Suchergebnisse

Supervised injection facilities (SIFs) have been shown to reduce infection, prevent overdose deaths, and increase treatment uptake. The United States is in the midst of an opioid epidemic, yet no sanctioned SIF currently operates in the United States. We estimate the economic costs and benefits of establishing a potential SIF in San Francisco using mathematical models that combine local public health data with previous research on the effects of existing SIFs. We consider potential savings from five outcomes: averted HIV and hepatitis C virus (HCV) infections, reduced skin and soft tissue infection (SSTI), averted overdose deaths, and increased medication-assisted treatment (MAT) uptake. We find that each dollar spent on a SIF would generate US$2.33 in savings, for total annual net savings of US$3.5 million for a single 13-booth SIF. Our analysis suggests that a SIF in San Francisco would not only be a cost-effective intervention but also a significant boost to the public health system.

Drug paraphernalia laws in 47 U.S. states make it illegal for injection drug users (IDUs) to possess syringes. It has been suggested that these laws lead to syringe sharing by deterring IDUs from carrying their own syringes. We examined the relationship between concern about arrest while carrying drug paraphernalia and injection-related risk behaviors among street-recruited IDUs in Northern California. In 1996, 424 IDUs were interviewed, of whom 76 percent were African American, 36 percent were female, and 15 percent were HIV positive. Thirty-five percent (150) reported concern about being arrested while carrying drug paraphernalia. In multivariate analyses that controlled for potential confounders, IDUs concerned about being arrested were significantly more likely than other IDUs to share syringes (adjusted odds ratio [AOR] =2.28; 95 percent confidence interval [Cl]=1.19, 4.34) and injection supplies (AOR= 3.23; 95 percent Cl=2.03, 5.13). These data suggest that decriminalizing syringes and needles would likely result in reductions in the behaviors that expose IDUs to blood borne viruses.

This study described the prevalence and risk factors for nonmedical prescription drug use (NMPD) among injection drug users (IDUs) recruited at syringe exchange programs (SEPs) in California. Interviews were conducted with 1,586 IDUs recruited from 24 SEPs across three annual cross-sections between 2001 and 2003. Any NMPD use in the past 6 months was reported by 17% of the sample. Factors independently associated with depressant use include recent participation in a drug treatment program, recent injection of heroin, and frequency of injection. Factors independently associated with opioid use include frequency of injection and history of incarceration. NMPD depressant use increased the odds of a nonfatal overdose in the past year. The authors' findings represent a first step toward creating an epidemiologic profile of NMPD use that may be useful for targeting the implementation of interventions that are effective in reducing overdoses, a significant cause of mortality among IDUs worldwide.

We examined whether gang membership history was associated with earlier age of first drug use, first drug injection, and shorter time to injection (TTI) drug use among people who inject drugs (PWID). PWID ( N = 438) were interviewed in California (2011-2013). Surveys addressed demographics, current/former drug use practices, gang membership, and parental drug use. Multivariate analyses were conducted to identify whether gang membership history was associated with age at first drug use, first injection drug use, and TTI. Gang membership was reported by 23% of sample. Gang membership history was associated with earlier ages of first drug use (–1.35 years; 95% confidence interval [CI]= [−0.50, −2.20]), age at first injection (–1.89 years; 95% CI = [0.00, −3.78]), but not TTI. Gang involvement facilitates drug use including earlier age of first injection drug use.