Risk Of Drug Use Research Articles

The association between alcohol abstinence, drinking or binge drinking and drug use: is alcohol abstinence that safe?

Purpose The purpose of this paper is to investigate the association between alcohol abstinence and illicit drug use during early adulthood, and compares abstinence to moderate drinking and binge drinking, regrouped in different frequencies. Design/methodology/approach A total of 5,968 young male adults who completed the questionnaires were selected for the analyses. Alcohol abstinent participants were compared to moderate drinkers (who did not experience binge drinking during the previous 12 months), and casual, monthly, weekly and daily binge drinkers in terms of prevalence of drug use during early adulthood. Findings Alcohol abstinence was associated with higher risks of drug use than moderate drinking (odds ratio (OR)>3) for most of drugs, especially last-stage drugs: crystal meth, solvents, spice and heroin (6.50<OR<13.50). Such findings encourage rethinking prevention among alcohol abstainers who were so far considered at low risk of drug use. Research limitations/implications The main limitations of the study are the fact that it is cross-sectional, gender-blind and focussing on Swiss native who are less vulnerable than migrants. Practical implications High-risk subjects should be identified among young people who do not drink in order to develop specific preventive interventions. Originality/value This study is one of the first that compare alcohol abstinence, moderate drinking and binge drinking. Separate results covering 15 different drugs are presented.

Knowledge, perceptions and practices of pharmacovigilance amongst community and hospital pharmacists in a selected district of North West Province, South Africa

BackgroundPharmacovigilance (PV) as a means of ensuring drug safety is an essential component of the process ensuring that the risk of drug use does not outweigh the benefit. Pharmacists are valuable in collecting PV information, but not many studies explored the knowledge, perceptions and practices of both community and hospital pharmacists towards the practice of PV. ObjectivesThe aim of the study was to explore the knowledge, perceptions and practise of PV amongst the pharmacists in a selected district of North West Province, South Africa. MethodA cross sectional study was conducted amongst pharmacists in a selected district of the North West province, using a pre-tested questionnaire. Descriptive statistics were used to analyse the results including ANOVA testing. ResultsOne hundred and two pharmacists (68.9%) completed the questionnaire. Although familiar with the concept of PV, pharmacists knowledge scores were low. Pharmacists agreed that PV is a useful tool, but perceived the PV authorities to be distant and remote. Although more than 90% indicated that all adverse drug reactions should be reported, only 44.1% indicated that they have reported adverse drug reactions (ADRs). Only 6.7% of pharmacists were satisfied with feedback received from authorities after reporting an ADR. Barriers were cited that prevented them from reporting ADRs. Over 80% indicated they would participate in further PV training. ConclusionThe majority of pharmacists are familiar with the concept of PV, but less than half reported any ADR. They are willing to participate in PV processes but are unsure what their exact role playing should be. More than half indicated that they would like to see improvements to the current PV system in South Africa. The majority are prepared to undergo further education to improve their PV knowledge.

Topical Vasoconstrictors in Cosmetic Rhinoplasty: Comparative Evaluation of Cocaine Versus Epinephrine Solutions

The use of topical vasoconstrictors is a common practice in nasal surgery. These agents reduce bleeding and enable a good surgical field. Topical cocaine and epinephrine, which are frequently used in cosmetic rhinoplasty, are considered safe and effective, but secondary effects have been described. The aim of the present study was to evaluate and compare the benefits and risks of epinephrine and cocaine employed as topical vasoconstrictive agents in cosmetic rhinoplasty. This prospective non-randomised study included 65 consecutive female patients undergoing primary closed rhinoplasty. Patients were treated with topical aqueous solutions of 4% cocaine (n=33) or 1:1000 epinephrine (n=32). Benefits and risks of drug use were compared between groups. Vasoconstriction was assessed by quantitative and qualitative evaluation of bleeding during surgery. Systemic effects were studied in terms of cardiovascular changes during the procedure. The Mann-Whitney test and mixed-effects models were used to compare continuous variables and to assess the effects of vasoconstrictor treatment, respectively. Cocaine exerted a stronger and more predictable vasoconstrictive effect than epinephrine. This difference was linked to better field quality, but did not relate to shorter surgery times. Increased heart rate was detected with both agents and was significantly higher with cocaine (p<0.05). Blood pressure did not significantly differ between groups. Both cocaine and epinephrine, at the concentrations used in this study, are suitable as topical vasoconstrictive agents in aesthetic rhinoplasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Risk and protective profile of tobacco and alcohol use among Iranian adolescents: a population- based study.

Identification of risk and protective factors is of great importance in designing preventive and interventional programs. The aim of the present study has been to investigate peer/individual, family, school, and community risk and protective factors as predictors of tobacco and alcohol use among Iranian adolescents. In a cross-sectional population-based study, 870 Iranian adolescents aged 15-18 years old, filled out the adopted form of "Communities That Care Youth Survey". Thirty-two risk and protective factors were entered in adjusted logistic regression analyses to predict the lifetime cigarette and alcohol use. Sixteen risk and seven protective factors predicted both lifetime cigarette and alcohol use in the bivariate logistic regression analysis. In the multivariate logistic regression analysis 12 risk factors including friends' use of drugs, interaction with antisocial peers, sensation seeking, intention to use, perceived risks of drug use, family history of drug use, poor family management, parental attitudes favorable toward drug use, family conflict, academic failure, school low commitment, perceived availability of drugs predicted both lifetime cigarette and alcohol use as well as four protective factors including religiosity, self-esteem, family rewards for prosocial involvement, and school rewards for prosocial involvement. The highest OR were related to the risk factor of "Rewards for antisocial involvement" [3.9(1.5-10)], and protective factor of "Religiosity" [0.1(0.1-0.3)]. The present study has produced evidences about risk and protective factors related to adolescents substance use and can help designing and implementing of preventive interventions for maintaining and promoting adolescents health.

Use of hierarchical cluster analysis to classify prisons in Ireland into mutually exclusive drug-use risk categories

Aims: The aim of this paper is to propose a methodology for classifying prisons into distinct drug-use risk categories based on prisoners’ use of specified prescription and illegal drugs. The categories of prisons thus defined have particular relevance for the planning of drug-related interventions, education and services in Irish prisons. The methodology may be transferable to, and of value in, prison systems elsewhere. Methods: From the 14 prisons in Ireland, 824 randomly selected prisoners completed a self-administered questionnaire on lifetime, last year and last month use of specified prescription and non-prescription drugs. Questions were derived from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and other sources. Oral fluid samples were collected for verification of recent drug use. The EMCDDA definition of “recent problematic drug use” was used in post hoc hierarchical cluster analysis to define categories of prisons with similar drug-use patterns. Findings: Four categories of prisons, designated “low”, “medium”, “high” and “very high” drug use, were identified. While the prisons comprising each category were known, drug use patterns in individual prisons were not disclosed because of concerns about prisoner confidentiality in a small jurisdiction. The clusters identified were used to contextualise subsequent analyses of drug use, the availability and use of harm-reduction services and differential service requirements by prison category. Conclusions: The methodology described allows for identification of prison categories by drug-use patterns. With restrictions on disclosure of information by individual prison, it provides more valuable information than would derive from data on all prisons combined.

Patterns of prescription drugs use among pregnant women at Sultan Qaboos University Hospital and Sultan Qaboos University Hospital Family and Community Medicine Clinic, Oman.

Objective:This study evaluates the patterns of prescription drugs use among women attending antenatal clinic at Sultan Qaboos University Hospital (SQUH) and SQUH Family and Community Medicine clinic (FAMCO), Oman.Methods:The study was a descriptive retrospective cross-sectional study on pregnant women who attended the antenatal clinic at SQUH and FAMCO from February to April 2014 and received a prescription containing at least one drug. Patients’ information was extracted from SQUH electronic records.Results:A total of 105 pregnant women were included in the study. Among the recruited pregnant women, 35 (33.3%) had at least one chronic disease. The average number of drugs prescribed per patient per prescription during the period of pregnancy was 2.33 ± 1.43. Vitamins and minerals were the most frequently prescribed class of drugs (30.60%) followed by analgesics (11.19%) and antidiabetic drugs (10.13%). According to the Food and Drug Administration risk classification, most of the prescribed drugs were from category B (30.0%) and C (27.14%). No drug was prescribed from category X. There was a significant decrease in prescribing category A drugs over the three trimesters (20.7%, 12.7%, and 9.3%, respectively) (P < 0.047).Conclusion:The study gives an overview of the extent of drug prescription during pregnancy and increases the awareness of health-care providers and women about the potential risks of drug use during pregnancy.

Influence of the Novelty-Seeking Endophenotype on the Rewarding Effects of Psychostimulant Drugs in Animal Models.

Novelty seeking (NS), defined as a tendency to pursue novel and intense emotional sensations and experiences, is one of the most relevant individual factors predicting drug use among humans. High novelty seeking (HNS) individuals present an increased risk of drug use compared to low novelty seekers. The NS endophenotype may explain some of the differences observed among individuals exposed to drugs of abuse in adolescence. However, there is little research about the particular response of adolescents to drugs of abuse in function of this endophenotype, and the data that do exist are inconclusive. The present work reviews the literature regarding the influence of NS on psychostimulant reward, with particular focus on adolescent subjects. First, the different animal models of NS and the importance of this endophenotype in adolescence are discussed. Later, studies that have used the most common animal models of reward (self-administration, conditioned place preference paradigms) to evaluate how the NS trait influences the rewarding effects of psychostimulants are reviewed. Finally, possible explanations for the enhanced risk of developing substance dependence among HNS individuals are discussed. In conclusion, the studies referred to in this review show that the HNS trait is associated with: (1) increased initial sensitivity to the rewarding effects of psychostimulants, (2) a higher level of drug craving when the subject is exposed to the environmental cues associated with the drug, and (3) enhanced long-term vulnerability to relapse to drug consumption after prolonged abstinence.

Clinical, Ethical, and Socioeconomic Considerations for Prescription Drug Use During Pregnancy in Women Suffering From Chronic Diseases.

The increasing proportion of women conceiving later in life, associated with the higher probability of contracting a chronic disease, highlights an increasing need to understand the impact of drug use for chronic diseases pre- and postpartum. In this study, the authors report the results of systematic reviews of drug use during pregnancy by focusing on pregnant women with a chronic disease, specifically, epilepsy, rheumatoid arthritis (RA), or schizophrenia. The authors studied the clinical impact of drug use in these chronic diseases on the mother and fetus, as well as the ethical issues and socioeconomic impact of drug use during pregnancy for women with these conditions. The results indicate that treatment discontinuation in epilepsy and schizophrenia can lead to serious adverse effects, whereas pregnancy can have an ameliorating effect on RA symptoms. Delivery and neonatal complications were associated with the use of older generation drugs across the 3 diseases. Newer generation drugs were deemed safer but more expensive. Ethical considerations for physicians and patients involved mainly the potential risks of drug use for the fetus. In conclusion, treatment guidelines need to be developed in the future; additionally, better insight into the economics of pregnancy for women with chronic diseases will improve value for money in obstetric care.

Sexual and reproductive health risks amongst female adolescents who use amphetamine-type stimulants and sell sex: a qualitative inquiry in Yunnan, China.

BackgroundChina, as other Southeast Asian countries, has witnessed an increased use in amphetamine-type stimulants (ATS) amongst urban youth. Amongst female adolescents who both sell sex and use ATS, risk behaviours are compounded resulting in even poorer health outcomes. However, limited knowledge exists on ATS use patterns and ATS-related risk behaviours, particularly in this context. This research aimed to improve the understanding of these issues amongst female adolescents who use ATS and sell sex, and to inform future programming.MethodThis study utilised monthly focus group discussions (four in total) with the same study participants in Yunnan, China. From within a drug-treatment programme, female adolescents who reported both a history of drug use and selling sex were purposively enrolled in the study.ResultsParticipating adolescent females were aged 17–19 years and were all internal-migrants with low literacy. All reported polydrug use (mainly methamphetamine and heroin, whereas ecstasy and ketamine have been infrequently employed). Being less informed about risks of drug use and lack of sexual and reproductive health knowledge seemed to contribute to problematic drug use, rough and prolonged sexual intercourse, inconsistent condom use and ineffective contraceptive practice. For their income, participants largely relied on selling sex, which was frequently coupled with drug sharing services to clients. However, despite the practices, women did not self-identify as sex workers, and therefore did not think that existing intervention services targeting female sex workers were relevant to them. Moreover, criminalization and stigmatisation of drug use and selling sex impeded their access to care services.ConclusionCurrent harm reduction and HIV/sexually transmitted infection (STI) prevention services are unlikely to address the demand of female adolescents engaged in drug use and commercial sex. Our findings highlight that a comprehensive and coordinated harm reduction and sexual and reproductive health response should be conducted involving these most vulnerable adolescents.

Parent Programs for Reducing Adolescent's Antisocial Behavior and Substance Use: A Randomized Controlled Trial.

Two theoretically based parent training programs, delivered in real-world settings by the social services, were examined in this randomized controlled trial for effectiveness in reducing adolescents’ antisocial behavior and substance use. Two hundred and thirty-seven (237) adolescents in ages between 12 and 18 and their parents were assigned to one of two programs or to a wait-list control condition. The programs were the nine weekly group sessions program Comet 12–18 (Swedish Parent Management Training Program) and the six weekly ParentSteps (Swedish shortened version by Strengthening Families Program 10–14). Outcome measures were antisocial behavior, substance use, and delinquency, and psychosocial dysfunction. Data based on adolescents’ and parents’ ratings of the adolescents’ problem behavior at baseline and 6 months later were analyzed with repeated measures ANVOA, Logistic regression, and Kruskal–Wallis H test. The results showed that parents’ ratings of adolescents’ antisocial behaviors decreased significantly over time, but no time by group effect emerged. No program effects were found in the adolescents’ self-reported antisocial behavior, delinquency, or psychosocial functioning. A threefold risk of illicit drug use was found in both intervention groups. The results suggest that neither Comet nor ParentSteps had beneficial effects on adolescent’s antisocial or delinquent behavior, or on alcohol use. The only significant group difference found was a threefold risk of drug use in the intervention adolescents at follow-up, but for several reasons this finding should be interpreted with caution.Trial registration number: ISRCTN76141538.

Macro Social Flaws and Intervention's Unfinished Business: A Personal Note on Young People's Drug Use in Hong Kong

This paper traces how social, economic, and cultural changes in Hong Kong in the past five decades might have affected the pattern of illicit drug use among young people in Hong Kong. The prevalence of illicit drug use by young people had been very low before the 1990s, and like adult users, young users mostly used heroin. This pattern of drug use started to change in the late 1990s, when there was a sudden upsurge of drug use among young people, and psychoactive drugs such as ketamine quickly replaced heroin as the most popular drugs among them. An attempt is made to explain the new pattern of young people's drug use with respect to the changes of the social, economic and cultural conditions of Hong Kong since the 1960s, making use of Beck's risk society perspective and Parker's concept of normalization of recreational drug use. The identification of macro social flaws points to the need to address societal factors impeding successful interventions, which will involve reducing the blockage of upward mobility for young people, and providing them with the latest scientific knowledge of the physical and mental damages of ketamine and other psychoactive drugs for their better understanding of the risk of drug use.

Factors Associated with Time Since Last HIV Test Among Persons at High Risk for HIV Infection, National Survey of Family Growth, 2006-2010.

The Centers for Disease Control and Prevention (CDC) recommends annual HIV screening for persons at high risk for HIV infection. We assessed the testing history and factors associated with recent testing (tested in the last 12 months) among persons at high risk for HIV infection. We analyzed 2006-2010 National Survey of Family Growth data and classified respondents aged 15-44 who reported a sexual or drug-use risk behavior in the past year as 'high-risk'. Logistic regression models estimated prevalence ratios assessing the association between demographic and health-related factors and having been recently tested for HIV compared with never been tested. Among high-risk men, 29.3% had recently tested for HIV, 30.7% tested more than 12 months ago, and 40.0% had never been tested. Among high-risk women, 38.0% had recently tested, 36.9% tested more than 12 months ago, and 26.1% had never been tested. Compared with men who were aged 15-19, white, heterosexual, and had not recently visited a doctor, men who were aged 40-44, black/African American, homosexual/gay or bisexual, and had visited a doctor in the past year were more likely to have recently tested. Compared with women who were white, had not recently visited a doctor, and had never been pregnant, women more likely to have recently tested were black/African American, had visited a doctor in the past year, and had been pregnant. Approximately two-thirds of high-risk men and women had not been recently tested for HIV. CDC recommendations for annual screening are not being implemented for the majority of persons at risk.

The Relationship Between Social Stress and Substance Use Among Black Youths Residing in South Florida

Prior research has produced what, at surface, appears to be paradoxical findings regarding race/ethnic differences in the relationship between social stress and substance use. Despite exposure to higher levels of stress and adversity, Blacks are less likely to report drug use compared to their White counterparts, suggesting that their stress exposure may be unrelated to substance use. We revisit this issue by analyzing data from a South Florida-based sample of 426 male youths. Using multiple group analyses, results indicate that stress exposure increases risk of drug use for Blacks and Whites; however, the magnitude of these linkages varied by race. We find that stress exposure was related to substance use among Black youths, and that these linkages explained more variance in alcohol and marijuana use compared to White youths. Findings suggest a continued effort in the development and implementation of social interventions aimed at reducing the environmental and social structural correlates of adolescent drug use.

Association of exposure to neighborhood drug activity, neurobehavioral traits, and marijuana use among at-risk African American females

IntroductionTheories of relative deprivation suggest African Americans in disadvantaged communities are at increased risk for drug use. This increased risk may be due, in part, to exposure to drugs and drug subcultures. Given the significance of the prefrontal cortex (PFC) functioning in yielding behavior that is strategically guided rather than reactive to environmental demands, it is important to examine the relationship between PFC functioning, neighborhood drug activity and substance use among African Americans residing in high risk communities. MethodsA sample of 120 young adult African American females was recruited from high-risk neighborhoods. Each completed the modified version of the neighborhood environment scale, a neurobehavioral assessment designed to measure apathy, behavioral disinhibition and executive dysfunction, and provided a urine sample that was tested for the presence of psychoactive drugs. ResultsLogistic regression analyses indicated that females with higher scores on behavioral disinhibition were 2.6 times more likely to test positive for marijuana (95%CI=1.02, 6.57). Neither apathy nor executive dysfunction was related to marijuana use. No relationship emerged between neighborhood drug activity and marijuana use. ConclusionsAmong the neurobehavioral traits considered only behavioral disinhibition was associated with marijuana use, suggesting that different neurobehavioral domains may be uniquely related to marijuana use. For females living in high risk environments, the extent to which they are able to control impulses may provide some protection against marijuana use. Future studies focused on the moderating effects of behavioral disinhibition on the association of exposure to risk environments and marijuana use may prove beneficial. Further, the study adds to the small base of literature supporting the Frontal Systems Behavior Scale as a brief assessment to evaluate frontally-mediated neurobehavioral traits relevant to substance use. However, future studies aimed at examining the influence of neighborhood drug activity might benefit from more precise measures of exposure to neighborhood drug activity. More research to replicate and expand on the present findings is warranted.

Illicit drug use among rave attendees in a nationally representative sample of US high school seniors

BackgroundThe popularity of electronic dance music and rave parties such as dance festivals has increased in recent years. Targeted samples of party-goers suggest high rates of drug use among attendees, but few nationally representative studies have examined these associations. MethodsWe examined sociodemographic correlates of rave attendance and relationships between rave attendance and recent (12-month) use of various drugs in a representative sample of US high school seniors (modal age: 18) from the Monitoring the Future study (2011–2013; Weighted N=7373). ResultsOne out of five students (19.8%) reported ever attending a rave, and 7.7% reported attending at least monthly. Females and highly religious students were less likely to attend raves, and Hispanics, students residing in cities, students with higher income and those who go out for fun multiple times per week were more likely to attend. Rave attendees were more likely than non-attendees to report use of an illicit drug other than marijuana (35.5% vs. 15.6%, p<0.0001). Attendees were more likely to report use of each of the 18 drugs assessed, and attendees were more likely to report more frequent use (≥6 times) of each drug (ps<0.0001). Controlling for sociodemographic covariates, frequent attendance (monthly or more often) was associated with higher odds of use of each drug (ps<0.0001). Frequent attendees were at highest risk for use of “club drugs.” DiscussionFindings from this study can help inform prevention and harm reduction among rave attendees at greatest risk for drug use.

Long-term effects of minimum legal drinking age laws on marijuana and other illicit drug use in adulthood

BackgroundExposure to permissive minimum legal drinking age (MLDA) laws (ability to purchase alcohol <21 years) during adolescence can have long-term effects, including heavy alcohol use or alcohol use disorders as adults. We examined whether exposure to permissive MLDA laws during adolescence has long-term effects on illicit drug use and disorders in adulthood. MethodsParticipants from the 2004–2012 National Survey of Drug Use and Health (NSDUH) were linked with historical state MLDA laws. Participants born in 1949–1972 (age 31–63 years at observation, n=110,300) were analyzed because they came of legal age for alcohol purchase when changes occurred in state MLDA laws. Logistic regression was used to model drug use measures as a function of exposure to permissive MLDA during adolescence, adjusting for state and birth-year fixed effects, demographics, and salient state characteristics. ResultsRates of past month use, past year use, and abuse/dependence of marijuana were 4.7%, 7.8%, and 1.2%, respectively. Rates of past month use, past year use, and abuse/dependence of illicit drugs other than marijuana were 2.9%, 6.2%, and 0.7%, respectively. Among the full sample, exposure to permissive MLDA laws was not significantly associated with drug use or abuse/dependence in adulthood. Men exposed to permissive MLDA laws were at 20% increased odds of past year illicit drug use (aOR 1.20, 95% CI 1.09–1.32). ConclusionsRestricting alcohol access during adolescence did not increase long-term drug use. Allowing the purchase of alcohol among those less than 21 years of age could increase the risk of drug use later in life.

Drug Use and Involvement in a Safety-Critical Event

This study used the Naturalistic Truck Driving Study data set to test the feasibility of applying naturalistic data to evaluation of the relationship between prescription (Rx) and over-the-counter (OTC) drug use and involvement in a safety-critical event (SCE). The risk of drug use was calculated by comparing SCEs and baseline epochs that occurred within a drug's half-life with SCEs and baseline epochs that did not occur within a drug's half-life (for the same half-life period). This research found that nearly 97% of commercial motor vehicle drivers used an OTC drug at least once (mostly caffeine), and 25% used at least one Rx drug. Furthermore, Rx and noncaffeine OTC drug use was not associated with an increased or decreased risk of involvement in an SCE. As caffeine was the only drug classification used multiple times by many drivers, this odds ratio analysis was the only analysis performed. Caffeine use while driving was found to be associated with a decreased risk of SCE involvement in all seven half-lives (half-life odds ratios ranging from 0.44 to 0.66). This project illustrated the feasibility of using a naturalistic driving approach to assess the risk associated with Rx and OTC drug use while driving. It is possible that analyses for specific medications could be performed with a sufficiently large sample of drivers who used each classification of drug.

A Biopsychosocial Examination of ATOD Use among Middle and High School Students.

To examine Indiana middle and high school students' use of 17 licit and illicit substances using item response theory to produce theta scores to identify sociodemographics, psychological factors, and normative beliefs associated with life-time drug use. Cross-sectional data from 1233 students were examined. Theta scores were calculated across 17 substances using 2PL item response theory modeling. General least squares regressions were performed. Those perceiving their peers/parents approved substance use and those reporting worse worry control had higher theta scores. Those perceiving the risks of drug use outweighed the benefits and conforming less to negative influences had significantly lower theta scores. Findings support the utility of the Biopsychosocial Model to examine lifetime drug use and the severity of substances used among adolescents simultaneously.

Impact of antiretroviral therapy on drug-using and high risk sexual behaviors among HIV-positive methadone maintenance treatment clients: a qualitative study

To understand that whether initiation of antiretroviral therapy (ART) would impact on the change and its reasons regarding the HIV-related high risk behaviors among HIV-positive clients who attending the methadone maintenance treatment (MMT). In-depth interviews were conducted among 34 MMT clients in Yunnan province who were under ART. The related contents would include information on general demographic charicteristics, HIV infection,MMT, number of sexual partners before and after ART, sexual behavior and frequency of condom use, drug use, needle sharing, changes in risk behaviors before and after the ART, reasons for high-risk behavior, of the clients. The average age of the interviewees was 38.5 years, and most of them were male (70.6%). The clients under this study all admitted that the frequencies of unsafe sex and needle sharing did not increase after the ART initiation, with the main reasons as increasing HIV related awareness, the use of methadone, high accessibility of free condoms and access to clean needles etc. However, 12 of 34 reported being relapsed and 3 reported inconsistent condom use. The interaction of ART and dosage of methadone were connected to the episodes of relapsing and the ART optimism would result in inconsistent condom use. No evidence supported that the ART initiation would increase the risk behaviors among the HIV-infected MMT clients. However, attention needs to be paid to the new challenges caused by high expectation of ART.

İlaçların gebelikte kullanımlarına dair risk iletişiminde yeni dönem: FDA gebelik risk kategorileri değişiyor

Summary Twenty nine years after the introduction of Pregnancy Risk Categories, U.S. Food and Drug Administration (FDA) concluded that categories were not successful at conveying the possible risks of drug use in pregnancy. FDA announced its second generation approach to labeling drugs for use in pregnancy and lactation with the publication of Proposed Rule for Pregnancy and Lactation Labeling for Human Prescription Drug and Biological Products on May 29, 2008. The proposed rule is designed as a narrative text containing elements such as fetal risk summary, clinical considerations and data. This manuscript aims to increase information and awareness of family practitioners on this subject.