scholarly journals Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

2021 ◽  
Vol 12 ◽  
Author(s):  
Seyed Ramin Radfar ◽  
Cornelis A. J. De Jong ◽  
Ali Farhoudian ◽  
Mohsen Ebrahimi ◽  
Parnian Rafei ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Service Providers ◽  
Vulnerable Groups ◽  
Business Continuity ◽  
Treatment Modalities ◽  
Addiction Medicine ◽  
Global Survey ◽  
Prevention Interventions ◽  
Needle And Syringe Programs

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

scholarly journals Reorganization of Substance Use Treatment and Harm Reduction Services during the COVID-19 Pandemic: A Global Survey

2020 ◽  
Author(s):  
Seyed Ramin Radfar ◽  
Cornelis A J De Jong ◽  
Ali Farhoudian ◽  
Mohsen Ebrahimi ◽  
Parnian Rafei ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Service Providers ◽  
Vulnerable Groups ◽  
Business Continuity ◽  
Treatment Modalities ◽  
Addiction Medicine ◽  
Global Survey ◽  
Health Response ◽  
Prevention Interventions

Background: The COVID-19 pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic. Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health response is categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups. Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. 57% of overdose prevention interventions and 81% of outreach services also having been negatively impacted. Conclusions: Participants reported that SUD treatment and harm reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we provide a series of recommendations to support countries to be prepared more efficiently for future waves or similar pandemics to 1) help policymakers generate business continuity plans, 2) maintain the use of evidence-based interventions for people with SUDs, 3) be prepared for adequate medication supplies, 4) integrate harm reduction programs with other treatment modalities and 5) have specific considerations for vulnerable groups such as immigrants and refugees.

scholarly journals Substance use Treatment and Harm Reduction Services for Migrants and Refugees in the COVID-19 Pandemic: Findings from a Global Survey

2020 ◽  
Author(s):  
Cornelis De Jong ◽  
Ali Farhoudian ◽  
Mehrnoosh Vahidi ◽  
Mohsen Ebrahimi ◽  
Hamed Ekhtiari ◽  
...  
Keyword(s):  
Substance Use ◽  
Harm Reduction ◽  
Substance Use Disorders ◽  
Mental Health Problems ◽  
World Health ◽  
Substance Use Treatment ◽  
Second Phase ◽  
Addiction Medicine ◽  
Global Survey ◽  
The Impact

Abstract Migrants and refugees are considered vulnerable to mental health problems and substance use disorders; and may be particularly affected by service disruptions associated with the COVID-19 pandemic The International Society of Addiction Medicine (ISAM) ran a multi-phased global survey among clinicians and health professional that are actively working in the field of addiction medicine to investigate the impact of the COVID-19 pandemic on substance use and related services. In March 2020, the first month after the announcement of the pandemic by the World Health Organization, 177 informants from 77 countries took part in the global survey, and only 12.9% of them reported their countries’ substance use treatment and harm reduction services for the migrants and refugees with substance use disorders continued as usual. In May 2020, 11.7% of respondents of the second phase reported that the services for refugees and migrants improved in comparison to March 2020; 11.7% reported that these services in their country discontinued. Results suggest that refugee and migrants access to treatment and harm reduction services has been reduced as a result of COVID-19. It can be concluded that it is crucial to improve the visibility of migrants’ needs and exploit appropriate interventions for those with substance use disorders.

scholarly journals A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Ali Farhoudian ◽  
Seyed Ramin Radfar ◽  
Hossein Mohaddes Ardabili ◽  
Parnian Rafei ◽  
Mohsen Ebrahimi ◽  
...  
Keyword(s):  
Substance Use ◽  
Illicit Drugs ◽  
Epidemiologic Studies ◽  
Addiction Medicine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Global Survey ◽  
Use Patterns ◽  
Drug And Alcohol ◽  
Supply Price

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.Design: Cross-sectional survey.Setting: Worldwide.Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries.Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic.Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall.Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

Implementing a Harm Reduction Approach to Substance Use in an Intimate Partner Violence Agency: Practice Issues in an Irish Setting

Partner Abuse ◽  
2015 ◽  
Vol 6 (3) ◽  
pp. 337-350 ◽  
Author(s):  
Sarah Morton ◽  
Melinda Hohman ◽  
Amanda Middleton
Keyword(s):  
Intimate Partner Violence ◽  
Substance Use ◽  
Harm Reduction ◽  
Partner Violence ◽  
Service Providers ◽  
Intimate Partner ◽  
Substance Use Services ◽  
Barriers And Challenges ◽  
Integrated Response ◽  
Reduction Approach

There has been growing recognition of the co-occurrence of substance use and intimate partner violence (IPV) victimization in women’s and men’s lives, yet many IPV service providers have not developed an integrated response to these issues. Fewer still have implemented substance use services from a harm reduction approach. This article outlines the approach, policy changes, initial outcomes, and learning points for an IPV agency in Ireland, which implemented a harm reduction response to female IPV survivors who were also using substances problematically. Barriers and challenges for staff and management seeking to coordinate and integrate service delivery on the dual issues are also presented.

scholarly journals A global survey on changes in the supply, price and use of illicit drugs and alcohol, and related complications during the 2020 COVID-19 pandemic

2020 ◽  
Author(s):  
Ali Farhoudian ◽  
Seyed Ramin Radfar ◽  
Hossein Mohaddes Ardabili ◽  
Parnian Rafei ◽  
Mohsen Ebrahimy ◽  
...  
Keyword(s):  
Substance Use ◽  
Illicit Drugs ◽  
Epidemiologic Studies ◽  
Addiction Medicine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Global Survey ◽  
Use Patterns ◽  
Drug And Alcohol ◽  
Supply Price

Background and aims: COVID-19 has infected more than 13 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing and ′lockdown′ measures have affected drug and alcohol supply chains and subsequently their availability, price and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic. Design: Cross-sectional survey. Setting: Worldwide. Participants: Starting on April 4th, 2020 during a 5-week period, the survey received 185 responses from 77 countries. Measurements: To assess addiction medicine professionals′ perceived changes in drug and alcohol supply, price, use pattern and related complications during the COVID-19 pandemic. Findings: Participants reported (among who answered ″decreased″ or ″increased″, percentage of those who were in majority is reported in the parenthesis) a decrease in drug supply (69.0%), and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall. Conclusions: The global report on changes in the availability, use patterns and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to SUDs. Key words: COVID-19, pandemic, alcohol, drug, substance use disorder, supply, price.

scholarly journals Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Erika L. Crable ◽  
Allyn Benintendi ◽  
David K. Jones ◽  
Alexander Y. Walley ◽  
Jacqueline Milton Hicks ◽  
...  
Keyword(s):  
Substance Use ◽  
Policy Implementation ◽  
Substance Use Disorder ◽  
Service Providers ◽  
Implementation Strategies ◽  
Local Context ◽  
Public Healthcare ◽  
Structured Interviews ◽  
Addiction Medicine ◽  
Us States

Abstract Background Despite the important upstream impact policy has on population health outcomes, few studies in implementation science in health have examined implementation processes and strategies used to translate state and federal policies into accessible services in the community. This study examines the policy implementation strategies and experiences of Medicaid programs in three US states that responded to a federal prompt to improve access to evidence-based practice (EBP) substance use disorder (SUD) treatment. Methods Three US state Medicaid programs implementing American Society of Addiction Medicine (ASAM) Criteria-driven SUD services under Section 1115 waiver authority were used as cases. We conducted 44 semi-structured interviews with Medicaid staff, providers and health systems partners in California, Virginia, and West Virginia. Interviews were triangulated with document review of state readiness and implementation plans. The Exploration, Preparation, Implementation, Sustainment Framework (EPIS) guided qualitative theme analysis. The Expert Recommendations for Implementing Change and Specify It criteria were used to create a taxonomy of policy implementation strategies used by policymakers to promote providers’ uptake of statewide EBP SUD care continuums. Results Four themes describe states’ experiences and outcomes implementing a complex EBP SUD treatment policy directive: (1) Medicaid agencies adapted their inner/outer contexts to align with EBPs and adapted EBPs to fit their local context; (2) enhanced financial reimbursement arrangements were inadequate bridging factors to achieve statewide adoption of new SUD services; (3) despite trainings, service providers and managed care organizations demonstrated poor fidelity to the ASAM Criteria; and (4) successful policy adoption at the state level did not guarantee service providers’ uptake of EBPs. States used 29 implementation strategies to implement EBP SUD care continuums. Implementation strategies were used in the Exploration (n=6), Preparation (n=10), Implementation (n=19), and Sustainment (n=6) phases, and primarily focused on developing stakeholder interrelationships, evaluative and iterative approaches, and financing. Conclusions This study enhances our understanding of statewide policy implementation outcomes in low-resource, public healthcare settings. Themes highlight the need for additional pre-implementation and sustainment focused implementation strategies. The taxonomy of detailed policy implementation strategies employed by policymakers across states should be tested in future policy implementation research.

scholarly journals Substance Use and The Necessity for Harm Reduction Programs in Prisons: A Qualitative Study in Central Prison of Sanandaj, Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Bagher Saberi Zafarghandi ◽  
Sahar Eshrati ◽  
Reza Arezoomandan ◽  
Marziyeh Farnia
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Harm Reduction ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Antiretroviral Treatment ◽  
Service Providers ◽  
Methadone Maintenance ◽  
Opioid Substitution Therapy ◽  
Self Injury

Background: For decades, harm reduction programs for addiction have been started in Iranian prisons. The programs comprise methadone maintenance treatment, antiretroviral treatment, and other harm reduction programs implemented as a triangular clinic. Despite the lack of funding to provide mental health services, particularly for substance use and harm reduction in prisons of low- and middle-income countries, Iran provides well-developed services. Objectives: The study investigated the implementation and achievements of harm reduction programs in Sanandaj prison located in the center of Kurdistan Province, west of Iran. Methods: This was a qualitative cross-sectional study. We used various information sources such as a checklist and group discussions. The participants were chosen by the purposive sample method and included prison authorities and harm reduction service providers and recipients. The data were analyzed by content analysis. Results: The harm reduction programs included opioid substitution therapy, providing information and education, voluntary counseling and testing for blood-borne diseases, providing condoms, hepatitis C virus screening, and antiretroviral treatment. Following the implementation of the program, a significant decrease in violence, self-injury, illegal drug use and shared syringes, HIV-positive new comers, and no necessity for the needle and syringe program when starting methadone treatment was reported. Conclusions: Commitment to a strict ban on the entering of drugs to the prison is a reason for the use of high-risk methods of drug use and behaviors such as injection, self-injury, or violence. Sharing syringes and needles is a major cause of the transmission of HIV and hepatitis viruses among drug users. Harm reduction programs, especially methadone maintenance treatment and antiretroviral treatment, have reduced a large proportion of drug-related harms in prisons. Scaling up the programs and their extension to post-release treatment will greatly reduce the country's health costs.

Haemophilia Registry of the Medical Committee of the Swiss Haemophilia Society

2009 ◽  
Vol 29 (S 01) ◽  
pp. S16-S18 ◽  
Author(s):  
B. Brand ◽  
N. von der Weid
Keyword(s):  
Quality Control ◽  
Infectious Diseases ◽  
Mutation Analysis ◽  
Clinical Data ◽  
Age Groups ◽  
Treatment Modalities ◽  
Global Survey ◽  
On Demand ◽  
Per Capita ◽  
Severity Of The Disease

SummaryThe Swiss Haemophilia Registry of the Medical Committee of the Swiss Haemophilia Society was established in 2000. Primarily it bears epidemiological and basic clinical data (incidence, type and severity of the disease, age groups, centres, mortality). Two thirds of the questions of the WFH Global Survey can be answered, especially those concerning use of concentrates (global, per capita) and treatment modalities (on-demand versus prophylactic regimens). Moreover, the registry is an important tool for quality control of the haemophilia treatment centres.There are no informations about infectious diseases like hepatitis or HIV, due to non-anonymisation of the data. We plan to incorporate the results of the mutation analysis in the future.

scholarly journals Service providers’ use of harm reduction approaches in working with older adults experiencing abuse: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donna Goodridge ◽  
Kerstin Stieber Roger ◽  
Christine A. Walsh ◽  
Elliot PausJenssen ◽  
Marina Cewick ◽  
...  
Keyword(s):  
Older Adults ◽  
Harm Reduction ◽  
Professional Practice ◽  
Service Provision ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Risk Environment ◽  
Intervention Process ◽  
Process Enactment ◽  
Humanistic Approach

Abstract Background Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse. Methods Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes. Results Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers’ description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult’s autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse. Conclusions Harm reduction approaches are evident in service providers’ accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse.

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