Opiate Substitution Treatment: Medical treatment for opioid dependence using a substitute opiate such as METHADONE or BUPRENORPHINE.Methadone: A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of MORPHINE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)Narcotics: Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.Opioid-Related Disorders: Disorders related or resulting from abuse or mis-use of opioids.Buprenorphine: A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.Substance Abuse, Intravenous: Abuse, overuse, or misuse of a substance by its injection into a vein.Disease Transmission, Infectious: The transmission of infectious disease or pathogens. When transmission is within the same species, the mode can be horizontal or vertical (INFECTIOUS DISEASE TRANSMISSION, VERTICAL).Amino Acid Substitution: The naturally occurring or experimentally induced replacement of one or more AMINO ACIDS in a protein with another. If a functionally equivalent amino acid is substituted, the protein may retain wild-type activity. Substitution may also diminish, enhance, or eliminate protein function. Experimentally induced substitution is often used to study enzyme activities and binding site properties.Opiate Alkaloids: Alkaloids found in OPIUM from PAPAVER that induce analgesic and narcotic effects by action upon OPIOID RECEPTORS.

*  Pupillometry and Pain Thresholds Patients Substituted by Methadone and Buprenorphine - Full Text View - ClinicalTrials.gov

Opiate substitution treatment. Methadone. Buprenorphine. Hyperalgesia. Pupil. Pain. Psychophysics. previous illicit drug intake ... buprenorphine in opiate-dependent patients following a substitution program. ... buprenorphine in opiate-dependent patients following a substitution program. ... A first session shall be done at time of residual effect of the opiate. A second session shall be done at time of peak effect ...
https://clinicaltrials.gov/ct2/show/NCT01560442?recr=Open&intr=methadone&rank=17

*  How patterns of injecting drug use evolve in a cohort of people who inject drugs

Prospective observational study of outcomes and effect of opiate substitution treatment. BMJ 341: c3172 ... Oral substitution treatment of injecting opioid users for prevention of HIV infection. Cochrane Database of Systemic Review 8 ... Treatment programs such as OST are designed to reduce use and harms (Ward, Hall et al. 1999). In Australia OST is provided in ... Drug treatment series no. 23. Cat. no. HSE 147. Canberra: AIHW. *Barnett AG, van der Pols JC & Dobson AJ 2005. Regression to ...
aic.gov.au/publications/current series/tandi/501-520/tandi502.html

*  Specialist Adult Psychiatry - Travail-Emploi

We also wish you to have an interest in ADHD treatment and substitution treatment for opiate addiction. ... Clinical experience, what kind of treatments / patients do you expect the doctor to have experience with. Years of Experience? ... As a specialist, you are responsible for the assessment and treatment of these patients. The work is done in teams taking into ... The aim is, however, that the patient should be able to return to his regular treatment contacts in open care. The department ...
https://travail-emploi.com/offre/specialist-adult-psychiatry/

*  New Hepatitis C Treatment Offers 90% Cure, May Halve Infection Rate In Afflicted Areas

... opiate substitution treatment and needle exchange-- which have previously also been shown to be highly cost effective," Hellard ... opiate substitution treatment and needle exchange," said Matthew Hickman, professor of public health and epidemiology at the ... But treatment may lead to lower costs in the long run.. "Although the cost of these treatments appear to be expensive, economic ... At present, an antiviral HCV treatment exists that can cure approximately 60 percent of people treated. The current treatment ...
medicaldaily.com/new-hepatitis-c-treatment-offers-90-cure-may-halve-infection-rate-afflicted-areas-245594

*  Transitions: Linkages From Jail To Community - Full Text View - ClinicalTrials.gov

... propose to expand the availability of opiate substitution treatment and to enhance clinical and social services for PLWHA, who ... Adherence to HIV treatment and care among previously homeless jail detainees. AIDS Behav. 2013 Oct;17(8):2654-66. doi: 10.1007/ ... This model of case management has its roots in assertive community treatment (ACT) and has demonstrated a 37% greater reduction ... Contribution of substance use disorders on HIV treatment outcomes and antiretroviral medication adherence among HIV-infected ...
https://clinicaltrials.gov/show/NCT00841711?order=189

*  Dr Sayeed Haque - Institute of Clinical Sciences - University of Birmingham

Social Network Support for Individuals Receiving Opiate Substitution Treatment and Its Association with Treatment Progress. ... Prasher VP, Sachdeva N, Adams C and Haque MS (2013) Rivastigmine transdermal patches in the treatment of dementia in ...
birmingham.ac.uk/staff/profiles/clinical-sciences/haque-sayeed.aspx

*  News & Media

The Opioid Treatment Service pharmacotherapy program provides opiate substitution treatment to people in the ACT. ... Effective treatment for people with drug problems and support for their families is the right approach, not increasing stigma ... when we know that treatment services are already chronically underfunded.. "This scheme would either rely on cheap tests that ... Already there are not enough drug and alcohol services available in Australia to provide access to treatment for people who ...
https://apsad.org.au/news-a-media/

*  Transform Drug Policy Foundation Blog: UN Secretary General calls for decriminalisation of injecting drug users

... including needle exchange programs and opiate substitution treatment, and says governments should abandon counterproductive " ...
transform-drugs.blogspot.com/2008/03/un-secretary-general-calls-for.html

*  Transform Drug Policy Foundation Blog: UN INCB is 'obstacle' to HIV prevention and drug treatment programs

INCB members have spoken out against sterile syringe programs and opiate substitution treatment, despite findings by the Joint ... It should provide technical assistance to help countries accurately estimate the need for opiate substitution treatment, ... it has not acted to help countries accurately estimate their need for the opiate substitution treatment shown to be effective ... the Board has made no public effort to promote opiate substitution treatment (OST) in countries where large numbers of people ...
transform-drugs.blogspot.com/2007/03/un-incb-is-obstacle-to-hiv-prevention.html

*  Godzilla Threshold - TV Tropes

... cannabis or even opiates are far less permanently damaging to an adult brain than alcohol. A similar variant of substitution ... Quite a few medical treatments, both current and historical: * Both chemotherapy and radiation treatment are poisonous and can ... opiates for treatment-resistant depression, psilocybin for intense migraine or cluster headaches. The condition has to be so ... And if he doesn't, it will still consent to saving Merry... if Cross considers the Ivankov treatment. No one objects when Cross ...
tvtropes.org/pmwiki/pmwiki.php/Main/GodzillaThreshold

(1/268) Integration of methadone maintenance treatment and HIV care for injecting drug users: a cohort study in Bandung, Indonesia.

AIM: to know the effectiveness of antiretroviral treatment (ART) among methadone clients and patients who started ART outside the methadone program during the same period. METHODS: uptake of HIV testing and treatment were evaluated in a cohort of IDUs starting MMT. Effectiveness of anti-retroviral treatment (ART) was compared with matched 175 HIV-patients with a history of IDU outside MMT. RESULTS: overall, 223 patients were enrolled in MMT between May 2006 and January 2009, of whom 44% were tested for HIV, with an HIV prevalence of 73%. Screening of MMT clients was responsible for diagnosing HIV and starting ART in 31.9%, respectively 45.7%. Two year retention (100% vs 97.1%; p=0.23) and survival (93.9% vs 92.3%; p=0.76) during ART were not significantly different for 35 patients who combined ART with methadone, and the control group (n=175). Virological failure was found in one patient (3.7%) in MMT compared to 10.5% of the control group. CONCLUSION: providing HIV testing and treatment is a feasible and effective way to increase detection and treatment of HIV among clients enrolled in MMT. HIV- treatment integrated with methadone maintenance can be very effective. These results support wider application of integrated HIV care and opioid substitution.  (+info)

(2/268) HIV and injecting drug use in Indonesia: epidemiology and national response.

Indonesia is facing one of the most rapidly growing HIV-epidemics in Asia. Risk behaviour associated with injecting drug use, such as sharing contaminated needles, is the main risk factor for HIV infection. Among the general population the prevalence of HIV-infection is still low (0.2%), but up to 50% or more of the estimated 145.000 - 170.000 injecting drug users are already HIV-positive. Overrepresentation of injecting drug users and continued risk behavior inside Indonesian prisons contribute to spread of HIV. Through sexual contacts, HIV is transmitted from current or previous injecting drug users to their non-injecting sexual partners; 10-20% of this group may already be infected. The national response targeted to limit spread of HIV through injecting drug use has included needle and syringe program (NSP), methadone maintenance treatment (MMT), voluntary counseling and testing (VCT), and outreach program as priority programs. However coverage and utilization of the harm reduction services is still limited, but effective integration with HIV testing and treatment is expanding. By 2008, there were 110 service points for NSP and 24 operational MMT clinics. Nevertheless, utilization of these services has been less satisfactory and their effectiveness has been questioned. Besides effective prevention, HIV- testing and earlier treatment of HIV-seropositve individuals, including those with a history of injecting drug use, will help control the growing HIV-epidemic in Indonesia.  (+info)

(3/268) A longitudinal study of incarceration and HIV risk among methadone maintained men and their primary female partners.

 (+info)

(4/268) Methadone deaths: risk factors in pain and addicted populations.

 (+info)

(5/268) A transitional opioid program to engage hospitalized drug users.

 (+info)

(6/268) The Physician Clinical Support System-Buprenorphine (PCSS-B): a novel project to expand/improve buprenorphine treatment.

 (+info)

(7/268) Methadone maintenance and the cost and utilization of health care among individuals dependent on opioids in a commercial health plan.

 (+info)

(8/268) Methadone disposition in oral fluid during pharmacotherapy for opioid-dependence.

 (+info)



Buprenorphine


  • The purpose is to study the relation between pupillary diameter measured under scotopic conditions, and the pain thresholds measured at the time of peak and residual effect of methadone/buprenorphine in opiate-dependent patients following a substitution program. (clinicaltrials.gov)
  • Buprenorphine-based Opioid Substitution Therapy (OST) underwent a program shift from the use of Subutex to Suboxone (NPS RADAR 2011, Australian Institute of Health and Welfare 2014), however the effect of this on OST uptake is unknown and total OST use in Victoria has been largely stable since 2008 (Cogger et al. (aic.gov.au)
  • Evidence-based interventions will include, but not be limited to, enhanced rapid HIV testing within the New Haven Community Correctional Center (NHCCC, local jail), intensive case management, continuity of buprenorphine treatment from the jail to the community setting and a novel Money Management (MM) program. (clinicaltrials.gov)
  • The purpose of this study is to determine the effectiveness of drug and risk reduction counseling combined with either substitution drug treatment with buprenorphine/naloxone (BUP/NX) or short-term detoxification with BUP/NX in preventing HIV transmission among injection drug users. (clinicaltrials.gov)

syringe programs


  • Hepatitis C can be cured using antivirals, and the current prevention strategy is clean needle and syringe programs, as well as opiate substitution therapy. (medicaldaily.com)
  • INCB members have spoken out against sterile syringe programs and opiate substitution treatment, despite findings by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization, the United Nations Office on Drugs and Crime (UNODC) and the INCB itself that these measures are effective and important components of HIV prevention. (blogspot.com)

addiction


  • In 2005, a memorandum signed by an INCB member from Russia included numerous misstatements of fact meant to discredit the use of methadone as a treatment for opiate addiction. (blogspot.com)
  • Clinical trials with those who have had poor outcomes with conventional psychological or pharmacological addiction therapies could be a good starting point to further our under- standing of cannabis-based substitution effect. (alternet.org)
  • Full text of the study, "Cannabis as a substitute for alcohol and other drugs: A dispensary-based survey of substitution effect in Canadian medical cannabis patients," appears online in Addiction Research and Theory. (alternet.org)
  • Also, this treatment model provides an opportunity for individuals using illicit opioids to connect and engage with the addiction treatment system. (biomedcentral.com)
  • In summary, our findings provided the first evidence for the involvement of NCK2 in the susceptibility to opiates addiction and further revealed the racial and gender specificities of its impact. (hindawi.com)

dependence


  • A significant body of scientific evidence has shown the importance of measures such as effective treatment for chemical dependence and provision of sterile syringes in preventing HIV. (blogspot.com)
  • While the UN drug conventions clearly mandate treatment for drug users, the INCB has remained silent on the shortage of effective chemical dependence programs, and the abuses committed in the name of drug treatment and rehabilitation. (blogspot.com)
  • Treatment for opiate dependence was basically nonexistent until 1935, when U.S. Public Health Services opened a hospital in Lexington, Kentucky, devoted to the treatment of opiate dependence. (womenshealthsection.com)
  • The purpose of this document is to provide the reader with a current, evidence-based overview of opiate abuse and dependence and its treatment. (womenshealthsection.com)
  • and management of opiate dependence, including treatment of overdose, detoxification and withdrawal, agonist replacement therapy, and drug-free approaches. (womenshealthsection.com)
  • A confusing aspect of the body of research on opiate abuse and dependence is the inconsistent use of important terminology that describes the nature and severity of involvement with therapeutic and illicit opiates. (womenshealthsection.com)
  • Authors concluded: "While some studies have found that a small percentage of the general population that uses cannabis may develop a dependence on this substance, a growing body of research on cannabis-related substitution suggests that for many patients cannabis is not only an effective medicine, but also a potential exit drug to problematic substance use. (alternet.org)
  • The intervention that we will study will be directly observed therapy (DAART/DOT) and we will compare this to the current standard of care that involves self-administered therapy (SAT). All subjects will get transitional case management and all subjects with a prior history of opiate dependence will be offered opiate substitution therapy (buprenorphine or methadone). (clinicaltrials.gov)
  • Understanding the etiology of substance dependence is imperative to the development of effective treatment and prevention strategies. (hindawi.com)
  • The World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) reported that opiates dependence is associated with a high risk of HIV infection when opiates are injected using contaminated injection equipment [ 4 ]. (hindawi.com)
  • Linkage and genome-wide association studies (GWASs) have implicated many regions and genes for dependence on alcohol, tobacco, and opiates. (hindawi.com)

illicit


  • Illicit heroin use and treatment retention were assessed at 24-months for those voluntarily and involuntarily transitioning (n = 95) to oral methadone. (biomedcentral.com)

opioid


  • The Alcohol and Drug Services (ADS) incorporates 6 areas including the Opioid Treatment Service, Medical Services, Consultation and Liaison Service, 10 bed Inpatient Withdrawal Service, Police and Court Drug Diversion Service and Counselling and Treatment Services. (apsad.org.au)
  • The Opioid Treatment Service pharmacotherapy program provides opiate substitution treatment to people in the ACT. (apsad.org.au)
  • The most widely used maintenance treatment for opioid dependency is substitution with long-acting oral opioids. (biomedcentral.com)
  • 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. (biomedcentral.com)
  • Diversified opioid treatment should be available so patients and physicians can flexibly choose the best treatment at the time. (biomedcentral.com)

harm


  • Scaling up HCV treatment is critical to the prevention of HCV in the population to support and enhance traditional harm reduction measures - opiate substitution treatment and needle exchange," said Matthew Hickman, professor of public health and epidemiology at the University of Bristol and lead author of the study. (medicaldaily.com)
  • The services provided range from prevention and treatment to recovery and maintenance and harm minimisation. (apsad.org.au)
  • The report urges governments to provide a comprehensive package of harm reduction, including needle exchange programs and opiate substitution treatment, and says governments should abandon counterproductive "war on drugs" programmes. (blogspot.com)
  • A 2010 study published in the Harm Reduction Journal reported that cannabis-using adults enrolled in substance abuse treatment programs fared equally or better than nonusers in various outcome categories, including treatment completion. (alternet.org)

dependency


  • All subjects would be assessed and offered opiate substitution therapy if there was a prior history of opiate dependency as a means of relapse prevention. (clinicaltrials.gov)

Infection


  • The development of highly effective simplified new HCV treatments has the potential to greatly enhance existing HCV prevention strategies," said Professor Greg Dore, head of the Viral Hepatitis Clinical Research Program, Kirby Institute for Infection and Immunity in Society at the University of New South Wales, Australia. (medicaldaily.com)
  • The primary endpoint for the study was cumulative HIV infection or death after a second year of follow-up (i.e. at week 104), one year after completion of the treatment phase, designed to test a durable intervention effect. (clinicaltrials.gov)

needle


  • Data from the Tasmania Needle Availability Program suggested that almost half of all transactions from non-pharmacy outlets were associated with the use of pharmaceutical opiates. (ndlerf.gov.au)

Therapy


  • Comparisons are made between the injection frequency of participants on or off Opioids Substitution Therapy (OST), and according to the settings in which drugs are most frequently purchased and used (eg street, house). (aic.gov.au)

Diseases


  • The HIV in Prisons Program and the Community Health Care Van (CHCV) at the Yale University AIDS Program, in collaboration with the Connecticut Department of Correction and the Waterbury Hospital Infectious Diseases Clinic, propose to expand the availability of opiate substitution treatment and to enhance clinical and social services for PLWHA, who are transitioning from the jail to the community setting. (clinicaltrials.gov)

Methadone Treatment


  • The Office of National Drug Control Policy subsequently made changes in the 1995 Federal Regulations of Methadone Treatment to encourage the development of a less restrictive approach and to give physicians more latitude in prescribing methadone. (womenshealthsection.com)

detoxification


  • However, treatment was entirely detoxification-based at that time. (womenshealthsection.com)
  • A separate 2009 study published in the American Journal on Addictions reported that moderate cannabis use and improved retention in naltrexone treatment among opiate-dependent subjects in a New York state inpatient detoxification program. (alternet.org)

involvement


  • There is an unmet need for research applying the treatment cascade to improve outcomes for those with criminal justice involvement. (biomedcentral.com)

programs


  • Treatment programs such as OST are designed to reduce use and harms (Ward, Hall et al. (aic.gov.au)
  • There may also be an opportunity to reduce the supply of pharmaceuticals by enhancing the capabilities of medical practitioners as far as patient assessment is concerned and by increasing access to specialist pain management and drug treatment programs. (ndlerf.gov.au)

clinical


  • The new antiviral HCV treatment, a type of interferon -free direct-active antiviral (DAA), has been shown in clinical studies to be more effective. (medicaldaily.com)

withdrawal


  • The three main reasons cited for cannabis-related substitution are 'less withdrawal' (67.7 percent), 'fewer side-effects' (60.4 percent), and 'better symptom management' suggesting that many patients may have already identified cannabis as an effective and potentially safer adjunct or alternative to their prescription drug regimen. (alternet.org)

severity


  • This model of case management has its roots in assertive community treatment (ACT) and has demonstrated a 37% greater reduction in homelessness and a 26% greater improvement in psychiatric symptom severity compared with standard case management treatments. (clinicaltrials.gov)

participants


  • Among the participants randomized to injectable treatments, a sub-group voluntarily chose to transition to oral methadone (n = 16) during the treatment period. (biomedcentral.com)
  • The present study sought to determine outcomes of participants receiving injectable DAM in a Canadian trial who voluntarily transitioned to oral methadone during the study period compared to those whose treatment was discontinued as the study ended. (biomedcentral.com)

Research


  • The STTR treatment cascade provides a framework for research aimed at improving the delivery of services, care and outcomes of PLWH. (biomedcentral.com)

patients


  • There is a clear structure, where all patients undergo structured diagnosis initially, treatment plan is planned accordingly. (travail-emploi.com)
  • This ensures that all patients receive evidence-based care and treatment based on each patient's condition. (travail-emploi.com)
  • As a specialist, you are responsible for the assessment and treatment of these patients. (travail-emploi.com)
  • Patients have their main contact and treatment at our outpatient clinics but in case of failure or severe deterioration, in patient-care can be considered. (travail-emploi.com)
  • Treatment with injectable diacetylmorphine provides an opportunity for patients to stabilize and possibly transition to oral treatment, if clinically indicated. (biomedcentral.com)
  • Moreover, after starting treatment with DAM, some patients may choose to transfer to MMT. (biomedcentral.com)

drugs


  • The current treatment is poorly tolerated, long in duration (five to 11 months), and has a low rate of adherence among people who inject drugs, the cure's principal target. (medicaldaily.com)
  • Opiates are drugs derived from opium, including the natural products morphine, codeine, and thebaine, and numerous semisynthetic derivatives. (womenshealthsection.com)

effect


  • A first session shall be done at time of residual effect of the opiate. (clinicaltrials.gov)
  • A second session shall be done at time of peak effect of the opiate. (clinicaltrials.gov)

availability


  • Although the Board is responsible for ensuring the global availability of legal opiates, it has not acted to help countries accurately estimate their need for the opiate substitution treatment shown to be effective in reducing HIV risk and increasing adherence to antiretroviral medications. (blogspot.com)

evidence-based


  • Transitions involves the integration of evidence-based interventions, intensive case management that incorporates outreach elements similar to assertive community treatment (ACT). (clinicaltrials.gov)

further


  • Researchers believe that the new treatment could work in conjunction with existing strategies to further prevent and treat HCV. (medicaldaily.com)

fewer


  • Trials suggest that treatment duration is shorter (12 weeks), presents fewer complications and side effects, and has a cure rate of 90 percent. (medicaldaily.com)

support


  • Day E, Copello A, Karia M, Roche J, Grewal P, George S, Haque S , Chohan G. (2013) Social Network Support for Individuals Receiving Opiate Substitution Treatment and Its Association with Treatment Progress. (birmingham.ac.uk)

people


  • At present, an antiviral HCV treatment exists that can cure approximately 60 percent of people treated. (medicaldaily.com)

substance


  • The Seek, Test, Treat, and Retain (STTR) criminal justice (CJ) cohort combines data from 11 studies across the HIV treatment cascade that focused on persons involved in the criminal justice system, often but not exclusively for reasons related to substance use. (biomedcentral.com)

impact


  • Additional areas of the course will be devoted to the abuse liability of prescription opiates and the impact of abused opiates on the fetus. (womenshealthsection.com)

Study


  • Prasher VP, Sachdeva N, Adams C and Haque MS (2013) Rivastigmine transdermal patches in the treatment of dementia in Alzheimer's disease in adults with Down syndrome - pilot study. (birmingham.ac.uk)

Services


  • It could also unnecessarily burden those who have a legitimate need to obtain these medications and lead to an increase in demand for already stretched drug treatment and pain management services. (ndlerf.gov.au)

engage


  • The development of effective approaches to increase HIV diagnoses and engage PLWH in subsequent steps of the treatment cascade could lead to earlier and sustained ART treatment resulting in viral suppression. (biomedcentral.com)

Improvements


  • If we had continued offering treatment with diacetylmorphine, those retained to injectable medication may have sustained the achieved improvements in the first 12 months. (biomedcentral.com)

Consultation


  • Therefore, if clinically indicated and in consultation with the patient, transitions to other forms of treatments, in particular long acting oral opioids, might be a favourable outcome. (biomedcentral.com)

months


  • Treatment was provided for 12-months with an additional 3 months for transition and weaning. (biomedcentral.com)

maintenance


  • Methadone syrup was typically purchased directly from friends or others who were receiving methadone maintenance treatment (MMT). (ndlerf.gov.au)