Risk Factors for Methadone Outside Treatment Programs: Implications for HIV Treatment Among Injection Drug Users
September 7, 2007
"Diversion of methadone outside treatment programs occurs, yet reasons for use of 'street methadone' are characterized poorly. Self-medication for withdrawal symptoms is one plausible hypothesis. Among HIV-infected drug users, some antiretroviral medications can reduce potency of methadone, yet any association between such effects and the use of supplemental methadone sources remains undetermined," explained the study authors, who sought to estimate the frequency and risk factors for use of street methadone.
The researchers followed injection drug users (IDUs) recruited through extensive community outreach in 1988-89 and 1994, using semi-annual questionnaires about health history, use of licit and illicit drugs such as methadone, and HIV-related assays. Analyses were conducted using generalized estimating equation logistic regression.
Analysis of 2,811 eligible and enrolled IDUs found 493 reported use of street methadone over 12,315 person-years of follow-up (4.0/100 person-years). According to multivariate analyses, street methadone use was more common among women, whites, those ages 40-59, those who reported withdrawal symptoms, past methadone program attendance (6-12 months prior to visit), recent heroin injection with or without cocaine (but not cocaine alone), smoking or sniffing heroin and reported trading sex. HIV infection or treatment was not associated with street methadone.
"The results suggest that older IDUs still using heroin may be using street methadone to treat signs of withdrawal. The absence of a higher rate of street methadone use in HIV seropositive IDUs reveals that antiretroviral/methadone interactions are not a primary determinant of use outside of treatment settings," the authors concluded.
05.2007; Vol. 102; No. 5: P. 771-777; D. Vlahov; P. O’Driscoll; S.H. Mehta; D.C. Ompad; R. Gern; N. Galai; G.D. Kirk
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.