Providing opioid substitution treatment to Indigenous heroin users within a community health service setting in Adelaide

Williams, Nicholas; Nasir, Rus; Smither, Graham; Troon, Steven

doi:10.1080/09595230600644699

Cited by 21 publications

(45 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since these earlier studies, culturally-centered MAT services have been successfully implemented with Indigenous people in Australia and Canada (19–21). In Australia, success was attributed to the culturally-specific design, integrated care, and a focus on family and community wellness (21).…”

Section: Pharmacological Treatment Of Opioid Use Disorder With Ai/ansmentioning

confidence: 99%

“…In Australia, success was attributed to the culturally-specific design, integrated care, and a focus on family and community wellness (21). In Canada, patients reported positive treatment outcomes, improvements in housing, employment, and family support, and general satisfaction and acceptance of MAT (20).…”

Section: Pharmacological Treatment Of Opioid Use Disorder With Ai/ansmentioning

confidence: 99%

See 1 more Smart Citation

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

Venner

Donovan

Campbell

et al. 2018

Addictive Behaviors

View full text Add to dashboard Cite

The U.S. is experiencing an alarming opioid epidemic, and although American Indians and Alaska Natives (AI/AN) are especially hard hit, there is a paucity of opioid-related treatment research with these communities. AI/ANs are second only to Whites in the U.S. for overdose mortality. Thus, the National Institute on Drug Abuse convened a meeting of key stakeholders to elicit feedback on the acceptability and uptake of medication assisted treatment (MAT) for opioid use disorders (OUDs) among AI/ANs. Five themes from this one-day meeting emerged: (1) the mismatch between Western secular and reductionistic medicine and the AI/AN holistic healing tradition; (2) the need to integrate MAT into AI/AN traditional healing; (3) the conflict between standardized MAT delivery and the traditional AI/AN desire for healing to include being medicine free; (4) systemic barriers; and (5) the need to improve research with AI/ANs using culturally relevant methods. Discussion is organized around key implementation strategies informed by these themes and necessary for the successful adoption of MAT in AI/AN communities: (1) type of medication; (2) educational interventions; (3) coordination of care; and (4) adjunctive psychosocial counseling. Using a community-based participatory research approach is consistent with a “two eyed seeing” approach that integrates Western and Indigenous worldviews. Such an approach is needed to develop impactful research in collaboration with AI/AN communities to address OUD health disparities.

show abstract

Section: Pharmacological Treatment Of Opioid Use Disorder With Ai/ansmentioning

confidence: 99%

Section: Pharmacological Treatment Of Opioid Use Disorder With Ai/ansmentioning

confidence: 99%

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

Venner

Donovan

Campbell

et al. 2018

Addictive Behaviors

View full text Add to dashboard Cite

show abstract

“…The findings are consistent with the successful community health service program for Aboriginal heroin users in Adelaide. 19 It is this supportive framework that enables people to achieve the stability required to remain in maintenance treatment.…”

Section: Heroin Use (Days Per Month)mentioning

confidence: 99%

“…Winnunga has offered opioid replacement pharmacotherapy since 1999 to patients who are opioid-dependent. As in other urban Indigenous communities, 18,19 there was ambivalence to the introduction of harm minimisation strategies with many people supporting abstinence models to address drug addiction. Community support for opioid replacement pharmacotherapy was achieved through discussions between the Winnunga Board, other influential community leaders and the Winnunga staff involved.…”

mentioning

confidence: 99%

An evaluation of opioid replacement pharmacotherapy in an urban Aboriginal Health Service

Black

Khan

Brown

et al. 2007

Australian and New Zealand Journal of Public Health

View full text Add to dashboard Cite

Objective: This study aimed to evaluate the opioid replacement pharmacotherapy at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) in the Australian Capital Territory. Methods: Existing and new adult patients at Winnunga who were receiving opioid replacement pharmacotherapy were recruited. Twenty‐one of 30 eligible patients participated in this cohort study. The Brief Treatment Outcome Measure was administered to patients twice with an interval of at least three months. Primary outcome measures were retention rate in the program and self‐reported heroin use. Results: Eighty‐one per cent (17/21) of patients remained in treatment at three months. Median self‐reported heroin use for existing patients was 0 days/month at initial interview and follow‐up (95% CI 0–1). There was no significant difference between self‐reported heroin use at initial and follow‐up interview (paired Wilcoxon test, R=10, alpha=0.05). Mean self‐reported heroin use was 1.5 days/month at initial interview and 2.4 days/month at follow‐up. Conclusion: The retention rate of 81% and low levels of heroin use suggest that opioid replacement pharmacotherapy at Winnunga is comparable to the outcomes of mainstream treatment programs. Implications: Opioid replacement pharmacotherapy is beneficial to opioid‐dependent Aboriginal people in urban settings. Access to this treatment in culturally appropriate settings needs to be expanded.

show abstract

“…20 Although this applied to harm reduction strategies, it was suggested that the implementation of methadone maintenance treatment programs within Aboriginal communities can be accompanied by apprehension and distrust. 21 Thus, although individual-level benefits of methadone programs have been established, knowledge on the perceptions and opinions of Aboriginal communities on these programs remains elusive.…”

mentioning

confidence: 99%

Impact of a methadone maintenance program on an Aboriginal community: a qualitative study: Table 1:

Landry¹,

Veilleux²,

Arseneault³

et al. 2016

CMAJ Open

View full text Add to dashboard Cite

Background: Methadone maintenance treatment programs implemented in Aboriginal communities have proven to be beneficial for the control of opioid addiction and its associated consequences, but the perceptions and opinions of different community members about these programs remain elusive. The goal of this study was to determine the perceptions of members of a First Nation community in New Brunswick, Canada, on the implementation of a methadone maintenance treatment program and its effects on the community. Methods:We conducted a qualitative study using semistructured focus group discussions with 3 distinct groups composed of health care professionals and influential community members, patients in the methadone maintenance treatment program and community members at large. Thematic analysis of discussion transcripts was performed.Results: A total of 22 partipants were included in the 3 focus groups. All groups of participants expressed that patients in the program are stigmatized and marginalized. Discussions also revealed widespread misconceptions about the program. Participants associated the program with improvements in community-level outcomes and in parenting abilities of patients, but also with difficulties preserving family unity.Interpretation: Despite being culturally adapted to the community, elements surrounding the methadone maintenance treatment program in this First Nation community appear to be misunderstood and stigmatized. It may be beneficial to provide community education on these programs to assure community buy-in for the successful implementation of harm reduction programs in Aboriginal communities. Abstract Research Research CMAJ OPEN E432CMAJ OPEN, 4(3)non-Aboriginal participants. [17][18][19] A report from the Health Council of Canada highlighted the importance of considering and respecting culture in Aboriginal health care to offer "culturally competent care" in "culturally safe environments." 20Although this applied to harm reduction strategies, it was suggested that the implementation of methadone maintenance treatment programs within Aboriginal communities can be accompanied by apprehension and distrust.21 Thus, although individual-level benefits of methadone programs have been established, knowledge on the perceptions and opinions of Aboriginal communities on these programs remains elusive.The First Nation reserve of Elsipogtog (population 3272) is located in southeastern New Brunswick, Canada. The Elsipogtog methadone maintenance treatment program was started at the Elsipogtog Health & Wellness Centre in 2007 to help counter the community's high rates of substance abuse and its related consequences. The program's mission is true to First Nation cultural beliefs and provides care according to the native medicine wheel. Most of the program's staff are from the Elsipogtog community and provide services in Mi'kmaq. They include a family physician, a nurse practitioner, a registered nurse, an alcohol-drug counsellor and a psychologist, as well as a traditional elder and a medical receptio...

show abstract

Providing opioid substitution treatment to Indigenous heroin users within a community health service setting in Adelaide

Cited by 21 publications

References 3 publications

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives

An evaluation of opioid replacement pharmacotherapy in an urban Aboriginal Health Service

Impact of a methadone maintenance program on an Aboriginal community: a qualitative study: Table 1:

Contact Info

Product

Resources

About