Long-term, low-level exposure of mice prone to mammary tumors to 435 MHz radiofrequency radiation

Six hundred and thirty four interviews of injecting drug users were performed between 1992 and 1994 as part of a study of injecting drug use and HIV prevalence in Edinburgh, Scotland. Amphetamine was injected by more subjects (44%) than any other drug. Preference for injection as the route of administration of amphetamine increased over the period despite no change in the popularity of the drug generally. Simultaneously, heroin use and injection declined. Analyses indicated that amphetamine injectors comprised two distinct sub-groups. The majority were polydrug injectors who injected frequently, had a longer injecting history and were more likely to share injection equipment. About one-fifth were stimulant-only injectors who injected infrequently, were relatively recent initiates to injecting and whose numbers increased over the 3 years. Drug treatment and prevention services may need to explore alternative methods to respond effectively to these emerging trends.     

Opiate users and the first years after treatment: outcome analysis of the proportion of follow up time spent in abstinence

This second report on a follow-up study of drug users focuses on changes that occurred on a number of variables between intake and follow-up and during the follow-up period. The length of abstinence from opiates was considered as a proportion of the total follow-up period. Overall there was a reduction in opiate use, in injecting and sharing equipment at follow-up. There had been, however, a high level of these risky activities during the follow-up period. Sustained abstinence from opiates was associated with increased employment, enhanced social stability and mental health. Intake drug use was strongly related to follow-up drug status. In particular, those who were injectors of multiple drugs at intake were far less likely to be long term opiate abstainers at follow-up than those who were not injectors at intake or injectors of opiates only.     

Promoters of epithelialization induce expression of vascular endothelial growth factor in human gastric epithelial cells in primary culture

Three routes of heroin use were identified--injecting, 'chasing the dragon' and snorting. Whilst injecting and 'chasing the dragon' accounted for virtually all current heroin use, snorting had been the first route of use for nearly a fifth of heroin users in both the treatment and community samples. Overlap of lifetime experience of the different routes was widespread, with the majority of heroin users in both the treatment and community samples having used heroin by more than one route. Although less than half of the treatment sample had used heroin by injection on the first occasion, more than 90% had injected at least once, and over 80% had at some time used by 'chasing the dragon'. Only a quarter of the community sample had first used heroin by injecting, and yet, by the time of interview, two-thirds of the sample had injected. The majority of durable changes in route of heroin use were towards injecting and 'chasing the dragon', with transitions to snorting being extremely rare. For both the samples, transitions to injecting were twice as frequent as transitions to 'chasing'. Snorting appeared to be an unstable route of use, with almost all who initially snorted their heroin now using by injecting or 'chasing the dragon'.     

Injecting equipment provision in Australia: the state of play

Injecting equipment provision measures in Australia can be judged reasonably successful as HIV prevention measures. In the capital cities of all Australian States and Territories, access to needles and syringes is easy, at least during the day in at least some areas. In conjunction with peer education and other activities, needle and syringe supply appears to have led to a change in norms away from the sharing of needles and other injecting equipment among at least older heroin injectors in large population centers. However, in many other areas, and in many subpopulations-particularly further marginalized groups such as Aboriginal and Vietnamese-Australian injectors-messages about HIV/AIDS risk are either not penetrating or are being ignored, and needle and other equipment sharing still appears to be common. The strategy of providing access to needles and syringes as a separate activity from peer education among injecting drug users (IDUs) needs to be reconsidered in the light of the widespread epidemic of hepatitis C among Australian IDUs. The level of supply of all injecting equipment also needs to be increased to assist all IDUs in learning and carrying out an aseptic injecting technique given the lack of an effective disinfection technique to prevent the spread of hepatitis C, and the problems surrounding both the promotion of disinfection and the promotion of noninjecting routes of administration.     

Prescribing drug of choice to illicit heroin users: the experience of a U.K. community drug team

Functioning across several life domains, in the first cohort of illicit heroin users to be prescribed injectable diamorphine (pharmaceutical heroin) as an adjunct to treatment within a community drugs service, was assessed in a cross-sectional study with a 6-month follow-up. Case-control matching procedures were employed to compare outcomes in this group with an oral methadone-prescribed sample, attending different clinics within the same community service and geographical locale. The Heroin Prescribed (HP) group manifested lower levels of psychopathology and showed greater retention in treatment. Although reduced, illicit heroin misuse was not eliminated; the use of other illicit substances was comparable between groups but significantly more of the HP group were using illicit cocaine. Although no differences in current physical health were apparent, the sharing of used injecting equipment was reported only in the MP group. Criminal activity appeared significantly reduced, but not eliminated, in the HP group. Implications for prescribing practice are discussed.     

High rates of drug use, but low rates of HIV risk behaviours among injecting drug users during incarceration in Dutch prisons

AIMS: To determine levels of injecting drug use and sexual risk behaviours in injecting drug users during and immediately following imprisonment in The Netherlands. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional survey of drug injectors attending methadone clinics, a sexually transmitted disease clinic and a central research site in Amsterdam. The mean age of the 188 participants was 35 years, 78% were male and 34% had HIV antibodies. MEASUREMENTS: Self-reported drug use and sexual behaviours during the last period of imprisonment in Dutch prisons within the previous 3 years and injecting drug use in the week following release from prison. FINDINGS: A period of imprisonment in the preceding 3 years was reported by 188 (41%) of 463 interviewed drug injectors. The mean duration of last imprisonment was 3.6 months. Any use of cannabis, heroin or cocaine during imprisonment was reported by 55%, 37% and 20%, respectively. Five injectors (3%) admitted to having injected in prison, but no sharing of needles and syringes was reported. Vaginal or anal sex was reported by two (1%) of the men and none of the women. Relapse to drug injecting during the week following release from prison was reported by 78/186 (42%) participants, in most cases (34%) at the very first day of release. Drug use behaviours during imprisonment were similar for those who were designated current injectors at the time of imprisonment and those who were not, but injecting in the first week following release from prison was far higher among 'current' injectors (63%) than among those who were not (11%). CONCLUSIONS: Contrary to findings from other countries, low levels of HIV risk behaviours occur among imprisoned drug injectors in The Netherlands. Intra-prison HIV preventive measures should be considered taking into account the nationally, regionally or locally varying conditions within the existing prisons.     

Sequences in the ligand-binding domains of the human androgen and progesterone receptors which determine their distinct ligand identities

A cross-sectional survey was undertaken to describe risk-taking behaviors and to assess the knowledge and risk perception of HIV and AIDS among young males aged 18 to 29 years in 82 villages in Longchuan, Yunnan, China, in 1994. Information on demographic, behavioral, and drug-using factors, and knowledge of HIV transmission and prevention, and risk perception was collected using an interviewer-administered anonymous questionnaire. A total of 1,548 individuals were interviewed and 433 drug users, including 52 nonsharing injectors and 140 sharing injectors, were identified. Over half the individuals scored 0 on HIV knowledge, but knowledge was greater among nonsharing drug injectors. Most drug injectors had initiated drug injection after 1990. The reported incidence continues to increase in all three major ethnic groups. Sharing of equipment was common (73%) among injectors. Drug users were four times more likely to have had premarital or extramarital sex, but condoms were used by only 2.5%. Thus, factors promoting spreading of HIV are common in this area. We recommend that a community-based intervention program, targeting both young men and women, be implemented and evaluated in Longchuan as soon as possible.     

Drug use and injection risk-taking among prison methadone maintenance patients

AIMS: To examine the drug use and injection risk-taking among incarcerated methadone maintenance (MM) patients; to determine the impact of a diagnosis of antisocial personality disorder (ASPD) on prison-based MM treatment; to compare incarcerated patients with community patients. DESIGN: Structured interview. SETTINGS: New South Wales (NSW) prisons and community methadone maintenance (MM) units. PARTICIPANTS: One hundred incarcerated MM patients and 183 community MM patients. MEASUREMENTS: Subjects were interviewed about drug use and needle risk-taking in the previous 6 months, and assessed for a diagnosis of ASPD. FINDINGS: Heroin had been used by 38% of prison MM patients in the 6 months prior to interview, on a median of 4.5 days. Forty-four per cent of prison patients had injected a drug in the preceding 6 months. A third (32%) of prison subjects had borrowed used injecting equipment within the preceding 6 months, and 35% had lent used injecting equipment to others. Community patients were more likely to have injected a drug in the preceding 6 months (84% vs. 44%), to have used heroin (72% vs. 38%) and to have done so more frequently (20 vs. 4.5 days). Prisoners, however, were more likely to have borrowed (32% vs. 15%) and lent (35% vs. 21%) injecting equipment in that time. While injecting at lower rates than their community counterparts, the injecting occasions of prisoners were of much higher levels of risk. A diagnosis of ASPD was unrelated to both drug use and needle risk-taking. CONCLUSIONS: Incarcerated patients injected less frequently than community patients, but had higher levels of needle risk-taking.     

Dorsal defect of the patella

The aim of this study was to measure the prevalence of HIV infection and assess the level of equipment-sharing and unsafe sexual activity among attendees at a Dublin needle exchange. Using an anonymous unlinked approach, attendees were asked to complete a brief questionnaire and provide a sample of saliva for HIV testing. Of the 144 attendees eligible for inclusion during the study period, 106 agreed to participate and complete a questionnaire, a response rate of 74%. Of the 81 respondents who submitted a usable saliva sample, 14.8% were HIV positive. Half of the respondents claimed that they had not shared equipment during the preceding 28 days, but a third had shared with multiple partners. Half of the respondents claimed that they had multiple sexual partners during the preceding year, but only a quarter said that they always used condoms. The prevalence of HIV infection is similar to that found in routine linked testing of drug users in Ireland. The high level of unsafe injecting and sexual activity makes clear the need for more effective health promotion among drug users in Dublin.     

Subpontic osseous hyperplasia: a five-patient report

As an alternative approach to individually-focused understanding of HIV risk behavior, this study explored the relationship between social network characteristics and HIV-risk injecting behaviors. Subjects were 499 inner-city injection drug users (IDUs) recruited from the streets of Baltimore, Maryland. Analysis of structural and functional network data indicates that a substantial proportion of drug sharing network members also provided social support, often because of family and sexual partner relationships. IDUs with larger drug networks which also provided social support were more likely to share needles, while IDUs with larger drug networks which did not provide social support were more likely to inject in commercial settings. The findings suggest that social support from drug network members has differential effects on injecting HIV-risk behaviors among IDUs. HIV prevention efforts should be expanded to reach drug-sharing networks and should take into account their social support relationships.     

Drug abuse in Nepal: a rapid assessment study

A rapid assessment of drug abuse in Nepal was conducted at different sites, including eight municipalities in the five development regions of the country. To interview various groups of key informants, such methods as semi-structured interviews, in-depth interviews and focus group discussions were used. A snowball sampling strategy for respondents who were drug abusers and a judgemental sampling strategy for the non-drug-using key informants were applied. About one fifth of the sample was recruited from the treatment centres and the rest from the community. Drug abusers in prison were interviewed, and secondary data from treatment centres and prisons analysed. The study revealed that the sample of drug abusers had a mean age of 23.8 years and was overwhelmingly male. Most respondents lived with their families and were either unemployed or students. About 30 per cent of the sample was married. A large majority of the sample had a family member or a close relative outside the immediate family who smoked or drank alcohol and a friend who smoked, drank or used illicit drugs. Apart from tobacco and alcohol, the major drugs of abuse were cannabis, codeine-containing cough syrup, nitrazepam tablets, buprenor-phine injections and heroin (usually smoked, rarely injected). The commonest sources of drugs were other drug-using friends, cross-border supplies from India or medicine shops. The commonest source of drug money was the family. There has been a clear trend towards the injection of buprenorphine by abusers who smoke heroin or drink codeine cough syrup. The reasons cited for switching to injections were the unavailability and rising cost of non-injectable drugs and the easy availability and relative cheapness of injectables. About a half of the injecting drug users (IDUs) commonly reported sharing injecting equipment inadequately cleaned with water. Over a half of IDUs reported visiting needle-exchange programmes at two of the study sites where such programmes were available. Infection by the human immunodeficiency virus (HIV) appears to be low among IDUs, although systematic surveillance is absent. Two thirds of the sample had experienced sexual intercourse. The last sex partners reported by respondents were commercial sex workers, wives or girl friends. Condom use was low with primary partners and relatively high with sex workers. Treatment facilities, mostly located in the central urban areas of the country, are meagre. An overwhelming majority of drug abusers felt the need to stop abusing drugs. Cost-effective drug treatment and HIV prevention programmes for IDUs are urgently needed in all areas of the country.     

Diurnal variation in clinical depression and accessibility of memories of positive and negative experiences.

Each of 12 depressed patients with diurnal mood variation was seen at 2 different times during the day. On one of these occasions they were substantially more depressed than on the other. On each occasion they recalled life experiences associated to stimulus words. At the end of the 2nd occasion they rated these experiences for happiness or unhappiness at the time the experience occurred and also for current happiness or unhappiness. Memories of experiences that had been unhappy were more likely to be retrieved on the more depressed occasion than on the less depressed occasion. Memories of experiences that had been happy were more likely to be retrieved on the less depressed occasion than on the more depressed occasion. The current hedonic tone of a recalled experience was more likely to be rated less positive (or more negative) than the original hedonic tone the more depressed a person was while making the ratings. Findings are discussed in relation to cognitive theories of the development and maintenance of depression and in relation to its treatment. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug scene roles and HIV risk

AIMS: Drug scenes (social and spatial drug-using and drug-selling environments) have complex role structures. Many drug injectors earn money or drugs as drug or syringe sellers, hit doctors (people who help others to inject) commercial sex workers, or in other roles. This paper aims to measure "role behaviors" of drug injectors; describe which drug injectors are more likely to engage in such role behaviors; and to determine whether roles are related to elements of HIV risk. DESIGN: Cross-sectional study of drug injectors. SETTING: Bushwick, a section of Brooklyn, New York, a major location for injection drug use and drug sales. PARTICIPANTS: Seven hundred and sixty-seven street-recruited drug injectors. MEASUREMENTS: Participants were interviewed about their roles, behaviors, socio-demographics and risk networks; sera were collected and assayed for HIV and hepatitis B core antibody. FINDINGS: Socio-demographic variables are related to role-holding in complex ways. Economic need is generally associated with engaging in drug-scene role behaviors. Holders of these roles are at greater behavioral and network risk for HIV and other blood-borne infections than are other drug injectors. They also engage in extensive communication with other drug users, including discussion of HIV risk reduction. CONCLUSION: Role behaviors can be measured in quantitative studies, and seem to be related to HIV risk. Role-holders may be strategic targets for risk-reduction campaigns. It seems feasible and advisable to measure drug scene role-holding in research on drug users.     

Sexual and drug use behaviors among women crack users: implications for prevention

The literature suggests that important and contributing factors in the rise of HIV and AIDS among women are crack use and the exchange of sex for drugs or money. However, not all women who use crack report they are exchanging sex for drugs or money. Thus, women are at differential risk for HIV and AIDS. The purpose of this study is to compare and describe women crack users (n = 292) who reported exchanging sex for drugs and money with women crack users who did not report exchanging sex. Results indicated that both women crack users who exchanged sex (n = 162) and women crack users who did not exchange sex (n = 130) were likely to be African American, to be about the same age, to have had incomes below +500 during the previous month, to have had similar education and martial backgrounds, to have had unprotected sexual intercourse as often, to have had similar drug use patterns, and to have initiated drug use at similar ages. However, women who exchanged sex had more sexual partners, had unprotected oral sex more often, used drugs before and during sex more often, and had a higher rate of sexually transmitted diseases than women who did not exchange sex. In addition, women who exchanged sex were also twice as likely to be homeless, four times more likely to have been in treatment, and twice as likely to have been arrested and charged/booked two or more times in their lifetime than women who did not exchange sex.     

Differences in impulsivity and risk-taking propensity between primary users of crack cocaine and primary users of heroin in a residential substance-use program.

Crack cocaine use is more associated with impulsivity and a propensity to take risks than heroin use, yet no studies have examined this relationship in the absence of acute drug effects. The current study examined impulsivity (using the Delay Discounting Task) and risk-taking propensity (using the Balloon Analogue Risk Task) across independent groups of primary crack cocaine users with minimal heroin use (n=16) and primary heroin users with minimal crack cocaine use (n=11) in residential treatment, with all participants drug abstinent during participation. Crack cocaine users evidenced greater levels of impulsivity and risk-taking propensity, with only the difference in impulsivity persisting after controlling for age and gender. These data hold potential theoretical importance in understanding differences between crack cocaine and heroin users, as the findings cannot be attributed solely to acute pharmacological drug effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Syringe exchange in Germany

Syringe exchange in Germany is clearly linked to a recent shift of local responses to drug-use(r) associated problem. Since the end of the 1980s, metropolitan communities in Northern and Central Germany-concerned by the emergence of "Open Drug Scenes," increasing HIV and mortality rates among drug users, and drug-use-related property crime-began to favor measures of survival-oriented drug-user help. While the Federal Government still favors repression and law enforcement efforts, they nevertheless made syringe exchange explicitly legal in 1992-some 5 years after the creation of local Syringe Exchange Programs. In general, the new approach of local authorities includes a variety of services, such as housing facilities, crisis intervention centers, primary medical care, maintenance with substitute drugs, and syringe exchange programs. The creation of pilot heroin maintenance programs is planned for Frankfurt and Hamburg. While the established programs are successfully functioning in large cities such as Hamburg, Bremen, and Frankfurt, the demand for sterile needles and syringes remains unmet in smaller cities and in the conservative governed Bundeslander (states), where pharmacies remain the primary and often single legal supply source for syringes. Another major problem continues to be the drug-use situation in prisons. Although injection drug use is common in prisons, injection equipment is not legally available for the 10,000 injecting drug users imprisoned at any given time. Two of Germany's 220 prisons started an experimental syringe exchange in 1996.     

Injecting risk behavior among drug users in Amsterdam, 1986 to 1992, and its relationship to AIDS prevention programs

OBJECTIVES: Serial, cross-sectional trends in injecting risk behavior were studied among drug users from 1986 to 1992. METHODS: From a cohort study in Amsterdam, 616 intake visits of drug users who had injected in the 6 months preceding intake were selected. RESULTS: The proportion of drug users who reported borrowing and lending used injection equipment and reusing needles/syringes (in the previous 6 months), continuously declined from 51% to 20%, from 46% to 10% and from 63% to 39%, respectively. In multivariate analysis, it appeared unlikely that a selective recruitment of participants over time was responsible for these trends. Participants, recruited later in time, had been previously tested for human immunodeficiency virus (HIV) more often, had received daily methadone less often, and had obtained a higher proportion of new needles via exchange programs. Indications were found that (1) voluntary HIV testing and counseling leads to less borrowing, lending, and reusing equipment; and (2) obtaining needles via exchange programs leads to less reusing needles/syringes. It appeared that nonattenders of methadone and exchange programs have reduced borrowing and lending to the same extent as attenders. CONCLUSIONS: Methodologically, evaluating specific measures is difficult. However, the combination of various preventive measures in Amsterdam is likely to be responsible for the observed decrease in injecting risk behavior.     

Risk of human immunodeficiency virus infection among pregnant crack cocaine users in a rural community

OBJECTIVE: To investigate why women who use crack cocaine are at increased risk of human immunodeficiency virus (HIV) infection. METHODS: One thousand one hundred fifty-two (99.7%) of 1155 consecutive prenatal patients attending a rural public health clinic were interviewed about drug use and sexual practices and tested for HIV infection and other sexually transmitted diseases. RESULTS: Fifty-one (4.7%) of 1096 pregnant women reported ever using crack cocaine, but only five (10%) of the crack cocaine users had ever injected drugs. Eighteen (35%) of the crack users were HIV infected compared with 22 (2%) of the 1045 women who reported never using crack (odds ratio 25, 95% confidence interval 12-52; P < .001). Crack users were more likely to have had a known HIV-infected sex partner, exchanged sex for money or drugs, and tested positive for syphilis than were non-crack users (for each comparison, P < .001). Before using crack, 18% of crack users had exchanged sex for money or drugs and 8% had averaged three or more sex partners per month; in contrast, after beginning to use crack, 76% of crack users exchanged sex for money or drugs and 63% averaged three or more sex partners per month (for both comparisons, P < .001). Crack users who were not HIV infected were more likely to have almost always used condoms and/or had fewer than three sex partners per month than were HIV-infected crack users (P < .01). CONCLUSION: Women who reported using crack cocaine were at an increased risk of HIV infection because crack use was associated with a significant increase in unprotected sexual contact.