Treatment of Kratom Withdrawal and Addiction With Buprenorphine.

: In this article, we describe a middle-aged woman with a history of addiction to opioid medications who eventually became dependent on kratom. Her kratom-related withdrawal symptoms responded to a trial of buprenorphine-naloxone. Subsequently, she was maintained on this medication.

Outcomes of Outpatient Parenteral Antimicrobial Therapy in Patients With Injection Drug Use.

Background: Historically, there has been a restrictive approach toward outpatient parenteral antimicrobial therapy (OPAT) in patients with injection drug use (IDU) due to the fear that they might utilize the intravenous catheter to inject illicit substances.

Objective: We tested the hypothesis that patients with current IDU on OPAT would have less favorable treatment outcomes compared to those without current IDU.

Methods: In this retrospective cohort chart review study of Cleveland Clinic OPAT registry, we identified patients with current IDU by both electronic and manual review.

Bath salts in the emergency department: a survey of emergency clinicians' experience with bath salts-intoxicated patients.

Objectives: Several novel synthetic amphetamines have been marketed worldwide as "bath salts." The use of bath salts is associated with severe medical consequences resulting in a US federal ban over the last 3 years on the more common substances found in this group. Bath salts intoxication has a relatively nonspecific presentation, and urine toxicology confirmation in emergency departments (EDs) is impractical because the turnaround time is several days.

Transition to injection amongst opioid users in Iran: implications for harm reduction.

Driven by opioid use, HIV prevalence is high (15-27%) amongst injection drug users (IDU) in Iran. Harm reduction programmes are associated with a reduction in high risk injecting behaviours; however, Iran has a large number of non-injecting opioid users not immediately targeted by harm reduction programmes. The vast majority of heroin injectors tend to have a history of several years of smoking opium or heroin before transitioning to injection, and a small fraction may even start their drug career by injection of opioids, behaviours that can undermine the effectiveness of the harm reduction programmes.

Injection drug use in Rural Iran: integrating HIV prevention into iran's rural primary health care system.

Major opium trafficking routes traverse rural Iran, but patterns of drug use and HIV infection in these areas are unknown. In 2004, Iran's Ministry of Health integrated substance use treatment and HIV prevention into the rural primary health care system. Active opium or heroin users (N = 478) were enrolled in a rural clinic.

Needle and syringe sharing practices among injecting drug users in Tehran: a comparison of two neighborhoods, one with and one without a needle and syringe program.

This study was conducted to compare needle and syringe sharing practices among injecting drug users (IDUs) in two neighborhoods, one with and one without a needle and syringe program (NSP). In 2005, 419 street-based IDUs were interviewed at specific locations in two neighborhoods where IDUs are known to congregate. We compared self-reported needle and syringe access and use between IDUs from a neighborhood with an active NSP to IDUs from a neighborhood without such an intervention.

Prevalence and correlates of hepatitis C virus infection among injecting drug users in Tehran.

This study aimed to investigate the prevalence and correlates of hepatitis C virus infection among injecting drug users in a community-based setting in Tehran, Iran. In October 2004, injecting drug users were recruited from a drop-in centre and neighboring parks and streets in a drug-populated neighborhood in Tehran. Participants were interviewed using a structured questionnaire, and a sample of oral mucosal transudate was collected for detection of HIV and HCV antibodies.

The impact of Bam earthquake on substance users in the first 2 weeks: a rapid assessment.

In the final days of the year 2003, an earthquake in the city of Bam, Iran, led to the death of some 35,000 of its inhabitants. The rate of opium abuse, which had been high among the male population in this city, caused problems after the earthquake. The aim of the following study was to examine the status of substance abusers during the first 2 weeks after the earthquake.

Prevalence of and factors associated with HIV-1 infection among drug users visiting treatment centers in Tehran, Iran.

Objectives: This study was conducted to identify the prevalence of and potential risk factors for HIV-1 infection among drug users visiting drug treatment centers in Tehran, Iran.

Design: Cross-sectional quantitative study.

Methods: Between October 2003 and May 2004, drug users who visited three public drug treatment centers in Tehran were interviewed and information about their sociodemographics, drug use characteristics, incarceration history, sexual history, and HIV/AIDS knowledge and risk perception were collected.