HIV infection and drug overdose
Source: The Sangai Express / Source:Eurekalert
UK, December 18 2011:
A link between HIV infection and risk of overdose has been analysed by researchers.
Findings of the study show a 74 percent greater risk of overdose among drug users if they are HIV-infected.
The researchers found that reasons for the increased risk are biological and behavioral, but may also include environmental and structural factors.
Drug overdose is a common cause of non-AIDS death among people with HIV and is the leading cause of death for people who inject drugs.
People with HIV are often exposed to opioid medication as part of their treatment, while others may continue to use illicit opioids despite their disease status.
Both scenarios present a heightened risk for fatal and non-fatal overdose.
While the association between HIV infection and injection drug use has been well documented, the potential association between HIV and overdose has received less attention.
With this in mind, Traci Green, Ph.D., M.Sc., a researcher with Rhode Island Hospital and the Lifespan/Tufts/Brown Center for AIDS Research, led a study to systematically review the literature on the putative association of HIV infection with overdose, meta-analyse the results and explore the causes.
Green reports that 46 studies were reviewed, and 24 of those reported data that were sufficient for inclusion in their analysis.
Based on those studies, He says, "Our results suggest that people who use drugs have a 74 percent greater risk of overdose if they are HIV-infected compared to their counterparts who are not HIV-infected.
Over the past 30 years, we have made impressive strides in caring for and prolonging the lives of people with HIV.
Our study found that premature death by overdose is an issue that affects people with HIV disproportionately" .
Green further explains that other reasons for the association may include factors such as poor access to medication-assisted therapy to treat opioid dependence, homelessness and poverty, which may contribute to a higher risk of overdose.
He said "The good news is that we already have several cost-effective overdose prevention tools to call upon.
The first is access to highly active antiretroviral therapy medications and second is the medication-assisted therapy, and in particular, methadone and buprenorphine, which have been shown to protect against fatal overdose.
The third tool is distribution of Naloxone, a prescription medication with no abuse potential that reverses an opioid overdose, to people who are HIV positive and use opiates.
Green adds, "Bringing overdose awareness and prevention into the HIV care setting is critical to reducing overdose deaths.
Health care providers who treat HIV-infected patients with a history of substance abuse or who are taking opioid medications should consider counseling patients on how to reduce their risk of overdose.
They may also consider prescribing Naloxone to patients, or offering a referral to MAT to reduce the risk of overdose" .