Subject of the article

Authors

Pikirenya Vladimir Ivanovich , Pechko Tatyana Leonidovna , Kopytov Andrey Vasilyevich

Institution

Belarusian State Medical University, Republic of Belarus, Minsk NGO “Positive Movement”, Republic of Belarus, Minsk

Abstract

The article describes the use of additional psychoactive substances by patients receiving maintenance therapy with opioid agonists, analyzes published data on the use of various groups of substances and the risks associated with it. The data of our own study are presented: 85.9% of patients smoked cigarettes in the last day (the same figure for the week), 33.1% consumed light alcohol in the week preceding the survey and 62.2% in the year preceding the survey, sedatives and hypnotics, taken without a doctor's prescription in the previous week was consumed by 26.8% of patients and 46.9% - in the year preceding the survey. Next in popularity are (the share of respondents who consumed per year) strong alcohol – 44.1%, cannabinoids – 21.6%, substances with anticholinergic activity – 19.3%, synthetic cathinones – 18.1%, opioids – 9.9%, amphetamines – 8% and synthetic cannabinoids – 0.5%.

Key words

maintenance therapy with opioid agonists; opioid addiction; harm reduction; polysubstance use; comorbidity.

Literature

1. Винницкая А.Г., Разводовский Ю.Е., Лелевич В.В. Оценка численности инъекционных потребителей наркотиков в Беларуси с использованием метода повторного захвата // Вопросы Наркологии. 2011. № 5. P. 46–50.
2. Александров А., Петрович М. Оценка социо-экономической эффективности реализации программ заместительной терапии наркотической зависимости на примере Гомельской области. Minsk, 2013. 104 p.
3. Platt L. et al. Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs. // Cochrane Database Syst. Rev. 2017. Vol. 9. P. CD012021.
4. Degenhardt L. et al. Global patterns of opioid use and dependence: harms to populations, interventions, and future action // The Lancet. Elsevier Ltd, 2019. Vol. 394, № 10208. P. 1560–1579.
5. Low A.J. et al. Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis. // Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am. 2016. Vol. 63, № 8. P. 1094–1104.
6. Moore K.E. et al. Effectiveness of medication assisted treatment for opioid use in prison and jail settings: A meta-analysis and systematic review. // J. Subst. Abuse Treat. 2019. Vol. 99. P. 32–43.
7. Sordo L. et al. Mortality risk during and after opioid substitution treatment: systematic review and metaanalysis of cohort studies. // BMJ. BMJ, 2017. Vol. 357. P. j1550.
8. Пикиреня В.И., Копытов А.В. Факторы, влияющие на эффективность заместительной терапии метадоном // Медицинский Журнал. 2018. Vol. 1. P. 30–34.
9. Пикиреня В.И., Копытов А.В. Клинико-психологические характеристики пациентов заместительной терапии метадоном и их связь с приверженностью лечению // Военная Медицина. 2019. Vol. 4. P. 120–125.
10. Ward J. et al. The effectiveness and safety of methadone maintenance // Addiction. 1996. Vol. 91, № 11. P. 1727–1729.
11. Jones J.D., Mogali S., Comer S.D. Polydrug abuse: A review of opioid and benzodiazepine combination use // Drug Alcohol Depend. Elsevier, 2012. Vol. 125, № 1–2. P. 8–18.
12. Berger H. Smoking Characteristics Of Methadone Patients // JAMA J. Am. Med. Assoc. 1972. Vol. 222, № 6. P. 705.
13. Пикиреня В.И., Копытов А.В. Приверженность заместительной терапии метадоном и ее связь с социально-демографической характеристикой пациентов // Медицинские Новости. 2018. Vol. 4. P. 18– 26.
14. Maremmani I. et al. Alcohol and cocaine use and abuse among opioid addicts engaged in a methadone maintenance treatment program. // J Addict Dis. 2007. Vol. 26, № 1. P. 61–70.
15. Lin C., Cao X., Li L. Psychoactive Substance Use among Methadone Maintenance Therapy Clients in China. // Int. J. Ment. Health Addict. 2017. Vol. 15, № 4. P. 801–811.
16. Emzhik M. et al. Concomitant Drug Use in Patients on Methadone Maintenance Therapy // Mashhad Univ. Med. Sci. Mashhad University of Medical Sciences, 2017. Vol. 6, № 2. P. 42–46.
17. Heikman P.K., Muhonen L.H., Ojanperä I.A. Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine // BMC Psychiatry. 2017. Vol. 17, № 1. P. 245.
18. Heikman P. et al. New psychoactive substances as part of polydrug abuse within opioid maintenance treatment revealed by comprehensive high-resolution mass spectrometric urine drug screening // Hum. Psychopharmacol. 2016. Vol. 31, № 1. P. 44–52.
19. Abrahamsson T. et al. Benzodiazepine, z-drug and pregabalin prescriptions and mortality among patients in opioid maintenance treatment-A nation-wide register-based open cohort study. // Drug Alcohol Depend. Elsevier Ireland Ltd, 2017. Vol. 174. P. 58–64.
20. Elkader A.K. et al. Methadone-nicotine interactions in methadone maintenance treatment patients. // J. Clin. Psychopharmacol. 2009. Vol. 29, № 3. P. 231–238.
21. jamovi - Stats. Open. Now. [Electronic resource]. URL: https://www.jamovi.org/ (accessed: 12.04.2022).
22. Zimmerman D.W. Comparative Power of Student T Test and Mann-Whitney U Test for Unequal Sample Sizes and Variances // J. Exp. Educ. Routledge, 1987. Vol. 55, № 3. P. 171–174.
23. Gibbons J.D., Chakraborti S. Comparisons of the Mann-Whitney, Student’s t, and Alternate t Tests for Means of Normal Distributions // J. Exp. Educ. Routledge, 1991. Vol. 59, № 3. P. 258–267.
24. Balhara Y.P.S., Jain R. Cannabis use among opioid-dependent individuals on opioid substitution therapy // J. Pharmacol. Pharmacother. Wolters Kluwer -- Medknow Publications, 2014. Vol. 5, № 3. P. 203–205.
25. Vadlamani N.L., Pontani R.B., Misra A.L. Increased brain uptake of morphine in the presence of the antihistamine tripelennamine. // J. Pharm. Pharmacol. J Pharm Pharmacol, 1984. Vol. 36, № 1. P. 61–63.
26. Barke K.E., Hough L.B. Opiates, mast cells and histamine release. // Life Sci. Life Sci, 1993. Vol. 53, № 18. P. 1391–1399.