Intrapretuvalisuse of Methadone, Buprenorphine and Buprenorphine-Naloxone in Patients Under Opioid Maintenance Treatment: A Cross-Sectional Multicentre Study

2019 ◽  
Vol 25 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Fabio Lugoboni ◽  
Lorenzo Zamboni ◽  
Mauro Cibin ◽  
Stefano Tamburin ◽  
Keyword(s):  
Multicentre Study ◽  
Maintenance Treatment ◽  
Opioid Maintenance Treatment ◽  
Cross Sectional

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.

scholarly journals Sexual Functioning and Opioid Maintenance Treatment in Women. Results From a Large Multicentre Study

2019 ◽  
Vol 13 ◽  
Author(s):  
Lorenzo Zamboni ◽  
Anna Franceschini ◽  
Igor Portoghese ◽  
Laura Morbioli ◽  
Fabio Lugoboni ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Sexual Functioning ◽  
Maintenance Treatment ◽  
Opioid Maintenance Treatment ◽  
Large Multicentre Study

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.

Prescribing practices of Indian psychiatrists in the treatment of bipolar disorder

2019 ◽  
Vol 53 (5) ◽  
pp. 458-469 ◽  
Author(s):  
YC Janardhan Reddy ◽  
Venugopal Jhanwar ◽  
Rajesh Nagpal ◽  
MS Reddy ◽  
Nilesh Shah ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Maintenance Treatment ◽  
Bipolar Depression ◽  
Mood Stabilizer ◽  
Self Report ◽  
Mood Stabilizers ◽  
Prescribing Practices ◽  
Term Outcome ◽  
Cross Sectional ◽  
Long Term Outcome

Objective: The treatment of bipolar disorder is challenging because of its clinical complexity and availability of multiple treatment options, none of which are ideal mood stabilizers. This survey studies prescription practices of psychiatrists in India and their adherence to guidelines. Method: In total, 500 psychiatrists randomly selected from the Indian Psychiatric Society membership directory were administered a face-to-face 22-item questionnaire pertaining to the management of bipolar disorder. Results: For acute mania, most practitioners preferred a combination of a mood stabilizer and an atypical antipsychotic to monotherapy. For acute depression, there was a preference for a combination of an antidepressant and a mood stabilizer over other alternatives. Electroconvulsive therapy was preferred in the treatment of severe episodes and to hasten the process of recovery. Approximately, 50% of psychiatrists prescribe maintenance treatment after the first bipolar episode, but maintenance therapy was rarely offered lifelong. While the majority (85%) of psychiatrists acknowledged referring to various clinical guidelines, their ultimate choice of treatment was also significantly determined by personal experience and reference to textbooks. Limitations: The study did not study actual prescriptions. Hence, the responses to queries in the survey are indirect measures from which we have tried to understand the actual practices, and of course, these are susceptible to self-report and social-desirability biases. This was a cross-sectional study; therefore, temporal changes in responses could not be considered. Conclusion: Overall, Indian psychiatrists seemed to broadly adhere to recommendations of clinical practice guidelines, but with some notable exceptions. The preference for antidepressants in treating depression is contrary to general restraint recommended by most guidelines. Therefore, the efficacy of antidepressants in treating bipolar depression in the context of Indian psychiatrists’ practice needs to be studied systematically. Not initiating maintenance treatment early in the course of illness may have serious implications on the long-term outcome of bipolar disorder.

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
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