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Opioids & SU
The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
10858 Results
4301
Helping 'them': Our role in recovery from opioid dependence
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: The crisis of opioid addiction in America has been fueled by the diversion of prescription pain pills and the emergence of pure and inexpensive heroin. Until recently, benefits of and access to therapy were limited. This situation changed in 2003 with Food and Drug Administration approval of buprenorphine for the office-based treatment of opioid dependence. Now armed with a potent drug, primary care physicians can treat addicted patients in their own practice and from their own neighborhood, but first we must overcome deficiencies in our training and personal biases about addicts and what they need. This a report of one doctor's progress.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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Reference Links: View the PubMed citation for Helping 'them': Our role in recovery from opioid dependence
4305
Helping to End Addiction Over the Long-term: The Research Plan for the NIH HEAL Initiative
Type: Journal Article
Year: 2018
Abstract: This article outlines the initial components of the cross-cutting, interdisciplinary program known as the National Institutes of Health HEAL (Helping to End Addiction Long-Term) Initiative.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Helping to End Addiction Over the Long-term: The Research Plan for the NIH HEAL Initiative
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View the PubMed citation for Helping to End Addiction Over the Long-term: The Research Plan for the NIH HEAL Initiative4307
Hepatitis C Cascade of Care Among Pregnant Women on Opioid Agonist Pharmacotherapy Attending a Comprehensive Prenatal Program
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract:
Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype. Information was abstracted from the medical records of women who were followed at a comprehensive prenatal care clinic for women with substance use disorders at the University of New Mexico. Results The sample included 190 pregnant women, of whom 188 were on pharmacotherapy (43.7% on buprenorphine and 55.3% on methadone); the remaining two had tested positive for heroin or prescription opioids. A total of 178 (93.7%) were tested for anti-HCV, 94 (98.9%) of whom were tested for RNA, and 41 (57.7%) were genotyped. Prevalence of exposure to HCV by anti-HCV results was 53.3%, and 37.3% were positive for HCV RNA indicating chronic infection. Conclusions The high prevalence of exposure and infection with HCV in pregnant women involved in pharmacotherapy for a substance use disorder indicate a need for ongoing surveillance and testing for HCV. Identifying HCV during pregnancy is crucial because this identification would serve to enhance medical care and potentially prevent vertical transmission. Identifying HCV would also facilitate referrals to newly available curative HCV treatments following delivery.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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4308
Hepatitis C treatment in a co-located mental health and alcohol and drug service using a nurse-led model of care
Type: Journal Article
Year: 2021
Publication Place: England
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Hepatitis C treatment in a co-located mental health and alcohol and drug service using a nurse-led model of care
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View the PubMed citation for Hepatitis C treatment in a co-located mental health and alcohol and drug service using a nurse-led model of care4311
Hepatitis infection in the treatment of opioid dependence and abuse
Type: Journal Article
Year: 2008
Publication Place: New Zealand
Abstract: Many new and existing cases of viral hepatitis infections are related to injection drug use. Transmission of these infections can result directly from the use of injection equipment that is contaminated with blood containing the hepatitis B or C virus or through sexual contact with an infected individual. In the latter case, drug use can indirectly contribute to hepatitis transmission through the dis-inhibited at-risk behavior, that is, unprotected sex with an infected partner. Individuals who inject drugs are at-risk for infection from different hepatitis viruses, hepatitis A, B, or C. Those with chronic hepatitis B virus infection also face additional risk should they become co-infected with hepatitis D virus. Protection from the transmission of hepatitis viruses A and B is best achieved by vaccination. For those with a history of or who currently inject drugs, the medical management of viral hepatitis infection comprising screening, testing, counseling and providing care and treatment is evolving. Components of the medical management of hepatitis infection, for persons considering, initiating, or receiving pharmacologic therapy for opioid addiction include: testing for hepatitis B and C infections; education and counseling regarding at-risk behavior and hepatitis transmission, acute and chronic hepatitis infection, liver disease and its care and treatment; vaccination against hepatitis A and B infection; and integrative primary care as part of the comprehensive treatment approach for recovery from opioid abuse and dependence. In addition, participation in a peer support group as part of integrated medical care enhances treatment outcomes. Liver disease is highly prevalent in patient populations seeking recovery from opioid addiction or who are currently receiving pharmacotherapy for opioid addiction. Pharmacotherapy for opioid addiction is not a contraindication to evaluation, care, or treatment of liver disease due to hepatitis virus infection. Successful pharmacotherapy for opioid addiction stabilizes patients and improves patient compliance to care and treatment regimens as well as promotes good patient outcomes. Implementation and integration of effective hepatitis prevention programs, care programs, and treatment regimens in concert with the pharmacological therapy of opioid addiction can reduce the public health burdens of hepatitis and injection drug use.
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Hepatitis infection in the treatment of opioid dependence and abuse
4312
Heroin maintenance for chronic heroin-dependent individuals
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: BACKGROUND: Several types of medications have been used for stabilizing heroin users: Methadone, Buprenorphine and levo-alpha-acetyl-methadol (LAAM.) The present review focuses on the prescription of heroin to heroin-dependent individuals. OBJECTIVES: To compare heroin maintenance to methadone or other substitution treatments for opioid dependence regarding: efficacy and acceptability, retaining patients in treatment, reducing the use of illicit substances, and improving health and social functioning. SEARCH METHODS: A review of the Cochrane Central Register of Trials (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to november 2009), EMBASE (1980 to 2005) and CINAHL until 2005 (on OVID) was conducted. Personal communications with researchers in the field of heroin prescription identified ongoing trials. SELECTION CRITERIA: Randomised controlled trials of heroin maintenance treatment (alone or combined with methadone) compared with any other pharmacological treatment for heroin-dependent individuals. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. MAIN RESULTS: Eight studies involving 2007 patients met the inclusion criteria. Five studies compared supervised injected heroin plus flexible dosages of methadone treatment to oral methadone only and showed that heroin helps patients to remain in treatment (valid data from 4 studies, N=1388 Risk Ratio 1.44 (95%CI 1.19-1.75) heterogeneity P=0.03), and to reduce use of illicit drugs. Maintenance with supervised injected heroin has a not statistically significant protective effect on mortality (4 studies, N=1477 Risk Ratio 0.65 (95% CI 0.25-1.69) heterogeneity P=0.89), but it exposes at a greater risk of adverse events related to study medication (3 studies N=373 Risk Ratio 13.50 (95% CI 2.55-71.53) heterogeneity P=0.52). Results on criminal activity and incarceration were not possible to be pooled but where the outcome were measured results of single studies do provide evidence that heroin provision can reduce criminal activity and incarceration/imprisonment. Social functioning improved in all the intervention groups with heroin groups having slightly better results. If all the studies comparing heroin provision in any conditions vs any other treatment are pooled the direction of effect remain in favour of heroin. AUTHORS' CONCLUSIONS: The available evidence suggests an added value of heroin prescribed alongside flexible doses of methadone for long-term, treatment refractory, opioid users, to reach a decrease in the use of illicit substances, involvement in criminal activity and incarceration, a possible reduction in mortaliity; and an increase in retention in treatment. Due to the higher rate of serious adverse events, heroin prescription should remain a treatment for people who are currently or have in the past failed maintenance treatment, and it should be provided in clinical settings where proper follow-up is ensured.
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Heroin maintenance for chronic heroin-dependent individuals
4313
Heroin or conventional opioid maintenance? The patients' perspective
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: OBJECTIVE: This study focused on the question whether patients with conventional opioid maintenance treatment (COMT) would prefer a switch to heroin maintenance treatment (HMT). METHODS: We performed a region-wide anonymous survey of patients in the opioid maintenance program in Berlin, Germany. All 20 psychiatric hospitals and all 110 physicians' practices in Berlin licensed to offer COMT were approached to reach patients under COMT and also fulfilling the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria of opiate dependence. The anonymous questionnaire focused on the question whether patients would prefer HMT to COMT. In our study, 986 of 5032 patients (19.6%) with COMT in Berlin participated. Of them, 881 (89.4%) patients gave information whether they would prefer HMT to COMT. RESULTS: Of the participating patients, 40.9% would prefer HMT to COMT. These patients report more detoxification therapies (P < 0.001), a higher dose of methadone equivalent (P = 0.001), and more often continued use of multiple illegal drugs despite COMT (P < 0.001) than patients not preferring HMT. They also report less improvement in mental health (P < 0.001) and working abilities (P < 0.001) because of COMT than patients not preferring HMT. CONCLUSIONS: The data on the patients' perspective complement the existing clinical studies, showing that previously unresponsive opioid-addicted patients especially would switch to HMT, whereas most patients would prefer continuation of COMT.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Heroin or conventional opioid maintenance? The patients' perspective
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View the PubMed citation for Heroin or conventional opioid maintenance? The patients' perspective4314
Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'
Type: Journal Article
Year: 2017
Publication Place: Netherlands
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'
4316
Heterogeneity of nonadherent buprenorphine patients: subgroup characteristics and outcomes
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: OBJECTIVES: To examine patient characteristics and outcomes associated with nonadherence to buprenorphine and to identify specific patterns of nonadherent behavior. STUDY DESIGN: Cross-sectional, retrospective analysis of health claims data. METHODS: Aetna's administrative claims data were used to categorize incident opioid use disorder (OUD) patients based on buprenorphine medication possession ratio (MPR) into adherent (n = 172) and nonadherent (n = 305) groups. Adherent groups were then divided into 5 subgroups based on level of MPR, as well as 2 a priori-defined groups: intermittent adherent (IA) and early treatment discontinuation-no consequences (ETDNC). Groups were compared on patient characteristics and outcomes. RESULTS: Nonadherent members incurred significantly greater healthcare costs and were more likely to relapse (P <.05). The use of high-cost healthcare services increased as a function of decreasing MPR (P <.05). Assessment of the a priori groups revealed IA members to have outcomes similar to nonadherent patients, while ETDNC members exhibited outcomes similar to adherent members. CONCLUSIONS: Administrative claims can be used to define subgroups of buprenorphine-medication assisted treatment (B-MAT) patients. Nonadherence was related to an increased likelihood of relapse, and there is an inverse relationship between MPR and cost. The heterogeneity observed within this sample indicates that treatment regimens effective for 1 subgroup may not be appropriate for all OUD patients. Increased understanding of B-MAT nonadherent subgroups may facilitate development of new interventions and medications specifically designed for nonadherent B-MAT patients, potentially leading to improved outcomes and reduced costs of care.
Topic(s):
Financing & Sustainability
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, Opioids & Substance Use
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Reference Links: View the PubMed citation for Heterogeneity of nonadherent buprenorphine patients: subgroup characteristics and outcomes