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Sample records for drug users receiving

  1. An Approach for Casual Drug Users. Technical Paper.

    Science.gov (United States)

    Bloom, Erwin S., Ed.

    This publication was written to respond to the fact that many drug treatment centers receive inappropriate referrals of casual or recreational marihuana users from the courts for "treatment" as an alternative to jail. A drug abuse task force recommended that agencies give priority to abusers of the high-risk categories and to compulsive users of…

  2. Correlates of HIV-1 viral suppression in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam

    Science.gov (United States)

    Jordan, Michael R; La, Hanh; Nguyen, Hien Duc; Sheehan, Heidi; Lien, Trinh Thi Minh; Van Dang, Duong; Hellinger, James; Wanke, Christine; Tang, Alice M

    2009-01-01

    Summary Injection drug users bear the burden of HIV in Vietnam and are a focus of national treatment programs. To date, determinants of successful therapy in this population are unknown. Substance use and clinical correlates of viral suppression were studied in 100 HIV-1 infected drug users receiving antiretroviral therapy (ART) for at least 6 months in Hanoi, Vietnam. Mean age of the cohort was 29.9 + 4.9 years; all were men. A majority of patients (73%) achieved viral suppression (HIV-RNA 95% adherence (p<0.01) and current use of trimethoprim/sulfamethoxazole (p<0.01); current or ever diagnosed with tuberculosis was associated with viral non-suppression (p=0.006). Tobacco use was prevalent (84%), and surprisingly 48% of patients reported active drug use; neither was associated with viral non-suppression. This is the first study to document successful ART treatment in a population of Vietnamese drug users; rates of viral suppression are comparable to other international populations. The 28% of patients without HIV-1 suppression highlights the need for adherence promotion, risk reduction programs, and population based surveillance strategies for assessing the emergence of HIV drug resistance in settings where access to viral load and drug resistance testing is limited. PMID:19451329

  3. Resilient children of injection drug users.

    Science.gov (United States)

    Pilowsky, Daniel J; Zybert, Patricia A; Vlahov, David

    2004-11-01

    To examine associations between resilience in children of injection drug users and children's coping strategies, parenting stress, and children's social support. Injection drug-using parents (n=91) and their children aged 6 to 11 (n=117) were recruited in Baltimore (1997-1999). Resilience was defined as scoring in the lowest quartile of the Child Behavior Checklist total psychopathology score. Coping strategies used by resilient and nonresilient children, the extent and types of social support that they received, and the level of parenting stress reported by their parents were compared and contrasted. Rates of depressive, anxiety, and disruptive behavior disorders were 15.4%, 22.2%, and 21.4%, respectively, for the entire sample. Compared with the nonresilient, resilient children were less likely to use two avoidance coping strategies (internalizing [p=.002] and externalizing [p=.017]). The level of actual support received by resilient and nonresilient children did not differ significantly (p=.202). Perceived support was greater among resilient children (as reported by their parents; p parents reported lower parenting stress (p=.042). A significant proportion of children of injection drug users are in need of clinical care. Interventions to help children of substance-abusing parents modify their coping style merit exploration.

  4. Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China.

    Science.gov (United States)

    Su, Shu; Mao, Limin; Zhao, Jinxian; Chen, Liang; Jing, Jun; Cheng, Feng; Zhang, Lei

    2018-04-26

    The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8-3.4]; 2.3, [1.6-3.1]) and syphilis infection (AOR = 4.1, [2.1-6.9]; 3.9, [1.8-5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.

  5. Impact of Active Drug Use on Antiretroviral Therapy Adherence and Viral Suppression in HIV-infected Drug Users

    OpenAIRE

    Arnsten, Julia H; Demas, Penelope A; Grant, Richard W; Gourevitch, Marc N; Farzadegan, Homayoon; Howard, Andrea A; Schoenbaum, Ellie E

    2002-01-01

    Despite a burgeoning literature on adherence to HIV therapies, few studies have examined the impact of ongoing drug use on adherence and viral suppression, and none of these have utilized electronic monitors to quantify adherence among drug users. We used 262 electronic monitors to measure adherence with all antiretrovirals in 85 HIV-infected current and former drug users, and found that active cocaine use, female gender, not receiving Social Security benefits, not being married, screening po...

  6. Patterns of drug use among a sample of drug users and injecting drug users attending a General Practice in Iran

    Directory of Open Access Journals (Sweden)

    Shakeshaft Anthony

    2006-01-01

    Full Text Available Abstract Aim This study aimed to examine drug use, drug treatment history and risk behaviour among a sample of Iranian drug users seeking treatment through a general practice clinic in Iran. Methods Review of medical records and an intake questionnaire at a large general practice in Marvdasht, Iran, with a special interest in drug dependence treatment. Records from a random sample of injecting drug users (IDU, non-injecting drug users (DU and non-drug using patients were examined. Results 292 records were reviewed (34% IDU, 31% DU and 35% non-drug users. Eighty-three percent were males; all females were non-drug users. The mean age of the sample was 30 years. Of the IDU sample, 67% reported sharing a needle or syringe, 19% of these had done so in prison. Of those who had ever used drugs, being 'tired' of drug use was the most common reason for seeking help (34%. Mean age of first drug use was 20 years. The first drugs most commonly used were opium (72%, heroin (13% and hashish/ other cannabinoids (13%. Three quarters reported having previously attempted to cease their drug use. IDU were more likely than DU to report having ever been imprisoned (41% vs 7% and 41% to have used drugs in prison. Conclusion This study has shown that there is a need for general practice clinics in Iran to treat drug users including those who inject and that a substantial proportion of those who inject have shared needles and syringes, placing them at risk of BBVI such as HIV and hepatitis C. The expansion of services for drug users in Iran such as needle and syringe programs and pharmacotherapies are likely to be effective in reducing the harms associated with opium use and heroin injection.

  7. 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...

  8. 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.

  9. Treatment of imprisoned drug users

    OpenAIRE

    Koňák, Tomáš

    2015-01-01

    The main goal of the theoretical part of submitted theses is to describe the field of specialized treatment of imprisoned drug users. The author's emphasis is to put the specialized treatment to a broader frame of the Risk-needs theory as well as to the frame of physical diseases and mental disorders that are often associated with addiction or drug abuse. Different kinds of specialized interventions that are usually used for treatment of imprisoned drug users in different countries are descri...

  10. Drug use trajectory patterns among older drug users

    Directory of Open Access Journals (Sweden)

    Tyndall B

    2011-05-01

    Full Text Available Miriam Boeri, Thor Whalen, Benjamin Tyndall, Ellen BallardKennesaw State University, Department of Sociology and Criminal Justice, Kennesaw GA, USAAbstract: To better understand patterns of drug use trajectories over time, it is essential to have standard measures of change. Our goal here is to introduce measures we developed to quantify change in drug use behaviors. A secondary goal is to provide effective visualizations of these trajectories for applied use. We analyzed data from a sample of 92 older drug users (ages 45 to 65 to identify transition patterns in drug use trajectories across the life course. Data were collected for every year since birth using a mixed methods design. The community-drawn sample of active and former users were 40% female, 50% African American, and 60% reporting some college or greater. Their life histories provided retrospective longitudinal data on the diversity of paths taken throughout the life course and changes in drug use patterns that occurred over time. Bayesian analysis was used to model drug trajectories displayed by innovative computer graphics. The mathematical techniques and visualizations presented here provide the foundation for future models using Bayesian analysis. In this paper we introduce the concepts of transition counts, transition rates and relapse/remission rates, and we describe how these measures can help us better understand drug use trajectories. Depicted through these visual tools, measurements of discontinuous patterns provide a succinct view of individual drug use trajectories. The measures we use on drug use data will be further developed to incorporate contextual influences on the drug trajectory and build predictive models that inform rehabilitation efforts for drug users. Although the measures developed here were conceived to better examine drug use trajectories, the applications of these measures can be used with other longitudinal datasets.Keywords: drug use, trajectory patterns

  11. 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

    drug users accounted for 75.4% of their use in 2012, and five of these were cardiovascular drugs. The development over time for the ten most used drug classes followed the same pattern among heavy drug users and in the general population. CONCLUSION: There is a skewed utilization of prescription drugs...... frequently used drugs among heavy drug users and development in use over time. METHOD: This is a descriptive study. Heavy drug users were defined as the accumulated top 1 percentile who accounted for the largest share of prescription drug use measured in number of dispensed defined daily doses (DDDs...

  12. HIV prevalence and sexual risk behaviour among non-injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Deiss, Robert G; Lozada, Remedios M; Burgos, Jose Luis; Strathdee, Steffanie A; Gallardo, Manuel; Cuevas, Jazmine; Garfein, Richard S

    2012-01-01

    Prior studies estimate HIV prevalence of 4% among injection drug users (IDUs), compared with 0.8% in the general population of Tijuana, Mexico. However, data on HIV prevalence and correlates among non-injecting drug users (NIDUs) are sparse. Individuals were recruited through street outreach for HIV testing and behavioural risk assessment interviews to estimate HIV prevalence and identify associated sexual risk behaviours among NIDUs in Tijuana. Descriptive statistics were used to characterise 'low-risk' NIDUs (drug users who were not commercial sex workers or men who have sex with men). Results showed that HIV prevalence was 3.7% among low-risk NIDUs. During the prior six months, 52% of NIDUs reported having >1 casual partner; 35% reported always using condoms with a casual partner; and 13% and 15%, respectively, reported giving or receiving something in exchange for sex. Women were significantly more likely than men to have unprotected sex with an IDU (pTijuana. Broad interventions including HIV testing, condom promotion and sexual risk reduction should be offered to all drug users in Tijuana.

  13. Risk behaviours of illicit drug users while travelling

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    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

  14. 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.

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

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

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    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

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

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

    Science.gov (United States)

    Cohen, J Elizabeth; Amon, Joseph J

    2008-12-09

    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. 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. 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 and imperil drug users' health.

  20. 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.

  1. Admissions of injection drug users to drug abuse treatment following HIV counseling and testing.

    Science.gov (United States)

    McCusker, J; Willis, G; McDonald, M; Lewis, B F; Sereti, S M; Feldman, Z T

    1994-01-01

    The outcomes of counseling and testing programs related to human immunodeficiency virus (HIV) infection and risk of infection among injection drug users (IDUs) are not well known or understood. A counseling and testing outcome of potential public health importance is attaining admission to drug abuse treatment by those IDUs who are either infected or who are at high risk of becoming infected. The authors investigated factors related to admission to drug abuse treatment among 519 IDUs who received HIV counseling and testing from September 1987 through December 1990 at a men's prison and at community-based testing sites in Worcester, MA. By June 1991, 123 of the 519 IDUs (24 percent) had been admitted to treatment. Variables associated with their admission included a long history of drug injection, frequent recent drug injection, cleaning injection equipment using bleach, prior drug treatment, and a positive HIV test result. Logistic regression analyses, controlling for effects of recruitment site, year, sex, and area of residence, generally confirmed the associations. IDUs in the study population who were HIV-infected sought treatment or were admitted to treatment more frequently than those who were not infected. The results indicate that access to drug abuse treatment should be facilitated for high-risk IDUs and for those who have begun to inject drugs recently.

  2. 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 illicit 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.

  3. [The treatment received by public health services users in Mexico].

    Science.gov (United States)

    Puentes Rosas, Esteban; Gómez Dantés, Octavio; Garrido Latorre, Francisco

    2006-06-01

    To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users' socioeconomic status. The data were obtained by means of a survey of 18 018 users who visited 73 health services in 13 states within Mexico. They were asked to grade the way the institution had performed in seven of the eight domains that define appropriate user treatment (autonomy, confidentiality, communication, respectful manner, condition of basic facilities, access to social assistance networks, and free user choice). The questionnaire included some vignettes to help determine user expectations. A composite ordinal probit model was applied; the perception of quality in connection with each of the appropriate treatment domains was the independent variable, whereas gender, educational level, age, type of provider, and user expectations were used as control variables. The type of provider was the main factor that determined users' perceptions regarding the treatment they received when visiting health services in Mexico. Institutions belonging to the social security system performed the worst, while the services provided under the program targeting the rural population (IMSS Oportunidades) received the highest scores. Overall, the domain that was most highly ranked was respectful manner, whereas the lowest score was given to the ability to choose the provider. Men felt they had been able to communicate better than women, while respectful manner, communication, and social support showed a significant negative association with educational level (P < 0.05). Differences were noted in the way different public health service providers in Mexico treat their users, regardless of the latter's socioeconomic status. Social security system providers showed the greatest deficiencies in this respect. Respectful manner was the domain that received the highest scores in the case of all providers. Organizational

  4. 75 FR 12555 - Prescription Drug User Fee Act; Public Meeting

    Science.gov (United States)

    2010-03-16

    ...] Prescription Drug User Fee Act; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of... Prescription Drug User Fee Act (PDUFA). The legislative authority for PDUFA expires in September 2012. At that time, new legislation will be required for FDA to continue collecting user fees for the prescription...

  5. 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.

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

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    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.

  7. [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

  8. How do researchers categorize drugs, and how do drug users categorize them?

    Science.gov (United States)

    Lee, Juliet P; Antin, Tamar M J

    2012-01-01

    This paper considers drug classifications and terms widely used in US survey research, and compares these to classifications and terms used by drug users. We begin with a critical review of drug classification systems, including those oriented to public policy and health services as well as survey research. We then consider the results of a pile sort exercise we conducted with 76 respondents within a mixed method study of Southeast Asian American adolescent and young adult drug users in urban Northern California, USA. We included the pile sort to clarify how respondents handled specific terms which we understood to be related to Ecstasy and methamphetamines. Results of the pile sort were analyzed using graphic layout algorithms as well as content analysis of pile labels. Similar to the national surveys, our respondents consistently differentiated Ecstasy terms from methamphetamine terms. We found high agreement between some specific local terms ( thizz , crystal ) and popular drug terms, while other terms thought to be mainstream ( crank , speed ) were reported as unknown by many respondents. In labeling piles, respondents created taxonomies based on consumption method (in particular, pill ) as well as the social contexts of use. We conclude by proposing that divergences between drug terms utilized in survey research and those used by drug users may reflect two opposing tendencies: the tendency of survey researchers to utilize standardized language that constructs persons and experiences as relatively homogeneous, varying only within measurable degrees, and the tendency of drug users to utilize specialized language (argot) that reflects their understandings of their experiences as hybrid and diverse. The findings problematize the validity of drug terms and categories used in survey research.

  9. 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.

    2008-01-01

    Background 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). Methods Data from 5,049 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. Results 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. Conclusion 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. PMID:18068314

  10. 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.

  11. Values and beliefs of psychedelic drug users: a cross-cultural study.

    Science.gov (United States)

    Lerner, Michael; Lyvers, Michael

    2006-06-01

    Psychedelic drugs such as LSD and psilocybin are often claimed to be capable of inducing life-changing experiences described as mystical or transcendental, especially if high doses are taken. The present study examined possible enduring effects of such experiences by comparing users of psychedelic drugs (n = 88), users of nonpsychedelic illegal drugs (e.g., marijuana, amphetamines) (n = 29) and non illicit drug-using social drinkers (n = 66) on questionnaire measures of values, beliefs and emotional empathy. Samples were obtained from Israel (n = 110) and Australia (n = 73) in a cross-cultural comparison to see if values associated with psychedelic drug use transcended culture of origin. Psychedelic users scored significantly higher on mystical beliefs (e.g., oneness with God and the universe) and life values of spirituality and concern for others than the other groups, and lower on the value of financial prosperity, irrespective of culture of origin. Users of nonpsychedelic illegal drugs scored significantly lower on a measure of coping ability than both psychedelic users and non illicit drug users. Both groups of illegal drug users scored significantly higher on empathy than non illicit drug users. Results are discussed in the context of earlier findings from Pahnke (1966) and Doblin (1991) of the transformative effect of psychedelic experiences, although the possibility remains that present findings reflect predrug characteristics of those who chose to take psychedelic drugs rather than effects of the drugs themselves.

  12. 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.

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

    Science.gov (United States)

    Pettenon, Márcia; Kessler, Felix Henrique Paim; Guimarães, Luciano S. P.; Pedroso, Rosemeri Siqueira; Hauck, Simone; Pechansky, Flavio

    2014-01-01

    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 (ORadj = 9.68; 95% CI: 2.82, 33.20) to perceive neglectful mothers, as well as more likely (ORadj = 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. PMID:25109717

  14. Risk of high-grade cervical dysplasia and cervical cancer in women with systemic lupus erythematosus receiving immunosuppressive drugs.

    Science.gov (United States)

    Feldman, C H; Liu, J; Feldman, S; Solomon, D H; Kim, S C

    2017-06-01

    Objective Prior studies suggest an increased risk of cervical cancer among women with systemic lupus erythematosus. However, the relationship with immunosuppressive drugs is not well studied in US nationwide cohorts. We compared the risk of high-grade cervical dysplasia and cervical cancer among women with systemic lupus erythematosus who started immunosuppressive drugs versus hydroxychloroquine. Methods We identified systemic lupus erythematosus patients initiating immunosuppressive drugs or hydroxychloroquine using claims data from two US commercial health plans and Medicaid (2000-2012). We used a validated claims-based algorithm to identify high-grade cervical dysplasia or cervical cancer. To account for potential confounders, including demographic factors, comorbidities, medication use, HPV vaccination status, and health care utilization, immunosuppressive drugs and hydroxychloroquine initiators were 1:1 matched on the propensity score. We used inverse variance-weighted, fixed effect models to pool hazard ratios from the propensity score-matched Medicaid and commercial cohorts. Results We included 2451 matched pairs of immunosuppressive drugs and hydroxychloroquine new users in the commercial cohort and 7690 matched pairs in Medicaid. In the commercial cohort, there were 14 cases of cervical dysplasia or cervical cancer among immunosuppressive drugs users and five cases among hydroxychloroquine users (hazard ratio 2.47, 95% CI 0.89-6.85, hydroxychloroquine = ref). In Medicaid, there were 46 cases among immunosuppressive drugs users and 29 cases in hydroxychloroquine users (hazard ratio 1.24, 95% CI 0.78-1.98, hydroxychloroquine = ref). The pooled hazard ratio of immunosuppressive drugs was 1.40 (95% CI 0.92-2.12). Conclusion Among women with systemic lupus erythematosus, immunosuppressive drugs may be associated with a greater, albeit not statistically significant, risk of high-grade cervical dysplasia and cervical cancer compared to patients receiving

  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 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....

  16. 76 FR 79198 - Generic Drug User Fee; Public Meeting; Correction

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Correction AGENCY: Food and Drug Administration, HHS. ACTION... meeting entitled ``Generic Drug User Fee.'' The document published with an inadvertent error in the Dates...

  17. 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

  18. 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.

  19. Drug users in contact with general practice.

    Science.gov (United States)

    Robertson, J R

    1985-01-05

    A group of heroin users who are in contact with a general practice in north west Edinburgh are described. The study group was younger and included more women than previous studies. These people used a large variety of drugs and mainly purchased them locally. Frequent and often prolonged abstinent periods occurred with no prescribed opiate treatment. The group had experienced a high rate of drug related medical disorders. All these points raise the possibility that opiate users who are known to general practitioners may be a distinctly different population from those who attend drug dependency clinics. The frequency of remission and the prevalence of polydrug use have profound implications for planning and evaluating an effective medical response.

  20. 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...

  1. Other drug use does not impact cognitive impairments in chronic ketamine users.

    Science.gov (United States)

    Zhang, Chenxi; Tang, Wai Kwong; Liang, Hua Jun; Ungvari, Gabor Sandor; Lin, Shih-Ku

    2018-05-01

    Ketamine abuse causes cognitive impairments, which negatively impact on users' abstinence, prognosis, and quality of life. of cognitive impairments in chronic ketamine users have been inconsistent across studies, possibly due to the small sample sizes and the confounding effects of concomitant use of other illicit drugs. This study investigated the cognitive impairment and its related factors in chronic ketamine users with a large sample size and explored the impact of another drug use on cognitive functions. Cognitive functions, including working, verbal and visual memory and executive functions were assessed in ketamine users: 286 non-heavy other drug users and 279 heavy other drug users, and 261 healthy controls. Correlations between cognitive impairment and patterns of ketamine use were analysed. Verbal and visual memory were impaired, but working memory and executive functions were intact for all ketamine users. No significant cognitive differences were found between the two ketamine groups. Greater number of days of ketamine use in the past month was associated with worse visual memory performance in non-heavy other drug users. Higher dose of ketamine use was associated with worse short-term verbal memory in heavy other drug users. Verbal and visual memory are impaired in chronic ketamine users. Other drug use appears to have no impact on ketamine users' cognitive performance. Copyright © 2018. Published by Elsevier B.V.

  2. Flexible Receiver Radiation Detection System (FRRDS) Users Manual

    International Nuclear Information System (INIS)

    Troyer, G.L.

    1996-01-01

    The Flexible Receiver Radiation Detection System (FRRDS) comprises a control computer, a remote data acquisition subsystem, and three hyperpure germanium gamma radiation detectors. The scope of this document is the description of various steps for the orderly start-up, use, and shutdown of the FRRDS. Only those items necessary for these oprations are included. This document is a companion to WHC-SD-W151-UM-002, 'Operating Instructions for the 42 Inch Flexible Receiver,' WHC-SD-W151-UM-003, 'Operating Instructions for the 4-6 Inch Flexible Receiver,' and the vendor supplied system users guide (Ref. 6)

  3. Drugs and personality: comparison of drug users, nonusers, and other clinical groups on the 16PF.

    Science.gov (United States)

    Spotts, J V; Shontz, F C

    1991-10-01

    This article reviews published 16PF research on drug users. It also compares the 16PF scores of a new sample of nonusers with scores of matched groups of heavy, chronic users of cocaine, amphetamine, opiates, and barbiturates/sedative hypnotics, as well as combined groups of stimulant users, depressant users, and a combined group of users of all substances. No significant differences were found among drug user groups, but the profile of the nonuser group was distinctive. K-Means Cluster Analyses, as well as Cattell's Similarity and Pearson Product Moment Correlation Coefficients, were used to compare profiles of these new samples with the 19 groups described in an earlier meta-analysis of published 16PF studies. Data from the new samples did not cluster with data from other published research, although certain specific similarities appeared in more detailed correlational analyses. Methodological problems are discussed, and it is recommended that in future studies drug user groups be more carefully selected and defined, sample descriptions be more thorough and complete, complete profile information be routinely provided, and efforts be made to explore the utility of the Cattell CAQ in studies of drug users/misusers.

  4. 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.

  5. The high prevalence of substance use disorders among recent MDMA users compared with other drug users: implications for intervention

    Science.gov (United States)

    Wu, Li-Tzy; Parrott, Andy C.; Ringwalt, Christopher L.; Patkar, Ashwin A.; Mannelli, Paolo; Blazer, Dan G.

    2009-01-01

    Aim In light of the resurgence in MDMA use and its association with polysubstance use, we investigated the 12-month prevalence of substance use disorders (SUDs) among adult MDMA users to determine whether they are at risk of other drug-related problems that would call for targeted interventions. Methods Data were drawn from the 2006 National Survey on Drug Use and Health. Past-year adult drug users were grouped into three mutually exclusive categories: 1) recent MDMA users, who had used the drug within the past year; 2) former MDMA users, who had a history of using this drug but had not done so within the past year; and 3) other drug users, who had never used MDMA. Logistic regression procedures were used to estimate the association between respondents’ SUDs and MDMA use while adjusting for their socioeconomic status, mental health, age of first use, and history of polydrug use. Results Approximately 14% of adults reported drug use in the past year, and 24% of those past-year drug users reported a history of MDMA use. Recent MDMA users exhibited the highest prevalence of disorders related to alcohol (41%), marijuana (30%), cocaine (10%), pain reliever/opioid (8%), and tranquilizer (3%) use. Adjusted logistic regression analyses revealed that, relative to other drug users, those who had recently used MDMA were twice as likely to meet criteria for marijuana and pain reliever/opioid use disorders. They were also about twice as likely as former MDMA users to meet criteria for marijuana, cocaine, and tranquilizer use disorders. Conclusions Seven out of ten recent MDMA users report experiencing an SUD in the past year. Adults who have recently used MDMA should be screened for possible SUDs to ensure early detection and treatment. PMID:19361931

  6. 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.

  7. Patterns of Drug Use in a Sample of 200 Young Drug Users in London

    Science.gov (United States)

    McCambridge, Jim; Strang, John

    2004-01-01

    A cross-sectional analysis of baseline data collected during a secondary prevention intervention study was conducted to describe patterns of drug use in a non-treatment sample of young drug users recruited in ten further-education colleges across inner London. Participants were 200 young people who were either weekly cannabis users and/or who had…

  8. 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.

  9. Coffee shops and clinics: the give and take of doing HIV/AIDS research with injecting drug users.

    Science.gov (United States)

    Marsh, A; Loxley, W

    1992-06-01

    We discuss recruiting and interviewing injecting drug users and using research as health promotion in the context of collecting information related to human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) from a convenience sample of 200 injecting drug users, half in treatment and half not, in 1989 and 1990 in Perth, Western Australia. A variety of recruiting methods were used including advertising, referral by agency staff, 'snowballing' and approaches to personal contacts and others known to inject by the interviewer. Snowballing and personal contacts were the most successful means of recruiting those not in treatment, while advertising was comparatively unsuccessful with this group because of the importance of establishing the credibility of the study and the interviewer among injecting drug users before they will volunteer to be involved. The promotion of behavioural risk reduction among respondents during the interview is detailed. We argue that the traditionally rigid separation between research and intervention is inappropriate in the HIV/AIDS context. When lives are potentially at stake, any contact with injecting drug users, especially those not in treatment (where may receive HIV/AIDS education), must be used as an HIV/AIDS prevention opportunity, and the interview is an ideal opportunity. The employment of research as community intervention is also discussed.

  10. Cross-border drug injection relationships among injection drug users in Tijuana, Mexico

    Science.gov (United States)

    Wagner, Karla D.; Pollini, Robin A.; Patterson, Thomas L.; Lozada, Remedios; Ojeda, Victoria D.; Brouwer, Kimberly C.; Vera, Alicia; Volkmann, Tyson A.; Strathdee, Steffanie A.

    2010-01-01

    Background International borders are unique social and environmental contexts characterized by high levels of mobility. Among drug users, mobility increases risk for human immunodeficiency virus (HIV) in part through its effects on the social environment. However, the social dynamics of drug users living in border regions are understudied. Methods 1056 injection drug users (IDUs) residing in Tijuana, Mexico were recruited using respondent-driven sampling (RDS) from 2006 to 2007, and underwent surveys and testing for HIV, syphilis, and tuberculosis (TB). Using logistic regression on baseline data, we identified correlates of having ever injected drugs with someone from the US. Results Almost half (48%) reported ever injecting drugs with someone from the US. In RDS-adjusted logistic regression, factors independently associated with having ever injected with someone from the US included: having greater than middle school education (Adjusted Odds Ratio [AOR] 2.91; 95% Confidence Interval [C.I.] 1.52, 5.91), speaking English (AOR 3.24, 95% C.I. 1.96, 5.36), age (AOR 1.10 per year; 95% C.I. 1.07, 1.14), age at initiation of injection drug use (AOR 0.90 per year; 95% C.I. 0.86, 0.94), homelessness (AOR 2.61; 95% C.I. 1.27, 5.39), and having ever been incarcerated (AOR 11.82; 95% C.I., 5.22, 26.77). No associations with HIV, syphilis, TB, drug use, or injection risk behavior were detected. Conclusion Findings suggest that IDU networks in Mexico and the US may transcend international borders, with implications for cross-border transmission of infectious disease. Binational programs and policies need to consider the structure and geographic distribution of drug using networks. PMID:20889270

  11. 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.

  12. Drug choice, spatial distribution, HIV risk, and HIV prevalence among injection drug users in St. Petersburg, Russia

    Directory of Open Access Journals (Sweden)

    Shaboltas Alla V

    2009-07-01

    Full Text Available Abstract Background The HIV epidemic in Russia has been driven by the unsafe injection of drugs, predominantly heroin and the ephedrine derived psychostimulants. Understanding differences in HIV risk behaviors among injectors associated with different substances has important implications for prevention programs. Methods We examined behaviors associated with HIV risk among 900 IDUs who inject heroin, psychostimulants, or multiple substances in 2002. Study participants completed screening questionnaires that provided data on sociodemographics, drug use, place of residence and injection- and sex-related HIV risk behaviors. HIV testing was performed and prevalence was modeled using general estimating equation (GEE analysis. Individuals were clustered by neighborhood and disaggregated into three drug use categories: Heroin Only Users, Stimulant Only Users, and Mixed Drug Users. Results Among Heroin Only Users, younger age, front/backloading of syringes, sharing cotton and cookers were all significant predictors of HIV infection. In contrast, sharing needles and rinse water were significant among the Stimulant Only Users. The Mixed Drug Use group was similar to the Heroin Only Users with age, front/back loading, and sharing cotton significantly associated with HIV infection. These differences became apparent only when neighborhood of residence was included in models run using GEE. Conclusion The type of drug injected was associated with distinct behavioral risks. Risks specific to Stimulant Only Users appeared related to direct syringe sharing. The risks specific to the other two groups are common to the process of sharing drugs in preparation to injecting. Across the board, IDUs could profit from prevention education that emphasizes both access to clean syringes and preparing and apportioning drug with these clean syringes. However, attention to neighborhood differences might improve the intervention impact for injectors who favor different drugs.

  13. New indicators of illegal drug use to compare drug user populations for policy evaluation

    Directory of Open Access Journals (Sweden)

    Francesco Fabi

    2013-11-01

    Full Text Available Background: New trends in drug consumption show a trend towards higher poly-use. Epidemiological indicators presently used are mostly based on the prevalence of users of the “main” substances and the ranking of harm caused by drug use is based on a single substance analysis.Methods: In this paper new indicators are proposed; the approach consider the segmentation of the population with respect to the frequency of use in the last 30 days and the harm score of the various substances used by a poly-user. Scoring is based on single substance score table reported in recent papers and principal component analysis is applied to reduce dimensionality. Any user ischaracterized by the two new scores: frequency of use score and poly-use score.Results: The method is applied to the drug user populations interviewed in Communities and Low Threshold Services within the Problem Drug Use 2012 survey in four different European countries. The comparison of the poly-use score cumulative distributions gives insight about behavioural trends of drug use and also evaluate the efficacy of the intervention services. Furthermore, the application of this method to School Population Survey 2011 data allows a definition of the expected behaviour of the poly-drug score for the General Population Survey to be representative.Conclusions: In general, the method is simply and intuitive, and could be applied to surveys containing questions about drug use. A possible limitations could be that the median is chosen for calculating the frequency of use score in questionnaires containing the frequency of drug use in classes.

  14. Immunogenicity and safety of high-dose hepatitis B vaccine among drug users: A randomized, open-labeled, blank-controlled trial.

    Science.gov (United States)

    Feng, Yongliang; Shi, Jing; Gao, Linying; Yao, Tian; Feng, Dan; Luo, Dan; Li, Zhansheng; Zhang, Yawei; Wang, Fuzhen; Cui, Fuqiang; Li, Li; Liang, Xiaofeng; Wang, Suping

    2017-06-03

    Due to the low uptake, adherence, and completion of vaccination among drug users, and their compromised immune responses to hepatitis B vaccination, the current practice of hepatitis B vaccination may not provide optimal protection. The aim of this study was to evaluate the immunogenicity and safety of 60 µg and 20 µg hepatitis B vaccines among drug users. A randomized, open-labeled, blank-controlled trial was conducted among drug users at 2 drug rehabilitation centers in China. The eligible participants were drug users who were serologically negative for the hepatitis B surface antigen (HBsAg) and the hepatitis B surface antibody (anti-HBs). Participants were randomized in a ratio of 1:1:1 to receive 20 µg (IM20 group) or 60 µg (IM60 group) of hepatitis B vaccine or blank control at months 0, 1, and 6, and followed at months 6, 7, and 12. Seroconversion rates of 94.7% and 92.6% were observed in IM20 and IM60 groups at month 7, and correspondingly decreased to 89.5% and 91.7% respectively at month 12. The IM60 group showed significantly higher geometric mean concentrations (GMCs) of anti-HBs (2022.5 and 676.7 mIU mL-1) than the IM20 group did (909.6 and 470.5 mIU mL-1) at months 7 and 12 (P B vaccines showed good immunogenicity among the drug users.

  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. The generic drug user fee amendments: an economic perspective

    Science.gov (United States)

    Berndt, Ernst R; Murphy, Stephen J

    2018-01-01

    Abstract Since the vast majority of prescription drugs consumed by Americans are off patent (‘generic’), their regulation and supply is of wide interest. We describe events leading up to the US Congress's 2012 passage of the Generic Drug User Fee Amendments (GDUFA I) as part of the Food and Drug Administration Safety and Innovation Act (FDASIA). Under GDUFA I, generic manufacturers agreed to pay approximately $300 million in fees each year of the five-year program. In exchange, the US Food and Drug Administration (FDA) committed to performance goals. We describe GDUFA I’s FDA commitments, provisions, goals, and annual fee structure and compare it to that entailed in the authorization and implementation of GDUFA II on October 1, 2017. We explain how user fees required under GDUFA I erected barriers to entry and created scale and scope economies for incumbent manufacturers. Congress changed user fees under GDUFA II in part to lessen these incentives. In order to initiate and sustain user fees under GDUFA legislation, FDA requires the submission of self-reported data on generic manufacturers including domestic and foreign facilities. These data are public and our examination of them provides an unprecedented window into the recent organization of generic drug manufacturers supplying the US market. Our results suggest that generic drug manufacturing is increasingly concentrated and foreign. We discuss the implications of this observed market structure for GDUFA II’s implementation among other outcomes. PMID:29707218

  17. 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 ...

  18. 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...

  19. 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.

  20. 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

  1. Temporal differences in gamma-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki: a retrospective study

    Directory of Open Access Journals (Sweden)

    Boyd James J

    2012-02-01

    Full Text Available Abstract Background Gamma-hydroxybutyrate (GHB and gamma-butyrolactone (GBL have been profiled as 'party drugs' used mainly at dance parties and in nightclubs on weekend nights. The purpose of this study was to examine the frequency of injecting drug use among GHB/GBL overdose patients and whether there are temporal differences in the occurrence of GHB/GBL overdoses of injecting drug and recreational drug users. Methods In this retrospective study, the ambulance and hospital records of suspected GHB- and GBL overdose patients treated by the Helsinki Emergency Medical Service from January 1st 2006 to December 31st 2007 were reviewed. According to the temporal occurrence of the overdose, patients were divided in two groups. In group A, the overdose occurred on a Friday-Saturday or Saturday-Sunday night between 11 pm-6 am. Group B consisted of overdoses occurring on outside this time frame. Results Group A consisted of 39 patient contacts and the remaining 61 patient contacts were in group B. There were statistically significant differences between the two groups in (group A vs. B, respectively: history of injecting drug abuse (33% vs. 59%, p = 0.012, reported polydrug and ethanol use (80% vs. 62%, p = 0.028, the location where the patients were encountered (private or public indoors or outdoors, 10%, 41%, 41% vs. 25%, 18%, 53%, p = 0.019 and how the knowledge of GHB/GBL use was obtained (reported by patient/bystanders or clinical suspicion, 72%, 28% vs. 85%, 10%, p = 0.023. Practically all (99% patients were transported to emergency department after prehospital care. Conclusion There appears to be at least two distinct groups of GHB/GBL users. Injecting drug users represent the majority of GHB/GBL overdose patients outside weekend nights.

  2. Syringe vending machines for injection drug users: an experiment in Marseille, France.

    Science.gov (United States)

    Obadia, Y; Feroni, I; Perrin, V; Vlahov, D; Moatti, J P

    1999-01-01

    OBJECTIVES: This study evaluated the usefulness of vending machines in providing injection drug users with access to sterile syringes in Marseille, France. METHODS: Self-administered questionnaires were offered to 485 injection drug users obtaining syringes from 32 pharmacies, 4 needle exchange programs, and 3 vending machines. RESULTS: Of the 343 respondents (response rate = 70.7%), 21.3% used the vending machines as their primary source of syringes. Primary users of vending machines were more likely than primary users of other sources to be younger than 30 years, to report no history of drug maintenance treatment, and to report no sharing of needles or injection paraphernalia. CONCLUSIONS: Vending machines may be an appropriate strategy for providing access to syringes for younger injection drug users, who have typically avoided needle exchange programs and pharmacies. PMID:10589315

  3. Illicit drug use is increasing among non-medical users of prescription drugs-Results from population-based surveys 2002-2014.

    Science.gov (United States)

    Karjalainen, Karoliina; Lintonen, Tomi; Hakkarainen, Pekka

    2017-09-01

    Non-medical use of prescription drugs (NMUPD) is known to be associated with illicit drug use, but less is known about how illicit drug use has changed in NMUPD. We examined (1) the changes in illicit drug use among Finnish non-medical users of prescription drugs during the 2000s and (2) whether the trends of illicit drug use differ by non-medical use of prescription drugs in the general population. Data were derived from population-based (aged 15-69) Drug Surveys conducted in Finland in 2002, 2006, 2010 and 2014. The response rates varied between 63% and 48%. NMUPD during the last year was measured (n=252). Past-year illicit drug use among non-medical users of prescription drugs and the reference population not reporting NMUPD (n=10,967) was compared. Logistic regression was used to estimate the p-values for trends. Illicit drug use has increased notably among Finnish non-medical users of prescription drugs (from 21% to 70%, p for trendillicit drug use also increased statistically significantly, but much more moderately (from 2.5% to 5.4%). The difference between the trends was confirmed by an interaction test (p=0.022). NMUPD seems to be increasingly merging with illicit drug use. This indicates an increasing prevalence of polydrug use among non-medical users of prescription drugs, which may bring about more severe harms and worse health outcomes for users and more challenges in regard to treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. 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

  5. Economic Impacts of the Generic Drug User Fee Act Fee Structure.

    Science.gov (United States)

    Dong, Ke; Boehm, Garth; Zheng, Qiang

    2017-06-01

    A Food and Drug Administration (FDA) Generic Drug User system, Generic Drug User Fee Amendment of 2012 (GDUFA), started October 1, 2012, and has been in place for over 3 years. There is controversy about the GDUFA fee structure but no analysis of GDUFA data that we could find. To look at the economic impact of the GDUFA fee structure. We compared the structure of GDUFA with that of other FDA Human Drug User fees. We then, using FDA-published information, analyzed where GDUFA facility and Drug Master File fees are coming from. We used the Orange Book to identify the sponsors of all approved Abbreviated New Drug Applications (ANDAs) and the S&P Capital IQ database to find the ultimate parent companies of sponsors of approved ANDAs. The key differences between the previous structure for Human Drug User fees and the GDUFA are as follows: GDUFA has no approved product fee and no first-time or small business fee exemptions and GDUFA charges facility fees from the time of filing and charges a foreign facility levy. Most GDUFA fees are paid by or on behalf of foreign entities. The top 10 companies hold nearly 50% of all approved ANDAs but pay about 14% of GDUFA facility fees. We conclude that the regressive nature of the GDUFA fee structure penalizes small, new, and foreign firms while benefiting the large established firms. A progressive fee structure in line with other human drug user fees is needed to ensure a healthy generic drug industry. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. Fitness levels and physical activity among class A drug users entering prison.

    Science.gov (United States)

    Fischer, Jan; Butt, Christine; Dawes, Helen; Foster, Charlie; Neale, Joanne; Plugge, Emma; Wheeler, Carly; Wright, Nat

    2012-12-01

    Physical activity could benefit drug users' physiological and mental health. Previous research has suggested that physical activity levels change when drug users enter prison. Twenty-five class A drug users who were new to prison answered physical activity and drug use cross-sectional questionnaires, took a submaximal fitness test and wore a pedometer for 1 week. Participants' mean aerobic capacity was estimated as 49 mls O2/kg/min (±12 SD). Their mean self-reported walking distance outside of prison was 4.67 miles on an average day (±4.14 SD). Pedometer data suggest they walked a mean of 1.8 miles/day in prison. Many class A drug users entering prison had high levels of fitness and physical activity before admission, often gained from walking. Walking activity reduced when they entered prison, posing a challenge to maintaining healthy activity levels.

  7. Factors That Affect Adolescent Drug Users' Suicide Attempts

    OpenAIRE

    Park, Subin; Song, Hokwang

    2016-01-01

    Drug abuse has been widely linked to suicide risk. We examined the factors that affect adolescent drug users' suicide attempts in South Korea. This study analyzed the data of 311 adolescents who had used drugs such as inhalants, psychotropic drugs, and marijuana (195 males and 116 females). Among 311 subjects, 109 (35.0%) had attempted suicide during the last 12 months. After adjusting for other variables, depressive mood (OR=19.79) and poly-drug use (OR=2.79), and low/middle levels of academ...

  8. Impact of HIV prevention programs on drug users in Malaysia.

    Science.gov (United States)

    Kamarulzaman, Adeeba

    2009-11-01

    Faced with a rising HIV epidemic among injecting drug users, harm reduction policies and programs were introduced in Malaysia in 2005. The positive impact seen since the introduction of these programs comprise the inclusion of the health aspects of illicit drug use in the country's drug policies; better access to antiretroviral therapy for injecting drug users who are HIV infected; reduction in HIV-risk behavior; and greater social benefits, including increased employment. Despite these achievements, tension between law enforcement and public health persists, as harm reduction exists alongside an overall drug policy that is based on abstinence and zero tolerance. Unless there is harmonization of this policy, sustainability and scale-up of harm reduction programs will remain a challenge.

  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. 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…

  11. 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

  12. Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact of community-level risk-reduction interventions.

    Science.gov (United States)

    Parry, C D H; Carney, T; Petersen Williams, P

    2017-12-01

    Alcohol and other drug (AOD) use is increasingly recognised as having a direct and indirect effect on the transmission of human immunodeficiency virus (HIV). However, there is evidence to suggest that drug- and sex-related HIV risk-reduction interventions targeted at drug users within drug treatment centres or via community outreach efforts can lead to positive health outcomes. This study aimed to test whether a community-level intervention aimed at AOD users has an impact on risky AOD use and sexual risk behaviour. In 2007, in collaboration with a local non-governmental organisation (NGO) in Durban, an initiative was begun to implement a number of harm reduction strategies for injection and non-injection drug users. The NGO recruited peer outreach workers who received intensive initial training, which was followed by six-monthly monitoring and evaluation of their performance. Participants had to be 16 years of age or older, and self-reported alcohol and/or drug users. Peer outreach workers completed a face-to-face baseline questionnaire with participants which recorded risk behaviours and a risk-reduction plan was developed with participants which consisted of reducing injection (if applicable) and non-injection drug use and sex-related risks. Other components of the intervention included distribution of condoms, risk-reduction counselling, expanded access to HIV Testing Services, HIV/sexually transmitted infection care and treatment, and referrals to substance abuse treatment and social services. At follow-up, the baseline questionnaire was completed again and participants were also asked the frequency of reducing identified risk behaviours. Baseline information was collected from 138 drug users recruited into the study through community-based outreach, and who were subsequently followed up between 2010 and 2012. No injection drug users were reached. The data presented here are for first contact (baseline) and the final follow-up contact with the participants

  13. 76 FR 79195 - Animal Drug User Fee Act; Reopening of the Comment Period

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0656] Animal Drug User Fee Act; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS... notice, FDA requested comments on the Animal Drug User Fee Act (ADUFA) program to date and solicited...

  14. 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.

  15. 75 FR 45632 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2011

    Science.gov (United States)

    2010-08-03

    ...), beginning with the letters AD, from the upper right-hand corner of your completed Animal Drug User Fee Cover...] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2011 AGENCY: Food and Drug... payment procedures for fiscal year (FY) 2011 animal drug user fees. The Federal Food, Drug, and Cosmetic...

  16. 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.

  17. The Role of the Curiosity in Interviews with Drug Users

    Directory of Open Access Journals (Sweden)

    Jozsef Racz

    2008-05-01

    Full Text Available In studies with questionnaires the main reason reported for trying drugs is the curiosity. However, curiosity does not have an unambiguous meaning. The word itself (in English as well as in Hungarian has more, sometimes contradictory meanings. In my own research I examined the usage of the term curiosity among injecting and non-injecting drug users in qualitative interviews, conducted in Hungary. I encountered different functions of curiosity: in accounts it appeared as an excuse or, less frequently, as justification of drug use behaviour. Contrary to dominant contemporary drug policy literature, drug users themselves rarely used curiosity as the cause of their drug use in the context of its risk or dangers. The results of this research on curiosity demonstrate that the normalisation of drug use, which is already in progress in Western countries, has not yet taken place in Hungary. URN: urn:nbn:de:0114-fqs0802166

  18. Drug use in first pregnancy and lactation

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Steffensen, Flemming Hald; Nielsen, Gunnar Lauge

    1999-01-01

    pregnancy 44.2% of the women received prescriptions for at least one drug. Users received 2.6 prescriptions on average during pregnancy: 5% of the users redeemed 24.2% of all prescriptions. The proportion of women who redeemed prescriptions for more than three different drugs was 2.7%. The majority.......7%). CONCLUSION: A high proportion of the women received drugs during pregnancy. The pattern of drug use within the Anatomical Therapeutical Chemical (ATC) groups changed, i.e. the amount of broad spectrum antibiotics decreased and the proportion of prescriptions for local use increased. A small proportion...... of women redeemed prescriptions for more than three different drugs during pregnancy....

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

    African Journals Online (AJOL)

    Administrator

    The spread of HIV among drug and alcohol users, as a high-risk group, is a significant problem in Africa, as in other ... alcohol and drug addiction in many ... training in providing addiction recovery ..... because of its large scale availability and.

  20. Narrative of a drug user's daughter: impact on family daily routine

    Directory of Open Access Journals (Sweden)

    Lúcia Margarete dos Reis

    2017-08-01

    Full Text Available Abstract Objective: To understand the repercussions of coexisting with the drug use in a family based on the daughter's narrative of a woman who is a multiple drugs user. Method: A case study with a family accessed in 2014, through the records of a Poison Control Center in the North of Paraná. It was used a semi-structured interview and field journal, and resources of thematic oral history to apprehend the story, from the question "How is/was for you and your family to live with a mother who is a drug user?” Results: The daughter's memories emphasized repercussions in the family context: long-term of living with drug abuse; absence or transience of the motherly figure, with rupture processes for homeless situation; cycle of parental disruption/forgiveness and continued presence and fatherly support. Final considerations: The narrative indicated a family that could be added to the process of rehabilitation and social reintegration of the female drug user.

  1. 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.

  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. HIV antibodies among intravenous drug users in Bahrain.

    Science.gov (United States)

    al-Haddad, M K; Khashaba, A S; Baig, B Z; Khalfan, S

    1994-09-01

    A 12-month study was conducted to identify risk factors for human immunodeficiency virus (HIV) infections among intravenous drug users (IDU) attending drug rehabilitation clinic of the Psychiatric Hospital, Manama, Bahrain. Patients provided demographic and behavioural information based on a questionnaire. Two hundred and forty male IDUs participated in the study on voluntary basis. The seroprevalence of HIV was 21.1 per cent. The presence of HIV antibody was associated with educational status, frequency of injecting drugs and needle sharing.

  4. From Abstinence to Relapse: A Preliminary Qualitative Study of Drug Users in a Compulsory Drug Rehabilitation Center in Changsha, China.

    Directory of Open Access Journals (Sweden)

    Mei Yang

    Full Text Available Relapse among abstinent drug users is normal. Several factors are related to relapse, but it remains unclear what individuals' actual life circumstances are during periods of abstinence, and how these circumstances facilitate or prevent relapse.To illuminate drug users' experiences during abstinence periods and explore the real-life catalysts and inhibitors contributing to drug use relapse.Qualitative in-depth interviews were conducted with 20 drug users recruited from a compulsory isolated drug rehabilitation center in Changsha. The interviews were guided by open-ended questions on individuals' experiences in drug use initiation, getting addicted, treatment history, social environment, abstinence, and relapse. Participants were also encouraged to share their own stories. Interviews were digitally recorded and fully transcribed. The data of 18 participants who reported abstinence experiences before admission were included in the analyses. The data were analyzed using a thematic analysis with inductive hand coding to derive themes.Most drug users were able to successfully abstain from drugs. During abstinence, their lives were congested with challenges, such as adverse socioeconomic conditions, poor family/social support, interpersonal conflicts, and stigma and discrimination, all of which kept them excluded from mainstream society. Furthermore, the police's system of ID card registration, which identifies individuals as drug users, worsened already grave situations. Relapse triggers reported by the participants focused mainly on negative feelings, interpersonal conflicts, and stressful events. Craving was experienced but not perceived as a relapse trigger by most participants.This study of in-depth interview with drug users found evidence of situations and environments they live during abstinence appear rather disadvantaged, making it extremely difficult for them to remain abstinent. Comprehensive programs on relapse prevention that acknowledge

  5. 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.

  6. 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.

  7. 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

  8. The emerging of xylazine as a new drug of abuse and its health consequences among drug users in Puerto Rico.

    Science.gov (United States)

    Reyes, J C; Negrón, J L; Colón, H M; Padilla, A M; Millán, M Y; Matos, T D; Robles, R R

    2012-06-01

    During the last decade, the veterinary anesthetics have gained popularity as recreational drugs. The aim of this study was to document the use of "anestecia de caballo" (xylazine) and its consequences among drug users in Puerto Rico. The study combined a cross-sectional survey with 89 drug users and two focus groups conducted in Mayagüez with frontline drug treatment providers. Drug users were recruited from communities of the San Juan metropolitan area using a variety of ethnographic and outreach strategies. A short questionnaire developed for the study collected information on sociodemographics, xylazine use, and its consequences. The two focus groups were conducted to discuss the details related to xylazine use, its consequences, and utilization awareness. The sample comprised 63 males (70.8%) and 26 females with a mean age of 37.2 years. The mean number of years of drug use was 14.3, with a mean frequency of drug use of 5.9 times daily. More than 65% reported speedball as the principal drug of use. The prevalence of xylazine use was 80.7%. More than 42% of the sample used xylazine in a mixture with speedball. The main route of administration of xylazine was injection but 14% reported the use of xylazine by inhalation. More than 35% of the sample reported skin lesions and 21.1% reported at least one overdose episode. Multiple logistic regression analysis revealed that males (OR = 3.47, CI = 1.10-12.00) and those who reported speedball as their main drug of use (OR = 9.34, CI = 2.51-34.70) were significantly more likely to be xylazine users. Focus groups revealed that drug users claimed to recognize the presence of xylaxine in a mixture of speedball based on its effects, taste, the color of the drug (dark brown), and its odor. In conclusion, the use of xylazine among drug users in Puerto Rico seems to be an emerging trend with potentially serious health consequences.

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

    DEFF Research Database (Denmark)

    Moessner, Belinda K; Jørgensen, Tina R; Skamling, Merete

    2011-01-01

    Aims  Transient elastography (TE) is a non-invasive sensitive tool for diagnosing cirrhosis in hospital-based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users. Design  Cross-sectional study. Setting  All treatment centres in the county of Funen, Denmark....... 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...

  10. 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.

  11. 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.

  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. 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.

  14. 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.

  15. 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.

  16. '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

  17. Auditory verbal learning in drug-free Ecstasy polydrug users.

    Science.gov (United States)

    Fox, H. C.; Toplis, A. S.; Turner, J. J. D.; Parrott, A. C.

    2001-12-01

    Drug-free Ecstasy polydrug users have shown impairment on tasks of verbal working memory and memory span. Current research aims to investigate how these deficits may affect the learning of verbal material by administration of the Auditory Verbal Learning Task (AVLT) (Rey, 1964). The task provides a learning curve by assessing immediate memory span over multiple trials. Learning strategies are further analysed by tendencies to confabulate as well as demonstrate either proactive or retroactive interference elicited by a novel 'distractor' list. Three groups completed the task: two groups of 14 Ecstasy users (short- and long-term) and one group of 14 polydrug controls. Compared with controls both Ecstasy groups recalled significantly fewer words and made more confabulation errors on the initial three recall trials as well as a delayed recall trial. Long-term users demonstrated increased confabulation on the initial trials and the novel 'distractor7' trial, compared with short-term users. Only following repeated presentations were both short- and long-term users shown to perform at control levels. As such, deficits in verbal learning may be more related to storage and/or retrieval problems than problems associated with capacity per se. No interference errors were demonstrated by either of the Ecstasy groups. However, a high level of intrusion errors may indicate selective working memory problems associated with longer-term use of the drug. Copyright 2001 John Wiley & Sons, Ltd.

  18. 77 FR 45629 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2013

    Science.gov (United States)

    2012-08-01

    ..., beginning with the letters ``AG'', from the upper right-hand corner of your completed Animal Generic Drug...] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2013 AGENCY: Food and Drug... payment procedures for fiscal year (FY) 2013 generic new animal drug user fees. The Federal Food, Drug...

  19. Human rights of drug users according to public health professionals in Brazil.

    Science.gov (United States)

    Ventura, Carla A A; Mendes, Isabel A C; Trevizan, Maria A; Rodrigues, Driéli P

    2013-03-01

    Health is a basic human right, and drug use represents a severe influence on people's health. This qualitative study aimed to understand how health professionals in a public health-care team working with drug users in a city of the state of São Paulo, Brazil, perceive the human rights of these users and how these rights are being respected in health care. Data were collected through semistructured interviews with 10 health professionals at the service under analysis. A thematic analysis of the interviews reveals the professionals' difficulty to define the concept of human right and contextualize these rights in their work environment. A deeper understanding of the right to health, however, represents an important premise for a more humanized care practice in health services to drug users.

  20. 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

  1. [Injecting drug users and antiretroviral therapy: perceptions of pharmacy teams].

    Science.gov (United States)

    Yokaichiya, Chizuru Minami; Figueiredo, Wagner dos Santos; Schraiber, Lilia Blima

    2007-12-01

    To understand the perceptions of pharmacy teams about their role in the healthcare assistance challenges and adherence to antiretroviral therapy by injecting drug users living with HIV/AIDS. Qualitative study through focus groups and thematic discourse analysis of pharmacists, technicians and assistants with more than six months of experience with medication supply, in 15 assisting units for STD/AIDS in the city of São Paulo, in 2002. Three groups were formed, totaling 29 participants, originating from 12 out of the 15 existing services, and including 12 university level professionals and 17 high-school level professionals. The groups concluded that the pharmacy has an important role in the antiretroviral drug supply, which is reflected in the treatment adherence, because trust-based relationships can be built up through their procedures. In spite of this, they pointed out that such building-up does not take place through excessively bureaucratic activities. This has negative repercussions for all patients, especially for injecting drug users, considered "difficult people". Such concept sums up their behavior: they are supposed to be confused and incapable to adhere to treatment, and have limited understanding. Staff members, however, affirm they treat these patients equally. They do not realize that, by this acting, the specific needs of injecting drug users may become invisible in the service. There is also the possibility that stigmatizing stereotypes may be created, resulting in yet another barrier to the work on adherence. Although the pharmacy is recommended as a potentially favorable place to listen to and form bonds with users, the results show objective and subjective obstacles to render it suitable for the work on adherence.

  2. [Illicit drug use and the critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro City, Brazil].

    Science.gov (United States)

    Loyola, Cristina Maria Douat; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

    2009-01-01

    This article presents the partial results of a multicenter, cross-temporal study, which was performed using multiple methods, and involved seven Latin-American countries and Canada. The results presented refer to the city center of Rio de Janeiro (n=108). The central question of the study was: 'How do illicit drug users' relatives and acquaintances describe protective and risk factors, prevention initiatives, treatment services, laws and policies regarding illicit drugs?' The quantitative data was collected using an instrument containing closed questions. In total, 108 young adults (18 years of age or older) were interviewed, who stated being affected by the drug although they were not users. For 104 interviewees (96%), negligence is the family dynamics that causes the greatest exposure to drugs, and 106 (98%) consider that parent support is what offers the greatest protection. Policies, the police and the criminal system have neither reduced drug use nor do they protect users.

  3. Feelings and codependent behavior in the family of illicit drugs users

    Directory of Open Access Journals (Sweden)

    Bruna da Costa

    2017-08-01

    Full Text Available Current descriptive and qualitative study described feelings and codependent behavior in relatives of illicit drug users. Data were collected between March and April 2012 by an open interview with eight family members of illicit drugs-dependent individuals and subjected to theme-mode content analysis. Results were classified into two categories which showed intense suffering coupled to feelings of guilt, fear, shame, sadness, shame and manifestation of codependent behaviors such as denial and control of the one´s situation and that of others. Professionals should know the situation in which the families of drug addicts live to assist them in a different way. They should also identify codependent relatives, since they also need care so that their behavior does not worsen the symptoms and behavior of the drug user and prevents a possible medical or psychiatric diagnosis.

  4. 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

  5. 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.

  6. Conflict and user involvement in drug misuse treatment decision-making: a qualitative study.

    Science.gov (United States)

    Fischer, Jan; Neale, Joanne; Bloor, Michael; Jenkins, Nicholas

    2008-10-06

    This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making. Seventy-nine in-depth interviews were conducted with new treatment clients in two residential and two community drug treatment agencies. Fifty-nine of these clients were interviewed again after twelve weeks. Twenty-seven interviews were also conducted with staff, who were the keyworkers for the interviewed clients. Drug users did not expect, desire or prepare for conflict at treatment entry. They reported few actual conflicts within the treatment setting, but routinely discussed latent conflicts--that is, negative experiences and problematic aspects of current or previous treatment that could potentially escalate into overt disputes. Conflict resulted in a number of possible outcomes, including the premature termination of treatment; staff deciding on the appropriate outcome; the client appealing to the governance structure of the agency; brokered compromise; and staff skilfully eliciting client consent for staff decisions. Although the implementation of user involvement in drug treatment decision-making has the potential to trigger high levels of staff-client conflict, latent conflict is more common than overt conflict and not all conflict is negative. Drug users generally want to be co-operative at treatment entry and often adopt non-confrontational forms of covert resistance to decisions about which they disagree. Staff sometimes deploy user involvement as a strategy for managing conflict and soliciting client compliance to treatment protocols. Suggestions for minimising and avoiding harmful conflict in treatment settings are given.

  7. An AIDS risk reduction program for Dutch drug users: an intervention mapping approach to planning.

    Science.gov (United States)

    van Empelen, Pepijn; Kok, Gerjo; Schaalma, Herman P; Bartholomew, L Kay

    2003-10-01

    This article presents the development of a theory- and evidence-based AIDS prevention program targeting Dutch drug users and aimed at promoting condom use. The emphasis is on the development of the program using a five-step intervention development protocol called intervention mapping (IM). Preceding Step 1 of the IM process, an assessment of the HIV problem among drug users was conducted. The product of IM Step 1 was a series of program objectives specifying what drug users should learn in order to use condoms consistently. In Step 2, theoretical methods for influencing the most important determinants were chosen and translated into practical strategies that fit the program objectives. The main strategy chosen was behavioral journalism. In Step 3, leaflets with role-model stories based on authentic interviews with drug users were developed and pilot tested. Finally, the need for cooperation with program users is discussed in IM Steps 4 and 5.

  8. Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange.

    Science.gov (United States)

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

    2008-01-01

    Secondary syringe exchange (SSE) refers to the exchange of sterile syringes between injection drug users (IDUs). To date there has been limited examination of SSE in relation to the social networks of IDUs. This study aimed to identify characteristics of drug injecting networks associated with the receipt of syringes through SSE. Active IDUs were recruited from syringe exchange and methadone treatment programs in Montreal, Canada, between April 2004 and January 2005. Information on each participant and on their drug-injecting networks was elicited using a structured, interviewer-administered questionnaire. Subjects' network characteristics were examined in relation to SSE using regression models with generalized estimating equations. Of 218 participants, 126 were SSE recipients with 186 IDUs in their injecting networks. The 92 non-recipients reported 188 network IDUs. Networks of SSE recipients and non-recipients were similar with regard to network size and demographics of network members. In multivariate analyses adjusted for age and gender, SSE recipients were more likely than non-recipients to self-report being HIV-positive (OR=3.56 [1.54-8.23]); require or provide help with injecting (OR=3.74 [2.01-6.95]); have a social network member who is a sexual partner (OR=1.90 [1.11-3.24]), who currently attends a syringe exchange or methadone program (OR=2.33 [1.16-4.70]), injects daily (OR=1.77 [1.11-2.84]), and shares syringes with the subject (OR=2.24 [1.13-4.46]). SSE is associated with several injection-related risk factors that could be used to help focus public health interventions for risk reduction. Since SSE offers an opportunity for the dissemination of important prevention messages, SSE-based networks should be used to improve public health interventions. This approach can optimize the benefits of SSE while minimizing the potential risks associated with the practice of secondary exchange.

  9. Receiver Operator Characteristic Tools Graphic User Interface Extension for R Commander

    Directory of Open Access Journals (Sweden)

    Daniel Corneliu LEUCUŢA

    2015-12-01

    Full Text Available Background: Receiver Operator Characteristic (ROC curve, is a graphical plot which presents the performance of a binary classifier when the discrimination cutoff is varied. The aim of this work was to create an extension for R Commander that offers a graphical user interface for Receiver Operator Characteristic tools provided by several existing command line accessible packages like pROC and ROCR. Material and Methods: The extension was built and tested with R version 3.2.0 and R Commander 2.1-7. Results: We built an extension called RcmdrPlugin.ROC that we uploaded on the CRAN servers. The extension adds a new menu called ROC, along with two submenus pROC and ROCR that broadly corresponds to commands available to access the functions of these packages. The pROC menu offers several commands: to plot a ROC curve for a dataset or for a logistic regression model, to compare paired and unpaired ROC curves, each providing the following tabs: General (to select the variables for the analysis, and options for switching cases with controls; Smoothing (allowing the user to select different types of smoothing – binominal, density, distributions like normal, lognormal, ...; AUC (to specify the partial area under the curve (AUC options, CI (to select the options of confidence intervals (CI – the level, computing method: DeLong, bootstrap, ...; Plot (for the plotting options. The ROCR dialogue window offers more options in choosing the performance measures for the plot. Conclusion: The RcmdrPlugin.ROC extension helps less advanced users of R accessing ROC tools in a friendly graphical user interface.

  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. Routines and rituals: a grounded theory of the pain management of drug users in acute care settings.

    Science.gov (United States)

    McCreaddie, May; Lyons, Imogen; Watt, Debbie; Ewing, Elspeth; Croft, Jeanette; Smith, Marion; Tocher, Jennifer

    2010-10-01

    This study reviewed the perceptions and strategies of drug users and nurses with regard to pain management in acute care settings. Drug users present unique challenges in acute care settings with pain management noted to be at best suboptimal, at worst non-existent. Little is known about why and specifically how therapeutic effectiveness is compromised. Qualitative: constructivist grounded theory. A constructivist grounded theory approach incorporating a constant comparative method of data collection and analysis was applied. The data corpus comprised interviews with drug users (n = 11) and five focus groups (n = 22) of nurses and recovering drug users. Moral relativism as the core category both represents the phenomenon and explains the basic social process. Nurses and drug users struggle with moral relativism when addressing the issue of pain management in the acute care setting. Drug users lay claim to expectations of compassionate care and moralise via narration. Paradoxically, nurses report that the caring ideal and mutuality of caring are diminished. Drug users' individual sensitivities, anxieties and felt stigma in conjunction with opioid-induced hyperalgesia complicate the processes. Nurses' and hospitals' organisational routines challenge drug user rituals and vice versa leading both protagonists to become disaffected. Consequently, key clinical issues such as preventing withdrawal and managing pain are left unaddressed and therapeutic effectiveness is compromised. This study provides a robust account of nurses' and drug users' struggle with pain management in the acute care setting. Quick technological fixes such as urine screens, checklists or the transient effects of (cognitive-based) education (or training) are not the answer. This study highlights the need for nurses to engage meaningfully with this perceptibly 'difficult' group of patients. The key aspects likely to contribute to problematic interactions with this patient cohort are outlined so that

  12. An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India.

    Science.gov (United States)

    Phukan, Sanjib Kumar; Medhi, Gajendra Kumar; Mahanta, Jagadish; Adhikary, Rajatashuvra; Thongamba, Gay; Paranjape, Ramesh S; Akoijam, Brogen S

    2017-07-03

    Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur. A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes. The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors. Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users

  13. [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.

  14. 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...... presenting to the 2 treatment centres. Individuals with chronic hepatitis B virus or HIV infection were excluded. Participants completed the Major Depression Inventory (MDI) questionnaire when presenting at the centres. Patients with MDI scores indicating severe depression (total MDI score ≥ 35) were......-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...

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

    OpenAIRE

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

    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...

  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. 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

  18. Attitudes and knowledge about naloxone and overdose prevention among detained drug users in Ningbo, China

    Directory of Open Access Journals (Sweden)

    Liu Yu

    2012-02-01

    Full Text Available Abstract Background To date there has been limited research on both the prevalence of overdose and drug user knowledge about overdose prevention and response methods in China. In addition, there has been no effort to integrate naloxone information and distribution into pre-release services for drug users detained in isolated compulsory detoxification facilities in China. Methods The authors conducted a survey of 279 heroin users in isolated compulsory detoxification centers in Ningbo, China in an attempt to evaluate the possibility of conducting prelease peer naloxone programs in Ningbo isolated compulsory detoxification centers. Respondents' demographic background, history of heroin overdoses, and attitudes/knowledge about overdose prevention and response were collected. Results While drug users in Ningbo's compulsory detoxification centers have limited understandings of how to effectively respond to overdoses, they expressed concern about the possibility of overdose, interest in participating in overdose prevention and response programs, and a willingness to help their peers. In general, there was no significant difference in history and attitudes/knowledge of overdose between male and female participants. Conclusion Based on the findings of this research, our survey provides preliminary evidence that detained drug users have considerable interest in overdose prevention and response information and willingness to help peers. However, drug users in Ningbo isolated compulsory detoxification centers currently have limited understandings of effective ways of helping to prevent overdose deaths.

  19. Estimating the number of HIV-infected injection drug users in Bangkok: a capture--recapture method.

    Science.gov (United States)

    Mastro, T D; Kitayaporn, D; Weniger, B G; Vanichseni, S; Laosunthorn, V; Uneklabh, T; Uneklabh, C; Choopanya, K; Limpakarnjanarat, K

    1994-07-01

    The purpose of the study was to estimate the number of injection drug users infected with the human immunodeficiency virus (HIV) in Bangkok to allow planning for health services for this population. A two-sample capture-recapture method was used. The first capture listed all persons on methadone treatment for opiate addiction from April 17 through May 17, 1991, at 18 facilities in Bangkok. The second capture involved urine testing of persons held at 72 Bangkok police stations from June 3 through September 30, 1991. Persons whose urine tests were positive for opiate metabolites or methadone were included on the second list. The first capture comprised 4064 persons and the recapture 1540 persons. There were 171 persons included on both lists, yielding an estimate of 36,600 opiate users in Bangkok. Existing data indicate that 89% of opiate users in Bangkok inject drugs and that about one third are infected with HIV, yielding an estimate of approximately 12,000 HIV-infected injection drug users in Bangkok in 1991. During the 1990s the number of cases of acquired immunodeficiency syndrome (AIDS) and other HIV-related diseases, including tuberculosis, in the population of HIV-infected injection drug users in Bangkok will increase dramatically, placing new demands on existing health care facilities. The capture-recapture method may be useful in estimating difficult-to-count populations, including injection drug users.

  20. Age-related patterns of drug use initiation among polydrug using regular psychostimulant users.

    Science.gov (United States)

    Darke, Shane; Kaye, Sharlene; Torok, Michelle

    2012-09-01

    To determine age-related patterns of drug use initiation, drug sequencing and treatment entry among regular psychostimulant users. Cross-sectional study of 269 regular psychostimulant users, administered a structured interview examining onset of use for major licit and illicit drugs. The mean age at first intoxication was not associated with age or gender. In contrast, younger age was associated with earlier ages of onset for all of the illicit drug classes. Each additional year of age was associated with a 4 month increase in onset age for methamphetamine, and 3 months for heroin. By the age of 17, those born prior to 1961 had, on average, used only tobacco and alcohol, whereas those born between 1986 and 1990 had used nine different drug classes. The period between initial use and the transition to regular use, however, was stable. Age was also negatively correlated with both age at initial injection and regular injecting. Onset sequences, however, remained stable. Consistent with the age-related patterns of drug use, each additional year of age associated with a 0.47 year increase in the age at first treatment. While the age at first intoxication appeared stable, the trajectory through illicit drug use was substantially truncated. The data indicate that, at least among those who progress to regular illicit drug use, younger users are likely to be exposed to far broader polydrug use in their teens than has previously been the case. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  1. 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

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

    Science.gov (United States)

    Wright, Nat; Oldham, Nicola; Francis, Katharine; Jones, Lesley

    2006-01-01

    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. PMID:17014725

  3. 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.

  4. Long-term mortality and causes of death among hospitalized Swedish drug users.

    Science.gov (United States)

    Fugelstad, Anna; Annell, Anders; Ågren, Gunnar

    2014-06-01

    To study long-term mortality and causes of death in a cohort of drug users in relation to main type of drug use and HIV-status. A total of 1640 hospitalized drug users in Stockholm was followed up from 1985 to the end of 2007. The mortality was compared with the general Swedish population and hazard ratios (HR) for the main risk indicators were calculated. The causes of death were studied, using information from death certificates. 630 persons died during the observation period. The Standard Mortality Ratio (SMR) was 16.1 (males 13.8, females 18.5). The crude mortality rate was 2.0 % (males 2.2% and females 1.5%). The mortality rate was higher in heroin users than among amphetamine users, HR 1.96, controlled for age and other risk factors. The mortality rate among individuals infected with the human immunodeficiency virus (HIV) was high (4.9 %), HR 2.64, compared with HIV-negative individuals. Most of the deaths were from other causes than acquired immune deficiency syndrome. One-third of deaths (227) were caused by heroin intoxication. The number of deaths from HIV-related causes decreased after 1996, when highly active anti-retroviral therapy was introduced. In all, there were 92 HIV-related deaths. Deaths from natural causes increased during the observation period. The SMR was highest for cardiovascular and gastrointestinal diseases. The results indicate a correlation between amphetamine use and death from cerebral haemorrhage. A high proportion of natural deaths were alcohol-related. The death rate among illicit drug users was persistently high. Alcohol consumption was a contributing factor to premature death. © 2014 the Nordic Societies of Public Health.

  5. 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.

  6. 76 FR 59705 - Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and Biological...

    Science.gov (United States)

    2011-09-27

    ...] Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and Biological Products..., Reductions, and Refunds for Drug and Biological Products.'' This guidance provides recommendations to... ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This guidance provides...

  7. 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.

  8. Psychotropic Drug Use in Physically Restrained, Critically Ill Adults Receiving Mechanical Ventilation.

    Science.gov (United States)

    Guenette, Melanie; Burry, Lisa; Cheung, Alexandra; Farquharson, Tara; Traille, Marlene; Mantas, Ioanna; Mehta, Sangeeta; Rose, Louise

    2017-09-01

    Restraining therapies (physical or pharmacological) are used to promote the safety of both patients and health care workers. Some guidelines recommend nonpharmacological or pharmacological interventions be used before physical restraints in critically ill patients. To characterize psychotropic drug interventions before and after use of physical restraints in critically ill adults receiving mechanical ventilation. A single-center, prospective, observational study documenting psychotropic drug use and Sedation-Agitation Scale (SAS) scores in the 2 hours before and the 6 hours after application of physical restraints. Ninety-three patients were restrained for a median of 21 hours (interquartile range, 9-70 hours). Thirty percent of patients did not receive a psychotropic drug or had a drug stopped or decreased before physical restraints were applied. More patients received a psychotropic drug intervention after use of physical restraints than before (86% vs 56%, P = .001). Administration of opioids was more common after the use of physical restraints (54% vs 20% of patients, P = .001) and accounted for more drug interventions (45% vs 29%, P = .001). Fifty patients had SAS scores from both time periods; 16% remained oversedated, 24% were appropriately sedated, and 16% remained agitated in both time periods. Patients became oversedated (20%), more agitated (10%), less agitated (8%), and less sedated (6%) after restraint use. Psychotropic drug interventions (mostly using opioids) were more common after use of physical restraints. Some patients may be physically restrained for anticipated treatment interference without consideration of pharmacological options and without documented agitation. ©2017 American Association of Critical-Care Nurses.

  9. Willingness to pay for methadone maintenance treatment in Vietnamese epicentres of injection-drug-driven HIV infection.

    Science.gov (United States)

    Tran, Bach Xuan

    2013-07-01

    Willingness to pay for methadone maintenance treatment (MMT) in three Vietnamese epicentres of injection-drug-driven human immunodeficiency virus (HIV) infection was assessed. A convenience sample of 1016 patients receiving HIV treatment in seven clinics was enrolled during 2012. Contingent valuation was used to assess willingness to pay. Interviewers reviewed adverse consequences of injection drug use and the benefits of MMT. Interviewers then described the government's plan to scale up MMT and the financial barriers to scale-up. Willingness to pay was assessed using double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay. A total of 548 non-drug-users and 468 injection drug users were enrolled; 988 were willing to pay for MMT. Monthly mean willingness to pay among non-drug-users, 347 drug users not receiving MMT and 121 drug users receiving MMT was 10.7 United States dollars [US$] (35.7% of treatment costs), US$ 21.1 (70.3%) and US$ 26.2 (87.3%), respectively (mean: US$ 15.9; 95% confidence interval, CI: 13.6-18.1). Fifty per cent of drug users were willing to pay 50% of MMT costs. Residence in households with low monthly per capita income and poor health status predicted willingness to pay less among drug users; educational level, employment status, health status and current antiretroviral therapy receipt predicted willingness to pay less among non-drug-users. Willingness to pay for MMT was very high, supporting implementation of a co-payment programme.

  10. 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

  11. Rise in needle sharing among injection drug users in Pakistan during the Afghanistan war.

    Science.gov (United States)

    Strathdee, Steffanie A; Zafar, Tariq; Brahmbhatt, Heena; Baksh, Ahmed; ul Hassan, Salman

    2003-07-20

    The war in Afghanistan in 2001 may have had direct or indirect effects on drug users' behaviors in nearby Pakistan. We studied drug use patterns and correlates of needle sharing among injection drug users (IDUs) in Lahore, Pakistan, before and after the beginning of the Afghanistan war. Between August and October 2001, 244 drug users registering for needle exchange and other services underwent an interviewer-administered survey on sociodemographics, drug use and HIV/AIDS awareness. chi(2)-tests were used to compare drug use behaviors among subjects interviewed before and after October 6th, 2001, coinciding with the start of the Afghanistan war. Correlates of needle sharing among IDUs were identified using logistic regression. Comparing IDUs interviewed before and after October 6th, 2001, levels of needle sharing were significantly higher after the war (56% versus 76%, respectively; P=0.02). Factors independently associated with needle sharing included registering after the war began (adjusted odds ratio, AOR=3.76 (95% CI: 1.23-11.48)), being married (AOR=0.36), being homeless (AOR=3.91), having been arrested (AOR=6.00), and re-using syringes (AOR=6.19). Expansion of needle exchange, drug treatment and supportive services is urgently needed to avoid an explosive HIV epidemic in Pakistan.

  12. The understanding of law professionals from the Federal District about drug users under the current new law / A compreensão dos operadores de direito do Distrito Federal sobre o usuário de drogas na vigência da nova lei

    Directory of Open Access Journals (Sweden)

    Maria Fátima Olivier Sudbrack

    2010-01-01

    Full Text Available Drugs users have been receiving contradictory treatments thereby promoting their stigma besides hiding and limiting the understanding of the phenomenon. The objective of this study was to investigate how the District Attorneys and Judges are considering and applying the new law which legislates on the conduct of drug use in Brazil. Eleven Law professionals from the Federal District participated in semi-structured interviews divided in three areas: the point of view in relation to the user of drugs, how the law is being applied, and how they conceive the work of the multidisciplinary teams. The results showed very heterogeneous positions, showing that there is no unanimity on the understanding of the new law. For some, there is a shared belief that drugs abuse is a public health problem, for others, it is believed that the user must receive a punishment for his/her illegal act. An effective and efficient interdisciplinary dialogue should allow a reflective action aiming at favoring those who come to justice.

  13. A randomized study of contingency management and spirometric lung age for motivating smoking cessation among injection drug users.

    Science.gov (United States)

    Drummond, Michael B; Astemborski, Jacquie; Lambert, Allison A; Goldberg, Scott; Stitzer, Maxine L; Merlo, Christian A; Rand, Cynthia S; Wise, Robert A; Kirk, Gregory D

    2014-07-28

    Even after quitting illicit drugs, tobacco abuse remains a major cause of morbidity and mortality in former injection drug users. An important unmet need in this population is to have effective interventions that can be used in the context of community based care. Contingency management, where a patient receives a monetary incentive for healthy behavior choices, and incorporation of individual counseling regarding spirometric "lung age" (the age of an average healthy individual with similar spirometry) have been shown to improve cessation rates in some populations. The efficacy of these interventions on improving smoking cessation rates has not been studied among current and former injection drug users. In a randomized, factorial design study, we recruited 100 active smokers from an ongoing cohort study of current and former injection drug users to assess the impact of contingency management and spirometric lung age on smoking cessation. The primary outcome was 6-month biologically-confirmed smoking cessation comparing contingency management, spirometric lung age or both to usual care. Secondary outcomes included differences in self-reported and biologically-confirmed cessation at interim visits, number of visits attended and quit attempts, smoking rates at interim visits, and changes in Fagerstrom score and self-efficacy. Six-month biologically-confirmed smoking cessations rates were 4% usual care, 0% lung age, 14% contingency management and 0% for combined lung age and contingency management (p = 0.13). There were no differences in secondary endpoints comparing the four interventions or when pooling the lung age groups. Comparing contingency management to non-contingency management, 6-month cessation rates were not different (7% vs. 2%; p = 0.36), but total number of visits with exhaled carbon monoxide-confirmed abstinence were higher for contingency management than non-contingency management participants (0.38 vs. 0.06; p = 0.03), and more contingency management

  14. 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...

  15. 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.

  16. 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.

  17. 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…

  18. 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

  19. 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.

  20. 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.

  1. 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 ...

  2. [Laws and policies on illicit drugs in Brazil and the perspective of drug users' family members and acquaintances: a study in the City of Ribeirão Preto, São Paulo, Brazil].

    Science.gov (United States)

    Ventura, Carla Aparecida Arena; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto; Ferreira, Paulo Sérgio

    2009-01-01

    Brazilian drugs legislation has evolved from a prohibitionist system to a less repressive one in terms of drug users. The objective of this study was to identify the perception of relatives and acquaintances of drug users living in Ribeirão Preto, São Paulo, Brazil, about the country's laws and policies on drugs. Data collection was performed using a structured questionnaire. The sample consisted of 100 drug users' relatives or acquaintances, selected at a public health service. Respondents' relationships with the drug user were as follows: 31% friend, 23% sibling, 15% child and 7% spouse. Most users (78%) were men, with an average age of 26 years. Results confirm that national laws and policies have a direct effect on individuals' attitude and behaviors. There is a lack of trust in the police and a general perception that, despite recent chances that favor user rehabilitation, the laws on drugs do not respect users' human rights.

  3. 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.

  4. Influences of Cross-Border Mobility on Tuberculosis Diagnoses and Treatment Interruption Among Injection Drug Users in Tijuana, Mexico

    Science.gov (United States)

    Deiss, Robert; Garfein, Richard S.; Lozada, Remedios; Burgos, Jose Luis; Brouwer, Kimberly C.; Moser, Kathleen S.; Zuniga, Maria Luisa; Rodwell, Timothy C.; Ojeda, Victoria D.

    2009-01-01

    Objectives. We sought to identify correlates of reported lifetime diagnoses of TB among injection drug users in the border city of Tijuana, Mexico. Methods. Injection drug users in Tijuana were recruited into a prospective cohort study during 2006 and 2007. We used weighted multivariate logistic regression to identify correlates of TB diagnoses. Results. Of the 1056 participants, 103 (9.8%) reported a history of TB, among whom 93% received anti-TB medication and 80% were diagnosed in the United States. Treatment was prematurely halted among 8% of patients; deportation from the United States was the cause of half of these treatment interruptions. History of travel to (odds ratio [OR] = 6.44; 95% confidence interval [CI] = 1.53, 27.20) or deportation from (OR = 1.83; 95% CI = 1.07, 3.12) the United States and incarceration (OR = 2.20; 95% CI = 1.06, 4.58) were independently associated with a reported lifetime diagnosis of TB. Conclusions. Mobility and migration are important factors in identifying and treating TB patients diagnosed in the US–Mexico border region. Strengthening capacity on both sides of the border to identify, monitor, and treat TB is a priority. PMID:19542040

  5. Prescription drugs purchased through the internet: who are the end users?

    Science.gov (United States)

    Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Rosenblum, Andrew; Ahwah, Candice; Bailey, J Elise; Dart, Richard C; Burke, John J

    2010-07-01

    Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of "end users" of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  6. The filter of choice: filtration method preference among injecting drug users

    Directory of Open Access Journals (Sweden)

    Keijzer Lenneke

    2011-08-01

    Full Text Available Abstract Background Injection drug use syringe filters (IDUSF are designed to prevent several complications related to the injection of drugs. Due to their small pore size, their use can reduce the solution's insoluble particle content and thus diminish the prevalence of phlebitis, talcosis.... Their low drug retention discourages from filter reuse and sharing and can thus prevent viral and microbial infections. In France, drug users have access to sterile cotton filters for 15 years and to an IDUSF (the Sterifilt® for 5 years. This study was set up to explore the factors influencing filter preference amongst injecting drug users. Methods Quantitative and qualitative data were gathered through 241 questionnaires and the participation of 23 people in focus groups. Results Factors found to significantly influence filter preference were duration and frequency of injecting drug use, the type of drugs injected and subculture. Furthermore, IDU's rationale for the preference of one type of filter over others was explored. It was found that filter preference depends on perceived health benefits (reduced harms, prevention of vein damage, protection of injection sites, drug retention (low retention: better high, protective mechanism against the reuse of filters; high retention: filter reuse as a protective mechanism against withdrawal, technical and practical issues (filter clogging, ease of use, time needed to prepare an injection and believes (the conviction that a clear solution contains less active compound. Conclusion It was concluded that the factors influencing filter preference are in favour of change; a shift towards the use of more efficient filters can be made through increased availability, information and demonstrations.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 78 FR 46980 - Prescription Drug User Fee Rates for Fiscal Year 2014

    Science.gov (United States)

    2013-08-02

    ... U.S. postal money order payable to the order of the Food and Drug Administration. Please include the user fee identification (ID) number on your check, bank draft, or postal money order. Your payment can be mailed to: Food and Drug Administration, P.O. Box 979107, St. Louis, MO 63197-9000. If checks are...

  12. 77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013

    Science.gov (United States)

    2012-08-01

    ..., or U.S. postal money order payable to the order of the Food and Drug Administration. Please include the user fee identification (ID) number on your check, bank draft, or postal money order. Your payment can be mailed to: Food and Drug Administration, P.O. Box 979107, St. Louis, MO 63197-9000. If checks...

  13. 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.

    Science.gov (United States)

    Oliveira, Sabrina A N; Hacker, Mariana A; Oliveira, M Lourdes A; Yoshida, Clara F T; Telles, Paulo R; Bastos, Francisco I

    2005-01-01

    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. 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. 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. 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.

  14. 76 FR 45831 - Prescription Drug User Fee Rates for Fiscal Year 2012

    Science.gov (United States)

    2011-08-01

    ... for the process for the review of human drug applications (see section 736(c)(2) of the FD&C Act... provide for not more than 3 months of operating reserves of carryover user fees for the process for the... establishment fees will be exempted this year based on the orphan drug exemption in FDAAA (see section 736(k) of...

  15. 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.

  16. 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.

  17. 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.

  18. 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…

  19. 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)

  20. [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.

  1. Perceived risk of HIV infection among deported male injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Pinedo, Miguel; Burgos, José Luis; Robertson, Angela M; Vera, Alicia; Lozada, Remedios; Ojeda, Victoria D

    2014-01-01

    Deported injection drug users (IDUs) in Mexico may be vulnerable to HIV infection following expulsion from the USA. We examined factors associated with HIV risk perception among a sample of deportees in Tijuana. From January to April 2010, 313 male IDUs who reported ever being deported from the USA completed a questionnaire. Overall, 35% (N=110) of deportees perceived HIV risk. In multivariate logistic regression analyses, factors independently associated with HIV risk perception included ever having a steady female partner in Tijuana post-deportation (adjusted odds ratio [AOR]: 2.26; 95% confidence interval [CI]: 1.01-5.07) and years spent in a US prison (AOR: 1.29 per year; 95% CI: 1.13-1.48). Conversely, years of drug injection use (AOR: 0.95 per year; 95% CI: 0.91-0.99), ever witnessing family members use drugs prior to first migration trip (AOR: 0.24; 95% CI: 0.09-0.65), years of residence in the USA (AOR: 0.91 per year; 95% CI: 0.84-0.98) and being a Tijuana native (AOR: 0.40; 95% CI: 0.16-0.99) were negatively associated with HIV risk perception. US-Mexico border cities that receive deported migrants should target HIV prevention interventions to specific subgroups, including drug-using male deportees. Interventions should consider migrant's time in the USA, the role of their social networks, and reducing missed opportunities for HIV testing/education.

  2. 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

  3. [Use of illicit drugs and critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro City, Brazil].

    Science.gov (United States)

    Vargens, Octavio Muniz da Costa; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

    2009-01-01

    This article presents the partial results of a multicenter, qualitative study, which involved seven Latin-American countries and Canada. The results presented refer to Northern Rio de Janeiro (city), Brazil. The objective of the study was to describe the perspective of relatives/acquaintances of illicit drug users about protective and risk factors, prevention initiatives, treatment services, and legal aspects regarding illicit drugs. Interviews were performed with 99 individuals, who reported being affected by their relationship with an illicit drug user (relative or acquaintance), approaching their perspectives regarding the key-domains. Most participants were women (73.7%); relatives who used drugs were mostly men (78.2%); the most consumed drug was marijuana (77.8%). The highlighted protective factor was having recreational-sports activities in the community (88.9%), and the risk factor was curiosity for trying something new (94.4%). The main treatment services were Church Groups (51.5%), and participants stated that laws should be more punitive (82.8%). In conclusion, this information is essential to fight against drug use/abuse, showing that there is a need for actions that consider different perspectives at different levels.

  4. 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...

  5. 77 FR 45624 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2013

    Science.gov (United States)

    2012-08-01

    .... currency by check, bank draft, or U.S. postal money order payable to the order of the Food and Drug... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0806] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2013 AGENCY: Food and Drug...

  6. 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.

  7. 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.

  8. 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.

  9. Rationality of Antimicrobial Prescriptions in Community Pharmacy Users.

    Directory of Open Access Journals (Sweden)

    Sara I V C Lima

    Full Text Available Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs.A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug.Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.

  10. 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

    . Centers receiving users from other countries should be supervised and alternatives should be designed for users who abandon treatment. International cooperation and programs to reduce the risk of drug consumption should be developed. Treatment should be prevented from becoming a business.

  11. Frequency and structure of stimulant designer drug consumption among suspected drug users in Budapest and South-East Hungary in 2012-2013.

    Science.gov (United States)

    Institóris, László; Árok, Zsófia; Seprenyi, Katalin; Varga, Tibor; Sára-Klausz, Gabriella; Keller, Éva; Tóth, Réka A; Sala, Leonardo; Kereszty, Éva; Róna, Kálmán

    2015-03-01

    Identification of abuse and frequency patterns of stimulant designer drugs (SDDs) provides important information for their risk assessment and legislative control. In the present study urine and/or blood samples of suspected drug users in criminal cases were analysed by GC-MS for 38 SDDs, and for the most frequent illicit and psychoactive licit drugs in Hungary. Between July 2012 and June 2013, 2744 suspected drug users were sampled in Budapest and during 2012 and 2013, 774 persons were sampled in South-East Hungary (Csongrád County - neighbour the Romanian and Serbian borders). In Budapest 71.4% of cases, and in South-East Hungary 61% of cases were positive for at least one substance. Pentedrone was the most frequent SDD in both regions; however, the frequency distribution of the remaining drugs was highly diverse. SDDs were frequently present in combination with other drugs - generally with amphetamine or other stimulants, cannabis and/or benzodiazepines. The quarterly distribution of positive samples indicated remarkable seasonal changes in the frequency and pattern of consumption. Substances placed on the list of illicit drugs (mephedrone, 4-fluoro-amphetamine, MDPV, methylone, 4-MEC) showed a subsequent drop in frequency and were replaced by other SDDs (pentedrone, 3-MMC, methiopropamine, etc.). Newly identified compounds from seized materials were added to the list of new psychoactive substances ("Schedule C"). While the risk assessment of substances listed in Schedule C has to be performed within 2 years after scheduling, continuous monitoring of their presence and frequency among drug users is essential. In summary, our results suggest which substances should be dropped from the list of SDDs measured in biological samples; while the appearance of new substances from seized materials indicate the need for developing adequate standard analytical methods. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Transitions in drug use in a new generation of problem drug users in Amsterdam: a 6-year follow-up study

    NARCIS (Netherlands)

    Buster, Marcel C. A.; Witteveen, Ewald; Prins, Maria; van Ameijden, Erik J. C.; Schippers, Gerard; Krol, Anneke

    2009-01-01

    This study describes the transitions in drug use in Amsterdam among young drug users (YDUs) who are inhaling or injecting cocaine or using illicitly obtained opiates. From 2000 until 2003, 187 YDUs (

  13. 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.

  14. Vitamin A levels and human immunodeficiency virus load in injection drug users.

    Science.gov (United States)

    Semba, R D; Farzadegan, H; Vlahov, D

    1997-01-01

    Although low plasma vitamin A levels are associated with increased mortality and higher vertical transmission during human immunodeficiency virus (HIV) infection, it is unknown whether plasma low vitamin A levels are a marker for circulating HIV load. We conducted a cross-sectional study within a prospective cohort study of injection drug users in order to evaluate the relationship between plasma vitamin A levels and HIV viral load. Plasma vitamin A level was measured by high-performance liquid chromatography. Infectious viral load was measured by quantitative microculture of serial fivefold dilutions of 10(6) peripheral blood mononuclear cells. A total of 284 HIV-infected adults (79 women, 205 men) were studied. Plasma vitamin A levels consistent with deficiency were found in 28.9% of adults. A total of 38.0% of women and 25.3% of men had vitamin A deficiency (P < 0.04). The median infectious viral load for the entire study population was 8 infectious units per million cells. No significant relationship between plasma vitamin A levels and infectious viral load was observed in these injection drug users. This study suggests that there is no correlation between HIV viral load and plasma vitamin A levels in injection drug users, and these variables may represent independent risk factors during HIV infection. HIV-infected adult women appear to be at higher risk of developing vitamin A deficiency. PMID:9008289

  15. Are long-term bisphosphonate users a reality?

    DEFF Research Database (Denmark)

    Abrahamsen, B

    2012-01-01

    The prevalence of long-term bisphosphonate use may be low due to low refill compliance and gaps in treatment. An analysis of the prescription history of 58,674 bisphosphonate users in Denmark found that only 2.8 % had received ten dose years of treatment or above. INTRODUCTION: This study aims...... to describe the demographics of present bisphosphonate (BP) users, to determine the prevalence of long-term BP use, and to establish if long-term use (a 10-year history of osteoporosis treatment) translated to ten dose years of bisphosphonate prescriptions filled, given the propensity for treatment gaps...... more than ten dose years of a BP. For any osteoporosis drug, 3.0 % had received ten dose years or more, while 23.2 % had received between 5 and 10 years of treatment. CONCLUSION: Long-term users with ten dose years or more of a BP are rare due to periods of low compliance and gaps, with a discrepancy...

  16. 78 FR 46955 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

    Science.gov (United States)

    2013-08-02

    ... courier such as Federal Express or United Parcel Service, the courier may deliver the check and printed... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0007] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug...

  17. Cross sectional study of factors associated to self-reported blood-borne infections among drug users.

    Science.gov (United States)

    Reyes-Urueña, Juliana; Brugal, M Teresa; Majo, Xavier; Domingo-Salvany, Antonia; Caylà, Joan A

    2015-11-13

    The study's aim was to estimate the self-reported prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV), and to describe their associated risk factors in a population of users of illicit drugs recruited in Catalonia- Spain, during 2012. Cross-sectional study. People with illicit drugs use were selected in three different types of healthcare centres. The questionnaire was a piloted, structured ad hoc instrument. An analysis was made to identify factors associated to self-reported HCV, HIV and co-infection. Correlates of reported infections were determined using univariate and multivariate Poisson regression (with robust variance). Among 512 participants, 39.65% self-reported positive serostatus for HCV and 14.84% for HIV, co-infection was reported by 13.48%. Among the 224 injecting drug users (IDUs), 187 (83.48%), 68 (30.36%) and 66 (29.46%) reported being positive for HCV, HIV and co-infection, respectively. A higher proportion of HIV-infected cases was observed among women, (18.33% vs. 13.78% in men). Prevalence of HCV, HIV and co-infection were higher among participants with early onset of drug consumption, long periods of drug injection or who were unemployed. A positive serostatus was self-reported by 21(7.34%) participants who did not report any injection; among them 16 and eight, reported being positive for HCV and HIV, respectively; three reported co-infection. Only two people declared exchanging sex for money. For those that reported a negative test, the median time since the last HIV test was 11.41 months (inter-quartile range (IQR) 4-12) and for the HCV test was 4.5 months (IQR 2-7). Among drug users in Catalonia, HIV, HCV and co-infection prevalence are still a big issue especially among IDUs. Women and drug users who have never injected drugs are groups with a significant risk of infection; this might be related to their high-risk behaviours and to being unaware of their serological status.

  18. Male injection drug users try new drugs following U.S. deportation to Tijuana, Mexico.

    Science.gov (United States)

    Robertson, Angela M; Rangel, M Gudelia; Lozada, Remedios; Vera, Alicia; Ojeda, Victoria D

    2012-01-01

    Among male injection drug users (IDUs) in Tijuana, Mexico, U.S. deportation is associated with HIV transmission. Changing drug use behaviors following deportation, including the use of new drugs, may increase HIV risk but are understudied. We identify correlates of trying new drugs following male IDUs' most recent U.S. deportation to Mexico. In 2010, we recruited 328 deported male IDUs in Tijuana, Mexico. Questionnaires collected retrospective data on drug use and other HIV risk behaviors throughout migratory events. Logistic regression identified correlates of trying new drugs/combinations following their most recent deportations. Informed consent was obtained from all participants. Nearly one in six men (n=52, 16%) tried new drugs following their most recent deportation, including heroin (n=31), methamphetamine (n=5), and heroin/methamphetamine combined (n=17). Trying new drugs following deportation was independently associated with U.S. incarceration (adjusted odds ratio [AOR]=3.96; 95% confidence interval [C.I.] 1.78, 8.84), increasing numbers of U.S. deportations (AOR=1.11 per deportation; C.I. 1.03, 1.20), feeling sad following deportation (AOR 2.69; C.I. 1.41, 5.14), and perceiving that one's current lifestyle increases HIV/AIDS risk (AOR 3.91; C.I. 2.05, 7.44). Trying new drugs following U.S. deportation may be related to the unique contexts and stressors experienced by drug-abusing migrants as they attempt to reestablish their lives in Mexico. Findings imply an unmet need for health and social programs to alleviate pre- and post-deportation stressors faced by undocumented and return migrants in the U.S.-Mexico context. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. FACSIM/MRS-1: Cask receiving and consolidation model documentation and user's guide

    International Nuclear Information System (INIS)

    Lotz, T.L.; Shay, M.R.

    1987-06-01

    The Pacific Northwest Laboratory (PNL) has developed a stochastic computer model, FACSIM/MRS, to assist in assessing the operational performance of the Monitored Retrievable Storage (MRS) waste-handling facility. This report provides the documentation and user's guide for the component FACSIM/MRS-1, which is also referred to as the front-end model. The FACSIM/MRS-1 model simulates the MRS cask-receiving and spent-fuel consolidation activities. The results of the assessment of the operational performance of these activities are contained in a second report, FACSIM/MRS-1: Cask Receiving and Consolidation Performance Assessment (Lotz and Shay 1987). The model of MRS canister storage and shipping operations is presented in FACSIM/MRS-2: Storage and Shipping Model Documentation and User's Guide (Huber et al. 1987). The FACSIM/MRS model uses the commercially available FORTRAN-based SIMAN (SIMulation ANalysis language) simulation package (Pegden 1982). SIMAN provides a set of FORTRAN-coded commands, called block operations, which are used to build detailed models of continuous or discrete events that make up the operations of any process, such as the operation of an MRS facility. The FACSIM models were designed to run on either an IBM-PC or a VAX minicomputer. The FACSIM/MRS-1 model is flexible enough to collect statistics concerning almost any aspect of the cask receiving and consolidation operations of an MRS facility. The MRS model presently collects statistics on 51 quantities of interest during the simulation. SIMAN reports the statistics with two forms of output: a SIMAN simulation summary and an optional set of SIMAN output files containing data for use by more detailed post processors and report generators

  20. 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.

  1. Nationwide trends in glucose-lowering drug use, Denmark, 1999-2014

    DEFF Research Database (Denmark)

    Christensen, Diana Hedevang; Rungby, Jørgen; Thomsen, Reimar Wernich

    2016-01-01

    drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes. RESULTS: The annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362) to 41 per 1...... changed substantially reflecting the recommendations of metformin as first-line treatment. The newer glucose-lowering drug classes have been well received.......PURPOSE: The objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014. METHODS: Based on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering...

  2. 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

  3. Residual Neurocognitive Features of Long-Term Ecstasy Users With Minimal Exposure to Other Drugs

    Science.gov (United States)

    Halpern, John H.; Sherwood, Andrea R.; Hudson, James I.; Gruber, Staci; Kozin, David; Pope, Harrison G.

    2010-01-01

    Aims In field studies assessing cognitive function in illicit ecstasy users, there are several frequent confounding factors that might plausibly bias the findings toward an overestimate of ecstasy-induced neurocognitive toxicity. We designed an investigation seeking to minimize these possible sources of bias. Design We compared illicit ecstasy users and non-users while 1) excluding individuals with significant lifetime exposure to other illicit drugs or alcohol; 2) requiring that all participants be members of the “rave” subculture; and 3) testing all participants with breath, urine, and hair samples at the time of evaluation to exclude possible surreptitious substance use. We compared groups with adjustment for age, gender, race/ethnicity, family-of-origin variables, and childhood history of conduct disorder and attention deficit hyperactivity disorder. We provide significance levels without correction for multiple comparisons. Setting Field study. Participants Fifty-two illicit ecstasy users and 59 non-users, age 18-45. Measurements Battery of 15 neuropsychological tests tapping a range of cognitive functions. Findings We found little evidence of decreased cognitive performance in ecstasy users, save for poorer strategic-self-regulation, possibly reflecting increased impulsivity. However this finding might have reflected a premorbid attribute of ecstasy users, rather than a residual neurotoxic effect of the drug. Conclusions In a study designed to minimize limitations found in many prior investigations, we failed to demonstrate marked residual cognitive effects in ecstasy users. This finding contrasts with many previous findings—including our own—and emphasizes the need for continued caution in interpreting field studies of cognitive function in illicit ecstasy users. PMID:21205042

  4. 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.

  5. [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.

  6. 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.

  7. Vulnerability to drug-related infections and co-infections among injecting drug users in Budapest, Hungary

    Science.gov (United States)

    Neaigus, Alan; Ujhelyi, Eszter

    2009-01-01

    Background: Drug-related infectious diseases are among the major health consequences of drug use, and any existing drug-related infection may predispose injecting drug users (IDUs) to other infections. Methods: We assessed among IDUs in Budapest, Hungary the prevalence of and vulnerability to selected drug-related infections and co-infections. The sample consisted of 186 participants recruited between October 2005 and December 2006. Results: We found 0% HIV, 37% HCV, 24% HAV, and 14% past HBV infection. Infections with Herpes 1 or 2, tuberculosis, Chlamydia, syphilis, and gonorrhoea were 79%, 12%, 7%, 4%, and 0%, respectively. Co-infection with HAV/HCV was 12%, HBV/HCV 9%, HAV/HBV 7%, and HAV/HBV/HCV 4%. Those over age 30, the ethnic Roma, and the homeless were more likely to have any hepatitis and a higher number of drug-related infections. Amphetamine injectors were more likely to have a higher number of drug-related infections and those who travelled within Hungary were more likely to have any STI. However, those who worked at least part time and those who were in treatment were less likely to have drug-related infections. Conclusions: These results highlight the need of interventions in Hungary to reach and focus on marginalized (Roma or homeless) IDUs and address not only injecting and sex risk, but also hygienic living and injecting conditions. Furthermore, structural interventions to increase social integration (working or being in treatment) may improve welfare and decrease drug use and infection risk tied to drug use/injection among disadvantaged, marginalized, mostly minority populations. PMID:19224936

  8. 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.

  9. 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.

  10. Theories of addiction: methamphetamine users' explanations for continuing drug use and relapse.

    Science.gov (United States)

    Newton, Thomas F; De La Garza, Richard; Kalechstein, Ari D; Tziortzis, Desey; Jacobsen, Caitlin A

    2009-01-01

    A variety of preclinical models have been constructed to emphasize unique aspects of addiction-like behavior. These include Negative Reinforcement ("Pain Avoidance"), Positive Reinforcement ("Pleasure Seeking"), Incentive Salience ("Craving"), Stimulus Response Learning ("Habits"), and Inhibitory Control Dysfunction ("Impulsivity"). We used a survey to better understand why methamphetamine-dependent research volunteers (N = 73) continue to use methamphetamine, or relapse to methamphetamine use after a period of cessation of use. All participants met DSM-IV criteria for methamphetamine abuse or dependence, and did not meet criteria for other current Axis I psychiatric disorders or dependence on other drugs of abuse, other than nicotine. The questionnaire consisted of a series of face-valid questions regarding drug use, which in this case referred to methamphetamine use. Examples of questions include: "Do you use drugs mostly to make bad feelings like boredom, loneliness, or apathy go away?", "Do you use drugs mostly because you want to get high?", "Do you use drugs mostly because of cravings?", "Do you find yourself getting ready to take drugs without thinking about it?", and "Do you impulsively take drugs?". The scale was anchored at 1 (not at all) and 7 (very much). For each question, the numbers of participants rating each question negatively (1 or 2), neither negatively or affirmatively (3-5), and affirmatively (6 or 7) were tabulated. The greatest number of respondents (56%) affirmed that they used drugs due to "pleasure seeking." The next highest categories selected were "impulsivity" (27%) and "habits"(25%). Surprisingly, many participants reported that "pain avoidance" (30%) and "craving" (30%) were not important for their drug use. Results from this study support the contention that methamphetamine users (and probably other drug users as well) are more heterogeneous than is often appreciated, and imply that treatment development might be more successful if

  11. 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

  12. Socio-demographic and sexual practices associated with HIV infection in Kenyan injection and non-injection drug users.

    Science.gov (United States)

    Budambula, Valentine; Matoka, Charles; Ouma, James; Ahmed, Aabid A; Otieno, Michael F; Were, Tom

    2018-01-30

    Substance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection. Although socio-demographic factors influence substance consumption and risk of HIV infection, the association of these factors with HIV infection is poorly understood among substance users on the African continent. The objective of the study was to assess socio-demographic and sexual practices that are associated with HIV infection among injection drug users (IDUs), non-IDUs, and non-drug users (DUs) at an urban setting of coastal Kenya. A cross-sectional descriptive study was conducted among 451 adults comprising HIV-infected and -uninfected IDUs (n = 157 and 39); non-IDUs (n = 17 and 48); and non-DUs (n = 55 and 135); respectively at coastal, Kenya. Respondent driven sampling, snowball and makeshift methods were used to enroll IDUs and non-IDUs. Convenience and purposive sampling were used to enroll non-DUs from the hospital's voluntary HIV testing unit. Participant assisted questionnaire was used in collecting socio-demographic data and sexual practices. Binary logistic regression analysis indicated that higher likelihood of HIV infection was associated with sex for police protection (OR, 9.526; 95% CI, 1.156-78.528; P = 0.036) and history of sexually transmitted infection (OR, 5.117; 95% CI, 1.924-13.485; P = 0.001) in IDUs; divorced, separated or widowed marital status (OR, 6.315; 95% CI, 1.334-29.898; P = 0.020) in non-IDUs; and unemployment (OR, 2.724; 95% CI, 1.049-7.070; P = 0.040) in non-drug users. However, never married (single) marital status (OR, 0.140; 95% CI, 0.030-0.649; P = 0.012) was associated with lower odds for HIV infection in non-drug users. Altogether, these results suggest that socio-demographic and sexual risk factors for HIV transmission differ with drug use status, suggesting targeted preventive measures for drug users.

  13. The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users.

    Science.gov (United States)

    Corsi, Karen F; Lehman, Wayne E; Min, Sung-Joon; Lance, Shannon P; Speer, Nicole; Booth, Robert E; Shoptaw, Steve

    2012-06-04

    This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk.

  14. 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.

  15. Staphylococcus aureus nasal colonization in HIV-seropositive and HIV-seronegative drug users

    NARCIS (Netherlands)

    K.A. Holbrook; R.S. Klein; D. Hartel; D.A. Elliott; T. B. Barsky; L. H. Rothschild; F. D. Lowy

    1997-01-01

    textabstractNasal colonization plays an important role in the pathogenesis of Staphylococcus aureus infections. To identify characteristics associated with colonization, we studied a cross-section of a well-described cohort of HIV-seropositive and -seronegative active and former drug users

  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. 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.

  18. Gender differences in clinical manifestations before AIDS diagnosis among injecting drug users

    NARCIS (Netherlands)

    Spijkerman, I. J.; Langendam, M. W.; van Ameijden, E. J.; Coutinho, R. A.; van den Hoek, A.

    1998-01-01

    We compared incidence rates of self-reported HIV-related symptoms and illnesses, verified clinical manifestations and findings on physical examination between female and male injecting drug users (IDU) stratified by HIV serostatus in the Amsterdam cohort study on the natural history of HIV

  19. 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....

  20. 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.

  1. Evaluation of Altered Drug Pharmacokinetics in Critically Ill Adults Receiving Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Ha, Michael A; Sieg, Adam C

    2017-02-01

    Extracorporeal membrane oxygenation (ECMO) is a life-support modality used in patients with refractory cardiac and/or respiratory failure. A significant resurgence in the use ECMO has been seen in recent years as a result of substantial improvements in technology and survival benefit. With expanding ECMO use, a better understanding of how ECMO affects drug pharmacokinetics (PK) is necessary. The vast majority of PK studies in patients receiving ECMO have been conducted within neonatal or pediatric populations or within a controlled environment (e.g., in vitro or ex vivo). Because of significant differences in absorption, distribution, metabolism, and excretion, it may be inappropriate to extrapolate these PK data to adults. Thus, the aims of this review are to evaluate the changes in drug PK during ECMO and to summarize the available PK data for common drugs used in the adult critically ill patients during ECMO support. A search of the PubMed (1965-July 2016), EMBASE (1965-July 2016), and Cochrane Controlled Trial Register databases was performed. All relevant studies describing PK alterations during ECMO in ex vivo experiments and in adults were included. Evaluation of the data indicated that drug PK in adults receiving ECMO support may be significantly altered. Factors influencing these alterations are numerous and have intricate relationships with each other but can generally be classified as ECMO circuit factors, drug factors, and patient factors. Commonly used drugs in these patients include antimicrobials, sedatives, and analgesics. PK data for most of these drugs are generally lacking; however, recent research efforts in this patient population have provided some limited guidance in drug dosing. With an improved understanding of altered drug PK secondary to ECMO therapy, optimization of pharmacotherapy within this critically ill population continues to move forward. © 2016 Pharmacotherapy Publications, Inc.

  2. Deep vein thrombosis of the lower limbs in intravenous drug users

    Directory of Open Access Journals (Sweden)

    Wiesława Kwiatkowska

    2015-04-01

    Full Text Available Addiction to intravenously administered drugs has been a serious epidemiological problem for years. Among the related health complications, deep vein thrombosis (DVT is one of the most important. This paper provides an illustrative presentation of DVT in intravenous drug users (IDUs, HIV-positive subjects among them.We searched PubMed, Ovid Journals, Scopus, ScienceDirect, Cochrane Library, Google Scholar and references from articles obtained. The main terms used to identify appropriate studies of DVT in IDUs were ‘intravenous drug users’, ‘substance-related disorders’ and ‘deep vein thrombosis’.No guidelines exist for DVT in intravenous drug users. As many as 47.6% of IDUs report having suffered from DVT. IDUs may constitute approx. 50% of patients under 40 years of age with DVT, this being promoted by multiple vein punctures, groin injections, lack of sterility, insoluble microparticles and other factors. The clinical appearance is more complex than in the general population, which also makes prognosis more difficult. HIV infection can worsen DVT. It often appears as proximal iliofemoral thrombosis, accompanied by local and general complications. Ultrasound with a compression test is an objective method of choice, but must often be complemented with computed tomography. Antithrombotic therapy in IDUs needs to be applied individually. The optimal method is supervised therapy at addiction treatment services.Individual and public preventive measures, among them locally prepared guidelines for DVT in IDUs, may be the most important processes capable of effectively reducing the morbidity of septic and non-septic DVT.

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. Satisfaction with nursing care in drug users: the evolution of a scale.

    Science.gov (United States)

    Seabra, Paulo Rosário Carvalho; Sá, Luis Octávio; Amendoeira, José Joaquim Penedos; Ribeiro, Ana Leonor

    2017-07-13

    To identify the degree of satisfaction with nursing care, the significant variables and contribute to the evolution of the scale. Descriptive, correlational, cross study, with 180 drug users. Data collected using the scale called "Satisfaction of users with the Nursing Health Center26", between February and December 2012 in three treatment units in the region of Lisbon and Vale do Tejo, Portugal. Users indicated 83.3% satisfaction. The dimension "Information individualization" was the most marked (98.5%). The more stability in the programs, abstinence from stimulants and benzodiazepines and more nursing interventions, the greater the satisfaction. Better working conditions, specializing in mental health, younger ages and less experience of nurses also contributed to satisfaction. Four items of the scale were extracted, assuming new SUCECS22 designation. Satisfaction was high, influenced by structural variables of users, nurses and working conditions. The scale has proved suitable for assessment in this population.

  8. Boredom, depressive symptoms, and HIV risk behaviors among urban injection drug users

    Science.gov (United States)

    German, Danielle; Latkin, Carl A.

    2013-01-01

    Boredom is closely aligned with depression, but is understood to be conceptually distinct. Little is known about boredom among active drug users and the potential association with depression and HIV risk. Current IDUs (n=845) completed a baseline behavioral survey including socio-demographic characteristics, self-reported boredom, depressive symptoms (CESD score), and HIV risk behaviors. One-third of the sample reported high boredom in the past week. In multivariate analysis, those who reported boredom were less likely to be older, African-American, have a main partner, and to be employed at least part-time. Controlling for covariates, those with high boredom were almost five times as likely to report high depressive symptoms. Co-occurrence of boredom and depressive symptoms (28%) was strongly and independently associated with a range of injection risk behaviors and sex exchange. This study demonstrates the need for more thorough understanding of mental health and HIV risk among urban drug users. PMID:22760741

  9. 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 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 ...

  10. 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)

  11. Surviving in two worlds: social and structural violence of Thai female injecting drug users.

    Science.gov (United States)

    Haritavorn, Niphattra

    2014-01-01

    Thai females injecting drugs are ensnared in a web of problems arising from forms of prejudice that magnify their vulnerability. They are vulnerable, at risk, and exposed to a high degree of social suffering. This paper aims to elucidate how social production and structural violence combine to shape the lives of these women. Using a qualitative methodology, two focus groups with 5 key informants and in-depth interviews involving a total of 35 women injecting drugs were conducted in Bangkok. The findings reveal that the structural environment that directly impacts upon these women's lives becomes the reason for their suffering. The structural environment puts these women at risk of violence in numerous social settings in which these women engage as well as generating tension at a subjective level (i.e. the habitus) of these women. Thai female injecting drug users are trapped in a difficult tension between the demands for being Thai women seeking to exist in the masculine world of drug use but at the same time meeting Thai society's expectations of womanhood. Unequal gender relations are manifest in the everyday violence that women face in the drug community, culminating in the essential nature of women being questioned, undermined and threatened. Living in the drug community, women are subjected to violence and harassment, and gendered brutality by intimate partners. In conclusion, the social suffering that Thai female injecting drug users find themselves confronting is confined to dilemmas cause by tensions between drug use and the overriding gender habitus. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. 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.

  13. 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.

  14. 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.

  15. Prevalence of hepatitis C virus infection and associated factors among male illicit drug users in Cuiabá, Mato Grosso, Brazil.

    Science.gov (United States)

    Novais, Antônia Carlos Magalhães; Lopes, Carmen Luci Rodrigues; Reis, Nádia Rúbia da Silva; Silva, Agabo Macêdo Costa E; Martins, Regina Maria Bringel; Souto, Francisco José Dutra

    2009-09-01

    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.

  16. 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)

  17. Examining the Acceptability of mHealth Technology in HIV Prevention Among High-Risk Drug Users in Treatment.

    Science.gov (United States)

    Shrestha, Roman; Huedo-Medina, Tania B; Altice, Frederick L; Krishnan, Archana; Copenhaver, Michael

    2017-11-01

    Despite promising trends of the efficacy of mobile health (mHealth) based strategies to a broad range of health conditions, very few if any studies have been done in terms of the examining the use of mHealth in HIV prevention efforts among people who use drugs in treatment. Thus, the goal of this study was to gain insight into the real-world acceptance of mHealth approaches among high-risk people who use drugs in treatment. A convenience sample of 400 HIV-negative drug users, who reported drug- and/or sex-related risk behaviors, were recruited from a methadone clinic in New Haven, Connecticut. Participants completed standardized assessments of drug- and sex-related risk behaviors, neurocognitive impairment (NCI), and measures of communication technology access and utilization, and mHealth acceptance. We found a high prevalence of current ownership and use of mobile technologies, such as cell phone (91.5%) including smartphone (63.5%). Participants used mobile technologies to communicate mostly through phone calls (M = 4.25, SD = 1.24), followed by text messages (M = 4.21, SD = 1.29). Participants expressed interest in using mHealth for medication reminders (72.3%), receive information about HIV (65.8%), and to assess drug-related (72.3%) and sex-related behaviors (64.8%). Furthermore, participants who were neurocognitively impaired were more likely to use cell phone without internet and show considerable interest in using mHealth as compared to those without NCI. The findings from this study provide empirical evidence that mHealth-based programs, specifically cell phone text messaging-based health programs, may be acceptable to this high-risk population.

  18. General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil.

    Science.gov (United States)

    Ventura, Carla Aparecida Arena; Carrara, Bruna Sordi; Bobbili, Sireesha; Vedana, Kelly Graziani Giacchero; Khenti, Akwatu; Hayashida, Miyeko; Ferreira, Paulo Sergio

    2017-09-01

    People who use drugs are continuously subjected to harsh stigmatization through a process of relational and social degradation, which limits their possibility for recovery. This quantitative study explores the perspectives of family members or significant others of illicit drug users, regarding general beliefs about illicit drug use and their stigma. Respondents agree that most people do not trust people who use drugs, disregard individuals who have been hospitalized due to drug problems and do not think people who use drugs are as intelligent as the general population. These findings reveal a high level of public stigma regarding illicit drug use.

  19. Clonidine blocks stress-induced craving in cocaine users.

    Science.gov (United States)

    Jobes, Michelle L; Ghitza, Udi E; Epstein, David H; Phillips, Karran A; Heishman, Stephen J; Preston, Kenzie L

    2011-11-01

    Reactivity to stressors and environmental cues, a putative cause of relapse in addiction, may be a useful target for relapse-prevention medication. In rodents, alpha-2 adrenergic agonists such as clonidine block stress-induced reinstatement of drug seeking, but not drug cue-induced reinstatement. The objective of this study is to test the effect of clonidine on stress- and cue-induced craving in human cocaine users. Healthy, non-treatment-seeking cocaine users (n = 59) were randomly assigned to three groups receiving clonidine 0, 0.1, or 0.2 mg orally under double-blind conditions. In a single test session, each participant received clonidine or placebo followed 3 h later by exposure to two pairs of standardized auditory-imagery scripts (neutral/stress and neutral/drug). Subjective measures of craving were collected. Subjective responsivity ("crave cocaine" Visual Analog Scale) to stress scripts was significantly attenuated in the 0.1- and 0.2-mg clonidine groups; for drug-cue scripts, this attenuation occurred only in the 0.2-mg group. Other subjective measures of craving showed similar patterns of effects but Dose × Script interactions were not significant. Clonidine was effective in reducing stress-induced (and, at a higher dose, cue-induced) craving in a pattern consistent with preclinical findings, although this was significant on only one of several measures. Our results, though modest and preliminary, converge with other evidence to suggest that alpha-2 adrenergic agonists may help prevent relapse in drug abusers experiencing stress or situations that remind them of drug use.

  20. 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.

  1. 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.

  2. MDMA: interactions with other psychoactive drugs.

    Science.gov (United States)

    Mohamed, Wael M Y; Ben Hamida, Sami; Cassel, Jean-Christophe; de Vasconcelos, Anne Pereira; Jones, Byron C

    2011-10-01

    3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) is one of the most widely abused illegal drugs. Some users self-report euphoria and an increased perception and feeling of closeness to others. When taken in warm environments, MDMA users may develop acute complications with potential fatal consequences. In rodents, MDMA increases locomotor activity and, depending on ambient temperature, may produce a dose-dependent, potentially lethal hyperthermia. Like most other recreational drugs, MDMA is frequently taken in combination with other substances including tobacco, EtOH, marijuana, amphetamines, cocaine and, caffeine. Although polydrug use is very common, the understanding of the effects of this multiple substance use, as well as the analysis of consequences of different drug-drug associations, received rather little attention. The purpose of this review is to summarize our current knowledge about the changes on MDMA-related behavior, pharmacology, and neurotoxicity associated with co-consumption of other drugs of abuse and psychoactive agents. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Correlates of lending needles/syringes among HIV-seropositive injection drug users.

    Science.gov (United States)

    Metsch, Lisa R; Pereyra, Margaret; Purcell, David W; Latkin, Carl A; Malow, Robert; Gómez, Cynthia A; Latka, Mary H

    2007-11-01

    Among HIV-positive injection drug users (IDUs), we examined the correlates of lending needles/syringes with HIV-negative and unknown status injection partners. HIV-positive IDUs (N=738) from 4 cities in the United States who reported injection drug use with other IDUs in the past 3 months participated in an audio computer-assisted self-administered interview. Eighteen percent of study participants self-reported having lent their needles to HIV-negative or unknown status injection partners. Multivariate analyses showed that 6 variables were significantly associated with this high-risk injecting practice. Older IDUs, high school graduates, and those reporting more supportive peer norms for safer drug use were less likely to lend needles/syringes. Admission to a hospital for drug treatment in the past 6 months, having injected with >1 person in the past 3 months, and having more psychiatric symptoms were all associated with more risk. These findings underscore the need for a continued prevention focus on HIV-positive IDUs that recognizes the combination of drug use, mental health factors, and social factors that might affect this high-risk injecting practice, which could be associated with HIV and hepatitis C transmission.

  4. 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.

  5. Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency.

    Science.gov (United States)

    Mars, Sarah G; Ondocsin, Jeff; Ciccarone, Daniel

    2018-05-16

    Internationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks. Between 2015 and 2016, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption. Ninety-one current heroin injectors were interviewed (Baltimore, n = 22; Chicago, n = 24; Massachusetts and New Hampshire, n = 36; San Francisco, n = 9). Experience injecting heroin ranged from methods of sampling "heroin" were identified, sometimes used in combination, ranging from non-injecting routes (snorting, smoking or tasting a small amount prior to injection) to injecting a partial dose and waiting. Partial injection took different forms: a "slow shot" where the user injected a portion of the solution in the syringe, keeping the needle in the injection site, and continuing or withdrawing the syringe or a "tester shot" where the solution was divided into separate injections. Other techniques included getting feedback from others using heroin of the same batch or observing those with higher tolerance injecting heroin from the same batch before judging how much to inject themselves. Although a minority of those interviewed described using these drug sampling techniques, there is clearly receptivity among some users to protecting themselves by using a variety of methods. The use of drug sampling as a means of preventing an overdose from injection drug use reduces the quantity absorbed at any one time allowing users to monitor drug strength and titrate their dose accordingly. Given the highly unpredictable potency of the drugs currently being sold as heroin in the US

  6. 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

  7. 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.

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

    Science.gov (United States)

    Guimarães, Rafael Alves; Rodovalho, Aurélio Goulart; Fernandes, Inaina Lara; Silva, Graciele Cristina; de Felipe, Rodrigo Lopes; Vera, Ivânia; Gregório, Valéria Duarte; Lucchese, Roselma

    2016-01-01

    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 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.

  9. Predictors of sharing injection equipment by HIV-seropositive injection drug users.

    Science.gov (United States)

    Latkin, Carl A; Buchanan, Amy S; Metsch, Lisa R; Knight, Kelly; Latka, Mary H; Mizuno, Yuko; Knowlton, Amy R

    2008-12-01

    Among HIV-positive injection drug users (IDUs), we examined baseline predictors of lending needles and syringes and sharing cookers, cotton, and rinse water in the prior 3 months at follow-up. Participants were enrolled in Intervention for Seropositive Injectors-Research and Evaluation, a secondary prevention intervention for sexually active HIV-positive IDUs in 4 US cities during 2001-2005. The analyses involved 357 participants who reported injecting drugs in the prior 6 months at either the 6- or 12-month follow-up visit. About half (49%) reported at least 1 sharing episode. In adjusted analyses, peer norms supporting safer injection practices and having primary HIV medical care visits in the prior 6 months were associated with reporting no sharing of injection equipment. Higher levels of psychological distress were associated with a greater likelihood of reporting drug paraphernalia sharing. These findings suggest that intervention approaches for reducing HIV-seropositive IDUs' transmission of blood-borne infections should include peer-focused interventions to alter norms of drug paraphernalia sharing and promoting primary HIV care and mental health services.

  10. 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.

  11. "Injection first": a unique group of injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Morris, Meghan D; Brouwer, Kimberly C; Lozada, Remedios M; Gallardo, Manuel; Vera, Alicia; Strathdee, Steffanie A

    2012-01-01

    Using baseline data from a study of injection drug users (IDUs) in Tijuana, Mexico (N = 1,052), we identified social and behavioral factors associated with injecting at the same age or earlier than other administration routes of illicit drug use (eg, "injection first") and examined whether this IDU subgroup had riskier drug using and sexual behaviors than other IDUs. Twelve-percent "injected first." Characteristics independently associated with a higher odds of "injection first" included being younger at first injection, injecting heroin as their first drug, being alone at the first injection episode, and having a sexual debut at the same age or earlier as when they initiated drug use; family members' illicit drug use was associated with lower odds of injecting first. When adjusting for age at first injection and number of years injecting, "injection first" IDUs had lower odds of ever overdosing, and ever trading sex. On the other hand, they were less likely to have ever been enrolled in drug treatment, and more commonly obtained their syringes from potentially unsafe sources. In conclusion, a sizable proportion of IDUs in Tijuana injected as their first drug using experience, although evidence that this was a riskier subgroup of IDUs was inconclusive.  Copyright © American Academy of Addiction Psychiatry.

  12. The social and environmental context of cross-border drug use in Mexico: findings from a mixed methods study of young injection drug users living in San Diego, CA.

    Science.gov (United States)

    Wagner, Karla D; Moynihan, Matthew J; Strathdee, Steffanie A; Cuevas-Mota, Jazmine; Clark, Maureen; Zúñiga, María Luisa; Volkmann, Tyson A; Teshale, Eyasu; Garfein, Richard S

    2012-01-01

    The authors report the results of qualitative (n = 19) and quantitative (n = 545) interviews with young injection drug users (IDUs) in San Diego, California about their experiences using drugs in Tijuana, Mexico, and associated risks for HIV infection. Young IDUs who have ever traveled to Mexico (n = 365) used a variety of injection (54%) and noninjection (30%) drugs there and appear to be heavier users than those who have never traveled to Mexico. Sociocultural themes influencing drug use in Mexico included interactions among the purpose of travel, drug preference, and route of administration; familiarity with the border region; evolving relationships with the United States and Mexican drug markets; and the experience of crossing the U.S.-Mexico border. Interventions for IDUs in border regions need to be sensitive to the ethnicity, familiarity with the border region, and life history of participants, as well as differences in national policies that could influence drug use and risk for HIV on both sides of the border.

  13. Illicit use of opioid substitution drugs: prevalence, user characteristics, and the association with non-fatal overdoses.

    Science.gov (United States)

    Bretteville-Jensen, Anne Line; Lillehagen, Mats; Gjersing, Linn; Andreas, Jasmina Burdzovic

    2015-02-01

    Diversion of opioid substitution drugs (OSD) is of public concern. This study examined the prevalence, frequency, and predictors of illicit OSD use in a group of injecting drug users (IDUs) and assessed if such use was associated with non-fatal overdoses. Semi-annual cross-sectional interviews conducted in Oslo, Norway (2006-2013), from 1355 street-recruited IDUs. Hurdle, logistic, and multinomial regression models were employed. Overall, 27% reported illicit OSD use in the past four weeks; 16.8% methadone, 12.5% buprenorphine, and 2.9% both drugs. Almost 1/10 reported at least one non-fatal overdose in the past four weeks, and roughly 1/3 reported such experience in the past year. Use of additional drugs tended to be equally, or more prevalent among illicit OSD users than other IDUs. In terms of illicit OSD use being a risk factor for non-lethal overdoses, our results showed significant associations only for infrequent buprenorphine use (using once or less than once per week). Other factors associated with non-fatal overdoses included age, education, homelessness, as well as the benzodiazepines, stimulants, and heroin use. Users of diverted OSD may represent a high-risk population, as they used more additional drugs and used them more frequently than other IDUs. However, illicit OSD use may be less harmful than previously assumed. After accounting for an extensive set of covariates, only infrequent illicit buprenorphine use, but not methadone use, was associated with non-fatal overdoses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. 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.

  15. 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

  16. Comparing the Trend of Physical Activity and Caloric Intake between Lipid-Lowering Drug Users and Nonusers among Adults with Dyslipidemia: Korean National Health and Nutrition Examination Surveys (2010-2013).

    Science.gov (United States)

    Oh, Jin-Young; Chekal, Lan; Kim, Se-Won; Lee, Jee-Yon; Lee, Duk-Chul

    2016-03-01

    The purpose of this study was to compare the physical activity and caloric intake trends of lipid-lowering drug users with those of non-users among Korean adults with dyslipidemia. This study was a repeated cross-sectional study with a nationally representative sample of 2,635 Korean adults with dyslipidemia based on the 2010-2013 Korea National Health and Nutrition Examination Survey. Physical activity was assessed using the International Physical Activity Questionnaire, and caloric intake was estimated through 24-hour dietary recall. All statistical analyses were conducted using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The changes in physical activity and caloric intake were investigated for lipid-lowering drug users and non-users using generalized linear models. The proportion of lipid-lowering drug users in the 2010-2013 survey population increased from 3.5% to 5.0% (PPhysical activity trends were tested separately for the lipid-lowering drug users and non-users, and a significant decrease was found among the drug users during the study period. Physical activity among the drug users in 2013 was 38% lower (1,357.3±382.7 metabolic equivalent [MET]; P for trend=0.002) than in 2010 (2,201.4±442.6 MET). In contrast, there was no statistically significant difference between drug users and non-users in the trend of caloric intake during the same period. Physical activity significantly decreased among lipid-lowering drug users between 2010 and 2013, which was not observed among non-users. The importance of physical activity may need to be re-emphasized for lipid-lowering drug users.

  17. Intact goal-directed control in treatment-seeking drug users indexed by outcome-devaluation and Pavlovian to instrumental transfer: Critique of habit theory.

    Science.gov (United States)

    Hogarth, Lee; Lam-Cassettari, Christa; Pacitti, Helena; Currah, Tara; Mahlberg, Justin; Hartley, Lucie; Moustafa, Ahmed

    2018-05-22

    Animal studies have demonstrated that chronic exposure to drugs of abuse impairs goal-directed control over action selection indexed by the outcome-devaluation and specific Pavlovian to instrumental transfer procedures, suggesting this impairment might underpin addiction. However, there is currently only weak evidence for impaired goal-directed control in human drug users. Two experiments were undertaken in which treatment-seeking drug users and non-matched normative reference samples (controls) completed outcome-devaluation and specific Pavlovian to instrumental transfer procedures notionally translatable to animal procedures (Experiment 2 used a more challenging biconditional schedule). The two experiments found significant outcome-devaluation and specific Pavlovian to instrumental transfer effects overall and there was no significant difference between groups in the magnitude of these effects. Moreover, Bayes factor supported the null hypothesis for these group comparisons. Although limited by non-matched group comparisons and small sample sizes, the two studies suggest that treatment-seeking drug users have intact goal-directed control over action selection, adding uncertainty to already mixed evidence concerning the role of habit learning in human drug dependence. Neuro-interventions might seek to tackle goal-directed drug-seeking rather than habit formation in drug users. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  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. A cross-sectional national survey assessing self-reported drug intake behavior, contact with the primary sector and drug treatment among service users of Danish drug consumption rooms

    DEFF Research Database (Denmark)

    Toth, Eva Charlotte; Tegner, Jette; Lauridsen, Sigurd

    2016-01-01

    Background Drug consumption rooms (DCRs) have been implemented worldwide as a harm-reducing strategy. In 2012, Denmark passed legislation allowing establishment of DCRs. The aim of this study was to identify characteristics and gain knowledge of the way service users use the DCRs including bridge...... building to specialized health care. Associations between nationality, opioid substitution treatment (OST), drug intake method, and response to staff advice on harm-reducing education was investigated, as well as service user’s reasons for using the DCRs, and their perceptions of safety and trust...... care took place in the DCR. Conclusions Staff of Danish DCRs educate service users on health related issues and harm-reducing interventions. A subgroup who smoke and a subgroup of nationality other than Danish are underserved and have less likely been in OST. More research on these groups is needed....

  20. Development of drug resistance in patients receiving combinations of zidovudine, didanosine and nevirapine

    NARCIS (Netherlands)

    Conway, B.; Wainberg, M. A.; Hall, D.; Harris, M.; Reiss, P.; Cooper, D.; Vella, S.; Curry, R.; Robinson, P.; Lange, J. M.; Montaner, J. S.

    2001-01-01

    OBJECTIVE: To evaluate the development of phenotypic and genotypic resistance to zidovudine, didanosine and nevirapine as a function of the virologic response to therapy in a group of drug-naive individuals receiving various combinations of these agents. DESIGN: All patients were enrolled in a

  1. Profiles of risk: a qualitative study of injecting drug users in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Green Traci

    2006-03-01

    Full Text Available Abstract Background In Iran, there are an estimated 200,000 injecting drug users (IDUs. Injecting drug use is a relatively new phenomenon for this country, where opium smoking was the predominant form of drug use for hundreds of years. As in many countries experiencing a rise in injecting drug use, HIV/AIDS in Iran is associated with the injection of drugs, accounting for transmission of more than two-thirds of HIV infections. This study aimed to: describe the range of characteristics of IDUs in Tehran, Iran's capital city; 2 examine the injecting-related HIV risk behaviors of IDUs, and 3 suggest necessary interventions to prevent HIV transmission among IDUs and their families and sex partners. Methods Using rapid assessment and response methods with a qualitative focus, six districts of Tehran were selected for study. A total of 81 key informants from different sectors and 154 IDUs were selected by purposeful, opportunistic and snowball sampling, then interviewed. Ethnographic observations were done for mapping and studying injecting-related HIV risk settings and behaviors. Modified content analysis methods were used to analyze the data and extract typologies of injecting drug users in Tehran. Results Evidence of injecting drug use and drug-related harm was found in 5 of 6 study districts. Several profiles of IDUs were identified: depending on their socioeconomic status and degree of stability, IDUs employed different injecting behaviors and syringe hygiene practices. The prevalence of sharing injection instruments ranged from 30–100%. Varied magnitudes of risk were evident among the identified IDU typologies in terms of syringe disinfection methods, level of HIV awareness, and personal hygiene exhibited. At the time of research, there were no active HIV prevention programs in existence in Tehran. Conclusion The recent rise of heroin injection in Iran is strongly associated with HIV risk. Sharing injection instruments is a common and complex

  2. Past 12-month and lifetime comorbidity and poly-drug use of ecstasy users among young adults in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

    Science.gov (United States)

    Keyes, Katherine M.; Martins, Silvia S.; Hasin, Deborah S.

    2013-01-01

    Background Ecstasy use is prevalent among young people and often co-occurs with other drug use, but little is known about the past 12-month and lifetime psychiatric comorbidity and specific additional drug abuse among young adult ecstasy users in the general population. To provide this information, we compared current ecstasy users to former users, other illicit drug users, and non-illicit drug users. Method Data were gathered in a face-to-face survey of the United States conducted in the 2001–2002 (NESARC). Participants were household and group quarters residents aged 18–29 years (n = 8666). We measured current ecstasy use defined as any use in the past year; former ecstasy use as use prior to the past year only; other lifetime drug use included any drug other than ecstasy; lifetime non-illicit drug use as no illicit drug use. Associations were determined for nine other classes of illicit drugs, eight personality disorders, and seven mood and anxiety disorders. Results Of current ecstasy users, 44% used >3 other classes of illicit drugs in the past year, compared to 1.6% of non-ecstasy drug users. Current ecstasy use was associated with current anxiety (OR = 3.7), specifically panic disorder (OR = 7.7) and specific phobia (OR = 4.1), also alcohol abuse (OR = 21.6) and dependence (OR = 4.1) and any personality disorder (OR = 5.1) compared to non-illicit drug users. Conclusions Results indicate important differences in comorbidities of current and former ecstasy users compared to other drug users and lifetime non-illicit drug users that may affect phenotype definitions and etiologic studies. Ecstasy use may represent a distinct population of drug users for which unique treatments may be necessary. PMID:18524499

  3. 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

  4. 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.

  5. An assessment of factorial structure and health-related quality of life in problem drug users using the Short Form 36 Health Survey

    NARCIS (Netherlands)

    Buchholz, Angela; Krol, Anneke; Rist, Fred; Nieuwkerk, Pythia T.; Schippers, Gerard M.

    2008-01-01

    AIMS: To confirm the factorial structure of the Short Form 36 Health Survey (SF-36) in problem drug users and to compare their health-related quality of life (HRQOL) with general Dutch population norms. METHOD: Data of 394 participants from the Amsterdam Cohort Study among drug users, who had

  6. Association of opioid agonist therapy with lower incidence of hepatitis C virus infection in young adult injection drug users.

    Science.gov (United States)

    Tsui, Judith I; Evans, Jennifer L; Lum, Paula J; Hahn, Judith A; Page, Kimberly

    2014-12-01

    Injection drug use is the primary mode of transmission for hepatitis C virus (HCV) infection. Prior studies suggest opioid agonist therapy may reduce the incidence of HCV infection among injection drug users; however, little is known about the effects of this therapy in younger users. To evaluate whether opioid agonist therapy was associated with a lower incidence of HCV infection in a cohort of young adult injection drug users. Observational cohort study conducted from January 3, 2000, through August 21, 2013, with quarterly interviews and blood sampling. We recruited young adult (younger than 30 years) injection drug users who were negative for anti-HCV antibody and/or HCV RNA. Substance use treatment within the past 3 months, including non-opioid agonist forms of treatment, opioid agonist (methadone hydrochloride or buprenorphine hydrochloride) detoxification or maintenance therapy, or no treatment. Incident HCV infection documented with a new positive result for HCV RNA and/or HCV antibodies. Cumulative incidence rates (95% CI) of HCV infection were calculated assuming a Poisson distribution. Cox proportional hazards regression models were fit adjusting for age, sex, race, years of injection drug use, homelessness, and incarceration. Baseline characteristics of the sample (n = 552) included median age of 23 (interquartile range, 20-26) years; 31.9% female; 73.1% white; 39.7% who did not graduate from high school; and 69.2% who were homeless. During the observation period of 680 person-years, 171 incident cases of HCV infection occurred (incidence rate, 25.1 [95% CI, 21.6-29.2] per 100 person-years). The rate ratio was significantly lower for participants who reported recent maintenance opioid agonist therapy (0.31 [95% CI, 0.14-0.65]; P = .001) but not for those who reported recent non-opioid agonist forms of treatment (0.63 [95% CI, 0.37-1.08]; P = .09) or opioid agonist detoxification (1.45 [95% CI, 0.80-2.69]; P = .23). After adjustment for

  7. 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.

  8. 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

  9. [Prevalence of Avoidable Potential Interactions Between Antidepressants and Other Drugs in Colombian Patients].

    Science.gov (United States)

    Machado-Alba, Jorge E; Morales-Plaza, Cristhian David

    2013-06-01

    To determine the possible drugs interactions with antidepressive agents in data bases of patients in the Health Insurance System of Colombia. From data bases of about 4 million users in Colombia, a systematic review of drugs dispensation statistics was made to identify drug interactions between antidepressive agents, cholinergic antagonists and tramadol in 2010. We identified 114,465 monthly users of antidepressive agents. Of these, 5776 (5.0%) received two, and 178 (0.2%) received three antidepressive agents simultaneously. The most frequent combination was fluoxetine+trazodone (n=3235; 56.9% of cases). About 1127 (1.0%) patients were prescribed a cholinergic antagonist simultaneously; 2523 (2.1%) users were dispensed tramadol at the same time, while raising the risk of serotonin syndrome. Drug interactions represent a potential risk that is often underestimated by physicians. Pharmacovigilance is a useful tool to optimize resources and prevent negative outcomes associated with medication. It is recommended that systematic search is made to enhance surveillance programs for the rational use of medicines in this country. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  10. [Harm reduction interventions in drug users: current situation and recommendations].

    Science.gov (United States)

    Bosque-Prous, Marina; Brugal, María Teresa

    2016-11-01

    Harm reduction encompasses interventions, programmes and policies that seek to reduce the negative consequences of the consumption of both legal and illegal drugs on the individual and public health. Harm reduction looks to mitigate the harm suffered by drug users through drug use monitoring and prevention, and promotes initiatives that respect and protect the human rights of this population. The harm reduction policies that have proven effective and efficient are: opioid substitution maintenance therapy (methadone); needle and syringe exchange programmes; supervised drug consumption rooms; and overdose prevention through peer-based naloxone distribution. In order to be effective, these policies must have comprehensive coverage and be implemented in areas where the target population is prevalent. Resident-based opposition to the implementation of these policies is known as the NIMBY (Not In My Back Yard) phenomenon, which is characterised by being against the implementation of new measures in a particular place, but does not question their usefulness. Given that any NIMBY phenomenon is a complex social, cultural and political phenomenon, it is important to conduct a thorough analysis of the situation prior to implementing any of these measures. Harm reduction policies must be extended to other substances such as alcohol and tobacco, as well as to other conditions beyond infectious/contagious diseases and overdose. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Avoiding emotional bonds: An examination of the dimensions of therapeutic alliance among cannabis users

    Directory of Open Access Journals (Sweden)

    Alison eHealey

    2013-07-01

    Full Text Available There is a growing need to provide treatment for cannabis users, yet engaging and maintaining this population in treatment is particularly difficult. Although past research has focused on the importance of therapeutic alliance on drug treatment outcomes, this is the first study to examine the dimensions of therapeutic alliance for cannabis users compared with users of alcohol or other drugs in a naturalistic setting. The acceptability of Internet-delivered interventions for drug and alcohol treatments is also investigated. Participants (N = 77 included clients who were receiving outpatient drug and alcohol treatment at a publicly-funded health service, including a Specialist Cannabis Clinic. The results indicated that one particular domain of alliance, Bond, was consistently lower, from both client and clinician perspectives, for current cannabis users relative to those not currently using cannabis. Client perceptions of Bond decreased as the severity of cannabis use increased (r =-0.373, p=0.02. Cannabis Clinic clients did not report a significantly lower Bond with their clinicians, suggesting that specialised cannabis services may be better placed to provide appropriate treatment for this population than embedding cannabis treatment within traditional drug and alcohol treatment teams. In addition, Internet/computer based treatments may be one potential way to engage, transition or retain cannabis users in treatment.Trial Registration: Australian Clinical Trial Registration Number: ACTRN12611000382976

  12. Mediators of interpersonal violence and drug addiction severity among methamphetamine users in Cape Town, South Africa.

    Science.gov (United States)

    Hobkirk, Andréa L; Watt, Melissa H; Green, Kimberly T; Beckham, Jean C; Skinner, Donald; Meade, Christina S

    2015-03-01

    South Africa has high rates of interpersonal violence and a rapidly growing methamphetamine epidemic. Previous research has linked experiences of interpersonal violence to higher rates of substance use, and identified mental health constructs as potential mediators of this association. The aim of this study was to examine the relationship between interpersonal violence and addiction severity among active methamphetamine users in Cape Town, South Africa, and to explore symptoms of posttraumatic stress disorder (PTSD) and substance use coping as mediators of this relationship. A community sample of 360 methamphetamine users was recruited through respondent driven sampling and surveyed on their experiences of violence, mental health, coping, and drug use and severity. A series of one-way ANOVAs were conducted to examine the relationship of self-reported interpersonal violence with drug addiction severity, and multiple mediation analyses were used to determine if PTSD symptoms and substance use coping mediated this relationship. The majority (87%) of the sample reported experiencing at least one instance of interpersonal violence in their lifetime, and the number of violent experiences was associated with increased drug addiction severity. PTSD and substance use coping were significant mediators of this association. Only the indirect effect of substance use coping remained significant for the female sample when the mediation model was conducted separately for men and women. The findings point to the need for integrated treatments that address drug use and PTSD for methamphetamine users in South Africa and highlight the importance of coping interventions for women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. 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.

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

    OpenAIRE

    Guimar?es, Rafael Alves; Rodovalho, Aur?lio Goulart; Fernandes, Inaina Lara; Silva, Graciele Cristina; de Felipe, Rodrigo Lopes; Vera, Iv?nia; Greg?rio, Val?ria Duarte; Lucchese, Roselma

    2016-01-01

    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 Goi?s 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 ri...

  15. Having multiple sexual partners among Iranian Injection Drug Users

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    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.

  16. Crack/cocaine users show more family problems than other substance users

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    Helena Ferreira Moura

    2014-07-01

    Full Text Available OBJECTIVES:To evaluate family problems among crack/cocaine users compared with alcohol and other substance users.METHODS:A cross-sectional multi-center study selected 741 current adult substance users from outpatient and inpatient Brazilian specialized clinics. Subjects were evaluated with the sixth version of the Addiction Severity Index, and 293 crack users were compared with 126 cocaine snorters and 322 alcohol and other drug users.RESULTS:Cocaine users showed more family problems when compared with other drug users, with no significant difference between routes of administration. These problems included arguing (crack 66.5%, powder cocaine 63.3%, other drugs 50.3%, p= 0.004, having trouble getting along with partners (61.5%×64.6%×48.7%, p= 0.013, and the need for additional childcare services in order to attend treatment (13.3%×10.3%×5.1%, p= 0.002. Additionally, the majority of crack/cocaine users had spent time with relatives in the last month (84.6%×86.5%×76.6%, p= 0.011.CONCLUSIONS:Brazilian treatment programs should enhance family treatment strategies, and childcare services need to be included.

  17. 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.

  18. Characteristics of Hemorrhagic Peptic Ulcers in Patients Receiving Antithrombotic/Nonsteroidal Antiinflammatory Drug Therapy

    OpenAIRE

    Nakamura, Kazuhiko; Akahoshi, Kazuya; Ochiai, Toshiaki; Komori, Keishi; Haraguchi, Kazuhiro; Tanaka, Munehiro; Nakamura, Norimoto; Tanaka, Yoshimasa; Kakigao, Kana; Ogino, Haruei; Ihara, Eikichi; Akiho, Hirotada; Motomura, Yasuaki; Kabemura, Teppei; Harada, Naohiko

    2012-01-01

    Background/Aims Antithrombotic/nonsteroidal antiinflammatory drug (NSAID) therapies increase the incidence of upper gastrointestinal bleeding. The features of hemorrhagic peptic ulcer disease in patients receiving antithrombotic/NSAID therapies were investigated. Methods We investigated the medical records of 485 consecutive patients who underwent esophagogastroduodenoscopy and were diagnosed with hemorrhagic gastroduodenal ulcers. The patients treated with antithrombotic agents/NSAIDs were c...

  19. Playing the Game or Played by the Game? Young Drug Users' Educational Trajectories

    Science.gov (United States)

    Järvinen, Margaretha; Ravn, Signe

    2018-01-01

    This article analyses the relationship between cannabis use and educational trajectories among 42 young drug users, recruited at addiction treatment centres in Denmark. Quantitative research shows regular cannabis use to be associated with poor school performance and drop-out. However, these studies do not pay much attention to differences between…

  20. Drug Retention Times

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2007-05-01

    The purpose of this monograph is to provide information on drug retention times in the human body. The information provided is based on plausible illegal drug use activities that might be engaged in by a recreational drug user. Based on anecdotal evidence, most people “party” during extended time away from the work environment. Therefore, the following scenarios were envisioned: (1) a person uses an illicit drug at a party on Saturday night (infrequent user); (2) a person uses a drug one time on Friday night and once again on Saturday night (infrequent user); and (3) a person uses a drug on Friday night, uses a drug twice on Saturday night, and once again on Sunday (frequent user).

  1. Self reported health status, and health service contact, of illicit drug users aged 50 and over: a qualitative interview study in Merseyside, United Kingdom

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    Duffy Paul

    2009-10-01

    Full Text Available Abstract Background The populations of industrialised countries are ageing; as this occurs, those who continue to use alcohol and illicit drugs age also. While alcohol use among older people is well documented, use of illicit drugs continues to be perceived as behaviour of young people and is a neglected area of research. This is the first published qualitative research on the experiences of older drug users in the United Kingdom. Methods Semi-structured interviews were conducted in Merseyside, in 2008, with drug users aged 50 and over recruited through drug treatment services. Interviews were recorded and transcribed and analysed thematically. Only health status and health service contact are reported here. Results Nine men and one woman were interviewed (age range: 54 to 61 years; all but one had been using drugs continuously or intermittently for at least 30 years. Interviewees exhibited high levels of physical and mental morbidity; hepatitis C was particularly prevalent. Injecting-related damage to arm veins resulted in interviewees switching to riskier injecting practices. Poor mental health was evident and interviewees described their lives as depressing. The death of drug-using friends was a common theme and social isolation was apparent. Interviewees also described a deterioration of memory. Generic healthcare was not always perceived as optimal, while issues relating to drug specific services were similar to those arising among younger cohorts of drug users, for example, complaints about inadequate doses of prescribed medication. Conclusion The concurrent effects of drug use and ageing are not well understood but are thought to exacerbate, or accelerate the onset of, medical conditions which are more prevalent in older age. Here, interviewees had poor physical and mental health but low expectations of health services. Older drug users who are not in contact with services are likely to have greater unmet needs. The number of drug users

  2. Prescription Pattern of Analgesic Drugs for Patients Receiving Palliative Care in a Teaching Hospital in India.

    Science.gov (United States)

    Menezes, Vishma Hydie; Nair, Shoba N; Soumya, M S; Tarey, S D

    2016-01-01

    Drugs used in the palliative care unit for managing symptoms are major contributors toward the expenditure occurring in palliative care. This study was conducted to understand the prescription pattern of analgesic drugs in the patients who are receiving palliative care in a teaching hospital in India by a retrospective study of case records. Case record based, retrospective, descriptive study was conducted at the Pain and Palliative Care Department of St. John's Medical College Hospital, Bengaluru. Case record files of all patients referred to Pain and Palliative Care Department for the treatment of pain in the year of 2012 were studied. Patients' age, gender, diagnoses, numerical pain rating scale (0-10), drugs prescribed, dosage, frequency, route of administration were recorded. The difference in drug utilization between the genders was done using Chi-square test. Data were collected from 502 patients of which 280 (56%) were males and 222 (44%) were females. Twelve percent of patients had mild pain (1-3), 34% had moderate pain (4-6), and 54% had severe pain (7-10). The most commonly used analgesic drugs were opioids (47%), followed by nonsteroidal anti-inflammatory drugs (36%). The opioids used were tramadol (56%), and morphine (38%). Ninety percent of patients with numerical pain scale more than 6 received morphine. There was no difference in analgesic drug utilization with regards to gender. Prescription pattern differed depending on the severity of pain. Opioids were the most commonly used drugs for pain management. The study shows that prescription pattern in palliative care unit of this hospital was in accordance with WHO pain management guidelines. The study showed the current trend in prescription of analgesic drugs in the teaching hospital where the study was conducted.

  3. Drug use and AIDS: estimating injection prevalence in a rural state.

    Science.gov (United States)

    Leukefeld, Carl G; Logan, T K; Farabee, David; Clayton, Richard

    2002-01-01

    This paper presents approaches used in one rural U.S. state to describe the level of injecting drug use and to estimate the number of injectors not receiving drug-user treatment. The focus is on two broad areas of estimation that were used to present the prevalence of injecting drug use in Kentucky. The first estimation approach uses available data from secondary data sources. The second approach involves three small community studies.

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

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    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.

  5. Patterns of drug treatment entry by Latino male injection drug users from different national/geographical backgrounds.

    Science.gov (United States)

    Reynoso-Vallejo, Humberto; Chassler, Deborah; Witas, Julie; Lundgren, Lena M

    2008-02-01

    This study examined patterns of treatment entry by Puerto Rican, Central American, Dominican, and other Latino male injection drug users (IDUs) in the state of Massachusetts over the time period 1996-2002. Specifically, it explored whether these populations had different patterns relative to three paths: entry into detoxification only, entry into residential treatment, or entry into methadone maintenance. Using a state-level MIS dataset on all substance abuse treatment entries to all licensed treatment programs, bi-variate and logistic regression methods were employed to examine patterns of drug treatment utilization among Latino men residing in Massachusetts. Three logistic regression models, which controlled for age, education, homelessness, employment, history of mental health treatment, health insurance, criminal justice involvement, having injected drugs in the past month, and number of treatment entries, indicated that Puerto Rican men were significantly less likely to only use detoxification services and residential treatment services, and significantly more likely to enter methadone maintenance compared to Latino men from Central American, Dominican, or other Latino backgrounds. For example, Central American men were 2.4 times more likely to enter only detoxification programs and 54% less likely to enter methadone maintenance programs than Puerto Rican male IDUs. For program planning, include the need to (a) develop varied drug treatment services to meet the needs of non-homogenous Latino groups within the population, (b) tailor outreach efforts to effectively reach all Latino groups, and (c) increase awareness among practitioners of differential patterns of treatment utilization.

  6. Non-natural manners of death among users of illicit drugs: Substance findings.

    Science.gov (United States)

    Delaveris, Gerd Jorunn M; Teige, Brita; Rogde, Sidsel

    2014-05-01

    The aim of the study was to explore differences and similarities between the various non-natural manners of death (accident, suicide, homicide) regarding toxicological findings in illicit drug users. Medicolegal autopsy reports from the Institute of Forensic Medicine University of Oslo concerning deaths from 2000 to 2009 were investigated. Those aged 20-59 whose manner of death was non-natural and who tested positive for any narcotic drug (morphine/heroin, amphetamines, ecstasy, cannabis, LSD, PCP, and high levels of GHB in addition to methadone and buprenorphine) were selected. All substance findings were registered and categorized (narcotics, ethanol, and medicinal products). Of the 1603 autopsies that met the selection criteria, 1204 were accidental intoxications, 122 accidents other than intoxication, 114 suicides by intoxication, 119 non-intoxication suicides, and 44 victims of homicide. Poly drug use was found in all manners of death. The drug profile as well as the mean number of substances (illicit drugs and medicinal products) varied from 2.9 to 4.6 substances per case, depending on the manner of death. Intoxication suicides had the highest number of substances and a total drug profile similar to accidental intoxications. Non-intoxication suicides had a total drug profile similar to homicide and accidents other than intoxication. The number of substances found per case increased during the decade, mainly due to increased findings of methadone, cannabis, amphetamines, and benzodiazepines. Methadone findings increased much more than buprenorphine. Methadone was found 20 times more often than buprenorphine in accidental intoxication cases. In summary, poly drug findings are common in adults who suffer a non-natural death while using illicit drugs. The different manners of death have some specific characteristics and significant differences regarding drug profile. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

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    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.

  8. 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.

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

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    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.

  10. Health care costs of adults treated for attention-deficit/hyperactivity disorder who received alternative drug therapies.

    Science.gov (United States)

    Wu, Eric Q; Birnbaum, Howard G; Zhang, Huabin F; Ivanova, Jasmina I; Yang, Elaine; Mallet, David

    2007-09-01

    2004 U.S. dollars using the consumer price index for medical care. T tests were used for descriptive cost comparisons. Generalized linear models (GLMs) were used to compare costs of adults receiving alternative therapies, adjusting for demographic characteristics, substance abuse, depression, and the Charlson Comorbidity Index. Of the 4,569 patients who received 1 of these 3 drug therapies for ADHD, 31.8% received OROS-MPH for a median duration of 99 days of therapy, 34.0% received MAS-XR for a median 128 days, and 34.2% received atomoxetine for a median 86 days. In the 6-month follow-up period, the mean (standard deviation) total medical and drug costs were $2,008 ($3,231) for OROS-MPH, $2,169 ($4,828) for MAS-XR, and $2,540 ($4,269) for atomoxetine-treated adults. The GLM for patient characteristics suggested that 6-month, risk-adjusted mean medical costs, excluding drug costs, for adults treated with OROS-MPH were $142 less (10.4%, $1,220 vs. $1,362) compared with MAS-XR (P =0.022) and $132 less (9.8%, $1,220 vs. $1,352) compared with atomoxetine (P =0.033); risk-adjusted mean medical costs were not significantly different between MAS-XR and atomoxetine. The GLM comparison of risk-adjusted total direct costs, including drug cost, was on average $156 less (8.0%, $1,782 vs. $1,938) for OROS-MPH compared with MAS-XR (P = 0.017) and $226 less (11.3%, $1,782 vs. $2,008) compared with atomoxetine (P costs were not significantly different between MAS-XR and atomoxetine. Two high-cost outliers (greater than 99.96th percentile, 1 each for OROS-MPH and atomoxetine) accounted for $47 (30%) of the $156 cost difference between OROS-MPH and MAS-XR and $11 (5%) of the $226 cost difference between OROS-MPH and atomoxetine, and the medical diagnoses for the highest-cost claims for these 2 outlier patients were unrelated to ADHD. After adjusting for patient characteristics including substance abuse, depression, and the Charlson Comorbidity Index, adults treated with OROS-MPH had, on

  11. Outreach nurses in Harm Reduction projects: improving acceptability and availability of medical care to drug users

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    Dvinskykh, Natalya

    2012-07-01

    Full Text Available BACKGROUND: Injection drug users (IDU remain one of the most vulnerable population segments in Ukraine, with HIV prevalence up to 22% among this group. At the same time, drug users lack access to basic health care and reportedly face stigma and discrimination from medical workers. Harm reduction projects in Ukraine partially address this problem by providing regular HIV and STI testing for their clients, and by referring them to medical institutions, where IDU can get free treatment for STI, TB, and ARV therapy for HIV. However, issues of acceptability and availability of medical care for drug users are far from being resolved. METHODS: During 2011, the new approach of ‘outreach nurses’ was piloted by All Ukrainian Harm Reduction Association (UHRA with support from ICF “International HIV/AIDS Alliance in Ukraine”. The aim of the project was to bring medical services closer to IDU by integrating work of medical professionals into a comprehensive package of Harm Reduction project services. The project employed fifteen nurses from five regions of Ukraine. During the project, nurses provided basic medical services, consultations on health improvement issues and referrals. The services were provided at the places convenient for clients: syringe exchange points, community centers, mobile clinics, and at home. RESULTS: The services of the project were well accepted by the clients. From June till December 2011 the project reached 1703 unique clients, with a total of 4525 visits (300 visits per nurse on average. For comparison, in the HR projects that employed surgeons, on average there were 58 visits per doctor (from 30 to 93 during the same period of time. CONCLUSIONS: To improve access to medical care for the drug using population Harm Reduction projects should consider including work of ‘outreach nurses’ to the package of services they provide.

  12. EMPLOYMENT-BASED ABSTINENCE REINFORCEMENT PROMOTES OPIATE AND COCAINE ABSTINENCE IN OUT-OF-TREATMENT INJECTION DRUG USERS

    OpenAIRE

    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 treatmen...

  13. Analysis of the importance of drug packaging quality for end users and pharmaceutical industry as a part of the quality management system

    Directory of Open Access Journals (Sweden)

    Lončar Irma M.

    2013-01-01

    Full Text Available In this study, we collected and analyzed information on the importance of drug packaging quality to end users and pharmaceutical industry, as an indicator of the process of traceability and originality of drugs. Two surveys were conducted: one among the end users of drugs (252 patients and the other among professionals working in seven pharmaceutical companies in Serbia. For most end users (82.5% quality on the packaging of drugs was important, but only 41.8% of them thought that the appearance of the packaging could be an indicator of genuinity of drugs. The existence of the control marks (KM on drug packaging was not of great importance, since most of them (86.9% know, its function, but majority (60.2% would nevertheless decide to buy the drug without KM. Regarding the experts from the pharmaceutical industry, more then two-thirds of them (68.4% believed that the existence of KM did not contribute to efficient operations. Although a great number of pharmaceutical industry professionals (84.2% answered that the introduction of GS1 DataMatrix system would allow for complete traceability of the drug from the manufacturer to the end user, only 22.2% of them introduced this system to their products. This study also showed that domestic producers did not have a great interest for additional protection (special inks, holograms, special graphics, smart multicolor design, watermark, chemically labeled paper and cardboard etc.. on their products, given that only 15.8 % of them had some kind of additional protection against counterfeiting. Monitoring drug traceability from a manufacturer to end user is achieved by many complex activities regulated by law. A high percentage of responders said they were satisfied with the functionality of traceability systems used in their companies. As a way to increase the quality of drug packaging and business performance most responders saw in the continuous improvement of the system of traceability within the company

  14. Pregabalin Use Among Users of Illicit Drugs: A Cross-Sectional Survey in Southern Germany.

    Science.gov (United States)

    Snellgrove, Brendan J; Steinert, Tilman; Jaeger, Susanne

    2017-10-01

    The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs). Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population. We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013. We used an extensive questionnaire, part of the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) Axis I Disorders (SCID-I) and urine samples. Of the 253 participating patients, 56% had used pregabalin at least once. Of these, 92% had acquired it at least in part from illegal sources. The main motives for the use of pregabalin were the attenuation of opioid withdrawal symptoms, the augmentation of other psychotropic substances, and the psychotropic effects of pregabalin itself. Predictors for pregabalin use were opioid and sedative use as well as younger age. The criteria of dependency according to DSM-IV was met by 11% of pregabalin users and 13% of urine samples were positive for pregabalin. Use of pregabalin is common among users of illicit drugs in large parts of southern Germany, with motives for use, acquisition, and mode of use suggesting misuse. The mode of use, especially intake of high doses and concomitant use of other drugs, poses a serious risk to this population, including the development of dependency.

  15. A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C.

    Science.gov (United States)

    Latka, Mary H; Hagan, Holly; Kapadia, Farzana; Golub, Elizabeth T; Bonner, Sebastian; Campbell, Jennifer V; Coady, Micaela H; Garfein, Richard S; Pu, Minya; Thomas, Dave L; Thiel, Thelma K; Strathdee, Steffanie A

    2008-05-01

    We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups. Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCV-positive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy. This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.

  16. Demographic and health related data of users of a mobile application to support drug adherence is associated with usage duration and intensity.

    Directory of Open Access Journals (Sweden)

    Stefan Becker

    Full Text Available A wealth of mobile applications are designed to support users in their drug intake. When developing software for patients, it is important to understand the differences between individuals who have, who will or who might never adopt mobile interventions. This study analyzes demographic and health-related factors associated with real-life "longer usage" and the "usage-intensity per day" of the mobile application "Medication Plan".Between 2010-2012, the mobile application "Medication Plan" could be downloaded free of charge from the Apple-App-Store. It was aimed at supporting the regular and correct intake of medication. Demographic and health-related data were collected via an online questionnaire. This study analyzed captured data.App-related activities of 1799 users (1708 complete data sets were recorded. 69% (1183/1708 applied "Medication Plan" for more than a day. 74% were male (872/1183, the median age 45 years. Variance analysis showed a significant effect of the users' age with respect to duration of usage (p = 0.025. While the mean duration of use was only 23.3 days for users younger than 21 years, for older users, there was a substantial increase over all age cohorts up to users of 60 years and above (103.9 days. Sex and educational status had no effect. "Daily usage intensity" was directly associated with an increasing number of prescribed medications and increased from an average of 1.87 uses per day and 1 drug per day to on average 3.71 uses per day for users stating to be taking more than 7 different drugs a day (p<0.001. Demographic predictors (sex, age and educational attainment did not affect usage intensity.Users aged 60+ as well as those with complicated therapeutic drug regimens relied on the service we provided for more than three months on average. Mobile applications may be a promising approach to support the treatment of patients with chronic conditions.

  17. User evaluations offer promise for pod-intravaginal ring as a drug delivery platform: A mixed methods study of acceptability and use experiences.

    Science.gov (United States)

    Guthrie, Kate M; Rosen, Rochelle K; Vargas, Sara E; Getz, Melissa L; Dawson, Lauren; Guillen, Melissa; Ramirez, Jaime J; Baum, Marc M; Vincent, Kathleen L

    2018-01-01

    Effective HIV prevention requires efficient delivery of safe and efficacious drugs and optimization of user adherence. The user's experiences with the drug, delivery system, and use parameters are critical to product acceptability and adherence. Prevention product developers have the opportunity to directly control a drug delivery system and its impact on acceptability and adherence, as well as product efficacy. Involvement of potential users during preclinical design and development can facilitate this process. We embedded a mixed methods user evaluation study into a safety and pharmacokinetics (PK) trial of a pod-intravaginal ring delivering antiretroviral agents. Women enrolled in two cohorts, ultimately evaluating the safety/PK of a pod-IVRs delivering TDF-alone, TDF-FTC, and/or TDF-FTC-MVC. A 7-day use period was targeted for each pod-IVR, regardless of drug or drug combination. During the clinical study, participants provided both quantitative (i.e., survey) and qualitative (i.e., in-depth interview) data capturing acceptability, perceptibility, and adherence behaviors. Initial sexual and reproductive health history surveys, daily diaries, a final acceptability and willingness to use survey, and a qualitative in-depth interview comprised the user evaluation data for each pod-IVR experienced by the participants. Overall, the majority of participants (N = 10) reported being willing to use the pod-IVR platform for HIV prevention should it advance to market. Confidence to use the pod-IVR (e.g., insertion, removal) was high. There were no differences noted in the user experience of the pod-IVR platform; that is, whether the ring delivered TDF-alone, TDF-FTC, or TDF-FTC-MVC, users' experiences of the ring were similar and acceptable. Participants did report specific experiences, both sensory and behavioral, that impacted their use behaviors with respect to the ring, and which could ultimately impact acceptability and adherence. These experiences, and user

  18. 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.

  19. 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.

  20. 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…

  1. The relationship between risk networks' patterns of crack cocaine and alcohol consumption and HIV-related sexual behaviors among adult injection drug users: a prospective study.

    Science.gov (United States)

    Latkin, C A; Mandell, W; Vlahov, D

    1996-11-01

    Social context may be an important determinant of drug and alcohol consumption and HIV-related behaviors. To assess the influence of peers on drug users' risk behaviors this study examined the association between individual level and group level behaviors. This analysis reports on the prospective association between baseline self-reported drug and alcohol use of the network members of injection drug users, and self-reported sexual behaviors and alcohol use at 5-month follow-up. Participants were a nontreatment sample of inner-city injection drug users who volunteered for a network-oriented HIV preventive intervention. They were predominantly unemployed, African American males. Of the 71 index participants who completed both the baseline and follow-up interviews, 227 of their drug network members were enrolled in the study. At baseline indexes' sexual risk behaviors were significantly associated with their drug network members' level of crack cocaine use. At follow-up higher levels of alcohol and crack use among drug network members were associated with indexes' reports of multiple sex partners and increased alcohol consumption. Higher levels of crack use among the drug network members were associated with the indexes' reporting casual sex partners at follow-up. These results highlight the importance of studying the role of peer group influence and the social context of risk behaviors.

  2. 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).

  3. 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).

  4. 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

    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...

  5. Use of drugs during lactation by users of a basic health UNIT

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    Luana Soriano Mota

    2013-05-01

    Full Text Available The objective was to identify the drugs used during lactation acompanhadas among women in a primary care unit. Quantitative study carried out with 132 lactating mothers of a basic health unit. Data were collected through a questionnaire with objective questions and subjective August-October 2011. The nursing mothers used medication along the breast feeding 105 (80%, while 27 (20% did not use any kind of medication. The drugs most commonly cited as the use were: nonsteroidal anti-inflammatory 82 (58%, contraceptives 16 (11%, antianemics 14 (11%, antibiotics 12 (9%, antihypertensive 5 (4%​​, antacids 3 (2%, among others 9 (6%. Of the mothers 77 (58.3% breastfeeding women reported not having received counseling. Medication use by nursing mothers may have repercussions for the baby because the drugs are excreted in breast milk.

  6. Seroprevalence study of HCV among hospitalized intravenous drug users in Ahvaz, Iran (2001–2006

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    Seyed Mohammad Alavi

    Full Text Available Summary: Background and aims: Prevalence of hepatitis C virus (HCV in intravenous drug users (IDU varies in different areas according to socioeconomic and geographical circumstances. The present study was performed to determine seroprevalence of HCV in IDU individuals in Ahvaz, Iran. Materials and methods: 142 IDU patients were included in this retrospective study in Ahvaz southwest Iran from 2001 to 2006. Patients were placed in two groups determined by HCV Ab positive or negative status. Data were analyzed using SPSS for Windows (version 11.5; SPSS Inc., USA software. Results: Out of total 142 cases, 74 persons (52.11% had a positive HCV-Ab test according to the ELISA method. There was no difference in age, sex, level of education, residency and co-infection with HIV and hepatitis B virus between HCV-Ab positive (HAP and HCV-Ab negative (HAN groups (p > 0.05. HCV-Ab positivity was significantly related to imprisonment and duration spent in prison [OR: 3.22, 95% (CI 2.61–3.76, p < 0.0001]. Conclusion: Patients with IDU constitute a high-risk group for acquisition of HCV infection. Transmission of HCV via sharing syringe and needle as well as blood transfusion has been a significant source of hepatitis C infection for patients with intravenous drug addiction. Keywords: Intravenous drug user, Hepatitis C virus, Seroprevalence, Ahvaz

  7. 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.

  8. DGIdb 3.0: a redesign and expansion of the drug-gene interaction database.

    Science.gov (United States)

    Cotto, Kelsy C; Wagner, Alex H; Feng, Yang-Yang; Kiwala, Susanna; Coffman, Adam C; Spies, Gregory; Wollam, Alex; Spies, Nicholas C; Griffith, Obi L; Griffith, Malachi

    2018-01-04

    The drug-gene interaction database (DGIdb, www.dgidb.org) consolidates, organizes and presents drug-gene interactions and gene druggability information from papers, databases and web resources. DGIdb normalizes content from 30 disparate sources and allows for user-friendly advanced browsing, searching and filtering for ease of access through an intuitive web user interface, application programming interface (API) and public cloud-based server image. DGIdb v3.0 represents a major update of the database. Nine of the previously included 24 sources were updated. Six new resources were added, bringing the total number of sources to 30. These updates and additions of sources have cumulatively resulted in 56 309 interaction claims. This has also substantially expanded the comprehensive catalogue of druggable genes and anti-neoplastic drug-gene interactions included in the DGIdb. Along with these content updates, v3.0 has received a major overhaul of its codebase, including an updated user interface, preset interaction search filters, consolidation of interaction information into interaction groups, greatly improved search response times and upgrading the underlying web application framework. In addition, the expanded API features new endpoints which allow users to extract more detailed information about queried drugs, genes and drug-gene interactions, including listings of PubMed IDs, interaction type and other interaction metadata.

  9. 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

  10. Comparing subjective well-being and health-related quality of life of Australian drug users in treatment in regional and rural Victoria.

    Science.gov (United States)

    Miller, Peter G; Hyder, Shannon; Zinkiewicz, Lucy; Droste, Nicolas; Harris, Jane B

    2014-11-01

    The aim of this study is to examine the self-reported subjective well-being and health-related quality of life (HRQOL) of alcohol and other drug users and to examine whether subjective well-being in this sample would be predicted by either HRQOL and/or severity of dependence. A cross-sectional survey was conducted of 201 Victorian substance users in individual targeted outpatient treatment for a variety of types of substance use. Participants were administered an interview, including the personal well-being index, the SF-8 health survey and the severity of dependence scale, in order to assess subjective well-being, the mental health component of HRQOL and severity of drug dependence respectively. Subjective well-being was predicted by mental health aspects of HRQOL (sr(2)  = 0.03) and by employment (sr(2)  = 0.05), rather than by severity of dependence [F(5, 146) = 5.60, P well-being than do the general population. Subjective well-being was predicted by mental aspects of HRQOL and not by severity of drug dependence or by physical aspects of HRQOL. Treatment which aims to improve substance users' well-being should include mental health interventions and pathways to employment. © 2014 Australasian Professional Society on Alcohol and other Drugs.

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

    Science.gov (United States)

    Pacheco, Suzy Danielly Barbosa; Silva-Oliveira, Gláucia Caroline; Maradei-Pereira, Luciana Maria Cunha; Crescente, José Ângelo Barletta; Lemos, José Alexandre Rodrigues de; Oliveira-Filho, Aldemir Branco de

    2014-01-01

    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. 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. 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. Strategies for preventing and controlling HCV transmission should be implemented among DUs.

  12. Spatial Epidemiology of HIV among Injection Drug Users in Tijuana, Mexico.

    Science.gov (United States)

    Brouwer, Kimberly C; Rusch, Melanie L; Weeks, John R; Lozada, Remedios; Vera, Alicia; Magis-Rodríguez, Carlos; Strathdee, Steffanie A

    2012-01-01

    The northwest border city of Tijuana is Mexico's fifth largest and is experiencing burgeoning drug use and human immunodeficiency virus (HIV) epidemics. Since local geography influences disease risk, we explored the spatial distribution of HIV among injection drug users (IDUs). From 2006-2007, 1056 IDUs were recruited using respondent-driven sampling, and then followed for eighteen months. Participants underwent semi-annual surveys, mapping, and testing for HIV, tuberculosis, and syphilis. Using Average Nearest Neighbor and Getis-Ord Gi* statistics, locations where participants lived, worked, bought and injected drugs were compared with HIV status and environmental and behavioral factors. Median age was thirty-seven years; 85 percent were male. Females had higher HIV prevalence than males (10.2 percent vs. 3.4 percent; p =0.001). HIV cases at baseline ( n =47) most strongly clustered by drug injection sites ( Z -Score -6.173; p light district. Spatial correlates of HIV included syphilis infection, female gender, younger age, increased hours on the street per day, and higher number of injection partners. Almost all HIV seroconverters injected within a 2.5 block radius of each other immediately prior to seroconversion. Only history of syphilis infection and female gender were strongly associated with HIV in the area where incident cases injected. Directional trends suggested a largely static epidemic until July-December 2008, when HIV spread to the southeast, possibly related to intensified violence and policing that spiked in the latter half of 2008. While clustering allows for targeting interventions, the dynamic nature of epidemics suggests the importance of mobile treatment and harm reduction programs.

  13. Spatial distribution of HIV, HCV, and co-infections among drug users in the southwestern border areas of China (2004-2014): a cohort study of a national methadone maintenance treatment program.

    Science.gov (United States)

    Li, Mingli; Li, Rongjian; Shen, Zhiyong; Li, Chunying; Liang, Nengxiu; Peng, Zhenren; Huang, Wenbo; He, Chongwei; Zhong, Feng; Tang, Xianyan; Lan, Guanghua

    2017-09-30

    A methadone maintenance treatment (MMT) program to curb the dual epidemics of HIV/AIDS and drug use has been administered by China since 2004. Little is known regarding the geographic heterogeneity of HIV and hepatitis C virus (HCV) infections among MMT clients in the resource-constrained context of Chinese provinces, such as Guangxi. This study aimed to characterize the geographic distribution patterns and co-clustered epidemic factors of HIV, HCV and co-infections at the county level among drug users receiving MMT in Guangxi Zhuang Autonomous Region, located in the southwestern border area of China. Baseline data on drug users' demographic, behavioral and biological characteristics in the MMT clinics of Guangxi Zhuang Autonomous Region during the period of March 2004 to December 2014 were obtained from national HIV databases. Residential addresses were entered into a geographical information system (GIS) program and analyzed for spatial clustering of HIV, HCV and co-infections among MMT clients at the county level using geographic autocorrelation analysis and geographic scan statistics. A total of 31,015 MMT clients were analyzed, and the prevalence of HIV, HCV and co-infections were 13.05%, 72.51% and 11.96% respectively. Both the geographic autocorrelation analysis and geographic scan statistics showed that HIV, HCV and co-infections in Guangxi Zhuang Autonomous Region exhibited significant geographic clustering at the county level, and the Moran's I values were 0.33, 0.41 and 0.30, respectively (P areas surrounding P county. HIV, HCV and co-infections among MMT clients in Guangxi Zhuang Autonomous Region all presented substantial geographic heterogeneity at the county level with a number of overlapping significant clusters. The areas surrounding P county were effective in enrolling high-risk clients in their MMT programs which, in turn, might enable people who inject drugs to inject less, share fewer syringes, and receive referrals for HIV or HCV treatment in

  14. Survival and mortality among users and non-users of hydroxyurea with sickle cell disease.

    Science.gov (United States)

    de Araujo, Olinda Maria Rodrigues; Ivo, Maria Lúcia; Ferreira Júnior, Marcos Antonio; Pontes, Elenir Rose Jardim Cury; Bispo, Ieda Maria Gonçalves Pacce; de Oliveira, Eveny Cristine Luna

    2015-01-01

    to estimate survival, mortality and cause of death among users or not of hydroxyurea with sickle cell disease. cohort study with retrospective data collection, from 1980 to 2010 of patients receiving inpatient treatment in two Brazilian public hospitals. The survival probability was determined using the Kaplan-Meier estimator, survival calculations (SPSS version 10.0), comparison between survival curves, using the log rank method. The level of significance was p=0.05. of 63 patients, 87% had sickle cell anemia, with 39 using hydroxyurea, with a mean time of use of the drug of 20.0±10.0 years and a mean dose of 17.37±5.4 to 20.94±7.2 mg/kg/day, raising the fetal hemoglobin. In the comparison between those using hydroxyurea and those not, the survival curve was greater among the users (p=0.014). A total of 10 deaths occurred, with a mean age of 28.1 years old, and with Acute Respiratory Failure as the main cause. the survival curve is greater among the users of hydroxyurea. The results indicate the importance of the nurse incorporating therapeutic advances of hydroxyurea in her care actions.

  15. Characteristics of the use of 3-MMC and other new psychoactive drugs in Slovenia, and the perceived problems experienced by users.

    Science.gov (United States)

    Sande, Matej

    2016-01-01

    The study presents the characteristics of the use of new psychoactive substances (NPS), the perceived problems experienced by users, and the reasons for cessation or cutting down. The research focused mainly on synthetic cathinones and the use of 3-MMC in Slovenia. In order to research the characteristics of NPS use, we used a questionnaire which had been developed to determine the characteristics of the use of ATS and cocaine in the context of nightlife and was elaborated in our study on the use of mephedrone. The final non-representative sample included 249 users of NPS from Slovenia, who had completed an on-line survey over a period of 5 months in 2014. Part of the sampling was conducted on the ground and with the help of peer-groups. DrogArt's outreach workers and correspondents visited open public places, clubs, and discotheques to encourage users to participate in the survey. Most users of NPS in Slovenia have tried NPS from the groups of synthetic cathinones and amphetamines. Most respondents included in the sample (67.9%) have tried 3-MMC, while 43.0% have tried methylone and 37.3% have tried mephedrone (4-MMC). Users attributed greater risks to the use of new drugs and preferred the effects of traditional drugs to those of new drugs. The most frequently reported problems were depression (55.2% of users), concentration difficulties (44.0%), damage to the mucous membrane of the nose and to the throat (39.8%), feelings of fear and anxiety (39.4%), and tingling in the arms or legs (34.4%). The main reasons for cutting down or discontinuing the use of NPS were 'fear of the health consequences', 'actual health consequences', and 'growing weary of using'. Among users of NPS, 7% have sought help, while 9.1% have considered doing so. The results also highlight differences between the NPS drug markets in Slovenia and the United Kingdom. In 2014, the most frequently used NPS in Slovenia were synthetic cathinones such as 3-MMC. Users experienced various problems

  16. 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

  17. Drug and alcohol-impaired driving among electronic music dance event attendees.

    Science.gov (United States)

    Furr-Holden, Debra; Voas, Robert B; Kelley-Baker, Tara; Miller, Brenda

    2006-10-15

    Drug-impaired driving has received increased attention resulting from development of rapid drug-screening procedures used by police and state laws establishing per se limits for drug levels in drivers. Venues that host electronic music dance events (EMDEs) provide a unique opportunity to assess drug-impaired driving among a high proportion of young adult drug users. EMDEs are late-night dance parties marked by a substantial number of young adult attendees and elevated drug involvement. No studies to date have examined drug-impaired driving in a natural environment with active drug and alcohol users. Six EMDEs were sampled in San Diego, California, and Baltimore, Maryland. A random sample of approximately 40 attendees per event were administered surveys about alcohol and other drug (AOD) use and driving status, given breath tests for alcohol, and asked to provide oral fluid samples to test for illicit drug use upon entering and exiting the events. Driving status reduced the level of alcohol use (including abstaining) but the impact on drug-taking was not significant. However, 62% of individuals who reported their intention to drive away from the events were positive for drugs or alcohol upon leaving. This suggests that these events and settings are appropriate ones for developing interventions for reducing risks for young adults.

  18. The geographic distribution patterns of HIV-, HCV- and co-infections among drug users in a national methadone maintenance treatment program in Southwest China.

    Science.gov (United States)

    Zhou, Yi-Biao; Liang, Song; Wang, Qi-Xing; Gong, Yu-Han; Nie, Shi-Jiao; Nan, Lei; Yang, Ai-Hui; Liao, Qiang; Song, Xiu-Xia; Jiang, Qing-Wu

    2014-03-10

    HIV-, HCV- and HIV/HCV co-infections among drug users have become a rapidly emerging global public health problem. In order to constrain the dual epidemics of HIV/AIDS and drug use, China has adopted a methadone maintenance treatment program (MMTP) since 2004. Studies of the geographic heterogeneity of HIV and HCV infections at a local scale are sparse, which has critical implications for future MMTP implementation and health policies covering both HIV and HCV prevention among drug users in China. This study aimed to characterize geographic patterns of HIV and HCV prevalence at the township level among drug users in a Yi Autonomous Prefecture, Southwest of China. Data on demographic and clinical characteristics of all clients in the 11 MMTP clinics of the Yi Autonomous Prefecture from March 2004 to December 2012 were collected. A GIS-based geographic analysis involving geographic autocorrelation analysis and geographic scan statistics were employed to identify the geographic distribution pattern of HIV-, HCV- and co-infections among drug users. A total of 6690 MMTP clients was analyzed. The prevalence of HIV-, HCV- and co-infections were 25.2%, 30.8%, and 10.9% respectively. There were significant global and local geographic autocorrelations for HIV-, HCV-, and co-infection. The Moran's I was 0.3015, 0.3449, and 0.3155, respectively (P geographic autocorrelation analysis and the geographic scan statistical analysis showed that HIV-, HCV-, and co-infections in the prefecture exhibited significant geographic clustering at the township level. The geographic distribution pattern of each infection group was different. HIV-, HCV-, and co-infections among drug users in the Yi Autonomous Prefecture all exhibited substantial geographic heterogeneity at the township level. The geographic distribution patterns of the three groups were different. These findings imply that it may be necessary to inform or invent site-specific intervention strategies to better devote currently

  19. Treatment of hypopituitarism in patients receiving antiepileptic drugs.

    Science.gov (United States)

    Paragliola, Rosa Maria; Prete, Alessandro; Kaplan, Peter W; Corsello, Salvatore Maria; Salvatori, Roberto

    2015-02-01

    Evidence suggests that there may be drug interactions between antiepileptic drugs and hormonal therapies, which can present a challenge to endocrinologists dealing with patients who have both hypopituitarism and neurological diseases. Data are scarce for this subgroup of patients; however, data for the interaction of antiepileptic drugs with the pituitary axis have shown that chronic use of many antiepileptic drugs, such as carbamazepine, oxcarbazepine, and topiramate, enhances hepatic cytochrome P450 3A4 (CYP3A4) activity, and can decrease serum concentrations of sex hormones. Other antiepileptic drugs increase sex hormone-binding globulin, which reduces the bioactivity of testosterone and estradiol. Additionally, the combined oestrogen-progestagen contraceptive pill might decrease lamotrigine concentrations, which could worsen seizure control. Moreover, sex hormones and their metabolites can directly act on neuronal excitability, acting as neurosteroids. Because carbamazepine and oxcarbazepine can enhance the sensitivity of renal tubules, a reduction in desmopressin dose might be necessary in patients with central diabetes insipidus. Although the effects of antiepileptic drugs in central hypothyroidism have not yet been studied, substantial evidence indicates that several antiepileptic drugs can increase thyroid hormone metabolism. However, although it is reasonable to expect a need for a thyroxine dose increase with some antiepileptic drugs, the effect of excessive thyroxine in lowering seizure threshold should also be considered. There are no reports of significant interactions between antiepileptic drugs and the efficacy of human growth hormone therapy, and few data are available for the effects of second-generation antiepileptic drugs on hypopituitarism treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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    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.

  1. 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.

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

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    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.

  3. Prisoners' views about the drugs problem in prisons, and the new Prison Service drug strategy.

    Science.gov (United States)

    Gore, S M; Bird, A G; Cassidy, J

    1999-09-01

    Three hundred and seventy-five out of 575 prisoners (222/299 drug users and 153/267 non-users) who responded to a self-completion health care questionnaire at two prisons in 1997 commented on drugs in prisons. One hundred and forty-eight out of 176 responses expressed negative opinions about mandatory drugs testing (MDT), and 107 said that MDT promoted switching to or increased use of heroin/hard drugs'. Sixty-two prisoners suggested that more help/counselling was needed for drug users, 52 segregation of drug users/drug-free wings, and 50 more security on visits/in corridors after medication. The new Prison Service drug strategy has revised random MDT. It targets those who supply drugs, and supports those who want to stop using drugs, and accords with prisoners' views about the heroin problem in prisons.

  4. Postmortem Blood Concentrations of R- and S-Enantiomers of Methadone and EDDP in Drug Users: Influence of Co-Medication and P-glycoprotein Genotype

    DEFF Research Database (Denmark)

    Buchard, Anders; Linnet, Kristian; Johansen, Sys Stybe

    2010-01-01

    We investigated toxicological and pharmacogenetic factors that could influence methadone toxicity using postmortem samples. R- and S-methadone were measured in femoral blood from 90 postmortem cases, mainly drug users. The R-enantiomer concentrations significantly exceeded that of the S-enantiome......We investigated toxicological and pharmacogenetic factors that could influence methadone toxicity using postmortem samples. R- and S-methadone were measured in femoral blood from 90 postmortem cases, mainly drug users. The R-enantiomer concentrations significantly exceeded that of the S...

  5. 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.

  6. Employment-Based Reinforcement of Adherence to Oral Naltrexone Treatment in Unemployed Injection Drug Users

    OpenAIRE

    Dunn, Kelly; 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

    2012-01-01

    Naltrexone has high potential for use as a relapse prevention pharmacotherapy for opiate dependence; however suffers from notoriously poor adherence when prescribed for oral self-administration. This study evaluated whether entry to a therapeutic workplace could be used to 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 fo...

  7. Predictors of incident and recurrent participation in the sale or delivery of drugs for profit amongst young methamphetamine users in Chiang Mai Province, Thailand, 2005-2006.

    Science.gov (United States)

    Latimore, Amanda D; Rudolph, Abby; German, Danielle; Sherman, Susan G; Srirojn, Bangorn; Aramrattana, Apinun; Celentano, David D

    2011-07-01

    Despite Thailand's war on drugs, methamphetamine ("yaba" in Thai) use and the drug economy both thrive. This analysis identifies predictors of incident and recurrent involvement in the sale or delivery of drugs for profit amongst young Thai yaba users. Between April 2005 and June 2006, 983 yaba users, ages 18-25, were enrolled in a randomized behavioural intervention in Chiang Mai Province (415 index and 568 of their drug network members). Questionnaires administered at baseline, 3-, 6-, 9-, and 12-month follow-up visits assessed socio-demographic factors, current and prior drug use, social network characteristics, sexual risk behaviours and drug use norms. Exposures were lagged by three months (prior visit). Outcomes included incident and recurrent drug economy involvement. Generalized linear mixed models were fit using GLIMMIX (SASv9.1). Incident drug economy involvement was predicted by yaba use frequency (adjusted odds ratio [AOR]: 1.05; 95% confidence interval [CI]: 1.01, 1.10), recent incarceration (AOR: 2.37; 95% CI: 1.07, 5.25) and the proportion of yaba-using networks who quit recently (AOR: .34; 95% CI: .15, .78). Recurrent drug economy involvement was predicted by age (AOR: 0.81; 95% CI: 0.68, 0.96), frequency of yaba use (AOR: 1.06; 95% CI: 1.02, 1.09), drug economy involvement at the previous visit (AOR: 2.61; CI: 1.59, 4.28), incarceration in the prior three months (AOR: 2.29; 95% CI: 1.07, 4.86), and the proportion of yaba-users in his/her network who quit recently (AOR: .38; 95% CI: .20, .71). Individual drug use, drug use in social networks and recent incarceration were predictors of incident and recurrent involvement in the drug economy. These results suggest that interrupting drug use and/or minimizing the influence of drug-using networks may help prevent further involvement in the drug economy. The emergence of recent incarceration as a predictor for both models highlights the need for more appropriate drug rehabilitation programmes and

  8. 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.

  9. Health care service utilization and associated factors among heroin users in northern Taiwan.

    Science.gov (United States)

    Chen, Yi-Chih; Chen, Chih-Ken; Lin, Shih-Ku; Chiang, Shu-Chuan; Su, Lien-Wen; Wang, Liang-Jen

    2013-11-01

    Due to the needs of medical care, the probability of using health care service from heroin users is high. This cross-sectional study investigated the frequency and correlates of health service utilization among heroin users. From June to September 2006, 124 heroin users (110 males and 14 females, mean age: 34.2 ± 8.3 years) who entered two psychiatric hospitals (N = 83) and a detention center (N = 41) in northern Taiwan received a face-to-face interview. Therefore, socio-demographic characteristics, patterns of drug use, psychiatric comorbidities, blood-borne infectious diseases and health service utilization were recorded. The behaviors of health service utilization were classified into the frequency of out-patient department visit and hospitalization, as well as the purchase of over-the-counter drugs. During 12 months prior to interview, 79.8% of the participants attended health care service at least once. The rate of having any event in out-patients service visit, hospitalization, and over-the-counter drugs were 66.1%, 29.8% and 25.8% respectively. The frequency of health service utilization was associated with numerous factors. Among these factors, patients who were recruited from hospital and having a mood disorder were conjoint predictors of out-patient department visit, hospitalization and purchase of over-the-counter drugs. According to the results of this study, social education and routine screening for mood disorders can help heroin users to obtain adequate health care service. The findings of this study are useful references for targeting the heroin users for whom a successful intervention represents the greatest cost benefit. © 2013 Elsevier Ltd. All rights reserved.

  10. 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

  11. Opportunities for AIDS prevention in a rural state in criminal justice and drug treatment settings.

    Science.gov (United States)

    Farabee, D; Leukefeld, C G

    1999-01-01

    This study examined the likelihood that drug users would receive HIV/ AIDS prevention information and supplies (e.g., condoms and bleach) in the rural state of Kentucky. Despite evidence of high HIV risk among criminal justice and substance-using populations, incarceration and substance-user treatment were only minimally associated with prior HIV prevention exposure or HIV testing. These data strongly support the use of criminal justice and treatment settings to provide AIDS prevention interventions for the high-risk drug-using populations they serve, and to target HIV prevention services in rural as well as urban areas.

  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. Stigmatization of alcohol and other drug users by primary care providers in Southeast Brazil.

    Science.gov (United States)

    Ronzani, Telmo Mota; Higgins-Biddle, John; Furtado, Erikson F

    2009-10-01

    This study reports on the views of Primary Health Care (PHC) providers in Southeast Brazil on the use of alcohol and other drugs which reflect stigma, moralization, or negative judgment. Six hundred nine PHC professionals from the Brazilian states of São Paulo and Minas Gerais took part in the study. The majority (86.5%) of these professionals were female. Attitudes toward the use of alcohol and other drugs were evaluated in comparison to Hansen's disease, obesity, depression, schizophrenia, HIV/AIDS, and tobacco use. The use of tobacco, marijuana/cocaine, and alcohol were the most negatively judged behaviors (p health care workers demonstrated the severest judgment of alcohol use. In addition, marijuana/cocaine addicts and alcoholics suffered the highest rate of rejection by professionals. The hypothesis that the use of alcohol and other drugs is a behavior stigmatized by health professionals being confirmed, it is important to develop strategies for changing provider attitudes in order to provide a higher quality of service to these patients. This study is important as a first study among PHC professionals about social stigma of alcohol and other drugs users.

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

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    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.

  15. Injecting Drug Users and Their Health Seeking Behavior: A Cross-Sectional Study in Dhaka, Bangladesh

    Directory of Open Access Journals (Sweden)

    Sheikh Mohammed Shariful Islam

    2015-01-01

    Full Text Available Introduction and Aim. Injecting drug users (IDUs are amongst the most vulnerable people to acquisition of HIV/AIDS. This study aims to collect information on IDUs and their health seeking behavior in Bangladesh. Design and Methods. A cross-sectional study was conducted among 120 IDUs attending a drug rehabilitation center in Dhaka, Bangladesh. Data were collected on sociodemographics, drug use, health seeking behavior, knowledge of injecting drugs, and sexual behavior. Results. The mean ± SD and median (IQR age of the participants were 32.5±21.3 and 33 (27–38 years, respectively, with only 9.2% females. Injection buprenorphine was the drug of choice for 40% of participants, and 58% of the participants first started drug use with smoking cannabis. 73.3% of participants shared needles sometimes and 57.5% were willing to use the needle exchange programs. 60% of the participants had no knowledge about the diseases spread by injection. Condom use during the last intercourse with regular partners was 11.7% and with any partners 15.8%. Conclusion. IDUs in Bangladesh are a high-risk group for HIV/AIDS due to lack of knowledge and risky behaviors. Education and interventions specifically aimed at IDUs are needed, because traditional education may not reach IDUs or influence their behavior.

  16. Decreased Risk of Squamous Cell Carcinoma of the Head and Neck in Users of Nonsteroidal Anti-Inflammatory Drugs

    Directory of Open Access Journals (Sweden)

    Neda Ahmadi

    2010-01-01

    Full Text Available We evaluated the chemopreventive effect of nonsteroidal anti-inflammatory drug (NSAID use in head and neck squamous cell carcinomas (HNSCC by conducting a case-control study based on the administration of a standardized questionnaire to 71 incident HNSCC cases and same number of healthy controls. NSAID use was associated with a 75% reduction in risk of developing HNSCC. A significant risk reduction was noted in association with frequency of NSAID use. Restricting the analysis to aspirin users revealed a significant 90% reduction in risk of developing HNSCC. This study provides evidence for a significant reduction in the risk of developing HNSCC in users of NSAIDs, and specifically aspirin users.

  17. Incarcerated intravenous heroin users: predictors of post-release utilization of methadone maintenance treatment.

    Science.gov (United States)

    Lin, Huang-Chi; Wang, Peng-Wei; Yang, Yi-Hsin; Tsai, Jih-Jin; Yen, Cheng-Fang

    2016-01-01

    Incarcerated intravenous heroin users have more problematic patterns of heroin use, but are less likely to access methadone maintenance treatment by their own initiative than heroin users in the community. The present study examined predictors for receiving methadone maintenance treatment post-release among incarcerated intravenous heroin users within a 24-month period. This cohort study recruited 315 incarcerated intravenous heroin users detained in 4 prisons in southern Taiwan and followed up within the 24-month period post-release. Cox proportional hazards regression analysis was applied to determine the predictive effects of sociodemographic and drug-use characteristics, attitude toward methadone maintenance treatment, human immunodeficiency virus serostatus, perceived family support, and depression for access to methadone maintenance treatment after release. There were 295 (93.7%) incarcerated intravenous heroin users released that entered the follow-up phase of the study. During the 24-month follow-up period, 50.8% of them received methadone maintenance treatment. After controlling for the effects of the detainment period before and after recruitment by Cox proportional hazards regression analysis, incarcerated intravenous heroin users who had positive human immunodeficiency virus serostatus (HR = 2.85, 95% CI = 1.80-4.52, p maintenance treatment before committal (HR = 1.94, 95% CI = 1.23-3.05, p maintenance treatment within the 24-month follow-up period. Positive human immunodeficiency virus serostatus with fully subsidized treatment and previous methadone maintenance treatment experiences predicted access of methadone maintenance treatment post-release. Strategies for getting familiar with methadone maintenance treatment during detainment, including providing methadone maintenance treatment prior to release and lowering the economic burden of receiving treatment, may facilitate entry of methadone maintenance treatment for incarcerated intravenous heroin

  18. A Peer-Educator Network HIV Prevention Intervention Among Injection Drug Users: Results of a Randomized Controlled Trial in St. Petersburg, Russia

    Science.gov (United States)

    Latkin, Carl A.; Kukhareva, Polina V.; Malov, Sergey V.; Batluk, Julia V.; Shaboltas, Alla V.; Skochilov, Roman V.; Sokolov, Nicolay V.; Verevochkin, Sergei V.; Hudgens, Michael G.; Kozlov, Andrei P.

    2014-01-01

    We evaluated the efficacy of a peer-educator network intervention as a strategy to reduce HIV acquisition among injection drug users (IDUs) and their drug and/or sexual networks. A randomized controlled trial was conducted in St. Petersburg, Russia among IDU index participants and their risk network participants. Network units were randomized to the control or experimental intervention. Only the experimental index participants received training sessions to communicate risk reduction techniques to their network members. Analysis includes 76 index and 84 network participants who were HIV uninfected. The main outcome measure was HIV sero-conversion. The incidence rates in the control and experimental groups were 19.57 (95 % CI 10.74–35.65) and 7.76 (95 % CI 3.51–17.19) cases per 100 p/y, respectively. The IRR was 0.41 (95 % CI 0.15–1.08) without a statistically significant difference between the two groups (log rank test statistic X2 = 2.73, permutation p value = 0.16). Retention rate was 67 % with a third of the loss due to incarceration or death. The results show a promising trend that this strategy would be successful in reducing the acquisition of HIV among IDUs. PMID:23881187

  19. Characterization of new users of cilostazol in the UK, Spain, Sweden, and Germany.

    Science.gov (United States)

    Castellsague, Jordi; Perez-Gutthann, Susana; Calingaert, Brian; Bui, Christine; Varas-Lorenzo, Cristina; Arana, Alejandro; Prados-Torres, Alexandra; Poblador-Plou, Beatriz; Gonzalez-Rubio, Francisca; Giner-Soriano, Maria; Roso-Llorach, Albert; Linder, Marie; Citarella, Anna; Scholle, Oliver; Blenk, Tilo; Garbe, Edeltraut

    2017-06-01

    To describe the characteristics of new users of cilostazol in Europe with the aim to support the evaluation of its benefit/risk as used in regular clinical practice before the implementation of labeling changes recommended by the European Medicines Agency. New users of cilostazol were identified in populations enrolled in five European health automated databases in the UK (The Health Improvement Network [THIN]), Spain (EpiChron cohort and Information System for the Improvement of Research in Primary Care [SIDIAP]), Sweden (National Registers), and Germany (German Pharmacoepidemiological Research Database [GePaRD]) between 2002 and 2012. New users were characterized according to the prevalence of cardiovascular disease and other comorbidities, concurrent use of interacting medications, new contraindications, duration of use, and potential off-label prescribing. We identified 22 593 new users of cilostazol. The median age was between 68.0 (THIN) and 73.7 (Sweden) years. More than 78% of users had concomitant cardiovascular disease, and between 78.8% (GePaRD) and 91.6% (THIN) were treated with interacting medications. Prevalence of new cardiovascular contraindications ranged from 1.5% (THIN) to 11.6% (GePaRD), and concurrent use of two or more antiplatelet drugs ranged from 6.3% (SIDIAP) to 13.5% (EpiChron cohort). Between 39.4% (Sweden) and 52.9% (THIN) of users discontinued cilostazol in the first 3 months. Between 41.0% (SIDIAP) and 93.4% (THIN) were considered to have received cilostazol according to the European Medicines Agency labeling. In this collaborative European study, most cilostazol users were elderly patients with a high prevalence of cardiovascular diseases and other comorbidity and concurrent use of interacting drugs, indicating that this is a vulnerable population at high risk of complications, especially cardiovascular events. © 2017 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd. © 2017 The Authors

  20. 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…

  1. Dental Disease Prevalence among Methamphetamine and Poly-drug Users in an Urban Setting: A Pilot Study

    Science.gov (United States)

    Brown, Carolyn; Krishnan, Sumathi; Hursh, Kevin; Yu, Michelle; Johnson, Paul; Page, Kimberly; Shiboski, Caroline H.

    2013-01-01

    Background/Objectives Rampant tooth decay has been reported among methamphetamine users. We investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared to heroin users. Methods This pilot project is a cross-sectional study of an on-going cohort of young adult injection-drug users (IDUs) in San Francisco. An oral health questionnaire was administered by a research-assistant, and two dentists performed clinical examinations to record the Decayed-Missing-Filled-Surfaces (DMFS) index, presence of residual roots, the Simplified Oral Hygiene Index, and salivary hypofunction. Results The prevalence of dental disease among 58 young adult IDUs was strikingly high compared to the U.S. general population, however, there was no difference in the level of dental disease between the methamphetamine and heroin users in this study. The mean DMFS and number of decayed surfaces exceeded 28 in both groups. Conclusions While no difference in dental disease between methamphetamine and heroin users was detected, we found a high prevalence of caries and caries-associated behaviors in this sample of young adult IDUs. Clinical Implications Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventative measures (e.g., distribution of chlorhexidine rinses, xylitol gum, application of fluoride varnishes) through outreach workers. PMID:22942146

  2. [Designer drugs in Jutland].

    Science.gov (United States)

    Simonsen, K W; Kaa, E

    2001-04-16

    The aim of this investigation was to examine illegal tablets and capsules seized in Jutland, the western part of Denmark, during the period 1995-1999. The drugs are described according to technical appearance (colour, logo, score, diameter) and content of synthetic drugs. All illegal tablets and capsules received during the period 1995-1999 (109 cases containing 192 different samples) were examined. MDMA was the most common drug and was seen during the entire period. Amphetamine was the second most common drug and has been frequently detected during the the last two years. Drugs like MDE, MBDB, BDB, and 2-CB were rarely seen and they disappeared quickly from the illegal market. MDA appeared on the market at the end of 1999. Only 53% of the tablets contained MDMA as the sole drug. Eighty-one percent of the tablets/capsules contained only one synthetic drug, whereas 13% contained a mixture of two or more synthetic drugs. Six per cent of the samples did not contain a euphoric drug/designer drug. The content of MDMA, MDE, and amphetamine in the tablets varied greatly. MDMA is apparently the drug preferred by the users, but still only half of the tablets contained MDMA as the only drug. The rest of the tablets contained either another synthetic drug or a mixture of drugs. In conclusion, the increasing supply of various drugs with different and unpredictable effects and of miscellaneous quality brings about the risk of serious and complicated intoxications.

  3. Plasma HIV-1 RNA viral load rebound among people who inject drugs receiving antiretroviral therapy (ART) in a Canadian setting: an ethno-epidemiological study.

    Science.gov (United States)

    Small, Will; Milloy, M J; McNeil, Ryan; Maher, Lisa; Kerr, Thomas

    2016-01-01

    People who inject drugs (PWID) living with HIV often experience sub-optimal antiretroviral therapy (ART) treatment outcomes, including HIV plasma viral load (PVL) rebound. While previous studies have identified risk factors for PVL rebound among PWID, no study has examined the perspectives of PWID who have experienced PVL rebound episodes. We conducted an ethno-epidemiological study to investigate the circumstances surrounding the emergence of rebound episodes among PWID in Vancouver, BC, Canada. Comprehensive clinical records linked to a community-based prospective observational cohort of HIV-positive drug users were used to identify PWID who had recently experienced viral rebound. In-depth qualitative interviews with 16 male and 11 female participants explored participant perspectives regarding the emergence of viral rebound. A timeline depicting each participant's HIV viral load and adherence to ART was used to elicit discussion of circumstances surrounding viral rebound. Viral rebound episodes were shaped by interplay between various individual, social, and environmental factors that disrupted routines facilitating adherence. Structural-environmental influences resulting in non-adherence included housing transitions, changes in drug use patterns and intense drug scene involvement, and inadequate care for co-morbid health conditions. Social-environmental influences on ART adherence included poor interactions between care providers and patients producing non-adherence, and understandings of HIV treatment that fostered intentional treatment discontinuation. This study describes key pathways which led to rebound episodes among PWID receiving ART and illustrates how environmental forces may increase vulnerability for non-adherence leading to treatment failure. Our findings have potential to help inform interventions and supports that address social-structural forces that foster non-adherence among PWID.

  4. Identifying programmatic gaps: inequities in harm reduction service utilization among male and female drug users in Dar es Salaam, Tanzania.

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    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.

  5. Identifying Programmatic Gaps: Inequities in Harm Reduction Service Utilization among Male and Female Drug Users in Dar es Salaam, Tanzania

    Science.gov (United States)

    Lambdin, Barrot H.; Bruce, R. Douglas; Chang, Olivia; Nyandindi, Cassian; Sabuni, Norman; Zamudio-Haas, Sophia; McCurdy, Sheryl; Masao, Frank; Ivo, Yovin; Msami, Amani; Ubuguy, Omar; Mbwambo, Jessie

    2013-01-01

    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. PMID:23825620

  6. Drug injecting and HIV risk among injecting drug users in Hai Phong, Vietnam: a qualitative analysis.

    Science.gov (United States)

    Ahmed, Tanvir; Long, Thanh Nguyen; Huong, Phan Thi; Stewart, Donald Edwin

    2015-01-29

    Hai Phong, located in northern Vietnam, has become a high HIV prevalence province among Injecting Drug Users (IDUs) since the infection shifted from the southern to the northern region of the country. Previous research indicates high levels of drug and sex related risk behaviour especially among younger IDUs. Our recent qualitative research provides a deeper understanding of HIV risk behaviour and highlights views and experiences of IDUs relating to drug injecting and sharing practices. Fifteen IDUs participated in semi-structured interviews conducted in September-October, 2012. Eligible participants were selected from those recruited in a larger scale behavioural research project and identified through screening questions. Interviews were conducted by two local interviewers in Vietnamese and were audiotaped. Ethical procedures, including informed consent and participants' understanding of their right to skip and withdraw, were applied. Transcripts were translated and double checked. The data were categorised and coded according to themes. Thematic analysis was conducted and a qualitative data analysis thematic framework was used. Qualitative analysis highlighted situational circumstances associated with HIV risks among IDUs in Hai Phong and revealed three primary themes: (i) places for injecting, (ii) injecting drugs in small groups, and (iii) sharing practices. Our results showed that shared use of jointly purchased drugs and group injecting were widespread among IDUs without adequate recognition of these as HIV risk behaviours. Frequent police raids generated a constant fear of arrest. As a consequence, the majority preferred either rail lines or isolated public places for injection, while some injected in their own or a friend's home. Price, a heroin crisis, and strong group norms encouraged collective preparation and group injecting. Risk practices were enhanced by a number of factors: the difficulty in getting new syringes, quick withdrawal management

  7. Spatial Epidemiology of HIV among Injection Drug Users in Tijuana, Mexico

    Science.gov (United States)

    Brouwer, Kimberly C.; Rusch, Melanie L.; Weeks, John R.; Lozada, Remedios; Vera, Alicia; Magis-Rodríguez, Carlos; Strathdee, Steffanie A.

    2012-01-01

    The northwest border city of Tijuana is Mexico’s fifth largest and is experiencing burgeoning drug use and human immunodeficiency virus (HIV) epidemics. Since local geography influences disease risk, we explored the spatial distribution of HIV among injection drug users (IDUs). From 2006–2007, 1056 IDUs were recruited using respondent-driven sampling, and then followed for eighteen months. Participants underwent semi-annual surveys, mapping, and testing for HIV, tuberculosis, and syphilis. Using Average Nearest Neighbor and Getis-Ord Gi* statistics, locations where participants lived, worked, bought and injected drugs were compared with HIV status and environmental and behavioral factors. Median age was thirty-seven years; 85 percent were male. Females had higher HIV prevalence than males (10.2 percent vs. 3.4 percent; p=0.001). HIV cases at baseline (n=47) most strongly clustered by drug injection sites (Z-Score −6.173; p < 0.001), with a 16 km2 hotspot near the Mexico/U.S. border, encompassing the red-light district. Spatial correlates of HIV included syphilis infection, female gender, younger age, increased hours on the street per day, and higher number of injection partners. Almost all HIV seroconverters injected within a 2.5 block radius of each other immediately prior to seroconversion. Only history of syphilis infection and female gender were strongly associated with HIV in the area where incident cases injected. Directional trends suggested a largely static epidemic until July–December 2008, when HIV spread to the southeast, possibly related to intensified violence and policing that spiked in the latter half of 2008. While clustering allows for targeting interventions, the dynamic nature of epidemics suggests the importance of mobile treatment and harm reduction programs. PMID:23606753

  8. High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia

    Science.gov (United States)

    Toussova, Olga V.; Verevochkin, Sergei V.; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P.

    2011-01-01

    The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting. PMID:18843531

  9. Baseline HCV Antibody Prevalence and Risk Factors among Drug Users in China's National Methadone Maintenance Treatment Program.

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    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.

  10. To give is better than to receive: compliance with WHO guidelines for drug donations during 2000-2008.

    Science.gov (United States)

    Bero, Lisa; Carson, Brittany; Moller, Helene; Hill, Suzanne

    2010-12-01

    to assess drug donations in terms of their adherence to the drug donation guidelines put forth by the World Health Organization (WHO). in 2009 we searched the academic and lay literature - journal articles, media articles and industry and donor web sites - to identify reports about drug donations made from 2000 to 2008. Publications focusing on molecular mechanisms of drug action, general descriptions of guidelines or specific one-time drug donations before 2000 were excluded. For cases with sufficient information, we assessed compliance with each of the 12 articles of WHO's guidelines. we found 95 articles describing 96 incidents of drug donations between 2000 and 2008. Of these, 50 were made in response to disaster situations, 43 involved the long-term donation of a drug to treat a specific disease and 3 were drug recycling cases. Disaster-related donations were less likely to comply with the guidelines, particularly in terms of meeting the recipient's needs, quality assurance and shelf-life, packaging and labelling, and information management. Recipient countries were burdened with the costs of destroying the drugs received through inappropriate donations. Although long-term donations were more likely to comply with WHO guidelines related to quality assurance and labelling, they did not consistently meet the needs of the recipients. Furthermore, they discouraged local drug production and development. drug donations can do more harm than good for the recipient countries. Strengthening the structures and systems for coordinating and monitoring drug donations and ensuring that these are driven by recipient needs will improve adherence to the drug donation guidelines set forth by WHO.

  11. The prevalence of visual symptoms in poppers users: a global survey.

    Science.gov (United States)

    Davies, Andrew J; Borschmann, Rohan; Kelly, Simon P; Ramsey, John; Ferris, Jason; Winstock, Adam R

    2017-01-01

    The use of 'poppers' (volatile alkyl nitrites) has been associated with the development of visual symptoms secondary to the development of maculopathy. There are currently no data regarding the prevalence of this condition among poppers users. The aim of this study was to quantify the presence of visual symptoms among poppers users from a global cohort. The Global Drug Survey (GDS) conducts annual anonymous online surveys of drug and alcohol use. Within the 2012 GDS, questions were inserted regarding the presence of visual symptoms in poppers users. The GDS received a total of 21 575 valid responses, with a total of 17 479 from the UK, Australia, USA and Eurozone. Within these areas, 5152 (29.5%) had used poppers within their lifetime and 1322 (7.6%) within the previous year. Of the 'last year' users, when asked the question: 'Do you think poppers use has affected your eyesight?', 29 (2.2%) people responded 'yes', 130 (10.0%) responded 'maybe' and 1146 (87.8%) responded 'no (17 people did not answer). Both multiple choice and free-text responses regarding the nature of visual symptoms correlated with the central visual disturbance that would be expected from maculopathy. There was significant increased symptom prevalence with age (likelihood ratio (χ 2 )=19.0; ppoppers users have visual symptoms. Clinical correlation is required to determine whether these reported symptoms are due to poppers associated maculopathy, or an alternative cause.

  12. Unexpectedly high proportion of drug users and men having sex with men who develop chronic hepatitis B infection

    NARCIS (Netherlands)

    van Houdt, Robin; Bruisten, Sylvia M.; Speksnijder, Arjen G. C. L.; Prins, Maria

    2012-01-01

    Background & Aims: In low endemic countries, most hepatitis B virus (HBV) infections are found in adult behavioural risk groups, such as drug users (DU) and men having sex with men (MSM). These risk groups are frequently exposed to HBV, which might induce a different rate of viral clearance compared

  13. Teens and Prescription Drugs: An Analysis of Recent Trends on the Emerging Drug Threat

    Science.gov (United States)

    Office of National Drug Control Policy, 2007

    2007-01-01

    This report synthesizes a number of national studies that show the intentional abuse of prescription drugs to get high is a growing concern, particularly among teens. The analysis shows that teens are turning away from street drugs and using prescription drugs to get high. New users of prescription drugs have caught up with new users of marijuana.…

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

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    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.

  15. Assessment tools for the measurement of the self-efficacy of drug users: protocol for a systematic review.

    Science.gov (United States)

    Vasconcelos, Selene Cordeiro; Frazão, Iracema da Silva; Sougey, Everton Botelho; Souza, Sandra Lopes de; Silva, Tatiana de Paula Santana da; Lima, Murilo Duarte da Costa

    2018-03-14

    The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers. This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations. The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be performed in the PsycINFO, Cochrane, Pubmed, Web of Science, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria for the articles will be (1) assessment tool validation studies; (2) assessment tools developed to measure self-efficacy; (3) quantitative measures; (4) measures designed for use on adults; (5) data from self-reports of the participants; (6) studies involving a description of psychometric properties of the measures; and (7) studies that explain how the level of self-efficacy is scored. The search, selection and analysis will be performed by two independent reviewers. In cases of a divergence of opinion, a third reviewer will be consulted. The COSMIN checklist will be used for the appraisal of the methodological quality of the assessment tools and the certainty of the evidence in the articles (risk of bias) will be analysed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. This protocol does not require ethical approval. However, this protocol is part of the thesis entitled Drug-Taking Confidence Questionnaire for use in Brazil, presented for obtaining a doctorate in neuropsychiatry and behavioural sciences from the Federal University of Pernambuco, and has received approval from the human research ethics committee of the Federal

  16. Low Non-structured Antiretroviral Therapy Interruptions in HIV-Infected Persons Who Inject Drugs Receiving Multidisciplinary Comprehensive HIV Care at an Outpatient Drug Abuse Treatment Center.

    Science.gov (United States)

    Vallecillo, Gabriel; Mojal, Sergio; Roquer, Albert; Samos, Pilar; Luque, Sonia; Martinez, Diana; Martires, Paula Karen; Torrens, Marta

    2016-05-01

    Continuous HIV treatment is necessary to ensure successful combined antiretroviral therapy (cART). The aim of this study was to evaluate the incidence of patient-initiated non-structured treatment interruptions in HIV-infected persons who inject drugs and who received a multidisciplinary comprehensive program, including medical HIV care, drug-dependence treatment and psychosocial support, at a drug outpatient addiction center. Non-structured treatment interruptions were defined as ≥30 consecutive days off cART without medical indication. During a median follow-up of 53.8 months, 37/132 (28 %) patients experienced the first non-structured treatment interruptions. The cumulative probability of cART interruption at 5 years was 31.2 % (95 % CI 22.4-40.0). Current drug use injection ≥1/day (HR 14.77; 95 % CI 5.90-36.96) and cART naive patients (HR 0.35, 95 % CI 0.14-0.93) were predictive factors for non-structured treatment interruptions. HIV care provided at a drug addiction center is a useful strategy to sustain continuous cART, however, drug abstinence is essential for the long-term maintenance of cART.

  17. Rhizobium radiobacter Endocarditis in an Intravenous Drug User: Clinical Presentation, Diagnosis, and Treatment.

    Science.gov (United States)

    Zahoor, Bilal A

    2016-08-01

    Rhizobium radiobacter, a soil-based organism, is not, usually, pathogenic unless in the immunecompromised. Endocarditis, in the immunocompromised, is a typical presentation generally as a result of catheter-based infections. We describe the presentation of R. radiobacter prosthetic valve endocarditis and the inherent challenges in its presentation and diagnosis. A patient presented with acute limb ischemia secondary to R. radiobacter-mediated endocarditis and subsequent thromboembolization of the distal superior femoral and proximal popliteal arteries in the left lower limb. He underwent an uneventful thrombolectomy that restored blood flow distal to the occlusion and restored the patency of the affected arteries. Postoperatively, the patient maintained several unexplained febrile episodes. Blood cultures remained negative for infection. A cardiac work-up demonstrated the presence of vegetative growth on the prosthetic mitral and native aortic valves. Histopathologic analysis of the extracted thrombus confirmed the presence of R. radiobacter. On further history, it was elucidated that the patient was an intravenous drug user who routinely stored drug paraphernalia in plant beds. The patient recovered uneventfully after Piptazobactam was administered. R. radiobacter, and similarly other soil-based pathogens, should be considered as a potential source of endocarditic infection and thromboembolization in patients who similarly describe a history of intravenous drug use. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. HIV risk, health, and social characteristics of sexual minority female injection drug users in Baltimore

    OpenAIRE

    German, Danielle; Latkin, Carl A.

    2015-01-01

    Female injection drug users {IDU} who report sex with women are at increased risk for HIV and social instability, but it is important to assess whether these disparities also exist according to sexual minority identity rather than behaviorally defined categories. Within a sample of current IDU in Baltimore, about 17% of female study participants (n=307) identified as gay/lesbian/bisexual. In controlled models, sexual minorities were three times as likely to report sex exchange behavior and fo...

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

    OpenAIRE

    Pacheco,Suzy Danielly Barbosa; Silva-Oliveira,Gláucia Caroline; Maradei-Pereira,Luciana Maria Cunha; Crescente,José Ângelo Barletta; Lemos,José Alexandre Rodrigues de; Oliveira-Filho,Aldemir Branco de

    2014-01-01

    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 infec...

  20. New benzodiazepine and Z-hypnotic users and disability pension: an eight-year nationwide observational follow-up study.

    Science.gov (United States)

    Tvete, Ingunn F; Bjørner, Trine; Skomedal, Tor

    2017-09-01

    To compare how newly initiated treatment with benzodiazepines, Z-hypnotics or both associates with the reception of disability pension among 40,661 individuals of a working age. Prescription register study. Norwegian nationwide prescriptions socio-economic and disability status data. Cox regression analyses. New benzodiazepine or Z-hypnotic users. Time to receive disability pension given benzodiazepine or Z-hypnotic use or both. Additional analyses focused on the benzodiazepine first redeemed. Among new users 8.65% of Z-hypnotic users, 12.29% of benzodiazepines users and 13.96% of combined Z-hypnotic and benzodiazepine users became disability pensioners. Z-hypnotic users were weaker associated with becoming disability pensioners (HR = 0.78, CI: 0.73-0.84) and combined users were stronger associated (HR = 1.09, CI: 1.01-1.17), than benzodiazepine users. Women had higher risk than men for becoming disability pensioners. Higher age, lower education, previous drug use and psychiatrist as first prescriber were risk factors. Comparing first benzodiazepine redeemed; clonazepam initiators were stronger associated with becoming disability pensioners than diazepam initiators were (HR = 2.22, CI: 1.81-2.71). No differences between other benzodiazepine users were found. Adjusting for known risk factors gave lower risk for Z-hypnotic users compared to benzodiazepine users for receiving disability pension. Combined use increased the risk further. Clonazepam initiators are especially at risk. These findings may be helpful in prescribing situations to identify and guide individuals at risk for becoming disability pensioners.

  1. Prevalence of hepatitis C virus and HIV infection among injection drug users in two Mexican cities bordering the U.S

    OpenAIRE

    White, Emily Faye; Garfein, Richard S.; Brouwer, Kimberly C; Lozada, Remedios; Ramos, Rebeca; Firestone-Cruz, Michelle; Pérez, Saida G; Magis-Rodríguez, Carlos; Conde-Glez, Carlos J; Strathdee, Steffanie A

    2007-01-01

    OBJECTIVE: To estimate the prevalence of the hepatitis C virus (HCV) and HIV infection and associated risk behaviors among injection drug users (IDUs) in two northern Mexican cities. MATERIAL AND METHODS: Between February and April 2005, IDUs were recruited in Tijuana (N=222) and Ciudad Juarez (N=206) using respondent-driven sampling (RDS), a chain referral sampling approach. Interviewer-administered questionnaires assessed drug-using behaviors during the prior six months. Venous blood was co...

  2. Employment-based Reinforcement of Adherence to Oral Naltrexone in Unemployed Injection Drug Users: 12-month Outcomes

    OpenAIRE

    Dunn, Kelly; 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

    2014-01-01

    Oral naltrexone could be a promising relapse prevention pharmacotherapy for recently detoxified opioid-dependent patients, however interventions are often needed to promote adherence with this treatment approach. We recently conducted a study to evaluate a 26-week employment-based reinforcement intervention of oral naltrexone in unemployed injection drug users (Dunn et al., 2013). Participants were randomly assigned into a Contingency (n=35) group required to ingest naltrexone under staff obs...

  3. Early stages of the HIV epidemic among injecting drug users: Lessons to be learned

    Directory of Open Access Journals (Sweden)

    Tanvir Ahmed

    2014-09-01

    Full Text Available Injecting drug use driving the HIV epidemic is currently a major global public health concern. However, the early epidemic among injecting drug users (IDUs, more than three decades ago, was only concentrated in few places. The HIV epidemic among the IDUs in New York, USA; Edinburgh, Scotland, UK; and northern Italy provides examples of where the recorded prevalence exceeded 50% within a very short period of time. This brief review highlights historical perspectives of HIV transmission risk among IDUs during the early stages of the epidemic. Salient features and related experiences during this period might provide valuable insights for current HIV prevention. Our overview of the selected locations reemphasizes the importance of early prevention. The discussion also introduces to new researchers the early situation associated with the HIV epidemic in IDUs and highlights some crucial components need to be included during current HIV prevention activities.

  4. Using phylogenetic analysis to trace HIV-1 migration among western European injecting drug users seroconverting from 1984 to 1997

    NARCIS (Netherlands)

    Op de Coul, E. L.; Prins, M. [= Maria; Cornelissen, M.; van der Schoot, A.; Boufassa, F.; Brettle, R. P.; Hernández-Aguado, L.; Schiffer, V.; McMenamin, J.; Rezza, G.; Robertson, R.; Zangerle, R.; Goudsmit, J.; Coutinho, R. A.; Lukashov, V. V.

    2001-01-01

    OBJECTIVE: To reconstruct the epidemiological relationships of the HIV epidemics among injecting drug users (IDU) in western Europe. METHODS: HIV env V3 sequences of and epidemiological data were obtained from 145 IDU who seroconverted in three sequential periods: 1984-1988, 1989-1992 and 1993-1997.

  5. 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.

  6. Primary care physicians' adoption of new drugs is not associated with their clinical interests: A pharmacoepidemiologic study

    DEFF Research Database (Denmark)

    Dybdahl, Torben; Søndergaard, Jens; Kragstrup, Jakob

    2011-01-01

    Abstract Objectives. Increasing drug expenditures call for better understanding of the reasons behind individual general practitioners' (GPs') prescribing decisions. The aim was to analyse associations between GPs' clinical interests and their preference for new drugs. Design. Historical cohort...... association between GPs' self-rated clinical interest and their prescribing of new drugs was found.......-II antagonists) were analysed. The preference was defined as the percentage of patients receiving a new drug among first-time users of either the new drug or an older alternative. The GPs' preference proportion was modelled using linear regression analysis. Data from a questionnaire on GPs' interest...

  7. Receiving recommendations and providing feedback : the user-experience of a recommender system

    NARCIS (Netherlands)

    Knijnenburg, B.P.; Willemsen, M.C.; Hirtbach, S.; Buccafurri, F.; Semeraro, G.

    2010-01-01

    This paper systematically evaluates the user experience of a recommender system. Using both behavioral data and subjective measures of user experience, we demonstrate that choice satisfaction and system effectiveness increase when a system provides personalized recommendations (compared to the same

  8. Oropharyngeal candidiasis and resistance to antifungal drugs in patients receiving radiation for head and neck cancer

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    Maryam Rad DMD, MSc

    2012-04-01

    Full Text Available BACKGROUND: Oropharyngeal candidiasis is a common infection in patient receiving radiotherapy for head and neckcancer. Accurate and rapid identification of candida species is very important in clinical laboratory, because theincidence of candidiasis continues to rise after radiotherapy. The genus Candida has about 154 species that showdifferent level of resistance to antifungal drugs and have high degree of phenotypic similarity. The aim of this study wasto investigate oral yeast colonization and infection and resistance to antifungal drugs in these patients.METHODS: Thirty patients receiving a 6-week course of radiation therapy for treatment of head and neck cancer at theOncology Unit in Shafa Hospital, in 2008, were enrolled in the study. Specimens from patients were cultured weeklyfor Candida. All isolates were plated on CHROM agar and RPMI-based medium. They were subcultured and submittedfor antifungal susceptibility testing (nystatin, fluconazole, clotrimazole and ketoconazole and molecular typing.RESULTS: Infection (clinical and microbiological evidence occurred in 50% of the patients and Candida colonization(only microbiological evidence occurred in 70% of subjects in the first week. Candida albicans alone was isolated in94.9% of patient visits with positive cultures. Candida tropicalis was isolated from 5.1% of patient visits with positivecultures. All isolates were susceptible to nystatin, but did not respond to the other antifungal drugsCONCLUSIONS: The irradiation-induced changes of the intraoral environment such as xerostomia lead to increasedintraoral colonization by Candida species. All yeast isolates were susceptible to nystatin. Thus prophylactic therapywith nystatin should be considered for these patients.

  9. 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

  10. Prevalence and correlates of hepatitis C virus infection among street-recruited injection drug users in San Juan, Puerto Rico.

    Science.gov (United States)

    Reyes, Juan C; Colón, Héctor M; Robles, Rafael R; Rios, Eddy; Matos, Tomás D; Negrón, Juan; Marrero, Carmen Amalia; Calderón, José M; Shepard, Elizabeth

    2006-11-01

    Throughout the world, injection drug users (IDUs) are the group at highest risk for hepatitis C virus (HCV) infection. IDUs residing in the island of Puerto Rico and Puerto Rican IDUs residing in the U.S. mainland have been shown to be at very high risk of infection with HIV. However, the extent to which HCV infection has spread among IDUs in Puerto Rico is not yet known. The aims of this study were to estimate seroprevalence of HCV and to identify the correlates associated with HCV transmission. The sample was drawn through street outreach strategies and was comprised of 400 injection drug users not in treatment, living in the San Juan metropolitan area. HCV and HIV infection were detected by enzyme-linked immunosorbent assay and the results were confirmed by Western blot. Information on sociodemographics, drug use patterns, and risk behaviors was obtained through structured interviews. Bivariate analyses and multivariate logistic regression were used to assess covariates of infection with HCV. The prevalence of HCV infection was 89%. After controlling for sociodemographic characteristics, HCV infection was positively associated with increasing years of injection, injecting in a shooting gallery, tattooing in prison, and self-reported STD infection. Notably, IDUs who had initiated drug injection within the year prior to the study interview had an HCV infection rate of 57%. This study indicates that more aggressive educational programs are urgently needed to reduce the spread of HCV infection among IDUs in Puerto Rico.

  11. Low prevalence of human T-cell leukaemia virus-I and -II infection among drug users in Amsterdam, The Netherlands

    NARCIS (Netherlands)

    van den Hoek, J. A.; Al, E. J.; Huisman, J. G.; Goudsmit, J.; Coutinho, R. A.

    1991-01-01

    The prevalence of human T-cell leukaemia virus-I and -II infection was studied in a cohort of 346 intravenous and nonintravenous drug users in Amsterdam. Three participants (0.86%) had antibodies to HTLV-I by two commercially available HTLV-I enzyme immunoassays (EIA). Infection in these three

  12. 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

  13. Should pediatric patients with hyperlipidemia receive drug therapy?

    Science.gov (United States)

    Bhatnagar, Deepak

    2002-01-01

    Hyperlipidemia is now established as a major risk factor for causation of coronary heart disease (CHD) in adults; however, there is much debate on the level of coronary risk at which lipid-lowering drugs should be used. These issues of possible harm or lack of benefit from long-term use of lipid-lowering therapy, and cost effectiveness, are also pertinent in the pediatric setting. Evidence from several countries indicates that children have an increasing prevalence of obesity, hyperlipidemia and type 2 diabetes mellitus. Children who have high serum lipids 'track' these increased levels into adulthood. In some countries there is a trend to screen children for hypercholesterolemia. Family history itself is a poor discriminator in determining which children need to be screened and treated. Estimation of apolipoprotein B and/or apolipoprotein E genotype can improve prediction. Measuring high density lipoprotein cholesterol also helps, but obesity appears to be the best marker for screening children at high risk. These considerations should not cloud the need for case finding and treatment of children with genetic disorders. Low fat diets have been shown to be well tolerated and effective in children; however, there are no major long-term studies demonstrating harm or benefit in those on lipid-lowering drugs. Nevertheless, concerns regarding the psychological effect and the theoretical metabolic effects of long-term lipid lowering remain. Lipid-lowering drugs should be generally restricted to children with genetic disorders of lipid metabolism. Children with diabetes mellitus, hypertension or nonlipid-related inherited disorders leading to premature CHD in adults should be treated with diet, and with lipid-lowering drugs when they reach adulthood. Children with secondary hyperlipidemia should be assessed individually. A number of drugs and nutriceuticals are available for use in children, but only a few drugs are licensed for use in children.

  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. Linking the pharmacological content of ecstasy tablets to the subjective experiences of drug users.

    Science.gov (United States)

    Brunt, Tibor M; Koeter, Maarten W; Niesink, Raymond J M; van den Brink, Wim

    2012-04-01

    Most studies on the subjective effects of ecstasy are based on the assumption that the substance that was taken is 3,4-methylenedioxymethamphetamine (MDMA). However, many tablets sold as ecstasy contain other substances and MDMA in varying doses. So far, few attempts have been made to take this into account while assessing subjective effects. This study aims to link the pharmacological content of tablets sold as ecstasy to the subjective experiences reported by ecstasy users. Self-reported effects on ecstasy tablets were available from 5,786 drug users who handed in their tablets for chemical analysis at the Drug Information and Monitoring System (DIMS) in the Netherlands. Logistic regression was employed to link the pharmacological content of ecstasy tablets to the self-reported subjective effects and compare effects with MDMA to other substances present. MDMA showed a strong association with desirable subjective effects, unparalleled by any other psychoactive substance. However, the association of MDMA was dose-dependent, with higher doses (>120 mg/tablet) likely to evoke more adverse effects. The novel psychostimulants mephedrone and p-fluoroamphetamine were considered relatively desirable, whereas meta-chlorophenylpiperazine (mCPP) and p-methoxymethamphetamine (PMMA) were strongly associated with adverse subjective effects. Also, 3,4-methylene-dioxyamphetamine (MDA) and benzylpiperazine (BZP) were not appreciated as replacement for MDMA. Linking the pharmacological content of ecstasy sold on the street to subjective experiences contributes to a better understanding of the wide range of subjective effects ascribed to ecstasy and provides a strong rationale for the prolonged endurance of MDMA as the key ingredient of the ecstasy market.

  16. Institutional ethical review and ethnographic research involving injection drug users: a case study.

    Science.gov (United States)

    Small, Will; Maher, Lisa; Kerr, Thomas

    2014-03-01

    Ethnographic research among people who inject drugs (PWID) involves complex ethical issues. While ethical review frameworks have been critiqued by social scientists, there is a lack of social science research examining institutional ethical review processes, particularly in relation to ethnographic work. This case study describes the institutional ethical review of an ethnographic research project using observational fieldwork and in-depth interviews to examine injection drug use. The review process and the salient concerns of the review committee are recounted, and the investigators' responses to the committee's concerns and requests are described to illustrate how key issues were resolved. The review committee expressed concerns regarding researcher safety when conducting fieldwork, and the investigators were asked to liaise with the police regarding the proposed research. An ongoing dialogue with the institutional review committee regarding researcher safety and autonomy from police involvement, as well as formal consultation with a local drug user group and solicitation of opinions from external experts, helped to resolve these issues. This case study suggests that ethical review processes can be particularly challenging for ethnographic projects focused on illegal behaviours, and that while some challenges could be mediated by modifying existing ethical review procedures, there is a need for legislation that provides legal protection of research data and participant confidentiality. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. 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.

  18. Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial

    Science.gov (United States)

    Safren, Steven A.; O'Cleirigh, Conall M.; Bullis, Jacqueline R.; Otto, Michael W.; Stein, Michael D.; Pollack, Mark H.

    2012-01-01

    Objective: Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment adherence. Injection drug users comprise a substantial portion of individuals with HIV in the United States and globally. The present study tested cognitive behavioral therapy for adherence and depression (CBT-AD) in patients…

  19. 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.

  20. A compreensão dos operadores de direito do Distrito Federal sobre o usuário de drogas na vigência da nova lei The understanding of law professionals from the Federal District about drug users under the current new law

    Directory of Open Access Journals (Sweden)

    Luiza Barros Santoucy

    2010-04-01

    Full Text Available O usuário de drogas tem recebido tratamentos contraditórios que promovem sua estigmatização e clandestinidade e limitam a compreensão do fenômeno. O objetivo foi investigar como Promotores e Juízes estão entendendo e aplicando a nova lei que legisla sobre a conduta de usar e portar drogas no Brasil. Onze operadores do Direito do Distrito Federal (DF participaram de entrevistas semi-estruturadas divididas em três eixos: a visão em relação ao usuário de droga; como a lei vem sendo aplicada; e como concebe o trabalho da equipe multidisciplinar. As respostas demonstraram posições muito heterogêneas, denotando não haver ainda unanimidade quanto à compreensão da nova lei: se por um lado há uma crença compartilhada de que o uso de drogas é um problema de saúde pública, por outro, acredita-se que o usuário deve receber uma punição por seu ato ilegal. Um diálogo interdisciplinar efetivo permitiria uma atuação eficaz e reflexiva visando a beneficiar as pessoas que chegam à justiça.Drugs users have been receiving contradictory treatments thereby promoting their stigma besides hiding and limiting the understanding of the phenomenon. The objective of this study was to investigate how the District Attorneys and Judges are considering and applying the new law which legislates on the conduct of drug use in Brazil. Eleven Law professionals from the Federal District participated in semi-structured interviews divided in three areas: the point of view in relation to the user of drugs, how the law is being applied, and how they conceive the work of the multidisciplinary teams. The results showed very heterogeneous positions, showing that there is no unanimity on the understanding of the new law. For some, there is a shared belief that drugs abuse is a public health problem, for others, it is believed that the user must receive a punishment for his/her illegal act. An effective and efficient interdisciplinary dialogue should allow a

  1. To give is better than to receive: compliance with WHO guidelines for drug donations during 2000–2008

    Science.gov (United States)

    Carson, Brittany; Moller, Helene; Hill, Suzanne

    2010-01-01

    Abstract Objective To assess drug donations in terms of their adherence to the drug donation guidelines put forth by the World Health Organization (WHO). Methods In 2009 we searched the academic and lay literature – journal articles, media articles and industry and donor web sites – to identify reports about drug donations made from 2000 to 2008. Publications focusing on molecular mechanisms of drug action, general descriptions of guidelines or specific one-time drug donations before 2000 were excluded. For cases with sufficient information, we assessed compliance with each of the 12 articles of WHO‘s guidelines. Findings We found 95 articles describing 96 incidents of drug donations between 2000 and 2008. Of these, 50 were made in response to disaster situations, 43 involved the long-term donation of a drug to treat a specific disease and 3 were drug recycling cases. Disaster-related donations were less likely to comply with the guidelines, particularly in terms of meeting the recipient’s needs, quality assurance and shelf-life, packaging and labelling, and information management. Recipient countries were burdened with the costs of destroying the drugs received through inappropriate donations. Although long-term donations were more likely to comply with WHO guidelines related to quality assurance and labelling, they did not consistently meet the needs of the recipients. Furthermore, they discouraged local drug production and development. Conclusion Drug donations can do more harm than good for the recipient countries. Strengthening the structures and systems for coordinating and monitoring drug donations and ensuring that these are driven by recipient needs will improve adherence to the drug donation guidelines set forth by WHO. PMID:21124717

  2. 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

  3. Using 'payment by results' to fund the treatment of dependent drug users--proceed with care!

    Science.gov (United States)

    Maynard, Alan; Street, Andrew; Hunter, Rachael

    2011-10-01

    The UK government is changing its system of payment for drug treatment services in order to reward the achievement of better patient outcomes. This is a model that may be taken up internationally. This 'payment by results' funding system will reward providers for achieving good outcomes in terms of whether clients are drug free, employed and/or not convicted of a criminal offence. Providers will also receive a payment based on health and wellbeing outcome measurement. The definition and measurement of success in achieving these outcomes is complex and challenging, as is the need to bridge treatment costs during the period in which outcomes are pursued. This experiment requires careful evaluation if the delivery of drug treatment is not to be jeopardized or fragmented. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  4. 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.

  5. RURAL/URBAN RESIDENCE, ACCESS, AND PERCEIVED NEED FOR TREATMENT AMONG AFRICAN AMERICAN COCAINE USERS

    Science.gov (United States)

    BORDERS, TYRONE F.; BOOTH, BRENDA M.; STEWART, KATHARINE E.; CHENEY, ANN M.; CURRAN, GEOFFREY M.

    2014-01-01

    Objective To examine how rural/urban residence, perceived access, and other factors impede or facilitate perceived need for drug use treatment, a concept closely linked to treatment utilization. Study Design Two hundred rural and 200 urban African American cocaine users who were not receiving treatment were recruited via Respondent-Driven Sampling and completed a structured in-person interview. Bivariate and multivariate analyses were conducted to test the associations between perceived need and rural/urban residence, perceived access, and other predisposing (eg, demographics), enabling (eg, insurance), and health factors (eg, psychiatric distress). Principal Findings In bivariate analyses, rural relative to urban cocaine users reported lower perceived treatment need (37% vs 48%), availability, affordability, overall ease of access, and effectiveness, as well as lower perceived acceptability of residential, outpatient, self-help, and hospital-based services. In multivariate analyses, there was a significant interaction between rural/urban residence and the acceptability of religious counseling. At the highest level of acceptability, rural users had lower odds of perceived need (OR=.23); at the lowest level, rural users had higher odds of perceived need (OR=2.74) than urban users. Among rural users, the acceptability of religious counseling was negatively associated with perceived need (OR=.64). Ease of access was negatively associated (OR=.71) whereas local treatment effectiveness (OR=1.47) and the acceptability of hospital-based treatment (OR=1.29) were positively associated with perceived need among all users. Conclusions Our findings suggest rural/urban disparities in perceived need and access to drug use treatment. Among rural and urban cocaine users, improving perceptions of treatment effectiveness and expanding hospital-based services could promote treatment seeking. PMID:25213603

  6. Application of a drug-induced apoptosis assay to identify treatment strategies in recurrent or metastatic breast cancer.

    Directory of Open Access Journals (Sweden)

    Linda Bosserman

    Full Text Available A drug-induced apoptosis assay has been developed to determine which chemotherapy drugs or regimens can produce higher cell killing in vitro. This study was done to determine if this assay could be performed in patients with recurrent or metastatic breast cancer patients, to characterize the patterns of drug-induced apoptosis, and to evaluate the clinical utility of the assay. A secondary goal was to correlate assay use with clinical outcomes.In a prospective, non-blinded, multi institutional controlled trial, 30 evaluable patients with recurrent or metastatic breast cancer who were treated with chemotherapy had tumor samples submitted for the MiCK drug-induced apoptosis assay. After receiving results within 72 hours after biopsy, physicians could use the test to determine therapy (users, or elect to not use the test (non-users.The assay was able to characterize drug-induced apoptosis in tumor specimens from breast cancer patients and identified which drugs or combinations gave highest levels of apoptosis. Patterns of drug activity were also analyzed in triple negative breast cancer. Different drugs from a single class of agents often produced significantly different amounts of apoptosis. Physician frequently (73% used the assay to help select chemotherapy treatments in patients, Patients whose physicians were users had a higher response (CR+PR rate compared to non-users (38.1% vs 0%, p = 0.04 and a higher disease control (CR+PR+Stable rate (81% vs 25%, p<0.01. Time to relapse was longer in users 7.4 mo compared to non-users 2.2 mo (p<0.01.The MiCK assay can be performed in breast cancer specimens, and results are often used by physicians in breast cancer patients with recurrent or metastatic disease. These results from a good laboratory phase II study can be the basis for a future larger prospective multicenter study to more definitively establish the value of the assay.Clinicaltrials.gov NCT00901264.

  7. Willingness to Provide a Hair Sample for Drug Testing among Electronic Dance Music Party Attendees.

    Science.gov (United States)

    Palamar, Joseph J; Salomone, Alberto; Cleland, Charles M; Sherman, Scott

    2018-04-25

    Non-disclosure of drug use on surveys is common and many drug users unknowingly ingest adulterant or replacement drugs, which leads to underreporting of use of these drugs. Biological testing can complement survey research, and hair-testing is an appealing method as many drugs are detectable for months post-use. We examined willingness to donate a hair sample to be tested among those surveyed in a population at high risk for consuming adulterated drugs-electronic dance music (EDM) party attendees. We surveyed 933 adults entering EDM parties in New York City in 2017. Hair donation response rates and reasons for refusal were examined from this cross-sectional study. A third (n = 312; 33.4%) provided a hair sample. Lack of interest (21.0%), lack of time (19.8%), not wanting a lock of hair cut (17.7%), and disinterest in having hair cut in public (13.8%) were the main reported reasons for refusal. 4.7% refused because they could not receive results. Past-year drug users were more likely to fear identification than non-users (p<.001). Asian participants were at lower odds of providing a hair sample (aOR = 0.53, 95% CI = 0.32-0.87), and those reporting past-year use of LSD (aOR = 1.62, 95% CI = 1.11-2.35), opioids (nonmedical; aOR = 1.93, 95% CI = 1.25-2.99), and/or methamphetamine (aOR = 3.43, 95% CI = 1.36-8.62) were at higher odds of providing a sample than non-users of these drugs. Only a third of participants provided a hair sample and we found individual-level differences regarding willingness to provide a sample. Factors contributing to refusal should be considered to increase response rates and generalizability of results.

  8. Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

    Directory of Open Access Journals (Sweden)

    Lauzon Sylvie

    2004-08-01

    Full Text Available Abstract Background In the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support. Method Empirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32 were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined. Results Most reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed. Conclusions The large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.

  9. Social-structural contexts of needle and syringe sharing behaviours of HIV-positive injecting drug users in Manipur, India: a mixed methods investigation

    Directory of Open Access Journals (Sweden)

    Shunmugam Murali

    2011-05-01

    Full Text Available Abstract Background Few investigations have assessed risk behaviours and social-structural contexts of risk among injecting drug users (IDUs in Northeast India, where injecting drug use is the major route of HIV transmission. Investigations of risk environments are needed to inform development of effective risk reduction interventions. Methods This mixed methods study of HIV-positive IDUs in Manipur included a structured survey (n = 75, two focus groups (n = 17, seven in-depth interviews, and two key informant interviews. Results One-third of survey participants reported having shared a needle/syringe in the past 30 days; among these, all the men and about one-third of the women did so with persons of unknown HIV serostatus. A variety of social-structural contextual factors influenced individual risk behaviours: barriers to carrying sterile needles/syringes due to fear of harassment by police and "anti-drug" organizations; lack of sterile needles/syringes in drug dealers' locales; limited access to pharmacy-sold needles/syringes; inadequate coverage by needle and syringe programmes (NSPs; non-availability of sterile needles/syringes in prisons; and withdrawal symptoms superseding concern for health. Some HIV-positive IDUs who shared needles/syringes reported adopting risk reduction strategies: being the 'last receiver' of needles/syringes and not a 'giver;' sharing only with other IDUs they knew to be HIV-positive; and, when a 'giver,' asking other IDUs to wash used needles/syringes with bleach before using. Conclusions Effective HIV prevention and care programmes for IDUs in Northeast India may hinge on several enabling contexts: supportive government policy on harm reduction programmes, including in prisons; an end to harassment by the police, army, and anti-drug groups, with education of these entities regarding harm reduction, creation of partnerships with the public health sector, and accountability to government policies that protect IDUs

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

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    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

  11. Trato a los usuarios en los servicios públicos de salud en México The treatment received by public health services users in Mexico

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    Esteban Puentes Rosas

    2006-06-01

    Full Text Available OBJETIVO: Documentar que las diferencias en el trato recibido por los usuarios de los servicios de salud en México dependen principalmente del proveedor, independientemente de las condiciones socioeconómicas de los usuarios. MÉTODOS: Los datos se obtuvieron mediante una encuesta aplicada a 18 018 usuarios que asistieron a 73 servicios de salud de 13 estados de México. Los usuarios debían calificar la forma en que la institución se había desempeñado en siete de los ocho dominios del trato adecuado de los usuarios (autonomía, confidencialidad, comunicación, trato respetuoso, condiciones de las instalaciones básicas, acceso a redes de apoyo social y capacidad de elección. En el cuestionario se presentaron viñetas para valorar las expectativas de los usuarios. Se aplicó un modelo probit ordinal compuesto con la percepción sobre la calidad de cada uno de los dominios del trato adecuado como variable dependiente y el sexo, la escolaridad, la edad, el tipo de proveedor y las expectativas de los usuarios como variables de control. RESULTADOS: El principal factor que determinó la percepción de los usuarios sobre el trato que recibieron en los servicios de salud en México fue el proveedor. Las instituciones de seguridad social mostraron el peor desempeño, mientras que los servicios del programa destinado a la población rural (IMSS Oportunidades recibieron las mejores calificaciones. En general, el dominio mejor calificado fue el trato respetuoso, mientras que la menor calificación se asignó a la capacidad de elección del proveedor. Los hombres consideraron haber tenido mejor comunicación que las mujeres, mientras que el trato respetuoso, la comunicación y el apoyo social tuvieron una asociación significativa inversa con respecto al nivel educacional (P OBJECTIVE: To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users

  12. Mortality in HIV-infected injection drug users with active vs cleared hepatitis C virus-infection: a population-based cohort study

    DEFF Research Database (Denmark)

    Omland, L H; Jepsen, P; Weis, N

    2010-01-01

    Acute hepatitis C virus (HCV) infection may lead to chronic HCV-infection with detectable HCV RNA or to spontaneous clearance with no HCV RNA, but detectable HCV antibodies. It is unknown whether HCV RNA status is associated with mortality in HIV-infected injection drug users (IDUs). We conducted...

  13. Impact of Florida's prescription drug monitoring program and pill mill law on high-risk patients: A comparative interrupted time series analysis.

    Science.gov (United States)

    Chang, Hsien-Yen; Murimi, Irene; Faul, Mark; Rutkow, Lainie; Alexander, G Caleb

    2018-04-01

    We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012. We identified 3 types of high-risk patients: (1) concomitant users: patients with concomitant use of benzodiazepines and opioids; (2) chronic users: long-term, high-dose, opioid users; and (3) opioid shoppers: patients receiving opioids from multiple sources. We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk/low-risk patients. Our monthly measures included (1) average morphine milligram equivalent per transaction, (2) total opioid volume across all prescriptions, (3) average days supplied per transaction, and (4) total number of opioid prescriptions dispensed. Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users, and 0.46% were opioid shoppers. Following policy implementation, Florida's high-risk patients experienced relative reductions in morphine milligram equivalent (opioid shoppers: -1.08 mg/month, 95% confidence interval [CI] -1.62 to -0.54), total opioid volume (chronic users: -4.58 kg/month, CI -5.41 to -3.76), and number of dispensed opioid prescriptions (concomitant users: -640 prescriptions/month, CI -950 to -340). Low-risk patients generally did not experience statistically significantly relative reductions. Compared with Georgia, Florida's prescription drug monitoring program and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients. Copyright © 2018 John Wiley & Sons, Ltd.

  14. Subjective, behavioral, and physiological effects of acute caffeine in light, nondependent caffeine users.

    Science.gov (United States)

    Childs, Emma; de Wit, Harriet

    2006-05-01

    Caffeine produces mild psychostimulant effects that are thought to underlie its widespread use. However, the direct effects of caffeine are difficult to evaluate in regular users of caffeine because of tolerance and withdrawal. Indeed, some researchers hypothesize that the psychostimulant effects of caffeine are due largely to the reversal of withdrawal and question whether there are direct effects of caffeine consumption upon mood, alertness, or mental performance in nondependent individuals. This study investigated the physiological, subjective, and behavioral effects of 0, 50, 150, and 450 mg caffeine in 102 light, nondependent caffeine users. Using a within-subjects design, subjects participated in four experimental sessions, in which they received each of the four drug conditions in random order under double blind conditions. Participants completed subjective effects questionnaires and vital signs were measured before and at repeated time points after drug administration. Forty minutes after the capsules were ingested, subjects completed behavioral tasks that included tests of sustained attention, short-term memory, psychomotor performance, and behavioral inhibition. Caffeine significantly increased blood pressure, and produced feelings of arousal, positive mood, and high. Caffeine increased the number of hits and decreased reaction times in a vigilance task, but impaired performance on a memory task. We confirm that acute doses of caffeine, at levels typically found in a cup of coffee, produce stimulant-like subjective effects and enhance performance in light, nondependent caffeine users. These findings support the idea that the drug has psychoactive effects even in the absence of withdrawal.

  15. Quality of life of users of psychoactive substances, relatives, and non-users assessed using the WHOQOL-BREF

    Directory of Open Access Journals (Sweden)

    Taís de Campos Moreira

    2013-07-01

    Full Text Available Quality of life is related to one of the basic human desires, which is to live well and feel good. The scope of this study was to evaluate the quality of life of psychoactive substance users and relatives, compared to non-users, analyzed by socioeconomic strata. A cross-sectional study with users of psychoactive substances, relatives, and other individuals who called the Information and Orientation Service regarding drug abuse. Data collection took place between November 2009 and December 2010. Data was collected from users, relatives, and non-users, including socioeconomic characteristics and data regarding substance consumption when appropriate. In addition to this the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF questionnaire was given to 347 individuals. Among the 138 users (70% used alcohol, 76 (39%, marijuana, 111 (57% tobacco, 78 (40% cocaine and 70 (36% crack. Control subjects had higher, scores than the relatives of users and users in all areas of the questionnaire (p < 0.05. Psychoactive substance users scored lower in almost all domains and overall score in the WHOQOL-BREF questionnaire in comparison with the sample of non-drug users. These findings reflect poor quality of life of patients and their relatives.

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

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    Strike Carol

    2012-12-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  17. The importance of drug checking outside the context of nightlife in Slovenia.

    Science.gov (United States)

    Sande, Matej; Šabić, Simona

    2018-01-12

    The main purpose of the research was to evaluate the implementation of the drug checking service in Slovenia and to obtain the opinion of users included in harm reduction programmes for high-risk drug users and of drug users in nightlife settings on drug checking, the reasons for drug checking, and their attitude towards adulterants in the drugs that they use. The two final unrepresentative research samples included 102 respondents from harm reduction programmes and 554 respondents from the online sample. The questionnaire was designed based on analysis of the interviews conducted with professionals from the programmes, who took part in the drug checking project, and based on previous research on drug use in nightlife. The main findings related to users' opinions on the drug checking service are that users from both samples perceive drug checking as a contribution to risk reduction and that they find providing information for them about the harmful adulterants and substances that they use very important. In addition, users from both samples considered accessibility of the drug checking service as very important and would be in favour of brief counselling at the collection of the drug sample. One of the salient differences between samples was that nightlife drug users found it more important to recognise substances in the drugs that they use. Drug users from two different samples attach a relatively high importance to the drug checking service, and they consider it to be a contribution to risk reduction. As well as drug users in nightlife settings, high-risk drug users also perceive the drug checking service to be important, which is relevant in the phase of planning drug checking services outside the context of nightlife and for the act of incorporating these services into contemporary harm reduction policy.

  18. Drug Retention Times

    Energy Technology Data Exchange (ETDEWEB)

    Center for Human Reliability Studies

    2007-05-01

    The purpose of this monograph is to provide information on drug retention times in the human body. The information provided is based on plausible illegal drug use activities that might be engaged in by a recreational drug user.

  19. Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

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    Christensen DH

    2016-10-01

    Full Text Available Diana Hedevang Christensen,1 Jørgen Rungby,2,3 Reimar Wernich Thomsen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Denmark; 2Department of Pharmacology, University of Aarhus, Aarhus, Denmark; 3Department of Endocrinology, Gentofte University Hospital, Copenhagen, Denmark Purpose: The objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014. Methods: Based on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes. Results: The annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362 to 41 per 1,000 in 2014 (n=233,230. Metformin use increased more than sevenfold during the period and was used by 30 of 1,000 inhabitants in 2014, while the prevalence of insulin use increased 1.8-fold to 13 per 1,000 in 2014. After peaking in 2007, use of sulfonylurea halved to 6 per 1,000 in 2014. Newer drug classes including the glucagon-like peptide 1 receptor agonists, the dipeptidylpeptidase-4 inhibitors, and the sodium–glucose cotransporter 2 inhibitors had reached a considerable position by 2014, with 4 per 1,000, 6 per 1,000, and 0.8 per 1,000 inhabitants, respectively; however, the use of glucagon-like peptide 1 receptor agonists and sodium–glucose cotransporter 2 inhibitors in elderly people remained low. Thiazolidinediones decreased to virtually no use (0.03 per 1,000 in 2014. Conclusion: The use of glucose-lowering drugs has doubled during 1999–2014. The pattern of glucose-lowering drug use has changed substantially reflecting the recommendations of metformin as first-line treatment. The newer glucose-lowering drug classes have been well received

  20. Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France.

    Science.gov (United States)

    Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y

    2001-03-01

    In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel

  1. Hypothermia following antipsychotic drug use

    NARCIS (Netherlands)

    Marum, R.J. van; Wegewijs, M.A.; Loonen, A.J.M.; Beers, E.

    2007-01-01

    Objective: Hypothermia is an adverse drug reaction (ADR) of antipsychotic drug (APD) use. Risk factors for hypothermia in ADP users are unknown. We studied which risk factors for hypothermia can be identified based on case reports. Method: Case reports of hypothermia in APD-users found

  2. Prescripción, acceso y gasto en medicamentos entre usuarios de servicios de salud en México Medical prescription, drug access and drug expenditure among health service users in Mexico

    Directory of Open Access Journals (Sweden)

    RENÉ LEYVA-FLORES

    1998-01-01

    Full Text Available Objetivo. Analizar la prescripción, el acceso y el gasto en medicamentos entre usuarios de servicios de salud a partir de la Encuesta Nacional de Salud en México, 1994. Material y métodos. Se realizó un análisis descriptivo del acceso y gasto en medicamentos, y se identificaron factores relacionados con la prescripción mediante una regresión logística en 3 324 usuarios. Resultados. El 78% de usuarios recibieron prescripción de medicamentos. El 92% de los usuarios de la seguridad social y 35% de la Secretaría de Salud obtuvieron los medicamentos sin pago directo (p =0.000. La región con mayor índice de pobreza presentó menor acceso gratuito a los medicamentos. Entre los usuarios que gastaron en medicamentos, la mediana del gasto fue de 40.00 pesos (12.50 dólares, lo que resultó mayor en instituciones privadas que en públicas. Conclusiones. El acceso y el gasto en medicamentos se encuentran relacionados con las características socioeconómicas de los grupos de población y con las instituciones donde estos últimos se atendieron. Lograr mayor equidad en el acceso a medicamentos representa uno de los retos del sistema de salud en México.Objective. To analyze the medical prescription, drug access and drug expenditure by patients based on the National Health Survey in Mexico, 1994. Materials and methods. A descriptive analysis of drug access and expenditure was undertaken and predictive factors for medical prescription were identified by logistic regression for 3 324 patients. Results. 78% of the patients received drug prescriptions. 92% of the Social Security patients and 35% of the Ministry of Health patients received drugs free of charge (p =0.000. The region with the highest poverty index received the least amount of drugs free of charge. Regarding drug expenditure of patients who purchased drugs, median expenditure was 40.00 pesos (12.50 USD. Private health service patients spent significantly more than public health service

  3. Surviving crack: a qualitative study of the strategies and tactics developed by Brazilian users to deal with the risks associated with the drug

    Directory of Open Access Journals (Sweden)

    Nappo Solange A

    2010-11-01

    Full Text Available Abstract Background Due to marginalization, trafficking violence, conflicts with the police and organic and social psychological problems associated with the drug, crack is one of the most devastating drugs currently in use. However, there is evidence that some users manage to stay alive and active while using crack cocaine for many years, despite the numerous adversities and risks involved with this behavior. In this context, the aim of the present study was to identify the strategies and tactics developed by crack users to deal with the risks associated with the culture of use by examining the survival strategies employed by long-term users. Method A qualitative research method was used involving semi-structured, in-depth interviews. Twenty-eight crack users fulfilling a pre-defined enrollment criterion were interviewed. This criterion was defined as the long-term use of crack (i.e., at least four years. The sample was selected using information provided by key informants and distributed across eight different supply chains. The interviews were literally transcribed and analyzed via content analysis techniques using NVivo-8 software. Results There was diversity in the sample with regard to economic and education levels. The average duration of crack use was 11.5 years. Respondents believed that the greatest risks of crack dependence were related to the drug's psychological effects (e.g., cravings and transient paranoid symptoms and those arising from its illegality (e.g., clashes with the police and trafficking. Protection strategies focused on the control of the psychological effects, primarily through the consumption of alcohol and marijuana. To address the illegality of the drug, strategies were developed to deal with dealers and the police; these strategies were considered crucial for survival. Conclusions The strategies developed by the respondents focused on trying to protect themselves. They proved generally effective, though they

  4. 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.

  5. Are medical marijuana users different from recreational users? The view from primary care.

    Science.gov (United States)

    Roy-Byrne, Peter; Maynard, Charles; Bumgardner, Kristin; Krupski, Antoinette; Dunn, Chris; West, Imara I; Donovan, Dennis; Atkins, David C; Ries, Richard

    2015-10-01

    Marijuana is currently approved for medical use in 23 states. Both clinicians and the lay public have questioned whether users of marijuana for medical purposes are different from users of marijuana for recreational purposes. This study examined similarities and differences in important clinical characteristics between users of medical marijuana and users of recreational marijuana. The sample consisted of 868 adult primary care patients in Washington State, who reported use of medical marijuana (n = 131), recreational marijuana (n = 525), or drugs other than marijuana (n = 212). Retention was over 87% at 3-, 6-, 9-, and 12-month assessments. The majority of medical, psychiatric, substance use, and service utilization characteristic comparisons were not significant. However, medical marijuana users had significantly more medical problems, a significantly larger proportion reported >15 days medical problems in the past month, and significantly smaller proportions reported no pain and no mobility limitations (p marijuana users also had significantly lower drug problem severity, lower alcohol problem severity, and significantly larger proportions reported using marijuana alone and concomitant opioid use only (p marijuana with at least two additional substances (48% vs. 58%, respectively, p = .05). Although our results suggest that there are few distinct differences between medical and recreational users of marijuana, the differences observed, while mostly very small in effect size (marijuana to relieve symptoms and distress associated with medical illness. © American Academy of Addiction Psychiatry.

  6. 21 CFR 1020.10 - Television receivers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Television receivers. 1020.10 Section 1020.10 Food...) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING PRODUCTS § 1020.10 Television receivers. (a) Applicability. The provisions of this section are applicable to television receivers...

  7. Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

    Science.gov (United States)

    Wright, Adam; Aaron, Skye; Seger, Diane L; Samal, Lipika; Schiff, Gordon D; Bates, David W

    2018-05-15

    Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

  8. Analyzing user-generated online content for drug discovery: development and use of MedCrawler.

    Science.gov (United States)

    Helfenstein, Andreas; Tammela, Päivi

    2017-04-15

    Ethnopharmacology, or the scientific validation of traditional medicine, is a respected starting point in drug discovery. Home remedies and traditional use of plants are still widespread, also in Western societies. Instead of perusing ancient pharmacopeias, we developed MedCrawler, which we used to analyze blog posts for mentions of home remedies and their applications. This method is free and accessible from the office computer. We developed MedCrawler, a data mining tool for analyzing user-generated blog posts aiming to find modern 'traditional' medicine or home remedies. It searches user-generated blog posts and analyzes them for correlations between medically relevant terms. We also present examples and show that this method is capable of delivering both scientifically validated uses as well as not so well documented applications, which might serve as a starting point for follow-up research. Source code is available on GitHub at {{ https://github.com/a-hel/medcrawler }}. paivi.tammela@helsinki.fi. Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  9. Hypothermia following antipsychotic drug use

    NARCIS (Netherlands)

    van Marum, Rob J.; Wegewijs, Michelle A.; Loonen, Anton J. M.; Beers, Erna

    Objective Hypothermia is an adverse drug reaction (ADR) of antipsychotic drug (APD) use. Risk factors for hypothermia in ADP users are unknown. We studied which risk factors for hypothermia can be identified based on case reports. Methods Case reports of hypothermia in APD-users found in PUBMED or

  10. The potential drug-drug interaction between proton pump inhibitors and warfarin

    DEFF Research Database (Denmark)

    Henriksen, Daniel Pilsgaard; Stage, Tore Bjerregaard; Hansen, Morten Rix

    2015-01-01

    BACKGROUND: Proton pump inhibitors (PPIs) have been suggested to increase the effect of warfarin, and clinical guidelines recommend careful monitoring of international normalized ratio (INR) when initiating PPI among warfarin users. However, this drug-drug interaction is sparsely investigated...... in a clinical setting. The aim was to assess whether initiation of PPI treatment among users of warfarin leads to increased INR values. METHODS: The study was an observational self-controlled study from 1998 to 2012 leveraging data on INR measurements on patients treated with warfarin from primary care...... and outpatient clinics and their use of prescription drugs. Data were analyzed in 2015. We assessed INR, warfarin dose, and dose/INR ratio before and after initiating PPI treatment using the paired student's t-test. RESULTS: We identified 305 warfarin users initiating treatment with PPIs. The median age was 71...

  11. 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.

  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. Writing Drug Cultures

    DEFF Research Database (Denmark)

    Nissen, Morten

    2012-01-01

    The paper juxtaposes the cultural mediation of experience through drugs with that performed with text. As a sample of the currently radically changing relations between professional and lay knowledge in the field of drug interventions, the website of a Copenhagen institution for young drug users ...

  14. Assessment of addiction severity among ritual users of ayahuasca.

    Science.gov (United States)

    Fábregas, Josep Maria; González, Débora; Fondevila, Sabela; Cutchet, Marta; Fernández, Xavier; Barbosa, Paulo César Ribeiro; Alcázar-Córcoles, Miguel Ángel; Barbanoj, Manel J; Riba, Jordi; Bouso, José Carlos

    2010-10-01

    Ayahuasca is a psychoactive beverage used for magico-religious purposes in the Amazon. Recently, Brazilian syncretic churches have helped spread the ritual use of ayahuasca abroad. This trend has raised concerns that regular use of this N,N-dimethyltryptamine-containing tea may lead to the medical and psychosocial problems typically associated with drugs of abuse. Here we assess potential drug abuse-related problems in regular ayahuasca users. Addiction severity was assessed using the Addiction Severity Index (ASI), and history of alcohol and illicit drug use was recorded. In Study 1, jungle-based ayahuasca users (n=56) were compared vs. rural controls (n=56). In Study 2, urban-based ayahuasca users (n=71) were compared vs. urban controls (n=59). Follow-up studies were conducted 1 year later. In both studies, ayahuasca users showed significantly lower scores than controls on the ASI Alcohol Use, and Psychiatric Status subscales. The jungle-based ayahuasca users showed a significantly higher frequency of previous illicit drug use but this had ceased at the time of examination, except for cannabis. At follow-up, abstinence from illicit drug use was maintained in both groups except for cannabis in Study 1. However, differences on ASI scores were still significant in the jungle-based group but not in the urban group. Despite continuing ayahuasca use, a time-dependent worsening was only observed in one subscale (Family/Social relationships) in Study 2. Overall, the ritual use of ayahuasca, as assessed with the ASI in currently active users, does not appear to be associated with the deleterious psychosocial effects typically caused by other drugs of abuse. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  15. Mobility of Scottish injecting drug users and risk of HIV infection.

    Science.gov (United States)

    Goldberg, D J; Frischer, M; Taylor, A; Green, S T; McKeganey, N; Bloor, M; Reid, D; Cossar, J

    1994-08-01

    Nine hundred and nineteen injecting drug users (IDUs) were interviewed in Glasgow, Scotland during 1990 and 1991, as part of a wider study of HIV risk behaviour, about their injecting and sexual behaviour outside the city in the previous two years. Forty-five percent of respondents injected outside Glasgow, 6% shared needles and syringes (n/s) and 20% had sexual intercourse. Much activity occurred outside Scotland but mainly within the UK, particularly London. Predictors of n/s sharing outside Glasgow during the previous two years included current injecting with and passing on of used n/s and sexual intercourse with casual partners. Predictors of sexual behaviour outside Glasgow included passing on used n/s, having sexual intercourse with casual partners and, for females, engaging in prostitution. Glasgow IDUs are a highly mobile group and although HIV prevalence remains low within this population, considerable potential for importation/exportation of HIV and other bloodborne and sexually transmitted infections exists. Further work is required to establish why IDUs travel to, and engage in high-risk activities in locations outside their home environment, and detailed data about activities such as frequency of condom usage and n/s cleaning practices need to obtained. While there is a widespread network of services for IDUs in the UK, information provided usually relates to local services and may not fully address the needs of this mobile population. Therefore, we recommend that IDUs be provided with details of facilities such as n/s exchange schemes and drug-treatment establishments in centres to where they most commonly travel.

  16. Cigarette smoking and quit attempts among injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Shin, Sanghyuk S; Moreno, Patricia Gonzalez; Rao, Smriti; Garfein, Richard S; Novotny, Thomas E; Strathdee, Steffanie A

    2013-12-01

    Injection drug use and cigarette smoking are major global health concerns. Limited data exist regarding cigarette smoking behavior and quit attempts among injection drug users (IDUs) in low- and middle-income countries to inform the development of cigarette smoking interventions. We conducted a cross-sectional study to describe cigarette smoking behavior and quit attempts among IDUs in Tijuana, Mexico. IDUs were recruited through community outreach and administered in-person interviews. Multivariable Poisson regression models were constructed to determine prevalence ratios (PRs) for quit attempts. Of the 670 participants interviewed, 601 (89.7%) were current smokers. Of these, median number of cigarettes smoked daily was 10; 190 (31.6%) contemplated quitting smoking in the next 6 months; 132 (22.0%) had previously quit for ≥1 year; and 124 (20.6%) had made a recent quit attempt (lasting ≥1 day during the previous 6 months). In multivariable analysis, recent quit attempts were positively associated with average monthly income (≥3,500 pesos [US$280] vs. <1,500 pesos [US$120]; PR = 2.30; 95% CI = 1.57-3.36), smoking marijuana (PR = 1.38; 95% CI = 1.01-2.90), and smoking heroin (PR = 1.85; 95% CI = 1.23-2.78), and they were negatively associated with number of cigarettes smoked daily (PR = 0.96; 95% CI = 0.94-0.98). One out of 5 IDUs attempted to quit cigarette smoking during the previous 6 months. Additional research is needed to improve the understanding of the association between drug use patterns and cigarette smoking quit attempts, including the higher rate of quit attempts observed among IDUs who smoke marijuana or heroin compared with IDUs who do not smoke these substances.

  17. 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.

  18. [Recreational usage of dextromethorphan--analysis based on internet users experiences].

    Science.gov (United States)

    Zajac, Maciej; Andrzejczyk, Agata; Kuich, Aleksandra; Tyrańska-Fobke, Anna; Waldman, Wojciech; Sein Anand, Jacek

    2013-01-01

    In the last decade we have observed a considerable increase in nonmedical usage of dextromethorphan (DXM) among young age groups, especially school children between 13 and 16 yrs. We analysed the "trip reports" after use of DXM, available on a website: www.hyperreal.info in the years 1999-2013. The data collected by authors were analysed according to: age, sex, symptoms, dose of DXM, a reason and a place of using the drug. A review of 124 "trip reports" showed that the majority of their writers are male (M 90.3%, F 9.7%). Young people, aged 16-20 (80.4%), dominated among the study population. The most common place of using DXM was a flat of a drug user (70.2%), and the reason of using a willingness to experiment with new psychoactive substances (41.9%) as well as the desire of "get high" (25.8%). The majority of users used DXM at least once again in their lives (56.5%). A single dose of the ingested drug ranged from 120 mg to 1575 mg (mean 539.25 mg). Most often received doses were 450 mg (30.4%), 300 mg (12%), 900 mg (11.2%). DXM was positively assessed by the internauts as a recreational psychoactive substance (84.7%). The most common clinical symptoms described by internauts were: difficulties with walking (74.2%), visual illusions (73.4%), altered sense of time (41.9%), feeling of exteriorisation (35.5%), euphoria (33.1%), nausea and vomiting (32.3%), auditory illusions (30.6%) and pruritus (29.8%). 1. DXM is the popular psychoactive substance which has gained a positive opinion among the Internet users. 2. Easy accessibility of DXM may pose a serious threat to health of young people who experiment with psychoactive substances. 3. The improvement of DXM sales control should be considered.

  19. The intersection between sex and drugs: a cross-sectional study among the spouses of injection drug users in Chennai, India

    Directory of Open Access Journals (Sweden)

    Anand Santhanam

    2011-01-01

    Full Text Available Abstract Background It is estimated that there are up to 1.1 million injection drug users (IDUs in India; the majority are likely married. We characterize HIV, hepatitis B (HBV and hepatitis C (HCV prevalence and the risk environment of a sample of spouses of IDUs. Methods A cohort of 1158 IDUs (99% male was recruited in Chennai, India from 2005-06. A convenience sample of 400 spouses of the male IDUs in this cohort was recruited in 2009. A risk assessment questionnaire was administered and a blood sample collected. Logistic regression was used to identify factors associated with prevalent HIV. Results Median age was 31 years; thirteen percent were widowed and 7% were not currently living with their spouse. Only 4 (1% reported ever injecting drugs; Twenty-two percent and 25% reported ever using non-injection drugs and alcohol, respectively. The majority had one lifetime sexual partner and 37 (9% reporting exchanging sex. Only 7% always used condoms with their regular partner. HIV, HBV and HCV prevalence were 2.5%, 3.8% and 0.5%, respectively; among spouses of HIV+ IDUs (n = 78, HIV prevalence was 10.3%. The strongest predictor of HIV was spousal HIV status (OR: 17.9; p Conclusions Our finding of a 10-fold higher HIV prevalence among spouses of IDUs compared with general population women indicates their vulnerability; prevalence is likely to increase given the context of low condom use and frequent sexual violence. Prevention efforts directed at IDUs should also include programs for spouses.

  20. INJECTING EQUPMENT SHARING AND PERCEPTION OF HIV AND HEPATITIS RISK AMONG INJECTING DRUG USERS IN BUDAPEST

    Science.gov (United States)

    Gyarmathy, V. Anna; Neaigus, Alan; Ujhelyi, Eszter

    2008-01-01

    In Central European states, rates of HIV among IDUs have been low although HCV infection is widespread. The goal of our study was to assess HIV infection, risk perceptions and injecting equipment sharing among injection drug users in Budapest, Hungary. Altogether 150 IDUs were interviewed (121 structured between 1999-2000 and 29 ethnographic between 2003-2004). The majority of them injected heroin (52% and 79%) and many injected amphetamines (51% and 35%). One person tested positive for HIV. Two thirds (68% of 121) shared injecting equipment (syringes, cookers and filters). Some participants said they shared syringes because they were not carrying them for fear of police harassment, and that they reused filters as a backup drug supply. In multivariate analysis, sharing of injecting equipment was associated with higher perceived susceptibility to HIV/AIDS, lower self-efficacy for sterile equipment use, higher motivation to comply with peer pressure to use dirty injecting equipment, and with having a criminal record. The high levels of injecting risk behaviors found in this study are a cause for serious concern. HIV prevention interventions need to address not only sharing syringes but also sharing and reusing other injecting equipment and drug filters. PMID:17129858

  1. Understanding your users a practical guide to user requirements methods, tools, and techniques

    CERN Document Server

    Baxter, Kathy

    2005-01-01

    Today many companies are employing a user-centered design (UCD) process, but for most companies, usability begins and ends with the usability test. Although usability testing is a critical part of an effective user-centered life cycle, it is only one component of the UCD process. This book is focused on the requirements gathering stage, which often receives less attention than usability testing, but is equally as important. Understanding user requirements is critical to the development of a successful product. Understanding Your Users is an easy to read, easy to implement, how-to guide on

  2. Responsibility attribution of HIV infection and coping among injection drug users in Malaysia.

    Science.gov (United States)

    Chou, Chih-Chin; Chronister, Julie; Chou, Chih-Hung; Tan, Sooyin; Macewicz, Thomas

    2013-01-01

    This study explored responsibility attribution (RA) of HIV/AIDS infection (i.e., how an individual perceives the cause of their HIV/AIDS infection) and its relationship to coping styles among injection drug users (IDUs) with HIV/AIDS. In addition, this study investigated whether self-esteem, social support, and religiosity mediate the relationship between RA and coping styles of IDUs with HIV/AIDS. Participants were 201 adult IDUs with HIV/AIDS participating in the National Drug Rehabilitation Center in Malaysia. Five measures were used to assess the above constructs. Cluster analysis, analysis of variance, and mediation analyses were conducted. Results of this study indicated that IDUs with HIV/AIDS in Malaysia can be classified into four homogenous attribution groups: external, fatalistic, internal, and indeterminate. Mediator analyses revealed that combination of self-esteem, social support, and religiosity mediate the relationship between RA and coping behaviors. Clinicians working with IDUs with HIV/AIDS need to address the role of RA, self-esteem, religiosity, and social support as these psychosocial constructs are linked to coping with HIV/AIDS. Future researchers should investigate whether enhancing self-esteem, social support, and religiosity can promote active problem-solving coping and reduce the use of avoidance coping behaviors.

  3. Science and scepticism: Drug information, young men and counterpublic health.

    Science.gov (United States)

    Farrugia, Adrian; Fraser, Suzanne

    2017-11-01

    It is perhaps no surprise that young people can be sceptical of the drug-related information they receive in school-based health education, health promotion and the media. Significant societal anxiety surrounds young people's drug consumption, so it is tempting to approach this scepticism as a problem to be solved. In this article, we look closely at a group of young Australian men (n = 25), all of whom hold deeply sceptical views about the drug information they received in schools, social marketing campaigns and public speech generally. We do not approach their scepticism as a problem to be solved in itself, however. Instead, we analyse its origins and how it relates to the way knowledge is constructed in drug education, health promotion and media accounts of drug use. To conceptualise this scepticism, we draw on Irwin and Michael's analysis of the changing relationship between science and society, Warner's theorisation of publics and counterpublics, and Race's related notion of 'counterpublic health'. The article organises the data into three key themes: scepticism about the accuracy of the claims made about drug risks and dangers, scepticism about representations of drug users, and scepticism about the motivations behind the health messages and drug policy in general. We then draw these different aspects of scepticism together to argue that the young men can be seen to constitute a health 'counterpublic', and we consider the implications of this approach, arguing for what has been described as a more diplomatic engagement between science and publics.

  4. Contested identities: Identity constructions in a youth recreational drug culture

    DEFF Research Database (Denmark)

    Ravn, Signe

    2012-01-01

    as responsible drug users. The article studies this recreational drug culture and its internal distinctions, conceptions and norms as they are expressed discursively. The analysis identifies six dimensions of the identity as a responsible, recreational drug user: drug practice, general drug knowledge, context...

  5. User's manual for DELSOL2: a computer code for calculating the optical performance and optimal system design for solar-thermal central-receiver plants

    Energy Technology Data Exchange (ETDEWEB)

    Dellin, T.A.; Fish, M.J.; Yang, C.L.

    1981-08-01

    DELSOL2 is a revised and substantially extended version of the DELSOL computer program for calculating collector field performance and layout, and optimal system design for solar thermal central receiver plants. The code consists of a detailed model of the optical performance, a simpler model of the non-optical performance, an algorithm for field layout, and a searching algorithm to find the best system design. The latter two features are coupled to a cost model of central receiver components and an economic model for calculating energy costs. The code can handle flat, focused and/or canted heliostats, and external cylindrical, multi-aperture cavity, and flat plate receivers. The program optimizes the tower height, receiver size, field layout, heliostat spacings, and tower position at user specified power levels subject to flux limits on the receiver and land constraints for field layout. The advantages of speed and accuracy characteristic of Version I are maintained in DELSOL2.

  6. Illicit drug use among adolescent students. A peer phenomenon?

    OpenAIRE

    Cousineau, D.; Savard, M.; Allard, D.

    1993-01-01

    Illicit drug use was studied in 2071 students 11 to 18 years of age. Almost all drug users had friends who consumed drugs, compared with only one third of those who did not use drugs. This suggests a bond between adolescent drug users, who form a distinct group of which most students are unaware.

  7. Distinct Circulating Recombinant HIV-1 Strains Among Injecting Drug Users and Sex Workers in Afghanistan

    Science.gov (United States)

    2010-05-01

    assessed sociodemographics, travel history, sex- work history, and activity for SWs and sexual -activity history for IDUs, past and current drug-use...behaviors, past and current STI symptoms, condom (men and women) and contraceptive (women only) use, and knowledge about HIV. SW participants received a...32.7 years. Most were married (72.7%) and had >6 years of formal education (72.7%). The mean reported duration of injecting was 2.45 years (SD¼ 1.63

  8. 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.

  9. Determination of Relative Frequency of HBS Ag, HCV and HIV Antibodies Serum Markers among Admitted Intravenous Drug Users in Infectious Disease Ward of Razi Hospital in Ahvaz, 2004-2005

    Directory of Open Access Journals (Sweden)

    Abdolrasool Nikkhooy

    2012-07-01

    Full Text Available Introduction: Intravenous drug users as a serious health problem in communities have economical and social effects as well as health and hygienic complications. Viral infections may be transmitted through drug injection by shared syringes among users. The aim of this study has been to determine the relative frequency of HBV, HCV and HIV infection’s markers as epidemiological data in Ahvaz. Materials & Methods: This retrospective cross sectional study was conducted on IV drug users (IVDUs who were admitted in infectious diseases ward of Razi Ahvaz Hospital in 2004-2005. The collected data of serum markers of these patients were coded, and statistical analyses were conducted. Results: 1890 patients were evaluated and 258 patients were IVDUs (14.6%. 154 patients (59.98% were tested for anti HCV-Ab of whom 65 patients were HCV-Ab positive (42.2%. 205 patients (79.45% were tested for anti HIV-Ab of whom 38 patients were HIV-Ab positive (18.53%. 67 patients (25.96% were tested for HBs-Ag of whom 15 patients were HBs-Ag positive (22.67%. 12 patients (4.65% were tested for anti HBc-Ab of whom 8 patients were HBc-Ab positive (66.66%. Conclusion: In this study, high infection rate relates to different causes such as increasing consumes of opium substances and recent differences in fumigated opium substances pattern toward injecting drug use in society level, which increases the prevalence of these infections, The present study determined some critical information about the prevalence of serum markers HBS Ag, HCV and HIV antibodies among intravenous drug users in southwestern of Iran.

  10. Controlling user access to electronic resources without password

    Science.gov (United States)

    Smith, Fred Hewitt

    2015-06-16

    Described herein are devices and techniques for remotely controlling user access to a restricted computer resource. The process includes pre-determining an association of the restricted computer resource and computer-resource-proximal environmental information. Indicia of user-proximal environmental information are received from a user requesting access to the restricted computer resource. Received indicia of user-proximal environmental information are compared to associated computer-resource-proximal environmental information. User access to the restricted computer resource is selectively granted responsive to a favorable comparison in which the user-proximal environmental information is sufficiently similar to the computer-resource proximal environmental information. In at least some embodiments, the process further includes comparing user-supplied biometric measure and comparing it with a predetermined association of at least one biometric measure of an authorized user. Access to the restricted computer resource is granted in response to a favorable comparison.

  11. Differentiating Characteristics of Juvenile Methamphetamine Users

    Science.gov (United States)

    Fass, Daniel; Calhoun, Georgia B.; Glaser, Brian A.; Yanosky, Daniel J., II

    2009-01-01

    The authors investigated the differences in characteristics and risk behaviors endorsed by detained adolescent methamphetamine users and compared them with other drug users. Subjects completed the Millon Adolescent Clinical Inventory and a questionnaire in which sociodemographics and behavioral information were explored and compared. Multivariate…

  12. Topical Antimycotics for Oral Candidiasis in Warfarin Users

    DEFF Research Database (Denmark)

    Hellfritzsch, Maja; Pottegård, Anton; Pedersen, Andreas James Thestrup

    2017-01-01

    Treatment for oral candidiasis in warfarin users may be complicated by drug-drug interactions (DDIs) between warfarin and topically applied antimycotics. However, current knowledge of these putative DDIs is merely based on case series. We therefore performed a cohort cross-over study with the obj......Treatment for oral candidiasis in warfarin users may be complicated by drug-drug interactions (DDIs) between warfarin and topically applied antimycotics. However, current knowledge of these putative DDIs is merely based on case series. We therefore performed a cohort cross-over study...... increased from 2.5 (95% CI: 2.1-2.8) to 3.8 (95% CI: 2.8-4.8) after exposure, corresponding to a mean INR increase of 1.4 (95% CI: 0.3-2.4). Among 30 warfarin users exposed to nystatin oral solution, the mean INR was 2.7 (95% CI: 2.3-3.1) before and 2.5 (95% CI: 2.2-2.9) after exposure. In conclusion, we...

  13. Head shop compound abuse amongst attendees of the Drug Treatment Centre Board.

    LENUS (Irish Health Repository)

    McNamara, S

    2010-05-01

    The use of "Head Shop" compounds has received much media attention lately. There is very little research in the current literature with regard to the extent of the usage of these substances amongst the drug using population in Ireland. We conducted a study to examine the extent of the usage of Mephedrone, Methylone and BZP amongst attendees of Methadone maintenance programs at the DTCB. Two hundred and nine samples in total were tested. The results showed significant usage of these compounds amongst this cohort of drug users, with 29 (13.9%) of samples tested being positive for Mephedrone, 7 (3.3%) positive for Methylone and 1 (0.5%) positive for BZP.

  14. Drug use, travel and HIV risk.

    Science.gov (United States)

    Lee, D; Bell, D C; Hinojosa, M

    2002-08-01

    A study was conducted to examine the travel experiences of a community sample of 160 drug users and 44 non-users recruited as part of a study of HIV risk. Of the sample, 47% (96/204) reported intercity travel in the previous ten years. Results showed that men were more likely to travel than women, Anglos more than minorities, and young persons more than old. When travellers testing HIV-seropositive (n = 13) were compared with seronegative travellers, HIV-positive travellers reported more sex while travelling than HIV-negative persons, but virtually all of the difference reported involved sex with condoms. There were no significant differences in sex risk behaviours while travelling between drug users and non-drug users, or in sex risk behaviors between drug injectors and non-injectors. Travellers had fewer injection partners while travelling than they had while at home. There was also a significant difference in number of sex partners with whom a condom was not used, with fewer sex partners while travelling.

  15. The NBOMe hallucinogenic drug series: Patterns of use, characteristics of users and self-reported effects in a large international sample.

    Science.gov (United States)

    Lawn, Will; Barratt, Monica; Williams, Martin; Horne, Abi; Winstock, Adam

    2014-08-01

    The NBOMe compounds are a novel series of hallucinogenic drugs that are potent agonists of the 5-HT2A receptor, have a short history of human consumption and are available to buy online, in most countries. In this study, we sought to investigate the patterns of use, characteristics of users and self-reported effects. A cross-sectional anonymous online survey exploring the patterns of drug use was conducted in 2012 (n = 22,289), including questions about the use of 25B-NBOMe, 25C-NBOMe, and 25I-NBOMe and comparison drugs. We found that 2.6% of respondents (n = 582) reported having ever tried one of the three NBOMe drugs and that at 2.0%, 25I-NBOMe was the most popular (n = 442). Almost all (93.5%) respondents whose last new drug tried was a NBOMe drug, tried it in 2012, and 81.2% of this group administered the drug orally or sublingually/buccally. Subjective effects were similar to comparison serotonergic hallucinogens, though higher 'negative effects while high' and greater 'value for money' were reported. The most common (41.7%) drug source was via a website. The NBOMe drugs have emerged recently, are frequently bought using the internet and have similar effects to other hallucinogenic drugs; however, they may pose larger risks, due to the limited knowledge about them, their relatively low price and availability via the internet. © The Author(s) 2014.

  16. Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya.

    Science.gov (United States)

    Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

    2016-12-23

    The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Drug shops and pharmacies offer an important

  17. Reduction in mental distress among substance users receiving inpatient treatment

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    Friborg Oddgeir

    2010-12-01

    Full Text Available Abstract Background Substance users being admitted to inpatient treatment experience a high level of mental distress. In this study we explored changes in mental distress during treatment. Methods Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis. Results We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress. Conclusions The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.

  18. Assessing the HIV-1 Epidemic in Brazilian Drug Users: A Molecular Epidemiology Approach.

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    Monick Lindenmeyer Guimarães

    Full Text Available Person who inject illicit substances have an important role in HIV-1 blood and sexual transmission and together with person who uses heavy non-injecting drugs may have less than optimal adherence to anti-retroviral treatment and eventually could transmit resistant HIV variants. Unfortunately, molecular biology data on such key population remain fragmentary in most low and middle-income countries. The aim of the present study was to assess HIV infection rates, evaluate HIV-1 genetic diversity, drug resistance, and to identify HIV transmission clusters in heavy drug users (DUs. For this purpose, DUs were recruited in the context of a Respondent-Driven Sampling (RDS study in different Brazilian cities during 2009. Overall, 2,812 individuals were tested for HIV, and 168 (6% of them were positive, of which 19 (11.3% were classified as recent seroconverters, corresponding to an estimated incidence rate of 1.58%/year (95% CI 0.92-2.43%. Neighbor joining phylogenetic trees from env and pol regions and bootscan analyses were employed to subtype the virus from132 HIV-1-infected individuals. HIV-1 subtype B was prevalent in most of the cities under analysis, followed by BF recombinants (9%-35%. HIV-1 subtype C was the most prevalent in Curitiba (46% and Itajaí (86% and was also detected in Brasília (9% and Campo Grande (20%. Pure HIV-1F infections were detected in Rio de Janeiro (9%, Recife (6%, Salvador (6% and Brasília (9%. Clusters of HIV transmission were assessed by Maximum likelihood analyses and were cross-compared with the RDS network structure. Drug resistance mutations were verified in 12.2% of DUs. Our findings reinforce the importance of the permanent HIV-1 surveillance in distinct Brazilian cities due to viral resistance and increasing subtype heterogeneity all over Brazil, with relevant implications in terms of treatment monitoring, prophylaxis and vaccine development.

  19. ERP evidence suggests executive dysfunction in ecstasy polydrug users.

    Science.gov (United States)

    Roberts, C A; Fairclough, S H; Fisk, J E; Tames, F; Montgomery, C

    2013-08-01

    Deficits in executive functions such as access to semantic/long-term memory have been shown in ecstasy users in previous research. Equally, there have been many reports of equivocal findings in this area. The current study sought to further investigate behavioural and electro-physiological measures of this executive function in ecstasy users. Twenty ecstasy-polydrug users, 20 non-ecstasy-polydrug users and 20 drug-naïve controls were recruited. Participants completed background questionnaires about their drug use, sleep quality, fluid intelligence and mood state. Each individual also completed a semantic retrieval task whilst 64 channel Electroencephalography (EEG) measures were recorded. Analysis of Variance (ANOVA) revealed no between-group differences in behavioural performance on the task. Mixed ANOVA on event-related potential (ERP) components P2, N2 and P3 revealed significant between-group differences in the N2 component. Subsequent exploratory univariate ANOVAs on the N2 component revealed marginally significant between-group differences, generally showing greater negativity at occipito-parietal electrodes in ecstasy users compared to drug-naïve controls. Despite absence of behavioural differences, differences in N2 magnitude are evidence of abnormal executive functioning in ecstasy-polydrug users.

  20. 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

    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...... how zonal banning is also used to target drug-using clubbers in Denmark. Methods: 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. Results: 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...

  1. Molecular epidemiology of HCV monoinfection and HIV/HCV coinfection in injection drug users in Liuzhou, Southern China.

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    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.

  2. Hidden Wholesale: The drug diffusing capacity of online drug cryptomarkets

    OpenAIRE

    Aldridge, Judith A; Décary-Hétu, David

    2016-01-01

    Background: In spite of globalizing processes ‘offline’ retail drug markets remain localized and – in recent decades – typically ‘closed’, in which dealers sell primarily to known customers. We characterize drug cryptomarkets as ‘anonymous open’ marketplaces that allow the diffusion of drugs across locales. Where cryptomarket customers make stock-sourcing purchases for offline distribution, the cryptomarket may indirectly serve drug users who are not themselves cryptomarket customers, thereby...

  3. Barriers to Access to Sterile Syringes as Perceived by Pharmacists and Injecting Drug Users: Implications for Harm Reduction in Lebanon.

    Science.gov (United States)

    Ghaddar, Ali; Nassar, Karine; Elsoury, Ghadier

    2017-09-19

    Access to sterile syringes to injecting drug users (IDU) reduces sharing behavior and prevents the transmission of HIV. To describe the barriers to access to sterile syringes for IDUs in Lebanon from the perspectives of pharmacists and IDUs. in this qualitative study conducted in Lebanon, data were collected from 72 syringe purchase tests at pharmacies, 64 interviewees with pharmacists and 2 focus groups with injecting drug users. Two independent researchers analyzed the verbatim transcripts. Results revealed that pharmacists often deny access to sterile syringes to IDUs who are frequently stigmatized and intimidated at pharmacies. While no large gender differences in pharmacists' attitudes and practices were observed, inequalities in syringe access were noticed with men IDUs more often denied purchase. Pharmacists had several barriers to sell syringes to IDUs including fear of disease spread, increased drug use, inappropriately discarded syringes, staff and customer safety, and business concerns. IDUs had several challenges to purchase syringes including stigmatization, intimidation, physical harassment, concern to reveal identity, fear of arrest and syringe price abuse. Identifying the barriers to and facilitators of access to sterile syringes to IDUs is important to guide the development of efficient policies. Findings implicate the importance of empowering IDUs to purchase syringes at pharmacies through reducing the negative attitude towards IDUs and strengthening pharmacists' role in the promotion of health of IDUs. Findings also suggest that the habit of syringe sharing would decrease if the legal and cultural barriers to access are reduced.

  4. 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.

  5. Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study.

    Science.gov (United States)

    Meade, Christina S; Towe, Sheri L; Watt, Melissa H; Lion, Ryan R; Myers, Bronwyn; Skinner, Donald; Kimani, Stephen; Pieterse, Desiree

    2015-07-01

    Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and treatment experiences of a community-recruited sample of methamphetamine users in Cape Town. Using respondent driven sampling, 360 methamphetamine users (44% female) completed structured clinical interviews to assess substance abuse and treatment history and computerized surveys to assess drug-related risks. A sub-sample of 30 participants completed in-depth interviews to qualitatively explore experiences with methamphetamine use and drug treatment. Participants had used methamphetamine for an average of 7.06 years (SD=3.64). They reported using methamphetamine on an average of 23.49 of the past 30 days (SD=8.90); 60% used daily. The majority (90%) met ICD-10 criteria for dependence, and many reported severe social, financial, and legal consequences. While only 10% had ever received drug treatment, 90% reported that they wanted treatment. In the qualitative interviews, participants reported multiple barriers to treatment, including beliefs that treatment is ineffective and relapse is inevitable in their social context. They also identified important motivators, including desires to be drug free and improve family functioning. This study yields valuable information to more effectively respond to emerging methamphetamine epidemics in South Africa and other low- and middle-income countries. Interventions to increase uptake of evidence-based services must actively seek out drug users and build motivation for treatment, and offer continuing care services to prevent relapse. Community education campaigns are also needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Reduced attentional scope in cocaine polydrug users.

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    Lorenza S Colzato

    Full Text Available Cocaine is Europe's second preferred recreational drug after cannabis but very little is known about possible cognitive impairments in the upcoming type of recreational cocaine user (monthly consumption. We asked whether recreational use of cocaine impacts early attentional selection processes. Cocaine-free polydrug controls (n = 18 and cocaine polydrug users (n = 18 were matched on sex, age, alcohol consumption, and IQ (using the Raven's progressive matrices, and were tested by using the Global-Local task to measure the scope of attention. Cocaine polydrug users attended significantly more to local aspects of attended events, which fits with the idea that a reduced scope of attention may be associated with the perpetuation of the use of the drug.

  7. Predictors of mortality in patients with extensively drug-resistant Acinetobacter baumannii pneumonia receiving colistin therapy.

    Science.gov (United States)

    Choi, Ik Sung; Lee, Yu Ji; Wi, Yu Mi; Kwan, Byung Soo; Jung, Kae Hwa; Hong, Woong Pyo; Kim, June Myong

    2016-08-01

    The ratio of the area under the free (unbound) concentration-time curve to minimum inhibitory concentration (fAUC/MIC) was proposed to be the pharmacokinetic/pharmacodynamic index most strongly linked to the antibacterial effect of colistin against Acinetobacter baumannii. A retrospective study of patients who received colistin to treat pneumonia caused by extensively drug-resistant (XDR) A. baumannii over a 4-year period was performed to assess the impact of the colistin MIC on mortality. A total of 227 patients were included in the analysis. The 7-day and 14-day mortality rates of patients with XDR A. baumannii pneumonia receiving colistin therapy were 15.0% and 23.8%, respectively. In the multivariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score, days from index culture to first dose of colistin, underlying tumour and septic shock at presentation were independent predictors of mortality in patients with XDR A. baumannii pneumonia receiving colistin therapy. In the univariate analysis, the colistin dose based on ideal body weight (IBW) correlated with patient outcome. Therefore, the use of IBW appeared to be more appropriate to calculate the colistin dosage. In addition, these results highlight the clinical significance of colistin MIC in patients with XDR A. baumannii pneumonia receiving colistin therapy. Although MICs were in the 'susceptible' range, patients infected with isolates with high colistin MICs showed a poorer clinical response rate than patients infected with isolates with low colistin MICs. Further clinical studies are needed to evaluate the roles of colistin MIC for predicting mortality in XDR A. baumannii pneumonia with a high colistin MIC. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  8. Gauging the Acceptability of HIV Vaccines: An Exploratory Study Examining Knowledge, Attitudes, and Beliefs among Injecting Drug Users in Viet Nam

    Science.gov (United States)

    Nguyen, France

    2007-01-01

    In contrast to other countries in Southeast Asia, the HIV/ AIDS epidemic is in the initial stages in Viet Nam, although the rates have increased notably since 1997. This study examined attitudes towards the use of an HIV vaccine (when one becomes available) as a means for preventing the disease. Since injecting drug users are the great majority of…

  9. Proportion of long-term injection drug users as an indicator to characterize the state and prognosis of HIV-epidemic within a certain territory

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    Andreeva, Tatiana

    2012-07-01

    Full Text Available BACKGROUND: Epidemics of drug use and thus the spread of HIV have different duration in different regions, and, therefore, the prognosis of these epidemics may differ. We aimed to assess indicators measuring the peculiarities of injection drug use epidemics by region, informative for prevention activities among vulnerable to HIV groups. METHODS: Data from cross-sectional survey of 4026 injection drug users (IDUs conducted in 2007 in Ukraine were analyzed. The outcome measure was a binary variable depicting whether a respondent injects drugs for 20 years and over. Binary Logistic Regression in SPSS software was used to test associations with socio-demographic characteristics. RESULTS: More respondents from Odessa, Mykolayiv, Dnipropetrovsk, Cherkassy, Poltava, and Crimea regions inject over 20 years. Older respondents were more likely to belong to the group of long-term users. Men were more likely to inject over 20 years than women. Those respondents who were married, but did not live with their spouse or other sexual partner were more likely to inject longer than 20 years compared to those single or in a stable marriage. Those respondents who use opiates or combine them with stimulants were more likely to inject over 20 years and those who use only stimulants were more likely to inject less than 20 years. CONCLUSION: Injection drug use in Ukraine started earlier among men, on certain territories and was associated with opiate use. Percentage of IDUs who inject for more than 20 years was found to be a good indicator to distinguish territories with long-lasting epidemics.

  10. Pilot study of a social network intervention for heroin users in opiate substitution treatment: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Day, Edward; Copello, Alex; Seddon, Jennifer L; Christie, Marilyn; Bamber, Deborah; Powell, Charlotte; George, Sanju; Ball, Andrew; Frew, Emma; Freemantle, Nicholas

    2013-08-19

    Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. The National Treatment Agency for Substance Misuse recommends the involvement of families and wider social networks in supporting drug users' psychological treatment, and this pilot randomized controlled trial aims to evaluate the impact of a social network-focused intervention for patients receiving OST. In this two-site, early phase, randomized controlled trial, a total of 120 patients receiving OST will be recruited and randomized to receive one of three treatments: 1) Brief Social Behavior and Network Therapy (B-SBNT), 2) Personal Goal Setting (PGS) or 3) treatment as usual. Randomization will take place following baseline assessment. Participants allocated to receive B-SBNT or PGS will continue to receive the same treatment that is routinely provided by drug treatment services, plus four additional sessions of either intervention. Outcomes will be assessed at baseline, 3 and 12 months. The primary outcome will be assessment of illicit heroin use, measured by both urinary analysis and self-report. Secondary outcomes involve assessment of dependence, psychological symptoms, social satisfaction, motivation to change, quality of life and therapeutic engagement. Family members (n = 120) of patients involved in the trial will also be assessed to measure the level of symptoms, coping and the impact of the addiction problem on the family member at baseline, 3 and 12 months. This study will provide experimental data regarding the feasibility and efficacy of implementing a social network intervention within routine drug treatment services in the UK National Health Service. The study will explore the impact of the

  11. Latent Classes of Polydrug Users as a Predictor of Crash Involvement and Alcohol Consumption.

    Science.gov (United States)

    Scherer, Michael; Romano, Eduardo; Voas, Robert; Taylor, Eileen

    2018-05-01

    Polydrug users have been shown to be at higher risk for alcohol consumption and crash involvement. However, research has shown that polydrug groups differ in some important ways. It is currently unknown how polydrug-using groups differ in terms of crash involvement and alcohol consumption. The current study used latent class analysis to examine subgroups of polydrug users (n = 384) among a sample of drivers in Virginia Beach, Virginia (N = 10,512). A series of logistic regression analyses were conducted to determine the relationship between polydrug use categories and crash involvement and alcohol consumption. Four distinct subclasses of users were identified among polydrug-using drivers: Class 1 is the "marijuana-amphetamines class" and accounts for 21.6% of polydrug users. Class 2 is the "benzo-antidepressant class" and accounts for 39.0% of polydrug users. Class 3 is the "opioid-benzo class" and accounts for 32.7% of polydrug users. Finally, Class 4 is the "marijuana-cocaine class" and accounts for 6.7% of the study sample. Drivers in the opioid-benzo class were significantly more likely than those in any other class as well as non-drug users and single-drug users to be involved in a crash and were more likely than those in most other conditions to consume alcohol. No significant difference was found between marijuana-amphetamine users or benzo-antidepressant users and non-drug users on crash risk. Some polydrug users are indeed at greater risk for crash involvement and alcohol consumption; however, not all polydrug users are significantly worse than single-drug users and/or non-drug users, and the practice of lumping polydrug users together when predicting crash risk runs the risk of inaccurately attributing crash involvement to certain drivers.

  12. Safer scoring? Cryptomarkets, social supply and drug market violence.

    Science.gov (United States)

    Barratt, Monica J; Ferris, Jason A; Winstock, Adam R

    2016-09-01

    Cryptomarkets are digital platforms that use anonymising software (e.g. Tor) and cryptocurrencies (e.g. Bitcoin) to facilitate trade of goods and services, most notably illicit drugs. Cryptomarkets may reduce systemic violence compared with in-person drug trading because no face-to-face contact is required and disputes can be resolved through a neutral third party. In this paper, we describe the purchasing behaviour of cryptomarket users and then compare the self-reported experiences of threats, violence and other drug-market concerns when obtaining drugs from cryptomarkets with obtaining drugs through friends, known dealers and strangers. The Global Drug Survey was completed in late 2014 by a self-selected sample who reported accessing drugs through cryptomarkets in the last 12 months (N=3794). Their median age was 22 years and 82% were male. The drug types most commonly obtained through cryptomarkets were MDMA/Ecstasy (55%), cannabis (43%) and LSD (35%). Cryptomarket users reported using a median of 2 sources in addition to cryptomarkets to access drugs, the most common being in-person friendships (74%), in-person dealers (57%) and open markets/strangers (26%). When asked to nominate the main source they would use if cryptomarkets were unavailable, 49% nominated friends, 34% known dealers and 4% strangers. 'Threats to personal safety' (3%) and 'experiencing physical violence' (1%) were less often reported when using cryptomarkets compared with sourcing through friends (14%; 6%), known dealers (24%; 10%) or strangers (35%; 15%). Concerns about drug impurities and law enforcement were reported more often when using the alternative source, while loss of money, waiting too long and not receiving the product were more often reported when using cryptomarkets. Cryptomarkets are associated with substantially less threats and violence than alternative market types used by cryptomarket customers, even though a large majority of these alternatives were closed networks where

  13. 'Surfing the Silk Road': a study of users' experiences.

    Science.gov (United States)

    Van Hout, Marie Claire; Bingham, Tim

    2013-11-01

    The online drug marketplace called 'Silk Road' has operated anonymously on the 'Deep Web' since 2011. It is accessible through computer encrypting software (Tor) and is supported by online transactions using peer to peer anonymous and untraceable crypto-currency (Bit Coins). The study aimed to describe user motives and realities of accessing, navigating and purchasing on the 'Silk Road' marketplace. Systematic online observations, monitoring of discussion threads on the site during four months of fieldwork and analysis of anonymous online interviews (n=20) with a convenience sample of adult 'Silk Road' users was conducted. The majority of participants were male, in professional employment or in tertiary education. Drug trajectories ranged from 18 months to 25 years, with favourite drugs including MDMA, 2C-B, mephedrone, nitrous oxide, ketamine, cannabis and cocaine. Few reported prior experience of online drug sourcing. Reasons for utilizing 'Silk Road' included curiosity, concerns for street drug quality and personal safety, variety of products, anonymous transactioning, and ease of product delivery. Vendor selection appeared to be based on trust, speed of transaction, stealth modes and quality of product. Forums on the site provided user advice, trip reports, product and transaction reviews. Some users reported solitary drug use for psychonautic and introspective purposes. A minority reported customs seizures, and in general a displacement away from traditional drug sourcing (street and closed markets) was described. Several reported intentions to commence vending on the site. The study provides an insight into 'Silk Road' purchasing motives and processes, the interplay between traditional and 'Silk Road' drug markets, the 'Silk Road' online community and its communication networks. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Coalition building by drug user and sex worker community-based organizations in Vietnam can lead to improved interactions with government agencies: a qualitative study.

    Science.gov (United States)

    Le, Leah T; Grau, Lauretta E; Nguyen, Huong H; Khuat, Oanh Hai T; Heimer, Robert

    2015-10-16

    Drug users and female sex workers are among the groups most vulnerable to HIV infection in Vietnam. To address the HIV epidemic within these communities, former drug users and sex workers established the first community-based organizations (CBOs) in 2009. The study provides a focused assessment of CBOs' expanding efforts to advocate for their members that identifies existing collaborations with Vietnamese government programs. This assessment explores the barriers to and facilitators of expansion in order to propose recommendations to improve the working relationship between CBOs and government programs. Thirty-two individuals from drug user and sex worker CBOs (n = 24) and relevant government programs (n = 8) participated in face-to-face interviews in Hanoi, Ho Chi Minh City, and Hai Phong. Coded interview transcripts were analyzed qualitatively concerning the purpose of CBOs, the interactions between CBOs and government programs, and the perceived barriers, facilitators, and feasibility of future CBO-government program collaborations. Services provided by the CBOs were considered to improve members' quality of life. The formation of coalitions among CBOs increased efficiency in meeting members' specific service needs, in addition to internal capacity building. Government field staff interacted with CBOs by providing CBOs with technical and legal support. CBOs and methadone maintenance treatment (MMT) clinics collaborated to help the clinics meet patient enrollment quotas and facilitate entry into treatment for CBO members. Barriers to CBO-government program collaboration included perceived conflicting missions on how to address drug use and sex work in the community, limited CBO-government program communication, CBO mistrust of the MMT system, and lack of legal status for CBOs. To reduce these barriers, we recommend (1) introduction of CBO consultative services at government healthcare centers, (2) enlistment of CBO outreach to ensure full access to the

  15. HIV-1 subtype A infection in a community of intravenous drug users in Pakistan

    Directory of Open Access Journals (Sweden)

    Khan Muhammad N

    2006-11-01

    Full Text Available Abstract Background Data on the subtypes of HIV in a population help in predicting the potential foci of epidemic, tracking the routes of infection and following the patterns of the virus' genetic divergence. Globally, the most prevalent HIV infection is the HIV-1 subtype C. In Asia, predominant subtypes of HIV-1 are B, C, and CRF-01AE. During the last few years, HIV prevalence in Pakistan has taken the form of a concentrated epidemic in at least two high risk groups, namely, Intravenous Drug Users (IDUs and Male Sex Workers (MSWs. Factors that have facilitated the proliferation of HIV infection include transmission through a large number of repatriates and needle-sharing intravenous drug users, unscreened blood transfusions, and sexual illiteracy. The HIV subtypes infecting Pakistani populations have not been explored to date. In this study, we analyzed HIV-1 subtypes from in a high-risk community of IDUs in Karachi, the largest city of Pakistan. Methods Samples were collected from 34 IDUs after their informed consent. In addition, the study subjects were administered a questionnaire regarding their sexual behavior and travel history. For HIV analysis, DNA was extracted from the samples and analyzed for HIV types and subtypes using subtype-specific primers in a nested polymerase chain reaction (PCR. The results from this PCR were further confirmed using the Heteroduplex Mobility Assay (HMA. Results We found HIV-1 subtype A in all the 34 samples analyzed. A few of the study subjects were found to have a history of travel and stay in the United Arab Emirates. The same subjects also admitted to having contact with commercial sex workers during their stay abroad. Conclusion Our study therefore shows clade A HIV-1 to be prevalent among the IDUs in Karachi. As the prevalence of HIV in Pakistan continues to rise, more work needs to be done to track the infection, and to analyze the strains of HIV spreading through the country.

  16. 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.

  17. "Shotgunning" as an illicit drug smoking practice.

    Science.gov (United States)

    Perlman, D C; Perkins, M P; Paone, D; Kochems, L; Salomon, N; Friedmann, P; Des Jarlais, D C

    1997-01-01

    There has been a rise in illicit drug smoking in the United States. "Shotgunning" drugs (or "doing a shotgun") refers to the practice of inhaling smoke and then exhaling it into another individual's mouth, a practice with the potential for the efficient transmission of respiratory pathogens. Three hundred fifty-four drug users (239 from a syringe exchange and 115 from a drug detoxification program) were interviewed about shotgunning and screened for tuberculosis (TB). Fifty-nine (17%; 95% CI 12.9%-20.9%) reported shotgunning while smoking crack cocaine (68%), marijuana (41%), or heroin (2%). In multivariate analysis, age alcohol to intoxication (OR 2.2, 95% CI 1.1-4.3), having engaged in high-risk sex (OR 2.6, 95% CI 1.04-6.7), and crack use (OR 6.0, 95% CI 3.0-12) were independently associated with shotgunning. Shotgunning is a frequent drug smoking practice with the potential to transmit respiratory pathogens, underscoring the need for education of drug users about the risks of specific drug use practices, and the ongoing need for TB control among active drug users.

  18. Evaluation of HIV/AIDS patients' knowledge on antiretroviral drugs

    Directory of Open Access Journals (Sweden)

    Regina Flávia de Castro Almeida

    Full Text Available Lack of information on antiretroviral drugs or the misunderstanding of available information can facilitate incorrect use of such drugs. This can result in non-adherence to the prescribed regimen, leading to a great possibility of a therapeutic failure. The aim of this study was to know which information HIV/AIDS patients, who receive their medicines at the pharmacy of a reference hospital in the northeast Brazil, have on the drugs they use, the source of this information and whether there is a need for additional information. A total of 195 HIV/AIDS patients, who were using either zidovudina + lamivudina 300+150mg (AZT+3TC, efavirenz 600mg (EFZ or lopinavir/ritonavir 133.33/33mg (LPV/r, were interviewed. The mean age was 41 years (SD = 9.55 and 70.8% were males. Of the total, 55.4% didn't know the effect of the drug in the organism; 35.9% were unaware of the necessity of taking antiretroviral drugs for the rest of their lives; only 14.4% knew how to proceed when a dosage was missed; 22.1% said they could die and the same number of individuals believed in aggravation of the disease in case of treatment interruption. The majority, 68.2%, considered it very necessary to receive drug information. The results show that there is an apparent lack of general information among users of antiretroviral drugs, and at the same time a need for it. It is necessary that all professionals involved in the health care of the patients agree that an efficient supply of information on prescribed drugs is an ethical component of the treatment that favors and fosters its adherence.

  19. 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.

  20. Differences in behavioral health disorders and unmet treatment needs between medical marijuana users and recreational marijuana users: Results from a national adult sample.

    Science.gov (United States)

    Park, Ji-Yeun; Wu, Li-Tzy

    2017-11-01

    Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet treatment needs between medical and recreational marijuana users. We compared past-year prevalence of behavioral health disorders and unmet treatment needs across three marijuana subgroups (recreational use only, medical use only, and both). Sex-stratified logistic regression was performed to determine their associations with marijuana use status. We analyzed data from adults (≥18 years) who used marijuana in the past year (N=15,440) from 2013 to 2014 National Surveys on Drug Use and Health. Among 15,440 past-year marijuana users, 90.2% used recreational marijuana only, 6.2% used medical marijuana only, and 3.6% used both. Both users had the highest prevalence of behavioral health disorders and unmet treatment needs overall, with no significant sex differences. In the sex-specific logistic regression analysis, medical only users and both users showed somewhat different patterns of associations (reference group=recreational only users). Medical only users had decreased odds of alcohol or drug use disorders, and unmet need for alcohol or drug treatment among males and females. Additionally, female medical only users had decreased odds of opioid use disorder. Both users had increased odds of major depressive episode, hallucinogen use disorder, and unmet need for mental health services among males, and cocaine use disorder among females. Different approaches tailored to individuals' sex and motives for marijuana use is needed for the prevention and treatment of behavioral health problems. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Individual and couple-level risk factors for hepatitis C infection among heterosexual drug users: a multilevel dyadic analysis.

    Science.gov (United States)

    McMahon, James M; Pouget, Enrique R; Tortu, Stephanie

    2007-06-01

    Hepatitis C virus (HCV) is the most common bloodborne pathogen in the United States and is a leading cause of liver-related morbidity and mortality. Although it is known that HCV is most commonly transmitted among injection drug users, the role of sexual transmission in the spread of HCV remains controversial because of inconsistent findings across studies involving heterosexual couples. A novel multilevel modeling technique designed to overcome the limitations of previous research was performed to assess multiple risk factors for HCV while partitioning the source of risk at the individual and couple level. The analysis was performed on risk exposure and HCV screening data obtained from 265 drug-using couples in East Harlem, New York City. In multivariable analysis, significant individual risk factors for HCV included a history of injection drug use, tattooing, and older age. At the couple level, HCV infection tended to cluster within couples, and this interdependence was accounted for by couples' drug-injection behavior. Individual and couple-level sexual behavior was not associated with HCV infection. Our results are consistent with prior research indicating that sexual contact plays little role in HCV transmission. Rather, couples' injection behavior appears to account for the clustering of HCV within heterosexual dyads.

  2. [Family and acquaintances of illicit drug users: community perspectives on laws and public policies in Western Rio de Janeiro, Brazil].

    Science.gov (United States)

    Silva, Jaqueline da; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

    2009-01-01

    This article is part of the study 'Illicit Drug Use in Seven Latin American Countries and Canada: Critical Perspectives of Family and Familiars' (7LACC), which investigated four domains: protective and risk factors; preventive initiatives; treatment facilities; and laws and policies. The article presents a section of the results based on four items of the laws and policies domain--as perceived by the family and acquaintances of illicit drug users living in the community. Participants were recruited in urban primary health care units located in Western Rio de Janeiro (city), Brazil. This multi-method, cross-temporal study performed interviews with 100 adults (18 years of age or older), all cognitively healthy. Results and key conclusions included non-compliance with the fundamental principles of the Unique Health System Legislation / Law 8.080/90 and the erroneous implementation of laws and public policies on illicit drug.

  3. 'Social evils' and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam.

    Science.gov (United States)

    Hammett, Theodore M; Wu, Zunyou; Duc, Tran Tien; Stephens, David; Sullivan, Sheena; Liu, Wei; Chen, Yi; Ngu, Doan; Des Jarlais, Don C

    2008-01-01

    This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective 'champions' for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi-sectoral training, collaboration and support are also needed.

  4. Dynamics of Drug Use

    Science.gov (United States)

    Rollins, Joan H.; Holden, Raymond H.

    1977-01-01

    This paper analyzes data from interviews with 167 drug users in the community, including age, sex, birth order, education, family constellation, and circumstances of first drug use. The majority of subjects had tried to stop using drugs, but most had been unsuccessful at the time of the interview. (Author)

  5. Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs.

    Science.gov (United States)

    Hansen, Richard A; Qian, Jingjing; Berg, Richard; Linneman, James; Seoane-Vazquez, Enrique; Dutcher, Sarah K; Raofi, Saeid; Page, C David; Peissig, Peggy

    2017-04-01

    Generic drugs contain identical active ingredients as their corresponding brand drugs and are pharmaceutically equivalent and bioequivalent, whereas authorized generic drugs (AGs) contain both identical active and inactive ingredients as their corresponding brand drugs but are marketed as generics. This study compares generic-to-brand switchback rates between generic and AGs. Retrospective cohort study. Claims and electronic health record data from a regional U.S. health care system. The full cohort consisted of 5542 unique patients who received select branded drugs during the 6 months prior to their generic drug market availability (between 1999 and 2014) and then were switched to an AG or generic drug within 30 months of generic drug entry. For these patients, 5929 unique patient-drug combinations (867 with AGs and 5062 with generic drugs) were evaluated. Ten drugs with AGs and generics marketed between 1999 and 2014 were evaluated. The date of the first generic prescription was considered the index date for each drug, and it marked the beginning of follow-up to evaluate the occurrence of generic-to-brand switchback patterns over the subsequent 30 months. Switchback rates were compared between patients receiving AGs versus those receiving generics using multivariable Cox proportional hazards models, controlling for individual drug effects, age, sex, Charlson Comorbidity Score, pre-index drug use characteristics, and pre-index health care utilization. Among the 5542 unique patients who switched from brand to generic or brand to AG, 264 (4.8%) switched back to the brand drug. Overall switchback rates were similar for AGs compared with generics (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.65-1.15). The likelihood of switchback was higher for alendronate (HR 1.64, 95% CI 1.20-2.23) and simvastatin (HR 1.81, 95% CI 1.30-2.54) and lower for amlodipine (HR 0.27, 95% CI 0.17-0.42) compared with the other drugs evaluated. Overall switchback rates were similar

  6. Individual and combined effects of cannabis and tobacco on drug reward processing in non-dependent users.

    Science.gov (United States)

    Hindocha, Chandni; Lawn, Will; Freeman, Tom P; Curran, H Valerie

    2017-11-01

    Cannabis and tobacco are often smoked simultaneously in joints, and this practice may increase the risks of developing tobacco and/or cannabis use disorders. Currently, there is no human experimental research on how these drugs interact on addiction-related measures. This study aimed to investigate how cannabis and tobacco, each alone and combined together in joints, affected individuals' demand for cannabis puffs and cigarettes, explicit liking of drug and non-drug-related stimuli and craving. A double-blind, 2 (active cannabis, placebo cannabis) × 2 (active tobacco, placebo tobacco) crossover design was used with 24 non-dependent cannabis and tobacco smokers. They completed a pleasantness rating task (PRT), a marijuana purchase task (MPT) and a cigarette purchase task (CPT) alongside measures of craving pre- and post-drug administration. Relative to placebo cannabis, active cannabis reduced liking of cannabis-associated stimuli and increased response time to all stimuli except cigarette-related stimuli. Relative to placebo cannabis, active cannabis decreased demand for cannabis puffs (trends for breakpoint and elasticity) and cigarettes (breakpoint, P max , O max ) on several characteristics of the purchase tasks. We found no evidence that active tobacco, both alone or combined with cannabis, had an effect on liking, demand or craving. Acutely, cannabis reduced liking of cannabis-related stimuli and demand for cannabis itself. Acute cannabis also reduced demand for cigarettes on the CPT. Acute tobacco administration did not affect demand or pleasantness ratings for cigarettes themselves or cannabis. In non-dependent cannabis and tobacco co-users, tobacco did not influence the rewarding effects of cannabis.

  7. Barriers to antiretroviral treatment access for injecting drug users living with HIV in Chennai, South India.

    Science.gov (United States)

    Chakrapani, Venkatesan; Velayudham, Jaikumar; Shunmugam, Murali; Newman, Peter A; Dubrow, Robert

    2014-01-01

    India's National AIDS Control Organization provides free antiretroviral treatment (ART) to people living with HIV (PLHIV), including members of marginalized groups such as injecting drug users (IDUs). To help inform development of interventions to enhance ART access, we explored barriers to free ART access at government ART centers for IDUs living with HIV in Chennai by conducting three focus groups (n = 19 IDUs) and four key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family and social, health-care system, and individual levels. Family and social level barriers included lack of family support and fear of societal discrimination, as well as unmet basic needs, including food and shelter. Health-care system barriers included actual or perceived unfriendly hospital environment and procedures such as requiring proof of address and identity from PLHIV, including homeless IDUs; provider perception that IDUs will not adhere to ART, resulting in ART not being initiated; actual or perceived inadequate counseling services and lack of confidentiality; and lack of effective linkages between ART centers, needle/syringe programs, and drug dependence treatment centers. Individual-level barriers included active drug use, lack of self-efficacy in ART adherence, low motivation to initiate ART stemming from a fatalistic attitude, and inadequate knowledge about ART. These findings indicate that to facilitate IDUs gaining access to ART, systemic changes are needed, including steps to make the environment and procedures at government ART centers more IDU-friendly and steps to decrease HIV- and drug use-related stigma and discrimination faced by IDUs from the general public and health-care providers. Housing support for homeless IDUs and linkage of IDUs with drug dependence treatment are also essential.

  8. Misuse of prescription and illicit drugs among high-risk young adults in Los Angeles and New York

    Directory of Open Access Journals (Sweden)

    Stephen E. Lankenau

    2012-02-01

    Full Text Available Background. Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA and New York (NY, which represent different local markets for illicit and prescription drugs. Design and Methods. Between 2009 and 2011, 596 young adults (16 to 25 years old who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs; homeless persons; and polydrug users. Results. In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. Conclusion. Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs.

  9. Self-reports of executive dysfunction in current ecstasy/polydrug Users.

    Science.gov (United States)

    Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Bridges, Nikola

    2012-09-01

    Ecstasy/polydrug users have exhibited deficits in executive functioning in laboratory tests. We sought to extend these findings by investigating the extent to which ecstasy/polydrug users manifest executive deficits in everyday life. Forty-two current ecstasy/polydrug users, 18 previous (abstinent for at least 6 months) ecstasy/polydrug users, and 50 non-users of ecstasy (including both non-users of any illicit drug and some cannabis-only users) completed the self-report Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) measure. Current ecstasy/polydrug users performed significantly worse than previous users and non-users on subscales measuring inhibition, self-monitoring, initiating action, working memory, planning, monitoring ongoing task performance, and organizational ability. Previous ecstasy/polydrug users did not differ significantly from non-users. In regression analyses, although the current frequency of ecstasy use accounted for statistically significant unique variance on 3 of the 9 BRIEF-A subscales, daily cigarette consumption was the main predictor in 6 of the subscales. Current ecstasy/polydrug users report more executive dysfunction than do previous users and non-users. This finding appears to relate to some aspect of ongoing ecstasy use and seems largely unrelated to the use of other illicit drugs. An unexpected finding was the association of current nicotine consumption with executive dysfunction.

  10. Polypharmacy: correlations with sex, age and drug regimen

    DEFF Research Database (Denmark)

    Bjerrum, L; Søgaard, J; Hallas, J

    1998-01-01

    by inhabitants in the county of Funen (n = 466567). The number of individuals concurrently using two to four drugs (minor PP) and five or more drugs (major PP) was calculated on a random day in 1994. Drugs were classified according to the Anatomical Therapeutical Chemical (ATC) classification index. The main...... therapeutic class (second level of the ATC code) was used as an indicator for the type of health problem. A stepwise backwards logistic regression was used to identify predictors of major PP. Odds ratios were calculated for different drug classes, and the age and sex of all drug users. RESULTS: On a random...... day, 8.3% of the population were exposed to minor PP and 1.2% to major PP. The prevalence of PP increased with age, and from the age of 70 years, two thirds of all drug users were PP users. Drug use was 50% more prevalent among women than men, but over the age of 70, the sexes did not differ...

  11. Neurocognitive Predictors of Drug Relapse

    NARCIS (Netherlands)

    R. Marhe (Reshmi)

    2013-01-01

    textabstractWorldwide, about 35 million people, that is 0.8% of the world’s adult population, use heroin and/or cocaine and more than 10-13% of these drug users are or will become drug dependent (UNODC, World Drug Report, 2012). Drug dependency is characterized as a chronic relapsing disorder

  12. The burden and management of cytochrome P450 2D6 (CYP2D6)-mediated drug-drug interaction (DDI): co-medication of metoprolol and paroxetine or fluoxetine in the elderly.

    Science.gov (United States)

    Bahar, Muh Akbar; Hak, Eelko; Bos, Jens H J; Borgsteede, Sander D; Wilffert, Bob

    2017-07-01

    Metoprolol and paroxetine/fluoxetine are inevitably co-prescribed because cardiovascular disorders and depression often coexist in the elderly. This leads to CYP2D6-mediated drug-drug interactions (DDI). Because systematic evaluations are lacking, we assessed the burden of metoprolol-paroxetine/fluoxetine interaction in the elderly and how these interactions are managed in Dutch community pharmacies. Dispensing data were collected from the University of Groningen pharmacy database (IADB.nl, 1999-2014) for elderly patients (≥60 years) starting beta-blockers and/or antidepressants. Based on the two main DDI alert systems (G-Standard and Pharmabase), incidences were divided between signalled (metoprolol-fluoxetine/paroxetine) and not-signalled (metoprolol-alternative antidepressants and alternative beta-blockers-paroxetine/fluoxetine) combinations. Incident users were defined as patients starting at least one signalled or a non-signalled combination. G-Standard signalled throughout the study period, whereas Pharmabase stopped after 2005. A total of 1763 patients had 2039 metoprolol-paroxetine/fluoxetine co-prescriptions, despite DDI alert systems, and about 57.3% were signalled. The number of metoprolol-alternative antidepressant combinations (incidences = 3150) was higher than alternative beta-blocker-paroxetine/fluoxetine combinations (incidences = 1872). Metoprolol users are more likely to be co-medicated with an alternative antidepressant (incidences = 2320) than paroxetine/fluoxetine users (incidences = 1232) are. The number of paroxetine/fluoxetine users co-prescribed with alternative beta-blockers was comparable to those co-medicated with metoprolol (about 50%). Less than 5% of patients received a substitute therapy after using metoprolol-paroxetine/fluoxetine. Most of the metoprolol users (90%) received a low dose (mean DDD = 0.47) regardless whether they were prescribed paroxetine/fluoxetine. Despite the signalling software, metoprolol

  13. 77 FR 65198 - Generic Drug User Fee-Abbreviated New Drug Application, Prior Approval Supplement, and Drug...

    Science.gov (United States)

    2012-10-25

    ..., U.S. postal money order, or wire transfer. FDA has partnered with the U.S. Department of the... money order and make payable to the order of the Food and Drug Administration. Your payment can be mailed to: Food and Drug Administration, P.O. Box 979108, St. Louis, MO 63197-9000. If checks are to be...

  14. High prevalence of latent tuberculosis infection among injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Garfein, R S; Lozada, R; Liu, L; Laniado-Laborin, R; Rodwell, T C; Deiss, R; Alvelais, J; Catanzaro, A; Chiles, P G; Strathdee, S A

    2009-05-01

    We studied prevalence and correlates of latent tuberculosis infection (LTBI) among injection drug users (IDUs) in Tijuana, Mexico, where tuberculosis (TB) is endemic. IDUs aged > or =18 years were recruited via respondent-driven sampling (RDS) and underwent standardized interviews, human immunodeficiency virus (HIV) antibody testing and LTBI screening using Quanti-FERON((R))-TB Gold In-Tube, a whole-blood interferon-gamma release assay (IGRA). LTBI prevalence was estimated and correlates were identified using RDS-weighted logistic regression. Of 1020 IDUs, 681 (67%) tested IGRA-positive and 44 (4%) tested HIV-positive. Mean age was 37 years, 88% were male and 98% were Mexican-born. IGRA positivity was associated with recruitment nearest the US border (aOR 1.64, 95%CI 1.09-2.48), increasing years of injection (aOR 1.20/5 years, 95%CI 1.07-1.34), and years lived in Tijuana (aOR 1.10/5 years, 95%CI 1.03-1.18). Speaking some English (aOR 0.38, 95%CI 0.25-0.57) and injecting most often at home in the past 6 months (aOR 0.68, 95%CI 0.45-0.99) were inversely associated with IGRA positivity. Increased LTBI prevalence among IDUs in Tijuana appears to be associated with greater drug involvement. Given the high risk for HIV infection among Tijuana's IDUs, interventions are urgently needed to prevent HIV infection and treat LTBI among IDUs before these epidemics collide.

  15. 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.

  16. Injecting risk behavior among traveling young injection drug users: travel partner and city characteristics.

    Science.gov (United States)

    Montgomery, Martha E; Fatch, Robin S; Evans, Jennifer L; Yu, Michelle; Davidson, Peter J; Page, Kimberly; Hahn, Judith A

    2013-06-01

    Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004-2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000-1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56-8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25-22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11-27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46-5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42-7.68; AOR = 3.03; 95 % CI, 1.32-6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.

  17. Decline in HIV incidence and injecting, but not in sexual risk behaviour, seen in drug users in Amsterdam: a 19-year prospective cohort study

    NARCIS (Netherlands)

    Lindenburg, Catharina E. A.; Krol, Anneke; Smit, Colette; Buster, Marcel C. A.; Coutinho, Roel A.; Prins, Maria

    2006-01-01

    OBJECTIVE: To study temporal changes in HIV incidence, HIV transmission routes, and both injecting and sexual risk behaviour in the open Amsterdam Cohort Study (ACS) among drug users. Initiated in 1985, the ACS enables us to study changes in trends since HAART became widespread in 1996. METHODS:

  18. Why firm-established user communities work for innovation

    DEFF Research Database (Denmark)

    Jeppesen, Lars Bo; Frederiksen, Lars

    Studies of the sources of innovations have recognized that many innovations are developedby users. However, the fact that firms employ communities of users to strengthen their innovationprocess has not yet received much attention. In firm-established user communities users freely revealinnovation...... by selling them to all users. We study the key personal attributes of the individuals responsiblefor innovations and the creation of value in this organizational context, namely the innovative users, toexplain why firm-established user communities work. Analyzing data derived from a web...

  19. Why firm-established user communities work for innovation

    DEFF Research Database (Denmark)

    Jeppesen, Lars Bo; Frederiksen, Lars

    2004-01-01

    Studies of the sources of innovations have recognized that many innovations are developedby users. However, the fact that firms employ communities of users to strengthen their innovationprocess has not yet received much attention. In firm-established user communities users freely revealinnovation...... by selling them to all users. We study the key personal attributes of the individuals responsiblefor innovations and the creation of value in this organizational context, namely the innovative users, toexplain why firm-established user communities work. Analyzing data derived from a web...

  20. The effect of acute tryptophan depletion on mood and impulsivity in polydrug ecstasy users.

    Science.gov (United States)

    Young, Simon N; Regoli, Martine; Leyton, Marco; Pihl, Robert O; Benkelfat, Chawki

    2014-02-01

    Several studies suggest users of 3,4-methylenedioxymethamphetamine (ecstasy) have low levels of serotonin. Low serotonin may make them susceptible to lowered mood. This work aims to study the acute effects on mood and impulsivity of lowering serotonin levels with acute tryptophan depletion in polydrug ecstasy users and to determine whether effects were different in men and women. In a double-blind cross-over study, participants who had used ecstasy at least 25 times (n = 13) and nonuser controls (n = 17) received a tryptophan-deficient amino acid mixture and a control amino acid mixture containing tryptophan, at least 1 week apart. Mood was measured using the profile of mood states, and impulsivity was measured with the Go/No-Go task. The main result shows that a lowering of mood after acute tryptophan depletion occurred only in female polydrug ecstasy users (n = 7), relative to controls (n = 9). Results from the Go/No-Go task suggested that impulsivity was not increased by acute tryptophan depletion in polydrug ecstasy users. The group sizes were small, when males and females were considered separately. Women polydrug ecstasy users appear to be more susceptible than men to the effects of lowered serotonin levels. If use of ecstasy alone or in conjunction with other drugs causes progressive damage of serotonin neurons, women polydrug ecstasy users may become susceptible to clinical depression.

  1. Anti-human immunodeficiency virus-1 antibody titers in injection drug users compared to sexually infected individuals.

    Science.gov (United States)

    Bongertz, Vera; Ouverney, Elaine Priscilla; Teixeira, Sylvia L M; Silva-de-Jesus, Carlos; Hacker, Mariana A; Morgado, Mariza G; Bastos, Francisco I

    2003-03-01

    Sera from infected injection drug users (IDU) have shown to have antibodies against synthetic human immunodeficiency virus-1 (HIV-1) envelope peptides more frequently. In this study, reactivity of 48 IDU plasma were compared to 60 plasmas obtained from sexually infected individuals (S). The overall reactivity of plasma from IDU compared to S was higher, and the reactivity titers were much higher for IDU plasma than S. IDU plasma also showed a broader antibody response. The higher reactivity titers were observed mainly for the gp41 immunodominant epitope and V3 peptides corresponding to the consensus sequences of HIV-1 subtypes/variants prevalent in Brazil (B, F, C) indicating the specificity in the higher immune response of IDU.

  2. DrugQuest - a text mining workflow for drug association discovery.

    Science.gov (United States)

    Papanikolaou, Nikolas; Pavlopoulos, Georgios A; Theodosiou, Theodosios; Vizirianakis, Ioannis S; Iliopoulos, Ioannis

    2016-06-06

    Text mining and data integration methods are gaining ground in the field of health sciences due to the exponential growth of bio-medical literature and information stored in biological databases. While such methods mostly try to extract bioentity associations from PubMed, very few of them are dedicated in mining other types of repositories such as chemical databases. Herein, we apply a text mining approach on the DrugBank database in order to explore drug associations based on the DrugBank "Description", "Indication", "Pharmacodynamics" and "Mechanism of Action" text fields. We apply Name Entity Recognition (NER) techniques on these fields to identify chemicals, proteins, genes, pathways, diseases, and we utilize the TextQuest algorithm to find additional biologically significant words. Using a plethora of similarity and partitional clustering techniques, we group the DrugBank records based on their common terms and investigate possible scenarios why these records are clustered together. Different views such as clustered chemicals based on their textual information, tag clouds consisting of Significant Terms along with the terms that were used for clustering are delivered to the user through a user-friendly web interface. DrugQuest is a text mining tool for knowledge discovery: it is designed to cluster DrugBank records based on text attributes in order to find new associations between drugs. The service is freely available at http://bioinformatics.med.uoc.gr/drugquest .

  3. Differences in prefrontal blood oxygenation during an acute multitasking stressor in ecstasy polydrug users.

    Science.gov (United States)

    Roberts, C A; Wetherell, M A; Fisk, J E; Montgomery, C

    2015-01-01

    Cognitive deficits are well documented in ecstasy (3,4-methylenedioxymethamphetamine; MDMA) users, with such deficits being taken as evidence of dysregulation of the serotonin (5-hydroxytryptamine; 5-HT) system. More recently neuroimaging has been used to corroborate these deficits. The present study aimed to assess multitasking performance in ecstasy polydrug users, polydrug users and drug-naive individuals. It was predicted that ecstasy polydrug users would perform worse than non-users on the behavioural measure and this would be supported by differences in cortical blood oxygenation. In the study, 20 ecstasy-polydrug users, 17 polydrug users and 19 drug-naive individuals took part. On day 1, drug use history was taken and questionnaire measures were completed. On day 2, participants completed a 20-min multitasking stressor while brain blood oxygenation was measured using functional near infrared spectroscopy (fNIRS). There were no significant differences between the three groups on the subscales of the multitasking stressor. In addition, there were no significant differences on self-report measures of perceived workload (NASA Task Load Index). In terms of mood, ecstasy users were significantly less calm and less relaxed compared with drug-naive controls. There were also significant differences at three voxels on the fNIRS, indicating decreased blood oxygenation in ecstasy users compared with drug-naive controls at voxel 2 (left dorsolateral prefrontal cortex), voxel 14 and voxel 16 (right dorsolateral prefrontal cortex), and compared with polydrug controls at V14. The results of the present study provide support for changes in brain activation during performance of demanding tasks in ecstasy polydrug users, which could be related to cerebral vasoconstriction.

  4. User input in iterative design for prevention product development: leveraging interdisciplinary methods to optimize effectiveness.

    Science.gov (United States)

    Guthrie, Kate M; Rosen, Rochelle K; Vargas, Sara E; Guillen, Melissa; Steger, Arielle L; Getz, Melissa L; Smith, Kelley A; Ramirez, Jaime J; Kojic, Erna M

    2017-10-01

    The development of HIV-preventive topical vaginal microbicides has been challenged by a lack of sufficient adherence in later stage clinical trials to confidently evaluate effectiveness. This dilemma has highlighted the need to integrate translational research earlier in the drug development process, essentially applying behavioral science to facilitate the advances of basic science with respect to the uptake and use of biomedical prevention technologies. In the last several years, there has been an increasing recognition that the user experience, specifically the sensory experience, as well as the role of meaning-making elicited by those sensations, may play a more substantive role than previously thought. Importantly, the role of the user-their sensory perceptions, their judgements of those experiences, and their willingness to use a product-is critical in product uptake and consistent use post-marketing, ultimately realizing gains in global public health. Specifically, a successful prevention product requires an efficacious drug, an efficient drug delivery system, and an effective user. We present an integrated iterative drug development and user experience evaluation method to illustrate how user-centered formulation design can be iterated from the early stages of preclinical development to leverage the user experience. Integrating the user and their product experiences into the formulation design process may help optimize both the efficiency of drug delivery and the effectiveness of the user.

  5. From "herbal highs" to the "heroin of cannabis": Exploring the evolving discourse on synthetic cannabinoid use in a Norwegian Internet drug forum.

    Science.gov (United States)

    Bilgrei, Ola Røed

    2016-03-01

    In the early 2000s, online vendors began selling an array of so-called "legal highs"--apparently organic produce made from exotic herbs. Simultaneously, members of online drug discussion forums began to debate the alleged effects of the new drugs, creating an enormous base of user-derived information based on personal experiences. This study combines the historical data spanning a seven-year period derived from a Norwegian drug discussion forum about synthetic cannabinoids and interviews with 14 male forum members who all had experience with the drug. By combining the two sources, this study reveals not only the evolving discourse on synthetic cannabinoid use but also how forum members related to the online information that they gathered and co-produced. Analysis of the evolving online discourse revealed three distinct phases. The first was an enthusiastic phase, with users embracing the new drugs. The second was a phase characterized by growing ambivalence and scepticism towards use of the drugs. The third was one in which members of the community rejected the new drugs based on negative reviews from users. The analysis displays the communal process whereby members co-operate in the exchange of an extensive body of knowledge accumulated about synthetic cannabinoids, and the way in which this evolving discourse influences members of the forum in their views and representations of the drugs. Paradoxically, the online discussions of synthetic cannabinoids, which had great significance for their proliferation when they were initially introduced to the market, now seem to be a deterrent. The role of online drug communities in the development of new drug trends should receive renewed attention. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Gender stereotypes in psychosocial care for female crack and powder cocaine users.

    Science.gov (United States)

    Silva, Érika Barbosa de Oliveira; Pereira, Adriana Lenho de Figueiredo; Penna, Lúcia Helena Garcia

    2018-05-10

    The study analyzed health professionals' conceptions toward female users of crack and powder cocaine currently receiving psychosocial care, based on a gender perspective. Seventeen health professionals were interviewed, and systematic observations were made of the spaces for collective care in a Center for Psychosocial Care specializing in alcohol and drug addiction in Greater Metropolitan Rio de Janeiro, Brazil. Analysis of the interviews and field diaries using the hermeneutic-dialectic method revealed three categories: frailty as a constitutive attribute of women's condition, the women's emotional addiction to crack and powder cocaine use, and gender stereotypes during psychosocial care. The health professionals voiced a traditional view of the heterosexual, docile, and maternal woman and reproduced stereotypical concepts when addressing female crack and cocaine users as sensitive, frail individuals, emotionally dependent on men and more involved in the home and family. These professionals need a more refined understanding of gender issues in the mental health-disease process in order to allow overcoming preconceived notions and reductionist health care practices.

  7. National Drug Control Strategy. Update.

    Science.gov (United States)

    Office of National Drug Control Policy, Washington, DC.

    President Bush's new National Drug Control Strategy for 2003 focuses on three core priorities: stopping drug use before it starts; healing America's drug users; and disrupting the market. The 2003 strategy reports progress toward meeting the President's goals of reducing drug use by 10 percent over 2 years, and 25 percent over 5 years. With regard…

  8. From ecstasy to MDMA: Recreational drug use, symbolic boundaries, and drug trends.

    Science.gov (United States)

    Edland-Gryt, Marit; Sandberg, Sveinung; Pedersen, Willy

    2017-12-01

    Ecstasy pills with MDMA as the main ingredient were introduced in many European countries in the 1980s, and were often linked to the rave and club scenes. However, use gradually levelled off, in part as a response to increased concerns about possible mental health consequences and fatalities. Extensive use of MDMA now seems to be re-emerging in many countries. In this study, we investigated the cultural and social meaning associated with MDMA use in Oslo, Norway, with an emphasis on how users distinguish MDMA crystals and powder from "old ecstasy pills". Qualitative in-depth interviews (n=31, 61,3% males) were conducted with young adult party-goers and recreational MDMA/ecstasy users (20-34 years old, mean age 26.2 years). Research participants emphasised three important perceived differences between the MDMA crystals and ecstasy pills: (i) The effects of MDMA were described as better than ecstasy; (ii) MDMA was regarded as a safer drug; (iii) Users of MDMA crystals were described as more distinct from and less anchored in out-of-fashion rave culture than those using ecstasy. These differences were an important part of the symbolic boundary work MDMA users engaged in when justifying their drug use. MDMA has re-emerged as an important psychoactive substance in Oslo's club scene. One important reason for this re-emergence seems to be its perceived differentiation from ecstasy pills, even though the active ingredient in both drugs is MDMA. This perceived distinction between MDMA and ecstasy reveals the importance of social and symbolic meanings in relation to psychoactive substance use. Insights from this study can be important in terms of understanding how trends in drug use develop and how certain drugs gain or lose popularity. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Toward a Rational View of Hallucinogenic Drugs.

    Science.gov (United States)

    McGlothlin, William H.

    The enactment of California's "LSD Bill" is presented as an example of poor judgment in drug legislation on the state level. An appraisal of the nonmedical use of hallucinogens centering around the types of users, and the results of drug use, shows that the principal social impact of hallucinogens is on the personalities and values of the users.…

  10. A Precoded OFDMA System with User Cooperation

    NARCIS (Netherlands)

    Yu, Yao; Yatawatta, Sarod; Petropulu, Athina P.

    2010-01-01

    A new cooperative scheme for a two-user orthogonal frequency division multiple access (OFDMA) uplink communication scenario is proposed. Each user is equipped with one transmit/receive antenna. Before transmission, inter-block linear precoding is introduced to pairs of blocks. The cooperative

  11. Rationality and drug use: an experimental approach.

    Science.gov (United States)

    Blondel, Serge; Lohéac, Youenn; Rinaudo, Stéphane

    2007-05-01

    In rational addiction theory, higher discount rates encourage drug use. We test this hypothesis in the general framework of rationality and behaviour under risk. We do so using an experimental design with real monetary incentives. The decisions of 34 drug addicts are compared with those of a control group. The decisions of drug users (DU) are not any less consistent with standard theories of behaviour over time and under risk. Further, there is no difference in the estimated discount rate between drug users and the control group, but the former do appear to be more risk-seeking.

  12. Topical Antimycotics for Oral Candidiasis in Warfarin Users.

    Science.gov (United States)

    Hellfritzsch, Maja; Pottegård, Anton; Pedersen, Andreas James Thestrup; Burghle, Alaa; Mouaanaki, Fatima; Hallas, Jesper; Grove, Erik Lerkevang; Damkier, Per

    2017-04-01

    Treatment for oral candidiasis in warfarin users may be complicated by drug-drug interactions (DDIs) between warfarin and topically applied antimycotics. However, current knowledge of these putative DDIs is merely based on case series. We therefore performed a cohort cross-over study with the objective to evaluate the potential DDIs between warfarin and miconazole oral gel or nystatin oral solution. The cohort consisted of individuals using warfarin in the period of 1998-2012 (n ≈ 7400). We collected data on cohort members' measurements of the international normalized ratio (INR) from a clinical database, and obtained information on their use of topically applied miconazole and nystatin from a regional prescription register. Potential DDIs were assessed by comparing INR values before and after initiation of an antimycotic drug. Among 17 warfarin users exposed to miconazole oral gel, the mean INR increased from 2.5 (95% CI: 2.1-2.8) to 3.8 (95% CI: 2.8-4.8) after exposure, corresponding to a mean INR increase of 1.4 (95% CI: 0.3-2.4). Among 30 warfarin users exposed to nystatin oral solution, the mean INR was 2.7 (95% CI: 2.3-3.1) before and 2.5 (95% CI: 2.2-2.9) after exposure. In conclusion, we found evidence supporting a clinically relevant drug-drug interaction between warfarin and miconazole oral gel. In contrast, we did not find any indication of an interaction between warfarin and nystatin oral solution. Nystatin rather than miconazole should be preferred when treating warfarin users for oral candidiasis. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  13. Abnormal maximal finger tapping in abstinent cannabis users.

    Science.gov (United States)

    Flavel, Stanley C; White, Jason M; Todd, Gabrielle

    2013-11-01

    To investigate movement speed and rhythmicity in abstinent cannabis users, we hypothesized that abstinent cannabis users exhibit decreased maximal finger tapping frequency and increased variability of tapping compared with non-drug users. The study involved 10 healthy adult cannabis users and 10 age-matched and gender-matched controls with no history of illicit drug use. Subjects underwent a series of screening tests prior to participation. Subjects were then asked to tap a strain gauge as fast as possible with the index finger of their dominant hand (duration 5 s). The average intertap interval did not significantly differ between groups, but the coefficient of variation of the intertap interval was significantly greater in the cannabis group than in controls (p=0.011). The cannabis group also exhibited a slow tapping frequency at the beginning of the task. Rhythmicity of finger tapping is abnormal in individuals with a history of cannabis use. The abnormality appears to be long lasting and adds to the list of functional changes present in abstinent cannabis users. Copyright © 2013 John Wiley & Sons, Ltd.

  14. Wound Botulism in Injection Drug Users: Time to Antitoxin Correlates with Intensive Care Unit Length of Stay

    Directory of Open Access Journals (Sweden)

    Offerman, Steven R

    2009-11-01

    Full Text Available Objectives: We sought to identify factors associated with need for mechanical ventilation (MV, length of intensive care unit (ICU stay, length of hospital stay, and poor outcome in injection drug users (IDUs with wound botulism (WB.Methods: This is a retrospective review of WB patients admitted between 1991-2005. IDUs were included if they had symptoms of WB and diagnostic confirmation. Primary outcome variables were the need for MV, length of ICU stay, length of hospital stay, hospital-related complications, and death.Results: Twenty-nine patients met inclusion criteria. Twenty-two (76% admitted to heroin use only and seven (24% admitted to heroin and methamphetamine use. Chief complaints on initial presentation included visual changes, 13 (45%; weakness, nine (31%; and difficulty swallowing, seven (24%. Skin wounds were documented in 22 (76%. Twenty-one (72% patients underwent mechanical ventilation (MV. Antitoxin (AT was administered to 26 (90% patients but only two received antitoxin in the emergency department (ED. The time from ED presentation to AT administration was associated with increased length of ICU stay (Regression coefficient = 2.5; 95% CI 0.45, 4.5. The time from ED presentation to wound drainage was also associated with increased length of ICU stay (Regression coefficient = 13.7; 95% CI = 2.3, 25.2. There was no relationship between time to antibiotic administration and length of ICU stay.Conclusion: MV and prolonged ICU stays are common in patients identified with WB. Early AT administration and wound drainage are recommended as these measures may decrease ICU length of stay.[West J Emerg Med. 2009;10(4:251-256.

  15. Perceptions of community and family level IDU and HIV related stigma, disclosure decisions and experiences with layered stigma among HIV positive injection drug users in Vietnam

    OpenAIRE

    Rudolph, A.E.; Davis, W.W.; Quan, V.M.; Ha, T.V.; Minh, N.L.; Gregowski, A.; Salter, Megan; Celentano, D.D.; Go, V.

    2011-01-01

    This paper explores how perceived stigma and layered stigma related to injection drug use and being HIV positive influence the decision to disclose one’s HIV status to family and community and experiences with stigma following disclosure among a population of HIV positive male injection drug users (IDUs) in Thai Nguyen, Vietnam. In qualitative interviews conducted between 2007 and 2008, 25 HIV positive male IDUs described layered stigma in their community but an absence of layered stigma with...

  16. Teledermatologist expert skin advice: A unique model of care for managing skin disorders and adverse drug reactions in hepatitis C patients.

    Science.gov (United States)

    Charlston, Samuel; Siller, Gregory

    2018-03-23

    To conduct an audit of teledermatologist expert skin advice, a store and forward tele-dermatological service, to determine its effectiveness and user satisfaction in managing cutaneous adverse drug reactions in patients with hepatitis C, and to demonstrate a unique collaborative model of care for patients receiving specialised drug therapy. A retrospective analysis of data on teledermatologist expert skin advice referrals from January 2014 to December 2015 was performed. The primary outcomes assessed included number of referrals, referral locations, diagnoses, response times, quality of clinical information provided and user satisfaction ratings. Altogether 43 consultations from 29 referring sites were received from Australian metropolitan and rural settings. Of the patients, 43 were diagnosed with an adverse drug reaction related to the use of either telaprevir or simeprevir. The average time taken for the dermatologist to reply electronically with a final diagnosis and management plan was 1 h 57 min. As many as 26% of referrals required additional photos to establish a diagnosis due to poor-quality images or insufficient detail. Altogether 18 clinicians completed the customer satisfaction survey, all of whom rated teledermatologist expert skin advice nine or above on a scale of one to 10. Teledermatologist expert skin advice was regarded by clinicians as a valuable patient care service. The platform is a novel modality that supports patients undergoing specialised treatments at risk of cutaneous adverse drug reaction. © 2018 The Australasian College of Dermatologists.

  17. Representation of the disease, motivation sphere and medical communication as a target for prevention and treatment of HIV infection in substance users.

    Directory of Open Access Journals (Sweden)

    Buzina T.S.

    2014-07-01

    Full Text Available The psychological aspect of treating HIV-infected substance users entails changing their behaviour, as their behaviour is what leads to the risk of them transmitting and spreading HIV. Psychological treatment must facilitate their adaptation so that they may be otherwise treated for substance abuse and HIV. We propose establishing the psychological objective of helping patients overcome substance addiction by addressing their internal representation of the disease (IRD, value-sense and motivational sphere, as well as their relationships with their physician, as this is the main person who interacts with the patient in the clinic. An IRD study of patients with an opioid dependency, complicated with infectious diseases, showed that the IPD emotional level of opioid patients, as interconditional for other levels, can be an indicator of the status and impact of the main objective. A comparative study of substance users who received psychotherapy with those not receiving psychotherapy showed that the value-sense and motivational sphere is also an important target for preventive action. A study of the physician’s image of drug treatment clinics’ patients revealed that increases in the communicative competence of drug treatment facilities’ personnel represents a third course of preventing the transmission of HIV among substance dependent patients.

  18. ASTRID© - Advanced Solar Tubular ReceIver Design: A powerful tool for receiver design and optimization

    Science.gov (United States)

    Frantz, Cathy; Fritsch, Andreas; Uhlig, Ralf

    2017-06-01

    In solar tower power plants the receiver is one of the critical components. It converts the solar radiation into heat and must withstand high heat flux densities and high daily or even hourly gradients (due to passage of clouds). For this reason, the challenge during receiver design is to find a reasonable compromise between receiver efficiency, reliability, lifetime and cost. There is a strong interaction between the heliostat field, the receiver and the heat transfer fluid. Therefore, a proper receiver design needs to consider these components within the receiver optimization. There are several design and optimization tools for receivers, but most of them focus only on the receiver, ignoring the heliostat field and other parts of the plant. During the last years DLR developed the ASTRIDcode for tubular receiver concept simulation. The code comprises both a high and a low-detail model. The low-detail model utilizes a number of simplifications which allow the user to screen a high number of receiver concepts for optimization purposes. The high-detail model uses a FE model and is able to compute local absorber and salt temperatures with high accuracy. One key strength of the ASTRIDcode is its interface to a ray tracing software which simulates a realistic heat flux distributions on the receiver surface. The results generated by the ASTRIDcode have been validated by CFD simulations and measurement data.

  19. 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...... who need it, here we examine whether IDUs in the 52 countries in the WHO European Region have equitable access to HAART and whether that access has changed over time between 2002 and 2004. We consider regional and country differences in IDU HAART access; examine preliminary data regarding...

  20. Evaluation of drug therapy problems among renal patients receiving ...

    African Journals Online (AJOL)

    Adibe et al. Trop J Pharm Res, March 2017; 16(3): 697 .... suggestions to address medication problems, ..... Preventable drug-related hospital admissions. Ann. Pharmacother. 2002;. 36: .... geriatric hospitalized patients in yogyakarta hospitals,.

  1. AutoDrug: fully automated macromolecular crystallography workflows for fragment-based drug discovery

    International Nuclear Information System (INIS)

    Tsai, Yingssu; McPhillips, Scott E.; González, Ana; McPhillips, Timothy M.; Zinn, Daniel; Cohen, Aina E.; Feese, Michael D.; Bushnell, David; Tiefenbrunn, Theresa; Stout, C. David; Ludaescher, Bertram; Hedman, Britt; Hodgson, Keith O.; Soltis, S. Michael

    2013-01-01

    New software has been developed for automating the experimental and data-processing stages of fragment-based drug discovery at a macromolecular crystallography beamline. A new workflow-automation framework orchestrates beamline-control and data-analysis software while organizing results from multiple samples. AutoDrug is software based upon the scientific workflow paradigm that integrates the Stanford Synchrotron Radiation Lightsource macromolecular crystallography beamlines and third-party processing software to automate the crystallography steps of the fragment-based drug-discovery process. AutoDrug screens a cassette of fragment-soaked crystals, selects crystals for data collection based on screening results and user-specified criteria and determines optimal data-collection strategies. It then collects and processes diffraction data, performs molecular replacement using provided models and detects electron density that is likely to arise from bound fragments. All processes are fully automated, i.e. are performed without user interaction or supervision. Samples can be screened in groups corresponding to particular proteins, crystal forms and/or soaking conditions. A single AutoDrug run is only limited by the capacity of the sample-storage dewar at the beamline: currently 288 samples. AutoDrug was developed in conjunction with RestFlow, a new scientific workflow-automation framework. RestFlow simplifies the design of AutoDrug by managing the flow of data and the organization of results and by orchestrating the execution of computational pipeline steps. It also simplifies the execution and interaction of third-party programs and the beamline-control system. Modeling AutoDrug as a scientific workflow enables multiple variants that meet the requirements of different user groups to be developed and supported. A workflow tailored to mimic the crystallography stages comprising the drug-discovery pipeline of CoCrystal Discovery Inc. has been deployed and successfully

  2. [Drug advertising--users want information. Report of telephone survey conducted by North-Rhine Westphalia Public Health Service on the topic of drug advertising and drug information for users].

    Science.gov (United States)

    Puteanus, U

    2000-10-01

    In Germany, drug advertising of non-prescription drugs is a controversial subject. On the one hand, consumer organisations plead for placing a ban on advertising or at least to offer a detailed description of medical risks in respect of protection. On the other hand, the pharmaceutical industry is keen on liberalizing the specific advertising law for drugs. A representative telephone survey among the population of North Rhine-Westphalia was conducted in April and May 1999. It showed consumer interest in advertising, the value of information on risks, the institution with maximum credibility in drug information for consumers, the importance of the now obligatory sentence after every advertisement: Regarding risks and side effects read the leaflet in the package and ask your physician or pharmacist, and to what extend the consumer would take advice from independent experts over the telephone about drugs. It was found that, in particular women, about 30% are occasionally interested in advertising, younger people are more open-minded about advertising than older people; and that doctors and pharmacists have the most credibility and are consulted for further information. It was also found that more than 80% of the population demanded precise information on the side effects of drugs. One-third of the consumers declared that the obligatory sentence (see above) led to greater demand for information from doctors or to read attentively the instruction leaflet. Nevertheless, there is a need for more information from more than half of the consumers, who would take advantage of an independent advice centre if this should exist.

  3. Receiver based PAPR reduction in OFDMA

    KAUST Repository

    Ali, Anum Z.; Al-Zahrani, Ali Y.; Al-Naffouri, Tareq Y.; Naguib, Ayman F.

    2014-01-01

    High peak-to-average power ratio is one of the major drawbacks of orthogonal frequency division multiplexing (OFDM). Clipping is the simplest peak reduction scheme, however, it requires clipping mitigation at the receiver. Recently compressed sensing has been used for clipping mitigation (by exploiting the sparse nature of clipping signal). However, clipping estimation in multi-user scenario (i.e., OFDMA) is not straightforward as clipping distortions overlap in frequency domain and one cannot distinguish between distortions from different users. In this work, a collaborative clipping removal strategy is proposed based on joint estimation of the clipping distortions from all users. Further, an effective data aided channel estimation strategy for clipped OFDM is also outlined. Simulation results are presented to justify the effectiveness of the proposed schemes. © 2014 IEEE.

  4. Receiver based PAPR reduction in OFDMA

    KAUST Repository

    Ali, Anum Z.

    2014-05-01

    High peak-to-average power ratio is one of the major drawbacks of orthogonal frequency division multiplexing (OFDM). Clipping is the simplest peak reduction scheme, however, it requires clipping mitigation at the receiver. Recently compressed sensing has been used for clipping mitigation (by exploiting the sparse nature of clipping signal). However, clipping estimation in multi-user scenario (i.e., OFDMA) is not straightforward as clipping distortions overlap in frequency domain and one cannot distinguish between distortions from different users. In this work, a collaborative clipping removal strategy is proposed based on joint estimation of the clipping distortions from all users. Further, an effective data aided channel estimation strategy for clipped OFDM is also outlined. Simulation results are presented to justify the effectiveness of the proposed schemes. © 2014 IEEE.

  5. Oral health assessment for users of marijuana and cocaine/crack substances

    Directory of Open Access Journals (Sweden)

    Mariane Beatriz Sordi

    2017-12-01

    Full Text Available Abstract: The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT index, salivary flow rate (SFR, and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%, followed by marijuana (68.6%, and crack (51.4%. The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001, smoking (22.86% and heavy drinking (5.7% habits (p = 0.0001, SFR (31.4%; p = 0.0308, and oral lesions (p = 0.0488 were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148. It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.

  6. Oral health assessment for users of marijuana and cocaine/crack substances.

    Science.gov (United States)

    Sordi, Mariane Beatriz; Massochin, Rachel Captzan; Camargo, Alessandra Rodrigues de; Lemos, Tadeu; Munhoz, Etiene de Andrade

    2017-12-18

    The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.

  7. Autobiographical and semantic memory of adolescent drug users Memória autobiográfica e semântica em adolescentes usuários de drogas

    Directory of Open Access Journals (Sweden)

    Christian César Candido de Oliveira

    2007-01-01

    Full Text Available BACKGROUND: Psychiatric disorders in infancy and adolescence may impair the access to the memory of facts and events occurred during these periods. OBJECTIVE: The main purpose of this study was to investigate the autobiographical and semantic memory of a group of adolescent drug users and a control group of adolescent non-users. METHODS: Twenty-five males participated in each group between 13 and 17 years old. Two questionnaires were applied: Kihlstrom e Schacter (1995 for semantic memory and Borrini et al. (1989 for autobiographical memory. RESULTS: The group of drug users had more difficulties in accessing autobiographical memory (p = 0.0205 and semantic memory (p = 0.0057. CONCLUSIONS: Some hypotheses might be raised: users presented cognitive complications that make difficult the access to long-term memories, as well as others related to the dynamics of drug use.CONTEXTO: Transtornos psiquiátricos na infância e adolescência podem prejudicar o acesso às memórias de fatos e eventos ocorridos durante esse período. OBJETIVO: O objetivo deste estudo foi investigar as memórias autobiográfica e semântica de adolescentes usuários e não usuários de drogas. MÉTODOS: Participaram de cada grupo 25 adolescentes do gênero masculino, com idades entre 13 e 17 anos. Dois questionários foram aplicados: Kihlstrom e Schacter (1995, que avalia a memória semântica e Borrini et al. (1989, que avalia a memória autobiográfica. RESULTADOS: O grupo de usuários de drogas apresentou maior dificuldade para acessar as memórias autobiográfica (p = 0,0205 e semântica (p = 0,0057. CONCLUSÕES: Algumas hipóteses podem ser levantadas: usuários apresentam complicações cognitivas que dificultam o acesso às memórias de longo prazo, e também outras causas relacionadas à dinâmica do uso de drogas.

  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. Anti-human immunodeficiency virus-1 antibody titers in injection drug users compared to sexually infected individuals

    Directory of Open Access Journals (Sweden)

    Bongertz Vera

    2003-01-01

    Full Text Available Sera from infected injection drug users (IDU have shown to have antibodies against synthetic human immunodeficiency virus-1 (HIV-1 envelope peptides more frequently. In this study, reactivity of 48 IDU plasma were compared to 60 plasmas obtained from sexually infected individuals (S. The overall reactivity of plasma from IDU compared to S was higher, and the reactivity titers were much higher for IDU plasma than S. IDU plasma also showed a broader antibody response. The higher reactivity titers were observed mainly for the gp41 immunodominant epitope and V3 peptides corresponding to the consensus sequences of HIV-1 subtypes/variants prevalent in Brazil (B, F, C indicating the specificity in the higher immune response of IDU.

  10. Preliminary evidence of hippocampal damage in chronic users of ecstasy.

    Science.gov (United States)

    den Hollander, Bjørnar; Schouw, Marieke; Groot, Paul; Huisman, Henk; Caan, Matthan; Barkhof, Frederik; Reneman, Liesbeth

    2012-01-01

    Various studies have shown that ecstasy (3,4-methylenedioxymethamphetamine) users display significant memory impairments, whereas their performance on other cognitive tests is generally normal. The hippocampus plays an essential role in short-term memory. There are, however, no structural human data on the effects of ecstasy on the hippocampus. The objective of this study was to investigate whether the hippocampal volume of chronic ecstasy users is reduced when compared with healthy polydrug-using controls, as an indicator of hippocampal damage. The hippocampus was manually outlined in volumetric MRI scans in 10 male ecstasy users (mean age 25.4 years) and seven healthy age- and gender-matched control subjects (21.3 years). Other than the use of ecstasy, there were no statistically significant differences between both groups in exposure to other drugs of abuse and alcohol. The ecstasy users were on average drug-free for more than 2 months and had used on average 281 tablets over the past six and a half years. The hippocampal volume in the ecstasy using group was on average 10.5% smaller than the hippocampal volume in the control group (p=0.032). These data provide preliminary evidence that ecstasy users may be prone to incurring hippocampal damage, in line with previous reports of acute hippocampal sclerosis and subsequent atrophy in chronic users of this drug.

  11. 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.

  12. Clinical toxicology of newer recreational drugs.

    Science.gov (United States)

    Hill, Simon L; Thomas, Simon H L

    2011-10-01

    Novel synthetic 'designer' drugs with stimulant, ecstasy-like (entactogenic) and/or hallucinogenic properties have become increasingly popular among recreational drug users in recent years. The substances used change frequently in response to market trends and legislative controls and it is an important challenge for poisons centres and clinical toxicologists to remain updated on the pharmacological and toxicological effects of these emerging agents. To review the available information on newer synthetic stimulant, entactogenic and hallucinogenic drugs, provide a framework for classification of these drugs based on chemical structure and describe their pharmacology and clinical toxicology. A comprehensive review of the published literature was performed using PUBMED and Medline databases, together with additional non-peer reviewed information sources, including books, media reports, government publications and internet resources, including drug user web forums. Novel synthetic stimulant, entactogenic or hallucinogenic designer drugs are increasingly available to users as demonstrated by user surveys, poisons centre calls, activity on internet drug forums, hospital attendance data and mortality data. Some population sub groups such as younger adults who attend dance music clubs are more likely to use these substances. The internet plays an important role in determining the awareness of and availability of these newer drugs of abuse. Most novel synthetic stimulant, entactogenic or hallucinogenic drugs of abuse can be classified according to chemical structure as piperazines (e.g. benzylpiperazine (BZP), trifluoromethylphenylpiperazine), phenethylamines (e.g. 2C or D-series of ring-substituted amfetamines, benzodifurans, cathinones, aminoindans), tryptamines (e.g. dimethyltryptamine, alpha-methyltryptamine, ethyltryptamine, 5-methoxy-alphamethyltryptamine) or piperidines and related substances (e.g. desoxypipradrol, diphenylprolinol). Alternatively classification may

  13. Characterizing users of new psychoactive substances using psychometric scales for risk-related behavior

    NARCIS (Netherlands)

    Vreeker, Annabel; van der Burg, Babette G.; van Laar, Margriet; Brunt, Tibor M.

    2017-01-01

    Studies investigating risk-related behavior in relation to new psychoactive substance (NPS) use are sparse. The current study investigated characteristics of NPS users by comparing risk-related behavior of NPS users to that of illicit drugs (ID) users and licit substances users and non-users (NLC)

  14. Sociology of Drug Consumption

    OpenAIRE

    2004-01-01

    In this article which is a review of sociological ideas and studies of drug abusers in social situation, drug addiction steps (particularly alcohol, heroin and cocaine consumption) are revised and some explanations are made. Also, the role of some sociological ideas in drug addiction is considered in which Anomie Theory reads: "because of such duality, the individuals who are not satisfied with their role are in hurt." According to this theory, drug users choose seclusion and neglecting usual...

  15. Correlates of Incarceration Among Young Methamphetamine Users in Chiang Mai, Thailand

    Science.gov (United States)

    Thomson, Nicholas; Sutcliffe, Catherine G.; Sirirojn, Bangorn; Keawvichit, Rassamee; Wongworapat, Kanlaya; Sintupat, Kamolrawee; Aramrattana, Apinun

    2009-01-01

    Objectives. We examined correlates of incarceration among young methamphetamine users in Chiang Mai, Thailand in 2005 to 2006. Methods. We conducted a cross-sectional study among 1189 young methamphetamine users. Participants were surveyed about their recent drug use, sexual behaviors, and incarceration. Biological samples were obtained to test for sexually transmitted and viral infections. Results. Twenty-two percent of participants reported ever having been incarcerated. In multivariate analysis, risk behaviors including frequent public drunkenness, starting to use illicit drugs at an early age, involvement in the drug economy, tattooing, injecting drugs, and unprotected sex were correlated with a history of incarceration. HIV, HCV, and herpes simplex virus type 2 (HSV-2) infection were also correlated with incarceration. Conclusions. Incarcerated methamphetamine users are engaging in behaviors and being exposed to environments that put them at increased risk of infection and harmful practices. Alternatives to incarceration need to be explored for youths. PMID:18923109

  16. Uma visão crítica das políticas de descriminalização e de patologização do usuário de drogas Public policies' attempts to reduce the drugs use either by criminating or treating the drug user

    Directory of Open Access Journals (Sweden)

    Ari Bassi Nascimento

    2006-04-01

    Full Text Available Concorda-se que conseqüências da manufatura, síntese, tráfico e uso de drogas resultem em ameaça ao bem-estar coletivo. Todavia, o Estado dispõe de políticas públicas que só simbolicamente previnem a materialização dessa ameaça. É possível identificar duas políticas públicas com vistas a atenuar problemas derivados do uso de drogas. A primeira fundamenta suas ações sobre os princípios do estatuto punitivo brasileiro, perpetuando uma afronta ao princípio da lesividade, já que constitucionalmente a autolesão não tipifica conduta criminosa. A segunda ampara-se sobre uma abordagem de descriminalização, mas patologiza o usuário. O objeto de ação das duas políticas é a conduta ou o usuário e ambas se fundamentam sobre o viés filosófico da retributividade ou da máxima de que punição resulta em educação; tratando-o como criminoso ou como doente, as conseqüências dessas políticas resultam em robustez da economia da droga e iatrogenia do mal a ser tratado.If the welfare state is threatened either by synthesis, manufacture, traffic or drugs use, it is expected that State formulates public policies to prevent injuries to the common good In layman terms, activities related to the use abusive of drugs are able to threaten that common good. So, public policies should prevent the materialization of such threat. Two sorts of public policies intending to attenuate the social problems raised by drug abuse can be identified. The first is supported by a punitive philosophy which approaches the problem by criminating the drug user. By using penal rights, it does force users to face the consequences of the law, such as prison. The second seeks protection in a de-criminalization approach, but pathologizes the user. The object of action of the two politics is the conduct or the user, and both are based in the philosophical belief of compensation or in the rule of conduct that punishment results in education. Be the user treated

  17. HIV risk, health, and social characteristics of sexual minority female injection drug users in Baltimore

    Science.gov (United States)

    German, Danielle; Latkin, Carl A.

    2015-01-01

    Female injection drug users {IDU} who report sex with women are at increased risk for HIV and social instability, but it is important to assess whether these disparities also exist according to sexual minority identity rather than behaviorally defined categories. Within a sample of current IDU in Baltimore, about 17% of female study participants (n=307) identified as gay/lesbian/bisexual. In controlled models, sexual minorities were three times as likely to report sex exchange behavior and four times as likely to report a recent STI. Injection risk did not differ significantly, but sexual minority women reported higher prevalence of socio-economic instability, negative health indicators, and fewer network financial, material, and health support resources. There is a need to identify and address socio-economic marginalization, social support, and health issues among female IDUs who identify as lesbian or bisexual. PMID:25504312

  18. 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.

  19. Risk behaviours and healthcare needs of homeless drug users in Saint Lucia and Trinidad.

    Science.gov (United States)

    Day, Marcus; Devieux, Jessy G; Reid, Sandra D; Jones, Dionne J; Meharris, Joseph; Malow, Robert M

    2004-01-01

    In the Caribbean AIDS has become the leading cause of death among those aged 15-45. The homeless are at high risk due to the nexus of mobility, psychiatric disorders and substance use, particularly crack. Seventy-four homeless, out-of-treatment drug users were recruited in Saint Lucia and Trinidad to assess risk behaviour and healthcare needs. Information was collected in several domains: medical, mental health, substance use, sexual risk, and barriers to care. Ninety-five percent of the sample reported crack cocaine use within the previous 30 days. Approximately 35% of the sample had ever been diagnosed with a sexually transmitted disease and 25% of the sample reported being HIV+. Approximately 40% had a history of trading sex for crack or money. Due to the range of needs in this population, interventions should be multimodal. A focus on the individual, community, and structural levels is warranted to improve chances of program effectiveness.

  20. Detecting drug-drug interactions using a database for spontaneous adverse drug reactions: an example with diuretics and non-steroidal anti-inflammatory drugs.

    Science.gov (United States)

    van Puijenbroek, E P; Egberts, A C; Heerdink, E R; Leufkens, H G

    2000-12-01

    Drug-drug interactions are relatively rarely reported to spontaneous reporting systems (SRSs) for adverse drug reactions. For this reason, the traditional approach for analysing SRS has major limitations for the detection of drug-drug interactions. We developed a method that may enable signalling of these possible interactions, which are often not explicitly reported, utilising reports of adverse drug reactions in data sets of SRS. As an example, the influence of concomitant use of diuretics and non-steroidal anti-inflammatory drugs (NSAIDs) on symptoms indicating a decreased efficacy of diuretics was examined using reports received by the Netherlands Pharmacovigilance Foundation Lareb. Reports received between 1 January 1990 and 1 January 1999 of patients older than 50 years were included in the study. Cases were defined as reports with symptoms indicating a decreased efficacy of diuretics, non-cases as all other reports. Exposure categories were the use of NSAIDs or diuretics versus the use of neither of these drugs. The influence of the combined use of both drugs was examined using logistic regression analysis. The odds ratio of the statistical interaction term of the combined use of both drugs was increased [adjusted odds ratio 2.0, 95% confidence interval (CI) 1.1-3.7], which may indicate an enhanced effect of concomitant drug use. The findings illustrate that spontaneous reporting systems have a potential for signal detection and the analysis of possible drug-drug interactions. The method described may enable a more active approach in the detection of drug-drug interactions after marketing.