scholarly journals Neurocognitive interventions based on network neuroscience may break the cycle of drug addiction relapse

2020 ◽  
Vol 3 (2) ◽  
pp. 15-22
Author(s):  
Kavinash Loganathan ◽  
Eric Tatt Wei Ho
Keyword(s):  
Substance Abuse ◽  
Harm Reduction ◽  
Drug Addiction ◽  
Methadone Maintenance ◽  
Brain Activity ◽  
Well Being ◽  
Cognitive Networks ◽  
Cognitive Interventions ◽  
The Impact ◽  
Network Neuroscience

In Malaysia, abstinence-centric programs failed to reduce drug use and stem the spread of HIV. The Malaysian government shifted its focus to implement harm reduction strategies with methadone maintenance therapy (MMT), in particular proving to be effective in improving the overall health and well-being of people who inject drugs (PWIDs). Despite this success, MMT retention rates remain low, as methadone is only able to stall drug consumption, but not stop it completely. Neuroimaging research revealed that PWIDs enrolled in MMT still display addictive behavior, including drug cue sensitivity, craving, and withdrawal, despite treatment adherence. Brain activity amongst treated PWIDs continues to bear similarities to untreated individuals, as they struggle with cognitive impairments and poor self-control. Findings from the emerging field of network neuroscience could provide fresh insight into the mechanics of addiction, especially the impact of substance abuse on brain-wide cognitive networks. Concurrently, the development of non-intrusive cognitive interventions, such as neurofeedback and transcranial magnetic stimulation, shows promise to reprogram a person's patterns of brain activity, including those regulated by large-scale networks, to a state resembling normalcy. We highlight the importance of relapse in the life-long rehabilitation of substance abuse. The lack of treatment options to handle relapse after successful harm-reduction policies is due to the absence of a conceptual framework to reason about interventions. We review recent research in the new field of network neuroscience, which suggests that altered brain activity due to drug addiction underlies the propensity for relapse and that this dysfunction is not addressed in drug rehabilitation programs. We hypothesize that non-invasive, non-pharmacological cognitive interventions based on network neuroscience to correct brain activity dysfunction associated with addiction are potential therapies to treat drug addiction relapse. In complement with medicine-substitution-based therapies, we hope this approach will finally break the cycle of addiction.

scholarly journals Outpatient methadone maintenance treatment program Quality of life and health of opioid-dependent persons in Lithuania

Medicina ◽  
2006 ◽  
Vol 43 (3) ◽  
pp. 235 ◽  
Author(s):  
Žilvinas Padaiga ◽  
Emilis Subata ◽  
Giedrius Vanagas
Keyword(s):  
Quality Of Life ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Perceived Health ◽  
Well Being ◽  
Life Study ◽  
Assess Quality ◽  
The Impact

Background. The evaluation of quality of life and self-perceived health represents an assessment of the impact of treatment on patient functioning and well-being. Objective. Our aim was to explore the impact of methadone maintenance treatment on quality of life and self-perceived health of opioid-dependent persons in Lithuania. Methods. A total of 102 opioid-dependent patients were recruited in the study. A prospective follow-up study design was used. To assess quality of life, the WHOQOL-BREF 26-item version was used. The impact of methadone maintenance treatment on self-perceived health was assessed by Opiate Treatment Index (OTI). Results. Following 6 months of methadone maintenance treatment, significant improvements in physical (P=0.004), psychological (P=0.004), and environmental (P=0.048) components of quality of life were observed; no statistically significant improvements were found in social component of quality of life. Study participants reported lower rates of medical morbidity associated with injection (P<0.001), cardiorespiratory (P=0.034), musculoskeletal (P<0.001), neurological (P=0.013), gastrointestinal (P<0.001), and general health (P<0.001). Conclusions. Methadone maintenance treatment substantially reduces morbidity associated with opioid dependence and improves the quality of life of patients.

scholarly journals The impact of the COVID-19 pandemic on harm reduction services in Spain

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Camila A. Picchio ◽  
Jorge Valencia ◽  
Jason Doran ◽  
Tracy Swan ◽  
Marta Pastor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Harm Reduction ◽  
Social Services ◽  
Methadone Maintenance ◽  
The State ◽  
People Who Use Drugs ◽  
Service Users ◽  
Cross Sectional ◽  
The Impact ◽  
Disease Testing

Abstract Background Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. Methods This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers. Results All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for 2 months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses, human immunodeficiency virus, and tuberculosis) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm. Conclusion Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy.

scholarly journals The impact of the COVID-19 pandemic on harm reduction services in Spain

2020 ◽  
Author(s):  
Camila A Picchio ◽  
Jorge Valencia ◽  
Jason Doran ◽  
Tracy Swan ◽  
Marta Pastor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Harm Reduction ◽  
Social Services ◽  
Methadone Maintenance ◽  
The State ◽  
People Who Use Drugs ◽  
Service Users ◽  
Cross Sectional ◽  
The Impact ◽  
Disease Testing

Abstract Background: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain.Methods: This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers.Results: All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for two months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses [HBV, HCV], human immunodeficiency virus (HIV), and tuberculosis [TB]) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm.Conclusion: Overall, like other European countries, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment (methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy).

Designing meditation for doctor well-being: can ‘Om’ help obstetrics and gynaecology doctors?

2020 ◽  
Vol 28 (3) ◽  
pp. 342-347 ◽  
Author(s):  
Rosie Allen ◽  
Andrew Robinson ◽  
Shelley Allen ◽  
Elizabeth Nathan ◽  
Edwina Coghlan ◽  
...  
Keyword(s):  
Stress Responses ◽  
Salivary Cortisol ◽  
Physiological Stress ◽  
Brain Activity ◽  
High Stress ◽  
Depression Scale ◽  
Well Being ◽  
Brain Wave ◽  
Obstetrics And Gynaecology ◽  
The Impact

Objective: The study aimed to measure the impact of meditation on participants’ ability to regulate brain wave activity in high-stress situations, control physiological stress responses and improve subjective wellbeing. Methods: Twelve obstetrics and gynaecology (O&G) doctors meditated for 20 minutes daily for 21 days utilising a portable EEG (electroencephalogram) providing instantaneous audio feedback. Their brain activity levels and salivary cortisol were measured before and after performing three surgical procedures. Participants were interviewed about their experiences and completed self-ratings of distress (e.g. DASS-21, Depression, Anxiety and Depression Scale). Data were analysed statistically and thematically. Results: (a) Measures of pre- and post-operative brain activity showed no significantly higher levels of alpha waves. (b) Pre- and post-operative salivary cortisol levels did not significantly decrease. (c) DASS-21 scores showed significant decreases in levels of anxiety and stress. Conclusion: Results suggest that, with biofeedback meditation, O&G doctors can learn to reduce situational stress and improve mood overall through a focussed intervention.

scholarly journals The impact of the COVID-19 pandemic on harm reduction services in Spain

2020 ◽  
Author(s):  
Camila A Picchio ◽  
Jorge Valencia ◽  
Jason Doran ◽  
Tracy Swan ◽  
Marta Pastor ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Harm Reduction ◽  
Social Services ◽  
Methadone Maintenance ◽  
The State ◽  
People Who Use Drugs ◽  
Service Users ◽  
Cross Sectional ◽  
The Impact ◽  
Disease Testing

Abstract Background: Containment policies and other restrictions introduced by the Spanish government in response to the COVID-19 pandemic present challenges for marginalised populations, such as people who use drugs. Harm reduction centres are often linked to social services, mental health services, and infectious disease testing, in addition to tools and services that help to reduce the harms associated with injecting drugs. This study aimed to explore the impact of the pandemic on these services in four autonomous communities in Spain. Methods: This is a cross-sectional study that employed a seven-section structured survey administered electronically to 20 centres in July 2020. Data from the most heavily affected months (March–June) in 2020 were compared to data from the same period in 2019. Averages were calculated with their ranges, rates, and absolute numbers.Results: All 11 responding centres reported having had to adapt or modify their services during the Spanish state of alarm (14 March–21 June 2020). One centre reported complete closure for two months and four reported increases in their operating hours. The average number of service users across all centres decreased by 22% in comparison to the same period in the previous year and the average needle distribution decreased by 40% in comparison to 2019. Most centres reported a decrease in infectious disease testing rates (hepatitis B and C viruses [HBV, HCV], human immunodeficiency virus (HIV), and tuberculosis [TB]) for March, April, and May in 2020 compared to the previous year. Reported deaths as a result of overdose did not increase during the state of alarm, but 2/11 (18%) centres reported an increase in overdose deaths immediately after finalisation of the state of alarm.Conclusion: Overall, Spanish harm reduction centres were able to continue operating and offering services by adjusting operating hours. The number of overall service users and needles distributed fell during the Spanish state of alarm lockdown period, suggesting that fewer clients accessed harm reduction services during this time, putting them at greater risk of reusing or sharing injecting equipment, overdosing, acquiring infectious diseases with decreased access to testing or discontinuing ongoing treatment such as methadone maintenance therapy, hepatitis C treatment, or antiretroviral therapy.

scholarly journals Managed Care's Dual Impact on Outpatient Substance Abuse Treatment: Methadone Maintenance vs. Drug Free

2005 ◽  
Vol 35 (3) ◽  
pp. 507-528 ◽  
Author(s):  
Jody L. Sindelar ◽  
Todd A. Olmstead
Keyword(s):  
Substance Abuse ◽  
Managed Care ◽  
Substance Abuse Treatment ◽  
Methadone Maintenance ◽  
Treatment Services ◽  
Treatment Facilities ◽  
Using Data ◽  
Abuse Treatment ◽  
The Impact ◽  
Drug Free

The number and type of services offered at substance abuse treatment (SAT) facilities are important aspects of the quality of care. Managed care (MC) is a growing presence in SAT and has been shown to affect the provision of treatment. We expand on earlier work and examine the impact of managed care on the number and type of services offered by methadone maintenance (MM) and drug-free (DF) outpatient treatment facilities. We use the econometric technique of instrumental variables to address the issue of endogeneity of MC and service offerings, thereby allowing a causal interpretation of results. Using data from the 2000 National Survey of Substance Abuse Treatment Services, we find that MC significantly increases the total number of services offered in MM outpatient facilities by four, yet decreases the number by two in DF outpatient facilities. We also show how the impact on specific services differs by modality and provide explanations for our findings.

scholarly journals Maximizing Health or Sufficient Capability in Economic Evaluation? A Methodological Experiment of Treatment for Drug Addiction

2016 ◽  
Vol 37 (5) ◽  
pp. 498-511 ◽  
Author(s):  
Ilias Goranitis ◽  
Joanna Coast ◽  
Ed Day ◽  
Alex Copello ◽  
Nick Freemantle ◽  
...  
Keyword(s):  
Decision Making ◽  
Economic Evaluation ◽  
Drug Addiction ◽  
Well Being ◽  
Economic Evaluations ◽  
Health And Social Care ◽  
Evaluative Space ◽  
The Impact ◽  
Decision Making Rule

Conventional practice within the United Kingdom and beyond is to conduct economic evaluations with “health” as evaluative space and “health maximization” as the decision-making rule. However, there is increasing recognition that this evaluative framework may not always be appropriate, and this is particularly the case within public health and social care contexts. This article presents a methodological case study designed to explore the impact of changing the evaluative space within an economic evaluation from health to capability well-being and the decision-making rule from health maximization to the maximization of sufficient capability. Capability well-being is an evaluative space grounded on Amartya Sen’s capability approach and assesses well-being based on individuals’ ability to do and be the things they value in life. Sufficient capability is an egalitarian approach to decision making that aims to ensure everyone in society achieves a normatively sufficient level of capability well-being. The case study is treatment for drug addiction, and the cost-effectiveness of 2 psychological interventions relative to usual care is assessed using data from a pilot trial. Analyses are undertaken from a health care and a government perspective. For the purpose of the study, quality-adjusted life years (measured using the EQ-5D-5L) and years of full capability equivalent and years of sufficient capability equivalent (both measured using the ICECAP-A [ICEpop CAPability measure for Adults]) are estimated. The study concludes that different evaluative spaces and decision-making rules have the potential to offer opposing treatment recommendations. The implications for policy makers are discussed.

scholarly journals EFFECT OF HARD DRUG ADDICTION ON PSYCHOLOGICAL WELL-BEING OF PERSONS ATTENDING MAT CLINIC

2021 ◽  
Vol 3 (1) ◽  
pp. 18-23
Author(s):  
Alex Ivono Otoyo
Keyword(s):  
At Risk ◽  
Substance Abuse ◽  
Sample Size ◽  
Drug Addiction ◽  
Well Being ◽  
Good Representation ◽  
Unique Contribution ◽  
Psychological Well Being ◽  
Hard Drug ◽  
Primary Data Analysis

Purpose: The study, therefore, seeks to establish the effect of hard drug addiction on psychological well-being of persons attending mat clinic.Methodology: This study will adopt a descriptive survey design. The study will employ a population of 450 respondents, that is the, guardians /patients, and nurses of the clinic. The population of the study will include the patients attending and nurses working with the patients at MAT clinic in Kenya. According to Kothari (2004), a sample size of between 10 and 30% is a good representation of the target population, for populations not exceeding 1000. The target sample size for this study, therefore, will be 10% of the total respondents of the clinic, i.e., 45 respondents selected by simple random sampling method. Inclusion criteria and exclusion criteria will be used where the guardians/patients who attended the clinic and the nurses working in the clinic will be included, while the patients who are mentally incapacitated to respond to the questions as well as the nurses not directly involved with the patients will be excluded. The study will use questionnaires, key information and interview guides to collect the primary data. Analysis of data will be done by use of Statistical Package for Social Sciences (SPSS) computer software.Findings: The study finds that there is a significant impact of hard drug addiction on psychological well-being of persons attending mat clinic. Unique contribution to theory, policy, and practice: Both psychological well-being and substance abuse are influenced by numerous overlapping and interacting factors and as such, any psychometric scales trying to identify adolescents at risk for psychological problems and substance abuse would have to look at them in interaction. Fortunately, it seems that the Psychological Well-Being Scale used for the purpose of this research can serve this dual purpose, namely to identify adolescents with a negative psychological well-being and consequently identify those adolescents at risk for substance abuse.

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