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The purposes of this study were to examine predictors of benzodiazepine use among methadone maintenance treatment patients, to determine whether baseline benzodiazepine use influenced ongoing use during methadone maintenance treatment, and to assess the effect of ongoing benzodiazepine use on treatment outcomes (i.e., opioid and cocaine use and treatment retention). A retrospective chart review of 172 methadone maintenance treatment patients (mean age = 34.6 years; standard deviation = 8.5 years; 64% male) from January 1997 to December 1999 was conducted. At baseline, 29% were "non-users" (past year) of benzodiazepine, 36% were "occasional users," and 35% were "regular/problem users." Regular/problem users were more likely to have started opioid use with prescription opioids, experienced more overdoses, and reported psychiatric comorbidity. Being female, more years of opioid use, and a history of psychiatric treatment were significant predictors of baseline benzodiazepine use. Ongoing benzodiazepine users were more likely to have opioid-positive and cocaine-positive urine screens during methadone maintenance treatment. Only ongoing cocaine use was negatively related to retention. Benzodiazepine use by methadone maintenance treatment patients is associated with a more complex clinical picture and may negatively influence treatment outcomes.

Supervised methadone consumption is an important part of methadone maintenance treatment (MMT) but may contribute to stigma for clients. Data from qualitative interviews with MMT clients (n = 64) conducted in 2002-2003 in Canada were analyzed using thematic analytic methods. Three themes dominated clients' accounts of supervised consumption (convenient access to services, relationships with pharmacists and dispensing staff, and attributes of the dispensing space) and were interwoven with experiences of stigmatization. While some dispensing contexts may help clients manage a stigmatized identity, others confer or make visible this identity. Reducing stigmatizing experiences within dispensing environments may improve MMT outcomes and decrease barriers to treatment. The study's limitations are noted.

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Smoking is highly prevalent (85%-98%) in methadone maintenance treatment (MMT) patients. Methadone has been shown to increase cigarette smoking in a dose-dependent manner, whereas smoking/nicotine has been shown to increase methadone self-administration and reinforcing properties. The objective of this study was to evaluate methadone-nicotine interactions in MMT patients during trough and peak methadone effect conditions. Subjective effects of nicotine (administered by cigarette smoking, 4 mg of nicotine gum and placebo gum) and methadone and their combination were assessed in 40 regularly smoking, stabilized MMT patients using a randomized, placebo-controlled, within-subject study design. Subjects responded to a battery of subjective assessments before and after nicotine administration both before methadone administration (cycles 1 and 2) and 3 hours after methadone administration (cycles 3 and 4). There was a main effect of methadone on the decrease of opioid withdrawal scores (P < 0.001), and cigarette smoking enhanced this effect (day x methadone interaction, P = 0.031). Both nicotine and methadone had main effects on the decrease of nicotine withdrawal scores (P < 0.001 and P = 0.001, respectively); this was associated with the cigarette day (day x nicotine interaction, P = 0.003, and day x methadone interaction, P = 0.004). Nicotine plasma levels were highest on the cigarette smoking day (P < 0.001). Methadone and nicotine shared main effects on the increase of ratings of euphoria and drug liking and on the decrease of restlessness, irritability, and depression. The overall results may help to explain high smoking rates in the MMT population and may account for reports of increased positive effects of methadone when the drugs are taken together.

Using cost-of-illness methodology applied to a comprehensive survey of 114 daily opiate users not currently in or seeking treatment for their addiction, we estimated the 1996 social costs of untreated opioid dependence in Toronto (Ontario, Canada). The survey collected data on social and demographic characteristics, drug use history, physical and mental health status, the use of health care and substance treatment services, drug use modality and sex-related risks of infectious diseases, sources of income, as well as criminality and involvement with the law enforcement system. The annual social cost generated by this sample, calculated at Canadian $5.086 million, is explained mostly by crime victimization (44.6%) and law enforcement (42.4%), followed by productivity losses (7.0%) and the utilization of health care (6.1%). Applying the $13,100 cost to the estimated 8,000 to 13,000 users and 2.456 million residents living in Toronto yields a range of social cost between $43 and $69 per capita. KEY WORDSCost of illness, Illicit drugs, Opioid dependence.

A quantitative, descriptive and exploratory study, with a cross-sectional design aimed at investigated the role of the family, spirituality and entertainment in moderate relationship of influence of pairs and drug consuption among university students of one university. The sample was composed of 250 students from a public university in Brazil. A questionnaire was developed with 5 validated scales that interrogated about the influence of the peer group, the family relationships, the entertainment, the spirituality, and drug consumption. It was used SPSS version 18 for the statistical analysis. The data indicated that 90.8% of students had at least one friend who is drug consumer, most of them use alcohol, tobacco and marijuana. There was significant association between some academic and sociocultural factors and the consumption of licit and illicit drugs. We recommended that some preventive strategies should be elaborated considering the influence of sociocultural factors about drug consuption among university students.DESCRIPTORS: Drug abuse. University. Family. Cultural factors. Peer group. CONSUMO DE DROGAS ENTRE ESTUDIANTES UNIVERSITARIOS: FAMILIA, ESPIRITUALIDAD Y ENTRETENIMIENTO MODERADOR LA INFLUENCIA DE PARESRESUMEN: Investigación cuantitativa de tipo descriptiva-exploratoria, con diseño transversal que investigado el papel de la familia, la espiritualidad y entretenimiento en la moderá a la relación entre influencia de la pares y el consumo de drogas entre estudiantes universitarios. La muestra fue conformada por 250 estudiantes de una universidad pública brasileira de forma no probabilística. Fue elaborado un cuestionario con 5 escalas ya validadas, que interrogaba sobre la influencia del grupo de pares, las relaciones familiares, el entretenimiento, la espiritualidad y el consumo de drogas. Se utilizó el programa SPSS versión 18 para el análisis estadística. Los datos indicaran que el 90,8% de los estudiantes de la muestran reportaron tener por lo menos un amigo que consumía drogas, las drogas mas consumidas fueron alcohol, tabaco y marihuana. Se estableció asociación significativa entre algunos factores académicos y culturales con el consumo de drogas legales e ilegales Se recomienda que deben ser elaboradas estrategias preventivas considerando la influencia de los factores culturales sobre el consumo de drogas entre los estudiantes universitarios. DESCRIPTORES:Consumo de drogas. Universidad. Familia. Factores culturales. Grupo paritario. CONSUMO DE DROGAS ENTRE ESTUDANTES UNIVERSITÁRIOS: FAMÍLIA, ESPIRITUALIDADE E ENTRETENIMENTO MODERANDO A INFLUÊNCIA DOS PARESRESUMO: pesquisa quantitativa, descritiva e exploratória, com desenho transversal que investigou o papel da família, da espiritualidade e do entretenimento em moderar a relação da influência dos pares sobre o consumo de drogas entre estudantes universitários. A amostra foi composta por 250 estudantes de uma universidade pública brasileira de forma não probabilística. Foi elaborado um questionário com cinco escalas validadas que indaga...

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