The North American opioid epidemic: current challenges and a call for treatment as prevention

Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico a...
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Gespeichert in:

Autor*in:	Vashishtha, Devesh [verfasserIn] Mittal, Maria Luisa Werb, Daniel

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	Opioid epidemic North America Treatment as Prevention Injection initiation People who inject drugs Medication-assisted treatment

Anmerkung:	© The Author(s). 2017

Übergeordnetes Werk:	Enthalten in: Harm reduction journal - London : BioMed Central, 2004, 14(2017), 1 vom: 12. Mai
Übergeordnetes Werk:	volume:14 ; year:2017 ; number:1 ; day:12 ; month:05

Links:	Volltext

DOI / URN:	10.1186/s12954-017-0135-4

Katalog-ID:	SPR028775619

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allfields	10.1186/s12954-017-0135-4 doi (DE-627)SPR028775619 (SPR)s12954-017-0135-4-e DE-627 ger DE-627 rakwb eng Vashishtha, Devesh verfasserin aut The North American opioid epidemic: current challenges and a call for treatment as prevention 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. Opioid epidemic (dpeaa)DE-He213 North America (dpeaa)DE-He213 Treatment as Prevention (dpeaa)DE-He213 Injection initiation (dpeaa)DE-He213 People who inject drugs (dpeaa)DE-He213 Medication-assisted treatment (dpeaa)DE-He213 Mittal, Maria Luisa aut Werb, Daniel (orcid)0000-0003-0614-9386 aut Enthalten in Harm reduction journal London : BioMed Central, 2004 14(2017), 1 vom: 12. Mai (DE-627)388089350 (DE-600)2146691-9 1477-7517 nnns volume:14 year:2017 number:1 day:12 month:05 https://dx.doi.org/10.1186/s12954-017-0135-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2017 1 12 05
spelling	10.1186/s12954-017-0135-4 doi (DE-627)SPR028775619 (SPR)s12954-017-0135-4-e DE-627 ger DE-627 rakwb eng Vashishtha, Devesh verfasserin aut The North American opioid epidemic: current challenges and a call for treatment as prevention 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. Opioid epidemic (dpeaa)DE-He213 North America (dpeaa)DE-He213 Treatment as Prevention (dpeaa)DE-He213 Injection initiation (dpeaa)DE-He213 People who inject drugs (dpeaa)DE-He213 Medication-assisted treatment (dpeaa)DE-He213 Mittal, Maria Luisa aut Werb, Daniel (orcid)0000-0003-0614-9386 aut Enthalten in Harm reduction journal London : BioMed Central, 2004 14(2017), 1 vom: 12. Mai (DE-627)388089350 (DE-600)2146691-9 1477-7517 nnns volume:14 year:2017 number:1 day:12 month:05 https://dx.doi.org/10.1186/s12954-017-0135-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2017 1 12 05
allfields_unstemmed	10.1186/s12954-017-0135-4 doi (DE-627)SPR028775619 (SPR)s12954-017-0135-4-e DE-627 ger DE-627 rakwb eng Vashishtha, Devesh verfasserin aut The North American opioid epidemic: current challenges and a call for treatment as prevention 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. Opioid epidemic (dpeaa)DE-He213 North America (dpeaa)DE-He213 Treatment as Prevention (dpeaa)DE-He213 Injection initiation (dpeaa)DE-He213 People who inject drugs (dpeaa)DE-He213 Medication-assisted treatment (dpeaa)DE-He213 Mittal, Maria Luisa aut Werb, Daniel (orcid)0000-0003-0614-9386 aut Enthalten in Harm reduction journal London : BioMed Central, 2004 14(2017), 1 vom: 12. Mai (DE-627)388089350 (DE-600)2146691-9 1477-7517 nnns volume:14 year:2017 number:1 day:12 month:05 https://dx.doi.org/10.1186/s12954-017-0135-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2017 1 12 05
allfieldsGer	10.1186/s12954-017-0135-4 doi (DE-627)SPR028775619 (SPR)s12954-017-0135-4-e DE-627 ger DE-627 rakwb eng Vashishtha, Devesh verfasserin aut The North American opioid epidemic: current challenges and a call for treatment as prevention 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. Opioid epidemic (dpeaa)DE-He213 North America (dpeaa)DE-He213 Treatment as Prevention (dpeaa)DE-He213 Injection initiation (dpeaa)DE-He213 People who inject drugs (dpeaa)DE-He213 Medication-assisted treatment (dpeaa)DE-He213 Mittal, Maria Luisa aut Werb, Daniel (orcid)0000-0003-0614-9386 aut Enthalten in Harm reduction journal London : BioMed Central, 2004 14(2017), 1 vom: 12. Mai (DE-627)388089350 (DE-600)2146691-9 1477-7517 nnns volume:14 year:2017 number:1 day:12 month:05 https://dx.doi.org/10.1186/s12954-017-0135-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2017 1 12 05
allfieldsSound	10.1186/s12954-017-0135-4 doi (DE-627)SPR028775619 (SPR)s12954-017-0135-4-e DE-627 ger DE-627 rakwb eng Vashishtha, Devesh verfasserin aut The North American opioid epidemic: current challenges and a call for treatment as prevention 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. Opioid epidemic (dpeaa)DE-He213 North America (dpeaa)DE-He213 Treatment as Prevention (dpeaa)DE-He213 Injection initiation (dpeaa)DE-He213 People who inject drugs (dpeaa)DE-He213 Medication-assisted treatment (dpeaa)DE-He213 Mittal, Maria Luisa aut Werb, Daniel (orcid)0000-0003-0614-9386 aut Enthalten in Harm reduction journal London : BioMed Central, 2004 14(2017), 1 vom: 12. Mai (DE-627)388089350 (DE-600)2146691-9 1477-7517 nnns volume:14 year:2017 number:1 day:12 month:05 https://dx.doi.org/10.1186/s12954-017-0135-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2017 1 12 05
language	English
source	Enthalten in Harm reduction journal 14(2017), 1 vom: 12. Mai volume:14 year:2017 number:1 day:12 month:05
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authorswithroles_txt_mv	Vashishtha, Devesh @@aut@@ Mittal, Maria Luisa @@aut@@ Werb, Daniel @@aut@@
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author	Vashishtha, Devesh
spellingShingle	Vashishtha, Devesh misc Opioid epidemic misc North America misc Treatment as Prevention misc Injection initiation misc People who inject drugs misc Medication-assisted treatment The North American opioid epidemic: current challenges and a call for treatment as prevention
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topic_title	The North American opioid epidemic: current challenges and a call for treatment as prevention Opioid epidemic (dpeaa)DE-He213 North America (dpeaa)DE-He213 Treatment as Prevention (dpeaa)DE-He213 Injection initiation (dpeaa)DE-He213 People who inject drugs (dpeaa)DE-He213 Medication-assisted treatment (dpeaa)DE-He213
topic	misc Opioid epidemic misc North America misc Treatment as Prevention misc Injection initiation misc People who inject drugs misc Medication-assisted treatment
topic_unstemmed	misc Opioid epidemic misc North America misc Treatment as Prevention misc Injection initiation misc People who inject drugs misc Medication-assisted treatment
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title	The North American opioid epidemic: current challenges and a call for treatment as prevention
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title_full	The North American opioid epidemic: current challenges and a call for treatment as prevention
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title_sort	north american opioid epidemic: current challenges and a call for treatment as prevention
title_auth	The North American opioid epidemic: current challenges and a call for treatment as prevention
abstract	Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. © The Author(s). 2017
abstractGer	Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. © The Author(s). 2017
abstract_unstemmed	Abstract There is a need for creative, public health-oriented solutions to the increasingly intractable problems associated with the North American opioid epidemic. This epidemic is a fundamentally continental problem, as routes of migration, drug demand, and drug exchange link the USA with Mexico and Canada. The challenges faced throughout North America include entrenched prescribing practices of opioid medications, high costs and low availability of medication-assisted treatment (MAT), and policy approaches that present substantial barriers to care. We advocate for the scale up of a low-threshold treatment model for MAT that incorporates the best practices in addiction treatment. Such a model would remove barriers to care through widespread treatment availability and affordability and also a policy of decriminalization. Given that MAT reduces the frequency of drug injecting among opioid injectors, this treatment model should also be guided by an understanding of the socially communicable nature of injection drug use, such that increasing MAT availability may also prevent the spread of injecting practices to individuals at risk of transitions from non-injection to injection drug use. To that end, the “Treatment as Prevention” model employed to respond to the individual- and population-level risks for HIV/AIDS prevention could be adapted to efforts to halt the North American opioid epidemic. © The Author(s). 2017
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title_short	The North American opioid epidemic: current challenges and a call for treatment as prevention
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