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Byrne CJ, Sani F, Flynn T, Malaguti A. 'It was like coming back from the clouds': a qualitative analysis of the lived experience of overdose consequent to drug use among a cohort of people who use drugs in Scotland. Harm Reduct J 2024; 21:112. [PMID: 38849877 PMCID: PMC11157918 DOI: 10.1186/s12954-024-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Globally, non-fatal overdose (NFOD) rates consequent to drug use, typically opioids, continue increasing at a startling rate. Existing quantitative research has revealed myriad factors and characteristics linked to experiencing NFOD, but it is critically important to explore the lived context underlying these associations. In this qualitative study, we sought to understand the experiences of NFOD among people who use drugs in a Scottish region in order to: enhance public policy responses; inform potential intervention development to mitigate risk; and contribute to the literature documenting the lived experience of NFOD. METHODS From June to July 2021, two peer researchers conducted face-to-face semi-structured interviews with people who use drugs who had experienced recent NFOD attending harm reduction services in Tayside, Scotland. These were transcribed verbatim and evaluated using thematic analysis with an inductive approach which had an experiential and essentialist orientation. RESULTS Twenty people were interviewed across two sites. Of those, 15 (75%) were male and mean age was 38.2 (7.7) years. All had experienced at least one NFOD in the prior six months, and all reported polydrug use. Five themes were identified, within which 12 subthemes were situated. The themes were: social context; personal risk-taking triggers; planned and impulsive consumption; risk perception; and overdose reversal. The results spoke to the environmental, behavioural, cognitive, economic, and marketplace, factors which influence the context of NFOD in the region. CONCLUSIONS A complex interplay of behavioural, psychological, and situational factors were found to impact the likelihood of experiencing NFOD. Structural inequities which policy professionals and civic leaders should seek to remedy were identified, while service providers may seek to reconfigure healthcare provision for people who use drugs to account for the interpersonal, psychological, and social factors identified, which appear to precipitate NFOD. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Christopher J Byrne
- Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
- Directorate of Public Health, NHS Tayside, Kings Cross Hospital, Dundee, UK.
| | - Fabio Sani
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Scrymgeour Building, Dundee, UK
| | | | - Amy Malaguti
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Scrymgeour Building, Dundee, UK
- Tayside Drug and Alcohol Recovery Psychology Service, NHS Tayside, Dundee, UK
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Clingan SE, Woodruff SI, Gaines TL, Davidson PJ. Detoxification, 12-step meeting attendance, and non-fatal opioid overdoses among a suburban/exurban population with opioid use disorder. J Addict Dis 2023; 41:266-273. [PMID: 35950698 PMCID: PMC9918603 DOI: 10.1080/10550887.2022.2108287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Drug overdoses are the leading cause of injury death in the United States with an estimated 105,752 individuals dying from an overdose in the United States in a 12-month period ending October 2021. Given that people who have opioid use disorder (OUD) are at an increased risk of death, it is crucial to assess risk factors associated with opioid overdose to improve interventions. OBJECTIVES We examine factors associated with non-fatal overdose among a suburban/exurban population with OUD in Southern California. METHODS Participants were recruited by convenience sampling (n = 355) and were interviewed between November 2017 to August 2018. Participants were eligible for the study if they had a history of pharmaceutical opioid use. RESULTS A total of 198 (55.8%) participants reported at least one overdose in their lifetime. A total of 229 participants identified as male, 124 identified as female, and 2 identified as non-binary. When controlling for demographic factors, non-oral opioid administration at first opioid use (AOR 2.82, 95% CI 1.52-5.22), having a history of methadone detoxification, (AOR 2.23, 95% CI 1.27-3.91), history of buprenorphine detoxification (AOR 1.77, 95% CI 1.02-3.07), and history of 12 step attendance (AOR 1.89, 95% CI 1.12-3.20) were found to be independently and positively associated with lifetime opioid overdose. CONCLUSIONS Detoxification with buprenorphine and methadone was found to be associated with having a non-fatal opioid overdose. Buprenorphine and methadone should not be prescribed as a detoxification medication as long-term use of medication for OUD results in better outcomes than medication that is used short-term.
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Affiliation(s)
- Sarah E. Clingan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Susan I. Woodruff
- School of Social Work, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4119
| | - Tommi L. Gaines
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093
| | - Peter J. Davidson
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093
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Campbell A, Millen S, Guo L, Jordan U, Taylor-Beswick A, Rintoul C, Diamond A. Reducing opioid related deaths for individuals who are at high risk of death from overdose: a co-production study with people housed within prison and hostel accommodation during Covid-19. Front Public Health 2023; 11:1080629. [PMID: 37404271 PMCID: PMC10316785 DOI: 10.3389/fpubh.2023.1080629] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Background A record number of Opioid-related deaths occurred in Northern Ireland in 2021 and it is acknowledged that the Covid-19 pandemic compounded drugs related deaths crisis. This co-production study set out to refine the design of a wearable device for Opioid users to detect and subsequently prevent a potential overdose situation. Method Purposive sampling was used to recruit people who had substance use disorders and were living in a hostel and prison during the Covid-19 pandemic. Principles of co-production influenced the study, which encompassed a focus group phase and a wearable phase. The initial phase included three focus groups with participants who inject Opioids and one focus group with workers from a street injector support service. During the wearable phase, the participant group tested the feasibility of the wearable technology in a controlled environment. This included testing the transferability of data from the device to a backend server on the cloud. Results All focus group participants expressed an interest in the wearable technology when it was presented to them and agreed, that in principle, such a device would be extremely beneficial to help reduce the risk of overdose within the active drug using community. Participants outlined factors which would help or hinder the design of this proposed device and their decision to wear it, if it were readily available to them. Findings from wearable phase indicated that it was feasible to use a wearable device for monitoring Opioid users' biomarkers remotely. The provision of information regarding the specific functionality of the device was considered key and could be disseminated via front line services. The data acquisition and transfer process would not be a barrier for future research. Conclusion Understanding the benefit and disadvantages of technologies such as a wearable device to prevent Opioid-related deaths will be critical for mitigating the risk of overdose for people who use Heroin. It was also clear that this would be particularly relevant during Covid-19 lock-down periods, when the effects of the pandemic further exacerbated the isolation and solitude experienced by people who use Heroin.
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Affiliation(s)
- Anne Campbell
- SSESW, Queens University Belfast, Belfast, United Kingdom
| | - Sharon Millen
- SSESW, Queens University Belfast, Belfast, United Kingdom
| | - Li Guo
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Uisce Jordan
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | | | - Chris Rintoul
- Cranstoun, St. Andrew's House, Surbiton, United Kingdom
| | - Aisling Diamond
- Southern Health and Social Care Trust, Craigavon, United Kingdom
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Jimenez-Coll V, Llorente S, Boix F, Alfaro R, Galián JA, Martinez-Banaclocha H, Botella C, Moya-Quiles MR, Muro-Pérez M, Minguela A, Legaz I, Muro M. Monitoring of Serological, Cellular and Genomic Biomarkers in Transplantation, Computational Prediction Models and Role of Cell-Free DNA in Transplant Outcome. Int J Mol Sci 2023; 24:ijms24043908. [PMID: 36835314 PMCID: PMC9963702 DOI: 10.3390/ijms24043908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023] Open
Abstract
The process and evolution of an organ transplant procedure has evolved in terms of the prevention of immunological rejection with the improvement in the determination of immune response genes. These techniques include considering more important genes, more polymorphism detection, more refinement of the response motifs, as well as the analysis of epitopes and eplets, its capacity to fix complement, the PIRCHE algorithm and post-transplant monitoring with promising new biomarkers that surpass the classic serum markers such as creatine and other similar parameters of renal function. Among these new biomarkers, we analyze new serological, urine, cellular, genomic and transcriptomic biomarkers and computational prediction, with particular attention to the analysis of donor free circulating DNA as an optimal marker of kidney damage.
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Affiliation(s)
- Víctor Jimenez-Coll
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Santiago Llorente
- Nephrology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Francisco Boix
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Rafael Alfaro
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - José Antonio Galián
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Helios Martinez-Banaclocha
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Carmen Botella
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - María R. Moya-Quiles
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Manuel Muro-Pérez
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Alfredo Minguela
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Correspondence: (I.L.); (M.M.); Tel.: +34-699986674 (M.M.); Fax: +34-868834307 (M.M.)
| | - Manuel Muro
- Immunology Service, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), 30120 Murcia, Spain
- Correspondence: (I.L.); (M.M.); Tel.: +34-699986674 (M.M.); Fax: +34-868834307 (M.M.)
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Alfaro R, Lorente S, Jimenez-Coll V, Martínez-Banaclocha H, Galián JA, Botella C, Moya-Quiles MR, Muro-Pérez M, de la Peña-Moral J, Minguela A, Legaz I, Muro M. Evaluating the Link between BAFF System Gene Expression and Acute Rejection Development in Kidney Transplantation. J Clin Med 2022; 11:jcm11143956. [PMID: 35887720 PMCID: PMC9319040 DOI: 10.3390/jcm11143956] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
B-cell activating factor (BAFF) system signaling is critical for B-cell homeostasis, effector functions, and tolerance maintenance in transplants, but it has not been studied in kidney transplant recipients (KTRs). The aim was to analyze the changes in BAFF system expression in KTRs with/without acute rejection (AR/NAR). The BAFF system expression was analyzed by qPCR in 40 KTRs. A meta-analysis of BAFF system expression and histological renal damage was identified by the Chronic Allograft Damage Index (CADI) and performed from the GEO database. Proliferation-inducing ligand (APRIL) expression increased at three- and six-months post-KT (p = 0.014 and p < 0.001). B-cell maturation antigen (BCMA) expression increased at six-months post-KT (p = 0.038). BAFF expression remained stable in NAR-KTRs, but was increased in CADI concerning the No-CADI group at one year (p = 0.008). BCMA expression increased in the CADI group at one- (p = 0.001) and six-years post-KT (p = 0.024). At three months, the transmembrane activator and calcium modulator interactor (TACI) gene significantly elevated KTRs with DSAs (donor-specific antibody; p = 0.034). KTRs with DSAs significantly increase the B-cell activating factor receptor (R-BAFF; p = 0.021) and TACI (p = 0.018) between pre- and three-month post-KT. Changes in the expression of the BAFF system increase during post-KTR in the development of AR and chronic allograft damage, and could be an important pathological tool to detect and prevent kidney graft outcomes.
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Affiliation(s)
- Rafael Alfaro
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - Santiago Lorente
- Nephrology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain;
| | - Víctor Jimenez-Coll
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - Helios Martínez-Banaclocha
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - José Antonio Galián
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - Carmen Botella
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - María Rosa Moya-Quiles
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - Manuel Muro-Pérez
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - Jesús de la Peña-Moral
- Pathology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain;
| | - Alfredo Minguela
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30100 Murcia, Spain
- Correspondence: (I.L.); (M.M.)
| | - Manuel Muro
- Immunology Services, University Clinical Hospital, Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), 30100 Murcia, Spain; (R.A.); (V.J.-C.); (H.M.-B.); (J.A.G.); (C.B.); (M.R.M.-Q.); (M.M.-P.); (A.M.)
- Correspondence: (I.L.); (M.M.)
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Collados-Ros A, Torres-Sánchez C, Pérez-Cárceles MD, Luna A, Legaz I. Suicidal Behavior and Its Relationship with Postmortem Forensic Toxicological Findings. TOXICS 2022; 10:319. [PMID: 35736927 PMCID: PMC9229491 DOI: 10.3390/toxics10060319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Suicide affects all sociodemographic levels, age groups, and populations worldwide. The factors that can increase the risk of suicidal tendencies are widely studied. The aim of this study was to analyze the types and combinations of toxics found in fatal suicide victims with different suicide mechanisms. A total of 355 autopsies were retrospectively studied, and 26 toxics were determined and related to mechanisms of suicide. Hanging (55%), drug overdose (22.7%), and jumping from a height (17.8%) were most represented suicide mechanisms with positive toxicology. Hanging was the most represented in men (50.3%; p = 0.019), while jumping from a height was more represented in women (29.7%, p = 0.028). Drugs of abuse were the most frequent toxics found in men (55.5%; p < 0.001), while medicines were the most frequent type found in women (70.3%, p < 0.001). Alcohol, nordiazepam, cocaine, and venlafaxine were the most consumed toxics. Benzodiazepines and venlafaxine were found in suicides involving drug overdose, hanging, and jumping from a height. In conclusion, most suicides were associated with drug abuse in men. Hanging was more represented in men and jumping from a height in women. Alcohol was present in combination with other toxics and medicines. The toxicological analysis is fundamental to understanding consumption patterns and establishing strategies and protocols for detecting and preventing suicide.
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Affiliation(s)
- Aurelia Collados-Ros
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Carmen Torres-Sánchez
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
- Pathology Service, Institute of Legal Medicine and Forensic Sciences, 30100 Murcia, Spain
| | - María Dolores Pérez-Cárceles
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Aurelio Luna
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
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Spring C, Croxford S, Ward Z, Ayres R, Lord C, Desai M, Vickerman P, Artenie A. Perceived availability and carriage of take-home naloxone and factors associated with carriage among people who inject drugs in England, Wales and Northern Ireland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 102:103615. [DOI: 10.1016/j.drugpo.2022.103615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/27/2022] [Accepted: 02/05/2022] [Indexed: 11/15/2022]
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Armoon B, Higgs P, Mohammadi R. Mental health status, health service utilization, drug use behaviors associated with non-fatal overdose among people who use illicit drugs: A meta-analysis. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.2019331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Bahram Armoon
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Armoon B, Bayani A, Griffiths MD, Bayat AH, Mohammadi R, Fattah Moghaddam L, Ahounbar E. Prevalence and high-risk behaviors associated with non-fatal overdose among people who use illicit opioids: A systematic review and meta-analysis. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1978112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bahram Armoon
- Research Center, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, Qc, Canada
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir-Hossein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Elahe Ahounbar
- Substance Abuse and Dependence Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Dunleavy K, Hutchinson SJ, Palmateer N, Goldberg D, Taylor A, Munro A, Shepherd SJ, Gunson RN, Given S, Campbell J, McAuley A. The uptake of foil from needle and syringe provision services and its role in smoking or snorting heroin among people who inject drugs in Scotland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103369. [PMID: 34340168 DOI: 10.1016/j.drugpo.2021.103369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/01/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the UK, legislation was implemented in 2014 allowing needle and syringe provision (NSP) services to offer foil to people who inject drugs (PWID) to encourage smoking rather than injecting. This paper aims to examine the association between foil uptake and smoking or snorting heroin among PWID. This is the first large scale national study to examine foil uptake and smoking or snorting heroin among PWID post legislative change. METHOD Data from 1453 PWID interviewed via Scotland's Needle Exchange Surveillance Initiative in 2017-2018 were analysed using multivariate logistic regression. RESULTS Overall, 36% of PWID had obtained foil from NSP services in the past six months. The odds of smoking or snorting heroin were higher among those who had obtained foil (Adjusted Odds Ratio (AOR) 3.79 (95% CI 2.98-4.82) p<0.001) compared to those who had not. Smoking or snorting heroin was associated with lower odds of injecting four or more times daily (AOR 0.60 (95% CI 0.40-0.90) p = 0.012) and injecting into the groin or neck (AOR 0.57 (95% CI 0.46-0.71) p<0.001) but increased odds of having had a skin and soft tissue infection (SSTI) (AOR 1.49 (95% CI 1.17-1.89) p = 0.001) and having experienced an overdose (AOR 1.58 (95% CI 1.18-2.10) p = 0.002) both in the past year. CONCLUSION The promotion of smoking drugs via foil provision from NSP services may contribute to the package of harm reduction measures for PWID alongside the provision of injecting equipment. We found that those in receipt of foil were more likely to smoke or snort heroin, and that smoking or snorting heroin was associated with a lower likelihood of some risky injecting behaviours, namely frequent injecting and injecting into the groin or neck. But it remains uncertain if the provision of foil can lead to a reduction in health harms, such as SSTI and overdose. Future research is needed to understand PWID motivations for smoking drugs, obtaining foil from NSP services, and its uses particularly among polydrug users.
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Affiliation(s)
- Karen Dunleavy
- School of Education and Social Sciences, University of the West of Scotland, Paisley, PA1 2BE, Scotland.
| | - Sharon J Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; Public Health Scotland, NHS National Services Scotland, Glasgow, Scotland
| | - Norah Palmateer
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; Public Health Scotland, NHS National Services Scotland, Glasgow, Scotland
| | - David Goldberg
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; Public Health Scotland, NHS National Services Scotland, Glasgow, Scotland
| | - Avril Taylor
- School of Education and Social Sciences, University of the West of Scotland, Paisley, PA1 2BE, Scotland
| | - Alison Munro
- School of Health Sciences, University of Dundee, Dundee, Scotland
| | | | - Rory N Gunson
- West of Scotland Specialist Virology Centre, Glasgow, Scotland
| | - Sophie Given
- Scottish Drugs Forum, 139 Morrison Street, Edinburgh, Scotland
| | | | - Andrew McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland; Public Health Scotland, NHS National Services Scotland, Glasgow, Scotland
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Armoon B, SoleimanvandiAzar N, Rostami M, Higgs P, Bayani A, Bayat AH, Mohammadi R, Ahounbar E, Fattah Moghaddam L. Drug type and risk behaviors associated with non-fatal overdose among people who use drugs: a systematic review and meta-analysis. J Addict Dis 2021; 40:114-125. [PMID: 34286664 DOI: 10.1080/10550887.2021.1950262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The present study aimed to determine the association between drug type, risk behaviors and non-fatal overdose among people who use drugs (PWUD). We searched for studies in English published before February 1, 2021, on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUD. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. After a detailed assessment of over 13,845 articles, a total of 49 studies met the eligibility criteria. We found that non-injection opioid use, heroin injection, cocaine use, concurrent use of buprenorphine and benzodiazepines, benzodiazepine use, incarceration, injecting drugs, and duration of injecting were associated with greater odds of non-fatal overdose among PWUD. The findings of the current meta-analysis support the requirement to improve suitable harm reduction strategies for drug users, such as peer-based overdose management, and further focusing on the need to balance the current emphasis on enforcement-based responses to illegal drug use with health-related interventions.
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Affiliation(s)
- Bahram Armoon
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Neda SoleimanvandiAzar
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rostami
- Department of Counseling, Faculty of Humanities and Social Sciences, University of Kurdistan, Kurdistan, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Azadeh Bayani
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Amir-Hossein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elahe Ahounbar
- Substance Abuse and Dependence Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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12
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Grella CE, Ostlie E, Scott CK, Dennis ML, Carnevale J, Watson DP. A scoping review of factors that influence opioid overdose prevention for justice-involved populations. Subst Abuse Treat Prev Policy 2021; 16:19. [PMID: 33618744 PMCID: PMC7898779 DOI: 10.1186/s13011-021-00346-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is a high risk of death from opioid overdose following release from prison. Efforts to develop and implement overdose prevention programs for justice-involved populations have increased in recent years. An understanding of the gaps in knowledge on prevention interventions is needed to accelerate development, implementation, and dissemination of effective strategies. METHODS A systematic search process identified 43 published papers addressing opioid overdose prevention in criminal justice settings or among justice-involved populations from 2010 to February 2020. Cross-cutting themes were identified, coded and qualitatively analyzed. RESULTS Papers were coded into five categories: acceptability (n = 8), accessibility (n = 4), effectiveness (n = 5), feasibility (n = 7), and participant overdose risk (n = 19). Common themes were: (1) Acceptability of naloxone is associated with injection drug use, overdose history, and perceived risk within the situational context; (2) Accessibility of naloxone is a function of the interface between corrections and community; (3) Evaluations of overdose prevention interventions are few, but generally show increases in knowledge or reductions in opioid overdose; (4) Coordinated efforts are needed to implement prevention interventions, address logistical challenges, and develop linkages between corrections and community providers; (5) Overdose is highest immediately following release from prison or jail, often preceded by service-system interactions, and associated with drug-use severity, injection use, and mental health disorders, as well as risks in the post-release environment. CONCLUSION Study findings can inform the development of overdose prevention interventions that target justice-involved individuals and policies to support their implementation across criminal justice and community-based service systems.
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Affiliation(s)
| | - Erika Ostlie
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| | - Christy K. Scott
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
| | | | - John Carnevale
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| | - Dennis P. Watson
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
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13
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Kahn LS, Wozniak M, Vest BM, Moore C. “Narcan encounters:” overdose and naloxone rescue experiences among people who use opioids. Subst Abus 2020; 43:113-126. [DOI: 10.1080/08897077.2020.1748165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Linda S. Kahn
- Primary Care Research Institute, Department of Family Medicine, University at Buffalo, New York, USA
| | - Monika Wozniak
- Primary Care Research Institute, Department of Family Medicine, University at Buffalo, New York, USA
| | - Bonnie M. Vest
- Primary Care Research Institute, Department of Family Medicine, University at Buffalo, New York, USA
| | - Cheryll Moore
- Erie County Department of Health, University at Buffalo, Buffalo, New York, USA
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14
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Abstract
This paper is the fortieth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2017 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, CUNY, 65-30 Kissena Blvd., Flushing, NY, 11367, United States.
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15
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Trayner KMA, McAuley A, Palmateer NE, Goldberg DJ, Shepherd SJ, Gunson RN, Tweed EJ, Priyadarshi S, Milosevic C, Hutchinson SJ. Increased risk of HIV and other drug-related harms associated with injecting in public places: national bio-behavioural survey of people who inject drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 77:102663. [PMID: 31981949 PMCID: PMC8330401 DOI: 10.1016/j.drugpo.2020.102663] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/27/2019] [Accepted: 01/02/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Whilst injecting drugs in public places is considered a proxy for high risk behaviour among people who inject drugs (PWID), studies quantifying its relationship with multiple drug-related harms are lacking and none have examined this in the context of an ongoing HIV outbreak (located in Glasgow, Scotland). We aimed to: 1) estimate the prevalence of public injecting in Scotland and associated risk factors; and 2) estimate the association between public injecting and HIV, current HCV, overdose, and skin and soft tissue infections (SSTI). METHODS Cross-sectional, bio-behavioural survey (including dried blood spot testing to determine HIV and HCV infection) of 1469 current PWID (injected in last 6 months) recruited by independent interviewers from 139 harm reduction services across Scotland during 2017-18. Primary outcomes were: injecting in a public place (yes/no); HIV infection; current HCV infection; self-reported overdose in the last year (yes/no) and SSTI the last year (yes/no). Multi-variable logistic regression was used to determine factors associated with public injecting and to estimate the association between public injecting and drug-related harms (HIV, current HCV, overdose and SSTI). RESULTS Prevalence of public injecting was 16% overall in Scotland and 47% in Glasgow city centre. Factors associated with increased odds of public injecting were: recruitment in Glasgow city centre (aOR=5.45, 95% CI 3.48-8.54, p<0.001), homelessness (aOR=3.68, 95% CI 2.61-5.19, p<0.001), high alcohol consumption (aOR=2.42, 95% CI 1.69-3.44, p<0.001), high injection frequency (≥4 per day) (aOR=3.16, 95% CI 1.93-5.18, p<0.001) and cocaine injecting (aOR=1.46, 95% CI 1.00 to 2.13, p = 0.046). Odds were lower for those receiving opiate substitution therapy (OST) (aOR=0.37, 95% CI 0.24 to 0.56, p<0.001) and older age (per year increase) (aOR=0.97, 95% CI 0.95 to 0.99, p = 0.013). Public injecting was associated with an increased risk of HIV infection (aOR=2.11, 95% CI 1.13-3.92, p = 0.019), current HCV infection (aOR=1.49, 95% CI 1.01-2.19, p = 0.043), overdose (aOR=1.59, 95% CI 1.27-2.01, p<0.001) and SSTI (aOR=1.42, 95% CI 1.17-1.73, p<0.001). CONCLUSIONS These findings highlight the need to address the additional harms observed among people who inject in public places and provide evidence to inform proposals in the UK and elsewhere to introduce facilities that offer safer drug consumption environments.
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Affiliation(s)
- Kirsten M A Trayner
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK.
| | - Andrew McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK
| | - Norah E Palmateer
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK
| | - David J Goldberg
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK
| | | | - Rory N Gunson
- West of Scotland Specialist Virology Centre, Glasgow, UK
| | - Emily J Tweed
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | - Catriona Milosevic
- Public Health Protection Unit, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Sharon J Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Glasgow, UK
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16
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The prevalence of non-fatal overdose among people who inject drugs: A multi-stage systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:172-184. [DOI: 10.1016/j.drugpo.2019.07.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022]
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17
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Bird SM. Survey representativeness, quantifying uncertainty, and the importance of well-posed questions about the administration of take-home naloxone. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 51:18-19. [PMID: 29154108 DOI: 10.1016/j.drugpo.2017.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/11/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Sheila M Bird
- MRC Biostatistics Unit, Cambridge CB2 0SR, United Kingdom.
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