A Five-year Report on Body Packing and Body Stuffing in Isfahan

Background: Body packing and body stuffing of illicit drugs have increased in recent decades. The drug contents of the packages vary from region to region, and there are controversies surrounding the diagnostic and therapeutic methods. The aim of this study was to explore the clinical presentations, diagnostic and therapeutic measures, and the subsequent clinical outcomes of drug concealment by people. Methods: A retrospective analysis was performed on data for all cases of body packing and body stuffing that were referred to a university hospital, in Isfahan, Iran, from Mar. 2013 to Feb. 2018. Results: Sixty-eight body stuffers and 18 body packers (n=86) were included in this study. Seventy-eight patients (90.7%) were male, mostly aged between 20 to 40 years. There was no significant difference between the two groups with respect to the signs and symptom, hospital stay, treatment and clinical outcomes. Heroin and crystal methamphetamine, n=52 (60%) and n=22 (25%), respectively, were the most substances detected, irrespective of the concealment method. Abdominal X-ray and CT scan tests were positive for the detection of at least one packet in each of the 94.4% of the patients. Conclusion: Heroin and crystal methamphetamine were the most common substances concealed in the bodies of the patients. Based on our findings, CT scan was more sensitive than abdominal X-ray test in the detection of illicit drug packets concealed in the patients. Close observation and whole bowel irrigation were effective therapeutic modalities in most cases. All cases were fully recovered and discharged from the hospital.

1220Barriers to care for people who use crystal methamphetamine

Background Crystal methamphetamine (‘ice’) causes significant societal harm in Australia and is perceived by the public to be the drug of most concern nationally. Although effective treatments exist, it is estimated that only a third of people dependent on amphetamine-type stimulants receive treatment each year. Barriers to care may for people who use ice can include psychosocial (e.g., knowledge, attitudinal) and structural barriers. This study aimed to look at the perceived and actual barriers to care for Australians, as well as help-seeking behaviours among people who use ice. Methods An online survey was conducted among 2,110 Australians including people with lived experience, health workers, affected family members/friends and community members. All participants were asked about perceived barriers to care. People with lived experience were asked additional questions about help seeking. Results Attitudinal reasons were the highest perceived barrier to care among 63.1% of participants, followed by knowledge (21.9%). People with lived experience were more likely to endorse attitudinal barriers (OR 1.35), whereas health workers were more likely to endorse knowledge related barriers (OR 0.69). Among people with lived experience who had sought help, 74.5% had visited a counsellor/psychologist and 60.6% had asked help from a family member/friend. Conclusions Understanding and reducing barriers to care is essential to reduce the harms associated with the drug. It is important to support families and friends as they are often asked to help or support a loved one using ice. Key messages It is important to understand and reduce the perceived and actual barriers to care for people who use ice. This is essential to reduce the harms associated with the drug.

Crystal methamphetamine use in British Columbia, Canada: A cross-sectional study of people who access harm reduction services

Introduction Increased use of crystal methamphetamine (“crystal meth”) has been observed across North America and international jurisdictions, including a notable increase in the presence of methamphetamines in illicit drug toxicity deaths in British Columbia (BC), Canada. We used data from a cross-sectional survey and urine toxicology screening to report the prevalence, correlates, and validity of self-reported crystal meth use among clients of harm reduction sites in BC. Materials and methods Survey data were collected from 1,107 participants across 25 communities in BC, through the 2018 and 2019 Harm Reduction Client Survey. We described reported substance use and used a multivariate logistic regression model to characterize crystal meth use. Urine samples provided by a subset of participants were used to derive validity of self-reported three-day crystal meth use compared to urine toxicology screening. Results Excluding tobacco, crystal meth was the most frequently reported substance used in the past three days in 2018 and 2019 (59.7% and 71.7%, respectively). Smoking was the dominant route of administration for crystal meth, crack, heroin, and fentanyl. Multivariate analysis determined significantly higher odds of crystal meth use among those who used opioids (Adjusted Odds Ratio [AOR] = 3.13), cannabis (AOR = 2.10), and alcohol (1.41), and among those who were not regularly housed (AOR = 2.08) and unemployed (AOR = 1.75). Age ≥50 was inversely associated with crystal meth use (AOR = 0.63). Sensitivity of self-reported crystal meth use was 86%, specificity was 86%, positive predictive value was 96%, and negative predictive value was 65%. Conclusions Crystal meth was the most commonly used substance among clients of harm reduction sites in BC in 2018 and 2019, and was frequently used concurrently with opioids. Comparison to urine samples demonstrated high validity of self-reported crystal meth use. Understanding evolving patterns of substance use will be imperative in tailoring harm reduction and substance use services for individuals that use crystal meth.

The Psycho-Social and Socio-Cultural Factors of Crystal Methamphetamine Use Among the Gay, Bi and MSM (GBM) Population

In the United States, men who have sex with men (MSM) remain as the demographic group with the highest HIV incidence rates and account for 53% of new HIV infections in 2006 (Rajasingham, Mimiaga, White, Pinkston, Baden, & Mitty, 2012). One of the reasons accounting for such high rates of HIV transmission between gay, bisexual and MSM (GBM) can be attributed to poly-substance use and the use of crystal methamphetamine (Solomon, Halkitis, Moeller, & Pappas, 2012; Rajasingham et al., 2012). The U.S. Centre for Disease Control and Prevention (2007) reported methamphetamine use in the MSM community is of particular concern due to the high prevalence of HIV and the use of the stimulant. Meanwhile, researchers have found methamphetamine use is closely corrleated to sexual risk taking among GBM and such intimate link between risky sexual behaviour and methamphetamine use have led to a possible double epidemic (Halkitis, Green, & Carragher, 2006). In particular, the use of methamphetamine has been found to be correlated to the frequency of unprotected insertive anal intercourse (UIAI) and unprotected receptive anal intercourse (URAI) among HIV positive and persons with unknown serostatus causal partners over time (Halkitis, Mukherjee, & Palamar, 2009). As an effort to better understand this social pheonemon, this paper focuses on the exploration and identification of the psycho-social and socio-cultural factors of crystal methamphetamine use among the GBM population.

The Psycho-Social and Socio-Cultural Factors of Crystal Methamphetamine Use Among the Gay, Bi and MSM (GBM) Population

In the United States, men who have sex with men (MSM) remain as the demographic group with the highest HIV incidence rates and account for 53% of new HIV infections in 2006 (Rajasingham, Mimiaga, White, Pinkston, Baden, & Mitty, 2012). One of the reasons accounting for such high rates of HIV transmission between gay, bisexual and MSM (GBM) can be attributed to poly-substance use and the use of crystal methamphetamine (Solomon, Halkitis, Moeller, & Pappas, 2012; Rajasingham et al., 2012). The U.S. Centre for Disease Control and Prevention (2007) reported methamphetamine use in the MSM community is of particular concern due to the high prevalence of HIV and the use of the stimulant. Meanwhile, researchers have found methamphetamine use is closely corrleated to sexual risk taking among GBM and such intimate link between risky sexual behaviour and methamphetamine use have led to a possible double epidemic (Halkitis, Green, & Carragher, 2006). In particular, the use of methamphetamine has been found to be correlated to the frequency of unprotected insertive anal intercourse (UIAI) and unprotected receptive anal intercourse (URAI) among HIV positive and persons with unknown serostatus causal partners over time (Halkitis, Mukherjee, & Palamar, 2009). As an effort to better understand this social pheonemon, this paper focuses on the exploration and identification of the psycho-social and socio-cultural factors of crystal methamphetamine use among the GBM population.