Paradoxes of evidence in Russian addiction medicine

Abstract

This fact casts doubt on credibility and validity of scientific recommendations. Thus, one may say that Russian addiction medicine is not based on evidence, which is, in our view, erroneous and may impair the quality of care.

Is There a Potential of Misuse for Quetiapine?

“…On the other hand, trazodone prescribing has been advised for the treatment of alcohol-, drugand benzodiazepine-dependent patients [77]. Although the use of SSRIs for the treatment of addictions is quite controversial [78], it is of interest that, similarly to remaining psychotropics, SSRIs have indeed been associated with the occurrence of a proper withdrawal syndrome [79], and this may have overlapped with the quetiapine and olanzapine withdrawal reporting levels here identified. The quetiapine vs olanzapine withdrawal PRR value (5.25) resulted here to be particularly high.…”

Implementation of methadone therapy for opioid use disorder in Russia – a modeled cost-effectiveness analysis

“…Unfortunately, the care for patients with an OUD in Russian narcology hospitals is associated with low successful treatment outcomes and follow up rates [24, 32]. To our knowledge, this study is the first to estimate the effectiveness of implementing an evidence-based form of OAT in Russia, as well as the associated costs.…”

“…Because opioid agonist therapy (OAT) using methadone or buprenorphine is not legal in Russia and funding for effective, legal programs such as needle and syringe exchanges is limited, it is assumed that many preventable HIV infections occur each year in Russia [26, 27, 32]. …”

“…The process, which occurs mostly at inpatient setting, typically utilizes the following medications for opioid withdrawal therapy: antidepressants, antipsychotics, anticonvulsants, non-opiate analgesics, adrenergic, and alfa 2 agonist. The only available medication in Russia that has been shown to be effective at preventing opioid use relapse is the opiate antagonist naltrexone, which is generally only administrated upon discharge from inpatient care [21, 22, 32]. During inpatient hospitalization, patients receive drug counselling and treatment for comorbid psychiatric conditions, but integration to other treatment modalities such as HIV care is limited [14, 19].…”

Rusya'da Alkol ve Alkolizm: Politikalar ve Etkileri

“…Other treatments generally disagreeing with the internationally accepted practice have been applied, e.g. antipsychotic drugs (phenothiazines, haloperidol) for the treatment of alcohol dependence 4,13 . Among contraindications, additive or synergistic interactions between some antipsychotic drugs and alcohol 14 , potentially aggravating liver injury, should have been considered.…”