Objective: The aim of this study was to explore client experiences in a community-based injectable opioid agonist therapy (iOAT) program.
Study Setting: The study occurred across two cities in Alberta, Canada.
Study Design: The research team conducted secondary interpretive description analysis on qualitative interview transcripts.
Data Collection: Twenty-three iOAT clients were interviewed as part of a prior quality improvement initiative. Using secondary analysis of the transcripts, interviews were analyzed for themes, to create an understanding of clients' experiences.
Principal Findings: Participants accessed iOAT through other health services, for treatment of opioid use disorder. Participants reported that building trusting and supportive relationships with nurses was crucial to their success in the program. Through these relationships, participants experienced stopping and starting. They stopped behaviors such as illicit drug use, having withdrawal symptoms and anxiety, and prohibited income generation activities. They started taking care of themselves, accessing housing, increasing financial stability, receiving primary care, and connecting with friends and family. The global experience of iOAT was one of positive change for participants.
Conclusions: The findings of this study are largely consistent with other published examples-iOAT programs create benefits for both clients and their communities. Although clients may join the program to access the hydromorphone, the relationships between staff and clients are the key driver of success.
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http://dx.doi.org/10.1097/JAN.0000000000000536 | DOI Listing |
Addiction
January 2025
Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA.
Background And Aims: Opioid smoking is becoming more common in the United States. The aim of this analysis was to estimate relative mortality risk among those who primarily smoke opioids compared with those who inject.
Design: Retrospective propensity score-matched cohort analysis.
Contemp Clin Trials
January 2025
New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY 10032, USA; Columbia University Irving Medical Center, 630 West 168(th) St., New York, NY 10032, USA. Electronic address:
Introduction And Background: The three medications approved to address OUD are effective in decreasing opioid use and morbidity and mortality; however, their utility is limited by high rates of dropout from treatment. The CTN-0100 trial will develop an evidence base for strategies to improve retention on buprenorphine and extended-release naltrexone.
Research Design And Methods: The National Drug Abuse Treatment Clinical Trials Network (CTN) study CTN-0100, "Optimizing Retention, Duration and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy" (RDD), is a multicenter, randomized, non-blinded trial enrolling more than a thousand patients from 18 community-based substance use disorder treatment programs.
Int J Drug Policy
January 2025
Emory University Rollins School of Public Health, 1518 Clifton Road, Atlanta, GA 30322, United States. Electronic address:
Background: Harm reduction vending machines (HRVMs) that dispense safe injection equipment and other supplies have operated globally for more than 30 years, yet few operate in the U.S., particularly in the rural epicenters of drug-related harms.
View Article and Find Full Text PDFInt J Drug Policy
January 2025
Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States.
Healthcare avoidance or delays for wounds and related skin- and soft-tissue infections are often attributed to negative interactions with medical providers. An infrastructural violence framework posits that healthcare infrastructure serves as a material channel for structural violence, maintaining inequities in healthcare experiences and outcomes. Infrastructural violence ensues when infrastructure is designed for some members or groups within a society while perpetuating violence among others.
View Article and Find Full Text PDFInt J Drug Policy
January 2025
Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 rue St-Denis, Montréal, Québec H2X 0A9, Canada; Department of Emergency and Family Medicine, Université de Montréal, 2900 blvd Edouard Montpetit, Montréal, Québec H3T 1J4, Canada; National Drug and Alcohol Research Centre, UNSW Sydney, Anzac Parade, Kensington NSW 2052, Australia. Electronic address:
Background: Supervised injection sites (SIS) offer a hygienic environment in which people can inject drugs under observation; as such, these harm reduction services have been on the forefront of the overdose epidemic. We sought to understand factors predictive of an overdose requiring an emergency response intervention at SIS in Montréal, Canada.
Methods: We used administrative data from all four Montréal SIS from 1 March 2018 - 31 October 2022 to first calculate the rate of onsite overdose requiring intervention (e.
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