BACKGROUND In eastern Europe, the high prevalence rates of HIV and the hepatitis C virus (HCV) are concentrated among injecting drug users (IDUs). Harm reduction programmes such as needle and syringe programmes and opioid substitution therapy (OST) have been shown to be effective in preventing these infections. However, structural barriers can limit their effectiveness by hindering access. ME...

This policy brief reviews the evidence to date on providing antiretroviral (ARV) therapy to HIV-positive injecting drug users. A number of related medical, psychological and social issues are also addressed including the need to manage drug interactions and the benefi t of harm reduction interventions in supporting optimum care for HIV-positive injecting drug users. General issues related to HI...

A. The endogenous opioid system and natural reinforcement 1383 B. The endogenous opioid system and drugs of abuse 1387 C. Perspectives: extending studies to animal models of drug addiction 1393 IV. Genetic Manipulation of the Opioid System, Reinforcement, and Drug Dependence 1393 A. Opioid receptor knockout mice 1393 B. Opioid peptide knockout mice 1394 C. Conclusion 1395 D. Perspectives: towar...

BACKGROUND Tajikistan and other Central Asian republics are facing intertwined epidemics of injecting drug use and HIV. This paper aims to examine drug scene, drug use, drug-related infectious diseases, drug treatment and other responses to health consequences of drug injecting in two Tajik cities of Kulob (Khatlon Region) and Khorog (Gorno-Badakhshan Autonomous Oblast). METHODS We conducted ...

Opioids are important, if not essential, agents in treating certain types of chronic pain. However, the prevalence of drug misuse, abuse, and addiction has fostered considerable consternation among physicians, who may hesitate to prescribe these medications both due to concern for patients (misuse, abuse, and addiction), and fears of prosecution and/or professional sanction. Such practice may r...

In the era of highly effective anti-retroviral therapy (ART), data show a significant difference in treatment outcomes between injecting drug users (IDUs) and non-IDUs. Factors that may contribute to suboptimal treatment outcomes in IDUs include delayed access to ART, competing comorbid diseases, psychosocial barriers and poor long-term adherence to ART. This review describes and compares sever...

BACKGROUND There is good evidence for the effectiveness of opioid substitution therapy (OST) for injecting drug users (IDUs) in middle and high-income countries but little evidence regarding the provision of OST by non-government organisations (NGOs) in resource-poor settings. This paper reports on outcomes of an NGO-based OST program providing sub-lingual buprenorphine to opiate dependent IDUs...

BACKGROUND Previous reviews have examined the existence of HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide, but they did not quantify the scale of coverage. We undertook a systematic review to estimate national, regional, and global coverage of HIV services in IDUs. METHODS We did a systematic search of peer-reviewed (Medline, BioMed Central), internet, ...