BACKGROUND Opioid substitution therapy (OST) programs involve the dispensing of OST medicines to patients to address their dependence on heroin and/or other opioid substances. OST medicines are subsidised by the Australian government but patients need to pay the dispensing fees. This study explored opinions from OST patients and stakeholders about the potential impact of dispensing fees on comp...

Heroin overdose deaths are preventable. Overdose prevention in Australia has largely rested on opioid substitution treatment supplemented with outreach services and education for injecting drug users (IDUs) about overdose risks and responses. We believe now is the time to make naloxone hydrochloride (Narcan ®) available to Australian IDUs to help prevent overdose deaths. At the end of 2000 hero...

The art of medicine Tilting at windmills and the evidence base on injecting drug use After reading through many of the 500 or so papers on harm reduction in drug users listed in the PubMed database, it's hard not to conclude that researchers are really bad at understanding the evidence base. Paper after paper begins its introduction with a homily about the need for evidence-based policies. Pape...

Opioid addiction has affected different population groups and socioeconomic classes in the United States at different times. Society's response has changed along with changes in the groups or classes most affected, shifts in social and political attitudes toward opioid addiction, and the accumulation of more and better information about its causes and treatments (Musto 1999). The consensus pane...

OBJECTIVE To assess whether patients receiving opioid substitution therapy (OST) in general practice cause other patients sufficient distress to change practices--a perceived barrier that prevents general practitioners from prescribing OST. DESIGN, SETTING AND PARTICIPANTS A cross-sectional questionnaire-based survey of consecutive adult patients in the waiting rooms of a network of research ...

BACKGROUND Both methadone- and buprenorphine-treated opioid-dependent patients frequently show cognitive deficits in attention, working memory, and verbal memory. However, no study has compared these patient groups with each other during early opioid substitution treatment (OST). Therefore, we investigated attention, working memory, and verbal memory of opioid-dependent patients within six week...

People who inject drugs (PWID) are the group most affected by HCV; however, treatment uptake has been low. Engagement between PWID and healthcare workers has been characterized by mistrust and discrimination. Peer support for HCV is one way to overcome these barriers. Peer support models for chronic disease management have been successfully applied for other diseases. HCV peer support models ha...

Opioid rotation has been proposed for management of cancer pain. No studies directly investigating dose equivalence between morphine injection (continuous IV administration) and the transdermal fentanyl patch have been reported. Therefore, we examined dose conversion ratios in patients undergoing opioid rotation from morphine injection to fentanyl patches. The subjects consisted of 45 patients ...

Objective To compare the risk for all cause and overdose mortality in people with opioid dependence during and after substitution treatment with methadone or buprenorphine and to characterise trends in risk of mortality after initiation and cessation of treatment.Design Systematic review and meta-analysis.Data sources Medline, Embase, PsycINFO, and LILACS to September 2016.Study selection Prosp...

INTRODUCTION There is a strong evidence base that the stigma, discrimination and criminalization affecting adolescent key populations (KPs) aged 10-17 is intensified due to domestic and international legal constructs that rely on law-enforcement-based interventions dependent upon arrest, pre-trial detention, incarceration and compulsory "rehabilitation" in institutional placement. While there e...