Does paying service providers by results improve recovery outcomes for drug misusers in treatment in England?

Abstract AimTo compare drug recovery outcomes in commissioning areas included in a ‘payment by results’ scheme with all other areas. DesignObservational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database, and Police National Computer criminal records, for two years before and after introduction of the scheme. Pre‚Äźpost controlled comparison compared outcomes in participating versus non‚Äźparticipating areas following adjustment for drug use, functioning and drug treatment status. SettingDrug services in England providing publicly‚Äźfunded, structured treatment. ParticipantsAdults in treatment (between 2010 and 2014): 154,175 (10,716 in participating areas, 143,459 non‚Äźparticipating) treatment journeys in the two years before, and 148,941 (10,012 participating, 138,929 non‚Äźparticipating) after the introduction of the scheme. InterventionScheme participation, with payment to treatment providers based on patient outcomes versus all other areas. MeasurementsRate of treatment initiation; waiting time (> or
Source: Addiction - Category: Addiction Authors: Tags: Research Report Source Type: research

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Buprenorphine is an effective medication for the treatment of opioid addiction, but current barriers to buprenorphine access limit treatment availability for many patients. We identify and characterize regions within the United States (US) with poor buprenorphine access relative to the observed burden of overdose deaths.
Source: Journal of Substance Abuse Treatment - Category: Addiction Authors: Source Type: research
As a physician licensed to prescribe narcotics, I am legally   permitted to prescribe the powerful opioid methadone (also known by the brand name Dolophine  ) to my patients suffering from severe, intractable pain that hasn ’t been adequately controlled by other, less powerful pain killers. Most patients I encounter who might fall into that category are likely to be terminal cancer patients. I’ve often wondered why I am approved to prescribe methadone to my patients as a treatment for pain, but I am not allowed to prescribe methadone to taper my patients off of a physical dependence the...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
Attorney General Jeff Sessions put in a plug for President Donald Trump's Supreme Court nominee on Friday as he touted the role of law enforcement in reducing addiction and overdose deaths plaguing Maine and New England.
Source: ABC News: Health - Category: Consumer Health News Tags: Health Source Type: news
The increased use of opioid pain medications in North America in the last 2 decades has given rise an epidemic of addictions, overdoses and deaths, to which both the US and Canadian governments have enacted strategies to help combat these crises [1-3]. While these strategies develop multiple interventions to curb opioid use, a common target is to reduce physician opioid prescribing. Many patients may receive their first dose of opioid in the Emergency Department (ED), and recent studies show that there has been a steady increase in opioid prescribing in US EDs to adults (relative increase of 49% from 2001 to 2010) [4, 5].
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Correspondence Source Type: research
Conclusions: The results of this study show the favorable epidemiological trend because of the decreasing number of new opiate patients in treatment. The retention of opiate patients in substitution therapy indicates the effectiveness of methadone maintenance programs. Our research did not determine any influence of methadone substitution therapy on an increasing risk of specific (overdose) mortality.
Source: Therapeutic Drug Monitoring - Category: Drugs & Pharmacology Tags: Original Article Source Type: research
Publication date: May–June 2018Source: EXPLORE, Volume 14, Issue 3Author(s): Heather Tick, Arya Nielsen, Kenneth R. Pelletier, Robert Bonakdar, Samantha Simmons, Ronald Glick, Emily Ratner, Russell L. Lemmon, Peter Wayne, Veronica Zador, The Pain Task Force of the Academic Consortium for Integrative Medicine and HealthABSTRACTMedical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action ...
Source: EXPLORE: The Journal of Science and Healing - Category: Complementary Medicine Source Type: research
Publication date: Available online 1 August 2017Source: Progress in Neuro-Psychopharmacology and Biological PsychiatryAuthor(s): Patrick H. Finan, Bethany Remeniuk, Kelly E. DunnAbstractProblematic prescription opioid use is cited as a primary contributor to the current ‘opioid epidemic’ in the United States, which is characterized by recent rapid increases in individuals seeking treatment for opioid dependence and staggering rates of opioid overdose deaths. Individuals with chronic pain are commonly prescribed opioids to treat pain, and by this mere exposure are at increased risk for the development of problem...
Source: Progress in Neuro Psychopharmacology and Biological Psychiatry - Category: Psychiatry Source Type: research
Publication date: Available online 18 February 2018Source: Neuroscience LettersAuthor(s): Marta FilizolaAbstractHaving accidental deaths from opioid overdoses almost quadrupled over the past fifteen years, there is a strong need to develop new, non-addictive medications for chronic pain to stop one of the deadliest epidemics in American history. Given their potentially fewer on-target overdosing risks and other adverse effects compared to classical opioid drugs, attention has recently shifted to opioid allosteric modulators and G protein-biased opioid agonists as likely drug candidates to prevent and/or reverse opioid over...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
AbstractPurpose of reviewRates of suicide and opiate overdose have recently skyrocketed in the USA. In light of impulsivity and impaired motivation common in people with substance use disorders, suicidality is common in addiction.Recent findingsChart review surveys indicate two primary suicidal populations that are important to distinguish for clinical practice and healthcare policy. One group is heavily composed of people with substance use disorders, in whom chronic compulsive use fosters a numbambivalence about death (low death intentionality). Many of these individuals with opiate use disorder (OUD) exaggerate suicidal...
Source: Current Treatment Options in Psychiatry - Category: Psychiatry Source Type: research
Introduction: Disinformation and Stealth Marketing CampaignsBack in the distant past the US government made some attempt to hold big health care corporations to account for misleading marketing practices.  We learned a lot about these practices from documents revealed in the resulting litigation, and in particular, about stealthy, deceptive systematicmarketing,lobbying, andpolicy advocacy campaigns on behalf of big health care organizations, often pharmaceutical, biotechnology and medical device companies.  For example, in 2012 wefound out about the stealth marketing campaign used by GlaxoSmithKline to sell its a...
Source: Health Care Renewal - Category: Health Management Tags: deception disinformation narcotics perverse incentives propaganda public relations Purdue Pharma stealth marketing Source Type: blogs
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