Drug and alcohol dependence
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Drug Alcohol Depend · May 2009
Health-related quality of life in methadone maintenance patients with untreated hepatitis C virus infection.
To assess health-related quality of life (HRQOL) in methadone maintenance treatment (MMT) patients with untreated chronic HCV infection and to determine the clinical factors that predict HRQOL. ⋯ Untreated HCV patients in MMT had lower HRQOL than HCV patients not in MMT. Depression Severity was associated with significantly lower quality of life measures, suggesting that psychiatric evaluation and intervention prior to the start of HCV treatment may improve overall quality of life and could influence HCV treatment outcomes in MMT patients.
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Drug Alcohol Depend · May 2009
Methadone metabolism and clearance are induced by nelfinavir despite inhibition of cytochrome P4503A (CYP3A) activity.
Methadone plasma concentrations are decreased by nelfinavir. Methadone clearance and the drug interactions have been attributed to CYP3A4, but actual mechanisms of methadone clearance and the nelfinavir interaction are unknown. We assessed nelfinavir effects on methadone pharmacokinetics and pharmacodynamics, intestinal and hepatic CYP3A4/5 activity, and intestinal P-glycoprotein transport activity. CYP3A4/5 and transporters were assessed using alfentanil and fexofenadine, respectively. ⋯ Nelfinavir induced methadone clearance by increasing renal clearance, and more so by stereoselectively increasing hepatic metabolism, extraction and clearance. Induction occurred despite 50% inhibition of hepatic CYP3A4/5 activity and more than 75% inhibition of first-pass CYP3A4/5 activity, suggesting little or no role for CYP3A in clinical methadone disposition. Nelfinavir may alter methadone pharmacodynamics, increasing clinical effects.
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Drug Alcohol Depend · May 2009
Variations by age and sex in alcohol-related problematic behaviour per drinking volume and heavier drinking occasion.
This study aims to assess the relationships between age, sex, drinking behaviour and self-reported alcohol-related problem behaviour. ⋯ The results of this study provide strong evidence that young drinkers behave more problematically than older drinkers with drinking behaviour controlled for. The study also provides further evidence that women and men do not report substantially different rates of alcohol-related problems for similar amounts or patterns of drinking. The study has implications for public health messages that focus on the risk of harm from drinking, clearly demonstrating that young drinkers are more likely to report problems for a given amount of drinking.