scholarly journals Rates of opioid agonist treatment prescribing in provincial prisons in Ontario, Canada, 2015–2018: a repeated cross-sectional analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e048944
Author(s):  
Claire Bodkin ◽  
Susan Bondy ◽  
Leonora Regenstreif ◽  
Lori Kiefer ◽  
Fiona Kouyoumdjian
Keyword(s):  
General Population ◽  
Scale Up ◽  
Unmet Need ◽  
Opioid Overdose ◽  
Opioid Agonist ◽  
Access To Treatment ◽  
Monthly Basis ◽  
Cross Sectional ◽  
Opioid Agonist Treatment ◽  
Need For Treatment

ObjectiveTo describe opioid agonist treatment prescribing rates in provincial prisons and compare with community prescribing rates.DesignWe used quarterly, cross-sectional data on the number and proportion of people prescribed opioid agonist treatment in prison populations. Trends were compared with Ontario surveillance data from prescribers, reported on a monthly basis.SettingProvincial prisons and general population in Ontario, Canada between 2015 and 2018.ParticipantsAdults incarcerated in provincial prisons and people ages 15 years and older in Ontario.Main outcomes and measuresOpioid agonist treatment prescribing prevalence, defined as treatment with methadone or buprenorphine/naloxone.ResultsIn prison, 6.9%–8.4% of people were prescribed methadone; 0.8% to 4.8% buprenorphine/naloxone; and 8.2% to 13.2% either treatment over the study period. Between 2015 and 2018, methadone prescribing prevalence did not substantially change in prisons or in the general population. The prevalence rate of buprenorphine/naloxone prescribing increased in prisons by 1.70 times per year (95% CI 1.47 to 1.96), which was significantly higher than the increase in community prescribing: 1.20 (95% CI 1.19 to 1.21). Buprenorphine/naloxone prescribing prevalence was significantly different across prisons.ConclusionsThe increase in opioid agonist treatment prescribing between 2015 and 2018 in provincial prisons shows that efforts to scale up access to treatment in the context of the opioid overdose crisis have included people who experience incarceration in Ontario. Further work is needed to understand unmet need for treatment and treatment impacts.

scholarly journals Correlates of HIV Risky Sexual Behaviours in an Era of Antiretroviral Therapy Scale‐Up: A Cross-Sectional Study among the Adult General Population in Nasarawa State, Nigeria

2019 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
I A Bako ◽  
J O. Anyanti ◽  
A Roca-Feltrer
Keyword(s):  
Sexual Behavior ◽  
General Population ◽  
Risky Sexual Behavior ◽  
Scale Up ◽  
Outcome Variable ◽  
Cluster Sampling ◽  
Community Based Interventions ◽  
Cross Sectional ◽  
Sexual Behaviours ◽  
Risky Sexual Behaviours

Analyses of HIV incidence in Nasarawa State Nigeria estimate that most of the new HIV infections occur among persons who reported low HIV risk including couples. The study was aimed at identifying the factors that predict risky sexual behavior among the general population in Nasarawa state, Nigeria. Data analysis was carried on a total of 801 respondents sampled from the general population of Nasarawa State, Nigeria. The original sample was obtained through a two-stage cluster sampling technique using probability proportionate to size. The primary outcome variable was risky sexual behavior. Chi-square and logistic regression analyses were used to determine the association between the outcome and selected Sociodemographic and other independent variables. Females were 54.2% of the total sampled population analysed, the mean age of the respondents was 29.8 years (SD: 10.3). About two-third of the respondents engaged in risky sexual behaviours (65.9%) but only 4.7% considered themselves to be at high risk of HIV. The multivariable regression analysis showed that factors associated with risky sexual behaviour included : been male sex [OR: 0.63; 95% CI: 0.436-0.915], married [OR: 0.26: 95% CI: 0.163 - 0.419], rural resident [OR: 1.20; 95% CI: 0.775 to 1.871 ], age 20-24 [OR: 1.93, 95% CI: 1.113 - 3.360] and 25-29 years [OR: 2.34; 95% CI: 1.267-1.308]; and knowledge of HIV [OR: 1.49; 95% CI: 1.056-2.108].There is a need to urgently intensify media campaigns, community-based interventions including one on one communications to reduce risky sexual behaviours.

scholarly journals Correlates of HIV Risky Sexual Behaviours in an Era of Antiretroviral Therapy Scale‐Up: A Cross-Sectional Study among the Adult General Population in Nasarawa State, Nigeria

2019 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
I A Bako ◽  
J O. Anyanti ◽  
A Roca-Feltrer
Keyword(s):  
Sexual Behavior ◽  
General Population ◽  
Risky Sexual Behavior ◽  
Scale Up ◽  
Outcome Variable ◽  
Cluster Sampling ◽  
Community Based Interventions ◽  
Cross Sectional ◽  
Sexual Behaviours ◽  
Risky Sexual Behaviours

Analyses of HIV incidence in Nasarawa State Nigeria estimate that most of the new HIV infections occur among persons who reported low HIV risk including couples. The study was aimed at identifying the factors that predict risky sexual behavior among the general population in Nasarawa state, Nigeria. Data analysis was carried on a total of 801 respondents sampled from the general population of Nasarawa State, Nigeria. The original sample was obtained through a two-stage cluster sampling technique using probability proportionate to size. The primary outcome variable was risky sexual behavior. Chi-square and logistic regression analyses were used to determine the association between the outcome and selected Sociodemographic and other independent variables. Females were 54.2% of the total sampled population analysed, the mean age of the respondents was 29.8 years (SD: 10.3). About two-third of the respondents engaged in risky sexual behaviours (65.9%) but only 4.7% considered themselves to be at high risk of HIV. The multivariable regression analysis showed that factors associated with risky sexual behaviour included : been male sex [OR: 0.63; 95% CI: 0.436-0.915], married [OR: 0.26: 95% CI: 0.163 - 0.419], rural resident [OR: 1.20; 95% CI: 0.775 to 1.871 ], age 20-24 [OR: 1.93, 95% CI: 1.113 - 3.360] and 25-29 years [OR: 2.34; 95% CI: 1.267-1.308]; and knowledge of HIV [OR: 1.49; 95% CI: 1.056-2.108].There is a need to urgently intensify media campaigns, community-based interventions including one on one communications to reduce risky sexual behaviours.

scholarly journals Opioid Agonist Treatment and Risk of Mortality During an Opioid Overdose Public Health Emergency: A Population-Based Retrospective Cohort Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Lindsay A Pearce ◽  
Jeong Eun Min ◽  
Micah Piske ◽  
Haoxuan Zhou ◽  
Fahmida Homayra ◽  
...  
Keyword(s):  
Relative Risk ◽  
Illicit Drug ◽  
Opioid Overdose ◽  
Drug Supply ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Risk Of Death ◽  
Synthetic Opioids ◽  
Risk Of Mortality ◽  
Stopping Treatment

IntroductionOpioid agonist treatment (OAT) is a safe and effective treatment for opioid use disorder (OUD). However, people commonly stop and start OAT and their risk of death is high immediately after stopping. The prevalence of illicitly manufactured fentanyl and other highly potent synthetic opioids have increased in the illicit drug supply globally. Yet, there is limited evidence examining the relationship between OAT and mortality when these contaminants are widely available in the illicit drug supply. Objectives and ApproachWe aimed to compare the risk of mortality on and off OAT in a setting with a high prevalence of illicitly manufactured fentanyl and other potent synthetic opioids in the illicit drug supply. We linked five health administrative datasets in British Columbia, Canada, creating a cohort of 55,347 people with OUD who received OAT during a 23-year period (1996 to 2018). We compared the risk of mortality on and off treatment over time, and according to time since starting or stopping treatment and by medication type. Results7,030 of 55,347 (12.7%) OAT recipients died during follow-up. All-cause SMR was substantially lower on OAT (4.6 [4.4 to 4.8]) compared to off OAT (9.7 [9.5 to 10.0]). In a period of increasing prevalence of fentanyl, the relative risk of mortality off OAT was 2.1 [1.8 to 2.4] times higher than on OAT prior to the introduction of fentanyl, and increased to 3.4 [2.8 to 4.3] at the end of the study period (65% increase in relative risk). Conclusion / ImplicationsThe protective effect of OAT on mortality increased as fentanyl and other synthetic opioids became common in the illicit drug supply, while the risk of mortality remained high off OAT. As fentanyl becomes more widespread globally, these findings highlight the importance of interventions that improve retention on opioid agonist treatment and prevent recipients from stopping treatment.

scholarly journals Understanding Steps and Challenges to Take-home Naloxone and Buprenorphine/naloxone Implementation in Québec Emergency Rooms: Suboxed Project

2020 ◽  
Author(s):  
Annie Talbot ◽  
Rania Khemiri ◽  
Luc Londei-Leduc ◽  
Christine Robin ◽  
Suzanne Marcotte ◽  
...  
Keyword(s):  
At Risk ◽  
Governance Structure ◽  
The United States ◽  
Opioid Overdose ◽  
Emergency Rooms ◽  
Opioid Agonist ◽  
Clinical Algorithm ◽  
Opioid Agonist Treatment ◽  
System A ◽  
Clinical Culture

Abstract BackgroundDeaths attributable to drug abuse are on the rise across Canada. It is estimated that there were more than 13,900 opioid-related deaths from January 2016 to June 2019 in the country. Emergency departments (EDs) are often on the frontline of care provided to people at risk of opioid overdose within Québec’s healthcare system. A variety of programs to implement take-home naloxone distribution and/or the provision of opioid agonist treatment for ED patients who are at risk for overdose have been created in the United States and in Europe. However, few EDs in Canada have developed protocols for the provision of take-home naloxone and/or opioid agonist treatment by ED doctors.MethodsA clinical algorithm for take home naloxone (THN) and prescription of buprenorphine/naloxone (B/N) was implemented in three EDs of Québec, Canada. This first phase of the SuboxED project required selecting clinical experts, describing the patient population, and creating partnerships with pharmacists and opioid agonist treatment clinics.Results:The clinical experts developed tools based on literature reviews and national and international guidelines. They also created educational tools and trained over 328 ED clinical staff. In addition, SuboxED ensured that a supply of take-home naloxone and B/n was available in the three ED sites for the study.ConclusionImplementing the proposed clinical algorithm for THN and prescription of B/N was challenging: drug supply and ED staff’s buy-in were among the most notable difficulties of SuboxED. Planning training sessions at three different institutions, each with its own governance structure and clinical culture, local realities and harm reduction priorities was complicated. Engaging already overworked ED teams consistently working in a gridlocked environments, revealed in itself to be a difficult endeavour.In the next phase of SuboxED, we will focus on data collection and analysis to evaluate both the implementation of the protocol through a retrospective review of electronic health records and satisfaction surveys of patients and healthcare professionals.Trial registration: none

scholarly journals Opioid agonist treatment scale-up and the initiation of injection drug use: A dynamic modeling analysis

PLoS Medicine ◽  
2019 ◽  
Vol 16 (11) ◽  
pp. e1002973 ◽  
Author(s):  
Charles Marks ◽  
Annick Borquez ◽  
Sonia Jain ◽  
Xiaoying Sun ◽  
Steffanie A. Strathdee ◽  
...  
Keyword(s):  
Drug Use ◽  
Injection Drug Use ◽  
Dynamic Modeling ◽  
Scale Up ◽  
Injection Drug ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Modeling Analysis

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 Cross-sectional assessment of predictors for COVID-19 vaccine uptake: an online survey in Greece

2021 ◽  
Author(s):  
Petros A Galanis ◽  
Irene Vraka ◽  
Olga Siskou ◽  
Olympia Konstantakopoulou ◽  
Aglaia Katsiroumpa ◽  
...  
Keyword(s):  
General Population ◽  
Online Survey ◽  
Demographic Data ◽  
Scale Up ◽  
Cross Sectional Study ◽  
Vaccination Rate ◽  
Vaccine Uptake ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Level Of Education

Background: A high level of COVID-19 vaccine uptake in the general population is essential to control the pandemic. Objective: To estimate the percentage of the general population vaccinated against the COVID-19 and to investigate the factors associated with COVID-19 vaccine uptake. Methods: We conducted an online cross-sectional study in Greece during August 2021. We included individuals over 18 years of age. Independent variables included socio-demographic data of the participants and attitudes towards COVID-19 vaccination and pandemic. Our outcome variable was COVID-19 vaccination status, measured through yes/no answers. Results: Most participants had been vaccinated against the COVID-19 (87.8%), while about half had been vaccinated against influenza (52.5%). Multivariate analysis identified that increased age and a higher level of education were associated with an increased likelihood of COVID-19 vaccination. Also, participants working in health services, participants without a previous COVID-19 diagnosis, and those with previous seasonal influenza vaccination history had a greater probability to take a COVID-19 vaccine. Additionally, increased self-perceived severity of COVID-19, knowledge regarding COVID-19, and trust in COVID-19 vaccines and scientists were associated with COVID-19 vaccine uptake. On the other hand, the likelihood of vaccination was lower for participants who were more concerned about the side effects of COVID-19 vaccination. Conclusions: Understanding the factors affecting individuals decision to take a COVID-19 vaccine is essential to improve the COVID-19 vaccination coverage rate. Policymakers and scientists should scale up their efforts to increase the COVID-19 vaccination rate among specific population groups such as young people, people with a low level of education, people with negative attitudes towards vaccination, etc.

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