3 results on '"Buxton, Jane"'
Search Results
2. Estimating the total utilization of take home naloxone during an unregulated drug toxicity crisis: A Bayesian modeling approach.
- Author
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Irvine, Michael A, Bardwell, Samantha, Williams, Sierra, Liu, Lisa, Ge, Wenxue, Kinniburgh, Brooke, Coombs, Daniel, and Buxton, Jane A
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STATISTICAL models , *DRUG toxicity , *LOGISTIC regression analysis , *DRUG delivery systems , *DESCRIPTIVE statistics , *NALOXONE , *CONFIDENCE intervals - Abstract
British Columbia (BC) Canada has a large take-home naloxone (THN) program, implemented as part of the provincial response to the ongoing toxic unregulated drug supply emergency. Ascertaining the rate of use of THN kits is vital to understanding the full impact of the program. However, this is a challenging problem due to under-reporting of kit distribution. This study aims to estimate the total number of THN kits used based on the number of THN kits shipped, the number of THN kits reported as distributed, and the number of THN kits reported as used. We used BC THN shipment and distribution records (February 2015 to August 2023) to inform a simple Bayesian model of naloxone kit distribution and use. A logistic regression term by health region and distribution site type was incorporated to account for variable under-reporting, and a convolution term was incorporated to account for kit distribution. We find the number of THN kits reported as used, and the number of total THN kits distributed, are largely under-reported. An estimated 1,500 (95 % CrI: 1,430 - 1,590) THN kits per 10,000 BC population were used, of which 288 per 10,000 had been reported as used. Of all the THN kits shipped, the model estimated that 43 % (95 % CrI: 41–45 %) of kits were used. We also found variation in both distribution and use by distribution site type, with kits distributed from overdose prevention sites having the highest rate of use (56 %; 95 % CrI: 53–59 %). Across all sites, kit use is approximately five times higher than has been reported. Our framework can also be applied to other localities where THN programs operate, in order to better estimate the true reach and impact of take home naloxone distribution. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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3. Interest in using buprenorphine-naloxone among a prospective cohort of street-involved young people in Vancouver, Canada.
- Author
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Pilarinos, Andreas, Bingham, Brittany, Kwa, Yandi, Joe, Ronald, Grant, Cameron, Fast, Danya, Buxton, Jane A., and DeBeck, Kora
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SUBSTANCE abuse , *CONFIDENCE intervals , *BUPRENORPHINE , *MULTIPLE regression analysis , *NALOXONE , *HARM reduction , *DESCRIPTIVE statistics , *ODDS ratio , *LONGITUDINAL method , *PROPORTIONAL hazards models , *ADULTS , *ADOLESCENCE - Abstract
Limited research examines buprenorphine-naloxone interest among adolescents and young adults (AYA). This longitudinal study examined factors associated with initial buprenorphine-naloxone interest and the time to a positive change in buprenorphine-naloxone interest or enrollment, in addition to identifying reasons for buprenorphine-naloxone disinterest. The study derived data from a cohort of street-involved AYA in Vancouver, Canada between December 2014 and June 2018. The analysis was restricted to AYA who reported weekly or daily illicit opioid use in the last six months but had not initiated buprenorphine-naloxone. The study examined factors associated with initial buprenorphine-naloxone interest using multivariable logistic regression, while multivariable Cox regression identified factors associated with the time to a positive change in buprenorphine-naloxone interest or actual enrollment over follow-up among AYA initially disinterested in buprenorphine-naloxone. Of 281 participants who reported weekly illicit opioid use but were not on buprenorphine-naloxone, 52 (18.5 %) AYA reported initial buprenorphine-naloxone interest, while 68 (24.2 %) AYA who were initially disinterested in buprenorphine-naloxone reported interest or enrollment over follow-up. In multivariable logistic regression, initial interest was positively associated with older age (Adjusted Odds Ratio [AOR] = 1.09, 95 % Confidence Interval [CI]: 1.03–1.15), but negatively associated with self-reported Indigenous identity (AOR = 0.22, 95 % CI: 0.07–0.68). In multivariable Cox regression, recent detoxification program access (Adjusted Hazard Ratio [AHR] = 0.85, 95 % CI: 0.73–0.98) was positively associated with the time to a positive change in buprenorphine-naloxone interest or enrollment. Common reasons for buprenorphine-naloxone disinterest included not wanting opioid agonist treatments (OAT) (initial n = 67, follow-up n = 105); not wanting to experience precipitated withdrawal (initial n = 42, follow-up n = 54), being satisfied with or preferring other OAT (initial n = 33, follow-up n = 52), not knowing what buprenorphine-naloxone is (initial n = 27, follow-up n = 9), previous negative treatment experiences (initial n = 19, follow-up n = 20), and wanting to continue opioid use (initial n = 13, follow-up n = 9), among others. We documented persistent disinterest in buprenorphine-naloxone among AYA, though participants' reasons for disinterest provide insight into the potential benefits of expanding micro-dosing induction; ensuring treatment is culturally safe; and communicating changes in buprenorphine-naloxone programming to AYA. Nevertheless, a need remains to improve the continuum of harm reduction and treatment supports for AYA. • Young people reported low interest in buprenorphine-naloxone (BUP-NAL). • Race-based factors were negatively associated with initial BUP-NAL interest. • Recent detoxification was positively associated with BUP-NAL interest or enrolment over follow-up. • A continuum of harm reduction and treatment supports for young people is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
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