Nutritional assessment of drug addicts. Relation with HIV infection in early stages

Gómez-Sirvent, J.L.; Santolaria-Fernández, Francisco; González-Reimers, C.E.; Batista-López, J.N.; Jorge-Hernández, J.A.; Rodríguez-Moreno, F.; Martı́nez-Riera, Antonio; Hernández-García, M

doi:10.1016/0261-5614(93)90055-9

Cited by 9 publications

(6 citation statements)

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“…Despite the importance of diet and nutrition to human health, the overall volume of research investigating the nutritional status and dietary habits of heroin users is small. Studies have, however, been undertaken in many countries and point repeatedly to malnutrition [1–5], low body weight [1,3,6–8] and essential nutrient and vitamin deficiencies [3,9–12]. There is evidence of worse nutritional status and lowered body mass index (BMI) among female drug users [2,8], those sleeping on the streets [8], those with more severe addiction [2,13] and those with disturbed social and family links [2,8].…”

Section: Introductionmentioning

confidence: 99%

Eating patterns among heroin users: a qualitative study with implications for nutritional interventions

et al. 2012

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Section: Introductionmentioning

confidence: 99%

Eating patterns among heroin users: a qualitative study with implications for nutritional interventions

et al. 2012

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“…MetS represents a complex pathophysiological condition that may develop in OUD patients [54][55][56][57] even independent of MAT, from increased caloric intake, decreased energy expenditure owing to reduced physical activity or a combination of both 8,21 . This assertion is however undermined by: (1) preponderance of studies reporting low body weight in short half-life opioid (e.g., heroin) abusers who are not on MAT agonist therapy [58][59][60][61] even in the face of glucoregulatory abnormalities [62][63][64] ; and (2) excessive BWG consistently noted in OUD patients following the initiation of methadone [65][66][67][68][69][70][71] and to a lesser degree buprenorphine 6,7,72 treatment. Nonetheless, the debate about the issue is still ongoing 73 with a number of reports on the opposite directionality of the metabolic responses 74,75 , including hemoglobin A1C level decreases in buprenorphine-maintained NIDDM patients 76 in conjunction with heightened insulin sensitivity in methadone-treated OUD patients 77 as well as hypoglycemia in patients receiving chronic analgesia with methadone 78 .…”

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confidence: 99%

Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone

Elman

Howard²,

Borodovsky

et al. 2020

Sci Rep

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Metabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use disorder (OUD) with buprenorphine or methadone. Plasma lipids, hemoglobin A1C, body composition, the oral glucose tolerance test (oGtt) and the Sweet taste test (Stt) were measured in buprenorphine-(n = 26) or methadone (n = 32)-treated subjects with OUD. On the whole, the subjects in both groups were overweight or obese and insulin resistant; they displayed similar oGtt and Stt performance. As compared to methadone-treated subjects, those on buprenorphine had significantly lower rates of metabolic syndrome (MetS) along with better values of the high-density lipoproteins (HDL). Subjects with-vs. without MetS tended to have greater addiction severity. correlative analyses revealed that more buprenorphine exposure duration was associated with better HDL and opioid craving values. in contrast, more methadone exposure duration was associated with worse triglycerides-, HDL-, blood pressure-, fasting glucose-and hemoglobin A1C values. Buprenorphine appears to produce beneficial HDL-and craving effects and, contrary to methadone, its role in the metabolic derangements is not obvious. our data call for further research aimed at understanding the distinctive features of buprenorphine metabolic effects vis-à-vis those of methadone and their potential role in these drugs' unique therapeutic profiles. Opioid use disorder (OUD) is an ominous public health problem afflicting about 16 million people worldwide 1. In the US, OUD constitutes the seventh cause for disability-adjusted life-years 2-4 ; including opioids' propensity 5 for the excessive body weight gain (BWG) and its medical sequelae in the form of the 'Metabolic Syndrome' (MetS) 5-7 , that is to say, a cluster of interrelated cardiometabolic risk factors comprised of insulin resistance, impaired glucose tolerance, dyslipidemia, abdominal adiposity and hypertension 8-10. Consequently, even though medication-assisted treatment (MAT) via opioid agonist replacement with long-acting opioids namely, buprenorphine and methadone, usually yields positive clinical outcomes in terms of overdose mortality, infectious diseases, crime, and societal ties 11-14 concerns have been raised about further worsening of the metabolic status 5. There are several lines of evidence that link OUD to metabolic derangements. With regard to genetic antecedents, the TCF7L2 gene codes a transcription factor implicated 15,16 in non-insulin-dependent

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“…Retainment in the program in the initial phase of OST tends to increase the patient’s chance of obtaining long-term stability and abstinence from the addicted drug [ 26 ]. Patients often need to work on repairing relationships, treating other health issues (HIV [ 5 , 8 ], malnutrition [ 29 ], and mental health disorders [ 30 ]), and gain financial stability via a regular income source [ 22 , 28 , 31 ]. In order for patients to achieve these goals they require OST to treat the physical withdrawal symptoms caused by ceasing the use of the abused drug.…”

Section: Discussionmentioning

confidence: 99%

The impact of dispensing fees on compliance with opioid substitution therapy: a mixed methods study

Shepherd

Perrella

Hattingh

2014

Subst Abuse Treat Prev Policy

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BackgroundOpioid substitution therapy (OST) programs involve the dispensing of OST medicines to patients to address their dependence on heroin and/or other opioid substances. OST medicines are subsidised by the Australian government but patients need to pay the dispensing fees. This study explored opinions from OST patients and stakeholders about the potential impact of dispensing fees on compliance and OST program retention. Current and past experiences and the potential impact of OST dispensing fees were evaluated.MethodsMixed methodology was used to obtain data from OST patients and stakeholders. This involved 1) interviews with OST stakeholders, 2) a focus group of OST patients and 3) surveys of OST patients in Perth, Australia, between June and August 2013.ResultsThe majority of the eight stakeholders declared cost as the factor mostly impacting on OST compliance. Almost all of the stakeholders commented that there was a positive correlation between time on the OST program and success in terms of relapse. Most stakeholders advocated for OST fees to contribute towards the Pharmaceutical Benefits Scheme Safety Net, and for fee subsidy. Focus group themes supported stakeholder interview findings. A total of 138 surveys were completed. Survey analysis illustrated a strong correlation between patient debt and impacted lifestyle: 82.4% (p < 0.001, Chi-square test) of the 138 survey participants stated that dispensing fees impacted significantly on patients’ finances and lifestyle, specifically those patients with major debt. The cost of dispensing fees was identified by 46.3% (64/138) of survey participants as the biggest impacting factor on patient success. Logistic regression models showed that the cost of dispensing fees was also found to significantly influence both the occurrence of debt (57.7%, p < 0.0001) and lifestyle difficulties (80.0%, p = 0.0004).ConclusionFindings provided insight into OST patients’ financial difficulties with data suggesting that dispensing fees are likely to have a negative impact on OST patients’ compliance with therapy, retention in the OST program and lifestyle. Government sponsorship of the OST dispensing fees should be considered as sponsorship would potentially increase the retention rates of income-poor OST program recipients.

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Nutritional assessment of drug addicts. Relation with HIV infection in early stages

Cited by 9 publications

References 20 publications

Eating patterns among heroin users: a qualitative study with implications for nutritional interventions

Eating patterns among heroin users: a qualitative study with implications for nutritional interventions

Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone

The impact of dispensing fees on compliance with opioid substitution therapy: a mixed methods study

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