Integrating OST and HIV care can help increase access to services, but how do we integrate so it really works for people? By Dr Andy Guise.
BACKGROUND: Approximately 3% of people receiving opioid substitution therapy (OST) in the UK manage to achieve abstinence from prescribed and illicit drugs within three years of commencing treatment. Involvement of families and wider social networks in supporting psychological treatment may be an effective strategy in facilitating recovery, and this pilot study aimed to evaluate the impact of a social network-focused intervention for patients receiving OST. METHODS: A two-site, open feasibility trial randomised patients receiving OST for at least 12 months but still reporting illicit opiate use in the past 28 days to one of three treatments: 1) treatment as usual (TAU), 2) Brief Social Behaviour and Network Therapy (B-SBNT) + TAU, or 3) Personal Goal Setting (PGS) + TAU ...
Drug and Alcohol Findings Effectiveness Bank analysis titled: Substitution treatment of injecting opioid users for prevention of HIV infection
The paper sets out the current position on supplying naloxone saying that it can be prescribed to anyone who is: currently using illicit opiates (such as heroin); receiving an opioid substitution therapy; leaving prison with a history of drug use; those who have previously taken opiates (in order to prevent relapse). Equally importantly, if the person who has been supplied naloxone agrees then it can also be supplied to family members, carers, peers and friends. They do warn that ...
Figure 3. Total number of deaths due to liver-related, drug-related, and other causes in a large population-based study of people diagnosed with hepatitis C virus (HCV) infection in New South Wales, Australia, from 1992 to 2006 (Scott Walter, personal communication, August 11, 2011).. Consistent with increasing numbers of people with HCV dying from liver-related causes, the proportion of all liver disease deaths with underlying HCV is increasing in many settings, as demonstrated in a population-based study in Scotland.[4] The burden of HCV-related advanced liver disease is also seen in increasing numbers of HCV-related liver transplants in many countries.[16]. Mortality Among Injection Drug Users With HCV Infection. The prevalence of HCV among regular IDUs and people receiving opioid substitution therapy (OST) is 60 to 80%;[61] thus, mortality studies in these populations are likely to reflect mortality among IDUs with HCV infection. Overall, mortality rates in these two populations are 1 to 2 ...
The provision of programs to prevent the spread of HIV and hepatitis among people who inject drugs (PWID) is inadequate in many countries around the world and presents a critical public health problem, comprehensive reviews by Australian researchers from the National Drug and Alcohol Research Centre at UNSW Sydney have found.. The two reviews of the global prevalence of injecting drug use and of interventions to prevent the spread of blood borne viruses among PWID are published today in leading international journal The Lancet Global Health.. The authors estimate that 15.6 million people have recently injected drugs. Of these, 18% are living with HIV infection and 52% test positive for hepatitis C (HCV) antibody.. Yet despite evidence that needle and syringe programs (NSP) and opioid substitution therapy (OST) reduce HIV and HCV infections, they are still not being implemented in many places, and few people can access them in many countries, the authors found.. Australia is one of only four ...
Results 975 patients were identified of which 684/975 (70%) were male and median 53 (23-89) years old. 608/975 (62%) were HCV GT 1, 50/975 (5%) were GT 2, 237/975 (24%) were GT 3, 65/975 (7%) were GT 4. 564/975 (58%) were cirrhotic.. The HCV regimens chosen based on local policies are listed in table 1.. 3808 co-medicines were identified in 804/975 (82%) of patients (median of 5.5 medicines/patient). Of the co-medications prescribed: 26% were CNS drugs, 19% cardiac drugs, 12% gastric drugs, 5% HIV drugs and 4.5% opioid substitution therapies. There were 702 interactions identified. Of these 678 (96%) were amber DDIs (close monitoring/dosage adjustment required), with 24 (4%) were red (do not co-administer). ...
Patients with a history of opiate abuse (IVDU) are not only a patient population that is frequently difficult to reach by the healthcare system, but it also exhibits specific problems in HIV-treatment (ART). These patients frequently have a chaotic lifestyle, which makes it difficult to take medications regularly. Amongst the reasons for this are housing difficulties, intoxication and substance abuse.. The introduction of opiate substitution treatment can help to provide some structure and certainty to patients. Even so IVDU patients are often started on ART later than others and have a greater tendency to have treatment interruptions and sub-optimal adherence to ART. The end result can be treatment failure and the development of drug resistance.. There is an unmet medical need for ART regimens that make adherence easier and may be suitable for co-administration with once-daily opiate substitution.. The availability of tenofovir disoproxil fumarate (DF) 300 mg offers new options in the creation ...
Patients with a history of opiate abuse (IVDU) are not only a patient population that is frequently difficult to reach by the healthcare system, but it also exhibits specific problems in HIV-treatment (ART). These patients frequently have a chaotic lifestyle, which makes it difficult to take medications regularly. Amongst the reasons for this are housing difficulties, intoxication and substance abuse.. The introduction of opiate substitution treatment can help to provide some structure and certainty to patients. Even so IVDU patients are often started on ART later than others and have a greater tendency to have treatment interruptions and sub-optimal adherence to ART. The end result can be treatment failure and the development of drug resistance.. There is an unmet medical need for ART regimens that make adherence easier and may be suitable for co-administration with once-daily opiate substitution.. The availability of tenofovir disoproxil fumarate (DF) 300 mg offers new options in the creation ...
The latest issue of the Journal of Viral Hepatitis investigates perceptions of clients and health professionals and hepatitis C treatment in opiate substitution treatment.. ...
Methadone maintenance treatment (MMT) was implemented in China since 2004. It was initiated in 8 pilot clinics and subsequently expanded to 738 clinics by the end of 2011. Numerous individual research studies have been conducted to estimate HIV and HCV prevalence among MMT clients but an overview of the epidemics in relations to MMT remains unclear. The aim of this study is to estimate the magnitude and changing trends of HIV, HCV and HIV-HCV co-infections among entry clients to MMT clinics in China during 2004-2010. Chinese and English databases of literature were searched for studies reporting HIV, HCV and co-infection prevalence among MMT clients in China from 2004 to 2010. The prevalence estimates were summarized through a systematic review and meta-analysis of published literatures. Ninety eligible articles were selected in this review (2 in English and 88 in Chinese). Nationally, pooled prevalence of HIV-HCV and HIV-HCV co-infection among MMT clients was 6.0% (95%CI: 4.7%-7.7%), 60.1% (95%CI: 52.8
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO P O L I C Y S TAT E M E N T # Methadone Maintenance Treatment for Opioid Dependence APPROVED BY COUNCIL: PUBLICATION DATE: KEY WORDS: REFERENCE MATERIALS:
(Prison-Based Methadone Maintenance Programs) Ensuring that offenders have access to interventions that address their substance abuse issues allows the Correctional Service of Canada (CSC) to support the safe reintegration of offenders into society. The treatment needs of offenders with opioid dependence are met through CSCs Methadone Maintenance Treatment (MMT) Program.1
This Methadone Saves Lives brochure (one in a series of three) provides addiction counsellors with practical information on methadone maintenance treatment, including information on treatment benefits.
2011-2016 University of Minnesota Press , Privacy Policy , The University of Minnesota is an equal opportunity educator and employer.. ...
Data, statistics and information about conventional opioid substitution therapy including methadone, buprenorphine and naltrexone
Susie McLean, senior adviser on drug use and HIV for the International HIV/AIDS Alliance. "…The evidence for the effectiveness of harm reduction interventions - reducing the negative consequences of drug use rather than focusing solely on reducing drug use - is described by UNAIDS as irrefutable and all relevant U.N. agencies now endorse a harm reduction approach to HIV and drug use. … Yet in Vienna last week, references to harm reduction, needle and syringe programs, and opioid substitution therapy (OST) were contested. The policy process has been widely criticized, and the negotiations heavily influenced by countries including Russia who are vetoing harm reduction in favor of a bald restatement of the decades-old illusion of a drug-free world. … [I]ts unbelievable that U.N. member states are likely to recommit to another ineffective and dangerous policy on drugs when it is put before them in New York next month, at the first U.N. General Assembly special session on drugs. While this ...
A needle exchange and support service aimed at fishermen is delivered harbour-side in Terengganu, Malaysia. ©International HIV/AIDS Alliance. Unfortunately, many of the gains made at last years UNGASS are being eroded by some member states. In the Phillippines, people who use drugs are being killed and arrested, and in Cambodia, Tanzania and other countries people who use drugs are increasingly incarcerated. Police harassment drives people who use drugs away from HIV and hepatitis C prevention services.. The HIV situation among people who inject drugs remains critical. UNAIDS data from 2016 shows that new HIV infections among people who inject drugs have increased by a staggering one third, from 114,000 in 2011 to 152,000. Since 2014, no new countries have introduced needle and syringe programmes or opioid substitution therapy - the first time that this has happened since 2006.. It is not possible to end the HIV and hepatitis C epidemics amongst people who inject drugs, and uphold the UNGASS ...
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BACKGROUND: Injecting drug use is a major risk factor for the acquisition and transmission of HIV and Hepatitis C virus (HCV). Prevention of these infections among people who inject drugs (PWID) is critical to reduce ongoing transmission, morbidity and mortality.. METHODS: A review of reviews was undertaken involving systematic literature searches of Medline, Embase, CINAHL, PsychINFO, IBSS and the Cochrane Library (2000-2011) to identify English language reviews regarding the effectiveness of harm reduction interventions in relation to HIV transmission, HCV transmission and injecting risk behaviour (IRB). Interventions included needle and syringe programmes (NSP); the provision of injection paraphernalia; opiate substitution treatment (OST); information, education and counselling (IEC); and supervised injecting facilities (SIFs). Reviews were classified into core or supplementary using critical appraisal criteria, and the strength of review-level evidence was assessed.. RESULTS: Twelve core ...
In this cross-sectional study with 2121 MMT participants from western China, we observed the overall prevalence of ever, current and heavy/hazardous for smoking was 98.6%, 97.8% and 66.3%, respectively; and the prevalence for alcohol drinking was 86.6%, 58.6% and 16.6%, respectively. We also found significantly different patterns of tobacco and alcohol consumption when comparing men and women, or HIV-positive and negative participants. Moreover, we reported that gender, age, ethnicity, level of education and sexual activity were associated with smoking and drinking behaviours, while length of MMT and HIV infection were negatively associated with heavier drinking. Smoking and drinking were also correlated with each other in the models.. MMT patients in the survey showed an overall prevalence of current smoking of 97.8%, which was more than three times that of 28.3% in Chinese general adults. When looking by gender, the prevalence of current smoking was about twice and 30 times than that of ...
The research follows internationally recognised guidelines for costing substance use treatment interventions and standard economic principles for cost estimations and analysis of cost-effectiveness of the two drug dependence treatment approaches. For this study a treatment provider perspective is adopted. The design and methods for costing and measurement of effectiveness of CCT (Part A) and MMT (Part B) are described below.. Part A (focuses on measuring the costs and effectiveness of CCT):. Primary data on the costs to Government and participants who are placed into the treatment were collected. To measure the effectiveness of the CCT modality, a total of 208 CCT-released participants (sample size based on power analysis) were interviewed about their drug use and drug-related problems at baseline (after their release from CCT) and at 3, 6 and 12 month follow-up interviews.. Primary data were collected to measure the effectiveness of CCT. A combined retrospective and prospective longitudinal ...
Participants were recruited from methadone clinic waiting rooms, and were enrolled if they were HIV infected, were prescribed ART, were receiving HIV care at the methadone clinic or affiliated site, had a 5- or 6-day methadone pick-up schedule, and were on a stable dose of methadone for at least 2 weeks. Patients were tested for genotypic resistance to their ART; only those sensitive to their regimen were enrolled. Patients were randomized to either DOT or treatment as usual, and were block-stratified by once versus twice-daily ART regimen. Those in the DOT arm received one dose of ART at the same time they received their daily methadone. Non-observed ART included evening doses for those on twice-daily regimens, some Saturday and all Sunday doses. Participants in the treatment-as-usual (TAU) group received ART prescriptions from their regular HIV providers. All trial participants received adherence counseling. Study visits included a baseline visit and 8 weekly visits, followed by 4 monthly ...
If it is set that a affected person could take advantage of methadone therapy by a medical Qualified, they may be referred to methadone clinics in the area. Some clinics do let people combating habit to simply wander in off the street with no referral. The patient might be offered an analysis with the severity from the dependancy, commonly by determining the type of drug or medications which have been utilized, simply how much, and because of the evidence of withdrawal signs or symptoms ...
HCV Next | Methadone clinics are emerging as an important setting for the education and treatment of patients with hepatitis C virus infection. Programs such as the START Treatment and Recovery Centers in New York City are leading the way in providing a venue for individuals not only to kick their addiction to opiates, but also to receive screening for HCV, learn about disease prevention measures and stay
Kayla Lackeys mother Erin has reached a $1.8 million wrongful death agreement with Community Health Care Inc., a for-profit Massachusetts methadone clinic - April 15, 2010
This scares me alot but Ive turned to each other avenue but dont want to ruin my body either i am only 26 yrs aged and be sure to keep in mind i am not on methadone since i am receiving off of drugs it can be for pain management only,moreover i wanted to know how often am i allowed to take methadone i am using it each and every six hrs today and just ensuring that Im not overdosing myself,but for many rationale the methadone keeps my pain absent longer than the narcos, I also am worried about gaining weight i have previously gained about fifty five pounds given that i had my breast reduction so i do desire to unfastened weight but I website need to do it the best way!!!Im also involved about two other items having the somas with the methadone my medical professional suggests its Alright but just require another viewpoint,and 2nd issue is Im worried that methadone will impact my intimate romantic relationship with my spouse is there n e issue i can perform to help me in this Division?? I ...
Methadone withdrawal will be required sooner or later, after methadone maintenance or a pain management program using methadone has begun. If your feeling enslaved by having to go to a Tenaha TX clinic or a pharmacy everyday and going through hell if you want to travel, there is a way out.. ...
Methadone withdrawal will be required sooner or later, after methadone maintenance or a pain management program using methadone has begun. If your feeling enslaved by having to go to a Adah PA clinic or a pharmacy everyday and going through hell if you want to travel, there is a way out.. ...
The pages that follow outline procedures for the counsellor to help the methadone maintenance treatment (MMT) team determine a clients eligibility for MMT, and describe the process of formalizing a commitment to participating in MMT and developing a detailed plan of care.. When a potential client contacts a substance use treatment service, an assessment process begins. The two most fundamental issues in assessment are the following: determining the most appropriate treatment alternatives and developing a plan of care that is consistent with the clients particular needs and preferences ...
Press release issued 6 May 2013. Scientists show potential impact of therapy in reducing transmission in UK, Canada and Australia Around 150 million people globally are chronically infected with the hepatitis C virus (HCV) - a major cause of liver disease and the fastest growing cause of liver transplantation and liver cancer.1 New prevention strategies are urgently required as people are continuing to be infected with HCV. Findings, published in Hepatology, reveal the impact of a new antiviral treatment that could potentially reduce HCV rates in some cities affected by chronic HCV prevalence by half over 15 years. In Europe, the US and other developed countries the majority of HCV infections occur among people who inject drugs (PWID). Although current prevention strategies, which are based on needle and syringe programmes and opiate substitution therapy, can avert HCV infections and have reduced its prevalence in some cities from the very high levels that occurred in the 1980s, these ...
The takeaway policy for methadone is determined for each jurisdiction in line with the National Policy on Methadone Treatment. There are both benefits and problems associated with takeaway doses and particular care should be exercised when authorising this as a component of management ...
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Metro East is a Methadone maintenance treatment rehab with a primary focus on Substance abuse treatment and drug rehab. Metro East specializing in Outpatient Substance Abuse Treatment and Drug Rehab Program
The report [PDF] singled out tactics such as forced labor, punitive use of electric shock, prolonged restraint and isolation, rape and other sexual violence in detention, as well as and denial of maintenance medications like methadone or buprenorphine (Suboxone) in treating addiction. It also reported on failures to provide adequate pain treatment as potentially constituting torture.". "A particular form of ill-treatment and possibly torture of drug users is the denial of opiate substitution treatment," the report says, noting that this is considered a human rights violation when done in jails and prisons. "Similar reasoning should apply to the non-custodial context," it says, meaning that provision of such treatment should be required when desired by patients and where evidence suggests it would help. Some countries - like Russia - completely ban the use of maintenance treatments, despite the fact that they have been shown to cut overdose deaths dramatically. American prisons also routinely ...
Treatment center listing for Beth Israel Methadone Clinic in New York, New York. Find local drug rehab listings in New York near Beth Israel Methadone Clinic at TheGoodDrugsGuide.com.
The treatment of HCV has evolved rapidly. The first agent approved for treatment was interferon , which as monotherapy induced a sustained biochemical and virologic response in less than 20% of treated patients (Poynard et al., 1996). More recently, the addition of oral ribavirin has led to a substantial improvement in virologic response rates. A typical treatment regimen now consists of 6-12 months of interferon/ribavirin combination therapy. Approximately 40% of patients who complete the treatment will exhibit a sustained virologic response (SVR), as demonstrated by the absence of virus 6 months after the completion of therapy ( Poynard and McHutchison). Importantly, over 95% of these patients will remain virus-free 5 years later and may be cured of the disease ( Reichard et al., 1999). In addition, the US FDA has recently approved a longer acting form of interferon, called pegylated interferon, which elicits a SVR in nearly 40% as a monotherapy (Zeuzem et al., 2000). Studies combining this ...
While acknowledging that WHO added methadone and buprenorphine to its Model List of Essential Medicines in 2005, the Board has made no public effort to promote opiate substitution treatment (OST) in countries where large numbers of people inject drugs. It also has failed to highlight OST as an essential tool in HIV care or treatment. Although Ukraine, China, Malaysia and Iran have moved in recent years to expand OST programs and/or needle exchange programs to contain HIV, INCB reports have not expressed appreciation for or satisfaction with these developments. Instead, the Board has expressed concern about diversion of methadone and buprenorphine, and urged WHO to advocate for tightened controls on these medications ...
McLellan, A.T., Arndt, I., Metzger, D., Woody, G.E., OBrien, Ch.P. The Effects of Psychosocial Services in Substance Abuse Treatment. JAMA, 269, 15, 1953-1959, 1993. Objective.-To examine whether the addition of counseling, medical care, and psychosocial services improves the efficacy of methadone hydrochloride therapy in the rehabilitation of opiate-dependent patients.. Design.-Random assignment to one of three treatment groups for a 6-month clinical that: (1) minimum methadone services (MMS)-methadone alone (a minimum of 60 mg/d) with no other services-, (2) standard methadone services (SMS) -same dose of methadone plus counseling-, or (3) enhanced methadone services (EMS)-same dose of methadone plus counseling and on-site medical/psychiatric, employment. and family therapy.. Setting.-The methadone maintenance program of the Philadelphia (Pa) Veterans Affairs Medical Center.. Subjects.-Ninety-two male intravenous opiate users in methadone maintenance treatment Results.-While methadone ...
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The study, published today in the Canadian Medical Association Journal (CMAJ), attributed most of the economic benefits to the fact that recipients of medically prescribed heroin (diacetylmorphine) stayed in treatment longer and spent less time in relapse than those receiving methadone. Both results are associated with reduced criminal activity and lower health care costs.. Additionally, an individual in the diacetylmorphine group was more likely to live longer than someone receiving methadone maintenance therapy.. The findings were drawn from the North American Opiate Medication Initiative (NAOMI), a trial of medically prescribed heroin that took place in Vancouver from 2005 to 2008, as well as administrative drug data from British Columbia. NAOMI was North Americas first-ever clinical trial of prescribed heroin.. The researchers - led by Dr. Aslam Anis, director of the Centre for Health Evaluation and Outcome Sciences (CHÉOS) at Providence Health Care and professor in UBCs School of ...
They came to the podium in a two-hour procession. Dressed in gym clothes and jeans, in skirts and suits, residents turned out Thursday to voice strong opposition to a planned methadone clinic on
Methadone maintenance treatment (MMT) has been accepted as therapy for opioid-addicted pregnant women since several decades. Previous studies indicate increased risk of psychomotor dif culties in children prenatally exposed to opioids. Conclusion: During the first two years of life, neurodevelopmental outcome of children born from MMT mothers tended to be lower than normative mean, with motor abilities being more affected than cognitive competences. Our results suggest that higher methadone doses during pregnancy can have a detrimental effect on neonatal characteristics and children psychomotor development.
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... Methadone/Buprenorphine Treatment: available. Substitution treatment is provided by specialized state-run clinics [Centros de Atendimento de Toxicodependentes (CATs)] and a few hospitals. There is a large network of general health centres and pharmacies, i.e. patients need not stay at one of the places providing a CAT but can be forwarded to one of the health centres or pharmacies participating in the network (greater mobility). Foreign substitution patients will be accepted for temporary treatment provided their home prescribers get in touch with the director of a CAT one or two weeks before the expected arrival of the patient to provide sufficient time for arrangements to be made. When the patient arrives at the treatment center he/she must present a certificate from his/her home prescriber (in English or French - best would be to have it translated into Portuguese) detailing the daily dosage, the patients full name and address and the dates of arrival in and departure from ...
Pyramid Healthcares methadone treatment center in Butler PA provides effective meth addiction treatment and rehabilitation programs.
Methadone Maintenance is the most tested and proven way to cure opiate/heroin addiction. It has been used for 30 years, yet people do not see it as medicine but trading one addiction for another. No other medication has such stigma attached to it. But it still has the highest success rate in treating addiction.
April 17, 2011 4. Methadone maintenance is a controversial treatment model for heroin and other narcotic addiction. Write a one page paper either for or
In the interest of maintaining the independence of its continuing medical education (CME) activities, and in accordance with the policies of the Accreditation Council for Continuing Medical Education (ACCME), the IAS-USA requires all persons with control of content (ie, faculty, IAS-USA Board members, and program staff) to disclose any financial relationships that they or their spouses or partners have had with commercial companies within the past 12 months. Any real or apparent conflicts of interest of those parties are resolved prior to the CME activity being delivered. Individuals who refuse to disclose financial interests may not participate in an IAS-USA CME activity.. ...