The Persian methamphetamine use in methadone treatment in Iran: implication for prevention and treatment in an upper-middle income country

Dual Unsafe Injection and Sexual Behaviors for HIV Infection Among People Who Inject Drugs in Iran

We used two national surveys (2010: N = 1597; 2013: N = 1057) of people who inject drugs (PWID) in past-month to assess the prevalence and population size of PWID with either safe or unsafe injection and sex behaviors, overall and by HIV status. In 2013, only 27.0% (vs. 32.3% in 2010) had safe injection and sex, 24.6% (vs. 23.3% in 2010) had unsafe injection and sex, 26.4% (vs. 26.5% in 2010) had only unsafe injection, and 22.0% (vs. 18.0% in 2010) had unsafe sex only. Among HIV-positive PWID in 2013, only 22.1% (~ 2200 persons) had safe injection and sex, 14.2% (~ 1400 persons) had unsafe injection and sex, 53.1% (~ 5200 persons) had unsafe injection, and 10.6% had unsafe sex (~ 1100 persons). Among HIV-negative PWID in 2013, only 27.5% (~ 22,200 persons) had safe injection and sex, 25.9% (~ 20,900 PWID) had unsafe injection and sex, 23.2% (~ 18,700 persons) had unsafe injection, and 23.3% (~ 18,800 persons) had unsafe sex. HIV-positive and -negative PWID in Iran continue to be at risk of HIV acquisition or transmission which calls for targeted preventions services.

History of Alcohol and Opioid Use Impacts on the Long-Term Recovery Trajectories of Methamphetamine-Dependent Patients

Methamphetamine (MA) has become one of the most widely used illicit substances in China and the rest of the world as well. Relapse, incarceration or death was observed after compulsory rehabilitation. However, the knowledge of recovery patterns among MA-dependent patients, early or late occurrence of these negative consequences, is limited. The aims were to explore the long-term recovery patterns and associated factors among MA-dependent patients in Shanghai, China. MA-dependent patients discharged from Shanghai compulsory rehabilitation facilities in 2009-2012 were recruited in a baseline survey. The baseline data of 232 patients were then linked with their long-term follow-up data from official records. Group-based trajectory modeling was applied to identify distinctive trajectories of the occurrence of negative consequences (incarceration, or readmission to compulsory rehabilitation, or death). Patients with monthly status data were found recovering with three distinctive trajectories: rare, late, and early occurrence groups. Multinomial logistic regression showed that having alcohol use history was associated with an increased likelihood of being in the late occurrence group relative to the rare occurrence group. Having opioid use history was associated with an increased likelihood of being in the early occurrence group relative to the rare occurrence group. In addition, being female was associated with decreased likelihood of being in the late occurrence group relative to the rare occurrence group.

Club drugs and alcohol abuse predicted dropout and poor adherence among methadone maintenance treatment patients in Guangzhou, China

Club drugs and alcohol abuse are prevalent among methadone maintenance treatment (MMT) patients. However, little is known about the association between these abuse and treatment outcomes among MMT patients. The aim of this study was to examine the prevalence of club drugs and alcohol abuse among MMT patients and to investigate the associations between these abuse and treatment outcomes - dropout and poor adherence. In this one-year cohort study conducting in Guangzhou, China, data including background characteristics, club drugs use in the last six months, alcohol use history and treatment-related information was collected. Cox regression analyses and log-binomial regression analyses were applied to identify the associations between these abuse and dropout and poor adherence, respectively. Thirty-seven participants (9.2%) admitted to the use of at least one type of club drugs in the last six months and 88 (21.9%) were identified as alcohol abusers. Of all participants, 21.0% had dropped out of treatment and 27.7% exhibited poor adherence during the study period. Adjusting for significant background variables, use of at least one type of club drugs [hazards ratio (HR) = 1.90, 95% confidence interval (CI) = 1.01-3.56] and use of methamphetamine in the last six months (HR = 2.26, 95% CI = 1.15-4.43) significantly predicted dropout. Frequency of having six or more drinks on one drinking occasion when drinking [relative risk (RR) = 1.87, 95% CI = 1.16-2.95] significantly predicted poor adherence. Our findings indicated that club drugs and alcohol abuse predicted dropout and poor adherence among MMT patients. Early identification and intervention for the abuse should be taken into consideration when developing interventions tailored to improve treatment outcomes among MMT patients.