The Cannabis-Dependent Relationship Between Methadone Treatment Dose and Illicit Opioid Use in a Community-Based Cohort of People Who Use Drugs

Author(s):  
Stephanie Lake ◽  
Thomas Kerr ◽  
Jane Buxton ◽  
Zach Walsh ◽  
Ziva D. Cooper ◽  
...  
2021 ◽  
Author(s):  
Ellis Jaewon Yeo ◽  
Hannah Kralles ◽  
David Sternberg ◽  
Dana McCullough ◽  
Ajetha Nadanasabesan ◽  
...  

Abstract BackgroundThe COVID-19 pandemic has had especially devastating effects on people who use drugs. Due to pandemic protocols in the United States, medication-assisted treatment (MAT) regulations became more flexible, permitting our community-based nonprofit organization to transition its low-threshold MAT clinic to an audio-only telehealth model of care in 2020. Case PresentationThis case study describes our transition from a low-threshold community-based in-person MAT clinic to an audio-only telehealth model. We extracted data from electronic health records to describe patient characteristics and to calculate treatment retention rates. We measure the success of our intervention relative to published retention rates, both overall as well as for in-person and telehealth care. ConclusionsLow-threshold medication-assisted treatment in the care of people with opioid use disorder is essential to increasing treatment access and continuity. We found that an audio-only telehealth model was viable. Although we had decreased retention rates following the transition to an audio-only telehealth model, our rates remained excellent compared to published values for in-person MAT care. We call for advocacy and regulations to support continued use of telehealth services throughout and beyond the COVID-19 pandemic.


PLoS Medicine ◽  
2019 ◽  
Vol 16 (11) ◽  
pp. e1002967 ◽  
Author(s):  
Stephanie Lake ◽  
Zach Walsh ◽  
Thomas Kerr ◽  
Ziva D. Cooper ◽  
Jane Buxton ◽  
...  

2021 ◽  
Vol 7 ◽  
pp. 205032452110349
Author(s):  
Dang Minh Hieu ◽  
Benjamin Gray ◽  
Dang Minh Tuan ◽  
Benjamin P Colman

Drug addiction is a historical issue in Vietnam. Although Vietnam has a long history as a producer of opium poppies and crossroads for the illicit drug trade, it is now has some of the most stringent drug laws in the world. Vietnam has shown some success in reducing the production, trade, and transportation of narcotics. There has also been a shift in the attitudes of lawmakers and government authorities toward viewing drug abuse as a health problem rather than a social vice. Educating and encouraging citizens to collaboratively reduce drug use has also proven effective. However, despite these changes, the number of people who use drugs has increased in recent years. The US, too, has also experienced an increase in illicit opioid use. The Trump administration declared opioid addiction a public health emergency and has established goals to address the crisis. The results of these efforts have also been uneven. This article reviews Vietnam’s efforts to tackle its opioid epidemic, with the goal of identifying areas where Vietnam’s approach to opioid addiction may be improved. A brief overview of efforts by the U.S. government, an important foreign partner for Vietnam in the control of illicit opioids, serves to demonstrate the difficulty of treating opioid use in different political systems.


Author(s):  
Wayne Jones ◽  
Lenka Vojtila ◽  
Paul Kurdyak ◽  
Benedikt Fischer

Abstract Canada has been home to comparatively extreme developments in prescription opioid (PO) availability and related harms (e.g. morbidity, mortality) post-2000. Following persistent pan-Canadian increases in PO use, select control measures were implemented and PO dispensing levels—while only inconsistently by province—inverted, and began to plateau or decrease post-2012. We examined annual PO dispensing levels in Canada up until 2018, based on representative prescription sample data from community-based retail pharmacies. Annual prescription-based dispensing data were converted into defined daily doses/1000 population/day by province, and mainly categorized into ‘weak’ and ‘strong’ opioids. All provinces indicated decreasing trends in strong PO levels in most recent years, yet with inter-provincial differences of up to one magnitude in 2018; in about half the provinces, dispensing fell to below-2005 levels. British Columbia had the largest decline in strong PO dispensing from its peak rate (− 48.5%) in 2011. Weak opioid dispensing trends remained more inconsistent and bifurcated across Canada. The distinct effects of individual—including many provincially initiated and governed—PO control measures urgently need to be evaluated. In the meantime, recent reductions in general PO availability across Canada appear to have contributed to shortages in opioid supply for existent, sizable (including non-medical) user populations and may have contributed to recent marked increases in illicit opioid use and harms (including rising deaths).


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ellis Jaewon Yeo ◽  
Hannah Kralles ◽  
David Sternberg ◽  
Dana McCullough ◽  
Ajetha Nadanasabesan ◽  
...  

Abstract Background The COVID-19 pandemic has had especially devastating effects on people who use drugs. Due to pandemic protocols in the USA, medication-assisted treatment (MAT) regulations became more flexible, permitting our community-based nonprofit organization to transition its low-threshold MAT clinic to an audio-only telehealth model of care in 2020. Lessons learned have the potential to improve MAT delivery to people with OUD. Case presentation This case study describes our transition from a low-threshold community-based in-person MAT clinic to an audio-only telehealth model. We extracted data from electronic health records to describe patient characteristics and to calculate treatment retention rates. Patients were predominantly male (74.4%) and black (90.6%). The mean age was 53 years old with more than half of the clients aged 55 or older. Less than half (42.3%) of the patients lived in stable housing. Patients commonly had self-reported comorbid conditions such as hypertension (35.4%), hepatitis C (23.5%), diabetes (11.9%), human immunodeficiency virus (HIV) (7.2%). A majority of patients (68.6%) reported engagement with behavioral health care. We measure the success of our intervention relative to published retention rates, both overall as well as for in-person and telehealth care. In-person retention rates at 90- and 180-days were substantially higher than telehealth retention rates (93.9% vs 68.4% and 91.5% vs 51.9%, respectively). Conclusions Low-threshold medication-assisted treatment in the care of people with opioid use disorder is essential to increasing treatment access and continuity. We found that an audio-only telehealth model was viable. Although we had decreased retention rates following the transition to an audio-only telehealth model, our rates remained excellent compared to published values for in-person MAT care. We call for advocacy and regulations to support continued use of telehealth services throughout and beyond the COVID-19 pandemic.


2012 ◽  
Author(s):  
Lianping Ti ◽  
◽  
Despina Tzemis ◽  
Margot Kuo ◽  
Jane Buxton

2020 ◽  
Author(s):  
Genevieve Fullerton Dash ◽  
Nicholas G. Martin ◽  
Arpana Agrawal ◽  
Michael Lynskey ◽  
Wendy S. Slutske

Background. Drug classes are grouped based on their chemical and pharmacological properties, but prescription and illicit drugs differ in other important ways. Opioid and stimulant classes contain prescription and illicit forms differentially associated with salient risk factors (common route of administration, legality), making them useful comparators for examining the potential differences in the etiological influences on (mis)use of prescription and illicit drugs. Methods. 2,410 individual Australian twins (Mage=31.77 [SD=2.48]; 67% women) were interviewed about prescription misuse and illicit use of opioids and stimulants. Univariate and bivariate biometric models partitioned variances and covariances into additive genetic, shared environmental, and unique environmental influences across drug types. Results. Variation in the propensity to misuse prescription opioids was primarily attributable to genes (37%) and unique environment (59%). Illicit opioid use was attributable to shared (71%) and unique (29%) environment. Prescription stimulant misuse was primarily attributable to genes (78%) and unique environment (21%). Illicit stimulant use was influenced by genes (48%), and shared (29%) and unique environment (23%). There was evidence for genetic influence common to both stimulant types, but limited evidence for genetic influence common to both opioid types. Conclusions. Prescription opioid misuse may share little genetic influence with illicit opioid use. Future research may consider avoiding unitary drug classifications, particularly when examining genetic influences.


2021 ◽  
pp. 1-8
Author(s):  
Genevieve F. Dash ◽  
Nicholas G. Martin ◽  
Arpana Agrawal ◽  
Michael T. Lynskey ◽  
Wendy S. Slutske

Abstract Background Drug classes are grouped based on their chemical and pharmacological properties, but prescription and illicit drugs differ in other important ways. Potential differences in genetic and environmental influences on the (mis)use of prescription and illicit drugs that are subsumed under the same class should be examined. Opioid and stimulant classes contain prescription and illicit forms differentially associated with salient risk factors (common route of administration, legality), making them useful comparators for addressing this etiological issue. Methods A total of 2410 individual Australian twins [Mage = 31.77 (s.d. = 2.48); 67% women] were interviewed about prescription misuse and illicit use of opioids and stimulants. Univariate and bivariate biometric models partitioned variances and covariances into additive genetic, shared environmental, and unique environmental influences across drug types. Results Variation in the propensity to misuse prescription opioids was attributable to genes (41%) and unique environment (59%). Illicit opioid use was attributable to shared (71%) and unique (29%) environment. Prescription stimulant misuse was attributable to genes (79%) and unique environment (21%). Illicit stimulant use was attributable to genes (48%), shared environment (29%), and unique environment (23%). There was evidence for genetic influence common to both stimulant types, but limited evidence for genetic influence common to both opioid types. Bivariate correlations suggested that prescription opioid use may be more genetically similar to prescription stimulant use than to illicit opioid use. Conclusions Prescription opioid misuse may share little genetic influence with illicit opioid use. Future research may consider avoiding unitary drug classifications, particularly when examining genetic influences.


2021 ◽  
pp. 107182
Author(s):  
Cara A. Struble ◽  
Jamey J. Lister ◽  
Joseph Urbiel ◽  
Amesika N. Nyaku ◽  
Cynthia L. Arfken

Sign in / Sign up

Export Citation Format

Share Document