Literature Collection

4921

Hepatitis C treatment outcomes among patients treated in co-located primary care and addiction treatment settings

Type: Journal Article

Authors: Belle V. Ngo, Jocelyn R. James, Kendra L. Blalock, Sara L. Jackson, Lisa D. Chew, Judith I. Tsui

Year: 2021

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4922

Hepatitis C virus testing and treatment among persons receiving buprenorphine in an office-based program for opioid use disorders.

Type: Journal Article

Authors: Katelyn J. Carey, Wei Huang, Benjamin P. Linas, Judith I. Tsui

Year: 2016

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4923

Hepatitis infection in the treatment of opioid dependence and abuse

Type: Journal Article

Authors: T. F. Kresina, D. Sylvestre, L. Seeff, A. H. Litwin, K. Hoffman, R. Lubran, H. W. Clark

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.

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4924

Heroin maintenance for chronic heroin-dependent individuals

Type: Journal Article

Authors: M. Ferri, M. Davoli, C. A. Perucci

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.

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4925

Heroin or conventional opioid maintenance? The patients' perspective

Type: Journal Article

Authors: L. K. Bald, F. Bermpohl, A. Heinz, J. Gallinat, S. Gutwinski

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.

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4926

Heroin uncertainties: Exploring users' perceptions of fentanyl-adulterated and -substituted 'heroin'

Type: Journal Article

Authors: D. Ciccarone, J. Ondocsin, S. G. Mars

Year: 2017

Publication Place: Netherlands

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4927

Heterogeneity in the Development of Drug Use Versatility: Risk Factors for Polydrug Use throughout the Life-Course

Type: Journal Article

Authors: Thomas W. Wojciechowski

Year: 2019

Publication Place: Philadelphia

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4928

Heterogeneity of nonadherent buprenorphine patients: subgroup characteristics and outcomes

Type: Journal Article

Authors: C. Ruetsch, J. Tkacz, V. R. Nadipelli, B. L. Brady, N. Ronquest, H. Un, J. Volpicelli

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.

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4929

Hey, Doc, Can We Cut Down on the Pain Pills? Current Status of Opioid Tapering Guidelines and How to Do It (SA525)

Type: Journal Article

Authors: Eric Prommer, Mary Lynn McPherson, Kathryn Walker, Mellar Davis

Year: 2017

Publication Place: Madison

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4930

HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics

Type: Government Report

Authors: Department of Health and Human Services

Year: 2019

Topic(s):

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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4931

HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics

Type: Web Resource

Authors: Department of Health and Human Services

Year: 2019

Topic(s):

, ,

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.; This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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4932

HHS Roadmap for Behavioral Health Integration Fact Sheet of Accomplishments

Type: Report

Authors: U.S. Department of Health and Human Services

Year: 2024

Publication Place: Washington, DC

Topic(s):

, , , , ,

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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4933

HHS’s Strategic Approach to Addressing Social Determinants of Health to Advance Health Equity – At a Glance

Type: Web Resource

Authors: U.S. Department of Health and Human Services

Year: 2022

Publication Place: Washington, DC

Topic(s):

, ,

Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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4934

High Override Rate for Opioid Drug-allergy Interaction Alerts: Current Trends and Recommendations for Future

Type: Journal Article

Authors: M. Topaz, D. L. Seger, K. Lai, P. G. Wickner, F. Goss, N. Dhopeshwarkar, F. Chang, D. W. Bates, L. Zhou

Year: 2015

Publication Place: Netherlands

Abstract: This study examined trends in drug-allergy interaction (DAI) alert overrides for opioid medications - the most commonly triggered alerts in the computerized provider order entry (CPOE). We conducted an observational analysis of the DAI opioid alerts triggered over the last decade (2004-2013, n=342,338) in two large academic hospitals in Boston (United States). We found an increasing rate of DAI alert overrides culminating in 89.7% in 2013. Allergic reactions included a high proportion (38.2%) of non-immune mediated opioid reactions (e.g. gastrointestinal upset). The DAI alert override rate was high for immune mediated (88.6%) and life threatening reactions (87.8%). Exact allergy-medication matches were overridden less frequently (about 70%) compared to non-exact matches within allergy groups (over 90%). About one-third of the alert override reasons pointed to irrelevant alerts (i.e."Patient has tolerated the medication before") and 44.9% were unknown. Those findings warrant further investigation into providers' reasons for high override rate. User interfaces should evolve to enable less interruptive and more accurate alerts to decrease alert fatigue.

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4935

High Prevalence of Buprenorphine in Prenatal Drug Screens in an Appalachian City

Type: Journal Article

Authors: C. Alexander, K. Breuel, M. Olsen

Year: 2020

Publication Place: United States

Abstract:

OBJECTIVES: To define the magnitude of buprenorphine presence in the urine drug screens of pregnant women and to assess the presence of illicit buprenorphine use versus the presence of prescribed buprenorphine use. METHODS: Initial prenatal drug screen results for all pregnant patients in our practice for a 1-year period were analyzed and tabulated. RESULTS: Buprenorphine was found in the urine drug screens of 16% of pregnant patients. The presence of buprenorphine was by far the highest for any substance associated with neonatal abstinence syndrome (NAS). We estimate that the exposure to buprenorphine of approximately one-third of individuals in our population is associated with illicit buprenorphine use. CONCLUSIONS: The high rate of NAS in our region is primarily associated with both illicit and prescribed buprenorphine rather than other substances. Buprenorphine usage at the time that prenatal care is initiated, rather than opiate use at the onset of prenatal care, is the underlying factor that must be addressed if our region is to successfully combat our high rates of NAS.

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4936

High prevalence of urine tampering in an office-based opioid treatment practice detected by evaluating the norbuprenorphine to buprenorphine ratio

Type: Journal Article

Authors: A. J. Accurso, J. D. Lee, J. McNeely

Year: 2017

Publication Place: United States

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4937

High Quality of Care Persists With Shifting Depression Services From VA Specialty to Integrated Primary Care

Type: Journal Article

Authors: L. B. Leung, J. J. Escarce, J. Yoon, C. A. Sugar, K. B. Wells, A. S. Young, L. V. Rubenstein

Year: 2019

Publication Place: United States

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4938

High throughput mu-SPE based elution coupled with UPLC-MS/MS for determination of eluxadoline in plasma sample: Application in pharmacokinetic characterization of PLGA nanoparticle formulations in rats

Type: Journal Article

Authors: M. Iqbal, E. Ezzeldin, K. A. Al-Rashood, R. Al-Shdefat, M. K. Anwer

Year: 2018

Publication Place: England

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4939

High willingness to use overdose prevention sites among suburban people who use drugs who do not inject

Type: Journal Article

Authors: K. E. Schneider, G. J. Urquhart, S. Rouhani, S. T. Allen, M. Morris, S. G. Sherman

Year: 2023

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4940

High willingness to use rapid fentanyl test strips among young adults who use drugs

Type: Journal Article

Authors: Maxwell S. Krieger, Jesse L. Yedinak, Jane A. Buxton, Mark Lysyshyn, Edward Bernstein, Josiah D. Rich, Traci C. Green, Scott E. Hadland, Brandon D. L. Marshall

Year: 2018

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