Concurrent alcohol and opioid withdrawal syndrome is a common and challenging clinical scenario with little published evidence or guidance to inform pharmacotherapy strategies. Concurrent use of benzodiazepines and opioid agonists, which are considered first-line agents for management of each withdrawal syndrome independently, is controversial and often avoided in clinical practice. Strategies to provide effective, simultaneous medication treatment of alcohol and opioid withdrawal while optimizing patient safety are demonstrated through 3 patient cases.
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http://dx.doi.org/10.9740/mhc.2023.12.268 | DOI Listing |
Drug Alcohol Depend Rep
March 2025
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States.
Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.
Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018-9/30/20.
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.
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
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.
Int J Drug Policy
January 2025
School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Background: In October 2018, Canada legalized recreational cannabis, with Ontario distributing retailer licenses through a lottery system in 2019. This study investigates the impact of recreational cannabis retailer allocation on emergency department (ED) visits related to cannabis, alcohol, and opioids.
Method: A longitudinal study of 278 communities in Ontario (proxied by Forward Sortation Areas, FSAs) was conducted using health administrative data from ICES for all Ontario residents covered by public health insurance.
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