Sexual and drug use risk behaviors and HIV- and Hepatitis-C transmission knowledge among non-treatment-seeking individuals with opioid use disorders in NYC

2017 ◽  
Vol 171 ◽  
pp. e143-e144
Author(s):  
Verena Metz ◽  
Maria Sullivan ◽  
Jermaine D. Jones ◽  
Elizabeth Evans ◽  
Rachel Luba ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Use ◽  
Risk Behaviors ◽  
Treatment Seeking ◽  
Opioid Use ◽  
Opioid Use Disorders

scholarly journals Effect of a Mobile-Health Intervention (A-CHESS) on Hepatitis C Testing Uptake Among People with Opioid Use Disorder: A Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Karli R Hochstatter ◽  
David H Gustafson Sr ◽  
Gina Landucci ◽  
Klaren Pe-Romashko ◽  
Olivia Cody ◽  
...  
Keyword(s):  
Hepatitis C ◽  
High Risk ◽  
Drug Use ◽  
Risk Behaviors ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Injection Equipment ◽  
Testing Uptake ◽  
Hcv Antibody ◽  
Hcv Testing

BACKGROUND The growing epidemic of opioid use disorder (OUD) and associated injection drug use has resulted in a surge of new hepatitis C virus (HCV) infections. Approximately half of persons with HCV infection are unaware of their HCV status. Improving HCV awareness and increasing screening among people with OUD is critical. A-CHESS is an evidence-based, smartphone-delivered relapse prevention system that has been implemented among people with OUD who are receiving medication-assisted treatment (MAT) to improve long-term recovery. OBJECTIVE We incorporated HCV content and functionality into A-CHESS to (1) to characterize the HCV care continuum among people in early remission and receiving MAT for OUD and (2) determine whether incorporating HCV content and functionality into A-CHESS increases HCV testing. METHODS HCV intervention content, including dissemination of educational information, private messages tailored to individual’s stage of HCV care, and a public discussion forum, were implemented into the A-CHESS platform. Individuals with OUD were randomly assigned to receive MAT alone (control arm) or MAT + A-CHESS (experimental arm). Quarterly telephone interviews, conducted from baseline to month 24, assessed risk behaviors and HCV testing history. Cox proportional hazards regression was used to assess overall whether individuals who received A-CHESS were tested for HCV (including either antibody or RNA tested) at a higher rate than those in the control arm. To assess the effect of A-CHESS on subsets of individuals at highest risk for HCV, additional analyses examined the effect of the intervention among individuals who injected drugs and shared injection equipment. RESULTS Between April 2016 and April 2020, 416 individuals with OUD were enrolled. Overall, 44% of the study population was HCV-antibody positive, 30% were HCV-antibody negative, and 25% were considered untested at baseline. At month 24 there was no difference in HCV testing uptake between intervention and control participants overall. However, among the subset of 109 individuals who engaged in injection drug use, there was a slight trend towards increased HCV testing uptake among those who received A-CHESS (89% versus 85%; Hazard Ratio: 1.34; 95% CI: 0.87-2.05; P=.18), and a stronger trend was observed when focusing on the subset of 32 individuals who reported sharing injection equipment (87% versus 56%; Hazard Ratio: 2.92; 95% CI: 0.959-8.86; P=.059). CONCLUSIONS Incorporating HCV prevention and care information into A-CHESS may increase the uptake of HCV testing while preventing opioid relapse when implemented among populations who engage in high risk behaviors such as sharing contaminated injection equipment; however, studies that are powered to detect differences in HCV testing among high risk groups are needed. CLINICALTRIAL ClinicalTrials.gov, NCT02712034. Registered on 14 March 2016. INTERNATIONAL REGISTERED REPORT RR2-10.2196/12620

scholarly journals Probability and predictors of treatment-seeking for prescription opioid use disorders: A National Study

2013 ◽  
Vol 131 (1-2) ◽  
pp. 143-148 ◽  
Author(s):  
Carlos Blanco ◽  
Miren Iza ◽  
Robert P. Schwartz ◽  
Claudia Rafful ◽  
Shuai Wang ◽  
...  
Keyword(s):  
Treatment Seeking ◽  
National Study ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Opioid Use Disorders ◽  
Prescription Opioid Use

scholarly journals Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders

2015 ◽  
Vol 153 ◽  
pp. 286-292 ◽  
Author(s):  
Judith I. Tsui ◽  
Marlene C. Lira ◽  
Debbie M. Cheng ◽  
Michael R. Winter ◽  
Daniel P. Alford ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Maintenance Therapy ◽  
Pain Sensitivity ◽  
Hepatitis C Virus Infection ◽  
Opioid Use ◽  
Opioid Use Disorders

Mortality among individuals with cannabis, cocaine, amphetamine, MDMA, and opioid use disorders: a nationwide follow-up study of danish substance users in treatment

2011 ◽  
Vol 26 (S2) ◽  
pp. 8-8 ◽  
Author(s):  
M. Arendt ◽  
P. Munk-Jørgensen ◽  
L. Sher ◽  
S.O.W. Jensen
Keyword(s):  
Drug Use ◽  
Injection Drug Use ◽  
Excess Mortality ◽  
Psychiatric Comorbidity ◽  
Injection Drug ◽  
Opioid Use ◽  
Primary Users ◽  
Opioid Use Disorders ◽  
The Impact

IntroductionLittle is known about the excess mortality associated with use of some illicit substances. In particular, this concerns the risks associated with injection drug use and psychiatric disorders.AimsThis study estimated mortality following substance abuse treatment among primary users of cannabis, cocaine, amphetamine, MDMA, and opioids. The risks associated with injection drug use and psychiatric comorbidity were assessed.MethodsA register of individuals in treatment for illicit substance disorders was linked with registers on psychiatric treatment and mortality. The study population consisted of 20581 individuals who received treatment in Denmark between 1996 and 2006. There were 1441 deaths recorded over 111445 person-years of follow-up.ResultsStandardized Mortality Ratios (SMRs) for primary users of specific substances were: Cannabis: 4.9, cocaine: 6.4, amphetamine: 6.0, heroin: 9.1, and other opioids 7.7. For MDMA the crude mortality rate was 1.75/1000 person-years, and the SMR was not significantly elevated. Sharing of syringes was associated with increased mortality in both primary users of opioids (hazard ratio (HR): 1.58 [95% CI 1.22–1.99], p < .001) and cocaine/amphetamine (HR: 9.52 (95% CI 3.94–23.02, p < .001). Overall, psychiatric comorbidity was associated with modestly increased mortality (HR: 1.15 [95% CI 1.03–1.29], p = .012) and in particular for primary users of cocaine/amphetamine (HR: 2.74 [95% CI 1.56–4.80], p < .001).ConclusionsHigh SMRs were found among individuals who had received treatment for cannabis, cocaine, amphetamine, and opioid use disorders. Injection drug use was clearly associated with excess mortality, while the impact of psychiatric comorbidity was generally modest.

scholarly journals Concurrent Initiation of Hepatitis C and Opioid Use Disorder Treatment in People Who Inject Drugs

2020 ◽  
Vol 71 (7) ◽  
pp. 1715-1722 ◽  
Author(s):  
Elana S Rosenthal ◽  
Rachel Silk ◽  
Poonam Mathur ◽  
Chloe Gross ◽  
Rahwa Eyasu ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Use ◽  
People Who Inject Drugs ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Agonist Therapy ◽  
Hcv Treatment ◽  
Opioid Agonist ◽  
Opioid Agonist Therapy ◽  
The Impact

Abstract Background People who inject drugs have a high prevalence of hepatitis C virus (HCV) and significant disease associated with drug use; however, HCV treatment often occurs in absence of interventions to address opioid use disorder and drug use–related harms. The impact of concurrent initiation of opioid agonist therapy (OAT) on HCV treatment and drug use outcomes is unknown. Methods In this prospective, open-label, observational trial at a harm reduction organization’s drop-in center in Washington, DC, 100 patients with chronic HCV infection, opioid use disorder, and ongoing injection drug use were treated with sofosbuvir-velpatasvir for 12-weeks and offered buprenorphine initiation. The primary end point was sustained virologic response (SVR), and secondary end points included uptake of and retention in OAT, change in risk behavior, and determinants of SVR. Results Eighty-two patients (82%) achieved SVR, which was not associated with baseline OAT status (P = .33), on-treatment drug use (P &gt;.99), or imperfect daily adherence (P = .35) but was significantly associated with completing 2 or more 28-pill bottles of sofosbuvir-velpatasvir (P &lt; .001) and receiving OAT at week 24 (P = .01). Of 67 patients not already receiving OAT at baseline, 53 (79%) started OAT. At week 24, 68 (68%) patients were receiving OAT. Receipt of OAT was associated with fewer opiate-positive urine drug screens (P = .003), lower human immunodeficiency virus risk-taking behavior scores (P &lt; .001), and lower rates of opioid overdose (P = .04). Conclusions The Novel Model of Hepatitis C Treatment as an Anchor to Prevent HIV, Initiate Opioid Agonist Therapy, and Reduce Risky Behavior study demonstrates high uptake of buprenorphine collocated with HCV treatment, and it shows that concurrent initiation of OAT with HCV treatment can result in high rates of SVR while reducing risks associated with drug use. Clinical Trials Registration NCT03221309.

The association of psychedelic use and opioid use disorders among illicit users in the United States

2017 ◽  
Vol 31 (5) ◽  
pp. 606-613 ◽  
Author(s):  
Vincent D Pisano ◽  
Nathaniel P Putnam ◽  
Hannah M Kramer ◽  
Kevin J Franciotti ◽  
John H Halpern ◽  
...  
Keyword(s):  
Drug Use ◽  
Risk Ratio ◽  
Opioid Dependence ◽  
Substance Misuse ◽  
Illicit Drug ◽  
Opioid Abuse ◽  
Opioid Use ◽  
Opioid Use Disorders ◽  
Opioid Users ◽  
Reduced Risk

Background: Preliminary studies show psychedelic compounds administered with psychotherapy are potentially effective and durable substance misuse interventions. However, little is known about the association between psychedelic use and substance misuse in the general population. This study investigated the association between psychedelic use and past year opioid use disorders within illicit opioid users. Methods: While controlling for socio-demographic covariates and the use of other substances, the relationship between classic psychedelic use and past year opioid use disorders was analyzed within 44,000 illicit opioid users who completed the National Survey on Drug Use and Health from 2008 to 2013. Results: Among respondents with a history of illicit opioid use, psychedelic drug use is associated with 27% reduced risk of past year opioid dependence (weighted risk ratio = 0.73 (0.60–0.89) p = 0.002) and 40% reduced risk of past year opioid abuse (weighted risk ratio = 0.60 (0.41–0.86) p = 0.006). Other than marijuana use, which was associated with 55% reduced risk of past year opioid abuse (weighted risk ratio = 0.45 (0.30–0.66) p < 0.001), no other illicit drug was associated with reduced risk of past year opioid dependence or abuse. Conclusion: Experience with psychedelic drugs is associated with decreased risk of opioid abuse and dependence. Conversely, other illicit drug use history is largely associated with increased risk of opioid abuse and dependence. These findings suggest that psychedelics are associated with positive psychological characteristics and are consistent with prior reports suggesting efficacy in treatment of substance use disorders.

Sign in / Sign up

Export Citation Format

Share Document