Alcohol Use among Persons on Methadone Treatment
NEW PAPER OUT NOW
Limited evidence that alcohol causes mortality among persons on methadone treatment
What is the study about?
· We wanted to find out whether alcohol causes deaths among persons on methadone treatment
QUICK FACT:
Current evidence is mixed about the negative impact of alcohol on deaths among persons on methadone treatment.
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| photocredit: addictiondisorders |
How was the study done?
· We looked at how, how many, and what types of people in methadone treatment in the Vancouver Injection Drug Users Study (VIDUS) died because of alcohol.
What did the study find?
140 (of the 1139 included) participants died during follow-up, and 21 died due to overdose
85 reported heavy drinking at baseline
heavy drinking and mortality were not related, regardless of whether they were on methadone treatment
85 reported heavy drinking at baseline
heavy drinking and mortality were not related, regardless of whether they were on methadone treatment
Alcohol could possibly contribute to deaths among persons on methadone treatment but it did not so in this study.
Why is the study important?
• Methadone is effective in treating heroin addiction, but many people taking it also drink excessively. One common complication in this treatment is hepatitis C infection. Together with alcohol, it affects liver negatively
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Reference: Klimas, J., Dong, H., Dobrer, S., Milloy, M-J, Kerr, T., Wood, E., Hayashi, K. (2016) Alcohol Use among Persons on Methadone Treatment. Addictive Disorders& Their Treatment In Press
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Changing the ways of CPDD – College on Problems of Drug Dependence – June 12-16, #CPDD2016
Change is the ultimate law of life. Those that do not change and adapt, do not survive. In the life of scientific meetings, this means constantly improving the organisation of the events and tailoring them to the changing needs of the conference delegates. This year, the annual meeting of the College on Problems of Drug Dependence (CPDD) introduced several improvements and more are on the way in next years.
 photocredit: cpdd.org |
Bye Bye Tote Bags
Many of us were used to the traditional design of the CPDD tote bags. Each year had a different colour. For years when conference visited a warm region, such as Phoenix, AR, the tote bag included a special layer for keeping the contents cool. The non-bag policy brought the desired recognition of sustainability and (un-)expected diversity among the conference bags – everyone was different.
Bye Bye Printed Programs
For years, the conference book was a comprehensive bible for the conference week. Everybody read it and most followed it. Although the College printed a limited number of copies, this year, the e-programs drained participants smartphones’ batteries. What more, they offered note-taking and photograph uploading that many appreciated. Welcome to the digital age.
Hello Mentors
Since the early days, the senior delegates offered mentorship to junior delegates. Mostly informal. Following the new trends adopted at other conferences, such as AHSR or NAPCRG, the CPDD sent out emails to all Members in Training (MIT), offering to match them with a potential mentor (mentor bios included). If both parties agreed, the match-maker introduced them via email. I have learned a lot from my mentor. Especially that the decision makers may not read addiction journals, also that the team identity strengthens sense of ownership among team members and that the road to the research success can be long and winding. Let’s hope that the beneficial mentoring program continues in future.
Hello Shorter Conference
With the increasing demands on scientists’ workloads, there is a chance that the upcoming conferences will be shorter.
See also my previous blog posts about CPDD from the previous years:
2015: Getting the most out of the Conference of the College on Problems of Drugs Dependence #CPDD2015
2014: 76th Annual Conference of College on Problems of Drug Dependence: Decide to be fearless& fabulous
2013: My itinerary for the Conference – College on Problems of Drug Dependence, San Diego, June 15-20
Need more skilled addiction specialists? New paper out now
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| photocredit: Wolters Kluwer |
Training in addiction medicine gives clinicians early intervention tools, prevents the escalation of addiction and prevents costly and lengthy treatment. The problem is that very little information exists on the treatment workforce. It seems that most health systems do not have enough providers trained in addiction medicine to reduce the public health consequences of this increasing societal problem. In 2014, the Boston-based Advocates for Human Potential, Inc., developed a so-called Provider Availability Index. It measures the gap between the need for and availability of trained healthcare providers, but similar efforts have not been done in Canadian setting. This paper briefly describes mathematical estimates of the number of skilled addiction care providers in British Columbia, Canada, and offers recommendations for steps that can be taken immediately to increase provider availability. The article was published ahead of print in the Journal of Addiction Medicine on May 13, 2016 and the suggested citation is:
McEachern, J., Ahamad, K., Nolan, S., Mead, A., Wood, E., & Klimas, J. (9000). A needs assessment of the number of comprehensive addiction care physicians required in a canadian setting. J Addict Med, Publish Ahead of Print. doi:10.1097/adm.0000000000000230
New article out now: Time to confront the iatrogenic opioid addiction
The Medical Post
May 2, 2016
OPINION by: JAN KLIMAS
Time to confront iatrogenic opioid addiction
Canada has been grappling for decades in a largely ineffective attempt to keep heroin out of our borders. Now the unsafe prescribing of opioids has organized crime groups turning their attention to ‘customers’ whose addiction started in the doctor’s office.
Physicians are going to have to face the tough conversations that involve two of the hardest words in a doctor’s vocabulary: ‘enough’ and ‘no.
The full article is now online, and has appeared in the Doctor Daily e-newsletter on Monday, May 2, 2016.
New study out now: Replacing heroin with alcohol upon entry to methadone?
April 4: Methadone is a medication used in treatment of people with dependence from heroin or other opioids. Many people who take it drink too much alcohol. We don’t know whether it’s because or in spite of taking this medication. We wanted to know the impact of enrolment in methadone treatment on the onset of heavy drinking among people who use heroin.
| photocredit: karger.com/EAR |
Our approach: We analysed information from thousands of interviews from long-term, community-based studies of people who inject drugs in Vancouver, Canada, between December 1, 2005 and May 31, 2014.
What have we found: In total, 357 people who use heroin were included in this study. Of these, 58% enrolled in methadone at some point between 2005-2014, and 32% reported starting to drink heavily. Those who started the treatment said they drank less compared to those who did not start it. It didn’t even make them start drinking faster than those who did not start taking methadone. People who started drinking heavily when they enrolled in methadone were younger than those who did not start drinking heavily. They also used more cannabis.
What does this mean: It is clear that many people in the methadone treatment have problems with alcohol. It seems that they do not drink because they take this medication which may even appear to decrease the initiation of heavy drinking. Our findings suggest younger age and cannabis use may predict heavy drinking. These findings could help inform on-going discussions about the effects of opioid agonist therapy on alcohol consumption among people who use heroin.
This blog is based on article was Accepted for publication in the European Addiction Research Journal on January 31, 2016. The full title of the article is: The Impact of Enrolment in Methadone Maintenance Therapy on Initiation of Heavy Drinking among People who Use Heroin. The authors of the article are following:
Jan Klimas
Evan Wood
Paul Nguyen
Huiru Dong
M-J Milloy
Thomas Kerr
Kanna Hayashi