THE DRUG PROBLEM
HIV infection among injecting Drug Users - A Devastating Combination
Drug injecting is a problem of global dimension, with major significance for the spread of HIV-1 infection and other blood-borne pathogens, notably hapatitis B and hepatitis C. Injecting drug use (IDU) has been reported in 120 countries & in many areas of world. Injecting drug use is the dominant mode of HIV transmission. At least 10 million people worldwide inject illicit drugs. In the last 20 years there have been many explosive epidemics of HIV among these people, 90% of them becoming infected often in very short period of time. Together, drug injecting and HIV form an explosive combination. For example, in Manipur, the first seropositive drug injector was not detected until October 1989, within 3 months 9 percent were positive and in the next 3 months, the prevalence rate had increased to 56 percent - a rise from 0 to 56 percent within six months.
The number of HIV infections in Eastern Europe has increased nine-fold in just three years, growing from less than 30,000 HIV infections in 1995 to an estimated 270,000 infections by December 1998. Ukraine has had the most dramatic epidemic, with an estimated 110,000 people living with HIV in December 1997, two-thirds of them injecting drug users. Since then the epidemic has grown rapidly. Similarly Belarus, Moldova, Kazakstan, & the Russian Federation have growing HIV epidemics; over 80% of injections are in individuals with a history of injecting drugs.
There is also potential for significant HIV spread outside the drug-injecting community. Drug users also have sex, and unsafe sexual behavior is highly associated with drug use.The majority of the drug users state that they rarely use condoms. In Central Asia, Tashkent, Uzbekistan, more than half of drug users' sex partners do not use drugs themselves, but practice unprotected sex with their IDU partners.
Current Approach towards Drug dependence treatment
Buprenorphine is currently the only available Pharmacotherapy for treatment of drug addicts. Providing substitution treatment with an Opioid like Buprenorphine has become one of the basic principles for preventing HIV infection among injecting drug users. These principles are recommended by eminent world authorities like World Health Organization,UNAIDS, and the Council of Europe. Buprenorphine has emerged as the most effective Pharmacotherapies for treatment of injecting drug users.
Rusan Pharma Ltd., India has been working diligently to make available this "New Hope" Buprenorphine, for the treatment of these unfortunate victims of addiction. Rusan has developed the in - house technology to manufacture Buprenorphine hydrochloride & its formulation. The formulation is marked under the brand name of Addnok & is avaiable as Addnok 2 mg /0.4mg/0.2mg sublingual tablets. Rusan is the only Indian company & 2nd in the world permitted to market Higher strengths of Buprenorphine sublingual tablets for treatment of Opioid dependence. Rusan has been regularly supplying Addnok tablets to a number of Premier Institutions in india namely All India Institute of Medical Sciences (AIIMS ) - New Delhi; Post Graduate Institute of Medical Sciences, Chandigarh; TTK Hospital ( T.T Raganathan Clinical & Research Foundation ) - Chennai.
The European Union had identified the problem of injecting drug use and AIDS long back and are currently funding a major project - "Comprehensive HIV/AIDS & STD treatment and care programme for IDUs and their parteners" in india. This project is being conducted by a prominent NGO ( Society for service to Urban Poverty ,New Delhi ) and is covering treatment of IDUs in the five major cities in india - Delhi, Mumbai, Calcutta, Chennai & Imphal, Rusan's Addnok tablets are an integral part of this EU project.
It is a known fact that majority of these addicts are in their productive years & hence industry suffers major losses due to them. In the US industry faces manufacturing defects as high as 34 % As it is well said prevention is better that cure. Rusan is also introducing Addline Opioid Strips ( Dipsticks for the detection of Opioid in unine ) .
The Dipsticks will drastically help control drug abuse among school children & adults at work place:
Either due to the fear of being caught red handed by way of Opioids detected by the dupsticks or the parents too can use these strips at home for early detection of their child's drug taking habit & hence prevent further complications of drug abuse.
Alcohol consumption and intoxication is another major problem faces globally & has strong link with drug abuse. To tackle this problem of alcoholism, Rusan is working on Alcosate ( Acamprosate tablets ) used for the treatment of chronic alcoholism.
World over the HIV epidemic is largely driven by heterosexual transmission ( NACO,1999 ). Unprotected sex and commercial sex is common with a high prevalence of sexually transmitted infection among IDUs. In addition to Addnok sublingual tablets. Rusan is working on Nevira ( Nevirapine 200 mg tablets ) for prevention of transmission of the HIV virus from The HIV + ve mother to the child.Additionally Rusan's anti-retrivial range comprises of Lamivudine 150 mg tablets & Stavudine 40 mg capsules.
Rusan has also applied for permission to market Buprenorphine/Naloxone combination in sublingual tablets & injectable dosage forms. The company will very soon also introduce Naloxone, Naltrexone & Nalbuphine formulations.
Rusan is thus commited to the cause of eliminating Drug abuse, HIV/AIDS & Alcohol dependence .