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Gondwal R, Avinash P, Victor R, Dharuvika. The Missing Link Between Opioid Use Disorder and Seizures During Opioid Withdrawal: A Case Series from North India. Indian J Psychol Med 2024; 46:81-84. [PMID: 38524948 PMCID: PMC10958083 DOI: 10.1177/02537176231167080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Affiliation(s)
- Rohit Gondwal
- State Mental Health Institute, Dehradun, Uttarakhand, India
| | - Priyaranjan Avinash
- Dept. of Psychiatry, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Robin Victor
- Dept. of Psychiatry, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Dharuvika
- Dept. of Psychiatry, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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Ganapathi L, McFall AM, Greco KF, Srikrishnan AK, Suresh Kumar M, Mayer KH, O’Cleirigh C, Mehta SH, Lucas GM, Solomon SS. Buprenorphine treatment receipt characteristics and retention among people who inject drugs at Integrated Care Centers in India. Drug Alcohol Depend 2023; 246:109839. [PMID: 37031487 PMCID: PMC10416117 DOI: 10.1016/j.drugalcdep.2023.109839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/21/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND India is facing overlapping opioid injection and HIV epidemics among people who inject drugs (PWID) in several cities. Integrated Care Centers (ICCs) provide single-venue HIV and substance use services to PWID. We evaluated PWID engagement in daily observed buprenorphine treatment at 7 ICCs to inform interventions. METHODS We analyzed 1-year follow-up data for PWID initiating buprenorphine between 1 January - 31 December 2018, evaluating receipt frequency, treatment interruptions (no buprenorphine receipt for 60 consecutive days with subsequent re-engagement), and drop-out (no buprenorphine receipt for 60 consecutive days without re-engagement). Using descriptive statistics, we explored differences between ICCs in the opioid-endemic Northeast region and ICCs in the emerging opioid epidemic North/Central region. We used a multivariable logistic regression model to determine predictors of treatment drop-out by 6 months. RESULTS 1312 PWID initiated buprenorphine (76% North/Central ICCs vs. 24% Northeast ICCs). 31% of PWID in North/Central, and 25% in Northeast ICCs experienced ≥ 1 treatment interruption in 1 year. Over 6 months, 48% of PWID in North/Central vs. 60% in Northeast ICCs received buprenorphine ≤ 2 times/week (p < 0.0001). A third of PWID in North/Central vs. half in Northeast ICCs experienced treatment drop-out by 6 months (p < 0.001). In the multivariable model, living in Northeast cities was associated with increased odds of drop-out while counseling receipt was associated with decreased odds. CONCLUSIONS Retention among PWID initiating buprenorphine at ICCs was comparable to global reports. However, regional heterogeneity in retention, and low daily buprenorphine receipt suggest patient-centered interventions adapted to regional contexts are urgently needed.
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Affiliation(s)
- Lakshmi Ganapathi
- Division of Pediatric Global Health, Massachusetts General Hospital for Children, 55 Fruit Street, Boston, Massachusetts 02114
- Division of Pediatric Infectious Diseases, Massachusetts General Hospital for Children, 55 Fruit Street, Boston, Massachusetts 02114
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115
| | - Allison M. McFall
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 733 N Broadway, Baltimore, Maryland 21205
| | - Kimberly F. Greco
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, 21 Autumn Street, Boston, Massachusetts 02215
| | - Aylur K. Srikrishnan
- YR Gaitonde Centre for AIDS Research and Education, No. 34, East Street, Kilpauk Garden Colony, Chennai, India 600010
| | - Muniratnam Suresh Kumar
- YR Gaitonde Centre for AIDS Research and Education, No. 34, East Street, Kilpauk Garden Colony, Chennai, India 600010
| | - Kenneth H. Mayer
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, Massachusetts 02215
- The Fenway Institute, 1340 Boylston Street, Boston, Massachusetts 02215
| | - Conall O’Cleirigh
- Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts 02115
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Shruti H. Mehta
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 733 N Broadway, Baltimore, Maryland 21205
| | - Gregory M. Lucas
- Division of Infectious Diseases, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, Maryland 21205
| | - Sunil S. Solomon
- Division of Infectious Diseases, The Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, Maryland 21205
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Sharma M, Kataria D, Raut N, Ramesh O, Rehman S, Gracy BK. Impact of COVID-19 pandemic on treatment seeking in opioid users: A retrospective comparative study. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_11_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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