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Biomedical subjects

S Treacy

Publications and source records attributed to S Treacy.

7 recordsLinked to original sources
PubMed2002

Reduced injection risk and sexual risk behaviours after drug misuse treatment: results from the National Treatment Outcome Research Study.

This paper investigates injecting, shared use of needles/syringes and sexual risk behaviours at intake to treatment and at one-year follow-up among 753 drug users recruited to the National Treatment Outcome Research Study (NTORS). Injecting, sharing and having unprotected sex were substantially reduced among clients admitted to methadone programmes and among those admitted to residential treatments. The overall levels of risk fell after treatment, and the majority of those who were engaged in high risk behaviours at intake had stopped at follow-up. The results also show the variability of individual outcomes. A minority persisted with their risk behaviour, and others who were not at risk at intake who had started to engage in risky behaviours at follow-up. The behaviour of these clients creates a focal point for risk as well as being a threat to public health. Several social and psychological factors were predictive of health risk behaviours. These included frequency and duration of heroin use, polydrug use, alcohol use, gender, ethnicity, having a drug-using partner, anxiety and depression. The results indicate the important role that can be played by treatment services in helping to reduce the risk of blood-borne infections. We suggest that risk reduction interventions are an important and effective component of treatment programmes.

Adult↗
PubMed2002

A general screening method for acidic, neutral, and basic drugs in whole blood using the Oasis MCX column.

Solid-phase extraction (SPE) is becoming a commonly used extraction technique. Most existing SPE methods extract a single drug from a relatively clean biological matrix (e.g., plasma, serum, or urine) using a silica-based column. These methods, however, are generally not satisfactory for forensic applications because the majority of biological samples are not as clean (e.g., whole blood, bile, tissues). Silica-based columns also may have reproducibility and stability problems. Polymer-based columns have been developed to overcome some of these limitations. In this study, sequential extraction of acidic, neutral, and basic drugs from whole blood using a polymer-based column, Oasis MCX, was undertaken. The extraction procedure developed involved a conditioning step using methanol followed by water; a three-step wash sequence using water, 0.1 M hydrochloric acid, then water/methanol (95:5); and two elution steps. One elution step was for acidic and neutral drugs utilizing acetone/chloroform (1:1), and a second used ethyl acetate/ammonium hydroxide (98:2) for basic drugs. Of the drugs tested, 75% were extractable from whole blood and detectable at therapeutic concentrations. Good recoveries and clean extracts were achieved for the basic drugs; however, the extracts were not as clean for acidic drugs. Unfortunately, the Oasis MCX procedure was not suitable for extracting all drugs (e.g., benzodiazepines).

Animals↗
PubMed2001

Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment Outcome Research Study.

This paper provides a detailed analysis of the 2-year outcomes for 351 drug misusers allocated on an intention-to-treat basis to methadone maintenance or methadone reduction treatments. Both groups showed substantial reductions in their use of illicit drugs and in other outcome areas. However, whereas most methadone maintenance patients received maintenance, only about one third of those allocated to methadone reduction received methadone reduction, and many actually received a form of methadone maintenance. Reduction patients were more likely to receive low doses of methadone, and were less likely to remain in treatment. For maintenance patients, higher doses and retention in treatment were both associated with improvements in illicit heroin use at 2 years. For the reduction patients, the more rapidly the methadone was reduced, the worse the heroin use outcomes. For patients in both treatment conditions, reductions in heroin use were associated with improvements in other outcome areas. The more severely dependent patients showed better outcomes in methadone maintenance. Methadone reduction treatment processes were associated with poor outcomes, and many patients who were allocated to methadone reduction treatment did not receive reduction treatment as intended. This calls into question the appropriateness of either the initial treatment planning process or the treatment delivery process, or both. A clearer distinction should be made between methadone maintenance and methadone reduction. Treatment goals should be made explicit both to the patient and to the clinical staff at the start of treatment. We suggest the need for a reappraisal of the goals and procedures of methadone reduction treatment.

Chi-Square Distribution↗
PubMed2000

Routes of drug administration and multiple drug misuse: regional variations among clients seeking treatment at programmes throughout England.

AIMS: To investigate regional variations across England in routes of administration for heroin, non-prescribed methadone, non-prescribed benzodiazepines, cocaine powder, crack cocaine and amphetamines. DESIGN, SETTING, PARTICIPANTS: A survey of 1053 clients recruited to 54 residential and community drug misuse programmes. MEASUREMENTS: Structured face-to-face interviews conducted with clients at admission to treatment. FINDINGS: Routes of administration included injecting, smoking, snorting and oral use. For some drugs (methadone and benzodiazepines) one main route of administration was used. For other drugs (heroin, amphetamines and cocaine powder) there were marked variations in route. For all drugs except benzodiazepines, there were regional differences in routes of administration. Heroin injectors were more likely also to use other drugs by injection. CONCLUSIONS: The differences in routes of administration of different drugs, and the regional differences in routes of use, have implications for the provision of preventive and treatment services. Interventions to prevent transitions to injecting may be especially appropriate in areas where injecting is not prevalent. Hepatitis B vaccination continues to be advisable in both areas of high and low injecting prevalence. Needle exchange schemes and interventions targeted at drug overdose may be more suitable in areas of high injecting prevalence. Further research into regional differences in routes of drug use should be conducted with non-clinical samples.

Administration, Inhalation↗
PubMed1992

Reduced-size liver transplantation for infants and children.

Pediatric liver transplantation, although successful, was limited by the lack of available size-matched organs. Up to 25% to 50% of children died on the waiting list. RLT was initiated and developed to help alleviate donor shortage. Over time, RLT has proven to be an acceptable option for children requiring hepatic transplantation. In experienced centers survival rates are comparable to OLT, and long-term organ function is equally good. Future application of this technique may also provide more innovative approaches to pediatric liver transplantation.

Anastomosis, Surgical↗