‘A human rights issue’: Lack of treatment for drug users means deaths behind bars – CBC – 2018-04-03

Michelle McPherson’s son Curtis McGowan was rushed to the Guelph, Ont., hospital by paramedics after overdosing, where he was revived with the opioid-reversal drug naloxone. “The police were there to arrest him … because part of his probation is not using drugs,” she recalled. A month later, he was found

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‘I have it just in case’ — Naloxone access and changes in opioid use behaviours – 2018-01

Background The past decade has seen over a four-fold increase in deaths from opioid overdose in the United States. To address this growing epidemic, many localities initiated policies to expand access to naloxone (a drug that reverses the effects of opioids); however, little is known how naloxone access affects opioid

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‘The right way to be a woman’: Negotiating femininity in a prison-based drug treatment programme – 2017-12-22

Drawing from an ethnographic study in a drug treatment wing for women in a Danish prison, the authors explore how femininity is negotiated between prisoners and staff. It is shown how the staff view the prisoners as both passive and disruptive and how the treatment aims to teach them what

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“I Was Not Sick and I Didn’t Need to Recover”: Methadone Maintenance Treatment (MMT) as a Refuge from Criminalization – 2017-07

Background: Methadone Maintenance Treatment (MMT) in the United States (U.S.) has been undergoing a shift towards conceptualizing the program as recovery-based treatment. Although recovery is seen by some as a means to restore MMT to its rightful position as a medically-based treatment for addiction, it may not represent the experiences,

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A randomized trial of female-specific cognitive behavior therapy for alcohol dependent women – 2018-02

This study compared Female-Specific Cognitive Behavioral Therapy (FS-CBT) to evidence-based, gender-neutral CBT (GN-CBT; Epstein & McCrady, 2009) for women with alcohol use disorder (AUD). Women (N = 99) with AUD, mean age 48, were randomly assigned to 12 outpatient manual-guided sessions of FS-CBT (n = 44) or GN-CBT (n =

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A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: Findings at 12 months post-release – 2018-03

Highlights • MMT during incarceration leads to lower injection drug and heroin use. • MMT during incarceration leads to fewer non-fatal overdoses. • MMT during incarceration leads to higher rates of engagement in treatment. Abstract Recently, incarcerated individuals are at increased risk of opioid overdose. Methadone maintenance treatment (MMT) is

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Alcohol, drugs, and violence: A meta-meta-analysis – 2018

Objective: The aim of this project was to provide a comprehensive overview and quantitative synthesis of the links between alcohol, drugs, and violence with established meta-meta-analysis methodology. Gender, psychotic illness (present vs. absent), role (perpetrator vs. victim), substance (alcohol, drugs, or both), operationalizations of violence (e.g., laboratory observed violence, community

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Alcohol, drugs, and violence: A meta-meta-analysis – 2018-02

Objective: The aim of this project was to provide a comprehensive overview and quantitative synthesis of the links between alcohol, drugs, and violence with established meta-meta-analysis methodology. Gender, psychotic illness (present vs. absent), role (perpetrator vs. victim), substance (alcohol, drugs, or both), operationalizations of violence (e.g., laboratory observed violence, community

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An Evaluation of e-CHECKUP TO GO in Canada: The Mediating Role of Changes in Social Norm Misperceptions – 2018

Background: Alcohol use and related problems are key concerns among colleges, and web-based interventions to mitigate these issues are increasingly popular across campuses. A variety of programs are commercially available and have demonstrated efficacy in reducing alcohol use and consequences; however, little is known about how these programs reduce alcohol

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An Exploration of Emergency Physicians’ Attitudes Toward Patients With Substance Use Disorder – 2018

Objectives: Much is known about some healthcare professionals’ attitudes toward patients with substance use disorders, but few studies have specifically looked at emergency department (ED) physicians. Individuals with substance use disorders are more likely to be people who chronically, frequently use the ED, and thus ED physicians are in a

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Are People Who Inject Drugs Frequent Users of Emergency Department Services? A Cohort Study (2008–2013) – 2017-10

Background: Although people who inject drugs (PWID) have been described as frequent users of emergency services, the majority of research is cross-sectional and involves records from a single emergency department (ED). Objectives: We describe characteristics of state-wide ED presentations in a cohort of PWID, and compare presentation rates to the

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Are take‐home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria – 2016

Background and Aims Fatal outcome of opioid overdose, once detected, is preventable through timely administration of the antidote naloxone. Take‐home naloxone provision directly to opioid users for emergency use has been implemented recently in more than 15 countries worldwide, albeit mainly as pilot schemes and without formal evaluation. This systematic

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Are we anywhere near there yet? The state of harm reduction in North America in 2017

The emergence of the new disease, AIDS (first reported as a clinical syndrome in the USA in 1981), was the principal reason for the birth of harm reduction in the mid to late 1980s. The first appearance of clinical evidence of AIDS was based on the appearance of opportunistic infections

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Association between alcohol and substance use disorders and psychiatric service use in patients with severe mental illness: a nationwide Danish register-based cohort study – 2018-02

Substance use disorder is highly prevalent in people with psychiatric disorders, and known to impede the psychiatric treatment. Some studies show increased rates of service use, while others show a decrease. These conflicting results are further hampered by a lack of large-scale studies. The aim of this study was to

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Associations between methadone maintenance treatment and crime: a 17-year longitudinal cohort study of Canadian provincial offenders

Aims To estimate and test the difference in rates of violent and non-violent crime during medicated and non-medicated methadone treatment episodes. Design, Setting and Participants The study involved linkage of population level administrative data (health and justice) for all individuals (n = 14 530) in British Columbia, Canada with a history

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Associations between pharmacotherapy for opioid dependence and clinical and criminal justice outcomes among adults with co-occurring serious mental illness – 2018

Highlights • Opioid-dependence pharmacotherapy is effective for adults with severe mental illness and opioid dependence. • Opioid-dependence pharmacotherapy substantially reduces this population’s risk for hospitalization. • Naltrexone appears to reduce risk for convicted arrests, including felonies. • Opioid-dependence pharmacotherapy was not superior to other treatment in reducing incarceration risk. • Opioid-dependence

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Associations between substance use and type of crime in prisoners with substance use problems – a focus on violence and fatal violence – 2018-01-15

Aim: The present study aimed to study the associations between substance use patterns and types of crimes in prisoners with substance use problems, and specifically whether substance use patterns were different in violent offenders. Methods: Interview data of prisoners with substance use problems (N=4,202, mean age 33.5 years, SD 9.8),

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Availability of naloxone in Canadian pharmacies:a population-based survey – 2017

Background: Naloxone is life-saving when administered after opioid overdose. In March 2016, the Canadian government made the antidote available without prescription, but anecdotal reports suggest members of the public have difficulty in procuring it. We examined the availability of naloxone in community pharmacies across Canada. Methods: We identified community pharmacies

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Behavioral Addictions and Criminal Responsibility – 2017-12

Certain behavioral addictions pose difficult and unresolved problems for the criminal justice system. These disorders are characterized by strong desire states and may be associated with illegal behaviors that are committed to support the addiction. In this article, we begin with a general account of criminal responsibility and provide the

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Can scare tactics and fear-based messages help deter substance misuse: a systematic review of recent (2005–2017) research – 2018-01-15

Introduction: Historically, substance use prevention relied heavily on scare tactics and fear-based messages. However, these messages were discouraged from use due to research finding them ineffective or harmful. This review sought to determine if recent research continues to support this finding. Methods: We conducted a literature review of relevant peer-reviewed

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Canadian guidelines urge buprenorphine-naloxone to treat opioid use disorders – 2018-03

Canadian clinical practice guidelines published in CMAJ for the management of opioid use disorders recommend clinicians use buprenorphine–naloxone as first-line opioid agonist treatment when possible, utilize a stepped and integrated care approach and reject withdrawal management alone. “Opioid use disorder is a public health emergency nationwide, and this guideline provides

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Cannabis Webinar – North York HSJCC – 2018-02-01

Speaker: April Trewhitt is the Agency/Addictions Coordinator at Canadian Mental Health Association. Learn About: • What is cannabis? • Cannabis & Psychosis • Cannabis and Brain Development • Considerations with Legalization     Alternate video link: http://moresettlement.org/downloads/NY-HSJCC-lunch-and-learn-webinar–20180201.mp4     Slides: NY-HSJCC Webinar – Cannabis – 2018-02-01    

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Changes in public order after the opening of an overdose monitoring facility for people who inject drugs – 2018

Background In the face of an increasingly fatal opioid crisis, Boston Health Care for the Homeless Program (BHCHP) opened the Supportive Place for Observation and Treatment (SPOT), a unique low-threshold harm reduction program for monitoring people who have injected drugs and are at imminent risk of overdose. This study examines

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Changes in the dispensing of opioid medications in Canada following the introduction of a tamper-deterrent formulation of long-acting oxycodone: a time series analysis – 2017

Background: In February 2012, a reformulated tamper-deterrent form of long-acting oxycodone, OxyNeo, was introduced in Canada. We investigated the impact of the introduction of OxyNeo on patterns of opioid prescribing. Methods: We conducted population-based, cross-sectional analyses of opioid dispensing in Canada between 2008 and 2016. We estimated monthly community pharmacy

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Co-occurring serious mental illnesses and substance use disorders as predictors of assaultive infraction charges among adult male jail inmates – 2017-07

This study used self-report data from 4642 adult male jail inmates to test the hypothesis that inmates with co-occurring serious mental illnesses (SMIs) and substance use disorders (SUDs) (i.e. co-occurring disorders) would report having been officially charged for assaulting staff or inmates more often than inmates without co-occurring disorders. Negative

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