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[Accessibility to methadone substitution treatment: the role of a low-threshold program].

https://arctichealth.org/en/permalink/ahliterature185068
Source
Can J Public Health. 2003 May-Jun;94(3):197-200
Publication Type
Article
Author
Michel Perreault
Michel Rousseau
Céline Mercier
Pierre Lauzon
Carole Gagnon
Pierre Côté
Author Affiliation
Centre de recherche de l'hôpital Douglas, Département de psychiatrie, Université McGill, Montreal, Qc. michel.perreault@douglas.mcgill.ca
Source
Can J Public Health. 2003 May-Jun;94(3):197-200
Language
French
Publication Type
Article
Keywords
Adult
Chi-Square Distribution
Female
HIV Infections - transmission
Health Services Accessibility
Heroin Dependence - rehabilitation
Humans
Male
Methadone - administration & dosage
Narcotics - administration & dosage
Program Evaluation
Quebec
Questionnaires
Abstract
To evaluate the accessibility to a Montreal low-threshold methadone program (Relais-Méthadone). This program is aimed at a marginalized population of heroin addicts who are injection drug users (IDU).
The data (n = 141 clients) were collected during the first year of the program implementation with questionnaires administered by the programme workers.
Analysis of the characteristics of the clients revealed that the program does reach the target population. The program's clientele is characterized by long-time and frequent heroin use, unstable lifestyles, and the presence of numerous behaviours that put them at high risk for HIV transmission. The retention of clients in the program is very high (88%) within the first 30 days.
These results demonstrate the importance and value of flexible intervention programs in reaching a marginalized clientele exposed to the HIV virus, who would not have access to regular programs characterized by restrictive selection criteria and limited availability.
PubMed ID
12790494 View in PubMed
Less detail

[Are substitution practices indicated in withdrawal within the framework of health care of drug addicts and according to what modalities?].

https://arctichealth.org/en/permalink/ahliterature217000
Source
Ann Med Interne (Paris). 1994 Nov;145 Suppl 3:87-8
Publication Type
Article
Date
Nov-1994
Author
P. Lauzon
Author Affiliation
Centre de Recherche et Aide pour Narcomanes, Montréal, Québec, Canada.
Source
Ann Med Interne (Paris). 1994 Nov;145 Suppl 3:87-8
Date
Nov-1994
Language
French
Publication Type
Article
Keywords
Clonidine - therapeutic use
Heroin Dependence - rehabilitation
Humans
Inpatients
Methadone - administration & dosage - adverse effects - therapeutic use
Outpatients
Prognosis
Quebec
Social Support
Therapeutic Community
Time Factors
PubMed ID
7880036 View in PubMed
Less detail

Chemical dependence in Canada: a view from the hill.

https://arctichealth.org/en/permalink/ahliterature242081
Source
NIDA Res Monogr. 1983 Apr;43:10-20
Publication Type
Article
Date
Apr-1983

Controversy over brain surgery for heroin addiction in Russia.

https://arctichealth.org/en/permalink/ahliterature184590
Source
Lancet Neurol. 2002 Oct;1(6):333
Publication Type
Article
Date
Oct-2002

A day-by-day investigation of changes in criminal convictions before and after entering and leaving opioid maintenance treatment: a national cohort study.

https://arctichealth.org/en/permalink/ahliterature259537
Source
BMC Psychiatry. 2013;13:262
Publication Type
Article
Date
2013
Author
Anne Bukten
Jo Røislien
Svetlana Skurtveit
Helge Waal
Michael Gossop
Thomas Clausen
Source
BMC Psychiatry. 2013;13:262
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Analgesics, Opioid - therapeutic use
Cohort Studies
Crime
Criminal Law
Criminals
Female
Heroin Dependence - rehabilitation
Humans
Longitudinal Studies
Male
Methadone - therapeutic use
Middle Aged
Norway
Opiate Substitution Treatment
Registries
Abstract
Opioid maintenance treatment (OMT) is associated with reduced crime among heroin users, but little is known about how crime changes during different phases of treatment. The aim of this study was to investigate changes in criminal convictions on a day-to-day basis before and after entry or discharge from OMT.
National cohort study of all patients (n = 3221) in OMT in Norway 1997-2003. Patients were followed over a 9-year period, before, during, and after treatment. Criminal convictions were studied on a day-to-day basis in relation to treatment status. A time-continuous estimate of the probability of convictions within the population for all days during observation was calculated.
Changes in convictions were evident before changes of treatment status. During the 3 years prior to OMT, the convictions rate was approximately 0.4% per day. Prior to OMT, convictions decreased to about 0.2% per day on the day of treatment initiation. During the weeks before dropping out of treatment, convictions increased. The patterns during periods of transition were the same across gender, age and pre-treatment conviction-levels.
Changes in convictions often occurred prior to changes in treatment status. Reductions in criminal convictions were found in the period before entry (or re-entry) to OMT, and increases in criminal activity were found in the months prior to treatment interruption.
Notes
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PubMed ID
24131480 View in PubMed
Less detail

'Diversion' of methadone or buprenorphine: 'harm' versus 'helping'.

https://arctichealth.org/en/permalink/ahliterature106659
Source
Harm Reduct J. 2013;10:24
Publication Type
Article
Date
2013
Author
Ingrid Amalia Havnes
Thomas Clausen
Anne-Lise Middelthon
Author Affiliation
Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO Box 4956, Oslo 0424, Norway. i.a.havnes@medisin.uio.no.
Source
Harm Reduct J. 2013;10:24
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Buprenorphine
Crime
Female
Heroin Dependence - rehabilitation
Humans
Male
Methadone
Middle Aged
Narcotics
Norway - epidemiology
Opiate Substitution Treatment
Opioid-Related Disorders - rehabilitation
Patient compliance
Prescription Drug Diversion - statistics & numerical data
Prisoners
Street Drugs
Substance-Related Disorders - complications - psychology
Young Adult
Abstract
'Non-compliant' individuals in opioid maintenance treatment, OMT, are often met with tight control regimes to reduce the risk of 'diversion', which may lead to harm or death among persons outside of OMT. This article explores reported practices of, and motivations for, diversion of methadone and buprenorphine, in a group of imprisoned individuals in OMT.
28 in-depths interviews were conducted among 12 OMT-enrolled, imprisoned individuals, most of whom were remand prisoners. All had experienced tight control regimes prior to imprisonment due to varying degrees of 'non-compliance' and illicit drug use during treatment. Their acquired norm of sharing with others in a drug using community was maintained when entering OMT. Giving one's prescription opioids to an individual in withdrawal was indeed seen as an act of helping, something that takes on particular significance for couples in which only one partner is included in OMT and the other is using illicit heroin. Individuals enrolled in OMT might thus be trapped between practicing norms of helping and sharing and adhering to treatment regulations. 'Diversion', as this term is conventionally used, is not typically understood as practices of giving and helping, but may nevertheless be perceived as such by those who undertake them.
As we see it, the need to sustain oneself as a decent person in one's own eyes and those of others through practices such as sharing and helping should be recognized. Treatment providers should consider including couples in which both individuals are motivated for starting OMT.
Notes
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Cites: BMJ. 2010;341:c485120847018
Cites: J Subst Abuse Treat. 2011 Dec;41(4):407-1421839605
Cites: Lancet. 2012 Jan 7;379(9810):71-8322225672
Cites: Addiction. 2012 Feb;107(2):393-921883606
Cites: Drug Alcohol Depend. 2012 Aug 1;124(3):307-1022382045
Cites: Forensic Sci Int. 2013 Jan 10;224(1-3):111-623246070
Cites: Int J Drug Policy. 2013 Nov;24(6):e43-5023199896
PubMed ID
24131626 View in PubMed
Less detail

[General practitioners can take responsibility for medication-based rehabilitation]

https://arctichealth.org/en/permalink/ahliterature78908
Source
Tidsskr Nor Laegeforen. 2007 Feb 1;127(3):296-7
Publication Type
Article
Date
Feb-1-2007
Author
Skeie Ivar
Brekke Mette
Lindbaek Morten
Waal Helge
Author Affiliation
Aslundmarka Legesenter, 2827 Hunndalen. ivskeie@online.no
Source
Tidsskr Nor Laegeforen. 2007 Feb 1;127(3):296-7
Date
Feb-1-2007
Language
Norwegian
Publication Type
Article
Keywords
Family Practice
Heroin Dependence - rehabilitation
Humans
Methadone - administration & dosage
Narcotics - administration & dosage
Registries
Social Support
Socioeconomic Factors
Treatment Outcome
Abstract
BACKGROUND: In Gjoevik, a Norwegian town with 28,000 inhabitants, general practitioners (GPs) have taken more responsibility for Methadone Maintenance Treatment (MMT) of heroin addicts than usual in Norway. We have assessed the treatment results in Gjoevik by comparing the fraction of patients who continue with treatment (retention in treatment, from 1999 to 2003), frequency of patient contact with professionals and the treatment outcome with the results for the rest of Norway. MATERIAL AND METHODS: In Norway, annual treatment results are reported for every MMT patient and the results are entered into a national register. This study is based on data in the national register from 2003. RESULTS: Retention is significantly higher in Gjoevik (93% vs. 77%) than in the rest of Norway. Patients have more contact with their GP in Gjoevik, while contact with local social service and so-called "responsibility groups" (organised cooperation between patient and professionals) are on the same level as for the country as a whole. The patients have less contact with specialized substance abuse and MMT centres than the average Norwegian patient. Treatment outcome regarding social rehabilitation (housing, source of income, occupation) and control of addictive behaviour (injecting drugs, opiate and illegal benzodiazepines in urine tests and overall assessment of drug behaviour) is close to the national average. INTERPRETATION: This may indicate that MMT programs with considerable delegation of treatment responsibility to GPs and local social service, can function as well as programs that rely more on specialised MMT-centres.
PubMed ID
17279108 View in PubMed
Less detail

Heroin substitution in Canada: a necessary public health intervention?

https://arctichealth.org/en/permalink/ahliterature206641
Source
Can J Public Health. 1997 Nov-Dec;88(6):365-6
Publication Type
Article
Author
R. de Burger
Source
Can J Public Health. 1997 Nov-Dec;88(6):365-6
Language
English
French
Publication Type
Article
Keywords
Canada
Crime - prevention & control
Drug and Narcotic Control
HIV Infections - prevention & control
Heroin Dependence - rehabilitation
Humans
Methadone - therapeutic use
Narcotics - therapeutic use
Notes
Comment On: Can J Public Health. 1997 Nov-Dec;88(6):367-709458560
PubMed ID
9458559 View in PubMed
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36 records – page 1 of 4.