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Aims
To estimate the association between punitive policies for women with substance use during pregnancy and odds of neonatal abstinence syndrome (NAS) diagnosis among Medicaid‐insured infants, and to estimate this association controlling for the presence of four other policies related to substance use in pregnancy.
Design, Setting and Participants
Analysis of live births in Medicaid claims data...
Aims
To investigate whether reduction in opioid use differs when treated by either buprenorphine–naloxone (BUP) or methadone (MET) among adults with comorbid opioid use disorder (OUD) and mental disorders.
Design, Setting and Participants
In a randomized controlled trial, adults with OUD were randomized to 24 weeks of either BUP or MET treatment and were followed up in 3‐yearly assessments. The...
Background and aims
Ibogaine is an indole alkaloid used in rituals of the African Bwiti tribe. It is also used in non‐medical settings to treat addiction. However, ibogaine has been linked to several deaths, mainly due to cardiac events called torsades des pointes preceded by QTc prolongation as well as other safety concerns. This study aimed to evaluate the cardiac, cerebellar and psychomimetic...
Background and aims
Prescription drug‐seeking (PDS) from multiple prescribers is a primary means of obtaining prescription opioids; however, PDS behavior has probably evolved in response to policy shifts, and there is little agreement about how to operationalize it. We systematically compared the performance of traditional and novel PDS indicators.
Design
Longitudinal study using a de‐identified...
Aims
To assess differences in the quality of opioid use disorder (OUD) treatment received by Medicare beneficiaries enrolled in health plans that used prior authorization (PA) for buprenorphine–naloxone compared with those enrolled in plans that did not use PA.
Design, Setting and Participants
Cross‐sectional observational study, United States. Continuously enrolled beneficiaries (71 294) with...
Background and aims
Pharmacy administration and dispensing of methadone for methadone maintenance treatment (MMT) can expand treatment access for opioid use disorder (OUD). This study investigated the feasibility and acceptability of a novel model permitting an opioid treatment program (OTP) physician to prescribe methadone for OUD treatment through collaboration with a partnered pharmacy.
Design...
Opioid use disorder (OUD) has gained increasing publicity and interest during recent years, with many countries describing problems of epidemic proportions with regard to opioid use and deaths related to opioids. While opioids are not themselves acutely neurotoxic, the chronic relapsing and remitting nature of this disorder means that individuals are often exposed to exogenous opioids for lengthy...
Background and aims
Opioid agonist treatment is effective but resource intensive to administer safely in custodial settings, leading to significant under‐treatment of opioid dependence in these settings world‐wide. This study assessed the safety of subcutaneous slow‐release depot buprenorphine in custody.
Design
Open‐label, non‐randomized trial.
Setting
Correctional centres in New South Wales,...
Aim
To evaluate and document the impacts of re‐scheduling codeine to a prescription‐only medication in Australia in February 2018.
Design
Prospective cohort study. Participants completed an on‐line survey with a range of outcome measures at four time‐points, once before codeine was re‐scheduled (November 2017) and three times after the event: 1 month after (February 2018), 4 months after (June...
Background and Aims
Dynamic, adaptive pharmacologic treatment for opioid use disorder (OUD) has been previously recommended over static dosing to prevent relapse, and is aligned with personalized medicine. However, there has been no quantitative evidence demonstrating its advantage. Our objective was to estimate the extent to which a hypothetical intervention that increased buprenorphine dose in...
Background and Aims
Several randomized controlled trials (RCTs) conclude that heroin‐assisted‐treatment (HAT) has a larger benefit–cost ratio than oral methadone because HAT more reliably and substantially reduces participants’ criminal activity. This review: (1) summarizes results from RCTs concerning the comparative effectiveness of HAT for reducing criminal activity and (2) examines the role of...
Background and Aims
Multiple interventions and policy changes related to opioid agonist treatment (OAT) have been introduced in British Columbia, Canada to increase engagement and retention in OAT. We aimed to estimate the impact of policy changes and the announcement of the opioid overdose‐related public health emergency on the use of OAT for incarcerated individuals with opioid use disorder.
...
Aim
To investigate the real‐world effectiveness of pharmacological treatments (buprenorphine, methadone) of opioid use disorder (OUD).
Design
A nation‐wide, register‐based cohort study.
Setting
Sweden.
Participants
All residents aged 16–64 years living in Sweden using OUD medication from July 2005 to December 2016 (n = 5757, 71.8% men) were identified from registers of prescriptions, inpatient...
Aims
To characterize comparative risks and benefits of methadone versus buprenorphine/naloxone in a contemporary cohort where the unregulated drug supply is dominated by fentanyl.
Design, Setting and Participants
Population‐based propensity‐score matched cohort study conducted in Ontario, Canada among people aged 18+ initiating opioid agonist therapy (OAT) for an opioid use disorder between October...
Background and Aim
There is no gold‐standard and considerable heterogeneity in outcome measures used to evaluate treatments for opioid use disorder (OUD) along the opioid treatment cascade. The aim of this study was to develop the US National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder core outcomes set (OUD–COS).
Design
Four‐round,...
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