A multilevel approach for assessing the variability of hepatitis C prevalence in injection drug users by their gathering places.

Filed under: Methadone Clinics

Int J Infect Dis. 2012 Nov 16;
Wong NS, Chan PC, Lee SS, Lee SL, Lee CK

OBJECTIVES: The aim of this study was to investigate the variation in hepatitis C virus (HCV) prevalence in injection drug users (IDUs) by their gathering places, using a multilevel approach. METHODS: IDUs recruited from their gathering places were invited to respond to a questionnaire on demographics, drug use history, injection behaviors, and methadone treatment. Dried blood spots were collected for HCV antibody testing by ELISA. Factors associated with the anti-HCV test result were explored by linear logistic regression, followed by the evaluation of heterogeneity between gathering places by multilevel analysis. RESULTS: A total of 622 respondents from 19 gathering places in Hong Kong, recruited between August and September 2011, were evaluated. Anti-HCV seroprevalence was 81.7% (95% confidence interval 78.6-84.7%), ranging from 67% to 100% by gathering place. HCV infection was associated with current practice of injection, needle-sharing, and midazolam injection. On multilevel analysis, there was a modest but significant variation in HCV antibody prevalence by gathering place, adjusted by midazolam injection (adjusted odds ratio (AOR) 3.91) and current injection (AOR 2.88) or injection over a long duration (AOR 3.17). CONCLUSIONS: There was heterogeneity in HCV antibody prevalence in IDUs by gathering place, while the influence of injection behaviors varied, suggesting interactivity between factors at the individual and group levels.
HubMed – Methadone

Deficits in social perception in opioid maintenance patients, abstinent opioid users and non-opioid users.

Filed under: Methadone Clinics

Addiction. 2012 Nov 16;
McDonald S, Darke S, Kaye S, Torok M

AIMS: This study aimed to compare emotion perception and social inference in opioid maintenance patients with abstinent ex-users and non-heroin using controls, and determine whether any deficits in could be accounted for by cognitive deficits and/or risk factors for brain damage. DESIGN: Case control. PARTICIPANTS: 125 maintenance patients (MAIN), 50 abstinent opiate users (ABST) and 50 matched controls (CON). MEASUREMENTS: The Awareness of Social Inference Test (TASIT) was used to measure emotion perception and social inference. Measures were also taken of executive function, working memory, information processing speed, verbal/ non-verbal learning, and psychological distress. FINDINGS: After adjusting for age, sex, pre-morbid IQ and psychological distress, the MAIN group was impaired relative to CON (?=-.19, p<.05) and ABST (?=-.19, p<.05) on emotion perception and relative to CON (?=-.25, p<.001) and ABST (?=-.24, p<.01) on social inference. In neither case did the CON and ABST groups differ. For both emotion perception (p<.001) and social inference (p<.001) premorbid IQ was a significant independent predictor. Cognitive function was a major predictor of poor emotion perception (?=-.44, p<.001) and social inference (?=-.48, p<.001). Poor emotion recognition was also predicted by number of heroin overdoses (?=-.14, p<.05). Neither time in treatment or type of maintenance medication (methadone or buprenorphine) were related to performance. CONCLUSIONS: People in opioid maintenance treatment may have an impaired capacity for emotion perception and ability to make inferences about social situations. HubMed – Methadone

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