Documents disponibles écrits par cet auteur

*** / RITTER A. ; CAMERON J. in Drug and Alcohol Dependence, 87 (2-3) (2007)

[article]  in Drug and Alcohol Dependence > 87 (2-3) (2007)  - p.312-315 Titre : *** Titre autre langue : Australian clinician attitudes toward contingency management: Comparing down under with America Type de document : Périodique Auteurs : RITTER A. ; CAMERON J. Année de publication : 2007 Article en page(s) : p.312-315 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus PRISE EN CHARGE ; MEDECIN ; METHODE ; ATTITUDE Résumé : Background Contingency management (CM) is an efficacious treatment intervention. Research from the US indicates that clinicians have both positive and negative attitudes towards CM. Concerns about the practicalities of implementation and potential philosophical differences have been identified in American samples. To date, no research has examined Australian clinicians attitudes towards CM nor assessed the extent to which Australian clinicians share the concerns of American clinicians. Method The Provider Survey of Incentives was completed by 102 Australian drug and alcohol treatment providers. The survey assesses both positive and negative attitudes towards tangible and social incentives. Comparisons are made with published data on American samples. Results The proportion of respondents agreeing with positive opinions about CM in this Australian sample was lower than that reported in the American sample. The average percentage agreement for positive aspects of tangible rewards was 41% whereas the average percent agreement for social rewards was 51% indicating more positive views towards social rewards. Objections to CM were similar between the two samples, but American respondents more strongly agreed with the idea that it would not be right to give incentives when clients are still using drugs, whereas the Australian sample had much less difficulty with this concept. Conclusions There appears to be broad support for CM from about half of the clinicians surveyed. The areas of concern were highly similar between the Australian sample and published American data. Many Australian clinicians expressed neutral views about CM, indicating that the environment may be ripe for implementation of programs. (Review's abstract). Cote CIRDD : 806371 Thématique : Drogues illicites Bibliographie : 9 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=8484 [article]

(La buprénorphine : nouveau traitement de la dépendance à l'héroïne) / RITTER A. in Drug and Alcohol Review, 20 (1) (2001)

[article]  in Drug and Alcohol Review > 20 (1) (2001)  - p.5-7 Titre : (La buprénorphine : nouveau traitement de la dépendance à l'héroïne) Titre autre langue : Buprenorphine for the treatment of heroin dependence Type de document : Périodique Auteurs : RITTER A. Année de publication : 2001 Article en page(s) : p.5-7 Langues : Anglais (eng) Mots-clés : Thésaurus EVOLUTION ; DEPENDANCE ; BUPRENORPHINE ; TRAITEMENT DE MAINTENANCE ; OPIACES ; HEROINE Descripteurs géographiques AUSTRALIE Résumé : La buprénorphine haut dosage (Subutex°) est désormais mise sur le marché australien et agréée comme médication de substitution pour le traitement des dépendances aux opiacés. Les formes galéniques sont les mêmes qu'en France : comprimés sublinguaux de 0,4mg, 4mg et 8mg. Ce médicament semble avoir une bonne efficacité et peu d'effets secondaires. Il élargit la palette des choix thérapeutiques, avec l'objectif d'optimiser la réussite du traitement. Cote CIRDD : 803629 Thématique : Drogues illicites Bibliographie : 20 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=4365 [article]

*** / CAMERON J. ; RITTER A. in Drug and Alcohol Review, 26 (2) (2007)

[article]  in Drug and Alcohol Review > 26 (2) (2007)  - p.183-189 Titre : *** Titre autre langue : Contingency management : perspectives of Australian service providers Type de document : Périodique Auteurs : CAMERON J. ; RITTER A. Année de publication : 2007 Article en page(s) : p.183-189 Langues : Anglais (eng) Mots-clés : Thésaurus OBLIGATION DE SOINS ; REPRESENTATION SOCIALE Résumé : Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Examples of the use of contingency management provided by key informants demonstrated an over-inclusive definition : all the examples did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study. (Review's abstract). Cote CIRDD : 806518 Thématique : Plusieurs addictions Bibliographie : 44 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=7521 [article]

*** / RITTER A. ; BAMMER G. ; HAMILTON M. ; MAZEROLLE L. in Drug and Alcohol Review, 26 (3) (2007)

[article]  in Drug and Alcohol Review > 26 (3) (2007)  - p.265-271 Titre : *** Titre autre langue : Effective drug policy : a new approach demonstrated in the Drug Policy Modelling Program Type de document : Périodique Auteurs : RITTER A. ; BAMMER G. ; HAMILTON M. ; MAZEROLLE L. Année de publication : 2007 Article en page(s) : p.265-271 Langues : Anglais (eng) Mots-clés : Thésaurus SANTE PUBLIQUE ; EVALUATION ; MODELE ; PRODUIT ILLICITE ; POLITIQUE ; PROGRAMME ; RECHERCHE ; THEORIE Descripteurs géographiques AUSTRALIE Résumé : The aim of this paper is to describe a new comprehensive approach to studying illicit drug policy-one that integrates evidence, disciplinary approaches, drug use behaviours and policy making processes. The methods described here include systematic reviews of the evidence, studies of the ways in which policy decision-making actually occurs, and the use of modelling approaches that can explicate the multi-dimensional nature of drug policy responses and their dynamic interactions. The approach described has the potential to facilitate new drug policy that would not have been possible or apparent through the sole study of one aspect of drug policy, such as the evidence-base or the political context or the economics of drug markets. We believe this approach may be more likely to produce strategic drug policy because it reflects the richness and complexity of the real world of drug use, and drug policy. The purpose of employing an integrative methodology is to create the potential for new drug policy insights, ideas and interventions-not restricted to one body of evidence, nor to accidental or fortuitous policy-making processes. (Review's abstract). Cote CIRDD : 805263 Thématique : Drogues illicites Bibliographie : 54 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=7730 [article]

*** / TEESSON M. ; ROSS J. ; DARKE S. ; LYNSKEY M. ; ALI R. ; RITTER A. ; COOKE R. in Drug and Alcohol Dependence, 83 (2) (2006)

[article]  in Drug and Alcohol Dependence > 83 (2) (2006)  - p.174-180 Titre : *** Titre autre langue : One year outcomes for heroin dependence : Findings from the Australian Treatment Outcome Study (ATOS) Type de document : Périodique Auteurs : TEESSON M. ; ROSS J. ; DARKE S. ; LYNSKEY M. ; ALI R. ; RITTER A. ; COOKE R. Année de publication : 2006 Article en page(s) : p.174-180 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus ETUDE LONGITUDINALE ; DEPENDANCE ; TRAITEMENT ; SUIVI DU PATIENT ; COHORTE ; HEROINE Résumé : Aim To determine 1 year outcomes for drug use, criminality, psychopathology and injection-related health problems in those entering treatment for heroin dependence in Australia. Design Longitudinal prospective cohort study. Participants Seven hundred and forty five individuals entering treatment (methadone/buprenorphine maintenance therapy; detoxification; residential rehabilitation) and 80 heroin users not seeking treatment. Setting Sydney, Melbourne and Adelaide, Australia. Findings A total of 657 individuals were re-interviewed at 1 year, 80 % of the original sample. There were substantial reductions in heroin and other drug use across all three treatment modalities. The majority of those who had entered treatment were heroin abstinent at 1 year (maintenance therapy 65 %, detoxification 52 %, residential rehabilitation 63 %) compared to 25 % of the non-treatment sample. The reduction in heroin use among the treatment samples was paralleled by reductions in poly drug use. There were also substantial reductions in risk-taking, crime and injection-related health problems across all treatment groups, and less marked reductions among the non-treatment group. Psychopathology was dramatically reduced among the treatment modalities, while remaining stable among the non-treatment group. Positive outcomes at 1 year were associated with a greater number of cumulative treatment days experienced over the 1 year follow-up period ("treatment dose") and fewer treatment episodes undertaken in that time ("treatment stability"). Conclusions At 1 year, there were impressive reductions in drug use, criminality, psychopathology and injection-related health problems following treatment exposure. The positive findings were associated with a greater "dose" of treatment, and with more treatment stability over the follow-up period. (Review's abstract). Cote CIRDD : 806193 Thématique : Drogues illicites Bibliographie : 34 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=8351 [article]

*** / RITTER A. ; CAMERON J. in Drug and Alcohol Review, 25 (6) (2006)

[article]  in Drug and Alcohol Review > 25 (6) (2006)  - p.611-624 Titre : *** Titre autre langue : A review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco and illicit drugs Type de document : Périodique Auteurs : RITTER A. ; CAMERON J. Année de publication : 2006 Article en page(s) : p.611-624 Langues : Anglais (eng) Mots-clés : Thésaurus SANTE PUBLIQUE ; EFFICACITE ; PRODUIT ILLICITE ; POLITIQUE ; ALCOOL ; REDUCTION DES RISQUES ; TABAC Résumé : Harm reduction is both a policy approach and used to describe a specific set of interventions. These interventions aim to reduce the harms associated with drug use. Employing a strict definition of harm reduction, evidence for the efficacy and effectiveness of alcohol, tobacco and illicit drug harm reduction interventions were reviewed. Systematic searches of the published literature were undertaken. Studies were included if they provided evaluation data (pre-post, or control group comparisons). More than 650 articles were included in the review. The majority of the literature concerned illicit drugs. For alcohol, harm reduction interventions to reduce road trauma are well-founded in evidence. Otherwise, there is limited research to support the efficacy and effectiveness of other alcohol harm reduction interventions. For tobacco, the area is controversial but promising new products that reduce the harms associated with smoking are being developed. In the area of illicit drugs there is solid efficacy, effectiveness and economic data to support needle syringe programmes and outreach programmes. There is limited published evidence to date for other harm reduction interventions such as non-injecting routes of administration, brief interventions and emerging positive evidence for supervised injecting facilities. There is sufficient evidence to support the wide-spread adoption of harm reduction interventions and to use harm reduction as an overarching policy approach in relation to illicit drugs. The same cannot be concluded for alcohol or tobacco. Research at a broad policy level is required, especially in light of the failure by many policy makers to adopt cost-effective harm reduction interventions. (Review's abstract). Cote CIRDD : 806492 Thématique : Plusieurs addictions Bibliographie : 193 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=7187 [article]

*** / ROSS J. ; TEESSON M. ; DARKE S. ; LYNSKEY M. ; ALI R. ; RITTER A. ; COOKE R. in Drug and Alcohol Review, 24 (5) (2005)

[article]  in Drug and Alcohol Review > 24 (5) (2005)  - p.411-418 Titre : *** Titre autre langue : The characteristics of heroin users entering treatment: findings from the Australian treatment outcome study (ATOS) Type de document : Périodique Auteurs : ROSS J. ; TEESSON M. ; DARKE S. ; LYNSKEY M. ; ALI R. ; RITTER A. ; COOKE R. Année de publication : 2005 Article en page(s) : p.411-418 Caractéristiques matérielles : fig., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus DEPENDANCE ; PSYCHOPATHOLOGIE ; TRAITEMENT ; SUIVI DU PATIENT ; COMPARAISON ; HEROINE Résumé : The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities ; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne : 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55 %) were criminally active in the month preceding interview. Injection-related health problems (74 %) and a history of heroin overdose (58 %) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49 % reporting severe psychological distress, 28 % having current major depression, 37 % having attempted suicide and 42 % having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72 % meeting criteria for antisocial personality disorder and 47 % screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories. (Review's abstract). Cote CIRDD : 805011 Thématique : Drogues illicites Bibliographie : 45 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6167 [article]

*** / MOORE T. J. ; RITTER A. ; CAULKINS J. P. in Drug and Alcohol Review, 26 (4) (2007)

[article]  in Drug and Alcohol Review > 26 (4) (2007)  - p.369-378 Titre : *** Titre autre langue : The costs and consequences of three policy options for reducing heroin dependency Type de document : Périodique Auteurs : MOORE T. J. ; RITTER A. ; CAULKINS J. P. Année de publication : 2007 Article en page(s) : p.369-378 Caractéristiques matérielles : graph., tabl. Langues : Anglais (eng) Mots-clés : Thésaurus SANTE PUBLIQUE ; EFFICACITE ; POLITIQUE ; DEPENDANCE ; TRAITEMENT ; TRAITEMENT DE MAINTENANCE ; COMPARAISON ; COUT ; HEROINE Descripteurs géographiques AUSTRALIE Résumé : This study compares the costs and consequences of three interventions for reducing heroin dependency: pharmacotherapy maintenance, residential rehabilitation and prison. Using Australian data, the interventions' cost-consequence ratio was estimated, taking into consideration reduction in heroin use during the intervention; the length of intervention; and post-intervention effects (as measured by abstinence rates). Sensitivity analyses were conducted, including varying the magnitude and duration of treatment effects, and ascribing positive outcomes only to treatment completers. A hybrid model that combined pharmacotherapy maintenance with a prison term was also considered. If the post-programme abstinence rates are sustained for 2 years, then for an average heroin user the cost of averting a year of heroin use is approximately AUD$5000 for pharmacotherapy maintenance, AUD$11 000 for residential rehabilitation and AUD$52 000 for prison. Varying the parameters does not change the ranking of the programmes. If the completion rate in pharmacotherapy maintenance was raised above 95% (by the threat of prison for non-completers), the combined model of treatment plus prison may become the most cost-effective option. Relative performance in terms of costs and consequences is an important consideration in the policy decision-making process, and quantitative data such as those reported herein can provide insights pertinent to evidence-based policy. (Review's abstract). Cote CIRDD : 805274 Thématique : Drogues illicites Bibliographie : 33 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=7738 [article]

*** / WINSTOCK A. R. ; LEA T. ; RITTER A. in Drug and Alcohol Review, 26 (4) (2007)

[article]  in Drug and Alcohol Review > 26 (4) (2007)  - p.411-416 Titre : *** Titre autre langue : The impact of community pharmacy dispensing fees on the introduction of buprenorphine-naloxone in Australia Type de document : Périodique Auteurs : WINSTOCK A. R. ; LEA T. ; RITTER A. Année de publication : 2007 Article en page(s) : p.411-416 Caractéristiques matérielles : tabl. Langues : Anglais (eng) Mots-clés : Thésaurus PHARMACIE ; REGLEMENTATION ; BUPRENORPHINE ; SUBSTITUTION ; NALOXONE Descripteurs géographiques AUSTRALIE Résumé : The introduction of buprenorphine-naloxone in Australia in April 2006 has permitted the revision of takeaway policies in many states and has introduced the possibility of unsupervised treatment. This study explored the implications of the introduction of buprenorphine-naloxone in terms of cost to patients through a survey of pharmacists' intended pricing practices. The aim of the research was to examine the intentions of pharmacists in relation to fees for buprenorphine-naloxone and study the potential implications to patients when compared with the existing fee structure for methadone and for buprenorphine alone. A self-complete questionnaire was mailed to every community pharmacy in New South Wales (NSW) (n = 593) dispensing methadone or buprenorphine to people with opioid dependence. A response rate of 68.6% (n = 407) was achieved after three mailouts. The majority of pharmacies charged a flat weekly fee for methadone (92.2%; mean = $31.90) and buprenorphine (74.8%; mean = $31. 00). The mean intended fees for buprenorphine-naloxone according to different dosing and takeaway regimens ranged from $19.19 per week for no supervised doses and fortnightly takeaways to a $30.88 per week flat fee. There appeared to be little variation in fee structure irrespective of the takeaway regimen, until reaching the 2 weeks' unsupervised dose regimen. This study highlights the importance of the early dissemination of unambiguous information regarding the introduction of a new medication, especially where supervised dispensing through community pharmacies is essential to the provision of treatment. The potential impact upon the successful rollout of a new treatment paradigm that was developed to benefit stable patients in the community may be jeopardised when such processes are not followed. (Review's abstract). Cote CIRDD : 805279 Thématique : Drogues illicites Bibliographie : 24 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=7743 [article]

*** / RITTER A. ; DI NATALE R. in Drug and Alcohol Review, 24 (4) (2005)

[article]  in Drug and Alcohol Review > 24 (4) (2005)  - p.347-352 Titre : *** Titre autre langue : The relationship between take-away methadone policies and methadone diversion Type de document : Périodique Auteurs : RITTER A. ; DI NATALE R. Année de publication : 2005 Article en page(s) : p.347-352 Caractéristiques matérielles : fig. Langues : Anglais (eng) Mots-clés : Thésaurus TRAITEMENT AMBULATOIRE ; METHADONE ; TRAITEMENT DE MAINTENANCE ; USAGE DETOURNE Résumé : The development of policies in relation to unsupervised doses of methadone (take-away doses) should be based upon the best available evidence. There are both risks and benefits associated with take-away doses. This study aimed to explore the relationship between take-away policies and one measure of harm : methadone injection rates. Six different states in Australia were compared in relation to their methadone take-away policy and rates of methadone injection within their population of injecting drug users. At a simplistic level, those states with restrictive and less flexible take-away policies tended to have the lowest reported prevalence of methadone injection. However, this does not fully explain variability in methadone injecting. There were also considerable differences between those states with similar take-away policies. Variables which appear to impact upon methadone injecting rates include : take-away policies, drug preference, drug availability, treatment availability and degree of treatment penetration. Consideration of the benefits, rather than merely the harms, of various take-away policy options may provide an evidence-based platform for take-away policy development. (Review's abstract). Cote CIRDD : 805005 Thématique : Drogues illicites Bibliographie : 32 Permalink : http://doc.cirddalsace.fr/index.php?lvl=notice_display&id=6196 [article]