L.A. Moves the Needle – The City’s Early Action in AIDS/HIV Prevention by Providing a Needle Exchange Program Proved to be Prescient. Now is no Time to Back Off

April 20, 2012 By ATForum Leave a Comment

In 1992 in Los Angeles, where needle exchanges were already in effect, the rate of HIV among those who injected drugs was 8.4%. In 1993, the HIV rate in Miami for that population was the highest in the country: 48%. Although Miami put into place HIV-prevention programs, there has never been a large-scale needle exchange program there. Today the rate of HIV among injection drug users in Miami is 16%. In Los Angeles, the rate stayed low, and as of 2009, the most recent data available, it was 5%.

These facts have important consequences. Extrapolating from county data, it’s believed that about 34,000 Los Angeles residents are injection drug users. The California Department of Public Health calculates the lifetime costs of treating one person with HIV at $385,200. If those 34,000 Angelenos had an HIV rate of 16% rather than 5%, we’d be spending an additional $1.4 billion in treatment costs.

http://www.latimes.com/news/opinion/commentary/la-oe-scholar-hiv-needle-exchange-20120410,0,4371176.story

Source:  Los Angeles Times – April 10, 2012

Filed Under: 2012-04-20, News Updates Tagged With: ,

Study: Benzodiazepine Update: Alprazolam and Other Benzodiazepine Use Among People Who Inject Drugs

April 13, 2012 By ATForum Leave a Comment

The use of benzodiazepines among people who use illicit drugs is complex as reasons for use are not always straightforward and use does not necessarily infer abuse. On the other hand, higher dosing than prescribed is common among drug users (Nielsen et al. 2008) and use in combination with drugs such as heroin and alcohol is likely to promote adverse effects.

http://ndarc.med.unsw.edu.au/sites/ndarc.cms.med.unsw.edu.au/files/ndarc/resources/IDRS%20April%202012.pdf

Source: McIlwraith, F., Hickey, S., and Alati, R. (April 2012). Benzodiazepine update: alprazolam and other benzodiazepine use among people who inject drugs. IDRS Drug Trends Bulletin April 2012, Sydney: National Drug and Alcohol Research Centre, The University of New South Wales.

Filed Under: 2012-04-13, Medication-Assisted Treatment (MAT), News Updates, Other Drugs of Abuse, Prescription Drugs Tagged With: , ,

Injection Drug Abuse Admissions to Substance Abuse Treatment: 1992 and 2009

December 19, 2011 By ATForum Leave a Comment


According to a recent TEDS Report, the number of injection admissions to substance abuse treatment increased from over 199,000 in 1992 to nearly 278,000 in 2009, although they remained a relatively constant proportion of all admissions (13.2 percent of all substance abuse treatment admissions in 1992 and 14.3 percent in 2009). In 2009, most injection admissions (85.1 percent) reported that they injected their primary drug of abuse, 1 in 7 (14.9 percent) injected their secondary or tertiary drug of abuse.

Heroin

The proportion of heroin injection admissions that were young adults (aged 18 to 25) more than tripled between 1992 and 2009 from 8.7 to 28.2 percent. The proportion of heroin injection admissions age 50+ more than doubled from 5.0 percent to 11.6 percent (see Table below).

The pattern of admissions for heroin injection drug use by race/ethnicity also changed between 1992 and 2009. The proportion of all heroin injection admissions that were non-Hispanic White increased from 49.4 percent in 1992 to 69.9 percent in 2009.

Opiates Other Than Heroin

The proportion of opiates other than heroin injection admissions that were young adults (aged 18 to 25) increased more than 400 percent between 1992 and 2009 from 7.3 to 40.4 percent while the proportion of opiates other than heroin admissions age 50+ declined by over 60 percent from 5.0 percent to 11.6 percent.

The pattern of admissions for opiates other than heroin injection drug use by race/ethnicity also changed between 1992 and 2009. The proportion of all heroin injection admissions that were non-Hispanic White increased from 82.9 percent in 1992 to 91.0 percent in 2009.

TEDS Report: Percent Distribution of Injection Admissions, by Age, Race/Ethnicity, and Substance of Abuse: 1992 and 2009

Age and Race/Ethnicity All Heroin Opiates Other
than Heroin
1992 2009 1992 2009 1992 2009
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Age            
12-17     0.5%     0.7%     0.3%     0.6%     0.4%     1.4%
18-25   10.5%   26.9%     8.4%   27.6%     6.9%   39.0%
26-34   37.7%   31.9%   34.4%   30.8%   36.8%   36.4%
35-49   47.2%   30.1%   51.9%   29.4%   52.8%   18.9%
50 or Older     4.1%   10.4%     5.0%   11.6%     3.1%     4.3%
Race/Ethnicity            
White, Non-Hispanic   55.2%   73.4%   49.4%   69.9%   82.9%   91.0%
Black, Non-Hispanic   20.9%     7.8%   21.9%     9.0%   11.6%     2.0%
Hispanic   20.8%   15.2%   25.7%   18.0%     3.4%     3.2%
American Indian/Alaska Native     1.4%     1.2%     1.0%     0.7%     1.2%     2.0%
Other     1.7%     2.4%     2.0%     2.4%     0.9%     1.8%

The report also noted that the data show that examining primary injection admissions alone would ignore a substantial number of secondary/tertiary injection admissions. Overall, about 1 in 7 injection admissions in 2009 were non-primary injection admissions. Public health professionals and substance abuse providers who monitor secondary/tertiary injection drug use may identify users at risk for disease transmission who would otherwise be overlooked if surveillance focused only on primary injection drug use.

The report can be access at: http://store.samhsa.gov/product/Injection-Drug-Abuse-Admissions-to-Substance-Abuse-Treatment-1992-and-2009/TEDS11-1201

Source: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (December 1, 2011). The TEDS Report: Injection Drug Abuse Admissions to Substance Abuse Treatment: 1992 and 2009. Rockville, MD.

Filed Under: Addiction, December 2011, News Updates, Opioid Abuse/Addiction Tagged With: , , ,

MaineCare at Core of Pain-Pill Epidemic – Prescription Drug Abuse and Related Health Care Costs are a Drain, But Funding for Treatment Also Saves Money

October 18, 2011 By ATForum Leave a Comment

Treatment is the only way out of the spiral of opiate addiction, doctors say. But it isn’t cheap.

MaineCare payments for all substance abuse treatment totaled more than $100 million in the fiscal year that ended last June, according to figures provided by DHHS. Prescription pain relievers account for about one-third of the admissions for substance abuse treatment in Maine, second only to alcohol, according to the Office of Substance Abuse.

The biggest cost to MaineCare, however, is health care services related to abuse and addiction, from emergency department visits for withdrawal and overdoses, to treatments for hepatitis C and collapsed veins to the care provided to pregnant addicts and their babies.

http://www.pressherald.com/special/opiates/Sunday/MaineCare-at-core-of-pain-pill-epidemic-.html

Source: Portland Press Herald – October 16, 2011

Filed Under: Funding, News Updates, October 2011, Opioid Abuse/Addiction Tagged With: , , ,

Small Rhode Island Study Finds IDUs More Likely to Use Diverted Buprenorphine/Naloxone to Self-Medicate; Non-IDUs More Likely to Use to Get High

August 29, 2011 By ATForum Leave a Comment

The motivation for using diverted buprenorphinenaloxone varies significantly between injecting drug users (IDUs) and non-IDUs, according to data from a study of self-reported adult opioid users in Providence, Rhode Island. Overall, approximately three-fourths (76%) of opioid users reported obtaining buprenorphine/naloxone illicitly. IDUs were significantly more likely than non-IDUs to report using diverted buprenorphine/naloxone for self-medication reasons, such as to reduce withdrawal symptoms or to self-treat opioid addiction (see figure below). In contrast, non-IDUs were significantly more likely than IDUs to report using diverted buprenorphine/naloxone to get high (69% vs. 32%).

The authors suggest that these differences may be because IDUs have a greater severity of dependence—they were more likely to report high frequency opioid use, a history of enrollment in methadone maintenance treatment, and utilization of detoxification services. The authors also note that “The number of opioid users in our sample who reported having ever used buprenorphine/naloxone to ‘get high’ is surprising, given that buprenorphine/ naloxone is a partial opioid agonist that is not expected to produce euphoria in regular users with a tolerance to opioids. It is possible that some participants, particularly noninjecting opioid users, did not use opioids regularly enough to develop significant tolerance*.

Motivation for Using Diverted Buprenorphine/Naloxone
Among Opioid Users, Rhode Island, 2009

* P < 0.05; ** p < 0.01

Editor’s Note: While these findings are limited by the fact that this study used a small convenience sample of opioid users from one area of Providence, we believe the results are noteworthy because they are the first to suggest that individual drug use patterns and the severity of opioid dependence may be related to an individual’s motivation for using diverted buprenorphine.

Note: Adults who self-reported opioid use in the previous 30 days were recruited in Providence between August and November 2009 from a fixed-site syringe exchange program and by outreach workers recruiting from areas they identified to have high concentrations of active opioid user.

Original Source: Adapted by CESAR from data from Bazazi, A.R., Yokell, M., Fu, J.J., Rich, J.D., Zaller, N.D., “Illicit Use of Buprenorphine/Naloxone Among Injecting and Noninjecting Opioid Users,” Journal of Addiction Medicine, Published Ahead-of-Print, 2011. For more information, contact Dr. Nickolas Zaller at nzaller@lifespan.org.

Source: Cesar Fax – August 8, 2011

Filed Under: August 2011, Medication-Assisted Treatment (MAT), News Updates, Opioid Abuse/Addiction Tagged With: , , ,

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