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1.
AUSTRALIA: Buprenorphine Diversion and Injecting an
Emerging Issue?
Addiction, 100 197-205, 2005
Although there is a great deal
of enthusiasm for the potential role of buprenorphine as an opiate medication to complement
methadone in the treatment of addiction. An article from Australia reminds us of
the significant misuse of the sublingual preparation of Buprenorphine, and the wide array of
adverse effects – including death – that can result.
Jenkinson RA et. Al. Buprenorphine diversion and injection in Melbourne, Australia: an emerging issue?
2.USA- NEW YORK CITY: The Dept. of Health Embraces Harm
Reduction in Helping Residents Quit Smoking
The Dept. of Health & Mental Hygiene has given out more
than 28,000 nicotine patches to city residents who want to quit smoking. The city is using
the 311 hotline for inquiries and has 45,000 kits available. This effort is an excellent
example of pragmatic harm reduction in general and replacement therapy in particular.
3.CANADA - EDMONTON: An Editorial Headlines Buprenorphine as a "New Hope for Heroin Addicts."
One can only hope that "it could, indeed, prove to be a wonder drug,"
but we must beware of false expectations. We know
from France and elsewhere that at least 25% of buprenorphine recipients use it by injection –
and there are estimates more than twice that proportion. Click for more.
4.IRAN:
A Just-Published Study Concludes "Harm Reduction" Programs Should Be Expanded
The study indicates that "harm reduction programs, which have just
begun in Iran, should be urgently expanded, particularly in correctional settings . . . " The article, entitled Prevalence of and factors associated with HIV-1 infection among drug users visiting treatment centers in Tehran appeared in AIDS, 2005, 19:709-716. Click for more .
5. CANADA- Abbotsford: The Never Ending Threat to Treatment and Harm Reduction - The Evidence Be Damned?
Abbotsford city councilors are contemplating a plan to ban safe injection sites,
methadone clinics and needle exchanges in their city, saying they don't think such
services are the best way to deal with drug addiction.
The Council voted unanimously to proceed with plans to amend a zoning bylaw to prohibit such
services. The plan would also prohibit facilities that produce or distribute marijuana for
medicinal purposes. Abbotsford is heading in the opposite direction of Vancouver... for more
6.SWITZERLAND: Methadone Treatment in Addicted Pregnant Women & Outcome of the Offspring
Two articles have just appeared from the Department of Obstetrics and
Gynecology and the Clinic of Neonatology of the distinguished Zurich University Hospital.
They purport to study the association between methadone treatment of addicted pregnant women and
the outcome of the offspring. For more.
7.USA- VERMONT: State Approves Mobile Methadone Clinics in Northeast Kingdom
Vermont has approved $1.3 million for a mobile methadone program. The clinics
will be the first mobile treatment program not only in Vermont, and perhaps in the country,
according to VT Dept. of Health. For more.
8.METHADONE DOSE: Start Low, Go Slow, Aim High
This general guideline has been recognized for decades as critical to safe
methadone maintenance treatment. Starting doses above 30-40 mg, and increments of more than 5-10mg
once or twice weekly, are known to be associated with risk of fatal overdose. The latest evidence:
a study of methadone patient deaths in Texas between 1994 and 2002 (Drug and Alc Dep 78
(2005), 73-81). One-quarter of the deaths occurred in the first week of treatment, among
patients with an average daily dose of 58mg.
9.METHADONE: Effect on QTc Interval
A just-published study of EKGs of methadone maintained patients concluded: "Our study suggests that methadone may prolong the QTc interval in specific subpopulations but poses little risk of serious prolongation." Cruiciani, Sekine et al. J Pain Symptom Management (2005 April; 29(4):385-391) |
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