Consumer Attitudes About Opioid Addiction Treatment: A Focus Group Study in New York City.
Consumer attitudes about opioid addiction treatment: A focus group study in New York City.
J Opioid Manag. 2013 March-April; 9(2): 111-119
Sohler NL, Weiss L, Egan JE, López CM, Favaro J, Cordero R, Cunningham CO
Objective: To develop effective programs for people who are opioid dependent and to impact the opioid epidemic in New York City, it is crucial to monitor attitudes about opioid addiction treatments among opioid users who have experienced barriers to engagement and retention in addiction treatment. Design: The authors conducted a qualitative study using focus groups. Methods: Six focus groups in three needle exchanges in New York City were audio recorded, transcribed, and systematically coded. The authors report on the main themes related to the study objectives. Participants: Participants of each needle exchange who were opioid dependent and had some knowledge of both methadone and buprenorphine were eligible. Results: There were four main findings. Participants felt the following: 1) buprenorphine is an appropriate option for those heroin users who are motivated to stop using, 2) they have less control over their addiction treatment with methadone than they would have with buprenorphine, 3) buprenorphine treatment is not accessible to many New York City residents who would benefit from this treatment, and 4) lack of access to buprenorphine treatment is a cause of treatment-related diversion. Conclusions: Both methadone maintenance and buprenorphine treatment opportunities are necessary to address the diverse treatment needs of opioid-dependent people in New York City. However, the current medical model of buprenorphine treatment may be too restrictive for some opioid-dependent people and may be contributing to the use of illicit buprenorphine. New models to deliver buprenorphine treatment may address these problems.
HubMed – Methadone
Hypoglycemia during rapid methadone dose escalation.
J Opioid Manag. 2013 January-February; 9(1): 29-34
Moryl N, Pope J, Obbens E
Objectives: To answer a question whether or not rapid methadone dose increase can be associated with onset of hypoglycemia. This hypothesis is based on the previously reported case reports of hypoglycemia with rapid methadone increase and our clinical experience of a number of cases when symptomatic hypoglycemia during rapid methadone escalation was initially mistaken for methadone overdose. Methods: A retrospective chart review of 59 consecutive opioid-tolerant patients with cancer who received methadone for pain while inpatients in a tertiary cancer center within 1 year was performed. In patients who also had hypoglycemia during the admission, blood glucose levels were analyzed in relationship to the time of methadone titration. Use of steroid, presence of fever, renal insufficiency, and periods of fasting were recorded. Results: Eleven patients (19 percent) had hypoglycemia while receiving methadone, of them two patients had at least two episodes of hypoglycemia. In the 11 cases of documented hypoglycemia, mean methadone dose was nearly doubled (92 percent increase) within 2 days before the onset of hypoglycemia. None of the other recorded factors correlated with glucose level in this group of patients. Conclusions: Present report is the first reported series of patients with hypoglycemic episodes associated with rapid methadone dose escalation. Based on our results, a patient who develops unexplained sweating, palpitations, or lethargy during methadone titration may benefit from blood glucose monitoring.
HubMed – Methadone
Variation in Use of Buprenorphine and Methadone Treatment by Racial, Ethnic, and Income Characteristics of Residential Social Areas in New York City.
J Behav Health Serv Res. 2013 May 24;
Hansen HB, Siegel CE, Case BG, Bertollo DN, Dirocco D, Galanter M
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