15 May 2012
Gus Cairns
Published: 11 May 2012
The US Food and Drug Administration (FDA) took a decisive step yesterday towards approving the use of the combination pill Truvada (tenofovir/FTC) as a prevention method for HIV-negative people.
The FDA’s Antiviral Drugs Advisory Committee (ADAC) voted by a majority of 19 to 3 in favour of recommending Truvada as PrEP (pre-exposure prophylaxis) for men who have sex with men, and by 19 to 2 with one abstention for an approval for use by the HIV-negative partner in serodiscordant couples.
There was a closer vote, however, when it came to recommending its use generally in individuals: 12 to 8, with two abstentions, voted for a general recommendation for any person at risk of HIV.
The ADAC decision was taken after an all-day meeting on 10 May. This meeting discussed the findings of a written report and also heard submissions from a large number of community prevention and treatment advocates. Interest was such that the FDA extended the time for submissions from advocates and community members from one hour to two and had to organise a ballot for access to the hearings.
The written report had concluded that concerns about safety and HIV drug resistance were not sufficient to delay the introduction of PrEP. It also decided that concerns about poor adherence levels seen in some randomised controlled trials, and about whether PrEP would negatively influence behaviour to such a degree that people ended up at greater risk of HIV, were beyond the remit of the FDA.
“I don’t think it’s our charge to judge whether people will take the medicine,” panellist Dr Tom Giordano told the Los Angeles Times. “Our charge is to judge whether it works when taken.”
08 May 2012
By Ainslie Cruickshank on May 7, 2012 at 2:49 pm
Questions arose in the legislature last Thursday about the possibility of opening a “wet” shelter in Whitehorse.
Darius Elias, the interim leader of the Liberal party, noted that other jurisdictions have seen success with a wet shelter program. He inquired whether the government was considering the option in responding to Whitehorse’s homelessness problem.
“Wet shelters do not require sobriety from people who stay there, and staff may provide small amounts of alcohol to residents to lower and balance out their alcohol consumption,” he said. “It is very difficult to get sober when people are living on the street.”
Health and Social Services Minister Doug Graham said the government isn’t looking at a wet shelter at present, saying it would like to observe the experience with the shelters in other communities over a longer time period.
Graham did note that Whitehorse has what he termed a “damp shelter” at the Salvation Army. Here, people are admitted even if they are intoxicated, but not if they have any alcohol with them.
The government would also like to see the medical detoxification centre at the Sarah Steele Building up and running before further consideration is given to a wet shelter, said Graham.
He pointed to the government’s investment of between $645,000 and $665,000 into the program.
Elias said studies and examples in other communities have demonstrated numerous benefits of wet shelters.
“For lifetime alcoholics, a wet shelter is their first step to getting well,” he said.
02 May 2012
OTTAWA — A team of researchers Wednesday recommended the creation of two supervised injection facilities in Ottawa and three in Toronto.
After what is thought to be the broadest study of its kind, the researchers concluded that such facilities would improve the health and reduce harm among drug users. They could also reduce public drug use and save money for the health system, they said.
"We projected that supervised injection facilities would prevent HIV and hepatitis C infections and result in multiple benefits for people who use drugs in Toronto and Ottawa," said the University of Toronto's Carol Strike, who led the research with Dr. Ahmed Bayoumi of St. Michael's Hospital in Toronto.
Such facilities "are likely to represent good investments of health-care dollars," added Bayoumi, an HIV specialist.
The report of the Toronto and Ottawa Supervised Consumption Assessment said multiple sites are preferable to a single, central location like Vancouver's Insite clinic.
25 Apr 2012
Voluntary testing and counseling (VT/C) for HIV or sexually transmitted infections (STI) among cocaine and heroin users who were treated in the emergency department (ED), accompanied by referral to drug treatment, was associated with reduction in unprotected sex acts and fewer sex acts while high according to researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC).
These findings currently appear on-line in Academic Emergency Medicine.
In the United States, sexual risk behaviors are a greater source of HIV transmission than injection drug use. Although recent articles have focused on the opportunity for early HIV detection and treatment through an array of ED screening and testing strategies, the effect of VT/C and referral to drug treatment on the sexual behaviors of out-of-treatment drug users over time has not yet been reported.
20 Apr 2012
A decade of research into hepatitis C may have yielded results as researchers in Canada have announced the discovery of a vaccine against the disease.
Hepatitis C is more virulent than HIV, and it was believed coming up with a vaccine would be almost impossible. However, researchers from the University of Alberta say a vaccine has been developed from a single strain, and has shown to be effective against all known strains of the virus.
The vaccine was capable of eliciting broad cross-neutralising antibodies against all the different major strains – a finding which bodes well for those with the disease, and those travelling to areas where it is prevalent.
19 Apr 2012
People with an opioid addiction had the highest risk of death when compared with rates for alcohol and other drugs, according to a new study by the Centre for Addiction and Mental Health (CAMH).
For those dependent on opioids, the risk of death was 5.71 times higher than healthy individuals in the population of the same age, gender and race. Those with methamphetamine use disorders were next highest with a 4.67-fold risk, followed by those with addictions to cannabis (3.85), alcohol (3.83) and cocaine (2.96). Alcohol dependence was related to the highest number of deaths overall.
The study, available online in the journal Drug and Alcohol Dependence, is the largest North American study to compare mortality rates among different drug users with the longest follow-up. It tracked records of more than 800,000 individuals hospitalized with drug dependence between 1990 and 2005. Of this group, more than 188,000 died during this period.
18 Apr 2012
13 April 2012 - At a time of declining international aid flows to low income countries home to a high number of people living with HIV, Yury Fedotov, Executive Director of UNODC, yesterday addressed the 36th Meeting of the UNAIDS Committee of Cosponsoring Organizations (CCO) in Geneva. "This is resulting in a devastating situation, particularly in those countries where HIV epidemics are concentrated among key population groups such as drug users", said Mr. Fedotov, adding that "life saving HIV services are closing down".
UNODC is playing a critical role in assisting governments to tackle drug demand reduction and to provide comprehensive HIV prevention, treatment and care. The need for targeted and integrated services for drug users was more important than ever, said the Executive Director.
Mr. Fedotov expressed particular concern about the increasing global abuse of synthetic drugs, mainly amphetamine-type stimulants (ATS) and prescription drugs. Increasing evidence suggests that the use of ATS facilitates HIV transmission. Methamphetamine use elevates the risk of contracting HIV and increases the progression of the disease.
28 Mar 2012
Postmedia News March 27, 2012
A number of interveners have come forward to add weight to a scheduled Ontario Court of Appeal hearing to address a constitutional challenge of proposed changes to Canada's medical marijuana rules.
The case centres around Matt Mernagh, who was previously charged with marijuana production after police found the plants he used to treat his chronic pain and other symptoms of scoliosis, fibromyalgia and epilepsy. Police discovered Mernagh's plants in 2008 when they were in his apartment building on an unrelated call.
The matter, which is scheduled over two consecutive days starting May 7, has heard from three proposed interveners. The B.C. Civil Liberties Association and the Canadian Civil Liberties Association are included as well as a joint application from the Canadian AIDS Society, the Canadian AIDS/HIV Legal Network and HIV and AIDS Legal Clinic Ontario.
13 Mar 2012
CTVNews.ca Staff, Date: Monday Mar. 12, 2012
Using a medically prescribed form of heroin to treat addicts is less costly and more beneficial in the long run than regular methadone therapy, a recent study suggests.
The prescribed form of heroin, known diacetylmorphine, is generally considered more expensive than methadone therapy. But researchers have found that addicts who are given the pricier option stay in treatment longer and are less likely to relapse, and therefore be involved with drug-related criminal activity such as robberies to support a drug habit, leading to long-term savings.
The findings, published in the Canadian Medical Association Journal, hint that heroin-assisted therapy is both medically helpful for patients and an economically-wise choice for society.
Those findings were drawn from the North American Opiate Medication Initiative (NAOMI), a trial that compared the effectiveness of medically-prescribed heroin and methadone therapy in addicts from 2005 to 2008.
13 Mar 2012
March 12, 2012
Prescription narcotic addiction has been a growing problem in Ontario. Recent studies have suggested an increase in opioid painkiller addiction as playing a contributing role in hundreds of overdose deaths.
On March 1, 2012, Purdue Pharma stopped distributing the brandname opioid formulation OxyContin into the Canadian market and replaced it with OxyNEO, a tamper-resistant tablet that is more difficult to crush and abuse.
Ontario also decided to restrict access to OxyNEO by funding it through the Exceptional Access Program and the Facilitated Access to Palliative Care Drugsmechanism. This decision balances appropriate use, patient care and the growing problem of opioid addiction in Ontario, and was based on advice from Ontario's Committee to Evaluate Drugs and extensive discussions with pain specialists, addiction experts and other health care providers.
I support these changes as a necessary response to a life-threatening problem. At the same time, Ontario is taking action to help recovering OxyContin users find addiction treatment.
OHSUTP
