Problematic Opioid Use: A Scoping Literature Review of Profiles

Archambault, Léonie; Bertrand, Karine; Perreault, Michel

doi:10.1177/11782218221103581

Cited by 3 publications

(2 citation statements)

References 55 publications

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“…Mental health problems are prevalent among PWID and may precede, be exacerbated or induced by drug consumption (Reddon et al, 2018). Furthermore, a web of other complex and interrelated factors are associated with drug use and dependence including: seeking freedom from oppressive social conformity (Fernandez, 2010(Fernandez, , 2014, seeking pleasure, a high, or relief from the demoralization for instance linked with joblessness loss of purpose, or medical conditions, such as chronic pain (Archambault, Bertrand & Perreault, 2022;Friedman et al, 2020).…”

Section: The Harm Reduction Approachmentioning

confidence: 99%

Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

Poliquin

Perreault

Guilhon

et al. 2022

Journal of Drug Issues

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Harm reduction (HR) is an alternative to the moralization of drug use and a pragmatic public health approach aimed at minimizing harms associated with use. This study sought to gain the perspectives of persons who inject drugs (PWID) on the adequacy of services provided by HR organizations in Montreal. Twenty-two semi-structured interviews and two focus groups were conducted with 30 participants. Some of the key advantages of HR perceived by participants include access to injection equipment, psychosocial support, and reduced social isolation. However, many wanted more opportunities for social insertion and greater value to be placed on their knowledge and life experiences (e.g., experiential knowledge of the street scene, drug use, sex work, or homelessness). This study suggests that PWID who access HR services in Montreal are interested in paid work opportunities in environments that promote power sharing, and activities that are conducted and managed by and for them.

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Section: The Harm Reduction Approachmentioning

confidence: 99%

Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

Poliquin

Perreault

Guilhon

et al. 2022

Journal of Drug Issues

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“…Overall, it is important to understand how socio-clinical patterns may differ among different OUD patient profiles, suggesting distinct treatment and service needs [33,[35][36][37][38]. Profiles and associated needs may vary according to geographical differences and socio-political environment, which can also change over time [39]. Thus, this study aims to identify different profiles of people with OUD in a sample of patients admitted in a specialised OAT facility located in a Canadian urban setting, in order to support the development of a profile-based approach to care.…”

Section: Introductionmentioning

confidence: 99%

People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile‐based approach to care

Archambault

Bertrand

Jutras‐Aswad

et al. 2023

Drug and Alcohol Review

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Introduction: People with opioid use disorders (OUD) present with high levels of medical and psychosocial vulnerabilities. In recent years, studies have highlighted a shift in demographic and biopsychosocial profiles of people with OUD. In order to support the development of a profile-based approach to care, this study aims to identify different profiles of people with OUD in a sample of patients admitted to a specialised opioid agonist treatment (OAT) facility. Methods: Twenty-three categorical variables (demographic, clinical, indicators of health and social precariousness) were retrieved from a sample of 296 patient charts in a large Montréal-based OAT facility (2017-2019). Descriptive analyses were followed by a three-step latent class analysis (LCA) to identify different socio-clinical profiles and examine their association with demographic variables. Results: The LCA revealed three socio-clinical profiles: (i) "polysubstance use with psychiatric, physical and social vulnerabilities" (37% of the sample); (ii) "heroin use with vulnerabilities to anxiety and depression" (33%); (iii) "pharmaceutical-type opioid use with vulnerabilities to anxiety, depression and chronic pain" (30%). Class 3 individuals were more likely to be aged 45 years and older. Discussion and Conclusion: While current approaches (such as low-and regular-threshold services) may be suited for many OUD treatment entrants, there may be a need to improve the continuum of care between mental health, chronic pain, and addiction services for those characterised by the use of pharmaceuticaltype opioids, chronic pain and older age. Overall, the results support further exploring profile-based approaches to care, tailored to subgroups of patients with differing needs or abilities. K E Y W O R D S health services needs, opioid use disorder, taxonomy Key Points• Three classes of socio-clinical profiles emerged from the analysis.• Profile 1 is characterised by polysubstance use and multiple vulnerabilities.

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Konsten att göra (sprut)utbyten: Sprutbytets betydelse i skärningspunkten mellan politik, yrkespraktik och människors vardagsliv

Nordstedt

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The Art of Needle Exchange: The Significance of Needle Exchange Programs at the Intersection of Politics, Professional Practice, and People's Everyday Lives This doctoral thesis discusses how social meanings are constructed in needle exchange programs. For nearly four decades, Sweden has implemented needle exchange programs to prevent the spread of bloodborne viral infections. However, a restrictive drug policy and resistance to harm reduction efforts have led to limitations in access to these programs, both in terms of geography and through an exclusionary regulatory framework. The effectiveness of needle exchange programs in reducing the risk of infection associated with injection-related behaviour is clearly positive. However, there are limited scientific studies on the more socially oriented meanings of needle exchange programs. With needle exchange programs as a physical and social place, the overarching aim of this thesis is to understand how the creation of social meanings of needle exchanges is achieved through time, space, and social interaction, primarily between the program's visitors and its staff. The empirical material primarily consists of 16 months of ethnographic fieldwork, including participant observations and informal conversations at two needle exchange programs in southern Sweden, as well as in the everyday lives of individuals who visit these programs. Through extensive ethnographic narratives and analyses based on theories of everyday life, resistance, time, and gifts, the thesis demonstrates that needle exchange programs hold multiple meanings created through interactions between visitors and staff. Two concurrent and parallel tracks contribute to understanding what needle exchange programs mean to those who visit them. One track starts with a counterproductive regulatory framework where requirements and rules result in some visitors coming less often than they need to or not at all. The other track involves countless material and relational exchanges that foster positive experiences of the needle exchange program, turning it into a place of social hope and a changed future. One of the thesis's most significant findings concerns the social work that takes place at the needle exchange program in the interactions between visitors and staff. These interactions also occur at the intersection of the norms and hierarchies of the drug world and the Swedish dream of a drug- free society. In the waiting room of the needle exchange program, negotiations are constantly underway to maintain it as a place of hopeful encounters, as opposed to a destructive refuge.

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Problematic Opioid Use: A Scoping Literature Review of Profiles

Cited by 3 publications

References 55 publications

Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile‐based approach to care

Konsten att göra (sprut)utbyten: Sprutbytets betydelse i skärningspunkten mellan politik, yrkespraktik och människors vardagsliv

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