Literature DB >> 26135571

Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction†.

John Strang1, Teodora Groshkova2, Ambros Uchtenhagen2, Wim van den Brink2, Christian Haasen2, Martin T Schechter2, Nick Lintzeris2, James Bell2, Alessandro Pirona2, Eugenia Oviedo-Joekes2, Roland Simon2, Nicola Metrebian2.   

Abstract

BACKGROUND: Supervised injectable heroin (SIH) treatment has emerged over the past 15 years as an intensive treatment for entrenched heroin users who have not responded to standard treatments such as oral methadone maintenance treatment (MMT) or residential rehabilitation. AIMS: To synthesise published findings for treatment with SIH for refractory heroin-dependence through systematic review and meta-analysis, and to examine the political and scientific response to these findings.
METHOD: Randomised controlled trials (RCTs) of SIH treatment were identified through database searching, and random effects pooled efficacy was estimated for SIH treatment. Methodological quality was assessed according to criteria set out by the Cochrane Collaboration.
RESULTS: Six RCTs met the inclusion criteria for analysis. Across the trials, SIH treatment improved treatment outcome, i.e. greater reduction in the use of illicit 'street' heroin in patients receiving SIH treatment compared with control groups (most often receiving MMT).
CONCLUSIONS: SIH is found to be an effective way of treating heroin dependence refractory to standard treatment. SIH may be less safe than MMT and therefore requires more clinical attention to manage greater safety issues. This intensive intervention is for a patient population previously considered unresponsive to treatment. Inclusion of this low-volume, high-intensity treatment can now improve the impact of comprehensive healthcare provision. © The Royal College of Psychiatrists 2015.

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Year:  2015        PMID: 26135571     DOI: 10.1192/bjp.bp.114.149195

Source DB:  PubMed          Journal:  Br J Psychiatry        ISSN: 0007-1250            Impact factor:   9.319


  46 in total

Review 1.  Supervised Injectable Opioid Treatment for the Management of Opioid Dependence.

Authors:  James Bell; Vendula Belackova; Nicholas Lintzeris
Journal:  Drugs       Date:  2018-09       Impact factor: 9.546

2.  Clinical guideline for homeless and vulnerably housed people, and people with lived homelessness experience.

Authors:  Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell
Journal:  CMAJ       Date:  2020-03-09       Impact factor: 8.262

3. 

Authors:  Kevin Pottie; Claire E Kendall; Tim Aubry; Olivia Magwood; Anne Andermann; Ginetta Salvalaggio; David Ponka; Gary Bloch; Vanessa Brcic; Eric Agbata; Kednapa Thavorn; Terry Hannigan; Andrew Bond; Susan Crouse; Ritika Goel; Esther Shoemaker; Jean Zhuo Jing Wang; Sebastian Mott; Harneel Kaur; Christine Mathew; Syeda Shanza Hashmi; Ammar Saad; Thomas Piggott; Neil Arya; Nicole Kozloff; Michaela Beder; Dale Guenter; Wendy Muckle; Stephen Hwang; Vicky Stergiopoulos; Peter Tugwell
Journal:  CMAJ       Date:  2020-10-13       Impact factor: 8.262

4.  Injectable opioid agonist treatment for opioid use disorder: a national clinical guideline.

Authors:  Nadia Fairbairn; Josey Ross; Michael Trew; Karine Meador; Jeff Turnbull; Scott MacDonald; Eugenia Oviedo-Joekes; Bernard Le Foll; Marie-Ève Goyer; Michel Perreault; Christy Sutherland
Journal:  CMAJ       Date:  2019-09-23       Impact factor: 8.262

5.  Federal Barriers to Addressing the Opioid Epidemic.

Authors:  Robert A Kleinman; Nathaniel P Morris
Journal:  J Gen Intern Med       Date:  2020-02-19       Impact factor: 5.128

Review 6.  Opioid use disorder.

Authors:  John Strang; Nora D Volkow; Louisa Degenhardt; Matthew Hickman; Kimberly Johnson; George F Koob; Brandon D L Marshall; Mark Tyndall; Sharon L Walsh
Journal:  Nat Rev Dis Primers       Date:  2020-01-09       Impact factor: 52.329

7.  Heroin overdose resuscitation with naloxone: patient uses own prescribed supply to save the life of a peer.

Authors:  Ian Winston; Rebecca McDonald; Basak Tas; John Strang
Journal:  BMJ Case Rep       Date:  2015-09-14

8.  A Low-Barrier and Comprehensive Community-Based Harm-Reduction Site in Vancouver, Canada.

Authors:  Michelle Olding; Andrew Ivsins; Samara Mayer; Alex Betsos; Jade Boyd; Christy Sutherland; Coco Culbertson; Thomas Kerr; Ryan McNeil
Journal:  Am J Public Health       Date:  2020-04-16       Impact factor: 9.308

9.  Supervised injectable opioid agonist therapy in a supported housing setting for the treatment of severe opioid use disorder.

Authors:  Rupinder Brar; Christy Sutherland; Seonaid Nolan
Journal:  BMJ Case Rep       Date:  2019-08-01

10.  Income generation and attitudes towards addiction treatment among people who use illicit drugs in a Canadian setting.

Authors:  Nicole M Luongo; Huiru Dong; Thomas H Kerr; M-J S Milloy; Kanna Hayashi; Lindsey A Richardson
Journal:  Addict Behav       Date:  2016-08-31       Impact factor: 3.913

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