Periodico bimestrale - Sped. in Abb. Post. - D.L. 353/2003 conv. in L. 27/02/2004 n° 46 art. 1, comma 1, DCB PISA Aut. tirb. di Pisa n.5 del 9-3-2000
20 th ye ar
ISSN 1592-1638 - ISSN 2531-4122 (on line)
Vol. 20 • N. s1 • May 2018
the official journal of
World Federation for the Treatment of Opiod Dependence
Addiction is a treatable disease Millions of people worldwide are suffering from diseases of addiction We at Indivior envision a day in which all patients around the world will have unrestricted access to quality treatments and services for the chronic relapsing conditions and co-morbidities of addiction.
Indivior Italia S.r.l. Via Spadolini, 7 - 20141 Milano Italy www.indivior.com
Editorial Board Editor in Chief Icro Maremmani
VP Dole Dual Diagnosis Unit, Santa Chiara University Hospital, University of Pisa, Italy, EU
Associate Editors Thomas Clausen Pier Paolo Pani
SERAF, Norwegian Centre for Addiction Research, University of Oslo, Norway Socio Health Local Area, Sardinia Region Health Protection Trust, Olbia, Italy, EU
Marta Torrens
University of Barcelona, Spain, EU
International Advisory Board Hannu Alho
National Public Health Institute (KTL), University of Helsinki, Finland, EU
Marc Auriacombe
Université Victor Segalen, Bordeaux 2, France, EU
Alexander Baldacchino University of St Andrews Medical School. North Haugh, St Andrews, Scotland, United Kingdom, EU James Bell
South London and Maudsley NHS FoundationTrust & Langston Centre, Sydney, Austrelia
Olof Blix
County Hospital Ryhov, Jönköping, Sweden, EU
Barbara Broers
University Hospital of Geneva, Switzerland
Miguel Casas
University Hospital of "Vall d’Hebron" - University of Barcelona, Spain, EU
Michael Farrell
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
Loretta Finnegan
National Institutes of Health, Bethesda, MD, USA, [Retired]
Gabriele Fischer
Addiction Clinic, University of Vienna, Austria, EU
Carla Gambarana
Department of Molecular and Developmental Medicine, University of Siena, Italy
Gilberto Gerra
United Nations Office on Drugs and Crime (UNODC), Vienna
Gian Luigi Gessa
University of Cagliari, Italy, EU, [Emeritus]
Michael Gossop
King’s College, University of London, UK, EU
Leift Grönbladh
Institute of Addictive Diseases, University Hospital of Uppsala, Sweden, EU
Lars Gunne
University of Uppsala, Sweden, EU, [Emeritus]
Herman Joseph
Stop Stigma Now; NAMARecovery, New York, NY, USA
Andrej Kastelic
Center for Treatment of Drug Addiction, University Hospital, Ljubljana, Slovenia, EU
Michael Krausz
St.Paul’s Hospital, University of British Columbia, Canada
Mary Jane Kreek
The Rockfeller University, New York, USA
Evgeny Krupitsky
St. Petersburg Bekhterev Psychoneurological Research Institute, Saint Petersburg, Russia
Mercedes Lovrecic
Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia, EU
Joyce Lowinson
Albert Einstein College of Medicine, The Rockfeller University, New York, USA, [Emeritus]
Angelo GI Maremmani Department of Psychiatry, Northern-West Tuscany Region Local Health Unit, Versilian Zone,Viareggio, Italy, EU Robert Newman
Baron de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY, USA
Charles P. O'Brien
University of Pennsylvania, Phildelphia, USA
Lubomir Okruhlica
Centre for Treatment of Drug Dependencies, Bratislava, Slovak Republic, EU
Matteo Pacini
Institute of Behavioural Sciences, Pisa, Italy, EU
Mark Parrino
American Association for the Treatment of Opioid Dependence, New York, USA
Einat Peles
Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
Giulio Perugi
Department of Clinical and Experimental Medicine, University of Pisa, Italy, EU
Jens Reimer
University of Hamburg, Germany and Psychiatry Health North, Bremen, Germany, EU
Marc Reisinger
European Opiate Addiction Treatment Association, Brussels, Belgium, EU
Lorenzo Somaini
Addiction Treatment Center, Cossato (Biella), Italy, EU
Marlene Stenbacka
Karolinska Institute, Stockholm, Sweden, EU
Ambros Uchtenhagen Research Foundation on Public Health and Addiction, Zurich University, Switzerland Helge Waal
Center for Addiction Research (SERAF), University of Oslo, Norway, [Emeritus]
George Woody
University of Pennsylvania, Philadelphia, USA
Editorial Coordinator Marilena Guareschi
Psychologist Association for the Application of Neuroscientific Knowledge to Social Aims, AU-CNS, Pietrasanta, Lucca, Italy, EU
Assistants Silvia Bacciardi
School of Psychiatry, University of Pisa, Italy, EU Master in Addictologia, University of Pisa Psychologist
Iacopo Belcari Denise Gazzarrini
Specialty in Psychiatry, University of Pisa, Italy, EU Master in Addictologia, University of Pisa Specialty in Psychiatry, Master in Addictologia, University of Pisa, Italy, EU
Enrico Massimetti Alessandro Pallucchini
School of Psychiatry, University of Pisa, Italy, EU Master in Addictologia, University of Pisa School of Psychiatry, University of Naples, Italy, EU Master in Addictologia, University of Pisa School of Psychiatry, University of Pisa, Italy, EU
Fabio Rugani Vincenza Spera
Publishers Association for the Application of Neuroscientific Knowledge to Social Aims, AU-CNS "From science to public policy"
Not for profit Agency Via 20 Settembre, 83 - 55045 Pietrasanta, Lucca, Italy, EU Phone +39 0584 790073 - Fax +39 0584 72081 - E-mail:
[email protected] Internet:http://www.aucns.org Pacini Editore Via A. Gherardesca - 56121 Ospedaletto, Pisa, Italy, EU Phone +39 050 313011 - Fax +39 050 3130300 - E-mail:
[email protected] Internet:http:// www.pacinieditore.it
Cited in: EMBASE Excerpta Medica Database SCOPUS EMCave Social Sciences Citation Index (SSCI) - Thomson Reuters Open Access at: http://www.heroinaddictionrelatedclinicalproblems.org
CONTENTS
Selected oral presentation 5 Years of Methadone Maintenance Treatment in Arena Omt Center-Bucharest A. O. Abagiu, A. Koulosousas, M. Georgescu, L. N. Stoica, C. Blaga, S. Briceag, M. Dan, R. Ianos-Rancovici, A. Avram and C. I. Fierbinteanu
13
Sofosbuvir-Based Direct-Acting Antiviral Therapies for Hcv in People Receiving Opioid Substitution Therapy: An Analysis of Phase 3 Studies O. Dalgard, J. Grebely, J. J. Feld, D. Wyles, M. Sulkowski, L. Ni, J. Llewellyn, T. Soyemi, N. Sajed, L. M. Stamm, R. H. Hyland, J. McNally, D. M. Brainard, I. Jacobson (7-9), S. Zeuzem, M. Bourlière, G. Foster, N. Afdhal and G. J. Dore
13
Sofosbuvir and Velpatasvir for Hepatitis C Virus Infection in People with Recent Injecting Drug Use (Simplify): An Open-Label, Single-Arm, Phase 4, Multicentre Trial O. Dalgard, J. Grebely, B. Conway, E. Cunningham, P. Bruggmann, B. Hajarizadeh, J. Amin, P. Marks, S. Quiene, T. L. Applegate, T. Swan, J. Byrne, M. Lacalamita, A. Dunlop, J. Bruneau, M. E. Hellard, G. V. Matthews, J. Powis, D. Shaw, M. C. Thurnheer, M. Weltman, I. Kronborg, C. Cooper, J. J. Feld, C. Fraser, A. Litwin, J. Dillon, P. Read, E. Gane, G. J. Dore on behalf of the SIMPLIFY Study Group
14
Addict Assist: A Study About Acceptability of a Questionnaire to Assess Substance Use Troubles in a French Psychiatric Hospital A. Deschenau, D. T. ouzeau and T. David
15
Disturbances of Eyeballs Movements in Hiv Positive and Hiv Negative Opioid Addicted Individuals before and after the Administration of Therapeutic Dose of Methadone J. Feit
15
Predictors of Poor Health and Heroin Use in Methadone-Treated Injecting Heroin Users: The Importance of Methadone Dosage and Crack Cocaine Use F. Heidebrecht, J. Corless, M. B. MacLeod and L. Dawkins
15
Opiates Versus Other Opioids - Are These Relevant Diagnostics? B. Monwell and A. Gerdner
16
Cannabis Use Is Associated with Worse Methadone Maintenance Treatment Outcome but Not among Schizophrenia and Other Psychotic Patients E. Peles, E. Malik, S. Schreiber and M. Adelson
17
Induced Delusional Disorder among Opiate Users: A Case Report O. Sinai and O. Livne
17
Clinical and Psychological Interventions in Heroine Addicion. Spiritual Approach for the Treatmant of Opiod Addiction J. Williams
18
Plenary Session Policy and Political Dynamics of the Opioid Addiction Crisis in the United States M. Parrino
19
Therapeutic Strategies: Which Treatment for Which Patients? M. Dematteis
19
“You’ve Come a Long Way Baby!” Neonatal Abstinence Syndrome and Progress over 5 Decades L. Finnegan
19
Heroin Addiction Treatment: What Else? M. Auriacombe
20
The Opioid Epidemic and the Need for New Interventions R. Rosenthal
20
Treatment Efficacy in AOT: The Possible Role of Extended Release Formulations L. Somaini
21
Pre-conference symposia 1-Pain management and addiction Chair: Wojciech Leppert (Poznań, Poland, EU)
23
The Current Role of Cannabinoids in the Treatment of Chronic Pain A. Przeklasa-Muszyńska 23 Acute Pain Treatment in Opioid Tolerant Patients M. Kocot-Kępska and J. Dobrogowski
23
Neurobiology of Opioid Addiction R. Przewłocki
24
New Possibilities of Chronic Pain Management W. Leppert
24
Parallel symposia 1-Prisoners with Substance Use Disorders and Other Co-morbidities - Medical and Human Rights Considerations Chair: Gabriele Fischer (Vienna, Austria) - Marta Torrens (Barcelona, Spain) Opioid Maintenance in European Prisons: Is the Treatment Gap Closing? From an European Perspective L. Montanari
25
Opcat Mandate in Europe Highlighting Results from Austria in Improving Accessibility to Medical Care for Prisoners under the Legal Mandate (2012-2017) P. Kastner
25
Preventive Human Rights Protection for Prisoners in Health Issues - an International Perspective M. Amos
26
Cost Effectiveness and Management of Hepatitis C Treatment in Patients with Substance Use Disorder R. Martin-Santos
26
2-Expanding Access to Buprenorphine Treatment
4
Chair: Christopher Welsh (Baltimore, MD, USA) Overview of the Problem and Structural Obstacles to Implementing Change Y. Olsen
27
Tele-Bup: Prescribing Buprenorphine to Patients in Underserved Areas Using Tele-Medicine E. Weintraub
27
Initiating Buprenorphine from the Emergency Department or Hospital: Capitalizing on the Window of Opportunity C. Welsh
27
Increasing Primary Care Providers' Comfort with Buprenorphine Prescribing Via Telephone Consultation A. Greenblatt
28
3-Opiod Addiction Mechanisms Chair: Wojciech Solecki (Krakow, Poland, EU) Behavioral and Molecular Endophenotypes of Opioid Addiction W. Solecki
29
Ventral Tegmental Area Regulation of Cocaine and Oxycodone Craving M. Kiełbiński 29 Serotonin and Glutamate Co-Transmision in Reward Anticipation Measured by 50-Khz Ultrasonic Vocalization in Morphine Conditioned Context A. Hamed and M. B. Kursab
29
Motivational and Physiological Symptoms of Morphine Physical Dependence - Role of Adrenergic and Corticoid Receptor Mechanisms K. Karwowska
30
4-Continuity of Treatment in Israel Chair: Suzan Ben Ezrra (Jerusalem, Israel) Ayahuasca in the Treatment and Harm Reduction of Substance Use Disorder- Mechanism of Action and Clinical Aspects A. G. Lerner
31
The New Dual Disorders Division – System in Progress A. Wolf and S. Hertz-Keisar
31
Multi-Disciplinary Model for Prescription Opioids Misuse in Private Setting I. Tal
31
The Connection between Resilience and Craving among Inpatient Programs M. Amnon
32
5-Novel Psychoactive Substances: Psychiatric Consequences and Related Behavioural Addictions Chair: Rok Tavcar (Ljubljana, Slovenia) Novel Psychoactive Substances: What Every Clinician Needs to Know About R. Tavcar, B. Lovrecic and M. Lovrecic
33
Novel Synthetic Cannabinoids: Lessons Learned M. Lovrecic and B. Lovrecic
33
Novel Synthetic Cathinones: Lessons Learned B. Lovrecic and M. Lovrecic
34
5
Assessing, Treatment and Clinical Management of Psychiatric Consequences of Novel Psychoactive Substances Use and Related Behavioural Addictions M. Z. Dernovsek, R. T. Tavcar, B. Lovrecic and M. Lovrecic
34
6-Addictive Disorders: Pre-existing Factors and Specific Psychopathology Chair: Francesco Lamanna (Pisa, Italy, EU) Are Personality Disorders Pre-Existing Factors of Addictive Behaviour? I. Belcari, C. Conversano, L. Marchi, A. G. I. Maremmani (3-4) and I. Maremmani (4-5-6)
35
Are Affective Temperaments Pre-Existing Factors of Addictive Behaviour? L. Rovai, A. G. I. Maremmani, S. Bacciardi, D. Gazzarrini, A. Pallucchini, V. Spera, G. Perugi and I. Maremmani
36
Towards a Specific Psychopathology of Substance Use Disorders A. G. I. Maremmani, P. P. Pani, L. Rovai, S. Bacciardi and I. Maremmani
37
Should Emotional Responses to Life Events Be Included in the Specific Psychopathology of Substance Use Disorders? I. Maremmani, M. Maiello, M. G. Carbone, A. Pallucchini, F. Brizi, I. Belcari, C. Conversano, G. Perugi and A. G. I. Maremmani
37
7-Supporting Recovery and Normalizing Life of People in OAT Programmes Chair: Andrej Kastelic (Ljubljana, Slovenia, EU) & Liljana Ignatova (Skopje, Macedonia) Stigma and Secrecy Coping in Individuals in Treatment for Substance Dependence in Macedonia and Slovenia L. Ignjatova, A. Kastelic, N. Shegrec and S. Kattusevska Vangelski
38
Reducing Discrimination - Treating Difficult to Reach Populations with Mental Health and Substance Use Disorders N. Segrec and A. Kastelic
39
Employability of Patients with Opioid Addiction in Inpatient Treatment M. Delic, K. Kajdiz and P. Pregelj
39
Reducing Discrimination - Addiction Treatment & Difficult to Reach Populations A. Kastelic
40
8-Hot topics in Heroin Use Disorder patients Chair: Thomas Clausen (Oslo, Norway) Can a Measure of Heart Rate Variability Serve as a Marker for Stress among Patients in Methadone Maintenance Treatment (MMT)? E. Peles, A. Sason, Y. Altman, A. Baharav and M. Adelson
40
Opiate Addiction Treatment and Free Movement in the Schengen Area : A Complaint against Norway M. Reisinger
41
How Do Mothers/Parents in Opioid Maintenance Treatment (OMY) Do 8-12 Years after Their Child Was Born? G. K. Welle-Strand and M. Sarfi
41
The Use of Non-Prescribed Benzodiazepines and/or Amphetamines Predict Treatment Instability in Opioid Maintenance Treatment T. Clausen and A. Muller
41
6
9-Harm Redaction in Israel-Policy, Programs and Research Chair: Haim Mell(Jerusalem, Israel) “A Thousand-Mile Journey Begins with One Step” - a “First Step” for Drug and Alcohol Addicts S. B. Ezra
42
HIV Outbreak Related to Injection of New Psychoactive Substances in Tel Aviv, Israel H. Mell
43
Injecting Drug Use, Sex Work and Differential Harm Reduction Approaches for Women: An Ethnographic Study in Israel’s Largest Open Drug Scene H. Bonny-Noach and S. Toys
43
Infectious Diseases among OMT Patients in Israel - Results of a Historical Cohort Study and the New Treatment Policy P. Rosca and Y. Neumark
43
10-Hot Topics in Heroin Use Disorder Patients Chair: Edward Jacek Gorzelańczyk (Bydgoszcz, Poland, EU)
44
The Opioid Overdose Epidemic in the United States and the Utilization of Intranasal Naloxone to Reverse It A. M. Fareed
44
Addiction and Dual Diagnosis in Perspective O Cortico-Subcortical Loop Function E. J. Gorzelańczyk 44 Addiction and Humanistic Treatment Goals H. Lothane
45
Novel Psychoactive Substances – New Players in the Old Drama J. B. Zawilska
45
11-Hot Topics in Heroin Use Disorder Patients Chair: Matteo Pacini (Pisa, Italy, EU)
46
Benzodiazepines Use “to Get High” in Patients Admitted for Addiction Treatment in Spain F. Fonseca, M. T. Torrens, M. Farré, K. E. McBride, I. Maremmani, M. Guareschi and R. C. Dart
46
Agonist Opioid Treatment (AOT) with Buprenorphine (BPN) and Often Benzodiazepine (BZD) in the GP-Setting: Enabling a Normalized Life M. Haraldsen
47
The Reverse Tolerance Effect in Methadone Treated Patients A. Kantchelov
47
Benzodiazepine Use Disorder in Patients with and without Opioid Use Disorder M. Pacini
48
12-A New Way to Think About Dual Disorders: Opioid System and Mental Disorders In collaboration with World Association on Dual Disorder (WADD) Chair: Miguel Casas (Barcelona, Spain, EU) Opioid System and Mental Disorders N. Szerman
49
Mood Disorders and Opioid System M. Torrens
49
Psychosis and Opioid System C. Roncero
49
7
How to Manage Benzodiazepines Use Disorder during Methadone Treatment I. Maremmani, A. G. I. Maremmani and L. Rovai
50
13-Psychological Therapies and Interventions in the Treatment of Opiate Use Disorder Chair: Alexander Kantchelov, (Sofia, Bulgaria, EU) Why a Willingness to Change Is Often Not Sufficient – Utilizing Motivational Interviewing to Develop Self-Efficacy and Confidence to Change P. Delaney
50
How to Touch the Souls of Our Addicted Patients Better A. Ulmer
50
Integrative Therapeutic Model of Recovery Network Turning Point South London, Uk A. Belchev
51
Attachment Theory and Open Dialogue in Addictions: How Can Mentalizing Help? C. Norman
51
14-Hot Topics in Addiction Medicine In collaboration with ISAM Chair: Riaz Khan (Geneva, Stwitzerland) Public Health Approach as the Basis for Addiction Policy, the Swiss Report on the Challenge of Addictions R. Khan
52
Could and Should Cognitive Behaviour Models Being Applied across Substance Misuse Groups; Are There More Differences Than Commonalities? C. Kouimtsidis
52
How to Manage Alcohol Use Disorder During Methadone Treatment I. Maremmani, A. G. I. Maremmani and L. Rovai
53
Oxytocin in (Opioid) Addiction: From Early Discoveries to the Present L. Somaini
53
15-Hot Topics in Heroin Use Disorder Patients Chair: Marc Auriacombe (Bordeaux, France, EU) Opiate Use Disorder, and Other Substance Uses: What Else? A. Benyamina
54
The Goals and Conditions for Success of Opiate Addiction Treatments in Opiate Use Disorders: What Else? J.-P. Daulouede
54
How to prevent misuse of opioid treatment? D. Touzeau, F. Pascuttini and A. Deschenau
54
Opiate Use Disorder, Psychiatric Comorbidities, Dual Disorders: What Else? M. Auriacombe
54
8
Special Events 1-Shaping tomorrow together: Changing perceptions of managing HCV in people who use drugs Chair: Carlos Roncero (Salamanca, Spain, EU)
Changing Perceptions: Treating Hcv in People Who Use Drugs C. Roncero
55
Perspectives from People Living with Hepatitis C: How Do Patients Feel? M. Harris
55
Challenging Perceptions: Re-Thinking Treatment of Hcv in People Who Use Drugs. Changing Perspectives of the Liver Specialist V. Rehak
56
Challenging Perceptions: Re-Thinking Treatment of Hcv in People Who Use Drugs. Changing Perspectives of the Liver Specialist C. Roncero
57
Changing Perceptions: Multidisciplinary Holistic Care Can Be a Reality O. Dalgard
57
2-Achieving best outcome in OUD care. Current challenges, future trends Chair: Gabriele Fischer (Vienna, Austria, EU)
What is “standard of care in opioid use disorder?” How to achieve this? M. Sandell
58
Making Treatment Work in OUD: Practical Choices for Individuals. What Matters Most? M. Dematteis
59
Challenges to achieving best outcomes in OUD care. Where are the gaps, what are solutions now and in the future L. Somaini 59 3 - Levomethadone: a solid pillar for the treatment of opioid addicted patients Chair: Icro Maremmani (Pisa, Italy, EU) & Edward J. Gorzelanczyk (Bydgoszcz, Poland, EU)
Overview on treatment access systems across Europe A.G.I. Maremmani
60
Levomethadone: A Solid Pillar for the Treatment of Opioid Addicted Patients Stephan Walcher
60
Real World Data: the Italian Experience M. Riglietta
60
Poster session 1-Are We Missing Substance Use Disorders Diagnosis in the Emergency Department ? S. Bitri Tivari, E. Sotiri, E. Thoma, E. Puca and E. Puca
61
2-Alcohol Use Disorder and Heroin Addiction. What Are the Challenges? S. Bitri Tivari, E. Sotiri, E. Thoma, E. Puca and E. Puca
61
3-The SCL90-Based Psychopathological Structure May Be Applied in Substance Use Disorder Patients Irrespectively of the Involved Drug Also in Heroin, Alcohol and Cocaine Mono-Drug Users M. G. Carbone, M. Maiello, V. Spera, C. Manni, A. Pallucchini and I. Maremmani
62
9
4-Buprenorphine/Naloxone in Add on to Psychopharmacological Therapy for Mood Disorder, Alcohol and Sedative/Hypnotics Addiction: A Case Report E. Cerrai and F. Lamanna
62
5-Further Evidence of a Psychopathology Specific to Heroin Use Disorder. Relationships between Psychopathological Dimensions and Addictive Behaviours F. Della Rocca, A. G. I. Maremmani, L. Rovai, S. Bacciardi, F. Lamanna and I. Maremmani
62
6-Prevalence of Opioid Misuse in Chronic Opioid Analgesic Therapy for Non-Cancer Pain Is High in France M. Dematteis, D. Bouhassira and S. Perrot
63
7-RBP-6000 Buprenorphine Monthly Depot Demonstrates Sustained Clinical Efficacy and Safety in Phase III Opioid Use Disorder Trials B. Haight, A. Andorn, C. M. Laffont, M. Young, A. Jones, S. Learned, Y. Zhao, F. Gray and C. Heidbreder
64
8-Practitioners’ Experiences of Working with Dual Users of Heroin and Crack Cocaine. A Thematic Analysis F. Heidebrecht and M. B. MacLeod
64
9-Differences in Treatment Outcomes by Frequency and Drug Preference for Dual Users of Heroin and Crack in Opiate Substitution Therapy - a Pilot Study F. Heidebrecht, M. B. MacLeod and L. Dawkins
65
10-Characteristics of the "Revolving Door" Patients Enrolling in the Opioid Dependence Treatment in the Europad - Radars Surveillance Initiative D. Hill, I. Maremmani (2-17), M. Guareschi, K. McBride, O. D'Agnone, K. Ratcliffe, M. Auriacombe, J.-P. Daulouède, P. Villèger, D. Touzeau, A. Benyamina, N. Scherbaum, G. Deruvo, T. Clausen, M. F. Fonseca, S. Bacciardi, J. Iwanicki and R. C. Dart
66
11-Reported Gabapentin and Pregabalin Use by Patient Enrolling in the Opioid Dependence Treatment in the Europad - Radars Surveillance Initiative D. Hill, N. Scherbaum, M. Guareschi, I. Maremmani , K. McBride, O. D'Agnone, K. Ratcliffe, M. Auriacombe, J.-P. Daulouède, P. Villèger, D. Touzeau, A. Benyamina, G. Deruvo, T. Clausen, M. F. Fonseca, S. Bacciardi, J. Iwanicki and R. C. Dart
66
12-Inventory of Opiates Addiction Treatment (Oat) in Prisons in France in 2017 M. Jouhanneau and F. Meroueh
67
14-Excess Suicide Mortality in Heroin Use Disorder Patients Seeking Opioid Agonist Treatment in Slovenia and Risk Factors for Suicide M. Lovrecic, B. Lovrecic, I. Maremmani and A. G. I. Maremmani
67
15-Capgras Syndrome in a Heroin Addict. A Case Study M. Lovrecic and B. Lovrecic
68
16-Atomoxetine and Methylphenidate in the Treatment of Cocaine Use Disorder in Heroin Use Disorder Patients with Concomitant Adult ADHD. C. Manni, A. Pallucchini, V. Spera, M. Maiello, C. Tagliarini, G. Perugi and I. Maremmani
68
17-Lived Experience Assessment of Depot Formulations of Buprenorphine: Opinion of 35 Persons with 400 Years of Combined Oud Experience Mark Gilman, L. Li, T. Lumley, G. Myers, C. Corte and R. Littlewood
69
18-Effectiveness of Opioid Overdose and Take-Home Naloxone Training for Staff S. Mayet, P. Bhasme and J. Jaganthan
69
19-The Use of Suboxone (Buprenorphine and Naloxone) in Prison F. Meroueh
70
10
20-Comparing Prescription Opioid Use among Heroin Users Using the Radars® System Europad Program H. A. Olsen, S. G. Severtson, K. McBride, C. Kern, M. Guareschi, D. Hill, O. D’Agnone, K. Ratcliffe, M. Auriacombe, J.-P. Daulouède, P. Villèger, D. Touzeau, A. Benyamina, N. Scherbaum, G. Deruvo, T. Clausen, M. F. Fonseca, S. Bacciardi, J. Iwanicki, Richard C. Dart and I. Maremmani
70
21-Attention Deficit Hyperactivity Disorder in Heroin Use Disorder Patients P. Rocco
71
22-Nutrition Intervention among Methadone Maintenance Treatment (MMT) Patients and Food Addiction A. Sason, M. Adelson and E. Peles
71
11
Medicina delle
Dipendenze
Italian Journal of the Addictions Organo ufficiale della Società Italiana Tossicodipendenze Presidente Onorario Gaetano Di Chiara
Presidente Luigi Stella
Segretario Franco Montesano
Tesoriere Riccardo Gionfriddo
Consiglio Direttivo Mauro Cibin Ernesto De Bernardis Giovambattista De Sarro Riccardo Gionfriddo Anna Loffreda Piergiovanni Mazzoli Roberto Mollica Edoardo Polidori Fabrizio Starace Eugenia Vernole
Past Presidents Gian Luigi Gessa Alessandro Tagliamonte † Gian Paolo Guelfi Pier Paolo Pani Icro Maremmani
Collegio dei Revisori Giuseppe Falcone (Presidente) Ciro D'Ambra (Membro Effettivo) Andrea Fuscone (Membro Effettivo) Domenico Cante (Membro Supplente) Bruno Aiello (Membro Supplente)
12
EUROPAD 13th Congress Krakow, Poland, EU - May 25-27, 2018 Selected Oral Presentation Heroin Addict Relat Clin Probl 2018; 20(s1): 13-18
Selected Oral Presentations
SOP-01 5 Years of Methadone Maintenance Treatment in Arena Omt Center-Bucharest A. O. Abagiu (1-2), A. Koulosousas (2), M. Georgescu (2), L. N. Stoica (1), C. Blaga (1), S. Briceag (2), M. Dan (2), R. Ianos-Rancovici, A. Avram and C. I. Fierbinteanu(2) 1-National Institute for Infectious Diseases Prof Dr. Matei Bals (NIIDMB); 2-Romanian Association Against AIDS (ARAS)
BACKGROUND: Romania declared an HIV outbreak in 2011 and ECDC and EMCDDA issued in 2012 some recommendations to tackle the issue, but almost no measures were taken by the government. In 2012 we had around 200 patients a month in OMT in our center and in order to improve something we decided to increase our patients to 350. METHODS: We analyzed the patients entered from June 2012 to June 2017, looking at retention, relapses and treatment success. Patients received 2 group therapy sessions and 1 individual psychotherapy hour/month with a median dose of 82,5 mg/day. RESULTS: We had 1118 patients, 877 men and 241 women. With a number of 1558 entries and 1219 exits. 287 patients had relapses. The median duration in treatment was 37 weeks (1 day - 264 weeks). From the 65 patients with best frequency to individual psychotherapy sessions 57 patients are abstinent and out of OMT for more than 2 years. CONCLUSION: Sustained psychotherapy and adequate methadone doses are mandatory for good results. Key Words: OMT; Bucarest
SOP-02 Sofosbuvir-Based Direct-Acting Antiviral Therapies for Hcv in People Receiving Opioid Substitution Therapy: An Analysis of Phase 3 Studies
O. Dalgard (1), J. Grebely (2), J. J. Feld (3), D. Wyles (4), M. Sulkowski (5), L. Ni (6), J. Llewellyn (6), T. Soyemi (6), N. Sajed (6), L. M. Stamm (6), R. H. Hyland (6), J. McNally (6), D. M. Brainard (6), I. Jacobson (7-9), S. Zeuzem (8), M. Bourlière (9), G. Foster (10), N. Afdhal (11) and G. J. Dore (2) 1-Akershus University, Oslo, Norway; 2-The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia; 3-Toronto Centre for Liver Disease, Toronto, Ontario, Canada; 4-Division of Infectious Diseases, Denver Health and Hospital Authority, Denver, Colorado, United States ; 5-Johns Hopkins University, Baltimore, Maryland, United States; 6-Gilead Sciences, Inc., Foster City, California, United States; 7-Mount Sinai Beth Israel, New York; New York, United States; 8-Johann Wolfgang Goethe University Medical Center, Frankfurt am Main, Germany; 9-Hospital Saint Joseph, Marseille, France; 10-Queen Mary University London, London, UK; 11-Beth Israel Deaconess Medical Center, Boston Massachusetts, United States.
BACKGROUND: Hepatitis C virus (HCV) DAA therapy is effective among people receiving opioid substitution therapy (OST), but studies are limited by small numbers of non-genotype 1 (GT1) patients. The aim of this study was to evaluate treatment completion, adherence, SVR12, and safety of sofosbuvirbased therapies in HCV patients receiving and not receiving OST. METHODS: Ten Phase 3 studies of sofosbuvir-based regimens included ION (ledipasvir/sofosbuvir ± ribavirin for 8, 12, or 24 weeks in GT1), ASTRAL (sofosbuvir/velpatasvir for 12 weeks in GT1-6), and POLARIS (sofosbuvir/velpatasvir and sofosbuvir/velpatasvir/voxilaprevir in GT1-6). Patients with clinically significant drug use (last 12 months) or non-cannabinoids detected at screening were ineligible. RESULTS: Among 4,743 patients, 4% (n=194) were receiving OST (methadone; n=113; buprenorphine, n=75; other, n=6). Compared to those not receiving OST (n=4,549), those receiving OST (n=194) were younger (mean age 48 vs. 54), more
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Heroin Addiction and Related Clinical Problems 20(s1): 13-18
often male (73% vs. 61%), GT3 (38% vs. 17%), treatment-naïve (78% vs. 65%), and cirrhotic (36% vs. 23%). Among those receiving and not receiving OST, there was no significant difference in treatment completion (97% vs. 99%, P=0.06), SVR12 (94% vs. 97%, P=0.06), relapse (0.5% vs. 2.1%, P=0.19), adverse events (78% vs. 77%, P=0.79), serious adverse events (3.6% vs. 2.4%, P=0.24). There was no difference in SVR12 in patients with cirrhosis (99% vs. 95%; P=0.25) or those with G3 (95% vs. 95%, P=0.77) in those receiving OST. Among patients receiving OST, SVR12 was high among those receiving methadone (95%) and buprenorphine (96%). CONCLUSION: Sofosbuvir-based therapies are effective and safe in patients receiving OST. Key Words: Sofosbuvir; antiviral therapies; HCV; opioid substitution therapy
SOP-03 Sofosbuvir and Velpatasvir for Hepatitis C Virus Infection in People with Recent Injecting Drug Use (Simplify): An Open-Label, Single-Arm, Phase 4, Multicentre Trial O. Dalgard (1), J. Grebely (2), B. Conway (3), E. Cunningham (2), P. Bruggmann (4), B. Hajarizadeh (2), J. Amin (2), P. Marks (2), S. Quiene (2), T. L. Applegate (2), T. Swan (5), J. Byrne (6), M. Lacalamita (7), A. Dunlop (8), J. Bruneau (9), M. E. Hellard (10), G. V. Matthews (2-11), J. Powis (12), D. Shaw (13), M. C. Thurnheer (7), M. Weltman (14), I. Kronborg (15), C. Cooper (16), J. J. Feld (17), C. Fraser (18), A. Litwin (19), J. Dillon (20), P. Read (21), E. Gane (22), G. J. Dore (2-11) on behalf of the SIMPLIFY Study Group 1-Akershus University Hospital, Oslo, Norway; 2-The Kirby Institute, UNSW Sydney, Sydney, Australia; 3-Vancouver Infectious Diseases Center, Vancouver, Canada; 4-Arud Centres for Addiction Medicine, Zurich, Switzerland; 5-Médecins Sans Frontières, New York, United States; 6-Australian Injecting & Illicit Drug Users League; 7-Poliklinik für Infektiologie, Inselspital, Bern, Switzerland; 8-Newcastle Pharmacotherapy Service, Newcastle, Australia; 9-Centre Hospitalier de l’Université de Montréal, Canada; 10-The Burnet Institute, Melbourne, Australia; 11St Vincent’s Hospital, Sydney Australia; 12-South Riverdale Community Health Centre, Toronto, Canada; 13-Royal Adelaide Hospital, Adelaide, Australia; 14-Nepean Hospital, Penrith, Australia; 15-Footscray Hospital, Footscray, Australia; 16-Ottawa Hospital Research Institute, Ottawa, Canada; 17-Toronto General Hospital, Toronto; 18-Coolaid Community Health Centre, Victoria, Canada; 19-Montefiore
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Medical Centre, New York, United States; 20-Ninewells Hospital, Dundee, United Kingdom; 21-Kirketon Road Centre, Sydney, Australia; 22-Auckland Hospital, Auckland, New Zealand
BACKGROUND: Despite revised guidelines that no longer exclude people who inject drugs (PWID) from treatment for hepatitis C virus (HCV) infection, many clinicians are reluctant to treat recent PWID. This study aimed to evaluate the efficacy of sofosbuvir and velpatasvir therapy in people with chronic HCV infection and recent injecting drug use. METHODS: In this open-label, single-arm phase 4 trial (SIMPLIFY), we recruited participants with recent injecting drug use (past 6 months) and chronic HCV genotype 1–6 infection from seven countries (19 sites). Participants received oral sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks. Therapy was given in one-week electronic blister packs to record the time and date of each dose. The primary endpoint was sustained virological response 12 weeks after completion of treatment (SVR12; defined as HCV RNA
