A- A A+

Evidence Brief: Barriers and Facilitators to Use of Medications for Opioid Use Disorder.

Mackey K, Veazie S, Anderson J, Bourne D, Peterson K.

Washington (DC): Department of Veterans Affairs (US); 2019 Aug.

PMID: 31670926

https://www.ncbi.nlm.nih.gov/books/NBK549203/

Myanmar/Burma. Drug Addiction Rises in Myanmar’s Kachin State

The clanking sound of leg irons shackled around the ankles of the unwilling patients signals the arrival of a small group of heroin addicts at the mess hall located inside a fortified Pat Ja San compound near Laiza in Myanmar’s Kachin state, located in the country’s north along the border with China. 

The compound is one of 28 run in Kachin and neighboring Shan state by Pat Ja San, a Christian anti-drug vigilante group.

International observers say treatments at the rehabilitation centers are rudimentary and brutal compared to modern Western methods. The detoxification program often includes locking patients in barred rooms and confining their legs to wooden stocks to prevent escape during the initial treatment when addicts experience the painful effects of withdrawal.

Methadone is sometimes available, but medical training for the workers and access to modern drugs are limited, especially in the rural areas where military battles persist. (New Delhi Times, Indien, 06.11.2019)

https://www.newdelhitimes.com/drug-addiction-rises-in-myanmars-kachin-state/

USA. Activists, Cuomo in “Full-Out War” Over Poor People’s MAT Access

Drug-user activists are fighting to ensure access to medication-assisted treatment (MAT) for some of New York State’s most vulnerable citizens, in the face of a governor seemingly reluctant to help and an administration that continues to offend. (Filter, USA, 30.10.2019)

https://filtermag.org/cuomo-medication-assisted-treatment-medicaid-bill-new-york-state

Post-overdose interventions triggered by calling 911: Centering the perspectives of people who use drugs (PWUDs).

Wagner KD, Harding RW, Kelley R, Labus B, Verdugo SR, Copulsky E, et al. (2019) 

PLoS ONE 14(10): e0223823. doi.org/10.1371/journal.pone.0223823

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223823

Kasachstan. When a tank is urgently needed to transport… methadone to hospitals

A tank is urgently needed! It doesn’t have to be a new one. The tank is needed to transport methadone to hospitals in Kazakhstan. Drug control authorities require paramilitary security for the transportation of drugs. However, the state is not going to allocate funds for security measures and this issue has not been resolved in 10 years. (EHRA – European Harm Reduction Association, 28.10.2019)

https://harmreductioneurasia.org/a-tank-is-urgently-needed/

USA. Treatment Finder: Millions of Americans have a substance use disorder. Help is available.

The Substance Abuse and Mental Health Services Administration (SAMHSA) collects information on thousands of state-licensed providers who specialize in treating substance use disorders, addiction, and mental illness. (United States Government, Department of Health and Human Services’s, Substance Abuse and Mental Health Services Administration (SAMHSA), 30.10.2019)

https://findtreatment.gov/

Irland. Long-term methadone maintenance treatment: Stigma and social isolation

Mirroring trends throughout Europe, there has been a distinct rise in the age of Ireland’s opiate users who are in treatment. In 2015, 42.5% of treated opiate users nationally were over the age of 35 years compared to 27% in 2009. In the Dublin region, this trend is more pronounced: while 31.5% of individuals treated for opiate use in 2009 were over the age of 35, this proportion increased to 54% by 2015. Yet, very little is known about the lives of individuals who have been accessing methadone maintenance treatment (MMT) for a prolonged period of time and their experiences remain largely invisible. (Merchants Quay, Ireland, Homeless & Drugs Service, Irland, Oktober 2019)

https://mqi.ie/long-term-methadone-maintenance-treatment-stigma-and-social-isolation/

Global patterns of opioid use and dependence: harms to populations, interventions, and future action

Degenhardt, Louisa et al.

The Lancet, Volume 394, Issue 10208, 1560 - 1579 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32229-9/fulltext

USA. Growing opioid crisis tests limits of methadone clinics - Advocates favor expansion

(…) Several organizations are considering opening new clinics—mostly in the middle of the state, along the shoreline and in the more rural areas. But when they propose new clinics, they typically face fierce opposition. (The Connecticut News, USA, 16.10.2019)

https://ctmirror.org/2019/10/16/growing-opioid-crisis-tests-limits-of-methadone-clinics/

USA. My Years in the Florida Shuffle of Drug Addiction

Cycling through relapse and recovery, and the industry that enables both. (The New Yorker, 14.10.2019, Issue October 21, 2019)

https://www.newyorker.com/magazine/2019/10/21/my-years-in-the-florida-shuffle-of-drug-addiction

Kenia. Kenya struggles to cope with growing number of heroin users

KIAMBU, Kenya. In a discreet clinic just outside the Kenyan capital, a recovering heroin addict named Peter holds the hand of his two-year-old daughter as he drinks a dose of methadone. (Reuters, 07.10.2019)

https://www.reuters.com/article/kenya-drugs/kenya-struggles-to-cope-with-growing-number-of-heroin-users-idUSL5N26P0FT

Indien. Evidence-based treatment option for heroin

Dr M Suresh Kumar 
A heroin user? The label often provokes negative assumptions… (Times of India, 15.10.2019)

https://timesofindia.indiatimes.com/city/chandigarh/evidence-based-treatment-option-for-heroin/articleshow/71592445.cms

When Early Dropout from Opioid Agonist Therapy Seems Likely, Identifying Problems and Taking Action May Help Keep Patients in Treatment

Too often, patients drop out early from opioid agonist therapy and lose the many benefits it offers. Is there some way to intervene early and retain patients?

A new study in Drug and Alcohol Dependence suggests that, indeed, there may be. (ATForum, USA, 11.10.2019)

http://atforum.com/2019/10/early-dropout-opioid-agonist-therapy/

USA. Rural Areas Have the Longest Drive Times for OTPs

It should come as no surprise that rural areas have longer drive times to opioid treatment programs (OTPs) than urban ones. (ATForum, USA, 11.10.2019)

http://atforum.com/2019/10/rural-areas-have-the-longest-drive-times-for-otps

USA. One in three young adults receive medication for opioid use disorder after overdose

A new study found that one in three young adults receive medication for opioid use disorder within 12 months of a non-fatal opioid overdose. The study, led by researchers at Boston Medical Center's Grayken Center for Addiction, in collaboration with the Massachusetts Department of Public Health (DPH), shows which medications—buprenorphine, methadone or naltrexone—are being taken, and how long after the overdose they receive the treatment. Published online in Annals of Emergency Medicine, the results provide important new data that can help increase access and time to medication for opioid use disorder for young adults who survive an overdose, including in an emergency department setting. (Boston Medical Center, USA, 08.10.2019)

https://medicalxpress.com/news/2019-10-young-adults-medication-opioid-disorder.html

Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting.

Beamish L, Sagorin Z, Stanley C, English K, Garelnabi R, Cousineau D, Barrios R, Klimas J.

BMC Health Serv Res. 2019 Sep 14;19(1):663. doi: 10.1186/s12913-019-4472-8.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744636/

Norwegen. 'The entire pharmaceutical compendium' in the treatment of substance use disorders

Jørg Mørland, Helge Waal

Tidsskr Nor Legeforen 2019, doi: 10.4045/tidsskr.18.0678

https://tidsskriftet.no/en/2019/02/kronikk/entire-pharmaceutical-compendium-treatment-substance-use-disorders

Predictors of Medication-Assisted Treatment Initiation for Opioid Use Disorder in an Interdisciplinary Primary Care Model.

Cantone RE, Garvey B, O'Neill A, Fleishman J, Cohen D, Muench J, Bailey SR.

J Am Board Fam Med. 2019 Sep-Oct;32(5):724-731. doi: 10.3122/jabfm.2019.05.190012.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754209/

'Communities are attempting to tackle the crisis': a scoping review on community plans to prevent and reduce opioid-related harms.

Leece P, Khorasheh T, Paul N, Keller-Olaman S, Massarella S, Caldwell J, Parkinson M, Strike C, Taha S, Penney G, Henderson R, Manson H.

BMJ Open. 2019 Sep 12;9(9):e028583. doi: 10.1136/bmjopen-2018-028583.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747643/

Schweiz/Zürich. Soziale Situation des OAT-Patientenkollektives der Arud

Die kantonale Substitutions-Statistik gibt Aufschluss über die soziale Situation von Patientinnen und Patienten, die sich in einer Opioid-Agonisten-Therapie (OAT) befinden.

2018 verfügten von den insgesamt 673 einbezogenen Arud-Patient*innen [520 Männer (77%), 153 Frauen (23%)] in laufender OAT (exkl. heroingestützte Behandlung) mehr als ein Drittel über eine private Unterkunft, Arbeit und ein eigenes Einkommen. Dies kann als gute soziale Situation gedeutet werden. (ARUD - Arbeitsgemeinschaft für risikoarmen Umgang mit Drogen, Schweiz, 03.10.2019)

https://arud.ch/uber-uns/news-und-info/aktuelles/soziale-situation-des-oat-patientenkollektives-der-arud

USA. Barrier to rural opioid treatment: Driving distance to methadone clinics

People who live in rural counties in five states heavily affected by the opioid epidemic must drive longer distances to obtain methadone, a treatment for opioid addiction, compared to individuals from urban counties, say Yale researchers. Their study, published in the Journal of the American Medical Association (JAMA), suggests these long drive times in rural counties could be reduced by making methadone more accessible in primary care clinics, they said. (Yale University, 01.10.2019)

https://medicalxpress.com/news/2019-10-barrier-rural-opioid-treatment-distance.html

USA. Methadone Barriers Persist, Despite Decades Of Evidence

Methadone, one of three medications approved by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD), is effective in reducing illicit opioid use and mortality.   Despite extensive evidence of its effectiveness, methadone remains one of the most heavily regulated drugs in the United States. At a time when additional methadone treatment capacity is desperately needed, federal, state, and local governments have imposed significant restrictions on how and where patients can receive the medication. (ATForum, USA, 26.09.2019)

http://atforum.com/2019/09/methadone-barriers-persist-despite-decades-of-evidence/

The scope and impact of mobile health clinics in the United States: a literature review.

Yu SWY, Hill C, Ricks ML, Bennet J, Oriol NE.

Int J Equity Health. 2017 Oct 5;16(1):178. doi: 10.1186/s12939-017-0671-2.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629787/

Rumänien. DIFFICULTIES ACCESSING OST IN ROMANIA - A call for international support

In the last weeks, the complicated access to Opioid Substitution Treatment (OST) in Romania has become even more unstable. Normally, from an estimated population 10.000 people who would need access to this service, a maximun of 2.000 places are covered. However, problems with delivery have put at risk this already difficult situation. (Correlation – European Harm Reduction Network, NL, 18.09.2019)

https://idpc.net/alerts/2019/09/difficulty-accessing-ost-in-romania-a-call-for-international-support

 

 

Malaysia. Malaysia's Government looks to decriminalise drug use in bid to stem disadvantage

The non-descript white van parked at the mosque entrance went mostly unnoticed.

In conservative Malaysia, very few of the Muslim faithful on their way to afternoon prayers could ever have imagined its true purpose.

After a 40-year war on drugs that has seen two Australians hanged and countless thousands of drug users locked up, the van is a symbol of a dramatic shift in Malaysia's approach to narcotics.

It's a mobile methadone clinic, set up to provide support on the ground as the nation prepares to decriminalise drug use. (abc.net.au, Australien, 14.09.2019)

https://www.abc.net.au/news/2019-09-15/malaysias-government-looks-to-decriminalise-drug-use/11511492

USA. Opioid crackdown forces pain patients to taper off drugs they say they need

(...) When researchers surveyed 194 primary care clinics in Michigan in 2018, they found that 79 of them would not accept new patients taking opioids, according to a study published last month in JAMA Network Open.

“We’ve entered a new era of opiophobia,” said Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute who is critical of the way some chronic pain patients are being treated. Some “have the kind of pain that’s unbearable. Every day of your life. Unbearable. And those are the people who are suffering. And their doctors are terrified.” (Washington Post, 10.09.2019)

https://www.washingtonpost.com/health/opioid-crackdown-forces-pain-patients-to-taper-off-drugs-they-say-they-need/2019/09/10/3920f220-c8da-11e9-a4f3-c081a126de70_story.html

Russland. Drogenabhängige in Russland: Leben mit der Sucht 

Russland zählt zu den größten Heroinmärkten der Welt, die Zahl der Abhängigen steigt. Der Fotograf Aleksandr Martynov hat Süchtige mit der Kamera begleitet. (Spiegel, 05.09.2019)

https://www.spiegel.de/politik/ausland/drogenabhaengige-in-russland-leben-mit-der-sucht-a-1284016.html

 

Barriers and facilitators to office-based opioid agonist therapy prescribing and effective interventions to increase provider prescribing: protocol for a systematic review.

Nixon LL, Marlinga JC, Hayden KA, Mrklas KJ.

Syst Rev. 2019 Jul 25;8(1):186. doi: 10.1186/s13643-019-1076-7.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657163/

Physicians' satisfaction with providing buprenorphine treatment.

Knudsen HK, Brown R, Jacobson N, Horst J, Kim JS, Collier E, Starr S, Madden LM, Haram E, Toy A, Molfenter T.

Addict Sci Clin Pract. 2019 Aug 26;14(1):34. doi: 10.1186/s13722-019-0163-3.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709557/