Do needle and syringe programs reduce risky behaviours among people who inject drugs in Kermanshah City, Iran? A coarsened exact matching approach

Noroozi, Mehdi; Marshall, Brandon D. L.; Noroozi, Alireza; Armoon, Bahram; Sharifi, Hamid; Farhoudian, Ali; Ghiasvand, Hesam; Vameghi, Meroe; Rezaei, Omid; Sayadnasiri, Mohammad; Pouya, Rokhsane Hosseini

doi:10.1111/dar.12646

Cited by 16 publications

(11 citation statements)

References 25 publications

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“…Our finding is in line with other studies [36,37] showing that the provision of other services from needle and syringe programs, including overdose education and providing naloxone can prevent overdose, [37]. Also, other services include, providing counseling and testing PWIDs about substance abuse treatment, HIV, hepatitis C virus (HCV), HBV counseling and testing [38][39][40][41][42][43], and naloxone for overdose educating PWIDs [44]. Additionally, integrating the health care systems with the services for PWIDs has positive influences both for PWIDs and the society [45,46].…”

Section: Discussionsupporting

confidence: 89%

Non -fatal overdose among people who inject drugs in Tehran, Iran

Noroozi

Higgs

Bayani

et al. 2020

Subst Abuse Treat Prev Policy

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Background With increasing frequencies of non-fatal overdose in people who inject drugs (PWID), it is essential to improve our knowledge about associated risk factors for overdose to inform overdose prevention and assistance programs. The aim of present study was to determine the prevalence of non-fatal overdose and the associated risk factors among PWID in Tehran, Iran. Methods Snowball sampling was used to collect data from 465 participants in Tehran using a cross-sectional survey. Consenting participants who reported drug injecting in the past month and were able to speak and comprehend Farsi enough to respond to survey questions were interviewed. The endpoint of interest was non-fatal overdose in the previous 6 months, or answering “Yes” to the question: “In the last six months, have you ever overdosed by accident? (at least once)”. We used STATA v. 14 for this analysis. Statistical significance was defined as p < 0.05 for all analyses. Results Of 465 PWIDs who participated in this study, all were male, and about half had less than a high school education. The prevalence of self-reported non-fatal overdose in the past 6 months was 38% (CI95%: 34, 43%). Our findings indicate that characteristics and behaviors that were associated with an increased risk of experiencing an overdose in the past 6 months were drug use initiation under 22 years (AOR =2.2, P < 0.05), using methamphetamine (AOR =2.8, P < 0.05), and using multiple drugs at the same time (AOR =2.1, P < 0.05). Also, more recent initiates to injecting (< 2 years) had an increased risk of experiencing an overdose in the past 6 months. The odds of experiencing a non-fatal overdose among PWIDs who regularly attended NSP were 0.6 times less than for those who did not attend regularly (OR = 0.6,95% CI: 0.2–0.9). Conclusion Methamphetamine and alcohol use were the most significant association for non-fatal overdose among PWIDs. Our results indicate that intervention and prevention initiatives seeking to reduce overdoses among PWIDs should not only be focused on the primary drug used but also the use of alcohol and poly-drug use.

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Section: Discussionsupporting

confidence: 89%

Non -fatal overdose among people who inject drugs in Tehran, Iran

Noroozi

Higgs

Bayani

et al. 2020

Subst Abuse Treat Prev Policy

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“…The criminalization of drug use has serious public health consequences that adversely impact on the global community [3][4][5]. Previous studies have highlighted the negative health consequences of some drugs for people who use them [6][7][8]. In relation to oral health specifically, there is evidence that people who use drugs (PWUD) have a high sugar intake [9,10].…”

Section: Introductionmentioning

confidence: 99%

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

et al. 2020

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Background: The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. Methods: We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. Results:We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. Conclusions: The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.

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“…A review by Sawangjit et al also showed that pharmacy-based NSEPs are effective for injection risk behaviors, although the effectiveness on blood-borne disease is still unclear 44 . Noroozi et al conducted a multilevel analysis in Iran and found that NSEPs might reduce HIV risk behavior, as well as injection-related risk behaviors, among PWID 45,46 . Fernandes et al conducted a systematic review and found that NSEP was effective in reducing HIV and injection risk behaviors among PWID 43 .…”

Section: Needle and Syringe Exchange Program (Nsep)mentioning

confidence: 99%

Substance Use Disorder, Intravenous Injection, and HIV Infection: A Review

Wang

Maher

2019

Cell Transplant

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DSM-V-defined substance use disorder comprises four groups of symptoms: impaired control, social impairment, risky use, and pharmacological reactions. Behavioral patterns of impaired control, including impulsivity and risk taking, are associated with HIV risk behaviors. Substance users with stronger craving symptoms are more likely to use drugs via intravenous injection than other routes because of the faster drug effect and the higher bioavailability; thus, they are at high risk of HIV infection. HIV risk behaviors such as unprotected sex and intravenous injection facilitate HIV disease spread. Public health policies such as Needle and Syringe Exchange Programs and medication-assisted treatment are proven to reduce HIV risk behaviors such as the frequency of intravenous injection and even the incidence of HIV infection, but both of them have limitations. While intravenous injection is a frequently discussed issue in public policies and the HIV-related literature, it is a much less frequent topic in the addiction literature. We believed that understanding the mental substrate behind impulsivity/risk taking and the possible biological mechanism of intravenous injection may help in creating more effective strategies to slow down HIV infection.

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Do needle and syringe programs reduce risky behaviours among people who inject drugs in Kermanshah City, Iran? A coarsened exact matching approach

Abstract: NSPs are a promising approach to reduce injection-related risk behaviours among PWID in Kermanshah, Iran. Expanded coverage of high-quality NSPs is recommended.

Cited by 16 publications

References 25 publications

Non -fatal overdose among people who inject drugs in Tehran, Iran

Non -fatal overdose among people who inject drugs in Tehran, Iran

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

Substance Use Disorder, Intravenous Injection, and HIV Infection: A Review

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