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. METHODS:We conducted a retrospective cohort study of patients enrolled in opioid agonist treatment between January 1, 2011, and December 31, 2015. Patients were stratified into two groups: those diagnosed with concurrent mental disorders and opioid use disorder and those with opioid use disorder only, using data from the Ontario Health Insurance Plan Database, Ontario Drug Benefit Plan Database. The primary outcome studied was all-cause mortality using data from the Registered Persons Database. Emergency department visits from the National Ambulatory Care Database, hospitalizations Discharge Abstract Database, and continuous retention in treatment, defined as 1 year of uninterrupted opioid agonist treatment using data from the Ontario Drug Benefit Plan Database were measured as secondary outcomes. Encrypted patient identifiers were used to link information across databases. RESULTS:We identified 55,924 individuals enrolled in opioid agonist treatment, and 87% had a concurrent mental disorder diagnosis during this period. We observed that having a mental disorder was associated with an increased likelihood of all-cause mortality (odds ratio (OR) 1.4; 95% confidence interval (CI) 1.2-1.5). For patients diagnosed with mental disorders, the estimated rate of ED visits per year was 2.25 times higher and estimated rate of hospitalization per year was 1.67 times higher than for patients with no mental disorders. However, there was no association between having a diagnosis of a mental disorder and 1-year treatment retention in OAT-adjusted hazard ratio (HR) = 1.0; 95% CI 0.9 to 1.1. CONCLUSION:Our findings highlight the consequences of the high prevalence of mental disorders for individuals with opioid use disorder in Ontario, Canada.
journal_name
Harm Reduct Jjournal_title
Harm reduction journalauthors
Morin KA,Eibl JK,Gauthier G,Rush B,Mushquash C,Lightfoot NE,Marsh DCdoi
10.1186/s12954-020-00396-xsubject
Has Abstractpub_date
2020-07-23 00:00:00pages
51issue
1issn
1477-7517pii
10.1186/s12954-020-00396-xjournal_volume
17pub_type
杂志文章abstract:OBJECTIVES:This study explored the relationship between product trials and consumer demand for alternative nicotine products (ANP). METHODS:An experimental auction was conducted with 258 adult smokers, wherein participants were randomly assigned to one of four experimental conditions. The participants received the opp...
journal_title:Harm reduction journal
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12954-015-0052-3
更新日期:2015-06-11 00:00:00
abstract::Substance-using women who exchange sex for money, drugs or shelter as a means of basic subsistence (ie. survival sex) have remained largely at the periphery of HIV and harm reduction policies and services across Canadian cities. This is notwithstanding global evidence of the multiple harms faced by this population, in...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-4-20
更新日期:2007-12-08 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: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:Prevalence of HIV infection among people who inject drugs (PWID) has been reported to be higher than that of the general population. The present study aimed to estimate the prevalence of HIV infection and associated risk factors among PWID in Dar es Salaam, Tanzania, following the introduction of a comprehen...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00364-5
更新日期:2020-03-24 00:00:00
abstract:BACKGROUND:The current illicit drug overdose crisis within North America and other countries requires expanded and new responses to address unpredictable and potentially lethal substances, including fentanyl analogues, in the unregulated drug market. Community-wide drug checking is being increasingly explored as one su...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00373-4
更新日期:2020-05-12 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:Smoking is endemic amongst people accessing homeless services, and they are disproportionately affected by smoking-related diseases. This paper reports on the results of a 3-month small scale intervention which explored the efficacy, challenges and opportunities of using electronic nicotine delivery systems ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00406-y
更新日期:2020-10-12 00:00:00
abstract:BACKGROUND:The HIV epidemic among people who inject drugs (PWID) in Russia continues to spread. This exploratory study examines how HIV-prevention measures are perceived and experienced by PWID in the northwestern region of Russia. METHODS:Purposive sampling was used to obtain a variety of cases that could reflect pos...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-017-0162-1
更新日期:2017-06-05 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:Stigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-016-0127-9
更新日期:2017-01-06 00:00:00
abstract:BACKGROUND:Options for opioid agonist therapy (OAT) are expanding with the development of prolonged-release (also known as extended-release) 1-week, 1-month, and 6-month formulations of buprenorphine. There is an assumption that patients will welcome these new treatments and medication adherence will correspondingly in...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-019-0296-4
更新日期:2019-04-03 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:INTRODUCTION:In 2008, one of the oldest fixed site needle exchanges in a large urban city in Canada was closed due to community pressure. This service had been in existence for over 20 years. CASE DESCRIPTION:This case study focuses on the consequences of the switch to mobile needle exchange services immediately after...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-7-11
更新日期:2010-05-25 00:00:00
abstract:AIM:Evidence is emerging that prescription opioid (PO) injection is associated with increased health risks. This mixed-methods study compares the mechanics of PO and heroin injection and examines the demographic and drug-related correlates of lifetime PO injection in a sample of young people who inject drugs (PWID) in ...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00367-2
更新日期:2020-03-30 00:00:00
abstract:OBJECTIVES:The COVID-19 pandemic led to the closure of the IDEA syringe services program medical student-run free clinic in Miami, Florida. In an effort to continue to serve the community of people who inject drugs and practice compassionate and non-judgmental care, the students transitioned the clinic to a model of Te...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-020-00438-4
更新日期:2020-11-17 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::Harm reduction is a controversial model for treating drug users, with little formal research available on its operation and effectiveness. In order to advance the field, we first conducted participatory research of harm reduction with 120 clients using nominal-group technique to develop culturally relevant outcomes to...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-1-7
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Recovery from substance use disorder (SUD) is often considered at odds with harm reduction strategies. More recently, harm reduction has been categorized as both a pathway to recovery and a series of services to reduce the harmful consequences of substance use. Peer recovery support services (PRSS) are effec...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/s12954-018-0258-2
更新日期:2018-10-22 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:UNLABELLED:This qualitative study of travel-related risk behaviours of Slovene injection drug users was based on interviews with individuals enrolled in drug addiction treatment programmes run by three regional centres for prevention and treatment of drug addiction. The primary objective of the study was to analyse beh...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-8-8
更新日期:2011-04-17 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: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: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: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::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:In some countries, "Big Events" like crises and transitions have been followed by large increases in drug use, drug injection and HIV/AIDS. Argentina experienced an economic crisis and political transition in 2001/2002 that affected how people use their time. This paper studies how time use changes between y...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-8-2
更新日期:2011-01-20 00:00:00
abstract::BACKGROUND: Harm reduction is a relatively new and controversial model for treating drug users, with little formal research on its operation and effectiveness. In order to advance the study of harm reduction programs and our understanding of how drug users define their progress, qualitative research was conducted to d...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-1-8
更新日期:2004-08-26 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 AND RATIONALE:The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk f...
journal_title:Harm reduction journal
pub_type: 杂志文章
doi:10.1186/1477-7517-9-27
更新日期:2012-07-09 00:00:00