Linda Montanari - Academia.edu (original) (raw)

Papers by Linda Montanari

European Journal of Public Health

Introduction Prisons are high-risk environments for the transmission of drug related infections, ... more Introduction Prisons are high-risk environments for the transmission of drug related infections, due to over-incarceration of people who inject drugs; often inadequate healthcare, substandard prison conditions; and others. An overview of the availability and coverage of prison-based harm reduction interventions in Europe is presented. Methods National Focal Points of the EMCDDA (30) collected 2019 data, which were integrated with findings from the European funded project HA-REACT (Joint Action on HIV and Co-infection Prevention and Harm Reduction). Results Prison based harm reduction interventions are available in European countries, but only few of them are available in most countries and often with a low coverage (e.g. less than 10% of prison population in Opioid Substitution Treatment (OST) in most countries). Interventions available in most countries (20 or more) include: HIV, HBV, HCV testing (29), OST continued from community (29), Referral to HIV treatment upon release (28), ...

Drugs: Education, Prevention and Policy, 2021

Abstract Current data on the prevalence of prior illicit drug use among the prison population in ... more Abstract Current data on the prevalence of prior illicit drug use among the prison population in Europe is scarce. The aim of this study is to identify the prevalence of illicit drug use prior to incarceration, as reported by studies conducted in 30 European countries. A comprehensive literature review was conducted from the 5–31 of March 2018 using the databases Cochrane Library, Embase, MEDLINE, PsychINFO and PubMed. After the deletion of duplications, 2607 articles meeting the eligibility criteria for review were identified. In total, 26 studies from 12 different countries have been included in this review. The review found that the lifetime prevalence of illicit drug use before imprisonment ranged from 30 to 93%; last year prevalence from 51 to 69%; last 6 months prevalence from 13 to 75% and last month prevalence from 58 to 62%. The prevalence of illicit drug use was especially high among women. The rates varied across the 26 studies although high prevalence values are reported in most studies and variations are partly related to methodological differences in the reviewed studies. The high levels of prior involvement with drugs, necessitates prisons to develop clear strategies to deal with illicit drug use.

<b>Copyright information:</b>Taken from "Patients in long-term maintenance thera... more <b>Copyright information:</b>Taken from "Patients in long-term maintenance therapy for drug use in Italy: analysis of some parameters of social integration and serological status for infectious diseases in a cohort of 1091 patients"BMC Public Health 2006;6():216-216.Published online 23 Aug 2006PMCID:PMC1570141.

Opioid substitution treatment (OST) is a key evidence-based tool in managing opioid dependence ac... more Opioid substitution treatment (OST) is a key evidence-based tool in managing opioid dependence across Europe, but increasing reports of the diversion and misuse of prescription OST medications are a cause of concern. This report reviews how OST is implemented in European countries and examines the public health consequences of the diversion and misuse of prescription OST medications. It looks at how OST medications are diverted to the illicit market, the motivations behind diversion and misuse, and considers the measures to prevent diversion and how they must ensure that the treatment remains available and accessible for those who need it. About the EMCDDA The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the central source and confirmed authority on drug-related issues in Europe. For over 25 years, it has been collecting, analysing and disseminating scientifically sound information on drugs and drug addiction and their consequences, providing its audiences with an evidence-based picture of the drug phenomenon at European level. The EMCDDA's publications are a prime source of information for a wide range of audiences including policymakers and their advisors; professionals and researchers working in the drugs field; and, more broadly, the media and general public. Based in Lisbon, the EMCDDA is one of the decentralised agencies of the European Union. I Legal notice This publication of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is protected by copyright. The EMCDDA accepts no responsibility or liability for any consequences arising from the use of the data contained in this document. The contents of this publication do not necessarily reflect the official opinions of the EMCDDA's partners, any EU Member State or any agency orinstitution of the European Union.

Publication View. 55423155. BMC Public Health BioMed Central (2002). John R Williams,; Piero Manf... more Publication View. 55423155. BMC Public Health BioMed Central (2002). John R Williams,; Piero Manfredi,; Alisa R Butler,; Marta Ciofi Degli Atti,; Stefania Salmaso,; Open Access,; Marta Ciofi Degli Atti,; Stefania Salmaso. Abstract. ...

BMC Public Health

Background Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and... more Background Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and United Kingdom is driven by injecting drug use (IDU), which contributes to the high burden of chronic infection among people in prisons. This study aimed to describe the context, epidemiology and response targeting HCV in prisons across the region. Methods We retrieved and collated HCV-related data from the World Health Organization’s Health in Prisons European Database and the European Centre for Disease Prevention and Control’s hepatitis C prevalence database. Prisons population data were obtained from the Council of Europe Annual Penal Statistics on prison populations (SPACE I). Results There were 12 to 93,266 people in prisons, with rates of 31·5 to 234·9 per 100,000 population. Median age was between 31 and 40 years, with up to 72% foreign nationals. Average detention time ranged from one to 31 months. Ministries of Health had sole authority over prisons health, budget administrati...

Addiction

Abstract Aims To describe cocaine treatment demand in 10 western European countries and to examin... more Abstract Aims To describe cocaine treatment demand in 10 western European countries and to examine the size, direction and temporality of recent trends in the proportion of cocaine users among all clients entering treatment. Design Aggregated data collected through the European Union standardized treatment demand monitoring system (TDI) between 2011 and 2018 were used. Setting Belgium, England, France, Germany, Ireland, Italy, Luxembourg, Spain, Switzerland and the Netherlands. Participants In total, more than 700 000 cocaine treatment records were analysed. Clients in treatment for cocaine as primary drug were predominantly male (85%), with an average age of 35 years. Measurements Number of treatment episodes for substance use and for cocaine as primary or secondary drug were collected year‐ and country‐wise. When available, powder cocaine and crack and patients with and without previous treatment were differentiated. Findings Among the participating countries the share of cocaine as primary drug in treatment demand ranged between 4.7% [95% confidence interval (CI) = 4.6–4.9%] in Germany and 43.1% in Spain (95% CI = 42.6–43.5%). The general trend analysis showed a decreasing proportion of cocaine‐related treatment entrants between 2011 and 2014 among all subgroups followed by a strong increase in 2015. The increase appeared stronger than for powder cocaine. Seven of 10 countries observed a recent significant increase in the proportion of treatment entrants reporting cocaine as the primary substance: Belgium [annual percentage change (APC) = 9.6%, P < 0.01], England (APC = 14.9%, P < 0.05), France (APC = 21.8%, P < 0.01), Ireland (APC = 28.2%, P < 0.01), Italy (APC = 7.8%, P < 0.01), Spain (APC = 7.0%, P < 0.05) and Switzerland (APC = 12.0%, P < 0.05). Trends were similar when looking at cocaine reported as primary or adjunctive substance. Conclusions Despite substantial country‐specific variation regarding cocaine prevalence and treatment demand, there has been an overall significant increase since 2015 in the share of cocaine‐related treatment demand in western Europe.

Eurosurveillance

Background People who inject drugs (PWID) are frequently incarcerated, which is associated with m... more Background People who inject drugs (PWID) are frequently incarcerated, which is associated with multiple negative health outcomes. Aim We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe. Methods Aggregate data from PWID recruited in drug services (excluding prison services) or elsewhere in the community were reported by 17 of 30 countries (16 per virus) collaborating in a European drug monitoring system (2006–2020; n = 52,368 HIV+/−; n = 47,268 HCV+/−). Country-specific odds ratios (OR) and prevalence ratios (PR) were calculated from country totals of HIV and HCV antibody status and self-reported life-time incarceration history, and pooled using meta-analyses. Country-specific and overall population attributable risk (PAR) were estimated using pooled PR. Results Univariable HIV OR ranged between 0.73 and 6.37 (median: 2.1; pooled OR: 1.92; 95% CI: 1.52–2.42). Pooled PR was 1.66 (95% CI 1.38–1.98), giv...

This report provides an overview of the various types of brief interventions (BIs) currently used... more This report provides an overview of the various types of brief interventions (BIs) currently used in European countries in the field of substance use, particularly illicit drugs. Targeted at policymakers and practitioners alike, it covers more than 30 BIs carried out in the EU and serves as a starting point for preparing concrete proposals to improve the evidence base on this topic. Table of contents: • Executive Summary • Introduction • Methods • Results • Discussion and conclusions • References • Annex 1: Brief interventions identified in the study for substance use in the European Union Member States, Norway and Turkey, 2010-2014

The report describes trends in drug injection in the EU Member States, Norway and Turkey between ... more The report describes trends in drug injection in the EU Member States, Norway and Turkey between 2000 and 2011, through an analysis of data on those admitted to drug treatment. Results indicate that current drug injection, including its incidence, has declined in recent years in Europe. While heroin remains the drug most frequently involved in drug injection, data show how drug injectors are now more likely to be using stimulants than in the past.

All European experts, networks and institutions who were involved in the different stages of this... more All European experts, networks and institutions who were involved in the different stages of this study.

Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and United Kin... more Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and United Kingdom is driven by injecting drug use (IDU), which contributes to the high burden of chronic infection among people in prisons. This study aimed to describe the context, epidemiology and response targeting HCV in prisons across the region. We retrieved and collated HCV-related data from the World Health Organization’s Health in Prisons European Database and the European Centre for Disease Prevention and Control’s hepatitis C prevalence database. Prisons population data were obtained from the Council of Europe Annual Penal Statistics on prison populations (SPACE I). There were 12 to 93,266 people in prisons, with rates of 31·5 to 234·9 per 100,000 population. Median age was between 31 and 40 years, with up to 72% foreign nationals. Average detention time ranged from one to 31 months. Ministries of Health had sole authority over prisons health, budget administration and funding in 27, 31 an...

European Journal of Public Health

Introduction Prisons are high-risk environments for the transmission of drug related infections, ... more Introduction Prisons are high-risk environments for the transmission of drug related infections, due to over-incarceration of people who inject drugs; often inadequate healthcare, substandard prison conditions; and others. An overview of the availability and coverage of prison-based harm reduction interventions in Europe is presented. Methods National Focal Points of the EMCDDA (30) collected 2019 data, which were integrated with findings from the European funded project HA-REACT (Joint Action on HIV and Co-infection Prevention and Harm Reduction). Results Prison based harm reduction interventions are available in European countries, but only few of them are available in most countries and often with a low coverage (e.g. less than 10% of prison population in Opioid Substitution Treatment (OST) in most countries). Interventions available in most countries (20 or more) include: HIV, HBV, HCV testing (29), OST continued from community (29), Referral to HIV treatment upon release (28), ...

Drugs: Education, Prevention and Policy, 2021

Abstract Current data on the prevalence of prior illicit drug use among the prison population in ... more Abstract Current data on the prevalence of prior illicit drug use among the prison population in Europe is scarce. The aim of this study is to identify the prevalence of illicit drug use prior to incarceration, as reported by studies conducted in 30 European countries. A comprehensive literature review was conducted from the 5–31 of March 2018 using the databases Cochrane Library, Embase, MEDLINE, PsychINFO and PubMed. After the deletion of duplications, 2607 articles meeting the eligibility criteria for review were identified. In total, 26 studies from 12 different countries have been included in this review. The review found that the lifetime prevalence of illicit drug use before imprisonment ranged from 30 to 93%; last year prevalence from 51 to 69%; last 6 months prevalence from 13 to 75% and last month prevalence from 58 to 62%. The prevalence of illicit drug use was especially high among women. The rates varied across the 26 studies although high prevalence values are reported in most studies and variations are partly related to methodological differences in the reviewed studies. The high levels of prior involvement with drugs, necessitates prisons to develop clear strategies to deal with illicit drug use.

<b>Copyright information:</b>Taken from "Patients in long-term maintenance thera... more <b>Copyright information:</b>Taken from "Patients in long-term maintenance therapy for drug use in Italy: analysis of some parameters of social integration and serological status for infectious diseases in a cohort of 1091 patients"BMC Public Health 2006;6():216-216.Published online 23 Aug 2006PMCID:PMC1570141.

Opioid substitution treatment (OST) is a key evidence-based tool in managing opioid dependence ac... more Opioid substitution treatment (OST) is a key evidence-based tool in managing opioid dependence across Europe, but increasing reports of the diversion and misuse of prescription OST medications are a cause of concern. This report reviews how OST is implemented in European countries and examines the public health consequences of the diversion and misuse of prescription OST medications. It looks at how OST medications are diverted to the illicit market, the motivations behind diversion and misuse, and considers the measures to prevent diversion and how they must ensure that the treatment remains available and accessible for those who need it. About the EMCDDA The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the central source and confirmed authority on drug-related issues in Europe. For over 25 years, it has been collecting, analysing and disseminating scientifically sound information on drugs and drug addiction and their consequences, providing its audiences with an evidence-based picture of the drug phenomenon at European level. The EMCDDA's publications are a prime source of information for a wide range of audiences including policymakers and their advisors; professionals and researchers working in the drugs field; and, more broadly, the media and general public. Based in Lisbon, the EMCDDA is one of the decentralised agencies of the European Union. I Legal notice This publication of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is protected by copyright. The EMCDDA accepts no responsibility or liability for any consequences arising from the use of the data contained in this document. The contents of this publication do not necessarily reflect the official opinions of the EMCDDA's partners, any EU Member State or any agency orinstitution of the European Union.

Publication View. 55423155. BMC Public Health BioMed Central (2002). John R Williams,; Piero Manf... more Publication View. 55423155. BMC Public Health BioMed Central (2002). John R Williams,; Piero Manfredi,; Alisa R Butler,; Marta Ciofi Degli Atti,; Stefania Salmaso,; Open Access,; Marta Ciofi Degli Atti,; Stefania Salmaso. Abstract. ...

BMC Public Health

Background Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and... more Background Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and United Kingdom is driven by injecting drug use (IDU), which contributes to the high burden of chronic infection among people in prisons. This study aimed to describe the context, epidemiology and response targeting HCV in prisons across the region. Methods We retrieved and collated HCV-related data from the World Health Organization’s Health in Prisons European Database and the European Centre for Disease Prevention and Control’s hepatitis C prevalence database. Prisons population data were obtained from the Council of Europe Annual Penal Statistics on prison populations (SPACE I). Results There were 12 to 93,266 people in prisons, with rates of 31·5 to 234·9 per 100,000 population. Median age was between 31 and 40 years, with up to 72% foreign nationals. Average detention time ranged from one to 31 months. Ministries of Health had sole authority over prisons health, budget administrati...

Addiction

Abstract Aims To describe cocaine treatment demand in 10 western European countries and to examin... more Abstract Aims To describe cocaine treatment demand in 10 western European countries and to examine the size, direction and temporality of recent trends in the proportion of cocaine users among all clients entering treatment. Design Aggregated data collected through the European Union standardized treatment demand monitoring system (TDI) between 2011 and 2018 were used. Setting Belgium, England, France, Germany, Ireland, Italy, Luxembourg, Spain, Switzerland and the Netherlands. Participants In total, more than 700 000 cocaine treatment records were analysed. Clients in treatment for cocaine as primary drug were predominantly male (85%), with an average age of 35 years. Measurements Number of treatment episodes for substance use and for cocaine as primary or secondary drug were collected year‐ and country‐wise. When available, powder cocaine and crack and patients with and without previous treatment were differentiated. Findings Among the participating countries the share of cocaine as primary drug in treatment demand ranged between 4.7% [95% confidence interval (CI) = 4.6–4.9%] in Germany and 43.1% in Spain (95% CI = 42.6–43.5%). The general trend analysis showed a decreasing proportion of cocaine‐related treatment entrants between 2011 and 2014 among all subgroups followed by a strong increase in 2015. The increase appeared stronger than for powder cocaine. Seven of 10 countries observed a recent significant increase in the proportion of treatment entrants reporting cocaine as the primary substance: Belgium [annual percentage change (APC) = 9.6%, P < 0.01], England (APC = 14.9%, P < 0.05), France (APC = 21.8%, P < 0.01), Ireland (APC = 28.2%, P < 0.01), Italy (APC = 7.8%, P < 0.01), Spain (APC = 7.0%, P < 0.05) and Switzerland (APC = 12.0%, P < 0.05). Trends were similar when looking at cocaine reported as primary or adjunctive substance. Conclusions Despite substantial country‐specific variation regarding cocaine prevalence and treatment demand, there has been an overall significant increase since 2015 in the share of cocaine‐related treatment demand in western Europe.

Eurosurveillance

Background People who inject drugs (PWID) are frequently incarcerated, which is associated with m... more Background People who inject drugs (PWID) are frequently incarcerated, which is associated with multiple negative health outcomes. Aim We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe. Methods Aggregate data from PWID recruited in drug services (excluding prison services) or elsewhere in the community were reported by 17 of 30 countries (16 per virus) collaborating in a European drug monitoring system (2006–2020; n = 52,368 HIV+/−; n = 47,268 HCV+/−). Country-specific odds ratios (OR) and prevalence ratios (PR) were calculated from country totals of HIV and HCV antibody status and self-reported life-time incarceration history, and pooled using meta-analyses. Country-specific and overall population attributable risk (PAR) were estimated using pooled PR. Results Univariable HIV OR ranged between 0.73 and 6.37 (median: 2.1; pooled OR: 1.92; 95% CI: 1.52–2.42). Pooled PR was 1.66 (95% CI 1.38–1.98), giv...

This report provides an overview of the various types of brief interventions (BIs) currently used... more This report provides an overview of the various types of brief interventions (BIs) currently used in European countries in the field of substance use, particularly illicit drugs. Targeted at policymakers and practitioners alike, it covers more than 30 BIs carried out in the EU and serves as a starting point for preparing concrete proposals to improve the evidence base on this topic. Table of contents: • Executive Summary • Introduction • Methods • Results • Discussion and conclusions • References • Annex 1: Brief interventions identified in the study for substance use in the European Union Member States, Norway and Turkey, 2010-2014

The report describes trends in drug injection in the EU Member States, Norway and Turkey between ... more The report describes trends in drug injection in the EU Member States, Norway and Turkey between 2000 and 2011, through an analysis of data on those admitted to drug treatment. Results indicate that current drug injection, including its incidence, has declined in recent years in Europe. While heroin remains the drug most frequently involved in drug injection, data show how drug injectors are now more likely to be using stimulants than in the past.

All European experts, networks and institutions who were involved in the different stages of this... more All European experts, networks and institutions who were involved in the different stages of this study.

Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and United Kin... more Hepatitis C virus (HCV) transmission in the European Union, European Economic Area and United Kingdom is driven by injecting drug use (IDU), which contributes to the high burden of chronic infection among people in prisons. This study aimed to describe the context, epidemiology and response targeting HCV in prisons across the region. We retrieved and collated HCV-related data from the World Health Organization’s Health in Prisons European Database and the European Centre for Disease Prevention and Control’s hepatitis C prevalence database. Prisons population data were obtained from the Council of Europe Annual Penal Statistics on prison populations (SPACE I). There were 12 to 93,266 people in prisons, with rates of 31·5 to 234·9 per 100,000 population. Median age was between 31 and 40 years, with up to 72% foreign nationals. Average detention time ranged from one to 31 months. Ministries of Health had sole authority over prisons health, budget administration and funding in 27, 31 an...