Influence of physician networks on the implementation of pharmaceutical alternatives to a toxic drug supply in British Columbia

Implementation Science, Journal Year: 2024, Volume and Issue: 19(1)

Published: Jan. 6, 2024

Abstract Background Characterizing the diffusion of adopted changes in policy and clinical practice can inform enhanced implementation strategies to ensure prompt uptake public health emergencies other rapidly evolving disease areas. A novel guidance document was introduced at onset COVID-19 pandemic British Columbia (BC), Canada, which supported clinicians prescribe opioids, stimulants, benzodiazepines. We aimed determine extent discontinuation an initial attempt a prescribed safer supply (PSS) program were influenced through networks prescribers. Methods executed retrospective population-based study using linked administrative data that captured all who least one client with substance use disorder from March 27, 2020, August 31, 2021. Our main exposure prescribing patterns individuals’ peers, defined as proportion prescribers’ professional network (based on shared clients), had previously PSS, updated monthly. The primary outcome measured whether clinician their PSS prescription during given calendar month. secondary prescribing, absence for prescriptions 3 months. estimated logistic regression models generalized equations monthly repeated measurements characterize peer initiation controlling network, clinician, caseload characteristics. Innovators individuals initiating prior May early adopters after. Results Among 14,137 prescribers treating clients disorder, there 228 innovators 1062 end follow-up, but 653 (50.6%) no longer by Prescribers over 20% peers whom nearly fourfold higher adjusted odds themselves ( aOR : 3.79, 95% CI (3.15, 4.56)), compared those connected Conclusions BC highly dependent behavior networks. Future support or policies would benefit leveraging

Language: Английский

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Is fentanyl in everything? Examining the unexpected occurrence of illicit opioids in British Columbia’s drug supply

Harm Reduction Journal, Journal Year: 2025, Volume and Issue: 22(1)

Published: March 10, 2025

Language: Английский

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Electrochemical Sensors, Biosensors, and Optical Sensors for the Detection of Opioids and Their Analogs: Pharmaceutical, Clinical, and Forensic Applications

Chemosensors, Journal Year: 2024, Volume and Issue: 12(4), P. 58 - 58

Published: April 8, 2024

Pharmaceutical opioids are intravenously or orally administered analgesics. While they effective in relieving chronic and acute pain, their narrow window of therapeutic use contributes to the high occurrence abuse. The associated abuse this family drugs can be correlated increase dependency, overdose, death users. negative effects extend beyond physical psychological experienced by user unregulated synthesis sale, which contribute socioeconomic challenges a biproduct global public health epidemic. From clinical point-of-care applications, detection real-time monitoring drug is critical fight decrease improve settings. Chromatographic separations chromatography–mass spectrometry traditional methods opioid analyses, but cost, long analysis time, absence portability highlight need for development fast, situ, analysis, community services. This review highlights recent electrochemical optical (FTIR, Raman, colorimetric, fluorescent) advances biosensors pharmaceutical illicit analysis. Specifically, an emphasis placed on metabolites biological samples vitro cellular assays diagnosis forensic applications. prospects role sensors, biosensors, sensors promoting diagnosis, study, point-of-care, services reduce harm also provided.

Language: Английский

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Fentanyl Concentration in Drug Checking Samples and Risk of Overdose Death in Vancouver, Canada

American Journal of Preventive Medicine, Journal Year: 2023, Volume and Issue: 66(1), P. 10 - 17

Published: Aug. 24, 2023

Language: Английский

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Opioid Coprescription Through Risk Mitigation Guidance and Opioid Agonist Treatment Receipt

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(5), P. e2411389 - e2411389

Published: May 15, 2024

Importance At the onset of COVID-19 pandemic, government British Columbia, Canada, released clinical guidance to support physicians and nurse practitioners in prescribing pharmaceutical alternatives toxic drug supply. These included opioids other medications under risk mitigation (RMG), a limited form prescribed safer supply, designed reduce SARS-CoV-2 infection harms associated with illicit use. Many clinicians chose coprescribe opioid RMG alongside agonist treatment (OAT). Objective To examine whether prescription hydromorphone tablets or sustained-release oral morphine (opioid RMG) OAT coprescription compared alone is subsequent receipt. Design, Setting, Participants This population-based, retrospective cohort study was conducted from March 27, 2020, August 31, 2021, individuals 10 linked health administrative databases Canada. Individuals who were receiving at initiation eligible but unexposed propensity score matched on sociodemographic variables. Data analyzed between January 2023 February 2024. Exposure Opioid receipt (≥4 days, 1-3 0 days dispensed) given week. Main Outcome Measures The main outcome receipt, defined as least 1 dispensed dose A marginal structural modeling approach used control for potential time-varying confounding. Results total 4636 (2955 [64%] male; median age, 38 [31-47] years after matching) time first dispensation (2281 ongoing 2352 initiating concurrently). 3 week increased probability by 27% (adjusted ratio, 1.27; 95% CI, 1.25-1.30), whereas 4 more resulted 46% increase 1.46; 1.43-1.49) those not RMG. biological gradient robust different exposure classifications, association stronger among concurrently. Conclusions Relevance study, which acknowledged intermittent use both medications, demonstrated that coprescribed had higher adjusted continued reengagement

Language: Английский

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Current attitudes toward drug checking services and a comparison of expected with actual drugs present in street drug samples collected from opioid users

Harm Reduction Journal, Journal Year: 2023, Volume and Issue: 20(1)

Published: July 7, 2023

The opioid epidemic continues to be associated with high numbers of fatalities in the USA and other countries, driven mainly by inclusion potent synthetic opioids street drugs. Drug checking means various technologies is being increasingly implemented as a harm reduction strategy inform users about constituent drugs their samples. We assessed how valued drug services (DCS) would for given ubiquity fentanyl related analogs supply, information they most value from checking, compared expected versus actual collected

Language: Английский

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The Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose

International Journal of Drug Policy, Journal Year: 2025, Volume and Issue: 139, P. 104789 - 104789

Published: April 10, 2025

Language: Английский

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Devices used in the detection of illicit drugs

Elsevier eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 245 - 274

Published: Jan. 1, 2025

Language: Английский

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Therapeutic drug monitoring of clozapine in human serum by high-throughput paper spray mass spectrometry

Journal of Mass Spectrometry and Advances in the Clinical Lab, Journal Year: 2024, Volume and Issue: 32, P. 41 - 46

Published: Feb. 15, 2024

Monitoring the atypical antipsychotic drug clozapine is crucial to ensure patient safety. This article showcases a high-throughput analytical method for measuring and its primary metabolite norclozapine (N-desmethylclozapine) in serum using paper spray mass spectrometry (PS-MS). study aimed assess viability of PS-MS rapid measurement human samples as an alternative liquid chromatography (LC-MS). Serum were processed by protein precipitation followed deposition supernatant containing labelled internal standards onto substrates mounted cartridges. Analytes then analyzed triple quadrupole spectrometer equipped with commercial ionization source. The results obtained from compared those validated LC-MS assay. calibrations linear (R2 > 0.99) over five days. Between-run precision was below 8 %, within-run did not exceed 10 %. When method, mean bias 39 −9% −1% norclozapine, no outliers. Mass ion ratio comparisons indicated interference above lower limit quantification. There less than 7 % change measured concentrations both analytes days dried on substrates. Notably, virtually maintenance MS source required during this study. illustrates potential monitoring clinical laboratory.

Language: Английский

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Volatile drug use and overdose during the first year of the COVID-19 pandemic in the United States

International Journal of Drug Policy, Journal Year: 2024, Volume and Issue: 126, P. 104371 - 104371

Published: March 5, 2024

Language: Английский

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