms for exclusion from OST has been implemented. The aim of this study was to assess the impact of these policy changes on opioid-related deaths. Methods Detailed data on opioid-related deaths in Skåne during the 2 years prior to and following the policy change were obtained from forensic records and from health care services. Data on overdose deaths for Skåne and the rest of Sweden were obtained using publicly available national register data. Time periods were used as the predictor for opioid-related deaths in the forensic data. The national level data were used in a natural experiment design in which rates of overdose deaths were compared between Skåne and the rest of Sweden before and after the intervention. Results There was no significant difference in the number of deaths in Skåne between the data collection periods (RR: 1.18 95% CI:0.89–1.57, p= 0.251). The proportion of deaths among patients enrolled in OST increased between the two periods (2.61, 1.12–6.10, p= 0.026). There was no change in deaths related to methadone or buprenorphine in relation to deaths due to the other opioids included in the study (0.92, 0.51–1.63, p= 0.764). An analysis of national mortality data showed an annual relative decrease in unintentional drug deaths in Skåne compared to the rest of Sweden following the onset of the reform (0.90, 0.84–0,97, p= 0.004). Conclusions Opioid-related deaths, as assessed using forensic data, has not changed significantly in Skåne following a change to lower-threshold OST. By contrast, national level data indicate that the policy change has been associated with decreased overdose deaths. The discrepancy between these results highlights the need for more research to elucidate this issue. The result that more patients die during ongoing OST following an increase in access to treatment underlines the need for further preventive interventions within the OST treatment setting.

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