Treatment retention, drug use and social functioning outcomes in those receiving 3 months versus 1 month of supervised opioid maintenance treatment. Results from the Super C randomized controlled trial

Abstract

There was no evidence of a difference in treatment retention or opioid use rates between patients whose consumption of opioid maintenance treatment was supervised for 3 months daily (except Saturdays) compared with supervision for 1 month. There was some evidence that longer periods of supervised consumption were associated with higher levels of criminality.

Effect of a primary care based brief intervention trial among risky drug users on health-related quality of life

“…Mean values of our HRQOL measures were comparable with those of other drug using populations but lower than those of the general population (Gonzales et al, 2009; Holland et al, 2014; Lev-Ran et al, 2012). For example, in a sample of methamphetamine-dependent individuals mean and standard deviation for MCS and PCS were 39.2 (13.1) and 50.6 (9.0), respectively (Gonzales et al, 2009).…”

Management of opioid use disorders: a national clinical practice guideline

“…• Health Canada exemption is not required to prescribe buprenorphine-naloxone in most provinces and territories (Appendix 1) • Lower risk of overdose due to partial agonist properties and ceiling effect for respiratory depression (in the absence of benzodiazepines or alcohol) 19,24,25 • Lower risk of public safety harms if diverted 26,27 • Milder adverse effect profile 22,23 • Easier to transition from buprenorphine-naloxone to methadone if treatment is unsuccessful 22,23 • Shorter time to achieve therapeutic dose (1-3 d) [28][29][30] • Lower risk of toxicity and drug-drug interactions 31 • Milder withdrawal symptoms when discontinuing treatment; may be a better option for individuals with lower-intensity opioid dependence (e.g., oral opioid dependence, infrequent or no injection use, short history of opioid use disorder), and individuals planning to taper off opioid agonist treatment in a relatively short period 22,23 • Optimal for rural and remote locations where access to care is limited, methadone prescribers are lacking, or daily witnessed ingestion at a pharmacy is not feasible • More flexible dosing schedules (e.g., alternate-day dosing, earlier provision of 1-to 2-week take-home prescriptions, and unobserved home inductions) support patient autonomy and can reduce costs [32][33][34][35] • Easier to adjust and retitrate following missed doses, owing to its partial agonist properties…”

“…In contrast, because of comparative safety advantages, buprenorphine-naloxone can safely be provided for take-home dosing as soon as clinical stability is achieved (e.g., often within 7-10 days of treatment initiation), which has the potential to improve patients' quality of life and reduce the burden of requiring daily pharmacy attendance without compromising retention in care. 32,53,54 Further, the partial agonist effect allows more rapid titration to a therapeutic dose (< 1 wk). 22 There is also potential for cost savings and greater patient autonomy with home induction of buprenorphine-naloxone, 34,35 which under appropriate circumstances, yields similar outcomes as office-based induction in terms of patient safety, retention and reductions in nonmedical opioid use.…”

Reports of the benefits of drug use from individuals with substance use disorders

“…The second is the "drugs and performance" dimension, which centres around how drug behaviours follow functional patterns (Van Maanen, 1992). When problematic, drugs may be used to handle serious psychological problems (Drake, Mueser, Brunette, & McHugo, 2004) or conduct criminal actions (Holland et al, 2014;van der Pol, Henderson, Hendriks, Schaub, & Rigter, 2018). In non-problematic drug use, drug use often has an important social and cultural function in the workplace and in social life (Anderson-Gough, Grey, & Robson, 1998;Ho, 2009;Nixon & Crewe, 2004).…”