The Methamphetamine Epidemic: Implications for HIV Prevention and Treatment

San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, CA 94102, USA. .
Current HIV/AIDS Reports (Impact Factor: 3.8). 12/2005; 2(4):194-9. DOI: 10.1007/s11904-005-0016-4
Source: PubMed


Methamphetamine and related amphetamine compounds are among the most commonly used illicit drugs, with over 35 million users worldwide. In the United States, admissions for methamphetamine treatment have increased dramatically over the past 10 years. Methamphetamine use is prevalent among persons with HIV infection and persons at risk for HIV, particularly among men who have sex with men. In addition to being associated with increased sexual risk behavior, methamphetamine causes significant medical morbidity, including neurologic deficits, cardiovascular compromise, dental decay, and skin infections, all of which may be worsened in the presence of HIV/AIDS. Methamphetamine use may also result in decreased medication adherence, particularly during "binging" episodes. Behavioral counseling remains the standard of treatment for methamphetamine dependence, although the effectiveness of most counseling interventions has not been rigorously tested. Pharmacologic and structural interventions may prove valuable additional interventions to reduce methamphetamine use.

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    • "HIV care is as well-funded as it is effective, with numerous agencies and their agents helping HIV-positive people with everything from medication to housing; it is simply not as troubling or worrisome to my informants as is meth. Treatment for meth addiction is neither well-funded nor effective (Colfax and Shoptaw 2005; Elkashef et al. 2008), while the efforts to control meth, meth users, and meth dealers are extensive. These range from increased and aggressive policing (Garriott 2011) to restrictions on precursor ingredients for the manufacture of meth (Reding 2009) to advertising campaigns devoted to demonizing the use and condemning the users of meth ( "
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    ABSTRACT: I performed 14 person-centered ethnographies with methamphetamine-using HIV-positive men who have sex with men in San Diego, California, who were all subjects of the “anti-meth apparatus,” a collection of government and nongovernment organizations focused on meth use and its sequelae. The apparatus attempts to coerce addicts to develop and perform certain identities and emotions, though addicts are capable of both passive acceptance and active disruption. In my research, those who failed to become the apparatus's ideal subject felt shame, while those who succeeded expressed pride. Those hovering in the middle experienced a perpetual struggle to become normal and rarely, if ever, succeeded.
    Full-text · Article · Dec 2015 · Ethos
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    • "General METH use is seen as minimal exposure to the drug, primarily involving first time users; whereas, chronic METH abuse and dependence expose the user to a diverse range of adverse physical and cognitive health consequences (Panenka et al., 2013). The rate of treatment admissions for primary METH abuse has increased over 3-fold in recent years (Colfax and Shoptaw, 2005). Diverse routes for METH use exist, including oral ingestion, smoking, snorting, intravenous injection, and anal insertion. "
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    ABSTRACT: The prevalence of methamphetamine (METH) use is estimated at ~35 million people worldwide, with over 10 million users in the United States. METH use elicits a myriad of social consequences and the behavioral impact of the drug is well understood. However, new information has recently emerged detailing the devastating effects of METH on host immunity, increasing the acquisition of diverse pathogens and exacerbating the severity of disease. These outcomes manifest as modifications in protective physical and chemical defenses, pro-inflammatory responses, and the induction of oxidative stress pathways. Through these processes, significant neurotoxicities arise, and, as such, chronic abusers with these conditions are at a higher risk for heightened consequences. METH use also influences the adaptive immune response, permitting the unrestrained development of opportunistic diseases. In this review, we discuss recent literature addressing the impact of METH on infection and immunity, and identify areas ripe for future investigation.
    Full-text · Article · Jan 2014 · Frontiers in Neuroscience
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    • "Methamphetamine (Meth) is an illicit, highly addictive stimulant of the central nervous system (CNS); it is estimated that there are more than 35 million Meth abusers in the world [1]. "
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    ABSTRACT: Methamphetamine is a highly addictive psychostimulant with tens of millions of abusers around the world, and currently there is no effective or approved medication for addiction to it. Monoclonal antibodies with a high affinity for methamphetamine have the potential to sequester the drug in the vascular compartment and reduce entry into the brain, acting as peripheral pharmacokinetic antagonists without inducing adverse effects on neurons. However, in order to maintain the antibodies at an effective level, repeated administration is required, which would be expensive and problematic for patient compliance. In this study, we intended to investigate whether using a recombinant adeno-associated virus-mediated gene transfer technique can be an effective approach to achieve long-term expression of anti-methamphetamine monoclonal antibodies in mouse models. We generated a recombinant adeno-associated virus vector encoding the heavy and light chains of an anti-methamphetamine monoclonal antibody, which were constructed in a single open reading frame and linked with a 2A self-processing sequence. In the context of virus-mediated gene transfer, expression of full-length and functional monoclonal antibodies was successfully demonstrated in vitro and in vivo. Further investigations on dose optimization, long-term expression, and protection from methamphetamine challenge in mouse models are ongoing.
    Preview · Article · Dec 2013 · Journal of Food and Drug Analysis
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