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Salvalaggio G, Brooks H, Caine V, Gagnon M, Godley J, Houston S, Kennedy MC, Kosteniuk B, Livingston J, Saah R, Speed K, Urbanoski K, Werb D, Hyshka E. Flawed reports can harm: the case of supervised consumption services in Alberta. Can J Public Health 2023; 114:928-933. [PMID: 37930628 PMCID: PMC10661131 DOI: 10.17269/s41997-023-00825-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023]
Abstract
Supervised consumption services have been scaled up within Canada and internationally as an ethical imperative in the context of a public health emergency. A large body of peer-reviewed evidence demonstrates that these services prevent poisoning deaths, reduce infectious disease transmission risk behaviour, and facilitate clients' connections to other health and social services. In 2019, the Alberta government commissioned a review of the socioeconomic impacts of seven supervised consumption services in the province. The report is formatted to appear as an objective, scientifically credible evaluation of these services; however, it is fundamentally methodologically flawed, with a high risk of biases that critically undermine its authors' assessment of the scientific evidence. The report's findings have been used to justify decisions that jeopardize the health and well-being of people who use drugs both in Canada and internationally. Governments must ensure that future assessments of supervised consumption services and other public health measures to address drug poisoning deaths are scientifically sound and methodologically rigorous. Health policy must be based on the best available evidence, protect the right of structurally vulnerable populations to access healthcare, and not be contingent on favourable public opinion or prevailing political ideology.
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Affiliation(s)
- Ginetta Salvalaggio
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
| | - Hannah Brooks
- School of Public Health, University of Alberta, Nashville, TN, USA
| | - Vera Caine
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Marilou Gagnon
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, AB, Canada
| | - Stan Houston
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Mary Clare Kennedy
- British Columbia Centre On Substance Use, University of British Columbia - Okanagan School of Social Work, Vancouver, BC, Canada
| | - Brynn Kosteniuk
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Jamie Livingston
- Department of Criminology, Saint Mary's University, Halifax, NS, Canada
| | - Rebecca Saah
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Kelsey Speed
- School of Public Health, University of Alberta, Vancouver, BC, Canada
| | - Karen Urbanoski
- School of Public Health & Social Policy, University of Victoria, Victoria, BC, Canada
| | - Dan Werb
- Centre On Drug Policy Evaluation, MAP Centre On Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Division of Infectious Disease & Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Elaine Hyshka
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Nairn SA, Audet M, Stewart SH, Hawke LD, Isaacs JY, Henderson J, Saah R, Knight R, Fast D, Khan F, Lam A, Conrod P. Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review. Can J Psychiatry 2022; 67:881-898. [PMID: 35535396 PMCID: PMC9659799 DOI: 10.1177/07067437221089810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Youth and young adults have been significantly impacted by the opioid overdose and health crisis in North America. There is evidence of increasing morbidity and mortality due to opioids among those aged 15-29. Our review of key international reports indicates there are few youth-focused interventions and treatments for opioid use. Our scoping review sought to identify, characterize, and qualitatively evaluate the youth-specific clinical and pre-clinical interventions for opioid use among youth. METHOD We searched MedLine and PsycInfo for articles that were published between 2013 and 2021. Previous reports published in 2015 and 2016 did not identify opioid-specific interventions for youth and we thus focused on the time period following the periods covered by these prior reports. We input three groups of relevant keywords in the aforementioned search engines. Specifically, articles were included if they targeted a youth population (ages 15-25), studied an intervention, and measured impacts on opioid use. RESULTS We identified 21 studies that examined the impacts of heterogeneous interventions on youth opioid consumption. The studies were classified inductively as psycho-social-educational, pharmacological, or combined pharmacological-psycho-social-educational. Most studies focused on treatment of opioid use disorder among youth, with few studies focused on early or experimental stages of opioid use. A larger proportion of studies focused heavily on male participants (i.e., male gender and/or sex). Very few studies involved and/or included youth in treatment/program development, with one study premised on previous research about sexual minority youth. CONCLUSIONS Research on treatments and interventions for youth using or at-risk of opioids appears to be sparse. More youth involvement in research and program development is vital. The intersectional and multi-factorial nature of youth opioid use and the youth opioid crisis necessitates the development and evaluation of novel treatments that address youth-specific contexts and needs (i.e., those that address socio-economic, neurobiological, psychological, and environmental factors that promote opioid use among youth).
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Affiliation(s)
- Stephanie A Nairn
- Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, Québec, H3T 1J4, Canada.,Centre de Recherche, CHU Ste-Justine, Montréal, Quebec, H3T 1C4, Canada.,Department of Sociology, 5620McGill University, Montreal, Quebec, H3A 2T7, Canada
| | - Marion Audet
- Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, Québec, H3T 1J4, Canada.,Centre de Recherche, CHU Ste-Justine, Montréal, Quebec, H3T 1C4, Canada
| | - Sherry H Stewart
- Department of Psychiatry, 3688Dalhousie University, Halifax, Nova Scotia, B3H 2E2, Canada.,Department of Psychology & Neuroscience, 3688Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lisa D Hawke
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada
| | - Jason Y Isaacs
- Department of Psychiatry, 3688Dalhousie University, Halifax, Nova Scotia, B3H 2E2, Canada
| | - Joanna Henderson
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada
| | - Rebecca Saah
- Cumming School of Medicine, 70401University of Calgary, Calgary, Alberta, T2N 4N1, Canada.,Department of Community Health Sciences, 70401University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, British Columbia, V6Z 2A9, Canada
| | - Danya Fast
- British Columbia Centre on Substance Use, Vancouver, British Columbia, V6Z 2A9, Canada
| | - Faria Khan
- Cumming School of Medicine, 70401University of Calgary, Calgary, Alberta, T2N 4N1, Canada.,Department of Community Health Sciences, 70401University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - Alice Lam
- Research Centre du Chum, Montreal, Quebec, H2X 0C1, Canada
| | - Patricia Conrod
- Département de Psychiatrie, Faculté de Médecine, Université de Montréal, Montréal, Québec, H3T 1J4, Canada.,Centre de Recherche, CHU Ste-Justine, Montréal, Quebec, H3T 1C4, Canada
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Saah-Briffaut E, Collinet P, Saah R, Boman F, Leroy JL. Prise en charge des lésions malpighiennes intra-épithéliales de type CIN2 et CIN3 par vaporisation au laser. ACTA ACUST UNITED AC 2006; 35:785-9. [PMID: 17151534 DOI: 10.1016/s0368-2315(06)76480-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study was carried out over an 8-year period in order to evaluate the long-term effectiveness of laser CO2 vaporization in the treatment of squamous intraepithelial lesion of type CIN2 and CIN3. MATERIALS AND METHODS A retrospective study of 52 cases of cervical lesions of type CIN2 and CIN3 treated in first intention by laser CO2 vaporization was carried out at the hospital Jeanne-de-Flandre in CHRU of Lille from 1996 to 2003. This treatment was performed on only high-grade exo-cervical lesions, of small size (<2cm2), after a complete colposcopic examination. RESULTS Fifty-two patients were treated by first-intention laser vaporization only. Mean age was 29.4 years and 51.9% were nulliparous. At the first cyto-colposcopic control, there were 17 persistent lesions (32.7%). Among the 35 patients without persistent lesion, 29 achieved cure (absence of recurrence), 4 presented a recurrence and 2 were lost to follow-up. CONCLUSION The current data of the literature concerning the treatment by laser CO2 vaporization authorize application of this method for certain high-grade exocervical lesions after a complete colposcopic examination. This type of treatment remains less aggressive than a surgical treatment. The high rate of residual lesions in particular in the event of CIN3 can be due to an incomplete destruction of the lesion. Patients should thus be advised that monitoring is an integral part of the treatment. Laser vaporization could be limited to CIN1 and CIN2 lesions.
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Affiliation(s)
- E Saah-Briffaut
- Clinique de Gynécologie, Hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille Cedex
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