Hepatitis Infection Soars in IV Drug Users Worldwide

In a study published July 28th, 2011 in The Lancet,  Paul Nelson, from the National Drug and Alcohol Research Center at the University of New South Wales in Sydney, and colleagues, reported their analysis of  data from multiple international reporting sources. They found that rates of hepatitis C infection among injection drug users (IDUs) were 60 to 80 percent in 25 countries and greater than 80 percent in 12 other countries. Hepatitis can lead to cirrhosis, liver cancer and liver failure. It is the number one reason for liver transplants in the US.

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The results show that the top countries for infection were: The United Kingdom (50 percent), New Zealand (52 percent), Australia (55 percent), Spain (80 percent), Norway (76 percent), Germany (75 percent), France (74 percent), United States (73 percent), China (67 percent), Canada (64 percent), Italy (81 percent), Portugal (83 percent), Pakistan (84 percent), the Netherlands (86 percent), Thailand (90 percent) and Mexico (97 percent).

According to the researchers:

“The public-health response to blood-borne virus transmission in IDUs has mainly centered on HIV. Maintenance and strengthening of the response to HIV in IDUs remains crucial, but the significance of viral hepatitis needs to receive greater attention than it does at present,”

“Efforts to prevent, treat, and reduce harms related to liver disease in IDUs are essential — especially in situations in which HIV has successfully been prevented or managed — because the large numbers of IDUs infected with HCV and significant morbidity resulting from this infection mean that the health and economic costs of HCV transmitted by injected drug use might be as high as (or higher than) those of HIV.”

“Nonetheless, HCV treatment is underused. Part of the reason for this neglect is the high cost, which will remain a substantial barrier to increasing of treatment coverage in low-resource settings until costs are reduced”

Of course, enlightened clean-needle programs and similar measures could substantially reduce the incidence and cost of infections, but only a few countries — conspicuously not including the United States — have seen fit to implement such measures.

Injection Drug Users Need Targeted Help — Study

A study published in the July Journal of Addictive Diseases indicates what those of us in the treatment field have long known: that injection drug users, regardless of what kind of drugs they use, are at the greatest risk for associated medical problems, psychological problems and death, and most in need of effective intervention and treatment.  This is true despite the fact that injection users represent a relatively small percentage of alcohol and drug addicts as a whole.

Image - DEA

Because of the circumstances surrounding injection, which include overdose, infection, transmission of blood-borne diseases by dirty “works,” accompanying higher rates of abuse and addiction (as opposed to occasional use), and diverse psychological problems, the authors of the study believe that their findings can help spur targeting of these individuals.

The researchers analyzed data from the National Survey on Drug Abuse and Health, which is conducted annually on roughly 70,000 children and adults in order to gain a statistically accurate overview of the current state of drug use and abuse in the United States.  The study showed that injection drug users were likely to be older than other abusers and addicts, more likely to live in rural areas, be unemployed, and not have achieved graduation from high school or its equivalent in education.  Unemployment was one of the major issues defining the group.

Lead author Scott Novak, senior behavioral health epidemiologist at RTI International, stated “Our findings indicate that injection drug use is associated with substantially more substance abuse-related problems than non-injection drug use, including a higher prevalence of dependence, unemployment, and co-occurring mental and physical disorders.  “These problems appear to characterize a treatment-resistant population in need of specialized treatments.”

RTI International provides research and technical services to governments and businesses in the areas of health and pharmaceuticals, education and training, surveys and statistics, advanced technology, international development, economic and social policy, energy and the environment, and laboratory testing and chemical analysis.

These Are Our Lives

My older daughter, Tanya, turned me on to this site.  Its purpose is to provide oral histories in interview form, and I think it's a great idea.  As it happens, I know the woman who started it, and I think I probably know the young woman whose story I'm about to recommend.  (I'm not sure about the latter, though, and I don't need to know.)  However, that's not the reason I'm doing it.

In short, this is one of the best and — I believe — most honest stories about addiction and alcoholism that I've ever seen in print, and one of the best I've heard, period (and trust me: after more than 20 years of listening to stories, I'm no longer easily impressed).  Active addicts, those in recovery, and their families will get a lot out of  this interview with an extremely articulate woman who has clearly thought a lot about her life and how she got where she was — and is.

Please read it.  Pass it on, recommend it to your friends and acquaintances, link to it on your blogs.  Tweet about it.  Mention it on Facebook.  This is a story, and a site, that needs to be seen and heard.  I'd wish Molly good luck with her blog, but if she's able to keep this level of material coming, success is a foregone conclusion.

These Are Our Lives: Chrissy's Story

Oxymorphone — an increasing threat for overdose among drug abusers

Recent reports indicate a rise in the abuse of oxymorphone (Opana® and Opana ER®) a semi-synthetic opiate drug related to Percodan, Percocet and Oxycontin. Like the other opiates, it is used as an analgesic for moderate to severe pain.  However, because of some unusual characteristics of the drug, overdoses and deaths from oxymorphone abuse are on the rise, and likely to continue to increase.

Oxymorphone in varied strengths - USDOJ

Since January of 2008, oxymorphone deaths have been reported in California, Colorado, Connecticut, Florida, Michigan, New Mexico, North Carolina, Ohio, South Dakota, Washington, Tennessee and Kentucky. Between January and April of 2011, there were nine deaths in Louisville, KY alone. Newport, TN officials reported five fatalities within a three month period in March of 2009. Other deaths may have been oxymorphone-related as well, since toxicology results may not have been available for some victims at the time the reports were made. Like abuse of other prescription opiates, cases seem to be clustered in, but by no means limited to, areas with economic depression and high unemployment, and in areas such as Florida, where prescription drug mills proliferate.

Oxymorphone is known as: blues, biscuits, octagons, stop signs, pink, pink heaven, biscuits, Mrs O, Orgasna IR, OM, Pink O, The O Bomb and a variety of other names. Like other opiate drugs, it causes feelings of euphoria, well-being, increased sociability and similar effects that make it a desirable drug of abuse. The euphoria is usually less intense than with the other opioid drugs, and there is a tendency to take larger doses to obtain the desired level of intoxication. This, along with the fact that the effects of the drug vary widely among individuals due to physical condition, the presence of other drugs, food eaten and other factors, creates a situation where the “right” dose for one person may have little effect on another, while creating extreme intoxication or overdose in a third.

These circumstances are further complicated by the fact that when taken with alcohol, the availability and effects of the drug are nearly doubled — in addition to the added effects of the alcohol itself. These three factors, varying response, relatively low euphoric effect, and the synergistic effect with alcohol, combine to create a “perfect storm” for overdose. This is especially true in those who purposely attempt to enhance the effect of the drug by drinking. Oxymorphone overdose typically involves lethargy, relaxed muscles, respiratory depression and sometimes low blood pressure, progressing to coma, cardiac and respiratory collapse, and death if not treated quickly.

We will be hearing more about Opana® and oxymorphone abuse, addiction and overdose in the coming months. Parents, professionals and law enforcement, in particular, need to be aware of this “new” and deadly trend in illicit drug use.  Even more, we need to be aware that these tragedies are, to a great extent, avoidable. Painkiller abuse and addiction are treatable conditions.  Addiction is a recognized disease that responds well to proper treatment and aftercare.  The ill-conceived “War on Drugs” has diverted billions of dollars into an unproductive endeavor that does nothing to address the root of the problem — the drug users who make dealing profitable.  We need to develop a national policy of education, treatment and rehabilitation, and act as though we mean it.  It would save a lot of money but, more importantly, it would save a lot of lives.

Drug abuse costs rival those of chronic diseases

Drug abuse in the US (not including alcohol) costs the economy $193 billion a year, according to a new report.  That figure equals or exceeds the cost of chronic diseases such as diabetes.

Read about it…

How Do Drugs Lead To Diseases Like AIDS And Hepatitis?

Drugs (including alcohol) lead to physical problems in three ways. First of all, the drugs themselves can damage bodily systems. Cirrhosis of the liver, pancreatitis, alcoholic dementia, neurological damage due to heavy drug use, premature aging and diseases of the circulatory system are examples of direct harm to the body. The association of drug use with diseases such as HIV/AIDS, hepatitis and other pathogenic diseases (diseases caused by bacteria or virus) is less obvious, until we look at it closely.

Why do people abuse drugs? In every case, it is because we want to change the way we feel. Non-addicts want to feel differently from their “normal” state of mind and body. Addicts, on the other hand, want to feel better — because they hurt emotionally, and often physically, when they don’t use.

Photo: Don Hankins – Flickr

If there is one thing we can say about all drugs of abuse, it is that they change our view of the world. They may make us more cheerful, give us more energy, make us sleepy, cause euphoria, enable us to concentrate or perform at a higher level physically, make us feel “peaced out,” or combinations of these things. Frequently they make us stupid, as well.

A sober person might not pick up a stranger and have unprotected sex but, as we know, everyone becomes a prince or a princess as the evening wears on and intoxication increases. So we do things like having sex with strangers, sometimes prostitutes, and sometimes in ways that we might not consider if we were not impaired.


The same is true of intravenous drug users. A sober person might never consider sharing needles or “works” with someone else, taking the risk of injecting blood-borne pathogens like the hepatitis and HIV viruses. However, the rituals of sharing are a part of the drug subculture for many people, from drinking with a buddy to sharing a joint to sharing needles and syringes. Furthermore, when an addict is in the throes of withdrawal, his or her interest is decidedly not on hygiene. Hepatitis and HIV are not uncommon problems among addicts, along with a variety of other blood-borne diseases.

The third effect of alcohol and other drugs on health comes from self-neglect. People who are drunk or high, or busy seeking the means to become so, are less likely to pay attention to things like nutrition, medical and dental care, personal hygiene, exercise and the other things that make up a healthy lifestyle. Alcoholics, in particular, are likely to be heavy users of cigarettes and other tobacco products. Years of that sort of neglect take their toll, and also increase the damage from other potential health hazards.

That is why virtually all addicts and alcoholics who do not recover are eventually killed by their disease. An alcoholic who burns to death from smoking in bed is killed by addiction as surely as the victim who dies with a needle in his arm.  Finally, however, the greatest hazard is not from overdose or accidents, but simply from the body’s inability to deal with the abuses that it suffers due to the addictive lifestyle.

Opioids are now the most-prescribed class of drugs in America

Two reports published in the Journal of the American Medical Association (JAMA) show a huge shift in the pattern of prescribing by doctors.  They suggest that better training for prescribers and assessment of pain management programs are needed, among other steps to reduce opioid abuse.

The JAMA Research Report shows that there has been a drastic increase in opioid prescriptions while prescriptions for non-steroidal anti-inflammatory drugs (NSAIDs) have gone down. Prescriptions for hydrocodone and oxycodone account for 84.9 percent of opioid prescriptions. Over ten years, there has been a fivefold increase in admissions to substance abuse programs for opioid addiction.

Read the rest…