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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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AbstractPurpose of ReviewAcetaminophen (paracetamol, APAP) is the most commonly prescribed analgesic for the treatment of acute pain. It is also the most commonly prescribed analgesic and antipyretic for children. There has been extensive clinical use of acetaminophen in nonparenteral forms (e.g., oral or rectal) for over six decades and over 20  years of clinical experience outside the USA with the intravenous (IV) use of acetaminophen.Recent FindingsIn the USA, IV acetaminophen was approved by the Food and Drug Administration in November 2010. Studies indicate that IV acetaminophen is as effective for acute pain rel...
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research
A coalition of 41 states' attorneys general have served five major opioid manufacturers with subpoenas seeking information about how these companies marketed and sold prescription opioids. The coalition is also demanding documents and information related to distribution practices from three drug distributors. The investigative subpoenas and document requests were sent to pharmaceutical manufacturers Endo International, Janssen Pharmaceuticals, Teva Pharmaceutical Industries Ltd./Cephalon Inc. and Allergan. The group also served a supplemental investigative subpoena to Purdue Pharma. Documents were also requested of three ...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs
Police Executive Research Forum. 09/2017 This 92-page report summarizes the epidemic of overdoses by persons addicted to opioid drugs, and what was learned at a national conference held in April 2017. The Police Executive Research Forum focuses on the opioid crisis because despite the work that police and other agencies are doing, the epidemic is continuing to worsen. New concepts in the report include the use of synthetic opioids fentanyl and carfentanil, ways in which police agencies and their partners are developing ways to share information, and how police officers are saving lives with naloxone. (PDF)
Source: Disaster Lit: Resource Guide for Disaster Medicine and Public Health - Category: International Medicine & Public Health Authors: Source Type: news
Abstract The prescribing of opioid analgesics for pain management-particularly for management of chronic noncancer pain (CNCP)-has increased more than fourfold in the United States since the mid-1990s. Yet there is mounting evidence that opioids have only limited effectiveness in the management of CNCP, and the increased availability of prescribed opioids has contributed to upsurges in opioid-related addiction cases and overdose deaths. These concerns have led to critical revisiting and modification of prior pain management practices (e.g., guidelines from the Centers for Disease Control and Prevention), but the m...
Source: Annual Review of Medicine - Category: General Medicine Authors: Tags: Annu Rev Med Source Type: research
“Do not get caught” seems to be the real rule of the law in South Florida, where I live. I was trained to limit the use of controlled substances, narcotics, hypnotics and sedatives. Their use can affect consciousness, ability to drive a car and work.  More severe consequences include respiratory depression and overdose from too high of a dosage or mixing too many medications and over the counter items. The Joint Commission, medicine’s good housekeeping seal of approval authority, along with major medical organizations have accused clinicians of undertreating pain. “Pain is the fifth vital sign,...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Pain Management Primary Care Source Type: blogs
The number of teenagers dying from drug overdoses is rising, according to the CDC. But few pediatricians know how to treat opioid use disorder, creating a lack of care for addicted children.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
LOWELL (CBS) — For many people, the opioid addiction begins with prescription pain pills. It’s a story one local dad knows too well. After losing his son to an overdose he is now advocating for change — in the operating room. “You can see his bright, clear eyes and his warm smile. And really healthy and happy, really hopeful,” said Dr. James Baker describing his son, Max, after he shook his addiction to heroin. Max Baker (Photo Courtesy: Baker Family) “He said once the pills started it took less than a year to transition to heroin and he was an addict by 17,” Dr. Baker told WB...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health Local News Syndicated Local Confronting The Crisis Dr. Mallika Marshall Exparel Lowell General Hospital opioid crisis Source Type: news
Tracey Helton (pictured), 47, from California, mails packages of a lifesaving drug that prevents fatal overdoses to drug addicts. The addicts can request the medicine via her social media accounts.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
National surveys have found that teens today are much less likely to use alcohol and drugs compared to their parents’ generation. In fact, the proportion of high school seniors who chose not to use alcohol, tobacco, marijuana or other drugs has increased from 3 percent to 25 percent in the last thirty years. This remarkable good news is overshadowed by the growing number of teens who are daily marijuana users and the recent increase in opioid-related deaths among young people. It is important to understand the roots of this discrepancy in order to address it. Statistics show that between 2014 and 2015, the rates of d...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: Ask the Expert Parenting Teen Health Adolescent Substance Abuse Program Source Type: news
ConclusionsIn a Norwegian prospective cohort study, “hard‚Äźto‚Äźreach” polysubstance users had more than ten times higher mortality risk than the general population. Mortality risk was not a function of any single drug use indicator, but two distinct combinations of substances, frequencies and routes of administration were associated with the mortality risk.
Source: Addiction - Category: Addiction Authors: Tags: Research Report Source Type: research
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