Opiate agonist treatment to improve health of individuals with opioid use disorder in Lebanon

Ghaddar, Ali; Abbas, Zeinab; Haddad, Raymond N.

doi:10.1186/s12954-017-0204-8

Cited by 7 publications

(9 citation statements)

References 38 publications

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“…A longitudinal study by the same researchers and a different cohort examined the effects of OAT and psychosocial support on opioid-dependent males at the first outpatient community-based treatment centre in Lebanon. 48 An observational case series of 24 opiate-dependent participants evaluated the effects of a double naltrexone implant treatment. Patients travelled from Mauritius to Australia to undergo surgery and follow-ups were done in Mauritius.…”

Section: Combined Pharmacological-psycho-social-educational Intervent...mentioning

confidence: 99%

“…Vo et al 40 Young adult alternative treatment program (YAAP) Sigmon et al 42 Buprenorphine-naloxone stabilization and naltrexone therapy with behaviour therapy Vo et al 41 Home-based delivery of extended-release naltrexone Ruisenōr-Escudero et al 45 Opioid substitution therapy clinic Romero-Gonzalez et al 46 Buprenorphine-naloxone medication with group cognitive behavioural therapy Ghaddar et al 47 Opioid agonist therapy program Ghaddar et al 48 Opiate agonist treatment Gonzalez et al 43 Buprenorphine-Naloxone therapy with or without memantine Jhugroo et al 49 Sustained-release naltrexone implant Law et al 44 Detoxification and opioid substitution therapy Schuman-Olivier et al 50 Collaborative care buprenorphine treatment program The MATA study indicated that missing urine drug screening rates were low and buprenorphine-naloxone compliance rates and opioid abstinence rates were high while youth were engaged with the clinic. Retention was a major barrier to the success of treatment; 75% returned for a second visit, after one visit, at 2 months, 45% of patients were retained and at 1 year, 9% of patients were active in the program.…”

Section: Combined Interventionsmentioning

confidence: 99%

“…The reductions in arrests, anxiety scores, and increases in quality-of-life were significant at 3-and 12-month follow-ups. 48 In the double-blinded RCT comparing buprenorphinenaloxone with either placebo, memantine 15 or 30 mg, 82% of participants were compliant with medication. Retention rates were similar in both groups; 85% were retained at week 8, 50% at week 10, and 25% at week 13.…”

Section: -Moderatementioning

confidence: 99%

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Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review

et al. 2022

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Background Youth and young adults have been significantly impacted by the opioid overdose and health crisis in North America. There is evidence of increasing morbidity and mortality due to opioids among those aged 15–29. Our review of key international reports indicates there are few youth-focused interventions and treatments for opioid use. Our scoping review sought to identify, characterize, and qualitatively evaluate the youth-specific clinical and pre-clinical interventions for opioid use among youth. Method We searched MedLine and PsycInfo for articles that were published between 2013 and 2021. Previous reports published in 2015 and 2016 did not identify opioid-specific interventions for youth and we thus focused on the time period following the periods covered by these prior reports. We input three groups of relevant keywords in the aforementioned search engines. Specifically, articles were included if they targeted a youth population (ages 15–25), studied an intervention, and measured impacts on opioid use. Results We identified 21 studies that examined the impacts of heterogeneous interventions on youth opioid consumption. The studies were classified inductively as psycho-social-educational, pharmacological, or combined pharmacological-psycho-social-educational. Most studies focused on treatment of opioid use disorder among youth, with few studies focused on early or experimental stages of opioid use. A larger proportion of studies focused heavily on male participants (i.e., male gender and/or sex). Very few studies involved and/or included youth in treatment/program development, with one study premised on previous research about sexual minority youth. Conclusions Research on treatments and interventions for youth using or at-risk of opioids appears to be sparse. More youth involvement in research and program development is vital. The intersectional and multi-factorial nature of youth opioid use and the youth opioid crisis necessitates the development and evaluation of novel treatments that address youth-specific contexts and needs (i.e., those that address socio-economic, neurobiological, psychological, and environmental factors that promote opioid use among youth).

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Section: Combined Pharmacological-psycho-social-educational Intervent...mentioning

confidence: 99%

Section: Combined Interventionsmentioning

confidence: 99%

Section: -Moderatementioning

confidence: 99%

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Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review

et al. 2022

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“…From the perspective of population health, outcomes could be overdose mortality rate (12), prevalence of HIV (13) and hepatitis C virus infection acquisition (14), or cessation of injection drug use (15). From the perspective of the individuals health, controlled trials often assess the outcome as the time to opioid relapse (16), retention in treatment (17), self-reported craving and opioid withdrawal symptoms (18), opioid-positive urine drug tests (10), psychological and social well-being (19), or quality of life (20). However, there is no consensus as to which could be the most appropriate outcome measure.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Coaddictions and Rate of Successful Treatment Among a French Sample of Opioid-Dependent Patients With Long-Term Opioid Substitution Therapy: The OPAL Study

Grall‐Bronnec

Laforgue²,

Challet-Bouju

et al. 2019

Front. Psychiatry

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Background: Opioid use disorder (OUD) is a worldwide major health concern due to increased early mortality and morbidity. Opioid substitution therapy (OST) is approved in the context of a global OUD treatment (OUDT), in conjunction with psychosocial interventions. Many factors can explain why unsuccessful treatment rates remain high. While the phenomenon of addiction switching is often proposed, it is not known whether this also includes gambling addiction. The primary objective of the OPAL study was to determine the prevalence of coaddictions, including problem gambling, among patients with OUDT. Secondary objectives were to assess the rate of unsuccessful OUDT and to characterize the associated factors. Methods: For this observational transversal multicenter study, patients with OUDT including OST for at least 6 months were recruited. Clinical assessment was based on a clinically structured interview and a set of self-reported questionnaires. Coaddictions were screened using the Fagerström, the CRAFFT, and the Lie/Bet questionnaires. Unsuccessful OUDT was defined as the persistence of opioid use and/or the worsening of another substance use or gambling practice. After a descriptive analysis, a multivariate analysis was performed to identify the factors associated with unsuccessful OUDT. Results: The sample consisted of 263 patients. Prevalence of coaddictions reached 97% of the sample. Problem gambling was associated with 10% of the patients. OUDT was considered as “unsuccessful” for 60% of the patients. Associated factors included having drug-using friends, psychiatric and professional negative consequences related to opioid use, more than one OST-prescribing physician, and impulsivity, especially high scores for lack of premeditation and sensation seeking. Conclusions: This study provides further evidence of the need to consider coaddictions and the usefulness of global addictive evaluations. Poor prognostic factors must alert the clinician to initiate more sustained care. Further implications are discussed.

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“…A quantitative evaluation of the OAT program in Lebanon has recently been conducted [ 23 ]. Although the program produced positive outcomes on quality of life, mental and social wellbeing and reduction of risky behavior among users, very low retention rates has been observed.…”

Section: Introductionmentioning

confidence: 99%

Challenges in implementing opioid agonist therapy in Lebanon: a qualitative study from a user’s perspective

Ghaddar

Khandaqji

Abbass

2018

Subst Abuse Treat Prev Policy

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BackgroundOpioid agonist therapy (OAT) has been implemented for the treatment of individuals with opioid use disorders in Lebanon since 2011, but has not been evaluated yet. The aim of the study is to describe the implementation of the first pilot OAT program in Lebanon from the users’ perspective.MethodsData collectors gathered data from male participants during June 2016-July 2016. Eighty-one out of 94 patients agreed to participate in the study. Data regarding access to treatment, satisfaction with the treatment protocol and treatment outcomes, patient-provider relationship, and misuse and diversion was collected through semi-structured qualitative interviews. Data saturation was reached after 81 interviews; once no new themes were reported.ResultsFindings showed inequalities in access to treatment and showed that OAT improved mental and social wellbeing among users who had financial access and complied with the program protocols. Registering in the program protected users from arrest and reduced their economic burden. Among the main encountered challenges were fear of dependence to buprenorphine, restricted geographical access to treatment, misuse and diversion of buprenorphine.ConclusionResults implicate inequalities in access to OAT as one important gap to be tackled in the management of OAT in Lebanon. Further research should be done in order to understand the challenges in the implementation of the program from the providers’ perspectives.Electronic supplementary materialThe online version of this article (10.1186/s13011-018-0151-8) contains supplementary material, which is available to authorized users.

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Opiate agonist treatment to improve health of individuals with opioid use disorder in Lebanon

Cited by 7 publications

References 38 publications

Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review

Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review

Prevalence of Coaddictions and Rate of Successful Treatment Among a French Sample of Opioid-Dependent Patients With Long-Term Opioid Substitution Therapy: The OPAL Study

Challenges in implementing opioid agonist therapy in Lebanon: a qualitative study from a user’s perspective

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