Implementing Treatment of Opioid-Use Disorder in Rural Settings: a Focus on HIV and Hepatitis C Prevention and Treatment

Havens, Jennifer R.; Walsh, Sharon; Korthuis, P. Todd; Fiellin, David A.

doi:10.1007/s11904-018-0402-3

Cited by 27 publications

(17 citation statements)

References 73 publications

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“…Identification of higher rates of methamphetamine use in small metro and nonmetro areas are important given difficulties in delivering services to rural populations who might be disproportionately affected by methamphetamine use. Attention has been drawn to infectious disease transmission associated with opioid injection in these areas ( 7 ); the long-standing challenges with lower economic resources, prevalent substance use, and limited treatment availability also place these areas at risk for infectious disease outbreaks associated with methamphetamine injection. Expansion of evidence-based substance use treatment, syringe services programs, and other community-based interventions aimed at reducing use, including injection, are needed.…”

Section: Discussionmentioning

confidence: 99%

Patterns and Characteristics of Methamphetamine Use Among Adults — United States, 2015–2018

Jones¹,

Compton²,

Mustaquim³

2020

MMWR Morb. Mortal. Wkly. Rep.

161

117

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Section: Discussionmentioning

confidence: 99%

Patterns and Characteristics of Methamphetamine Use Among Adults — United States, 2015–2018

Jones¹,

Compton²,

Mustaquim³

2020

MMWR Morb. Mortal. Wkly. Rep.

161

117

View full text Add to dashboard Cite

“…Rural and remote areas present several challenges to the provision of effective prevention and treatment of opioid use disorder. According to Havens et al 58 some of these barriers “add to the usual barriers such as stigma, incorrect understanding of the role of partial and full opioid agonists in the treatment of opioid use disorder (OUD), limited access to medication-based treatments, limited supply of appropriately trained treatment providers, and others, seen in larger metropolitan regions of the country” while “the relatively low population density of rural regions exacerbates the challenges seen elsewhere.”…”

Section: Discussionmentioning

confidence: 99%

Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment

Blue

Dahly

Chhen

et al. 2021

J Prim Care Community Health

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Introduction: The continuing opioid crisis poses unique challenges to remote and often under-resourced rural communities. Emergency medical service (EMS) providers serve a critical role in responding to opioid overdose for individuals living in rural or remote areas who experience opioid overdoses. They are often first at the scene of an overdose and are sometimes the only health care provider in contact with an overdose patient who either did not survive or refused additional care. As such, EMS providers have valuable perspectives to share on the causes and consequences of the opioid crisis in rural communities. Methods: EMS providers attending a statewide EMS conference serving those from greater Minnesota and surrounding states were invited to take a 2-question survey asking them to reflect upon what they believed to be the causes of the opioid crisis and what they saw as the solutions to the opioid crisis. Results were coded and categorized using a Consensual Qualitative Research approach. Results: EMS providers’ perceptions on causes of the opioid crisis were categorized into 5 main domains: overprescribing, ease of access, socioeconomic vulnerability, mental health concerns, and lack of resources and education. Responses focused on solutions to address the opioid crisis were categorized into 5 main domains: need for increased education, enhanced opioid oversight, increased access to treatment programs, alternative therapies for pain management, and addressing socioeconomic vulnerabilities. Conclusion: Along with the recognition that the opioid crisis was at least partially caused by overprescribing, rural EMS providers who participated in this study recognized the critical role of social determinants of health in perpetuating opioid-related harm. Participants in this study reported that education and increased access to treatment facilities and appropriate pain management, along with recognition of the role of social determinants of health in opioid dependency, were necessary steps to address the opioid crisis.

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“…The majority of data in the review originated from either the United Kingdom or Ukraine, which may limit the generalizability of the findings. All studies were conducted in urban areas, and excluded prison populations where drug injecting and HIV testing practices may differ from other settings [43,44].…”

Section: Discussionmentioning

confidence: 99%

Association between opioid agonist therapy use and HIV testing uptake among people who have recently injected drugs: a systematic review and meta‐analysis

Ferraro

Stewart

Grebely³

et al. 2021

Addiction

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Background and aim Globally, nearly one in five people who inject drugs (PWID) are living with HIV, and the rate of new HIV infections in PWID is increasing in some settings. Early diagnosis is crucial for effective HIV control. We reviewed the evidence on the association between opioid agonist therapy (OAT) and HIV testing uptake among PWID.Methods We conducted a systematic review searching MEDLINE, Scopus, Web of Science, Cochrane Central Register of Controlled Trials and PsycINFO for studies published from January 2000 to March 2019. Reference lists and conference proceedings were hand-searched. Observational and intervention studies were eligible for inclusion. Risk of bias was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool. Meta-analyses were conducted using random-effects models. Results Of 13 373 records identified, 11 studies from Australia, Europe, Malaysia and the United States were included. All studies had at least a serious risk of bias, largely due to confounding and selection bias, making it difficult to draw causal conclusions from the evidence. Ten studies provided data on the association between current OAT use and recent HIV testing. Six showed a positive association, while four provided little evidence of an association: pooled odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.28-2.27. Looking at having ever been on OAT and having ever been HIV tested, seven studies showed a positive association and three showed either weak or no evidence of an association: pooled OR = 3.82, 95% CI = 2.96-4.95. Conclusions Opioid agonist therapy may increase uptake of HIV testing among people who inject drugs, providing further evidence that opioid agonist therapy improves the HIV treatment care cascade.

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Implementing Treatment of Opioid-Use Disorder in Rural Settings: a Focus on HIV and Hepatitis C Prevention and Treatment

Cited by 27 publications

References 73 publications

Patterns and Characteristics of Methamphetamine Use Among Adults — United States, 2015–2018

Patterns and Characteristics of Methamphetamine Use Among Adults — United States, 2015–2018

Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment

Association between opioid agonist therapy use and HIV testing uptake among people who have recently injected drugs: a systematic review and meta‐analysis

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