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Cited by 22HIV, Drug Use, Sexual RiskOpioid Use Disorder TreatmentSubstance Abuse Treatment and Outcomes

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Emergence of methadone as a street drug in St. Petersburg, Russia

Open access
Heimer, Robert, Lyubimova, Aleksandra, Barbour, Russell, Levina, Olga S.·2016·International Journal of Drug Policy
DOI 10.1016/j.drugpo.2015.10.001PMC PMC4715906
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Abstract

Background The syndemic of opioid addiction, HIV, hepatitis, tuberculosis, imprisonment, and overdose in Russia has been worsened by the illegality of opioid substitution therapy. As part of on-going serial studies, we sought to explore the influence of opioid availability on aspects of the syndemic as it has affected the city of St. Petersburg.Methods We employed a sequential approach in which quantitative data collection and statistical analysis were followed by a qualitative phase. Quantitative data were obtained in 2013-2014 from a respondent-driven sample (RDS) of people who inject drugs (PWID). Individuals recruited by RDS were tested for antibodies to HIV and interviewed about drug use and injection practices, sociodemographics, health status, and access to medical care. Subsequently, we collected in-depth qualitative data on methadone use, knowledge, and market availability from PWID recruited at nine different locations within St. Petersburg.Results Analysis of interview data from the sample revealed the percentage of PWID injecting methadone in the 30 days prior to interview increased from 3.6% in 2010 to 53.3% in 2012-2013. Injection of only methadone, as compared to injecting only heroin or both drugs, was associated with less frequent injection and reduced HIV-related injected risk, especially a lower rate of injecting with a previously used syringe. In-depth questioning of methadone injectors corroborated the finding from serial quantitative surveys of PWID that methadone's black market availability is a recent phenomenon. Spatial analysis revealed widespread methadone availability but no concentration in any specific districts of the city.Conclusion Despite the prohibition of substitution therapy and demonization of methadone, the drug has emerged to rival heroin as the most commonly available opioid in St. Petersburg. Ironically, its use is associated with reduced injection-related HIV risk even when its use is illegal.

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  • In Russia and other settings in Eastern Europe and Central Asia, HIV has been primarily transmitted through unsafe injection of opioids, more recently predominantly of illicitly produced methadone.

    “In Russia and other settings in Eastern Europe and Central Asia, HIV has been primarily transmitted through unsafe injection of opioids, more recently predominantly of illicitly produced methadone.11”

    From An acceptance-based, intersectional stigma coping intervention for people with HIV who inject drugs—a randomized clinical trial (2023) · cites this paper as [11]

    The Introduction links Russia’s HIV epidemic to injection drug use, and the Abstract Results report a recent rise in illicit methadone injection among people who inject drugs in St. Petersburg. The paper does not establish that methadone injection has become the predominant route of HIV transmission, or extend that finding to other Eastern European and Central Asian settings. It instead reports lower injection-related HIV risk among those injecting only methadone than among the comparison groups. (LLM, conf=0.88)

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  1. Shaboltas, 2006, HIV prevalence, socio-demographic and behavioral correlates and recruitment methods among injection drug users in St. Petersburg, Russia, Journal of Acquired Immune Deficiency Syndromes, 41, 657

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Metadata

Authors
Heimer, R., Lyubimova, A., Barbour, R., & Levina, O. S.
Affiliations
Yale University (US)
Corresponding author
Heimer, Robert
ORCID
Venue
International Journal of Drug Policy
Publisher
Elsevier BV
Published
2016-01
Volume
27
Pages
97-104
ISSN
0955-3959 (ISSN-L)
DOI
10.1016/j.drugpo.2015.10.001
PMC
PMC4715906
OpenAlex
W1770405343
Cited by
22
References
28
Citations by year
2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 2
FWCI
1.31
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Drug Policy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Drug Abuse, USA (# R01 DA029888)
  • Fogarty International Centre at the US National Institutes of Health (# D43 TW001028)
Topics
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
methadone, black market drugs, people who inject drugs, opioid substitution therapy, heroin, HIV risk, drug availability, drug policy, syndemic, St. Petersburg, syringe reuse, injection practices
MeSH terms
Adult, Data Collection, Female, Heroin Dependence, Humans, Male, Methadone, Opioid-Related Disorders, Russia, Illicit Drugs, Substance Abuse, Intravenous, Opiate Substitution Treatment

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