Evidence on the Effectiveness of Heroin-Assisted Treatment

Smart, Rosanna

doi:10.7249/wr1263

Cited by 10 publications

(13 citation statements)

References 117 publications

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“…This report consolidates and builds on insights from four working papers produced by RAND researchers as part of this project (Ober et al, 2018;Pardo, Caulkins, and Kilmer, 2018;Smart, 2018;Strang and Taylor, 2018). In addition to reviewing evidence reported in the scientific literature, we interviewed more than two dozen key informants in Canada, the Netherlands, Switzerland, and the United Kingdom to learn about their experiences with these programs.…”

Section: Box 11 Fda-approved Medications Currently Offered For Treamentioning

confidence: 97%

“…This chapter briefly describes the methodologies employed by each of the papers supporting this report. More detailed descriptions are included in the individual reports (Ober et al, 2018;Pardo, Caulkins, and Kilmer, 2018;Smart, 2018;Strang and Taylor, 2018).…”

Section: Research Approachmentioning

confidence: 99%

“…Finally, experts in the field who were participating in interviews for the project were given the opportunity to pass along any sources they believed to be of relevance. Additional details about the search strategies and inclusion criteria are reported in Pardo, Caulkins, and Kilmer (2018) and Smart (2018).…”

Section: Literature Reviews Of Evidence Concerning Hat and Scssmentioning

confidence: 99%

“…Following other work, we treat these as two separate RCTs. For further detail on each RCT, including citations for articles reporting secondary or subgroup analyses from the RCTs, see Smart (2018).…”

Section: Evidence From the Scientific Literaturementioning

confidence: 99%

“…Any relative benefits of HAT must be considered in light of its risks. There is strong evidence indicating that HAT carries significantly greater risk than oral methadone for serious medication-related adverse events, such as respiratory depression and seizures, although the magnitude of this risk differential varies across trials (see Smart, 2018). However, given that heroin administration in HAT is usually supervised by health care professionals and that patients are monitored following injection, the majority of serious adverse events were managed quickly, lessening the risk of more-serious consequences, such as death.…”

Section: Hat Versus Oral Methadonementioning

confidence: 99%

See 4 more Smart Citations

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

Kilmer¹,

Taylor²,

Caulkins³

et al. 2018

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This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. Support RANDMake a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org For more information on this publication, visit www.rand.org/t/RR2693Published by the RAND Corporation, Santa Monica, Calif.

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Section: Box 11 Fda-approved Medications Currently Offered For Treamentioning

confidence: 97%

Section: Research Approachmentioning

confidence: 99%

Section: Literature Reviews Of Evidence Concerning Hat and Scssmentioning

confidence: 99%

Section: Evidence From the Scientific Literaturementioning

confidence: 99%

Section: Hat Versus Oral Methadonementioning

confidence: 99%

See 3 more Smart Citations

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

Kilmer¹,

Taylor²,

Caulkins³

et al. 2018

Self Cite

View full text Add to dashboard Cite

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“It’s Helped Me a Lot, Just Like to Stay Alive”: a Qualitative Analysis of Outcomes of a Novel Hydromorphone Tablet Distribution Program in Vancouver, Canada

et al. 2020

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North America is experiencing an overdose crisis driven by fentanyl, related analogues, and fentanyl-adulterated drugs. In response, there have been increased calls for “safe supply” interventions based on the premise that providing a safer alternative (i.e., pharmaceutical drugs of known quality/quantity, non-adulterated, with user agency in consumption methods) to the street drug supply will limit people’s use of fentanyl-adulterated drugs and reduce overdose events. This study examined outcomes of a hydromorphone tablet distribution program intended to prevent overdose events among people who use drugs (PWUD) at high risk of fatal overdose. Semi-structured qualitative interviews were conducted with 42 people enrolled in the hydromorphone distribution program. Additionally, over 100 h of ethnographic observation were undertaken in and around the study site. Transcripts were coded using NVivo and based on categories extracted from the interview guides and those identified during initial interviews and ethnographic fieldwork. Analysis focused on narratives around experiences with the program, focusing on program-related outcomes. Our analysis identified the following positive outcomes of being enrolled in the hydromorphone tablet distribution program: (1) reduced street drug use and overdose risk, (2) improvements to health and well-being, (3) improvements in co-management of pain, and (4) economic improvements. Our findings indicate that the hydromorphone distribution program not only is effective in responding to the current overdose crisis by reducing people’s use of illicit drugs but also addresses inequities stemming from the intersection of drug use and social inequality. Safe supply programs should be further implemented and evaluated in both urban and rural setting across North America as a strategy to reduce exposure to the toxic drug supply and fatal overdose.

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Quality of Life Assessment in Danish Heroin Assisted Treatment Patients: Validity of the SF-36 Survey

Kvamme,

Thylstrup,

Hesse

2024

J. Psychosoc. Rehabil. Ment. Health

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Background Quality of life assessment is a crucial component of evaluating the treatment of substance use disorders such as opioid addiction. Method This study assessed the structural and external validity of the short form (SF-36) Health Survey in patients enrolled in the Danish Heroin Assisted Treatment Program (HAT). Exploratory and confirmation factor analysis was performed on 541 patients enrolled in the supervised injected HAT program who completed the SF-36 questionnaire at enrollment and with planned follow-ups. To investigate external validity, we correlated SF-36 factors with hospital contact prior to enrollment in HAT. Results Exploratory and confirmatory factor analysis demonstrated acceptable levels of statistical fit for the standard eight-factor model and provided evidence that quality of life can reliably be measured over time in this sample. SF-36 factors were correlated with the amount of prior somatic hospital contact but not psychiatric hospital contact. A stepwise regression approach revealed that the general health factor and the physical functioning factor were preferentially employed to predict the amount of prior somatic hospital contact. Conclusion Our findings support the validity of the SF-36 Health Survey as a measure of the quality of life in people undergoing Heroin Assisted Treatment. The fact that the factors structure of the SF-36 was stable over repeated measurements implies that it can be used as a measure of change in this population. Future studies should consider a longitudinal design and attempt to predict future hospital contact using quality-of-life measures in patients with opioid addiction.

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Evidence on the Effectiveness of Heroin-Assisted Treatment

Cited by 10 publications

References 117 publications

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States

“It’s Helped Me a Lot, Just Like to Stay Alive”: a Qualitative Analysis of Outcomes of a Novel Hydromorphone Tablet Distribution Program in Vancouver, Canada

Quality of Life Assessment in Danish Heroin Assisted Treatment Patients: Validity of the SF-36 Survey

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