Expanding access to diacetylmorphine and hydromorphone for people who use opioids in Canada.

Expanding access to diacetylmorphine and hydromorphone for people who use opioids in Canada. Can J Public Health. 2020 Mar 27;: Authors: Maghsoudi N, Bowles J, Werb D Abstract The increasing incidence of fatal opioid overdose is a public health crisis in Canada. While buprenorphine/naloxone and methadone are the standard first-line of opioid substitution options, limitations, including difficulty achieving long-term retention for some people who use opioids, are well known. For this group, injectable diacetylmorphine or hydromorphone can achieve positive outcomes, including high retention rates, reduced use of unregulated opioids, and reduced criminal activity. In May 2019, Health Canada announced changes to increase the accessibility of diacetylmorphine and hydromorphone, and in September 2019, the CIHR-funded Canadian Research Initiative in Substance Misuse released a national clinical guideline for diacetylmorphine and hydromorphone as additional frontline substitution options. While these developments present opportunities for scale-up, significant financial, structural, and practice barriers continue to impede access. This commentary explores the current state of policy and practice for diacetylmorphine and hydromorphone as opioid substitution options in Canada, outlines the rationale for rapid expansion of access, and highlights clinical and policy changes that must be undertaken or the death toll will continue to rise. PMID: 32221867 [PubMed ...
Source: Canadian Journal of Public Health - Category: International Medicine & Public Health Authors: Tags: Can J Public Health Source Type: research

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In Sketchy they say Sodium Bicarbonate is used to treat TCA overdose. One of the reasons they say is because it increases serum pH which favors the non-ionized form of the drug. Why is this? I thought increase serum pH> less H+. Then to compensate for this decrease in H+, wouldn't TCA ionize more to replace to lost H+ ions?
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ConclusionsWhole-body physiologically based pharmacokinetic models of metformin and cimetidine were built and qualified for the prediction of metformin pharmacokinetics during drug –gene interaction, drug–drug interaction, and different stages of renal disease. The model files will be freely available in the Open Systems Pharmacology model repository. Current guidelines for metformin treatment of renally impaired patients should be reviewed to avoid overdosing in CKD3 and to allow metformin therapy of CKD4 patients.
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology Source Type: research
BACKGROUND: Since 2010, heroin-related overdoses have risen sharply, coinciding with policies to restrict access to prescription opioids. It is unknown if patients tapered or discontinued off prescription opioids transitioned to riskier heroin use. This st...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
Conclusion: Fentanyl preference is highly prevalent among rural PWID in WV and associated with factors that may exacerbate overdose risks. There is an urgent need for increased access to tailored harm reduction services that address risks associated with fentanyl preference. PMID: 32441202 [PubMed - as supplied by publisher]
Source: Substance Use and Misuse - Category: Addiction Tags: Subst Use Misuse Source Type: research
Each year in the United States, approximately half a million reproductive-aged women are afflicted with major depression. Pregnant and postpartum women can be reluctant to openly disclose their suffering related to depression and other stigmatizing illnesses (eg, mood and anxiety disorders, posttraumatic stress disorder, and substance use disorders) and subsequently remain symptomatic with no relief. Maternal mortality related to these conditions is significant, with maternal suicide and overdose-related death peaking between 7 and 12 months postpartum. Geographic challenges in accessing perinatal mental health experts can...
Source: Obstetrics and Gynecology Clinics - Category: OBGYN Authors: Source Type: research
Conclusion There was strong agreement by participants on what should be considered core competencies for Australian pharmacists in opioid supply. Given the large number of items identified, further research may help determine priorities for training and education.
Source: International Journal of Clinical Pharmacy - Category: Drugs & Pharmacology Source Type: research
During this coronavirus pandemic, there are many risks posed to people who have an addiction....The postDangers of Overdosing During Coronavirus Quarantine appeared first onCliffside Malibu.
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Addiction Addiction Recovery addiction treatment aftercare coronavirus covid-19 covid19 drug overdose Source Type: blogs
Source: Substance Abuse - Category: Addiction Authors: Source Type: research
This article is republished from The Conversation under a Creative Commons license. Read the original article. The post Why More Must be Done to Fight Bogus COVID-19 Cure Claims appeared first on Inter Press Service.
Source: IPS Inter Press Service - Health - Category: International Medicine & Public Health Authors: Tags: Global Headlines Health Source Type: news
More than 151,000 Americans died from drug overdoses, alcohol and suicide combined in 2018, slightly lower than the overall numbers in 2017, and leveling off for the first time in two decades, according to a new study.
Source: CNN.com - Health - Category: Consumer Health News Source Type: news
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