heroin users
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2021 ◽  
Vol 144 ◽  
pp. 168-176
Author(s):  
Yan Xu ◽  
Shicong Wang ◽  
Longmao Chen ◽  
Ziqiang Shao ◽  
Min Zhang ◽  
...  

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Natasha Rachel Gloeck ◽  
Bernice Harris ◽  
Elizabeth Webb ◽  
Andrew Scheibe

Abstract Background In South Africa, increasing illicit opioid use and associated health challenges can be managed with opioid substitution therapy (OST), like methadone, provided it is prescribed at the recommended dose and duration. The Community Oriented Substance Use Programme (COSUP) provides free methadone to patients with Opiod Use Disorder across Tshwane, South Africa on need-based criteria. Methods A retrospective cohort using secondary data of patients treated with methadone at eight COSUP sites. The factors associated with the retention of 575 participants for the period December 2016 to September 2018 were analysed. Results Participants on lower methadone doses had decreased odds of being retained (0 to 20mg: adjusted odds ratio (aOR) 0.25, p-value (p)=0.002, 95% Confidence Interval (CI) 0.10 - 0.61; 20 to 40mg: aOR 0.20, p < 0.001, 95% CI 0.08 - 0.49). Participants receiving free methadone had 3.75 the odds to be retained (p < 0.001, 95% CI 2.47 - 5.70). Inner-city participants had 5.19 the odds to be retained (p < 0.001, 95% CI 2.99 - 9.03). White participants had 3.39 the odds of being retained (p = 0.001, 95% CI 1.64 - 7.00). Injecting heroin users had 0.63 the odds of being retained (p = 0.032; 95% CI 0.41 - 0.96). Conclusions Methadone doses above 50mg, access to free methadone, accessing care within the inner-city and the white population group were positively associated with retention. Injecting drug use was negatively associated. Key messages Provision of free methadone at adequate doses can aid in retaining patients within an outpatient OST programme.


Author(s):  
Liang Qiongdan ◽  
Wang Yong ◽  
Wang Fei ◽  
Li Zhiwen ◽  
Li Denghe ◽  
...  
Keyword(s):  

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marcelo Ribeiro ◽  
Rosana Frajzinger ◽  
Luciane Ogata Perrenoud ◽  
Benedikt Fischer

Purpose Brazil’s street-based drug use is mostly characterized by non-injection psychostimulant (e.g. crack-cocaine) drug use in Brazil, with limited interventions and service availability. Recently, an influx of multi-ethnic migrants within an urban drug scene in Sao Paulo was associated with heroin use, a drug normatively absent from Brazil. The purpose of this paper is to characterize and compare heroin use-related characteristics and outcomes for an attending sub-sample of clients from a large community-based treatment centre (“CRATOD”) serving Sao Paulo’s local urban drug scene. Design/methodology/approach All non-Brazilian patients (n = 109) receiving services at CRATOD for 2013–2016 were identified from patient files, divided into heroin users (n = 40) and non-heroin users (n = 69). Based on chart reviews, select socio-demographic, drug use and health status (including blood-borne-virus and other infections per rapid test methods) were examined and bi-variately compared. Multi-variate analyses examined factors independently associated with heroin use. Findings Most participants were male and middle-aged, poly-drug users and socio-economically marginalized. While heroin users primarily originated from Africa, they reported significantly more criminal histories, drug (e.g. injection) and sex-risk behaviors and elevated rates of BBV (e.g. Hepatitis C Virus and HIV). A minority of heroin users attending the clinic was provided methadone treatment, mostly for detoxification. Originality/value This study documented information on a distinct sample of mostly migration-based heroin users in Sao Paulo, Brazil. Based on the local experience, global migration dynamics can bring changes to established drug use cultures and services, including new challenges for drug use-related related behaviors and therapeutic interventions that require effective understanding and addressing.


2021 ◽  
Vol 12 ◽  
Author(s):  
Elena Psederska ◽  
Nicholas D. Thomson ◽  
Kiril Bozgunov ◽  
Dimitar Nedelchev ◽  
Georgi Vasilev ◽  
...  

Background: Psychopathy and substance use disorders (SUDs) are both characterized by neurocognitive impairments reflecting higher levels of impulsivity such as reward-driven decision-making and deficient inhibitory control. Previous studies suggest that psychopathy may exacerbate decision-making deficits, but it may be unrelated to other neurocognitive impairments among substance dependent individuals (SDIs). The aim of the present study was to examine the role of psychopathy and its interpersonal-affective and impulsive-antisocial dimensions in moderating the relationships between dependence on different classes of drugs and neurocognitive domains of impulsivity.Method: We tested 693 participants (112 heroin mono-dependent individuals, 71 heroin polysubstance dependent individuals, 115 amphetamine mono-dependent individuals, 76 amphetamine polysubstance dependent individuals, and 319 non-substance dependent control individuals). Participants were administered the Psychopathy Checklist: Screening Version (PCL:SV) and seven neurocognitive tasks measuring impulsive choice/decision-making (Iowa Gambling Task; Cambridge Gambling Task; Kirby Delay Discounting Task; Balloon Analog Risk Task), and impulsive action/response inhibition (Go/No-Go Task, Immediate Memory Task, and Stop Signal Task).Results: A series of hierarchical multiple regressions revealed that the interpersonal-affective dimension of psychopathy moderated the association between decision-making, response inhibition and both amphetamine and heroin dependence, albeit differently. For amphetamine users, low levels of interpersonal-affective traits predicted poor decision-making on the Iowa Gambling Task and better response inhibition on the Stop Signal task. In contrast, in heroin users high interpersonal-affective psychopathy traits predicted lower risk taking on the Cambridge Gambling Task and better response inhibition on the Go/No-Go task. The impulsive-antisocial dimension of psychopathy predicted poor response inhibition in both amphetamine and heroin users.Conclusions: Our findings reveal that psychopathy and its dimensions had both common and unique effects on neurocognitive function in heroin and amphetamine dependent individuals. Our results suggest that the specific interactions between psychopathy dimensions and dependence on different classes of drugs may lead to either deficient or superior decision-making and response inhibition performance in SDIs, suggesting that psychopathy may paradoxically play a protective role for some neurocognitive functions in specific subtypes of substance users.


NeuroImage ◽  
2021 ◽  
pp. 118169
Author(s):  
Shuang Liu ◽  
Shicong Wang ◽  
Min Zhang ◽  
Yan Xu ◽  
Ziqiang Shao ◽  
...  

2021 ◽  
Vol 9 ◽  
Author(s):  
Sebastian Sattler ◽  
Farzaneh Zolala ◽  
Mohammad Reza Baneshi ◽  
Javad Ghasemi ◽  
Saber Amirzadeh Googhari

Drug abuse and addiction exist around the world. People addicted to drugs such as opium or heroin often encounter dehumanizing discriminatory behaviors and health-care systems that are reluctant to provide services. Experiencing discrimination often serves as a barrier to receiving help or finding a home or work. Therefore, it is important to better understand the mechanisms that lead to the stigmatization of drug addiction and who is more prone to stigmatizing behaviors. There is also a dearth of research on whether different patterns of stigma exist in men and women. Therefore, this study investigated factors affecting gender-specific stigmatization in the context of drug addiction. In our vignette study (NMensample = 320 and NWomensample = 320) in Iran, we experimentally varied signals and signaling events regarding a person with drug addiction (i.e., NVignettes = 32 per sample), based on Attribution Theory, before assessing stigmatizing cognitions (e.g., blameworthiness), affective responses (e.g., anger), and discriminatory inclinations (e.g., segregation) with the Attribution Questionnaire. We also tested assumptions from the Familiarity Hypothesis by assessing indicators of respondents' familiarity with drug addiction (e.g., knowledge about addiction). Results, for example, show higher stigma if the person used “harder” drugs, displayed aggressive behavior, or had a less controllable drug urge. Self-attributed knowledge about addiction or prior drug use increased some forms of stigma, but diminished others. These findings only partially converged between men and women. We suggest that anti-stigma initiatives should consider information about the stigmatized person, conditions of the addiction, and characteristics of stigmatizers.


2021 ◽  
Vol 28 (1) ◽  
pp. 103-107
Author(s):  
Ileana Adela VACAROIU ◽  
◽  
Daniela RADULESCU ◽  
Anca Ioana STANESCU ◽  
◽  
...  

The article presents a case of severe necrotizing fasciitis and rhabdomyolysis-induced acute tubular necrosis resulting from the injection of heroin laced with a plant-fertilizer known as „Pure by magic”. We also review the literature data regarding the renal adverse effects of heroin. Due to the diversity of adulterants used by drug dealers for cutting heroin and the variety of substances patients mix the heroin with before injecting themselves, the effects of this practice are often unknown and the treatment lacks of antidote, being strictly symptomatic.


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