Drug and alcohol dependence
-
Drug Alcohol Depend · Apr 2009
Comparative StudyClinical characteristics of treatment-seeking prescription opioid vs. heroin-using adolescents with opioid use disorder.
To compare the clinical characteristics of treatment-seeking prescription opioid-using adolescents with DSM-IV opioid use disorder (OUD) to those with heroin-using OUD adolescents. ⋯ Both groups of treatment-seeking OUD adolescents had multiple comorbidities but there were substantial differences between prescription opioid-users and heroin-users. These differences may suggest different prognoses and treatment implications. Future research may shed light on the factors leading to differences in choice of opioids and their impact on treatment outcomes; and assess the role of agonist assisted treatments and integrated psychiatric care.
-
Drug Alcohol Depend · Mar 2009
Comparative StudyThe association of syringe type and syringe cleaning with HCV infection among IDUs in Budapest, Hungary.
We assessed whether syringe type, syringe cleaning and distributive syringe sharing were associated with self-reported and laboratory-confirmed HCV infection among Hungarian IDUs. Injecting drug users (N=215) were recruited from non-treatment settings in Budapest, Hungary between October 2005 and December 2006. Multivariate logistic regression models identified correlates of self-report of being HCV infected and testing positive for HCV. ⋯ Our findings also indicate that syringe type and syringe cleaning practices may play a role in HCV transmission. Ethnographic research should identify the reasons why IDUs may use two-piece syringes and suggest means to reduce their use. Thorough cleaning of one-piece syringes when sterile syringes are unavailable may be an efficient way to reduce the risk of HCV infection.
-
Drug Alcohol Depend · Jan 2009
Comparative StudyCorrelates of extramedical use of OxyContin versus other analgesic opioids among the US general population.
There has been substantial public and media attention regarding extramedical use of OxyContin, but few studies focus on the characteristics of extramedical OxyContin users and whether they differ from extramedical other opioid users. ⋯ Our findings point out differences between OxyContin and other opioid users that might help prevention specialists and assist efforts to curb opioid analgesics diversion.
-
Drug Alcohol Depend · Jan 2009
Randomized Controlled Trial Multicenter StudyPredictors of outcome for short-term medically supervised opioid withdrawal during a randomized, multicenter trial of buprenorphine-naloxone and clonidine in the NIDA clinical trials network drug and alcohol dependence.
Few studies in community settings have evaluated predictors, mediators, and moderators of treatment success for medically supervised opioid withdrawal treatment. This report presents new findings about these factors from a study of 344 opioid-dependent men and women prospectively randomized to either buprenorphine-naloxone or clonidine in an open-label 13-day medically supervised withdrawal study. Subjects were either inpatient or outpatient in community treatment settings; however not randomized by treatment setting. ⋯ Tobacco use was associated with worse opioid treatment outcomes. Severe baseline anxiety symptoms doubled treatment success. Medication type (buprenorphine-naloxone) was the most important predictor of positive outcome; however the paper also considers other clinical and policy implications of other results, including that inpatient setting predicted better outcomes and moderated medication outcomes.
-
Drug Alcohol Depend · Jan 2009
Comparative StudyClinical characteristics of treatment-seeking adolescents with opioid versus cannabis/alcohol use disorders.
To assess the clinical characteristics of adolescents with DSM-IV opioid use disorder (OUD) and compare them to adolescents with cannabis/alcohol use disorders. ⋯ While there were similarities between the two groups, OUD adolescents evidenced greater impairment in academic, substance use, depressive symptom and IDU-related HIV-risk areas. Findings suggest poorer long-term prognosis and highlight the need for specialized interventions for treatment-seeking OUD adolescents.