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Shifting North American drug markets and challenges for the system of care. 

Krausz RM, Westenberg JN, Mathew N, Budd G, Wong JSH, Tsang VWL, Vogel M, King C, Seethapathy V, Jang K, Choi F. 

Int J Ment Health Syst. 2021 Dec 20;15(1):86. doi: 10.1186/s13033-021-00512-9. PMID: 34930389; PMCID: PMC8685808.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8685808/

USA. ER Program Increases Use of Buprenorphine Treatment for Opioid Use Disorder

Doctors using a program to increase buprenorphine treatment for opioid use disorder were able to boost use of the medication sixfold, HealthDay reports.

The program used tactics including providing financial incentives for doctors to train to treat opioid use disorder, as well as automatically connecting patients with peer recovery specialists. (drugfree.org, USA, Januar 2022)

https://drugfree.org/drug-and-alcohol-news/er-program-increases-use-of-buprenorphine-treatment-for-opioid-use-disorder/

Clinical impact, costs, and cost-effectiveness of hospital-based strategies for addressing the US opioid epidemic: a modelling study

Barocas, Joshua A et al.

The Lancet Public Health, Volume 7, Issue 1, e56 - e64 

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00248-6/fulltext

Physician-Perceived Barriers to Treating Opioid Use Disorder in the Emergency Department. 

Logan G, Mirajkar A, Houck J, Rivera-Alvarez F, Drone E, Patel P, Craen A, Dub L, Elahi N, Lebowitz D, Walker A, Ganti L. 

Cureus. 2021 Nov 26;13(11):e19923. doi: 10.7759/cureus.19923. PMID: 34966614; PMCID: PMC8710303.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710303/

Methadone initiation in a bridge clinic for opioid withdrawal and opioid treatment program linkage: a case report applying the 72-hour rule. 

Laks J, Kehoe J, Farrell NM, Komaromy M, Kolodziej J, Walley AY, Taylor JL. 

Addict Sci Clin Pract. 2021 Dec 28;16(1):73. doi: 10.1186/s13722-021-00279-x. PMID: 34961554; PMCID: PMC8712102.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8712102/

A Smartphone-Smartcard Platform for Implementing Contingency Management in Buprenorphine Maintenance Patients With Concurrent Stimulant Use Disorder. 

DeFulio A, Furgeson J, Brown HD, Ryan S. 

Front Psychiatry. 2021 Dec 7;12:778992. doi: 10.3389/fpsyt.2021.778992. PMID: 34950072; PMCID: PMC8688352.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688352/

Universal screening for substance use by Peer Support Specialists in the Emergency Department is a pathway to buprenorphine treatment. 

Gertner AK, Roberts KE, Bowen G, Pearson BL, Jordan R. 

Addict Behav Rep. 2021 Sep 25;14:100378. doi: 10.1016/j.abrep.2021.100378. PMID: 34938837; PMCID: PMC8664965.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664965/

Self-Schema, Attachment Style, and Treatment Outcome of Patients in an Opiate Maintenance Treatment Unit. 

Hovelius E, Lindén E, Bengtsson H, Håkansson A.

Front Psychol. 2021 Nov 23;12:595883. doi: 10.3389/fpsyg.2021.595883. PMID: 34916983; PMCID: PMC8670402.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670402/

Patients'satisfaction and experience in treatment with opioid substitution therapy in Spain. The PREDEPO study. 

Pascual Pastor F, Muñoz Á, Oraa R, Flórez G, Notario P, Seijo P, Gonzalvo B, Assaf C, Gómez M, Casado MÁ. 

Adicciones. 2021 Nov 23;0(0):1684. English, Spanish. doi: 10.20882/adicciones.1684. Epub ahead of print. PMID: 34882243.

https://www.adicciones.es/index.php/adicciones/article/view/1684

Emergency department-initiated buprenorphine protocols: A national evaluation. 

Guo CZ, D'Onofrio G, Fiellin DA, Edelman EJ, Hawk K, Herring A, McCormack R, Perrone J, Cowan E. 

J Am Coll Emerg Physicians Open. 2021 Nov 29;2(6):e12606. doi: 10.1002/emp2.12606. PMID: 34877567; PMCID: PMC8630357.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630357/

Rapid Access to Medications for Opioid Use Disorder. 

Kleinman RA, Morris NP. 

J Gen Intern Med. 2021;36(11):3557-3558. doi:10.1007/s11606-021-06850-1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162156/

A 35-year follow-up study of patients admitted to methadone treatment between 1982-1984 in Asturias, Spain. 

Jiménez-Treviño L, Martínez-Cao C, Sánchez-Lasheras F, Iglesias C, Antuña MJ, Riera L, Sáiz PA, Bobes J. 

Adicciones. 2021 Nov 23;0(0):1662. English, Spanish. doi: 10.20882/adicciones.1662. Epub ahead of print. PMID: 34882240.

https://www.adicciones.es/index.php/adicciones/article/view/1662

Opium Addiction: Practical Issues in ICU. 

Das AK, Sharma A, Kothari N, Goyal S. 

Indian J Crit Care Med. 2021 Sep;25(9):1082-1083. doi: 10.5005/jp-journals-10071-23939. PMID: 34963736; PMCID: PMC8664020.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664020/

Combining medication and adjunct services for opioid use disorder: Identifying cost-saving combinations that reduce risk of overdose and death

Given limited treatment resources and unmet treatment needs for opioid use disorder, it is essential to identify exactly which treatments are worth the investment. Looking at the effects of medication treatments alone and combined with psychosocial services, and their cost-effectiveness can help determine their benefits and what provides the greatest benefit at the lowest cost. This study evaluated the effects of medication and add-on services on overdose and death, as well as their cost-effectiveness. (Recovera Research Inst6itute, USA, Dezember 2021)

https://www.recoveryanswers.org/research-post/combine-medication-adjunct-services-opioid-use-disorder-cost-saving-combinations-reduce-overdose-death/

SAMHSA Weighs Permanent Methadone Take-Homes, Decades Too Late

In March 2020, to reduce the risk of COVID-19 infections among patients and staff, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) made an unprecedented decision that made it a whole lot easier to get take-home doses of methadone. They issued temporary guidelines allowing clinics to dispense 28 days of take-home doses to “stable” patients and 14 for less “stable” patients. Normally, to methadone patients’ chagrin, it can take years to “earn” this many take-homes. (Filter, USA, 15.12.2021)

https://filtermag.org/samhsa-methadone-take-homes/

USA. Practical Tools for Prescribing and Promoting Buprenorphine in Primary Care Settings

This resource provides information to primary care providers and practices on how to implement opioid use disorder treatment using buprenorphine. It identifies common barriers and strategies to overcome them. It documents step-by-step tactics to support buprenorphine implementation. (SAMHSA - Substance Abuse and Mental Health Services Administration, Dezember 2021)

https://store.samhsa.gov/product/practical-tools-for-prescribing-promoting-buprenorphine-primary-care-settings/pep21-06-01-002

Increasing Access to Medications for Opioid Use Disorder in Primary Care: Removing the Training Requirement May Not Be Enough. 

Russell HA, Sanders M, Meyer JKV, Loomis E, Mullaney T, Fiscella K. 

J Am Board Fam Med. 2021 Nov-Dec;34(6):1212-1215. doi: 10.3122/jabfm.2021.06.210209. PMID: 34772776.

https://www.jabfm.org/content/34/6/1212.long

USA. Amid rising opioid overdose calls, city EMS to provide drug used in recovery 

(...)

On Monday, the Office of Community Health and Safety announced the successful beginnings of a pilot program that equips first responders to overdose calls with buprenorphine, a drug used to gradually helps opioid-users curb their use and recover from addiction. (Pittsburgh Post Gazette, USA, 07.12.2021)

https://www.post-gazette.com/news/health/2021/11/26/pittsburgh-opioid-overdose-deaths-ems-naloxone-buprenorphine-program/stories/202111190158

Fulfilling a Need: A Residency-Based Program to Preserve a Suboxone Treatment Program in a Rural Community. 

Buck MC, McCormick AN, Meagher MM, Kauppila G, Witt TJ. 

Ann Fam Med. 2021 Nov-Dec;19(6):561. doi: 10.1370/afm.2718. PMID: 34750133; PMCID: PMC8575508.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575508/

Association between Participation in Counseling and Retention in a Buprenorphine-Assisted Treatment Program for People Experiencing Homelessness with Opioid Use Disorder. 

Berry ARW, Finlayson TL, Mellis LM, Urada LA. 

Int J Environ Res Public Health. 2021 Oct 21;18(21):11072. doi: 10.3390/ijerph182111072. PMID: 34769591; PMCID: PMC8582897.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582897/

Caring for persons with drug use disorders in the Yangon Region, Myanmar: Socioeconomic and psychological burden, coping strategies and barriers to coping. 

Thein KZK, Herberholz C, Sandar WP, Yadanar (2021) 

PLoS ONE 16(10): e0258183. doi.org/10.1371/journal.pone.0258183

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258183

Accessibility to Medication for Opioid Use Disorder After Interventions to Improve Prescribing Among Nonaddiction Clinics in the US Veterans Health Care System. 

Hawkins EJ, Malte CA, Gordon AJ, et al. 

JAMA Netw Open. 2021;4(12):e2137238. doi:10.1001/jamanetworkopen.2021.37238

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2786900

Schweiz/Zürich. Die Opioid-Agonisten-Therapie (Video-Clip)

Die Opioid-Agonisten-Therapie (OAT) wurde früher Substitutionstherapie genannt. Anstelle von verunreinigtem Strassenheroin oder anderen auf dem Schwarzmarkt erworbenen erhalten Menschen in einer OAT pharmazeutisch hergestellte Medikamente. Je nach Medikament ist die Wirkung «retardiert» (= verzögert), d.h. es kommt zu keinem «Flash», sondern das Medikament wirkt über den ganzen Tag, so dass es zu keinen Entzugserscheinungen kommt. In einer OAT findet der Konsum somit nicht auf der Strasse statt, sondern in einem geschützten, medizinischen Rahmen. Die Dosis und Konsumfrequenz werden im Rahmen der Therapie von den Ärzt*innen gemeinsam mit den Patient*innen festgelegt und fortlaufend überprüft, um die passendste und verträglichste Dosis zu ermöglichen. (ARUD, Schweiz, 30.11.2021, Video, 01:56)

https://www.youtube.com/watch?v=jrUtiiVqoW0

Schweiz/Zürich. Die Arud wird 30!

Die Arud feiert heute ihr 30-jähriges Bestehen! Kurz bevor der Platzspitz im Februar 1992 von den Behörden überstürzt geschlossen worden ist, gründeten engagierte Ärzte und Fachleute am 30. November 1991 die «Arbeitsgemeinschaft für einen risikoarmen Umgang mit Drogen» – kurz Arud.

Mit 8 kurzen Clips möchten wir zum Jubiläum Einblick in die Arud geben: Sie zeigen, wie wir arbeiten und was unseren Mitarbeitenden und Patient:innen an der Arud gefällt. Die Clips dürfen gern auch geteilt werden! (ARUD, Schweiz, 30.11.2021)

Mehr zur eindrücklichen Geschichte der Arud

https://arud.ch/uber-uns/unternehmen/geschichte

Short-Acting Opioids Needed for Withdrawal in US Hospitals, Say Experts

Medscape - Nov 23, 2021.

https://www.medscape.com/viewarticle/963565

Telehealth for opioid use disorder treatment in low-barrier clinic settings: an exploration of clinician and staff perspectives. 

Aronowitz, S.V., Engel-Rebitzer, E., Dolan, A. et al.

Harm Reduct J 18, 119 (2021). doi.org/10.1186/s12954-021-00572-7

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-021-00572-7

Schweiz. Abgabe von medizinischem Heroin: Verlängerung der geänderten Regelung 

Bern, 24.11.2021 - Patientinnen und Patienten, die medizinisches Heroin erhalten, können weiterhin aufgrund strikter Kriterien bis zu sieben Tagesdosen Diacetylmorphin aufs Mal beziehen. Aufgrund der positiven Erfahrungen während der Pandemie hat der Bundesrat an seiner Sitzung vom 24. November 2021 beschlossen, diese Praxis bis zum 31. März 2023 zu verlängern und bis dahin die Betäubungsmittelsuchtverordnung (BetmSV) vollständig zu revidieren. (Schweizerische Eidgenossenschaft, Der Bundesrat, 24.11.2021)

https://www.admin.ch/gov/de/start/dokumentation/medienmitteilungen.msg-id-86057.html

Time to address addiction treatment inequality in hospital settings

Nielsen, Suzanne et al.

The Lancet Public Health, Volume 0, Issue 0 

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00260-7/fulltext

USA. Progress of Four Programs from the Comprehensive Addiction and Recovery Act. National Academies of Sciences, Engineering, and Medicine. 2021. 

Washington, DC: The National Academies Press. doi.org/10.17226/26060

Substance use disorder (SUD) and opioid use disorder are significant public health threats that affect millions of Americans each year. To help address overdose deaths and lack of access to treatment, the Comprehensive Addiction and Recovery Act (CARA) was signed into law on July 22, 2016. CARA is extensive legislation intended to address many facets of the opioid epidemic, including prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. It authorizes more than $181 million each year in new funding to fight the opioid epidemic and it requires the implementation of programs and services across the United States to address SUD and recovery.

https://www.nap.edu/catalog/26060/progress-of-four-programs-from-the-comprehensive-addiction-and-recovery-act

Assessing the determinants of completing OAT induction and long-term retention: A population-based study in British Columbia, Canada

Kurz, Megan et al.

Journal of Substance Abuse Treatment, Volume 0, Issue 0, 108647 

 https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(21)00373-1/fulltext