RESUMO
BACKGROUND AND AIM: In Switzerland, a cantonal authorisation is required to introduce opioid agonist treatments (OAT). We investigated and compared the terms of these cantonal OAT authorisations throughout Switzerland. The primary objective was to determine how the overseeing cantonal officials implemented and perceived the legal requirements. METHOD: We started with a cross-sectional analysis of legal texts and cantonal OAT guidelines. Based on the document analysis, we conducted 26 semi-structured interviews with the cantonal officials who grant OAT authorisations. FINDINGS: In most cantons (21 of 25), the OAT authorisation is specific to the person treated and must be renewed every year. Today, 21 cantons either have implemented or are implementing the same web-based software to process and manage OAT authorisation requests. Cantons have implemented diverging requirements regarding, amongst others, the involvement of third parties in OAT and the training required of prescribing physicians. Lastly, the OAT process does not seem to be a high priority for the overseeing officials. CONCLUSIONS: From a legal standpoint, OAT authorisations should be straightforward, yet we found significant divergences among cantonal systems. We could not find scientific evidence that supports a given framework. We recommend harmonizing the 26 cantonal systems while reviewing the need for OAT authorisation.
Assuntos
Analgésicos Opioides , Humanos , Suíça , Estudos Transversais , Analgésicos Opioides/uso terapêutico , Pesquisa Qualitativa , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológicoRESUMO
Addiction medicine is currently facing new challenges, such as drug epidemics and open drug scenes. It is responding to these challenges with a range of innovations: 1. The commercialization of opioid-assisted treatment (OAT) is a major step forward. 2. In Geneva, a community outreach project involving mental health peer practitioners targets the emerging crack scene, demonstrating its effectiveness in directing this marginalized population towards care. 3. In Switzerland, two projects in French-speaking Switzerland are testing hybrid models of cannabis regulation. Evaluation of these projects will guide the best approach to cannabis regulation.
L'addictologie est actuellement confrontée à des nouveaux défis, tels que des épidémies de consommation et des scènes de drogues ouvertes. Elle répond à ces défis par différentes innovations. 1. La commercialisation du traitement assisté par opioïdes (TAO) en dépôt est une avancée majeure. 2. À Genève, un projet communautaire de maraudes, impliquant des pairs praticiens en santé mentale, cible la scène de consommation de crack émergente, montrant son efficacité pour orienter cette population marginalisée vers les soins. 3. En Suisse, deux projets romands testent des modèles hybrides de régulation du cannabis. L'évaluation de ces projets guidera la meilleure approche pour la régulation du cannabis.
Assuntos
Medicina do Vício , Comportamento Aditivo , Cannabis , Epidemias , Alucinógenos , Humanos , Analgésicos OpioidesRESUMO
Asphaltenes, a distinct class of molecules found in crude oil, exhibit insolubility in nonpolar solvents like n-heptane but are soluble in aromatic solvents such as toluene and benzene. Understanding asphaltenes is crucial in the petroleum industry due to their detrimental effects on oil processing, resulting in significant economic losses and production disruptions. While no singular structure defines asphaltenes, two major molecular architectures, namely archipelago and continental models, have gained wide acceptance for their consistency with various experimental investigations and subsequent use in computational studies. The archipelago model comprises two or more polyaromatic hydrocarbon entities interconnected via aliphatic side chains. In contrast, the island or continental model features a unified polyaromatic hydrocarbon moiety with 4 to 10 fused aromatic rings, averaging around 7 rings. To establish a comprehensive collection, we meticulously curated over 250 asphaltene structures derived from previous experimental and computational studies in this field. Our curation process involved an extensive literature survey, conversion of figures from publications into molecular structure files, careful verification of conversion accuracy, and structure editing to ensure alignment with molecular formulas. Our database provides digital structure files and optimized geometries for both predominant structural motifs. The optimization procedure commenced with the PM6 semi-empirical method, followed by further optimization utilizing density functional theory employing the B3LYP functional and the 6-31+G(d,p) basis set. Furthermore, we compiled a range of structural and electronic features for these molecules, serving as a valuable foundation for employing machine learning algorithms to investigate asphaltenes. This work provides a ready to use structural database of asphaltenes and sets the stage for future research endeavours in this domain.