Opiate Addiction and Treatment (Annotated Bibliography)
Sordo, Luis, et al. “Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies.” BMJ 357, j1550: 2017.
The article prompted me to consider the effectiveness of the contemporary methods uses in treating addiction to opioids. Through the reading, I realized that it is important to consider the effects of the treatment administered on the health of the addict. The fact that multiple deaths have been registered following the administration of methadone or buprenorphine made me realize that treatment practices are not evidence–based. From the reading, I was led to understand the essence of an evidence-based approach to treatment administration. With facts regarding the effects of the treatment that is used on the addicts, I believe there will be better chances of succeeding in the efforts to rehabilitate.
The authors conducted this study with the aim of comparing the various risk factors and overdose mortality associated to use of buprenorphine and methadone as substitute treatment for the people with opioid addiction. Similarly, the study sought to find trends in the mortality-associated risks at the beginning and after the ending of treatment. For this study, two reviewers carried out data extraction and analyzed it. Mortality rates during and after treatment using buprenorphine or methadone were combined using meta-analysis. The results for the initiation phase of treatment using methadone and the time promptly after completion of treatment with methadone and buprenorphine were found to be periods of increased risk of mortality. The authors concluded that these findings could be critical. However, they recommend further research to be conducted to address issues such as the possible selection and confounding bias in the comparison of associated mortality risks including substitution treatment for opioid dependence as well as throughout the periods taken in and out of each of the treatments administered.
This article suggests treatment of addiction to opioids using the drugs methadone and buprenorphine may not be as successful as some health care providers originally had thought. The data put together by meta-analysis and assessed proved that there were periods of very high mortality rates that must be addressed and dealt with by both public health and by clinical strategies.
Holland S. The Human Embryonic Stem Cell Debate: Science, Ethics, and Public Policy. Boston: MIT UP; 2001.
As I read the source, I developed a different perspective on the topic. I was unaware that so many deaths and overdoses could be prevented by using the XR-NTX treatment before release from jail. I believe the study was well conducted as the results were based on evidence from the recordings from 4, 8, and 28 weeks after release. The reading also helped me understand the essence of application of treatment during incarceration as part of the efforts to prevent future relapses. The fact that most relapses that occur after incarceration are associated with the failure to administer treatment before the jail release also changed my attitude towards the individuals that return to addiction despite having been incarcerated.
This article offers the outcomes of a possible treatment for those who have been incarcerated due to their addiction to opioids. The author created an experiment consisting 67 jail releases with opioid dependence. 47 of the 67 received XR-NTX before their release while 20 received XR-NTX after their release. The research gives truthful and alarming results which will be used to benefit the chance of a drug-free life for those incarcerated with an opioid addiction. The results indicated that those who began initiating extended-release naltrexone (XR-NTX) before release from incarceration appeared to increase the treatment retention rate, compared to commencing after release. Instead of assuming the treatment before release would be more beneficial to those addicted, the experiment proved the treatment was more beneficial. Both the good and bad outcomes were recorded (including the records of deaths) leading to the truth about a possible, reliable treatment. I believe the only way the study could be improved is by using a bigger population to record. The information gathered from this study would be useful to my audience of practitioners because the treatment may be successful outside of jails if the patients are highly supervised. I discuss within my essay that nothing much was done to address the deaths, or prevalence of, due to opioid addiction. The deaths due to opioid addiction have grown immensely. This experiment, if implemented throughout jails worldwide, could lead to a significant decrease in deaths because of opioid overdose.