Diversion of Benzodiazepines through Healthcare Sources.

J Psychoactive Drugs. 2013; 45(1): 48-56
Ibañez GE, Levi-Minzi MA, Rigg KK, Mooss AD

Benzodiazepines (BZ) are often diverted from legal sources to illicit markets at various points in the distribution process which begins with a pharmaceutical manufacturer, followed by distribution to healthcare providers, and finally, to the intended users. Little is known about the extent of BZ diversion involving distribution points directly related to healthcare sources (e.g., a script doctor) as opposed to points further down the distribution chain (e.g., street dealers). The present study examines the scope of BZ diversion via mechanisms directly related to a healthcare source. It examines the association between BZ dependence and the direct utilization of particular healthcare-related diversion sources among a diverse sample of prescription drug abusers in South Florida.Cross-sectional data were collected from five different groups of drug users: methadone-maintenance clients (n = 247), street drug users (n = 238), public-pay treatment clients (n = 246), private-pay treatment clients (n = 228), and stimulant using men who have sex with men (MSM; n = 248).Findings suggest that those ages 26 to 35 years old, non-Hispanic White participants, private-pay treatment clients, those who are insured, and those with higher incomes had higher odds of utilizing healthcare diversion sources. Participants utilized a pharmacy as a diversion source more than other healthcare sources of diversion, and the highest number of BZs were obtained from doctor shopping compared to other diversion sources. Those who reported BZ dependence also had 2.5 times greater odds of using a healthcare source to obtain BZs than those who did not meet criteria for dependence.Prevention of BZ diversion through healthcare sources should include strategies to reduce doctor shopping and diversion from pharmacies.
HubMed – Methadone

Injecting drug users, sex workers and men who have sex with men: a national cross-sectional study to develop a framework and prevalence estimates for national HIV/AIDS programmes in the Republic of Serbia.

BMJ Open. 2013; 3(5):
Comiskey C, Dempsey O, Simic D, Baros S

The aim of this study was to develop a framework and best estimates of prevalence for the most at risk populations (MARPs) for HIV/AIDS to include sex workers (SW), men who have sex with men (MSM) and injecting drug users (IDUs) in order to evaluate national HIV/AIDS programmatic targets across the Republic of Serbia.A national, cross-sectional study and direct enumeration, multiplier and benchmark methods with integrated bio-behavioural surveys, capture/recapture and methods with Wald and Clopper-Pearson CIs were used.This study was carried out in the three largest cities and main regions of Serbia, the capital city, Belgrade, (population 1 639 121 persons), the Vojvodina region with main city Novi Sad (population 335 701) and the rest of Serbia with main city Nis (population 257 867).A total of 1301 respondents from the defined MARPs completed the survey in the 2009/2010 period across the three cities.Estimates of the hidden numbers at risk of HIV/AIDS.It was estimated that there were 1775-6027 SW between 18 and 49 years in Serbia in 2009. For MSM, national estimates for 2009 ranged from 20 789 to 90 104 individuals aged between 20 and 49 years. For IDU, a possible range of 12 682-48 083 individuals aged between 15 and 59 years in 2009 was estimated.For service planning across Central and Eastern Europe, it is important to highlight how credible estimates can be achieved and compared with numbers within HIV/AIDS-prevention programmes. Within needle exchange programmes, only 5.4-20.5% of the estimated population was observed and this proportion was lower within methadone treatment data. Results have implications for future IDU treatment and HIV incidence and spread across all populations at risk.
HubMed – Methadone

Psychosocial characteristics and poly-drug use of pregnant women enrolled in methadone maintenance treatment.

Neurotoxicol Teratol. 2013 Apr 29;
Davie-Gray A, Moor S, Spencer C, Woodward LJ

HubMed – Methadone

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