Understanding an emerging treatment population: Protocol for and baseline characteristics of a prospective cohort of people receiving treatment for pharmaceutical opioid dependence

Nielsen, Suzanne; Lintzeris, Nicholas; Murnion, Bridin; Degenhardt, Louisa; Bruno, Raimondo; Haber, Paul S.; Johnson, Jennifer; Hardy, Mark; Ling, Stephen; Saddler, Craig; Dunlop, Adrian; Demirkol, Apo; Silsbury, Catherine; Phung, Nghi; Houseman, Jennie; Larance, Briony

doi:10.1111/dar.12859

Cited by 6 publications

(7 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, some people (including patients with chronic pain) report reluctance to use opioid medication, and may not identify as having an opioid use disorder or conceal their use of opioid pharmacotherapy to avoid being stigmatised by friends and family. 6 , 82 , 83 …”

Section: Micro Levelmentioning

confidence: 99%

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

Cheetham¹,

Picco²,

Barnett³

et al. 2022

SAR

Self Cite

100

View full text Add to dashboard Cite

Illicit drug use disorders are the most stigmatised health conditions worldwide, and stigma acts as a meaningful barrier to treatment entry and treatment provision. In the context of dramatically rising opioid-related harms, it is critical that we understand the drivers of stigma and how it affects opioid use disorder treatment and policy. The aim of this narrative review is to discuss how opioid-related stigma impacts treatment provision and harm reduction, and provide potential strategies to reduce stigma at a social and structural level. We used the Framework for Integrating Normative Influences on Stigma (FINIS) to identify sources of opioid-related stigma at the macro (structural stigma), meso (public stigma) and micro (internalised stigma) levels. Reducing stigma requires strategies that target multiple levels, however addressing inequity in the laws, regulations, and rules that segregate people with opioid and other substance use disorders from mainstream society is essential.

show abstract

Section: Micro Levelmentioning

confidence: 99%

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

Cheetham¹,

Picco²,

Barnett³

et al. 2022

SAR

Self Cite

100

View full text Add to dashboard Cite

show abstract

“…When it comes to misuse of prescription opioids the gender difference in OUD prevalence tends to disappear. 11…”

Section: Patient Characteristics and Treatment Structurementioning

confidence: 99%

“…When it comes to misuse of prescription opioids the gender difference in OUD prevalence tends to disappear. 11 The development of any SUD is generally considered to be an interplay between genetic and environmental factors and drug availability. These relationships hold true for OUD.…”

Section: Who Develops Opioid Dependence?mentioning

confidence: 99%

“…34 In prescription opioid users, the risk of overdose increases with opioid dose, with one US study showing that those on a 100 mg or more oral morphine equivalent daily dose have a nine-fold increase in risk of overdose compared to those on a 20 mg or less oral morphine equivalent daily dose. 35 Nielsen et al (2018) demonstrated that in an Australian population of prescription opioid users undergoing OAT with methadone or buprenorphine, 45% had experienced an overdose event. 11 Increasingly, gabapentinoids are identified in post-mortem studies of those dying from opioid overdose.…”

Section: Assessment Of Oudmentioning

confidence: 99%

See 1 more Smart Citation

Opioid use disorder in anaesthesia and intensive care: Prevention, diagnosis and management

Murnion

Demirkol

2022

Anaesth Intensive Care

Self Cite

View full text Add to dashboard Cite

Opioid misuse is common, as is opioid agonist treatment of opioid dependence. Almost 3% of Australians and over 3.5% of those living in New Zealand report misuse of analgesics. Over 50,000 Australians receive opioid agonist treatment with methadone or buprenorphine for management of severe opioid use disorder. The perioperative period is an opportunity to identify pre-existing opioid misuse, and to introduce interventions to reduce the risk of development of opioid use disorder. Challenges of acute perioperative pain management or intensive care management of patients receiving opioid agonist treatment include opioid tolerance and ongoing prescribing of methadone or buprenorphine. There has been some ambiguity about the optimal perioperative management of buprenorphine, a partial agonist at the mu receptor. In this article, a framework to identify emerging opioid misuse problems, identify risk of overdose and to manage the opioid-dependent patient on opioid agonist treatment perioperatively or in the intensive care unit is provided. Diagnostic criteria and risk stratification criteria are presented. Management strategies include trauma-informed care, care planning and care coordination with community practitioners and opioid agonist treatment providers. Continuing methadone or buprenorphine perioperatively with additional opioid and non-opioid analgesia is generally recommended. Increased opioid agonist treatment doses may be required on discharge. An algorithm for decisions about opioid agonist treatment management in the intensive care unit based on the risks of opioid withdrawal and toxicity is considered. Strategies for managing the opioid-dependent patient who is not in treatment are also discussed.

show abstract

“…People who use prescription opioids, even in dependent ways, differ from people who use heroin in terms of their probable risk of overdose [11][12][13]. Typically, they display much lower rates of use by injection but high levels of mental health and physical comorbidities, which means that the risks of opioid-related mortality remain high, although they may be attributed to different factors [14,15].…”

Section: Introductionmentioning

confidence: 99%

The cost and impact of distributing naloxone to people who are prescribed opioids to prevent opioid‐related deaths: findings from a modelling study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background and aims Although most opioid‐related mortality in Australia involves prescription opioids, most research to understand the impact of naloxone supply on opioid‐related mortality has focused upon people who inject heroin. We aimed to examine the cost and probable impact of up‐scaling naloxone supply to people who are prescribed opioids. Design Decision‐tree model. Four scenarios were compared with a baseline scenario (the current status quo): naloxone scale‐up between 2020 and 2030 to reach 30 or 90% coverage by 2030, among the subgroups of people prescribed either ≥ 50 or ≥ 100 mg of oral morphine equivalents (OME). Setting Australia. Participants People who are prescribed opioids. Measurements Possible deaths averted, costs (ambulance and naloxone distribution) and cost per life saved for different scenarios of naloxone scale‐up. Findings Maintaining the status quo, there would be an estimated 7478 [uncertainty interval (UI) = 6868–8275] prescription opioid overdose deaths between 2020 and 2030, resulting in Australian dollars (A$)51.9 million (49.4, 56.0) in ambulance costs. If naloxone were scaled‐up to 90% of people prescribed > 50 mg OME, an estimated 657 (UI = 245, 1489) deaths could be averted between 2020 and 2030 (a 20% reduction in the final year of the model compared with the no naloxone scenario), with a cost of A$43 600 (20 800–110 500) per life saved. If naloxone were scaled‐up to 30% of people prescribed > 50 mg OME an estimated 219 (82–496) deaths could be averted with the same cost per live saved. If naloxone were restricted to those prescribed > 100 mg OME, an estimated 130 (UI = 44–289) deaths would be averted if scaled‐up to 30% or 390 (UI = 131–866) deaths averted if scaled‐up to 90%, with the cost per life saved for both scenarios A$38 200 (UI = 12 400–97 400). Conclusion In Australia, scaling‐up take‐home naloxone by 2030 to reach 90% of people prescribed daily doses of ≥ 50 mg of oral morphine equivalents would be cost‐effective and save more than 650 lives.

show abstract

Understanding an emerging treatment population: Protocol for and baseline characteristics of a prospective cohort of people receiving treatment for pharmaceutical opioid dependence

Cited by 6 publications

References 52 publications

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

Opioid use disorder in anaesthesia and intensive care: Prevention, diagnosis and management

The cost and impact of distributing naloxone to people who are prescribed opioids to prevent opioid‐related deaths: findings from a modelling study

Contact Info

Product

Resources

About