Drug use among patients at public clinics treating sexually transmitted infections (STI)

s / Drug and Alcohol Dependence 140 (2014) e2–e85 e83 day treatment (CM+). Participants completed the ASI at baseline, immediately following active treatment (six months), and at longterm follow-up (12 months). We hypothesized significant improvement in all 7 composite scores frompretopost-treatment. We also hypothesized the CM+ group would have significantly more improvement than the CM group. Results: A total of 141 participants had complete follow-updata at 12 months and were used in the analyses. A repeated measures MANOVA was conducted to determine if the two groups differed in improvement across time. Therewas no significant group× time interaction, F(12, 128) =1.360, p= .194, Wilk’s =0.887. Because there were no differences between CM and CM+, they were combined to examine improvement across time. Results indicated significant overall improvement, F(12, 129) =4.524, p= .000,Wilk’s =0.794. Graphs of the data show decreases in all areas between baseline and six months but no major changes from six to 12 months. Follow-up one-wayANOVAs showed significant decreases in mean scores for all composite scores except medical status. Conclusions: Participation in either treatment resulted in significant improvement in employment, alcohol use, drug use, legal status, family/social relationships, and psychiatric status immediately after treatment. These gains were sustained at a 12 month follow-up. That the CM intervention showed significant ASI gains not different from the CM+ group is consistent with the notion a less costly CM intervention may be used successfully as stepped care for many homeless persons with cocaine dependence. Financial support: Partially supported by NIDA grant R01 DA11789-04, RTI International and UAB. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.244 Drug use among patients at public clinics treating sexually transmitted infections (STI) Louise Haynes1, Kathleen T. Brady1, D.J. Feaster2, L.R. Metsch2 1 Medical University of South Carolina, Charleston, SC, United States 2 Miller School of Medicine, University of Miami, Miami, FL, United States Aims:We examined the substance use of individuals presenting for STI testing and the relationship of substance use to the prevalence of STI. Methods: 5012 participants were recruited between April and December 2010 among patients seeking treatment at nine public STI clinics. Self-reported alcohol and drug use in the prior 6-monthswere collected using Audio Computer Assisted Self Interview. Severe drug use was defined by a DAST-10 score >3. Results: The sample included heterosexual men (38.1%), men who have sex with men (MSM) (27.9%), and women (34%). Most participants (55.2%) reported using an illegal drug in the prior 6 months; over one-fourth (28.7%) reporteddruguse other thanmarijuana, and 17.0% reported stimulant use. About a quarter of the sample (24.7%) had DAST-10 scores consistent with severe drug use, and 6.1% reported intravenous drug use (IDU). There were 16.2% of participantswhodrank to intoxication.Womenhadhigher prevalence of any STI (55.7%) than either males (38.1%) or MSM (37.2%). Amphetamine use was associated with a higher prevalence of STI for MSM. Crack cocaine use was associated with higher prevalence of STI in all groups. Drinking to intoxication was also associated with higher STI prevalence in MSM and women. Current IDU was associated with an increased risk for STI across all three subgroups. Only 6% of the sample reported currently being engaged in substance abuse treatment. Conclusions: Severe drug use is common in this sample of STI clinic patients and is associated with higher prevalence of STI. Screening for substance use disorders in STI clinics may be an important strategy for expanding appropriate referrals to substance abuse intervention and treatment. Financial support:NIH/NIDAAward#RC2DA028973:HIV testing and counseling in HIV clinics: an adaptation of CTN0032 http://dx.doi.org/10.1016/j.drugalcdep.2014.02.245 Subjective and reinforcing effects of modafinil in rats David J. Heal1, N.W. Buckley1, J. Gosden1, D. Hackett2 1 RenaSci Ltd., Nottingham, United Kingdom 2 Shire Pharmaceutical Development Ltd., Basingstoke, United Kingdom Aims: Modafinil is a stimulant used to treat narcolepsy. In humans, its subjective effects are somewhat cocaine-like (Rush et al., 2002, Drug Alc Dep; 67:311) and it serves as a positive reinforcer in recreationaldrugusers (Jasinski, 2000, J Psychopharmacol; 14:53). Methods: We characterized the subjective effects of modafinil in groups of 6–9 female PVG rats trained to discriminate damfetamine (d-AMF) (0.5mg/kg ip) from saline and its reinforcing potential in groups of 7–9 male Sprague-Dawley rats trained to intravenously self administer cocaine (0.32mg/kg/injection) on a fixed ratio (FR2) schedule of drug reinforcement. Results: Tested 30min after dosing, modafinil (50, 100 and 150mg/kg ip) generalized partially to d-AMF (26-75%) at all doses. When tested at 60min, modafinil (100 and 150mg/kg ip) still partially generalized to d-AMF. Increasing the dose to 200mg/kg ip did not increase modafinil’s ability to generalize fully to dAMF. In rats which robustly self-administered cocaine (17.4 +0.4 infusions/session), modafinil (0.17, 0.50 and 1.66mg/kg/injection iv) did not maintain self-administration at levels above placebo (mean number of infusions/session: modafinil = 5.0–5.7 versus saline =4.4–5.1). Conclusions: Modafinil produces subjective effects in rats that were recognized as somewhat d AMF-like, but modafinil did not serve as a positive reinforcer in this species. The latter result is not definitive because modafinil’s limited solubility prevented the exploration of higher doses in the self-administrationmodel. These data agree with observations made in human subjects suggesting modafinil has only weak stimulant and reinforcing properties. The findings are also consistent with our results from the neurochemical and behavioural profiling ofmodafinil in rats (Rowley et al., this meeting). Financial support: Shire Pharmaceutical Development Ltd. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.246