Concept analysis of recovery from substance use.

In this paper, we provide an analysis of the concept of recovery from substance use. We performed a literature search in CINAHL Plus, PsycINFO, MEDLINE, and Embase using key terms that focused on the concept of recovery from substance use. We also conducted a grey literature search and included select resources. Inclusive years for the search ranged from January 1, 2000 to March 10, 2022. Records were screened for eligibility by two independent reviewers; data were extracted by one reviewer and confirmed by a second. A total of 22 literature sources were included. Identified core attributes of recovery include: (i) recovery as a process, (ii) recovery as more than managing substance use, (iii) recovery as life improvements, and (iv) recovery as a person-centred, individual concept. Antecedents, consequences, and empirical referents are identified, and model and contrary cases are presented. We propose the following definition for recovery: Recovery from substance use is defined by the affected individual, who sets goals and objectives for life improvements that include managing their substance use, but this is not the sole focus. Recovery is a person-centred, individualized process that can be measured by referents that suit the individual's own goals and objectives. What may constitute "recovery" and "recovered" requires definition by each individual.

Alberta's provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose.

SETTING: Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50-100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined. INTERVENTION: Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of community-based harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program. The successes and limitations of this program demonstrated the need for an expanded, multi-sectoral, multi-jurisdictional response. The provincial health authority, Alberta Health Services (AHS), used previously established incident command system processes to coordinate implementation of a provincial THN program. OUTCOMES: Alberta's provincial THN program was implemented on December 23, 2015. This collaborative program resulted in a coordinated response across jurisdictional levels with wide geographical reach. Between December 2015 and December 2016, 953 locations, including many community pharmacies, registered to dispense THN kits, 9572 kits were distributed, and 472 reversals were reported. The provincial supply of THN kits more than tripled from 3000 to 10 000. IMPLICATIONS: Alberta was uniquely poised to deliver a large, province-wide, multi-sectoral and multi-jurisdictional THN program as part of a comprehensive response to increasing opioid-related morbidity and mortality. The speed at which AHS was able to roll out the program was made possible by work done previously and the willingness of multiple jurisdictions to work together to build on and expand the program.

A rapid, sensitive electron-capture gas chromatographic procedure for analysis of metabolites of N-methyl,N-propargylphenylethylamine, a potential neuroprotective agent.

INTRODUCTION: N-Methyl,N-propargyphenylethylamine (MPPE) is a novel analog of (-)-deprenyl, a drug prescribed for Parkinson's disease and shown to have neuroprotective and neurorescue properties in a wide variety of in vitro and in vivo models. MPPE is also neuroprotective, but has the advantage over (-)-deprenyl of not being metabolized to amphetamine or N-methylamphetamine. METHOD: In this paper, extractive derivatization with pentafluorobenzenesulfonyl chloride (PFBSC) followed by electron-capture gas chromatography was utilized to study the metabolism of MPPE. RESULTS: The procedure is rapid and reproducible, giving derivatives with excellent chromatographic properties. Using this procedure, it has now been shown that beta-phenylethylamine (PEA), N-methylphenylethylamine (N-methylPEA) and N-propargylphenylethylamine (N-propargylPEA) are formed from MPPE during incubation of this drug with human liver microsomes. Levels of all three metabolites were shown to increase with increasing time of incubation with the microsomes. DISCUSSION: Extractive derivatization with PFBSC followed by electron-capture gas chromatography represents an efficient means of separating and quantitating the metabolites of MPPE, a novel neuroprotective agent.