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Record W2943673104 · doi:10.1097/cxa.0000000000000002

Diversity in the Needs and Outcomes of Low-Threshold/High-Tolerance Methadone Maintenance Therapy Clients

2017· article· en· W2943673104 on OpenAlex
Kelsey B. Morrison, Caroline Brunelle, Mary Ann Campbell, Timothy Christie, Julie Hildebrand

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
venuePublished in a venue whose home country is Canada.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueThe Canadian Journal of Addiction · 2017
Typearticle
Languageen
FieldMedicine
TopicOpioid Use Disorder Treatment
Canadian institutionsSt. Joseph's HospitalHorizon Health NetworkSaint John Regional HospitalDalhousie UniversityUniversity of New BrunswickUniversity of Saskatchewan
Fundersnot available
KeywordsMethadoneMedicineMethadone maintenancePsychological interventionMedical prescriptionLatent class modelMental healthOpiate Substitution TreatmentOpioidPsychiatryInternal medicineBuprenorphinePharmacology

Abstract

fetched live from OpenAlex

ABSTRACT Objective: The rise of opioid analgesic misuse in Canada has led to an increased demand for opioid substitution therapies, spurring the development of lower intensity methadone maintenance therapy (MMT) clinics in some provinces. However, relative to clients of comprehensive MMT services, less empirical attention has been given to clients accessing this alternative service delivery model, especially with regard to etiological variables associated with recovery. Thus, the current study aimed to examine the characteristics of opioid users in a low-threshold/high-tolerance MMT clinic with respect to their intake characteristics and long-term treatment outcomes. Methods: Latent class cluster analysis was used to identify subgroups of opioid misusers ( N = 52) based on their characteristics (eg, substance use profile, mental health) before entering the MMT program and their outcomes up to 2 years later. Results: Two subgroups of participants were identified: high severity-low treatment responders (n = 17) and low severity-high treatment responders (n = 35). The first cluster, in comparison to the second, had increased substance use severity before entering treatment and was less likely to respond to MMT as indicated by urinalysis screens 12 months following intake and physical and mental health status approximately 2 years post intake. Conclusions: These findings identified significant heterogeneity among prescription opioid misusers and point to the need for additional interventions targeting individuals at high risk of treatment nonresponse. Objectif: La hausse de la mauvaise utilisation des analgésiques opioïdes au Canada a entraîné une demande accrue de thérapies de substitution aux opioïdes, ce qui a stimulé le développement de cliniques de thérapie de maintenance à la méthadone à faible intensité (MMT) dans certaines provinces. Cependant, en ce qui concerne les clients des services MMT complets, moins d’attention empirique a été accordée aux clients qui accèdent à ce modèle de prestation de services alternatifs, plus particulièrement en ce qui concerne les variables étiologiques associées à la récupération. Ainsi, l’étude actuelle visait à examiner les caractéristiques des utilisateurs d’opioïdes dans une clinique MMT à faible seuil / tolérance élevée (LTHT) en ce qui concerne leurs caractéristiques d’admission et les résultats du traitement à long terme. Méthodes: L’analyse groupée de classe latente a été utilisée pour identifier les sous-groupes d’utilisatrices d’opioïdes (N = 52) en fonction de leurs caractéristiques (par exemple, profil d’utilisation de la substance, santé mentale) avant d’entrer dans le programme MMT et les résultats de cette analyse jusqu’à 2 ans plus tard. Résultats: Deux sous-groupes de participants ont été identifiés: répondants à des traitements à forte intensité de gravité (n = 17) et répondants à traitements de faible intensité de gravité (n = 35). Le premier groupe, par rapport au second, avait une intensité accrue de l’utilisation de la substance avant d’entrer en traitement et était moins susceptible de répondre au MMT, comme l’indiquent les écrans d’analyse d’urine 12 mois après l’admission et l’état de santé physique et mentale environ deux ans après l’admission. Conclusions: Ces résultats ont identifié une hétérogénéité significative chez les utilisateurs d’opioïdes et soulignent la nécessité d’interventions supplémentaires visant des individus présentant un risque élevé de non-réponse au traitement.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.013
Threshold uncertainty score0.986

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.023
GPT teacher head0.263
Teacher spread0.240 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it