Hanging patterns of treatment seeking for pharmaceutical opioids in Australia (2002–2011)

Abstract

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e163 effects were recorded. Scores were subtracted from −15min baseline value and then saline values subtracted from cocaine values to yield subjective effect score. Participants were genotyped for the SLC6A4 (serotonin transporter) 5-HTTLPR, TPH1 rs1799913, and TPH2 rs4290270 variants. Repeatedmeasures ANOVA corrected for population structure was used to analyze the data. Results: Participants had amean age of 43 years, were 80%male and 73% black, and smoked 2.3 g cocaine per day. Self-report of “Desire” and “Access” were found to be in association with the triallelic5-HTTLPR (p=3×10−5,p=2×10−4, respectively). Self-report of “Stimulated” and “Access” were found to be in association with the TPH1 rs1799913 (p=3×10−4, p=4×10−5, respectively). Selfreport of “Good effect”was found to be in associationwith the TPH2 rs4290270 (p=4×10−4). Conclusions: The serotonergic system may contribute to the subjective effects produced by acute cocaine exposure, which has relevance to models of drug-induced relapse. The role that these serotonergic genes and variants moderate these effects may aid in the development of specific pharmacotherapies tailored to those with specific genetic backgrounds. Financial support: Supported in part by NIH/NIDA P50 DA018197 (TK), for DN throughMDAnderson’s Cancer Center SupportGrantNIH/NIDADA026120, and the ToomimFamily Fund. This material is the result of work supportedwith resources and the use of facilities at the Michael E. DeBakey VAMedical Center, Houston, TX. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.443 Hanging patterns of treatment seeking for pharmaceutical opioids in Australia (2002–2011) Suzanne Nielsen3,1, Amanda Roxburgh2, Raimondo Bruno4,3, Nicholas Lintzeris1, Amber Jefferson5, Louisa Degenhardt3 1 Drug and Alcohol, SESLHD, Sydney, NSW, Australia 2 National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia 3 National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW, Australia 4 School of Psychology, University of Tasmania, Hobart, TAS, Australia 5 AIHW, Canberra, ACT, Australia Aims:Despitewell-documented increase in use and harmswith pharmaceutical opioids (PO), few detailed studies have examined treatment delivery, particularly for interventions other than opioid substitution treatment. We aimed to explore changes in opioid treatment for PO over time using national treatment data. Methods:Data fromcloseddrugandalcohol treatment episodes from the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS-NMDS), representing non-opioid substitution treatment) in Australia for 2002–2003 to 2010–2011were examined. In the four jurisdictions where detailed data was available, episodeswhere heroinwas the principal drug of concernwere compared to episodeswhere the fourmost frequently reportedopioids (morphine, codeine, fentanyl and oxycodone) were recorded as the principal drug of concern. Results: In 2002–2003,most (93%) opioid treatmentwas related to heroinwith 7% of all opioid treatment episodes reporting a PO as the principal drug of concern. In 2010–2011 20% of all opioid treatment episodes were attributed to pharmaceutical opioids. Distinct changes over time were observed for different opioids: an increase in the average age at the start of the episode was seen for heroin and oxycodone; and a reduction in the proportion of females in codeine episodes, with 67% in 2002–2003 compared with 44% in 2010–2011. Codeine and oxycodone users had the lowest current or past injection. Conclusions: Clear differences were observed over time and betweendifferent opioids.Monitoring theseemergingpatternswill be important to inform treatment needs, particularly in light of different patterns of poly drug use, different routes of administration and changing demographic characteristics. Financial support: NHMRC Research Fellowships (#1013803, #1041472). http://dx.doi.org/10.1016/j.drugalcdep.2015.07.444 Substance dependence criteria, not substance use, associated with HIV virologic control Seonaid Nolan1, Alexander Walley2, Timothy Heeren2, Greg Patts2, Alicia S. Ventura2, Meg Sullivan2, Jeffrey Samet2, Richard Saitz2 1 Department of Medicine, University of British Columbia, Vancouver, BC, Canada 2 Boston University, Boston, MA, United States Aims: This study aims to (a) describe a cohort of HIV-infected people on antiretroviral therapy (ART) who use substances and (b) explore which substance use-related factors are associated with lack of virologic control. Methods: Participants were selected from the Boston ARCH cohort (i.e. HIV-infected adults with 12-month DSM-IV substance dependence or ever injection drug use) who were currently taking ART. Substance use predictors of interest included number of DSMIV alcohol and drug dependence criteria and past 30 day substance specific use. Associations with HIV virologic control (HIV viral load [HVL] 200 copies/mL) were tested using logistic regression models. Multivariable analyses were adjusted for age, gender, homelessness and anxiety or depression. Results: Participants (n=200) were median age 50 years, 67% male, 51% African American, 76% self-reported >90% ART adherence, and 80% HVL 90% ART adherence. Substance dependence criteria (drug dependence in particular), and not substance specific use, were associated with a lack of virologic control. This suggests that substance dependence criteriawarrant particular clinical attention by HIV care providers. Financial support: U01AA020784, U24AA020778, U24AA020779, R25DA033211. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.445