Male Heroin Users Research Articles

The effect of detoxification on acoustic features of Mandarin speech in male heroin users.

This study aims to investigate the effect of detoxification on acoustic features of Mandarin speech. Speech recordings were collected from 66 male abstinent heroin users with different durations of drug detoxification, specifically early abstinent users with a detoxification duration of less than 2 years, sustained abstinent users with 2 years of detoxification, and long-term abstinent users with a detoxification duration of more than 2 years. The results of the acoustic analyses showed that early abstinent users exhibited lower loudness, relative energies of F1, F2, and F3, higher H1-A3, and fewer loudness peaks per second, as well as a longer average duration of unvoiced segments, compared to the sustained and long-term abstinent users. The findings suggest that detoxification may lead to a rehabilitation process in the speech production of abstinent heroin users (e.g., less vocal hoarseness). This study not only provides valuable insights into the effect of detoxification on speech production but also provides a theoretical basis for the speech rehabilitation and detoxification treatment of heroin users.

Prioritization of personally relevant stimuli in male abstinent heroin users

The prioritization of the processing of highly relevant personal stimuli pervades various cognitive domains and is vital to our survival and normal functioning. However, the extent to which this process is altered by drug addiction remains to be elucidated. The present study examined the self-prioritization effect in abstinent heroin users (AHUs) using the perceptual matching task, which controls for the confounding effect of familiarity, and further modified it to revalidate the drug-prioritization effect (DPE). Eighty male AHUs and forty healthy control (HC) participants were recruited for this study. Participants filled in the questionnaire and completed two perceptual matching tasks. The questionnaire included demographic information (e.g., age, education) and characteristics of drug use, whereas the HC participants only completed the demographic information. AHUs exhibited a robust self-advantage in the self-perceptual matching task, and that the magnitude of the self-prioritization effect (MSPE) was comparable to that in HCs. Only AHUs prioritized the processing of drug-related stimuli in the drug-perceptual matching task, and showed similar prioritization effects during self- and drug-related processing. The MSPE and magnitude of the drug-prioritization effect (MDPE) were correlated with the heroin consumption behavior in AHUs. The process of self-prioritization is intact in drug users, and they uniquely prioritize the processing of drug cues. The similar pattern between the self- and drug-related processing provided behavioral evidence to support that drug cues are likely to be associated with heightened personal relevance in drug users. These prioritization processes may play critical roles in addiction and provide a promising route for intervention.

Public Stigma Toward Female and Male Opium and Heroin Users. An Experimental Test of Attribution Theory and the Familiarity Hypothesis.

Drug abuse and addiction exist around the world. People addicted to drugs such as opium or heroin often encounter dehumanizing discriminatory behaviors and health-care systems that are reluctant to provide services. Experiencing discrimination often serves as a barrier to receiving help or finding a home or work. Therefore, it is important to better understand the mechanisms that lead to the stigmatization of drug addiction and who is more prone to stigmatizing behaviors. There is also a dearth of research on whether different patterns of stigma exist in men and women. Therefore, this study investigated factors affecting gender-specific stigmatization in the context of drug addiction. In our vignette study (NMensample = 320 and NWomensample = 320) in Iran, we experimentally varied signals and signaling events regarding a person with drug addiction (i.e., NVignettes = 32 per sample), based on Attribution Theory, before assessing stigmatizing cognitions (e.g., blameworthiness), affective responses (e.g., anger), and discriminatory inclinations (e.g., segregation) with the Attribution Questionnaire. We also tested assumptions from the Familiarity Hypothesis by assessing indicators of respondents' familiarity with drug addiction (e.g., knowledge about addiction). Results, for example, show higher stigma if the person used “harder” drugs, displayed aggressive behavior, or had a less controllable drug urge. Self-attributed knowledge about addiction or prior drug use increased some forms of stigma, but diminished others. These findings only partially converged between men and women. We suggest that anti-stigma initiatives should consider information about the stigmatized person, conditions of the addiction, and characteristics of stigmatizers.

Attenuation of response to drug-related cues in male heroin abstainers is modulated by cognitive control mechanisms

Background: Many research studies reveal that both attentional bias and impaired cognitive control significantly influence heroin addiction. However, limited research has been conducted into how the interplay between attentional bias and cognitive control modulates heroin-seeking behavior. Objectives: A modified version of the flanker task was used to investigate whether attentional bias to drug-related stimuli is modulated by cognitive control mechanisms among heroin users. Methods: Sixty participants (30 male heroin users during their abstinence period and 30 normal controls) responded to the direction of the middle arrow, while ignoring the adjacent arrow and the pictures (drug-related cues and neutral cues) presented as part of the task. Results: The abstinent heroin users had a significantly larger flanker effect under drug-related cues compared to neutral cues, whereas the control group showed no such trend. This effect was primarily influenced by increased reaction times in the presence of drug-related cues relative to neutral cues in the incongruent condition among abstinent heroin users, but not in the control group. Conclusions/Importance: Among abstinent heroin users, attentional bias to drug-related cues was moderated by attentional control. Further, high cognitive control demand was found to reduce heroin users’ ability to resist attentional capture from salient, but irrelevant, drug-related information, which may contribute to compulsive drug-seeking behavior and relapse in heroin users.

Abstinence Following a Motivation-Skill-Desensitization-Mental Energy Intervention for Heroin Dependence: A Three-year Follow-up Result of a Randomized Controlled Trial

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (n=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=0.033) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.

Gender and Age Effects on the Trajectory of Depression in Opioid Users during Methadone Maintenance Treatment.

Both heroin use and depression are significant health problems. Methadone maintenance treatment (MMT) can be of great benefit to heroin users. However, changes in the level of depression in heroin users during MMT are not clear. Gender and age are also important factors in the development of depression, and whether gender and age moderate changes in depression in heroin users during MMT warrants further study. This study aimed to explore: (1) the trajectory of depression in opioid users during MMT and (2) the moderating effects of gender and age on the trajectory of depression in opioid users receiving MMT. A total of 294 intravenous heroin users were recruited into this 9-month observational study. The level of depression was measured at the intake interview and at follow-up interviews every 3 months. A latent growth model was used to analyze the trajectory of the level of depression among the participants. Depression improved rapidly during the first 3 months of MMT and slowly after the first 3 months in both the female and male heroin users. There was no gender difference in the level of depression at each follow-up point. The level of depression in the female heroin users decreased faster than that in the male heroin users. In addition, the level of depression in the younger heroin users decreased faster than that in the older subjects. Depression in female and younger heroin users improved more rapidly than in male and older subjects, respectively.

Severity of Withdrawal Symptoms, Plasma Oxytocin Levels, and Treatment Outcome in Heroin Users Undergoing Acute Withdrawal

ABSTRACTPre-clinical studies show that, following chronic opioid exposure, oxytocin neurons exhibit over-excitation upon withdrawal, causing an increase in oxytocin brain and plasma levels. Relevant clinical data on humans are scarce. This study investigates the opioid withdrawal stress effect on oxytocin plasma levels in humans. We evaluated 57 male chronic heroin users in a residential detoxification program. We determined plasma oxytocin levels by ELISA and measured the stress effects of withdrawal using the COWS scale for opioid withdrawal, the VAS scale for craving, and the Hamilton scales for anxiety and depression on the second day of admission. Out of the 57 patients enrolled in the study, 27 completed the 21-day program, while the remaining 30 dropped out prior to completion. Plasma oxytocin levels were significantly higher in those individuals who dropped out than in those who completed the program. Participants who dropped out at some stage scored higher in the COWS, VAS-Craving, and Hamilton-anxiety scales, indicating a higher stress and explaining the higher oxytocin levels. In addition, plasma oxytocin levels correlated positively with the scores achieved in the COWS and Hamilton-anxiety scales. Higher withdrawal stress levels are associated with higher plasma oxytocin levels and early treatment discharge.

Migration, marginalization and metropolitaneity: negotiation of masculinities of Nepali drug users in Hong Kong

Many studies on men and masculinity have discussed how Asian male migrants who experience a ‘masculinity crisis’ negotiate their masculinity vis-à-vis dominant black and white masculinities in Western societies. Yet, few have discussed how they negotiate their masculinity in the Asian contexts. In this study, Nepalis have a tradition of transnational migration. Their transnational networks have facilitated the development of overseas Nepali communities. This research therefore aims to study the negotiation of masculinities of Nepali male heroin users, a marginalized group in Hong Kong. By using a qualitative mixed-methods approach, it is argued that their negotiation of masculinities is nuanced and relational; intersecting with race/ethnicity, social space, and generation. In the process, discursive resources in the cultural repertoire are utilized to construct alternative forms of masculinities in school, the workplace, and rehabilitation treatment. These masculinities are pluralistic and contingent, in relation to the transnational space and post-colonial situation of Hong Kong.

Gender Differences and Correlated Factors of Heroin Use Among Heroin Users

ABSTRACTBackground: Gender differences in illicit drug use are becoming increasingly recognized. However, there are few studies concerning differences between male and female heroin users in China. Objectives: The study aimed to explore gender differences in terms of socio-demographic characteristics, drug-related behaviors, and treatment history among a heroin-using population in China. Methods: A cross-sectional study was conducted in four cities in December 2013. A total of 788 participants were recruited from several types of sites in each city: compulsory detoxification centers, methadone maintenance treatment clinics, and detention facilities. The data were collected via a self-administered questionnaire. Analysis of variance, chi-square test, and multivariate logistic regression analyses were conducted to examine gender differences in socio-demographic characteristics, drug-related behaviors, and treatment history. Results: Female heroin users were more likely to be unemployed, have more education, and use heroin with their spouse/companion (p <.05). Male heroin users were more likely to be in detention facilities and MMT clinics, and relapse when they felt hopeless (p <.05). Conclusions/Importance: Although there were some similarities between male and female heroin users, significant gender differences do exist in some aspects of socio-demographic characteristics and heroin use. The data provide evidence that interventions aimed at preventing the initiation of heroin use and reducing relapse should take gender into account.

An integrated model of depression, compulsion, and mindfulness among heroin abusers in Taiwan.

Prevailing literature explains how depression, compulsion, and mindfulness affect heroin use; however, there is no comprehensive framework that explains their overall relationships. We therefore proposed and examined a hypothetical depression-compulsion-heroin use and mindfulness (DCHm) model. We recruited 234 male heroin users. Self-reported levels of depression, mindfulness, compulsion to use, and severity of heroin use were measured. Structural equation modeling was used to examine the proposed DCHm model. Compulsion was a mediator between depression and heroin use. In addition, the DCHm model had satisfactory model fit indices. Depression indirectly affected heroin use through compulsion to use. The moderating effects of mindfulness in the two competing models were compared between the high- and low-mindfulness groups. The DCHm model in the high-mindfulness group had more favorable model fit indices than it did in the low-mindfulness group. Through learned emotional regulation strategies, addicted people with higher mindfulness were less likely to compulsively take drugs because of a depressive mood than were those with lower mindfulness. Furthermore, effective emotion-regulation strategies should be developed and examined in future studies. These results raise questions about the effect of compulsion on heroin use disorders. Mindfulness-based approaches to emotional regulatory strategies should be developed based on these findings. Further experimentation and prospective studies are needed to more fully examine the moderating role of mindfulness on depression and compulsion.

Prevalence of human immunodeficiency virus, hepatitis C virus, and hepatitis B virus infection among heroin injectors in the central region of Saudi Arabia.

Objectives:To calculate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among inpatient heroin users, and to study the relationships between these infections and patient demographics.Methods:In this retrospective study, heroin users’ inpatient records from the Alamal Hospital, Riyadh, Saudi Arabia were reviewed for HIV, HBV, and HCV screening results, age, number of admissions, education, and marital and occupational status. The study took place between January 2006 and November 2012. The prevalences of HIV, HBV, and HCV and their associations to demographics were evaluated.Results:A sample of 357 inpatients Saudi male heroin users (all injectors) aged 40 (±8.6) years with lifetime admissions averaged 5.8 (±5) times were studied. Screening results revealed that 20.1% of subjects were infection-free, 56.6% had a single infection, 13.2% were infected by 2 viruses, and 1.1% were infected by 3 viruses. Prevalence of HBV surface antigen was 7.7%, antibodies for HCV 77.8%, and HIV 9.8%. A significant association was found between positive HCV and positive HIV tests. Furthermore, HCV was more common among patients aged 20-29 years, those who were unemployed, and who had primary, secondary, or postsecondary education. Finally, HBV was associated in patients aged 30-39 years and those with secondary educations.Conclusion:Contracting serious contagious viral infections is very common among Saudi heroin injectors at rates similar to those seen among injectors in Western countries. Infection control, education, and harm reduction programs are of paramount importance.

Diffusivity of the uncinate fasciculus in heroin users relates to their levels of anxiety.

Heroin use is closely associated with emotional dysregulation, which may explain its high comorbidity with disorders such as anxiety and depression. However, the understanding of the neurobiological etiology of the association between heroin use and emotional dysregulation is limited. Previous studies have suggested an impact of heroin on diffusivity in white matter involving the emotional regulatory system, but the specificity of this finding remains to be determined. Therefore, this study investigated the association between heroin use and diffusivity of white matter tracts in heroin users and examined whether the tracts were associated with their elevated anxiety and depression levels. A sample of 26 right-handed male abstinent heroin users (25 to 42 years of age) and 32 matched healthy controls (19 to 55 years of age) was recruited for this study. Diffusion tensor imaging data were collected, and their levels of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Our findings indicated that heroin users exhibited higher levels of anxiety and depression, but the heroin use-associated left uncinate fasciculus was only related to their anxiety level, suggesting that association between heroin and anxiety has an incremental organic basis but that for depression could be a threshold issue. This finding improves our understanding of heroin addiction and its comorbid affective disorder and facilitates future therapeutic development.

SY13-2-2 * IMPULSITIVY PERSONALITY TRAITS AND GENE POLYMORPHISMS ASSOCIATED WITH HEROIN DEPENDENCE IN A SRI LANKAN POPULATION

We assessed the impulsivity personality traits and nineteen candidate polymorphisms of the GABA, opioid and dopamine pathways of the reward system in 157 Sinhalese, male dependent heroin users and 155 age- and ethnicity-matched extreme controls using direct, indirect and epistatic association analyses...

A mosque-based methadone maintenance treatment strategy: Implementation and pilot results

BackgroundThis paper describes the rationale, implementation and operation of a “world first” Islamic inspired methadone maintenance treatment project delivered in a mosque setting and presents the outcome for the first group of participants. The project explored the viability of expanding addiction recovery services through the network of mosques in Muslim communities. MethodsThe project combined methadone maintenance with peer and religious counseling. Participants consisted of 36 male Muslim heroin users who went through the project. Urine tests and self-reported measures on various dimensions relevant to drug use and quality of life were collected at baseline and 12 months. ResultsThe project had a 12 month retention rate of 80%. At 12 months all but one participant tested negative for opioids and other substances. Self-report measures showed significant reductions in the degree and variety of drug use, improvements in general health, and psychological and social functioning of participants. Qualitative data showed that availability of methadone, convenient location and religion were the main reasons drawing participants to the program. ConclusionsMosques are viable venues for offering medication assisted recovery services and offer an alternative approach for managing addiction in Muslim communities. The prospect of mobilizing community resources to offer community-oriented long-term recovery management programs in mosques and other places of worship deserves consideration.

The tridimensional personality of male heroin users treated with methadone in Taiwan

It was our assumption that male heroin users have the personality traits of high impulsivity and low social interaction. Compliance regarding methadone maintenance therapy (MMT) is hypothesized to be related to personality features. We recruited 43 patients that had been receiving MMT and 43 healthy volunteers. All participants completed a Tridimensional Personality Questionnaire (TPQ). Information related to the Opiate Treatment Index (OTI) was gathered from the heroin group. The personality dimensions in the heroin user group and the control group were compared. We further investigated the association between TPQ and OTI. The heroin group presented with lower reward dependence than the control group. Regarding sub-dimensions, heroin users showed higher impulsivity and fatigability, and lower exploratory excitability and social dependence. The explosive (borderline) pattern was more common among the heroin users. The odds ratio of explosive pattern developing to heroin dependence was 4.19. Q scores of heroin use and the maximal methadone dose were associated with persistence.

Penile Bead Implantation in Relation to HIV Infection in Male Heroin Users in Taiwan

Recent reports indicate that injection risk behavior has declined among injection drug users (IDUs) but sexual risk behavior continues. RuJu, classified as a form of body modification, is the practice of permanently inserting beads beneath the foreskin of the penis. A man who has penis beads does not comfortably use a condom while having sex. This study examined the possible association of RuJu with human immunodeficiency virus (HIV) infection among IDUs in Taiwan. Of 644 eligible male heroin users who agreed to participate in the study, 573 (89%) completed consent forms and a questionnaire between June and August 2008. Clinical characteristics (HIV, hepatitis C, and RuJu) were retrieved from their medical files. Multinomial logistic regression was performed to examine the association of RuJu and HIV seropositivity, with drug risk behavior and sexual risk behavior controlled for. 206 respondents (36%) were HIV positive, 428 (75%) were HCV positive, and 232 (40%) had RuJu beads. 21% reported condom use at last sex and 34% reported multiple sexual partners during the last 6 months. 88% reported that they had injected heroin within the last 6 months, 18% shared a needle at last injection, and 26% shared rinses at last injection. Multinomial logistic regression analysis revealed that HIV-positive IDUs were more likely than HIV-negative IDUs to have HIV/AIDS knowledge, to have had RuJu and an IDU partner, and to have used a condom at last sex and shared needles and rinse water at last heroin use. Prevalence rates of HIV, HCV, and RuJu are high among IDUs seen at Taiwan drug detention centers. The results show that RuJu is highly associated with HIV seropositivity. Practitioners who seek to prevent HIV in male IDUs should be aware of the RuJu culture. More research on the role of RuJu in HIV infection is suggested.

Effect of prison‐based opioid substitution treatment and post‐release retention in treatment on risk of re‐incarceration

People who use heroin are frequently incarcerated multiple times. Reducing re-incarceration of this group is important for reducing both health risks associated with incarceration and the costs of correctional administration. Opioid substitution treatment (OST) in prisons may help to reduce re-incarceration, but research findings on this topic have been mixed. In this study, we examined the effect of OST in prison and after release on re-incarceration. Longitudinal cohort study. SETTING, PARTICIPANTS AND MEASUREMENTS: Data on OST and incarceration were linked for a cohort of 375 male heroin users recruited originally in prisons in New South Wales, Australia. Data were linked for the period 1 June 1997-31 December 2006. Re-incarceration was examined using recurrent-event survival analysis models. Model 1 examined the effect of OST status at release from prison (i.e. in treatment versus out of treatment on the day of release) on re-incarceration. Model 2 considered the effect of remaining in OST after release on risk of re-incarceration. Ninety per cent of participants were re-incarcerated following their first observed release. Pre-incarceration cocaine use was associated with a 13% increase in the average risk of re-incarceration. There was no significant association between simply being in OST at the time of release and risk of re-incarceration; however, in the model taking into account post-release retention in treatment, the average risk of re-incarceration was reduced by 20% while participants were in treatment. In New South Wales, Australia, opioid substitution treatment after release from prison has reduced the average risk of re-incarceration by one-fifth.

Accelerated Transition to Injection Among Male Heroin Initiates in Hanoi, Vietnam: Implications for Early Harm Reduction Interventions

This paper examines changes in the interval between first heroin smoking and onset of injection in a large, out-treatment sample of male heroin users in Hanoi, Vietnam (n = 1,115). Mean age at initiation of heroin use (smoking) was 18.4 and mean age of onset of heroin injection was 20.9 years. Full multivariate analysis indicates that the interval between first heroin use (smoking) and first heroin injection has been significantly attenuated among more recent heroin initiates (P = 0.0043), suggesting that heroin users in Vietnam may be at increased risk for exposure to HIV relatively soon after onset of heroin use, highlighting the need for behavioral interventions that target heroin smokers. Critical intervention goals include delaying the onset of injection and improved education about safer drug sharing and drug injection practices.

Diversity of Hepatitis C Virus Genotypes Among Intravenous Heroin Users in Taiwan

IntroductionLimited information is available about genotypes of hepatitis C virus (HCV) in intravenous heroin users in Taiwan. The purpose of this study was to examine the concordance of the detection of antibody to HCV and HCV-RNA and to determine the distribution of HCV genotypes in male intravenous heroin users. MethodsThis was a cross-sectional study. The study population included 274 intravenous heroin drug users newly sentenced in a male prison in central Taiwan from November 2004 to February 2005, whose antibodies to HCV were positive, and antibodies to human immunodeficiency virus were negative. The mean age was 33.9 years (standard deviation, 7.8). The molecular diagnosis used to identify HCV-RNA was PCR. ResultsAmong 274 subjects, 214 subjects were found to contain HCV-RNA. Positive predictive value of HCV infection using antibody to HCV as an indicator was 78.1%. Among 214 subjects, HCV genotype 2a was the most predominant (58.9%, n = 126), followed by 1a (17.3%, n = 37), 1b (14.5%, n = 31), 2b (8.9%, n = 19) and 1a + 2b (0.4%, n = 1). Age-specific analysis also showed genotype 2a was the most prominent genotype among the 4 age groups, with the highest prevalence in groups aged 20 to 29 years and 30 to 39 years (53.3% and 67.6%, respectively). ConclusionsThe concordance of antibody to HCV and HCV-RNA is remarkable in selected high-risk groups. HCV genotype 2a is the most prevalent in male intravenous heroin users in central Taiwan, especially in aged 20 to 29 years and aged 30 to 39 years.

Heroin Dependence and Bloodborne Virus Transmission Behaviors for HIV Infection Among Newly Incarcerated Injection Drug Users in Taiwan

The purpose of the study was to determine heroin dependence and risky behaviors associated with human immunodeficiency virus (HIV) infection among newly incarcerated injection drug users (IDUs). Three self-administrated questionnaires were collected among 450 newly incarcerated male heroin users during 2005–2007. Inmates were categorized as heroin-dependent if they met three or more of the six ICD-10 criteria. Heroin-dependent inmates had higher scores of bloodborne virus transmission risk than non-dependent IDUs (12.8 ± 16.0 vs. 7.2 ± 11.5, p < 0.001). Multiple logistic regression analysis indicated that heroin dependence was a significant moderator of the association between risky injection behaviors and HIV infection. It is crucial to integrate substance treatment with behavioral interventions into harm reduction programs to prevent bloodborne virus transmission among IDUs.