Drug dependence treatment in prison and upon release

Satellite on HIV/AIDS in Prison Settings
18th International Conference to Reduce Drug Related Harm
Warsaw, Poland May 13, 2007
™ 3-6 weeks inpatient hospital followed by extended out-patient talk therapy and/or 12 step programs ™ Pts. withdrawn from drugs under physician’s care, in-patient or out-patient (precursor to treatment) ™ Drug education/admonition/group & individual ™ Drug Substitution Treatment (opioid agonist ™Methadone™Buprenorphine™Codeine™Slow-release morphine™Opium™Heroin™Naltrexone* ™Opioid substitution therapy for illicit ™ Can be used as a detox. tool in tapering ™ Long-acting (typically 24 hours)™ Blocks effects of other opioids like heroin™ Stops cravings: biggest factor in relapse ™Methadone Maintenance treatment is the most
effective treatment available for heroin dependent injecting drug users (IDUs) for reducing
™ Mortality (Capelhorn, et al., 1994)
™ Heroin consumption (Gottheil, et al, 1993)
™ Criminality (Newman, et al., 1973) and
™ HIV infection (Blix and Gronbladh, 1981;
Reducing the spread of HIV and other
infections. Injecting drug users are over-
represented in prisons and they are at higher
risk for contracting and spreading infections.
Continuity of medical care. The increasing
number of IDUs in community-based
methadone programs means more prisoners in
opioid withdrawal.
™Pregnant IDUs at high risk.
Overdose Prevention. Highest risk of overdose
is after periods of abstinence or reduced use,
™ The introduction or expansion of methadone in prisons has
been recommended by a number of prominent medical &
™ UK’s Advisory Council on the Misuse of Drugs, 1993 ™ NIH Consensus Development Panel on Effective Treatment of Heroin Addiction, 1997 (U.S.A.) ™ World Health Organization/United Nations Office of Drugs and Crime, Joint United Nations Programme on ™ National Institute on Drug Abuse, 2006 (U.S.A.) Preventing HIV Infection Among Injecting Drug Users in
High Risk Countries: An Assessment of the Evidence
Commission by Global Fund and Gates Foundation
Released on: September 15, 2006
reduce the risk of transmission of HIV” “We do not end [the Report] with ‘More research is needed.’ … We say instead ™Prisoners should have access to the same medical care and health care services as ™External professional standards of care ™Additional Sources: Dolan 2001, EMCDDA 2002 ™MMT costs approx. $4000 per patient per and improves social productivity, all of which serve to reduce the societal costs of drug addiction, i.e. re-incarceration, ™Cost benefit analyses indicate savings of 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 19951997 1999 ™Patients often stop using opioids, but if Caplehorn 1996, Sporer 1999, 2003, Auriacombe 2004,Stancliff 2007 ™About 2% of heroin users die each year - ™1999: most common cause of death men age 25-54 in Portland OR and several other cities ™Incarceration ™Hospitalization ™Drug treatment/detox ™Primarily other CNS depressants™Cocaine is involved in nearly 40% of NYC ™Overdose is more likely in the presence of significant illness: cirrhosis, AIDS, coronary ™Major changes in opioid supply: >1000 deaths http://www.whitehousedrugpolicy.gov/news/fentnyl%5Fheroin%5Fforum ™Most often it’s dependent long term users with 5- 10 years of experience rather than hours- the stereotype “needle in the arm” ™Overall mortality: 2.5 times than expected™First 2 weeks: 12.7 times than expected ™ Opioids: 60%™ Cocaine and other stimulants: 74% ™Opioid antagonist which reverses opioid related sedation and respiratory depression and may cause ™Displaces opioids from the receptors, then occupies http://www.ofdt.fr/BDD/publications/docs/eftaack6.pdf e.g., long-term Rx in New York City 1970-72 GRAND TOTAL
12,450 52,782
Newman J. Pub. Health Policy 6(4):526-538 (1985) ™ End 1974: one “pilot” program, 500 patients ™ End 1975: approximately 2,000 enrolled ™ End 1976: approximately 10,000 enrolled (Admissions to voluntary in-patient drug-free programmes stable
Newman J. Pub. Health Policy 6(4):526-538 (1985) * Gölz, J.: Stellungnahme der DGS - Deutsche Gesellschaft für Suchtmedizin zur "Berliner Erklärung". In: Suchtmedizin in Forschung und Praxis 2006;8(3):156 ™Ralf Jurgens, WHO, UNODC, UNAIDS™Robert Newman, MD International Center

Source: http://www.aidslaw.ca/EN/documents/ICRDRH07-DrugTreatment.pdf

Formulary drug list - by therapy group - no cost - (updatable).xls

Formulary Drug List - MINNESOTA 6/9/2011 If you have any questions regarding pharmaceutical pricing, please contact PharmaCorr for clarification. 6705 Camille St; Oklahoma City , OK 73149 Toll Free: 888-321-7774 Local: 405-670-1400 Fax: 888-200-77746002 Corporate Way, Corporate Cntr North II; B; Indianapolis, IN 46278 Toll Free: 800-259-3067 Local: 317-299-3426 Fax: 800-259-3066 Fo

0701 - pentasa crohn folder se.indd

t. nr 755429 januari 2007, Rehn & Co: 040 - 611 90 11Riksförbundet för Mag- och Tarmsjuka (RMT), telefon 08-642 42 00 eller www.magotarm.seEuropeiska föreningen för patienter med IBD: www.efcca.org Denna folder har tagits fram som en service till sjukvården i samråd med Rikard Svernlöv, Specialistläkare, Universitetssjukhuset i Linköping. • Hur stor del av min tarm är in

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