Injection Drug Use Among Homeless Adults in the Southeast with Severe Mental Illness

2005 ◽  
Vol 16 (4A) ◽  
pp. 83-90 ◽  
Author(s):  
J. Gary Linn ◽  
Michael Brown ◽  
Lorna Kendrick
Keyword(s):  
Mental Illness ◽  
Drug Use ◽  
Severe Mental Illness ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Homeless Adults

scholarly journals Injection drug use among homeless adults with severe mental illness.

1997 ◽  
Vol 87 (5) ◽  
pp. 854-856 ◽  
Author(s):  
E Susser ◽  
P Betne ◽  
E Valencia ◽  
S M Goldfinger ◽  
A F Lehman
Keyword(s):  
Mental Illness ◽  
Drug Use ◽  
Severe Mental Illness ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Homeless Adults

scholarly journals Why the Treatment of Mental Disorders Is an Important Component of HIV Prevention among People Who Inject Drugs

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Elizabeth Buckingham ◽  
Ezra Schrage ◽  
Francine Cournos
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Drug Use ◽  
Mental Disorders ◽  
Hiv Infection ◽  
Injection Drug Use ◽  
People Who Inject Drugs ◽  
Injection Drug ◽  
Hiv Care ◽  
Hiv Positive

People who inject drugs are more likely to be HIV positive and to have a mental disorder than the general population. We explore how the detection and treatment of mental illness among people who are injecting drugs are essential to primary and secondary prevention of HIV infection in this population. Aside from opioid addiction, few studies have been conducted on the links between mental disorders and injection-drug use. However, independent of the injection-drug use literature, a growing number of studies demonstrate that untreated mental illness, especially depression and alcohol/substance use disorders, is associated with HIV-related risk behaviors, acquiring HIV infection, failure to access HIV care and treatment, failure to adhere to HIV care and treatment, and increased morbidity and mortality from HIV-related diseases and comorbidities. In our review of both the published literature and gray literature we found a dearth of information on models for providing care for both opioid addiction and other mental illnesses regardless of HIV status, particularly in low- and middle-income countries. We therefore make recommendations on how to address the mental health needs of HIV-positive people who inject drugs, which include the provision of opioid substitution therapy and integrated mental health, substance abuse, and HIV services.

scholarly journals 1315. Mind the Gap: Medical Trainees Require Training in Hepatitis C, Drug Use and Mental Health to Help Address the Opioid Crisis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S402-S402
Author(s):  
Kimberly Corace ◽  
Isabelle Ares ◽  
Nicholas Schubert ◽  
Jason Altenberg ◽  
Melanie Willows ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hepatitis C ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Opioid Epidemic ◽  
Hcv Treatment ◽  
Medical Trainees ◽  
Opioid Crisis

Abstract Background Dramatic increases in acute hepatitis C (HCV) incidence is linked to the opioid epidemic and increased injection drug use. Over 50% of people with HCV also have a mental illness. IDSA/HIVMA calls for the integration of infectious diseases, addiction medicine, and mental health as key to addressing the opioid epidemic. Barriers identified include limited physician education and stigma. This study examined medical trainees’ gaps in training and attitudes toward HCV, drug use, and mental illness. Methods Medical students and residents (N = 98) at a large Canadian University completed questionnaires assessing stigma, attitudes, knowledge, and training related to HCV, drug use, and mental illness. Results Most participants were medical residents (71%). Within-subjects ANOVAs showed that trainees worked with more patients with mental illness (71%) than drug use (55%) or HCV (21%) (P’s < 0.001). Trainees reported less positive experiences with patients with drug use (34%) and HCV (36%) compared with those with mental illness (55%) (p’s < 0.05). They reported that injection drug use (68%), prescription opioids (66%), and heroin use (59%) were the most challenging substance use problems to treat (P < 0.001). They were less satisfied working with patients with drug use (40%) or HCV (40%) than mental illness (59%) (P’s < 0.01). Trainees reported they were more able to help patients with mental illness (83%) than HCV (65%) or drug use (73%) (P’s < 0.01). Only 34% saw HCV treatment as central to their professional role. Their training better prepared them to treat mental illness (58%) than drug use (41%) or HCV (19%) (P’s < 0.001). They were more interested in training in drug use (76%) and mental health (71%) than HCV (62%) (P’s < 0.01). Conclusion Medical trainees report being ill-equipped to treat patients with HCV and drug use (specifically opioids) and are less satisfied with this work. Many report attitudes that may be viewed by patients as stigmatizing. There is a large knowledge gap related to the effectiveness of HCV treatment. Addressing the opioid crisis requires a physician workforce that is prepared to integrate treatment for HCV, drug use, and mental illness. Infectious disease specialists can take a leadership role in building capacity to foster integration. Disclosures All authors: No reported disclosures.

scholarly journals Tuberculosis Knowledge, Perceived Risk and Risk Behaviors Among Homeless Adults: Effect of Ethnicity and Injection Drug Use

2004 ◽  
Vol 29 (6) ◽  
pp. 483-497 ◽  
Author(s):  
Adeline Nyamathi ◽  
Heather Sands ◽  
Angela Pattatucci-Arag�n ◽  
Jill Berg ◽  
Barbara Leake
Keyword(s):  
Drug Use ◽  
Risk Behaviors ◽  
Injection Drug Use ◽  
Perceived Risk ◽  
Injection Drug ◽  
Homeless Adults

scholarly journals Prevalence, Distribution, and Correlates of Hepatitis C Virus Infection among Homeless Adults in Los Angeles

2012 ◽  
Vol 127 (4) ◽  
pp. 407-421 ◽  
Author(s):  
Lillian Gelberg ◽  
Marjorie J. Robertson ◽  
Lisa Arangua ◽  
Barbara D. Leake ◽  
Gerald Sumner ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Los Angeles ◽  
Drug Use ◽  
Injection Drug Use ◽  
Sexual Behaviors ◽  
Hcv Infection ◽  
Older Age ◽  
Injection Drug ◽  
Homeless Adults

Objective. We documented the prevalence, distribution, and correlates of hepatitis C virus (HCV) infection among urban homeless adults. Methods. We sampled a community-based probability sample of 534 homeless adults from 41 shelters and meal programs in the Skid Row area of downtown Los Angeles, California. Participants were interviewed and tested for HCV, hepatitis B, and HIV. Outcomes included prevalence, distribution, and correlates of HCV infection; awareness of HCV positivity; and HCV counseling and treatment history. Results. Overall, 26.7% of the sample tested HCV-positive and 4.0% tested HIV-positive. In logistic regression analysis, independent predictors of HCV infection for the total sample included older age, less education, prison history, and single- and multiple-drug injection. Among lifetime drug injectors, independent predictors of HCV infection included older age, prison history, and no history of intranasal cocaine use. Among reported non-injectors, predictors of HCV infection included older age, less education, use of non-injection drugs, and three or more tattoos. Sexual behaviors and snorting or smoking drugs had no independent relationship with HCV infection. Among HCV-infected adults, nearly half (46.1%) were unaware of their infection. Conclusions. Despite the high prevalence of HCV infection, nearly half of the cases were hidden and few had ever received any HCV-related treatment. While injection drug use was the strongest independent predictor, patterns of injection drug use, non-injection drug use, prison stays, and multiple tattoos were also independent predictors of HCV. Findings suggest that urgent interventions are needed to screen, counsel, and treat urban homeless adults for HCV infection.

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