scholarly journals Substance Use, Hospitalizations, and Co-Occurring Disorders among Patients Transferred from a Needle Exchange Program to Opioid Maintenance Treatment

2022 ◽  
Vol 19 (2) ◽  
pp. 697
Author(s):  
Martin Bråbäck ◽  
Anna Brantefors ◽  
Johan Franck ◽  
Louise Brådvik ◽  
Pernilla Isendahl ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Maintenance Treatment ◽  
Needle Exchange ◽  
Needle Exchange Program ◽  
Psychiatric Diagnoses ◽  
Opioid Maintenance Treatment ◽  
Exchange Program ◽  
Sedative Hypnotics

Opioid use disorders (OUD) is a relapsing condition with high mortality. Opioid maintenance treatment (OMT) reduces heroin use, and overall morbidity and mortality. The prevalence of psychiatric and substance use disorders, potential baseline predictors for psychiatric hospitalization, and psychiatric diagnoses at follow-up were investigated and may give hints about possible preventative strategies. The medical records for 71 patients were reviewed 36 months following referral to OMT from a needle exchange program (NEP). Their psychiatric diagnoses and hospitalizations were identified. Their baseline characteristics were assessed for potential differences between hospitalized versus non-hospitalized patients and between patients with and without psychiatric diagnoses in a longitudinal observational study without controls. A regression analysis was performed to identify predictors for hospitalization when controlling for OMT status. Sixty-five percent of the patients were hospitalized at least once with a psychiatric diagnosis. Substance-related reasons were prevalent, and detoxification occurred among 59% of patients, with sedative- hypnotics (benzodiazepines, zopiclone, zolpidem, and pregabalin) being the substance used by 52% of patients. Baseline use of these drugs and/or buprenorphine predicted for hospitalization when controlling for OMT status. During the follow-up period, 72% of patients met the criteria for a psychiatric diagnosis other than OUD. The prevalence of non-substance use disorders overlapping with SUD was 41%, and that overlapping with anxiety disorder was 27% of all participants. Increased attention to psychiatric co-occurring disorders in the treatment of OUD is required and the importance of addressing sedative-hypnotics use when initiating OMT is highlighted.

scholarly journals A Longitudinal Study on Substance Use and Related Problems in Women in Opioid Maintenance Treatment from Pregnancy to Four Years after Giving Birth

2014 ◽  
Vol 8 ◽  
pp. SART.S15055 ◽  
Author(s):  
Ingunn O. Lund ◽  
Håvar Brendryen ◽  
Edle Ravndal
Keyword(s):  
Substance Use ◽  
Maintenance Treatment ◽  
Positive Impact ◽  
Child Protective Services ◽  
Severity Index ◽  
Psychological Problems ◽  
Opioid Maintenance Treatment ◽  
Protective Services ◽  
One Year

Background Women in opioid maintenance treatment (OMT) have a past characterized by drug abuse, which is a challenging start for parenthood. Studies of mothers in OMT are typically limited to pregnancy and early infancy. Knowledge about how they cope with substance use and related problems in the years following birth is therefore important. The aims of the study were to examine changes in mothers’ substance use, psychological problems, and other challenges; from one to four years after their children were born, and describe kindergarten attendance and prevalence and type of child protective services involvement when the children were four years old. Method A four-year prospective cohort study of mothers in OMT. The European severity index was used to map substance use and related problems during the third trimester of pregnancy, one and four years after birth. Results At the four-year follow-up, use of illegal substances remained low (4%) and use of legal substances (39%) was similar to the one-year follow-up. The proportion of women with psychological problems was significantly higher than at one-year follow-up (69 vs. 39%, P = .009). At age four, most children (89%) attended kindergarten, and the child protective services were following 73% of the families, mostly with voluntary measures. Conclusion Mothers in OMT cope well with substance use over time, given access to sufficient support. The findings imply that a preventive governmental strategy with close support of mother and child, have a positive impact contributing to making OMT and motherhood more compatible.

scholarly journals Health Related Quality of Life in Individuals Transferred from a Needle Exchange Program and Starting Opioid Agonist Treatment

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Martin Bråbäck ◽  
Louise Brådvik ◽  
Katja Troberg ◽  
Pernilla Isendahl ◽  
Suzan Nilsson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Needle Exchange ◽  
Needle Exchange Program ◽  
Health Related Quality ◽  
Opioid Agonist ◽  
Exchange Program ◽  
Related Quality ◽  
Health Related

Background. Opioid agonist treatment (OAT), for the treatment of heroin dependence, has been reported to improve overall health and lower mortality. Drug use and retention in treatment have often been used as measures of treatment success. More recently, however, researchers have suggested that measurements of quality of life should be an outcome in substance use treatment evaluations. In a recent randomized controlled trial we demonstrated high rates of successful rapid referral from a needle exchange program (NEP) to OAT. The aim of this study was to see whether an improvement in health related quality of life (HRQoL) could be seen at 3-month follow-up after starting OAT and whether it was associated with any baseline characteristics. We also wanted to compare our sample to a sample from the general population with regard to HRQoL.Methods.This was a 3-month follow-up of 71 patients who started OAT. Measurements of HRQoL with EQ-5D (an instrument developed by the EuroQol group) were made at baseline and at three months.Results.Mean EQ-5D VAS (visual analogue scale) for the study sample at baseline was 47.3, which was lower than a Swedish reference population reporting 83.3. Individuals reporting being prescribed a drug for a psychiatric condition had significantly lower EQ-5D index values. Improvement in EQ-5D index score was significantly less for individuals reporting previous overdoses (-0.10, p=0.025). Individuals reporting previous suicide attempts had significantly lower EQ-5D VAS score at baseline. A significant increase of the EQ-5D VAS difference over time was found with a mean difference of 10.94 (p=0.008) for the total sample.Conclusion. To our knowledge this is the first time HRQoL as an outcome is reported in a population transferred from a NEP to OAT. Our results indicate that OAT can result in increased HRQoL, even with this type of rapid low-threshold referral.

Standard EMDR Protocol for Alcohol and Substance Dependence Comorbid With Posttraumatic Stress Disorder: Four Cases With 12-Month Follow-Up

2016 ◽  
Vol 10 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Claire Kullack ◽  
Jonathan Laugharne
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Alcohol Dependence ◽  
Posttraumatic Stress ◽  
Substance Use Disorders ◽  
Substance Dependence ◽  
Stress Disorder ◽  
Case Series ◽  
Post Traumatic Stress

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.

Comparing New Participants of a Mobile Versus a Pharmacy-Based Needle Exchange Program

2000 ◽  
Vol 24 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Elise D. Riley ◽  
Mahboobeh Safaeian ◽  
Steffanie A. Strathdee ◽  
Melissa A. Marx ◽  
Steve Huettner ◽  
...  
Keyword(s):  
Needle Exchange ◽  
Needle Exchange Program ◽  
Exchange Program
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