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opioid substitution therapy

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https://www.readbyqxmd.com/read/28628897/diverted-medications-and-new-psychoactive-substances-a-chemical-network-analysis-of-discarded-injecting-paraphernalia-in-hungary
#1
Valéria Anna Gyarmathy, Anna Péterfi, Tamás Figeczki, József Kiss, Katalin Medgyesi-Frank, János Posta, József Csorba
BACKGROUND: Until about 2010, people who inject drugs (PWIDs) injected almost exclusively heroin and amphetamines in Hungary. After 2010, self-reported studies have indicated a dominance of new psychoactive substances on the drug market for injectable drugs. METHODS: Between March 2015 and February 2016, we collected used and discarded injecting paraphernalia. We utilized chemical analysis to assess and UCINet to visualize the connections between the most prevalent main substances and their respective co-occurring additional components at 7 locations in Hungary...
June 16, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28624134/efficacy-of-response-guided-directly-observed-pegylated-interferon-and-self-administered-ribavirin-for-people-who-inject-drugs-with-hepatitis-c-virus-genotype-2-3-infection-the-activate-study
#2
Jason Grebely, Olav Dalgard, Evan B Cunningham, Behzad Hajarizadeh, Graham R Foster, Philip Bruggmann, Brian Conway, Markus Backmund, Geert Robaeys, Tracy Swan, Janaki Amin, Philippa S Marks, Sophie Quiene, Tanya L Applegate, Martin Weltman, David Shaw, Adrian Dunlop, Margaret Hellard, Julie Bruneau, Håvard Midgard, Stefan Bourgeois, Cornelia Staehelin, Gregory J Dore
BACKGROUND: There are few data on treatment for hepatitis C virus (HCV) infection among people with ongoing injecting drug use. This study evaluated the efficacy of response-guided therapy for chronic HCV genotypes 2/3 infection among people with ongoing injecting drug use or receiving opioid substitution therapy (OST). A secondary aim was to identify predictors of HCV treatment response. METHODS: ACTIVATE was a multicentre clinical trial recruited between 2012 and 2014...
June 14, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28618002/novel-psychoactive-substance-use-among-treatment-seeking-opiate-users-the-role-of-life-events-and-psychiatric-symptoms
#3
Máté Kapitány-Fövény, Judit Farkas, Patrícia Andrea Pataki, Anna Kiss, Janka Horváth, Róbert Urbán, Zsolt Demetrovics
OBJECTIVE: Over the past 5 years, a shift to the use of novel psychoactive substances (NPS) has been observed among opioid users. The aim of this study was to assess the potential reasons for NPS use among treatment-seeking patients receiving opiate substitution therapy. METHOD: A structured questionnaire was filled out by a sample of 198 opiate dependent patients of Hungary's National Institute of Psychiatry and Addiction. This questionnaire assessed demographics, treatment characteristics, lifetime substance use, potential reasons for NPS use, negative life events (Life Events Scale), and psychiatric symptoms (Brief Symptom Inventory)...
June 15, 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28615077/service-utilization-and-cost-of-implementing-a-comprehensive-hiv-prevention-and-care-program-among-people-who-inject-drugs-in-delhi-india
#4
Mary Philip Sebastian, Aparajita Dasgupta, Lopamudra Ray Saraswati, Asha Singh, Vartika Sharma, Ira Madan, Waimar Tun, Julie Pulerwitz, Ibou Thior, Avina Sarna
BACKGROUND: WHO, UNODC, and UNAIDS recommend a comprehensive package for prevention, treatment, and care of HIV among people who inject drugs (PWID). We describe the uptake of services and the cost of implementing a comprehensive package for HIV prevention, treatment, and care services in Delhi, India. METHODS: A cohort of 3774 PWID were enrolled for a prospective HIV incidence study and provided the comprehensive package: HIV and hepatitis testing and counseling, hepatitis B (HB) vaccination, syndromic management of sexually transmitted infections, clean needles-syringes, condoms, abscess care, and education...
June 14, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28610605/adherence-to-response-guided-pegylated-interferon-and-ribavirin-for-people-who-inject-drugs-with-hepatitis-c-virus-genotype-2-3-infection-the-activate-study
#5
Evan B Cunningham, Behzad Hajarizadeh, Olav Dalgard, Janaki Amin, Margaret Hellard, Graham R Foster, Philip Bruggmann, Brian Conway, Markus Backmund, Geert Robaeys, Tracy Swan, Philippa S Marks, Sophie Quiene, Tanya L Applegate, Martin Weltman, David Shaw, Adrian Dunlop, Julie Bruneau, Håvard Midgard, Stefan Bourgeois, Maria Christine Thurnheer, Gregory J Dore, Jason Grebely
BACKGROUND: The aims of this analysis were to investigate treatment completion and adherence among people with ongoing injecting drug use or receiving opioid substitution therapy (OST) in a study of response-guided therapy for chronic HCV genotypes 2/3 infection. METHODS: ACTIVATE was a multicenter clinical trial recruited between 2012 and 2014. Participants with genotypes 2/3 were treated with directly observed peg-interferon alfa-2b (PEG-IFN) and self-administered ribavirin for 12 (undetectable HCV RNA at week 4) or 24 weeks (detectable HCV RNA at week 4)...
June 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28587943/delivering-direct-acting-antiviral-therapy-for-hepatitis-c-to-highly-marginalised-and-current-drug-injecting-populations-in-a-targeted-primary-health-care-setting
#6
Phillip Read, Rebecca Lothian, Karen Chronister, Rosie Gilliver, John Kearley, Gregory J Dore, Ingrid van Beek
BACKGROUND: The Kirketon Road Centre (KRC) is a community-based public health facility in Sydney, Australia, that provides healthcare to people who inject drugs (PWID) care, including hepatitis C virus (HCV) treatment. From March 2016, the Australian Government has provided access to direct-acting antivirals (DAA) for adults with chronic HCV, without liver disease stage or drug and alcohol use restrictions. The aim of this study was to report DAA treatment outcomes among highly marginalised PWID treated at KRC...
June 3, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28529359/the-journey-of-opioid-substitution-therapy-in-india-achievements-and-challenges
#7
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
#8
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
#9
James Kenworthy, Yunni Yi, Antony Wright, Jim Brown, Ana Maria Madrigal, William C N Dunlop
AIMS: This study investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) vs 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 1 year. METHODS: Cost-effectiveness of OST vs no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model...
July 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
#10
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...
June 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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