Reporting on Diverse Current Practices
Bibliographic record
Abstract
As our field grows in complexity, so does the range of submissions to the Canadian Journal of Addiction. The leading policy debate is possibly about the relative effectiveness of Safer Supply (SS) and Opioid Agonist Treatment (OAT) programs to address the country’s skyrocketing number of overdose deaths. These have been estimated to be an average of 23 people killed each day in Canada last year, for a total of 40,000 opioid-related deaths since 2016, the year when the Public Health Agency of Canada began collecting such data. Kahan M, in a leading review of retrospective studies, identified reduced rates of hospitalizations and visits to emergency departments in patients of SS programs. There is evidence, however, of common diversion of hydromorphone tablets. By comparison, OAT programs reduce overdose mortality as well as rates of injection-related infections in this context despite limited access and low treatment retention rates. Recommended strategies involve the observed dosing of oral hydromorphone, a combination of hydromorphone with OAT, and coordination of care between program providers. The role of pharmacists in our clinical practice teams has gained increased recognition over the last decade. Llewelyn-Williams and colleagues report on 50 consultations involving opioid use disorders and alcohol use disorders. The expanding pharmacology now available, including initiation of acamprosate, naltrexone, and extended-release buprenorphine, as well as the needed follow-up and monitoring of their interactions with other medications, are examples of the positive impact of pharmacist involvement in patient care. We look forward to further studies demonstrating outcomes from the interventions. The third article, by Roy and colleagues, is a retrospective cohort study of patients admitted to 2 Canadian hospitals that evaluated the use of opioids during inpatient hospitalization between 2017 and 2019. An overall rate of 65% of opioid prescribing is reported, comprised mostly of as-needed opioids. These prescriptions remain active on the day of discharge. The patterns identified could be targets for eventual strategies to reduce opioid exposure. Mercante and colleagues, in a submission from Sao Paolo, Brazil, investigate the sociodemographic profile of role-playing games (RPG) players (N=115), their game habits, and psychopathological symptoms. Personal characteristics, such as having no emotional support and parents who are not interested in RPGs, appear to be risk factors for a pathological relationship to tabletop RPG playing. An international cultural comparison of these findings would be welcome. In a limited literature review, Prada and de Moissac provide a snapshot of substance use, addictions, and related treatment services available to 2 Official Language Minority Communities (OLMC) in Canada. Gaps in knowledge and service provision are reported. Networking, collaborating, financial support, and active offer of services in both languages are recommended to improve mental health and addiction services through a continuum of care. The last article, by Cavacuiti and colleagues, describes a “simplified care model” implemented in True North Medical Centre in Ontario and its efficacy for people who achieved sustained virologic response 12 weeks after antiviral treatment. In a sample of 1408 people, a higher proportion of treatment-eligible people initiated direct-acting antiviral (DAA) treatment for hepatitis C virus compared with traditional care. Traditional care included HCV antibody screening, ribonucleic (RNA) testing, noninvasive assessment of fibrosis, and referral to DAA treatment. Simplified care included the above, along with telemedicine consults. This model increased retention of care and higher rates of treatment completion due to a decentralized and simplified approach to HCV diagnosis and linkage to care. We hope this panoply of practice insights will facilitate our daily tasks. Nady el-Guebaly, CM, MD, FRCPC Editor-in-Chief, CJA
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.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".