Naltrexone facts What is naltrexone? Effects of naltrexone Supporting someone who is on the naltrexone program Withdrawal Further information &. A HISTORY OF METHADONE TREATMENT IN AUSTRALIA: THE INFLUENCE OF SOCIAL CONTROL ARGUMENTS IN ITS DEVELOPMENT Dr Morag McArthur Australian Catholic University, ACT Paper presented at the History of Crime, Policing and Punishment. The Non Government Organisation Treatment Grants Program (NGOTGP) is an ongoing initiative that funds alcohol and drug treatment services to provide treatment and support to individuals, their families, and communities. National Drug Control Strategy. Drug use affects every sector of society, straining our economy, our healthcare and criminal justice systems, and endangering the futures of young people. Learn about the Obama. The Drug Court is a 12 month program with clearly defined rules that assist drug-abusing offenders to accept responsibility for their own rehabilitation. Although participants volunteer to. Millions of Americans turn to PBS for the solid, reliable reporting that has made PBS NewsHour one of the most trusted news programs in television. The Australian Government funds the cost of buprenorphine, buprenorphine with naloxone and methadone supplied as pharmaceutical benefits through clinics and pharmacies approved. Best Practices: Methadone Maintenance Treatment. ISBN: 0- 6. 62- 3. Cat. No.: H4. 9- 1. EHelp on accessing alternative formats, such as Portable Document Format (PDF), Microsoft Word and Power. Point (PPT) files, can be obtained in the alternate format help section. Table of Contents. Preface. Methadone maintenance treatment is a key component of a comprehensive treatment and prevention strategy to address opioid dependence and its consequences. A review of the literature (Health Canada, 2. Methadone maintenance treatment has also been found to reduce injection- related risk behaviours, other risk behaviours for transmission of human immunodeficiency virus (HIV) and sexually transmitted diseases, and the transmission of HIV (and potentially the transmission of hepatitis C virus (HCV) and other blood- borne pathogens). Methadone maintenance treatment improves physical and mental health, social functioning, quality of life, and pregnancy outcomes. Methadone maintenance treatment has also been found to increase retention in treatment. Health Canada, in collaboration with the provinces and territories, is involved in efforts to increase access to effective methadone maintenance programs. Footnote 1 Part of these efforts includes the development of this document. This best practices document is intended to help improve the effectiveness of current programs and encourage the establishment of new programs. This document is an educational tool which synthesizes knowledge about best practices in methadone maintenance treatment design and delivery. It contributes to an ongoing process of knowledge development and education for policy makers and health and social services professionals responding to the issue of opioid dependence. Providing this information is not intended to tell policy makers or people working in the field what they must do; rather, it provides a summary of what current research and expert opinion - from within Canada and abroad - indicate are the best practices in the field of methadone maintenance treatment. It focuses on what a comprehensive approach to effective, accessible methadone maintenance treatment should look like, and how to achieve it. This best practices resource has been developed as a stand- alone information source, in that it is not intended to replace, but rather to serve as a companion to, existing federal or provincial guidelines for methadone maintenance treatment. For further information on providing methadone maintenance treatment, readers must consult the current national guidelines (Health and Welfare Canada, 1. Footnote 2 In addition, readers are encouraged to consult the literature review report which is a companion to this report and was produced on behalf of Canada's Drug Strategy Division (see Health Canada, 2. A brochure based on this report is also available (see Health Canada 2. Note. In developing this document, the Investigator Team referred to sources that are believed to be reliable. This document, however, is not intended to provide readers with sufficient information to prescribe or dispense methadone. Acknowledgements. This document was developed on behalf of the Office of Canada's Drug Strategy, Health Canada. The Investigator Team included. Dr. Bruna Brands, Centre for Addiction and Mental Health; Dr. David Marsh, Centre for Addiction and Mental Health; Ms. Liz Hart, Jamieson, Beals, Lalonde and Associates, Inc.; Ms. Wanda Jamieson, Jamieson, Beals, Lalonde and Associates, Inc. The project was carried out under the guidance of the federal/provincial/territorial Steering Committee on Best Practices in Methadone Maintenance Treatment. The Investigator Team would like to thank the Steering Committee, the Canadian and International experts who were interviewed as well as service providers, clients/patients and client/patient advocates and regulatory bodies who contributed to the development of this document. Introduction. 1. 1 Purpose of this Document This document is part of an ongoing effort supported by Canada's Drug Strategy to increase access to effective methadone maintenance treatment programs in Canada by promoting and disseminating information on effective strategies to implement methadone maintenance treatment. As noted in the Preface, this document is not intended to replace, but rather to accompany, existing national or provincial guidelines. Readers must consult the federal guidelines (Health and Welfare Canada, 1. This document provides information on evidence- based best practices in methadone maintenance treatment, and the key components of comprehensive methadone maintenance treatment programs. Links to the published literature are noted throughout the document. A list of references and further suggested reading is included at the end of the document. All other non- referenced material represents the wealth of clinical and consumer wisdom and experience contributed by the many individuals who were consulted during the course of the project. In this document, the sections entitled ? This document has been developed for use by the many different groups of people who are involved in delivering methadone maintenance treatment in Canada including, among others: physicians; pharmacists; nurses; psychologists; other health care practitioners; andservice providers working in the fields of substance use treatment and rehabilitation, mental health, social services, and corrections. The document is also designed for use by policy and program developers and decision makers who are working in - and across - federal, provincial and territorial government departments and agencies to increase access to methadone maintenance treatment in Canada. Although this document was not written explicitly for clients/patients or their families, the information it contains may be useful for them as well. Development of this Document Development Process for MMT Best Practices Products. This document is based on: the findings of an extensive literature review which identified evidence- based best practices in methadone maintenance treatment (Health Canada, 2. Footnote 4a review of selected Canadian and international methadone maintenance treatment program manuals to identify practices that are consistent with the evidence of effectiveness; andthe Investigator Team's critical assessment of all comments and suggestions provided by the individuals who participated in the extensive consultation process which included. Canadian and international experts including physicians, nurses, pharmacists, substance use treatment providers and researchers; anda series of three expert meetings held with service providers (physicians, psychologists, nurses, pharmacists, and substance use treatment providers); clients/patients and client/patient advocates, and representatives of key professional bodies (including the medical licensing bodies, and some pharmacy regulatory bodies). Background. 2. 1 What is Substance Dependence? According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM- IV)Footnote 5, the key feature of substance dependence is . According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM- IV), (reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1. 99. 4 American Psychiatric Association), opioid dependence is a substance dependence disorder. The DSM- IV specifies criteria for opioid dependence (which are the same as for substance dependence) and which include physical tolerance of, and dependence on, opioids, as well as the compulsive use of opioids despite harm. They are at high risk for premature death from accidental drug overdose, drug- related accidents and violence. Sharing needles, syringes, straws, cookers or other contaminated drug- taking equipment, for example, places them at high risk of acquiring human immunodeficiency virus (HIV), hepatitis C virus (HCV) or other blood- borne pathogens. The problem of opioid dependence may be exacerbated by multiple substance use, as well as by factors such as poverty, and homelessness. Mental health disorders - such as depression, antisocial personality disorder and phobias - are common. Often, people who are dependent on opioids have experienced a long history of rejection, exclusion, and incarceration, which reinforces their sense of alienation and antagonism. They may have little sense of control over their lives. Opioid dependence is a costly social problem. Researchers have estimated that there may be 4. Canada who regularly use heroin (Fischer and Rehm, 1. The majority of people who are dependent on opioids are injection drug users. Footnote 6 Untreated, opioid dependence involves costs related to criminal activity, medical care, drug treatment, lost productivity, and, increasingly, transmission of HIV, HCV and other blood- borne pathogens. In 1. 99. 6, approximately half of the estimated 4,2. HIV infections that occurred in Canada were among injection drug users (IDUs) (Health Canada, 1. Footnote 7 According to the Laboratory Centre for Disease Control (as cited in Health Canada, 2. HCV infections are related to injection drug use. Some populations of individuals who are dependent on opioids are particularly vulnerable to the dual problem of injection drug use and infection with HIV, HCV or other blood- borne pathogens including women, street youth, offenders in correctional facilities, and Aboriginal people (Canadian HIV/AIDS Legal Network, 1. Health Canada, 2. Research by Single et al. Overall, illicit drug use cost an estimated $1. Canada in 1. 99. 2, and about 7. Although other forms of treatment for opioid dependence continue to be explored, in Canada and internationally, methadone maintenance treatment remains the most widely used form of treatment for people who are dependent on opioids. Methadone itself is a long- acting synthetic opioid agonist, which is prescribed as a treatment for opioid dependence.
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