WorldWideScience

Sample records for drug users prospective

  1. Mortality among drug users after discharge from inpatient treatment: an 8-year prospective study.

    Science.gov (United States)

    Ravndal, Edle; Amundsen, Ellen J

    2010-04-01

    Drug users who are leaving/completing inpatient medication-free treatment may, like drug users released from prison, have an elevated risk of dying from fatal overdoses. This is mainly explained by their low drug tolerance. Two hundred and seventy-six drug users who had been admitted to 11 inpatient facilities in Norway, were followed prospectively after discharge from treatment during an 8-year period (1998-2006). The following instruments were used: EuropASI, SCL-25 and MCMI II. Information on deaths and causes of death were obtained from the National Death Register. A total of 36 deaths were registered after discharge from treatment during the observation period, of which 24 were classified as overdose deaths. During the first 4 weeks after discharge six persons died, yielding an unadjusted excess mortality of 15.7 (rate ratio) in this period (CI 5.3-38.3). All were dropouts and all deaths were classified as opiate overdoses. There was no significant association between time in index treatment and mortality after discharge, nor did any background characteristics correlate significantly with elevated mortality shortly after discharge. The elevated risk of dying from overdose within the first 4 weeks of leaving medication-free inpatient treatment is so dramatic that preventive measures should be taken. More studies from similar inpatient programmes are needed in order to obtain systematic knowledge about determinants of overdose deaths shortly after leaving treatment, and possible preventive measures. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  2. Longitudinal community plasma HIV-1 RNA concentrations and incidence of HIV-1 among injecting drug users: prospective cohort study

    OpenAIRE

    Wood, Evan; Kerr, Thomas; Marshall, Brandon D L; Li, Kathy; Zhang, Ruth; Hogg, Robert S; Harrigan, P Richard; Montaner, Julio S G

    2009-01-01

    Objective To examine the relation between plasma HIV-1 RNA concentrations in the community and HIV incidence among injecting drug users. Design Prospective cohort study. Setting Inner city community in Vancouver, Canada. Participants Injecting drug users, with and without HIV, followed up every six months between 1 May 1996 and 30 June 2007. Main outcome measures Estimated community plasma HIV-1 RNA in the six months before each HIV negative participant?s follow-up visit. Associated HIV incid...

  3. The Prevalence and Incidence of Sexually Transmitted Infections in a Prospective Cohort of Injection Drug Users in Vancouver, British Columbia

    Directory of Open Access Journals (Sweden)

    Laura M Kuyper

    2005-01-01

    Full Text Available BACKGROUND: While several studies have reported on sexual risk behaviours and the prevalence of sexually transmitted infections (STIs among injection drug users (IDUs, there are fewer prospective studies that have been able to examine populations of IDUs with no history of STIs. Therefore, the authors examined prevalence, correlates and factors associated with time to first STI infection in a prospective cohort of IDUs in Vancouver, British Columbia.

  4. Clinical manifestations and outcome in Staphylococcus aureus endocarditis among injection drug users and nonaddicts: a prospective study of 74 patients

    Directory of Open Access Journals (Sweden)

    Ruotsalainen Eeva

    2006-09-01

    Full Text Available Abstract Background Endocarditis is a common complication in Staphylococcus aureus bacteremia (SAB. We compared risk factors, clinical manifestations, and outcome in a large, prospective cohort of patients with S. aureus endocarditis in injection drug users (IDUs and in nonaddicts. Methods Four hundred and thirty consecutive adult patients with SAB were prospectively followed up for 3 months. Definite or possible endocarditis by modified Duke criteria was found in 74 patients: 20 patients were IDUs and 54 nonaddicts. Results Endocarditis was more common in SAB among drug abusers (46% than in nonaddicts (14% (odds ratio [OR], 5.12; 95% confidence interval [CI], 2.65–9.91; P P P P = 0.03, and their SAB was more often community-acquired (95% vs 39%, P P P = 0.70. Arterial thromboembolic events and severe sepsis were also equally common in both groups. There was no difference in mortality between the groups at 7 days, but at 3 months it was lower among IDUs (10% compared with nonaddicts (39% (OR, 5.73; 95% CI, 1.20–27.25; P = 0.02. Conclusion S. aureus endocarditis in IDUs was associated with as high complication rates including extracardiac deep infections, thromboembolic events, or severe sepsis as in nonaddicts. Injection drug abuse in accordance with younger age and lack of underlying diseases were associated with lower mortality, but after adjusting by age and underlying diseases injection drug abuse was not significantly associated with mortality.

  5. Does respondent driven sampling alter the social network composition and health-seeking behaviors of illicit drug users followed prospectively?

    Directory of Open Access Journals (Sweden)

    Abby E Rudolph

    2011-05-01

    Full Text Available Respondent driven sampling (RDS was originally developed to sample and provide peer education to injection drug users at risk for HIV. Based on the premise that drug users' social networks were maintained through sharing rituals, this peer-driven approach to disseminate educational information and reduce risk behaviors capitalizes and expands upon the norms that sustain these relationships. Compared with traditional outreach interventions, peer-driven interventions produce greater reductions in HIV risk behaviors and adoption of safer behaviors over time, however, control and intervention groups are not similarly recruited. As peer-recruitment may alter risk networks and individual risk behaviors over time, such comparison studies are unable to isolate the effect of a peer-delivered intervention. This analysis examines whether RDS recruitment (without an intervention is associated with changes in health-seeking behaviors and network composition over 6 months. New York City drug users (N = 618 were recruited using targeted street outreach (TSO and RDS (2006-2009. 329 non-injectors (RDS = 237; TSO = 92 completed baseline and 6-month surveys ascertaining demographic, drug use, and network characteristics. Chi-square and t-tests compared RDS- and TSO-recruited participants on changes in HIV testing and drug treatment utilization and in the proportion of drug using, sex, incarcerated and social support networks over the follow-up period. The sample was 66% male, 24% Hispanic, 69% black, 62% homeless, and the median age was 35. At baseline, the median network size was 3, 86% used crack, 70% used cocaine, 40% used heroin, and in the past 6 months 72% were tested for HIV and 46% were enrolled in drug treatment. There were no significant differences by recruitment strategy with respect to changes in health-seeking behaviors or network composition over 6 months. These findings suggest no association between RDS recruitment and changes in

  6. Highly active antiretroviral therapy (HAART) among HIV-infected drug users: a prospective cohort study of sexual risk and injecting behaviour

    NARCIS (Netherlands)

    Smit, Colette; Lindenburg, Karen; Geskus, Ronald B.; Brinkman, Kees; Coutinho, Roel A.; Prins, Maria

    2006-01-01

    AIMS: To study sexual risk and injecting behaviour among HIV-infected drug users (DU) receiving highly active antiretroviral therapy (HAART). DESIGN AND SETTING: As part of an ongoing prospective cohort study, HIV-infected DU who commenced HAART (n=67) were matched with those not starting HAART

  7. Predictors of injection drug use cessation and relapse in a prospective cohort of young injection drug users in San Francisco, CA (UFO Study).

    Science.gov (United States)

    Evans, Jennifer L; Hahn, Judith A; Lum, Paula J; Stein, Ellen S; Page, Kimberly

    2009-05-01

    Studies of injection drug use cessation have largely sampled adults in drug treatment settings. Little is known about injection cessation and relapse among young injection drug users (IDU) in the community. A total of 365 HCV-negative IDU under age 30 years were recruited by street outreach and interviewed quarterly for a prospective cohort between January 2000 and February 2008. Participants were followed for a total of 638 person-years and 1996 visits. We used survival analysis techniques to identify correlates of injection cessation (> or =3 months) and relapse to injection. 67% of subjects were male, median age was 22 years (interquartile range (IQR) 20-26) and median years injecting was 3.6 (IQR 1.3-6.5). 28.8% ceased injecting during the follow-up period. Among those that ceased injecting, nearly one-half resumed drug injection on subsequent visits, one-quarter maintained injecting cessation, and one-quarter were lost to follow-up. Participating in a drug treatment program in the last 3 months and injecting less than 30 times per month were associated with injection cessation. Injecting heroin or heroin mixed with other drugs, injecting the residue from previously used drug preparation equipment, drinking alcohol, and using benzodiazepines were negatively associated with cessation. Younger age was associated with relapse to injection. These results suggest that factors associated with stopping injecting involve multiple areas of intervention, including access to drug treatment and behavioral approaches to reduce injection and sustain cessation. The higher incidence of relapse in the younger subjects in this cohort underscores the need for earlier detection and treatment programs targeted to adolescents and transition-age youth.

  8. Attitudes towards drug legalization among drug users.

    Science.gov (United States)

    Trevino, Roberto A; Richard, Alan J

    2002-01-01

    Research shows that support for legalization of drugs varies significantly among different sociodemographic and political groups. Yet there is little research examining the degree of support for legalization of drugs among drug users. This paper examines how frequency and type of drug use affect the support for legalization of drugs after adjusting for the effects of political affiliation and sociodemographic characteristics. A sample of 188 drug users and non-drug users were asked whether they would support the legalization of marijuana, cocaine, and heroin. Respondents reported their use of marijuana, crack, cocaine, heroin, speedball, and/or methamphetamines during the previous 30 days. Support for legalization of drugs was analyzed by estimating three separate logistic regressions. The results showed that the support for the legalization of drugs depended on the definition of "drug user" and the type of drug. In general, however, the results showed that marijuana users were more likely to support legalizing marijuana, but they were less likely to support the legalization of cocaine and heroin. On the other hand, users of crack, cocaine, heroin, speedball, and/or methamphetamines were more likely to support legalizing all drugs including cocaine and heroin.

  9. Risk of hepatitis-related mortality increased among hepatitis C virus/HIV-coinfected drug users compared with drug users infected only with hepatitis C virus: a 20-year prospective study

    NARCIS (Netherlands)

    Smit, Colette; van den Berg, Charlotte; Geskus, Ronald; Berkhout, Ben; Coutinho, Roel; Prins, Maria

    2008-01-01

    BACKGROUND: Progression of liver-related disease is accelerated in individuals coinfected with HIV and hepatitis C virus (HCV). Because the life expectancy of HIV-infected drug users (DUs) improved after the widespread use of highly active antiretroviral therapy (HAART), HCV-related death is likely

  10. Chronic hepatitis C virus infection and increases in viral load in a prospective cohort of young, HIV-uninfected injection drug users.

    Science.gov (United States)

    Boodram, Basmattee; Hershow, Ronald C; Cotler, Scott J; Ouellet, Lawrence J

    2011-12-15

    Chronic hepatitis C (HCV) infection, defined as persistent RNA (viral load) for at least 6 months, accounts for up to 50% of all cirrhosis, end-stage liver disease and liver cancer cases. Moreover, elevated HCV viral load is consistently associated with high infectivity and poor therapy response. This study aims to identify modifiable behavioral correlates both chronic HCV infection and increases in viral load over time among injection drug users (IDUs). Cross-sectional and longitudinal analyses were performed using self-interview and serological data from a prospective cohort study (2002-2006) among young (age 18-35), HIV-negative, HCV therapy-naïve IDUs (n=113) from metropolitan Chicago, Illinois, USA. After adjustment for age, gender and race/ethnicity, using drugs measured or mixed in someone else's syringe (odds ratio=2.7, 95% confidence interval: 1.1, 6.7) was associated with chronic (n=75, 66%) versus resolved (n=38, 34%) HCV infection status. Among chronically-infected IDUs, injecting with a new, sterile syringe infrequently (<1/2 half the time when injecting) compared to frequently (1/2 the time or more when injecting) was associated with increases in viral load over time after adjusting for age, gender, race/ethnicity and time effects. Reductions in risky injection-related practices among young IDUs may ameliorate both the burden of chronic HCV infection-related liver disease and elevated viral load-related poor treatment response. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. The Parents Of Drug Users

    Science.gov (United States)

    Frankel, Phylis M.; And Others

    1975-01-01

    Students' perceptions of their parents were explored as possible correlates of extensive drug usage. Father's coldness, but not mother's, was found related to usage. Perceived parental permissiveness was not found related, but alienation from parental values and life style was correlated with usage. Implications for counseling are suggested.…

  12. How does tuberculosis relate to HIV positive and HIV negative drug users?

    NARCIS (Netherlands)

    Keizer, S. T.; Langendam, M. M.; van Deutekom, H.; Coutinho, R. A.; van Ameijden, E. J.

    2000-01-01

    (1) To compare the incidence of active tuberculosis in HIV positive and HIV negative drug users. (2) To describe the main characteristics of the tuberculosis cases. A prospective study was performed from 1986 to 1996 as part of an ongoing cohort study of HIV infection in Amsterdam drug users. Data

  13. Medical and nonmedical users of prescription drugs among college students.

    Science.gov (United States)

    Rozenbroek, Katelyn; Rothstein, William G

    2011-01-01

    To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Undergraduates at an urban mid-Atlantic university with 12,000 students. A questionnaire administered in classes provided 413 responses, with a usable response rate of 94%. Nonmedical users obtained prescription drugs from friends and took them with friends. More nonmedical users than medical users took combinations of drugs. Nonmedical users did not show strong preferences for particular drugs. Nonmedical users compared to medical users who took only 1 drug were more likely to take stimulants and less likely to take opioids. The nonmedical use of prescription drugs by college students is a social activity that involves sharing drugs and taking combinations of drugs with friends. Discouraging nonmedical use must focus on the dangers of combining drugs, sharing drugs, and using social gatherings to consume drugs.

  14. A pilot study of loss aversion for drug and non-drug commodities in cocaine users.

    Science.gov (United States)

    Strickland, Justin C; Beckmann, Joshua S; Rush, Craig R; Stoops, William W

    2017-11-01

    Numerous studies in behavioral economics have demonstrated that individuals are more sensitive to the prospect of a loss than a gain (i.e., loss aversion). Although loss aversion has been well described in "healthy" populations, little research exists in individuals with substance use disorders. This gap is notable considering the prominent role that choice and decision-making play in drug use. The purpose of this pilot study was to evaluate loss aversion in active cocaine users. Current cocaine users (N=38; 42% female) participated in this within-subjects laboratory pilot study. Subjects completed a battery of tasks designed to assess loss aversion for drug and non-drug commodities under varying risk conditions. Standardized loss aversion coefficients (λ) were compared to theoretically and empirically relevant normative values (i.e., λ=2). Compared to normative loss aversion coefficient values, a precise and consistent decrease in loss aversion was observed in cocaine users (sample λ≈1). These values were observed across drug and non-drug commodities as well as under certain and risky conditions. These data represent the first systematic study of loss aversion in cocaine-using populations and provide evidence for equal sensitivity to losses and gains or loss equivalence. Futures studies should evaluate the specificity of these effects to a history of cocaine use as well as the impact of manipulations of loss aversion on drug use to determine how this phenomenon may contribute to intervention development efforts. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Active drug users - struggling for rights and recognition in Denmark

    DEFF Research Database (Denmark)

    Anker, Jørgen

    This paper examines the strategic dilemmas and the self-representation of the Drug Users’ Union in Denmark. The paper explores how a group of drug users on the one hand seeks to struggle for the rights of drug users and one the other hand seeks to gain legitimacy and access to public funding and ...... and support. It reveals how the organisation attempts to advance a more balanced image of drug users as persons who are able to run an effective organisation while they also claim the right to use drugs.......This paper examines the strategic dilemmas and the self-representation of the Drug Users’ Union in Denmark. The paper explores how a group of drug users on the one hand seeks to struggle for the rights of drug users and one the other hand seeks to gain legitimacy and access to public funding...

  16. Rural drug users: factors associated with substance abuse treatment utilization.

    Science.gov (United States)

    Oser, Carrie B; Leukefeld, Carl G; Tindall, Michele Staton; Garrity, Thomas F; Carlson, Robert G; Falck, Russel; Wang, Jichuan; Booth, Brenda M

    2011-06-01

    The purpose of this study is to use a modified version of Andersen's Behavioral Model of Health Services Use to identify the correlates of the number of substance abuse treatment episodes received by rural drug users. Data were collected from face-to-face interviews with 711 drug users in rural areas of Ohio, Arkansas, and Kentucky. Descriptive analyses examine rural drug users' substance use histories and retrospective substance abuse treatment service utilization patterns. A negative binomial regression model indicated that selected predisposing, historical health, and enabling factors were significantly associated with the utilization of substance abuse treatment among rural drug users. Despite high levels of recent and lifetime self-reported substance use among these rural drug users, treatment services were underutilized. Future studies are needed to examine the impact of the health care system and characteristics of the external environment associated with rural substance abuse treatment in order to increase utilization among drug users.

  17. Cognitive impairments in poly-drug ketamine users.

    Science.gov (United States)

    Liang, H J; Lau, C G; Tang, A; Chan, F; Ungvari, G S; Tang, W K

    2013-11-01

    Cognitive impairment has been found to be reversible in people with substance abuse, particularly those using ketamine. Ketamine users are often poly-substance users. This study compared the cognitive functions of current and former ketamine users who were also abusing other psychoactive substances with those of non-users of illicit drugs as controls. One hundred ketamine poly-drug users and 100 controls were recruited. Drug users were divided into current (n = 32) and ex-users (n = 64) according to the duration of abstinence from ketamine (>30 days). The Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scale (HADSA) and the Severity of Dependence Scale (SDS) were used to evaluate depression and anxiety symptoms and the severity of drug use, respectively. The cognitive test battery comprised verbal memory (Wechsler Memory Scale III: Logic Memory and Word List), visual memory (Rey-Osterrieth Complex Figure, ROCF), executive function (Stroop, Wisconsin Card Sorting Test, and Modified Verbal Fluency Test), working memory (Digit Span Backward), and general intelligence (Information, Arithmetic and Digit-Symbol Coding) tests. Current users had higher BDI and HADSA scores than ex-users (p recognition than controls (p = 0.002). No difference was found between the cognitive functions of current and ex-users. Ketamine poly-drug users displayed predominantly verbal and visual memory impairments, which persisted in ex-users. The interactive effect of ketamine and poly-drug use on memory needs further investigation. © 2013 Elsevier Ltd. All rights reserved.

  18. Chapter 9. Drug user researchers as autoethnographers: "doing reflexivity" with women drug users.

    Science.gov (United States)

    Ettorre, Elizabeth

    2013-11-01

    This article explores autoethnography, based upon transcribed, narratives, conversations, and research notes, as a useful method of creating social and cultural insights into the lives of women drug users and their particular kinds of problems and to related issues of reflexivity, reliability, and validity. A critical issue is raised by asking the question "where do we go from here?" contending that we must challenge outdated methodological traditions and canons that deny autoethnographers their voice and close the door to their claims of authenticity.

  19. Prospective approach to managing antimicrobial drug shortages.

    Science.gov (United States)

    Griffith, Milena M; Patel, Jean A; Sutton, Sarah H; Bolon, Maureen K; Esterly, John S; Gross, Alan E; Postelnick, Michael J; Zembower, Teresa R; Scheetz, Marc H

    2012-07-01

    Antimicrobial drug shortages continue to increase, with few new therapeutic options available. Nationally, proposals have been offered to alleviate drug shortages; however, these recommendations are unlikely to effect change in the near future. Thus, antimicrobial stewardship leaders in acute care hospitals must develop a prospective management strategy to lessen the impact of these shortages on patient care. Herein, we describe several resources available to aid professionals in antimicrobial stewardship and healthcare epidemiology to manage drug shortages. An effective approach should include prospectively tracking shortages and maximizing inventory by appropriately managing usage. Several tenets should underpin this management. Alternative agents should be rationally chosen before the inventory of the primary agent has reached zero, ethical considerations should be taken into account, and timely notification and communication with key stakeholders should occur throughout the prescribing and dispensing process.

  20. Reconstructed Living Lab: supporting drug users and families ...

    African Journals Online (AJOL)

    based organisations are discussed. Data on relatives of drug users using the system are included. Conclusion: The use of mobile phone technology has advantages for community-based organisations acting as a first point of contact to drug ...

  1. 75 FR 12555 - Prescription Drug User Fee Act; Public Meeting

    Science.gov (United States)

    2010-03-16

    ...Information/Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FoodandDrug... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0128] Prescription Drug User Fee Act; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of...

  2. hiv prevention among drug and alcohol users: models of ...

    African Journals Online (AJOL)

    Administrator

    HIV PREVENTION AMONG DRUG AND ALCOHOL USERS: MODELS. OF INTERVENTION IN KENYA. Clement S. Deveau. Academy for Educational Development (AED). Capable Partners Program (CAP). Nairobi, Kenya. ABSTRACT. The spread of HIV among drug and alcohol users, as a high-risk group, is a significant ...

  3. Rates of inappropriate antiretroviral prescription among injection drug users

    Directory of Open Access Journals (Sweden)

    Bonner Simon

    2007-01-01

    Full Text Available Abstract Background Although the survival benefits of antiretroviral therapy (ART for the treatment of HIV infection are well established, the clinical management of HIV disease continues to present major challenges. There are particular concerns regarding access to appropriate HIV treatment among HIV-infected injection drug users (IDU. Methods In a prospective cohort study of HIV-infected IDU in Vancouver, Canada, we examined initial ART regimens vis-à-vis the provincial government's therapeutic guidelines at the time ART was initiated. Briefly, there have been four sets of guidelines: Era 1 (1992 to November 1995; double-drug (dual NRTIs ART for patients with a CD4 cell count of 350 or less; Era 2 (December 1995 to May 1996; double-drug therapy for patients with a CD4+ cell count of 500 or less; Era 3 (June 1996 to June 1997; triple-drug therapy (dual NRTIs with a PI or NNRTI for patients who had a plasma viral load of > 100,000 HIV-1 RNA copies/mL; dual therapy with two NRTIs for those with a plasma viral load of 5,000 to 100,000 HIV-1 RNA copies/mL; Era 4 (since July 1997; universal use of triple drug therapy as first-line treatment. Results Between May 1996 and May 2003, 431 HIV-infected individuals were enrolled into the cohort. By May 31, 2003, 291 (67.5% individuals had initiated ART. We noted instances of inappropriate antiretroviral prescription in each guideline era, with 9 (53% in Era 1, 3 (12% in Era 2, 22 (28% in Era 3, and 23 (15% in Era 4. Of the 57 subjects who received an inappropriate ART regimen initially, 14 never received the appropriate therapy; among the remaining 43, the median time to the initiation of a guideline-appropriate ART regimen was 12 months (inter-quartile range 5 – 20. Conclusion The present study identified measurable rates of guideline-inappropriate ART prescription for patients who were injection drug users. Rates were highest in the era of dual therapy, although high rates persisted into the triple

  4. Prospective memory, everyday cognitive failure and central executive function in recreational users of Ecstasy.

    Science.gov (United States)

    Heffernan, T. M.; Jarvis, H.; Rodgers, J.; Scholey, A. B.; Ling, J.

    2001-12-01

    Chronic use of MDMA (3,4-methylenedioxymethamphetamine), or Ecstasy, is believed to lead to impaired psychological performance, including well-documented decrements in laboratory and field tests of retrospective memory. Less is known about the impact of Ecstasy on aspects of 'everyday' memory, despite obvious concerns about such effects. The three studies reported here focused on the impact of chronic Ecstasy use on prospective memory (PM), associated central executive function and other aspects of day-to-day cognition. In study 1 46 regular Ecstasy users were compared with 46 Ecstasy-free controls using the Prospective Memory Questionnaire (PMQ). Ecstasy users reported significantly more errors in PM (remembering to do something in the future); these findings persisted after controlling for other drug use and the number of strategies used to aid memory. No difference was found between representative subgroups on the Lies Scale of the Eysenck Personality Questionnaire. In study 2 a different group of 30 regular Ecstasy users and 37 Ecstasy-free controls was assessed on the PMQ and on a central executive task comprising verbal fluency measures. The results confirmed the significant impairments in long- and short-term PM and revealed corresponding impairments in verbal fluency. In study 3 15 Ecstasy users, 15 cannabis users and 15 non-drug users were assessed using the Cognitive Failures Questionnaire, which requires participants to provide ratings of the frequency of various day-to-day cognitive slips. The results indicate that the Ecstasy users did not perceive their general cognitive performance to be worse than that of controls. Taken together, these results suggest that Ecstasy users have impaired PM that cannot be explained by an increased propensity to exaggerate cognitive failures. These may be attributable, in part, to central executive deficits that are due to frontal lobe damage associated with Ecstasy use. Copyright 2001 John Wiley & Sons, Ltd.

  5. Homelessness among problem drug users: prevalence, risk factors and trigger events.

    Science.gov (United States)

    Kemp, Peter A; Neale, Joanne; Robertson, Michele

    2006-07-01

    The present paper uses data from a prospective cohort study of 877 problem drug users entering treatment in Scotland to extend knowledge of homelessness and drug misuse in three important respects: First, the prevalence of homelessness among problem drug users is investigated; secondly, key risk factors for homelessness among problem drug users are identified; and thirdly, trigger events associated with movements into or out of homelessness by problem drug users over time are explored. Data were collected during two waves of interviewing which were conducted 8 months apart. Thirty-six per cent of problem drug users entering treatment were homeless at either or both interviews, a prevalence rate that is at least seven times greater than among the general population. Whilst many of the risk factors found to be associated with homelessness are common to homeless people in general, at least one homelessness risk factor - recent drug injection [OR = 1.40; 95% confidence interval (CI) = 1.01-1.96]- is clearly specific to those who take drugs. Movements into homelessness among problem drug users were associated with recently losing residency of children (OR = 2.28; 95% CI = 1.27-4.08), other recent family problems (OR = 1.88; 95% CI = 1.21-2.94) and worsening general health (OR = 2.17; 95% CI = 1.15-4.09). Movements out of homelessness were associated with not having recent family problems (OR = 0.43; 95% CI = 0.24-0.79). The findings provide empirical support for the good practice guidelines now being published by various UK Government departments, but also suggest that the relatives of problem drug users should be offered increased assistance to help them deal with the many stresses that having a drug-dependent family member can bring.

  6. Perinatal Outcomes in Pregnant Women Users of Illegal Drugs.

    Science.gov (United States)

    Oliveira, Tenilson Amaral; Bersusa, Ana Aparecida Sanches; Santos, Tatiana Fiorelli Dos; Aquino, Márcia Maria Auxiliadora de; Mariani Neto, Corintio

    2016-04-01

    Objective The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs. Methods A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group. Results We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p drugs. Conclusions The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  7. Risk behaviours of illicit drug users while travelling

    Directory of Open Access Journals (Sweden)

    Tatja Kostnapfel Rihtar

    2013-07-01

    Full Text Available Introduction: Despite various formal limitations, an increasing number of opioid users, especially those stabilised in substitution therapy, travel abroad, away from their permanent residence to neighbouring and remote countries on other continents. Drug users are particularly at risk to get infected with hepatitis A, B, C and HIV during travelling.The main objectives of the study were to identify and determine the frequency of potential travel-related risk behaviour, such as illicit drug use, sharing of injecting equipment, unprotected sex, involvement in criminal activities and the extent of risk in illicit drug users, included in the programmes of the Centers for Prevention and Treatment of Drug Addiction in Slovenia.Methods: The study was carried out in two phases. The first phase included semi-structured interviews conducted in a group of drug users willing to participate in the study. Based on the analysis of transcripts and additional data, the original questionnaire Risky behaviour of illicit drug users during travels was developed and filled in anonymously and on a voluntary basis at the network of Centres for Prevention and Treatment of Drug Addiction. Univariate analysis between independent and dependent factors was conducted based on chi-square test and t-test for independent factors. Multivariate analysis of the impact of independent factors on the dependent factor was conducted based on binary logistic regression.Results: The questionnaire was filled out anonymously and voluntarily by 776 individuals in 14 Slovene centres for prevention and treatment of drug addiction. The results confirmed the first hypothesis that drug users travelling away from their permanent residence are more likely to share their injecting equipment, and engage in unprotected sex and in drug-related crime, and the second hypothesis stating that illegal drug users included in the substitution treatment programmes, who regularly use drugs at home, more often

  8. Cognitive reserve during neuropsychological performance in HIV intravenous drug users.

    Science.gov (United States)

    Vázquez-Justo, Enrique; Blanco, Adolfo Piñón; Vergara-Moragues, Esperanza; Gestoso, Carlos Guillén; Pérez-García, Miguel

    2014-01-01

    HIV-associated neurocognitive disorders are frequently observed in people with HIV. We aimed to evaluate the influence of cognitive reserve on the neuropsychological performance of seropositive drug users. We carried out a neuropsychological assessment and compared the performance of seropositive drug users (n = 75) with that of a group of seronegative drug users (n = 48). The results showed that a low cognitive reserve makes the seropositive patients neuropsychologically vulnerable. Likewise, we found that a high cognitive reserve has a protective effect in the presence of neuropsychological impairment associated with HIV. In the seronegative group, differences in a small number of tests were found between participants with low and high cognitive reserve. Overall, these data suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users; rather, these alterations are multifactorial.

  9. Characteristics and drug utilization patterns for heavy users of prescription drugs among the elderly

    DEFF Research Database (Denmark)

    Øymoen, Anita; Pottegård, Anton; Almarsdóttir, Anna Birna

    2015-01-01

    PURPOSE: The objectives of this study were to (1) identify and characterize heavy users of prescription drugs among persons aged 60 years and above; (2) investigate the association of demographic, socioeconomic, and health-related variables with being a heavy drug user; and (3) study the most......). The nationwide Danish registers were used to obtain data. Multivariable logistic binary regression was used to determine which factors were associated with being a heavy drug user. RESULTS: Heavy drug users among persons aged 60 years and above accounted for 6.8, 6.0, and 5.5% of prescription drug use in 2002......, 2007, and 2012, respectively. Male gender, those aged 60-69 years, being divorced, shorter education, low annual income, and recent hospitalization were all significantly associated with being in the top 1 percentile group of drug users (p drug classes among heavy...

  10. [Users sceptical about generic drugs: an anthropological approach].

    Science.gov (United States)

    Sarradon-Eck, A; Blanc, M-A; Faure, M

    2007-06-01

    Since the enactment of the 2002 legislative measures favoring the prescription of generic drugs, various quantitative studies have shown that approval by prescribers and users has risen in France. Nevertheless, scepticism remains as well as distrust towards these drugs focusing on their effectiveness compared with brand-name drugs, on potential dangers, and on the interruption they cause in prescription and consumption habits. Using a comprehensive approach, this article analyzes the social and cultural logic behind the negative image of generic drugs. The materials issued from an ethnographic study on the prescription of drugs for high blood pressure. Sixty-eight interviews were undertaken between April 2002 and October 2004 with people (39 women and 29 men, between the age of 40 and 95, 52 over the age of 60) treated for over a year for high blood pressure in rural areas in the Southeast of France. Thirteen people provided unsolicited opinions about generic drugs. Analysis of the information collected shows that users have various representations of generic drugs, including the idea of counterfeited and foreign drugs. These representations interfere with the adjustment process and the development of consumer loyalty. They are part of a set of social representations about drugs which form and express the user's reality. In these representations, the drug is an ambivalent object, carrier of both biological effectiveness and toxicity; it is also the metonymical extension of the prescriber, bestowing upon the prescription a symbolic value. By placing the generic drug in its network of symbolic and social meaning, this study highlights the coherence of the scepticism towards generic drugs by consumers (and prescribers) with a system of common opinion in which drugs are everyday things, personalized and compatible with users, symbolic exchange carriers in the physician-patient relationship, and in which confidence in the drug is also that given to the health care

  11. Current status of drug use and HIV/AIDS prevention in drug users in China.

    Science.gov (United States)

    Li, Jianhua; Li, Xinyue

    2013-12-01

    The objective of this paper is to review the current status of drug use and HIV/AIDS prevention for drug users in China and provide scientific evidence for HIV/AIDS prevention and control in drug users. Literature and articles related to drug abuse in China, as well as the results of prevention efforts and successful cases regarding HIV/AIDS prevention in drug users, are reviewed. Lessons learned are drawn out for the future improvement of work and the sustainable development of treatment programs. The number of drug users in China is increasing. Even though the number of opioid-type drug users is growing more slowly than in the past, the number of amphetamine-type stimulant users has increased sharply. It has been proven that methadone maintenance treatment and syringe exchange programs gradually and successfully control HIV/AIDS transmission in drug users. However, it is necessary to enhance these prevention methods and expand their coverage. In addition, the strengthening of antiretroviral therapy (ART) treatment for HIV-infected drug users is crucial for HIV/AIDS prevention and control. The rapidly growing number of amphetamine-type stimulant users, along with their high-risk behavior, poses a hidden danger of greater HIV/AIDS transmission through sexual intercourse in the near future.

  12. 42 CFR 456.705 - Prospective drug review.

    Science.gov (United States)

    2010-10-01

    ... Claims Management System for Outpatient Drug Claims § 456.705 Prospective drug review. (a) General... because of the presence, in the patient for whom it is prescribed, of a disease condition; or (ii) An adverse effect of the drug on the patient's disease condition. (3) Adverse drug-drug interaction, that is...

  13. Drug problems in contemporary China: a profile of Chinese drug users in a metropolitan area.

    Science.gov (United States)

    Huang, Kaicheng; Zhang, Lening; Liu, Jianhong

    2011-03-01

    Drug problems are reemerging in China since the nation implemented economic reform and an "open door" policy in the early 1980s. This is causing both national and international concern. However, knowledge and understanding of the Chinese drug problem is fairly limited because of the nation's unique social and political history. In response to this shortage of information, our study presents a profile of Chinese drug users. Data were collected from a survey of drug users attending mandatory treatment centres in a large city in 2009. We present a demographic profile of the drug users, describe their patterns of drug use, their access to drugs and their history of drug treatment. Chinese drug users, like those from the U.S., are likely to be unemployed and have a low level of education. However, they are more likely than those in the U.S. to use heroin, Bingdu (methamphetamine) and Maguo (a derivative of methamphetamine), and they pay less for their drugs. This profile of drug users is informative and valuable for drug prevention, intervention, and treatment in the Chinese setting because knowing and understanding the drug population is essential for effective control. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. Relapse Model among Iranian Drug Users: A Qualitative Study.

    Science.gov (United States)

    Jalali, Amir; Seyedfatemi, Naiemeh; Peyrovi, Hamid

    2015-01-01

    Relapse is a common problem in drug user's rehabilitation program and reported in all over the country. An in-depth study on patients' experiences can be used for exploring the relapse process among drug users. Therefore, this study suggests a model for relapse process among Iranian drug users. In this qualitative study with grounded theory approach, 22 participants with rich information about the phenomenon under the study were selected using purposive, snowball and theoretical sampling methods. After obtaining the informed consent, data were collected based on face-to-face, in-depth, semi-structured interviews. All interviews were analyzed in three stages of axial, selective and open coding methods. Nine main categories emerged, including avoiding of drugs, concerns about being accepted, family atmosphere, social conditions, mental challenge, self-management, self-deception, use and remorse and a main category, feeling of loss as the core variable. Mental challenge has two subcategories, evoking pleasure and craving. Relapse model is a dynamic and systematic process including from cycles of drug avoidance to remorse with a core variable as feeling of loss.  Relapse process is a dynamic and systematic process that needs an effective control. Determining a relapse model as a clear process could be helpful in clinical sessions. RESULTS of this research have depicted relapse process among Iranian drugs user by conceptual model.

  15. Mortality of registered drug users in Central Asia.

    Science.gov (United States)

    Mravcik, Viktor; Zabransky, Tomas; Talu, Ave; Jasaitis, Ernestas; Gafarova, Nuriya; Musabekova, Zhannat; Baymirova, Luiza; Makhsutov, Makhsut; Ganiev, Furkat

    2014-11-01

    Within the fifth phase of the Central Asia Drug Action Programme (CADAP) covering five post-Soviet Central Asian countries, an analysis of the mortality of drug users was performed. The results for Kazakhstan and Uzbekistan are presented in detail in this paper since results from Kyrgyzstan and Tajikistan are not considered valid and Turkmenistan did not provide data at all. A system of registration of all users of illegal drugs known to the health and/or law enforcement authorities ("narcological registers") exists in Central Asian countries inherited from the system of Soviet "narcology". According to the legal norms, the death of a registered person should be recorded. We conducted indirect standardisation of crude mortality rates and computed the standardised mortality ratio (SMR) comparing observed number of deaths with expected number of deaths according to age and gender specific mortality rates in the general population of the same country. The results show excess mortality in registered drug users, particularly in registered females, in Uzbekistan (the latest available SMR for all those registered is 7.4; the SMR in females is 16.3) and Kazakhstan (4.0 and 12.9). The excess mortality is highest among young adults (18-34) in all the studies. Taking into account the limited quality and reliability of the data - first of all, the likely under-reporting of deaths in the narcological registers - the crude mortality rate among registered drug users is quite high when compared to EU countries. The SMR in total is comparably lower as a result of the high background mortality in the general population. This excess mortality is preventable and should be targeted by the national drug policies. Specifically, the programmes should target registered and unregistered female drug users. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Do adolescent ecstasy users have different attitudes towards drugs when compared to marijuana users?

    Science.gov (United States)

    Martins, Silvia S; Storr, Carla L; Alexandre, Pierre K; Chilcoat, Howard D

    2008-04-01

    Perceived risk and attitudes about the consequences of drug use, perceptions of others expectations and self-efficacy influence the intent to try drugs and continue drug use once use has started. We examine associations between adolescents' attitudes and beliefs towards ecstasy use; because most ecstasy users have a history of marijuana use, we estimate the association for three groups of adolescents: non-marijuana/ecstasy users, marijuana users (used marijuana at least once but never used ecstasy) and ecstasy users (used ecstasy at least once). Data from 5049 adolescents aged 12-18 years old who had complete weighted data information in Round 2 of the Restricted Use Files (RUF) of the National Survey of Parents and Youth (NSPY). Data were analyzed using jackknife weighted multinomial logistic regression models. Adolescent marijuana and ecstasy users were more likely to approve of marijuana and ecstasy use as compared to non-drug using youth. Adolescent marijuana and ecstasy users were more likely to have close friends who approved of ecstasy as compared to non-drug using youth. The magnitudes of these two associations were stronger for ecstasy use than for marijuana use in the final adjusted model. Our final adjusted model shows that approval of marijuana and ecstasy use was more strongly associated with marijuana and ecstasy use in adolescence than perceived risk in using both drugs. Information about the risks and consequences of ecstasy use need to be presented to adolescents in order to attempt to reduce adolescents' approval of ecstasy use as well as ecstasy experimentation.

  17. Perceptions of parental bonding in freebase cocaine users versus non-illicit drug users

    Directory of Open Access Journals (Sweden)

    Marcia Pettenon

    2014-01-01

    Full Text Available Background & objectives: Evidence has suggested that parenting styles have peculiar characteristics in families with drug-related issues. This study was undertaken to investigate the perception of crack (smoke cocaine users and non-users about parental bonding quality regarding care and control in Brazil. Methods: A total of 198 hospitalized crack users and 104 users of any non-illicit drug were assessed using the Parental Bonding Instrument (PBI, the sixth version of the Addiction Severity Index (ASI and Mini International Neuropsychiatric Interview (MINI. Results: Adjusted logistic regression analysis showed that crack users were more likely (OR adj = 9.68; 95% CI: 2.82, 33.20 to perceive neglectful mothers, as well as more likely (OR adj = 4.71, 95% CI: 2.17, 10.22 to perceive controlling and affectionless fathers in comparison with non-illicit drug users who were more likely to perceive optimal parenting. Interpretation & conclusions: Our findings indicate that the perception of neglectful mothers and affectionless controlling fathers may be associated with the tendency of the children to be less resilient when facing stressful events, leading them to a greater risk to use crack.

  18. Injection Drug Users' Involvement In Drug Economy: Dynamics of Sociometric and Egocentric Social Networks.

    Science.gov (United States)

    Yang, Cui; Latkin, Carl; Muth, Stephen Q; Rudolph, Abby

    2013-07-01

    The purpose of this analysis was to examine the effect of social network cohesiveness on drug economy involvement, and to test whether this relationship is mediated by drug support network size in a sample of active injection drug users. Involvement in the drug economy was defined by self-report of participation in at least one of the following activities: selling drugs, holding drugs or money for drugs, providing street security for drug sellers, cutting/packaging/cooking drugs, selling or renting drug paraphernalia (e.g., pipes, tools, rigs), and injecting drugs in others' veins. The sample consists of 273 active injection drug users in Baltimore, Maryland who reported having injected drugs in the last 6 months and were recruited through either street outreach or by their network members. Egocentric drug support networks were assessed through a social network inventory at baseline. Sociometric networks were built upon the linkages by selected matching characteristics, and k-plex rank was used to characterize the level of cohesiveness of the individual to others in the social network. Although no direct effect was observed, structural equation modeling indicated k-plex rank was indirectly associated with drug economy involvement through drug support network size. These findings suggest the effects of large-scale sociometric networks on injectors' drug economy involvement may occur through their immediate egocentric networks. Future harm reduction programs for injection drug users (IDUs) should consider providing programs coupled with economic opportunities to those drug users within a cohesive network subgroup. Moreover, individuals with a high connectivity to others in their network may be optimal individuals to train for diffusing HIV prevention messages.

  19. Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities

    Directory of Open Access Journals (Sweden)

    Elisabet Arribas-Ibar

    2017-07-01

    Conclusions: Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users’ suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated.

  20. Drug trafficking routes and hepatitis B in injection drug users, Manipur, India.

    Science.gov (United States)

    Datta, Sibnarayan; Banerjee, Arup; Chandra, Partha K; Mahapatra, Pradip K; Chakrabarti, Shekhar; Chakravarty, Runu

    2006-12-01

    Prevalence of hepatitis B genotype C in injection drug users in the northeastern Indian state of Manipur, neighboring the "Golden Triangle," correlates well with overland drug-trafficking routes, the injection drug use epidemic, and the spread of HIV. Further spread to other regions of India through mobile populations is possible.

  1. Five-Factor Model personality profiles of drug users

    Directory of Open Access Journals (Sweden)

    Crum Rosa M

    2008-04-01

    Full Text Available Abstract Background Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals' traits. Furthermore, there is increasing interest in developing treatment approaches that match an individual's personality profile. To advance our knowledge of the role of individual differences in drug use, the present study compares the personality profile of tobacco, marijuana, cocaine, and heroin users and non-users using the wide spectrum Five-Factor Model (FFM of personality in a diverse community sample. Method Participants (N = 1,102; mean age = 57 were part of the Epidemiologic Catchment Area (ECA program in Baltimore, MD, USA. The sample was drawn from a community with a wide range of socio-economic conditions. Personality traits were assessed with the Revised NEO Personality Inventory (NEO-PI-R, and psychoactive substance use was assessed with systematic interview. Results Compared to never smokers, current cigarette smokers score lower on Conscientiousness and higher on Neuroticism. Similar, but more extreme, is the profile of cocaine/heroin users, which score very high on Neuroticism, especially Vulnerability, and very low on Conscientiousness, particularly Competence, Achievement-Striving, and Deliberation. By contrast, marijuana users score high on Openness to Experience, average on Neuroticism, but low on Agreeableness and Conscientiousness. Conclusion In addition to confirming high levels of negative affect and impulsive traits, this study highlights the links between drug use and low Conscientiousness. These links provide insight into the etiology of drug use and have implications for public health interventions.

  2. Five-Factor Model personality profiles of drug users.

    Science.gov (United States)

    Terracciano, Antonio; Löckenhoff, Corinna E; Crum, Rosa M; Bienvenu, O Joseph; Costa, Paul T

    2008-04-11

    Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals' traits. Furthermore, there is increasing interest in developing treatment approaches that match an individual's personality profile. To advance our knowledge of the role of individual differences in drug use, the present study compares the personality profile of tobacco, marijuana, cocaine, and heroin users and non-users using the wide spectrum Five-Factor Model (FFM) of personality in a diverse community sample. Participants (N = 1,102; mean age = 57) were part of the Epidemiologic Catchment Area (ECA) program in Baltimore, MD, USA. The sample was drawn from a community with a wide range of socio-economic conditions. Personality traits were assessed with the Revised NEO Personality Inventory (NEO-PI-R), and psychoactive substance use was assessed with systematic interview. Compared to never smokers, current cigarette smokers score lower on Conscientiousness and higher on Neuroticism. Similar, but more extreme, is the profile of cocaine/heroin users, which score very high on Neuroticism, especially Vulnerability, and very low on Conscientiousness, particularly Competence, Achievement-Striving, and Deliberation. By contrast, marijuana users score high on Openness to Experience, average on Neuroticism, but low on Agreeableness and Conscientiousness. In addition to confirming high levels of negative affect and impulsive traits, this study highlights the links between drug use and low Conscientiousness. These links provide insight into the etiology of drug use and have implications for public health interventions.

  3. Pregnancy and Sexual Health among Homeless Young Injection Drug Users

    Science.gov (United States)

    Hathazi, Dodi; Lankenau, Stephen E.; Sanders, Bill; Bloom, Jennifer Jackson

    2009-01-01

    Research on pregnancy and sexual health among homeless youth is limited. In this study, qualitative interviews were conducted with 41 homeless young injection drug users (IDUs) in Los Angeles with a history of pregnancy. The relationship between recent pregnancy outcomes, contraception practices, housing status, substance use, utilization of…

  4. Reconstructed Living Lab: supporting drug users and families ...

    African Journals Online (AJOL)

    2009-08-08

    Aug 8, 2009 ... the co-operative counselling model in a Living Lab context. Results: The advantages of the DAS technology and what it offers to community-based organisations are discussed. Data on relatives of drug users using the system are included. Conclusion: The use of mobile phone technology has advantages ...

  5. HIV prevention among drug and alcohol users: models of ...

    African Journals Online (AJOL)

    The spread of HIV among drug and alcohol users, as a high-risk group, is a significant problem in Africa, as in other parts of the world. Few programs have been implemented in Africa to deal specifically with this issue. Since November 2006, the AED Capable Partners Program in Kenya project has provided technical ...

  6. Comorbidity and Risk Behaviors among Drug Users Not in Treatment.

    Science.gov (United States)

    Johnson, Mark E.; Brems, Christiane; Wells, Rebecca S.; Theno, Shelley A.; Fisher, Dennis G.

    2003-01-01

    In a sample of 700 drug users, 64% evidenced comorbidity (i.e., coexisting substance use and psychiatric disorders). Robust relationships between the presence of comorbidity and increased levels of risk behavior, such as needle sharing and trading sex for money, were revealed. (Contains 44 references and 2 tables.) (Author)

  7. Determinants of loneliness of young adult drug users.

    Science.gov (United States)

    Rokach, Ami

    2002-11-01

    Loneliness is a subjective experience that is influenced by such variables as personality, life experiences, and situation. In the present study, the author examined the connection between the use of ecstasy (MDMA) and the antecedents of loneliness. MDMA users were compared with non-MDMA drug users and with a group of young adults in the general population who did not use drugs. A total of 818 participants from all 3 groups volunteered to answer a 30-item yes-no questionnaire reflecting on their experiences of loneliness and what caused them. Results showed that the predominant causes of loneliness were personal inadequacies, developmental deficits, unfulfilling intimate relationships, relocation or significant separations, and social marginality. There were significant differences between the scores of the MDMA users and scores of the other groups. Gender differences between and within groups were also examined.

  8. Effectiveness of HIV prevention social marketing with injecting drug users.

    Science.gov (United States)

    Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

    2010-10-01

    Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide.

  9. Prevalence and risk factors of HIV infections among drug users and drug-using prostitutes in Amsterdam

    NARCIS (Netherlands)

    van den Hoek, J. A.; Coutinho, R. A.; van Haastrecht, H. J.; van Zadelhoff, A. W.; Goudsmit, J.

    1988-01-01

    In December 1985 we started a study to determine the prevalence and risk factors of HIV infection among drug users and drug-using prostitutes in Amsterdam. Recruitment took place at methadone posts (not drug-free; i.e. a low-threshold programme on which some drug users continue to use hard drugs,

  10. 76 FR 44014 - Generic Drug User Fee; Public Meeting; Request for Comments

    Science.gov (United States)

    2011-07-22

    ... generic drug user fees. New legislation would be required for FDA to establish and collect user fees for... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS...

  11. The impact of continuing illegal drug use on teenage pregnancy outcomes--a prospective cohort study.

    Science.gov (United States)

    Quinlivan, Julie A; Evans, Sharon F

    2002-10-01

    To evaluate the impact of continuing illegal drug use on teenage pregnancy outcomes. Prospective cohort study. Three Australian obstetric hospitals. Four hundred and fifty-six teenage antenatal patients. Teenage antenatal patients were interviewed and completed questionnaires to establish their pattern of non-prescription drug use before and during pregnancy. Illegal drug use data provided by the participants were validated in a subgroup of 180 who were interviewed six months postpartum. Antenatal, intrapartum and postnatal outcomes were collated independently. Data were analysed using SAS. Antenatal co-morbidity, delivery and newborn outcomes. In the cohort, 20.3% used marijuana throughout their pregnancy. However, 33.5% of these were multidrug users. The remaining 79.6% did not use illegal drugs throughout pregnancy (non-users). However, half the 'non-users' were 'ex-users' who ceased drug use immediately before or during early pregnancy. Illegal drug use was associated with an increased incidence of concurrent cigarette and alcohol use (both OR > 4.1 and P 1.95 and P effects on birthweight, birthweight ratio or preterm birth. Good antenatal care may be able to ameliorate many adverse pregnancy outcomes in teenagers who use illegal drugs throughout pregnancy. The high levels of coexisting psychosocial morbidity are a concern for future mothercrafting.

  12. Welfare Checks, Drug Consumption, and Health: Evidence from Vancouver Injection Drug Users

    Science.gov (United States)

    Riddell, Chris; Riddell, Rosemarie

    2006-01-01

    This paper investigates the link between welfare payments and drug use among injection drug users. The authors find an increase in the likelihood of an overdose in the days following check arrival, and in the probability of leaving the hospital against medical advice (AMA) on check day. Using the check arrival date as an instrument, we estimate…

  13. Survey of abuses against injecting drug users in Indonesia

    Directory of Open Access Journals (Sweden)

    Triwahyuono Agus

    2009-10-01

    Full Text Available Abstract In Indonesia, an ongoing government "war on drugs" has resulted in numerous arrests and anecdotal reports of abuse in detention, but to date there has been little documentation or analysis of this issue. JANGKAR (also known in English as the Indonesian Harm Reduction Network, a nongovernmental organization (NGO based in Jakarta, surveyed 1106 injecting drug users in 13 cities about their experiences of police abuse. Of those interviewed, 667 or 60% reported physical abuse by police. These findings indicate the importance of continuing efforts to promote police reform and harm reduction in Indonesia.

  14. Outreach screening of drug users for cirrhosis with transient elastography

    DEFF Research Database (Denmark)

    Mössner, Belinda Klemmensen; Jørgensen, Tina R; Skamling, Merete

    2011-01-01

    . Participants  Drug users attending treatment centres during the presence of the study team. Measurements  Liver stiffness measurements (LSM) by transient elastography using the Fibroscan device; blood tests for viral hepatitis, HIV infection and hyaluronic acid (HA) levels; and routine liver tests. Individuals...... with LSM ≥ 8 kPa were referred to the hospital for treatment evaluation. Individuals with LSM ≥ 12 kPa were recommended a liver biopsy. Findings  Among 175 drug users negative for hepatitis C, 13% had LSM = 8-11.9 kPa and 4% had LSM ≥ 12 kPa; elevated LSM was associated with a body mass index (BMI) > 30...

  15. Clinical case of tetanus in an injecting drug user

    Directory of Open Access Journals (Sweden)

    L.R. Schostakovych-Koretska

    2017-11-01

    Full Text Available The article presents data on the incidence of tetanus in the Dnipropetrovsk region from 2014 to 2017. At the present time, taking into account the decrease of the immune layer of the population of our country, the clinical data of the course of tetanus in an injecting drug user have been considered, and the need for attention of both primary doctors and narrowly focused specialists regarding the risk of tetanus occurrence in unvaccinated persons has been discussed. Physicians should take tetanus into consideration in the differential diagnosis of meningitis, convulsive syndrome, etc., especially among injecting drug users who are at risk for this disease in all countries of the world, including Ukraine. The mistakes and ways of differential diagnosis in establishing the initial diagnosis of the patient are discussed. The need for vaccination against tetanus in the non-immune population is emphasized.

  16. Evaluation of a needle social marketing strategy to control HIV among injecting drug users in China.

    Science.gov (United States)

    Wu, Zunyou; Luo, Wei; Sullivan, Sheena G; Rou, Keming; Lin, Peng; Liu, Wei; Ming, Zhongqiang

    2007-12-01

    To evaluate the effectiveness of a needle social marketing strategy to reduce needle sharing and hepatitis C Virus (HCV)/HIV transmission among injecting drug users (IDU) in China. Two-armed, prospective, community-randomized prevention trial. Four counties/townships in Guangxi and Guangdong provinces; one randomized to intervention the other to control in each province. Injecting drug users: 823 (443 intervention, 382 control) at baseline and 852 (415 intervention, 407 control) at the second cross-sectional survey 12 months later. A needle social marketing programme, including promotion of safe injection norms and increased access to clean needles over a 12 month period. Cross sectional surveys at baseline and follow-up compared changes in drug using behaviours and HIV and HCV rates in the intervention and control communities. Needle sharing behaviours were similar in the two groups at baseline (68.4 vs. 67.8%), and dropped significantly to 35.3% in the intervention community and remained relatively stable in the control community (62.3%; P marketing can reduce risky injecting behaviour and HIV/HCV transmission among injecting drug users in China and should be expanded.

  17. Buprenorphine substitution treatment in France: drug users' views of the doctor-user relationship

    Science.gov (United States)

    Guichard, Anne; Lert, France; Brodeur, Jean-Marc; Richard, Lucie

    2007-01-01

    The French system for drug substitution, or maintenance treatment, established in 1996, differs from the often strict conditions attached to methadone clinics in other countries. Because of the predominant role of general practitioners and the flexible prescription rules for Subutex® in France, the relationship between the physician and the drug user becomes a central element in the treatment. This article deals with the expectations that these users have of the physician, and their perception of his or her attitude towards them. In order to identify possible reasons for the absence of treatment compliance and of Subutex® misuse, it focuses on the users’ assessment of the physician’s response to the problems they report. This study, based on a diversified sample of 28 persons in treatment, showed 4 patterns of relationships between physicians and users, which differed in their focus: a) dosage, b) compliance, c) the person and d) obtaining a prescription. In all four case types, users had difficulty reporting other drug use or intravenous Subutex® injection within this relationship in which the stigma attached to drug dependence seems to reappear. Moreover, the lack of clarity about the treatment objectives and time frame limits the users’ ability to integrate the treatment into their lives and to commit themselves to it. The heterogeneity and fragility of the users’ situations are elements related to dependence that, during contact with the physician, require regular assessment of the individual’s situation and of the treatment objectives. This constant reappraisal of the situation with the physician should help to optimize the treatment and avoid the hiatus that can generate or continue “misuse.” PMID:17442473

  18. Overdose experiences among injection drug users in Bangkok, Thailand

    Directory of Open Access Journals (Sweden)

    Wood Evan

    2010-05-01

    Full Text Available Abstract Background Although previous studies have identified high levels of drug-related harm in Thailand, little is known about illicit drug overdose experiences among Thai drug users. We sought to investigate non-fatal overdose experiences and responses to overdose among a community-recruited sample of injection drug users (IDU in Bangkok, Thailand. Methods Data for these analyses came from IDU participating in the Mit Sampan Community Research Project. The primary outcome of interest was a self-reported history of non-fatal overdose. We calculated the prevalence of past overdose and estimated its relationship with individual, drug-using, social, and structural factors using multivariate logistic regression. We also assessed the prevalence of ever witnessing an overdose and patterns of response to overdose. Results These analyses included 252 individuals; their median age was 36.5 years (IQR: 29.0 - 44.0 and 66 (26.2% were female. A history of non-fatal overdose was reported by 75 (29.8% participants. In a multivariate model, reporting a history of overdose was independently associated with a history of incarceration (Adjusted Odds Ratio [AOR] = 3.83, 95% Confidence Interval [CI]: 1.52 - 9.65, p = 0.004 and reporting use of drugs in combination (AOR = 2.48, 95% CI: 1.16 - 5.33, p = 0.019. A majority (67.9% reported a history of witnessing an overdose; most reported responding to the most recent overdose using first aid (79.5%. Conclusions Experiencing and witnessing an overdose were common in this sample of Thai IDU. These findings support the need for increased provision of evidence-based responses to overdose including peer-based overdose interventions.

  19. 77 FR 65199 - Generic Drug User Fee-Backlog Fee Rate for Fiscal Year 2013

    Science.gov (United States)

    2012-10-25

    ... INFORMATION CONTACT: David Miller, Office of Financial Management (HFA-100), Food and Drug Administration...] Generic Drug User Fee--Backlog Fee Rate for Fiscal Year 2013 AGENCY: Food and Drug Administration, HHS... the backlog fee related to generic drug user fees for fiscal year (FY) 2013. The Federal Food, Drug...

  20. The Effects of Childhood Exposure to Drug Users and Religion on Drug Use in Adolescence and Young Adulthood

    Science.gov (United States)

    Jang, Sung Joon; Johnson, Byron R.

    2011-01-01

    Previous research finds drug-using peers and religiosity to be key predictors of drug use among youth, but the effects of childhood exposure to drug users and religion on later drug use have been understudied. The authors hypothesize a child's exposure to parental drug use and religious upbringing have a causal influence on drug use in youth…

  1. A change in the Navy's drug testing policy: how will it affect costs and the probability of detecting drug users?

    OpenAIRE

    Jones, John R.

    1995-01-01

    This thesis analyzes changes in the Navy's drug testing policy as they relate to costs and the probability of detecting a gaming or non-gaming drug user. Additionally, this thesis considers actual command level testing policies showing how a policy change would affect the commands' probability of detecting a drug user. The Navy's zero tolerance policy for drug use has significantly reduced drug use within the Navy. This zero tolerance policy is primarily enforced with the drug testing prog...

  2. Prevalence, incidence, and risk factors of hepatitis C virus infection among drug users in Amsterdam

    NARCIS (Netherlands)

    van den Hoek, J. A.; van Haastrecht, H. J.; Goudsmit, J.; de Wolf, F.; Coutinho, R. A.

    1990-01-01

    The prevalence, risk factors, and incidence of hepatitis C virus (HCV) infection were studied in a cohort of drug users in Amsterdam. In intravenous drug users, the seroprevalence was 74% (224/304) versus 10% (4/42) in nonintravenous drug users. Risk factors independently associated with HCV

  3. Permissive Attitude Towards Drug Use, Life Satisfaction, and Continuous Drug Use Among Psychoactive Drug Users in Hong Kong.

    Science.gov (United States)

    Cheung, N Wt; Cheung, Y W; Chen, X

    2016-06-01

    To examine the effects of a permissive attitude towards regular and occasional drug use, life satisfaction, self-esteem, depression, and other psychosocial variables in the drug use of psychoactive drug users. Psychosocial factors that might affect a permissive attitude towards regular / occasional drug use and life satisfaction were further explored. We analysed data of a sample of psychoactive drug users from a longitudinal survey of psychoactive drug abusers in Hong Kong who were interviewed at 6 time points at 6-month intervals between January 2009 and December 2011. Data of the second to the sixth time points were stacked into an individual time point structure. Random-effects probit regression analysis was performed to estimate the relative contribution of the independent variables to the binary dependent variable of drug use in the last 30 days. A permissive attitude towards drug use, life satisfaction, and depression at the concurrent time point, and self-esteem at the previous time point had direct effects on drug use in the last 30 days. Interestingly, permissiveness to occasional drug use was a stronger predictor of drug use than permissiveness to regular drug use. These 2 permissive attitude variables were affected by the belief that doing extreme things shows the vitality of young people (at concurrent time point), life satisfaction (at concurrent time point), and self-esteem (at concurrent and previous time points). Life satisfaction was affected by sense of uncertainty about the future (at concurrent time point), self-esteem (at concurrent time point), depression (at both concurrent and previous time points), and being stricken by stressful events (at previous time point). A number of psychosocial factors could affect the continuation or discontinuation of drug use, as well as the permissive attitude towards regular and occasional drug use, and life satisfaction. Implications of the findings for prevention and intervention work targeted at

  4. Review of modern biometric user authentication and their development prospects

    Science.gov (United States)

    Boriev, Z. V.; Sokolov, S. S.; Nyrkov, A. P.

    2015-09-01

    This article discusses the possibility of using biometric information technologies in management. Made a brief overview of access control and time attendance. Analyzed biometrics and identification system user. Recommendations on the use of various systems depending on the specific tasks.

  5. Prospective of clinical drugs for radioprotection

    International Nuclear Information System (INIS)

    Alok, Amit; Kumar, Sandeep; Kumar, Arun; Chaudhury, N.K.

    2014-01-01

    We are living in an era of nuclear power where power derived from nuclear reaction is used for power generation as well as for nuclear weapons. The terrorism and the threat of dirty bombs looms around the civilized population. Therefore, there is a need to develop radioprotector which could prevent against the harmful effect of radiation. The research on radioprotector started more than fifty years ago but still there is no approved radioprotector in the drug market. Hundreds of lead molecule have been screened and have shown varying amount of radioprotection either in vitro or in vivo or in both. Only one drug amifostine was approved by FDA but due to its toxicity in head and neck cancer, this drug is no more in use. Antioxidants too have proven to be a potential radioprotector but the dose required for radioprotection is too high for maintenance of homeostasis in physiological system. We have taken an alternative approach of using clinical drugs like diclofenac and tetracycline for development of approach for radioprotection and reported the radioprotective role of diclofenac. The advantage of using clinical drug is its wide availability in the market and the ease with which it could be channelized for radioprotection. Antiradical assays have demonstrated possible use of tetracycline for radioprotection. Tetracycline has also ability to reduce oxidative damages ex vivo. Studies related to comet assay as well as antioxidant assays in different organs are in progress for designing further work for efficacy and elucidation of mechanisms. (author)

  6. DENTAL CARIES AND TREATMENT NECESSITY IN INSTITUTIONALIZED DRUG USERS

    Directory of Open Access Journals (Sweden)

    Marina Ferraz Neves Oliveira

    2016-11-01

    Full Text Available Dependence on drugs is a complex disease, incurable and that its use persists in the face of extremely negative consequences. Objective: was to evaluate the prevalence and severity of caries in users of legal drugs. Methods:It is an epidemiological, cross-sectional, descriptive study, held with adults, users of legal and illegal drugs, institutionalized in rehabilitation centers of municipalities in the southwestern region of the state of Bahia. We used a form with sociodemographic questions about the use of licit and illicit drugs. To assess tooth decay, we used the decayed, missing and filled teeth index (DMFT, and the dental units were assessed with a World Health Organization (WHO Model probe and a dental mirror. Data were tabulated and analyzed in Excel. Results: 73 individuals were evaluated, aged between 18 and 64, mean age 35.5 (SD ± 10.7. It was found that 71.4% are single, 73,7% with low level of education, 74.6% do not use dental floss. Caries prevalence was 98.6%, DMF-T average 15.6. In 18-34 years old individuals, the DMF-T average was 12.1 and from 35 to 64 years old it was 19.8. Regarding dentition, 52.6% of the teeth were affected by the disease. Among the affected teeth, 39.9% were decayed, 44.1% lost and 16% filled. Conclusion: We conclude that there is a high prevalence of caries in this population. Among the dental needs, the restoration of the dental element has to be highlighted.

  7. Sex differences in drug use among polysubstance users.

    Science.gov (United States)

    Lewis, Ben; Hoffman, Lauren A; Nixon, Sara Jo

    2014-12-01

    Available evidence indicates women with substance use disorders may experience more rapid progression through usage milestones (telescoping). The few investigations of sex differences in treatment-seeking populations often focus on single substances and typically do not account for significant polysubstance abuse. The current study examined sex differences in a heterogeneous sample of treatment seeking polysubstance users. We examined patterns of drug use, age at drug use milestones (e.g., initial use, regular use), and progression rates between milestones. Nicotine and alcohol use were also evaluated. Participants (n = 543; 288 women) completed personal histories of substance use, including chronicity, frequency, and regularity, as well as inventories assessing affect, and intellectual ability. Rates of drug use and milestone ages varied by sex and specific drug. Analyses suggested pronounced telescoping effects for pain medication and marijuana, with women progressing more rapidly through usage milestones. Our data were generally supportive of telescoping effects, although considerable variance in progression measures was noted. The contrast between the marked telescoping observed in pain medication use and the absence of telescoping in other opioids was of particular interest. The discrepancy in telescoping effects, despite shared pharmacologies, suggests the need for further work examining underlying psychosocial factors. These results highlight that the specific sample population, substance, and outcome measure should be carefully considered when interpreting sex differences in substance use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Seroprevalence of hepatitis B markers among incarcerated intravenous drug users.

    Science.gov (United States)

    Nokhodian, Zary; Yaran, Majid; Adibi, Peyman; Kassaian, Nazila; Meshkati, Marjan; Ataei, Behrooz

    2014-03-01

    Drug injection is one of the most prominent risk factors for transmission of viral hepatitis. Prevalence of hepatitis B virus (HBV) is generally higher in prisoners compared with the general population. The object of this study was to assess the markers of HBV and related risk factors among intravenous drug users (IVDU) in prisoners. Through a cross-sectional study in 2012 HBV infection and its risk factors were assessed in prisoners with a history of intravenous drug use in Isfahan, Iran. A checklist was fulfilled for each participant and 5 ml blood was taken from each subject. Sera were analyzed for markers of the hepatitis B: Hepatitis B virus surface antigen (HBsAg), antibody to hepatitis B virus surface antigen (HBsAb) and hepatitis B virus core antibody (HBcAb) by ELISA. We used Chi-square test and logistic regression model to analyze data and P HBcAb+. 120 (12.37%) were found positive for isolated HBsAb, 45 (4.64%) for isolated HBcAb and 67 (6.9%) for both HBsAb and HBcAb. History of sharing needle (odds ratio: 2.25, 95% confidence interval: 1.09-4.65) had a significant association with HBsAg positivity. The results suggest that history of sharing needle had a significant association with HBsAg positivity. It seems that educational programs for injecting drug related behaviors, especially syringe sharing, are needed for IVDU.

  9. 76 FR 24035 - Generic Drug User Fee; Public Meeting; Request for Comments

    Science.gov (United States)

    2011-04-29

    ... legislation would be required for FDA to establish and collect user fees for generic drugs, and FDA is... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS...

  10. 78 FR 53152 - Prescription Drug User Fee Rates for Fiscal Year 2014; Correction

    Science.gov (United States)

    2013-08-28

    ... INFORMATION CONTACT: David Miller, Office of Financial Management (HFA-100), Food and Drug Administration...] Prescription Drug User Fee Rates for Fiscal Year 2014; Correction AGENCY: Food and Drug Administration, HHS... ``Prescription Drug User Fee Rates for Fiscal Year 2014'' that appeared in the Federal Register of August 2, 2013...

  11. Drug-related decrease in neuropsychological functions of abstinent drug users

    NARCIS (Netherlands)

    van Holst, Ruth Janke; Schilt, Thelma

    2011-01-01

    This article reviews neuropsychological performance in frequent users of cocaine, (meth)amphetamines, ecstasy, opiates, alcohol, and cannabis. We searched the scientific literature published in the last five years, focusing on studies that required at least 2 weeks of abstinence from drug use, and

  12. Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities.

    Science.gov (United States)

    Arribas-Ibar, Elisabet; Suelves, Josep Maria; Sanchez-Niubò, Albert; Domingo-Salvany, Antònia; T Brugal, M

    We assessed prevalence of suicidal ideation and plans among illicit drug users and their association with contextual factors, by gender. Cross-sectional study. In a sample of 511 illicit drug users recruited during spring 2012 in drug treatment and prevention facilities in Catalonia (Spain), the prevalence of suicidal ideation/plans in the last 12 months was assessed. Poisson regression was used to examine associations between suicidal ideation/plans and various factors (socio-demographic, psychological, illegal drug market activities and marginal income generation activities, which included any reported sex work, stealing, peddling, begging or borrowing on credit from a dealer). The average age was 37.9 years (standard deviation: 8.62); 76.3% were men. Suicidal ideation/plans were reported by 30.8% of men and 38.8% of women, with no significant differences by age or gender. Recent aggression (male prevalence ratio [PR]=2.2; female PR=1.4), psychological treatment (male PR=1.2; female PR=1.3) and illegal/marginal income generation activities (male PR=1.5; female PR=1.1) were associated with suicidal ideation/plans. Men who trafficked were more likely to have suicidal ideation/plans (PR=1.3), while prison history was positive for women (PR=1.8) and negative for men (PR=0.7). Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users' suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Drug user organizations in the Nordic countries--local, national, and international dimensions.

    Science.gov (United States)

    Frank, Vibeke Asmussen; Anker, Jørgen; Tammi, Tuukka

    2012-04-01

    The article focuses on drug user organizations that represent and advocate for active "hard drug" users in the Nordic countries. It discusses the opportunities and challenges that these organizations face in their search for legitimacy and political influence. The comparative perspective points at similarities and differences in national contexts that both support and challenges the existence of drug user organizations, including drug policy, social welfare policy, trends in drug use, and organizational conditions. The article also discusses the importance of international network and transnational organizations that support drug user organizations.

  14. Perceived Values and Prospective Users' Acceptance of Prospective Technology: The Case of a Career ePortfolio System

    Science.gov (United States)

    Tzeng, Jeng-Yi

    2011-01-01

    Technology-acceptance tests are traditionally conducted after users have obtained at least a certain amount of experience with a technology. Taking college students who had no real interaction with a prospective eportfolio system, this study investigated both their perceptions of the system and the perceptions' association with attitude towards…

  15. Non-medical use of prescription drugs among illicit drug users: A case study on an online drug forum.

    Science.gov (United States)

    Rönkä, Sanna; Katainen, Anu

    2017-01-01

    The non-medical use of prescription drugs is a growing phenomenon associated with increasing health-related harms. However, little is known about the drivers of this process among illicit drug users. Our aim is to show how the qualities of pharmaceutical drugs, pharmaceutical related knowledge, online communities sharing this knowledge and medical professionals mediate and transform the consumption behaviour related to pharmaceutical drugs. The data consist of discussion threads from an online drug use forum. Using actor network theory (ANT), we analysed translations that mediate the online user community's relationship with pharmaceutical drugs. Differences in experienced drug effects are explained both as a process of 'learning' and as differences in brain chemistry at the receptor level. Both science- and experience-based information are shared on best practices to optimise use, avoid adverse health effects and maximise the experience of intoxication. The expanded context of doctors' practices places stress on the medical framework for drug use. Our analysis shows how the non-medical use of psychoactive pharmaceuticals relates to joint, medicalised ideas of bodies as sites of medical experimentation, as well as to the collective process of constructing 'pharmaceutical competences' in user networks. Understandings of intoxication have increasingly been permeated with the pharmacological and scientific logic of knowledge. The forum works as a platform for harm reduction inspired exchange of knowledge. However, the user community's knowledge sharing practices can generate a shared perception of a sufficient or even superior drug use experience and knowledge. This may lead to overdoses and other risky behaviour, and thereby contribute to increased harms related to non-medical use of prescription drugs. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Mileage-Based User Fees : Prospects and Challenges

    Science.gov (United States)

    2012-06-01

    This report reviews the current research regarding mileage-based user fees for vehicle travel (MBUF), possibly as a replacement or supplement to fuel taxes, which is currently the primary source of transportation revenues in New York State and the na...

  17. Reducing HIV Risks Among Active Injection Drug and Crack Users: The Safety Counts Program

    OpenAIRE

    Rotheram-Borus, Mary Jane; Rhodes, Fen; Desmond, Katherine; Weiss, Robert E.

    2009-01-01

    The efficacy of Safety Counts, a CDC-diffused intervention, was reanalyzed. In a quasi experimental, cross-over design, injection drug users (IDU) and crack users in two neighborhoods were assigned by neighborhood to receive individual Voluntary HIV Counseling and Testing or Safety Counts and 78% were reassessed at 5?9?months. Drug users in the Safety Counts program reported significantly greater reductions in risky sex, crack and hard drug use, and risky drug injection. The more sessions of ...

  18. Homosexual prostitution among male drug users and its risk for HIV infection.

    OpenAIRE

    van den Hoek, J A; van Haastrecht, H J; Coutinho, R A

    1991-01-01

    OBJECTIVE--to assess whether male prostitution is an independent risk factor for HIV infection among male (intravenous and nonintravenous) drug users. DESIGN--a cross-sectional study. SETTING--various low-threshold methadone clinics and the sexually transmitted diseases clinic of the Municipal Health Service in Amsterdam and a drug-treatment centre in The Hague. PARTICIPANTS--343 male intravenous drug users and 106 male non-intravenous drug users. MAIN OUTCOME MEASURES--characteristics concer...

  19. Psychiatric comorbidity in injecting drug users in Asia and Africa.

    Science.gov (United States)

    Iskandar, Shelly; Kamal, Rama; De Jong, Cor A

    2012-05-01

    The prevalence of psychiatric co-morbidity in injecting drug users (IDUs) in the Western countries is high and is associated with lower quality of life and reduces the effectiveness of treatment programs. The aim of this study is to provide a review about psychiatric comorbidity in IDUs in Asia and Africa, where HIV prevalence is high and still increasing. Studies focusing on psychiatric comorbidity in Asia and Africa are scarce. The prevalence of psychiatric comorbidity is comparable with the prevalence in western countries. Psychiatric disorders can occur before or during drug abuse and are also associated with substance abuse and physical comorbidity and its treatments. Childhood trauma followed by post-traumatic disorders is a significant risk factor for substance abuse. Psychiatric co-occurring disorders influence the adherence to the physical and drug use treatment. Evidence-based treatment for psychiatric comorbidity in IDUs is still limited. A better understanding of the prevalence of psychiatric disorders in IDUs and its impact on the overall treatments is growing. However, more studies focusing on the treatment for psychiatric comorbidity in IDUs in Asia and Africa are needed.

  20. Continued high prevalence of HIV, HBV and HCV among injecting and noninjecting drug users in Italy

    Directory of Open Access Journals (Sweden)

    Laura Camoni

    2010-03-01

    Full Text Available We estimated the prevalence of HIV, HBV and HCV infections among injecting and non-injecting drug users treated within public drug-treatment centres in Italy to determine the correlates of infection. In the sample of 1330 drug users, the prevalence of HIV was 14.4% among drug injectors and 1.6% among non-injectors; the prevalence of HBV was 70.4% among injecting drug users and 22.8% among non-injectors and of HCV was 83.2% among injecting drug users and 22.0% among non-injectors. Old age, unemployment, and intravenous drug use were significantly correlated with each of the infections, as well as a longer history of injecting drug use. The results indicate that these infections continue to circulate among drug users, highlighting the need for monitoring of this group in Italy.

  1. Solar sorptive cooling. Technologies, user requirements, practical experience, future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Treffinger, P. [DLR Deutsches Zentrum fuer Luft- und Raumfahrt e.V., Hardthausen (Germany); Hertlein, H.P. [eds.] [Forschungsverbund Sonnenenergie, Koeln (Germany)

    1998-09-01

    Sorptive cooling techniques permit the use of low-temperature solar heat, i.e. a renewable energy of low cost and world-wide availability. The Forschungsverbund Sonnenenergie intends to develop solar sorptive cooling technologies to the prototype stage and, in cooperation with the solar industry and its end users, to promote practical application in air conditioning of buildings and cold storage of food. The workshop presents an outline of the state of development of solar sorptive cooling from the view of users and developers. Exemplary solar cooling systems are described, and the potential of open and closed sorptive processes is assessed. Future central activities will be defined in an intensive discussion between planners, producers, users and developers. [German] Der Einsatz von Sorptionstechniken zur Kaelteerzeugung erlaubt es, als treibende Solarenergie Niedertemperatur-Solarwaerme einzusetzen, also eine regenerative Energie mit sehr geringen Kosten und weltweiter Verfuegbarkeit. Der Forschungsverbund Sonnenenergie hat sich als Aufgabe gestellt, die Techniken der solaren Sorptionskuehlung bis zum Prototyp zu entwickeln und mit Industrie und Nutzern die praktische Anwendung voranzubringen. Die Anwendungsfelder sind die Klimatisierung von Gebaeuden und die Kaltlagerung von Lebensmitteln. Der Workshop gibt einen Ueberblick zum Entwicklungsstand der solaren Sorptionskuehlung aus der Sicht der Anwender und Entwickler. Bereits ausgefuehrte Beispiele zur solaren Kuehlung werden vorgestellt und das Potential geschlossener und offener Sorptionsverfahren angegeben. In intensiver Diskussion zwischen Planern, Herstellern, Nutzern und Entwicklern sollen kuenftige Arbeitsschwerpunkte herausgearbeitet werden. (orig.)

  2. Having multiple sexual partners among Iranian Injection Drug Users

    Directory of Open Access Journals (Sweden)

    Shervin eAssari

    2014-10-01

    Full Text Available Background: Transmission of HIV from intra-venous drug users (IDUs to the community occurs predominantly through high-risk sexual behaviors. Limited information exists regarding the high-risk sexual behaviors of IDUs in Iran. Aim. The aim of this study was to determine the prevalence and factors associated with having multiple sexual partners among Iranian IDUs. Methods. This is a national survey on drug-dependent adults. Participants were sampled from medical centers, prisons, and streets of capitals of 29 provinces in Iran, between May 2007 and February 2008. We analyzed data of 1,416 current IDUs. Socio-demographics and drug use characteristics were entered into a binary logistic regression model to determine predictors of having multiple sexual partners. Results. Having multiple sexual partners in the past or at the time of survey was reported by 56.4% of Iranian IDUs. Multivariate analysis showed that the likelihood of having multiple sexual partners in IDUs decreased by being married (odds ratio [OR], 0.38; P < .001 and increased by female gender (OR, 13.44; P = .02, having illegal income (OR, 1.72; P = .003, higher monthly family income (OR, 1.01; P = .003, pleasure, curiosity, and recreation as cause of first drug use (OR, 1.37; P = .04, ruins as usual place for injection (OR, 1.89; P = .001, and history of syringe sharing (OR, 1.50; P = .02. Conclusions. Having multiple sexual partners was reported by majority of Iranian IDUs, and this was linked to socio-demographics, initiation data, and other risk behaviors. This information should be considered in prevention efforts to reduce sexual transmission of HIV infection in Iran.

  3. Depressive symptoms are frequent among drug users, but not associated with hepatitis C infection

    DEFF Research Database (Denmark)

    Madsen, Lone W; Fabricius, Thilde; Hjerrild, Simon

    2014-01-01

    AIM: To compare the prevalence and severity of depressive symptoms among drug users with and without hepatitis C virus (HCV) infection. METHODS: This was a cross-sectional survey study carried out at the 2 major drug treatment centres on the island of Funen, Denmark. Participants were drug users......-infected 35%; p = 0.25). Forty-one percent (11/27) of the evaluated participants started antidepressant treatment. CONCLUSIONS: Our study demonstrated a high prevalence of depressive symptoms among drug users, but this was not more frequent among HCV-infected patients. The high overall prevalence...... of depression underlines the relevance of screening for depression in patients who are drug users....

  4. Advancing Drug Safety Through Prospective Pharmacovigilance.

    Science.gov (United States)

    Pitts, Peter J; Le Louet, Hervé

    2018-01-01

    Much has changed in a relatively short period of time. There is a raging debate over the level of evidence expected to first introduce a treatment to patients based on smaller, more adaptive data sets. Some argue for less data followed by postapproval follow-up, others for more adaptive clinical trial designs and end-point modification driven by patient-focused drug development and use of real-world evidence. The transition in both the review and postmarketing regulatory framework is happening in front of our eyes in real time. To improve the ability of patients to receive high-quality, safe, effective, and timely care, better information via pharmacovigilance must be a priority as the world's many regulatory systems build the capacity to harness electronic health information to improve health, care quality, and safety. Globally, the widely variable ability of nations to build reliable regulatory systems (from precise review to robust pharmacovigilance) is a dangerous source of health care inequality. Developing validated tools and techniques for "predictive pharmacovigilance" will assist all health systems in better understanding the risks and benefits of the medicines they regulate by understanding what should be happening once a new medicine moves from risk-benefit regulatory efficacy to real-world risk-effectiveness. This will be of particular utility for smaller regulatory agencies with fewer resources. By comparing preapproval predictive pharmacovigilance data, developing regulatory authorities will be able to better understand the potential gap between what was predicted and what was actually measured (via more traditional pharmacovigilance methodologies). Predictive pharmacovigilance recognizes the value of understanding the imperfect reporting of real-world clinical use and that the absence of reporting is, in itself, an important postmarketing signal.

  5. Nonnatural deaths among users of illicit drugs: pathological findings and illicit drug abuse stigmata.

    Science.gov (United States)

    Delaveris, Gerd Jorunn Møller; Hoff-Olsen, Per; Rogde, Sidsel

    2015-03-01

    The aim of the study was to provide information on illicit drug abuse stigmata and general pathological findings among an adult narcotic drug-using population aged 20 to 59 years whose death was nonnatural. A total of 1603 medicolegal autopsy reports from 2000 to 2009 concerning cases positive for morphine, heroin, amphetamines, ecstasy, cannabis, LSD (lysergic acid diethylamide), PCP (phencyclidine), and high levels of GHB (γ-hydroxybutyric acid) in addition to methadone and buprenorphine were investigated. Reported findings of hepatitis, portal lymphadenopathy, recent injection marks, drug user's equipment, and numbers of significant pathological conditions were registered and analyzed according to cases positive for opiates, opioids (OPs), and central nervous system (CNS)-stimulating illicit drugs, respectively. Of the selected cases, 1305 were positive for one or more opiate or OP. Cases positive for OPs had significantly more findings of noninfectious pathological conditions. Hepatitis, portal lymphadenopathy, recent injections marks findings of drug user's equipment were all findings found more frequently among the opiate OP-positive individuals. Portal lymphadenopathy was significantly more often found in cases with hepatitis than in cases with other or no infection. In the population positive for CNS stimulants, hepatitis recent injection marks were more frequent findings than in the CNS stimulant-negative group, irrespective of whether they were opiate OP positive or negative.

  6. Health, perceived quality of life and health services use among homeless illicit drug users.

    Science.gov (United States)

    O'Brien, K K; Schuttke, A; Alhakeem, A; Donnelly-Swift, E; Keogh, C; O'Carroll, A; O'Sullivan, K; Galvin, R; Fahey, T

    2015-09-01

    Drug misuse has been identified as a significant problem in homeless populations. This study examines aspects of physical and mental health, perceived quality of life and health service use among homeless illicit drug users and compares these to non-drug users. Participants were recruited through health clinics across Dublin. A questionnaire assessed participants' drug use, health and well-being, health behaviours and use of health services. Descriptive statistics are presented for the entire cohort and drug users separately. Logistic regression analysis was used to examine the relationship between drug use and (i) multimorbidity, (ii) anxiety and/or depression, (iii) perceived quality of life and (iv) use of health services. Of 105 participants recruited, 35 (33%) were current drug users. Current and previous drug users were significantly more likely to have multimorbidity than those who had never taken drugs (OR 4.86, 95% CI 1.00-23.66). There was no significant difference between drug users and non-drug users in the prevalence of anxiety and/or depression. Drug users were five times more likely than non-drug users to have a low perceived quality of life (OR 5.2, 95% CI 1.7-16.0). Health service utilization was high, although some services were used less by drug users (e.g., dentist and psychiatric outpatient services) while others were used more often (e.g., phoneline services and day care centres). This study highlights the high levels of drug use in this population and the negative impact of drug use on health and perceived quality of life of a homeless population in Dublin. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. 76 FR 58279 - Animal Drug User Fee Act; Public Meeting; Request for Comments

    Science.gov (United States)

    2011-09-20

    ... Internet at http://www.fda.gov/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/ucm042891.htm approximately... better understand the history and evolution of ADUFA, and its current status. II. What is ADUFA? What...

  8. Seroprevalence of hepatitis B markers among incarcerated intravenous drug users

    Directory of Open Access Journals (Sweden)

    Zary Nokhodian

    2014-01-01

    Full Text Available Background: Drug injection is one of the most prominent risk factors for transmission of viral hepatitis. Prevalence of hepatitis B virus (HBV is generally higher in prisoners compared with the general population. The object of this study was to assess the markers of HBV and related risk factors among intravenous drug users (IVDU in prisoners. Materials and Methods: Through a cross-sectional study in 2012 HBV infection and its risk factors were assessed in prisoners with a history of intravenous drug use in Isfahan, Iran. A checklist was fulfilled for each participant and 5 ml blood was taken from each subject. Sera were analyzed for markers of the hepatitis B: Hepatitis B virus surface antigen (HBsAg, antibody to hepatitis B virus surface antigen (HBsAb and hepatitis B virus core antibody (HBcAb by ELISA. We used Chi-square test and logistic regression model to analyze data and P < 0.05 was considered to be significant. Results: All of the studied participants (n = 970 were men. The mean ± standard deviation of the age of the subjects was 32.61 ± 8.1 years and the majority of them had less than high school education. More than 40% of these men had a history of injection drug inside prison and 2.27% of them self-reported history of HBV infection. Of the 970 IVDU, 32 (3.3% were positive for HBsAg. Among HBsAg + subjects, 23 (71.88% were HBcAb+. 120 (12.37% were found positive for isolated HBsAb, 45 (4.64% for isolated HBcAb and 67 (6.9% for both HBsAb and HBcAb. History of sharing needle (odds ratio: 2.25, 95% confidence interval: 1.09-4.65 had a significant association with HBsAg positivity. Conclusion: The results suggest that history of sharing needle had a significant association with HBsAg positivity. It seems that educational programs for injecting drug related behaviors, especially syringe sharing, are needed for IVDU.

  9. Violent and Non-Violent Criminal Behavior among Young Chinese Drug Users: A Mixed Methods Study.

    Science.gov (United States)

    Liu, Liu; Chui, Wing Hong; Chen, Ye

    2018-03-02

    Young drug users are found to be increasingly involved in criminal justice issues. This exploratory and descriptive study aims to analyze the criminal behaviors among young Chinese drug users through a mixed methods research design. Quantitative analysis indicates that young drug users with and without a history of criminality show significant differences in terms of several features. Male drug users, particularly, those who are older, with religious beliefs, and initiated into drug use at younger age were most likely to commit crimes. Among drug users with criminal experiences, those who committed crimes prior to drug initiation have a greater likelihood of committing violent crimes. Furthermore, young drug users with severe depression are more likely to commit crimes, especially violent ones. Qualitative analysis further illustrates that young male drug users often get involved in criminal conduct of the youth gang nature with propensity for engaging in violent crimes as compared to their female counterparts who are more likely to turn into drug dealers and traffickers, in addition to engaging in larceny. The research findings are consistent with developmental theories and "victim to offender cycle". Integrated mental health and substance use services are suggested for crime prevention among young Chinese drug users.

  10. Violent and Non-Violent Criminal Behavior among Young Chinese Drug Users: A Mixed Methods Study

    Directory of Open Access Journals (Sweden)

    Liu Liu

    2018-03-01

    Full Text Available Young drug users are found to be increasingly involved in criminal justice issues. This exploratory and descriptive study aims to analyze the criminal behaviors among young Chinese drug users through a mixed methods research design. Quantitative analysis indicates that young drug users with and without a history of criminality show significant differences in terms of several features. Male drug users, particularly, those who are older, with religious beliefs, and initiated into drug use at younger age were most likely to commit crimes. Among drug users with criminal experiences, those who committed crimes prior to drug initiation have a greater likelihood of committing violent crimes. Furthermore, young drug users with severe depression are more likely to commit crimes, especially violent ones. Qualitative analysis further illustrates that young male drug users often get involved in criminal conduct of the youth gang nature with propensity for engaging in violent crimes as compared to their female counterparts who are more likely to turn into drug dealers and traffickers, in addition to engaging in larceny. The research findings are consistent with developmental theories and “victim to offender cycle”. Integrated mental health and substance use services are suggested for crime prevention among young Chinese drug users.

  11. Frequent food insecurity among injection drug users: correlates and concerns.

    Science.gov (United States)

    Strike, Carol; Rudzinski, Katherine; Patterson, Jessica; Millson, Margaret

    2012-12-08

    Food insecurity and nutrition are two topics that are under-researched among injection drug users (IDUs). Our study examined the extent and correlates of food insecurity among a sample of IDUs and explored whether there is an association between food insecurity and injection-related HIV risk. A cross-sectional survey was conducted using interviewer-administered questionnaires. Data were collected at a needle exchange program in London, Ontario, Canada between September 2006 and January 2007. Participants included 144 English-speaking IDUs who had injected drugs in the past 30 days. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, food insecurity, and health/social service use. In the past 6 months, 54.5% of participants reported that on a daily/weekly basis they did not have enough to eat because of a lack of money, while 22.1% reported this type of food insecurity on a monthly basis. Moreover, 60.4% and 24.3% reported that they did not eat the quality or quantity of food they wanted on a daily/weekly or a monthly basis, respectively. Participants reported re-using someone else's injection equipment: 21% re-used a needle, 19% re-used water, and 37.3% re-used a cooker. The odds of sharing injection equipment were increased for food insecure individuals. Findings show that IDUs have frequent and variable experiences of food insecurity and these experiences are strongly correlated with sharing of injection-related equipment. Such behaviours may increase the likelihood of HIV and HCV transmission in this population. Addressing food-related needs among IDUs is urgently needed.

  12. Reconstructing the AIDS epidemic among injection drug users in Brazil

    Directory of Open Access Journals (Sweden)

    Mariana A. Hacker

    2006-04-01

    Full Text Available The HIV/AIDS epidemic among injection drug users (IDUs in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000 were used as the dependent variable, with a set of social indicators as independent variables (covariates. In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.

  13. Reconstructing the AIDS epidemic among injection drug users in Brazil.

    Science.gov (United States)

    Hacker, Mariana A; Leite, Iuri C; Renton, Adrian; Torres, Tania Guillén de; Gracie, Renata; Bastos, Francisco I

    2006-04-01

    The HIV/AIDS epidemic among injection drug users (IDUs) in Brazil has been unique in terms of temporal and geographical contrasts. This analysis explores these contrasts through the use of multilevel modeling. Standardized AIDS incidence rates among IDUs for Brazilian municipalities (1986-2000) were used as the dependent variable, with a set of social indicators as independent variables (covariates). In some States of the North/Northeast, the epidemic among IDUs has been incipient. The São Paulo epidemic extended to reach a network of municipalities, most of which located far from the capital. More recently, on a smaller scale, a similar extension has been observed in the southernmost States of the country. Both "number of physicians per inhabitant" and "standard distance to the State capital" were found to be associated with AIDS incidence. AIDS cases among IDUs appeared to cluster in wealthier, more developed municipalities. The relative weight of such extensive dissemination in key, heavily populated States prevails in the Brazilian IDU epidemic, defining a central-western-southeastern strip of wealthier middle-sized municipalities and more recently a southern strip of municipalities deeply affected by the epidemic in this population.

  14. Similarity and Difference in Drug Addiction Process Between Heroin- and Methamphetamine-Dependent Users.

    Science.gov (United States)

    Wang, Ziyun; Li, Wei-Xiu; Zhi-Min, Liu

    2017-03-21

    This study aimed to compare the drug addiction process between Chinese heroin- and methamphetamine (MA)-dependent users via a modified 4-stage addiction model (experimentation, occasional use, regular use, and compulsive use). A descriptive study was conducted among 683 eligible participants. In the statistical analysis, we selected 340 heroin- and 295 MA-dependent users without illicit drug use prior to onset of heroin or MA use. The addiction process of heroin-dependent users was shorter than that of MA-dependent users, with shorter transitions from the onset of drug-use to the first drug craving (19.5 vs. 50.0 days), regular use (30.0 vs. 60.0 days), and compulsive use (50.0 vs. 85.0 days). However, no significant differences in the addiction process were observed in frequency of drug administration, except that heroin users reported more administrations of the drug (20.0 vs. 15.0) before progressing to the stage of compulsive drug use. A larger proportion of regular heroin users progressed to use illicit drugs recklessly than did MA users. Most heroin and MA users reported psychological dependence as their primary motivation for compulsive drug use, but more heroin users selected uncomfortable symptoms upon ceasing drug use as further reason to continue. Our results suggest that typical heroin and MA users may experience a similar four-stage addiction process, but MA users might undergo a longer addiction process (in days). More research is necessary to further explore factors influencing the drug addiction process.

  15. Presence of dual diagnosis between users and non-users of licit and illicit drugs in Brazil

    Directory of Open Access Journals (Sweden)

    Mariana Bandeira Formiga

    2015-12-01

    Full Text Available ABSTRACT Objective Investigate the occurrence of dual diagnosis in users of legal and illegal drugs. Methods It is an analytical, cross-sectional study with a quantitative approach, non-probabilistic intentional sampling, carried out in two centers for drug addiction treatment, by means of individual interviews. A sociodemographic questionnaire, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST and the Mini-International Neuropsychiatric Interview (MINI were used. Results One hundred and ten volunteers divided into abstinent users (group 1, alcoholics (group 2 and users of alcohol and illicit drugs (group 3. The substances were alcohol, tobacco, crack and marijuana. A higher presence of dual diagnosis in group 3 (71.8% was observed, which decreased in group 2 (60% and 37.1% of drug abstinent users had psychiatric disorder. Dual diagnosis was associated with the risk of suicide, suicide attempts and the practice of infractions. The crack consumption was associated with the occurrence of major depressive episode and antisocial personality disorder. Conclusion It was concluded that the illicit drug users had a higher presence of dual diagnosis showing the severity of this clinical condition. It is considered essential that this clinical reality is included in intervention strategies in order to decrease the negative effects of consumption of these substances and provide better quality of life for these people.

  16. Memory for drug-related visual stimuli in young adult, cocaine-dependent polydrug users.

    Science.gov (United States)

    Ray, Suchismita; Pandina, Robert; Bates, Marsha E

    2014-03-01

    Implicit (unconscious) and explicit (conscious) memory associations with drugs have been examined primarily using verbal cues. However, drug seeking, drug use behaviors, and relapse in chronic cocaine and other drug users are frequently triggered by viewing substance-related visual cues in the environment. We thus examined implicit and explicit memory for drug picture cues to understand the relative extent to which conscious and unconscious memory facilitation of visual drug cues occurs during cocaine dependence. Memory for drug-related and neutral picture cues was assessed in 14 inpatient cocaine-dependent polydrug users and a comparison group of 21 young adults with limited drug experience (n = 35). Participants completed picture cue exposure, free recall and recognition tasks to assess explicit memory, and a repetition priming task to assess implicit memory. Drug cues, compared to neutral cues, were better explicitly recalled and implicitly primed, and especially so in the cocaine group. In contrast, neutral cues were better explicitly recognized, and especially in the control group. Certain forms of explicit and implicit memory for drug cues were enhanced in cocaine users compared to controls when memory was tested a short time following cue exposure. Enhanced unconscious memory processing of drug cues in chronic cocaine users may be a behavioral manifestation of heightened drug cue salience that supports drug seeking and taking. There may be value in expanding intervention techniques to utilize cocaine users' implicit memory system.

  17. High HCV seroprevalence and HIV drug use risk behaviors among injection drug users in Pakistan

    Directory of Open Access Journals (Sweden)

    Zafar Tariq

    2006-08-01

    Full Text Available Abstract Introduction HIV and HCV risk behaviors among injection drug users (IDUs in two urban areas in Pakistan were identified. Methods From May to June 2003, 351 IDUs recruited in harm-reduction drop-in centers operated by a national non-governmental organization in Lahore (Punjab province and Quetta (Balochistan province completed an interviewer-administered survey and were tested for HIV and HCV. Multivariable logistic regression identified correlates of seropositivity, stratifying by site. All study participants provided written, informed consent. Results All but two were male; median age was 35 and Discussion Despite no HIV cases, overall HCV prevalence was very high, signaling the potential for a future HIV epidemic among IDUs across Pakistan. Programs to increase needle exchange, drug treatment and HIV and HCV awareness should be implemented immediately.

  18. HIV-1 binding and neutralizing antibodies of injecting drug users

    Directory of Open Access Journals (Sweden)

    Ouverney E.P.

    2005-01-01

    Full Text Available Previous studies have demonstrated a stronger seroreactivity against some synthetic peptides responsible for inducing neutralizing antibodies in injecting drug users (IDU compared to that of individuals sexually infected with HIV-1 (S, but the effectiveness in terms of the neutralizing ability of these antibodies has not been evaluated. Our objective was to study the humoral immune response of IDU by determining the specificity of their antibodies and the presence of neutralizing antibodies. The neutralization capacity against the HIV-1 isolate MN (genotype B, the primary HIV-1 isolate 95BRRJ021 (genotype F, and the seroreactivity with peptides known to induce neutralizing antibodies, from the V2 and V3 loops of different HIV-1 subtypes, were analyzed. Seroreactivity indicates that IDU plasma are more likely to recognize a broader range of peptides than S plasma, with significantly higher titers, especially of V3 peptides. Similar neutralization frequencies of the MN isolate were observed in plasma of the IDU (16/47 and S (20/60 groups in the 1:10 dilution. The neutralization of the 95BRRJ021 isolate was more frequently observed for plasma from the S group (15/23 than from the IDU group (15/47, P = 0.0108. No correlation between neutralization and seroreactivity with the peptides tested was observed. These results suggest that an important factor responsible for the extensive and broad humoral immune response observed in IDU is their infection route. There was very little difference in neutralizing antibody response between the IDU and S groups despite their differences in seroreactivity and health status.

  19. Presence of dual diagnosis between users and non-users of licit and illicit drugs in Brazil

    OpenAIRE

    Mariana Bandeira Formiga; Selene Cordeiro Vasconcelos; Melyssa Kellyane Cavalcanti Galdino; Murilo Duarte da Costa Lima

    2015-01-01

    ABSTRACT Objective Investigate the occurrence of dual diagnosis in users of legal and illegal drugs. Methods It is an analytical, cross-sectional study with a quantitative approach, non-probabilistic intentional sampling, carried out in two centers for drug addiction treatment, by means of individual interviews. A sociodemographic questionnaire, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Mini-International Neuropsychiatric Interview (MINI) were used. R...

  20. Category 3 and 4 Controlled Drugs Users' Perceptions of Participating in Drug-Abuse-Health Prevention Lectures in Taiwan.

    Science.gov (United States)

    Sun, Fan-Ko; Long, Ann; Yu, Pei-Jane; Huang, Hui-Man; Chiang, Chun-Ying; Yao, YuChun

    2017-08-01

    This study was designed to explore Category 3 and 4 controlled drug users' perceptions of participating in health-prevention lectures. A phenomenological approach was used. Twelve participants were interviewed after completing the lectures. Findings revealed five themes (1) mixed emotions; (2) self-development; (3) finding the lectures lacked practicality and relevance; (4) highlighting three stages for discontinuing drug-usage; and, (5) suggesting tips for the advancement of lectures. These findings could be used as a map to help health professionals understand drug users' perceptions of attending health prevention lectures and provide insight into how young people might stop using drugs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Memory for Drug Related Visual Stimuli in Young Adult, Cocaine Dependent Polydrug Users

    Science.gov (United States)

    Ray, Suchismita; Pandina, Robert; Bates, Marsha E.

    2015-01-01

    Background and Objectives Implicit (unconscious) and explicit (conscious) memory associations with drugs have been examined primarily using verbal cues. However, drug seeking, drug use behaviors, and relapse in chronic cocaine and other drug users are frequently triggered by viewing substance related visual cues in the environment. We thus examined implicit and explicit memory for drug picture cues to understand the relative extent to which conscious and unconscious memory facilitation of visual drug cues occurs during cocaine dependence. Methods Memory for drug related and neutral picture cues was assessed in 14 inpatient cocaine dependent polydrug users and a comparison group of 21 young adults with limited drug experience (N = 35). Participants completed picture cue exposure, free recall and recognition tasks to assess explicit memory, and a repetition priming task to assess implicit memory. Results Drug cues, compared to neutral cues were better explicitly recalled and implicitly primed, and especially so in the cocaine group. In contrast, neutral cues were better explicitly recognized, and especially in the control group. Conclusion Certain forms of explicit and implicit memory for drug cues were enhanced in cocaine users compared to controls when memory was tested a short time following cue exposure. Enhanced unconscious memory processing of drug cues in chronic cocaine users may be a behavioral manifestation of heightened drug cue salience that supports drug seeking and taking. There may be value in expanding intervention techniques to utilize cocaine users’ implicit memory system. PMID:24588421

  2. [Development of antituberculous drugs: current status and future prospects].

    Science.gov (United States)

    Tomioka, Haruaki; Namba, Kenji

    2006-12-01

    authors reviewed (1) the history and present status of chemical genomics that is defined as the systemic search for a selective small molecular modulator for each function of all gene products, (2) recent studies of the authors on profiles of the interactions between various kinds of human proteins and small molecule modulators using the new technology devised by Reverse Proteomics Research Institute, and (3) future prospects of the development of new antituberculous drugs based on chemical genomics. 3. It appears also promising to develop new types of drug administration systems using drug vehicles, which enable efficacious drug delivery to their target in vivo. Dr. Izumikawa, Dr. Ohno and Dr. Kohno reviewed the usefulness of liposome- and polymer-based technologies, which enable efficacious delivery of encapsulated drugs at required doses for prolonged periods of time with only a single shot without toxicity, and also enable highly targeted delivery of drugs to their target in vivo. They indicated that the applications of drug delivery system using conventional anti-mycobacterial agents are challenging to improve the compliance of treatment and better clinical outcome. 4. Immunoadjunctive therapy appears to be promising in improving outcome of clinical control of refractory mycobacterial infections, including MDR-TB and M. avium complex infection. Dr. Shimizu, Dr. Sato and Dr. Tomioka reviewed the present status of immunotherapy of mycobacterial infections in combination with antimycobacterial drugs. They indicated that the development of new classes of immunomodulators other than cytokines (IL-2, IFN-gamma, GM-CSF, IL-12, etc.) particularly those with no severe side-effects, are urgently needed. Their review dealed with some promising immunoadjunctive agents, especially ATP and its analogues, which potentiate macrophage antimycobacterial activity via purinergic P2 receptors. The aim of this symposium is to address the future prospects of the development of new drugs

  3. Are cannabis users exposed to other drug use opportunities? Investigation of high-risk drug exposure opportunities among young cannabis users in London.

    Science.gov (United States)

    Strang, John; McCambridge, Jim

    2005-03-01

    In a study of young cannabis users attending further education colleges across London which specifically excluded young heroin users or injecting drug users, 35% were found to have been offered heroin, 36% had been present during heroin smoking, and 12% present at injecting. Factors associated with these exposure opportunities were investigated. The proportion of friends who use drugs other than cannabis was also considered, both as an indicator of risk in its own right and as a possible mechanism for high-risk drug exposure opportunities involving heroin and/or injecting. Alcohol variables and interactional problems perceived by the study subjects to be caused by their own drug use were found to be predictive of the involvement of friends in drug use other than cannabis and of exposure to heroin and injecting drug use. Non-cannabis illicit drug use among friends was also found to be associated with offers of heroin and with having been present during injecting drug use by others. Interpretations of these data are considered and the need for more detailed study with an area of increasing public policy significance is discussed.

  4. USER S GUIDE FOR THE RANDOM DRUG SCREENING SYSTEM

    Energy Technology Data Exchange (ETDEWEB)

    McNeany, Karen I [ORNL

    2013-12-01

    The Random Drug Screening System (RDSS) is a desktop computing application designed to assign nongameable drug testing dates to each member in a population of employees, within a specific time line. The program includes reporting capabilities, test form generation, unique test ID number assignment, and the ability to flag high-risk employees for a higher frequency of drug testing than the general population.

  5. Early Onset of Drug and Polysubstance Use as Predictors of Injection Drug Use Among Adult Drug Users

    Science.gov (United States)

    Trenz, Rebecca C.; Scherer, Michael; Harrell, Paul; Zur, Julia; Sinha, Ashish; Latimer, William

    2012-01-01

    Early onset of alcohol, marijuana, and cigarette use is an indicator of later substance use problems in adulthood such as alcohol or other drug dependence. This paper seeks to address the association between early onset alcohol, marijuana, cigarette, and polysubstance use with injection drug use among recent illicit drug users. The current study used baseline data from the Baltimore site of the NEURO-HIV Epidemiologic Study, an investigation of neuropsychological and social-behavioral risk factors of HIV, hepatitis A, hepatitis B, and Hepatitis C among both injection and non-injection drug users in Baltimore Maryland. The present study used a subset (N = 651) of the larger parent study that identified as White or Black, and reported any drug use in the past 6 months. In the full sample slightly more than half (52.5%) of study participants were IDUs. IDUs differed from non-IDUs on age of initiation for cigarettes, marijuana, and alcohol, with IDUs initiating the use of all three substances significantly earlier than non-IDUs. IDUs also had significantly greater proportions of early onset of alcohol (χ2 = 19.71, p < .01), cigarette (χ2 = 11.05, p < .01), marijuana (χ2 = 10.83, p < .01), and polysubstance use (χ2 = 23.48, p < .01) than non-IDUs. After adjusting for age, gender, and race/ethnicity, only participants identified as early onset alcohol users (AOR = 1.47, 95% CI: 1.00-2.18) and early onset polysubstance users (AOR = 1.62, 95% CI: 1.10-2.38) were more likely to have IDU status than those who reported initiating substance use later. IDU status was then stratified by race/ethnicity. After controlling for age and gender, only early polysubstance use was a significant predictor of IDU status for Whites (AOR = 2.06, 95% CI: 1.07-3.93). Consistent with literature on early substance initiation and later illicit substance use, early onset alcohol and polysubstance use is an important risk factor for IDU in adulthood. PMID:22172686

  6. STUDI ETNOGRAFI PENGGUNA INJECTION DRUG USER (IDU PADA KELOMPOK WARIA DI SURABAYA

    Directory of Open Access Journals (Sweden)

    Setia Pranata

    2012-11-01

    Full Text Available Injection Drug User (IDU as abuse activities is one of causes to increase HIV/AIDS cases. To provide a holistic overview on IDU users behaviour, it needs an ethnography study. This ethnography study would focuss to potrait IDU users on each community group. One of there was transvestate group. A specifis effort was conducted to get and provide profile of each IDU users, history of use, their activities and their sexual activities. Because the IDU users group was exclusively closed, so data collection were more relied on key informan. If thouroughly observed on the main problem, most influencing factor drive them to drug abuse was psychologic distress associated with their characteristics. To observe the overview on IDU users activities in transvestate group, we shoud be open-hearted in seeing the problem of drug abuse, especially not only on law enforcement aspect but also on humanistic aspect. For the reasons, it is a need to minimalize psichologic distress for IDU users presence. With concern to drug abuse, especially IDU users, the government should facilitate social respectable organizations to do control activities by attendanship.   Keywords: ethnography, injection drug user, transvestate group

  7. Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non-users : a drug utilisation study

    NARCIS (Netherlands)

    Crijns, H.J.; van Rein, N.; Gispen-de Wied, C.C.; Straus, S.M.; de Jong-van den Berg, L.T.

    2012-01-01

    Purpose To assess the compliance with the isotretinoin Pregnancy Prevention Programme (PPP) by evaluating the use of prescribed contraceptives among isotretinoin users. The PPP contains a requirement for the use of contraceptive methods for women of childbearing potential. Methods A drug utilisation

  8. 75 FR 32483 - Prescription Drug User Fee Act; Meetings on Reauthorization; Request for Notification of...

    Science.gov (United States)

    2010-06-08

    .../Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FoodandDrugAdministration... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0128] Prescription Drug User Fee Act; Meetings on Reauthorization; Request for Notification of Stakeholder Intention...

  9. Quantitative Authorship Attribution of Users of Mexican Drug Dealing Related Online Forums

    Science.gov (United States)

    Rico Sulayes, Antonio

    2012-01-01

    As the violence in the Mexican drug war escalates, a proliferation of social media sites about drug trafficking in Mexico was followed by the murder of some of their users, and the eventual disappearance of many of those sites. Despite these events, there still exist a number of drug-dealing related social media outlets in this country with a…

  10. Perspectives on Health among Adult Users of Illicit Stimulant Drugs in Rural Ohio

    Science.gov (United States)

    Siegal, Harvey A.; Draus, Paul J.; Carlson, Robert G.; Falck, Russel S.; Wang, Jichuan

    2006-01-01

    Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may…

  11. Drug-Avoidance Self-Efficacy Among Exclusive Cannabis Users vs. Other Drug Users Visiting the Emergency Department.

    Science.gov (United States)

    Clingan, Sarah E; Woodruff, Susan I

    2017-07-29

    Medical care in the emergency department (ED) is a growing and complex area of outpatient care, with about 256 visits made to EDs every minute in 2013. Studies report that, compared to people who do not use drugs, people who use illicit drugs are more likely to use the ED for their medical care. Self-efficacy has been shown to be a predictor of abstinence or reduced use among drug-using individuals. The current study describes drug avoidance self-efficacy among exclusive cannabis-using individuals and other drug-using individuals who use the ED for any reason. Participants were 693 adult patients visiting the trauma units and EDs of two large urban "safety net" hospitals (i.e., providing care to low-income, uninsured, and vulnerable population) in Southern California who reported using illicit drugs in the past 30 days. For people who use only cannabis, higher drug-avoidance self-efficacy was associated with older age, lower drug involvement scores, lower drug severity scores, and higher readiness to change use. For people who use other drugs, higher drug avoidance self-efficacy scores was associated with lower drug severity scores, lower psychiatric severity scores, higher medical severity scores, and higher readiness to change use. This study identified several factors (some common, some unique) related to higher drug-avoidance self-efficacy for both groups. Results may be important when designing intervention protocols for use in the ED.

  12. Homeless drug users in Rotterdam, the Netherlands: profile, way of life, and the need for assistance.

    Science.gov (United States)

    Lempens, Ankie; van de Mheen, Dike; Barendregt, Cas

    2003-01-01

    Decreasing the number of homeless drug users is one of the main characteristics of inner city drugs policy. The present study selected an urban-ethnographic perspective (the subculture theory) in order to explore why one drug user is homeless and another 7 not, and to attempt to describe and define the homeless and their immediate social environment. These issues were formulated into the following research questions: 1. What are the sociodemographic characteristics of homeless drug users in Rotterdam, and do they differ from domiciled drug users? 2. What are their living conditions? 3. What are the reasons for being homeless? 4. Does the period of homelessness play a role in the need to change one's lifestyle? Five research methods were employed for this study: a literature search, interviews with key persons, field notes from community fieldworkers, a survey among drug users (n = 204), and photographic reports from six homeless users. Data were collected in 1998/1999. The results document that in our study population there were more women, more illegal persons, and more foreigners than among domiciled drug users, and that the homeless group used heroin and cocaine on more days. A large proportion of the homeless users had no identity papers and no health insurance. This did not, however, lead to more self-reported sickness or a higher prevalence of infectious diseases compared with nonhomeless drug users. Easily accessible (low threshold) social care centers and assistance are very important. Few of the homeless had voluntarily chosen a homeless life-most describe an event that was a trigger for their homelessness. The average duration of being homeless was 17 months, and the longer someone had been homeless the less inclined they were to change their situation. This paper also discusses policymaking implications.

  13. Studi Etnografi Pengguna Injection Drug User (Idu) pada Kelompok Waria di Surabaya

    OpenAIRE

    Pranata, Setia; Ernawan, Yusuf

    2005-01-01

    Injection Drug User (IDU) as abuse activities is one of causes to increase HIV/AIDS cases. To provide a holistic overview on IDU users behaviour, it needs an ethnography study. This ethnography study would focuss to potrait IDU users on each community group. One of there was transvestate group. A specifis effort was conducted to get and provide profile of each IDU users, history of use, their activities and their sexual activities. Because the IDU users group was exclusively closed, so data c...

  14. Hepatitis C testing and treatment among active drug users in Amsterdam: results from the DUTCH-C project

    NARCIS (Netherlands)

    Lindenburg, Catharina E. A.; Lambers, Femke A. E.; Urbanus, Anouk T.; Schinkel, Janke; Jansen, Peter L. M.; Krol, Anneke; Casteelen, Gerty; van Santen, Gerrit; van den Berg, Charlotte H. S. B.; Coutinho, Roel A.; Prins, Maria; Weegink, Christine J.

    2011-01-01

    Background Although hepatitis C virus (HCV) treatment has shown to be effective, uptake of treatment among active drug users is still low. The Drug Users Treatment for Chronic Hepatitis-C project aims to offer active drug users in Amsterdam HCV testing and treatment using a multidisciplinary

  15. Prevalence of thrombocytopenia in HIV-infected and non-HIV infected drug users and homosexual men

    NARCIS (Netherlands)

    Mientjes, G. H.; van Ameijden, E. J.; Mulder, J. W.; van den Hoek, J. A.; Coutinho, R. A.; von dem Borne, A. E.

    1992-01-01

    We studied the prevalence and risk factors for thrombocytopenia among 299 drug users and 461 homosexual men. The prevalence of thrombocytopenia was 3.3% in HIV-negative homosexual men, 8.7% in HIV-negative drug users, 16.4% in HIV-positive homosexual men, and 36.9% in HIV-positive drug users. With

  16. Reducing HIV risks among active injection drug and crack users: the safety counts program.

    Science.gov (United States)

    Rotheram-Borus, Mary Jane; Rhodes, Fen; Desmond, Katherine; Weiss, Robert E

    2010-06-01

    The efficacy of Safety Counts, a CDC-diffused intervention, was reanalyzed. In a quasi experimental, cross-over design, injection drug users (IDU) and crack users in two neighborhoods were assigned by neighborhood to receive individual Voluntary HIV Counseling and Testing or Safety Counts and 78% were reassessed at 5-9 months. Drug users in the Safety Counts program reported significantly greater reductions in risky sex, crack and hard drug use, and risky drug injection. The more sessions of Safety Counts attended, the greater were the reductions in risky acts. Different analytic decisions result in very different findings for the same intervention. Safety Counts is an effective intervention for IDU and crack users. Analytic decision of intervention outcomes is highly related to evaluations of an intervention's efficacy.

  17. Medical and Nonmedical Users of Prescription Drugs among College Students

    Science.gov (United States)

    Rozenbroek, Katelyn; Rothstein, William G.

    2011-01-01

    Objectives: To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Participants: Undergraduates at an urban mid-Atlantic university with 12,000 students. Methods: A questionnaire administered in classes provided 413 responses, with a usable response…

  18. Botulism in injecting drug users, Dublin, Ireland, November-December 2008.

    LENUS (Irish Health Repository)

    Ward, M

    2009-01-08

    In November and December 2008, six cases of suspect wound botulism were reported in heroin injecting drug users, all residents in Dublin, Ireland. Patients were aged between 23-42 years of age; four cases were male; one patient died shortly after admission. The patients presented to four different hospitals across the city. Botulism in injecting drug users in Ireland was last reported in 2002.

  19. A PROSPECTIVE STUDY OF CENTCHROMAN USERS WITH SPECIAL REFERENCE TO ITS CONTRACEPTIVE BENEFIT

    Directory of Open Access Journals (Sweden)

    Hema Sreedharan Nair

    2016-12-01

    scanty flow in 12%. Pearl index calculated for centchroman was 2. This was slightly higher compared to the product specification of 1-1.8. Of the 153 patients in the study group, pregnancy occurred in 11 patients. 4 pregnancies were user failures and seven pregnancies were drug failures. CONCLUSION 1. Centchroman is a safe nonsteroidal contraceptive for spacing of pregnancies. 2. Centchroman does not alter carbohydrate or lipid metabolism, coagulation factors or blood pressure and hence can be safely used in women in whom steroidal pills are contraindicated. 3. Menstrual irregularity is the major reason for discontinuation of centchroman. 4. Majority of menstrual disorders revert back to normal by 6-9 months of use. 5. Centchroman does not cause pathological ovarian enlargement. 6. Pearl index of centchroman was calculated to be 2. 7. Resumption of fertility following discontinuation was prompt.

  20. Nursing Care in Alcohol and Drug User Treatment Facilities.

    Science.gov (United States)

    Naegle, Madeline A

    2015-01-01

    Registered and advanced practice nurses are employed in substance user treatment facilities across the US and in most industrialized countries. Patterns of employment and job descriptions for nurses, however, are highly inconsistent and seriously flawed. Many regulatory system, legislative and government agency factors and to some degree, the nursing profession itself, sustain the flaws and limit the delivery of comprehensive care. Competencies linked to addictions nursing best practices are often underutilized because of narrow job descriptions. This results in limited health and nursing service delivery to vulnerable populations receiving treatment in these government funded programs. This article highlights the increasing demand for the delivery of integrated care to psychiatric and substance using populations. The author considers factors which stake holders can influence to change flawed employment patterns and limited access to comprehensive care for substance users.

  1. Concepts of illicit drug quality among darknet market users: Purity, embodied experience, craft and chemical knowledge.

    Science.gov (United States)

    Bancroft, Angus; Scott Reid, Peter

    2016-09-01

    Users of darknet markets refer to product quality as one of the motivations for buying drugs there, and vendors present quality as a selling point. However, what users understand by quality and how they evaluate it is not clear. This article investigates how users established and compared drug quality. We used a two-stage method for investigating users' assessments. The user forum of a darknet market that we called 'Merkat' was analysed to develop emergent themes. Qualitative interviews with darknet users were conducted, then forum data was analysed again. To enhance the applicability of the findings, the forum was sampled for users who presented as dependent as well as recreational. Quality could mean reliability, purity, potency, and predictability of effect. We focused on the different kinds of knowledge users drew on to assess quality. These were: embodied; craft; and chemical. Users' evaluations of quality depended on their experience, the purpose of use, and its context. Market forums are a case of indigenous harm reduction where users share advise and experiences and can be usefully engaged with on these terms. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. 76 FR 59705 - Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and Biological...

    Science.gov (United States)

    2011-09-27

    ... Refunds for Drug and Biological Products; Availability AGENCY: Food and Drug Administration, HHS. ACTION... industry entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This... a guidance for industry entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological...

  3. 'Silk Road', the virtual drug marketplace: a single case study of user experiences.

    Science.gov (United States)

    Van Hout, Marie Claire; Bingham, Tim

    2013-09-01

    The online promotion of 'drug shopping' and user information networks is of increasing public health and law enforcement concern. An online drug marketplace called 'Silk Road' has been operating on the 'Deep Web' since February 2011 and was designed to revolutionise contemporary drug consumerism. A single case study approach explored a 'Silk Road' user's motives for online drug purchasing, experiences of accessing and using the website, drug information sourcing, decision making and purchasing, outcomes and settings for use, and perspectives around security. The participant was recruited following a lengthy relationship building phase on the 'Silk Road' chat forum. The male participant described his motives, experiences of purchasing processes and drugs used from 'Silk Road'. Consumer experiences on 'Silk Road' were described as 'euphoric' due to the wide choice of drugs available, relatively easy once navigating the Tor Browser (encryption software) and using 'Bitcoins' for transactions, and perceived as safer than negotiating illicit drug markets. Online researching of drug outcomes, particularly for new psychoactive substances was reported. Relationships between vendors and consumers were described as based on cyber levels of trust and professionalism, and supported by 'stealth modes', user feedback and resolution modes. The reality of his drug use was described as covert and solitary with psychonautic characteristics, which contrasted with his membership, participation and feelings of safety within the 'Silk Road' community. 'Silk Road' as online drug marketplace presents an interesting displacement away from 'traditional' online and street sources of drug supply. Member support and harm reduction ethos within this virtual community maximises consumer decision-making and positive drug experiences, and minimises potential harms and consumer perceived risks. Future research is necessary to explore experiences and backgrounds of other users. Copyright © 2013

  4. Helicobacter pylori and risk of ulcer bleeding among users of nonsteroidal anti-inflammatory drugs

    DEFF Research Database (Denmark)

    Aalykke, C; Lauritsen, Jens; Hallas, J

    1999-01-01

    Peptic ulcer complications related to use of nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common serious adverse drug reactions. Whether Helicobacter pylori infection potentiates this gastrointestinal toxicity of NSAIDs is still unresolved. In this study, we investigated...... the role of H. pylori as a cause of bleeding peptic ulcer among NSAID users....

  5. 76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan

    Science.gov (United States)

    2011-09-19

    ...] Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration, HHS. ACTION... information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to achieve... Information Technology Plan.'' This plan will meet one of the performance goals agreed to under the 2007...

  6. Use of alcohol among treatment seeking illicit drug users in India

    Directory of Open Access Journals (Sweden)

    Hem Sethi

    2014-01-01

    Full Text Available Introduction: Concomitant multiple substance use by clients in drug abuse treatment settings has been recognized as an important treatment issue for many years, and remains under-researched in Indian context. Aim: To examine the patterns and prevalence of concomitant alcohol and illicit drug use among the patients seeking treatment for illicit drug use. Materials and Methods: A total of 110 patients attending the National drug dependence treatment centre having multiple drug use were included for the present study. Data was collected by face-to-face structured interview on a semi-structured proforma. Results: It was observed that overall 38.2% of the illicit drug users had concomitant alcohol use. Concomitant use of alcohol was found to be 37.1%, 45.5% and 44.4% among heroin, cannabis users and Doda (opium users respectively. The maximum quantity of alcohol consumption was reported by patients who used opium (Doda (mean = 703.13 ml/day. A multinomial logistic regression analysis showed that middle aged males and those with lower educational levels, were at greater risk for concomitant exposure to alcohol and illicit drugs. Conclusion: Many people use alcohol in combination with illicit drugs. Clinicians should warn every patient about alcohol-drug interactions, especially those at high risk for concomitant exposure. These findings have implications for prevention, as well as clinical risk for adverse consequences of concomitant alcohol and illicit drug consumption.

  7. Family functioning and health issues associated with codependency in families of drug users

    Directory of Open Access Journals (Sweden)

    Cassandra Borges Bortolon

    2016-01-01

    Full Text Available Abstract Substance abuse affects both the user and the family system as a whole, yet substance abuse treatment is centered on the user, leaving the family in the background. Objective: To identify the symptoms of codependency and health issues in the codependent family members of drug users who called a toll-free telephone counseling service. In total, 505 family members participated in this cross-sectional study. Drug users’ mothers and wives who had less than 8 years of education and those who were unemployed had a greater chance of high codependency. It was also determined that a high level of codependency imposed a significant burden on the physical and emotional well-being of those affected, resulting in poor health, reactivity, self-neglect and additional responsibilities. It was concluded that codependency has a negative impact on the family system and on the health of the family members of drug users.

  8. Interaction between Nurses and Hospitalized Drug Users in Somatic Hospital Wards

    DEFF Research Database (Denmark)

    Kappel, Nanna

    the understandings of the nurses which will contribute to the feeling of stigmatization of users of hard drugs when in contact with the health care system. By virtue of their profession and position nurses have a big influence on how citizens while admitted to hospital feel accepted and welcomed. Nurses are subdued...... rules and regulations when performing their task, but are also obliged to offer nursing of high quality to all patients. Drug users have high frequency of morbidity compared to other citizens. Due to their somewhat chaotic lifestyle they get severe infections, wounds, injection damages, and therefore...... advanced hospital care is necessary. Drug users have often bad experiences in their contact with the hospital system beyond these, experiences of conflicts during hospitalization and due to this they might postpone contact to the health care system. Apparently conflicts often break out when users of hard...

  9. Performance-Enhancing Drugs in Sports: How Chemists Catch Users

    Science.gov (United States)

    Werner, T. C.; Hatton, Caroline K.

    2011-01-01

    The "cat-and-mouse game" between those who enable athletes to use performance-enhancing drugs (PEDs) and those who try to detect such use provides a wealth of interesting examples for the undergraduate chemistry and biochemistry classroom. In this article, we focus on several commonly used PEDs, including amphetamine, anabolic steroids,…

  10. Cotton Fever: A Condition Self-Diagnosed by IV Drug Users.

    Science.gov (United States)

    Zerr, Ashley Michelle; Ku, Kimberly; Kara, Areeba

    2016-01-01

    The presentation of fever in an intravenous drug user prompts diagnostic testing targeted at identifying infectious etiologies. However, an alternate diagnosis exists in "cotton fever." While few reports describe this phenomenon in the peer-reviewed literature, the diagnosis is well recognized among the intravenous drug user community. Although its etiology is not well understood, cotton fever seems to be a self-limited, febrile response to the intravenous administration of a drug filtered through cotton. Educating clinicians regarding cotton fever may limit unnecessary hospital admissions and improve our ability to care for this population. © Copyright 2016 by the American Board of Family Medicine.

  11. HIV and drug users in Ukraine: building confidence to reduce HIV risk.

    Science.gov (United States)

    Hyde, L

    1999-09-01

    This article discusses the programs of nongovernmental organizations (NGOs) towards the drug practices and sexual behaviors of HIV infected individuals and drug users in Mykolaiv, Ukraine. Blagodiynist (Charity Foundation), one of the NGOs operating in Ukraine, has been helping drug users and sex workers. This group has collaborated with other group projects to produce better and effective interventions. As such, the needle-exchange project was organized, where drug users could not only exchange needles for clean ones, but also obtain information, advice, and even condoms. Role model stories approach was also another effective method that Blagodiynist utilized to make drug users and sex workers aware not only of the risk and reality of HIV, but to encourage behavior change as well, and to generate the self-confidence needed to alter their erroneous practices. The fact that sex workers and drug users have begun to take the risks of HIV infection seriously and have taken measures to protect themselves, reflect the success of these programs.

  12. Social psychological determinants of the use of performance-enhancing drugs by gym users.

    Science.gov (United States)

    Wiefferink, C H; Detmar, S B; Coumans, B; Vogels, T; Paulussen, T G W

    2008-02-01

    The aim of this study is to identify the social psychological determinants of the use of performance-enhancing drugs by gym users who practice bodybuilding, fitness, powerlifting or combat sports. In this questionnaire-based study, 144 respondents answered questions on their actual use and intention to use such drugs and also on their background characteristics and beliefs, such as their attitudes, social influences and self-efficacy. While all social psychological determinants correlated with intention to use these drugs, the most important predictors were personal norms, beliefs about performance outcomes and the perceived behavior of others. Non-users held more restrictive norms about using performance-enhancing drugs, were less optimistic about the performance-enhancing outcomes and believed that fewer significant others used performance-enhancing drugs than users and ex-users. The results of this study indicate that users attribute advantages to performance-enhancing drugs and are inclined to overlook the risks of using them. Preventive interventions should focus on influencing personal norms and social processes.

  13. Trends in reports of driving following illicit drug consumption among regular drug users in Australia, 2007-2013: Has random roadside drug testing had a deterrent effect?

    Science.gov (United States)

    Horyniak, Danielle; Dietze, Paul; Lenton, Simon; Alati, Rosa; Bruno, Raimondo; Matthews, Allison; Breen, Courtney; Burns, Lucy

    2017-07-01

    Driving following illicit drug consumption ('drug-driving') is a potential road safety risk. Roadside drug testing (RDT) is conducted across Australia with the dual aims of prosecuting drivers with drugs in their system and deterring drug-driving. We examined trends over time in self-reported past six-month drug-driving among sentinel samples of regular drug users and assessed the impact of experiences of RDT on drug-driving among these participants. Data from 1913 people who inject drugs (PWID) and 3140 regular psychostimulant users (RPU) who were first-time participants in a series of repeat cross-sectional sentinel studies conducted in Australian capital cities from 2007 to 2013 and reported driving in the past six months were analysed. Trends over time were assessed using the χ 2 test for trend. Multivariable logistic regressions assessed the relationship between experiences of RDT and recent drug-driving, adjusting for survey year, jurisdiction of residence and socio-demographic and drug use characteristics. The percentage of participants reporting recent (past six months) drug-driving decreased significantly over time among both samples (PWID: 83% [2007] vs. 74% [2013], p<0.001; RPU: 72% vs. 56%, p<0.001), but drug-driving remained prevalent. Lifetime experience of RDT increased significantly over time (PWID: 6% [2007] vs. 32% [2013], p<0.001; RPU: 2% vs. 11%, p<0.001). There were no significant associations between experiencing RDT and drug-driving among either PWID or RPU. Although there is some evidence that drug-driving among key risk groups of regular drug users is declining in Australia, possibly reflecting a general deterrent effect of RDT, experiencing RDT appears to have no specific deterrent effect on drug-driving. Further intervention, with a particular focus on changing attitudes towards drug-driving, may be needed to further reduce this practice among these groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Changing drug use and HIV prevalence among injecting drug users in Ukraine: evidence from biobehavioral surveys

    Directory of Open Access Journals (Sweden)

    Dumchev, Kostyantyn

    2012-07-01

    Full Text Available BACKGROUND: Integrated biobehavioral surveys (IBBS have been used to evaluate the impact of HIV prevention efforts among most-at-risk groups in Ukraine since 2007. Harm reduction program coverage among injecting-drug users (IDUs increased substantially from 96,000 in 2008 to 170,000 in 2010 with support from the Global Fund, and IBBS have shown declining HIV prevalence. Aim of the study was to examine the changes in HIV prevalence, drug use patterns and risky behaviors in IDUs on national and city level.METHODS: For this analysis, three IDU-IBBS datasets were combined – 2008 (N=3711, 2009 (N=3962, and 2011 (N=9069. The analysis included 25 cities that participated in either 2008 or 2009, and 2011. Changes in HIV prevalence, drug use, and risk behaviors were compared between 2008/9 and 2011.RESULTS: The surveyed IDU population in 2011 was older than in 2008/9 (31.0 vs. 32.8 years; p<.0001, and included more females (23.5% vs. 25.5%; p=.0038, with substantial variation across cities.Overall HIV prevalence in the sample declined slightly (22.9% to 21.6%; p=.05. In eight cities, HIV prevalence decreased significantly (-5% to -18%, while significant increases were seen in five cities (8% to 15%. Prevalence among IDUs younger than 25 years declined (9.9% to 7.2%; p=.0078.The combined dataset showed no difference in opioid or stimulant past-30-day use, with variation at city level. Clean needle/syringe use during last injection increased significantly (88.8% to 97.0%; p<.0001, with no opposing trend in any city. Three cities had an increase in past-30-day needle/syringe sharing; nine – in container sharing; twelve – in use of preloaded syringes. Changes in condom use were not significant (54.1% to 54.9%, p=.32.CONCLUSIONS: IDUs in Ukraine are ageing and HIV seroprevalence among IDUs continues to decline, especially among young IDUs. However, prevention programming needs to respond to significant regional variations in risk behaviors and HIV

  15. Knowledge of AIDS and HIV transmission among drug users in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Clair Scott

    2011-02-01

    Full Text Available Abstract Background Proper knowledge of HIV transmission is not enough for people to adopt protective behaviors, but deficits in this information may increase HIV/AIDS vulnerability. Objective To assess drug users' knowledge of HIV/AIDS and the possible association between knowledge and HIV testing. Methods A Cross-sectional study conducted in 2006/7 with a convenience sample of 295 illicit drug users in Rio de Janeiro, assessing knowledge on AIDS/HIV transmission and its relationship with HIV testing. Information from 108 randomly selected drug users who received an educational intervention using cards illustrating situations potentially associated with HIV transmission were assessed using Multidimensional Scaling (MDS. Results Almost 40% of drug users reported having never used condoms and more than 60% reported not using condoms under the influence of substances. Most drug users (80.6% correctly answered that condoms make sex safer, but incorrect beliefs are still common (e.g. nearly 44% believed HIV can be transmitted through saliva and 55% reported that HIV infection can be transmitted by sharing toothbrushes, with significant differences between drug users who had and who had not been tested for HIV. MDS showed queries on vaginal/anal sex and sharing syringes/needles were classified in the same set as effective modes of HIV transmission. The event that was further away from this core of properly perceived risks referred to blood donation, perceived as risky. Other items were found to be dispersed, suggesting inchoate beliefs on transmission modes. Conclusions Drug users have an increased HIV infection vulnerability compared to the general population, this specific population expressed relevant doubts about HIV transmission, as well as high levels of risky behavior. Moreover, the findings suggest that possessing inaccurate HIV/AIDS knowledge may be a barrier to timely HIV testing. Interventions should be tailored to such specific

  16. Knowledge of AIDS and HIV transmission among drug users in Rio de Janeiro, Brazil

    Science.gov (United States)

    2011-01-01

    Background Proper knowledge of HIV transmission is not enough for people to adopt protective behaviors, but deficits in this information may increase HIV/AIDS vulnerability. Objective To assess drug users' knowledge of HIV/AIDS and the possible association between knowledge and HIV testing. Methods A Cross-sectional study conducted in 2006/7 with a convenience sample of 295 illicit drug users in Rio de Janeiro, assessing knowledge on AIDS/HIV transmission and its relationship with HIV testing. Information from 108 randomly selected drug users who received an educational intervention using cards illustrating situations potentially associated with HIV transmission were assessed using Multidimensional Scaling (MDS). Results Almost 40% of drug users reported having never used condoms and more than 60% reported not using condoms under the influence of substances. Most drug users (80.6%) correctly answered that condoms make sex safer, but incorrect beliefs are still common (e.g. nearly 44% believed HIV can be transmitted through saliva and 55% reported that HIV infection can be transmitted by sharing toothbrushes), with significant differences between drug users who had and who had not been tested for HIV. MDS showed queries on vaginal/anal sex and sharing syringes/needles were classified in the same set as effective modes of HIV transmission. The event that was further away from this core of properly perceived risks referred to blood donation, perceived as risky. Other items were found to be dispersed, suggesting inchoate beliefs on transmission modes. Conclusions Drug users have an increased HIV infection vulnerability compared to the general population, this specific population expressed relevant doubts about HIV transmission, as well as high levels of risky behavior. Moreover, the findings suggest that possessing inaccurate HIV/AIDS knowledge may be a barrier to timely HIV testing. Interventions should be tailored to such specific characteristics. PMID:21324119

  17. A map of representations of Use / s User / s of illegal drugs from semiotics Statements

    Directory of Open Access Journals (Sweden)

    Fernando Palazzolo

    2014-12-01

    Full Text Available The aim of this paper is to describe, implement and evaluate the scope of the analytical method known as Statements Semiotics for the analysis of social representations, from interviews with actors involved in the phenomenon of illegal drugs. This time it made possible to establish a first conceptual map of how different actors (lawmakers, social activists, drug users and ex drug users, state workers on addictions, members of civil organizations define use and users of illegal drugs, being identified two discursive formations that are in tension. Also shows clearly some tensions within each discursive formation, as well as correlations between the two formations, and contradictions or opacities in the discourse of the actors

  18. Health and human rights concerns of drug users in detention in Guangxi Province, China.

    Directory of Open Access Journals (Sweden)

    J Elizabeth Cohen

    2008-12-01

    Full Text Available BACKGROUND: Although confinement in drug detoxification ("detox" and re-education through labor (RTL centers is the most common form of treatment for drug dependence in China, little has been published about the experience of drug users in such settings. We conducted an assessment of the impact of detention on drug users' access to HIV prevention and treatment services and consequent threats to fundamental human rights protections. METHODS AND FINDINGS: Chinese government HIV and anti-narcotics legislation and policy documents were reviewed, and in-depth and key informant interviews were conducted with 19 injection drug users (IDUs and 20 government and nongovernmental organization officials in Nanning and Baise, Guangxi Province. Significant contradictions were found in HIV and antinarcotics policies, exemplified by the simultaneous expansion of community-based methadone maintenance therapy and the increasing number of drug users detained in detox and RTL center facilities. IDU study participants reported, on average, having used drugs for 14 y (range 8-23 y and had been confined to detox four times (range one to eight times and to RTL centers once (range zero to three times. IDUs expressed an intense fear of being recognized by the police and being detained, regardless of current drug use. Key informants and IDUs reported that routine HIV testing, without consent and without disclosure of the result, was the standard policy of detox and RTL center facilities, and that HIV-infected detainees were not routinely provided medical or drug dependency treatment, including antiretroviral therapy. IDUs received little or no information or means of HIV prevention, but reported numerous risk behaviors for HIV transmission while detained. CONCLUSIONS: Legal and policy review, and interviews with recently detained IDUs and key informants in Guangxi Province, China, found evidence of anti-narcotics policies and practices that appear to violate human rights

  19. Nutrition issues in chronic drug users living with HIV infection.

    Science.gov (United States)

    Hendricks, Kristy; Gorbach, Sherwood

    2009-04-01

    Human immunodeficiency virus (HIV) infection and chronic drug abuse both compromise nutritional status. For individuals with both disorders, the combined effects on wasting, the nutritional consequence that is most closely linked to mortality, appear to be synergistic. Substance abuse clinicians can improve and extend patients' lives by recommending healthy diets; observing and assessing for food insecurity, nutritional deficits, signs of weight loss and wasting, body composition changes, and metabolic abnormalities; and providing referrals to food programs and nutritionists. More studies are needed on the nutritional consequences of using specific illicit drugs, the impact on health of specific micronutrient and metabolic deficiencies seen in people with HIV, and the causes and clinical implications of body fat changes associated with HIV.

  20. Nutrition Issues in Chronic Drug Users Living With HIV Infection

    OpenAIRE

    Hendricks, Kristy; Gorbach, Sherwood

    2009-01-01

    Human immunodeficiency virus (HIV) infection and chronic drug abuse both compromise nutritional status. For individuals with both disorders, the combined effects on wasting, the nutritional consequence that is most closely linked to mortality, appear to be synergistic. Substance abuse clinicians can improve and extend patients? lives by recommending healthy diets; observing and assessing for food insecurity, nutritional deficits, signs of weight loss and wasting, body composition changes, and...

  1. Congregation sites for youthful multiple drug users: locations for epidemiological research and intervention.

    Science.gov (United States)

    Shick, J F; Wiebel, W W

    1981-02-01

    Field research techniques were used to collect observational and interview data at outdoor sites in the south Chicago suburbs where youthful drug users congregated during good weather to buy, sell and use multiple drugs. Results indicated that the distribution system for non-opiate drugs is more stable than previously thought and that drug purchase occurs at such outdoor sites in the summer months and at the homes of drug users' friends during the winter. The largest and most active site in the area, a forest preserve, was intensively studied utilizing epidemiological survey and participant observation techniques. In contrast to smaller, neighborhood sites, this area attracted drug users and dealers extensively involved in heavy multiple drug use. Subjects came from an extremely wide area and were not organized into cohesive friendship groups formed during grade school and high school. A wide range of drug types was regularly available. The large proportion of unemployed youth and high school dropouts among the sample suggested that field techniques at such sites would be more likely to contact those youth most heavily involved in drug distribution and use than programs based in schools or industry.

  2. A Qualitative View of Drug Use Behaviors of Mexican Male Injection Drug Users Deported from the United States

    OpenAIRE

    Ojeda, Victoria D.; Robertson, Angela M.; Hiller, Sarah P.; Lozada, Remedios; Cornelius, Wayne; Palinkas, Lawrence A.; Magis-Rodriguez, Carlos; Strathdee, Steffanie A.

    2011-01-01

    Deportees are a hidden yet highly vulnerable and numerous population. Significantly, little data exists about the substance use and deportation experiences of Mexicans deported from the United States. This pilot qualitative study describes illicit drug use behaviors among 24 Mexico-born male injection drug users (IDUs), ≥18 years old, residing in Tijuana, Mexico who self-identified as deportees from the United States. In-person interviews were conducted in Tijuana, Mexico in 2008. Content ana...

  3. Voice of the psychonauts: coping, life purpose, and spirituality in psychedelic drug users.

    Science.gov (United States)

    Móró, Levente; Simon, Katalin; Bárd, Imre; Rácz, József

    2011-01-01

    Psychoactive drug use shows great diversity, but due to a disproportionate focus on problematic drug use, predominant nonproblematic drug use remains an understudied phenomenon. Historic and anecdotal evidence shows that natural sources of "psychedelic" drugs (e.g., mescaline and psilocybin) have been used in religious and spiritual settings for centuries, as well as for psychological self-enhancement purposes. Our study assessed a total of 667 psychedelic drug users, other drug users, and drug nonusers by online questionnaires. Coping, life purpose, and spirituality were measured with the Psychological Immune Competence Inventory, the Purpose in Life test, and the Intrinsic Spirituality Scale, respectively. Results indicate that the use of psychedelic drugs with a purpose to enhance self-knowledge is less associated with problems, and correlates positively with coping and spirituality. Albeit the meaning of "spirituality" may be ambiguous, it seems that a spiritually-inclined attitude in drug use may act as a protective factor against drug-related problems. The autognostic use of psychedelic drugs may be thus hypothesized as a "training situation" that promotes self-enhancement by rehearsing personal coping strategies and by gaining self-knowledge. However, to assess the actual efficiency and the speculated long-term benefits of these deliberately provoked exceptional experiences, further qualitative investigations are needed.

  4. Addiction treatment and stable housing among a cohort of injection drug users.

    Directory of Open Access Journals (Sweden)

    Anita Palepu

    Full Text Available Unstable housing and homelessness is prevalent among injection drug users (IDU. We sought to examine whether accessing addiction treatment was associated with attaining stable housing in a prospective cohort of IDU in Vancouver, Canada.We used data collected via the Vancouver Injection Drug User Study (VIDUS between December 2005 and April 2010. Attaining stable housing was defined as two consecutive "stable housing" designations (i.e., living in an apartment or house during the follow-up period. We assessed exposure to addiction treatment in the interview prior to the attainment of stable housing among participants who were homeless or living in single room occupancy (SRO hotels at baseline. Bivariate and multivariate associations between the baseline and time-updated characteristics and attaining stable housing were examined using Cox proportional hazard regression models.Of the 992 IDU eligible for this analysis, 495 (49.9% reported being homeless, 497 (50.1% resided in SRO hotels, and 380 (38.3% were enrolled in addiction treatment at the baseline interview. Only 211 (21.3% attained stable housing during the follow-up period and of this group, 69 (32.7% had addiction treatment exposure prior to achieving stable housing. Addiction treatment was inversely associated with attaining stable housing in a multivariate model (adjusted hazard ratio [AHR]=0.71; 95% CI: 0.52-0.96. Being in a partnered relationship was positively associated with the primary outcome (AHR=1.39; 95% CI: 1.02-1.88. Receipt of income assistance (AHR=0.65; 95% CI: 0.44-0.96, daily crack use (AHR=0.69; 95% CI: 0.51-0.93 and daily heroin use (AHR=0.63; 95% CI: 0.43-0.92 were negatively associated with attaining stable housing.Exposure to addiction treatment in our study was negatively associated with attaining stable housing and may have represented a marker of instability among this sample of IDU. Efforts to stably house this vulnerable group may be occurring in contexts

  5. The relationship between housing status and HIV risk among active drug users: a qualitative analysis.

    Science.gov (United States)

    Dickson-Gomez, Julia; Hilario, Helena; Convey, Mark; Corbett, A Michelle; Weeks, Margaret; Martinez, Maria

    2009-01-01

    This paper examines the relationship between housing status and HIV risk using longitudinal, qualitative data collected in 2004-2005, from a purposeful sample of 65 active drug users in a variety of housed and homeless situations in Hartford, Connecticut. These data were supplemented with observations and in-depth interviews regarding drug use behavior collected in 2001-2005 to evaluate a peer-led HIV prevention intervention. Data reveal differences in social context within and among different housing statuses that affect HIV risk or protective behaviors including the ability to carry drug paraphernalia and HIV prevention materials, the amount of drugs in the immediate environment, access to subsidized and supportive housing, and relationships with those with whom drug users live. Policy implications of the findings, limitations to the data, and future research are discussed.

  6. [Health care models for users of alcohol and other drugs: political discourse, knowledge, and practices].

    Science.gov (United States)

    Alves, Vânia Sampaio

    2009-11-01

    This article aims to characterize health care models for users of alcohol and other drugs in the Brazilian context. Discourse analysis was performed on public drug policy in Brazil from the 1970s. This analysis was contextualized by a brief digression on the main political positions identified in several countries of the world in relation to drug use problems. Beginning in the current decade, drug policies in Brazil have been receptive to harm reduction approaches, resulting in reorientation of the health care model. In conclusion, the structuring and strengthening of a network of care for users of alcohol and other drugs and their families, based on community care and the harm reduction approach and combined with other social and health services, is now a key public health challenge for the country.

  7. Hepatitis B virus in drug users in France

    DEFF Research Database (Denmark)

    Brouard, C; Pillonel, J; Sogni, P

    2017-01-01

    People who use drugs (PWUD) are a key population for hepatitis B virus (HBV) vaccination and screening. We aimed to estimate the seroprevalence of HBs antigen (HBsAg) and self-reported HBV vaccination history in French PWUD attending harm reduction centres using data from the ANRS...... (2·2%, 95% CI 0·8-5·7) and low (0·7%, 95% CI 0·3-1·5) endemic zones. Factors independently associated with HBsAg carriage were being born in a moderate or high endemic zone or reporting precarious housing. Self-reported HBV vaccination history varied from 47·4% in high endemic zones, to 59·3% and 62...

  8. Drug use and risk behaviours among injecting drug users: a comparison between sex workers and non-sex workers in Sydney, Australia

    OpenAIRE

    Roxburgh, Amanda; Degenhardt, Louisa; Breen, Courtney

    2005-01-01

    Abstract Background This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU) who report engaging in sex work for money or drugs and regular injecting drug users who do not. Methods Cross sectional data collected from regular IDU interviewed as part of the New South Wales (NSW) Illicit Drug Reporting System (IDRS) in 2003 were analysed. Results IDU who reported engaging in sex work were more likely to be...

  9. [The Characteristics of Law-evading Drug Users and Effective Approaches].

    Science.gov (United States)

    Kondo, Ayumi

    2016-01-01

      The increasing number of law-evading drug users in Japan is becoming a serious social problem. Previous studies have shown that law-evading drug users are younger, more educated, and less antisocial than methamphetamine users. They also tend to have some type of psychiatric disorder before starting drug use; therefore one of the reasons that they start using drugs may be to alleviate certain psychiatric symptoms. Furthermore, if drug users are successful in avoiding arrest, they often lack the motivation to stop, which makes treatment difficult. Therapists are required to be non-confrontational, to keep pace with their patients, and to take their patients' other existing disorders into account. Recently, the Matrix Model has shown promise as a new treatment strategy for drug abusers in Japan. The Matrix Model, which was originally developed in response to the 1980s cocaine epidemic in the USA, is an intensive outpatient treatment approach for drug abuse and dependence. The Matrix Model integrates cognitive-behavioral therapy, contingency management, motivational interviewing, 12-step facilitation, family involvement, and so on, with a directive, non-confrontational approach, and this style of therapy seems to fit with law-evading drug users. A Matrix Model-based treatment program was first established in Japan in 2006. The aim of this report is to introduce and assess the benefits of the TAMA Mental Health and Welfare Center Relapse Prevention Program, a Matrix Model-based treatment program established at the Tama Mental Health and Welfare Center in 2007.

  10. Risk factors associated with injection initiation among drug users in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Suriyanon Vinai

    2006-03-01

    Full Text Available Abstract Background Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand. Methods A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection. Results After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation. Conclusion Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection.

  11. Behavioural profile of drug users attending public drug-treatment centres in Sicily: the role of social context

    Directory of Open Access Journals (Sweden)

    Francesco Vitale

    2007-12-01

    Full Text Available

    Objective: Investigations of injecting drug users (IDUs have suggested that the social context may influence high-risk behaviours in this population. The aim of this study was to describe knowledge, attitudes and behaviours of IDUs attending public drug-treatment centres in our area.

    Study design and methods: A cross-sectional survey was conducted between July 2002 and February 2004, enrolling 607 drug users attending four public drug-treatment centres in the Palermo area. Two of them were located inside the urban area, whereas the other two were in rural districts near the city. All participants answered an anonymous questionnaire concerning social and demographic characteristic and potential high-risk behaviours.

    Results: IDUs living in urban context have a higher educational level, higher number of sexual partners, as well as a lower prevalence of exchanging sex for drugs. Conversely, IDUs living in suburban/rural context are less likely to share syringes and more likely to have used light drugs in the past. Suburban/rural IDUs drink more alcohol but smoke less cigarettes/day, although both groups are strong smokers.

    Conclusions: The results suggest that public drug-treatment centres should take in consideration the adoption of specific programs targeting specific groups, in line with the profile and needs of the subjects in each context in order to promote approaches leading to risk reduction.

  12. Nonsteroidal antiinflammatory drugs and dyspepsia in general practice – a prospective, controlled study

    Directory of Open Access Journals (Sweden)

    Marija Skok

    2005-01-01

    Full Text Available Background: Treatment of dyspeptic patients is a diagnostic and therapeutic problem frequently encountered by general and family practitioners, by internists and gastroenterologists.Aims: In our study we attempted to assess the prevalence of dyspeptic symptoms in patients over 60 who are regular users of nonsteroidal antiinflammatory drugs.Patients and methods: This is a prospective cohort study based on an interview during examination in the OPC, the results obtained by the diagnostic procedures and follow-up. It was carried out between 1999 and 2003 at a family practitioner’s and a gastroenterologic OPC. In patients who were regular users of nonsteroidal antiinflammatory drugs, we established the prevalence of dyspeptic symptoms, the most often used drugs and the type of diagnostic procedure applied to define the cause of dyspepsia. The control group was composed of patients over 60 who were also exhibiting dyspeptic symptoms but not using any NSAID.Results: The study comprised 50 patients, 27 women and 23 men, the mean age was 67.3 years, the range 60–80 years. The control group comprised 50 patients, 28 women and 22 men, the mean age was 66.6 years, the range 61–80 years. All patients of the study group had used NSAR or preparations of acetylsalicylic acid during the past 3 months. There were no statistically significant differences between the patients of both groups as regards the number and use of other drugs, p = 0.65. The average score of dyspeptic complaints in our study group was 3.02, SD ± 0.6, and 70% of patients wished to use H2 antagonists or proton pump inhibitors for these complaints. In patients of the control group, the average score of complaints was 2.72, SD ± 0.7, and they also took drugs for the alleviation of their complaints more rarely.Conclusions: Nonsteroidal antiinflammatory drugs belong among the important causes of dyspepsia in the elderly. When making decisions about the various diagnostic procedures for

  13. Differences in illegal drug consumption between native and immigrants in a large sample of injected drug users in Catalonia (Spain).

    Science.gov (United States)

    Saigí, Núria; Espelt, Albert; Folch, Cinta; Sarasa-Renedo, Ana; Castellano, Yolanda; Majó, Xavier; Meroño, Mercè; Brugal, M Teresa; Casabona, Jordi

    2014-01-01

    The aims of this study were to describe illegal drug abuse patterns in relation to the migration process and use of drug treatment centers among immigrant injected drug users (IDUs) involved in harm reduction programs, and to compare the characteristics of immigrant and native IDUs. Cross-sectional study of 748 IDUs aged ≥18 years attending harm reduction centers between 2008 and 2009. We explored differences in socio-economic status, illegal drug consumption, health status and use of treatment centers in native versus immigrant IDUs. We also described whether immigrant IDUs started using injected drugs before or after entering the host country. Immigrant IDUs tend to live alone more frequently, start injection at later ages, use heroin and inject it more frequently and use drug treatment centers less frequently than native IDUs. Seventy-six percent of immigrants began using illegal drugs before arriving at the host country. Those who started in other countries were residing in the host country for 5 years or less (63.9%). Overall, immigrant IDUs attended drug treatment centers (36.9%) less frequently than native IDUs (71.8%). In conclusion, migration could be a risk factor for illegal drug abuse initiation or increase in consumption, often with the adoption of local consumption patterns and aggravated due to a lower access to drug treatment centers.

  14. 75 FR 22601 - Draft Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g...

    Science.gov (United States)

    2010-04-29

    ...] Draft Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g); Requests for... the Internet. To receive ``Draft Guidance for Industry and Food and Drug Administration Staff; User... and Industry Procedures for Section 513(g) Requests for Information under the Federal Food, Drug, and...

  15. Compulsory drug detention center experiences among a community-based sample of injection drug users in Bangkok, Thailand

    Directory of Open Access Journals (Sweden)

    Zhang Ruth

    2011-10-01

    Full Text Available Abstract Background Despite Thailand's official reclassification of drug users as "patients" deserving care and not "criminals," the Thai government has continued to rely heavily on punitive responses to drug use such as "boot camp"-style compulsory "treatment" centers. There is very little research on experiences with compulsory treatment centers among people who use drugs. The work reported here is a first step toward filling that gap. Methods We examined experiences of compulsory drug treatment among 252 Thai people who inject drugs (IDU participating in the Mitsampan Community Research Project in Bangkok. Multivariate logistic regression was used to identify factors independently associated with a history of compulsory treatment experience. Results In total, 80 (31.7% participants reported a history of compulsory treatment. In multivariate analyses, compulsory drug detention experience was positively associated with current spending on drugs per day (adjusted odds ratio [AOR] = 1.86; 95%CI: 1.07 - 3.22 and reporting drug planting by police (AOR = 1.81; 95%CI: 1.04 - 3.15. Among those with compulsory treatment experience, 77 (96.3% reported injecting in the past week, and no difference in intensity of drug use was observed between those with and without a history of compulsory detention. Conclusion These findings raise concerns about the current approach to compulsory drug detention in Thailand. Exposure to compulsory drug detention was associated with police abuse and high rates of relapse into drug use, although additional research is needed to determine the precise impact of exposure to this form of detention on future drug use. More broadly, compulsory "treatment" based on a penal approach is not consistent with scientific evidence on addressing drug addiction and should be phased out in favor of evidence-based interventions.

  16. Access to health and human services for drug users: an urban/rural community systems perspective.

    Science.gov (United States)

    Rivers, J E; Komaroff, E; Kibort, A C

    1999-01-01

    Publicly funded drug-user treatment programs in both urban and rural areas are under unprecedented pressure to adapt to multiple perspectives of their mission, reduced governmental funding, diminished entitlement program resources for clients, managed care reforms, and continuing unmet need for services. This article describe an ongoing health services research study that is investigating how these and related health and human service programs currently serve and cross-refer chronic drug users and how they perceive and are reacting to systemic pressures. Interim analysis on intra-agency diversity and managed care perceptions are reported.

  17. Decline in hepatitis B infection observed after 11 years of regional vaccination among Danish drug users

    DEFF Research Database (Denmark)

    Mössner Klemmensen, Belinda; Skamling, M; Jørgensen, T Riis

    2010-01-01

    The aims of this study were to determine the current prevalence of viral hepatitis and HIV among drug users, and to compare this prevalence with previous findings in the same geographical region. Cross-sectional surveys of drug users attending treatment centers on the island of Funen with approxi...... with approximately 500,000 inhabitants were administered in 1996 and 2007. The 2007 prevalence estimates were: anti-HBc 50.2%, HBsAg 0.9%, anti-HCV 66.8%, HCV-RNA 40%, and anti-HIV 1.1%. The corresponding 1996 prevalence values were: anti-HBc 70% (P ...

  18. Recruiting and Retaining Mobile Young Injection Drug Users in a Longitudinal Study

    Science.gov (United States)

    Lankenau, Stephen E.; Sanders, Bill; Hathazi, Dodi; Jackson Bloom, Jennifer

    2011-01-01

    Longitudinal studies that research homeless persons or transient drug users face particular challenges in retaining subjects. Between 2005 and 2006, 101 mobile young injection drug users were recruited in Los Angeles into a 2-year longitudinal study. Several features of ethnographic methodology, including fieldwork and qualitative interviews, and modifications to the original design, such as toll-free calls routed directly to ethnographer cell phones and wiring incentive payments, resulted in retention of 78% of subjects for the first follow-up interview. Longitudinal studies that are flexible and based upon qualitative methodologies are more likely to retain mobile subjects while also uncovering emergent research findings. PMID:20222779

  19. Psychiatric side effects and antiepileptic drugs: Observations from prospective audits.

    Science.gov (United States)

    Stephen, Linda J; Wishart, Abbie; Brodie, Martin J

    2017-06-01

    Psychiatric comorbidities are common in people with epilepsy. A retrospective study of characteristics associated with withdrawal due to psychiatric side effects was undertaken in patients with treated epilepsy participating in prospective audits with new antiepileptic drugs (AEDs). A total of 1058 treated patients with uncontrolled seizures (942 focal-onset seizures, 116 generalized genetic epilepsies [GGEs]) participated in eight prospective, observational audits from 1996 to 2014. These patients were prescribed adjunctive topiramate (n=170), levetiracetam (n=220), pregabalin (n=135), zonisamide (n=203), lacosamide (n=160), eslicarbazepine acetate (n=52), retigabine (n=64), or perampanel (n=54). Doses were titrated according to efficacy and tolerability to optimize zeizure outcomes and reduce side effects. Psychiatric comorbidities were recorded prior to and after the addition of each AED. At baseline, patients with focal-onset seizures (189 of 942; 20.1%) were statistically more likely to have psychiatric diagnoses compared to patients with GGEs (14 of 116, 12.1%; p=0.039). Following adjunctive AED treatment, neuropsychiatric adverse effects led to AED withdrawal in 1.9-16.7% of patients. Patients with a pre-treatment psychiatric history (22 of 209; 10.5%) were statistically more likely to discontinue their new AED due to psychiatric issues compared to patients with no previous psychiatric diagnosis (50 of 849; 5.9%; p=0.017). Patients receiving sodium channel blocking AEDs (4 of 212, 1.9%) were statistically less likely to develop intolerable psychiatric problems, compared to those on AEDs possessing other mechanisms of action (68 of 846, 8.0%; p=0.012). Depression was the commonest problem, leading to discontinuation of AEDs in 2.8% (n=30) patients. Aggression was statistically more common in men (11 of 527, 2.1%) compared to women (1 of 531, 0.2%; p=0.004). Patients with learning disability (12 of 122, 9.8%; p=0.0015) were statistically less likely to have

  20. Increased synthetic drug abuse and trends in HIV and syphilis prevalence among female drug users from 2010-2014 from Beijing, China.

    Science.gov (United States)

    Sun, Yanming; Guo, Wei; Li, Guiying; He, Shufang; Lu, Hongyan

    2018-01-01

    The objective of this study was to monitor the trend of addiction drug use and its relationship with sexually transmitted infections (STIs) among female drug users (FDUs). Serial cross-sectional surveys were conducted during 2010-2014 among FDUs in Beijing to collect information on addiction drug usage, sexual behaviors, and STI prevalence. Characteristics were analyzed and compared between traditional and synthetic drug users among FDUs by logistic regression method. A total of 3859 FDUs were surveyed during 2010-2014, with the median age being 32.7 years old. The proportion of synthetic drug users among FDUs increased from 43.7% in 2010 to 70.7% in 2014. Compared with traditional drug users, synthetic drug users were younger (P drug FDUs. However, the engagement of commercial sexual activities (P drug users were significantly higher than traditional drug users. Synthetic drug abuse appears to be correlated with commercial sex behavior and higher syphilis prevalence among FDUs. Tailored strategies on health education to curb the prevalence of synthetic drug abuse are urgently needed in Beijing.

  1. Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders

    Directory of Open Access Journals (Sweden)

    Kittirattanapaiboon P

    2014-03-01

    Full Text Available Phunnapa Kittirattanapaiboon,1 Sirijit Suttajit,2 Boonsiri Junsirimongkol,1 Surinporn Likhitsathian,2 Manit Srisurapanont2 1Department of Mental Health, Ministry of Public Health, Nonthaburi, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods: Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI, current suicidality (1 month prior to assessment, mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results: Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59% and (methamphetamine (24%. Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537 had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81. While those who used illicit drugs alone (no mental/alcohol use disorder (n=348 had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65, the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively. Conclusion: A key

  2. The melding of drug markets in Houston after Katrina: dealer and user perspectives.

    Science.gov (United States)

    Kotarba, Joseph A; Fackler, Jennifer; Johnson, Bruce D; Dunlap, Eloise

    2010-07-01

    In the aftermath of Hurricane Katrina, the majority of routine activities in New Orleans were disrupted, including the illegal drug market. The large-scale relocation of New Orleans evacuees (NOEs), including many illegal drug users and sellers, to host cities led to a need for new sources of illegal drugs. This need was quickly satisfied by two initially distinct drug markets (1) drug dealers from New Orleans who were themselves evacuees and (2) established drug dealers in the host cities. To be expected, the two markets did not operate indefinitely in parallel fashion. This paper describes the evolving, operational relationship between these two drug markets over time, with a focus on Houston. We analyze the reciprocal evolution of these two markets at two significant points in time: at the beginning of the relocation (2005) and two years later (2007). The overall trend is towards a melding of the two drug markets, as evidenced primarily by decreases in drug-related violence and the cross-fertilization of drug tastes. We describe the process by which the two drug markets are melded over time, in order to seek a better understanding of the social processes by which drug markets in general evolve.

  3. Comparative analysis of three drug-drug interaction screening systems against probable clinically relevant drug-drug interactions: a prospective cohort study.

    Science.gov (United States)

    Muhič, Neža; Mrhar, Ales; Brvar, Miran

    2017-07-01

    Drug-drug interaction (DDI) screening systems report potential DDIs. This study aimed to find the prevalence of probable DDI-related adverse drug reactions (ADRs) and compare the clinical usefulness of different DDI screening systems to prevent or warn against these ADRs. A prospective cohort study was conducted in patients urgently admitted to medical departments. Potential DDIs were checked using Complete Drug Interaction®, Lexicomp® Online™, and Drug Interaction Checker®. The study team identified the patients with probable clinically relevant DDI-related ADRs on admission, the causality of which was assessed using the Drug Interaction Probability Scale (DIPS). Sensitivity, specificity, and positive and negative predictive values of screening systems to prevent or warn against probable DDI-related ADRs were evaluated. Overall, 50 probable clinically relevant DDI-related ADRs were found in 37 out of 795 included patients taking at least two drugs, most common of them were bleeding, hyperkalemia, digitalis toxicity, and hypotension. Complete Drug Interaction showed the best sensitivity (0.76) for actual DDI-related ADRs, followed by Lexicomp Online (0.50), and Drug Interaction Checker (0.40). Complete Drug Interaction and Drug Interaction Checker had positive predictive values of 0.07; Lexicomp Online had 0.04. We found no difference in specificity and negative predictive values among these systems. DDI screening systems differ significantly in their ability to detect probable clinically relevant DDI-related ADRs in terms of sensitivity and positive predictive value.

  4. The prevalence of homelessness among injection drug users with and without HIV infection

    OpenAIRE

    Song, John Y.; Safaeian, Mahboobeh; Strathdee, Steffanie A.; Vlahov, David; Celentano, David D.

    2000-01-01

    Cross-sectional investigations of homelessness have many potential biases. Data from 2,452 individuals enrolled in a longitudinal cohort study of Baltimore, Maryland, residents recruited in 1988–1989 with a history of injection drug use were analyzed to identify the extent and determinants of homelessness. Proportions having ever experienced homelessness were compared across subgroups of injection drug users (IDUs) who were human immunodeficiency virus (HIV) negative, HIV positive, and HIV se...

  5. Risk factors of suicidal ideation and attempt in women with drug user spouses

    Directory of Open Access Journals (Sweden)

    Roya Noori

    2013-11-01

    Conclusion: The findings of this study showed that a personal history of drug use, an elevated anxiety score, and depression and exposure to physical abuse by their spouse may act as predictors of suicidal ideation or attempt in women with a drug user spouse. These findings may serve to benefit and support healthcare systems, associated with ongoing efforts to develop preventive programs for suicidal behavior in this population.

  6. Medical Marijuana Users are More Likely to Use Prescription Drugs Medically and Nonmedically.

    Science.gov (United States)

    Caputi, Theodore L; Humphreys, Keith

    2018-04-17

    Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use. Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana. Medical marijuana users were significantly more likely (RR 1.62, 95% confidence interval [CI] 1.50-1.74) to report medical use of prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug (RR 2.12, 95% CI 1.67-2.62), with elevated risks for pain relievers (RR 1.95, 95% CI 1.41-2.62), stimulants (RR 1.86, 95% CI 1.09-3.02), and tranquilizers (RR 2.18, 95% CI 1.45-3.16). Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

  7. [Social network analysis and high risk behavior characteristics of recreational drug users: a qualitative study].

    Science.gov (United States)

    Wu, Di; Wang, Zhenhong; Jiang, Zhenxia; Fu, Xiaojing; Li, Hui; Zhang, Dapeng; Liu, Hui; Hu, Yifei

    2014-11-01

    To understand the characteristics of recreational drug users' behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI). Qualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use. A total of 120 participants were recruited by convenient sampling from April to October, 2013 in a community of Qingdao city. Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network. All participants used methamphetamine and 103 of them showed social connection. The prevalence of syphilis and HIV were 24.2% (29/120) and 2.5% (3/120) respectively. The estimated size of recreational drug users was big with a wide diversity of occupations and age range, and males were more frequent than females. Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities. The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors. Recreational drug use could increase the size of social network among sex partners, the frequency of risky sexual behaviors and syphilis prevalence, which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future.

  8. Route of administration for illicit prescription opioids: a comparison of rural and urban drug users

    Directory of Open Access Journals (Sweden)

    Havens Jennifer R

    2010-10-01

    Full Text Available Abstract Background Nonmedical prescription opioid use has emerged as a major public health concern in recent years, particularly in rural Appalachia. Little is known about the routes of administration (ROA involved in nonmedical prescription opioid use among rural and urban drug users. The purpose of this study was to describe rural-urban differences in ROA for nonmedical prescription opioid use. Methods A purposive sample of 212 prescription drug users was recruited from a rural Appalachian county (n = 101 and a major metropolitan area (n = 111 in Kentucky. Consenting participants were given an interviewer-administered questionnaire examining sociodemographics, psychiatric disorders, and self-reported nonmedical use and ROA (swallowing, snorting, injecting for the following prescription drugs: buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, OxyContin® and other oxycodone. Results Among urban participants, swallowing was the most common ROA, contrasting sharply with substance-specific variation in ROA among rural participants. Among rural participants, snorting was the most frequent ROA for hydrocodone, methadone, OxyContin®, and oxycodone, while injection was most common for hydromorphone and morphine. In age-, gender-, and race-adjusted analyses, rural participants had significantly higher odds of snorting hydrocodone, OxyContin®, and oxycodone than urban participants. Urban participants had significantly higher odds of swallowing hydrocodone and oxycodone than did rural participants. Notably, among rural participants, 67% of hydromorphone users and 63% of morphine users had injected the drugs. Conclusions Alternative ROA are common among rural drug users. This finding has implications for rural substance abuse treatment and harm reduction, in which interventions should incorporate methods to prevent and reduce route-specific health complications of drug use.

  9. Online drug user-led harm reduction in Hungary: a review of “Daath”

    Science.gov (United States)

    2013-01-01

    Harm reduction has been increasingly finding its way into public drug policies and healthcare practices worldwide, with successful intervention measures justifiably focussing on the highest-risk groups, such as injecting drug users. However, there are also other types of drug users in need for harm reduction, even though they pose less, low, or no public health risk. Occasionally, drug users may autonomously organise themselves into groups to provide advocacy, harm reduction, and peer-help services, sometimes online. The http://www.daath.hu website has been operated since 2001 by the “Hungarian Psychedelic Community”, an unorganised drug user group with a special interest in hallucinogenic and related substances. As of today, the website serves about 1200 visitors daily, and the online community comprises of more than 8000 registered members. The Daath community is driven by a strong commitment to the policy of harm reduction in the form of various peer-help activities that aim to expand harm reduction without promoting drug use. Our review comprehensively summarises Daath’s user-led harm reduction services and activities from the last ten years, firstly outlining the history and growth phases of Daath, along with its self-set guidelines and policies. Online services (such as a discussion board, and an Ecstasy pill database) and offline activities (such as Ecstasy pill field testing, and a documentary film about psychedelics) are described. In order to extend its harm reduction services and activities in the future, Daath has several social, commercial, and legislative challenges to face. Starting with a need to realign its focus, outlooks for the upcoming operation of Daath are pondered. Future trends in harm reduction, such as separating harm-decreasing from benefit-increasing, are also discussed. We aim to share these innovative harm reduction measures and good practices in order to be critically assessed, and – if found useful – adapted and applied

  10. Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders

    Science.gov (United States)

    Kittirattanapaiboon, Phunnapa; Suttajit, Sirijit; Junsirimongkol, Boonsiri; Likhitsathian, Surinporn; Srisurapanont, Manit

    2014-01-01

    Background It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI), current suicidality (1 month prior to assessment), mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59%) and (meth)amphetamine (24%). Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537) had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81). While those who used illicit drugs alone (no mental/alcohol use disorder) (n=348) had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65), the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively) had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively). Conclusion A key limitation of this study was the combined suicidal behaviors as a suicidality risk. Mental or alcohol use disorders found in this population actually increased the suicide risk. These findings support the coexisting relationship that mental and alcohol use disorders play a vital role in increasing the suicide

  11. Someone to Count On: Homeless, Male Drug Users and Their Friendship Relations.

    Science.gov (United States)

    Sterk-Elifson, Claire; Elifson, Kirk W.

    1992-01-01

    A study exploring friendship relations of homeless, male drug users (aged between 21 and 50 years) through 27 in-depth interviews in Atlanta (Georgia) found that subjects were engaged in friendship networks that offered social support and that there was a relationship between friendships and patterns of crack cocaine use. (JB)

  12. Clinical and Molecular Epidemiology of Infective Endocarditis in Intravenous Drug Users

    Directory of Open Access Journals (Sweden)

    Pei-Jiuan Chao

    2009-12-01

    Conclusion: Our results suggest that coinfection with hepatitis C was common in intravenous drug users with IE, and that molecular patterns of MRSA isolates had high similarity. SCCmec type III, which is usually hospital-acquired, could have caused the community-associated MRSA endocarditis in our patients.

  13. An outbreak of hepatitis A among homeless drug users in Rotterdam, The Netherlands

    NARCIS (Netherlands)

    Tjon, G. M. S.; Götz, H.; Koek, A. G.; de Zwart, O.; Mertens, P. L. J. M.; Coutinho, R. A.; Bruisten, S. M.

    2005-01-01

    From the end of January to mid-June 2004 (weeks 5-24) a hepatitis A virus (HAV) outbreak occurred among a homeless and drug user community in Rotterdam, The Netherlands. To prevent further spread of the virus within this group and to the general population, the Municipal Health Service of Rotterdam

  14. Estimating the size of the HIV epidemic among injecting drug users in Amsterdam

    NARCIS (Netherlands)

    van Haastrecht, H. J.; Bindels, P. J.; van den Hoek, A. A.; Coutinho, R. A.

    1997-01-01

    Aim of this study was to assess the cumulative incidence of HIV-infection, AIDS and pre-AIDS death in the population of injecting drug users (IDU) in Amsterdam. By assuming equivalence, between a cohort of IDU and the IDU population, of the ratios of incidences of AIDS and pre-AIDS death to the

  15. Adaptation and Validation of the Sexual Assertiveness Scale (SAS) in a Sample of Male Drug Users.

    Science.gov (United States)

    Vallejo-Medina, Pablo; Sierra, Juan Carlos

    2015-04-21

    The aim of the present study was to adapt and validate the Sexual Assertiveness Scale (SAS) in a sample of male drug users. A sample of 326 male drug users and 322 non-clinical males was selected by cluster sampling and convenience sampling, respectively. Results showed that the scale had good psychometric properties and adequate internal consistency reliability (Initiation = .66, Refusal = .74 and STD-P = .79). An evaluation of the invariance showed strong factor equivalence between both samples. A high and moderate effect of Differential Item Functioning was only found in items 1 and 14 (∆R 2 Nagelkerke = .076 and .037, respectively). We strongly recommend not using item 1 if the goal is to compare the scores of both groups, otherwise the comparison will be biased. Correlations obtained between the CSFQ-14 and the safe sex ratio and the SAS subscales were significant (CI = 95%) and indicated good concurrent validity. Scores of male drug users were similar to those of non-clinical males. Therefore, the adaptation of the SAS to drug users provides enough guarantees for reliable and valid use in both clinical practice and research, although care should be taken with item 1.

  16. Continuing injecting risk behaviour: results from the Amsterdam Cohort Study of drug users

    NARCIS (Netherlands)

    van Ameijden, E. J.; Langendam, M. W.; Notenboom, J.; Coutinho, R. A.

    1999-01-01

    To give a detailed description of injection-related risk behaviours, and to estimate the relative importance of these behaviours with regard to HIV transmission. The present study was part of the Amsterdam Cohort Study of drug users. In Amsterdam, a city with extensive preventive measures, large

  17. Treatment of early AIDS dementia in intravenous drug users : High versus low dose peptide T

    NARCIS (Netherlands)

    Kosten, TR; Rosen, MI; McMahon, TL; Bridge, TP; OMalley, SS; Pearsall, R; OConnor, PG

    1997-01-01

    This placebo-controlled, double blind, cross-over study tested the efficacy of two different doses of Peptide T in the treatment of nine intravenous drug users with early AIDS dementia who were also receiving methadone and AZT. Subjects received Peptide T doses of either 15 or 1.5 mg daily for four

  18. Frequent HCV reinfection and superinfection in a cohort of injecting drug users in Amsterdam

    NARCIS (Netherlands)

    van de Laar, Thijs J. W.; Molenkamp, Richard; van den Berg, Charlotte; Schinkel, Janke; Beld, Marcel G. H. M.; Prins, Maria; Coutinho, Roel A.; Bruisten, Sylvia M.

    2009-01-01

    Background/Aims:This study investigates the occurrence of HCV reinfection and superinfection among HCV seroconverters participating in the Amsterdam Cohort Studies among drug users from 1985 through 2005. Methods: HCV seroconverters (n = 59) were tested for HCV RNA at five different time points: the

  19. 78 FR 46955 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

    Science.gov (United States)

    2013-08-02

    ....gov payment option is available to you after you submit a cover sheet. Click the ``Pay Now'' button... Identification Number (PIN), beginning with the letters AD, from the upper right-hand corner of your completed Animal Drug User Fee Cover Sheet. Also write the FDA post office box number (P.O. Box 953877) on the...

  20. Social psychological determinants of the use of performance-enhancing drugs by gym users

    NARCIS (Netherlands)

    Wiefferink, C.H.; Detmar, S.B.; Coumans, B.; Vogels, T.; Paulussen, T.G.W.

    2008-01-01

    The aim of this study is to identify the social psychological determinants of the use of performance-enhancing drugs by gym users who practice bodybuilding, fitness, powerlifting or combat sports. In this questionnaire-based study, 144 respondents answered questions on their actual use and intention

  1. Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.

    Science.gov (United States)

    Brown, Ronni E; Morisky, Donald E; Silverstein, Steven J

    2013-06-01

    Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.

  2. Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders.

    Science.gov (United States)

    Ostovar, Afshin; Haerinejad, Mohammad Javad; Akbarzadeh, Samad; Keshavarz, Mojtaba

    2017-10-01

    Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported. Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants' information, including demographic characteristics, sports' status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests. Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders. Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders.

  3. Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders

    Directory of Open Access Journals (Sweden)

    Afshin Ostovar

    2017-10-01

    Full Text Available Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported.Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants’ information, including demographic characteristics, sports’ status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests.Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders.Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders.

  4. High risk behavior for HIV transmission among former injecting drug users:a survey from Indonesia

    Directory of Open Access Journals (Sweden)

    Iskandar Shelly

    2010-08-01

    Full Text Available Abstract Background Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use. Methods Current and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test. Results Ninety-two out of 210 participants (44% were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66% and current (60% IDUs. Conclusion Former IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.

  5. A success story: HIV prevention for injection drug users in Rhode Island

    Directory of Open Access Journals (Sweden)

    Zaller Nickolas

    2006-12-01

    Full Text Available Abstract Background New HIV diagnoses related to injection drug use (IDU have declined in the United States. Access to clean syringes and decreasing HIV transmission among injection drug users have been HIV prevention priorities of the Rhode Island (RI HIV community. To examine trends in IDU-related new HIV diagnoses in RI, we performed a retrospective analysis of new HIV diagnoses according to HIV risk factor from 1990–2003. Results There has been an 80% absolute reduction in IDU-related new HIV diagnoses in RI coincident with IDU-specific prevention efforts. Conclusion There has been a greater decline in IDU-related new HIV diagnoses in Rhode Island compared to national data reported by the Centers for Disease Control and Prevention. We hypothesize that this dramatic decline in Rhode Island is related to extensive HIV prevention efforts targeting IDUs. Further research is needed to examine the impact of specific HIV prevention interventions for injection drug users.

  6. MONITORING POTENTIAL DRUG INTERACTIONS AND REACTIONS VIA NETWORK ANALYSIS OF INSTAGRAM USER TIMELINES

    Science.gov (United States)

    CORREIA, RION BRATTIG; LI, LANG; ROCHA, LUIS M.

    2015-01-01

    Much recent research aims to identify evidence for Drug-Drug Interactions (DDI) and Adverse Drug reactions (ADR) from the biomedical scientific literature. In addition to this “Bibliome”, the universe of social media provides a very promising source of large-scale data that can help identify DDI and ADR in ways that have not been hitherto possible. Given the large number of users, analysis of social media data may be useful to identify under-reported, population-level pathology associated with DDI, thus further contributing to improvements in population health. Moreover, tapping into this data allows us to infer drug interactions with natural products—including cannabis—which constitute an array of DDI very poorly explored by biomedical research thus far. Our goal is to determine the potential of Instagram for public health monitoring and surveillance for DDI, ADR, and behavioral pathology at large. Most social media analysis focuses on Twitter and Facebook, but Instagram is an increasingly important platform, especially among teens, with unrestricted access of public posts, high availability of posts with geolocation coordinates, and images to supplement textual analysis. Using drug, symptom, and natural product dictionaries for identification of the various types of DDI and ADR evidence, we have collected close to 7000 user timelines spanning from October 2010 to June 2015. We report on 1) the development of a monitoring tool to easily observe user-level timelines associated with drug and symptom terms of interest, and 2) population-level behavior via the analysis of co-occurrence networks computed from user timelines at three different scales: monthly, weekly, and daily occurrences. Analysis of these networks further reveals 3) drug and symptom direct and indirect associations with greater support in user timelines, as well as 4) clusters of symptoms and drugs revealed by the collective behavior of the observed population. This demonstrates that

  7. MONITORING POTENTIAL DRUG INTERACTIONS AND REACTIONS VIA NETWORK ANALYSIS OF INSTAGRAM USER TIMELINES.

    Science.gov (United States)

    Correia, Rion Brattig; Li, Lang; Rocha, Luis M

    2016-01-01

    Much recent research aims to identify evidence for Drug-Drug Interactions (DDI) and Adverse Drug reactions (ADR) from the biomedical scientific literature. In addition to this "Bibliome", the universe of social media provides a very promising source of large-scale data that can help identify DDI and ADR in ways that have not been hitherto possible. Given the large number of users, analysis of social media data may be useful to identify under-reported, population-level pathology associated with DDI, thus further contributing to improvements in population health. Moreover, tapping into this data allows us to infer drug interactions with natural products-including cannabis-which constitute an array of DDI very poorly explored by biomedical research thus far. Our goal is to determine the potential of Instagram for public health monitoring and surveillance for DDI, ADR, and behavioral pathology at large. Most social media analysis focuses on Twitter and Facebook, but Instagram is an increasingly important platform, especially among teens, with unrestricted access of public posts, high availability of posts with geolocation coordinates, and images to supplement textual analysis. Using drug, symptom, and natural product dictionaries for identification of the various types of DDI and ADR evidence, we have collected close to 7000 user timelines spanning from October 2010 to June 2015.We report on 1) the development of a monitoring tool to easily observe user-level timelines associated with drug and symptom terms of interest, and 2) population-level behavior via the analysis of co-occurrence networks computed from user timelines at three different scales: monthly, weekly, and daily occurrences. Analysis of these networks further reveals 3) drug and symptom direct and indirect associations with greater support in user timelines, as well as 4) clusters of symptoms and drugs revealed by the collective behavior of the observed population. This demonstrates that Instagram

  8. Female spouses of injection drug users in Pakistan: a bridge population of the HIV epidemic?

    Science.gov (United States)

    Ahmad, S; Mehmood, J; Awan, A B; Zafar, S T; Khoshnood, K; Khan, A A

    2011-04-01

    An estimated 21% of injection drug users (IDUs) in Pakistan are HIV-positive and data suggest that the spouses of IDUs may be a critical component of the HIV transmission chain. This study interviewed 101 spouses of male IDUs about their sexual practices and drug use. We found that 43% had been sexually active with their partners in the past month but only 4% reported selling sex. Almost a quarter (23%) used drugs and 19% injected drugs, usually a combination of diazepam and pheniramine. Although sex work was infrequent among spouses of IDUs, their risk of contracting HIV and transmitting it to others was high because they received injection drugs, sometimes along with their IDU husbands, from the same health centres that provided therapeutic injections to the rest of the community. IDU spouses may thus serve as a bridge group via therapeutic injections, rather than via sex work.

  9. The importance of social networks in their association to drug equipment sharing among injection drug users: a review.

    Science.gov (United States)

    De, Prithwish; Cox, Joseph; Boivin, Jean-François; Platt, Robert W; Jolly, Ann M

    2007-11-01

    To examine the scientific evidence regarding the association between characteristics of social networks of injection drug users (IDUs) and the sharing of drug injection equipment. A search was performed on MEDLINE, EMBASE, BIOSIS, Current Contents, PsycINFO databases and other sources to identify published studies on social networks of IDUs. Papers were selected based on their examination of social network factors in relation to the sharing of syringes and drug preparation equipment (e.g. containers, filters, water). Additional relevant papers were found from the reference list of identified articles. Network correlates of drug equipment sharing are multi-factorial and include structural factors (network size, density, position, turnover), compositional factors (network member characteristics, role and quality of relationships with members) and behavioural factors (injecting norms, patterns of drug use, severity of drug addiction). Factors appear to be related differentially to equipment sharing. Social network characteristics are associated with drug injection risk behaviours and should be considered alongside personal risk behaviours in prevention programmes. Recommendations for future research into the social networks of IDUs are proposed.

  10. The Role of Drinking Severity on Sex Risk Behavior and HIV Exposure among Illicit Drug Users

    Science.gov (United States)

    Scherer, Michael; Trenz, Rebecca; Harrell, Paul; Mauro, Pia; Latimer, William

    2015-01-01

    Objectives The current study examined how drinking severity among injection and non-injection drug users is associated with sex risk behaviors and risk of HIV exposure. Methods The study is a secondary analysis of an investigation of risk factors among drug users in Baltimore known as the NEURO-HIV Epidemiologic Study. Participants (N = 557) completed an interview, self-reported 30-day alcohol use, lifetime injection and non-injection drug use, and provided blood samples to screen for HIV. Participants were grouped into one of three drinking severity conditions: Abstinent (no reported alcohol use in prior 30-days), Moderate Alcohol Use (≤30 drinks for females, or ≤ 60 drinks for males), or Problematic Alcohol Use (>30 drinks for females, or >60 drinks for males). Drinking severity groups were significantly different on lifetime injection drug use, heroin injection, snorting/sniffing cocaine, and smoking crack. Results Logistic regression analyses found problematic alcohol users to be more likely than alcohol abstainers to inject drugs before or during sex (AOR = 5.78; 95% CI = 2.07-16.10), and more likely than moderate alcohol users to use alcohol before/during sex (AOR = 4.96; 95% CI = 2.09-11.81), inject drugs before/during sex (AOR = 2.96; 95% CI = 1.29-6.80) and to be HIV+ among Black participants (AOR = 2.72; 95% CI = 1.14-6.49). Conclusions These results outline the necessity for research and clinical intervention among this population to reduce sex risk behaviors and potential HIV exposure, while highlighting the need to examine drinking severity as a predictor of sex risk behaviors. PMID:23617865

  11. Differences in sociodemographic, drug use and health characteristics between never, former and current injecting, problematic hard-drug users in the Netherlands

    NARCIS (Netherlands)

    Havinga, Petra; van der Velden, Claudia; de Gee, Anouk; van der Poel, Agnes; Yin, Huifang

    2014-01-01

    Background: Injecting drug users are at increased risk for harmful effects compared to non-injecting drug users. Some studies have focused on differences in characteristics between these two groups (e. g., housing, overall health). However, no study has investigated the specific Dutch situation

  12. [Users' perception of a harm reduction program in an outpatient drug dependency treatment center].

    Science.gov (United States)

    Daigre, Constanza; Comín, Marina; Rodríguez-Cintas, Laia; Voltes, Nuria; Alvarez, Alba; Roncero, Carlos; Gonzalvo, Begoña; Casas, Miguel

    2010-01-01

    We analyzed the perspective of users enrolled in a harm reduction program that provides syringe exchange, an educational room for «warmth and coffee», a methadone maintenance program, a room for supervised drug consumption, a place for personal hygiene, and medical and psychosocial follow-up. The particularity of this program lies in its integration within an outpatient drug treatment center forming part of a general hospital. We performed a descriptive study using qualitative methods. Theoretical sampling was conducted. Twelve in-depth interviews and one focus group composed of eight users were carried out. Information analysis was based on grounded theory. Literal transcriptions were coded and subsequently sorted into broad categories. Three researchers participated in this process and finally a fourth researcher triangulated the results. Five dimensions were identified in the users' discourse: accessibility, service, relationship, localization, and identity. Each consisted of several topics that were evaluated based on the participants' experiences and expectations. The dimension of identity emerged as a distinctive element in patient-program bonding. The users' overall evaluation of the program was positive. Facilitators and barriers influencing patient-program bonding were identified and participants suggested ways to remove barriers. The coexistence among users of the harm reduction program and patients treated conventionally provoked ambivalence but the team's management was deemed helpful in easing the difficulties arising from this situation. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. Increased risk for hepatitis C associated with solvent use among Canadian Aboriginal injection drug users

    Directory of Open Access Journals (Sweden)

    Jolly Ann M

    2010-07-01

    Full Text Available Abstract Background Solvent abuse is a particularly serious issue affecting Aboriginal people. Here we examine the association between solvent use and socio-demographic variables, drug-related risk factors, and pathogen prevalence in Aboriginal injection drug users (IDU in Manitoba, Canada. Methods Data originated from a cross-sectional survey of IDU from December 2003 to September 2004. Associations between solvent use and variables of interest were assessed by multiple logistic regression. Results A total of 266 Aboriginal IDU were included in the analysis of which 44 self-reported recent solvent use. Hepatitis C infection was 81% in solvent-users, compared to 55% in those reporting no solvent use. In multivariable models, solvent-users were younger and more likely to be infected with hepatitis C (AOR: 3.5; 95%CI: 1.3,14.7, to have shared needles in the last six months (AOR: 2.6; 95%CI:1.0,6.8, and to have injected talwin & Ritalin (AOR: 10.0; 95%CI: 3.8,26.3. Interpretation High hepatitis C prevalence, even after controlling for risky injection practices, suggests that solvent users may form closed networks of higher risk even amongst an already high-risk IDU population. Understanding the social-epidemiological context of initiation and maintenance of solvent use is necessary to address the inherent inequalities encountered by this subpopulation of substance users, and may inform prevention strategies for other marginalized populations.

  14. Analysis of the functioning of a therapeutic comunity for drug users

    Directory of Open Access Journals (Sweden)

    Mariane Capellato Melo

    2016-11-01

    Full Text Available Prolonged hospitalization of drug users in Therapeutic Communities (TC has become a public policy in Brazil. The aim of this study was to understand and analyze the functioning of a TC, considering the activities carried out there, the relationships established and the intervention process. Five visits to a TC were carried out. These visits were registered in a field diary. The notes were analyzed seeking to understand discursive features of the functioning of the TC and the impact of its functioning on the subjectivity of the users. The activities were labor therapy and group activities, and the Christian religious believes were explored. Relations were hierarchical, using strategies of control, confrontation and construction of guilt. Activities positioned the users as impulsive, addicts and deviants. The influence of the limited access to consumer goods and citizenship rights in the life trajectories of the users were not taken into consideration. Their problems with drugs were treated only as something internal, creating only strategies towards reconstructing the user's identity.

  15. 77 FR 20825 - Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for...

    Science.gov (United States)

    2012-04-06

    ...] Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information... Administration (FDA) is announcing the availability of the guidance entitled ``Guidance for Industry and Food and... ``Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information...

  16. Prevalence and correlates of psychological distress among drug users in Phnom Penh, Cambodia.

    Science.gov (United States)

    Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Choub, Sok Chamreun; Mburu, Gitau

    2016-10-01

    Compared to the general population, drug users are at increased risk of both poor mental health and HIV infection. The aim of this study was to determine the prevalence and correlates of high psychological distress among drug users in Cambodia. In April 2014, a two-stage cluster sampling method was used to randomly select 169 drug users from hotspots in Phnom Penh. Psychological distress was measured using General Health Questionnaire (GHQ-12). Bivariate and multivariable analyses were conducted to identify factors associated with levels of psychological distress among this population. Our study found high prevalence of attempted suicide (15.3%), drug related arrests (46.2%), and incarceration (31.4%). Of the 169 participants, 42.0% were found to have high levels of psychological distress, indicating poor mental health. After adjustment, high levels of psychological distress were independently associated with suicidal ideation (pCambodia. Health system interventions, such as screening, referral, and training of health providers, need to be strengthened. In addition, interventions addressing social determinants of mental health and mitigation of frequent arrests and improving conditions in rehabilitation centres are required. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Association of pulmonary histopathological findings with toxicological findings in forensic autopsies of illicit drug users

    Directory of Open Access Journals (Sweden)

    Todorović Miloš S.

    2011-01-01

    Full Text Available Background/Aim. Drug abuse remains a significant social problem in many countries. The aim of the study was to estimate association between pulmonary histopathological changes and results of toxicological analyses in forensic autopsies of illicit drug users. Methods. This investigation was performed in the Institute of Forensic Medicine, Belgrade, and in the Clinical Center, Department of Forensic Medicine, Kragujevac, from 2000 to 2004, and included 63 medicolegal autopsies of heroin or other drug consumers who suddenly died. Autopsies, postmortem toxicological examination of drugs and serological analyses of anti- HIV/HBV/HCV antibodies were performed. Results. The deceased persons were mostly male, 46/63 (73.01%, ranged in age from 19 to 49 years (mean 31 years and all were whites. Postmortem toxicological examination was performed on all of the deceased persons and drugs in the fatal range were identified in only eight of them (12.7%, in the toxic range in ten (15.87%, and in minimal concentrations in 35 (55.56% of the deceased persons. Drugs identified in the fatal, toxic or minimal range included heroin-morphine (38/53, cocaine (4/53, tramadol (3/53, and lorazepam (1/53. In the 7 remaining subjects, ethanol in combination with heroin was found in 4 cases, and diazepam in combination with heroin in 3 cases. Dominant pathomorphological changes were findings in the lung tissue. Most common histological changes observed in drug users were pulmonary edema - 55/63 (87.3%, acute alveolar hemorrhages - 49/63 (77.78%, hemosiderin-laden macrophages (siderophages - 52/63 (82,54%, and emphysematous changes - 51/63 (80,95%. Conclusion. Pulmonary edema is the frequent non-specific autopsy finding which is associated with virtually all routes of drug administration. The histopatological study is necessary to determinate a cause of death when a deceased person has the history of dependence or abouse of psychoactive drugs with negative toxicological

  18. Factors Related to Abstinence from Drug Use and Seeking Help from Medical Services in Taiwanese Heroin and Methamphetamine Users

    Directory of Open Access Journals (Sweden)

    Chia-Nan Yen

    2008-02-01

    Full Text Available The aim of this study was to examine the factors related to abstinence from heroin and methamphetamine (MAMP use and to seeking help from medical services in Taiwanese drug users. Atotal of 196 heroin users and 226 MAMP users were recruited in this study. Their experience of previous abstinence from drug use and the routes taken to seek help for abstinence were determined at interview. Demographic data, characteristics of drug use and reasons to abstain from drug use were compared between subjects who had and those who had never tried to abstain from drug use before, as well as between the subjects who had previously sought help from medical services and those who had tried to abstain from drug use by themselves. Those who had previously tried to abstain from heroin use had longer durations of heroin use, spent more money on getting heroin, were more likely to have a criminal record of illicit drug use and had longer durations of being detained due to illicit drug use compared with those who had never tried to abstain from heroin use. Those who had sought help from medical services for abstinence were more likely to be heroin users and to spend more money on getting illicit drugs, and tried to abstain due to concerns about relationships with family. Demographic data, characteristics of drug use and reasons to abstain from drug use were different between drug users who had different experiences of abstinence.

  19. Natal status of infants of cocaine users and control subjects: a prospective comparison.

    Science.gov (United States)

    Hurt, H; Brodsky, N L; Braitman, L E; Giannetta, J

    1995-01-01

    Cocaine use by pregnant women has increased dramatically in recent years. To assess the effect of maternal cocaine use on infant outcome, we enrolled 224 women (105 cocaine users, 119 control subjects) and their infants (all of 34 weeks or more gestational age and nonasphyxiated) in a prospective, blinded study. Results showed that infants exposed to cocaine were more likely to be admitted to the newborn intensive care unit, be treated for congenital syphilis, have a greater length of stay, and be discharged to a person other than the mother (all p 0.80). Infants of cocaine-using mothers and control subjects had a similar incidence of abnormal cranial and renal ultrasonographic findings and abnormal pneumocardiograms (all p > or = 0.32). We conclude that in this cohort of nonasphyxiated infants of 34 weeks or more gestational age, infants exposed to cocaine had more medical and social problems than control infants but did not differ statistically in the incidence of severe growth retardation, abnormal cranial or renal ultrasonographic findings, or abnormal pneumocardiograms. We suggest that natal interventions for the nonasphyxiated term and near-term infant exposed to cocaine should include a careful history and physical examination, follow-up plans, and social service involvement.

  20. Relationship between hunger, adherence to antiretroviral therapy and plasma HIV RNA suppression among HIV-positive illicit drug users in a Canadian setting.

    Science.gov (United States)

    Anema, Aranka; Kerr, Thomas; Milloy, M-J; Feng, Cindy; Montaner, Julio S G; Wood, Evan

    2014-04-01

    Food insecurity may be a barrier to achieving optimal HIV treatment-related outcomes among illicit drug users. This study therefore, aimed to assess the impact of severe food insecurity, or hunger, on plasma HIV RNA suppression among illicit drug users receiving antiretroviral therapy (ART). A cross-sectional Multivariate logistic regression model was used to assess the potential relationship between hunger and plasma HIV RNA suppression. A sample of n = 406 adults was derived from a community-recruited open prospective cohort of HIV-positive illicit drug users, in Vancouver, British Columbia (BC), Canada. A total of 235 (63.7%) reported "being hungry and unable to afford enough food," and 241 (59.4%) had plasma HIV RNA hunger was associated with lower odds of plasma HIV RNA suppression (Odds Ratio = 0.59, 95% confidence interval [CI]: 0.39-0.90, p = 0.015). In multivariate analyses, this association was no longer significant after controlling for socio-demographic, behavioral, and clinical characteristics, including 95% adherence (Adjusted Odds Ratio [AOR] = 0.65, 95% CI: 0.37-1.10, p = 0.105). Multivariate models stratified by 95% adherence found that the direction and magnitude of this association was not significantly altered by the adherence level. Hunger was common among illicit drug users in this setting. Although, there was an association between hunger and lower likelihood of plasma HIV RNA suppression, this did not persist in adjusted analyses. Further research is warranted to understand the social-structural, policy, and physical factors shaping the HIV outcomes of illicit drug users.

  1. Alcohol screening and brief intervention among drug users in primary care: a discussion paper.

    LENUS (Irish Health Repository)

    Field, C A

    2011-08-24

    BACKGROUND: Problem alcohol use is common among problem drug users (PDU) and associated with adverse health outcomes. Primary care has an important role in the overall stepped approach to alcohol treatment, especially screening and brief intervention (SBI). AIM: To discuss three themes that emerged from an exploration of the literature on SBI for problem alcohol use in drug users attending primary care. METHODS: Material for this discussion paper was gathered from three biomedical databases (PubMed, PsycINFO and Cochrane library), conference proceedings and online resources of professional organisations or national health agencies. RESULTS: Themes discussed in this paper are: (a) the potential of primary care for delivery of alcohol SBIs to PDUs, (b) screening methods and (c) application of brief interventions to PDUs. CONCLUSIONS: Although SBI improves health outcomes associated with problem alcohol use in the general population, further research is needed among high-risk patient groups, especially PDUs.

  2. Towards an Explanation of Subjective Ketamine Experiences among Young Injection Drug Users

    Science.gov (United States)

    LANKENAU, STEPHEN E.; SANDERS, BILL; BLOOM, JENNIFER JACKSON; HATHAZI, DODI

    2008-01-01

    Ketamine is a dissociative anesthetic with powerful sedative and hallucinogenic properties. Despite the wide variability in reported subjective experiences, no study has attempted to describe the particular factors that shape these experiences. This manuscript is based upon a sample of 213 young injection drug users recruited in New York, New Orleans, and Los Angeles with histories of ketamine use. Qualitative interviews focused on specific ketamine events, such as first injection of ketamine, most recent injection of ketamine, and most recent experience sniffing ketamine. Findings indicate that six factors impacted both positive and negative ketamine experiences: polydrug use, drug using history, mode of administration, quantity and quality of ketamine, user group, and setting. Most subjective experiences during any given ketamine event were shaped by a combination of these factors. Additionally, subjective ketamine experiences were particularly influenced by a lifestyle characterized by homelessness and traveling. PMID:18941540

  3. Transmission dynamics for Methicilin-resistant Staphalococous areus with injection drug user.

    Science.gov (United States)

    Wagner, Rebekah; Agusto, Folashade B

    2018-02-07

    Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial pathogen resistance to antibiotics including methicillin. The resistance first emerged in 1960 in a healthcare setting only after two years of using methicillin as a viable treatment for methicillin-susceptible Staphylococcus aureus. MRSA leads to infections in different parts of the body including the skin, bloodstream, lungs, or the urinary tract. A deterministic model for methicillin-resistant Staphylococcus aureus (MRSA) with injection drug users is designed. The model incorporates transmission of MRSA among non-injection drug users and injection drug users (IDUs) who are both low-and high-risk users. A reduced MRSA transmission model with only non-IDUs is fitted to a 2008-2013 MRSA data from the Agency for Healthcare and Research and Quality (AHRQ). The parameter estimates obtained are projected onto the parameters for the low-and high-risk IDUs subgroups using risk factors obtained by constructing a risk assessment ethogram. Sensitivity analysis is carried out to determine parameters with the greatest impact on the reproduction number using the reduced non-IDUs model. Change in risk associated behaviors was studied using the full MRSA transmission model via the increase in risky behaviors and enrollment into rehabilitation programs or clean needle exchange programs. Three control effectiveness levels determined from the sensitivity analysis were used to study control of disease translation within the subgroups. The sensitivity analysis indicates that the transmission probability and recovery rates within the subgroup have the highest impact on the reproduction number of the reduced non-IDU model. Change in risk associated behaviors from non-IDUs to low-and high-risk IDUs lead to more MRSA cases among the subgroups. However, when more IDUs enroll into rehabilitation programs or clean needle exchange programs, there was a reduction in the number of MRSA cases in the community. Furthermore, MRSA

  4. Premature death as the ultimate failure: predictors of death in the US drug user treatment population.

    Science.gov (United States)

    Schildhaus, Sam; Dugoni, Bernard

    2012-01-01

    Premature death is the ultimate failure in public health. Failure to complete substance user treatment increases the likelihood of death. Using the five-year follow-up (1990/91-1995/96) of a representative sample of 3,047 clients discharged from drug user treatment, this article documents that deaths after treatment were 4.7 times higher for substance user treatment clients than for the U.S. population matched by age, sex, and race; death rates ranged from 3.5 times as likely for Black males to nine times as likely for White females. Logistic regression models show that completion of treatment is associated with a three-fifths decreased likelihood of death.

  5. Drugs, sex and AIDS: Sexual relationships among injecting drug users and their sexual partners in Vietnam

    NARCIS (Netherlands)

    Nguyen, L.T.

    2008-01-01

    HIV transmission in Vietnam is strongly linked to drug injection, but there is the potential for an epidemic driven by sexual behaviour. HIV‐education programmes to date focus largely on personal responsibility and fail to address adequately other aspects of HIV‐related risks in social contexts.

  6. Self-reports of consumption of amphetamines, cocaine and heroin in a survey among marginalized drug users

    OpenAIRE

    Amundsen, Ellen Johanna; Reid, Malcolm James

    2014-01-01

    - Scientific literature offers few measurements of the quantities consumed by individual drug users. Such measurements are used for calculating the total drug consumption by the quantity-frequency method, and are extremely important for the comparison with waste water derived consumption estimates. The aim of this study was to measure quantities of amphetamines, cocaine and heroin consumed by marginalized drug users, using a multi-city questionnaire survey design. Variation by gender, age,...

  7. Directly administered antiretroviral therapy for HIV-infected drug users does not have an impact on antiretroviral resistance: results from a randomized controlled trial.

    Science.gov (United States)

    Maru, Duncan Smith-Rohrberg; Kozal, Michael J; Bruce, R Douglas; Springer, Sandra A; Altice, Frederick L

    2007-12-15

    Directly administered antiretroviral therapy (DAART) is an effective intervention that improves clinical outcomes among HIV-infected drug users. Its effects on antiretroviral drug resistance, however, are unknown. We conducted a community-based, prospective, randomized controlled trial of DAART compared with self-administered therapy (SAT). We performed a modified intention-to-treat analysis among 115 subjects who provided serum samples for HIV genotypic resistance testing at baseline and at follow-up. The main outcomes measures included total genotypic sensitivity score, future drug options, number of new drug resistance mutations (DRMs), and number of new major International AIDS Society (IAS) mutations. The adjusted probability of developing at least 1 new DRM did not differ between the 2 arms (SAT: 0.41 per person-year [PPY], DAART: 0.49 PPY; adjusted relative risk [RR] = 1.04; P = 0.90), nor did the number of new mutations (SAT: 0.76 PPY, DAART: 0.83 PPY; adjusted RR = 0.99; P = 0.99) or the probability of developing new major IAS new drug mutations (SAT: 0.30 PPY, DAART: 0.33 PPY; adjusted RR = 1.12; P = 0.78). On measures of GSS and FDO, the 2 arms also did not differ. In this trial, DAART provided on-treatment virologic benefit for HIV-infected drug users without affecting the rate of development of antiretroviral medication resistance.

  8. Homeless drug users and information technology: a qualitative study with potential implications for recovery from drug dependence.

    Science.gov (United States)

    Neale, Joanne; Stevenson, Caral

    2014-09-01

    Having access to information and communication technologies (ICTs) is a prerequisite to meaningful participation in society. This paper seeks to: i. explore the engagement of homeless drug users (HDUs) with ICTs and ii. discuss the findings with reference to recovery from drug dependence. The study design was qualitative and longitudinal, involving data collected in 2012-13 via 52 semi-structured interviews with 30 homeless drug users (25 men; five women). Participants were recruited from 17 hostels in two English cities. Interview data were analyzed using Framework. HDUs had access to ICTs, used ICTs, and wanted to engage with them more. Experiences of digital exclusion were a function of participants' inability to afford ICTs, the relatively cheap and poor quality technology available to them, limited knowledge about ICTs, and lack of support in using them. That HDUs were often unable to take full advantage of technology because they had nobody to explain what their devices could do or to show them how they worked was ironic given that using ICTs to (re)establish and maintain relationships were functions of technology that HDUs particularly liked. The physical, human, cultural, and social capital of HDUs influenced their access to, and use of, ICTs. Equally, ICTs were themselves an important recovery resource. Services and others should endeavor to provide HDUs with easy access to good quality technology, as well as offers of support and education so that all individuals have the knowledge and confidence to make optimum use of the technology that is available to them.

  9. Impact of mobile radiographic screening on tuberculosis among drug users and homeless persons.

    Science.gov (United States)

    de Vries, Gerard; van Hest, Rob A H; Richardus, Jan H

    2007-07-15

    In 2002, a mobile radiographic screening program was started in Rotterdam to respond to high rates of tuberculosis (TB) among illicit drug users and homeless persons. We studied trends and characteristics of TB among these risk groups and assessed the impact of the screening program on transmission, using molecular typing. Description of trends, and of demographic and disease-related characteristics of tuberculosis cases among these risk groups between 1993 and 2005. TB was considered to result from recent transmission if the mycobacterial DNA fingerprints of cases were identical to those of other cases in the risk groups in the previous 2 years. During the study period, 206 individuals with TB among illicit drug users and homeless persons were notified, representing 11.4% of the total case load of 1,811 in Rotterdam. The annual number of tuberculosis cases declined from 24 at the start of the screening program to 11 cases in 2005. The screening program identified 28 cases (a prevalence rate of 327 per 100,000 radiographs), of which 12 were smear positive. In 1997-2002, more than 80% of the illicit drug users or homeless persons with TB were infected with one of the Mycobacterium tuberculosis strains prevalent among these risk groups. After nearly 4 years of systematic radiographic screening this proportion declined to 45% in 2005. DNA fingerprinting can be a useful tool to evaluate the impact of a TB screening program. We advocate that screening of illicit drug users and homeless persons should be continued to prevent a resurgence of TB.

  10. Human papillomavirus awareness among HIV-infected drug users in two urban areas.

    Science.gov (United States)

    Rosa-Cunha, Isabella; Hooton, Thomas M; Cardenas, Gabriel A; Del Rio, Carlos; Bonney, Loida E; Pereyra, Margaret; Metsch, Lisa R

    2014-12-01

    Human papillomavirus (HPV) is the cause of cervical and anal cancer. Human immunodeficiency virus (HIV) infection and cocaine use are associated with increased risk for HPV infection and associated diseases, but little is known about HIV-infected drug users' awareness of HPV. We investigate HPV awareness among HIV-infected, sexually-active crack cocaine users from two inner-city hospitals in Florida and Georgia during their inpatient stays. Multivariate logistic regression analysis was used to examine potential correlates of HPV awareness. We interviewed 215 participants (110 women; 105 men) about their awareness of HPV infection. Overall, only 25% of respondents reported having heard of HPV. The odds of having heard of HPV were greater for respondents having a high-school degree or higher, having ever gone to an HIV provider for HIV care, and having two or more sexual partners. Despite increased susceptibility to HPV infection and HPV-related cancers, our study findings suggest that sexually-active HIV-infected crack cocaine users have little awareness of HPV and highlight the need for programmes targeting HPV education for HIV-infected crack cocaine drug users. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. [Drug users' quality of life, self-esteem and self-image].

    Science.gov (United States)

    Silveira, Camila da; Meyer, Carolina; Souza, Gabriel Renaldo de; Ramos, Manoella de Oliveira; Souza, Melissa de Carvalho; Monte, Fernanda Guidarini; Guimarães, Adriana Coutinho de Azevedo; Parcias, Sílvia Rosane

    2013-07-01

    This cross-sectional study aimed to investigate the quality of life, self-esteem and self-image among drug users of São José Institute in São José in the State of Santa Catarina. The accessibility sample was comprised of 100 male patients with a mean age of 43.0 ± 10.7, who had studied for a mean period of 8.4 ± 3.7 years. 48% of them were married and had been hospitalized or treated for a minimum period of seven days. When the participants were not hospitalized they lived with wives and children (23%), were married (48%), employed (72%), were part of income level B (58%), had done something they regret in their lives (57%) and perceived their health as good (57%). Regarding quality of life, the highest scores were found in the environmental domain (65%) and the lowest scores were in the psychological domain (58%). All patients were taking medication and had low self-esteem and self-image (77% and 96% respectively). The absence of interference of the quality of life on self-esteem and self-image of the drug users was observed by means of logistic regression. Positive quality of life did not interfere in changes in low self-esteem and self-image of drug users.

  12. Amount of self-reported illicit drug use compared to quantitative hair test results in community-recruited young drug users in Amsterdam

    NARCIS (Netherlands)

    Welp, Esther A. E.; Bosman, Ingrid; Langendam, Miranda W.; Totté, Maja; Maes, Robert A. A.; van Ameijden, Erik J. C.

    2003-01-01

    To assess the dose-effect relationship between self-reported drug intake and the concentration of drugs and/or their metabolites in hair and to examine factors that may mediate this relationship. A cohort study among young drug users (YDU) in Amsterdam, the Netherlands, which began in July 2000. At

  13. Drug policing assemblages: Repressive drug policies and the zonal banning of drug users in Denmark's club land.

    Science.gov (United States)

    Søgaard, Thomas F; Houborg, Esben; Pedersen, Michael M

    2017-03-01

    Zonal banning of disorderly and intoxicated young people has moved to centre stage in debates about nightlife governance. Whereas existing research has primarily focused on the use of zonal banning orders to address problems of alcohol-related harm and disorder, this article highlights how zonal banning is also used to target drug-using clubbers in Denmark. Based on ethnographic observations and interviews with nightlife control agents in two Danish cities, the article aims to provide new insights into how the enforcement of national drug policies on drug-using clubbers, is shaped by plural nightlife policing complexes. The paper demonstrates how the policing of drug-using clubbers is a growing priority for both police and private security agents. The article also demonstrates how the enforcement of zonal bans on drug-using clubbers involves complex collaborative relations between police, venue owners and private security agents. The paper argues that a third-party policing perspective combined with assemblage theory is useful for highlighting how the enforcement of national drug policies and nightlife banning systems is shaped by their embeddedness in local 'drug policing assemblages' characterized by inter-agency relation-building, the creative combination of public and private (legal) resources and internal power struggles. It also provides evidence of how drug policing assemblages give rise to many different, and often surprising, forms of jurisdiction involving divergent performances of spaces-, objects- and authorities of governance. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Gender differences among regular injecting drug users in Sydney, Australia, 1996-2003.

    Science.gov (United States)

    Breen, Courtney; Roxburgh, Amanda; Degenhardt, Louisa

    2005-07-01

    Previous research has found that female injecting drug users (IDU) are younger and more likely to be involved in risky behaviours such as needle sharing and sex work than male IDU. Aboriginal female drug users, in particular, are over-represented in IDU and prison populations. These factors place female IDU at increased risk of health problems and complicate issues such as homelessness, unemployment and poverty. Although a substantial body of research exists, little trend analysis has been done in Australia and much of the previous literature has focused on treatment populations. Cross-sectional data from 1996 to 2003 from regular IDU in Sydney interviewed as part of Australia's drug monitoring system, the Illicit Drug Reporting System (IDRS) were examined for trends over time. The demographic characteristics, drug use patterns and self-reported risk behaviours of the most recent sample (2003) were analysed for gender differences. Female IDU were younger in all sample years. Female IDU were more likely to identify as Aboriginal or Torres Strait Islander (ATSI) and engage in sex work. There has been a steady increase in these proportions over time. Female IDU were less likely to have a prison history, although there has been an increase among both male and female IDU over time. There were no gender differences in drug use patterns or frequency of drug use. Larger proportions of females report lending needles. Reports of lending and borrowing needles have decreased over time among both male and female IDU. Female IDU may place themselves at greater risk than male IDU by being more likely to share injecting equipment and engage in sex work. Treatment and other measures to reduce harm may need to be targeted specifically at women and, in particular, indigenous women.

  15. Therapeutic effects of acetylspiramycin and garlicin on cryptosporidiosis among drug users

    Directory of Open Access Journals (Sweden)

    Min-Zhu Huang

    2015-12-01

    Full Text Available Cryptosporidiosis affects humans of all ages, particularly malnourished children and those with compromised immune systems such as HIV/AIDS. This study investigated the therapeutic effects of acetylspiramycin and garlicin on Cryptosporidium infection in institutionalized male drug users receiving rehabilitative treatment. Examination of stool specimens from 903 drug users via modified acid-fast bacilli staining resulted in 172 positive cases. Among them 151 subjects consented to participate in a randomized trial of acetylspiramycin and garlicin in four groups: acetylspiramycin plus garlicin, acetylspiramycin only, garlicin only, and placebo control. The cryptosporidiosis rate was higher in younger subjects with longer drug use history than subjects who are older with shorter history of drug use. After two segments of treatments, 76.2% of the cases achieved negative test results, with the four groups achieving the rates of 92.1%, 76.7%, 72.2%, and 61.8%, respectively (χ2 = 9.517, P = 0.023. These results indicate clinical potential of garlicin in conjunction with acetylspiramycin in treating cryptosporidiosis.

  16. Outlier populations: individual and social network correlates of solvent-using injection drug users.

    Directory of Open Access Journals (Sweden)

    Souradet Y Shaw

    Full Text Available We previously identified a high prevalence of Hepatitis C (HCV amongst solvent-using injection drug users (S-IDU relative to other injection drug users within the same locality. Here we incorporated social network variables to better characterize some of the behavioural characteristics that may be putting this specific subgroup of IDU at elevated disease risk.A cross-sectional survey of at-risk populations was carried out in Winnipeg, Canada in 2009. Individuals reporting any history of injection drug and/or solvent use were included in the study. Associations between subgroup membership, infection with HCV and HIV and individual and social network variables were examined.In relation to other IDU, S-IDU were more likely to be infected with HCV, to report ever having shared a syringe, and to associate with other IDU. They were further differentiated in terms of their self-reported sexual orientation, ethnicity and in the injection drugs typically used.Solvent use stands as a proxy measure of numerous other characteristics that put this group of IDU at higher risk of infection. Provision of adequate services to ostracized subpopulations may result in wider population-level benefits.

  17. Drug policing assemblages: Repressive drug policies and the zonal banning of drug users in Denmark’s club land

    DEFF Research Database (Denmark)

    Søgaard, Thomas F.; Houborg, Esben; Pedersen, Michael M.

    2017-01-01

    relations between police, venue owners and private security agents. Conclusion: The paper argues that a third-party policing perspective combined with assemblage theory is useful for highlighting how the enforcement of national drug policies and nightlife banning systems is shaped by their embeddedness...... in local ‘drug policing assemblages’ characterized by inter-agency relation-building, the creative combination of public and private (legal) resources and internal power struggles. It also provides evidence of how drug policing assemblages give rise to many different, and often surprising, forms...

  18. Epidemiology of syphilis infection among drug users at methadone maintenance treatment clinics in China: systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Bing-xiang; Zhang, Li; Wang, Yu-jie; Yan, Jun-wei; Wan, Ya-nan; Peng, Wen-jia; Wang, Jing

    2014-07-01

    Illicit drug trade has re-emerged in China since 1979 and the number of drug addicts had increased. Syphilis is mainly spread through sexual contact and blood. The incidence of syphilis is high among drug users. Methadone maintenance treatment (MMT) clinics have been implemented in China since 2004. The aim of this study was to estimate the prevalence and risk factors of syphilis among drug users at MMT clinics in China between 2004 and 2013. Chinese and English databases (CBM, CNKI, Weipu, Pubmed) of literature were searched for studies reporting syphilis among drug users in MMT clinics from 2004 to 2013. The prevalence estimates and risk factors were summarized through a systematic review and meta-analysis of published literatures. In all, 29 eligible articles with a total of 8899 drug users, were selected in this review. The pooled prevalence of syphilis infection was 7.78% (95%CI: 5.83%-9.99%). The meta-analyses demonstrated significant differences in syphilis infection rates between men and women (OR = 0.34 [95%CI: 0.26-0.45]) but not between drug users and non-intravenous drug users (OR = 0.82 [95%CI: 0.51-1.32]). Enhanced detection of syphilis and health promotion is warranted in MMT clinics in China. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. Echocardiographic Findings Suggestive of Infective Endocarditis in Asymptomatic Danish Injection Drug Users Attending Urban Injection Facilities

    DEFF Research Database (Denmark)

    Axelsson, Anna; Søholm, Helle; Dalsgaard, Morten

    2014-01-01

    attending a supervised injection facility. We performed transthoracic echocardiographic examinations on-site in the injection facilities. A total of 206 IDUs (mean age 43 ± 9 years, 23% women) with a median injection drug abuse of 18 years (interquartile range 10 to 26) were included. Fourteen IDUs (14......Injection drug users (IDUs) account for a considerable number of the hospitalizations for infective endocarditis (IE), but the prevalence of diagnosed and unrecognized IE in IDUs is unknown. The aim of the present study was to assess the prevalence of valvular abnormalities suggestive of IE in IDUs...... of 206, 7%, 95% confidence interval [CI] 4% to 11%) had a previous history of IE. IDUs with a history of IE were significantly older than IDUs without a history of IE (48 ± 8 vs 42 ± 9 years, respectively, p = 0.03) and had a longer duration of injection drug use (27 [18 to 36] vs 17 years [10 to 25], p...

  20. Perceptions of community health agents about users of alcohol and other drugs

    Directory of Open Access Journals (Sweden)

    Larissa Sandy Carvalho Teles

    2016-07-01

    Full Text Available Introduction: Chemical dependency has been the center of debates in governmental and non-governmental sectors and presents itself as a serious social and public health problem. Objectives: To investigate the profile of community health agents (CHA from the city of Sorocaba, São Paulo, Brazil, and to identify their perceptions regarding the use and abuse of drugs in the territory, as well as the interventions used by these professionals. Material and Methods: This is an exploratory, descriptive, transversal, predominantly qualitative study. The instruments chosen to collect data were a sociodemographic questionnaire and a semi-structured interview. Results and Discussion: Data were analyzed by the technique of the collective subject discourse. A total of 64 CHA were included, being 98.4% women, 90.6% married, 92.1% Christians, with an average of 11.2 years of study, 4.9 years of labor and an average age of 36,8 years. Data analyzed were grouped into five categories: drugs are one of the biggest problems in the neighborhood, user´s identifications, interventions, training for interventions, and harm reduction. Conclusions: The CHA consider drugs as one of the biggest problems affecting society. However, they feel a lack of training for effective interventions with users. Their social and professional relationships lead to represent the problem as a phenomenon linked to violence and fear, but they also understand that actions must be carried out with the permission and participation of the users and that professionals should be primarily supportive and inclusive. From the CHA perception, it is necessary to seek ways to reduce the harm and to improve health and quality of life of users.

  1. Monetary versus nonmonetary incentives for TB skin test reading among drug users.

    Science.gov (United States)

    Malotte, C K; Hollingshead, J R; Rhodes, F

    1999-04-01

    In a prior study, we reported that monetary incentives were effective in increasing return for tuberculosis (TB) skin test reading. The purpose of this study was to compare the effects of monetary versus nonmonetary incentives and a theory-based educational intervention on return for TB skin test reading in a sample of newly recruited active injection and crack cocaine users, and to determine the prevalence of TB infection in this sample. Active injection drug and/or crack cocaine users (n = 1,078), recruited using street outreach techniques, were skin tested for TB. They were randomly assigned to 1 of 5 experimental treatment conditions: $10 cash, grocery store coupons, bus tokens/fast-food coupons, motivational education, or usual encouragement to return. Nonmonetary incentives had a $10 value, and all incentives were provided at return for skin test reading. Ninety-five percent of those who received $10 returned for skin test reading compared to 86% of those who received grocery store coupons and 83% of those who received either bus tokens or fast-food coupons. In contrast, only 47% of those who received the educational session and only 49% of those who received usual encouragement returned for skin test reading. The prevalence of a positive tuberculin test was 21%, and was similar for crack cocaine and injection drug users. Nonmonetary and monetary incentives dramatically increased the return rate for TB skin test reading among drug users who are at high risk of TB infection. Nonmonetary incentives were somewhat less effective than monetary incentives.

  2. Kalaban: Young drug users' engagements with law enforcement in the Philippines.

    Science.gov (United States)

    Lasco, Gideon

    2018-02-01

    A violent 'war on drugs' continues to be waged in the Philippines, even as the use of drugs - particular methamphetamine - continues to rise. Furnishing contextual background to the current situation, this paper explores how long-running law enforcement approaches in the Philippines might be viewed by those in their receiving end by presenting findings of an ethnography among marginalized young men. Semi-structured interviews and focus group discussions were conducted among 20 young men throughout a 12-month period of participant-observation from December 2011 to September 2013. Young people make use of various 'tactics' to keep using drugs and evade law enforcement, even as drug use itself is a tactic in their everyday lives. A sense of hypocrisy and injustice, borne of their own experiences, informs their view of law enforcers, whom they call kalaban (enemy). They feel they are being unfairly targeted, but in their view, this danger is just part of the perils of their everyday lives. Young men's resort to various tactics speaks of an agency that is often ignored in public discourses. Their 'lay assessments of risks' and experience-based perceptions of law enforcement raises questions about the efficacy of fear-based anti-drug campaigns. Overall, the study offers an ethnographic argument against the punitive methods being employed by the Philippines, and for measures that reframe the relationship between police and young drug users - from hostility to trust. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Oral transmucosal drug delivery--current status and future prospects.

    Science.gov (United States)

    Sattar, Mohammed; Sayed, Ossama M; Lane, Majella E

    2014-08-25

    Oral transmucosal drug delivery (OTDD) dosage forms have been available since the 1980s. In contrast to the number of actives currently delivered locally to the oral cavity, the number delivered as buccal or sublingual formulations remains relatively low. This is surprising in view of the advantages associated with OTDD, compared with conventional oral drug delivery. This review examines a number of aspects related to OTDD including the anatomy of the oral cavity, models currently used to study OTDD, as well as commercially available formulations and emerging technologies. The limitations of current methodologies to study OTDD are considered as well as recent publications and new approaches which have advanced our understanding of this route of drug delivery. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Efficacy of combined antiviral therapy with pegylated interferon α-2a and ribavirin for chronic hepatitis C infection in intravenous drug users

    Directory of Open Access Journals (Sweden)

    Ružić Maja

    2010-01-01

    Full Text Available Introduction. Hepatitis C Virus infection represents not just a medical, but also a socio-economic problem. It is estimated that among 170 million infected, 60% belongs to the category of intravenous drug users (IDUs. Objective. The aim of this paper was to compare the response to the combined therapy of pegylated interferon alfa 2a and ribavirin, in the group of patients with HCV infection who were intravenous drug users (IDUs and in patients who were identified in the other way of transmission of HCV. Also to identify the influence of the therapy on diseases of addiction, during the course of HCV infection and on the effects of the combined therapy of pegylated interferon alfa 2a and ribavirin. Methods. We conducted a retrospective-prospective study, on 60 patients, treated with combined antiviral therapy-pegylated interferon alfa 2a and ribavirin. 30 patients were from the group of IDUs, and 30 patients from other epidemiological groups. Results. There were significant differences between the age of the patients (30.2±7.1 vs. 39.3±11.2 years; p=0.002, but no significant difference in the duration of the HCV infection between the two groups of patients (8.9±7.4 vs. 13.1±7.0 years; p>0.05. A large number of the patients in the group of IDUs had a problem with the abstinence of the drug abuse. In this group, there was the influence of alcohol (30% and other substances with potential hepatotoxicity: marihuana (23.3% and psycho-active drugs (73.6%. Staging of the liver fibrosis was not influenced by those two parameters and was similar in both groups (p>0.05. The genotype 3a was dominant in intravenous drug users (50.0% and genotype 1b in the control group of the patients (76.6%. In both groups, SVR was achieved at a higher percentage (86% vs. 70.00%; p>0.05, but among the intravenous drug users the relapses of HCV infection were at a lower percentage (3.3% vs. 20.0%; p=0.044. Side effects were noticed in solitary cases in both of the examined

  5. A Prospective Method to Guide Small Molecule Drug Design

    Science.gov (United States)

    Johnson, Alan T.

    2015-01-01

    At present, small molecule drug design follows a retrospective path when considering what analogs are to be made around a current hit or lead molecule with the focus often on identifying a compound with higher intrinsic potency. What this approach overlooks is the simultaneous need to also improve the physicochemical (PC) and pharmacokinetic (PK)…

  6. A Prospective Research on Self-medication Practices of Drug ...

    African Journals Online (AJOL)

    Preferred Customer

    self-medication were antibiotics [30]. When used correctly, antimicrobials are among the most important drugs. When they are overused or inappropriately used, however, they contribute to a troublesome, increasingly worrisome problem in patient care, i.e., the development of antimicrobial resistant pathogens [31-32].

  7. Drug treatment of obesity: current status and future prospects.

    Science.gov (United States)

    Kakkar, Ashish Kumar; Dahiya, Neha

    2015-03-01

    Obesity is a growing epidemic and a major contributor to the global burden of disease. Obesity strains the healthcare systems and has profound economic and psychosocial consequences. Historically, pharmacotherapy for obesity has witnessed the rise and fall of several promising drug candidates that had to be eventually withdrawn due to unacceptable safety concerns. Currently four drugs are approved for chronic weight management in obese adults: orlistat, lorcaserin, phentermine/topiramate extended release and naltrexone/bupropion extended release. While lorcaserin and phentermine/topiramate were approved by US Food and Drug Administration (FDA) in 2012, after a gap of 13 years following the licensing of orlistat, naltrexone/bupropion has been recently approved in 2014. This review provides a brief overview of these current therapeutic interventions available for management of obesity along with the evidence of their safety and efficacy. Additionally, several novel monotherapies as well as combination products are undergoing evaluation in various stages of clinical development. These therapies if proven successful will strengthen the existing armamentarium of antiobesity drugs and will be critical to combat the global public health crisis of obesity and its associated co-morbidities. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. [Overdose of heroin and influencing factors in intravenous drug users in parts of Yunnan].

    Science.gov (United States)

    Zhou, Y; Luo, W; Cao, X B; Zhang, B; Wu, Z Y

    2016-05-01

    To assess the prevalence of overdose of heroin and risk factors in intravenous drug users(IDUs)in Yunnan Province. During July-August of 2015, IDUs were recruited from four methadone maintenance treatment(MMT)clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures, Yunnan province. The information about IDUs ' demographic characteristics and drug use history, overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey. The factors associated with overdose of heroin were evaluated with logistic regression models. Of the 340 IDUs surveyed, 85.3%(290/340)were males, the mean age was 37.7±8.7 years, 65.6%(223/340)were Han ethnicity, and 49.4%(167/338)were HIV positive, 22.6%(77/340)reported having used club-related drugs(such as ephedrine, methamphetamine, benzodiazepines and ketamine)in the previous 12 months. Of the 340 IDUs, 41.8%(142/340)had at least one overdose of heroin in their lifetime(median: 3 overdoses)and 15.6%(53/340)had at least one overdose of heroin(median : 1 overdose use)in previous 12 months. The mean age of the 53 IDUs was(36.7 ± 8.4)years, and 83.0%(44/53)of them were males, the average drug use history was(16.5 ± 7.6)years. Dosage increase(26.4%, 14/53)and multidrug use(28.3%, 15/53)were the main causes for overdose of heroin. Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year(OR=0.534, 95%CI: 0.290-0.980)was independently associated with decreased risk of overdose of heroin, needle sharing in the past 6 months(OR=2.735, 95%CI: 1.383-5.407)and being forced to receive drug rehabilitation for less than one year(OR=2.881, 95% CI: 1.226-6.767)were independently associated with increased risk of overdose of heroin. Overdose of heroin is common among IDUs in Yunnan. It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin

  9. Homeless drug users' awareness and risk perception of peer "Take Home Naloxone" use – a qualitative study

    Directory of Open Access Journals (Sweden)

    Oldham Nicola

    2006-10-01

    Full Text Available Abstract Background Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. Methods In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. Results Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. Conclusion There is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users.

  10. Severity of club drug dependence and perceived need for treatment among a sample of adult club drug users in Shanghai, China.

    Science.gov (United States)

    Ding, Yingying; He, Na; Shoptaw, Steven; Gao, Meiyang; Detels, Roger

    2014-03-01

    Examine the severity of club drug dependence and perceived need for treatment, and further identify their determinants among a sample of club drug users in Shanghai, China. Two hundred and seventy-six club drug users were recruited using respondent-driven sampling (RDS). Severity of dependence on club drugs was measured using the Severity of Dependence Scale (SDS). 69.9% reported dependence on club drugs (i.e., SDS ≥ 4) and 36.6% reported severe dependence (i.e., SDS ≥ 6). One-eighth (12.7%) perceived need for drug treatment. Severe dependence on club drugs was more likely among those who reported recent use of ecstasy and those who had more depressive symptoms, but less likely among those reporting recent use of methamphetamine. Perceived need for treatment was more likely among those who lived with a spouse or boy/girlfriend, but less likely among those had prior drug treatment experience and more severe club drug dependence. Our findings suggest that educational activities should be implemented to raise public awareness about the powerful addictive properties of club drugs, along with efforts to reduce stigma towards drug abuse and psychiatric disorders. Programs to motivate drug users to seek treatment and encourage treatment linkage are urgently needed.

  11. Brief Intervention for Drug Users Presenting in Emergency Departments (NIDA CTN Protocol 0047: SMART-ED)

    Science.gov (United States)

    Bogenschutz, Michael P.; Donovan, Dennis M.; Mandler, Raul N.; Perl, Harold I.; Forcehimes, Alyssa A.; Crandall, Cameron; Lindblad, Robert; Oden, Neal L.; Sharma, Gaurav; Metsch, Lisa; Lyons, Michael S.; McCormack, Ryan; Konstantopoulos, Wendy Macias; Douaihy, Antoine

    2014-01-01

    %) or the BI-B group (244/275, 89%). Hair analysis differences between groups at other time points were not significant. CONCLUSIONS AND RELEVANCE In this sample of drug users seeking emergency medical treatment, a relatively robust brief intervention did not improve substance use outcomes. More work is needed to determine how drug use disorders may be addressed effectively in the ED. PMID:25179753

  12. Using the internet to research hidden populations of illicit drug users: a review.

    Science.gov (United States)

    Miller, Peter G; Sønderlund, Anders L

    2010-09-01

    To review the current research of hidden populations of illicit drugs users using web-based methods and discuss major advantages and disadvantages. Systematic review of 16 databases, including PubMed, PsycINFO (EBSCOhost), CSA Sociological Abstracts, Expanded Academic ASAP and Google Scholar. Substances researched were most commonly 'party/club drugs' (such as ecstasy) and cannabis. All of the studies reviewed concluded that the internet is a useful tool for reaching hidden populations, but is likely to impose some bias in samples. Advantages include: access to previously under-researched target groups; speed; international applications; increased ease of data entry; and improved confidentiality for respondents. The major disadvantage is a lack of representativeness of samples. Internet research is successful at accessing hidden populations of illicit drugs users, when appropriately targeted and provides unprecedented opportunities for research across a wide range of topics within the addictions field. Findings are unlikely to be generalisable to the general public, but appropriate for describing target populations.

  13. The Effect of Brief Cognitive Behavioural Therapy Group Intervention on Self Esteem among Drug Users

    Directory of Open Access Journals (Sweden)

    Hussin Huzilil

    2018-01-01

    Full Text Available Self-esteem is related to the individuals understanding and accepting the existing character and attitude to themselves. Failure to understand and accept their own strengths and weaknesses and in the same time do not have the skills to cope with it will caused them to be classified in the group who have low levels of self esteem. The up and down in self esteem will seriously affect the person emotional development and their reasoning process. Thus, reforming self esteem is an important key to help the rehabilition of drug abuser. Therefore, the purpose of this study is to investigate the effects of Brief Group Cognitive Behavioural Therapy on self-esteem among drug users. The quasi experimental design with one treatment group and one control group and four measurements (Pre Test, Post 1, Post 2 and Post 3 were employed in this study. The sample of 108 drugs users was chosen using purposive sampling procedure. Data were collected using standardized psychometric instruments, including Internal Control Index (Patricia Duttweiler, 1984 and The Rosenberg Self-Esteem Scale and were analysed using descriptive analysis. The findings shows the intervention of group Brief Cognitive Behavioural Therapy CBT (B are succeed in increasing self-esteem mean score compared to control group in different time interval. As a conclusion, self-esteem among the subjects can be enhanced with an intervention of proper and systematic therapy instead of unplanned therapy sessions

  14. An evaluation of high-risk behaviors among female drug users based on Health Belief Model.

    Science.gov (United States)

    Ilika, F; Jamshidimanesh, M; Hoseini, M; Saffari, M; Peyravi, H

    2015-01-01

    Objectives. Because of the physiological nature of the female reproductive system, women are susceptible to infectious diseases, especially STD and AIDS. Addiction and high-risk behaviors also grow danger of these diseases. The reason of this paper was to examine high-risk behaviors among female drug users based on the Health Belief Model. Methods. Participants of this study were 106 female drug users aged 18 years and older; by the undermost level of literacy skills and been involved in sexual relationships. They came to Drop-In-Centers (DIC) in Tehran, the capital of Iran. Data study was controlled by using a logistic reflux investigation and Pearson correlation analysis. Results. The conclusion showed that women's overall awareness was moderate. There were a considerable relationship among awareness and years old (p=0.006), awareness and education (p> 0.0001), and awareness and conjugal situation (p=0.062). Perceived sensitivity and severity were clearly compared by education level (p=0.007) and (p=0.014), respectively. Mean scores of perceived benefits and perceived severity of high-risk behaviors were estimated to be superior to other components. Conclusion. Awareness and perceived susceptibility must be raised regarding the educational schedule, which is according to the health belief model in the addiction field, to reduce perceived barriers to risky behavior prevention of women who use drugs.

  15. Hepatitis C virus infection among illicit drug users in an archipelago of the Amazon.

    Science.gov (United States)

    Silva, Fabricio Q; Santos, Francisco J A; Andrade, Andreia P; Pacheco, Suzy D B; Fischer, Benedikt; Pinho, João Renato R; Lemos, José Alexandre R; Oliveira-Filho, Aldemir B

    2018-03-01

    Hepatitis C virus (HCV) infection causes acute and chronic liver disease and may lead to cirrhosis, liver failure or hepatocellular carcinoma. The behavior of illicit drug users (DUs) typically exposes them to risks of viral infection. In the Brazilian Amazon region, a number of studies have identified high rates of drug use among adolescents, and a high prevalence of HBV infection in DUs, disseminated by sexual and parenteral activities. However, the epidemiological scenario of HCV infection in the region is still poorly understood. This study determined the prevalence, genotypes, and risk factors for HCV infection among DUs of the Marajó Archipelago. This cross-sectional study collected samples and epidemiological information from DUs in 11 municipalities. The diagnosis was established by EIA and real-time PCR, and the samples were genotyped by multiplex real time PCR. The data were analyzed by simple and multiple logistical regression. In 466 DUs, 28.3% had anti-HCV antibodies, and 25.5% had HCV-RNA. In 92 injecting drug users, 88.0% had anti-HCV antibodies, and 80.4% had HCV-RNA. Genotypes 1 and 3 were detected, with three cases of mixed infections. The multivariate analysis indicated associations of HCV infection with age (≥ 35 years), tattoos, intravenous drug use, shared use of injection equipment, and the daily and long-term (> 3 years) use of illicit drugs. These findings will contribute to the development of effective measures for the prevention of HCV infection among Brazilian DUs, as well as its general population.

  16. INTERPOLYELECTROLYTE COMPLEXES AS PROSPECTIVE CARRIERS FOR CONTROLLED DRUG DELIVERY

    OpenAIRE

    Kaur Jasmeet; Harikumar S.L.; Kaur Amanpreet

    2012-01-01

    In the current scenario, polymers as carriers have revolutionized the drug delivery system. A more successful approach, to exploit the different properties of polymers in a solitary system is the complexation of polymers to form polyelectrolyte complexes. These complexes circumvent the use of chemical crosslinking agents, thereby reducing the risk of toxicity. The complex formed is generally applied in different dosage forms for the formulation of stable aggregated macromolecules. There are t...

  17. Factors that help injecting drug users to access and benefit from services: A qualitative study

    Directory of Open Access Journals (Sweden)

    sheard Laura

    2007-10-01

    Full Text Available Abstract Background International research shows that injecting drug users (IDUs can encounter many barriers when they try to access drug treatment and other services. However, the existing literature is mostly quantitative and does not consider the kinds of factors that injectors themselves identify as enabling them to access and benefit from services. Responding to this gap in knowledge, our paper explores IDUs' own suggestions for improving service engagement and their reports of other factors enabling them to seek help. Methods Semi-structured qualitative interviews were conducted with 75 current illicit drug injectors in three geographically diverse areas of West Yorkshire, England. Recruitment was through needle exchange programmes, with additional snowball sampling to ensure inclusivity of gender, ethnicity and primary drug injected. Transcribed data were analysed thematically using Framework. Results Although participants were often satisfied with current access to services, they made three broad suggestions for improving engagement. These were: providing more services (more providers and more forms of support; better operation of existing services (including better communication systems and more flexibility around individual needs; and staffing-related improvements (particularly, less judgemental and more understanding staff attitudes. Other factors identified as important enablers of help seeking were: having supporting relationships (particularly with family members; personal circumstances/life events (especially becoming a parent; and an injector's state of mind (such as feeling motivated and positive. Conclusion A range of practical suggestions for improving IDUs' access to drug treatment and other services are identified.

  18. Sentiment Analysis of User-Generated Content on Drug Review Websites

    Directory of Open Access Journals (Sweden)

    Na, Jin-Cheon

    2015-03-01

    Full Text Available This study develops an effective method for sentiment analysis of user-generated content on drug review websites, which has not been investigated extensively compared to other general domains, such as product reviews. A clause-level sentiment analysis algorithm is developed since each sentence can contain multiple clauses discussing multiple aspects of a drug. The method adopts a pure linguistic approach of computing the sentiment orientation (positive, negative, or neutral of a clause from the prior sentiment scores assigned to words, taking into consideration the grammatical relations and semantic annotation (such as disorder terms of words in the clause. Experiment results with 2,700 clauses show the effectiveness of the proposed approach, and it performed significantly better than the baseline approaches using a machine learning approach. Various challenging issues were identified and discussed through error analysis. The application of the proposed sentiment analysis approach will be useful not only for patients, but also for drug makers and clinicians to obtain valuable summaries of public opinion. Since sentiment analysis is domain specific, domain knowledge in drug reviews is incorporated into the sentiment analysis algorithm to provide more accurate analysis. In particular, MetaMap is used to map various health and medical terms (such as disease and drug names to semantic types in the Unified Medical Language System (UMLS Semantic Network.

  19. Injection Drug User Quality of Life Scale (IDUQOL: Findings from a content validation study

    Directory of Open Access Journals (Sweden)

    Palepu Anita

    2007-07-01

    Full Text Available Abstract Background Quality of life studies among injection drug users have primarily focused on health-related measures. The chaotic life-style of many injection drug users (IDUs, however, extends far beyond their health, and impacts upon social relationships, employment opportunities, housing, and day to day survival. Most current quality of life instruments do not capture the realities of people living with addictions. The Injection Drug Users' Quality of Life Scale (IDUQOL was developed to reflect the life areas of relevance to IDUs. The present study examined the content validity of the IDUQOL using judgmental methods based on subject matter experts' (SMEs ratings of various elements of this measure (e.g., appropriateness of life areas or items, names and descriptions of life areas, instructions for administration and scoring. Methods Six SMEs were provided with a copy of the IDUQOL and its administration and scoring manual and a detailed content validation questionnaire. Two commonly used judgmental measures of inter-rater agreement, the Content Validity Index (CVI and the Average Deviation Mean Index (ADM, were used to evaluate SMEs' agreement on ratings of IDUQOL elements. Results A total of 75 elements of the IDUQOL were examined. The CVI results showed that all elements were endorsed by the required number of SMEs or more. The ADM results showed that acceptable agreement (i.e., practical significance was obtained for all elements but statistically significant agreement was missed for nine elements. For these elements, SMEs' feedback was examined for ways to improve the elements. Open-ended feedback also provided suggestions for other revisions to the IDUQOL. Conclusion The results of the study provided strong evidence in support of the content validity of the IDUQOL and direction for the revision of some IDUQOL elements.

  20. Characterization of Occult Hepatitis B Infection Among Injecting Drug Users in Tehran, Iran.

    Science.gov (United States)

    Asli, Maryam; Kandelouei, Tahmineh; Rahimyan, Koroush; Davoodbeglou, Foad; Vaezjalali, Maryam

    2016-03-01

    Hepatitis B virus (HBV) infection is a major health problem worldwide. The aim of this study was to investigate the frequency of occult hepatitis B infection (OBI) and its associated risk factors, together with the molecular characterization of the virus in injecting drug users of Tehran. The study consisted of 229 injecting drug users. Serum samples were collected and tested for the presence of hepatitis B core antibody (HBcAb) and hepatitis B surface antigen (HBsAg) by an enzyme-linked immunosorbent assay (ELISA). HBV B virus DNA was extracted from the serum samples, and a fragment of the S gene was amplified using the nested polymerase chain reaction. The genotype, subgenotypes, subtype, and S gene mutation of HBV were determined by direct sequencing. A phylogenetic tree was constructed using the neighbor-joining method. Sixty-four (28%) participants were HBcAb positive, 59 cases were HBcAb positive and HBsAg negative, and 5 cases were HBsAg positive. Hepatitis B DNA was found in three HBsAg-positive cases. Thirteen of 59 (22%) individuals were hepatitis B DNA positive. The phylogenetic tree of hepatitis B DNA showed the existence of genotype D. The only significant correlation was between sharing a syringe and OBI. In comparison with the rate of HBcAb positivity reported in other Iranian studies, the rate was higher in the present study. There were a few variations, genotypes, and subtypes among the infected injecting drug users. Further investigations are needed to unravel the molecular characterization of OBI.

  1. 78 FR 3900 - Generic Drug User Fee-Active Pharmaceutical Ingredient and Finished Dosage Form Facility Fee...

    Science.gov (United States)

    2013-01-17

    ... March 4, 2013. FOR FURTHER INFORMATION CONTACT: David Miller, Office of Financial Management (HFA-100... reference the user fee payment ID number when completing your transfer. The originating financial...] Generic Drug User Fee--Active Pharmaceutical Ingredient and Finished Dosage Form Facility Fee Rates for...

  2. Rapidly Progrediating Aortic Valve Infective Endocarditis in an Intravenous Drug User Treated by Antibiotics and Surgery

    Directory of Open Access Journals (Sweden)

    Malkia S. Swedi

    2012-01-01

    Full Text Available We report the case of a 22-year old male, a self-confessed recreational drug user who developed cardiogenic shock because of severe destruction of the aortic valve by rapidly progressive aortic valve endocarditis. The disease progression was acute; in a matter of days, the clinical manifestations were life-threatening necessitating urgent aortic valve replacement surgery. Cultivation revealed Streptococcus viridans as the microbial agent. Subsequent recovery with antibiotic treatment was without complication. This case report shows that immediately performed transoesophageal echocardiography and early consultation with a cardiac surgeon has fundamental importance in diagnosis and management of acute infective endocarditis in haemodynamically instable patients.

  3. Anti-Aging Drugs - Prospect of Longer Life?

    Science.gov (United States)

    Klimova, Blanka; Novotny, Michal; Kuca, Kamil

    2017-11-29

    Aging is a natural part of human life. However, recent discoveries indicate that pharmacological approaches used for the improvement and possibly, for the delay of the aging process, might shed a new light on this topic. This might obviously contribute to the extension of the active life of older people and maintenance of their quality of life, which could consequently reduce both social and economic burden of each country, especially the developed ones. The purpose of this study is to explore pharmacological discoveries which may help to the delay or improvement of the aging process. More specifically, the authors focus on three anti-aging drugs candidates: metformin, rapamycin and resveratrol and one anti-aging component NAD+ precursors whose randomized control trials on animals have appeared to provide some efficacy in this respect and they seem to be promising in the aging process of human beings. This was done by conducting a literature review of available sources describing the issue of aging process with special focus on those anti-aging drug candidates. The results of this study indicate that promising anti-aging candidates seem to be metformin, especially as far as cardiovascular or cancer mortality is concerned, and NAD+ precursors since they appear to promote better organ function, increased physical resistance, disease resistance and prolonged life expectancy. There is a call for more longitudinal clinical trials, which would prove the efficacy of the promising anti-aging drugs candidates in humans. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Profile of users intoxicated by drugs of abuse and association with death

    Directory of Open Access Journals (Sweden)

    Lúcia Margarete dos Reis

    2016-01-01

    Full Text Available Objective: to characterize the profile of users intoxicated by drugs of abuse reported to a center of information and toxicological assistance and related this to the occurrence of deaths. Methods: study of case series reported in the 2010-2011 biennium after active case finding. Data were obtained from epidemiological records filed in the center and submitted to univariate analysis, with chi-squared test and Fischer test. Results: three hundred and thirty nine cases were found, most were men (87.3%, with basic education (61.0% and elderly (37.2%. Alcohol use (83.8% and chronic intoxications (89.9% were predominant. Clinical complications were present in most medical diagnoses (63.4%. However, mortality was higher in the event deferral by cold and fire weapons. Conclusion: the consumption of drugs of abuse influences morbidity and mortality, particularly in men aged at 60 years or above and with low level of education.

  5. Profile of users intoxicated by drugs of abuse and association with death

    Directory of Open Access Journals (Sweden)

    Lúcia Margarete dos Reis

    2016-05-01

    Full Text Available Objective: to characterize the profile of users intoxicated by drugs of abuse reported to a center of information and toxicological assistance and related this to the occurrence of deaths. Methods: study of case series reported in the 2010-2011 biennium after active case finding. Data were obtained from epidemiological records filed in the center and submitted to univariate analysis, with chi-squared test and Fischer test. Results: three hundred and thirty nine cases were found, most were men (87.3%, with basic education (61.0% and elderly (37.2%. Alcohol use (83.8% and chronic intoxications (89.9% were predominant. Clinical complications were present in most medical diagnoses (63.4%. However, mortality was higher in the event deferral by cold and fire weapons. Conclusion: the consumption of drugs of abuse influences morbidity and mortality, particularly in men aged at 60 years or above and with low level of education.

  6. Assessment of Sexual Dysfunction Symptoms in Female Drug Users: Standardized vs. Unstandardized Methods.

    Science.gov (United States)

    Diehl, Alessandra; Rassool, G Hussein; dos Santos, Manoel Antônio; Pillon, Sandra Cristina; Laranjeira, Ronaldo

    2016-01-01

    The aim of this study is to evaluate whether there is a difference in the identified prevalence between the assessment of symptoms of sexual dysfunction in female drug users using a standardized scale and by means of a nonstandardized set of questions about sexual dysfunctions. A cross-sectional study was conducted with two groups of substance-dependent women using the Drug Abuse Screening Test, the Short Alcohol Dependence Data questionnaire, the Fagerström Test for Nicotine Dependence for the evaluation of the severity of dependence, and the Arizona Sexual Experience Scale. In both groups, the severity of dependence and the prevalence of symptoms of sexual dysfunctions in women were similar. The use of standardized and nonstandardized instruments to assess sexual dysfunction symptoms is an essential resource for the provision of good-quality care to this clientele.

  7. Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission

    Directory of Open Access Journals (Sweden)

    Rafael Alves Guimarães

    2016-01-01

    Full Text Available Noninjecting illicit drug users (NIDUs present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goiás State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p<0.001. Crack use and history of sexually transmitted infections (STI were risk factors for transactional sex in men. Homelessness, crack use, sex under the influence of drugs, and history of sexual violence were risk factors for transactional sex in women. A high prevalence of transactional sex was observed among NIDUs. This risk behavior may contribute to the high rates of HIV among this population and their social networks and in the general population.

  8. The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model

    Directory of Open Access Journals (Sweden)

    Glickman Andrea

    2010-01-01

    Full Text Available Abstract Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

  9. The dynamics of injection drug users' personal networks and HIV risk behaviors.

    Science.gov (United States)

    Costenbader, Elizabeth C; Astone, Nan M; Latkin, Carl A

    2006-07-01

    While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time. Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%. The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

  10. Non-Dependent and Dependent Daily Cannabis Users Differ in Mental Health but Not Prospective Memory Ability

    Directory of Open Access Journals (Sweden)

    Ruth Braidwood

    2018-03-01

    Full Text Available Research suggests that daily cannabis users have impaired memory for past events, but it is not clear whether they are also impaired in prospective memory (PM for future events. The present study examined PM in daily cannabis users who were either dependent (n = 18 or non-dependent (n = 18, and compared them with non-using controls (n = 18. The effect of future event simulation (FES on PM performance was also examined. Participants were matched across groups on age, gender, and highest level of education. The virtual week (VW was used to objectively assess PM abilities, both at baseline and following FES. Other measures used were: cannabis use variables, immediate and delayed prose recall, phonemic and category fluency, spot-the-word test (premorbid intelligence, Beck Depression Inventory, Beck Anxiety Inventory, and a measure of schizotypy (Oxford-Liverpool Inventory of Feelings and Experiences: unusual experiences subscale. No group differences were found in PM performance on the VW, and FES did not improve PM performance in any group. Dependent cannabis users scored higher on depression, anxiety, and schizotypy than both other groups with non-dependent cannabis users scoring at a similar level to controls. There were no group differences in alcohol use. Findings suggest that when carefully matched on baseline variables, and not differing in premorbid IQ or alcohol use, young, near-daily cannabis users do not differ from non-using controls in PM performance.

  11. Social Representations Used by the Parents of Mexican Adolescent Drug Users under Treatment to Explain Their Children's Drug Use: Gender Differences in Parental Narratives

    Science.gov (United States)

    Nuno-Gutierrez, Bertha Lidia; Alvarez-Nemegyei, Jose; Rodriguez-Cerda, Oscar

    2008-01-01

    The aim of this study was to explore the social representations used by the parents of adolescent drug users to explain the onset of drug use. Differences in explanations between the parents of male and female adolescents were also explored. Sixty parents who accompanied their children to four rehabilitation centers in 2004 completed two…

  12. Drug use and risk behaviours among injecting drug users: a comparison between sex workers and non-sex workers in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Breen Courtney

    2005-06-01

    Full Text Available Abstract Background This paper examines the differences in demographics, drug use patterns and self reported risk behaviours between regular injecting drug users (IDU who report engaging in sex work for money or drugs and regular injecting drug users who do not. Methods Cross sectional data collected from regular IDU interviewed as part of the New South Wales (NSW Illicit Drug Reporting System (IDRS in 2003 were analysed. Results IDU who reported engaging in sex work were more likely to be female, and identify as being of Aboriginal and/or Torres Strait Islander descent. They initiated injecting drug use at a significantly younger age and were more likely to report injection related problems than IDU who had not engaged in sex work. There were no differences in the drug classes used, but findings suggested that the sex workers tended to be more frequent users of crystalline methamphetamine (ice and benzodiazepines. Conclusion The similarities between these groups were more striking than the differences. Further research, examining a larger sample is needed to clarify whether injecting drug users who are sex workers have heavier use patterns.

  13. Vulnerable among the vulnerable: drug users in situations of poverty and indigence in Argentina.

    Science.gov (United States)

    Vivas, Luis Enrique; Radulich, Graciela; Bruno, Daniela

    2003-12-15

    To study drug use in the context of poverty, it is necessary to undertake a complex analysis of various perspectives to understand the dense interweaving of socioeconomic, political, and cultural factors involved in the problem. The analysis of this social scenario was our starting point in planning holistic actions for the prevention of human immunodeficiency virus/acquired immunodeficiency syndrome and other illnesses related to drug use. Merely copying successful models from developed countries, which are designed for other contexts and populations, would result in insufficient and ineffective actions. The Asociación Civil Cristiana Recuperación Atención de Drogadependientes (ACCRAD), also known as "El Retoño" ("sprout"), is a nongovernmental organization that has been working since 1985 to consolidate a model of analysis and intervention that considers this complex framework and seeks to meet the needs of drug users from the poorest sectors of society. Our research on the use of drugs and its relationship to poverty, together with the documentation of harm-reduction interventions, has been carried out since 1997.

  14. Hunger and associated harms among injection drug users in an urban Canadian setting

    Directory of Open Access Journals (Sweden)

    Anema Aranka

    2010-08-01

    Full Text Available Abstract Background Food insufficiency is often associated with health risks and adverse outcomes among marginalized populations. However, little is known about correlates of food insufficiency among injection drug users (IDU. Methods We conducted a cross-sectional study to examine the prevalence and correlates of self-reported hunger in a large cohort of IDU in Vancouver, Canada. Food insufficiency was defined as reporting "I am hungry, but don't eat because I can't afford enough food". Logistic regression was used to determine independent socio-demographic and drug-use characteristics associated with food insufficiency. Results Among 1,053 participants, 681 (64.7% reported being hungry and unable to afford enough food. Self-reported hunger was independently associated with: unstable housing (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.20 - 2.36, spending ≥ $50/day on drugs (AOR: 1.43, 95% CI: 1.06 - 1.91, and symptoms of depression (AOR: 3.32, 95% CI: 2.45 - 4.48. Conclusion These findings suggest that IDU in this setting would likely benefit from interventions that work to improve access to food and social support services, including addiction treatment programs which may reduce the adverse effect of ongoing drug use on hunger.

  15. Developing and articulating intersectorial networks for integral care of drug users in vulnerable contexts

    Directory of Open Access Journals (Sweden)

    Maria de Nazareth Rodrigues Malcher de Oliveira Silva

    2014-08-01

    Full Text Available This manuscript presents an experience report with some activities that the Reference Center on Drugs and Associated Vulnerabilities - CRR, ‘Faculdade Ceilândia’/University of Brasilia - UNB implemented and developed in 2013. This account allows us to reflect on the process of building partnerships based on social networks and the notion of territory for people with problems related to drugs and their associated vulnerability. The experience follows the current national framework, in which the social network has become a central paradigm of public practices and policies (e.g. Law 10.216/2001. These changes occur in the model of care for people with mental disorders, including the integral health policy for users and dependents of alcohol and other drugs. The CRR team mapped local social networks, i.e. several public institutions in different sectors, in four municipalities: one in the Federal District (Brazlândia and three in the state of Goiás (Valparaiso, Luziânia, Águas Lindas. After the mapping, the CRR team sought to articulate and establish an agenda to discuss alcohol and drug use and its associated vulnerabilities among these different institutions, sectors and professionals, e.g. nurses, physicians, occupational therapists, social workers, and police officers. This strategy enabled several actors to develop and qualify their local intersectorial network, which consequently qualifies the integral care actions, as recommended by several national policies.

  16. Profile of male Brazilian injecting drug users who have sex with men

    Directory of Open Access Journals (Sweden)

    Ferreira Aline Dayrell

    2006-01-01

    Full Text Available This study aims to characterize the profile of male injecting drug users who have sex with other men (MSM IDUs recruited through a cross-sectional multi-city survey (AjUDE-Brasil II Project in six Brazilian cities, in 2000-2001. MSM IDUs were compared to other male IDUs using bivariate and multivariate procedures (logistic regression and answer tree analysis with the CHAID algorithm. Among the 709 male IDUs, 187 (26.4% reported ever having had sex with other men, while only 37 reported sex with other men in the previous six months. MSM IDUs were more likely to be unemployed (OR = 2.3, to have injected tranquilizers (OR = 3.6, and to be HIV-seropositive (OR = 2.1, compared to other male IDUs. Male same-sex relations in this subgroup appear to be associated with strategies to finance drug consuming habits, including sex for drugs with occasional female partners or obtaining injection paraphernalia from occasional sex partners. Further studies should focus on this especially vulnerable subgroup of IDUs, due to the bidirectional and complex interrelationships between their drug injecting habits and sexual risk behaviors.

  17. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study

    NARCIS (Netherlands)

    Heus, R.; Mol, B.W.; Erwich, J.J.; Geijn, van H.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; Holsbeke, van C.D.; Duvekot, J.J.; Schobben, F.F.; Wolf, de H.; Visser, G.H.A.

    2009-01-01

    OBJECTIVE: To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. DESIGN: Prospective cohort study. SETTING: 28 hospitals in the Netherlands and Belgium. PARTICIPANTS: 1920 consecutive

  18. Adverse drug reactions to tocolytic treatment for preterm labour : prospective cohort study

    NARCIS (Netherlands)

    de Heus, R.; Mol, B.W.; Erwich, J.J.H.M.; van Geijn, H.P.; Gyselaers, W.J.; Hanssens, M.; Harmark, L.; van Holsbeke, C.D.; Duvekot, J.J.; Schobben, F.F.A.M.; Wolf, Hans; Visser, G. H. A.

    2009-01-01

    Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women

  19. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study

    NARCIS (Netherlands)

    de Heus, Roel; Mol, Ben Willem; Erwich, Jan-Jaap H. M.; van Geijn, Herman P.; Gyselaers, Wilfried J.; Hanssens, Myriam; Härmark, Linda; van Holsbeke, Caroline D.; Duvekot, Johannes J.; Schobben, Fred F. A. M.; Wolf, Hans; Visser, Gerard H. A.

    2009-01-01

    Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women

  20. Prospects for the control of neglected tropical diseases by mass drug administration

    NARCIS (Netherlands)

    Smits, Henk L.

    2009-01-01

    The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In

  1. Adverse drug reactions to tocolytic treatment for preterm labour: Prospective cohort study

    NARCIS (Netherlands)

    R. de Heus (Roel); B.W.J. Mol (Ben); J.J.H.M. Erwich; H.P. van Geijn (Herman); W.J. Gyselaers (Wilfried); M. Hanssens (Myriam); L. Harmark (Linda); C.D. van Holsbeke (Caroline); J.J. Duvekot (Hans); F. Famschobben; H. Wolf (Hans Uwe); G.H. Visser (Gerhard Henk)

    2009-01-01

    textabstractObjective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920

  2. Drug Exposure Opportunities and Use Patterns among College Students: Results of a Longitudinal Prospective Cohort Study

    Science.gov (United States)

    Arria, Amelia M.; Caldeira, Kimberly M.; O'Grady, Kevin E.; Vincent, Kathryn B.; Fitzelle, Dawn B.; Johnson, Erin P.; Wish, Eric D.

    2008-01-01

    Underage drinking and drug use among college students are major public health concerns, yet few studies have examined these behaviors and their associated risk factors and consequences prospectively. This paper describes the sampling and recruitment methods of a longitudinal study of 1253 college students at a large, mid-Atlantic university.…

  3. Differences in sociodemographic, drug use and health characteristics between never, former and current injecting, problematic hard-drug users in the Netherlands.

    Science.gov (United States)

    Havinga, Petra; van der Velden, Claudia; de Gee, Anouk; van der Poel, Agnes

    2014-02-13

    Injecting drug users are at increased risk for harmful effects compared to non-injecting drug users. Some studies have focused on differences in characteristics between these two groups (e.g., housing, overall health). However, no study has investigated the specific Dutch situation which in the last years has seen a decrease in homelessness among problematic hard-drug users and an increasing focus on physical health in low-threshold addiction care. The purpose of this study was to determine differences in sociodemographic, drug use and health characteristics between never-injecting (NIDUs), former-injecting (FIDUs) and current-injecting drug users (IDUs) and describe injecting practices. A total of 202 problematic hard-drug users (NIDU = 64; FIDU = 76; IDU = 62) were recruited from 22 low-threshold care facilities, including drug consumption rooms, methadone maintenance treatment, heroin-assisted therapy, day shelter and/or night shelter, supported housing and day activity centres. Data were collected on-site through structured face-to-face interviews. Results indicate that IDUs represented a separate group of problematic hard-drug users, with distinct sociodemographic and drug use characteristics. Overall, IDUs appeared to be the group with least favourable characteristics (unstable housing/homelessness, illegal activities, polydrug use) and NIDUs appeared to have the most favourable characteristics (stable housing, help with debts, less polydrug use). The FIDU group lies somewhere in between. The three groups did not differ significantly in terms of health. Regarding injecting practices, results showed that majority of IDUs had injected drugs for over 10 years and IDUs injected heroin, cocaine, amphetamine and/or methadone in the past 6 months. Sharing syringes was not common. A quarter reported public injecting. Unstable housing and homelessness are related to (former) injecting drug use, and stable housing is related to never-injecting drug use. Our study

  4. The application of the drug user quality of life scale (DUQOL in Australia

    Directory of Open Access Journals (Sweden)

    Zubaran Carlos

    2012-03-01

    Full Text Available Abstract Background The concept of quality of life relates to the perceptions of individuals about their mental and physical health as well as non-health related areas. The evaluation of quality of life in the context of substance abuse has been conducted using generic instruments. The Drug Users Quality of Life Scale (DUQOL is a specific assessment tool in which the most pertinent and salient areas to drug abusers are taken into consideration. In this study, the authors report the results of a validation study in which the DUQOL was used for the first time in Australia. Methods A sample of 120 participants from inpatient and outpatient treatment facilities completed a series of questionnaires, including the DUQOL and the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF. Parameters investigated in this study included the demographic characteristics of the sample, internal structure, and convergent validity. Correlations between the DUQOL scale scores and the scores of the WHOQOL-Bref test were investigated via Pearson product-moment correlation analyses. Results The English version of the DUQOL attained a significant overall Cronbach's alpha of 0.868. The factorial analysis of the DUQOL identified one principal factor that accounted for 28.499% of the variance. Convergent validity analyses demonstrate significant correlations (p Conclusions This study demonstrates that the DUQOL constitutes a reliable research instrument for evaluating quality of life of substance users in Australia.

  5. Planning deficits in polysubstance dependent users: Differential associations with severity of drug use and intelligence.

    Science.gov (United States)

    Valls-Serrano, C; Verdejo-García, A; Caracuel, A

    2016-05-01

    Polysubstance use is associated with alterations in different components of executive functioning such as working memory and response inhibition. Nevertheless, less attention has been given to executive planning skills, which are required to benefit of low structured interventions. This study examines the association between severity of use of cocaine, heroin, alcohol, fluid and crystallized intelligence and planning tasks varying on degree of structure. Data were collected from 60 polysubstance users and 30 healthy controls. Cognitive assessment consisted of three planning tasks with different structure levels: Stockings of Cambridge, Zoo Map test, and Multiple Errands Test. Polysubstance users had significant planning deficits across the three tasks compared to healthy controls. Hierarchical regression models showed that severity of drug use and fluid and crystallized intelligence significantly explained performance in all the planning tasks. However, these associations were higher for low-structured real world tasks. These low-structured tasks also showed a unique association with crystallized but not fluid intelligence. Drug abuse is negatively associated with planning abilities, and intelligence is positively associated with planning performance in real-world tasks. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Body Image Disturbance in 1000 Male Appearance and Performance Enhancing Drug Users

    Science.gov (United States)

    Hildebrandt, Tom; Alfano, Lauren; Langenbucher, James W.

    2010-01-01

    Body image disturbance (BID) among men has only recently become a phenomenon of clinical significance with noted heterogeneity in the behavioral consequences of these disturbances. The degree of heterogeneity among appearance and performance enhancing drug (APED) users is unknown and an empirically derived framework for studying BID is necessary. 1000 APED users were recruited via the Internet and they completed a comprehensive online assessment APED use patterns, motivations, consequences, and BID. Data were evaluated using latent trait, latent class, and factor mixture models. Model results were validated using a range of covariates including cycle characteristics, age, APED history, and APED risk. A 1-Factor, 4-Class model provided the best fit to the data with Class 1 scoring the highest on all measures of BID and Class 4 the lowest on all measures. Class 2 differed in their preference for being lean over muscular and Class 3 preferred adding mass and size. Each class was associated with unique risks, APED history, and training identity. Not all APED users suffer from significant BID and there are unique profiles for those with elevated BID. Future research on male BID should account for this structure in order to better define relevant diagnostic categories and evaluate the clinical significance of BID. PMID:20110092

  7. The Commissioning and Provision of Advocacy for Problem Drug Users in English DATS: A Cross-Sectional Survey

    Science.gov (United States)

    Cargill, Tamsin; Weaver, Tim D.; Patterson, Sue

    2012-01-01

    Aims: This study investigated the commissioning and delivery of advocacy for problem drug users. We aimed to quantify provision, describe the commissioning of advocacy services in Drug Action Teams (DATs) and to identify factors influencing advocacy provision. Methods: A cross-sectional survey of a randomly selected sample of 50 English DATs. The…

  8. Effects of transnational migration on drug use: an ethnographic study of Nepali female heroin users in Hong Kong.

    Science.gov (United States)

    Tang, Wai-Man

    2015-01-01

    Past studies of female drug users in South Asia tend to focus on their plights, for instance, how they have been driven to drug use and encounter more problems than their male counterparts, such as HIV/AIDS and sexual abuse. Few studies focus on their active role--how they actively make use of resources in the external environment to construct their desired femininity through drug consumption. Furthermore, little is known about the situation of female South Asian drug users who are living overseas. This paper is a study of transnational migration, drug use and gender--how transnational migration influences the drug use of female transnational migrants. An 18-month ethnography has been carried out in a Nepali community in Hong Kong and 13 informants were interviewed. Data were coded and analyzed by using the grounded-theory approach. Themes related to the drug use of the female Nepali heroin users were identified. The findings show that there are three important themes that significantly affect the drug use of female Nepali heroin users, which include (1) their relationships with intimate partners, (2) their means of support, and (3) their legal status in migration. The findings are consistent with the concept of post-structuralism in gender and transnationalism theories. Female Nepali heroin users in Hong Kong are neither active agents nor passive victims; their active/passive role is largely dependent on their reconfigured opportunities and constraints in transnational migration. Thus, transnationalism should be taken as an important perspective to study the situation of female drug users in a globalized context. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Non-adherence to telemedicine interventions for drug users: systematic review

    Directory of Open Access Journals (Sweden)

    Taís de Campos Moreira

    2014-06-01

    Full Text Available OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library, Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.

  10. User profiles of a smartphone application to support drug adherence--experiences from the iNephro project.

    Directory of Open Access Journals (Sweden)

    Stefan Becker

    Full Text Available PURPOSE: One of the key problems in the drug therapy of patients with chronic conditions is drug adherence. In 2010 the initiative iNephro was launched (www.inephro.de. A software to support regular and correct drug intake was developed for a smartphone platform (iOS. The study investigated whether and how smartphone users deployed such an application. METHODS: Together with cooperating partners the mobile application "Medikamentenplan" ("Medication Plan" was developed. Users are able to keep and alter a list of their regular medication. A memory function supports regular intake. The application can be downloaded free of charge from the App Store™ by Apple™. After individual consent of users from December 2010 to April 2012 2042338 actions were recorded and analysed from the downloaded applications. Demographic data were collected from 2279 users with a questionnaire. RESULTS: Overall the application was used by 11688 smartphone users. 29% (3406/11688 used it at least once a week for at least four weeks. 27% (3209/11688 used the application for at least 84 days. 68% (1554/2279 of users surveyed were male, the stated age of all users was between 6-87 years (mean 44. 74% of individuals (1697 declared to be suffering from cardiovascular disease, 13% (292 had a previous history of transplantation, 9% (205 were suffering from cancer, 7% (168 reported an impaired renal function and 7% (161 suffered from diabetes mellitus. 69% (1568 of users were on <6 different medications, 9% (201 on 6 - 10 and 1% (26 on more than 10. CONCLUSION: A new smartphone application, which supports drug adherence, was used regularly by chronically ill users with a wide range of diseases over a longer period of time. The majority of users so far were middle-aged and male.

  11. A family outreach intervention for engaging young out-of-treatment drug users: pre- versus post-treatment comparison.

    Science.gov (United States)

    Santis, Rodrigo; Hidalgo, Carmen Gloria; Jaramillo, Andrea; Hayden, Viviana; Armijo, Ivan; Lasagna, Andrea

    2013-01-01

    Only a small fraction of drug users worldwide enter treatment each year. We evaluated the efficacy of a systemic family outreach intervention (SFOI) for young, untreated drug users, using a quasi-experimental design in which the experimental group (EG) received SFOI and the control group (CG) received traditional outreach work (OW). Both pre- and post-treatment, we administered the Addiction Severity Index-6 (ASI-6), the Family Environment Scale (FES), and tests of parental practices and risky behavior. Post-treatment, there was a fivefold improvement on the ASI-6 and a significant worsening on the conflict sub-scale of the FES in the EG as compared with the CG. SFOI was more efficacious than OW in reducing drug use in the drug user's home environment. The increased conflict in the EG might be explained by parents' increased awareness of abnormal behaviors and implementation of strategies to protect their children. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Studying Psychosocial Barriers to Drug Treatment Among Chinese Methamphetamine Users Using A 3-Step Latent Class Analysis.

    Science.gov (United States)

    Wang, Jichuan; Kelly, Brian C; Liu, Tieqiao; Hao, Wei

    2016-03-01

    Given the growth in methamphetamine use in China during the 21st century, we assessed perceived psychosocial barriers to drug treatment among this population. Using a sample of 303 methamphetamine users recruited via Respondent Driven Sampling, we use Latent Class Analysis (LCA) to identify possible distinct latent groups among Chinese methamphetamine users on the basis of their perceptions of psychosocial barriers to drug treatment. After covariates were included to predict latent class membership, the 3-step modeling approach was applied. Our findings indicate that the Chinese methamphetamine using population was heterogeneous on perceptions of drug treatment barriers; four distinct latent classes (subpopulations) were identified--Unsupported Deniers, Deniers, Privacy Anxious, and Low Barriers--and individual characteristics shaped the probability of class membership. Efforts to link Chinese methamphetamine users to treatment may require a multi-faceted approach that attends to differing perceptions about impediments to drug treatment. Copyright © 2015. Published by Elsevier Inc.

  13. Incarceration experiences among a community-recruited sample of injection drug users in Bangkok, Thailand

    Directory of Open Access Journals (Sweden)

    Lai Calvin

    2009-12-01

    Full Text Available Abstract Background Since 2003 Thailand has waged an aggressive "war on drugs" campaign focused on arresting and incarcerating suspected drug users and dealers. However, little is known about incarceration experiences among IDU in the wake of the recent war on drugs. Therefore, we sought to examine incarceration experiences among IDU in Bangkok, Thailand. Methods We examined the prevalence of incarceration among community-recruited IDU participating in the Mitsampan Community Research Project. Multivariate logistic regression was used to identify factors associated with a self-reported history of incarceration. We also examined the prevalence of injection drug use and syringe sharing within prisons. Results 252 IDU were recruited in August 2008; 66 (26.2% were female and the median age was 36.5 years. In total, 197 (78.2% participants reported a history of incarceration. In multivariate analyses, reporting a history of incarceration was associated with a history of compulsory drug treatment (adjusted odds ratio [AOR] = 4.93; 95% confidence interval [CI]: 1.95 - 12.48, non-fatal overdose (AOR = 3.69; 95%CI: 1.45 - 9.39, syringe sharing (AOR = 2.20; 95%CI: 1.12 - 4.32, and female gender (AOR = 0.41; 95%CI: 0.20 - 0.82. Among those who reported a history of incarceration, 59 (29.9% reported injection drug use in prison, and 48 (81.4% of these individuals reported sharing syringes in prison. Incarceration was not associated with the number of injections performed in the previous week (p = 0.202. Conclusion Over three-quarters of the IDU participating in this study reported a history of incarceration, and 30% of these individuals reported injection drug use within prison. Further, an alarmingly high level of syringe sharing within prison was reported, and incarceration was not associated with reductions in drug use. These findings provide further evidence of the need for community diversion strategies, as well as harm reduction programs, in Thai

  14. Attitudes toward Methadone among Out-of-Treatment Minority Injection Drug Users: Implications for Health Disparities

    Directory of Open Access Journals (Sweden)

    Nickolas D. Zaller

    2009-02-01

    Full Text Available Injection drug use (IDU continues to be a significant public health issue in the U.S. and internationally, and there is evidence to suggest that the burden of injection drug use and associatedmorbidity and mortality falls disproportionately on minority communities. IDU is responsible for a significant portion of new and existing HIV/AIDS cases in many parts of the world. In the U.S., the prevalence of HIV and hepatitis C virus is higher among populations of African-American and Latino injection drug users (IDUs than among white IDUs. Methadone maintenance therapy (MMT has been demonstrated to effectively reduce opiate use, HIV risk behaviors and transmission, general mortality and criminal behavior, but opiate-dependent minorities are less likely to access MMT than whites. A better understanding of the obstacles minority IDUs face accessing treatment is needed to engage racial and ethnic disparities in IDU as well as drug-related morbidity and mortality. In this study, we explore knowledge, attitudes and beliefs about methadone among 53 out-of-treatment Latino and African-American IDUs in Providence, RI. Our findings suggest that negative perceptions of methadone persist among racial and ethnic minority IDUs in Providence, including beliefs that methadone is detrimental to health and that people should attempt to discontinue methadone treatment. Additional potential obstacles to entering methadone therapy include cost and the difficulty of regularly attending a methadone clinic as well as the belief that an individual on MMT is not abstinent from drugs. Substance use researchers and treatment professionals should engage minority communities, particularly Latino communities, in order to better understand the treatment needs of a diverse population, develop culturally appropriate MMT programs, and raise awareness of the benefits of MMT.

  15. Unhealthy alcohol use, HIV infection and risk of liver fibrosis in drug users with hepatitis C.

    Directory of Open Access Journals (Sweden)

    Roberto Muga

    Full Text Available AIM: To analyze alcohol use, clinical data and laboratory parameters that may affect FIB-4, an index for measuring liver fibrosis, in HCV-monoinfected and HCV/HIV-coinfected drug users. PATIENTS AND METHODS: Patients admitted for substance abuse treatment between 1994 and 2006 were studied. Socio-demographic data, alcohol and drug use characteristics and clinical variables were obtained through hospital records. Blood samples for biochemistry, liver function tests, CD4 cell count, and serology of HIV and HCV infection were collected at admission. Multivariate linear regression was used to analyze the predictors of FIB-4 increase. RESULTS: A total of 472 (83% M, 17% F patients were eligible. The median age at admission was 31 years (Interquartile range (IQR 27-35 years, and the median duration of drug use was 10 years (IQR 5.5-15 years. Unhealthy drinking (>50 grams/day was reported in 32% of the patients. The FIB-4 scores were significantly greater in the HCV/HIV-coinfected patients (1.14, IQR 0.76-1.87 than in the HCV-monoinfected patients (0.75, IQR 0.56-1.11 (p<0.001. In the multivariate analysis, unhealthy drinking (p = 0.034, lower total cholesterol (p = 0.042, serum albumin (p<0.001, higher GGT (p<0.001 and a longer duration of addiction (p = 0.005 were independently associated with higher FIB-4 scores in the HCV-monoinfected drug users. The effect of unhealthy drinking on FIB-4 scores disappeared in the HCV/HIV-coinfected patients, whereas lower serum albumin (p<0.001, a lower CD4 cell count (p = 0.006, higher total bilirubin (p<0.001 and a longer drug addiction duration (p<0.001 were significantly associated with higher FIB-4 values. CONCLUSIONS: Unhealthy alcohol use in the HCV-monoinfected patients and HIV-related immunodeficiency in the HCV/HIV-coinfected patients are important risk factors associated with liver fibrosis in the respective populations.

  16. Risky Behaviors of Injecting Drug Users (IDUs Referred to Addiction Rehabilitation Centers in Khuzestan Province in 2014

    Directory of Open Access Journals (Sweden)

    Farkhondeh Jamshidi

    2017-07-01

    Full Text Available Aim: In the last decade, the prevalence of injecting drugs has been increasing rapidly. Injecting drug use puts one at the risk of risky behaviors that affect the health of individual and society. The present study aims at evaluating and comparing risky behaviors of injecting and non-injecting drug users. Methods: In this cross-sectional descriptive study, 4400 addicts referred to public, private and drop-in-centers (DICs in 2014 were enrolled. The addicts were divided into injecting and non-injecting drug users. A researcher-made questionnaire was used to collect demographic data and the pattern of drug use and risky behavior. Data were analyzed by SPSSV21, chi-square test and ANOVA. A significance level of less than 0.05 was considered. Results: Among the addicts, 4% were injecting drug users (IDUs and 96% non-injecting drug addicts (non-IDUs. The age of the first injection was 24.68 ± 6.45 years old. The age of onset of drug use in IDUs was significantly lower than in non-IDUs (P<0.001. Risky behaviors including the use of shared needles, risky sexual relations, a history of sexually transmitted infections and a history of imprisonment and suicide were significantly higher in IDUs. Addiction relapse and slip during treatment were higher in IDUs (P<0.001. Conclusion: Injecting drug addiction significantly increases the risk of relapse and risky behaviors. Priority should be given to risky behavior prevention programs.

  17. Social network members' roles and use of mental health services among drug users in New York City.

    Science.gov (United States)

    Sapra, Katherine J; Crawford, Natalie D; Rudolph, Abby E; Jones, Kandice C; Benjamin, Ebele O; Fuller, Crystal M

    2013-10-01

    Depression is more common among drug users (15-63 %) than the general population (5-16 %). Lack of social support network members may be associated with low mental health service (MHS) use rates observed among drug users. We investigated the relationship between social network members' roles and MHS use among frequent drug users using Social Ties Associated with Risk of Transition into Injection Drug Use data (NYC 2006-2009). Surveys assessed depression, MHS use, demographics, drug use and treatment, and social network members' roles. Participants reporting lifetime depressive episode with start/end dates and information on social/risk network members were included (n = 152). Adjusting for emotional support and HIV status, having one or more informational support network members remained associated with MHS use at last depressive episode (adjusted odds ratio (AOR) 3.37, 95 % confidence interval (CI) 1.38-8.19), as did history of drug treatment (AOR 2.75, 95 % CI 1.02-7.41) and no legal income (AOR 0.23, 95 % CI 0.08-0.64). These data suggest that informational support is associated with MHS utilization among depressed drug users.

  18. Estimation of Intravenous Drug Users' Population in Kermanshah City, West of Iran in 2016 using Capture-recapture Method.

    Science.gov (United States)

    Azhdar, Forod; Esmaeilnasab, Nader; Moradi, Ghobad; Roshani, Daem; Ghaderi, Ebrahim; Nori, Bijan

    2017-08-07

    Drug abuse, particularly intravenous drug use, is one of the most common challenges in human communities so that its negative impact on economic and cultural conditions of society and physical as well as mental health of individuals is evident. We aimed to estimate the IDUs' population in Kermanshah City, West of Iran using Capture-recapture method. A Cross-sectional study. The data in this study were collected from three different sources: Drop in Centers (DICs), Out Reach Teams (ORTs) and Methadone Maintenance Treatment centers (MMTs) in Kermanshah City from Mar 2015 until Mar 2016, and then indirect Capture-recapture was used to estimate the IDUs' population. The number of IDUs registered in DICs, ORTs, and MMTs were 694, 731, and 156 cases, respectively. Having determined the commonalities and removing duplicates, the number of drug users registered were 1,375 cases, after analysis of data, the number of drug users not registered in any center was estimated as 2,042 (95% CI: 1708, 2444). By counting 1,375 cases recorded in these sources, the total number of injection drug users in the Kermanshah City was about 3,417 people, (95% CI: (3083, 3819). The prevalence of IDUs in Kermanshah City is high, which could cause severe economic and social problems in the society. To reduce the negative effects of drug use, awareness and measuring of the drug users population, seem to be necessary overtime.

  19. No evidence of compensatory drug use risk behavior among heroin users after receiving take-home naloxone.

    Science.gov (United States)

    Jones, Jermaine D; Campbell, Aimee; Metz, Verena E; Comer, Sandra D

    2017-08-01

    Some fear that distribution of naloxone to persons at risk of experiencing an opioid overdose may reduce the perceived negative consequences of drug use, leading to riskier patterns of use. This study assessed whether participation in naloxone/overdose training altered drug use frequency, quantity or severity among heroin users in and out of treatment. Clinical interviews were performed assessing patterns of heroin and other drug use prior to, and at multiple timepoints after overdose education and naloxone training. This study compared baseline drug use to that at 1 and 3months post training. Both current heroin users (n=61) and former users in agonist maintenance (n=69) typically showed decreases in heroin and polydrug use at both 1 and 3months after training. The Addiction Severity Index drug composite score also decreased at follow up. This analysis found no evidence of compensatory drug use following naloxone/overdose training among two groups of heroin users. These findings support the acceptance and expansion of naloxone distribution to at-risk populations and may assist in allaying concerns about the potential for unintended negative consequences on drug use. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Injection Drug Users' Perceived Barriers to Using Self-Initiated Harm Reduction Strategies.

    Science.gov (United States)

    Bonar, Erin E; Rosenberg, Harold

    2014-08-01

    Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs' perceived barriers to engaging in these behaviors. We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one's drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants' most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated.

  1. Women users of drugs of abuse during pregnancy: characterization of a series of cases

    Directory of Open Access Journals (Sweden)

    Sônia Regina Marangoni

    2015-06-01

    Full Text Available This study characterized the sociodemographic and obstetric profile of women users of drugs of abuse during pregnancy. This is a descriptive and exploratory study, whose approach technique was the document records analysis of toxicological occurrence and medical charts of 32 women referred to a center for information and toxicological assistance of the Paraná State, between 2008 and 2010. The data were subjected to descriptive statistics. Most women had between 15 and 24 years (59.4%, between the first and third gestation, without prenatal care, poorly educated, without paid occupation (93.8%, and were in a common-law marriage (50%. Tobacco was used by 27 women (84.4%, crack by 24 (75%, and alcohol by 23 (71.7%. Besides the habitual use of drugs of abuse, it also stood out as risk factors before the pregnancy: teenage pregnancy, insecure marital status, and low education. As for the risks during the pregnancy, the most important clinical and obstetric problems were associated with addictive behavior. The sociodemographic profile corroborated the literature, but the multiparity, the low adhrence to the prenatal care, the multiuse of drugs, and the high number of complications, have indicated problems of health services to reach these women, resulting in a prolonged stay length, increased use of neonatal beds, and neonatal death.

  2. The role of prisons in the HIV epidemic among female injecting drug users.

    Science.gov (United States)

    Estébanez, P; Zunzunegui, M V; Aguilar, M D; Russell, N; Cifuentes, I; Hankins, C

    2002-02-01

    The objective of this study was to describe factors associated with imprisonment of female injecting drug users (IDUs) and to assess if female IDUs who have been in prison have different HIV risk behaviours when compared to females IDUs who have never been incarcerated. A seroepidemiological survey was conducted of 304 female IDUs recruited in outreach and treatment programmes in Madrid, Spain. Data on sociodemographic characteristics and recent and lifetime risk factors, sexual and reproductive history and history of imprisonment were collected. Bivariate analysis and a logistic regression model were used to identify factors associated with imprisonment. Risk factors for imprisonment were having illegal sources of income, not having a fixed address, leaving education before finishing primary school and starting injection of drugs early in adolescence. HIV risk behaviours were highly prevalent among this population of female IDUs and drug injection in prison was reported by more than one-third of those who had ever been imprisoned. In addition, recent HIV risk behaviour indicators were not associated with imprisonment, suggesting that incarceration did not lead to risk reduction after release from prison. Female IDUs who have been in prison have substantial reproductive health problems that require gynaecological care. These results point to the urgent need for prevention programmes which address HIV and other blood-borne infections using gender specific approaches for women IDUs incarcerated in Spanish prisons.

  3. The oral health of street-recruited injecting drug users: prevalence and correlates of problems.

    Science.gov (United States)

    Laslett, Anne-Marie; Dietze, Paul; Dwyer, Robyn

    2008-11-01

    To examine the effects of a series of injecting drug users' (IDU) characteristics and drug use behaviours upon the self-reported oral health of a sample of IDU. Cross-sectional survey. Melbourne, Australia. A total of 285 IDU recruited through needle and syringe programmes, snowballing and outreach across six sites. Structured survey that collected information on current drug use patterns, self-reported blood-borne virus status and general health factors, including open-ended questions on past-year dental health problems. Sixty-eight per cent of the sample reported dental problems that were commonly severe and caused dental pain. Despite these reported problems, almost half the sample had not visited the dentist in the 12 months prior to the survey. Participants who were older, and reported homelessness, not eating every day and more common injection of amphetamines rather than heroin in the previous month, were more likely to report having a past-year dental problem. Dental problems in IDUs are common but few receive treatment. Further, those using amphetamines, with poor housing, hygiene and poor nutrition, are most at risk. Programmes designed to improve the oral health of IDU need to be developed and implemented in a manner amenable to the varying social circumstances of this marginalized group in the community.

  4. Prevalence and risk factors for unrecognized obstructive lung disease among urban drug users

    Directory of Open Access Journals (Sweden)

    M Bradley Drummond

    2011-01-01

    Full Text Available M Bradley Drummond1, Gregory D Kirk1,2, Jacquie Astemborski2, Meredith C McCormack1, Mariah M Marshall2, Shruti H Mehta2, Robert A Wise1, Christian A Merlo11Department of Medicine, School of Medicine, 2Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USABackground: Obstructive lung disease (OLD is frequently unrecognized and undertreated. Urban drug users are at higher risk for OLD due to race, behavioral, and socioeconomic characteristics, yet little data exist on prevalence and risk factors associated with unrecognized OLD in this population.Objective: The objective of this study is to determine the prevalence of unrecognized OLD in an urban population and identify the characteristics associated with lack of physician-diagnosed OLD.Design: Cross-sectional analysis from the Acquired Immunodeficiency Syndrome Linked to the Intravenous Experience (ALIVE study, an observational study of current and former injection drug users in Baltimore, Maryland, USA.Participants: All participants with spirometry-defined airflow obstruction were stratified by the presence or absence of physician diagnosis of OLD.Main measures: Using cross-sectional demographic, clinical, and spirometric measurements, multivariable regression models were generated to identify factors independently associated with unrecognized OLD.Key results: Of the 1083 participants evaluated in the ALIVE lung substudy, 176 (16.3% met spirometric criteria for OLD. Of those, only 88 (50% had a physician diagnosis of OLD. The prevalence of unrecognized OLD decreased as severity of airflow obstruction increased. Factors independently associated with unrecognized OLD were absence of respiratory symptoms (prevalence ratio [PR], 1.70; 95% confidence interval [CI]: 1.29–2.23; P < 0.01 and less severe dyspnea (PR, 0.83; 95% CI: 0.72–0.96, per point increase in dyspnea scale; P = 0.01. In the subset of human immunodeficiency virus (HIV

  5. Polysubstance use in cannabis users referred for treatment: Drug use profiles, psychiatric comorbidity and cannabis-related beliefs

    Directory of Open Access Journals (Sweden)

    Jason Paul Connor

    2013-08-01

    Full Text Available Background: Population-based surveys demonstrate cannabis users are more likely to use both illicit and licit substances, compared with non-cannabis users. Few studies have examined the substance use profiles of cannabis users referred for treatment. Coexisting mental health symptoms and underlying cannabis-related beliefs associated with these profiles remains unexplored.Methods: Comprehensive drug use and dependence severity (Severity of Dependence Scale- Cannabis [SDS-C] data were collected on a sample of 826 cannabis users referred for treatment. Patients completed the General Health Questionnaire (GHQ-28, Cannabis Expectancy Questionnaire (CEQ, and Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ and Positive Symptoms and Manic-Excitement subscales of the Brief Psychiatric Rating Scale (BPRS. Latent class analysis (LCA was performed on last month use of drugs to identify patterns of multiple drug use. Mental health comorbidity and cannabis beliefs were examined by identified drug use pattern.Results: A three-class solution provided the best fit to the data- (1 Cannabis and tobacco users (n = 176, (2 Cannabis, tobacco, and alcohol users (n = 498, and (3 wide-ranging substance users (n = 132. Wide-ranging substance users (3 reported higher levels of cannabis dependence severity, negative cannabis expectancies, lower opportunistic and emotional relief self-efficacy, higher levels of depression and anxiety, and higher manic-excitement and positive psychotic symptoms.Conclusion: In a sample of cannabis users referred for treatment, wide-ranging substance use was associated with elevated risk on measures of cannabis dependence, comorbid psychopathology and dysfunctional cannabis cognitions. These findings have implications for cognitive-behavioural assessment and treatment.

  6. Unofficial policy: access to housing, housing information and social services among homeless drug users in Hartford, Connecticut

    Directory of Open Access Journals (Sweden)

    Corbett A Michelle

    2007-03-01

    Full Text Available Abstract Background Much research has shown that the homeless have higher rates of substance abuse problems than housed populations and that substance abuse increases individuals' vulnerability to homelessness. However, the effects of housing policies on drug users' access to housing have been understudied to date. This paper will look at the "unofficial" housing policies that affect drug users' access to housing. Methods Qualitative interviews were conducted with 65 active users of heroin and cocaine at baseline, 3 and 6 months. Participants were purposively sampled to reflect a variety of housing statuses including homeless on the streets, in shelters, "doubled-up" with family or friends, or permanently housed in subsidized, unsubsidized or supportive housing. Key informant interviews and two focus group interviews were conducted with 15 housing caseworkers. Data were analyzed to explore the processes by which drug users receive information about different housing subsidies and welfare benefits, and their experiences in applying for these. Results A number of unofficial policy mechanisms limit drug users' access to housing, information and services, including limited outreach to non-shelter using homeless regarding housing programs, service provider priorities, and service provider discretion in processing applications and providing services. Conclusion Unofficial policy, i.e. the mechanisms used by caseworkers to ration scarce housing resources, is as important as official housing policies in limiting drug users' access to housing. Drug users' descriptions of their experiences working with caseworkers to obtain permanent, affordable housing, provide insights as to how access to supportive and subsidized housing can be improved for this population.

  7. Tuberculosis among drug users and homeless persons: impact of voluntary X-ray investigation on active case finding.

    Science.gov (United States)

    Goetsch, U; Bellinger, O K; Buettel, K-L; Gottschalk, R

    2012-08-01

    Illicit drug use and homelessness are major contributors to the incidence of tuberculosis (TB) among inhabitants of major cities. The primary objective of this study was to establish a sustainable low-threshold chest X-ray screening programme for pulmonary TB among illicit drug users and homeless persons and to integrate this into the existing public health programme for active case finding. A secondary objective was to estimate the coverage of the programme, assess other risk factors and determine TB rates and treatment outcome in these two groups. Illicit drug users and homeless persons were asked to voluntarily participate in an X-ray screening programme. The coverage of the intervention, total number and characteristics of cases and the follow-up of treatment were assessed. A total of 4,529 chest radiographs were made from 3,477 persons, of whom 66% were homeless and 34% were illicit drug users, between May 2002 and April 2007. Coverage for screening once every 2 years ranged between 18 and 26%. Thirty-nine TB cases (14 drug users, 25 homeless persons) were identified, representing 8.7% of the total case load of 448 notified cases of pulmonary TB in Frankfurt during this period. Among the drug users, human immunodeficiency virus coinfection (10/14) seemed to play a key role in the development of TB. The case-finding rate of 861/100,000 radiographs (1,122/100,000 persons) is as high as that in routine contact investigations (1,078/100,000). Among all individuals with TB, 76% completed treatment. A novel targeted TB screening approach with voluntary radiographic examination of illicit drug users and homeless persons can be integrated into the existing public TB prevention programme and provides a high case-finding rate.

  8. The social determinants of emergency department and hospital use by injection drug users in Canada.

    Science.gov (United States)

    Palepu, A; Strathdee, S A; Hogg, R S; Anis, A H; Rae, S; Cornelisse, P G; Patrick, D M; O'Shaughnessy, M V; Schechter, M T

    1999-12-01

    The aim of this study was to describe the relationship between sociodemographic characteristics and human immunodeficiency (HIV) status of a cohort of injection drug users (IDUs) on their self-reported health service utilization. Interviewer-administered questionnaire. IDUs who had injected illicit drugs within the previous month were recruited through street outreach. They underwent serology for HIV-1 and questionnaires on demographics, drug using behaviors, housing status, and health service utilization (hospitalization overnight and emergency department visits) in the previous 6 months. Logistic regression analysis was used to identify independent associations with the use of health services. Of 1,103 cohort participants, 65% were male, 63% were white, and 23% were HIV positive. Cocaine was the most frequently injected drug used. Almost half (47%) had used health services in the previous 6 months. The following variables were associated independently with health service utilization (adjusted odds ratio; 95% confidence interval): unstable housing, defined as living primarily in a hotel, boarding room, or transition house or on the street in the past 6 months (1.44; 1.11-1.86); female gender (1.45; 1.11-1.89); HIV-positive status (1.43; 1.06-1.92); injection of cocaine (1.50; 1.12-2.02); and primary care I physician visit in past 6 months (1.91; 1.39-2.64). IDUs with unstable housing were more likely to report emergency department and hospital use, which may be a reflection of their disorganized lifestyle or poorer health status. Further studies are required to assess the effect on the health status and health care use of IDUs of interventions that increase the availability of safe, affordable housing.

  9. Factors associated with reported hepatitis C and HIV among injecting drug users in ten European cities.

    Science.gov (United States)

    March, Joan Carles; Oviedo-Joekes, Eugenia; Romero, Manuel

    2007-02-01

    To analyze self-reported prevalence of HCV and HIV in a sample of socially excluded injecting drug users, as well as factors associated with the presence of these diseases. Cross-sectional study. Data were collected with a structured, face-to-face questionnaire by outreach workers and privileged access interviewers in 1131 participants who had injected heroin and/or cocaine over the past year (71.5% men; mean age, 30 years) from Seville and Granada, Spain; Cologne, Germany; Vienna, Austria; Brussels, Belgium; Athens, Greece; Dublin, Ireland; London, England; Lisbon, Portugal and Perugia, Italy. Among the total sample, 595 (52.6%) participants reported HCV-positive status and 143 (12.6%) HIV-positive status. Multivariate analysis for HCV showed that women are at less risk than men, and that longer drug use, injecting while in prison, sharing needles, and reported positive status for tuberculosis, HBV, HIV or sexually-transmitted disease are positively associated with HCV. Participants reporting positive HIV status were generally older, had injected drugs while in prison, had completed less than 8 years of schooling, were divorced, had no regular employment, and declared infection with tuberculosis, sexually-transmitted disease and HCV. The highest incidences of HCV and HIV were reported by participants in a poorer social and health situation. Drug addicts must cope not only with their addiction but also with the process of social exclusion they are immersed in. To the greatest extent possible, any course of action for this group should be built into integrated, coordinated plans that take a broad approach to the main issues involved.

  10. Factors associated with premature mortality among young injection drug users in Vancouver

    Directory of Open Access Journals (Sweden)

    Strathdee Steffanie A

    2007-01-01

    Full Text Available Abstract Background Young injection drug users (IDUs may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mortality causes, rates and associations among this population. We undertook this study to investigate patterns of premature mortality, prior to age 30 years, among young IDUs. Methods Since 1996, 572 young (≤29 years IDUs have been enrolled in the Vancouver Injection Drug Users Study (VIDUS. Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and hepatitis C (HCV. Mortality data have been continually updated through linkages with the Provincial Coroner's Office. Crude and age-specific mortality rates, standardized mortality ratios, and life expectancy measures were calculated using person-time methods. Predictors of mortality were identified using Cox regression analyses. Findings Twenty-two participants died prior to age 30 years during the follow-up period for an overall crude mortality rate of 1,368 per 100,000 person-years. Overall, young IDUs were 16.4 times (95% confidence interval [CI]; 9.1–27.1 more likely to die; young women IDUs were 54.1 times (95%CI; 29.6–90.8 and young men IDUs were 12.9 times (95%CI; 5.5, 25.3 more likely to die when compared to the Canadian non-IDU population of the same age. The leading observed cause of death among females was: homicide (N = 9; and among males: suicide (N = 3 and overdose (N = 3. In Cox regression analyses, factors associated with mortality were, HIV infection (Hazard Ratio [HR]: 4.55; CI: 1.92–10.80 and sex work (HR: 2.76; CI: 1.16–6.56. Interpretation Premature mortality was 13 and 54 times higher among young men and women who use injection drugs in Vancouver than among the general population in Canada. The majority of deaths among the women were attributable to

  11. An experiential program to reduce AIDS risk among female sex partners of injection-drug users.

    Science.gov (United States)

    Rhodes, F; Wolitski, R J; Thornton-Johnson, S

    1992-11-01

    This article describes the development and implementation of an acquired immune deficiency syndrome (AIDS) intervention program for female sex partners of male injection-drug users. Four psychoeducational workshops were designed to motivate personal risk reduction, provide participants with necessary cognitive and behavioral skills, and enhance participants' perceived ability to enact positive changes in their lives. The development of the workshop modules was guided by traditional theories of health behavior change and social learning. Also included in the intervention are referral and advocacy services, personal risk reduction counseling, and human immunodeficiency virus (HIV) antibody testing. Preliminary results indicate that the program has made a significant impact on the AIDS risk of participants--91 percent of women who completed the program reported that they had made positive changes in their lives to reduce their risk of HIV infection.

  12. Eikenella corrodens endocarditis of the tricuspid valve in an intravenous drug user.

    Science.gov (United States)

    Elikowski, Waldemar; Małek-Elikowska, Małgorzata; Lisiceka, Monika; Wróblewski, Dariusz; Fertała, Natalia

    2017-02-20

    Infective endocarditis of the tricuspid valve (TVE) occurs predominantly in selected groups of patients including intravenous drug users (IVDUs). The most often cultured pathogen in IVDUs is Staphylococcus aureus. Eikenella corrodens, normally existing as a commensal in the mouth and the upper respiratory tract, is identified as an etiologic pathogen of endocarditis very rarely. The authors describe a case of a 27-year-old male with a past history of staphylococcal TVE readmitted to hospital after 5 months due to progression of right-sided heart failure. Bacteriological work-up revealed typical features and growth of E. corrodens. In echocardiography large vegetations on the damaged tricuspid valve and massive tricuspid regurgitation were seen. The prognosis of the disease, despite introduction of appropriate antibiotic therapy, was poor as he refused to undergo cardiac surgery.

  13. Drug addiction and alcoholism as predictors for tuberculosis treatment default in Brazil: a prospective cohort study.

    Science.gov (United States)

    Silva, M R; Pereira, J C; Costa, R R; Dias, J A; Guimarães, M D C; Leite, I C G

    2017-12-01

    This study aimed to evaluate the risk factors for tuberculosis (TB) treatment default in a priority city for disease control in Brazil. A cohort of TB cases diagnosed from 2008 to 2009 was followed up from patients' entry into three outpatient sites, in Juiz de Fora, Minas Gerais (Brazil), until the recording of the outcomes. Drug addiction, alcoholism and treatment site appeared to be independently associated with default. Current users of crack as the hardest drug (odds ratio (OR) 12·25, 95% confidence interval (CI) 3·04-49·26) were more likely to default than other hard drug users (OR 5·67, 95% CI 1·34-24·03), former users (OR 4·12, 95% CI 1·11-15·20) and those not known to use drugs (reference group). Consumers at high risk of alcoholism (OR 2·94, 95% CI 1·08-7·99) and those treated in an outpatient hospital unit (OR 8·22, 95% CI 2·79-24·21%) also were more likely to default. Our results establish that substance abuse was independently associated with default. National TB programmes might be more likely to achieve their control targets if they include interventions aimed at improving adherence and cure rates, by diagnosing and treating substance abuse concurrently with standard TB therapy.

  14. Getting the message straight: effects of a brief hepatitis prevention intervention among injection drug users.

    Science.gov (United States)

    Grau, Lauretta E; Green, Traci C; Singer, Merrill; Bluthenthal, Ricky N; Marshall, Patricia A; Heimer, Robert

    2009-12-15

    To redress gaps in injection drug users' (IDUs) knowledge about hepatitis risk and prevention, we developed a brief intervention to be delivered to IDUs at syringe exchange programs (SEPs) in three US cities. Following a month-long campaign in which intervention packets containing novel injection hygiene supplies and written materials were distributed to every client at each visit, intervention effectiveness was evaluated by comparing exposed and unexposed participants' self-reported injection practices. Over one-quarter of the exposed group began using the novel hygiene supplies which included an absorbent pad ("Safety Square") to stanch blood flow post-injection. Compared to those unexposed to the intervention, a smaller but still substantial number of exposed participants continued to inappropriately use alcohol pads post-injection despite exposure to written messages to the contrary (22.8% vs. 30.0%). It should also be noted that for those exposed to the intervention, 8% may have misused Safety Squares as part of pre-injection preparation of their injection site; attention should be paid to providing explicit and accurate instruction on the use of any health promotion materials being distributed. While this study indicates that passive introduction of risk reduction materials in injection drug users through syringe exchange programs can be an economical and relatively simple method of changing behaviors, discussions with SEP clients regarding explicit instructions about injection hygiene and appropriate use of novel risk reduction materials is also needed in order to optimize the potential for adoption of health promotion behaviors. The study results suggest that SEP staff should provide their clients with brief, frequent verbal reminders about the appropriate use when distributing risk reduction materials. Issues related to format and language of written materials are discussed.

  15. Impunity or Criminal Selection? The Subjetivity to Differentiate the Drug User and Drug Dealer in the City of Vitoria/ES

    Directory of Open Access Journals (Sweden)

    Elcio Cardozo Miguel

    2015-12-01

    Full Text Available This article objetives annalyze the subjectivity of paragraph 2o of the article 28 of brazilian Drug Law and the criminal system in state of Espirito Santo. It was proceeded a bibliographic study about the history of drug criminalization in Brazil. Subsequently, the data of criminal Judgments by Rio de Janeiro Court and the Federal District Court relating to drug traffic were analyzed. Then, a statistical summary of the Fourth Criminal Court of Vitória / ES, former Private Drug Court, was conducted to analyze how they are being applied present the subjective criteria to differentiate the user figures and drug dealer in the city. Finally, based on the research conducted, it was noted if exists economic interest implicit in the criminalization of drugs, and the difference in treatment agent involved with drugs as their socioeconomic conditions.

  16. Use of synthetic cathinones and cannabimimetics among injection drug users in San Diego, California.

    Science.gov (United States)

    Wagner, Karla D; Armenta, Richard F; Roth, Alexis M; Maxwell, Jane C; Cuevas-Mota, Jazmine; Garfein, Richard S

    2014-08-01

    Use of synthetic cathinones (SC) and cannabimimetics (i.e., "THC homologues" [TH]) is associated with adverse health effects. We investigated the epidemiology of synthetic drug use among a cohort of injection drug users (IDUs) in San Diego, California. We used logistic regression analysis to identify correlates of SC and TH use among 485 IDUs enrolled from June 2012 to September 2013. Seven percent of participants reported ever using SC and 30% reported ever using TH. In multivariate logistic regression, age and recent hospitalization were significantly associated with odds of SC use (Adjusted Odds Ratio [AOR] 0.93, 95% Confidence Interval [C.I.] 0.90, 0.97; and AOR 2.34 95% C.I. 1.00, 5.49, respectively) and TH use (AOR 0.96, 95% C.I. 0.94, 0.98; and AOR 2.62, 95% C.I. 1.47, 4.68, respectively). Use of methamphetamine (AOR 9.35, 95% C.I. 1.20, 72.79) and club drugs in the past six months (AOR 3.38, 95% C.I. 1.17, 9.76) were significantly associated with SC use. Being on probation/parole (AOR 2.42, 95% C.I. 1.44, 4.07), initiating injection drug use with stimulants (AOR 1.89 95% C.I. 1.13, 3.16), and past six-month marijuana (AOR 9.22, 95% C.I. 4.49, 18.96) and prescription drug use (AOR 1.98, 95% C.I. 1.20, 3.27) were significantly associated with TH use. A considerable proportion of IDU use synthetic drugs and may experience harms associated with their use. Findings have implications for criminal justice system management. Prevention efforts should emphasize the risks associated with rapidly changing synthetic formulations, and the potential harms associated with polydrug use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Physician experience and rates of plasma HIV-1 RNA suppression among illicit drug users: an observational study

    Directory of Open Access Journals (Sweden)

    Sangsari Sassan

    2012-01-01

    Full Text Available Abstract Background Despite the availability of antiretroviral therapy (ART, suboptimal treatment outcomes have been observed among HIV-seropositive illicit drug users. As there is an urgent need to improve responses to antiretroviral therapy among this population, we undertook this study to evaluate the role of physician experience on rates of plasma HIV-1 RNA suppression following initiation of ART. Methods Using data from a community-recruited cohort of HIV-positive illicit drug users, we used Cox proportional hazards regression to model the time to plasma viral HIV RNA Results Between May 1996 and December 2008, 267 individuals initiated ART among whom 227 (85% achieved a plasma HIV RNA Conclusions In this setting of universal HIV/AIDS care, illicit drug users with more experienced physicians exhibited faster rates of plasma viral load suppression. These findings argue for specialized services to help optimize HIV treatment outcomes among this population.

  18. Examining the relationship between ethnicity and the use of drug-related services: an ethnographic study of Nepali drug users in Hong Kong

    Science.gov (United States)

    Tang, Wai-Man

    2014-01-01

    A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed. PMID:25114609

  19. Access to highly active antiretroviral therapy for injection drug users: adherence, resistance, and death

    Directory of Open Access Journals (Sweden)

    David Vlahov

    Full Text Available Injection drug users (IDUs continue to comprise a major risk group for HIV infection throughout the world and represent the focal population for HIV epidemics in Asia and Eastern Europe/Russia. HIV prevention programs have ranged from HIV testing and counseling, education, behavioral and network interventions, drug abuse treatment, bleach disinfection of needles, needle exchange and expanded syringe access, as well as reducing transition to injection and primary substance abuse prevention. With the advent of highly active antiretroviral therapy (HAART in 1996, dramatic clinical improvements have been seen. In addition, the treatment's impact on reducing HIV viral load (and therefore transmission by all routes provides a stronger rationale for an expansion of the focus on prevention to emphasize early identification and treatment of HIV infected individuals. However, treatment of IDUs has many challenges including adherence, resistance and relapse to high risk behaviors, all of which impact issues of access and ultimately effectiveness of potent antiretroviral treatment. A major current challenge in addressing the HIV epidemic revolves around an appropriate approach to HIV treatment for IDUs.

  20. Access to highly active antiretroviral therapy for injection drug users: adherence, resistance, and death

    Directory of Open Access Journals (Sweden)

    Vlahov David

    2006-01-01

    Full Text Available Injection drug users (IDUs continue to comprise a major risk group for HIV infection throughout the world and represent the focal population for HIV epidemics in Asia and Eastern Europe/Russia. HIV prevention programs have ranged from HIV testing and counseling, education, behavioral and network interventions, drug abuse treatment, bleach disinfection of needles, needle exchange and expanded syringe access, as well as reducing transition to injection and primary substance abuse prevention. With the advent of highly active antiretroviral therapy (HAART in 1996, dramatic clinical improvements have been seen. In addition, the treatment's impact on reducing HIV viral load (and therefore transmission by all routes provides a stronger rationale for an expansion of the focus on prevention to emphasize early identification and treatment of HIV infected individuals. However, treatment of IDUs has many challenges including adherence, resistance and relapse to high risk behaviors, all of which impact issues of access and ultimately effectiveness of potent antiretroviral treatment. A major current challenge in addressing the HIV epidemic revolves around an appropriate approach to HIV treatment for IDUs.

  1. 'On the same level': facilitators' experiences running a drug user-led safer injecting education campaign.

    Science.gov (United States)

    Callon, Cody; Charles, Grant; Alexander, Rick; Small, Will; Kerr, Thomas

    2013-03-06

    Unsafe injection practices play a major role in elevated rates of morbidity and mortality among people who inject drugs (IDU). There is growing interest in the direct involvement of IDU in interventions that seek to address unsafe injecting. This study describes a drug user-led safer injecting education campaign, and explores facilitators' experiences delivering educational workshops. We conducted semi-structured qualitative interviews with 8 members of the Injection Support (IS) Team who developed and facilitated a series of safer injecting education workshops. Interviews explored facilitator's perceptions of the workshops, experiences being a facilitator, and perspectives on the educational campaign. Interviews were transcribed verbatim and a thematic analysis was conducted. IS Team facilitators described how the workshop's structure and content enabled effective communication of information about safer injecting practices, while targeting the unsafe practices of workshop participants. Facilitators' identity as IDU enhanced their ability to relate to workshop participants and communicate educational messages in language accessible to workshop participants. Facilitators reported gaining knowledge and skills from their involvement in the campaign, as well as positive feelings about themselves from the realization that they were helping people to protect their health. Overall, facilitators felt that this campaign provided IDU with valuable information, although facilitators also critiqued the campaign and suggested improvements for future efforts. This study demonstrates the feasibility of involving IDU in educational initiatives targeting unsafe injecting. Findings illustrate how IDU involvement in prevention activities improves relevance and cultural appropriateness of interventions while providing individual, social, and professional benefits to those IDU delivering education.

  2. Individual, social, and environmental influences associated with HIV infection among injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Strathdee, Steffanie A; Lozada, Remedios; Pollini, Robin A; Brouwer, Kimberly C; Mantsios, Andrea; Abramovitz, Daniela A; Rhodes, Tim; Latkin, Carl A; Loza, Oralia; Alvelais, Jorge; Magis-Rodriguez, Carlos; Patterson, Thomas L

    2008-03-01

    We examined correlates of HIV infection among injection drug users (IDUs) in Tijuana, Mexico, a city bordering the United States, which is situated on major migration and drug trafficking routes. IDUs aged > or =18 years were recruited using respondent-driven sampling. Participants underwent antibody testing for HIV and syphilis and structured interviews. Weighted logistic regression identified correlates of HIV infection. Of 1056 IDUs, the median age was 37 years, 86% were male, and 76% were migrants. HIV prevalence was higher in female participants than in male participants (8% vs. 3%; P = 0.01). Most IDUs testing HIV-positive were previously unaware of their serostatus (93%). IDUs reported injecting with a median of 2 people in the prior 6 months and had been arrested for having injection stigmata (ie, "track-marks") a median of 3 times. Factors independently associated with HIV infection were being female, syphilis titers consistent with active infection, larger numbers of recent injection partners, living in Tijuana for a shorter duration, and being arrested for having track-marks. Individual, social, and environmental factors were independently associated with HIV infection among IDUs in Tijuana. These findings suggest the need to intervene not solely on individual risk behaviors but on social processes that drive these behaviors, including problematic policing practices.

  3. Bisexual Behavior Among Male Injection Drug Users in New York City.

    Science.gov (United States)

    Reilly, Kathleen H; Neaigus, Alan; Wendel, Travis; Marshall, David M; Hagan, Holly

    2016-02-01

    Drug using men who have sex with men and women (MSMW) may be at high risk for HIV infection and transmitting HIV to sex partners. In 2012, injection drug users (IDUs) were sampled in New York City for the National HIV Behavioral Surveillance cross-sectional study using respondent-driven sampling. Logistic regression was used to calculate crude and adjusted odds ratios (aOR) and 95 % confidence intervals (95 %CI) to determine correlates of bisexual behavior in the past 12 months. Of 333 participants, 47(14.1 %) reported MSMW. Variables independently associated (p bisexual sexual identity (vs. "straight") (adjusted odds ratio (aOR) 92.6; 95 % CI 18.9, 454.5), Bronx residence [vs. Manhattan (aOR 8.4; 95 %CI 1.6,43.7)], past 12 month behaviors of having sex with ≥3 sex partners (aOR 18.1; 95 % CI 3.3,98.4), "sold" sex (aOR 8.5; 95 % CI 2.3, 31.5), "bought" sex (aOR 0.2; 95 % CI 0.1, 0.9), and injection methamphetamine use (aOR 20.5; 95 % CI 3.0, 139.7). MSM IDUs are an important subgroup to consider for HIV interventions, as they may not be reached through HIV prevention programming aimed at MSM.

  4. Mortality in HIV-Infected Alcohol and Drug Users in St. Petersburg, Russia.

    Science.gov (United States)

    Fairbairn, Nadia S; Walley, Alexander Y; Cheng, Debbie M; Quinn, Emily; Bridden, Carly; Chaisson, Christine; Blokhina, Elena; Lioznov, Dmitry; Krupitsky, Evgeny; Raj, Anita; Samet, Jeffrey H

    2016-01-01

    In Russia, up to half of premature deaths are attributed to hazardous drinking. The respective roles of alcohol and drug use in premature death among people with HIV in Russia have not been described. Criminalization and stigmatization of substance use in Russia may also contribute to mortality. We explored whether alcohol, drug use and risk environment factors are associated with short-term mortality in HIV-infected Russians who use substances. Secondary analyses were conducted using prospective data collected at baseline, 6 and 12-months from HIV-infected people who use substances recruited between 2007-2010 from addiction and HIV care settings in a single urban setting of St. Petersburg, Russia. We used Cox proportional hazards models to explore associations between 30-day alcohol hazardous drinking, injection drug use, polysubstance use and environmental risk exposures (i.e. past incarceration, police involvement, selling sex, and HIV stigma) with mortality. Among 700 participants, 59% were male and the mean age was 30 years. There were 40 deaths after a median follow-up of 12 months (crude mortality rate 5.9 per 100 person-years). In adjusted analyses, 30-day NIAAA hazardous drinking was significantly associated with mortality compared to no drinking [adjusted Hazard Ratio (aHR) 2.60, 95% Confidence Interval (CI): 1.24-5.44] but moderate drinking was not (aHR 0.95, 95% CI: 0.35-2.59). No other factors were significantly associated with mortality. The high rates of short-term mortality and the strong association with hazardous drinking suggest a need to integrate evidence-based alcohol interventions into treatment strategies for HIV-infected Russians.

  5. Access to highly active antiretroviral therapy (HAART) for injecting drug users in the WHO European Region 2002-2004

    DEFF Research Database (Denmark)

    Donoghoe, Martin C; Bollerup, Annemarie R; Lazarus, Jeff

    2007-01-01

    Providing equitable access to highly active antiretroviral treatment (HAART) to injecting drug users (IDUs) is both feasible and desirable. Given the evidence that IDUs can adhere to HAART as well as non-IDUs and the imperative to provide universal and equitable access to HIV/AIDS treatment for all...... the injecting status of those initiating HAART and the use of opioid substitution therapy among HAART patients, and discuss how HAART might be better delivered to injecting drug users. Our data adds to the evidence that IDUs in Europe have poor and inequitable access to HAART, with only a relatively small...

  6. Seroepidemiology and risk factors of Hepatitis B and C virus infections among drug users in Jakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Rino A. Gani

    2002-03-01

    Full Text Available The number of drug users is markedly increased in recent times. Data were collected consecutively in Cipto Mangunkusumo Hospital and Mitra Menteng Abadi Hospital in Jakarta. HBsAg were examined using reverse passive hemaglutination assay (RPHA and anti-HCV with dipstick method; both were from the laboratoium Hepatika, Mataram, Indonesia. In a 5 month period (March - August 1999 there were 203 cases of drug users. Most of them were male ( 185 cases or 91.1% with a mean age of 21.2 ± 4.3 years. Mean age in starting to use the drug was 18.8 ± 4.0 years. The prevalence of anti-HCV and HBsAg positivity were 74.9% (151 cases and 9.9% (19 cases, respectively. The prevalence of double infection was 7.4% (15 cases. Injection drug users (IDU were 168 cases (84%. Extramarital sex was done by 62 cases (30.5%, but only 16 cases (8% with more than one partner. Tattoo was found in 32 cases ( 15.8%. Multivariate analysis revealed that lDU and tattoo were the risk factors for anti-HCV positivity, with the OR of 9.15 (95% CI 3.28-5.53 and 13.24 (96% CI 1.6 - 109.55, respectively. No significant medical risk factor could be identified for HBsAg positivity. Double infection of HBV and HCV was found in 15 cases (7.4%. We concluded that the prevalence of HBV, HCV infection and double infection of HBV - HCV in drug users were high, with tattoo and injection drug usage as risk factors for hepatitis C virus infection. (Med J Indones 2002; 11: 48-55Keywords: HBsAg, Anti-HCV, tattoo, injection drug users

  7. Gender differences in HIV risk behaviours among intravenous drug users in Catalonia, Spain.

    Science.gov (United States)

    Folch, Cinta; Casabona, Jordi; Espelt, Albert; Majó, Xavier; Meroño, Mercè; Gonzalez, Victoria; Brugal, Maria Teresa

    2013-01-01

    To describe gender differences in injection and sexual risks behaviours, and human immunodeficiency virus (HIV) and hepatitis C (HCV) prevalence among injecting drug users (IDU) in Catalonia, Spain. Cross-sectional studies in 2008-2009 (n=748) and 2010-2011 (n=597) in the network of harm reduction centres. Face to face interviews were conducted and oral fluid samples were collected to estimate HIV/HCV prevalence. Female were more likely than male IDU to have had a steady sexual partner (68.2% versus 44.9%), to have had an IDU steady sexual partner (46.6% versus 15.1%) and to have exchanged sex for money or drugs in the last 6 months (25.5% versus 2.3%). There were no gender differences in injecting risk behaviours. HIV prevalence was 38.7% (91/235) in women and 31.5% (347/1103) in men (p=0.031). HIV prevalence among female IDU who reported having exchange sex for money or drugs was 53.3% (32/60). The prevalence of HCV was 67.4% (159/236) and 73.6% (810/1101) in female and male IDU, respectively (p=0.053). After adjustment by immigrant status, age and years of injection, differences among HIV/HCV prevalence by gender were not significant. This study demonstrated differences in sexual risk behaviours between male and female IDU, but failed to find gender differences in injecting risk behaviours. Apart from that, the higher prevalence of HIV among women than among men, together with a lower prevalence of HCV, provides evidence that sexual transmission of HIV is important among female IDU. Additional studies are needed to analyze in-depth these specific risk factors for women in order to develop appropriate prevention and health education programs. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Hepatitis C virus genotype diversity among intravenous drug users in Yunnan Province, Southwestern China.

    Directory of Open Access Journals (Sweden)

    Zhihui Zhang

    Full Text Available BACKGROUND: Recently, high proportions (15.6%-98.7% of intravenous drug users (IDUs in China were found to be positive for hepatitis C virus (HCV. Yunnan Province is located in southwestern China and borders one of the world's most important opium-producing regions, thus it is an important drug trafficking route to other regions of China. METHODOLOGY/PRINCIPAL FINDINGS: Here, we assessed 100 HCV-positive plasma samples from IDUs who were enrolled through the Kunming Center for Disease Control and Prevention in 2012. HCV C/E1 fragments were PCR-amplified and sequenced. We identified eight HCV subtypes (1a, 1b, 3a, 3b, 6a, 6n, 6u and 6v, of which genotype 6 was most predominant (frequency, 47% followed by genotypes 3 (41% and 1 (12%. HCV subtypes 6n (30% and 3b (29% were most common and were identified in 59% of the IDUs. We compared HCV genotypes among IDUs in Yunnan Province with those from other regions and found that the distribution patterns of HCV genotypes in Yunnan Province were similar to those in southern China, but different from those in eastern China. However, the distribution patterns of HCV subtypes varied among Yunnan Province and southern China, despite the shared similar genotypes. A comparison of the current data with those previously reported showed that the frequency of HCV genotype 6 increased from 25% to 47% within 5 years, especially subtypes 6a (5% to 15% and 6n (11.2% to 30%. In contrast, the frequencies of subtypes 3b and 1b decreased by almost 50% within 5 years. CONCLUSION/SIGNIFICANCE: Our results provided further information to support the assertion that drug trafficking routes influence HCV transmission patterns among IDUs in Yunnan Province. The frequency of HCV genotypes and subtypes changed rapidly among IDUs in Yunnan Province and subtypes 6a and 6n may have originated in Vietnam and Myanmar, respectively.

  9. Hepatitis C Virus Genotype Diversity among Intravenous Drug Users in Yunnan Province, Southwestern China

    Science.gov (United States)

    Wu, Wenlong; Feng, Ruilin; Wu, Zhongxiang; Cun, Wei; Dong, Shaozhong

    2013-01-01

    Background Recently, high proportions (15.6%–98.7%) of intravenous drug users (IDUs) in China were found to be positive for hepatitis C virus (HCV). Yunnan Province is located in southwestern China and borders one of the world's most important opium-producing regions, thus it is an important drug trafficking route to other regions of China. Methodology/Principal Findings Here, we assessed 100 HCV-positive plasma samples from IDUs who were enrolled through the Kunming Center for Disease Control and Prevention in 2012. HCV C/E1 fragments were PCR-amplified and sequenced. We identified eight HCV subtypes (1a, 1b, 3a, 3b, 6a, 6n, 6u and 6v), of which genotype 6 was most predominant (frequency, 47%) followed by genotypes 3 (41%) and 1 (12%). HCV subtypes 6n (30%) and 3b (29%) were most common and were identified in 59% of the IDUs. We compared HCV genotypes among IDUs in Yunnan Province with those from other regions and found that the distribution patterns of HCV genotypes in Yunnan Province were similar to those in southern China, but different from those in eastern China. However, the distribution patterns of HCV subtypes varied among Yunnan Province and southern China, despite the shared similar genotypes. A comparison of the current data with those previously reported showed that the frequency of HCV genotype 6 increased from 25% to 47% within 5 years, especially subtypes 6a (5% to 15%) and 6n (11.2% to 30%). In contrast, the frequencies of subtypes 3b and 1b decreased by almost 50% within 5 years. Conclusion/Significance Our results provided further information to support the assertion that drug trafficking routes influence HCV transmission patterns among IDUs in Yunnan Province. The frequency of HCV genotypes and subtypes changed rapidly among IDUs in Yunnan Province and subtypes 6a and 6n may have originated in Vietnam and Myanmar, respectively. PMID:24358211

  10. ANTITUBERCULOSIS DRUG DOSAGE FORMS: RANGE, KEY BENEFITS AND PROSPECTS OF TECHNOLOGICAL IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    M. E. Kim

    2016-01-01

    Full Text Available Interest to research in the development of new formulations of antituberculosis drugs due to the high incidence of tuberculosis in the Republic of Kazakhstan and the Russian Federation nowadays, including with acquired drug resistance. The reason for the development of acquired drug resistance is to interrupt the treatment of patients is the high toxicity of antituberculosis drugs. The improving the efficiency of antituberculosis therapy remains one of the most pressing.The aim this study was to review the dosage forms of antituberculosis drugs currently used and the ways to improve them.Methods. The study was conducted on the basis of scientific analysis (eLibrary database, PubMed, Cyberleninca, patent (kzpatents, reference (Klifar, Drugs register and technical literature.Results. It was revealed that the antituberculosis drugs are available in the form of tablets, capsules, granules for oral use and injection solutions. The advantages and disadvantages of oral dosage forms of antituberculosis drugs: tablets, capsules, granules, syrups, suspensions are described. The importance of the development and implementation in practice of pediatric formulations of antituberculosis drugs is mentioned. The state of current research inhaled formulations for the treatment of tuberculosis is described. The prospects of directional inhalation exposure by immobilization of antituberculosis drugs in liposomes, niosomes, nanocapsules, micelles, micro- and nanoparticles are mentioned. The prospect of the rectal formulations use is described. The increase in interest in the molecular encapsulation of medicinal substances with cyclodextrins in connection with the possibility of increasing the bioavailability of active ingredients, reduce the harmful effects on the gastrointestinal tract, extension, elimination of interaction of incompatible components in combination preparations, the protection of unstable substances is

  11. Approach-bias predicts development of cannabis problem severity in heavy cannabis users: results from a prospective FMRI study.

    Directory of Open Access Journals (Sweden)

    Janna Cousijn

    Full Text Available A potentially powerful predictor for the course of drug (abuse is the approach-bias, that is, the pre-reflective tendency to approach rather than avoid drug-related stimuli. Here we investigated the neural underpinnings of cannabis approach and avoidance tendencies. By elucidating the predictive power of neural approach-bias activations for future cannabis use and problem severity, we aimed at identifying new intervention targets. Using functional Magnetic Resonance Imaging (fMRI, neural approach-bias activations were measured with a Stimulus Response Compatibility task (SRC and compared between 33 heavy cannabis users and 36 matched controls. In addition, associations were examined between approach-bias activations and cannabis use and problem severity at baseline and at six-month follow-up. Approach-bias activations did not differ between heavy cannabis users and controls. However, within the group of heavy cannabis users, a positive relation was observed between total lifetime cannabis use and approach-bias activations in various fronto-limbic areas. Moreover, approach-bias activations in the dorsolateral prefrontal cortex (DLPFC and anterior cingulate cortex (ACC independently predicted cannabis problem severity after six months over and beyond session-induced subjective measures of craving. Higher DLPFC/ACC activity during cannabis approach trials, but lower activity during cannabis avoidance trials were associated with decreases in cannabis problem severity. These findings suggest that cannabis users with deficient control over cannabis action tendencies are more likely to develop cannabis related problems. Moreover, the balance between cannabis approach and avoidance responses in the DLPFC and ACC may help identify individuals at-risk for cannabis use disorders and may be new targets for prevention and treatment.

  12. Approach-bias predicts development of cannabis problem severity in heavy cannabis users: results from a prospective FMRI study.

    Science.gov (United States)

    Cousijn, Janna; Goudriaan, Anna E; Ridderinkhof, K Richard; van den Brink, Wim; Veltman, Dick J; Wiers, Reinout W

    2012-01-01

    A potentially powerful predictor for the course of drug (ab)use is the approach-bias, that is, the pre-reflective tendency to approach rather than avoid drug-related stimuli. Here we investigated the neural underpinnings of cannabis approach and avoidance tendencies. By elucidating the predictive power of neural approach-bias activations for future cannabis use and problem severity, we aimed at identifying new intervention targets. Using functional Magnetic Resonance Imaging (fMRI), neural approach-bias activations were measured with a Stimulus Response Compatibility task (SRC) and compared between 33 heavy cannabis users and 36 matched controls. In addition, associations were examined between approach-bias activations and cannabis use and problem severity at baseline and at six-month follow-up. Approach-bias activations did not differ between heavy cannabis users and controls. However, within the group of heavy cannabis users, a positive relation was observed between total lifetime cannabis use and approach-bias activations in various fronto-limbic areas. Moreover, approach-bias activations in the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) independently predicted cannabis problem severity after six months over and beyond session-induced subjective measures of craving. Higher DLPFC/ACC activity during cannabis approach trials, but lower activity during cannabis avoidance trials were associated with decreases in cannabis problem severity. These findings suggest that cannabis users with deficient control over cannabis action tendencies are more likely to develop cannabis related problems. Moreover, the balance between cannabis approach and avoidance responses in the DLPFC and ACC may help identify individuals at-risk for cannabis use disorders and may be new targets for prevention and treatment.

  13. Eosinophilic drug reactions detected by a prospective pharmacovigilance programme in a tertiary hospital.

    Science.gov (United States)

    Ramírez, Elena; Medrano-Casique, Nicolás; Tong, Hoi Y; Bellón, Teresa; Cabañas, Rosario; Fiandor, Ana; González-Ramos, Jessica; Herranz, Pedro; Trigo, Elena; Muñoz, Mario; Borobia, Alberto M; Carcas, Antonio J; Frías, Jesús

    2017-02-01

    We conducted a prospective evaluation of all eosinophilic drug reactions (EDRs) through the Prospective Pharmacovigilance Program from Laboratory Signals at Hospital to find out the incidence and distribution of these entities in our hospital, their causative drugs, and predictors. All peripheral eosinophilia >700 × 10 6  cells l -1 detected at admission or during hospitalisation, were prospectively monitored over 42 months. The spectrum of the localised or systemic manifestation of EDR, the incidence, the distribution of causative drugs, and the predictors were analysed. The incidence of EDR was 16.67 (95% Poisson confidence interval [CI]: 9.90-25.98) per 10 000 admissions. Of 274 cases of EDR, 154 (56.2%) cases in 148 patients were asymptomatic hypereosinophilia. In the remaining 120 (43.8%) cases, there was other involvement. Skin and soft tissue reactions were detected in 36 (13.1%) cases; visceral EDRs in 19(7.0%) cases; and drug-induced eosinophilic cutaneous and visceral manifestations were detected in the remaining 65 (23.7%) cases, 64 of which were potential drug reaction with eosinophilia and systemic symptoms (DRESS). After adjusting for age, sex, and hospitalisation wards, predictors of symptomatic eosinophilia were earlier onset of eosinophilia (hazard ratio [HR], 10.49; 95%CI: 3.13-35.16) higher eosinophil count (HR, 8.51; 95%CI: 3.28-22.08), and a delayed onset of corticosteroids (HR, 1.34; 95%CI: 1.01-1.73). A higher eosinophil count in patients with DRESS was significantly associated with greater impairment of liver function, prolonged hospitalisation, higher cumulative doses of corticosteroids, and if hypogammaglobinaemia was detected, a reactivation of human-herpesvirus 6 was subsequently detected. Half (53.3%, 64/120 cases) of symptomatic EDRs were potential DRESS. The main predictor of severity of EDR was an early severe eosinophilia. © 2016 The British Pharmacological Society.

  14. [Impact of personality disorders in a sample of 212 homeless drug users].

    Science.gov (United States)

    Combaluzier, S; Gouvernet, B; Bernoussi, A

    2009-10-01

    The impact of the mental disorders (axis I and II, according to DSM IV) on psychosocial problems (axis IV) is now a well-known fact, notably when substance abuse disorders are encountered on axis I. This leads to the conclusion that personality disorders increase the risk of substance abuse, that substance abuse increases the risk of homelessness, that dual diagnosis has a high impact on homelessness and underlines interactions between personality disorders (PD), drug abuse (DA) and homelessness. The aim of this paper is also to study these interactions. We will process the classical epidemiological measures, which have already produced interesting findings on other substance-linked disorders. We will study the multiplicative interaction (I(AB)) and the etiological fraction (EFi) linked to interaction, which evaluate the effects of two factors on another. According to the authors, the I(AB) determines whether the co-occurrence of two risk factors in a group induces more cases than each factor acting together; also if the I(AB) is greater than 1 it is possible to estimate the EFi, that proportionally measures the number of cases of the third factor that can be attributed to the co-occurrence. We will also study the interactions of homelessness and PD on DA, of the PD and DA on homelessness, and of this association DA and homelessness on PD. The data we will use in the paper deal with the prevalence of PD in general, drug users (n=226), homeless (n=999) and homeless drug abusers (n=212). The two last data are extracted from the same population and have been collected through clinical interviews, and the diagnosis follows the DSM criteria. They are comparable to Kokkevi et al.'s sample regarding the drug (heroin), the mean age (28 years for Kokkevi et al., 27 years in our sample), and the geographic origin of the populations (Mediterranean basin). The repartition of PD differs significantly (0.001) in the homeless population and the homeless drug abusers (chi(2

  15. A window of opportunity: declining rates of hepatitis B virus infection among injection drug users in Rio de Janeiro, and prospects for targeted hepatitis B vaccination Ventana de oportunidad: reducción de las tasas de infección por el virus de la hepatitis B entre usuarios de drogas inyectadas en Río de Janeiro, Brasil, y planes futuros en torno a la vacunación contra la hepatitis B

    Directory of Open Access Journals (Sweden)

    Sabrina A. N. Oliveira

    2005-11-01

    Full Text Available OBJECTIVES: To measure hepatitis B virus (HBV infection rates among injection drug users in Rio de Janeiro, Brazil, and to report their knowledge of and attitudes toward hepatitis and HBV vaccination. METHODS: 609 injection drug users recruited in Rio de Janeiro between 1999 and 2001 answered a questionnaire and were tested for hepatitis B and other blood-borne infections. Questions covered sociodemographic information, alcohol and illicit drug consumption, drug injection and sexual practices, medical history, and knowledge about HIV, AIDS and viral hepatitis. RESULTS: The prevalence of HBV infection was 27.1% , with 3.4% of the sample positive for HbsAg (active infection and 0.8% positive for anti-HBs (indicating previous HBV vaccination. Most interviewees (81.3% were aware of at least one form of viral hepatitis and received information from many different sources. In agreement with laboratory findings, 96.7% of the interviewees stated they had never been vaccinated against hepatitis B, but almost all unvaccinated interviewees (97.8% said they would volunteer to be vaccinated if HBV vaccination were available. CONCLUSIONS: Few of the injection drug users surveyed had ever been vaccinated against HBV. Although most were aware of the risks posed by viral hepatitis, this awareness seldom translated into consistent behavioral change. The participants' willingness to be vaccinated against HBV suggests that the implementation of vaccination for this population may help decrease rates of hepatitis B infection.OBJETIVOS: Calcular las tasas de infección por el virus de la hepatitis B (VHB en usuarios de drogas inyectadas en Río de Janeiro, Brasil, y dar a conocer sus conocimientos y actitudes en torno a la hepatitis y a la vacunación contra el VHB. MÉTODOS: Seiscientos nueve usuarios de drogas que se reclutaron en Río de Janeiro entre 1999 y 2001 respondieron a un cuestionario y fueron sometidos a pruebas para detectar la presencia de hepatitis B

  16. Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use - a qualitative study.

    Science.gov (United States)

    Bell, Hege Therese; Steinsbekk, Aslak; Granas, Anne Gerd

    2017-09-01

    The aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use. A qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation. The main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician's choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician. Elderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs.

  17. A PROSPECTIVE, OBSERVATIONAL STUDY OF ADVERSE REACTIONS TO DRUG REGIME FOR MULTI-DRUG RESISTANT PULMONARY TUBERCULOSIS IN CENTRAL INDIA.

    Directory of Open Access Journals (Sweden)

    Dr. Rohan C. Hire

    2014-09-01

    Full Text Available Abstract Objective: 1 To assess the adverse drug reactions of second line anti-tubercular drugs used to treat Multi-drug resistant Tuberculosis (MDR TB in central India on the basis of causality, severity and avoidability scales. 2 To study the relationship of type of MDR TB (primary or secondary and presence of diabetes mellitus (DM with mean smear conversion time. Material and Methods: A prospective, observational study was carried out on diagnosed multidrug resistant tuberculosis patients enrolled for DOTS‑Plus regimen at TB and Chest Disease Department from January to December 2012. They were followed for 9 months thereafter and encountered adverse drug reactions (ADRs were noted along with the time of sputum conversion. The data were analysed by Chi-square or Fisher’s exact test and unpaired student’s‘t’ test. Results: Total 64 ADRs were reported in 55 patients out of total 110 patients (n = 110. As per the Naranjo causality assessment of ADRs, 7 patients had “definite” causal relation, 45 had “probable” causal relation and 3 had “possible” causal relation with drugs of DOTS Plus regime. As per the Hartwig’s severity assessment scale, there were total 7 ADRs in Level 1, 6 in Level 2, 33 in Level 3 and 9 in Level 4. Hallas avoidability assessment scale divided the ADRs as 3 being “Definitely avoidable”, 26 “Possibly avoidable”, 23 “Not avoidable” and 3 “unevaluable”. . Mean sputum smear conversion time is significantly higher in patients with secondary type than that of primary type of MDR TB (p = 0.0001 and in patients with DM than those without DM (p <0.0001. Conclusion: ADRs were common in patients of MDR TB on DOTs-Plus drug regime. It was due to lack of availability of safer and equally potent drugs in DOTs-Plus drug regime compared to DOTS regime in non-resistant TB. The frequency and severity of ADRs can be reduced by strict vigilance about known and unknown ADRs, monitoring their laboratory and

  18. HIV prevalence and risks among injection and noninjection drug users in northern Thailand: need for comprehensive HIV prevention programs.

    Science.gov (United States)

    Razak, Myat Htoo; Jittiwutikarn, Jaroon; Suriyanon, Vinai; Vongchak, Tassanai; Srirak, Namtip; Beyrer, Chris; Kawichai, Surinda; Tovanabutra, Sodsai; Rungruengthanakit, Kittipong; Sawanpanyalert, Pathom; Celentano, David D

    2003-06-01

    The authors sought to determine sociodemographic and sexual and drug use risk factors for HIV infection among drug users in northern Thailand adjacent to the Golden Triangle. The authors enrolled patients admitted for inpatient drug detoxification at one treatment center in northern Thailand and studied HIV risks and prevalence using an interviewer-administered questionnaire and serum collection with HIV pretest and posttest counseling. Between February 1, 1999 and January 31, 2000, 1865 patients admitted for opiate and methamphetamine dependence completed study procedures. Overall HIV prevalence was 10.3%: 30.0% among 513 injection drug users (IDUs) and 2.8% among non-IDUs (OR = 14.8, 95% CI: 10.2, 21.6). HIV seroprevalence was 2.4% among exclusive methamphetamine users (98% of whom are non-IDUs) and 3.4% among opium smokers. Injection drug use was the dominant risk factor in multivariate models. Although Thailand is widely recognized as having a successful national response to the heterosexual HIV epidemic, seroprevalence in IDUs remains high. Despite a sharp increase of non-IDUs admitted to the drug treatment center, HIV infection and risks remained high among IDUs in northern Thailand. HIV prevention campaigns need to focus on IDUs and to implement harm reduction strategies to reduce transmission to IDUs and further contain the HIV epidemic in Thailand.

  19. Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

    Directory of Open Access Journals (Sweden)

    Suzy Danielly Barbosa Pacheco

    2014-06-01

    Full Text Available Introduction: Illicit drug users (DUs are vulnerable to hepatitis C virus (HCV infection. The shared use of illicit drugs is the main method of HCV transmission. Methods: A cross-sectional study was conducted in Breves, in northern Brazil. We surveyed 187 DUs to determine the prevalence of and factors associated with HCV infection. Results: The prevalence of anti-HCV antibodies was 36.9%, and the prevalence of hepatitis C virus-ribonucleic acid (HCV-RNA was 31%. Hepatitis C virus infection was associated with tattoos, intravenous drug use, shared use of equipment for drug use, drug use for longer than 3 years, and daily drug use. Conclusions: Strategies for preventing and controlling HCV transmission should be implemented among DUs.

  20. Application of hot melt extrusion for poorly water-soluble drugs: limitations, advances and future prospects.

    Science.gov (United States)

    Lu, Ming; Guo, Zhefei; Li, Yongcheng; Pang, Huishi; Lin, Ling; Liu, Xu; Pan, Xin; Wu, Chuanbin

    2014-01-01

    Hot melt extrusion (HME) is a powerful technology to enhance the solubility and bioavailability of poorly water-soluble drugs by producing amorphous solid dispersions. Although the number of articles and patents about HME increased dramatically in the past twenty years, there are very few commercial products by far. The three main obstacles limiting the commercial application of HME are summarized as thermal degradation of heat-sensitive drugs at high process temperature, recrystallization of amorphous drugs during storage and dissolving process, and difficulty to obtain products with reproducible physicochemical properties. Many efforts have been taken in recent years to understand the basic mechanism underlying these obstacles and then to overcome them. This article reviewed and summarized the limitations, recent advances, and future prospects of HME.

  1. Nonsteroidal anti-inflammatory drug choice and adverse outcomes in clopidogrel users: A retrospective cohort study.

    Science.gov (United States)

    Nam, Young Hee; Brensinger, Colleen M; Bilker, Warren B; Leonard, Charles E; Kasner, Scott E; Grosser, Tilo; Li, Xuanwen; Hennessy, Sean

    2018-01-01

    To examine the comparative safety of individual NSAIDs when given concomitantly with clopidogrel. We conducted a retrospective cohort study using Medicaid claims from five US states during 1999-2010, supplemented with Medicare claims for dual-enrollees. The exposure of interest was the first concomitant use of clopidogrel and one of the 10 selected NSAIDs after a 1-year baseline period. The outcomes were: all-cause mortality; acute myocardial infarction (AMI)/ischemic stroke; and gastrointestinal bleeding (GIB)/intracranial hemorrhage (ICH). We calculated the hazard ratio of each NSAID for each outcome, with ibuprofen as the reference drug, using high-dimensional propensity score-adjusted proportional-hazards regression models. Of 1,060,412 clopidogrel users, 268,114 concomitant NSAID users met inclusion/exclusion criteria, contributing 48,483 person-years. We observed 2,463 deaths, 2,822 AMI/ischemic stroke outcomes, and 2,620 GIB/ICH outcomes, for unadjusted incidence rates of 50.8, 58.6, and 54.3 per 1,000 person-years, respectively. Compared with ibuprofen and controlling for potential confounders, rofecoxib (hazard ratio [HR] = 1.22; 95% confidence interval [CI]: 1.04, 1.43) and valdecoxib (HR = 0.66; 95% CI: 0.48, 0.92) showed higher and lower hazards of mortality, respectively. Indomethacin showed an increased AMI/ischemic stroke hazard (HR = 1.38; 95% CI: 1.09, 1.74). For GIB/ICH, indomethacin (HR = 2.18; 95% CI: 1.74, 2.73), diclofenac (HR = 1.65; 95% CI: 1.39, 1.97), naproxen (HR = 1.47; 95% CI: 1.28, 1.70), and rofecoxib (HR = 1.26; 95% CI: 1.08, 1.48) showed higher hazards, and valdecoxib (HR = 0.73; 95% CI: 0.55, 0.98) showed a lower hazard. The bleeding risks of individual NSAIDs varied more markedly than thrombotic risks when used concomitantly with clopidogrel. Moreover, bleeding risk and thrombotic risk among individual NSAIDs did not appear to be inversely related to each other in the presence of clopidogrel. Further studies are needed to

  2. Patterns of drug abuse among drug users with regular and irregular attendance for treatment as detected by comprehensive UHPLC-HR-TOF-MS.

    Science.gov (United States)

    Sundström, Mira; Pelander, Anna; Simojoki, Kaarlo; Ojanperä, Ilkka

    2016-01-01

    The most severe consequences of drug abuse include infectious diseases, overdoses, and drug-related deaths. As the range of toxicologically relevant compounds is continually changing due to the emergence of new psychoactive substances (NPS), laboratories are encountering analytical challenges. Current immunoassays are insufficient for determining the whole range of the drugs abused, and a broad-spectrum screening method is therefore needed. Here, the patterns of drug abuse in two groups of drug users were studied from urine samples using a comprehensive screening method based on high-resolution time-of-flight mass spectrometry. The two groups comprised drug abusers undergoing opioid maintenance treatment (OMT) or drug withdrawal therapy and routinely visiting a rehabilitation clinic, and drug abusers with irregular attendance at a harm reduction unit (HRU) and suspected of potential NPS abuse. Polydrug abuse was observed in both groups, but was more pronounced among the HRU subjects with a mean number of concurrent drugs per sample of 3.9, whereas among the regularly treated subjects the corresponding number was 2.1. NPS and pregabalin were more frequent among HRU subjects, and their abuse was always related to drug co-use. The most common drug combination for an HRU subject included amphetamine, cannabis, buprenorphine, benzodiazepine, and alpha-pyrrolidinovalerophenone. A typical set of drugs for treated subjects was buprenorphine, benzodiazepine, and occasionally amphetamine. Abuse of several concurrent drugs poses a higher risk of drug intoxication and a threat of premature termination of OMT. Since the subjects attending treatment used fewer concurrent drugs, this treatment could be valuable in reducing polydrug abuse. Copyright © 2015 John Wiley & Sons, Ltd.

  3. THE PROSPECTIVE OBSERVATIONAL STUDY ON CUTANEOUS ADVERSE DRUG REACTIONS TO CHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    Prakash Mani

    2016-07-01

    Full Text Available INTRODUCTION There are a wide spectrum of adverse cutaneous drug reactions (ACDRs varying from transient maculopapular rash to fatal toxic epidermal necrolysis (TEN. With the advent of newer and targeted therapy in the field of dermatology, the pattern of cutaneous adverse drug eruptions and the drugs responsible for them keep changing every year. Hence, this study was undertaken to ascertain the clinical spectrum of ACDRs and the causative drugs, in a tertiary care centre in South India. MATERIALS AND METHODS This study was a prospective, observational study conducted in Department of Medical Oncology, Government Rajaji Hospital, Madurai Medical College, Madurai during the period of March 2015 - August 2015 (6 months. Severity of the reaction was assessed using CTCAE (Common Terminology Criteria for Adverse Events scale version 4.1. Causality of the drug was assessed using Naranjo Causality Assessment Scale. The scale was calculated first for the regimen and then for individual drugs separately. The adverse events with score of 6 or more (probable and definite adverse events were taken for the study. RESULTS AND CONCLUSION The overall incidence of ACDRs found in this study was 85%. Alopecia was the commonest ACDR occurring in 51.6% of patients. Nail pigmentation and supravenous pigmentation were the next common ACDRs, recorded in 35% and 16% of patients respectively. Imatinib caused generalised hypopigmentation in 40% of patients. Bleomycin induced, flagellate erythema and pigmentation in 17% of patients and stomatitis was seen in 11% of patients. Acneiform eruptions were recorded with erlotinib and gefitinib therapy. Supravenous pigmentation was common with 5-fluorouracil and docetaxel, occurring in 53% & 48% respectively. Newer targeted therapies like EGFR (Epidermal growth factor receptor inhibitors recorded low incidence of ACDRs like alopecia as against conventional antineoplastic agents. The cancer chemotherapeutic drugs are associated

  4. Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

    Science.gov (United States)

    Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

    2014-01-01

    Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

  5. Suicidal ideation and HIV risk behaviors among a cohort of injecting drug users in New Delhi, India

    Directory of Open Access Journals (Sweden)

    Sarin Enisha

    2013-01-01

    Full Text Available Abstract Background Data on mental health among injecting drug users in South Asia is scarce yet poor mental health among users has significant implications for the success of HIV prevention and treatment programmes. A cohort of 449 injecting drug users in Delhi was examined on the following issues (1 examine trends in suicidal ideation, suicide plan and suicidal attempts over a 12-month period, (2 examine association between injecting practices (receive and give used syringes and suicidal ideation over a 12 month study period. Methods An observational study was conducted providing phased interventions with follow up interviews every 3 months to 449 injecting drug users (IDUs, from August 2004 to November 2005. The study was conducted in Yamuna Bazaar, a known hub of drug peddling in Delhi. Interventions included nutrition, basic medical services, needle exchange, health education, HIV voluntary counseling and testing, STI diagnosis and treatment, oral buprenorphine substitution, and detoxification, each introduced sequentially. Results Suicidal ideation and suicide attempts, did not significantly change over 12 months of observation, while suicide plans actually increased over the time period. Keeping other factors constant, IDUs with suicidal ideation reported more giving and receiving of used syringes in the recent past. Conclusions: Mental health services are warranted within harm reduction programmes. Special attention must be paid to suicidal IDUs given their higher risk behaviours for acquiring HIV and other blood borne infections. IDU intervention programmes should assess and address suicide risk through brief screening and enhanced counseling.

  6. Pre-AIDS mortality and its association with HIV disease progression in haemophilic men, injecting drug users and homosexual men

    NARCIS (Netherlands)

    Prins, M. [= Maria; Sabin, C. A.; Lee, C. A.; Devereux, H.; Coutinho, R. A.

    2000-01-01

    To study pre-AIDS mortality and its association with HIV disease progression in different exposure groups with known intervals of HIV seroconversion. The type and rate of pre-AIDS deaths were assessed in 111 HIV-infected haemophilic men followed in London, and 118 injecting drug users and 158

  7. High risky behaviors among intravenous drug users in Isfahan, Iran: A study for hepatitis C harm reduction programs

    Directory of Open Access Journals (Sweden)

    Razieh Hassannejad

    2012-01-01

    Conclusions: According to the high prevalence of unprotected sexual contacts and unsafe injection among IVDUs, effectiveness interventions and harm reduction programs are necessary to prevent spread of blood-borne infection diseases particularly HCV. With reduction of risky behaviors and consequently decrease of spread of HCV, these programs benefit both drug users and society.

  8. Weighing the Consequences: Self-Disclosure of HIV-Positive Status among African American Injection Drug Users

    Science.gov (United States)

    Valle, Maribel; Levy, Judith

    2009-01-01

    Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV…

  9. Heterogeneity in risk-behaviour matters; Modelling the spread of HIV and Hepatitis C Virus among injecting drug users

    NARCIS (Netherlands)

    Vos, A.S. de

    2014-01-01

    By sharing injecting equipment, blood borne infections are spread among Injecting Drug Users (IDU). One infection that affects many IDU is the Hepatitis C Virus (HCV), which can cause liver cirrhosis and liver carcinoma. The virus that causes AIDS, HIV, is also spread by this route. In this thesis,

  10. The validity of drug users' self-reports in a non-treatment setting: prevalence and predictors of incorrect reporting methadone treatment modalities

    NARCIS (Netherlands)

    Langendam, M. W.; van Haastrecht, H. J.; van Ameijden, E. J.

    1999-01-01

    Epidemiological studies among drug users are often based on retrospective self-reports. However, among others, memory failure, being under the influence of drugs, psychopathology, misunderstanding of questions and socially desirable answering may generate inaccurate reporting. This study validated

  11. Injection drug users report good access to pharmacy sale of syringes.

    Science.gov (United States)

    Reich, Wendy; Compton, Wilson M; Horton, Joeseph C; Cottler, Linda B; Cunningham-Williams, Renee M; Booth, Robert; Singer, Merrill; Leukefeld, Carl; Fink, Joseph; Stopka, Tom J; Corsi, Karen Fortuin; Tindall, Michelle Staton

    2002-01-01

    To examine injection drug users (IDUs) opinions and behavior regarding purchase of sterile syringes from pharmacies. Focus groups. Urban and rural sites in Colorado, Connecticut, Kentucky, and Missouri. Eight focus groups, with 4 to 15 IDU participants per group. Transcripts of focus group discussions were evaluated for common themes by the authors and through the use of the software program NUD*IST. Knowledge of human immunodeficiency virus (HIV), pharmacy use, barriers to access from pharmacies, high-risk and risk-reducing behavior, and rural/urban difference. Almost all participants knew the importance of using sterile syringes for disease prevention and reported buying syringes from pharmacies more than from any other source. Two IDUs believed pharmacists knew the syringes were being used for injecting drugs and perceived pharmacists' sales of syringes to be an attempt to contribute to HIV prevention. Most IDUs reported that sterile syringes were relativity easy to buy from pharmacies, but most also reported barriers to access, such as having to buy in packs of 50 or 100, being made to sign a book, having to make up a story about being diabetic, or having the feeling that the pharmacists were demeaning them. While the majority of IDUs reported properly cleaning or not sharing syringes and safely disposing of them, others reported inadequate cleaning of syringes and instances of sharing syringes or of improper disposal. There were few differences in IDUs' reported ability to buy syringes among states or between urban and rural sites, although the data suggest that IDUs could buy syringes more easily in the urban settings. For the most part, participants understood the need for sterile syringes in order to protect themselves from HIV, hepatitis B virus, and hepatitis C virus and saw pharmacies as the best source of sterile syringes. Although these data are not generalizable, they suggest that pharmacists can and do serve as HIV-prevention service providers in

  12. Frailty, HIV infection, and mortality in an aging cohort of injection drug users.

    Directory of Open Access Journals (Sweden)

    Damani A Piggott

    Full Text Available Frailty is associated with morbidity and premature mortality among elderly HIV-uninfected adults, but the determinants and consequences of frailty in HIV-infected populations remain unclear. We evaluated the correlates of frailty, and the impact of frailty on mortality in a cohort of aging injection drug users (IDUs.Frailty was assessed using standard criteria among HIV-infected and uninfected IDUs in 6-month intervals from 2005 to 2008. Generalized linear mixed-model analyses assessed correlates of frailty. Cox proportional hazards models estimated risk for all-cause mortality.Of 1230 participants at baseline, the median age was 48 years and 29% were HIV-infected; the frailty prevalence was 12.3%. In multivariable analysis of 3,365 frailty measures, HIV-infected IDUs had an increased likelihood of frailty (OR, 1.66; 95% CI, 1.24-2.21 compared to HIV-uninfected IDUs; the association was strongest (OR, 2.37; 95% CI, 1.62-3.48 among HIV-infected IDUs with advanced HIV disease (CD4<350 cells/mm3 and detectable HIV RNA. No significant association was seen with less advanced disease. Sociodemographic factors, comorbidity, depressive symptoms, and prescription drug abuse were also independently associated with frailty. Mortality risk was increased with frailty alone (HR 2.63, 95% CI, 1.23-5.66, HIV infection alone (HR 3.29, 95% CI, 1.85-5.88, and being both HIV-infected and frail (HR, 7.06; 95%CI 3.49-14.3.Frailty was strongly associated with advanced HIV disease, but IDUs with well-controlled HIV had a similar prevalence to HIV-uninfected IDUs. Frailty was independently associated with mortality, with a marked increase in mortality risk for IDUs with both frailty and HIV infection.

  13. Decreased injecting is associated with increased alcohol consumption among injecting drug users in northern Vietnam.

    Science.gov (United States)

    Go, Vivian F; Minh, Nguyen Le; Frangakis, Constantine; Ha, Tran Viet; Latkin, Carl A; Sripaipan, Teerada; Davis, Wendy; Zelaya, Carla; Ngoc, Nguyen Phuong; Quan, Vu Minh

    2013-07-01

    Reducing injecting frequency may reduce the risk of HIV infection and improve health outcomes among injection drug users (IDUs). However, the reduction of one risk behavior may be associated with an increase in other risk behaviors, including the use of other risk-associated substances. Our objective was to determine if an association exists between a reduction in injecting and level of alcohol use among IDU. We conducted a longitudinal analysis of data collected for a randomized controlled trial examining the efficacy of a peer education intervention in reducing HIV risk among IDU and their network members in Thai Nguyen, Vietnam. Our analysis included active male injectors (n = 629) who were study participants and attended both baseline and 3-month visits. Frequency of alcohol consumption was assessed as the number of alcoholic drinks in the past 30 days. Change in risk and outcome behaviors was calculated as the difference in frequencies of behaviors between baseline and 3-month follow-up visits. The outcome of interest was concurrent decreased drug injection and increased alcohol consumption. The mean difference between baseline and 3-month follow-up of alcohol consumption and injection frequency in the past 30 days was 19.03 drinks (93.68 SD) and 20.22 injections (35.66 SD), respectively. Participants who reported reduced injection frequency were almost three times as likely to report increased alcohol consumption (OR 2.8; 95% CI, 2.0, 4.0). The proportion that both decreased injecting and increased alcohol by any amount in the past 30 days was 35.6%. In multivariate analysis higher education was significantly associated with an increase in alcohol and decrease in injecting of any amount. Male IDU may be at risk for increasing alcohol consumption when they reduce injection frequency. Interventions with male IDU that encourage reduction of injection may need to review specific strategies to limit alcohol consumption. Copyright © 2012 Elsevier B.V. All rights

  14. CCR5 Haplotypes Influence HCV Serostatus in Caucasian Intravenous Drug Users

    Science.gov (United States)

    Huik, Kristi; Avi, Radko; Carrillo, Andrew; Harper, Nathan; Pauskar, Merit; Sadam, Maarja; Karki, Tõnis; Krispin, Tõnu; Kongo, Ulvi-Kaire; Jermilova, Tatiana; Rüütel, Kristi; Talu, Ave; Abel-Ollo, Katri; Uusküla, Anneli; Ahuja, Sunil K.; He, Weijing; Lutsar, Irja

    2013-01-01

    Background Up to 90% HIV-1 positive intravenous drug users (IDUs) are co-infected with HCV. Although best recognized for its function as a major co-receptor for cell entry of HIV, CC chemokine receptor 5 (CCR5) has also been implicated in the pathogenesis of HCV infection. Here, we investigated whether CCR5 haplotypes influence HIV-1 and HCV seropositivity among 373 Caucasian IDUs from Estonia. Methods Of these IDUs, 56% and 44% were HIV and HCV seropositive, respectively, and 47% were coinfected. 500 blood donors seronegative for HIV and HCV were also evaluated. CCR5 haplotypes (HHA to HHG*2) were derived after genotyping nine CCR2–CCR5 polymorphisms. The association between CCR5 haplotypes with HIV and/or HCV seropositivity was determined using logistic regression analysis. Co-variates included in the models were length of intravenous drug use, HBV serostatus and copy number of CCL3L1, the gene encoding the most potent HIV-suppressive chemokine and ligand for CCR5. Results Compared to IDUs seronegative for both HCV and HIV (HCV−/HIV-), IDUs who were HCV+/HIV- and HCV+/HIV+were 92% and 82%, respectively, less likely to possess the CCR5-HHG*1 haplotype, after controlling for co-variates (Padjusted = 1.89×10−4 and 0.003, respectively). This association was mostly due to subjects bearing the CCR5 HHE and HHG*1 haplotype pairs. Approximately 25% andHIV- IDUs and HCV−/HIV- blood donors, respectively, possessed the HHE/HHG*1 genotype. Conclusions Our findings suggest that HHG*1-bearing CCR5 genotypes influence HCV seropositivity in a group of Caucasian IDUs. PMID:23936229

  15. Human-computer interaction in radiotherapy target volume delineation: a prospective, multi-institutional comparison of user input devices.

    Science.gov (United States)

    2011-10-01

    The purpose of this study was the prospective comparison of objective and subjective effects of target volume region of interest (ROI) delineation using mouse-keyboard and pen-tablet user input devices (UIDs). The study was designed as a prospective test/retest sequence, with Wilcoxon signed rank test for matched-pair comparison. Twenty-one physician-observers contoured target volume ROIs on four standardized cases (representative of brain, prostate, lung, and head and neck malignancies) twice: once using QWERTY keyboard/scroll-wheel mouse UID and once with pen-tablet UID (DTX2100, Wacom Technology Corporation, Vancouver, WA, USA). Active task time, ROI manipulation task data, and subjective survey data were collected. One hundred twenty-nine target volume ROI sets were collected, with 62 paired pen-tablet/mouse-keyboard sessions. Active contouring time was reduced using the pen-tablet UID, with mean ± SD active contouring time of 26 ± 23 min, compared with 32 ± 25 with the mouse (p ≤ 0.01). Subjective estimation of time spent was also reduced from 31 ± 26 with mouse to 27 ± 22 min with the pen (p = 0.02). Task analysis showed ROI correction task reduction (p = 0.045) and decreased panning and scrolling tasks (p < 0.01) with the pen-tablet; drawing, window/level changes, and zoom commands were unchanged (p = n.s.) Volumetric analysis demonstrated no detectable differences in ROI volume nor intra- or inter-observer volumetric coverage. Fifty-two of 62 (84%) users preferred the tablet for each contouring task; 5 of 62 (8%) denoted no preference, and 5 of 62 (8%) chose the mouse interface. The pen-tablet UID reduced active contouring time and reduced correction of ROIs, without substantially altering ROI volume/coverage.

  16. Active and latent tuberculosis among HIV-positive injecting drug users in Indonesia.

    Science.gov (United States)

    Meijerink, Hinta; Wisaksana, Rudi; Lestari, Mery; Meilana, Intan; Chaidir, Lydia; van der Ven, Andre J A M; Alisjahbana, Bachti; van Crevel, Reinout

    2015-01-01

    Injecting drug use (IDU) is associated with tuberculosis but few data are available from low-income settings. We examined IDU in relation to active and latent tuberculosis (LTBI) among HIV-positive individuals in Indonesia, which has a high burden of tuberculosis and a rapidly growing HIV epidemic strongly driven by IDU. Active tuberculosis was measured prospectively among 1900 consecutive antiretroviral treatment (ART)-naïve adult patients entering care in a clinic in West Java. Prevalence of LTBI was determined cross-sectionally in a subset of 518 ART-experienced patients using an interferon-gamma release assay. Patients with a history of IDU (53.1%) more often reported a history of tuberculosis treatment (34.8% vs. 21.9%, p history of IDU (29.1 vs. 30.4%, NS). The risk estimates did not change after adjustment for CD4 cell count or ART. HIV-positive individuals with a history of IDU in Indonesia have more active tuberculosis, with similar rates of LTBI. Within the HIV clinic, LTBI screening and isoniazid preventive therapy may be prioritized to patients with a history of IDU.

  17. BiodieselAnalyzer: a user-friendly software for predicting the properties of prospective biodiesel

    Directory of Open Access Journals (Sweden)

    Ahmad Farhad Talebi

    2014-06-01

    Full Text Available The procedures used to experimentally determine the quality parameters of a biodiesel are lengthy and expensive. Occasionally it may be impossible to obtain a sufficient amount of oil for the relevant analyses. This is often the case for algal biodiesel, for example. Here we report on a new software package, the BiodieselAnalyzer© Version 1.1, for predicting the properties of a prospective biodiesel. BiodieselAnalyzer© can estimate 16 different quality parameters of a biodiesel based on the fatty acid methyl ester profile of the oil feedstock used in making it. The current version of the BiodieselAnalyzer© is intended for the Windows platform and is publically available at http://www.brteam.ir/biodieselanalyzer.

  18. Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand.

    Science.gov (United States)

    Fairbairn, Nadia; Kaplan, Karyn; Hayashi, Kanna; Suwannawong, Paisan; Lai, Calvin; Wood, Evan; Kerr, Thomas

    2009-10-07

    Drug policy in Thailand has relied heavily on law enforcement-based approaches. Qualitative reports indicate that police in Thailand have resorted to planting drugs on suspected drug users to extort money or provide grounds for arrest. The present study sought to describe the prevalence and factors associated with this form of evidence planting by police among injection drug users (IDU) in Bangkok. Multivariate logistic regression was used to identify factors associated with evidence planting of drugs by police among a community-based sample of IDU in Bangkok. We also examined the prevalence and average amount of money paid by IDU to police in order to avoid arrest. 252 IDU were recruited between July and August, 2008, among whom 66 (26.2%) were female and the median age was 36.5 years. In total, 122 (48.4%) participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11), recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66), syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66), and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36). Among those who reported having drugs planted on them, 59 (48.3%) paid police a bribe in order to avoid arrest. A high proportion of community-recruited IDU participating in this study reported having drugs planted on them by police. Drug planting was found to be associated with numerous risk factors including syringe sharing and participation in government-run drug treatment programs. Immediate action should be taken to address this form of abuse of power reportedly used by police.

  19. Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand

    Directory of Open Access Journals (Sweden)

    Lai Calvin

    2009-10-01

    Full Text Available Abstract Background Drug policy in Thailand has relied heavily on law enforcement-based approaches. Qualitative reports indicate that police in Thailand have resorted to planting drugs on suspected drug users to extort money or provide grounds for arrest. The present study sought to describe the prevalence and factors associated with this form of evidence planting by police among injection drug users (IDU in Bangkok. Methods Multivariate logistic regression was used to identify factors associated with evidence planting of drugs by police among a community-based sample of IDU in Bangkok. We also examined the prevalence and average amount of money paid by IDU to police in order to avoid arrest. Results 252 IDU were recruited between July and August, 2008, among whom 66 (26.2% were female and the median age was 36.5 years. In total, 122 (48.4% participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11, recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66, syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66, and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36. Among those who reported having drugs planted on them, 59 (48.3% paid police a bribe in order to avoid arrest. Conclusion A high proportion of community-recruited IDU participating in this study reported having drugs planted on them by police. Drug planting was found to be associated with numerous risk factors including syringe sharing and participation in government-run drug treatment programs. Immediate action should be taken to address this form of abuse of power reportedly used by police.

  20. Examining the relationship between ethnicity and the use of drug-related services: an ethnographic study of Nepali drug users in Hong Kong

    Directory of Open Access Journals (Sweden)

    Tang WM

    2014-06-01

    Full Text Available Wai-Man Tang Anthropology Department, The Chinese University of Hong Kong, Hong Kong Abstract: A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed. Keywords: methadone, residential rehabilitation services, drug treatment, ethnicity, Nepalis

  1. Choosing Money over Drugs: The Neural Underpinnings of Difficult Choice in Chronic Cocaine Users.

    Science.gov (United States)

    Wesley, Michael J; Lohrenz, Terry; Koffarnus, Mikhail N; McClure, Samuel M; De La Garza, Richard; Salas, Ramiro; Thompson-Lake, Daisy G Y; Newton, Thomas F; Bickel, Warren K; Montague, P Read

    2014-01-01

    Addiction is considered a disorder that drives individuals to choose drugs at the expense of healthier alternatives. However, chronic cocaine users (CCUs) who meet addiction criteria retain the ability to choose money in the presence of the opportunity to choose cocaine. The neural mechanisms that differentiate CCUs from non-cocaine using controls (Controls) while executing these preferred choices remain unknown. Thus, therapeutic strategies aimed at shifting preferences towards healthier alternatives remain somewhat uninformed. This study used BOLD neuroimaging to examine brain activity as fifty CCUs and Controls performed single- and cross-commodity intertemporal choice tasks for money and/or cocaine. Behavioral analyses revealed preferences for each commodity type. Imaging analyses revealed the brain activity that differentiated CCUs from Controls while choosing money over cocaine. We observed that CCUs devalued future commodities more than Controls. Choices for money as opposed to cocaine correlated with greater activity in dorsal striatum of CCUs, compared to Controls. In addition, choices for future money as opposed to immediate cocaine engaged the left dorsolateral prefrontal cortex (DLPFC) of CCUs more than Controls. These data suggest that the ability of CCUs to execute choices away from cocaine relies on activity in the dorsal striatum and left DLPFC.

  2. Employment-based reinforcement of adherence to oral naltrexone treatment in unemployed injection drug users.

    Science.gov (United States)

    Dunn, Kelly E; Defulio, Anthony; Everly, Jeffrey J; Donlin, Wendy D; Aklin, Will M; Nuzzo, Paul A; Leoutsakos, Jeannie-Marie S; Umbricht, Annie; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

    2013-02-01

    Oral naltrexone has high potential for use as a relapse prevention pharmacotherapy for opiate dependence yet suffers from notoriously poor adherence. This study evaluated whether entry to a therapeutic workplace could reinforce adherence with oral naltrexone. Opiate-dependent and cocaine-using injection drug users were detoxified, inducted onto oral naltrexone, and randomly assigned to a contingency (n = 35) or prescription (n = 32) group for a 26-week period. Contingency participants were required to ingest naltrexone under staff observation to gain access to the therapeutic workplace. Prescription participants received a take-home supply of naltrexone and could access the workplace independent of naltrexone ingestion. Primary outcome measures were percent of urine samples positive for naltrexone at 30-day assessments and negative for opiates and cocaine at 30-day assessments. Contingency participants provided significantly more urine samples that were positive for naltrexone compared with prescription participants (72% vs. 21%, p workplace significantly promoted adherence to oral naltrexone, and that the majority of opiate use occurred in conjunction with cocaine use, suggesting that untreated cocaine use may limit the effectiveness of oral naltrexone in promoting opiate abstinence. (c) 2013 APA, all rights reserved.

  3. Survival of Hepatitis C Virus in Syringes: Implication for Transmission among Injection Drug Users

    Science.gov (United States)

    Paintsil, Elijah; He, Huijie; Peters, Christopher; Lindenbach, Brett D.; Heimer, Robert

    2010-01-01

    Background We hypothesized that the high prevalence of HCV among injection drug users (IDUs) might be due to prolonged virus survival in contaminated syringes. Methods We developed a microculture assay to examine the viability of HCV. Syringes were loaded with blood spiked with HCV reporter virus (Jc1/GLuc2A) to simulate two scenarios of residual volumes; low (2 μl) void volume for 1-ml insulin syringes, and high (32 μl) void volume for 1-ml tuberculin syringes. Syringes were stored at 4°C, 22°C, and 37°C for up to 63 days before testing for HCV infectivity using luciferase activity. Results The virus decay rate was biphasic (t½ α = 0.4h and t½β = 28h). Insulin syringes failed to yield viable HCV beyond day one at all storage temperatures except for 4o in which 5% of syringes yielded viable virus on day 7. Tuberculin syringes yielded viable virus from 96%, 71%, and 52% of syringes following storage at 4o, 22° and 37o for 7 days, respectively, and yielded viable virus up to day 63. Conclusions The high prevalence of HCV among IDUs may be partly due to the resilience of the virus and the syringe type. Our findings may be used to guide prevention strategies. PMID:20726768

  4. AIDS incidence and mortality in injecting drug users: the AjUDE-Brasil II Project

    Directory of Open Access Journals (Sweden)

    Cardoso Mauro Nogueira

    2006-01-01

    Full Text Available This paper presents AIDS incidence and mortality among injecting drug users (IDUs reached by the AjUDE-Brasil II Project. From a cross-sectional survey, 478 IDUs were interviewed in three Brazilian cities: Porto Alegre, São José do Rio Preto, and Itajaí. The cohort was followed up in the Brazilian surveillance database for AIDS and mortality during 2000 and 2001. AIDS incidence was 1.1 cases per 100 person-years, and the mortality rate was 2.8 deaths per 100 person-years. AIDS cases only occurred in IDUs who reported ever having shared injecting equipment. Female gender (RR = 5.30, homelessness (RR = 6.16, and report of previous sexual relations with same-sex partners (RR = 6.21 were associated with AIDS. Deaths occurred only among males. Homelessness (RR = 3.00, lack of income (RR = 2.65, HIV seropositive status (RR = 4.52, and no history of incarceration (RR = 3.71 were also associated with death. These findings support evidence that gender and socioeconomic conditions are both determinants of morbidity and mortality in Brazilian IDUs.

  5. AIDS incidence and mortality in injecting drug users: the AjUDE-Brasil II Project.

    Science.gov (United States)

    Cardoso, Mauro Nogueira; Caiaffa, Waleska Teixeira; Mingoti, Sueli Aparecida

    2006-04-01

    This paper presents AIDS incidence and mortality among injecting drug users (IDUs) reached by the AjUDE-Brasil II Project. From a cross-sectional survey, 478 IDUs were interviewed in three Brazilian cities: Porto Alegre, São José do Rio Preto, and Itajaí. The cohort was followed up in the Brazilian surveillance database for AIDS and mortality during 2000 and 2001. AIDS incidence was 1.1 cases per 100 person-years, and the mortality rate was 2.8 deaths per 100 person-years. AIDS cases only occurred in IDUs who reported ever having shared injecting equipment. Female gender (RR = 5.30), homelessness (RR = 6.16), and report of previous sexual relations with same-sex partners (RR = 6.21) were associated with AIDS. Deaths occurred only among males. Homelessness (RR = 3.00), lack of income (RR = 2.65), HIV seropositive status (RR = 4.52), and no history of incarceration (RR = 3.71) were also associated with death. These findings support evidence that gender and socioeconomic conditions are both determinants of morbidity and mortality in Brazilian IDUs.

  6. Decline and changing profile of hepatitis delta among injection drug users in Spain.

    Science.gov (United States)

    Aguilera, Antonio; Trastoy, Rocio; Barreiro, Pablo; Costa, José Javier; de Mendoza, Carmen; Peña, Jose M; Soriano, Vicente

    2018-01-01

    Roughly 15 million people worldwide have hepatitis delta, the most severe form of chronic viral hepatitis that often leads to cirrhosis and liver cancer. Injection drug users (IDUs) are the largest HDV reservoir. Their resurgence in North America and Europe may represent a new opportunity for HDV to spread more widely. We examined all consecutive active IDUs seen for the first time and enrolled in detoxification programmes at two clinics in Spain during two periods (1993-1996 and 2011-2014, respectively). Serum markers of HIV, HBV and HDV infection were tested. A total of 209 IDUs were examined in the first period. Mean age was 27-years-old. All had markers of past or current HBV infection. The rate of HIV-antibody (Ab), hepatitis B surface antigen (HBsAg) and HDV-Ab was as follows: 122 (58.4%), 73 (34.9%) and 62 (29.7%), respectively. Serum HDV-Ab was recognized in 53.4% of HBsAg+ and 16.9% of HBsAg- patients (Pforeign immigrants. It may reflect the benefit of universal HBV vaccination as well as the success of needle exchange programmes in Spain.

  7. A mixed methods approach to identifying factors related to voluntary HIV testing among injection drug users in Shanghai, China.

    Science.gov (United States)

    Du, Jiang; Lombardi, Christina; Evans, Elizabeth; Jiang, Haifeng; Zhao, Min; Meng, Ying-Ying

    2012-07-01

    Injection drug use is a major route of HIV transmission in China, yet relatively little is known about why so few injection drug users utilize free HIV testing services. This study aimed to examine barriers to HIV testing and voluntary counseling and testing (VCT) service utilization among injection drug users in Shanghai, China. Utilizing mixed methods, we analyzed data from a survey of 540 compulsory drug abuse treatment patients and data from focus groups with 70 service providers and patients. Only 24.4% of patients expressed willingness to be tested for HIV. Willingness to be tested was associated with younger age and more positive attitudes towards condom use. Patients reported several barriers to utilization of voluntary HIV testing services, including lack of information about these services, perceptions of no risk or low-risk for HIV infection, fear of positive results, and the stigma or discrimination that may be experienced by the patient or their family. Having limited skills related to HIV counseling was reported by service providers as the primary barrier to encouraging patients to utilize HIV testing/VCT services. Special intervention programs targeting injection drug users, their family members, and service providers may increase HIV testing in China. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  8. Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

    Science.gov (United States)

    Krupski, Antoinette; Graves, Meredith C; Bumgardner, Kristin; Roy-Byrne, Peter

    2015-11-01

    The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. 'Workers', 'clients' and the struggle over needs: understanding encounters between service providers and injecting drug users in an Australian city.

    Science.gov (United States)

    Moore, David

    2009-03-01

    A feature of contemporary Western, neo-liberal democracies is the frequent interaction between representatives of health and social services and the members of stigmatised and 'unruly' populations, such as injecting drug users. Previous research on drugs has tended to ignore the power relations and cultural dynamics at work in these encounters, and the ways in which they are framed by the wider neo-liberal context. Drawing on an ethnography of street-based heroin use in Melbourne, Australia's second largest city, I show how the discourses of both service providers and injecting drug users draw on wider neo-liberal values of independence, autonomy, rationality and responsibility. Service providers negotiate a framework of needs interpretation that creates and reproduces professional identities, and maintains boundaries between 'workers' and 'clients'. It also includes tensions around the definition of injecting drug users as 'chaotic' (i.e., failed neo-liberal) subjects, and slippage between service philosophies that emphasise a social model of health and forms of service delivery that emphasise the production of responsibilised subjects. For their part, street-based injectors construct an alternative framework of needs interpretation that emphasises their self-reliance, autonomy and independence, attributes and capacities largely denied them in service-provider discourse. In encounters with service providers, street-based injectors respond in various ways that include elements of resistance, strategic accommodation and the incorporation of therapeutic discourse. I conclude by considering the implications of my analysis for the future development of drug policy and practice.

  10. [Prevalence of human immunodeficiency virus infection and behaviors associated with its transmission among parenteral drug users selected on the street].

    Science.gov (United States)

    Rodés, A; Vall, M; Casabona, J; Nuez, M; Rabella, N; Mitrani, L

    1998-10-03

    To estimate the prevalence of HIV infection and the associated risk behaviours among intravenous drug users not receiving treatment for their drug dependence. A cross-sectional study of 200 intravenous drug users recruited from the streets of Barcelona in 1993. Information about the socio-demographic aspects and behaviours was obtained through a personal interview using a standardised questionnaire which was carried out by three ex-drug users. Saliva samples were used to determine anti HIV antibodies. The prevalence of HIV infection was 51%. 57% borrowed used syringes, 65% lended their syringes, and 41% practised back of frontloading. 85% if those who shared syringes always cleaned them, however 59% only used water. 78% had heterosexual relations, in 33% of the cases with a non-injecting sexual partner. 65% always used condoms with sexual clients although only 26% always used them with stable sexual partners and 36% with casual sexual partners. 78% had performed the HIV test and among those who knew they were seropositive, 40% had received some kind of health control in the last 6 months. Not having a legal income, injecting speedball or barbiturates, unknowing self HIV negative status and practicing forms of indirect sharing were found to be independently associated with syringe sharing. The high prevalence of HIV infection and associated risk behaviours highlights the need to increase and adapt the prevention efforts and investigation to this group. Social marginalization and poliuse of drugs should be addressed in HIV prevention programs.

  11. Tuberculosis report among injection drug users and their partners in Kazakhstan.

    Science.gov (United States)

    Hermosilla, S; El-Bassel, N; Aifah, A; Terlikbayeva, A; Zhumadilov, Z; Berikkhanova, K; Darisheva, M; Gilbert, L; Schluger, N; Galea, S

    2015-05-01

    Tuberculosis (TB) is a major threat to global public health. Kazakhstan has the second highest percentage of multidrug-resistant tuberculosis (MDR-TB) cases among incident tuberculosis cases in the world (WHO 2013). A high burden of MDR-TB suggests TB prevention, control, and treatment programs are failing. This study provides an epidemiologic profile of TB among injection drug users (IDUs), a high-risk and chronically underserved population, in Kazakhstan. Cross-sectional study. The authors studied the characteristics and risk environment of IDUs with self-reported previous active TB and their primary sexual partners in Almaty, Kazakhstan. 728 individuals (364 couples) participated in a couple-based study in 2009. 16.75% of participants reported at least one positive TB test (x-ray) in their lifetime. In a multivariable logistic regression adjusting for couple-based sampling, persons with positive TB test were significantly more likely to be older (odds ratio (OR) 7.26, 95% confidence interval (CI): 1.73, 30.43), male (OR 5.53, 95% CI: 2.74, 11.16), have a shorter duration of injection drug use (OR 0.17, 95% CI: 0.04, 0.65), have received high social support from their significant other (OR 2.13, 95% CI: 1.03, 4.40) and more likely (non-significantly) to have been incarcerated (OR 7.03, 95% CI: 0.64, 77.30). Older men with a history of incarceration and recent injection drug use were more likely to have positive TB test in Kazakhstan. Social network support, while potentially positive for many aspects of population health, may increase risk of TB among IDUs in this context. Public health policies that target high-risk populations and their at-risk networks may be necessary to stem the rise of MDR-TB in Central Asia. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. The effect of vacuum assisted socket suspension on prospective, community-based falls by users of lower limb prostheses.

    Science.gov (United States)

    Rosenblatt, Noah J; Ehrhardt, Tess

    2017-06-01

    Individuals with lower limb amputation are at increased risk of falling compared to age-matched peers. The purpose of this study was to quantify the effect of socket suspension on the risk of falling, by comparing prospectively tracked falls between a group of participants that used vacuum assisted socket suspension (VASS) and a group that did not use this system. Fifteen current users of VASS and 12 non-VASS users received an email every two weeks for one year, with a link to an online survey that asked whether they fell (i.e., "unintentionally came to rest on a lower surface") or stumbled (i.e., lost balance but did not fall) in the prior two weeks. A Chi-squared test was used to compare fall and stumble risk between groups, after stratifying by level of amputation, and the phi coefficient (φ) was used to quantify effect size. While the use of VASS did not affect the rate of falling (i.e., falls per person year) for either persons with transtibial amputation (TTA) or those with transfemoral amputation (TFA), the absolute risk of having multiple falls was reduced by nearly 75% in the former (φ=0.83), which is particularly important given that recurrent falls are associated with more severe injuries. There was no effect of VASS on the risk of falls in TFA. Further work is warranted to demonstrate the persistence of these effects in larger, more controlled samples. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Personality characteristics of students who became heavy drug users: an MMPI study of an avant-garde.

    Science.gov (United States)

    Goldstein, J W; Sappington, J T

    1977-01-01

    A psychometric study assessed the possibility of a preexisting personality configuration in students who became heavy drug users. We compared the MMPI profiles of 33 Carnegie Institute of Technology students who became heavy users of marijuana and hallucinogenic drugs and 33 peer control subjects. All subjects had been given the MMPI as entering freshmen in the years 1962-1965. The preuser sample constituted an avant-garde of drug-oriented counterculture in this setting. Profiles for both groups were well within normal limits yet unique in respective configurations. Preusers appeared to be socially skillful, adventorous, impulsive, and resistant to authority, while control subjects seemed less socially skilled, reserved, compulsive, and compliant. Significant scale differences appeared on Hy, Pd, and Ma, all being higher for preusers, and Es which favored the controls.

  14. 78 FR 78366 - Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment

    Science.gov (United States)

    2013-12-26

    ... increases FDA's authorities and responsibilities to address issues such as drug shortages, drug supply chain... and describes new standards and processes affecting drug and biologics approvals, drug supply chain... Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD...

  15. Low-threshold Care for Marginalised Hard Drug Users: Marginalisation and Socialisation in the Rotterdam Hard Drug Scene

    NARCIS (Netherlands)

    J. van der Poel (Agnes)

    2009-01-01

    textabstractSince the early 1990s several developments have taken place in the hard drug scene in the Netherlands. Key elements in these developments were harm reduction measures, introduction of crack, open drug scenes, police interventions, drug-related nuisance, low-threshold care facilities and

  16. Some characteristics of early-onset injection drug users prior to and at the time of their first injection.

    Science.gov (United States)

    Abelson, Jeanne; Treloar, Carla; Crawford, June; Kippax, Susan; van Beek, Ingrid; Howard, John

    2006-04-01

    This paper examines differences between early- and late-onset injection drug users (12-16 years versus 17-24 years) in terms of the antecedents and circumstances of first injection. Cross-sectional retrospective design, using logistic regression. Setting Australia: Sydney, Brisbane, rural New South Wales. A total of 336 injection drug users aged 16-25 years at the time of interview. Independent variables included family injection drug use, homelessness and other demographic variables, drugs used prior to the first injection, length of pre-injection drug career, behaviours at time of first injection (e.g. drug injected, reasons/motives for the first injection, risk behaviours). Early-onset injection was associated independently with: having a family who injected drugs, having left school early, an unreliable source of income, a short pre-injection drug career, planning of the first injection, reliance on others for administration of the first injection and denial that experimentation was the motive for the first injection. In bivariate analysis, early-onset injection was associated further with: homelessness, being an Indigenous Australian, omission of use of certain pre-injection drugs, group presence at first injection, reliance on others for acquisition of the first needle and syringe and having injected the first time because an injection was offered. The research shows that early-onset, compared with late-onset injectors, are more likely to have an immediate family who inject drugs and other problematic beginnings in early life. They have an accelerated transition to injection, and differences in autonomy and motivation at first injection. These characteristics may make them more vulnerable to risk taking.

  17. Functioning of Water Users Associations or Pani Panchayat in Orissa: Principle, Procedure, Performance and Prospects

    Directory of Open Access Journals (Sweden)

    Sushanta Kumar Mahapatra

    2007-09-01

    Full Text Available The current paper deals with an evaluation of water management through community participation and emergence of Pani Panchayat (PP in a case study of the Vir Bajrang Bali Pani Panchayat under Lift Irrigation Project of the Hirakud Command Area (HCA, Orissa state in Eastern India . The broad objective of this paper is to examine the functioning of Water User Association (WUA or Pani Panchayat promoted by the State and the local traditional irrigation institutions in the HCA, Orissa and to evaluate their functioning & characteristics in the context of local water management. The precise objectives are: (1 to analytically review the Orissa Farmers Management of Irrigation Systems Act and study the functioning of the Pani Panchayat, (2 to examine people's participation (3 study the apparatus of water management and control, and the impact of such management on productivity among the members and (4 to recommend policy interventions to make the formal institutions more successful. The paper concludes that the Pani Panchayats performance as regulatory institutions in charge of water distribution on equitable basis has been weak and unsuccessful. Even though the Pani Panchayat has been initiated and endorsed in the State for more than a couple of years, the acceptance of this model have been lethargic and scattered. As Pani Panchayat is a new concept needing experimentation and experience before finalisation of its content in greater detail, the irrigation agency is not in a position to spell out the different components of the programme in concrete terms. A detailed action plan should be prepared by the irrigation authority in consultation with the water users through Participatory Rural Appraisal method. A feasibility study should be under taken by examining the caste/class conflict, groupism, political differences and history of confrontation and conflict, if any. It is necessary to apply a bottom-up approach instead of a top-down one for

  18. Social media in health professional education: a student perspective on user levels and prospective applications.

    Science.gov (United States)

    Maloney, Stephen; Moss, Alan; Ilic, Dragan

    2014-12-01

    Social Networking Sites (SNS) have seen exponential growth in recent years. The high utilisation of SNS by tertiary students makes them an attractive tool for educational institutions. This study aims to identify health professional students' use and behaviours with SNS, including students' perspectives on potential applications within health professional curricula. Students enrolled in an undergraduate physiotherapy program were invited to take part in an anonymous, online questionnaire at the end of 2012. The survey consisted of 20 items, gathering demographic data, information on current use of SNS, and opinions regarding the application of SNS into education. Both quantitative and qualitative data were gathered. A total of 142 students, from all years of study, completed the online questionnaire. Only two participants were not current users of social media. Facebook and YouTube had been utilised for educational purposes by 97 and 60 % of participants respectively; 85 % believed that SNS could benefit their learning experience. Only five respondents were not interested in following peers, academic staff, clinicians or professional associations on Facebook. Four key themes emerged: peer collaboration, need for separation between personal and professional realms, complimentary learning and enhanced communication. Students wish to make educational connections via SNS, yet expressed a strong desire to maintain privacy, and a distinction between personal and professional lives. Educational utilisation of SNS may improve communication speed and accessibility. Any educator involvement should be viewed with caution.

  19. An international prospective cohort study of mobile phone users and health (COSMOS)

    DEFF Research Database (Denmark)

    Toledano, Mireille B; Auvinen, Anssi; Tettamanti, Giorgio

    2018-01-01

    This study investigates validity of self-reported mobile phone use in a subset of 75 993 adults from the COSMOS cohort study. Agreement between self-reported and operator-derived mobile call frequency and duration for a 3-month period was assessed using Cohen's weighted Kappa (κ). Sensitivity...... and specificity of both self-reported high (≥10 calls/day or ≥4h/week) and low (≤6 calls/week or mobile phone use were calculated, as compared to operator data. For users of one mobile phone, agreement was fair for call frequency (κ=0.35, 95% CI: 0.35, 0.36) and moderate for call duration (κ=0.50, 95......-reported mobile phone use was lower in women, younger age groups and those reporting symptoms during/shortly after using a mobile phone. This study highlights the ongoing value of using self-report data to measure mobile phone use. Furthermore, compared to continuous scale estimates used by previous studies...

  20. 78 FR 27113 - Generic Drug User Fee Amendments of 2012; Regulatory Science Initiatives Public Hearing; Request...

    Science.gov (United States)

    2013-05-09

    .... Postmarketing assessment of generic drugs and their brand-name counterparts 12. Physicochemical characterization... of Information (ELEM-1029), Food and Drug Administration, 12420 Parklawn Dr., Element Bldg...

  1. Latent Class Analysis of Polysubstance Use, Sexual Risk Behaviors, and Infectious Disease Among South African Drug Users

    Science.gov (United States)

    Trenz, Rebecca C.; Scherer, Michael; Duncan, Alexandra; Harrell, Paul; Moleko, Anne Gloria; Latimer, William

    2013-01-01

    Background HIV transmission risk among non-injection drug users is high due to the co-occurrence of drug use and sexual risk behaviors. The purpose of the current study was to identify patterns of drug use among polysubstance users within a high HIV prevalence population. Methods The study sample included 409 substance users from the Pretoria region of South Africa. Substances used by 20% or more the sample included: cigarettes, alcohol, marijuana and heroin in combination, marijuana and cigarettes in combination, and crack cocaine. Latent class analysis was used to identify patterns of polysubstance use based on types of drugs used. Multivariate logistic regression analyses compared classes on demographics, sexual risk behavior, and disease status. Results Four classes of substance use were found: MJ+Cig (40.8%), MJ+Her (30.8%), Crack (24.7%), and Low Use (3.7%). The MJ+Cig class was 6.7 times more likely to use alcohol and 3 times more likely to use drugs before/during sex with steady partners than the Crack class. The MJ+Cig class was16 times more likely to use alcohol before/during sex with steady partners than the MJ+Her class. The Crack class was 6.1 times more likely to engage in transactional sex and less likely to use drugs before/during steady sex than the MJ+Her class. Conclusions Findings illustrate patterns of drug use among a polysubstance using population that differ in sexual risk behavior. Intervention strategies should address substance use, particularly smoking as a route of administration (ROA), and sexual risk behaviors that best fit this high-risk population. PMID:23562370

  2. "They should have them all over the place": a health program for children of illicit drug users.

    Science.gov (United States)

    Byrne, J T; Bedford, H; Richter, K P; Bammer, G

    2000-08-01

    A peer-based support and advocacy group for illicit drug users in collaboration with a community nurse developed an innovative program for the children of users. The program provides well-baby checks, immunization monitoring, parenting advice, monitoring of children's safety, a free lunch and education about nutrition, as well as activities for the children and mothers. In addition, it allows mothers to have time out in a friendly, relaxed, safe, and nonjudgmental environment. The program has been running for more than 7 years, costs little, and gives a hard-to-reach population access to valuable health care.

  3. Impact of a longitudinal community HIV intervention targeting injecting drug users' stage of change for condom and bleach use.

    Science.gov (United States)

    Jamner, M S; Wolitski, R J; Corby, N H

    1997-01-01

    To evaluate the impact of the Long Beach AIDS Community Demonstration Project, a community-based HIV-prevention intervention incorporating principles from the Transtheoretical model in its design and evaluation. Repeated cross-sectional sampling with matched intervention and comparison communities. Neighborhoods in Long Beach, California, having a high prevalence of drug abuse and prostitution. 3081 injecting drug users who were sexually active and/or shared injection equipment. Trained peer volunteers distributed fliers featuring role model stories targeted to the population's stage of change. Fliers were packaged with bleaching kits and/or condoms. Primary outcome measures were exposure to the intervention, condom carrying, and stage of change for disinfecting injection equipment with bleach and for using condoms with main and other partners. Toward the end of the study, 77% of injection drug users in the intervention area reported being exposed to the intervention. In the intervention area, rates of condom carrying increased from 10 to 27% (p project exposure had higher stage-of-change scores for using condoms with a main partner (p Project intervention for reaching injecting drug users in the community and for motivating the adoption of risk-reducing practices.

  4. 78 FR 46958 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

    Science.gov (United States)

    2013-08-02

    ... product fees and annual sponsor fees, is $2,748,000 each (see 21 U.S.C. 379j-21(b)). B. Inflation... drug products, and for certain sponsors of such abbreviated applications for generic new animal drugs... applications for generic new animal drugs; (2) annual fees for certain generic new animal drug products; and (3...

  5. Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000-2001.

    Science.gov (United States)

    Des Jarlais, Don C; McKnight, Courtney; Friedmann, Patricia

    2002-01-01

    To assess preliminary results of the Expanded Syringe Access Demonstration Program (ESAP) in New York City. Temporal trends of pharmacy use among injection drug users (IDUs) in Brooklyn and Queens were analyzed from December 2000 through December 2001. Brooklyn and Queens, New York City. PARTIPANTS: IDUs. Attempts to purchase syringes from pharmacies and success in doing so. Of the 1,072 IDUs interviewed from December 2000 through December 2001, the majority were daily heroin injectors, but there was also substantial speedball and cocaine injection. There was a clear increase over time in both the percentage of subjects who attempted to purchase syringes in pharmacies and in the percentage who successfully purchased syringes. Among IDUs interviewed 4 or more months after ESAP began, large majorities of those who attempted to purchase syringes were successful in doing so. No differences in use of ESAP by IDUs were identified in Brooklyn versus Queens: 27% of IDUs interviewed in Queens reported that they had attempted to purchase syringes in pharmacies versus 28% in Brooklyn. Persons who reported injecting on a daily or more frequent basis were more likely to have attempted pharmacy purchases than persons who reported injecting less frequently, 32% versus 21%. The ESAP program has led to an increase in the use of pharmacies as sources of sterile injection equipment among IDUs in New York City. The extent to which pharmacies become an important source of sterile injection equipment and the effect of legal pharmacy sales on risk behaviors for human immunodeficiency virus (HIV) infection remain to be determined.

  6. HIV infection among injecting drug users in north-east Malaysia, 1992.

    Science.gov (United States)

    Singh, S; Crofts, N

    1993-01-01

    Human immunodeficiency virus (HIV) has spread widely among injecting drug users (IDUs) in countries to the north and west of the 'Golden Triangle' region of South-East Asia; it is likely to have spread southwards to Malaysia as well. In order to assess HIV seroprevalence among IDUs in north-east Malaysia and describe risk factors for HIV infection in this population, we performed a cross-sectional seroepidemiological study among 210 IDUs recruited at the detoxification ward of the General Hospital in the capital city of the north-eastern Malaysian state, Kelantan. Subjects were sequential entrants to the detoxification ward, interviewed about HIV risk behaviour, and tested for antibody to HIV and to syphilis. Nearly a third (62/210, 30%) of these IDUs were HIV seropositive. Three-quarters (159/210) had travelled to Thailand in the preceding 5 years, of whom 32% (51/159) were HIV seropositive; this was associated with injecting in Thailand, but not with sexual contact there. Of those who had not left Malaysia in the preceding 5 years, 26% (11/43) were HIV seropositive, a rate not significantly different from those who had travelled. Travel within Malaysia was common (144/210, 69%) among IDUs interviewed, as was unsafe injecting and unsafe sexual behaviour (20% had shared injecting equipment and 21% had had unprotected intercourse) in other states. In every locale, rates of unsafe injecting behaviour were high (55% sharing in last month), even among those who knew they were HIV infected, and rates of condom usage were low (93% of 160 sexually active IDUs had never used a condom). Syphilis was not associated with HIV infection, but with contact with Thai prostitutes.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. MBL2 and Hepatitis C Virus Infection among Injection Drug Users

    Directory of Open Access Journals (Sweden)

    Edlin Brian R

    2008-05-01

    Full Text Available Abstract Background Genetic variations in MBL2 that reduce circulating levels and alter functional properties of the mannose binding lectin (MBL have been associated with many autoimmune and infectious diseases. We examined whether MBL2 variants influence the outcome of hepatitis C virus (HCV infection. Methods Participants were enrolled in the Urban Health Study of San Francisco Bay area injection drug users (IDU during 1998 through 2000. Study subjects who had a positive test for HCV antibody were eligible for the current study. Participants who were positive for HCV RNA were frequency matched to those who were negative for HCV RNA on the basis of ethnicity and duration of IDU. Genotyping was performed for 15 single nucleotide polymorphisms in MBL2. Statistical analyses of European American and African American participants were conducted separately. Results The analysis included 198 study subjects who were positive for HCV antibody, but negative for HCV RNA, and 654 IDUs who were positive for both antibody and virus. There was no significant association between any of the genetic variants that cause MBL deficiency and the presence of HCV RNA. Unexpectedly, the MBL2 -289X promoter genotype, which causes MBL deficiency, was over-represented among European Americans who were HCV RNA negative (OR = 1.65, 95% CI 1.05–2.58, although not among the African Americans. Conclusion This study found no association between genetic variants that cause MBL deficiency and the presence of HCV RNA. The observation that MBL2 -289X was associated with the absence of HCV RNA in European Americans requires validation.

  8. High HIV incidence in a cohort of male injection drug users in Delhi, India.

    Science.gov (United States)

    Sarna, Avina; Saraswati, Lopamudra Ray; Sebastian, Mary; Sharma, Vartika; Madan, Ira; Lewis, Dean; Pulerwitz, Julie; Thior, Ibou; Tun, Waimar

    2014-06-01

    India has an estimated 177,000 injection drug users (IDU) with a national HIV prevalence of 7.14%. Reliable estimates of HIV incidence are not available for this population. We report HIV incidence in a cohort of male, HIV-negative IDUs recruited through peer-referral, targeted outreach and as walk-in clients in Delhi from May to October, 2011. Fourth-generation Antigen-Antibody tests were used to diagnose new infections and results were confirmed using Western blot tests. HIV incidence based on HIV seroconversion was calculated as number of events/person-years. Cox regression was used to identify significant (p<0.05) seroconversion predictors. A total of 2790 male HIV-negative IDUs were recruited at baseline; 67.4% (n=1880) returned for their first follow-up visit and 96% (n=1806) underwent HIV testing. Participants were followed for a median of 9.7 months. A total of 112 new HIV infections occurred over a cumulative 1398.5 person-years of follow-up resulting in an incidence rate of 8.01 new infections/100 person-years (95% CI: 6.65-9.64); 74% of these participants reported risky injection practices in the past month. In multivariate analysis, moderate-high risk injection behaviors (Adjusted Hazard Ratio [AHR] 2.59; 95% CI 1.45-4.62) were associated with a higher risk of new infections. Male IDUs in Delhi continue to practice unsafe injection practices leading to high sero-incidence despite the availability of HIV prevention services offered through targeted intervention programs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Differential Risk of Peptic Ulcer Among Users of Antidepressants Combined With Nonsteroidal Anti-inflammatory Drugs.

    Science.gov (United States)

    Shin, Ju-Young; Song, Inmyung; Lee, Jin-Ho; Yoon, Jong Lull; Kwon, Jun Soo; Park, Byung-Joo

    2017-04-01

    Selective serotonin reuptake inhibitors (SSRIs) have been reported to have an increased risk of gastrointestinal adverse events, and the risk may be further increased by combined use of nonsteroidal anti-inflammatory drugs (NSAIDs). However, little has been known about the risk of peptic ulcer associated with other classes of antidepressants or individual antidepressants combined with NSAIDs. We conducted a retrospective cohort study to define the risk of peptic ulcer associated with combined use of antidepressants and NSAIDs, as compared with use of antidepressants alone. Using the Korean Health Insurance Review and Assessment Service database, we identified a total of 1,127,622 patients who began receiving antidepressants between 2009 and 2012. Propensity-based matching and Cox proportional hazards models were used to compare the risk of peptic ulcer between antidepressant users with NSAIDs and those without NSAIDs matched in a 1:1 ratio, for a total of 768,850 patients. The risk of peptic ulcer did not increase with combined use of overall antidepressants and NSAIDs, as compared with antidepressant use alone (hazard ratio [HR], 1.02; 95% confidence interval [CI], 0.99-1.06). A slightly increased risk was observed for combined use of NSAIDs with tricyclic antidepressants (HR, 1.15; 95% CI, 1.09-1.21) and with SSRIs (HR, 1.08; 95% CI, 1.01-1.16). We found that although concomitant use of NSAIDs and antidepressants was not associated with an increased risk of peptic ulcer for antidepressants in general, it was so for some specific classes including tricyclic antidepressants and SSRIs. However, we cannot rule out the possibility that the increased risk was solely due to NSAID use.

  10. Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study

    Directory of Open Access Journals (Sweden)

    Khodabakhsh Ahmadi

    2012-01-01

    Full Text Available Purpose. To assess the prevalence and associated factors of unprotected sex with injecting drug users (IDUs among a sample of female sex workers (FSWs in Iran. Methods. This cross-sectional study included 144 FSWs who were interviewed as a part of Unhide HIV Risk Study, a national behavioral survey focusing on various high-risk populations, including IDUs, FSWs, and Men who have Sex with Men (MSMs in 2009. The survey was conducted in eight provinces in Iran using respondent-driven sampling. Participants’ sociodemographic status, HIV knowledge, and HIV attitude were analyzed via logistic regression to determine the predictors of unprotected sex with IDU(s during the past month. Results. Nineteen percent of FSWs reported at least one occasion of unprotected sex with IDU(s in the month preceding the study. Higher educational level (OR=−0.653, 95%CI=-1.192 to −0.115, perceived HIV risk (OR=−1.047, 95%CI=-2.076 to −0.019, and perceived family intimacy during childhood (OR=−1.104, 95%CI=-1.957 to −0.251 were all independently associated with lower odds of having unprotected sex with IDU(s in the month preceding the study. Age, marital status, living condition, HIV knowledge, and perceived behavioral control did not affect the odds of FSWs having sex with IDUs. Conclusion. Perceived HIV risk, which is a modifiable factor, seems to be a promising target for harm reduction interventions amongst Iranian female sex workers. Data presented here may aid in reducing or eliminating the role of sex workers as a bridge for HIV transmission from IDUs to the general population in Iran.

  11. Low Multiplicity of HIV-1 Infection and No Vaccine Enhancement in VAX003 Injection Drug Users

    Science.gov (United States)

    Sterrett, Sarah; Learn, Gerald H.; Edlefsen, Paul T.; Haynes, Barton F.; Hahn, Beatrice H.; Shaw, George M.; Bar, Katharine J.

    2014-01-01

    Background  We performed human immunodeficiency virus type 1 (HIV-1) transmitted/founder (T/F) virus analysis of the VAX003 vaccine efficacy trial participants to characterize the transmission bottleneck and test for vaccine-associated reduction or enhancement of infection in this injection drug user (IDU) cohort. Methods  We performed single genome sequencing of plasma vRNA from 50 subjects sampled in early HIV infection. Sequences were analyzed phylogenetically, T/F viruses enumerated, and a sieve analysis performed. Results  Eight of 19 (42%) placebo recipients were productively infected by more than 1 virus (range 1–5, median 1, mean 1.7). This frequency of multiple virus transmission was greater than reported for heterosexual cohorts (19%, P = .03) but not statistically different from vaccine recipients (22.6%, P > .05), where the range was 1–3, median 1, and mean 1.3 (P > .05 for all comparisons). An atypical sieve effect was detected in Env V2 but was not associated with reduction or enhancement of virus acquisition. Conclusions  The number of T/F viruses in IDUs was surprising low, with 95% of individuals infected by only 1–3 viruses. This finding suggests that a successful vaccine or other prevention modality generally needs to protect against only one or a few viruses regardless of risk behavior. T/F analysis identified an atypical genetic sieve in the V2 region of Envelope and found no evidence for vaccine-mediated enhancement in VAX003. PMID:25734126

  12. The impact of compulsory drug detention exposure on the avoidance of healthcare among injection drug users in Thailand.

    Science.gov (United States)

    Kerr, Thomas; Hayashi, Kanna; Ti, Lianping; Kaplan, Karyn; Suwannawong, Paisan; Wood, Evan

    2014-01-01

    Although Thailand has relied on the use of compulsory drug detention centres as a strategy to try to address problematic drug use, little is known about the effects of exposure to these centres on people who inject drugs (IDU). Therefore, we undertook this study to explore whether exposure to compulsory drug detention was associated with avoiding healthcare among Thai IDU. Using Poisson regression analyses, we examined the relationship between compulsory drug detention exposure and avoiding healthcare among participants in the Mitsampan Community Research Project based in Bangkok. 435 IDU participated in this study, including 111 (25.5%) participants who reported avoiding healthcare. In multivariate analyses, avoiding healthcare was positively associated with exposure to compulsory drug detention (adjusted prevalence ratio [APR]=1.60; 95% confidence interval [CI]: 1.16-2.21), having been refused healthcare (APR=3.46; 95% CI: 2.61-4.60), and experiencing shame associated with one's drug use (APR=1.93; 95% CI: 1.21-3.09). Exposure to compulsory drug detention was associated with avoiding healthcare among Thai IDU, suggesting that this system of detention may be contributing to the burden of preventable morbidity among IDU in this setting. Although further research is needed to confirm these findings, the results of this study reinforce previous calls to replace the system of compulsory drug detention with evidence-based public health interventions for IDU. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study

    OpenAIRE

    Meador, Kimford J; Baker, Gus A; Browning, Nancy; Cohen, Morris J; Bromley, Rebecca L; Clayton-Smith, Jill; Kalayjian, Laura A; Kanner, Andres; Liporace, Joyce D; Pennell, Page B; Privitera, Michael; Loring, David W

    2013-01-01

    Background: Many women of childbearing potential take antiepileptic drugs, but the cognitive effects of fetal exposure are uncertain. We aimed to assess effects of commonly used antiepileptic drugs on cognitive outcomes in children up to 6 years of age. Methods: In this prospective, observational, assessor-masked, multicentre study, we enrolled pregnant women with epilepsy on antiepileptic drug monotherapy (carbamazepine, lamotrigine, phenytoin, or valproate) between October, 1999, and Februa...

  14. The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial.

    Science.gov (United States)

    Holtyn, August F; Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Strain, Eric C; Schwartz, Robert P; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

    2014-11-01

    Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. Clinical trial registration number: NCT01416584. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The lay user perspective on the quality of pharmaceuticals, drug therapy and pharmacy services--results of focus group discussions

    DEFF Research Database (Denmark)

    Traulsen, Janine Morgall; Almarsdóttir, Anna Birna; Björnsdóttir, Ingunn

    2002-01-01

    BACKGROUND: This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland. OBJECTIVES: This sub-study addressed the question: what...... is the lay user perspective on pharmaceuticals and pharmacy services, including their perception of risk? METHODS: To answer this question, seven focus group discussions were conducted with pharmacy customers in different locations in Iceland following new drug distribution legislation in 1996. RESULTS......: The lay perspective emphasizes a definite split between lay and expert views on the value and quality of pharmaceuticals, drug therapy and pharmacy services, as well as in their assessment of risk. Participants voiced spontaneous criticism of the roles of both physicians and pharmacists in drug therapy...

  16. 78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...

    Science.gov (United States)

    2013-03-08

    ...-Risk Assessment Ensuring the safety, effectiveness, and quality of human drugs is a complicated... assessment framework that is designed to make explicit the consideration of the various benefit-risk factors...-risk assessment in the human drug and biologic review process and the opportunity for public comment on...

  17. Comparing Characteristics of Early-Onset Injection Drug Users to Those With Late-Onset Injection in Kermanshah, Iran.

    Science.gov (United States)

    Jorjoran Shushtari, Zahra; Noroozi, Alireza; Mirzazadeh, Ali; Ahounbar, Elahe; Hajbi, Ahmad; Najafi, Mohammad; Bazrafshan, Ali; Farhadi, Mohammad Hossin; Farhoudian, Ali; Higgs, Peter; Shahboulagh, Farahnaz Mohammadi; Waye, Katherine; Noroozi, Mehdi

    2017-05-12

    Characteristics and behaviors of early-onset injection drug users are under studied topics in Iran. This study aimed to identify and compare the demographic characteristics as well as the drug using behaviors of early-onset and late-onset injection drug users in Kermanshah, West Iran. In this cross-sectional study using snowball and convenience sampling, we recruited 450 people during the Fall of 2014 from two drop in centers in Kermanshah, Iran. We collected data through face-to-face interviews. Early-onset injection is defined as whether the person reported their first injection at 22 years of age or younger. Subsequently, late-onset injection is defined as 23 years of age or older. We compared the characteristics of the two groups through both univariate and multiple logistic analyses. Overall, 54% (CI 95%: 44.3%, 62.2%) were early injectors. After controlling for low socioeconomic status, initiation of drug use at a young age, multiple drug use and methamphetamine use were all significantly associated with a higher likelihood of early-onset injection. Additionally, early-onset injection was associated with recent syringe borrowing (OR = 2.6, p = 0.001), recent syringe lending (OR = 1.4, p = 0.01), recent cooker sharing (OR = 3.2, p = 0.01) and injecting two or more times a day (OR = 2.2, p = 0.04). Early-onset injectors were more likely to report a lower socioeconomic status, initiation of first drug use at a younger age, using methamphetamine alongside polydrug use, and engaging in higher risk taking behaviors like borrowing needles. With these associations, the study emphasizes the need for drug-prevention programs to focus on the transition to injection drug use at younger ages.

  18. Employment-based abstinence reinforcement promotes opiate and cocaine abstinence in out-of-treatment injection drug users.

    Science.gov (United States)

    Holtyn, August F; Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Strain, Eric C; Schwartz, Robert P; Silverman, Kenneth

    2014-01-01

    We examined the use of employment-based abstinence reinforcement in out-of-treatment injection drug users, in this secondary analysis of a previously reported trial. Participants (N = 33) could work in the therapeutic workplace, a model employment-based program for drug addiction, for 30 weeks and could earn approximately $10 per hr. During a 4-week induction, participants only had to work to earn pay. After induction, access to the workplace was contingent on enrollment in methadone treatment. After participants met the methadone contingency for 3 weeks, they had to provide opiate-negative urine samples to maintain maximum pay. After participants met those contingencies for 3 weeks, they had to provide opiate- and cocaine-negative urine samples to maintain maximum pay. The percentage of drug-negative urine samples remained stable until the abstinence reinforcement contingency for each drug was applied. The percentage of opiate- and cocaine-negative urine samples increased abruptly and significantly after the opiate- and cocaine-abstinence contingencies, respectively, were applied. These results demonstrate that the sequential administration of employment-based abstinence reinforcement can increase opiate and cocaine abstinence among out-of-treatment injection drug users. © Society for the Experimental Analysis of Behavior.

  19. Randomized controlled trial of motivational interviewing compared with drug information and advice for early intervention among young cannabis users.

    Science.gov (United States)

    McCambridge, Jim; Slym, Renee L; Strang, John

    2008-11-01

    To test the effectiveness of motivational interviewing (MI) in comparison with drug information and advice in opportunistically securing reductions in drug-related risk among young cannabis users not seeking help. Randomized controlled trial. Eleven London Further Education colleges. A total of 326 students aged 16-19 years who smoked cannabis weekly or more frequently. Participants were randomized to a single-session intervention of MI or drug information and advice-giving. Cannabis use, cigarette smoking and alcohol consumption and harm outcomes were assessed after both 3 and 6 months. No differences were found between MI and drug information and advice, although MI fidelity was not high. There were wide-ranging individual practitioner effects on observed outcomes and a practitioner-intervention interaction was detected in relation to cannabis cessation after 3 months. Change over time was more pronounced for cannabis use than for other drug use. Further study of the nature and consequences of MI fidelity, and individual practitioner effects more generally, is needed. Advice may be an effective brief intervention with young cannabis users in its own right and should be evaluated further in trials.

  20. Assessing bias in community-based prevalence estimates: towards an unduplicated count of problem drinkers and drug users.

    Science.gov (United States)

    Weisner, C; Schmidt, L; Tam, T

    1995-03-01

    General population survey estimates of the overall prevalence of problem drinking and drug use in a community are biased by the exclusion of non-household populations. Estimates based on compiling prevalences in community institutions may also be biased due to over-counting of users of more than one institution. This paper examines prevalence estimates derived from probability samples of problem drinkers in the general population and within alcohol treatment, drug treatment, mental health, criminal justice and welfare agencies in a single US county. Data sets are merged and weighted to reflect a community sample of institutions, and a 17% subset of cases is identified within the institutional samples that are not living in housing units typically included in general population sampling frames. The difference in prevalences of problem drinking in the household and non-household populations is found to be large: 11% and 48%, respectively. Even greater differences are found between estimates of unprescribed weekly drug use (6% and 47%, respectively) and combined problem drinking and weekly drug use (2% and 27%, respectively). This suggests that confining samples to the household population can systematically under-represent the prevalence of problem drinking and drug use. A second source of bias in prevalence is characteristic of studies using records from multiple institutions. When duplication of service use in the five agency samples is considered, it becomes apparent that prevalence may be biased upward due to over-counting of multiple service users.

  1. Estimating the coverage of a targeted mobile tuberculosis screening programme among illicit drug users and homeless persons with truncated models.

    Science.gov (United States)

    van Hest, N A H; De Vries, G; Smit, F; Grant, A D; Richardus, J H

    2008-05-01

    Truncated models are indirect methods to estimate the size of a hidden population which, in contrast to the capture-recapture method, can be used on a single information source. We estimated the coverage of a tuberculosis screening programme among illicit drug users and homeless persons with a mobile digital X-ray unit between 1 January 2003 and 31 December 2005 in Rotterdam, The Netherlands, using truncated models. The screening programme reached about two-third of the estimated target population at least once annually. The intended coverage (at least two chest X-rays per person per year) was about 23%. We conclude that simple truncated models can be used relatively easily on available single-source routine data to estimate the size of a population of illicit drug users and homeless persons. We assumed that the most likely overall bias in this study would be overestimation and therefore the coverage of the targeted mobile tuberculosis screening programme would be higher.

  2. Incidence, risk factors and causes of death in an HIV care programme with a large proportion of injecting drug users.

    OpenAIRE

    Spillane, Heidi; Nicholas, Sarala; Tang, Zhirong; Szumilin, Elisabeth; Balkan, Suna; Pujades-Rodriguez, Mar

    2012-01-01

    Objectives  To identify factors influencing mortality in an HIV programme providing care to large numbers of injecting drug users (IDUs) and patients co-infected with hepatitis C (HCV). Methods  A longitudinal analysis of monitoring data from HIV-infected adults who started antiretroviral therapy (ART) between 2003 and 2009 was performed. Mortality and programme attrition rates within 2 years of ART initiation were estimated. Associations with individual-level factors were assessed with multi...

  3. Hair analysis and its concordance with self-report for drug users presenting in emergency department.

    Science.gov (United States)

    Sharma, Gaurav; Oden, Neal; VanVeldhuisen, Paul C; Bogenschutz, Michael P

    2016-10-01

    Secondary analysis using data from the National Drug Abuse Treatment Clinical Trials Network randomized trial (NCT # 01207791), in which 1285 adult ED patients endorsing moderate to severe problems related to drug use were recruited from 6 US academic hospitals. To investigate the utility of hair analysis in drug use disorder trials with infrequent visits, and its concordance with Timeline Follow Back (TLFB). This study compared the self-reported drug use on the TLFB instrument with the biological measure of drug use from hair analysis for four major drug classes (Cannabis, Cocaine, Prescribed Opioids and Street Opioids). Both hair analysis and TLFB were conducted at 3, 6 and 12 month follow-up visit and each covered a 90-day recall period prior to the visit. The concordance between the hair sample results and the TLFB was high for cannabis and street opioids, but was low to moderate for cocaine and prescribed opioids. Under-reporting of drug use given the positive hair sample was always significantly lower for the drug the study participant noted as their primary drug of choice compared with other drugs the participant reported taking, irrespective of whether the drug of choice was cannabis, cocaine, street opioids and prescribed opioids. Over-reporting of drug use given the negative hair sample was always significantly higher for the drug of choice, except for cocaine. This study extends the literature on hair analysis supporting its use as a secondary outcome measure in clinical trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: Moving toward effective harm reduction

    Directory of Open Access Journals (Sweden)

    Thanh Duong

    2009-04-01

    Full Text Available Abstract Background Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices. Methods This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users. Results The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals. Conclusion HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.

  5. The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: moving toward effective harm reduction.

    Science.gov (United States)

    Thanh, Duong Cong; Moland, Karen Marie; Fylkesnes, Knut

    2009-04-06

    Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices. This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users. The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals. HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.

  6. Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care.

    LENUS (Irish Health Repository)

    Cullen, Walter

    2012-02-01

    BACKGROUND: Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched \\'controls\\' and to develop and pilot test a valid study instrument. METHODS: A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status. RESULTS: Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation. CONCLUSION: Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words).

  7. Chronic illness and multimorbidity among problem drug users: a comparative cross sectional pilot study in primary care.

    LENUS (Irish Health Repository)

    Cullen, Walter

    2009-01-01

    BACKGROUND: Although multimorbidity has important implications for patient care in general practice, limited research has examined chronic illness and health service utilisation among problem drug users. This study aimed to determine chronic illness prevalence and health service utilisation among problem drug users attending primary care for methadone treatment, to compare these rates with matched \\'controls\\' and to develop and pilot test a valid study instrument. METHODS: A cross-sectional study of patients attending three large urban general practices in Dublin, Ireland for methadone treatment was conducted, and this sample was compared with a control group matched by practice, age, gender and General Medical Services (GMS) status. RESULTS: Data were collected on 114 patients. Fifty-seven patients were on methadone treatment, of whom 52(91%) had at least one chronic illness (other then substance use) and 39(68%) were prescribed at least one regular medication. Frequent utilisation of primary care services and secondary care services in the previous six months was observed among patients on methadone treatment and controls, although the former had significantly higher chronic illness prevalence and primary care contact rates. The study instrument facilitated data collection that was feasible and with minimal inter-observer variation. CONCLUSION: Multimorbidity is common among problem drug users attending general practice for methadone treatment. Primary care may therefore have an important role in primary and secondary prevention of chronic illnesses among this population. This study offers a feasible study instrument for further work on this issue. (238 words).

  8. Transmission of Multidrug-Resistant and Drug-Susceptible Tuberculosis within Households: A Prospective Cohort Study

    Science.gov (United States)

    Grandjean, Louis; Gilman, Robert H.; Martin, Laura; Soto, Esther; Castro, Beatriz; Lopez, Sonia; Coronel, Jorge; Castillo, Edith; Alarcon, Valentina; Lopez, Virginia; San Miguel, Angela; Quispe, Neyda; Asencios, Luis; Dye, Christopher; Moore, David A. J.

    2015-01-01

    Background The “fitness” of an infectious pathogen is defined as the ability of the pathogen to survive, reproduce, be transmitted, and cause disease. The fitness of multidrug-resistant tuberculosis (MDRTB) relative to drug-susceptible tuberculosis is cited as one of the most important determinants of MDRTB spread and epidemic size. To estimate the relative fitness of drug-resistant tuberculosis cases, we compared the incidence of tuberculosis disease among the household contacts of MDRTB index patients to that among the contacts of drug-susceptible index patients. Methods and Findings This 3-y (2010–2013) prospective cohort household follow-up study in South Lima and Callao, Peru, measured the incidence of tuberculosis disease among 1,055 household contacts of 213 MDRTB index cases and 2,362 household contacts of 487 drug-susceptible index cases. A total of 35/1,055 (3.3%) household contacts of 213 MDRTB index cases developed tuberculosis disease, while 114/2,362 (4.8%) household contacts of 487 drug-susceptible index patients developed tuberculosis disease. The total follow-up time for drug-susceptible tuberculosis contacts was 2,620 person-years, while the total follow-up time for MDRTB contacts was 1,425 person-years. Using multivariate Cox regression to adjust for confounding variables including contact HIV status, contact age, socio-economic status, and index case sputum smear grade, the hazard ratio for tuberculosis disease among MDRTB household contacts was found to be half that for drug-susceptible contacts (hazard ratio 0.56, 95% CI 0.34–0.90, p = 0.017). The inference of transmission in this study was limited by the lack of genotyping data for household contacts. Capturing incident disease only among household contacts may also limit the extrapolation of these findings to the community setting. Conclusions The low relative fitness of MDRTB estimated by this study improves the chances of controlling drug-resistant tuberculosis. However, fitter

  9. Procrastination and Self-Efficacy Among Intravenous Drug Users on a Methadone Maintenance Program in Sari City, Iran, 2013.

    Science.gov (United States)

    Taghizadeh, Fatemeh; Yazdani Cherati, Jamshid

    2015-12-01

    Self-efficacy is the belief that one has the ability to implement the behaviors needed to produce a desired effect. There has been growing interest in the role of self-efficacy as a predictor and/or mediator of treatment outcome in a number of domains. Procrastination is a self-regulatory failure, defined as the voluntary delay of an intended course of action despite expecting to be worse off for the delay. Behavioral procrastination is a self-sabotage strategy that allows people to shift blame and avoid action; the decisional procrastination strategy is to put off making a decision when dealing with conflicts or choices. Procrastination has a great role in quitting drug addiction. The aim of this study was to determine the relationship between procrastination and self-efficacy and other factors among intravenous drug users. This cross-sectional study was conducted on 178 intravenous drug users in the behavioral disease counseling, health center in Sari city, Mazandaran province, Iran, in 2013. The samples were selected through census sampling, descriptive and inferential statistics were used to measure the properties of distribution that depicts a set of data shown as frequency distribution tables, while for the mean and standard deviation, chi-square, Fisher and Spearman-Brown coefficients were used to analyze the data. The mean age of the participants was 43 years. Seventy-two percent of them were married and opium was the first drug used. The first substance used in them was 54% of opium, 33% cannabis and 5% alcohol and 79% smoking. The reason of the first drug use in 32% of the subjects was temptation and in 10% a friend's influence. The mean age of the first drug use was 23 years, and the frequency was 2 times per day. All of them had relapse at least once. Seven percent of them currently use other materials (2% crystal, 5% alcohol and opium and crack) both in methadone treatment. Behavioral procrastination in 60.5% of them and decisional procrastination in

  10. Cortical thickness in adolescent marijuana and alcohol users: A three-year prospective study from adolescence to young adulthood

    Directory of Open Access Journals (Sweden)

    Joanna Jacobus

    2015-12-01

    Full Text Available Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ + ALC, n = 30 and controls (CON, n = 38 with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ + ALC showed thicker cortical estimates across the brain (23 regions, particularly in frontal and parietal lobes (ps < .05. More cumulative marijuana use was associated with increased thickness estimates by 3-year follow-up (ps < .05. Heavy marijuana use during adolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use.

  11. Risk factors for disability progression among Japanese long-term care service users: A 3-year prospective cohort study.

    Science.gov (United States)

    Kamiya, Kuniyasu; Adachi, Takuji; Sasou, Kenji; Suzuki, Tadashi; Yamada, Sumio

    2017-04-01

    To examine the predictive ability of memory deterioration and grip strength for disability progression among those who utilized the home-help service. We prospectively followed a cohort of community-dwelling older people who were aged 65 years or older, certified support level 1-2 or care level 1-2 and home-help service users provided by Consumers' Cooperatives in Aichi and Kanagawa prefecture. Memory capability, grip strength, chronic conditions and other indices were surveyed at baseline. Disability progression was defined as being certified care level 3 or higher, or institutionalization during 3-year follow up. We assessed 417 older adults, of which 386 were included (7.4% excluded). In multivariate Cox regression analyses, a higher eligibility level and memory deterioration were independently associated with a higher hazard ratio. When chronic conditions were entered in the model, cancer and low grip strength were additionally associated. The findings of the present study show that memory deterioration is a risk factor for disability progression. Also, grip strength might be a risk factor with consideration of chronic conditions. The cause-effect relationship of those factors and disability progression would be a future challenging issue. Geriatr Gerontol Int 2017; 17: 568-574. © 2016 Japan Geriatrics Society.

  12. Cortical thickness in adolescent marijuana and alcohol users: A three-year prospective study from adolescence to young adulthood.

    Science.gov (United States)

    Jacobus, Joanna; Squeglia, Lindsay M; Meruelo, Alejandro D; Castro, Norma; Brumback, Ty; Giedd, Jay N; Tapert, Susan F

    2015-12-01

    Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ+ALC, n=30) and controls (CON, n=38) with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ+ALC showed thicker cortical estimates across the brain (23 regions), particularly in frontal and parietal lobes (psadolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use. Published by Elsevier Ltd.

  13. Effect of a primary care based brief intervention trial among risky drug users on health-related quality of life.

    Science.gov (United States)

    Baumeister, Sebastian E; Gelberg, Lillian; Leake, Barbara D; Yacenda-Murphy, Julia; Vahidi, Mani; Andersen, Ronald M

    2014-09-01

    Improvement in quality of life (QOL) is a long term goal of drug treatment. Although some brief interventions have been found to reduce illicit drug use, no trial among adult risky (moderate non-dependent) drug users has tested effects on health-related quality of life. A single-blind randomized controlled trial of patients enrolled from February 2011 to November 2012 was conducted in waiting rooms of five federally qualified health centers. 413 adult primary care patients were identified as risky drug users using the WHO-ASSIST and 334 (81% response; 171 intervention, 163 control) consented to participate in the trial. Three-month follow-ups were completed by 261 patients (78%). Intervention patients received the QUIT intervention of brief clinician advice and up to two drug-use health telephone sessions. The control group received usual care and information on cancer screening. Outcomes were three-month changes in the Short Form Health Survey (SF-12) mental health component summary score (MCS) and physical health component summary score (PCS). The average treatment effect (ATE) was non-significant for MCS (0.2 points, p-value=0.87) and marginally significant for PCS (1.7 points, p-value=0.08). The average treatment effect on the treated (ATT) was 0.1 (p-value=0.93) for MCS and 1.9 (p-value=0.056) for PCS. The effect on PCS was stronger at higher (above median) baseline number of drug use days: ATE=2.7, p-value=0.04; ATT=3.21, p-value=0.02. The trial found a marginally significant effect on improvement in PCS, and significant and stronger effect on the SF-12 physical component among patients with greater frequency of initial drug use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Identifying programmatic gaps: inequities in harm reduction service utilization among male and female drug users in Dar es Salaam, Tanzania.

    Directory of Open Access Journals (Sweden)

    Barrot H Lambdin

    Full Text Available INTRODUCTION: Current estimates suggest an HIV prevalence of 42% among people who inject drugs (PWIDs in Dar es Salaam, while HIV prevalence is estimated to be 8.8% among the general population in the city. To address the HIV epidemic in this population, the government of Tanzania began establishing HIV prevention, treatment and care services including outreach and medication assisted treatment (MAT for PWIDs in 2010. We assessed gender inequities in utilization of outreach and MAT services and evaluated differences in HIV risk behaviors between female and male PWIDs. MATERIALS AND METHODS: Routine outreach data between December 2010 to mid-August 2012 and baseline data on clients enrolling in methadone from February 2011 to August 2012 were utilized. Binomial regression was used to estimate adjusted relative risk estimates comparing females to males. RESULTS: From December 2010 to August 2012, 8,578 contacts were made to drug users; among them 1,898 were injectors. A total of 453 injectors were eligible and referred to MAT, of which, 443 enrolled in treatment. However, regarding total outreach contacts, outreach to PWID, referral to MAT and enrollment in MAT, 8% or less of drug users accessing services were women. In contrast, weighted estimations from surveys suggest that 34% of PWIDs are female, and this approximation is similar to recent population size estimations. Overall, 43% of traditional outreach workers conducting outreach with drug users were female. Though reporting higher levels of condom usage, female PWID were more likely to report multiple sex partners, anal sex, commercial sex work and struggle under a higher burden of addiction, mental disorders and abuse. CONCLUSIONS: Services have not been mobilized adequately to address the clear needs of females who inject drugs. A clear and urgent need exists for women-centered strategies that effectively engage female PWID into HIV prevention services.

  15. Overdose prevention for injection drug users: Lessons learned from naloxone training and distribution programs in New York City

    Directory of Open Access Journals (Sweden)

    Nandi Vijay

    2007-01-01

    Full Text Available Abstract Background Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs. Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. Methods During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. Results There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a political climate surrounding naloxone distribution; b extant prescription drug laws; c initial low levels of recruitment into the program; d development of participant appropriate training methodology; e challenges in the design of a suitable formal evaluation; and f evolution of program response to naloxone. Conclusion Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in

  16. Overdose prevention for injection drug users: lessons learned from naloxone training and distribution programs in New York City.

    Science.gov (United States)

    Piper, Tinka Markham; Rudenstine, Sasha; Stancliff, Sharon; Sherman, Susan; Nandi, Vijay; Clear, Allan; Galea, Sandro

    2007-01-25

    Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention) and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP) in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a) political climate surrounding naloxone distribution; b) extant prescription drug laws; c) initial low levels of recruitment into the program; d) development of participant appropriate training methodology; e) challenges in the design of a suitable formal evaluation; and f) evolution of program response to naloxone. Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in program planning and implementation, developing evaluation

  17. CDC international HIV prevention research activities among injection drug users in Thailand and Russia.

    Science.gov (United States)

    Greenberg, Alan E; Tappero, Jordan; Choopanya, Kachit; van Griensven, Frits; Martin, Mike; Vanichseni, Suphak; Santibanez, Scott; Molotilov, Valerie; Hader, Shannon; Broyles, Laura N

    2005-09-01

    The Centers for Disease Control and Prevention (CDC) has participated in collaborative HIV prevention research activities in injection drug users (IDUs) with the Bangkok Metropolitan Administration (BMA) in Bangkok, Thailand, from 1995 to the present and with the Orel AIDS Center in Orel Oblast, Russia, from 2001 to 2003. Studies in Bangkok have included an HIV prevention trial preparatory cohort from 1995 to 1998, a seroconverter cohort from 1998 to the present, a phase III trial of the AIDSVAX B/E gp120 HIV vaccine from 1999 to 2003, and a phase II/III HIV prophylaxis trial with tenofovir scheduled to begin in 2005. Activities in Orel included a review of HIV surveillance data in 2001, focus group discussions and a case-control study with HIV-infected and -uninfected IDUs in 2001, a cross-sectional study with the female sex partners of male IDUs in 2002, and a community outreach intervention in 2002-2003. In Bangkok, 1,209 IDUs were enrolled in the preparatory cohort which revealed an HIV incidence of 5.8% per 100 person-years; 133 HIV-infected IDUs have been followed in the seroconverter cohort with >85% follow-up and HIV and tuberculosis care provided; 2,546 IDUs were enrolled in the HIV vaccine efficacy trial which was successfully completed with a follow-up rate of >95%, although the vaccine was not shown to be effective at reducing HIV incidence; and 1,600 IDUs will be enrolled in the daily tenofovir HIV prophylaxis trial in 2005. In Orel, initial focus group discussions and epidemiologic studies revealed low HIV knowledge and high rates of unsafe injecting and sexual practices among IDUs and their female sex partners; and educational campaigns and the community outreach intervention were developed and implemented. A steady decline in new HIV infections in IDUs was then observed in Orel in 2002-2003. CDC has participated in the conduct of successful collaborative HIV prevention research activities in Thailand and Russia over the past decade. The

  18. Transmission of hepatitis C virus among intravenous drug users in the Uppsala region of Sweden

    Directory of Open Access Journals (Sweden)

    Axel Danielsson

    2014-01-01

    Full Text Available Background: Epidemiology and transmission patterns of hepatitis C virus (HCV are important subjects as we enter a new era of treatment with directly acting antivirals (DAAs. The highest prevalence of HCV in developed countries is found among intravenous drug users (IDUs, where unsafe needle sharing practices provide the main route of infection. Efforts to prohibit the continuous spread of HCV among these groups have been initiated by the community services and health care providers. Our goal was to understand how HCV was transmitted among IDUs within a limited population group. We provide a retrospective study (2005–2007 of the HCV transmission patterns in a population of IDUs in the Uppsala region of Sweden. Method: Eighty-two serum samples were collected from IDUs in Uppsala County. Our reverse transcription nested polymerase chain reaction (RT-nested PCR and sequencing method enabled a comprehensive genetic analysis for a broad spectrum of genotypes of two relatively conserved regions, NS5B and NS3, that encodes for the viral polymerase and protease, respectively. HCV RNA in serum samples was amplified and sequenced with in-house primers. Sequence similarities between individuals and subgroups were analyzed with maximum likelihood (ML phylogenetic trees. Published HCV reference sequences from other geographic regions and countries were also included for clarity. Results: Phylogenetic analysis was possible for 59 NS5B (72% and 29 NS3 (35% sequences from Uppsala patients. Additionally, we also included 15 NS3 sequences from Örebro patients, making a total of 44 NS3 sequences for the analysis. By analyzing the NS3 sequences, two transmission sets were found between the IDUs (>98% sequence identity, with one set consisting of two individuals and another set consisting of three individuals. In addition, the phylogenetic analysis done with our serum samples displayed clusters that distinguished them from the reference sequences. Conclusion: Our

  19. Variability in SCCmecN1 spreading among injection drug users in Zurich, Switzerland

    Directory of Open Access Journals (Sweden)

    McCallum Nadine

    2007-07-01

    Full Text Available Abstract Background An extremely low level methicillin resistant Staphylococcus aureus (MRSA belonging to ST45, circulates among intravenous drug users in the Zurich area. This clone can be misinterpreted as an MSSA by phenotypic oxacillin resistance tests, although it carries a staphylococcal cassette chromosome mec (SCCmec element encoding a functional mecA gene and it produces PBP2a. Results This clone carried a new 45.7-kb element, termed SCCmecN1, containing a class B mec complex (mecA-ΔmecR1::IS1272, a truncated Tn4003 harbouring the dfrA gene, and a fusB1 gene, conferring methicillin, trimethoprim and low level fusidic acid resistance, respectively. In addition to the two insertion site sequences (ISS framing the SCCmec, a third ISS (ISS* was identified within the element. SCCmecN1 also harboured two distinct ccrAB complexes belonging to the class 4 subtype, both of which were shown to be active and to be able to excise the SCCmecN1 or parts thereof. Slight variations in the SmaI-PFGE pattern of the clinical MRSA isolates belonging to this clone were traced back to differences in the sizes of the SCCmec J2 regions and/or to a 6.4-kb deletion extending from ISS* to the right end ISS. This latter deletion led to a variant right SCCmec-chromosomal junction site. MRSA clones carrying the shorter SCCmec with the 6.4-kb deletion were usually ciprofloxacin resistant, while strains with the complete SCCmecN1 were co-trimoxazole resistant or had no additional resistances. This suggested that the genetic backbone of the host S. aureus, although identical by PFGE pattern, had at some stage diverged with one branch acquiring a sulfonomide resistance mutation and the other ciprofloxacin resistance. Conclusion This description of the structure and variations of SCCmecN1 will allow for quicker and easier molecular detection of this clone and monitoring of its spread.

  20. Delivery dilemmas: How drug cryptomarket users identify and seek to reduce their risk of detection by law enforcement.

    Science.gov (United States)

    Aldridge, Judith; Askew, Rebecca

    2017-03-01

    Cryptomarkets represent an important drug market innovation by bringing buyers and sellers of illegal drugs together in a 'hidden' yet public online marketplace. We ask: How do cryptomarket drug sellers and buyers perceive the risks of detection and arrest, and attempt to limit them? We analyse selected texts produced by vendors operating on the first major drug cryptomarket, Silk Road (N=600) alongside data extracted from the marketplace discussion forum that include buyer perspectives. We apply Fader's (2016) framework for understanding how drug dealers operating 'offline' attempt to reduce the risk of detection and arrest: visibility reduction, charge reduction and risk distribution. We characterize drug transactions on cryptomarkets as 'stretched' across time, virtual and physical space, and handlers, changing the location and nature of risks faced by cryptomarket users. The key locations of risk of detection and arrest by law enforcement were found in 'offline' activities of cryptomarket vendors (packaging and delivery drop-offs) and buyers (receiving deliveries). Strategies in response involved either creating or disrupting routine activities in line with a non-offending identity. Use of encrypted communication was seen as 'good practice' but often not employed. 'Drop shipping' allowed some Silk Road vendors to sell illegal drugs without the necessity of handling them. Silk Road participants neither viewed themselves as immune to, nor passively accepting of, the risk of detection and arrest. Rational choice theorists have viewed offending decisions as constrained by limited access to relevant information. Cryptomarkets as 'illicit capital' sharing communities provide expanded and low-cost access to information enabling drug market participants to make more accurate assessments of the risk of apprehension. The abundance of drug market intelligence available to those on both sides of the law may function to speed up innovation in illegal drug markets, as well

  1. [A prospective study of drug-facilitated sexual assault in Barcelona].

    Science.gov (United States)

    Xifró-Collsamata, Alexandre; Pujol-Robinat, Amadeo; Barbería-Marcalain, Eneko; Arroyo-Fernández, Amparo; Bertomeu-Ruiz, Antonia; Montero-Núñez, Francisco; Medallo-Muñiz, Jordi

    2015-05-08

    To determine the frequency and characteristics of suspected drug-facilitated sexual assault (DFSA) among the victims of sexual assault in Barcelona. Prospective study of every adult consulting an emergency service because of alleged sexual assault and receiving forensic assessment in the city of Barcelona in 2011. A total of 35 of 114 cases (30.7%) met suspected DFSA criteria. Compared with the other victims, suspected DFSA cases were more likely to experience amnesia, to have been assaulted by night, after a social situation and by a recently acquainted man, to have used alcohol before the assault and to be foreigners. In this group ethanol was detected in blood or urine in 48.4% of analyzed cases; their mean back calculated blood alcohol concentration was 2.29g/l (SD 0.685). Also, at least one central nervous system drug other than ethanol was detected in 60,6%, mainly stimulant drugs of abuse. Suspected DFSA is frequent among victims of alleged sexual assault in Barcelona nowadays. The depressor substance most commonly encountered is alcohol, which contributes to victims' vulnerability. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. Ciudadanos del este de Europa consumidores de drogas en Barcelona Injecting drug users from Eastern Europe in Barcelona, Spain

    Directory of Open Access Journals (Sweden)

    M. González

    2003-06-01

    Full Text Available Desde mayo de 1999 hasta mayo de 2001, hemos contactado en el SAPS (Servicio de Atención Social y Sanitaria de Barcelona con usuarios de drogas de países del este de Europa. Acuden a centros terapéuticos gratuitos, aunque pagan por la organización del viaje unos 500 euros. Son jóvenes entre 18 y 30 años y mantienen el contacto con sus familiares. Conocen los riesgos de transmisión de enfermedades, pero suelen reutilizar las jeringas. Es alta la prevalencia de hepatitis C (92% y B (62% y menor la de infección por el VIH (19%. Si no abandonan las drogas, el retorno es un fracaso y tienen dificultades para proseguir los tratamientos con metadona o antirretrovirales. La respuesta asistencial ha de adecuarse a sus necesidades. Se debe procurar la mediación cultural y la información en los lugares de origen, supervisar los centros terapéuticos y diseñar alternativas a los abandonos. Hay que desarrollar la colaboración internacional, estimular programas de disminución de riesgos derivados del consumo y evitar que del tratamiento se haga un comercio.From May 1999 to May 2001, we made contact with injecting drug users from Eastern Europe in the healthcare and prevention service of the Red Cross (servicio de atención y prevención sociosanitaria [SAPS] in Barcelona (Spain. The users attended free therapeutic centers, but paid approximately 500 € for the trip. The users were aged between 18 and 30 years old and maintained family contact. The knew the risk of disease transmission, but often exchanged needles. The prevalence of hepatitis C (92% and B (62% was high but less than that of HIV (19%. If they did not stop taking drugs their return would be a failure and they would have difficulties in following methadone and antiretroviral treatments in their countries of origin. The healthcare provided in these centers should respond to user' needs: cultural mediation should be sought, as well as information from users' countries of origin

  3. 77 FR 67820 - Privacy Act of 1974; Report of a New System of Records; Food and Drug Administration User Fee System

    Science.gov (United States)

    2012-11-14

    ... HUMAN SERVICES Food and Drug Administration Privacy Act of 1974; Report of a New System of Records; Food and Drug Administration User Fee System AGENCY: Food and Drug Administration, HHS. ACTION: Notice of a new system of records. SUMMARY: In accordance with the requirements of the Privacy Act of 1974 and the...

  4. The perspectives of structurally vulnerable people who use drugs on volunteer stipends and work experiences provided through a drug user organization: Opportunities and limitations.

    Science.gov (United States)

    Bardwell, Geoff; Anderson, Solanna; Richardson, Lindsey; Bird, Lorna; Lampkin, Hugh; Small, Will; McNeil, Ryan

    2018-03-01

    While drug user organizations (DUO) have received public health attention as a means to potentially reduce the harms associated with drug use, there is a lack of research on the compensation and structural forces that promote or inhibit participation in DUO. Against the backdrop of structural vulnerability experienced by people who use drugs (PWUD), we examined the impact of monetary 'volunteer stipends' provided through a DUO and explore their role in providing low-threshold employment opportunities and shaping participation in DUO. Participants were purposively sampled to reflect a range of perspectives and experiences volunteering at Vancouver Area Network of Drug Users (VANDU) and receiving stipends. Semi-structured qualitative interviews were conducted with 23 members of VANDU. Interview transcripts were coded in Atlas.ti 7 for key a priori themes and emergent categories from the data and analyzed thematically. Stipends provided participants with symbolic and material recognition of the time, effort, and expertise they contribute to the organization, and functioned to facilitate ongoing participation. Payments that rewarded, skills, labour and drug-related knowledge reduced participant's perception of stigma against PWUD. Paid work in VANDU further provided participants with non-material benefits commonly attributed to regular employment, including social connections and a sense of purpose. Participants also identified the low level of pay as a limitation of VANDU's paid participation program. The daily demands of survival (accessing shelter, food, and drugs) posed more complex structural vulnerabilities to participate in VANDU, as small stipends were not sufficient to address these needs. Low threshold employment opportunities within DUO may provide significant individual and public health benefits. However, these benefits are constrained by the small size of stipends. Therefore, to ensure better inclusion of PWUD, our findings recommend the development and

  5. Inferring about individual drug and schizotypy effects on cognitive functioning in polydrug using mephedrone users before and after clubbing.

    Science.gov (United States)

    Herzig, Daniela A; Brooks, Rowan; Mohr, Christine

    2013-03-01

    Mephedrone has been recently made illegal in Europe, but little empirical evidence is available on its impact on human cognitive functions. We investigated acute and chronic effects of mephedrone consumption on drug-sensitive cognitive measures, while also accounting for the influence of associated additional drug use and personality features. Twenty-six volunteers from the general population performed tasks measuring verbal learning, verbal fluency and cognitive flexibility before and after a potential drug-taking situation (pre-clubbing and post-clubbing at dance clubs, respectively). Participants also provided information on chronic and recent drug use, schizotypal (Oxford-Liverpool Inventory of Feelings and Experiences) and depressive symptoms (Beck Depression Inventory), sleep pattern and premorbid IQ. We found that (i) mephedrone users performed worse than non-users pre-clubbing and deteriorated from the pre-clubbing to the post-clubbing assessment; (ii) pre-clubbing cannabis and amphetamine (not mephedrone) use predicted relative cognitive attenuations; (iii) post-clubbing, depression scores predicted relative cognitive attenuations; and (iv) schizotypy was largely unrelated to cognitive functioning, apart from a negative relationship between cognitive disorganisation and verbal fluency. Results suggest that polydrug use and depressive symptoms in the general population negatively affect cognition. For schizotypy, only elevated cognitive disorganisation showed potential links to a pathological cognitive profile previously reported along the psychosis dimension. Copyright © 2013 John Wiley & Sons, Ltd.

  6. The influence of cyclo-oxygenase specificity of non-steroidal anti-inflammatory drugs on bleeding complications in concomitant coumarine users.

    Science.gov (United States)

    Knijff-Dutmer, E A J; Van der Palen, J; Schut, G; Van de Laar, M A F J

    2003-07-01

    Concomitant use of coumarines and non-steroidal anti-inflammatory drugs (NSAIDs) may induce bleeding complications, due to the inhibition of both coagulant factors and platelet function. Unlike non-selective NSAIDs, cyclo-oxygenase-2 (COX-2)-selective NSAIDs interfere very little with platelet aggregation. To determine whether COX-2-selective NSAIDs are associated with less bleeding complications in coumarine users, compared with non-selective NSAIDs. Prospective, nested case-control study. We studied concomitant coumarine and NSAID users over two years. Patients with bleeding (cases), and frequency-matched patients without bleeding (controls), were sent questionnaires regarding possible risk factors for bleeding. International normalized ratio (INR) values were recorded. Univariate and multivariate analyses were used to detect factors contributing to bleeding. There were 1491 reported bleeds. NSAIDs were involved in 14.8%; 3.9% involving COX-2-selective NSAIDs. In non-bleeders, 2601 prescriptions with a coumarine/NSAID combination were detected; 9.7% were COX-2-selective. Adjusted ORs (95% CI) for a bleeding complication were 3.07 (1.18-8.03) for non-selective NSAID use, 3.01 (1.42-6.37) for NSAID use > 1 month, and 1.89 (1.03-3.49) for INR > or = 4.0. In coumarine users, COX-2-selective NSAIDs are associated with less bleeding complications than non-selective NSAIDs are. Duration of NSAID use, as well as intensity of coumarine treatment, plays an important additional role. When the coumarine-NSAID combination is inevitable in an individual patient, a COX-2-selective NSAID may be preferred, with careful monitoring of the INR.

  7. Computer-based typing and keypad skills raining outcomes of unemployed injection drug users in a therapeutic workplace.

    Science.gov (United States)

    Dillon, Erin M; Wong, Conrad J; Sylvest, Christine E; Crone-Todd, Darlene E; Silverman, Kenneth

    2004-01-01

    The Therapeutic Workplace is an employment-based treatment for chronic drug misuse and unemployment. As a part of this intervention, participants are taught skills to perform data entry jobs and are paid based on attendance and productivity. In this study, computerized typing and keypad training programs were evaluated in recently detoxified HIV-positive injection drug users (n = 32) enrolled in the Therapeutic Workplace treatment program between October 2000 and September 2001. Results show that trainees can be taught fundamental typing and keypad skills in an average of 51.48 and 1.73h of training, respectively, administered over 17.91 and 12.59 weeks, respectively. Overall, the results demonstrate that adults with long histories of chronic unemployment and drug addiction can reliably acquire typing and keypad skills and do so over relatively short periods of time.

  8. Elements of well-being affected by criminalizing the drug user.

    Science.gov (United States)

    Iguchi, Martin Y.; London, Jennifer A.; Forge, Nell Griffith; Hickman, Laura; Fain, Terry; Riehman, Kara

    2002-01-01

    OBJECTIVE: The authors examine the possible adverse consequences of incarceration on drug offenders, their families, and their communities. OBSERVATIONS: State and federal policies on drug felons may affect eight elements of personal and community well-being: children and families, access to health benefits, access to housing benefits, access to assistance for higher education, immigration status, employment, eligibility to vote, and drug use or recidivism. CONCLUSIONS: Minorities have a high chance of felony conviction and an increasing lack of access to resources, suggesting that patterns of drug conviction and health disparities may be mutually reinforcing. Large numbers of people sent to prison for drug offenses are now completing their terms and reentering communities. Their reentry will disproportionately affect minority communities. Without resources (education, job opportunities, insurance, health care, housing, and the right to vote) drug abusers face a higher risk of recidivism and increase the burden on their communities. PMID:12435838

  9. NETL CO2 Storage prospeCtive Resource Estimation Excel aNalysis (CO2-SCREEN) User's Manual

    Energy Technology Data Exchange (ETDEWEB)

    Sanguinito, Sean M. [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Goodman, Angela [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States); Levine, Jonathan [National Energy Technology Lab. (NETL), Pittsburgh, PA, (United States)

    2017-04-03

    This user’s manual guides the use of the National Energy Technology Laboratory’s (NETL) CO2 Storage prospeCtive Resource Estimation Excel aNalysis (CO2-SCREEN) tool, which was developed to aid users screening saline formations for prospective CO2 storage resources. CO2- SCREEN applies U.S. Department of Energy (DOE) methods and equations for estimating prospective CO2 storage resources for saline formations. CO2-SCREEN was developed to be substantive and user-friendly. It also provides a consistent method for calculating prospective CO2 storage resources that allows for consistent comparison of results between different research efforts, such as the Regional Carbon Sequestration Partnerships (RCSP). CO2-SCREEN consists of an Excel spreadsheet containing geologic inputs and outputs, linked to a GoldSim Player model that calculates prospective CO2 storage resources via Monte Carlo simulation.

  10. Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self-selecting online survey.

    Science.gov (United States)

    Lawn, Will; Hallak, Jaime E; Crippa, Jose A; Dos Santos, Rafael; Porffy, Lilla; Barratt, Monica J; Ferris, Jason A; Winstock, Adam R; Morgan, Celia J A

    2017-11-09

    Ayahuasca is a natural psychedelic brew, which contains dimethyltryptamine (DMT). Its potential as a psychiatric medicine has recently been demonstrated and its non-medical use around the world appears to be growing. We aimed to investigate well-being and problematic alcohol use in ayahuasca users, and ayahuasca's subjective effects. An online, self-selecting, global survey examining patterns of drug use was conducted in 2015 and 2016 (n = 96,901). Questions were asked about: use of ayahuasca, lysergic acid diethylamide (LSD) and magic mushrooms; demographics, current well-being and past-year problematic alcohol use of past-year ayahuasca users and comparison drug users; and subjective effects of ayahuasca and comparison drugs. Ayahuasca users (n = 527) reported greater well-being than both classic psychedelic users (n = 18,138) and non-psychedelic drug-using respondents (n = 78,236). Ayahuasca users reported less problematic drinking than classic psychedelic users, although both groups reported greater problematic drinking than the other respondents. Ayahuasca's acute subjective effects usually lasted for six hours and were most strongly felt one hour after consumption. Within our online, self-selecting survey, ayahuasca users reported better well-being than comparison groups and less problematic drinking than classic psychedelic users. Future longitudinal studies of international samples and randomised controlled trials are needed to dissect the effects of ayahuasca on these outcomes.

  11. Designing an experimental HIV/HCV intervention to promote the safe re-use of drug preparation materials by injection drug users in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Robles Rafaela R

    2008-04-01

    Full Text Available Abstract Injection drug users (IDUs in San Juan, Puerto Rico are characterized by high rates of daily injecting, injection of shared drugs, re-use of injection syringes, and use of shooting galleries. They lack adequate access to new injection syringes and drug preparation equipment, and experience elevated rates of HIV and HCV infection. Between April and August, 2006, researchers and active IDUs collaborated in the development of an experimental HIV/HCV intervention aimed at identifying drug preparation items and practices that will enable IDUs to make drug solutions without potentially contaminated injection syringes contacting materials used to prepare drugs. The collaboration involved discussing and testing a variety of drug preparation items and practices in office and community settings. The process was repeated until concerns that had been raised were resolved, and a tentative set of intervention items and practices to be evaluated in a community field trial was identified. Throughout, a strong emphasis was placed on the capacity of an item or practice to address common problems confronted by IDUs (blunted needles, clogged syringes, injected particles in addition to the core aim of reducing contamination of preparation materials by blood in injection syringes. This report describes the final selection of items and practices: 1 A small water bottle that permits IDUs to add approximately .05 cc water drops directly to drug powder in cookers; 2 A preparation syringe (a type of ancillary equipment not used for injecting that permits IDUs to pull up a measurable amount of water to add to drug powder, an alternative to producing water drops; 3 A filtering device, the Sterifilt filter, attached to a preparation syringe, which eliminates the need for cotton or cigarette filters; 4 Use of a preparation syringe to distribute drug solution by backloading to injection syringe(s; 5 A small water bottle enabling IDUs to clean injection syringes by

  12. 78 FR 78367 - Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment

    Science.gov (United States)

    2013-12-26

    ... biologics approvals, drug supply chain, and other topics related to human pharmaceuticals. The draft PDUFA V... standards-based environment that enhances the regulatory review process for human pharmaceuticals. DATES... . Submit written comments to the Division of Dockets Management (HFA-305), Food and Drug Administration...

  13. Endovascular Treatment of a Vertebral Artery Pseudoaneurysm in a Drug User

    International Nuclear Information System (INIS)

    Mourikis, Dimitrios; Chatziioannou, Achilleas; Doriforou, Ortansia; Skiadas, Vasilios; Koutoulidis, Vasilios; Katsenis, Konstantinos; Vlahos, Lampros

    2006-01-01

    A 26-year-old drug abuser who presented with sepsis was found to have a pseudoaneurysm in the left vertebral artery. This aneurysm was presumed to be post-traumatic, since the patient reported multiple attempts to inject drugs in the left jugular vein 15 days prior to admission. The pseudoaneurysm was treated effectively with stent-graft placement

  14. Risking risk: the influence of types of capital and social networks on the injection practices of drug users.

    Science.gov (United States)

    Lovell, Anne M

    2002-09-01

    Although syringe exchange and other harm reduction interventions have generally been effective in reducing bloodborne pathogen incidence among injection drug users (IDUs), in some cases a minority of IDUs continues to engage in risky injection behavior. Building on emerging perspectives in social epidemiology and research on drug use in anthropology that point to the importance of examining fundamental social causes of risk behavior, or what puts individuals at risk for risk, this study used a multilevel perspective to explore whether forms of capital, social network characteristics, and other contextual factors influence continued risky injection behavior. Quantitative and qualitative data were collected on IDUs in the city of Marseilles, France, where sterile injection equipment has been legal and officially promoted since 1995. In multivariate analysis on data concerning active users, location in the densest part of a large, interconnected network of IDUs greatly increased the likelihood of risky injection practices, while there was a non-significant tendency for low Acquired Cultural and Economic Capital to predict this behavior. Among the strongest individual-level characteristics to predict this outcome were illicit use of prescribed medication, generally high dose buprenorphine, and unprotected sex. Parental abuse of psychoactive drugs during the subject's childhood, on the other hand, greatly decreased the chances of engaging in risky injection behavior. Additionally, qualitative data analysis suggests that risky injection may be linked to lack of resources to procure drugs, and not simply to inadequate sterile injection equipment. Further research, including ecological models, is needed to better understand how fundamental social conditions are related to "risk for risk". However, public health interventions can already address the need for community-level interventions, while rethinking the consequences of inaccessible drugs and unintended "leakage" from

  15. The Impact of Social Structures on Deviant Behaviors: The Study of 402 High Risk Street Drug Users in Iran.

    Science.gov (United States)

    Mehrabi, Maryam; Eskandarieh, Sharareh; Khodadost, Mahmoud; Sadeghi, Maneli; Nikfarjam, Ali; Hajebi, Ahmad

    2016-01-01

    This study is a sociological analysis of the three dimensions of social structure including institutional, relational, and embodied structures that have an impact on the individuals' deviant behaviors in the society. The authors used a mix method to analyze the qualitative and quantitative data of 402 high risk abandoned substance users in 2008 in Tehran, capital city of Iran. The leading reasons of substance use were categorized into four fundamental themes as follows: stress, deviant social networks, and low social capital and weak social support sources. In addition, the epidemiology model of regression analysis provides a brief explanation to assess the association between the demographical and etiological variables, and the drug users' deviant behaviors. In sum, substance use is discussed as a deviant behavior pattern which stems from a comorbidity of weak social structures.

  16. A Pilot Randomized Clinical Trial of Two Medication Adherence and Drug Use Interventions For HIV+ Crack Cocaine Users*

    Science.gov (United States)

    Ingersoll, Karen S.; Farrell-Carnahan, Leah; Cohen-Filipic, Jessye; Heckman, Carolyn J.; Ceperich, Sherry D.; Hettema, Jennifer; Marzani-Nissen, Gabrielle

    2011-01-01

    Background Crack cocaine use undermines adherence to highly active antiretroviral therapy (HAART). This pilot randomized clinical trial tested the feasibility and efficacy of 2 interventions based on the Information-Motivation-Behavioral Skills model to improve HAART adherence and reduce crack cocaine problems. Methods Participants were 54 adults with crack cocaine use and HIV with viral loads (VL) were detectable (log VL 2.97). The interventions included 6 sessions of Motivational Interviewing plus feedback and skills building (MI+), or Video information plus debriefing (Video+) over 8 weeks. Primary outcomes were adherence by 14-day timeline follow-back and Addiction Severity Index (ASI) Drug Composite Scores at 3 and 6 months. Repeated measures ANOVA assessed main effects of the interventions and interactions by condition. Results Significant increases in adherence and reductions in ASI Drug Composite Scores occurred in both conditions by 3 months and were maintained at 6 months, representing medium effect sizes. No between group differences were observed. No VL changes were observed in either group. Treatment credibility, retention, and satisfaction were high and not different by condition. Conclusions A counseling and a video intervention both improved adherence and drug problems durably among people with crack cocaine use and poor adherence in this pilot study. The interventions should be tested further among drug users with poor adherence. Video interventions may be feasible and scalable for people with HIV and drug use. PMID:21306837

  17. A pilot randomized clinical trial of two medication adherence and drug use interventions for HIV+ crack cocaine users.

    Science.gov (United States)

    Ingersoll, Karen S; Farrell-Carnahan, Leah; Cohen-Filipic, Jessye; Heckman, Carolyn J; Ceperich, Sherry D; Hettema, Jennifer; Marzani-Nissen, Gabrielle

    2011-07-01

    Crack cocaine use undermines adherence to highly active antiretroviral therapy (HAART). This pilot randomized clinical trial tested the feasibility and efficacy of 2 interventions based on the Information-Motivation-Behavioral Skill model to improve HAART adherence and reduce crack cocaine problems. Participants were 54 adults with crack cocaine use and HIV with viral loads (VL) were detectable (logVL 2.97). The interventions included 6 sessions of Motivational Interviewing plus feedback and skills building (MI+), or Video information plus debriefing (Video+) over 8 weeks. Primary outcomes were adherence by 14-day timeline follow-back and Addiction Severity Index (ASI) Drug Composite Scores at 3 and 6 months. Repeated measure ANOVA assessed main effects of the interventions and interactions by condition. Significant increases in adherence and reductions in ASI Drug Composite Scores occurred in both conditions by 3 months and were maintained at 6 months, representing medium effect sizes. No between group differences were observed. No VL changes were observed in either group. Treatment credibility, retention, and satisfaction were high and not different by condition. A counseling and a video intervention both improved adherence and drug problems durably among people with crack cocaine use and poor adherence in this pilot study. The interventions should be tested further among drug users with poor adherence. Video interventions may be feasible and scalable for people with HIV and drug use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. 75 FR 45632 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2011

    Science.gov (United States)

    2010-08-03

    ... act (21 U.S.C. 379j-12) establishes four different kinds of user fees: (1) Fees for certain types of...)). When certain conditions are met, FDA will waive or reduce fees (21 U.S.C. 379j-12(d)). For FY 2009... these calculations are presented in the first two columns of table 1 of this document. Column 3 reflects...

  19. Factorial Structure of Rosenberg's Self-Esteem Scale among Crack-Cocaine Drug Users.

    Science.gov (United States)

    Wang, Jichuan; Siegal, Harvey A.; Falck, Russell S.; Carlson, Robert G.

    2001-01-01

    Used nine different confirmatory factor analysis models to test the factorial structure of Rosenberg's (M. Rosenberg, 1965) self-esteem scale with a sample of 430 crack-cocaine users. Results partly support earlier research to show a single global self-esteem factor underlying responses to the Rosenberg scale, method effects associated with item…

  20. Exercise referral for drug users aged 40 and over: results of a pilot study in the UK.

    Science.gov (United States)

    Beynon, Caryl M; Luxton, Amy; Whitaker, Rhiannon; Cable, N Tim; Frith, Lucy; Taylor, Adrian H; Zou, Lu; Angell, Peter; Robinson, Scott; Holland, Dave; Holland, Sharon; Gabbay, Mark

    2013-05-28

    To test whether older drug users (aged 40 and over) could be recruited to an exercise referral (ER) scheme, to evaluate the feasibility and acceptability and measure the impact of participation on health. Observational pilot. Liverpool, UK. (1) 12 men and 5 women recruited to ER. (2) 7 specialist gym instructors. Logistic feasibility and acceptability of ER and associated research, rate of recruitment, level of participation over 8 weeks and changes in health. 22 gym inductions were arranged (recruitment time: 5 weeks), 17 inductions were completed and 14 participants began exercising. Attendance at the gym fluctuated with people missing weeks then re-engaging; in week 8, seven participants were in contact with the project and five of these attended the gym. Illness and caring responsibilities affected participation. Participants and gym instructors found the intervention and associated research processes acceptable. In general, participants enjoyed exercising and felt fitter, but would have welcomed more support and the offer of a wider range of activities. Non-significant reductions in blood pressure and heart rate and improvements in metabolic equivalents (METs; a measure of fitness) and general well-being were observed for eight participants who completed baseline and follow-up assessments. The number of weeks of gym attendance was significantly associated with a positive change in METs. It is feasible to recruit older drug users into a gym-based ER scheme, but multiple health and social challenges affect their ability to participate regularly. The observed changes in health measures, particularly the association between improvements in METs and attendance, suggest further investigation of ER for older drug users is worthwhile. Measures to improve the intervention and its evaluation include: better screening, refined inclusion/exclusion criteria, broader monitoring of physical activity levels, closer tailored support, more flexible exercise options and the use

  1. MALTODESXTRIN USE FOR WOUND AND INFLAMMATORY PROCESSES TREATMENT AND PROSPECTS OF DRUG FORMS MANUFACTURING ON ITS BASIS

    Directory of Open Access Journals (Sweden)

    M. V. Aroyan

    2015-01-01

    Full Text Available The article reviews the use of maltodextrine as one of the active substances in external drug forms which are used in purulent and inflammatory processes treatment abroad. The article considers a manufacturing prospect of import-substituting preparations on the basis of domestic maltodextrin

  2. A PROSPECTIVE ANALYSIS OF RISK-FACTORS FOR THE DISCONTINUATION OF 2ND-LINE ANTIRHEUMATIC DRUGS

    NARCIS (Netherlands)

    WIJNANDS, MJ; VANTHOF, MA; VANLEEUWEN, MA; VANRIJSWIJK, MH; VANDEPUTTE, LBA; VANRIEL, PLCM

    1993-01-01

    Clinical and laboratory factors influencing the discontinuation of second-line antirheumatic drugs were prospectively studied using survival analysis in a consecutive series of 245 patients with recently diagnosed rheumatoid arthritis. A statistically significant influence of age, sex, serum IgA and

  3. 76 FR 58277 - Animal Generic Drug User Fee Act; Public Meeting; Request for Comments

    Science.gov (United States)

    2011-09-20

    ... support for lower-cost alternatives to brand drugs for consumers. Under AGDUFA, FDA agreed to meet review... Parklawn Dr., Element Bldg., Rockville, MD 20857. Dated: September 13, 2011. Leslie Kux, Acting Assistant...

  4. 77 FR 72359 - Animal Generic Drug User Fee Act; Public Meeting; Request for Comments

    Science.gov (United States)

    2012-12-05

    ... Parklawn Dr., Element Bldg., Rockville, MD 20857. Comments: Interested persons may submit either written... to brand name drugs for consumers. Under AGDUFA I, FDA agreed to meet review performance goals for...

  5. Representações sociais do medicamento genérico por usuários Social representations of the generic drug by drug users

    Directory of Open Access Journals (Sweden)

    Maria Cleide Ribeiro Dantas de Carvalho

    2006-12-01

    Full Text Available O artigo objetivou captar as representações sociais do medicamento genérico por usuários de medicamentos no intuito de que seus resultados possam ser utilizados no aprimoramento da política desse tipo de medicamento no Brasil. Utilizou-se a Teoria das Representações Sociais como suporte teórico-metodológico. A pesquisa foi realizada no período de abril de 2002 a fevereiro de 2003, na cidade do Natal/RN, com 116 usuários de medicamentos, abordados em farmácias e/ou drogarias. O instrumento de coleta de dados foi a entrevista semi-estruturada, com uso de gravador. Os dados foram avaliados através do programa ALCESTE 4.5, além da análise de conteúdo preconizada por Laurence Bardin. O ALCESTE isolou 5 classes semânticas e a análise de conteúdo identificou 10 categorias. Para os usuários, o genérico representa um medicamento comercializado a preço mais barato, sem marca, equivalente a outro mais caro, mas que supre as necessidades imediatas de consumo, além do que a palavra genérico encerra uma representação mais ampla, absorvendo e englobado quaisquer produtos que tenham a característica dos medicamentos genéricos, porém com qualidade duvidosa.The paper aimed to apprehend the social representations of the generic drug by drug users, establishing mechanisms that could be used to improve the policy of this type of medicines in Brazil. The Theory of Social Representations was employed as theoretic-methodological support. The research was done from April, 2002 through February, 2003 in the city of Natal/RN with 116 drug users approached at pharmacies and/or drugstores. The instrument of data collection was a semistructured interview with a tape recorder. The data analysis was performed with the aid of both the ALCESTE 4.5 program and the content analysis recommended by Laurence Bardin. The ALCESTE isolated 5 semantic classes and the content analysis identified 10 categories. For users the generic drug stands for a medicine

  6. The development of multiple drug use among anabolic-androgenic steroid users: six subjective case reports

    Directory of Open Access Journals (Sweden)

    Nyberg Fred

    2008-11-01

    Full Text Available Abstract Background The inappropriate use of anabolic androgenic steroids (AAS was originally a problem among athletes but AAS are now often used in nonsport situations and by patients attending regular addiction clinics. The aim of this study was to improve understanding of the development of multiple drug use in patients seeking treatment at an addiction clinic for AAS-related problems. Methods We interviewed six patients (four men and two women with experience of AAS use who were attending an addiction clinic for what they believed were AAS-related problems. The patients were interviewed in-depth about their life stories, with special emphasis on social background, substance use, the development of total drug use and subjective experienced psychological and physical side effects. Results There was significant variation in the development of drug use in relation to social background, onset of drug use, relationship to AAS use and experience of AAS effects. All patients had initially experienced positive effects from AAS but, over time, the negative experiences had outweighed the positive effects. All patients were dedicated to excess training and took AAS in combination with gym training, indicating that the use of these drugs is closely related to this form of training. Use of multiple drugs was common either in parallel with AAS use or serially. Conclusion The study shows the importance of understanding how AAS use can develop either with or without the concomitant use of other drugs of abuse. The use of AAS can, however, progress to the use of other drugs. The study also indicates the importance of obtaining accurate, comprehensive information about the development of AAS use in designing treatment programmes and prevention strategies in this area.

  7. The development of multiple drug use among anabolic-androgenic steroid users: six subjective case reports.

    Science.gov (United States)

    Skårberg, Kurt; Nyberg, Fred; Engström, Ingemar

    2008-11-28

    The inappropriate use of anabolic androgenic steroids (AAS) was originally a problem among athletes but AAS are now often used in nonsport situations and by patients attending regular addiction clinics. The aim of this study was to improve understanding of the development of multiple drug use in patients seeking treatment at an addiction clinic for AAS-related problems. We interviewed six patients (four men and two women) with experience of AAS use who were attending an addiction clinic for what they believed were AAS-related problems. The patients were interviewed in-depth about their life stories, with special emphasis on social background, substance use, the development of total drug use and subjective experienced psychological and physical side effects. There was significant variation in the development of drug use in relation to social background, onset of drug use, relationship to AAS use and experience of AAS effects. All patients had initially experienced positive effects from AAS but, over time, the negative experiences had outweighed the positive effects. All patients were dedicated to excess training and took AAS in combination with gym training, indicating that the use of these drugs is closely related to this form of training. Use of multiple drugs was common either in parallel with AAS use or serially. The study shows the importance of understanding how AAS use can develop either with or without the concomitant use of other drugs of abuse. The use of AAS can, however, progress to the use of other drugs. The study also indicates the importance of obtaining accurate, comprehensive information about the development of AAS use in designing treatment programmes and prevention strategies in this area.

  8. Sexual identity and its relationship to injecting in a sample of disadvantaged young drug users.

    Science.gov (United States)

    Wilson, Hannah; Bryant, Joanne; Ellard, Jeanne; Howard, John; Treloar, Carla

    2016-03-01

    People who are new to injecting are at the highest risk of acquiring blood-borne viruses, and certain other characteristics, such as sexual identity, have been known to further heighten this risk. We investigate whether disadvantaged drug-using young people who are gay, lesbian, bisexual or who identify as other sexual identity (GLBO) are more likely to have ever injected drugs compared with their heterosexual peers. Convenience sampling was employed across 15 youth services in metropolitan Sydney. Respondents were required to be 16-24 years of age, to have used an illicit drug, to have been exposed to injecting through social networks and been socially disadvantaged in the past 12 months. Participants self-completed a survey using touch screen laptops. In a sample of 250 young people, GLBO participants more commonly reported ever injecting drugs [37.1%, confidence interval (CI) 21.5-55.1% vs. 12.3%, CI 8.1-17.4%] or injecting drugs in the past 12 months [31.4%, CI 16.9-49.3% vs. 5.7%, CI 2.9-9.6%] compared with participants who identified as heterosexual. The higher rates of injecting among GLBO young people found in this sample advocates for the development of targeted prevention strategies for this group. Utilising existing networks in GLBO communities could be one strategy to limit the transition to injecting drug use and reduce the risk of drug-related harms among this group. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  9. Explanations and expectations: drug narratives among young cannabis users in treatment.

    Science.gov (United States)

    Järvinen, Margaretha; Ravn, Signe

    2015-07-01

    This article analyses how young people enrolled in drug addiction treatment in Copenhagen, Denmark, explain their cannabis careers and how they view their possibilities for quitting drug use again. Inspired by Mead and narrative studies of health and illness, the article identifies four different drug use 'aetiologies' drawn upon by the interviewees. These cover childhood experiences, self-medication, the influence of friends and cannabis use as a specific lifestyle. A central argument of the article is that these explanations not only concern the past but also point towards the future by assigning the interviewee a more or less agential position in relation to drugs. Further, the drug narratives are viewed as interactional achievements, related to the social context in which they were produced, namely, the institutional setting of the treatment centres. The article is based on 30 qualitative interviews with young people in drug addiction treatment. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

  10. HIV vaccine trial willingness among injection and non-injection drug users in two urban centres, Barcelona and San Francisco.

    Science.gov (United States)

    Etcheverry, M Florencia; Lum, Paula J; Evans, Jennifer L; Sanchez, Emilia; de Lazzari, Elisa; Mendez-Arancibia, Eva; Sierra, Ernesto; Gatell, José M; Page, Kimberly; Joseph, Joan

    2011-02-24

    Being able to recruit high-risk volunteers who are also willing to consider future participation in vaccine trials are critical features of vaccine preparedness studies. We described data from two cohorts of injection- and non-injection drug users in Barcelona, Spain [Red Cross centre] and in San Francisco, USA, [UFO-VAX study] at high risk of HIV/HCV infection to assess behaviour risk exposure and willingness to participate in future preventive HIV vaccine trials. We successfully identified drug-using populations that would be eligible for future HIV vaccine efficacy trials, based on reported levels of risk during screening and high levels of willingness to participate. In both groups, Red Cross and UFO-VAX respectively, HCV infection was highly prevalent at baseline (41% and 34%), HIV baseline seroprevalence was 4.2% and 1.5%, and high levels of willingness were seen (83% and 78%). Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Felt Stigma in Injection Drug Users and Sex Workers: Focus Group Research with HIV-Risk Populations in Puerto Rico.

    Science.gov (United States)

    Jiménez, Julio; Puig, Marieva; Sala, Ana Cecilia; Ramos, Juan Carlos; Castro, Eida; Morales, Marangelie; Santiago, Lydia; Zorrilla, Carmen

    Though many studies have conclusively linked felt stigma and HIV, few have focused on the experiences of rejection felt by members of such socially marginalized groups as intravenous drug users (IDU) and sex workers (SW). Using focus groups, our study explored these experiences in 34 individuals (17 male UDUs and 17 female SWs) at risk of becoming infected with HIV, the objective being to discover why they engaged in maladaptive behaviors as a way of coping with felt stigma. We used deductive and inductive analysis to codify the resulting data. Concepts associated with the word stigma, emotional reactions to felt stigma, and the impact of felt stigma on self-schema helped elucidate how the internalization of felt stigma can lead to negative affective states and self-destructive behaviors (e.g., drug use and syringe exchange). Results underline the importance of developing intervention models that reduce stigma as a means of HIV prevention in vulnerable populations.

  12. 'We are always in some form of contact': friendships among homeless drug and alcohol users living in hostels.

    Science.gov (United States)

    Neale, Joanne; Brown, Caral

    2016-09-01

    Homeless drug and alcohol users are one of the most marginalised groups in society. They frequently have complex needs and limited social support. In this paper, we explore the role of friendship in the lives of homeless drug and alcohol users living in hostels, using the concepts of 'social capital' and 'recovery capital' to frame the analyses. The study was undertaken in three hostels, each in a different English city, during 2013-2014. Audio recorded semi-structured interviews were conducted with 30 residents (9 females; 21 males) who self-reported drink and/or drug problems; follow-up interviews were completed 4-6 weeks later with 22 participants (6 females; 16 males). Data were transcribed verbatim, coded using the software package MAXQDA, and analysed using Framework. Only 21 participants reported current friends at interview 1, and friendship networks were small and changeable. Despite this, participants desired friendships that were culturally normative. Eight categories of friend emerged from the data: family-like friends; using friends; homeless friends; childhood friends; online-only friends; drug treatment friends; work friends; and mutual interest friends. Routine and regular contact was highly valued, with family-like friends appearing to offer the most constant practical and emotional support. The use of information and communication technologies (ICTs) was central to many participants' friendships, keeping them connected to social support and recovery capital outside homelessness and substance-using worlds. We conclude that those working with homeless drug and alcohol users - and potentially other marginalised populations - could beneficially encourage their clients to identify and build upon their most positive and reliable relationships. Additionally, they might explore ways of promoting the use of ICTs to combat loneliness and isolation. Texting, emailing, online mutual aid meetings, chatrooms, Internet penpals, skyping and other social media

  13. Determinants of HIV sero-conversion among male injection drug users enrolled in a needle exchange programme at Karachi, Pakistan

    International Nuclear Information System (INIS)

    Samo, R. N.; Altaf, A.

    2013-01-01

    Objective: To assess the determinants of HIV sero-conversion among male injection drug users enrolled in needle exchange programme at Karachi. Methods: An unmatched retrospective case control study was conducted among male injection drug users receiving needle exchange services in Karachi. The cases and controls were identified from one drop in center providing needle exchange services. The data for the study participants was collected retrospectively from the programme. Descriptive statistics, univariate analysis, and multivariate regression analysis for determinants of HIV sero-conversion and Hosmer and Lameshow goodness of fit test for model adequacy were performed. Results: Mean age of the study participants was 34.17 +- 10.74 years. Average monthly income of the participants was US$ 125.15+-76.32. In unconditional multivariate regression analysis being unmarried (AOR: 3.0 95% CI 1.14-7.9, p=0.02), not living with family (AOR: 2.8 95% CI 1.18-6.79 p=0.02), family history of addiction (AOR: 2.5, 95% CI 1.01-6.49, p=0.04), injecting drugs in groups (AOR: 2.8, 95% CI 1.12 7.02 p=0.02), not obtaining syringes from the programme (AOR: 26.45, 95% CI 2.47-282.8 p=0.007), and history of blood transfusion (AOR: 52.9, 95% CI 1.32-2118.41 p=0.03) were significantly associated with HIV positive sero-status. Model adequacy was assessed by Hosmer and Lameshow goodness of (J: 4.95, p=0.7) indicating that the model was accurate. Conclusion: Social and drug related risky behaviours are important determinants of HIV among male IDUs in Karachi. The situation calls for programmatic initiatives for addressing the risky behaviours among IDUs for effective control of epidemic in the country. (author)

  14. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China's National Methadone Maintenance Treatment Program.

    Directory of Open Access Journals (Sweden)

    Changhe Wang

    Full Text Available Hepatitis C virus (HCV is the most common viral infection among injecting drug users worldwide. We aimed to assess HCV antibody prevalence and associated risk factors among clients in the Chinese national methadone maintenance treatment (MMT program.Data from 296,209 clients who enrolled in the national MMT program between March 2004 and December 2012 were analyzed to assess HCV antibody prevalence, associated risk factors, and geographical distribution.Anti-HCV screening was positive for 54.6% of clients upon MMT entry between 2004 and 2012. HCV antibody prevalence at entry declined from 66.8% in 2005 to 45.9% in 2012. The most significant predictors of HCV seropositivity were injecting drug use (adjusted odds ratio [AOR]: 8.34, 95% confidence interval [CI]: 8.17-8.52, p<0.0001 and a history of drug use ≥9 years (AOR: 2.01, 95% CI: 1.96-2.06, p<0.0001. Being female, of Uyghur or Zhuang ethnicity, and unmarried were identified as demographic risk factors (all p-values<0.0001. Of the 28 provincial-level divisions included in the study, we found that 5 divisions had HCV antibody prevalence above 70% and 20 divisions above 50%. The HCV screening rate within 6 months after MMT entry greatly increased from 30.4% in 2004 to 93.1% in 2012.The current HCV antibody prevalence remains alarmingly high among MMT clients throughout most provincial-level divisions in China, particularly among injecting drug users and females. A comprehensive prevention strategy is needed to control the HCV epidemic among MMT clients in China.

  15. Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption

    Science.gov (United States)

    Bergen, Andrew W.; Michel, Martha; Nishita, Denise; Krasnow, Ruth; Javitz, Harold S.; Conneely, Karen N.; Lessov-Schlaggar, Christina N.; Hops, Hyman; Zhu, Andy Z. X.; Baurley, James W.; McClure, Jennifer B.; Hall, Sharon M.; Baker, Timothy B.; Conti, David V.; Benowitz, Neal L.; Lerman, Caryn; Tyndale, Rachel F.; Swan, Gary E.

    2015-01-01

    The Nicotine Metabolite Ratio (NMR, ratio of trans-3’-hydroxycotinine and cotinine), has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET) gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs) at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 PACT=4.1E-7, rs4803381 PACT=4.5E-5, rs1137115, PACT=1.2E-3). Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis. PMID:26132489

  16. Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption.

    Directory of Open Access Journals (Sweden)

    Andrew W Bergen

    Full Text Available The Nicotine Metabolite Ratio (NMR, ratio of trans-3'-hydroxycotinine and cotinine, has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 PACT=4.1E-7, rs4803381 PACT=4.5E-5, rs1137115, PACT=1.2E-3. Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis.

  17. Injecting drug users' experiences of policing practices in two Mexican-U.S. border cities: public health perspectives.

    Science.gov (United States)

    Miller, Cari L; Firestone, Michelle; Ramos, Rebeca; Burris, Scott; Ramos, Maria Elena; Case, Patricia; Brouwer, Kimberly C; Fraga, Miguel Angel; Strathdee, Steffanie A

    2008-08-01

    Previous research has identified the impact of law enforcement practices on the behaviours and health of injection drug users (IDUs). We undertook a qualitative study of IDUs' experiences of policing practices in two Mexican cities on the U.S. border. In 2004, two teams of Mexican interviewers conducted in-depth interviews with IDUs residing in Tijuana and Ciudad Juarez (Cd. Juarez), Mexico, who had injected drugs at least once in the prior month. Topics included types of drug used, injection settings, access to sterile needles and experiences with police. Field notes and transcribed interviews were analysed to identify emergent themes. Amongst the 43 participants, most reported that it is common for IDUs to be arrested and detained for 36h for carrying sterile or used syringes. Most reported that they or someone they knew had been beaten by police. Interviews suggested five key themes relating to police influence on the risk environment: (1) impact of policing practices on accessibility of sterile syringes, (2) influence of police on choice of places to inject drugs (e.g., shooting galleries), (3) police violence, (4) police corruption and (5) perceived changes in policing practices. Findings suggest that some behaviour of police officers in Tijuana and Cd. Juarez is inconsistent with legal norms and may be negatively influencing the risk of acquiring blood-borne infections amongst IDUs. Implementing a comprehensive and successful HIV prevention programme amongst IDUs requires interventions to influence the knowledge, attitudes and practices of law enforcement officers.

  18. Candida albicans lumbar spondylodiscitis in an intravenous drug user: a case report.

    Science.gov (United States)

    Chen, Chang-Hua; Chen, Wei Liang; Yen, Hua-Cheng

    2013-12-11

    Spondylodiscitis leads to debility, and few data exist on Candida spondylodiscitis in patients with intravenous drug use. We present a case of Candida albicans lumbar spondylodiscitis in a patient with intravenous drug use. This patient was treated with surgical debridement and 9 months of fluconazole therapy, and the neurological deficits resolved completely. The infection did not recur clinically or radiologically during 9 months of follow-up. Although Candida albicans lumbar spondylodiscitis is rare, Candida should be suspected as a causative pathogen in patients with intravenous drug use except for Staphylococcus aureus, Pseudomonas aeruginosa, and Mycobacterium tuberculosis. As soon as Candida albicans lumbar spondylodiscitis is suspected, magnetic resonance imaging and percutaneous biopsy should be performed. Surgical intervention combined with treatment with antifungal medications can successfully eradicate the infection and resolve the neurological deficits.

  19. Are Alcohol Anti-relapsing and Alcohol Withdrawal Drugs Useful in Cannabinoid Users?

    Science.gov (United States)

    Kleczkowska, Patrycja; Smaga, Irena; Filip, Małgorzata; Bujalska-Zadrozny, Magdalena

    2016-11-01

    Cannabinoids are still classified as illegal psychoactive drugs despite their broad and increasingly acknowledged therapeutic potential. These substances are most famous for their wide recreational use, particularly among young adults to either alter the state of consciousness, intensify pleasure induced by other psychoactive substances or as an alternative to the previously abused drugs. It is important to emphasize that cannabinoids are often taken together with a variety of medications intended for the treatment of alcohol use disorder (AUD) or alcohol withdrawal syndrome (AWS). These medications include disulfiram, acamprosate, and naltrexone. In this paper, we summarize recent advances in the knowledge of possible beneficial effects and interactions between cannabinoids and drugs commonly used for treatment of AUD and AWS either comorbid or existing as a separate disorder.

  20. Hair testing to assess both known and unknown use of drugs amongst ecstasy users in the electronic dance music scene.

    Science.gov (United States)

    Palamar, Joseph J; Salomone, Alberto; Gerace, Enrico; Di Corcia, Daniele; Vincenti, Marco; Cleland, Charles M

    2017-10-01

    Data on both known and unknown drug use in the electronic dance music (EDM) scene is important to inform prevention and harm reduction. While surveys are the most common method of querying drug use, additional biological data can help validate use and detect unknown/unintentional use of drugs such as new psychoactive substances (NPS). We sought to determine the extent of both known and unknown use of various substances in this high-risk scene. We hair-tested 90 self-reported past-year ecstasy/MDMA/Molly users attending EDM parties in New York City during the summer of 2016 using UHPLC-MS/MS. Results were compared to self-reported past-year use. Three quarters (74.4%) tested positive for MDMA, a third (33.3%) tested positive for an NPS, and 27.8% tested positive specifically for one or more synthetic cathinones (e.g., butylone, ethylone, pentylone, methylone, alpha-PVP). Half (51.1%) of participants tested positive for a drug not self-reported, with most testing positive for synthetic cathinones (72.0%), methamphetamine (69.0%), other NPS stimulants (e.g., 4-FA, 5/6-APB; 66.7%), or new dissociatives (e.g., methoxetamine, diphenidine; 60.0%). Attending parties every other week or more often, reporting higher-frequency ecstasy pill use, having tested one's ecstasy, and having found out one's ecstasy was adulterated, were risk factors for testing positive for synthetic cathinones and NPS in general. Hair testing appears to be a valuable addition to drug epidemiology studies. Many EDM party attendees-even those who test their ecstasy-are unknowingly using NPS and/or other drugs. Prevention information and harm reduction may help reduce unknown/unintentional use. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Comparing exponential and exponentiated models of drug demand in cocaine users.

    Science.gov (United States)

    Strickland, Justin C; Lile, Joshua A; Rush, Craig R; Stoops, William W

    2016-12-01

    Drug purchase tasks provide rapid and efficient measurement of drug demand. Zero values (i.e., prices with zero consumption) present a quantitative challenge when using exponential demand models that exponentiated models may resolve. We aimed to replicate and advance the utility of using an exponentiated model by demonstrating construct validity (i.e., association with real-world drug use) and generalizability across drug commodities. Participants (N = 40 cocaine-using adults) completed Cocaine, Alcohol, and Cigarette Purchase Tasks evaluating hypothetical consumption across changes in price. Exponentiated and exponential models were fit to these data using different treatments of zero consumption values, including retaining zeros or replacing them with 0.1, 0.01, or 0.001. Excellent model fits were observed with the exponentiated model. Means and precision fluctuated with different replacement values when using the exponential model but were consistent for the exponentiated model. The exponentiated model provided the strongest correlation between derived demand intensity (Q0) and self-reported free consumption in all instances (Cocaine r = .88; Alcohol r = .97; Cigarette r = .91). Cocaine demand elasticity was positively correlated with alcohol and cigarette elasticity. Exponentiated parameters were associated with real-world drug use (e.g., weekly cocaine use) whereas these correlations were less consistent for exponential parameters. Our findings show that selection of zero replacement values affects demand parameters and their association with drug-use outcomes when using the exponential model but not the exponentiated model. This work supports the adoption of the exponentiated demand model by replicating improved fit and consistency and demonstrating construct validity and generalizability. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Mortality among young injection drug users in San Francisco: a 10-year follow-up of the UFO study.

    Science.gov (United States)

    Evans, Jennifer L; Tsui, Judith I; Hahn, Judith A; Davidson, Peter J; Lum, Paula J; Page, Kimberly

    2012-02-15

    This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.

  3. Molecular epidemiology of HCV monoinfection and HIV/HCV coinfection in injection drug users in Liuzhou, Southern China.

    Directory of Open Access Journals (Sweden)

    Yi Tan

    Full Text Available BACKGROUND: Hepatitis C virus (HCV mono-infection and HCV/HIV (human immunodeficiency virus co-infection are growing problems in injection drug users (IDU. Their prevalence and genotypic patterns vary with geographic locations. Access to harm reduction measures is opening up opportunities for improving the HIV/HCV profiling of IDU in China, where IDUs account for a significant proportion of the two infections especially in the southern part of the country. METHODOLOGY/PRINCIPAL FINDINGS: A cross sectional study was conducted. Through the Liuzhou Methadone Clinic, a total of 117 injection drug users (IDUs were recruited from Guangxi, Southern China. A majority of the IDUs (96% were HCV antibody positive, of which 21% were HIV infected. Unlike HCV monoinfection, there was spatial heterogeneity in the distribution of HIV/HCV coinfection, the latter also characterized by a higher prevalence of needle-sharing. Phylogenetic analysis revealed that genotype 6a was predominant in the study population. There were shorter genetic distances among the 6a sequences compared to the other HCV subtypes-1a, 3a, and 3b. CONCLUSION/SIGNIFICANCE: The results suggested that HIV and HCV were introduced at around the same time to the IDU populations in Southern China, followed by their differential spread as determined by the biologic characteristics of the virus and the intensity of behavioural risk. This pattern is different from that in other South East Asian countries where HCV infections have probably predated HIV.

  4. Estimating the coverage of a targeted mobile tuberculosis screening programme among illicit drug users and homeless persons with truncated models

    Science.gov (United States)

    VAN HEST, N. A. H.; De VRIES, G.; SMIT, F.; GRANT, A. D.; RICHARDUS, J. H.

    2008-01-01

    SUMMARY Truncated models are indirect methods to estimate the size of a hidden population which, in contrast to the capture–recapture method, can be used on a single information source. We estimated the coverage of a tuberculosis screening programme among illicit drug users and homeless persons with a mobile digital X-ray unit between 1 January 2003 and 31 December 2005 in Rotterdam, The Netherlands, using truncated models. The screening programme reached about two-third of the estimated target population at least once annually. The intended coverage (at least two chest X-rays per person per year) was about 23%. We conclude that simple truncated models can be used relatively easily on available single-source routine data to estimate the size of a population of illicit drug users and homeless persons. We assumed that the most likely overall bias in this study would be overestimation and therefore the coverage of the targeted mobile tuberculosis screening programme would be higher. PMID:17631692

  5. Complications in cosmetic laser surgery: a review of 494 Food and Drug Administration Manufacturer and User Facility Device Experience Reports.

    Science.gov (United States)

    Zelickson, Zachary; Schram, Sarah; Zelickson, Brian

    2014-04-01

    Complications in cosmetic laser and energy based surgery affect a number of patients every year and may cause scars, burns, blisters, and pigmentation damage. To evaluate documented complications in cosmetic laser- and energy-based surgeries, determine the most common errors, and recommend a simple procedural sequence to reduce patient complications. U.S. Food and Drug Administration Manufacturer and User Facility Device Experience Adverse Event Reports after cosmetic laser- and energy-based procedures with varied devices were reviewed (N = 494). The laser manufacturer, device used, event type, injury type, cause, operator, and indication for treatment for each case were identified. In the 494 cases reviewed between 2006 and 2011, the most common complications were burns, scarring, blistering, pigmentation damage, and infection. The most common cause of these complications was user error by a healthcare provider (30%), followed by laser device malfunction (20%) and patient error (4%). Indications for treatment were unknown for 69% of cases, and 38% of the cases were an unknown cause of complication. User error was a major factor in laser surgery complications. To improve safety and reduce errors, we propose the implementation of a procedural sequence for cosmetic laser surgery. © 2014 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  6. Nowhere to go: How stigma limits the options of female drug users after release from jail

    Directory of Open Access Journals (Sweden)

    Freudenberg Nicholas

    2009-05-01

    Full Text Available Abstract Background Drug and alcohol using women leaving prison or jail face many challenges to successful re-integration in the community and are severely hampered in their efforts by the stigma of drug or alcohol use compounded by the stigma of incarceration. Methods This qualitative study is based on individual semi-structured interviews and focus groups with 17 women who had recently left jail about the challenges they faced on reentry. Results Our analysis identified three major themes, which are related by the overarching influence of stigma: survival (jobs and housing, access to treatment services, and family and community reintegration. Conclusion Stigma based on drug use and incarceration works to increase the needs of women for health and social services and at the same time, restricts their access to these services. These specific forms of stigma may amplify gender and race-based stigma. Punitive drug and social policies related to employment, housing, education, welfare, and mental health and substance abuse treatment make it extremely difficult for women to succeed.

  7. 75 FR 45636 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2011

    Science.gov (United States)

    2010-08-03

    ... animal drugs (21 U.S.C. 379j-21(a)). When certain conditions are met, FDA will waive or reduce fees for.... 379j-21(c)(1)). FDA calculated the average number of each of the four types of applications and... ended on June 30, 2010. The results of these calculations are presented in the first two columns of...

  8. 76 FR 45814 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012

    Science.gov (United States)

    2011-08-01

    ...)). When certain conditions are met, FDA will waive or reduce fees for generic new animal drugs intended.... 379j-21(c)(1)). FDA calculated the average number of each of the four types of applications and... ended on June 30, 2011. The results of these calculations are presented in the first two columns of...

  9. 77 FR 45629 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2013

    Science.gov (United States)

    2012-08-01

    ... conditions are met, FDA will waive or reduce fees for generic new animal drugs intended solely to provide for... (21 U.S.C. 379j-21(c)(1)). FDA calculated the average number of each of the four types of applications... that ended on June 30, 2012. The results of these calculations are presented in the first two columns...

  10. 77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013

    Science.gov (United States)

    2012-08-01

    ... FURTHER INFORMATION CONTACT: David Miller, Office of Financial Management (HFA-100), Food and Drug... (Washington-Baltimore, DC-MD-VA-WV; not seasonally adjusted; all items; annual index) for the first 3 of the... this document provides the summary data for the percent change in the specified CPI for the Baltimore...

  11. Predictors of HIV infection and prevalence for syphilis infection among injection drug users in China: community-based surveys along major drug trafficking routes.

    Science.gov (United States)

    Jia, Yujiang; Lu, Fan; Zeng, Gang; Sun, Xinhua; Xiao, Yan; Lu, Lin; Liu, Wei; Ni, Mingjian; Qu, Shuquan; Li, Chunmei; Liu, Jianbo; Wu, Pingsheng; Vermund, Sten H

    2008-08-25

    To assess the predictors and prevalence of HIV infection among injection drug users in highly endemic regions along major drug trafficking routes in three Chinese provinces. We enrolled participants using community outreach and peer referrals. Questionnaire-based interviews provided demographic, drug use, and sexual behavior information. HIV was tested via ELISA and syphilis by RPR. Of the 689 participants, 51.8% were HIV-infected, with persons living in Guangxi having significantly lower prevalence (16.4%) than those from Xinjiang and Yunnan (66.8% and 67.1%, respectively). Syphilis seropositivity was noted in 5.4%. Longer duration of IDU, greater awareness of HIV transmission routes, and living in Xinjiang or Yunnan were associated with HIV seropositivity on multivariable analysis. Independent risk factors differed between sites. In Guangxi, being male and having a longer duration of IDU were independent risk factors for HIV infection; in Xinjiang, older age and sharing needles and/or syringes were independent factors; in Yunnan, more frequent drug injection, greater awareness of HIV transmission routes, and higher income were independent predictors of HIV seropositivity. Prevalence rates of HIV among IDUs in China are more than two out of three in some venues. Risk factors include longer duration of IDU and needle sharing. Also associated with HIV were factors that may indicate some success in education in higher risk persons, such as higher knowledge. A systemic community-level intervention with respect to evidenced-based, population-level interventions to stem the spread of HIV from IDU in China should include needle exchange, opiate agonist-based drug treatment, condom distribution along with promotion, and advocacy for community-based VCT with bridges to HIV preventive services and care.

  12. UPPER GASTROINTESTINAL TRACT HEMORRHAGE AND NONSTEROIDALANTIINFLAMMATORY DRUGS (NSAIDs – A 5-YEAR PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2002-03-01

    Full Text Available Background. Adverse effects of nonsteroidal antiinflammatory drugs (NSAIDs are a common cause of digestive tract hemorrhage.Study aims. The purpose of the study was to ascertain the percent of patients taking NSAIDs with upper digestive tract hemorrhage.Type of study. Prospective, analytical.Patients and methods. The study includes patients in which urgent endoscopic investigations of the upper digestive tract were carried out due to gastrointestinal hemorrhage between 1 January 1994 and 31 December 1998.Results. 3366 patients were investigated: 1222 women and 2144 men; the average age of our patients was 57.5 years (SD ± 17.1, a 2–97 year span. In 2905 patients (86.3% the source of bleeding was confirmed in the upper gastrointestinal tract. Among our patients 55% were aged over 60 years, 26.7% were older than 80 years. Sequelae of peptic ulcer disease were the most significant cause of gastrointestinal hemorrhage, in 47.7% of our patients (1387/2905. In the last week prior to bleeding, 19% of patients (552/2905 were taking regularly NSAIDs, corticosteroids, salycilates or anticoagulant therapy at least in single daily dose. The majority of patients, 94.5%, were taking NSAIDs or salycilates. Among NSAIDs they were taking most often ketoprofen, diclofenac or naproxen/ naproxen natrium, less often ibuprofen, nabumeton, etodolac or piroxicam.Conclusions. Upper digestive tract hemorrhage is a serious complication of NSAIDs medication, particularly in older patients

  13. A Study of Department of Defense Drug Abuse Prevention and Control Programs. Volume II. Findings, Conclusions and Recommendations. Part D. Identification of Drug Users. Part E. Treatment, Rehabilitation, and Counseling for Drug Users.

    Science.gov (United States)

    Drug abuse , *Military personnel, *Military planning, Department of Defense, Management, Problem solving, Comparison, Identification, Urine, Effectiveness, Pattern recognition, Hypotheses, Errors, Correlation techniques

  14. Prospective evaluation of drug-induced lung toxicity with high-resolution CT and transbronchial biopsy.

    Science.gov (United States)

    Piciucchi, S; Romagnoli, M; Chilosi, M; Bigliazzi, C; Dubini, A; Beomonte Zobel, B; Gavelli, G; Carloni, A; Poletti, V

    2011-03-01

    This study compared the results of high-resolution computed tomography (HRCT) and cytohistology after transbronchial biopsy in the evaluation of drug-related interstitial lung disease (DR-ILD). Patients with a clinical and imaging diagnosis of DR-ILD were prospectively included in a study protocol lasting 5 years. All patients were evaluated by bronchoscopy with transbronchial biopsy or bronchoalveolar lavage (BAL) following an HRCT examination that raised a suspicion of DR-ILD. Two radiologists (one senior and one junior), unaware of the diagnosis, reported the single HRCT findings, their distribution and predominant pattern. In the event of disagreement, the diagnosis was subsequently reached by consensus. Cytohistological examination was considered the gold standard in the diagnosis of DR-ILD. Patients who were unable to undergo the endoscopic procedure were excluded from the study. The study included 42 patients (25 men, 17 women; age range 20-84 years). Transbronchial biopsy was performed in all but four patients (one case of alveolar haemorrhage and three cases of lipoid pneumonia) in whom the diagnosis was established with BAL. Assessment of the HRCT images revealed the following patterns: noncardiogenic pulmonary oedema (n=13); organising pneumonia (OP) (n=9); hypersensitivity pneumonitis (HP) (n=2); alveolar haemorrhage (AH) (n=2); nonspecific interstitial pneumonia (NSIP) (n=5); lipoid pneumonia (LP) (n=1); sarcoid-like pattern (n=1). Cytohistological diagnosis revealed diffuse alveolar damage (DAD) in 11 patients, OP in seven, HP in three, AH in three, chronic interstitial pneumonia (CIP) in eight, LP in three and pseudosarcoidosis in one. Subdivision of the drugs into antineoplastic and nonantineoplastic agents showed that the most common patterns were CIP (n=6), DAD (n=2) and OP (n=2) in the antineoplastic group and DAD (n=9) and OP (n=5) in the nonantineoplastic group. Sensitivity and specificity of the radiological analysis was excellent, especially

  15. Perceptions of Iranian Female Drug Users Toward HIV Testing: A Qualitative Content Analysis.

    Science.gov (United States)

    Jamshidimanesh, Mansoureh; Khoie, Effat Merghati; Mousavi, Seyed Abbas; Keramat, Afsaneh; Emamian, Mohammad Hassan

    Drug-dependent women are the vulnerable population deprived of access to health services and also have particular relevance to public health perspective because they are important bridge population for driving HIV/AIDS epidemic. This qualitative study aimed to explore the perception of drug-dependent women regarding HIV testing. In this qualitative study, we approached 23 women with substance use disorders in 2 of the selected drop-in centers in the south Tehran. Focus group discussion, face-to-face semistructured interviews, and field notes were used to collect the data. Qualitative content analysis was used to extract the explanatory model of women's perceptions about HIV testing. Four main themes emerged from the data: forgotten health during use, having misconception, and sharing of sexual partner in secrecy and concerns. Seven subthemes were extracted, including not being sex worker, point of ruin, voluntary selection and concerns about fear of abandonment and fear of loss and death, double concern, and future of children. Beliefs and values of drug-dependent women can be positive points leading them to do an HIV test, and misconceptions of these women would be corrected by using safe behavioral skills training.

  16. Adaptation and validation of a questionnaire about risk behaviors for AIDS among drug users

    Directory of Open Access Journals (Sweden)

    Pechansky Flavio

    2002-01-01

    Full Text Available Objectives: To initiate the process of validation of an instrument based on an American self-reported questionnaire named RAB (Risk Assessment Battery -- called CRA in its Brazilian version --, which covers aspects related to drug use, HIV testing, sexual behavior and concern with the transmission of the virus. The questionnaire was back-translated and its concurrent validity was tested, as well as the utility of an Overall Risk Score (ORS for the transmission of the HIV virus or of subscores for Drug Use (SDU or Sexual Risk (SSR. Methods: Case vignettes of ten typical cases had their questionnaire scores compared with the impression of independent referees. Results: There were systematic differences in the comparison with the specific referees for each area, suggesting that only the ORS has clinical validity, specifically regarding the exposure to risk of infection/reinfection by HIV. Conclusion: The questionnaire in its current use and format is not adequate to express impairment already caused by exposure to the virus. The specific subscores were not clinically valid to express such risk, and the instrument needs the addition of a more comprehensive section about intravenous drug use to be used in future studies.

  17. Prevalence of hepatitis C virus infection and associated factors among male illicit drug users in Cuiabá, Mato Grosso, Brazil

    Directory of Open Access Journals (Sweden)

    Antônia Carlos Magalhães Novais

    2009-09-01

    Full Text Available Intravenous drug injection has been reported as the main risk factor for hepatitis C virus (HCV infection. The aim of the present study was to describe the prevalence and the epidemiological profile of HCV infection among abusers of illegal injected and non-injected drugs in Cuiabá, state of Mato Grosso, Central Brazil. A cross-sectional study including 314 male drug users from eight detoxification centres was performed. Out of 314 subjects studied, 48 (15.2% were intravenous drug users. Participants were interviewed and had blood samples taken and tested for the presence of anti-HCV antibodies. Positive samples were tested for the presence of HCV RNA. Genotyping was performed on HCV RNA-positive samples. The overall prevalence of anti-HCV antibodies was 6.4% (n = 20. Out of 20 anti-HCV antibody-positive subjects, 16 (80% were also HCV RNA-positive. Genotype 1 predominated (75%, followed by 3a (25%. Subtype 1a was more common than 1b. HCV infection was more prevalent among intravenous drug users (33% than non-injecting users (1.5%. Logistic regression analyses showed independent associations between HCV infection and intravenous drug use, imprisonment and increasing age. In the present study, injecting drug use was the factor most strongly associated to HCV infection and inhaling or sniffing did not represent an increased susceptibility to infection.

  18. Epidemiological characteristics of novel influenza A (H1N1 in antiviral drug users in Korea.

    Directory of Open Access Journals (Sweden)

    Kyunghi Choi

    Full Text Available Soon after the first novel influenza A (H1N1 death was documented in Korea on August 15, 2009, prompt treatment with antiviral drugs was recommended when an infection was suspected. Free antiviral drugs were distributed to patients who met the case definition in the treatment guidelines, and patients prescribed the antiviral drugs were included in the Antiviral Drug Surveillance System (ADSS. A total of 2,825,821 patients were reported to the ADSS from September 1 to December 31, 2009. Odds ratios were calculated to compare the risks of severe diseases, as indicated by general hospital admissions or intensive care unit (ICU admissions according to demographic characteristics, underlying medical conditions, and behavioral factors. Approximately 6% of the total population received antiviral drugs during the study period. Of these, 2,709,611 (95.9% were outpatients, 114,840 (4.06% were hospitalized, and 1,370 (0.05% were admitted to the ICU. Children aged 0-9 yr accounted for 33.94% of all reported cases, whereas only 3.89% of the patients were ≥ 60 yr. The estimated incidence of novel influenza A (H1N1 during the pandemic was 5.68/100 of all reported cases. Mortality due to influenza A (H1N1 during the pandemic was 0.33/100,000, with the highest mortality of 1.31/100,000 for patients aged ≥ 60 years. Severe pandemic H1N1 influenza was associated with the presence of one or more underlying medical conditions in elderly aged ≥ 60 years and with lower economic status. Moreover, influenza A (H1N1 appeared to be age-specific in terms of mortality. Although the incidence and admission rates of influenza A (H1N1 were higher in younger age groups, fatal cases were much more likely to occur in the elderly (≥ 60 years. In contrast to earlier influenza A (H1N1 reports, the risks of a severe outcome were elevated among those who were underweight (body mass index < 18.5 kg/m(2.

  19. Health and oral health care needs and health care-seeking behavior among homeless injection drug users in San Francisco.

    Science.gov (United States)

    Robbins, Jonathan Leserman; Wenger, Lynn; Lorvick, Jennifer; Shiboski, Caroline; Kral, Alex H

    2010-12-01

    Few existing studies have examined health and oral health needs and treatment-seeking behavior among the homeless and injection drug users (IDUs). This paper describes the prevalence and correlates of health and oral health care needs and treatment-seeking behaviors in homeless IDUs recruited in San Francisco, California, from 2003 to 2005 (N = 340). We examined sociodemographic characteristics, drug use patterns, HIV status via oral fluid testing, physical health using the Short Form 12 Physical Component Score, self-reported needs for physical and oral health care, and the self-reported frequency of seeking medical and oral health care. The sample had a lower health status as compared to the general population and reported a frequent need for physical and oral health care. In bivariate analysis, being in methadone treatment was associated with care-seeking behavior. In addition, being enrolled in Medi-Cal, California's state Medicaid program, was associated with greater odds of seeking physical and oral health care. Methamphetamine use was not associated with higher odds of needing oral health care as compared to people who reported using other illicit drugs. Homeless IDUs in San Francisco have a large burden of unmet health and oral health needs. Recent cuts in Medi-Cal's adult dental coverage may result in a greater burden of oral health care which will need to be provided by emergency departments and neighborhood dental clinics.

  20. Incident users of antipsychotic agents and future use of cholesterol-lowering drugs: an observational, pharmacoepidemiologic study.

    Science.gov (United States)

    Skrede, Silje; Tvete, Ingunn F; Tanum, Lars; Steen, Vidar M; Bramness, Jørgen G

    2015-01-01

    Antipsychotic agents have serious metabolic adverse effects, among them dyslipidemia, which may necessitate secondary prophylaxis with cholesterol-lowering drugs. Second-generation antipsychotics (SGAs), particularly clozapine and olanzapine, are known to confer a higher risk of metabolic adverse effects than first-generation antipsychotics (FGAs). However, little is known regarding the real-life number of antipsychotic-treated patients receiving statins. By extracting data from the Norwegian prescription database, all patients 18-69 years old that started treatment with an antipsychotic during 2004-2012 formed the basis for analysis (n = 301,713). The primary outcome measure was the proportion of FGA and SGA users prescribed with cholesterol-lowering agent during the same period. We used Cox proportional hazards regression to evaluate the risk of redeeming a cholesterol-lowering drug for formerly antipsychotic drug-naive patients (n = 147,218). Statin prescription rates in patients receiving antipsychotic agents were lower (5.3%) than comparable rates in studies covering the general population (34%) and lower than would be expected based on the recognized negative impact of antipsychotics on serum lipids. Statin prescription rates were affected by patient age, antipsychotic dose, and the number of antipsychotic agents prescribed, but rates were only 5% elevated in patients receiving SGAs compared to patients receiving FGAs (P = .048). Our results may support the notion that patients treated with antipsychotic agents receive suboptimal care with regard to metabolic adverse effects. © Copyright 2015 Physicians Postgraduate Press, Inc.

  1. The risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptic drugs.

    Science.gov (United States)

    Frey, Noel; Bodmer, Michael; Bircher, Andreas; Rüegg, Stephan; Jick, Susan S; Meier, Christoph R; Spoendlin, Julia

    2017-12-01

    Older antiepileptic drugs (AEDs) are known to cause Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). However, evidence for newer AED is sparse. We quantified risks of SJS/TEN in association with use of all AEDs in the United Kingdom. In a matched case-control study of 480 previously validated SJS/TEN cases (1995-2013) we used conditional logistic regression to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and calculated absolute risks of SJS/TEN within separate cohorts of new users of 28 AEDs. We assessed causality between drugs and SJS/TEN in each exposed case, using an adapted version of the algorithm of drug causality for epidermal necrolysis (ALDEN) score. We observed a strong association between SJS/TEN and new use of carbamazepine (OR 92.57, 95% CI 19.89-∞), phenytoin (OR 49.96, 95% CI 10.13-∞), and lamotrigine (OR 26.90, 95% CI 4.88-∞), where causality, according to the ALDEN score, was very probable or probable for most exposed cases. Absolute risks for SJS/TEN were highest for phenytoin (45.86 cases/100,000 exposed), lamotrigine (44.17 cases/100,000 exposed), and carbamazepine (20.38 cases/100,000 exposed). Despite increased ORs for valproate (40,941 exposed), gabapentin (116,037 exposed), pregabalin (59,967 exposed), and clobazam (4,300 exposed), ALDEN suggested no causal association. There were no observed cases of SJS/TEN among new users of levetiracetam (n = 96,77), clonazepam (n = 18,075), or topiramate (n = 11,307). The results of our study are consistent with those of previous studies of SJS/TEN, which found increased risks of SJS/TEN in new use of carbamazepine, phenytoin, and lamotrigine. Despite frequent use, no ALDEN-score confirmed cases were observed in new users of valproate, gabapentin, pregabalin, levetiracetam, topiramate, or clonazepam. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  2. Treatment Utilization Among Adolescent Substance Users: Findings from the 2002 to 2013 National Survey on Drug Use and Health.

    Science.gov (United States)

    Haughwout, Sarah P; Harford, Thomas C; Castle, I-Jen P; Grant, Bridget F

    2016-08-01

    Adolescent substance users face serious health and social consequences and benefit from early diagnosis and treatment. The objectives of this study were to observe trends in treatment utilization; examine correlates of treatment utilization and treatment types/settings among adolescent substance users with and without substance use disorder (SUD); and assess gender differences. National Survey on Drug Use and Health data were pooled across 2002 to 2013, with a combined sample of 79,885 past-year substance users ages 12 to 17 (17,510 with SUD and 62,375 without SUD). Treatment was defined as receiving treatment or counseling for use of alcohol or any drug, not counting cigarettes. Trends were assessed by joinpoint linear regression, and multivariable logistic regression assessed odds ratios of treatment utilization. Percentages of past-year treatment use did not change in 2002 to 2013. Treatment utilization was more prevalent among adolescents with SUD than without (11.4% vs. 1.4%) and among males than females. Among adolescents with and without SUD, criminal justice involvement and perceiving a need for treatment increased adolescent treatment utilization, while SUDs other than alcohol abuse, older age, and talking to parents increased treatment use among adolescents with SUD, and polysubstance use and male gender increased treatment among those without SUD. Treatment gaps persisted among non-Hispanic Blacks for both groups with and without SUD, male Hispanics with SUD, female non-Hispanic Asians without SUD, and private insurance coverages. Gender differences were observed in SUD, race/ethnicity, and insurance coverage. Most adolescents received treatment for both alcohol and drug use, and self-help group and outpatient rehabilitation facility were the most used treatment settings. Treatment utilization among adolescents with past-year substance use remained low and unimproved in 2002 to 2013. Treatment gaps among minority populations, insurance coverage, and in

  3. Infective endocarditis caused by Cellulomonas spp. in an intravenous drug user: case report.

    Science.gov (United States)

    Logar, Mateja; Lejko-Zupanc, Tatjana

    2013-06-01

    Cellulomonas spp. are often believed to be of low virulence. There are only a few reports of human infections. We report the first case of endocarditis caused by Cellulomonas in an intravenous drug abuser. The diagnosis of infective endocarditis (IE) in this case was definite using the Duke criteria. The course of the disease was complicated with a heart failure and possible mycotic aneurysm in the left leg. After the end of antimicrobial therapy aortic valve replacement was done because of severe heart failure.

  4. Medical image of the week: infective endocarditis in an IV drug user

    Directory of Open Access Journals (Sweden)

    Hawke AS

    2013-12-01

    Full Text Available A 30 year old man presented with a one week history of fever, chills, body aches, and fatigue, as well as lower extremity and right wrist edema and pain. The patient also had a history of intravenous (IV drug use. On exam, a previously undocumented 3/6 blowing crescendo murmur was heard at the fifth intercostal space in the midclavicular line. Transthoracic echocardiogram demonstrated a large, irregular, mobile mass, measuring 2.0 x 2.5 cm, attached to the posterior mitral annulus (Figure 1. Cardiothoracic surgery performed a primary repair of the mitral valve.

  5. Utilization of buprenorphine and methadone among opioid users who inject drugs.

    Science.gov (United States)

    Tsui, Judith I; Burt, Richard; Thiede, Hanne; Glick, Sara N

    2018-01-02

    There has been a rise in opioid abuse and related injection drug use in the United States, and treatment for opioid use disorders may be underutilized. The study aim was to describe utilization of opioid agonist therapy (OAT), and assess factors associated with utilization of OAT, among persons who inject drugs (PWID) in the Seattle metropolitan area. Data were obtained from the 2015 National HIV Behavioral Surveillance (NHBS) system among PWID in the Seattle area. Persons aged ≥18 years who injected drugs in the past year were recruited using respondent-driven sampling. Local supplemental questions assessed whether participants had received methadone or buprenorphine treatment in the past year. The analysis was restricted to participants who reported use of any opioids in the past year. Analyses compared the demographic, health insurance status, duration of injection drug use, prior history of overdose, prior receipt of hepatitis C virus/human immunodeficiency virus (HCV/HIV) testing (self-report), and screening positive for HCV/HIV via study testing between methadone- or buprenorphine-treated and untreated PWID. Multivariate logistic models were performed to assess adjusted associations with receipt of any OAT. The sample included 487 PWID who used opioids in the past year, of whom 27.1% (95% confidence interval [CI]: 23.1-31.1) reported past-year treatment with methadone and 4.7% (95% CI: 2.8-6.6) reported treatment with buprenorphine. There were no significant differences in demographics among participants who did and did not report past-year OAT; however, participants who were treated with methadone were more likely to be insured and have hepatitis C. After adjustment for other covariates, having health insurance was strongly associated with receipt of OAT (adjusted odds ratio [aOR] = 18.6; 95% CI: 2.5-138.7). OAT, in particular buprenorphine, has been underutilized by opioid-using PWID in the Seattle area. Health insurance is a critical factor for enabling

  6. Attitude of Health Care Workers (HCWs toward Patients Affected by HIV/AIDS and Drug Users: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Caterina Ledda

    2017-03-01

    Full Text Available Caring for HIV/AIDS patients and/or drug users requires health care workers (HCWs to have good knowledge of the issues. Cultural differences in HCWs, combined with professional ethics and personal beliefs, could also result in conflicting attitudes, leading to difficulties related to looking after people affected by HIV/AIDS or drug users. A cross-sectional study was carried out to assess the attitude towards HIV/AIDS patients and/or drug users in a sample of workers operating in a large university hospital in southern Italy. A total of 736 workers were surveyed from May to November 2016. During the periodic occupational health surveillance, a questionnaire was administered about attitudes of discrimination, acceptance and fear towards these patients. Respondents showed average levels of acceptance to HIV/AIDS and drug user patients. As years of experience and professional training increased, scores for discrimination, acceptance of HIV/AIDS, acceptance of drug users and fear decreased. Factors positively influencing levels of attitudes were being female and younger. Supplementary education is needed to strengthen the awareness of HCWs.

  7. A randomized trial of employment-based reinforcement of cocaine abstinence in injection drug users.

    Science.gov (United States)

    Silverman, Kenneth; Wong, Conrad J; Needham, Mick; Diemer, Karly N; Knealing, Todd; Crone-Todd, Darlene; Fingerhood, Michael; Nuzzo, Paul; Kolodner, Kenneth

    2007-01-01

    High-magnitude and long-duration abstinence reinforcement can promote drug abstinence but can be difficult to finance. Employment may be a vehicle for arranging high-magnitude and long-duration abstinence reinforcement. This study determined if employment-based abstinence reinforcement could increase cocaine abstinence in adults who inject drugs and use cocaine during methadone treatment. Participants could work 4 hr every weekday in a workplace where they could earn about $10.00 per hour in vouchers; they were required to provide routine urine samples. Participants who attended the workplace and provided cocaine-positive urine samples during the initial 4 weeks were invited to work 26 weeks and were randomly assigned to an abstinence-and-work (n = 28) or work-only (n = 28) group. Abstinence-and-work participants had to provide urine samples showing cocaine abstinence to work and maintain maximum pay. Work-only participants could work independent of their urinalysis results. Abstinence-and-work participants provided more (p = .004; OR = 5.80, 95% CI = 2.03-16.56) cocaine-negative urine samples (29%) than did work-only participants (10%). Employment-based abstinence reinforcement can increase cocaine abstinence.

  8. Doing Research with Vulnerable Populations: The Case of Intravenous Drug Users

    Directory of Open Access Journals (Sweden)

    Murdoch, Blake

    2016-09-01

    Full Text Available This review article considers ethical concerns when doing research on potentially vulnerable people who inject drugs (PWID in a Canadian context. The Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans broadly addresses many of the traditional ethical principles of research on vulnerable persons, but does so at the cost of clarity and precision. Vulnerability is contextual rather than absolute. When doing research with vulnerable persons, informed consent should be obtained from an independent person, and comprehension should be checked using questioning. Participants can be vulnerable due to many factors, including addiction, chronic disease, socioeconomic and racial status, and lack of education. The ability of PWID to give informed consent can be compromised by undue influence or intoxication, but existing research shows that neither the mode nor the magnitude of compensation has a significant effect on new rates of drug use. Compensation can also help dispel the therapeutic misconception. Intoxication rather than undue influence is the main concern when obtaining informed consent from PWID. The stigmatization of PWID as incapable of consent should be avoided. Paternalistic exclusion from research can harm PWID and exacerbate their vulnerability by reducing our knowledge of and ability to specifically treat them. As such, we must collect better data about the effects of research ethics policies. Studies to this effect should focus on experiences, perspectives and needs of potentially vulnerable research participants. Research ethics boards in Canada should adopt an evidence-based approach when applying discretionary power to proposals for clinical research.

  9. Therapeutic Community Effectiveness on Self-Esteem and Relapse Rate among Drug Users

    Directory of Open Access Journals (Sweden)

    Mosayyeb Yarmohammadi-Vasel

    2012-04-01

    Full Text Available Objective: In recent years, the Therapeutic Community(TC has become a widespread treatment alternative for drug addicts. TC have been widely studied with emphasis on thair effectiveness. The aims of the present study was to examined effectiveness of TC on self esteem and decrease of relapse. Materials & Methods: Research Statistics universe constitutes of all the substance abusers who have come to the TC centers of Tehran and Mashad. samples is chosen as stratified sampling of the cities of Tehran & Mashad. This study conducted among 165 substance abuser, examined their drug use 2 years. The study utilized a quasi-experimental design with one group, clients were tested at 3 points in time pretest (at admission time, posttest (3-6 months after treatment and 1-year Follo-up (1-year after treatment using the self esteem questionnaire. Results: The findings show that (a about half (50% the clients were clean at follow-up (b significant linear increases on self esteem After 3 to 6 months of treatment(P<0.05. Conclusion: This study provides evidence that TC could effective approach to increases on self esteem and decrease of relapse.

  10. Gender differences in sexual and injection risk behavior among active young injection drug users in San Francisco (the UFO Study).

    Science.gov (United States)

    Evans, Jennifer L; Hahn, Judith A; Page-Shafer, Kimberly; Lum, Paula J; Stein, Ellen S; Davidson, Peter J; Moss, Andrew R

    2003-03-01

    Female injection drug users (IDUs) represent a large proportion of persons infected with HIV in the United States, and women who inject drugs have a high incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Therefore, it is important to understand the role of gender in injection risk behavior and the transmission of blood-borne virus. In 2000-2002, 844 young (<30 years old) IDUs were surveyed in San Francisco. We compared self-reported risk behavior between 584 males and 260 female participants from cross-sectional baseline data. We used logistic regression to determine whether demographic, structural, and relationship variables explained increased needle borrowing, drug preparation equipment sharing, and being injected by another IDU among females compared to males. Females were significantly younger than males and were more likely to engage in needle borrowing, ancillary equipment sharing, and being injected by someone else. Females were more likely than males to report recent sexual intercourse and to have IDU sex partners. Females and males were not different with respect to education, race/ethnicity, or housing status. In logistic regression models for borrowing a used needle and sharing drug preparation equipment, increased risk in females was explained by having an injection partner who was also a sexual partner. Injecting risk was greater in the young female compared to male IDUs despite equivalent frequency of injecting. Overlapping sexual and injection partnerships were a key factor in explaining increased injection risk in females. Females were more likely to be injected by another IDU even after adjusting for years injecting, being in a relationship with another IDU, and other potential confounders. Interventions to reduce sexual and injection practices that put women at risk of contracting hepatitis and HIV are needed.

  11. HIV and hepatitis C virus infections among hanka injection drug users in central Ukraine: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Slobodyanyuk Pavel

    2009-08-01

    Full Text Available Abstract Background Ukraine has experienced an increase in injection drug use since the 1990s. An increase in HIV and hepatitis C virus infections has followed, but not measures of prevalence and risk factors. The purposes of this study are to estimate the prevalence of HIV, HCV, and co-infection among injection drug users (IDUs in central Ukraine and to describe risk factors for HIV and HCV. Methods A sample of 315 IDUs was recruited using snowball sampling for a structured risk interview and HIV/HCV testing (81.9% male, 42% single, average age 28.9 years [range = 18 to 55]. Results HIV and HCV antibodies were detected in 14.0% and 73.0%, respectively, and 12.1% were seropositive for both infections. The most commonly used drug was hanka, home-made from poppy straw and often mixed with other substances including dimedrol, diazepines, and hypnotics. The average period of injecting was 8.5 years; 62.5% reported past-year sharing needles or injection equipment, and 8.0% shared with a known HIV-positive person. More than half (51.1% reported multiple sexual partners, 12.9% buying or selling sex, and 10.5% exchanging sex and drugs in the past year. Those who shared with HIV positive partners were 3.4 times more likely to be HIV positive than those who did not. Those who front- or back-loaded were 4 times more likely to be HCV positive than those who did not. Conclusion Harm reduction, addiction treatment and HIV prevention programs should address risk factors to stop further spread of both HIV and HCV among IDUs and to the general population in central Ukraine.

  12. Long-term use of calcium channel blocking drugs and breast cancer risk in a prospective cohort of US and Puerto Rican women.

    Science.gov (United States)

    Wilson, Lauren E; D'Aloisio, Aimee A; Sandler, Dale P; Taylor, Jack A

    2016-07-05

    In a recent case-control study, long-term use of calcium channel blocking drugs was associated with a greater-than-twofold increased breast cancer risk. If prospectively collected data confirm that calcium channel blocker use increases breast cancer risk, this would have major implications for hypertension treatment. The objective of this study was to determine whether women using calcium channel blockers for 10 years or more were at increased risk of developing breast cancer compared with women not using calcium channel blockers. The Sister Study is a prospective volunteer cohort study of women from the USA and Puerto Rico designed to evaluate environmental and genetic risk factors for breast cancer. Beginning in 2003, women between the ages of 35 and 74 were recruited. They were eligible to participate if they had a sister with breast cancer but had not been diagnosed with breast cancer themselves. In total, 50,884 women enrolled in the cohort between 2003 and 2009; 50,757 women with relevant baseline data and available follow-up data are included in this study. The exposure of interest is current use of calcium channel blocking drugs and the reported duration of use at entry into the cohort. Secondary exposures of interest were the duration and frequency of use for all other subclasses of antihypertensive drugs. Our main outcome is a self-reported diagnosis of breast cancer during the study follow-up period. With patient permission, self-reported diagnoses were confirmed using medical records. Results showed 15,817 participants were currently using an antihypertensive drug, and 3316 women were currently using a calcium channel blocker at study baseline; 1965 women reported a breast cancer diagnosis during study follow-up. Using Cox proportional hazards modeling, we found no increased risk of breast cancer among women who had been using calcium channel blockers for 10 years or more compared with never users of calcium channel blockers (HR 0.88, 95 % CI 0

  13. Resilience among IDUs: planning strategies to help injection drug users to protect themselves and others from HIV/HCV infections.

    Science.gov (United States)

    Sirikantraporn, Skultip; Mateu-Gelabert, Pedro; Friedman, Samuel R; Sandoval, Milagros; Torruella, Rafael A

    2012-08-01

    Many long-term injection drug users (IDUs) engage in planning strategies. In this pilot study, we examine the relation of one planning strategy to IDUs' engaging in safer injection practices. Sixty-eight IDUs were recruited in 2010 from a New York City (NYC) needle exchange program and referrals to participate in an innovative Staying Safe Intervention that teaches strategies to stay HIV/HCV uninfected. Responses to a baseline 185-item survey were analyzed using correlations and odds ratios. Planning ahead to have steady access to clean equipment was correlated with both individually based and networks-based safety behaviors including storing clean needles; avoiding sharing needles, cookers, and filters with other injectors; and providing clean needles to sex partners. Implications related to resilience in IDUs are discussed and the study's limitations have been noted.

  14. A comparison of network sampling designs for a hidden population of drug users: Random walk vs. respondent-driven sampling.

    Science.gov (United States)

    Bell, David C; Erbaugh, Elizabeth B; Serrano, Tabitha; Dayton-Shotts, Cheryl A; Montoya, Isaac D

    2017-02-01

    Both random walk and respondent-driven sampling (RDS) exploit social networks and may reduce biases introduced by earlier methods for sampling from hidden populations. Although RDS has become much more widely used by social researchers than random walk (RW), there has been little discussion of the tradeoffs in choosing RDS over RW. This paper compares experiences of implementing RW and RDS to recruit drug users to a network-based study in Houston, Texas. Both recruitment methods were implemented over comparable periods of time, with the same population, by the same research staff. RDS methods recruited more participants with less strain on staff. However, participants recruited through RW were more forthcoming than RDS participants in helping to recruit members of their social networks. Findings indicate that, dependent upon study goals, researchers' choice of design may influence participant recruitment, participant commitment, and impact on staff, factors that may in turn affect overall study success. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. A preliminary study of spiritual self-schema (3-S(+)) therapy for reducing impulsivity in HIV-positive drug users.

    Science.gov (United States)

    Margolin, Arthur; Schuman-Olivier, Zev; Beitel, Mark; Arnold, Ruth M; Fulwiler, Carl E; Avants, S Kelly

    2007-10-01

    The purpose of this study was twofold. First, pretreatment correlations are presented among impulsivity, intoxicant use, HIV risk behavior, spirituality, and motivation in a sample of 38 HIV-positive drug users. Second, treatment outcomes are presented from a preliminary study of spiritual self-schema (3-S(+)) therapy - a manual-guided psychotherapy integrating cognitive and Buddhist psychologies - for increasing motivation for abstinence, HIV prevention, and medication adherence. Impulsivity was negatively correlated with spiritual practices and motivation for recovery, and was positively related to intoxicant use and HIV risk behavior. Relative to a standard care comparison condition, patients completing 3-S(+) therapy reported greater decreases in impulsivity and intoxicant use, and greater increases in spiritual practices and motivation for abstinence, HIV prevention, and medication adherence. (c) 2007 Wiley Periodicals, Inc.

  16. The Impact of Social Structures on Deviant Behaviors: The Study of 402 High Risk Street Drug Users in Iran

    Directory of Open Access Journals (Sweden)

    Maryam Mehrabi

    2016-01-01

    Full Text Available This study is a sociological analysis of the three dimensions of social structure including institutional, relational, and embodied structures that have an impact on the individuals’ deviant behaviors in the society. The authors used a mix method to analyze the qualitative and quantitative data of 402 high risk abandoned substance users in 2008 in Tehran, capital city of Iran. The leading reasons of substance use were categorized into four fundamental themes as follows: stress, deviant social networks, and low social capital and weak social support sources. In addition, the epidemiology model of regression analysis provides a brief explanation to assess the association between the demographical and etiological variables, and the drug users’ deviant behaviors. In sum, substance use is discussed as a deviant behavior pattern which stems from a comorbidity of weak social structures.

  17. Herbal medicine use and linked suspected adverse drug reactions in a prospective cohort of Ugandan inpatients.

    Science.gov (United States)

    Kiguba, Ronald; Ononge, Sam; Karamagi, Charles; Bird, Sheila M

    2016-05-26

    Clinical history-taking can be employed as a standardized approach to elucidate the use of herbal medicines and their linked suspected adverse drug reactions (ADRs) among hospitalized patients. We sought to identify herbal medicines nominated by Ugandan inpatients; compare nomination rates by ward and gender; confirm the herbs' known pharmacological properties from published literature; and identify ADRs linked to pre-admission use of herbal medicines. Prospective cohort of consented adult inpatients designed to assess medication use and ADRs on one gynaecological and three medical wards of 1790-bed Mulago National Referral Hospital. Baseline and follow-up data were obtained on patients' characteristics, including pre-admission use of herbal medicines. Fourteen percent (26/191) of females in Gynaecology nominated at least one specific herbal medicine compared with 20 % (114/571) of inpatients on medical wards [20 % (69/343) of females; 20 % (45/228) of males]. Frequent nominations were Persea americana (30), Mumbwa/multiple-herb clay rods (23), Aloe barbadensis (22), Beta vulgaris (12), Vernonia amygdalina (11), Commelina africana (7), Bidens pilosa (7), Hoslundia opposita (6), Mangifera indica (4), and Dicliptera laxata (4). Four inpatients experienced 10 suspected ADRs linked to pre-admission herbal medicine use including Commelina africana (4), multiple-herb-mumbwa (1), or unspecified local-herbs (5): three ADR-cases were abortion-related and one kidney-related. The named herbal medicines and their nomination rates generally differed by specialized ward, probably guided by local folklore knowledge of their use. Clinical elicitation from inpatients can generate valuable safety data on herbal medicine use. However, larger routine studies might increase the utility of our method to assess herbal medicine use and detect herb-linked ADRs. Future studies should take testable samples of ADR-implicated herbal medicines for further analysis.

  18. High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Memon Ashraf

    2007-02-01

    Full Text Available Abstract Background Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3% IDUs HIV positive in the city. Methods We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA method. Syphilis tests (RPR & TPHA were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Results Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5% IDUs. Over half 94 (58.3% reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%. 1 of 161 was HIV positive (0.6%. The prevalence of hepatitis B was 12 (7.5%, hepatitis C 151 (94.3% and syphilis 21 (13.1%. IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom

  19. Trends in methamphetamine use in young injection drug users in San Francisco from 1998 to 2004: the UFO Study.

    Science.gov (United States)

    Inglez-Dias, Aline; Hahn, Judith A; Lum, Paula J; Evans, Jennifer; Davidson, Peter; Page-Shafer, Kimberly

    2008-05-01

    To describe temporal trends in methamphetamine use among young injection drug users (IDU) in San Francisco. Secondary analysis of cross-sectional baseline data collected for a longitudinal study of young IDU from 1998 to 2004. Participants were 1445 young IDU (<30 years old) who reported injection in the previous month, English-speaking, and recruited by street outreach methods. We examined trends for: lifetime (ever) and recent (30-day) methamphetamine use, including injected and non-injected, and by age group and sexual risk behaviour [men who have sex with men injecting drug users (MSM-IDU), male IDU (non-MSM) and female IDU]. In 1998, 1999, 2000, 2001, 2003 and 2004 we interviewed 237, 276, 431, 310, 147 and 44 participants, respectively. Overall, median age was 22 years [interquartile range (IQR) 20-25], 30.3% were women and median duration of injecting was 4.4 years (IQR 2-7). Prevalence of methamphetamine use was high, with 50.1% reporting recent injection, but overall there were no temporal increases in reported 'ever' injected use. Recent methamphetamine injection (past 30 days) increased significantly, and peaked at 60% in 2003. MSM-IDU had higher methamphetamine injection ever (92.3%) and recently (59.5%) compared to heterosexual male (non-MSM) IDU (81.6% and 47.3%, respectively) and to female IDU (78.4% and 46.1%, respectively). Despite reports of ubiquitous increases in methamphetamine use, there were no significant increases in 6 years in ever injecting methamphetamine overall among young IDU. MSM-IDU who reported the highest methamphetamine use overall reported some increases in recent injected use. The methamphetamine 'epidemic' was probably under way among young IDU earlier than other populations.

  20. Association of Prescription Drug