Untreated opiate addiction remains a major health care crisis in New York and in most other urban centers in America. Optimism for closing the gap between need and demand for treatment and its availability has greeted the recent approval of a new opiate medication for addiction, buprenorphine--which unlike methadone may be prescribed by independent, office-based practitioners. The likelihood of buprenorphine fulfilling its potential is assessed in the light of the massive expansion of methadone treatment more than 30 years earlier. It is concluded that the key, indispensable ingredient of success will be true commitment on the part of Government to provide care to all those who need it.
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http://dx.doi.org/10.1186/1477-7517-3-20 | DOI Listing |
Harm Reduct J
December 2024
EUDA, Praça Europa 1, Cais do Sodré, 1249-289, Lisbon, Portugal.
Background: Harm Reduction, conceptualized by Russell Newcombe in the late 1980s, has revolutionized how drug use, individuals who use drugs, and drug policies are understood globally. Emerging from the HIV/AIDS crisis, Harm Reduction sought to address the dire rates of drug-related infections and the overwhelming burden on healthcare providers. Early initiatives, such as Opioid Substitution Treatment (OST) and needle exchange programs, were met with resistance but gradually established new standards of care, transforming attitudes toward people who use drugs and prioritizing human-centered, rather than solely medical, approaches.
View Article and Find Full Text PDFJ Subst Use Addict Treat
January 2025
Department of Psychiatry, Columbia University Vagelos College of Physician and Surgeons, United States of America; Department of Epidemiology, Columbia University Mailman School of Public Health, United States of America.
Introduction: Medications for opioid use disorder (MOUD) are considered the first line treatment for opioid use disorder. As states expanded Medicaid beginning in 2014 under the Affordable Care Act, policymakers and public health officials were interested in the potential for expansion to increase access to MOUD. This study examined whether there were changes in MOUD use within outpatient admissions to specialty treatment facilities in Medicaid expansion states beyond the initial expansion period.
View Article and Find Full Text PDFBMJ Open
November 2024
School of Public Health, University of Texas, Houston, Texas, USA.
Introduction: As the US continues to battle the opioid epidemic, recovery residences remain valuable services for people in recovery. While there is a growing body of literature describing positive outcomes experienced by people who live in recovery residences, little is known about the experience of people who live in these residences while taking medications for an opioid use disorder (MOUD) as part of their recovery. Thus, this study has three aims: (1) expand the availability of recovery residences that meet the National Alliance for Recovery Residences standards in Texas and serve individuals taking medications for an opioid use disorder as part of their recovery; (2) evaluate recovery residences for people taking MOUD as part of their recovery; and (3) compare the cost-effectiveness of recovery residences to treatment-as-usual.
View Article and Find Full Text PDFAddiction
February 2025
Massachusetts Department of Public Health, Bureau of Substance Addiction Services and Grayken Center for Addiction, Section of General Internal Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Background And Aims: During the COVID-19 pandemic, there was a surge in opioid overdose deaths (OODs) in Massachusetts, USA, particularly among Black and Hispanic/Latinx populations. Despite the increasing racial and ethnic disparities in OODs, there was no compensatory increase in naloxone distributed to these groups. We aimed to evaluate two community-based naloxone expansion strategies, with the objective of identifying approaches that could mitigate mortality and racial and ethnic disparities in OODs.
View Article and Find Full Text PDFGut Microbes
October 2024
Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, USA.
IgA binding dictates the composition of the intestinal microbiome and reflects dysbiotic states during chronic disease. Both pathogenic and commensal bacteria differentially bind to IgA with varying outcomes. Little is known regarding IgA dynamics immediately following microbial dysbiosis.
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