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Journal of Urban Health

, Volume 85, Issue 6, pp 812–825 | Cite as

The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

  • Eugenia Oviedo-Joekes
  • Bohdan Nosyk
  • Suzanne Brissette
  • Jill Chettiar
  • Pascal Schneeberger
  • David C. Marsh
  • Michael Krausz
  • Aslam Anis
  • Martin T. Schechter
Article

Abstract

The North American Opiate Medication Initiative (NAOMI) is a randomized controlled trial evaluating the feasibility and effectiveness of heroin-assisted treatment (HAT) in the Canadian context. Our objective is to analyze the profile of the NAOMI participant cohort in the context of illicit opioid use in Canada and to evaluate its comparability with patient profiles of European HAT studies. Recruitment began in February 2005 and ended in March 2007. Inclusion criteria included opioid dependence, 5 or more years of opioid use, regular opioid injection, and at least two previous opiate addiction treatment attempts. Standardized assessment instruments such as the European Addiction Severity Index and the Maudsley Addiction Profile were employed. A total of 251 individuals were randomized from Vancouver, BC (192, 76.5%), and Montreal, Quebec (59, 23.5%); 38.5% were female, the mean age was 39.7 years (SD:8.6), and participants had injected drugs for 16.5 years (SD:9.9), on average. In the prior month, heroin was used a mean of 26.5 days (SD:7.4) and cocaine 16 days (SD;12.6). Vancouver had significantly more patients residing in unstable housing (88.5 vs. 22%; p < 0.001) and higher use of smoked crack cocaine (16.9 days vs. 2.3 days in the prior month; p < 0.001), while a significantly higher proportion of Montreal participants reported needle sharing in the prior 6 months (25% vs. 3.7%; p < 0.001). In many respects, the patient cohort was similar to the European trials; however, NAOMI had a higher proportion of female participants and participants residing in unstable housing. This study suggests that the NAOMI study successfully recruited participants with a profile indicated for HAT. It also raises concern about the high levels of crack cocaine use and social marginalization.

Keywords

Heroin dependence Injection Drug Use Substitution treatment Cocaine abuse Opioid-related disorders Treatment refusals 

Notes

Acknowledgments

The NAOMI study is being funded by the Canadian Institute of Health Research.

The authors would like to thank Kara Sievewright, Kurt Lock, Sophie Alarie, Maryse Beaulieu, and Suzanne Marcotte for their priceless work interviewing participants; Vanessa Chu for editorial assistance; the NAOMI staff; and finally, to all the NAOMI participants.

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Copyright information

© The New York Academy of Medicine 2008

Authors and Affiliations

  • Eugenia Oviedo-Joekes
    • 1
    • 2
  • Bohdan Nosyk
    • 2
  • Suzanne Brissette
    • 3
  • Jill Chettiar
    • 2
  • Pascal Schneeberger
    • 3
  • David C. Marsh
    • 1
    • 2
    • 4
    • 5
    • 6
  • Michael Krausz
    • 2
    • 4
  • Aslam Anis
    • 1
    • 2
  • Martin T. Schechter
    • 1
    • 2
  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.Centre for Health Evaluation and Outcome SciencesProvidence Health CareVancouverCanada
  3. 3.Centre de recherche du l’Université de MontréalMontrealCanada
  4. 4.Department of PsychiatryUniversity of British ColumbiaVancouverCanada
  5. 5.Vancouver Coastal HealthVancouverCanada
  6. 6.Centre for Addiction Research British ColumbiaVancouverCanada

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