scholarly journals Epidemiological findings and medical, legal, and public health challenges of an investigation of severe soft tissue infections and deaths among injecting drug users – Ireland, 2000

2005 ◽  
Vol 134 (4) ◽  
pp. 894-901 ◽  
Author(s):  
K. MURRAY-LILLIBRIDGE ◽  
J. BARRY ◽  
S. REAGAN ◽  
D. O'FLANAGAN ◽  
G. SAYERS ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Users ◽  
Methadone Treatment ◽  
Injecting Drug Users ◽  
Clinical Findings ◽  
Severe Illness ◽  
Laboratory Findings ◽  
16S Rdna Pcr ◽  
Public Health Challenges ◽  
Systemic Symptoms

In May 2000, public health authorities in Dublin, Ireland, identified a cluster of unexplained severe illness among injecting drug users (IDUs). Similar clusters were also reported in Scotland and England. Concurrent investigations were undertaken to identify the aetiology and source of the illnesses. In Dublin, 22 IDUs were identified with injection-site inflammation resulting in hospitalization or death; eight (36%) died. Common clinical findings among patients with severe systemic symptoms included leukaemoid reaction and cardiogenic shock. Seventeen (77%) patients reported injecting heroin intramuscularly in the 2 weeks before illness. Of 11 patients with adequate specimens available for testing, two (18%) were positive by 16S rDNA PCR for Clostridium novyi. Clinical and laboratory findings suggested that histotoxic Clostridia caused a subset of infections in these related clusters. Empiric treatment for infections among IDUs was optimized for anaerobic organisms, and outreach led to increased enrolment in methadone treatment in Dublin. Many unique legal, medical, and public health challenges were encountered during the investigation of this outbreak.

Change in Drug-Using Networks of Injecting Drug Users during Methadone Treatment: A Pilot Study Using Snowball Recruitment and Intensive Interviews

1997 ◽  
Vol 32 (11) ◽  
pp. 1539-1554 ◽  
Author(s):  
Johannes C. E. W. Willems ◽  
Martin Y. Iguchi ◽  
Victor Lidz ◽  
Donald A. Bux
Keyword(s):  
Pilot Study ◽  
Drug Users ◽  
Methadone Treatment ◽  
Injecting Drug Users

scholarly journals Hepatitis C virus infection among injecting drug users in Scotland: a review of prevalence and incidence data and the methods used to generate them

2006 ◽  
Vol 135 (3) ◽  
pp. 433-442 ◽  
Author(s):  
K. M. ROY ◽  
S. J. HUTCHINSON ◽  
S. WADD ◽  
A. TAYLOR ◽  
S. O. CAMERON ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Users ◽  
Methadone Maintenance ◽  
Injecting Drug Users ◽  
Incidence Rates ◽  
Hepatitis C Virus Infection ◽  
Incidence Data ◽  
Public Health Challenges ◽  
Related Liver Disease

It is estimated that of 50000 persons in Scotland (1% of the county's population), infected with the hepatitis C virus (HCV), around 90% injected drugs. This paper reviews data on the prevalence and incidence of HCV, and the methods used to generate such information, among injecting drug users (IDUs), in Scotland. The prevalence estimate for HCV among IDUs in Scotland as a whole (44% in 2000), is comparable with those observed in many European countries. Incidence rates ranged from 11·9 to 28·4/100 person-years. The data have shaped policy to prevent infection among IDUs and have informed predictions of the number of HCV-infected IDUs who will likely progress to, and require treatment and care for, severe HCV-related liver disease. Although harm reduction interventions, in particular needle and syringe exchanges and methadone maintenance therapy, reduced the transmission of HCV among IDUs during the early to mid-1990s, incidence in many parts of the country remains high. The prevention of HCV among IDUs continues to be one of Scotland's major public health challenges.

scholarly journals Methadone Maintenance Therapy in Vietnam: An Overview and Scaling-Up Plan

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Tam T. M. Nguyen ◽  
Long T. Nguyen ◽  
Manh D. Pham ◽  
Hoang H. Vu ◽  
Kevin P. Mulvey
Keyword(s):  
Drug Users ◽  
Hiv Transmission ◽  
Methadone Maintenance ◽  
Methadone Treatment ◽  
Scaling Up ◽  
Injecting Drug Users ◽  
Heroin Addiction ◽  
Rehabilitation Centers ◽  
Positive Treatment ◽  
The Government

Vietnam is among the countries with the highest rate of HIV transmission through injecting drug users. HIV prevalence among injecting drug users is 20% and up to 50% in many provinces. An estimated number of drug users in the country by the end of 2011 were 171,000 in which the most common is heroin (85%). Detoxification at home, community, and in rehabilitation centers have been the main modalities for managing heroin addiction until Methadone Maintenance Treatment (MMT) was piloted in 2008. Recent reports have demonstrated positive treatment outcomes. Incidence of HIV was found remarkably low among patients on MMT. Treatment has significantly improved the quality of life as well as stability for society. The government has granted the Ministry of Health (MoH) to expand Methadone treatment to at least 30 provinces to provide treatment for more than 80,000 drug users by 2015. The Vietnam Administration for HIV/AIDS Control (VAAC) and MOH have outlined the role and responsibility of key departments at the central and local levels in implementing and maintaining MMT treatment. This paper will describe the achievements of the MMT pilot program and the scaling-up plan as well as strategies to ensure quality and sustainability and to overcome the challenges in the coming years.

Unexplained Severe Illness and Death among Injecting Drug Users in Scotland, Ireland, and England from April to August 2000

2014 ◽  
pp. 121-132 ◽  
Author(s):  
Marc Fischer ◽  
Anne Whitney ◽  
Syed Ahmed ◽  
Joe Barry ◽  
Jane Jones
Keyword(s):  
Drug Users ◽  
Injecting Drug Users ◽  
Severe Illness

HIV risk-taking behaviour among injecting drug users currently, previously and never enrolled in methadone treatment

Addiction ◽  
2006 ◽  
Vol 90 (4) ◽  
pp. 545-554 ◽  
Author(s):  
AMANDA BAKER ◽  
NICKY KOCHAN ◽  
JULIE DIXON ◽  
ALEX WODAK ◽  
NICK HEATHER
Keyword(s):  
Hiv Risk ◽  
Risk Taking ◽  
Drug Users ◽  
Methadone Treatment ◽  
Injecting Drug Users

A Comparison of Injecting Drug Users Reached through Outreach and Methadone Treatment

1993 ◽  
Vol 23 (4) ◽  
pp. 667-687 ◽  
Author(s):  
Wendee M. Wechsberg ◽  
Michael L. Dennis ◽  
Elizabeth Cavanaugh ◽  
J. Valley Rachal
Keyword(s):  
Drug Users ◽  
Methadone Treatment ◽  
Prevention Programs ◽  
Injecting Drug Users ◽  
Common Assumption ◽  
Formal Treatment ◽  
The Past ◽  
The Common

The authors examine the common assumption that AIDS/HIV outreach prevention programs and similar programs in methadone treatment compete for the same population by comparing injecting drug users (IDUs) reached by each intervention in four communities. Similar results across sites reinforced the conclusions that, compared to IDUs entering methadone treatment, the IDUs contacted in outreach were more likely to be male, black, and young; to start injecting drugs when they were older, have shorter histories of injecting risk, and currently inject drugs less often than daily; to inject infrequently only opiates and frequently inject only cocaine; and to have not been in formal treatment ever or in the past six months.

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