36,035 results match your criteria Opioid Abuse

Impact of intensity of behavioral treatment, with or without medication treatment, for opioid use disorder on HIV outcomes in persons with HIV.

J Subst Abuse Treat 2021 May 29;132:108509. Epub 2021 May 29.

Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA; VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. Electronic address:

Background: Persons with HIV (PWH) and opioid use disorder (OUD) can have poor health outcomes. We assessed whether intensity of behavioral treatment for OUD (BOUD) with and without medication for OUD (MOUD) is associated with improved HIV clinical outcomes.

Methods: We used Veterans Aging Cohort Study (VACS) data from 2008 to 2017 to identify PWH and OUD with ≥1 BOUD episode. Read More

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Investigation of patterns and dynamics of substance users: A long-term toxicology study on a sample of the Greek population between 2005 and 2019.

J Forensic Sci 2021 Jun 15. Epub 2021 Jun 15.

Laboratory of Forensic Sciences, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece.

The purpose of the present study is to investigate dynamics underlying drug abuse and identify statistical correlations/patterns of forensic findings and sociodemographic factors in a population of illicit substance users. The following long-term studies were conducted: (a) a retrospective autopsy cohort study on autopsy incidents with available toxicological screening results (N = 482) in investigation of any possible forensic associations of exposure to illicit drugs; and (b) a cross-sectional study on a sample of arrested drug law offenders with available toxicological screening results (N = 195) as well as cluster analysis in order to possibly identify user profiles. Although outside the scope of the present study, ethanol was generally considered to be the main substance of abuse, as more than half of the premature deaths reported tested positive on the ethanol toxicology screen. Read More

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Insights into the mechanisms underlying opioid use disorder and potential treatment strategies.

Br J Pharmacol 2021 Jun 14. Epub 2021 Jun 14.

Beijing Key Laboratory of Neuropsychopharmacology, State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27th Taiping Road, Beijing, 100850, China.

Opioid use disorder is a worldwide societal problem and public health burden. Strategies for treating opioid use disorder can be divided those that target the opioid receptor system and those that target non-opioid receptor systems, including the dopamine and glutamate receptor systems. Currently, the clinical drugs used to treat anti-opioid use disorder include the opioid receptor agonists methadone and buprenorphine, which are limited by abuse liability, and the opioid receptor antagonist naltrexone, which is limited by poor compliance. Read More

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A Case Report of Torsade de Pointes and Brugada Pattern Associated with Loperamide Misuse and Supratherapeutic Loperamide Concentrations.

J Emerg Med 2021 Jun 11. Epub 2021 Jun 11.

Department of Emergency Medicine, Denver Health and Hospital Authority, Denver, Colorado; Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, Colorado.

Background: Loperamide, commonly sold under the brand name Imodium® (Johnson & Johnson, Fort Washington, PA), is a widely available, over-the-counter antidiarrheal medication that possesses µ-opioid agonist properties and can have catastrophic cardiac events when misused or abused. Since the start of the opioid epidemic in the United States, there has been an increasing number of case reports and deaths linking loperamide abuse with cardiac events such as torsades de pointes (TdP) and Brugada syndrome.

Case Report: This case report presents a 22-year-old man who presented in cardiac arrest from polymorphic ventricular tachycardia consistent with TdP and a Type 1 Brugada pattern after intentional loperamide abuse. Read More

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HIV Testing and Counseling at U.S. Substance Use Treatment Facilities: A Missed Opportunity for Early Identification.

Psychiatr Serv 2021 Jun 15:appips202000524. Epub 2021 Jun 15.

Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences (Riano, Bazazi, Mangurian), School of Medicine (Borowsky, Arnold), Center for AIDS Prevention Studies (Arnold), and Department of Epidemiology and Biostatistics (Vittinghoff, Mangurian), University of California, San Francisco, San Francisco; New York State Psychiatric Institute, New York City (Olfson, Cournos); Department of Psychiatry, Vagelos College of Physicians and Surgeons (Olfson), and Mailman School of Public Health (Cournos), Columbia University, New York City; Institute for Health, Health Care Policy and Aging Research (Walkup) and Center for Health Services Research (Crystal), Rutgers University, New Brunswick, New Jersey; Kaiser Family Foundation, HIV Policy, Washington, D.C. (Dawson).

Objective: The objective of this study was to determine the availability and national distribution of HIV testing and counseling at substance use treatment facilities in the United States.

Methods: Analyses of data from the 2018 National Survey of Substance Abuse Treatment Services assessed HIV testing and counseling availability in U.S. Read More

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Endogenous and exogenous opioid effects on oligodendrocyte biology and developmental brain myelination.

Neurotoxicol Teratol 2021 Jun 12;86:107002. Epub 2021 Jun 12.

Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA. Electronic address:

The elevated presence of opioid receptors and their ligands throughout the developing brain points to the existence of maturational functions of the endogenous opioid system that still remain poorly understood. The alarmingly increasing rates of opioid use and abuse underscore the urgent need for clear identification of those functions and the cellular bases and molecular mechanisms underlying their physiological roles under normal and pathological conditions. This review is focused on current knowledge on the direct and indirect regulatory roles that opioids may have on oligodendrocyte development and their generation of myelin, a complex insulating membrane that not only facilitates rapid impulse conduction but also participates in mechanisms of brain plasticity and adaptation. Read More

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Social Information Processing in Substance Use Disorders: Insights From an Emotional Go-Nogo Task.

Front Psychiatry 2021 28;12:672488. Epub 2021 May 28.

Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States.

Positive social connections are crucial for recovery from Substance Use Disorder (SUD). Of interest is understanding potential social information processing (SIP) mediators of this effect. To explore whether persons with different SUD show idiosyncratic biases toward social signals, we administered an emotional go-nogo task (EGNG) to 31 individuals with Cocaine Use Disorder (CoUD), 31 with Cannabis Use Disorder (CaUD), 79 with Opioid Use Disorder (OUD), and 58 controls. Read More

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A High Note: Drug Misuse in Popular Rap Music.

Ben Stickle

Subst Use Misuse 2021 Jun 13:1-9. Epub 2021 Jun 13.

Criminal Justice Administration, Middle Tennessee State Univeristy, Murfreesboro, Tennessee, USA.

Background: During the last decade, drug abuse rates, particularly prescription drugs, have increased. Simultaneously, music consumption has dramatically increased, and the leading genre is currently rap music. While the casual relationship is debated, musical preference is related to substance misuse and other risky behaviors. Read More

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Opium tincture-assisted treatment for opioid use disorder: A systematic review.

J Subst Abuse Treat 2021 Jun 4;129:108519. Epub 2021 Jun 4.

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address:

Background: Some countries have used opioid agonist medications other than methadone and buprenorphine as a strategy to increase treatment diversity. In Iran and other countries where opium use is common and culturally tolerated, opium tincture (OT) has gained growing popularity and been approved to treat opioid use disorder (OUD). Given the increasing interest in this intervention, we conducted a systematic review of the literature to evaluate the safety and efficacy of OT-assisted treatment for OUD. Read More

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Reductions in tobacco use in naltrexone, relative to buprenorphine-maintained individuals with opioid use disorder: Secondary analysis from the National Drug Abuse Treatment Clinical Trials Network.

J Subst Abuse Treat 2021 May 21;130:108489. Epub 2021 May 21.

Department of Psychiatry, NYU Grossman School of Medicine, One Park Avenue, New York, NY 10016, USA.

Background: Smoking prevalence in individuals with opioid use disorder (OUD) is over 80%. Research suggests that opioid use significantly increases smoking, which could account for the strikingly low smoking-cessation rates observed in both methadone- and buprenorphine-maintained patients, even with the use of first-line smoking-cessation interventions. If opioids present a barrier to smoking-cessation, then better smoking outcomes should be observed in OUD patients treated with extended-release naltrexone (XR-NTX, an opioid antagonist) compared to those receiving buprenorphine (BUP-NX, a partial opioid agonist). Read More

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Experiences of stigma among individuals in recovery from opioid use disorder in a rural setting: A qualitative analysis.

J Subst Abuse Treat 2021 May 21;130:108488. Epub 2021 May 21.

Maine Maternal Opioid Misuse Initiative (MaineMOM), MaineHealth Director of Perinatal IMAT, 22 Bramhall Street, Portland, ME 04102, United States.

Introduction: Stigma is a barrier to accessing treatment and support services for individuals with substance use disorder. Stigma is negatively associated with completion of treatment for substance use disorder and management of recovery.

Objective: To learn from individuals in recovery from opioid use disorder in a largely rural area about how their personal experiences of stigma affected their ability to enter into treatment and stay in recovery. Read More

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Drug and sexual HIV-risk behaviors among adolescents and young adults with opioid use disorder.

J Subst Abuse Treat 2021 May 19;130:108477. Epub 2021 May 19.

Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, United States of America.

Opioid use disorder (OUD) among adolescents and young adults (youth) is associated with drug use and sexual HIV-related risk behaviors and opioid overdose. This mixed methods analysis assesses risk behaviors among a sample of 15-21-year-olds (N = 288) who were being treated for OUD in a residential drug treatment program in Baltimore, Maryland. Participants were enrolled in a parent study in which they received either extended-release naltrexone (XR-NTX) or Treatment as Usual (TAU), consisting of outpatient counseling with or without buprenorphine, prior to discharge. Read More

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Impact of a pharmacist-led substance use disorder transitions of care clinic on postdischarge medication treatment retention.

J Subst Abuse Treat 2021 Apr 28;130:108440. Epub 2021 Apr 28.

VA Tennessee Valley Healthcare System, 1310 24th Avenue South, Nashville, TN 37212, United States.

Background: The Veterans Health Administration (VHA) has made significant improvements in increasing prescribing of medication treatment for opioid use disorder (MOUD) and medication treatment for alcohol use disorder (MAUD); however, several barriers to treatment retention remain. In an effort to improve MOUD/MAUD retention, a Veterans Affairs (VA) facility established a pharmacist-led substance use disorder (SUD) transitions of care telephone clinic for patients discharged from an inpatient hospitalization on MOUD/MAUD, including buprenorphine/naloxone (BUP/NAL) and extended-release (ER) naltrexone injections. Pharmacists within the clinic assess aspects of treatment retention such as medication tolerability, perceived barriers to continuing treatment, status of current prescriptions, and appointment coordination. Read More

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Examining factors that shape use and access to diverted prescription opioids during an overdose crisis: A qualitative study in Vancouver, Canada.

J Subst Abuse Treat 2021 Apr 20;130:108418. Epub 2021 Apr 20.

Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver V6Z 1Y6, BC, Canada; British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver V6Z 2A9, BC, Canada.

Objective: Prescription opioid (PO) diversion is widely regarded as a driver of overdose mortality. However, less is known about the rationale for using diverted POs during an overdose epidemic and how contextual factors (e.g. Read More

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Feasibility and acceptability of mindful recovery opioid use care continuum (M-ROCC): A concurrent mixed methods study.

J Subst Abuse Treat 2021 Apr 15;130:108415. Epub 2021 Apr 15.

Harvard Medical School, Boston, MA, United States of America; Cambridge Health Alliance, Cambridge, MA, United States of America; Geisel School of Medicine at Dartmouth College, Hanover, NH, United States of America. Electronic address:

As opioid overdose deaths increase, buprenorphine/naloxone (B/N) treatment is expanding, yet almost half of patients are not retained in B/N treatment. Mindfulness-based interventions (MBIs) designed to promote non-judgmental awareness of present moment experience may be complementary to B/N treatment and offer the potential to enhance retention by reducing substance use and addressing comorbid symptoms. In this pilot study, we examined the feasibility and acceptability of the Mindful Recovery OUD Care Continuum (M-ROCC), a trauma-informed, motivationally sensitive, 24-week MBI. Read More

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Facilitators and barriers to post-overdose service delivery in Rhode Island emergency departments: A qualitative evaluation.

J Subst Abuse Treat 2021 Apr 14;130:108411. Epub 2021 Apr 14.

Department of Health Services, Policy, and Practice, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02903, United States.

Background: Emergency departments (EDs) in the US have increasingly incorporated interventions that seek to reduce opioid-related morbidity and mortality. However, many of these interventions are underutilized. This study examined ED provider-identified barriers and facilitators to policy-prescribed service provision for patients treated for an opioid overdose in Rhode Island EDs, and opportunities to improve care delivery. Read More

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Bridge clinic buprenorphine program decreases emergency department visits.

J Subst Abuse Treat 2021 Apr 17;130:108410. Epub 2021 Apr 17.

Department of Emergency Medicine, Upstate Medical University, Syracuse, NY, USA.

Introduction: Opioid withdrawal due to opioid use disorder (OUD) is an increasing health emergency and complaint in emergency departments (EDs) across the United States. As a response to the increased need for OUD treatment, a low threshold buprenorphine program, or Bridge Clinic, was established within our hospital system. Patients are primarily connected to the Bridge Clinic through the ED, and are able to complete their consultation appointment reliably within 1-3 days of referral. Read More

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Extended-release naltrexone for youth with opioid use disorder.

J Subst Abuse Treat 2021 Apr 15;130:108407. Epub 2021 Apr 15.

Friends Research Institute, 1040 Park Avenue, Suite, 103 Baltimore, MD, USA. Electronic address:

Background: Few published research studies have examined the effectiveness of extended-release naltrexone (XR-NTX) for the treatment of opioid use disorder (OUD) among adolescents and young adults.

Methods: This two-group randomized controlled trial recruited 288 youth, ages 15-21, with moderate/severe OUD from a residential addiction treatment program in Baltimore, Maryland. The study randomized the youth within the first week of treatment entry to receive either XR-NTX or treatment-as-usual (TAU; either buprenorphine maintenance treatment or treatment without OUD medication following medically managed withdrawal) prior to discharge, with continued treatment in the community for 6 months. Read More

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Buprenorphine use and disparities in access among emergency department patients with opioid use disorder: A cross-sectional study.

J Subst Abuse Treat 2021 Apr 20;130:108405. Epub 2021 Apr 20.

Cooper Medical School of Rowan University, 401 Broadway, Camden, NJ 08103, United States of America; Cooper University Hospital, Department of Emergency Medicine, Keleman 152, 1 Cooper Plaza, Camden, NJ 08103, United States of America. Electronic address:

Background: Buprenorphine, a partial mu-opioid agonist and kappa-opioid antagonist, is an approved treatment for opioid use disorder (OUD). Studies demonstrate that buprenorphine decreases cravings for other opioids, effectively ameliorates withdrawal symptoms, and decreases opioid overdose and mortality. However, buprenorphine remains under-utilized. Read More

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The cascade of care for opioid use disorder among youth in British Columbia, 2018.

J Subst Abuse Treat 2021 Apr 18;130:108404. Epub 2021 Apr 18.

Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada. Electronic address:

Background: Medication for opioid use disorder (MOUD) is associated with substantial reductions in the risk of mortality, and American and Canadian guidelines recommend it as part of the full range of available treatments for youth with opioid use disorder (OUD). We estimated the OUD cascade of care for all adolescents (ages 12-18) and young adults (19-24) with OUD in British Columbia, Canada (BC) in 2018.

Methods: Using a provincial-level linkage of six health administrative databases, we classified youth with OUD as adolescents (ages 12-18) or young adults (19-24) to compare with older adults (≥25) and described key factors known to influence engagement in health care. Read More

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Precision dosing of methadone during pregnancy: A pharmacokinetics virtual clinical trials study.

J Subst Abuse Treat 2021 Jun 3;130:108521. Epub 2021 Jun 3.

Humankind Charity, Inspiration House, Unit 22, Bowburn North Industrial Estate, Durham DH6 5PF, United Kingdom.

Background: Methadone use for the management of opioid dependency during pregnancy is commonplace. Methadone levels are altered during pregnancy due to changes in maternal physiology. Despite this, a paucity of data exist regarding the most appropriate optimal dosing regimens during pregnancy. Read More

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The new services that opioid treatment programs have adopted in response to COVID-19.

J Subst Abuse Treat 2021 Apr 9;130:108393. Epub 2021 Apr 9.

Department of Public Administration, University of Illinois at Chicago, 412 S. Peoria St., 136, Chicago, IL 60607 (MC 278), USA. Electronic address:

COVID-19 has exacerbated the opioid epidemic and transformed how programs treat opioid use disorder. In response to the pandemic, the federal government modified guidelines to allow opioid treatment programs (OTPs) greater flexibility in the provision of medication for opioid use disorder. We conducted a telephone survey of 31. Read More

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Interactive effects of (±)-trans-U50488 and its stereoisomers with cannabinoids.

Pharmacol Biochem Behav 2021 Jun 9:173218. Epub 2021 Jun 9.

Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; Alcohol and Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.

The adverse effects of mu opioid agonists have spurred a renewed interest in using kappa opioid receptor (KOR) agonists as analgesics. KOR agonists also have potential for development as diuretics for the treatment of edema and hypertension. Here, we evaluated the discriminative stimulus, antinociceptive, and diuretic effects of the kappa agonist (±)-trans-U-50488 and its stereoisomers (-)-(1S,2S)-U-50488 or (+)-(1R,2R)-U-50488) alone and in combination with the cannabinoid agonist (-)-CP 55,940. Read More

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Identifying counties at risk of high overdose mortality burden during the emerging fentanyl epidemic in the USA: a predictive statistical modelling study.

Lancet Public Health 2021 Jun 9. Epub 2021 Jun 9.

Department of Medicine, University of California, San Diego, CA, USA.

Background: The emergence of fentanyl around 2013 represented a new, deadly stage of the opioid epidemic in the USA. We aimed to develop a statistical regression approach to identify counties at the highest risk of high overdose mortality in the subsequent years by predicting annual county-level overdose death rates across the contiguous USA and to validate our approach against observed overdose mortality data collected between 2013 and 2018.

Methods: We fit mixed-effects negative binomial regression models to predict overdose death rates in the subsequent year for 2013-18 for all contiguous state counties in the USA (ie, excluding Alaska and Hawaii). Read More

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Negative affect-associated drug refusal self-efficacy, illicit opioid use, and medication use following short-term inpatient opioid withdrawal management.

J Subst Abuse Treat 2021 Jul 27;126:108309. Epub 2021 Jan 27.

Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, USA; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.

Introduction: Persons with opioid use disorder (OUD) are prone to frequent relapse following brief inpatient medically managed withdrawal. This longitudinal, naturalistic study examines associations among illicit opioid use, use of medication for opioid use disorder (MOUD), and one's confidence in the ability to resist drug use in the face of negative emotions (i.e. Read More

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Access to treatment for pregnant incarcerated people with opioid use disorder: Perspectives from community opioid treatment providers.

J Subst Abuse Treat 2021 Jul 25;126:108338. Epub 2021 Feb 25.

Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, Johns Hopkins Bayview Hospital, 4940 Eastern Ave, A121, Baltimore, MD 21224, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 24 N. Broadway, Hampton House 737, Baltimore, MD 21205, United States. Electronic address:

Background And Aims: Many jail facilities provide limited access to medications for opioid use disorder (MOUD) for pregnant people with opioid use disorder (OUD), despite it being the standard of care. We aim to explore the perspectives of opioid treatment providers (OTPs) on access to MOUD for pregnant people while incarcerated and postincarceration.

Methods: We conducted 16 semistructured phone interviews with providers and administrators representing 16 unique OTPs in various U. Read More

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Who stays in medication treatment for opioid use disorder? A national study of outpatient specialty treatment settings.

J Subst Abuse Treat 2021 Jul 18;126:108329. Epub 2021 Feb 18.

Department of Population Health, NYU Grossman School of Medicine, United States of America.

Background: Maintenance treatments with medications for opioid use disorder (MOUD) are highly effective at reducing overdose risk while patients remain in care. However, few patients initiate medication and retention remains a critical challenge across settings. Much remains to be learned about individual and structural factors that influence successful retention, especially among populations dispensed MOUD in outpatient settings. Read More

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Use of an electronic pillbox to increase number of methadone take-home doses during the COVID-19 pandemic.

J Subst Abuse Treat 2021 07 11;126:108328. Epub 2021 Feb 11.

Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Addiction Treatment Services - BBRC, Johns Hopkins Bayview Medical Center, 5510 Nathan Shock Drive, Suite 1500, Baltimore, MD 21224, United States of America.

This study describes use of the commercially available Medminder electronic pillbox at a community substance use disorder treatment program to safely increase the number of methadone take-home doses administered during the COVID-19 pandemic. The pillbox contains 28 cells that lock independently and can be opened only during preprogrammed time windows. This study provided patients (n = 42) deemed vulnerable to take-home mismanagement or more severe symptoms from COVID-19 infection the pillbox and observed them for 11 weeks. Read More

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