Abstract:
:Whilst unsupervised injectable methadone and diamorphine treatment has been part of the British treatment system for decades, the numbers receiving injectable opioid treatment (IOT) has been steadily diminishing in recent years. In contrast, there has been a recent expansion of supervised injectable diamorphine programs under trial conditions in a number of European and North American cities, although the evidence regarding the safety, efficacy and cost effectiveness of this treatment approach remains equivocal. Recent British clinical guidance indicates that IOT should be a second-line treatment for those patients in high-quality oral methadone treatment who continue to regularly inject heroin, and that treatment be initiated in newly-developed supervised injecting clinics. The Randomised Injectable Opioid Treatment Trial (RIOTT) is a multisite, prospective open-label randomised controlled trial (RCT) examining the role of treatment with injected opioids (methadone and heroin) for the management of heroin dependence in patients not responding to conventional substitution treatment. Specifically, the study examines whether efforts should be made to optimise methadone treatment for such patients (e.g. regular attendance, supervised dosing, high oral doses, access to psychosocial services), or whether such patients should be treated with injected methadone or heroin. Eligible patients (in oral substitution treatment and injecting illicit heroin on a regular basis) are randomised to one of three conditions: (1) optimized oral methadone treatment (Control group); (2) injected methadone treatment; or (3) injected heroin treatment (with access to oral methadone doses). Subjects are followed up for 6-months, with between-group comparisons on an intention-to-treat basis across a range of outcome measures. The primary outcome is the proportion of patients who discontinue regular illicit heroin use (operationalised as providing >50% urine drug screens negative for markers of illicit heroin in months 4 to 6). Secondary outcomes include measures of other drug use, injecting practices, health and psychosocial functioning, criminal activity, patient satisfaction and incremental cost effectiveness. The study aims to recruit 150 subjects, with 50 patients per group, and is to be conducted in supervised injecting clinics across England.
journal_name
Harm Reduct Jjournal_title
Harm reduction journalauthors
Lintzeris N,Strang J,Metrebian N,Byford S,Hallam C,Lee S,Zador D,RIOTT Group.doi
10.1186/1477-7517-3-28subject
Has Abstractpub_date
2006-09-27 00:00:00pages
28issn
1477-7517pii
1477-7517-3-28journal_volume
3pub_type
杂志文章abstract:BACKGROUND:Treatment of hepatitis C (HCV) among people who inject drugs (PWID) is a critical component of efforts to eliminate viral hepatitis. A recent study found high HCV prevalence among PWID in two cities, Pretoria (84%) and Cape Town (44%). Very few (< 5%) HCV-infected individuals attended follow-up appointments....
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00382-3
更新日期:2020-06-10 00:00:00
abstract:BACKGROUND:Health services globally are struggling to manage the impact of COVID-19. The existing global disease burden related to opioid use is significant. Particularly challenging groups include older drug users who are more vulnerable to the effects of COVID-19. Increasing access to safe and effective opioid agonis...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00394-z
更新日期:2020-07-17 00:00:00
abstract:BACKGROUND:During the 1990s, the New York Police Department (NYPD) greatly expanded arrests for smoking marijuana in public view (MPV). By 2000, MPV accounted for 15% of all arrests. The NYPD's supporters report this arrest activity is just part of quality-of-life (QOL) policing, which seeks to promote order in public ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-3-22
更新日期:2006-08-04 00:00:00
abstract:BACKGROUND:Injection drug use is on the rise in the USA, and skin and soft tissue infections (SSTI) are a common complication, resulting in significant morbidity and mortality. Due to structural barriers to care-seeking, many people who inject drugs avoid formal care and resort to self-care techniques, but little is kn...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0345-z
更新日期:2019-12-12 00:00:00
abstract:BACKGROUND:Due to the high prevalence of mental disorders among people with opioid use disorder, the objective of this study was to determine the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment in Ontario, Canada. METHOD...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00396-x
更新日期:2020-07-23 00:00:00
abstract:BACKGROUND:Smoking cessation treatment service is concerned to be a critical element in methadone maintenance treatment (MMT) in order to diminish the effect of smoke on health outcomes. To implement the smoking cessation services in Vietnam, we examined the stages of change to quit and determined associated factors am...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-015-0085-7
更新日期:2015-10-30 00:00:00
abstract:BACKGROUND:We utilized multiple recruitment approaches to recruit IDUs in a longitudinal cohort study to examine HIV incidence and behavior change pre- and post-introduction of comprehensive HIV prevention services. METHODS:IDUs were recruited through peer referral, targeted outreach by outreach workers (ORWs) and as ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-16
更新日期:2013-09-25 00:00:00
abstract:BACKGROUND:We have recently published some work on CEA levels in hookah (also called narghile, shisha elsewhere) and cigarette smokers. Hookah smokers had higher levels of CEA than non-smokers although mean levels were low compared to cigarette smokers. However some of them were also users of other tobacco products (ci...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-5-19
更新日期:2008-05-24 00:00:00
abstract:BACKGROUND:There are few studies of mortality amongst people who inject drugs (PWID) in Australia. In this study, we estimate mortality in a cohort of PWID in Melbourne and examine predictors of mortality including health service use, demographic characteristics, drug use and personal wellbeing. FINDINGS:We linked ide...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-015-0089-3
更新日期:2015-12-09 00:00:00
abstract:BACKGROUND:The hepatitis C virus (HCV) is a major cause of drug-related morbidity and mortality, with incidence data implicating a wide range of HCV transmission risk practices. The Blood-Borne Virus Transmission Risk Assessment Questionnaire (BBV-TRAQ) is a content valid instrument that comprehensively assesses HCV ri...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-5-12
更新日期:2008-04-23 00:00:00
abstract:BACKGROUND:In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are well-positioned to administer naloxone and prevent overdose death. METHODS:We conducted key informa...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0352-0
更新日期:2020-01-09 00:00:00
abstract::Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs) must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-7-1
更新日期:2010-01-04 00:00:00
abstract:BACKGROUND:Condom provision is one of the most effective harm reduction interventions to control sexually transmitted infections (STIs) including HIV/AIDS and viral hepatitis in prisons. Yet, very few countries around the world provide prisoners with condoms. The present study aimed to elucidate principles of effective...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-021-00462-y
更新日期:2021-01-28 00:00:00
abstract:BACKGROUND:Gambling has quickly emerged as an important global public health issue. With new technologies used to develop high intensity gambling products and promotions aimed at driving consumption, public health organisations and researchers, community groups, and politicians have argued for a range of regulatory and...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-017-0173-y
更新日期:2017-07-25 00:00:00
abstract:BACKGROUND:Patients with substance use disorders grow older thanks to effective treatments. Together with a high prevalence of comorbidities, psychological problems, and low social support, these patients are at high risk for medication non-adherence. Established treatment facilities face challenges to accommodate thes...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-017-0182-x
更新日期:2017-08-16 00:00:00
abstract:BACKGROUND:The growing HIV epidemic in Eastern Europe and Central Asia has been driven by high rates of injection drug use. The Republic of Georgia has among the highest injection drug use rates globally, with a prevalence of 2.24%. The reach of evidence-based HIV prevention interventions like needle and syringe progra...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0292-8
更新日期:2019-03-21 00:00:00
abstract:BACKGROUND:People who smoke crack cocaine experience a wide variety of health-related issues. However, public health programming designed for this population is limited, particularly in comparison with programming for people who inject drugs. Canadian best practice recommendations encourage needle and syringe programs ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-017-0144-3
更新日期:2017-05-12 00:00:00
abstract:BACKGROUND:To examine the predictors of continued drug- and sex-related HIV-risk behaviors among drug users in methadone maintenance therapy (MMT) programs in China. METHODS:We followed a sample of 5,035 drug users enrolled for the first time in MMT programs at baseline, 6 months, and 12 months utilizing a longitudina...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-23
更新日期:2013-10-10 00:00:00
abstract:BACKGROUND:Illicit drug users have a high prevalence of HCV and represent the majority of newly infected persons in the U.S. Despite the availability of effective HCV treatment, few drug users have been evaluated or treated for HCV. Racial and ethnic minorities have a higher incidence and prevalence of HCV and higher H...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-10
更新日期:2013-06-20 00:00:00
abstract:BACKGROUND:Patients with opioid use disorder (OUD) frequently present to the emergency department for acute treatment of overdose and withdrawal. CASE PRESENTATION:A 29-year-old male presented to the emergency room after intravenous heroin use followed by accidental ingestion of naltrexone. He was treated with bupreno...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00417-9
更新日期:2020-10-07 00:00:00
abstract:BACKGROUND:New, more effective and better-tolerated therapies for hepatitis C (HCV) have made the elimination of HCV a feasible objective. However, for this to be achieved, it is necessary to have a detailed understanding of HCV epidemiology in people who inject drugs (PWID). Respondent-driven sampling (RDS) can provid...
journal_title:Harm reduction journal
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12954-017-0172-z
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:In Cambodia, HIV prevalence among female entertainment and sex workers (FESW) is up to twenty times higher than in the general population. Use of amphetamine-type stimulants (ATS) has been associated with increased risk of HIV and other sexually transmitted infections in key populations, including FESW. Whil...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-015-0068-8
更新日期:2015-10-16 00:00:00
abstract::With a worldwide prevalence of 15.4%, hepatitis C virus (HCV) has been estimated to be the most prevalent major infectious disease in prisons. The exceptionally high prevalence of HCV in prisons is attributable to common risk behaviors including sharing contaminated tattooing equipment and drug paraphernalia, as well ...
journal_title:Harm reduction journal
pub_type: 信件
doi:10.1186/s12954-020-00379-y
更新日期:2020-05-24 00:00:00
abstract::Young people aged 15-24 years account for fifty percent of all new AIDS cases worldwide. Moreover, half of all new HIV infections are associated with injection drug use. The average age for initiation into injecting drug use is 20 years of age. This paper investigates whether HIV prevention programs have reduced risk ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-2-5
更新日期:2005-03-17 00:00:00
abstract:BACKGROUND:This study aimed to investigate the development of opioid tolerance in patients receiving long-term methadone maintenance treatment (MMT). METHODS:A region-wide cross-sectional study was performed focusing on dosage and duration of treatment. Differences between racemic methadone and levomethadone were exam...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-016-0095-0
更新日期:2016-02-16 00:00:00
abstract::A decade of research in Switzerland, The Netherlands, Germany, and Spain now constitutes a massive body of work supporting the use of heroin treatment for the most difficult patients addicted to opiates. These trials concur on this method's safety and efficacy and are now serving as a prelude to the institution of her...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-3-16
更新日期:2006-05-02 00:00:00
abstract:: In their commentary, Dar and Frenk call into question the validity of all published data that describe the onset of nicotine addiction. They argue that the data that describe the early onset of nicotine addiction is so different from the conventional wisdom that it is irrelevant. In this rebuttal, the author argues t...
journal_title:Harm reduction journal
pub_type: 社论
doi:10.1186/1477-7517-7-26
更新日期:2010-11-04 00:00:00
abstract:AIMS:To identify geographic "hotspots" for potential transmission of HIV and HCV and for drug overdose among persons who use heroin and cocaine in New York City and to examine historical continuities in problem drug use hotspots in the city. METHODS:A total of 2714 study participants were recruited among persons enter...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0326-2
更新日期:2019-09-02 00:00:00
abstract:BACKGROUND:There is paucity of data on the smoking habits of rural populations in developing countries. This study aimed to explore cigarette smoking practices of a rural community in Ethiopia. METHODS:A community based cross-sectional study was conducted among 548 individuals from a random sample of households in a r...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-10-28
更新日期:2013-10-31 00:00:00
abstract:: For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HI...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-9-23
更新日期:2012-07-09 00:00:00