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Can a limited period of being prescribed opiate-type medications generate longer term reductions in the criminal behaviour of patients dependent on illegal opiates like heroin? And of the two main medications – buprenorphine and methadone – which performs best? It seems a key factor is how well they retain patients in treatment.
How do different pathways for the treatment of problem opioid use compare under real-world conditions? For US patients with health insurance, opioid substitution therapy was associated with the greatest risk reduction. However, its protective effect may not be fully realised while federal and insurance plan restrictions continue to limit access to this treatment option.
In the Canadian province of British Columbia there was a rapid rise in overdose deaths from 2015, leading to the declaration of a public health emergency in 2016. The response rested on three key interventions: take-home naloxone, opioid substitution therapy, and drug consumption rooms. The province’s highly detailed surveillance data offered an opportunity to estimate their collective and individual impacts on opioid overdose deaths.
STUDY 2012 HTM file
Housing first for severely mentally ill homeless methadone patients
Homelessness is a significant obstacle to regular participation in methadone maintenance treatment, particularly among people leaving prison. This study in a major US city examines whether a ‘housing first’ programme could improve outcomes among this cohort.
The UK has a long history of prescribing heroin for the treatment of heroin dependence. What has research from six countries concluded about this intensive intervention intended for patients who would otherwise be considered ‘unresponsive’ to treatment?
In the new form of extended-release injections with effects lasting a month, the opioid medication buprenorphine was found to suppress illegal opioid use more effectively than a placebo, reinforcing its promise as a possible “game-changer” in opiate addiction treatment.
Opioid substitution therapy is a safe and effective approach for suppressing illicit opioid use. Helping to guide optimal provision, this review investigates the relative effects of methadone and buprenorphine on the rate of mortality over time.
REVIEW 2016 HTM file
Buprenorphine versus methadone for opioid dependence in pregnancy
Among pregnant women, substitute prescribing is preferable to continued illicit opioid use and supervised withdrawal. Buprenorphine has different properties to the dominant treatment option methadone, but both stand to improve pregnancy and infant outcomes.
In the new form of extended-release injections whose effects last up to a month, the opioid medication buprenorphine was found to suppress illegal opioid use more effectively than the standard daily regimen.
Based on detailed treatment records kept by the Canadian province of British Columbia, a slow taper liberally interspersed with stabilisation periods offers the best chance of sustainably withdrawing from methadone without severe relapse, but still very few manage to avoid this risk – an argument for careful consideration and informed consent before making the attempt.
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