Drug and alcohol dependence
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Drug Alcohol Depend · Nov 2013
ReviewUncovering the epidemic of HIV among men who have sex with men in Central Asia.
Research among people who inject drugs (PWID) in Central Asia has described same sex behavior among male PWID and may be associated with HIV and other infections. Little is known about the population of men who have sex with men (MSM) and the burden of HIV among MSM in Central Asian countries. ⋯ Improved understanding of risks, including potential linkages between sexual exposures and substance use, among MSM are important for response. The little known about HIV among MSM in Central Asia speaks to the urgency of improvements in HIV research, prevention, and care.
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Drug Alcohol Depend · Nov 2013
ReviewHIV among female sex workers in the Central Asian Republics, Afghanistan, and Mongolia: contexts and convergence with drug use.
Central Asia is culturally and demographically diverse, both between and within its respective countries. That diversity is represented in the range of individual, network, community, and structural risks for female sex workers (FSWs) regionally. FSWs have several risk factors for HIV acquisition and transmission including behavioral, biological, and structural risk factors. Across Central Asia, sexual risks have become conflated with risks associated with injection and non-injection illicit drug use. ⋯ The Central Asian HIV epidemic has traditionally been assumed to be driven nearly exclusively by drug use, resulting in surveillance systems focused on parenteral transmission. The reviewed data highlight limited attention to characterizing the burden of HIV and risk factors for HIV acquisition and transmission among FSWs who use drugs. Moving forward will require enhanced HIV surveillance and research to inform HIV prevention approaches to address all levels of HIV risks affecting FSWs in Central Asia.
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Drug Alcohol Depend · Nov 2013
Randomized Controlled TrialEfficacy of extended-release tramadol for treatment of prescription opioid withdrawal: a two-phase randomized controlled trial.
Tramadol is an atypical analgesic with monoamine and modest mu opioid agonist activity. The purpose of this study was to evaluate: (1) the efficacy of extended-release (ER) tramadol in treating prescription opioid withdrawal and (2) whether cessation of ER tramadol produces opioid withdrawal. ⋯ ER tramadol 200mg modestly attenuated opioid withdrawal. Mild opioid withdrawal occurred after cessation of treatment with 600 mg tramadol. These data support the continued investigation of tramadol as a treatment for opioid withdrawal.
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Drug Alcohol Depend · Nov 2013
Associations between pain clinic density and distributions of opioid pain relievers, drug-related deaths, hospitalizations, emergency department visits, and neonatal abstinence syndrome in Florida.
Community-level associations between pain clinics and drug-related outcomes have not been empirically demonstrated. ⋯ Although pain clinics, some of which are "pill mills," are clearly a source of drugs used nonmedically, their impact on health outcomes might be difficult to quantify because the pills they prescribe might be consumed in other counties or states. The impact of "pill mill" laws might be better measured by more proximal measures such as the number of such facilities.