Relevant bibliographies by topics / Opioid substitution treatment program

Academic literature on the topic 'Opioid substitution treatment program'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles

Select a source type:

Contents

Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Opioid substitution treatment program.'

Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.

You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.

Journal articles on the topic "Opioid substitution treatment program"

1

Stubley, Carolyn, and Garth Popple. "Providing therapeutic community initiatives for individuals on opioid substitution treatment." Therapeutic Communities: The International Journal of Therapeutic Communities 38, no. 2 (June 12, 2017): 79–86. http://dx.doi.org/10.1108/tc-04-2016-0009.

Full text
Abstract:
Purpose Developing therapeutic community (TC) programs in Australia for individuals on opioid substitution treatment (OST) has been a process spanning 16 years for the We Help Ourselves (WHOS) organization. Supported reduction of OST and stabilization services for those remaining on OST are offered to this population and continue to break down barriers of discrimination in offering the same services to all drug using populations. The paper aims to discuss these issues. Design/methodology/approach A number of research projects have been undertaken with the WHOS Opioid Treatment Program (OTP) TC services profiling clients accessing the services; looking at health benefits whilst in the programs; looking at retention and completion rates and conducting an evaluation post-treatment for one of the two programs currently being offered. Findings The excerpts from the research findings are presented identifying the complexity of individuals accessing WHOS services; highlighting the benefits for individuals on OST and assessing the effectiveness of the TC model for the client groups. Originality/value Working with multiple complex needs clients on OST in a residential TC environment offers many challenges and opportunity to work with an array of issues that present before during and after the residential stay. Provision of a history and overview of the WHOS OTP TC services and recent enhancements to these programs highlight a continuum of care for the individual on OST.
APA, Harvard, Vancouver, ISO, and other styles
2

Bond, Alyson J., and John Witton. "Perspectives on the Pharmacological Treatment of Heroin Addiction." Clinical Medicine Insights: Psychiatry 8 (January 1, 2017): 117955731773732. http://dx.doi.org/10.1177/1179557317737322.

Full text
Abstract:
Opioids are very addictive drugs because of their powerful effects on reward and pain pathways in the brain. Opioid addiction is currently a worldwide problem and injecting heroin presents serious health risks including death from overdose. The increase in the nonmedical use of prescription opioids and the increase in overdose deaths are worrying trends in North America. There is therefore an increasing need for access to effective treatments. The 2 major drug treatments, methadone and buprenorphine, have proven efficacy but are not necessarily administered in the most effective doses or under optimum conditions. Alternative approaches such as slow-release oral morphine, tincture of opium, and the use of the opioid antagonist naltrexone to maintain abstinence are used seemingly effectively in some countries but have yet to be fully evaluated in randomized controlled trials. Heroin-assisted treatment has proven to be a valuable and effective treatment when administered in specialized clinics but is only appropriate for those who have failed to improve on optimal methadone or buprenorphine maintenance. Recent innovations and substitution treatment as an alternative to incarceration are described. Drug treatment of opioid addiction is most effective when administered as part of a therapeutic program as demonstrated in the initial methadone evaluations and the more recent trials with heroin-assisted treatment.
APA, Harvard, Vancouver, ISO, and other styles
3

Springer, MD, Sandra A., and Robert D. Bruce, MD. "A pilot survey of attitudes and knowledge about opioid substitution therapy for HIV-infected prisoners." Journal of Opioid Management 4, no. 2 (January 30, 2018): 81. http://dx.doi.org/10.5055/jom.2008.0012.

Full text
Abstract:
A majority of inmates in the state of Connecticut Department of Corrections use opioids or are opioid dependent before incarceration. None of the state’s prisons offer opioid substitution therapy other than for detoxification or maintenance therapy for women during pregnancy. On release to the community, most prisoners relapse to drug use and this has been associated with higher recidivism rates, and less adherence to antiretroviral medications for HIV-infected persons. Nationally and internationally, methadone (METH) and buprenorphine (BUP) have been found to decrease relapse to drug use, decrease recidivism rates, improve adherence to antiretroviral medications, decrease HIV-risk taking behaviors, and improve mortality. However, the general knowledge about opioid substitution therapy among correctional facility staff has been reported as substandard. This pilot study compiled results of answers to anonymous surveys from 27 individuals who work directly with inmates in a patient-care capacity for the Connecticut Department of Corrections (CT DOC) and CT DOC case-management referral program (Project TLC) in the year 2006. The surveys included questions regarding current attitudes and knowledge about opioid substitution therapy for prisoners. A minority of respondents refer released prisoners with a history of opioid dependency to METH or BUP treatment. The majority of correctional workers and case-management referral workers did not have knowledge about BUP or METH’s ability to improve health and decrease HIV risk taking behaviors. This study found that more education of individuals treating and caring for HIV-infected opioid dependent prisoners is needed.
APA, Harvard, Vancouver, ISO, and other styles
4

Vaidya, Leepa, Rajan Sharma, Lumeshwor Acharya, Nirmal Lamichhane, and Ravi Raj Timasina. "Adherence to Buprenorphine Maintenance Treatment Program in Western Nepal." Medical Journal of Pokhara Academy of Health Sciences 2, no. 2 (December 31, 2019): 205–8. http://dx.doi.org/10.3126/mjpahs.v2i2.28192.

Full text
Abstract:
Background: Opioid use is a serious global problem and the problem is increasing over years. Buprenorphine has been approved as a substitution therapy in Nepal, but there are few long-term studies of its effectiveness. Aim: This study aimed to assess the 1-year efficacy of buprenorphine and reasons for dropout. Materials and Methods: This study was conducted at Western Regional Hospital, Pokhara from 29th August 2016 to 31st August 2017. The Buprenorphine Maintenance Treatment Program (BMT) was started on 29th August 2016 and all the clients enrolled in the program within 1 year of starting BMT were included in the study. Results: 75% of the enrolled clients dropped out in 1-year period. Conclusion: Adherence to Buprenorphine was better in flexible dose adjustment group. Combination of buprenorphine and psychosocial treatment would have been related with better outcome.
APA, Harvard, Vancouver, ISO, and other styles
5

Banaszak, Maria. "Voice in the discussion about the goals and methods of treatment in Poland of people addicted to opioids." Problemy Opiekuńczo-Wychowawcze 570, no. 5 (May 31, 2018): 3–13. http://dx.doi.org/10.5604/01.3001.0012.1360.

Full text
Abstract:
For several years, a debate has been taking place in Poland on the effectiveness and appropriateness of using various methods of treating addiction to psychoactive substances. On one side there are representatives of rehabilitation centres with the assumptions of the therapeutic community, on the other side, advocates of substitution treatment, based on the paradigm of harm reduction. Substitute programs are usually conducted in outpatient clinics. Representatives of stationary treatment are accused that the endeavour of total abstinence is too difficult for patients to achieve; Substitutive programs are criticized for sustaining patients' addiction. At the bottom of the dispute, however, there are two logical errors. First, outpatient and stationary treatments are not competing because they meet the needs of different groups of clients and should be targeted at people who are at a different stage of addiction development. Secondly, non-counselling is the most appropriate place for substitution programs. Around the outpatient clinics, especially those who have a methadone program in their offer, are gathering patients in advance stages of addiction. The contact with people who do not take drugs in a problematic way has many negative consequences. In addition, it has been scientifically proven that benefiting from substitution programs results in harm reduction, but they are not accompanied by significant changes in social and emotional functioning. An optimal solution would be to reorganize substitution treatment and divide it into two streams, depending on the individual goal of the patient - those interested in the low-threshold goal - methadone prescription in out-of-ward care, and for those seeking actual change and abstinence – incorporating substitution programs into the therapeutic community.
APA, Harvard, Vancouver, ISO, and other styles
6

Le, Phuong-Phi, Annette Braunack-Mayer, and Caroline Laurence. "Collaborative pharmacist prescribing within the opioid substitution treatment program in South Australia: Patient and pharmacist views." Research in Social and Administrative Pharmacy 14, no. 2 (February 2018): 187–95. http://dx.doi.org/10.1016/j.sapharm.2017.02.017.

Full text
APA, Harvard, Vancouver, ISO, and other styles
7

Torrens, Marta, Francina Fonseca, Claudio Castillo, and Antònia Domingo Salvany. "Opioid substitution treatment in Spain: 20 years of experience in harm reduction programs." Drug and Alcohol Dependence 156 (November 2015): e223. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.601.

Full text
APA, Harvard, Vancouver, ISO, and other styles
8

Pahuja, Erika, Santosh Kumar, Ajay Kumar, Fareed Uzzafar, Siddharth Sarkar, Narayana Manjunatha, Yatan Pal Singh Balhara, C. Naveen Kumar, and Suresh Bada Math. "Collaborative Video Consultations from Tertiary Care Based Telepsychiatrist to a Remote Primary Care Doctor to Manage Opioid Substitution Therapy Clinic." Journal of Neurosciences in Rural Practice 11, no. 03 (June 12, 2020): 498–501. http://dx.doi.org/10.1055/s-0040-1713293.

Full text
Abstract:
AbstractOpioid use is a major problem in India and has high morbidity and mortality with a prevalence of 2.06%. There is a huge treatment gap for opioid use disorders (OUDs). Due to limited mental health resources and limited psychiatric training of medical practitioners in OUDs, a significant proportion of patients do not receive appropriate medical intervention. This article demonstrates how a primary care doctor working in a remote opioid substitution therapy (OST) clinic received assistance from the optional opioid module of clinical schedule for primary care psychiatry (CSP) and collaborative video consultation (CVC) module to address specific difficulties of patients already on Buprenorphine OST and improve the quality of care, thereby reducing chances of relapses. CVC module is a part of one-year digitally driven primary care psychiatry program designed by National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. The opioid module was designed by NIMHANS, Bengaluru in collaboration with the All India Institute of Medical Sciences (AIIMS), New Delhi These observations warrant replication of this approach across diverse settings and at a larger scale to explore and evaluate its impact and effectiveness.
APA, Harvard, Vancouver, ISO, and other styles
9

Katt, Mae, Claudette Chase, Andriy V. Samokhvalov, Elena Argento, Jürgen Rehm, and Benedikt Fischer. "Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario." International Journal of Indigenous Health 9, no. 1 (June 9, 2013): 52. http://dx.doi.org/10.18357/ijih91201212394.

Full text
Abstract:
<p>Objective: Non-medical prescription opioid use (NMPOU) is a major health problem in North America and increasingly prevalent among First Nations people. More than 50% of many Nishnawbe Aski Nation communities in northern Ontario report NMPOU, resulting in extensive health and social problems. Opioid substitution therapy (OST) is the most effective treatment for opioid dependence yet is unavailable in remote First Nations communities. Suboxone (buprenorphine and naloxone) specifically has reasonably good treatment outcomes for prescription opioid (PO) dependence. A pilot study examining the feasibility and outcomes of a community-based Suboxone taper-to-low-dose-maintenance program for PO-dependent adults was conducted in a small NAN community as a treatment option for this particular setting.</p><p>Design: Participants (N = 22, ages 16–48 years) were gradually stabilized on and tapered off Suboxone (provided on an outpatient and directly-observed basis) over a 30-day period. Low dose maintenance was offered post-taper to patients with continued craving and relapse risk; community-based aftercare was provided to all participants. Results: Of 22 participants, 21 (95%) completed the taper phase of the program. Fifteen (88%) of 17 participants tested by urine toxicology screening had no evidence of PO use on day 30. No adverse side effects were observed. All but one of the taper completers were continued on low-dose maintenance. Conclusion: Community-based Suboxone taper-to-low-dose-maintenance is feasible and effective as an initial treatment for PO-dependence in remote First Nations populations, although abstinence is difficult to achieve and longer term maintenance may be required. More research on OST for First Nations people is needed; existing OST options, however, should be made available to First Nations communities given the acute need for treatment.</p>
APA, Harvard, Vancouver, ISO, and other styles
10

Bilban, Marjan, Andrej Kastelič, and Lijana Zaletel-Kragelj. "Ability to Work and Employability of Patients in Opioid Substitution Treatment Programs in Slovenia." Croatian Medical Journal 49, no. 6 (December 2008): 842–52. http://dx.doi.org/10.3325/cmj.2008.49.842.

Full text
APA, Harvard, Vancouver, ISO, and other styles
More sources

Dissertations / Theses on the topic "Opioid substitution treatment program"

1

Nikic, Matthew James. "Factors affecting treatment outcome in opioid dependence substitution treatment : the influence of mood and withdrawal symptoms /." Title page, abstract and table of contents only, 2004. http://web4.library.adelaide.edu.au/theses/09HS/09hsn692.pdf.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Li, Suzanne Sayuri. "Diet and nutrition among people receiving opioid substitution treatment : a mixed methods study." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/diet-and-nutrition-among-people-receiving-opioid-substitution-treatment(01e03b14-6d09-45d2-9db7-e148047755d4).html.

Full text
Abstract:
Aim: This study’s aim was to improve our understanding of the dietary behaviours of people receiving opioid substitution treatment (OST) in the UK. Setting: The study focuses on people receiving prescribing interventions for OST from pharmacies in Oxfordshire, England. Methods: Dietary behaviours were assessed using a longitudinal convergent parallel mixed methods research design. Quantitative methods included a socio-demographic and drug use questionnaire, SF-36 health related quality of life questionnaire, 24-hour dietary recall interview, and anthropometry measures. Qualitative semi-structured face-to-face interviews were conducted to understand how individuals’ experiences with food and diet influence their dietary behaviours. Follow-ups were conducted four months after baseline data collection. The same quantitative and qualitative research tools were applied at the second stage of the study. Results: Mean (SD) Body Mass Index for males (n=15) and females (n=10) exceeded the normal range [25.2 (5.9) kg/m2 and 33.3 (8.6) kg/m2, respectively] at baseline. Males decreased to the normal range at follow-up [mean (SD) = 24.1 (± 6.2) kg/m2]. Females increased to Obesity Class II at follow-up [mean (SD) = 35.1 (± 8.0) kg/m2]. Non-starch polysaccharide intakes were significantly lower than the Reference Nutrient Intake (RNI). Iron intakes among females were significantly below the RNI. Saturated fat intake and sodium intake exceeded the RNI. Eleven (44%) participants had multiple health conditions. Food consumption was influenced by factors such as childhood eating, mental health issues, digestive issues, limited financial resources, drug use and accommodation. Conclusions: People receiving OST in the UK may be at risk of development of non-communicable diseases (NCDs). Dietary and nutritional recommendations may benefit this population. Recommendations must accommodate for specialised needs. Further research is required in the UK to understand aspects such as multi-morbidity rates, rates of overweight and obesity, food acquisition, food preparation skills and food expenditures.
APA, Harvard, Vancouver, ISO, and other styles
3

Davies, H. R. "Drug use and opioid substitution treatment in pregnancy : evidence from electronic health records." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/1544123/.

Full text
Abstract:
BACKGROUND: Misuse of drugs is a public health problem which can lead to poor health outcomes. Drug use during pregnancy could potentially harm the unborn baby. Pregnancy usually triggers women to visit their general practitioner (GP) which may provide an opportunity for drug use to be raised and recorded. To date, there are no UK studies with large sample sizes to estimate the burden of drug use during pregnancy. Therefore, my aim was to describe and understand drug use and opioid substitution treatment in and around pregnancy using electronic health records. METHODS: Using a mixed methods design, I firstly, utilized The Health Improvement Network (THIN) to estimate GP recording rates of individuals who use drugs and/or are prescribed opioid substitution treatment in the general population, of women in and around pregnancy and infants with neonatal abstinence syndrome (NAS). Next, I compared rates with national surveys and hospital birth data. Finally, I conducted qualitative interviews to gain GPs’ perspectives regarding their decisions about recording drug-use. RESULTS: GP recording trends for the general population were in keeping with national surveys, but with lower rates. Recording was relatively low in and around pregnancy. GP recording of NAS was similar to hospital data, however rates were lower. Finally, qualitative interview analysis identified that influences on recording drug use were complex and related to pressures at the individual as well as organisational (general practices, Clinical Commissioning Groups) and governmental levels in the shape of government policies. CONCLUSIONS: In conclusion, evidence from the thesis supports the use of THIN as a suitable tool for monitoring trends but not rates of problem drug use in the general population. Electronic primary health records could potentially be used to monitor the impact of problematic drug use in and around pregnancy. The thesis also supports utilising THIN for researching drug use and opioid substitution treatment in the general population.
APA, Harvard, Vancouver, ISO, and other styles
4

Wheeler, Carly. "Understanding physical activity among individuals receiving opioid substitution treatment : a mixed methods study." Thesis, Oxford Brookes University, 2015. https://radar.brookes.ac.uk/radar/items/2a36dac0-b5ad-40ea-b821-e10a95fb5222/1/.

Full text
Abstract:
This thesis explores the physical activity (PA) practices and experiences of a group of drug users receiving opioid substitution treatment (OST). Opioid Substitution treatment is the most widely used form of treatment for individuals with opioid dependence. Existing research in this group (and drug users in general) has tended to focus on harmful behaviours, as opposed to their everyday lives. Additionally, a recent shift in UK drugs policy has places an increased emphasis on the wider aspects of recovery from drug use, including the improvement of health, well-being and re- integration into society. Despite the numerous benefits associated with PA, little research has explored PA among individuals receiving OST. The use of a social-ecological approach to guide and understand the research findings was utilized, with both quantitative and qualitative data collected. Self- reported quantitative data was first collected on demographic information, PA participation, perceived benefits and barriers to PA and health-related quality of life from 100 participants. Objective PA data was also collected from a smaller sub- sample of participants through the use of pedometers. Secondly, semi-structured interviews were conducted with 30 participants, to gain further understanding of PA in this group, with the qualitative data analyzed using the Framework approach. Both quantitative and qualitative findings indicate that much of this population is physically active, largely through walking as a form of active transport, with participant in structured sport and exercise occurring less frequently. However, nearly all participants reported previous participation in structured PA prior to drug use and an a desire to resume participation. The benefits of PA participation were unanimously recognized, with perceived barriers to participation highlighted at multiple levels of influence in line with the social-ecological approach used to theoretically underpin the study. While many individuals receiving OST appear to be physically active through unstructured PA, increased participation in structured PA is often desired, yet prohibited through the presence of multiple barriers, some similar to the general population and others specific to this group. Participation in structured PA may yield additional benefits beyond those gained from unstructured activity, contributing to the wider aspects of individuals’ recovery from opioid dependence in line with current UK policy. However, strategies to increase participation may need to consider the multiple needs of this group in addressing barriers to participation.
APA, Harvard, Vancouver, ISO, and other styles
5

Strobel, Spencer. "A pilot study of an emergency department's overdose education and naloxone distribution program." Thesis, Boston University, 2013. https://hdl.handle.net/2144/21257.

Full text
Abstract:
Thesis (M.A.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Opioid overdoses are increasing and several efforts are being made to reduce this problem. One potential solution is overdose education and naloxone distribution. Project ASSERT began distributing naloxone in conjunction with its overdose education program in 2009. Project ASSERT’s overdose education and naloxone distribution program trained opioid users in recognition, risk factors, and response to overdoses, as well as how to use nasal naloxone kits. Opioid users that had received overdose education only were compared with those that received overdose education and naloxone kits. The goal was to determine if there were any differences in occurrence of nonfatal overdoses, overdose response, illicit opioid use, and opioid agonist treatment. This retrospective study involved phone-surveying patients from a hospital billing list. It was obtained through Project ASSERT and contained the names of patients that had received overdose education only or overdose education and naloxone distribution from January 2011 to February 2012. Questions were asked about the respondents’ naloxone kits, overdose history since their Project ASSERT visit, response to the last witnessed overdose, 30-day substance use, and overdose risk knowledge. Chi-square tests were used to compare the groups. 51 out of 415 eligible were successfully surveyed from March 2012 to October 2012. The surveys occurred on average 11.8 months after their Project ASSERT visit. 73% (37) had naloxone kits and most kept them where they lived (12). There were 9 successful overdose reversals reported. 76% (39) of the respondents did not overdose in the intervening period. There was no statistical difference between the two groups in overdose occurrence, 19% trained with naloxone versus 29% trained without naloxone (p=0.45). 16 out of 19 (84%) of the naloxone group properly responded to an overdose, whereas 3 out of 8 (38%) of those trained without naloxone properly responded (p=.03). There was no statistical difference in illicit opioid use (p=1.0) and opioid agonist treatment (p=.53), 36% of the group trained with naloxone versus 35% of the group trained without naloxone, and 49% of those trained with naloxone versus 36% of those trained without naloxone, respectively. In studying the association between overdose education only and overdose education and naloxone distribution, it was found that there is not an increase in overdose and illicit opioid use. There also is no reduction in seeking for opioid agonist treatment. However, it was found that having naloxone kits does increase proper response to overdose. This is a promising result that could have an impact in reducing opioid overdose deaths.
2031-01-01
APA, Harvard, Vancouver, ISO, and other styles
6

Nyström, Robert, and Gustav Grut. "The Patients' Perspective on Opioid Substitution Treatment : A study of desistance from illicit drug use." Thesis, Mittuniversitetet, Avdelningen för samhällsvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-31977.

Full text
Abstract:
Using thematic analysis, this qualitative study investigates desistance from illicit drug use from the perspective of patients within opioid substitution treatment (OST). Wikström's theoretical framework was used to explain this process. From semi-structured reflective interviews with 12 patients admitted to an OST clinic in Sundsvall, three main themes were identified as relevant to the research aim. These main themes were labelled as follows: Motives for desistance, Perspectives on OST and Recipe for successful desistance. The findings were similar to those of previous research. The participants expressed criticism on specific regulations within OST, but were positive to the treatment in general. They felt a lack of emotional support from OST, but still reported an improvement in mental well being. While varied views on diversion of OST medication were expressed, a majority believe dillicitly used opioids to originate from sources other than OST. In conclusion, the participants viewed OST as an essential method for desistance from illicit drug use. Having a sincere will to desist and perceiving the past illicit opioid use as problematic were also deemed necessary for the treatment to be successful.

2017-06-01

APA, Harvard, Vancouver, ISO, and other styles
7

Wittchen, Hans-Ulrich, Sabine M. Apelt, Michael Soyka, Markus Gastpar, Markus Backmund, Jörg Gölz, Michael R. Kraus, et al. "Feasibility and outcome of substitution treatment of heroin-dependent patients in specialized substitution centers and primary care facilities in Germany: A naturalistic study in 2694 patients." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-110756.

Full text
Abstract:
Background: In many countries, buprenorphine and methadone are licensed for the maintenance treatment (MT) of opioid dependence. Despite many short-term studies, little is known about the long-term (12-month) effects of these treatments in different settings, i.e. primary care-based (PMC) and specialized substitution centers (SSCs). Objectives: To describe over a period of 12 months: (1) mortality, retention and abstinence rates; (2) changes in concomitant drug use, somatic and mental health; and (3) to explore differences between different types of provider settings. Methods: 12-Month prospective-longitudinal naturalistic study with four waves of assessment in a prevalence sample of N= 2694 maintenance patients, recruited from a nationally representative sample of N= 223 substitution physicians. Results: The 12-month retention rate was 75%; the mortality rate 1.1%. 4.1% of patients became “abstinent” during follow-up. 7% were referred to drug-free addiction treatment. Concomitant drug use decreased and somatic health status improved. No significant improvements were observed for mental health and quality of life. When controlling for initial severity, small PMC settings revealed better retention, abstinence and concomitant drug use rates. Conclusion: The study underlines the overall 12-month effectiveness of various forms of agonist MT. Findings reveal relatively high retention rates, low mortality rates, and improvements in most 12-month outcome domains, except for mental health and quality of life. PMC settings appear to be a good additional option to improve access to MTs.
APA, Harvard, Vancouver, ISO, and other styles
8

Wittchen, Hans-Ulrich, Sabine M. Apelt, Michael Soyka, Markus Gastpar, Markus Backmund, Jörg Gölz, Michael R. Kraus, et al. "Feasibility and outcome of substitution treatment of heroin-dependent patients in specialized substitution centers and primary care facilities in Germany: A naturalistic study in 2694 patients." Technische Universität Dresden, 2008. https://tud.qucosa.de/id/qucosa%3A26834.

Full text
Abstract:
Background: In many countries, buprenorphine and methadone are licensed for the maintenance treatment (MT) of opioid dependence. Despite many short-term studies, little is known about the long-term (12-month) effects of these treatments in different settings, i.e. primary care-based (PMC) and specialized substitution centers (SSCs). Objectives: To describe over a period of 12 months: (1) mortality, retention and abstinence rates; (2) changes in concomitant drug use, somatic and mental health; and (3) to explore differences between different types of provider settings. Methods: 12-Month prospective-longitudinal naturalistic study with four waves of assessment in a prevalence sample of N= 2694 maintenance patients, recruited from a nationally representative sample of N= 223 substitution physicians. Results: The 12-month retention rate was 75%; the mortality rate 1.1%. 4.1% of patients became “abstinent” during follow-up. 7% were referred to drug-free addiction treatment. Concomitant drug use decreased and somatic health status improved. No significant improvements were observed for mental health and quality of life. When controlling for initial severity, small PMC settings revealed better retention, abstinence and concomitant drug use rates. Conclusion: The study underlines the overall 12-month effectiveness of various forms of agonist MT. Findings reveal relatively high retention rates, low mortality rates, and improvements in most 12-month outcome domains, except for mental health and quality of life. PMC settings appear to be a good additional option to improve access to MTs.
APA, Harvard, Vancouver, ISO, and other styles
9

Komalasari, Rita. "Key perspectives on Opioid Substitution Treatment (OST) programmes, using Methadone Maintenance Treatment (MMT) programmes in Indonesian prisons as a case study." Thesis, University of Stirling, 2018. http://hdl.handle.net/1893/28543.

Full text
Abstract:
Background Heroin dependence is associated with increased risk of the transmission of blood-borne viral (BBV) infections such as HIV, as a result of unsafe injecting practices. Opioid Substitution Treatment (OST) Programmes including Methadone Maintenance Treatment (MMT) programmes are a recommended way of addressing heroin dependence with the dual aims of reducing both heroin use and associated harms. However, OST programmes, particularly in prison settings, are often unavailable, in spite of large numbers of prisoners with heroin dependence and the high risk of HIV transmission in the prison setting. Little is currently known about the delivery of OST programmes within prison settings. A systematic literature review conducted within this study revealed that there are only a small number of studies from middle and lower-income countries and the perspectives of the range of stakeholders are often underrepresented. Aim and setting of this study This aim of this study was to understand the role of Methadone Maintenance Treatment (MMT) programmes within the context of HIV prevention programmes and to identify barriers and facilitators that influence the implementation, routine delivery and sustainability of methadone programmes in Indonesian prisons. Study design Three prison settings were selected as part of a qualitative case study. These comprised: a narcotics prison that provided methadone, a general prison that provided methadone, and a general prison, where there was no methadone programme. This allowed the exploration of multiple perspectives of prisoners and the diverse range of staff involved in the implementation of programmes. Interview and observational data were supplemented by data from medical case notes. Qualitative data underwent thematic analysis, with the help of framework analysis for data management. Principal findings This study found that there were many misconceptions about methadone programmes. HIV infection was not recognised as a problem and prison staff, healthcare staff and prisoners alike lacked understanding of the roles of methadone programmes. Prisoners participating in programmes were often stigmatised, while many prisoners believed methadone withdrawal was dangerous and could lead to death. These factors all contributed to low level participation, observed in both prisons with methadone programmes. Lack of confidentiality and associated stigmatisation as well as inappropriate assessment criteria also contributed to this, as did a lack of support systems. A reduction in international funding and a shift in national drug policy priorities away from the provision of methadone to drug-free Therapeutic Community (TC) programmes, together with a failure to embed methadone programmes within the daily prison routine currently pose challenges to effective implementation, delivery and programme sustainability. Conclusion Educating policy makers and practitioners could improve understanding of the roles of methadone programmes and increase support for programme delivery within prisons. It is therefore recommended that Indonesian government and prison policy focuses on ensuring effective delivery and sustainability of methadone programmes for people with heroin dependence in the prison setting.
APA, Harvard, Vancouver, ISO, and other styles
10

Frick, Ulrich, Jürgen Rehm, Daniele Zullino, Manrique Fernando, Gerhard Wiesbeck, Jeannine Ammann, and Ambros Uchtenhagen. "Long-Term Follow-Up of Orally Administered Diacetylmorphine Substitution Treatment." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133129.

Full text
Abstract:
Background: To assess the long-term course of the feasibility and safety of orally administered heroin [diacetylmorphine (DAM)] tablets in substitution treatment of severely addicted opioid users. Design: Open-label, prospective cohort study with 2 non-randomly assigned treatment arms: DAM tablets only (n = 128) or DAM tablets combined with injected DAM and/or other opioids (n = 237). The average duration of the observation period was 62 months. Study endpoints were the time to discharge from treatment and the number of serious adverse events. Results: Both patient groups had a higher than 70% retention rate after the first 48 months of treatment, with similar long-term retention rates (after 8 years both groups had retention over 50%). The physician-verified rate of serious adverse events was 0.01 events per application year among the exclusively oral substitution group (intention-to-treat analysis) during the last year of observation, and 0.005 events per application year in the other group. Conclusions: Because of their feasibility and safety over years, DAM tablets may be a valuable long-term therapeutic alternative
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
APA, Harvard, Vancouver, ISO, and other styles
More sources

Books on the topic "Opioid substitution treatment program"

1

Kauffman, Janice Fay. Matching treatment to patient needs in opioid substitution therapy. Rockville, MD (Rockwall II, 5600 Fishers Lane, Rockville 20857): U.S. Dept. of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1995.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
2

Kauffman, Janice Fay. Matching treatment to patient needs in opioid substitution therapy. Rockville, MD (Rockwall II, 5600 Fishers Lane, Rockville 20857): U.S. Dept. of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 1995.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
3

Dolan, Kate, Zahra Alam-Mehrjerdi, and Babak Moazen. Drug Treatment for Prisoners. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199374847.003.0016.

Full text
Abstract:
Globally more than 10.2 million people are held in prisons on any given day, of whom 10% to 48% of males and 30% to 60% of females are estimated to be drug-dependent. Rates of incarceration for people with drug-related problems have increased in the past couple of decades. The preponderance of people who use or inject drugs in prisons, high rates of drug-related harm in prison and after release, and the high level of re-incarceration among drug users after release from prison are the main reasons for providing drug treatment in prisons. This chapter provides an overview of the rationale for prison drug treatment programs in prison., It describes three main forms of treatment: opioid substitution treatment (OST), therapeutic communities or drug free units, and cognitive behavioral therapy. A review of the evidence on the effectiveness of each treatment is presented, and the chapter concludes with recommendations for drug treatment in the prison setting.
APA, Harvard, Vancouver, ISO, and other styles
4

Brummer, Julie, Lars Møller, and Stefan Enggist. Preventing Drug-Related Death in Recently Released Prisoners. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199374847.003.0018.

Full text
Abstract:
The mortality risk for recently released prisoners is alarmingly high. These individuals, especially in the first 2 weeks following release, are at an increased risk for death compared with an age- and gender-matched general population, with the majority of fatalities attributed to overdoses. Although a number of factors contribute to these incidents, the decreased tolerance resulting from a period of abstinence during incarceration is believed to be especially important. Other important factors are the concurrent use of multiple drugs, the lack of pre-release counseling and post-release follow-up, and the failure to identify those at greatest risk. This chapter describes studies conducted in various countries on post-release drug-related deaths. The literature review supports the finding that there is a significantly heightened risk of overdose death during the initial post-release period and suggests a number of prevention and harm reduction responses that may be applied at various levels of the criminal justice system to reduce drug-related deaths in ex-prisoners. Some identified potential preventive responses are the provision of opioid substitution therapy delivered in combination with psychosocial intervention for opioid-dependent prisoners and a continuity of care and stability of treatment through all stages of the criminal justice system, including during community integration, which can be supported by close linkages between prison-health and public-health systems. Take-home naloxone programs are another promising strategy to prevent overdose deaths among people recently released from prison.
APA, Harvard, Vancouver, ISO, and other styles
5

Handbook Of Methadone Prescribing And Buprenorphine Therapy. Springer-Verlag New York Inc., 2013.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
6

Non-methadone chemical dependency treatment for opiate addiction reduces health care costs, arrests and convictions. [Olympia, Wash.]: Washington State Dept. of Social and Health Services, Research and Data Analysis Division, 2004.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
7

Non-methadone chemical dependency treatment for opiate addiction reduces health care costs, arrests and convictions. [Olympia, Wash.]: Washington State Dept. of Social and Health Services, Research and Data Analysis Division, 2004.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
8

J, Nordlund Daniel, Washington (State). Dept. of Social and Health Services. Research and Data Analysis., and Washington (State). Division of Alcohol and Substance Abuse., eds. Methadone treatment for opiate addiction lowers health care costs and reduces arrests and convictions. [Olympia, Wash.]: Washington State Dept. of Social and Health Services, Research and Data Analysis Division, 2004.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
9

Gourlay, Douglas L., and Howard A. Heit. The Use of Drug Testing in Promoting Treatment Adherence in Pain Medicine. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190600075.003.0004.

Full text
Abstract:
Drug testing has become an important component of a comprehensive risk assessment and mitigation program when prescribing controlled substances to patients with chronic pain. State and federal opioid prescribing guidelines strongly recommend the use of drug testing, although there is lack of evidence in the literature supporting the efficacy of drug testing in reducing prescription opioid abuse. Drug testing can be useful in facilitating adherence to prescribed medications. This chapter provides an overview of the strengths and weaknesses of drug testing in pain medicine, insights into laboratory and test selection, test interpretation, and communicating results to patients within a patient-centered model.
APA, Harvard, Vancouver, ISO, and other styles

Book chapters on the topic "Opioid substitution treatment program"

1

Uchtenhagen, A. "Substitution management in opioid dependence." In Addiction Mechanisms, Phenomenology and Treatment, 33–60. Vienna: Springer Vienna, 2003. http://dx.doi.org/10.1007/978-3-7091-0541-2_3.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Rehm, J. "Scientific Evaluations of Opioid-Assisted Substitution Treatment." In Basic and Clinical Science of Opioid Addiction, 33–38. Basel: KARGER, 2003. http://dx.doi.org/10.1159/000070326.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Greenwald, Mark K. "Opioid Substitution Treatment and Harm Minimization Approaches." In The Routledge Handbook of Philosophy and Science of Addiction, 478–89. 1 [edition]. | New York : Routledge, 2018. | Series: Routledge handbooks in philosophy: Routledge, 2018. http://dx.doi.org/10.4324/9781315689197-39.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Tidder, James, Alexander M. Baldacchino, and Joseph Tay Wee Teck. "Medication-Assisted Treatment (MAT) 1: Opioid Substitution Therapy." In Opioids, 315–42. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-09936-6_14.

Full text
APA, Harvard, Vancouver, ISO, and other styles
5

Khan, Sharful Islam, Tanveer Khan Ibne Shafiq, Samira Dishti Irfan, and Mohammad Niaz Morshed Khan. "The opioid substitution therapy (OST) program for the people who inject drugs (PWID) in Bangladesh: Lessons learned and way forward." In Handbook of Substance Misuse and Addictions, 1–25. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-67928-6_147-1.

Full text
APA, Harvard, Vancouver, ISO, and other styles
6

Khan, Sharful Islam, Tanveer Khan Ibne Shafiq, Samira Dishti Irfan, and Mohammad Niaz Morshed Khan. "The Opioid Substitution Therapy (OST) Program for the People Who Inject Drugs (PWID) in Bangladesh: Lessons Learned and Way Forward." In Handbook of Substance Misuse and Addictions, 2715–38. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-92392-1_147.

Full text
APA, Harvard, Vancouver, ISO, and other styles
7

Salam, Shumona Sharmin, and Caroline Mitchell. "Evaluating Alcohol, Tobacco, and Other Substance Use in Pregnant Women." In Evidence Based Global Health Manual for Preterm Birth Risk Assessment, 53–62. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04462-5_7.

Full text
Abstract:
AbstractUse of tobacco, alcohol, and psychoactive substances during pregnancy is associated with increased risks of preterm birth. Concurrent use of these substances is also quite common and further increases the risk of adverse outcomes. Health-care providers should ask pregnant women about their exposure to tobacco, second-hand smoke, alcohol, and illicit substances (past and present) at every antenatal visit using validated screening instruments and offer brief interventions.Pregnant women with alcohol or substance dependence should be assessed individually and offered psychosocial interventions (e.g. motivational interviewing, cognitive behavioural therapy, contingency management). Pregnant women should be advised to quit and referred to detoxification services or opioid substitution treatment (for opioid users). Pharmacological treatment for maintenance and relapse prevention is not recommended for amphetamine, cannabis, and cocaine dependence and requires individual risk-benefit analysis for alcohol dependence. Opioid maintenance therapy with methadone or buprenorphine is recommended for opiate dependence. Pregnant women who are current tobacco users or have recently quit should be offered psychosocial interventions (e.g. counselling, incentives, social support). Evidence on impact of pharmacological interventions for cessation of tobacco use is limited. Interventions to make public places and homes smoke-free are recommended. Evidence of impact of these interventions in reducing PTB especially in LMIC settings is low and further research recommended.
APA, Harvard, Vancouver, ISO, and other styles
8

"Opioid Substitution Treatment." In Encyclopedia of Criminology and Criminal Justice, 3342. New York, NY: Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4614-5690-2_100466.

Full text
APA, Harvard, Vancouver, ISO, and other styles
9

Himelhoch, Seth, Marion Currens, Jewell Benford, and Eric Weintraub. "Somewhere to Go: Implementing Medication-Based Treatment for Opioid Use Disorders in Rural Maryland and beyond." In Leading Community Based Changes in the Culture of Health in the US - Experiences in Developing the Team and Impacting the Community. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.98462.

Full text
Abstract:
Treatment for opioid use disorders is highly effective yet unavailable in many rural areas. “Somewhere to Go: Ensuring Access to Medication-Assisted Treatment in Rural Maryland” is a Robert Wood Johnson Funded Clinical Scholars project intended to expand the use of tele-health medication-based treatment for opioid use disorders services directly to rural areas in need. We demonstrated that a University-based substance use treatment team can successfully collaborate with a geographically distant rural substance use treatment clinic to provide medication-based treatment for opioid use disorders using a HIPPA compliant telehealth strategy. We provide an overview of the implementation strategies our team used to expand overall access in different locales throughout the State of Maryland and beyond. We describe implementation results of a tele-health medication-based treatment program for opioid use disorders that focuses on implementation successes and how to identify and overcome implementation challenges and barriers. Implementation of a telemedicine approach can be challenging, but careful consideration and forethought can map a successful path to program development, operation and sustainability.
APA, Harvard, Vancouver, ISO, and other styles
10

Taneja, Anjali, and William Wagner. "Transforming Opioid Addictions Care in New Mexico: Combining Medication Treatment with Patient Autonomy, Civic Engagement and Integrative Healing." In Leading Community Based Changes in the Culture of Health in the US - Experiences in Developing the Team and Impacting the Community. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.98463.

Full text
Abstract:
Opioid addiction is a complex issue. New Mexico has historically experienced some of the highest rates of deaths from opioid overdose, and opioid addictions have affected generations of New Mexicans -- starting many years before the more recent national crisis. Treatment approaches to opioid and other addictions are fraught with paternalism, stigma, surveillance, criminalization, shaming, racism, discrimination, and issues with access to care. Current treatment paradigms fail to take into account the social and economic factors of people, community, and context. New paradigms embracing a broader, more-just contextualization of addictions, along with evidence-based treatment approaches are needed to transform medicine’s historic role in the “war on drugs”. The Strong Roots/Raices Fuertes program was developed by two community clinics, Casa de Salud and Centro Sávila, in Albuquerque, New Mexico. The program evolved from a desire to to acknowledge and right historical harms that the medical-industrial complex has caused; to provide rapid access to dignified, life-saving, evidence-based holistic treatment for opioid addictions in a community setting; and to build a model of care that transforms the biomedical model into one of solidarity with community and collective care. Five key concepts underpin the program design: 1) Harm Reduction, Autonomy, and Agency; 2) Healing-Centered Engagement; 3) Language and Cultural Humility; 4) Transforming Health Systems Design; 5) Workforce Diversity and Pipeline Training. The program’s core components include conventional approaches such as low-barrier access buprenorphine (suboxone®) to medication treatment, primary care, case management, syringe exchange, and counseling/therapy in addition to more community-rooted and integrative healing modalities such as healing circles, acupuncture, massage, reiki, ear acudetox, and civic engagement. In sharing the values, lessons learned, and tools from our work in the Strong Roots/Raices Fuertes program, we hope to inspire and encourage others wishing to develop new systems of care for people dealing with addiction issues.
APA, Harvard, Vancouver, ISO, and other styles

Conference papers on the topic "Opioid substitution treatment program"

1

Shah-Mohammadi, Fatemeh, Wanting Cui, Keren Bachi, Yasmin Hurd, and Joseph Finkelstein. "Using Natural Language Processing of Clinical Notes to Predict Outcomes of Opioid Treatment Program." In 2022 44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC). IEEE, 2022. http://dx.doi.org/10.1109/embc48229.2022.9871960.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

"METHADONE WITHDRAWAL PSYCHOSIS: A CLINICAL CASE." In 23° Congreso de la Sociedad Española de Patología Dual (SEPD) 2021. SEPD, 2021. http://dx.doi.org/10.17579/sepd2021p132v.

Full text
Abstract:
The purpose of this article is, through a clinical case, to review the literature on psychosis secondary to methadone withdrawal. Observation of the patient and consultation of the clinical file. Non-systematic literature review on methadone use, methadone discontinuation and dual pathology. A 47-year-old male, history of opioid and cannabinoid use disorder, currently in abstinence and under opioid substitution therapy with methadone. After abrupt discontinuation of methadone, he began presenting delusional ideas of jealousy and persecution with multiple delusional interpretations. A diagnosis of persistent delusional disorder was made, and he was medicated with long-term injectable aripiprazole. Methadone is a synthetic opioid agonist used to treat addictions to opioids, such as heroin. Methadone maintenance treatment (MMT) contributes to cessation or reduction of heroin use, reduced risk of HIV and hepatitis virus infections, decreased mortality, improved family and social relationships and employment status. Side effects include dizziness, drowsiness, vomiting, sweating, respiratory depression and prolongation of the QT interval. Other important consequences are precipitation of withdrawal symptoms with consequent relapse to heroin use and withdrawal from MMT. Methadone withdrawal leads to the classic symptoms of opiate withdrawal - abnormalities in vital signs, dilated pupils, agitation, irritability, insomnia, sneezing, nausea and vomiting. In a minority of cases, it can lead to the sudden onset of affective disorders and psychotic disorders. Although scarce, psychotic symptoms after opioid withdrawal have already been described in the literature. Opioids function not only as neurotransmitters, but also as neuromodulators that may be involved in the regulation of the dopaminergic system. An altered neuromodulation of the central opioid-dopamine systems due to long-term MTM may be related to psychotic pathogenesis. Considering the high prevalence of psychiatric comorbidity in patients with substance use disorder, it's important to pay attention and monitor any change in opioid medication, with close observation for possible psychotic symptoms.
APA, Harvard, Vancouver, ISO, and other styles
3

Christensen, S., M. Specka, P. Buggisch, A. Stoehr, R. Heyne, U. Naumann, H. Klinker, et al. "Health related quality of life of patients in opioid substitution therapy at the beginning of hepatitis C treatment - Data from the German Hepatitis C-Registry." In Viszeralmedizin 2021 Gemeinsame Jahrestagung Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Sektion Endoskopie der DGVS, Deutsche Gesellschaft für Allgemein und Viszeralchirurgie (DGAV). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1733696.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Christensen, S., M. Specka, P. Buggisch, A. Stoehr, R. Heyne, U. Naumann, H. Klinker, et al. "Health related quality of life of patients in opioid substitution therapy at the beginning of hepatitis C treatment - Data from the German Hepatitis C-Registry." In Viszeralmedizin 2021 Gemeinsame Jahrestagung Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Sektion Endoskopie der DGVS, Deutsche Gesellschaft für Allgemein und Viszeralchirurgie (DGAV). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1733696.

Full text
APA, Harvard, Vancouver, ISO, and other styles

Reports on the topic "Opioid substitution treatment program"

1

Vanderwood, Karl, Grace Stonecipher, Sue Myers, and Brandn Green. Feasibility study for mobile opioid treatment program planning and service delivery considerations in Montana. JG Research and Evaluation, September 2022. http://dx.doi.org/10.36855/sor2022.2.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Skelly, Andrea C., Roger Chou, Joseph R. Dettori, Erika D. Brodt, Andrea Diulio-Nakamura, Kim Mauer, Rongwei Fu, et al. Integrated and Comprehensive Pain Management Programs: Effectiveness and Harms. Agency for Healthcare Research and Quality (AHRQ), October 2021. http://dx.doi.org/10.23970/ahrqepccer251.

Full text
Abstract:
Objectives. To evaluate the effectiveness and harms of pain management programs that are based on the biopsychosocial model of care, particularly in the Medicare population. Data sources. Electronic databases (Ovid® MEDLINE®, PsycINFO®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) from 1989 to May 24, 2021; reference lists; and a Federal Register notice. Review methods. Given lack of consensus on terminology and program definition for pain management, we defined programs as integrated (based in and integrated with primary care) and comprehensive (referral based and separate from primary care) pain management programs (IPMPs and CPMPs). Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) comparing IPMPs and CPMPs with usual care or waitlist, physical activity, pharmacologic therapy, and psychological therapy in patients with complex acute/subacute pain or chronic nonactive cancer pain. Patients needed to have access to medication support/review, psychological support, and physical function support in programs. Meta-analyses were conducted to improve estimate precision. We classified the magnitude of effects as small, moderate, or large based on predefined criteria. Strength of evidence (SOE) was assessed for the primary outcomes of pain, function, and change in opioid use. Results. We included 57 RCTs; 8 evaluated IPMPs and 49 evaluated CPMPs. Compared with usual care or waitlist, IPMPs were associated with small improvements in pain in the short and intermediate term (SOE: low) and in function in the short term (SOE: moderate), but there were no clear differences at other time points. CPMPs were associated with small improvements in pain immediately postintervention (SOE: moderate) but no differences in the short, intermediate, and long term (SOE: low); for function, improvements were moderate immediately postintervention and in the short term; there were no differences in the intermediate or long term (SOE: low at all time points). CPMPs were associated with small to moderate improvements in function and pain versus pharmacologic treatment alone at multiple time frames (SOE: moderate for function intermediate term; low for pain and function at all other times), and with small improvements in function but no improvements in pain in the short term when compared with physical activity alone (SOE: moderate). There were no differences between CPMPs and psychological therapy alone at any time (SOE: low). Serious harms were not reported, although evidence on harms was insufficient. The mean age was 57 years across IPMP RCTs and 45 years across CPMP RCTs. None of the trials specifically enrolled Medicare beneficiaries. Evidence on factors related to program structure, delivery, coordination, and components that may impact outcomes is sparse and there was substantial variability across studies on these factors. Conclusions. IPMPs and CPMPs may provide small to moderate improvements in function and small improvements in pain in patients with chronic pain compared with usual care. Formal pain management programs have not been widely implemented in the United States for general populations or the Medicare population. To the extent that programs are tailored to patients’ needs, our findings are potentially applicable to the Medicare population. Programs that address a range of biopsychosocial aspects of pain, tailor components to patient need, and coordinate care may be of particular importance in this population.
APA, Harvard, Vancouver, ISO, and other styles
You might also be interested in the extended bibliographies on the topic 'Opioid substitution treatment program' for particular source types:
Journal articles Dissertations / Theses
We offer discounts on all premium plans for authors whose works are included in thematic literature selections. Contact us to get a unique promo code!

To the bibliography