Article

Non-injection drug use and Hepatitis C Virus: A systematic review

Center for Drug Use and HIV Research, National Development and Research Institutes (NDRI), 71 West 23rd Street, 8th Floor, New York, NY 10010, United States.
Drug and Alcohol Dependence (Impact Factor: 3.28). 07/2007; 89(1):1-12. DOI: 10.1016/j.drugalcdep.2006.11.014
Source: PubMed

ABSTRACT This systematic review examined the evidence on the prevalence of the Hepatitis C Virus (HCV) in non-injecting drug users (NIDUs) who sniff, smoke or snort drugs such as heroin, cocaine, crack or methamphetamine. The search included studies published from January 1989 to January 2006. Twenty-eight eligible studies were identified and the prevalence of HCV in these NIDU populations ranged from 2.3 to 35.3%. There was substantial variation in study focus and in the quality of the NIDU data presented in the studies. The results of our systematic review suggested that there are important gaps in the research of HCV in NIDUs. We identified a problem of study focus; much of the research did not aim to study HCV in users of non-injection drugs. Instead, NIDUs were typically included as a secondary research concern, with a principal focus on the problem of transmission of HCV in IDU populations. Despite methodological issues, HCV prevalence in this population is much higher than in a non-drug using population, even though some IDUs might have inadvertently been included in the NIDU samples. These studies point to a real problem of HCV in NIDU populations, but the causal pathway to infection remains unclear.

Download full-text

Full-text

Available from: Don C Des Jarlais, Feb 20, 2014
1 Follower
 · 
124 Views
  • Source
    • "People who smoke crack experience disproportionately high levels of morbidity, such as chronic and infectious diseases, physical health problems, and mental health challenges (Falck et al., 2004; Fischer & Coghlan, 2007), even in comparison to other drug-using populations (Fischer et al., 2006). Crack smoking is independently associated with HIV and hepatitis C (HCV) infection (DeBeck et al., 2009; Roy et al., 2001), and the incidence of HIV and HCV among crack-smoking populations has been documented to be as high as 7.5% and 35.3%, respectively (Kral et al., 1998; Scheinmann et al., 2007). Crack-smoking populations are also severely socially marginalized, and disproportionately impacted by intersecting social inequities that function to increase their exposure to violence and compromise their health (Bungay, Johnson, Varcoe, & Boyd, 2010; Fischer & Coghlan, 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Many cities around the globe have experienced substantial increases in crack cocaine use. Public health programmes have begun to address crack smoking, primarily through the distribution of safer crack use equipment, but their impacts have been limited. More comprehensive safer environmental interventions, specifically safer smoking rooms (SSR), have been implemented only in select European cities. However, none have been subjected to rigorous evaluation. This ethnographic study was undertaken at an ‘unsanctioned’ SSR operated by a drug user-led organization in Vancouver, Canada, to explore how this intervention shaped crack smoking practices, public crack smoking, and related harms.
    International Journal of Drug Policy 01/2015; DOI:10.1016/j.drugpo.2015.01.015 · 2.40 Impact Factor
  • Source
    • "HIV and HCV acquisition among substance users have historically been associated with injection drug use and risky sexual behaviors . More recent research, however, has also found a correlation between noninjection drug use and increased risk for HIV and HCV (Strathdee and Sherman, 2003; Neaigus et al., 2007; Scheinmann et al., 2007), making risk-behavior prevention critical for all substance abusers. This increased risk for HIV and HCV is particularly serious among prescription opioid (PO) abusers. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The high rates of HIV and Hepatitis C (HCV) infection among opioid abusers is a serious public health problem, and efforts to enhance knowledge regarding risks for HIV/hepatitis infection in this population are important. Abuse of prescription opioids (POs), in particular, has increased substantially in the past decade and is associated with increasing rates of injection drug use and HCV infection. This study describes the effects of a brief HIV/HCV educational intervention delivered in the context of a larger randomized, double-blind clinical trial evaluating the relative efficacy of 1-, 2-, and 4-week outpatient buprenorphine tapers and subsequent oral naltrexone maintenance for treating PO dependence. HIV- and HCV-related knowledge and risk behaviors were characterized pre- and post-intervention in 54 primary PO abusers. The educational intervention was associated with significant improvements in HIV (p<.001) and HCV (p<.001) knowledge. Significant improvements (p<.001) were observed on all three domains of the HIV questionnaire (i.e., general knowledge, sexual risk behaviors, drug risk behaviors) and on 21 and 11 individual items on the HIV and HCV questionnaires, respectively. Self-reported likelihood of using a condom also increased significantly (p<.05) from pre- to post-intervention. No additional changes in self-reported risk behaviors were observed. These results suggest that a brief, easy-to-administer intervention is associated with substantial gains in HIV and HCV knowledge among PO abusers and represents the necessary first step toward the dissemination of a structured prevention HIV and HCV intervention for PO abusers.
    Drug and alcohol dependence 08/2013; 133(2). DOI:10.1016/j.drugalcdep.2013.08.007 · 3.28 Impact Factor
  • Source
    • "With regard to prescription opioids, users may crush the pills into particles small enough for insufflation ( " snorting " ), or crush and dissolve the pills for injection ( " shooting " ; Raffa and Pergolizzi, 2010). Administration of drugs in either manner is accompanied by increased health risks, such as overdose, or the transfer of communicable disease (Green et al., 2011; Scheinmann et al., 2007; Surratt et al., 2011; Martinez and Talal, 2008; Macias et al., 2008). To counter medication-tampering techniques that may lead to behaviors that are accompanied by such health risks, a great deal of attention is being paid to drug formulation technologies that may deter abuse (Coleman et al., 2005, 2010; Cone, 2006; Hamed and Moe, 2010; Katz et al., 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The extent of prescription opioid abuse has led to the development of formulations that are difficult to crush. The purpose of the present studies was to examine whether experienced prescription opioid abusers (individuals using prescription opioids for non-medical purposes regardless of how they were obtained) were able to prepare a formulation of oxymorphone hydrochloride ER 40mg designed to be crush-resistant (DCR) for intranasal (Study 1) or intravenous abuse (Study 2), utilizing a non-crush-resistant formulation of oxymorphone (40mg; OXM) as a positive control. No drug was administered in these studies. Participants were provided with DCR and OXM tablets in random order and asked to prepare them for abuse with tools/solutions that they had previously requested. The primary outcome for Study 1 was particle size distribution, and the primary outcome for Study 2 was percent yield of active drug in the extracts. Other descriptive variables were examined to better understand potential responses to these formulations. Fewer DCR than OXM particles were smaller than 1.705mm (9.8% vs. 97.7%), and thus appropriate for analyses. Percent yield of active drug in extract was low and did not differ between the two formulations (DCR: 1.95%; OXM: 1.29%). Most participants were not willing to snort (92%) or inject (84%) the tampered products. Participants indicated that they found less relative value in the DCR than the OXM formulation across both studies. These data suggest that the oxymorphone DCR formulations may be a promising technology for reducing opioid abuse.
    Drug and alcohol dependence 06/2012; 126(1-2):206-15. DOI:10.1016/j.drugalcdep.2012.05.013 · 3.28 Impact Factor
Show more