1
|
Pitpitan EV, Horvath KJ, Aldous J, Stockman JK, Patterson TL, Liang M, Barrozo C, Moore V, Penninga K, Smith LR. Peers plus mobile app for treatment in HIV (PATH): protocol for a randomized controlled trial to test a community-based integrated peer support and mHealth intervention to improve viral suppression among Hispanic and Black people living with HIV. Trials 2024; 25:212. [PMID: 38520030 PMCID: PMC10958824 DOI: 10.1186/s13063-024-08042-8] [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: 12/21/2023] [Accepted: 03/08/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Significant disparities continue to exist in the HIV care continuum, whereby Hispanic and Black people living with HIV (PLWH) are less likely to achieve viral suppression compared to their White counterparts. Studies have shown that intervention approaches that involve peer navigation may play an important role in supporting patients to stay engaged in HIV care. However, implementation may be challenging in real-world settings where there are limited resources to support peer navigators. Combining a peer navigation approach with scalable mobile health (mHealth) technology may improve impact and implementation outcomes. METHODS We combined a peer navigation intervention with a mHealth application and are conducting a randomized controlled trial (RCT) to test the efficacy of this integrated "Peers plus mobile App for Treatment in HIV" (PATH) intervention to improve HIV care engagement, and ultimately sustained viral suppression, among Hispanic and Black PLWH. We will enroll up to 375 PLWH into a two-arm prospective RCT, conducting follow-up assessments every 3 months up to 12 months post-baseline. Participants randomized to the control arm will continue to receive usual care Ryan White Program case management services. Individuals randomized to receive the PATH intervention will receive usual care plus access to two main intervention components: (1) a peer navigation program and (2) a mHealth web application. The primary outcome is sustained HIV viral suppression (undetectable viral load observed at 6- and 12-month follow-up). Secondary outcomes are retention in HIV care, gaps in HIV medical visits, and self-reported ART adherence. Recruitment for the RCT began in November 2021 and will continue until June 2024. Follow-up assessments and medical chart abstractions will be conducted to collect measurements of outcome variables. DISCUSSION The efficacy trial of PATH will help to fill gaps in our scientific understanding of how a combined peer navigation and mHealth approach may produce effects on HIV care outcomes while addressing potential implementation challenges of peer navigation in Ryan White-funded clinics. TRIAL REGISTRATION The PATH trial is registered at the United States National Institutes of Health National Library of Medicine (ClinicalTrials.gov) under ID # NCT05427318 . Registered on 22 June 2022.
Collapse
Affiliation(s)
- Eileen V Pitpitan
- School of Social Work, San Diego State University, San Diego, USA.
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, USA.
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, USA
| | | | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, USA
| | - Thomas L Patterson
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Megan Liang
- San Diego State University Research Foundation, San Diego, USA
| | | | | | | | - Laramie R Smith
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, USA
| |
Collapse
|
2
|
Denning CJE, Madory LE, Herbert JN, Cabrera RA, Szumlinski KK. Neuropharmacological Evidence Implicating Drug-Induced Glutamate Receptor Dysfunction in Affective and Cognitive Sequelae of Subchronic Methamphetamine Self-Administration in Mice. Int J Mol Sci 2024; 25:1928. [PMID: 38339206 PMCID: PMC10856401 DOI: 10.3390/ijms25031928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Methamphetamine (MA) is a highly addictive drug, and MA use disorder is often comorbid with anxiety and cognitive impairment. These comorbid conditions are theorized to reflect glutamate-related neurotoxicity within the frontal cortical regions. However, our prior studies of MA-sensitized mice indicate that subchronic, behaviorally non-contingent MA treatment is sufficient to dysregulate glutamate transmission in mouse brain. Here, we extend this prior work to a mouse model of high-dose oral MA self-administration (0.8, 1.6, or 3.2 g/L; 1 h sessions × 7 days) and show that while female C57BL/6J mice consumed more MA than males, MA-experienced mice of both sexes exhibited some signs of anxiety-like behavior in a behavioral test battery, although not all effects were concentration-dependent. No MA effects were detected for our measures of visually cued spatial navigation, spatial learning, or memory in the Morris water maze; however, females with a history of 3.2 g/L MA exhibited reversal-learning deficits in this task, and mice with a history of 1.6 g/L MA committed more working-memory incorrect errors and relied upon a non-spatial navigation strategy during the radial-arm maze testing. Relative to naïve controls, MA-experienced mice exhibited several changes in the expression of certain glutamate receptor-related proteins and their downstream effectors within the ventral and dorsal areas of the prefrontal cortex, the hippocampus, and the amygdala, many of which were sex-selective. Systemic pretreatment with the mGlu1-negative allosteric modulator JNJ 162596858 reversed the anxiety-like behavior expressed by MA-experienced mice in the marble-burying test, while systemic pretreatment with NMDA or the NMDA antagonist MK-801 bi-directionally affected the MA-induced reversal-learning deficit. Taken together, these data indicate that a relatively brief history of oral MA is sufficient to induce some signs of anxiety-like behavior and cognitive dysfunction during early withdrawal that reflect, at least in part, MA-induced changes in the corticolimbic expression of certain glutamate receptor subtypes of potential relevance to treating symptoms of MA use disorder.
Collapse
Affiliation(s)
- Christopher J. E. Denning
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Lauren E. Madory
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Jessica N. Herbert
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Ryan A. Cabrera
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
| | - Karen K. Szumlinski
- Department of Psychological and Brain Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA; (C.J.E.D.); (L.E.M.); (J.N.H.); (R.A.C.)
- Department of Molecular, Cellular and Developmental Biology, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| |
Collapse
|
3
|
Cummins-Beebee PN, Chvilicek MM, Rothenfluh A. The Stage-Based Model of Addiction-Using Drosophila to Investigate Alcohol and Psychostimulant Responses. Int J Mol Sci 2023; 24:10909. [PMID: 37446084 PMCID: PMC10341944 DOI: 10.3390/ijms241310909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Addiction is a progressive and complex disease that encompasses a wide range of disorders and symptoms, including substance use disorder (SUD), for which there are few therapeutic treatments. SUD is the uncontrolled and chronic use of substances despite the negative consequences resulting from this use. The progressive nature of addiction is organized into a testable framework, the neurobiological stage-based model, that includes three behavioral stages: (1) binge/intoxication, (2) withdrawal/negative affect, and (3) preoccupation/anticipation. Human studies offer limited opportunities for mechanistic insights into these; therefore, model organisms, like Drosophila melanogaster, are necessary for understanding SUD. Drosophila is a powerful model organism that displays a variety of SUD-like behaviors consistent with human and mammalian substance use, making flies a great candidate to study mechanisms of behavior. Additionally, there are an abundance of genetic tools like the GAL4/UAS and CRISPR/Cas9 systems that can be used to gain insight into the molecular mechanisms underlying the endophenotypes of the three-stage model. This review uses the three-stage framework and discusses how easily testable endophenotypes have been examined with experiments using Drosophila, and it outlines their potential for investigating other endophenotypes.
Collapse
Affiliation(s)
- Pearl N. Cummins-Beebee
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84112, USA
- Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112, USA
- Neuroscience Graduate Program, University of Utah, Salt Lake City, UT 84112, USA
| | - Maggie M. Chvilicek
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84112, USA
- Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112, USA
- Neuroscience Graduate Program, University of Utah, Salt Lake City, UT 84112, USA
| | - Adrian Rothenfluh
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84112, USA
- Molecular Medicine Program, University of Utah, Salt Lake City, UT 84112, USA
- Neuroscience Graduate Program, University of Utah, Salt Lake City, UT 84112, USA
- Department of Neurobiology, University of Utah, Salt Lake City, UT 84112, USA
- Department of Human Genetics, University of Utah, Salt Lake City, UT 84112, USA
| |
Collapse
|
4
|
Kolluru GK, Glawe JD, Pardue S, Kasabali A, Alam S, Rajendran S, Cannon AL, Abdullah CS, Traylor JG, Shackelford RE, Woolard MD, Orr AW, Goeders NE, Dominic P, Bhuiyan MSS, Kevil CG. Methamphetamine causes cardiovascular dysfunction via cystathionine gamma lyase and hydrogen sulfide depletion. Redox Biol 2022; 57:102480. [PMID: 36167027 PMCID: PMC9513700 DOI: 10.1016/j.redox.2022.102480] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 12/01/2022] Open
Abstract
Methamphetamine (METH) is an addictive illicit drug used worldwide that causes significant damage to blood vessels resulting in cardiovascular dysfunction. Recent studies highlight increased prevalence of cardiovascular disease (CVD) and associated complications including hypertension, vasospasm, left ventricular hypertrophy, and coronary artery disease in younger populations due to METH use. Here we report that METH administration in a mouse model of 'binge and crash' decreases cardiovascular function via cystathionine gamma lyase (CSE), hydrogen sulfide (H2S), nitric oxide (NO) (CSE/H2S/NO) dependent pathway. METH significantly reduced H2S and NO bioavailability in plasma and skeletal muscle tissues co-incident with a significant reduction in flow-mediated vasodilation (FMD) and blood flow velocity revealing endothelial dysfunction. METH administration also reduced cardiac ejection fraction (EF) and fractional shortening (FS) associated with increased tissue and perivascular fibrosis. Importantly, METH treatment selectively decreased CSE expression and sulfide bioavailability along with reduced eNOS phosphorylation and NO levels. Exogenous sulfide therapy or endothelial CSE transgenic overexpression corrected cardiovascular and associated pathological responses due to METH implicating a central molecular regulatory pathway for tissue pathology. These findings reveal that therapeutic intervention targeting CSE/H2S bioavailability may be useful in attenuating METH mediated cardiovascular disease.
Collapse
Affiliation(s)
- Gopi K Kolluru
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | - John D Glawe
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | - Sibile Pardue
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | - Ahmad Kasabali
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | - Shafiul Alam
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | | | - Allison L Cannon
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | | | - James G Traylor
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA
| | | | - Matthew D Woolard
- Department of Microbiology and Immunology, LSU Health Sciences Center- Shreveport, USA
| | - A Wayne Orr
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA; Department of Cellular Biology and Anatomy, LSU Health Sciences Center- Shreveport, USA; Department of Molecular and Cellular Physiology, LSU Health Sciences Center- Shreveport, USA
| | - Nicholas E Goeders
- Department of Pharmacology, Toxicology & Neuroscience, LSU Health Sciences Center- Shreveport, USA
| | - Paari Dominic
- Division of Cardiology Department of Medicine, LSU Health Sciences Center- Shreveport, USA
| | | | - Christopher G Kevil
- Department of Pathology, LSU Health Sciences Center- Shreveport, USA; Department of Cellular Biology and Anatomy, LSU Health Sciences Center- Shreveport, USA; Department of Molecular and Cellular Physiology, LSU Health Sciences Center- Shreveport, USA.
| |
Collapse
|
5
|
Bax T. “I Had No Problems and Just Felt So Fabulous”: The “Storylines” of Methamphetamine Initiation in Aotearoa/New Zealand. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221134903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative life course-based study analyses the key circumstances preceding methamphetamine initiation. This paper utilizes Agnew’s “storylines” concept to analyse the background and situational factors that led 42 Aotearoa/New Zealanders to initiate methamphetamine. Multiple exposure to adversity across multiple life domains placed participants at heightened risk of early-onset drug use. Preceding methamphetamine initiation, the impact of social bonds and social roles were identified within the domains of family, romantic relationships, friendship and work. Whilst drug use onset broadly follows the stage theory sequence of drug use, participants did not initiate methamphetamine until age 27 on average. Initial use typically took place in a private setting among friends, family and co-workers. The initial effect was typically very positive, which greatly contributed to escalating use. Analysis revealed four main storylines, which highlight the importance of psychological state, social bonds, romantic attachments and social functioning in methamphetamine initiation.
Collapse
Affiliation(s)
- Trent Bax
- Department of Sociology, Ewha Womans University, South Korea
| |
Collapse
|
6
|
Jordan Walter T, Minassian A, Perry W, Young JW. Combined prior chronic methamphetamine treatment and gp120 expression reduce PPI in aged male but not female mice. Neurosci Lett 2022; 780:136639. [PMID: 35452766 DOI: 10.1016/j.neulet.2022.136639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/19/2022] [Accepted: 04/17/2022] [Indexed: 11/27/2022]
Abstract
Methamphetamine (METH) use disorder is highly prevalent among people with HIV and is a significant public health problem. Furthermore, people with HIV are living longer and using drugs such as METH even into old age, making it important to understand the effects of METH use and aging in this population. HIV, METH, and aging negatively impact a variety of brain functions, including sensorimotor gating (i.e. - automatic, pre-conscious information processing). Sensorimotor gating is often measured using prepulse inhibition (PPI), a paradigm that can be conducted in animals, thereby allowing for preclinical studies. Little is known about how HIV, METH, and aging interact to affect PPI. The goal of this study was therefore to examine how METH affects PPI in aged gp120 mice, a mouse model of HIV. PPI was measured at 8, 14, and 22 months in male and female wild type (WT) and gp120 mice. PPI was also measured during and after METH treatment at 23-24 months. Aging was associated with decreased PPI in both sexes and genotypes. Combined prior METH treatment and gp120 expression caused the greatest reduction in PPI in aged male mice. Prior METH treatment decreased PPI in aged WT female mice, but not aged gp120 female mice. Overall, these results suggest the effects of HIV and METH on information processing seem to be influenced by age and sex. Combined HIV and METH may impair information processing in older men, but not older women.
Collapse
Affiliation(s)
- T Jordan Walter
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Arpi Minassian
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; VA Center of Excellence for Stress and Mental Health, Veterans Administration San Diego HealthCare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
| | - William Perry
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Research Services, Veterans Administration San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
| |
Collapse
|
7
|
Risky Sexual Practices, Sexually Transmitted Infections, Motivations, and Mental Health among Heterosexual Women and Men Who Practice Sexualized Drug Use in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116387. [PMID: 35681972 PMCID: PMC9180103 DOI: 10.3390/ijerph19116387] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 12/10/2022]
Abstract
Sexualized drug use (SDU) has been poorly studied among heterosexuals. The purpose of the present study was to analyze the prevalence of and gender differences in types of substances, risky sexual practices, sexually transmitted infections (STIs), motivations, and psychological adjustment among heterosexual women and men who engage in SDU. The study sample consisted of 1181 heterosexuals (795 women) between 18 and 78 years old (mean age = 24.4, SD = 7.4). Approximately 12% of the participants had engaged in SDU. No differences were found in the prevalence of SDU between men and women. Alcohol, cannabis, and 3,4-methylenedioxy-methamphetamine (MDMA) were the substances most frequently used for sexual purposes. Men were significantly more likely to use MDMA, ecstasy, cocaine, and erectile dysfunction (ED) drugs, and they tended to have more sexual partners than women. Likewise, SDU was related to have more sexual partners, penetrative sex without a condom, practice a fetish, be diagnosed with syphilis, chlamydia, and others STIs, and present more depression symptoms (but not with more anxiety). In conclusion, SDU was associated with poorer physical and mental health. It is, therefore, necessary to design programs aimed at reducing the incidence of the consequences of SDU on the physical and mental health of both men and women. Moreover, programs that seek to understand why these individuals engage in SDU should be undertaken.
Collapse
|
8
|
Lanièce Delaunay C, Maheu-Giroux M, Marathe G, Saeed S, Martel-Laferrière V, Cooper CL, Walmsley S, Cox J, Wong A, Klein MB. Gaps in hepatitis C virus prevention and care for HIV-hepatitis C virus co-infected people who inject drugs in Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103627. [PMID: 35218989 DOI: 10.1016/j.drugpo.2022.103627] [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: 11/08/2021] [Revised: 02/09/2022] [Accepted: 02/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND People who inject drugs (PWID) living with HIV are a priority population for eliminating hepatitis C virus (HCV) as a public health threat. Maximizing access to HCV prevention and treatment strategies are key steps towards elimination. We aimed to evaluate engagement in harm reduction programs and HCV treatment, and to describe injection practices among HIV-HCV co-infected PWID in Canada from 2003 to 2019. METHODS We included Canadian Coinfection Cohort study participants who reported injecting drugs between 2003 and 2019 in Quebec, Ontario, Saskatchewan, and British Columbia, Canada. We investigated temporal trends in HCV treatment uptake, efficacy, and effectiveness; injection practices; and engagement in harm reduction programs in three time periods based on HCV treatment availability: 1) interferon/ribavirin (2003-2010); 2) first-generation direct acting antivirals (DAAs) (2011-2013); 3) second-generation DAAs (2014-2019). Harm reduction services assessed included needle and syringe programs (NSP), opioid agonist therapy (OAT), and supervised injection sites (SIS). RESULTS Median age of participants (N = 1,077) at cohort entry was 44 years; 69% were males. Province-specific HCV treatment rates increased among HCV RNA-positive PWID, reaching 16 to 31 per 100 person-years in 2014-2019. Treatment efficacy improved from a 50 to 70% range in 2003-2010 to >90% across provinces in 2014-2019. Drug injecting patterns among active PWID varied by province, with an overall decrease in cocaine injection frequency and increasing opioid injections. In the most recent time period (2014-2019), needle/syringe sharing was reported at 8-22% of visits. Gaps remained in engagement in harm reduction programs: NSP use decreased (58-70% of visits), OAT engagement among opioid users was low (8-26% of visits), and participants rarely used SIS (1-15% of visits). CONCLUSION HCV treatment uptake and outcomes have improved among HIV-HCV coinfected PWID. Yet, this population remains exposed to drug-related harms, highlighting the need to tie HCV elimination strategies with enhanced harm reduction programs to improve overall health for this population.
Collapse
Affiliation(s)
- Charlotte Lanièce Delaunay
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Faculty of Medicine, McGill University, 1020 Avenue des Pins Ouest, H3A 1A2, Montreal QC, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 Boulevard de Maisonneuve Ouest, H4A 3S5, Montreal QC, Canada
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Faculty of Medicine, McGill University, 1020 Avenue des Pins Ouest, H3A 1A2, Montreal QC, Canada
| | - Gayatri Marathe
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Faculty of Medicine, McGill University, 1020 Avenue des Pins Ouest, H3A 1A2, Montreal QC, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 Boulevard de Maisonneuve Ouest, H4A 3S5, Montreal QC, Canada
| | - Sahar Saeed
- Institute for Public Health, Washington University, 600 S Taylor Avenue, St. Louis, MO 63110, United States of America
| | - Valérie Martel-Laferrière
- Département de Médecine Spécialisée et de Médecine des Laboratoires, Centre Hospitalier de L'Université de Montréal, 264 Boulevard René-Lévesque Est, H2×1P1, Montreal QC, Canada; Centre de Recherche du Centre Hospitalier de L'Université de Montréal, 900 Rue Saint-Denis, H2×0A9, Montreal QC, Canada; Département de Microbiologie, Maladies Infectieuses, et Immunologie, Université de Montréal, 2900 Boulevard Édouard-Monpetit, H3T 1J4, Montreal QC, Canada
| | - Curtis L Cooper
- Division of Infectious Diseases, Department of Medicine, Ottawa Hospital Research Institute, 725 Parkdale Avenue, K1Y 4E9, Ottawa ON, Canada
| | - Sharon Walmsley
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of Toronto, 6 Queen's Park Crescent West, M5S 3H2, Toronto ON, Canada; University Health Network, University of Toronto, 190 Elizabeth Street, M5G 2C4, Toronto ON, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Faculty of Medicine, McGill University, 1020 Avenue des Pins Ouest, H3A 1A2, Montreal QC, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University Health Centre, 1001 Boulevard Décarie, H4A 3J1, Montreal QC, Canada
| | - Alexander Wong
- Division of Infectious Diseases, Department of Medicine, University of Saskatchewan, 107 Wiggins Road, S7N 5E5, Saskatoon SK, Canada
| | - Marina B Klein
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Faculty of Medicine, McGill University, 1020 Avenue des Pins Ouest, H3A 1A2, Montreal QC, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University Health Centre, 1001 Boulevard Décarie, H4A 3J1, Montreal QC, Canada; Canadian HIV Trials Network, Canadian Institutes of Health Research, 588-1081 Burrard Street, V6Z 1Y6, Vancouver BC, Canada.
| |
Collapse
|
9
|
Minoyan N, Høj SB, Jutras-Aswad D, Vlad D, Martel-Laferrière V, Sylvestre MP, Bruneau J. Gender-specific associations between psychological distress and injecting risk behaviours among people who inject drugs in Montreal, Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 96:103319. [PMID: 34154905 DOI: 10.1016/j.drugpo.2021.103319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/15/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Psychological distress is common among people who inject drugs (PWID) and may be associated with HCV-related risk behaviours. Previous studies have documented increased vulnerability to both psychological distress and HCV infection among female relative to male PWID. It is, however, unclear whether behavioural responses to distress differ by gender. This study estimated gender-specific associations between psychological distress and i) binge drug injection, and ii) sharing of injection materials. METHODS Data were drawn from HEPCO, a longitudinal cohort study involving three-monthly interviews with active PWID in Montreal, Canada. Past-month psychological distress was assessed with the Kessler (K10) scale, categorized for descriptive analyses as minimal (score 10-15), moderate (16-21), high (22-29), or severe (30-50). Binge was defined as injecting large quantities of drugs until participants could no longer continue (past 3 months). Sharing was defined as injection with previously-used needles or equipment (past 3 months). Generalized additive models were fit to estimate smooth, nonlinear associations between K10 scores and risk behaviours, by gender. Models were adjusted for known determinants of drug-related harms and included random intercepts to model within-subject correlation. RESULTS 805 individuals (82% male) provided 8158 observations (2011-2020). High to severe levels of distress were common and more frequent among women (55% vs 37%). Among men, the odds of binge and sharing monotonically and non-linearly increased with increasing scores of psychological distress. Associations for binge among women were attenuated relative to men but nevertheless increased with distress, albeit in a linear fashion. Sharing was not associated with distress among women. CONCLUSION Psychological distress was differentially associated with injecting risk behaviours among men and women who inject drugs. Assessment of distress may provide novel prevention opportunities for select PWID. Further investigation into gender differences is warranted to inform development and tailoring of interventions.
Collapse
Affiliation(s)
- Nanor Minoyan
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9; Department of social and preventive medicine, École de Santé Publique, Université de Montréal. 7101 Ave Parc, Montréal (Québec), Canada H3N 1X9
| | - Stine Bordier Høj
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9
| | - Didier Jutras-Aswad
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montreal. 2900 boul. Édouard-Montpetit, Montréal (Québec), Canada H3C 3J7
| | - Dragos Vlad
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9; Department of social and preventive medicine, École de Santé Publique, Université de Montréal. 7101 Ave Parc, Montréal (Québec), Canada H3N 1X9
| | - Valérie Martel-Laferrière
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9; Department of microbiology, infectiology and immunology, Faculty of Medicine, Université de Montréal. 2900 boul. Édouard-Montpetit, Montréal (Québec), Canada H3C 3J7
| | - Marie-Pierre Sylvestre
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9; Department of social and preventive medicine, École de Santé Publique, Université de Montréal. 7101 Ave Parc, Montréal (Québec), Canada H3N 1X9
| | - Julie Bruneau
- Université de Montréal Hospital Research Centre (CRCHUM), 900 Rue Saint Denis, Montréal (Québec), Canada H2X 0A9; Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal. 2900 boul. Édouard-Montpetit, Montréal (Québec), Canada H3C 3J7.
| |
Collapse
|
10
|
Stockman JK, Syvertsen JL, Hayashi HD, Ludwig-Barron N, Tsuyuki K, Morris MD, Palinkas LA. "Violence and love and drugs…it all goes hand in hand": A mixed methods analysis of the substance abuse, violence, and HIV/AIDS syndemic among women who use methamphetamine. Subst Abus 2021; 42:821-831. [PMID: 33492198 PMCID: PMC8442613 DOI: 10.1080/08897077.2020.1865242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The synergistic epidemics of substance use, violence, and HIV/AIDS, also known as the SAVA syndemic, disproportionately affects vulnerable women in the United States. Methamphetamine use is closely linked with physical and sexual violence, including intimate partner violence (IPV), which heightens women's vulnerability to HIV. This mixed methods study examined the prevalence and correlates of violence among women who use methamphetamine, (n = 209) enrolled in an HIV intervention study in San Diego, California. Methods: At baseline, 209 women completed an interviewer-administered computer-assisted survey. A sub set of women who reported lifetime IPV (n = 18) also participated in qualitative interviews to contextualize our understanding of patterns of violence over time. Results: In the overall cohort, reports of lifetime (66.0%) and past 2-month (19.6%) IPV were prevalent. Moreover, women reported lifetime physical only (27.3%), sexual only (6.2%), or both forms of violence (50.7%) by multiple perpetrators. Factors independently associated with lifetime IPV were having unprotected sex with a steady partner (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.04, 6.00) and being high on methamphetamine during unprotected sex with a steady partner (OR: 2.56, 95% CI: 1.30, 5.09) within the past 2 months. Our qualitative narratives illuminated how IPV in women's steady relationships often reflects a culmination of violent victimization throughout their lifetime which is further exacerbated by methamphetamine use and sexual risk through gendered power dynamics. Conclusions: HIV prevention interventions should address the SAVA syndemic in a holistic manner, including the role of methamphetamine use in the context of women's abusive steady relationships.
Collapse
Affiliation(s)
- Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | - Hitomi D. Hayashi
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, USA
| | - Natasha Ludwig-Barron
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Meghan D. Morris
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | |
Collapse
|
11
|
Berquist MD, McGill MR, Mazur A, Findley DL, Gorman G, Jones CB, Hambuchen MD. Effect of bile duct ligation-induced liver dysfunction on methamphetamine pharmacokinetics in male and female rats. Drug Alcohol Depend 2020; 215:108190. [PMID: 32736295 DOI: 10.1016/j.drugalcdep.2020.108190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Several disease states commonly associated with methamphetamine (METH) use produce liver dysfunction, and in the bile duct ligation (BDL) model of hepatic dysfunction, rats with liver injury are more sensitive to METH effects. Additionally, both female rats and humans are known to be more sensitive to METH than males. In consideration of known sex-dependent differences in METH pharmacokinetics, this study sought to determine the potential interaction between sex and liver dysfunction variables on METH pharmacokinetics. METHODS Sham or BDL surgery was performed on male and female rats on day 0. Serum biomarker and pharmacokinetics studies with 3 mg/kg subcutaneous (SC) METH were performed on day 7. METH-induced weight loss was measured on day 8. Liver histology evaluation and brain METH concentration measurements were performed on day 9. RESULTS While BDL surgery produced significantly elevated alanine aminotransferase and bile duct proliferation in male compared to female rats, there were no significant interactions between sex and liver function in the pharmacokinetic parameters. Both liver dysfunction and female sex, however, were associated with significantly slower METH serum clearance and significantly higher brain METH concentrations (p < .05). CONCLUSIONS BDL-induced hepatic dysfunction produces substantial reductions in METH clearance and increased brain METH concentrations in both male and female rats, despite less liver injury in females. This preclinical model may be useful to identify and correct potential liver dysfunction comorbidity-related problems with future pharmacotherapy for stimulant use disorder with METH prior to expensive clinical trials.
Collapse
Affiliation(s)
- Michael D Berquist
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Mitchell R McGill
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Anna Mazur
- Department of Biomedical Science, Marshall University School of Medicine, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - David L Findley
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - Greg Gorman
- Department of Pharmaceutical, Social and Administrative Sciences, Samford University McWhorter School of Pharmacy, 800 Lakeshore Drive, Birmingham, AL, 35209, USA
| | - Cynthia B Jones
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV, 25755, USA
| | - Michael D Hambuchen
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, 1 John Marshall Drive, Huntington, WV, 25755, USA.
| |
Collapse
|
12
|
Subu R, Jayanthi S, Cadet JL. Compulsive methamphetamine taking induces autophagic and apoptotic markers in the rat dorsal striatum. Arch Toxicol 2020; 94:3515-3526. [PMID: 32676729 DOI: 10.1007/s00204-020-02844-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/09/2020] [Indexed: 01/14/2023]
Abstract
Methamphetamine (METH) use disorder (MUD) is often accompanied by psychotic symptoms, cognitive deficits, and pathological changes in the brains of users. Animals that experimenters injected with drugs also show neurodegenerative changes in their brains. Recently, we have been investigating METH-induced molecular and biochemical consequences in animals that had infused themselves with METH using the drug self-administration (SA) paradigm. In that model, footshocks administered contingently help to separate rats that had already escalated their METH intake into resilient-to-drug (shock-sensitive, SS) or compulsive (shock-resistant, SR) METH takers. Herein, we used that model to test the idea that compulsive METH takers might show evidence of drug-induced autophagic changes in their brains. There were significant increases in mRNA levels of autophagy-related genes including Atg2a, Atg5, Atg14, and Atg16L1 in the rat dorsal striatum. Levels of two autophagy biomarkers, autophagy activating kinase (ULK1) and phospho-Beclin1, were also increased. In addition, we found increased p53 but decreased Bcl-2 protein levels. Moreover, the expression of cleaved initiator caspase-9 and effector caspase-6 was higher in compulsive METH takers in comparison to shock-sensitive rats. When taken together, these results suggest that the striata of rats that had escalated and continue to take METH compulsively the presence of adverse consequences exhibit some pathological changes similar to those reported in post-mortem human striatal tissues. These results provide supporting evidence that compulsive METH taking is neurotoxic. Our observations also support the notion of developing neuro-regenerative agents to add to the therapeutic armamentarium against METH addiction.
Collapse
Affiliation(s)
- Rajeev Subu
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, 251 Bayview Boulevard, Baltimore, MD, 21224, USA
| | - Subramaniam Jayanthi
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, 251 Bayview Boulevard, Baltimore, MD, 21224, USA
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, 251 Bayview Boulevard, Baltimore, MD, 21224, USA.
| |
Collapse
|
13
|
Recent Partner Violence, Sexual Relationship Power, and STIs among Women Who Use Methamphetamine: Does Type of Sexual Partner Matter? J Urban Health 2020; 97:387-394. [PMID: 32232654 PMCID: PMC7305268 DOI: 10.1007/s11524-020-00435-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Methamphetamine use, sexual relationship power (SRP), and partner violence (PV) are associated with increased risk of sexually transmitted infections (STIs) among women. The objective of our study was to examine the association of recent PV and SRP on STIs by partner type among HIV-negative, heterosexual women who use methamphetamine in San Diego, CA. Using baseline survey data from 209 women enrolled in FASTLANE II, an HIV behavioral intervention trial, we conducted logistic regression analyses to examine associations between PV, SRP, and self-reported lifetime STIs (e.g., chlamydia, gonorrhea). Models focused on PV perpetrated within the past 2 months by: (1) spouse, live-in, or steady sexual partners and (2) casual or anonymous sexual partners. Seventy-eight percent of women reported lifetime physical PV and 57% reported lifetime sexual PV. In the past 2 months, 19.6% reported physical and/or sexual violence by a spouse, live-in, or steady sexual partner, and 7.2% reported physical and/or sexual PV by a casual or anonymous partner. Median SRP score was 2.36 (interquartile range: 2.02-2.68). Twenty-six percent of women reported ever being diagnosed with ≥ 1 STI. While recent physical violence and sexual violence were not associated with STI history among women in steady relationships, women who reported recent sexual violence by casual/anonymous partners were approximately 8 times more likely to ever have an STI compared with those with no history of recent PV by casual/anonymous partners (AOR: 7.70; 95% CI: 1.32, 44.84). SRP was not associated with lifetime STIs among women who reported either partner type. Our findings support a relationship between recent sexual violence perpetrated by casual/anonymous partners and women's STI history. Women who use methamphetamine need help in navigating partner violence experiences. Risk reduction interventions to support this marginalized population are needed.
Collapse
|
14
|
Kesby JP, Chang A, Najera JA, Marcondes MCG, Semenova S. Brain Reward Function after Chronic and Binge Methamphetamine Regimens in Mice Expressing the HIV-1 TAT Protein. Curr HIV Res 2020; 17:126-133. [PMID: 31269883 DOI: 10.2174/1570162x17666190703165408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/11/2019] [Accepted: 06/21/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Methamphetamine abuse and human immunodeficiency virus (HIV) are common comorbidities. HIV-associated proteins, such as the regulatory protein TAT, may contribute to brain reward dysfunction, inducing an altered sensitivity to methamphetamine reward and/or withdrawal in this population. OBJECTIVE These studies examined the combined effects of TAT protein expression and, chronic and binge methamphetamine regimens on brain reward function. METHODS Transgenic mice with inducible brain expression of the TAT protein were exposed to either saline, a chronic, or a binge methamphetamine regimen. TAT expression was induced via doxycycline treatment during the last week of methamphetamine exposure. Brain reward function was assessed daily throughout the regimens, using the intracranial self-stimulation procedure, and after a subsequent acute methamphetamine challenge. RESULTS Both methamphetamine regimens induced withdrawal-related decreases in reward function. TAT expression substantially, but not significantly increased the withdrawal associated with exposure to the binge regimen compared to the chronic regimen, but did not alter the response to acute methamphetamine challenge. TAT expression also led to persistent changes in adenosine 2B receptor expression in the caudate putamen, regardless of methamphetamine exposure. These results suggest that TAT expression may differentially affect brain reward function, dependent on the pattern of methamphetamine exposure. CONCLUSION The subtle effects observed in these studies highlight that longer-term TAT expression, or its induction at earlier stages of methamphetamine exposure, may be more consequential at inducing behavioral and neurochemical effects.
Collapse
Affiliation(s)
- James P Kesby
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States.,Queensland Brain Institute, The University of Queensland, St. Lucia, Qld, Australia.,UQ Centre for Clinical Research, The University of Queensland, Brisbane, Qld, Australia
| | - Ariel Chang
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Julia A Najera
- Department of Neurosciences, The Scripps Research Institute, La Jolla, CA, United States
| | - Maria Cecilia G Marcondes
- Department of Neurosciences, The Scripps Research Institute, La Jolla, CA, United States.,San Diego Biomedical Research Institute, San Diego, CA 92121, United States
| | - Svetlana Semenova
- Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States
| |
Collapse
|
15
|
Abstract
PURPOSE OF REVIEW This paper reports on the results of a study comparing two behavioral treatments for methamphetamine users. The outcome was the effectiveness of the interventions in reducing meth use. The interventions were contingency management (CM) and contingency management plus strengths-based case management (CM/SBCM). RECENT FINDINGS CM/SBCM was found to be associated with attending more sessions for people who reported being in a couple. Also, participants who earned more money in the first part of the study were more likely to have more clean urinalysis in the second part of the study. Latent class analysis identified a class of participants who were in a couple, without sexual abuse history, and less meth use at baseline. This class tended to have more clean urinalysis in the CM/SBCM intervention. These results indicate that incentive-based interventions with case management may be useful for helping meth users reduce their drug use.
Collapse
|
16
|
Examining the Association Between Psychiatric Disorders and Cocaine Binges: Results From the COSMO Study. J Addict Med 2019; 12:136-142. [PMID: 29283956 DOI: 10.1097/adm.0000000000000378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Although cocaine binges and mental health problems have both been identified as significant risk factors for different health hazards, little is known about the relationship between mental health and cocaine binging. Hence, the aim of this study is to examine the association between psychiatric disorders and cocaine binge. METHODS Participants were part of a prospective cohort study of individuals who either smoke or inject cocaine. The dependent variable, namely a cocaine binge within the past month, was defined as the repetitive use of large quantities of cocaine until the individual was unable to access more of the drug or was physically unable to keep using. Psychiatric disorders were assessed using the Composite International Diagnostic Interview and the Diagnostic Interview Schedule questionnaires. Logistic regression models were performed to examine the association between cocaine binging and psychiatric disorders, adjusting for potential confounders. RESULTS Of the 492 participants, 24.4% reported at least 1 cocaine binging episode during the prior month. Among the study population, 48.0% met the criteria for antisocial personality disorder (ASPD), 45.5% for anxiety disorders, and 28.2% for mood disorders. Participants with ASPD were more likely to binge (adjusted odds ratio 1.73, 95% confidence interval 1.10-2.73), whereas those with a mood disorder were not. The association between anxiety disorders and cocaine binging was significant only in univariate analyses. CONCLUSION ASPD increased the odds of reporting cocaine binge in our study population. These results highlight the need for a better understanding of the specific dimensions of ASPD that contribute to the increased risk of unsafe drug use behaviors.
Collapse
|
17
|
Rosenkranz M, O'Donnell A, Verthein U, Zurhold H, Addison M, Liebregts N, Rowicka M, Barták M, Petruželka B, Kaner EF, Martens MS. Understanding pathways to stimulant use: a mixed-methods examination of the individual, social and cultural factors shaping illicit stimulant use across Europe (ATTUNE): study protocol. BMJ Open 2019; 9:e029476. [PMID: 31401601 PMCID: PMC6701668 DOI: 10.1136/bmjopen-2019-029476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Amphetamine-type stimulants (ATS) including amphetamine, methylenedioxymethamphetamine/'ecstasy', methamphetamine, synthetic cathinones and 'Ritalin' are the second most commonly used illicit drugs globally. Yet, there is little evidence on which factors are associated with the development of different patterns of ATS use over the life course. This study aims to examine which individual, social and environmental factors shape different pathways and trajectories of ATS consumption. The study will be conducted in five European countries: Germany, the Netherlands, Poland, Czech Republic and the UK. METHODS AND ANALYSIS We will use a sequential mixed-methods study design to investigate the multiple factors (familial, social and occupational situation, critical life events, general risk behaviour, mental and physical health, satisfaction with life) that shape individual ATS use pathways. A systematic literature review will be performed to provide an overview of the current academic literature on the topic. In module 1, qualitative semistructured interviews (n=ATS users and non-users) will be conducted to explore individual experiences of, and perspectives on, dynamics of change in stimulant consumption patterns. In module 2, structured questionnaires (n=2000 ATS users and non-users) will be administered via tablet computers to validate and enhance the generalisability of the interview findings. Data integration will take place at two key points. First, during the study, where the findings from the first qualitative interviews will inform the design of the structured questionnaire. Second, at the end of the study, where mixed methods data will be brought together to generate an in-depth, contextualised understanding of the research topic. ETHICS AND DISSEMINATION The study has been approved by the respective responsible ethics committee in each participating country. Data will be treated confidentially to ensure participants' anonymity. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings for policy and practice.
Collapse
Affiliation(s)
- Moritz Rosenkranz
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Amy O'Donnell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Uwe Verthein
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Zurhold
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Michelle Addison
- Department of Social Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Nienke Liebregts
- Bonger Institute of Criminology, University of Amsterdam, Amsterdam, The Netherlands
| | - Magdalena Rowicka
- Maria Grzegorzewska Academy of Special Education, Institute of Applied Psychology, Warsaw, Poland
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Eileen Fs Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Marcus-Sebastian Martens
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
18
|
Shabani S, Schmidt B, Ghimire B, Houlton SK, Hellmuth L, Mojica E, Phillips TJ. Depression-like symptoms of withdrawal in a genetic mouse model of binge methamphetamine intake. GENES BRAIN AND BEHAVIOR 2018; 18:e12533. [PMID: 30375183 DOI: 10.1111/gbb.12533] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/05/2018] [Accepted: 10/27/2018] [Indexed: 12/25/2022]
Abstract
Binge methamphetamine (MA) users have higher MA consumption, relapse rates and depression-like symptoms during early periods of withdrawal, compared with non-binge users. The impact of varying durations of MA abstinence on depression-like symptoms and on subsequent MA intake was examined in mice genetically prone to binge-level MA consumption. Binge-level MA intake was induced using a multiple-bottle choice procedure in which mice were offered one water drinking tube and three tubes containing increasing concentrations of MA in water, or four water tubes (control group). In two studies, depression-like symptoms were measured using a tail-suspension test and a subsequent forced-swim test, after forced abstinence of 6 and 30 hours from a 28-day course of chronic MA intake. An additional study measured the same depression-like symptoms, as well as MA intake, after prolonged abstinence of 1 and 2 weeks. MA high drinking mice and one of their progenitor strains DBA/2J escalated their MA intake with increasing MA concentration; however, MA high drinking mice consumed almost twice as much MA as DBA/2J mice. Depression-like symptoms were significantly higher early after MA access was withdrawn, compared to levels in drug-naïve controls, with more robust effects of MA withdrawal observed in MA high drinking than DBA/2J mice. When depression-like symptoms were examined after 1 or 2 weeks of forced abstinence in MA high drinking mice, depression-like symptoms dissipated, and subsequent MA intake was high. The MA high drinking genetic mouse model has strong face validity for human binge MA use and behavioral sequelae associated with abstinence.
Collapse
Affiliation(s)
- Shkelzen Shabani
- Grand Valley State University, Biomedical Sciences, Allendale, Michigan, USA.,Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Bryan Schmidt
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Bikalpa Ghimire
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Sydney K Houlton
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Laura Hellmuth
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Erika Mojica
- Minot State University, Department of Biology, Minot, North Dakota, USA
| | - Tamara J Phillips
- Oregon Health and Science University, Department of Behavioral Neuroscience and Methamphetamine Abuse Research Center, Portland, Oregon, USA.,VA Portland Health Care System, Research Division, Portland, Oregon, USA
| |
Collapse
|
19
|
Murphy DA, Harrell L, Fintzy R, Belin TR, Gutierrez A, Vitero SJ, Shetty V. A Comparison of Methamphetamine Users to a Matched NHANES Cohort: Propensity Score Analyses for Oral Health Care and Dental Service Need. J Behav Health Serv Res 2018; 43:676-690. [PMID: 25398257 DOI: 10.1007/s11414-014-9449-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dental problems are among the most frequently reported health issues of drug users. This study describes, among the largest population of methamphetamine (MA) users to date (N = 459, including both HIV-negative and HIV-positive participants) oral hygiene practice, dental care access, and dental quality of life. A matched control group from the Third National Health and Nutrition Examination Survey was utilized. Findings conclusively establish that MA users have severe oral health deficits compared to the general population: they are 3.5 times more likely to experience painful toothaches, 6.6 times to experience difficulty eating, and 8.6 times to be self-conscious due to dental appearance. HIV-positive users were more likely to have regular dental visits than HIV-negative users. Severity of use (both high-frequency use as well as injection as the method) was associated with poorer oral health care. Despite the magnitude of the need, few MA users receive the needed care.
Collapse
Affiliation(s)
- Debra A Murphy
- Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California Los Angeles, 11075 Santa Monica Blvd., Suite 100, Los Angeles, CA, 90025, USA.
| | - Lauren Harrell
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
| | - Rachel Fintzy
- Section of Oral and Maxillofacial Surgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Thomas R Belin
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Steven J Vitero
- AIDS Project Los Angeles Dental Services, Inc., Los Angeles, CA, USA
| | - Vivek Shetty
- Section of Oral and Maxillofacial Surgery, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
20
|
Kesby JP, Chang A, Markou A, Semenova S. Modeling human methamphetamine use patterns in mice: chronic and binge methamphetamine exposure, reward function and neurochemistry. Addict Biol 2018; 23:206-218. [PMID: 28224681 PMCID: PMC5565728 DOI: 10.1111/adb.12502] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/26/2017] [Accepted: 02/03/2017] [Indexed: 11/29/2022]
Abstract
Different methamphetamine use patterns in human subjects may contribute to inconsistent findings regarding the effects of methamphetamine abuse on brain and behavior. The present study investigated whether human-derived chronic and binge methamphetamine use patterns have differential effects on reward and neurochemistry in mice. Brain reward function in mice was evaluated during acute/prolonged withdrawal, and in response to methamphetamine challenge using the intracranial self-stimulation procedure. Brain dopaminergic, serotonergic and glutamatergic neurochemistry was determined with high-performance liquid chromatography. Chronic and binge regimens induced withdrawal-related decreases in reward function that were more severe during the binge regimen during cycles 1-2. Despite large differences in methamphetamine dose, both regimens induced similar reward deficits during cycles 3-4. Neither methamphetamine regimen led to persistent alterations in the sensitivity to the reward-enhancing effects of acute methamphetamine challenge. The binge regimen severely depleted striatal dopamine levels and increased brain glutamine levels. The chronic regimen had milder effects on striatal dopamine levels and altered cortical dopamine and serotonin levels. This work highlights that the magnitude of acute/prolonged withdrawal may not reflect amount or frequency of methamphetamine intake. In contrast, the array of underlying neurochemical alterations was methamphetamine regimen dependent. Thus, stratifying methamphetamine-dependent individuals based on use pattern may help to cater therapeutic interventions more appropriately by targeting use pattern-specific neurotransmitter systems.
Collapse
Affiliation(s)
- James P Kesby
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Queensland Brain Institute, The University of Queensland, St. Lucia, Qld, Australia
| | - Ariel Chang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Athina Markou
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Svetlana Semenova
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
21
|
Fournier C, Ghabrash MF, Artenie A, Roy E, Zang G, Bruneau J, Jutras-Aswad D. Association between binge drug use and suicide attempt among people who inject drugs. Subst Abus 2017; 39:315-321. [DOI: 10.1080/08897077.2017.1389800] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Charles Fournier
- Centre hospitalier de l'Université de Montréal (CHUM) Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Maykel Farag Ghabrash
- Centre hospitalier de l'Université de Montréal (CHUM) Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| | - Adelina Artenie
- Centre hospitalier de l'Université de Montréal (CHUM) Research Centre, Montreal, Quebec, Canada
| | - Elise Roy
- Sherbrooke University, Longueuil, Quebec, Canada
| | - Geng Zang
- Centre hospitalier de l'Université de Montréal (CHUM) Research Centre, Montreal, Quebec, Canada
| | - Julie Bruneau
- Centre hospitalier de l'Université de Montréal (CHUM) Research Centre, Montreal, Quebec, Canada
- Department of Family and Emergency Medicine, Université de Montréal, Montréal, Québec, Canada; Addiction Studies and Research Program, Faculty of Medicine and Health Sciences, Sherbrooke, University, Longueuil, Quebec, Canada
| | - Didier Jutras-Aswad
- Centre hospitalier de l'Université de Montréal (CHUM) Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montréal, Québec, Canada
| |
Collapse
|
22
|
A comparison of psychotic symptoms in subjects with methamphetamine versus cocaine dependence. Psychopharmacology (Berl) 2017; 234:1535-1547. [PMID: 28190084 DOI: 10.1007/s00213-017-4551-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/25/2017] [Indexed: 01/02/2023]
Abstract
RATIONALE The psychostimulant drugs cocaine and methamphetamine are potent indirect dopamine receptor agonists which act through similar but not identical mechanisms. Studies in humans have observed that a large proportion of those who chronically use these drugs experience psychotic symptoms. However, direct comparisons of psychotic symptom severity between cocaine and methamphetamine users are lacking. OBJECTIVES The goal of the present study was to directly compare severity of psychotic symptoms between cocaine- and methamphetamine-dependent individuals. Additionally, we sought to determine how concurrent cocaine + methamphetamine dependence would influence psychotic symptoms. METHODS We recruited 153 polysubstance-using subjects meeting DSM-IV-TR criteria for cocaine dependence, 38 with methamphetamine dependence, and 32 with cocaine + methamphetamine dependence. Psychotic symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) and analyzed using a five-factor model. All participants were also assessed for physical and mental illnesses as well as recent substance use. Most subjects completed a comprehensive neurocognitive battery. RESULTS While all three groups exhibited high total PANSS scores, the positive symptom subscale was significantly higher in the methamphetamine-dependent (17.03 ± 6.3) than the cocaine-dependent group (13.51 ± 4.12) and non-significantly higher (p = 0.08) than the cocaine + methamphetamine group (14.44 ± 5.50). Groups also differed on demographic variables, viral infection, and other indices of substance use, which were unlikely to account for the difference in positive symptoms. There were only modest differences between groups in neurocognitive function. CONCLUSIONS Methamphetamine dependence was associated with more severe positive symptoms of psychosis than cocaine dependence. Concurrent cocaine + methamphetamine dependence did not increase psychosis severity.
Collapse
|
23
|
Roy É, Arruda N, Jutras-Aswad D, Berbiche D, Perreault M, Bertrand K, Dufour M, Bruneau J. Examining the link between cocaine binging and individual, social and behavioral factors among street-based cocaine users. Addict Behav 2017; 68:66-72. [PMID: 28103534 DOI: 10.1016/j.addbeh.2017.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/22/2016] [Accepted: 01/04/2017] [Indexed: 01/27/2023]
Abstract
AIMS To estimate the prevalence of cocaine binging and examine associated factors, to characterize binge episodes and to study the relationship between cocaine binging and HIV and HCV risk behaviors among street-based cocaine users. METHODS A prospective cohort study was conducted in Montréal, Canada. Interviewer-administered questionnaire were carried out at 3-month intervals. Cocaine binging was defined as using large quantities of cocaine, without stopping, over a limited period of time, until resources run out or until being physically incapable of consuming. Generalized Estimation Equations (GEE) analyses were used. Covariates considered included demographic, behavioral, mental health and social risk factors. FINDINGS In total, 605 participants were recruited. Prevalence of cocaine binging over the month prior to recruitment was 24.5%. Correlates of cocaine binging were older age (AOR 1.46), homelessness (AOR 1.44), criminal/marginal income strategies (AOR 1.61), high psychological distress (AOR 1.31), high cocaine dependence (AOR 3.71), drug overdoses (AOR 1.56) and smoking as the main route of cocaine administration (AOR 1.38). Additional GEE analyses showed that cocaine binging was significantly associated with the sharing of drug paraphernalia (AOR 1.35) and sexual relations under the influence of cocaine (AOR 1.21). CONCLUSION Cocaine binging is frequent among street-based cocaine users and is associated with markers of vulnerability. It is also associated with increased odds of both sexual and drug use risk behaviors. Interventions need to be tailored in order to help cocaine bingers develop personal strategies that could prevent binging. Harm reduction programs should help cocaine bingers adequately assess their drug equipment needs.
Collapse
|
24
|
Shabani S, Houlton SK, Hellmuth L, Mojica E, Mootz JRK, Zhu Z, Reed C, Phillips TJ. A Mouse Model for Binge-Level Methamphetamine Use. Front Neurosci 2016; 10:493. [PMID: 27853417 PMCID: PMC5090006 DOI: 10.3389/fnins.2016.00493] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/14/2016] [Indexed: 11/21/2022] Open
Abstract
Binge/crash cycles of methamphetamine (MA) use are frequently reported by individuals suffering from MA use disorders. A MA binge is self-reported as multiple daily doses that commonly accumulate to 800 mg/day (~10 mg/kg/day for a 170 pound human). A genetic animal model with a similar vulnerability to binge-level MA intake is missing. We used selectively bred MA high drinking (MAHDR) and low drinking (MALDR) mouse lines to determine whether several procedural variations would result in binge-level MA intake. Data were also collected in two progenitor populations of the MA drinking lines, the DBA/2J (D2) strain and the F2 cross of the D2 and C57BL/6J strains. The impact of 3 factors was examined: (1) concentration of MA in the two-bottle choice procedure used for selective breeding; (2) ratio of bottles containing MA vs. water, and (3) length of the withdrawal (or abstinence) period between MA drinking sessions. When MA concentration was progressively increased every 4 days in 20 mg/l amounts from 20 to 140 mg/l, maximum intake in MALDR mice was 1.1 mg/kg, whereas MAHDR mice consumed as much as 14.6 mg/kg. When these concentrations were tested in a multiple bottle choice procedure, the highest ratio of MA to water bottles (3:1) was associated with escalated MA intake of up to 29.1 mg/kg in MAHDR mice and 12.0 mg/kg in F2 mice; MALDR mice did not show a ratio-dependent escalation in MA intake. Finally, MAHDR and D2 mice were offered 3 bottles of MA vs. water at increasing concentrations from 20 to 80 mg/l, and tested under an intermittent 6-h withdrawal period, which was lengthened to 30 h (D2 mice) or to 30 or 78 h (MAHDR). D2 and MAHDR mice initially consumed similar amounts of 14–16 mg/kg MA, but D2 mice reduced their MA intake 3-fold after introduction of 30-h abstinence periods, whereas MAHDR mice retained their high level of intake regardless of withdrawal period. MAHDR mice provide a genetic model of binge-level MA intake appropriate for the study of associated MA-induced neurobiological changes and pharmaceutical treatments.
Collapse
Affiliation(s)
| | | | - Laura Hellmuth
- Department of Biology, Minot State University Minot, ND, USA
| | - Erika Mojica
- Department of Biology, Minot State University Minot, ND, USA
| | - John R K Mootz
- Department of Behavioral Neuroscience and Methamphetamine Abuse Research Center, Oregon Health & Science University Portland, OR, USA
| | - Zhen Zhu
- Department of Behavioral Neuroscience and Methamphetamine Abuse Research Center, Oregon Health & Science University Portland, OR, USA
| | - Cheryl Reed
- Department of Behavioral Neuroscience and Methamphetamine Abuse Research Center, Oregon Health & Science University Portland, OR, USA
| | - Tamara J Phillips
- Department of Behavioral Neuroscience and Methamphetamine Abuse Research Center, Oregon Health & Science UniversityPortland, OR, USA; VA Portland Health Care SystemPortland, OR, USA
| |
Collapse
|
25
|
Dugosh KL, Festinger DS, Lipkin JL. Identifying and Addressing the Unmet Health Care Needs of Drug Court Clients. J Subst Abuse Treat 2016; 71:30-35. [PMID: 27776674 DOI: 10.1016/j.jsat.2016.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/17/2016] [Accepted: 08/24/2016] [Indexed: 12/11/2022]
Abstract
Drug courts address issues such as employment and housing but largely miss the opportunity to address important health care issues. The current study examined the prevalence and correlates of chronic medical conditions among a sample of drug court clients who were participating in a clinical trial of an intervention to reduce HIV risk. A total of 256 clients completed a health survey at entry into the drug court program and 9 months post-entry. The baseline health survey included a comprehensive list of chronic medical conditions, and participants were asked to indicate which, if any, they had ever been diagnosed as having. They were also asked to indicate whether or not they were currently receiving treatment for each chronic condition that they endorsed. The follow-up survey was identical to the baseline survey, with the exception that it contained items reflecting (1) whether or not any member of the drug court team engaged in discussion with the client about each of the chronic conditions reported and (2) whether the client received a referral to medical care for endorsed conditions while in the drug court program. Results indicated that over 50% of clients reported at least one chronic condition and 21% reported more than one condition. Among those with chronic conditions, 71% reported having chronic conditions for which they were not currently receiving treatment. Unfortunately, drug court clients reported that the drug court team did little to address these unmet health needs. Findings from this study suggest that clients could benefit if drug court programs began to widen their focus to include addressing health-related issues.
Collapse
Affiliation(s)
- Karen L Dugosh
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, United States.
| | - David S Festinger
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, United States
| | - Jessica L Lipkin
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, United States
| |
Collapse
|
26
|
Festinger DS, Dugosh KL, Kurth AE, Metzger DS. Examining the efficacy of a computer facilitated HIV prevention tool in drug court. Drug Alcohol Depend 2016; 162:44-50. [PMID: 26971228 PMCID: PMC5824990 DOI: 10.1016/j.drugalcdep.2016.02.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/05/2016] [Accepted: 02/06/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Although they have demonstrated efficacy in reducing substance use and criminal recidivism, competing priorities and limited resources may preclude drug court programs from formally addressing HIV risk. This study examined the efficacy of a brief, three-session, computer-facilitated HIV prevention intervention in reducing HIV risk among adult felony drug court participants. METHODS Two hundred participants were randomly assigned to an HIV intervention (n=101) or attention control (n=99) group. All clients attended judicial status hearings approximately every six weeks. At the first three status hearings following study entry, clients in the intervention group completed the computerized, interactive HIV risk reduction sessions while those in the control group viewed a series of educational life-skill videos of matched length. Outcomes included the rate of independently obtained HIV testing, engagement in high risk HIV-related behaviors, and rate of condom procurement from the research site at each session. RESULTS Results indicated that participants who received the HIV intervention were significantly more likely to report having obtained HIV testing at some point during the study period than those in the control condition, although the effect was marginally significant when examined in a longitudinal model. In addition, they had higher rates of condom procurement. No group differences were found on rates of high-risk sexual behavior, and the low rate of injection drug reported precluded examination of high-risk drug-related behavior. CONCLUSIONS The study provides support for the feasibility and utility of delivering HIV prevention services to drug court clients using an efficient computer-facilitated program.
Collapse
Affiliation(s)
- David S Festinger
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, United States.
| | - Karen L Dugosh
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, United States
| | - Ann E Kurth
- New York University School of Nursing & College of Global Public Health, 41 East 11th Street, New York, NY 10003, United States
| | - David S Metzger
- Treatment Research Institute, 600 Public Ledger Building, 150 S. Independence Mall West, Philadelphia, PA 19106, United States; University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, United States
| |
Collapse
|
27
|
Roy É, Arruda N, Bruneau J, Jutras-Aswad D. Epidemiology of Injection Drug Use: New Trends and Prominent Issues. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:136-44. [PMID: 27254088 PMCID: PMC4813418 DOI: 10.1177/0706743716632503] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
After more than 30 years of research, numerous studies have shown that injection drug use is associated with a wide range of adverse health outcomes such as drug overdoses, drug-related suicidal behaviours, comorbid psychiatric disorders, bloodborne pathogens and other infectious diseases, and traumas. This review explores new trends and prominent issues associated with injection drug use. The dynamic nature of injection drug use is underlined by examining its recent trends and changing patterns in Canada and other "high-income countries." Three research topics that could further contribute to the development of comprehensive prevention and intervention strategies aimed at people who inject drugs are also discussed: risk behaviours associated with the injection of prescription opioids, binge injection drug use, and mental health problems as determinants of injection risk behaviours.
Collapse
Affiliation(s)
- Élise Roy
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québc, Canada Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Nelson Arruda
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québc, Canada
| | - Julie Bruneau
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Québc, Canada Department of Family Medicine, Université de Montréal, Montréal, Québc, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Québc, Canada Department of Psychiatry, Université de Montréal, Montréal, Québc, Canada
| |
Collapse
|
28
|
Reynolds GL, Fisher DG, Laurenceau JP, Fortenberry JD. An Electronic Daily Diary Study of Anal Intercourse in Drug-Using Women. AIDS Behav 2015; 19:2325-32. [PMID: 25835461 PMCID: PMC4592690 DOI: 10.1007/s10461-015-1045-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Women (N = 138) with histories of illicit drug use were recruited into an electronic diary study that used Android smartphones for data collection. The diary was to be completed each day for 12 weeks using an "app" created in HTML5 and accessed over the Internet via smartphone. Data collection included information on sexual behaviors with up to 10 partners per day and contextual factors surrounding sexual behavior such as drug use before/after, type of sexual behavior (oral, vaginal, anal), and other activities such as using condoms for vaginal and anal intercourse and use of sexual lubricants. The sample was predominantly African American (58 %); 20 % Latina, 20 % White and 2 % reported as Other. Most women reported either less than a high school education (33 %) or having a high school diploma (33 %). The mean age was 39 years (SD = 11.78). Anal intercourse occurred on days when women also reported using illicit drugs, specifically methamphetamine and cocaine. Anal intercourse was not an isolated sexual activity, but took place on days when vaginal intercourse and giving and receiving oral sex also occurred along with illicit drug use. Anal intercourse also occurred on days when women reported they wanted sex. HIV prevention interventions must address the risks of anal intercourse for women, taking into account concurrent drug use and sexual pleasure that may reduce individual harm-reduction behaviors.
Collapse
Affiliation(s)
- Grace L Reynolds
- Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840, USA.
| | - Dennis G Fisher
- Center for Behavioral Research and Services, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840, USA
| | | | - J Dennis Fortenberry
- Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
29
|
Ti L, Richardson L, DeBeck K, Nguyen P, Montaner J, Wood E, Kerr T. The impact of engagement in street-based income generation activities on stimulant drug use cessation among people who inject drugs. Drug Alcohol Depend 2014; 141:58-64. [PMID: 24909853 PMCID: PMC4090016 DOI: 10.1016/j.drugalcdep.2014.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/05/2014] [Accepted: 05/06/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Despite the growing prevalence of illicit stimulant drug use internationally, and the widespread involvement of people who inject drugs (IDU) within street-based drug markets, little is known about the impact of different types of street-based income generation activities on the cessation of stimulant use among IDU. METHODS Data were derived from an open prospective cohort of IDU in Vancouver, Canada. We used Kaplan-Meier methods and Cox proportional hazards regression to examine the effect of different types of street-based income generation activities (e.g., sex work, drug dealing, and scavenging) on time to cessation of stimulant use. RESULTS Between December, 2005 and November, 2012, 887 IDU who use stimulant drugs (cocaine, crack cocaine, or crystal methamphetamine) were prospectively followed-up for a median duration of 47 months. In Kaplan-Meier analyses, compared to those who did not engage in street-based income generation activities, participants who reported sex work, drug dealing, scavenging, or more than one of these activities were significantly less likely to report stimulant drug use cessation (all p<0.001). When considered as time-updated variables and adjusted for potential confounders in a multivariable model, each type of street-based income generation activity remained significantly associated with a slower time to stimulant drug cessation (all p<0.005). CONCLUSIONS Our findings highlight the urgent need for strategies to address stimulant dependence, including novel pharmacotherapies. Also important, structural interventions, such as low-threshold employment opportunities, availability of supportive housing, legal reforms regarding drug use, and evidence-based approaches that reduce harm among IDU are urgently required.
Collapse
Affiliation(s)
- Lianping Ti
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
| | - Lindsey Richardson
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6
| | - Kora DeBeck
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; School of Public Policy, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6
| | - Paul Nguyen
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6
| | - Julio Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9.
| |
Collapse
|
30
|
Fast D, Kerr T, Wood E, Small W. The multiple truths about crystal meth among young people entrenched in an urban drug scene: a longitudinal ethnographic investigation. Soc Sci Med 2014; 110:41-8. [PMID: 24721446 DOI: 10.1016/j.socscimed.2014.03.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 03/06/2014] [Accepted: 03/27/2014] [Indexed: 10/25/2022]
Abstract
Transitions into more harmful forms of illicit drug use among youth have been identified as important foci for research and intervention. In settings around the world, the transition to crystal methamphetamine (meth) use among youth is considered a particularly dangerous and growing problem. Epidemiological evidence suggests that, particularly among young, street-involved populations, meth use is associated with numerous sex- and drug-related "risks behaviors" and negative health outcomes. Relatively few studies, however, have documented how youth themselves understand, experience and script meth use over time. From 2008 to 2012, we conducted over 100 in-depth interviews with 75 street-entrenched youth in Vancouver, Canada, as well as ongoing ethnographic fieldwork, in order to examine youth's understandings and experiences of meth use in the context of an urban drug scene. Our findings revealed positive understandings and experiences of meth in relation to other forms of drug addiction and unaddressed mental health issues. Youth were simultaneously aware of the numerous health-related harms and social costs associated with heavy meth use. Over time, positive understandings of meth may become entirely contradictory to a lived reality in which escalating meth use is a factor in further marginalizing youth, although this may not lead to cessation of use. Recognition of these multiple truths about meth, and the social structural contexts that shape the scripting of meth use among youth in particular settings, may help us to move beyond moralizing debates about how to best educate youth on the "risks" associated with meth, and towards interventions that are congruent with youth's lived experiences and needs across the lifecourse.
Collapse
Affiliation(s)
- Danya Fast
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, B.C., Canada V6Z 1Y6.
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, B.C., Canada V6Z 1Y6; Department of Medicine, University of British Columbia, Canada.
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, B.C., Canada V6Z 1Y6; Department of Medicine, University of British Columbia, Canada.
| | - Will Small
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, B.C., Canada V6Z 1Y6; Faculty of Health Sciences, Simon Fraser University, Canada.
| |
Collapse
|
31
|
Reece R, Dugdale C, Touzard-Romo F, Noska A, Flanigan T, Rich JD. Care at the Crossroads: Navigating the HIV, HCV, and Substance Abuse Syndemic. Fed Pract 2014; 31:37S-40S. [PMID: 25520548 PMCID: PMC4266471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
For patients with both HIV/HCV coinfection and substance addiction, multidisciplinary teams can facilitate coordination of care and improve clinical outcomes. Such teams should include HIV/HCV treatment providers, mental health specialists, case managers, social workers, and substance abuse counselors.
Collapse
Affiliation(s)
- Rebecca Reece
- Dr. Reece, Dr. Touzard-Romo, Dr. Noska, Dr. Flanigan, and Dr. Rich work in the Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Dugdale works in the Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Flanigan and Dr. Rich also work at the Center for Prisoner Health and Human Rights at the Miriam Hospital, Providence, Rhode Island
| | - Caitlin Dugdale
- Dr. Reece, Dr. Touzard-Romo, Dr. Noska, Dr. Flanigan, and Dr. Rich work in the Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Dugdale works in the Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Flanigan and Dr. Rich also work at the Center for Prisoner Health and Human Rights at the Miriam Hospital, Providence, Rhode Island
| | - Francine Touzard-Romo
- Dr. Reece, Dr. Touzard-Romo, Dr. Noska, Dr. Flanigan, and Dr. Rich work in the Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Dugdale works in the Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Flanigan and Dr. Rich also work at the Center for Prisoner Health and Human Rights at the Miriam Hospital, Providence, Rhode Island
| | - Amanda Noska
- Dr. Reece, Dr. Touzard-Romo, Dr. Noska, Dr. Flanigan, and Dr. Rich work in the Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Dugdale works in the Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Flanigan and Dr. Rich also work at the Center for Prisoner Health and Human Rights at the Miriam Hospital, Providence, Rhode Island
| | - Timothy Flanigan
- Dr. Reece, Dr. Touzard-Romo, Dr. Noska, Dr. Flanigan, and Dr. Rich work in the Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Dugdale works in the Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Flanigan and Dr. Rich also work at the Center for Prisoner Health and Human Rights at the Miriam Hospital, Providence, Rhode Island
| | - Josiah D Rich
- Dr. Reece, Dr. Touzard-Romo, Dr. Noska, Dr. Flanigan, and Dr. Rich work in the Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Dugdale works in the Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Flanigan and Dr. Rich also work at the Center for Prisoner Health and Human Rights at the Miriam Hospital, Providence, Rhode Island
| |
Collapse
|
32
|
Calsyn DA, Hatch-Maillette MA, Meade CS, Tross S, Campbell ANC, Beadnell B. Gender differences in heterosexual anal sex practices among women and men in substance abuse treatment. AIDS Behav 2013; 17:2450-8. [PMID: 23321947 DOI: 10.1007/s10461-012-0387-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Heterosexual anal intercourse (HAI) is an understudied risk behavior among women and men in substance abuse treatment. Rates of HAI for women (n = 441) and men (n = 539) were identified for any, main and casual partners. More men (32.8 %) than women (27.1 %) reported engaging in HAI in the previous 90 days. These rates are higher than those reported for both men (6.0-15.9 %) and women (3.5-13.0 %) ages 25-59 in the National Survey of Sexual Health and Behavior. Men were significantly more likely to report HAI with their casual partners (34.1 %) than women (16.7 %). In a logistic regression model generated to identify associations between HAI and variables previously shown to be related to high risk sexual behavior, being younger, bisexual, and White were significantly associated with HAI. For men, having more sex partners was also a significant correlate. HAI is a logical target for increased focus in HIV prevention interventions.
Collapse
Affiliation(s)
- Donald A Calsyn
- Alcohol and Drug Abuse Institute and the Department of Psychiatry and Behavioral Sciences, University of Washington, 1107 NE 45th St., Ste. 120, Seattle, WA 98105, USA.
| | | | | | | | | | | |
Collapse
|
33
|
Cornett EM, Goeders NE. 96-hour methamphetamine self-administration in male and female rats: a novel model of human methamphetamine addiction. Pharmacol Biochem Behav 2013; 111:51-7. [PMID: 23958580 DOI: 10.1016/j.pbb.2013.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 08/07/2013] [Accepted: 08/09/2013] [Indexed: 10/26/2022]
Abstract
Methamphetamine (MA) is a highly addictive psychostimulant drug of abuse for which no FDA-approved treatment exists. While high on MA, both male and female MA users report engaging in risky behaviors and are more likely to be involved in violent criminal activities and to engage in domestic and sexual violence. A unique aspect of MA is that it is typically used in binges. However, there is no animal model of MA self-administration that appears to represent a human MA self-administration binge. We recently developed a 96-hour MA self-administration paradigm in rats that more closely resembles how human MA users take the drug. Male and female rats were trained to self-administer MA for 96 consecutive hours for 5 weeks. Responding by female and male rats tended to escalate to binge-like behavior, as the animals responded continuously during their normal periods of activity as well as during their inactive periods for up to 72 h, followed by a crash of 6 or more hours. Thus, this 96-hour model of MA self-administration is a novel way to study MA addition in rats that may contribute to the development of improved treatments for recovering human MA users.
Collapse
Affiliation(s)
- Elyse M Cornett
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Shreveport Health Sciences Center, Shreveport, LA 71103, United States.
| | | |
Collapse
|
34
|
Panenka WJ, Procyshyn RM, Lecomte T, MacEwan GW, Flynn SW, Honer WG, Barr AM. Methamphetamine use: a comprehensive review of molecular, preclinical and clinical findings. Drug Alcohol Depend 2013; 129:167-79. [PMID: 23273775 DOI: 10.1016/j.drugalcdep.2012.11.016] [Citation(s) in RCA: 293] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 11/20/2012] [Accepted: 11/21/2012] [Indexed: 12/11/2022]
Abstract
Methamphetamine (MA) is a highly addictive psychostimulant drug that principally affects the monoamine neurotransmitter systems of the brain and results in feelings of alertness, increased energy and euphoria. The drug is particularly popular with young adults, due to its wide availability, relatively low cost, and long duration of psychoactive effects. Extended use of MA is associated with many health problems that are not limited to the central nervous system, and contribute to increased morbidity and mortality in drug users. Numerous studies, using complementary techniques, have provided evidence that chronic MA use is associated with substantial neurotoxicity and cognitive impairment. These pathological effects of the drug, combined with the addictive properties of MA, contribute to a spectrum of psychosocial issues that include medical and legal problems, at-risk behaviors and high societal costs, such as public health consequences, loss of family support and housing instability. Treatment options include pharmacological, psychological or combination therapies. The present review summarizes the key findings in the literature spanning from molecular through to clinical effects.
Collapse
Affiliation(s)
- William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | | | | | | | | | | |
Collapse
|
35
|
Digiusto E, Rawstorne P. Is it really crystal clear that using methamphetamine (or other recreational drugs) causes people to engage in unsafe sex? Sex Health 2013; 10:133-7. [DOI: 10.1071/sh12053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 10/11/2012] [Indexed: 11/23/2022]
Abstract
Many studies have found associations between unsafe sexual behaviour and use of crystal methamphetamine (and many other recreational drugs). Researchers and authors of relevant articles in popular media have often interpreted these associations as meaning that using ‘crystal’ directly causes people to engage in unsafe sex, and that interventions should aim to reduce crystal use in order to reduce the prevalence of sexually transmissible infections such as HIV. There is consistent evidence that crystal users are a high-risk group in terms of sexual behaviour. However, most relevant studies have provided only circumstantial evidence regarding a causal relationship. Promoting the idea that a particular recreational drug is a major direct cause of unsafe sex may have the unintended adverse effect of creating an excuse for engaging in unsafe sex, thereby increasing its use, and may incur opportunity costs by preventing limited available health promotion resources from being directed more usefully. This paper examines the limitations, in terms of demonstrating causality, of various types of study that have been published on this topic in relation to crystal use in particular. Researchers who investigate relationships between recreational drug use and behaviour, including sexual behaviour, should be careful about the wording of their conclusions and recommendations, and should consider the possibly counterproductive ways in which their findings might be represented in the media.
Collapse
|
36
|
Semple SJ, Strathdee SA, Zians J, Patterson TL. Methamphetamine-using parents: the relationship between parental role strain and depressive symptoms. J Stud Alcohol Drugs 2012; 72:954-64. [PMID: 22051209 DOI: 10.15288/jsad.2011.72.954] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The methamphetamine epidemic in the United States involves a large number of men and women with dependent-age children. However, we know little about the parenting strains experienced by methamphetamine-using mothers and fathers and the relationship of these parenting strains to mental health outcomes, specifically depressive symptoms. METHOD The primary goal of this study was to examine five dimensions of parental role strain in relation to depressive symptoms in a sample of 180 methamphetamine-using parents of dependent-age children in San Diego, CA. Dimensions of parental role strain included child emotional and behavioral problems, child physical health problems, child-related financial strain, interpersonal conflict involving children, and intrapsychic strain related to children. RESULTS Methamphetamineusing mothers reported significantly more child-related emotional and behavioral problems compared with methamphetamine-using fathers (7.9 vs. 6.8; t = 2.5, p < .05). In multiple regression analysis, higher Beck depression scores were associated with being a mother (β = .186, p < .05), having more children younger than 18 years old (β = .165, p < .05), less emotional support (β = -.230, p < .01), and higher scores on intrapsychic parental role strain related to children (β = .288, p < .01). CONCLUSIONS These findings suggest the importance of considering the multidimensional nature of parenting strain in the development of drug treatment and counseling programs for methamphetamine-using parents.
Collapse
Affiliation(s)
- Shirley J Semple
- Department of Psychiatry (0680), University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093-0680, USA
| | | | | | | |
Collapse
|
37
|
Festinger DS, Dugosh KL, Metzger DS, Marlowe DB. The Prevalence of HIV Risk Behaviors among Felony Drug Court Participants. DRUG COURT REVIEW 2012; 8:131-146. [PMID: 25309974 PMCID: PMC4191852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
15 HIV RISK BEHAVIORS IN DRUG COURT A small percentage of participants in a large metropolitan felony Drug Court engaged in high-risk injection drug use, but a large percentage engaged in high-risk sexual behaviors. 16 HIV RISK FACTORS IN DRUG COURT HIV risk behaviors were associated with being male, African-American, and younger. 17 GEOGRAPHIC RISK FOR HIV A large proportion of Drug Court participants resided in areas of the city with a high prevalence of persons living with HIV/AIDS, thus heightening the probability of exposure to the virus.
Collapse
|
38
|
Zaller ND, Fu JJ, Nunn A, Beckwith CG. Linkage to care for HIV-infected heterosexual men in the United States. Clin Infect Dis 2011; 52 Suppl 2:S223-30. [PMID: 21342911 DOI: 10.1093/cid/ciq046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the United States, the human immunodeficiency virus (HIV) epidemic among heterosexual men disproportionately affects individuals involved with the criminal justice system, injection drug and other substance users, and racial and ethnic minorities. These overlapping populations confront similar social and structural disparities that contribute to HIV risk and limit access to HIV testing, treatment, and care. In this review, we discuss barriers to linkage to comprehensive HIV care for specific subpopulations of heterosexual men and examine approaches for enhancing linkage to care for this diverse population.
Collapse
Affiliation(s)
- Nickolas D Zaller
- Alpert Medical School, Brown University, Providence, Rhode Island, USA.
| | | | | | | |
Collapse
|
39
|
Psychiatric risk factors for HIV disease progression: the role of inconsistent patterns of antiretroviral therapy utilization. J Acquir Immune Defic Syndr 2011; 56:146-50. [PMID: 21116186 DOI: 10.1097/qai.0b013e318201df63] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the era of antiretroviral therapy (ART), depression and substance use predict hastened HIV disease progression, but the underlying biological or behavioral mechanisms that explain these effects are not fully understood. METHODS Using outcome data from 603 participants enrolled in a randomized controlled trial of a behavioral intervention, binary logistic and linear regression were employed to examine whether inconsistent patterns of ART utilization partially mediated the effects of depression and substance use on higher HIV viral load over a 25-month follow-up. RESULTS Elevated affective symptoms of depression independently predicted ART discontinuation [adjusted odds ratio = 1.39, 95% confidence interval (CI) = 1.08 to 1.78], and use of stimulants at least weekly independently predicted intermittent ART utilization (adjusted odds ratio = 2.62, 95% CI = 1.45 to 4.73). After controlling for the average self-reported percentage of ART doses taken and baseline T-helper (CD4) count, elevated depressive symptoms predicted a 50% higher mean viral load, and weekly stimulant use predicted a 137% higher mean viral load. These effects became nonsignificant after accounting for inconsistent patterns of ART utilization, providing evidence of partial mediation. CONCLUSIONS Inconsistent patterns of ART utilization may partially explain the effects of depression and stimulant use on hastened HIV disease progression.
Collapse
|
40
|
Abstract
Amphetamine-group substances are used worldwide and are more prevalent than either cocaine or opioids. We reviewed published reports about amphetamine-group substances and did a meta-analysis of randomised controlled trials of behavioural interventions for their use. Most research was done in developed countries. Many, but not all, studies show an association between amphetamine-group substance use and risk of HIV infection. Much use of amphetamine-group substances is non-injection and is associated with increased HIV risk, particularly in men who have sex with men. The structural, social, interpersonal, and personal factors that link to amphetamine-group substance use and HIV risk are poorly understood. 13 studies, with a cumulative sample size of 1997 individuals, qualified for the meta-analysis. Overall, high-intensity behavioural interventions were moderately effective in reducing use of amphetamine-group substances (effect size 0.28, 95% CI 0.13-0.44). We did not find conclusive evidence that behavioural interventions as a group are more effective than are passive or minium treatment for reduction of amphetamine-group substance use or sexual risk behaviours. The search for effective, scalable, and sustainable interventions for amphetamine-group substance use, including pharmacotherapies, should be supported and encouraged.
Collapse
Affiliation(s)
- Grant Colfax
- HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
| | | | | | | | | | | | | |
Collapse
|