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Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice

OBJECTIVE: To describe current approaches in treatment of opioid use disorder (OUD) within Canadian psychosocial outpatient, day, and residential addiction treatment programs, with an emphasis on the use of opioid agonist therapy (OAT). METHOD: An online census survey was conducted in English and Fr...

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Autores principales: Hodgins, David C., Budd, Mathew, Czukar, Gail, Dubreucq, Simon, Jackson, Lois A., Rush, Brian, Quilty, Lena C., Adams, Denise, Cameron Wild, T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301153/
https://www.ncbi.nlm.nih.gov/pubmed/35257596
http://dx.doi.org/10.1177/07067437221082858
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author Hodgins, David C.
Budd, Mathew
Czukar, Gail
Dubreucq, Simon
Jackson, Lois A.
Rush, Brian
Quilty, Lena C.
Adams, Denise
Cameron Wild, T.
author_facet Hodgins, David C.
Budd, Mathew
Czukar, Gail
Dubreucq, Simon
Jackson, Lois A.
Rush, Brian
Quilty, Lena C.
Adams, Denise
Cameron Wild, T.
author_sort Hodgins, David C.
collection PubMed
description OBJECTIVE: To describe current approaches in treatment of opioid use disorder (OUD) within Canadian psychosocial outpatient, day, and residential addiction treatment programs, with an emphasis on the use of opioid agonist therapy (OAT). METHOD: An online census survey was conducted in English and French of Canadian psychosocial addiction treatment programs (N = 214). RESULTS: Programs estimated that 25% of their clients have OUD. A slight majority of programs provide some type of specialized services to clients with OUD (58%), most frequently providing or facilitating access to OAT but also specialized counselling, case management, education, and harm reduction services. Most programs reported that they admitted clients on OAT (88%) and only a minority expected or encouraged clients to taper (14%) or discontinue (6%). Programs focusing on client abstinence as the treatment goal were more likely to expect or encourage tapering or discontinuation than programs that focus on helping clients achieve personal consumption goals. Of programs that did not currently facilitate OAT, 44% indicated that they would provide OAT, but lacked the necessary accreditation, physician support, or other resources. No philosophical objections to OAT were noted. OAT initiation was provided by 30% of programs, 23% referred to another service within their organization, and 29% referred to a service outside their organization. The remaining 18% did not facilitate OAT initiation at all, ranging from 0% in Quebec to 23% in the Prairies. Overdose response kits were provided by 86% of programs. The majority not providing kits indicated willingness if policy support and resources were provided (67%). CONCLUSIONS: Overall, the results demonstrate that psychosocial programs provide some specialized services for OUD but desire further support specifically to provide OAT, including training, knowledge, and the expertise of individuals qualified to prescribe and dispense OAT. Many psychosocial treatment programs expressed a need for staff and resources for this purpose.
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spelling pubmed-93011532022-07-22 Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice Hodgins, David C. Budd, Mathew Czukar, Gail Dubreucq, Simon Jackson, Lois A. Rush, Brian Quilty, Lena C. Adams, Denise Cameron Wild, T. Can J Psychiatry Original Research OBJECTIVE: To describe current approaches in treatment of opioid use disorder (OUD) within Canadian psychosocial outpatient, day, and residential addiction treatment programs, with an emphasis on the use of opioid agonist therapy (OAT). METHOD: An online census survey was conducted in English and French of Canadian psychosocial addiction treatment programs (N = 214). RESULTS: Programs estimated that 25% of their clients have OUD. A slight majority of programs provide some type of specialized services to clients with OUD (58%), most frequently providing or facilitating access to OAT but also specialized counselling, case management, education, and harm reduction services. Most programs reported that they admitted clients on OAT (88%) and only a minority expected or encouraged clients to taper (14%) or discontinue (6%). Programs focusing on client abstinence as the treatment goal were more likely to expect or encourage tapering or discontinuation than programs that focus on helping clients achieve personal consumption goals. Of programs that did not currently facilitate OAT, 44% indicated that they would provide OAT, but lacked the necessary accreditation, physician support, or other resources. No philosophical objections to OAT were noted. OAT initiation was provided by 30% of programs, 23% referred to another service within their organization, and 29% referred to a service outside their organization. The remaining 18% did not facilitate OAT initiation at all, ranging from 0% in Quebec to 23% in the Prairies. Overdose response kits were provided by 86% of programs. The majority not providing kits indicated willingness if policy support and resources were provided (67%). CONCLUSIONS: Overall, the results demonstrate that psychosocial programs provide some specialized services for OUD but desire further support specifically to provide OAT, including training, knowledge, and the expertise of individuals qualified to prescribe and dispense OAT. Many psychosocial treatment programs expressed a need for staff and resources for this purpose. SAGE Publications 2022-03-08 2022-08 /pmc/articles/PMC9301153/ /pubmed/35257596 http://dx.doi.org/10.1177/07067437221082858 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Hodgins, David C.
Budd, Mathew
Czukar, Gail
Dubreucq, Simon
Jackson, Lois A.
Rush, Brian
Quilty, Lena C.
Adams, Denise
Cameron Wild, T.
Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice
title Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice
title_full Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice
title_fullStr Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice
title_full_unstemmed Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice
title_short Treatment of Opioid Use Disorder in Canadian Psychosocial Addiction Programs: A National Survey of Policy, Attitudes, and Practice
title_sort treatment of opioid use disorder in canadian psychosocial addiction programs: a national survey of policy, attitudes, and practice
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301153/
https://www.ncbi.nlm.nih.gov/pubmed/35257596
http://dx.doi.org/10.1177/07067437221082858
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