Category: Overdose

General practice is a key route for distribution of naloxone in the community

Naloxone
Naloxone is an antidote to opioid overdose also known as Narcan.

Irish family doctors in training want Narcan to be more available and want to distribute it.    

We poled 136 Irish family doctors attending a training conference. They were in their third and final years of residency.

photocredit: oxywatchdog.com

We found that trainees have real experience of the problem at an early phase of their careers, and
trainees are conscious of the needs of people with opioid use disorders and the potential of family medicine to meet these needs, but trainees receive little structured preparation for this role.

Irish family doctors in training are keen to distribute Naloxone in the community.

More people die in Ireland due to opioid overdoses than in car accidents.
Naloxone can save lives. Ireland has approximately 640 doctors in specialist training for family medicine at any time. Although 60% of them have administered Naloxone to a person in overdose, only 13% of their training clinics prescribe methadone to people with opioid use disorders.

Reference:
Klimas, J., Tobin, H., Egan, M., Barry, T., Bury, G. (2016) General Practice – a key route for distribution of naloxone in the community. Experience, interest and training needs in Ireland. J Int Drug Policy, 38:1-3

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.

cpdd logo

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:

2015Getting 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 

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

Irish doctors trained to save by the nose

Can junior doctors learn to spray a life-saving medication into noses of people who overdosed on opioids? A new study from Ireland attempted to answer the question.

Overdose is the most common cause of fatalities among opioid users. Naloxone is a life-saving medication for reversing opioid overdose. In Ireland, it is currently available to ambulance and emergency care services, but General Practitioners (GP) are in regular contact with opioid users and their families. This positions them to provide naloxone themselves or to instruct patients how to use it. The new Clinical Practice Guidelines of the Pre-hospital Emergency Care Council of Ireland allows trained bystanders to administer intranasal naloxone.

We describe the development and process evaluation of an educational intervention, designed to help GP trainees identify and manage opioid overdose with intranasal naloxone.

Participants (N = 23) from one postgraduate training scheme in Ireland participated in a one-hour training session. The repeated-measures design, using the validated Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales, examined changes immediately after training. Acceptability and satisfaction with training were measured with a self-administered questionnaire.
Knowledge of the risks of overdose and appropriate actions to be taken increased significantly post-training [OOKS mean difference, 3.52 (standard deviation 4.45); P < 0.001]; attitudes improved too [OOAS mean difference, 11.13 (SD 6.38); P < 0.001]. The most and least useful delivery methods were simulation and video, respectively.

Appropriate training is a key requirement for the distribution of naloxone through general practice. In future studies, the knowledge from this pilot will be used to inform a train-the-trainer model, whereby healthcare professionals and other front-line service providers will be trained to instruct opioid users and their families in overdose prevention and naloxone use.
BMC Medical Education 2015, 15:206  doi:10.1186/s12909-015-0487-y
The electronic version of this article is the complete one and can be found online at:http://www.biomedcentral.com/1472-6920/15/206