Psychosocial interventions and opioid detoxification for drug misuse: summary of NICE guidance

Drug misuse is an increasing problem that not only impairs the physical and mental health of people who misuse drugs but also negatively affects their families and wider society (for example, in its association with crime). Recently expanded drug services in the United Kingdom involve general practitioners to a considerable degree, who care for at least a third of opioid misusers in treatment. Many clinicians remain pessimistic, however, about the possible benefits of any treatment and how to engage drug users in treatment.1 This article summarises two new NICE guidelines that identify the most effective, safe detoxification regimens for primary and secondary care, the most cost effective psychosocial interventions, and effective ways to promote patient engagement

A QUASI-VARIATIONAL INEQUALITY PROBLEM IN SUPERCONDUCTIVITY

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Are take-home naloxone programmes effective?:Systematic review utilizing application of the Bradford Hill criteria

Background and Aims: Fatal outcome of opioid overdose, once detected, is preventable through timely administration of the antidote naloxone. Take-home naloxone provision directly to opioid users for emergency use has been implemented recently in more than 15 countries worldwide, albeit mainly as pilot schemes and without formal evaluation. This systematic review assesses the effectiveness of take-home naloxone, with two specific aims: (1) to study the impact of take-home naloxone distribution on overdose-related mortality; and (2) to assess the safety of take-home naloxone in terms of adverse events. Methods: PubMed, MEDLINE and PsychINFO were searched for English-language peer-reviewed publications (randomized or observational trials) using the Boolean search query: (opioid OR opiate) AND overdose AND prevention. Evidence was evaluated using the nine Bradford Hill criteria for causation, devised to assess a potential causal relationship between public health interventions and clinical outcomes when only observational data are available. Results: A total of 1397 records (1164 after removal of duplicates) were retrieved, with 22 observational studies meeting eligibility criteria. Due to variability in size and quality of the included studies, meta-analysis was dismissed in favour of narrative synthesis. From eligible studies, we found take-home naloxone met all nine Bradford Hill criteria. The additional five World Health Organization criteria were all either met partially (two) or fully (three). Even with take-home naloxone administration, fatal outcome was reported in one in 123 overdose cases (0.8%; 95% confidence interval = 0.4, 1.2). Conclusions: Take-home naloxone programmes are found to reduce overdose mortality among programme participants and in the community and have a low rate of adverse events.</p

Long-Acting Injectable Buprenorphine for Opioid Use Disorder:A Qualitative Analysis of Patients’ Interpersonal Relationships during the First Year of Treatment

Introduction: Long-acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder. Drawing upon new materialism and the concept of social capital, this article provides a focused analysis of how LAIB affects, and is affected by, patients’ relationships with other people. Methods: Data derive from a longitudinal qualitative study. Twenty-six people (18 males; 8 females) initiating LAIB were recruited from England and Wales (2020/2021) and interviewed up to six times each over a year (125 interviews in total). Interviews were audio-recorded, transcribed, and coded. Coded relationship data were summarized in Excel and analyzed via Iterative Categorization. Results: Core significant others who did not use substances offered participants important support with LAIB. Children and grandchildren provided motivation for LAIB, whilst other family relationships could be supportive and unsupportive. Participants wanted to avoid friends, peers and associates who might offer them substances, but valued sharing experiences with others in similar circumstances. Whilst some participants were unconcerned when treatment staff did not contact them, others were angry and upset. Those who did not continue LAIB or were lost from the study were more isolated at recruitment. Meanwhile, participants who remained on LAIB described increased sociability over time. Conclusions: Findings are consistent with ideas relating to new materialism (LAIB is part of an interacting network of material and non-material factors) and social capital (those with supportive relationships benefited more from LAIB). Interpersonal relationships need to be considered as part of routine care and should be reviewed with patients throughout the treatment journey.</p

Green Bean Variety Evaluation, 2017

This is a compilation of 18 research trial reports from four land-grant universities in the Midwestern United States. Crops include cantaloupe, pickling cucumber, pepper, potato, pumpkin, summer squash and zucchini, sweet corn, tomato, and watermelon. Somecrops were evaluated in high tunnels or hoophouses. Most trials evaluated different cultivars or varieties. One report addressed plant spacing for sweet corn and one addressed soil block for production of tomato seedlings. A list of vegetable seed sources and a list of other online sources of vegetable trial reports are also included

Bell Pepper Cultivar Evaluation, 2017

This is a compilation of 18 research trial reports from four land-grant universities in the Midwestern United States. Crops include cantaloupe, pickling cucumber, pepper, potato, pumpkin, summer squash and zucchini, sweet corn, tomato, and watermelon. Somecrops were evaluated in high tunnels or hoophouses. Most trials evaluated different cultivars or varieties. One report addressed plant spacing for sweet corn and one addressed soil block for production of tomato seedlings. A list of vegetable seed sources and a list of other online sources of vegetable trial reports are also included