scholarly journals Opioid-Induced Hyperalgesia in a Cancer Patient on High-Dose Methadone Maintenance Therapy: A Case for Subspecialty Opioid Use Disorder Primary Care

Cureus ◽  
2020 ◽  
Author(s):  
Ebubechukwu Ezeh ◽  
Davinder Singh ◽  
Varun Dobariya ◽  
Esiemoghie J Akhigbe ◽  
Christine Gilkerson
Keyword(s):  
Primary Care ◽  
Cancer Patient ◽  
Maintenance Therapy ◽  
Methadone Maintenance ◽  
Opioid Use Disorder ◽  
Methadone Maintenance Therapy ◽  
High Dose ◽  
Opioid Use ◽  
Opioid Induced Hyperalgesia

scholarly journals Harm Reduction Service Utilization Among People Who Inject Drugs in Tajikistan: Prevalence and Precipitating Factors

2020 ◽  
Author(s):  
Mary M. Tate ◽  
Daniel J. Bromberg ◽  
Kamiar Alaei ◽  
Saifuddin Karimov ◽  
Dilshod Saidi ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Harm Reduction ◽  
People Who Inject Drugs ◽  
Methadone Maintenance ◽  
Opioid Use Disorder ◽  
Methadone Maintenance Therapy ◽  
People Who Use Drugs ◽  
People Living With Hiv ◽  
Opioid Use ◽  
Needle And Syringe Programs

Abstract Tajikistan is in a unique geopolitical location along the global heroin trade route, exacerbating its own opioid use disorder and HIV epidemics. With one of the highest rates of opioid use disorder in the world, and 20,000-30,000 people who inject drugs in the country, Tajikistan’s government and international actors have provided harm reduction measures for people who use drugs, like narcology centers, needle and syringe programs, and methadone maintenance therapy. No implementation science studies have been conducted in Tajikistan and the current implementation gaps in service uptake are unknown. The purpose of this paper is to determine the prevalence of harm reduction service uptake among people who use drugs in Tajikistan, and determine which factors are associated with service uptake. Methods This paper uses data from the National AIDS Registry, subset to patients who use drugs (n=11,029) and cross-sectional data from a bio-behavioral survey conducted in 2017 (n=2,390). Univariate and multivariate logistic regression were used to assess associations between study variables and probably of uptake of narcology center registration, uptake of needle and syringe programs, and registration into methadone maintenance therapy. Results Fewer than half of all people who inject drugs (42.4%) were registered with the narcology center , most people who inject drugs (88.6%) reported always having access to clean syringes, and only 5.3% of PWID had ever engaged in methadone treatment in Tajikistan. There were ethnic differences in service uptake – with ethnic Russians and Uzbeks less likely to use services than ethnic Tajiks. Men who have sex with men and people living with HIV were also more likely to access services than heterosexual or seronegative individuals. Conclusion Narcology center registration and clean needle coverage are high in Tajikistan. Methadone maintenance therapy uptake, however, is low, like in other countries in Eastern Europe and Central Asia. NGO and government initiatives that target risk groups (like LGBTQ+ people and people living with HIV) seem to have been somewhat effective at recruiting their clientele into services. Future research might focus on the “positive deviancy” of these subgroups of people who use drugs to learn how to increase service uptake generally.

Stigma Associated with Opioid Use Disorder and Medication Assisted Treatment

2019 ◽  
Author(s):  
Dr. Harry Holt
Keyword(s):  
Primary Care ◽  
Maintenance Therapy ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Methadone Maintenance ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Negative Stereotypes ◽  
Medication Assisted Treatment

<b>Purpose</b>: This paper reviews and integrates the literature on the stigma associated with opioid use disorder (OUD) and how this acts as a barrier for patients seeking Medication Assisted Treatment (MAT). Implications for patients in rural areas who face stigma for opioid use disorder are reviewed. <b>Methods: </b>We examine the extant literature since 2007, reviewing studies focused on the stigma against patients suffering from OUD and MAT. <b>Findings</b>: The review identifies five categories of sources of stigma that research has addressed: Stigma against the patient; stigma by nurses; stigma by primary care physicians; stigma from counselors; stigma by pharmacy and dispensary staff; stigma against MAT by drug courts, stigma by family members, coworkers, and employers. <b>Conclusions</b>: Stigma exists as prejudice, negative stereotypes and associations, and labels. Despite widespread evidence supporting Methadone Maintenance Therapy (MMT) and Buprenorphine Maintenance Therapy (BMT) effectiveness, stigma abounds within the medical community and society at large. Discriminatory practices, poor relationships with dispensing staff, pharmacists, counselors, and doctors, and a feeling of being separate or “alien” from others are cited as barriers to involvement and participation in MAT. This has created disparities in health care outcomes as well as the access and availability of MAT services. Rural patients experience these sources of stigma and face a heightened barrier to access for MAT services. However, the primary care setting along with delivery of care through primary care physicians, physician assistants, and nurse practitioners offers a means to increase care in rural areas.

Stigma Associated with Opioid Use Disorder and Medication Assisted Treatment

2019 ◽  
Author(s):  
Dr. Harry Holt
Keyword(s):  
Primary Care ◽  
Maintenance Therapy ◽  
Nurse Practitioners ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Methadone Maintenance ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Negative Stereotypes ◽  
Medication Assisted Treatment

<b>Purpose</b>: This paper reviews and integrates the literature on the stigma associated with opioid use disorder (OUD) and how this acts as a barrier for patients seeking Medication Assisted Treatment (MAT). Implications for patients in rural areas who face stigma for opioid use disorder are reviewed. <b>Methods: </b>We examine the extant literature since 2007, reviewing studies focused on the stigma against patients suffering from OUD and MAT. <b>Findings</b>: The review identifies five categories of sources of stigma that research has addressed: Stigma against the patient; stigma by nurses; stigma by primary care physicians; stigma from counselors; stigma by pharmacy and dispensary staff; stigma against MAT by drug courts, stigma by family members, coworkers, and employers. <b>Conclusions</b>: Stigma exists as prejudice, negative stereotypes and associations, and labels. Despite widespread evidence supporting Methadone Maintenance Therapy (MMT) and Buprenorphine Maintenance Therapy (BMT) effectiveness, stigma abounds within the medical community and society at large. Discriminatory practices, poor relationships with dispensing staff, pharmacists, counselors, and doctors, and a feeling of being separate or “alien” from others are cited as barriers to involvement and participation in MAT. This has created disparities in health care outcomes as well as the access and availability of MAT services. Rural patients experience these sources of stigma and face a heightened barrier to access for MAT services. However, the primary care setting along with delivery of care through primary care physicians, physician assistants, and nurse practitioners offers a means to increase care in rural areas.

Use of Methadone Maintenance Therapy for Opioid Use Disorder in Pregnancy

NeoReviews ◽  
2021 ◽  
Vol 22 (10) ◽  
pp. e699-e704
Author(s):  
Julia Knypinski ◽  
Thammatat Vorawandthanachai ◽  
Diana S. Wolfe
Keyword(s):  
Maintenance Therapy ◽  
Methadone Maintenance ◽  
Opioid Use Disorder ◽  
Methadone Maintenance Therapy ◽  
Opioid Use ◽  
In Pregnancy

scholarly journals Modulation of Attentional Bias to Drug and Affective Cues by Therapeutic and Neuropsychological Factors in Patients With Opioid Use Disorder on Methadone Maintenance Therapy

2022 ◽  
Vol 12 ◽  
Author(s):  
Wenhui Li ◽  
Jin Huang ◽  
Nan Zhang ◽  
Kathrin Weidacker ◽  
Jun Li ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Attentional Bias ◽  
Methadone Maintenance ◽  
Methadone Treatment ◽  
Opioid Use Disorder ◽  
Methadone Maintenance Therapy ◽  
Opioid Use ◽  
Drug Cues ◽  
Affective Cues ◽  
Attentional Avoidance

Objective: Abnormal selective attention to drug cues and negative affect is observed in patients with substance dependence, and it is closely associated with drug addiction and relapse. Methadone maintenance is an effective replacement therapy to treat heroin addiction, which significantly reduces the relapse rate. The present study examines whether the patients with opioid use disorder on chronic methadone maintenance therapy exhibit abnormal attentional bias to drug cues and negative-affective cues. Moreover, its relation to therapeutic and neuropsychological factors is also examined.Methods: Seventy-nine patients with opioid use disorder under chronic methadone maintenance therapy and 73 age-, sex-, and education-matched healthy controls were recruited and assessed for attentional bias to drug cues and negative affect using a dot-probe detection task. Correlational analysis was used to examine the relationships between the attentional bias and the demographic, therapeutic, and neuropsychological factors.Results: No significant overall patient-control group difference is observed in drug-related or negative-affective-related attentional bias scores. In the patient group, however, a significant negative correlation is found between the attentional bias scores to negative-affective cues and the duration of methadone treatment (p = 0.027), with the patients receiving longer methadone treatment showing less attentional avoidance to negative-affective cues. A significant positive correlation is found between the negative affect-induced bias and the impulsivity score (p = 0.006), with more impulsive patients showing higher attentional avoidance to negative affective cues than less impulsive patients. Additionally, the patients detect a smaller percentage of probe stimuli following the drug (p = 0.029) or negative-affective pictures (p = 0.009) than the healthy controls.Conclusion: The results of the present study indicate that the patients under chronic methadone maintenance therapy show normalized attentional bias to drug and negative-affective cues, confirming the involuntary attention of the patients is not abnormally captured by external drug or negative-affective clues. Our findings also highlight that the attentional avoidance of negative-affective cues is modulated by the duration of methadone treatment and the impulsivity level in the patients.

scholarly journals Decreased Level of Blood MicroRNA-133b in Men with Opioid Use Disorder on Methadone Maintenance Therapy

2019 ◽  
Vol 8 (8) ◽  
pp. 1105
Author(s):  
Hsu ◽  
Huang ◽  
Tsai
Keyword(s):  
Animal Studies ◽  
Methadone Maintenance ◽  
Opioid Use Disorder ◽  
Methadone Maintenance Therapy ◽  
Healthy Controls ◽  
Opioid Use ◽  
Ribonucleic Acids ◽  
Methadone Dosage ◽  
The Difference ◽  
Serum Micrornas

Although previous animal studies have indicated that certain micro ribonucleic acids (microRNAs) play a part in the pathway of opioid addiction, whether such findings extend to human models is yet unknown. This study aims to investigate the important microRNA expressions in patients with opioid use disorder (OUD) on methadone maintenance treatment (MMT) compared to healthy controls and analyze the correlation between microRNAs and opioid characteristics among the patients. We recruited 50 patients and 25 controls, and both groups were matched regarding gender, age, and body mass index. Serum microRNAs (miR-133b, miR-23b, miR-190, miR-206, miR-210, and miR-21) were measured. The age of OUD onset, duration of MMT participation, and recent daily methadone dosage were considered the opioid characteristics. We adopted the t-test to compare the difference between patients and controls and Pearson's correlation to evaluate the association between microRNAs and opioid profiles. Only the level of miR-133b in OUD patients on MMT was significantly lower than that in healthy controls. We did not detect differences of any other microRNA expressions between the two groups. Furthermore, we found no evidence to support the association between microRNAs and opioid characteristics. This study indicates that miR-133b values may be decreased in OUD patients on MMT.

scholarly journals Better retention of Malaysian opiate dependents treated with high dose methadone in methadone maintenance therapy

2010 ◽  
Vol 7 (1) ◽  
pp. 30 ◽  
Author(s):  
Nasir Mohamad ◽  
Nor Bakar ◽  
Nurfadhlina Musa ◽  
Nazila Talib ◽  
Rusli Ismail
Keyword(s):  
Maintenance Therapy ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
High Dose
Sign in / Sign up

Export Citation Format

Share Document