The International journal on drug policy
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This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Int. J. Drug Policy · Jul 2020
Use of analgesics following rescheduling of codeine in Australia: An interrupted time series analysis in the veteran population.
The Australian medicines regulator, the Therapeutic Goods Administration (TGA), rescheduled all codeine-containing medicines to be available only on prescription on 1 February 2018. This study was conducted to determine whether use of analgesics changed following codeine re-scheduling to prescription only status, and whether there was a change in the use of codeine preparations and a therapeutic shift to stronger opioids or other analgesics in the Australian veteran population following the change. ⋯ A significant increase in prescription use of paracetamol with codeine 8mg was observed after the February 2018 codeine re-scheduling. Therapeutic shift to stronger opioid analgesics was not observed in the study population.
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Int. J. Drug Policy · Apr 2020
"Bed Bugs and Beyond": An ethnographic analysis of North America's first women-only supervised drug consumption site.
Attention to how women are differentially impacted within harm reduction environments is salient amidst North America's overdose crisis. Harm reduction interventions are typically 'gender-neutral', thus failing to address the systemic and everyday racialized and gendered discrimination, stigma, and violence extending into service settings and limiting some women's access. Such dynamics highlight the significance of North America's first low-threshold supervised consumption site exclusively for women (transgender and non-binary inclusive), SisterSpace, in Vancouver, Canada. This study explores women's lived experiences of this unique harm reduction intervention. ⋯ SisterSpace demonstrates the value and effectiveness of initiatives that engage with socio-structural factors beyond the often narrow focus of overdose prevention and that account for the complex social relations that constitute such initiatives. In the context of structural inequities, criminalization, and an overdose crisis, SisterSpace represents an innovative approach to harm reduction that accounts for situations of gender inequality not being met by mixed-gender services, with relevance to other settings.
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Int. J. Drug Policy · Mar 2020
Trajectories of retention in opioid agonist therapy in a Canadian setting.
Long-term engagement in opioid agonist therapy (OAT) has been consistently associated with reduced risk for morbidity and mortality in people with opioid use disorder (OUD). However, the dynamic nature of engagement/disengagement in OUD care for over time is poorly captured by traditional metrics. We characterized long-term longitudinal trajectories of engagement in OAT in Vancouver, Canada, between 2005 and 2018. ⋯ We identified four distinct OAT engagement trajectories in Vancouver, Canada, with employment being a common predictor of sub-optimal care trajectories, suggesting the need to explore alternative OAT models to address employment-related barriers. Care trajectory analysis could help inform tailored interventions to specific populations of people with OUD at specific time points to improve engagement in OAT, and decrease opioid-related morbidity and mortality.
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Int. J. Drug Policy · Mar 2020
The effect of an opioid prescription days' supply limit on patients receiving long-term opioid treatment.
Since 2016, an increasing number of states have passed laws restricting the days' supply for opioid prescriptions, yet little is known about how these laws affect patients. This study evaluates the effect of the Tennessee Prescription Regulatory Act, which was implemented on Oct. 1st, 2013 and restricted the maximum days' supply that could be dispensed for any opioid prescription by any prescriber to 30 days, on patients receiving long-term opioid treatment. ⋯ Prescribers responded to the Addison Sharp Prescription Regulatory Act by significantly decreasing the days' supply in opioid prescriptions among current patients receiving long-term opioid treatment who had at least one prescription exceeding the maximum days' supply set by the law in the pre-policy period.