Abstract：
BACKGROUND:Regional variation in pharmacy-dispensed naloxone rates could create access disparities that undermine the effectiveness of this approach. We explored individual and public health unit (PHU)-level determinants of regional variation in naloxone distribution through the Ontario Naloxone Program for Pharmacies. METHODS:We conducted a population-based study between April 1, 2017 and March 31, 2018. We calculated age- and sex-standardized pharmacy-dispensed naloxone rates for the 35 Ontario PHUs, and identified determinants of these rates using generalized estimating equations negative binomial regression. RESULTS:The age- and sex-standardized pharmacy-dispensed naloxone rate in Ontario was 5.5 (range 1.8-11.6) kits per 1000 population. Variables associated with higher naloxone dispensing rates included opioid use disorder history [rate ratio (RR) 2.27; 95% confidence interval (CI) 1.75-2.96], opioid agonist therapy (RR 11.17; 95% CI 7.15-17.44), and PHU opioid overdose rate (RR 1.09 per 10 deaths; 95% CI 1.06-1.13). Pharmacy-dispensed naloxone rates were lower in rural areas (RR 0.83; 95% CI 0.73-0.94) and among individuals dispensed one (RR 0.72; 95% CI 0.65-0.79), two to five (RR 0.67; 95% CI 0.54-0.84) or 6-10 (RR 0.92; 95% CI 0.74-1.14) opioids in the prior year relative to those receiving no opioids. CONCLUSION:Pharmacy-dispensed naloxone programs are important components of a public health response to the opioid overdose crisis. We found considerable variation in pharmacy-dispensed naloxone rates that could limit program effectiveness, particularly in rural settings with limited access to health and harm reduction services..
journal_name
Drug Alcohol Dependjournal_title
Drug and alcohol dependenceauthors
Antoniou T,McCormack D,Campbell T,Sutradhar R,Tadrous M,Lum-Wilson N,Leece P,Munro C,Gomes Tdoi
10.1016/j.drugalcdep.2020.108238subject
Has Abstractpub_date
2020-11-01 00:00:00pages
108238eissn
0376-8716issn
1879-0046pii
S0376-8716(20)30403-8journal_volume
216pub_type
杂志文章abstract：BACKGROUND:Illicit drug users account for the majority of cases of HCV infection in the developed world, but few have received treatment. METHODS:We evaluated barriers to initiating HCV treatment -- including general treatment willingness -- and factors associated with these among HCV infected illicit drug users. Part...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2007.09.008
更新日期：2008-01-11 00:00:00
abstract：BACKGROUND:The opioid epidemic is one of the greatest public health crises of our times, driven increasingly by synthetic opioids such as fentanyl in the heroin supply. The implementation of drug checking in community settings has the potential to reduce the burden of fatal overdose, provide harm reduction education ar...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2018.10.017
更新日期：2019-01-01 00:00:00
abstract：BACKGROUND:The opioid crisis has led to an increased number of pregnant opioid-dependent women receiving opioid-maintenance therapy (e.g. buprenorphine, BUP), but little is known about the consequences of gestational BUP exposure on pregnancy outcomes, maternal care, or offspring development. METHODS:Our translational...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2019.107625
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Heavy drinkers are at high risk for suicide attempt and suicide. Multiple factors, when examined in isolation, have been implicated in the risk of suicide attempt in this population. In this report, we present a comprehensive model of the 3-year risk of suicide attempt in heavy drinkers using a longitudinal ...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2018.01.010
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Drink-driving is a crime and traffic offences are a common cause of detention in police custody. Legal assessment of alcohol intoxication is based on breath or blood testing. We hypothesize that refusal of breath alcohol testing or inability to perform it can correspond to singular medical characteristics of...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2012.04.013
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2006.03.012
更新日期：2006-10-15 00:00:00
abstract：BACKGROUND:A cascade of care framework has been proposed to identify and address implementation gaps in addiction medicine. Using this framework, we characterized temporal trends in engagement in care for opioid use disorder (OUD) in Vancouver, Canada. METHODS:Using data from two cohorts of people who use drugs, we as...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2018.04.026
更新日期：2018-08-01 00:00:00
abstract：:Young injection drug users are at heightened risk for acquisition of blood-borne infections because of their high rates of unsafe injection behaviors, yet there has been little research examining the circumstances surrounding injection drug users' first injection experience ('hit'). We examined the relationship betwee...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2004.08.021
更新日期：2005-03-07 00:00:00
abstract：BACKGROUND:Research indicates that many adolescents frequently use multiple substances. This study examines stability and transitions in the use and co-use of multiple substances (cigarette, alcohol, marijuana, illicit drugs) from adolescence to young adulthood. METHODS:Data were collected biennially from 662 youth in...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2018.05.015
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Alcohol Use Disorder (AUD) is associated with problems with processing complex social scenarios. Little is known about the relationship between distinct AUD-related factors (e.g., years of problematic drinking), aspects of cognitive function and dysfunction in individuals diagnosed with AUD, and the relative...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2018.03.004
更新日期：2018-06-01 00:00:00
abstract：:The study proposes and tests an integrative and directional (structural equations) model to explain how pre-treatment motivation, frequency and content of counselling services, programme perceptions, and methadone dose are related to 1 and 6 months heroin use outcomes among opiate addicts receiving outpatient methadon...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章,多中心研究
doi：10.1016/s0376-8716(03)00067-x
更新日期：2003-07-20 00:00:00
abstract：BACKGROUND:Clock genes have been demonstrated to play a role in behavioral responses to a variety of drugs of abuse, including cocaine, amphetamine, morphine, and ethanol. However, no studies to date have examined the role of Clock genes on nicotine-mediated behaviors. We examined the involvement of Clock, one of sever...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2013.08.024
更新日期：2013-12-01 00:00:00
abstract：:We examine the association between education and smoking by women in the population, including smoking during pregnancy, and identify risk factors for smoking and the consequences of smoking in pregnancy for children's smoking and behavioral problems. Secondary analyses of four national data sets were implemented: The...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章,评审
doi：10.1016/j.drugalcdep.2008.12.005
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Kratom use in the West has increased recently, yet the prevalence and motives for use among individuals with a history of substance use disorder (SUD) have not been fully examined. Kratom has been documented as a means of treating chronic pain, mitigating drug dependence, and easing withdrawal symptoms, yet ...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2017.08.034
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND:Kratom (Mitragyna speciosa) preparations have been traditionally used in Southeast Asia for its medicinal properties. Lately, Kratom use has spread to Europe and the US, where abuse potential and health hazards increasingly emerge. This study is the first to measure systematically Kratom dependence, withdraw...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2014.03.017
更新日期：2014-06-01 00:00:00
abstract：BACKGROUND:Opioid-use disorder is associated with a high degree of co-abuse with benzodiazepines. While the mechanisms underlying the co-abuse of opioids and benzodiazepines remain unknown, α1 subunit-containing GABAA receptors may play a critical role in the reinforcing effects of benzodiazepine-type compounds, depend...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2020.108076
更新日期：2020-05-25 00:00:00
abstract：BACKGROUND:European Medicines Agency guidelines recognize two different treatment goals for alcohol dependence: abstinence and reduction in alcohol consumption. All currently approved agents are indicated for abstinence. This systematic review aimed to identify drugs in development for alcohol dependence treatment and ...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章,评审
doi：10.1016/j.drugalcdep.2013.04.025
更新日期：2013-11-01 00:00:00
abstract：AIMS:This study aimed at examining a possible association between cannabis use in adolescence and future disability pension (DP). DP can be granted to any person in Sweden aged 16-65 years if working capacity is judged to be permanently reduced due to long-standing illness or injury. METHODS:Data were obtained from a ...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2014.07.038
更新日期：2014-10-01 00:00:00
abstract：:The availability of increasingly sophisticated drug formulations and delivery devices has created new opportunities in drug development. These newer approaches can result in improved drug bioavailability, or they can alter key pharmacokinetic parameters in such a way as to decrease dosing interval, decrease variabilit...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2005.10.018
更新日期：2006-06-01 00:00:00
abstract：:In 1974 we started a follow-up of patients with different psychoactive substance use disorders (PSUD) according to DSM-III; 2082 cases out of 2127 were analyzed; 1370 patients had taken legal drugs (i.e. prescription drugs and/or over-the-counter drugs); 444 patients suffered from abuse or dependence of legal drugs al...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/0376-8716(92)90035-b
更新日期：1992-04-01 00:00:00
abstract：:This article reports recent findings from a program of experimental research examining the effects of adapting judicial supervision to the risk level of drug-abusing offenders. Prior studies revealed that high-risk participants with (1) antisocial personality disorder or (2) a history of drug abuse treatment performed...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.drugalcdep.2006.10.001
更新日期：2007-05-01 00:00:00
abstract：PURPOSE:This review characterizes empirically derived patterns of multiple (multi-) substance use among adolescents. A secondary objective was to examine the extent to which mental health symptomatology was included in the empirical analyses examining substance use patterns. METHODS:Eligible studies included those tha...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章,评审
doi：10.1016/j.drugalcdep.2020.108222
更新日期：2020-11-01 00:00:00
abstract：:The purpose of the present investigation was to examine the development of tolerance to the effects of morphine and other mu opioids in rats responding under a fixed-consecutive-number (FCN) schedule of food presentation. To this end, five rats were trained under an FCN schedule and subsequently tested with a variety ...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/s0376-8716(97)00039-2
更新日期：1997-06-06 00:00:00
abstract：BACKGROUND:The purpose of this study was to examine rates of traumatic events and PTSD in cocaine-dependent cases and a community comparison sample. METHODS:Participants were interviewed as part of the Family Study of Cocaine Dependence. A cross-sectional case-cohort design assessed a total of 918 participants: 459 co...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2010.05.012
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Despite calls for non-abstinence endpoints in randomized clinical trials (RCTs) for cocaine use disorder, there is a lack of data validating non-abstinence endpoints. We conducted a clinical validation of reduction in cocaine frequency level as a non-abstinence endpoint in RCTs for cocaine use disorder (CUD)...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2019.107648
更新日期：2019-12-01 00:00:00
abstract：:Tyrosine hydroxylase (TH) is the rate-limiting enzyme in catecholamine biosynthesis. Previously published results have established that chronic cocaine administration (30-45 mg/kg per day, 10-14 days) resulted in an upregulation of TH gene expression in dopaminergic pathways of rats. The present studies tested the eff...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/s0376-8716(00)00119-8
更新日期：2000-12-22 00:00:00
abstract：:Self-reported levels of alcohol consumption were recorded from residents of three areas in Britain with different official rates of drinking problems. Previous publications have shown minor area differences in the drinking habits of both sexes. The present analyses found no significant area differences for each sex in...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/0376-8716(88)90064-6
更新日期：1988-05-01 00:00:00
abstract：:Intranasal cocaine (COC) and oral ethanol (ETOH) were administered to one group of seven research volunteers during daily experimental sessions. Following the determination of baseline subjective and performance measures, an ETOH cocktail (0, 19.4, 38.7 or 58.1 g of ETOH in lemonade) was consumed over a 10-min period....
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/0376-8716(93)80001-u
更新日期：1993-04-01 00:00:00
abstract：BACKGROUND:Although marijuana is the most commonly used illicit substance in the US, only a small portion of users go on to develop dependence, suggesting that there are substantial individual differences in vulnerability to marijuana-related problems among users. Deficits in working memory and high trait impulsivity a...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章
doi：10.1016/j.drugalcdep.2012.12.016
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:Cocaine addiction continues to be a significant healthcare issue, yet there are no FDA approved medications for the treatment of cocaine use disorder within the United States. METHODS:This 12-week, prospective, double-blind, randomized, placebo-controlled study examined the effectiveness of quetiapine (Sero...
journal_title：Drug and alcohol dependence
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.drugalcdep.2014.12.037
更新日期：2015-04-01 00:00:00
