The American journal on addictions
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Despite recent increases in crystal methamphetamine use among high-risk populations such as street-involved youth, few prospective studies have examined the health and social outcomes associated with active crystal methamphetamine use. ⋯ Evidence-based strategies to prevent and treat crystal methamphetamine use are urgently needed.
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The non-medical use of prescription opioids (PO) has increased dramatically in North America. Special consideration for PO prescription is required for individuals in methadone maintenance treatment (MMT). Our objective is to describe the prevalence and correlates of PO use among British Columbia (BC) MMT clients from 1996 to 2007. ⋯ A large proportion of MMT clients in BC received co-occurring PO prescriptions, often from physicians and pharmacies not delivering MMT. Experimental evidence for the treatment of pain in MMT clients is required to guide clinical practice.
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Recently, use of prescription opioids (POs) has increased; non-medical PO (NMPO) use is linked to overdose. NMPO use is common among individuals prescribed opioids for pain, and those in substance use disorder (SUD) treatment with pain could be at increased risk for unintentional overdose due to NMPO use. We examined associations between pain, NMPO use, and overdose among SUD treatment patients. ⋯ The relationship between pain and overdose among substance users may be, in part, explained by the association between pain and heavy NMPO use.
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Concern about diversion of buprenorphine/naloxone (B/N) in the United States may affect prescribing patterns and policy decisions. This study examines addiction treatment clinician beliefs and attitudes regarding B/N diversion. ⋯ Attitudes and beliefs, not education level, were associated with clinician's perceived danger from B/N diversion. Clinicians with greater B/N patient experience were more likely to believe treatment access barriers are the major cause of B/N diversion.
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Patients with prescription opioid use disorders and co-occurring pain present a formidable challenge for healthcare providers, and little is known about patients with this dual diagnosis. This study examined the prevalence of pain and motives for use among individuals with prescription opioid dependence. ⋯ Pain is a significant comorbidity and motivator for the non-medical use of prescription opioids. Provider and patient education regarding the safe use of prescription opioids, as well as interventions targeting prescription opioid dependence, are needed.