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  1. Article ; Online: Changes and trends in medication-assisted treatment in Israel.

    Marom, Adi / Levy, Iris / Rosca, Paola

    Israel journal of health policy research

    2023  Volume 12, Issue 1, Page(s) 1

    Abstract: Background: As opioid prescription in Israel is increasing, there is a growing need for monitoring opioid use disorder and providing opioid agonist therapy. Our goal is to describe, sub-analyze, and identify obstacles in the treatment of opioid misuse ... ...

    Abstract Background: As opioid prescription in Israel is increasing, there is a growing need for monitoring opioid use disorder and providing opioid agonist therapy. Our goal is to describe, sub-analyze, and identify obstacles in the treatment of opioid misuse in the Israeli medication assisted treatment centers.
    Methods: Data on methadone, buprenorphine, and buprenorphine combined with naloxone for the indication of opioid addiction treatment for the period 2013-2020 were obtained from pharmaceutical companies that distribute them in Israel. Data on utilization of these drugs were also extracted from the database maintained by the Israel Ministry of Health's Pharmaceutical Administration Division. The data were converted to defined daily doses (DDD)/1000 inhabitants/day.
    Results: The number of patients receiving medication assisted treatment increased by 10% since 2013, with a shift from buprenorphine alone to buprenorphine/naloxone in government-run centers. Methadone remains the most popular maintenance drug.
    Conclusions: The change in opioid maintenance prescription does not match the significant increase in opioid consumption. Optimization of treatment can be achieved by the creation of a comprehensive database, cooperation between healthcare organizations and the government and further development of non-stigmatic and accessible services.
    MeSH term(s) Humans ; Analgesics, Opioid/therapeutic use ; Israel ; Buprenorphine/therapeutic use ; Opioid-Related Disorders/drug therapy ; Methadone/therapeutic use ; Naloxone/therapeutic use ; Pharmaceutical Preparations
    Chemical Substances Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ) ; Methadone (UC6VBE7V1Z) ; Naloxone (36B82AMQ7N) ; Pharmaceutical Preparations
    Language English
    Publishing date 2023-01-26
    Publishing country England
    Document type Journal Article
    ZDB-ID 2657655-7
    ISSN 2045-4015 ; 2045-4015
    ISSN (online) 2045-4015
    ISSN 2045-4015
    DOI 10.1186/s13584-022-00551-8
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  2. Article: [ESKETAMINE FOR TREATMENT RESISTANT DEPRESSION: RESEARCH AND RISK MANAGEMENT].

    Marom, Adi / Rosca, Paola

    Harefuah

    2021  Volume 160, Issue 6, Page(s) 372–376

    Abstract: Introduction: About 15-18% of the population will experience depression in their lifetime. One third among them will suffer from treatment resistant depression (TRD) which does not respond to two accepted treatment protocols. There is a pressing need ... ...

    Abstract Introduction: About 15-18% of the population will experience depression in their lifetime. One third among them will suffer from treatment resistant depression (TRD) which does not respond to two accepted treatment protocols. There is a pressing need for effective TRD treatments and especially for a rapid-acting drug for patients with suicidal ideation. Nasal spray esketamine, the S-enantiomer of the anesthetic agent and dissociative drug ketamine, was approved by the FDA to treat TRD in 2019 and was included in the 2020 Israeli Healthcare Basket. Clinical research suggests that esketamine, combined with an oral antidepressant, has a sustainable antidepressant effect as well as a manageable safety profile. However, ketamine has abuse potential and may cause adverse effects that require medical attention. The risk management plan includes administration under direct medical supervision in ambulatory care, and monitoring of blood pressure, awareness changes, dissociation, and dependence symptoms.
    MeSH term(s) Administration, Intranasal ; Depression/drug therapy ; Depressive Disorder, Treatment-Resistant/drug therapy ; Humans ; Ketamine/adverse effects ; Risk Management
    Chemical Substances Esketamine (50LFG02TXD) ; Ketamine (690G0D6V8H)
    Language Hebrew
    Publishing date 2021-06-23
    Publishing country Israel
    Document type Journal Article ; Review
    ZDB-ID 953872-0
    ISSN 0017-7768
    ISSN 0017-7768
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    In stock of ZB MED Cologne/Königswinter

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  3. Article ; Online: Changes and trends in medication-assisted treatment in Israel

    Adi Marom / Iris Levy / Paola Rosca

    Israel Journal of Health Policy Research, Vol 12, Iss 1, Pp 1-

    2023  Volume 8

    Abstract: Abstract Background As opioid prescription in Israel is increasing, there is a growing need for monitoring opioid use disorder and providing opioid agonist therapy. Our goal is to describe, sub-analyze, and identify obstacles in the treatment of opioid ... ...

    Abstract Abstract Background As opioid prescription in Israel is increasing, there is a growing need for monitoring opioid use disorder and providing opioid agonist therapy. Our goal is to describe, sub-analyze, and identify obstacles in the treatment of opioid misuse in the Israeli medication assisted treatment centers. Methods Data on methadone, buprenorphine, and buprenorphine combined with naloxone for the indication of opioid addiction treatment for the period 2013–2020 were obtained from pharmaceutical companies that distribute them in Israel. Data on utilization of these drugs were also extracted from the database maintained by the Israel Ministry of Health's Pharmaceutical Administration Division. The data were converted to defined daily doses (DDD)/1000 inhabitants/day. Results The number of patients receiving medication assisted treatment increased by 10% since 2013, with a shift from buprenorphine alone to buprenorphine/naloxone in government-run centers. Methadone remains the most popular maintenance drug. Conclusions The change in opioid maintenance prescription does not match the significant increase in opioid consumption. Optimization of treatment can be achieved by the creation of a comprehensive database, cooperation between healthcare organizations and the government and further development of non-stigmatic and accessible services.
    Keywords Opioid use disorder ; Opioid maintenance treatment ; Opioid agonist therapy ; Medication assisted treatment ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
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  4. Article ; Online: Patterns of psychiatric hospitalizations of Arab and Jewish adults with chronic psychotic disorders, before and after national mental health reforms, Israel, 1991-2016.

    Florentin, Sharon / Rosca, Paola / Reuveni, Inbal / Haled, Razek / Neumark, Yehuda

    BMC psychiatry

    2023  Volume 23, Issue 1, Page(s) 653

    Abstract: Background: Members of the Arab minority in Israel are at increased risk of developing mental illness, although less likely to seek care and have accessible treatment. This study compares trends in psychiatric hospitalizations between Arabs and Jews ... ...

    Abstract Background: Members of the Arab minority in Israel are at increased risk of developing mental illness, although less likely to seek care and have accessible treatment. This study compares trends in psychiatric hospitalizations between Arabs and Jews with chronic psychotic disorders, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000, and governmental recognition of the need to allocate resources for patients with co-occurring substance use disorder and mental illness in 2010.
    Methods: The National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorder, hospitalized in 1991-2016 (at least once in 2010-2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of population-group (Arabs and Jews), time-period (Period
    Results: The proportion of Arab patients hospitalized with a diagnosis of chronic psychotic disorder (14.4%) was significantly lower than their proportion in the general population (21%), and their average age at first hospitalization (28.4 years) was older than that of Jewish inpatients (27.0 years). The average number of hospitalization days and LOS of Jewish patients were double that of Arab patients in Period
    Conclusions: The findings reveal a narrowing of disparities in psychiatric hospitalizations between Arab and Jewish patients in Israel over time. However, among Arab women the number of hospitalization days remains considerably lower than that of Jewish women, raising concerns that Arab women may be receiving insufficient care. Further study is needed to fully understand the underpinnings of these disparities, although increasing the number of Arabic-language mental health services and providing psycho-education, will help further close the gap.
    MeSH term(s) Male ; Humans ; Adult ; Female ; Mental Health ; Jews ; Arabs ; Israel ; Health Care Reform ; Psychotic Disorders ; Hospitalization ; Intellectual Disability
    Language English
    Publishing date 2023-09-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050438-X
    ISSN 1471-244X ; 1471-244X
    ISSN (online) 1471-244X
    ISSN 1471-244X
    DOI 10.1186/s12888-023-05132-w
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  5. Article ; Online: Early-life trauma, negative and positive life events, compulsive sexual behavior disorder and risky sexual action tendencies among young women with substance use disorder.

    Efrati, Yaniv / Goldman, Keren / Levin, Katya / Rosca, Paola

    Addictive behaviors

    2022  Volume 133, Page(s) 107379

    Abstract: Although significant advances have been made in the field to date, gender-based issues for women remain a neglected area in much of substance abuse research. In the current study we examined two gaps in the literature: the co-occurrence of compulsive ... ...

    Abstract Although significant advances have been made in the field to date, gender-based issues for women remain a neglected area in much of substance abuse research. In the current study we examined two gaps in the literature: the co-occurrence of compulsive sexual behavior disorder (CSBD) and risky sexual action tendencies among women with substance use disorders (SUDs), and their shared antecedents in the form of early life adversity and negative life events. The sample comprised 132 women of whom 62 had substance use disorder (drug and alcohol) and 70 were healthy controls. Each participant completed self-report measures of drug abuse and alcoholism, compulsive sexual behavior disorder and risky sexual action tendencies as well as early-life trauma and negative and positive life events. Results indicate that young women with substance use disorder have higher compulsive sexual behavior disorder symptoms and more prevalent risky sexual action tendencies than controls. Compulsive sexual behavior was also found to mediate the association between substance use and risky sexual action tendencies. In addition, all addictive behaviors were linked with emotional abuse at childhood but not with other types of abuse. Conversely, negative life events in adulthood were only linked with CSBD and not with substance use. The findings provide deeper insights into the comorbidity of addictive behaviors and an opportunity for developing more effective treatments for women who suffer from these addictions.
    MeSH term(s) Adult ; Behavior, Addictive ; Child ; Compulsive Behavior/epidemiology ; Compulsive Behavior/psychology ; Female ; Humans ; Sexual Behavior/psychology ; Sexual Dysfunctions, Psychological/psychology ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/psychology
    Language English
    Publishing date 2022-05-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 197618-7
    ISSN 1873-6327 ; 0306-4603
    ISSN (online) 1873-6327
    ISSN 0306-4603
    DOI 10.1016/j.addbeh.2022.107379
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1214: Show issues Location:
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  6. Article ; Online: Schizophrenia or schizoaffective disorder? A 50-year assessment of diagnostic stability based on a national case registry.

    Florentin, Sharon / Reuveni, Inbal / Rosca, Paola / Zwi-Ran, Shlomo Rahmani / Neumark, Yehuda

    Schizophrenia research

    2023  Volume 252, Page(s) 110–117

    Abstract: Background: Schizoaffective disorder (SAD) remains a controversial diagnosis in terms of necessity and reliability.: Objectives: We assessed diagnostic patterns of SAD and schizophrenia (SZ) among hospitalized psychiatric patients over a fifty-year ... ...

    Abstract Background: Schizoaffective disorder (SAD) remains a controversial diagnosis in terms of necessity and reliability.
    Objectives: We assessed diagnostic patterns of SAD and schizophrenia (SZ) among hospitalized psychiatric patients over a fifty-year period.
    Method: Data from the Israeli National Psychiatric Registry on 16,341 adults diagnosed with SZ or SAD, hospitalized at least twice in 1963-2017, were analyzed. Stability between most-frequent, first and last diagnosis, and diagnostic-constancy (the same diagnosis in >75 % of a person's hospitalizations) were calculated. Three groups were compared: People with both SAD and SZ diagnoses over the years (SZ-SAD), and people with only one of these diagnoses (SZ-only; SAD-only). The incidence of SAD and SZ before and after DSM-5 publication was compared.
    Results: Reliability between last and first diagnosis was 60 % for SAD and 94 % for SZ. Agreement between first and most-frequent diagnosis was 86 % for SAD and 92 % for SZ. Diagnostic shifts differ between persons with SAD and with SZ. Diagnostic-constancy was observed for 50 % of SAD-only patients. In the SZ-SAD group, 9 % had a constant SAD diagnosis. Compared to the other groups, the SZ-SAD group exhibited a higher substance use prevalence, younger age at first-hospitalization, and more hospitalizations/person (p < 0.0001). The incidence of a first-hospitalization SAD diagnosis increased by 2.2 % in the 4-years after vs. prior to DSM-5.
    Conclusions: A SAD diagnosis is less stable than SZ. The incidence of a SAD diagnosis increased after DSM-5, despite stricter diagnostic criteria. The SZ-SAD group exhibited the poorest outcomes. SAD may evolve over time necessitating periodic re-evaluation.
    MeSH term(s) Adult ; Humans ; Schizophrenia/diagnosis ; Reproducibility of Results ; Psychotic Disorders/psychology ; Hospitalization ; Diagnostic and Statistical Manual of Mental Disorders
    Language English
    Publishing date 2023-01-12
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 639422-x
    ISSN 1573-2509 ; 0920-9964
    ISSN (online) 1573-2509
    ISSN 0920-9964
    DOI 10.1016/j.schres.2023.01.007
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    Zs.A 2351: Show issues Location:
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  7. Article ; Online: Trends and correlated outcomes in population-level prescription opioid and transdermal fentanyl use in Israel.

    Shapira, Barak / Berkovitz, Ronny / Haklai, Ziona / Goldberger, Nehama / Lipshitz, Irena / Rosca, Paola

    Israel journal of health policy research

    2023  Volume 12, Issue 1, Page(s) 9

    Abstract: Background: In the last twenty years, there was a documented increase in prescription opioid procurement in Israel. However, there is still little evidence of the association between opioid procurement rates, health service utilisation in secondary care, ...

    Abstract Background: In the last twenty years, there was a documented increase in prescription opioid procurement in Israel. However, there is still little evidence of the association between opioid procurement rates, health service utilisation in secondary care, and enrollment rates to substance use disorder treatment programmes. In this study, we show trends in the reports of opioid-related hospitalisations, emergency department visits, enrollment to community-based outpatient treatment for Prescription Opioid Use Disorder and opioid-related mortality rates. Additionally, we examine potential correlations between these health service utilisation rates and prescription opioid procurement rates at the population level, with a focus on transdermal fentanyl.
    Methods: A longitudinal study at the population level. We used seven-year data on indicators of opioid-related morbidity, prescription opioid procurement data for 2015-2021, and six-year opioid-related mortality data for 2015-2020. We measure the correlation between procurement rates of prescription opioids in Oral Morphine Equivalent per capita, and aggregated rates obtained from hospital administrative data for hospitalisations, emergency department visits, and patient enrolment in specialised prescription opioid use disorder outpatient treatment in the community setting.
    Results: Between 2015 and 2021, procurement rates in primary care per capita for all prescription opioids increased by 85%, while rates of transdermal fentanyl procurement increased by 162%. We found a significant positive correlation at the population level, between annual opioid procurement rates, and rates per population of opioid-related visits to emergency departments (r = 0.96, p value < 0.01, [CI 0.74-0.99]), as well as a positive correlation with the rates per population of patient enrolment in specialised prescription opioid use disorder outpatient treatment (r = 0.93, p value = 0.02, [CI 0.58-0.99]). Opioid-related mortality peaked in 2019 at 0.31 deaths per 100,000 but decreased to 0.20 deaths per 100,000 in 2020.
    Conclusion: Data shows that all-opioid and transdermal fentanyl procurement has increased yearly between 2015 and 2021. This increase is positively correlated with a growing demand for community-based Prescription Opioid Use Disorder outpatient treatment. Efforts to reduce opioid-related morbidity may require effective approaches toward appropriate prescribing, monitoring, and further increasing access to prescription opioid outpatient treatment.
    MeSH term(s) Humans ; Analgesics, Opioid/therapeutic use ; Fentanyl ; Longitudinal Studies ; Israel/epidemiology ; Opioid-Related Disorders/drug therapy ; Opioid-Related Disorders/epidemiology ; Prescriptions
    Chemical Substances Analgesics, Opioid ; Fentanyl (UF599785JZ)
    Language English
    Publishing date 2023-03-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2657655-7
    ISSN 2045-4015 ; 2045-4015
    ISSN (online) 2045-4015
    ISSN 2045-4015
    DOI 10.1186/s13584-023-00558-9
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  8. Article: Community Rehabilitation and Hospitalizations Among People With Chronic Psychotic Disorder: Is There a Differential Association by Co-occurring Substance Use Disorder?

    Florentin, Sharon / Rosca, Paola / Bdolah-Abram, Tali / Neumark, Yehuda

    Frontiers in psychiatry

    2021  Volume 12, Page(s) 621259

    Abstract: Objective: ...

    Abstract Objective:
    Language English
    Publishing date 2021-02-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2021.621259
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  9. Article ; Online: Isolating the isolated: Implications of COVID-19 quarantine measures on in-patient detoxification treatment for substance use disorders.

    Rosca, Paola / Shapira, Barak / Neumark, Yehuda

    The International journal on drug policy

    2020  Volume 83, Page(s) 102830

    MeSH term(s) COVID-19/prevention & control ; Humans ; Israel ; Male ; Middle Aged ; Quarantine ; SARS-CoV-2 ; Substance Abuse Treatment Centers ; Substance-Related Disorders
    Keywords covid19
    Language English
    Publishing date 2020-07-06
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 2010000-0
    ISSN 1873-4758 ; 0955-3959
    ISSN (online) 1873-4758
    ISSN 0955-3959
    DOI 10.1016/j.drugpo.2020.102830
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  10. Article ; Online: Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users.

    Shapira, Barak / Berkovitz, Ronny / Rosca, Paola / Neumark, Yehuda

    Journal of psychoactive drugs

    2020  Volume 52, Issue 4, Page(s) 334–343

    Abstract: The use of synthetic cannabinoids receptor agonists (SCRA) and synthetic opioids is associated with significant morbidity and mortality. This study examined the patterns-of-use of prescription oral opioids or transdermal fentanyl formulations, and SCRA, ... ...

    Abstract The use of synthetic cannabinoids receptor agonists (SCRA) and synthetic opioids is associated with significant morbidity and mortality. This study examined the patterns-of-use of prescription oral opioids or transdermal fentanyl formulations, and SCRA, among 342 patients enrolled in treatment for drug-dependence in Israel. 16.1% of participants reported recent (past-12 months) SCRA use, while 24.9% reported recent use of prescription oral opioids, transdermal fentanyl patches, or both. Odds of reporting recent use of SCRA were positively and significantly associated with reporting recent use of cannabis (Adjusted Odds Ratio [AOR] 9.86, 95% Confidence Interval [CI] 4.44-21.90) and synthetic cathinones (AOR 5.47, CI 2.50-11.96). Recent use of prescription oral opioids or transdermal fentanyl formulations use was positively and significantly associated with recent use of gabapentinoids (AOR 14.33, CI 7.10, 28.90), stimulants (AOR 7.12, CI 3.82,13.28), heroin (AOR 5.81, CI 3.39,9.97), benzodiazepines (AOR 4.63, CI 2.74,7.84), synthetic cathinones (AOR 4.12, CI 1.95, 8.70), and hallucinogens (AOR 2.48, CI 1.24, 2.96). Clinicians should be informed about the extent of prescription oral opioids or transdermal fentanyl formulations and SCRA use among high-risk drug users, and the associated higher odds of concomitantly using other psychoactive substance, for they represent actual risk to patients and complicate treatment.
    MeSH term(s) Analgesics, Opioid ; Cannabinoids/adverse effects ; Drug Users ; Fentanyl ; Humans ; Psychotropic Drugs
    Chemical Substances Analgesics, Opioid ; Cannabinoids ; Psychotropic Drugs ; Fentanyl (UF599785JZ)
    Language English
    Publishing date 2020-04-29
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 392405-1
    ISSN 2159-9777 ; 0279-1072
    ISSN (online) 2159-9777
    ISSN 0279-1072
    DOI 10.1080/02791072.2020.1754534
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