In people with depression during opioid agonist treatment for opioid dependence, what are the effects of antidepressants?

2015 ◽  
Keyword(s):  
Opioid Dependence ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment

scholarly journals Prevalence of Opioid Dependence and Opioid Agonist Treatment in the Berlin Custodial Setting: A Cross-Sectional Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Kira von Bernuth ◽  
Peter Seidel ◽  
Julia Krebs ◽  
Marc Lehmann ◽  
Britta Neumann ◽  
...  
Keyword(s):  
Opioid Dependence ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Opioid Agonist ◽  
Cross Sectional ◽  
Opioid Agonist Treatment

scholarly journals Development of quality indicators for the continued and safe delivery of Opioid Agonist Treatment (OAT), throughout and beyond COVID-19, using a Delphi Consensus technique

2021 ◽  
Vol 4 ◽  
pp. 90
Author(s):  
Gráinne Cousins ◽  
Louise Durand ◽  
Fiona Boland ◽  
Norma Harnedy ◽  
Íde Delargy ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Opioid Dependence ◽  
Clinical Decision Making ◽  
National Level ◽  
Healthcare Delivery ◽  
Unintended Consequences ◽  
Delphi Consensus ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Wide Range

Opioid agonist treatment (OAT) is the most effective treatment for opioid dependence, although it relies heavily on regular face-to-face healthcare delivery. Following the emergence of COVID-19, policies were rapidly changed in Ireland to reduce the risk of contracting the virus for both clients and treatment providers. From March 2020, the Health Service Executive (HSE) National Social Inclusion Office introduced a series of national contingency guidelines, to ensure fast and uninterrupted access to OAT while balancing efforts to mitigate COVID-19 risks. The Programme for Government 2020 states they will retain many of the measures introduced during the COVID-19 pandemic to reduce waiting times in accessing treatment services and reduce overdose mortality. It is therefore essential to examine the impacts, benefits and unintended consequences of the special measures introduced during COVID-19 at a national level, thus informing which measures can and should be sustained throughout and beyond COVID-19 to support effective, safe and patient-centered care promoting the health and wellbeing of all people with opioid dependence. The aim of this project is to identify priorities for quality improvements which will inform clinical decision making throughout and beyond the pandemic. This will be achieved through a Delphi consensus study. Quality indicators will be identified by comparing the national contingency guidelines with the national 2016 Clinical Guidelines. The project steering group will review the proposed indicators, and the agreed quality indicators will be integrated into an on-line Delphi questionnaire. One hundred participants will be invited to form the Delphi consensus panel and will include a wide range of stakeholders, including people accessing OAT services, general practitioners, pharmacists and outreach workers. Evidence generated from this study will inform national policy decisions in relation to improving quality of care in OAT.

scholarly journals Effectiveness and Safety of Low-Threshold Opioid-Agonist Treatment in Hard-To-Reach Populations with Opioid Dependence

2021 ◽  
pp. 1-11
Author(s):  
Fatemeh Chalabianloo ◽  
Christian Ohldieck ◽  
Øystein A. Haaland ◽  
Lars Thore Fadnes ◽  
Kjell Arne Johansson
Keyword(s):  
Healthcare Utilization ◽  
Opioid Dependence ◽  
Treatment Retention ◽  
Retention Rates ◽  
Vulnerable Groups ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Fatal Overdose ◽  
Low Threshold

<b><i>Objectives:</i></b> Opioid-use disorder is related to premature death worldwide. Opioid-agonist treatment (OAT) is an effective treatment for opioid dependence. OAT delivery platforms may influence treatment access and outcomes, especially for the most vulnerable groups. The aim of this study was to determine the effectiveness and safety of low-threshold OAT compared to the standard treatment. <b><i>Methods:</i></b> Patients with diagnosed opioid dependence undergoing low-threshold OAT at the Bergen delivery platform in Norway were enrolled in a cohort study in 2014–2019. A national OAT cohort was the reference group. The main outcomes were treatment retention, the use of illicit opioids, non-fatal overdose, overdose death, and all-cause mortality during the first year following treatment initiation and the full treatment period. Additionally, healthcare utilization in the periods before and during OAT was investigated. <b><i>Results:</i></b> Compared to the reference cohort, the low-threshold cohort (<i>n</i> = 128, mean age: 38 years, women: 28%) showed treatment retention rates of 95% versus 92%, illicit opioid use of 7% versus 10%, non-fatal overdose of 7% versus 6%, and death at 1.0% versus 1.3%, respectively. The incident rate ratios (IRRs) for healthcare utilization increased substantially during the OAT period compared to the period before; the IRR increased by 3.3 (95% confidence interval (CI): 2.8, 3.9) and 3.4 (95% CI: 3.1, 3.9) for all in- and outpatient healthcare, respectively. <b><i>Conclusions:</i></b> Low-threshold OAT was at least as effective and safe as the standard OAT in terms of treatment retention, the use of illicit opioids, non-fatal overdose, and death. Healthcare utilization increased during the OAT compared to the period before. Lowering the threshold for OAT entrance within proper delivery platforms should be broadly considered to reduce harm and improve healthcare access among patients with opioid dependence.

Nasal Opioid Agonist Treatment in Patients with Severe Opioid Dependence: A Case Series

2021 ◽  
Vol 28 (1) ◽  
pp. 80-86
Author(s):  
Marc Vogel ◽  
Patrick Köck ◽  
Johannes Strasser ◽  
Christoph Kalbermatten ◽  
Hannes Binder ◽  
...  
Keyword(s):  
Opioid Dependence ◽  
Case Series ◽  
Rapid Onset ◽  
First Line ◽  
Opioid Agonist ◽  
Onset Of Action ◽  
Opioid Agonist Treatment ◽  
Routes Of Administration ◽  
Alternative Treatment Option ◽  
Insufficient Response

<b><i>Introduction:</i></b> Opioid agonist treatment (OAT) is the first-line treatment for opioid dependence. Currently available OAT options comprise oral (methadone and morphine) and sublingual (buprenorphine) routes of administration. In Switzerland and some other countries, severely opioid-dependent individuals with insufficient response to oral or sublingual OAT are offered heroin-assisted treatment (HAT), which involves the provision of injected or oral medical heroin (diacetylmorphine [DAM]). However, many patients on treatment with injectable DAM (i-HAT) suffer from injection-related problems such as deteriorated vein status, ulcerations, endocarditis, and abscesses. Other patients who do not respond to oral OAT do not inject but snort opioids, and are not eligible for i-HAT. For this population, there is no other short-acting OAT with rapid onset of action available unless they switch to injecting, which is associated with higher risks. Nasal DAM (n-HAT) could be an alternative treatment option suitable for both populations of patients. <b><i>Methods:</i></b> We present a case series of 3 patients on i-HAT who successfully switched to n-HAT. <b><i>Results/Conclusions:</i></b> This is the first description of the clinical use of the nasal route of administration for HAT. n-HAT may constitute an important risk-reduced rapid-onset alternative to i-HAT. In particular, it may be suited for patients with injection-related complications, or noninjecting opioid-dependent patients failing to respond to oral OAT.

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