The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
James M Greenberg - One of the best experts on this subject based on the ideXlab platform.
-
universal maternal drug testing in a high prevalence region of prescription Opiate Abuse
The Journal of Pediatrics, 2015Co-Authors: Scott L Wexelblatt, Laura P Ward, Kimberly Torok, Elizabeth Tisdale, Jareen Meinzenderr, James M GreenbergAbstract:Objective To evaluate the efficacy of a universal maternal drug testing protocol for all mothers in a community hospital setting that experienced a 3-fold increase in neonatal abstinence syndrome (NAS) over the previous 5 years. Study design We conducted a retrospective cohort study between May 2012 and November 2013 after the implementation of universal maternal urine drug testing. All subjects with positive urine tests were reviewed to identify a history or suspicion of drug use, insufficient prenatal care, placental abruption, sexually transmitted disease, or admission from a justice center, which would have prompted urine testing using our previous risk-based screening guidelines. We also reviewed the records of infants born to mothers with a positive toxicology for opioids to determine whether admission to the special care nursery was required. Results Out of the 2956 maternal specimens, 159 (5.4%) positive results were recorded. Of these, 96 were positive for opioids, representing 3.2% of all maternity admissions. Nineteen of the 96 (20%) opioid-positive urine tests were recorded in mothers without screening risk factors. Seven of these 19 infants (37%) required admission to the special care nursery for worsening signs of NAS, and 1 of these 7 required pharmacologic treatment. Conclusion Universal maternal drug testing improves the identification of infants at risk for the development of NAS. Traditional screening methods underestimate in utero opioid exposure.
N Lodhia - One of the best experts on this subject based on the ideXlab platform.
-
geographic variation in indicators of Opiate Abuse and treatment availability in california
Clinical Pharmacology & Therapeutics, 2004Co-Authors: John Mendelson, N LodhiaAbstract:The geographic distribution of medical and legal consequences of Opiate Abuse and the relationships between treatment access and complications are poorly described. In this study, we assessed the relationship between indicators of Opiate addiction and the availability of licensed Opiate treatment in California. The most recent available statistics (for 2000 and 2001) from all California counties on medical (death and hospital discharge ascribed to Opiate overdose) and legal (felony narcotic arrests) complications of Opiate Abuse were obtained from online databases and contrasted with the number of Opiate dependence treatment slots. Results show that all California counties had Opiate-associated medical and societal complications. All but two small counties (<1% of the state population) had felony narcotic arrests. Counties large enough to support an acute care hospital reported at least one death or hospital discharge due to Opiate overdose. The rates of Opiate-associated problems in counties with and without Opiate substitution programs were similar, suggesting Opiate Abuse is prevalent in California. When adjusted for population, treatment availability did not systematically affect legal or medical repercussions of Opiate Abuse. The medical and legal consequences of Opiate addiction appear widespread in California. Given the large and heterogeneous population of the state, similar results can be expected in other parts of the U.S. Clinical Pharmacology & Therapeutics (2004) 75, P28–P28; doi: 10.1016/j.clpt.2003.11.105
-
Geographic variation in indicators of Opiate Abuse and treatment availability in California
Clinical Pharmacology & Therapeutics, 2004Co-Authors: John Mendelson, N LodhiaAbstract:The geographic distribution of medical and legal consequences of Opiate Abuse and the relationships between treatment access and complications are poorly described. In this study, we assessed the relationship between indicators of Opiate addiction and the availability of licensed Opiate treatment in California. The most recent available statistics (for 2000 and 2001) from all California counties on medical (death and hospital discharge ascribed to Opiate overdose) and legal (felony narcotic arrests) complications of Opiate Abuse were obtained from online databases and contrasted with the number of Opiate dependence treatment slots. Results show that all California counties had Opiate-associated medical and societal complications. All but two small counties (
Marina Davoli - One of the best experts on this subject based on the ideXlab platform.
-
psychosocial treatment for Opiate Abuse and dependence
Cochrane Database of Systematic Reviews, 2014Co-Authors: Soraya Mayet, Michael Farrell, Marica Ferri, Laura Amato, Marina DavoliAbstract:Substance dependence is a social and public health problem; therefore it is a priority to develop effective treatments. Previous Cochrane reviews have explored the efficacy of pharmacotherapy for Opiate dependence. This current review focuses on the role of psychosocial interventions alone for the treatment of Opiate dependence. There is some evidence for the effectiveness of psychosocial interventions, but no systematic review has even been carried out. Objectives To assess the efficacy and acceptability of psychosocial interventions alone for treating Opiate use disorders. Randomised controlled trials comparing psychosocial interventions alone versus pharmacological interventions or placebo or non-intervention for treating opioid use disorders were undertaken. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Five trials involving 389 participants were included. These analysed Contingency Management, Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management, Cue Exposure therapy, Alternative Program for Methadone Maintenance Treatment Program Drop-outs (MMTP) and Enhanced Outreach-Counselling Program. All the treatments were studied against the control (standard) treatment; therefore it was not possible to identify which type of psychosocial therapy was most effective. Both Enhanced Outreach Counselling and Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management had significantly better outcomes than standard therapy regarding relapse to opioid use, re-enrolment in treatment and retention in treatment. At 1-month and 3- month follow up the effects of Reinforcement Based Intensive Outpatient Therapy were not sustained. There was no further follow up of the Enhanced Outreach Counselling group. The Alternative Program for MMTP Drop-outs and the behavioural therapies of Cue Exposure and Contingency Management alone were no better than the control. As the studies were heterogeneous, it was not possible to pool the results and perform a meta-analysis.
-
should psychosocial intervention be added to pharmacological treatment for Opiate Abuse dependence an overview of systematic reviews of the literature
Italian Journal of Public Health, 2006Co-Authors: Laura Amato, Marina Davoli, Silvia Minozzi, Simona Vecchi, Carlo A PerucciAbstract:Background : Opioid Abuse and dependence are major health and social issues in most societies. Different interventions are available, but the majority of heroin patients relapse and these relapses are a substantial problem to their rehabilitation. Psychosocial interventions for drug addicts have been suggested as possible instruments to overcome the difficulty of maintaining a drug-free state. The aim of this paper is to provide a summary of the available evidence of effectiveness. Methods : We summarised the results from two systematic reviews on psychosocial interventions combined with Methadone Maintenance Treatment and Methadone or Buprenorphine Detoxification Treatment. Results: For detoxification treatments, the results show that benefits can be gained from adding any psychosocial treatment to any substitution detoxification treatment in terms of completion of treatment: relative risk (RR) 1.68 (95% CI 1.11-2.55), and compliance (proportion of clinical absences): RR 0.48 (95% CI 0.38-0.59); for the use of heroin during treatment, the differences were not statistically significant. For maintenance treatments, there is an additional benefit to be gained in adding any psychosocial treatment to methadone maintenance treatment in relation to the use of heroin during treatment: RR 0.69(95% CI 0.53-0.91); no statistically significant additional benefit was shown in terms of treatment retention and results at follow-up. Conclusions : Psychosocial treatments offered in addition to pharmacological detoxification treatments are effective in terms of completion of treatment and compliance, while adding any psychosocial support to methadone maintenance significantly improves the non-use of heroin during treatment but does not improve the other outcomes considered.
-
The Cochrane Library - Psychosocial treatment for Opiate Abuse and dependence
Cochrane Database of Systematic Reviews, 2005Co-Authors: Soraya Mayet, Michael Farrell, Marica Ferri, Laura Amato, Marina DavoliAbstract:Substance dependence is a social and public health problem; therefore it is a priority to develop effective treatments. Previous Cochrane reviews have explored the efficacy of pharmacotherapy for Opiate dependence. This current review focuses on the role of psychosocial interventions alone for the treatment of Opiate dependence. There is some evidence for the effectiveness of psychosocial interventions, but no systematic review has even been carried out. Objectives To assess the efficacy and acceptability of psychosocial interventions alone for treating Opiate use disorders. Randomised controlled trials comparing psychosocial interventions alone versus pharmacological interventions or placebo or non-intervention for treating opioid use disorders were undertaken. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Five trials involving 389 participants were included. These analysed Contingency Management, Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management, Cue Exposure therapy, Alternative Program for Methadone Maintenance Treatment Program Drop-outs (MMTP) and Enhanced Outreach-Counselling Program. All the treatments were studied against the control (standard) treatment; therefore it was not possible to identify which type of psychosocial therapy was most effective. Both Enhanced Outreach Counselling and Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management had significantly better outcomes than standard therapy regarding relapse to opioid use, re-enrolment in treatment and retention in treatment. At 1-month and 3- month follow up the effects of Reinforcement Based Intensive Outpatient Therapy were not sustained. There was no further follow up of the Enhanced Outreach Counselling group. The Alternative Program for MMTP Drop-outs and the behavioural therapies of Cue Exposure and Contingency Management alone were no better than the control. As the studies were heterogeneous, it was not possible to pool the results and perform a meta-analysis.
Laura Amato - One of the best experts on this subject based on the ideXlab platform.
-
psychosocial treatment for Opiate Abuse and dependence
Cochrane Database of Systematic Reviews, 2014Co-Authors: Soraya Mayet, Michael Farrell, Marica Ferri, Laura Amato, Marina DavoliAbstract:Substance dependence is a social and public health problem; therefore it is a priority to develop effective treatments. Previous Cochrane reviews have explored the efficacy of pharmacotherapy for Opiate dependence. This current review focuses on the role of psychosocial interventions alone for the treatment of Opiate dependence. There is some evidence for the effectiveness of psychosocial interventions, but no systematic review has even been carried out. Objectives To assess the efficacy and acceptability of psychosocial interventions alone for treating Opiate use disorders. Randomised controlled trials comparing psychosocial interventions alone versus pharmacological interventions or placebo or non-intervention for treating opioid use disorders were undertaken. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Five trials involving 389 participants were included. These analysed Contingency Management, Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management, Cue Exposure therapy, Alternative Program for Methadone Maintenance Treatment Program Drop-outs (MMTP) and Enhanced Outreach-Counselling Program. All the treatments were studied against the control (standard) treatment; therefore it was not possible to identify which type of psychosocial therapy was most effective. Both Enhanced Outreach Counselling and Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management had significantly better outcomes than standard therapy regarding relapse to opioid use, re-enrolment in treatment and retention in treatment. At 1-month and 3- month follow up the effects of Reinforcement Based Intensive Outpatient Therapy were not sustained. There was no further follow up of the Enhanced Outreach Counselling group. The Alternative Program for MMTP Drop-outs and the behavioural therapies of Cue Exposure and Contingency Management alone were no better than the control. As the studies were heterogeneous, it was not possible to pool the results and perform a meta-analysis.
-
should psychosocial intervention be added to pharmacological treatment for Opiate Abuse dependence an overview of systematic reviews of the literature
Italian Journal of Public Health, 2006Co-Authors: Laura Amato, Marina Davoli, Silvia Minozzi, Simona Vecchi, Carlo A PerucciAbstract:Background : Opioid Abuse and dependence are major health and social issues in most societies. Different interventions are available, but the majority of heroin patients relapse and these relapses are a substantial problem to their rehabilitation. Psychosocial interventions for drug addicts have been suggested as possible instruments to overcome the difficulty of maintaining a drug-free state. The aim of this paper is to provide a summary of the available evidence of effectiveness. Methods : We summarised the results from two systematic reviews on psychosocial interventions combined with Methadone Maintenance Treatment and Methadone or Buprenorphine Detoxification Treatment. Results: For detoxification treatments, the results show that benefits can be gained from adding any psychosocial treatment to any substitution detoxification treatment in terms of completion of treatment: relative risk (RR) 1.68 (95% CI 1.11-2.55), and compliance (proportion of clinical absences): RR 0.48 (95% CI 0.38-0.59); for the use of heroin during treatment, the differences were not statistically significant. For maintenance treatments, there is an additional benefit to be gained in adding any psychosocial treatment to methadone maintenance treatment in relation to the use of heroin during treatment: RR 0.69(95% CI 0.53-0.91); no statistically significant additional benefit was shown in terms of treatment retention and results at follow-up. Conclusions : Psychosocial treatments offered in addition to pharmacological detoxification treatments are effective in terms of completion of treatment and compliance, while adding any psychosocial support to methadone maintenance significantly improves the non-use of heroin during treatment but does not improve the other outcomes considered.
-
The Cochrane Library - Psychosocial treatment for Opiate Abuse and dependence
Cochrane Database of Systematic Reviews, 2005Co-Authors: Soraya Mayet, Michael Farrell, Marica Ferri, Laura Amato, Marina DavoliAbstract:Substance dependence is a social and public health problem; therefore it is a priority to develop effective treatments. Previous Cochrane reviews have explored the efficacy of pharmacotherapy for Opiate dependence. This current review focuses on the role of psychosocial interventions alone for the treatment of Opiate dependence. There is some evidence for the effectiveness of psychosocial interventions, but no systematic review has even been carried out. Objectives To assess the efficacy and acceptability of psychosocial interventions alone for treating Opiate use disorders. Randomised controlled trials comparing psychosocial interventions alone versus pharmacological interventions or placebo or non-intervention for treating opioid use disorders were undertaken. Data collection and analysis Two reviewers independently assessed trial quality and extracted data. Five trials involving 389 participants were included. These analysed Contingency Management, Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management, Cue Exposure therapy, Alternative Program for Methadone Maintenance Treatment Program Drop-outs (MMTP) and Enhanced Outreach-Counselling Program. All the treatments were studied against the control (standard) treatment; therefore it was not possible to identify which type of psychosocial therapy was most effective. Both Enhanced Outreach Counselling and Brief Reinforcement Based Intensive Outpatient Therapy coupled with Contingency Management had significantly better outcomes than standard therapy regarding relapse to opioid use, re-enrolment in treatment and retention in treatment. At 1-month and 3- month follow up the effects of Reinforcement Based Intensive Outpatient Therapy were not sustained. There was no further follow up of the Enhanced Outreach Counselling group. The Alternative Program for MMTP Drop-outs and the behavioural therapies of Cue Exposure and Contingency Management alone were no better than the control. As the studies were heterogeneous, it was not possible to pool the results and perform a meta-analysis.
-
psychosocial treatment for Opiate Abuse and dependence withdrawn review
2004Co-Authors: Soraya Mayet, Michael Farrell, Marica Ferri, Laura AmatoAbstract:The review has been withdrawn from publication because it is out of date and the authors are currently not available for updating it To view the published versions of this article, please click the 'Other versions' tab. Objective: To assess the efficacy and acceptability of psychosocial interventions alone for treating Opiate use disorders. Psychosocial interventions alone are offered to people with Opiate use disorders indiscriminately across countries; sometimes representing the most prevalent treatment after substitution therapy. Despite its wide use in clinical practice, no systematic review of effectiveness has ever been carried out. This review demonstrated that there was inadequate evidence available to prove the effectiveness of psychosocial interventions alone for the treatment of Opiate dependence or that they are superior to any other type of treatment.
Scott L Wexelblatt - One of the best experts on this subject based on the ideXlab platform.
-
universal maternal drug testing in a high prevalence region of prescription Opiate Abuse
The Journal of Pediatrics, 2015Co-Authors: Scott L Wexelblatt, Laura P Ward, Kimberly Torok, Elizabeth Tisdale, Jareen Meinzenderr, James M GreenbergAbstract:Objective To evaluate the efficacy of a universal maternal drug testing protocol for all mothers in a community hospital setting that experienced a 3-fold increase in neonatal abstinence syndrome (NAS) over the previous 5 years. Study design We conducted a retrospective cohort study between May 2012 and November 2013 after the implementation of universal maternal urine drug testing. All subjects with positive urine tests were reviewed to identify a history or suspicion of drug use, insufficient prenatal care, placental abruption, sexually transmitted disease, or admission from a justice center, which would have prompted urine testing using our previous risk-based screening guidelines. We also reviewed the records of infants born to mothers with a positive toxicology for opioids to determine whether admission to the special care nursery was required. Results Out of the 2956 maternal specimens, 159 (5.4%) positive results were recorded. Of these, 96 were positive for opioids, representing 3.2% of all maternity admissions. Nineteen of the 96 (20%) opioid-positive urine tests were recorded in mothers without screening risk factors. Seven of these 19 infants (37%) required admission to the special care nursery for worsening signs of NAS, and 1 of these 7 required pharmacologic treatment. Conclusion Universal maternal drug testing improves the identification of infants at risk for the development of NAS. Traditional screening methods underestimate in utero opioid exposure.