Category: Addiction
Posts by Jano Klimas about addiction and substance use disorders, including epidemiology, prevention, education, assessment and treatment.
Does this opioid naïve patient really need potent opioids? Think twice
Think Twice, exercise caution and generally avoid making assumptions about patient risk of subsequent prescription opioid use disorder, write authors of a recent editorial.
A worker in his 30’s had a “fall at work three weeks ago and has presented describing excruciating persistent back pain. An MRI scan of his spine has been normal. He has tried physiotherapy and non-steroidal anti-inflammatories for pain, but he reports persistent pain particularly when trying to work. (more…)
Moving on: helping young people
In this Insight article Gemma Turner, Cobh Community Based Drugs Worker, provides a brief history of the project while Jano Klimas gives a sense of the impact of the youth initiative from the evaluation in 2009.
Expanding opioid agonist therapy while learning from HIV/AIDS
This post elaborates on the ideas from a recent freely-available commentary published in the journal Addiction.
Accessing opioid agonist therapy (OAT) and maintaining good adherence faces many barriers which can be geographical, financial, regulatory, situational or logistic. In some settings, lack of services hinders access to treatment for people living with opioid use disorder (OUD). In other settings—even where health‐care and medications are provided free of charge—many people who have OUD do not seek OAT. In the United States, recent ‘estimates suggest a gap between treatment need and capacity of 1.4 and 1.3 million in 2012, respectively’ [4]. The ongoing epidemic of OUD needs to develop strategies to recruit and keep patients on OAT.
Finding good endpoints for diagnostic test accuracy reviews on substance use
Diagnostic test accuracy reviews increasingly are being used in substance use research, yet the majority of the studies considered in these reviews do not account appropriately for the primary endpoints of interest. (more…)
Irish Canadian project highlights global issue
This toolkit is based on a study that aimed to establish the feasibility and accessibility of training primary care practitioners in addiction medicine.
In particular how international models of addiction medicine training might inform the future of development of General Practice education in Ireland.
The study had three phases: in the first phase we conducted a literature review, the second phase assessed needs in both systems. And in the third phase we explored the feasibility of the education.