Addressing misuse and diversion of opioid substitution medication: guidance based on systematic evidence review and real-world experience.
J Public Health (Oxf)
; 38(3): e368-e374, 2016 09.
Article
en En
| MEDLINE
| ID: mdl-26508767
ABSTRACT
BACKGROUND:
Opioid dependence treatment, comprising opioid substitution treatment (OST) and psychosocial intervention, is accepted to improve outcomes in opioid addiction for both the individual and public health. OST medication such as methadone or buprenorphine may be misused or diverted. This results in failure to recover from addiction, increased crime and the spread of blood-borne viruses. Worldwide, attempts to address misuse and diversion have been proposed and implemented with varying impact.METHODS:
A structured, expert-led process recommended the most impact. As an initial step, a broad range of strategies were defined, and a systematic review of published literature identified 37 highly relevant sources of evidence. Experts reviewed this evidence and ranked the list of strategies for effectiveness and ease of implementation, based on their clinical experience. RESULTS/CONCLUSIONS:
Three groups of strategies to address misuse or diversion are defined, depending on impact (effectiveness and ease of implementation). Preferred strategies include the promotion of access to treatment and the use of product formulations less likely to be misused. However, additional data and innovative approaches to address this complex problem are needed.Palabras clave
Buscar en Google
Bases de datos:
MEDLINE
Asunto principal:
Tratamiento de Sustitución de Opiáceos
/
Mal Uso de Medicamentos de Venta con Receta
/
Desvío de Medicamentos bajo Prescripción
Tipo de estudio:
Evaluation_studies
/
Guideline
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Public Health (Oxf)
Año:
2016
Tipo del documento:
Article
País de afiliación:
Reino Unido