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STUDY 2010 HTM file
Favorable mortality profile of naltrexone implants for opiate addiction
Few treatments for opiate addiction arouse as much controversy as naltrexone implants. Inserted under the skin, these block the effects of heroin for up to several months - for some, a magic bullet, for others, an unsafe and ethically dubious experiment. More evidence from Australia that the overdose death risk is less than with oral forms of the drug.
This wide-ranging review uniquely draws together findings from authoritative reviews of rigorous research conducted for the Cochrane collaboration and later studies concerned with the pharmacological and psychosocial treatment of dependence on opiate-type drugs like heroin, concluding that retention is the common key to success.
The evidence which led the UK government's drug policy advisers to call for the legalisation of the supply of foil by medical and drug services to drug users to promote transition from injecting to smoking heroin and crack cocaine.
Introduced in Scotland and England in the mid-late 1990s to prevent overdose, did supervised consumption of methadone really make methadone maintenance safer? After accounting for increased prescribing, this analysis concludes that it did curb methadone-related deaths.
This systematic review of 35 trials found that several sessions of information and skills training were no more effective than minimal educational interventions at reducing the kind of substance use and sexual behaviour which risks HIV infection in drug users who inject and/or use cocaine.
Intriguing suggestion from a Norwegian study that taking measures to effectively reduce bullying in schools (including improving the social climate and setting clear and consistently enforced boundaries) also curbs the development of forms of substance use most associated with disturbed child development.
This thorough review formed the evidential basis for recent guidance from England's National Institute for Health and Clinical Excellence on how best to distribute sterile syringes. Maximising the proportion of injections done with sterile equipment is the key objective.
Ironically, the fact that opiate substitute prescribing has been opposed and limited in Sweden has meant that country has been able provide solid evidence of its lifesaving potential. This study concluded that easing the restrictions was associated with and may have led to fewer opiate-related deaths.
Maintenance prescribing of drugs like methadone to heroin-dependent prisoners seems to reduce injecting and the sharing of injecting equipment, changes which should reduce the risk of becoming infected with HIV.
Evidence that the supervised injecting centre which opened in 2001 in Sydney’s ‘red light’ district resulted in fewer opioid overdoses requiring an ambulance, relieving pressure on emergency services.
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