Long-term self-treatment with methadone or buprenorphine as a response to barriers to opioid substitution treatment : the case of Sweden
Torkel Richert,Björn Johnson +1 more
TLDR
Moves for self-treatment are investigated, as well as attitudes and perceived barriers to OST among drug users with an opioid dependence in Sweden, to find out whether a restrictive and strict rehabilitation-oriented treatment model may force many to manage their own treatment.Abstract:
Background: It is well known that illicit use of methadone and buprenorphine is common among people with an opioid dependence Less notice has been taken of the fact that these substances are also used for extended periods of self-treatment, as a way of handling barriers to OST In this study, motives for self-treatment are investigated, as well as attitudes and perceived barriers to OST among drug users with an opioid dependence in Sweden Method: The study is based on qualitative research interviews with 27 opioid users who have treated themselves with methadone or buprenorphine for a period of at least three months Results: The duration of self-treatment among the interviewees varied from 5 months to 7 years Self-treatment often began as a result of a wish to change their life situation or to cut back on heroin, in conjunction with perceived barriers to OST These barriers consisted of (1) difficulties in gaining access to OST due to strict inclusion criteria, limited access to treatment or a bureaucratic and arduous assessment process, (2) difficulties remaining in treatment, and (3) ambivalence toward or reluctance to seek OST, primarily due to a fear of stigmatization or disciplinary action Self-treatment was described as an attractive alternative to OST, as a stepping stone to OST, and as a way of handling waiting lists, or as a saving resource in case of involuntary discharge Conclusion: Illicit use of methadone and buprenorphine involve risks but may also have important roles to play for users who are unwilling or not given the opportunity to enter OST A restrictive and strict rehabilitation-oriented treatment model may force many to manage their own treatment More generous inclusion criteria, a less complex admission process, fewer involuntary discharges, and less paternalistic treatment may lead to increasing numbers seeking OST Control measures are necessary to prevent diversion and harmful drug use but must be designed in such a way that they impose as few restrictions as possible on the daily life of patientsread more
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Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012-2015.
Ban Ahmed Majeed,Scott R. Weaver,Kyle R. Gregory,Carrie F. Whitney,Paul Slovic,Terry F. Pechacek,Michael P. Eriksen +6 more
TL;DR: There is an increase in the proportion of U.S. adults who misperceive the harm of e-cigarettes and consider them to be as harmful as combustible cigarettes, and the need to design public health messages that accurately interpret the scientific data on the potential harm of electronic cigarettes and clearly differentiate the absolute from the relative harm is highlighted.
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Evaluation of a fentanyl drug checking service for clients of a supervised injection facility, Vancouver, Canada
Mohammad Karamouzian,Mohammad Karamouzian,Mohammad Karamouzian,Carolyn Dohoo,Sara Forsting,Ryan McNeil,Ryan McNeil,Thomas Kerr,Thomas Kerr,Mark Lysyshyn,Mark Lysyshyn +10 more
TL;DR: Drug checking at harm reduction facilities such as SIFs might be a feasible intervention that could contribute to preventing overdoses in the context of the current overdose emergency, and intended dose reduction was associated with significantly lower odds of overdose.
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Benzodiazepine, z-drug and pregabalin prescriptions and mortality among patients in opioid maintenance treatment—A nation-wide register-based open cohort study
TL;DR: Caution is advised when prescribing sedative drugs, including benzodiazepines, z-drugs and pregabalin, to patients in opioid maintenance treatment, to ensure they do not increase risk of death in opioid users.
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Caring for Pregnant Women with Opioid Use Disorder in the USA: Expanding and Improving Treatment
Kelley Saia,Davida M. Schiff,Elisha M. Wachman,Pooja Mehta,Annmarie Vilkins,Michelle Sia,Jordana Price,Tirah Samura,Justin DeAngelis,Clark V. Jackson,Sawyer F. Emmer,Daniel Shaw,Sarah M. Bagley +12 more
TL;DR: The US health care system can adapt to provide quality care for these mother-infant dyads by expanding comprehensive treatment services and improving access to care by expanding evidence-based treatment practices for this vulnerable population.
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Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically
Alexandria Macmadu,Jennifer J. Carroll,Scott E. Hadland,Traci C. Green,Brandon D.L. Marshall,Brandon D.L. Marshall +5 more
TL;DR: Exposure to fentanyl-contaminated heroin is an emerging trend among young adult NMPO users in Rhode Island, and overdose prevention programs addressing FCH use are urgently needed.
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