Deep Brain Stimulation of the Nucleus Accumbens as a Novel Treatment in Severe Opioid Addiction...
AddictionThe main objective of this study is to assess the efficacy of bilateral deep brain stimulation (DBS) of the Nucleus accumbens (NAc) as a novel treatment in severe opioid addiction. The included patients have been treated so far with a substitute in form of methadone. Our hypothesis is that bilateral DBS of the NAc will significantly reduce the craving for heroin and thus enable the patients to decrease their Levomethadone-dosage substantially.
AWAITS: A Web-based E-health Application for Active Illicit Opioid Users
Opioid-use DisorderIV Drug Usage3 moreThe purpose of this research study is to: assess how participants like the AWAITS e-health application as measured by their feedback on the intervention test the impact of AWAITS on knowledge about opioid overdose and risk-reduction strategies. assess the proportion of participants who accept a list of local treatment providers test the impact of AWAITS on interest in being tested for HCV/HIV.
SMART Brain Health in African-Americans
Opioid Use DisorderSubstance Use Disorders2 moreThe investigators hypothesize that opioid use in African-Americans will be associated with hypodopaminergic alleles that alter the threshold for activating feelings of reward and pleasure within the dopaminergic system, and that these allelic frequencies will differ significantly from European Americans. Planned is a targeted system to study genetic risks for reward deficiency using risk gene panel to assign a genetic addiction risk score (GARS), comprehensive surveys to determine quality of life and exposure to stressors and trauma. This system will allow prediction of addiction and relapse potential and delivery of personalized treatment.
Effectiveness of a Hospital Addiction Service in Treating Opioid and Alcohol Addiction
Alcohol AddictionOpiate AddictionHypothesis: Patients who are addicted to opioids or alcohol will have reduced substance use, health care utilization if they have immediate and convenient access to pharmacotherapy and addiction counselling. Summary: This randomized trial will compare two different interventions for 124 alcohol and opioid-addicted patients admitted to either Women's Own Detox (WOD) at the University Health Network or the Withdrawal Management Service (WMS) at Saint Michael's Hospital (SMH. The Delayed Intervention group will receive a card with contact information for the St. Michael's Hospital and Women's College Hospital addiction medicine services. The Rapid Intervention group will be seen by an addiction physician from one of these services, within a day or two of their admission to the WOD or the SMH WMS. The addiction physician will prescribe buprenorphine or anti-alcohol medications, and the physician, nurse and/or therapist will provide ongoing counseling, follow-up and shared care with the family physician. Outcomes (measured at 6 and 12 months) include treatment retention, health care utilization and cost, medications prescribed, and alcohol and opioid use.
RETAIN: Retaining Opioid Users Entering Medication Assisted Treatment and Encouraging HCV/HIV Testing...
Opioid-Related DisordersOpioid-use Disorder2 moreThe purpose of this research study is to: assess how well individuals entering medication assisted treatment like the RETAIN e-health application as measured by their feedback on the intervention. test the impact of RETAIN on knowledge about medication-assisted treatment(MAT). assess treatment retention rates in patients completing the RETAIN intervention. test the impact of RETAIN on knowledge about HCV/HIV test the impact of RETAIN on interest in being tested for HCV/HIV
Administration of Acetazolamide to Prevent Remifentanil Induced Hyperalgesia
HyperalgesiaOpioid-Related DisordersRemifentanil is a potent opioid widely used during the administration of general anesthesia. There is a lot of evidence that suggest that the used of remifentanil is associated with the development of hyperalgesia (a reduction of nociceptive thresholds). However, the mechanism of this hyperalgesia is not fully understood. Recently, it was demonstrated that the disruption of the Cl- homeostasis could be involved. Interestingly, this was prevented in a murine model with the administration of Acetazolamide, a carbonic anhydrase inhibitor. In our clinical trial we will try to determine if the preoperative administration of acetazolamide could prevent the hyperalgesia induced by remifentanil in patients scheduled for thyroidectomy with general anesthesia.
HIV Counseling Intervention for Methadone-Maintained Patients - 2
Opioid-Related DisordersThe purpose of this study is to evaluate HIV counseling intervention for Methadone-Maintained Patients.
Healthy Adult Male Facial Skin Surface Lipid Pheromone p.o. to Treat Opioid Addiction
Opioid AddictionOpioid Abuse10 moreHealthy adult human male facial skin surface lipid liquid pheromone given by mouth to opioid addicts cures them without any withdrawal symptoms whatsoever 250mg on chewing gum vehicle by mouth. Elevated mood eventually becomes accommodated after a few weeks. The pheromone contains volatile airborne sub-pheromones which cause aversive behavior (distrust, superstition, suspicion, arrogance, astonishment/stupidity, jealousy). Artificial jealousy can be avoided by patient isolation for 40 days until the pheromone "taste" wears off the saliva. The pheromone provided is odorless, colorless, and tasteless to the conscious brain.
Impact of Direct Outreach to Expand Access to Naloxone in the Context of Standing Orders
Opioid AbuseOverdose1 moreIn the setting of naloxone standing orders, this study will assess if direct outreach with a web-based "Naloxone Navigator 1.0" to patients prescribed chronic opioid therapy (COT) changes opioid risk behaviors, increases naloxone uptake, and increases knowledge about overdose and naloxone
Naloxone Auto-injector as a Universal Precaution for Patients With Opioid Substance Use Disorder...
Opiate Antagonist OverdoseOpioid-Related DisordersThe purpose of this pilot-study is to to distribute naloxone auto-injector in a "Universal Precaution" manner to patients with opioid substance use disorder. The objectives are to decrease the number of fatal and nonfatal overdose deaths, to examine and understand the risk factors for serious opioid toxicity and overdose, and to evaluate the unintentional opioid overdose risk utilizing an evidence-based screening questionnaire.