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Biomedical subjects

P Blanken

Publications and source records attributed to P Blanken.

8 recordsLinked to original sources
PubMed2001

Heroin self-administration by means of 'chasing the dragon': pharmacodynamics and bioavailability of inhaled heroin.

In this controlled clinical study, the bioavailability and pharmacodynamics of inhaled heroin are evaluated and compared between 'chasing the dragon' and inhalation from a heating device, and at three dose levels, 25, 50 and 100 mg heroin, in two separate study phases. In study phase 1, no differences between the inhalation methods were detected on any of the physiological or behavioral measures, nor in bioavailability. Subjectively, the participants had a strong preference for the method of chasing, which was therefore used in study phase 2. In phase 2, heroin produced a dose-related increase in subjective drug-liking, body temperature and heart rate, and a clear, dose-related decline in reaction time. Linearly dose-related differences were found in the amount of total morphine in urine, amounting to an average of 45% of the parent heroin base received. Based on these findings, it is concluded that chasing is quite an effective route of heroin administration, producing rapid, dose-related subjective and objective effects and a sufficiently high and reproducible bioavailability.

Administration, Inhalation↗
PubMed2000

[Dutch research on the effectiveness of medical prescription of heroin; background, research design and preliminary results].

In the Netherlands the total number of heroin addicts amounts to approximately 25,000. Of these about 70% is in contact with the treatment system. The remaining 30% have not been seeking help, believes that no help is needed or has lost faith in a better future altogether. Of those who are in treatment, 30% attempt to stop the use of opiates through participation in drug free abstinence oriented outpatient or inpatient treatment programs. The remaining 70% have given up the outlook of a drug free existence at least temporarily, and they participate in a methadone maintenance program directed at stabilizing drug use, harm minimization and social integration. In two-thirds these goals are not or only partially achieved. For these patients additional treatment options are needed. Medical prescription of heroin is such an option. However, currently no data are available on the effectiveness of this option. The Dutch study on the effectiveness of medical prescription of heroin is an attempt to obtain these data. In the study, simultaneously two randomized trials are being executed: one with inhalable and one with injectable heroin. In these trials, 625 (375 inhalers and 250 injectors) chronic treatment-resistant heroin addicts who are currently enrolled in a methadone maintenance program are offered heroin (in combination with oral methadone) seven days per week, three times per day for a period of six to twelve months. It is a multi-center study with eight treatment units in six cities in the Netherlands (Amsterdam, The Hague, Groningen, Heerlen, Rotterdam, Utrecht). At this moment 180 patients have been randomized. During the treatment no medical complications have been observed and no serious public order or safety problems have occurred. Study participants have been very compliant both with the treatment regimen and the research requirements. The latter is indicated by the fact that 85% of all the two-monthly assessments have been completed.

Administration, Inhalation↗
PubMed1997

[Anticipated effects of experimental heroin prescription on the method of administration and the use of other drugs].

OBJECTIVE: Pending a Dutch heroin prescription trial (intended to regulate drug abuse), preliminary research was conducted into client factors that may influence the course and outcome, notably into administration patterns and changes in concomitant use of other drugs. DESIGN: Interview. SETTING: Methadone programme Baan in Rotterdam, the Netherlands. METHOD: In a Rotterdam methadone programme, 60 clients were identified matching the target group of a heroin prescription trial; 42 respondents were interviewed. Using a semistructured questionnaire, data were collected on characteristics of drug use in the preceding month. RESULTS: In addition to their methadone supply, the majority (90%) of the respondents used both heroin and cocaine. Heroin and cocaine were smoked as well as injected by 22% and 31% respectively. In the choice of a route of administration individually experienced effects played a major part, which suggests that participation in a prescription trial will not lead to shifts in employed routes of administration. Cocaine was often found to have a central position in polydrug use, while the function of heroin was mostly that of a modulator. This suggests that no direct effect on the use of cocaine can be expected from the prescription of heroin. On the contrary, the relationship between the available amount of money and the cocaine used was such that, considering that participants in a prescription trial may be left with more money, a prescription trial might lead to an increased use of cocaine. CONCLUSION: The prescription of heroin does not seem to have a direct effect on the use of cocaine. Indirectly the use of cocaine might increase.

Adult↗
PubMed1996

A research perspective on drug related nuisance--Dutch experiences.

The Dutch policy on drugs has yielded positive results from the public health point of view. Drug related nuisance, however, is an enduring problem and society's acceptance of this nuisance is diminishing. This article discusses the concept of drug-related nuisance and addresses the question how this nuisance can be measured. Next to it, attention is paid to the question whether the so-called Dutch "harm reduction policy" will survive.

Crime↗
PubMedDate not supplied

Drug sharing and HIV transmission risks: the practice of frontloading in the Dutch injecting drug user population.

Injecting drug users may now be the largest group at risk for contracting HIV, mainly through the sharing of drug injection equipment (including lending, borrowing, and renting). This article presents the results of an ongoing ethnographic study into the drug-taking rituals of heroin addicts. A possible additional route of HIV contamination is presented, namely the ritual sharing of drugs through a practice termed "frontloading," which is embedded in a broader pattern of the sharing of resources among addicts. It is hypothesized that in the Netherlands this practice may be responsible for a substantial proportion of HIV spread among injecting drug users.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Reaching the unreached: targeting hidden IDU populations with clean needles via known user groups.

Needle exchange is a practical and important part of the Dutch prevention strategy to check the spread of HIV among injecting drug users (IDUs). However, needle-exchange programs are often tied to drug treatment programs that only reach a limited number of IDUs. To overcome this limitation, alternative designs are considered and initiated. This article describes a community-based approach to needle exchange that is built on empowerment of, and intense participation by, known IDUs to target unknown IDUs for delivery of clean needles. The needle-exchange patterns of the IDUs participating in this collective scheme are compared to those of other users who exchanged needles on an individual basis. It was found that this approach extended the reach of the program to a great degree and that it was well received in the IDU community. However, the results were negatively influenced by police activities aimed at closing down places where drugs were used and sold. It is concluded that engaging IDUs in peer-group-directed prevention efforts is both feasible and promising.

Acquired Immunodeficiency Syndrome↗