The International journal on drug policy
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Int. J. Drug Policy · May 2018
Ageing opioid users' increased risk of methadone-specific death in the UK.
The first evidence that the hazard ratio (HR) for methadone-specific death rises more steeply with age-group than for all drug-related deaths (DRDs) came from Scotland's cohort of 33,000 methadone-prescription clients. We aim to examine, for England, whether illicit opioid users' risk of methadone-specific death increases with age; and to pool age-related HRs for methadone-specific deaths with those for Scotland's methadone-prescription clients. ⋯ International testing and explanation are needed of UK's sharp age-related increase in the risk of methadone-specific death. Clients should be alerted that their risk of methadone-specific death increases as they age.
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Int. J. Drug Policy · May 2018
Heroic journeys through sobriety: How temporary alcohol abstinence campaigns portray participant experiences.
In Australia, recent years have seen a rise in the popularity of temporary abstinence campaigns, in which people pledge to abstain from alcohol for a month while raising funds for charity. In addition to their fundraising aims, such initiatives have been viewed as tools for broader behavioural and cultural change around alcohol, encouraging participants to reflect on their drinking and make longer-term changes to their behaviour. The extent to which these initiatives promote enduring change may depend on how they portray the experience of temporarily abstaining from alcohol, and how they position participants. ⋯ Our findings emphasise the need to attend to how campaigns materials position participants in order to strengthen the effectiveness of such campaigns as health promotion tools.
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Int. J. Drug Policy · May 2018
Effects of naloxone distribution to likely bystanders: Results of an agent-based model.
Opioid overdose deaths in the US rose dramatically in the past 16 years, creating an urgent national health crisis with no signs of immediate relief. In 2017, the President of the US officially declared the opioid epidemic to be a national emergency and called for additional resources to respond to the crisis. Distributing naloxone to community laypersons and people at high risk for opioid overdose can prevent overdose death, but optimal distribution methods have not yet been pinpointed. ⋯ Community-based naloxone distribution to reverse opioid overdose may significantly reduce deaths. Optimal distribution methods may include secondary distribution so that the person who picks up naloxone kits can enable others in the community to administer naloxone, as well as targeting naloxone distribution to sites where individuals at high-risk for opioid overdose death are likely to visit, such as syringe-exchange programs. This study design, which paired exploratory qualitative data with agent-based modeling, can be used in other settings seeking to implement and improve naloxone distribution programs.
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Int. J. Drug Policy · Apr 2018
Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.
Opioid overdose is a significant public health problem. Collaborative programs between local public health and public safety agencies have emerged to connect overdose survivors and their personal networks with harm reduction and addiction treatment services following a non-fatal overdose event. This study explored the prevalence of these programs in Massachusetts and the different ways they have been structured and function. ⋯ This study represents the first attempt to systematically document an emerging approach intended to connect opioid overdose survivors and their personal networks with harm reduction and addiction treatment services soon after a non-fatal overdose event. These programs have the potential to increase engagement with the social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose.
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Int. J. Drug Policy · Apr 2018
Comparative StudyUsing medical examiner case narratives to improve opioid overdose surveillance.
Current opioid overdose mortality surveillance methods do not capture the complexity of the overdose epidemic. Most rely on death certificates, which may underestimate both opioid analgesic and heroin deaths. Categorizing deaths using other characteristics from the death record including route of drug administration may provide useful information to design and evaluate overdose prevention interventions. ⋯ Using additional sources of information to classify opioid overdose cases resulted in a modest increase in the count of heroin overdose deaths but identified a substantial number of non-heroin injection-related opioid analgesic deaths. Including the route of administration in the characterization of opioid overdose deaths can identify meaningful subgroups of opioid users to enhance surveillance efforts and inform targeted public health programming including overdose prevention programs.