Methadone maintenance treatment among patients exposed to illicit fentanyl in Rhode Island: Safety, dose, retention, and relapse at 6 months

Stone, A. C.; Carroll, Jennifer; Rich, Josiah D.; Green, Traci C.

doi:10.1016/j.drugalcdep.2018.07.019

Cited by 44 publications

(29 citation statements)

References 17 publications

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“…This study also highlighted the suboptimal retention in MMT, as demonstrated by the 6-month retention rates at 60.5% and 47.6% in the intervention and control groups, respectively. These findings corroborate MMT retention rates reported in other settings such as the US [47], Ireland [48] and Iran [49], characterizing an urgent need for improving MMT retention in those settings.…”

Section: Discussionsupporting

confidence: 89%

Effectiveness of a Psycho-Social Intervention Aimed at Reducing Attrition at Methadone Maintenance Treatment Clinics: A Propensity Score Matching Analysis

Fan

Zhang

et al. 2019

IJERPH

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Methadone maintenance treatment (MMT) is an important approach to address opioid dependence. However, MMT clinics usually report high attrition rates. Our previous randomized controlled trial demonstrated additional psycho-social services delivered by social workers could reduce attrition rates compared to MMT alone. This study aimed to evaluate the effectiveness of psycho-social service in a real-world context. A quasi-experimental design and propensity score matching was adopted. 359 clients were recruited from five MMT clinics in Guangzhou from July 2013 to April 2015. One 20-minute counseling session was offered to the control group after enrolment. The intervention group received six sessions of psycho-social services. The baseline characteristics were unbalanced between two arms in the original sample. After propensity score matching, 248 participants remained in the analysis. At month six, the intervention group had a lower attrition rate [intervention (39.5%) versus control (52.4%), P = 0.041], higher monthly income [monthly income of 1000 CNY or higher: intervention (55.9%) versus control (39.0%), P = 0.028)], higher detoxification intention score [full intention score: intervention (51.6%) versus control (32.5%), P = 0.012)], higher family support in MMT participation [intervention (77.9%) versus control (61.4%), P = 0.049)]. This study demonstrated that psycho-social services delivered by social workers can reduce MMT clients’ attrition and improve their well-being in real-world settings.

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Section: Discussionsupporting

confidence: 89%

Effectiveness of a Psycho-Social Intervention Aimed at Reducing Attrition at Methadone Maintenance Treatment Clinics: A Propensity Score Matching Analysis

Fan

Zhang

et al. 2019

IJERPH

View full text Add to dashboard Cite

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“…Despite the important role that harm reduction programs play, the overdose epidemic has brought to light the limitations of existing interventions ( Stone et al., 2018 ). While supervised injection sites and community-centered naloxone programs can save lives through intervening in overdoses once they occur, these interventions are not able to reduce the chances of overdosing in the first place nor do they reduce the harms, violence and interaction with policing that is associated with acquiring the drugs ( Cooper, 2015 ).…”

Section: The Overdose Epidemicmentioning

confidence: 99%

Safer opioid distribution in response to the COVID-19 pandemic

Tyndall

2020

International Journal of Drug Policy

102

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COVID-19 has turned the world upside down in a very short period of time. The impact of COVID-19 will disproportionately effect people who are least able to protect themselves and this will include people who use drugs. The arrival of the COVID-19 pandemic comes at time when North America is in the midst of a protracted overdose epidemic caused by a toxic illegal drug supply. Overdose deaths are likely to rise when people are isolated, social support programs are cut back, and the illicit drug supply is further compromised. Safer opioid distribution in response to a toxic street drug supply is a pragmatic and effective way to reduce overdose deaths. COVID-19 makes such an approach even more urgent and compelling.

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“…There are limited data on the efficacy of methadone or buprenorphine for the treatment of illicit fentanyl use. A retrospective study in Rhode Island showed that 6 months of methadone maintenance protected against death and promoted abstinence in fentanyl-exposed patients, but relapse rates were still high 109 . Buprenorphine is a μ-opioid receptor partial agonist and κ-opioid receptor antagonist that is commonly used to treat opioid use disorder.…”

Section: Interventions For the Management And Prevention Of Fentanyl mentioning

confidence: 99%

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

et al. 2019

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Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

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Methadone maintenance treatment among patients exposed to illicit fentanyl in Rhode Island: Safety, dose, retention, and relapse at 6 months

Cited by 44 publications

References 17 publications

Effectiveness of a Psycho-Social Intervention Aimed at Reducing Attrition at Methadone Maintenance Treatment Clinics: A Propensity Score Matching Analysis

Effectiveness of a Psycho-Social Intervention Aimed at Reducing Attrition at Methadone Maintenance Treatment Clinics: A Propensity Score Matching Analysis

Safer opioid distribution in response to the COVID-19 pandemic

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

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