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Silkoff D, Chenhall R, Guillemin M, McDougall R. The ethical dimensions of everyday alcohol and other drug work: An empirical ethics investigation. Drug Alcohol Rev 2023; 42:614-624. [PMID: 36691114 DOI: 10.1111/dar.13604] [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] [Received: 09/12/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The complex and contentious nature of alcohol and other drug (AOD) clinical work affords the likelihood of significant ethical dimensions. However, little attention has been paid to clinicians' perspectives of ethics in their practice within AOD settings. This potentially neglects an important aspect of AOD clinical work. METHODS We used an insider empirical ethics methodology, where the first author (DS) concurrently worked as an AOD clinician in the research setting. Participants were 30 experienced AOD clinicians, working within a large specialist AOD service in Victoria, Australia. We used three qualitative data collection methods: moral conversation, involving semi-structured interviews; moral participation, involving the first author reflecting on his own ethical practices; and participant-observation, involving observation of clinical meetings. We used Applied Thematic Analysis to analyse the data. RESULTS Although participants rarely used explicitly ethical language to describe their work, they described four ethical goals: helping clients to access AOD care and treatment; facilitating change in clients' lives; challenging stigma; and keeping people safe. We argue that these clinical goals should also be conceptualised as ethical goals. DISCUSSION AND CONCLUSIONS Ethics is an integral component of everyday AOD work. Our findings had some overlap with established ethical principles. Participants demonstrated expertise in engaging with ethical dimensions, without using ethical language. Given the limited attention paid to ethics in AOD clinical settings, increasing the focus on ethics in everyday clinical practice is an important contribution to future AOD clinical work. Its absence negates important aspects of care for clients.
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Affiliation(s)
- David Silkoff
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Richard Chenhall
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Marilys Guillemin
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Rosalind McDougall
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Poudel P, Kong A, Hocking S, Whitton G, Srinivas R, Borgnakke WS, George A. Oral health-care needs among clients receiving alcohol and other drugs treatment-A scoping review. Drug Alcohol Rev 2023; 42:346-366. [PMID: 36529982 PMCID: PMC10107646 DOI: 10.1111/dar.13583] [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: 04/07/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
ISSUES Poor oral health is a significant problem among people who access alcohol and other drugs (AOD) health services, yet little is known about their oral health-care needs and whether any interventions and guidelines are implemented within AOD treatment services. APPROACH A scoping review was conducted to identify scientific literature in three focus areas: oral health knowledge, attitudes and practices of clients and clinicians at AOD-related services; oral health guidelines for AOD clinicians; and interventions that describe clinicians promoting oral health among clients. KEY FINDINGS Thirty-two reports were identified. Twenty-three studies focused on the oral health knowledge, attitudes and practices of AOD clients, but none of the studies explored perspectives of clinicians. Seven clinical practice guidelines were identified but recommendations varied. Only two interventions in which an AOD clinician promoted oral health were identified. IMPLICATIONS Most reports provided insight into the perspectives of clients accessing AOD treatment services. Little evidence demonstrated that clinical practice guidelines were being implemented into practice, or that oral health promotion was part of the tasks of AOD clinicians. CONCLUSION This review identified oral health knowledge gaps and perceived poor attitudes that appeared to be reflected in certain oral health practices among clients. This finding indicates a need to educate clients about oral health while receiving AOD treatment. There was an absence of research about the needs for AOD clinicians to advocate for good oral health, and little evidence exists about effective interventions that could enhance integrating oral health care into AOD treatment services.
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Affiliation(s)
- Prakash Poudel
- eHealth New South Wales, Sydney, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Ariana Kong
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | | | - Gilbert Whitton
- Drug Health Services, South Western Sydney Local Health District, Sydney, Australia
| | - Ravi Srinivas
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- Oral Health Services, South Western Sydney Local Health District, Sydney, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, The University of Michigan, Ann Arbor, USA
| | - Ajesh George
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Saki F, Cheraghi M, Mohamadian H, Ghorbanyjavadpour F. Oral Health-Related Quality of Life Among Narcotic and Stimulant Users Referred to Maintenance Methadone Therapy Centers in Ahvaz City: Iran. Front Public Health 2022; 10:850550. [PMID: 35669740 PMCID: PMC9163318 DOI: 10.3389/fpubh.2022.850550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction We aimed to assess quality of life related to oral health in narcotic or stimulant users those were referred to maintenance methadone therapy (MMT) centers in Ahvaz City, Iran. Methods It was a cross-sectional study based on exploratory approach which has conducted on 187 narcotic and stimulant users in Ahvaz city; during 15th May till September 2020. Data was selected by available non-random sampling method. The data collection tools included the demographic variables and the standard OHIP-14 questionnaires. All tests were used as descriptive statistics, Kolmogorov-Smirnov tests, independent t-test, one-way analysis of variance. P-values of less than 0.05 was considered significant. Results The mean and standard deviation of the participants' age was 36.03 ± 8.98 years. The quality-of-life scores related to oral health were totally 34.89 ± 6.50 as well as 37.37 and 33.96 in narcotic and stimulant users, respectively. The total quality of life related to OHIP-14 did not have a significant relationship with variables of age, life companions, level of education, number of children, economic status, employment status, insurance status, underlying disease, toothbrush use status, last dentist visit, and number of missing teeth (P > 0.05). However, a significant difference was found between the quality of life related to oral health based on the type of substance used (narcotic or stimulant), so that the mean quality of life related to oral health was higher in narcotic than stimulant users (P < 0.05). Conclusion Quality of life related to OHIP-14 was more unfavorable in stimulant users than narcotic users. So, policy makers and authorities are required to focus their interventions and research programs to improve health-related quality of life in users, especially stimulant.
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Affiliation(s)
- Fatemeh Saki
- Department of Community Oral Health, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maria Cheraghi
- Social Determinant of Health Research Center, Department of Community Oral Health, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hashem Mohamadian
- Department of Health Education and Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fataneh Ghorbanyjavadpour
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abdelsalam S, Van Den Boom W, Higgs P, Dietze P, Erbas B. The association between depression and oral health related quality of life in people who inject drugs. Drug Alcohol Depend 2021; 229:109121. [PMID: 34688121 DOI: 10.1016/j.drugalcdep.2021.109121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/24/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Oral health related quality of life (OHRQoL) is known to be reduced in disadvantaged populations, including people who inject drugs. Mental health issues, such as depression are also commonly reported. In this study we examined the association between depression and OHRQoL. METHODS Cross-sectional analysis survey data was collected from the Melbourne Injecting Drug User Cohort Study (SuperMIX) of people who inject drugs (N = 982). Three measures derived from the Oral Health Impact Profile (OHIP-14) were used to assess OHRQoL: Prevalence (reporting one or more dental issue "Very often" or "Fairly often" in the previous year), Extent (number of items reported either "Very often" or "Fairly often") and Severity (summary score of all ordinal responses). Regression analyses assessed the association between depression, indexed as scoring above 10 on the Patient Health Questionnaire (PHQ-9), and OHIP-14 measures, adjusted for sociodemographic, drug use and dental service utilisation variables. RESULTS Overall, participants had low levels of OHRQoL, indexed through OHIP-14 scores (46% exhibiting prevalence, mean extent of 2.35 and mean severity of 12.72). Depression was associated with increases in all OHIP-14 measures, after adjustment for potential confounders. CONCLUSIONS We found a significant association between depression and poor OHRQoL in this sample of people who inject drugs. Further research using a longitudinal frame is needed to determine the direction of this relationship. Interventions to improve oral health of people who inject drugs are urgently needed, and these may benefit mental health outcomes for people who inject drugs.
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Affiliation(s)
- Shady Abdelsalam
- National Drug Research Institute, Curtin University, 85 Commercial Rd, Melbourne, Vic 3004, Australia; Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia; La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, Vic 3086, Australia.
| | - Wijnand Van Den Boom
- Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia; National Institute for Public Health and The Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Peter Higgs
- Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia; La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, Vic 3086, Australia.
| | - Paul Dietze
- National Drug Research Institute, Curtin University, 85 Commercial Rd, Melbourne, Vic 3004, Australia; Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia.
| | - Bircan Erbas
- La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, Vic 3086, Australia; Faculty of Public Health, Universitas AirLangga, Surabaya 60115, Indonesia.
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Simon L, Choudhary A, Ticku S, Barrow J, Tobey M. Dental care utilization in Massachusetts before and after initiation of medication for opioid use disorder: A cross-sectional study of a state all-payer claims database. J Public Health Dent 2021; 82:461-467. [PMID: 34816438 DOI: 10.1111/jphd.12488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with opioid use disorder (OUD) are at higher risk of poor oral health. Medication for opioid use disorder (MOUD) has been shown to improve outcomes for patients with OUD, but it is unknown how initiation of MOUD affects access to oral health services. METHODS This was a retrospective analysis of all individuals in the Massachusetts All-Payer Claims Database prescribed oral buprenorphine-naloxone or injectable naltrexone from 2013 to 2016. We evaluated dental utilization in the year before and after beginning MOUD. A logistic regression predicting dental utilization was conducted. RESULTS Among the 54,791 individuals, rates of dental utilization were low both before and after MOUD (10.5% and 10% with a dental visit, respectively). Of those who did not have a dental visit in the year before starting MOUD, 95.1% did not have a dental visit in the year after. Rates of various procedure types were comparable before and after MOUD. In a logistic regression, a prior dental visit was associated with 9.82 times the odds (95% CI 9.14-10.55) of having a dental visit after starting MOUD; increasing age, being prescribed naltrexone, having a mood disorder or HIV, year of initiation or being on Medicaid were also associated with having a dental visit. Male patients and those with Medicare or private insurance were less likely to have a dental visit. CONCLUSIONS Initiating MOUD did not substantially result in increased dental access or substantial changes in dental procedures received. Patients receiving treatment for OUD may require additional support to access dental care.
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Affiliation(s)
- Lisa Simon
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Abhishek Choudhary
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shenam Ticku
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jane Barrow
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Matthew Tobey
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Rossow I. Illicit drug use and oral health. Addiction 2021; 116:3235-3242. [PMID: 33247857 DOI: 10.1111/add.15360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/16/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
People with drug use disorders (PWDUD) have elevated prevalence of oral diseases, in particular dental caries (tooth decay), periodontal (gum) disease and xerostomia (dry mouth). When left untreated, these oral health conditions may progress and lead to tooth ache, abscesses and tooth loss, and in turn, to poor chewing functioning and digestion, dental aesthetic problems and reduced wellbeing. Illicit drug use may, per se, cause xerostomia, which in turn increases vulnerability for dental caries. However, the other main drivers of oral diseases and their progression-poor oral hygiene, frequent sugar intake and infrequent dental visits-can mainly be ascribed to the irregular lifestyle, poor economy and mental health problems that often accompany illicit drug use. Establishment of good oral health habits is essential in the dental care for PWDUD. Dental treatment is often comprehensive and challenging; because the patients may have extensive treatment needs but also difficulties adhering to preventive measures and dental appointments. An integrated care approach for PWDUD would likely benefit both their oral and general health.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Jaffe K, Choi J, Hayashi K, Milloy MJ, Richardson L. A paradox of need: Gaps in access to dental care among people who use drugs in Canada's publicly funded healthcare system. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1799-1806. [PMID: 33491849 PMCID: PMC8310531 DOI: 10.1111/hsc.13289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/07/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
In Canada, publicly funded healthcare provides no-cost access to a large but not comprehensive suite of services. Dental care is largely funded by private insurance or patients, creating employment- and income-dependent gaps in care access. Difficulties accessing dental care may be amplified among vulnerable populations, including people who use drugs (PWUD), who may experience greater dental need due to side effects of substance use and health comorbidities, as well as barriers to care. Using data collected between 2014 and 2018 from two ongoing prospective cohort studies of PWUD in Vancouver, Canada, the aim of this study was to explore factors associated with dental care access. Among 1,638 participants, 246 participants (15%) reported never or only occasionally accessing adequate dental care. In generalised linear mixed-effects models, results showed significant negative associations between accessing dental care and using opioids (Adjusted Odds Ratios [AOR] = 0.73, 95% Confidence Interval [CI] = 0.58-0.91), methamphetamine (AOR = 0.75, 95% CI = 0.59-0.95) and cannabis (AOR = 0.78, 95% CI = 0.63-0.97), as well experiencing homelessness (AOR = 0.54, 95% CI = 0.42-0.70) and street-based income generation (AOR = 0.75, 95% CI = 0.59-0.94). There were significant positive associations between adequate dental care and accessing opioid agonist treatment (OAT) for opioid dependence (AOR = 1.36, 95% CI = 1.07-1.72) and receiving income assistance (AOR = 1.70, 95% CI = 1.05-2.77). These results highlight specific substance use patterns and structural exposures that may hinder dental care access, as well as how direct and indirect benefits of income assistance and OAT may improve access. These findings provide support for recent calls to expand healthcare coverage and address dental care inequities.
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Affiliation(s)
- Kaitlyn Jaffe
- British Columbia Centre on Substance Use, Vancouver, BC Canada
- Department of Sociology, University of British Columbia, Vancouver, BC Canada
| | - JinCheol Choi
- British Columbia Centre on Substance Use, Vancouver, BC Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, Vancouver, BC Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, BC Canada
- Department of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Lindsey Richardson
- British Columbia Centre on Substance Use, Vancouver, BC Canada
- Department of Sociology, University of British Columbia, Vancouver, BC Canada
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Yang Y, Yu X, Yang X, Zeng K, Liu G, Hao W, Zhang S, Wang G. Oral Microbiota Profile of Individuals Who Abuse Methamphetamine. Front Cell Infect Microbiol 2021; 11:706961. [PMID: 34568092 PMCID: PMC8461105 DOI: 10.3389/fcimb.2021.706961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
The poor oral health condition of individuals who abuse methamphetamine (MA) is well known. The roles of the oral and fecal microbiomes in addiction and nervous system diseases have been the focus of many studies. However, changes in the microbiota composition of MA users have not been reported. This was addressed in the present study in 20 MA users and 14 sex-matched healthy subjects. Saliva samples were collected and high-throughput 16S rRNA sequencing and bioinformatic analysis were performed to evaluate oral microbiome profiles. The results showed that species richness was significantly lower in the MA group than in the control group. Bacterial taxa that are known to be related to oral diseases such as Negativicutes, Veillonellaceae, Veillonella, and Selenomonadales had higher relative abundance in the MA group than in the control group, and the relative abundance of Prevotella melaninogenica-a putative etiologic agent of periodontal disease-was also higher. Avoiding MA use and improving oral hygiene practices over a short term (i.e., during hospitalization for 2 weeks) did not alter the oral microbiota composition of MA users. Although the causal relationship between changes in oral microbiome profile and MA abuse remains to be determined, our results suggest that oral disease prevention and treatment strategies are important for MA users.
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Affiliation(s)
- Yongde Yang
- Wuhan Mental Health Center, The Ninth Clinical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Yu
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Education Ministry of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue Yang
- Wuhan Mental Health Center, The Ninth Clinical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kuan Zeng
- Wuhan Mental Health Center, The Ninth Clinical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Wei Hao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sheng Zhang
- Wuhan Mental Health Center, The Ninth Clinical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Wang
- Wuhan Mental Health Center, The Ninth Clinical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Yazdanian M, Armoon B, Noroozi A, Mohammadi R, Bayat AH, Ahounbar E, Higgs P, Nasab HS, Bayani A, Hemmat M. Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis. BMC Oral Health 2020; 20:44. [PMID: 32041585 PMCID: PMC7011515 DOI: 10.1186/s12903-020-1010-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/15/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. METHODS We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. RESULTS We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. CONCLUSIONS The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Bahram Armoon
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Public Health,, Loresatn University of Medical Sciences, Khoram Abad, Iran
| | - Amir-Hosein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Elahe Ahounbar
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hormoz Sanaei Nasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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Bowes C, Page G, Wassall R, Lloyd C. The need for further oral health research surrounding the provision of dental treatment for people with drug dependency. Br Dent J 2019; 227:58-60. [PMID: 31300786 DOI: 10.1038/s41415-019-0469-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this article is to highlight the need for further research in providing dental care for people with drug dependency. The association between people who misuse substances and dental disease is widely known occurrence, yet there have been few studies conducted in the UK surrounding this issue due to the nature of the cohort. Further to this, there are a multitude of barriers to accessing/seeking dental care that exist for those with drug dependency. Going forward, there is a need for the development of a new service model where dental care is part of a multidisciplinary team working towards treating people with drug dependency in a holistic way.
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Affiliation(s)
- Charlotte Bowes
- Newcastle University, Restorative Dentistry, Dental Hospital, Newcastle, UK.
| | - Geoff Page
- University of York, Department of Social Policy and Social Work, York, UK
| | - Rebecca Wassall
- Newcastle University, School of Dental Sciences, Newcastle, UK
| | - Charlie Lloyd
- University of York, Social Policy and Criminal Justice, Director of Graduate School, York, UK
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11
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Goel D, Patthi B, Singla A, Malhi R, Chaudhary PK, Khan A. Assessment of knowledge and attitude regarding management of patients with substance usage in dental clinics in Modinagar- A cross-sectional study. J Family Med Prim Care 2019; 8:3683-3688. [PMID: 31803673 PMCID: PMC6881923 DOI: 10.4103/jfmpc.jfmpc_733_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction The consequences of oral issues among drug users necessitate the implementation of a comprehensive dental care program. Integrated oral health-care services should be programmed for the management of drug addiction as a multi-organ disease needs a multi-disciplinary approach. Aim The aim of the present study was to assess the knowledge and attitude regarding the management of patients with substance usage at a dental clinic. Methodology A cross-sectional study was conducted among 208 dentists working as clinicians. A self-structured 27-item questionnaire consisting of questions related to the management of patients with substance usage at a dental clinic was distributed to them. Data were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 (SPSS Inc., Chicago, IL, USA) and descriptive and analytical tests, including mean, standard deviation, and Chi-square test were used. P < 0.05 was considered statistically significant. Results Majority of the dentist irrespective of qualification were unaware of the modalities regarding the management of the patients with substance usage at the dental clinic. Most dental clinicians were having a positive attitude regarding such patients and agreed that abuser should be identified and managed in dental settings. Conclusion Educating dental graduates and postgraduates about the oral implications of substance usage and making it a part of the dental curriculum may help us deal with the global issues of substance usage. The dental setting is recognized increasingly as an untapped venue for the delivery of medical screenings, given the long-term nature and frequent contacts associated with the patient-dentist relationship.
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Affiliation(s)
- Divyangi Goel
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Basavaraj Patthi
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Ashish Singla
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Ravneet Malhi
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Pankaj Kumar Chaudhary
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Ambar Khan
- Department of Public Health Dentistry, D.J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
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Mehmood A, Abduljabbar T, Al-Hamoudi N, Gholamiazizi E, Kellesarian SV, Vohra F, Javed F. Self-perceived oral symptoms and periodontal status among young intravenous heroin addicts: A cross-sectional case-control study. J Periodontol 2019. [PMID: 29520791 DOI: 10.1002/jper.17-0495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is hypothesized that (a) self-perceived oral symptoms (OSs) are worse in intravenous heroin addicts (IHA) than controls; and (b) clinical periodontal inflammatory parameters (plaque index [PI], bleeding on probing [BOP], PD and clinical attachment loss [AL]), number of missing teeth (MT), and radiographic marginal bone loss (MBL) are higher in IHA compared with controls. The aim was to compare the self-perceived OSs and periodontal parameters among young IHA and controls. METHODS Sociodemographic data, self-perceived OSs and duration and daily frequency of intravenous heroin use was gathered using a structured questionnaire. Full-mouth PI, BOP, PD, and clinical AL were measured, and number of MT were recorded. Mesial and distal MBL on all teeth was measured on digital radiographs. Odds ratios (OR) with 95% confidence intervals (CI) were computed for self-perceived OSs and periodontal parameters were assessed using the Mann Whitney U-test and logistic regression analysis. Sample-size was estimated, and level of significance was set at P < 0.05. RESULTS OR (95% CI) for self-perceived loose teeth (P < 0.001), pain in teeth (P < 0.001), dry mouth (P < 0.001), burning sensation in mouth (P < 0.001), bleeding gums (P < 0.001) and pain during chewing (P < 0.001) were significantly higher in the test than control group. Number of MT (P < 0.05), PI (P < 0.05), clinical AL (P < 0.05), and mesial (P < 0.05) and distal (P < 0.05) MBL were statistically significantly higher among individuals in the test group compared with the control group. CONCLUSION Self-perceived OSs and periodontal inflammatory parameters were worse in IHA than controls.
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Affiliation(s)
- Abid Mehmood
- Department of Dentistry, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Eng. Abdullah Bugshan research chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nawwaf Al-Hamoudi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Eng. Abdullah Bugshan research chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY
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14
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Lorencini BV, Bissoli BC, Simões JC, Miotto MHMDB, Siqueira MMD, Zandonade E. [Dental pain among psychoactive substance users in CAPS AD in Vitoria, Vila Velha and Serra, ES, Brazil]. CIENCIA & SAUDE COLETIVA 2019; 24:4093-4102. [PMID: 31664382 DOI: 10.1590/1413-812320182411.29582017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 04/22/2018] [Indexed: 11/22/2022] Open
Abstract
Toothache is a public health problem that causes great inconvenience to psychoactive substances users. The objective was to verify the prevalence of dental pain and its associations among psychoactive substances users from Alcohol and Drug Psychosocial Care Centers (CAPS AD) in Vitoria, Vila Velha and Serra, Espírito Santo, Brazil. A transversal study was conducted with 280 participants between June 2015 and February 2016, using five scripts: one for socio-demographic data and health perception; another for oral health; the Oral Health Impact Profile; the Alcohol Smoking and Substance Involvement Screening Test and the World Health Organization Quality of Life Test. Data were organized in frequency tables and analyzed with the SPSS 20 statistical package. Comparisons were made with Fisher's test and the Odds Ratio (OR) was used to check the strength of the association between the variables. The prevalence of pain in the population studied was 59.3%, and individuals whose quality of life was impacted due to their oral conditions were 2.2 times more likely to report toothache in the last 6 months. The population studied showed a high prevalence of dental pain and the study indicates that dental pain interferes in the quality of life of psychoactive substances users who are treated at CAPS AD services in these three cities.
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Affiliation(s)
- Bruna Venturin Lorencini
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo (UFES). Av. Marechal Campos 1468, Bonfim. 29047-105. Vitória, ES, Brasil.
| | - Bruna Costa Bissoli
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo (UFES). Av. Marechal Campos 1468, Bonfim. 29047-105. Vitória, ES, Brasil.
| | - Jeremias Campos Simões
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo (UFES). Av. Marechal Campos 1468, Bonfim. 29047-105. Vitória, ES, Brasil.
| | - Maria Helena Monteiro de Barros Miotto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo (UFES). Av. Marechal Campos 1468, Bonfim. 29047-105. Vitória, ES, Brasil.
| | - Marluce Mechelli de Siqueira
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo (UFES). Av. Marechal Campos 1468, Bonfim. 29047-105. Vitória, ES, Brasil.
| | - Eliana Zandonade
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo (UFES). Av. Marechal Campos 1468, Bonfim. 29047-105. Vitória, ES, Brasil.
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Teoh L, Moses G, McCullough MJ. Oral manifestations of illicit drug use. Aust Dent J 2019; 64:213-222. [DOI: 10.1111/adj.12709] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2019] [Indexed: 11/27/2022]
Affiliation(s)
- L Teoh
- Melbourne Dental School The University of Melbourne Carlton Victoria Australia
| | - G Moses
- School of Pharmacy University of Queensland Woolloongabba Queensland Australia
| | - MJ McCullough
- Melbourne Dental School The University of Melbourne Carlton Victoria Australia
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16
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Hanson GR, McMillan S, Mower K, Bruett CT, Duarte L, Koduri S, Pinzon L, Warthen M, Smith K, Meeks H, Trump B. Comprehensive oral care improves treatment outcomes in male and female patients with high-severity and chronic substance use disorders. J Am Dent Assoc 2019; 150:591-601. [PMID: 31122616 DOI: 10.1016/j.adaj.2019.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/18/2019] [Accepted: 02/06/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Using data from a workforce training program funded by the Health Resources and Services Administration, the authors de-identified pre- and posttreatment assessments of high-severity and chronic substance use disorders (SUDs) to test the effect of integrated comprehensive oral health care for patients with SUDs on SUD therapeutic outcomes. METHODS After 1 through 2 months of treatment at a SUD treatment facility, 158 male self-selected (First Step House) or 128 randomly selected sex-mixed (Odyssey House) patients aged 20 through 50 years with major dental needs received integrated comprehensive dental treatment. The SUD treatment outcomes for these groups were compared with those of matched 862 male or 142 sex-mixed patients, respectively, similarly treated for SUDs, but with no comprehensive oral health care (dental controls). Effects of age, primary drug of abuse, sex, and SUD treatment facility-influenced outcomes were determined with multivariate analyses. RESULTS The dental treatment versus dental control significant outcomes were hazard ratio (95% confidence interval [CI]) 3.24 (2.35 to 4.46) increase for completion of SUD treatment, and odds ratios (95% CI) at discharge were 2.44 (1.66 to 3.59) increase for employment, 2.19 (1.44 to 3.33) increase in drug abstinence, and 0.27 (0.11 to 0.68) reduction in homelessness. Identified variables did not contribute to the outcomes. CONCLUSIONS AND PRACTICAL IMPLICATIONS Improvement in SUD treatment outcomes at discharge suggests that complementary comprehensive oral health care improves SUD therapeutic results in patients with SUDs. Integrated comprehensive oral health care of major dental problems significantly improves treatment outcomes in patients whose disorders are particularly difficult to manage, such as patients with SUDs.
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Priwe C, Carlsson P. Oral Health Status of Male Swedish Citizens at Admission to Prison. JOURNAL OF CORRECTIONAL HEALTH CARE 2018; 24:382-394. [DOI: 10.1177/1078345818792243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Christer Priwe
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Peter Carlsson
- Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
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18
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Ye T, Sun D, Dong G, Xu G, Wang L, Du J, Ren P, Yu S. The effect of methamphetamine abuse on dental caries and periodontal diseases in an Eastern China city. BMC Oral Health 2018; 18:8. [PMID: 29321070 PMCID: PMC5763656 DOI: 10.1186/s12903-017-0463-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 12/17/2017] [Indexed: 01/20/2023] Open
Abstract
Background Dental diseases are among the most frequently reported health problems in drug abusers. However, few studies have been conducted on oral health of methamphetamine (meth) abusers in China. The aim of the present study was to investigate the caries and periodontal health profile of former meth abusers in Eastern China. Methods A cross-sectional study was conducted on 162 former meth abusers in the male Zhoushan Compulsory Detoxification Center. A standardized questionnaire, which collected information about age, drug-use duration / pattern, oral hygiene habit and systemic diseases, was administered. Then, a dental examination was performed to investigate the severity of dental caries and periodontal diseases. In evaluating dental caries, the prevalence of dental caries, the scores of decayed teeth (DT), missing teeth (MT), filled teeth (FT), and decayed, missing, filled teeth (DMFT) were recorded. In evaluating periodontal diseases, community periodontal index (CPI), and the prevalence of gingival bleeding, dental calculus, periodontal pocket and loose teeth, were recorded. Additionally, the non-parametric test was adopted to analyze the potential risk factors via SPSS. Results All the participants abused meth by inhalation. The mean scores of DT, MT, FT and DMFT in the former meth users were 2.72 ± 2.78, 3.07 ± 3.94, 0.33 ± 1.03 and 6.13 ± 5.20 respectively. The prevalence of gingival bleeding, dental calculus, periodontal pocket and loose teeth was 97.53%, 95.68%, 51.23% and 9.26% respectively. The DT, DMFT and CPI scores in those who had abused meth for longer than 4 years were significantly higher than those who abused for less than 4 years (P = 0.039, 0.045, P < 0.001, respectively). The DT score in those who brushed their teeth more than twice a day were significantly lower than those who brushed less (P = 0.018). Conclusions The status of caries and periodontal diseases among former male meth users in Eastern China was poor. Prolonged drug abuse and lower frequency of tooth brushing may be the risk factors of their poor status of caries and periodontal diseases. Electronic supplementary material The online version of this article (10.1186/s12903-017-0463-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tao Ye
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Dongliang Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Guangying Dong
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Guangjie Xu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.,Department of Stomatology, Chinese PLA 413 Hospital, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Ligang Wang
- Department of Stomatology, Chinese PLA 413 Hospital, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Jinjin Du
- Department of Stomatology, Chinese PLA 413 Hospital, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Pengcheng Ren
- Tangdu Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
| | - Shibin Yu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
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Parish CL, Pereyra MR, Pollack HA, Cardenas G, Castellon PC, Abel SN, Singer R, Metsch LR. Screening for substance misuse in the dental care setting: findings from a nationally representative survey of dentists. Addiction 2015; 110:1516-23. [PMID: 26032243 PMCID: PMC4521977 DOI: 10.1111/add.13004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/13/2015] [Accepted: 05/21/2015] [Indexed: 01/21/2023]
Abstract
AIMS The dental setting is a potentially valuable venue for screening for substance misuse. Therefore, we assessed dentists' inquiry of substance misuse through their patient medical history forms and their agreement with the compatibility of screening as part of the dentists' professional role. DESIGN A nationally representative survey of general dentists using a sampling frame obtained from the American Dental Association Survey Center (November 2010-November 2011). SETTING United States of America. PARTICIPANTS A total of 1802 general dentists. MEASUREMENTS A 38-item survey instrument assessing the relationship between dentists' practice, knowledge, behaviors and attitudes with their query about substance misuse and their belief that such screening is part of their professional role. FINDINGS Dentists who accepted substance misuse screening as part of their professional role were more likely to query about misuse with their patients (85.8%) compared with those who did not accept such screening as part of their role (68.2%) (P < 0.001). Prior experience and knowledge about substance misuse were the strongest predictors of dentists' inquiry about patient substance use/misuse and acceptance of screening as part of their role in their clinical practice (P < 0.05). CONCLUSION While more than three-quarters of US dentists report that they ask their patients about substance misuse, two-thirds do not agree that such screening is compatible with their professional role.
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Affiliation(s)
- Carrigan L. Parish
- Department of Sociomedical Sciences, Mailman School of Public
Health, Columbia University, 722 West 168 Street, New York, NY 10032,Department of Public Health Sciences, Miller School of Medicine,
University of Miami, 1120 NW 14 Street, Miami, FL 33136
| | - Margaret R. Pereyra
- Department of Sociomedical Sciences, Mailman School of Public
Health, Columbia University, 722 West 168 Street, New York, NY 10032,Department of Public Health Sciences, Miller School of Medicine,
University of Miami, 1120 NW 14 Street, Miami, FL 33136
| | - Harold A. Pollack
- School of Social Service Administration, University of Chicago,
900 East 60 Street, Chicago, IL 60637
| | - Gabriel Cardenas
- Department of Public Health Sciences, Miller School of Medicine,
University of Miami, 1120 NW 14 Street, Miami, FL 33136
| | - Pedro C. Castellon
- Department of Sociomedical Sciences, Mailman School of Public
Health, Columbia University, 722 West 168 Street, New York, NY 10032,Department of Public Health Sciences, Miller School of Medicine,
University of Miami, 1120 NW 14 Street, Miami, FL 33136
| | - Stephen N. Abel
- School of Dental Medicine, University at Buffalo, 250 Squire
Hall, Buffalo, NY 14214,College of Dental Medicine, Nova Southeastern University, 3200
South University Drive, Fort Lauderdale, FL 33328
| | - Richard Singer
- Department of Public Health Sciences, Miller School of Medicine,
University of Miami, 1120 NW 14 Street, Miami, FL 33136,College of Dental Medicine, Nova Southeastern University, 3200
South University Drive, Fort Lauderdale, FL 33328
| | - Lisa R. Metsch
- Department of Sociomedical Sciences, Mailman School of Public
Health, Columbia University, 722 West 168 Street, New York, NY 10032,Department of Public Health Sciences, Miller School of Medicine,
University of Miami, 1120 NW 14 Street, Miami, FL 33136
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20
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Truong A, Higgs P, Cogger S, Jamieson L, Burns L, Dietze P. Oral health-related quality of life among an Australian sample of people who inject drugs. J Public Health Dent 2015; 75:218-24. [PMID: 25753928 DOI: 10.1111/jphd.12092] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/26/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVES People who inject drugs (PWID) have poor oral health. However, their oral health-related quality of life (OHRQoL) is unknown. Our study was designed to measure the OHRQoL of PWID. METHODS The Oral Health Impact Profile-14 (OHIP-14) was administered to 794 PWID recruited in Australian capital cities as part of the 2013 Illicit Drug Reporting System (IDRS). Three OHIP-14 summary indicators were examined: "Prevalence" (proportion reporting ≥1 item at least "fairly often"), "severity" (mean total OHIP-14 score), and "extent" (number of impacts reported at least "fairly often"). Associations between "prevalence" and "extent" and variables drawn from the health, drug use, and social domains were investigated. RESULTS All OHIP-14 summary indicators among IDRS participants were significantly higher than in the general Australian population. In multivariate analysis, the "prevalence" indicator was significantly and positively associated with female gender [adjusted odds ratio (AOR) = 1.75, 95% CI 1.27-2.38], those born in Australia (AOR = 2, 95% CI 1.25-3.23), not completing Year 10 compared with those who had completed Year 12 or a higher qualification (AOR = 1.59, 95% CI 1.03-2.44), and methadone treatment (AOR = 1.61, 95% CI 1.14-2.29). The "extent" indicator was significantly and positively associated with female gender [adjusted incidence rate ratio (AIRR) = 1.56, 95% CI 1.19-2.08], unemployment (AIRR = 1.59, 95% CI 1.01-2.44), and having an injecting career of 10-20 years (AIRR = 1.76, 95% CI 1.03-3.01). CONCLUSIONS PWID have poorer OHRQoL than the Australian general population. Poor OHRQoL was particularly common in female PWID and those with longer injecting careers. Interventions to improve the oral health of PWID may improve their OHRQoL.
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Affiliation(s)
- Arthur Truong
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,National Drug Research Institute, Curtin University, Fitzroy, VIC, Australia
| | - Shelley Cogger
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
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21
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Shirani K, Nokhodian Z, Kassaian N, Adibi P, Naeini AE, Ataei B. The prevalence of isolated hepatitis B core antibody and its related risk factors among male injected drug users in Isfahan prisons. Adv Biomed Res 2015; 4:17. [PMID: 25709982 PMCID: PMC4333428 DOI: 10.4103/2277-9175.148675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 02/19/2014] [Indexed: 01/15/2023] Open
Abstract
Background: The prevalence of isolated hepatitis B core antibody (anti-HBc) varies between 1% and 30% in different populations. Isolated anti-HBc-positive patients who suffer from occult hepatitis B virus (HBV) infection have the potential to transmit HBV infection. So isolated anti-HBc screening is a valuable tool to prevent HBV transmission. Considering the importance of isolated anti-HBc screening and high prevalence of HBV among injected drug users (IDU) prisoners, we designed this study to evaluate the isolated anti-HBc positivity among inmates with the history of IDU in our area. Materials and Methods: We did this cross-sectional study from September 2009 to March 2010 among volunteer male IDU prisoners in Isfahan. Blood samples were taken from all of subjects and tested for HBV markers. Then a questionnaire containing socio-demographic, drug histories and high risk behaviors information was completed for all participants. Data analysis was done utilizing univariate analysis and multiple logistic regressions. A P < 0.05 was considered significant. Results: Totally 970 male IDU prisoners (mean age 32.6 ± 8.1) were included in our study. The prevalence of isolated HBc Ab was 4.5%. Isolated anti-HBc significantly was related to tooth filling (OR: 2.62, CI: 1.20-7.14) and imprisonment (OR: 3.95, CI: 1.39-11.18). We couldn’t find any relationship between isolated anti-HBc positivity and addiction duration, incarceration frequency, recent incarceration duration or number of injection per month. Conclusion: For screening high risk groups in parallel with hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb) and other viral markers, maybe it is better to check HBcAb too, because isolated HBcAb-positive patients may have occult hepatitis B infection which could transfer the infection to others.
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Affiliation(s)
- Kiana Shirani
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zary Nokhodian
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Kassaian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Department of Gastroenterology, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Emami Naeini
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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22
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Truong A, Higgs P, Cogger S, Dietze P. Further research required to determine unique factors associated with dental care access among deprived populations. Public Health 2014; 128:1131-3. [PMID: 25457804 DOI: 10.1016/j.puhe.2014.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 07/25/2014] [Accepted: 10/12/2014] [Indexed: 11/16/2022]
Affiliation(s)
- A Truong
- Centre for Population Health, Burnet Institute, Melbourne, Australia.
| | - P Higgs
- Centre for Population Health, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - S Cogger
- Centre for Population Health, Burnet Institute, Melbourne, Australia
| | - P Dietze
- Centre for Population Health, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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23
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Wang P, Chen X, Zheng L, Guo L, Li X, Shen S. Comprehensive dental treatment for “meth mouth”: A case report and literature review. J Formos Med Assoc 2014; 113:867-71. [DOI: 10.1016/j.jfma.2012.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2011] [Revised: 11/25/2011] [Accepted: 01/31/2012] [Indexed: 11/25/2022] Open
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Saini GK, Gupta ND, Prabhat KC. Drug addiction and periodontal diseases. J Indian Soc Periodontol 2014; 17:587-91. [PMID: 24174750 PMCID: PMC3808011 DOI: 10.4103/0972-124x.119277] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 08/25/2013] [Indexed: 11/10/2022] Open
Abstract
The prevalence of drug addiction is increasing globally. Drug abuse damages many parts of the body such as oral cavity, lungs, liver, brain, heart etc., Addicts suffer from physical, psychological, emotional and behavioral problems. Their nutrition is also compromised. There is certainly an impact of all these factors on the health of periodontium. Dentists should be aware of the effects of drugs while treating the drug addicts. This article correlates the studies done on the impact of abused drugs such as alcohol, tobacco, opiates, cannabis, amphetamines etc., on general and periodontal health.
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Affiliation(s)
- Gurpreet Kaur Saini
- Department of Periodontology, Bhojia Dental College, Baddi, Himachal Pradesh, India
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25
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Are the dental health needs of adults with illegal drug dependence being met by current service provision in the United Kingdom?: a literature review. J Addict Nurs 2014; 23:191-9. [PMID: 24335736 DOI: 10.1097/jan.0b013e31826f4bf2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This literature review outlines the current issues and debates relating to the dental health of adults with drug dependence. The dental health of adults with illegal drug dependence (IDD) continues to be under debate throughout dental practice, and the most appropriate model of care suitable to meet the high complex needs of this client group remains uncertain. The study aims to review and critically analyze available research relating to the oral health effects of illegal drug misuse and the dental health needs and status of adults with drug dependence. Second, it aims to identify and critically evaluate current models of dental service/care delivery, including relevant best practice guidance and potential barriers to dental access for adults with IDD. The available literature pertaining to dental health and adults with drug dependence are systematically reviewed and critically analyzed and evaluated in order to execute a rigorous investigation. The oral effects along with general medical complications associated with IDD are increasingly being recognized. There are substantive negative effects of IDD on oral health, particularly for those with opioid dependence; therefore, these clients have high complex dental needs and low use of dental services. Adults with drug dependence comprise a group with special dental needs and therefore need greater access to dental care than most people due to their high level of need. A high awareness of the implications for oral health care for adults with drug dependence is essential. Dental professionals have a key role in supporting the rehabilitation of these patients from potentially severe or fatal addictions. There is a distinct lack of national policy and guidance relating specifically to adults with drug dependence, and therefore, problems persist. Key findings and recommendations are presented to enhance the development of dental services for adults with IDD.
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The oral health of heroin drug users: case study in Bosnia and Herzegovina. BMC Public Health 2013; 13:1202. [PMID: 24355082 PMCID: PMC3878313 DOI: 10.1186/1471-2458-13-1202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 12/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injection drug use is a major public health problem. Oral health problems and the appearance of dental disease among injection drug users (IDUs) are caused by their lifestyle. The aim of the present study was to examine the relations between socioeconomic factors, drug use, and oral hygiene habits on the oral health of heroin drug users. METHODS A cross-sectional survey on oral health was carried out as part of UNICEF's research on the biological and behaviours survey among injection drug users in Sarajevo, Banja Luka and Zenica in Bosnia and Herzegovina. A sample of 519 IDUs participated in the survey. Respondent Driven Sampling (RDS) was used to obtain the sample. The data were obtained through face-to-face interviews using a structured questionnaire related to socio-demographic characteristics, duration of drug injection, frequency of drug injection in the last month and oral health. RESULTS Older participants (OR = 1.06; 95% CI = 1.02 -1.10), part-time employment (OR = 3.57; 95% CI = 1.02 - 12.20) and unemployment (OR = 3.23; 95% CI = 1.23 - 8.33) in comparison to full-time employment as the referent category, and longer duration of drug injection (OR = 1.06; 95% CI = 1.003 - 1.12) were predictors of bad oral health. A higher level of education (OR = 0.56; 95% CI = 0.39 - 0.79), more frequent tooth brushing (OR = 0.59; 95% CI = 0.49 - 0.71), and regular dental checkups (OR = 3.30; 95% CI = 1.42 - 7.67) were predictors of good oral health. CONCLUSIONS Socioeconomic characteristics of IDUs as well as their lifestyles may contribute to oral health problems. Heroin drug users have specific dental needs, and programmes to improve their oral health should be an integral part of strategies to prevent addictions including treatments and harm reduction programmes.
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Beynon C, Baron L, Hackett A. Perceptions of food choices of people aged 50 and over in contact with a specialist drug service: a pilot qualitative interview study. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2012.707282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A Preliminary Study Examining Nutritional Risk Factors, Body Mass Index, and Treatment Retention in Opioid-Dependent Patients. J Behav Health Serv Res 2013; 42:401-8. [DOI: 10.1007/s11414-013-9371-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Fisher R, Ewing J, Garrett A, Harrison EK, Lwin KK, Wheeler DW. The nature and prevalence of chronic pain in homeless persons: an observational study. F1000Res 2013; 2:164. [PMID: 24555079 PMCID: PMC3886796 DOI: 10.12688/f1000research.2-164.v1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2013] [Indexed: 11/20/2022] Open
Abstract
Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs. Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters. Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs. Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people’s lives.
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Affiliation(s)
- Rebecca Fisher
- Department of Primary Health Care Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Judith Ewing
- Public Health Agency, 12-22 Linenhall Street, Belfast, BT2 8BS, UK
| | - Alice Garrett
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Box 111,
Hills Road, Cambridge, CB2 0SP, UK
| | - E Katherine Harrison
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Box 111,
Hills Road, Cambridge, CB2 0SP, UK
| | - Kimberly Kt Lwin
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Box 111,
Hills Road, Cambridge, CB2 0SP, UK
| | - Daniel W Wheeler
- Division of Anaesthesia, University of Cambridge Addenbrooke's Hospital, Box 93, Hills Road, Cambridge, CB2 2QQ, UK
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Mateos-Moreno MV, Del-Río-Highsmith J, Riobóo-García R, Solá-Ruiz MF, Celemín-Viñuela A. Dental profile of a community of recovering drug addicts: Biomedical aspects. Retrospective cohort study. Med Oral Patol Oral Cir Bucal 2013; 18:e671-9. [PMID: 23722124 PMCID: PMC3731097 DOI: 10.4317/medoral.18669] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 02/19/2013] [Indexed: 11/07/2022] Open
Abstract
Objectives: to obtain a biomedical oral profile of a community of adult drug addicts in treatment by analysing their dental health, with a view to determining whether the state of their oral health could be attributed primarily to their lifestyle and the direct consequences of drug abuse on their overall condition, rather than to the effects of the drugs used.
Experimental Design: the study was conducted under the terms of an agreement between the Complutense University of Madrid’s (UCM) Odontology Faculty and the City of Madrid’s Substance Abuse Institute. Seventy drug addicts and 34 control group subjects were examined. The study assessed oral hygiene habits, systemic pathology, type of drugs used and the duration of use, oral pathology, oral health indices, risk of caries based on saliva tests, oral candidiasis and periodontal microbiology.
Results: statistically significant differences (p<0.05) were found between the test and control groups for practically all the variables analysed. In the drug users group, dental hygiene was wanting, systemic and oral pathology prevailed and the decayed/missing/filled teeth or surface (DMFT/S) indices denoted very poor buccodental health. The saliva tests showed a substantial risk of caries and candidiasis rates were high. By contrast, with a single exception, the microbiological studies detected no statistically significant difference between drug users and control groups periodontal flora.
Conclusions: drug-dependent patients had poor oral health and a significant increase in oral pathology, essentially caries and periodontal disease. Their risk of caries was high and the presence of candidiasis was representative of their poor general and oral health. Drug users’ poor buccodental condition was more closely related to lifestyle than to drug abuse itself.
Key words:Buccal, dental, drug addicts.
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Horyniak D, Higgs P, Jenkinson R, Degenhardt L, Stoové M, Kerr T, Hickman M, Aitken C, Dietze P. Establishing the Melbourne Injecting Drug User Cohort Study (MIX): rationale, methods, and baseline and twelve-month follow-up results. Harm Reduct J 2013; 10:11. [PMID: 23786848 PMCID: PMC3691755 DOI: 10.1186/1477-7517-10-11] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 06/14/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cohort studies provide an excellent opportunity to monitor changes in behaviour and disease transmission over time. In Australia, cohort studies of people who inject drugs (PWID) have generally focused on older, in-treatment injectors, with only limited outcome measure data collected. In this study we specifically sought to recruit a sample of younger, largely out-of-treatment PWID, in order to study the trajectories of their drug use over time. METHODS Respondent driven sampling, traditional snowball sampling and street outreach methods were used to recruit heroin and amphetamine injectors from one outer-urban and two inner-urban regions of Melbourne, Australia. Information was collected on participants' demographic and social characteristics, drug use characteristics, drug market access patterns, health and social functioning, and health service utilisation. Participants are followed-up on an annual basis. RESULTS 688 PWID were recruited into the study. At baseline, the median age of participants was 27.6 years (IQR: 24.4 years - 29.6 years) and two-thirds (67%) were male. Participants reported injecting for a median of 10.2 years (range: 1.5 months - 21.2 years), with 11% having injected for three years or less. Limited education, unemployment and previous incarceration were common. The majority of participants (82%) reported recent heroin injection, and one third reported being enrolled in Opioid Substitution Therapy (OST) at recruitment. At 12 months follow-up 458 participants (71% of eligible participants) were retained in the study. There were few differences in demographic and drug-use characteristics of those lost to follow-up compared with those retained in the study, with attrition significantly associated with recruitment at an inner-urban location, male gender, and providing incomplete contact information at baseline. CONCLUSIONS Our efforts to recruit a sample of largely out-of-treatment PWID were limited by drug market characteristics at the time, where fluctuating heroin availability has led to large numbers of PWID accessing low-threshold OST. Nevertheless, this study of Australian injectors will provide valuable data on the natural history of drug use, along with risk and protective factors for adverse health outcomes associated with injecting drug use. Comprehensive follow-up procedures have led to good participant retention and limited attrition bias.
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Affiliation(s)
- Danielle Horyniak
- Centre for Population Health, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004, Australia.
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Shekarchizadeh H, Khami MR, Mohebbi SZ, Virtanen JI. Oral health behavior of drug addicts in withdrawal treatment. BMC Oral Health 2013; 13:11. [PMID: 23368406 PMCID: PMC3583702 DOI: 10.1186/1472-6831-13-11] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 01/28/2013] [Indexed: 11/24/2022] Open
Abstract
Background Oral health behavior (OHB), one major factor contributing to proper oral health status, has been addressed insufficiently in addiction literature. The aim of our study was to investigate OHB and its determinants among drug addicts in withdrawal treatment. Methods Through a stratified cluster sampling method, we collected the data from 685 patients in withdrawal treatment in Tehran using self-administered questionnaires on OHB components and conducting interviews about patients’ characteristics and addiction history. The T-test, ANOVA, and a linear regression model served for statistical analysis. Results Of the patients, 48% reported brushing their teeth less than once a day, more than 90% used fluoride toothpaste almost or always, and 81% flossed their teeth rarely or never. Eating sugary products twice a day or more was reported by 57% of the patients and 85% of them were current smokers. Poor OHB was associated with male gender, lower education, being addicted mainly to crystalline heroin, starting drug abuse at a younger age, and having a longer history of addiction (p < .05). Conclusion Poor OHB was found among the participants in drug withdrawal treatment. Preventive strategies on oral health should be planned and be integrated into other health promotion programs for addicts along with their withdrawal treatment taking into account special groups at higher risk.
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Affiliation(s)
- Hajar Shekarchizadeh
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, North Kargar Street, Tehran 1439955991, Iran
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Dental disease prevalence among methamphetamine and heroin users in an urban setting. J Am Dent Assoc 2012; 143:992-1001. [DOI: 10.14219/jada.archive.2012.0326] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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McNeil R, Guirguis-Younger M. Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: perceptions of health and social services professionals. Palliat Med 2012; 26:350-9. [PMID: 21464120 DOI: 10.1177/0269216311402713] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the challenges of end-of-life care services to homeless illicit drug users based on data collected during a national study on end-of-life care services delivery to homeless persons in Canada. The authors conducted qualitative interviews with 50 health and social services professionals involved in health services delivery to homeless persons in five cities. Interviews were transcribed verbatim and analysed thematically. Themes were organised into two domains. First, barriers preventing homeless illicit drug users from accessing end-of-life care services, such as competing priorities (e.g. withdrawal management), lack of trust in healthcare providers and discrimination. Second, challenges to end-of-life care services delivery to this population in health and social care settings, including non-disclosure of illicit drug use, pain and symptom management, interruptions in care, and lack of experience with addictions. The authors identify a need for increased research on the role of harm reduction in end-of-life care settings to address these challenges.
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Affiliation(s)
- Ryan McNeil
- The University of British Columbia, British Columbia, Canada
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D'Amore MM, Cheng DM, Kressin NR, Jones J, Samet JH, Winter M, Kim TW, Saitz R. Oral health of substance-dependent individuals: impact of specific substances. J Subst Abuse Treat 2011; 41:179-85. [PMID: 21474269 DOI: 10.1016/j.jsat.2011.02.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 02/03/2011] [Accepted: 02/07/2011] [Indexed: 11/26/2022]
Abstract
Little is known about how different types of substances affect oral health. Our objective was to examine the respective effects of alcohol, stimulants, opioids, and marijuana on oral health in substance-dependent persons. Using self-reported data from 563 substance-dependent individuals, we found that most reported unsatisfactory oral health, with their most recent dental visit more than 1 year ago. In multivariable logistic regressions, none of the substance types were significantly associated with oral health status. However, opioid use was significantly related to a worse overall oral health rating compared to 1 year ago. These findings highlight the poor oral health of individuals with substance dependence and the need to address declining oral health among opioid users. General health and specialty addiction care providers should be aware of oral health problems among these patients. In addition, engagement into addiction and medical care may be facilitated by addressing oral health concerns.
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Affiliation(s)
- Meredith M D'Amore
- Health/care Disparities Research Program, Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, MA 02118, USA.
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Day CA, Islam MM, White A, Reid SE, Hayes S, Haber PS. Development of a nurse-led primary healthcare service for injecting drug users in inner-city Sydney. Aust J Prim Health 2011; 17:10-5. [DOI: 10.1071/py10064] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Accepted: 01/11/2011] [Indexed: 02/03/2023]
Abstract
Injecting drug users (IDUs) experience numerous health problems, but report barriers to utilising general practitioners (GPs). A nurse-led Harm Minimisation-based Primary Healthcare (HMPH) service for IDUs was established within a needle and syringe program in inner-city Sydney with Area Health Service medical support and clinical governance. This paper aimed to describe the HMPH service, review service utilisation and assess nurses’ perceptions of their work with IDUs. A review of the most recent 200 clinic files was undertaken. Service utilisation, GP and other health service use and access were extracted and analysed using SPSS. A semi-structured qualitative interview with clinic nurses regarding their experience working with IDUs and local GPs was conducted and analysed. Since its inception in mid-2006, the service has been utilised by 417 clients. Of the most recent 200 files, blood-borne virus and sexually transmitted infection screening were the primary reason for presentation (64.5%). At least one follow-up visit was attended by 90% of clients. A total of 62% of clients reported consulting a GP in the last 12 months. The service provided 102 referrals. Nurses believed that IDUs tend to utilise GPs ineffectively and that self-care is a low priority, but that they can support IDUs to overcome some barriers to GPs and facilitate access. Targeted primary health care services led by nurses with focussed medical support and co-located with needle and syringe programs can fill an important gap in delivering and facilitating health care to IDUs.
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Robbins JL, Wenger L, Lorvick J, Shiboski C, Kral AH. Health and oral health care needs and health care-seeking behavior among homeless injection drug users in San Francisco. J Urban Health 2010; 87:920-30. [PMID: 20945108 PMCID: PMC3005094 DOI: 10.1007/s11524-010-9498-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Few existing studies have examined health and oral health needs and treatment-seeking behavior among the homeless and injection drug users (IDUs). This paper describes the prevalence and correlates of health and oral health care needs and treatment-seeking behaviors in homeless IDUs recruited in San Francisco, California, from 2003 to 2005 (N = 340). We examined sociodemographic characteristics, drug use patterns, HIV status via oral fluid testing, physical health using the Short Form 12 Physical Component Score, self-reported needs for physical and oral health care, and the self-reported frequency of seeking medical and oral health care. The sample had a lower health status as compared to the general population and reported a frequent need for physical and oral health care. In bivariate analysis, being in methadone treatment was associated with care-seeking behavior. In addition, being enrolled in Medi-Cal, California's state Medicaid program, was associated with greater odds of seeking physical and oral health care. Methamphetamine use was not associated with higher odds of needing oral health care as compared to people who reported using other illicit drugs. Homeless IDUs in San Francisco have a large burden of unmet health and oral health needs. Recent cuts in Medi-Cal's adult dental coverage may result in a greater burden of oral health care which will need to be provided by emergency departments and neighborhood dental clinics.
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Affiliation(s)
- Jonathan Leserman Robbins
- Joint Medical Program, University of California, Berkeley and University of California, San Francisco, 570 University Hall, Berkeley, CA, 94720-1190, USA.
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Abstract
Oral manifestations of nutritional deficiencies can affect the mucous membranes, teeth, periodontal tissue, salivary glands, and perioral skin. This contribution reviews how the water-soluble vitamins (B(2), B(3), B(6), B(12), C, and folic acid), fat-soluble vitamins (A, D, and E), and minerals (calcium, fluoride, iron, and zinc) can affect the oral mucosa.
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Affiliation(s)
- Joanne Neale
- School of Health and Social Care, Oxford Brookes University, Jack Straw's Lane, Marston, Oxford OX3 0FL, UK.
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