Methadone Maintenance Therapy Decreases the Rate of Antiretroviral Therapy Discontinuation Among HIV-Positive Illicit Drug Users

Reddon, Hudson; Milloy, M.‐J.; Simo, Annick; Montaner, Julio S. G.; Wood, Evan; Kerr, Thomas

doi:10.1007/s10461-013-0584-z

Cited by 49 publications

(39 citation statements)

References 45 publications

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“…83 In Vancouver, Canada, several longitudinal studies showed not only that OST continuation improved ART adherence over time, 84 but also the converse – that OST discontinuation significantly increased the risk of ART non-adherence 85 – and that OST patients with higher opioid agonist doses had the strongest adherence to ART. 86 In China, the understanding of the importance of the OST-ART link led to an effort to integrate ART services in methadone clinics.…”

Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

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Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms. Health impact of drug policy based on enforcement of prohibition The pursuit of drug prohibition has generated a parallel economy run by criminal networks. Both these networks, which resort to violence to protect their markets, and the police and sometimes military ...

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Section: Drug Policy and Infectious Diseasesmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

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“…Recent studies have found that OST among PWID is associated with higher CD4+ cell count at ART initiation[71], ART initiation and access[83,84], ART medication adherence[85,86], decreases in ART discontinuation[87], and decreases in delayed care visits[88]. …”

Section: Recent Work In Interventions To Improve Outcomes For Key Popmentioning

confidence: 99%

HIV treatment cascade in MSM, people who inject drugs, and sex workers

Risher

Mayer

Beyrer

2015

Current Opinion in HIV and AIDS

124

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Purpose of review People who inject drugs (PWID), sex workers and men who have sex with men (MSM) simultaneously bear a high burden of HIV and stigma and discrimination. The purpose of this review was to summarize recent information about the understanding of the HIV care cascade among PWID, sex workers, and MSM populations around the globe. Recent findings A review of the published literature relating to the care cascade in these three key populations was conducted. Data on the care cascade among key populations is sparse, particularly for PWID and sex workers. In the twelve countries in which a study or report of the care cascade was available stratified by these populations, all three populations have care cascade outcomes that are far below the 90-90-90 target set by UNAIDS for 2020. Culturally-tailored interventions including co-location of services and peer navigators can improve care cascade outcomes among key populations. Summary Key populations’ care cascade outcomes must be included in international reporting metrics to expand cascade data for these groups. Improving care cascade outcomes in these key populations through culturally-tailored interventions should be a priority in the coming years.

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“…It is well known that drug use can have direct deleterious consequences on an individual’s health, as well as indirect harms, for instance unsafe practices [2]. Studies have shown that drug use plays a maladaptive role in adherence to HIV treatment [3–5]. Antiretroviral therapy (ART) effectiveness relies on high and sustained levels of medication adherence.…”

Section: Introductionmentioning

confidence: 99%

“…These treatments are complex with various protocols, dietary restrictions, and potential side effects. Proper treatment may be hindered by factors such as homelessness, incarceration, untreated psychiatric illnesses and drug addiction [3]. HIV positive drug users tend to have a lower uptake of treatment compared to HIV positive individuals who do not use drugs [4].…”

Section: Introductionmentioning

confidence: 99%

Oral Fluid vs. Urine Analysis to Monitor Synthetic Cannabinoids and Classic Drugs Recent Exposure

Blandino

Wetzel

Kim

et al. 2018

CPB

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Background Urine is a common biological sample to monitor recent drug exposure, and oral fluid is an alternative matrix of increasing interest in clinical and forensic toxicology. Limited data are available about oral fluid vs. urine drug disposition, especially for synthetic cannabinoids. Objective To compare urine and oral fluid as biological matrices to monitor recent drug exposure among HIV-infected homeless individuals. Methods Seventy matched urine and oral fluid samples were collected from 13 participants. Cannabis, amphetamines, benzodiazepines, cocaine and opiates were analyzed in urine by the enzyme-multiplied-immunoassay-technique and in oral fluid by liquid chromatography tandem mass spectrometry (LC-MSMS). Eleven synthetic cannabinoids were analyzed in urine and in oral fluid by LC-MSMS. Results Five oral fluid samples were positive for AB-FUBINACA. In urine, 4 samples tested positive for synthetic cannabinoids PB-22, 5-Fluoro-PB-22, AB-FUBINACA, and metabolites UR-144 5-pentanoic acid and UR-144 4-hydroxypentyl. In only one case, oral fluid and urine results matched, both specimens being AB-FUBINACA positive. For cannabis, 40 samples tested positive in urine and 30 in oral fluid (85.7% match). For cocaine, 37 urine and 52 oral fluid samples were positive (75.7% match). Twenty-four urine samples were positive for opiates, and 25 in oral fluid (81.4% match). For benzodiazepines, 23 samples were positive in urine and 25 in oral fluid (85.7% match). Conclusion/Discussion These results offer new information about drugs disposition between urine and oral fluid. Oral fluid is a good alternative matrix to urine for monitoring cannabis, cocaine, opiates and benzodiazepines recent use; however, synthetic cannabinoids showed mixed results.

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Methadone Maintenance Therapy Decreases the Rate of Antiretroviral Therapy Discontinuation Among HIV-Positive Illicit Drug Users

Cited by 49 publications

References 45 publications

Public health and international drug policy

Public health and international drug policy

HIV treatment cascade in MSM, people who inject drugs, and sex workers

Oral Fluid vs. Urine Analysis to Monitor Synthetic Cannabinoids and Classic Drugs Recent Exposure

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