The Color of Meth: Is It Related to Adverse Health Outcomes? An Exploratory Study in Tijuana, Mexico

Strathdee, Steffanie A.; Case, Patricia; Lozada, Remedios; Mantsios, Andrea; Alvelais, Jorge; Pu, Minya; Brouwer, Kimberly C.; Miller, Cari L.; Patterson, Thomas L.

doi:10.1080/10550490701862944

Cited by 12 publications

(7 citation statements)

References 7 publications

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“…The most consistent difference in medical conditions was that current and past amphetamine injectors reported more dermatological illnesses than nonusers. Similarly, previous reports have suggested that drug users’ use of contaminated needles or injection without disinfecting the surrounding skin is associated with abscesses, cellulitis, and other skin infections, such as methicillin-resistant Staphylococcus aureus (MRSA) skin infections 43–45. We also found an elevated prevalence of dermatological illnesses among noninjecting amphetamine users, a finding that is not often reported in the literature.…”

Section: Discussionsupporting

confidence: 75%

Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network

Pilowsky

Wu²,

Burchett³

et al. 2011

SAR

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Background In response to the rising rate of treatment admissions related to illicit use of amphetamines (eg, methamphetamine), we examined the prevalence of amphetamine use among treatment-seeking, opioid-dependent adults, explored whether amphetamine users were as likely as nonamphetamine users to enroll in opioid-dependence treatment trials, and determined whether amphetamine users manifested greater levels of medical and psychiatric comorbidity than nonusers. Methods The sample included 1257 opioid-dependent adults screened for participation in three-multisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001-003), which studied the effectiveness of buprenorphine for opioid detoxification under varying treatment conditions. Patients were recruited from 23 addiction treatment programs across the US. Medical and psychiatric comorbidity were examined by past-month amphetamine use (current vs former) and route of administration. Five mutually exclusive groups were examined, ie, nonusers, current amphetamine injectors, current amphetamine noninjectors, former amphetamine injectors, and former amphetamine noninjectors. Results Of the sample (n = 1257), 22.3% had a history of regular amphetamine use. Of the 280 amphetamine users, 30.3% reported injection as their primary route. Amphetamine users were more likely than nonusers to be white and use more substances. Amphetamine users were as likely as non-users to enroll in treatment trials. Bivariate analyses indicated elevated rates of psychiatric problems (depression, anxiety, hallucinations, cognitive impairment, violence, suicidal thoughts/attempts) and medical illnesses (dermatological, hepatic, cardiovascular, respiratory, neurological, seizure, allergy conditions) among amphetamine users. After adjusting for demographic variables and lifetime use of other substances: current amphetamine users and former injectors showed an increased likelihood of having medical illnesses and hospitalizations; current injectors had elevated odds of suicidal thoughts or attempts; current noninjectors exhibited elevated odds of anxiety, cognitive impairment, and violent behaviors; and former noninjectors had increased odds of depression. Conclusion Treatment-seeking, amphetamine-using, opioid-dependent adults manifest greater levels of medical and psychiatric morbidity than treatment-seeking, opioid-dependent adults who have not used amphetamines, indicating a greater need for intensive clinical management.

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Section: Discussionsupporting

confidence: 75%

Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network

Pilowsky

Wu²,

Burchett³

et al. 2011

SAR

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“…A prior study in Tijuana, Mexico, found that IDUs who injected white or colored methamphetamine were more likely to report abscesses than those who injected clear methamphetamine 13. Black tar heroin injection has also been associated with soft tissue infections.…”

Section: Introductionmentioning

confidence: 97%

High prevalence of abscesses and self-treatment among injection drug users in Tijuana, Mexico

Pollini

Gallardo

Hasan

et al. 2010

International Journal of Infectious Diseases

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Summary Background Soft tissue infections are common among injection drug users (IDUs), but information on correlates and treatment in this highly marginalized population is lacking. Methods Six hundred twenty-three community-recruited IDUs in Tijuana, Mexico, completed a detailed interview on abscess history and treatment. Univariate and multiple logistic regressions were used to identify factors independently associated with having an abscess in the prior 6 months. Results Overall, 46% had ever had an abscess and 20% had had an abscess in the past 6 months. Only 12% had sought medical care for their most recent abscess; 60% treated the abscess themselves. The most common self-treatment method was to apply heated (24%) or unheated (23%) Aloe vera leaf. Other methods included draining the wound with a syringe (19%) or knife (11%). Factors independently associated with recent abscess were having income from sex work (adjusted odds ratio (aOR) 4.56, 95% confidence interval (CI) 2.08–10.00), smoking methamphetamine (aOR 1.65, 95% CI 1.05–2.62), seeking someone to help with injection (aOR 2.06, 95% CI 1.18–3.61), and reporting that police affected where they used drugs (aOR 2.14, 95% CI 1.15–3.96). Conclusions Abscesses are common among IDUs in this setting, but appropriate treatment is rare. Interventions to reduce barriers to medical care in this population are needed. Research on the effectiveness of Aloe vera application in this setting is also needed, as are interventions to provide IDU sex workers, methamphetamine smokers, and those who assist with injection with the information and equipment necessary to reduce abscess risk.

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“…Since Tijuana lies on a major drug trafficking route, illicit drugs are widely available and easily accessible. Meth is one of the most widely used drugs in Tijuana, along with heroin [16, 17]. HIV testing rates in the city are low [18], which leaves many individuals, including high-risk MSM, unaware of their HIV status.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of HIV among men who have sex with men in Tijuana, Mexico

Pitpitan

Goodman‐Meza

Burgos

et al. 2015

Journal of the International AIDS Society

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IntroductionMen who have sex with men (MSM) in developing countries such as Mexico have received relatively little research attention. In Tijuana, Mexico, a border city experiencing a dynamic HIV epidemic, data on MSM are over a decade old. Our aims were to estimate the prevalence and examine correlates of HIV infection among MSM in this city.MethodsWe conducted a cross-sectional study of 191 MSM recruited through respondent-driven sampling (RDS) in 2012. Biological males over the age of 18 who resided in Tijuana and reported sex with a male in the past year were included. Participants underwent interviewer-administered surveys and rapid tests for HIV and syphilis with confirmation.ResultsA total of 33 MSM tested positive for HIV, yielding an RDS-adjusted estimated 20% prevalence. Of those who tested positive, 89% were previously unaware of their HIV status. An estimated 36% (95% CI: 26.4–46.5) had been tested for HIV in the past year, and 30% (95% CI: 19.0–40.0) were estimated to have ever used methamphetamine. Independent correlates of being infected with HIV were methamphetamine use (odds ratio [OR]=2.24, p=0.045, 95% CI: 1.02, 4.92) and active syphilis infection (OR=4.33, p=0.01, 95% CI: 1.42, 13.19).ConclusionsOur data indicate that MSM are a key sub-population in Tijuana at higher risk for HIV. Tijuana would also appear to have the highest proportion among upper-middle-income countries of HIV-positive MSM who are unknowingly infected. More HIV prevention research on MSM is urgently needed in Tijuana.

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The Color of Meth: Is It Related to Adverse Health Outcomes? An Exploratory Study in Tijuana, Mexico

Cited by 12 publications

References 7 publications

Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network

Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network

High prevalence of abscesses and self-treatment among injection drug users in Tijuana, Mexico

Prevalence and correlates of HIV among men who have sex with men in Tijuana, Mexico

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