• Addiction Social Work Fellowship Program in Canada

      Callon, Cody; Bosma, Harvey; Klimas, Jan; Reel, Brianne; Durante, Elise; Johnson, Cheyenne; Wood, Evan; British Columbia Centres on Substance Use, School of Medicine, University College Dublin (Journal of Social Work Practice in the Addictions, 2018)
    • The Administration of Naloxone: Social Care Worker Perspectives and Experiences

      Deacy, J.J.P.; Houghton, F. (Irish Medical Journal, 2019-07)
    • Alcohol screening among opioid agonist patients in a primary care clinic and an opioid treatment program

      Klimas, Jan; Muench, John; Wiest, Katharina; Croff, Raina; Rieckman, Traci; McCarty, Dennis (2015-02-25)
    • Alcohol Use Among Persons on Methadone Treatment

      Klimas, Jan; Dong, Huiru; Dobrer, Sabina; Milloy, Michael J.; Kerr, Thomas; Wood, Evan; Hayashi, Kanna (2016-08)
    • Alcohol use in opioid agonist treatment

      Nolan, Seonaid; Klimas, Jan; Wood, Evan (2016-12-08)
    • Clinician–Scientist Training in Addiction Medicine

      Klimas, Jan; McNeil, Ryan; Small, Will; Cullen, Walter (2017-10)
    • Closing the gap between training needs and training provision in addiction medicine

      Arya, Sidharth; Delic, Mirjana; Ruiz, Blanca Iciar Indave; Klimas, Jan; Papanti, Duccio; Stepanov, Anton; Cock, Victoria; Krupchanka, Dzmitry (Royal College of Psychiatrists, 2019-12-02)
    • Codeine Usage in Ireland- A Timely Discussion on an Imminent Epidemic

      McDonnell, E; Graduate Entry Medical School, University of Limerick (Irish Medical Journal, 2019-03)
    • Commentary on Zeremski et al. (2016)

      McCombe, Geoff; Henihan, Anne Marie; Leahy, Dorothy; Klimas, Jan; Lambert, John S.; Cullen, Walter (2016)
    • Comparing Canadian and United States opioid agonist therapy policies.

      Priest, Kelsey C; Gorfinkel, Lauren; Klimas, Jan; Jones, Andrea A; Fairbairn, Nadia; McCarty, Dennis (2019-02-11)
      Canada and the United States (U.S.) face an opioid use disorder (OUD) and opioid overdose epidemic. The most effective OUD treatment is opioid agonist therapy (OAT)-buprenorphine (with and without naloxone) and methadone. Although federal approval for OAT occurred decades ago, in both countries, access to and use of OAT is low. Restrictive policies and complex regulations contribute to limited OAT access. Through a non-systematic literature scan and a review of publicly available policy documents, we examined and compared OAT policies and practice at the federal (Canada vs. U.S.) and local levels (British Columbia [B.C.] vs. Oregon). Differences and similarities were noted between federal and local OAT policies, and subsequently OAT access. In Canada, OAT policy control has shifted from federal to provincial authorities. Conversely, in the U.S., federal authorities maintain primary control of OAT regulations. Local OAT health insurance coverage policies were substantively different between B.C. and Oregon. In B.C., five OAT options were available, while in Oregon, only two OAT options were available with administrative limitations. The differences in local OAT access and coverage policies between B.C. and Oregon, may be explained, in part, to the differences in Canadian and U.S. federal OAT policies, specifically, the relaxation of special federal OAT regulatory controls in Canada. The analysis also highlights the complicating contributions, and likely policy solutions, that exist within other drug policy sub-domains (e.g., the prescription regime, and drug control regime) and broader policy domains (e.g., constitutional rights). U.S. policymakers and health officials could consider adopting Canada's regulatory policy approach to expand OAT access to mitigate the harms of the ongoing opioid overdose epidemic.
    • Core Addiction Medicine Competencies for Doctors, An International Consultation on Training.

      Ayu, Astri Parawita; El-Guebaly, Nady; Schellekens, Arnt; De Jong, Cor; Welle-Strand, Gabrielle; Small, William; Wood, Evan; Cullen, Walter; Klimas, Jan (2017-07-18)
      Despite the high prevalence of substance use disorders, associated comorbidities and the evidence-base upon which to base clinical practice, most health systems have not invested in standardised training of healthcare providers in addiction medicine. As a result, people with substance use disorders often receive inadequate care, at the cost of quality of life and enormous direct health care costs and indirect societal costs. Therefore, we undertook this study to assess the views of international scholars, representing different countries, on the core set of addiction medicine competencies that need to be covered in medical education.
    • Development and Evaluation of the Online Addiction Medicine Certificate: Free Novel Program in a Canadian Setting.

      Gorfinkel, Lauren Renee; Giesler, Amanda; Dong, Huiru; Wood, Evan; Fairbairn, Nadia; Klimas, Jan (2019-05-24)
    • Development and process evaluation of an educational intervention for overdose prevention and naloxone distribution by general practice trainees

      Klimas, Jan; Egan, Mairead; Tobin, Helen; Coleman, Neil; Bury, Gerard; Funder:HRA-HSR-2012-14; Funder:ELEVATEPD/2014/6 (2015-11-20)
    • Development and process evaluation of an educational intervention to support primary care of problem alcohol among drug users

      Klimas, J; Lally, K; Murphy, L; Crowley, L; Anderson, R; Meagher, D; Smyth, B P; Bury, G; Cullen, W (Emerald insight, 2014-04-15)
    • Dublin City Wide Drugs Crisis Campaign: responding together: a realistic community and trade union response to the drugs crisis.

      Dublin City Wide Drug Crisis Campaign; SIPTU (Dublin City Wide Drug Crisis Campaign, 1996-05)
    • Excellent reliability and validity of the Addiction Medicine Training Need Assessment Scale across four countries.

      Pinxten, W J Lucas; Fitriana, Efi; De Jong, Cor; Klimas, Jan; Tobin, Helen; Barry, Tomas; Cullen, Walter; Jokubonis, Darius; Mazaliauskiene, Ramune; Iskandar, Shelly; et al. (2019-04-01)
      Addiction is a context specific but common and devastating condition. Though several evidence-based treatments are available, many of them remain under-utilized, among others due to the lack of adequate training in addiction medicine (AM). AM Training needs may differ across countries because of difference in discipline and level of prior AM training or contextual factors like epidemiology and availability of treatment. For appropriate testing of training needs, reliability and validity are key issues. The aim of this study was to evaluate the psychometric properties of the AM-TNA Scale: an instrument specifically designed to develop the competence-based curriculum of the Indonesian AM course. In a cross-sectional study in Indonesia, Ireland, Lithuania and the Netherlands the AM-TNA was distributed among a convenience sample of health professionals working in addiction care in The Netherlands, Lithuania, Indonesia and General Practitioners in-training in Ireland. 428 respondents completed the AM-TNA scale. To assess the factor structure, we used explorative factor analysis. Reliability was tested using Cronbach's Alpha, ANOVA determined the discriminative validity. Validity: factor analysis revealed a two-factor structure: One on providing direct patient treatment and care (Factor 1: clinical) and one factor on facilitating/supporting direct patient treatment and care (Factor 2: non-clinical) AM competencies and a cumulative 76% explained variance. Reliability: Factor 1 α = 0.983 and Factor 2: α = 0.956, while overall reliability was (α = 0.986). The AM-TNA was able to differentiate training needs across groups of AM professionals on all 30 addiction medicine competencies (P = .001). In our study the AM-TNA scale had a strong two-factor structure and proofed to be a reliable and valid instrument. The next step should be the testing external validity, strengthening discriminant validity and assessing the re-test effect and measuring changes over time.
    • Feasibility of alcohol screening among patients receiving opioid treatment in primary care

      Henihan, Anne M; McCombe, Geoff; Klimas, Jan; Swan, Davina; Leahy, Dorothy; Anderson, Rolande; Bury, Gerard; Dunne, Colum P; Keenan, Eamon; Lambert, John S; et al. (2016-11-05)
      Abstract Background Identifying and treating problem alcohol use among people who also use illicit drugs is a challenge. Primary care is well placed to address this challenge but there are several barriers which may prevent this occurring. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting. Methods A randomised, controlled, pre-and-post design measured feasibility and acceptability of alcohol screening based on recruitment and retention rates among patients and practices. Efficacy was measured by screening and brief intervention rates and the proportion of patients with problem alcohol use. Results Of 149 practices that were invited, 19 (12.8 %) agreed to participate. At follow up, 13 (81.3 %) practices with 81 (62.8 %) patients were retained. Alcohol screening rates in the intervention group were higher at follow up than in the control group (53 % versus 26 %) as were brief intervention rates (47 % versus 19 %). Four (18 %) people reduced their problem drinking (measured by AUDIT-C), compared to two (7 %) in the control group. Conclusions Alcohol screening among people receiving opioid agonist treatment in primary care seems feasible. A definitive trial is needed. Such a trial would require over sampling and greater support for participating practices to allow for challenges in recruitment of patients and practices.
    • Impact of a Brief Addiction Medicine Training Experience on Knowledge Self-assessment among Medical Learners

      Klimas, Jan; Ahamad, Keith; Fairgrieve, Kit; McLean, Mark; Mead, Annabel; Nolan, Seonaid; Wood, Evan (2017-02-21)