Correlates of Nine-Month Retention following Interim Buprenorphine-Naloxone Treatment in Opioid Dependence: A Pilot Study

Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT) in opioiddependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent ( = 30). While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT ( = 0.09), urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout ( < 0.01), in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout

Television gambling advertisements: Extent and content of gambling advertisements with a focus on potential high-risk commercial messages

Background: In problem gambling, recent years have seen an expansion of online gambling in treatment-seeking patients. Television advertising may promote risky gambling, and this study aimed to assess gambling-related advertisements, with respect to potentially risky messages, in a country with high rates of online gambling among treatment seekers, for online casino particularly in treatment-seeking women. Methods: A total of 144 h in six commercial television channels were studied with respect to frequency, extent and content of gambling-related advertisements, which were analyzed with respect to potentially risky messages and specific target groups, and compared with respect to legal status of gambling companies and for online casino gambling vs other gambling types. Aspects to analyze were elected theoretically and based on acceptable inter-rater agreement between the authors. Results: Nineteen percent (11–28% across different channels) of advertisements promoted gambling, with online casino being by far the most common type of gambling exposed. Messages promoting ease to gamble (including bonuses and rapid cash-out messages) and a female focus were significantly more common in online casino gambling and in non-licensed companies, whereas sports-related messages were more common in licensed companies. Gambling-related advertisements were also common in relation to family movies, and appeared even during children's programs. Conclusions: Online casino was by far the most common type of televised gambling advertisements. Several risky messages were identified, and female gender, as well as messages promoting the rapidity and facility of gambling, were more commonly addressed by online casino companies. Public health aspects are discussed

Spelberoende är en högaktuell diagnos - Snabba internetspel om pengar har stor beroendepotential – KBT ger god effekt

Gambling disorder is a serious condition and a current issue in Sweden. The national prevalence of problem gambling is 2 %, including 0.4 % meeting criteria for gambling disorder, but the incidence numbers are substantially higher due to the dynamic pattern of the disorder with people moving into and out of the problem gambling group. Rapid internet games, such as internet casinos and sports betting, cause a predominant share of the gambling problems, and the market has shown an unrestrained growth for years. New public amendments are upcoming and from the 1st of January 2018, healthcare and social services have a pronounced obligation to offer investigations and treatment (mainly CBT) for gambling disorder. The psychiatric comorbidity is high, and the risk of suicide is clearly elevated among people with gambling disorder. There are quick, evidence-based screening tools that can easily be used in clinical work, as initial steps of investigations. The need for implementing effective national strategies and further research in the area is considerable

Correlates of Nine-Month Retention following Interim Buprenorphine-Naloxone Treatment in Opioid Dependence: A Pilot Study

Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT) in opioid-dependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent (n=30). While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT (p=0.09), urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout (p<0.01), in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout