Showing posts with label Overdose. Show all posts
Showing posts with label Overdose. Show all posts

Sunday, August 30, 2015

Factors Associated with Illicit Methadone Injecting in a Canadian Setting

Background And Objectives:  While methadone is well established as an evidence-based treatment for opioid use disorder, safety concerns persist regarding its diversion. The authors examine the prevalence of and risk factors associated with injection of methadone in an urban population.

Methods: Between December 2005 and November 2013, data were derived from two open prospective studies of persons who inject drugs (PWID) in Vancouver, Canada. Generalized estimating equations (GEE) logistic regression was used to determine factors independently associated with illicit methadone injecting.

Results: During the study, 1911 individuals (34% women) were recruited; 134 (7%) participants reported methadone injecting at least once. In multivariable analysis, Caucasian ethnicity; homelessness; drug dealing ; ≥daily heroin injection; ≥daily crack smoking; being a victim of violence; and non-fatal overdose were independently and positively associated with methadone injection; female gender was negatively associated.

Discussion and Conclusions: The diversion of methadone for illicit injection in this urban setting was associated with several markers of addiction severity and other health and social vulnerabilities.

Scientific Significance: These findings underscore the need to ensure methadone accessibility while limiting diversion-related risk.

Thursday, August 6, 2015

Orienting patients to greater opioid safety: Models of community pharmacy-based naloxone

Below:  Overdose deaths and pharmacy-based naloxone prescriptions dispensed in Rhode Island, 2009 to 2015, by quarter.



The leading cause of adult injury death in the USA is drug overdose, the majority of which involves prescription opioid medications. Outside of the USA, deaths by drug overdose are also on the rise, and overdose is a leading cause of death for drug users. Reducing overdose risk while maintaining access to prescription opioids when medically indicated requires careful consideration of how opioids are prescribed and dispensed, how patients use them, how they interact with other medications, and how they are safely stored. Pharmacists, highly trained professionals expert at detecting and managing medication errors and drug-drug interactions, safe dispensing, and patient counseling, are an under-utilized asset in addressing overdose in the US and globally. Pharmacies provide a high-yield setting where patient and caregiver customers can access naloxone—an opioid antagonist that reverses opioid overdose—and overdose prevention counseling. This case study briefly describes and provides two US state-specific examples of innovative policy models of pharmacy-based naloxone, implemented to reduce overdose events and improve opioid safety: Collaborative Pharmacy Practice Agreements and Pharmacy Standing Orders.

Read at:   http://ht.ly/QzlDI HT @RIHospital