Opioid-related hospitalizations and intravenous drug users: Sociodemographic, spatial, and comorbid associations among hospital inpatients and community-based harm reduction organization participants

Objective: To provide an updated analysis of opioid-related injuries in Nevada and provide a first-time analysis of the intravenous drug user (IDU) population within Clark County.Design: Cross-sectional study.Setting: Center for Health Information Analysis (CHIA) database and IDU data from Trac-B Exchange (Trac-B).Participants: Patients hospitalized for opioid-related causes (n = 9,064) and participants from Trac-B.Main outcome measure(s): Variables assessed included age, gender, and race/ethnicity. Zip codes were retrieved to find differences in geographical usage patterns of hospital or sterile injection equipment (SEP) sites. Contingency tables were utilized to determine the frequency of comorbidities. Additionally, GIS was used to investigate potential spatial patterns of interest.Results: Totally 5,268 out of the 9,064 opioid-related cases reported in Nevada were Clark County residents. The highest frequency for comorbidities associated with opioid-related hospitalizations (ORHs) included: infections, chronic bodily pain, and malnutrition. There was a higher proportion of 18-35-year-olds who used SEPs as compared to hospitals and a higher proportion of individuals aged 36 years or older who used hospitals as compared to using SEPs. Of the nearly 100 zip codes in Clark County, six showed a disproportionally high frequency of ORHs, and three comprised the majority of injection drug use.Conclusions: There is an opioid epidemic in Nevada that has contributed to addiction, heroin usage, injection drug use, and transmission of bloodborne diseases. Understanding the ORHs and intravenous drug use trends can help guide the development of program interventions.

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Outcomes of Ligation without Revascularization in Pseudoaneurysms of Peripheral Arteries in Intravenous Drug Users

Journal of Nepal Medical Association ◽

10.31729/jnma.4472 ◽

2019 ◽

Vol 57 (217) ◽

Cited By ~ 1

Author(s):

Lokesh Shekher Jaiswal ◽

Narendra Pandit ◽

Shailesh Adhikary

Keyword(s):

Drug Use ◽

Femoral Artery ◽

Drug Users ◽

Saphenous Vein Graft ◽

Limb Ischemia ◽

Intravenous Drug ◽

Intravenous Drug Users ◽

Cross Sectional ◽

Autologous Vein ◽

Graft Thrombosis

Introduction: Management of pseudoaneurysms in intravenous drug users is complex andchallenging due to an associated infection and unavailability of autologous vein grafts. Here weobserve the outcomes of ligation and local debridement as a primary modality of treatment in thissubset of patients with pseudoaneurysms. Methods: This is a descriptive cross sectional study of 15patients over a period of 4 years whopresented with pseudoaneurysm of peripheral artery from intravenous drug use. In this study,we describe the presentations and management outcomes in 15 patients with peripheral arterialpseudoaneurysmfrom IV drug use. Results: The most common site involved was common femoral artery among 12 (80%) patientsfollowed by superficial femoral artery among 8 (13.3%) patients and external iliac artery in 1 (6.7%)patient. Twelve (80%) patients were having signs of infection. All patients underwent surgicalintervention which comprised of excision of pseudoaneurysm and ligation of artery withoutrevascularization among 12 (80%) patients and with revascularization with autologous venous graftamong 3 (20%) patients. There was no mortality or a major bleeding requiring re-exploration. Noneof the patients developed limb ischemia necessitating amputation.One patient with femoral arteryligation without revascularization at one year of follow up is having claudication on brisk walking.There was one saphenous vein graft thrombosis in immediate postoperative period. Conclusions: With the use of ligation without revascularization technique, there was no mortality ormajor bleeding requiring re-exploration. None of the patients developed limb ischemia necessitatingamputation so this treatment modality seems promising in treatment of pseudoaneurysms inintravenous drug users.

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Socio-Demographic Correlates of Injection Drug Use Among Male Drug Users: A Cross Sectional Study in Nepal

Journal of Community Health ◽

10.1007/s10900-014-9867-1 ◽

2014 ◽

Vol 39 (6) ◽

pp. 1124-1132 ◽

Cited By ~ 1

Author(s):

Sanjeev Raj Neupane ◽

Shiva Raj Mishra ◽

Samaj Adhikari ◽

Amod Kumar Poudyal

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

Drug Users ◽

Cross Sectional Study ◽

Injection Drug ◽

Sectional Study ◽

Cross Sectional ◽

Demographic Correlates

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FREQUENCY OF HBV, HCV, AND HIV AMONG INJECTION DRUG USERS (IDUS), AND CO-RELATION WITH SOCIOECONOMIC STATUS, TYPE USE AND DURATION OF SUBSTANCE USE.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.07.3788 ◽

2019 ◽

Vol 26 (07) ◽

pp. 1147-1150

Author(s):

Muhammad Ilyas Jat ◽

Ghulam Rasool Rind

Keyword(s):

Socioeconomic Status ◽

Substance Use ◽

Drug Use ◽

Injection Drug Users ◽

Drug Users ◽

Tertiary Care ◽

Hiv Infections ◽

Injection Drug ◽

Tertiary Care Centre ◽

Cross Sectional

Introduction: Psychoactive drug use is a continual and chronic psychological and physical disease that is characterized by persistent substance use, regardless of detrimental results. Hepatitis B, C and HIV infections constitute serious healthcare issues worldwide. Objectives: To determine the frequency of HBV, HCV, and HIV among Injection Drug Users (IDUs), visiting a tertiary care centre at Karachi, Pakistan, co-relation with socioeconomic status, type of substance use and duration of substance use. Study Design: A descriptive cross-sectional study. Setting: Psychiatry Outpatient Department (OPD), Department of Psychiatry and Behavioral Sciences, JPMC, Karachi. Period: 5th Aug 2016 to 5th Feb 2017. Material and Methods: Total 280 cases of both genders having Injection Drug Use history were enrolled in the study. Non-probability (consecutive) sampling was done. The data was analysed on SPSS version 20.0. Results: The average age of patients was 32.26 ±9.83 years. Majority 256 (91.4%) were male. Out of 280, 142 (50.7%) were married, 108 (38.6%) were single, 20 (7.1%) were widow and 10 (3.6%) were divorced/separated. Most of patients belonged to lower socioeconomic class. Opioids were the most common substance used and most of patients were using substance for more than 2 years. Majority of patients were preliterate or educated till primary and were jobless. HCV was predominantly present followed by HBV, HIV as 47 (16.8%), 22 (7.9%) and 9 (3.2%) respectively. Conclusion: Frequency of infections with HBV, HCV and HIV is quite high and alarming.

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Rapid Assessment of Injecting Drug Users (IDUs) in Nairobi and Mombasa counties, Kenya: A Respondent Driven Sampling Survey

10.21203/rs.3.rs-44785/v1 ◽

2020 ◽

Author(s):

Gabriel O Dida ◽

Francis Oguya ◽

Patrick Kenya ◽

Francisca Ongecha ◽

Patrick Mureithi ◽

...

Keyword(s):

Drug Use ◽

Risk Behaviors ◽

Drug Users ◽

Injecting Drug Users ◽

Injecting Drug Use ◽

Hiv Prevalence ◽

Injection Drug ◽

Respondent Driven Sampling ◽

Cross Sectional ◽

Situational Assessment

Abstract Background: A Cross-sectional Rapid Situational Assessment of Injecting Drug Users (IDUs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injection drug users in Nairobi and Mombasa counties of Kenya. The study sought to establish HIV prevalence and document risk behaviors among IDUs in the two regions, as well as assess their spatial distribution and size estimates in the general population. Methods: A cross-sectional study design was adopted in which a set of initial subjects referred to as ‘seeds’ were first identified from which an expanding chain of referrals was obtained, with subjects from each wave referring subjects of subsequent wave. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, Community based organizations (CBO's), among others. Three NGOs located in the Mombasa county and one in Nairobi county were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides. Results: A total of 646 individuals (344 in Nairobi and 302 at the coast) were recruited for the study between January and March 2010. Of these 590 (91%) were males and 56 (9%) were female. Findings showed that most IDUs initiated injecting drug use between the ages of 20-29 years, with the youngest age of initiation being 11 years and oldest age being 53 years. Most commonly injected drug was heroin (98%), with a small (2%) percentage injecting cocaine. Other non-injecting methods such as smoking or combining these two drugs with other drugs such as cannabis or rohypnol were also common. Most IDUs used other substances (cigarettes, alcohol, and cannabis) before initiating injecting drug use. While all IDUs continue to be at risk in the two regions, those from the Western parts of Nairobi were at a relatively higher risk given their higher rate of sharing injecting equipment and solutions. Conclusions: Given that initiation of injection drug use begins early and peaks mainly after formal school years (20-29 years), preventive programmes should be targeted at secondary school, college and out of school youth. Further, to protect People who inject drugs (PWIDs) from HIV infection, the country should introduce free Needle Syringe Programs with provision of condoms and Methadone Assisted Therapy as a substitute for drug use.

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Transition from first illicit drug use to first injection drug use among rural Appalachian drug users: a cross-sectional comparison and retrospective survival analysis

Addiction ◽

10.1111/j.1360-0443.2011.03635.x ◽

2011 ◽

Vol 107 (3) ◽

pp. 587-596 ◽

Cited By ~ 100

Author(s):

April M. Young ◽

Jennifer R. Havens

Keyword(s):

Survival Analysis ◽

Drug Use ◽

Injection Drug Use ◽

Drug Users ◽

Illicit Drug ◽

Illicit Drug Use ◽

Injection Drug ◽

Cross Sectional

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Injection drug use, depression, and HIV screening in rural primary care settings: A retrospective cross-sectional study

International Journal of Care Coordination ◽

10.1177/2053434521999903 ◽

2021 ◽

Vol 24 (1) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Shameka Cody ◽

David L Albright ◽

Justin McDaniel ◽

Shanna McIntosh

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

Injection Drug Users ◽

Drug Users ◽

Hiv Infections ◽

Injection Drug ◽

Hiv Screening ◽

Hiv Diagnosis ◽

Cross Sectional ◽

The Relationship

Introduction Antiretroviral therapy (ART) has reduced HIV viral replication and transmission of disease. However, continuing incidence of new HIV infections has been attributed to undiagnosed HIV infections among injection drug users. This purpose of this retrospective cross-sectional study was to determine whether depression moderates the relationship between injection drug use and HIV screening among people with substance use in the screening, brief intervention, and referral to treatment in Alabama (AL-SBIRT) program. Methods Electronic health record data were obtained from three consenting medical facilities (n = 103). Multivariable logistic regression analysis was conducted to determine the moderating effect of depression on the relationship between injection drug use and HIV screening. Results Bivariate analyses revealed that HIV screening was more common among individuals not engaged in injection drug use, 75% and 57% respectively. Participants who had never been screened had worse depressive symptoms on the PHQ-2 (M = 3.00, SE = 0.42) than individuals who had been screened for HIV (M = 1.45, SE = 0.17). After controlling for demographic variables, tobacco use, alcohol consumption, and drug abuse, results indicated a moderating effect of depression on the relationship between injection drug use and receipt of HIV screening (aOR = 0.85 [95% CI = 0.84, 0.86). Discussion Findings suggest that high risk subgroups such as injection drug users with severe depression may not be using HIV prevention services, leading to possible delays in HIV diagnosis. Integration of behavioral interventions and HIV prevention services may reduce risk factors among depressed injection drug users. Such interventions may improve retention for injection drug users who experience worse depressive symptoms post HIV diagnosis.

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