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Social network support for individuals receiving opiate substitution treatment and its association with treatment progress.

Buprenorphine Research (PubMed) - Fri, 11/07/2014 - 6:00am
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Social network support for individuals receiving opiate substitution treatment and its association with treatment progress.

Eur Addict Res. 2013;19(4):211-21

Authors: Day E, Copello A, Karia M, Roche J, Grewal P, George S, Haque S, Chohan G

Abstract
BACKGROUND/AIMS: Social networks have been hypothesized to protect people from the harmful effects of stress, but may also provide dysfunctional role models and provide cues associated with drug use. This study describes the range, type and level of social support available to patients engaged in UK opiate substitution treatment (OST) programmes, and explores the association between network factors and continued use of illicit heroin.
METHODS: A cross-sectional survey of a randomly selected sample of OST patients (n = 118) utilised measures of current substance use and social network structure and support.
RESULTS: More than half of the participants had used heroin in the previous month, and most described networks that were both supportive and positive about treatment. Multivariate analysis showed that the substance use involvement of network members was higher in those patients still using heroin, even when other treatment factors were controlled for.
CONCLUSION: There was a strong association between ongoing contact with other drug users and continued use of illicit heroin in this treatment sample. Whilst there is potential for the involvement of social networks in treatment, future research needs to ascertain the exact nature of the relationship between social support and drug use.

PMID: 23391965 [PubMed - indexed for MEDLINE]

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Increased somatic morbidity in the first year after leaving opioid maintenance treatment: results from a Norwegian cohort study.

Buprenorphine Research (PubMed) - Fri, 11/07/2014 - 6:00am
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Increased somatic morbidity in the first year after leaving opioid maintenance treatment: results from a Norwegian cohort study.

Eur Addict Res. 2013;19(4):194-201

Authors: Skeie I, Brekke M, Clausen T, Gossop M, Lindbaek M, Reinertsen E, Thoresen M, Waal H

Abstract
BACKGROUND/AIMS: Some patients on opioid maintenance treatment (OMT) leave treatment temporarily or permanently. This study investigated whether patients interrupting their OMT differed from non-interrupters in sociodemographic and drug-use characteristics and examined acute/sub-acute somatic morbidity among the interrupters, prior to, during, and after OMT.
METHODS: Cohort design. OBSERVATION PERIOD: 5 years prior to, up to first 5 years during, and up to 5 years after interruption of OMT.
PARTICIPANTS: The sample (n = 200) comprised 51 OMT interrupters and 149 non-interrupters. Data on patient characteristics were obtained from interviews and OMT register information. Data on somatic morbidity were gathered from hospital records.
MEASUREMENTS: Key patient characteristics among OMT interrupters and non-interrupters. Incidence rates of acute and sub-acute somatic disease incidents leading to hospital treatment (drug-related/non-drug-related/injuries) prior to/during/after OMT.
RESULTS: Interrupters and non-interrupters did not differ in sociodemographic characteristics, while longer duration of amphetamine and benzodiazepine dependence predicted OMT interruption. Interrupters scored significantly higher on drug-taking and overdose during OMT but still had a significant 41% reduction in drug-related treatment, episodes. After interruption of treatment, such episodes increased markedly and were 3.6 times more frequent during the first post-OMT year compared to the pre-OMT period (p < 0.001). This increase was highest during the first months after OMT interruption. 2-5 years after interruption there was no significant increase.
CONCLUSIONS: Increased somatic morbidity was found among OMT interrupters during the first year after OMT, and especially during the immediate post-treatment period.

PMID: 23257574 [PubMed - indexed for MEDLINE]

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Diversion of methadone and buprenorphine from opioid substitution treatment: a staff perspective.

Buprenorphine Research (PubMed) - Wed, 11/05/2014 - 8:00am
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Diversion of methadone and buprenorphine from opioid substitution treatment: a staff perspective.

J Psychoactive Drugs. 2014 Nov-Dec;46(5):427-35

Authors: Johnson B, Richert T

Abstract
Abstract Opioid substitution treatment (OST) is still controversial, despite positive results. The issue of diversion to the illicit drug market is a cornerstone in the criticism typically voiced against the treatment. Little research is available concerning how professionals who work in OST view the issue of diversion. In this article, we discuss existing ideas and attitudes toward diversion of methadone and buprenorphine among OST staff in Sweden. The article is based on semi-structured interviews with 25 professionals working in eight OST-programs in southern Sweden. Diversion was seen as a deleterious phenomenon by the interviewees. Three problematic aspects were highlighted: medical risks in the form of overdose fatalities and the recruitment of new opiate/opioid users; negative consequences for the legitimacy of OST; and moral objections, since diversion means that the patients remain in a criminal environment. However, positive aspects were also highlighted. Illicit methadone or buprenorphine is perceived as safer than heroin. In this way, diversion can fulfill a positive function; for instance, if there is a shortage of access to regular treatment. Patients who share their medication with opioid-dependent friends are seen as less culpable than those who sell to anyone for money.

PMID: 25364995 [PubMed - in process]

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Patient Perspectives on Buprenorphine/Naloxone: A Qualitative Study of Retention During the Starting Treatment with Agonist Replacement Therapies (START) Study.

Buprenorphine Research (PubMed) - Wed, 11/05/2014 - 8:00am
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Patient Perspectives on Buprenorphine/Naloxone: A Qualitative Study of Retention During the Starting Treatment with Agonist Replacement Therapies (START) Study.

J Psychoactive Drugs. 2014 November-December;46(5):412-426

Authors: Teruya C, Schwartz RP, Mitchell SG, Hasson AL, Thomas C, Buoncristiani SH, Hser YI, Wiest K, Cohen AJ, Glick N, Jacobs P, McLaughlin P, Ling W

Abstract
Abstract This study examines the barriers and facilitators of retention among patients receiving buprenorphine/naloxone at eight community-based opioid treatment programs across the United States. Participants (n = 105) were recruited up to three and a half years after having participated in a randomized clinical trial comparing the effect of buprenorphine/naloxone and methadone on liver function. Semi-structured interviews were conducted with 67 patients provided with buprenorphine/naloxone who had terminated early and 38 patients who had completed at least 24 weeks of the trial. Qualitative data were analyzed using the constant comparison method. Barriers to buprenorphine/naloxone retention that emerged included factors associated with: (1) the design of the clinical trial; (2) negative medication or treatment experience; and (3) personal circumstances. The facilitators comprised: (1) positive experience with the medication; (2) personal determination and commitment to complete; and (3) staff encouragement and support. The themes drawn from interviews highlight the importance of considering patients' prior experience with buprenorphine/naloxone and methadone, medication preference, personal circumstances, and motivation to abstain from illicit use or misuse of opioids, as these may influence retention. Ongoing education of patients and staff regarding buprenorphine/naloxone, especially in comparison to methadone, and support from staff and peers are essential.

PMID: 25364994 [PubMed - as supplied by publisher]

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Treatment Outcomes of African American Buprenorphine Patients by Parole and Probation Status.

Buprenorphine Research (PubMed) - Wed, 11/05/2014 - 8:00am
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Treatment Outcomes of African American Buprenorphine Patients by Parole and Probation Status.

J Drug Issues. 2014 Jan;44(1):69-82

Authors: Mitchell SG, Gryczynski J, Kelly SM, O'Grady KE, Jaffe JH, Olsen YK, Schwartz RP

Abstract
This secondary analysis compared outcomes of African-American adults newly-admitted to buprenorphine treatment who were on parole and probation to patients who were not under criminal justice supervision. Buprenorphine patients (N=300) were randomly assigned to receive either Intensive Outpatient Treatment (IOP) or Standard Outpatient Treatment (OP) treatment and were assessed at baseline, 3- and 6-months. There were no differences between groups in treatment retention. Among probationers/parolees, IOP was associated with lower 3-month treatment retention compared to OP, but among participants not on probation/parole the relationship was reversed (p=.004). Both conditions showed significant declines in heroin and cocaine use, illegal activity, and in meeting DSM-IV criteria for opioid and cocaine dependence. Probationers/parolees reported lower frequency of illegal activities at 3-months compared to non-probationers/parolees (p=.007). Buprenorphine treatment should be made more widely available to individuals on parole/probation as they respond as well to treatment as patients not supervised by the criminal justice system.

PMID: 25364037 [PubMed - as supplied by publisher]

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Striatal dopamine D1 and D2 receptors are differentially regulated following buprenorphine or methadone treatment.

Buprenorphine Research (PubMed) - Sun, 11/02/2014 - 8:30am
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Striatal dopamine D1 and D2 receptors are differentially regulated following buprenorphine or methadone treatment.

Psychopharmacology (Berl). 2014 Oct 31;

Authors: Allouche S, Le Marec T, Coquerel A, Noble F, Marie N

Abstract
RATIONALE: Chronic administration of morphine induces adaptations in neurotransmission system such as the dopamine pathway, and these modifications could be influenced by the drug administration pattern. Methadone and buprenorphine are the two main opioid substitution therapies, and despite their protracted use in humans, no study has investigated their ability to regulate dopamine system after chronic exposure/withdrawal.
OBJECTIVES: We evaluated the consequences of two administration patterns of methadone and buprenorphine on striatal dopamine D1 (D1R) and D2 (D2R) receptor levels.
METHODS: Mice were treated with escalating doses of methadone or buprenorphine for 5 days either once daily (binge) or three times a day (TTD). D1R and D2R density in striatum was measured by autoradiography using [(3)H]-SCH23390 and [(3)H]-raclopride, respectively, at 1 (WD1), 14 (WD14), and 35 (WD35) days after the last opioid injection.
RESULTS: A downregulation of D1R was observed upon TTD administration of buprenorphine and binge methadone treatment while an increase of those receptor levels was detected both with binge buprenorphine and TTD methadone treatments. Concerning the D2R, we rather measured an early or late downregulation with both agonists and administration patterns.
CONCLUSIONS: Our results demonstrated that methadone and buprenorphine were able to differentially regulate dopamine receptor density depending on the withdrawal period and the administration pattern.

PMID: 25358852 [PubMed - as supplied by publisher]

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23-year-old woman being treated for opioid dependence, unexpected weight gain.

Buprenorphine Research (PubMed) - Sun, 11/02/2014 - 8:30am
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23-year-old woman being treated for opioid dependence, unexpected weight gain.

J Fam Pract. 2014 Jul;63(7):366-7

Authors: Chudgar NP, Greenblatt L

PMID: 25198209 [PubMed - indexed for MEDLINE]

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Prescribing of drugs for attention-deficit hyperactivity disorder in opioid maintenance treatment patients in Norway.

Buprenorphine Research (PubMed) - Sun, 11/02/2014 - 8:30am
Related Articles

Prescribing of drugs for attention-deficit hyperactivity disorder in opioid maintenance treatment patients in Norway.

Eur Addict Res. 2014;20(2):59-65

Authors: Karlstad Ø, Furu K, Skurtveit S, Selmer R

Abstract
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a risk factor for the development of substance use disorders. Treatment of ADHD with psychostimulants in patients on opioid maintenance treatment (OMT) has been restricted in Norway. We examined the use of prescribed drugs for ADHD in OMT patients and assessed co-medication with other psychotropics.
METHODS: Data were drawn from the nationwide Norwegian Prescription Database (NorPD), which includes all prescriptions filled at pharmacies. The study population included subjects ≥18 years on OMT during 2008-2010.
RESULTS: In 2010, 6,116 patients received OMT and 2.8% of these also received ADHD drugs. This percentage is seven times greater than that in the gender- and age-specific general population of Norway. The prevalence was higher in the youngest patients, while there was no gender difference. Methylphenidate was the most commonly used drug for ADHD in OMT patients, followed by atomoxetine. 60% of OMT patients filled at least one prescription for antidepressants, anxiolytics or hypnotics, and percentages were similar for users and non-users of ADHD drugs.
CONCLUSION: Treatment with ADHD drugs was higher in OMT patients than expected from the general population, but was relatively low compared to the prevalence of ADHD in patients with substance use disorders reported in the literature.

PMID: 24080771 [PubMed - indexed for MEDLINE]

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Methadone versus morphine for treatment of neonatal abstinence syndrome: A prospective randomized clinical trial.

Buprenorphine Research (PubMed) - Fri, 10/31/2014 - 7:00am
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Methadone versus morphine for treatment of neonatal abstinence syndrome: A prospective randomized clinical trial.

J Perinatol. 2014 Oct 30;

Authors: Brown MS, Hayes MJ, Thornton LM

Abstract
Objective:Compare duration of treatment of neonatal abstinence syndrome between methadone and morphine.Study design:A prospective, double-masked, randomized trial at a single site. Randomization of methadone or morphine was stratified for maternal treatment with methadone or buprenorphine. Inclusion criteria were (i) maternal treatment with prescribed methadone or buprenorphine, (ii) withdrawal treatment criteria, (iii) adjusted gestational age ⩾35(0/7) weeks and (iv) medically stable. Primary outcome was length of opioid treatment.Result:From January 2011 through October 2012, 78 infants were eligible for the study: 41 methadone-exposed and 37 buprenorphine-exposed. Consent was obtained from 31 mothers, 13/41 (32%) methadone-treated and 18/37 (49%) buprenorphine-treated. Length of opioid treatment was significantly shorter for methadone than morphine treatment, median 14 versus 21 days (P=0.008).Conclusion:Methadone had a shorter length of neonatal withdrawal treatment compared with morphine. Owing to the smaller sample size and single site, a larger randomized study is needed.Journal of Perinatology advance online publication, 30 October 2014; doi:10.1038/jp.2014.194.

PMID: 25357093 [PubMed - as supplied by publisher]

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Executive function in preschool children prenatally exposed to methadone or buprenorphine.

Buprenorphine Research (PubMed) - Fri, 10/31/2014 - 7:00am
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Executive function in preschool children prenatally exposed to methadone or buprenorphine.

Child Neuropsychol. 2014 Oct 30;:1-16

Authors: Konijnenberg C, Melinder A

Abstract
Although an increasing number of children are born with prenatal methadone or buprenorphine exposure, little is still known about the potential long-term effects of these opioids. The aim of this study was to investigate executive function (EF) in children of women in opioid maintenance therapy (OMT). A total of 66 children (aged 48-57 months) participated in the study, 35 of which had histories of prenatal methadone or buprenorphine exposure. EF was measured using a battery of neuropsychological tests and the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Results showed that children of women in OMT perform lower on tasks of short-term memory and inhibition compared to nonexposed children, which was mainly associated with lower maternal education and employment rate. The OMT group scored significantly lower on all EF tasks compared to the nonexposed group, although scores fell within the average range on all measures. The development of these children should be monitored to assess for the possible problem behaviors and to promote optimal outcomes.

PMID: 25354916 [PubMed - as supplied by publisher]

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Somatosensory and auditory processing in opioid-exposed newborns with neonatal abstinence syndrome: a magnetoencephalographic approach.

Buprenorphine Research (PubMed) - Thu, 10/30/2014 - 10:30am
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Somatosensory and auditory processing in opioid-exposed newborns with neonatal abstinence syndrome: a magnetoencephalographic approach.

J Matern Fetal Neonatal Med. 2014 Oct 29;:1-17

Authors: Kivistö K, Nevalainen P, Lauronen L, Tupola S, Pihko E, Kivitie-Kallio S

Abstract
Abstract Objective: Opioid exposure during pregnancy is a potential risk factor for the developing central nervous system of the fetus. We studied evoked responses in buprenorphine-exposed newborns who displayed neonatal abstinence syndrome (NAS) to elucidate the possible alterations in functioning of the somatosensory and auditory systems. Methods: We compared somatosensory (SEFs) and auditory evoked magnetic fields (AEFs), recorded with magnetoencephalography (MEG), of 11 prenatally buprenorphine-exposed newborns with those of 12 healthy newborns. Peak latencies, source strength, and location of SEFs or AEFs were recorded. Results: AEFs were present in all buprenorphine-exposed newborns without significant differences from those of healthy newborns. In contrast, though no group level differences in SEFs existed, at individual level the response deviated from the typical neonatal morphology in four buprenorphine-exposed newborns. Conclusions: Although buprenorphine exposure during pregnancy does not seem to cause constant deficiencies in somatosensory or auditory processing, in some newborns the typical development of somatosensory networks may be - at least transiently - disrupted.

PMID: 25354289 [PubMed - as supplied by publisher]

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Livedo-like dermatitis and necrotic lesions after high-dose buprenorphine injections: a national French survey.

Buprenorphine Research (PubMed) - Thu, 10/30/2014 - 10:30am
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Livedo-like dermatitis and necrotic lesions after high-dose buprenorphine injections: a national French survey.

Br J Dermatol. 2014 Oct 29;

Authors: Wainstein L, Bernier C, Gérardin M, Bouquié R, Espitia O, Mussini JM, Jolliet P, Victorri-Vigneau C

Abstract
Buprenorphine is a partial opioid agonist used as an oral maintenance treatment for opioid dependence, under the form of high-dose. The branded form of high-dose buprenorphine (HDB) -Subutex(®) - was introduced in France in 1996. Several generic drugs have been marketed ten years later. HDB has become the first oral maintenance treatment for opioid dependence in France. This article is protected by copyright. All rights reserved.

PMID: 25353069 [PubMed - as supplied by publisher]

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Clinical Benchmarks Regarding Multimodal Peripheral Nerve Blocks for Postoperative Analgesia: Observations Regarding Combined Perineural Midazolam-Clonidine-Buprenorphine-Dexamethasone.

Buprenorphine Research (PubMed) - Thu, 10/30/2014 - 10:30am
Related Articles

Clinical Benchmarks Regarding Multimodal Peripheral Nerve Blocks for Postoperative Analgesia: Observations Regarding Combined Perineural Midazolam-Clonidine-Buprenorphine-Dexamethasone.

Pain Med. 2014 Oct 28;

Authors: Williams BA, Ibinson JW, Mangione MP, Scanlan RL, Cohen PZ

PMID: 25351887 [PubMed - as supplied by publisher]

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Trick and Treat: 5 Ways to Reduce Teen Mischief this Halloween

Drug and Alcohol News (JoinTogether.com) - Wed, 10/29/2014 - 4:04pm

Its a fact: teens trick their parents from time to time. Experts say its normal for teens to stretch rules, take risks and try out some trickery (just think back to when you were a teen.) But there are some key things parents can do to keep their teens safe and healthy. With Halloween this weekend, why not roll up your sleeves and do some productive tricking and treating of your own?

Here are 5 ways parents can reduce teen mischief and encourage a healthy relationship with their teen on Halloween and beyond.

  1. Trick Them Into Talking

* Listen First: Let teens vent, talk and not feel judged and be sure to keep the focus on them when they are talking to you.

* Ask The Right Questions: Instead of giving advice, ask questions. Ask them more about how they feel, what they think they should do, what others have done. Not only will you learn more about how your teen thinks, you will also help them explore their own situation.

* Let them, or show them, how to come to their own answers: When you ask them questions, try to guide them to come up with the answer on their own, instead of you telling them what to do. That way, they will feel more empowered.

2. Treat Your Family to a Screen-Free Evening

Turn off all smartphones, gaming devices, iPads, TVs, etc. and give one another your undivided attention. Make eye-contact, ask questions and share stories. As hard as it might be — don’t jump to respond to every ping or text on your phone. Show your teen that you’re curious about her world and that what she has to say is more important than any screen. (And make sure she does the same.)

3. Trick Your Teens Into Staying Out of Trouble

Encourage your teen to do something out of her wheelhouse. Perhaps he joins a new club at school, tries a new sport or does some community service. This will give her something structured to do after school, and she can include her wider circle of friends in the activities — and, it’s always worthwhile to try new things, even if he’s not good at it. Ask other parents in your community or at your place of worship for how your teen can get actively involved in community volunteering.

4. Trick Them Into Feeling Good About Themselves

Give your teen lots of praise and positive feedback. Teens need to hear the “good stuff” just like the rest of us. They need to know you can still see beyond the things they do wrong from time to time. Catch them being good and always reward positive, responsible, mature behavior to help build their own self-esteem so they make more positive choices.

5. Treat Them with Love and Support

It’s important that teens feel supported by their parents, so be sure to let your child know that he or she can always count on you and come to you for guidance when she’s stressed or dealing with a personal issue. Remind your teen that the reason you’re always talking with her and asking questions is because you love her, care about her and want her to be healthy and successful.

Have a safe, happy and healthy Halloween!

The post Trick and Treat: 5 Ways to Reduce Teen Mischief this Halloween appeared first on Partnership for Drug-Free Kids.

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