Brief Interventions for Harmful Alcohol Use in Opioid-dependent Patients on Maintenance Treatment With Buprenorphine: A Prospective Study From India

Varshney, Mohit; Ambekar, Atul; Lal, Rakesh; Yadav, Deepak; Rao, Ravindra; Mishra, Ashwani Kumar

doi:10.1097/adt.0000000000000076

Cited by 9 publications

(28 citation statements)

References 21 publications

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“…Further, other work has suggested that MMT may also decrease the initiation of heavy drinking, further underlining the beneficial effects of opioid maintenance treatment on the health of people with opioid use disorders. 5 These findings could help inform future investigations into the role of heavy alcohol use, as described by the prospective study from India, 1 in the context of maintenance therapy.…”

Section: Discussionmentioning

confidence: 88%

“…1 While alcohol is found in the majority of drug-related deaths that involve illicit drugs, around the globe, 23 maintenance therapy with methadone (MMT), or buprenorphine, reduces morbidity and mortality among people who use opiates. 4 Although one common clinical challenge is comorbid alcohol use and opioid use disorder, with guidelines often recommending withholding methadone in this context given the potential for fatal overdose due to drug interactions, 5 alcohol's impact on the health outcomes of MMT patients has been “overlooked and underestimated”.…”

Section: Alcohol Use Among Persons On Methadone Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Alcohol Use Among Persons on Methadone Treatment

Klimas¹,

Dong²,

Dobrer³

et al. 2017

Addictive Disorders &Amp; Their Treatment

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Section: Discussionmentioning

confidence: 88%

Section: Alcohol Use Among Persons On Methadone Treatmentmentioning

confidence: 99%

Alcohol Use Among Persons on Methadone Treatment

Klimas¹,

Dong²,

Dobrer³

et al. 2017

Addictive Disorders &Amp; Their Treatment

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“…For example, incorporating counseling services and naltrexone pharmacotherapy into a differentiated care model for MSM could address both depression and alcohol use [29]. Several interventions exist that could be delivered by counselors using minimal infrastructure and have been shown to impact alcohol use [30][31][32]. While the prevalence of recreational drug use is low in this population, it is critical that programs take cognizance of the growing recreational drug use epidemic among MSM in low-and middle-income countries and implement interventions to address them.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Barriers to Viral Suppression in a Community-based Sample of Human Immunodeficiency Virus–infected Men Who Have Sex With Men and People Who Inject Drugs in India

Prabhu

McFall

Mehta

et al. 2019

Clinical Infectious Diseases

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Background Little is known about the impact of psychosocial factors and substance use on viral suppression among human immunodeficiency virus (HIV)–infected key populations in resource-limited settings. Accordingly, we examined the association and interactions between depression, alcohol use, and recreational drug use on viral suppression among men who have sex with men (MSM) and people who inject drugs (PWID) in India. Methods MSM and PWID were recruited across India using respondent-driven sampling (RDS). Correlates of viral suppression were determined using Poisson regression models incorporating RDS-II weights. Two-way multiplicative interactions were assessed with separate models of all combinations of the 3 variables of interest using interaction terms; 3-way interactions were evaluated by stratifying 2-way interactions by the third variable. Results Among 1454 treatment-eligible HIV-infected MSM and 1939 PWID, older age (adjusted prevalence ratio [aPR], 1.14 for MSM; 1.41 for PWID) and higher HIV treatment literacy (aPR, 1.58 for MSM; 3.04 for PWID) were positively associated with viral suppression. Among MSM, there was evidence of a synergistic negative association between severe depression and recreational drug use (aPR, 0.37 [95% confidence interval {CI}, .16–.84]), alcohol dependence and recreational drug use (aPR, 0.45 [95% CI, .20–.99]), and severe depression, alcohol dependence, and recreational drug use (aPR, 0.23 [95% CI, .09–.57]). Among PWID, daily injection (aPR, 0.51 [95% CI, .31–.82]) was the primary barrier to suppression. Conclusions Incorporating psychosocial and harm-reduction services into differentiated care models targeting MSM and PWID in low-resource settings is critical to achieving the 90-90-90 HIV/AIDS targets.

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“…Of these, 35 patients underwent all the sessions of BI, and most of them reported significant influence of the BI on their alcohol use with reduction in their alcohol use. [ 39 ]…”

Section: Other Substance Use During Opioid Substitution Therapymentioning

confidence: 99%

Research on opioid substitution therapy in India: A brief, narrative review

Ambekar

Rao

Agrawal

et al. 2018

Indian J Psychiatry

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Opioid dependence is a significant clinical and public health issue in India. Opioid substitution therapy (OST) is the most evidence-based treatment for opioid dependence. Although available in India for about three decades now, Indian research on this treatment modality has not been adequately reviewed so far. We conducted a narrative review of Indian research on OST. We conducted an online search for relevant literature in the peer-reviewed journals as well as the general online search for books and monographs. We present the findings of the review in the form of description of literature according to certain identified themes. Considering that methadone has became available in India, only recently, the Indian research on OST predominantly features buprenorphine as the agent. Effectiveness of OST among Indian opioid-dependent patients has been well established through prospective, experimental designs as well as through naturalistic studies using retrospective, chart-review approach. Naturalistic and observational postmarketing surveillance studies have demonstrated the safety of buprenorphine and methadone when used as OST. There are certain areas in which more research on OST will be beneficial for Indian clinicians as well as policy-makers. However, the quantum of evidence base that exists in India is more than adequate to justify the scale-up of this modality of treatment. A conducive policy environment for scaling-up OST is need of the hour.

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Brief Interventions for Harmful Alcohol Use in Opioid-dependent Patients on Maintenance Treatment With Buprenorphine: A Prospective Study From India

Cited by 9 publications

References 21 publications

Alcohol Use Among Persons on Methadone Treatment

Alcohol Use Among Persons on Methadone Treatment

Psychosocial Barriers to Viral Suppression in a Community-based Sample of Human Immunodeficiency Virus–infected Men Who Have Sex With Men and People Who Inject Drugs in India

Research on opioid substitution therapy in India: A brief, narrative review

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