Episodic Sexual Addiction in a Depressed Woman Treated With Cyproterone Acetate.

Episodic Sexual Addiction in a Depressed Woman Treated With Cyproterone Acetate.

Filed under: Addiction Rehab

J Clin Psychopharmacol. 2013 Feb 14;
Dardennes R, Al Anbar N, Rouillon F

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Trends in Opioid Agonist Therapy in the Veterans Health Administration: Is Supply Keeping up with Demand?

Filed under: Addiction Rehab

Am J Drug Alcohol Abuse. 2013 Mar; 39(2): 103-7
Oliva EM, Trafton JA, Harris AH, Gordon AJ

Background: Opioid agonist therapy (OAT) through addiction specialty clinic settings (clinic-based OAT) using methadone or buprenorphine or office-based settings using buprenorphine (office-based OAT) is an evidence-based treatment for opioid dependence. The low number of clinic-based OATs available to veterans (N = 53) presents a barrier to OAT access; thus, the expansion in office-based OAT has been encouraged. Objectives: To examine trends in office-based OAT utilization over time and whether availability of office-based OAT improved the proportion of veterans with opioid use disorders treated with OAT. Methods: We examined Veterans Health Administration (VHA) administrative data for evidence of buprenorphine prescribing and clinic-based OAT clinic stops from October 2003 through September 2010 [fiscal years (FY) 2004-2010]. Results: The number of patients receiving buprenorphine increased from 300 at 27 facilities in FY2004 to 6147 at 118 facilities in FY2010. During this time, the number of patients diagnosed with an opioid use disorder increased by 45%; however, the proportion of opioid use disorder patients receiving OAT remained relatively stable, ranging from 25% to 27%, Conclusions: Office-based OAT utilization and the number of opioid use disorder veterans treated with OAT are increasing at the same rate over time, suggesting that office-based OAT is being used to meet the growing need for OAT care. Although office-based OAT is increasingly being used within the VHA and may be one way the VHA is keeping up with the demand for OAT, more research is needed to understand how to engage a greater proportion of opioid use disorder patients in treatment.
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Self-reported alcohol abuse in HIV-HCV co-infected patients: a better predictor of HIV virological rebound than physician’s perceptions (HEPAVIH ANRS CO13 cohort).

Filed under: Addiction Rehab

Addiction. 2013 Feb 20;
Marcellin F, Lions C, Winnock M, Salmon D, Durant J, Spire B, Mora M, Loko MA, Dabis F, Dominguez S, Roux P, Carrieri MP,

AIMS: Studying alcohol abuse impact, as measured by physicians’ perceptions and patients’ self-reports, on HIV virological rebound among patients chronically co-infected with HIV and hepatitis C virus (HCV). DESIGN: Cohort study. SETTING: Seventeen French hospitals. PARTICIPANTS: 512 patients receiving antiretroviral therapy (ART) with an undetectable initial HIV viral load and at least two viral load measures during follow-up. MEASUREMENTS: Medical records and self-administered questionnaires. HIV virological rebound defined as HIV viral load above the limit of detection of the given hospital’s laboratory test. Alcohol abuse defined as reporting to have drunk regularly at least 4 (for men) or 3 (for women) alcohol units per day during the previous six months. Correlates of time to HIV virological rebound identified using Cox proportional hazards models. FINDINGS: At enrolment, nine percent of patients reported alcohol abuse. Physicians considered 14.8% of all participants as alcohol abusers. Self-reported alcohol abuse was independently associated with HIV virological rebound (hazard ratio [95% confidence interval]: 2.04 [1.13-3.67]; p=0.02), after adjustment for CD4 count, time since ART initiation and hospital HIV caseload. No significant relationship was observed between physician-reported alcohol abuse and virological rebound (p=0.87). CONCLUSIONS: In France, the assessment of alcohol abuse in patients co-infected with HIV and hepatitis C virus should be based on patients’ self-reports, rather than physicians’ perceptions. Baseline screening of self-reported alcohol abuse may help identify co-infected patients at risk of subsequent HIV virological rebound.
HubMed – addiction

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