The Long-Term Outcomes of Drug Use by Methadone Maintenance Patients

<p>Background: The aim of this study is to investigate the association between problematic drug use (PDU) and social exclusion and stigma in a deindustrialised New Zealand town (DNZT). The purpose of this research is to capture the perceptions; experiences and life course journey of individuals with long term problematic drug use (IPDUs) and contribute new knowledge and understanding of this lived experience. Method: A review of national and international literature related to the phenomena of social exclusion, stigmatisation and problematic drug use was conducted to theoretically inform the study. The small-scale study employed a qualitative approach that involved a non-probability sample that met the criteria for long-term problematic drug use. This allowed respondents to share their perceptions and experiences of social exclusion, stigma and PDU in their own words and by their own frames of reference. The researcher occupied a position of insider. Following transcription of the interviews a six stage thematic analysis was conducted on the data. Findings: The downward social and psychological trajectory of this respondent group began before the respondents encountered long-term unemployment and before the onset of problematic drug use, initiated at an early age by common experiences of trauma, exclusion and damaged home environments. For this cohort it appears problematic drug use may have become a coping mechanism or relief from the reverberating impact of stigma, exclusion and marginalisation. Conclusion: The cohort interviewed show significant experiences of stigma, trauma and a disrupted life journey. These experiences became considerably exacerbated by problematic drug use and it appears most of the respondents have internalised and embraced a permanent status as ‘addicts’ with limited expectation of change. Respondents spoke of being ‘parked’ on methadone in respect of their drug problem and excluded from employment. This research suggests there is a need to look beyond the presented problem of addiction and its apparent solution of methadone maintenance treatment (MMT) and explore a more holistic strength-based approach that addresses issues of inequality, social care and discrimination.</p>

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Long-Term Outcomes of Psychoactive Drug Use in Trauma Patients

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000003032 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Mohamad El Moheb ◽

Juan P. Herrera-Escobar ◽

Kerry Breen ◽

Claudia Orlas ◽

Ashley N. Haynes ◽

...

Keyword(s):

Drug Use ◽

Psychoactive Drug ◽

Trauma Patients ◽

Long Term Outcomes

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Surgery in drug use-associated infective endocarditis: long-term survival is negatively affected by recurrence

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz302 ◽

2019 ◽

Vol 30 (4) ◽

pp. 528-534 ◽

Cited By ~ 1

Author(s):

Vilem Rohn ◽

Branislav Laca ◽

Milan Horn ◽

Lukas Vlk ◽

Petra Antonova ◽

...

Keyword(s):

Drug Use ◽

Intravenous Drug ◽

Long Term Outcomes ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Number Of Patients ◽

Significant Difference

Abstract OBJECTIVES The prevalence of infectious endocarditis (IE) in intravenous drug users (IDUs) is increasing, and the number of patients who need surgery is also rising. Relatively little is known about the short-term and long-term outcomes of these operations. METHODS This study is a retrospective analysis of our institutional results, focussing on risk factors for perioperative death, major adverse events and long-term survival. A total of 50 of the 66 (75.75%) patients had postoperative follow-up, and the mean follow-up time was 53.9 ± 9.66 months. Patients were divided into 2 groups depending on whether they were having their first operation or were being reoperated for recurrent IE. RESULTS From March 2006 to December 2015, a total of 158 patients underwent surgery for IE; 72 (45.6%) of them were identified as active IDUs. The operative mortality in IDUs was 8.33% (6 patients), with no significant difference between the 2 groups (P = 0.6569). Survival rates at 1 year, at 3 years and at the end of follow-up were 92%, 72% and 64%, respectively. There was significantly worse survival of patients with recurrent IE (log-rank test, P = 0.03). CONCLUSIONS Although the short-term results of operation for IE in IDUs are good, long-term outcomes are not satisfactory. The survival of patients with recurrence of IE caused by return to intravenous drug use is significantly worse.

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Long-term outcomes of protease inhibitor-based therapy in antiretroviral treatment-naive HIV-infected injection drug users on methadone maintenance programmes

AIDS ◽

10.1097/00002030-200105250-00021 ◽

2001 ◽

Vol 15 (8) ◽

pp. 1068-1070 ◽

Cited By ~ 16

Author(s):

Ana Moreno ◽

María J. Perez-Elías ◽

Jose L. Casado ◽

Vicente Muñoz ◽

Antonio Antela ◽

...

Keyword(s):

Protease Inhibitor ◽

Injection Drug Users ◽

Drug Users ◽

Antiretroviral Treatment ◽

Methadone Maintenance ◽

Injection Drug ◽

Long Term Outcomes ◽

Treatment Naïve

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Long-term outcomes of intravenous drug use associated infective endocarditis: a contemporary 20-year study

European Heart Journal ◽

10.1093/eurheartj/ehab724.2770 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

I Khan ◽

E Brookes ◽

J Santamaria ◽

A Wilson ◽

J Darby ◽

...

Keyword(s):

Infective Endocarditis ◽

Drug Use ◽

Sample Size ◽

Intravenous Drug ◽

P Value ◽

Intravenous Drug Use ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival

Abstract Introduction Intravenous drug use (IVDU) associated infective endocarditis (IE) is a clinically challenging case. Not only can the natural history of IE in the IVDU population be significantly different, making detection a diagnostic dilemma, additional social factors associated with this population can drastically change management, including suitability for surgery or long-term intravenous access for antibiotics Furthermore, the rates of IVDU are increasing globally, leading to increasing incidence of IVDU associated IE. Purpose With a lack of clear mangement guidelines for IVDU associated IE, our study assesses the differences in presentation, management and long-term prognosis of IE between the IVDU population and the non-IVDU population to help guide future care. Methods This is an observational cohort study on a prospectively collected database of 350 patients treated for IE at our centre between 1999 and 2015. Patients were followed-up until death or January 2021. The primary outcome was all-cause mortality. Continuous variables were compared using unpaired t-test. Categorical variables were compared using Chi-square test when sample size was >5 or Fisher's exact test when sample size was ≤5. Long-term survival data was analysed using Kaplan-Meier survival curves. Results The IVDU population was younger, more likely to have concurrent infections and other substance use, while the non-IVDU population was older with a higher level of overall comorbidity. IVDU patients were more likely to become reinfected (p-value=0.034) but had better long-term survival compared to the non-IVDU population (p<0.001). Survival estimates at 15-years were 64.98% (95% CI: 50.94–75.92%) for the IVDU population compared to 26.67% (95% CI: 19.76–34.05%) for the non-IVDU population (p-value<0.0001). Conclusion Despite having higher levels of reinfection, IVDU patients have better long-term outcomes of IE compared to non-IVDU patients. Therefore, IVDU patients should not have blanket restrictions on the management they are offered unless the individual has clear contraindications to a particular therapy. FUNDunding Acknowledgement Type of funding sources: None.

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