Journal of addictive diseases
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Registry data on methadone reveal that QTc-prolongation is reported more often among opioid-dependent patients than chronic pain patients. This suggests that opioid treatment programs may be an important venue for implementing arrhythmia risk-reduction strategies. An electrocardiography-based strategy in the opioid treatment program setting demonstrated a reduction in the QTc-interval among patients with marked QTc-prolongation. ⋯ Therefore, we performed qualitative interviews among opioid treatment program staff to determine the barriers and benefits of implementation. Overall, the program was well received by staff; however, a need for training and algorithms was identified. No patient was denied access to care.
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An increasing percentage of women are U. S. Military Veterans. ⋯ Women Veterans may have higher rates of substance misuse and comorbid psychiatric and medical disorders than male Veterans and women who are not Veterans. Studies support the AUDIT-C as a scaled marker of alcohol-related risk among female Veterans, but validated drug screening instruments are needed. We discuss evidence-based approaches in terms of treating women Veterans' substance misuse in primary and specialty care settings, along with knowledge gaps and potential research priorities to improve care in this special population.
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Randomized Controlled Trial
A preliminary study comparing methadone and buprenorphine in patients with chronic pain and coexistent opioid addiction.
Patients with opioid addiction who receive prescription opioids for treatment of nonmalignant chronic pain present a therapeutic challenge. Fifty-four participants with chronic pain and opioid addiction were randomized to receive methadone or buprenorphine/naloxone. ⋯ Other differences between the two conditions were not found. Long-term, low-dose methadone or buprenorphine/naloxone treatment produced analgesia in participants with chronic pain and opioid addiction.
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This study explores strategies that Suboxone misusers utilize while in drug treatment. Ethnographic interviews were conducted with 14 patients who had cycled in and out of Suboxone treatment. ⋯ Many patients suggest that they manage their opiate/opioid dependency through a sequential use of Suboxone and heroin to avoid withdrawal and to continue their misuse of opiates/opioids. Results are discussed in conjunction with the difficulties inherent to substance abuse treatment and suggestions for improvement are offered.