Ethnic- and gender-specific differences in the prevalence of HIV among patients in opioid maintenance treatment—a case register analysis

Liebrenz, Michael; Stohler, Rudolf; Nordt, Carlos

doi:10.1186/1477-7517-11-23

Cited by 4 publications

(3 citation statements)

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“…In addition, Greenfield and colleagues (2007) identified pregnancy, lack of services for pregnant women, fear of losing custody for a new born, or fear of prosecution, coupled with lack of child care outside of treatment, to be gender-specific barriers keeping women from entering treatment for substance use disorders (Ashley, Marsden, & Brady, 2003;Schober & Annis, 1996). Furthermore, women have repeatedly been reported to experience greater social stigma and discrimination than males, when entering treatment programs for substance abuse (Kline, 1996;Liebrenz, Stohler, & Nordt, 2014). Such barriers must be addressed by crime reduction policies and strategies.…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic Information, Aversive and Traumatic Events, Offence-Related Characteristics, and Mental Health of Delinquent Women in Forensic-Psychiatric Care in Switzerland

Krammer

Eisenbarth

Fallegger

et al. 2017

Int J Offender Ther Comp Criminol

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The present study describes a much understudied group-namely, female prisoners under forensic-psychiatric care in the German-speaking part of Switzerland-to improve understanding of their risks and their needs. Data were derived from internal databases of a Forensic-Psychiatric Service. Data were collected in the form of their sociodemographic characteristics, prevalence of aversive and traumatic events, type of offence committed, and mental health conditions. Based on a full-sample approach, a total of 1,571 files were analysed. Results reveal that two thirds of the participants were not in a stable relationship, more than half did not complete a school degree, and three quarters were without stable employment prior to their incarceration. Two thirds were mothers and about one third did not grow up with their parents. Almost half grew up with an alcohol abusing parent, about half experienced violence and/or neglect in childhood, and about a quarter of the cases sexual abuse. About 95% had a mental health diagnosis according to International Classification of Diseases-Version 10 (ICD-10), and the most prevalent mental and behavioural disorder was due to psychoactive substance abuse. The most frequent offence type was drug-related crimes. Women convicted for drug-related crimes were more likely to have an ICD-10 F1 disorder compared with those convicted for other crimes. Conversely, women with violent offences were less likely to suffer from ICD-10 F1 disorder than those who had committed nonviolent offences. Findings have implications for practitioners and policy makers, and contribute to the cycle of violence theory discussion. In conclusion, future research areas are suggested.

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Section: Discussionmentioning

confidence: 99%

Sociodemographic Information, Aversive and Traumatic Events, Offence-Related Characteristics, and Mental Health of Delinquent Women in Forensic-Psychiatric Care in Switzerland

Krammer

Eisenbarth

Fallegger

et al. 2017

Int J Offender Ther Comp Criminol

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“…This finding suggests that BZD dependence in this group could have partly been avoided by offering low-threshold access to treatment [ 53 , 54 ]. Although it has been suggested that this reason for initiating BZD use has decreased in importance because of the increased availability of OMT in Switzerland over the last decades [ 55 , 56 ], it might still be a significant factor for patients elsewhere who have less access to maintenance therapy [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

High-Dose Benzodiazepine Dependence: A Qualitative Study of Patients’ Perceptions on Initiation, Reasons for Use, and Obtainment

et al. 2015

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BackgroundHigh-dose benzodiazepine (BZD) dependence is associated with a wide variety of negative health consequences. Affected individuals are reported to suffer from severe mental disorders and are often unable to achieve long-term abstinence via recommended discontinuation strategies. Although it is increasingly understood that treatment interventions should take subjective experiences and beliefs into account, the perceptions of this group of individuals remain under-investigated.MethodsWe conducted an exploratory qualitative study with 41 adult subjects meeting criteria for (high-dose) BZD-dependence, as defined by ICD-10. One-on-one in-depth interviews allowed for an exploration of this group’s views on the reasons behind their initial and then continued use of BZDs, as well as their procurement strategies. Mayring’s qualitative content analysis was used to evaluate our data.ResultsIn this sample, all participants had developed explanatory models for why they began using BZDs. We identified a multitude of reasons that we grouped into four broad categories, as explaining continued BZD use: (1) to cope with symptoms of psychological distress or mental disorder other than substance use, (2) to manage symptoms of physical or psychological discomfort associated with somatic disorder, (3) to alleviate symptoms of substance-related disorders, and (4) for recreational purposes, that is, sensation-seeking and other social reasons. Subjects often considered BZDs less dangerous than other substances and associated their use more often with harm reduction than as recreational. Specific obtainment strategies varied widely: the majority of participants oscillated between legal and illegal methods, often relying on the black market when faced with treatment termination.ConclusionsIrrespective of comorbidity, participants expressed a clear preference for medically related explanatory models for their BZD use. We therefore suggest that clinicians consider patients’ motives for long-term, high-dose BZD use when formulating treatment plans for this patient group, especially since it is known that individuals are more compliant with approaches they perceive to be manageable, tolerable, and effective.

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“…This effect could be related either to additive hERG channel blockade or to increased serum drug concentrations resulting from changes in metabolism . An estimated 10–15% of all heroin users are HIV‐positive , and medication‐assisted opioid treatment programs provide structure including directly administered treatment that increase adherence to anti‐retroviral therapy . Therefore, HIV‐positive opioid addicts on anti‐retroviral therapy may represent an important subgroup of patients at higher risk of cardiac arrhythmia due to QTc prolongation.…”

Section: Discussionmentioning

confidence: 99%

Arrhythmia associated with buprenorphine and methadone reported to the food and drug administration

et al. 2015

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Aim To assess the relative frequency of reporting of adverse events involving ventricular arrhythmia, cardiac arrest, QTc prolongation, or torsade de pointes to the US Food and Drug Administration (FDA) between buprenorphine and methadone. Design Retrospective pharmacoepidemiologic study Setting Adverse drug events spontaneously reported to the FDA between 1969-June 2011 originating in 196 countries (71% events from the US). Cases Adverse event cases mentioning methadone (n=14,915) or buprenorphine (n=7,283) were evaluated against all other adverse event cases (n= 4,796,141). Measurements The primary outcome was the composite of ventricular arrhythmia or cardiac arrest. The secondary outcome was the composite of QTc prolongation or torsade de pointes. The proportional reporting ratio (PRR) was used to identify disproportionate reporting defined as a PRR>2, χ2 error>4, with ≥3 cases. Findings There were 132 (1.8%) ventricular arrhythmia/cardiac arrest and 19 (0.3%) QTc prolongation/torsade de pointes cases associated with buprenorphine compared with 1729 (11.6%) ventricular arrhythmia/cardiac arrest and 390 (2.6%) QTc prolongation/torsade de pointes cases involving methadone. PRRs associated with buprenorphine were not significant for ventricular arrhythmia/cardiac arrest (1.1 95% confidence interval (CI) 0.9–1.3, χ2=1.2) or QTc prolongation/torsade de pointes (1.0 95% CI 0.7–1.9, χ2=0.0006), but were for methadone (7.2 95% CI 6.9–7.5, χ2=9160; 10.6 95% CI 9.7–11.8, χ2=3305, respectively). Conclusion In spontaneously reported adverse events, methadone is associated with disproportionate reporting of cardiac arrhythmias, whereas buprenorphine is not. Although these findings probably reflect clinically relevant differences, a causal connection cannot be presumed and disproportionality analysis cannot quantify absolute risk per treatment episode. Population-based studies to definitively quantify differential incidence rates are warranted.

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Ethnic- and gender-specific differences in the prevalence of HIV among patients in opioid maintenance treatment—a case register analysis

Cited by 4 publications

References 71 publications

Sociodemographic Information, Aversive and Traumatic Events, Offence-Related Characteristics, and Mental Health of Delinquent Women in Forensic-Psychiatric Care in Switzerland

Sociodemographic Information, Aversive and Traumatic Events, Offence-Related Characteristics, and Mental Health of Delinquent Women in Forensic-Psychiatric Care in Switzerland

High-Dose Benzodiazepine Dependence: A Qualitative Study of Patients’ Perceptions on Initiation, Reasons for Use, and Obtainment

Arrhythmia associated with buprenorphine and methadone reported to the food and drug administration

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