Sample records for abuse misuse dependence

  1. Alcohol and drug misuse, abuse, and dependence in women veterans.

    PubMed

    Hoggatt, Katherine J; Jamison, Andrea L; Lehavot, Keren; Cucciare, Michael A; Timko, Christine; Simpson, Tracy L

    2015-01-01

    We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  2. Psychometric modeling of abuse and dependence symptoms across six illicit substances indicates novel dimensions of misuse

    PubMed Central

    Clark, Shaunna L.; Gillespie, Nathan A.; Adkins, Daniel E.; Kendler, Kenneth S.; Neale, Michael C.

    2015-01-01

    Aims This study explored the factor structure of DSM III-R/IV symptoms for substance abuse and dependence across six illicit substance categories in a population-based sample of males. Method DSM III-R/IV drug abuse and dependence symptoms for cannabis, sedatives, stimulants, cocaine, opioids and hallucinogens from 4179 males born 1940-1970 from the population-based Virginia Adult Twin Study of Psychiatric and Substance Use Disorders were analyzed. Confirmatory factor analyses tested specific hypotheses regarding the latent structure of substance misuse for a comprehensive battery of 13 misuse symptoms measured across six illicit substance categories (78 items). Results Among the models fit, the latent structure of substance misuse was best represented by a combination of substance-specific factors and misuse symptom-specific factors. We found no support for a general liability factor to illicit substance misuse. Conclusions Results indicate that liability to misuse illicit substances is drug class specific, with little evidence for a general liability factor. Additionally, unique dimensions capturing propensity toward specific misuse symptoms (e.g., tolerance, withdrawal) across substances were identified. While this finding requires independent replication, the possibility of symptom-specific misuse factors, present in multiple substances, raises the prospect of genetic, neurobiological and behavioral predispositions toward distinct, narrowly defined features of drug abuse and dependence. PMID:26517709

  3. Codeine misuse and dependence in South Africa--learning from substance abuse treatment admissions.

    PubMed

    Dada, S; Harker Burnhams, N; Van Hout, M C; Parry, C D H

    2015-09-14

    Misuse of prescription and over-the-counter codeine-containing products is a global public health issue. To investigate the extent of treatment demand related to the misuse of codeine or codeine dependence in South Africa (SA) and the profile of patients seeking treatment, so as to understand the nature and extent of the problem. Data were collected from centres participating in the South African Community Epidemiology Network on Drug Use in 2014. A total of 17 260 admissions were recorded. There were 435 recorded treatment admissions for codeine misuse or dependence as a primary or secondary substance of abuse (2.5% of all admissions). Of treatment admissions, 137 (0.8%) involved codeine as the primary substance of abuse; 74.9% of patients were males, with an even spread across population groups. Ages ranged from 11 to 70 years, with the highest proportion aged 20 - 29 years; >40% were referred by self, family and/or friends, and 26.7% by health professionals; and 36.8% had received treatment previously. The majority reported misuse of tablets/capsules, with 17.6% reporting misuse of syrups. Oral use comprised 96.6% and daily use 63.1%. Data from treatment admissions related to codeine misuse and dependence are informative, but provide an incomplete picture of the nature and extent of codeine-related problems in SA. Other data sources must be considered before further regulatory/policy changes regarding codeine are implemented.

  4. Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics.

    PubMed

    Schaeffer, Tammi

    2012-12-01

    The increased use of opioid pain medication has been mirrored by the increased misuse and abuse of these drugs. As part of a multidisciplinary approach to this epidemic, pharmaceutical companies, with the encouragement of the Food and Drug Administration, have increased the development of abuse-deterrent formulations. While all have the goal of treating pain while mitigating misuse and abuse, there are different technologies utilized to impart the abuse-deterrent properties. The goal of this paper is to review the basis of abuse-deterrent formulations, the different types and approaches of some of the abuse-deterrent products, and their current regulatory status in the USA.

  5. 14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

  6. 14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

  7. 14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

  8. 14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

  9. 14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

  10. Intentional Misuse and Abuse of Loperamide: A New Look at a Drug with "Low Abuse Potential".

    PubMed

    Borron, Stephen W; Watts, Susan H; Tull, Jonathan; Baeza, Salvador; Diebold, Stephanie; Barrow, Alison

    2017-07-01

    Despite its opioid properties, loperamide has long been thought to have low abuse potential due to its poor absorption from the gastrointestinal tract and limited potential to cross the blood-brain barrier. A recent patient reportedly taking loperamide to avoid heroin withdrawal symptoms, at doses approximately 100 times those recommended, directed our attention to this issue. 1) Investigate number of cases of intentional loperamide abuse and misuse reported to poison centers between 2009 and 2015; 2) Compile reports of clinical effects of loperamide abuse; and 3) Search for evidence of increasing Internet interest in the central opioid effects of loperamide. For the years 2009 thru 2015, we reviewed exposure calls related to misuse/abuse of loperamide in the Texas Poison Center Network's database and the National Poison Data System. We used Google trend analysis to detect evidence of increased Internet interest in the illicit use of loperamide. Between 2009 and 2015, the number of misuse/abuse calls related to loperamide alone nearly doubled, with about one-third of cases occurring in teens and young adults in their 20s. Of particular concern are reports of significant cardiotoxic effects (∼18% of cases), including conduction defects and various dysrhythmias, sometimes leading to death. Google Trends analysis demonstrates an increasing number of searches for "loperamide high" and "loperamide withdrawal" beginning in 2011. Loperamide misuse/abuse seems to be on the rise. Given its propensity to induce conduction disturbances and dysrhythmias at very high doses, emergency physicians should be vigilant for this form of drug abuse. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Abuse and Misuse of Prescription and Nonprescription Drugs from Community Pharmacies in Aden City-Yemen.

    PubMed

    Abood, Ebtesam A; Wazaify, Mayyada

    2016-06-06

    The abuse and misuse of prescription and nonprescription or the so-called Over-The-Counter (OTC) drugs is a serious and growing public health problem worldwide. The increased availability of these drugs has contributed to a dramatic rise of inappropriate use. The aim of this study was to investigate abuse/misuse of prescription and non-prescription drugs in community pharmacies in Aden city-Yemen and to gather information about suspected drug abusers in the community. A cross-sectional survey using a structured questionnaire randomly distributed to 200 community pharmacies (June-September 2013). Data were coded and analyzed using SPSS Results: A total of 170 pharmacists completed the questionnaire (85.0% response rate), more than half of which (57.7%) suspected drug abuse/misuse in their pharmacies. The top four suspected medications of abuse were Alprazolam, Ketoprofen, Tramadol, and antibiotics. Most participating pharmacists in this study (83.3%) noticed an increasing pattern of abuse/misuse. The majority of suspects of prescription and non-prescription drug abuse (64.1%) were either chewing Khat or carrying it while buying the drug from the pharmacists. Abuse/misuse of prescription and nonprescription drugs is present in community pharmacies in Aden and it is linked to the recreational use of Khat. Current methods for controlling the problem are ineffective, and better methods should be developed.

  12. Prevalence of Prescription Opioid Misuse/Abuse as Determined by International Classification of Diseases Codes: A Systematic Review.

    PubMed

    Roland, Carl L; Lake, Joanita; Oderda, Gary M

    2016-12-01

    We conducted a systematic review to evaluate worldwide human English published literature from 2009 to 2014 on prevalence of opioid misuse/abuse in retrospective databases where International Classification of Diseases (ICD) codes were used. Inclusion criteria for the studies were use of a retrospective database, measured abuse, dependence, and/or poisoning using ICD codes, stated prevalence or it could be derived, and documented time frame. A meta-analysis was not performed. A qualitative narrative synthesis was used, and 16 studies were included for data abstraction. ICD code use varies; 10 studies used ICD codes that encompassed all three terms: abuse, dependence, or poisoning. Eight studies limited determination of misuse/abuse to an opioid user population. Abuse prevalence among opioid users in commercial databases using all three terms of ICD codes varied depending on the opioid; 21 per 1000 persons (reformulated extended-release oxymorphone; 2011-2012) to 113 per 1000 persons (immediate-release opioids; 2010-2011). Abuse prevalence in general populations using all three ICD code terms ranged from 1.15 per 1000 persons (commercial; 6 months 2010) to 8.7 per 1000 persons (Medicaid; 2002-2003). Prevalence increased over time. When similar ICD codes are used, the highest prevalence is in US government-insured populations. Limiting population to continuous opioid users increases prevalence. Prevalence varies depending on ICD codes used, population, time frame, and years studied. Researchers using ICD codes to determine opioid abuse prevalence need to be aware of cautions and limitations.

  13. Topical review on the abuse and misuse potential of tramadol and tilidine in Germany.

    PubMed

    Radbruch, Lukas; Glaeske, Gerd; Grond, Stefan; Münchberg, Frank; Scherbaum, Norbert; Storz, Elisabeth; Tholen, Kathrin; Zagermann-Muncke, Petra; Zieglgänsberger, Walter; Hoffmann-Menzel, Helmut; Greve, Hendrik; Cremer-Schaeffer, Peter

    2013-01-01

    Tramadol and tilidine (in combination with naloxone) are used as weak opioid analgesics in Germany. Tramadol is not scheduled in the German Narcotic Drugs Act. Tilidine is scheduled, whereas Tilidine in fixed combinations with naloxone is exempt from some of the provisions of the Narcotic Drugs Act. Recent reports on misuse of both substances led to an evaluation of their potential for misuse, abuse, and dependency by the expert advisory committee established by the German Federal Government, resident at the Federal Institute for Drugs and Medical Devices. A subcommittee formulated key questions and identified available data sources for each of these questions. Additional information was solicited where necessary, including a survey among a panel of pharmacists, a survey in an addiction clinic, analysis of prescription patterns, and information from the boards of pharmacists of the federal states and the Federal Bureau of Criminal Investigation. Analgesic efficiency in the treatment of acute and chronic pain has been proven for both tramadol and tilidine/naloxone. For tramadol, high evidence has been confirmed in systematic reviews, and tramadol is listed in national and international guidelines on acute and chronic pain management. Animal and human studies found a low potential for misuse, abuse, and dependency for both substances. Information from 2 tramadol safety databases allowed calculation of the incidence of abuse or dependency as 0.21 and 0.12 cases per million defined daily dosages (DDDs), with lower incidences in recent years. For tilidine/naloxone, the incidence was calculated as 0.43 cases per million DDDs for oral solution and 0.18 for slow-release tablets. In an online survey among German pharmacies as well as in the reports from state pharmacy boards, fraud attempts were repeated more frequently with tilidine/naloxone than with tramadol in the last 2 years. The Federal Bureau of Criminal Investigations reported prescription fraud only with tilidine

  14. Trends in abuse and misuse of prescription opioids among older adults.

    PubMed

    West, Nancy A; Severtson, Stevan G; Green, Jody L; Dart, Richard C

    2015-04-01

    Dramatic increases in the prescriptive use of opioid analgesics during the past two decades have been paralleled by alarming increases in rates of the abuse and intentional misuse of these drugs. We examined recent trends in the abuse and misuse and associated fatal outcomes among older adults (60+ years) and compared these to trends among younger adults (20-59 years). Trend analysis using linear regression models was used to analyze 184,136 cases and 1149 deaths associated with abuse and misuse of the prescription opioids oxycodone, fentanyl, hydrocodone, morphine, oxymorphone, hydromorphone, methadone, buprenorphine, tramadol, and tapentadol that were reported to participating U.S. Poison Centers of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS(®)) System between 2006-Q1 and 2013-Q4. Rates of abuse and misuse of prescription opioids were lower for older adults than for younger adults; however, mortality rates among the older ages followed an increasing linear trend (P < 0.0001) and surpassed rates for younger adults in 2012 and 2013. In contrast, mortality rates among younger adults rose and fell during the period, with recent rates trending downward (P = 0.0003 for quadratic trend). Sub-analysis revealed an increasing linear trend among older adults specifically for suicidal intent (P < 0.0001), whereas these rates increased and then decreased among younger adults (P < 0.0001 for quadratic trend). Recent linear increases in rates of death and use of prescription opioids with suicidal intent among older adults have important implications as the U.S. undergoes a rapid expansion of its elderly population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Monitoring Technology Misuse & Abuse: A Five-Step Plan for Creating a Digital Citizenship Program in Your School

    ERIC Educational Resources Information Center

    Ribble, Mike S.; Bailey, Gerald D.

    2004-01-01

    Over the last two years, it has become evident that a behavior pattern of misuse and abuse with respect to technology is beginning to emerge in society. This outbreak of technology misuse and abuse is documented in continual news coverage on TV, in newspapers and on the Internet--both inside and outside of schools. The endless list of misuse and…

  16. Abuse and Intentional Misuse of Promethazine Reported to US Poison Centers: 2002 to 2012.

    PubMed

    Tsay, M Ellen; Procopio, Gabrielle; Anderson, Bruce D; Klein-Schwartz, Wendy

    2015-01-01

    Promethazine abuse has been reported. The objective was to investigate promethazine abuse/misuse in the United States. An 11-year retrospective review was conducted of promethazine abuse and intentional misuse cases without co-ingestants in persons 10 years and older reported to the National Poison Data System. Data were stratified by product (promethazine-alone [PA] or co-formulation [PC]) and evaluated for demographics, toxicity, management sites, and outcomes. There were 354 single product abuse or misuse exposures-95 PA and 259 PC. Over the 11-year timeframe, the annual exposure rate per 100,000 population doubled. Exposures were most prevalent among 10 to 19 years old and young adults (20s), accounting for 69.5% of PA and 57.5% of PC cases. Clinical effects due to PA included drowsiness (43.2%), tachycardia (7.4%), agitation (13.7%), confusion (13.7%), slurred speech (12.6%), hallucinations (7.4%), dizziness (7.4%), and hypertension (5.3%). Drowsiness (53.4%) and tachycardia (20.8%) were more frequent with PC. There were significant differences between PA and PC in management site (P = 0.0078). Management sites for PA and PC, respectively, were emergency department (37.9%, 55.6%), non-health care facility (33.7%, 14.7%), critical care unit (8.4%, 11.2%), non-critical care unit (7.4%, 7.3%), psychiatry (2.1%, 4.2%), and other/unknown (10.5%, 7.0%). Outcomes for PA and PC, respectively, were no effect (21.0%, 12.4%), minor (58.9%, 53.7%), moderate (17.9%, 32.0%), and major effects (2.1%, 1.9%). Promethazine-alone abuse/misuse most frequently resulted in minor outcomes, and less than 20% required medical admission. Abuse/misuse of PC resulted in a higher frequency of health care facility treatment and a trend toward more moderate outcomes. These differences are most likely attributed to the co-formulate.

  17. Active surveillance of abused and misused prescription opioids using poison center data: a pilot study and descriptive comparison.

    PubMed

    Hughes, Alice A; Bogdan, Gregory M; Dart, Richard C

    2007-01-01

    Prescription opioids are abused throughout the United States. Several monitoring programs are in existence, however, none of these systems provide up-to-date information on prescription opioid abuse. This article describes the use of poison centers as a real-time, geographically specific, surveillance system for prescription opioid abuse and compares our system with an existing prescription drug abuse monitoring program, the Drug Abuse Warning Network (DAWN). Data were collected from eight geographically dispersed poison centers for a period of twelve months. Any call involving buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone was considered a case. Any case coded as intentional exposure (abuse, intentional misuse, suicide, or intentional unknown) was regarded as misuse and abuse. Comparative data were obtained from DAWN. Poison center rates of abuse and misuse were highest for hydrocodone at 3.75 per 100,000 population, followed by oxycodone at 1.81 per 100,000 population. DAWN emergency department (ED) data illustrate a similar pattern of abuse with most mentions involving hydrocodone and oxycodone. Poison center data indicate that people aged 18 to 25 had the highest rates of abuse. DAWN reported the majority of ED mentions among 35 to 44-year-olds. Geographically, Kentucky had the uppermost rates of abuse and misuse for all opioids combined at 20.69 per 100,000 population. CONCLUSIONS. Comparing poison center data to DAWN yielded mostly comparable results, including hydrocodone as the most commonly mentioned drug. Our results suggest poison center data can be used as an indicator for prescription opioid abuse and misuse and can provide timely, geographically specific information on prescription drug abuse.

  18. Polysubstance use and misuse or abuse of prescription opioid analgesics: a multi-level analysis of international data.

    PubMed

    Morley, Katherine I; Ferris, Jason A; Winstock, Adam R; Lynskey, Michael T

    2017-06-01

    Increasing mortality and morbidity associated with opioid analgesics has led to concerns about their misuse and abuse, even when obtained through a prescription. These concerns have been most pronounced in the United States, but limited data make it difficult to determine whether it is a problem in other countries. We investigated opioid analgesic misuse and abuse in participants from the Global Drug Survey 2015 resident in the United States (N = 1334), United Kingdom (N = 1199), France (N = 1258), Germany (N = 866), and Australia (N = 1013) who had used at least 1 prescription opioid analgesic medication in the past year. We also investigated the relationship with polysubstance use, one of the most consistent predictors of problematic opioid analgesic use. Data included misuse and abuse of codeine, hydrocodone, oxycodone, and tramadol; ability to obtain a prescription; different sources for obtaining drugs; and past-year use of benzodiazepines and illicit drugs. In multilevel models, country of residence accounted for less than 3% of the variance in opioid analgesic misuse or abuse. Adjusting for country of residence and sociodemographic factors, use of illicit drugs and benzodiazepines was associated with 4-fold greater odds of misuse (odds ratio 4.36, 95% confidence interval 3.29-5.93) and 6-fold greater odds of abuse compared with not using either drug (odds ratio 6.49, 95% confidence interval 4.0-10.48), although the strength of the association with abuse varied by country. Misuse and abuse by those prescribed opioid analgesics seem to be a problem that is not limited to the United States and warrant attention on an international scale.

  19. Characterization of Adolescent Prescription Drug Abuse and Misuse Using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS®) System

    PubMed Central

    Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

    2013-01-01

    Objective To describe the characteristics and health effects of adolescent (age 13–19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS®) System. Method Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. Results A total of 16,209 intentional adolescent exposures to prescription drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD ± 1.7 years). Slightly more than half (52.4%) of drug mentions involved females. The five most frequently misused or abused drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38%were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to prescription drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Conclusions Prescription drug misuse and abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent prescription drug abuse and misuse by adolescents. PMID:23357446

  20. Characterization of adolescent prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-related Surveillance (RADARS(®)) System.

    PubMed

    Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

    2013-02-01

    To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS(®)) System. Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. A total of 16,209 intentional adolescent exposures to prescription drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD ± 1.7 years). Slightly more than half (52.4%) of drug mentions involved females. The five most frequently misused or abused drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38% were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to prescription drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Prescription drug misuse and abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent prescription drug abuse and misuse by adolescents. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  1. Characterization of Adolescent Prescription Drug Abuse and Misuse Using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R]) System

    ERIC Educational Resources Information Center

    Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick

    2013-01-01

    Objective: To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R])) System. Method: Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all…

  2. Abuse and Misuse of Selected Dietary Supplements Among Adolescents: a Look at Poison Center Data

    PubMed Central

    Morgan, Jill A.; Lardieri, Allison B.; Kishk, Omayma A.; Klein-Schwartz, Wendy

    2017-01-01

    OBJECTIVE The use of dietary supplements has increased and is associated with adverse effects. Indications for use include recreation, body image concerns, mood enhancement, or control of medical conditions. The risk of adverse effects may be enhanced if agents are used improperly. The objective of this study was to determine the frequency of abuse and misuse of 4 dietary substances among adolescents reported nationally to poison centers. Secondary outcomes included an assessment of medical outcomes, clinical effects, location of treatments provided, and treatments administered. METHODS This descriptive retrospective review assessed data concerning the use of garcinia (Garcinia cambogia), guarana (Paullinia cupana), salvia (Salvia divinorum), and St John's wort (Hypericum perforatum) among adolescents reported nationally to poison centers from 2003 to 2014. Adolescents with a singlesubstance exposure to one of the substances of interest coded as intentional abuse or misuse were included. Poison center calls for drug information or those with unrelated clinical effects were excluded. Data were collected from the National Poison Data System. RESULTS There were 84 cases: 7 cases of Garcinia cambogia, 28 Paullinia cupana, 23 Salvia divinorum, and 26 Hypericum perforatum. Garcinia cambogia was used more frequently by females (100% versus 0%), and Paullinia cupana and Salvia divinorum were used more frequently by males (61% versus 36% and 91% versus 9%, respectively). Abuse, driven by Salvia divinorum, was more common overall than misuse. Abuse was also more common among males than females (p <0.001). Use of these agents fluctuated over time. Overall, use trended down since 2010, except for Garcinia cambogia use. In 62 cases (73.8%), the medical outcome was minor or had no effect or was judged as nontoxic or minimally toxic. Clinical effects were most common with Paullinia cupana and Salvia divinorum. Treatment sites included emergency department (n = 33; 39.3%), non

  3. Measures That Identify Prescription Medication Misuse, Abuse, and Related Events in Clinical Trials: ACTTION Critique and Recommended Considerations.

    PubMed

    Smith, Shannon M; Jones, Judith K; Katz, Nathaniel P; Roland, Carl L; Setnik, Beatrice; Trudeau, Jeremiah J; Wright, Stephen; Burke, Laurie B; Comer, Sandra D; Dart, Richard C; Dionne, Raymond; Haddox, J David; Jaffe, Jerome H; Kopecky, Ernest A; Martell, Bridget A; Montoya, Ivan D; Stanton, Marsha; Wasan, Ajay D; Turk, Dennis C; Dworkin, Robert H

    2017-11-01

    Accurate assessment of inappropriate medication use events (ie, misuse, abuse, and related events) occurring in clinical trials is an important component in evaluating a medication's abuse potential. A meeting was convened to review all instruments measuring such events in clinical trials according to previously published standardized terminology and definitions. Only 2 approaches have been reported that are specifically designed to identify and classify misuse, abuse, and related events occurring in clinical trials, rather than to measure an individual's risk of using a medication inappropriately: the Self-Reported Misuse, Abuse, and Diversion (SR-MAD) instrument and the Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS). The conceptual basis, strengths, and limitations of these methods are discussed. To our knowledge, MADDERS is the only system available to comprehensively evaluate inappropriate medication use events prospectively to determine the underlying intent. MADDERS can also be applied retrospectively to completed trial data. SR-MAD can be used prospectively; additional development may be required to standardize its implementation and fully appraise the intent of inappropriate use events. Additional research is needed to further demonstrate the validity and utility of MADDERS as well as SR-MAD. Identifying a medication's abuse potential requires assessing inappropriate medication use events in clinical trials on the basis of a standardized event classification system. The strengths and limitations of the 2 published methods designed to evaluate inappropriate medication use events are reviewed, with recommended considerations for further development and current implementation. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  4. The role of abuse-deterrent formulations in countering opioid misuse and abuse.

    PubMed

    Nguyen, V; Raffa, R B; Taylor, R; Pergolizzi, J V

    2015-12-01

    Pain is a prevalent, and due to the ageing population, increasing medical problem. Opioids are frequently prescribed to meet the unmet medical need. Unfortunately, with the increase in the legitimate use of opioids, there has been a corresponding increase in abuse. A practical way to retain the pain relief afforded by opioids while decreasing opportunities for abuse is to make it more difficult to extract the opioid from the product or to make it less desirable to do so by designing an abuse-deterrent formulation (ADF). We provide a brief overview of the strategies and early evidence related to opioid ADFs. Published and unpublished literature, websites, and other sources were searched for current opioid formulation options, including immediate-release and extended-release products. Each was summarized, reviewed and assessed. The strategies that have been used to design the current opioid ADFs involve one or more of four approaches: a physical barrier; incorporation of an opioid receptor antagonist (e.g. naloxone) that self-limits opioid action when taken in excess amount; inclusion of a noxious agent that is released during inappropriate use; or a pro-drug. Legitimate use of opioid analgesics carries with it certain risks, including the risk of abuse. The new ADFs utilize four major strategies and provide innovative additions to the armamentarium. They likely will become an important part of a comprehensive approach to limiting, although not eliminating, opioid misuse and abuse. © 2015 John Wiley & Sons Ltd.

  5. Determinants of Fentanyl and other Potent μ Opioid Agonist Misuse in Opioid-Dependent Individuals

    PubMed Central

    Cicero, Theodore J.; Ellis, Matthew S.; Paradis, Alethea; Ortbal, Zachary

    2010-01-01

    Purpose Based on preclinical and clinical abuse liability assessments, fentanyl and other potent μ opioid agonists (e.g. hydromorphone and morphine) should be the most misused opioids if accessibility in the real world were not an issue. Since the latter is seldom true, we postulated that there would be a significant mismatch between actual and predicted rates of misuse. Methods We recruited 1,818 prescription-opioid dependent patients entering drug treatment programs to complete an anonymous survey, covering drug use and health related issues. Results Hydrocodone and oxycodone products were the drugs of choice in 75% of patients, whereas potent μ opioid agonists (fentanyl, hydromorphone and morphine), with the greatest predicted abuse potential, were very rarely chosen (<5% each). Most unexpectedly, the rank order of the actual drug of choice and the preferred drug in an ideal world were highly correlated. The reason most commonly given for the failure to endorse fentanyl, for example, as an actual or preferred drug, was fear of toxicity and overdose. We found few differences in drug use patterns between a subset of high-risk, impaired health care professionals (N=196) and all other patients other than source of drug, (forged prescriptions and doctors more common and dealers much less common in the HC sample). Conclusions These results indicate that it should not be assumed- particularly for new drug formulations- that a high potential for abuse will result in actual abuse; and, most importantly, that the hesitancy to use potent opioids because of fears of abuse may be misguided. PMID:20597128

  6. Measures that identify prescription medication misuse, abuse, and related events in clinical trials: ACTTION critique and recommended considerations

    PubMed Central

    Smith, Shannon M.; Jones, Judith K.; Katz, Nathaniel P.; Roland, Carl L.; Setnik, Beatrice; Trudeau, Jeremiah J.; Wright, Stephen; Burke, Laurie B.; Comer, Sandra D.; Dart, Richard C.; Dionne, Raymond; Haddox, J. David; Jaffe, Jerome H.; Kopecky, Ernest A.; Martell, Bridget A.; Montoya, Ivan D.; Stanton, Marsha; Wasan, Ajay D.; Turk, Dennis C.; Dworkin, Robert H.

    2017-01-01

    Accurate assessment of inappropriate medication use events (i.e., misuse, abuse, and related events [MAREs]) occurring in clinical trials is an important component in evaluating a medication’s abuse potential. A meeting was convened to review all instruments measuring such events in clinical trials according to previously published standardized terminology and definitions [27]. Only 2 approaches have been reported that are specifically designed to identify and classify MAREs occurring in clinical trials, rather than to measure an individual’s risk of using a medication inappropriately: the Self-Reported Misuse, Abuse, and Diversion [SR-MAD] instrument and the Misuse, Abuse, and Diversion Drug Event Reporting System [MADDERS]. The conceptual basis, strengths, and limitations of these methods are discussed. To our knowledge, MADDERS is the only system available to comprehensively evaluate inappropriate medication use events prospectively in order to determine the underlying intent. MADDERS can also be applied retrospectively to completed trial data. SR-MAD can be used prospectively; additional development may be required to standardize its implementation and fully appraise the intent of inappropriate use events. Additional research is needed to further demonstrate the validity and utility of both MADDERS and SR-MAD. PMID:28479207

  7. Trends in intentional abuse or misuse of benzodiazepines and opioid analgesics and the associated mortality reported to poison centers across the United States from 2000 to 2014.

    PubMed

    Calcaterra, S L; Severtson, S G; Bau, G E; Margolin, Z R; Bucher-Bartelson, B; Green, J L; Dart, R C

    2018-04-03

    Prior works demonstrates an increased risk of death when opioid analgesics and benzodiazepines are used concomitantly to gain a high. Using poison center data, we described trends in abuse or misuse of benzodiazepines and opioid analgesics. We quantified mortality risk associated with abuse or misuse of benzodiazepines, opioid analgesics and the combination of opioid analgesics and benzodiazepines. This was a retrospective chart review of data from the National Poison Data System which collects information from 55 poison centers located across the United States. We identified reported cases of "intentional abuse or misuse" of benzodiazepine and/or opioid analgesic exposures. Poisson regression was used to compare the number of cases from each year between 2001 and 2014 to the year 2000. Logistic regression was used to determine whether cases exposed to both benzodiazepines and opioids had greater odds of death relative to cases exposed to opioid analgesics alone. From 2000 to 2014, there were 125,485 benzodiazepine exposures and 84,627 opioid exposures among "intentional abuse or misuse" cases. Of the benzodiazepine exposures, 17.3% (n = 21,660) also involved an opioid. In 2010, exposures involving both opioids and benzodiazepines were 4.26-fold (95% CI: 3.87-4.70; p < .001) higher than in 2000. The risk of death was 1.55 (95% CI: 1.01-2.37; p = .04) times greater among those who used both an opioid and a benzodiazepine compared to opioids alone. This association held after adjusting for gender and age. Intentional abuse or misuse of benzodiazepines and opioids in combination increased significantly from 2000 to 2014. Benzodiazepine abuse or misuse far exceeded cases of opioid abuse or misuse. Death was greater with co-abuse or misuse of benzodiazepines and opioids. Population-level campaigns to inform the public about the risk of death with co-abuse or misuse of benzodiazepines and opioids are urgently needed to address this overdose epidemic.

  8. Misuse and dependence on non-prescription codeine analgesics or sedative H1 antihistamines by adults: a cross-sectional investigation in France.

    PubMed

    Roussin, Anne; Bouyssi, Annabelle; Pouché, Lucie; Pourcel, Laure; Lapeyre-Mestre, Maryse

    2013-01-01

    Given the growing worldwide market of non-prescription drugs, monitoring their misuse in the context of self-medication represents a particular challenge in Public Health. The aim of this study was to investigate the prevalence of misuse, abuse, and dependence on non-prescription psychoactive drugs. During one month, in randomly solicited community pharmacies, an anonymous questionnaire was offered to adults requesting paracetamol (control group), codeine combined with paracetamol in analgesics, or sedative H1 antihistamines. Responses about misuse (drug use not in agreement with the Patient Information Leaflet) abuse (excessive drug use having detrimental consequences), and dependence (established according to questions adapted from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria) on psychoactive drugs were compared to those of the paracetamol control group. 295 patients (mean age 48.5 years, 68.5% of women) having used one of the studied drugs during the previous month were included. Misuse and dependence to codeine analgesics concerned 6.8% and 17.8% of the patients exposed to these drugs, respectively, (n = 118), which was significantly higher than for paracetamol. 19.5% had used codeine analgesics daily for more than six months. Headache was the most frequent reason for persistent daily use. A high prevalence of persistent daily users of sedative H1 antihistamines was also observed. Whereas these drugs are recommended only for short treatment courses of occasional insomnia, 72.2% of the participants having taken doxylamine (n = 36) were daily users, predominantly for more than six months. Results on misuse and dependence on non-prescription codeine analgesics suggest that chronic pain, in particular chronic cephalalgia, requires better medical care. In addition, as for hypnotics on prescription, persistent use of doxylamine for self-medication is not justified until an acceptable benefit-risk ratio for chronic sleep

  9. Stimulant Medication Use, Misuse, and Abuse in an Undergraduate and Graduate Student Sample

    ERIC Educational Resources Information Center

    White, Barbara Prudhomme; Becker-Blease, Kathryn A.; Grace-Bishop, Kathleen

    2006-01-01

    In this study, the authors investigated the characteristics of use, misuse, and abuse of stimulant medication (primarily methylphenidate and variants) among students at a northeastern US university. Researchers sent an invitation to take an Internet survey to student e-mail addresses and passed 150 paper surveys in undergraduate classes, analyzing…

  10. Strategies to Prevent Opioid Misuse, Abuse, and Diversion That May Also Reduce the Associated Costs

    PubMed Central

    Hahn, Kathryn L.

    2011-01-01

    Background The use of prescription opioid drugs has the potential to lead to patient abuse of these medications, addiction, and diversion. Such an abuse is associated with increased costs because of excessive healthcare utilization. Finding ways to minimize the risk for abuse and addiction can enhance patient outcomes and reduce costs to patients and to payers. Objective To review current strategies that may reduce the risk for misuse and abuse of opioid medications, which in turn can enhance patient outcomes and lower costs to health insurers and patients. Discussion Implementing approaches that will encourage the use of safe practices (universal precautions) in pain management by providers can reduce the risk for abuse and misuse associated with chronic pain medications, especially opioids. These approaches include, but are not limited to, extensive physician and patient education regarding these medications and their associated risks for abuse; the development of prescription monitoring programs to detect physician or pharmacy shopping; the detection of inappropriate prescribing and medical errors; the use of physician-patient contracts concerning opioid treatment; the requirement of presenting a photo identification to pick up an opioid prescription at the pharmacy; urine drug toxicology screening; provisions for safe disposal of unused opioids; referrals to pain and addiction specialists; and potentially encouraging the use of opioid formulations aimed at reducing abuse. Conclusion Supporting such approaches by health insurers and educating providers and patients on the risks associated with chronic pain medications can help minimize the risk of prescription opioid abuse, addiction, and diversion; reduce health services utilization associated with opioid abuse; improve patient outcomes; and reduce overall costs. PMID:25126342

  11. Changes in misuse and abuse of prescription opioids following implementation of Extended-Release and Long-Acting Opioid Analgesic Risk Evaluation and Mitigation Strategy.

    PubMed

    Bucher Bartelson, Becki; Le Lait, M Claire; Green, Jody L; Cepeda, M Soledad; Coplan, Paul M; Maziere, Jean-Yves; Wedin, Gregory P; Dart, Richard C

    2017-09-01

    An unintended consequence of extended-release (ER) and long-acting (LA) prescription opioids is that these formulations can be more attractive to abusers than immediate-release (IR) formulations. The US Food and Drug Administration recognized these risks and approved the ER/LA Opioid Analgesic Risk Evaluation and Mitigation Strategy (ER/LA REMS), which has a goal of reducing opioid misuse and abuse and their associated consequences. The primary objective of this analysis is to determine whether ER/LA REMS implementation was associated with decreased reports of misuse and abuse. Data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS(R)) System Poison Center Program were utilized. Poison center cases are assigned a reason for exposure, a medical outcome, and a level of health care received. Rates adjusted for population and drug utilization were analyzed over time. RADARS System Poison Center Program data indicate a notable decrease in ER/LA opioid rates of intentional abuse and misuse as well as major medical outcomes or hospitalizations following implementation of the ER/LA REMS. While similar decreases were observed for the IR prescription opioid group, the decreasing rate for the ER/LA opioids exceeded the decreasing rates for the IR prescription opioids and was distinctly different than that for the prescription stimulants, indicating that the ER/LA REMS program may have had an additional effect on decreases in opioid abuse and intentional misuse beyond secular trends. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Is There a Potential of Misuse for Quetiapine?: Literature Review and Analysis of the European Medicines Agency/European Medicines Agency Adverse Drug Reactions' Database.

    PubMed

    Chiappini, Stefania; Schifano, Fabrizio

    2018-02-01

    A recent years' increase in both prescribing and availability of second-generation antipsychotics (SGAs) has been observed. According to the literature, typically made up by case studies/series, quetiapine seems to be the most commonly misused SGA, with both intranasal and intravenous intake modalities having been described. Another SGA that has been anecdotally reported to be misused is olanzapine. For these molecules, both a previous history of drug misuse and being an inmate have been described as factors associated with misuse. Hence, while providing here an updated literature review of the topic, we aimed at assessing all cases of quetiapine misuse/abuse/dependence/withdrawal as reported to the European Medicines Agency's EudraVigilance (EV) database; this was carried out in comparison with the reference drug olanzapine. All spontaneous, European Medicines Agency database reports relating to both quetiapine (2005-2016) and olanzapine (2004-2016) misuse/abuse/dependence/withdrawal issues were retrieved, and a descriptive analysis was performed. From the EV database, 18,112 (8.64% of 209,571) and 4178 (7.58% of 55,100) adverse drug reaction reports of misuse/abuse/dependence/withdrawal were associated with quetiapine and olanzapine, respectively. The resulting proportional reporting ratio values suggested that the misuse/abuse-, dependence-, and withdrawal-related adverse drug reactions were more frequently reported for quetiapine (1.07, 1.01, and 5.25, respectively) in comparison with olanzapine. Despite data collection limitations, present EV data may suggest that, at least in comparison with olanzapine, quetiapine misuse may be a cause for concern.

  13. Best Practices and Innovations for Managing Codeine Misuse and Dependence.

    PubMed

    Norman, Ian J; Bergin, Michael; Parry, Charles D; Van Hout, Marie Claire

    Promoting and ensuring safe use of codeine containing medicines remains a public health issue given the rise in reporting of misuse and dependence particularly in countries where available over-the-counter (OTC). The aim of this unique study was to identify best practices in management of opioid abuse and dependence, particularly codeine, and innovations to meet challenges surrounding safe and compliant use, patient awareness-raising, reducing health harms and enhancing successful treatment of dependence. A mixed methods approach using three data points was used that included : (1) analysis of data from existing scoping reviews to identify potential areas for innovation (2) interviews with key national stakeholders from public health, pharmaceutical, regulatory, primary care and addiction practice in three distinct regulatory regimes (Ireland, United Kingdom and South Africa); and (3) a circular email request for information on potential innovations to members of the European Medicine's Agency European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCEPP). Data from these three sources were analysed to identify best practices and opportunities for innovation. Best practices and potential innovations were identified under the nine headings: (1) manufacture; (2) product information and public education; (3) responsible prescribing; (4) monitoring and surveillance; (5) dispensing, screening and brief interventions in community pharmacies; (6) safety in the workplace and on the road; (7) internet supply of codeine and online support; (8) treatment of codeine dependence; and (9) learning resources and training for health professionals. Challenges ensuring availability of codeine containing medicines for legitimate therapeutic use, while minimising misuse, dependence and related health harms warrant consideration of new innovations. Most promising innovative potential lies across the products' retail lifecycle from manufacture to prescriber and

  14. A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency's 'Suspected Adverse Drug Reactions' Database.

    PubMed

    Chiappini, Stefania; Schifano, Fabrizio

    2016-07-01

    The gabapentinoids pregabalin and gabapentin are being increasingly prescribed for a range of clinical conditions. Recently, although gabapentinoids at therapeutic dosages may present with low addictive liability levels, cases of misuse and rising numbers of related fatalities have been reported. The aim of the study was to identify and assess cases of gabapentinoid misuse or dependence as reported to the European Medicines Agency's EudraVigilance database, to identify the magnitude of this problem and the characteristics of these reactions. All spontaneous reports of both gabapentin- (2004-2015) and pregabalin- (2006-2015) related misuse/abuse/dependence were retrieved. A descriptive analysis by source, sex, age, and type of report was performed. From the EudraVigilance database 7639 (6.6 % of a total of 115,616) and 4301 (4.8 % of 90,166) adverse drug reaction reports of misuse/abuse/dependence were, respectively, associated with pregabalin and gabapentin, with an overall reporting frequency increasing over time. For both molecules, subjects typically involved were female adults. A total of 27 and 86 fatalities, respectively, associated with pregabalin and gabapentin, and mostly in combination with opioids, were identified. Analysis of proportional reporting ratios for drug abuse/dependence/intentional product misuse values seem to indicate that these adverse drug reactions were more frequently reported for pregabalin (1.25, 1.39, and 1.58, respectively) compared with gabapentin. Despite data collection/methodological approach limitations, the present data seem to suggest that gabapentinoid misuse may be a cause for concern, especially in patients with a history of substance misuse. Hence, healthcare professionals should be vigilant when prescribing these molecules.

  15. Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study

    PubMed Central

    Agniel, Denis; Beam, Andrew; Yorkgitis, Brian; Bicket, Mark; Homer, Mark; Fox, Kathe P; Knecht, Daniel B; McMahill-Walraven, Cheryl N; Palmer, Nathan; Kohane, Isaac

    2018-01-01

    Abstract Objective To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. Design Retrospective cohort study. Setting Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. Participants 1 015 116 opioid naive patients undergoing surgery. Main outcome measures Use of oral opioids after discharge as defined by refills and total dosage and duration of use. The primary outcome was a composite of misuse identified by a diagnostic code for opioid dependence, abuse, or overdose. Results 568 612 (56.0%) patients received postoperative opioids, and a code for abuse was identified for 5906 patients (0.6%, 183 per 100 000 person years). Total duration of opioid use was the strongest predictor of misuse, with each refill and additional week of opioid use associated with an adjusted increase in the rate of misuse of 44.0% (95% confidence interval 40.8% to 47.2%, P<0.001), and 19.9% increase in hazard (18.5% to 21.4%, P<0.001), respectively. Conclusions Each refill and week of opioid prescription is associated with a large increase in opioid misuse among opioid naive patients. The data from this study suggest that duration of the prescription rather than dosage is more strongly associated with ultimate misuse in the early postsurgical period. The analysis quantifies the association of prescribing choices on opioid misuse and identifies levers for possible impact. PMID:29343479

  16. Sexual orientation disparities in substance misuse: the role of childhood abuse and intimate partner violence among patients in care at an urban community health center.

    PubMed

    Reisner, Sari L; Falb, Kathryn L; Wagenen, Aimee Van; Grasso, Chris; Bradford, Judith

    2013-02-01

    This study examined disparities in lifetime substance misuse by sexual orientation among 2,653 patients engaged in care at an urban community health center in Boston, MA, as well as the potential mediating roles of childhood abuse misuse, as was identifying as a sexual minority compared to heterosexual. CA and IPV experiences partly explained disparities in substance abuse by sexual orientation with differences seen by sex. Clinicians should assess history of CA and IPV among sexual minorities presenting with a history of substance abuse disorders. The study's limitations are noted.

  17. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis.

    PubMed

    Vowles, Kevin E; McEntee, Mindy L; Julnes, Peter Siyahhan; Frohe, Tessa; Ney, John P; van der Goes, David N

    2015-04-01

    Opioid use in chronic pain treatment is complex, as patients may derive both benefit and harm. Identification of individuals currently using opioids in a problematic way is important given the substantial recent increases in prescription rates and consequent increases in morbidity and mortality. The present review provides updated and expanded information regarding rates of problematic opioid use in chronic pain. Because previous reviews have indicated substantial variability in this literature, several steps were taken to enhance precision and utility. First, problematic use was coded using explicitly defined terms, referring to different patterns of use (ie, misuse, abuse, and addiction). Second, average prevalence rates were calculated and weighted by sample size and study quality. Third, the influence of differences in study methodology was examined. In total, data from 38 studies were included. Rates of problematic use were quite broad, ranging from <1% to 81% across studies. Across most calculations, rates of misuse averaged between 21% and 29% (range, 95% confidence interval [CI]: 13%-38%). Rates of addiction averaged between 8% and 12% (range, 95% CI: 3%-17%). Abuse was reported in only a single study. Only 1 difference emerged when study methods were examined, where rates of addiction were lower in studies that identified prevalence assessment as a primary, rather than secondary, objective. Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.

  18. [Detection of zopiclone in many drivers--a sign of misuse or abuse].

    PubMed

    Bramness, J G; Skurtveit, S; Mørland, J

    1999-08-20

    In 1998 zopiclone had a 42% share of the prescribed hypnotic drug market in Norway. The National Institute of Forensic Toxicology analyses all blood samples from suspected drugged drivers. The rise in zopiclone prescription was partly reflected in an increase in the number of drivers with zopiclone detected in the blood. We looked closer at the test results from 101 drivers with zopiclone detected in their blood in the January 1994 to April 1999 period. 60% had blood concentrations of zopiclone above the concentration observed after intake of therapeutic doses; 80% had higher blood concentrations than those expected 8 hours after intake of therapeutic doses. The majority of the drivers also tested positive for illegal drugs, prescription drugs with abuse potential, or alcohol. This indicates that zopiclone is misused or abused. Therefore the same caution should be applied when prescribing zopiclone as is applied when prescribing e.g. benzodiazepines.

  19. Abuse, misuse, and suicidal substance use by children on school property.

    PubMed

    Vakkalanka, J Priyanka; King, Joshua D; Holstege, Christopher P

    2015-11-01

    The purpose of this study was to characterize the epidemiological trends associated with substances used in intentional exposures among children while on school property reported to the U.S. National Poison Data System (NPDS). NPDS was queried for intentional (abuse, misuse, suspected suicide, and unknown intentional) exposures reported to occur on school property between calendar years 2004 and 2013. Records were restricted to children 6-18 years of age. Demographic, exposure, and clinical characteristics were assessed. A total of 56,882 substances were intentionally used on school property by 50,379 children, of which 39.8% were females (n = 20,070), 57.7% were males (n = 29,084), and 2.4% were unknown gender (n = 1,225). The most frequent pharmaceutical exposures reported included sedatives (n = 4,096; 8.1%), analgesics (n = 4,022; 8.0%), and cough and cold preparations (n = 3,529; 7.0%). The majority of exposures were managed on site (n = 21,464; 42.6%), followed by care at a healthcare facility (n = 20,048; 39.7%). Serious outcomes (moderate or major effects and death) accounted for nine percent of all reported exposures. Compared to reference groups, female gender, teenagers 17-18 years, and pharmaceutical substances (Prevalence Ratios = 4.6, 9.4, and 9.9, respectively) were associated with suspected suicides when compared with other intentional exposures. Along with other national data about behaviors in the adolescent and teenage population, additional trends in risky behavior may be gleaned by surveillance through poison centers. With over 5,000 annual reports to the poison centers about intentional exposures on school property, school personnel and parents/guardians must be vigilant about the range of pharmaceutical and non-pharmaceutical substances that are used for abuse, misuse, or suicide.

  20. Correlates of lifetime alcohol misuse among older community residents in Brazil

    PubMed Central

    Blay, Sergio Luis; Fillenbaum, Gerda G.; Andreoli, Sergio Baxter; Gastal, Fabio Leite

    2009-01-01

    Background Little is known about the sociodemographic correlates and health effects associated with lifetime alcohol misuse in community resident elderly in Brazil. Method Data came from a representative sample of 6961 residents aged 60+ in the State of Rio Grande do Sul, Brazil. The structured interview included a five-item lifetime alcohol use questionnaire addressing abuse and dependence, and enquiry regarding sociodemographic characteristics, lifestyle and social support, and health conditions. Results Of the sample, 10.6% (25.3% men, 2.9% women) endorsed at least one lifetime alcohol misuse question. Controlled analyses comparing a gradient of alcohol misuse (none, one, more than one item endorsed), found that men, people age 60–69 (compared to older persons), and tobacco users were more likely to endorse alcohol misuse items. Persons reporting lower income, and of nonWhite race/ethnicity did not differ from their comparison groups with respect to endorsing one item, but they were more likely to endorse two or more items. Endorsing more than one item was associated with impaired activities of daily living, the presence of respiratory problems and psychiatric disorder, but was protective against vascular conditions. Conclusions Major lifetime alcohol misuse (defined as endorsing more than one of five items reflecting alcohol abuse or dependence) is more common in certain sociodemographic groups (men, younger elderly, lower income, nonWhites). With the exception of vascular conditions, it is associated with smoking, poorer functional status, respiratory problems, and psychiatric disorder. Endorsing only one item has a reduced association, significant only for male gender, smoking, and psychiatric disorder. PMID:19141169

  1. Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings.

    PubMed

    Marotta, Phillip L

    2017-05-12

    Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

  2. Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review

    PubMed Central

    Yokell, Michael A.; Zaller, Nickolas D.; Green, Traci C.; Rich, Josiah D.

    2011-01-01

    The diversion, misuse, and non-medically supervised use of buprenorphine and buprenorphine/naloxone by opioid users are reviewed. Buprenorphine and buprenorphine/naloxone are used globally as opioid analgesics and in the treatment of opioid dependency. Diversion of buprenorphine and buprenorphine/naloxone represents a complex medical and social issue, and has been widely documented in various geographical regions throughout the world. We first discuss the clinical properties of buprenorphine and its abuse potential. Second, we discuss its diversion and illicit use on an international level, as well as motivations for those activities. Third, we examine the medical risks and benefits of buprenorphine’s non-medically supervised use and misuse. These risks and benefits include the effect of buprenorphine’s use on HIV risk and the risk of its concomitant use with other medications and drugs of abuse. Finally, we discuss the implications of diversion, misuse, and non-medically supervised use (including potential measures to address issues of diversion); and potential areas for further research. PMID:21466501

  3. Development and feasibility of the misuse, abuse, and diversion drug event reporting system (MADDERS®).

    PubMed

    Treister, Roi; Trudeau, Jeremiah J; Van Inwegen, Richard; Jones, Judith K; Katz, Nathaniel P

    2016-12-01

    Inappropriate use of analgesic drugs has become increasingly pervasive over the past decade. Currently, drug abuse potential is primarily assessed post-marketing; no validated tools are available to assess this potential in phase II and III clinical trials. This paper describes the development and feasibility testing of a Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS), which aims to identify potentially abuse-related events and classify them according to a recently developed classification scheme, allowing the quantification of these events in clinical trials. The system was initially conceived and designed with input from experts and patients, followed by field-testing to assess its feasibility and content validity in both completed and ongoing clinical trials. The results suggest that MADDERS is a feasible system with initial validity. It showed higher rates of the triggering events in subjects taking medications with known abuse potential than in patients taking medications without abuse potential. Additionally, experts agreed on the classification of most abuse-related events in MADDERS. MADDERS is a new systematic approach to collect information on potentially abuse-related events in clinical trials and classify them. The system has demonstrated feasibility for implementation. Additional research is ongoing to further evaluate its validity. Currently, there are no validated tools to assess drug abuse potential during clinical trials. Because of its ease of implementation, its systematic approach, and its preliminary validation results, MADDERS could provide such a tool for clinical trials. (Am J Addict 2016;25:641-651). © 2016 American Academy of Addiction Psychiatry.

  4. Suboxone misuse along the opiate maintenance treatment pathway.

    PubMed

    Furst, R Terry

    2013-01-01

    This study explores strategies that Suboxone misusers utilize while in drug treatment. Ethnographic interviews were conducted with 14 patients who had cycled in and out of Suboxone treatment. The objective of the study is to identify strategies implemented by patients who intermittently use opiates/opioids while in Suboxone treatment. Findings indicate that some patients serially stop and start treatment in a Harm Reduction setting in New York City. Many patients suggest that they manage their opiate/opioid dependency through a sequential use of Suboxone and heroin to avoid withdrawal and to continue their misuse of opiates/opioids. Results are discussed in conjunction with the difficulties inherent to substance abuse treatment and suggestions for improvement are offered.

  5. Prescription opioid abuse and misuse: gap between primary-care investigator assessment and actual extent of these behaviors among patients with chronic pain.

    PubMed

    Setnik, Beatrice; Roland, Carl L; Pixton, Glenn C; Sommerville, Kenneth W

    2017-01-01

    To compare the results of two open-label primary care-based studies that examined investigator assessment of patient risk for prescription opioid misuse, abuse, and diversion relative to patient self-reports and urine drug tests (UDTs). Risk assessment data from two open-label, multicenter, primary care-based US studies in patients with chronic pain were compared. In one study (n = 1487), 54.4% of patients were at moderate, 24.8% at high, and 20.8% at low risk based on patients' self-reports at baseline on the Screener and Opioid Assessment for Patients with Pain®-Revised questionnaire. Investigators assigned 1.3% of patients as high risk despite 5.0% self-reporting prior illicit drug use and 15.3% with positive UDT(s) for an illicit drug at baseline. In the second study (n = 684), few patients were considered by investigators to be at high risk for misuse (1.6%), abuse (1.8%), or diversion (1.0%). However, 10.4% of patients reported prior illicit drug use; 23.4% had at least one abnormal baseline UDT; 60% of 537 patients reported on the Self-Reported Misuse, Abuse, and Diversion questionnaire they took more opioids than prescribed; and 10.9% reported chewing/crushing opioids in the past. Of patients completing the Current Opioid Misuse Measure, 40.6% were classified as having aberrant behaviors. A comparison of risk assessment across two studies indicates a tendency for investigators to assess patients as lower risk for opioid-related aberrant behaviors despite a significant proportion self-reporting aberrant behavior and/or presenting with illicit UDTs. These consistent findings underline the importance of appropriate implementation of objective measures and self-reporting tools when evaluating risk in patients. www.clinicaltrials.gov identifiers: NCT00640042 and NCT01179191.

  6. Instruments to Identify Prescription Medication Misuse, Abuse, and Related Events in Clinical Trials: An ACTTION Systematic Review.

    PubMed

    Smith, Shannon M; Paillard, Florence; McKeown, Andrew; Burke, Laurie B; Edwards, Robert R; Katz, Nathaniel P; Papadopoulos, Elektra J; Rappaport, Bob A; Slagle, Ashley; Strain, Eric C; Wasan, Ajay D; Turk, Dennis C; Dworkin, Robert H

    2015-05-01

    Measurement of inappropriate medication use events (eg, abuse or misuse) in clinical trials is important in characterizing a medication's abuse potential. However, no gold standard assessment of inappropriate use events in clinical trials has been identified. In this systematic review, we examine the measurement properties (ie, content validity, cross-sectional reliability and construct validity, longitudinal construct validity, ability to detect change, and responder definitions) of instruments assessing inappropriate use of opioid and nonopioid prescription medications to identify any that meet U.S. and European regulatory agencies' rigorous standards for outcome measures in clinical trials. Sixteen published instruments were identified, most of which were not designed for the selected concept of interest and context of use. For this reason, many instruments were found to lack adequate content validity (or documentation of content validity) to evaluate current inappropriate medication use events; for example, evaluating inappropriate use across the life span rather than current use, including items that did not directly assess inappropriate use (eg, questions about anger), or failing to capture information pertinent to inappropriate use events (eg, intention and route of administration). In addition, the psychometric data across all instruments were generally limited in scope. A further limitation is the heterogeneous, nonstandardized use of inappropriate medication use terminology. These observations suggest that available instruments are not well suited for assessing current inappropriate medication use within the specific context of clinical trials. Further effort is needed to develop reliable and valid instruments to measure current inappropriate medication use events in clinical trials. This systematic review evaluates the measurement properties of inappropriate medication use (eg, abuse or misuse) instruments to determine whether any meet regulatory

  7. Methylphenidate Transdermal System in Adults with Past Stimulant Misuse: An Open-Label Trial

    ERIC Educational Resources Information Center

    McRae-Clark, Aimee L.; Brady, Kathleen T.; Hartwell, Karen J.; White, Kathleen; Carter, Rickey E.

    2011-01-01

    Objective: This 8-week, open-label trial assessed the efficacy of methylphenidate transdermal system (MTS) in 14 adult individuals diagnosed with ADHD and with a history of stimulant misuse, abuse, or dependence. Method: The primary efficacy endpoint was the Wender-Reimherr Adult ADHD Scale (WRAADS), and secondary efficacy endpoints included the…

  8. [Abuse, dependence and intoxication of substances].

    PubMed

    Wada, Kiyoshi

    2015-09-01

    As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.

  9. "Codeine Is My Helper": Misuse of and Dependence on Codeine-Containing Medicines in South Africa.

    PubMed

    Van Hout, Marie Claire; Rich, Eileen; Dada, Siphokazi; Bergin, Michael

    2017-02-01

    Misuse of codeine-containing medicines is an emerging global public health concern. The majority of research has been conducted in developed countries (European Members States, Australia, the United States). This study aimed to gain an understanding of unique individual and collective experiences of trajectories of codeine misuse and dependence in South Africa. In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents ( n = 25). Narratives were analyzed using the empirical phenomenological psychological five-step method. Nine themes with 63 categories emerged, with two additional high levels of abstraction. Findings are illustrated: participant profile and product preferences, motives for use, transitioning to misuse and dependence, pharmacy purchasing and alternative sourcing routes, effects and withdrawal experiences, help-seeking and treatment experiences, and strategies for prevention. The study underscores the need for continued support for enhanced patient awareness of risk of habit forming use and related health consequences and professional pharmacovigilance.

  10. Personality disorders, alcohol use, and alcohol misuse.

    PubMed

    Maclean, Johanna Catherine; French, Michael T

    2014-11-01

    Personality disorders (PDs) are psychiatric conditions that manifest early in life from a mixture of genetics and environment, are highly persistent, and lead to substantial dysfunction for the affected individual and those with whom s/he interacts. In this study we offer new information on the associations between PDs and alcohol use/misuse. Specifically, we consider all 10 PDs recognized by the American Psychiatric Association; carefully address important sources of bias in our regression models; and study heterogeneity across PDs, drinking pattern, and gender. To investigate the relationships between PDs and alcohol consumption we analyze data from the 2004/2005 National Epidemiological Survey of Alcohol and Related Conditions (N=34,653). We construct measures of any drinking, drinking quantity, and patterns of misuse that could lead to significant social costs including drinking to intoxication, driving after drinking, drinking during the day, and alcohol abuse/dependence. Results show that persons with PDs are significantly more likely to use and misuse alcohol, although associations vary across gender. Moreover, antisocial, borderline, histrionic, and narcissistic PDs display the strongest links with alcohol use and misuse, and the relationships are strongest among the heaviest drinkers. These findings have important public health implications and underscore the potential social costs associated with mental health conditions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Opioid Abuse or Dependence Increases 30-day Readmission Rates after Major Operating Room Procedures: A National Readmissions Database Study.

    PubMed

    Gupta, Atul; Nizamuddin, Junaid; Elmofty, Dalia; Nizamuddin, Sarah L; Tung, Avery; Minhaj, Mohammed; Mueller, Ariel; Apfelbaum, Jeffrey; Shahul, Sajid

    2018-05-01

    Although opioids remain the standard therapy for the treatment of postoperative pain, the prevalence of opioid misuse is rising. The extent to which opioid abuse or dependence affects readmission rates and healthcare utilization is not fully understood. It was hypothesized that surgical patients with a history of opioid abuse or dependence would have higher readmission rates and healthcare utilization. A retrospective cohort analysis was performed of patients undergoing major operating room procedures in 2013 and 2014 using the National Readmission Database. Patients with opioid abuse or dependence were identified using International Classification of Diseases codes. The primary outcome was 30-day hospital readmission rate. Secondary outcomes included hospital length of stay and estimated hospital costs. Among the 16,016,842 patients who had a major operating room procedure whose death status was known, 94,903 (0.6%) had diagnoses of opioid abuse or dependence. After adjustment for potential confounders, patients with opioid abuse or dependence had higher 30-day readmission rates (11.1% vs. 9.1%; odds ratio 1.26; 95% CI, 1.22 to 1.30), longer mean hospital length of stay at initial admission (6 vs. 4 days; P < 0.0001), and higher estimated hospital costs during initial admission ($18,528 vs. $16,617; P < 0.0001). Length of stay was also higher at readmission (6 days vs. 5 days; P < 0.0001). Readmissions for infection (27.0% vs. 18.9%; P < 0.0001), opioid overdose (1.0% vs. 0.1%; P < 0.0001), and acute pain (1.0% vs. 0.5%; P < 0.0001) were more common in patients with opioid abuse or dependence. Opioid abuse and dependence are associated with increased readmission rates and healthcare utilization after surgery. An online visual overview is available for this article at http://links.lww.com/ALN/B704.

  12. Subjective Effects, Misuse, and Adverse Effects of Osmotic-Release Methylphenidate Treatment in Adolescent Substance Abusers with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Lewis, Daniel F.; Riggs, Paula D.; Davies, Robert D.; Adler, Lenard A.; Sonne, Susan; Somoza, Eugene C.

    2011-01-01

    Abstract Objective Psychostimulants are effective treatments for attention-deficit/hyperactivity disorder (ADHD) but may be associated with euphoric effects, misuse/diversion, and adverse effects. These risks are perceived by some clinicians to be greater in substance-abusing adolescents relative to non–substance-abusing adults. The present study evaluates the subjective effects, misuse/diversion, and adverse effects associated with the use of osmotic-release oral system methylphenidate (OROS-MPH), relative to placebo, for treating ADHD in adolescents with a substance use disorder (SUD) as a function of substance use severity and compared these risks with those associated with the treatment of ADHD in adults without a non-nicotine SUD. Method Datasets from two randomized placebo-controlled trials of OROS-MPH for treating ADHD, one conducted with 303 adolescents (13–18) with at least one non-nicotine SUD and one with 255 adult smokers (18–55), were analyzed. Outcome measures included the Massachusetts General Hospital Liking Scale, self-reported medication compliance, pill counts, and adverse events (AEs). Results Euphoric effects and misuse/diversion of OROS-MPH were not significantly affected by substance use severity. The euphoric effects of OROS-MPH did not significantly differ between the adolescent and adult samples. Adults rated OROS-MPH as more effective in treating ADHD, whereas adolescents reported feeling more depressed when taking OROS-MPH. The adolescents lost more pills relative to the adults regardless of treatment condition, which suggests the importance of careful medication monitoring. Higher baseline use of alcohol and cannabis was associated with an increased risk of experiencing a treatment-related AE in OROS-MPH, but baseline use did not increase the risk of serious AEs or of any particular category of AE and the adolescents did not experience more treatment-related AEs relative to the adults. Conclusions With good monitoring, and in the

  13. Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder.

    PubMed

    Winhusen, Theresa M; Lewis, Daniel F; Riggs, Paula D; Davies, Robert D; Adler, Lenard A; Sonne, Susan; Somoza, Eugene C

    2011-10-01

    Psychostimulants are effective treatments for attention-deficit/hyperactivity disorder (ADHD) but may be associated with euphoric effects, misuse/diversion, and adverse effects. These risks are perceived by some clinicians to be greater in substance-abusing adolescents relative to non-substance-abusing adults. The present study evaluates the subjective effects, misuse/diversion, and adverse effects associated with the use of osmotic-release oral system methylphenidate (OROS-MPH), relative to placebo, for treating ADHD in adolescents with a substance use disorder (SUD) as a function of substance use severity and compared these risks with those associated with the treatment of ADHD in adults without a non-nicotine SUD. Datasets from two randomized placebo-controlled trials of OROS-MPH for treating ADHD, one conducted with 303 adolescents (13-18) with at least one non-nicotine SUD and one with 255 adult smokers (18-55), were analyzed. Outcome measures included the Massachusetts General Hospital Liking Scale, self-reported medication compliance, pill counts, and adverse events (AEs). Euphoric effects and misuse/diversion of OROS-MPH were not significantly affected by substance use severity. The euphoric effects of OROS-MPH did not significantly differ between the adolescent and adult samples. Adults rated OROS-MPH as more effective in treating ADHD, whereas adolescents reported feeling more depressed when taking OROS-MPH. The adolescents lost more pills relative to the adults regardless of treatment condition, which suggests the importance of careful medication monitoring. Higher baseline use of alcohol and cannabis was associated with an increased risk of experiencing a treatment-related AE in OROS-MPH, but baseline use did not increase the risk of serious AEs or of any particular category of AE and the adolescents did not experience more treatment-related AEs relative to the adults. With good monitoring, and in the context of substance abuse treatment, OROS-MPH can

  14. Evaluation of abuse and dependence on drugs used for self-medication: a pharmacoepidemiological pilot study based on community pharmacies in France.

    PubMed

    Orriols, Ludivine; Gaillard, Julia; Lapeyre-Mestre, Maryse; Roussin, Anne

    2009-01-01

    Drugs that can be obtained without a medical prescription in community pharmacies are used to treat minor pathologies that can easily be diagnosed by the patient. Some of these drugs contain psychoactive substances with a potential for abuse and dependence. However, there is a lack of data concerning their problematic use in a wide population. To explore the feasibility of a pharmacoepidemiological method to investigate misuse, non-medical use, abuse and dependence on drugs used for self-medication. This cross-sectional pilot study, conducted during a 2-month period (from 15 January to 15 March 2007), was based on the participation of community pharmacies in the Midi-Pyrénées region of France to collect patient data. Patients requesting one drug from a list of available drugs used for self-medication and containing psychoactive substances (codeine in analgesics, pseudoephedrine, dextromethorphan and histamine H(1) receptor antagonists [antihistamines]) were included in the study. A control group was set up that consisted of patients requesting antacid drugs. The pharmacy staff proposed to the patients that they filled in an anonymous questionnaire. The questionnaire was designed to investigate patterns of drug use and the harmful consequences of overuse (abuse). In addition, questions on lack of control over drug use were adapted from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for evaluation of dependence. Thirty-two percent (n = 74) of the solicited pharmacies participated in the survey. Only 4.8% of the solicited patients (n = 817) refused to complete the questionnaire distributed by the pharmacy staff. The questionnaire was completed inside the pharmacy by 53.3% of the patients. The other patients took the questionnaire away from the pharmacy and 31.7% of them returned it in a prepaid envelope. The patient participation rate was 64.9%, and was higher for the psychoactive substance groups than the control group

  15. Exploring the victimization‒early substance misuse relationship: In search of moderating and mediating effects.

    PubMed

    Walters, Glenn D; Espelage, Dorothy L

    2018-07-01

    This study was designed to address two research questions. The first research question asked whether physical abuse victimization at the hands of parents/guardians, bullying victimization at the hands of peers, and the abuse x bullying interaction encouraged early involvement in substance misuse. The second research question inquired as to whether the victimization‒substance misuse relationship was mediated by variables proposed by various theories and research studies-specifically, cognitive impulsivity, negative affect, and low self-esteem. A moderated mediation hypothesis was tested in a group of 865 (417 boys, 448 girls) schoolchildren from the Illinois Study of Bullying and Sexual Violence who were 10 to 15 years of age at the time of initial contact. A path analysis performed with three waves of data revealed that physical abuse and bullying victimization predicted substance misuse with mediation by cognitive impulsivity, but there was no evidence of moderation. On the basis of these results, it was concluded that victimization, whether through parental physical abuse or peer bullying, increases cognitive impulsivity, and that cognitive impulsivity, in turn, encourages early involvement in substance misuse. The practical implications of these results are that interventions designed to counter cognitive impulsivity and encourage cognitive control may be effective in preventing children traumatized by physical abuse and bullying from entering the early stages of a drug or substance using lifestyle. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Classification and definition of misuse, abuse, and related events in clinical trials: ACTTION systematic review and recommendations.

    PubMed

    Smith, Shannon M; Dart, Richard C; Katz, Nathaniel P; Paillard, Florence; Adams, Edgar H; Comer, Sandra D; Degroot, Aldemar; Edwards, Robert R; Haddox, J David; Jaffe, Jerome H; Jones, Christopher M; Kleber, Herbert D; Kopecky, Ernest A; Markman, John D; Montoya, Ivan D; O'Brien, Charles; Roland, Carl L; Stanton, Marsha; Strain, Eric C; Vorsanger, Gary; Wasan, Ajay D; Weiss, Roger D; Turk, Dennis C; Dworkin, Robert H

    2013-11-01

    As the nontherapeutic use of prescription medications escalates, serious associated consequences have also increased. This makes it essential to estimate misuse, abuse, and related events (MAREs) in the development and postmarketing adverse event surveillance and monitoring of prescription drugs accurately. However, classifications and definitions to describe prescription drug MAREs differ depending on the purpose of the classification system, may apply to single events or ongoing patterns of inappropriate use, and are not standardized or systematically employed, thereby complicating the ability to assess MARE occurrence adequately. In a systematic review of existing prescription drug MARE terminology and definitions from consensus efforts, review articles, and major institutions and agencies, MARE terms were often defined inconsistently or idiosyncratically, or had definitions that overlapped with other MARE terms. The Analgesic, Anesthetic, and Addiction Clinical Trials, Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership convened an expert panel to develop mutually exclusive and exhaustive consensus classifications and definitions of MAREs occurring in clinical trials of analgesic medications to increase accuracy and consistency in characterizing their occurrence and prevalence in clinical trials. The proposed ACTTION classifications and definitions are designed as a first step in a system to adjudicate MAREs that occur in analgesic clinical trials and postmarketing adverse event surveillance and monitoring, which can be used in conjunction with other methods of assessing a treatment's abuse potential. Copyright © 2013 International Association for the Study of Pain. All rights reserved.

  17. A descriptive study of adverse events from clenbuterol misuse and abuse for weight loss and bodybuilding.

    PubMed

    Spiller, Henry A; James, Kyla J; Scholzen, Steven; Borys, Douglas J

    2013-01-01

    Clenbuterol is a β2-agonist approved in the United States for veterinary use in nonfood animals. Clenbuterol use is emerging among bodybuilders and fitness enthusiasts attracted to the hypertrophic and lipolytic effects. This was a retrospective chart review of clenbuterol exposures reported to 2 poison control centers. Misuse of clenbuterol for weight loss and bodybuilding was reported in 11 of 13 clenbuterol users. Reported clinical effects included tachycardia, widened pulse pressure, tachypnea, hypokalemia, hyperglycemia, ST changes on electrocardiogram (ECG), elevated troponin, elevated creatine phosphokinase (CPK), palpitations, chest pain, and tremor. Measured serum clenbuterol concentration was 2983 pg/mL post 4.5 mg ingestion. Co-ingestants included T3 and anabolic steroids. Treatments included activated charcoal, benzodiazepines, β-blockers, potassium replacement, and intravenous (IV) fluid. There is an increasing use of the Internet for illicit drug use for bodybuilding and weight loss purposes. These patients may not present as the stereotype of illicit drug abusers, but as healthy athletic low-risk patients. Clinical effects persisted greater than 24 hours with evidence of myocardial injury in 2 patients. Clenbuterol is increasingly being abused within the bodybuilding subculture. These cases illustrate the hidden dangers of clenbuterol abuse among bodybuilders and fitness enthusiasts.

  18. Alcohol misuse in Greece: a 15-year experience from a specialized outpatient service.

    PubMed

    Pomini, V; Mellos, L; Paparrigopoulos, T; Liappas, J

    2014-01-01

    Alcohol use in Greece is traditionally diffused among its population. According to general population surveys, three out of four Greeks aged 12-64 referred to alcohol consumption during the last year and 10% reported at least one episode of alcohol abuse during the last month. Furthermore, the large majority of young people aged 13-18 reported lifetime use of alcohol and 14.8% of them reported more than three episodes of alcohol abuse during the last month. Apparently, cultural factors have influenced the pattern of alcohol consumption and the ensuing alcohol-related problems during the last two decades. The "Athena" Service is an outpatient therapeutic unit for the management of substance misusers and their families. It is a specialized abstinence-oriented service that does not administer substance substitutes; mental health professionals of the service work as a multidisciplinary team. Motivational approaches, individual cognitive-behavioural psychotherapy and family interventions of a systemic orientation are the principal therapeutic techniques applied. Adjunctive medication is prescribed whenever mild to moderate concomitant psychopathology is detected. Support measures such as provisional use of medication, use of antagonistic agents or brief hospitalization can be provided if deemed necessary. No strict time limits are applied regarding treatment duration and discharge from the program. During the period 1998-2013, a total of 1511 individuals with alcohol-related problems addressed the service. The changing pattern of substance misuse over the last fifteen years can be summarized as follows: (a) there is a gradually increasing number of women misusing substances; (b) there is an increasing proportion of young adults reporting multi-substance use with concurrent psychiatric disorders; (c) there is an increasing proportion of young adults regularly using/misusing substances; (d) there is a decreasing proportion of middle-aged individuals presenting with

  19. 32 CFR 161.18 - Benefits for abused dependents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... offense involving physical or emotional abuse of the spouse or child, or was administratively discharged... 32 National Defense 1 2014-07-01 2014-07-01 false Benefits for abused dependents. 161.18 Section... Other Eligible Individuals § 161.18 Benefits for abused dependents. (a) Abused dependents of active duty...

  20. [On the relationship between emotional dependency and abuse].

    PubMed

    Leemans, C; Loas, S

    2016-01-01

    Abuse is a complex psychosocial issue with multiple implications. This paper takes a look at the physical and psychological manifestations of domestic violence, i.e. between adult (romantic) partners as well as abuse of the elderly. Past studies have looked at the relationship between emotional dependency, the occurence and sustainability of abuse and the likehood that a victimized person will terminate a relationship. Indeed, individuals with Dependent Personality Disorder (DPD) or with dependent characteristics present a higher risk of becoming abusive (both physically and mentally) as well as becoming a victim of abuse. Regarding the elderly, the concept of "reverse violence"--where the current abuser was the victim of the senior who is being abused-, also entails dependent relationships. We identified three concepts that are necessary in the understanding of how dependent relationships underpin abuse: Rusbult's model of commitment in intimate relationships, the notion of dependency-possessiveness and Murphy et al's notion of escalating affective dependency. Thus, it is imperative that future studies in the field of domestic violence look at the dynamics of dyads rather than the individuals alone.

  1. OPPIDUM surveillance program: 20 years of information on drug abuse in France.

    PubMed

    Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle

    2013-12-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities. © 2013 The Authors Fundamental and Clinical Pharmacology © 2013 Société Française de Pharmacologie et de Thérapeutique.

  2. Homelessness and drug misuse in developing countries: A mathematical approach

    NASA Astrophysics Data System (ADS)

    Bhunu, C. P.

    2014-06-01

    Homelessness and drug-misuse are known to exist like siamese twins. We present a model to capture the dynamics in the growth in the number of homeless (street kids and street adults) and drug misusers. The reproduction numbers of the model are determined and analyzed. Results from this study suggests that adult peer pressure plays a more significant role in the growth of drug-misuse and the number of street kids. This result suggests that in resource constrained settings intervention strategies should be tailor made to target adults whose behaviour influence others to misuse drugs and abuse children. Furthermore, numerical simulations show that homelessness and drug-misuse positively enhances, the growth of each other. Thus, to effectively control these two social problems require strategies targeting both of them.

  3. Under Treatment of Pain: A Prescription for Opioid Misuse Among the Elderly?

    PubMed Central

    Levi-Minzi, Maria A.; Surratt, Hilary L.; Kurtz, Steven P.; Buttram, Mance E.

    2013-01-01

    Objective To examine the demographic, physical, and mental health characteristics; current drug use patterns; motivations for use; and diversion sources among elderly prescription opioid misusers. Design Mixed methods design. Setting Research field offices, or senior or community center offices in South Florida. Subjects Individuals aged 60 and over reporting past 90-day prescription medication misuse; only prescription opioid misusers (N = 88) were included in the final analysis. Methods The Global Appraisal of Individual Needs was the main survey instrument. A subsample of elderly reporting substantial prescription drug misuse were chosen for the in-depth interview (N = 30). Results The mean age was 63.3. Fifty percent reported ever being admitted to a drug treatment program; several endorsed recent illicit drug use: powder cocaine and/or crack (35.2%), marijuana (30.7%), heroin (14.8%). The majority reported past year severe physical pain and discomfort (86.4%), and misuse of their primary opioid for pain (80.7%); over half (52.3%) obtained their primary opioid from their regular doctor. Qualitative data highlight the misuse of prescription opioids due to untreated or undertreated pain. Participants with primary opioid misuse for pain had over 12 times higher odds of obtaining the medication from their regular doctor (odds ratio [OR] = 12.22, P = 0.002) and had lower odds of using a dealer (OR = 0.20, P = 0.005). Conclusions Findings suggest that this group of elderly participants often misuse their own prescriptions for pain management. This study highlights the need to educate prescribing professionals on appropriate pain management for older adults while still being sensitive to issues of substance abuse and dependence. PMID:23841571

  4. A Review of Alprazolam Use, Misuse, and Withdrawal

    PubMed Central

    Ait-Daoud, Nassima; Hamby, Allan Scott; Sharma, Sana; Blevins, Derek

    2018-01-01

    Alprazolam is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder. Its clinical use has been a point of contention as most addiction specialists consider it to be highly addictive, given its unique psychodynamic properties which limit its clinical usefulness, whereas many primary care physicians continue to prescribe it for longer periods than recommended. Clinical research data has not fully shed light on its “abuse liability,” yet it is one of the most frequently prescribed benzodiazepines. “Abuse liability” is the degree to which a psychoactive drug has properties that facilitate people misusing it, or becoming addicted to it, and is commonly used in the literature. We have replaced it in our manuscript with “misuse liability” as it reflects a more updated terminology consistent with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this paper, we have reviewed alprazolam’s indications for use, its effect on pregnant women, misuse liability, withdrawal syndrome, pharmacodynamic properties, and suggest better clinical prescription practice of alprazolam by presenting an indepth theory of its clinical effects with use and withdrawal. PMID:28777203

  5. Volatile substance misuse : clinical considerations, neuropsychopharmacology and potential role of pharmacotherapy in management.

    PubMed

    Garland, Eric L; Howard, Matthew O

    2012-11-01

    Volatile substance misuse is among the most prevalent and toxic forms of psychoactive drug use, and often results in highly deleterious social, psychological and medical consequences. The prevalence of this pernicious form of substance misuse owes in part to the fact that volatile substances of misuse are ubiquitous in the natural environment. Commonly misused commercial products include glue, shoe polish, nail polish remover, butane lighter fluid, gasoline and computer duster spray. National samples of volatile substance misusers tend to exhibit high rates of psychiatric problems and antisocial behaviour. In addition, cognitive impairments and affective dysregulation are often observed among these individuals. Volatile substances exert their complex neuropharmacological effects on dopaminergic, glutamatergic, GABAergic and serotoninergic receptor systems, as well as on cell membranes and ion channels. Concomitantly, pharmacotherapies for volatile substance abuse might profitably target a number of mechanisms, including reward circuitry in the brain, symptoms of craving and withdrawal, neuropsychiatric and emotional impairments that promote volatile substance abuse, and cognitive enhancement to rectify deficits in executive function. This review details the modes of use, subjective effects, epidemiology, adverse consequences, neuropsychopharmacology and drug treatment of volatile substance misuse, and discusses the potential role of novel forms of pharmacological intervention for this oft-overlooked public health threat of epidemic proportions.

  6. Clinical importance of caffeine dependence and abuse.

    PubMed

    Ogawa, Naoshi; Ueki, Hirofumi

    2007-06-01

    Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder-fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in 'eutrophic' (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder-fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long-term use of caffeine carry health risks.

  7. Cocaine abuse or dependency and other pyschiatric disorders. Madrid study on dual pathology.

    PubMed

    Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babin, Francisco

    2013-01-01

    The main objective of this study was to analyse the cocaine addict subgroup from the Madrid study of prevalence of dual disorders in community mental health and substance misuse services. The sample consisted of 837 outpatients from Madrid, Spain. We compared 488 subjects who had a lifetime diagnosis of cocaine abuse or dependence, and 222 subjects who did not have a cocaine substance use disorder. We used the Mini International Neuropsychiatric Interview to evaluate axis I mental disorders, and the Personality Disorder Questionnaire to evaluate personality disorders. Almost three-quarters (73.4%) of cocaine addicts had a current dual disorder. Most prevalent were mood and anxiety disorders. Almost half (49.6%) had a personality disorder. Most of them (94.9%) had other substance use disorders. Cocaine addicts did not have higher prevalence rates of dual pathology than addicts with no cocaine abuse or dependence. Cocaine addicts were associated to a diagnosis of antisocial personality disorder, agoraphobia, and post-traumatic stress disorder, and they had an early age of onset of alcohol and cannabis use. Dual pathology is no higher in cocaine addicts in treatment than in addicts who do not use cocaine, however cocaine addicts started other drugs earlier, and were associated with specific mental disorders. Copyright © 2012 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  8. 49 CFR 655.12 - Required elements of an anti-drug use and alcohol misuse program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... verified positive drug test result or an alcohol concentration of 0.04 or greater to a Substance Abuse... misuse program. 655.12 Section 655.12 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND...

  9. 49 CFR 655.12 - Required elements of an anti-drug use and alcohol misuse program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... verified positive drug test result or an alcohol concentration of 0.04 or greater to a Substance Abuse... misuse program. 655.12 Section 655.12 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND...

  10. 49 CFR 655.12 - Required elements of an anti-drug use and alcohol misuse program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... verified positive drug test result or an alcohol concentration of 0.04 or greater to a Substance Abuse... misuse program. 655.12 Section 655.12 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND...

  11. 49 CFR 655.12 - Required elements of an anti-drug use and alcohol misuse program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... verified positive drug test result or an alcohol concentration of 0.04 or greater to a Substance Abuse... misuse program. 655.12 Section 655.12 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND...

  12. 49 CFR 655.12 - Required elements of an anti-drug use and alcohol misuse program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... verified positive drug test result or an alcohol concentration of 0.04 or greater to a Substance Abuse... misuse program. 655.12 Section 655.12 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND...

  13. [Dependency, abuse, and depression by gender in widowed elderly].

    PubMed

    Kim, Ok-Soo; Yang, Kyoung-Mi; Kim, Kye-Ha

    2005-04-01

    The purpose of this study was to investigate the effects of dependency and abuse on depression according to gender in widowed elderly. A convenient sample consisted of 246 widowed elderly who were more than 65 years old in four cities. Data was collected using a structured questionnaire from August to September, 2002. A dependency Scale developed by Ahn (1999) was used to measure the level of dependency. Emotional abuse and physical abuse were measured by 10 items for emotional abuse and 7 items for physical abuse selected out of the Conditions Scale of Elder Abuse. The level of depression was measured by the Geriatric Depression Scale (GDS). The SPSS WIN 11.0 version program was used for data analysis. In male widowed elderly, dependency affected depression indirectly through emotional abuse. While in female widowed elderly, dependency affected depression directly and affected emotional abuse indirectly. The study showed that dependency was the most explainable variable on depression in widowed female elderly. Therefore, it dependency should be assessed first in nursing intervention to relieve depression of widowed elderly.

  14. Geriatric Alcoholism and Drug Abuse

    ERIC Educational Resources Information Center

    Schuckit, Marc A.

    1977-01-01

    This paper reviews the literature and presents new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates, inadvertent misusers, and deliberate abusers of nonopiates. Two to 10 percent of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. (Author)

  15. Prescription Stimulant Medication Misuse: Where Are We and Where Do We Go from Here?

    PubMed Central

    Weyandt, Lisa L.; Oster, Danielle R.; Marraccini, Marisa Ellen; Gudmundsdottir, Bergljot Gyda; Munro, Bailey A.; Rathkey, Emma S.; Mccallum, Alison

    2016-01-01

    Prescription stimulants, including methylphenidate (e.g., Ritalin) and amphetamine compounds (e.g., dextroamphetamine; Adderall), have been approved by the U.S. Food and Drug Administration for the treatment of attention deficit hyperactivity disorder (ADHD) and are classified by the United States Drug Enforcement Administration (DEA) as Schedule II medications due to their high potential for abuse and dependence (DEA, U.S. Department of Justice, 2015). Despite the potential health and judicial consequences, misuse of prescription stimulants, typically defined as taking stimulants without a valid prescription, or use of stimulants other than as prescribed, has become a serious problem in the United States and abroad, especially on college campuses. The purpose of the present paper is to review historical information concerning prescription stimulants and to summarize the literature with respect to misuse among adults, particularly college students, including risk factors, mediators and moderators, and motivations for prescription stimulant misuse. In addition, evidence is presented concerning the question of whether prescription stimulants truly enhance cognitive functioning in individuals with and without ADHD, and the ethical and professional implications of these findings are explored. Lastly, recommendations for addressing prescription stimulant misuse and suggestions for future research are advanced. PMID:27690507

  16. Association of childhood abuse and prescription opioid use in early adulthood.

    PubMed

    Austin, Anna E; Shanahan, Meghan E; Zvara, Bharathi J

    2018-01-01

    Previous research has examined the association of childhood abuse with opioid misuse and dependence in adulthood. However, little research has focused specifically on prescription opioids, and no studies have examined associations with prescription opioid use, a potential pathway to later opioid misuse and dependence. The aim of the present study was to examine the association of childhood emotional, physical, and sexual abuse with prescription opioid use in early adulthood. We used data from Waves I (12-18years) and IV (24-32years) of the National Longitudinal Study of Adolescent to Adult Health. At Wave IV, respondents reported experiences of childhood abuse occurring prior to age 18years and prescription opioid use in the last four weeks. We conducted multivariable logistic regression to examine associations of childhood abuse with recent prescription opioid use. In multivariable models adjusted for respondent sex, race/ethnicity, age, and socioeconomic status, childhood emotional abuse (OR=1.57, 95% CI 1.29, 1.90), physical abuse (OR=1.46, 95% CI 1.14, 1.87), and any childhood abuse (OR=1.51, 95% CI 1.24, 1.82) were significantly associated with recent prescription opioid use. Given continued increases in prescription opioid use and opioid-related morbidity and mortality in the U.S., understanding upstream social and environmental factors associated with prescription opioid use is important to strengthening and expanding current prevention and intervention strategies. Future research is needed to examine factors potentially mediating the association between childhood abuse and prescription opioid use in order to provide additional insights for prevention and intervention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Longitudinal Effects of Early Childhood Maltreatment on Co-Occurring Substance Misuse and Mental Health Problems in Adulthood: The Role of Adolescent Alcohol Use and Depression

    PubMed Central

    Skinner, Martie L.; Hong, Seunghye; Herrenkohl, Todd I.; Brown, Eric C.; Lee, Jungeun Olivia; Jung, Hyunzee

    2016-01-01

    Objective: This study tested a developmental model in which subtypes of childhood maltreatment were hypothesized to have direct and indirect effects on co-occurring depression, anxiety, and substance misuse in adulthood. Indirect effects involved adolescent alcohol use and depression, which were included as mediators in the tested models. Method: This prospective longitudinal study (N = 332; 52.4% male) followed the participants from childhood (18 months to 6 years of age) to adulthood (31–41 years old, M = 36.21). Maltreatment subtypes included parent-reported physical and emotional abuse and child-reported sexual abuse. Adult outcomes included measures of substance misuse and mental health (i.e., depression and anxiety). Latent class analysis and structural equation models were used to identify classes of substance misuse and mental health co-occurrence and to test mediating effects of adolescent alcohol use and depression. Results: Three classes were identified: (a) low risk of substance misuse and low mental health symptoms, (b) moderate substance misuse risk and mild depression and anxiety, and (c) moderate substance misuse risk and moderate to high depression and anxiety. Structural models showed that effects of childhood sexual abuse were fully mediated by adolescent alcohol use and depression. Physical abuse increased adolescent depression but did not have direct or indirect effects on adult outcome classes. Emotional abuse had a direct effect on the adult classes. Conclusions: Children exposed to severe emotional abuse are at higher risk for comorbid substance misuse, depression, and anxiety into their mid-30s, after taking into account evidence of alcohol use and depression during adolescence. Sexual and physical abuse have more proximal effects on adolescent alcohol use and depression, which then influence the risk of adult problems. PMID:27172579

  18. A Review of Buprenorphine Diversion and Misuse: The Current Evidence Base and Experiences from Around the World

    PubMed Central

    Lofwall, Michelle R.; Walsh, Sharon L.

    2014-01-01

    Outpatient opioid addiction treatment with sublingual buprenorphine pharmacotherapy (OBOT) has rapidly expanded in the United States and abroad, and, with this increase in medication availability, there have been increasing concerns about its diversion, misuse and related harms. This narrative review defines the behaviors of diversion and misuse, examines how the pharmacology of buprenorphine alone and in combination with naloxone influence its abuse liability, and describes the epidemiological data on buprenorphine diversion and intravenous misuse, risk factors for its intravenous misuse and the unintended consequences of misuse and diversion. Physician practices to prevent, screen for, and therapeutically respond to these behaviors, which are a form of medication non-adherence, are discussed and gaps in knowledge are identified. OBOT experiences from other countries that have varied health care systems, public policies, and access to addiction treatment are shared in order to make clear that diversion and misuse occur across the world in various contexts, for many different reasons, and are not limited to buprenorphine. Comparisons are made with other opioids with known abuse liability as well as medications with no known abuse. The objective is to facilitate understanding of diversion and misuse so that all factors influencing their expression (patient and provider characteristics and public policy) can be appreciated within a framework that also recognizes the benefits of addiction treatment. With this comprehensive perspective, further careful work can help determine how to minimize these behaviors without eroding the current benefits realized through improved addiction treatment access and expansion. PMID:25221984

  19. Benzodiazepine dependence among multidrug users in the club scene

    PubMed Central

    Kurtz, Steven P.; Surratt, Hilary L.; Levi-Minzi, Maria A.; Mooss, Angela

    2011-01-01

    Background Benzodiazepines (BZs) are among the most frequently prescribed drugs with the potential for abuse. Young adults ages 18–29 report the highest rates of BZ misuse in the United States. The majority of club drug users are also in this age group, and BZ misuse is prevalent in the nightclub scene. BZ dependence, however, is not well documented. This paper examines BZ dependence and its correlates among multidrug users in South Florida’s nightclub scene. Methods Data were drawn from structured interviews with men and women (N=521) who reported regular attendance at large dance clubs and recent use of both club drugs and BZs. Results Prevalences of BZ-related problems were 7.9% for BZ dependence, 22.6% BZ abuse, and 25% BZ abuse and/or dependence. In bivariate logistic regression models, heavy cocaine use (OR 2.27; 95% CI 1.18, 4.38), severe mental distress (OR 2.63; 95% CI 1.33, 5.21), and childhood victimization history (OR 2.43; 95% CI 1.10, 5.38) were associated with BZ dependence. Heavy cocaine use (OR 2.14; 95% CI 1.10, 4.18) and severe mental distress (OR 2.16; 95% CI 1.07, 4.37) survived as predictors in the multivariate model. Discussion BZ misuse is widespread among multidrug users in the club scene, who also exhibit high levels of other health and social problems. BZ dependence appears to be more prevalent in this sample than in other populations described in the literature. Recommendations for intervention and additional research are described. PMID:21708434

  20. Benzodiazepine dependence among multidrug users in the club scene.

    PubMed

    Kurtz, Steven P; Surratt, Hilary L; Levi-Minzi, Maria A; Mooss, Angela

    2011-12-01

    Benzodiazepines (BZs) are among the most frequently prescribed drugs with the potential for abuse. Young adults ages 18-29 report the highest rates of BZ misuse in the United States. The majority of club drug users are also in this age group, and BZ misuse is prevalent in the nightclub scene. BZ dependence, however, is not well documented. This paper examines BZ dependence and its correlates among multidrug users in South Florida's nightclub scene. Data were drawn from structured interviews with men and women (N=521) who reported regular attendance at large dance clubs and recent use of both club drugs and BZs. Prevalences of BZ-related problems were 7.9% for BZ dependence, 22.6% BZ abuse, and 25% BZ abuse and/or dependence. In bivariate logistic regression models, heavy cocaine use (OR 2.27; 95% CI 1.18, 4.38), severe mental distress (OR 2.63; 95% CI 1.33, 5.21), and childhood victimization history (OR 2.43; 95% CI 1.10, 5.38) were associated with BZ dependence. Heavy cocaine use (OR 2.14; 95% CI 1.10, 4.18) and severe mental distress (OR 2.16; 95% CI 1.07, 4.37) survived as predictors in the multivariate model. BZ misuse is widespread among multidrug users in the club scene, who also exhibit high levels of other health and social problems. BZ dependence appears to be more prevalent in this sample than in other populations described in the literature. Recommendations for intervention and additional research are described. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Alcohol Misuse and Psychological Resilience among U.S. Iraq and Afghanistan Era Veteran Military Personnel

    PubMed Central

    Green, Kimberly T.; Beckham, Jean C.; Youssef, Nagy; Elbogen, Eric B.

    2013-01-01

    Objective The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse. Methodology Data were from National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up. Results Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models. Conclusions These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which

  2. Principles of laboratory assessment of drug abuse liability and implications for clinical development

    PubMed Central

    Carter, Lawrence P.; Griffiths, Roland R.

    2009-01-01

    Abuse liability testing plays an important role in informing drug development, regulatory processes, and clinical practice. This paper describes the current “gold standard” methodologies that are used for laboratory assessments of abuse liability in non-human and human subjects. Particular emphasis is given to procedures such as non-human drug discrimination, self-administration, and physical dependence testing, and human dose effect abuse liability studies that are commonly used in regulatory submissions to governmental agencies. The potential benefits and risks associated with the inclusion of measures of abuse liability in industry-sponsored clinical trials is discussed. Lastly, it is noted that many factors contribute to patterns of drug abuse and dependence outside of the laboratory setting and positive or negative signals in abuse liability studies do not always translate to high or low levels of actual abuse or dependence. Well-designed patient and physician education, pharmacovigilance, and postmarketing surveillance can reduce the diversion and misuse of drugs with abuse liability and can effectively foster the protection and promotion of public health. PMID:19443137

  3. Assessment of the trends in medical use and misuse of opioid analgesics from 2004 to 2011.

    PubMed

    Atluri, Sairam; Sudarshan, Gururau; Manchikanti, Laxmaiah

    2014-01-01

    The epidemic of medical use and abuse of opioid analgesics is linked to the economic burden of opioid-related abuse and fatalities in the United States. Multiple studies have estimated the extent to which prescription opioid analgesics contribute to the national drug abuse problem; studies also assessing the trends in medical use and abuse of opioid analgesics have confirmed the relationship between increasing medical use of opioids and increasing fatalities.The available data is limited until 2002. Retrospective analysis of data from 2004 to 2011 from 2 databases: Automation of Reports and Consolidated Orders System (ARCOS) for opioid use data and Drug Abuse Warning Network (DAWN) for drug misuse data. To determine the proportion of drug abuse related to opioid analgesics and the various trends in the medical use and abuse of 8 opioid analgesics commonly used to treat pain: buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone. The data obtained from DAWN is a nationally representative sample of hospital emergency department admissions resulting from drug abuse. Main outcome measure was the identification of trends in the medical use and misuse of opioid analgesics from 2004 to 2011. From 2004 to 2011, there was an increase in the medical use of all opioids except for a 20% decrease in codeine. The abuse of all opioids including codeine increased during this period. Increases in medical use ranged from 2,318% for buprenorphine to 35% for fentanyl, including 140% for hydromorphone, 117% for oxycodone, 73% for hydrocodone, 64% for morphine, and 37% for methadone. The misuse increased 384% for buprenorphine with available data from 2006 to 2011, whereas from 2004 to 2011, it increased 438% for hydromorphone, 263% for oxycodone, 146% for morphine, 107% for hydrocodone, 104% for fentanyl, 82% for methadone, and 39% for codeine. Comparison of opioid use showed an overall increase of 1,448% from 1996 to 2011, with increases of

  4. Ground-penetrating radar: use and misuse

    NASA Astrophysics Data System (ADS)

    Olhoeft, Gary R.

    1999-10-01

    Ground penetrating radar (GPR) has been used to explore the subsurface of the earth since 1929. Over the past 70 years, it has been widely used, misused and abused. Use includes agriculture, archaeology, environmental and geotechnical site characterization, minerals, groundwater and permafrost exploration, tunnel, utility, and unexploded ordnance location, dam inspection, and much more. Misuse includes mistaking above ground reflections for subsurface events or mapping things from off to the side as if they were directly below, synthetic aperture processing of dispersive data, minimum phase deconvolution, locating objects smaller than resolution limits of the wavelength in the ground, ignoring Fresnel zone limitations in mapping subsurface structure, processing radar data through seismic software packages without allowing for the differences, mapping the bottom of metal pipes from the top, claiming to see through thousands of feet of sediments, and more. GPR is also being abused as the regulatory environment changes and the radiofrequency spectrum is becoming more crowded by cellular phones, pagers, garage door openers, wireless computer networks, and the like. It is often thought to be a source of interference (though it never is) and it is increasingly interfered with by other radiofrequency transmitters.

  5. Gender differences in discharge dispositions of emergency department visits involving drug misuse and abuse-2004-2011.

    PubMed

    Manuel, Jennifer I; Lee, Jane

    2017-05-30

    Drug use-related visits to the emergency department (ED) can undermine discharge planning and lead to recurrent use of acute services. Yet, little is known about where patients go post discharge. We explored trends in discharge dispositions of drug-involved ED visits, with a focus on gender differences. We extracted data from the 2004-2011 Drug Abuse Warning Network, a national probability sample of drug-related visits to hospital EDs in the U.S. We computed weighted multinomial logistic regression models to estimate discharge dispositions over time and to examine associations between gender and the relative risk of discharge dispositions, controlling for patient characteristics. The final pooled sample included approximately 1.2 million ED visits between 2004 and 2011. Men accounted for more than half (57.6%) of all ED visits involving drug misuse and abuse. Compared with women, men had a greater relative risk of being released to the police/jail, being referred to outpatient detox or other treatment, and leaving against medical advice than being discharged home. The relative risk of being referred to outpatient detox/drug treatment than discharged home increased over time for men versus women. Greater understanding of gender-based factors involved in substance-related ED visits and treatment needs may inform discharge planning and preventive interventions.

  6. Misuse of OTC drugs in Poland.

    PubMed

    Zaprutko, Tomasz; Koligat, Dorota; Michalak, Michał; Wieczorek, Marta; Józiak, Malwina; Ratajczak, Monika; Szydłowska, Kinga; Miazek, Joanna; Kus, Krzysztof; Nowakowska, Elżbieta

    2016-08-01

    The misuse of over-the-counter (OTC) drugs became a global public health concern. Although abuse with dextrometorphan (DXM), pseudoefedrine (PSD), codeine (COD) or benzydamine (BND) may lead even to psychosis, drugs containing these substances are relatively cheap and freely available. In Poland the Act on Counteracting Drug Addiction was amended in 2015, however it seems that there are still some points which could be improved. Study was conducted between October 2014 and June 2015 using a specially designed questionnaire delivered to pharmacists from the Greater Poland region. Questionnaire consisting of 11 closed questions was distributed by direct contact and via the Internet. From over 2500 distributed questionnaires, we received 761 sheets and 680 were included. The misuse of OTC drugs is increasing in Poland from pharmacists point of view. The most popular substance was PSD followed by COD and DXM. The main reason of misuse of these drugs could be related to the use of Internet and free access to these medications. In respondents (58.2%) opinion OTC drugs containing analyzed substances should be moved into the prescription status. The misuse of OTC drugs should be considered as a very dangerous phenomenon. Although the Act on Counteracting Drug Addiction was amended in Poland in 2015, there are some facets requiring improvement. Social education may play a key role in the limitation of misuse of OTC drugs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Oregon’s Strategy to Confront Prescription Opioid Misuse: A Case Study

    PubMed Central

    McCarty, Dennis; Bovett, Rob; Burns, Thomas; Cushing, Judy; Glynn, Mary Ellen; Kruse, Senator Jeff; Millet, Lisa M.; Shames, Jim

    2014-01-01

    Governor John Kitzhaber appointed a Prescription Drug Taskforce to address Oregon’s opioid epidemic. This case study reviews the Taskforce’s participation in the National Governors Association State Policy Academy on Reducing Prescription Drug Abuse. To address the challenge of the misuse and abuse of prescription opioids, the Taskforce developed a strategy for practice change, community education and enhanced access to safe opioid disposal using stakeholder meetings, consensus development, and five action steps: 1) fewer pills in circulation, 2) educate prescribers and the public on the risks of opioid use, 3) foster safe disposal of unused medication, 4) provide treatment for opioid dependence, and 5) continued leadership from the Governor, health plans and health professionals. Although the story is ongoing, there are lessons for leadership in other states and for public health and medical practitioners throughout the country. PMID:25168199

  8. Prescription stimulant medication misuse: Where are we and where do we go from here?

    PubMed

    Weyandt, Lisa L; Oster, Danielle R; Marraccini, Marisa E; Gudmundsdottir, Bergljot Gyda; Munro, Bailey A; Rathkey, Emma S; McCallum, Alison

    2016-10-01

    Prescription stimulants, including methylphenidate (e.g., Ritalin) and amphetamine compounds (e.g., dextroamphetamine; Adderall), have been approved by the U.S. Food and Drug Administration for the treatment of attention-deficit/hyperactivity disorder (ADHD) and are classified by the United States Drug Enforcement Administration as Schedule II medications because of their high potential for abuse and dependence (Drug Enforcement Administration, U.S. Department of Justice, 2015). Despite the potential health and judicial consequences, misuse of prescription stimulants, typically defined as taking stimulants without a valid prescription, or use of stimulants other than as prescribed, has become a serious problem in the United States and abroad, especially on college campuses. The purpose of the present article is to review historical information concerning prescription stimulants and to summarize the literature with respect to misuse among adults, particularly college students, including risk factors, mediators and moderators, and motivations for prescription stimulant misuse. In addition, evidence is presented concerning the question of whether prescription stimulants truly enhance cognitive functioning in individuals with and without ADHD, and the ethical and professional implications of these findings are explored. Lastly, recommendations for addressing prescription stimulant misuse and suggestions for future research are advanced. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. Changes in Inmates’ Substance Use and Dependence From Pre-Incarceration to One Year Post-Release

    PubMed Central

    Tangney, June P.; Folk, Johanna B.; Graham, David M.; Stuewig, Jeffrey B.; Blalock, Daniel V.; Salatino, Andrew; Blasko, Brandy B.; Moore, Kelly E.

    2016-01-01

    Purpose To assess changes in inmates’ misuse of substances from pre- to post-incarceration. Methods In Study 1, professionals (n = 162) and laypersons (n = 50) predicted how jail inmates’ substance misuse would change from pre-incarceration to post-release. In Study 2, a longitudinal study of 305 jail inmates, we examined actual changes in substance use and dependence from pre-incarceration to the first year post-incarceration, as well as whether changes varied as a function of demographic, criminal justice, treatment, and personality factors. Results Professionals and laypersons predicted little change in substance misuse whereas, in fact, inmates’ frequency of substance use and dependence decreased substantially from pre-incarceration to post-release. Sharper decreases were observed for inmates who were female, younger, more educated, serving longer sentences, enrolled in substance abuse treatment, high in shame-proneness, and low in criminogenic thinking. Race, first time incarceration, transfer to other correctional facilities, mandated community supervision (probation), and guilt-proneness did not predict changes in substance use or dependence. Conclusions Although substance misuse decreased, this remains a population high in need of substance abuse treatment both upon arrest and at one year post-incarceration; 60% of former inmates met at least one DSM-IV criterion for substance dependence at one year post-release. PMID:27458324

  10. Medical use, medical misuse, and nonmedical use of prescription opioids: results from a longitudinal study.

    PubMed

    McCabe, Sean Esteban; West, Brady T; Boyd, Carol J

    2013-05-01

    The objective of this study was to examine the prevalence and patterns associated with past-year medical use, medical misuse, and nonmedical use of prescription opioids (NMUPO) among adolescents over a 2-year time period and to examine substance abuse, sleeping problems, and physical pain symptoms associated with these patterns of medical use, medical misuse, and NMUPO. A Web-based survey was self-administered by a longitudinal sample of 2050 middle and high school students in 2009-2010 (Year 1) and again in 2010-2011 (Year 2). The study was set in 2 southeastern Michigan school districts. The longitudinal sample consisted of 50% females, 67% Whites, 28% African-Americans, and 5% from other racial/ethnic categories. Main outcome measures were past-year medical use, medical misuse, and NMUPO. Of those reporting appropriate medical use of prescription opioids in Year 1, approximately 34% continued medical use in Year 2. Of those reporting past-year NMUPO in Year 1, approximately 25% continued NMUPO in Year 2. Appropriate medical use and NMUPO for pain relief was more prevalent among girls than boys. Multiple logistic regression analyses indicated that the odds of a positive screen for substance abuse in Year 2 were greater for adolescents who reported medical misuse or NMUPO for non-pain-relief motives in Year 1 compared with those who did not use prescription opioids. The findings indicate an increased risk for substance abuse among adolescents who report medical misuse or NMUPO for non-pain-relief motives over time. The findings have important clinical implications for interventions to reduce medical misuse and NMUPO among adolescents. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  11. Abuse or dependence on cannabis and other psychiatric disorders. Madrid study on dual pathology prevalence.

    PubMed

    Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babin, Francisco

    2013-01-01

    Cannabis use has been associated to a wide variety of mental disorders, the possible causal role of this use in the etiology of severe mental disorders as schizophrenia or bipolar disorder standing out. Moreover, the cannabinoid system is involved in emotional regulation, so cannabis use could disturb this process and provoke anxiety and mood disorders. The main objective of this study was to analyze the cannabis addict subgroup from Madrid study of prevalence of dual disorders in community mental health and substance misuse services. The sample consisted of 837 outpatients under treatment in the mental health network or drug network of the Community of Madrid (Spain). Of these, 353 subjects had a lifetime diagnosis of cannabis abuse or dependence and 357 subjects did not have cannabis substance use disorder. We used the Mini International Neuropsychiatric Interview (MINI) to evaluate axis I mental disorders, and Personality Disorder Questionnaire to evaluate personality disorders. It was considered that 76.5% of the cannabis addicts had a current dual disorder. The most prevalent ones were mood and anxiety disorders. Of those addicted to cannabis, 51% had a personality disorder. Most of them had several substance use disorders. Cannabis abuse or dependence subjects had an earlier onset in consumption of other drugs such as alcohol, cocaine, and tobacco than addicts without cannabis abuse or dependence. The cannabis addicts also differed from the other addicts because of an association to antisocial personality disorder, bipolar disorder, psychosis and agoraphobia. The presence of these mental disorders was significantly associated to a lower age at initiation of cannabis use. Dual pathology is very high in cannabis addicts under treatment. Said consumption of cannabis, probably within a polysubstance use pattern, is associated to severe mental disorders as psychosis and bipolar disorder. An earlier age of onset in cannabis use is associated to a greater risk of

  12. Illicit gamma-hydroxybutyrate (GHB) and pharmaceutical sodium oxybate (Xyrem): differences in characteristics and misuse.

    PubMed

    Carter, Lawrence P; Pardi, Daniel; Gorsline, Jane; Griffiths, Roland R

    2009-09-01

    There are distinct differences in the accessibility, purity, dosing, and misuse associated with illicit gamma-hydroxybutyrate (GHB) compared to pharmaceutical sodium oxybate. Gamma-hydroxybutyrate sodium and sodium oxybate are the chemical and drug names, respectively, for the pharmaceutical product Xyrem (sodium oxybate) oral solution. However, the acronym GHB is also used to refer to illicit formulations that are used for non-medical purposes. This review highlights important differences between illicit GHB and sodium oxybate with regard to their relative abuse liability, which includes the likelihood and consequences of abuse. Data are summarized from the scientific literature; from national surveillance systems in the U.S., Europe, and Australia (for illicit GHB); and from clinical trials and post-marketing surveillance with sodium oxybate (Xyrem). In the U.S., the prevalence of illicit GHB use, abuse, intoxication, and overdose has declined from 2000, the year that GHB was scheduled, to the present and is lower than that of most other licit and illicit drugs. Abuse and misuse of the pharmaceutical product, sodium oxybate, has been rare over the 5 years since its introduction to the market, which is likely due in part to the risk management program associated with this product. Differences in the accessibility, purity, dosing, and misuse of illicit GHB and sodium oxybate suggest that risks associated with illicit GHB are greater than those associated with the pharmaceutical product sodium oxybate.

  13. Sexual abuses.

    PubMed

    Abel, G G; Rouleau, J L

    1995-03-01

    The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator.

  14. Cannabinoid Receptor 1 Gene Polymorphisms and Marijuana Misuse Interactions On White Matter and Cognitive Deficits in Schizophrenia

    PubMed Central

    Ho, Beng-Choon; Wassink, Thomas H.; Ziebell, Steven; Andreasen, Nancy C.

    2011-01-01

    Marijuana exposure during the critical period of adolescent brain maturation may disrupt neuro-modulatory influences of endocannabinoids and increase schizophrenia susceptibility. Cannabinoid receptor 1 (CB1/CNR1) is the principal brain receptor mediating marijuana effects. No study to-date has systematically investigated the impact of CNR1 on quantitative phenotypic features in schizophrenia and inter-relationships with marijuana misuse. We genotyped 235 schizophrenia patients using 12 tag single nucleotide polymorphisms (tSNPs) that account for most of CB1 coding region genetic variability. Patients underwent a high-resolution anatomic brain magnetic resonance scan and cognitive assessment. Almost a quarter of the sample met DSM marijuana abuse (14%) or dependence (8%) criteria. Effects of CNR1 tSNPs and marijuana abuse/dependence on brain volumes and neurocognition were assessed using ANCOVA, including co-morbid alcohol/non-marijuana illicit drug misuse as covariates. Significant main effects of CNR1 tSNPs (rs7766029, rs12720071, and rs9450898) were found in white matter (WM) volumes. Patients with marijuana abuse/dependence had smaller fronto-temporal WM volumes than patients without heavy marijuana use. More interestingly, there were significant rs12720071 genotype-by-marijuana use interaction effects on WM volumes and neurocognitive impairment; suggestive of gene-environment interactions for conferring phenotypic abnormalities in schizophrenia. In this comprehensive evaluation of genetic variants distributed across the CB1 locus, CNR1 genetic polymorphisms were associated with WM brain volume variation among schizophrenia patients. Our findings suggest that heavy cannabis use in the context of specific CNR1 genotypes may contribute to greater WM volume deficits and cognitive impairment, which could in turn increase schizophrenia risk. PMID:21420833

  15. From Pubs to Scrubs: Alcohol Misuse and Health Care Use

    PubMed Central

    Balsa, Ana I; French, Michael T; Maclean, Johanna Catherine; Norton, Edward C

    2009-01-01

    Objective To analyze the relationships between alcohol misuse and two types of acute health care use—hospital admissions and emergency room (ER) episodes. Data Sources/Study Setting The first (2001/2002) and second (2004/2005) waves of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). Study Design Longitudinal study using a group of adults (18–60 years in Wave 1, N=23,079). Gender-stratified regression analysis adjusted for a range of covariates associated with health care use. First-difference methods corrected for potential omitted variable bias. Data Collection The target population of the NESARC was the civilian noninstitutionalized population aged 18 and older residing in the United States and the District of Columbia. The survey response rate was 81 percent in Wave 1 (N=43,093) and 65 percent in Wave 2 (N=34,653). Principal Findings Frequent drinking to intoxication was positively associated with hospital admissions for both men and women and increased the likelihood of using ER services for women. Alcohol dependence and/or abuse was related to higher use of ER services for both genders and increased hospitalizations for men. Conclusions These findings provide updated and nationally representative estimates of the relationships between alcohol misuse and health care use, and they underscore the potential implications of alcohol misuse on health care expenditures. PMID:19500163

  16. Chronic pain and opioid misuse: a review of reviews.

    PubMed

    Voon, Pauline; Karamouzian, Mohammad; Kerr, Thomas

    2017-08-15

    The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse. A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Eligible studies were systematic reviews related to chronic non-cancer pain and PO or other substance misuse. Evidence from the included reviews was synthesized according to epidemiology and clinical management themes. Of 1908 identified articles, 18 systematic reviews were eligible for final inclusion. Two meta-analyses estimated the prevalence of chronic non-cancer pain in individuals using POs non-medically to be approximately 48% to 60%, which is substantially higher than the prevalence of chronic non-cancer pain in general population samples (11% to 19%). Five systematic reviews estimated the rates of PO or other opioid use in chronic pain populations with substantial variation in results (0.05% to 81%), likely due to widely varying definitions of dependence, substance use disorder, misuse, addiction, and abuse. Several clinical assessment and treatment approaches were identified, including: standardized assessment instruments; urine drug testing; medication counts; prescription drug monitoring programs; blood level monitoring; treatment agreements; opioid selection; dosing and dispensing strategies; and opioid agonist treatment. However, the reviews commonly noted serious limitations, inconsistencies, and imprecision of studies, and a lack of evidence on effectiveness or clinical utility for the majority of these strategies. Overall, current systematic reviews have found a lack of high-quality evidence or consistent findings on the prevalence, risk factors, and optimal clinical assessment and treatment approaches related to concurrent chronic pain and substance misuse. Given

  17. Prescription Drug Misuse Among Club Drug-Using Young Adults

    PubMed Central

    Kelly, Brian C.; Parsons, Jeffrey T.

    2009-01-01

    Nonmedical prescription (Rx) drug use has recently increased, particularly among young adults. Using time-space sampling to generate a probability-based sample of club-going young adults (18–29), 400 subjects provided data on Rx drug misuse. Club-going young adults misuse Rx drugs at high rates. An overwhelming majority of the sample indicated lifetime use of pain killers, sedatives, and stimulants. A majority indicated recent pain killer use. Variations by gender and sexuality exist in this population. Young lesbian/bisexual women emerged as the group most likely to abuse Rx drugs. Research into the contexts influencing these patterns is imperative. PMID:17994483

  18. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Projecting the cost, utilization, and patient care impact of prescribing extended release non-abuse-deterrent opioids to chronic pain patients.

    PubMed

    Yenikomshian, Mihran Ara; White, Alan G; Carson, Michael E; Garrison, Louis P; Oderda, Gary M; Biskupiak, Joseph E; Hlavacek, Patrick R; Roland, Carl L

    To estimate healthcare resource utilization, associated costs, and number needed to harm (NNH) from a physician's decision to prescribe extended-release (ER) non-abuse-deterrent opioids (non-ADO) as compared to ER ADOs in a chronic pain population. A 12-month probabilistic simulation model was developed to estimate the reduction of misuse and/or abuse from a physician's prescribing decisions for 10,000 patients. Model inputs included probabilities for opioid misuse and/or abuse-related events, opioid discontinuation, and switching from ADO to non-ADO. Estimated reductions in abuse associated with ADOs were obtained from positive subjective measures using human abuse liability studies. The model was run separately for commercial, Medicare, Medicaid, and Veterans Administration (VA) populations. The difference in healthcare resource utilization and associated costs (2015 USD) between the ADO and non-ADO simulations was calculated. NNH for non-ADO was also calculated. Misuse and/or abuse-related events for patients prescribed ER non-ADOs ranged from 223-1,410 and associated costs ranged from $20-$98 per patient for commercial and Medicare populations, respectively. Prescribing ER ADOs were associated with 87, 289, 264, and 417 fewer misuse and/or abuse-related events, saving $8, $35, $21, and $29 per patient in commercial, VA, Medicaid, and Medicare populations, respectively. NNH ranged from 185 in the commercial population to 40 in the Medicare population. Results were sensitive to decreases in the probability of misuse and/or abuse events but showed reductions. A physician's decision to prescribe ER ADOs could lead to large reductions in misuse and/or abuse-related events and associated costs across many patient populations.

  20. [Pharmacist as gatekeeper: combating medication abuse and dependence].

    PubMed

    Shimane, Takuya

    2013-01-01

      The nonmedical use of medications, including psychotropic drugs, is a growing health problem in Japan. According to a nationwide survey of mental hospitals, the proportion of patients with sedative (mainly benzodiazepine)-related disorders has more than doubled over the last decade. An association between psychotropic drug overdose and suicide risk has also been reported. Furthermore, over-the-counter drug abuse is still a serious problem in Japan. In recent years, pharmacists have been expected to act as gatekeepers, making timely identifications of suicide risk or substance abuse and directing these individuals to appropriate medical care facilities. In August 2012, the revised Comprehensive Suicide Measures Act identified pharmacists as one professional group that should act as gatekeepers. This article begins by reviewing the fundamental terms involved in understanding the nonmedical use of medications, including abuse, dependence, and intoxication. The current situation of substance abuse and dependence is then introduced through a summary of several epidemiological surveys conducted in Japan. Finally, the role of pharmacists as gatekeepers in preventing substance abuse and dependence on medications is discussed.

  1. Illicit gamma-hydroxybutyrate (GHB) and pharmaceutical sodium oxybate (Xyrem®): differences in characteristics and misuse

    PubMed Central

    Carter, Lawrence P.; Pardi, Daniel; Gorsline, Jane; Griffiths, Roland R.

    2009-01-01

    There are distinct differences in the accessibility, purity, dosing, and misuse associated with illicit gamma-hydroxybutyrate (GHB) compared to pharmaceutical sodium oxybate. Gamma-hydroxybutyrate sodium and sodium oxybate are the chemical and drug names, respectively, for the pharmaceutical product Xyrem® (sodium oxybate) oral solution. However, the acronym GHB is also used to refer to illicit formulations that are used for non-medical purposes. This review highlights important differences between illicit GHB and sodium oxybate with regard to their relative abuse liability, which includes the likelihood and consequences of abuse. Data are summarized from the scientific literature; from national surveillance systems in the U.S., Europe, and Australia (for illicit GHB); and from clinical trials and post-marketing surveillance with sodium oxybate (Xyrem). In the U.S., the prevalence of illicit GHB use, abuse, intoxication, and overdose has declined from 2000, the year that GHB was scheduled, to the present and is lower than that of most other licit and illicit drugs. Abuse and misuse of the pharmaceutical product, sodium oxybate, has been rare over the 5 years since its introduction to the market, which is likely due in part to the risk management program associated with this product. Differences in the accessibility, purity, dosing, and misuse of illicit GHB and sodium oxybate suggest that risks associated with illicit GHB are greater than those associated with the pharmaceutical product sodium oxybate. PMID:19493637

  2. Benzodiazepine Dependence among Young Adult Participants in the Club Scene Who Use Drugs.

    PubMed

    Kurtz, Steven P; Buttram, Mance E; Surratt, Hilary L

    2017-01-01

    Young adults ages 18-29 report the highest rates of benzodiazepine (BZD) misuse in the United States. The majority of club drug users are also in this age group, and BZD misuse is prevalent among participants in club scenes. This article examines BZD dependence and its correlates among young adult participants in the electronic dance music (EDM) culture in Miami, Florida, who use drugs. Structured interviews were with men and women (N = 356) ages 18 to 29 who reported regular attendance at EDM venues and recent use of both club drugs and BZDs. Prevalences of BZD-related problems were 12.6% for BZD dependence, 21.1% BZD abuse, and 24.2% BZD abuse and/or dependence. In a multivariate logistic regression model, younger age (OR 0.85; 95% CI 0.76, 0.96), severe mental distress (OR 8.30; 95% CI 3.07, 22.49), daily marijuana use (OR 2.10; 95% CI 1.03, 4.27), and heavy opioid use (OR 2.33; 95% CI 1.12, 4.83) were associated with BZD dependence. BZD dependence was higher in this sample than in other populations described in the literature. The links between BZD dependence, overdose history, and heavy opioid misuse are especially worrisome among this young sample. Recommendations for intervention and research are discussed.

  3. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women.

    PubMed

    Peltan, Jessica R; Cellucci, Tony

    2011-10-01

    Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications.

    PubMed

    Stone, Amanda M; Merlo, Lisa J

    2011-02-01

    Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P < .001). Psychiatric medication misusers reported less stigmatized beliefs toward mental illness, including lower anxiety around the mentally ill (t = 3.26, P < .001) as well as more favorable attitudes toward psychiatric medications (t = 2.78, P < .01) and stronger beliefs in the potential for recovery from mental illness (t = -2.11, P < .05). Students with more stigmatized beliefs had greater concerns about psychiatric medications and less favorable beliefs regarding their effectiveness. Reasons for misuse varied by medication class, with 57.1% of stimulant misusers noting help with studying as their primary reason for use and 33.3% of benzodiazepine misusers noting attempts to get high or "party" as their primary reason for misuse. Results suggest the need for improved education regarding the

  5. School and work status, drug-free workplace protections, and prescription drug misuse among Americans ages 15-25.

    PubMed

    Miller, Ted; Novak, Scott P; Galvin, Deborah M; Spicer, Rebecca S; Cluff, Laurie; Kasat, Sandeep

    2015-03-01

    We assessed the prevalence and characteristics of prescription drug misuse among youth ages 15-25 to examine differences by student and employment status, and associations with workplace antidrug policies and programs. Multivariate logistic regressions analyzed associations in weighted data on the 20,457 young adults in the combined 2004-2008 National Surveys on Drug Use and Health. Demographic controls included sex, race, community size, and age group. After we accounted for demographic controls, at ages 15-25, students were less likely than nonstudents to misuse prescription drugs. Segmenting student from nonstudent groups, working consistently was associated with a further reduction in misuse for those ages 18-25. When we controlled for demographics and substance use history, both Employee Assistance Program (EAP) services and awareness that one's employer had a drug-free workplace policy were associated with significantly lower misuse of prescription drugs (OR = 0.85 for each program, 95% CI [0.73, 1.00] and [0.72, 1.00]). Associations of workplace antidrug policies and programs with marijuana use and with Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for alcohol abuse and dependence contrasted sharply with these patterns. All four aspects were significantly associated with lower marijuana use. None was associated with problem drinking. Protective effects of drug-free workplace policy and EAPs persist after other substance use was controlled for. Comparing the effects of workplace programs on illicit drug use and problem drinking versus prescription misuse suggests that those protective associations do not result from selection bias. Thus, drug-free workplace policies and EAPs appear to help protect younger workers against prescription misuse. If workplace substance use disorder programs focused prevention messages and interventions on prescription drug misuse, their impact on misuse might increase.

  6. Identifying and Preventing Health Problems among Young Drug-Misusing Offenders

    ERIC Educational Resources Information Center

    Bennett, Trevor; Holloway, Katy

    2008-01-01

    Purpose: The purpose of this paper is to identify the health problems and treatment needs of drug-misusing offenders and to draw out the implications of the findings for health education and prevention. Design/methodology/approach: This analysis is based on data collected as part of the New English and Welsh Arrestee Drug Abuse Monitoring…

  7. Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students.

    PubMed

    Jackson, Eric R; Shanafelt, Tait D; Hasan, Omar; Satele, Daniel V; Dyrbye, Liselotte N

    2016-09-01

    To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students. In 2012, the authors completed a national survey of medical students from the American Medical Association's Physician Masterfile containing validated items assessing alcohol abuse/dependence, burnout, depression, suicidality, quality of life (QOL), and fatigue. Descriptive and comparative statistical analyses were computed, including chi-square and multivariate logistic regression, to determine relationships between variables. Of the 12,500 students, 4,402 (35.2%) responded. Of these, 1,411 (32.4%) met diagnostic criteria for alcohol abuse/dependence. Students who were burned out (P = .01), depressed (P = .01), or reported low mental (P =.03) or emotional (P = .016) QOL were more likely to have alcohol abuse/dependence. Emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse/dependence. On multivariate analysis, burnout (OR 1.20; 95% CI 1.05-1.37; P < .01), having $50,000 to $100,000 (OR 1.21 versus < $50,000; CI 1.02-1.44; P < .05) or > $100,000 (OR 1.27 versus < $50,000; CI 1.08-1.48; P < .01) of educational debt, being unmarried (OR 1.89; CI 1.57-2.27; P < .001), and being younger (for every five years, OR 1.15; CI 1.02-1.28; P = .01) were independently associated with increased risk for alcohol abuse/dependence. Burnout was strongly related to alcohol abuse/dependence among sampled medical students and increased educational debt predicted a higher risk. A multifaceted approach addressing burnout, medical education costs, and alcohol use is needed.

  8. Drug and Substance Abuse

    MedlinePlus

    ... Some older adults also abuse illegal drugs, including marijuana, cocaine, hallucinogens, and injected narcotics. Some people misuse more than one substance. Many older adults who become addicted to drugs also have another serious medical condition, such as chronic pain or a mental ...

  9. Abuse-deterrent formulations of prescription opioid analgesics in the management of chronic noncancer pain.

    PubMed

    Hale, Martin E; Moe, Derek; Bond, Mary; Gasior, Maciej; Malamut, Richard

    2016-10-01

    Misuse, abuse and diversion of prescription opioid analgesics represent a global public health concern. The development of abuse-deterrent formulations (ADFs) of prescription opioid analgesics is an important step toward reducing abuse and diversion of these medications, as well as potentially limiting medical consequences when misused or administered in error. ADFs aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or aversive. However, opioid ADFs may still be abused via the intended route of administration by increasing the dose and/or dosing frequency. The science of abuse deterrence and the regulatory landscape are still relatively new and evolving. This paper reviews the current status of opioid ADFs, with particular focus on different approaches that can be used to deter abuse, regulatory considerations and implications for clinical management.

  10. An update on zolpidem abuse and dependence.

    PubMed

    Victorri-Vigneau, Caroline; Gérardin, Marie; Rousselet, Morgane; Guerlais, Marylène; Grall-Bronnec, Marie; Jolliet, Pascale

    2014-01-01

    In 2004, the health authorities (French National Agency for Medicines and Health Products Safety-ANSM) modified the summary of zolpidem characteristics. Particularly it now includes the sentence "a pharmacodependence may materialize." The current article aims to show that despite this modification, zolpidem continues to be associated with problematic drug use, as the official system (Center for Evaluation and Information on Pharmacodependence-Addictovigilance network) providing information on the abuse and dependence potential of drugs informs us. The authors reviewed the literature on this topic and analyzed French data from zolpidem's postmarketing period that were collected by the Addictovigilance network from 2003 to 2010. Postmarketing data and the 30 case reports yielded from the literature review highlight a significant dependence and abuse potential for zolpidem. This survey led to propose in stronger additional rules in France to try to mitigate the abuse potential of zolpidem.

  11. Personality disturbances in drug-dependent women: relationship to childhood abuse.

    PubMed

    Haller, Deborah L; Miles, Donna R

    2004-05-01

    This study examined associations between childhood abuse and personality disturbances in 228 drug-dependent women. Thirty-six percent denied abuse, 50% reported emotional, 42% physical, and 42% sexual abuse. Million Clinical Multiarial Inventory (MCMI-III) scores > 74 provided evidence of personality disturbance and scores on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales measuring somatic complaints, depression, anxiety and postraumatic stress disorder (PTSD) served as covariates. Emotional and physical abuse survivors were at increased risk for borderline, masochistic, and avoidant disturbances and decreased risk for narcissistic disturbances. Emotional abuse survivors were also less likely to be sadistic whereas physical abuse survivors were more likely to be paranoid. Sexual abuse survivors were twice as likely be antisocial; however, no association was found with borderline personality. Finally, an increased prevalence of severe personality disturbances was observed among those experiencing multiple types of abuse. Childhood trauma predisposes drug-dependent women to develop troublesome personality characteristics that are independent of drug addiction and other psychological problems associated with childhood trauma.

  12. Risk factors for high levels of prescription drug misuse and illicit drug use among substance-using young men who have sex with men (YMSM).

    PubMed

    Kecojevic, Aleksandar; Wong, Carolyn F; Corliss, Heather L; Lankenau, Stephen E

    2015-05-01

    Limited research has focused on prescription drug misuse among young men who have sex with men (YMSM), or investigated risk factors contributing to misuse. This study aims to investigate the relationship between multiple psychosocial risk factors (i.e., childhood abuse, discrimination, mental health distress) and prescription drug misuse among YMSM who are current substance users. YMSM (N=191) who reported prescription drug misuse in the past 6 months were recruited in Philadelphia between 2012 and 2013 to complete an anonymous survey assessing demographic information, substance use, and psychosocial factors. High levels of childhood physical abuse and perceived stress were associated with higher opioid misuse, while high levels of depression were associated with lower misuse of opioids. Those with higher levels of perceived stress were more likely to report higher tranquilizer misuse, while those with more experiences of social homophobia/racism and higher levels of depression and somatization reported higher stimulant misuse. Regarding demographic correlates, older participants were more likely than younger participants to report higher opioid misuse, while racial minorities were less likely than White participants to report higher misuse of tranquilizers, stimulants, and illicit drug use. Bisexual/heterosexual/other identified participants were more likely than gay identified participants to report higher misuse of all three classes of prescription drugs. Associations of risk factors with substance use among YMSM are complex and offer opportunities for additional research. Our findings show that prevention efforts must address substance use among YMSM in sync with psychosocial stressors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Fenetylline: therapeutic use, misuse and/or abuse.

    PubMed

    Kristen, G; Schaefer, A; von Schlichtegroll, A

    1986-06-01

    Fenetylline (CAPTAGON) is included in a list of compounds to be considered by a World Health Organization (WHO) Expert Committee in April 1985 for possible international scheduling under the Convention on Psychotropic Substances, 1971. For over 23 years, this central stimulant has been used therapeutically in hyperkinetic children and other indications in place of amphetamines and other central stimulants with higher risk levels. In good correspondence with recent animal data fenetylline also shows significant qualitative and quantitative differences compared to amphetamine in man. It has few adverse side effects, a lower abuse potential and little actual abuse compared to amphetamine. Thus its benefit/risk assessment is substantially more favourable than that of other central stimulants. For proper therapeutic use of the substance, prescription status is or should be required by national authorities.

  14. [Current situation of and the political measures for drug abuse/dependence].

    PubMed

    Wada, Kiyoshi; Ozaki, Shigeru; Kondo, Ayumi

    2008-04-01

    More than 10 years has passed since 1995 when the third epidemic of methamphetamine abuse started in Japan. We are now still in the third epidemic of methamphetamine abuse, thought the current situation of drug abuse/dependence has obviously changed from previously. Considering several kinds of nationwide surveys and censuses, the authors summarized the change as follows: a) obvious decrease in solvent abuse/dependence, b) stabilization of methamphetamine abuse/dependence, c) increase in abuse of such drugs as cannabis or MDMA which don't have high potential to cause drug-induced psychosis, and d) emergence of non-regulatory drugs represented by designer drugs. These imply the change a) from "hard drugs" to "soft drugs", b) from Japanese unique situation which is symbolized by solvent abuse to Western situation which is symbolized by cannabis abuse, and c) from "illicit drugs" to "non-regulatory drugs". These characteristics reveal that there is the limitation to the Japanese Government policy which has tried to control the drug issue mainly as criminal cases for many years and that it is time now to change its policy. The authors stress the necessities of development of medical treatment targeting drug dependence and of its social support system.

  15. Sadness, suicide, and drug misuse in Arkansas: results from the Youth Risk Behavior Survey 2011.

    PubMed

    Kaley, Sean; Mancino, Michael J; Messias, Erick

    2014-02-01

    Exposure to drugs is unfortunately common among high school students and its use has been linked to depression and suicide risk. We used the 2011 Arkansas Youth Risk Behavior Survey to estimate the prevalence of drug abuse and to measure its association with teen suicidality. Three types of substance misuse were reported by more than 10% of Arkansas high school students: cannabis (33.3% ever use). inhalants (18.7% ever use). and prescription drugs without a prescription (13.2% ever use). We found in all suicide outcomes a stronger association with prescription drug abuse, followed by inhalant abuse, then cannabis abuse.

  16. Prescription Stimulant Misuse, Alcohol Abuse, and Disordered Eating among College Students

    ERIC Educational Resources Information Center

    Ward, Rose Marie; Oswald, Barbara B.; Galante, Marina

    2016-01-01

    The misuse of prescription stimulants (MPS), risky drinking, and drunkorexia are current public health concerns. The present study assessed the prevalence of MPS and drunkorexia using an online survey. Specifically, we examined alcohol consumption, the Rutgers Alcohol Problem Index, Compensatory Eating and Behaviors in Response to Alcohol…

  17. Decreased risk of alcohol dependence and/or misuse in women with high self-assertiveness and leadership abilities.

    PubMed

    Hensing, G; Spak, F; Thundal, K L; Ostlund, A

    2003-01-01

    To analyse dimensions of gender identity and its association to psychiatric disorders and alcohol consumption. The study was performed in two stages: an initial screening (n = 8335) for alcohol consumption, followed by a structured psychiatric interview (n = 1054). The Masculinity/Femininity-Questionnaire was used as an indicator of gender identity. The final study group included 836 women. Leadership, caring, self-assertiveness and emotionality were dimensions of gender identity found in a factor analysis. Low self-assertiveness, high emotionality and to some extent low leadership were associated with increased odds for having bipolar disorders, severe anxiety disorders and alcohol dependence and misuse. Low self-assertiveness and high emotionality were not only associated with alcohol dependence and misuse, but also with high episodic drinking. There was an association between some of the dimensions of gender identity and psychiatric disorders and alcohol consumption. Further attention is needed in both clinical work and research.

  18. Topical Steroid Damaged/Dependent Face (TSDF): An Entity of Cutaneous Pharmacodependence

    PubMed Central

    Lahiri, Koushik; Coondoo, Arijit

    2016-01-01

    Topical Steroid Damaged/Dependent face (TSDF) is a phenomenon which has been described very recently (2008). It is characterized by a plethora of symptoms caused by an usually unsupervised misuse/abuse/overuse of topical corticosteroid of any potency on the face over an unspecified and/or prolonged period of time. This misuse and damage have a serious effect on the quality of life of the patients in general and the skin of the face in particular. Management is difficult and necessitates psychological counseling as well as physical soothing of the sensitive skin. PMID:27293246

  19. Do abuse deterrent opioid formulations work?

    PubMed

    Dart, Richard C; Iwanicki, Janetta L; Dasgupta, Nabarun; Cicero, Theodore J; Schnoll, Sidney H

    We performed a systematic review to answer the question, "Does the introduction of an opioid analgesic with abuse deterrent properties result in reduced overall abuse of the drug in the community?" We included opioid analgesics with abuse deterrent properties (hydrocodone, morphine, oxycodone) with results restricted to the metasearch term "delayed onset," English language, use in humans, and publication years 2009-2016. All articles that contained data evaluating misuse, abuse, overdose, addiction, and death were included. The results were categorized using the Bradford-Hill criteria. We included 44 reports: hydrocodone (n = 7), morphine (n = 5), or oxycodone (n = 32) with Food and Drug Administration-approved Categories 1, 2, or 3 abuse deterrent labeling. The data currently available support the Hill criteria of strength (effect size), consistency (reproducibility), temporality, plausibility, and coherence. There was insufficient or no information available for the criteria of biological gradient, experiment, and analogy. We also assessed confounding factors and bias, which indicated that both were present and substantial in magnitude. Our analysis found that only oxycodone extended release (ER) had information available to evaluate abuse deterrence in the community. In Australia, Canada, and the United States, reformulation of oxycodone ER was followed by marked reduction in measures of abuse. The precise extent of reduced abuse cannot be calculated because of heterogeneous data sets, but the reported reductions ranged from 10 to 90 percent depending on the measure and the duration of follow-up.

  20. Genetic moderators and psychiatric mediators of the link between sexual abuse and alcohol dependence.

    PubMed

    Copeland, William E; Magnusson, Asa; Göransson, Mona; Heilig, Markus A

    2011-06-01

    This study used a case-control female sample to test psychiatric mediators and genetic moderators of the effect of sexual abuse on later alcohol dependence. The study also tested differences between alcohol dependent women with or without a history of sexual abuse on variables that might affect treatment planning. A case-control design compared 192 treatment-seeking alcohol dependent women with 177 healthy population controls. All participants were assessed for alcohol-related behaviors, sexual abuse history, psychiatric problems, and personality functioning. Markers were genotyped in the CRHR1, MAO-A and OPRM1 genes. The association of sexual abuse with alcohol dependence was limited to the most severe category of sexual abuse involving anal or vaginal penetration. Of the five psychiatric disorders tested, anxiety, anorexia nervosa, and bulimia met criteria as potential mediators of the abuse-alcohol dependence association. Severe sexual abuse continued to have an independent effect on alcohol dependence status even after accounting for these potential mediators. None of the candidate genetic markers moderated the association between sexual abuse and alcohol dependence. Of alcohol dependent participants, those with a history of severe abuse rated higher on alcoholism severity, and psychiatric comorbidities. Sexual abuse is associated with later alcohol problems directly as well as through its effect on psychiatric problems. Treatment-seeking alcohol dependent women with a history of abuse have distinct features as compared to other alcohol dependent women. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Genetic Moderators and Psychiatric Mediators of the link between Sexual Abuse and Alcohol Dependence

    PubMed Central

    Copeland, William E.; Magnusson, Åsa; Göransson, Mona; Heilig, Markus A.

    2011-01-01

    Background/Objective This study used a case-control female sample to test psychiatric mediators and genetic moderators of the effect of sexual abuse on later alcohol dependence. The study also tested differences between alcohol dependent women with or without a history of sexual abuse on variables that that might affect treatment planning. Methods A case-control design compared 192 treatment-seeking alcohol dependent women with 177 healthy population controls. All participants were assessed for alcohol-related behaviors, sexual abuse history, psychiatric problems, and personality functioning. Markers were genotyped in the CRHR1, MAO-A and OPRM1 genes. Results The association of sexual abuse with alcohol dependence was limited to the most severe category of sexual abuse involving anal or vaginal penetration. Of the five psychiatric disorders tested, anxiety, anorexia nervosa, and bulimia met criteria as potential mediators of the abuse-alcohol dependence association. Severe sexual abuse continued to have an independent effect on alcohol dependence status even after accounting for these potential mediators. None of the candidate genetic markers moderated the association between sexual abuse and alcohol dependence. Of alcohol dependent participants, those with a history of severe abuse rated higher on alcoholism severity, and psychiatric comorbidities. Conclusion Sexual abuse is associated with later alcohol problems directly as well as through its effect on psychiatric problems. Treatment-seeking alcohol dependent women with a history of abuse have distinct features as compared to other alcohol dependent women. PMID:21193270

  2. Childhood and Adolescent Predictors of Alcohol Abuse and Dependence in Young Adulthood*

    PubMed Central

    Guo, Jie; Hawkins, J. David; Hill, Karl G.; Abbott, Robert D

    2007-01-01

    Objective To provide a comprehensive examination of childhood and adolescent predictors of alcohol abuse and dependence at age 21, theoretically guided by the social development model. Method Data were taken from an ethnically diverse urban sample of 808 students [51% male), surveyed at age 10 and followed prospectively to age 21 in 1996. Potential predictors of alcohol abuse and dependence at age 21 were measured at ages 10, 14 and 16. Relationships between these predictors and alcohol abuse and dependence were examined at each age, to assess changes in their patterns of prediction over time. Results Strong bonding to school, close parental monitoring of children and clearly defined family rules for behavior, appropriate parental rewards for good behaviors, high level of refusal skills and strong belief in the moral order predicted a lower risk for alcohol abuse and dependence at age 21. Of these, strong bonding to school consistently predicted lower alcohol abuse and dependence from all three ages (10, 14 and 16). By contrast, youths who had a higher risk of alcohol abuse and dependence at age 21 engaged in more problem behaviors, had more opportunities to be involved with antisocial individuals and spent more time with and were more bonded to those individuals, viewed fewer negative consequences from antisocial behaviors and held more favorable views on alcohol use. Of these, prior problem behaviors and antisocial opportunities and involvements at ages 10, 14 and 16 consistently predicted alcohol abuse and dependence at age 21. Conclusions These important malleable predictors, identifiable as early as age 10, provide potential intervention targets for the prevention of alcohol abuse and dependence in early adulthood. PMID:11838912

  3. Instruments to identify prescription medication misuse, abuse, and related events in clinical trials: an ACTTION systematic review

    PubMed Central

    Smith, Shannon M.; Paillard, Florence; McKeown, Andrew; Burke, Laurie B.; Edwards, Robert R.; Katz, Nathaniel P.; Papadopoulos, Elektra J.; Rappaport, Bob A.; Slagle, Ashley; Strain, Eric C.; Wasan, Ajay D.; Turk, Dennis C.; Dworkin, Robert H.

    2017-01-01

    Measurement of inappropriate medication use events (e.g., abuse, misuse) in clinical trials is important in characterizing a medication’s abuse potential. However, no “gold standard” assessment of inappropriate use events in clinical trials has been identified. In this systematic review, we examine the measurement properties (i.e., content validity, cross-sectional reliability and construct validity, longitudinal construct validity, ability to detect change, and responder definitions) of instruments assessing inappropriate use of opioid and non-opioid prescription medications to identify any that meet U.S. and European regulatory agencies’ rigorous standards for outcome measures in clinical trials. Sixteen published instruments were identified, most of which were not designed for the selected concept of interest and context of use. For this reason, many instruments were found to lack adequate content validity (or documentation of content validity) to evaluate current inappropriate medication use events; for example, evaluating inappropriate use across the lifespan rather than current use, including items that did not directly assess inappropriate use (e.g., questions about anger), or failing to capture information pertinent to inappropriate use events (e.g., intention, route of administration). In addition, the psychometric data across all instruments were generally limited in scope. A further limitation is the heterogeneous, non-standardized use of inappropriate medication use terminology. These observations suggest that available instruments are not well suited for assessing current inappropriate medication use within the specific context of clinical trials. Further effort is needed to develop reliable and valid instruments to measure current inappropriate medication use events in clinical trials. PMID:25660826

  4. A Ten-year Assessment of Anabolic Steroid Misuse among Competitive Athletes in Puerto Rico

    PubMed Central

    Acevedo, P; Jorge, JC; Cruz-Sánchez, A; Amy, E; Barreto-Estrada, JL

    2012-01-01

    Objective Little is known about anabolic androgenic steroids (AAS) misuse in the Caribbean region in spite of increased popularity among athletes and adolescents. The present study examines the usage of AAS among competitive athletes in Puerto Rico. Methods Doping test results of competitive athletes obtained by random sampling out of competition during the 2000–2009 period were analysed. Doping tests were executed by the Centre for Sports, Health and Exercise Sciences (Albergue Olímpico, Salinas, Puerto Rico). A total of 550 athletes were monitored during 2000–2009. Information was collected with regard to competitive sport, gender and AAS compounds whenever a positive test result was encountered. Results From the total sample of monitored cases during the past decade, 5.4% showed adverse analytical findings. Anabolic androgenic steroids misuse was detected among male (62%) and female (38%) athletes. Weightlifting showed the greatest percentage of positive AAS doping test results (70% of total cases) and stanozolol was the most commonly misused exogenous androgen (60% of abused AAS whether alone or as part of a cocktail). Testosterone was the most common endogenous misused steroid (10% of misused compounds). Conclusion In Puerto Rico, AAS misuse was detected across competitive sports for both genders. Although AAS misuse among Puerto Rican athletes shares some features that are consistent with the international sports community, it is imperative to address AAS misuse in the Caribbean region. PMID:22519228

  5. Abuse of prescription drugs.

    PubMed Central

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

  6. Effect of Middle School Interventions on Alcohol Misuse and Abuse in Mexican American High School Adolescents: Five-Year Follow-up of a Randomized Clinical Trial.

    PubMed

    Gonzales, Nancy A; Jensen, Michaeline; Tein, Jenn Yun; Wong, Jessie J; Dumka, Larry E; Mauricio, Anne Marie

    2018-05-01

    Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking, particularly for US Latino populations. To test whether a universal middle school prevention program can reduce the frequency of alcohol misuse and rates of alcohol use disorder 5 years after implementation with a Mexican American sample. A previous randomized clinical trial was conducted with 516 Mexican American 7th graders and at least 1 parent who identified as having Mexican origin. Three annual cohorts of families were recruited from rosters of 4 middle schools and randomized to the 9-session Bridges/Puentes family-focused group intervention or a workshop control condition. Recruitment, screening, pretest, and randomization occurred in the same academic year for each cohort: 2003-2004, 2004-2005, and 2005-2006. Data acquisition for the follow-up assessments of late-adolescent alcohol misuse and abuse, which were not included in the initial randomized clinical trial, was conducted from September 2009 to September 2014; analysis was conducted between August 2016 and July 2017. In this assessment, 420 children (81.4%) of the sample were included, when the majority were in their final year of high school. The 9-session Bridges/Puentes intervention integrated youth, parent, and family intervention sessions that were delivered in the spring semester at each school, with separate groups for English-dominant vs Spanish-dominant families. The control workshop was offered during the same semester at each school, also in English and Spanish. Primary outcomes were diagnostic assessment of lifetime alcohol use disorder in the 12th grade, 5 years after the intervention, based on the Diagnostic Interview Schedule for Children and past-year frequency of alcohol use

  7. Alcohol Dependence and Domestic Violence as Sequelae of Abuse and Conduct Disorder in Childhood.

    ERIC Educational Resources Information Center

    Kunitz, Stephen J.; Levy, Jerrold E.; McCloskey, Joanne; Gabriel, K. Ruben

    1998-01-01

    This study compared 204 Navajo men and women for alcohol dependence and domestic violence as sequelae of abuse and conduct disorders in childhood. Both physical and sexual abuse were risk factors for conduct disorder. Physical abuse and conduct disorder were risk factors for alcohol dependence. Alcohol dependence and physical abuse were…

  8. PRESCRIPTION OPIOID USE: PATIENT CHARACTERISTICS AND MISUSE IN COMMUNITY PHARMACY

    PubMed Central

    Cochran, Gerald; Bacci, Jennifer L.; Ylioja, Thomas; Hruschak, Valerie; Miller, Sharon; Seybert, Amy L.; Tarter, Ralph

    2016-01-01

    Objective Opioid pain medication misuse is a major concern for U.S. public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings and 2) describe the extent of opioid medication misuse behaviors among these patients. Design We recruited and screened a convenience sample of patients using a tablet computer-based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics. Setting Patients were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Participants Survey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis. Main Outcome Measures Validated screening measures included the: Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test-C, Short-Form-12, Drug Abuse Screening Test-10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire-2. Results A total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse—with hydrocodone having higher odds for misuse by more than four times compared to other medications (AOR=4.48; 95% CI=1.1–17.4). Patients with positive screens for illicit drug use (AOR=8.07; 95% CI=2.7–24.0), PTSD (AOR=5.88; 95% CI=2.3–14.7), and depression (AOR=2.44; 95% CI=1.0–5.9) also had significantly higher odds for misuse compared to those with negative screening results. Conclusion These findings provide important foundational data that suggest implementation of regular opioid misuse

  9. Selected Materials on Drug Abuse and Misuse.

    ERIC Educational Resources Information Center

    Vigo County Public Library, Terre Haute, IN.

    The Vigo County Public Library has a Center for Drug Information which contains pamphlets, leaflets, newsletters, realia kits, films, records, cassettes, slides, educational aids and other materials on drug use, abuse and education. The materials in this list were selected for their relevance to the needs of local groups and organizations in…

  10. Prescription Pain Reliever Abuse and Dependence among Adolescents: A Nationally Representative Study

    ERIC Educational Resources Information Center

    Wu, Li-Tzy; Ringwalt, Christopher L.; Mannelli, Paolo; Patkar, Ashwin A.

    2008-01-01

    The study investigates the prevalence, patterns, and correlates of adolescents' abuse, sub-threshold dependence, and dependence on prescription pain relievers (PPRs) in a nationally representative sample. Results show dependence on PPRs can take place without abuse and that sub-threshold dependence could have implications for major diagnostic…

  11. Prescription opioid use: Patient characteristics and misuse in community pharmacy.

    PubMed

    Cochran, Gerald; Bacci, Jennifer L; Ylioja, Thomas; Hruschak, Valerie; Miller, Sharon; Seybert, Amy L; Tarter, Ralph

    2016-01-01

    Opioid pain medication misuse is a major concern for US public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings; and 2) describe the extent of opioid medication misuse behaviors among these patients. We recruited and screened a convenience sample of patients with the use of a tablet computer-based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics. Patients were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Survey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis. None. Validated screening measures included the Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test C, Short Form 12, Drug Abuse Screening Test 10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire 2. A total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse-with hydrocodone having more than 4 times higher odds of misuse compared with other medications (adjusted odds ratio [AOR] 4.48, 95% confidence interval [CI] 1.1-17.4). Patients with positive screens for illicit drug use (AOR 8.07, 95% CI 2.7-24.0), PTSD (AOR 5.88, 95% CI 2.3-14.7), and depression (AOR 2.44, 95% CI 1.0-5.9) also had significantly higher odds for misuse compared with those with negative screening results. These findings provide important foundational data that suggest implementation of regular opioid misuse screening protocols within

  12. Drug Education Curriculum: Grade Two. Health Education: Substance Abuse Prevention. Revised.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Drug Education.

    This revised curriculum guide, one of nine sequential manuals for elementary and secondary teachers and administrators, is designed to prevent drug misuse and abuse through activities for developing students' affective and cognitive skills. The introductory section presents the rationale for the school-community drug abuse prevention program…

  13. Gender Differences in Substance Dependence and Abuse. The NSDUH Report

    ERIC Educational Resources Information Center

    US Department of Health and Human Services, 2004

    2004-01-01

    Males are more likely to use, abuse, and be dependent on alcohol or illicit drugs than females. The 2003 National Survey on Drug Use and Health (NSDUH) asked questions of persons aged 12 or older to assess their use of alcohol and illicit drugs, as well as their symptoms of substance dependence or abuse during the past year. NSDUH defines "any…

  14. Comorbid psychiatric and alcohol abuse/dependence disorders: psychosocial stress, abuse, and personal history factors of those in treatment.

    PubMed

    De Bernardo, Gina L; Newcomb, Michael; Toth, Amanda; Richey, Gary; Mendoza, Richard

    2002-01-01

    Factors related to comorbid versus only substance disorders are essential to understanding and treating these complex problems. Medical records of sixty-nine inpatients at a private rehabilitation hospital in Southern California were reviewed to determine the associations between personal history factors and (1) comorbid psychiatric and substance abuse disorders and (2) participant's self-assessed progress in treatment. Results revealed significant differences between dual diagnosis patients (alcohol abuse/dependence and an affective disorder) and alcohol abuse/dependence only in regard to gender, previous diagnosis, length of illness, suicide attempts, psychotropic medication history, maternal emotional, physical and sexual abuse, paternal abuse, legal difficulties, and psychosocial stressors. No significant differences between substance abusing patients and dually diagnosed patients were found in terms of self-assessment of progress in treatment. Significant correlations were found between self-assessed progress in treatment and major depression (versus bipolar disorder), use of psychotropic medication, and less abuse from mother or primary caretaker. Identification of these personal history factors may be useful in developing and implementing treatment plans.

  15. Pilot study of traumatic brain injury and alcohol misuse among service members.

    PubMed

    Bogner, Jennifer; French, Louis M; Lange, Rael T; Corrigan, John D

    2015-01-01

    Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Service members (n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention.

  16. Alcohol dependence and domestic violence as sequelae of abuse and conduct disorder in childhood.

    PubMed

    Kunitz, S J; Levy, J E; McCloskey, J; Gabriel, K R

    1998-11-01

    To examine in the Navajo population: (1) the importance of childhood abuse as a risk factor for conduct disorder; (2) the importance of each form of abuse and conduct disorder as risk factors for alcohol dependence; and (3) the relative importance of each form of abuse, conduct disorder, and alcohol dependence as risk factors for being a perpetrator and/or victim of domestic violence. The study is based on a case-control design. Cases (204 men and 148 women) between the ages of 21 and 65 were interviewed in alcohol treatment program and matched to community controls. There were two groups of controls: alcohol dependent (374 men, 60 women) and nonalcohol dependent (157 men, 143 women). When adjusted for stratification by age, community of residence, and sex, the combined control groups comprise a representative sample of the Navajo male and female population 21-65 years of age. The prevalence of physical and sexual abuse before age 15 is within limits observed in other populations. Each form of abuse is a risk factor for conduct disorder. Along with conduct disorder, physical abuse is a risk factor for alcohol dependence. Physical abuse and alcohol dependence are independent risk factors for being involved in domestic violence as both perpetrator and victim. There appears to have been no secular trend in the incidence of childhood abuse over the past several generations, but there is suggestive evidence that domestic violence has become more common. Physical abuse is a significant risk factor for alcohol dependence as well as for domestic violence independent of the effects of alcohol abuse. The effects of sexual abuse with regard to both domestic violence and alcohol dependence do not appear to be significant.

  17. Correlates of Abusing and Misusing Over-the-Counter Pain Relievers Among Adult Population of Wrocław (Poland).

    PubMed

    Wójta-Kempa, Monika; Krzyżanowski, Dominik M

    2016-01-01

    Almost 90% of households in Poland buy medicines on their own initiative. The most popular OTC medicines bought by Polish consumers are painkillers and non-steroid-anti-inflammatory drugs. The aim of this article was to recognize and describe the most important predictive factors of the abuse and misuse of over-the-counter pain relievers among adults in Wrocław (Poland). The groups of users were selected and described. Some examples of misuse were analyzed. Three hundred eighty six adult inhabitants of Wrocław took part in the survey. The quota sample was representative referring to the most important socio-demographic factors (sex and median age). Almost 91% of participants declare taking OTC pain relievers, and 1.3% of them are their daily users. Only 6.2% of adult inhabitants of Wrocław never take OTC pain relievers. The category of "heavy users" embraces 11% of participants. The most important risk factors of overusing OTC pain relievers are sex (female), age over 55 years and the low health status. Only half of participants read the box label regularly and 25% of users admit they have modified recommended doses. Over 60% shortened recommended intervals between doses and 16% took two or more different pain medications (containing different substances). The non-medical purposes of using OTC pain relievers were: tiredness (7%), stressful situations (5.4%), and discomfort (18.4%). Some users take pain medications to cure hangovers (26%), or instead of the appropriate medicine (7%). About 20% take pain medications without a doctor's advice for longer than the recommended 3 days, and 10% never consult taking such medications with doctors. Pain should be treated aggressively and successfully, especially among chronically ill patients. We should monitor the consumption of OTC pain relievers and limit their current excessively supply and high availability.

  18. Sexual Abuse of Children: A Clinical Spectrum

    ERIC Educational Resources Information Center

    Summit, Roland; Kryso, JoAnn

    1978-01-01

    The paper suggests that incest has been underestimated as a significant determinant of emotional disturbance, and that misuse of sexuality between parents and children can have detrimental consequences that parallel those resulting from other forms of child abuse. (Author)

  19. Experience with an extended-release opioid formulation designed to reduce abuse liability in a community-based pain management clinic

    PubMed Central

    Rubino, Daniel

    2011-01-01

    Context With the growing public health concern over rising rates of opioid abuse, physicians have a responsibility to incorporate safeguards into their practice to minimize the potential for opioid misuse, abuse, and diversion. Patient-specific treatment regimens should include steps to monitor treatment success with regard to optimal pain management as well as inappropriate use of opioids and other substances. Opioid formulations designed to be less attractive for abuse are also being developed. While future studies are needed to determine the impact of such formulations in addressing the issue of opioid misuse in the community as a whole, the experience of practitioners who have utilized these formulations can highlight the practical steps to incorporate such formulations into the everyday patient-care setting. Purpose The purpose of this report is to describe experience in managing patients with chronic, moderate-to-severe pain using morphine sulfate and naltrexone hydrochloride extended release capsules (MS-sNT) (EMBEDA®, King Pharmaceuticals® Inc, Bristol, TN, which was acquired by Pfizer Inc, New York, NY, in March 2011), a formulation designed with features to deter abuse/misuse, in a community-based pain management clinic. Case presentations Case reports demonstrating a clinical management plan for assessment, initial interview procedures, explanation/discussion of proposed therapies, patients’ treatment goals, conversion to MS-sNT, and titration and treatment outcomes are provided. Results The management approach yielded successful outcomes including pain relief, improved quality of life, treatment satisfaction, and patient acceptance of a formulation designed to deter abuse/misuse. Discussion The cases presented demonstrate that the communication accompanying complete pretreatment assessment, goal-setting and expectations, and attention to individual patient needs can enable optimization of pain-related outcomes, resulting in improved quality of life

  20. Substance misuse and sexual function in adolescents with chronic diseases.

    PubMed

    Araújo, Priscila; Carvalho, Márcio Guilherme Nunes; van Weelden, Marlon; Lourenço, Benito; Queiroz, Lígia Bruni; Silva, Clovis Artur

    2016-09-01

    To evaluate alcohol/tobacco and/or illicit drug misuse in Chronic Diseases (CDs). A cross-sectional study with 220 CDs adolescents and 110 healthy controls including: demographic/anthropometric data; puberty markers; modified questionnaire evaluating sexual function, alcohol/smoking/illicit drug misuse and bullying; and the physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk. The frequencies of alcohol/tobacco and/or illicit drug use were similar in both groups (30% vs. 34%, p=0.529), likewise the frequencies of bullying (42% vs. 41%, p=0.905). Further analysis solely in CDs patients that used alcohol/tobacco/illicit drug versus those that did not use showed that the median current age [15 (11-18) vs. 14 (10-18) years, p<0.0001] and education years [9 (5-14) vs. 8 (3-12) years, p<0.0001] were significant higher in substance use group. The frequencies of Tanner 5 (p<0.0001), menarche (p<0.0001) and spermarche (p=0.001) were also significantly higher in patients with CDs that used alcohol/tobacco/illicit, likewise sexual activity (23% vs. 3%, p<0.0001). A trend of a low frequency of drug therapy was observed in patients that used substances (70% vs. 82%, p=0.051). A positive correlation was observed between CRAFFT score and current age in CD patients (p=0.005, r=+0.189) and controls (p=0.018, r=+0.226). A later age was evidenced in CDs patients that reported licit/ilicit drug misuse. In CDs adolescent, substance use was more likely to have sexual intercourse. Our study reinforces that these patients should be systematically screened by pediatricians for drug related health behavioral patterns. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  1. Prescription Opioid Abuse and Dependence: Assessment Strategies for Counselors

    ERIC Educational Resources Information Center

    Weigel, Daniel J.; Donovan, Kimberly A.; Krug, Kevin S.; Dixon, Wayne A.

    2007-01-01

    The authors review the article "Prescription Drug Use and Abuse: Risk Factors, Red Flags, and Prevention Strategies" (J. H. Isaacson, J. A. Hopper, D. P. Alford, & T. Parran, 2005), which provides an overview of the recent increase in prescription opioid abuse and dependence from the physician's perspective. In the present article, the authors…

  2. Workplace harassment/abuse and alcohol-related outcomes: the mediating role of psychological distress.

    PubMed

    Richman, Judith A; Shinsako, Stephanie A; Rospenda, Kathleen M; Flaherty, Joseph A; Freels, Sally

    2002-07-01

    This article embraces a tension-reduction or self-medication perspective on alcohol use and misuse. It empirically addresses the role that psychological distress plays in mediating the relationships between harassing and abusive interpersonal experiences in the workplace and altered alcohol use and misuse. A mail survey was completed by 2,038 university employees (1,098 women and 940 men) at two points in time. Specific hypotheses were tested involving (1) the extent to which the onset and chronicity of harassment and abuse predicted varied Wave-2 drinking outcomes, (2) the extent to which the onset and chronicity of harassment and abuse predicted three forms of Wave-2 psychological distress, (3) the associations between Wave-2 psychological distress and drinking outcomes and (4) the extent to which the associations between harassment/abuse and drinking outcomes disappeared when the salient forms of symptomatic distress functioned as control variables. The data showed that harassment and abuse predicted drinking outcomes and psychological distress, and that the associations between harassment/abuse and drinking outcomes were partially mediated by distress. The findings lend support to the tension-reduction perspective and have important implications for intervention and prevention involving workplace harassment and abuse.

  3. The physician as perpetrator of abuse.

    PubMed

    Kluft, R P

    1993-06-01

    Although the exploitation and abuse of patients is forbidden by every code of medical ethics, physicians are in a power position vis-a-vis their patients, and this power may be misused. The spectrum of abusive physician behaviors includes doctors functioning as agents of control, exploiting physicianly perogatives, acting out personal problems in the medical setting, allowing subversion of their judgment, deliberately delivering suboptimal care, dehumanizing care, and sexually exploiting patients. Guidelines for the treatment of patients with such prior experiences are offered.

  4. Correlates of Sexual Abuse among Boys in Treatment for Chemical Dependency.

    ERIC Educational Resources Information Center

    Harrison, Patricia Ann; And Others

    1990-01-01

    Examined data from 1,227 boys in adolescent chemical dependency treatment centers to determine prevalence of history of child sexual abuse. Found only small proportion (6.6%) disclosed history of intra- or extra-familial sexual abuse. Abuse victims could be distinguished from counterparts by more serious psychopathology, behavior problems, and…

  5. Development of a rational scale to assess the harm of drugs of potential misuse.

    PubMed

    Nutt, David; King, Leslie A; Saulsbury, William; Blakemore, Colin

    2007-03-24

    Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.

  6. 77 FR 43538 - Misuse of Internet Protocol (IP) Relay Service; Telecommunications Relay Services and Speech-to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-25

    ... the Internet, this service has become subject to abuse. Among other things, persons have been using IP...] Misuse of Internet Protocol (IP) Relay Service; Telecommunications Relay Services and Speech-to-Speech.... ACTION: Final rule. SUMMARY: In this document, the Commission adopts a measure that prohibits Internet...

  7. Subjective reactions to cocaine and marijuana are associated with abuse and dependence.

    PubMed

    Grant, Julia D; Scherrer, Jeffrey F; Lyons, Michael J; Tsuang, Ming; True, William R; Bucholz, Kathleen K

    2005-09-01

    Subjective effects of marijuana and cocaine use are associated with amount of drug use and potentially with risk of abuse and dependence. We used Latent Class Analyses (LCA) to examine subjective responses to two categories of drugs and link these to abuse and dependence. In 1992, subjective responses were queried of 2506 marijuana and 661 cocaine lifetime users who were members of the Vietnam Era Twin Registry. LCA was used to identify classes of subjective effects. Multinomial logistic regression models were computed to test for an association between classes and marijuana and cocaine abuse or dependence. The best LCA solution for marijuana identified 6 distinct classes characterized as positive, relaxed, reactive, adverse, low and very reactive. The best LCA solution for cocaine identified 5 distinct classes characterized as positive, alert, adverse, low and very reactive. Marijuana abuse and dependence were significantly associated with each latent class. Cocaine abuse was associated with the reactive class (OR=3.9; 95% CI: 1.6-9.5). Cocaine dependence was associated with reactive (OR=15.3; 95% CI: 7.1-32.6), adverse (OR=9.7; 95% CI: 4.5-21.0) and very reactive (OR=18.7; 95% CI: 5.6-62.6) classes. We found evidence for both qualitative and quantitative subjective effect profiles. Subjective effects, both positive and adverse are associated with lifetime risk for marijuana and cocaine dependence.

  8. [Quetiapine in substance use disorders, abuse and dependence possibility: a review].

    PubMed

    Erdoğan, Serap

    2010-01-01

    Quetiapine is an atypical antipsychotic approved by the FDA (Food and Drug Administration) for use in the treatment of schizophrenia, acute mania, and bipolar depression. Pharmacologically, it has antagonistic effects on serotonin 5-HT1A and 5-HT2A, dopamine D1 and D2, histamine H1, and adrenergic alpha1 and alpha2 receptors. In addition to reports of its use in schizophrenia and bipolar disorder, many studies have examined the use of quetiapine in the treatment of anxiety disorders and substance use disorders. In the treatment of patients with psychotic or bipolar disorder with a comorbid substance abuse disorder even though quetiapine was prescribed primarily for the treatment of the underlying psychotic symptoms, patients taking this medication reported a significant reduction in substance use. Yet, there are also case reports of quetiapine abuse and dependence; in particular among prisoners and patients diagnosed with substance abuse. Though quetiapine should be used peroral, it is also used intranasally and intravenously in these patient groups. Moreover, in some cases quetiapine is combined with other substances, such as cocaine or marijuana, to increase sedation. This abuse of quetiapine is thought to occur due to the anxiolytic and sedative effects of the drug. There are no controlled studies on quetiapine dependence in the literature and it remains unknown whether or not quetiapine causes dependence. This review aimed to present all published case reports on quetiapine abuse and to discuss the possible mechanisms that underlie its abuse and dependence.

  9. Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

    PubMed Central

    Tommasello, Anthony C

    2004-01-01

    Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine) 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use PMID:15169544

  10. Psychiatric co-morbidity associated with pheniramine abuse and dependence

    PubMed Central

    Pal, Hemraj; Kumar, Rajesh; Bhushan, Shashi; Berry, Neeraj

    2005-01-01

    The abuse of cough syrups containing antihistamines and codeine is being increasingly noted. The abuse of antihistamines alone has also been reported. The use of antihistamines alone or in combination with other substances of abuse may predispose individuals to develop psychiatric symptoms or syndromes as a part of intoxication, withdrawal or as co-morbid conditions. We present two case reports to highlight the occurrence of co-morbid psychopathology in association with antihistamine abuse and dependence. Case I used high doses of pheniramine for about 2 years and became suspicious of his wife; he even doubted the paternity of his yet-to-be-born child. The associated behavioural abnormalities suggested that he was acting out on the delusion. He also had seizures associated with the intake of a high dose of pheniramine. Case II had multiple substance use, and dependence on alcohol and pheniramine. He demonstrated abnormal behaviour suggestive of psychosis and organic brain syndrome that persisted for a few days and remitted on discontinuation of the substances. These two cases demonstrate the occurrence of psychotic syndromes associated with heavy pheniramine use. The psychopathology can vary from an independent psychotic syndrome to an organic brain syndrome-like disorder.

  11. An Item Response Theory Analysis of DSM-IV Cannabis Abuse and Dependence Criteria in Adolescents

    PubMed Central

    Hartman, Christie A.; Gelhorn, Heather; Crowley, Thomas J.; Sakai, Joseph T.; Stallings, Michael; Young, Susan E.; Rhee, Soo Hyun; Corley, Robin; Hewitt, John K.; Hopfer, Christian J.

    2008-01-01

    Objective To examine three aspects of adolescent cannabis problems: 1) do DSM-IV cannabis abuse and dependence criteria represent two different levels of severity of substance involvement, 2) to what degree do each of the 11 abuse and dependence criteria assess adolescent cannabis problems, and 3) do the DSM-IV items function similarly across different adolescent populations? Method We examined 5587 adolescents aged 11–19, including 615 youth in treatment for substance use disorders, 179 adjudicated youth, and 4793 youth from the community. All subjects were assessed with a structured diagnostic interview. Item response theory was utilized to analyze symptom endorsement patterns. Results Abuse and dependence criteria were not found to represent different levels of severity of problem cannabis use in any of the samples. Among the 11 abuse and dependence criteria, Problems cutting down and Legal problems were the least informative for distinguishing problem users. Two dependence criteria and three of the four abuse criteria indicated different severities of cannabis problems across samples. Conclusions We found little evidence to support the idea that abuse and dependence are separate constructs for adolescent cannabis problems. Furthermore, certain abuse criteria may indicate severe substance problems while specific dependence items may indicate less severe problems. The abuse items in particular need further study. These results have implications for the refinement of the current substance use disorder criteria for DSM-V. PMID:18176333

  12. Misuse of Prescribed Stimulant Medication for ADHD and Associated Patterns of Substance Use: Preliminary Analysis Among College Students

    PubMed Central

    Sepúlveda, Dalissa R.; Thomas, Lisl M.; McCabe, Sean Esteban; Cranford, James A.; Boyd, Carol J.; Teter, Christian J.

    2012-01-01

    Objectives To explore the prevalence and characteristics associated with college students who misuse their prescribed stimulants for attention-deficit hyperactivity disorder (ADHD) and examine diversion and substance use behaviors as a function of misuse. Methods Cohort of 55 past-year prescribed stimulant users was identified from a random sample (n = 1738) at a large Midwestern research university following the self-administration of a web-based survey. An index was created to assess misuse of prescribed stimulants (i.e., Misuse Index). Results Of 55 college students who reported past-year use of prescribed stimulants for ADHD, 22 (40%) endorsed at least one item on the misuse index. The most frequently endorsed misuse items were used too much (36%), self-reported misuse (19%), and intentionally used with alcohol or other drugs (19%). Misusers of prescribed stimulant medication were more likely to report cigarette smoking (p = 0.022), binge drinking (p = 0.022), illicit use of cocaine (p = 0.032), and screen positive on the Drug Abuse Screening test (DAST-10) criteria (p = 0.002). The bivariate odds ratio for the DAST-10 findings was 8.4 (95% CI: 2.0–34.6). Diversion of prescribed stimulants was common (36%) and occurred more frequently among stimulant misusers (57%; p = 0.008). Conclusion There is a strong relationship between misuse of prescribed stimulants for ADHD and substance use behaviors, as well as other deleterious behaviors such as diversion. These findings suggest the need for close screening, assessment, and therapeutic monitoring of medication use in the college population. PMID:22095577

  13. Motivations for prescription drug misuse among young men who have sex with men (YMSM) in Philadelphia.

    PubMed

    Kecojevic, Aleksandar; Corliss, Heather L; Lankenau, Stephen E

    2015-08-01

    Prescription drug misuse (i.e. opioids, tranquilizers and stimulants) has become the fastest growing area of substance abuse among young adults. Limited studies focus on prescription drug misuse among young men who have sex with men (YMSM, aged 18-29 years). Furthermore, little is known about YMSM's motivations for misuse. The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors. As part of a larger mixed methods study of 191 YMSM recruited in Philadelphia during 2012-2013, we conducted semi-structured qualitative interviews with 25 of these participants to gather additional contextual information about their prescription drug misuse. We conducted thematic analysis of qualitative data. While our results corroborated previous literature on motives for misuse of prescription drugs, our data yielded some distinct motivations specific among YMSM. These motives included social/recreational motives, facilitating sex with other men (including motives such as use of opioids for less painful anal receptive sex), and psychological motives such as depression, stress management, coping with everyday hardships (opioids and tranquilizers) or feeling more energized (stimulants). Prescription drugs were commonly misused within the broader contexts of participants' polysubstance use, adding to the significance of this problem. Our findings offer insights into YMSM's motivations for prescription drug misuse, and point to the importance of recognizing and addressing them. While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to significant health consequences. Results support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. The influence of age and gender on the likelihood of endorsing cannabis abuse/dependence criteria.

    PubMed

    Delforterie, Monique J; Creemers, Hanneke E; Agrawal, Arpana; Lynskey, Michael T; Jak, Suzanne; Huizink, Anja C

    2015-03-01

    Higher prevalence rates of cannabis abuse/dependence and abuse/dependence criteria in 18-24year old versus older cannabis users and in males versus females might reflect true differences in the prevalence of these disorders across age and gender or, alternatively, they could arise from age- and gender-related measurement bias. To understand differences in endorsement across important subgroups, we examined the influence of age and gender simultaneously on the likelihood of endorsement of the various abuse/dependence criteria. The sample consisted of 1603 adult past year cannabis users participating in the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a U.S. population study (39.6% aged 18-24; 62.1% male). Past year DSM-IV cannabis abuse/dependence criteria and withdrawal were assessed with the AUDADIS-IV. A restricted factor analysis with latent moderated structures was used to detect measurement bias. Although cannabis abuse and dependence diagnoses and various individual abuse/dependence criteria showed different prevalence rates across younger and older male and female cannabis users, none of the items showed uniform or non-uniform measurement bias with respect to age or gender. The results indicate that, although prevalence rates of cannabis abuse/dependence criteria differ across age and gender, past year abuse/dependence criteria function similarly across these groups. It can thus be concluded that the criteria are applicable to younger and older, as well as male and female, adult cannabis users. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. [Quality of life of older women with dependency and abuse experience].

    PubMed

    Lang, G; Enzenhofer, E

    2013-01-01

    Quality of life is largely determined by changing biographical contexts of a person's behavioural action. In later age, health and social relationships are major determinants for a "good life". A decline in health status may lead to the need for support which may result in further dependency; thus, social relations play an even more important role for older people. Relationships characterised by strain and tension may increase the risk of exposure to force and violence. This article investigates the influence of dependency and abuse on the subjective quality of life of older people. The dataset was drawn from an Austrian survey of 593 home-dwelling older women aged 60 and over (71.0 ± 8.1 years). Quality of life was assessed by the EUROHIS-QOL Scale, dependency by the degree of need for support with respect to activities of daily living and by the levels of care allowance received by this cohort. Following the Conflict Tactics Scales (CTS), six different types of abuse have been operationalised by 34 indicators. The data were analysed by descriptive statistics, confirmatory factor analysis and structural equation modelling. With increasing dependency the subjective quality of life of older women decreases. At the same time it is reduced by the experience of abuse in the close social environment. Neglect, psychological abuse and the violation of personal liberties and rights can be identified as factors which have a negative impact on quality of life. It is also noted that neglect can be found particularly among women with a greater need for support and a higher level of care allowance, which is a particularly problematic situation. Dependency and abuse are major risk factors for low quality of life in old age. The results stress the importance of raising general awareness on violence and highlight the social taboos around the issue of abuse against older people, especially in the case of increasing dependency. In addition, the results point to an increasing

  16. Nonmedical Abuse of Benzodiazepines in Opiate-Dependent Patients in Tehran, Iran

    PubMed Central

    Babakhanian, Masuade; Sadeghi, Maliheh; Mansoori, Nader; Alam Mehrjerdi, Zahra; Tabatabai, Mahmood

    2012-01-01

    Objective: The purpose of the present preliminary study was to explore the prevalence of nonmedical abuse of benzodiazepines in a group of opiate-dependent patients who were on methadone maintenance treatment (MMT) program in outpatient clinics in the south-west of Tehran, Iran. Methods: 114 male and female opiate-dependent clients who met DSM.IV-TR criteria for opiate dependence with mean age 36.5 years participated in the study from 16 clinics and completed a self-report questionnaire on demographics and substance use details. Then the participants were interviewed on the details of nonmedical abuse of benzodiazepines. Results: The study findings indicated that the current nonmedical abuse of benzodiazepines was commonly prevalent among participants. The most common current benzodiazepines abused were alprazolam (100%) followed by chlordiazepoxide (96.5%), clonazepam (94.7%), diazepam (86.8%), lorazepam (79.8%) and oxazepam (73.7%) respectively. Depression (77%) and anxiety (72.8%) were frequently reported as the most important reasons associated with consuming benzodiazepines followed by problem in anger control (44.7%), suicide thought (12.3%), self-injury (7.9%), and suicide commitment (5.3%) respectively. Conclusion: Nonmedical abuse of benzodiazepines is an important problem among opiate addicts which should be considered in treatment interventions during MMT program. PMID:24644471

  17. Pre-deployment Alcohol Misuse Among Shipboard Active-Duty U.S. Military Personnel.

    PubMed

    Harbertson, Judith; Hale, Braden R; Watkins, Eren Y; Michael, Nelson L; Scott, Paul T

    2016-08-01

    The burden of alcohol misuse is unknown among shipboard U.S. Navy and Marine Corps military personnel immediately prior to deployment and may be elevated. Anonymous survey data on hazardous, dependent, and binge alcohol misuse and involuntary drug consumption were collected during 2012-2014 among shipboard personnel within approximately 2 weeks of deployment. Using the Alcohol Use Disorders Identification Test Consumption (AUDIT-C), hazardous alcohol misuse was defined using two cut-point scoring criteria: (1) ≥3 for women and ≥4 for men; and (2) ≥4 for women and ≥5 for men; binge drinking as ≥4 drinks for women and ≥5 drinks for men on a typical day in past 30 days; and dependent alcohol misuse as an AUDIT-C score of ≥8. Demographic- and sex-stratified self-reported alcohol misuse prevalence was reported for analysis conducted during 2014-2015. Among 2,351 male and female shipboard personnel, 39%-54% screened positive for hazardous, 27% for binge, and 15% for dependent alcohol use. Seven percent reported involuntary drug consumption history. A larger proportion of those aged 17-20 years screened positive for dependent alcohol use compared with the overall study population prevalence. A large proportion of shipboard personnel screened positive for hazardous and dependent alcohol use (18% among those aged <21 years) at deployment onset. These data can inform interventions targeting shipboard personnel engaging in hazardous use before progression to dependent use and enable early identification and care for dependent users. Future studies should include more comprehensive assessment of factors associated with involuntary drug consumption. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

  18. Opioids with abuse-deterrent properties: A regulatory and technological overview.

    PubMed

    Haddox, J David

    Three concurrent public health problems coexist in the United States: endemic nonmedical use/misuse of opioid analgesics, epidemic overdose fatalities involving opioid analgesics, and endemic chronic pain in adults. These intertwined issues comprise an opioid crisis that has spurred the development of formulations of opioids with abuse-deterrent properties and label claims (OADP). To reduce abuse and misuse of prescription opioids, the federal Food and Drug Administration (FDA) has issued a formal Guidance to drug developers that delineates four categories of testing to generate data sufficient for a description of a product's abuse-deterrent properties, along with associated claims, in its Full Prescribing Information (FPI). This article reviews the epidemiology of the crisis as background for the development of OADP, summarizes the FDA Guidance for Industry regarding abuse-deterrent technologies, and provides an overview of some technologies that are currently employed or are under study for incorporation into OADP. Such technologies include physical and chemical barriers to abuse, combined formulations of opioid agonists and antagonists, inclusion of aversive agents, use of delivery systems that deter abuse, development of new molecular entities and prodrugs, and formulation of products that include some combination of these approaches. Opioids employing these novel technologies are one part of a comprehensive intervention strategy that can deter abuse of prescription opioid analgesics without creating barriers to the safe use of prescription opioids. The maximal public health contribution of OADP will probably occur only when all opioids have FDA-recognized abuse-deterrent properties and label claims.

  19. A transdisciplinary focus on drug abuse prevention: an introduction.

    PubMed

    Sussman, Steve; Stacy, Alan W; Johnson, C Anderson; Pentz, Mary Ann; Robertson, Elizabeth

    2004-01-01

    This article introduces the scope of the Special Issue. A variety of scientific disciplines are brought together to establish theoretical integration of the arenas of drug use, misuse, "abuse," and drug misuse prevention. Transdisciplinary scientific collaboration (TDSC) is utilized as a process of integration. Introductory comments regarding the strengths and limitations of TDSC are presented. Then, the relevance of genetics to substance misuse and substance misuse prevention is presented. Next, the relevance of cognition for prevention is discussed. Specifically, neurologically plausible distinctions in cognition and implicit cognition and their relevance for prevention are discussed. At a relatively molar social-level of analysis, social network theory, systems dynamic models, geographic information systems models, cultural psychology, and political science approaches to drug misuse and its prevention are introduced. The uses of both quantitative and qualitative statistical approaches to prevention are mentioned next. Finally, targeted prevention, bridging the efficacy-effectiveness gap, and a statement on overcoming disbalance round out the Special Issue. The bridges created will serve to propel drug misuse "prevention science" forward in the years to come. Advances in understanding etiological issues, translation to programs, and ecological fit of programming are desired results.

  20. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

  1. Motivations for prescription drug misuse among young men who have sex with men (YMSM) in Philadelphia

    PubMed Central

    Kecojevic, Aleksandar; Corliss, Heather L.; Lankenau, Stephen E.

    2015-01-01

    Background Prescription drug misuse (i.e. opioids, tranquilizers and stimulants) has become the fastest growing area of substance abuse among young adults. Limited studies focus on prescription drug misuse among young men who have sex with men (YMSM, aged 18–29 years). Furthermore, little is known about YMSM’s motivations for misuse. The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors. Methods As part of a larger mixed methods study of 191 YMSM recruited in Philadelphia during 2012–2013, we conducted semi-structured qualitative interviews with 25 of these participants to gather additional contextual information about their prescription drug misuse. We conducted thematic analysis of qualitative data. Results While our results corroborated previous literature on motives for misuse of prescription drugs, our data yielded some distinct motivations specific among YMSM. These motives included social/recreational motives, facilitating sex with other men (including motives such as use of opioids for less painful anal receptive sex), and psychological motives such as depression, stress management, coping with everyday hardships (opioids and tranquilizers) or feeling more energized (stimulants). Prescription drugs were commonly misused within the broader contexts of participants' polysubstance use, adding to the significance of this problem. Conclusions Our findings offer insights into YMSM’s motivations for prescription drug misuse, and point to the importance of recognizing and addressing them. While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to significant health consequences. Results support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM. PMID:25936445

  2. Dependency Traits Among Parents of Drug Abusers

    ERIC Educational Resources Information Center

    Tennant, Forest S., Jr.

    1976-01-01

    Studies question whether there is a significant association between parents' dependency traits and drug habits in their offspring. Reported here is a survey of 1,091 young males. The reported occurrence of parents' alcohol consumption, smoking, use of stimulants and sedatives, and overeating were compared among abusers and non-users of hashish,…

  3. Current Impact and Application of Abuse-Deterrent Opioid Formulations in Clinical Practice.

    PubMed

    Lee, Ya-Han; Brown, Daniel L; Chen, Hsiang-Yin

    2017-11-01

    Abuse-deterrent formulations (ADFs) represent one novel strategy for curbing the potential of opioid abuse. We aim to compare and contrast the characteristics and applications of current abuse-deterrent opioid products in clinical practice. Literature searches were conducted in databases (Pubmed Medline, International Pharmaceutical Abstracts, Google Scholar) and official reports. Relevant data were screened and organized into: 1) epidemiology of opioid abuse, 2) mitigation strategies for reducing opioid abuse, 3) development of ADFs, and 4) clinical experience with these formulations. Increasing trends of opioid abuse and misuse have been reported globally. There are 5 types of abuse-deterrent opioid products: physical chemical barrier, combined agonist/antagonist, sequestered aversive agent, prodrug, and novel delivery system. The advantages and disadvantages of the 5 options are discussed in this review. A total of 9 products with abuse-deterrent labels have been approved by the Food and Drug Administration (FDA). The rates of abuse, diversion, and overdose deaths of these new products are also discussed. A framework for collecting in-time data on the efficacy, benefit and risk ratio, and cost-effectiveness of these new products is suggested to facilitate their optimal use. The present review did not utilize systematic review standards or meta-analytic techniques, given the large heterogeneity of data and outcomes reviewed. ADFs provide an option for inhibiting the abuse or misuse of oral opioid products by hindering extraction of the active ingredient, preventing alternative routes of administration, or causing aversion. Their relatively high costs, uncertain insurance policies, and limited data on pharmacoeconomics warrant collaborative monitoring and assessment by government agencies, pharmaceutical manufacturers, and data analysis services to define their therapeutic role in the future. Opioid abuse, abuse-deterrent formulations, ADF, post-marketing, FDA

  4. [Prevalence of Alcohol Abuse and Dependence in Adults With Social Phobia in Medellin].

    PubMed

    Peña-Salas, Gabriel Felipe; Bareño, José; Berbesi Fernández, Dedsy Yajaira; Gaviria, Silvia L

    2014-01-01

    Having a social phobia may lead to consuming alcohol for greater social assertiveness, running the risk of leading to an abuse disorder or alcohol dependence. The aim of the study was to estimate prevalence of pathological comorbidity between social phobia and alcohol consumption in adults of the city of Medellin, and the behavior of comorbidity by gender, age, presence of a father figure in childhood, and education. Secondary analysis of the database of the first Mental Health Population Survey conducted in the city of Medellin in 2011 and 2012 based on the methodology of the World Mental Health Survey guidelines and coordinated by WHO-HARVARD. The lifetime prevalence of abuse and dependence in people with social phobia was 24.1% and 11.2%, respectively. For people with social phobia the prevalence was 13% for abuse and 4.4% for dependence (OR=2.11 for abuse, OR=2.46 for dependence). Annual prevalence of people with social phobia who abused or were dependent on alcohol was 7.8% and 5.9%, respectively, compared to those who do not suffer from this disorder, with a prevalence of 3.4% and 1.7%, respectively (OR=2.39 for abuse and OR=3.57 for dependence). There was significant correlation in the annual and lifetime prevalence between social phobia and the pathological consumption of alcohol. Statistically significant relationships were found for the variables associated with social phobia, however, more work is needed to confirm or refute these associations. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. Initiation into Prescription Opioid Misuse among Young Injection Drug Users

    PubMed Central

    Lankenau, Stephen E.; Teti, Michelle; Silva, Karol; Bloom, Jennifer Jackson; Harocopos, Alex; Treese, Meghan

    2011-01-01

    Background Prescription opioids are the most frequently misused class of prescription drugs among young adults. Initiation into prescription opioid misuse is an important public health concern since opioids are increasingly associated with drug dependence and fatal overdose. Descriptive data about initiation into prescription opioid misuse among young injection drug users (IDUs) are scarce. Methods An exploratory qualitative study was undertaken to describe patterns of initiation into prescription opioid misuse among IDUs aged 16 to 25 years. Those young IDUs who had misused a prescription drug at least three times in the past three months were recruited during 2008 and 2009 in Los Angeles (n=25) and New York (n=25). Informed by an ethno-epidemiological approach, descriptive data from a semi-structured interview guide were analysed both quantitatively and qualitatively. Results Initiation into prescription opioid misuse was facilitated by easy access to opioids via participant’s own prescription, family, or friends, and occurred earlier than misuse of other illicit drugs, such as heroin. Nearly all transitioned into sniffing opioids, most injected opioids, and many initiated injection drug use with an opioid. Motives for transitions to sniffing and injecting opioids included obtaining a more potent high and/or substituting for heroin; access to multiple sources of opioids was common among those who progressed to sniffing and injecting opioids. Conclusion Prescription opioid misuse was a key feature of trajectories into injection drug use and/or heroin use among this sample of young IDUs. A new pattern of drug use may be emerging whereby IDUs initiate prescription opioid misuse before using heroin. PMID:21689917

  6. Item Response Theory Analysis of DSM-IV Cannabis Abuse and Dependence Criteria in Adolescents

    ERIC Educational Resources Information Center

    Hartman, Christie A.; Gelhorn, Heather; Crowley, Thomas J.; Sakai, Joseph T.; Stallings, Michael; Young, Susan E.; Rhee, Soo Hyun; Corley, Robin; Hewitt, John K.; Hopfer, Christian J.

    2008-01-01

    A study to examine the DSM-IV criteria for cannabis abuse and dependence among adolescents is conducted. Results conclude that abuse and dependence criteria were not found to affect the different levels of severity in cannabis use.

  7. A systematic review of substance misuse assessment packages.

    PubMed

    Sweetman, Jennifer; Raistrick, Duncan; Mdege, Noreen D; Crosby, Helen

    2013-07-01

    Health-care systems globally are moving away from process measures of performance to payments for outcomes achieved. It follows that there is a need for a selection of proven quality tools that are suitable for undertaking comprehensive assessments and outcomes assessments. This review aimed to identify and evaluate existing comprehensive assessment packages. The work is part of a national program in the UK, Collaborations in Leadership of Applied Health Research and Care. Systematic searches were carried out across major databases to identify instruments designed to assess substance misuse. For those instruments identified, searches were carried out using the Cochrane Library, Embase, Ovid MEDLINE(®) and PsychINFO to identify articles reporting psychometric data. From 595 instruments, six met the inclusion criteria: Addiction Severity Index; Chemical Use, Abuse and Dependence Scale; Form 90; Maudsley Addiction Profile; Measurements in the Addictions for Triage and Evaluation; and Substance Abuse Outcomes Module. The most common reasons for exclusion were that instruments were: (i) designed for a specific substance (239); (ii) not designed for use in addiction settings (136); (iii) not providing comprehensive assessment (89); and (iv) not suitable as an outcome measure (20). The six packages are very different and suited to different uses. No package had adequate evaluation of their properties and so the emphasis should be on refining a small number of tools with very general application rather than creating new ones. An alternative to using 'off-the-shelf' packages is to create bespoke packages from well-validated, single-construct scales. [ © 2013 Australasian Professional Society on Alcohol and other Drugs.

  8. Preventing and Treating Substance Abuse among Adolescents

    ERIC Educational Resources Information Center

    Sussman, Steve

    2011-01-01

    Substance misuse is one of the most prevalent causes of adolescent injury and death. Additionally, 5-8% of adolescents in the U.S. qualify for a diagnosis of substance abuse disorder. This article discusses formal prevention and treatment program models, focusing on a continuum of care which extends from prevention to treatment alternatives.…

  9. The impacts of marijuana dispensary density and neighborhood ecology on marijuana abuse and dependence

    PubMed Central

    Mair, Christina; Freisthler, Bridget; Ponicki, William R.; Gaidus, Andrew

    2015-01-01

    Background As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001–2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations. Methods We analyzed panel population data relating hospitalizations coded for marijuana abuse or dependence and assigned to residential ZIP codes in California from 2001 through 2012 (20,219 space-time units) to ZIP code demographic and ecological characteristics. Bayesian space-time misalignment models were used to account for spatial variations in geographic unit definitions over time, while also accounting for spatial autocorrelation using conditional autoregressive priors. We also analyzed cross-sectional associations between marijuana abuse/dependence and the density of dispensaries in local and spatially adjacent ZIP codes in 2012. Results An additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8% increase in the number of marijuana hospitalizations (95% credible interval 1.033, 1.105) with a marijuana abuse/dependence code. Other local characteristics, such as the median household income and age and racial/ethnic distributions, were associated with marijuana hospitalizations in cross-sectional and panel analyses. Conclusions Prevention and intervention programs for marijuana abuse and dependence may be particularly essential in areas of concentrated disadvantage. Policy makers may want to consider regulations that limit the density of dispensaries. PMID:26154479

  10. Men's and women's pathways to adulthood and associated substance misuse.

    PubMed

    Oesterle, Sabrina; Hawkins, J David; Hill, Karl G

    2011-09-01

    Social role transitions have been linked to changes in substance use and misuse during young adulthood. This study examined how commonly observed pathways to adulthood, defined by education, employment, marriage, and parenthood, were associated with alcohol, tobacco, and marijuana misuse from ages 18 to 33. Data came from a longitudinal panel of 412 men and 396 women recruited when they were in fifth grade in Seattle public schools in 1985. Participants were followed through age 33 in 2008, with 92% retention. Young adults who had little postsecondary education and remained unmarried through age 30 generally had the highest rates of substance misuse. Those who were involved in postsecondary education and postponed family formation had the lowest rates, particularly with respect to daily smoking and nicotine dependence. Parenting during the young adult years was associated with lower rates of substance misuse for both men and women. However, taking on parenting responsibilities early, during the late teen years and early 20s (observed mostly for women), was associated with higher rates of tobacco misuse. Differences in substance misuse by pathways to adulthood were fairly constant across the young adulthood years and were already observed at age 18, suggesting that substance misuse patterns are established early. Young adults may change their substance use only partially in response to new freedoms and responsibilities in young adulthood. Preventive efforts should include a focus on early initiation of substance use and educational experiences that move people into life trajectories and associated substance misuse patterns.

  11. Men's and Women's Pathways to Adulthood and Associated Substance Misuse*

    PubMed Central

    Oesterle, Sabrina; Hawkins, J. David; Karl G. Hill

    2011-01-01

    Objective: Social role transitions have been linked to changes in substance use and misuse during young adulthood. This study examined how commonly observed pathways to adulthood, defined by education, employment, marriage, and parenthood, were associated with alcohol, tobacco, and marijuana misuse from ages 18 to 33. Method: Data came from a longitudinal panel of 412 men and 396 women recruited when they were in fifth grade in Seattle public schools in 1985. Participants were followed through age 33 in 2008, with 92% retention. Results: Young adults who had little postsecondary education and remained unmarried through age 30 generally had the highest rates of substance misuse. Those who were involved in postsecondary education and postponed family formation had the lowest rates, particularly with respect to daily smoking and nicotine dependence. Parenting during the young adult years was associated with lower rates of substance misuse for both men and women. However, taking on parenting responsibilities early, during the late teen years and early 20s (observed mostly for women), was associated with higher rates of tobacco misuse. Differences in substance misuse by pathways to adulthood were fairly constant across the young adulthood years and were already observed at age 18, suggesting that substance misuse patterns are established early. Conclusions: Young adults may change their substance use only partially in response to new freedoms and responsibilities in young adulthood. Preventive efforts should include a focus on early initiation of substance use and educational experiences that move people into life trajectories and associated substance misuse patterns. PMID:21906504

  12. Personality disorders among alcohol-dependent patients manifesting or not manifesting cocaine abuse: a comparative pilot study.

    PubMed

    Echeburúa, Enrique; De Medina, Ricardo Bravo; Aizpiri, Javier

    2009-01-01

    This study assessed personality disorders (PDs) in 158 alcohol-dependent outpatients (62 manifesting cocaine abuse and 96 without cocaine abuse) with the International Personality Disorders Examination interview between 2003 and 2006. Thirty-nine alcohol-dependent/cocaine abusers (62.9% of this group) and 51 only alcohol-dependent patients (53.1% of this group) manifested at least one PD. There were no statistically significant differences between groups in the overall prevalence rate of PDs. The most prevalent PDs, among the alcohol-dependent/cocaine abusers, were antisocial (21%), narcissistic (14.5%), and borderline (11.3%) PDs. The most frequently diagnosed PDs among the only alcohol-dependent patients were obsessive-compulsive (20.8%), paranoid (10.4%), and dependent (9.4%) PDs. There were significant differences between the groups. The study limitations are discussed.

  13. Traumas and other adverse life events in adolescents with alcohol abuse and dependence.

    PubMed

    Clark, D B; Lesnick, L; Hegedus, A M

    1997-12-01

    Clinical observation suggests that adolescents with alcohol use disorders often have complex histories that include childhood maltreatment and other traumas. The aim of this study was to determine the relationships among adolescent alcohol use disorders and a broad range of traumas and adverse life events. The subjects were 132 adolescents with alcohol dependence, 51 adolescents with alcohol abuse, and 73 adolescents recruited from the community as a control group. Trauma history was assessed by a semistructured interview and other adverse life events by questionnaire. Traumatic events reflecting interpersonal violence had occurred in many of the adolescents with alcohol dependence and abuse and few of the control adolescents. Adolescents with alcohol abuse or dependence, compared with control subjects, were 6 to 12 times more likely to have a physical abuse history and 18 to 21 times more likely to have a sexual abuse history. Sexual abuse was more common in females, and victimization by other violent acts was more common in males. Many other adverse life events were also significantly more common in the alcohol use disorder groups than in the control group, including having a close friend die, arguments within the family, and legal difficulties. These results demonstrate that trauma and other adverse life events are strongly associated with alcohol use disorders in adolescents. Clinical screening of adolescents with alcohol use disorders for a range of traumatic events is recommended.

  14. The Rate of Cyber Dating Abuse among Teens and How It Relates to Other Forms of Teen Dating Violence

    ERIC Educational Resources Information Center

    Zweig, Janine M.; Dank, Meredith; Yahner, Jennifer; Lachman, Pamela

    2013-01-01

    To date, little research has documented how teens might misuse technology to harass, control, and abuse their dating partners. This study examined the extent of cyber dating abuse--abuse via technology and new media--in youth relationships and how it relates to other forms of teen dating violence. A total of 5,647 youth from ten schools in three…

  15. The impacts of marijuana dispensary density and neighborhood ecology on marijuana abuse and dependence.

    PubMed

    Mair, Christina; Freisthler, Bridget; Ponicki, William R; Gaidus, Andrew

    2015-09-01

    As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001 to 2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations. We analyzed panel population data relating hospitalizations coded for marijuana abuse or dependence and assigned to residential ZIP codes in California from 2001 through 2012 (20,219 space-time units) to ZIP code demographic and ecological characteristics. Bayesian space-time misalignment models were used to account for spatial variations in geographic unit definitions over time, while also accounting for spatial autocorrelation using conditional autoregressive priors. We also analyzed cross-sectional associations between marijuana abuse/dependence and the density of dispensaries in local and spatially adjacent ZIP codes in 2012. An additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8% increase in the number of marijuana hospitalizations (95% credible interval 1.033, 1.105) with a marijuana abuse/dependence code. Other local characteristics, such as the median household income and age and racial/ethnic distributions, were associated with marijuana hospitalizations in cross-sectional and panel analyses. Prevention and intervention programs for marijuana abuse and dependence may be particularly essential in areas of concentrated disadvantage. Policy makers may want to consider regulations that limit the density of dispensaries. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Exploring the Etiologic Factors and Dynamics of Prescription Drug Abuse in Southwest Virginia

    PubMed Central

    Redican, Kerry J; Marek, Lydia I; Brock, Donna JP; McCance-Katz, Elinore F

    2012-01-01

    Background: Prescription drug abuse in Southwest Virginia is a serious problem affecting indi-viduals, families, and communities. The aim of this study was to characterize and understand the extent of the prescription drug abuse problem in Southwest, Virginia as well as the dynamics that surround that abuse. More specifically, the study focused on learning the extent of the problem along with which prescription drugs are typically used prior to entering treatment, reasons for prescription drug and methadone abuse, and the sources for prescription drug use, misuse and abuse. Methods: Mixed methodology was employed which included surveying methadone clinic con-sumers at two treatment clinics in Southwest, Virginia and seven focus field interviews of key community stakeholders. Results: The extent of prescription drug abuse is high and that the demographics of prescription drug users are getting younger and now involve more males than females. Oxycodone, hydroco¬done, methadone, and morphine were the most commonly used drugs prior to enrollment in the clinics with over one-half of methadone-maintained consumers reporting that they had abused benzodiazepines along with opioids. Focus groups and clinic consumer data highlighted the key etiological factors in prescription drug abuse: use (due to workforce related injuries) turning to abuse, wanting to get high, overprescribing and physician issues, lack of information, and cultural acceptance of drug taking as problem solving behavior. The two most common sources for the abused prescription drugs were physicians and street dealers. Conclusions: A constellation of conditions have led to the epidemic of prescription drug abuse in Southwest Virginia, including poverty, unemployment and work-related injuries, besides, public health education programs on the dangers of prescription opiate misuse and abuse are urgently needed. PMID:24688929

  17. Substance Dependence among those without symptoms of Substance Abuse in the World Mental Health Survey

    PubMed Central

    Lago, Luise; Glantz, Meyer; Kessler, Ronald C.; Sampson, Nancy; Al-Hamzawi, Ali; Florescu, Silvia; Moskalewicz, Jacek; Murphy, Sam; Navarro-Mateu, Fernando; de Galvis, Yolanda Torres; Viana, Maria Carmen; Xavier, Miguel; Degenhardt, Louisa

    2017-01-01

    The WHO World Mental Health (WMH) Survey Initiative uses the Composite International Diagnostic Interview (CIDI) for data collection and operationalizes diagnoses using DSM-IV criteria. The first 13 WMH surveys used CIDI version 3.0, which only assessed substance dependence among respondents with a history of substance abuse, while subsequent surveys also assessed substance dependence without symptoms of abuse. The aim of the current report is to compare results across the two sets of surveys to assess the implications of the revised skip logic and develop an imputation model for missing values of lifetime dependence without symptoms of abuse in the earlier surveys. Prevalence of lifetime dependence without symptoms of abuse was low in the second set of WMH surveys (0.3% for alcohol and 0.2% for drugs). Regression-based imputation models were built in random half-samples of the new surveys and validated in the other half-samples. There were minimal difference in the distributions of imputed and reported cases in the validation dataset for important correlates such as age, gender and quantity though higher numbers of additional mental disorders and number of days out of role were found in the imputed than reported cases. Concordance between imputed and observed estimates of total lifetime dependence in the full sample was high both for alcohol dependence (sensitivity 88.0%, specificity 99.8%, TCA 99.5% and AUC 0.94) and drug dependence (sensitivity 100.0%, specificity 99.8%, TCA 99.8% and AUC 1.00). This study provides cross-national evidence of the degree to which each of lifetime alcohol dependence and lifetime drug dependence occur without symptoms of abuse. Additionally imputation of substance dependence without symptoms of abuse in the earlier WMH surveys will result in improved estimates of lifetime prevalence for comparison with other epidemiological studies both cross-nationally and over time. PMID:28211594

  18. Interrelated effects of substance use diagnosis, race, and smoking severity on abstinence initiation in dually dependent male smokers: results of a retrospective chart review.

    PubMed

    Heffner, Jaimee L; Blom, Thomas J; Camerota, Elaine; Sansone, Linda E; Bodie, Linda; Smith, Joshua; Lin, Show; Drake, J Michael; Meyer, Corey; Anthenelli, Robert M

    2007-12-01

    : Study goals were 2-fold: 1) to examine differences in demographic and clinical characteristics of smokers who fell into 3 diagnostic groups: alcohol abuse/dependence only (ALC), cocaine abuse/dependence only (COC), and mixed alcohol and cocaine abuse/dependence (ALC + COC); and 2) to determine the degree to which diagnostic grouping predicted short-term abstinence from smoking. : Retrospective chart reviews were conducted by using the treatment records of male veterans (N = 175) who participated in a voluntary smoking cessation program during their stay in residential substance dependence treatment. : The ALC group smoked more heavily, had higher levels of nicotine dependence, and reported more emotional problems than the other 2 groups. Short-term abstinence rates were high across the 3 groups (38%, 58%, and 57% for the ALC, COC, and ALC + COC groups, respectively). Lighter smoking at treatment entry, non-white race, and a diagnosis of cocaine abuse/dependence (with or without alcohol abuse/dependence) predicted short-term abstinence in the program. : Substance misusers motivated to quit smoking can initiate smoking abstinence at relatively high rates with the aid of combined pharmacotherapy and intensive group counseling. White subjects who smoke more heavily and have a diagnosis of alcohol abuse/dependence only have lower success rates for abstinence initiation.

  19. "You can never work with addictions in isolation": Addressing intimate partner violence perpetration by men in substance misuse treatment.

    PubMed

    Radcliffe, Polly; Gilchrist, Gail

    2016-10-01

    Studies have shown rates of IPV-perpetration among men in substance misuse treatment at rates far higher than the general population. There is poor evidence for the effectiveness of IPV perpetrator programmes. An analysis of drugs and alcohol policy documents 1998-2015 was conducted using discourse analysis to examine how English drug and alcohol policy has addressed IPV among substance misusers. Transcripts of interviews with 20 stake holders were analysed thematically. How policy 'frames' IPV-perpetration among drug and alcohol misusers has implications for service provision. IPV has increasingly been framed in terms of its implications for child safeguarding, and has been 'folded in' to policies targeting Troubled Families. With increasing 'localism' in English drug and alcohol policy there has been little specification of services for substance misusing IPV-perpetrators. Policy and literature produced by IPV perpetrator and victim organisations has framed IPV-perpetration as an individual choice with intoxication as a post hoc excuse for violence with limited implications for effective service development. Interviews with stake holders indicate a range of understandings/explanations for IPV among substance misusing men. Stake holders suggest that not all staff have the confidence or skills to ask men about their relationships and that there are few referral routes for substance misusing men who seek help for their IPV perpetration. There are gaps and contradictions in the extent to which English drug and alcohol policy has sought to address IPV-perpetration among substance misusers. Recent National Institute for Health and Care Excellence guidance provide an opportunity to include domestic abuse training for all front line social care staff including in the substance misuse sector. There is a need for further research into effective services for substance misusing perpetrators and the development of training for front-line staff. Copyright © 2016 The Authors

  20. The Impact of Drug Abuse upon Adolescent Suicide.

    ERIC Educational Resources Information Center

    Downey, Ann M.

    1991-01-01

    Explored the hypothesis that the increased use, misuse, and abuse of drugs is one of the myriad explanations for the escalation in youth suicidal behavior during the past 25 years. Used clinical case histories and research results to exemplify the impact of heightened drug usage as an argument for the upsurge in youth suicide. (Author/LLL)

  1. The Fentanyl Patch Boil-Up - A Novel Method of Opioid Abuse.

    PubMed

    Schauer, Cameron K M W; Shand, James A D; Reynolds, Thomas M

    2015-11-01

    Fentanyl is a potent opioid analgesic used in the treatment of pain. Transdermal fentanyl patches are now widely utilized as an acceptable and efficacious method of medication delivery. Unfortunately, the potential for their abuse is well recognized. Previous case reports have documented deaths after intravenous (IV) misuse of fentanyl which had been extracted from Duragesic (liquid reservoir type) patches. We present a case of IV fentanyl abuse after the extraction from a Mylan (matrix type) patch. This method of abuse has not previously been described in the literature. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  2. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013.

    PubMed

    Florence, Curtis S; Zhou, Chao; Luo, Feijun; Xu, Likang

    2016-10-01

    It is important to understand the magnitude and distribution of the economic burden of prescription opioid overdose, abuse, and dependence to inform clinical practice, research, and other decision makers. Decision makers choosing approaches to address this epidemic need cost information to evaluate the cost effectiveness of their choices. To estimate the economic burden of prescription opioid overdose, abuse, and dependence from a societal perspective. Incidence of fatal prescription opioid overdose from the National Vital Statistics System, prevalence of abuse and dependence from the National Survey of Drug Use and Health. Fatal data are for the US population, nonfatal data are a nationally representative sample of the US civilian noninstitutionalized population ages 12 and older. Cost data are from various sources including health care claims data from the Truven Health MarketScan Research Databases, and cost of fatal cases from the WISQARS (Web-based Injury Statistics Query and Reporting System) cost module. Criminal justice costs were derived from the Justice Expenditure and Employment Extracts published by the Department of Justice. Estimates of lost productivity were based on a previously published study. Calendar year 2013. Monetized burden of fatal overdose and abuse and dependence of prescription opioids. The total economic burden is estimated to be $78.5 billion. Over one third of this amount is due to increased health care and substance abuse treatment costs ($28.9 billion). Approximately one quarter of the cost is borne by the public sector in health care, substance abuse treatment, and criminal justice costs. These estimates can assist decision makers in understanding the magnitude of adverse health outcomes associated with prescription opioid use such as overdose, abuse, and dependence.

  3. Cognitive impairment associated with cocaine use: The role of co-existent alcohol abuse/dependence.

    PubMed

    Blanco-Presas, Laura; Moreno-Alcázar, Ana; Alonso-Lana, Silvia; Salvador, Raymond; Pomarol-Clotet, Edith; McKenna, Peter

    2018-05-29

    Cocaine abuse has been reported as leading to impaired cognitive function. However, cocaine abusers commonly also abuse alcohol, which can itself produce cognitive impairment. This study, therefore, aimed to examine the potential confounding effect of alcohol abuse on neuropsychological test performance in cocaine and alcohol abusing individuals, comparing them with individuals who abused alcohol alone and non-abusing controls. Nineteen cocaine abusers who also met DSM-IV criteria for alcohol abuse/dependence (14 m, 5f; mean age 38.65 ± 3.83) and 20 matched individuals who met criteria for alcohol abuse/dependence alone (12 m, 8f; mean age 38.19 ± 4.82) were administered a battery of neuropsychological tests covering executive function, memory, language and visual/visuospatial function after two to four weeks of abstinence. Nineteen matched healthy controls (8 m, 11f; mean age 37.01 ± 5.98) were also tested. Both the cocaine + alcohol group and the alcohol group performed significantly more poorly than the healthy controls on the executive (ESs 2.13 and 2.57) and memory tests (ESs 0.58 and 1.06). The findings were similar for language (ESs 0.92 and 1.69), where the cocaine + alcohol abusers additionally performed significantly better than the alcohol abusers. Both patient groups were impaired on two of the five tests of visual/visuospatial function, with better performance by the cocaine + alcohol group on one of them. Chronic cocaine abuse does not appear from this study to be associated with cognitive impairment over and above that which can be attributed to co-existent alcohol abuse. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Drug Education Curriculum: Junior High. Health Education: Substance Abuse Prevention.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Drug Education.

    This curriculum guide, one of nine sequential manuals for elementary and secondary teachers and administrators, is designed to prevent drug misuse and abuse through activities for developing students' cognitive and affective skills. The materials emphasize the involvement of parents and community members and resources in implementing drug abuse…

  5. Short-term recovery from alcohol abuse or dependence: any evidence of a relationship with treatment use in a general population sample?

    PubMed

    Cunningham, John A

    2005-01-01

    To test whether survey respondents who report alcohol misuse in the past year are more likely to be abstinent or binge-free in the past 30 days if they have used treatment, than if they have not. Analysis of data from the 2002 US National Survey on Drug Use and Health was obtained. A total of 5730 respondents scored positive for alcohol abuse or dependence in the preceding year. Fewer than 10% had used any treatment for alcohol or drugs in this period, but this was associated with a 10% increase in the past-month abstinence and past-month binge-free drinking compared with respondents who did not access treatment. Such an apparent short-term recovery appeared greater in those whose treatment had been received in a formal treatment setting, a doctor's office, or in self-help groups than in the emergency room or in prison. Even if part of the association between treatment and recent abstinence and non-binge drinking was causal, indicating that treatment has some impact, it is a pathway chosen only by the minority.

  6. Drugs of abuse and addiction: A slippery slope toward liver injury.

    PubMed

    Roy, Dijendra Nath; Goswami, Ritobrata

    2016-08-05

    Substances of abuse induce alteration in neurobehavioral symptoms, which can lead to simultaneous exacerbation of liver injury. The biochemical changes of liver are significantly observed in the abused group of people using illicit drugs or drugs that are abused. A huge amount of work has been carried out by scientists for validation experiments using animal models to assess hepatotoxicity in cases of drugs of abuse. The risk of hepatotoxicity from these psychostimulants has been determined by different research groups. Hepatotoxicity of these drugs has been recently highlighted and isolated case reports always have been documented in relation to misuse of the drugs. These drugs induce liver toxicity on acute or chronic dose dependent process, which ultimately lead to liver damage, acute fatty infiltration, cholestatic jaundice, liver granulomas, hepatitis, liver cirrhosis etc. Considering the importance of drug-induced hepatotoxicity as a major cause of liver damage, this review emphasizes on various drugs of abuse and addiction which induce hepatotoxicity along with their mechanism of liver damage in clinical aspect as well as in vitro and in vivo approach. However, the mechanisms of drug-induced hepatotoxicity is dependent on reactive metabolite formation via metabolism, modification of covalent bonding between cellular components with drug and its metabolites, reactive oxygen species generation inside and outside of hepatocytes, activation of signal transduction pathways that alter cell death or survival mechanism, and cellular mitochondrial damage, which leads to alteration in ATP generation have been notified here. Moreover, how the cytokines are modulated by these drugs has been mentioned here. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Controlling the misuse of cobalt in horses.

    PubMed

    Ho, Emmie N M; Chan, George H M; Wan, Terence S M; Curl, Peter; Riggs, Christopher M; Hurley, Michael J; Sykes, David

    2015-01-01

    Cobalt is a well-established inducer of hypoxia-like responses, which can cause gene modulation at the hypoxia inducible factor pathway to induce erythropoietin transcription. Cobalt salts are orally active, inexpensive, and easily accessible. It is an attractive blood doping agent for enhancing aerobic performance. Indeed, recent intelligence and investigations have confirmed cobalt was being abused in equine sports. In this paper, population surveys of total cobalt in raceday samples were conducted using inductively coupled plasma mass spectrometry (ICP-MS). Urinary threshold of 75 ng/mL and plasma threshold of 2 ng/mL could be proposed for the control of cobalt misuse in raceday or in-competition samples. Results from administration trials with cobalt-containing supplements showed that common supplements could elevate urinary and plasma cobalt levels above the proposed thresholds within 24 h of administration. It would therefore be necessary to ban the use of cobalt-containing supplements on raceday as well as on the day before racing in order to implement and enforce the proposed thresholds. Since the abuse with huge quantities of cobalt salts can be done during training while the use of legitimate cobalt-containing supplements are also allowed, different urinary and plasma cobalt thresholds would be required to control cobalt abuse in non-raceday or out-of-competition samples. This could be achieved by setting the thresholds above the maximum urinary and plasma cobalt concentrations observed or anticipated from the normal use of legitimate cobalt-containing supplements. Urinary threshold of 2000 ng/mL and plasma threshold of 10 ng/mL were thus proposed for the control of cobalt abuse in non-raceday or out-of-competition samples. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Sex differences in disinhibition and its relationship to physical abuse in a sample of stimulant-dependent patients.

    PubMed

    Winhusen, Theresa; Lewis, Daniel

    2013-04-01

    Research suggests that impulsivity is a vulnerability factor for developing stimulant dependence, that women develop dependence more quickly than men, and that physical abuse can increase impulsivity and may have greater adverse health consequences in women. This study sought to tie these findings together by evaluating: (1) sex differences in disinhibition prior to lifetime initiation of stimulant abuse and (2) the relationship between physical abuse and disinhibition in stimulant-dependent patients. The Frontal Systems Behavior Scale (FrSBe) is a reliable and valid self-report assessment of three neurobehavioral domains associated with frontal systems functioning (Apathy, Disinhibition, and Executive Dysfunction, summed for a Total), that assesses pre-morbid functioning and has a specific cutoff for defining clinically significant abnormalities. Six sites evaluating 12-step facilitation for stimulant abusers obtained the FrSBe from 118 methamphetamine- and/or cocaine-dependent participants. Lifetime physical abuse was measured by the Addiction Severity Index (ASI). The proportion reporting clinically significant disinhibition was significantly higher in women (64.9%) than in men (45.0%, p=0.04), with no significant difference on the other FrSBe scales. Physical abuse in women, but not men, was associated with worse functioning, with physically abused, relative to non-abused, women having a significantly greater proportion with clinically significant disinhibition (p<0.01) and total neurobehavioral abnormalities (p<0.01). These findings suggest that women may have significantly greater disinhibition than men prior to lifetime initiation of stimulant abuse and that physical abuse in women is associated with greater disinhibition. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Current status and evolving role of abuse-deterrent opioids in managing patients with chronic pain.

    PubMed

    Webster, Lynn; St Marie, Barbara; McCarberg, Bill; Passik, Steven D; Panchal, Sunil J; Voth, Eric

    2011-01-01

    Opioids are widely used for the treatment of patients with chronic pain; yet, the increase in their abuse, misuse, and diversion is an ongoing focus of regulatory, governmental, and legal scrutiny. As a consequence, clinicians are faced with numerous challenges in an effort to use opioids in appropriate patients with pain while minimizing the potential for opioid abuse, misuse, and diversion. Policies and programs such as state prescription monitoring programs, which have been in existence for decades, are but one attempt to address some of the issues regarding the prescribing of opioids. Another is a risk evaluation and mitigation strategy for opioids under consideration by the US Food and Drug Administration. At the clinical level, a universal precautions and risk management package that includes risk assessment and patient monitoring is a recommended approach. This approach can also include the use of abuse-deterrent and abuse-resistant formulations designed to reduce the nonmedical use of opioids. Several of these opioid formulations have been approved or should soon be on the market for use in the United States; however, their role and other questions regarding their use remain unanswered. The authors offer their clinical perspective on several of these key questions.

  10. A rationale and model for addressing tobacco dependence in substance abuse treatment.

    PubMed

    Richter, Kimber P; Arnsten, Julia H

    2006-08-14

    Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.

  11. School-based administration of ADHD drugs decline, along with diversion, theft, and misuse.

    PubMed

    Dupont, Robert L; Bucher, Richard H; Wilford, Bonnie B; Coleman, John J

    2007-12-01

    Since 2000 researchers have reported a decline in the administration of attention-deficit/hyperactivity disorder (ADHD) medications given by school nurses, although no decline has been noted in the incidence of ADHD in school-age populations. Government data for the same period show reduced levels of methylphenidate abuse as measured by its involvement in hospital emergency department (ED) admissions. Offsetting this, however, is an increase in the involvement of amphetamine-dextroamphetamine in hospital ED admissions for the same period. Because ADHD medications are often administered in the school setting, a survey of school nurses was undertaken to identify factors related to the administration as well as to the diversion, theft, and misuse of ADHD medications. Of 311 school nurses responding, 295 (95%) reported a significant or moderate decline between 2002 and 2004 in the need for school-based administration of ADHD medications. Respondents also reported reductions in diversion, theft, and misuse of ADHD drugs.

  12. Interpreting labels of abuse-deterrent opioid analgesics.

    PubMed

    Webster, Lynn R

    To provide an overview of available abuse-deterrent opioids (ADOs) and the labeling text that describes abuse-deterrent (AD) properties. A nonsystematic review of ADO literature and regulatory documents guiding their development. A critical assessment and discussion of common routes of opioid abuse, AD methods and properties, US Food and Drug Administration (FDA) study requirements to achieve AD labeling, and brief guide to understanding AD labels. The FDA has issued guidance as incentive and direction to industry to develop ADOs as one component of a multi-pronged public-health strategy to combat opioid abuse and misuse. The guidance describes separate categories of premarket and postmarket studies and makes recommendations for claims that may be made based on study findings. Ten ADOs have FDA-approved labeling attesting to AD properties. Available formulations that fail to conform to FDA guidance in study and labeling recommendations cannot be considered ADO. Formulations with AD properties are expected to reduce risk compared to the same agents without AD properties but cannot prevent all abuse and adverse clinical outcomes.

  13. Mood disorder, anxiety, and suicide risk among subjects with alcohol abuse and/or dependence: a population-based study.

    PubMed

    Wiener, Carolina D; Moreira, Fernanda P; Zago, Alethea; Souza, Luciano M; Branco, Jeronimo C; Oliveira, Jacqueline F de; Silva, Ricardo A da; Portela, Luis V; Lara, Diogo R; Jansen, Karen; Oses, Jean P

    2018-01-01

    To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI). Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.

  14. A conceptual model of the risk of elder abuse posed by incontinence and care dependence.

    PubMed

    Ostaszkiewicz, Joan

    2017-12-08

    To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care. Contemporary biomedical understandings about incontinence and influencing concepts from the fields of sociology, psychology and nursing were analysed to inform the design of a conceptual model that elucidates possible associations between incontinence, care dependence and elder abuse. Ideas generated from an analysis of the concepts led to the development of a model termed the "Model of Attributes to Abuse of Dependent Elders in Continence Care" (MADE-CC). The MADE-CC theorises factors that cause and contribute to abuse in continence care. Carer factors include physical and emotional exhaustion, frustration related to the inability to control or predict incontinence, resentment associated with constraints imposed by care dependence, disgust associated with physical contact with urine/faeces, limited knowledge and skills about incontinence and ethical conflicts concerning care. Care recipient factors include frequent and severe incontinence, cognitive impairment and a history of physical or psychological trauma. Social factors that are theorised include the stigmatised nature of incontinence, social taboos and cultural norms and the private nature of continence care. The MADE-CC illuminates the potential risk of elder abuse posed by incontinence and care dependence. It should be used to improve ethical care of older people and stimulate debate about everyday ethics in the care of older people who are care dependent and to optimise

  15. Representations of Codeine Misuse on Instagram: Content Analysis

    PubMed Central

    Cherian, Roy; Westbrook, Marisa; Ramo, Danielle

    2018-01-01

    Background Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). Objective The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. Methods We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. Results A majority of images (50/100; 50.0%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. Conclusions The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. PMID:29559422

  16. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... other community-based treatment facilities, when considered to be medically advantageous and cost... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

  17. Misuse of child restraints

    DOT National Transportation Integrated Search

    2004-03-01

    The purpose of this study was to obtain a measure of the current level of misuse of child restraint systems (CRSs) among the general public. The project focused specifically on forms of misuse that can be expected to raise the risk of injury. CRS use...

  18. A Systemic Approach to the Development of a Sexual Abuse Protocol in a Rural Community: An Examination of Social Work Leadership Theory and Practice. Issues in Clinical Practice.

    ERIC Educational Resources Information Center

    Catalano, Stephen

    The paper presents the multi-factorial problem of sexual abuse of children within their families, provides definitions of relevant terms (incest, sexual abuse, sexual misuse, molestation, sexual assault, rape), reviews the epidemiology of sexual abuse and its effects, and traces development of a Sexual Abuse Resource Team in a rural/resort New…

  19. Comorbid mental disorders among the patients with alcohol abuse and dependence in Korea.

    PubMed Central

    Cho, Maeng Je; Hahm, Bong-Jin; Suh, Tongwoo; Suh, Guk-Hee; Cho, Seong-Jin; Lee, Chung Kyoon

    2002-01-01

    This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence. PMID:11961310

  20. [Post-marketing surveillance systems for psychoactive prescription drug abuse].

    PubMed

    Nordmann, Sandra; Frauger, Elisabeth; Pauly, Vanessa; Rouby, Frank; Mallaret, Michel; Micallef, Joëlle; Thirion, Xavier

    2011-01-01

    Drugs affecting the central nervous system form a unique group of products for surveillance because they could be misused, abused or diverted. Considering the characteristics of this behaviour that is often concealed, specific post-marketing surveillance systems have been developed to monitor abuse of prescription drugs in some countries. The purpose of this review is to list and to describe post-marketing surveillance systems, according their methodology, in France and in foreign countries. These programs are based on adverse effect notifications, medical or legal consequences of abuse, general or specific population-based survey, professional networks or medication databases. Some programs use simultaneously several information sources. In conclusion, the multifaceted nature, the diversity and the inventiveness of post-marketing surveillance systems reflects the complexity of the abuse issue. © 2011 Société Française de Pharmacologie et de Thérapeutique.

  1. Risk factor characteristics in carers who physically abuse or neglect their elderly dependants.

    PubMed

    Reay, A M; Browne, K D

    2001-02-01

    This study investigates the prevalence of, and differences in, risk factor characteristics in a sample of two select populations of carers, one of which physically abused their elderly dependants and one of which neglected them. Nineteen carers (nine who had physically abused and 10 who had neglected their elderly relatives), who were referred to clinical psychology by either their general practitioner or their psychiatrist, were invited to take part in this study. A detailed history of risk factors was obtained, including history of alcohol dependency, type and history of mental ill health, history of maltreatment earlier in life, who they were caring for, how long they had been a carer and whether they felt isolated as a carer. Subjects were then given five assessments to determine whether there were any differences between the two groups. These were the Conflict Tactic Scale, Strain Scale, Beck Depression Inventory, Beck Anxiety Inventory and Cost of Care Index. An examination of the risk factors suggests that heavy alcohol consumption and past childhood abuse by fathers were likely to lead to physical abuse. Significantly higher conflict and depression scores were also present in the physical abuse group, while the neglect group had significantly higher anxiety scores. It is suggested that these findings should be incorporated into an assessment of future risk of abuse or neglect by the carer.

  2. Abuse potential, pharmacokinetics, pharmacodynamics, and safety of intranasally administered crushed oxycodone HCl abuse-deterrent controlled-release tablets in recreational opioid users

    PubMed Central

    Harris, Stephen C; Perrino, Peter J; Smith, Ira; Shram, Megan J; Colucci, Salvatore V; Bartlett, Cynthia; Sellers, Edward M

    2014-01-01

    The objective of this study was to evaluate abuse potential, pharmacokinetics, pharmacodynamics, and safety of intranasally administered, crushed reformulated OxyContin® (oxycodone HCl controlled-release) tablets (ORF), relative to crushed original OxyContin® (OC), oxycodone powder (Oxy API), and OC placebo. This randomized, double-blind, positive- and placebo-controlled crossover study enrolled healthy, adult, nonphysically dependent recreational opioid users with recent history of intranasal drug abuse (N = 27). Active treatments contained oxycodone (30 mg). Pharmacokinetics, pharmacodynamics (e.g., Overall Drug Liking [ODL], Take Drug Again [TDA], and High Visual Analog Scales [VAS]; Subjective Drug Value [SDV]; pupillometry; intranasal irritation), and safety (e.g., adverse events, vital signs, laboratory tests) were assessed to 24 hours postdose. Crushed ORF administration yielded reduced oxycodone Cmax and increased Tmax versus crushed OC and Oxy API. Peak effects for pharmacodynamic measures were delayed with ORF (1–2 hours) versus OC and Oxy API (0.5–1 hour). ODL, TDA, High VAS, and SDV Emax values were significantly lower (P ≤ .05) and some intranasal irritation ratings were greater for ORF versus OC and Oxy API. No significant or unexpected safety findings were observed. Compared with OC and Oxy API, intranasally administered ORF was associated with lower and delayed peak plasma concentrations, decreased drug-liking, and decreased intranasal tolerability. This suggests that ORF has a decreased potential for intranasal oxycodone abuse. There were no significant or unexpected safety findings. As is true for all abuse potential studies, epidemiological or other appropriate post-marketing studies are required to assess the impact of the reduction in intranasal oxycodone abuse potential observed in the present study on real-world patterns of ORF misuse, abuse, and diversion. PMID:24243216

  3. Stimulant ADHD medication and risk for substance abuse

    PubMed Central

    Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D’Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik

    2013-01-01

    Background There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Methods Using Swedish national registers, we studied all individuals born 1960–1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. Results ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also the longer duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. Conclusions We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. PMID:25158998

  4. Androgen abuse in the community.

    PubMed

    Melnik, Bodo C

    2009-06-01

    To provide information of the current prevalence of illicit use of androgens by individuals of the community. Prevalence of abuse of androgens in individuals of the general population has reached alarming dimensions. Use of androgens is no longer limited to competitive sports, but has spread to leisure and fitness sports, bodybuilding, and nonathletes motivated to increase muscular mass and physical attractiveness. Alarming studies from Germany demonstrated that members of the healthcare systems provide illegal androgens to 48.1% of abusers visiting fitness centers. The new trend to combine androgens with growth hormone, insulin, and insulinotropic milk protein-fortified drinks may potentiate health risks of androgen abuse. The use of androgens has changed from being a problem restricted to sports to one of public health concern. The potential health hazards of androgen abuse are underestimated in the medical community, which unfortunately contributes to illegal distribution of androgens. Both the adverse effects of current androgen abuse especially in young men as well as the chronic toxicity from past long-term abuse of now middle-aged men has to be considered as a growing public health problem. In the future, an increasing prevalence of androgen misuse in combination with other growth-promoting hormones and insulinotropic milk protein products has to be expected, which may have further promoting effects on the prevalence of chronic western diseases.

  5. Methylxanthines and drug dependence: a focus on interactions with substances of abuse.

    PubMed

    Morelli, Micaela; Simola, Nicola

    2011-01-01

    This chapter examines the psychostimulant actions of methylxanthines, with a focus on the consequences of their excessive use. Consumption of methylxanthines is pervasive and their use is often associated with that of substances known to produce dependence and to have abuse potential. Therefore, the consequences of this combined use are taken into consideration in order to evaluate whether, and to what extent, methylxanthines could influence dependence on or abuse of other centrally active substances, leading to either amplification or attenuation of their effects. Since the methylxanthine that mostly influences mental processes and readily induces psychostimulation is caffeine, this review mainly focuses on caffeine as a prototype of methylxanthine-produced dependence, examining, at the same time, the risks related to caffeine use.

  6. Self-Stigma in Substance Abuse: Development of a New Measure

    PubMed Central

    Luoma, Jason B.; Nobles, Richard H.; Drake, Chad E.; Hayes, Steven C.; O’Hair, Alyssa; Fletcher, Lindsay; Kohlenberg, Barbara S.

    2012-01-01

    Little attention has been paid to the examination and measurement of self-stigma in substance misuse. This paper aims to fill this gap by reporting on the development of a new scale to measure self-stigma experienced by people who are misusing substances, the Substance Abuse Self-Stigma Scale. Content validity and item refinement occurred through an iterative process involving a literature search, focus groups, and expert judges. Psychometric properties were examined in a cross-sectional study of individuals (n = 352) receiving treatment for substance misuse. Factor analyses resulted in a 40-item measure with self devaluation, fear of enacted stigma, stigma avoidance, and values disengagement subscales. The measure showed a strong factor structure and good reliability and validity overall, though the values disengagement subscale showed a mixed pattern. Results are discussed in terms of their implications for studies of stigma impact and intervention. PMID:23772099

  7. Substance dependence among those without symptoms of substance abuse in the World Mental Health Survey.

    PubMed

    Lago, Luise; Glantz, Meyer D; Kessler, Ronald C; Sampson, Nancy A; Al-Hamzawi, Ali; Florescu, Silvia; Moskalewicz, Jacek; Murphy, Sam; Navarro-Mateu, Fernando; Torres de Galvis, Yolanda; Viana, Maria Carmen; Xavier, Miguel; Degenhardt, Louisa

    2017-09-01

    The World Health Organization (WHO) World Mental Health (WMH) Survey Initiative uses the Composite International Diagnostic Interview (CIDI). The first 13 surveys only assessed substance dependence among respondents with a history of substance abuse; later surveys also assessed substance dependence without symptoms of abuse. We compared results across the two sets of surveys to assess implications of the revised logic and develop an imputation model for missing values of lifetime dependence in the earlier surveys. Lifetime dependence without symptoms of abuse was low in the second set of surveys (0.3% alcohol, 0.2% drugs). Regression-based imputation models were built in random half-samples of the new surveys and validated in the other half. There were minimal differences for imputed and actual reported cases in the validation dataset for age, gender and quantity; more mental disorders and days out of role were found in the imputed cases. Concordance between imputed and observed dependence cases in the full sample was high for alcohol [sensitivity 88.0%, specificity 99.8%, total classification accuracy (TCA) 99.5%, area under the curve (AUC) 0.94] and drug dependence (sensitivity 100.0%, specificity 99.8%, TCA 99.8%, AUC 1.00). This provides cross-national evidence of the small degree to which lifetime dependence occurs without symptoms of abuse. Imputation of substance dependence in the earlier WMH surveys improved estimates of dependence. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Representations of Codeine Misuse on Instagram: Content Analysis.

    PubMed

    Cherian, Roy; Westbrook, Marisa; Ramo, Danielle; Sarkar, Urmimala

    2018-03-20

    Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. A majority of images (50/100; 50.0%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. ©Roy Cherian, Marisa Westbrook, Danielle Ramo, Urmimala Sarkar. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.03.2018.

  9. The impact of race, income, drug abuse and dependence on health insurance coverage among US adults.

    PubMed

    Wang, Nianyang; Xie, Xin

    2017-06-01

    Little is known about the impact of drug abuse/dependence on health insurance coverage, especially by race groups and income levels. In this study, we examine the disparities in health insurance predictors and investigate the impact of drug use (alcohol abuse/dependence, nicotine dependence, and illicit drug abuse/dependence) on lack of insurance across different race and income groups. To perform the analysis, we used insurance data (8057 uninsured and 28,590 insured individual adults) from the National Surveys on Drug Use and Health (NSDUH 2011). To analyze the likelihood of being uninsured we performed weighted binomial logistic regression analyses. The results show that the overall prevalence of lacking insurance was 19.6 %. However, race differences in lack of insurance exist, especially for Hispanics who observe the highest probability of being uninsured (38.5 %). Furthermore, we observe that the lowest income level bracket (annual income <$20,000) is associated with the highest likelihood of being uninsured (37.3 %). As the result of this investigation, we observed the following relationship between drug use and lack of insurance: alcohol abuse/dependence and nicotine dependence tend to increase the risk of lack of insurance for African Americans and whites, respectively; illicit drug use increases such risk for whites; alcohol abuse/dependence increases the likelihood of lack of insurance for the group with incomes $20,000-$49,999, whereas nicotine dependence is associated with higher probability of lack of insurance for most income groups. These findings provide some useful insights for policy makers in making decisions regarding unmet health insurance coverage.

  10. Prevalence and Correlates of Prescription Stimulant Use, Misuse, Use Disorders, and Motivations for Misuse Among Adults in the United States.

    PubMed

    Compton, Wilson M; Han, Beth; Blanco, Carlos; Johnson, Kimberly; Jones, Christopher M

    2018-04-16

    The authors sought to simultaneously examine the prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse in the U.S. adult population. This was a nationally representative household population study of adults age 18 or older from the 2015 and 2016 National Surveys on Drug Use and Health (N=102,000). Measurements included prescription stimulant use, use without misuse, misuse without use disorders, and misuse with use disorders, as well as sociodemographic characteristics, health conditions, and mental health factors. Among U.S. adults, 6.6% (annual average) used prescription stimulants overall; 4.5% used without misuse, 1.9% misused without use disorders, and 0.2% had use disorders. Adults with past-year prescription stimulant use disorders did not differ from those with misuse without use disorders in any of the examined sociodemographic characteristics and in many of the examined substance use problems. The most commonly reported motivations for misuse were to help be alert or concentrate (56.3%). The most likely source of misused prescription stimulants was by obtaining them free from friends or relatives (56.9%). More frequent prescription stimulant misuse and use disorder were associated with an increased likelihood of obtaining medications from physicians or from drug dealers or strangers and less likelihood of obtaining them from friends or relatives. Approximately 16.0 million U.S. adults used prescription stimulants in the preceding year (annual average), 5.0 million misused prescription stimulants without use disorders, and 0.4 million had use disorders. Cognitive enhancement was the most commonly reported reason for misusing prescription stimulants. Patients who are using their medication for cognitive enhancement or diverting their medication to others present a high risk.

  11. Abuse of Medications Employed for the Treatment of ADHD: Results From a Large-Scale Community Survey

    PubMed Central

    Bright, George M.

    2008-01-01

    Objective The objective is to assess abuse of prescription and illicit stimulants among individuals being treated for attention-deficit/hyperactivity disorder (ADHD). Methods A survey was distributed to patients enrolled in an ADHD treatment center. It included questions designed to gain information about demographics; ADHD treatment history; illicit drug use; and misuse of prescribed stimulant medications, including type of stimulant medication most frequently misused or abused, and how the stimulant was prepared and administered. Results A total of 545 subjects (89.2% with ADHD) were included in the survey. Results indicated that 14.3% of respondents abused prescription stimulants. Of these, 79.8% abused short-acting agents; 17.2% abused long-acting stimulants; 2.0% abused both short- and long-acting agents; and 1.0% abused other agents. The specific medications abused most often were mixed amphetamine salts (Adderall; 40.0%), mixed amphetamine salts extended release (Adderall XR; 14.2%), and methylphenidate (Ritalin; 15.0%), and the most common manner of stimulant abuse was crushing pills and snorting (75.0%). Survey results also showed that 39.1% of respondents used nonprescription stimulants, most often cocaine (62.2%), methamphetamine (4.8%), and both cocaine and amphetamine (31.1%). Choice of illicit drug was based on rapidity of high onset (43.5%), ease of acquisition (40.7%), ease of use (10.2%), and cost (5.5%). Conclusions The risks for abuse of prescription and illicit stimulants are elevated among individuals being treated in an ADHD clinic. Prescription agents used most often are those with pharmacologic and pharmacokinetic characteristics that provide a rapid high. This suggests that long-acting stimulant preparations that have been developed for the treatment of ADHD may have lower abuse potential than short-acting formulations. PMID:18596945

  12. Pills, Thrills and Bellyaches: Case Studies of Prescription Pill Use and Misuse among Marijuana/Blunt Smoking Middle Class Young Women.

    PubMed

    Bardhi, Flutura; Sifaneck, Stephen J; Johnson, Bruce D; Dunlap, Eloise

    2007-01-01

    Recent survey research has documented important increases during the 2000s in the misuse and abuse of several prescription drugs (Vicodin, Percocet, Codeine, Dilaudid, Xanax, Klonopin, Valium, Ativan, Adderall, Ritalin, among others). This article focuses upon the patterns of pill use and misuse among young women who are middle-class white and college-educated, and they are also experienced marijuana users who report recreational consumption of other illegal drugs. The ethnographic data provides insights about various ways and reasons that such prescription pill misuse occurs among 12 college-educated, (upper) middle-class, white/Asian women in their 20s who were involved in a major ethnographic study of marijuana and blunts. Three patterns of pill use were observed: recreational; quasi-medical; and legal medical; shifts among these patterns of pill use was common. Few reported that their pill use interfered with their conventional jobs and lifestyles; they concealed such use from their employers and coworkers, and from non-using friends and family members. None reported contacts with police nor seeking treatment specifically for their pill misuse. Many reported misusing prescription pills in conjunction with illegal drugs (marijuana, cocaine, ecstasy) and alcohol. Pills were used as a way to enhance the euphoric effects of other drugs, as well as a way to avoid the negative side effects of illegal drugs. Some reported pill use as a means for reducing expenditures (and use of) alcohol and cocaine. The implications suggest a hidden subpopulation of prescription pill misusers among regular users of marijuana and other illegal drugs. Future research should include users and misusers of various pills to better understand how prescriptions pills interact with illegal drug use patterns.

  13. Pills, Thrills and Bellyaches: Case Studies of Prescription Pill Use and Misuse among Marijuana/Blunt Smoking Middle Class Young Women

    PubMed Central

    Bardhi, Flutura; Sifaneck, Stephen J.; Johnson, Bruce D.; Dunlap, Eloise

    2008-01-01

    Recent survey research has documented important increases during the 2000s in the misuse and abuse of several prescription drugs (Vicodin, Percocet, Codeine, Dilaudid, Xanax, Klonopin, Valium, Ativan, Adderall, Ritalin, among others). This article focuses upon the patterns of pill use and misuse among young women who are middle-class white and college-educated, and they are also experienced marijuana users who report recreational consumption of other illegal drugs. The ethnographic data provides insights about various ways and reasons that such prescription pill misuse occurs among 12 college-educated, (upper) middle-class, white/Asian women in their 20s who were involved in a major ethnographic study of marijuana and blunts. Three patterns of pill use were observed: recreational; quasi-medical; and legal medical; shifts among these patterns of pill use was common. Few reported that their pill use interfered with their conventional jobs and lifestyles; they concealed such use from their employers and coworkers, and from non-using friends and family members. None reported contacts with police nor seeking treatment specifically for their pill misuse. Many reported misusing prescription pills in conjunction with illegal drugs (marijuana, cocaine, ecstasy) and alcohol. Pills were used as a way to enhance the euphoric effects of other drugs, as well as a way to avoid the negative side effects of illegal drugs. Some reported pill use as a means for reducing expenditures (and use of) alcohol and cocaine. The implications suggest a hidden subpopulation of prescription pill misusers among regular users of marijuana and other illegal drugs. Future research should include users and misusers of various pills to better understand how prescriptions pills interact with illegal drug use patterns. PMID:19081798

  14. New formulation of methadone for opioid dependence in France: acceptability and diversion/misuse liability.

    PubMed

    Eiden, Céline; Léglise, Yves; Bertomeu, Lisa; Clavel, Vivianne; Faillie, Jean-Luc; Petit, Pierre; Peyrière, Hélène

    2013-01-01

    A new formulation of methadone as capsules is marketed in France since 2008. Few data are available on the patient acceptability and the risk of misuse of this new formulation. To assess the patient acceptability after the switch methadone syrup/capsules and the diversion/misuse liability of the methadone capsule, a study through an anonymous questionnaire was conducted between March 2011 and May 2012 in two methadone centers of the region. Forty-one patients (men 75.6%) participated, with a median age of 37 years [IQR: 33-43 years]. The median duration of syrup methadone maintenance therapy was 1 year [IQR: 1-3 years]. A majority of patients (80.5%) described side-effects due to the syrup formulation. Median daily dose at the switch to methadone capsules was 75 mg [IQR: 42-105 mg]. Six patients described differences in the pharmacologic effect between the two formulations. Concerning the diversion and misuse liability of methadone capsules, 26.8% of patients reported that the medication was available at the "street market". Three patients have tried to solubilize and eight have tried to snooze it. All patients recognize the contribution of this new formulation concerning the use, side-effects and transport. None of them returned to the syrup. © 2013 Société Française de Pharmacologie et de Thérapeutique.

  15. History of childhood abuse, sensation seeking, and intimate partner violence under/not under the influence of a substance: a cross-sectional study in Russia.

    PubMed

    Zhan, Weihai; Shaboltas, Alla V; Skochilov, Roman V; Krasnoselskikh, Tatiana V; Abdala, Nadia

    2013-01-01

    To examine correlates of perpetration and victimization of intimate partner violence (IPV) under and not under the influence of a substance, we conducted a study among women in Russia. In 2011, a cross-sectional survey was conducted among patients receiving services at a clinic for sexually transmitted infections in St. Petersburg, Russia. Multinomial logistic regression was used for analysis. Of 299 women, 104 (34.8%) and 113 (37.8%) reported a history of IPV perpetration and victimization, respectively. Nearly half (47.1%) of perpetrators and 61.1% of victims reported that the latest IPV event (perpetration and victimization, respectively) was experienced under the influence of a substance. Factors independently associated with IPV victimization under the influence of a substance were alcohol misuse and a higher number of lifetime sex partners, whereas only experience of childhood abuse (emotional and physical abuse) was independently associated with IPV victimization that did not occur under the influence of a substance. Childhood physical abuse, lower age of first sex, sensation seeking, and alcohol misuse were independently associated with IPV perpetration under the influence of a substance, while only childhood abuse (emotional and physical abuse) was independently associated with IPV perpetration that did not occur under the influence of a substance. IPV under and not under the influence of a substance had different correlates (e.g., alcohol misuse and sensation seeking). Despite the strong association between substance use and IPV, experience of childhood abuse is an important predictor of IPV perpetration and victimization in Russia, above and beyond substance use.

  16. History of Childhood Abuse, Sensation Seeking, and Intimate Partner Violence under/Not under the Influence of a Substance: A Cross-Sectional Study in Russia

    PubMed Central

    Zhan, Weihai; Shaboltas, Alla V.; Skochilov, Roman V.; Krasnoselskikh, Tatiana V.; Abdala, Nadia

    2013-01-01

    Objectives To examine correlates of perpetration and victimization of intimate partner violence (IPV) under and not under the influence of a substance, we conducted a study among women in Russia. Methods In 2011, a cross-sectional survey was conducted among patients receiving services at a clinic for sexually transmitted infections in St. Petersburg, Russia. Multinomial logistic regression was used for analysis. Results Of 299 women, 104 (34.8%) and 113 (37.8%) reported a history of IPV perpetration and victimization, respectively. Nearly half (47.1%) of perpetrators and 61.1% of victims reported that the latest IPV event (perpetration and victimization, respectively) was experienced under the influence of a substance. Factors independently associated with IPV victimization under the influence of a substance were alcohol misuse and a higher number of lifetime sex partners, whereas only experience of childhood abuse (emotional and physical abuse) was independently associated with IPV victimization that did not occur under the influence of a substance. Childhood physical abuse, lower age of first sex, sensation seeking, and alcohol misuse were independently associated with IPV perpetration under the influence of a substance, while only childhood abuse (emotional and physical abuse) was independently associated with IPV perpetration that did not occur under the influence of a substance. Conclusions IPV under and not under the influence of a substance had different correlates (e.g., alcohol misuse and sensation seeking). Despite the strong association between substance use and IPV, experience of childhood abuse is an important predictor of IPV perpetration and victimization in Russia, above and beyond substance use. PMID:23844148

  17. Prescription opioid abuse, pain and addiction: clinical issues and implications.

    PubMed

    Ling, Walter; Mooney, Larissa; Hillhouse, Maureen

    2011-05-01

    Prescription opioid misuse in the USA has increased over threefold since 1990 to epidemic proportions, with substantial increases in prescription opioid use also reported in other countries, such as Australia and New Zealand. The broad availability of prescription pain medications, coupled with public misconceptions about their safety and addictive potential, have contributed to the recent surge in non-medical use of prescription opioids and corresponding increases in treatment admissions for problems related to opioid misuse. Given competing pressures faced by physicians to both diagnose and treat pain syndromes and identify individuals at risk for addictive disorders, the use of opioids in the treatment of pain poses a significant clinical challenge. This paper reviews the interaction between pain and opioid addiction with a focus on clinical management issues, including risk factors for opioid dependence in patients with chronic pain and the use of assessment tools to identify and monitor at-risk individuals. Treatment options for opioid dependence and pain are reviewed, including the use of the partial µ agonist buprenorphine in the management of concurrent pain and opioid addiction. Physicians should strive to find a reasonable balance between minimising potential adverse effects of opioid medications without diminishing legitimate access to opioids for analgesia. The article discusses the need to identify methods for minimising risks and negative consequences associated with opioid analgesics and poses research directions, including the development of abuse-deterrent opioid formulations, genetic risk factors for opioid dependence and opioid-induced hyperalgesia as a potential target for medication therapy. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  18. Prescription opioid abuse, pain and addiction: Clinical issues and implications

    PubMed Central

    LING, WALTER; MOONEY, LARISSA; HILLHOUSE, MAUREEN

    2014-01-01

    Issues Prescription opioid misuse in the USA has increased over threefold since 1990 to epidemic proportions, with substantial increases in prescription opioid use also reported in other countries, such as Australia and New Zealand. The broad availability of prescription pain medications, coupled with public misconceptions about their safety and addictive potential, have contributed to the recent surge in non-medical use of prescription opioids and corresponding increases in treatment admissions for problems related to opioid misuse. Given competing pressures faced by physicians to both diagnose and treat pain syndromes and identify individuals at risk for addictive disorders, the use of opioids in the treatment of pain poses a significant clinical challenge. Approach This paper reviews the interaction between pain and opioid addiction with a focus on clinical management issues, including risk factors for opioid dependence in patients with chronic pain and the use of assessment tools to identify and monitor at-risk individuals. Treatment options for opioid dependence and pain are reviewed, including the use of the partial μ agonist buprenorphine in the management of concurrent pain and opioid addiction. Implications Physicians should strive to find a reasonable balance between minimising potential adverse effects of opioid medications without diminishing legitimate access to opioids for analgesia. Conclusions The article discusses the need to identify methods for minimising risks and negative consequences associated with opioid analgesics and poses research directions, including the development of abuse-deterrent opioid formulations, genetic risk factors for opioid dependence and opioid-induced hyperalgesia as a potential target for medication therapy. PMID:21545561

  19. A Trigger for Opioid Misuse: Chronic Pain and Stress Dysregulate the Mesolimbic Pathway and Kappa Opioid System.

    PubMed

    Massaly, Nicolas; Morón, Jose A; Al-Hasani, Ream

    2016-01-01

    Pain and stress are protective mechanisms essential in avoiding harmful or threatening stimuli and ensuring survival. Despite these beneficial roles, chronic exposure to either pain or stress can lead to maladaptive hormonal and neuronal modulations that can result in chronic pain and a wide spectrum of stress-related disorders including anxiety and depression. By inducing allostatic changes in the mesolimbic dopaminergic pathway, both chronic pain and stress disorders affect the rewarding values of both natural reinforcers, such as food or social interaction, and drugs of abuse. Despite opioids representing the best therapeutic strategy in pain conditions, they are often misused as a result of these allostatic changes induced by chronic pain and stress. The kappa opioid receptor (KOR) system is critically involved in these neuronal adaptations in part through its control of dopamine release in the nucleus accumbens. Therefore, it is likely that changes in the kappa opioid system following chronic exposure to pain and stress play a key role in increasing the misuse liability observed in pain patients treated with opioids. In this review, we will discuss how chronic pain and stress-induced pathologies can affect mesolimbic dopaminergic transmission, leading to increased abuse liability. We will also assess how the kappa opioid system may underlie these pathological changes.

  20. Psychiatric diagnosis, psychiatric power and psychiatric abuse.

    PubMed Central

    Szasz, T

    1994-01-01

    Psychiatric abuse, such as we usually associate with practices in the former Soviet Union, is related not to the misuse of psychiatric diagnoses, but to the political power intrinsic to the social role of the psychiatrist in totalitarian and democratic societies alike. Some reflections are offered on the modern, therapeutic state's proclivity to treat adults as patients rather than citizens, disjoin rights from responsibilities, and thus corrupt the language of political-philosophical discourse. PMID:7996558

  1. History of sexual, emotional or physical abuse and psychiatric comorbidity in substance-dependent patients.

    PubMed

    Daigre, Constanza; Rodríguez-Cintas, Laia; Tarifa, Núria; Rodríguez-Martos, Lola; Grau-López, Lara; Berenguer, Marta; Casas, Miguel; Roncero, Carlos

    2015-10-30

    Sexual, emotional or physical abuse history is a risk factor for mental disorders in addicted patients. However, the relationship between addiction and abuse lifespan is not well known. This study aims to compare clinical and psychopathological features of addicted patients according to the experience of abuse and to the number of different types of abuse suffered. Bivariate and multivariate analyses were conducted. 512 addicted patients seeking treatment were included, 45.9% reported abuse throughout life (38.9% emotional, 22.3% physical and 13.5% sexual abuse). It was found that female gender; depressive symptoms and borderline personality disorder were independently associated with history of any abuse throughout life. As well, it was found that 14% have been suffered from all three types of abuse (sexual, emotional and physical), 34.5% from two and 55.5% from one type. Female gender and borderline personality disorder were independently associated independently with a greater number of different types of abuse. Results suggest that history of abuse is frequent among substance-dependent patients and these experiences are more prevalent in women and are associated with more psychiatric comorbidity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations.

    PubMed

    Gasior, Maciej; Bond, Mary; Malamut, Richard

    2016-01-01

    Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

  3. Pregabalin misuse in methadone maintenance treatment patients in Israel: Prevalence and risk factors.

    PubMed

    Sason, Anat; Adelson, Miriam; Schreiber, Shaul; Peles, Einat

    2018-05-29

    Drug users reportedly abuse pregabalin, and its combination with opiates was related to fatalities. We aimed to estimate the prevalence of pregabalin misuse and risk factors among patients in methadone maintenance treatment (MMT). A cross-sectional study included all current MMT patients (n = 300) after excluding 9 with prescriptions, from a large tertiary medical center university-affiliated MMT clinic in Israel. Pregabalin was tested in one of the routine urine tests for other substances in December 2017. Data on urine results and patients' characteristics were retrieved from the patients' records. Pregabalin was detected among 53 (17.7%) patients. The group had higher depressive symptoms severity score (21-HAM-D) (11.1 ± 8.4 vs. 8.3 ± 7.8, p = 0.03), a higher prevalence of sero-positive HIV (13.7% vs. 4.2%, p = 0.02), sero-positive hepatitis C (66.7% vs. 50.4%, p = 0.04), DSM-IV-TR Axis I psychiatric diagnosis (54.0% vs. 41.7%, p = 0.03), and positive urine for opiates (22.6% vs. 8.9%, p = 0.008), cannabis (39.6% vs. 4.0 p < 0.0005) benzodiazepine (BDZ) (77.4% vs. 18.2%, p < 0.0005) and oxycodone (11.3% vs. 0.4%, p < 0.0005). Logistic regression found pregabalin group as more likely to be urine positive to BDZ (OR = 12.8 95%CI 5.0-32.5) cannabis (OR = 22.7, 95%CI 6.3-81.6) and oxycodone (OR = 43.9, 95%CI 3.6-541.4), with higher 21-HAM-D scores (OR = 1.1, 95%CI 1.04-1.2) and hepatitis C sera-positive (OR = 4.1, 95% CI 1.5-11.4). Unexpectedly, 13.2% of the pregabalin group had take-home dose privileges, which are rewards to non-drug abusers. High prevalence of pregabalin misuse among both BDZ abusers and non-abusers and patients with depressive symptoms supports both the inclusion of routine monitoring for pregabalin and intervention in MMT population. Copyright © 2018. Published by Elsevier B.V.

  4. Does gender contribute to heterogeneity in criteria for cannabis abuse and dependence? Results from the national epidemiological survey on alcohol and related conditions.

    PubMed

    Agrawal, Arpana; Lynskey, Michael T

    2007-05-11

    Previous research has noted that a unidimensional latent construct underlies criteria for cannabis abuse and dependence. However, no study to date has explored whether gender contributes to heterogeneity in the latent abuse and dependence construct and furthermore, whether after accounting for differences in the mean scores of abuse and dependence across genders, there is any evidence for heterogeneity in the individual abuse and dependence criteria. The present study utilizes data on criteria for cannabis abuse and dependence from a large, nationally representative sample (National Epidemiological Survey on Alcohol and Related Conditions) of 8172 lifetime cannabis users to investigate whether gender contributes to heterogeneity in the underlying construct of cannabis abuse and dependence, and in each individual criterion as well. Analyses, all of which were conducted in MPlus, included factor analysis, as well as MIMIC and multiple-group models for an examination of dimensionality and gender heterogeneity, respectively. Results favor a unidimensional construct for cannabis abuse/dependence, as seen in prior research. We also identify two abuse (legal and hazard) and two dependence (quit and problems) criteria, which show significant gender heterogeneity with the abuse criteria exhibiting higher thresholds in women and the dependence criteria in men. We conclude that the criteria that serve as indicators of DSM-IV cannabis abuse and dependence do not function identically in men and women and that certain criteria (e.g. hazardous use) require further refinement.

  5. [Surveillance system on drug abuse: Interest of the French national OPPIDUM program of French addictovigilance network].

    PubMed

    Frauger, Elisabeth; Pochard, Liselotte; Boucherie, Quentin; Giocanti, Adeline; Chevallier, Cécile; Daveluy, Amélie; Gibaja, Valérie; Caous, Anne-Sylvie; Eiden, Céline; Authier, Nicolas; Le Boisselier, Reynald; Guerlais, Marylène; Jouanjus, Émilie; Lepelley, Marion; Pizzoglio, Véronique; Pain, Stéphanie; Richard, Nathalie; Micallef, Joëlle

    2017-09-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data. OPPIDUM is a cross-sectional survey repeated each year since 1995. In 2015, 5003 patients described the modality of use of 10,159 psychoactive drugs. Among them, 77% received an opiate maintenance treatment: 68% methadone (half of them consumed capsule form) and 27% buprenorphine (39% consumed generic form). Brand-name buprenorphine is more often injected than generic buprenorphine (10% vs. 2%) and among methadone consumers 7% of methadone capsule consumers have illegally obtained methadone (vs. 9% for syrup form). The proportion of medications among psychoactive drugs injected is important (42%), with morphine representing 21% of the total psychoactive drugs injected and buprenorphine, 16%. OPPIDUM highlighted emergent behaviors of abuse with some analgesic opioids (like tramadol, oxycodone or fentanyl), pregabalin, or quetiapine. OPPIDUM highlighted variations of drugs use regarding geographic approaches or by drug dependence care centers (like in harm reduction centers). OPPIDUM clearly demonstrated that collection of valid and useful data on drug abuse is possible, these data have an interest at regional, national and international levels. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  6. Stimulant ADHD medication and risk for substance abuse.

    PubMed

    Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik

    2014-08-01

    There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  7. Managing misuse of novel psychoactive substances.

    PubMed

    Solomon, David; Grewal, Pardeep; Taylor, Chloe; Solomon, Bernadette

    Misuse of novel psychoactive substances, also known as legal highs, is growing in the UK. These substances include more than 200 psychoactive chemicals and are associated with harm to physical and mental health, but are not controlled under the Misuse of Drugs Act 1971 or regulated as a medicine. This article reviews the evidence relating to psychosocial interventions for illegal substance misuse to identify how therapies could improve rates of abstinence and awareness in adults who are misusing novel psychoactive substances. The evidence is limited and there is a need for further research and increased awareness among health professionals and the general population of this growing problem.

  8. Alcohol Misuse and Associations with Childhood Maltreatment and Out-of-Home Placement among Urban Two-Spirit American Indian and Alaska Native People

    PubMed Central

    Yuan, Nicole P.; Duran, Bonnie M.; Walters, Karina L.; Pearson, Cynthia R.; Evans-Campbell, Tessa A.

    2014-01-01

    This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals. PMID:25317980

  9. Prescription opioid misusing chronic pain patients exhibit dysregulated context-dependent associations: Investigating associative learning in addiction with the cue-primed reactivity task.

    PubMed

    Garland, Eric L; Bryan, Craig J; Kreighbaum, Lydia; Nakamura, Yoshio; Howard, Matthew O; Froeliger, Brett

    2018-06-01

    Associative learning undergirds the development of addiction, such that drug-related cues serve as conditioned stimuli to elicit drug-seeking responses. Plausibly, among opioid misusing chronic pain patients, pain-related information may serve as a conditioned stimulus to magnify opioid cue-elicited autonomic and craving responses through a process of second-order conditioning. We utilized a novel psychophysiological probe of pain-opioid conditioned associations, the Cue-Primed Reactivity (CPR) task. In this task, participants were presented with images as primes (200 ms) and cues (6000 ms) in pairs organized in four task blocks: "control-opioid," "pain-opioid," "control-pain," and "opioid-pain." Opioid-treated chronic pain patients (N = 30) recruited from an Army base in the Western United States were classified as opioid misusers (n = 17) or non-misusers (n = 13) via a validated cutpoint on the Prescription Drug Use Questionnaire (PDUQ; Compton et al., 2008). Opioid misuse status was examined as a predictor of HRV, craving, and mood responses on the CPR task. HRV increased to a greater extent during the pain-opioid block compared to the control-opioid block for non-misusers compared to misusers (p = .003, η 2 partial  = 0.27). In contrast, craving increased to a greater extent from baseline to the pain-opioid block for misusers than for non-misusers (p = .03, η 2 partial  = .16). Findings suggest that opioid-treated chronic pain patients exhibit Pavlovian conditioned responses to opioid cues strengthened by an associative learning process of second-order conditioning when primed by pain-related images. This pain-opioid contingency appears to become disrupted among individuals who engage in opioid misuse, such that opioid-related stimuli elicit motivational responses irrespective of pain-related contextual stimuli. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey.

    PubMed

    Lown, E Anne; Nayak, Madhabika B; Korcha, Rachael A; Greenfield, Thomas K

    2011-02-01

    Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR(adj) = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR(adj) = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR(adj) = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR(adj) = 3.5; 95% CI 2.6 to 4.8) and dependence (OR(adj) = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in

  11. Just Say Know: An Examination of Substance Use Disorders among Older Adults in Gerontological and Substance Abuse Journals

    PubMed Central

    Rosen, Daniel; Engel, Rafael J.; Hunsaker, Amanda E.; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F.

    2014-01-01

    This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders. PMID:23731426

  12. Impulsivity and risk for prescription opioid misuse in a chronic pain patient sample.

    PubMed

    Vest, Noel; Reynolds, Caleb J; Tragesser, Sarah L

    2016-09-01

    Misuse of, and addiction to, prescription opioid pain relievers is a growing concern, in both non-clinical samples and chronic pain patients receiving opioid analgesic therapy. Research is needed to identify which patients may be more prone to misuse or dependence on opioids in a chronic pain treatment setting. Based on literature showing the role of impulsivity in substance use disorders generally, we predicted that impulsivity may also be important to understanding which individuals may be at risk for opioid misuse when opioids are prescribed for pain. The present study examined associations between impulsivity facets and measures of prescription opioid misuse and symptoms. Four facets of impulsivity were examined: urgency, sensation seeking, lack of premeditation, and lack of perseverance. 143 patients receiving treatment for chronic pain at a regional pain clinic completed a series of questionnaires including the UPPS and measures of opioid risk and misuse. Consistent with predictions, urgency was associated with risk for future misuse (β=0.246, p<0.05), current misuse (β=0.253, p<0.01), and symptoms of current opioid use disorder (OUD; β=0.206, p<0.05). Sensation seeking was also associated with current misuse (β=0.279, p<0.01). These results suggest that identifying facets of impulsivity is important to understanding and assessing for risk of prescription opioid misuse in the context of chronic pain treatment. These data indicate that patients who react impulsively to negative mood states and cravings may be especially prone to developing aberrant use patterns when taking prescription opioids. This is the first known study to identify the role of urgency in predicting risk for OUDs in chronic pain patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Characterizing the Intersection of Co-Occurring Risk Factors for Illicit Drug Abuse and Dependence in a U.S. Nationally Representative Sample

    PubMed Central

    Kurti, Allison N.; Keith, Diana R.; Noble, Alyssa; Priest, Jeff S.; Sprague, Brian; Higgins, Stephen T.

    2016-01-01

    Few studies have attempted to characterize how co-occurring risk factors for substance use disorders intersect. A recent study examined this question regarding cigarette smoking and demonstrated that co-occurring risk factors generally act independently. The present study examines whether that same pattern of independent intersection of risk factors extends to illicit drug abuse/dependence using a U.S. nationally representative sample (National Survey on Drug Use and Health, 2011–2013). Logistic regression and classification and regression tree (CART) modeling were used to examine risk of past-year drug abuse/dependence associated with a well-established set of risk factors for substance use (age, gender, race/ethnicity, education, poverty, smoking status, alcohol abuse/dependence, mental illness). Each of these risk factors was associated with significant increases in the odds of drug abuse/dependence in univariate logistic regressions. Each remained significant in a multivariate model examining all eight risk factors simultaneously. CART modeling of these 8 risk factors identified subpopulation risk profiles wherein drug abuse/dependence prevalence varied from < 1% to > 80% corresponding to differing combinations of risk factors present. Alcohol abuse/dependence and cigarette smoking had the strongest associations with drug abuse/dependence risk. These results demonstrate that co-occurring risk factors for illicit drug/abuse dependence generally intersect in the same independent manner as risk factors for cigarette smoking, underscoring further fundamental commonalities across these different types of substance use disorders. These results also underscore the fundamental importance of differences in the presence of co-occurring risk factors when considering the often strikingly different prevalence rates of illicit drug abuse/dependence in U.S. population subgroups. PMID:27687534

  14. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment and...

  15. NKTR-181: A Novel Mu-Opioid Analgesic with Inherently Low Abuse Potential.

    PubMed

    Miyazaki, Takahiro; Choi, Irene Y; Rubas, Werner; Anand, Neel K; Ali, Cherie; Evans, Juli; Gursahani, Hema; Hennessy, Marlene; Kim, Grace; McWeeney, Daniel; Pfeiffer, Juergen; Quach, Phi; Gauvin, David; Riley, Timothy A; Riggs, Jennifer A; Gogas, Kathleen; Zalevsky, Jonathan; Doberstein, Stephen K

    2017-10-01

    The increasing availability of prescription opioid analgesics for the treatment of pain has been paralleled by an epidemic of opioid misuse, diversion, and overdose. The development of abuse-deterrent formulations (ADFs) of conventional opioids such as oxycodone and morphine represents an advance in the field and has had a positive but insufficient impact, as most opioids are still prescribed in highly abusable, non-ADF forms, and abusers can tamper with ADF medications to liberate the abusable opioid within. The abuse liability of mu-opioid agonists appears to be dependent on their rapid rate of entry into the central nervous system (CNS), whereas analgesic activity appears to be a function of CNS exposure alone, suggesting that a new opioid agonist with an inherently low rate of influx across the blood-brain barrier could mediate analgesia with low abuse liability, regardless of formulation or route of administration. NKTR-181 is a novel, long-acting, selective mu-opioid agonist with structural properties that reduce its rate of entry across the blood-brain barrier compared with traditional mu-opioid agonists. NKTR-181 demonstrated maximum analgesic activity comparable to that of oxycodone in hot-plate latency and acetic-acid writhing models. NKTR-181 was distinguishable from oxycodone by its reduced abuse potential in self-administration and progressive-ratio break point models, with behavioral effects similar to those of saline, as well as reduced CNS side effects as measured by the modified Irwin test. The in vitro and in vivo studies presented here demonstrate that NKTR-181 is the first selective mu-opioid agonist to combine analgesic efficacy and reduced abuse liability through the alteration of brain-entry kinetics. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

  16. Does Typography of Substance Abuse and Dependence Differ as a Function of Exposure to Child Maltreatment?

    PubMed Central

    Danielson, Carla Kmett; Amstadter, Ananda; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2009-01-01

    We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (n=281). Over 60% of the sample reported a history of CSA and/or CPA. Results indicated significant differences in typography of substance abuse and dependence symptoms and rates of comorbid lifetime PTSD based on assault history, specific assault incident characteristics, and sex. Clinical implications for substance abusing youth with maltreatment histories are discussed. PMID:20151043

  17. Does Typography of Substance Abuse and Dependence Differ as a Function of Exposure to Child Maltreatment?

    PubMed

    Danielson, Carla Kmett; Amstadter, Ananda; Dangelmaier, Ruth E; Resnick, Heidi S; Saunders, Benjamin E; Kilpatrick, Dean G

    2009-01-01

    We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (n=281). Over 60% of the sample reported a history of CSA and/or CPA. Results indicated significant differences in typography of substance abuse and dependence symptoms and rates of comorbid lifetime PTSD based on assault history, specific assault incident characteristics, and sex. Clinical implications for substance abusing youth with maltreatment histories are discussed.

  18. 49 CFR 199.202 - Alcohol misuse plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Alcohol misuse plan. 199.202 Section 199.202... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.202 Alcohol misuse plan. Each operator must maintain and follow a written alcohol...

  19. 49 CFR 199.202 - Alcohol misuse plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Alcohol misuse plan. 199.202 Section 199.202... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.202 Alcohol misuse plan. Each operator must maintain and follow a written alcohol...

  20. Nigerian medical students' opinions about individuals who use and abuse psychoactive substances.

    PubMed

    James, Bawo O; Omoaregba, Joyce O

    2013-01-01

    Substance use disorders are prevalent in Nigeria. The number of available specialist health providers is inadequate to fill the treatment gap. Interventions can be provided by nonspecialist health providers and have been found to be beneficial. However, attitudes toward substance misuse and misusers can impede the provision of this service. We aimed to determine attitudes of medical trainees toward substance use by utilizing a modified form of the Substance Abuse Attitude Scale (SAAS). Medical students (n = 200) had positive attitudes toward individuals who misuse psychoactive substances. The medial students, however, preferred treatment to be offered by trained specialists and held restrictive views regarding cannabis and alcohol use. More positive attitudes were expressed by participants who were male or had a lifetime history of psychoactive substance use. The role of personal and family-related psychoactive substance use factors are probably associated with attitudinal responses and would require further exploration.

  1. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    PubMed Central

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  2. Risk of substance abuse and dependence among young adult sexual minority groups using a multidimensional measure of sexual orientation.

    PubMed

    Goldberg, Shoshana; Strutz, Kelly L; Herring, Amy A; Halpern, Carolyn T

    2013-01-01

    We examined associations between two definitions of sexual minority status (SMS) and substance abuse and/or dependence among young adults in a national population. A total of 14,152 respondents (7,529 women and 6,623 men) interviewed during wave four of the National Longitudinal Study of Adolescent Health were included in the study (age range: 24-32 years). We used two definitions of SMS based on self-reported attraction, behavior, and identity: 1-indicator SMS (endorsing any dimension) and 3-indicator SMS (endorsing all dimensions). Outcomes included nicotine dependence as well as ≥3 signs of substance dependence, any sign of substance abuse, and lifetime diagnosis of abuse or dependence for alcohol, marijuana, and a composite measure of other drugs. Weighted logistic regression models were fit to estimate the odds of each outcome for each of the sexual minority groups (compared with the heterosexual majority), controlling for sociodemographic covariates. SMS women were more likely than exclusively heterosexual women to experience substance abuse and dependence, regardless of substance or SMS definition. In adjusted models for women, 3-indicator SMS was most strongly associated with abuse/dependence (adjusted odds ratio [AOR] range: 2.74-5.17) except for ≥3 signs of cannabis dependence, where 1-indicator SMS had the strongest association (AOR=3.35). For men, the 1-indicator SMS group had higher odds of nicotine dependence (AOR=1.35) and the 3-indicator SMS group had higher odds of ≥3 signs of alcohol dependence (AOR=1.64). Young adult female sexual minority groups, regardless of how defined, are at a higher risk than their heterosexual peers of developing alcohol, drug, or tobacco abuse and dependence.

  3. Cognitive Performance Enhancement: Misuse or Self-Treatment?

    ERIC Educational Resources Information Center

    Peterkin, Alexander L.; Crone, Catherine C.; Sheridan, Michael J.; Wise, Thomas N.

    2011-01-01

    Objective: This cross-sectional survey study examines the link between ADHD medication misuse and a positive screen for adult ADHD symptoms. Method: Surveys from 184 college student volunteers in Northern Virginia are collected and analyzed. Results: A total of 71% of ADHD stimulant misusers screen positive for ADHD symptoms. Misusers are 7 times…

  4. Drug Education Curriculum, Junior High. Health Education: Substance Abuse Prevention. Revised 1982.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Health and Drug Education and Services.

    This junior high school level curriculum guide on drug education is a revision of a 1981 guide. It is one of nine sequential guides for elementary and secondary teachers and administrators designed to prevent drug misuse and abuse through combined cognitive and affective development. The affective model upon which this curriculum is based has…

  5. Dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria: implications for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.

    PubMed

    Kerridge, Bradley T; Saha, Tulshi D; Smith, Sharon; Chou, Patricia S; Pickering, Roger P; Huang, Boji; Ruan, June W; Pulay, Attila J

    2011-09-01

    Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM-IV currently lacking empirical justification. Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population. Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity. Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse

  6. The Hispanic Americans Baseline Alcohol Survey (HABLAS): The association between birthplace, acculturation and alcohol abuse and dependence across Hispanic national groups

    PubMed Central

    Caetano, Raul; Ramisetty-Mikler, Suhasini; Rodriguez, Lori A.

    2009-01-01

    Hispanics are heterogeneous in national origin, evidenced by wide ranges of alcohol abuse and dependence rates across different Hispanic national groups. This paper examines associations between 12-month rates of DSM-IV alcohol abuse and dependence with birthplace and acculturation. The 2006 Hispanic Americans Baseline Alcohol Survey, using a multistage cluster sample design, interviewed 5,224 adults (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. Comprehensive data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Alcohol abuse and dependence rates were higher among U.S.-born Puerto Ricans and South/Central Americans compared to their foreign-born counterparts, while no such differences were found for Cuban and Mexican Americans. Overall, those with higher acculturation report higher rates of abuse and dependence (statistically significant only for abuse among Puerto Ricans). Risk factors for abuse include being male and being in the high acculturation group. Risk factors for dependence include being male, being Puerto Rican or Mexican American, having less than a college education, and being U.S.-born. Hispanics were found to share several common risk factors with the larger U.S. population for abuse and dependence, such as male gender, lower education, and lower income. PMID:18945554

  7. The Hispanic Americans Baseline Alcohol Survey (HABLAS): the association between birthplace, acculturation and alcohol abuse and dependence across Hispanic national groups.

    PubMed

    Caetano, Raul; Ramisetty-Mikler, Suhasini; Rodriguez, Lori A

    2009-01-01

    Hispanics are heterogeneous in national origin, evidenced by wide ranges of alcohol abuse and dependence rates across different Hispanic national groups. This paper examines associations between 12-month rates of DSM-IV alcohol abuse and dependence with birthplace and acculturation. The 2006 Hispanic Americans Baseline Alcohol Survey, using a multistage cluster sample design, interviewed 5224 adults (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. Comprehensive data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Alcohol abuse and dependence rates were higher among U.S.-born Puerto Ricans and South/Central Americans compared to their foreign-born counterparts, while no such differences were found for Cuban and Mexican Americans. Overall, those with higher acculturation report higher rates of abuse and dependence (statistically significant only for abuse among Puerto Ricans). Risk factors for abuse include being male and being in the high acculturation group. Risk factors for dependence include being male, being Puerto Rican or Mexican American, having less than a college education, and being U.S.-born. Hispanics were found to share several common risk factors with the larger U.S. population for abuse and dependence, such as male gender, lower education, and lower income.

  8. Adolescent substance use and abuse: recognition and management.

    PubMed

    Griswold, Kim S; Aronoff, Helen; Kernan, Joan B; Kahn, Linda S

    2008-02-01

    Substance abuse in adolescents is undertreated in the United States. Family physicians are well positioned to recognize substance use in their patients and to take steps to address the issue before use escalates. Comorbid mental disorders among adolescents with substance abuse include depression, anxiety, conduct disorder, and attention-deficit/ hyperactivity disorder. Office-, home-, and school-based drug testing is not routinely recommended. Screening tools for adolescent substance abuse include the CRAFFT questionnaire. Family therapy is crucial in the management of adolescent substance use disorders. Although family physicians may be able to treat adolescents with substance use disorders in the office setting, it is often necessary and prudent to refer patients to one or more appropriate consultants who specialize specifically in substance use disorders, psychology, or psychiatry. Treatment options include anticipatory guidance, brief therapeutic counseling, school-based drug-counseling programs, outpatient substance abuse clinics, day treatment programs, and inpatient and residential programs. Working within community and family contexts, family physicians can activate and oversee the system of professionals and treatment components necessary for optimal management of substance misuse in adolescents.

  9. Industrialization Stresses, Alcohol Abuse & Substance Dependence: Differential Gender Effects in a Kenyan Rural Farming Community

    ERIC Educational Resources Information Center

    Walt, Lisa C.; Kinoti, Elias; Jason, Leonard A.

    2013-01-01

    Developing countries' industrialization and urbanization attempts have been linked to psychological distress and alcohol abuse. We used Hobfoll's COR theory to examine the relationship between gender, perceived resource loss (an indicator of industrialization stress), and alcohol abuse and dependence in a sample of Kenyan rural village men and…

  10. Predicting Vocational Rehabilitation Outcomes for People with Alcohol Abuse/Dependence: An Application of Chi-Squared Automatic Interaction Detector

    ERIC Educational Resources Information Center

    Brickham, Dana M.

    2012-01-01

    People with alcohol abuse/dependence disabilities are often faced with a complex recovery process due to the exacerbating and chronic aspects of their condition. Vocational rehabilitation for people with alcohol abuse/dependence can help individuals access and maintain employment, and through employment can enhance physical and psychological…

  11. Misuse study of latch attachment: a series of frontal sled tests.

    PubMed

    Menon, Rajiv; Ghati, Yoganand

    2007-01-01

    This study was initiated to quantify the effects of the misuse in LATCH lower webbing. In the short period since the implementation of the LATCH system several cases of potential misuses have been reported. A series of sled tests in frontal impact mode were conducted with various misuse conditions (loose attachment of LATCH lower webbing, misrouting of LATCH lower webbing and child seat back inclination) for both forward and rearward facing child safety seats (FFCSS and RFCSS). Results from these tests are compared and discussed with that of the standard test with no misuse and showed that as the slack in the lower LATCH webbing increased, ATD injury measures exceeded the limits. The FFCSS tests in the reclined condition yielded lower injury values for all except the chest G's when compared to the standard upright test. In the misrouting tests the ATD kinematics depended on the routing pivot point, the lower the pivot point the better the ATD kinematics. Similar findings were also observed in the RFCSS tests. The use of top tether with the FFCSS substantially improved the performance of the Hybrid III 3 year old ATD in spite of misuse conditions and the injury values were lower than the corresponding tests with no top tether. The effective reduction was 37% in the HIC values, 6% in the chest G's, 30% in the head excursion, 22 % in the knee excursion and finally 37 % reduction in the Nij values.

  12. Opioid Attentional Bias and Cue-Elicited Craving Predict Future Risk of Prescription Opioid Misuse Among Chronic Pain Patients*

    PubMed Central

    Garland, Eric L.; Howard, Matthew O.

    2014-01-01

    Background Some chronic pain patients receiving long-term opioid analgesic pharmacotherapy are at risk for misusing opioids. Like other addictive behaviors, risk of opioid misuse may be signaled by an attentional bias (AB) towards drug-related cues. The purpose of this study was to examine opioid AB as a potential predictor of opioid misuse among chronic pain patients following behavioral treatment. Methods Chronic pain patients taking long-term opioid analgesics (N = 47) completed a dot probe task designed to assess opioid AB, as well as self-report measures of opioid misuse and pain severity, and then participated in behavioral treatment. Regression analyses examined opioid AB and cue-elicited craving as predictors of opioid misuse at 3-months posttreatment follow-up. Results Patients who scored high on a measure of opioid misuse risk following treatment exhibited significantly greater opioid AB scores than patients at low risk for opioid misuse. Opioid AB for 200 ms cues and cue-elicited craving significantly predicted opioid misuse risk 20 weeks later, even after controlling for pre-treatment opioid dependence diagnosis, opioid misuse, and pain severity (Model R2 = .50). Conclusion Biased initial attentional orienting to prescription opioid cues and cue-elicited craving may reliably signal future opioid misuse risk following treatment. These measures may therefore provide potential prognostic indicators of treatment outcome. PMID:25282309

  13. Neuropsychological Functioning in College Students Who Misuse Prescription Stimulants

    PubMed Central

    Wilens, Timothy; Carrellas, Nicholas W.; Martelon, MaryKate; Yule, Amy M.; Fried, Ronna; Anselmo, Rayce; McCabe, Sean E.

    2017-01-01

    Background and Objectives Relatively little is known about the neuropsychological profiles of college students who misuse prescription stimulant medications. Methods Data presented are from college students aged 18 to 28 years who misused prescription stimulants prescribed for attention-deficit/hyperactivity disorder and controls (no prescription stimulant misuse). Students were assessed neuropsychologically using the self-report Behavioral Rating Inventory of Executive Functioning (BRIEF-A), the Cambridge Automated Neuropsychological Test and Battery (CANTAB), and other tests of cognitive functioning. The analyses included 198 controls (age 20.7 ± 2.6 years) and 100 prescription stimulant misusers (age 20.7 ± 1.7 years). Results On the BRIEF-A, misusers were more likely than controls to endorse greater dysfunction on 8 of 12 measures including Inhibition, Self Monitor, Initiation, Working Memory, and Plan/Organize, when adjusting for race and sex (all p’s <0.05). Similarly, when dichotomizing the BRIEF-A as abnormal (T score ≥ 65), misusers had more abnormalities on 5 of 9 subscales, as well as all major indices (p’s<0.05). Misusers also performed worse on several subtests of the CANTAB and standardized cognitive battery (p’s <0.05). A proxy of prescription stimulant misuse frequency was positively correlated with greater executive dysfunction on the BRIEF-A. Discussion and Conclusions These data demonstrate elevated risk for neuropsychological dysfunction among students who misuse prescription stimulants compared to non-misusing peers. The presence of ADHD contributed significantly to these cognitive findings. Students who misuse prescription stimulants should be screened for neuropsychological dysfunction. Scientific Significance These data may better elucidate the neuropsychological profile of college-aged prescription stimulant misusers. PMID:28494131

  14. Drug misuse in sport: a New Zealand perspective.

    PubMed

    Curtis, Andrew; Gerrard, David; Burt, Peter; Osborne, Hamish

    2015-12-04

    Drug misuse in elite sport is a world-wide phenomenon. This article explores the culture of contemporary sport, provides estimates of doping prevalence, discusses dietary supplementation and highlights major factors influencing high-performance athletes and their support personnel. The aim is to stimulate discussion, informed by the World Anti-Doping Code (WADC), which is particularly relevant to doctors caring for athletes. Online databases were searched for relevant peer-reviewed research from 2009 to 2015. Comparative New Zealand data have been included. Estimates of the prevalence of sports doping range from less than 1% to as high as 52%, dependent upon the demographics of the identified cohort. The culture of elite sport, personal stressors, competitive demands, financial reward and the influence of an 'entourage' of support personnel were identified as critical determinants of drug misuse. The culture of elite contemporary sport is seductive to many aspiring young athletes. To combat drug misuse, effective education should embody moral, ethical and clinical dangers, recognising the importance of support at times of increased athlete vulnerability. Inadvertent doping from product contamination is a recognised risk of unsupervised dietary supplementation. Doctors responsible for the care of high-performance athletes must be cognisant of these issues and the provisions of the WADC.

  15. Psychiatric disorders, spouse abuse and child abuse.

    PubMed

    Bland, R C; Orn, H

    1986-01-01

    The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.

  16. Substance abuse and dependence in the hospital workplace: detection and handling.

    PubMed

    Ossi, J

    1991-01-01

    A hospital can take many avenues in dealing with an employee or professional who is impaired by substance abuse or dependence. The most difficult aspect of dealing with the problem is detection. Fortunately, increasing public awareness and concern regarding workplace substance abuse is forcing legislators to address the issue and expose the problem. The legislative response appears to be geared toward treatment and education rather than punishment, which in the opinion of this author is a desirable approach. The pharmacy department can be a valuable asset to the hospital risk manager in detecting diversion of controlled substances and educating employees as to the clinical signs and symptoms of impairment.

  17. Recent cannabis abuse decreased stress-induced BOLD signals in the frontal and cingulate cortices of cocaine dependent individuals.

    PubMed

    Li, Chiang-Shan Ray; Milivojevic, Verica; Constable, R Todd; Sinha, Rajita

    2005-12-30

    Previous neuroimaging studies showed that use of marijuana can alter patterns of cortical activation during rest or a task challenge. We used functional magnetic resonance imaging to examine whether recent cannabis abuse contributed to stress-induced blood-oxygen-level-dependent (BOLD) contrast in a group of cocaine-dependent individuals. Emotional stress was induced using the script-guided imagery paradigm, in which subjects imagined being in a real-life stressful situation and, as a control, in a neutral situation, while BOLD signals of their brain were acquired with a 1.5 T scanner. Abstinent cocaine-dependent subjects with recent marijuana abuse (n=8) were compared with abstinent cocaine-dependent subjects who had not abused marijuana recently (n=18). The two groups were otherwise matched in their demographic characteristics and drug use history. All subjects were abstinent for at least 15 days and drug free as confirmed by urine drug screening before the imaging session. Recent cannabis abusers demonstrated hypo-activation in frontal cortical areas including the perigenual anterior cingulate during increased emotional stress. In contrast, at the same statistical threshold, no brain regions showed increased activation in recent cannabis abusers compared with non-abusers. The group difference in the perigenual anterior cingulate remained even when lifetime cocaine and alcohol consumption was accounted for in covariance analysis. These results provide evidence that recent cannabis abuse is associated with decreased activation in the frontal cortex during an emotional stress task. The results suggest an abnormal cognitive control mechanism during affective processing in association with heavy cannabis use.

  18. Smoking, Alcohol, Drug Use, Abuse and Dependence in Narcolepsy and Idiopathic Hypersomnia: A Case-Control Study

    PubMed Central

    Barateau, Lucie; Jaussent, Isabelle; Lopez, Régis; Boutrel, Benjamin; Leu-Semenescu, Smaranda; Arnulf, Isabelle; Dauvilliers, Yves

    2016-01-01

    Study Objectives: Basic experiments support the impact of hypocretin on hyperarousal and motivated state required for increasing drug craving. Our aim was to assess the frequencies of smoking, alcohol and drug use, abuse and dependence in narcolepsy type 1 (NT1, hypocretin-deficient), narcolepsy type 2 (NT2), idiopathic hypersomnia (IH) (non-hypocretin-deficient conditions), in comparison to controls. We hypothesized that NT1 patients would be less vulnerable to drug abuse and addiction compared to other hypersomniac patients and controls from general population. Methods: We performed a cross-sectional study in French reference centres for rare hypersomnia diseases and included 450 adult patients (median age 35 years; 41.3% men) with NT1 (n = 243), NT2 (n = 116), IH (n = 91), and 710 adult controls. All participants were evaluated for alcohol consumption, smoking habits, and substance (alcohol and illicit drug) abuse and dependence diagnosis during the past year using the Mini International Neuropsychiatric Interview. Results: An increased proportion of both tobacco and heavy tobacco smokers was found in NT1 compared to controls and other hypersomniacs, despite adjustments for potential confounders. We reported an increased regular and frequent alcohol drinking habit in NT1 versus controls but not compared to other hypersomniacs in adjusted models. In contrast, heavy drinkers were significantly reduced in NT1 versus controls but not compared to other hypersomniacs. The proportion of patients with excessive drug use (codeine, cocaine, and cannabis), substance dependence, or abuse was low in all subgroups, without significant differences between either hypersomnia disorder categories or compared with controls. Conclusions: We first described a low frequency of illicit drug use, dependence, or abuse in patients with central hypersomnia, whether Hcrt-deficient or not, and whether drug-free or medicated, in the same range as in controls. Conversely, heavy drinkers were

  19. [Pilot study on the prevalence of dual pathology in community mental health and substance misuse services in Madrid].

    PubMed

    Szerman Bolotner, Néstor; Arias Horcajadas, Francisco; Vega Astudillo, Pablo; Babín Vich, Francisco; Mesías Perez, Beatriz; Basurte Villamor, Ignacio; Morant, Consuelo; Ochoa Mangado, Enriqueta; Poyo Calvo, Félix

    2011-01-01

    To evaluate retrospectively the comorbidity of mental and addictive disorders in community mental health and substance misuse services in Madrid. The medical records of 400 patients from mental health and substance misuse services in Madrid were evaluated. Records were examined for the last 20 patients from each service unit. Dual pathology was constituted when a current diagnosis of mental and addictive disorders, excluding nicotine addiction, appeared on the patient's records. Prevalence of dual pathology was 34%. There were differences in the prevalence figures for the two kinds of service: 36.78% in substance misuse services, and 28.78% in mental health services. There was an association of dual diagnosis with alcohol or cocaine dependence, but not with opioid dependence. The mental disorders more prevalent in dually diagnosed than in non-dually diagnosed patients were mood disorders, personality disorders, and schizophrenia. There is a high prevalence of dual pathology in those seeking treatment, being higher in substance misuse services than in mental health services, and higher in patients with alcohol or cocaine dependence. These findings could be of help in the planning of care resource policies for these patients.

  20. Dimensionality of Hallucinogen and Inhalant/Solvent Abuse and Dependence Criteria: Implications for the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition

    PubMed Central

    Kerridge, Bradley T.; Saha, Tulshi D.; Smith, Sharon; Chou, Patricia S.; Pickering, Roger P.; Huang, Boji; Ruan, June W.; Pulay, Attila J.

    2012-01-01

    Background Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM- IV currently lacking empirical justification. Methods Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population. Results Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity. Conclusion Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria

  1. Exploring Relationships Between Delinquent Peer Groups, Participation in Delinquency, Substance Abuse, and Injecting Drug Use Among the Incarcerated: Findings From a National Sample of State and Federal Inmates in the United States

    PubMed Central

    Marotta, Phillip

    2017-01-01

    The following study assesses the relationship between affiliating with delinquent peer groups, participation in delinquency, and several substance misuse and injecting drug use outcomes in a nationally representative sample of inmates in state and federal facilities in the United States. After controlling for potential confounders, affiliating with peers who engaged in deviant behaviors and participation in delinquency was associated with onset of alcohol and illicit drug use, substance dependence, alcohol dependence, types of substances used, and injecting drug use outcomes. Inmates who began engaging in delinquency at older ages reported initiating drug and alcohol use at older ages, and were less likely to meet the criteria for drug abuse or dependence, less likely to use substances daily or near daily, and less likely to report having ever injected or shared syringes. The implications of these findings for substance abuse, HIV, and crime prevention interventions are discussed. PMID:28966393

  2. Education, income and alcohol misuse: a stress process model.

    PubMed

    Elliott, Marta; Lowman, Jennifer

    2015-01-01

    This study applies stress process theory to study and explain the negative association between socioeconomic status (SES) and alcohol misuse. SES is theorized to reduce alcohol misuse by reducing exposure to stressors and increasing access to resources. The National Co-Morbidity panel sample (N = 4,979) interviewed in 1990-1992 and 2000-2002 are analyzed to estimate direct and indirect pathways between SES and alcohol misuse over time via stressors and resources. Higher education and income predict decreased alcohol misuse via internal and external locus of control. External locus of control is associated with increased alcohol intake over time, whereas internal locus of control is associated with a lower likelihood of developing future alcohol-related disorders. Income is also associated with increased alcohol misuse via religiosity, which is more common among people of low income, and protects against alcohol misuse. SES is negatively associated with alcohol misuse because low SES increases people's perceptions that their lives are determined by luck, and reduces their sense of personal control. However, low income has a countervailing negative influence on alcohol misuse via its association with religiosity.

  3. Emotional traits and affective temperaments in alcohol users, abusers and dependents in a national sample.

    PubMed

    Leite, Leticia; Machado, Leonardo N; Lara, Diogo R

    2014-07-01

    It is unclear how temperament is related to alcohol-related behavior in large population studies. We have used the Affective and Emotional Composite Temperament Scale (AFECTS) model to evaluate how emotional traits and affective temperaments are associated with alcohol use, abuse, and dependence in the general population. Data from 10,603 subjects (mean age=28.0±7.8 years, 70.3% females) was collected anonymously by the Internet in Brazil using the AFECTS model and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Alcohol use was stratified into control, low use, abuse, and dependence groups. The analysis of dimensional traits showed that Volition and Coping were lower, and Sensitivity was higher, in the abuse and dependence groups, with no differences between the Control and the Low Use groups. Alcohol consumption was also associated with lower Control, Stability, and Caution, and higher with Anger, Anxiety, and Desire, with significant differences between all groups. Regarding affective temperament types, alcohol abuse and dependence were associated with euphoric and cyclothymic temperaments in both genders, which was mirrored by a lower frequency of both euthymic and hyperthymic types. Only hyperthymics were overrepresented in the Control group for both genders. Data was collected by Internet only. A global dysfunction of emotional traits and a predominance of cyclothymic and euphoric temperaments were associated with alcohol-related behavior. Prevention and treatment strategies may be developed more effectively if these traits are taken into account. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Exploring family and community involvement to protect Thai youths from alcohol and illegal drug abuse.

    PubMed

    Wongtongkam, Nualnong; Ward, Paul Russell; Day, Andrew; Winefield, Anthony Harold

    2015-01-01

    Youth substance abuse is widely recognized as a major public health issue in Thailand. This study explores family and community risk and protective factors relevant to alcohol and illegal drug misuse in 1,778 Thai teenagers. Strong family attachment and a family history of antisocial behaviors were strongly associated with nearly all forms of substance abuse, with adjusted odds ratios ranging from 5.05 to 8.45. Community disorganization was strongly associated with self-reported substance use, although involvement in prosocial activities acted as a protective factor. The findings suggest that interventions that promote family cohesion and encourage community involvement may have considerable benefits in reducing substance abuse in Thai adolescents.

  5. Phenibut (β-Phenyl-γ-aminobutyric Acid) Dependence and Management of Withdrawal: Emerging Nootropics of Abuse.

    PubMed

    Ahuja, Tania; Mgbako, Ofole; Katzman, Caroline; Grossman, Allison

    2018-01-01

    This case report describes the development of withdrawal from phenibut, a gamma-aminobutyric acid-receptor type B agonist. Although phenibut is not an FDA-approved medication, it is available through online retailers as a nootropic supplement. There are reports of dependence in patients that misuse phenibut. We report a case in which a patient experienced withdrawal symptoms from phenibut and was successfully treated with a baclofen taper. This case report highlights the development of phenibut use disorder with coingestion of alcohol and potential management for phenibut withdrawal. We believe clinicians must be aware of how phenibut dependence may present and how to manage the withdrawal syndrome.

  6. Managing severe pain and abuse potential: the potential impact of a new abuse-deterrent formulation oxycodone/naltrexone extended-release product.

    PubMed

    Pergolizzi, Joseph V; Taylor, Robert; LeQuang, Jo Ann; Raffa, Robert B

    2018-01-01

    Proper management of severe pain represents one of the most challenging clinical dilemmas. Two equally important goals must be attained: the humanitarian/medical goal to relieve suffering and the societal/legal goal to not contribute to the drug abuse problem. This is an age-old problem, and the prevailing emphasis placed on one or the other goal has resulted in pendulum swings that have resulted in either undertreatment of pain or the current epidemic of misuse and abuse. In an effort to provide efficacious strong pain relievers (opioids) that are more difficult to abuse by the most dangerous routes of administration, pharmaceutical companies are developing products in which the opioid is manufactured in a formulation that is designed to be tamper resistant. Such a product is known as an abuse-deterrent formulation (ADF). ADF opioid products are designed to deter or resist abuse by making it difficult to tamper with the product and extracting the opioid for inhalation or injection. To date, less than a dozen opioid formulations have been approved by the US Food and Drug Administration to carry specific ADF labeling, but this number will likely increase in the coming years. Most of these products are extended-release formulations.

  7. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations.

    PubMed

    Turk, Dennis C; O'Connor, Alec B; Dworkin, Robert H; Chaudhry, Amina; Katz, Nathaniel P; Adams, Edgar H; Brownstein, John S; Comer, Sandra D; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A; Klein, Michael; Leiderman, Deborah B; Lubran, Robert; Rappaport, Bob A; Zacny, James P; Ahdieh, Harry; Burke, Laurie B; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S; Raja, Srinivasa N; Rauschkolb, Christine; Roland, Carl L; Webster, Lynn R; Weiss, Roger D; Wolf, Kerry

    2012-10-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Because of the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability, (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation, (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse, and (4) postmarketing epidemiological studies. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  8. Global issues in volatile substance misuse.

    PubMed

    Dell, Colleen Anne; Gust, Steven W; MacLean, Sarah

    2011-01-01

    This special issue of Substance Use & Misuse addresses the public health issue of volatile substance misuse (VSM), the inhalation of gases or vapors for psychoactive effects, assessing the similarities and differences in the products misused, patterns, prevalence, etiologies, and impacts of VSM by examining it through sociocultural epidemiology, neuroscience, and interventions research. The Canadian, US, and Australian guest editors contend that, when compared with other drugs used at a similar prevalence, VSM has attracted relatively little research effort. The authors and editors call for further research to develop evidence-based policies and comprehensive interventions that respect culture and context-specific knowledge.

  9. Inhalant Use, Abuse, and Dependence among Adolescent Patients: Commonly Comorbid Problems.

    ERIC Educational Resources Information Center

    Sakai, Joseph T.; Hall, Shannon K.; Mikulich-Gilbertson, Susan K.; Crowley, Thomas J.

    2004-01-01

    Objective: Little is known about adolescents with DSM-IV-defined inhalant abuse and dependence. The aim of this study was to compare comorbidity among (1) adolescents with inhalant use disorders, (2) adolescents who reported using inhalants without inhalant use disorder, and (3) other adolescent patients drawn from an adolescent drug and alcohol…

  10. Substance Use and Dependence Education in Predoctoral Dental Curricula: Results of a Survey of U.S. and Canadian Dental Schools

    PubMed Central

    Huggett, Kathryn N.; Westerman, Gary H.; Barone, Eugene J.; Lofgreen, Amanda S.

    2012-01-01

    The purpose of this study was to obtain information about education in substance use and dependence that appears in the predoctoral curricula of U.S. and Canadian dental schools. Sixty-eight deans were sent a twenty-item survey requesting information about when in the curriculum these subjects were taught, what instructional methods were used, and whether behavior change instruction was included to address these issues in clinical interactions. The survey had an 81 percent response rate. The topics of alcohol use and dependence, tobacco use and dependence, and prescription drug misuse and abuse were reported in over 90 percent (N=55) of responding schools’ predoctoral curricula. The topic of other substance use and dependence was reported in only 72.7 percent (N=40) of these schools. The primary instructional method reported was the use of lecture. Less frequently used methods included small-group instruction, instruction in school-based clinic, community-based extramural settings, and independent study. As future health professionals, dental students are an important source for patients concerning substance use, abuse, and treatment. Our investigation confirmed that alcohol, tobacco, and prescription drug abuse is addressed widely in predoctoral dental curricula, but other substance use and dependence are less frequently addressed. PMID:21828293

  11. Risk based In Vitro Performance Assessment of Extended Release Abuse Deterrent Formulations

    PubMed Central

    Xu, Xiaoming; Gupta, Abhay; Al-Ghabeish, Manar; Calderon, Silvia N.; Khan, Mansoor A.

    2016-01-01

    High strength extended release opioid products, which are indispensable tools in the management of pain, are associated with serious risks of unintentional and potentially fatal overdose, as well as of misuse and abuse that might lead to addiction. The issue of drug abuse becomes increasingly prominent when the dosage forms can be readily manipulated to release a high amount of opioid or to extract the drug in certain products or solvents. One approach to deter opioid drug abuse is by providing novel abuse deterrent formulations (ADF), with properties that may be viewed as barriers to abuse of the product. However, unlike regular extended release formulations, assessment of ADF technologies are challenging, in part due to the great variety of formulation designs available to achieve deterrence of abuse by oral, parenteral, nasal and respiratory routes. With limited prior history or literature information, and lack of compendial standards, evaluation and regulatory approval of these novel drug products become increasingly difficult. The present article describes a risk-based standardized in-vitro approach that can be utilized in general evaluation of abuse deterrent features for all ADF products. PMID:26784976

  12. Erythropoietin abuse and erythropoietin gene doping: detection strategies in the genomic era.

    PubMed

    Diamanti-Kandarakis, Evanthia; Konstantinopoulos, Panagiotis A; Papailiou, Joanna; Kandarakis, Stylianos A; Andreopoulos, Anastasios; Sykiotis, Gerasimos P

    2005-01-01

    The administration of recombinant human erythropoietin (rhEPO) increases the maximum oxygen consumption capacity, and is therefore abused as a doping method in endurance sports. The detection of erythropoietin (EPO) abuse is based on direct pharmacological and indirect haematological approaches, both of which have several limitations. In addition, current detection methods cannot cope with the emerging doping strategies of EPO mimicry, analogues and gene doping, and thus novel detection strategies are urgently needed. Direct detection methods for EPO misuse can be either pharmacological approaches that identify exogenous substances based on their physicochemical properties, or molecular methods that recognise EPO transgenes or gene transfer vectors. Since direct detection with molecular methods requires invasive procedures, it is not appropriate for routine screening of large numbers of athletes. In contrast, novel indirect methods based on haematological and/or molecular profiling could be better suited as screening tools, and athletes who are suspect of doping would then be submitted to direct pharmacological and molecular tests. This article reviews the current state of the EPO doping field, discusses available detection methods and their shortcomings, outlines emerging pharmaceutical and genetic technologies in EPO misuse, and proposes potential directions for the development of novel detection strategies.

  13. Prospective risk factors for alcohol misuse in late adolescence.

    PubMed

    Ellickson, S L; Tucker, J S; Klein, D J; McGuigan, K A

    2001-11-01

    This longitudinal study investigated Grade-7 and Grade-10 risk factors for alcohol misuse at Grade 12. Alcohol misuse was conceptualized as problem-related drinking (e.g., missing school), high-risk drinking (e.g., drunk driving) and high consumption. Prospective analyses using two-part models predicted any alcohol misuse and the amount of misuse (given that some has occurred) for over 4,200 (52% male) participants in the RAND Adolescent Panel Study. Predictor variables were demographics, substance use and exposure, prodrug attitudes, rebelliousness and deviant behavior, self-esteem, family structure and relations, and grades. Grade-7 predictors of alcohol misuse 5 years later included early drinking onset, parental drinking, future intentions to drink, cigarette offers, difficulty resisting pressures to smoke, being white, being male, having an older sibling, deviant behavior and poor grades. By Grade 10, predictors of alcohol misuse 2 years later included drinking and marijuana use by self and peers, future intentions to drink, difficulty resisting pressures to drink and use marijuana, being male, coming from a disrupted family and deviant behavior. Somewhat different predictors were identified for problem-related, high-risk and high consumption drinking, emphasizing the importance of investigating multiple dimensions of misuse. The high social acceptability of alcohol use makes prevention difficult. Curbing alcohol misuse may be a more attainable goal than preventing any use. These results indicate that predictors of misuse in late adolescence can be identified by Grade 7 and are generally visible and modifiable. Prevention efforts should begin by early adolescence, address both familial and peer influences to drink and use other substances, and take into account problems that predict alcohol misuse (e.g., poor academic performance and early deviant behavior).

  14. Childhood Trajectories of Inattention, Hyperactivity and Oppositional Behaviors and Prediction of Substance Abuse/Dependence: A 15-Year Longitudinal Population-Based Study

    PubMed Central

    Pingault, Jean-Baptiste; Côté, Sylvana M.; Galéra, Cédric; Genolini, Christophe; Falissard, Bruno; Vitaro, Frank; Tremblay, Richard E.

    2014-01-01

    Numerous prospective studies have shown that children diagnosed with ADHD are at higher risk of long-term substance abuse/dependence. However, there are two important limits to these studies: a) most did not differentiate the role of hyperactivity and inattention; b) most did not control for associated behavioral problems; c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1804 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1 % for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (OR: 2.25; 95% CI: 1.63–3.11) and opposition (OR: 1.65; 95%: 1.20–2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40–3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06–8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98–1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained a key predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature. PMID:22733124

  15. Associations Between Compulsive Buying and Substance Dependence/Abuse, Major Depressive Episode, and Generalized Anxiety Disorder Among Men and Women

    PubMed Central

    Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.

    2016-01-01

    Aims The objective of this study was to examine the associations between compulsive buying (CB) and substance dependence/abuse, major depressive episode (MDE), and generalized anxiety disorder (GAD) at mean age 43. Methods Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. The prevalence of substance dependence/abuse, MDE, and GAD (during the past 5 years before the interviews) was 6.6%, 13.7, and 11.5%, respectively. Results Logistic regression analyses showed that CB was significantly associated with substance dependence/abuse [Adjusted Odds Ratio (A.O.R.) = 1.60], MDE (A.O.R. = 1.70), and GAD (A.O.R. = 1.63), despite controlling for substance dependence/abuse, MDE, and GAD, respectively, at mean age 37, and demographic factors. Discussion Since the study sample is limited to predominantly white participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, MDE, and GAD consider the role of CB. PMID:27215919

  16. Smoking, Alcohol, Drug Use, Abuse and Dependence in Narcolepsy and Idiopathic Hypersomnia: A Case-Control Study.

    PubMed

    Barateau, Lucie; Jaussent, Isabelle; Lopez, Régis; Boutrel, Benjamin; Leu-Semenescu, Smaranda; Arnulf, Isabelle; Dauvilliers, Yves

    2016-03-01

    Basic experiments support the impact of hypocretin on hyperarousal and motivated state required for increasing drug craving. Our aim was to assess the frequencies of smoking, alcohol and drug use, abuse and dependence in narcolepsy type 1 (NT1, hypocretin-deficient), narcolepsy type 2 (NT2), idiopathic hypersomnia (IH) (non-hypocretin-deficient conditions), in comparison to controls. We hypothesized that NT1 patients would be less vulnerable to drug abuse and addiction compared to other hypersomniac patients and controls from general population. We performed a cross-sectional study in French reference centres for rare hypersomnia diseases and included 450 adult patients (median age 35 years; 41.3% men) with NT1 (n = 243), NT2 (n = 116), IH (n = 91), and 710 adult controls. All participants were evaluated for alcohol consumption, smoking habits, and substance (alcohol and illicit drug) abuse and dependence diagnosis during the past year using the Mini International Neuropsychiatric Interview. An increased proportion of both tobacco and heavy tobacco smokers was found in NT1 compared to controls and other hypersomniacs, despite adjustments for potential confounders. We reported an increased regular and frequent alcohol drinking habit in NT1 versus controls but not compared to other hypersomniacs in adjusted models. In contrast, heavy drinkers were significantly reduced in NT1 versus controls but not compared to other hypersomniacs. The proportion of patients with excessive drug use (codeine, cocaine, and cannabis), substance dependence, or abuse was low in all subgroups, without significant differences between either hypersomnia disorder categories or compared with controls. We first described a low frequency of illicit drug use, dependence, or abuse in patients with central hypersomnia, whether Hcrt-deficient or not, and whether drug-free or medicated, in the same range as in controls. Conversely, heavy drinkers were rare in NT1 compared to controls but not to other

  17. Personality traits in alcohol-dependent individuals in the context of childhood abuse.

    PubMed

    Gerhant, Aneta; Olajossy, Marcin

    2016-10-31

    The aim of this study was to identify groups of alcohol-dependent individuals differing in the severity of childhood physical, emotional and sexual abuse and to find the personality variables that discriminate between those groups. The study included 90 individuals dependent on alcohol. The following questionnaires were used: the Temperament and Character Inventory (TCI), the Coping Inventory (COPE), the Buss and Perry Aggression Questionnaire (BPAQ), Cattell's IPAT Anxiety Scale, and the Early Trauma Inventory (ETI). Two groups of subjects addicted to alcohol were identified: group 1 with high and group 2 with low childhood physical, emotional and sexual abuse indices. The subjects in Group 1 had significantly higher scores than the subjects in Group 2 on the TCI Temperament scales of NS and HA and lower scores on the TCI character scales of SD, C2 and C4. Group 1 subjects were significantly more likely than those from Group 2 to use avoidant coping strategies; they were also less likely to use problem-focused strategies and had significantly higher scores on general anxiety, overt anxiety, latent anxiety, level of aggression, physical aggression, hostility and anger. The higher severity of childhood physical, emotional and sexual abuse in alcoholics is associated with those personality traits that seem to be crucial for maintaining abstinence and the quality of cooperation in therapy.

  18. Childhood trajectories of inattention, hyperactivity and oppositional behaviors and prediction of substance abuse/dependence: a 15-year longitudinal population-based study.

    PubMed

    Pingault, J-B; Côté, S M; Galéra, C; Genolini, C; Falissard, B; Vitaro, F; Tremblay, R E

    2013-07-01

    Numerous prospective studies have shown that children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at higher risk of long-term substance abuse/dependence. However, there are three important limits to these studies: (a) most did not differentiate the role of hyperactivity and inattention; (b) most did not control for associated behavioral problems; and (c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1803 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1% for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (odds ratio (OR): 2.25; 95% confidence interval (CI): 1.63-3.11) and opposition (OR: 1.65; 95%: 1.20-2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40-3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06-8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98-1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained an important predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature.

  19. Toward DSM-V: an item response theory analysis of the diagnostic process for DSM-IV alcohol abuse and dependence in adolescents.

    PubMed

    Gelhorn, Heather; Hartman, Christie; Sakai, Joseph; Stallings, Michael; Young, Susan; Rhee, Soo Hyun; Corley, Robin; Hewitt, John; Hopfer, Christian; Crowley, Thomas

    2008-11-01

    Item response theory analyses were used to examine alcohol abuse and dependence symptoms and diagnoses in adolescents. Previous research suggests that the DSM-IV alcohol use disorder (AUD) symptoms in adolescents may be characterized by a single dimension. The present study extends prior research with a larger and more comprehensive sample and an examination of an alternative diagnostic algorithm for AUDs. Approximately 5,587 adolescents between the ages of 12 and 18 years from adjudicated, clinical, and community samples were administered structured clinical interviews. Analyses were conducted to examine the severity of alcohol abuse and dependence symptoms and the severity of alcohol use problems (AUDs) within the diagnostic categories created by the DSM-IV. Although the DSM-IV diagnostic categories differ in severity of AUDs, there is substantial overlap and inconsistency in AUD severity of persons across these categories. Item Response Theory-based AUD severity estimates suggest that many persons diagnosed with abuse have AUD severity greater than persons with dependence. Similarly, many persons who endorse some symptoms but do not qualify for a diagnosis (i.e., diagnostic orphans) have more severe AUDs than persons with an abuse diagnosis. Additionally, two dependence items, "tolerance" and "larger/longer," show differences in severity between samples. The distinction between DSM-IV abuse and dependence based on severity can be improved using an alternative diagnostic algorithm that considers all of the alcohol abuse and dependence symptoms conjointly.

  20. Undergraduate Prescription Stimulant Misuse: The Impact of Academic Strain.

    PubMed

    Norman, Lauren; Ford, Jason

    2018-01-09

    This study investigated the misuse of prescription stimulants among undergraduates for academic purposes. This research is important as existing literature has indicated that this type of prescription drug misuse is a growing concern, especially among college undergraduates aged 18-25. This study focused on how various types of academic strain (i.e., academic strain, grade strain, and academic impediments) influenced the misuse of prescription stimulants. Roughly 900 quantitative surveys were collected at a large Southeastern university in May 2014 that specifically addressed prescription stimulant misuse. Results from regression analyses indicated that college students are at an increased likelihood of misusing prescription stimulants for academic purposes if they experienced academic impediments and/or grade strain during the past academic year. Conclusions/Importance: It is necessary to identify how academic strain impacts undergraduates' likelihood of engaging in the misuse of prescription stimulants as this information may aid in college based educational and prevention programs.

  1. Psychometric properties of DSM assessments of illicit drug abuse and dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

    PubMed

    Lynskey, M T; Agrawal, A

    2007-09-01

    DSM-IV criteria for illicit drug abuse and dependence are largely based on criteria developed for alcohol use disorders and there is a lack of research evidence on the psychometric properties of these symptoms when applied to illicit drugs. This study utilizes data on abuse/dependence criteria for cannabis, cocaine, stimulants, sedatives, tranquilizers, opiates, hallucinogens and inhalants from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC, n=43 093). Analyses included factor analysis to explore the dimensionality of illicit drug abuse and dependence criteria, calculation of item difficulty and discrimination within an item response framework and a descriptive analysis of 'diagnostic orphans': individuals meeting criteria for 1-2 dependence symptoms but not abuse. Rates of psychiatric disorders were compared across groups. Results favor a uni-dimensional construct for abuse/dependence on each of the eight drug classes. Factor loadings, item difficulty and discrimination were remarkably consistent across drug categories. For each drug category, between 29% and 51% of all individuals meeting criteria for at least one symptom did not receive a formal diagnosis of either abuse or dependence and were therefore classified as 'orphans'. Mean rates of disorder in these individuals suggested that illicit drug use disorders may be more adequately described along a spectrum of severity. While there were remarkable similarities across categories of illicit drugs, consideration of item difficulty suggested that some alterations to DSM regarding the relevant severity of specific abuse and dependence criteria may be warranted.

  2. Associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder among men and women.

    PubMed

    Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W

    2016-01-01

    The objective of this study was to examine the associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder at the mean age of 43. Participants came from a community-based random sample of residents in 2 New York counties in 1975 (N = 548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (standard deviation = 2.8). Of the participants, 55% were females. Over 90% of the participants were Caucasian. The prevalence of substance dependence/abuse, major depressive episodes, and generalized anxiety disorder (during the past 5 years before the interviews) was 6.6, 13.7, and 11.5%, respectively. Logistic regression analyses showed that compulsive buying was significantly associated with substance dependence/abuse (adjusted odds ratio = 1.60), major depressive episodes (adjusted odds ratio = 1.70), and generalized anxiety disorder (adjusted odds ratio = 1.63), despite controlling for substance dependence/abuse, major depressive episodes, and generalized anxiety disorder, respectively, at the mean age of 37, and demographic factors. Since the study sample is limited to predominantly Caucasian participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, major depressive episodes, and generalized anxiety disorder consider the role of compulsive buying.

  3. Patterns of misuse of child safety seats

    DOT National Transportation Integrated Search

    1996-01-01

    This project addressed the patterns of child safety seat (CSS) misuse in the nation and reported on the most appropriate techniques to accurately and efficiently collect these data. CSS use and misuse observations were collected for about 5,900 targe...

  4. The Behavioral Economics of Young Adult Substance Abuse

    PubMed Central

    Murphy, James G.; Dennhardt, Ashley A.

    2016-01-01

    Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes. PMID:27151545

  5. The behavioral economics of young adult substance abuse.

    PubMed

    Murphy, James G; Dennhardt, Ashley A

    2016-11-01

    Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews of available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Resonant Messages to Prevent Prescription Drug Misuse by Teens

    ERIC Educational Resources Information Center

    Twombly, Eric C.; Holtz, Kristen D.; Agnew, Christine B.

    2011-01-01

    Prescription drug misuse is a major health problem, particularly among teens. A key step in curbing misuse is the development of effective prescription drug prevention messages. This paper explores the elements of prescription drug misuse prevention messages that resonate with teens using data from focus groups with seventh and eighth grade…

  7. Psychiatric Syndromes in Adolescents with Marijuana Abuse and Dependency in Outpatient Treatment

    ERIC Educational Resources Information Center

    Diamond, Guy; Panichelli-Mindel, Susan M.; Shera, David; Dennis, Mike; Tims, Frank; Ungemack, Jane

    2006-01-01

    Objective: The purpose of the current study to assist in understanding the prevalence and clinical correlates of psychiatric distress in adolescents seeking outpatient services for marijuana abuse or dependency. Methods: In a multi-site randomized clinical trial, 600 adolescents and their parents were assessed at intake using the Global Appraisals…

  8. Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program.

    PubMed

    Merlo, Lisa J; Singhakant, Supachoke; Cummings, Simone M; Cottler, Linda B

    2013-01-01

    Substance-related impairment of physicians is a small but serious problem, with significant consequences for patient safety and public health. The purpose of this study was to identify reasons for prescription drug misuse among physicians referred to a physician health program for monitoring because of substance-related impairment, to develop better mechanisms for prevention and intervention. A total of 55 physicians (94.5% male) who were being monitored by their State physician health program because of substance-related impairment participated in guided focus group discussions. Participation was anonymous. Discussions were transcribed from 9 separate focus groups, lasting 60 to 90 minutes each. Qualitative analyses were conducted to examine themes. All participants were diagnosed with substance dependence, and 69.1% of them endorsed a history of misusing prescription drugs. Participants documented the following 5 primary reasons for prescription drug misuse: (1) to manage physical pain, (2) to manage emotional/psychiatric distress, (3) to manage stressful situations, (4) to serve recreational purposes, and (5) to avoid withdrawal symptoms. Our results emphasize the importance of self-medication as a leading reason for misusing prescription medications, although recreational use was also an important factor. Prevention efforts targeting prescription drug misuse among physicians should be initiated during medical training, with continuing education requirements throughout the physicians' careers.

  9. Losing Faith and Finding Religion: Religiosity over the life course and substance use and abuse

    PubMed Central

    Mezuk, Briana

    2014-01-01

    Background Religion has only come into the light of scientific inquiry as a factor influencing health and behavior in the last few decades. While religiosity is a protective factor for contemporaneous substance misuse, the relationship between longitudinal changes in religiosity and substance use outcomes is understudied. Methods Using data from the National Comorbidity Study–Replication (N=6203), we examined how changes in religiosity from childhood to adulthood are related to use and abuse/dependence of licit (alcohol and tobacco) and illicit drugs. Multivariable logistic regression was used to account for potential confounders including demographic characteristics, familial disruption during childhood, and comorbid major depression. Results Religiosity was inversely associated with use and misuse of both licit and illicit substances, however this relationship varied by level of childhood religiosity. Relative to stable levels of religiosity from childhood to adulthood, a 2-unit decrease in religiosity from childhood was associated with increased likelihood of illicit drug use in the past year (Odds ratio (OR):2.43, 95% Confidence Interval (CI):1.39–4.25). However, a 2-unit increase in religiosity was also associated with past-year illicit drug use (OR:1.85, 95% CI:1.09–3.13). Comparable associations were found with a range of recent and lifetime measures of alcohol, tobacco, and illicit drugs. Conclusions Substantial gains or losses in religiosity from childhood to adulthood are associated with substance use and misuse. Findings support the use of a life course approach to understanding the relationship between religiosity and substance use outcomes. PMID:24457044

  10. Losing faith and finding religion: religiosity over the life course and substance use and abuse.

    PubMed

    Moscati, Arden; Mezuk, Briana

    2014-03-01

    Religion has only come into the light of scientific inquiry as a factor influencing health and behavior in the last few decades. While religiosity is a protective factor for contemporaneous substance misuse, the relationship between longitudinal changes in religiosity and substance use outcomes is understudied. Using data from the National Comorbidity Study - Replication (N=6203), we examined how changes in religiosity from childhood to adulthood are related to use and abuse/dependence of licit (alcohol and tobacco) and illicit drugs. Multivariable logistic regression was used to account for potential confounders including demographic characteristics, familial disruption during childhood, and comorbid major depression. Religiosity was inversely associated with use and misuse of both licit and illicit substances; however this relationship varied by level of childhood religiosity. Relative to stable levels of religiosity from childhood to adulthood, a 2-unit decrease in religiosity from childhood was associated with increased likelihood of illicit drug use in the past year (odds ratio (OR): 2.43, 95% confidence interval (CI): 1.39-4.25). However, a 2-unit increase in religiosity was also associated with past-year illicit drug use (OR: 1.85, 95% CI: 1.09-3.13). Comparable associations were found with a range of recent and lifetime measures of alcohol, tobacco, and illicit drugs. Substantial gains or losses in religiosity from childhood to adulthood are associated with substance use and misuse. Findings support the use of a life course approach to understanding the relationship between religiosity and substance use outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Risk Factors for Opioid-Use Disorder and Overdose.

    PubMed

    Webster, Lynn R

    2017-11-01

    Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression. Risk factors for opioid misuse or addiction include past or current substance abuse, untreated psychiatric disorders, younger age, and social or family environments that encourage misuse. Opioid mortality prevalence is higher in people who are middle aged and have substance abuse and psychiatric comorbidities. Suicides are probably undercounted or frequently misclassified in reports of opioid-related poisoning deaths. Greater understanding and better assessment are needed of the risk associated with suicide risk in patients with pain. Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids.

  12. Cocaine abuse versus cocaine dependence: cocaine self-administration and pharmacodynamic response in the human laboratory.

    PubMed

    Walsh, Sharon L; Donny, Eric C; Nuzzo, Paul A; Umbricht, Annie; Bigelow, George E

    2010-01-01

    Cocaine has high abuse liability but only a subset of individuals who experiment with it develop dependence. The DSM-IV (APA. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-R. American Psychiatric Association, Washington, DC, 2000) provides criteria for diagnosing cocaine abuse and cocaine dependence as distinct disorders- the latter characterized by additional symptoms related to loss of control over drug use. In this study, two groups of cocaine users (n=8/group), matched on demographic factors and length of cocaine use history and meeting criteria for either cocaine abuse (CocAb) or cocaine dependence (CocDep), were compared on (1) measures related to impulsivity and sensation seeking, (2) response to experimenter-administered cocaine (0, 12.5, 25 and 50mg/70 kg, i.v.), and (3) cocaine self-administration using a Relapse Choice and a Progressive Ratio Procedure (0, 12.5 and 25mg/70 kg, i.v.). Groups did not differ on impulsivity or sensation seeking scores. After experimenter-administered cocaine, the CocAb group reported feeling more suspicious and observers rated them significantly higher on unpleasant effects (e.g., irritability, difficulty concentrating). In contrast, the CocDep group reported significantly greater desire for cocaine, which was sustained over the course of the study, and gave higher street value estimates for cocaine (p<0.05). While cocaine self-administration was dose-related and generally comparable across the two procedures, the CocDep users chose to take significantly more cocaine than the CocAb users. These data suggest that, while regular long-term users of cocaine with cocaine abuse or dependence diagnoses cannot be distinguished by trait measures related to impulsivity, they do exhibit significant differences with regard to cocaine-directed behavior and response to cocaine administration. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  13. Reliability of Use, Abuse, and Dependence of Four Types of Inhalants in Adolescents and Young Adults

    PubMed Central

    Ridenour, Ty A.; Bray, Bethany C.; Cottler, Linda B.

    2007-01-01

    Inhalants, as a class of drugs, consists of heterogeneous substances that include some of the most dangerous drugs on a per use basis. Research on inhalant abuse has lagged behind other drugs partly because of the need for a diagnostic instrument of different types of inhalants. This study was conducted to obtain reliability estimates for the new Substance Abuse Module DSM-IV inhalants diagnoses for four types of inhalants: aerosols, gases, nitrites, and solvents as well as different diagnostic configurations of inhalant use. Participants were 162 community sample adolescents or young adults (mean age = 20.3 years, SD = 2.4). Two-thirds of the sample was male and 83.3% was Caucasian. Kappas and intraclass correlation coefficients were computed to estimate test-retest reliabilities. Results suggested (a) abuse was more common than dependence (34.6% vs. 12.3%), (b) reliabilities of abuse criteria and diagnosis were good to excellent across subtypes, and (c) reliabilities of dependence criteria and diagnoses were poor to good across subtypes. Alternative configurations of DSM-IV criteria that were consistent with previous research on adolescents provided excellent reliabilities across subtypes of inhalants. Moreover, 11.1% of participants experienced inhalants withdrawal. PMID:17576041

  14. The Investigation of Tramadol Dependence with No History of Substance Abuse: A Cross-Sectional Survey of Spontaneously Reported Cases in Guangzhou City, China

    PubMed Central

    Zhang, Haoran; Liu, Zhimin

    2013-01-01

    The study was to survey and assess the drug dependence and abuse potential of tramadol with no history of substance abuse. Subjects of tramadol dependence with no prior history of substance abuse were surveyed by interview. Physical dependence of tramadol was assessed using 10 items opiate withdrawal scale (OWS), and psychological dependence was assessed by Addiction Research Center Inventory—Chinese Version (ARCI-CV). Twenty-three male subjects (the median age was 23.4 ± 4.1 years) referred to the addiction unit in Medical Hospital of Guangzhou with tramadol abuse problems were included in this cross-sectional study. The control group included 87 heroin addicts, 60 methamphetamine (MA) abusers, and 50 healthy men. The scores of OWS of tramadol were 0.83–2.30; the mean scores of identifying euphoric effects–MBG, sedative effects–PCAG, and psychotomimetic effects–LSD of ARCI were 8.96 ± 3.08, 6.52 ± 3.25, and 6.65 ± 2.50, respectively, F = 4.927, P < 0.001. Scores of MBG scale in tramadol did not differ from those in heroin and MA groups (P > 0.05) but were higher than those in healthy men (P < 0.05). Tramadol with no history of substance abuse has a clear risk of producing high abuse potential under the long-term infrequent abuse and the high doses. PMID:24151592

  15. 18 CFR 706.205 - Misuse of information.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Misuse of information. 706.205 Section 706.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL EMPLOYEE RESPONSIBILITIES AND CONDUCT Conduct and Responsibilities of Employees § 706.205 Misuse of information. For the...

  16. 18 CFR 706.205 - Misuse of information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Misuse of information. 706.205 Section 706.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL EMPLOYEE RESPONSIBILITIES AND CONDUCT Conduct and Responsibilities of Employees § 706.205 Misuse of information. For the...

  17. 18 CFR 706.205 - Misuse of information.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Misuse of information. 706.205 Section 706.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL EMPLOYEE RESPONSIBILITIES AND CONDUCT Conduct and Responsibilities of Employees § 706.205 Misuse of information. For the...

  18. 18 CFR 706.205 - Misuse of information.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Misuse of information. 706.205 Section 706.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL EMPLOYEE RESPONSIBILITIES AND CONDUCT Conduct and Responsibilities of Employees § 706.205 Misuse of information. For the...

  19. 18 CFR 706.205 - Misuse of information.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Misuse of information. 706.205 Section 706.205 Conservation of Power and Water Resources WATER RESOURCES COUNCIL EMPLOYEE RESPONSIBILITIES AND CONDUCT Conduct and Responsibilities of Employees § 706.205 Misuse of information. For the...

  20. Combining Motivational Interviewing with Cognitive-Behavioral Treatments for Substance Abuse: Lessons from the COMBINE Research Project

    ERIC Educational Resources Information Center

    Moyers, Theresa B.; Houck, Jon

    2011-01-01

    Motivational Interviewing began as a treatment for substance misuse and has strong empirical support as an intervention for these disorders. It is very common for MI to be combined with other types of treatment when it is used for substance abuse, and this article focuses on one example of this: the COMBINE Research Project. We examine the…

  1. Important statistical considerations in the evaluation of post-market studies to assess whether opioids with abuse-deterrent properties result in reduced abuse in the community.

    PubMed

    By, Kunthel; McAninch, Jana K; Keeton, Stephine L; Secora, Alex; Kornegay, Cynthia J; Hwang, Catherine S; Ly, Thomas; Levenson, Mark S

    2018-05-01

    Abuse, misuse, addiction, overdose, and death associated with non-medical use of prescription opioids have become a serious public health concern. Reformulation of these products with abuse-deterrent properties is one approach for addressing this problem. FDA has approved several extended-release opioid analgesics with abuse-deterrent labeling, the bases of which come from pre-market studies. As all opioid analgesics must be capable of delivering the opioid in order to reduce pain, abuse-deterrent properties do not prevent abuse, nor do pre-market evaluations ensure that there will be reduced abuse in the community. Utilizing data from various surveillance systems, some recent post-market studies suggest a decline in abuse of extended-release oxycodone after reformulation with abuse-deterrent properties. We discuss challenges stemming from the use of such data. We quantify the relationship between the sample, the population, and the underlying sampling mechanism and identify the necessary conditions if valid statements about the population are to be made. The presence of other interventions in the community necessitates the use of comparators. We discuss the principles under which the use of comparators can be meaningful. Results based on surveillance data need to be interpreted with caution as the underlying sampling mechanisms can bias the results in unpredictable ways. The use of comparators has the potential to disentangle the effect due to the abuse-deterrence properties from those due to other interventions. However, identifying a comparator that is meaningful can be very difficult. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  2. Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence

    PubMed Central

    Cerdá, Magdalena; Wall, Melanie; Keyes, Katherine M; Galea, Sandro; Hasin, Deborah

    2011-01-01

    Background Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. Methods We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ (n=34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ~68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. Results In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49-2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22-2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67-1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. Conclusions States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use. PMID:22099393

  3. The Misuse of Anabolic-Androgenic Steroids among Iranian Recreational Male Body-Builders and Their Related Psycho-Socio-Demographic factors

    PubMed Central

    ANGOORANI, Hooman; HALABCHI, Farzin

    2015-01-01

    Background: The high prevalence and potential side effects of anabolic-androgenic steroids (AAS) misuse by athletes has made it a major public health concern. Epidemiological studies on the abuse of such drugs are mandatory for developing effective preventive drug control programs in sports community. This study aimed to investigate the prevalence of AAS abuse and their association with some psycho-socio-demographic factors in Iranian male recreational body-builders. Methods: Between March and October 2011; 906 recreational male body-builders from 103 randomly selected bodybuilding clubs in Tehran, Iran were participated in this study. Some psycho-socio- demographic factors including age, job, average family income, family size, sport experience (months), weekly duration of the sporting activity (h), purpose of participation in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of AAS use were obtained by interviews using questionnaires. Results: Participants were all recreational male body-builders [mean age (SD): 25.7 (7.1), ranging 14–56 yr]. Self-report of AAS abuse was registered in 150 body-builders (16.6%). Among different psycho-socio-demographic factors, only family income and sport experience were inversely associated with AAS abuse. Conclusion: Lifetime prevalence of AAS abuse is relatively high among recreational body-builders based on their self-report. Some psycho-socio-demographic factors including family income and sport experience may influence the prevalence of AAS abuse. PMID:26811817

  4. The Misuse of Anabolic-Androgenic Steroids among Iranian Recreational Male Body-Builders and Their Related Psycho-Socio-Demographic factors.

    PubMed

    Angoorani, Hooman; Halabchi, Farzin

    2015-12-01

    The high prevalence and potential side effects of anabolic-androgenic steroids (AAS) misuse by athletes has made it a major public health concern. Epidemiological studies on the abuse of such drugs are mandatory for developing effective preventive drug control programs in sports community. This study aimed to investigate the prevalence of AAS abuse and their association with some psycho-socio-demographic factors in Iranian male recreational body-builders. Between March and October 2011; 906 recreational male body-builders from 103 randomly selected bodybuilding clubs in Tehran, Iran were participated in this study. Some psycho-socio- demographic factors including age, job, average family income, family size, sport experience (months), weekly duration of the sporting activity (h), purpose of participation in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of AAS use were obtained by interviews using questionnaires. Participants were all recreational male body-builders [mean age (SD): 25.7 (7.1), ranging 14-56 yr]. Self-report of AAS abuse was registered in 150 body-builders (16.6%). Among different psycho-socio-demographic factors, only family income and sport experience were inversely associated with AAS abuse. Lifetime prevalence of AAS abuse is relatively high among recreational body-builders based on their self-report. Some psycho-socio-demographic factors including family income and sport experience may influence the prevalence of AAS abuse.

  5. Characteristics and treatment patterns of US commercially insured and Medicaid patients with opioid dependence or abuse.

    PubMed

    Wollschlaeger, Bernd A; Willson, Tina M; Montejano, Leslie B; Ronquest, Naoko A; Nadipelli, Vijay R

    To identify the demographic and clinical characteristics of commercially insured and Medicaid patients with a diagnosis of opioid dependence or abuse and to describe the pharmacological and nonpharmacological treatments received by these patients. This was a retrospective observational study using de-identified administrative claims data. The analysis included commercially insured and Medicaid patient data extracted from the Truven Health MarketScan® Commercial and Medicaid Databases. Patients with a diagnosis of opioid dependence or abuse from 2008 to 2014 (earliest diagnosis = index date) and a minimum of 6 months of pre-index and postindex continuous enrollment in the database. Baseline demographic and clinical characteristics, medication-assisted treatment (MAT), and treatment other than MAT received following diagnosis, and the clinical practice setting in which patients received any opioid dependence-related care were reported. Data from commercially insured (N = 103,768) and Medicaid (N = 50,552) patients were analyzed. Common comorbid conditions included chronic pain (48.6 percent Commercial, 56.8 percent Medicaid), depressive disorder (24.0 percent Commercial, 32.8 percent Medicaid), and other substance abuse disorders (13.3 percent Commercial, 23.7 percent Medicaid). Nearly one third of both Commercial (31.6 percent) and Medicaid (33.6 percent) patients did not have any claims for psychosocial therapy or MAT during the follow-up period. Only 24.3 percent of Commercial patients and 20.4 percent of Medicaid patients had evidence of claims for both MAT and psychosocial treatment anytime following diagnosis. The results suggest that there are opportunities to improve care through comprehensive and coordinated treatment for opioid dependence/abuse. Policies aimed at improving treatment access may be warranted.

  6. Does power distance exacerbate or mitigate the effects of abusive supervision? It depends on the outcome.

    PubMed

    Lian, Huiwen; Ferris, D Lance; Brown, Douglas J

    2012-01-01

    We predicted that the effects of abusive supervision are likely to be moderated by subordinate power distance orientation and that the nature of the moderating effect will depend on the outcome. Drawing upon work suggesting that high power distance orientation subordinates are more tolerant of supervisory mistreatment, we posited that high power distance orientation subordinates would be less likely to view abusive supervision as interpersonally unfair. Drawing upon social learning theory suggestions that high power distance orientation subordinates are more likely to view supervisors as role models, we posited that high power distance orientation subordinates would be more likely to pattern their own interpersonally deviant behavior after that of abusive supervisors. Across 3 samples we found support for our predicted interactions, culminating in a mediated moderation model demonstrating that social learning mediates the interaction of abusive supervision and power distance on subordinate interpersonal deviance, while ruling out alternate self-regulation impairment or displaced aggression explanations. Implications for the abusive supervision literature are discussed.

  7. Association between experience of child abuse and severity of drug addiction measured by the Addiction Severity Index among Japanese drug-dependent patients.

    PubMed

    Ogai, Yasukazu; Senoo, Eiichi; Gardner, Fumiyuki Chin; Haraguchi, Ayako; Saito, Tamaki; Morita, Nobuaki; Ikeda, Kazutaka

    2015-03-03

    The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J). One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA) had a significantly higher severity of drug use than men who did not experience it (MNEA). Female participants who experienced child abuse (FEA) had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA). Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence.

  8. Association between Experience of Child Abuse and Severity of Drug Addiction Measured by the Addiction Severity Index among Japanese Drug-Dependent Patients

    PubMed Central

    Ogai, Yasukazu; Senoo, Eiichi; Gardner, Fumiyuki Chin; Haraguchi, Ayako; Saito, Tamaki; Morita, Nobuaki; Ikeda, Kazutaka

    2015-01-01

    The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J). One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA) had a significantly higher severity of drug use than men who did not experience it (MNEA). Female participants who experienced child abuse (FEA) had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA). Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence. PMID:25741639

  9. Risk Factors for Substance Misuse and Adolescents’ Symptoms of Depression

    PubMed Central

    Siennick, Sonja E.; Widdowson, Alex O.; Woessner, Mathew K.; Feinberg, Mark E.; Spoth, Richard L.

    2016-01-01

    Purpose Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. Methods The study used data from a place-randomized trial of the PROSPER (PROmoting School-Community-University Partnerships to Enhance Resilience) model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey and social network data from 636 adolescents followed from 6th through 9th grades. Results When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. Conclusions The PROSPER interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse. PMID:27751712

  10. The Protected Addiction: Exploring Staff Beliefs toward Integrating Tobacco Dependence into Substance Abuse Treatment Services

    ERIC Educational Resources Information Center

    Teater, Barbra; Hammond, Gretchen Clark

    2009-01-01

    Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…

  11. Impact of Child Sexual Abuse Medical Examinations on the Dependency and Criminal Systems.

    ERIC Educational Resources Information Center

    De Jong, Allan R.

    1998-01-01

    Reviews previous research on the sociolegal impact of medical evaluations for child sexual abuse; offers a recommended menu of research questions, concerning process and outcomes of these evaluations, interviewing techniques, the use of medical evidence in prosecution, and knowledge level of professionals in the criminal and dependency systems.…

  12. Substance abuse and dependence among low income African Americans: using data from the national survey on drug use & health to demystify assumptions.

    PubMed

    Windsor, Liliane Cambraia; Negi, Nalini

    2009-07-01

    The media has portrayed African Americans as drug users and criminals. The purpose of this study is to test the assumption that low-income African Americans use more alcohol, nicotine, marijuana, and illicit drugs than other racial groups using data from the 2005 National Survey on Drug Use and Health to compare drug abuse and dependence across low income racial groups (N = 20,172). Most respondents were white, female, and older than 26 years of age. The majority completed high school and reported annual family incomes between $10,000 and $19,000. Few participants reported receiving public assistance. Drug abuse and dependence rates varied across drug type and across race. Drug dependence and abuse were measured using the Nicotine Dependence Syndrome Scale and criteria from the Diagnostic and Statistical Manual of Mental Disorders. Hierarchical regression was conducted to examine the level of association between racial background and drug abuse and dependence after controlling for age and gender. Results reveal that the assumption of high drug and alcohol use and abuse rates among low-income African Americans should be, at best, reexamined. This study has significant implications for both policy and social work practice because it breaks down normalized and biased assumptions of low-income African American drug use.

  13. PTSD as a mediator between lifetime sexual abuse and substance use among jail diversion participants.

    PubMed

    Cusack, Karen J; Herring, Amy H; Steadman, Henry J

    2013-08-01

    Many of the individuals with serious mental illness involved in the criminal justice system have experienced interpersonal victimization, such as sexual abuse, and have high rates of alcohol and drug use disorders. Little attention has been paid to the prevalence of posttraumatic stress disorder (PTSD) and its potential role in the substance misuse of offenders with mental illness. The study used a path analytic framework to test the hypothesis that PTSD mediates the relationship between sexual abuse and level of alcohol and drug use among individuals (N=386) with mental illness enrolled in a multisite (N=7) jail diversion project. Sexual abuse was strongly associated with PTSD, which was in turn associated with both heavy drug use and heavy drinking. These findings suggest that PTSD may be an important target for jail diversion programs.

  14. Is urbanization a risk factor for substance misuse?

    PubMed

    Schifano, Fabrizio

    2008-07-01

    More than half of the world's population is living in urban areas, but the evidence about urban-rural differences in drug use is not clearly defined. The present paper aims to review the international literature addressing the role of urbanization and related parameters in association with substance misuse. In particular, the evidence of urbanization being a risk factor for substance misuse is examined. Although it has been suggested that substance misuse is typically a characteristic of large urban areas, this did not appear to be a consistent observation from the literature review. Furthermore, the urban context may offer a relative proximity of health services and prompter emergency intervention in case of overdose. Although more efforts have to be put into explaining substance misuse in general, identifying which characteristics of the urban context are modifiable, and under what circumstances, is an important theoretical, empirical, and public health question.

  15. Descriptive study on parents' knowledge, attitudes and practices on antibiotic use and misuse in children with upper respiratory tract infections in Cyprus.

    PubMed

    Rousounidis, Andreas; Papaevangelou, Vassiliki; Hadjipanayis, Adamos; Panagakou, Sotiria; Theodoridou, Maria; Syrogiannopoulos, George; Hadjichristodoulou, Christos

    2011-08-01

    Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents' and pediatricians' Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p < 0.001). Pediatricians (N = 33) denied prescribing antibiotics after parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians' view differs.

  16. Descriptive Study on Parents’ Knowledge, Attitudes and Practices on Antibiotic Use and Misuse in Children with Upper Respiratory Tract Infections in Cyprus

    PubMed Central

    Rousounidis, Andreas; Papaevangelou, Vassiliki; Hadjipanayis, Adamos; Panagakou, Sotiria; Theodoridou, Maria; Syrogiannopoulos, George; Hadjichristodoulou, Christos

    2011-01-01

    Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p < 0.001). Pediatricians (N = 33) denied prescribing antibiotics after parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs. PMID:21909304

  17. Tackling drug and alcohol misuse in Brazil: priorities and challenges for nurses.

    PubMed

    Rassool, G H; Villar-Luis, M

    2004-12-01

    To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.

  18. Desipramine in opioid-dependent cocaine abusers maintained on buprenorphine vs methadone.

    PubMed

    Oliveto, A H; Feingold, A; Schottenfeld, R; Jatlow, P; Kosten, T R

    1999-09-01

    Cocaine abuse occurs in 40% to 60% of patients entering opioid maintenance treatment, and effective pharmacotherapies are needed for this combined dependence. This 13-week, randomized, double-blind, placebo-controlled trial evaluated the efficacy of desipramine hydrochloride (0 or 150 mg/d) plus buprenorphine hydrochloride (12 mg/d) or methadone hydrochloride (65 mg/d) in 180 opioid-dependent cocaine abusers (124 men, 56 women). Supervised urine samples were obtained thrice weekly, and self-reported cocaine and heroin use was reported once weekly. Desipramine plasma levels were determined at weeks 4 and 10. In men, opioid abstinence was increased more rapidly over time when treated with methadone than with buprenorphine, whereas cocaine abstinence was increased more with buprenorphine than with methadone. In women, opioid abstinence was increased the least rapidly when treated with buprenorphine plus placebo, while cocaine abstinence was increased more rapidly over time when treated with methadone than with buprenorphine. Regardless of sex or opioid medication, desipramine increased opioid and cocaine abstinence more rapidly over time than placebo. Self-reported opioid use confirmed these findings. Desipramine plasma levels were higher in women than in men, particularly those on buprenorphine maintenance. Higher desipramine plasma levels were associated with greater opioid, but not cocaine, abstinence. Desipramine may be a useful adjunctive medication in facilitating opioid and cocaine abstinence in opioid-maintained patients. The efficacy of opioid medications to treat opioid or cocaine dependence may differ by sex. These findings highlight the importance of including sex as a factor when examining treatment outcome in these types of trials.

  19. Review about gabapentin misuse, interactions, contraindications and side effects

    PubMed Central

    Quintero, Gabriel C

    2017-01-01

    The current work is targeted to review the risks of gabapentin misuse, its potential interactions with other drugs, side effects and use contraindications. This review consists of a total of 99 biographical references (from the year 1983 to 2016). A publication search of PubMed was performed from January 1983 to December 2016. It included animal studies, clinical studies, case studies and reviews related to gabapentin misuse, potential interactions, side effects and use contraindications. The search terms were gabapentin, anticonvulsant and antiepileptic. In general, it seems that gabapentin has risks of being misused based on the increased level of prescriptions, related fatalities, recreational misuse and higher doses of self-administration. The main reasons for gabapentin misuse are as follows: getting high, alleviating opioid withdrawal symptoms and potentiating methadone effects. Some of the main substances that interact with gabapentin are morphine, caffeine, losartan, ethacrynic acid, phenytoin, mefloquine and magnesium oxide. Some of the side effects caused by gabapentin are teratogenicity, hypoventilation, respiratory failure and myopathy. Finally, reports in general contraindicate the use of gabapentin in conditions such as myasthenia gravis and myoclonus. PMID:28223849

  20. Military Dependents: Services Provide Limited Confidentiality in Family Abuse Cases

    DTIC Science & Technology

    2000-04-01

    regarding family abuse. To respond to this mandate, we determined (1) the extent of reported spousal and child abuse within the military, (2) the degree...violence and as emotional and financial maltreatment, including any actions that harm or limit the spouse’s freedom of choice. Child abuse includes...military services has established a Family Advocacy Program to provide family counseling and to help ensure the safety of alleged spousal and child abuse victims.

  1. Sources of Prescriptions for Misuse by Adolescents: Differences in Sex, Ethnicity, and Severity of Misuse in a Population-Based Study

    ERIC Educational Resources Information Center

    Schepis, Ty S.; Krishnan-Sarin, Suchitra

    2009-01-01

    A study found that adolescents who recently acquired medication by buying it had the worst risk profile among all medications classes in terms of concurrent substance use and the severity of prescription misuse. It is hoped that the findings could help identify subgroups of adolescents prescription misusers who are most vulnerable to consequences…

  2. Distress Intolerance and Prescription Opioid Misuse Among Patients With Chronic Pain.

    PubMed

    McHugh, R Kathryn; Weiss, Roger D; Cornelius, Marise; Martel, Marc O; Jamison, Robert N; Edwards, Robert R

    2016-07-01

    The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance-the perceived or actual inability to manage negative emotional and somatic states-was associated with opioid misuse in those with chronic pain. A sample of 51 participants prescribed opioid analgesics for chronic back or neck pain were recruited for a 1-time laboratory study. Participants completed measures of distress intolerance and opioid misuse, and a quantitative sensory testing battery. Results suggested that distress intolerance was associated with opioid misuse, even controlling for pain severity and negative affect. Distress intolerance was not associated with pain severity, threshold, or tolerance, but was associated with self-reported anxiety and stress after noxious stimuli. This study found robust differences in distress intolerance between adults with chronic pain with and without opioid medication misuse. Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain. This study demonstrated that distress intolerance was associated with opioid misuse in adults with chronic pain who were prescribed opioids. Distress intolerance can be modified with treatment, and thus may be relevant not only for identification of risk for opioid misuse, but also for mitigation of this risk. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. Mindfulness treatment for substance misuse: A systematic review and meta-analysis.

    PubMed

    Li, Wen; Howard, Matthew O; Garland, Eric L; McGovern, Patricia; Lazar, Michael

    2017-04-01

    High rates of relapse following substance misuse treatment highlight an urgent need for effective therapies. Although the number of empirical studies investigating effects of mindfulness treatment for substance misuse has increased dramatically in recent years, few reviews have examined findings of mindfulness studies. Thus, this systematic review examined methodological characteristics and substantive findings of studies evaluating mindfulness treatments for substance misuse published by 2015. The review also includes the first meta-analysis of randomized controlled trials of mindfulness treatments for substance misuse. Comprehensive bibliographic searches in PubMed, PsycInfo, and Web of Science, identified 42 pertinent studies. Meta-analytic results revealed significant small-to-large effects of mindfulness treatments in reducing the frequency and severity of substance misuse, intensity of craving for psychoactive substances, and severity of stress. Mindfulness treatments were also effective in increasing rates of posttreatment abstinence from cigarette smoking compared to alternative treatments. Mindfulness treatment for substance misuse is a promising intervention for substance misuse, although more research is needed examining the mechanisms by which mindfulness interventions exert their effects and the effectiveness of mindfulness treatments in diverse treatment settings. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Parental alcohol dependence and the transmission of adolescent behavioral disinhibition: a study of adoptive and non-adoptive families.

    PubMed

    King, Serena M; Keyes, Margaret; Malone, Stephen M; Elkins, Irene; Legrand, Lisa N; Iacono, William G; McGue, Matt

    2009-04-01

    To examine the genetic and environmental influences of parental alcoholism on offspring disinhibited behavior. We compared the effect of parental alcoholism history on offspring in adoptive and non-adoptive families. In families with a history of parental alcohol dependence, we examined the effect of exposure to parental alcoholism symptoms during the life-time of the adolescent. Setting Assessments occurred at the University of Minnesota from 1998 to 2004. Adolescents adopted in infancy were ascertained systematically from records of three private Minnesota adoption agencies; non-adopted adolescents were ascertained from Minnesota birth records. Adolescents and their rearing parents participated in in-person assessments. For adolescents, measures included self- reports of delinquency, deviant peers, substance use, antisocial attitudes and personality. For parents, we conducted DSM-IV clinical assessments of alcohol abuse and dependence. A history of parental alcohol dependence was associated with higher levels of disinhibition only when adolescents were related biologically to their rearing parents. Within families with a history of parental alcoholism, exposure to parental alcohol misuse during the life-time of the adolescent was associated with increased odds of using alcohol in adopted adolescents only. These findings suggest that the association between a history of parental alcohol dependence and adolescent offspring behavioral disinhibition is attributable largely to genetic rather than environmental transmission. We also obtained some evidence for parental alcohol misuse as a shared environmental risk factor in adoptive families.

  5. [Situations related to drug misuse in public schools in the city of São Paulo, Brazil].

    PubMed

    Moreira, Fernanda Gonçalves; Silveira, Dartiu Xavier da; Andreoli, Sérgio Baxter

    2006-10-01

    To explore situations, attitudes and behavior of public elementary school education supervisors concerning psychoactive substance misuse. The study was carried out in the city of São Paulo, Southeastern Brazil, in 2002. Data were collected using a semi-structured questionnaire applied to eight key informants in the administrative area experienced in education supervision. Qualitative content analysis with ethnographic reference was conducted. Most discourses show that knowledge transmission is thought as essential for drug use prevention, though supervisors reported being ill-informed on this subject. The most frequent attitudes toward drug users are impotence and inability to act and sometimes a repressive attitude. These are motivated by misinformation and fear due to mistaken association of drug users and criminals. In situations indirectly related to drug abuse (family and behavior problems) more understanding and inclusive attitudes are reported, following the harm reduction paradigm. Theoretical capacity building of educators for preventive attitudes would support their skills developed through dealing with situations (in)directly related to drug abuse in schools. Thus, educators would feel more confident to make interventions for harm or risk reduction among drug users.

  6. [Psychopathology of the misuse of Subutex®: The Popeye syndrome].

    PubMed

    Békaert, J; Podevin, G

    2015-06-01

    High dose buprenorphine (HDB), commonly known as Subutex(®), is nowadays largely prescribed as a replacement therapy for major opiate dependence. Its sublingual administration allows a decrease in the withdrawal syndrome accompanying opiate abuse cessation. Over the past few decades, epidemiological data on people on replacement therapy have emphasized an increase in the misuse of Subutex(®) and more specifically intravenous injections of HDB. These growing practices pave the way to major physical consequences or even death. Several studies have highlighted the infectious, vascular, venous and arterial (pseudo-aneurysm) complications stemming from this habit. Among the possible vascular complications, we can notice the presence of abscess, venous thrombosis, phlegmons, skin necrosis, cellulite, and profound and superficial thrombophlebitis at injection sites. These can evolve into chronic edemas of the tips and subcutaneous nodules. The Popeye syndrome is one of the possible complications of this misuse. This syndrome is characterized by the swelling of both sides of the forearms and hands. These edemas tend to become persistent and to be paired with tissue changes such as skin thickening. Besides, the increase in the hands volume can occur bilaterally or sometimes in an asymmetrical way, accentuated on the hand of the non-dominant limb. This syndrome does not decrease, or just a little, after the stoppage of injections. It can have a psychological, social, psychopathological and esthetic impact. In this article, we will focus on the clinical case of a 43-year-old man, who is hospitalized in an addictology unit for massive injections of HDB. This patient suffers from a Popeye syndrome as well as from an alcoholic dependence. Following the description of psychopathological disorders, our analysis will originate from a clarification relative to the specificities of the practice of intravenous HDB injection to better sharpen the understanding of these misuses in

  7. Do Child Abuse and Maltreatment Increase Risk of Schizophrenia?

    PubMed Central

    Sideli, Lucia; Mule, Alice; La Barbera, Daniele

    2012-01-01

    Introduction IntroductionaaAlthough childhood abuse is a recognised risk factor for depression, post-traumatic stress disorder, and substance misuse, its role in the aetiology of psychotic disorder remained controversial. This is in part because the putative effect of childhood trauma on psychosis has been mostly evaluated by small, cross sectional, uncontrolled studies that raised methodological issues. Methods Papers concerning the association between childhood trauma and psychotic disorders (to November, 2011) were identified using a comprehensive search of PubMed, Psychinfo, and Scopus and analysing reference list of relevant papers. A narrative synthesis was used to summarise results. Results An association between childhood abuse and psychotic symptoms was consistently reported by large cross sectional surveys with an effect ranging from 1.7 to 15. However, we cannot conclude that the relationship is causal as lack of longitudinal studies prevent us from fully excluding alternative explanations such as reverse causality. Gender, cannabis use, and depressive and post-traumatic stress disorder symptoms appear to moderate the effect of childhood trauma on psychotic disorders. However, specificity of childhood abuse in psychotic disorders and, particularly, in schizophrenia has not been demonstrated. Conclusion Although the association between childhood abuse and psychosis has been replicated, the etiological role of such early adversity has yet to be fully clarified. So far none of the studies reported support the hypothesis that childhood abuse is either sufficient or necessary to develop a psychotic disorder. It seems likely that any effect of childhood abuse on schizophrenia needs to be understood in terms of genetic susceptibility and interaction with other environmental risk factors. PMID:22707958

  8. The Hispanic Americans Baseline Alcohol Survey (HABLAS): rates and predictors of alcohol abuse and dependence across Hispanic national groups.

    PubMed

    Caetano, Raul; Ramisetty-Mikler, Suhasini; Rodriguez, Lori A

    2008-05-01

    The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States. Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes either in English or Spanish. There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Further, although the highest rates of abuse and dependence are among those in their 20s, the rate decline with age is not as strong as in the U.S. population. Thus, Hispanics at older ages (40-49, 50-59) are at considerably more risk of dependence and its health consequences than the U.S. general population. This is particularly true of Puerto Rican and Mexican American men. Future analysis must take this heterogeneity into consideration by conducting national group-specific analysis. Prevention efforts must also be guided by these findings, which suggest that Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics.

  9. Sexual health risks and health-seeking behaviours among substance-misusing women.

    PubMed

    Edelman, Natalie Lois; Patel, Harish; Glasper, Anthony; Bogen-Johnston, Leanne

    2014-12-01

    To report on a survey of sexual health service needs among substance-misusing women attending a substance misuse service. Substance-misusing women carry a disproportionate burden of sexual ill health, yet the range and frequency of their sexual health risks, morbidities and service engagement are poorly understood. A cross-sectional survey of a convenience sample of substance-misusing women attending a substance misuse service. From 4 April 2010-17 September 2010, substance-misusing women in Hastings & Ore, UK, were invited to complete a paper questionnaire addressing: drug use; cervical cytology, sexually transmitted infection and HIV screening history; pregnancy history, perceived pregnancy risk and contraceptive advice and supply; sexual activity and assault. Of 91 respondents, 77 attended local drug treatment services - results comprise analysis of this sub-sample. The study sample was characterized by long-term opioid and crack cocaine use. Of 53% sexually active in the previous 4 weeks, 66% perceived they had experienced sexual intercourse that could lead to pregnancy during that time. Fifty-five per cent had been forced to have sex against their will during their lifetime. High rates of sexually transmitted infections, pregnancy termination, miscarriage and abnormal cervical cytology were reported. Findings indicate the need to recognize the breadth of elevated sexual health risks and morbidities experienced by substance-misusing women with long-term opioid/crack use, including those not identifying as intravenous drug users. Poor recall of drop-in and appointment times, reluctance to disclose substance misuse and likelihood of previous sexual assault present significant challenges to nurses, who must take a sensitive, opportunistic approach to referral and provision of sexual health interventions to substance-misusing women. © 2014 John Wiley & Sons Ltd.

  10. Risk Factors for Substance Misuse and Adolescents' Symptoms of Depression.

    PubMed

    Siennick, Sonja E; Widdowson, Alex O; Woessner, Mathew K; Feinberg, Mark E; Spoth, Richard L

    2017-01-01

    Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. The study used data from a place-randomized trial of the Promoting School-Community-University Partnerships to Enhance Resilience model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey, and social network data from 636 adolescents followed from sixth through ninth grades. When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. The Promoting School-Community-University Partnerships to Enhance Resilience interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Abuse-Deterrent Formulations and the Prescription Opioid Abuse Epidemic in the United States: Lessons Learned From OxyContin.

    PubMed

    Cicero, Theodore J; Ellis, Matthew S

    2015-05-01

    In an effort to reduce wide-scale abuse of the proprietary oxycodone hydrochloride formulation OxyContin, an abuse-deterrent formulation (ADF) was introduced in 2010. Although the reformulation produced an immediate drop in abuse rates, a definite ceiling effect appeared over time, beyond which no further decrease was seen. To examine the factors that led to the initial steep decline in OxyContin abuse and the substantial levels of residual abuse that have remained relatively stable since 2012. We used data from the ongoing Survey of Key Informants' Patients program, part of the Researched Abuse, Diversion and Addiction-Related Surveillance system that collects and analyzes postmarketing data on misuse and diversion of prescription opioid analgesics and heroin. For our survey study, patients with a DSM-V diagnosis of opioid use disorder and primary drug of abuse consisting of a prescription opioid or heroin (N = 10,784) at entry to 1 of 150 drug treatment programs in 48 states completed an anonymous structured survey of opioid abuse patterns (surveys completed from January 1, 2009, through June 30, 2014). A subset of these patients (n = 244) was interviewed to add context and expand on the structured survey. In addition to key demographic measures, past-month abuse of opioids was the primary measure in the structured surveys. In the interviews, the effect of the introduction of the ADF on drug-seeking behavior was examined. Reformulated OxyContin was associated with a significant reduction of past-month abuse after its introduction (45.1% [95% CI, 41.2%-49.1%] in January to June 2009 to 26.0% [95% CI, 23.6%-28.4%] in July to December 2012; P < .001; χ(2) = 230.83), apparently owing to a migration to other opioids, particularly heroin. However, this reduction leveled off, such that 25% to 30% of the sample persisted in endorsing past-month abuse from 2012 to 2014 (at study end [January to June 2014], 26.7% [95% CI, 23.7%-29.6%]). Among the 88 participants who

  12. Rehabilitation of drug abusers: the roles of perceptions, relationships and family supports.

    PubMed

    Adejoh, Samuel Ojima; Temilola, Olusegun M; Adejuwon, Funmilayo F

    2018-05-14

    The increase in the use, abuse and misuse of psychoactive substances is not just of concern to national government of different countries but poses a big problem to the international community as well as of a global public health challenge. The study explored the perceived influence of perceptions, relationships and family support on rehabilitation of drug abusers undergoing rehabilitation in a rehabilitation centre. The non-experimental study design was used. The study population was that of drug abuse patients undergoing rehabilitation in the Neuropsychiatric Hospital in Lagos. Purposive sampling technique was used to select the respondents. Forty drug abusers who were met the criteria of not being a psychotic, had undergone detoxification, in the last stages of rehabilitation and consented to voluntarily participate were interviewed using In-depth Interview Guide to collect qualitative data based on the objectives of the study. The data were manually content analysed. The drug abusers viewed their condition as a mental disorder, an illness, a bad and dangerous habit that can be treated. They viewed their relationship with their rehabilitation officers as professional and cordial, which is essential for the rehabilitation process. Financial, material and moral supports given by the family were identified as important catalysts for quick rehabilitation. Rehabilitation officers and policy makers should consider on improving on the role of professional relationships and family support in the rehabilitation process of drug abusers undergoing rehabilitation.

  13. An item response theory analysis of DSM-IV criteria for hallucinogen abuse and dependence in adolescents

    PubMed Central

    Wu, Li-Tzy; Pan, Jeng-Jong; Yang, Chongming; Reeve, Bryce B.; Blazer, Dan G.

    2009-01-01

    Aim This study applied both item response theory (IRT) and multiple indicators–multiple causes (MIMIC) methods to evaluate item-level psychometric properties of diagnostic questions for hallucinogen use disorders (HUDs), differential item functioning (DIF), and predictors of latent HUD. Methods Data were drawn from 2004–2006 National Surveys on Drug Use and Health. Analyses were based on 1548 past-year hallucinogen users aged 12–17 years. Substance use and symptoms were assessed by audio computer-assisted self-interviewing methods. Results Abuse and dependence criteria empirically were arrayed along a single continuum of severity. All abuse criteria indicated middle-to-high severity on the IRT-defined HUD continuum, while dependence criteria captured a wider range from the lowest (tolerance and time spent) to the highest (taking larger amounts and inability to cut down) severity levels. There was indication of DIF by hallucinogen users’ age, gender, race/ethnicity, and ecstasy use status. Adjusting for DIF, ecstasy users (vs. non-ecstasy hallucinogen users), females (vs. males), and whites (vs. Hispanics) exhibited increased odds of HUD. Conclusions Symptoms of hallucinogen abuse and dependence empirically do not reflect two discrete conditions in adolescents. Trends and problems related to hallucinogen use among girls and whites should be examined further to inform the designs of effective gender-appropriate and culturally sensitive prevention programs. PMID:19896773

  14. Distress Intolerance and Prescription Opioid Misuse among Patients with Chronic Pain

    PubMed Central

    McHugh, R. Kathryn; Weiss, Roger D.; Cornelius, Marise; Martel, Marc O.; Jamison, Robert N.; Edwards, Robert R.

    2016-01-01

    The risk for misuse of opioid medications is a significant challenge in the management of chronic pain. The identification of those who may be at greater risk for misusing opioids is needed to facilitate closer monitoring of high-risk subgroups, and may help to identify therapeutic targets for mitigating this risk. The aim of this study was to examine whether distress intolerance--the perceived or actual inability to manage negative emotional and somatic states--was associated with opioid misuse in those with chronic pain. A sample of 51 participants prescribed opioid analgesics for chronic back or neck pain were recruited for a one-time laboratory study. Participants completed measures of distress intolerance and opioid misuse, and a quantitative sensory testing battery. Results suggested that distress intolerance was associated with opioid misuse, even controlling for pain severity and negative affect. Distress intolerance was not associated with pain severity, threshold or tolerance, but was associated with self-reported anxiety and stress following noxious stimuli. This study found robust differences in distress intolerance between adults with chronic pain with and without opioid medication misuse. Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain. PMID:27058161

  15. Prescription opioid abuse and diversion in an urban community: the results of an ultrarapid assessment.

    PubMed

    Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Beard, Ronald A

    2009-04-01

    and progression of prescription and illicit drug abuse. The primary sources of prescription drugs on the street were the elderly, patients with pain, and doctor shoppers, as well as pill brokers and dealers who work with all of the former. The popularity of prescription drugs in the street market was rooted in the abusers' perceptions of these drugs as 1) less stigmatizing; 2) less dangerous; and, 3) less subject to legal consequences than illicit drugs. For many, the abuse of prescription opioids also appeared to serve as a gateway to heroin use. The diversion of prescription opioids might be reduced through physician education focusing on 1) recognizing that a patient is misusing and/or diverting prescribed medications; 2) considering a patient's risk for opioid misuse before initiating opioid therapy; and 3) understanding the variation in the abuse potential of different opioid medications currently on the market. Patient education also appears appropriate in the areas of safeguarding medications, disposal of unused medications, and understanding the consequences of manipulating physicians and selling their medications.

  16. Diagnostic orphans: comparing self-report lifetime course to groups with DSM-IV alcohol abuse and dependence.

    PubMed

    McBride, Orla; Adamson, Gary; Bunting, Brendan; McCann, Siobhan

    2009-01-01

    Research has highlighted the significant alcohol symptoms and mental health problems experienced by diagnostic orphans - individuals who experience 1-2 criteria of DSM-IV alcohol dependence but do not meet the criteria for a DSM-IV alcohol use disorder. This study used a sub-sample (n=34827) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), and formed mutually exclusive groups to compare the self-report retrospective course of diagnostic orphans to individuals with DSM-IV abuse and dependence. Multinomial logistic regressions were conducted to examine the associations between the groups and a range of demographic and clinical variables. Collectively, the findings demonstrate that diagnostic orphans shared similar characteristics to the abuse and dependence groups, but appeared to experience specific comorbid mental health problems. Orphan status has the potential to be a persistent condition and may result in significant dysfunction. In conclusion, diagnostic orphans represent a distinct group that may benefit from cost-effective treatment or intervention, designed to prevent the escalation of alcohol symptoms.

  17. Prevalence and Correlates of Stimulant Medication Misuse among the Collegiate Population

    ERIC Educational Resources Information Center

    Prosek, Elizabeth A.; Giordano, Amanda L.; Turner, Kori D.; Bevly, Cynthia M.; Reader, Emily A.; LeBlanc, Yvette; Molina, Citlali E.; Vera, Ryan A.; Garber, Sage Ann

    2018-01-01

    Misuse of stimulant medication is pervasive among college students. In this study, we surveyed undergraduate college students (N = 3,038) at a large-sized Southwestern university. We examined unique characteristics of students misusing stimulant medication with a prescription (n = 74) and those misusing without a prescription (n = 356). Both…

  18. Abuse-deterrent formulations: part 1 - development of a formulation-based classification system.

    PubMed

    Mastropietro, David J; Omidian, Hossein

    2015-02-01

    Strategies have been implemented to decrease the large proportion of individuals misusing abusable prescription medications. Abuse-deterrent formulations (ADFs) have been grown to incorporate many different technologies that still lack a systematic naming and organizational nomenclature. Without a proper classification system, it has been challenging to properly identify ADFs, study and determine common traits or characteristics and simplify communication within the field. This article introduces a classification system for all ADF approaches and examines the physical, chemical and pharmacological characteristics of a formulation by placing them into primary, secondary and tertiary categories. Primary approaches block tampering done directly to the product. Secondary approaches work in vivo after the product is administered. Tertiary approaches use materials that discourage abuse but do not stop tampering. Part 2 of this article discusses proprietary technologies, patents and products utilizing primary approaches. Drug products using opioid antagonists and aversive agents have been seen over the past few decades to discourage primarily overuse and injection. However, innovation in formulation development has introduced products capable of deterring multiple forms of tampering and abuse. Often, this is accomplished using known excipients and manufacturing methods that are repurposed to prevent crushing, extraction and syringeability.

  19. Struggling with one's own parenting after an upbringing with substance abusing parents.

    PubMed

    Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd

    2018-12-01

    To add to our knowledge concerning the key elements involved in the individual's experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children's ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.

  20. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey

    PubMed Central

    Victorri-Vigneau, Caroline; Dailly, Eric; Veyrac, Gwenaëlle; Jolliet, Pascale

    2007-01-01

    Aim To show that the nonbenzodiazepine hypnotic zolpidem has a higher abuse potential than previously documented. Method An official enquiry was carried out by the Nantes Centre for Evaluation and Information on Pharmacodependence (CEIP). The authors made a review of literature and analysed French data corresponding to the drug's postmarketing period collected by the CEIP network from 1993 to 2002. Results The literature review yielded mixed results concerning the behavioural effects of zolpidem. Data from the CEIP and the 53 literature case reports highlight significant dependence and abuse potential of zolpidem. Conclusions This study adds to the growing evidence that zolpidem has the potential for abuse and dependence. As a consequence, the French drug monograph has been modified by the French Health Authorities. PMID:17324242

  1. Substance misuse in life and death in a 2-year cohort of suicides.

    PubMed

    Galway, Karen; Gossrau-Breen, Diana; Mallon, Sharon; Hughes, Lynette; Rosato, Michael; Rondon-Sulbaran, Janeet; Leavey, Gerard

    2016-03-01

    Although substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide. To examine the relationship between substance misuse and subsequent suicide. Linkage of coroners' reports to primary care records for 403 suicides occurring over 2 years. With alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse. A deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a 'cause of death'. © The Royal College of Psychiatrists 2016.

  2. The Hispanic Americans Baseline Alcohol Survey (HABLAS): Rates and Predictors of Alcohol Abuse and Dependence Across Hispanic National Groups*

    PubMed Central

    CAETANO, RAUL; RAMISETTY-MIKLER, SUHASINI; RODRIGUEZ, LORI A.

    2008-01-01

    Objective The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States. Method Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents’ homes either in English or Spanish. Results There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Further, although the highest rates of abuse and dependence are among those in their 20s, the rate decline with age is not as strong as in the U.S. population. Thus, Hispanics at older ages (40–49, 50–59) are at considerably more risk of dependence and its health consequences than the U.S. general population. This is particularly true of Puerto Rican and Mexican American men. Conclusions Future analysis must take this heterogeneity into consideration by conducting national group-specific analysis. Prevention efforts must also be guided by these findings, which suggest that Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics. PMID:18432387

  3. Self-Perceived Weight and Anabolic Steroid Misuse Among US Adolescent Boys

    PubMed Central

    Jampel, Jonathan D.; Murray, Stuart B.; Griffiths, Scott; Blashill, Aaron J.

    2016-01-01

    Purpose Anabolic steroid misuse is a growing concern among adolescent boys, and chronic misuse is associated with multisystemic health consequences. However, little is known about weight related predictors of anabolic steroid misuse. We examined the prediction of lifetime anabolic steroid misuse as a function of self-perceived weight status among US adolescent boys. Methods Analysis was undertaken using the 2013 Youth Risk Behavior Survey, a nationally representative data set sampling public and private high school students throughout the United States. Data from a total of 6,000 US adolescent boys were used in the present study. Results The prevalence of ever misusing anabolic androgenic steroids was 12.6% among boys who viewed themselves as very underweight, 11.9% for boys who viewed themselves as very overweight, compared with 3.8% for boys who viewed themselves as about the right weight. Compared to boys who viewed themselves as about the right weight, boys who self-perceived themselves as very underweight (adjusted odds ratio = 6.9, 95% confidence interval: 2.7–17.7, p < .001) and very overweight (adjusted odds ratio = 3.8, 95% confidence interval: 1.8–7.7, p < .001) were significantly associated with increased risk of anabolic androgenic steroid misuse. Conclusions Large effect size estimates were revealed, suggesting that anabolic androgenic steroid misuse is not solely a function of boys desiring increased mass; boys who desire leanness are also likely to misuse anabolic androgenic steroids. Future prevention efforts should target not only boys who view themselves as underweight but also those who perceive themselves as overweight. PMID:26598061

  4. Prevalence of use, abuse and dependence on legal and illegal psychotropic substances in an adolescent inpatient psychiatric population.

    PubMed

    Niethammer, Oliver; Frank, Reiner

    2007-06-01

    To examine the prevalence of use, abuse, and dependence on legal and illegal psychotropic substances in an adolescent in-patient psychiatric population in relation to age and gender. Participants were all consecutive admissions (patients aged from 14 to 17) to the adolescent psychiatric in-patient unit. Of the 86 patients who met all the criteria for taking part in the study 70 were interviewed, giving a response rate of 81%. Prevalence of use and of substance use disorders were assessed through structured diagnostic interviews (M-CIDI), conducted from March 2000 through July 2000. We found high prevalence of use and of the diagnosis of legal and illegal psychotropic substances. Around 76% reported a regular use of tobacco, 44% regular alcohol use, and 40% regular use of illegal substances. Diagnosis (abuse or dependence) was found in 50% of cases for nicotine, 29% for alcohol, and 26% for illegal substances. The adolescent in-patient psychiatric population is at high risk of use, abuse, and dependence on legal and illegal psychotropic substances. It is important to diagnose these disorders (anamnesis, screening tools) and to install preventive and therapeutic programs in clinical therapeutic settings.

  5. An explorative, population-based study of female disability pensioners: the role of childhood conditions and alcohol abuse/dependence.

    PubMed

    Upmark, Marianne; Thundal, Kajsa-Lena

    2002-01-01

    This study investigates the association in women between conditions during childhood and adolescence and alcohol dependence or abuse in adulthood on the one hand, and disability pensions and long-term sickness absence on the other. A stratified population-based sample of women in Göteborg was interviewed. For analyses in this study the following variables were selected from the interview protocol: childhood and adolescence, education, employment, social class, self-rated physical health and alcohol dependence or abuse (ADA), with diagnoses assessed according to DSM-III-R. Information on disability pension and sickness absence was obtained from the local Social Insurance Office. Unfavourable conditions during childhood and adolescence and school difficulties as well as early deviant behaviours predicted disability pension and long-term sickness absence in adulthood. For most risk factors ADA could explain only a minor part of the odds ratios found in crude and age-adjusted analyses. It is concluded that conditions early in life are predictors in women of disability pension and long-term incapacity to work. There are similarities in the pattern of early risk factors for later alcohol dependence or abuse and for disability pension/long-term sickness absence.

  6. Predicting Alcohol Misuse Among College Students in the US and South Korea.

    PubMed

    Kim, Sang-Yeon; Ahn, Seokhoon; Lim, Tae-Seop

    2015-01-01

    This study examines contributing factors of alcohol misuse among college students in South Korea and the U.S. Exploratory factor analyses (EFA) on measurements of alcohol expectancy, alcohol efficacy, and accommodation resulted in social and personal causes for alcohol misuse. Social causes alone predicted alcohol misuse for both countries. Social factors constituted a much stronger predictor of alcohol misuse among South Korean students than among American students. Practical implications for effective deterrence of student binge drinking are discussed.

  7. Abusive supervision and subordinate performance: Instrumentality considerations in the emergence and consequences of abusive supervision.

    PubMed

    Walter, Frank; Lam, Catherine K; van der Vegt, Gerben S; Huang, Xu; Miao, Qing

    2015-07-01

    Drawing from moral exclusion theory, this article examines outcome dependence and interpersonal liking as key boundary conditions for the linkage between perceived subordinate performance and abusive supervision. Moreover, it investigates the role of abusive supervision for subordinates' subsequent, objective work performance. Across 2 independent studies, an experimental scenario study (N = 157; Study 1) and a time-lagged field study (N = 169; Study 2), the negative relationship between perceived subordinate performance and abusive supervision was found to hinge on a supervisor's outcome dependence on subordinates but not on a supervisor's liking of subordinates. Furthermore, Study 2 demonstrated (a) a negative association between abusive supervision and subordinates' subsequent objective performance and (b) a conditional indirect effect of perceived performance on subsequent objective performance, through abusive supervision, contingent on the degree of outcome dependence, although these relationships did not reach conventional significance levels when controlling for prior objective performance. All in all, the findings highlight the role of instrumentality considerations in relation to abusive supervision and promote new knowledge on both origins and consequences of such supervisory behavior. (c) 2015 APA, all rights reserved).

  8. Narrative and attachment in the process of recovery from substance misuse.

    PubMed

    Waters, Kathryn; Holttum, Sue; Perrin, Ines

    2014-06-01

    transferable IWMs were truly internalized and influential in the recovering minds of substance misusers. Clinical Psychologists can play a vital role in the recovery of substance misusers who are ready to work through their psychological recovery. Forming a positive therapeutic relationship is dependent on the psychologists fulfilling the role of positive attachment figures for the clients. © 2013 The British Psychological Society.

  9. Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients

    PubMed Central

    2013-01-01

    Background Emergency department (ED) patients comprise a high-risk population for alcohol misuse and sexual risk for HIV. In order to design future interventions to increase HIV screening uptake, we examined the interrelationship among alcohol misuse, sexual risk for HIV and HIV screening uptake among these patients. Methods A random sample of 18-64-year-old English- or Spanish-speaking patients at two EDs during July-August 2009 completed a self-administered questionnaire about their alcohol use using the Alcohol Use Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the HIV Sexual Risk Questionnaire. Study participants were offered a rapid HIV test after completing the questionnaires. Binging (≥ five drinks/occasion for men, ≥ four drinks for women) was assessed and sex-specific alcohol misuse severity levels (low-risk, harmful, hazardous, dependence) were calculated using AUDIT scores. Analyses were limited to participants who had sexual intercourse in the past 12 months. Multivariable logistic regression was used to assess the associations between HIV screening uptake and (1) alcohol misuse, (2) sexual risk for HIV, and (3) the intersection of HIV sexual risk and alcohol misuse. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated. All models were adjusted for patient demographic characteristics and separate models for men and women were constructed. Results Of 524 participants (55.0% female), 58.4% identified as white, non-Hispanic, and 72% reported previous HIV testing. Approximately 75% of participants reported drinking alcohol within the past 30 days and 74.5% of men and 59.6% of women reported binge drinking. A relationship was found between reported sexual risk for HIV and alcohol use among men (AOR 3.31 [CI 1.51-7.24]) and women (AOR 2.78 [CI 1.48-5.23]). Women who reported binge drinking were more likely to have higher reported sexual risk for HIV (AOR 2.55 [CI 1.40-4.64]) compared to women who do

  10. Homicide, schizophrenia and substance abuse or dependency.

    PubMed

    Beaudoin, M N; Hodgins, S; Lavoie, F

    1993-10-01

    Few studies have extensively studied the aggressive behaviours of mentally disordered offenders. This investigation compared 14 schizophrenics found not guilty of homicide by reason of insanity (NGRI) with 12 schizophrenics convicted of homicide. A comparison group of 15 homicide offenders with no major mental disorder was used. Drug and alcohol consumption, previous history of aggression against others as well as mental health were assessed using standardized, reliable, valid instruments. Significantly more of the inmates with no major mental disorder were diagnosed as having a history of drug or alcohol abuse or dependency (60%) than the NGRI schizophrenics (35.7%). In addition, both groups of convicted homicide offenders were more likely to have committed homicide under the influence of drugs or alcohol than the NGRI group. No significant difference distinguished the groups for the mean number of aggressive incidents. The subjects found NGRI assaulted more often during an acute phase of mental illness than the convicted schizophrenics. Although both groups appeared to have a similar number of hospitalizations, most of the hospitalizations of the convicted schizophrenics occurred after the crime.

  11. 4 CFR 202.3 - Prohibitions against misuse of seal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Prohibitions against misuse of seal. 202.3 Section 202.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD OFFICIAL SEAL § 202.3 Prohibitions against misuse of seal. (a) Falsely making, forging, counterfeiting, mutilating, or altering the Board seal or...

  12. 4 CFR 202.3 - Prohibitions against misuse of seal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 4 Accounts 1 2011-01-01 2011-01-01 false Prohibitions against misuse of seal. 202.3 Section 202.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD OFFICIAL SEAL § 202.3 Prohibitions against misuse of seal. (a) Falsely making, forging, counterfeiting, mutilating, or altering the Board seal or...

  13. Substance abuse disorders in nurses.

    PubMed

    Griffith, J

    1999-01-01

    Substance abuse is a serious concern in the profession of nursing. The American Nurses Association (1997) estimates that 10% to 20% of nurses have substance abuse problems, and that 6% to 8% of registered nurses are impaired due to their abuse of alcohol and other drugs. Chemical dependency is considered a disease that requires treatment. Early identification and treatment of the chemically dependent nurse is important for the safety of the public and for the well-being of the nurse and her profession. This article addresses substance abuse from a biopsychosocial perspective, and includes a description of an approach to treatment and suggestions for the role of nursing administration.

  14. Comment on "a comparison of buprenorphine + naloxone to buprenorphine and methadone in the treatment of opioid dependence during pregnancy: maternal and neonatal outcomes".

    PubMed

    Newman, Robert G; Gevertz, Susan G

    2013-01-01

    In a recent article, Lund et al sought to compare maternal and neonatal outcomes of various treatment regimens for opioid dependence during pregnancy.1 In their background, discussion the authors state that "In the United States buprenorphine plus naloxone [Suboxone(®)] … has been the preferred form of prescribed buprenorphine due to its reduced abuse liability relative to buprenorphine alone [Subutex(®)]." This claim is certainly consistent with the view of the firm that has manufactured and sold both products, Reckitt Benckiser. In September of 2011, the company announced that it was "… discontinuing distribution and sale of Subutex(®) tablets as we believe that mono product (product containing buprenorphine alone with no naloxone) creates a greater risk of misuse, abuse and diversion …".2 Supporting evidence for the alleged "reduced abuse liability" appears to be lacking, however, and evidence cannot be located in the two references cited by Dr. Lund and his co-authors, which in fact are silent on the subject of abuse potential.3,4 In contrast, it has been reported that the transition to buprenorphine/naloxone from the mono formulation has been associated with "… no reduction in injection risk behaviors among IDUs."5.

  15. Neuropsychology of perpetrators of domestic violence: the role of traumatic brain injury and alcohol abuse and/or dependence.

    PubMed

    Romero-Martínez, Ángel; Moya-Albiol, Luis

    2013-12-01

    Neuropsychological impairments of the executive functions, memory, attention, intelligence quotient, and empathy have been found in perpetrators of domestic violence (intimate partner violence). These impairments could be partially explained by alcohol abuse, dependence, or traumatic brain injuries. This study reviews the neuropsychological deficits of perpetrators of intimate partner violence. At the same it seeks to integrate and relate these main points with their neuroanatomical correlates. We have also established the relationship between alcohol abuse, dependence, brain damage (including traumatic brain injuries) and those deficits. Scientific literature has been reviewed by means of Google Scholar, PsycINFO, PubMed, Medline and ISI Web of Knowledge. Perpetrators of domestic violence present high mental rigidity, as well as low levels of inhibition, processing speed, verbal and attention skills, and abstract reasoning. Additionally, perpetrators show working and long play memory impairments. Moreover, those deficits could be impaired by traumatic brain injuries and alcohol abuse and/or dependence. Nonetheless, these both variables are not enough to explain the deficits. Functional abnormalities on the prefrontal and occipital cortex, fusiform gyrus, posterior cingulate gyrus, hippocampus, thalamus and amygdala could be associated with these impairments. An analysis of these mechanisms may assist in the development of neuropsychological rehabilitation programmes that could help improve current therapies.

  16. Prescription drug misuse and risk behaviors among young injection drug users.

    PubMed

    Johnson, Kristen M; Fibbi, Meghan; Langer, Debra; Silva, Karol; Lankenau, Stephen E

    2013-01-01

    Prescription drug misuse among young adults, especially opioids, is a substantial public health problem in the United States. Although risks associated with injection of illicit drugs are well established, injection and sexual risks associated with misuse of prescription drugs are under-studied. Forty young injection drug users aged 16 to 25 who reported injection of a prescription drug were recruited in 2008-09 in Los Angeles and New York City. Descriptive quantitative and qualitative data were analyzed to illustrate risky injection and sexual behaviors reported in this sample. Over half of participants engaged in risky injection behavior, three-quarters engaged in risky sexual behavior, nearly half reported both risky behaviors, and five did not report either risk behavior while misusing a prescription drug. Prescription opioids, tranquilizers, and stimulants were misused in the context of risky sexual behaviors while only opioids were misused in the context of injection risk behaviors. Access to clean syringes, attitudes and beliefs regarding hepatitis C, and risk reduction through partner selection were identified as key themes that contextualized risk behaviors. Although these findings help identify areas to target educational campaigns, such as prevention of sexually transmitted infections, risk behaviors specifically associated with prescription drug misuse warrant further study.

  17. Symbolic Boundaries, Subcultural Capital, and Prescription Drug Misuse across Youth Cultures

    PubMed Central

    Kelly, Brian C; Trimarco, James; LeClair, Amy; Pawson, Mark; Parsons, Jeffrey T; Golub, Sarit A

    2014-01-01

    Prescription drug misuse among young adults has surged over the past decade. Yet, the contexts surrounding this misuse remain unclear, particularly subcultural contexts. Many urban young adults participate in youth cultures. This paper describes the subcultural contexts of prescription drug misuse within youth subcultures. Drawing on ethnographic data collected over 12 months from different youth cultural scenes, the authors describe the subcultural bases of prescription drug misuse. The symbolic boundaries and subcultural capital inherent in these scenes shape the ways youth think about drugs and behave accordingly. While young adults are often lumped together, ethnographic data show considerable variation across these subcultures with regard to what may enable or inhibit prescription drug misuse. The broader subcultural ethos in each scene, as well as attitudes towards other types of drugs, frame the ways that prescription drugs are perceived and used within each of these scenes. In this regard, the findings highlight the role of symbolic boundaries and subcultural capital in drug use among young adults by shaping their routine practices. These data highlight that education campaigns about prescription drug misuse should account for the variability in youth cultural scenes to maximize the efficacy of these messages aimed at young adults. PMID:25529457

  18. The association between speed of transition from initiation to subsequent use of cannabis and later problematic cannabis use, abuse and dependence.

    PubMed

    Hines, Lindsey A; Morley, Katherine I; Strang, John; Agrawal, Arpana; Nelson, Elliot C; Statham, Dixie; Martin, Nicholas G; Lynskey, Michael T

    2015-08-01

    To test whether speed of transition from initiation use to subsequent use of cannabis is associated with likelihood of later cannabis dependence and other outcomes, and whether transition speed is attributable to genetic or environmental factors. Cross-sectional interview study. Australia. A total of 2239 twins and siblings who reported using cannabis at least twice [mean age at time of survey = 32.0, 95% confidence interval (CI) = 31.9 - 32.1, range = 22-45]. Time between initiation and subsequent cannabis use (within 1 week; within 3 months; between 3 and 12 months; more than 1 year later), later use of cannabis and symptoms of DSM-IV cannabis abuse/dependence. Multinomial regression analyses (comparison group: more than 1 year later) adjusted the association between speed of transition and the outcomes of cannabis daily use, abuse/dependence and treatment-seeking after controlling for socio-demographic, childhood, mental health, peer and licit drug factors. Twin modelling estimated the proportion of variance in transition speed attributable to genetic (A), common environment (C) and unique environmental (E) factors. Subsequent use of cannabis within 1 week of initiation was associated with daily use [odds ratio (OR) = 2.64, 95% CI = 1.75-3.99], abuse and/or dependence (OR = 3.25, 95% CI = 2.31-4.56) and treatment-seeking for cannabis problems (OR = 1.89, 95% CI = 1.03-3.46). Subsequent use within 3 months was associated with abuse and/or dependence (OR = 1.61, 95% CI = 1.18-2.19). The majority of the variation of the speed of transition was accounted for by unique environment factors (0.75). Rapid transition from initiation to subsequent use of cannabis is associated with increased likelihood of subsequent daily cannabis use and abuse/dependence. © 2015 Society for the Study of Addiction.

  19. Brief Family Based Intervention for Substance Abusing Adolescents

    PubMed Central

    Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony

    2015-01-01

    Synopsis Research has consistently shown that a lack of parental involvement in the activities of their children predicts initiation and escalation of substance use. Parental monitoring, as well as youth disclosure about their whereabouts, parent child communication, positive parenting and family management strategies, e.g., consistent limit setting, and parental communication about and disapproval of substance use, have all been shown to protect against adolescent substance abuse and substance problems. Given the empirical evidence, family and parenting approaches to preventing and intervening on adolescent substance misuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief family-based intervention for adolescent substance use. PMID:26092741

  20. Not Just Academics: Paths of Longitudinal Effects From Parent Involvement to Substance Abuse in Emerging Adulthood.

    PubMed

    Hayakawa, Momoko; Giovanelli, Alison; Englund, Michelle M; Reynolds, Arthur J

    2016-04-01

    By the 12th grade, half of American adolescents have abused an illicit drug at least once (Johnston et al., 2015). Although many substance misuse prevention programs exist, we propose an alternative mechanism for reducing substance use. There is evidence that parent involvement is related to reductions in children's behavior problems which then predict later substance abuse. We examine the Child-Parent Center (CPC) program, an early childhood intervention, as a strategy to impact substance abuse. We conducted a path analysis from CPC to parent involvement through early adolescent problem behaviors and competencies to young adult substance abuse. Participants (N = 1,203; 51.5% female; 93.8% African-American) were assessed from age 3 to 26 years. CPC participation initiates a pathway to increased parent involvement and expectations, which positively impact adolescents' competencies and problem behaviors, lowering rates of substance abuse. Through early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with a foundation for positive behaviors and encouraging adaptive functioning in adolescence. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Health and Social Problems Associated with Prescription Opioid Misuse Among a Diverse Sample of High Risk Substance-Using MSM

    PubMed Central

    Buttram, Mance E.; Kurtz, Steven P.; Surratt, Hilary L.; Levi-Minzi, Maria A.

    2013-01-01

    This study examines associations between prescription opioid misuse and demographics, substance use, sexual behavior, and related health and social problems. Baseline data were collected between 2008 and 2010 from 515 high risk men who have sex with men (MSM), ages 18–55, in the Miami-Ft. Lauderdale metropolitan area who reported heavy substance use and HIV risk in the past 90 days. Prescription opioid misuse was associated with other substance use, drug injection, substance dependence, and history of arrest. Implications, limitations, and directions for future study are discussed. PMID:23971894

  2. Measuring benefits of opioid misuse treatment for economic evaluation: health related quality of life of opioid dependent individuals and their spouses as assessed by a sample of the US population

    PubMed Central

    Wittenberg, Eve; Bray, Jeremy W.; Aden, Brandon; Gebremariam, Achamyeleh; Nosyk, Bohdan; Schackman, Bruce R.

    2016-01-01

    Aims To understand how the general public views the quality of life effects of opioid misuse and opioid use disorder on an individual and his/her spouse, measured in terms used in economic evaluations. Design Cross-sectional internet survey of a US-population-representative respondent panel conducted December 2013-January 2014. Setting USA. Participants 2,054 randomly-selected adults; 51% male (before weighting). Measurements Mean (95% CI) and median health “utility” for 6 opioid misuse and treatment outcomes: active injection misuse; active prescription misuse; methadone maintenance therapy at initiation, and when stabilized in treatment; and buprenorphine therapy at initiation, and when stabilized. Utility is a numerical representation of health-related quality of life used in economic evaluations to “adjust” estimated survival to include peoples' preferences for health states. Utilities are determined by surveying the general population to estimate the value they assign to particular health states—on a scale where 0=the value of being dead, and 1.0=the value of being in perfect health. Spouse spillover utility is assigned to a spouse of an individual who is in a particular health state. Findings Mean individual utility ranged from 0.574 (95%CI: 0.538, 0.611) for active injection opioid misuse to 0.766 for stabilized buprenorphine therapy (95%CI: 0.738, 0.795), with other states in between. Female respondents assigned higher utility to the active prescription misuse and buprenorphine therapy at initiation states than did males (p<0.05); all other states did not differ by respondent gender. Mean spousal utilities were significantly lower than 1.0 but mostly higher than individual utility, and were similar between male and female respondents. Conclusions In the opinion of the US public, injection opioid misuse results in worse health-related quality of life than prescription misuse, and methadone therapy results in worse health-related quality of life

  3. [On the risk of dependence on gabapentinoids].

    PubMed

    Bonnet, Udo; Scherbaum, Norbert

    2018-02-01

    In the last ten years, the prescriptions of the gabapentinoids gabapentin and pregabalin increased largely also in Germany. Since several national and international pharmacovigilance-databases have warned for abuse liabilities and overdose fatalities in association with both gabapentinoids, which moreover, became to be sold on internet and black-markets, their addictive power has been subject to an ongoing clinical debate. As pre- and post-approval clinical trials did not reveal significant signs of dependence on gabapentin or pregabalin, we systematically searched in PubMed and Scopus for clinical studies and case reports being associated with abuse of and dependence on these drugs. We found 14 clinical-epidemiologic studies and 38 case reports/series. These were evaluated for i) fulfilled dependence criteria according to ICD-10, ii) non-medical self-administration and their duration, iii) relapses, iv) social sequels, and v) cases seeking treatment for misusing gabapentin or pregabalin. Mostly, the cases of abuse of and dependence on gabapentinoids appeared to be associated with other substance dependencies, primarily opiate dependence and polyvalent drug use. Drug users preferred pregabalin citing a faster and stronger euphoria ("liking") than achievable with oral gabapentin. Both gabapentinoids were anxiolytic in therapeutic doses, stimulating in lower and sedating along with increasing doses. Fatalities have been described mainly in the population of opiate dependents and polyvalent drug users, predominantly together with excessive pregabalin overdosing. It is debated whether the gabapentinoids were indeed the main cause of death in these cases or whether gabapentin and pregabalin had been only bystanders. Tolerance and withdrawal symptoms (physical dependence) of gabapentinoids appeared to be common in medical and non-medical use of gabapentinoids. There were only 4 persons who had fulfilled behavioral dependence criteria of gabapentinoids (all had used

  4. Emotion Dysregulation Facets as Mediators of the Relationship between PTSD and Alcohol Misuse

    PubMed Central

    Tripp, Jessica C.; McDevitt-Murphy, Meghan E.

    2015-01-01

    Introduction Posttraumatic stress disorder (PTSD) and alcohol misuse, which frequently co-occur among combat veterans, have been linked to emotion dysregulation. Emotion dysregulation may explain the link between PTSD and alcohol misuse, and this investigation tested emotion dysregulation as a mediator of that relationship. Method Correlations between PTSD symptoms and cluster symptoms, emotion dysregulation full and subscales, and alcohol misuse were examined in a sample of 139 combat Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans (45% African American; 89% men). Emotion dysregulation full scale and subscales were examined as mediators of the relationship between PTSD symptoms and alcohol misuse for the full sample and men only. Results PTSD symptoms and symptom clusters, emotion dysregulation, and alcohol misuse showed positive correlations for the full sample and men only. Neither the full scale of emotion dysregulation nor the facets of emotion dysregulation mediated the relationship between PTSD symptoms and alcohol misuse for the full sample; among men, the Impulse Control Difficulties when Upset and Lack of Emotional Clarity subscales were mediators of that relationship. Conclusions Impulse control difficulties and lack of emotional clarity may play an important role in the link between PTSD and alcohol misuse for male veterans and should be an important target in treatment for individuals with both disorders disorders. Addressing impulse control difficulties and lack of emotional clarity in those with PTSD and alcohol misuse may improve outcomes by helping individuals identify and describe upsetting emotions and develop healthy coping alternatives to alcohol misuse. PMID:25864136

  5. Association of Physical Activity with Alcohol Abuse and Dependence in a Nationally-Representative U.S. Sample.

    PubMed

    Damian, April Joy; Mendelson, Tamar

    2017-11-10

    Alcohol use is a pervasive and costly public health problem in the United States. Relapse rates from alcohol use disorders are high. Although exercise has been proposed as a strategy to prevent relapse, lifestyle modification is the least studied aspect of relapse prevention programs, especially among racial/ethnic minority populations. The current study assessed whether being physically active was associated with remission from alcohol abuse or dependence among Black (African American and Afro Caribbean) adults in the U.S. We utilized data on Black adult participants (n = 4,828) from the nationally representative National Survey of American Life (NSAL) conducted in 2001-2003. Logistic regression models were estimated to assess the odds of being in 12-month remission or currently meeting DSM-IV criteria for alcohol abuse or dependence based on level of physical activity, adjusting for socio-demographic and neighborhood characteristics. People who endorsed being physically active had higher odds of being in 12-month remission from alcohol use problems (OR: 1.67, 95% CI: 1.28, 2.17) than people who were physically inactive, adjusting for individual- and neighborhood-level characteristics. People who were physically active did not differ significantly from those who were inactive with respect to odds of currently meeting DSM-IV criteria for alcohol abuse or dependence. Conclusions/Importance: Physical activity was positively associated with being in 12-month remission from alcohol use problems. Longitudinal studies are needed to establish temporal ordering and to explore exercise as a potential relapse prevention strategy for alcohol use problems.

  6. Use and Misuse of Opioids in Maine: Results From Pharmacists, the Prescription Monitoring, and the Diversion Alert Programs

    PubMed Central

    Piper, Brian J.; Desrosiers, Clare E.; Lipovsky, John W.; Rodney, Matthew A.; Baker, Robert P.; McCall, Kenneth L.; Nichols, Stephanie D.; Martin, Sarah L.

    2016-01-01

    Objective: Although opioids have substantial efficacy for acute pain management, escalation to opioid misuse and abuse is a persistent concern. This report assesses the current status of the opioid epidemic in Maine using three complementary data sets. Method: A representative sample of pharmacists (N = 275) completed an online survey regarding the extent that opioids affected their practice. A county-level analysis of opioid prescriptions (N = 1.22 million) reported to the Maine Prescription Monitoring Program (M-PMP) in 2014 and the agents implicated in arrests as reported to the Maine Diversion Alert Program (DAP, N = 2,700) in 2014/15 also was completed. Results: A significantly greater number of pharmacists agreed that opioid misuse (85.9%), rather than diversion (76.8%) or access (54.2%), was a concern. Only half (56.2%) reported use of the M-PMP. Opioids were dispensed to 22.4% of residents (37.7% of women in their 80s). This was enough to supply everyone in Maine with a 16.1-day supply. Buprenorphine accounted for almost half of opioid prescriptions to young adults (46.3% women, 49.3% men). Arrests increased by 13.3% from 2014 to 2015, and the proportion of arrests that involved prescription opioids decreased while those involving stimulants and heroin were elevated. Conclusions: Pharmacists are very aware of the potential for opioid misuse, but many do not consistently use the M-PMP. There continues to be substantial legitimate use, as well as criminal activity, involving oxycodone and other prescription opioids. Continued vigilance and use of tools like the PMP and DAP are necessary to minimize nonmedical use of opioids in Maine. PMID:27340958

  7. Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews.

    PubMed

    Das, Jai K; Salam, Rehana A; Arshad, Ahmed; Finkelstein, Yaron; Bhutta, Zulfiqar A

    2016-10-01

    Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. We conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. We report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. Our overview findings suggest that among smoking/tobacco interventions, school-based prevention programs and family-based intensive interventions typically addressing family functioning are effective in reducing smoking. Mass media campaigns are also effective given that these were of reasonable intensity over extensive periods of time. Among interventions for alcohol use, school-based alcohol prevention interventions have been associated with reduced frequency of drinking, while family-based interventions have a small but persistent effect on alcohol misuse among adolescents. For drug abuse, school-based interventions based on a combination of social competence and social influence approaches have shown protective effects against drugs and cannabis use. Among the interventions targeting combined substance abuse, school-based primary prevention programs are effective. Evidence from Internet-based interventions, policy initiatives, and incentives appears to be mixed and needs further research. Future research should focus on evaluating the effectiveness of specific interventions components with standardized intervention and outcome measures. Various delivery platforms, including digital platforms and policy initiative, have the potential to improve substance abuse outcomes among adolescents; however, these require further research. Copyright © 2016 Society for Adolescent Health and Medicine

  8. Management of alcohol misuse in patients with liver diseases

    PubMed Central

    Peng, Jennifer L; Patel, Milan Prakash; McGee, Breann; Liang, Tiebing; Chandler, Kristina; Tayarachakul, Sucharat; O’Connor, Sean; Liangpunsakul, Suthat

    2017-01-01

    Excessive alcohol use not only causes alcoholic liver disease (ALD) but also increases the risk of liver-related mortality in patients who already have other chronic liver diseases. Screening for alcohol misuse or alcohol use disorder (AUD) among patients with underlying liver disease is essential. This clinical review covers what is known about ALD, the impact of alcohol in patients with underlying liver diseases, current management of alcohol misuse and AUD, and the management of alcohol misuse and AUD specifically in patients with liver diseases. Several treatment options for alcohol misuse and AUD exist such as psychosocial intervention and behavioral and pharmacological therapies. The strategies used in the treatment of alcohol misuse and AUD are still applicable in those who consume alcohol and have underlying liver disease. However, certain medications still need to be carefully used due to potentially worsening already compromised liver function. Screening of ongoing alcohol use in subjects with liver disease is important, and prompt intervention is needed to prevent the associated morbidity and mortality from the detrimental effects of continued alcohol use on underlying liver disease. Considering alcoholism is a complex disease, probably a multidisciplinary approach combining psychotherapy and comprehensive medical care will be the most effective. Future research could focus on identifying additional treatment options for addressing the psychotherapy component since the self-determination and will to quit drinking alcohol can play such a crucial role in promoting abstinence. PMID:27940551

  9. Readability of Self-Report Alcohol Misuse Measures

    PubMed Central

    McHugh, R Kathryn; Sugarman, Dawn E; Kaufman, Julia S; Park, Sara; Weiss, Roger D; Greenfield, Shelly F

    2014-01-01

    Objective: Self-report measures of alcohol misuse and alcohol use disorders are valuable assessment tools for both research and clinical practice settings. However, readability is often overlooked when establishing the validity of these measures, which may result in measures written at a reading-grade level that is higher than the ability level of many potential respondents. The aim of the current study was to estimate the reading-grade level of validated measures of alcohol misuse and associated problems. Method: A total of 45 measures were identified, and reading-grade level was calculated using three validated readability formulas. Results: The majority of measures were written above the recommended reading-grade level for patient materials (5th–6th grade), with particularly poor readability for measure instructions. Conclusions: Given that many self-report alcohol misuse measures are written at a high reading-grade level, the consideration of readability is important when selecting measures for use in research and practice settings. Moreover, the development or modification of measures to target low-literacy populations may facilitate the broader applicability of these instruments. PMID:24650827

  10. Medication misuse in India: a major public health issue in India.

    PubMed

    Porter, Gillian; Grills, Nathan

    2016-06-01

    In India, it has been estimated that 50% of family spending on healthcare is on unnecessary medications or investigations. This, combined with the wide availability of medications, has seemingly contributed to increasing rates of antibiotic resistance and further impoverishment. In this literature review, we aim to characterize the extent of misuse and describe underlying factors contributing to the misuse of medication in India. This literature review included relevant articles published after 2000 that assessed medication use and misuse in India. A narrative review framework was used to analyse each article, confirm its inclusion, extract relevant information and group the findings under thematic areas. There were 115 articles included in this literature review. The literature demonstrated that the misuse of medications in India is widespread. The factors resulting in this involves all levels of the health system including regulation, enforcement and policy, healthcare providers and consumers. This is one of the most comprehensive reviews of medication misuse in India. It indicates the widespread nature of the problem and so highlights the need for action. This review provides a detailed understanding as to the complex interplay of factors that result in medication misuse in India. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Chemical dependence - resources

    MedlinePlus

    Substance use - resources, Drug abuse - resources; Resources - chemical dependence ... and Drug Dependence -- ncadd.org National Institute on Drug Abuse -- www.drugabuse.gov Substance Abuse and Mental Health ...

  12. Unsafe from the Start: Serious Misuse of Car Safety Seats at Newborn Discharge.

    PubMed

    Hoffman, Benjamin D; Gallardo, Adrienne R; Carlson, Kathleen F

    2016-04-01

    To estimate prevalence of car safety seat (CSS) misuse for newborns on hospital discharge; and to identify potential risk and protective factors for CSS misuse. We randomly sampled 291 mother-baby dyads from the newborn unit of an academic health center. Participants completed a survey and designated someone (themselves or another caregiver) to position their newborn in the CSS and install the CSS in their vehicle. Certified child passenger safety technicians assessed positioning and installation using nationally standardized criteria. To examine factors associated with CSS misuse, we used logistic regression to compute ORs and 95% CIs. A total of 291 families (81% of those eligible) participated. Nearly all (95%) CSSs were misused, with 1 or more errors in positioning (86%) and/or installation (77%). Serious CSS misuse occurred for 91% of all infants. Frequent misuses included harness and chest clip errors, incorrect recline angle, and seat belt/lower anchor use errors. Families with mothers of color (OR, 6.3; 95% CI, 1.8-21.6), non-English language (OR, 4.9; 95% CI, 1.1-21.2), Medicaid (OR, 10.3; 95% CI, 2.4-44.4), or lower educational level (OR, 4.5; 95% CI, 1.7-12.4) were more likely to misuse CSSs. However, families that worked with a child passenger safety technician before delivery were significantly less likely to misuse their CSSs (OR, 0.1; 95% CI, 0.0-0.4). Nearly all parents of newborn infants misused CSSs. Resources should be devoted to ensuring families with newborns leave the hospital correctly using their CSS. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Personality disorder traits, family environment, and alcohol misuse: a multivariate behavioural genetic analysis.

    PubMed

    Jang, K L; Vernon, P A; Livesley, W J

    2000-06-01

    This study seeks to estimate the extent to which a common genetic and environmental basis is shared between (i) traits delineating specific aspects of antisocial personality and alcohol misuse, and (ii) childhood family environments, traits delineating broad domains of personality pathology and alcohol misuse. Postal survey data were collected from monozygotic and dizygotic twin pairs. Twin pairs were recruited from Vancouver, British Columbia and London, Ontario, Canada using newspaper advertisements, media stories and twin clubs. Data obtained from 324 monozygotic and 335 dizygotic twin pairs were used to estimate the extent to which traits delineating specific antisocial personality traits and alcohol misuse shared a common genetic and environmental aetiology. Data from 81 monozygotic and 74 dizygotic twin pairs were used to estimate the degree to which traits delineating personality pathology, childhood family environment and alcohol misuse shared a common aetiology. Current alcohol misuse and personality pathology were measured using scales contained in the self-report Dimensional Assessment of Personality Pathology. Perceptions of childhood family environment were measured using the self-report Family Environment Scale. Multivariate genetic analyses showed that a subset of traits delineating components of antisocial personality (i.e. grandiosity, attention-seeking, failure to adopt social norms, interpersonal violence and juvenile antisocial behaviours) are influenced by genetic factors in common to alcohol misuse. Genetically based perceptions of childhood family environment had little relationship with alcohol misuse. Heritable personality factors that influence the perception of childhood family environment play only a small role in the liability to alcohol misuse. Instead, liability to alcohol misuse is related to genetic factors common a specific subset of antisocial personality traits describing conduct problems, narcissistic and stimulus

  14. The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans.

    PubMed

    Hassija, Christina M; Jakupcak, Matthew; Maguen, Shira; Shipherd, Jillian C

    2012-04-01

    The present study evaluated the impact of combat and interpersonal trauma exposure in a sample of 115 U.S. women veterans from Gulf War I and the Iraq and Afghanistan wars on 3 postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Patients presenting for healthcare services at a Veterans Affairs postdeployment health specialty clinic completed screening questionnaires that assessed combat exposure, lifetime interpersonal trauma history of childhood neglect, physical, or sexual abuse, and adult sexual and physical assault. In a regression model, combat exposure was the only significant independent variable associated with PSS, DSS, and alcohol misuse (β = .42, .27 and B = 1.58, respectively) even after adding lifetime interpersonal assault exposure to the model. Results highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Incorporating combat exposure into routine screening procedures for Gulf War and Iraq and Afghanistan war women veterans can aid in mental health treatment planning. Copyright © 2012 International Society for Traumatic Stress Studies.

  15. Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications.

    PubMed

    Setlik, Jennifer; Bond, G Randall; Ho, Mona

    2009-09-01

    We sought to better understand the trend for prescription attention-deficit/hyperactivity disorder (ADHD) medication abuse by teenagers. We queried the American Association of Poison Control Center's National Poison Data System for the years of 1998-2005 for all cases involving people aged 13 to 19 years, for which the reason was intentional abuse or intentional misuse and the substance was a prescription medication used for ADHD treatment. For trend comparison, we sought data on the total number of exposures. In addition, we used teen and preteen ADHD medication sales data from IMS Health's National Disease and Therapeutic Index database to compare poison center call trends with likely availability. Calls related to teenaged victims of prescription ADHD medication abuse rose 76%, which is faster than calls for victims of substance abuse generally and teen substance abuse. The annual rate of total and teen exposures was unchanged. Over the 8 years, estimated prescriptions for teenagers and preteenagers increased 133% for amphetamine products, 52% for methylphenidate products, and 80% for both together. Reports of exposure to methylphenidate fell from 78% to 30%, whereas methylphenidate as a percentage of ADHD prescriptions decreased from 66% to 56%. Substance-related abuse calls per million adolescent prescriptions rose 140%. The sharp increase, out of proportion to other poison center calls, suggests a rising problem with teen ADHD stimulant medication abuse. Case severity increased over time. Sales data of ADHD medications suggest that the use and call-volume increase reflects availability, but the increase disproportionately involves amphetamines.

  16. Substance misuse prevention as corporate social responsibility.

    PubMed

    Radacsi, Gergely; Hardi, Peter

    2014-03-01

    All sectors of society should be involved in reducing substance misuse, including businesses. However, the business sector is typically involved only to the extent that their products compel them to be (e.g., alcohol producers promoting responsible alcohol consumption). This article examines why business participation has been limited and how embedding prevention within a framework of health promotion could increase participation. It reviews both Hungarian and international cases, concluding that although corporate social responsibility (CSR) offers a framework to approach substance misuse reduction, a different perception of the role of the business sector is necessary to make it viable.

  17. Children Living with Substance-Dependent or Substance-Abusing Parents: 2002 to 2007. The NSDUH Report

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2009

    2009-01-01

    This issue of "The NSDUH Report" examines the number of children living with substance-dependent or substance-abusing parents. It focuses on biological, step-, adoptive, and foster children under 18 years of age who were living with one or both parents at the time of the survey interview. All findings are based on annual averages from the…

  18. Alcohol misuse, depressive symptoms, and HIV/STI risks of US Hispanic women.

    PubMed

    McCabe, Brian E; Schaefer Solle, Natasha; Peragallo Montano, Nilda; Mitrani, Victoria B

    2017-10-01

    Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study's objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = -.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women's health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.

  19. Examining the Changing Influence of Predictors on Adolescent Alcohol Misuse

    ERIC Educational Resources Information Center

    Tyler, Kim A.; Stone, Rosalie Torres; Bersani, Bianca

    2007-01-01

    The purpose of this study was to examine whether the influence of key characteristics on adolescent alcohol misuse (i.e., maternal binge drinking, parenting, peers, school characteristics, and the adolescent's own behavior) change over time and whether predictors of adolescent alcohol misuse vary by gender and race/ethnicity. Using prospective,…

  20. The rate of cyber dating abuse among teens and how it relates to other forms of teen dating violence.

    PubMed

    Zweig, Janine M; Dank, Meredith; Yahner, Jennifer; Lachman, Pamela

    2013-07-01

    To date, little research has documented how teens might misuse technology to harass, control, and abuse their dating partners. This study examined the extent of cyber dating abuse-abuse via technology and new media-in youth relationships and how it relates to other forms of teen dating violence. A total of 5,647 youth from ten schools in three northeastern states participated in the survey, of which 3,745 reported currently being in a dating relationship or having been in one during the prior year (52 % were female; 74 % White). Just over a quarter of youth in a current or recent relationship said that they experienced some form of cyber dating abuse victimization in the prior year, with females reporting more cyber dating abuse victimization than males (particularly sexual cyber dating abuse). One out of ten youth said that they had perpetrated cyber dating abuse, with females reporting greater levels of non-sexual cyber dating abuse perpetration than males; by contrast, male youth were significantly more likely to report perpetrating sexual cyber dating abuse. Victims of sexual cyber dating abuse were seven times more likely to have also experienced sexual coercion (55 vs. 8 %) than were non-victims, and perpetrators of sexual cyber dating abuse were 17 times more likely to have also perpetrated sexual coercion (34 vs. 2 %) than were non-perpetrators. Implications for practice and future research are discussed.

  1. The Brisbane Longitudinal Twin Study: Pathways to Cannabis Use, Abuse, and Dependence project-current status, preliminary results, and future directions.

    PubMed

    Gillespie, Nathan A; Henders, Anjali K; Davenport, Tracy A; Hermens, Daniel F; Wright, Margie J; Martin, Nicholas G; Hickie, Ian B

    2013-02-01

    We describe the data being collected from the Brisbane Longitudinal Twin Study in Australia as part of the US National Institute on Drug Abuse (NIDA)-funded project, Pathways to Cannabis Use, Abuse and Dependence. The history, recruitment, assessment, and retention of twin families in this project are described in detail, along with preliminary findings and plans for future research. The goal of this NIDA project is to make a significant contribution to the discovery of quantitative trait loci influencing cannabis use disorders. Although the focus is cannabis use, abuse, and dependence in young adults, measures of comorbid illicit drug use disorders are also being collected. In addition, a variety of internalizing and externalizing disorders are being assessed, funded by support from the Australian National Health and Medical Research Council. Because these same twins have participated in numerous twin studies since 1992, future plans will include linking different phenotypes to investigate relationships between drug use, psychiatric disorders, and psychological phenotypes within cross-sectional and longitudinal or developmental frameworks.

  2. Feasibility of Implementing an Opioid Risk Mitigation System

    DTIC Science & Technology

    2016-05-20

    System 7. FUNDING RECEIVED FOR THIS STUDY? 181 YES 0 NO FUNDING SOURCE: JPC-5 Substance Abuse Working Group 8. DO YOU NEED FUNDING SUPPORT FOR...Perceptions •Provider ro I e Isett in g •Education/training ° Forma l training in pain or substance abuse relatively rare •Prior POMP experience ° Few...Active duty, retirees, dependents, injured, polytrauma •Opioid abuse /misuse/diversion •Patient needs and vulnerabilities 0 Let me make a comment on

  3. Struggling with one’s own parenting after an upbringing with substance abusing parents

    PubMed Central

    Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd

    2018-01-01

    ABSTRACT Aim: To add to our knowledge concerning the key elements involved in the individual’s experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. Methods: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Result: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. Conclusions: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children’s ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents. PMID:29482480

  4. Association of Alcohol Misuse With Sexual Identity and Sexual Behavior in Women Veterans.

    PubMed

    Lehavot, Keren; Williams, Emily C; Millard, Steven P; Bradley, Katharine A; Simpson, Tracy L

    2016-01-28

    Sexual minority women report greater alcohol misuse than heterosexual women in the general population, with more pronounced differences found among younger age groups. It is unknown whether these differences exist among women veterans. We evaluated differences in alcohol misuse across two dimensions of sexual orientation (identity and behavior) among women veterans, and examined whether these differences were modified by age. Women veterans were recruited via the internet to participate in an online survey. Participants provided information on their self-reported sexual identity and behavior and responded to the validated 3-item Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Regression models were used to compare the prevalence of alcohol misuse (AUDIT-C ≥ 3) and severity (AUDIT-C scores) across sexual identity and behavior and to test effect modification by age. Among the 702 participants (36% lesbian/bisexual), prevalence and severity of alcohol misuse varied by both sexual identity and behavior, but there were significant interactions with age. Prevalence and severity of alcohol misuse were higher among relatively younger self-identified lesbians compared to heterosexual women. Similarly, both prevalence and severity of alcohol misuse were generally higher among younger women who had any sex with women compared to those who had sex only with men. In this online study of women veterans, younger sexual minority women were more likely to screen positive for alcohol misuse, and they had more severe alcohol misuse, than their heterosexual counterparts. Prevention and treatment efforts focused specifically on sexual minority women veterans may be needed.

  5. The role of community nursing in providing integrated care for older people with alcohol misuse.

    PubMed

    Rao, Tony

    2014-02-01

    Alcohol misuse in older people is a growing problem for health and social care providers, but remains largely hidden from public view and therefore largely overlooked by commissioners. Many older people with alcohol misuse have a 'dual diagnosis' (alcohol misuse accompanying other mental disorders) rather than alcohol misuse alone, which requires specialist nursing expertise. Over the past 10 years, assessment of and interventions for the detection of alcohol misuse in older people have been developed within one London borough. This article details the background, strategy and outcomes of this service, which provides integrated care in a multi-disciplinary community mental health team covering an inner-city area with a high prevalence of alcohol misuse and dual diagnosis in older people.

  6. Seeking mental health care from private health practitioners among individuals with alcohol dependence/abuse; results from a study in the French general population.

    PubMed

    Constant, Aymery; Sherlaw, William; Kovess-Masfety, Viviane

    2017-03-01

    Better knowledge of the factors that have an impact on pathways to mental health care may contribute greatly to organizing optimum health-care delivery. However, surveillance systems concerning alcohol problems in the French general population are suboptimal. The objectives of this study were to investigate: 1) the prevalence of mental health-care seeking in individuals with alcohol abuse/dependence in France, 2) which category of medical practitioner was consulted, and 3) psychological and socio-environmental factors associated with mental health-care seeking. A total sample of 22,138 individuals was interviewed in a telephone survey. Individual data on alcohol dependence/abuse and other mental health disorders were collected using the Composite International Diagnosis Interview - short form. Mental health-care seeking was assessed, together with data on living conditions, deprivation, and self-reported drinking problems. Only respondents meeting criteria for alcohol dependence/abuse were included in analyses. Less than half of the 722 respondents with alcohol abuse/dependence had sought mental health care in the preceding 12 months, of whom 90.5% consulted their general practitioner (GP) (56.1%), or both a general practitioner and a psychiatrist (34.4%). Mental health-care seeking was associated with female sex, previous alcohol discussion with a doctor, and the presence of psychiatric comorbidities arising in the preceding 12 months. Living environment, socio-economic status, or self-reported drinking problems had no influence. A minority of people with alcohol abuse/dependence sought mental health care, mainly in relation to psychiatric comorbidities. In addition, most people consulting a GP were not referred to a psychiatrist. However, social deprivation and living in rural areas did not hinder mental health-care seeking among respondents. Adequate protocols to treat alcohol disorders could be implemented among private health-care providers to improve

  7. Prescription Opioid Use, Misuse, and Diversion among Street Drug Users in New York City

    PubMed Central

    Rees Davis, W.; Johnson, Bruce D.

    2008-01-01

    Objective The use of heroin, cocaine, and other drugs is well researched in New York City, but prescription opioids (POs) have been overlooked. This study documents patterns of PO use, misuse, and diversion among street drug users, and begins to indicate how drug culture practices interact with the legitimate therapeutic goals of PO prescriptions (e.g. pain management). Methods Staff completed interviews inquiring about the reasons for use of POs and illicit drugs with 586 street drug users. Ethnographers wrote extensive field notes about subjects’ complex patterns of PO use. Results Methadone was used (71.9%) and sold (64.7%) at a higher level than OxyContin, Vicodin, and Percocet, used by between 34% and 38% of the users and sold by between 28% and 41% of the sellers. Recent PO use is associated with the recency of using heroin and cocaine (p<.001). Half of the heroin/cocaine sellers sold POs, and one quarter of the PO sellers only sold POs. Subjects were classified into four groups by whether they diverted POs or used POs to relieve pain or withdrawal rather than for euphoria. This classification was associated with frequency of PO use, whether POs were obtained from doctors/pharmacies or from drug dealers and family members, and those mostly likely to use POs for pain and withdrawal. Conclusions POs are an important component of street drug users’ drug-taking regimes, especially those who are Physically III Chemical Abusers (PICA). Future research is needed to model PO use, misuse, and diversion among this population. PMID:17913395

  8. Prescription opioid use, misuse, and diversion among street drug users in New York City.

    PubMed

    Davis, W Rees; Johnson, Bruce D

    2008-01-01

    The use of heroin, cocaine, and other drugs is well researched in New York City, but prescription opioids (POs) have been overlooked. This study documents patterns of PO use, misuse, and diversion among street drug users, and begins to indicate how drug culture practices interact with the legitimate therapeutic goals of PO prescriptions (e.g. pain management). Staff completed interviews inquiring about the reasons for use of POs and illicit drugs with 586 street drug users. Ethnographers wrote extensive field notes about subjects' complex patterns of PO use. Methadone was used (71.9%) and sold (64.7%) at a higher level than OxyContin, Vicodin, and Percocet, used by between 34% and 38% of the users and sold by between 28% and 41% of the sellers. Recent PO use is associated with the recency of using heroin and cocaine (p<.001). Half of the heroin/cocaine sellers sold POs, and one quarter of the PO sellers only sold POs. Subjects were classified into four groups by whether they diverted POs or used POs to relieve pain or withdrawal rather than for euphoria. This classification was associated with frequency of PO use, whether POs were obtained from doctors/pharmacies or from drug dealers and family members, and those mostly likely to use POs for pain and withdrawal. POs are an important component of street drug users' drug-taking regimes, especially those who are Physically Ill Chemical Abusers (PICA). Future research is needed to model PO use, misuse, and diversion among this population.

  9. Incidence of iatrogenic opioid dependence or abuse in patients with pain who were exposed to opioid analgesic therapy: a systematic review and meta-analysis.

    PubMed

    Higgins, C; Smith, B H; Matthews, K

    2018-06-01

    The prevalence and incidence of chronic conditions, such as pain and opioid dependence, have implications for policy development, resource allocation, and healthcare delivery. The primary objective of the current review was to estimate the incidence of iatrogenic opioid dependence or abuse after treatment with opioid analgesics. Systematic electronic searches utilised six research databases (Embase, Medline, PubMed, Cinahl Plus, Web of Science, OpenGrey). A 'grey' literature search and a reference search of included articles were also undertaken. The PICOS framework was used to develop search strategies and the findings are reported in accordance with the PRISMA Statement. After eligibility reviews of 6164 articles, 12 studies (involving 310 408 participants) were retained for inclusion in the meta-analyses. A random effects model (DerSimonian-Laird method) generated a pooled incidence of opioid dependence or abuse of 4.7%. There was little within-study risk of bias and no significant publication bias; however, substantial heterogeneity was found among study effects (99.78%). Sensitivity analyses indicated that the diagnostic criteria selected for identifying opioid dependence or abuse (Diagnostic Statistical Manual (DSM-IV) vs International Classification of Diseases (ICD-9)) accounted for 20% and duration of exposure to opioid analgesics accounted for 18% of variance in study effects. Longer-term opioid analgesic exposure, and prescription of strong rather than weak opioids, were associated with a significantly lower incidence of opioid dependence or abuse. The incidence of iatrogenic opioid dependence or abuse was 4.7% of those prescribed opioids for pain. Further research is required to confirm the potential for our findings to inform prevention of this serious adverse event. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  10. 20 CFR 369.5 - Penalty for misuse of the seal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Penalty for misuse of the seal. 369.5 Section... OF THE SEAL OF THE RAILROAD RETIREMENT BOARD § 369.5 Penalty for misuse of the seal. Unauthorized use of the seal of the Railroad Retirement Board may result in criminal prosecution under applicable law. ...

  11. 20 CFR 369.5 - Penalty for misuse of the seal.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Penalty for misuse of the seal. 369.5 Section... OF THE SEAL OF THE RAILROAD RETIREMENT BOARD § 369.5 Penalty for misuse of the seal. Unauthorized use of the seal of the Railroad Retirement Board may result in criminal prosecution under applicable law. ...

  12. Life stress events and alcohol misuse: distinguishing contributing stress events from consequential stress events.

    PubMed

    Hart, Kenneth E; Fazaa, Norman

    2004-07-01

    This study examined the relationship between life stress events and level of alcohol misuse using two stress indices. The first index consisted of stress events that are not likely to be caused by alcohol misuse (i.e., alcohol uncontaminated stress events). The second stress index consisted of items that were judged as being likely consequences of alcohol misuse (i.e., alcohol contaminated stress events). Results based on a questionnaire study of 378 undergraduates in 2000 showed that level of alcohol misuse was much more strongly related to alcohol contaminated life stress events than alcohol uncontaminated life events. Comparative analysis of the coefficients of determination indicated the effect size of the association to alcohol contaminated life stress events was 240% larger than the corresponding effect size for the association to alcohol uncontaminated life events. Results suggest that studies, which are tests of the tension reduction hypothesis, should employ greater methodological rigor to ensure measures of life stress events are not inadvertently assessing the consequences of alcohol misuse. The results highlight the need to distinguish between stressful life events that contribute to alcohol misuse and stressful life events that are consequential to alcohol misuse.

  13. A dimensional approach to understanding severity estimates and risk correlates of marijuana abuse and dependence in adults

    PubMed Central

    WU, LI-TZY; WOODY, GEORGE E.; YANG, CHONGMING; PAN, JENG-JONG; REEVE, BRYCE B.; BLAZER, DAN G.

    2012-01-01

    While item response theory (IRT) research shows a latent severity trait underlying response patterns of substance abuse and dependence symptoms, little is known about IRT-based severity estimates in relation to clinically relevant measures. In response to increased prevalences of marijuana-related treatment admissions, an elevated level of marijuana potency, and the debate on medical marijuana use, we applied dimensional approaches to understand IRT-based severity estimates for marijuana use disorders (MUDs) and their correlates while simultaneously considering gender- and race/ethnicity-related differential item functioning (DIF). Using adult data from the 2008 National Survey on Drug Use and Health (N=37,897), DSM-IV criteria for MUDs among past-year marijuana users were examined by IRT, logistic regression, and multiple indicators–multiple causes (MIMIC) approaches. Among 6,917 marijuana users, 15% met criteria for a MUD; another 24% exhibited subthreshold dependence. Abuse criteria were highly correlated with dependence criteria (correlation=0.90), indicating unidimensionality; item information curves revealed redundancy in multiple criteria. MIMIC analyses showed that MUD criteria were positively associated with weekly marijuana use, early marijuana use, other substance use disorders, substance abuse treatment, and serious psychological distress. African Americans and Hispanics showed higher levels of MUDs than whites, even after adjusting for race/ethnicity-related DIF. The redundancy in multiple criteria suggests an opportunity to improve efficiency in measuring symptom-level manifestations by removing low-informative criteria. Elevated rates of MUDs among African Americans and Hispanics require research to elucidate risk factors and improve assessments of MUDs for different racial/ethnic groups. PMID:22351489

  14. Substance abuse in anaesthetists.

    PubMed

    Garcia-Guasch, Roser; Roigé, Jaume; Padrós, Jaume

    2012-04-01

    Anaesthesiologists have a significantly higher frequency of substance abuse by a factor of nearly 3 when compared with other physicians. This is still a current problem that must be reviewed. Many hypotheses have been formulated to explain why anaesthesiologists appear to be more susceptible to substance abuse than other medical professionals (genetic differences in sensitivity to opioids, stress, the association between chemical dependence and other psychopathology or the second-hand exposure hypothesis). Environmental exposure and sensitization may be an important risk factor in physician addiction. There is a long debate about returning to work for an anaesthetist who has been depending on opioid drugs, and recent debates are discussed. Institutional efforts have been made in many countries and physician health programmes have been developed. As drug abuse among anaesthesiologists has continued, new studies have been conducted to know the theories about susceptibility. Written substance abuse policies and controls must be taken in place and in all countries.

  15. Relationships between parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among South Korean adolescents.

    PubMed

    Park, Sookyung; Kim, Haeryun; Kim, Haesung

    2009-01-01

    This study examined the roles played by parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among adolescents in South Korea. Participants were adolescents between the ages of 15 and 22 years (mean, 18), residing in Seoul city and in surrounding Kyung-gi Province. Of 259 participants, 41.3% scored 2 or more on the POSIT scale, which suggested they met the problematic criteria for substance abuse risk. Logistic regression results suggested that the influence of social support on substance abuse risk among adolescents depended on the source of support--parents or peers. These findings need to be considered in the development of intervention programs for adolescents at risk for substance abuse.

  16. Does Power Distance Exacerbate or Mitigate the Effects of Abusive Supervision? It Depends on the Outcome

    ERIC Educational Resources Information Center

    Lian, Huiwen; Ferris, D. Lance; Brown, Douglas J.

    2012-01-01

    We predicted that the effects of abusive supervision are likely to be moderated by subordinate power distance orientation and that the nature of the moderating effect will depend on the outcome. Drawing upon work suggesting that high power distance orientation subordinates are more tolerant of supervisory mistreatment, we posited that high power…

  17. Prescription Drug Misuse and Sexual Behavior Among Young Adults.

    PubMed

    Wells, Brooke E; Kelly, Brian C; Rendina, H Jonathon; Parsons, Jeffrey T

    2015-01-01

    Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examined demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (ages 18 to 29) who misused prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs; more than three-quarters reported recent sex without a condom; and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that White race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts.

  18. Prescription Drug Misuse and Sexual Behavior among Young Adults

    PubMed Central

    Wells, Brooke E.; Kelly, Brian C.; Rendina, H. Jonathon; Parsons, Jeffrey T.

    2015-01-01

    Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of the alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examines demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (18–29) who misuse prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs, more than three quarters reported recent sex without a condom, and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that white race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts. PMID:25569204

  19. Motivations for Prescription Drug Misuse among Young Adults: Considering Social and Developmental Contexts

    PubMed Central

    LeClair, Amy; Kelly, Brian C.; Pawson, Mark; Wells, Brooke E.; Parsons, Jeffrey T.

    2015-01-01

    Aims As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants’ motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. Methods Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. Findings We identified experimentation and a “work hard, play hard” ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants’ social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. Conclusion Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of “recreation” and “self-medication” presently established in the research, policies targeting young adults may want to tailor intervention efforts based on motivations. PMID:26709337

  20. Motivations for Prescription Drug Misuse among Young Adults: Considering Social and Developmental Contexts.

    PubMed

    LeClair, Amy; Kelly, Brian C; Pawson, Mark; Wells, Brooke E; Parsons, Jeffrey T

    As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants' motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. We identified experimentation and a "work hard, play hard" ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants' social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of "recreation" and "self-medication" presently established in the research, policies targeting young adults may want to tailor intervention efforts based on motivations.

  1. Misuse and modification of fireworks with fatal injury.

    PubMed

    Fulcher, James; Luttrell, Harrison; Harvey, Whit; Ward, Michael

    2015-06-01

    Fireworks deaths are a rare event in the United States with minor injuries comprising most adverse events. We report the case of misuse and modification of a large "mortar" firework with fatal results. In this case, the firework charge was modified with additional fuses and placed into the launcher upside down. The decedent then held the mortar base closely to his chest and lit the modified fuse. The resulting explosion caused severe blunt force trauma with significant hydrostatic shock damage to the heart and liver. This cause highlights the dangers of fireworks, particularly when misused.

  2. Anabolic Steroid Misuse Among US Adolescent Boys: Disparities by Sexual Orientation and Race/Ethnicity.

    PubMed

    Blashill, Aaron J; Calzo, Jerel P; Griffiths, Scott; Murray, Stuart B

    2017-02-01

    To examine the prevalence of anabolic steroid misuse among US adolescent boys as a function of sexual orientation and race/ethnicity. We analyzed boys from the 2015 Youth Risk Behavior Survey (n = 6248; mean age = 16), a representative sample of US high school students. Lifetime prevalence of anabolic steroid misuse was dichotomized as never versus 1 or more times. Sexual minority boys reported elevated misuse compared with heterosexual boys, within each level of race/ethnicity. Black, Hispanic, and White sexual minority boys reported misuse at approximately 25%, 20%, and 9%, respectively. Sexual orientation health disparities in anabolic steroid misuse disproportionally affect Black and Hispanic sexual minority adolescent boys, but more research is needed to understand the mechanisms driving these disparities.

  3. 32 CFR 147.15 - Guideline M-Misuse of Information technology systems.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Guideline M-Misuse of Information technology... CLASSIFIED INFORMATION Adjudication § 147.15 Guideline M—Misuse of Information technology systems. (a) The... ability to properly protect classified systems, networks, and information. Information Technology Systems...

  4. 32 CFR 147.15 - Guideline M-Misuse of Information technology systems.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Guideline M-Misuse of Information technology... CLASSIFIED INFORMATION Adjudication § 147.15 Guideline M—Misuse of Information technology systems. (a) The... ability to properly protect classified systems, networks, and information. Information Technology Systems...

  5. 32 CFR 147.15 - Guideline M-Misuse of Information technology systems.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Guideline M-Misuse of Information technology... CLASSIFIED INFORMATION Adjudication § 147.15 Guideline M—Misuse of Information technology systems. (a) The... ability to properly protect classified systems, networks, and information. Information Technology Systems...

  6. 32 CFR 147.15 - Guideline M-Misuse of Information technology systems.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Guideline M-Misuse of Information technology... CLASSIFIED INFORMATION Adjudication § 147.15 Guideline M—Misuse of Information technology systems. (a) The... ability to properly protect classified systems, networks, and information. Information Technology Systems...

  7. 32 CFR 147.15 - Guideline M-Misuse of Information technology systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline M-Misuse of Information technology... CLASSIFIED INFORMATION Adjudication § 147.15 Guideline M—Misuse of Information technology systems. (a) The... technology systems may raise security concerns about an individual's trustworthiness, willingness, and...

  8. Volatile substance misuse among street children in India: a preliminary report.

    PubMed

    Sharma, Shridhar; Lal, Rakesh

    2011-01-01

    Although substance misuse among children in India has been documented for over a decade, volatile substance misuse (VSM) is a comparatively recent phenomenon there. This paper reviews available Indian studies about VSM among street children and documents the extent of misuse, experienced benefits and harms, and risk factors. Reported perceived benefits include enhanced physical strength, decreased shyness, sleep induction, feeling good, and numbing physical and psychological pain. Identified risk factors include domestic violence, a dictatorial father, presence of stepparents, migrant status, and substance use in the family. Limitations of the current paper and the need for further research are discussed.

  9. Deficits in Autonomic Indices of Emotion Regulation and Reward Processing Associated with Prescription Opioid Use and Misuse

    PubMed Central

    Garland, Eric L.; Bryan, Craig J.; Nakamura, Yoshio; Froeliger, Brett; Howard, Matthew O.

    2016-01-01

    Rationale Prescription opioid misuse and high dose opioid use may result in allostatic dysregulation of hedonic brain circuitry, leading to reduced emotion regulation capacity. In particular, opioid misuse may blunt the ability to experience and upregulate positive affect from natural rewards. Objectives The purpose of this study was to examine associations between opioid use/misuse and autonomic indices of emotion regulation capability in a sample of chronic pain patients receiving prescription opioid pharmacotherapy. Methods Chronic pain patients taking long-term opioid analgesics (N = 40) completed an emotion regulation task while heart rate variability (HRV) was recorded, as well as self-report measures of opioid misuse, craving, pain severity, and emotional distress. Based on a validated cut-point on the Current Opioid Misuse Measure, participants were grouped as opioid misusers or non-misusers. Opioid misuse status and morphine equivalent daily dose (MEDD) were examined as predictors of HRV and self-reports of emotion regulation. Results Opioid misusers exhibited significantly less HRV during positive and negative emotion regulation, and significantly less positive affect, than non-misusers, after controlling for confounders including pain severity and emotional distress. MEDD was inversely associated with positive emotion regulation efficacy. Conclusion Findings implicate the presence of reward processing deficits among chronic pain patients with opioid-misusing behaviors, and opioid dosage was associated with deficient emotion regulation, suggesting the presence of compromised top-down cognitive control over bottom-up hedonic processes. Emotion regulation among opioid misusers may represent an important treatment target. PMID:27933366

  10. Does Typography of Substance Abuse and Dependence Differ as a Function of Exposure to Child Maltreatment?

    ERIC Educational Resources Information Center

    Danielson, Carla Kmett; Amstadter, Ananda B.; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2009-01-01

    We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (N = 281). More than 60% of the sample reported a…

  11. Prevalence and Correlates of Prescription Drug Misuse Among a Racially Diverse Sample of Young Sexual Minority Men

    PubMed Central

    Mustanski, Brian

    2018-01-01

    Abstract Purpose: Sexual minority men (SMM) are at greater risk than heterosexual men for misusing prescription psychotropic medications. However, community prevalence estimates of prescription drug misuse among young SMM are lacking. The current study described lifetime and past-6-month stimulant, painkiller, and depressant/tranquilizer misuse in a large, racially diverse sample of 967 SMM aged 16–29 in Chicago, Illinois, and investigated demographic and other substance use associations. Methods: Data came from the baseline visit of the RADAR longitudinal cohort study. Associations were examined using bivariate and multivariable logistic regression. Results: A quarter of the sample reported ever misusing any prescription drug, and 14.2% reported recent misuse. Lifetime class-specific misuse was 16.9% for stimulants, 11.0% for painkillers, and 11.4% for depressants/tranquilizers; recent misuse was 8.0%, 5.7%, and 6.2%, respectively. In multivariable analysis, Non-Hispanic black participants had lower odds of lifetime stimulant and depressant/tranquilizer misuse and recent stimulant misuse than non-Hispanic white participants, and bisexual participants had greater odds of lifetime and recent painkiller and depressant/tranquilizer misuse than gay participants. Generally, using other substances was associated with greater odds of prescription drug misuse. Having ever been prescribed a psychotropic medication was associated with higher odds of lifetime painkiller misuse after controlling for covariates. Conclusion: These results provide critical information on a growing public health problem among young SMM. Future research should explore why differential rates of misuse exist across subgroups. New interventions emphasizing the risk of prescription drugs, discouraging drug sharing, and bolstering refusal and coping skills should be developed and evaluated. PMID:29360421

  12. Over-the-Counter and Out-of-Control: Legal Strategies to Protect Youths From Abusing Products for Weight Control

    PubMed Central

    Taylor, Lisa M.; Austin, S. Bryn

    2013-01-01

    Abuse of widely available, over-the-counter drugs and supplements such as laxatives and diet pills for weight control by youths is well documented in the epidemiological literature. Many such products are not medically recommended for healthy weight control or are especially susceptible to abuse, and their misuse can result in serious health consequences. We analyzed the government’s role in regulating these products to protect public health. We examined federal and state regulatory authority, and referred to international examples to inform our analysis. Several legal interventions are indicated to protect youths, including increased warnings and restrictions on access through behind-the-counter placement or age verification. We suggest future directions for governments internationally to address this pervasive public health problem. PMID:23237149

  13. Prevalence and correlates of prescription drug misuse among young, low-income women receiving public healthcare

    PubMed Central

    Berenson, Abbey B.; Rahman, Mahbubur

    2011-01-01

    The purpose of this study was to examine the prevalence and correlates of prescription drug misuse among young, low-income women seeking care at a public clinic in Texas. Collected data on 2976 women included frequency of use, demographic and reproductive characteristics, religiosity, smoking history, concurrent substance use, depressive symptoms, perceived stress, health beliefs, and exposure to traumatic events. Overall, 30% reported ever misusing a prescription drug; 15% reported misuse in the past year. Women who initiated sexual intercourse at <15 yo, used illicit drugs, and smoked everyday were more likely to have misused prescription drugs. Higher trauma, stress, and posttraumatic stress scores also were associated with ever misusing prescription drugs. This study adds to limited data available on medication misuse by young women with few resources and demonstrates needs for prevention efforts in public clinics. PMID:21745043

  14. Sexual maturation and control issues among sexually abused and non-abused anorexia patients.

    PubMed

    Walsh, J; Burns, F

    2000-09-01

    To assess the relative salience of the maintenance of control and the avoidance of sexual maturation as sources of motivation for maintaining pathological eating behaviours among sexually abused anorexic patients. A two-factor mixed experimental design was employed. Three independent groups (sexually abused anorexics (N = 12); non-abused anorexics (N = 9); non-anorexic/non-abused controls (N = 12)) constituted the between-subjects factor. Allocation to abuse/non-abuse group was dependent upon replies to a questionnaire-based measure of unwanted sexual experience. The within-subjects factor comprised three conditions in which words of various colours were presented to participants for colour-naming (Stroop, 1935). The conditions were represented by lists of neutral words, sexual maturation words, and control-related words. Two trials were carried out in each condition and mean response times were measured. Within-group analyses revealed that interference was greater from sexual maturation words than from control-related words among the sexually-abused anorexics, but of equal magnitude among non-abused counterparts. Between-groups analyses found that abused patients experienced marginally greater cognitive interference from sexual maturation words than the non-abused patients. Theoretically, support is offered for elaborated schematic models of cognitive processing. Clinically, treatment interventions may need to pay particular attention to issues of sexual maturation among sexually abused anorexic patients.

  15. The social costs of alcohol misuse in Estonia.

    PubMed

    Saar, Indrek

    2009-01-01

    The aim of this study was to estimate the social costs of alcohol misuse in Estonia in 2006. Using a prevalence-based cost-of-illness approach, both direct and indirect costs were considered, including tangible costs associated with health care, criminal justice, rescue services, damage to property, premature mortality, incarceration, incapability of working due to illnesses, and lower labor productivity. The results show that alcohol misuse cost Estonia more than EUR 200 million in 2006. The costs involved are estimated to represent 1.6% of the gross domestic product (GDP), which is relatively high in comparison with many other countries. In addition, the state receives less receipts from the alcohol excise tax than the costs that it incurs as a consequence of alcohol misuse, which points to the existence of economic inefficiency with respect to the alcohol market. The results of this study suggest that there is definitely a need for further cost-benefit analysis to reach a conclusion regarding the possible utility of government intervention. Copyright 2008 S. Karger AG, Basel.

  16. Drug Dependence and Abuse: A Selected Bibliography.

    ERIC Educational Resources Information Center

    National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD. National Clearinghouse for Drug Abuse Information.

    This selected list of references is designed to provide an introduction to both scientific and popular drug abuse literature. Criteria for selection are presented and include: (1) 1969 or 1970 books by recognized and authoritative writers, (2) current and responsible research, (3) classic books, articles and studies, and (4) factual popular…

  17. Childhood family characteristics and prescription drug misuse in a national sample of Latino adults.

    PubMed

    Vaughan, Ellen L; Waldron, Mary; de Dios, Marcel A; Richter, James; Cano, Miguel Ángel

    2017-08-01

    Prescription drug misuse is a growing public health concern and has been understudied in Latino populations. The current study tests the relationships between childhood and family characteristics and prescriptions drug misuse among adult Latinos. A subsample of 8,308 Latinos from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Logistic regression analyses tested associations between parental alcoholism, parental divorce before age 18, and parental death before age 18 and prescription drug misuse and prescription drug use disorder. Parental alcoholism and parental divorce increased the odds of both prescription drug misuse and use disorder. Parental death increased the odds of prescription drug use disorders. The results have important implications for understanding the complex associations between family psychosocial history and prescription drug misuse. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Anabolic Steroid Misuse Among US Adolescent Boys: Disparities by Sexual Orientation and Race/Ethnicity

    PubMed Central

    Calzo, Jerel P.; Griffiths, Scott; Murray, Stuart B.

    2017-01-01

    Objectives. To examine the prevalence of anabolic steroid misuse among US adolescent boys as a function of sexual orientation and race/ethnicity. Methods. We analyzed boys from the 2015 Youth Risk Behavior Survey (n = 6248; mean age = 16), a representative sample of US high school students. Lifetime prevalence of anabolic steroid misuse was dichotomized as never versus 1 or more times. Results. Sexual minority boys reported elevated misuse compared with heterosexual boys, within each level of race/ethnicity. Black, Hispanic, and White sexual minority boys reported misuse at approximately 25%, 20%, and 9%, respectively. Conclusions. Sexual orientation health disparities in anabolic steroid misuse disproportionally affect Black and Hispanic sexual minority adolescent boys, but more research is needed to understand the mechanisms driving these disparities. PMID:27997246

  19. Kratom abuse in Ramathibodi Poison Center, Thailand: a five-year experience.

    PubMed

    Trakulsrichai, Satariya; Tongpo, Achara; Sriapha, Charuwan; Wongvisawakorn, Sunun; Rittilert, Panee; Kaojarern, Sming; Wananukul, Winai

    2013-01-01

    Kratom (Mitragyna speciosa Korth), a native tree in Southeast Asia, is misused as an abuse drug and becomes legally widespread to several countries. Currently, it is available through the online market or by some shops. The clinical manifestations of Kratom's effects are not well-defined and the clinical studies are limited. This study was designed to identify the characteristics of Kratom poisoning and withdrawal cases from Kratom exposure cases in Ramathibodi Poison Center (RPC), Thailand, during a five-year period. We used a retrospective review of Kratom exposure cases from the RPC toxic surveillance system. A total of 52 Kratom exposure cases were identified. The trend of case consultations has been increasing. There were Kratom poisoning cases (76.9%) and withdrawal cases (23.1%). Common presenting symptoms in the poisoning group were palpitation (22.5%), followed by seizure (17.5%). For the withdrawal group, the common presenting symptoms were myalgia (33.3%), insomnia (16.67%), fatigue (16.67%), and chest discomfort (16.67%). There was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route. There were no deaths in either group. Kratom abuse can cause either poisoning or withdrawal. Most cases in both groups had good prognostic outcome.

  20. Genome wide analysis of rare copy number variations in alcohol abuse or dependence.

    PubMed

    Rodríguez-López, Julio; Flórez, Gerardo; Blanco, Vanessa; Pereiro, César; Fernández, José Manuel; Fariñas, Emilio; Estévez, Valentín; Gómez-Trigo, Jesús; Gurriarán, Xaquín; Calvo, Raquel; Sáiz, Pilar; Vázquez, Fernando Lino; Arrojo, Manuel; Costas, Javier

    2018-06-02

    Genetics plays an important role in alcohol abuse/dependence. Its heritability has been estimated as 45-65%. Rare copy number variations (CNVs) have been confirmed as relevant genetic factors in other neuropsychiatric disorders, such as autism spectrum disorders, schizophrenia, epilepsy, or Tourette syndrome. In the present study, we analyzed the role of rare CNVs affecting exons of coding genes in a sample from Northwest Spain genotyped using the Illumina Infinium PsychArray Beadchip. After rigorous genotyping quality control procedure, 712 patients with alcohol abuse or dependence and 804 controls were used for CNV detection. CNV calling was performed using PennCNV and cnvPartition, and analyses were restricted to CNVs of at least 100 kb and including at least 10 single nucleotide polymorphisms. Logistic regression was used to test for the effect of CNV as well as number of genes affected by CNVs on case/control status, after adjustment for demographic and experimental covariates. We have found an excess of deletions (p = 0.008) and genes affected by deletions (p = 0.017) in cases. This effect was restricted to the 14.8% of affected genes that are intolerant to loss-of-function mutations (gene count p = 0.009). The importance of this subset of genes is emerging in other psychiatric disorders of neurodevelopmental origin, suggesting that disturbance in neurodevelopment mediated by genetic alterations may be a risk factor for alcohol use disorder. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. The relationship of suicide attempt history with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality in substance dependents.

    PubMed

    Evren, Cuneyt; Evren, Bilge

    2006-01-01

    The aim of this study was to evaluate the prevalence of suicide in Turkish male substance dependents, and to investigate the relationship of suicide attempt history with childhood abuse and neglect, alexithymia, and temperament and character dimensions of personality. Participants were 154 consecutively admitted male substance dependents. Patients were investigated with the Childhood Abuse and Neglect Questionnaire, Toronto Alexithymia Scale (TAS-20) and Temperament and Character Inventory (TCI). Among substance-dependent patients, 28.6% was considered a group with suicide attempt history (SAH). Current age was lower and rate of being single was higher in the group with SAH. There were no significant differences between groups in terms of employment, educational status and duration of education. Rates of physical, emotional abuse and neglect, self-mutilation and being alexithymic were higher and ages at first substance use and regular substance use were lower in the group with SAH. Mean scores of "difficulty in identifying feelings" (DIF) and "difficulty in describing feelings" (DDF) subscale EOT of the TAS-20 were higher in the SAH group. Among temperament and character dimensions of the TCI, only "Self-directedness" and "Cooperativeness" were lower in SAH and there were no significant differences between groups in terms of other subscales. Age and Self-directedness score of TCI were determinants for suicide attempt. In particular, young drug users with low Self-directedness scores could be the target population in order to prevent suicidal behavior. This study also suggests that in substance-dependent patients, in the background of all suicidal behavior, childhood abuse and neglect must be evaluated.

  2. The Brisbane Longitudinal Twin Study Pathways to Cannabis Use, Abuse and Dependence Project: Current status, preliminary results and future directions

    PubMed Central

    Gillespie, NA; Henders, AK; Davenport, TA; Hermens, DF; Wright, MJ; Martin, NG; Hickie, IB

    2013-01-01

    We describe the data being collected from the Brisbane Longitudinal Twin Study (BLTS) in Australia as part of the US National Institute on Drug Abuse (NIDA) funded project Pathways to Cannabis Use, Abuse and Dependence. The history, recruitment, assessment and retention of twin families in this project are described in detail along with preliminary findings and plans for future research. The goal of this NIDA project is to make a significant contribution to the discovery of quantitative trait loci (QTL) influencing cannabis use disorders. Although the focus is cannabis use, abuse and dependence in young adults, measures of comorbid illicit drug use disorders are also being collected. In addition, a variety of internalizing and externalizing disorders are being assessed, funded by support from the Australian National Health and Medical Research Council. Because these same twins have participated in numerous twin studies since 1992, future plans will include linking different phenotypes to investigate relationships between drug use, psychiatric disorders and psychological phenotypes within cross-sectional and longitudinal or developmental frameworks. PMID:23187020

  3. Catastrophic thinking and increased risk for prescription opioid misuse in patients with chronic pain

    PubMed Central

    Martel, MO; Wasan, AD; Jamison, RN; Edwards, RR

    2013-01-01

    Background As a consequence of the substantial rise in the prescription of opioids for the treatment of chronic noncancer pain, greater attention has been paid to the factors that may be associated with an increased risk for prescription opioid misuse. Recently, a growing number of studies have shown that patients with high levels of catastrophizing are at increased risk for prescription opioid misuse. Objective The primary objective of this study was to examine the variables that might underlie the association between catastrophizing and risk for prescription opioid misuse in patients with chronic pain. Methods Patients with chronic musculoskeletal pain (n = 115) were asked to complete the SOAPP-R, a validated self-report questionnaire designed to identify patients at risk for prescription opioid misuse. Patients were also asked to complete self-report measures of pain intensity, catastrophizing, anxiety, and depression. Results Consistent with previous research, we found that catastrophizing was associated with an increased risk for prescription opioid misuse. Results also revealed that the association between catastrophizing and risk for opioid misuse was partially mediated by patients’ levels of anxiety. Follow-up analyses, however, indicated that catastrophizing remained a significant ‘unique’ predictor of risk for opioid misuse even when controlling for patients’ levels of pain severity, anxiety and depressive symptoms. Discussion Discussion addresses the factors that might place patients with high levels of catastrophizing at increased risk for prescription opioid misuse. The implications of our findings for the management of patients considered for opioid therapy are also discussed. PMID:23618767

  4. Alcohol misuse, firearm violence perpetration, and public policy in the United States.

    PubMed

    Wintemute, Garen J

    2015-10-01

    Firearm violence is a significant public health problem in the United States, and alcohol is frequently involved. This article reviews existing research on the relationships between alcohol misuse; ownership, access to, and use of firearms; and the commission of firearm violence, and discusses the policy implications of these findings. Narrative review augmented by new tabulations of publicly-available data. Acute and chronic alcohol misuse is positively associated with firearm ownership, risk behaviors involving firearms, and risk for perpetrating both interpersonal and self-directed firearm violence. In an average month, an estimated 8.9 to 11.7 million firearm owners binge drink. For men, deaths from alcohol-related firearm violence equal those from alcohol-related motor vehicle crashes. Enforceable policies restricting access to firearms for persons who misuse alcohol are uncommon. Policies that restrict access on the basis of other risk factors have been shown to reduce risk for subsequent violence. The evidence suggests that restricting access to firearms for persons with a documented history of alcohol misuse would be an effective violence prevention measure. Restrictions should rely on unambiguous definitions of alcohol misuse to facilitate enforcement and should be rigorously evaluated. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Domestic violence, parental substance misuse and the decision to substantiate child maltreatment.

    PubMed

    Victor, Bryan G; Grogan-Kaylor, Andrew; Ryan, Joseph P; Perron, Brian E; Gilbert, Terri Ticknor

    2018-05-01

    Families that experience domestic violence and parental substance misuse are disproportionately involved with the child welfare system. Prior research suggests that child protective services (CPS) caseworkers are more likely to substantiate maltreatment allegations when domestic violence and parental substance misuse are identified during the investigation, pointing to one possible mechanism for this disproportionate involvement. While previous studies have relied on nationally representative data sets, the current study used administrative records from a large Midwestern child welfare agency that accounts for state-level variation in child welfare policy and practice. A total of 501,060 substantiation decisions made between 2009 and 2013 were examined to assess the influence of caseworker-perceived domestic violence and parental substance misuse on the decision to substantiate reported maltreatment. Results from multilevel modeling suggest that the identification of domestic violence and parental substance misuse during an investigation significantly increased the probability that an allegation would be substantiated. The implication of these findings for child welfare practice are considered in light of the fact that many child welfare agencies do not consider exposure to domestic violence and parental substance misuse in and of themselves to constitute child maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

    PubMed

    Akram, Yasmin; Copello, Alex; Moore, David

    2014-08-15

    Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. Extensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded. The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted. This systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of

  7. Protocol for a cluster-randomised controlled trial evaluating the impact of a preschool-based capacity building intervention on intimate partner violence and substance misuse in Sri Lanka.

    PubMed

    Lokuge, Kamalini; Wallace, Polly; Subasinghe, Kalini; Thurber, Katherine; De Silva, Tissa; Clarke, Naomi; Waas, Dulshika; Liyanage, Nisansala; Attygalle, Udena; Carron-Arthur, Bradley; Rodrigo, Kalyana; Banks, Emily; D'Este, Cate; Rajapakse, Thilini

    2018-05-02

    Past research has identified links between intimate partner violence (IPV) and alcohol misuse and poverty in Sri Lanka. Services that address substance misuse are amongst the few interventions shown to reduce IPV in settings similar to Sri Lanka. This paper describes the protocol for a study examining the impact of a preschool-based capacity building intervention on the prevalence of IPV and substance misuse in parents with children attending preschools, including uptake of available government services. The study is a cluster randomised controlled trial. Government-managed preschools (n = 34) in Galle and Colombo municipalities  will be randomly assigned to an intervention (n = 17) or control group (n = 17). Parents with children attending these preschools will be recruited to participate. The study intervention will build the capacity of selected community volunteers (parents) and preschool teachers in the provision of information and support to families affected by IPV and substance misuse. This intervention is directed at improving uptake, access and coordination of existing services. Data will be collected from all parents, and teachers in the intervention group, pre-intervention and 10 months post-intervention. The primary outcome for this study is experience of IPV amongst mothers of preschool-attending children. Secondary outcomes are substance misuse amongst fathers, measured via the locally adapted Alcohol Use Disorders Identification Test and Drug Abuse Screening Test; and awareness and uptake of services for these issues measured through locally-relevant tools. Demographic information and satisfaction with the intervention will also be assessed. By intervening through preschools we aim to support high-risk families early enough to arrest the cycle of violence that results in children themselves becoming victims and perpetrators of such violence. The innovative project design will reach the most vulnerable sections of the community and will

  8. Substance Use, Abuse, and Dependency in Adolescence

    ERIC Educational Resources Information Center

    Lasser, Jon; Schmidt, Eric

    2009-01-01

    This article highlights the problem of substance use and abuse among adolescents and discusses the important role of school leaders in addressing this problem. Drug and alcohol use among adolescents is a significant and serious problem. In fact, an alarmingly high number of students report that they have used drugs or alcohol. Substance use and…

  9. Therapeutic Community Treatment of an Inmate Population with Substance Use Disorders: Post-Release Trends in Re-Arrest, Re-Incarceration, and Drug Misuse Relapse

    PubMed Central

    Galassi, Alexandra; Mpofu, Elias; Athanasou, James

    2015-01-01

    This systematic literature review maps the evidence for the effectiveness of the therapeutic community interventions (TCI) in reducing re-arrest, re-incarceration or drug misuse following release from prison, including the extent to which these effects are retained over time. The databases searched for the review included PsychINFO, Medline and Scopus and reference lists from relevant articles published between 2007 and 2014. Only quantitative studies that examined the effectiveness of TCI for a prisoner population with drug dependence at the time of initial incarceration were considered. Fourteen studies were identified for inclusion in the review. Three-quarters of the studies reported TCI were effective in reducing rates of re-incarceration. About 70% of studies that examined follow-up rates of drug misuse relapse found TCI effective in reducing rates of drug misuse amongst participants. TCI participation reduced re-arrests events in 55% of the studies. Results suggest TCI effective in the short-term rather than longer term for reducing rates of re-incarceration among participants, and to a slightly lesser extent, drug misuse relapse. PMID:26103591

  10. “I’m Stuck”: Women’s Navigations of Social Networks and Prescription Drug Misuse in Central Appalachia

    PubMed Central

    Buer, Lesly-Marie; Leukefeld, Carl G.; Havens, Jennifer R.

    2017-01-01

    This study utilizes anthropological analyses of kinship, care, gendered inequalities, and the state to examine how social networks affect women’s substance use in a rural Appalachian county where the primary drug of choice is prescription opioids. Of 503 participants from a larger study of social networks among rural drug users, 16 women who reported using drugs with four or more other study participants (drug network members) were interviewed from November 2011 to February 2012. The purpose of interviews is to analyze the substance use patterns among participants who are highly connected in their networks. Female participants say they feel “stuck” in cycles of prescription drug misuse because of entrenchment in moral economies, intensive caretaking responsibilities, and violence from those in their networks. Although women demonstrate agency in their navigations of drug use, relationships, and economic and health inequalities, the factors that constrain women’s actions culminate to create barriers for women accessing substance abuse treatment or decreasing substance use outside of treatment. This study adds to understandings of the relational and situational aspects of women’s drug use and efforts to decrease use. Recognizing these aspects of women’s lives will aid policies and programs in becoming more relevant to substance abusing women. (substance use; kinship; care; gendered inequalities; Appalachia) PMID:28736509

  11. Psychopathological features in a sample of substance-abusing individuals with criminal history: Towards a definition of a personality prototype of an 'Addict with Criminal Conduct'.

    PubMed

    Gori, Alessio; Ponti, Lucia; Tani, Franca; Iraci Sareri, Giuseppe; Giannini, Marco; Meringolo, Patrizia; Craparo, Giuseppe; Bruschi, Angelo; Caretti, Vincenzo; Cacioppo, Marco; Paterniti, Rolando; Schuldberg, David

    2017-10-01

    The relationship between substance use disorders and criminal activity is strong, and one that is not easily resolved in the criminal justice system. A better understanding of personality traits among substance misusers who commit offences could support better treatment efforts. The aim of this study is to explore associations between the psychopathology of people addicted to substances who have also committed crimes. We recruited 263 substance-dependent individuals (80% male, 20% female) from a cohort of people attending regional community services in Italy. They all completed an extensive evaluation of their current mental health and personality traits. Their official criminal records were obtained, and the psychopathology of those who had a criminal record compared with those who did not. The criminal group was more likely to perceive the external world as hostile and to consider others as responsible for their own problems and difficulties; in addition, substance-dependent individuals with criminal records showed more personality traits within the psychopathy range and fewer in the dependent personality range than the substance abusers who had never committed crimes. These findings allow us to hypothesise that substance abusers who also have criminal convictions may have a specific personality profile. If further research were to confirm this, then it could have important implications for identifying people for particular treatment pathways and developing more effective treatments. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Substance misuse prevention: addressing anhedonia.

    PubMed

    Sussman, Steve; Leventhal, Adam

    2014-01-01

    Anhedonia refers to the inability of experiencing pleasure in positive life events. It has been conceptualized as a stable yet malleable characteristic and is associated with hypoactivity in the mesolimbic and mesocortical dopaminergic systems. Very recently, it has been posited as an etiologic factor associated with drug addiction onset, escalation, and relapse. Prevention programming could be developed to counteract the harmful impact of anhedonia, so as to minimize its impact on drug misuse. Remedial efforts are those that either (1) permit the individual to tolerate low levels of pleasure without resorting to drug misuse or other maladaptive behaviors that may unhealthily besot pleasure (for example, through normalization, structuring time, or meditation) or (2) counteract anhedonia by enhancing ones capability to experience pleasure (for example, behavioral activation, positive psychology, pharmacotherapy, or pursuit of positive addictions). School-based activities could be developed that can be completed by individuals, small workgroups, or the whole classroom. The concept of anhedonia is described in this chapter, and possible prevention strategies that might be utilized in schools as well as other contexts are discussed. © WILEY PERIODICALS, INC.

  13. Modelling possible causality in the associations between unemployment, cannabis use, and alcohol misuse.

    PubMed

    Boden, Joseph M; Lee, Jungeun Olivia; Horwood, L John; Grest, Carolina Villamil; McLeod, Geraldine F H

    2017-02-01

    There has been considerable interest in the extent to which substance use and unemployment may be related, particularly the causal pathways that may be involved in these associations. It has been argued that these associations may reflect social causation, in which unemployment influences substance use, or that they may reflect social selection, in which substance use increases the risk of becoming and remaining unemployed. The present study sought to test these competing explanations. Data from the Christchurch Health and Development Study, featuring a longitudinal birth cohort, were used to model the associations between unemployment and both cannabis and alcohol. Data on patterns of unemployment, involvement with cannabis, and symptoms of alcohol use disorder were examined from ages 18-35 years. The associations between unemployment and both cannabis dependence and alcohol use disorder (AUD) were modelled using conditional fixed-effects regression models, augmented by time-dynamic covariate factors. The analyses showed evidence of possible reciprocal causal processes in the association between unemployment and cannabis dependence, in which unemployment of at least three months' duration significantly (p < 0.0001) increased the risk of cannabis dependence, and cannabis dependence significantly (p < 0.0001) increased the risk of being unemployed. Similar evidence was found for the associations between unemployment and AUD, although these associations were smaller in magnitude. The present findings support both social causation and social selection arguments, by indicating that unemployment plays a causal role in substance misuse, and that it is also likely that a reverse causal process whereby substance misuse increases the risk of unemployment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Effect of Alcohol Abuse and Dependence and School Experiences on Depression: A National Study of Adolescents

    ERIC Educational Resources Information Center

    Merianos, Ashley L.; King, Keith A.; Vidourek, Rebecca A.; Hardee, Angelica M.

    2016-01-01

    The study purpose was to examine the effect alcohol abuse/dependence and school experiences have on depression among a nationwide sample of adolescents. A secondary analysis of the 2013 National Survey on Drug Use and Health was conducted. The results of the final multivariable logistic regression model revealed that adolescents who reported…

  15. Logical Fallacies and the Abuse of Climate Science: Fire, Water, and Ice

    NASA Astrophysics Data System (ADS)

    Gleick, P. H.

    2012-12-01

    Good policy without good science and analysis is unlikely. Good policy with bad science is even more unlikely. Unfortunately, there is a long history of abuse or misuse of science in fields with ideological, religious, or economically controversial policy implications, such as planetary physics during the time of Galileo, the evolution debate, or climate change. Common to these controversies are what are known as "logical fallacies" -- patterns of reasoning that are always -- or at least commonly -- wrong due to a flaw in the structure of the argument that renders the argument invalid. All scientists should understand the nature of logical fallacies in order to (1) avoid making mistakes and reaching unsupported conclusion, (2) help them understand and refute the flaws in arguments made by others, and (3) aid in communicating science to the public. This talk will present a series of logical fallacies often made in the climate science debate, including "arguments from ignorance," "arguments from error," "arguments from misinterpretation," and "cherry picking." Specific examples will be presented in the area of temperature analysis, water resources, and ice dynamics, with a focus on selective use or misuse of data.; "Argument from Error" - an amusing example of a logical fallacy.

  16. A Covariance Structure Model Test of Antecedents of Adolescent Alcohol Misuse and a Prevention Effort.

    ERIC Educational Resources Information Center

    Dielman, T. E.; And Others

    1989-01-01

    Questionnaires were administered to 4,157 junior high school students to determine levels of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem. Conceptual model of antecendents of adolescent alcohol misuse and effectiveness of a prevention effort was…

  17. 16 CFR 23.5 - Misuse of the word “vermeil.”

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the word âvermeil.â 23.5 Section 23.5 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR THE JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.5 Misuse of the word “vermeil.” (a) It is unfair or...

  18. Treatment of substance misuse in older women: using a brief intervention model.

    PubMed

    Finfgeld-Connett, Deborah L

    2004-08-01

    Alcohol and benzodiazepine misuse is a significant problem in older women for a number of reasons such as physiological changes, outdated prescribing practices, and failure to identify hazardous use. In addition, treatment barriers involving the health-care system, conflicting information, and ageism also exist. Substance misuse among older women is predicted to become a bigger problem as the baby boom generation ages. Brief interventions that consist of assessment, feedback, responsibility, advice, menu, empathy, and self-efficacy, or A-FRAMES, have the potential to reduce alcohol and benzodiazepine misuse among older women in a cost-effective manner.

  19. 36 CFR 1200.16 - Will I be penalized for misusing the official seals and logos?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... misusing the official seals and logos? 1200.16 Section 1200.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES OFFICIAL SEALS Penalties for Misuse of NARA Seals and Logos § 1200.16 Will I be penalized for misusing the official seals and logos? (a) Seals. (1) If you...

  20. 36 CFR 1200.16 - Will I be penalized for misusing the official seals and logos?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... misusing the official seals and logos? 1200.16 Section 1200.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES OFFICIAL SEALS Penalties for Misuse of NARA Seals and Logos § 1200.16 Will I be penalized for misusing the official seals and logos? (a) Seals. (1) If you...

  1. Clinical pharmacokinetics of non-opiate abused drugs.

    PubMed

    Busto, U; Bendayan, R; Sellers, E M

    1989-01-01

    The present review discusses the available data on the kinetic properties of non-opiate abused drugs including psychomotor stimulants, hallucinogens and CNS-depressants. Some of the drugs of abuse reviewed here are illicit drugs (e.g. cannabis, cocaine), while others are effective pharmacological agents but have the potential to be abused (e.g. benzodiazepines). Although some of the drugs mentioned in this review have been in use for centuries (e.g. caffeine, nicotine, cocaine, cannabis), knowledge of their kinetics and metabolism is very recent and in some cases still incomplete. This is partially due to the difficulties inherent in studying drugs of abuse in humans, and to the complex metabolism of some of these drugs (e.g. cannabis, caffeine) which has made it difficult to develop sensitive assays to determine biological pathways. Although drugs of abuse may have entirely different intrinsic pharmacological effects, the kinetic properties of such drugs are factors contributing to abuse and dependence. The pharmacokinetic properties that presumably contribute to self-administration and drug abuse include rapid delivery of the drug into the central nervous system and high free drug clearance. Kinetic characteristics also play an important role in the development of physical dependence and on the appearance of a withdrawal syndrome: the longer the half-life, the greater the likelihood of the development of physical dependence; the shorter the half-life, the earlier and more severe the withdrawal. The balance between these 2 factors, which has not yet been carefully studied, will also influence abuse patterns. The clinical significance of kinetic characteristics with respect to abuse is discussed where possible.

  2. Stress-related factors in cannabis use and misuse: implications for prevention and treatment.

    PubMed

    Hyman, Scott M; Sinha, Rajita

    2009-06-01

    We examined the role of stress as a risk factor and motivation for cannabis use/misuse. A systematic review of studies gathered from PsychINFO and MEDLINE databases was conducted. Findings suggest that cannabis is commonly used as a stress-coping strategy. Negative life events, trauma, and maladaptive coping were all related to consumption. Cannabis use for stress-coping purposes was most evident when examining chronic as compared with experimental use. Although many individuals may be able to use cannabis without consequences, there appears to be a subset of individuals who experience greater life stress and who may be more likely to use for stress-coping purposes. These individuals may be at greatest risk for addiction. Chronic use may potentiate stress-related motivation to use/abuse cannabis and is associated with decision-making deficits and alterations in brain-stress pathways that may exacerbate compulsive drug seeking and sensitize individuals to stress-related drug use. Overall, stress-coping interventions and harm reduction focused on reducing the amount ingested may facilitate prevention and recovery efforts.

  3. Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients".

    PubMed

    Mattoo, Khurshid A; Garg, Rishabh; Kumar, Shalabh

    2015-01-01

    This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. The subjects were randomly selected from the medical and the dental OPDs of the university. Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.

  4. Risk factors for drug dependence among out-patients on opioid therapy in a large US health-care system.

    PubMed

    Boscarino, Joseph A; Rukstalis, Margaret; Hoffman, Stuart N; Han, John J; Erlich, Porat M; Gerhard, Glenn S; Stewart, Walter F

    2010-10-01

    Our study sought to assess the prevalence of and risk factors for opioid drug dependence among out-patients on long-term opioid therapy in a large health-care system. Using electronic health records, we identified out-patients receiving 4+ physician orders for opioid therapy in the past 12 months for non-cancer pain within a large US health-care system. We completed diagnostic interviews with 705 of these patients to identify opioid use disorders and assess risk factors. Preliminary analyses suggested that current opioid dependence might be as high as 26% [95% confidence interval (CI) = 22.0-29.9] among the patients studied. Logistic regressions indicated that current dependence was associated with variables often in the medical record, including age <65 [odds ratio (OR) = 2.33, P = 0.001], opioid abuse history (OR = 3.81, P < 0.001), high dependence severity (OR = 1.85, P = 0.001), major depression (OR = 1.29, P = 0.022) and psychotropic medication use (OR = 1.73, P = 0.006). Four variables combined (age, depression, psychotropic medications and pain impairment) predicted increased risk for current dependence, compared to those without these factors (OR = 8.01, P < 0.001). Knowing that the patient also had a history of severe dependence and opioid abuse increased this risk substantially (OR = 56.36, P < 0.001). Opioid misuse and dependence among prescription opioid patients in the United States may be higher than expected. A small number of factors, many documented in the medical record, predicted opioid dependence among the out-patients studied. These preliminary findings should be useful in future research efforts. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  5. Intersection of chronic pain treatment and opioid analgesic misuse: causes, treatments, and policy strategies

    PubMed Central

    Wachholtz, Amy; Gonzalez, Gerardo; Boyer, Edward; Naqvi, Zafar N; Rosenbaum, Christopher; Ziedonis, Douglas

    2011-01-01

    Treating chronic pain in the context of opioid misuse can be very challenging. This paper explores the epidemiology and potential treatments for chronic pain and opioid misuse and identifies educational and regulation changes that may reduce diversion of opioid analgesics. We cover the epidemiology of chronic pain and aberrant opioid behaviors, psychosocial influences on pain, pharmacological treatments, psychological treatments, and social treatments, as well as educational and regulatory efforts being made to reduce the diversion of prescription opioids. There are a number of ongoing challenges in treating chronic pain and opioid misuse, and more research is needed to provide strong, integrated, and empirically validated treatments to reduce opioid misuse in the context of chronic pain. PMID:24474854

  6. 16 CFR 23.25 - Misuse of the word “gem.”

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the word âgem.â 23.25 Section 23... JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.25 Misuse of the word “gem.” (a) It is unfair or deceptive to use the word “gem” to describe, identify, or refer to a ruby, sapphire, emerald, topaz, or...

  7. 16 CFR 23.19 - Misuse of the word “pearl.”

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the word âpearl.â 23.19 Section 23... JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.19 Misuse of the word “pearl.” (a) It is unfair or deceptive to use the unqualified word “pearl” or any other word or phrase of like meaning to describe...

  8. Surveillance and uncertainty: community pharmacy responses to over the counter medicine abuse.

    PubMed

    Cooper, Richard

    2013-05-01

    The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who

  9. Sleep driving: sleepwalking variant or misuse of z-drugs?

    PubMed

    Pressman, Mark R

    2011-10-01

    Sleep driving is most often classified as a variant of sleepwalking, but should be distinguished from impaired driving due to misuse or abuse of sedative/hypnotic drugs. Z-drugs; zolpidem and zopiclone in particular, have been associated with the majority of reported cases of impaired driving. Numerous studies have found z-drugs in driving under influence (DUI) related police stops, arrests and accidents. Impaired drivers are reported to have 1) blood levels of z-drugs that exceed therapeutic ranges 2) failed to take the medication at the correct time or remain in bed for sufficient time and/or 3) combined z-drugs with other central nervous system (CNS) depressants and/or alcohol. Consistent with CNS depression, z-drug-impaired drivers may demonstrate cognitive function at low levels with drivers still able to understand and respond to questions while sleepwalkers are completely unable to understand or interact with police. Z-drug-impaired drivers are often severely physically impaired, unable to stand up or maintain balance while sleepwalkers are able to stand and walk unaided. Sleep driving and impaired driving due to z-drugs may overlap. Sleep driving and drug-impaired driving are statistically rare events, but due to the billions of doses prescribed each year may still result in numerous DUI related arrests and accidents. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Understanding the neurobiology, assessment, and treatment of substances of abuse and dependence: a guide for the critical care nurse.

    PubMed

    Genung, Vanessa

    2012-03-01

    therapies. 8. An individual's treatment and services plan must be assessed continually and modified as necessary to ensure it meets his or her changing needs. 9. Many drug-addicted individuals also have other mental disorders that need treatment. 10. Medically assisted detoxification in the first stage of addiction treatment and by itself does little to change long-term drug abuse. 11. Treatment does not need to be voluntary to be effective. 12. Drug use during treatment must be monitored continuously, because lapses during treatment do occur. 13. Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases, as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases. To truly impact this disease, there needs to be improvement in the identification of risk factors and early identification and early intervention with children and adolescents. The future of neuroscience is in objective brain scans and genetic testing. Out of these approaches can come more objective measures of addiction and dependence using brain scans and genetic testing. These measures would potentially allow for the development of vaccines for specific drugs of abuse and dependence, as well as increasingly selective and effective pharmacologic approaches for treatment and a new consensus on standard of care for substance dependence.

  11. Discussing Opioid Risks With Patients to Reduce Misuse and Abuse: Evidence From 2 Surveys

    PubMed Central

    Hero, Joachim O.; McMurtry, Caitlin; Benson, John; Blendon, Robert

    2016-01-01

    We used 2 population-representative surveys to evaluate the recommendation from recent clinical guidelines for prescribing opioid analgesics that physicians discuss the risk of long-term use disorders with patients. In nationally representative data we observed a 60% lower rate, after adjustment for covariates, in a self-reported saving of pills among respondents who say they talked with their physicians about the risks of prescription painkiller addiction (67% lower rate without adjustment). These findings suggest patient education efforts, as currently practiced in the United States, may have positive behavioral consequences that could lower the risks of prescription painkiller abuse. Future research should test these associations under controlled settings. PMID:28376444

  12. Training and experience of nurses in responding to alcohol misuse in rural communities.

    PubMed

    Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine

    2013-07-01

    Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.

  13. Intranasal abuse of prescription hydrocodone/acetaminophen results in oronasal fistula: a case report.

    PubMed

    Sloan, Paul A; Klimkina, Oksana

    2009-01-01

    Opioids are becoming more common in the treatment of chronic nonmalignant pain. With increased availability of opioids for chronic pain we may expect an increased misuse of these as analgesics as well. The authors describe the case report of a young woman with chronic back pain and intranasal abuse of prescribed hydrocodone/acetaminophen who was diagnosed after presenting for hypernasal speech and foreign body in the nose. This case report highlights the need for vigilance on the part of the physician for any aberrant drug-related behaviors. Any unusual symptoms or signs such as hypernasal speech, chronic nasal infection, or unexplained foreign body sensation in the nose should be thoroughly investigated.

  14. [Alcohol and drug misuse of the elderly in health care facilities].

    PubMed

    Kuhn, S; Haasen, C

    2012-05-01

    A nationwide representative survey was conducted in residential care facilities and facilities offering care for the elderly in their homes (home care facilities) with the aim to estimate the rate of alcohol and drug misuse among this population and to evaluate the way in which nursing staff deal with the problem. A total of 5000 randomly selected facilities were contacted with a 2-page questionnaire. Reliable data were obtained from 550 residential care facilities and from 436 home care facilities. According to the investigated facilities, the mean rate of misuse among the elderly was 14%. Nearly all facilities acknowledge the necessity to react to these facts, but only a quarter of them considered their staff to be sufficiently trained. 38.4% of the residential care facilities and 26.9% of the home care facilities have a concept on how to react to misuse problems. Addiction services are rarely contacted. The prevalence of alcohol and drug misuse among the elderly in health care facilities is high compared to the same age cohort of the total population. The lack of networking between facilities for the elderly and addiction services is remarkable. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Will abuse-deterrent formulations of opioid analgesics be successful in achieving their purpose?

    PubMed

    Bannwarth, Bernard

    2012-09-10

    During the last 2 decades, there has been a dramatic increase in the use of strong opioids for chronic non-cancer pain. This increase has been accompanied by a steep increase in abuse, misuse, and both fatal and non-fatal overdoses involving prescription opioids. The situation is already alarming in the US. Prescription opioid-related harm is a complex, multifactorial issue that requires a multifaceted solution. In this respect, formulations of opioid analgesics designed to resist or deter abuse may be a useful component of a comprehensive opioid risk minimization programme. Such formulations have or are being developed. Abuse-resistant opioids include those that use some kind of physical barrier to prevent tampering with the formulation. Abuse-deterrent opioids are not necessarily resistant to tampering, but contain substances that are designed to make the formulation less attractive to abusers. This article focuses on two products intended to deter abuse that were reviewed by the US Food and Drug Administration (FDA). The first (Embeda®) consists of extended-release morphine with sequestered naltrexone, an opioid antagonist that is released if the tablet is compromised by chewing or crushing. Although Embeda® exhibited abuse-deterrent features, its label warns that it can be abused in a manner similar to other opioid agonists. Furthermore, tampering with Embeda® will result in the release of naltrexone, which may precipitate withdrawal in opioid-tolerant individuals. In March 2011, all dosage forms of Embeda® were recalled because the product failed to meet routine stability standards, and its return date to the market is currently unknown. The second product (Acurox®) was intended to be both tamper resistant and abuse deterrent. It consisted of an immediate-release oxycodone tablet with subtherapeutic niacin as an aversive agent and used a gel-forming ingredient designed to inhibit inhalation and prevent extraction of the drug for injection. The new drug

  16. Mobile Abuse in University Students and profiles of victimization and aggression.

    PubMed

    Polo Del Río, Mª Isabel; Mendo Lázaro, Santiago; León Del Barco, Benito; Felipe Castaño, Elena

    2017-09-29

    The vast majority of young people have mobile phones. This has become a must-have item in their lives, with traditional socialization spaces displaced by virtual ones. They use their mobile phones for many hours a day, to the detriment of their psychological and social functioning, showing greater vulnerability to abusive or excessive use, and more likely to become problematic or addicted users. This paper aims to study the impact of mobile phone abuse in a sample of college students, assessing the social, personal, and communicational realms and deepening understanding of the different cyberbullying profiles, analyzing who has more personal and social problems using mobiles: victims or aggressors. Whether the number of hours of mobile phone use has an effect on these problems will also be explored. The sample (1,200 students) was selected by multistage cluster sampling among the faculties of the University of Extremadura. Data were obtained through Victimization (CYB-VIC) and Aggression (CYB-AGRES) through the mobile phone scales, and the Questionnaire of Experiences related to Mobile (CERM). The results show that mobile phone abuse generates conflicts in young people of both sexes, although girls have more communication and emotional problems than boys. In addition, age, field of knowledge, victim/aggressor profile, and hours of mobile phone use are crucial variables in the communication and emotional conflicts arising from the misuse of mobile.

  17. Factors associated with the transition from abuse to dependence among substance abusers: Implications for a measure of addictive liability

    PubMed Central

    Ridenour, Ty A.; Maldonado-Molina, Mildred; Compton, Wilson M.; Spitznagel, Edward L.; Cottler, Linda B.

    2005-01-01

    This study was conducted to test the validity of a measure that has potential to bridge research on the addictive liability of drugs and on individuals' liability to addiction, which to date have evolved in largely parallel arenas. The length of time between onset of abuse and dependence (LOTAD) has evolved from recent findings on transitions through levels of addiction; it was hypothesized that shorter LOTAD is indicative of greater addictive liability. Hypotheses were based on animal studies and human studies. Retrospective data from the DSM-IV Substance Use Disorders Work Group were reanalyzed using configural frequency analysis, survival curves, bivariate Kendall's tau associations, and linear regression. The sample consisted of participants recruited from community and clinical settings. The measure was the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). The shortest LOTADs were observed for disorders related to use of cocaine and opiates, followed by cannabis and then alcohol regardless of the subsample that was analyzed. As hypothesized, females and early initiators of drug use had shorter LOTADs compared to men and other initiators of drug use; no consistent differences in LOTAD were observed between African-Americans and Caucasians. None of the LOTAD variance associated with differences between drugs could be accounted for by gender, early use of the drug, or ethnicity. Specific areas of research where LOTAD might be useful as well as how LOTAD might be improved are discussed. PMID:16157227

  18. Near-death states reported in a sample of 50 misusers.

    PubMed

    Corazza, Ornella; Schifano, Fabrizio

    2010-05-01

    Increase in recreational ketamine use may be a cause for concern. We aimed here at assessing, in a sample of ketamine misusers, concordance between the typical near-death experience (NDE) features and the on-drug psychoactive effects the subjects experienced. In 2003-2005, a sample of previous ketamine misusers recollecting a ketamine-related NDE were recruited through snowballing and screened with the means of the Greyson NDE Scale; 125 participants made an initial contact with the researcher and 50 reported a minimum score of seven at the "Greyson NDE Scale". Interviewees were in the range 21-66 years old; 27 participants (54%) were educated at BA level, 18 (36%) had an MSc, and 5 (10%) a PhD. Eight (16%) interviewees had a definite religious background. An average lifetime ketamine intake of 140 occasions was reported by the interviewees, who typically presented with a polydrug, including cannabis and MDMA/ecstasy, misuse history. In 45 (90%) cases, the NDE occurred during the first few occasions of intake. Most frequent features of reported NDE states included: altered perception of time (90%), strong sense of detaching from own physical body (88%), and a sense of peace/joy (76% of subjects). Although results here described were elicited from a self-selected, nonrandomized, limited size sample of misusers, we suggest that recreational ketamine intake may be associated with occurrence of near-death related states.

  19. 49 CFR 805.735-6 - Misuse of information by Members and employees.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Misuse of information by Members and employees. 805.735-6 Section 805.735-6 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL TRANSPORTATION SAFETY BOARD EMPLOYEE RESPONSIBILITIES AND CONDUCT § 805.735-6 Misuse of information by Members and employees. For the purpose...

  20. Drug-using and nonusing women: potential for child abuse, child-rearing attitudes, social support, and affection for expected baby.

    PubMed

    Williams-Petersen, M G; Myers, B J; Degen, H M; Knisely, J S; Elswick, R K; Schnoll, S S

    1994-10-01

    Eighty pregnant women (25 substance using, 55 nonusing) from an American prenatal clinic serving lower-income to working-class women responded to questionnaire measures of child-rearing attitudes. The drug users' primary substance of misuse was cocaine (68%), alcohol (16%), amphetamines (12%), or sedatives (4%); polydrug use was documented for 80% of the women. The two (user and nonuser) groups were not different on demographic (age, race, marital status, education, SES, source of income) or obstetrical factors (number of pregnancies, number of children). Drug-using women scored significantly higher on a measure of child abuse potential; more than half scored in the range of clinical criterion for extreme risk. As their babies were not yet born, no actual physical abuse was documented, only a higher potential for abuse. The subgroup who were both drug users and had lower social support scored higher on child abuse potential than all other subgroups. The drug users also had lower self-esteem scores than the nonusers. The two groups did not differ on measures of overall social support, authoritarian/democratic child-rearing beliefs, or affection for the expected baby.

  1. Teenagers are right--parents do not know much: an analysis of adolescent-parent agreement on reports of adolescent substance use, abuse, and dependence.

    PubMed

    Fisher, Sherri L; Bucholz, Kathleen K; Reich, Wendy; Fox, Louis; Kuperman, Samuel; Kramer, John; Hesselbrock, Victor; Dick, Danielle M; Nurnberger, John I; Edenberg, Howard J; Bierut, Laura J

    2006-10-01

    Previous studies have shown that when assessing child psychopathology, parents tend to report more symptoms than children for externalizing disorders such as attention deficit hyperactivity disorder (ADHD), whereas children tend to report more symptoms for internalizing disorders such as major depression. Whether for clinical or research purposes, parents are also frequently asked to report on their children's experiences with alcohol and drugs. The purpose of this study was to analyze correspondence between adolescent and parent reports of adolescent substance use and abuse or dependence. In the current study, 591 subjects 12 to 17 years old were interviewed using the child version of the Semi-Structured Assessment for the Genetics of Alcoholism (C-SSAGA) as part of the Collaborative Study on the Genetics of Alcoholism (COGA). One parent was also interviewed about each adolescent using the parent version of the C-SSAGA. Sensitivities, specificities, and kappa coefficients were calculated to assess parental agreement with adolescent reports of lifetime substance use and Diagnostic and Statistical Manual of Mental Disorders-Third Revision substance abuse or dependence. The results indicate that parents are somewhat knowledgeable about their children's use of substances, particularly those that are used most commonly. For example, 55% of adolescents who had smoked cigarettes, 50% who had used alcohol, and 47% who had used marijuana had a parent who knew that they used. However, parents were less aware of substance-related problems experienced by their offspring, agreeing with adolescent reports only 27% of the time for diagnoses of alcohol abuse or dependence and 26% of the time for diagnoses of marijuana abuse or dependence. Parent reports added few cases of substance use for 12- to 13 year-olds and essentially no cases for 16- to 17-year-olds. Parent reports added a nominal number of diagnoses of substance abuse or dependence for older adolescents. Whether for

  2. The Many Victims of Substance Abuse

    PubMed Central

    2007-01-01

    Substance abuse is a complicated disorder and has far reaching consequences. The victims of substance abuse extend beyond the unfortunate ones suffering from this disorder and often include family and friends. Treatment options for substance abuse are many; however, positive outcomes are not always guaranteed. Many factors play into the potential for successful treatment. Some of these include the adherence and motivation of the substance abusing patients as well as patients' surrounding environments and support systems. In this article, we present a clinical case of opioid dependence and discuss various treatment options and modalities. We will discuss different variables that may maximize positive treatment outcomes. Also a review of the current literature regarding substance abuse treatment, psychotherapy with the drug abuser, and grief therapy should the substance abusing patient die for the surviving family members will be presented. PMID:20532120

  3. The Influence of Parental Emotional Neglect on Assault Victims Seeking Treatment for Depressed Mood and Alcohol Misuse: A Pilot Study.

    PubMed

    Bailey, Kylie A; Baker, Amanda L; McElduff, Patrick; Kavanagh, David J

    2016-10-09

    This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS), depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants ( n = 220) with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions) project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation) identified the two assault factors of sexual assault ( SA ) and physical assault ( PA ). A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.

  4. Trait mindfulness, reasons for living and general symptom severity as predictors of suicide probability in males with substance abuse or dependence.

    PubMed

    Mohammadkhani, Parvaneh; Khanipour, Hamid; Azadmehr, Hedieh; Mobramm, Ardeshir; Naseri, Esmaeil

    2015-01-01

    The aim of this study was to evaluate suicide probability in Iranian males with substance abuse or dependence disorder and to investigate the predictors of suicide probability based on trait mindfulness, reasons for living and severity of general psychiatric symptoms. Participants were 324 individuals with substance abuse or dependence in an outpatient setting and prison. Reasons for living questionnaire, Mindfulness Attention Awareness Scale and Suicide probability Scale were used as instruments. Sample was selected based on convenience sampling method. Data were analyzed using SPSS and AMOS. The life-time prevalence of suicide attempt in the outpatient setting was35% and it was 42% in the prison setting. Suicide probability in the prison setting was significantly higher than in the outpatient setting (p<0.001). The severity of general symptom strongly correlated with suicide probability. Trait mindfulness, not reasons for living beliefs, had a mediating effect in the relationship between the severity of general symptoms and suicide probability. Fear of social disapproval, survival and coping beliefs and child-related concerns significantly predicted suicide probability (p<0.001). It could be suggested that trait mindfulness was more effective in preventing suicide probability than beliefs about reasons for living in individuals with substance abuse or dependence disorders. The severity of general symptom should be regarded as an important risk factor of suicide probability.

  5. Alcohol and Drug Use, Abuse, and Dependence in Urban Areas and Colonias of the Texas-Mexico Border

    ERIC Educational Resources Information Center

    Wallisch, Lynn S.; Spence, Richard T.

    2006-01-01

    This study describes the prevalence of alcohol and drug use, abuse, and dependence among adults on the Texas-Mexico border in 2002-2003. The findings are based on survey responses from a random sample of 1,200 adults living in households in three communities: El Paso, a densely populated city in west Texas; the less dense urbanized areas of the…

  6. Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare?

    PubMed

    McLellan, A Thomas

    2017-01-01

    This paper first introduces important conceptual and practical distinctions among three key terms: substance "use," "misuse," and "disorders" (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States. With this as background, the paper then describes historical views, perspectives, and efforts to deal with substance misuse problems in the United States and discusses how basic, clinical, and health service research, combined with recent changes in healthcare legislation and financing, have set the stage for a more effective, comprehensive public health approach.

  7. Child Abuse: One Tree in the Forest

    ERIC Educational Resources Information Center

    Burland, J. Alexis; And Others

    1973-01-01

    The records of 28 abused or severely neglected children, as reviewed and analyzed, show the importance of meeting the child's and parent's dependency needs, rather than focusing exclusively on the abuse itself. (Author/CS)

  8. Mining Patients' Narratives in Social Media for Pharmacovigilance: Adverse Effects and Misuse of Methylphenidate.

    PubMed

    Chen, Xiaoyi; Faviez, Carole; Schuck, Stéphane; Lillo-Le-Louët, Agnès; Texier, Nathalie; Dahamna, Badisse; Huot, Charles; Foulquié, Pierre; Pereira, Suzanne; Leroux, Vincent; Karapetiantz, Pierre; Guenegou-Arnoux, Armelle; Katsahian, Sandrine; Bousquet, Cédric; Burgun, Anita

    2018-01-01

    Background: The Food and Drug Administration (FDA) in the United States and the European Medicines Agency (EMA) have recognized social media as a new data source to strengthen their activities regarding drug safety. Objective: Our objective in the ADR-PRISM project was to provide text mining and visualization tools to explore a corpus of posts extracted from social media. We evaluated this approach on a corpus of 21 million posts from five patient forums, and conducted a qualitative analysis of the data available on methylphenidate in this corpus. Methods: We applied text mining methods based on named entity recognition and relation extraction in the corpus, followed by signal detection using proportional reporting ratio (PRR). We also used topic modeling based on the Correlated Topic Model to obtain the list of the matics in the corpus and classify the messages based on their topics. Results: We automatically identified 3443 posts about methylphenidate published between 2007 and 2016, among which 61 adverse drug reactions (ADR) were automatically detected. Two pharmacovigilance experts evaluated manually the quality of automatic identification, and a f-measure of 0.57 was reached. Patient's reports were mainly neuro-psychiatric effects. Applying PRR, 67% of the ADRs were signals, including most of the neuro-psychiatric symptoms but also palpitations. Topic modeling showed that the most represented topics were related to Childhood and Treatment initiation , but also Side effects . Cases of misuse were also identified in this corpus, including recreational use and abuse. Conclusion: Named entity recognition combined with signal detection and topic modeling have demonstrated their complementarity in mining social media data. An in-depth analysis focused on methylphenidate showed that this approach was able to detect potential signals and to provide better understanding of patients' behaviors regarding drugs, including misuse.

  9. Drug Abuse - Multiple Languages

    MedlinePlus

    ... Facts about Marijuana - العربية (Arabic) PDF Karen Chemical Dependency Taskforce of Minnesota Facts about Methamphetamine - English PDF Facts about Methamphetamine - العربية (Arabic) PDF Karen Chemical Dependency Taskforce of Minnesota Substance Abuse or Dependence - العربية ( ...

  10. Factors influencing recording of drug misuse in primary care: a qualitative study of GPs in England.

    PubMed

    Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona

    2018-04-01

    Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.

  11. Evaluation of Abuse-Deterrent or Tamper-Resistant Opioid Formulations on Overall Health Care Expenditures in a State Medicaid Program.

    PubMed

    Keast, Shellie L; Owora, Arthur; Nesser, Nancy; Farmer, Kevin

    2016-04-01

    The development of abuse-deterrent opioid prescription medications is a priority at the national level. Pharmaceutical manufacturers have begun marketing new formulations of currently available opioids that meet higher abuse resistance standards. Little information is available regarding the impact of these formulations on overall health care expenditures. To (a) examine the relationship between health care expenditures and use of brand abuse-deterrent or tamper-resistant (ADTR) extended-release opioids versus standard dosage form (SDF) extended-release opioids in a state Medicaid population, and (b) determine whether this relationship was influenced by member-specific characteristics. The study is a cross-sectional review of Oklahoma Medicaid members (aged ≥ 21 years) with at least 1 paid pharmacy claim for long-acting opioids between September 2013 and August 2014. Members who were adherent to extended-release opioid products were classified into ADTR and SDF opioid groups. The relationship between health care expenditures (prescription, medical, and overall) and opioid groups was examined using multiple linear regression models. The impact of member-specific characteristics (age, sex, race, urban classifications, and various comorbidities) on this relationship was examined. Prescription spending ($9,265,554) accounted for 35% of overall health care expenditures ($26,304,693) among 938 members during the 12-month reference period. Total prescription expenditures were higher among ADTR than SDF user groups, and the difference in median expenditures between these 2 groups was larger among members with more comorbidities, as measured by the Charlson Comorbidity Index score. Overall, ADTR users had higher median total health care and medical expenditures, and the difference in median expenditures was dependent on whether a member had comorbidities of addiction or not (higher expenditures were observed among members with comorbidities of addiction). The abuse and

  12. Reappraisal deficits promote craving and emotional distress among chronic pain patients at risk for prescription opioid misuse.

    PubMed

    Garland, Eric L; Hanley, Adam W; Bedford, Carter E; Zubieta, Jon-Kar; Howard, Matthew O; Nakamura, Yoshio; Donaldson, Gary W; Froeliger, Brett

    2018-06-04

    A subset of chronic pain patients misuse prescription opioids as a means of regulating negative emotions. However, opioid misuse may result in deficits in emotion regulation strategies like reappraisal by virtue of the deleterious effects of chronic opioid exposure. The aim of this study was to characterize differences in reappraisal use among chronic pain patients at risk for opioid misuse and those who report taking opioids as prescribed. A sample of 127 pain patients receiving chronic opioid analgesic pharmacotherapy were classified as at risk for opioid misuse (n = 62) or taking opioids as prescribed (n = 65) using the Current Opioid Misuse Measure (COMM). The Emotion Regulation Questionnaire (ERQ) characterized use of emotion regulation strategies including reappraisal and expressive suppression. Participants also reported levels of opioid craving, emotional distress, and pain severity. Patients at risk for opioid misuse reported significantly less reappraisal use (M = 25.31, SD = 7.33) than those who reportedly took opioids as prescribed (M = 30.28, SD = 7.50), p<.001, but did differ with regard to suppression strategies. Reduced reappraisal use was associated with higher opioid craving and emotional distress that mediated the association between reappraisal deficits and opioid misuse risk. Further, there was a significant indirect effect of opioid misuse on emotional distress via reappraisal use. Opioid misuse risk was associated with reduced use of reappraisal, which in turn was associated with dysregulated negative emotions and increased appetitive drive towards consuming opioids. Studying individual differences in emotion regulation may yield efficacious intervention and prevention approaches to stem the rising tide of the prescription opioid crisis.

  13. Protective Predictors of Alcohol Use Trajectories among Canadian Aboriginal Youth

    ERIC Educational Resources Information Center

    Rawana, Jennine S.; Ames, Megan E.

    2012-01-01

    Some Aboriginal youth are at disproportionate risk of using substances and developing abuse and dependence disorders. However, not all Aboriginal youth misuse substances and limited research has examined the protective factors conferring against substance use among these youth. The present study aimed to identify protective factors related to the…

  14. Screening for substance misuse in the dental care setting: findings from a nationally representative survey of dentists

    PubMed Central

    Parish, Carrigan L.; Pereyra, Margaret R.; Pollack, Harold A.; Cardenas, Gabriel; Castellon, Pedro C.; Abel, Stephen N.; Singer, Richard; Metsch, Lisa R.

    2015-01-01

    Aims The dental setting is a potentially valuable venue for screening for substance misuse. Therefore, we assessed dentists’ inquiry of substance misuse through their patient medical history forms and their agreement with the compatibility of screening as part of the dentists’ professional role. Design A nationally representative survey of general dentists using a sampling frame obtained from the American Dental Association Survey Center (November 2010 – November 2011). Setting United States of America Participants 1,802 general dentists Measurements A 38 item survey instrument assessing the relationship between dentists’ practice, knowledge, behaviors, and attitudes with their query about substance misuse and their belief that such screening is part of their professional role. Findings Dentists who accepted substance misuse screening as part of their professional role were more likely to query about misuse with their patients (85.8%) compared with those who did not accept such screening as part of their role (68.2%) (p<0.001). Prior experience and knowledge about substance misuse were the strongest predictors of dentists’ inquiry about patient substance use/misuse and acceptance of screening as part of their role in their clinical practice (p<0.05). Conclusion While more than three quarters of U.S. dentists-report that they ask their patients about substance misuse, two-thirds do not agree that such screening is compatible with their professional role. PMID:26032243

  15. Childhood emotional abuse, dissociation, and suicidality among patients with drug dependency in Turkey.

    PubMed

    Tamar-Gurol, Defne; Sar, Vedat; Karadag, Figen; Evren, Cuneyt; Karagoz, Mustafa

    2008-10-01

    The aim of the present study was to determine the prevalence and correlates of dissociative disorders among patients with drug dependency. The Dissociative Experiences Scale (DES) was used to screen 104 consecutive patients at an addiction treatment center. Thirty-seven patients who had scores >or=30 were compared with 21 patients who scored <10 on the DES. Both groups were then evaluated using the Dissociative Disorders Interview Schedule and the Structured Clinical Interview for Dissociative Disorders (SCID-D). The interviewers were blind to the DES scores. Twenty-seven patients (26.0%) had a dissociative disorder according to the SCID-D. Dissociative patients were younger than the non-dissociative group. History of suicide attempt and/or childhood emotional abuse was significant predictors of a dissociative disorder. The majority (59.3%) of dissociative drug users reported that dissociative experiences had existed prior to substance use. More patients in the dissociative disorder than in the non-dissociative group stopped their treatment prematurely. A considerable proportion of drug users have a dissociative disorder, which may also interfere with treatment process. The relatively young age of this subgroup of patients and frequent reports of childhood emotional abuse underline potential preventive benefits of early intervention among adolescents with developmental trauma history and dissociative psychopathology.

  16. Challenges of the pharmacological management of benzodiazepine withdrawal, dependence, and discontinuation.

    PubMed

    Fluyau, Dimy; Revadigar, Neelambika; Manobianco, Brittany E

    2018-05-01

    Benzodiazepines (BZDs) are among the most prescribed sedative hypnotics and among the most misused and abused medications by patients, in parallel with opioids. It is estimated that more than 100 million Benzodiazepine (BZD) prescriptions were written in the United States in 2009. While medically useful, BZDs are potentially dangerous. The co-occurring abuse of opioids and BZD, as well as increases in BZD abuse, tolerance, dependence, and short- and long-term side effects, have prompted a worldwide discussion about the challenging aspects of medically managing the discontinuation of BZDs. Abrupt cessation can cause death. This paper addresses the challenges of medications suggested for the management of BZD discontinuation, their efficacy, the risks of abuse and associated medical complications. The focus of this review is on the challenges of several medications suggested for the management of BZD discontinuation, their efficacy, the risks of abuse, and associated medical complications. An electronic search was performed of Medline, Worldwide Science, Directory of Open Access Journals, Embase, Cochrane Library, Google Scholar, PubMed Central, and PubMed from 1990 to 2017. The review includes double-blind, placebo-controlled studies for the most part, open-label pilot studies, and animal studies, in addition to observational research. We expand the search to review articles, naturalistic studies, and to a lesser extent, letters to the editor/case reports. We exclude abstract and poster presentations, books, and book chapters. The efficacy of these medications is not robust. While some of these medicines are relatively safe to use, some of them have a narrow therapeutic index, with severe, life-threatening side effects. Randomized studies have been limited. There is a paucity of comparative research. The review has several limitations. The quality of the documents varies according to whether they are randomized studies, nonrandomized studies, naturalistic studies

  17. The development of a comprehensive risk-management program for prescription opioid analgesics: researched abuse, diversion and addiction-related surveillance (RADARS).

    PubMed

    Cicero, Theodore J; Dart, Richard C; Inciardi, James A; Woody, George E; Schnoll, Sidney; Muñoz, Alvaro

    2007-03-01

    OBJECTIVE. Beginning in the late 1990's a marked increase in abuse of OxyContin emerged, which led to the development and establishment of a proactive surveillance program to monitor and characterize abuse, named the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS) System. The main goal of RADARS was to develop proactive, timely and geographically sensitive methods to assess the abuse and diversion of OxyContin, along with a number of other Schedule II and III opioids with the aim of using this information to guide risk reduction interventions. Thus, its major focus was the detection of abuse of OxyContin and other commonly prescribed opioid analgesics at the three-digit ZIP code level across the country utilizing a number of different detection systems. The detection systems selected were: (1) Quarterly-surveys of drug abuse experts who are knowledgeable about cases of prescription drug abuse; (2) Surveys of law enforcement agencies that detect diversion of prescription drugs; and (3) Poison Control Center reports of intentional misuse or abuse of prescription opioids. Collectively, the three systems provide overlapping coverage of over 80% of the nation's 973 three-digit ZIP codes. Preliminary results indicate that prescription drug abuse is prevalent nationwide, but it seems to be heavily localized in rural, suburban and small urban areas. Our results also indicate that hydrocodone and extended and immediate release oxycodone products are by far the most widely abused drugs in the country, but the abuse of all prescription opioids seems to have grown over the 14 quarters since the inception of RADARS. The next step in these studies is to develop regionally specific, risk-minimization-strategies, which is the goal of all risk-management programs. If successful, RADARS will serve as a prototype of such programs for any new drug approved that has measurable abuse potential.

  18. A Quantitative Analysis of the Relationship between Computer Self-Efficacy and Misuse Intention

    ERIC Educational Resources Information Center

    Desire, Jean Ronald

    2017-01-01

    Intention to misuse information systems (IS) is a growing problem where employees of organizations are contributors to successful IS security breaches. Misuse of IS resources in organizations in the healthcare and pharmaceutical industries can affect patient care. Researchers investigated factors that influence changes in behavior regarding…

  19. Opioid addiction and misuse in adult and adolescent patients with cancer.

    PubMed

    Pinkerton, Ross; Hardy, Janet R

    2017-06-01

    In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice. The potential ethical issues of limiting effective analgesia on the basis of addiction risk or history must be acknowledged. Both a judgemental or 'relaxed' approach to such patients is problematic. Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem. © 2017 Royal Australasian College of Physicians.

  20. A Criminological Perspective on the Prenatal Abuse of Substances during Pregnancy and the Link to Child Abuse in South Africa

    ERIC Educational Resources Information Center

    Ovens, Michelle

    2009-01-01

    The increase in drug abuse in South Africa has had major social implications in the country. Problems associated with drug dependency are poverty, unemployment, a heavier burden on the health care system, the disintegration of family systems and drug-related crimes. Another area of concern is the link between drug abuse and child abuse. While…

  1. Ten-year trends (1992 to 2002) in sociodemographic predictors and indicators of alcohol abuse and dependence among whites, blacks, and Hispanics in the United States.

    PubMed

    Caetano, Raul; Baruah, Jonali; Chartier, Karen G

    2011-08-01

    The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for "hazardous use." which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic "orphans." These respondents reported 1 or 2 indicators of alcohol dependence as present. The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic "orphans" to better design interventions to address their problems. Copyright © 2011 by the Research Society on Alcoholism.

  2. Misuse of Booster Cushions – An Observation Study of Children’s Performance during Buckling Up

    PubMed Central

    Osvalder, Anna-Lisa; Bohman, Katarina

    2008-01-01

    Booster cushions are effective tools to protect children from injuries in car crashes, but there remains a large amount of misuse. The aim of this study was to assess potential misuse of booster cushions in an observational laboratory study, and to identify whether booster cushion design, age or clothing had any effect. 130 Swedish children from the ages of 4–12 years participated. Each child buckled up on an integrated and on an aftermarket booster cushion in the rear seat. The older children also buckled up with seat belt only. Interviews, observations and body measurements were performed. Time to buckle up and amount of belt slack were registered. Photographs were taken to document misuse. Results showed that 77% failed to perform correct belt routing on the aftermarket cushion, independent of age, although they were familiar with this system. The misuse rate for the integrated cushion was only 4%. No misuse was found for seat belt only. Few children tightened the belt. The belt slack increased when wearing winter jackets. This indicates the importance of adding pretensioners to the rear seat. Sled tests with HIII&TNO 6y dummies were also performed for the most frequent misuse situations found. The main conclusion is that an integrated booster cushion has many advantages compared to an aftermarket cushion regarding both safety and comfort. It is easy and quick to handle, has few possibilities for misuse, has an intuitive design, the buckling up sequence is equal to buckling up with an ordinary seat belt, and younger children can buckle up correctly. PMID:19026222

  3. Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare?

    PubMed Central

    MCLELLAN, A. THOMAS

    2017-01-01

    This paper first introduces important conceptual and practical distinctions among three key terms: substance “use,” “misuse,” and “disorders” (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States. With this as background, the paper then describes historical views, perspectives, and efforts to deal with substance misuse problems in the United States and discusses how basic, clinical, and health service research, combined with recent changes in healthcare legislation and financing, have set the stage for a more effective, comprehensive public health approach. PMID:28790493

  4. Women's reasons for leaving abusive spouses.

    PubMed

    Ulrich, Y C

    1991-01-01

    Research has focused on factors associated with leaving physically abusive relationships, yet little is known about what the woman thinks when she leaves. Fifty-one formerly battered women from rural and metropolitan areas in two midwestern states described 86 reasons for leaving a physically abusive relationship. During open-ended interviews, women who rated themselves as severely abused spontaneously emphasized leaving as a process. Content analysis resulted in reasons categorized as safety, dependency, and personal growth. Self-report retrospective data from a nonrandom sample limit generalizability of results; however, the awareness and reasoning of the women, coupled with their emphasis on leaving as process and personal growth, suggest the importance of education and support programs for abused women and women at risk for abuse.

  5. 78 FR 14701 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and..., the information collection associated with the Commission's Misuse of Internet Protocol (IP) Captioned... Registration and Documentation of Disability for Eligibility to Use IP Captioned Telephone Service, CG Docket...

  6. Fatal child abuse: a study of 13 cases of continuous abuse.

    PubMed

    Kauppi, Anne Leena Marika; Vanamo, Tuija; Karkola, Kari; Merikanto, Juhani

    2012-07-26

    A parent who continuously physically abuses her/his child doesn't aim to kill the child but commits an accidental filicide in a more violent outburst of anger. Fatal abuse deaths are prevented by recognition of signs of battering in time. Out of 200 examined intra-familial filicides, 23 (12%) were caused by child battering and 13 (7%) by continuous battering. The medical and court records of the victim and the perpetrator were examined. The perpetrator was the biological mother and the victim was male in 69 per cent of the cases. The abused children were either younger than one year or from two-and-a-half to four years old. Risk factors of the victim (being unwanted, premature birth, separation from the parent caused by hospitalization or custodial care, being ill and crying a lot) and the perpetrator (personality disorder, low socioeconomic status, chaotic family conditions, domestic violence, isolation, alcohol abuse) were common. The injuries caused by previous battering were mostly soft tissue injuries in head and limbs and head traumas and the battering lasted for days or even an year. The final assault was more violent and occurred when the parent was more anxious, frustrated or left alone with the child. The perpetrating parent was diagnosed as having a personality disorder (borderline, narcissistic or dependent) and often substance dependence (31%). None of them were psychotic. Authorities and community members should pay attention to the change in child's behavior and inexplicable injuries or absence from daycare. Furthermore if the parent is immature, alcohol dependent, have a personality disorder and is unable to cope with the demands the small child entails in the parent's life, the child may be in danger.

  7. Psychotic Symptoms Associated with the use of Dopaminergic Drugs, in Patients with Cocaine Dependence or Abuse.

    PubMed

    Roncero, Carlos; Abad, Alfonso C; Padilla-Mata, Antonio; Ros-Cucurull, Elena; Barral, Carmen; Casas, Miquel; Grau-López, Lara

    2017-01-01

    In the field of dual diagnosis, physicians are frequently presented with pharmacological questions. Questions about the risk of developing psychotic symptoms in cocaine users who need treatment with dopaminergic drugs could lead to an undertreatment. Review the presence of psychotic symptoms in patients with cocaine abuse/dependence, in treatment with dopaminergic drugs. Systematic PubMed searches were conducted including December 2014, using the keywords: "cocaine", dopaminergic drug ("disulfuram-methylphenidate-bupropion-bromocriptine-sibutramineapomorphine- caffeine") and ("psychosis-psychotic symptoms-delusional-paranoia"). Articles in English, Spanish, Portuguese, French, and Italian were included. Articles in which there was no history of cocaine abuse/dependence, absence of psychotic symptoms, systematic reviews, and animal studies, were excluded. 313 papers were reviewed. 7 articles fulfilled the inclusion-exclusion criteria. There is a clinical trial including 8 cocaine-dependent patients using disulfiram in which 3 of them presented psychotic symptoms and 6 case-reports: disulfuram (1), methylphenidate (1), disulfiram with methylphenidate (2), and bupropion (2), reporting psychotic symptoms, especially delusions of reference and persecutory ideation. Few cases have been described, which suggests that the appearance of these symptoms is infrequent. The synergy of dopaminergic effects or the dopaminergic sensitization in chronic consumption are the explanatory theories proposed by the authors. In these cases, a relationship was found between taking these drugs and the appearance of psychotic symptoms. Given the low number of studies found, further research is required. The risk of psychotic symptoms seems to be acceptable if we compare it with the benefits for the patients but a closer monitoring seems to be advisable.

  8. Transdermal fentanyl: pharmacology and toxicology.

    PubMed

    Nelson, Lewis; Schwaner, Robert

    2009-12-01

    To evaluate the underlying pharmacology, safety, and misuse/abuse of transdermal fentanyl, one of the cornerstone pharmacotherapies for patients with chronic pain. Literature was identified through searches of Medline (PubMed) and several textbooks in the areas of pharmacology, toxicology, and pain management. A bibliographical review of articles identified by these searches was also performed. Search terms included combinations of the following: fentanyl, transdermal, patch, pharmacology, kinetics, toxicity, and poisoning. All pertinent clinical trials, retrospective studies, and case reports relevant to fentanyl pharmacology and transdermal fentanyl administered by any route and published in English were identified. Each was reviewed for data regarding the clinical pharmacology, abuse, misuse, and safety of transdermal fentanyl. Data from these studies and information from review articles and pharmaceutical prescribing information were included in this review. Fentanyl is a high-potency opioid that has many uses in the treatment of both acute and chronic pain. Intentional or unintentional misuse, as well as abuse, may lead to significant clinical consequences, including death. Both the US Food and Drug Administration (FDA) and Health Canada have warned of potential pitfalls associated with transdermal fentanyl, although these have not been completely effective in preventing life-threatening adverse events and fatalities related to its inappropriate use. Clinically consequential adverse effects may occur unexpectedly with normal use of transdermal fentanyl, or if misused or abused. Misuse and therapeutic error may be largely preventable through better education at all levels for both the prescriber and patient. The prevention of intentional misuse or abuse may require regulatory intervention.

  9. Inter-personal violence and abuse in adolescent intimate relationships: mental health impact and implications for practice.

    PubMed

    Barter, Christine; Stanley, Nicky

    2016-10-01

    This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.

  10. Reality Television Programs Are Associated With Illegal Drug Use and Prescription Drug Misuse Among College Students.

    PubMed

    Fogel, Joshua; Shlivko, Alexander

    2016-01-02

    Reality television watching and social media use are popular activities. Reality television can include mention of illegal drug use and prescription drug misuse. To determine if reality television and social media use of Twitter are associated with either illegal drug use or prescription drug misuse. Survey of 576 college students in 2011. Independent variables included watching reality television (social cognitive theory), parasocial interaction (parasocial interaction theory), television hours watched (cultivation theory), following a reality television character on Twitter, and demographics. Outcome variables were illegal drug use and prescription drug misuse. Watching reality television and also identifying with reality TV program characters were each associated with greater odds for illegal drug use. Also, following a reality TV character on Twitter had greater odds for illegal drug use and also in one analytical model for prescription drug misuse. No support was seen for cultivation theory. Those born in the United States had greater odds for illegal drug use and prescription drug misuse. Women and Asians had lower odds for illegal drug use. African Americans and Asians had lower odds for prescription drug misuse. Physicians, psychologists, and other healthcare practitioners may find it useful to include questions in their clinical interview about reality television watching and Twitter use. Physician and psychology groups, public health practitioners, and government health agencies should consider discussing with television broadcasting companies the potential negative impact of including content with illegal drugs and prescription drug misuse on reality television programs.

  11. Uses and Misuses of the Correlation Coefficient.

    ERIC Educational Resources Information Center

    Onwuegbuzie, Anthony J.; Daniel, Larry G.

    The purpose of this paper is to provide an in-depth critical analysis of the use and misuse of correlation coefficients. Various analytical and interpretational misconceptions are reviewed, beginning with the egregious assumption that correlational statistics may be useful in inferring causality. Additional misconceptions, stemming from…

  12. Examining the Frequency of Stimulant Misuse among Patients with Primary Disorders of Hypersomnolence: A Retrospective Cohort Study

    PubMed Central

    Mantyh, William G.; Auger, R. Robert; Morgenthaler, Timothy I.; Silber, Michael H.; Moore, Wendy R.

    2016-01-01

    Study Objectives: Narcolepsy and idiopathic hypersomnia are commonly treated by sleep specialists and encountered by other medical providers. Although pharmacotherapy with modafinil and traditional stimulants is considered the mainstay of treatment, physicians are often uncomfortable with their prescription because of concerns regarding misuse. The goal of this study was to assess the frequency of stimulant misuse in this population. Methods: A retrospective cohort study was performed evaluating patients 18 years and older diagnosed with narcolepsy with and without cataplexy and idiopathic hypersomnia with and without long sleep between 2003–2008. Patients were included if they obtained stimulant prescriptions from and had at least one follow-up visit subsequent to initial diagnosis at our center. Stimulant misuse was defined by multiple prescription sources or early refill requests, which are systematically entered into the record by nursing staff. Results: A total of 105 patients met inclusion criteria for the study; 45 (42%) were male. Mean age at multiple sleep latency test was 42 (± 16). Twelve (11%) patients had a history of illicit substance misuse, and one (1%) patient demonstrated previous stimulant misuse. Fifty-seven (54%) patients carried psychiatric diagnoses, 88% of whom reported depression. Median duration of monitored stimulant therapy was 26 months (range 1–250). None of the 105 patients was found to have evidence of stimulant misuse. Conclusion: This study suggests that the frequency of stimulant misuse in patients with narcolepsy and idiopathic hypersomnia is extremely low. Concerns regarding drug misuse should not leverage decisions to provide long-term therapy. Citation: Mantyh WG, Auger RR, Morgenthaler TI, Silber MH, Moore WR. Examining the frequency of stimulant misuse among patients with primary disorders of hypersomnolence: a retrospective cohort study. J Clin Sleep Med 2016;12(5):659–662. PMID:26943713

  13. Sources of Nonmedically Used Prescription Stimulants: Differences in Onset, Recency and Severity of Misuse in a Population-Based Study*

    PubMed Central

    Chen, Lian-Yu; Strain, Eric C.; Crum, Rosa M.; Storr, Carla L.; Mojtabai, Ramin

    2014-01-01

    Aim Epidemiological data indicate that nonmedical use of prescription stimulants has increased over the past decade. However, little is known regarding the source of the misused stimulants and whether different sources correspond to differences in risk profiles and associated social and health problems. Method Data from the 2006 to 2011 National Survey on Drug Use and Health were used. A total of 4,945 participants who used prescription stimulants nonmedically and also reported their source of misused stimulants were categorized by the source: friend/relative, physician and illegal. Logistic regression models compared the socio-demographic, mental health and behavioral problems, and stimulant use-related problems (onset, recency, frequency, severity) according to the source of the misused stimulants. Results The most common sources of stimulants were friends/relatives, followed by physicians and illegal sources. Compared to participants reporting friends/relatives as the source, participants reporting an illegal source were more likely to be male, unemployed, have less than a high school education, a history of criminal behavior and an earlier age of use onset. Participants reporting a physician source were more likely to have mental health problems and mental health service use. Higher odds of past-month stimulant use, frequent use (≥10 days per year), drug dependence and substance service use were found in individuals reporting physician and illegal sources. Conclusions Identifying the source of misused stimulants may be useful in detecting distinct subgroups of nonmedical prescription stimulant users, which may inform development of tailored prevention and treatment programs and contribute to individual treatment planning. PMID:25454408

  14. Substance use in remand prisoners: a consecutive case study.

    PubMed Central

    Mason, D.; Birmingham, L.; Grubin, D.

    1997-01-01

    OBJECTIVES: To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN: A consecutive case study of remand prisoners screened at reception for substance misuse and treatment needs and comparison of findings with those of prison reception screening and treatment provision. SETTING: A large adult male remand prison (Durham). SUBJECTS: 548 men aged 21 and over awaiting trial. MAIN OUTCOME MEASURES: Prevalence of substance misuse; treatment needs of substance misusers; effectiveness of prison reception screening for substance misuse; provision of detoxification programmes. RESULTS: Before remand 312 (57%) men were using illicit drugs and 181 (33%) met DSM-IV drug misuse or dependence criteria; 177 (32%) men met misuse or dependence criteria for alcohol. 391 (71%) men were judged to require help directed at their drug or alcohol use and 197 (36%) were judged to require a detoxification programme. The prison reception screen identified recent illicit drug use in 131 (24%) of 536 men and problem drinking in 103 (19%). Drug use was more likely to be identified by prison screening if an inmate was using multiple substances, using opiates, or had a diagnosis of abuse or dependence. 47 (9%) of 536 inmates were prescribed treatment to ease the symptoms of substance withdrawal. CONCLUSIONS: The prevalence of substance misuse in newly remanded prisoners is high. Prison reception health screening consistently underestimated drug and alcohol use. In many cases in which substance use is identified the quantities and numbers of different substances being used are underestimated. Initial management of inmates identified by prison screening as having problems with dependence producing substances is poor. Few receive a detoxification programme, so that many are left with the option of continuing to use drugs in prison

  15. Pregabalin abuse among opiate addicted patients.

    PubMed

    Grosshans, Martin; Lemenager, Tagrid; Vollmert, Christian; Kaemmerer, Nina; Schreiner, Rupert; Mutschler, Jochen; Wagner, Xenija; Kiefer, Falk; Hermann, Derik

    2013-12-01

    Pregabalin is a novel GABA-analogue approved for the treatment of partial onset seizures, neuropathic pain, and general anxiety disorder. Pregabalin has been classified as a Schedule V drug with a low risk of inflicting abuse or addiction. However, some publications have indicated that pregabalin may have a potential for abuse among patients with past or current opiate addiction. Thus, we hypothesized that pregabalin might be abused by patients who were undergoing an opiate replacement therapy and never had an indication for taking pregabalin on medical grounds. Urine specimens from 124 patients with opiate dependency syndrome and from 111 patients with other addiction disorders (alcohol, benzodiazepines, cannabis, amphetamines) were screened for pregabalin by means of a mass spectrometer analysis. We found 12.1 % of all urine specimens from patients with opiate addiction to be positive for pregabalin. None of the patients concerned had a medical indication for using pregabalin. In the control group, 2.7 % of the patients were tested positively for pregabalin, due to their taking it regularly for chronic pain or general anxiety. Our data suggest that pregabalin is liable to be abused among individuals with opiate dependency syndrome Thus, vigilance and caution are called for when patients with a past or current opiate dependency are exposed to treatment with pregabalin.

  16. An Australian Twin Study of Cannabis and Other Illicit Drug Use and Misuse, and Other Psychopathology

    PubMed Central

    Lynskey, Michael T.; Agrawal, Arpana; Henders, Anjali; Nelson, Elliot C.; Madden, Pamela A. F.; Martin, Nicholas G.

    2013-01-01

    Cannabis is the most widely used illicit drug throughout the developed world and there is consistent evidence of heritable influences on multiple stages of cannabis involvement including initiation of use and abuse/dependence. In this paper, we describe the methodology and preliminary results of a large-scale interview study of 3,824 young adult twins (born 1972–1979) and their siblings. Cannabis use was common with 75.2% of males and 64.7% of females reporting some lifetime use of cannabis while 24.5% of males and 11.8% of females reported meeting criteria for DSM-IV cannabis abuse or dependence. Rates of other drug use disorders and common psychiatric conditions were highly correlated with extent of cannabis involvement and there was consistent evidence of heritable influences across a range of cannabis phenotypes including early (≤15 years) opportunity to use (h2 = 72%), early (≤16 years) onset use (h2 = 80%), using cannabis 11+ times lifetime (h2 = 76%), and DSM abuse/dependence (h2 = 72%). Early age of onset of cannabis use was strongly associated with increased rates of subsequent use of other illicit drugs and with illicit drug abuse/dependence; further analyses indicating that some component of this association may have been mediated by increasing exposure to and opportunity to use other illicit drugs. PMID:22874079

  17. Intention and Willingness in Understanding Ritalin Misuse Among Iranian Medical College Students: A Cross-Sectional Study

    PubMed Central

    Eslami, Ahmad Ali; Jalilian, Farzad; Ataee, Mari; Alavijeh, Mehdi Mirzaei; Mahboubi, Mohammad; Afsar, Ali; Aghaei, Abbas

    2014-01-01

    Ritalin misuse can create powerful stimulant effects and serious health risks. The main aim of present study was compared that two cognitive construct (behavioral intention or behavioral willingness) for predicting Ritalin misuse. This cross-sectional study was conducted among 264 Iranian medical college students; participants selected in random sampling, and data were collected by using self-report questionnaire. Data were analyzed by SPSS version 21 at 95% significant level. Our findings showed, the three predictor variables of (1) attitude, (2) subjective norms, and (3) prototype accounted for 29% of the variation in intention and 25% of the variation in willingness to Ritalin misuse. In addition, behavioral intention was a stronger prediction factor compared to willingness for Ritalin misuse, with odds ratio estimate of 1.607 [95% CI: 1.167, 2.213]. There is some support to use the prototype willingness model to design interventions to improve individuals’ beliefs that academic goals are achievable without the misuse of Ritalin. PMID:25363098

  18. Antibiotics: Misuse Puts You and Others at Risk

    MedlinePlus

    ... those bacteria are said to be antibiotic resistant. Antibiotic resistance is one of the world's most pressing health ... misuse of antibiotics are key factors contributing to antibiotic resistance. The general public, doctors and hospitals all play ...

  19. Examining the Frequency of Stimulant Misuse among Patients with Primary Disorders of Hypersomnolence: A Retrospective Cohort Study.

    PubMed

    Mantyh, William G; Auger, R Robert; Morgenthaler, Timothy I; Silber, Michael H; Moore, Wendy R

    2016-05-15

    Narcolepsy and idiopathic hypersomnia are commonly treated by sleep specialists and encountered by other medical providers. Although pharmacotherapy with modafinil and traditional stimulants is considered the mainstay of treatment, physicians are often uncomfortable with their prescription because of concerns regarding misuse. The goal of this study was to assess the frequency of stimulant misuse in this population. A retrospective cohort study was performed evaluating patients 18 years and older diagnosed with narcolepsy with and without cataplexy and idiopathic hypersomnia with and without long sleep between 2003-2008. Patients were included if they obtained stimulant prescriptions from and had at least one follow-up visit subsequent to initial diagnosis at our center. Stimulant misuse was defined by multiple prescription sources or early refill requests, which are systematically entered into the record by nursing staff. A total of 105 patients met inclusion criteria for the study; 45 (42%) were male. Mean age at multiple sleep latency test was 42 (± 16). Twelve (11%) patients had a history of illicit substance misuse, and one (1%) patient demonstrated previous stimulant misuse. Fifty-seven (54%) patients carried psychiatric diagnoses, 88% of whom reported depression. Median duration of monitored stimulant therapy was 26 months (range 1-250). None of the 105 patients was found to have evidence of stimulant misuse. This study suggests that the frequency of stimulant misuse in patients with narcolepsy and idiopathic hypersomnia is extremely low. Concerns regarding drug misuse should not leverage decisions to provide long-term therapy. © 2016 American Academy of Sleep Medicine.

  20. [Personality variables, psychopathological alterations and personality disorders in alcohol-dependent patients according to Cloninger's typology of alcohol abuse].

    PubMed

    Echeburúa, Enrique; Bravo de Medina, Ricardo; Aizpiri, Javier

    2008-11-01

    In this paper, an evaluation of Cloninger's typology of alcohol abuse in personality, psychopathology and personality disorders is carried out. The sample consisted of 158 alcoholics in treatment (56 Type I alcohol-dependent patients and 102 Type II alcohol-dependent patients). All subjects were assessed with diverse assessment tools related to personality (Impulsiveness Scale, Sensation Seeking Scale and STAI), psychopathology (SCL-90-R, BDI and Inadaptation Scale) and personality disorders (IPDE). The main findings were that Type II alcohol-dependent patients were more impulsive and sensation-seeking and they displayed more hostility and emotional distress than Type I alcohol-dependent patients. Personality disorders were not so prevalent in the case of Type I alcohol-dependent patients. The most specific personality disorders for Type II alcohol-dependent patients were narcissistic and paranoid. The implications of this study for further research are commented on.