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Collaborative Addiction Research in Asian Populations Home and Abroad. International Conference on Global Health: Prevention and Treatment of Substance Use Disorders and HIV Taipei, Taiwan April 18, 2013. Gavin Bart, MD PhD FACP FASAM Director, Division of Addiction Medicine
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Collaborative Addiction Research in Asian Populations Home and Abroad International Conference on Global Health: Prevention and Treatment of Substance Use Disorders and HIV Taipei, Taiwan April 18, 2013 Gavin Bart, MD PhD FACP FASAM Director, Division of Addiction Medicine Department of Medicine Hennepin County Medical Center Associate Professor of Medicine University of Minnesota bartx005@umn.edu
Hmong and opiate dependence • Validate the assessment tool • MINI versus SSADDA • Prevalence • Laos ~ 10% • Thailand ~15% • US ~3% • Mode • Smoking opium • Smoking heroin Malison 2011; Westermeyer 1981, 1995; Wiewel 2005
Hmong entering treatment Westermeyer and Chitasombat 1996
Methadone maintained Hmong: psychiatric comorbidity Bart 2013
Hmong treatment outcome • Behavioral only ~90% relapse • Methadone ~80% retention • Hmong 49.0 mg (17.4) • Non-Hmong 77.1 mg (25.1) Bart 2012
Hmong: a pocket of people Listman et al, 2007 and unpublished data
Hmong genotype v. phenotype Straka et al. 2006
R-methadone population pharmacokinetics:Hmong and non-Hmong Bart 2013
More questions • Why are the Hmong different? • Diet • Transporter function • Genetics • Can we predict methadone dose requirements? • Does this happen with other medications?
Why Research? • To find cures to disease and illness • Describe the situation • Epidemiology • Cohort studies • Compare approaches • Outcome • Quality of life / Satisfaction • Cost-effective • To inform policy
Thank You • NIDA K23 DA024663 • SAMHSA • PEPFAR • USAID • CDC • Vietnam VAAC • FHI360 • Yih-IngHser • Betty Tai • NIDA R13DA035084