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Eugenia Oviedo-Joekes, Heather Palis, Daphne Guh, Kirsten Marchand, Suzanne Brissette, Kurt Lock, Scott MacDonald, Scott Harrison, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter
INTRODUCTION AND AIMS: To determine the effectiveness of injectable hydromorphone and dicaetylmorphine for Indigenous participants in the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) clinical trial. The study additionally aims to explore the prevalence and frequency of crack cocaine use among subgroups of participants (by gender and ethnicity). This secondary analysis is particularly relevant given the current need for expanded medication assisted treatments for opioid dependence across North America...
June 8, 2017: Drug and Alcohol Review
Heather Palis, Kirsten Marchand, Daphne Guh, Suzanne Brissette, Kurt Lock, Scott MacDonald, Scott Harrison, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter, Eugenia Oviedo-Joekes
BACKGROUND: To test whether there are gender differences in treatment outcomes among patients receiving injectable opioids for the treatment of long-term opioid-dependence. The study additionally explores whether men and women have different perceptions of treatment effectiveness. METHODS: This study is a secondary analysis from SALOME, a double-blind, phase III, randomized controlled trial testing the non-inferiorirty of injectable hydromorphone to injectable diacetylmorphine among 202 long-term street opioid injectors in Vancouver (Canada)...
May 19, 2017: Substance Abuse Treatment, Prevention, and Policy
Eugenia Oviedo-Joekes, Suzanne Brissette, Scott MacDonald, Daphne Guh, Kirsten Marchand, Salima Jutha, Scott Harrison, Amin Janmohamed, Derek Z Zhang, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter
AIMS: To review the safety profile of injectable hydromorphone and diacetylmorphine and explore if adverse events (AEs) or serious adverse events (SAEs) were associated with dose and patterns of attendance. METHODS: This was a non-inferiority randomized double-blind controlled trial (Vancouver, Canada) testing hydromorphone (n=100) and diacetylmorphine (n=102) for the treatment of severe opioid use disorder. Medications were delivered under the supervision of trained Registered Nurses up to three times daily...
July 1, 2017: Drug and Alcohol Dependence
Katrin Stange, Mathias Krüger, Eva Janke, Ralf Lichtinghagen, Stefan Bleich, Thomas Hillemacher, Annemarie Heberlein
Clinical studies report that substance addictions are associated with sociocognitive impairments. Regarding opiate-addicted patients, the few existing studies point to deficits in empathic abilities. Previous research suggests that testosterone might be a relevant biomarker of these impairments. The authors aimed to investigate whether opiate-addicted patients show specific impairments in emotional (empathic concern, personal distress) and cognitive empathy compared to healthy controls. Furthermore, the authors aimed to assess possible associations of testosterone levels with impaired empathic abilities in the patients' group...
March 10, 2017: Journal of Addictive Diseases
Manuel Sutter, Marc Walter, Kenneth M Dürsteler, Johannes Strasser, Marc Vogel
BACKGROUND AND AIMS: Dual diagnosis commonly occurs among patients with an opioid use disorder. Treatment is ideally performed in an integrated fashion. We present a case that illustrates the complex and challenging psychiatric and medical therapy of such patients in the light of the literature. CASE DESCRIPTION: We report on a 56-year-old patient with schizophrenia and opioid dependence who experienced both risperidone-induced Pisa syndrome and, 3 years later, acute psychosis after switching the opioid substitution medication from methadone to slow-release oral morphine due to QT prolongation...
April 2017: Journal of Dual Diagnosis
Limin Xu, Qingxiao Hong, Xiaoying Chen, Xuting Xu, Huifen Liu, Wenhua Zhou, Shiwei Duan
Diacetylmorphine hydrochloride (heroin) addiction is a chronic relapsing brain disorder that is a heavy public health burden worldwide. Brm/SWI2-related gene-1 (BRG1) is a tumor suppressor gene that can influence embryogenesis and the development of the cerebellum. The current study aimed to investigate the effect of histone H4 lysine 5 (H4K5) modifications on the BRG1 gene in brain tissue of the ventral tegmental area (VTA) of heroin-addicted rats. A total of 21 male Sprague Dawley rats were raised in a standard manner and underwent heroin self-administration training...
September 2016: Experimental and Therapeutic Medicine
Robert Hämmig, Antje Kemter, Johannes Strasser, Ulrich von Bardeleben, Barbara Gugger, Marc Walter, Kenneth M Dürsteler, Marc Vogel
BACKGROUND: Buprenorphine is a partial µ-opioid receptor agonist used for maintenance treatment of opioid dependence. Because of the partial agonism and high receptor affinity, it may precipitate withdrawal symptoms during induction in persons on full µ-opioid receptor agonists. Therefore, current guidelines and drug labels recommend leaving a sufficient time period since the last full agonist use, waiting for clear and objective withdrawal symptoms, and reducing pre-existing full agonist therapies before administering buprenorphine...
2016: Substance Abuse and Rehabilitation
Peter Blanken, Vincent M Hendriks, Ineke A Huijsman, Jan M van Ree, Wim van den Brink
AIMS: To determine the efficacy of contingency management (CM), targeting cocaine use, as an add-on intervention for heroin dependent patients in supervised heroin-assisted treatment (HAT) with frequent cocaine use. DESIGN: Multi-center, open-label, parallel group, randomized controlled trial. SETTING: Twelve specialized addiction treatment centers for HAT in The Netherlands; April 2006-January 2011. PARTICIPANTS: 214 chronic, treatment-refractory heroin dependent patients in HAT, with frequent cocaine use...
July 1, 2016: Drug and Alcohol Dependence
Levente Szöcs, Gábor Orgován, Gergő Tóth, Márta Kraszni, Lajos Gergó, Sándor Hosztafi, Béla Noszál
The hydroxide-catalyzed non-enzymatic, simultaneous and consecutive hydrolyses of diacetylmorphine (DAM, heroin) are quantified in terms of 10 site- and species-specific rate constants in connection with also 10 site- and species-specific acid-base equilibrium constants, comprising all the 12 coexisting species in solution. This characterization involves the major and minor decomposition pathways via 6-acetylmorphine and 3-acetylmorphine, respectively, and morphine, the final product. Hydrolysis has been found to be 18-120 times faster at site 3 than at site 6, depending on the status of the amino group and the rest of the molecule...
June 30, 2016: European Journal of Pharmaceutical Sciences
Eugenia Oviedo-Joekes, Daphne Guh, Suzanne Brissette, Kirsten Marchand, Scott MacDonald, Kurt Lock, Scott Harrison, Amin Janmohamed, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter
IMPORTANCE: Diacetylmorphine hydrochloride (the active ingredient in heroin), delivered under supervision, is effective for the treatment of severe opioid use disorder. However, owing to political and regulatory barriers, it is not available in many settings around the world, which limits the options for many long-term street opioid injectors not attracted into or retained in available treatments. OBJECTIVE: To test if injectable hydromorphone hydrochloride is noninferior to injectable diacetylmorphine in reducing illicit heroin use for chronic injection opioid users after 6 months of intervention...
May 1, 2016: JAMA Psychiatry
Lone Hvid, Mathias T Svendsen, Klaus E Andersen
No abstract text is available yet for this article.
May 2016: Contact Dermatitis
Mascha Nuijten, Peter Blanken, Ben van de Wetering, Bastiaan Nuijen, Wim van den Brink, Vincent M Hendriks
BACKGROUND: Heroin-assisted treatment is effective for methadone treatment-refractory heroin-dependent patients, but continued comorbid cocaine dependence remains problematic. Sustained-release dexamfetamine is a promising agonist pharmacotherapy for cocaine dependence and we aimed to assess its acceptance, efficacy, and safety. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, patients who were treatment-refractory, as indicated by at least two earlier failed treatments aimed at reducing or abstaining from cocaine use, and who regularly (≥8 days/month) used crack-cocaine were enrolled from four heroin-assisted treatment centres in the Netherlands...
May 28, 2016: Lancet
Camilla Montesano, Maria Chiara Simeoni, Roberta Curini, Manuel Sergi, Claudio Lo Sterzo, Dario Compagnone
Oral fluid (OF) has become a valuable biologic specimen for toxicological analysis, especially in driving under the influence of drugs (DUID) investigations, because of easy and non-invasive collection procedures. In OF testing, being the sample volume is limited, multi-analyte procedures are particularly advantageous since they save time and resources. In this work, a procedure for the simultaneous analysis of 20 illicit drugs, belonging to the classes of cocaine, amphetamines, natural and synthetic opioids and hallucinogens, is presented...
May 2015: Analytical and Bioanalytical Chemistry
Eugenia Oviedo-Joekes, Kirsten Marchand, Kurt Lock, Scott MacDonald, Daphne Guh, Martin T Schechter
BACKGROUND: The Study to Assess Long-term Opioid Medication Effectiveness (SALOME) is a two-stage phase III, single site (Vancouver, Canada), randomized, double blind controlled trial designed to test if hydromorphone is as effective as diacetylmorphine for the treatment of long-term illicit opioid injection. Recruiting participants for clinical trials continues to be a challenge in medical and addiction research, with many studies not being able to reach the planned sample size in a timely manner...
January 26, 2015: Substance Abuse Treatment, Prevention, and Policy
Christian L Seifert, Stefano Magon, Till Sprenger, Undine E Lang, Christian G Huber, Niklaus Denier, Marc Vogel, André Schmidt, Ernst-Wilhelm Radue, Stefan Borgwardt, Marc Walter
The neural mechanisms of heroin addiction are still incompletely understood, even though modern neuroimaging techniques offer insights into disease-related changes in vivo. While changes on cortical structure have been reported in heroin addiction, evidence from subcortical areas remains underrepresented. Functional imaging studies revealed that the brain reward system and particularly the nucleus accumbens (NAcc) play a pivotal role in the pathophysiology of drug addiction. The aim of this study was to investigate whether there was a volume difference of the NAcc in heroin addiction in comparison to healthy controls...
December 2015: European Archives of Psychiatry and Clinical Neuroscience
Eugenia Oviedo-Joekes, Luis Sordo, Daphne Guh, David C Marsh, Kurt Lock, Suzanne Brissette, Aslam H Anis, Martin T Schechter
AIMS: To investigate baseline and concurrent predictors of non-use of illicit heroin among participants randomized to injectable opioids in the North American Opiate Medication Initiative (NAOMI) clinical trial. METHODS: NAOMI was an open-label randomized controlled trial comparing the effectiveness of injectable diacetylmorphine and hydromorphone for long-term opioid-dependency. Outcomes were assessed at baseline and during treatment (3, 6, 9, 12months). Days of non-use of illicit heroin in the prior month at each follow-up visit were divided into three categories: Non-use; Low use (1 to 7days) and High use (8days or more)...
February 2015: Addictive Behaviors
Eugenia Oviedo-Joekes, Kirsten Marchand, Kurt Lock, Jill Chettiar, David C Marsh, Suzanne Brissette, Aslam H Anis, Martin T Schechter
BACKGROUND: The North American Opiate Medication Initiative (NAOMI) clinical trial compared the effectiveness of injectable diacetylmorphine (DAM) or hydromorphone (HDM) to oral methadone maintenance treatment (MMT). This study aimed to determine participants' perceptions of treatment delivered in NAOMI. METHODS: A qualitative sub-study was conducted with 29 participants (12 female): 18 (62.1%) received injectable DAM or HDM and 11 (37.9%) received MMT. A phenomenological theoretical framework was used...
September 29, 2014: Addiction Science & Clinical Practice
Eugenia Oviedo-Joekes, Daphne Guh, Kirsten Marchand, David C Marsh, Kurt Lock, Suzanne Brissette, Aslam H Anis, Martin T Schechter
BACKGROUND: The most widely used maintenance treatment for opioid dependency is substitution with long-acting oral opioids. Treatment with injectable diacetylmorphine provides an opportunity for patients to stabilize and possibly transition to oral treatment, if clinically indicated. The aim of this study was to explore outcomes of individuals that received injectable diacetylmorphine and voluntarily transitioned to oral methadone. DESIGN AND METHODS: The North American Opiate Medication Initiative was a randomized controlled trial that compared the effectiveness of injectable diacetylmorphine (or hydromorphone) to oral methadone for long-term opioid-dependency...
June 8, 2014: Substance Abuse Treatment, Prevention, and Policy
Julie Knight, Brandi L Puet, Anne DePriest, Rebecca Heltsley, Cheryl Hild, David L Black, Timothy Robert, Yale H Caplan, Edward J Cone
Surveys of current trends indicate heroin abuse is associated with nonmedical use of pain relievers. Consequently, there is an interest in evaluating the presence of heroin-specific markers in chronic pain patients who are prescribed controlled substances. A total of 926,084 urine specimens from chronic pain patients were tested for heroin/diacetylmorphine (DAM), 6-acetylmorphine (6AM), 6-acetylcodeine (6AC), codeine (COD), and morphine (MOR). Heroin and markers were analyzed using liquid chromatography tandem mass spectrometry (LC-MS-MS)...
October 2014: Forensic Science International
N Dubois, I Demaret, M Ansseau, E Rozet, Ph Hubert, C Charlier
The objective of the present study was to verify if severe physical health problems frequently encountered in heroin addicts and the concomitant use of alcohol and legal or illegal drugs other than heroin influenced the pharmacokinetics of the major metabolites of heroin. We conducted a 90 minutes follow-up of the plasma concentrations of the pharmaceutical heroin, named diacetylmorphine (DAM), in patients recruited in a DAM assisted treatment centre. TADAM (Traitement Assisté par DiAcétylMorphine) aimed to compare the efficacy of heroin-assisted treatment (HAT) compared with methadone maintenance treatment (MMT) for heroin users considered as treatment resistant patients and who have severe physical and mental health problems...
September 2013: Acta Clinica Belgica
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