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https://www.readbyqxmd.com/read/28529359/the-journey-of-opioid-substitution-therapy-in-india-achievements-and-challenges
#1
Ravindra Rao
Opioids are one of the most problematic illegal substances globally. Opioid abuse is associated with complications in various spheres of the user's life, his/her family, and the society. Injecting drug use (IDU) is also linked to public health problems such as HIV infection and viral hepatitis. Medications form an important cornerstone in the treatment of opioid dependence. Treatment strategies such as "detoxification" alone or long-term treatment with opioid antagonist have limited acceptability and retention rates...
January 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28499731/discovery-of-n-substituted-endo-3-8-aza-bicyclo-3-2-1-oct-3-yl-phenol-and-phenyl-carboxamide-series-of-%C3%AE-opioid-receptor-antagonists
#2
Lan Jiang, David T Beattie, John R Jacobsen, Samuel Kintz, Glenmar P Obedencio, Daisuke Saito, Ioanna Stergiades, Ross G Vickery, Daniel D Long
Gastrointestinal dysfunction as a consequence of the use of opioid analgesics is of significant clinical concern. First generation drugs to treat these opioid-induced side-effects were limited by their negative impact on opioid receptor agonist-induced analgesia. Second generation therapies target a localized, peripherally-restricted, non-CNS penetrant drug distribution of opioid receptor antagonists. Herein we describe the discovery of the N-substituted-endo-3-(8-aza-bicyclo[3.2.1]oct-3-yl)-phenol and -phenyl carboxamide series of μ-opioid receptor antagonists...
May 3, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28489467/use-of-opioid-substitution-therapies-in-the-treatment-of-opioid-use-disorder-results-of-a-uk-cost-effectiveness-modelling-study
#3
James Kenworthy, Yunni Yi, Antony Wright, Jim Brown, Ana Maria Madrigal, William C N Dunlop
AIMS: We investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) versus no opioid substitution therapy (OST) for the treatment of opioid use disorder, from the UK National Health Service (NHS)/personal social services (PSS) and societal perspectives over one year. METHODS: Cost-effectiveness of OST versus no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model...
May 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28477061/chronic-hepatitis-c-treatment-in-patients-with-drug-injection-history-findings-of-the-integrate-prospective-observational-study
#4
Geert Robaeys, Stefan Christensen, Damien Lucidarme, Amber Arain, Philip Bruggmann, Jan Kunkel, Sofia Keim, Martin Jäkel, Ralph DeMasi, Chris Liu, Isabelle Lonjon-Domanec, Graham R Foster
INTRODUCTION: People who inject drugs represent an under-treated chronic hepatitis C virus (HCV)-infected patient population. METHODS: INTEGRATE was a prospective, observational study investigating the effectiveness, safety, and adherence in routine clinical practice to telaprevir in combination with peg-interferon and ribavirin (Peg-IFN/RBV) in patients with history of injecting drug use chronically infected with genotype 1 HCV. RESULTS: A total of 46 patients were enrolled and included in the intent-to-treat (ITT) population...
May 5, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28463684/longitudinal-analysis-of-change-in-individual-level-needle-and-syringe-coverage-amongst-a-cohort-of-people-who-inject-drugs-in-melbourne-australia
#5
Daniel O'Keefe, Nick Scott, Campbell Aitken, Paul Dietze
BACKGROUND: Needle and syringe program (NSP) coverage is often calculated at the individual level. This method relates sterile needle and syringe acquisition to injecting frequency, resulting in a percentage of injecting episodes that utilise a sterile syringe. Most previous research using this method was restricted by their cross-sectional design, calling for longitudinal exploration of coverage. METHODS: We used the data of 518 participants from an ongoing cohort of people who inject drugs in Melbourne, Australia...
April 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28443503/kratom-and-future-treatment-for-the-opioids-addiction-and-chronic-pain-periculo-beneficium
#6
Ismaliza Ismail, Suzaily Wahab, Hatta Sidi, Srijit Das, Loo Jiann Lin, Rosdinom Razali
Kratom (Mitragynaspeciosa), a natural existing plant found in South-East Asia, is tradi-tionally used as an herb to help to elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (μ) and kappa (κ). The role of neural reward pathway linked to μ-opioid receptors and both dopaminergic and GABA-ergic interneurons that express μ-opioid receptors were deliberated...
April 25, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/28404135/incidence-risk-factors-and-prevention-of-hepatitis-c-reinfection-a-population-based-cohort-study
#7
Nazrul Islam, Mel Krajden, Jean Shoveller, Paul Gustafson, Mark Gilbert, Jane A Buxton, Jason Wong, Mark W Tyndall, Naveed Zafar Janjua
BACKGROUND: People remain at risk of reinfection with hepatitis C virus (HCV), even after clearance of the primary infection. We identified factors associated with HCV reinfection risk in a large population-based cohort study in British Columbia, Canada, and examined the association of opioid substitution therapy and mental health counselling with reinfection. METHODS: We obtained data from the British Columbia Hepatitis Testers Cohort, which includes all individuals tested for HCV or HIV at the British Columbia Centre for Disease Control Public Health Laboratory during 1990-2013 (when data were available)...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28397700/narcotic-bowel-syndrome
#8
REVIEW
Adam D Farmer, Jayne Gallagher, Caroline Bruckner-Holt, Qasim Aziz
Narcotic bowel syndrome is characterised by worsening abdominal pain in the context of escalating or continuous opioid therapy. Although narcotic bowel syndrome is rarely diagnosed, given the current epidemic of opioid use, it is likely to be under-recognised. The underlying pathophysiological mechanisms of narcotic bowel syndrome are incompletely understood; however, opioid-induced hyperalgesia is likely to be a central facet. The putative mechanisms of hyperalgesia include activation of bimodal opioid regulatory systems, counter-regulatory mechanisms, neuroinflammation, opioid facilitation, and interactions of the N-methyl D-aspartate receptor with opioids at the level of the spinal cord...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28376505/six-year-outcome-of-opioid-maintenance-treatment-in-heroin-dependent-patients-results-from-a-naturalistic-study-in-a-nationally-representative-sample
#9
Michael Soyka, Jens Strehle, Jürgen Rehm, Gerhard Bühringer, Hans-Ulrich Wittchen
BACKGROUND: In many countries, the opioid agonists, buprenorphine and methadone, are licensed for maintenance treatment of opioid dependence. Many short-term studies have been performed, but little is known about long-term effects. Therefore, this study described over 6 years (1) mortality, retention and abstinence rates and (2) changes in concomitant drug use and somatic and mental health. METHODS: A prevalence sample of n = 2,694 maintenance patients, recruited from a nationally representative sample of n = 223 substitution doctors, was evaluated in a 6-year prospective-longitudinal naturalistic study...
2017: European Addiction Research
https://www.readbyqxmd.com/read/28345206/treatment-with-direct-acting-antiviral-agents-of-hepatitis-c-virus-infection-in-injecting-drug-users-a-prospective-study
#10
Lucio Boglione, Simone Mornese Pinna, Amedeo De Nicolò, Jessica Cusato, Giuseppe Cariti, Giovanni Di Perri, Antonio D'Avolio
In this prospective study, we evaluated the effectiveness and tolerability of novel therapies against hepatitis C virus (HCV) in a cohort of PWID enrolled at our centre from April 2015 to July 2016. In this analysis, a total of 174 patients were included: 11 (6.3%) were treated with pegylated-interferon (PEG-IFN) and ribavirin (RBV) containing regimens, 163 (93.7%) with IFN-free treatments. RBV has been used in 70 patients (40.2%); 59 (33.9%) patients were in opioid substitution therapy (OST) with methadone or buprenorphine...
March 26, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28323752/impact-of-opioid-substitution-therapy-on-the-hiv-prevention-benefit-of-antiretroviral-therapy-for-people-who-inject-drugs
#11
Christinah Mukandavire, Andrea Low, Gitau Mburu, Adam Trickey, Margaret T May, Charlotte F Davies, Clare E French, Katharine J Looker, Tim Rhodes, Lucy Platt, Andy Guise, Matthew Hickman, Peter Vickerman
OBJECTIVE: A recent meta-analysis suggested that opioid substitution therapy (OST) increased uptake of antiretroviral treatment (ART) and HIV viral suppression. We modelled whether OST could improve the HIV prevention benefit achieved by ART among people who inject drugs (PWID). METHODS: We modelled how introducing OST could improve the coverage of ART across a PWID population for different baseline ART coverage levels. Using existing data on how yearly HIV-transmission risk is related to HIV plasma viral load, changes in the level of viral suppression across the population were used to project the relative reduction in yearly HIV-transmission risk achieved by ART, with or without OST, compared with if there was no ART - defined here as the prevention effectiveness of ART...
May 15, 2017: AIDS
https://www.readbyqxmd.com/read/28322465/opioid-substitution-therapy-or-hidden-opioids-are-a-minefield-for-nalmefene-an-atypical-case-series-of-11-patients-in-lorraine
#12
Melissa Yéléhé-Okouma, Hervé Martini, Jérémie Lemarié, Pierre Labroca, Nadine Petitpain, Valérie Gibaja, François Paille, Pierre Gillet
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment...
March 21, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28303199/hiv-aids-in-the-south-east-asia-region-progress-and-challenges
#13
EDITORIAL
Razia Pendse, Somya Gupta, Dongbao Yu, Swarup Sarkar
The South-East Asia region, with 11 member states, has an estimated 3.5 million people living with HIV (PLHIV). More than 99% of PLHIV live in five countries where HIV prevalence among the population aged 15-49 remains low but is between 2% and 29% among key populations. Since 2010, the region has made progress to combat the epidemic. Mature condom programmes exist in most countries but opioid substitution therapy, and needle and syringe exchange programmes need to be scaled up. HIV testing is recommended nationwide in four countries and is prioritised in high prevalence areas or for key populations in the rest...
November 28, 2016: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28281354/integrated-opioid-substitution-therapy-and-hiv-care-a-qualitative-systematic-review-and-synthesis-of-client-and-provider-experiences
#14
Andy Guise, Maureen Seguin, Gitau Mburu, Susie McLean, Pippa Grenfell, Zahed Islam, Sergii Filippovych, Happy Assan, Andrea Low, Peter Vickerman, Tim Rhodes
People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts...
March 10, 2017: AIDS Care
https://www.readbyqxmd.com/read/28258833/changes-in-substance-use-in-patients-receiving-opioid-substitution-therapy-and-resulting-clinical-challenges-a-17-year-treatment-case-register-analysis
#15
Marcus Herdener, Kenneth M Dürsteler, Erich Seifritz, Carlos Nordt
BACKGROUND: Although the beneficial effects of opioid substitution for the reduction of heroin use are well established, its effect on other substance use is unclear. We aimed to evaluate short-term and long-term changes in substance use in opioid-dependent patients on opioid substitution therapy. We focused on frequent use of heroin, cocaine, benzodiazepines, and alcohol under naturalistic conditions (ie, with non-selected patients and clinical practice as usual) over 17 years. METHODS: This was a treatment case register analysis...
February 28, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28258832/alcohol-problems-need-more-attention-in-patients-receiving-long-term-opioid-substitution-therapy
#16
Wayne D Hall, John Strang
No abstract text is available yet for this article.
February 28, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28209683/evaluation-of-6-remote-first-nations-community-based-buprenorphine-programs-in-northwestern-ontario-retrospective-study
#17
Solomon Mamakwa, Meldon Kahan, Dinah Kanate, Mike Kirlew, David Folk, Sharon Cirone, Sara Rea, Pierre Parsons, Craig Edwards, Janet Gordon, Fiona Main, Len Kelly
OBJECTIVE: To evaluate established opioid addiction treatment programs that use traditional healing in combination with buprenorphine-naloxone maintenance treatment in 6 First Nations communities in the Sioux Lookout region of northwestern Ontario. DESIGN: Retrospective cohort study. SETTING: Six First Nations communities in northwestern Ontario. PARTICIPANTS: A total of 526 First Nations participants in opioid-dependence treatment programs...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28160345/does-exposure-to-opioid-substitution-treatment-in-prison-reduce-the-risk-of-death-after-release-a-national-prospective-observational-study-in-england
#18
John Marsden, Garry Stillwell, Hayley Jones, Alisha Cooper, Brian Eastwood, Michael Farrell, Tim Lowden, Nino Maddalena, Chris Metcalfe, Jenny Shaw, Matthew Hickman
BACKGROUND AND AIMS: People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. DESIGN: Prospective observational cohort study using prison healthcare, national community drug misuse treatment and deaths registers. SETTING: Recruitment at 39 adult prisons in England (32 male; 7 female) accounting for 95% of OST treatment in England during study planning...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28130810/shift-in-disparities-in-hepatitis-c-treatment-from-interferon-to-daa-era-a-population-based-cohort-study
#19
N Z Janjua, N Islam, J Wong, E M Yoshida, A Ramji, H Samji, Z A Butt, M Chong, D Cook, M Alvarez, M Darvishian, M Tyndall, M Krajden
We evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015...
January 27, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28070918/stereotype-threat-and-social-function-in-opioid-substitution-therapy-patients
#20
Courtney von Hippel, Julie D Henry, Gill Terrett, Kimberly Mercuri, Karen McAlear, Peter G Rendell
OBJECTIVES: People with a history of substance abuse are subject to widespread stigmatization. It seems likely that this societal disapproval will result in feelings of stereotype threat, or the belief that one is the target of demeaning stereotypes. If so, stereotype threat has the potential to contribute to functional difficulties including poor social outcomes. METHODS: Eighty drug users on opioid substitution therapy and 84 demographically matched controls completed measures of mental health and social function...
June 2017: British Journal of Clinical Psychology
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