College Student Drug Use: A Note on Some Correlates of Cessation.

ERIC Educational Resources Information Center

Slappy, Charles A.

1985-01-01

A study of self-reported drug use by 433 undergraduates revealed significant differences between current and former users. Former users are less alienated, less likely to endorse drug use wholeheartedly, and less likely to condemn the law and legal institutions. Nonetheless, the attitudes of former users are closer to current users' than…

The Impact of Drug Use in Social Networks of Patients with Substance Use and Bipolar Disorders

PubMed Central

McDonald, Leah J.; Griffin, Margaret L.; Kolodziej, Monika E.; Fitzmaurice, Garrett M.; Weiss, Roger D.

2011-01-01

In this exploratory analysis, we assessed the effect of drug use among social network members on recovery from drug dependence in patients with co-occurring bipolar disorder. Patients (n=57) enrolled in a group therapy study completed assessments over 15 months. Patients with 0–1 drug users in their social networks at intake had few days of drug use during treatment and follow-up, whereas those with ≥ 2 drug users had significantly more days of drug use. Multivariate analysis showed that patients who consistently named multiple drug users in their social networks had a marked increase in drug use over 15 months, while those who never or occasionally named multiple drug users had a small decline in drug use over time. Multiple drug users in social networks of treatment-seeking drug dependent patients with co-occurring bipolar disorder may indicate poor drug use outcomes; efforts to reduce the association with drug users may be useful. This clinical trial has been registered in a public trials registry at clinicaltrials.gov (identifier is NCT00227838). PMID:21314751

A qualitative exploration of travel-related risk behaviours of injection drug users from two Slovene regions

PubMed Central

2011-01-01

This qualitative study of travel-related risk behaviours of Slovene injection drug users was based on interviews with individuals enrolled in drug addiction treatment programmes run by three regional centres for prevention and treatment of drug addiction. The primary objective of the study was to analyse behaviour patterns and practices of injection drug users during travel. Methods Travel-related problems of Slovene injection drug users were identified on the basis of data obtained by 25 in-depth interviews. A semi-structured questionnaire with 13 open-ended questions was developed after a preliminary study and review of the literature, and on the basis of experience with the treatment of drug addiction in Slovenia. Results The sample comprised 25 individuals, 18 men and seven women, aged 25 to 53 years. The interviews were 10 to 30 minutes long. The results obtained were presented as identified risk behaviours. Five categories were generated, providing information on the following topics: procurement of illicit drugs, criminal acts/environment, HIV and hepatitis B and C infections, storage and transport of substitution medication and pre-travel health protection. The first three categories comprise the injection drug users' risk behaviours that are most frequently explored in the literature. The other two categories - storage and transport of medication across the border and pre-travel health protection - reflect national specificities and the effectiveness of substitution treatment programmes. The majority of participants denied having shared needles and other injecting equipment when travelling. Participants who had no doctor's certificate had recourse to various forms of risk behaviour, finding a number of ways to hide the medication at the border. Conclusion This qualitative study provides insight into potential travel-related risk behaviour of injection drug users from two Slovene regions - central and coastal. The potential value of this qualitative study is primarily in the identification of potential risk behaviour of Slovene injection drug users travelling abroad. The study shows that injection drug users' experiences can contribute to better and more efficient treatment of drug addiction in Slovenia. PMID:21496340

Past 12-month and lifetime comorbidity and poly-drug use of ecstasy users among young adults in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Keyes, Katherine M.; Martins, Silvia S.; Hasin, Deborah S.

2013-01-01

Background Ecstasy use is prevalent among young people and often co-occurs with other drug use, but little is known about the past 12-month and lifetime psychiatric comorbidity and specific additional drug abuse among young adult ecstasy users in the general population. To provide this information, we compared current ecstasy users to former users, other illicit drug users, and non-illicit drug users. Method Data were gathered in a face-to-face survey of the United States conducted in the 2001–2002 (NESARC). Participants were household and group quarters residents aged 18–29 years (n = 8666). We measured current ecstasy use defined as any use in the past year; former ecstasy use as use prior to the past year only; other lifetime drug use included any drug other than ecstasy; lifetime non-illicit drug use as no illicit drug use. Associations were determined for nine other classes of illicit drugs, eight personality disorders, and seven mood and anxiety disorders. Results Of current ecstasy users, 44% used >3 other classes of illicit drugs in the past year, compared to 1.6% of non-ecstasy drug users. Current ecstasy use was associated with current anxiety (OR = 3.7), specifically panic disorder (OR = 7.7) and specific phobia (OR = 4.1), also alcohol abuse (OR = 21.6) and dependence (OR = 4.1) and any personality disorder (OR = 5.1) compared to non-illicit drug users. Conclusions Results indicate important differences in comorbidities of current and former ecstasy users compared to other drug users and lifetime non-illicit drug users that may affect phenotype definitions and etiologic studies. Ecstasy use may represent a distinct population of drug users for which unique treatments may be necessary. PMID:18524499

The Influence of Drug Testing and Benefit-Based Distribution of Opioid Substitution Therapy on Drug Abstinence.

PubMed

Gabrovec, Branko

2015-01-01

The objective of our research was to discover whether the new approach to urine drug testing has a positive effect on users' abstinence, users' treatment, and their cooperation, while remaining user-friendly, and whether this approach is more cost-effective. The centers are focused on providing high-quality treatment within a cost-efficient program. In this study, we focus on the influence of drug testing and benefit-based distribution of opioid substitution therapy (BBDOST) on drug abstinence. The purpose of this study was to find any possible positive effect of modified distribution of the therapy and illicit drug testing on the number of users who are abstinent from illicit drugs and users who are not abstinent from illicit drugs as well as the users' opinion on BBDOST and testing. We are also interested in a difference in abstinence rates between those on BBDOST and those not receiving BBDOST. In 2010, the method of drug testing at the center was changed (less frequent and random drug testing) to enable its users faster access to BBDOST (take-home therapy). It was found that the number of drug-abstinent program participants has increased from initial 44.5% (2010) to 54.1% (2014). According to the program participants, the new method allows them to achieve and maintain abstinence from drugs more easily. In addition, they are also satisfied with the modified way of drug testing. This opinion does not change with age, gender, and acquired benefits.

Gender differences in self-reported anxiety, depression, and somatization among ecstasy/MDMA polydrug users, alcohol/tobacco users, and nondrug users.

PubMed

Milani, Raffaella M; Parrott, Andy C; Turner, John J D; Fox, Helen C

2004-07-01

Previous research has found gender differences in both psychological and physiological responses to drugs. The present investigation explores gender variability in patterns of drug use in relation to self-reported depression, anxiety, and somatization. The current study confirms that heavy illegal drug users are represented by a preponderance of males than females. However, within each drug group category, females generally reported higher psychopathology scores than males. This was significant for all three subscales in the alcohol/tobacco group, for depression scores in the alcohol/tobacco, cannabis/alcohol, and light Ecstasy users group, and for depression scores for the alcohol group. Interestingly, in the male sample, drug users reported higher symptom ratings than nondrug users, whereas women's scores remained constant across drug groups. Copyright 2004 Elsevier Ltd.

The motivation for drug abuse treatment: testing cognitive and 12-step theories.

PubMed

Bell, D C; Montoya, I D; Richard, A J; Dayton, C A

1998-11-01

The purpose of this paper is to evaluate two models of behavior change: cognitive theory and 12-step theory. Research subjects were drawn from three separate, but parallel, samples of adults. The first sample consisted of out-of-treatment chronic drug users, the second consisted of drug users who had applied for treatment at a publicly funded multiple-provider drug treatment facility, and the third consisted of drug users who had applied for treatment at an intensive outpatient program for crack cocaine users. Cognitive theory was supported. Study participants applying for drug abuse treatment reported a higher level of perceived problem severity and a higher level of cognitive functioning than out-of-treatment drug users. Two hypotheses drawn from 12-step theory were not supported. Treatment applicants had more positive emotional functioning than out-of-treatment drug users, and one treatment-seeking sample had higher self-esteem.

Effects of transnational migration on drug use: an ethnographic study of Nepali female heroin users in Hong Kong.

PubMed

Tang, Wai-Man

2015-01-01

Past studies of female drug users in South Asia tend to focus on their plights, for instance, how they have been driven to drug use and encounter more problems than their male counterparts, such as HIV/AIDS and sexual abuse. Few studies focus on their active role--how they actively make use of resources in the external environment to construct their desired femininity through drug consumption. Furthermore, little is known about the situation of female South Asian drug users who are living overseas. This paper is a study of transnational migration, drug use and gender--how transnational migration influences the drug use of female transnational migrants. An 18-month ethnography has been carried out in a Nepali community in Hong Kong and 13 informants were interviewed. Data were coded and analyzed by using the grounded-theory approach. Themes related to the drug use of the female Nepali heroin users were identified. The findings show that there are three important themes that significantly affect the drug use of female Nepali heroin users, which include (1) their relationships with intimate partners, (2) their means of support, and (3) their legal status in migration. The findings are consistent with the concept of post-structuralism in gender and transnationalism theories. Female Nepali heroin users in Hong Kong are neither active agents nor passive victims; their active/passive role is largely dependent on their reconfigured opportunities and constraints in transnational migration. Thus, transnationalism should be taken as an important perspective to study the situation of female drug users in a globalized context. Copyright © 2014 Elsevier B.V. All rights reserved.

Unemployment, Drug Use, and HIV Risk among American Indian and Alaska Native Drug Users.

ERIC Educational Resources Information Center

Reynolds, Grace L.; Fisher, Dennis G.; Estrada, Antonio L.; Trotter, Robert

2000-01-01

Study and 6-month followup of 3,622 drug users in Tucson, Flagstaff, and Anchorage found that American Indian and Alaska Native drug users were younger, less educated, and less likely to be employed than non-Native subjects. Individuals employed at intake or followup had lower levels of HIV risk factors: injection drug use and needle sharing.…

Increased synthetic drug abuse and trends in HIV and syphilis prevalence among female drug users from 2010-2014 from Beijing, China.

PubMed

Sun, Yanming; Guo, Wei; Li, Guiying; He, Shufang; Lu, Hongyan

2018-01-01

The objective of this study was to monitor the trend of addiction drug use and its relationship with sexually transmitted infections (STIs) among female drug users (FDUs). Serial cross-sectional surveys were conducted during 2010-2014 among FDUs in Beijing to collect information on addiction drug usage, sexual behaviors, and STI prevalence. Characteristics were analyzed and compared between traditional and synthetic drug users among FDUs by logistic regression method. A total of 3859 FDUs were surveyed during 2010-2014, with the median age being 32.7 years old. The proportion of synthetic drug users among FDUs increased from 43.7% in 2010 to 70.7% in 2014. Compared with traditional drug users, synthetic drug users were younger (P < 0.001), lacked education (P < 0.001), were unmarried (P < 0.001), and were non-local residents (P < 0.001). No significant difference was found with condom usage during sexual activity between traditional and synthetic drug FDUs. However, the engagement of commercial sexual activities (P < 0.001) and syphilis prevalence (P < 0.001) among synthetic drug users were significantly higher than traditional drug users. Synthetic drug abuse appears to be correlated with commercial sex behavior and higher syphilis prevalence among FDUs. Tailored strategies on health education to curb the prevalence of synthetic drug abuse are urgently needed in Beijing.

Routines and rituals: a grounded theory of the pain management of drug users in acute care settings.

PubMed

McCreaddie, May; Lyons, Imogen; Watt, Debbie; Ewing, Elspeth; Croft, Jeanette; Smith, Marion; Tocher, Jennifer

2010-10-01

This study reviewed the perceptions and strategies of drug users and nurses with regard to pain management in acute care settings. Drug users present unique challenges in acute care settings with pain management noted to be at best suboptimal, at worst non-existent. Little is known about why and specifically how therapeutic effectiveness is compromised. Qualitative: constructivist grounded theory. A constructivist grounded theory approach incorporating a constant comparative method of data collection and analysis was applied. The data corpus comprised interviews with drug users (n = 11) and five focus groups (n = 22) of nurses and recovering drug users. Moral relativism as the core category both represents the phenomenon and explains the basic social process. Nurses and drug users struggle with moral relativism when addressing the issue of pain management in the acute care setting. Drug users lay claim to expectations of compassionate care and moralise via narration. Paradoxically, nurses report that the caring ideal and mutuality of caring are diminished. Drug users' individual sensitivities, anxieties and felt stigma in conjunction with opioid-induced hyperalgesia complicate the processes. Nurses' and hospitals' organisational routines challenge drug user rituals and vice versa leading both protagonists to become disaffected. Consequently, key clinical issues such as preventing withdrawal and managing pain are left unaddressed and therapeutic effectiveness is compromised. This study provides a robust account of nurses' and drug users' struggle with pain management in the acute care setting. Quick technological fixes such as urine screens, checklists or the transient effects of (cognitive-based) education (or training) are not the answer. This study highlights the need for nurses to engage meaningfully with this perceptibly 'difficult' group of patients. The key aspects likely to contribute to problematic interactions with this patient cohort are outlined so that they can be prevented and, or addressed. © 2010 Blackwell Publishing Ltd.

Perceived Drug Use Functions and Risk Reduction Practices Among High-Risk Nonmedical Users of Prescription Drugs

PubMed Central

Silva, Karol; Kecojevic, Aleksandar; Lankenau, Stephen E.

2014-01-01

Nonmedical use of prescription drugs has become the fastest growing drug problem in the United States, particularly among young adults. This study examines the reasons young polydrug users misuse prescription drugs, and explores how young users employ risk reduction strategies to minimize adverse consequences. The sample was recruited during 2008 and 2009 in Los Angeles and New York, and comprised 45 nonmedical users of prescription drugs, aged 16 to 25. Data from a semistructured interview were analyzed quantitatively and qualitatively. Participants reported nonmedical use of prescription drugs to change mood, to facilitate activity, and to monitor the intake of other substances. Commonly employed risk reduction strategies included calculating pill timing, dosage, and access, and monitoring frequency of use, particularly when combining different substances. Most study participants often planned drug use to occur within socially acceptable parameters, such that prescription drug misuse was a normalized feature of their everyday lives. PMID:25477621

How do drug users define their progress in harm reduction programs? Qualitative research to develop user-generated outcomes

PubMed Central

Ruefli, Terry; Rogers, Susan J

2004-01-01

Background Harm reduction is a relatively new and controversial model for treating drug users, with little formal research on its operation and effectiveness. In order to advance the study of harm reduction programs and our understanding of how drug users define their progress, qualitative research was conducted to develop outcomes of harm reduction programming that are culturally relevant, incremental, (i.e., capable of measuring change), and hierarchical (i.e., capable of showing how clients improve over time). Methods The study used nominal group technique (NGT) to develop the outcomes (phase 1) and focus group interviews to help validate the findings (phase 2). Study participants were recruited from a large harm-reduction program in New York City and involved approximately 120 clients in 10 groups in phase 1 and 120 clients in 10 focus groups in phase 2. Results Outcomes of 10 life areas important to drug users were developed that included between 10 to 15 incremental measures per outcome. The outcomes included ways of 1) making money; 2) getting something good to eat; 3) being housed/homeless; 4) relating to families; 5) getting needed programs/benefits/services; 6) handling health problems; 7) handling negative emotions; 8) handling legal problems; 9) improving oneself; and 10) handling drug-use problems. Findings also provided insights into drug users' lives and values, as well as a window into understanding how this population envisions a better quality of life. Results challenged traditional ways of measuring drug users based solely on quantity used and frequency of use. They suggest that more appropriate measures are based on the extent to which drug users organize their lives around drug use and how much drug use is integrated into their lives and negatively impacts other aspects of their lives. Conclusions Harm reduction and other programs serving active drug users and other marginalized people should not rely on institutionalized, provider-defined solutions to problems in living faced by their clients. PMID:15333130

Homeless drug users' awareness and risk perception of peer "Take Home Naloxone" use – a qualitative study

PubMed Central

Wright, Nat; Oldham, Nicola; Francis, Katharine; Jones, Lesley

2006-01-01

Background Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. Methods In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. Results Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. Conclusion There is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users. PMID:17014725

HIV seroprevalence among street-recruited injection drug and crack cocaine users in 16 US municipalities.

PubMed Central

Kral, A H; Bluthenthal, R N; Booth, R E; Watters, J K

1998-01-01

OBJECTIVES: This study deter- mined human immunodeficiency virus (HIV) seroprevalence and factors associated with HIV infection among street-recruited injection drug users and crack cocaine smokers. METHODS: An analysis was performed on HIV serologies and risk behaviors of 6402 injection drug users and 3383 crack smokers in 16 US municipalities in 1992 and 1993. RESULTS: HIV seroprevalence was 12.7% among injection drug users and 7.5% among crack smokers. Most high-seroprevalence municipalities (>25%) were located along the eastern seaboard of the United States. In high-seroprevalence municipalities, but not in others, HIV seroprevalence was higher for injection drug users than for crack smokers. Among injection drug users, cocaine injection, use of speedballs (cocaine or amphetamines with heroin), and sexual risk behaviors were independently associated with HIV infection. Among crack smokers, sexual risk behaviors were associated with HIV infection. CONCLUSIONS: Injection drug users and crack smokers are at high risk for HIV infection. PMID:9584014

Patterns of Drug Use in a Sample of 200 Young Drug Users in London

ERIC Educational Resources Information Center

McCambridge, Jim; Strang, John

2004-01-01

A cross-sectional analysis of baseline data collected during a secondary prevention intervention study was conducted to describe patterns of drug use in a non-treatment sample of young drug users recruited in ten further-education colleges across inner London. Participants were 200 young people who were either weekly cannabis users and/or who had…

Drug problems in contemporary China: a profile of Chinese drug users in a metropolitan area.

PubMed

Huang, Kaicheng; Zhang, Lening; Liu, Jianhong

2011-03-01

Drug problems are reemerging in China since the nation implemented economic reform and an "open door" policy in the early 1980s. This is causing both national and international concern. However, knowledge and understanding of the Chinese drug problem is fairly limited because of the nation's unique social and political history. In response to this shortage of information, our study presents a profile of Chinese drug users. Data were collected from a survey of drug users attending mandatory treatment centres in a large city in 2009. We present a demographic profile of the drug users, describe their patterns of drug use, their access to drugs and their history of drug treatment. Chinese drug users, like those from the U.S., are likely to be unemployed and have a low level of education. However, they are more likely than those in the U.S. to use heroin, Bingdu (methamphetamine) and Maguo (a derivative of methamphetamine), and they pay less for their drugs. This profile of drug users is informative and valuable for drug prevention, intervention, and treatment in the Chinese setting because knowing and understanding the drug population is essential for effective control. Copyright © 2010 Elsevier B.V. All rights reserved.

Drug use disorders in the polydrug context: new epidemiological evidence from a foodborne outbreak approach

PubMed Central

Lopez-Quintero, Catalina; Anthony, James C.

2016-01-01

As epidemiologists studying foodborne illness outbreaks, we do not ask luncheon attendees to say which food caused their illnesses. Instead, we use measurement and analysis methods to estimate food-specific risk variations. Here, we adapt the foodborne outbreak approach to develop new estimates of drug use disorder risk for single-drug and polydrug users, without attributing the syndrome to a specific drug when multiple drugs have been used. We estimate drug use disorder risk for cannabis-only users as a reference value. We then derive comparative relative risk estimates for users of other drug subtypes, including polydrug combinations. Data are from the 2002 to 2003 U.S. National Comorbidity Survey Replication, a nationally representative sample of household residents (18+ years), with standardized drug use and drug dependence assessments. Multiple logistic regression provides odds ratio estimates of relative risk. With this approach, for every 1000 cannabis-only users, an estimated 17 had become cases (1.7%). By comparison, polydrug users and cocaine-only users had much greater cumulative incidence (>10%), even with adjustment for covariates and local area matching (P < 0.001). Using this approach, we find exceptionally low risk for cannabis-only users and greater risk for polydrug and cocaine-only users. PMID:26348487

Attitude of Health Care Workers (HCWs) toward Patients Affected by HIV/AIDS and Drug Users: A Cross-Sectional Study.

PubMed

Ledda, Caterina; Cicciù, Francesca; Puglisi, Beatrice; Ramaci, Tiziana; Nunnari, Giuseppe; Rapisarda, Venerando

2017-03-09

Caring for HIV/AIDS patients and/or drug users requires health care workers (HCWs) to have good knowledge of the issues. Cultural differences in HCWs, combined with professional ethics and personal beliefs, could also result in conflicting attitudes, leading to difficulties related to looking after people affected by HIV/AIDS or drug users. A cross-sectional study was carried out to assess the attitude towards HIV/AIDS patients and/or drug users in a sample of workers operating in a large university hospital in southern Italy. A total of 736 workers were surveyed from May to November 2016. During the periodic occupational health surveillance, a questionnaire was administered about attitudes of discrimination, acceptance and fear towards these patients. Respondents showed average levels of acceptance to HIV/AIDS and drug user patients. As years of experience and professional training increased, scores for discrimination, acceptance of HIV/AIDS, acceptance of drug users and fear decreased. Factors positively influencing levels of attitudes were being female and younger. Supplementary education is needed to strengthen the awareness of HCWs.

Pulmonary and latent tuberculosis screening in opiate drug users: an essential and neglected approach for harm-reduction facilities.

PubMed

Honarvar, Behnam; Lankarani, Kamran Bagheri; Odoomi, Neda; Roudgari, Amir; Moghadami, Mohsen; Kazerooni, Parvin Afsar; Abadi, Alireza Hassan

2013-01-01

Opiates drug users are at much higher risk of developing tuberculosis (TB) infection than general population. We conducted this study to determine the susceptibility for pulmonary and latent TB infection in opiates drug users. In this cross-sectional study, all opiates drug users referred to drop-in centers, methadone maintenance clinics, and harm-reduction facilities affiliated with Shiraz University of Medical Sciences in southern Iran were screened for pulmonary and latent TB infection. The participation rate of opiate drug users was 87.66% (263 of 300). Mean age was 37.37 ± 8.33 (range, 20-65) years. Two hundred twenty-six (85.93%) were male and 197 (74.90%) were injection drug users (IDUs). One hundred sixty-three (61.97%) had TB-related symptoms. Culture for TB was positive in 3 patients (1.14%) (2 non-IDUs and 1 IDU). Two patients (0.76%) showed acid-fast bacilli in the direct sputum smear. Eighty-five of 244 patients (34.83%) had a 5- to 10-mm induration in the skin TB test. Twenty-nine of 223 patients (13%) had abnormal findings from chest x-ray films. The prevalence of smear-positive pulmonary TB in opiate drug users is more than 100 times in the general population in Iran. Therefore, active and appropriate screening to detect pulmonary TB infection should be integrated into routine activities at all harm-reduction facilities for drug users, irrespective of their route of drug use or human immunodeficiency virus status, in this country.

Relapse Model among Iranian Drug Users: A Qualitative Study.

PubMed

Jalali, Amir; Seyedfatemi, Naiemeh; Peyrovi, Hamid

2015-01-01

Relapse is a common problem in drug user's rehabilitation program and reported in all over the country. An in-depth study on patients' experiences can be used for exploring the relapse process among drug users. Therefore, this study suggests a model for relapse process among Iranian drug users. In this qualitative study with grounded theory approach, 22 participants with rich information about the phenomenon under the study were selected using purposive, snowball and theoretical sampling methods. After obtaining the informed consent, data were collected based on face-to-face, in-depth, semi-structured interviews. All interviews were analyzed in three stages of axial, selective and open coding methods. Nine main categories emerged, including avoiding of drugs, concerns about being accepted, family atmosphere, social conditions, mental challenge, self-management, self-deception, use and remorse and a main category, feeling of loss as the core variable. Mental challenge has two subcategories, evoking pleasure and craving. Relapse model is a dynamic and systematic process including from cycles of drug avoidance to remorse with a core variable as feeling of loss.  Relapse process is a dynamic and systematic process that needs an effective control. Determining a relapse model as a clear process could be helpful in clinical sessions. RESULTS of this research have depicted relapse process among Iranian drugs user by conceptual model.

Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users.

PubMed

Goulart, Douglas Rangel; Durante, Letícia; de Moraes, Márcio; Asprino, Luciana

2015-11-01

The aim of the current study was to identify and compare the characteristics of maxillofacial trauma in alcohol and drug users with those of nonusers. A retrospective study was conducted using the medical records of patients treated for facial trauma between April 1999 and March 2012 at the Maxillofacial Surgery Division of the Piracicaba Dental School. The data were analyzed by descriptive analysis, binary logistic regression, and correlational analysis using SPSS 18.0 software. The results were considered relevant at P < 0.05. Medical records of 3724 patients with facial trauma were analyzed, of which 173 were illicit drug users and 19.36% reported alcohol intake. The use of illicit drugs was reported by 4.64%. The prevalent etiological factor among drug and alcohol users was interpersonal violence. The mandible was the face part most affected by fractures. Male patients exhibited increased odds of experiencing fractures (OR = 1.43), as did users of illicit drugs (OR = 1.62), when compared with nonusers. When faced with maxillofacial trauma, male drug users exhibited an increased chance of experiencing fractures. This knowledge should be used as a baseline to implement more efficient prevention strategies for this population.

Illegal drug use and the economic recession--what can we learn from the existing research?

PubMed

Bretteville-Jensen, Anne Line

2011-09-01

Much research on the use of amphetamine, cocaine and heroin employs individual level data and analyses variations in drug use by factors like personal characteristics, socioeconomic factors, and the social environment. Less attention is given to how these individual responses inter-relate with key macroeconomic variables. From a drug policy perspective however, it is important to also understand the consequences for drug use and drug users of changes in the macroeconomic conditions. As the world is experiencing an economic recession one would like to know whether it will affect the number of drug users and/or consumption frequency and volume amongst established users. There are different channels through which a recession could influence drug consumption; here the main focus is on how an economic downturn may influence drug prices and drug users' incomes. We briefly refer to relevant economic theory before reviewing the research literature. A fall in drug prices and income seem likely. Empirical studies confirm drug users' price responsiveness. Only a few studies have dealt with income elasticity amongst this group. As the price and the income effect may pull in opposite directions, the full effect on drug use is difficult to predict. Still, it seems likely that an economic downturn of the current magnitude could increase the use of drugs. Copyright © 2011 Elsevier B.V. All rights reserved.

Latent tuberculosis infections in hard-to-reach drug using population-detection, prevention and control.

PubMed

Hwang, Lu-Yu; Grimes, Carolyn Z; Beasley, R Palmer; Graviss, Edward A

2009-12-01

Interferon-gamma release assays (IGRAs) need be evaluated for effectiveness as screening tests for tuberculosis (TB) infection in drug users. These tests have demonstrated improved sensitivity and specificity, but have not been studied in drug users. These one step blood tests are intended to replace the tuberculin skin test (TST), which is difficult to use and requires 48 hour follow-up, so they are expected to be particularly suitable for risk groups, like drug users, in whom follow-up is problematic. Drug users have traditionally been identified as being at increased risk for acquiring TB disease. The results of our pilot study using the TST and simpler and more sensitive interferon-gamma release assays showed that about 45% of current drug users in Houston tested have at least one test positive for latent tuberculosis infection (LTBI). These preliminary data suggest that there is an important reservoir of LTBI in drug using populations, and the risk of progression to active TB disease with other infections is great. However, LTBI in drug using populations has not been studied in depth and deserves further investigation. We need to evaluate the validity of IGRAs for detection of latent TB infection, the factors associated with LTBI, the incidence and risk for developing active TB disease in drug users and the effectiveness of early treatment of LTBI. We believe that using better tuberculosis screening tools will allow us to more accurately measure the prevalence of latent TB infection and incidence of active TB disease in drug using populations and develop more effective TB prevention and treatment interventions in the community.

Syringe vending machines for injection drug users: an experiment in Marseille, France.

PubMed Central

Obadia, Y; Feroni, I; Perrin, V; Vlahov, D; Moatti, J P

1999-01-01

OBJECTIVES: This study evaluated the usefulness of vending machines in providing injection drug users with access to sterile syringes in Marseille, France. METHODS: Self-administered questionnaires were offered to 485 injection drug users obtaining syringes from 32 pharmacies, 4 needle exchange programs, and 3 vending machines. RESULTS: Of the 343 respondents (response rate = 70.7%), 21.3% used the vending machines as their primary source of syringes. Primary users of vending machines were more likely than primary users of other sources to be younger than 30 years, to report no history of drug maintenance treatment, and to report no sharing of needles or injection paraphernalia. CONCLUSIONS: Vending machines may be an appropriate strategy for providing access to syringes for younger injection drug users, who have typically avoided needle exchange programs and pharmacies. PMID:10589315

Latent Classes of Polydrug Users as a Predictor of Crash Involvement and Alcohol Consumption.

PubMed

Scherer, Michael; Romano, Eduardo; Voas, Robert; Taylor, Eileen

2018-05-01

Polydrug users have been shown to be at higher risk for alcohol consumption and crash involvement. However, research has shown that polydrug groups differ in some important ways. It is currently unknown how polydrug-using groups differ in terms of crash involvement and alcohol consumption. The current study used latent class analysis to examine subgroups of polydrug users (n = 384) among a sample of drivers in Virginia Beach, Virginia (N = 10,512). A series of logistic regression analyses were conducted to determine the relationship between polydrug use categories and crash involvement and alcohol consumption. Four distinct subclasses of users were identified among polydrug-using drivers: Class 1 is the "marijuana-amphetamines class" and accounts for 21.6% of polydrug users. Class 2 is the "benzo-antidepressant class" and accounts for 39.0% of polydrug users. Class 3 is the "opioid-benzo class" and accounts for 32.7% of polydrug users. Finally, Class 4 is the "marijuana-cocaine class" and accounts for 6.7% of the study sample. Drivers in the opioid-benzo class were significantly more likely than those in any other class as well as non-drug users and single-drug users to be involved in a crash and were more likely than those in most other conditions to consume alcohol. No significant difference was found between marijuana-amphetamine users or benzo-antidepressant users and non-drug users on crash risk. Some polydrug users are indeed at greater risk for crash involvement and alcohol consumption; however, not all polydrug users are significantly worse than single-drug users and/or non-drug users, and the practice of lumping polydrug users together when predicting crash risk runs the risk of inaccurately attributing crash involvement to certain drivers.

[Study on the characteristics of serology and sexual behavior among drug users at the HIV sentinel surveillance sites in 2012].

PubMed

Ge, Lin; Cui, Yan; Wang, Lu; Li, Dongmin; Guo, Wei; Ding, Zhengwei; Wang, Lan

2014-02-01

To analyze the serological results and sexual behavior among different types of drug users (DUS) at the HIV sentinel surveillance sites. Sentinel surveillance programs were conducted between April and June annually. DUS were those involved in custodes, living at the communities and those attending the methadone maintenance treatment clinics but with positive urine tests one month before blood sampling collected and questionnaire survey started. 116 279 drug abusers were included in the analysis. The prevalence rates of HIV, Syphilis and HCV among traditional drug (heroin, etc.)users were 5.0%, 4.4% and 49.4%, while the prevalence rates of new narcotic (meth, etc.) users were 0.5%, 4.6%, 15.2%, respectively. The prevalence rates of HIV, syphilis among traditional drug uses were higher than the new narcotic users (P < 0.01). The proportion of sexual behavior in last month and the proportion of sexual behavior with casual and commercial sexual partners were 46.3%, 87.2% and 28.1% among the new narcotic users, respectively, which were higher than those among traditional drug users (40.7% , 82.8% and 22.2%). The proportion of using condom in last sexual contact with casual sexual partner was 33.3% among the new narcotic users which was less than traditional drug users (36.2%). The proportion of condom use in the last commercial sexual contact was 65.1% which was higher than those traditional drug users (62.9%). The proportion of never using condom with casual and commercial sexual partners in the past year was 43.2% and 19.0% among the traditional drug users, which were higher than those among new narcotic users (41.3%, 15.3%). Compared with the traditional drug abusers, the sexual behavior of new narcotic users seemed more active, less engaging in condom use but with higher risk of HIV transmission through sexual contact.

Prevalence of hepatitis C virus infection and associated factors among male illicit drug users in Cuiabá, Mato Grosso, Brazil.

PubMed

Novais, Antônia Carlos Magalhães; Lopes, Carmen Luci Rodrigues; Reis, Nádia Rúbia da Silva; Silva, Agabo Macêdo Costa E; Martins, Regina Maria Bringel; Souto, Francisco José Dutra

2009-09-01

Intravenous drug injection has been reported as the main risk factor for hepatitis C virus (HCV) infection. The aim of the present study was to describe the prevalence and the epidemiological profile of HCV infection among abusers of illegal injected and non-injected drugs in Cuiabá, state of Mato Grosso, Central Brazil. A cross-sectional study including 314 male drug users from eight detoxification centres was performed. Out of 314 subjects studied, 48 (15.2%) were intravenous drug users. Participants were interviewed and had blood samples taken and tested for the presence of anti-HCV antibodies. Positive samples were tested for the presence of HCV RNA. Genotyping was performed on HCV RNA-positive samples. The overall prevalence of anti-HCV antibodies was 6.4% (n = 20). Out of 20 anti-HCV antibody-positive subjects, 16 (80%) were also HCV RNA-positive. Genotype 1 predominated (75%), followed by 3a (25%). Subtype 1a was more common than 1b. HCV infection was more prevalent among intravenous drug users (33%) than non-injecting users (1.5%). Logistic regression analyses showed independent associations between HCV infection and intravenous drug use, imprisonment and increasing age. In the present study, injecting drug use was the factor most strongly associated to HCV infection and inhaling or sniffing did not represent an increased susceptibility to infection.

Self-esteem and trait anxiety in relation to drug misuse in Kuwait.

PubMed

al-Najjar, M; Clarke, D D

1996-05-01

This study was designed to document knowledge about Kuwaiti drug users and to investigate whether or not there is an association between their poor self-concept and high level of anxiety. One hundred and seven incarcerated drug users, 107 individuals serving prison terms for offenses other than drug use, and 107 "normal" individuals were included in this pilot study. The Arabic version of Rosenberg's Self-Esteem Scale and Spielberger's State-Trait Anxiety Inventory were used to measure the subjects' self-esteem and state-trait anxiety, respectively. The results documented revealed that there is a relationship between levels of self-esteem and anxiety in Kuwaiti drug user behavior.

Epidemiological aspects of HCV infection in non-injecting drug users in the Brazilian state of Pará, eastern Amazon

PubMed Central

2014-01-01

Background Currently, sharing of drug paraphernalia is the main form of HCV transmission worldwide. In South America, consistent findings indicate that shared sniffing equipment is an important factor in the spread of HCV among non-injecting drug users. Epidemiological data on the status of HCV infection in illicit drug users in the Amazon region are scarce, although reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups are numerous. Thereby, this study investigated the prevalence, genotype frequency, and epidemiological factors associated with HCV infection in non-injecting drug users in the state of Pará, eastern Amazon. Results During 2008–2011, 300 non-injecting drug users attending drug-treatment centers participated in this study. Most non-injecting drug users were male (63.7%). The mean age was 32.5 years. The non-injecting drugs most consumed were: cannabis (15.6%), cocaine paste (21.3%), and oxi cocaine (25.7%). Tobacco (60.9%) and alcohol (79.4%) were also commonly consumed. One hundred six (35.1%; CI 95%: 29.8 - 41.1) non-injecting drug users presented anti-HCV antibodies by EIA. The HCV-RNA prevalence was 28.0% (95% CI: 20.6 - 35.8). Genotypes 1 (76.9%) and 3 (23.1%) of HCV have been identified. A multivariate analysis demonstrated that HCV infection was independently associated with the following factors: “age (≥ 35 years)”, “tattoos”, “use of a needle or syringe sterilized at home”, “shared use of drug paraphernalia”, “uses drugs for more than 5 years”, and “use of drugs everyday”. Conclusions This study revealed a high prevalence of HCV infection in non-injecting drug users, and most infections are occasioned by genotype 1. Likely, HCV transmission is associated with the tattoos, the use of needle or syringe sterilized at home by people over the age of 35 years, and sharing, time and frequency of use of non-injecting drugs. These findings should serve as an incentive for the establishment of a program of Hepatitis C prevention and control by the local public-health authorities in order to develop effective policies and strategies for contain the spread of HCV infection. PMID:24564954

Epidemiological aspects of HCV infection in non-injecting drug users in the Brazilian state of Pará, eastern Amazon.

PubMed

Oliveira-Filho, Aldemir B; Sawada, Leila; Pinto, Laine C; Locks, Daiane; Bahia, Santana L; Castro, Jairo A A; Hermes, Renata B; Brasil-Costa, Igor; Amaral, Carlos E M; Lemos, José Alexandre R

2014-02-25

Currently, sharing of drug paraphernalia is the main form of HCV transmission worldwide. In South America, consistent findings indicate that shared sniffing equipment is an important factor in the spread of HCV among non-injecting drug users. Epidemiological data on the status of HCV infection in illicit drug users in the Amazon region are scarce, although reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups are numerous. Thereby, this study investigated the prevalence, genotype frequency, and epidemiological factors associated with HCV infection in non-injecting drug users in the state of Pará, eastern Amazon. During 2008-2011, 300 non-injecting drug users attending drug-treatment centers participated in this study. Most non-injecting drug users were male (63.7%). The mean age was 32.5 years. The non-injecting drugs most consumed were: cannabis (15.6%), cocaine paste (21.3%), and oxi cocaine (25.7%). Tobacco (60.9%) and alcohol (79.4%) were also commonly consumed. One hundred six (35.1%; CI 95%: 29.8 - 41.1) non-injecting drug users presented anti-HCV antibodies by EIA. The HCV-RNA prevalence was 28.0% (95% CI: 20.6 - 35.8). Genotypes 1 (76.9%) and 3 (23.1%) of HCV have been identified. A multivariate analysis demonstrated that HCV infection was independently associated with the following factors: "age (≥ 35 years)", "tattoos", "use of a needle or syringe sterilized at home", "shared use of drug paraphernalia", "uses drugs for more than 5 years", and "use of drugs everyday". This study revealed a high prevalence of HCV infection in non-injecting drug users, and most infections are occasioned by genotype 1. Likely, HCV transmission is associated with the tattoos, the use of needle or syringe sterilized at home by people over the age of 35 years, and sharing, time and frequency of use of non-injecting drugs. These findings should serve as an incentive for the establishment of a program of Hepatitis C prevention and control by the local public-health authorities in order to develop effective policies and strategies for contain the spread of HCV infection.

Coping with Loneliness: Young Adult Drug Users.

ERIC Educational Resources Information Center

Rokach, Ami; Orzeck, Tricia

Since there appears to be a connection between substance use (and abuse) and loneliness it is of theoretical and clinical interest to explore the differences of coping with loneliness which drug users employ. The present study examined the manner in which MDMA (Ecstasy) users in comparison with non-MDMA (Non-Ecstasy) users and the general…

Cognitive impairments in poly-drug ketamine users.

PubMed

Liang, H J; Lau, C G; Tang, A; Chan, F; Ungvari, G S; Tang, W K

2013-11-01

Cognitive impairment has been found to be reversible in people with substance abuse, particularly those using ketamine. Ketamine users are often poly-substance users. This study compared the cognitive functions of current and former ketamine users who were also abusing other psychoactive substances with those of non-users of illicit drugs as controls. One hundred ketamine poly-drug users and 100 controls were recruited. Drug users were divided into current (n = 32) and ex-users (n = 64) according to the duration of abstinence from ketamine (>30 days). The Beck Depression Inventory (BDI), the Hospital Anxiety Depression Scale (HADSA) and the Severity of Dependence Scale (SDS) were used to evaluate depression and anxiety symptoms and the severity of drug use, respectively. The cognitive test battery comprised verbal memory (Wechsler Memory Scale III: Logic Memory and Word List), visual memory (Rey-Osterrieth Complex Figure, ROCF), executive function (Stroop, Wisconsin Card Sorting Test, and Modified Verbal Fluency Test), working memory (Digit Span Backward), and general intelligence (Information, Arithmetic and Digit-Symbol Coding) tests. Current users had higher BDI and HADSA scores than ex-users (p < 0.001 for BDI and p = 0.022 for HADSA) and controls (p < 0.001 for BDI and p = 0.002 for HADSA). Ex-users had higher BDI (p = 0.006) but equal HADSA scores (p = 1.000) compared to controls. Both current and ex-users had lower scores on Logical Memory delayed recall (p = 0.038 for current users and p = 0.032 for ex-users) and ROCF delayed recall (p = 0.033 for current users and p = 0.014 for ex-users) than controls. Current users also performed worse on ROCF recognition than controls (p = 0.002). No difference was found between the cognitive functions of current and ex-users. Ketamine poly-drug users displayed predominantly verbal and visual memory impairments, which persisted in ex-users. The interactive effect of ketamine and poly-drug use on memory needs further investigation. © 2013 Elsevier Ltd. All rights reserved.

The Drug User's Identity and How It Relates to Being Hepatitis C Antibody Positive: A Qualitative Study

ERIC Educational Resources Information Center

Copeland, Lorraine

2004-01-01

The increasing health problem of hepatitis C virus infection has only recently attracted the attention of psychosocial research, especially among subjects at higher risk (e.g. injecting drug users). There is a lack of information about the knowledge, perceptions and feelings that injecting drug users hold about their hepatitis C antibody positive…

The emerging of xylazine as a new drug of abuse and its health consequences among drug users in Puerto Rico.

PubMed

Reyes, J C; Negrón, J L; Colón, H M; Padilla, A M; Millán, M Y; Matos, T D; Robles, R R

2012-06-01

During the last decade, the veterinary anesthetics have gained popularity as recreational drugs. The aim of this study was to document the use of "anestecia de caballo" (xylazine) and its consequences among drug users in Puerto Rico. The study combined a cross-sectional survey with 89 drug users and two focus groups conducted in Mayagüez with frontline drug treatment providers. Drug users were recruited from communities of the San Juan metropolitan area using a variety of ethnographic and outreach strategies. A short questionnaire developed for the study collected information on sociodemographics, xylazine use, and its consequences. The two focus groups were conducted to discuss the details related to xylazine use, its consequences, and utilization awareness. The sample comprised 63 males (70.8%) and 26 females with a mean age of 37.2 years. The mean number of years of drug use was 14.3, with a mean frequency of drug use of 5.9 times daily. More than 65% reported speedball as the principal drug of use. The prevalence of xylazine use was 80.7%. More than 42% of the sample used xylazine in a mixture with speedball. The main route of administration of xylazine was injection but 14% reported the use of xylazine by inhalation. More than 35% of the sample reported skin lesions and 21.1% reported at least one overdose episode. Multiple logistic regression analysis revealed that males (OR = 3.47, CI = 1.10-12.00) and those who reported speedball as their main drug of use (OR = 9.34, CI = 2.51-34.70) were significantly more likely to be xylazine users. Focus groups revealed that drug users claimed to recognize the presence of xylaxine in a mixture of speedball based on its effects, taste, the color of the drug (dark brown), and its odor. In conclusion, the use of xylazine among drug users in Puerto Rico seems to be an emerging trend with potentially serious health consequences.

Impact of a transient instability of the ecstasy market on health concerns and drug use patterns in The Netherlands.

PubMed

Brunt, Tibor M; Niesink, Raymond J M; van den Brink, Wim

2012-03-01

A recent decline in MDMA-like substances in ecstasy tablets has been reported by a number of countries in the European Union. This study describes the instability of the ecstasy market in The Netherlands during 2008 and 2009, and investigates whether this had any impact on drug testing or patterns of drug use. The health concerns of drug users handing in drug samples at drug testing facilities was measured using intervention time-series analysis. In addition, these ecstasy users were asked about changes in their drug use. Nationally, the unstable market situation for ecstasy has increased the number of users handing in ecstasy tablets for testing because of health concern. There was no change in the number of users handing in cocaine or gamma hydroxybutyrate (GHB). Respondents reported no major changes in their drug use resulting from the shortage of MDMA-like substances. These findings provide further insight in drug policy based on both harm reduction and use reduction. In the event of reduced ecstasy quality, ecstasy users in The Netherlands have increasingly used drug testing as a potential harm reduction tool, rather than changing their patterns of drug use. This might indicate that a transient reduction of drug quality does not serve as a good drug use reduction strategy for ecstasy users. Copyright © 2011 Elsevier B.V. All rights reserved.

[Illicit drug use and the critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro City, Brazil].

PubMed

Loyola, Cristina Maria Douat; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

This article presents the partial results of a multicenter, cross-temporal study, which was performed using multiple methods, and involved seven Latin-American countries and Canada. The results presented refer to the city center of Rio de Janeiro (n=108). The central question of the study was: 'How do illicit drug users' relatives and acquaintances describe protective and risk factors, prevention initiatives, treatment services, laws and policies regarding illicit drugs?' The quantitative data was collected using an instrument containing closed questions. In total, 108 young adults (18 years of age or older) were interviewed, who stated being affected by the drug although they were not users. For 104 interviewees (96%), negligence is the family dynamics that causes the greatest exposure to drugs, and 106 (98%) consider that parent support is what offers the greatest protection. Policies, the police and the criminal system have neither reduced drug use nor do they protect users.

Use of drugs for ADHD among adults-a multinational study among 15.8 million adults in the Nordic countries.

PubMed

Karlstad, Øystein; Zoëga, Helga; Furu, Kari; Bahmanyar, Shahram; Martikainen, Jaana E; Kieler, Helle; Pottegård, Anton

2016-12-01

The use of ADHD drugs among adults is controversial and has until recently not been approved for use in adults in most countries. The aim was to investigate use of ADHD drugs (stimulants and atomoxetine) among the entire adult population in the Nordic countries. We conducted a multinational population-based prescription register study based on the entire adult population in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden). All users of ADHD drugs aged 18-64 years during 2008-2012 were included, which for 2012 comprised 76,896 drug users among 15.8 million adult inhabitants. Annual prevalence of drug use increased during the study period for both genders and all age groups. The overall prevalence increased from 2.4 to 5.3 per 1000 men and 1.8 to 4.4 per 1000 women. Incidence also increased, but to a lesser extent in the last part of the study period. Methylphenidate was used by 88 % of drug users. Treatment was discontinued within the first year by 21 % of new drug users. Among all users of ADHD drugs, 53 % of men and 64 % of women concurrently used other psychotropic drugs, most frequently antidepressants and hypnotics. Psychotropic co-medication increased with age and was more pronounced among women than men. Use of ADHD drug among adults more than doubled over a 5-year period, and a majority were concurrently treated with other psychotropics. Adults constitute a substantial proportion of persons treated with ADHD drugs. Thus, evidence for long-term efficacy and safety in adults is urgently needed.

Causes and manners of death among users of heroin, methadone, amphetamine, and cannabis in relation to postmortem chemical tests for illegal drugs.

PubMed

Eksborg, Staffan; Rajs, Jovan

2008-01-01

A 12-year medicolegal investigation of deceased illegal drug users (ILDU) in Stockholm, Sweden, classified on the basis of postmortem chemical tests, showed noticeable variations in causes and manners of death as well as in the distribution of suicide methods. This study offers objective information about connection between the postmortem findings of illegal drugs and the causes and manners of death of their users. However, further studies, comparing prevalence of drug use in general population and at the postmortem tests, are needed for more detailed elucidation of this connection.

Transgender Women's Drug Use in the Dominican Republic

PubMed Central

Budhwani, Henna; Hearld, Kristine R.; Milner, Adrienne N.; McGlaughlin, Elaine; Charow, Rebecca; Rodriguez-Lauzurique, Rosa Mayra; Rosario, Santo; Paulino-Ramirez, Robert

2017-01-01

Abstract Purpose: Studies on drug use in transgender populations, particularly those in resource-limited settings, are scarce. Considering that drug use can be a coping mechanism to deal with stigma and traumatic experiences, we examined associations between stigma, trauma, and drug use in a national sample of transgender women from the Dominican Republic. Methods: Bivariate analyses examined differences between drug users and abstainers (n=287). Multivariate analyses reported odds ratios (OR) with general drug, marijuana, and cocaine use as outcomes (n=243). Results: A quarter of respondents (24.5%) experienced sexual abuse, 12.1% were tortured, and 20.1% experienced a murder attempt. More than a quarter reported using illegal drugs (26.1%). Drug users had lower socioeconomic status; 30.0% of drug users had a primary level of education or less (18.2% of abstainers) and 17.6% of drug users had higher income, defined as greater than 10,001 pesos (∼$210 United States Dollars, USD) per month (28.1% of abstainers). More than half of drug users experienced some form of trauma (51.4%) compared to 43.5% of abstainers, and 28.4% of drug users, compared to 17.1% of abstainers, experienced a murder attempt on her life. Independent sample t-tests found significant differences between drug users and abstainers. Transgender women who experienced sexual abuse had three times high odds of using cocaine. Drug users were more likely to have experienced sexual abuse and attempted suicide (p<0.05 for both). Respondents who attempted suicide had higher odds of using drugs generally and using marijuana specifically, compared to respondents who had not attempted suicide (OR=2.665 and 3.168, respectively). Higher scores on the stigma scale were associated with higher odds of any drug use and cocaine use (OR=1.132 and 1.325, respectively). Conclusions: Although some nations have implemented antidiscrimination policies protecting transgender citizens, these policies are not consistently enforced. Eliminating stigma and stigmatizing policies may reduce rates of drug use as a coping mechanism. PMID:29142909

Teens and Prescription Drugs: An Analysis of Recent Trends on the Emerging Drug Threat

ERIC Educational Resources Information Center

Office of National Drug Control Policy, 2007

2007-01-01

This report synthesizes a number of national studies that show the intentional abuse of prescription drugs to get high is a growing concern, particularly among teens. The analysis shows that teens are turning away from street drugs and using prescription drugs to get high. New users of prescription drugs have caught up with new users of marijuana.…

Assessment of addiction severity among ritual users of ayahuasca.

PubMed

Fábregas, Josep Maria; González, Débora; Fondevila, Sabela; Cutchet, Marta; Fernández, Xavier; Barbosa, Paulo César Ribeiro; Alcázar-Córcoles, Miguel Ángel; Barbanoj, Manel J; Riba, Jordi; Bouso, José Carlos

2010-10-01

Ayahuasca is a psychoactive beverage used for magico-religious purposes in the Amazon. Recently, Brazilian syncretic churches have helped spread the ritual use of ayahuasca abroad. This trend has raised concerns that regular use of this N,N-dimethyltryptamine-containing tea may lead to the medical and psychosocial problems typically associated with drugs of abuse. Here we assess potential drug abuse-related problems in regular ayahuasca users. Addiction severity was assessed using the Addiction Severity Index (ASI), and history of alcohol and illicit drug use was recorded. In Study 1, jungle-based ayahuasca users (n=56) were compared vs. rural controls (n=56). In Study 2, urban-based ayahuasca users (n=71) were compared vs. urban controls (n=59). Follow-up studies were conducted 1 year later. In both studies, ayahuasca users showed significantly lower scores than controls on the ASI Alcohol Use, and Psychiatric Status subscales. The jungle-based ayahuasca users showed a significantly higher frequency of previous illicit drug use but this had ceased at the time of examination, except for cannabis. At follow-up, abstinence from illicit drug use was maintained in both groups except for cannabis in Study 1. However, differences on ASI scores were still significant in the jungle-based group but not in the urban group. Despite continuing ayahuasca use, a time-dependent worsening was only observed in one subscale (Family/Social relationships) in Study 2. Overall, the ritual use of ayahuasca, as assessed with the ASI in currently active users, does not appear to be associated with the deleterious psychosocial effects typically caused by other drugs of abuse. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Detection of adverse drug reactions among ordinary users of liraglutide on the occasion of drug dispensing in the community pharmacy setting.

PubMed

Christensen, Søren Troels; Bjerrum, Ole Jannik

2013-12-01

Postmarketing studies of drugs forms an essential part of safety surveillance. In particular, this concerns new drugs as safety information of these by large rests on randomized clinical studies conducted on a limited number of subjects before licensing. Pharmacists in community pharmacies are in a unique position for detection of user experienced adverse drug reactions (ADRs) in relation to drug dispensing. The study reports from a research initiative exploring prompt and proactive ADR detection of liraglutide and reporting facilitated by pharmacy students undertaking internship in a community pharmacy in Denmark. Nineteen pharmacy students undertaking regular 6 months' internship--eighth semester--in a Danish community pharmacy participated in the data collection. Before the data collection, students attended an interactive training seminar addressing ADRs in general, organ symptoms, diagnostic classification, and pharmacovigilance systems. Pharmacy students approached recurrent drug users purchasing liraglutide. Participating users were asked about experienced ADRs linked to liraglutide use. Reported ADRs were collected and analyzed. Sixty-two liraglutide users participated in the study, of whom, 38 reported 84 ADRs possibly linked to liraglutide usage. Nausea was by far the most reported ADR followed by decreased appetite, diarrhea, fatigue, and abdominal pain (upper). The reported ADRs are in accordance with previously reported ADRs. The study has demonstrated the feasibility of community pharmacy driven pharmacovigilance. The study supports the thesis that community pharmacists in the future may play a proactive and prominent role in patient-centered pharmacovigilance.

Relationship between stress symptoms and drug use among secondary students.

PubMed

Frade, Iracema Francisco; De Micheli, Denise; Monezi Andrade, André Luiz; de Souza-Formigoni, Maria Lucia Oliveira

2013-01-01

The aim of this study was to evaluate the relationship between drug use and four kinds of stress symptoms in 954 Brazilian students from the 6th to the 11th grades, in 4 public and 5 private schools in the city of Sao Paulo. Based on their answers to the Drug Use Screening Inventory (DUSI-R) and to the Stress Scale for Adolescents (SSA), we compared regular drug users with non/occasional drug users regarding the frequency of four kinds of stress symptoms (psychological, cognitive, physiological, interpersonal), and the period in which it happened. When compared to non/occasional drug users, regular drug users presented higher levels of psychological, cognitive and physiological symptoms of stress and these symptoms were in the most severe spectrum of severity (near to exhaustion and exhaustion). The association between drug use and stress was even stronger in the youngest age group (11 to 13 years old). Most of the regular drug users were 16 years old and over, from upper-middle class families, had poor family relationships and more academic problems. These results confirm the association between drug use and stress in adolescents and highlight the need for early screening and intervention in both drug use and stressful situations.

Drug use and HIV risk in Trinidad and Tobago: qualitative study.

PubMed

Djumalieva, D; Imamshah, W; Wagner, U; Razum, O

2002-09-01

Crack use is an important risk factor for HIV infection because of its association with unsafe sexual practices. We investigated factors promoting the initiation of crack cocaine use; the sexual behaviour of crack users; and their rehabilitation care seeking behaviour in Trinidad and Tobago. We conducted 40 in-depth interviews with drug users. Respondents frequently reported a history of parental desertion, alcohol abuse, and physical abuse within the family. They perceived peer pressure and drug use in the family as important factors promoting first drug use. Exchanging sex for drugs was common, and practising oral sex was considered safe. Female drug users rarely seek rehabilitative care because of stigmatization and lack of care for their children. In Trinidad, attitudes towards drugs in society and families need to be changed. Campaigns promoting safer sex should emphasize the risk of oral sex. Rehabilitation facilities caring for female drug users should offer child care.

Differences in prefrontal blood oxygenation during an acute multitasking stressor in ecstasy polydrug users.

PubMed

Roberts, C A; Wetherell, M A; Fisk, J E; Montgomery, C

2015-01-01

Cognitive deficits are well documented in ecstasy (3,4-methylenedioxymethamphetamine; MDMA) users, with such deficits being taken as evidence of dysregulation of the serotonin (5-hydroxytryptamine; 5-HT) system. More recently neuroimaging has been used to corroborate these deficits. The present study aimed to assess multitasking performance in ecstasy polydrug users, polydrug users and drug-naive individuals. It was predicted that ecstasy polydrug users would perform worse than non-users on the behavioural measure and this would be supported by differences in cortical blood oxygenation. In the study, 20 ecstasy-polydrug users, 17 polydrug users and 19 drug-naive individuals took part. On day 1, drug use history was taken and questionnaire measures were completed. On day 2, participants completed a 20-min multitasking stressor while brain blood oxygenation was measured using functional near infrared spectroscopy (fNIRS). There were no significant differences between the three groups on the subscales of the multitasking stressor. In addition, there were no significant differences on self-report measures of perceived workload (NASA Task Load Index). In terms of mood, ecstasy users were significantly less calm and less relaxed compared with drug-naive controls. There were also significant differences at three voxels on the fNIRS, indicating decreased blood oxygenation in ecstasy users compared with drug-naive controls at voxel 2 (left dorsolateral prefrontal cortex), voxel 14 and voxel 16 (right dorsolateral prefrontal cortex), and compared with polydrug controls at V14. The results of the present study provide support for changes in brain activation during performance of demanding tasks in ecstasy polydrug users, which could be related to cerebral vasoconstriction.

Perinatal Outcomes in Pregnant Women Users of Illegal Drugs.

PubMed

Oliveira, Tenilson Amaral; Bersusa, Ana Aparecida Sanches; Santos, Tatiana Fiorelli Dos; Aquino, Márcia Maria Auxiliadora de; Mariani Neto, Corintio

2016-04-01

Objective The purpose of this study was to evaluate the perinatal outcomes in pregnant women who use illicit drugs. Methods A retrospective observational study of patients who, at the time of delivery, were sent to or who spontaneously sought a public maternity hospital in the eastern area of São Paulo city. We compared the perinatal outcomes of two distinct groups of pregnant women - illicit drugs users and non-users - that gave birth in the same period and analyzed the obstetric and neonatal variables. We used Student's t-test to calculate the averages among the groups, and the Chi-square test or Fisher's exact test to compare categorical data from each group. Results We analyzed 166 women (83 users and 83 non-users) in both groups with a mean of age of 26 years. Ninety-five percent of the drug users would use crack or pure cocaine alone or associated with other psychoactive substances during pregnancy. Approximately half of the users group made no prenatal visit, compared with 2.4% in the non-users group (p < 0.001). Low birth weight (2,620 g versus 3,333 g on average, p < 0.001) and maternal syphilis (15.7% versus 0%, p < 0.001) were associated with the use of these illicit drugs. Conclusions The use of illicit drugs, mainly crack cocaine, represents an important perinatal risk. Any medical intervention in this population should combine adherence to prenatal care with strategies for reducing maternal exposure to illicit drugs. Thieme Publicações Ltda Rio de Janeiro, Brazil.

From Abstinence to Relapse: A Preliminary Qualitative Study of Drug Users in a Compulsory Drug Rehabilitation Center in Changsha, China

PubMed Central

Yang, Mei; Mamy, Jules; Gao, Pengcheng; Xiao, Shuiyuan

2015-01-01

Background Relapse among abstinent drug users is normal. Several factors are related to relapse, but it remains unclear what individuals’ actual life circumstances are during periods of abstinence, and how these circumstances facilitate or prevent relapse. Objective To illuminate drug users’ experiences during abstinence periods and explore the real-life catalysts and inhibitors contributing to drug use relapse. Method Qualitative in-depth interviews were conducted with 20 drug users recruited from a compulsory isolated drug rehabilitation center in Changsha. The interviews were guided by open-ended questions on individuals’ experiences in drug use initiation, getting addicted, treatment history, social environment, abstinence, and relapse. Participants were also encouraged to share their own stories. Interviews were digitally recorded and fully transcribed. The data of 18 participants who reported abstinence experiences before admission were included in the analyses. The data were analyzed using a thematic analysis with inductive hand coding to derive themes. Results Most drug users were able to successfully abstain from drugs. During abstinence, their lives were congested with challenges, such as adverse socioeconomic conditions, poor family/social support, interpersonal conflicts, and stigma and discrimination, all of which kept them excluded from mainstream society. Furthermore, the police’s system of ID card registration, which identifies individuals as drug users, worsened already grave situations. Relapse triggers reported by the participants focused mainly on negative feelings, interpersonal conflicts, and stressful events. Craving was experienced but not perceived as a relapse trigger by most participants. Conclusions This study of in-depth interview with drug users found evidence of situations and environments they live during abstinence appear rather disadvantaged, making it extremely difficult for them to remain abstinent. Comprehensive programs on relapse prevention that acknowledge these disadvantages are implicated. PMID:26107639

Hair drug testing results and self-reported drug use among primary care patients with moderate-risk illicit drug use.

PubMed

Gryczynski, Jan; Schwartz, Robert P; Mitchell, Shannon Gwin; O'Grady, Kevin E; Ondersma, Steven J

2014-08-01

This study sought to examine the utility of hair testing as a research measure of drug use among individuals with moderate-risk drug use based on the internationally validated Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). This study is a secondary analysis using baseline data from a randomized trial of brief intervention for drug misuse, in which 360 adults with moderate-risk drug use were recruited from two community clinics in New Mexico, USA. The current study compared self-reported drug use on the ASSIST with laboratory analysis of hair samples using a standard commercially available 5-panel test with assay screening and gas chromatography/mass spectrometry (GC/MS) confirmation. Both self-report and hair testing covered a 3-month period. Overall concordance between hair testing and self-report was 57.5% (marijuana), 86.5% (cocaine), 85.8% (amphetamines), and 74.3% (opioids). Specificity of hair testing at standard laboratory cut-offs exceeded 90% for all drugs, but sensitivity of hair testing relative to self-report was low, identifying only 52.3% (127/243) of self-disclosed marijuana users, 65.2% (30/46) of cocaine users, 24.2% (8/33) of amphetamine users, and 2.9% (2/68) of opioid users. Among participants who disclosed using marijuana or cocaine in the past 3 months, participants with a negative hair test tended to report lower-frequency use of those drugs (p<.001 for marijuana and cocaine). Hair testing can be useful in studies with moderate-risk drug users, but the potential for under-identification of low-frequency use suggests that researchers should consider employing low detection cut-offs and using hair testing in conjunction with self-report. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Hair Drug Testing Results and Self-reported Drug Use among Primary Care Patients with Moderate-risk Illicit Drug Use

PubMed Central

Gryczynski, Jan; Schwartz, Robert P.; Mitchell, Shannon Gwin; O’Grady, Kevin E.; Ondersma, Steven J.

2014-01-01

Background This study sought to examine the utility of hair testing as a research measure of drug use among individuals with moderate-risk drug use based on the internationally-validated Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Methods This study is a secondary analysis using baseline data from a randomized trial of brief intervention for drug misuse, in which 360 adults with moderate-risk drug use were recruited from two community clinics in New Mexico, USA. The current study compared self-reported drug use on the ASSIST with laboratory analysis of hair samples using a standard commercially-available 5-panel test with assay screening and gas chromatography/mass spectrometry (GC/MS) confirmation. Both self-report and hair testing covered a 3 month period. Results Overall concordance between hair testing and self-report was 57.5% (marijuana), 86.5% (cocaine), 85.8% (amphetamines), and 74.3% (opioids). Specificity of hair testing at standard laboratory cut-offs exceeded 90% for all drugs, but sensitivity of hair testing relative to self-report was low, identifying only 52.3% (127/243) of self-disclosed marijuana users, 65.2% (30/46) of cocaine users, 24.2% (8/33) of amphetamine users, and 2.9% (2/68) of opioid users. Among participants who disclosed using marijuana or cocaine in the past 3 months, participants with a negative hair test tended to report lower-frequency use of those drugs (p< .001 for marijuana and cocaine). Conclusions Hair testing can be useful in studies with moderate-risk drug users, but the potential for under-identification of low-frequency use suggests that researchers should consider employing low detection cut-offs and using hair testing in conjunction with self-report. PMID:24932945

Characteristics of drug use among pregnant women in the United States: Opioid and non-opioid illegal drug use.

PubMed

Metz, Verena E; Brown, Qiana L; Martins, Silvia S; Palamar, Joseph J

2018-02-01

The opioid epidemic in the US is affecting pregnant women and their offspring, with rising numbers of maternal and neonatal treatment episodes. The aim of this study was to characterize pregnant drug users in order to inform intervention strategies based on sociodemographic, mental health, and substance use characteristics. Data on pregnant women aged 18-44 reporting past-year, nonmedical opioid use or use of non-opioid illegal drugs (other than marijuana) were analyzed from the National Survey on Drug Use and Health (2005-2014). Women (N = 818) were categorized into 3 groups: 1) use of opioids only (n = 281), 2) opioid-polydrug users (n = 241), and 3) other (non-opioid) illegal drug users (n = 296). Characteristics between the 3 groups of women were compared using bivariable analyses. Most women were non-Hispanic White (67.6%), had a high school diploma or less education (61.0%), a household income <$20,000/year (72.2%), and health insurance coverage (84.3%). No significant differences between the three groups were found regarding sociodemographic characteristics. Past-30-day marijuana use was less prevalent among opioid-only users (10.9%) compared to opioid-polydrug users (43.6%) and other pregnant illegal drug users (27.6%) (P < 0.001) and past-year drug/alcohol treatment was less prevalent among opioid-only users (6.3%) compared to opioid-polydrug users (20.3%) and other illegal drug users (8.3%) (P = 0.002). Opioid-only users also reported lower prevalence of past-year depression (P < 0.001) and anxiety (P = 0.039). Pregnant drug-using women were often of low socioeconomic status, with mental health and substance use patterns suggesting the need for targeted mental health/substance use screening and interventions before and during pregnancy, particularly for opioid-polydrug users. Copyright © 2017. Published by Elsevier B.V.

Assessing the effects of non-steroidal anti-inflammatory drugs on antihypertensive drug therapy using post-marketing surveillance database.

PubMed

Ishiguro, Chieko; Fujita, Toshiharu; Omori, Takashi; Fujii, Yosuke; Mayama, Takeshi; Sato, Tosiya

2008-01-01

Antihypertensive and non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat many common diseases. However, it has been suspected that interactions between these drugs exist. Here, we assessed the interactions between non-selective NSAIDs and several classes of antihypertensive drugs. The study design was a cohort study using "The Antihypertensive Drug Database," which is a collection of data accumulated from Drug Use Investigations. Subjects newly starting antihypertensive drug therapy were identified in the database. We compared the "User" group, who were co-administered NSAIDs, with the "Non-user" group, who were not. The outcome measure was the change in systolic blood pressure from the baseline after 2 months of treatment. We estimated the non-adjusted and adjusted differences in the change in systolic blood pressure between the "User" and "Non-user" groups. Data were collected for a total of 1,204 subjects, of whom 364 were prescribed beta blockers, 60 were prescribed diuretics, 628 were prescribed angiotensin-converting enzyme inhibitors, and 152 were prescribed calcium channel blockers. The adjusted difference in the change in systolic blood pressure between the User (n = 301) and Non-user (n = 903) groups was 2.88 mmHg (95% confidence interval: 0.89, 4.87); thus, systolic blood pressure in the Non-User group decreased further from the baseline than that in the User group. In subjects administered beta blockers, diuretics, angiotensin-converting enzyme inhibitors, and calcium channel blockers, the corresponding differences were 0.37 mmHg (-3.24, 3.98), 6.11 mmHg (-3.16, 15.37), 3.85 mmHg (1.16, 6.66), and 3.50 mmHg (-2.03, 9.02). The effectiveness of antihypertensive drugs was attenuated by the co-administration of NSAIDs. The differences in the effects of NSAIDs varied with different classes of antihypertensive drugs.

The relationship between risk networks' patterns of crack cocaine and alcohol consumption and HIV-related sexual behaviors among adult injection drug users: a prospective study.

PubMed

Latkin, C A; Mandell, W; Vlahov, D

1996-11-01

Social context may be an important determinant of drug and alcohol consumption and HIV-related behaviors. To assess the influence of peers on drug users' risk behaviors this study examined the association between individual level and group level behaviors. This analysis reports on the prospective association between baseline self-reported drug and alcohol use of the network members of injection drug users, and self-reported sexual behaviors and alcohol use at 5-month follow-up. Participants were a nontreatment sample of inner-city injection drug users who volunteered for a network-oriented HIV preventive intervention. They were predominantly unemployed, African American males. Of the 71 index participants who completed both the baseline and follow-up interviews, 227 of their drug network members were enrolled in the study. At baseline indexes' sexual risk behaviors were significantly associated with their drug network members' level of crack cocaine use. At follow-up higher levels of alcohol and crack use among drug network members were associated with indexes' reports of multiple sex partners and increased alcohol consumption. Higher levels of crack use among the drug network members were associated with the indexes' reporting casual sex partners at follow-up. These results highlight the importance of studying the role of peer group influence and the social context of risk behaviors.

Young adult Ecstasy users' enhancement of the effects of their Ecstasy use.

PubMed

Klein, Hugh; Elifson, Kirk W; Sterk, Claire E

2009-06-01

This study examines drug effect-enhancing behaviors practiced by young adult users of the drug, Ecstasy. Between August 2002 and August 2004, 283 face-to-face interviews were conducted with active Ecstasy users. Study participants were recruited in the Atlanta, Georgia metropolitan area using a targeted sampling approach. The large majority of study participants (87%) engaged in at least one behavior specifically designed to bolster the effects of their Ecstasy use, with 61% of the study participants reporting having engaged in at least three such behaviors during the past 30 days. Taking steps to boost one's Ecstasy-related high was associated with binging on Ecstasy and a variety of adverse outcomes, such as experiencing a greater number of negative consequences resulting from Ecstasy use and experiencing more Ecstasy-related drug dependency symptoms. Multivariate analysis revealed several factors associated with greater involvement in effects-boosting behaviors, including race (not being African American), spending time with other drug users, using Ecstasy for its touch-enhancing qualities, enjoyment of the music-and-Ecstasy-use experience, and childhood maltreatment experiences. The implications of these findings for treatment, prevention, and intervention for drug problems among Ecstasy users are discussed.

76 FR 44014 - Generic Drug User Fee; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-22

...] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... development of a generic drug user fee program. A user fee program could provide necessary supplemental... generic drug user fees. New legislation would be required for FDA to establish and collect user fees for...

The effects of perceived parenting style on the propensity for illicit drug use: the importance of parental warmth and control.

PubMed

Montgomery, Catharine; Fisk, John E; Craig, Laura

2008-11-01

Research in adolescents has shown that parental warmth and control are important factors in drug use. The present study focused upon investigating perceived parental warmth and control in a sample of post-adolescent ecstasy/polydrug users, and investigating their relationship to severity of drug use. A total of 128 (65 male) ecstasy/polydrug users, 51 (17 male), cannabis-only users and 54 (13 male) non-users were recruited from a university population. All participants completed the parenting styles and drug use questionnaires. Compared to non-users, a greater proportion of ecstasy/polydrug users characterised their parents' style as neglectful. The modal style endorsed by non-users was authoritative. Those who rated their parents' style as authoritative had significantly lower lifetime consumption and average dose of ecstasy relative to those describing their parents as neglectful. Again, relative to those describing their parents as neglectful, participants from authoritarian backgrounds had significantly smaller lifetime consumption of ecstasy and cocaine and significantly smaller average doses of cannabis, ecstasy and cocaine. Contrary to expectation, there was no significant association between perceived parental warmth and the severity of ecstasy use. The present study is, to our knowledge, the first to quantify drug use, and relate it to perceived parental practices in a post-adolescent sample of ecstasy/polydrug users. The results provide further support for the relationship between perceived parental control and drug use.

The relationship between perceived discrimination and high-risk social ties among illicit drug users in New York City, 2006-2009.

PubMed

Crawford, Natalie D; Ford, Chandra; Galea, Sandro; Latkin, Carl; Jones, Kandice C; Fuller, Crystal M

2013-01-01

Discrimination can influence risk of disease by promoting unhealthy behaviors (e.g., smoking, alcohol use). Whether it influences the formation of high-risk social ties that facilitate HIV transmission is unclear. Using cross-sectional data from a cohort of illicit drug users, this study examined the association between discrimination based on race, drug use and prior incarceration and risky sex and drug ties. Negative binomial regression models were performed. Participants who reported discrimination based on race and drug use had significantly more sex and drug-using ties. But, after accounting for both racial and drug use discrimination, only racial discrimination was associated with increased sex, drug-using, and injecting ties. Drug users who experience discrimination and subsequently develop more sex and drug-using ties, increase their risk of contracting HIV. Future longitudinal studies illuminating the pathways linking discrimination and social network development may guide intervention development and identify drug-using subpopulations at high risk for disease transmission.

The Chinese Youth Attitudes toward Young Drug Users scale: an initial scale development and refinement.

PubMed

Chui, Wing Hong; Chan, Heng Choon Oliver

2012-06-01

Little is known about adolescents' perspectives of young drug users, especially in the Chinese context. This study aimed to develop a scale to measure Chinese youth attitudes toward young drug users. Initially, a total of 26 non-at-risk and at-risk adolescents (15 male and 11 female) aged 13 to 20 years were interviewed in five separate focus group sessions to explore their general views of young drug users. At-risk youths recruited in this study were adolescents who previously had contact with the juvenile justice system. The responses of these 26 adolescents were documented, and subsequently 25 items were generated out of the respondents' common themes. These 25 items were then surveyed in a group of 137 secondary school-aged adolescents (68 male and 69 female), ranging 13 to 17 years, to examine its underlying factor structure for further scale refinement, with the use of the exploratory factor analysis. A five-factor structure with 12 items was ultimately selected for the Chinese Youth Attitudes toward Young Drug Users (CYAYDU) scale. This newly developed scale is anticipated to provide utility in the social work settings, especially for youth social workers to assist in providing effective social services to young drug users. Despite the promising strength of the CYAYDU scale, further validation with large sample size is needed. © 2011 Australasian Professional Society on Alcohol and other Drugs.

Long-Term Effectiveness of Accelerated Hepatitis B Vaccination Schedule in Drug Users

PubMed Central

Shah, Dimpy P.; Grimes, Carolyn Z.; Nguyen, Anh T.; Lai, Dejian

2015-01-01

Objectives. We demonstrated the effectiveness of an accelerated hepatitis B vaccination schedule in drug users. Methods. We compared the long-term effectiveness of accelerated (0–1–2 months) and standard (0–1–6 months) hepatitis B vaccination schedules in preventing hepatitis B virus (HBV) infections and anti-hepatitis B (anti-HBs) antibody loss during 2-year follow-up in 707 drug users (HIV and HBV negative at enrollment and completed 3 vaccine doses) from February 2004 to October 2009. Results. Drug users in the accelerated schedule group had significantly lower HBV infection rates, but had a similar rate of anti-HBs antibody loss compared with the standard schedule group over 2 years of follow-up. No chronic HBV infections were observed. Hepatitis C positivity at enrollment and age younger than 40 years were independent risk factors for HBV infection and antibody loss, respectively. Conclusions. An accelerated vaccination schedule was more preferable than a standard vaccination schedule in preventing HBV infections in drug users. To overcome the disadvantages of a standard vaccination schedule, an accelerated vaccination schedule should be considered in drug users with low adherence. Our study should be repeated in different cohorts to validate our findings and establish the role of an accelerated schedule in hepatitis B vaccination guidelines for drug users. PMID:25880946

Problematic versus non-problematic ecstasy/MDMA use: the influence of drug usage patterns and pre-existing psychiatric factors.

PubMed

Soar, K; Turner, J J D; Parrott, A C

2006-05-01

Recreational ecstasy (3,4-methylenedioxymethamphetamine; MDMA) use has been increasingly associated with a number of psychiatric symptoms and psychological problems. However, previous studies assessing possible psychopathological effects have not identified whether users consider their ecstasy use "problematic" or not. In addition, research has generally failed to address the potential role of premorbid psychiatric status. This study aimed to assess whether premorbid psychiatric history and/or patterns of ecstasy use would be associated with the degree of self-reported problems attributable to ecstasy. Problematic ecstasy users (n = 53) who had reported problems attributable to their ecstasy use were compared with non-problematic ecstasy users (n = 62), polydrug controls (n = 62) and illegal drug-naive controls (n = 111) on a recreational drug use questionnaire; a questionnaire, which ascertained personal and family psychiatric histories, and the Brief Symptom Inventory (BSI). Problematic ecstasy users exhibited significantly higher scores on a number of dimensions of the BSI compared to illegal drug-naive and/or polydrug controls. Problematic ecstasy users also exhibited significantly elevated scores on somatization, depression, anxiety and negative psychobiology compared to non-problematic ecstasy users. BSI scores for the non-problematic ecstasy users did not differ from polydrug or illegal drug-naive controls. Problematic ecstasy users reported significantly higher levels of ecstasy use, including lifetime consumption, average dosage and binge consumption compared to non-problematic ecstasy users. Additionally, a greater number of problematic ecstasy users reported personal and family psychiatric histories compared to controls and non-problematic ecstasy users. This study demonstrates two distinct ecstasy using groups: non-problematic ecstasy users who are not showing signs of psychopathology and problematic ecstasy users who are showing evidence of a range of symptoms. This data therefore partially supports the link between ecstasy dosage and negative psychological sequelae, but highlights the importance of the need to consider ecstasy-related attributions, pre-existing mental health status and vulnerability.

Mental Health Status, Drug Treatment Use, and Needle Sharing among Injection Drug Users

ERIC Educational Resources Information Center

Lundgren, Lena M.; Amodeo, Maryann; Chassler, Deborah

2005-01-01

This study examined the relationship among mental health symptoms, drug treatment use, and needle sharing in a sample of 507 injection drug users (IDUs). Mental health symptoms were measured through the ASI psychiatric scale. A logistic regression model identified that some of the ASI items were associated with needle sharing in an opposing…

Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, and HIV infection among drug users attending an STD/HIV prevention and needle-exchange program in Quebec City, Canada.

PubMed

Poulin, C; Alary, M; Bernier, F; Ringuet, J; Joly, J R

1999-08-01

To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, and human immunodeficiency virus (HIV) infection among injection and noninjection drug users in Quebec City and to identify associated risk factors. Cross-sectional study of 738 drug users attending a sexually transmitted disease/HIV prevention and needle-exchange program in Quebec City, Canada. The prevalences of N. gonorrhoeae and C. trachomatis were, respectively, 0.4% (95% CI: 0.08%-1.2%) and 3.4% (95% Cl: 2.2%-5.0%). Through multivariate analysis, risk factors associated with sexually transmitted diseases were: among women, being aged between 20 and 24 years and having unprotected sex with commercial partners; in noninjection drug users; cocaine use and first intercourse before 13 years of age; in male noninjection drug users, having regular sexual partners in the previous 6 months. No case of HIV was found in participants who have never injected drugs, but the prevalence was 5.5% (6/110) among the exinjectors and 10.1% (35/347) in current injectors. Moderate sexually transmitted disease and HIV prevalences were found, although a high proportion of drug users reported risky behaviors. Needle-exchange program sites may offer a good opportunity to provide sexually transmitted disease/HIV prevention and medical services to drug users.

Characterizing longitudinal health state transitions among heroin, cocaine, and methamphetamine users

PubMed Central

Nosyk, B; Li, L; Evans, E; Huang, D; Min, J; Kerr, T; Brecht, ML; Hser, YI

2014-01-01

Aims Characterize longitudinal patterns of drug use careers and identify determinants of drug use frequency across cohorts of primary heroin, methamphetamine (MA) and cocaine users. Design Pooled analysis of prospective cohort studies. Settings Illicit drug users recruited from community, criminal justice and drug treatment settings in California, USA. Participants We used longitudinal data on from five observational cohort studies featuring primary users of heroin (N=629), cocaine (N=694) and methamphetamine (N=474). The mean duration of follow-up was 20.9 years. Measurements Monthly longitudinal data was arranged according to five health states (incarceration, drug treatment, abstinence, non-daily and daily use). We fitted proportional hazards (PH) frailty models to determine independent differences in successive episode durations. We then executed multi-state Markov (MSM) models to estimate probabilities of transitioning between health states, and the determinants of these transitions. Findings Across primary drug use types, PH frailty models demonstrated durations of daily use diminished in successive episodes over time. MSM models revealed primary stimulant users had more erratic longitudinal patterns of drug use, transitioning more rapidly between periods of treatment, abstinence, non-daily and daily use. MA users exhibited relatively longer durations of high-frequency use. Criminal engagement had a destabilizing effect on health state durations across drug types. Longer incarceration histories were associated with delayed transitions towards cessation. Conclusions PH frailty and MSM modeling techniques provided complementary information on longitudinal patterns of drug abuse. This information can inform clinical practice and policy, and otherwise be used in health economic simulation models, designed to inform resource allocation decisions. PMID:24837584

Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact of community-level risk-reduction interventions.

PubMed

Parry, C D H; Carney, T; Petersen Williams, P

2017-12-01

Alcohol and other drug (AOD) use is increasingly recognised as having a direct and indirect effect on the transmission of human immunodeficiency virus (HIV). However, there is evidence to suggest that drug- and sex-related HIV risk-reduction interventions targeted at drug users within drug treatment centres or via community outreach efforts can lead to positive health outcomes. This study aimed to test whether a community-level intervention aimed at AOD users has an impact on risky AOD use and sexual risk behaviour. In 2007, in collaboration with a local non-governmental organisation (NGO) in Durban, an initiative was begun to implement a number of harm reduction strategies for injection and non-injection drug users. The NGO recruited peer outreach workers who received intensive initial training, which was followed by six-monthly monitoring and evaluation of their performance. Participants had to be 16 years of age or older, and self-reported alcohol and/or drug users. Peer outreach workers completed a face-to-face baseline questionnaire with participants which recorded risk behaviours and a risk-reduction plan was developed with participants which consisted of reducing injection (if applicable) and non-injection drug use and sex-related risks. Other components of the intervention included distribution of condoms, risk-reduction counselling, expanded access to HIV Testing Services, HIV/sexually transmitted infection care and treatment, and referrals to substance abuse treatment and social services. At follow-up, the baseline questionnaire was completed again and participants were also asked the frequency of reducing identified risk behaviours. Baseline information was collected from 138 drug users recruited into the study through community-based outreach, and who were subsequently followed up between 2010 and 2012. No injection drug users were reached. The data presented here are for first contact (baseline) and the final follow-up contact with the participants. There were no decreases in drug use practices such as use of cannabis, heroin, cocaine and Ecstasy after the intervention with drug users; however, there was a significant reduction in alcohol use following the intervention. While there was a substantial increase in the proportion of participants using drugs daily as opposed to more often, the reduction in the frequency of drug use was not statistically significant. Following the intervention, drug users had significantly fewer sexual partners, but there were no significant differences following the intervention with regard to frequency of sex or use of condoms. Substance use in general and during sex was, however, decreased. While the findings were mixed, the study shows that it is possible to provide HIV risk-reduction services to a population of substance users who are less likely to receive services through community outreach, and provide risk-reduction information, condoms and condom demonstration and other services. More intensive interventions might be needed to have a substantial impact on substance use and substance use-related HIV risk behaviours.

Drug abuse in Vietnam: a critical review of the literature and implications for future research.

PubMed

Nguyen, Van T; Scannapieco, Maria

2008-04-01

To provide an overall picture of drug abuse in Vietnam, its prevalence, correlates and patterns. Studies addressing the drug abuse problem in Vietnam are reviewed. Attention is paid to studies conducted from 1993 onwards. The reviewed studies were collected from both refereed and non-refereed sources. Drug abuse is rising sharply in Vietnam: almost threefold over the past 10 years. From a predominantly rural-mountainous phenomenon, illicit drug abuse spread rapidly to urban areas. Meanwhile, the average age of drug users has declined and more women have been engaging in drug consumption. At the same time, heroin has replaced opium as the most preferred drug in the country's illicit drug market, especially among young users in urban areas. At the national level, the second main route of drug administration, injecting, has exceeded smoking and taken precedence in the country's drug abuse culture, especially among heroin users. Drug abuse in Vietnam has changed radically over the past decade, which has implications for the national and international community and requires further research to fill the knowledge gap and to inform intervention policy for better drug control policy.

Transition to drug co-use among adolescent cannabis users: The role of decision-making and mental health.

PubMed

Lopez-Quintero, Catalina; Granja, Karen; Hawes, Samuel; Duperrouzel, Jacqueline C; Pacheco-Colón, Ileana; Gonzalez, Raul

2018-05-15

Co-use of cannabis and drugs other than cannabis (DOTC) influences the risk of experiencing cannabis disorders. Accordingly, we explored whether speed of transition to drug co-use, the number of DOTC used, and/or being an experimental cannabis-only user, a regular cannabis-only user, or a regular cannabis user who co-uses DOTC (i.e., cannabis-plus user) were associated with decision-making (DM), mental health disorder symptoms, or cannabis use-related characteristics. We analyzed baseline data from a sub-sample of 266 adolescent (ages 14 to 16) cannabis users (CU) participating in an ongoing longitudinal study. Assessments included semi-structured interviews, self-report questionnaires, and measures of drug use, DM (measured via the Iowa Gambling Task), mental health disorders, and cannabis use-related problems. Endorsing a larger number of mood disorders symptoms was associated with being a regular cannabis-plus user rather than a regular cannabis-only user (AOR = 1.08, C.I.95% 1.01, 1.15). Poorer DM was associated with a faster transition to co-use, such that for each one unit increase in DM performance, the years to onset of drug co-use increased by 1% (p = 0.032). Endorsing a larger number of cannabis use-related problems was positively associated with endorsing a larger number of DOTC used (p = 0.001). This study provides new evidence on the process of drug co-use among CU. Specifically, mood disorder symptoms were associated with use of DOTC among regular CU. Furthermore, poorer DM was associated with a faster transition to drug co-use. Poorer DM and mood disorder symptoms may aggravate or accelerate the onset of adverse consequences among adolescent CU. Copyright © 2018 Elsevier Ltd. All rights reserved.

"Overconfidence" versus "helplessness": A qualitative study on abstinence self-efficacy of drug users in a male compulsory drug detention center in China.

PubMed

Zhang, Yan; Feng, Bing; Geng, Wenxiu; Owens, Laurence; Xi, Juzhe

2016-08-31

Compulsory drug detention is the most frequent way to control drug use in China; however, it has often been criticized. This qualitative study aimed to investigate abstinence self-efficacy and its sources of drug users in a compulsory male drug detention center in Shanghai, China, and the attitudes of the drug users to this form of rehabilitation. Thirty-six participants were interviewed (semi-structured, in depth) about their history of drug use and rehabilitation, self-evaluation of addiction, motivations to abstain, plans for the future and attitudes toward rehabilitation. A thematic analysis was undertaken of the transcripts with responses to interview questions being coded for content. Two main types of self-efficacy were found - "overconfidence" (n = 16) and "helplessness" (n = 17). Overconfident participants underestimated their levels of addiction, overestimated their self-control and held external motivations and attributions. In contrast, helpless participants overestimated their levels of addiction, underestimated their self-control and had internal motivations and attributions. Compared to overconfident participants, helpless participants had more relapse history, and were more inclined to interpret relapse as a failure and attribute relapse to themselves. More helpless participants were abandoned by their family members, and received blame from the family members instead of encouragement, but their family members motivated them to abstain. Helpless participants experienced more negative emotions and had worse physical status. They said compulsory detention was a strong support for them and was the most effective way to abstain; while overconfident participants said compulsory detention was not necessary and not useful. It is important to increase the motivation of overconfident drug users and the perceived control of helpless drug users. Compulsory drug detention has strengths in supporting drug users who feel helpless to resist drug use. Adjustments and improvements of compulsory drug detention are suggested.

[Users sceptical about generic drugs: an anthropological approach].

PubMed

Sarradon-Eck, A; Blanc, M-A; Faure, M

2007-06-01

Since the enactment of the 2002 legislative measures favoring the prescription of generic drugs, various quantitative studies have shown that approval by prescribers and users has risen in France. Nevertheless, scepticism remains as well as distrust towards these drugs focusing on their effectiveness compared with brand-name drugs, on potential dangers, and on the interruption they cause in prescription and consumption habits. Using a comprehensive approach, this article analyzes the social and cultural logic behind the negative image of generic drugs. The materials issued from an ethnographic study on the prescription of drugs for high blood pressure. Sixty-eight interviews were undertaken between April 2002 and October 2004 with people (39 women and 29 men, between the age of 40 and 95, 52 over the age of 60) treated for over a year for high blood pressure in rural areas in the Southeast of France. Thirteen people provided unsolicited opinions about generic drugs. Analysis of the information collected shows that users have various representations of generic drugs, including the idea of counterfeited and foreign drugs. These representations interfere with the adjustment process and the development of consumer loyalty. They are part of a set of social representations about drugs which form and express the user's reality. In these representations, the drug is an ambivalent object, carrier of both biological effectiveness and toxicity; it is also the metonymical extension of the prescriber, bestowing upon the prescription a symbolic value. By placing the generic drug in its network of symbolic and social meaning, this study highlights the coherence of the scepticism towards generic drugs by consumers (and prescribers) with a system of common opinion in which drugs are everyday things, personalized and compatible with users, symbolic exchange carriers in the physician-patient relationship, and in which confidence in the drug is also that given to the health care system in general.

76 FR 24035 - Generic Drug User Fee; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

...] Generic Drug User Fee; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... development of a generic drug user fee program. A user fee program could provide necessary supplemental... announcing its intention to hold a public meeting related to generic drug user fees. The Agency continues to...

'Silk Road', the virtual drug marketplace: a single case study of user experiences.

PubMed

Van Hout, Marie Claire; Bingham, Tim

2013-09-01

The online promotion of 'drug shopping' and user information networks is of increasing public health and law enforcement concern. An online drug marketplace called 'Silk Road' has been operating on the 'Deep Web' since February 2011 and was designed to revolutionise contemporary drug consumerism. A single case study approach explored a 'Silk Road' user's motives for online drug purchasing, experiences of accessing and using the website, drug information sourcing, decision making and purchasing, outcomes and settings for use, and perspectives around security. The participant was recruited following a lengthy relationship building phase on the 'Silk Road' chat forum. The male participant described his motives, experiences of purchasing processes and drugs used from 'Silk Road'. Consumer experiences on 'Silk Road' were described as 'euphoric' due to the wide choice of drugs available, relatively easy once navigating the Tor Browser (encryption software) and using 'Bitcoins' for transactions, and perceived as safer than negotiating illicit drug markets. Online researching of drug outcomes, particularly for new psychoactive substances was reported. Relationships between vendors and consumers were described as based on cyber levels of trust and professionalism, and supported by 'stealth modes', user feedback and resolution modes. The reality of his drug use was described as covert and solitary with psychonautic characteristics, which contrasted with his membership, participation and feelings of safety within the 'Silk Road' community. 'Silk Road' as online drug marketplace presents an interesting displacement away from 'traditional' online and street sources of drug supply. Member support and harm reduction ethos within this virtual community maximises consumer decision-making and positive drug experiences, and minimises potential harms and consumer perceived risks. Future research is necessary to explore experiences and backgrounds of other users. Copyright © 2013 Elsevier B.V. All rights reserved.

Intact goal-directed control in treatment-seeking drug users indexed by outcome-devaluation and Pavlovian to instrumental transfer: Critique of habit theory.

PubMed

Hogarth, Lee; Lam-Cassettari, Christa; Pacitti, Helena; Currah, Tara; Mahlberg, Justin; Hartley, Lucie; Moustafa, Ahmed

2018-05-22

Animal studies have demonstrated that chronic exposure to drugs of abuse impairs goal-directed control over action selection indexed by the outcome-devaluation and specific Pavlovian to instrumental transfer procedures, suggesting this impairment might underpin addiction. However, there is currently only weak evidence for impaired goal-directed control in human drug users. Two experiments were undertaken in which treatment-seeking drug users and non-matched normative reference samples (controls) completed outcome-devaluation and specific Pavlovian to instrumental transfer procedures notionally translatable to animal procedures (Experiment 2 used a more challenging biconditional schedule). The two experiments found significant outcome-devaluation and specific Pavlovian to instrumental transfer effects overall and there was no significant difference between groups in the magnitude of these effects. Moreover, Bayes factor supported the null hypothesis for these group comparisons. Although limited by non-matched group comparisons and small sample sizes, the two studies suggest that treatment-seeking drug users have intact goal-directed control over action selection, adding uncertainty to already mixed evidence concerning the role of habit learning in human drug dependence. Neuro-interventions might seek to tackle goal-directed drug-seeking rather than habit formation in drug users. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Illegal aspects of illicit drugs use in Mexico].

PubMed

Gallegos Torres, Ruth Magdalena; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

The objective of this cross-sectional, descriptive study was to obtain the opinions of a group of people about legal issues regarding addiction. Data collection was performed using a structured questionnaire with four themes. In order to participate, the individual could not use any drugs but should have a close relationship with a drug user. The data was processed using SPSS V. 14. There were 100 participants, 75% of whom were women, and 38% had a drug user as a friend, mainly cocaine and marijuana users. The participants had one opinion in common: laws should be more severe for people who use, sell, or transport drugs. The current laws do not improve consumers' criminal behavior. There is a need for further studies addressing people's opinion about this phenomenon in order to obtain a more realistic view of this drug issue.

A pilot study of loss aversion for drug and non-drug commodities in cocaine users.

PubMed

Strickland, Justin C; Beckmann, Joshua S; Rush, Craig R; Stoops, William W

2017-11-01

Numerous studies in behavioral economics have demonstrated that individuals are more sensitive to the prospect of a loss than a gain (i.e., loss aversion). Although loss aversion has been well described in "healthy" populations, little research exists in individuals with substance use disorders. This gap is notable considering the prominent role that choice and decision-making play in drug use. The purpose of this pilot study was to evaluate loss aversion in active cocaine users. Current cocaine users (N=38; 42% female) participated in this within-subjects laboratory pilot study. Subjects completed a battery of tasks designed to assess loss aversion for drug and non-drug commodities under varying risk conditions. Standardized loss aversion coefficients (λ) were compared to theoretically and empirically relevant normative values (i.e., λ=2). Compared to normative loss aversion coefficient values, a precise and consistent decrease in loss aversion was observed in cocaine users (sample λ≈1). These values were observed across drug and non-drug commodities as well as under certain and risky conditions. These data represent the first systematic study of loss aversion in cocaine-using populations and provide evidence for equal sensitivity to losses and gains or loss equivalence. Futures studies should evaluate the specificity of these effects to a history of cocaine use as well as the impact of manipulations of loss aversion on drug use to determine how this phenomenon may contribute to intervention development efforts. Copyright © 2017 Elsevier B.V. All rights reserved.

Drug abuse in Costa Rica: a review of several studies.

PubMed

Alfaro Murillo, E

1990-01-01

This article provides a review of drug use surveys conducted by Costa Rica's Institute on Alcoholism and Drug Dependence during the years 1983-1987. These studies dealt with a wide range of subjects--residents of marginal neighborhoods, juvenile male and adult female detainees, and high school students--as well as with the general population. Overall, the studies indicated that the most commonly used illicit drug was marijuana, that the bulk of the drug users (excluding alcohol and tobacco users) were young males, that relevant levels of cocaine use were starting to occur, and that the country's general drug abuse picture poses a problem in need of immediate attention.

[Behaviors on drug-abuse and prevalence of sexually transmitted diseases among drug users in Tianjin, China, from 2011 to 2015].

PubMed

Guo, Y; Zhou, N; Li, J; Ning, T L; Guo, W

2016-02-01

To understand the change of behavioral characteristics among drug users (DUS) in Tianjin and the prevalence rates of major sexually transmitted disease infections. A series of cross-sectional surveys were used. Between April and June, 2011 to 2015, a cross-sectional survey with face to face interview, was undertaken. Interview was conducted among DUS who entered the drug rehabilitation center and blood samples were drawn to test for HIV/syphilis/HCV infections. Multivariate logistic regression analysis was used to analyze the relationship between the infection of major sexually transmitted diseases and drug abuse or sexual behavior. 2 000 DUS were included during the 5-year study, with the average age of the DUS as 34.5 ± 8.7. Female accounted for 17.9% and club drug (new drugs) users accounted 45.4% of the participants, with its proportion increasing over the years. Comparing to traditional drug users, club drug users showed more sexual activities with partners, but lower proportion of condom use. Prevalence rates of HIV/Syphilis and HCV were 1.3%, 11.0%, 52.0%, respectively. The prevalence of syphilis among club drug users was significantly higher than those on traditional-drug use (χ(2)=67.778,P<0.001). Data from Binary logistic regression analysis showed that club drug use (adjusted OR=1.607, 95% CI:1.191-2.170) and females (adjusted OR=5.287, 95%CI: 3.824-7.311) were associated with syphilis infection among DUS. Drug abuse behavior changed among the drug abuse in Tianjin. Proportion of club drug use continued to increase so as the risk of infected sexually transmitted diseases.

Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults.

PubMed

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Choi, Bryan Y

2016-04-01

Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA. The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts. Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17-2.03), 2.75 (95% CI = 1.75-4.33), and 2.12 (95% CI = 1.45-3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58-3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE. Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.

A typology of drug selling among young adults in the United States.

PubMed

Vaughn, Michael G; Salas-Wright, Christopher P; DeLisi, Matt; Shook, Jeffrey J; Terzis, Lauren

2015-02-01

Although studies have found that young adults who sell drugs are more likely to be involved in risky behaviors than those who do not sell drugs, there has been relatively little research that has explored heterogeneity among young adults who sell drugs. Using a pooled sample of 18 to 25 year olds from the National Survey on Drug Use and Health (2006-2010) who report past-year drug selling (N = 5,373), this study employs latent profile analysis to specify latent groups and assess the correlates of group membership. Findings indicate substantial differences among young adults who sell drugs. In particular, the analysis found four groups of drug sellers: normative (49.6%), club drug users (23.6%), polysubstance users (16.0%), and criminal offenders (10.8%). Club drug users were characterized by high levels of ecstasy and hallucinogen use, polysubstance users were more likely to be depressed and anxious, White and female than the other groups. Criminal offenders were overwhelmingly male and more likely to be comprised of African-Americans and Hispanics. RESULTS indicate that drug selling in early adulthood varies substantially. Contrary to media and popular notions most drug sellers are not involved in crime and polysubstance using drug sellers are in clear need of mental health services. Further, most drug sellers in this age range are White. Findings suggest that policy efforts that operate under the assumption of homogeneity of drug selling may be misguided.

Drug users in contact with general practice.

PubMed

Robertson, J R

1985-01-05

A group of heroin users who are in contact with a general practice in north west Edinburgh are described. The study group was younger and included more women than previous studies. These people used a large variety of drugs and mainly purchased them locally. Frequent and often prolonged abstinent periods occurred with no prescribed opiate treatment. The group had experienced a high rate of drug related medical disorders. All these points raise the possibility that opiate users who are known to general practitioners may be a distinctly different population from those who attend drug dependency clinics. The frequency of remission and the prevalence of polydrug use have profound implications for planning and evaluating an effective medical response.

Prospective memory deficits in illicit polydrug users are associated with the average long-term typical dose of ecstasy typically consumed in a single session.

PubMed

Gallagher, Denis T; Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Robinson, Sarita J; Judge, Jeannie

2014-01-01

Neuroimaging evidence suggests that ecstasy-related reductions in SERT densities relate more closely to the number of tablets typically consumed per session rather than estimated total lifetime use. To better understand the basis of drug related deficits in prospective memory (p.m.) we explored the association between p.m. and average long-term typical dose and long-term frequency of use. Study 1: Sixty-five ecstasy/polydrug users and 85 nonecstasy users completed an event-based, a short-term and a long-term time-based p.m. task. Study 2: Study 1 data were merged with outcomes on the same p.m. measures from a previous study creating a combined sample of 103 ecstasy/polydrug users, 38 cannabis-only users, and 65 nonusers of illicit drugs. Study 1: Ecstasy/polydrug users had significant impairments on all p.m. outcomes compared with nonecstasy users. Study 2: Ecstasy/polydrug users were impaired in event-based p.m. compared with both other groups and in long-term time-based p.m. compared with nonillicit drug users. Both drug using groups did worse on the short-term time-based p.m. task compared with nonusers. Higher long-term average typical dose of ecstasy was associated with poorer performance on the event and short-term time-based p.m. tasks and accounted for unique variance in the two p.m. measures over and above the variance associated with cannabis and cocaine use. The typical ecstasy dose consumed in a single session is an important predictor of p.m. impairments with higher doses reflecting increasing tolerance giving rise to greater p.m. impairment.

Diabetes hospitalizations and deaths in a cohort of treatment-seeking illicit drug users

PubMed Central

Aregbesola, Alex; Olubamwo, Olubunmi; Ronkainen, Kimmo; Tiihonen, Jari; Föhr, Jaana; Kauhanen, Jussi

2018-01-01

Background: Studies on diabetes among illicit drug users are scarce in Finland. This study aimed to describe hospitalization and death due to diabetes among treatment-seeking illicit drug users. Methods: Information of 4817 treatment-seeking drug users (3365 men and 1452 women) aged 11–65 years (mean 24.5 years) was linked to the Finnish national hospital discharge register and the national death registry to identify those clients who were hospitalized or died from diabetes mellitus during 1997–2013. Results: Fifty-three persons (42 men and 11 women) had primary diagnoses of diabetes, with a total of 146 hospitalizations (121 among men and 25 among women). The total length of stay among men (1183 days) far exceeded those of women (138 days). Overall, type 1 diabetes was the main contributor to hospitalizations (67%, n = 98/146). The proportion of Type 1 diabetes with complications was 31% in men (n = 37/121) and 44% in women (n = 11/25). All cases of deaths due to diabetes (n = 7) occurred in men. Conclusion: Diabetes hospitalizations were mainly due to Type 1 diabetes. Longer length of hospital stay was observed in men, and all diabetes deaths occurred among men. Male drug users and drug users in general would require more support to reduce morbidity and mortality due to diabetes.

[Comparative study on the HIV epidemic between the Chinese and Burmese drug users in drug rehabilitation places in Dehong Prefecture, Yunnan Province].

PubMed

Tang, R H; Zhang, Z M; Yang, Y C; Feng, K D; Yang, S J; Zhang, J N; Ye, R H; Qiu, M F; Duan, S

2016-11-06

Objective: To compare the prevalence of HIV infection and its risk factors among Chinese and Burmese drug users living in Dehong Prefecture, Yunnan Province. Methods: We obtained plasma specimens and gathered demographic data from 7 867 drug users with Chinese or Burmese nationality attending rehabilitation clinics in Dehong Prefecture from October 2014 to September 2015. Of these, 7 756 individuals who gave valid questionnaire responses, including 5 389 Chinese and 2 367 Burmese, were enrolled in the study after giving informed consent. We used the Chi-squared test to compare the demographic characteristics and HIV prevalence between the Chinese and Burmese drug users. Logistic regression was then used to identify risk factors for HIV infection. Results: The HIV infection rate of 7 756 subjects (aged (35.45 ± 10.91) years old) was 7.18%, in which Burmese with higher HIV infection rate (9.38%, 222/2 367) than Chinese (6.22%, 335/5 389) (χ 2 =24.21, P <0.001). In chinese drug users, OR (95% CI ) of HIV infection of those aged 25-34 years old, 35-44 years old and ≥45 years old were 2.88 (1.46-5.69), 5.72 (2.87-11.40) and 3.48 (1.66-7.27),compared with those aged below 25 years;Compared with married participants, OR (95% CI ) of those unmarried and divorced were 1.44 (1.08-1.93) and 1.56 (1.09-2.24); Jingpo drug users were 1.47 (1.07-2.04) times to get HIV infection,compared with Han ethnicity; OR (95% CI ) of HIV infection for IDUs was 11.48 (9.73-16.01) compared with NIDUs.In Burmese drug users, OR (95% CI ) of HIV infection for females was 0.50 (0.26-0.93) compared with men;Compared with those aged below 25 years,those aged 25-34,35-44 and ≥45 years had OR (95% CI ) of 1.82 (1.18-2.77), 2.90 (1.82-4.62) and 2.31 (1.24-4.30), respectively; OR (95% CI ) of Jingpo participants was 2.22 (1.44-3.41) compared with Han nationality; OR (95% CI ) of HIV infection for IDUs was 10.61 (7.68-14.64) compared with NIDUs. Conclusion: The HIV infection rate of Burmese drug users was higher than that of Chinese drug users. Measures of HIV prevention and control should be mainly allocated in those 25 years above, non-married, Jingpo ethnicity and IDU in Chinese drug users, while in Burmese drug users,those females, 25 years above, Jingpo ethnicity and IDU should be higlighted in HIV prevention and control.

Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self-selecting online survey.

PubMed

Lawn, Will; Hallak, Jaime E; Crippa, Jose A; Dos Santos, Rafael; Porffy, Lilla; Barratt, Monica J; Ferris, Jason A; Winstock, Adam R; Morgan, Celia J A

2017-11-09

Ayahuasca is a natural psychedelic brew, which contains dimethyltryptamine (DMT). Its potential as a psychiatric medicine has recently been demonstrated and its non-medical use around the world appears to be growing. We aimed to investigate well-being and problematic alcohol use in ayahuasca users, and ayahuasca's subjective effects. An online, self-selecting, global survey examining patterns of drug use was conducted in 2015 and 2016 (n = 96,901). Questions were asked about: use of ayahuasca, lysergic acid diethylamide (LSD) and magic mushrooms; demographics, current well-being and past-year problematic alcohol use of past-year ayahuasca users and comparison drug users; and subjective effects of ayahuasca and comparison drugs. Ayahuasca users (n = 527) reported greater well-being than both classic psychedelic users (n = 18,138) and non-psychedelic drug-using respondents (n = 78,236). Ayahuasca users reported less problematic drinking than classic psychedelic users, although both groups reported greater problematic drinking than the other respondents. Ayahuasca's acute subjective effects usually lasted for six hours and were most strongly felt one hour after consumption. Within our online, self-selecting survey, ayahuasca users reported better well-being than comparison groups and less problematic drinking than classic psychedelic users. Future longitudinal studies of international samples and randomised controlled trials are needed to dissect the effects of ayahuasca on these outcomes.

Ecstasy (MDMA) and high prevalence psychiatric symptomatology: somatic anxiety symptoms are associated with polydrug, not ecstasy, use.

PubMed

Bedi, G; Van Dam, N T; Redman, J

2010-02-01

Although previous studies have examined anxiety and depression in ecstasy (+/-3,4-methylenedioxymethamphetamine; MDMA) users, it remains unclear whether symptoms are associated specifically with ecstasy or with polydrug use in general. We compared mean symptomatology and clinically significant symptoms in 45 ecstasy polydrug, 48 cannabis polydrug and 40 legal drug users, who completed standardised self-report anxiety and depression symptom measures. We further examined whether group differences were secondary to increased somatic symptom reporting, which may reflect acute/subacute drug effects. Anxiety and depression scores were higher in polydrug than legal drug users, with no difference between ecstasy and cannabis groups. There was no difference in numbers meeting criteria for clinically significant depression or 'moderate' or 'severe' anxiety, but the polydrug group contained more individuals reporting at least 'mild' anxiety symptoms than the legal drug control. Multivariate analyses indicated that anxiety alone was sufficient to discriminate groups. Polydrug users reported more somatic anxiety symptoms than legal drug users, but endorsed equivalent numbers of non-somatic symptoms. High prevalence psychiatric symptomatology in ecstasy polydrug users may be associated with polydrug rather than ecstasy use. Higher ratings in polydrug users appear to be secondary to increased somatic symptom reporting, suggesting possible impacts of drug effects on symptom endorsement.

Mental disorder diagnoses among children and adolescents who use antipsychotic drugs.

PubMed

Nesvåg, Ragnar; Hartz, Ingeborg; Bramness, Jørgen G; Hjellvik, Vidar; Handal, Marte; Skurtveit, Svetlana

2016-09-01

Antipsychotic drugs are used increasingly by children and adolescents and there is concern about off-label use. We aimed to study which substances, and for which mental disorder diagnoses, antipsychotic drugs were prescribed to 0-18-year-old boys and girls in Norway. Linked data from the national health registry for prescription drugs in 2010 and mental disorder diagnoses in 2008-2012 were used to study the prevalence of antipsychotic drug use, the type of antipsychotic drug substances used, mental disorder diagnoses in users and distribution of drugs per diagnostic category across gender. In total, 0.18% of Norwegian children and adolescents were prescribed antipsychotic drugs during 2010, of which there were more boys (0.23%) than girls (0.13%). Risperidone was the most frequently used substance among boys (57.4%) and girls (32.3%), followed by aripiprazole (19.4%) in boys and quetiapine (27.4%) in girls. The most common mental disorder diagnoses among male users were hyperkinetic (49.9%) and autism spectrum disorder (27.1%), while anxiety disorders (41.5%) and depressive illness (33.6%) were most common among female users. A schizophrenia-like psychosis diagnosis was given to 11.1% of the male and 18.2% of the female users. A hyperkinetic disorder was diagnosed among 56.9% and 52.4% of the male risperidone and aripiprazole users, respectively. Among female quetiapine users, 57.1% were diagnosed with anxiety disorders and 52.4% with depressive illness. These results demonstrate that children and adolescents who use antipsychotic drugs are predominantly diagnosed with non-psychotic mental disorders such as hyperkinetic disorder among boys and anxiety disorder or depressive illness among girls. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Perceptions of parental bonding in freebase cocaine users versus non-illicit drug users

PubMed Central

Pettenon, Márcia; Kessler, Felix Henrique Paim; Guimarães, Luciano S. P.; Pedroso, Rosemeri Siqueira; Hauck, Simone; Pechansky, Flavio

2014-01-01

Background & objectives: Evidence has suggested that parenting styles have peculiar characteristics in families with drug-related issues. This study was undertaken to investigate the perception of crack (smoke cocaine) users and non-users about parental bonding quality regarding care and control in Brazil. Methods: A total of 198 hospitalized crack users and 104 users of any non-illicit drug were assessed using the Parental Bonding Instrument (PBI), the sixth version of the Addiction Severity Index (ASI) and Mini International Neuropsychiatric Interview (MINI). Results: Adjusted logistic regression analysis showed that crack users were more likely (ORadj = 9.68; 95% CI: 2.82, 33.20) to perceive neglectful mothers, as well as more likely (ORadj = 4.71, 95% CI: 2.17, 10.22) to perceive controlling and affectionless fathers in comparison with non-illicit drug users who were more likely to perceive optimal parenting. Interpretation & conclusions: Our findings indicate that the perception of neglectful mothers and affectionless controlling fathers may be associated with the tendency of the children to be less resilient when facing stressful events, leading them to a greater risk to use crack. PMID:25109717

Drug use, travel and HIV risk.

PubMed

Lee, D; Bell, D C; Hinojosa, M

2002-08-01

A study was conducted to examine the travel experiences of a community sample of 160 drug users and 44 non-users recruited as part of a study of HIV risk. Of the sample, 47% (96/204) reported intercity travel in the previous ten years. Results showed that men were more likely to travel than women, Anglos more than minorities, and young persons more than old. When travellers testing HIV-seropositive (n = 13) were compared with seronegative travellers, HIV-positive travellers reported more sex while travelling than HIV-negative persons, but virtually all of the difference reported involved sex with condoms. There were no significant differences in sex risk behaviours while travelling between drug users and non-drug users, or in sex risk behaviors between drug injectors and non-injectors. Travellers had fewer injection partners while travelling than they had while at home. There was also a significant difference in number of sex partners with whom a condom was not used, with fewer sex partners while travelling.

Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

PubMed

Krupski, Antoinette; Graves, Meredith C; Bumgardner, Kristin; Roy-Byrne, Peter

2015-11-01

The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevalence and correlates of crack-cocaine injection among young injection drug users in the United States, 1997-1999.

PubMed

Santibanez, Scott S; Garfein, Richard S; Swartzendruber, Andrea; Kerndt, Peter R; Morse, Edward; Ompad, Danielle; Strathdee, Steffanie; Williams, Ian T; Friedman, Samuel R; Ouellet, Lawrence J

2005-03-07

We estimated prevalence and identified correlates of crack-cocaine injection among young injection drug users in the United States. We analyzed data from the second Collaborative Injection Drug Users Study (CIDUS II), a 1997-1999 cohort study of 18-30-year-old, street-recruited injection drug users from six US cities. Crack-cocaine injection was reported by 329 (15%) of 2198 participants. Prevalence varied considerably by site (range, 1.5-28.0%). No participants injected only crack-cocaine. At four sites where crack-cocaine injection prevalence was greater than 10%, recent (past 6 months) crack-cocaine injection was correlated with recent daily injection and sharing of syringes, equipment, and drug solution. Lifetime crack-cocaine injection was correlated with using shooting galleries, initiating others into drug injection, and having serologic evidence of hepatitis B virus and hepatitis C virus infection. Crack-cocaine injection may be a marker for high-risk behaviors that can be used to direct efforts to prevent HIV and other blood-borne viral infections.

Is emotional intelligence impaired in ecstasy-polydrug users?

PubMed

Craig, L; Fisk, J E; Montgomery, C; Murphy, P N; Wareing, M

2010-02-01

Previous findings report use of the drug ecstasy (MDMA) to be associated with lower emotional intelligence (EI), and compromised functioning in brain areas responsible for emotion. This study explored the relationship between ecstasy use, EI, mood and parenting styles. Questionnaire measures of drug use, lifestyle, parenting style and EI were obtained, with separate IQ measures for fluid intelligence (Ravens matrices) and pre-morbid intelligence [National Adult Reading Test (NART)]. Current mood measures were obtained from an adjective checklist. The sample comprised 78 ecstasy/polydrug users, 38 cannabis only users and 34 non-drug users. Drug use was categorised at three levels (non-user, cannabis-only user and ecstasy-polydrug user). Factorial ANOVA using drug use as an independent variable showed no significant group effects in EI. EI showed significant correlations with current mood that were positive for arousal and negative for both anxiety and depression. EI was also significantly and positively correlated with the perceived degree of parental control. Regression analyses showed that these relationships remained significant after controlling for differences in IQ, age, gender, and ecstasy use. Adverse mood effects specifically associated with ecstasy use were significantly related to lower EI, and were independent of IQ, age and gender. Higher EI was significantly associated with ecstasy-related precautions used when taking this drug. Contrary to earlier findings, ecstasy-polydrug users did not differ from non-users on EI. However, self-reported ecstasy-related mood disturbances were related to lower EI, with the compromising of orbitofrontal cortical functioning being possible here.

E-Cigarettes and the Drug Use Patterns of Adolescents.

PubMed

Miech, Richard A; O'Malley, Patrick M; Johnston, Lloyd D; Patrick, Megan E

2016-05-01

This study examines the role of e-cigarettes in the drug use patterns of adolescents. Of specific interest is whether adolescent e-cigarette users fall into a group of (1) youth who do not use traditional drugs of abuse or (2) polysubstance users. Using latent class analysis, we identify major "classes" of substance users on the basis of recent use of e-cigarettes, alcohol, marijuana, cigarettes, and prescription drugs. Analyses are conducted separately for adolescents in 8th, 10th, and 12th grades. Data come from 16 615 participants in the 2014 Monitoring the Future survey. Youth who do not use traditional drugs of abuse account for about 50% of e-cigarette users in 8th grade, 35% in 10th grade, and 17% in 12th grade. These youth come from a large "low-level users" group found in each grade, characterized by low probability of use for all substances (e-cigarette probability in this group for 8th graders = .046; 10th graders = .071; 12th graders = .027). Other e-cigarette users come from a smaller, "poly-users" group found in each grade, characterized by high-to-moderate probabilities (.83-.21) of using e-cigarettes and other substances. Specific to 12th grade is a third, additional polysubstance group characterized by high likelihood of e-cigarette use (.93). The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances. The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

HIV antibodies among intravenous drug users in Bahrain.

PubMed

al-Haddad, M K; Khashaba, A S; Baig, B Z; Khalfan, S

1994-09-01

A 12-month study was conducted to identify risk factors for human immunodeficiency virus (HIV) infections among intravenous drug users (IDU) attending drug rehabilitation clinic of the Psychiatric Hospital, Manama, Bahrain. Patients provided demographic and behavioural information based on a questionnaire. Two hundred and forty male IDUs participated in the study on voluntary basis. The seroprevalence of HIV was 21.1 per cent. The presence of HIV antibody was associated with educational status, frequency of injecting drugs and needle sharing.

Drug driving and the management of risk: the perspectives and practices of a sample of problem drug users.

PubMed

McIntosh, James; O'Brien, Tommy; McKeganey, Neil

2008-06-01

This paper reports on a qualitative study of the attitudes and risk management strategies of a sample of problem drug users in relation to driving while under the influence of drugs. Interviews were conducted with 26 individuals (21 men and 5 women) all of whom had been addicted to heroin and had admitted to driving while under the influence of illegal drugs. The drug users reported four main strategies for managing the risks associated with drug driving: attempting to limit their drug intake to their tolerance level; delaying driving after taking a drug until they felt safe; stopping driving if they felt unsafe while behind the wheel; and avoiding driving altogether under the influence of certain drugs. However, the interviewees' accounts of their drug driving behaviour suggest that these strategies are not only far from reliable, they may also act to encourage drug driving by creating a false sense of security. The reassurance they provide may also undermine any educational messages targeting drug driving. There was little in the problem users' accounts to suggest that media campaigns or a more effective method of detection would have much influence upon their behaviour. The paper concludes that the most realistic approach to the problem may be to incorporate drug driving interventions within drug treatment programmes.

Attitudes towards drug legalization among drug users.

PubMed

Trevino, Roberto A; Richard, Alan J

2002-01-01

Research shows that support for legalization of drugs varies significantly among different sociodemographic and political groups. Yet there is little research examining the degree of support for legalization of drugs among drug users. This paper examines how frequency and type of drug use affect the support for legalization of drugs after adjusting for the effects of political affiliation and sociodemographic characteristics. A sample of 188 drug users and non-drug users were asked whether they would support the legalization of marijuana, cocaine, and heroin. Respondents reported their use of marijuana, crack, cocaine, heroin, speedball, and/or methamphetamines during the previous 30 days. Support for legalization of drugs was analyzed by estimating three separate logistic regressions. The results showed that the support for the legalization of drugs depended on the definition of "drug user" and the type of drug. In general, however, the results showed that marijuana users were more likely to support legalizing marijuana, but they were less likely to support the legalization of cocaine and heroin. On the other hand, users of crack, cocaine, heroin, speedball, and/or methamphetamines were more likely to support legalizing all drugs including cocaine and heroin.

'Allowing the right' and its currency in managing drug stigma in Greece.

PubMed

Fotopoulou, Maria; Munro, Alison; Taylor, Avril

2015-08-01

Evidence suggests that problem drug users are still subject to high levels of stigmatization. In countries, like Greece, where families occupy a central position and honour is collectively attained, secondary drug stigma is also highly prevalent. However, little is known about how drug users and their families manage drug stigma in the specific cultural milieu that makes up Greece. This article presents findings from a qualitative study exploring how drug stigma both manifests itself and is managed by drug users and parents in the context of Greek familial culture. The study was conducted in two state drug agencies in Thessaloniki - Greece and involved the participation of 40 problem drug users (PDU) (23 male/17 female) and 8 parents of PDU. Qualitative, in-depth, interviews were used to collect narrative accounts about experiences of managing addiction, drug stigma and secondary stigma in the Greek parental home. 'Allowing the right' - broadly understood as referring to passing to others information which might devalue a person and consequently that person's family - is discussed in terms of drug stigma management in Greece. We highlight how this culturally specific notion can be viewed as an active strategy adopted by both individual drug users and parents of PDU to manage stigmatization by illustrating the various way in which not 'allowing the right' was described by participants, including drug problem discovery or disclosure and subsequent management of drug using careers and drug stigma within the Greek family context. Given the significance of the cultural notion of 'allowing the right' in the trajectory of drug use amongst PDU and more particularly in stigma management and secondary stigma management, the paper highlights the need for further research into the field in Greece. The need for targeted culturally specific and culturally relevant interventions aimed at reducing drug stigma is also highlighted in relation to both policy and practice. Copyright © 2015 Elsevier B.V. All rights reserved.

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China.

PubMed

Chen, Xi; Li, Xingli; Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using "snowball" techniques, and internet advertisements were used to recruit study participants. Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM.

Harms and benefits associated with psychoactive drugs: findings of an international survey of active drug users

PubMed Central

Morgan, Celia JA; Noronha, Louise A; Muetzelfeldt, Mark; Fielding, Amanda

2013-01-01

There have been several recent efforts in the UK and the Netherlands to describe the harms of psychoactive substances based on ratings of either experts or drug users. This study aimed to assess the perceived benefits as well as harms of widely used recreational drugs, both licit and illicit, in an international sample of drug users. The survey was hosted at https://www.internationaldrugsurvey.org/ and was available in three languages. Residents reported their experience of 15 commonly used drugs or drug classes; regular users then rated their harms and benefits. In all, 5791 individuals from over 40 countries completed the survey, although the majority were from English speaking countries. Rankings of drugs differed across 10 categories of perceived benefits. Skunk and herbal cannabis were ranked consistently beneficial, whilst alcohol and tobacco fell below many classified drugs. There was no correlation at all between users’ harm ranking of drugs and their classification in schedules of the USA or ABC system in the UK. Prescription analgesics, alcohol and tobacco were ranked within the top 10 most harmful drugs. These findings suggest that neither the UK nor US classification systems act to inform users of the harms of psychoactive substances. It is hoped the results might inform health professionals and educators of what are considered to be both the harms and benefits of psychoactive substances to young people. PMID:23438502

Prevalence of Drug Combinations Increasing Bleeding Risk Among Warfarin Users With and Without Alzheimer's Disease.

PubMed

Taipale, Heidi; Vuorikari, Hanna; Tanskanen, Antti; Koponen, Marjaana; Tiihonen, Jari; Kettunen, Raimo; Hartikainen, Sirpa

2015-11-01

The aim of this study was to analyse the prevalence and predictors of drug combinations increasing bleeding risk among warfarin users with and without Alzheimer's disease (AD). This retrospective observational study utilised data from the Finnish MEDALZ-2005 cohort. The MEDALZ-2005 study included all community-dwelling persons with a clinically verified diagnosis of AD at the end of 2005, and one comparison person without AD for each case. Data on drug use was collected from the Prescription Register. We included persons who were warfarin users during the study period 2006-2009. Drug combinations increasing bleeding risk with warfarin included selective serotonin reuptake inhibitors (SSRIs), non-steroidal anti-inflammatory agents (NSAIDs), other antithrombotic drugs and tramadol. Factors associated with combination use were investigated with logistic regression. During the follow-up, 3385 persons with AD and 4830 persons without AD used warfarin. Drug combinations increasing bleeding risk were more common in warfarin users with AD than without AD [35.9 and 30.5%, respectively (p < 0.0001)]. The most common combination was SSRIs and warfarin, which was more common among persons with AD (23.8%) than among persons without AD (10.9%). NSAIDs and warfarin combination was more common among persons without AD. Combination use was associated with AD, female gender, younger age, diabetes mellitus, rheumatoid arthritis and asthma/chronic obstructive pulmonary disease (COPD). Use of drug combinations increasing bleeding risk was more common among warfarin users with AD. Special attention should be paid to minimise the duration of concomitant use and to find safer alternatives without increased bleeding risk.

Developing strategies for AIDS prevention research with black and Hispanic drug users.

PubMed Central

Schilling, R F; Schinke, S P; Nichols, S E; Zayas, L H; Miller, S O; Orlandi, M A; Botvin, G J

1989-01-01

More than 8 of 10 intravenous drug users infected with the human immunodeficiency virus (HIV) are black or Hispanic. Recognizing that sociocultural factors affect HIV transmission, public health officials have called for interventions designed for ethnic-racial minority groups. Considered in this paper are the nature and extent of AIDS among ethnic-racial minorities and the cultural aspects of drug use and sexual behavior related to HIV transmission. That drug users and their associates are practicing safer needle use is evident; that they are changing their sexual behavior is less so. Calling for rapid advances in knowledge and expanded efforts in intervention, Federal agencies have instituted numerous programs to support innovative research and demonstration projects in ethnic-racial minority communities. Needed are studies that (a) describe the phenomena of drug use and sexual behavior among ethnic-racial minority populations, (b) establish the efficacy of culturally specific AIDS prevention strategies in drug treatment and community settings, and (c) demonstrate new ways of recruiting, treating, and reducing relapse among drug users. PMID:2493660

Depressive Symptoms and Patterns of Drug Use among Street Youth

PubMed Central

Hadland, Scott E.; Marshall, Brandon D. L.; Kerr, Thomas; Qi, Jiezhi; Montaner, Julio S.; Wood, Evan

2010-01-01

Purpose Rates of depression among street youth are poorly characterized, particularly as they pertain to concurrent drug use. We sought to assess associations between drug type and degree of depression in this population. Methods From October 2005 to November 2007, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-recruited youth aged 14-26 in Vancouver, Canada. Active drug users were classified by predominant substance of use: daily marijuana use, weekly cocaine/crack use, weekly crystal methamphetamine use, or weekly heroin use. Adjusted mean number of depressive symptoms (measured by the Center for Epidemiological Studies Depression [CES-D] scale) was compared among the four groups using multiple linear regression. Logistic regression was also used to assess adjusted odds of CES-D score ≥22. Results Among 447 youth, mean CES-D score was highest among heroin users (adjusted mean [SD], 22.7 [1.2]), followed by crystal methamphetamine users (21.8 [1.1]), then cocaine/crack users (19.1 [1.0]), and finally, marijuana users (18.3 [1.1]), a difference significant among groups (p < 0.001). When compared to daily marijuana users, odds of CES-D score ≥22 were higher among heroin users (adjusted odds ratio [AOR], 2.64; 95% confidence interval [CI], 1.39–4.99), and among crystal methamphetamine users (AOR, 1.88; 95% CI, 1.04–3.42) but not among cocaine/crack users (AOR, 1.41; 95% CI, 0.79–2.52). Conclusions To our knowledge, this is the first report of drug use typologies and depression among street youth. Policymakers might heed the apparent vulnerability of heroin and crystal methamphetamine users to even greater degrees of depression than their peers. PMID:21575818

The Problem of “Just for Fun”: Patterns of Use Situations among Active Club Drug Users

PubMed Central

Starks, Tyrel J.; Golub, Sarit; Kelly, Brian C.; Parsons, Jeffrey T.

2010-01-01

Existing research has demonstrated the significance of situational antecedents to substance use. The current study used a cluster analytic approach to identify groups of club drug users who report using substances in similar situations (assessed by the Inventory of Drug Taking Situations) with longitudinal data from 400 active drug users. A three-cluster solution emerged in baseline data and was replicated in 12-month follow-up data. Groups were identified as Situationally Restricted, Pleasure Driven, and Situationally Broad users. Group differences were observed on measures of mental health, attitudes towards substance use, amount of substance use, and rates of substance dependence. Cluster membership predicted substance dependence after controlling for past dependence, current use, and current depression/anxiety. PMID:20696530

Review of HIV and HCV infection among drug users in China.

PubMed

Bao, Yan-ping; Liu, Zhi-min; Lu, Lin

2010-05-01

Drug abuse has resulted in a huge public health and economic burden in China, especially the rapid spread of HIV/AIDS and hepatitis C virus (HCV) infection. Multiple HIV and HCV subtypes were detected among drug users in China, this study reviews the molecular distribution of HIV and HCV among injection drug users (IDUs) and explores new epidemiologic trends of HIV and HCV among drug users in China. The 2009 National Narcotic Control Commission report showed that the percentage of users of 'new-type drugs', including amphetamine-type stimulants (ATS: methamphetamine and MDMA/ecstasy) and ketamine, was about 27% of total drug users. The pooled data from published papers showed that CRF07BC was the predominant HIV-1 subtype, which accounted for 38.8%, and it was followed by AE, which accounted for 22.7% among HIV-positive IDUs. Following these, the CRF08BC, B' and C subtypes accounted for about 10.8%, 9.9% and 9.2%, respectively. Subtype 6a was the predominant HCV subtype, accounting for 36.7%, and subtypes 3b, 1a, 3a and 1b were the next most predominant subtypes. With the increase of 'new-type drugs' use and AE HIV-1 subtype infection among IDUs, the situation regarding HIV/AIDS and HCV infection has become complicated. More comprehensive prevention and intervention strategies should be instigated for the extensive high-risk populations in China.

Sexual Violence in the Context of Drug Use Among Young Adult Opioid Users in New York City

PubMed Central

Jessell, Lauren; Mateu-Gelabert, Pedro; Guarino, Honoria; Vakharia, Sheila P.; Syckes, Cassandra; Goodbody, Elizabeth; Ruggles, Kelly V.; Friedman, Sam

2015-01-01

Drug and alcohol use have been associated with increased risk for sexual violence, but there is little research on sexual violence within the context of drug use among young adult opioid users. The current mixed-methods study explores young adult opioid users’ sexual experiences in the context of their drug use. Forty-six New York City young adults (ages 18–32) who reported lifetime nonmedical use of prescription opioids (POs) completed in-depth, semistructured interviews, and 164 (ages 18–29) who reported heroin and/or nonmedical PO use in the past 30 days completed structured assessments that inquired about their drug use and sexual behavior and included questions specific to sexual violence. Participants reported frequent incidents of sexual violence experienced both personally and by their opioid using peers. Participants described sexual violence, including sexual assault, as occurring within a context characterized by victimization of users who were unconscious as a result of substance use, implicit and explicit exchanges of sex for drugs and/or money that increased risk for sexual violence, negative sexual perceptions ascribed to drug users, and participants’ own internalized stigma. Recommendations to reduce sexual violence among young adult opioid users include education for users and service providers on the risk of involvement in sexual violence within drug using contexts and efforts to challenge perceptions of acceptability regarding sexual violence. PMID:26240068

Comparisons between the attitudes of student nurses and other health and social care students toward illicit drug use: An attitudinal survey.

PubMed

Harling, Martyn R

2017-01-01

In the context of a recent emphasis on compassion in the delivery of health care, the current study set out to measure the attitudes of different groups of health and social care students toward illicit drug users. Previous research has identified variations in the attitudes of different groups of health and social care professionals toward working with illicit drug users. Nurses, in particular, have been reported as holding moralistic or stereotypical views of illicit drug users. However, few studies have measured the attitudes of student nurses or compared their attitudes to other health and social care students. This article describes the use of a bespoke attitude scale to measure the attitudes of cohorts of student nurses, clinical psychology trainees, health and social care, social work and midwifery students at the start of their course (N=308). Results indicated that student nurses had the least tolerant attitudes, reinforcing the need for a specific educational focus on working with illicit drug users in nurse education. Variations between student groups indicate that Interprofessional Education can provide an opportunity to improve attitudes toward illicit drug users, particularly amongst student nurses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Higher binding of the dopamine D3 receptor-preferring ligand [11C]-(+)-propyl-hexahydro-naphtho-oxazin in methamphetamine polydrug users: a positron emission tomography study.

PubMed

Boileau, Isabelle; Payer, Doris; Houle, Sylvain; Behzadi, Arian; Rusjan, Pablo M; Tong, Junchao; Wilkins, Diana; Selby, Peter; George, Tony P; Zack, Martin; Furukawa, Yoshiaki; McCluskey, Tina; Wilson, Alan A; Kish, Stephen J

2012-01-25

Positron emission tomography (PET) findings suggesting lower D2-type dopamine receptors and dopamine concentration in brains of stimulant users have prompted speculation that increasing dopamine signaling might help in drug treatment. However, this strategy needs to consider the possibility, based on animal and postmortem human data, that dopaminergic activity at the related D3 receptor might, in contrast, be elevated and thereby contribute to drug-taking behavior. We tested the hypothesis that D3 receptor binding is above normal in methamphetamine (MA) polydrug users, using PET and the D3-preferring ligand [11C]-(+)-propyl-hexahydro-naphtho-oxazin ([11C]-(+)-PHNO). Sixteen control subjects and 16 polydrug users reporting MA as their primary drug of abuse underwent PET scanning after [11C]-(+)-PHNO. Compared with control subjects, drug users had higher [11C]-(+)-PHNO binding in the D3-rich midbrain substantia nigra (SN; +46%; p<0.02) and in the globus pallidus (+9%; p=0.06) and ventral pallidum (+11%; p=0.1), whereas binding was slightly lower in the D2-rich dorsal striatum (approximately -4%, NS; -12% in heavy users, p=0.01) and related to drug-use severity. The [11C]-(+)-PHNO binding ratio in D3-rich SN versus D2-rich dorsal striatum was 55% higher in MA users (p=0.004), with heavy but not moderate users having ratios significantly different from controls. [11C]-(+)-PHNO binding in SN was related to self-reported "drug wanting." We conclude that the dopamine D3 receptor, unlike the D2 receptor, might be upregulated in brains of MA polydrug users, although lower dopamine levels in MA users could have contributed to the finding. Pharmacological studies are needed to establish whether normalization of D3 receptor function could reduce vulnerability to relapse in stimulant abuse.

Higher binding of the dopamine D3 receptor-preferring ligand [11C]-(+)-PHNO in Methamphetamine Polydrug Users: A Positron Emission Tomography Study

PubMed Central

Boileau, Isabelle; Payer, Doris; Houle, Sylvain; Behzadi, Arian; Rusjan, Pablo M.; Tong, Junchao; Wilkins, Diana; Selby, Peter; George, Tony P.; Zack, Martin; Furukawa, Yoshiaki; McCluskey, Tina; Wilson, Alan A.; Kish, Stephen J.

2012-01-01

Positron emission tomography (PET) findings suggesting lower D2-type dopamine receptors and dopamine concentration in brains of stimulant users have prompted speculation that increasing dopamine signaling might help in drug-treatment. However, this strategy needs to consider the possibility, based on animal and postmortem human data, that dopaminergic activity at the related D3 receptor might, in contrast, be elevated, and thereby contribute to drug-taking behavior. We tested the hypothesis that D3 receptor binding is above-normal in methamphetamine (MA) polydrug users, using PET and the D3-preferring ligand [11C]-(+)-PHNO. Sixteen control subjects and 16 polydrug users reporting MA as their primary drug of abuse underwent PET scanning following [11C]-(+)-PHNO. Compared to control subjects, drug users had higher [11C]-(+)-PHNO binding in the D3-rich midbrain substantia nigra (SN, +46%, p<0.02) and in the globus pallidus (+9%, p=0.06) and ventral pallidum (+11%, p=0.1), whereas binding was slightly lower in the D2-rich dorsal striatum (~−4%, NS; −12% in heavy users, p=0.01) and related to drug-use severity. [11C]-(+)-PHNO binding ratio in D3-rich SN vs. D2-rich dorsal striatum was 55% higher in MA users (p=0.004), with heavy but not moderate users having ratios significantly different from controls. [11C]-(+)-PHNO binding in SN was related to self-reported “drug-wanting.” We conclude that the dopamine D3 receptor, unlike the D2 receptor, might be upregulated in brains of MA polydrug users although lower dopamine levels in MA users could have contributed to the finding. Pharmacological studies are needed to establish whether normalization of D3 receptor function could reduce vulnerability to relapse in stimulant abuse. PMID:22279219

Marijuana usage in relation to harmfulness ratings, perceived likelihood of negative consequences, and defense mechanisms in high school students.

PubMed

Como-Lesko, N; Primavera, L H; Szeszko, P R

1994-08-01

This study investigated high school students' marijuana usage patterns in relation to their harmfulness ratings of 15 licit and illicit drugs, perceived negative consequences from using marijuana, and types of defense mechanisms employed. Subjects were classified into one of five pattern-of-use groups based on marijuana usage: principled nonusers, nonusers, light users, moderate users, and heavy users. Principled nonusers (individuals who have never used marijuana and would not do so if it was legalized) rated marijuana, hashish, cocaine, and alcohol as significantly more harmful than heavy users. A cluster analysis of the drugs' harmfulness ratings best fit a three cluster solution and were named medicinal drugs, recreational drugs, and hard drugs. In general, principled nonusers rated negative consequences from using marijuana as significantly more likely to occur than other groups. Principled nonusers and heavy users utilized reversal from the Defense Mechanism Inventory, which includes repression and denial, significantly more than nonusers, indicating some trait common to the two extreme pattern-of-use groups.

The effect of methamphetamine and heroin price on polydrug use: A behavioural economics analysis in Sydney, Australia.

PubMed

Chalmers, Jenny; Bradford, Deborah; Jones, Craig

2010-09-01

A key aim of supply-side drug law enforcement is to reduce drug use by increasing the retail price of drugs. Since most illicit drug users are polydrug users the effectiveness of this strategy depends on the extent to which drug users reduce their overall consumption of drugs. The literature shows that drug users do reduce their consumption of a drug when its price increases. However the extent of that decrease and the implications for the use of other drugs vary across studies. A sample of 101 Australian methamphetamine users was surveyed using a behavioural economics approach. Participants were given a hypothetical fixed drug budget, presented with a range of drug price lists and asked how many units of each drug they would purchase. Methamphetamine and heroin prices were varied independently across trials. While demand for both methamphetamine and heroin was found to be price elastic, elasticity estimates were influenced by the nature of participants' drug dependence. The group least responsive to changes in methamphetamine price were those dependent only on methamphetamine, while the group most responsive were dependent only on heroin. Similar findings emerged in relation to changes in heroin price. Cross-price elasticity analysis showed limited substitution into other drugs as the price of methamphetamine increased. In contrast, for heroin, there was significant substitution into pharmaceutical opioids and to a lesser extent, benzodiazepines and methamphetamine. However, for the most part, the decreases in methamphetamine or heroin consumption outweighed any substitution into other drugs. The reduction in overall drug consumption and expenditure in response to price increases in heroin and methamphetamine observed in this sample lend support to supply-side enforcement strategies that aim to increase retail drug price. Notably, this analysis highlights the importance of accounting for the nature of users' drug dependence in estimating price responsiveness. Copyright 2010 Elsevier B.V. All rights reserved.

Drug user organizations in the Nordic countries--local, national, and international dimensions.

PubMed

Frank, Vibeke Asmussen; Anker, Jørgen; Tammi, Tuukka

2012-04-01

The article focuses on drug user organizations that represent and advocate for active "hard drug" users in the Nordic countries. It discusses the opportunities and challenges that these organizations face in their search for legitimacy and political influence. The comparative perspective points at similarities and differences in national contexts that both support and challenges the existence of drug user organizations, including drug policy, social welfare policy, trends in drug use, and organizational conditions. The article also discusses the importance of international network and transnational organizations that support drug user organizations.

A comparative analysis of methamphetamine use: black gay and bisexual men in relation to men of other races.

PubMed

Halkitis, Perry N; Jerome, Roy C

2008-01-01

We investigated the patterns and correlates of methamphetamine use among Black gay and bisexual men who participated in a large-scale study of club drug use, and sexual behavior in combination with club drug use in New York City. Almost half of the Black men (49%) in the sample indicated use of methamphetamine in the 4 months prior to assessment, a proportion somewhat lower than their White counterparts. In terms of the overall sample, the proportion of the Black men in the study was equivalent to the proportion of methamphetamine users who identified as Black. Black methamphetamine users tended not to reside in neighborhoods considered traditionally gay, were more likely to be HIV-positive, have lower educational attainment, and have lower levels of income than other methamphetamine users. In terms of frequency and reasons for use, Black methamphetamine users did not differ in any substantive way compared to other races and ethnicities. In addition, they did not differ along any key demographic lines from Black non-methamphetamine users. Poly-drug use was common among all Black men in the sample, with almost all methamphetamine users also reporting use of cocaine, but cocaine users not necessarily reporting methamphetamine use. Once a drug that was considered popular only among White gay men, methamphetamine use has been shown to transcend racial and ethnic lines. Because of the synergy that exists between use of the drug, the concentrated levels of HIV in the Black gay population, and the sexual disinhibition engendered with methamphetamine use, this drug presents a potentially mounting public health challenge.

A Comparative Analysis of Methamphetamine Use: Black Gay and Bisexual Men in Relation to Men of Other Races

PubMed Central

Halkitis, Perry N.; Jerome, Roy C.

2009-01-01

We investigated the patterns and correlates of methamphetamine use among Black gay and bisexual men who participated in a large-scale study of club drug use, and sexual behavior in combination with club drug use in New York City. Almost half of the Black men (49%) in the sample indicated use of methamphetamine in the 4 months prior to assessment, a proportion somewhat lower than their White counterparts. In terms of the overall sample, the proportion of the Black men in the study was equivalent to the proportion of methamphetamine users who identified as Black. Black methamphetamine users tended not to reside in neighborhoods considered traditionally gay, were more likely to be HIV-positive, have lower educational attainment, and have lower levels of income than other methamphetamine users. In terms of frequency and reasons for use, Black methamphetamine users did not differ in any substantive way compared to other races and ethnicities. In addition, they did not differ along any key demographic lines from Black non-methamphetamine users. Poly-drug use was common among all Black men in the sample, with almost all methamphetamine users also reporting use of cocaine, but cocaine users not necessarily reporting methamphetamine use. Once a drug that was considered popular only among White gay men, methamphetamine use has been shown to transcend racial and ethnic lines. Because of the synergy that exists between use of the drug, the concentrated levels of HIV in the Black gay population, and the sexual disinhibition engendered with methamphetamine use, this drug presents a potentially mounting public health challenge. PMID:17825996

Oral substitution treatment of injecting opioid users for prevention of HIV infection.

PubMed

Gowing, Linda; Farrell, Michael F; Bornemann, Reinhard; Sullivan, Lynn E; Ali, Robert

2011-08-10

Injecting drug users are vulnerable to infection with Human Immunodeficiency Virus (HIV) and other blood borne viruses as a result of collective use of injecting equipment as well as sexual behaviour To assess the effect of oral substitution treatment for opioid dependent injecting drug users on risk behaviours and rates of HIV infections We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and PsycINFO to May 2011. We also searched reference lists of articles, reviews and conference abstracts Studies were required to consider the incidence of risk behaviours, or the incidence of HIV infection related to substitution treatment of opioid dependence. All types of original studies were considered. Two authors independently assessed each study for inclusion Two authors independently extracted key information from each of the included studies. Any differences were resolved by discussion or by referral to a third author. Thirty-eight studies, involving some 12,400 participants, were included. The majority were descriptive studies, or randomisation processes did not relate to the data extracted, and most studies were judged to be at high risk of bias. Studies consistently show that oral substitution treatment for opioid-dependent injecting drug users with methadone or buprenorphine is associated with statistically significant reductions in illicit opioid use, injecting use and sharing of injecting equipment. It is also associated with reductions in the proportion of injecting drug users reporting multiple sex partners or exchanges of sex for drugs or money, but has little effect on condom use. It appears that the reductions in risk behaviours related to drug use do translate into reductions in cases of HIV infection. However, because of the high risk of bias and variability in several aspects of the studies, combined totals were not calculated. Oral substitution treatment for injecting opioid users reduces drug-related behaviours with a high risk of HIV transmission, but has less effect on sex-related risk behaviours. The lack of data from randomised controlled studies limits the strength of the evidence presented in this review.

Social Representations Used by the Parents of Mexican Adolescent Drug Users under Treatment to Explain Their Children's Drug Use: Gender Differences in Parental Narratives

ERIC Educational Resources Information Center

Nuno-Gutierrez, Bertha Lidia; Alvarez-Nemegyei, Jose; Rodriguez-Cerda, Oscar

2008-01-01

The aim of this study was to explore the social representations used by the parents of adolescent drug users to explain the onset of drug use. Differences in explanations between the parents of male and female adolescents were also explored. Sixty parents who accompanied their children to four rehabilitation centers in 2004 completed two…

Recalling the past: probation officers work with drug misusers during the 1960s.

PubMed

Sparrow, Paul

2014-11-01

Britain's first wave of non-therapeutic drug users during the 1960s were more likely to come into contact with the criminal courts than previous, therapeutic, drug users. This paper recounts the untold history of probation officers' work with drug misusing offenders in the United Kingdom during the 1960s. Using 'snowballing' to source participants (in which study subjects recruit future subjects from among their acquaintances) and in-depth interviews as a means of eliciting information, probation officers who had supervised drug users during this time were interviewed about their experiences. Interviews were transcribed verbatim and a thematic data set produced. Front-line probation officers in the United Kingdom in the 1960s had considerable contact with drug-misusing offenders. In explaining drug addiction, officers tended to draw upon a psychotherapeutic interpretation, and in terms of intervention they relied heavily upon the psychiatric services to deliver treatment. Probation officers did not always make the connection between addiction and an increase in criminality. In Britain's first wave of non-therapeutic drug users in the 1960s, probation officers appear not to have made a connection with criminality, which may have limited how far they developed a formalized approach to applying the expertise of the Probation Service. © 2014 Society for the Study of Addiction.

Neurocognitive and psychiatric dimensions of hot, but not cool, impulsivity predict HIV sexual risk behaviors among drug users in protracted abstinence.

PubMed

Wilson, Michael J; Vassileva, Jasmin

2016-03-01

Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies hot (i.e. affectively-mediated, reward-based) and cool (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. The present study examined the associations of neurocognitive and psychiatric varieties of hot and cool impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. The study sample was comprised of drug users in protracted (> 1 year) abstinence: heroin mono-dependent (n = 61), amphetamine mono-dependent (n = 44), and polysubstance dependent (n = 73). Hot impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. Cool impulsivity was operationalized via neurocognitive tasks of response inhibition and symptoms of attention deficit/hyperactivity disorder (ADHD). Hot impulsivity was associated with sexual risk behaviors among heroin and amphetamine users in protracted abstinence, whereas cool impulsivity was not associated with sexual risk behaviors among any drug-using group. Neurocognitive hot impulsivity was associated with recent (past 30-day) sexual risk behaviors, whereas psychopathy was associated with sexual risk behaviors during more remote time-periods (past 6 month and lifetime) and mediated the association between heroin dependence and past 6-month sexual risk behaviors. Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on hot neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy. Cool dimensions of impulsivity such as response inhibition and ADHD were not related to sexual risk behaviors among drug users in protracted abstinence.

Neurocognitive and psychiatric dimensions of “hot” impulsivity, but not “cool” impulsivity, predict HIV sexual risk behaviors among drug users in protracted abstinence

PubMed Central

Wilson, Michael J.; Vassileva, Jasmin

2016-01-01

Background Impulsivity is an important risk factor for HIV risky drug and sexual behaviors. Research identifies “hot” (i.e., affectively-mediated, reward-based) and “cool” (motoric, attentional, independent of context) neurocognitive and psychiatric dimensions of impulsivity, though the impact of specific drugs of abuse on these varieties of impulsivity remains an open question. Objectives The present study examined the associations of neurocognitive and psychiatric varieties of “hot” and “cool” impulsivity with measures of lifetime and recent sexual risk behaviors among users of different classes of drugs. Methods The study sample was comprised drug users in protracted (>1yr) abstinence: heroin monodependent (n=61), amphetamine monodependent (n=44), and polysubstance dependent (n= 73). “Hot” impulsivity was operationalized via neurocognitive tasks of reward-based decision-making and symptoms of psychopathy. “Cool” impulsivity was operationalized via neurocognitive tasks of response inhibition and symptoms of ADHD. Results “Hot” impulsivity was associated with sexual risk behaviors among heroin and amphetamine users in protracted abstinence, whereas “cool” impulsivity was not associated with sexual risk behaviors among any drug-using group. Neurocognitive “hot” impulsivity was associated with recent (past 30-day) sexual risk behaviors, whereas psychopathy was associated with sexual risk behaviors during more remote time-periods (past 6 month and lifetime) and mediated the association between heroin dependence and past 6-month sexual risk behaviors. Conclusion Assessments and interventions aimed at reducing sexual risk behaviors among drug users should focus on “hot” neurocognitive and psychiatric dimensions of impulsivity, such as decision-making and psychopathy. “Cool” dimensions of impulsivity such as response inhibition and ADHD were not related to sexual risk behaviors among drug users in protracted abstinence. PMID:26837332

Sleep impairment in ecstasy/polydrug and cannabis-only users.

PubMed

Fisk, John E; Montgomery, Catharine

2009-01-01

The present study investigated aspects of sleep quality in ecstasy and cannabis users. Two-hundred and twenty seven participants (117 ecstasy/polydrug users, 53 cannabis users and 57 drug naive participants) took part. The participants completed measures of daytime sleepiness, and indicators of sleep quality. The results demonstrated that ecstasy/polydrug users viewed themselves as being more evening types and having poorer sleep quality than cannabis users and drug naive participants. They were also more likely to have missed a night's sleep. The reported differences in sleep type may reflect ecstasy-related serotonergic dysfunction resulting in problems with shifting circadian rhythms.

A safer alternative: Cannabis substitution as harm reduction.

PubMed

Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

2015-11-01

Substitution is operationalised as a conscious choice made by users to use one drug instead of, or in conjunction with another based on: perceived safety, level of addiction potential, effectiveness in relieving symptoms, access and level of acceptance. Harm reduction is a set of strategies that aim to minimise problems associated with drug use while recognising that for some users, abstinence may be neither a realistic nor a desirable goal. In this paper, we aim for deeper understandings of older adult cannabis users' beliefs and substitution practices as part of the harm reduction framework. We present selected findings from our qualitative study of Baby Boomer (born 1946-1964) marijuana users in the San Francisco Bay Area. Although the sample consisted of primary cannabis users, many had personal experience with other drugs throughout their lifetimes. Data collection consisted of an audio-recorded, semi-structured in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analysed to discover users' harm reduction beliefs and cannabis substitution practices. Study participants described using cannabis as a safer alternative for alcohol, illicit drugs and pharmaceuticals based on their perceptions of less adverse side effects, low-risk for addiction and greater effectiveness at relieving symptoms, such as chronic pain. Cannabis substitution can be an effective harm reduction method for those who are unable or unwilling to stop using drugs completely. More research is needed on cannabis as a safer alternative. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Profile of Executive and Memory Function Associated with Amphetamine and Opiate Dependence

PubMed Central

Ersche, Karen D; Clark, Luke; London, Mervyn; Robbins, Trevor W; Sahakian, Barbara J

2007-01-01

Cognitive function was assessed in chronic drug users on neurocognitive measures of executive and memory function. Current amphetamine users were contrasted with current opiate users, and these two groups were compared with former users of these substances (abstinent for at least one year). Four groups of participants were recruited: amphetamine-dependent individuals, opiate-dependent individuals, former users of amphetamines, and/or opiates and healthy non-drug taking controls. Participants were administered the Tower of London (TOL) planning task and the 3D-IDED attentional set-shifting task to assess executive function, and Paired Associates Learning and Delayed Pattern Recognition Memory tasks to assess visual memory function. The three groups of substance users showed significant impairments on TOL planning, Pattern Recognition Memory and Paired Associates Learning. Current amphetamine users displayed a greater degree of impairment than current opiate users. Consistent with previous research showing that healthy men are performing better on visuo-spatial tests than women, our male controls remembered significantly more paired associates than their female counterparts. This relationship was reversed in drug users. While performance of female drug users was normal, male drug users showed significant impairment compared to both their female counterparts and male controls. There was no difference in performance between current and former drug users. Neither years of drug abuse nor years of drug abstinence were associated with performance. Chronic drug users display pronounced neuropsychological impairment in the domains of executive and memory function. Impairment persists after several years of drug abstinence and may reflect neuropathology in frontal and temporal cortices. PMID:16160707

The varieties of ecstatic experience: an exploration of the subjective experiences of ecstasy.

PubMed

Sumnall, Harry R; Cole, Jon C; Jerome, Lisa

2006-09-01

Previous investigations of the subjective effects of MDMA (material sold as ecstasy) have conducted interviews and surveys of various groups of ecstasy users within particular sub-populations. This study examined subjective drug effects reported by different sub-populations of ecstasy users and explored whether the function or purpose served by using ecstasy influenced the nature of the drug experience. Drawing on previous measures of alterations in consciousness, psychedelic drugs and cannabis, and informal interviews with ecstasy users and MDMA researchers, a 130-item survey assessing subjective effects of ecstasy/MDMA was developed. Principal components analysis of responses of ecstasy users revealed six components; perceptual alterations, entactogenic effects, prosocial effects, aesthetic effects, negative effects and sexual effects. The derived scale was used to predict ecstasy use behaviours, and functions and experiences of use. A variety of component scores were related to ecstasy use parameters; in particular, heavier users expected fewer negative, perceptual and aesthetic effects from taking the drug. The reasons given for using ecstasy (use function) also influenced reported drug effects. Abstainers expected greater negative, perceptual, aesthetic and sexual effects than users. These data indicate that the subjective ecstasy experience is influenced by a variety of extra-psychopharmacological factors. Drug intervention strategies may be made more effective by targeting particular user groups defined by reasons given for substance use, as it is likely that their experiences of ecstasy effects will differ. Future research into ecstasy may be improved by recognizing user diversity.

Patterns of drug use and the influence of gender on self-reports of memory ability in ecstasy users: a web-based study.

PubMed

Rodgers, J; Buchanan, T; Scholey, A B; Heffernan, T M; Ling, J; Parrott, A C

2003-12-01

Research indicates that the use of recreational drugs, including MDMA ('ecstasy') can result in impairments in cognitive functioning. Recent evidence, based on accounts of 'on drug' effects and cortical binding ratios suggests that women may be more susceptible to the effects of MDMA; however, no research has explored whether there are differences in the long-term behavioural sequelae of the drug between men and women. In addition, little is known about the profile of functioning of the 'typical' user. The present investigation accessed a large sample of recreational drug users, using the Internet, to obtain self-reports of memory functioning with a view to exploring any differences in self-reported ability amongst male and female users, and the level of difficulty reported by the 'typical' ecstasy user. A web site (www.drugresearch.org.uk) was developed and used for data collection. Prospective memory ability was assessed using the Prospective Memory Questionnaire. Self-report of day-to-day memory performance was investigated using the Everyday Memory Questionnaire. The UEL Drug Questionnaire assessed the use of other substances. The number of mistakes made while completing the questionnaires was also taken as an objective measure of performance errors. Findings, based on datasets submitted from 763 respondents, indicate no differences in self-reports of functioning between male and female participants. An overall dissociation between the effects of cannabis and ecstasy on self-reported memory functioning and on the likelihood of making an error during the completion of the questionnaire was found. Typical ecstasy users were found to report significantly more difficulties in long-term prospective memory and to make more completion errors than users of other substances and drug naive controls. Whilst taking into account the fact that participants were recruited via the World Wide Web and that a number of stringent exclusion criteria were applied to the data, a number of conclusions can be drawn. Recreational drug users perceive their memory ability to be impaired compared to non-users. The type of memory difficulties reported varies depending upon the drug of choice. These difficulties are exacerbated in ecstasy users. Individuals reporting average levels of use of ecstasy are more likely to report memory problems than non-ecstasy drug users or drug free individuals. The deleterious effects of ecstasy are therefore not restricted to heavy or chronic users. No gender differences were detected, suggesting that there may be a dissociation between cognitive impairment and cortical binding worthy of further exploration.

Neural mechanisms underlying ecstasy-related attentional bias.

PubMed

Roberts, Gloria M P; Garavan, Hugh

2013-08-30

Conditioned responses to cues associated with drug taking play a pivotal role in a number of theories of drug addiction. This study examined whether attentional biases towards drug-related cues exist in recreational drug users who predominantly used ecstasy (3,4-methylenedioxymethamphetamine). Experiment 1 compared 30 ecstasy users, 25 cannabis users, and 30 controls in an attentional distraction task in which neutral, evocative, and ecstasy-related pictures were presented within a coloured border, requiring participants to respond as quickly as possible to the border colour. Experiment 2 employed functional magnetic resonance imaging (fMRI) and the attentional distraction task and tested 20 ecstasy users and 20 controls. Experiment 1 revealed significant response speed interference by the ecstasy-related pictures in the ecstasy users only. Experiment 2 revealed increased prefrontal and occipital activity in ecstasy users in all conditions. Activations in response to the ecstasy stimuli in these regions showed an apparent antagonism whereby ecstasy users, relative to controls, showed increased occipital but decreased right prefrontal activation. These results are interpreted to reflect increased visual processing of, and decreased prefrontal control over, the irrelevant but salient ecstasy-related stimuli. These results suggest that right inferior frontal cortex may play an important role in controlling drug-related attentional biases and may thus play an important role in mediating control over drug usage. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Estimating the number of HIV-infected injection drug users in Bangkok: a capture--recapture method.

PubMed

Mastro, T D; Kitayaporn, D; Weniger, B G; Vanichseni, S; Laosunthorn, V; Uneklabh, T; Uneklabh, C; Choopanya, K; Limpakarnjanarat, K

1994-07-01

The purpose of the study was to estimate the number of injection drug users infected with the human immunodeficiency virus (HIV) in Bangkok to allow planning for health services for this population. A two-sample capture-recapture method was used. The first capture listed all persons on methadone treatment for opiate addiction from April 17 through May 17, 1991, at 18 facilities in Bangkok. The second capture involved urine testing of persons held at 72 Bangkok police stations from June 3 through September 30, 1991. Persons whose urine tests were positive for opiate metabolites or methadone were included on the second list. The first capture comprised 4064 persons and the recapture 1540 persons. There were 171 persons included on both lists, yielding an estimate of 36,600 opiate users in Bangkok. Existing data indicate that 89% of opiate users in Bangkok inject drugs and that about one third are infected with HIV, yielding an estimate of approximately 12,000 HIV-infected injection drug users in Bangkok in 1991. During the 1990s the number of cases of acquired immunodeficiency syndrome (AIDS) and other HIV-related diseases, including tuberculosis, in the population of HIV-infected injection drug users in Bangkok will increase dramatically, placing new demands on existing health care facilities. The capture-recapture method may be useful in estimating difficult-to-count populations, including injection drug users.

HIV infection among intravenous drug users: epidemiology and risk reduction.

PubMed

Des Jarlais, D C; Friedman, S R

1987-07-01

Research on the epidemiology of HIV infection among IV drug users is still at a relatively early stage. Multilocation studies that would permit better geographic comparisons are greatly needed. Multi-method studies within single geographic areas are also needed to assess possible biases with respect to sample recruitment and data collection procedures. The continuation of the epidemic provides a changing historical context that complicates any comparisons. Despite these problems, there are some consistencies that can be seen across studies. Studies of HIV seroprevalence among IV drug users show wide variation among cities in the United States and Europe. The time that the virus was introduced into the IV drug using group within the city is one factor in explaining these differences; other cross-city factors have yet to be identified. Once HIV has been introduced into the IV drug use group within a particular geographic area, there is the possibility of rapid spread up to seroprevalence levels of 50% or greater. Thus, a currently low seroprevalence rate should not be seen as a stable situation. Frequency of injection and sharing of equipment with multiple other drug users (particularly at shooting galleries) have been frequently associated with HIV exposure. Being female, ethnicity (in the USA) and engaging in prostitution also may be associated with increased risk for HIV exposure, suggesting that prevention programs should include special consideration of sex and ethnic differences. Studies of AIDS risk reduction show that substantial proportions of IV drug users are changing their behavior to avoid exposure to HIV. This risk reduction is probably more advanced in New York, with its high seroprevalence and incidence of cases, but is also occurring in cities with lower seroprevalence and limited numbers of cases. The primary forms of risk reduction are increasing the use of sterile equipment, reducing the number of needle sharing partners, and reducing the frequency of injection. These behavior changes are very similar to the frequently identified behavioral risk factors associated with HIV exposure, suggesting that they should be effective in at least slowing the spread of HIV among IV drug users. No linkage of risk reduction to decreases in seroconversion has yet been shown, however, and greater risk reduction is clearly required. A variety of prevention strategies will probably be needed to reduce the spread of HIV among IV drug users. Prevention of initiation into drug injection is an undeniable long-term goal for the control of HIV infection, but there is very little research being conducted in this area.

76 FR 33307 - Generic Drug User Fee; Notice of Public Meeting; Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

...] Generic Drug User Fee; Notice of Public Meeting; Extension of Comment Period AGENCY: Food and Drug... on the development of a generic drug user fee program. The Agency is taking this action to allow..., 75 FR 47820, FDA published a notice soliciting comment on development of a generic drug user fee...

78 FR 53152 - Prescription Drug User Fee Rates for Fiscal Year 2014; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

...] Prescription Drug User Fee Rates for Fiscal Year 2014; Correction AGENCY: Food and Drug Administration, HHS... ``Prescription Drug User Fee Rates for Fiscal Year 2014'' that appeared in the Federal Register of August 2, 2013 (78 FR 46980). The document announced the Fiscal Year 2014 fee rates for the Prescription Drug User...

Electrophysiological evidence of atypical processing underlying mental set shifting in ecstasy polydrug and polydrug users.

PubMed

Roberts, Carl A; Fairclough, Stephen H; McGlone, Francis P; Fisk, John E; Montgomery, Catharine

2013-12-01

Executive functioning deficits are reported in ecstasy users. However research into mental set switching has been equivocal, with behavioral studies suggesting the function is preserved. The current study sought to address the issue of switching deficits in ecstasy users by combining behavioral performance with electrophysiological correlates (electroencephalography; EEG). Twenty ecstasy polydrug users, 20 nonecstasy polydrug users, and 20 drug naive controls were recruited. Participants completed questionnaires about their drug use, sleep quality, fluid intelligence, and current mood state. Each participant completed a mental set switching task (the number-letter task) while EEG measures were recorded. Analysis of variance (ANOVA) revealed no between-group differences on performance of the task; however a regression suggested that ecstasy use was a significant predictor for performance, after controlling for cannabis use. Mixed ANOVA revealed a significant effect of group on the P3, with significant differences between both drug groups and naives. There was also an interaction between electrode and group on the P2 component, with ecstasy users differing from both other groups. On the P3 component the results suggest a reduction in positivity at parieto-occipital electrodes for drug users compared to controls. Furthermore a significant increase in negativity in ecstasy users compared to control groups could be observed in several occipito-parietal electrodes at an N2 component as well as observable atypicalities in early processing (P2) displayed by ecstasy users and polydrug controls. The present study provides evidence of atypical processing of attentional shifting in ecstasy and polydrug users. Deficits in this executive function could reflect cognitive inflexibility and paucity of rapid behavioral adjustment, which may be problematic in real world situations.

HIV infection in females dependent on drugs.

PubMed

Wai, B H; Singh, S; Varma, S L

1996-03-01

One hundred and seventy-one drug-dependent females in a drug rehabilitation centre were studied to estimate the prevalence of HIV infection among them. Twenty-four (14%) were positive on the Western Blot test. The presence of HIV infection was significantly correlated with syphilis (p < 0.03) and age (p < 0.001); 83% of those who were HIV positive were intravenous drug users. The need for harm reduction programmes to prevent spread of HIV infection among injecting drug users is stressed.

Human rights of drug users according to public health professionals in Brazil.

PubMed

Ventura, Carla A A; Mendes, Isabel A C; Trevizan, Maria A; Rodrigues, Driéli P

2013-03-01

Health is a basic human right, and drug use represents a severe influence on people's health. This qualitative study aimed to understand how health professionals in a public health-care team working with drug users in a city of the state of São Paulo, Brazil, perceive the human rights of these users and how these rights are being respected in health care. Data were collected through semistructured interviews with 10 health professionals at the service under analysis. A thematic analysis of the interviews reveals the professionals' difficulty to define the concept of human right and contextualize these rights in their work environment. A deeper understanding of the right to health, however, represents an important premise for a more humanized care practice in health services to drug users.

Demographic-Based Content Analysis of Web-Based Health-Related Social Media.

PubMed

Sadah, Shouq A; Shahbazi, Moloud; Wiley, Matthew T; Hristidis, Vagelis

2016-06-13

An increasing number of patients from diverse demographic groups share and search for health-related information on Web-based social media. However, little is known about the content of the posted information with respect to the users' demographics. The aims of this study were to analyze the content of Web-based health-related social media based on users' demographics to identify which health topics are discussed in which social media by which demographic groups and to help guide educational and research activities. We analyze 3 different types of health-related social media: (1) general Web-based social networks Twitter and Google+; (2) drug review websites; and (3) health Web forums, with a total of about 6 million users and 20 million posts. We analyzed the content of these posts based on the demographic group of their authors, in terms of sentiment and emotion, top distinctive terms, and top medical concepts. The results of this study are: (1) Pregnancy is the dominant topic for female users in drug review websites and health Web forums, whereas for male users, it is cardiac problems, HIV, and back pain, but this is not the case for Twitter; (2) younger users (0-17 years) mainly talk about attention-deficit hyperactivity disorder (ADHD) and depression-related drugs, users aged 35-44 years discuss about multiple sclerosis (MS) drugs, and middle-aged users (45-64 years) talk about alcohol and smoking; (3) users from the Northeast United States talk about physical disorders, whereas users from the West United States talk about mental disorders and addictive behaviors; (4) Users with higher writing level express less anger in their posts. We studied the popular topics and the sentiment based on users' demographics in Web-based health-related social media. Our results provide valuable information, which can help create targeted and effective educational campaigns and guide experts to reach the right users on Web-based social chatter.

Analysis of chats on French internet forums about drugs and pregnancy.

PubMed

Palosse-Cantaloube, Lucie; Lacroix, Isabelle; Rousseau, Vanessa; Bagheri, Haleh; Montastruc, Jean-Louis; Damase-Michel, Christine

2014-12-01

Some pregnant women use the internet to search for medical information. However, online information is not controlled. The objectives were to describe French online chats about drugs and pregnancy and evaluate the quality and reliability of information shared by internet users. This French descriptive study was performed in November 2012. In order to identify drugs and pregnancy-related forum websites, we used three French key words: forum, pregnancy and drug. We explored the first 10 websites from the search result. Diseases were described using the International Classification of Diseases and drugs classified with the Anatomical Therapeutic Chemical codes and the FDA risk classification. We selected 115 questions that were mainly posted by pregnant internet users in French forums. Drugs raising questions were mostly "nervous system," "anti-infective for systemic use" and "respiratory system" drugs. The risk during pregnancy for nearly half of these drugs had not been evaluated properly. Health professionals were only involved in 7% of the 214 answers. Internet users advised to take a drug in 21% of their answers. Thirty-four percent of those recommended drugs had not been well-evaluated or were potentially at risk during pregnancy. Finally, 12% of the answers could be at risk for pregnant woman. This study shows that information related to drugs and pregnancy in online chats could be at risk for pregnant women. Internet users must be aware that online forums are not reliable sources of information. Copyright © 2014 John Wiley & Sons, Ltd.

Risk of high-grade cervical dysplasia and cervical cancer in women with systemic lupus erythematosus receiving immunosuppressive drugs.

PubMed

Feldman, C H; Liu, J; Feldman, S; Solomon, D H; Kim, S C

2017-06-01

Objective Prior studies suggest an increased risk of cervical cancer among women with systemic lupus erythematosus. However, the relationship with immunosuppressive drugs is not well studied in US nationwide cohorts. We compared the risk of high-grade cervical dysplasia and cervical cancer among women with systemic lupus erythematosus who started immunosuppressive drugs versus hydroxychloroquine. Methods We identified systemic lupus erythematosus patients initiating immunosuppressive drugs or hydroxychloroquine using claims data from two US commercial health plans and Medicaid (2000-2012). We used a validated claims-based algorithm to identify high-grade cervical dysplasia or cervical cancer. To account for potential confounders, including demographic factors, comorbidities, medication use, HPV vaccination status, and health care utilization, immunosuppressive drugs and hydroxychloroquine initiators were 1:1 matched on the propensity score. We used inverse variance-weighted, fixed effect models to pool hazard ratios from the propensity score-matched Medicaid and commercial cohorts. Results We included 2451 matched pairs of immunosuppressive drugs and hydroxychloroquine new users in the commercial cohort and 7690 matched pairs in Medicaid. In the commercial cohort, there were 14 cases of cervical dysplasia or cervical cancer among immunosuppressive drugs users and five cases among hydroxychloroquine users (hazard ratio 2.47, 95% CI 0.89-6.85, hydroxychloroquine = ref). In Medicaid, there were 46 cases among immunosuppressive drugs users and 29 cases in hydroxychloroquine users (hazard ratio 1.24, 95% CI 0.78-1.98, hydroxychloroquine = ref). The pooled hazard ratio of immunosuppressive drugs was 1.40 (95% CI 0.92-2.12). Conclusion Among women with systemic lupus erythematosus, immunosuppressive drugs may be associated with a greater, albeit not statistically significant, risk of high-grade cervical dysplasia and cervical cancer compared to patients receiving hydroxychloroquine alone.

'Surfing the Silk Road': a study of users' experiences.

PubMed

Van Hout, Marie Claire; Bingham, Tim

2013-11-01

The online drug marketplace called 'Silk Road' has operated anonymously on the 'Deep Web' since 2011. It is accessible through computer encrypting software (Tor) and is supported by online transactions using peer to peer anonymous and untraceable crypto-currency (Bit Coins). The study aimed to describe user motives and realities of accessing, navigating and purchasing on the 'Silk Road' marketplace. Systematic online observations, monitoring of discussion threads on the site during four months of fieldwork and analysis of anonymous online interviews (n=20) with a convenience sample of adult 'Silk Road' users was conducted. The majority of participants were male, in professional employment or in tertiary education. Drug trajectories ranged from 18 months to 25 years, with favourite drugs including MDMA, 2C-B, mephedrone, nitrous oxide, ketamine, cannabis and cocaine. Few reported prior experience of online drug sourcing. Reasons for utilizing 'Silk Road' included curiosity, concerns for street drug quality and personal safety, variety of products, anonymous transactioning, and ease of product delivery. Vendor selection appeared to be based on trust, speed of transaction, stealth modes and quality of product. Forums on the site provided user advice, trip reports, product and transaction reviews. Some users reported solitary drug use for psychonautic and introspective purposes. A minority reported customs seizures, and in general a displacement away from traditional drug sourcing (street and closed markets) was described. Several reported intentions to commence vending on the site. The study provides an insight into 'Silk Road' purchasing motives and processes, the interplay between traditional and 'Silk Road' drug markets, the 'Silk Road' online community and its communication networks. Copyright © 2013 Elsevier B.V. All rights reserved.

Hepatitis C: clinical and biological features related to different forms of cocaine use.

PubMed

Schuch-Goi, Silvia Bassani; Scherer, Juliana Nichterwitz; Kessler, Felix Henrique Paim; Sordi, Anne Orgler; Pechansky, Flavio; von Diemen, Lisia

2017-01-01

Hepatitis C virus (HCV) infection is related with several liver diseases such as cirrhosis and hepatocellular carcinomas, leading to more than 0.5 million deaths every year and to a great global burden. It is known that injection drug users show a high prevalence of HCV infection, being considered a risk group for this disease. Cocaine users seem to be in greater risk than other drug users, and several hypotheses for this association are being studied. To review data on HCV infection in cocaine users, taking into consideration the relevance of the different routes of drug administration and other risk behaviors. This was a narrative review performed in the main scientific databases. Data suggest that cocaine use could be associated with HCV infection due to the specificities of cocaine consumption pattern, even in those subjects who do not inject drugs, in addition to other risky behaviors, such as tattooing and unprotected sex. Injectable cocaine users seem to be more susceptible to contamination than users who do not inject drugs. However, evidence is pointing to the possibility of infection by sharing drug paraphernalia other than syringes. Moreover, specific immune system impairments caused by cocaine use are also being linked with HCV infection susceptibility, persistence and increased pathological effects.

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China

PubMed Central

Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

Objective To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). Method A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using “snowball” techniques, and internet advertisements were used to recruit study participants. Results Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Conclusion Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM. PMID:25950912

National record linkage study of mortality for a large cohort of opioid users ascertained by drug treatment or criminal justice sources in England, 2005-2009.

PubMed

Pierce, Matthias; Bird, Sheila M; Hickman, Matthew; Millar, Tim

2015-01-01

Globally, opioid drug use is an important cause of premature mortality. In many countries, opioid using populations are ageing. The current study investigates mortality in a large cohort of opioid users; with a focus on testing whether excess mortality changes with age. 198,247 opioid users in England were identified from drug treatment and criminal justice sources (April, 2005 to March, 2009) and linked to mortality records. Mortality rates and standardised mortality ratios (SMRs) were calculated by age-group and gender. There were 3974 deaths from all causes (SMR 5.7, 95% Confidence Interval: 5.5 to 5.9). Drug-related poisonings (1715) accounted for 43% of deaths. Relative to gender-and-age-appropriate expectation, mortality was elevated for a range of major causes including: infectious, respiratory, circulatory, liver disease, suicide, and homicide. Drug-related poisoning mortality risk continued to increase beyond 45 years and there were age-related increases in SMRs for specific causes of death (infectious, cancer, liver cirrhosis, and homicide). A gender by age-group interaction revealed that whilst men have a greater drug-related poisoning mortality risk than women at younger ages, the difference narrows with increasing age. Opioid users' excess mortality persists into old age and for some causes is exacerbated. This study highlights the importance of managing the complex health needs of older opioid users. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

How many people in Canada use prescription opioids non-medically in general and street drug using populations?

PubMed

Popova, Svetlana; Patra, Jayadeep; Mohapatra, Satya; Fischer, Benedikt; Rehm, Jürgen

2009-01-01

Medical prescriptions for opioids as well as their non-medical use have increased in Canada in recent years. This study aimed to estimate the number of non-medical prescription opioid (PO) users in the general and street drug using populations in Canada. The number of non-medical PO users among the general population and the number of non-medical PO users, heroin users, or both among the street drug using population was estimated for Canada and for the most populous Canadian provinces. Different estimation methods were used: 1) the number of non-medical PO users in the Canadian general population was estimated based on Canadian availability data, and the ratio of US availability to non-medical PO use from US survey data; 2) numbers within the street drug using population were indirectly estimated based on overdose death data, and a key informants survey. Distribution and trends by usage of opioids were determined by using the multi-site Canadian OPICAN cohort data. Between 321,000 to 914,000 non-medical PO users were estimated to exist among the general population in Canada in 2003. The estimated number of non-medical PO users, heroin users, or both among the street drug using population was about 72,000, with more individuals using nonmedical PO than heroin in 2003. Based on data from the OPICAN survey, in 2005 the majority of the street drug using population in main Canadian cities was non-medical PO users, with the exception of Vancouver and Montreal. A relative increase of 24% was observed from 2002 to 2005 in the proportion of the street drug using population who used non-medical POs only. There is an urgent need to further assess the extent and patterns of non-medical prescription opioid use, related problems and drug distribution channels in Canada.

The Commissioning and Provision of Advocacy for Problem Drug Users in English DATS: A Cross-Sectional Survey

ERIC Educational Resources Information Center

Cargill, Tamsin; Weaver, Tim D.; Patterson, Sue

2012-01-01

Aims: This study investigated the commissioning and delivery of advocacy for problem drug users. We aimed to quantify provision, describe the commissioning of advocacy services in Drug Action Teams (DATs) and to identify factors influencing advocacy provision. Methods: A cross-sectional survey of a randomly selected sample of 50 English DATs. The…

Addiction Research Ethics and the Belmont Principles: Do Drug Users Have a Different Moral Voice?

PubMed Central

Fisher, Celia B.

2013-01-01

This study used semi-structured interviews and content analysis to examine moral principles that street drug users apply to three hypothetical addiction research ethical dilemmas. Participants (n = 90) were ethnically diverse, economically disadvantaged drug users recruited in New York City in 2009. Participants applied a wide range of contextually sensitive moral precepts, including respect, beneficence, justice, relationality, professional obligations, rules, and pragmatic self-interest. Limitations and implications for future research and the responsible conduct of addiction research are discussed. PMID:21073412

Young Adult Ecstasy Users’ Enhancement of the Effects of Their Ecstasy Use

PubMed Central

Klein, Hugh; Elifson, Kirk W.; Sterk, Claire E.

2013-01-01

In this paper, we examine drug effect-enhancing behaviors practiced by young adult users of the drug, ecstasy. Between August 2002 and August 2004, 283 face-to-face interviews were conducted with active ecstasy users. Study participants were recruited in the Atlanta, Georgia metropolitan area using a targeted sampling approach. The large majority of study participants (87%) engaged in at least one behavior specifically designed to bolster the effects of their ecstasy use, with 61% of the study participants reporting having engaged in at least three such behaviors during the past 30 days. Taking steps to boost one’s ecstasy-related high was associated with binging on ecstasy and a variety of adverse outcomes, such as experiencing a greater number of negative consequences resulting from ecstasy use and experiencing more ecstasy-related drug dependency symptoms. Multivariate analysis revealed several factors associated with greater involvement in effects-boosting behaviors, including race (not being African American), spending time with other drug users, using ecstasy for its touch-enhancing qualities, enjoyment of the music-and-ecstasy-use experience, and childhood maltreatment experiences. The implications of these findings for treatment, prevention, and intervention of drug problems among ecstasy users are discussed. PMID:19705673

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use - a qualitative study.

PubMed

Bell, Hege Therese; Steinsbekk, Aslak; Granas, Anne Gerd

2017-09-01

The aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use. A qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation. The main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician's choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician. Elderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs.

A comparison of male users and nonusers of marijuana on the perceived harmfulness of drugs.

PubMed

Primavera, L H; Pascal, R

1986-01-01

Subjects (n = 108) who volunteered to participate in a study in which they expected to smoke marijuana were asked, as part of a screening procedure, to rate the harmfulness of a number of illicit drugs including marijuana. Subjects were separated into three groups according to their reported history of use of marijuana. The three groups were: naive users (at least 1 but no more than 25 incidences of use in a lifetime), light users (1 to 3 incidences of use per week), and heavy users (at least 5 incidences of use per week). Groups did not differ in terms of their perceived harmfulness of any of the drugs. Cluster analyses of the results for each group and for the total group indicated three distinct clusters: the drugs perceived to be the most harmful were heroin, morphine, and LSD; drugs perceived to be less harmful were cocaine, amphetamines, barbiturates, and nicotine; and the drugs perceived to be the least harmful were caffeine and marijuana, with marijuana being judged the least harmful of all the drugs.

Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders.

PubMed

Ostovar, Afshin; Haerinejad, Mohammad Javad; Akbarzadeh, Samad; Keshavarz, Mojtaba

2017-10-01

Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported. Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants' information, including demographic characteristics, sports' status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests. Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders. Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders.

Binge use and sex and drug use behaviors among HIV(-), heterosexual methamphetamine users in San Diego.

PubMed

Cheng, W Susan; Garfein, Richard S; Semple, Shirley J; Strathdee, Steffanie A; Zians, James K; Patterson, Thomas L

2010-01-01

This study identified sociodemographic factors, drug using practices, sexual behaviors, and motivational factors associated with binge (a period of uninterrupted) methamphetamine (MA) use among heterosexual MA users. The FASTLANE study provided cross-sectional data collected by audio computer-assisted self-interview (ACASI) between June 2001 and August 2004 from 451 HIV-negative MA users in San Diego, California, USA who had engaged in unprotected sex and used MA in the previous two months. The study sample was 67.8% male, 49.4% Caucasian, 26.8% African-American, and 12.8% Hispanic with a mean age of 36.6 years; 183 (40.5%) reported binge use in the past 2 months. Compared with non-binge users, binge users of MA were more likely to report risky drug use and sex behaviors and differed in motivations to initiate and currently use MA. The final logistic regression model for binge use included more days of MA use in the last month, ever treated for MA use, injection drug use, higher Beck Depression Inventory score, "experimentation" as a motivation for initiating MA use, and engaging in sex marathons while high on MA. HIV prevention efforts should differentiate and address these differences in motivations for MA use and the associated HIV-risk sex and drug use behaviors as key targets for effective intervention.

Transitions in Illicit Drug Use Status over 3 Years: A Prospective Analysis of a General Population Sample

PubMed Central

Compton, Wilson M.; Dawson, Deborah A.; Conway, Kevin P.; Brodsky, Marc; Grant, Bridget F.

2015-01-01

Objective To examine 3-year transitions among nonuse, asymptomatic use and problem use of illicit drugs for US adults in the general household population. Method Data from the nationally representative NESARC study of 34,653 adults interviewed twice, 3 years apart. Three mutually exclusive categories of baseline drug status comprised past year non-users (n=32,675), past-year asymptomatic drug users (n=861), and past-year symptomatic drug users (n=1,117). Symptomatic drug use was defined as presence of one or more symptoms that operationalize DSM-IV drug abuse and dependence criteria. Variables tested for association with 3-year transitions to different status categories included sociodemographic, health, substance use and psychiatric covariates. Results Among baseline nonusers, 95.4% continued to be nonusers at follow-up, 2.1% became asymptomatic users, and 2.5% developed drug problems. Among baseline asymptomatic users, 66.6% had stopped using drugs at follow-up, 14.3% continued to be asymptomatic users and 19.1% had developed drug problems. Nearly half (49.0%) of those with drug problems at baseline had stopped using drugs at follow-up, 10.9% had transitioned to asymptomatic use and 40.1% continued to have drug problems. Younger age, male gender, white race, and not being married were associated with progression from non-use to use or problematic use, as were alcohol and tobacco categories, major depression and schizotypal, borderline and narcissistic personality disorders. Panic disorder and avoidant personality disorder were associated with less progression. Conclusions Transitions in drug use status are common. The finding that alcohol and tobacco-related variables and co-occurring psychopathology are important correlates of transitions suggests the value of addressing all co-occurring disorders and substance use in patient assessments and treatment planning, both for preventing adverse transitions and promoting positive transitions. PMID:23511653

Drugs As Instruments: Describing and Testing a Behavioral Approach to the Study of Neuroenhancement

PubMed Central

Brand, Ralf; Wolff, Wanja; Ziegler, Matthias

2016-01-01

Neuroenhancement (NE) is the non-medical use of psychoactive substances to produce a subjective enhancement in psychological functioning and experience. So far empirical investigations of individuals' motivation for NE however have been hampered by the lack of theoretical foundation. This study aimed to apply drug instrumentalization theory to user motivation for NE. We argue that NE should be defined and analyzed from a behavioral perspective rather than in terms of the characteristics of substances used for NE. In the empirical study we explored user behavior by analyzing relationships between drug options (use over-the-counter products, prescription drugs, illicit drugs) and postulated drug instrumentalization goals (e.g., improved cognitive performance, counteracting fatigue, improved social interaction). Questionnaire data from 1438 university students were subjected to exploratory and confirmatory factor analysis to address the question of whether analysis of drug instrumentalization should be based on the assumption that users are aiming to achieve a certain goal and choose their drug accordingly or whether NE behavior is more strongly rooted in a decision to try or use a certain drug option. We used factor mixture modeling to explore whether users could be separated into qualitatively different groups defined by a shared “goal × drug option” configuration. Our results indicate, first, that individuals' decisions about NE are eventually based on personal attitude to drug options (e.g., willingness to use an over-the-counter product but not to abuse prescription drugs) rather than motivated by desire to achieve a specific goal (e.g., fighting tiredness) for which different drug options might be tried. Second, data analyses suggested two qualitatively different classes of users. Both predominantly used over-the-counter products, but “neuroenhancers” might be characterized by a higher propensity to instrumentalize over-the-counter products for virtually all investigated goals whereas “fatigue-fighters” might be inclined to use over-the-counter products exclusively to fight fatigue. We believe that psychological investigations like these are essential, especially for designing programs to prevent risky behavior. PMID:27582720

Medical Marijuana Users are More Likely to Use Prescription Drugs Medically and Nonmedically.

PubMed

Caputi, Theodore L; Humphreys, Keith

2018-04-17

Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use. Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana. Medical marijuana users were significantly more likely (RR 1.62, 95% confidence interval [CI] 1.50-1.74) to report medical use of prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug (RR 2.12, 95% CI 1.67-2.62), with elevated risks for pain relievers (RR 1.95, 95% CI 1.41-2.62), stimulants (RR 1.86, 95% CI 1.09-3.02), and tranquilizers (RR 2.18, 95% CI 1.45-3.16). Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

Substance use disorders and psychiatric comorbidity in mid and later life: a review

PubMed Central

Wu, Li-Tzy; Blazer, Dan G

2014-01-01

Background Globally, adults aged 65 years or older will increase from 516 million in 2009 to an estimated 1.53 billion in 2050. Due to substance use at earlier ages that may continue into later life, and ageing-related changes in medical conditions, older substance users are at risk for substance-related consequences. Methods MEDLINE and PsychInfo databases were searched using keywords: alcohol use disorder, drug use disorder, drug misuse, substance use disorder, prescription drug abuse, and substance abuse. Using the related-articles link, additional articles were screened for inclusion. This review focused on original studies published between 2005 and 2013 to reflect recent trends in substance use disorders. Studies on psychiatric comorbidity were also reviewed to inform treatment needs for older adults with a substance use disorder. Results Among community non-institutionalized adults aged 50+ years, about 60% used alcohol, 3% used illicit drugs and 1–2% used nonmedical prescription drugs in the past year. Among adults aged 50+, about 5% of men and 1.4% of women had a past-year alcohol use disorder. Among alcohol users, about one in 14 users aged 50–64 had a past-year alcohol use disorder vs one in 30 elder users aged 65+. Among drug users aged 50+, approximately 10–12% had a drug use disorder. Similar to depressive and anxiety disorders, substance use disorders were among the common psychiatric disorders among older adults. Older drug users in methadone maintenance treatment exhibited multiple psychiatric or medical conditions. There have been increases in treatment admissions for illicit and prescription drug problems in the United States. Conclusions Substance use in late life requires surveillance and research, including tracking substance use in the racial/ethnic populations and developing effective care models to address comorbid medical and mental health problems. PMID:24163278

Disassortative mixing patterns of drug-using and sex networks on HIV risk behaviour among young drug users in Yunnan, China.

PubMed

Li, J; Luo, J; Li, J; Liu, H

2015-09-01

The dominant mode of HIV transmission in China has changed from injection drug use to sexual contact. The objectives of this study were to describe the disassortative and assortative mixing patterns of drug-using and sex networks among young drug users in China. Cross-sectional study. Respondent-driven sampling (RDS) was used to recruit young drug users in an egocentric network study in Yunnan, China. Egos were categorized as having disassortative mixing network patterns if they reported both sex and drug-using networks. Egos who only had a sex network (no drug-using network), or only a drug-using network (no sex network) were categorized as having assortative mixing network patterns. Multiple logistic regression was performed to analyze the relationships between disassortative patterns with risky sexual behaviour and drug-using practices. A total of 426 participants were recruited into the study. Two hundred forty-two egos reported disassortative mixing patterns and 139 egos had assortative patterns. The RDS-adjusted proportion of having a disassortative pattern was 53.2%. Participants with disassortative patterns were more likely to engage in HIV risk behaviour compared to those with assortative patterns. Specifically, drug users with disassortative patterns reported more multiple sex partners (31.4% vs 19.6%), concurrent partnerships (52.1% vs 39.0%), non-regular sex partners (12.0% vs 4.3%), and sex partners who were IDUs (24.9% vs 12.5%). Consistent condom use with regular or non-regular partners was low (between 18.9% and 47.2%) regardless of the mixing pattern. However, parenteral risk for HIV transmission was relatively low in both groups. The transition of the HIV epidemic in China from injection drug use to sexual contact may be attributed to disassortative mixing in drug-use and sexual networks. HIV programs should consider disassortative mixing patterns when designing new behavioural interventions. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Typology of club drug use among young adults recruited using time-space sampling

PubMed Central

Ramo, Danielle E.; Grov, Christian; Delucchi, Kevin; Kelly, Brian C.; Parsons, Jeffrey T.

2009-01-01

The present study examined patterns of recent club drug use among 400 young adults (18–29) recruited using time-space sampling in NYC. Subjects had used at least one of six club drugs (MDMA, Ketamine, GHB, Cocaine, Methamphetamine, and LSD) within the prior 3 months. We used latent class analysis (LCA) to estimate latent groups based on patterns of recent club drug use and examined differences in demographic and psychological variables by class. A 3-class model fit the data best. Patterns were: Primary cocaine users (42% of sample), Mainstream users (44% of sample), and Wide-range users (14% of sample). Those most likely to be Primary cocaine users were significantly less likely to be heterosexual males and had higher educational attainment than the other two classes. Those most likely to be Wide-range users were less likely to be heterosexual females, more likely to be gay/bisexual males, dependent on club drugs, had significantly greater drug and sexual sensation-seeking, and were more likely to use when experiencing physical discomfort or pleasant times with others compared to the other two groups. Findings highlight the utility of using person-centered approaches to understand patterns of substance use, as well as highlight several patterns of club drug use among young adults. PMID:19939585

Sexual Dysfunction and Sexual Behaviors in a Sample of Brazilian Male Substance Misusers.

PubMed

Diehl, Alessandra; Pillon, Sandra Cristina; Dos Santos, Manoel Antônio; Rassool, G Hussein; Laranjeira, Ronaldo

2016-09-01

The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual behavior, and severity of dependence were evaluated.The prevalence of sexual dysfunction was 37.2% and premature ejaculation was 63.8%. Men with sexual dysfunction presented from moderate to severe level of alcohol, tobacco, and other drugs of dependence. The findings from this study are particularly relevant identifying those sociodemographic factors, severity of drug use, and sexual behavior are related to men who experience sexual dysfunction. Health promotion and motivational interventions on sexual health targeted to male drug users can contribute in reducing these at-risk behaviors. More interdisciplinary research is desirable in future in considering men's sexual health. © The Author(s) 2015.

76 FR 13629 - Revised Draft Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

...] Revised Draft Guidance for Industry on User Fee Waivers, Reductions, and Refunds for Drug and Biological... entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This revised draft... industry entitled ``User Fee Waivers, Reductions, and Refunds for Drug and Biological Products.'' This...

Beyond 'Doing Gender': Incorporating Race, Class, Place, and Life Transitions into Feminist Drug Research.

PubMed

Miller, Jody; Carbone-Lopez, Kristin

2015-05-01

This essay draws from our research with US rural women methamphetamine users in 2009 to offer strategies for "revisioning" the drug use(r) field to better understand the impact of gender on drug use and drug market participation. We highlight the insights and limitations of a popular strategy in feminist research that conceptualizes gender as performance- commonly referred to as "doing gender"-using illustrations from our research. We encourage scholars to move beyond a primarily normative orientation in studying gender, and investigate gendered organizational features of social life including their intersections with other aspects of social inequality such as those of race, class, and place. In addition, we suggest that feminist scholars can integrate gender in a rigorous way into theoretical perspectives that are typically inattentive to its import, as a means of challenging, enriching, and refining research on drug use, drug users, and drug market participation.

Mental health, stress correlates and psychotropic drug use or non-use among aged caregivers to elders with dementia.

PubMed

Pérodeau, G; Lauzon, S; Lévesque, L; Lachance, L

2001-08-01

The goal of the study was to compare caregivers who used psychotropic drugs with caregivers who were non-users in order to pinpoint differences in coping styles between the two groups. We performed a secondary analysis of a study on the stress and psychological well-being of persons caring for relatives with dementia. We compared elderly caregivers, as either psychotropic drug users (n = 61) or non-users (n = 133), over various psychosocial characteristics relating to the care-giving context. Results reveal that users, as compared to non-users were: (a) more disturbed (appraised a greater stress) by the relative's dysfunctional behaviours, after controlling for the frequency of the behaviours; and (b) experienced more conflict during interpersonal interactions, although their appraisal of self-satisfaction with formal and informal support to their care-giving activities did not differ significantly. Strikingly, users combined and called on a greater number of problem-focused and emotion-reducing coping strategies than did non-users. They more frequently used affective regulation and information seeking coping styles. Stress-related measures (especially stress appraisal and conflict) contributed more to the variation in mental distress of users than of non-users. Results provide a theoretical and empirical rationale for therapeutic interventions such as the cognitive behavioural approach.

Prevalence of skin problems and leg ulceration in a sample of young injecting drug users.

PubMed

Coull, Alison F; Atherton, Iain; Taylor, Avril; Watterson, Andrew E

2014-08-13

Drug users suffer harm from the injecting process, and clinical services are reporting increasing numbers presenting with skin-related problems such as abscesses and leg ulcers. Skin breakdown can lead to long-term health problems and increased service costs and is often the first indication of serious systemic ill health. The extent of skin problems in injecting drug users has not previously been quantified empirically, and there is a dearth of robust topical literature. Where skin problems have been reported, this is often without clear definition and generic terms such as 'soft tissue infection' are used which lack specificity. The aim of this study was to identify the range and extent of skin problems including leg ulceration in a sample of injecting drug users. Definitions of skin problems were developed and applied to descriptions from drug users to improve rigour. Data were collected in needle exchanges and methadone clinics across Glasgow, Scotland, from both current and former drug injectors using face-to-face interviews. Two hundred participants were recruited, of which 74% (n = 148) were males and 26% (n = 52) were females. The age range was 21-44 years (mean 35 years). Just under two thirds (64%, n = 127) were currently injecting or had injected within the last 6 months, and 36% (n = 73) had previously injected and had not injected for more than 6 months.Sixty per cent (n = 120) of the sample had experienced a skin problem, and the majority reported more than one problem. Most common were abscesses, lumps, track marks and leg ulcers. Fifteen per cent (n = 30) of all participants reported having had a leg ulcer. This is an original empirical study which demonstrated unique findings of a high prevalence of skin disease (60%) and surprisingly high rates of leg ulceration (15%). Skin disease in injecting drug users is clearly widespread. Leg ulceration in particular is a chronic recurring condition that is costly to treat and has long-term implications for drug users and services caring for current or former injectors long after illicit drug use has ceased.

Cohort study of HIV infection among drug users in Ruili, Longchuan and Luxi of Yunnan Province, China.

PubMed

Zheng, X W; Zhang, J P; Tian, C Q; Cheng, H H; Yang, X Z; Duan, S; Li, D Q

1993-12-01

In March 1992, KAP investigation and HIV blood test were carried out for 860 drug users and 82 spouses in Ruili, Luxi, Longchuan of Yunnan Province, China. The results showed that there were 285 injecting drug users (IDUs) (33.1%) among 860 drug users. Among 282 blood samples of IDUs, the HIV infection rate was 49.0%, highest in Ruili (81.8%, 63/77), then Longchuan (44.6%, 74/166), lowest in Luxi county (5.1%, 2/39). Twelve new HIV(+) were found from 75 persons, who had been tested as HIV(-) in recent two years. Sixty-two blood samples were collected among 82 spouses of IDUs with HIV(+), and 6 were HIV(+) (9.8%), with an increase of 6.7% compared with results of the investigation two years ago (3.1%, 2/64).

The high prevalence of substance use disorders among recent MDMA users compared with other drug users: implications for intervention

PubMed Central

Wu, Li-Tzy; Parrott, Andy C.; Ringwalt, Christopher L.; Patkar, Ashwin A.; Mannelli, Paolo; Blazer, Dan G.

2009-01-01

Aim In light of the resurgence in MDMA use and its association with polysubstance use, we investigated the 12-month prevalence of substance use disorders (SUDs) among adult MDMA users to determine whether they are at risk of other drug-related problems that would call for targeted interventions. Methods Data were drawn from the 2006 National Survey on Drug Use and Health. Past-year adult drug users were grouped into three mutually exclusive categories: 1) recent MDMA users, who had used the drug within the past year; 2) former MDMA users, who had a history of using this drug but had not done so within the past year; and 3) other drug users, who had never used MDMA. Logistic regression procedures were used to estimate the association between respondents’ SUDs and MDMA use while adjusting for their socioeconomic status, mental health, age of first use, and history of polydrug use. Results Approximately 14% of adults reported drug use in the past year, and 24% of those past-year drug users reported a history of MDMA use. Recent MDMA users exhibited the highest prevalence of disorders related to alcohol (41%), marijuana (30%), cocaine (10%), pain reliever/opioid (8%), and tranquilizer (3%) use. Adjusted logistic regression analyses revealed that, relative to other drug users, those who had recently used MDMA were twice as likely to meet criteria for marijuana and pain reliever/opioid use disorders. They were also about twice as likely as former MDMA users to meet criteria for marijuana, cocaine, and tranquilizer use disorders. Conclusions Seven out of ten recent MDMA users report experiencing an SUD in the past year. Adults who have recently used MDMA should be screened for possible SUDs to ensure early detection and treatment. PMID:19361931

Acute Pancreatitis and Use of Pancreatitis-Associated Drugs: A 10-Year Population-Based Cohort Study.

PubMed

Bertilsson, Sara; Kalaitzakis, Evangelos

2015-10-01

To assess the use of acute pancreatitis (AP)-associated drugs in patients with AP, the relation between sales of these drugs and the incidence of AP, and the potential impact on AP severity and recurrence. All patients with incident AP between 2003 and 2012, in a well-defined area, were retrospectively identified. Data regarding AP etiology, severity, and recurrence and use of AP-associated drugs were extracted from medical records. Drugs were classified according to an evidence-based classification system. Annual drug sales data were obtained from the Swedish drug administration service. Overall, 1457 cases of incident AP were identified. Acute pancreatitis-associated drug users increased from 32% in 2003 to 51% in 2012, reflecting increasing user rates in the general population. The incidence of AP increased during the study period but was not related to AP-associated drug user rates (P > 0.05). Recurrent AP occurred in 23% but was unrelated to AP-associated drug use (P > 0.05). In logistic regression analysis, after adjustment for comorbidity, AP-associated drug use was not related to AP severity (P > 0.05). Use of AP-associated drugs is increasingly frequent in patients with AP. However, it does not have any major impact on the observed epidemiological changes in occurrence, severity, or recurrence of AP.

Prevalence of statin-drug interactions in older people: a systematic review.

PubMed

Thai, Michele; Reeve, Emily; Hilmer, Sarah N; Qi, Katie; Pearson, Sallie-Anne; Gnjidic, Danijela

2016-05-01

Statins are among the most frequently prescribed medications internationally. Older people are commonly prescribed multiple medications and are at an increased risk of drug-drug interactions, including statin-drug interactions. The aim of this study was to conduct a systematic review of current evidence on the prevalence of statin-drug interactions in older people. A systematic search of observational studies in Embase, Medline, and PubMed was conducted. Articles were included if they were published in English during the period July 2000-July 2014 and reported on the prevalence of statin-drug interactions in people over 65 years of age. Two reviewers independently assessed the articles for eligibility and extracted the data. The search returned 1556 eligible articles. A total of 19 articles met the inclusion criteria. In studies (n = 7) that focused on statin users only, the prevalence of potential statin-drug interactions assessed using different measures ranged from 0.19 to 33.0 %. In studies that examined drug interactions across a population of both statin users and non-users (n = 12), the prevalence of potential statin-drug interactions ranged from 0.1 to 7.1 % (n = 8), and the prevalence of clinically relevant statin-drug interactions ranged from 1.5 to 4 % (n = 4). Current published evidence suggests substantial variations in the prevalence of statin-drug interactions and their clinical relevance. Further studies are necessary to provide a better understanding of the prevalence of clinically significant statin-drug interactions, the medications most frequently contributing to statin-drug interactions, and impact on relevant clinical outcomes in older people.

Motivations for Sexual Risk Behavior across Commercial and Casual Partners among Male Urban Drug Users: Contextual Features and Clinical Correlates

ERIC Educational Resources Information Center

Bornovalova, Marina A.; Daughters, Stacey B.; Lejuez, Carl W.

2010-01-01

The current study aimed to develop a measure for assessing the various motivations for sexual risk behavior (SRB) across commercial (involving the exchange of sex for money or drugs) and casual (nonregular) partners in a sample of inner-city, primarily African American drug users, and to examine the relationship of these motivations with a history…

Economic constraint and modes of consumption of addictive goods.

PubMed

Ben Lakhdar, Christian; Bastianic, Tanja

2011-09-01

To see how economic recession, or, more generally, how increased economic constraint amongst drug users may impact their behaviour regarding the mode of drug consumption. The theoretical framework is the theory of rational addiction - drug users are considered to be rational and well-informed about the way they use drugs and the consequences of using them. Surveys in the specialist literature dealing with the potential changes in the economic context of drugs users, and with the mechanisms of the bioavailability of psychoactive substances are examined in order to highlight one of the strategies drug users can implement to circumvent economic problems - namely a change in the mode of administration. An examination of ethnographic studies and French data are also used to test our assumptions. Changes in the mode of drug consumption can be the result of a maximization behaviour. Injection is the most effective way to reach a maximum bioavailability of substances. There is evidence in favour of the hypothesis that in times of economic recession, when the economic resources of drug users can decrease, they may prefer injection to other modes of administration in order to maximize the effect of what they have purchased. In times of economic recession, harm reduction policy has to be reinforced as injection behaviour can increase. As a result, economic and social policies should be an integral consideration for health policy issues. Copyright © 2011 Elsevier B.V. All rights reserved.

MDMA, methamphetamine and their combination: possible lessons for party drug users from recent preclinical research.

PubMed

Clemens, Kelly J; McGregor, Iain S; Hunt, Glenn E; Cornish, Jennifer L

2007-01-01

The substituted amphetamines 3,4-methylenedioxymethamphetamine (MDMA, 'Ecstasy') and methamphetamine (METH, 'ice', 'speed') are increasingly popular drugs amongst party-drug users. Studies with humans have investigated the acute and possible long-term adverse effects of these drugs, yet outcomes of such studies are often ambiguous due to a variety of confounding factors. Studies employing animal models have value in determining the acute and long-term effects of MDMA and METH on brain and behaviour. Self-administration studies show that intravenous METH is a particularly potent reinforcer in rats and other species. In contrast, MDMA appears to have powerful effects in enhancing social behaviour in laboratory animals. Brief exposure to MDMA or METH may produce long-term reductions in dopamine, serotonin and noradrenaline in the brain and alterations in the density of various receptor and transporter proteins. However it is still unclear, particularly in the case of MDMA, whether this reflects a 'neurotoxic' effect of the drug. Lasting alterations in social behaviour, anxiety, depressive symptoms and memory have been demonstrated in laboratory rats given MDMA or METH and this matches long-term changes reported in some human studies. Recent laboratory studies suggest that MDMA/METH combinations may produce greater adverse neurochemical and behavioural effects than either drug alone. This is of some concern given recent evidence that party drug users may be frequently exposed to this combination of drugs.

Socio-demographic and sexual practices associated with HIV infection in Kenyan injection and non-injection drug users.

PubMed

Budambula, Valentine; Matoka, Charles; Ouma, James; Ahmed, Aabid A; Otieno, Michael F; Were, Tom

2018-01-30

Substance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection. Although socio-demographic factors influence substance consumption and risk of HIV infection, the association of these factors with HIV infection is poorly understood among substance users on the African continent. The objective of the study was to assess socio-demographic and sexual practices that are associated with HIV infection among injection drug users (IDUs), non-IDUs, and non-drug users (DUs) at an urban setting of coastal Kenya. A cross-sectional descriptive study was conducted among 451 adults comprising HIV-infected and -uninfected IDUs (n = 157 and 39); non-IDUs (n = 17 and 48); and non-DUs (n = 55 and 135); respectively at coastal, Kenya. Respondent driven sampling, snowball and makeshift methods were used to enroll IDUs and non-IDUs. Convenience and purposive sampling were used to enroll non-DUs from the hospital's voluntary HIV testing unit. Participant assisted questionnaire was used in collecting socio-demographic data and sexual practices. Binary logistic regression analysis indicated that higher likelihood of HIV infection was associated with sex for police protection (OR, 9.526; 95% CI, 1.156-78.528; P = 0.036) and history of sexually transmitted infection (OR, 5.117; 95% CI, 1.924-13.485; P = 0.001) in IDUs; divorced, separated or widowed marital status (OR, 6.315; 95% CI, 1.334-29.898; P = 0.020) in non-IDUs; and unemployment (OR, 2.724; 95% CI, 1.049-7.070; P = 0.040) in non-drug users. However, never married (single) marital status (OR, 0.140; 95% CI, 0.030-0.649; P = 0.012) was associated with lower odds for HIV infection in non-drug users. Altogether, these results suggest that socio-demographic and sexual risk factors for HIV transmission differ with drug use status, suggesting targeted preventive measures for drug users.

Effectiveness of HIV prevention social marketing with injecting drug users.

PubMed

Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

2010-10-01

Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide.

DYNAMICS OF OPIOID SUBSTITUTION TREATMENTIN DIFFERENT INITIAL SUBSTANCE USER OPIOID DEPENDENT PATIENTS.

PubMed

Todadze, Kh; Mosia, S

2016-05-01

Injecting drug user size estimation studies carried out in 2009, 2012 and 2015 revealed growing trends of drug abuse in Georgia:estimated number of people who inject drugs (PWID) have been increased from 40000 and 45000 to 50000. Since Soviet period the most popular injective narcotics have been opioids: home-made opium, heroine, buprenorphine and home-made desomorphine ("Krokodile") replacing each other on the black market. Self-made desomorphine typically contains big amounts of different toxic substances and causes significant somatic disorders, especially skin, bone, blood infections, liver and kidney failure; is highly addictive, associates with frequent injections that enhance injecting-related harm, including the risk of HIV transmission, in comparison with typical opioids. The aim of the study was to determine the effectiveness of opioid substitution treatment (OST) on depression and anxiety in opioid dependent clients with history of different opioid substance use. 104 opioid drug users undergoing OST with intensive psychological counseling have been divided in 5 groups according to the principal opioid drug that was abused during past 6 months before starting treatment: heroine, desomorphine, illicit methadone injectors, illicit buprenorphine injectors, and multiple drug abusers consuming opioids as primary drugs. Level of depression (Beck Depression Inventory), anxiety (Spielberger Anxiety Inventory) as well as clinical symptoms, risky behavior, quality of life (WHO), and other data were measured before starting and after 3, 9, 15, 21 months of treatment. The illegal use of psychotropic-narcotics was checked through random urine-testing 1-2 times per patient per month. In all five groups remarkable decrease of depression and anxiety was observed in comparison with the starting data. Before inclusion desomorphine and poly-drug users had the highest scores of depression and anxiety while buprenorphine users manifested the lowest rate. Improvement of figures was observed in all groups in three month period that have been continuing during 21 month of treatment process. Study revealed normalization of scores forbothstatesin groups of heroine, desomorphine, methadone and buprenorphine users. The highest scores of depression and anxiety were observed in the group of poly-drug abusers andwhile depression rate hesitated in the range of clear "no-depression", anxiety index still remained close to the clinical important threshold after 21 month of treatment. Urine-testingon psychotropic-narcotic substances indicated remarkable decrease of illegal drug abuse in all studied groups in three month and although abuse of benzodiazepine drugs was highest in desomorphine and poly-drug abusers, the difference between groups was not statistically significant. Although some disparities have been observed in dynamics of subjects with different spectrum of initial opioid substance use, including homemade desomorphine, there is no significant difference between groups and OST effectively supports to improve depression and anxiety indices, and dramatically decreases use of illegal psychotropic-narcotic drugs during treatment. However poly-drug users seems to be the most resistant to achieve stabilization and require more treatment time and targeted interventions.

General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil.

PubMed

Ventura, Carla Aparecida Arena; Carrara, Bruna Sordi; Bobbili, Sireesha; Vedana, Kelly Graziani Giacchero; Khenti, Akwatu; Hayashida, Miyeko; Ferreira, Paulo Sergio

2017-09-01

People who use drugs are continuously subjected to harsh stigmatization through a process of relational and social degradation, which limits their possibility for recovery. This quantitative study explores the perspectives of family members or significant others of illicit drug users, regarding general beliefs about illicit drug use and their stigma. Respondents agree that most people do not trust people who use drugs, disregard individuals who have been hospitalized due to drug problems and do not think people who use drugs are as intelligent as the general population. These findings reveal a high level of public stigma regarding illicit drug use.

Psychological and Personality Undercurrents of a Drug User. Student Drug Use and the Hang-Loose Ethic. Students and Drug Use: A Study of Personality Characteristics and Extent of Drug Using Behavior. A Report on Drug Abuse in the City of Edmonton to the Mayor's Executive Committee on Drug Abuse.

ERIC Educational Resources Information Center

Paterson, John G.; And Others

These 4 papers were presented at the Canadian Guidance and Counselling Convention, 1971. (1) Hughes used a questionnaire to show that marihuana users were more likely to subscribe to the "hang-loose ethic," i.e., a personal and social ethic antagonistic to the ideas of the Protestant ethic, as manifested in their behaviors; self-concepts;…

What Affects Reintegration of Female Drug Users after Prison Release? Results of a European Follow-Up Study

ERIC Educational Resources Information Center

Zurhold, Heike; Moskalewicz, Jacek; Sanclemente, Cristina; Schmied, Gabriele; Shewan, David; Verthein, Uwe

2011-01-01

The main objective of this follow-up study is to explore factors influencing the success or failure of women in reintegrating after their release from prison. Female drug users in five European cities were tracked after being released from prison. Out of 234 female prisoners contacted in prisons, 59 were included in the follow-up study. Structured…

Socio-Cultural Factors Associated with the Initiation of Opium Use in Darab, Iran

ERIC Educational Resources Information Center

Jafari, Siavash; Movaghar, Afarin Rahimi; Craib, Kevin; Baharlou, Souzan; Mathias, Richard

2009-01-01

This study aimed to identify socio-cultural factors facilitating initiation of opium use among drug users in Darab, Iran. A qualitative study using in-depth interviews was conducted. The study began in June 2006 and included 76 drug users, aged 20-43, of whom 95% (72) were male, and 5% (4) were female. The five most common factors facilitating…

Differences in prevalence, socio-behavioral correlates, and psychosocial distress between club drug and hard drug use in Taiwan: Results from the 2014 National Survey of Substance Use.

PubMed

Chen, Wei J; Wu, Shang-Chi; Tsay, Wen-Ing; Chen, Yen-Tyng; Hsiao, Po-Chang; Yu, Ya-Hui; Ting, Te-Tien; Chen, Chuan-Yu; Tu, Yu-Kang; Huang, Jiun-Hau; Yang, Hao-Jan; Li, Chung-Yi; Strong, Carol; Yen, Cheng-Fang; Yen, Chia-Feng; Hsu, Jui

2017-10-01

This study examined variation between users of 'club' and 'hard' drugs in Taiwan in terms of prevalence of use and demographics and psychosocial characteristics. Data were derived from a survey of 17,837 Taiwanese civilians, aged 12-64 years, using stratified, multi-stage, random sampling. Participants completed a computer-assisted self-interview on tablet computers which covered use of legal substances, sedatives/hypnotics and prescription analgesics; use of illicit drugs/inhalants, risky sexual experiences; expectations of drugs; and psychological distress. Approximately 1.29% of respondents reported ever using an illicit drug in their lifetime; prevalence estimates of club drugs (mainly ketamine, marijuana, and ecstasy) were slightly higher than hard drugs (mainly methamphetamine and heroin). Concurrent use of legal substances, particularly problematic use of alcohol and tobacco, as well as non-medical use of prescription drugs, were strong correlates of illicit drug use in general, with club drug use exhibiting an extremely strong association with alcohol use. Club drug users were demographically different from hard drug users, including in terms of their gender, age, and level of educational attainment. They were also more likely to be divorced or widowed, to report risky sexual partnerships and more depressive symptoms than hard drug users. Our findings indicate drug type specific distinct psychosocial characteristics, which may warrant further attention in the design of treatment and intervention programs. Copyright © 2017 Elsevier B.V. All rights reserved.

Demographic-Based Content Analysis of Web-Based Health-Related Social Media

PubMed Central

Shahbazi, Moloud; Wiley, Matthew T; Hristidis, Vagelis

2016-01-01

Background An increasing number of patients from diverse demographic groups share and search for health-related information on Web-based social media. However, little is known about the content of the posted information with respect to the users’ demographics. Objective The aims of this study were to analyze the content of Web-based health-related social media based on users’ demographics to identify which health topics are discussed in which social media by which demographic groups and to help guide educational and research activities. Methods We analyze 3 different types of health-related social media: (1) general Web-based social networks Twitter and Google+; (2) drug review websites; and (3) health Web forums, with a total of about 6 million users and 20 million posts. We analyzed the content of these posts based on the demographic group of their authors, in terms of sentiment and emotion, top distinctive terms, and top medical concepts. Results The results of this study are: (1) Pregnancy is the dominant topic for female users in drug review websites and health Web forums, whereas for male users, it is cardiac problems, HIV, and back pain, but this is not the case for Twitter; (2) younger users (0-17 years) mainly talk about attention-deficit hyperactivity disorder (ADHD) and depression-related drugs, users aged 35-44 years discuss about multiple sclerosis (MS) drugs, and middle-aged users (45-64 years) talk about alcohol and smoking; (3) users from the Northeast United States talk about physical disorders, whereas users from the West United States talk about mental disorders and addictive behaviors; (4) Users with higher writing level express less anger in their posts. Conclusion We studied the popular topics and the sentiment based on users' demographics in Web-based health-related social media. Our results provide valuable information, which can help create targeted and effective educational campaigns and guide experts to reach the right users on Web-based social chatter. PMID:27296242

Residual Neurocognitive Features of Long-Term Ecstasy Users With Minimal Exposure to Other Drugs

PubMed Central

Halpern, John H.; Sherwood, Andrea R.; Hudson, James I.; Gruber, Staci; Kozin, David; Pope, Harrison G.

2010-01-01

Aims In field studies assessing cognitive function in illicit ecstasy users, there are several frequent confounding factors that might plausibly bias the findings toward an overestimate of ecstasy-induced neurocognitive toxicity. We designed an investigation seeking to minimize these possible sources of bias. Design We compared illicit ecstasy users and non-users while 1) excluding individuals with significant lifetime exposure to other illicit drugs or alcohol; 2) requiring that all participants be members of the “rave” subculture; and 3) testing all participants with breath, urine, and hair samples at the time of evaluation to exclude possible surreptitious substance use. We compared groups with adjustment for age, gender, race/ethnicity, family-of-origin variables, and childhood history of conduct disorder and attention deficit hyperactivity disorder. We provide significance levels without correction for multiple comparisons. Setting Field study. Participants Fifty-two illicit ecstasy users and 59 non-users, age 18-45. Measurements Battery of 15 neuropsychological tests tapping a range of cognitive functions. Findings We found little evidence of decreased cognitive performance in ecstasy users, save for poorer strategic-self-regulation, possibly reflecting increased impulsivity. However this finding might have reflected a premorbid attribute of ecstasy users, rather than a residual neurotoxic effect of the drug. Conclusions In a study designed to minimize limitations found in many prior investigations, we failed to demonstrate marked residual cognitive effects in ecstasy users. This finding contrasts with many previous findings—including our own—and emphasizes the need for continued caution in interpreting field studies of cognitive function in illicit ecstasy users. PMID:21205042

Cross sectional study of factors associated to self-reported blood-borne infections among drug users.

PubMed

Reyes-Urueña, Juliana; Brugal, M Teresa; Majo, Xavier; Domingo-Salvany, Antonia; Caylà, Joan A

2015-11-13

The study's aim was to estimate the self-reported prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV), and to describe their associated risk factors in a population of users of illicit drugs recruited in Catalonia- Spain, during 2012. Cross-sectional study. People with illicit drugs use were selected in three different types of healthcare centres. The questionnaire was a piloted, structured ad hoc instrument. An analysis was made to identify factors associated to self-reported HCV, HIV and co-infection. Correlates of reported infections were determined using univariate and multivariate Poisson regression (with robust variance). Among 512 participants, 39.65% self-reported positive serostatus for HCV and 14.84% for HIV, co-infection was reported by 13.48%. Among the 224 injecting drug users (IDUs), 187 (83.48%), 68 (30.36%) and 66 (29.46%) reported being positive for HCV, HIV and co-infection, respectively. A higher proportion of HIV-infected cases was observed among women, (18.33% vs. 13.78% in men). Prevalence of HCV, HIV and co-infection were higher among participants with early onset of drug consumption, long periods of drug injection or who were unemployed. A positive serostatus was self-reported by 21(7.34%) participants who did not report any injection; among them 16 and eight, reported being positive for HCV and HIV, respectively; three reported co-infection. Only two people declared exchanging sex for money. For those that reported a negative test, the median time since the last HIV test was 11.41 months (inter-quartile range (IQR) 4-12) and for the HCV test was 4.5 months (IQR 2-7). Among drug users in Catalonia, HIV, HCV and co-infection prevalence are still a big issue especially among IDUs. Women and drug users who have never injected drugs are groups with a significant risk of infection; this might be related to their high-risk behaviours and to being unaware of their serological status.

Active Brazilian crack cocaine users: nutritional, anthropometric, and drug use profiles.

PubMed

Escobar, Mariana; Scherer, Juliana N; Soares, Cassia M; Guimarães, Luciano S P; Hagen, Martine E; von Diemen, Lisia; Pechansky, Flavio

2018-02-15

To evaluate the nutritional status of crack users and to analyze its correlation with drug use profiles. Cross-sectional study with 108 crack users. Anthropometric data were assessed through body mass index (BMI) and bioimpedance (BIA) measurements. A blood test to analyze hematocrit, hemoglobin, glucose, and lipid profiles was also performed. Crack use was determined through a standardized interview. Based on BMI and BIA, most individuals were eutrophic (about 70%). Regarding hematological parameters, we found that hemoglobin and hematocrit levels were below normal for 32.4 and 30.6% of patients, respectively. Considering normal parameters, a large part of the sample (60.2%) had low levels of HDL cholesterol and high levels of triglycerides (38%). There were no significant correlations between drug profile and nutritional variables. This is a pioneering study that examines the nutritional status of crack users. Our results showed that most crack users present normal anthropometric findings and the prevalence of underweight is low. However, blood analysis showed changes and a specific type of malnutrition.

Knowledge of AIDS and HIV transmission among drug users in Rio de Janeiro, Brazil

PubMed Central

2011-01-01

Background Proper knowledge of HIV transmission is not enough for people to adopt protective behaviors, but deficits in this information may increase HIV/AIDS vulnerability. Objective To assess drug users' knowledge of HIV/AIDS and the possible association between knowledge and HIV testing. Methods A Cross-sectional study conducted in 2006/7 with a convenience sample of 295 illicit drug users in Rio de Janeiro, assessing knowledge on AIDS/HIV transmission and its relationship with HIV testing. Information from 108 randomly selected drug users who received an educational intervention using cards illustrating situations potentially associated with HIV transmission were assessed using Multidimensional Scaling (MDS). Results Almost 40% of drug users reported having never used condoms and more than 60% reported not using condoms under the influence of substances. Most drug users (80.6%) correctly answered that condoms make sex safer, but incorrect beliefs are still common (e.g. nearly 44% believed HIV can be transmitted through saliva and 55% reported that HIV infection can be transmitted by sharing toothbrushes), with significant differences between drug users who had and who had not been tested for HIV. MDS showed queries on vaginal/anal sex and sharing syringes/needles were classified in the same set as effective modes of HIV transmission. The event that was further away from this core of properly perceived risks referred to blood donation, perceived as risky. Other items were found to be dispersed, suggesting inchoate beliefs on transmission modes. Conclusions Drug users have an increased HIV infection vulnerability compared to the general population, this specific population expressed relevant doubts about HIV transmission, as well as high levels of risky behavior. Moreover, the findings suggest that possessing inaccurate HIV/AIDS knowledge may be a barrier to timely HIV testing. Interventions should be tailored to such specific characteristics. PMID:21324119

Attachment styles in maltreated children: a comparative study.

PubMed

Finzi, R; Cohen, O; Sapir, Y; Weizman, A

2000-01-01

The study compares the emotional impact of maltreatment on the attachment styles in three groups of children aged 6-12 years: children of drug-user fathers (n = 76), physically abused children (n = 41), neglected children (n = 38); non-abused/non-neglected children (n = 35)--control group. The secure style characterized 52% of the children of drug-user fathers and the insecure style characterized the other 48% (anxious/ambivalent or avoidant); physically abused children were characterized mainly by the avoidant attachment style, and neglected children by the anxious/ambivalent style. The conclusion is that physically abused children are at risk of antisocial behavior and sustained suspicion towards others; neglected children are at risk of social withdrawal, social rejection and feelings of incompetence, and children of drug-user fathers may be at risk of behavioral problems and drug use in adolescence.

Motivations for Non-Medical Prescription Drug Use: A Mixed Methods Analysis

PubMed Central

Rigg, Khary K.; Ibañez, Gladys E.

2010-01-01

Despite a dramatic increase in the non-medical use of prescription drugs among illicit drug users, their motives for abusing prescription drugs are still largely unknown. The objective of this study was to 1) determine the motivations for engaging in the non-medical use of prescription opioids and sedatives among street-based illicit drug users, methadone maintenance patients, and residential drug treatment clients, 2) examine associations between prescription drug abuse motivations and gender, age, race/ethnicity, and user group, and 3) examine associations between specific motivations and prescription drug abuse patterns. Quantitative surveys (n = 684) and in-depth interviews (n = 45) were conducted with a diverse sample of prescription drug abusers in South Florida between March 2008 and November 2009. The three most common motivations reported were “to get high”, “to sleep”, and “for anxiety/stress”. There were age, race/ethnicity, and gender differences by motives. Prescription drug abuse patterns were also found to be associated with specific motivations. While additional research is needed, these findings serve to inform appropriate prevention and treatment initiatives for prescription drug abusers. PMID:20667680

Health Outcomes in Patients Using No-Prescription Online Pharmacies to Purchase Prescription Drugs

PubMed Central

2012-01-01

Background Many prescription drugs are freely available for purchase on the Internet without a legitimate prescription from a physician. Objective This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to purchase prescription drugs rather than using the traditional doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those who obtain the same drug through legitimate health care channels. Methods We selected tramadol as a representative drug to address our objective because it is widely prescribed as an unscheduled opioid analgesic and can easily be purchased from NPOPs. Using search engine marketing (SEM), we placed advertisements on search result pages stemming from the keyword “tramadol” and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to obtain tramadol (traditional users, n=349) or purchased it on the Web without a prescription from their local doctor (ie, nontraditional users, n=96), were then asked to complete an online survey. Results Respondents in both groups were primarily white, female, and in their mid-forties (nontraditional users) to upper forties (traditional users). Nearly all nontraditional users indicated that their tramadol use was motivated by a need to treat pain (95%, 91/96) that they perceived was not managed appropriately through legitimate health care channels. A majority of nontraditional users (55%, 41/75) indicated they used NPOPs because they did not have access to sufficient doses of tramadol to relieve pain. In addition, 29% (22/75) of nontraditional users indicated that the NPOPs were a far cheaper alternative than seeing a physician, paying for an office visit, and filling a prescription at a local pharmacy, which is often at noninsured rates for those who lack medical insurance (37%, 35/96, of NPOP users). The remainder of participants (16%, 12/96) cited other motivations (eg, anonymity) for using NPOPs. In terms of health outcomes, nontraditional users experienced a significantly (P<.01) greater number and severity of adverse events, including life-threatening seizures: 7% (7/96) of nontraditional users reported seizures, while none of the traditional users reported seizures. Conclusions Although online pharmacies can offer distinct advantages in terms of convenience and cost, users of these “rogue” pharmacies that offer drugs with no prescription or doctor supervision do so at great risk to their health, as evidenced by much higher rates of adverse events. The most logical explanation for these findings is that the lack of physician oversight of dosage schedules, contraindicated conditions, and concomitant medications, were responsible for the increased intensity and frequency of adverse events in the nontraditional users. Although we only examined tramadol, it is logical to postulate that similar results would be observed with dozens of equally accessible prescription drugs. As such, the geometric growth in the use of online pharmacies around the world should prompt intense medical and regulatory discussion about their role in the provision of medical care. PMID:23220405

Are multidose drug dispensing systems initiated for the appropriate patients?

PubMed

Mertens, Bram J; Kwint, H F; van Marum, Rob J; Bouvy, Marcel L

2018-05-16

It is unknown if multidose drug dispensing (MDD) systems are initiated for the appropriate patients. Therefore, the objective of this study was to compare the medication management problems of patients who were about to start with a MDD system (MDD patients) and patients who continued manually dispensed medication (non-MDD users) in order to identify if the appropriate patients receive a MDD system. Patient interviews (semi-structured) were conducted by 44 community pharmacists at the patient's home. Patients over 65 years of age, home dwelling and using at least five chronic drugs, were eligible for the study. An assessment tool was developed including 22 potential medication management problems, covering four domains: functional (7), organizational (7), medication adherence (6), and medication knowledge (2). Median scores were calculated with the interquartile range. Additionally, cognitive function was assessed with the Mini-Cog and frailty using the Groningen Frailty Indicator. One hundred eighty-eight MDD users and 230 non-MDD users were interviewed. MDD users were older, more often female, and using more drugs. Forty-two percent of the MDD users were possibly cognitively impaired and 63% were assessed as frail compared to 20 and 27% respectively of the non-MDD users. MDD users had more potential organizational problems (3 vs. 1; p < 0.01), functional problems (2 vs. 1; p < 0.01), medication adherence problems (1 vs. 0; p < 0.01), and medication knowledge problems (1 vs. 0; p < 0.01) compared to non-MDD users. Seventy percent of the MDD users scored six or more potential medication management problems while this was 22% among non-MDD users. The majority of MDD systems were initiated for patients who experienced multiple potential medication management problems suggesting a decreased medication management capacity.

Studying Psychosocial Barriers to Drug Treatment Among Chinese Methamphetamine Users Using A 3-Step Latent Class Analysis.

PubMed

Wang, Jichuan; Kelly, Brian C; Liu, Tieqiao; Hao, Wei

2016-03-01

Given the growth in methamphetamine use in China during the 21st century, we assessed perceived psychosocial barriers to drug treatment among this population. Using a sample of 303 methamphetamine users recruited via Respondent Driven Sampling, we use Latent Class Analysis (LCA) to identify possible distinct latent groups among Chinese methamphetamine users on the basis of their perceptions of psychosocial barriers to drug treatment. After covariates were included to predict latent class membership, the 3-step modeling approach was applied. Our findings indicate that the Chinese methamphetamine using population was heterogeneous on perceptions of drug treatment barriers; four distinct latent classes (subpopulations) were identified--Unsupported Deniers, Deniers, Privacy Anxious, and Low Barriers--and individual characteristics shaped the probability of class membership. Efforts to link Chinese methamphetamine users to treatment may require a multi-faceted approach that attends to differing perceptions about impediments to drug treatment. Copyright © 2015. Published by Elsevier Inc.

Pregnancy and Sexual Health among Homeless Young Injection Drug Users

ERIC Educational Resources Information Center

Hathazi, Dodi; Lankenau, Stephen E.; Sanders, Bill; Bloom, Jennifer Jackson

2009-01-01

Research on pregnancy and sexual health among homeless youth is limited. In this study, qualitative interviews were conducted with 41 homeless young injection drug users (IDUs) in Los Angeles with a history of pregnancy. The relationship between recent pregnancy outcomes, contraception practices, housing status, substance use, utilization of…

Association of testosterone levels and heroin usage characteristics in male heroin users.

PubMed

Wang, Zhuo; Zhou, Xiao-Bo; Yang, Xiao-Rong; Song, Hui; Cao, Bing-Rong; Yin, Fei; Kang, Lin; An, Zhen-Mei; Li, Jing

2017-05-01

Previous studies have shown that heroin abuse can alter the gonadal functions. Few studies examined the association between testosterone levels and heroin use in the existing literature. We aimed to determine the association between gonadal hormones and heroin usage characteristics over 12 weeks of abstinence in heroin users. We collected data on patient demographics and heroin use patterns for 65 men aged 18 to 45 and for 29 age-matched healthy controls. Serum levels of total testosterone, estradiol, and prolactin were assessed at 5 time points. Testosterone levels gradually increased and prolactin levels decreased in heroin users in this study. In heroin users, a significant positive correlation was observed between the way of using drug and the testosterone levels, the way of using drug and the estradiol levels, between the duration of heroin dependence and the testosterone levels, between the duration of heroin dependence and the estradiol levels on D0, and between relapse time and testosterone levels on D84. Our data reveal testosterone might promote injection drug use and repeated relapse in male heroin users.

Examining the relationship between ethnicity and the use of drug-related services: an ethnographic study of Nepali drug users in Hong Kong

PubMed Central

Tang, Wai-Man

2014-01-01

A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed. PMID:25114609

Mental health, drug use, and the transition from welfare to work.

PubMed

Montoya, Isaac D; Bell, David C; Atkinson, John S; Nagy, Carl W; Whitsett, Donna D

2002-05-01

This study examines the effects of drug use and work requirements on psychological distress and employment among chronic drug-using and non-drug-using welfare recipients. Using a natural history design, 442 female Temporary Assistance for Needy Families (TANF) recipients (including 251 with chronic drug use problems) were interviewed every 4 months in order to assess changes in psychological functioning, employment status, and wages. Data from the first year (four waves) indicate that employment and wages increased substantially, though less so for drug users than non-drug users. Psychological distress decreased only slightly over the study period. Growth curve analyses show that drug use had no direct effect on wages; however, drug use did significantly increase psychological distress. Both the work mandate and psychological distress contributed to wages. The authors consider the implications of these trends for the mental health service needs of drug-using TANF recipients.

Comparison of the Prevalence of Psychiatric Disorders in Performance-Enhancing Drug Users and Nonuser Bodybuilders

PubMed Central

Ostovar, Afshin; Haerinejad, Mohammad Javad; Akbarzadeh, Samad; Keshavarz, Mojtaba

2017-01-01

Objective: The present study aimed at comparing the prevalence of major psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, and generalized anxiety disorder between performance-enhancing drug users and nonuser bodybuilders. Moreover, the prevalence of major psychiatric disorders in bodybuilders was also reported. Method: In this study, 453 athletes were recruited from Bushehr bodybuilding gyms from February to May 2015. A structured questionnaire was used to collect the participants’ information, including demographic characteristics, sports’ status and performance-enhancing drug use. According to the condition of performance-enhancing drug use, the participants were divided into current users, non-current users, and nonusers. The psychiatric status of the participants was evaluated using DSM-IV diagnostic criteria for major depressive disorder, bipolar disorder, generalized anxiety disorder, and schizophrenia. We also asked about the acute psychotic disturbances after using performance-enhancing drugs, alcohol use, and history of aggressive behavior in bodybuilders. Data were analyzed using one-way analysis of variance and chi-square tests. Results: Prevalence of major depressive disorder, bipolar disorder, schizophrenia, generalized anxiety disorder, and the overall prevalence of psychiatric disorders in the bodybuilders was 19.7%, 3.8%, 1.5%, 16.6%, and 26.7%, respectively. After using performance-enhancing drugs, 33% of the bodybuilders had experienced acute psychological disturbances. There were no significant differences between current, non-current, and nonuser bodybuilding athletes in the measured psychiatric disorders. Conclusion: Prevalence of psychiatric disorders was not significantly different in performance-enhancing drug users and nonusers. Thus, it can be concluded that performance-enhancing drugs do not increase the risk of psychiatric disorders in bodybuilders. PMID:29472947

Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons

PubMed Central

Poulin, Céline; Alary, Michel; Lambert, Gilles; Godin, Gaston; Landry, Suzanne; Gagnon, Hélène; Demers, Éric; Morarescu, Elena; Rochefort, Jean; Claessens, Christiane

2007-01-01

Background To determine the prevalence of HIV and hepatitis C virus (HCV) infections and examine risk factors for these infections among inmates in Quebec provincial prisons. Methods Anonymous cross-sectional data were collected from January to June 2003 for men (n = 1357) and women (n = 250) who agreed to participate in the study and who completed a self-administrated questionnaire and provided saliva samples. Results The prevalence of HIV infection was 2.3% among the male participants and 8.8% among the female participants. The corresponding prevalence of HCV infection was 16.6% and 29.2%, respectively. The most important risk factor was injection drug use. The prevalence of HIV infection was 7.2% among the male injection drug users and 0.5% among the male non-users. Among the women, the rate was 20.6% among the injection drug users, whereas none of the non-users was HIV positive. The prevalence of HCV infection was 53.3% among the male injection drug users and 2.6% among the male non-users; the corresponding values among the women were 63.6% and 3.5%. Interpretation HIV and HCV infections constitute an important public health problem in prison, where the prevalence is affected mainly by a high percentage of injection drug use among inmates. PMID:17664448

[Clinical and social vulnerabilities in crack users according to housing status: a multicenter study in six Brazilian state capitals].

PubMed

Halpern, Silvia Chwartzmann; Scherer, Juliana Nichterwitz; Roglio, Vinicius; Faller, Sibele; Sordi, Anne; Ornell, Felipe; Dalbosco, Carla; Pechansky, Flavio; Kessler, Félix; Diemen, Lísia von

2017-07-03

The study had the goal to evaluate psychoactive substance use severity, violence, physical and emotional health of crack users who seeks specialized treatment in Psychosocial Care Centers for Alcohol and Drugs (CAPSad) concerning housing status. This is a multicenter cross-sectional study in six Brazilian capitals with 564 crack users categorized into two groups (1) users who have been homeless sometime in life (n = 266) and (2) individuals who have never lived on streets (n = 298). To assess the substance use severity and the characteristics of the individuals, the Addiction Severity Index, 6th version (ASI-6) was used. Group 1 users showed worse indicators regarding alcohol, medical and psychiatric problems, employment and family support subscales, as well as greater involvement with legal problems, violence, sexual abuse, suicide risk and health related problems such as HIV/AIDS, hepatitis and tuberculosis. In addition they have lower income to pay for basic needs. After analysis and control for possible confounders, not having enough income to pay for basic needs, showing depression symptoms, and having been arrested for theft remained statistically significant. This study evaluated more deeply drug use severity and housing status of crack users. Interventions developed in outpatient treatment should be designed and tailored to specific profiles and demands of drug users, especially homeless individuals.

Correlates of Incarceration Among Young Methamphetamine Users in Chiang Mai, Thailand

PubMed Central

Thomson, Nicholas; Sutcliffe, Catherine G.; Sirirojn, Bangorn; Keawvichit, Rassamee; Wongworapat, Kanlaya; Sintupat, Kamolrawee; Aramrattana, Apinun

2009-01-01

Objectives. We examined correlates of incarceration among young methamphetamine users in Chiang Mai, Thailand in 2005 to 2006. Methods. We conducted a cross-sectional study among 1189 young methamphetamine users. Participants were surveyed about their recent drug use, sexual behaviors, and incarceration. Biological samples were obtained to test for sexually transmitted and viral infections. Results. Twenty-two percent of participants reported ever having been incarcerated. In multivariate analysis, risk behaviors including frequent public drunkenness, starting to use illicit drugs at an early age, involvement in the drug economy, tattooing, injecting drugs, and unprotected sex were correlated with a history of incarceration. HIV, HCV, and herpes simplex virus type 2 (HSV-2) infection were also correlated with incarceration. Conclusions. Incarcerated methamphetamine users are engaging in behaviors and being exposed to environments that put them at increased risk of infection and harmful practices. Alternatives to incarceration need to be explored for youths. PMID:18923109

Laws prohibiting over-the-counter syringe sales to injection drug users: relations to population density, HIV prevalence, and HIV incidence.

PubMed

Friedman, S R; Perlis, T; Des Jarlais, D C

2001-05-01

This study sought to assess relations of laws prohibiting over-the-counter syringe sales (anti-OTC laws) to population prevalence of injection drug users and HIV prevalence or incidence among 96 US metropolitan areas. A cross-sectional analysis was used. Metropolitan areas with anti-OTC laws had a higher mean HIV prevalence (13.8% vs 6.7%) than other metropolitan areas (pseudo-P < .001). In 83 metropolitan areas with HIV prevalence of less than 20%, anti-OTC laws were associated with HIV incidence rates of 1% or greater (pseudo-P < .001). Population proportions of injection drug users did not vary by presence of anti-OTC laws. Anti-OTC laws are not associated with lower population proportions of injection drug users. Laws restricting syringe access are associated with HIV transmission and should be repealed.

"Why Has It Only become an Issue Now?": Young Drug Users' Perceptions of Drug Driving in Melbourne, Victoria

ERIC Educational Resources Information Center

Wilson, Laura Ann; Wilson, Dean

2010-01-01

Preliminary research into drug-user perceptions of drug driving was undertaken with a sample group of drug users aged 18 to 24 from Melbourne, Victoria. Eleven males and nine females participated in semi-structured interviews and completed self-report surveys. Participants discussed their drug driving and their perceptions of the likelihood of…

Specific effects of ecstasy and other illicit drugs on cognition in poly-substance users.

PubMed

Schilt, T; de Win, M M L; Jager, G; Koeter, M W; Ramsey, N F; Schmand, B; van den Brink, W

2008-09-01

A large number of studies, reviews and meta-analyses have reported cognitive deficits in ecstasy users. However most ecstasy users are polydrug users, and therefore it cannot be excluded that these deficits are (partly) the result of drugs other than ecstasy. The current study, part of the Netherlands XTC Toxicity (NeXT) study, investigates the specific sustained effects of ecstasy relative to amphetamine, cocaine and cannabis on the brain using neuropsychological examination. A stratified sample of 67 subjects with such a variation in type and amount of drug use was included that correlations between the consumption of the various drugs were relatively low allowing stepwise linear multiple regression analyses to differentiate between the effects of ecstasy and those of other substances. Subjects were assessed with neuropsychological tests measuring attention, working memory, verbal and visuospatial memory, and visuospatial ability. Ecstasy use [mean 327 (S.D.=364) tablets in lifetime] had a specific significant dose-related negative effect on verbal delayed recall after adjusting for the use of other drugs. These findings strongly suggest a specific sustained negative effect of ecstasy use on verbal memory. The clinical relevance is not immediately clear, because test performance generally remained within the normal range. However the magnitude of the effect is substantial (d>0.5) and long-term consequences cannot be excluded.

76 FR 79195 - Animal Drug User Fee Act; Reopening of the Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0656] Animal Drug User Fee Act; Reopening of the Comment Period AGENCY: Food and Drug Administration, HHS... notice, FDA requested comments on the Animal Drug User Fee Act (ADUFA) program to date and solicited...

Recoverable hearing loss with amphetamines and other drugs.

PubMed

Iqbal, Nayyer

2004-06-01

Prolonged and sustained consumption of alcohol, heroin and volatiles had been reported to impair hearing. Amphetamine related hearing loss is clinically different from the hearing loss seen with other agents. It seems that illicit drug use could result in two clinically different types of hearing losses. In May and June of 2001, 183 men aged 18 and above who met DSM-IV criteria for substance dependence were studied in a hospital in Saudia Arabia. The purpose of the study was to ascertain the prevalence of amphetamine-related recoverable hearing loss, establish whether similar hearing loss also occurred with other drugs of abuse and determine if drug-related psychosis was more prevalent in those amphetamine users who developed this type of hearing loss. Recoverable type of hearing loss was not just seen in amphetamine users but also occurred with cannabis, heroin, alcohol, dextromethorphan and glue use. Drug-induced psychosis was three and a half times more common in those amphetamine users who developed a hearing loss. Major depression and suicidality was also more common in these individuals. This association of major depression and subsequent development of hearing loss was also found in those using other type of drugs. It was concluded that a history of major depression was a good predictor of later development of both drug-induced psychosis and hearing loss in amphetamine users, and hypoperfusion was proposed as the possible explanation.

Correlates of HIV-1 viral suppression in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam

PubMed Central

Jordan, Michael R; La, Hanh; Nguyen, Hien Duc; Sheehan, Heidi; Lien, Trinh Thi Minh; Van Dang, Duong; Hellinger, James; Wanke, Christine; Tang, Alice M

2009-01-01

Summary Injection drug users bear the burden of HIV in Vietnam and are a focus of national treatment programs. To date, determinants of successful therapy in this population are unknown. Substance use and clinical correlates of viral suppression were studied in 100 HIV-1 infected drug users receiving antiretroviral therapy (ART) for at least 6 months in Hanoi, Vietnam. Mean age of the cohort was 29.9 + 4.9 years; all were men. A majority of patients (73%) achieved viral suppression (HIV-RNA < 1000 copies/ml). Correlates of viral suppression include self-reported >95% adherence (p<0.01) and current use of trimethoprim/sulfamethoxazole (p<0.01); current or ever diagnosed with tuberculosis was associated with viral non-suppression (p=0.006). Tobacco use was prevalent (84%), and surprisingly 48% of patients reported active drug use; neither was associated with viral non-suppression. This is the first study to document successful ART treatment in a population of Vietnamese drug users; rates of viral suppression are comparable to other international populations. The 28% of patients without HIV-1 suppression highlights the need for adherence promotion, risk reduction programs, and population based surveillance strategies for assessing the emergence of HIV drug resistance in settings where access to viral load and drug resistance testing is limited. PMID:19451329

Correlates of HIV-1 viral suppression in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam.

PubMed

Jordan, M R; La, H; Nguyen, H D; Sheehan, H; Lien, T T M; Duong, D V; Hellinger, J; Wanke, C; Tang, A M

2009-06-01

Injection drug users bear the burden of HIV in Vietnam and are a focus of national treatment programmes. To date, determinants of successful therapy in this population are unknown. Substance use and clinical correlates of viral suppression were studied in 100 HIV-1-infected drug users receiving antiretroviral therapy (ART) for at least six months in Hanoi, Vietnam. The mean age of the cohort was 29.9 + 4.9 years; all were men. A majority of patients (73%) achieved viral suppression (HIV-RNA <1000 copies/mL). Correlates of viral suppression include self-reported > or = 95% adherence (P < 0.01) and current use of trimethoprim/sulphamethoxazole (P < 0.01); current or ever diagnosed with tuberculosis was associated with viral non-suppression (P = 0.006). Tobacco use was prevalent (84%), and surprisingly 48% of patients reported active drug use; neither was associated with viral non-suppression. This is the first study to document successful ART treatment in a population of Vietnamese drug users; rates of viral suppression are comparable to other international populations. The 28% of patients without HIV-1 suppression highlight the need for adherence promotion, risk reduction programmes, and population-based surveillance strategies for assessing the emergence of HIV drug resistance in settings where access to viral load and drug resistance testing is limited.

Recent Translational Findings on Impulsivity in Relation to Drug Abuse

PubMed Central

Weafer, Jessica; Mitchell, Suzanne H.

2015-01-01

Impulsive behavior is strongly implicated in drug abuse, as both a cause and a consequence of drug use. To understand how impulsive behaviors lead to and result from drug use, translational evidence from both human and non-human animal studies is needed. Here, we review recent (2009 or later) studies that have investigated two major components of impulsive behavior, inhibitory control and impulsive choice, across preclinical and clinical studies. We concentrate on the stop-signal task as the measure of inhibitory control and delay discounting as the measure of impulsive choice. Consistent with previous reports, recent studies show greater impulsive behavior in drug users compared with non-users. Additionally, new evidence supports the prospective role of impulsive behavior in drug abuse, and has begun to identify the neurobiological mechanisms underlying impulsive behavior. We focus on the commonalities and differences in findings between preclinical and clinical studies, and suggest future directions for translational research. PMID:25678985

Illicit stimulant use in humans is associated with a long-term increase in tremor.

PubMed

Flavel, Stanley C; Koch, Jenna D; White, Jason M; Todd, Gabrielle

2012-01-01

Use of illicit stimulants such as methamphetamine, cocaine, and ecstasy is a significant health problem. The United Nations Office on Drugs and Crime estimates that 14-57 million people use stimulants each year. Chronic use of illicit stimulants can cause neurotoxicity in animals and humans but the long-term functional consequences are not well understood. Stimulant users self-report problems with tremor whilst abstinent. Thus, the aim of the current study was to investigate the long-term effect of stimulant use on human tremor during rest and movement. We hypothesized that individuals with a history of stimulant use would exhibit abnormally large tremor during rest and movement. Tremor was assessed in abstinent ecstasy users (n = 9; 22 ± 3 yrs) and abstinent users of amphetamine-like drugs (n = 7; 33 ± 9 yrs) and in two control groups: non-drug users (n = 23; 27 ± 8 yrs) and cannabis users (n = 12; 24 ± 7 yrs). Tremor was measured with an accelerometer attached to the index finger at rest (30 s) and during flexion and extension of the index finger (30 s). Acceleration traces were analyzed with fast-Fourier transform. During movement, tremor amplitude was significantly greater in ecstasy users than in non-drug users (frequency range 3.9-13.3 Hz; P<0.05), but was unaffected in cannabis users or users of amphetamine-like drugs. The peak frequency of tremor did not significantly differ between groups nor did resting tremor. In conclusion, abstinent ecstasy users exhibit an abnormally large tremor during movement. Further work is required to determine if the abnormality translates to increased risk of movement disorders in this population.

Illicit Stimulant Use in Humans Is Associated with a Long-Term Increase in Tremor

PubMed Central

Flavel, Stanley C.; Koch, Jenna D.; White, Jason M.; Todd, Gabrielle

2012-01-01

Use of illicit stimulants such as methamphetamine, cocaine, and ecstasy is a significant health problem. The United Nations Office on Drugs and Crime estimates that 14–57 million people use stimulants each year. Chronic use of illicit stimulants can cause neurotoxicity in animals and humans but the long-term functional consequences are not well understood. Stimulant users self-report problems with tremor whilst abstinent. Thus, the aim of the current study was to investigate the long-term effect of stimulant use on human tremor during rest and movement. We hypothesized that individuals with a history of stimulant use would exhibit abnormally large tremor during rest and movement. Tremor was assessed in abstinent ecstasy users (n = 9; 22±3 yrs) and abstinent users of amphetamine-like drugs (n = 7; 33±9 yrs) and in two control groups: non-drug users (n = 23; 27±8 yrs) and cannabis users (n = 12; 24±7 yrs). Tremor was measured with an accelerometer attached to the index finger at rest (30 s) and during flexion and extension of the index finger (30 s). Acceleration traces were analyzed with fast-Fourier transform. During movement, tremor amplitude was significantly greater in ecstasy users than in non-drug users (frequency range 3.9–13.3 Hz; P<0.05), but was unaffected in cannabis users or users of amphetamine-like drugs. The peak frequency of tremor did not significantly differ between groups nor did resting tremor. In conclusion, abstinent ecstasy users exhibit an abnormally large tremor during movement. Further work is required to determine if the abnormality translates to increased risk of movement disorders in this population. PMID:23272201

[Use of illicit drugs and critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro City, Brazil].

PubMed

Vargens, Octavio Muniz da Costa; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

This article presents the partial results of a multicenter, qualitative study, which involved seven Latin-American countries and Canada. The results presented refer to Northern Rio de Janeiro (city), Brazil. The objective of the study was to describe the perspective of relatives/acquaintances of illicit drug users about protective and risk factors, prevention initiatives, treatment services, and legal aspects regarding illicit drugs. Interviews were performed with 99 individuals, who reported being affected by their relationship with an illicit drug user (relative or acquaintance), approaching their perspectives regarding the key-domains. Most participants were women (73.7%); relatives who used drugs were mostly men (78.2%); the most consumed drug was marijuana (77.8%). The highlighted protective factor was having recreational-sports activities in the community (88.9%), and the risk factor was curiosity for trying something new (94.4%). The main treatment services were Church Groups (51.5%), and participants stated that laws should be more punitive (82.8%). In conclusion, this information is essential to fight against drug use/abuse, showing that there is a need for actions that consider different perspectives at different levels.

Sexual health risk among dance drug users: cross-sectional comparisons with nationally representative data.

PubMed

Mitcheson, Luke; McCambridge, Jim; Byrne, Angela; Hunt, Neil; Winstock, Adam

2008-08-01

To describe the sexual behaviour and related risk of a sample of dance drug users and compare this with data from the UK National Survey of Sexual Attitudes and Lifestyles 2000 survey. Cross-sectional purposive sampling using both self-completion postal and web-based questionnaires. This sample of dance drug users are more sexually active and have more concurrent partners than the general population. Rates of anal or vaginal sex within the last year without condom use are high and of concern (men 80 per cent; women 90 per cent). These dance drug users appear also to have higher lifetime prevalence of sexually transmitted infections than the general population and are also more likely to have ever attended a sexual health clinic. Clubbing and dance drug use, as part of a socially active lifestyle, is associated with elevated and pronounced sexual health risk. Future epidemiological studies of sexual health risk should incorporate investigation of both clubbing and recreational drug use in order to confirm the representativeness of these observations. Clubbers should be considered a target for dedicated sexual health promotion interventions, which may also be combined with interventions targeting drug and alcohol use.

Normalization of urinary drug concentrations with specific gravity and creatinine.

PubMed

Cone, Edward J; Caplan, Yale H; Moser, Frank; Robert, Tim; Shelby, Melinda K; Black, David L

2009-01-01

Excessive fluid intake can substantially dilute urinary drug concentrations and result in false-negative reports for drug users. Methods for correction ("normalization") of drug/metabolite concentrations in urine have been utilized by anti-doping laboratories, pain monitoring programs, and in environmental monitoring programs to compensate for excessive hydration, but such procedures have not been used routinely in workplace, legal, and treatment settings. We evaluated two drug normalization procedures based on specific gravity and creatinine. These corrections were applied to urine specimens collected from three distinct groups (pain patients, heroin users, and marijuana/ cocaine users). Each group was unique in characteristics, study design, and dosing conditions. The results of the two normalization procedures were highly correlated (r=0.94; range, 0.78-0.99). Increases in percent positives by specific gravity and creatinine normalization were small (0.3% and -1.0%, respectively) for heroin users (normally hydrated subjects), modest (4.2-9.8%) for pain patients (unknown hydration state), and substantial (2- to 38-fold increases) for marijuana/cocaine users (excessively hydrated subjects). Despite some limitations, these normalization procedures provide alternative means of dealing with highly dilute, dilute, and concentrated urine specimens. Drug/metabolite concentration normalization by these procedures is recommended for urine testing programs, especially as a means of coping with dilute specimens.

Demographic and health related data of users of a mobile application to support drug adherence is associated with usage duration and intensity.

PubMed

Becker, Stefan; Brandl, Christopher; Meister, Sven; Nagel, Eckhard; Miron-Shatz, Talya; Mitchell, Anna; Kribben, Andreas; Albrecht, Urs-Vito; Mertens, Alexander

2015-01-01

A wealth of mobile applications are designed to support users in their drug intake. When developing software for patients, it is important to understand the differences between individuals who have, who will or who might never adopt mobile interventions. This study analyzes demographic and health-related factors associated with real-life "longer usage" and the "usage-intensity per day" of the mobile application "Medication Plan". Between 2010-2012, the mobile application "Medication Plan" could be downloaded free of charge from the Apple-App-Store. It was aimed at supporting the regular and correct intake of medication. Demographic and health-related data were collected via an online questionnaire. This study analyzed captured data. App-related activities of 1799 users (1708 complete data sets) were recorded. 69% (1183/1708) applied "Medication Plan" for more than a day. 74% were male (872/1183), the median age 45 years. Variance analysis showed a significant effect of the users' age with respect to duration of usage (p = 0.025). While the mean duration of use was only 23.3 days for users younger than 21 years, for older users, there was a substantial increase over all age cohorts up to users of 60 years and above (103.9 days). Sex and educational status had no effect. "Daily usage intensity" was directly associated with an increasing number of prescribed medications and increased from an average of 1.87 uses per day and 1 drug per day to on average 3.71 uses per day for users stating to be taking more than 7 different drugs a day (p<0.001). Demographic predictors (sex, age and educational attainment) did not affect usage intensity. Users aged 60+ as well as those with complicated therapeutic drug regimens relied on the service we provided for more than three months on average. Mobile applications may be a promising approach to support the treatment of patients with chronic conditions.

Transitioning illicit drug preferences and emerging user identities in Ohio: The proliferation of methamphetamine use among African Americans.

PubMed

Flynn, Karen Coen; Hoffer, Lee D

2017-07-05

Understanding the social dynamics of local methamphetamine markets is critical to improving community health and reducing social costs associated with illicit drug use. We examine a local drug market in Summit County, Ohio, wherein methamphetamine users ascribe themselves different ethnic identities from those long associated with the drug elsewhere in the United States. Qualitative interviews with 52 study participants demonstrate that very poor and homeless White males and females are now using methamphetamine; however, even more surprising is that 31 of the participants identified themselves as poor or homeless, male or female African, Native, biracial, or multiracial Americans. The drug use trajectory of these 31 participants in particular involved a transition from a historical preference for crack to a present one for methamphetamine and, in some cases, a preference for concurrent use of methamphetamine and heroin. Many of these methamphetamine users also emphasized their ethnic identity to distinguish themselves as nonproducers of methamphetamine in comparison to Whites, who are commonly associated with methamphetamine production. Findings appear to suggest an emergent means of identity management resulting from the ethnic diversity of users in this methamphetamine market. These findings may have relevance in other communities with similar demographics and drug markets and may hold important implications for drug treatment, policy-making, and law enforcement professionals' work associated with methamphetamine users, producers, and distributors.

Health and human rights concerns of drug users in detention in Guangxi Province, China.

PubMed

Cohen, J Elizabeth; Amon, Joseph J

2008-12-09

Although confinement in drug detoxification ("detox") and re-education through labor (RTL) centers is the most common form of treatment for drug dependence in China, little has been published about the experience of drug users in such settings. We conducted an assessment of the impact of detention on drug users' access to HIV prevention and treatment services and consequent threats to fundamental human rights protections. Chinese government HIV and anti-narcotics legislation and policy documents were reviewed, and in-depth and key informant interviews were conducted with 19 injection drug users (IDUs) and 20 government and nongovernmental organization officials in Nanning and Baise, Guangxi Province. Significant contradictions were found in HIV and antinarcotics policies, exemplified by the simultaneous expansion of community-based methadone maintenance therapy and the increasing number of drug users detained in detox and RTL center facilities. IDU study participants reported, on average, having used drugs for 14 y (range 8-23 y) and had been confined to detox four times (range one to eight times) and to RTL centers once (range zero to three times). IDUs expressed an intense fear of being recognized by the police and being detained, regardless of current drug use. Key informants and IDUs reported that routine HIV testing, without consent and without disclosure of the result, was the standard policy of detox and RTL center facilities, and that HIV-infected detainees were not routinely provided medical or drug dependency treatment, including antiretroviral therapy. IDUs received little or no information or means of HIV prevention, but reported numerous risk behaviors for HIV transmission while detained. Legal and policy review, and interviews with recently detained IDUs and key informants in Guangxi Province, China, found evidence of anti-narcotics policies and practices that appear to violate human rights and imperil drug users' health.

Health and Human Rights Concerns of Drug Users in Detention in Guangxi Province, China

PubMed Central

Cohen, J. Elizabeth; Amon, Joseph J

2008-01-01

Background Although confinement in drug detoxification (“detox”) and re-education through labor (RTL) centers is the most common form of treatment for drug dependence in China, little has been published about the experience of drug users in such settings. We conducted an assessment of the impact of detention on drug users' access to HIV prevention and treatment services and consequent threats to fundamental human rights protections. Methods and Findings Chinese government HIV and anti-narcotics legislation and policy documents were reviewed, and in-depth and key informant interviews were conducted with 19 injection drug users (IDUs) and 20 government and nongovernmental organization officials in Nanning and Baise, Guangxi Province. Significant contradictions were found in HIV and antinarcotics policies, exemplified by the simultaneous expansion of community-based methadone maintenance therapy and the increasing number of drug users detained in detox and RTL center facilities. IDU study participants reported, on average, having used drugs for 14 y (range 8–23 y) and had been confined to detox four times (range one to eight times) and to RTL centers once (range zero to three times). IDUs expressed an intense fear of being recognized by the police and being detained, regardless of current drug use. Key informants and IDUs reported that routine HIV testing, without consent and without disclosure of the result, was the standard policy of detox and RTL center facilities, and that HIV-infected detainees were not routinely provided medical or drug dependency treatment, including antiretroviral therapy. IDUs received little or no information or means of HIV prevention, but reported numerous risk behaviors for HIV transmission while detained. Conclusions Legal and policy review, and interviews with recently detained IDUs and key informants in Guangxi Province, China, found evidence of anti-narcotics policies and practices that appear to violate human rights and imperil drug users' health. PMID:19071954

Identifying cases of heroin toxicity where 6-acetylmorphine (6-AM) is not detected by toxicological analyses.

PubMed

Ellis, Ashley D; McGwin, Gerald; Davis, Gregory G; Dye, Daniel W

2016-09-01

Heroin has a half-life of 2-6 min and is metabolized too quickly to be detected in autopsy samples. The presence of 6-acetylmophine (6-AM) in urine, blood, or other samples is convincing evidence of heroin use by a decedent, but 6-AM itself has a half-life of 6-25 min before it is hydrolyzed to morphine, so 6-AM may not be present in sufficient concentration to detect in postmortem samples. Codeine is often present in heroin preparations as an impurity and is not a metabolite of heroin. Studies report that a ratio of morphine to codeine greater than one indicates heroin use. We hypothesize that the ratio of morphine to codeine in our decedents abusing drugs intravenously will be no different in individuals with 6-AM present than in individuals where no 6-AM is detected, and we report our study of this hypothesis. All accidental deaths investigated by the Jefferson County Coroner/Medical Examiner Office from 2010 to 2013 with morphine detected in blood samples collected at autopsy were reviewed. Five deaths where trauma caused or contributed to death were excluded from the review. The presence or absence of 6-AM and the concentrations of morphine and codeine were recorded for each case. The ratio of morphine to codeine was calculated for all decedents. Any individual in whom no morphine or codeine was detected in a postmortem sample was excluded from further study. Absence or presence of drug paraphernalia or evidence of intravascular (IV) drug use was documented in each case to identify IV drug users. The proportion of the IV drug users with and without 6-AM present in a postmortem sample was compared to the M/C ratio for the individuals. Of the 230 deaths included in the analysis, 103 IV drug users with quantifiable morphine and codeine in a postmortem sample were identified allowing for calculation of an M/C ratio. In these IV drug users, the M/C ratio was greater than 1 in 98 % of decedents. When controlling for the absence or presence of 6-AM there was no statistically significant difference in the proportion of IV drug users when compared to non IV drug users with an M/C ratio of greater than 1 (p = 1.000). The M/C ratio in IV drug users, if greater than 1, is seen in deaths due to heroin toxicity where 6-AM is detected in a postmortem sample. This study provides evidence that a M/C ratio greater than one in an IV drug user is evidence of a death due to heroin toxicity even if 6-AM is not detected in the blood. Using the M/C ratio, in addition to scene and autopsy findings, provides sufficient evidence to show heroin is the source of the morphine and codeine. Listing heroin as a cause or contributing factor in deaths with evidence of IV drug abuse and where the M/C ratio exceeds 1 will improve identification of heroin fatalities, which will allow better allocation of resources for public health initiatives.

The use of crack and other illicit drugs impacts oral health-related quality of life in Brazilians.

PubMed

Antoniazzi, R P; Zanatta, F B; Ardenghi, T M; Feldens, C A

2018-04-01

The aim of this study was to investigate the impact of the use of crack and other illicit drugs on oral health-related quality of life (OHRQoL) in young adults. This cross-sectional study evaluated 106 crack users at a public treatment center for drug addiction and 106 controls matched for gender, age, and use of tobacco. Clinical examinations were performed for dental caries and periodontal disease. The outcome was OHRQoL, which was determined using the Oral Health Impact Profile (OHIP-14). The association between OHRQoL and illicit drugs was modeled using conditional Poisson regression. Users of crack and other illicit drugs had a poorer OHRQoL than the controls (p < .001). Among the crack users, the odds ratio to yield high OHIP-14 was 3.40 (95% confidence interval, 1.91-6.08). Adjustment for sex, age, schooling, income, smoking, dental caries, and periodontal disease did not change such an estimate considerably. The functional limitation and psychological discomfort domains were associated with the use of illicit drugs. Users of crack and other illicit drugs exerted a negative impact on OHRQoL independently of socio-demographic characteristics and tobacco use, suggesting the need for special attention regarding the specific oral health needs of this population as well as drug prevention and treatment strategies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

A Perfect Storm: Crack Cocaine, HSV-2, and HIV Among Non-Injecting Drug Users in New York City

PubMed Central

Des Jarlais, Don C.; McKnight, Courtney; Arasteh, Kamyar; Feelemyer, Jonathan; Perlman, David C.; Hagan, Holly; Dauria, Emily F.; Cooper, Hannah L.F.

2015-01-01

Prevalence of human immunodeficiency virus (HIV) infection has reached 16% among non-injecting drug users (NIDU) in New York City, an unusually high prevalence for a predominantly heterosexual population that does not inject drugs. Using a long-term study (1983–2011, >7,000 subjects) among persons entering the Beth Israel drug-treatment programs in New York City, we identified factors that contributed to this high prevalence: a preexisting HIV epidemic among injectors, a crack cocaine epidemic, mixing between injectors and crack users, policy responses not centered on public health, and herpes-simplex virus 2 facilitating HIV transmission. Implications for avoiding high prevalence among NIDU in other areas are discussed. PMID:24502371

Effectiveness of HIV Prevention Social Marketing With Injecting Drug Users

PubMed Central

Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M.

2010-01-01

Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide. PMID:20724686

HIV prevalence and sexual risk behaviour among non-injection drug users in Tijuana, Mexico.

PubMed

Deiss, Robert G; Lozada, Remedios M; Burgos, Jose Luis; Strathdee, Steffanie A; Gallardo, Manuel; Cuevas, Jazmine; Garfein, Richard S

2012-01-01

Prior studies estimate HIV prevalence of 4% among injection drug users (IDUs), compared with 0.8% in the general population of Tijuana, Mexico. However, data on HIV prevalence and correlates among non-injecting drug users (NIDUs) are sparse. Individuals were recruited through street outreach for HIV testing and behavioural risk assessment interviews to estimate HIV prevalence and identify associated sexual risk behaviours among NIDUs in Tijuana. Descriptive statistics were used to characterise 'low-risk' NIDUs (drug users who were not commercial sex workers or men who have sex with men). Results showed that HIV prevalence was 3.7% among low-risk NIDUs. During the prior six months, 52% of NIDUs reported having >1 casual partner; 35% reported always using condoms with a casual partner; and 13% and 15%, respectively, reported giving or receiving something in exchange for sex. Women were significantly more likely than men to have unprotected sex with an IDU (p<0.01). The finding that HIV prevalence among NIDUs was similar to that of IDUs suggests that HIV transmission has occurred outside of traditional core groups in Tijuana. Broad interventions including HIV testing, condom promotion and sexual risk reduction should be offered to all drug users in Tijuana.

Adaptation and Validation of the Sexual Assertiveness Scale (SAS) in a Sample of Male Drug Users.

PubMed

Vallejo-Medina, Pablo; Sierra, Juan Carlos

2015-04-21

The aim of the present study was to adapt and validate the Sexual Assertiveness Scale (SAS) in a sample of male drug users. A sample of 326 male drug users and 322 non-clinical males was selected by cluster sampling and convenience sampling, respectively. Results showed that the scale had good psychometric properties and adequate internal consistency reliability (Initiation = .66, Refusal = .74 and STD-P = .79). An evaluation of the invariance showed strong factor equivalence between both samples. A high and moderate effect of Differential Item Functioning was only found in items 1 and 14 (∆R 2 Nagelkerke = .076 and .037, respectively). We strongly recommend not using item 1 if the goal is to compare the scores of both groups, otherwise the comparison will be biased. Correlations obtained between the CSFQ-14 and the safe sex ratio and the SAS subscales were significant (CI = 95%) and indicated good concurrent validity. Scores of male drug users were similar to those of non-clinical males. Therefore, the adaptation of the SAS to drug users provides enough guarantees for reliable and valid use in both clinical practice and research, although care should be taken with item 1.

Party drug use in techno nights: a field survey among French-speaking Swiss attendees.

PubMed

Chinet, Léonie; Stéphan, Philippe; Zobel, Frank; Halfon, Olivier

2007-02-01

This study was designed to investigate the lifestyle and substance use habits of dance music event attendees together with their attitudes toward prevention of substance misuse, harm reduction measures and health-care resources. A total of 302 attendees aged 16-46 years (mean=22.70, S.D.=4.65) were randomly recruited as they entered dance music events. Rates for lifetime and current use (last 30 days) were particularly high for alcohol (95.3% and 86.6%, respectively), cannabis (68.8% and 53.8%, respectively), ecstasy (40.4% and 22.7%, respectively) and cocaine (35.9% and 20.7%, respectively). Several patterns of substance use could be identified: 52% were alcohol and/or cannabis only users, 42% were occasional poly-drug users and 6% were daily poly-drug users. No significant difference was observed between substance use patterns according to gender. Pure techno and open-air events attracted heavier drug users. Psychological problems (such as depressed mood, sleeping problems and anxiety attacks), social problems, dental disorders, accidents and emergency treatment episodes were strongly related to party drug use. Party drug users appeared to be particularly receptive to harm reduction measures, such as on-site emergency staff, pill testing and the availability of cool water, and to prevention of drug use provided via counseling. The greater the involvement in party drug use, the greater the need for prevention personnel to be available for counseling. General practitioners appeared to be key professionals for accessing health-care resources.

Psychedelic Drug Flashbacks: Psychotic Manifestation or Imaginative Role Playing?

ERIC Educational Resources Information Center

Matefy, Robert E.; Krall, Roger

1975-01-01

Examines possible differences in psychopathological characteristics among flashbackers, nonflashback drug users, and nondrug user controls. Results indicate that flashbackers show no more general maladjustment than the nonflashback drug users. (Author)

Experiences of police contact among young adult recreational drug users: A qualitative study.

PubMed

Leslie, Ellen M; Cherney, Adrian; Smirnov, Andrew; Kemp, Robert; Najman, Jake M

2018-06-01

While young adults who engage in recreational drug use are at increased risk of contact with police, their experiences of police contact have been largely overlooked. In-depth qualitative interviews were conducted with 70 young adult amphetamine-type stimulant (ATS; i.e., ecstasy [MDMA] and methamphetamine) users who had experienced intensive alcohol and other drug-related police contact (e.g., being arrested, charged, or raided by police). These interviews focused on perceptions of personal experiences of alcohol and other drug-related police contact and general perceptions of police and policing and were conducted as part of a larger longitudinal study of drug use among a population-based sample of young adults from South-East Queensland, Australia. ATS users' perceptions of their personal interactions with police and general perceptions of police and policing were influenced by a number of factors, including police behaviour, prior contact with police, friends and family members' contact with police, and perceptions of their own behaviour leading to their contact with police. While a majority of ATS users reported that their contact with police had either a neutral or negative impact on their general perceptions of police and policing, some ATS users reported that police contact had a positive impact. For 70% of ATS users, police contact was reported to have had an impact on their substance use behaviours, resulting in either modification of their substance use behaviours to avoid further police contact or reduction in their substance use. These findings suggest that police contact among young adult ATS users can impact on both perceptions of police and policing and substance use behaviours, emphasising the importance of the quality and nature of police contact and its potential role in harm reduction. Copyright © 2018 Elsevier B.V. All rights reserved.

Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non-users: a drug utilisation study.

PubMed

Crijns, Hubertina J M J; van Rein, Nienke; Gispen-de Wied, Christine C; Straus, Sabine M; de Jong-van den Berg, Lolkje T W

2012-10-01

To assess the compliance with the isotretinoin Pregnancy Prevention Programme (PPP) by evaluating the use of prescribed contraceptives among isotretinoin users. The PPP contains a requirement for the use of contraceptive methods for women of childbearing potential. A drug utilisation study was performed using data from a drug prescription database (containing Dutch community pharmacy data) covering a population of 500 000 patients. Contraceptive use in female isotretinoin users and in a reference group of female non-isotretinoin users (aged 15-49 years) was compared using data from 1999 until 2006 in 2-year periods. Descriptive statistics were used. Of the female isotretinoin users (n = 651), 52%-54% filled prescriptions on contraceptives in strict accordance to the PPP, used before, during, and after discontinuation of isotretinoin, compared with 39%-46% in the reference group. A more liberal approach of a minimum of one prescription for a contraceptive method showed 61%-64% use of contraceptives among isotretinoin users. Similar patterns were seen when data were broken down in age groups. Furthermore, a higher proportion of female patients using isotretinoin prescribed by general practitioners used prescribed contraceptives compared with those receiving isotretinoin by specialists. Compliance with the contraceptive use according to a PPP for a teratogenic drug such as isotretinoin is 52%-64%, which is lower than anticipated. Reasons for the low compliance will need to be clarified before further measures can be taken. Copyright © 2012 John Wiley & Sons, Ltd.

How do researchers categorize drugs, and how do drug users categorize them?

PubMed Central

Lee, Juliet P.; Antin, Tamar M.J.

2011-01-01

This paper considers drug classifications and terms widely used in US survey research, and compares these to classifications and terms used by drug users. We begin with a critical review of drug classification systems, including those oriented to public policy and health services as well as survey research. We then consider the results of a pile sort exercise we conducted with 76 respondents within a mixed method study of Southeast Asian American adolescent and young adult drug users in urban Northern California, USA. We included the pile sort to clarify how respondents handled specific terms which we understood to be related to Ecstasy and methamphetamines. Results of the pile sort were analyzed using graphic layout algorithms as well as content analysis of pile labels. Similar to the national surveys, our respondents consistently differentiated Ecstasy terms from methamphetamine terms. We found high agreement between some specific local terms (thizz, crystal) and popular drug terms, while other terms thought to be mainstream (crank, speed) were reported as unknown by many respondents. In labeling piles, respondents created taxonomies based on consumption method (in particular, pill) as well as the social contexts of use. We conclude by proposing that divergences between drug terms utilized in survey research and those used by drug users may reflect two opposing tendencies: the tendency of survey researchers to utilize standardized language that constructs persons and experiences as relatively homogeneous, varying only within measurable degrees, and the tendency of drug users to utilize specialized language (argot) that reflects their understandings of their experiences as hybrid and diverse. The findings problematize the validity of drug terms and categories used in survey research. PMID:24431475

How do researchers categorize drugs, and how do drug users categorize them?

PubMed

Lee, Juliet P; Antin, Tamar M J

2012-01-01

This paper considers drug classifications and terms widely used in US survey research, and compares these to classifications and terms used by drug users. We begin with a critical review of drug classification systems, including those oriented to public policy and health services as well as survey research. We then consider the results of a pile sort exercise we conducted with 76 respondents within a mixed method study of Southeast Asian American adolescent and young adult drug users in urban Northern California, USA. We included the pile sort to clarify how respondents handled specific terms which we understood to be related to Ecstasy and methamphetamines. Results of the pile sort were analyzed using graphic layout algorithms as well as content analysis of pile labels. Similar to the national surveys, our respondents consistently differentiated Ecstasy terms from methamphetamine terms. We found high agreement between some specific local terms ( thizz , crystal ) and popular drug terms, while other terms thought to be mainstream ( crank , speed ) were reported as unknown by many respondents. In labeling piles, respondents created taxonomies based on consumption method (in particular, pill ) as well as the social contexts of use. We conclude by proposing that divergences between drug terms utilized in survey research and those used by drug users may reflect two opposing tendencies: the tendency of survey researchers to utilize standardized language that constructs persons and experiences as relatively homogeneous, varying only within measurable degrees, and the tendency of drug users to utilize specialized language (argot) that reflects their understandings of their experiences as hybrid and diverse. The findings problematize the validity of drug terms and categories used in survey research.

Exploring sex differences in drug use, health and service use characteristics among young urban crack users in Brazil.

PubMed

Bertoni, Neilane; Burnett, Chantal; Cruz, Marcelo Santos; Andrade, Tarcisio; Bastos, Francisco I; Leal, Erotildes; Fischer, Benedikt

2014-08-28

Studies have shown important gender differences among drug (including crack) users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use. Crack use is prevalent in Brazil; however, few comparative data by sex exist. We examined and compared by sex key drug use, health, socio-economic indicators and service use in a bi-city sample of young (18-24 years), regular and marginalized crack users in Brazil. Study participants (total n = 159; n = 124 males and n = 35 females) were recruited by community-based methods from impoverished neighborhoods in Rio de Janeiro and Salvador. Assessments occurred by an anonymous interviewer-administered questionnaire and serum collection for blood-borne virus testing between November 2010 and June 2011. Descriptive statistics and differences for key variables by sex were computed; in addition, a 'chi-squared automatic interaction detector' ('CHAID') analysis explored potential primary factors differentiating male and female participants. Most participants were non-white, and had low education and multiple income sources. More women had unstable housing and income from sex work and/or panhandling/begging, whereas more men were employed. Both groups indicated multi-year histories of and frequent daily crack use, but virtually no drug injection histories. Men reported more co-use of other drugs. More women were: involved in sex-for-drug exchanges; blood-borne virus (BBV) tested and HIV+. Both groups reported similar physical and mental health patterns; however women more commonly utilized social or health services. The CHAID analysis identified sex work; paid work; begging/panhandling; as well as physical and mental health status (all at p < 0.05) as primary differentiating factors by sex. Crack users in our study showed notable differences by sex, including socio-economic indicators, drug co-use patterns, sex risks/work, BBV testing and status, and service utilization. Results emphasize the need for targeted special interventions and services for males and female crack users in Brazil.

78 FR 46955 - Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Animal Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug... payment procedures for fiscal year (FY) 2014 animal drug user fees. The Federal Food, Drug, and Cosmetic... submissions. This notice establishes the fee rates for FY 2014. FOR FURTHER INFORMATION CONTACT: Visit FDA's...

Risk control and rational recreation: A qualitative analysis of synthetic drug use among young urbanites in China.

PubMed

Lin, Shaozhen; Zhang, Yong-an

2014-07-01

To fight against the rapid growth of synthetic drugs, the Chinese government has strengthened the controls and regulation, incorporated synthetic drugs into the new detoxification system, and changed the inconsistent governance of synthetic and traditional drugs. This, however, has not stopped the spread of synthetic drugs among young urbanites. While scholars have focused on the loopholes and defects of specific drug control regulations, ethnographic inquiries illustrate how and why control does not work, or is even resisted by young drug users. In-depth qualitative interviews were conducted with 28 individuals aged between 20 and 35, recruited from a cohort of synthetic drug users in a Shanghai drug rehabilitation centre. Audio-recorded interviews elicited accounts of their daily experiences of drug use as well as their perspectives on the impact of the government's new drug control policies. The main themes voiced by our respondents include: (1) synthetic drugs are not addictive, and are used to feel 'high'; (2) synthetic drugs are used to achieve their goals, which are otherwise impossible through mainstream means; (3) users are confident that they will be able to manage the use of synthetic drugs without harm to themselves; (4) their worries concern administrative punishment rather than consequences to health. The participants of this study did not support the government's attempts to control the use of synthetic drugs. They viewed their use as rational recreation under the perceived boundaries of 'acceptable risks'. Even in the context of severe control, synthetic drugs have strong appeal to youths. Drug policy should acknowledge the experiences of users and consider the socio-cultural contexts of youth drug-taking. The personal experience of participants could help improve the Chinese Drug Control Act and regulations. Copyright © 2014 Elsevier B.V. All rights reserved.

Someone to Count On: Homeless, Male Drug Users and Their Friendship Relations.

ERIC Educational Resources Information Center

Sterk-Elifson, Claire; Elifson, Kirk W.

1992-01-01

A study exploring friendship relations of homeless, male drug users (aged between 21 and 50 years) through 27 in-depth interviews in Atlanta (Georgia) found that subjects were engaged in friendship networks that offered social support and that there was a relationship between friendships and patterns of crack cocaine use. (JB)

Rise in needle sharing among injection drug users in Pakistan during the Afghanistan war.

PubMed

Strathdee, Steffanie A; Zafar, Tariq; Brahmbhatt, Heena; Baksh, Ahmed; ul Hassan, Salman

2003-07-20

The war in Afghanistan in 2001 may have had direct or indirect effects on drug users' behaviors in nearby Pakistan. We studied drug use patterns and correlates of needle sharing among injection drug users (IDUs) in Lahore, Pakistan, before and after the beginning of the Afghanistan war. Between August and October 2001, 244 drug users registering for needle exchange and other services underwent an interviewer-administered survey on sociodemographics, drug use and HIV/AIDS awareness. chi(2)-tests were used to compare drug use behaviors among subjects interviewed before and after October 6th, 2001, coinciding with the start of the Afghanistan war. Correlates of needle sharing among IDUs were identified using logistic regression. Comparing IDUs interviewed before and after October 6th, 2001, levels of needle sharing were significantly higher after the war (56% versus 76%, respectively; P=0.02). Factors independently associated with needle sharing included registering after the war began (adjusted odds ratio, AOR=3.76 (95% CI: 1.23-11.48)), being married (AOR=0.36), being homeless (AOR=3.91), having been arrested (AOR=6.00), and re-using syringes (AOR=6.19). Expansion of needle exchange, drug treatment and supportive services is urgently needed to avoid an explosive HIV epidemic in Pakistan.

The drug-user husband and his wife: attachment styles, family cohesion, and adaptability.

PubMed

Finzi-Dottan, Ricky; Cohen, Orna; Iwaniec, Dorota; Sapir, Yaffa; Weizman, Abraham

2003-01-01

This study which assesses the association between the attachment styles of drug-user husbands (n = 56) and their wives (n = 56) and their perceptions of family dynamics was conducted in 1998. The population study included heroin (52.9%) and multidrug detoxified outpatients. All subjects completed the Adult Attachment Style Scale and the FACES III. Results indicated that the perceptions of family adaptability and cohesion among the drug-user husbands and their wives did not differ from the Israeli norm. Most of the drug users (60.7%) were characterized by the avoidant attachment style, followed by the secure style (26.8%), and the anxious/ambivalent style (12.5%). Half the wives (53.6%) were characterized by the secure style, followed by the avoidant style (42.9%) and the anxious/ambivalent style (3.6%). A secure style in husband and wife was associated with higher levels of family cohesion and adaptability, and the anxious/ambivalent style with a lower perception of family cohesion and adaptability. These findings have important implications for rehabilitation prospects and for planning intervention programs.

Prisoners' views about the drugs problem in prisons, and the new Prison Service drug strategy.

PubMed

Gore, S M; Bird, A G; Cassidy, J

1999-09-01

Three hundred and seventy-five out of 575 prisoners (222/299 drug users and 153/267 non-users) who responded to a self-completion health care questionnaire at two prisons in 1997 commented on drugs in prisons. One hundred and forty-eight out of 176 responses expressed negative opinions about mandatory drugs testing (MDT), and 107 said that MDT promoted switching to or increased use of heroin/hard drugs'. Sixty-two prisoners suggested that more help/counselling was needed for drug users, 52 segregation of drug users/drug-free wings, and 50 more security on visits/in corridors after medication. The new Prison Service drug strategy has revised random MDT. It targets those who supply drugs, and supports those who want to stop using drugs, and accords with prisoners' views about the heroin problem in prisons.

Club drug use and dependence among young adults recruited through time-space sampling.

PubMed

Parsons, Jeffrey T; Grov, Christian; Kelly, Brian C

2009-01-01

Ketamine, methylenedioxymethamphetamine (MDMA/ecstasy), cocaine, gamma-hydroxybutyrate (GHB), methamphetamine, and d-lysergic acid diethylamide (LSD/acid) have been identified as "club drugs" because of their link to club culture among young adults. Yet little is known about users' demographic differences in the prevalence of club drugs. This study sought to provide a comprehensive profile of users' demographic differences in prevalence of club drug use and dependence. Using time-space sampling, a stratified sample of 400 18- to 29-year-old club-going young adults was recruited into the Club Drugs and Health Project. Though participants reported using an array of club drugs, almost all participants (90.0%) were cocaine users. Although there were several sexual orientation and gender differences in recent drug exposure, patterns of use (measured in days) were fairly similar across gender, sexual orientation, and age. Finally, a majority of individuals (58.5%) met or exceeded criteria for club drug dependence, with most (61.7%) indicating cocaine was the one drug causing them significant problems. Cocaine is a major drug in club culture. It is essential to develop culturally appropriate drug education and prevention initiatives for young adults using club drugs.

Hopping on the methadone bus.

PubMed

Lippert, Steffen; Schumacher, Christoph

2009-05-01

This paper investigates the impact of a 'free drug program' on the market equilibrium of drugs. We introduce a screening model of the hard drug market in which dealers use payment and punishment options to screen between high and low risk users. We show that, if a free drug program selects sufficiently many high-risk drug users, the pure-strategy separating market equilibrium ceases to exist and a symmetric mixed-strategy equilibrium results, in which drug users derive a higher expected utility. This encourages new drug users to enter the market. The novelty of the paper is the transmission mechanism for this effect, which is via the influence on market price.

Employment Trajectories: Exploring Gender Differences and Impacts of Drug Use

PubMed Central

Huang, David Y.C.; Evans, Elizabeth; Hara, Motoaki; Weiss, Robert E.; Hser, Yih-Ing

2010-01-01

This study investigated the impact of drug use on employment over 20 years among men and women, utilizing data on 7,661 participants in the National Longitudinal Survey of Youth. Growth mixture modeling was applied, and five distinct employment trajectory groups were identified for both men and women. The identified patterns were largely similar for men and women except that a U-shape employment trajectory was uniquely identified for women. Early-initiation drug users, users of “hard” drugs, and frequent drug users were more likely to demonstrate consistently low levels of employment, and the negative relationship between drug use and employment was more apparent among men than women. Also, positive associations between employment and marriage became more salient for men over time, as did negative associations between employment and childrearing among women. Processes are dynamic and complex, suggesting that throughout the life course, protective factors that reduce the risk of employment problems emerge and change, as do critical periods for maximizing the impact of drug prevention and intervention efforts. PMID:21765533

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization

PubMed Central

Wu, F.; Fu, L.M.; Hser, Y.H.

2015-01-01

Background This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Methods Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Results Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Conclusions Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. PMID:24990956

The social and environmental context of cross-border drug use in Mexico: findings from a mixed methods study of young injection drug users living in San Diego, CA.

PubMed

Wagner, Karla D; Moynihan, Matthew J; Strathdee, Steffanie A; Cuevas-Mota, Jazmine; Clark, Maureen; Zúñiga, María Luisa; Volkmann, Tyson A; Teshale, Eyasu; Garfein, Richard S

2012-01-01

The authors report the results of qualitative (n = 19) and quantitative (n = 545) interviews with young injection drug users (IDUs) in San Diego, California about their experiences using drugs in Tijuana, Mexico, and associated risks for HIV infection. Young IDUs who have ever traveled to Mexico (n = 365) used a variety of injection (54%) and noninjection (30%) drugs there and appear to be heavier users than those who have never traveled to Mexico. Sociocultural themes influencing drug use in Mexico included interactions among the purpose of travel, drug preference, and route of administration; familiarity with the border region; evolving relationships with the United States and Mexican drug markets; and the experience of crossing the U.S.-Mexico border. Interventions for IDUs in border regions need to be sensitive to the ethnicity, familiarity with the border region, and life history of participants, as well as differences in national policies that could influence drug use and risk for HIV on both sides of the border.

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.

An Exploration of Social Circles and Prescription Drug Abuse Through Twitter

PubMed Central

2013-01-01

Background Prescription drug abuse has become a major public health problem. Relationships and social context are important contributing factors. Social media provides online channels for people to build relationships that may influence attitudes and behaviors. Objective To determine whether people who show signs of prescription drug abuse connect online with others who reinforce this behavior, and to observe the conversation and engagement of these networks with regard to prescription drug abuse. Methods Twitter statuses mentioning prescription drugs were collected from November 2011 to November 2012. From this set, 25 Twitter users were selected who discussed topics indicative of prescription drug abuse. Social circles of 100 people were discovered around each of these Twitter users; the tweets of the Twitter users in these networks were collected and analyzed according to prescription drug abuse discussion and interaction with other users about the topic. Results From November 2011 to November 2012, 3,389,771 mentions of prescription drug terms were observed. For the 25 social circles (n=100 for each circle), on average 53.96% (SD 24.3) of the Twitter users used prescription drug terms at least once in their posts, and 37.76% (SD 20.8) mentioned another Twitter user by name in a post with a prescription drug term. Strong correlation was found between the kinds of drugs mentioned by the index user and his or her network (mean r=0.73), and between the amount of interaction about prescription drugs and a level of abusiveness shown by the network (r=0.85, P<.001). Conclusions Twitter users who discuss prescription drug abuse online are surrounded by others who also discuss it—potentially reinforcing a negative behavior and social norm. PMID:24014109

Conflict and user involvement in drug misuse treatment decision-making: a qualitative study

PubMed Central

Fischer, Jan; Neale, Joanne; Bloor, Michael; Jenkins, Nicholas

2008-01-01

Background This paper examines client/staff conflict and user involvement in drug misuse treatment decision-making. Methods Seventy-nine in-depth interviews were conducted with new treatment clients in two residential and two community drug treatment agencies. Fifty-nine of these clients were interviewed again after twelve weeks. Twenty-seven interviews were also conducted with staff, who were the keyworkers for the interviewed clients. Results Drug users did not expect, desire or prepare for conflict at treatment entry. They reported few actual conflicts within the treatment setting, but routinely discussed latent conflicts – that is, negative experiences and problematic aspects of current or previous treatment that could potentially escalate into overt disputes. Conflict resulted in a number of possible outcomes, including the premature termination of treatment; staff deciding on the appropriate outcome; the client appealing to the governance structure of the agency; brokered compromise; and staff skilfully eliciting client consent for staff decisions. Conclusion Although the implementation of user involvement in drug treatment decision-making has the potential to trigger high levels of staff-client conflict, latent conflict is more common than overt conflict and not all conflict is negative. Drug users generally want to be co-operative at treatment entry and often adopt non-confrontational forms of covert resistance to decisions about which they disagree. Staff sometimes deploy user involvement as a strategy for managing conflict and soliciting client compliance to treatment protocols. Suggestions for minimising and avoiding harmful conflict in treatment settings are given. PMID:18837989

Crystal methamphetamine smoking among regular ecstasy users in Australia: increases in use and associations with harm.

PubMed

Kinner, Stuart A; Degenhardt, Louisa

2008-05-01

This study examined (a) changes in crystal methamphetamine use among regular ecstasy users (REU) in Australia and (b) associations of crystal use and smoking with demographics, drug use and harm. Cross-sectional surveys (2000-06) of REU in three Australian capital cities, and in 2006, 750 REU in all Australian capital cities. The interview included: demographics, drug use, risk behaviour, recent criminal activity and methamphetamine dependence using Severity of Dependence Scale. There was little change in overall methamphetamine use, but a marked increase in crystal methamphetamine smoking. Among recent methamphetamine users in 2006 (n = 606), crystal methamphetamine users (n = 364) reported more frequent methamphetamine use and higher levels of dependence. Compared with those who had used only other forms of methamphetamine, recent crystal methamphetamine users were more likely to 'binge' on drugs for > or = 48 hours, engage in crime and experience financial and legal problems related to drug use. Non-smoking crystal methamphetamine users (n = 78) more often reported recent injecting and heroin use. Recent smokers were more likely to have: greater polydrug use, recently overdosed on a 'party drug', and accessed medical services for their drug use. Many of these associations were accounted for by their injecting and heavier methamphetamine use, rather than smoking per se. Crystal methamphetamine smoking among REU has increased markedly and is associated with significant harm. This appears related to smokers' heavier levels of methamphetamine use. Effective harm reduction strategies should be tailored to these specific risks.

A 5-year follow-up study of users of benzodiazepine: starting with diazepam versus oxazepam.

PubMed

Tvete, Ingunn Fride; Bjørner, Trine; Skomedal, Tor

2016-04-01

Drug dependency may develop during long-term benzodiazepine use, indicated, for example, by dose escalation. The first benzodiazepine chosen may affect the risk of dose escalation. To detect possible differences in benzodiazepine use between new users of diazepam and oxazepam over time. This 5-year prescription database study included 19 747 new benzodiazepine users, inhabitants of Norway, aged 30-60 years, with first redemption for diazepam or oxazepam. Individuals starting on diazepam versus oxazepam were analysed by logistic regression with sex, age, other drug redemptions, prescriber's specialty, household income, education level, type of work, and vocational rehabilitation support as background variables. Time to reach a daily average intake of ≥1 defined daily doses (DDD) over a 3-month period was analysed using a Cox proportional hazard regression model. New users of oxazepam had a higher risk for dose escalation compared with new users of diazepam. This was true even when accounting for differences in sociodemographic status and previous drug use (hazard ratio [HR] 1.33, 95% confidence interval = 1.17 to 1.51). Most doctors prescribed, according to recommendations, oxazepam to individuals they may have regarded as prone to and at risk of dependency. However, these individuals were at higher risk for dose escalation even when accounting for differences in sociodemographic status and previous drug use. Differences between the two user groups could be explained by different preferences for starting drug, DDD for oxazepam being possibly too low, and some unaccounted differences in illness. © British Journal of General Practice 2016.

Can the prevalence of high blood drug concentrations in a population be estimated by analysing oral fluid? A study of tetrahydrocannabinol and amphetamine.

PubMed

Gjerde, Hallvard; Verstraete, Alain

2010-02-25

To study several methods for estimating the prevalence of high blood concentrations of tetrahydrocannabinol and amphetamine in a population of drug users by analysing oral fluid (saliva). Five methods were compared, including simple calculation procedures dividing the drug concentrations in oral fluid by average or median oral fluid/blood (OF/B) drug concentration ratios or linear regression coefficients, and more complex Monte Carlo simulations. Populations of 311 cannabis users and 197 amphetamine users from the Rosita-2 Project were studied. The results of a feasibility study suggested that the Monte Carlo simulations might give better accuracies than simple calculations if good data on OF/B ratios is available. If using only 20 randomly selected OF/B ratios, a Monte Carlo simulation gave the best accuracy but not the best precision. Dividing by the OF/B regression coefficient gave acceptable accuracy and precision, and was therefore the best method. None of the methods gave acceptable accuracy if the prevalence of high blood drug concentrations was less than 15%. Dividing the drug concentration in oral fluid by the OF/B regression coefficient gave an acceptable estimation of high blood drug concentrations in a population, and may therefore give valuable additional information on possible drug impairment, e.g. in roadside surveys of drugs and driving. If good data on the distribution of OF/B ratios are available, a Monte Carlo simulation may give better accuracy. 2009 Elsevier Ireland Ltd. All rights reserved.

The drug use behaviour of cocaine users.

PubMed

Moosburger, R; Plant, A J; Pierce, J P

1990-01-01

We interviewed 50 current cocaine users with the aim of providing insights into cocaine use in Sydney. The study sample was obtained by one researcher using a chain referral technique. Appointments were made for interview and the interview aimed to determine the quantity, frequency, pattern and circumstances of drug use in the respondents. The study sample included people with a wide range of incomes and occupations; all but one person were employed. Extensive current drug use was reported; 78% smoked tobacco, 98% drank alcohol with 36% having more than two drinks per day, 96% used marijuana with 40% smoking marijuana at least 5 times per week, 65% used amphetamines, 36% used hallucinogens and 10% used heroin. Ten per cent were unable to name one health risk of cocaine. When asked about the image of a cocaine user, 42% thought of a rock star, film industry worker or someone involved in the arts and entertainment world. The information obtained from a study such as this provides important data for targeting of people in anti-drug campaigns.

Prevalence and correlates of psychological distress among drug users in Phnom Penh, Cambodia.

PubMed

Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Choub, Sok Chamreun; Mburu, Gitau

2016-10-01

Compared to the general population, drug users are at increased risk of both poor mental health and HIV infection. The aim of this study was to determine the prevalence and correlates of high psychological distress among drug users in Cambodia. In April 2014, a two-stage cluster sampling method was used to randomly select 169 drug users from hotspots in Phnom Penh. Psychological distress was measured using General Health Questionnaire (GHQ-12). Bivariate and multivariable analyses were conducted to identify factors associated with levels of psychological distress among this population. Our study found high prevalence of attempted suicide (15.3%), drug related arrests (46.2%), and incarceration (31.4%). Of the 169 participants, 42.0% were found to have high levels of psychological distress, indicating poor mental health. After adjustment, high levels of psychological distress were independently associated with suicidal ideation (p<0.001), higher frequency of drug use (p=0.02), sharing of needles or syringes (p=0.005), and having been sent to a rehabilitation centre (p=0.02). In addition, participants who perceived their overall health as being poor or very poor were more likely to have high levels of psychological distress (p=0.002). Integration of mental health within HIV and needle and syringe exchange programmes is required to address psychological distress among drug users in Cambodia. Health system interventions, such as screening, referral, and training of health providers, need to be strengthened. In addition, interventions addressing social determinants of mental health and mitigation of frequent arrests and improving conditions in rehabilitation centres are required. Copyright © 2016 Elsevier B.V. All rights reserved.

Generic versus branded medicines: An observational study among patients with chronic diseases attending a public hospital outpatient department

PubMed Central

Das, Manisha; Choudhury, Supriyo; Maity, Somnath; Hazra, Avijit; Pradhan, Tirthankar; Pal, Aishee; Roy, Ranendra Kumar

2017-01-01

Background: The concept of generic prescription is widely accepted in various parts of the world. Nevertheless, it has failed to gain popularity in India due to factors such as nonavailability and distrust on the product quality. However, since 2012, the Government of West Bengal, India, has initiated exclusive generic drug outlets called “fair price medicine shop” (FPMS) inside the government hospital premises in a “public-private-partnership” model. This study was undertaken to evaluate the experience and attitude of patients who were consuming generic drugs purchased from these FPMS. Materials and Methods: It was a questionnaire-based cross-sectional study where we have interviewed 100 patients each consuming generic and branded drugs, respectively. The perceived effectiveness, reported safety, medication adherence, cost of therapy, and availability of drugs was compared between two mentioned groups. Medication adherence was estimated through Drug Attitude Inventory-10. Results: 93% of generic and 87% branded drug users believed that their drugs were effective (P = 0.238) in controlling their ailments. No significant difference (9% generic, 10% branded drug users, P = 1.000) was observed in reported adverse effects between generic and branded drug users. 82% and 77% of patients were adherent generic and branded drugs, respectively (P = 0.289). As expected, a significantly lower cost of generic drugs was observed compared to its branded counterpart. Conclusion: The policy of FPMS implemented by the Government of West Bengal, India appeared to be promising in terms of perceived effectiveness, safety, and adherence of generic drugs from FPMS compared to drugs purchased from open market retailers. Therefore, this study might act as an impetus for the policy-makers to initiate similar models across the country. PMID:28250671

Willingness to pay for methadone maintenance treatment in Vietnamese epicentres of injection-drug-driven HIV infection.

PubMed

Tran, Bach Xuan

2013-07-01

Willingness to pay for methadone maintenance treatment (MMT) in three Vietnamese epicentres of injection-drug-driven human immunodeficiency virus (HIV) infection was assessed. A convenience sample of 1016 patients receiving HIV treatment in seven clinics was enrolled during 2012. Contingent valuation was used to assess willingness to pay. Interviewers reviewed adverse consequences of injection drug use and the benefits of MMT. Interviewers then described the government's plan to scale up MMT and the financial barriers to scale-up. Willingness to pay was assessed using double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay. A total of 548 non-drug-users and 468 injection drug users were enrolled; 988 were willing to pay for MMT. Monthly mean willingness to pay among non-drug-users, 347 drug users not receiving MMT and 121 drug users receiving MMT was 10.7 United States dollars [US$] (35.7% of treatment costs), US$ 21.1 (70.3%) and US$ 26.2 (87.3%), respectively (mean: US$ 15.9; 95% confidence interval, CI: 13.6-18.1). Fifty per cent of drug users were willing to pay 50% of MMT costs. Residence in households with low monthly per capita income and poor health status predicted willingness to pay less among drug users; educational level, employment status, health status and current antiretroviral therapy receipt predicted willingness to pay less among non-drug-users. Willingness to pay for MMT was very high, supporting implementation of a co-payment programme.

The geographic distribution patterns of HIV-, HCV- and co-infections among drug users in a national methadone maintenance treatment program in Southwest China.

PubMed

Zhou, Yi-Biao; Liang, Song; Wang, Qi-Xing; Gong, Yu-Han; Nie, Shi-Jiao; Nan, Lei; Yang, Ai-Hui; Liao, Qiang; Song, Xiu-Xia; Jiang, Qing-Wu

2014-03-10

HIV-, HCV- and HIV/HCV co-infections among drug users have become a rapidly emerging global public health problem. In order to constrain the dual epidemics of HIV/AIDS and drug use, China has adopted a methadone maintenance treatment program (MMTP) since 2004. Studies of the geographic heterogeneity of HIV and HCV infections at a local scale are sparse, which has critical implications for future MMTP implementation and health policies covering both HIV and HCV prevention among drug users in China. This study aimed to characterize geographic patterns of HIV and HCV prevalence at the township level among drug users in a Yi Autonomous Prefecture, Southwest of China. Data on demographic and clinical characteristics of all clients in the 11 MMTP clinics of the Yi Autonomous Prefecture from March 2004 to December 2012 were collected. A GIS-based geographic analysis involving geographic autocorrelation analysis and geographic scan statistics were employed to identify the geographic distribution pattern of HIV-, HCV- and co-infections among drug users. A total of 6690 MMTP clients was analyzed. The prevalence of HIV-, HCV- and co-infections were 25.2%, 30.8%, and 10.9% respectively. There were significant global and local geographic autocorrelations for HIV-, HCV-, and co-infection. The Moran's I was 0.3015, 0.3449, and 0.3155, respectively (P < 0.0001). Both the geographic autocorrelation analysis and the geographic scan statistical analysis showed that HIV-, HCV-, and co-infections in the prefecture exhibited significant geographic clustering at the township level. The geographic distribution pattern of each infection group was different. HIV-, HCV-, and co-infections among drug users in the Yi Autonomous Prefecture all exhibited substantial geographic heterogeneity at the township level. The geographic distribution patterns of the three groups were different. These findings imply that it may be necessary to inform or invent site-specific intervention strategies to better devote currently limited resource to combat these two viruses.

Psychophysiological responses to drug-associated stimuli in chronic heavy cannabis use.

PubMed

Wölfling, Klaus; Flor, Herta; Grüsser, Sabine M

2008-02-01

Due to learning processes originally neutral stimuli become drug-associated and can activate an implicit drug memory, which leads to a conditioned arousing 'drug-seeking' state. This condition is accompanied by specific psychophysiological responses. The goal of the present study was the analysis of changes in cortical and peripheral reactivity to cannabis as well as alcohol-associated pictures compared with emotionally significant drug-unrelated and neutral pictures in long-term heavy cannabis users. Participants were 15 chronic heavy cannabis users and 15 healthy controls. Verbal reports as well as event-related potentials of the electroencephalogram and skin conductance responses were assessed in a cue-reactivity paradigm to determine the psychophysiological effects caused by drug-related visual stimulus material. The evaluation of self-reported craving and emotional processing showed that cannabis stimuli were perceived as more arousing and pleasant and elicited significantly more cannabis craving in cannabis users than in healthy controls. Cannabis users also demonstrated higher cannabis stimulus-induced arousal, as indicated by significantly increased skin conductance and a larger late positivity of the visual event-related brain potential. These findings support the assumption that drug-associated stimuli acquire increased incentive salience in addiction history and induce conditioned physiological patterns, which lead to craving and potentially to drug intake. The potency of visual drug-associated cues to capture attention and to activate drug-specific memory traces and accompanying physiological symptoms embedded in a cycle of abstinence and relapse--even in a 'so-called' soft drug--was assessed for the first time.

National record linkage study of mortality for a large cohort of opioid users ascertained by drug treatment or criminal justice sources in England, 2005–2009

PubMed Central

Pierce, Matthias; Bird, Sheila M.; Hickman, Matthew; Millar, Tim

2015-01-01

Background Globally, opioid drug use is an important cause of premature mortality. In many countries, opioid using populations are ageing. The current study investigates mortality in a large cohort of opioid users; with a focus on testing whether excess mortality changes with age. Methods 198,247 opioid users in England were identified from drug treatment and criminal justice sources (April, 2005 to March, 2009) and linked to mortality records. Mortality rates and standardised mortality ratios (SMRs) were calculated by age-group and gender. Results There were 3974 deaths from all causes (SMR 5.7, 95% Confidence Interval: 5.5 to 5.9). Drug-related poisonings (1715) accounted for 43% of deaths. Relative to gender-and-age-appropriate expectation, mortality was elevated for a range of major causes including: infectious, respiratory, circulatory, liver disease, suicide, and homicide. Drug-related poisoning mortality risk continued to increase beyond 45 years and there were age-related increases in SMRs for specific causes of death (infectious, cancer, liver cirrhosis, and homicide). A gender by age-group interaction revealed that whilst men have a greater drug-related poisoning mortality risk than women at younger ages, the difference narrows with increasing age. Conclusion Opioid users’ excess mortality persists into old age and for some causes is exacerbated. This study highlights the importance of managing the complex health needs of older opioid users. PMID:25454405

Preliminary evidence of hippocampal damage in chronic users of ecstasy.

PubMed

den Hollander, Bjørnar; Schouw, Marieke; Groot, Paul; Huisman, Henk; Caan, Matthan; Barkhof, Frederik; Reneman, Liesbeth

2012-01-01

Various studies have shown that ecstasy (3,4-methylenedioxymethamphetamine) users display significant memory impairments, whereas their performance on other cognitive tests is generally normal. The hippocampus plays an essential role in short-term memory. There are, however, no structural human data on the effects of ecstasy on the hippocampus. The objective of this study was to investigate whether the hippocampal volume of chronic ecstasy users is reduced when compared with healthy polydrug-using controls, as an indicator of hippocampal damage. The hippocampus was manually outlined in volumetric MRI scans in 10 male ecstasy users (mean age 25.4 years) and seven healthy age- and gender-matched control subjects (21.3 years). Other than the use of ecstasy, there were no statistically significant differences between both groups in exposure to other drugs of abuse and alcohol. The ecstasy users were on average drug-free for more than 2 months and had used on average 281 tablets over the past six and a half years. The hippocampal volume in the ecstasy using group was on average 10.5% smaller than the hippocampal volume in the control group (p=0.032). These data provide preliminary evidence that ecstasy users may be prone to incurring hippocampal damage, in line with previous reports of acute hippocampal sclerosis and subsequent atrophy in chronic users of this drug.

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users.

PubMed

Corsi, Karen F; Lehman, Wayne E; Min, Sung-Joon; Lance, Shannon P; Speer, Nicole; Booth, Robert E; Shoptaw, Steve

2012-06-04

This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk.

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users

PubMed Central

Corsi, Karen F.; Lehman, Wayne E.; Min, Sung-Joon; Lance, Shannon P.; Speer, Nicole; Booth, Robert E.; Shoptaw, Steve

2013-01-01

This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk. PMID:23493796

Mephedrone and 3,4-methylenedioxy-methamphetamine: Comparative psychobiological effects as reported by recreational polydrug users.

PubMed

Jones, Lewis; Reed, Phil; Parrott, Andrew

2016-12-01

The purpose of this study was to compare the effects of mephedrone and 3,4-methylenedioxy-methamphetamine (MDMA), as reported by young recreational polydrug users. 152 MDMA users and 81 mephedrone users were recruited through snowballing on social network sites. They completed a standard online questionnaire for either mephedrone or MDMA. The questions covered the average amount taken per session, the longest duration of usage in the last 12-months, subjective effects while on-drug, and recovery effects in the days afterwards. Mephedrone users reported a significantly longer maximum session of use than MDMA users. Mephedrone users also reported a significantly greater average amount used per session. The majority of on-drug subjective ratings did not differ between drugs, with similar increases in entactogenic effects. Although mephedrone users did report significantly more frequent issues with sleeping, anger and anxiety. In relation to recovery, mephedrone users reported more frequent craving, nasal irritation, paranoia, and relationship difficulties. Mephedrone users also rated general recovery effects as more severe over the seven-day period following use, taking more days to feel normal. The acute effects of MDMA and mephedrone were broadly similar. However, the recovery period for mephedrone was more enduring, possibly due to the longer duration of acute session usage. © The Author(s) 2016.

Response inhibition moderates the association between drug use and risky sexual behavior.

PubMed

Nydegger, Liesl A; Ames, Susan L; Stacy, Alan W; Grenard, Jerry L

2014-09-01

HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.

Are drug treatment services only for 'thieving junkie scumbags'? Drug users and the management of stigmatised identities.

PubMed

Radcliffe, Polly; Stevens, Alex

2008-10-01

This article uses qualitative interviews with 53 problematic drug users who had dropped out of treatment in England, UK to explore how they describe the stigmatisation of drug users and drug services. It discusses the construction of the category of the junkie through its association with un-controlled heroin use and criminality. It shows how some drug users carefully manage information about their discreditable identities by excluding themselves from this category, while acknowledging its validity for other drug users. The junkie identity was generally seen as shameful and therefore to be avoided, although it holds attractions for some drug users. For many of the interviewees, entry to treatment risked exposing their own activities as shaming, as they saw treatment as being a place that was populated by junkies and where it becomes more difficult to manage discreditable information. The treatment regime, e.g. the routine of supervised consumption of methadone, was itself seen by some as stigmatising and was also seen as hindering progress to the desired 'normal' life of conventional employment. Participation in the community of users of both drugs and drug services was perceived as potentially damaging to the prospects of recovery. This emphasises the importance of social capital, including links to people and opportunities outside the drug market. It also highlights the danger that using the criminal justice system to concentrate prolific offenders in treatment may have the perverse effects of excluding other people who have drug problems and of prolonging the performance of the junkie identity within treatment services. It is concluded that treatment agencies should address these issues, including through the provision of more drug services in mainstream settings, in order to ensure that drug services are not seen to be suitable only for one particularly stigmatised category of drug user.

Social context of needle selling in Baltimore, Maryland.

PubMed

Latkin, Carl A; Davey, Melissa A; Hua, Wei

2006-01-01

Although much of the debate surrounding the distribution of sterile syringes to injection drug users (IDUs) has focused on needle exchange programs (NEPs), IDUs acquire their syringes from three major sources: NEPs, pharmacies, and secondary exchangers or needle sellers. The purpose of the present study is to examine types and frequencies of social interactions among drug injectors who sell needles, most of which come from NEPs, compared with individuals who do not sell needles. Specifically, we compared engagement in drug-related behaviors, roles in the drug economy, and social network membership. Data were collected as part of the SHIELD study, an HIV prevention intervention targeted at drug users and their social networks (n=910) from February 2001 through September 2003 in Baltimore, Maryland (USA). In this sample, 56 participants reported selling needles. Needle sellers had higher levels of engagement in drug-related social interactions, including using drugs with others, giving or receiving drugs from others, and buying drugs with other users. Participants who sold needles had a significantly higher number of roles in the drug economy. Also, they had more social network members who were injectors, with whom they talked about risky drug behaviors, gave needles to, and shared cookers and bleach with. Compared with nonselling injectors, needle sellers engage in HIV risk-related behaviors, such as injecting daily and sharing injection equipment, more frequently. The study's findings may be useful to determine whether secondary exchangers should be targeted for HIV prevention activities both to reduce their own risk and to diffuse risk reduction information throughout the drug using community.

77 FR 72359 - Animal Generic Drug User Fee Act; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

... increase the revenue stream stability and reduce application fee costs. III. What information should you...] Animal Generic Drug User Fee Act; Public Meeting; Request for Comments AGENCY: Food and Drug... announcing the following meeting: Animal Generic Drug User Fee Act. The topic to be discussed is proposed...

Recent national trends in Salvia divinorum use and substance-use disorders among recent and former Salvia divinorum users compared with nonusers

PubMed Central

Wu, Li-Tzy; Woody, George E; Yang, Chongming; Li, Jih-Heng; Blazer, Dan G

2011-01-01

Context Media and scientific reports have indicated an increase in recreational use of Salvia divinorum. Epidemiological data are lacking on the trends, prevalence, and correlates of S. divinorum use in large representative samples, as well as the extent of substance use and mental health problems among S. divinorum users. Objective To examine the national trend in prevalence of S. divinorum use and to identify sociodemographic, behavioral, mental health, and substance-use profiles of recent (past-year) and former users of S. divinorum. Design Analyses of public-use data files from the 2006–2008 United States National Surveys on Drug Use and Health (N = 166,453). Setting Noninstitutionalized individuals aged 12 years or older were interviewed in their places of residence. Main measures Substance use, S. divinorum, self-reported substance use disorders, criminality, depression, and mental health treatment were assessed by standardized survey questions administered by the audio computer-assisted self-interviewing method. Results Among survey respondents, lifetime prevalence of S. divinorum use had increased from 0.7% in 2006 to 1.3% in 2008 (an 83% increase). S. divinorum use was associated with ages 18–25 years, male gender, white or multiple race, residence of large metropolitan areas, arrests for criminal activities, and depression. S. divinorum use was particularly common among recent drug users, including users of lysergic acid diethylamide (53.7%), ecstasy (30.1%), heroin (24.2%), phencyclidine (22.4%), and cocaine (17.5%). Adjusted multinomial logistic analyses indicated polydrug use as the strongest determinant for recent and former S. divinorum use. An estimated 43.0% of past-year S. divinorum users and 28.9% of former S. divinorum users had an illicit or nonmedical drug-use disorder compared with 2.5% of nonusers. Adjusted logistic regression analyses showed that recent and former S. divinorum users had greater odds of having past-year depression and a substance-use disorder (alcohol or drugs) than past-year alcohol or drug users who did not use S. divinorum. Conclusion S. divinorum use is prevalent among recent or active drug users who have used other hallucinogens or stimulants. The high prevalence of substance use disorders among recent S. divinorum users emphasizes the need to study health risks of drug interactions. PMID:21709724

Drug Retention Times

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

The purpose of this monograph is to provide information on drug retention times in the human body. The information provided is based on plausible illegal drug use activities that might be engaged in by a recreational drug user. Based on anecdotal evidence, most people “party” during extended time away from the work environment. Therefore, the following scenarios were envisioned: (1) a person uses an illicit drug at a party on Saturday night (infrequent user); (2) a person uses a drug one time on Friday night and once again on Saturday night (infrequent user); and (3) a person uses a drugmore » on Friday night, uses a drug twice on Saturday night, and once again on Sunday (frequent user).« less

Playing the Game or Played by the Game? Young Drug Users' Educational Trajectories

ERIC Educational Resources Information Center

Järvinen, Margaretha; Ravn, Signe

2018-01-01

This article analyses the relationship between cannabis use and educational trajectories among 42 young drug users, recruited at addiction treatment centres in Denmark. Quantitative research shows regular cannabis use to be associated with poor school performance and drop-out. However, these studies do not pay much attention to differences between…

Interpersonal Relationship Styles in Marathon Group Therapy: A Study with Illicit Drug Users.

ERIC Educational Resources Information Center

Page, Richard C.; Bridges, Ned

1983-01-01

Assessed how illegal drug users (N=12) related to one another during a 16-hour unstructured group marathon. Interaction analysis supported the effectiveness of the marathon group. Members and facilitators were able to relate to each other by confronting significant behaviors and receiving feedback about ways to cope with personal problems. (JAC)

Translation and validation of the Brown attention-deficit disorder scale for use in Brazil: identifying cases of attention-deficit/hyperactivity disorder among samples of substance users and non-users. Cross-cultural validation study.

PubMed

Kakubo, Simone Mayumi; Mendez, Mariel; Silveira, Juliana Doering; Maringolo, Leonardo; Nitta, Conrado; Silveira, Dartiu Xavier da; Fidalgo, Thiago Marques

2018-04-23

The Brown Attention-Deficit Disorder Scale (BADDS) was developed as a self-report assessment that was designed to screen for presence of symptoms of attention deficit hyperactivity disorder (ADHD). The objective here was to translate and validate the adult self-report BADDS for use in Brazil. Cross-cultural validation study conducted in an addiction unit at a public university hospital. This study included a control group (n = 100) and a drug-user group (n = 100). Both groups included subjects aged 18 to 60 years old. The control group had no prior diagnosis of drug addiction and the drug-user group included participants with a diagnosis of addiction. Each participant answered Brazilian Portuguese translations of both the BADDS and the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS) questionnaires, in paper-and-pencil format. The drug-user group scored higher than the control group on both scales. The mean scores on ASRS were 27.26 (standard deviation, SD: 11.99) and 25.85 (SD: 8.65) respectively (P > 0.05). The mean scores on BADDS were 79.56 (SD: 29.61) and 79.31 (SD: 18.09), respectively (P > 0.05). Cronbach's alpha for BADDS was 0.95. BADDS presented fair sensitivity (72% accuracy) and fair specificity (88% accuracy). This study provides discriminative validity evidence for use of BADDS among Brazilian adults with substance-use disorders.

Social influences upon injection initiation among street-involved youth in Vancouver, Canada: a qualitative study

PubMed Central

Small, Will; Fast, Danya; Krusi, Andrea; Wood, Evan; Kerr, Thomas

2009-01-01

Background Street-involved youth are a population at risk of adopting injection as a route of administration, and preventing the transition to injection drug use among street youth represents a public health priority. In order to inform epidemiological research and prevention efforts, we conducted a qualitative study to investigate the initiation of injection drug use among street-involved youth in Vancouver, Canada. Methods Qualitative interviews with street youth who inject drugs elicited descriptions of the adoption of injection as a route of administration. Interviewees were recruited from the At-Risk Youth Study (ARYS), a cohort of street-involved youth who use illicit drugs in Vancouver, Canada. Audio recorded interviews were transcribed verbatim and a thematic analysis was conducted. Results 26 youth aged 16 to 26 participated in this study, including 12 females. Among study participants the first injection episode frequently featured another drug user who facilitated the initiation of injecting. Youth narratives indicate that the transition into injecting is influenced by social interactions with drug using peers and evolving perceptions of injecting, and rejecting identification as an injector was important among youth who did not continue to inject. It appears that social conventions discouraging initiating young drug users into injection exist among established injectors, although this ethic is often ignored. Conclusion The importance of social relationships with other drug users within the adoption of injection drug use highlights the potential of social interventions to prevent injection initiation. Additionally, developing strategies to engage current injectors who are likely to initiate youth into injection could also benefit prevention efforts. PMID:19405977

What are the factors associated with HIV testing among male injecting and non-injecting drug users in Lashio, Myanmar: a cross-sectional study.

PubMed

Saw, Yu Mon; Yasuoka, Junko; Saw, Thu Nandar; Poudel, Krishna C; Tun, Soe; Jimba, Masamine

2013-06-20

HIV testing is an effective intervention for reducing HIV risk and providing information on HIV status. However, uptake of HIV testing is a major challenge within the drug-using population due to the stigma and discrimination associated with their illegal drug use behaviours. This study thus aimed to identify factors associated with HIV testing among injecting drug users (IDUs) and non-injecting drug users (NIDUs) in Lashio, Myanmar. A cross-sectional study was conducted from January 2010 to February 2010. This study was carried out in Lashio city, Northern Shan State, Myanmar. In total, 158 male IDUs and 210 male NIDUs were recruited using a respondent-driven sampling method. Proportion of both drug users who were ever tested for HIV and factors associated with HIV testing. Approximately 77% of IDUs and 46% of NIDUs were ever tested for HIV. The multivariate analysis revealed that having ever received drug treatment was positively associated with HIV testing among both IDUs (adjusted OR (AOR) 13.07; 95% CI 3.38 to 50.53) and NIDUs (AOR 3.58; 95% CI 1.38 to 9.24). IDUs who were married (AOR 0.24; 95% CI 0.06 to 0.94) and who injected at least twice daily (AOR 0.30; 95% CI 0.09 to 0.97) were less likely to undergo HIV testing. Among NIDUs, those who belonged to Shan (AOR 0.30; 95% CI 0.11 to 0.84) or Kachin (AOR 0.30; 95% CI 0.10 to 0.87) ethnicities were less likely to test for HIV. IDUs and NIDUs who have received drug treatment are more likely to test for HIV. Integrating HIV testing into drug treatment programmes alongside general expansion of HIV testing services may be effective in increasing HIV testing uptake among both IDUs and NIDUs in the Northern Shan State of Myanmar.

Cigarette smoking among marijuana users in the United States.

PubMed

Richter, Kimber P; Kaur, Haroshena; Resnicow, Ken; Nazir, Niaman; Mosier, Michael C; Ahluwalia, Jasjit S

2004-06-01

The vast majority of drug users smoke cigarettes. Most use marijuana and no other illicit drug. We analyzed adult responses to the 1997 NHSDA (n = 16,661) to explore relationships between marijuana use and cigarette smoking. Multivariate analyses controlled for other illicit drug use and other potential covariates. Nearly three-quarters of current marijuana users (74%) smoked cigarettes. Compared to nonusers, the adjusted odds of being a smoker were 5.43 for current marijuana users, 3.58 for past year marijuana users, and 2.02 for former marijuana users. Odds for cigarette smoking among current poly-drug users, compared to nonusers, were 2.3 to 1. Level of cigarette smoking was directly associated with frequency of marijuana use. Nationwide, an estimated 7 million adults smoke both substances and are at increased risk for respiratory illnesses and mortality. Cigarette smoking is a major co-morbidity of marijuana use and smoking cessation should be addressed among marijuana users in addition to their other illicit drug involvement.

Oral health assessment for users of marijuana and cocaine/crack substances.

PubMed

Sordi, Mariane Beatriz; Massochin, Rachel Captzan; Camargo, Alessandra Rodrigues de; Lemos, Tadeu; Munhoz, Etiene de Andrade

2017-12-18

The objective of this study was to assess the oral health status of users of illicit drugs such as marijuana and cocaine/crack and compare it with individuals not using these chemical substances. Questionnaires were applied to 35 illicit drugs users to gather information on demographic status, general health, and use of drugs. Then, a clinical assessment of the oral health condition was performed to collect data on decayed, missing and filled teeth (DMFT) index, salivary flow rate (SFR), and mucosal lesions. The control group was composed of 35 non-illicit drug users. In the experimental group, 91.43% were males, 80% were smokers, and 42.85% were alcoholics. Cocaine was the most common drug used (77.15%), followed by marijuana (68.6%), and crack (51.4%). The average DMFT index was 9.8 and the SFR was reduced in 60% of subjects. Mucosal alterations were detected, but no potentially malignant disorders or oral cancer were diagnosed. Compared to control group, significantly higher values for gender (40%, p = 0.0001), smoking (22.86%) and heavy drinking (5.7%) habits (p = 0.0001), SFR (31.4%; p = 0.0308), and oral lesions (p = 0.0488) were found for the experimental group, although significantly higher values were found in the control group for DMFT index (p = 0.0148). It can be concluded that the use of illicit drugs contributed to an increased prevalence of oral mucosa lesions. In addition, a decline on SFR and a reduced DMFT index was observed for illicit drug users.

Policing, massive street drug testing and poly-substance use chaos in Georgia - a policy case study.

PubMed

Otiashvili, David; Tabatadze, Mzia; Balanchivadze, Nino; Kirtadze, Irma

2016-01-16

Since early 2000, intensive policing, wide scale street drug testing, and actions aimed at limiting the availability of specific drugs have been implemented in Georgia. Supporters of this approach argue that fear of drug testing and resulting punishment compels drug users to stop using and prevents youth from initiating drug use. It has been also stated that reduction in the availability of specific drugs should be seen as an indication of the overall success of counter-drug efforts. The aim of the current review is to describe the drug-related law enforcement response in Georgia and its impact on illicit drug consumption and drug-related harm. We reviewed relevant literature that included peer-reviewed scientific articles, stand-alone research reports, annual drug situation reports, technical reports and program data. This was also supplemented by the review of relevant legislation and judicial practices for the twelve year period between 2002 and 2014. Every episode of reduced availability of any "traditional" injection drug was followed by the discovery/introduction of a new injection preparation. The pattern of drug consumption was normally driven by users' attempts to substitute their drug of choice through mixing together available alternative substances. Chaotic poly-substance use and extensive utilization of home-made injection drugs, prepared from toxic precursors, became common. Massive random street drug testing had little or no effect on the prevalence of problem drug use. Intensive harassment of drug users and exclusive focus on reducing the availability of specific drugs did not result in reduction of the prevalence of injecting drug use. Repressive response of Georgian anti-drug authorities relied heavily on consumer sanctions, which led to shifts in drug users' behavior. In most cases, these shifts were associated with the introduction and use of new toxic preparations and subsequent harm to the physical and mental health of drug consumers.

The relationship between social network characteristics and exchanging sex for drugs or money among drug users in Baltimore, MD, USA.

PubMed

Latkin, C A; Hua, W; Forman, V L

2003-11-01

The current study examined social network and drug use factors associated with buying and selling sex among a sample of opiate and cocaine users in Baltimore, Maryland. A sample of 702 drug users who were sexually active were administered a social network and risk behaviour inventory. Compared to 25% of men, only 1.7% of women reported a history of giving money or drugs to get sex during the past 90 days. Conversely, more women (21.2%) than men (4.7%) sold sex for money or drugs. Those who sold sex were more likely to be low frequency crack smokers, were more likely to drink alcohol at least once a day, had a higher average number of crack-only smokers in their network, and had a smaller number of kin in their network. Men who exchanged money or drugs for sex tended to be low frequency crack smokers and reported having more crack-only smokers and injectors and fewer kin in their networks. The results suggest that network composition may be a risk factor for exchanging sex, particularly with respect to crack users, while kin may be a protective factor. These associations may be either a cause or consequence of exchanging sex.

Whither RDS? An investigation of Respondent Driven Sampling as a method of recruiting mainstream marijuana users

PubMed Central

2010-01-01

Background An important challenge in conducting social research of specific relevance to harm reduction programs is locating hidden populations of consumers of substances like cannabis who typically report few adverse or unwanted consequences of their use. Much of the deviant, pathologized perception of drug users is historically derived from, and empirically supported, by a research emphasis on gaining ready access to users in drug treatment or in prison populations with higher incidence of problems of dependence and misuse. Because they are less visible, responsible recreational users of illicit drugs have been more difficult to study. Methods This article investigates Respondent Driven Sampling (RDS) as a method of recruiting experienced marijuana users representative of users in the general population. Based on sampling conducted in a multi-city study (Halifax, Montreal, Toronto, and Vancouver), and compared to samples gathered using other research methods, we assess the strengths and weaknesses of RDS recruitment as a means of gaining access to illicit substance users who experience few harmful consequences of their use. Demographic characteristics of the sample in Toronto are compared with those of users in a recent household survey and a pilot study of Toronto where the latter utilized nonrandom self-selection of respondents. Results A modified approach to RDS was necessary to attain the target sample size in all four cities (i.e., 40 'users' from each site). The final sample in Toronto was largely similar, however, to marijuana users in a random household survey that was carried out in the same city. Whereas well-educated, married, whites and females in the survey were all somewhat overrepresented, the two samples, overall, were more alike than different with respect to economic status and employment. Furthermore, comparison with a self-selected sample suggests that (even modified) RDS recruitment is a cost-effective way of gathering respondents who are more representative of users in the general population than nonrandom methods of recruitment ordinarily produce. Conclusions Research on marijuana use, and other forms of drug use hidden in the general population of adults, is important for informing and extending harm reduction beyond its current emphasis on 'at-risk' populations. Expanding harm reduction in a normalizing context, through innovative research on users often overlooked, further challenges assumptions about reducing harm through prohibition of drug use and urges consideration of alternative policies such as decriminalization and legal regulation. PMID:20618944

Prison, a missing target to address issues related to drug detoxification and rehabilitation: Nepalese experiences.

PubMed

Kant Jha, Chandra; M Donovan, Dennis

2013-01-01

Drug use has numerous consequences on health, the economy, culture and the peace and security of families and communities. Drug users often engage in various criminal activities, including drug dealing, to sustain their drug use. Under Nepalese law, consumption, possession and sale of drugs are illegal, which increases the risk of incarceration for drug users. Using a phenomenological/qualitative approach, the paper explores how various activities can lead to the arrest of drug users, how they cope without taking drugs in custody and prison and how they plan abstinence after release. Participants engaged in various categories of criminal activity, including stealing, looting, etc. Most of the drug users were in custody and prison at least once. Drug use relapses led the participants to re-engage in criminal activities including drug dealing. Parents were often overburdened by their sons and daughter's drug use and were worried about their repeated relapses. Finally, some parents negotiated with their sons and daughters to keep them in prison where they would be able to stay without taking drugs and their involvement in crimes and conflicts would decrease. Keeping substance abusers in prison does not appear to be an effective strategy, as many participants relapse after release from prison. However, a prison-based educational and health promotion strategy would be beneficial for drug users to develop knowledge and skills on staying drug-free. However, to date, no effort has been made to provide such services to drug users and develop their coping strategy after release.

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil.

PubMed

Pacheco, Suzy Danielly Barbosa; Silva-Oliveira, Gláucia Caroline; Maradei-Pereira, Luciana Maria Cunha; Crescente, José Ângelo Barletta; Lemos, José Alexandre Rodrigues de; Oliveira-Filho, Aldemir Branco de

2014-01-01

Illicit drug users (DUs) are vulnerable to hepatitis C virus (HCV) infection. The shared use of illicit drugs is the main method of HCV transmission. A cross-sectional study was conducted in Breves, in northern Brazil. We surveyed 187 DUs to determine the prevalence of and factors associated with HCV infection. The prevalence of anti-HCV antibodies was 36.9%, and the prevalence of hepatitis C virus-ribonucleic acid (HCV-RNA) was 31%. Hepatitis C virus infection was associated with tattoos, intravenous drug use, shared use of equipment for drug use, drug use for longer than 3 years, and daily drug use. Strategies for preventing and controlling HCV transmission should be implemented among DUs.

Health care service utilization and associated factors among heroin users in northern Taiwan.

PubMed

Chen, Yi-Chih; Chen, Chih-Ken; Lin, Shih-Ku; Chiang, Shu-Chuan; Su, Lien-Wen; Wang, Liang-Jen

2013-11-01

Due to the needs of medical care, the probability of using health care service from heroin users is high. This cross-sectional study investigated the frequency and correlates of health service utilization among heroin users. From June to September 2006, 124 heroin users (110 males and 14 females, mean age: 34.2 ± 8.3 years) who entered two psychiatric hospitals (N = 83) and a detention center (N = 41) in northern Taiwan received a face-to-face interview. Therefore, socio-demographic characteristics, patterns of drug use, psychiatric comorbidities, blood-borne infectious diseases and health service utilization were recorded. The behaviors of health service utilization were classified into the frequency of out-patient department visit and hospitalization, as well as the purchase of over-the-counter drugs. During 12 months prior to interview, 79.8% of the participants attended health care service at least once. The rate of having any event in out-patients service visit, hospitalization, and over-the-counter drugs were 66.1%, 29.8% and 25.8% respectively. The frequency of health service utilization was associated with numerous factors. Among these factors, patients who were recruited from hospital and having a mood disorder were conjoint predictors of out-patient department visit, hospitalization and purchase of over-the-counter drugs. According to the results of this study, social education and routine screening for mood disorders can help heroin users to obtain adequate health care service. The findings of this study are useful references for targeting the heroin users for whom a successful intervention represents the greatest cost benefit. © 2013 Elsevier Ltd. All rights reserved.

Willingness to pay for methadone maintenance treatment in Vietnamese epicentres of injection-drug-driven HIV infection

PubMed Central

2013-01-01

Abstract Objective Willingness to pay for methadone maintenance treatment (MMT) in three Vietnamese epicentres of injection-drug-driven human immunodeficiency virus (HIV) infection was assessed. Methods A convenience sample of 1016 patients receiving HIV treatment in seven clinics was enrolled during 2012. Contingent valuation was used to assess willingness to pay. Interviewers reviewed adverse consequences of injection drug use and the benefits of MMT. Interviewers then described the government’s plan to scale up MMT and the financial barriers to scale-up. Willingness to pay was assessed using double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay. Findings A total of 548 non-drug-users and 468 injection drug users were enrolled; 988 were willing to pay for MMT. Monthly mean willingness to pay among non-drug-users, 347 drug users not receiving MMT and 121 drug users receiving MMT was 10.7 United States dollars [US$] (35.7% of treatment costs), US$ 21.1 (70.3%) and US$ 26.2 (87.3%), respectively (mean: US$ 15.9; 95% confidence interval, CI: 13.6–18.1). Fifty per cent of drug users were willing to pay 50% of MMT costs. Residence in households with low monthly per capita income and poor health status predicted willingness to pay less among drug users; educational level, employment status, health status and current antiretroviral therapy receipt predicted willingness to pay less among non-drug-users. Conclusion Willingness to pay for MMT was very high, supporting implementation of a co-payment programme. PMID:23825874

Coffee shops and clinics: the give and take of doing HIV/AIDS research with injecting drug users.

PubMed

Marsh, A; Loxley, W

1992-06-01

We discuss recruiting and interviewing injecting drug users and using research as health promotion in the context of collecting information related to human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) from a convenience sample of 200 injecting drug users, half in treatment and half not, in 1989 and 1990 in Perth, Western Australia. A variety of recruiting methods were used including advertising, referral by agency staff, 'snowballing' and approaches to personal contacts and others known to inject by the interviewer. Snowballing and personal contacts were the most successful means of recruiting those not in treatment, while advertising was comparatively unsuccessful with this group because of the importance of establishing the credibility of the study and the interviewer among injecting drug users before they will volunteer to be involved. The promotion of behavioural risk reduction among respondents during the interview is detailed. We argue that the traditionally rigid separation between research and intervention is inappropriate in the HIV/AIDS context. When lives are potentially at stake, any contact with injecting drug users, especially those not in treatment (where may receive HIV/AIDS education), must be used as an HIV/AIDS prevention opportunity, and the interview is an ideal opportunity. The employment of research as community intervention is also discussed.

A survey of hallucinogenic mushroom use, factors related to usage, and perceptions of use among college students.

PubMed

Hallock, Robert M; Dean, Andrew; Knecht, Zachary A; Spencer, Jared; Taverna, Elise C

2013-06-01

Recreational usage and attitudes toward psilocybin-containing hallucinogenic mushrooms among college students are seldom explored. We surveyed 882 randomly selected undergraduates at Skidmore College in upstate New York and quantified whether participants had ever used psilocybin mushrooms, their attitudes toward the drug, and polydrug use. There were 409 responses and 29.5% of the sample reported psilocybin use. Among users, the mean number of times they reported using mushrooms was 3.4 (mode=1). The top factors cited that influenced their decisions to try hallucinogenic mushrooms for the first time were 'curiosity', 'to achieve a mystical experience', and 'introspection'. Users and non-users had significantly different perceptions of mushrooms: non-users were more likely to say that hallucinogenic mushrooms were addictive and had the potential for abuse than users. Users did not believe that psilocybin negatively impacts their academics, mental health, or physical health, while non-users did. Both users and non-users of psilocybin reported high life-time use of alcohol (97% vs 96%, respectively), marijuana (98% vs 73%, respectively) and tobacco (82% vs 54%, respectively). Psilocybin users were significantly more likely to use other drugs such as cocaine, ecstasy, opiates, non-prescribed prescription drugs, opiates, and lysergic acid diethylamide (LSD) than non-users of psilocybin. This study uncovers important insights into hallucinogenic mushroom use by college students. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities.

PubMed

Arribas-Ibar, Elisabet; Suelves, Josep Maria; Sanchez-Niubò, Albert; Domingo-Salvany, Antònia; T Brugal, M

We assessed prevalence of suicidal ideation and plans among illicit drug users and their association with contextual factors, by gender. Cross-sectional study. In a sample of 511 illicit drug users recruited during spring 2012 in drug treatment and prevention facilities in Catalonia (Spain), the prevalence of suicidal ideation/plans in the last 12 months was assessed. Poisson regression was used to examine associations between suicidal ideation/plans and various factors (socio-demographic, psychological, illegal drug market activities and marginal income generation activities, which included any reported sex work, stealing, peddling, begging or borrowing on credit from a dealer). The average age was 37.9 years (standard deviation: 8.62); 76.3% were men. Suicidal ideation/plans were reported by 30.8% of men and 38.8% of women, with no significant differences by age or gender. Recent aggression (male prevalence ratio [PR]=2.2; female PR=1.4), psychological treatment (male PR=1.2; female PR=1.3) and illegal/marginal income generation activities (male PR=1.5; female PR=1.1) were associated with suicidal ideation/plans. Men who trafficked were more likely to have suicidal ideation/plans (PR=1.3), while prison history was positive for women (PR=1.8) and negative for men (PR=0.7). Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users' suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Increased ventral striatal BOLD activity during non-drug reward anticipation in cannabis users.

PubMed

Nestor, Liam; Hester, Robert; Garavan, Hugh

2010-01-01

Despite an increased understanding of the pharmacology and long-term cognitive effects of cannabis in humans, there has been no research to date examining its chronic effects upon reward processing in the brain. Motivational theories regarding long-term drug use posit contrasting predictions with respect to how drug users are likely to process non-drug incentives. The reward deficiency syndrome (RDS) of addiction posits that there are deficits in dopamine (DA) motivational circuitry for non-drug rewards, such that only drugs of abuse are capable of normalizing DA in the ventral striatum (VS). Alternatively, the opponent process theory (OPT) holds that in individuals prone to drug use, there exists some form of mesolimbic hyperactivity, in which there is a bias towards reward-centred behaviour concomitant with impulsivity. The current study examined BOLD responses during reward and loss anticipation and their outcome deliveries in 14 chronic cannabis users and 14 drug-naive controls during a monetary incentive delay (MID) task. Despite no significant behavioural differences between the two groups, cannabis users had significantly more right VS BOLD activity during reward anticipation. Correlation analyses demonstrated that this right VS BOLD response was significantly correlated with life-time use and reported life-time cannabis joints consumed. No correlations between cannabis abstinence and BOLD responses were observed. We also observed a number of group differences following outcome deliveries, most notably hypoactivity in the left insula cortex in response to loss and loss avoidance outcome notifications in the cannabis group. These results may suggest hypersensitivity during instrumental response anticipation for non-drug rewards and a hyposensitivity to loss outcomes in chronic cannabis users; the implications of which are discussed with respect to the potentially sensitizing effects of cannabis for other rewards.

Neighborhood History as a Factor Shaping Syringe Distribution Networks Among Drug Users at a U.S. Syringe Exchange1

PubMed Central

Braine, Naomi; Acker, Caroline; Goldblatt, Cullen; Yi, Huso; Friedman, Samuel; DesJarlais, Don C.

2008-01-01

Throughout the US, high-visibility drug markets are concentrated in neighborhoods with few economic opportunities, while drug buyers/users are widely dispersed. A study of Pittsburgh Syringe Exchange participants provides data on travel between and network linkages across neighborhoods with different levels of drug activity. There are distinct racial patterns to syringe distribution activity within networks and across neighborhoods. Pittsburgh’s history suggests these patterns emerge from historical patterns of social and economic development. Study data demonstrate the ability of IDUs to form long term social ties across racial and geographic boundaries and use them to reduce the risk of HIV transmission. PMID:19578475

Nonmedical Use of Prescription Stimulants among College Students: Associations with ADHD and Polydrug Use

PubMed Central

Arria, Amelia M.; Caldeira, Kimberly M.; O’Grady, Kevin E.; Vincent, Kathryn B.; Johnson, Erin P.; Wish, Eric D.

2008-01-01

Study Objectives This study examines nonmedical use of prescription stimulants (NPS) among 1,253 first-year college students. Comparisons are made between non-users, nonmedical users, and medical users of prescription stimulants for ADHD (ADHD+), some of whom overused their medication. Design Cross-sectional study. Setting Large public university in the mid-Atlantic region. Subjects Twelve hundred fifty three college students. Measurements and Main Results Of 1,208 students who were not using prescription stimulants medically for ADHD (ADHD-), 18.0% (n = 218) engaged in NPS. Among 45 ADHD+ students, 26.7% (n = 12) overused their ADHD medication at least once in their lifetime, and 15.6% (n = 7) nonmedically used someone else’s prescription stimulants at least once in their lifetime. Among nonmedical users, NPS was infrequent and mainly associated with studying, although 15.6% used prescription stimulants to party or to get high. Lifetime NPS was associated with past-year other drug use. Both NPS and overuse of prescribed stimulants for ADHD were independently associated with past-year use of five drugs, holding constant sociodemographic characteristics. NPS was also associated with alcohol and marijuana dependence. Conclusions Physicians should be vigilant for possible overuse and/or diversion of prescription stimulants among ADHD+ patients attending college, as well as the co-occurrence of illicit drug use with NPS. Initiation of comprehensive drug prevention activities that involve parents as well as colleges is encouraged to raise awareness of NPS and its association with illicit drug use. PMID:18225963

Effects of Sex Work on the Prevalence of Syphilis Among Injection Drug Users in 3 Russian Cities

PubMed Central

Platt, Lucy; Rhodes, Tim; Judd, Ali; Koshkina, Evgeniya; Maksimova, Svetlana; Latishevskaya, Natalia; Renton, Adrian; McDonald, Tamara; Parry, John V.

2007-01-01

Objectives. We examined risk factors for syphilis infection among injection drug users in 3 Russian Federation cities, focusing particular attention on the potential roles of gender and sex work. Methods. We conducted a cross-sectional survey of injection drug users in Moscow, Volgograd, and Barnaul, collecting behavioral data and testing for antibodies to Treponema pallidum. Associations between presence of antibodies to T pallidum and covariates were explored. Results. Overall, the prevalence of antibodies to T pallidum was 11% (95% confidence interval=9.7%, 13.1%). Syphilis was associated with involvement in sex work and with gender in Moscow and Barnaul but not in Volgograd. Female injection drug users not involved in sex work were more likely than men to be younger and to have recently begun to inject; female injection drug users involved in sex work were more likely than those not involved in sex work to inject daily. Conclusions. Syphilis transmission dynamics varied by region. Sex work can increase syphilis risk among injection drug users, potentially feeding the momentum of sexually transmitted HIV and syphilis among noninjectors. Targeted interventions are needed to reduce both sexual and injection risk behaviors among injection drug users. PMID:17018827

Drug safety of macrolide and quinolone antibiotics in a tertiary care hospital: administration of interacting co-medication and QT prolongation.

PubMed

Niedrig, David; Maechler, Sarah; Hoppe, Liesa; Corti, Natascia; Kovari, Helen; Russmann, Stefan

2016-07-01

Some macrolide and quinolone antibiotics (MQABs) are associated with QT prolongation and life-threatening torsade de pointes (TdP) arrhythmia. MQAB may also inhibit cytochrome P450 isoenzymes and thereby cause pharmacokinetic drug interactions (DDIs). There is limited data on the frequency and management of such risks in clinical practice. We aimed to quantify co-administration of MQAB with interacting drugs and associated adverse drug reactions. We conducted an observational study within our pharmacoepidemiological database derived from electronic medical records of a tertiary care hospital. Among all users of MQAB associated with TdP, we determined the prevalence of additional QT-prolonging drugs and risk factors and identified contraindicated co-administrations of simvastatin, atorvastatin, or tizanidine. Electrocardiographic (ECG) monitoring and associated adverse events were validated in medical records. Among 3444 administered courses of clarithromycin, erythromycin, azithromycin, ciprofloxacin, levofloxacin, or moxifloxacin, there were 1332 (38.7 %) with concomitant use of additional QT-prolonging drugs. Among those, we identified seven cases of drug-related QT prolongation, but 49.1 % had no ECG monitoring. Of all MQAB users, 547 (15.9 %) had hypokalemia. Forty-four MQAB users had contraindicated co-administrations of simvastatin, atorvastatin, or tizanidine and three of those related adverse drug reactions. In the studied real-life setting, we found a considerable number of MQAB users with additional risk factors for TdP but no ECG monitoring. However, adverse drug reactions were rarely found, and costs vs. benefits of ECG monitoring have to be weighted. In contrast, avoidable risk factors and selected contraindicated pharmacokinetic interactions are clear targets for implementation as automated alerts in electronic prescribing systems.

Prospective memory functioning among ecstasy/polydrug users: evidence from the Cambridge Prospective Memory Test (CAMPROMPT).

PubMed

Hadjiefthyvoulou, Florentia; Fisk, John E; Montgomery, Catharine; Bridges, Nikola

2011-06-01

Prospective memory (PM) deficits in recreational drug users have been documented in recent years. However, the assessment of PM has largely been restricted to self-reported measures that fail to capture the distinction between event-based and time-based PM. The aim of the present study is to address this limitation. Extending our previous research, we augmented the range laboratory measures of PM by employing the CAMPROMPT test battery to investigate the impact of illicit drug use on prospective remembering in a sample of cannabis only, ecstasy/polydrug and non-users of illicit drugs, separating event and time-based PM performance. We also administered measures of executive function and retrospective memory in order to establish whether ecstasy/polydrug deficits in PM were mediated by group differences in these processes. Ecstasy/polydrug users performed significantly worse on both event and time-based prospective memory tasks in comparison to both cannabis only and non-user groups. Furthermore, it was found that across the whole sample, better retrospective memory and executive functioning was associated with superior PM performance. Nevertheless, this association did not mediate the drug-related effects that were observed. Consistent with our previous study, recreational use of cocaine was linked to PM deficits. PM deficits have again been found among ecstasy/polydrug users, which appear to be unrelated to group differences in executive function and retrospective memory. However, the possibility that these are attributable to cocaine use cannot be excluded.

[Talc-induced pulmonary granulomas in drug addicts].

PubMed

Latartseva, L N; Kryvenko, O N

2013-01-01

Among the diseases accompanied by granuloma formation in the lung, there is so-called granulomatosis developing in injection drug users who have been long injecting suspensions of oral medications containing talc and other water insoluble fillers. 102 deaths of chronic intravenous drug users were examined; 12 of whom showed pulmonary talc-induced granulomatosis. Their morphology was studied using polarized light microscopy. The main mechanisms of thanatogenesis in lethal cases within the first hours after intravenous injection of talc-containing oral medication suspensions are explained.

Nurses' perception of the quality of care they provide to hospitalized drug addicts: testing the theory of reasoned action.

PubMed

Natan, Merav Ben; Beyil, Valery; Neta, Okev

2009-12-01

A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.

Gauging the Acceptability of HIV Vaccines: An Exploratory Study Examining Knowledge, Attitudes, and Beliefs among Injecting Drug Users in Viet Nam

ERIC Educational Resources Information Center

Nguyen, France

2007-01-01

In contrast to other countries in Southeast Asia, the HIV/ AIDS epidemic is in the initial stages in Viet Nam, although the rates have increased notably since 1997. This study examined attitudes towards the use of an HIV vaccine (when one becomes available) as a means for preventing the disease. Since injecting drug users are the great majority of…

Trends in reports of driving following illicit drug consumption among regular drug users in Australia, 2007-2013: Has random roadside drug testing had a deterrent effect?

PubMed

Horyniak, Danielle; Dietze, Paul; Lenton, Simon; Alati, Rosa; Bruno, Raimondo; Matthews, Allison; Breen, Courtney; Burns, Lucy

2017-07-01

Driving following illicit drug consumption ('drug-driving') is a potential road safety risk. Roadside drug testing (RDT) is conducted across Australia with the dual aims of prosecuting drivers with drugs in their system and deterring drug-driving. We examined trends over time in self-reported past six-month drug-driving among sentinel samples of regular drug users and assessed the impact of experiences of RDT on drug-driving among these participants. Data from 1913 people who inject drugs (PWID) and 3140 regular psychostimulant users (RPU) who were first-time participants in a series of repeat cross-sectional sentinel studies conducted in Australian capital cities from 2007 to 2013 and reported driving in the past six months were analysed. Trends over time were assessed using the χ 2 test for trend. Multivariable logistic regressions assessed the relationship between experiences of RDT and recent drug-driving, adjusting for survey year, jurisdiction of residence and socio-demographic and drug use characteristics. The percentage of participants reporting recent (past six months) drug-driving decreased significantly over time among both samples (PWID: 83% [2007] vs. 74% [2013], p<0.001; RPU: 72% vs. 56%, p<0.001), but drug-driving remained prevalent. Lifetime experience of RDT increased significantly over time (PWID: 6% [2007] vs. 32% [2013], p<0.001; RPU: 2% vs. 11%, p<0.001). There were no significant associations between experiencing RDT and drug-driving among either PWID or RPU. Although there is some evidence that drug-driving among key risk groups of regular drug users is declining in Australia, possibly reflecting a general deterrent effect of RDT, experiencing RDT appears to have no specific deterrent effect on drug-driving. Further intervention, with a particular focus on changing attitudes towards drug-driving, may be needed to further reduce this practice among these groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vitamin A levels and human immunodeficiency virus load in injection drug users.

PubMed Central

Semba, R D; Farzadegan, H; Vlahov, D

1997-01-01

Although low plasma vitamin A levels are associated with increased mortality and higher vertical transmission during human immunodeficiency virus (HIV) infection, it is unknown whether plasma low vitamin A levels are a marker for circulating HIV load. We conducted a cross-sectional study within a prospective cohort study of injection drug users in order to evaluate the relationship between plasma vitamin A levels and HIV viral load. Plasma vitamin A level was measured by high-performance liquid chromatography. Infectious viral load was measured by quantitative microculture of serial fivefold dilutions of 10(6) peripheral blood mononuclear cells. A total of 284 HIV-infected adults (79 women, 205 men) were studied. Plasma vitamin A levels consistent with deficiency were found in 28.9% of adults. A total of 38.0% of women and 25.3% of men had vitamin A deficiency (P < 0.04). The median infectious viral load for the entire study population was 8 infectious units per million cells. No significant relationship between plasma vitamin A levels and infectious viral load was observed in these injection drug users. This study suggests that there is no correlation between HIV viral load and plasma vitamin A levels in injection drug users, and these variables may represent independent risk factors during HIV infection. HIV-infected adult women appear to be at higher risk of developing vitamin A deficiency. PMID:9008289

Mortality among young injection drug users in San Francisco: a 10-year follow-up of the UFO study.

PubMed

Evans, Jennifer L; Tsui, Judith I; Hahn, Judith A; Davidson, Peter J; Lum, Paula J; Page, Kimberly

2012-02-15

This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO ("U Find Out") Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths.

Are Ecstasy Induced Serotonergic Alterations Overestimated For The Majority Of Users?

PubMed

Szigeti, Balázs; Winstock, Adam R; Erritzoe, David; Maier, Larissa J

2018-05-01

Neuroimaging studies imply that the regular use of ±3,4-methylenedioxymethamphetamine (MDMA), the major constituent of ecstasy pills, alters the brain's serotonergic system in a dose-dependent manner. However, the relevance of these findings remains unclear due to limited knowledge about the ecstasy/MDMA use pattern of real-life users. We examined the representativeness of ecstasy users enrolled in neuroimaging studies by comparing their ecstasy use habits with the use patterns of a large, international sample. A systematic literature search revealed 10 imaging studies that compare serotonin transporter levels in recreational ecstasy users to matched controls. To characterize the ecstasy use patterns we relied on the Global Drug Survey, the world's largest self-report database on drug use. The basis of the dose comparison were the Usual Amount (pills/session), Use Frequency (sessions/month) and Dose Intensity (pills/year) variables. Both the average Usual Amount (pills/session) and Use Frequency (sessions/month) of neuroimaging study participants corresponded to the top 5-10% of the Global Drug Survey sample and imaging participants, on average, consumed 720% more pills over a year than the Global Drug Survey participants. Our findings suggest that the serotonin brain imaging literature has focused on unusually heavy ecstasy use and therefore the conclusions from these studies are likely to overestimate the extent of serotonergic alterations experienced by the majority of people who use ecstays.

Mortality Among Young Injection Drug Users in San Francisco: A 10-Year Follow-up of the UFO Study

PubMed Central

Evans, Jennifer L.; Tsui, Judith I.; Hahn, Judith A.; Davidson, Peter J.; Lum, Paula J.; Page, Kimberly

2012-01-01

This study examined associations between mortality and demographic and risk characteristics among young injection drug users in San Francisco, California, and compared the mortality rate with that of the population. A total of 644 young (<30 years) injection drug users completed a baseline interview and were enrolled in a prospective cohort study, known as the UFO (“U Find Out”) Study, from November 1997 to December 2007. Using the National Death Index, the authors identified 38 deaths over 4,167 person-years of follow-up, yielding a mortality rate of 9.1 (95% confidence interval: 6.6, 12.5) per 1,000 person-years. This mortality rate was 10 times that of the general population. The leading causes of death were overdose (57.9%), self-inflicted injury (13.2%), trauma/accidents (10.5%), and injection drug user-related medical conditions (13.1%). Mortality incidence was significantly higher among those who reported injecting heroin most days in the past month (adjusted hazard ratio = 5.8, 95% confidence interval: 1.4, 24.3). The leading cause of death in this group was overdose, and primary use of heroin was the only significant risk factor for death observed in the study. These findings highlight the continued need for public health interventions that address the risk of overdose in this population in order to reduce premature deaths. PMID:22227793

Youth tobacco use type and associations with substance use disorders.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Grucza, Richard A; Bierut, Laura Jean

2014-08-01

To examine the associations between youth poly-tobacco use and substance use disorders. Analysis of data from the 2007-11 US National Survey on Drug Use and Health. Randomly selected, household-dwelling adolescents from the non-institutionalized, civilian population of the United States. A total of 91 152 adolescents (aged 12-17 years). Logistic regression models were used to examine the associations between type of tobacco user (non-user, users of alternative tobacco products only, users of cigarettes only and users of cigarettes plus alternative tobacco products) with past year alcohol, marijuana or other illicit drug use disorders, adjusting for demographic and social variables. Compared with non-users of tobacco, the greatest risk for substance use disorders was among users of cigarettes plus alternative tobacco products [alcohol disorder adjusted odds ratio (aOR) = 18.3, 95% confidence interval (CI) = 16.2-20.6; marijuana disorder aOR = 37.2, 95% CI = 32.5-42.7; other drug disorder aOR = 18.4, 95% CI = 15.4-21.8], followed by users of cigarettes only (alcohol disorder aOR = 9.6, 95% CI = 8.8-10.6; marijuana disorder aOR = 20.4, 95% CI = 18.1-23.0; other drug disorder aOR = 9.4, 95% CI = 7.8-11.4), then users of alternative tobacco products only (alcohol disorder aOR = 8.1, 95% CI = 6.7-9.6; marijuana disorder aOR = 9.2, 95% CI = 7.5-11.4; other drug disorder aOR = 3.2, 95% CI = 2.4-4.3). Tobacco use in adolescence is associated with higher rates of substance use disorders across all tobacco users, especially among those who use cigarettes plus other tobacco products. © 2014 Society for the Study of Addiction.

Longitudinal changes in drug use severity and physical health-related quality of life among untreated stimulant users.

PubMed

Borders, Tyrone F; Booth, Brenda M; Falck, Russel S; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G

2009-11-01

The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8 Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well as among stimulant users.

Longitudinal Changes in Drug Use Severity and Physical Health-Related Quality of Life among Untreated Stimulant Users

PubMed Central

Borders, Tyrone F.; Booth, Brenda M.; Falck, Russel S.; Leukefeld, Carl; Wang, Jichuan; Carlson, Robert G.

2009-01-01

The primary objective of this study was to investigate whether drug use severity is associated with physical health-related quality of life (HRQL) over time. Data are from a longitudinal, multi-state, natural history community study of users of cocaine and/or methamphetamine who were interviewed at 6-month intervals over 2 years with a 79% follow-up participation rate. Physical HRQL was assessed with the physical component summary (PCS) of the SF-8™ Health Survey and drug, alcohol, and psychiatric severity were all assessed with the Addiction Severity Index (ASI). Random coefficient regression analyses were conducted to test for longitudinal associations between the independent variables and SF-8 PCS scores. Reductions in drug use severity over time were accompanied by only minor improvements in SF-8 PCS scores, underscoring the potential long-term harm of illicit drug use on physical health. Greater psychiatric severity was strongly associated with lower SF-8 PCS scores, suggesting that clinical attention to mental health issues could potentially lead to improvements in perceived physical health as well among stimulant users. PMID:19560873

Vaccination in the county jail as a strategy to reach high risk adults during a community-based hepatitis A outbreak among methamphetamine drug users.

PubMed

Vong, Sirenda; Fiore, Anthony E; Haight, Daniel O; Li, Jinfeng; Borgsmiller, Nancy; Kuhnert, Wendi; Pinero, Frances; Boaz, Kathy; Badsgard, Tracy; Mancini, Carmela; Nainan, Omana V; Wiersma, Steven; Bell, Beth P

2005-01-11

Illicit drug use (IDU) is an important risk factor for hepatitis A, but implementing vaccination programs among drug users is difficult. During January 2001-July 2002, 403 hepatitis A cases were reported in Polk County, Florida; 48% were drug users and of these, 80% were recently in jail. To assess the county jail as a potential vaccination venue, we interviewed 280 inmates and conducted a serologic survey during July--August 2002. Of these, 227 (81%) reported a past IDU history. Previous HAV infection was found in 33%. In communities with illicit drug users at risk for hepatitis A and who are frequently jailed, vaccination programs in jails could be an important component of a community-based strategy to control hepatitis A outbreaks among illicit drug users.

Crack-cocaine use accelerates HIV disease progression in a cohort of HIV-positive drug users.

PubMed

Baum, Marianna K; Rafie, Carlin; Lai, Shenghan; Sales, Sabrina; Page, Bryan; Campa, Adriana

2009-01-01

HIV infection is prevalent among substance abusers. The effects of specific illicit drugs on HIV disease progression have not been established. We evaluated the relationship between substances of abuse and HIV disease progression in a cohort of HIV-1-positive active drug users. A prospective, 30-month, longitudinal study was conducted on 222 HIV-1 seropositive drug users in Miami, FL. History of illicit drug, alcohol, and medication use, CD4+ cell count, and viral load were performed every 6 months. Crack-cocaine users were 2.14 times [95% confidence interval (CI): 1.08 to 4.25, P = 0.029] more likely to present a decline of CD4 to

Cue-Induced Craving to Paraphernalia and Drug Images in Opioid Dependence

PubMed Central

McHugh, R. Kathryn; Fulciniti, Francesca; Mashhoon, Yasmin; Weiss, Roger D.

2016-01-01

Background and Objectives Stimuli that are repeatedly paired with substance use, such as drug paraphernalia, can themselves elicit drug craving. The aim of this study was to examine whether particular cue types elicit greater craving responses than others among individuals with opioid dependence. Methods Participants seeking inpatient treatment for opioid dependence were recruited for a study of cue-induced craving. This sample (N=50), included 25 primary heroin users, 20 primary prescription opioid users, and 5 users of heroin and prescription opioids equally. Participants completed a cue reactivity task, in which images of drug-related stimuli were presented on a computer screen, each followed by a question assessing state drug craving. Results Overall, participants reported higher craving following paraphernalia stimuli relative to drug stimuli. However, this was moderated by opioid type; there was significantly higher craving in response to images of paraphernalia cues in the heroin group, and higher craving in response to drug cues in the prescription opioid group. Discussion and Conclusions These findings highlight potential differences in cue reactivity to opioid paraphernalia and drug cues, which appears to be moderated by drug type. Scientific Significance Cue-induced craving is an important factor in relapse. This study adds further to the literature on cue-induced craving in opioid dependence, suggesting that craving may vary based on both cue type and opioid type. Future studies designed to discriminate the impact of substance of abuse, route of administration, and cue type will help to further understand cue-induced craving in this population. PMID:26848719

Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Safren, Steven A.; O'Cleirigh, Conall M.; Bullis, Jacqueline R.; Otto, Michael W.; Stein, Michael D.; Pollack, Mark H.

2012-01-01

Objective: Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment adherence. Injection drug users comprise a substantial portion of individuals with HIV in the United States and globally. The present study tested cognitive behavioral therapy for adherence and depression (CBT-AD) in patients…

Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.

PubMed

Brown, Ronni E; Morisky, Donald E; Silverstein, Steven J

2013-06-01

Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.

Physical and Psychological Harms and Health Consequences of Methamphetamine Use amongst a Group of New Zealand Users

ERIC Educational Resources Information Center

Butler, Rachael; Wheeler, Amanda; Sheridan, Janie

2010-01-01

Methamphetamine has become a drug of concern in many countries. This qualitative study reports on the historical and current psychological and physical health of a group of methamphetamine users in Auckland, New Zealand in 2004, most of whom were in drug treatment. Participants reported they had experienced a range of physical health problems…

Weighing the Consequences: Self-Disclosure of HIV-Positive Status among African American Injection Drug Users

ERIC Educational Resources Information Center

Valle, Maribel; Levy, Judith

2009-01-01

Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV…

"El lado oscuro": "the dark side" of social capital in Mexican American heroin using men.

PubMed

Flores, David V; Torres, Luis R; Torres-Vigil, Isabel; Ren, Yi; Haider, Ali; Bordnick, Patrick S

2013-01-01

This article describes social capital in a cohort of 227 Mexican American men who are long-term injection heroin users. Social capital scores for current and former users were similar, suggesting equal absolute values of capital, but associated with illicit activities in current users and with cessation efforts in former users. Stable drug-using relationships provided high negative capital, whereas conventional relationships provided positive capital. Thus, social capital functions dichotomously in positive and negative contextualized roles. This study provides an alternative understanding of the dynamic interactions between individuals, environment, and drug abuse and can inform prevention and treatment interventions for an important demographic group.

Individual and Network Factors Associated With Prevalent Hepatitis C Infection Among Rural Appalachian Injection Drug Users

PubMed Central

Lofwall, Michelle R.; Frost, Simon D. W.; Oser, Carrie B.; Leukefeld, Carl G.; Crosby, Richard A.

2013-01-01

Objectives. We determined the factors associated with hepatitis C (HCV) infection among rural Appalachian drug users. Methods. This study included 394 injection drug users (IDUs) participating in a study of social networks and infectious disease risk in Appalachian Kentucky. Trained staff conducted HCV, HIV, and herpes simplex-2 virus (HSV-2) testing, and an interviewer-administered questionnaire measured self-reported risk behaviors and sociometric network characteristics. Results. The prevalence of HCV infection was 54.6% among rural IDUs. Lifetime factors independently associated with HCV infection included HSV-2, injecting for 5 or more years, posttraumatic stress disorder, injection of cocaine, and injection of prescription opioids. Recent (past-6-month) correlates of HCV infection included sharing of syringes (adjusted odds ratio = 2.24; 95% confidence interval = 1.32, 3.82) and greater levels of eigenvector centrality in the drug network. Conclusions. One factor emerged that was potentially unique to rural IDUs: the association between injection of prescription opioids and HCV infection. Therefore, preventing transition to injection, especially among prescription opioid users, may curb transmission, as will increased access to opioid maintenance treatment, novel treatments for cocaine dependence, and syringe exchange. PMID:23153148

Demographic and Health Related Data of Users of a Mobile Application to Support Drug Adherence is Associated with Usage Duration and Intensity

PubMed Central

Becker, Stefan; Brandl, Christopher; Meister, Sven; Nagel, Eckhard; Miron-Shatz, Talya; Mitchell, Anna; Kribben, Andreas; Albrecht, Urs-Vito; Mertens, Alexander

2015-01-01

Purpose A wealth of mobile applications are designed to support users in their drug intake. When developing software for patients, it is important to understand the differences between individuals who have, who will or who might never adopt mobile interventions. This study analyzes demographic and health-related factors associated with real-life “longer usage” and the “usage-intensity per day” of the mobile application “Medication Plan”. Methods Between 2010-2012, the mobile application “Medication Plan” could be downloaded free of charge from the Apple-App-Store. It was aimed at supporting the regular and correct intake of medication. Demographic and health-related data were collected via an online questionnaire. This study analyzed captured data. Results App-related activities of 1799 users (1708 complete data sets) were recorded. 69% (1183/1708) applied “Medication Plan” for more than a day. 74% were male (872/1183), the median age 45 years. Variance analysis showed a significant effect of the users´ age with respect to duration of usage (p = 0.025). While the mean duration of use was only 23.3 days for users younger than 21 years, for older users, there was a substantial increase over all age cohorts up to users of 60 years and above (103.9 days). Sex and educational status had no effect. “Daily usage intensity” was directly associated with an increasing number of prescribed medications and increased from an average of 1.87 uses per day and 1 drug per day to on average 3.71 uses per day for users stating to be taking more than 7 different drugs a day (p<0.001). Demographic predictors (sex, age and educational attainment) did not affect usage intensity. Conclusion Users aged 60+ as well as those with complicated therapeutic drug regimens relied on the service we provided for more than three months on average. Mobile applications may be a promising approach to support the treatment of patients with chronic conditions. PMID:25629939

MDMA (ecstasy/molly) use among African Americans: The perceived influence of hip-hop/rap music.

PubMed

Rigg, Khary K; Estreet, Anthony T

2018-02-12

Over the past two decades, the demographic profile of MDMA (ecstasy/molly) users has changed. In particular, African American MDMA use has risen in some cities. One explanation of this new trend is the drug's recent popularity (as molly) in hip-hop/rap (HHR) music. Several top rappers endorse the drug as a way to have fun or get women "loose." There are currently no studies, however, that investigate the extent to which African American MDMA users listen to HHR music or the influence that these pro-MDMA messages have on their use of the drug. To address this gap, the current study used survey data to (a) identify the extent to which HHR music is listened to by African American MDMA users and (b) assess the perceived influence of HHR music on their decision to begin using. Qualitative interview data are also presented to contextualize the influence of these messages on their use of MDMA. The findings of this study suggest that African American MDMA users are high consumers of HHR music and that pro-MDMA messages in HHR music are influencing their expectations of the drug and their decision to initiate use. These findings add to the limited amount of research on African American MDMA use and have the potential to inform future interventions.

Multisubstance use as a feature of addiction to anabolic-androgenic steroids.

PubMed

Skarberg, Kurt; Nyberg, Fred; Engstrom, Ingemar

2009-01-01

The aim of this study was to explore and describe total drug use among anabolic-androgenic steroid (AAS) users and the reasons given for the use of these drugs. The study was based on semi-structured interviews and questionnaires involving 32 patients who were attending an addiction centre in Orebro, Sweden, for AAS use. The results indicated that a history of polysubstance use among the patients was frequent. Over half were using drugs of abuse and also taking various other pharmaceuticals. Almost half of the patients took human growth hormones, and almost half of the interviewed persons were drinking alcohol to a hazardous or harmful extent. The most common reason given for taking AAS and other hormones was to increase muscle mass and strength, but some participants also used insulin as a means of losing fat. Cannabis was used to improve sleep, heroin to decrease pain and amphetamine to increase endurance and burn fat. Our data suggest that most of the current AAS users who have been admitted to a treatment programme are multiple drug users with polysubstance dependence. The study stresses the importance of carefully examining total drug use as part of the assessment regimen for this group. 2009 S. Karger AG, Basel.

Use of biological based therapy in patients with cardiovascular diseases in a university-hospital in New York City

PubMed Central

Chagan, Larisa; Bernstein, Diane; Cheng, Judy WM; Kirschenbaum, Harold L; Rozenfeld, Vitalina; Caliendo, Gina C; Meyer, Joanne; Mehl, Bernard

2005-01-01

Background The use of complementary and alternative products including Biological Based Therapy (BBT) has increased among patients with various medical illnesses and conditions. The studies assessing the prevalence of BBT use among patients with cardiovascular diseases are limited. Therefore, an evaluation of BBT in this patient population would be beneficial. This was a survey designed to determine the effects of demographics on the use of Biological Based Therapy (BBT) in patients with cardiovascular diseases. The objective of this study was to determine the effect of the education level on the use of BBT in cardiovascular patients. This survey also assessed the perceptions of users regarding the safety/efficacy of BBT, types of BBT used and potential BBT-drug interactions. Method The survey instrument was designed to assess the findings. Patients were interviewed from February 2001 to December 2002. 198 inpatients with cardiovascular diseases (94 BBT users and 104 non-users) in a university hospital were included in the study. Results Users had a significantly higher level of education than non-users (college graduate: 28 [30%] versus 12 [12%], p = 0.003). Top 10 BBT products used were vitamin E [41(43.6%)], vitamin C [30(31.9%)], multivitamins [24(25.5%)], calcium [19(20.2%)], vitamin B complex [17(18.1%)], fish oil [12(12.8%)], coenzyme Q10 [11(11.7%)], glucosamine [10(10.6%)], magnesium [8(8.5%)] and vitamin D [6(6.4%)]. Sixty percent of users' physicians knew of the BBT use. Compared to non-users, users believed BBT to be safer (p < 0.001) and more effective (p < 0.001) than prescription drugs. Forty-two potential drug-BBT interactions were identified. Conclusion Incidence of use of BBT in cardiovascular patients is high (47.5%), as is the risk of potential drug interaction. Health care providers need to monitor BBT use in patients with cardiovascular diseases. PMID:15745441

Addiction, stigma and movies.

PubMed

Cape, G S

2003-03-01

To identify common character stereotypes of alcohol and other drug users as portrayed in motion pictures. A selective review of a number of movies prominently portraying alcohol and other drug use and misuse. The great majority of popular films portray alcohol and drug use whether as a routinized background, routinized foreground or exceptional foreground. Four main stereotypes of alcohol and other drug users appear to be prevalent - the tragic hero, the demonized user, the rebellious free spirit and the comedic user. A number of movies are selected which portray alcohol and other drug use as a prominent theme. Movies, as a medium for mass communication, have a powerful influence on the public and perpetuate popular mythologies regarding alcohol and other drug use.

[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.

78 FR 46958 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2014 AGENCY: Food and Drug... and payment procedures for fiscal year (FY) 2014 generic new animal drug user fees. The Federal Food... for FY 2014. FOR FURTHER INFORMATION CONTACT: Visit FDA's Web site at http://www.fda.gov/ForIndustry...

75 FR 58411 - Center for Veterinary Medicine eSubmitter Workshop; Public Workshop; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... health industry that submits new animal drug applications to CVM's Office of New Animal Drug Evaluation... agreed to in the Animal Drug User Fee Amendments (ADUFA II) of 2008 ( http://www.fda.gov/ForIndustry/UserFees/AnimalDrugUserFeeActADUFA/ucm044941.htm ). The ONADE will be soliciting feedback on both the e...

Comparison of the Effects of a Brand-name Drug and Its Generic Drug on the Quality of Life of Alzheimer's Disease Patients.

PubMed

Sakakibara, Mikio; Kido, Mitsuhiko; Kuribayashi, Jun; Okada, Hiroshi; Igarashi, Ataru; Kamei, Hiroyuki; Nabeshima, Toshitaka

2015-08-31

The pharmacological effects of generic (GE) donepezil are the same as Aricept, its brand-name counterpart. However, little is known as to whether these two drugs provide the same quality of life (QOL). The study subjects were patients with Alzheimer's disease who were taking donepezil hydrochloride tablets, and were selected by visiting either the local pharmacies or the patients' homes. We chose the brand-name drug Aricept and its GE form donepezil to investigate, from a long-term caregiver's perspective, the influence of both drugs on the patients' QOL. An EuroQol-5 Dimension (EQ-5D) was used to assess the QOL of patients with Alzheimer's disease, before and after various Aricept and/or donepezil regimens. Patients were divided into four groups: first time users of Aricept (n=43), first time users of GE donepezil (n=45), users refilling previous prescriptions of Aricept (n=51), and users switching from Aricept to GE donepezil (n=51). The average change in the EQ-5D utility indices rose significantly in the patients starting a new regimen of Aricept and its GE drug. The patients continuing an existing regimen of Aricept showed no significant differences, even after Aricept was switched to a GE drug. The QOL of patients starting a new regimen of Aricept and its GE drug improved. The QOL was maintained upon switching to the GE drug form.

Illicit drug use is increasing among non-medical users of prescription drugs-Results from population-based surveys 2002-2014.

PubMed

Karjalainen, Karoliina; Lintonen, Tomi; Hakkarainen, Pekka

2017-09-01

Non-medical use of prescription drugs (NMUPD) is known to be associated with illicit drug use, but less is known about how illicit drug use has changed in NMUPD. We examined (1) the changes in illicit drug use among Finnish non-medical users of prescription drugs during the 2000s and (2) whether the trends of illicit drug use differ by non-medical use of prescription drugs in the general population. Data were derived from population-based (aged 15-69) Drug Surveys conducted in Finland in 2002, 2006, 2010 and 2014. The response rates varied between 63% and 48%. NMUPD during the last year was measured (n=252). Past-year illicit drug use among non-medical users of prescription drugs and the reference population not reporting NMUPD (n=10,967) was compared. Logistic regression was used to estimate the p-values for trends. Illicit drug use has increased notably among Finnish non-medical users of prescription drugs (from 21% to 70%, p for trend<0.001). This was not explained by the respondents' gender, age, employment status or alcohol use. Among the reference population, illicit drug use also increased statistically significantly, but much more moderately (from 2.5% to 5.4%). The difference between the trends was confirmed by an interaction test (p=0.022). NMUPD seems to be increasingly merging with illicit drug use. This indicates an increasing prevalence of polydrug use among non-medical users of prescription drugs, which may bring about more severe harms and worse health outcomes for users and more challenges in regard to treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

A Comparative Study of the Attitudes of College Students and Drug Treatment Center Residents Toward Drugs, Other Drug Users and Themselves.

ERIC Educational Resources Information Center

Page, Richard C.; Mitchell, Sam

1986-01-01

Assessed the attitudes of college students and drug treatment center residents with histories of using marijuana and amphetamines. The drug treatment center residents tended to devalue themselves, drugs, and peers in the drug culture to a greater extent than the students. (Author/BL)

Family Therapy for the Drug User: Conceptual and Practical Considerations

ERIC Educational Resources Information Center

Davis, Donald I.; And Others

1978-01-01

National surveys suggest that many drug treatment programs are utilizing family therapy. It is frequently the choice of treatment. Controlled studies of family therapy in drug abuse are sparce but encouraging. (MFD)

Social and structural aspects of the overdose risk environment in St. Petersburg, Russia.

PubMed

Green, Traci C; Grau, Lauretta E; Blinnikova, Ksenia N; Torban, Mikhail; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei; Heimer, Robert

2009-05-01

While overdose is a common cause of mortality among opioid injectors worldwide, little information exists on opioid overdoses or how context may influence overdose risk in Russia. This study sought to uncover social and structural aspects contributing to fatal overdose risk in St. Petersburg and assess prevention intervention feasibility. Twenty-one key informant interviews were conducted with drug users, treatment providers, toxicologists, police, and ambulance staff. Thematic coding of interview content was conducted to elucidate elements of the overdose risk environment. Several factors within St. Petersburg's environment were identified as shaping illicit drug users' risk behaviours and contributing to conditions of suboptimal response to overdose in the community. Most drug users live and experience overdoses at home, where family and home environment may mediate or moderate risk behaviours. The overdose risk environment is also worsened by inefficient emergency response infrastructure, insufficient cardiopulmonary or naloxone training resources, and the preponderance of abstinence-based treatment approaches to the exclusion of other treatment modalities. However, attitudes of drug users and law enforcement officials generally support overdose prevention intervention feasibility. Modifiable aspects of the risk environment suggest community-based and structural interventions, including overdose response training for drug users and professionals that encompasses naloxone distribution to the users and equipping more ambulances with naloxone. Local social and structural elements influence risk environments for overdose. Interventions at the community and structural levels to prevent and respond to opioid overdoses are needed for and integral to reducing overdose mortality in St. Petersburg.

A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users.

PubMed

Silins, Edmund; Swift, Wendy; Slade, Tim; Toson, Barbara; Rodgers, Bryan; Hutchinson, Delyse M

2017-09-01

The extent to which young adult former cannabis users fare better than infrequent users is unclear. We investigated the association between cannabis use status at age 23 and substance use and mental health outcomes at age 27. Data were from the 20+ year cohort of the PATH Through Life Study. Lifetime cannabis users (n = 1410) at age 23 were classified as former/occasional/regular users. Multivariable logistic regression was used to estimate the association between cannabis use status at age 23 and six outcomes assessed at age 27. Compared with occasional cannabis users: (i) former users had odds of subsequent tobacco use [odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.52-0.85], illicit drug use (cannabis, OR = 0.22, 95% CI 0.17-0.28; other illicit drugs, OR = 0.29, 95% CI 0.22-0.39) and mental health impairment (OR = 0.71, 95% CI 0.55-0.92) that were 29-78% lower; and (ii) regular users had odds of subsequent frequent alcohol use (OR = 2.34, 95% CI 0.67-1.34), tobacco use (OR = 3.67, 95% CI 2.54-5.30), cannabis use (OR = 11.73, 95% CI 6.81-20.21) and dependence symptoms (OR = 12.60, 95% CI 8.38-18.94), and other illicit drug use (OR = 2.95, 95% CI 2.07-4.21) that were 2-13 times greater. Associations attenuated after covariate adjustment, and most remained significant. Clear associations exist between cannabis use status in young adulthood and subsequent mental health and substance use. While early intervention remains important to prevent regular cannabis use and the associated harms, experimentation with cannabis use in the years leading into young adulthood may not necessarily determine an immutable pathway to mental health problems and illicit substance use. [Silins E, Swift W, Slade T, Toson B, Rodgers B, Hutchinson DM. A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

ERP evidence suggests executive dysfunction in ecstasy polydrug users.

PubMed

Roberts, C A; Fairclough, S H; Fisk, J E; Tames, F; Montgomery, C

2013-08-01

Deficits in executive functions such as access to semantic/long-term memory have been shown in ecstasy users in previous research. Equally, there have been many reports of equivocal findings in this area. The current study sought to further investigate behavioural and electro-physiological measures of this executive function in ecstasy users. Twenty ecstasy-polydrug users, 20 non-ecstasy-polydrug users and 20 drug-naïve controls were recruited. Participants completed background questionnaires about their drug use, sleep quality, fluid intelligence and mood state. Each individual also completed a semantic retrieval task whilst 64 channel Electroencephalography (EEG) measures were recorded. Analysis of Variance (ANOVA) revealed no between-group differences in behavioural performance on the task. Mixed ANOVA on event-related potential (ERP) components P2, N2 and P3 revealed significant between-group differences in the N2 component. Subsequent exploratory univariate ANOVAs on the N2 component revealed marginally significant between-group differences, generally showing greater negativity at occipito-parietal electrodes in ecstasy users compared to drug-naïve controls. Despite absence of behavioural differences, differences in N2 magnitude are evidence of abnormal executive functioning in ecstasy-polydrug users.

Psychedelic symptoms of cannabis and cocaine use as a function of trait impulsivity.

PubMed

van Wel, J H P; Spronk, D B; Kuypers, K P C; Theunissen, E L; Toennes, S W; Verkes, R J; Ramaekers, J G

2015-03-01

Trait impulsivity has been linked to addiction in humans. It has been suggested that drug users with high trait impulsivity levels are more sensitive to subjective drug intoxication. This study assessed whether subjective response to drugs differs between drug users with normal or high levels of trait impulsivity. Regular drug users (N = 122) received doses of cocaine HCl, cannabis, and placebo in a three-way crossover study. Their mood, dissociative state, and psychedelic symptoms were measured with subjective rating scales (CADDS, Bowdle, POMS). Trait impulsivity was assessed with the Barratt Impulsiveness Scale. Cannabis increased dissociation and psychedelic state, as well as fatigue, confusion, depression and anxiety, and decreased arousal, positive mood, vigor, friendliness, and elation. Cocaine increased dissociation, psychedelic state, vigor, friendliness, elation, positive mood, anxiety and arousal, while decreasing fatigue. Only a few subjective items revealed a drug × trait impulsivity interaction, suggesting that psychedelic symptoms were most intense in high impulsivity subjects. Trait impulsiveness ratings were negatively correlated with ratings of vigor (r = -.197) and positively correlated with ratings of loss of thought control (r = .237) during cannabis intoxication. It is concluded that a broad association between trait impulsivity and psychedelic subjective drug experience appears to be absent. © The Author(s) 2015.

An AIDS risk reduction program for Dutch drug users: an intervention mapping approach to planning.

PubMed

van Empelen, Pepijn; Kok, Gerjo; Schaalma, Herman P; Bartholomew, L Kay

2003-10-01

This article presents the development of a theory- and evidence-based AIDS prevention program targeting Dutch drug users and aimed at promoting condom use. The emphasis is on the development of the program using a five-step intervention development protocol called intervention mapping (IM). Preceding Step 1 of the IM process, an assessment of the HIV problem among drug users was conducted. The product of IM Step 1 was a series of program objectives specifying what drug users should learn in order to use condoms consistently. In Step 2, theoretical methods for influencing the most important determinants were chosen and translated into practical strategies that fit the program objectives. The main strategy chosen was behavioral journalism. In Step 3, leaflets with role-model stories based on authentic interviews with drug users were developed and pilot tested. Finally, the need for cooperation with program users is discussed in IM Steps 4 and 5.

Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: a mixed-methods study

PubMed Central

Meade, Christina S.; Towe, Sheri L.; Watt, Melissa H.; Lion, Ryan R.; Myers, Bronwyn; Skinner, Donald; Kimani, Stephen; Pieterse, Desiree

2015-01-01

Background Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and treatment experiences of a community-recruited sample of methamphetamine users in Cape Town. Methods Using respondent driven sampling, 360 methamphetamine users (44% female) completed structured clinical interviews to assess substance abuse and treatment history and computerized surveys to assess drug-related risks. A sub-sample of 30 participants completed in-depth interviews to qualitatively explore experiences with methamphetamine use and drug treatment. Results Participants had used methamphetamine for an average of 7.06 years (SD=3.64). They reported using methamphetamine on an average of 23.49 of the past 30 days (SD=8.90); 60% used daily. The majority (90%) met ICD-10 criteria for dependence, and many reported severe social, financial, and legal consequences. While only 10% had ever received drug treatment, 90% reported that they wanted treatment. In the qualitative interviews, participants reported multiple barriers to treatment, including beliefs that treatment is ineffective and relapse is inevitable in their social context. They also identified important motivators, including desires to be drug free and improve family functioning. Conclusion This study yields valuable information to more effectively respond to emerging methamphetamine epidemics in South Africa and other low- and middle-income countries. Interventions to increase uptake of evidence-based services must actively seek out drug users and build motivation for treatment, and offer continuing care services to prevent relapse. Community education campaigns are also needed. PMID:25977205

User evaluations offer promise for pod-intravaginal ring as a drug delivery platform: A mixed methods study of acceptability and use experiences.

PubMed

Guthrie, Kate M; Rosen, Rochelle K; Vargas, Sara E; Getz, Melissa L; Dawson, Lauren; Guillen, Melissa; Ramirez, Jaime J; Baum, Marc M; Vincent, Kathleen L

2018-01-01

Effective HIV prevention requires efficient delivery of safe and efficacious drugs and optimization of user adherence. The user's experiences with the drug, delivery system, and use parameters are critical to product acceptability and adherence. Prevention product developers have the opportunity to directly control a drug delivery system and its impact on acceptability and adherence, as well as product efficacy. Involvement of potential users during preclinical design and development can facilitate this process. We embedded a mixed methods user evaluation study into a safety and pharmacokinetics (PK) trial of a pod-intravaginal ring delivering antiretroviral agents. Women enrolled in two cohorts, ultimately evaluating the safety/PK of a pod-IVRs delivering TDF-alone, TDF-FTC, and/or TDF-FTC-MVC. A 7-day use period was targeted for each pod-IVR, regardless of drug or drug combination. During the clinical study, participants provided both quantitative (i.e., survey) and qualitative (i.e., in-depth interview) data capturing acceptability, perceptibility, and adherence behaviors. Initial sexual and reproductive health history surveys, daily diaries, a final acceptability and willingness to use survey, and a qualitative in-depth interview comprised the user evaluation data for each pod-IVR experienced by the participants. Overall, the majority of participants (N = 10) reported being willing to use the pod-IVR platform for HIV prevention should it advance to market. Confidence to use the pod-IVR (e.g., insertion, removal) was high. There were no differences noted in the user experience of the pod-IVR platform; that is, whether the ring delivered TDF-alone, TDF-FTC, or TDF-FTC-MVC, users' experiences of the ring were similar and acceptable. Participants did report specific experiences, both sensory and behavioral, that impacted their use behaviors with respect to the ring, and which could ultimately impact acceptability and adherence. These experiences, and user evaluations elicited by them, could both challenge use or be used to leverage use in future trials and product rollout once fully articulated. High willingness-to-use data and lack of salient differences in user experiences related to use of the pod-IVR platform (regardless of agents delivered) suggests that the pod-IVR is a feasible and acceptable drug delivery device in and of itself. This finding holds promise both for an anti-HIV pod-IVR and, potentially, a multipurpose prevention pod-IVR that could deliver both prevention for sexually transmitted infections (STIs) including HIV and contraception. Given the very early clinical trial context, further acceptability, perceptibility, and adherence data should continue to be explored, in the context of longer use periods (e.g., 28-day ring use), and in the contexts of sexual activity and menses. Using early design and development contexts to gain insights into potential challenges and facilitators of drug delivery systems such as the pod-IVR could save valuable resources and time as a potential biomedical technology moves through the clinical trial pipeline and into real-world use.

Web-Based Cognitive Behavioral Relapse Prevention Program With Tailored Feedback for People With Methamphetamine and Other Drug Use Problems: Development and Usability Study.

PubMed

Takano, Ayumi; Miyamoto, Yuki; Kawakami, Norito; Matsumoto, Toshihiko

2016-01-06

Although drug abuse has been a serious public health concern, there have been problems with implementation of treatment for drug users in Japan because of poor accessibility to treatment, concerns about stigma and confidentiality, and costs. Therapeutic interventions using the Internet and computer technologies could improve this situation and provide more feasible and acceptable approaches. The objective of the study was to show how we developed a pilot version of a new Web-based cognitive behavioral relapse prevention program with tailored feedback to assist people with drug problems and assessed its acceptance and usability. We developed the pilot program based on existing face-to-face relapse prevention approaches using an open source Web application to build an e-learning website, including relapse prevention sessions with videos, exercises, a diary function, and self-monitoring. When users submitted exercise answers and their diary, researchers provided them with personalized feedback comments using motivational interviewing skills. People diagnosed with drug dependence were recruited in this pilot study from a psychiatric outpatient ward and nonprofit rehabilitation facilities and usability was evaluated using Internet questionnaires. Overall, website usability was assessed by the Web Usability Scale. The adequacy of procedures in the program, ease of use, helpfulness of content, and adverse effects, for example, drug craving, mental distress, were assessed by original structured questionnaires and descriptive form questions. In total, 10 people participated in the study and completed the baseline assessment, 60% completed all relapse prevention sessions within the expected period. The time needed to complete one session was about 60 minutes and most of the participants took 2 days to complete the session. Overall website usability was good, with reasonable scores on subscales of the Web Usability Scale. The participants felt that the relapse prevention sessions were easy to use and helpful, but that the length of the videos was too long. The participant who until recently used drugs was satisfied with the self-monitoring, but others that had already maintained abstinence for more than a year felt this activity was unhelpful and were bored tracking and recording information on daily drug use. Feedback comments from researchers enhanced participants' motivation and further insight into the disease. Serious adverse effects caused by the intervention were not observed. Some possible improvements to the program were suggested. The Web-based relapse prevention program was easy to use and acceptable to drug users in this study. This program will be helpful for drug users who do not receive behavioral therapy. After the pilot program is revised, further large-scale research is needed to assess its efficacy among drug users who have recently used drugs.

Fitness levels and physical activity among class A drug users entering prison.

PubMed

Fischer, Jan; Butt, Christine; Dawes, Helen; Foster, Charlie; Neale, Joanne; Plugge, Emma; Wheeler, Carly; Wright, Nat

2012-12-01

Physical activity could benefit drug users' physiological and mental health. Previous research has suggested that physical activity levels change when drug users enter prison. Twenty-five class A drug users who were new to prison answered physical activity and drug use cross-sectional questionnaires, took a submaximal fitness test and wore a pedometer for 1 week. Participants' mean aerobic capacity was estimated as 49 mls O2/kg/min (±12 SD). Their mean self-reported walking distance outside of prison was 4.67 miles on an average day (±4.14 SD). Pedometer data suggest they walked a mean of 1.8 miles/day in prison. Many class A drug users entering prison had high levels of fitness and physical activity before admission, often gained from walking. Walking activity reduced when they entered prison, posing a challenge to maintaining healthy activity levels.

Impulsivity in men with prescription of benzodiazepines and methadone in prison.

PubMed

Moreno-Ramos, Luis; Fernández-Serrano, María José; Pérez-García, Miguel; Verdejo-García, Antonio

2016-06-14

Benzodiazepines and methadone use has been associated with various neuropsychological impairments. However, to the best of our knowledge, no studies have been carried out on the effect of these substances (either separately or combined) on impulsive personality, including studies in prisoners. The aim of this study is to examine the impulsive personality of a sample of 134 male prisoners using the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (Torrubia, Avila, Molto, & Caseras, 2001) and the UPPS-P Scale (Cyders et al., 2007). Some of these were methadone users, methadone and benzodiazepines users, polydrug users in abstinence and non-dependent drug users. The results showed that drug users have greater sensitivity to reward, positive urgency, negative urgency and sensation seeking than non-dependent users. Methadone users showed more sensitivity to punishment and lack of perseverance with respect to other users. No differences were found between methadone+benzodiazepines users and other groups. The secondary aim is to examine which impulsive personality dimensions are related to the two motivational systems proposed by Gray (BIS-BAS) using exploratory factor analysis. Results showed two different components. One component was defined by the subscales sensitivity to reinforcement, positive urgency, negative urgency and sensation seeking. The second component was defined by the subscales sensitivity to punishment, lack of perseverance and lack of premeditation.

OxyContin® as Currency: OxyContin® Use and Increased Social Capital among Rural Appalachian Drug Users

PubMed Central

Jonas, Adam B.; Young, April M.; Oser, Carrie B.; Leukefeld, Carl G.; Havens, Jennifer R.

2012-01-01

Studies have shown that position within networks of social relations can have direct implications on the health behaviors of individuals. The present study examines connections between drug use and individual social capital within social networks of drug users (n=503) from rural Appalachian Kentucky, U.S.A. Respondent driven sampling was used to recruit individuals age 18 and older who had used one of the following drugs to get high: cocaine, crack, heroin, methamphetamine, or prescription opioids. Substance use was measured via self-report and social network analysis of participants’ drug use network was used to compute effective size, a measure of social capital. Drug network ties were based on sociometric data on recent (past 6 month) drug co-usage. Multivariate multi-level ordinal regression was used to model the independent effect of sociodemographic and drug use characteristics on social capital. Adjusting for gender, income, and education, daily OxyContin® use was found to be significantly associated with greater social capital, and daily marijuana use was associated with less social capital. These results suggest that in regions with marked economic disparities such as rural Appalachia, OxyContin® may serve as a form of currency that is associated with increased social capital among drug users. Interventions focusing on increasing alternate pathways to acquiring social capital may be one way in which to alleviate the burden of drug use in this high-risk population. PMID:22465379

Behavioral Risk Reduction in a Declining HIV Epidemic: Injection Drug Users in New York City, 1990-1997.

ERIC Educational Resources Information Center

Des Jarlais, Don C.; Perlis, Theresa; Friedman, Samuel R.; Chapman, Timothy; Kwok, John; Rockwell, Russell; Paone, Denise; Milliken, Judith; Monterroso, Edgar

2000-01-01

Assessed trends in HIV risk behaviors among New York City injection drug users from 1990-97. Interviews at a drug detoxification program and a research storefront in a high drug-use area showed continuing risk reduction among users that indicated a declining phase in the large HIV epidemic in New York City. HIV prevention programs appeared to be…

77 FR 45634 - Biosimilar User Fee Rates for Fiscal Year 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0007] Biosimilar User Fee Rates for Fiscal Year 2013 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the rates for biosimilar user fees for...

Marathon Group Counseling with Illicit Drug Users: Analysis of Content.

ERIC Educational Resources Information Center

Page, Richard C.; Wills, Judy

1983-01-01

Summarized a 16-hour marathon group for illicit drug users (N=12) in residential treatment. Content analysis showed the group spent more time on interpersonal relationships and relatively little time on group process. Drug users were able to successfully participate in therapeutic group discussions involving self-investment. (JAC)

Estimating preferences for modes of drug administration: The case of US healthcare professionals.

PubMed

Tetteh, Ebenezer K; Morris, Steve; Titchener-Hooker, Nigel

2018-01-01

There are hidden drug administration costs that arise from a mismatch between end-user preferences and how manufacturers choose to formulate their drug products for delivery to patients. The corollary of this is: there are "intangible benefits" from considering end-user preferences in manufacturing patient-friendly medicines. It is important then to have some idea of what pharmaceutical manufacturers should consider in making patient-friendly medicines and of the magnitude of the indirect benefits from doing so. This study aimed to evaluate preferences of healthcare professionals in the US for the non-monetary attributes of different modes of drug administration. It uses these preference orderings to compute a monetary valuation of the indirect benefits from making patient-friendly medicines. A survey collected choice preferences of a sample of 210 healthcare professionals in the US for two unlabelled drug options. These drugs were identical except in the levels of attributes of drug administration. Using the choice data collected, statistical models were estimated to compute gross welfare benefits, measured by the expected compensating variation, from making drugs in a more patient-friendly manner. The monetary value of end-user benefits from developing patient-friendly drug delivery systems is: (1) as large as the annual acquisition costs per full treatment episode for some biologic drugs; and (2) likely to fall in the "high end" of the distribution of the direct monetary costs of drug administration. An examination of end-user preferences should help manufacturers make more effective and efficient use of limited resources for innovations in drug delivery system, or manufacturing research in general. Copyright © 2017 Elsevier Inc. All rights reserved.

Contribution of cannabis and MDMA ("ecstasy") to cognitive changes in long-term polydrug users.

PubMed

Dafters, Richard Ian; Hoshi, Rosa; Talbot, Annie Claire

2004-05-01

Establishing whether cognitive changes follow long-term use of MDMA ("ecstasy") in humans has been difficult because of possible confounds with other drug use, particularly cannabis. Convincing evidence may be only obtained using experimental designs that account for such confounds. In the present study, cognitive/behavioural measures were used to investigate whether long-term MDMA use or long-term cannabis use is responsible for the changes sometimes observed in recreational MDMA users. Tests of attention and memory were administered to subjects who used both MDMA and cannabis, cannabis only, or neither drug. The main finding was that cannabis users, whether or not they also used MDMA, showed significantly impaired memory function on word free-recall and on immediate and delayed story recall compared to non-users. The findings highlight the importance of controlling for other drug use (particularly cannabis) when investigating persistent effects of MDMA in humans.

Gender Differences and Correlated Factors of Heroin Use Among Heroin Users.

PubMed

Zhou, Xiaobo; Yi, Zhihua; Yang, Xiaorong; Wang, Zhuo; Lyu, Xianxiang; Li, Jing

2017-01-02

Gender differences in illicit drug use are becoming increasingly recognized. However, there are few studies concerning differences between male and female heroin users in China. The study aimed to explore gender differences in terms of socio-demographic characteristics, drug-related behaviors, and treatment history among a heroin-using population in China. A cross-sectional study was conducted in four cities in December 2013. A total of 788 participants were recruited from several types of sites in each city: compulsory detoxification centers, methadone maintenance treatment clinics, and detention facilities. The data were collected via a self-administered questionnaire. Analysis of variance, chi-square test, and multivariate logistic regression analyses were conducted to examine gender differences in socio-demographic characteristics, drug-related behaviors, and treatment history. Female heroin users were more likely to be unemployed, have more education, and use heroin with their spouse/companion (p <.05). Male heroin users were more likely to be in detention facilities and MMT clinics, and relapse when they felt hopeless (p <.05). Conclusions/Importance: Although there were some similarities between male and female heroin users, significant gender differences do exist in some aspects of socio-demographic characteristics and heroin use. The data provide evidence that interventions aimed at preventing the initiation of heroin use and reducing relapse should take gender into account.

Heightened Dopaminergic Response to Amphetamine at the D3 Dopamine Receptor in Methamphetamine Users

PubMed Central

Boileau, Isabelle; Payer, Doris; Rusjan, Pablo M; Houle, Sylvain; Tong, Junchao; McCluskey, Tina; Wilson, Alan A; Kish, Stephen J

2016-01-01

Neuroimaging studies in stimulant use (eg, cocaine, methamphetamine) disorders show that diminished dopamine release by dopamine-elevating drugs is a potential marker of relapse and suggest that increasing dopamine at the D2/3 receptors may be therapeutically beneficial. In contrast, recent investigations indicate heightened D3 receptor levels in stimulant users prompting the view that D3 antagonism may help prevent relapse. Here we tested whether a ‘blunted' response to amphetamine in methamphetamine (MA) users extends to D3-rich brain areas. Fourteen MA users and 15 healthy controls completed two positron emission tomographic scans with a D3-preferring probe [11C]-(+)-PHNO at baseline and after amphetamine (0.4 mg/kg). Relative to healthy controls, MA users had greater decreases in [11C]-(+)-PHNO binding (increased dopamine release) after amphetamine in D3-rich substantia nigra (36 vs 20%, p=0.03) and globus pallidus (30 vs 17%, p=0.06), which correlated with self-reported ‘drug wanting'. We did not observe a ‘blunted' dopamine response to amphetamine in D2-rich striatum; however, drug use severity was negatively associated with amphetamine-induced striatal changes in [11C]-(+)-PHNO binding. Our study provides evidence that dopamine transmission in extrastriatal ‘D3-areas' is not blunted but rather increased in MA users. Together with our previous finding of elevated D3 receptor level in MA users, the current observation suggests that greater dopaminergic transmission at the D3 dopamine receptor may contribute to motivation to use drugs and argues in favor of D3 antagonism as a possible therapeutic tool to reduce craving and relapse in MA addiction. PMID:27353309

Cigarette Smoking Trajectories From Sixth to Twelfth Grade: Associated Substance Use and High School Dropout.

PubMed

Orpinas, Pamela; Lacy, Beth; Nahapetyan, Lusine; Dube, Shanta R; Song, Xiao

2016-02-01

The purpose of this longitudinal study was to identify distinct trajectories of cigarette smoking from sixth to twelfth grade and to characterize these trajectories by use of other drugs and high school dropout. The diverse sample for this analysis consisted of a cohort of 611 students from Northeast Georgia who participated in the Healthy Teens Longitudinal Study (2003-2009). Students completed seven yearly assessments from sixth through twelfth grade. We used semi-parametric, group-based modeling to identify groups of students whose smoking behavior followed a similar progression over time. Current smoking (past 30 day) increased from 6.9% among sixth graders to 28.8% among twelfth graders. Four developmental trajectories of cigarette smoking were identified: Abstainers/Sporadic Users (71.5% of the sample), Late Starters (11.3%), Experimenters (9.0%), and Continuous Users (8.2%). The Abstainer/Sporadic User trajectory was composed of two distinct groups: those who never reported any tobacco use (True Abstainers) and those who reported sporadic, low-level use (Sporadic Users). The True Abstainers reported significantly less use of alcohol and other drugs and lower dropout rates than students in all other trajectories, and Sporadic Users had worse outcomes than True Abstainers. Experimenters and Continuous Users reported the highest drug use. Over one-third of Late Starters (35.8%) and almost half of Continuous Users (44.4%) dropped out of high school. Cigarette smoking was associated with behavioral and academic problems. Results support early and continuous interventions to reduce use of tobacco and other drugs and prevent high school dropout. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Heightened Dopaminergic Response to Amphetamine at the D3 Dopamine Receptor in Methamphetamine Users.

PubMed

Boileau, Isabelle; Payer, Doris; Rusjan, Pablo M; Houle, Sylvain; Tong, Junchao; McCluskey, Tina; Wilson, Alan A; Kish, Stephen J

2016-12-01

Neuroimaging studies in stimulant use (eg, cocaine, methamphetamine) disorders show that diminished dopamine release by dopamine-elevating drugs is a potential marker of relapse and suggest that increasing dopamine at the D 2/3 receptors may be therapeutically beneficial. In contrast, recent investigations indicate heightened D 3 receptor levels in stimulant users prompting the view that D 3 antagonism may help prevent relapse. Here we tested whether a 'blunted' response to amphetamine in methamphetamine (MA) users extends to D 3 -rich brain areas. Fourteen MA users and 15 healthy controls completed two positron emission tomographic scans with a D 3 -preferring probe [ 11 C]-(+)-PHNO at baseline and after amphetamine (0.4 mg/kg). Relative to healthy controls, MA users had greater decreases in [ 11 C]-(+)-PHNO binding (increased dopamine release) after amphetamine in D 3 -rich substantia nigra (36 vs 20%, p=0.03) and globus pallidus (30 vs 17%, p=0.06), which correlated with self-reported 'drug wanting'. We did not observe a 'blunted' dopamine response to amphetamine in D 2 -rich striatum; however, drug use severity was negatively associated with amphetamine-induced striatal changes in [ 11 C]-(+)-PHNO binding. Our study provides evidence that dopamine transmission in extrastriatal 'D 3 -areas' is not blunted but rather increased in MA users. Together with our previous finding of elevated D 3 receptor level in MA users, the current observation suggests that greater dopaminergic transmission at the D 3 dopamine receptor may contribute to motivation to use drugs and argues in favor of D 3 antagonism as a possible therapeutic tool to reduce craving and relapse in MA addiction.

Concurrent Use of Hypnotic Drugs and Chinese Herbal Medicine Therapies among Taiwanese Adults with Insomnia Symptoms: A Population-Based Study.

PubMed

Lee, Kuei-Hua; Tsai, Yueh-Ting; Lai, Jung-Nien; Lin, Shun-Ku

2013-01-01

Background. The increased practice of traditional Chinese medicine (TCM) worldwide has raised concerns regarding herb-drug interactions. The purpose of our study is to analyze the concurrent use of Chinese herbal products (CHPs) among Taiwanese insomnia patients taking hypnotic drugs. Methods. The usage, frequency of services, and CHP prescribed among 53,949 insomnia sufferers were evaluated from a random sample of 1 million beneficiaries in the National Health Insurance Research Database. A logistic regression method was used to identify the factors that were associated with the coprescription of a CHP and a hypnotic drug. Cox proportional hazards regressions were performed to calculate the hazard ratios (HRs) of hip fracture between the two groups. Results. More than 1 of every 3 hypnotic users also used a CHP concurrently. Jia-Wei-Xiao-Yao-San (Augmented Rambling Powder) and Suan-Zao-Ren-Tang (Zizyphus Combination) were the 2 most commonly used CHPs that were coadministered with hypnotic drugs. The HR of hip fracture for hypnotic-drug users who used a CHP concurrently was 0.57-fold (95% CI = 0.47-0.69) that of hypnotic-drug users who did not use a CHP. Conclusion. Exploring potential CHP-drug interactions and integrating both healthcare approaches might be beneficial for the overall health and quality of life of insomnia sufferers.

Evaluation of electronic prescription implementation in polymedicated users of Catalonia, Spain: a population-based longitudinal study

PubMed Central

Lizano-Díez, Irene; Modamio, Pilar; López-Calahorra, Pilar; Lastra, Cecilia F; Segú, Jose L; Gilabert-Perramon, Antoni; Mariño, Eduardo L

2014-01-01

Objectives To assess whether electronic prescribing is a comprehensive health management tool that may contribute to rational drug use, particularly in polymedicated patients receiving 16 or more medications in the public healthcare system in the Barcelona Health Region (BHR). Design 16 months of retrospective study followed by 12 months of prospective monitoring. Setting Primary healthcare in BHR, Catalonia, Spain. Participants All insured patients, especially those who are polymedicated in six basic health areas (BHA). Polymedicated patients were those with a consumption of ≥16 drugs/month. Interventions Monitoring demographic and consumption variables obtained from the records of prescriptions dispensed in pharmacies and charged to the public health system, as well as the resulting drug use indicators. Territorial variables related to implementation of electronic prescribing were also described and were obtained from the institutional data related to the deployment of the project. Main outcome measures Trend in drug use indicators (number of prescriptions per polymedicated user, total cost per polymedicated user and total cost per prescription) according to e-prescription implementation. Results There was a significant upward trend in the number of polymedicated users, number of prescriptions and total cost (p<0.05), which seemed independent from the implementation of electronic prescribing when comparing the preimplementation and postimplementation period. Prescriptions per user and cost per user showed a decrease between the preimplementation and postimplementation period, being significant in two BHAs (p<0.05). Conclusions Results suggest that after the implementation of electronic prescribing, the rationality of prescribing in polymedicated patients improved. In addition, this study provides a very valuable approach for future impact assessment. PMID:25377013

Peer Norms and Sharing of Injection Paraphernalia among Puerto Rican Injection Drug Users in New York and Puerto Rico

ERIC Educational Resources Information Center

Andia, Jonny F.; Deren, Sherry; Robles, Rafaela R.; Kang, Sung-Yeon; Colon, Hector M.

2008-01-01

This study examines the influence of peer norms on sharing of injection paraphernalia (e.g., indirect sharing behaviors, including sharing of cookers, cotton, rinse water and back/front loading) among Puerto Rican injection drug users (IDUs) in Bayamon, Puerto Rico, and East Harlem, New York City. Data were collected from 873 Puerto Rican IDUs…

Cognitive Behavioral Theories Used to Explain Injection Risk Behavior among Injection Drug Users: A Review and Suggestions for the Integration of Cognitive and Environmental Models

ERIC Educational Resources Information Center

Wagner, Karla Dawn; Unger, Jennifer B.; Bluthenthal, Ricky N.; Andreeva, Valentina A.; Pentz, Mary Ann

2010-01-01

Injection drug users (IDUs) are at risk for HIV and viral hepatitis, and risky injection behavior persists despite decades of intervention. Cognitive behavioral theories (CBTs) are commonly used to help understand risky injection behavior. The authors review findings from CBT-based studies of injection risk behavior among IDUs. An extensive…

Relationship between hunger, adherence to antiretroviral therapy and plasma HIV RNA suppression among HIV-positive illicit drug users in a Canadian setting.

PubMed

Anema, Aranka; Kerr, Thomas; Milloy, M-J; Feng, Cindy; Montaner, Julio S G; Wood, Evan

2014-04-01

Food insecurity may be a barrier to achieving optimal HIV treatment-related outcomes among illicit drug users. This study therefore, aimed to assess the impact of severe food insecurity, or hunger, on plasma HIV RNA suppression among illicit drug users receiving antiretroviral therapy (ART). A cross-sectional Multivariate logistic regression model was used to assess the potential relationship between hunger and plasma HIV RNA suppression. A sample of n = 406 adults was derived from a community-recruited open prospective cohort of HIV-positive illicit drug users, in Vancouver, British Columbia (BC), Canada. A total of 235 (63.7%) reported "being hungry and unable to afford enough food," and 241 (59.4%) had plasma HIV RNA < 50 copies/ml. In unadjusted analyses, self-reported hunger was associated with lower odds of plasma HIV RNA suppression (Odds Ratio = 0.59, 95% confidence interval [CI]: 0.39-0.90, p = 0.015). In multivariate analyses, this association was no longer significant after controlling for socio-demographic, behavioral, and clinical characteristics, including 95% adherence (Adjusted Odds Ratio [AOR] = 0.65, 95% CI: 0.37-1.10, p = 0.105). Multivariate models stratified by 95% adherence found that the direction and magnitude of this association was not significantly altered by the adherence level. Hunger was common among illicit drug users in this setting. Although, there was an association between hunger and lower likelihood of plasma HIV RNA suppression, this did not persist in adjusted analyses. Further research is warranted to understand the social-structural, policy, and physical factors shaping the HIV outcomes of illicit drug users.

The geographic distribution patterns of HIV-, HCV- and co-infections among drug users in a national methadone maintenance treatment program in Southwest China

PubMed Central

2014-01-01

Background HIV-, HCV- and HIV/HCV co-infections among drug users have become a rapidly emerging global public health problem. In order to constrain the dual epidemics of HIV/AIDS and drug use, China has adopted a methadone maintenance treatment program (MMTP) since 2004. Studies of the geographic heterogeneity of HIV and HCV infections at a local scale are sparse, which has critical implications for future MMTP implementation and health policies covering both HIV and HCV prevention among drug users in China. This study aimed to characterize geographic patterns of HIV and HCV prevalence at the township level among drug users in a Yi Autonomous Prefecture, Southwest of China. Methods Data on demographic and clinical characteristics of all clients in the 11 MMTP clinics of the Yi Autonomous Prefecture from March 2004 to December 2012 were collected. A GIS-based geographic analysis involving geographic autocorrelation analysis and geographic scan statistics were employed to identify the geographic distribution pattern of HIV-, HCV- and co-infections among drug users. Results A total of 6690 MMTP clients was analyzed. The prevalence of HIV-, HCV- and co-infections were 25.2%, 30.8%, and 10.9% respectively. There were significant global and local geographic autocorrelations for HIV-, HCV-, and co-infection. The Moran’s I was 0.3015, 0.3449, and 0.3155, respectively (P < 0.0001). Both the geographic autocorrelation analysis and the geographic scan statistical analysis showed that HIV-, HCV-, and co-infections in the prefecture exhibited significant geographic clustering at the township level. The geographic distribution pattern of each infection group was different. Conclusion HIV-, HCV-, and co-infections among drug users in the Yi Autonomous Prefecture all exhibited substantial geographic heterogeneity at the township level. The geographic distribution patterns of the three groups were different. These findings imply that it may be necessary to inform or invent site-specific intervention strategies to better devote currently limited resource to combat these two viruses. PMID:24612875

Transitions in illicit drug use status over 3 years: a prospective analysis of a general population sample.

PubMed

Compton, Wilson M; Dawson, Deborah A; Conway, Kevin P; Brodsky, Marc; Grant, Bridget F

2013-06-01

The authors examined 3-year transitions among nonuse, asymptomatic use, and problem use of illicit drugs for U.S. adults in the general household population. Data were from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions, a study of 34,653 adults interviewed twice, 3 years apart. Respondents were categorized on three mutually exclusive categories of baseline drug status: past-year nonusers (N=32,675), past-year asymptomatic drug users (N=861), and past-year symptomatic drug users (N=1,117). Symptomatic drug use, or problem use, was defined as presence of one or more symptoms that operationalize DSM-IV drug abuse and dependence criteria. The authors assessed sociodemographic, health, substance use, and psychiatric covariates for association with 3-year transitions to different status categories. Among baseline nonusers, 95.4% continued to be nonusers at follow-up, 2.1% became asymptomatic users, and 2.5% developed problem use. Among baseline asymptomatic users, 66.6% had stopped using drugs at follow-up, 14.3% continued to be asymptomatic users, and 19.1% had developed problem use. Nearly half (49.0%) of those with problem use at baseline had stopped using drugs at follow-up, 10.9% had transitioned to asymptomatic use, and 40.1% continued to have problem use. Younger age, male sex, white race, and not being married were associated with progression from nonuse to use or problem use, as were alcohol and tobacco use and disorders, major depression, and schizotypal, borderline, and narcissistic personality disorders. Panic disorder and avoidant personality disorder were associated with less progression. Transitions in drug use status are common. The finding that alcohol and tobacco variables and co-occurring psychopathology are important correlates of transitions suggests the value of addressing all co-occurring disorders and substance use in patient assessments and treatment planning, both to prevent adverse transitions and to promote positive transitions.

Psychometric properties of the World Health Organization quality of life assessment – brief in methadone patients: a validation study in northern Taiwan

PubMed Central

2013-01-01

Background Quality of life (QOL) is an important outcome measure in the treatment of heroin addiction. The Taiwan version of the World Health Organization Quality of Life assessment (WHOQOL-BREF [TW]) has been developed and studied in various groups, but not specifically in a population of injection drug users. The aim of this study was to analyze the psychometric properties of the WHOQOL-BREF (TW) in a sample of injection drug users undergoing methadone maintenance treatment. Methods A total of 553 participants were interviewed and completed the instrument. Item-response distributions, internal consistency, corrected item-domain correlation, criterion-related validity, and construct validity through confirmatory factor analysis were evaluated. Results The frequency distribution of the 4 domains of the WHOQOL-BREF (TW) showed no floor or ceiling effects. The instrument demonstrated adequate internal consistency (Cronbach’s alpha coefficients were higher than 0.7 across the 4 domains) and all items had acceptable correlation with the corresponding domain scores (r = 0.32-0.73). Correlations (p < 0.01) of the 4 domains with the 2 benchmark items assessing overall QOL and general health were supportive of criterion-related validity. Confirmatory factor analysis yielded marginal goodness-of-fit between the 4-domain model and the sample data. Conclusions The hypothesized WHOQOL-BREF measurement model was appropriate for the injection drug users after some adjustments. Despite different patterns found in the confirmatory factor analysis, the findings overall suggest that the WHOQOL-BREF (TW) is a reliable and valid measure of QOL among injection drug users and can be utilized in future treatment outcome studies. The factor structure provided by the study also helps to understand the QOL characteristics of the injection drug users in Taiwan. However, more research is needed to examine its test-retest reliability and sensitivity to changes due to treatment. PMID:24325611

Prevalence and associated factors of illicit drug use among university students in the association of southeast Asian nations (ASEAN).

PubMed

Yi, Siyan; Peltzer, Karl; Pengpid, Supa; Susilowati, Indri Hapsari

2017-04-06

Illicit drug use among university students has been recognized as a global public health issue in recent years. It may lead to poor academic performance that in turn leads to poor productivity in their later life. This study explores prevalence of and factors associated with illicit drug use among university students in the Association of Southeast Asian Nations (ASEAN). This multi-country cross-sectional study was conducted in 2015 in Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam. A multi-stage cluster sampling was used to select undergraduate students from one or two universities in each country for self-administered questionnaire survey. Multivariate logistic regression analyses was performed to explore risk factors related to illicit drug use. Participants included 7,923 students with a mean age of 20.6 years (SD = 2.8), ranging from 18-30 years. The overall prevalence of frequent (≥10 times), infrequent (1-9 times) and ever (at least once) illicit drug use in the past 12 months was 2.2, 14.7, and 16.9%, respectively. After adjustment, male students were significantly less likely to be infrequent (1-9 times vs. never), but significantly more likely to be ever users compared to females. Compared to those living with parents/guardians, students living away from parents/guardians were significantly less likely to be frequent (≥10 times vs. never) and infrequent users. Students from lower-middle-income countries were significantly more likely to be frequent and infrequent users, but significantly less likely to be ever users compared to those from upper-middle or high-income countries. Students with poor subjective health status were significantly more likely to be frequent users compared to those who reported good subjective health status. Students who reported binge drinking in the past month were significantly more likely to be infrequent users, but significantly less likely to be ever users. Our findings indicate that prevalence of illicit drug use among university students in the ASEAN region varied by country. Concerted social intervention programs should be designed to address related health and behavioral problems such as illicit drug use and alcohol drinking with particular emphasis on at-risk subgroups of this young population.

Energy drink consumption among young Australian adults: associations with alcohol and illicit drug use.

PubMed

Trapp, Georgina S A; Allen, Karina L; O'Sullivan, Therese; Robinson, Monique; Jacoby, Peter; Oddy, Wendy H

2014-01-01

Energy drinks are becoming increasingly popular among young people. The purpose of this study was to determine the prevalence of energy drink consumption and its associations with socio-demographic characteristics, alcohol, cigarette and illicit drug use in a population-based sample of young adults participating in the Western Australian Pregnancy Cohort (Raine) Study. We used self-administered questionnaires to assess energy drink consumption patterns, alcohol intake, cigarette and illicit drug use at the 20-year cohort follow-up. Data was also collected on socio-demographics, physical activity, body mass index (BMI) and dietary intake. Our sample included 1234 participants (47% male, mean age 20 ± 0.5 years). We considered energy-drink consumption as a categorical (users versus non-users) variable. Overall, 48% of participants consumed energy drinks at least once per month, with an average intake of 1.31 ± 0.75 cans per day amongst energy drink users. The most significant correlates of energy drink use were being in part-time or full-time employment, being male, being a cigarette smoker, having heavier alcoholic spirit consumption patterns and being an ecstasy user (all p<0.05). No significant associations were observed with BMI or dietary intake. Australian energy drink users tend to have heavier alcohol consumption patterns be a cigarette smoker and use illicit drugs relative to non-users. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance abuse problems. Copyright © 2013. Published by Elsevier Ireland Ltd.

Depression, impulsiveness, sleep, and memory in past and present polydrug users of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy).

PubMed

Taurah, Lynn; Chandler, Chris; Sanders, Geoff

2014-02-01

Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is a worldwide recreational drug of abuse. Unfortunately, the results from human research investigating its psychological effects have been inconsistent. The present study aimed to be the largest to date in sample size and 5HT-related behaviors; the first to compare present ecstasy users with past users after an abstinence of 4 or more years, and the first to include robust controls for other recreational substances. A sample of 997 participants (52 % male) was recruited to four control groups (non-drug (ND), alcohol/nicotine (AN), cannabis/alcohol/nicotine (CAN), non-ecstasy polydrug (PD)), and two ecstasy polydrug groups (present (MDMA) and past users (EX-MDMA). Participants completed a drug history questionnaire, Beck Depression Inventory, Barratt Impulsiveness Scale, Pittsburgh Sleep Quality Index, and Wechsler Memory Scale-Revised which, in total, provided 13 psychometric measures. While the CAN and PD groups tended to record greater deficits than the non-drug controls, the MDMA and EX-MDMA groups recorded greater deficits than all the control groups on ten of the 13 psychometric measures. Strikingly, despite prolonged abstinence (mean, 4.98; range, 4-9 years), past ecstasy users showed few signs of recovery. Compared with present ecstasy users, the past users showed no change for ten measures, increased impairment for two measures, and improvement on just one measure. Given this record of impaired memory and clinically significant levels of depression, impulsiveness, and sleep disturbance, the prognosis for the current generation of ecstasy users is a major cause for concern.

Association of Attorney Advertising and FDA Action with Prescription Claims: A Time Series Segmented Regression Analysis.

PubMed

Tippett, Elizabeth C; Chen, Brian K

2015-12-01

Attorneys sponsor television advertisements that include repeated warnings about adverse drug events to solicit consumers for lawsuits against drug manufacturers. The relationship between such advertising, safety actions by the US Food and Drug Administration (FDA), and healthcare use is unknown. To investigate the relationship between attorney advertising, FDA actions, and prescription drug claims. The study examined total users per month and prescription rates for seven drugs with substantial attorney advertising volume and FDA or other safety interventions during 2009. Segmented regression analysis was used to detect pre-intervention trends, post-intervention level changes, and changes in post-intervention trends relative to the pre-intervention trends in the use of these seven drugs, using advertising volume, media hits, and the number of Medicare enrollees as covariates. Data for these variables were obtained from the Center for Medicare and Medicaid Services, Kantar Media, and LexisNexis. Several types of safety actions were associated with reductions in drug users and/or prescription rates, particularly for fentanyl, varenicline, and paroxetine. In most cases, attorney advertising volume rose in conjunction with major safety actions. Attorney advertising volume was positively correlated with prescription rates in five of seven drugs, likely because advertising volume began rising before safety actions, when prescription rates were still increasing. On the other hand, attorney advertising had mixed associations with the number of users per month. Regulatory and safety actions likely reduced the number of users and/or prescription rates for some drugs. Attorneys may have strategically chosen to begin advertising adverse drug events prior to major safety actions, but we found little evidence that attorney advertising reduced drug use. Further research is needed to better understand how consumers and physicians respond to attorney advertising.

An Approach for Casual Drug Users. Technical Paper.

ERIC Educational Resources Information Center

Bloom, Erwin S., Ed.

This publication was written to respond to the fact that many drug treatment centers receive inappropriate referrals of casual or recreational marihuana users from the courts for "treatment" as an alternative to jail. A drug abuse task force recommended that agencies give priority to abusers of the high-risk categories and to compulsive users of…

Assessing the Effects of Non-steroidal Anti-inflammatory Drugs on Antihypertensive Drug Therapy Using Post-Marketing Surveillance Database

PubMed Central

Ishiguro, Chieko; Fujita, Toshiharu; Omori, Takashi; Fujii, Yosuke; Mayama, Takeshi; Sato, Tosiya

2008-01-01

Background Antihypertensive and non-steroidal anti-inflammatory drugs (NSAIDs) are used to treat many common diseases. However, it has been suspected that interactions between these drugs exist. Here, we assessed the interactions between non-selective NSAIDs and several classes of antihypertensive drugs. Methods The study design was a cohort study using “The Antihypertensive Drug Database,” which is a collection of data accumulated from Drug Use Investigations. Subjects newly starting antihypertensive drug therapy were identified in the database. We compared the “User” group, who were co-administered NSAIDs, with the “Non-user” group, who were not. The outcome measure was the change in systolic blood pressure from the baseline after 2 months of treatment. We estimated the non-adjusted and adjusted differences in the change in systolic blood pressure between the “User” and “Non-user” groups. Results Data were collected for a total of 1,204 subjects, of whom 364 were prescribed beta blockers, 60 were prescribed diuretics, 628 were prescribed angiotensin-converting enzyme inhibitors, and 152 were prescribed calcium channel blockers. The adjusted difference in the change in systolic blood pressure between the User (n = 301) and Non-user (n = 903) groups was 2.88 mmHg (95% confidence interval: 0.89, 4.87); thus, systolic blood pressure in the Non-User group decreased further from the baseline than that in the User group. In subjects administered beta blockers, diuretics, angiotensin-converting enzyme inhibitors, and calcium channel blockers, the corresponding differences were 0.37 mmHg (-3.24, 3.98), 6.11 mmHg (-3.16, 15.37), 3.85 mmHg (1.16, 6.66), and 3.50 mmHg (-2.03, 9.02). Conclusion The effectiveness of antihypertensive drugs was attenuated by the co-administration of NSAIDs. The differences in the effects of NSAIDs varied with different classes of antihypertensive drugs. PMID:18469490

Comparing Characteristics of Early-Onset Injection Drug Users to Those With Late-Onset Injection in Kermanshah, Iran.

PubMed

Jorjoran Shushtari, Zahra; Noroozi, Alireza; Mirzazadeh, Ali; Ahounbar, Elahe; Hajbi, Ahmad; Najafi, Mohammad; Bazrafshan, Ali; Farhadi, Mohammad Hossin; Farhoudian, Ali; Higgs, Peter; Shahboulagh, Farahnaz Mohammadi; Waye, Katherine; Noroozi, Mehdi

2017-05-12

Characteristics and behaviors of early-onset injection drug users are under studied topics in Iran. This study aimed to identify and compare the demographic characteristics as well as the drug using behaviors of early-onset and late-onset injection drug users in Kermanshah, West Iran. In this cross-sectional study using snowball and convenience sampling, we recruited 450 people during the Fall of 2014 from two drop in centers in Kermanshah, Iran. We collected data through face-to-face interviews. Early-onset injection is defined as whether the person reported their first injection at 22 years of age or younger. Subsequently, late-onset injection is defined as 23 years of age or older. We compared the characteristics of the two groups through both univariate and multiple logistic analyses. Overall, 54% (CI 95%: 44.3%, 62.2%) were early injectors. After controlling for low socioeconomic status, initiation of drug use at a young age, multiple drug use and methamphetamine use were all significantly associated with a higher likelihood of early-onset injection. Additionally, early-onset injection was associated with recent syringe borrowing (OR = 2.6, p = 0.001), recent syringe lending (OR = 1.4, p = 0.01), recent cooker sharing (OR = 3.2, p = 0.01) and injecting two or more times a day (OR = 2.2, p = 0.04). Early-onset injectors were more likely to report a lower socioeconomic status, initiation of first drug use at a younger age, using methamphetamine alongside polydrug use, and engaging in higher risk taking behaviors like borrowing needles. With these associations, the study emphasizes the need for drug-prevention programs to focus on the transition to injection drug use at younger ages.

76 FR 79198 - Generic Drug User Fee; Public Meeting; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting; Correction AGENCY: Food and Drug Administration, HHS. ACTION: Notice; correction. SUMMARY: The Food and Drug Administration (FDA) is correcting a notice that appeared...

Evaluation of the US Food and Drug Administration sentinel analysis tools in confirming previously observed drug-outcome associations: The case of clindamycin and Clostridium difficile infection.

PubMed

Carnahan, Ryan M; Kuntz, Jennifer L; Wang, Shirley V; Fuller, Candace; Gagne, Joshua J; Leonard, Charles E; Hennessy, Sean; Meyer, Tamra; Archdeacon, Patrick; Chen, Chih-Ying; Panozzo, Catherine A; Toh, Sengwee; Katcoff, Hannah; Woodworth, Tiffany; Iyer, Aarthi; Axtman, Sophia; Chrischilles, Elizabeth A

2018-03-13

The Food and Drug Administration's Sentinel System developed parameterized, reusable analytic programs for evaluation of medical product safety. Research on outpatient antibiotic exposures, and Clostridium difficile infection (CDI) with non-user reference groups led us to expect a higher rate of CDI among outpatient clindamycin users vs penicillin users. We evaluated the ability of the Cohort Identification and Descriptive Analysis and Propensity Score Matching tools to identify a higher rate of CDI among clindamycin users. We matched new users of outpatient dispensings of oral clindamycin or penicillin from 13 Data Partners 1:1 on propensity score and followed them for up to 60 days for development of CDI. We used Cox proportional hazards regression stratified by Data Partner and matched pair to compare CDI incidence. Propensity score models at 3 Data Partners had convergence warnings and a limited range of predicted values. We excluded these Data Partners despite adequate covariate balance after matching. From the 10 Data Partners where these models converged without warnings, we identified 807 919 new clindamycin users and 8 815 441 new penicillin users eligible for the analysis. The stratified analysis of 807 769 matched pairs included 840 events among clindamycin users and 290 among penicillin users (hazard ratio 2.90, 95% confidence interval 2.53, 3.31). This evaluation produced an expected result and identified several potential enhancements to the Propensity Score Matching tool. This study has important limitations. CDI risk may have been related to factors other than the inherent properties of the drugs, such as duration of use or subsequent exposures. Copyright © 2018 John Wiley & Sons, Ltd.

“I’m not afraid of those ones just 'cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids

PubMed Central

Daniulaityte, Raminta; Falck, Russel; Carlson, Robert G.

2012-01-01

Background There has been a rise in the illicit use of pharmaceutical opioids (”pain pills”) in the United States. Conducted with young adult non-medical users of pharmaceutical opioids, this study uses qualitative methods and cultural consensus analysis to describe risk perceptions associated with pharmaceutical opioids and to determine patterns of cultural sharing and intra-cultural variation of these views. Methods The qualitative sub-sample (n=47) was selected from a larger sample of 396 young adults (18–23 years old), who were participating in a natural history study of illicit pharmaceutical opioid use. Qualitative life history interviews, drug ranking task, and cultural consensus analysis were used to elicit participant views about risks and harms associated with pain pills and other drugs, as well as alcohol and tobacco. Results Cultural consensus analysis revealed that the participants shared a single cultural model of drug risks, but the level of agreement decreased with the increasing range of drugs ever used. Further, those with more extensive drug use histories differed from less “experienced” users in their views about OxyContin and some other drugs. Overall, pain pills were viewed as addicting and potentially deadly substances, but these properties were linked to the patterns and methods of use, as well as characteristics of an individual user. Further, risks associated with pharmaceutical opioids were further curtailed because they “came from the doctor,” and thus had a legitimate aspect to their use. Conclusions This study highlights potential problems with universal approaches to substance use prevention and intervention among young people since such approaches ignore the fact that substance use education messages may be experienced differently depending on an individual’s drug use history and his/her perceptions of drug risks. Findings reported here may be useful in the development of prevention and intervention programs aimed at reducing the harm associated with illicit use of pain pills. PMID:22417823

Web-Based Alcohol, Smoking, and Substance Involvement Screening Test Results for the General Spanish Population: Cross-Sectional Study

PubMed Central

2018-01-01

Background Information technology in health sciences could be a screening tool of great potential and has been shown to be effective in identifying single-drug users at risk. Although there are many published tests for single-drug screening, there is a gap for concomitant drug use screening in general population. The ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) website was launched on February 2015 in Madrid, Spain, as a tool to identify those at risk. Objective The aim of this study was to describe the use of a tool and to analyze profiles of drug users, their consumption patterns, and associated factors. Methods Government- and press-released launching of a Spanish-validated ASSIST test from the World Health Organization (WHO) was used for voluntary Web-based screening of people with drug-related problems. The tests completed in the first 6 months were analyzed . Results A total of 1657 visitors of the 15,867 visits (1657/15,867, 10.44%) completed the whole Web-based screening over a 6-month period. The users had an average age of 37.4 years, and 78.87% (1307/1657) screened positive for at least one of the 9 drugs tested. The drugs with higher prevalence were tobacco (840/1657, 50.69%), alcohol (437/1657, 26.37%), cannabis (361/1657, 21.79%), and sedatives or hypnotics (192/1657, 11.59%). Polyconsumption or concomitant drug use was stated by 31.80% (527/1657) of the users. Male respondents had a higher risk of having alcohol problems (odds ratio, OR 1.55, 95% CI 1.18-2.04; P=.002) and double the risk for cannabis problems (OR 2.07, 95% CI 1.46-2.92; P<.001). Growing age increased by 3 times the risk of developing alcohol problems for people aged between 45 and 65 years (OR 3.01, 95% CI 1.89-4.79; P<.001). Conclusions A Web-based screening test could be useful to detect people at risk. The drug-related problem rates detected by the study are consistent with the current literature. This tool could be useful for users, who use information technology on a daily basis, not seeking medical attention. PMID:29453188

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization.

PubMed

Wu, F; Fu, L M; Hser, Y H

2015-09-01

This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Increased alcohol consumption, nonmedical prescription drug use, and illicit drug use are associated with energy drink consumption among college students

PubMed Central

Arria, Amelia M.; Caldeira, Kimberly M.; Kasperski, Sarah J.; O’Grady, Kevin E.; Vincent, Kathryn B.; Griffiths, Roland R.; Wish, Eric D.

2009-01-01

Objectives This longitudinal study examined the prevalence and correlates of energy drink use among college students, and investigated its possible prospective associations with subsequent drug use, including nonmedical prescription drug use. Methods Participants were 1,060 undergraduates from a large, public university who completed three annual interviews, beginning in their first year of college. Use of energy drinks, other caffeinated products, tobacco, alcohol, and other illicit and prescription drugs were assessed, as well as demographic and personality characteristics. Results Annual weighted prevalence of energy drink use was 22.6%wt and 36.5%wt in the second and third year of college, respectively. Compared to energy drink non-users, energy drink users had heavier alcohol consumption patterns, and were more likely to have used other drugs, both concurrently and in the preceding assessment. Regression analyses revealed that Year 2 energy drink use was significantly associated with Year 3 nonmedical use of prescription stimulants and prescription analgesics, but not with other Year 3 drug use, holding constant demographics, prior drug use, and other factors. Conclusions A substantial and rapidly-growing proportion of college students use energy drinks. Energy drink users tend to have greater involvement in alcohol and other drug use and higher levels of sensation-seeking, relative to non-users of energy drinks. Prospectively, energy drink use has a unique relationship with nonmedical use of prescription stimulants and analgesics. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance use problems. PMID:20729975

Characteristics of New-Onset and Chronic Sleep Medication Users Among Older Adults: A Retrospective Study of a US Medigap Plan Population using Propensity Score Matching.

PubMed

Musich, Shirley; Wang, Shaohung S; Slindee, Luke B; Saphire, Lynn; Wicker, Ellen

2018-05-01

Prescription sleep medications are often utilized to manage sleep problems among older adults even though these drugs are associated with multiple risks. The aim was to determine the prevalence and characteristics of new-onset compared to chronic sleep medication users and to examine factors associated with the conversion from new to chronic use. A secondary objective was to investigate the impact of sleep medications on health outcomes of injurious falls and patterns of healthcare utilization and expenditures. A 25% random sample of adults ≥ 65 years with 3-year continuous AARP ® Medicare Supplement medical and AARP ® MedicareRx drug plan enrollment was utilized to identify new-onset and chronic sleep medication users. Prescription sleep medication drugs were defined using National Drug Codes (NDCs); falls or hip fractures were identified from diagnosis codes. New users had no sleep medication use in 2014, but initiated medication use in 2015; chronic users had at least one sleep medication prescription in 2014 and in 2015; both groups had follow-up through 2016. Characteristics associated with new users, new users who converted to chronic use, and chronic users were determined using multivariate logistic regression. Prevalence of falls, healthcare utilization and expenditures were regression adjusted. Among eligible insureds, 3 and 9% were identified as new-onset and chronic sleep medication users, respectively. New-onset sleep medication prescriptions were often associated with an inpatient hospitalization. The strongest characteristics associated with new users, those who converted to chronic use, and chronic users were sleep disorders, depression and opioid use. About 50% of new users had > 30 days' supply; 25% converted to chronic use with ≥ 90 days' supply. The prevalence of falls for new-onset users increased by 70% compared to a 22% increase among chronic users. New-onset and chronic sleep medication users were characterized by sleep disorders, depression and pain. Addressing the underlying problems associated with sleep problems among older adults may decrease the need for sleep medications and thus reduce the risk of sleep medication-related adverse events.

The Effects of Childhood Exposure to Drug Users and Religion on Drug Use in Adolescence and Young Adulthood

ERIC Educational Resources Information Center

Jang, Sung Joon; Johnson, Byron R.

2011-01-01

Previous research finds drug-using peers and religiosity to be key predictors of drug use among youth, but the effects of childhood exposure to drug users and religion on later drug use have been understudied. The authors hypothesize a child's exposure to parental drug use and religious upbringing have a causal influence on drug use in youth…

76 FR 76738 - Generic Drug User Fee; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0381] Generic Drug User Fee; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. The Food and Drug Administration (FDA) is announcing a public meeting to...

The effectiveness of substance use measures in the detection of full and partial denial of drug use.

PubMed

Wooley, Chelsea N; Rogers, Richard; Fiduccia, Chelsea E; Kelsey, Katherine

2013-12-01

Appraisals of substance abuse often constitute a key component of psychological assessments affecting both diagnostic and treatment issues. Because of negative consequences, many substance users engage in outright denials and marked minimization regarding their drug use. Psychological measures, especially those with transparent items, are highly vulnerable to this denial. To address this response style, indirect items are often included on substance use measures to identify those who deny their use. The purpose of this study was to examine the effects of complete and partial denial on the Drug Abuse Screening Test-20, Substance Abuse Subtle Screening Inventory-3, and Drug Use Screening Inventory-Revised. Partial denial refers to the disacknowledgement of drug-related impairment interfering in multiple domains of a client's functioning. The study used a mixed within- and between-subjects design with 102 inpatient substance users. Each participant completed the study under two conditions: a disclosing condition and an experimental condition (either complete denial or partial denial). Results show partial denial is distinctly different from complete denial across three self-report substance use measures. Importantly, substance users engaging in these denial conditions were often undetected by these measures. Contrary to expectations, subtle scales with indirect item content were only minimally more effective than the face valid scales alone for the assessment of denied drug use.

Tuberculosis knowledge among injecting drug users visiting syringe exchange programme in Tallinn, Estonia.

PubMed

Rüütel, Kristi; Parker, R David; Sobolev, Igor; Loit, Helle-Mai

2012-12-01

The purpose of the current study was to describe tuberculosis (TB) knowledge, beliefs, and experience with TB services among injecting drug users. Participants for this anonymous, cross-sectional study were recruited from a community based syringe exchange programme in Tallinn, Estonia. A structured questionnaire was completed and included information on socio-demographics, health history, drug use, and knowledge about TB and HIV. The study included 407 people (79% male, mean age 27.9 years, mean injection drug use 9.4 years). 32.9% of participants reported HIV infection and 1.7% lifetime history of TB. 26.4% participants (n=106) reported symptoms suggestive of TB. 93% of participants recognized correctly that TB is air-borne infection and 91% that HIV is a risk factor for TB. Only 40% of the participants knew that TB diagnostics and treatment in Estonia are free of charge for everybody and 58% reported they knew where to get health care services in case they suspected that they had TB. TB transmission and treatment adherence knowledge was better among those in contact with either health care or harm reduction services, e.g the community based syringe exchange programme. Similar to HIV services, TB prevention and education should be integrated into harm reduction and drug treatment programmes to facilitate early diagnosis and treatment of TB among injecting drug users.

Efficacy of motivational enhancement therapy to decrease alcohol and illicit-drug use in pregnant substance users reporting baseline alcohol use.

PubMed

Osterman, Robin; Lewis, Daniel; Winhusen, Theresa

2017-06-01

Approximately 35% of pregnant substance users in treatment report alcohol abuse, which increases the risk of fetal alcohol spectrum disorders (FASD) in their offspring. The present study was a preliminary evaluation of the efficacy of motivational enhancement therapy (MET) in decreasing alcohol use in pregnant women attending substance use treatment. Secondary analysis of a trial evaluating the efficacy of MET, relative to treatment as usual (TAU), in improving treatment outcomes in 200 pregnant substance users. The present study included the 41 women (n=27 MET and n=14 TAU) who reported alcohol use in the 28days prior to randomization. Alcohol and illicit-drug use days were assessed with self-report; illicit drug use was assessed with urine drug screens. All measures were obtained weekly for the 4week active study phase and at 1 and 3month follow-ups. Significant treatment-by-time interaction effects were found for illicit-drug use days during the active (X 2 =6.89, df=1, p<0.01) and follow-up (X 2 =8.26, df=1, p<0.01) phases and for alcohol use during the follow-up phase (X 2 =13.07, df=1, p<0.001), all reflecting a beneficial effect for MET, relative to TAU. All other treatment effects were non-significant. These findings suggest that MET may be effective in decreasing alcohol and illicit-drug use in pregnant substance users reporting alcohol use. With 2-5% of US births affected by FASD, future research to replicate these findings seems warranted. ClinicalTrials.gov http://www.clinicaltrials.gov; Identifier: NCT00078143. Copyright © 2017 Elsevier Inc. All rights reserved.

Driving under the influence of drugs: Perceptions and attitudes of New Zealand drivers.

PubMed

Malhotra, Neha; Starkey, Nicola J; Charlton, Samuel G

2017-09-01

This study explored the patterns of drug driving in New Zealand by investigating 1) drivers' perceptions about impairment caused by legal and illegal drugs 2) countermeasures employed by drivers when under the influence of drugs (e.g., decisions not to drive) 3) drivers' attitudes about police enforcement of drug driving and 4) the factors that predict the likelihood of engaging in drug driving. Participants (n=434) were licensed drivers who completed an online questionnaire. Results of the questionnaire indicated that drivers rated hallucinogens and opiates as being the illegal drugs producing the highest level of driving impairment and cannabis the lowest. For legal drugs, sedatives were rated as having the highest driving impairment and anti-nausea and anti-depressants the lowest. Respondents' drug use history had an effect on their ratings of impairment for anti-anxiety drugs, anti-depressants, kava, sedatives, cannabis and hallucinogens such that drug users reported higher impairment ratings than Non-user. Making a decision not to drive after taking drugs was reported by users of alcohol (73.6%), cannabis (57.0%), strong painkillers (42.5%), and anti-depressants (10.0%). Respondents who reported drink driving were 3.26 times more likely to report drug driving than those reporting no drink driving. Respondents also showed greater acceptance towards driving under the influence of legal drugs (43.5%) compared to illegal drugs (10.3%). Those who did not have favourable attitudes about drug driving were less likely to report having driven under the influence of drugs. Drivers in this sample were less aware of the potential negative effects of legal drugs on driving compared to illegal drugs. More than half the respondents from this study acknowledged drug driving as a road safety issue which needs more resources dedicated to it. Copyright © 2017 Elsevier Ltd. All rights reserved.

Use transition between illegal drugs among Brazilian university students.

PubMed

Castaldelli-Maia, João Mauricio; Martins, Silvia S; de Oliveira, Lúcio Garcia; van Laar, Margriet; de Andrade, Arthur Guerra; Nicastri, Sergio

2014-03-01

The aim of the present study was to test whether the first use of an illicit drug increases the chance of first use of other illicit drugs. The transitions from the first use of a drug to the first use of another drug were analyzed. Comparisons were made between first drug users and non-users. Survival analysis methods were used to compare the cumulative probability of second drug use after adjusting for socio-demographic covariates and the intermediate use of alcohol and/or tobacco. A total of 12,721 Brazilian university students participated in this study. Inhalants and marijuana were used prior to the use of several other drugs, whereas the opposite pattern was not found. Ecstasy was used before other drugs in several instances. Other well-examined drugs, such as amphetamines, cocaine and hallucinogens, were used both before and after other illicit drugs without any marked predominance for either of the two roles. This study supports the role of the use of marijuana and inhalants almost exclusively before the use of other illicit drugs, whereas the use of ecstasy has an opposite role. These roles could be linked to the prevalence of lifetime use and whether individuals were at an earlier or later age during experimentation.

Anti-hypertensive drugs and skin cancer risk: a review of the literature and meta-analysis.

PubMed

Gandini, Sara; Palli, Domenico; Spadola, Giuseppe; Bendinelli, Benedetta; Cocorocchio, Emilia; Stanganelli, Ignazio; Miligi, Lucia; Masala, Giovanna; Caini, Saverio

2018-02-01

Several anti-hypertensive drugs have photosensitizing properties, however it remains unclear whether long-term users of these drugs are also at increased risk of skin malignancies. We conducted a literature review and meta-analysis on the association between use of anti-hypertensive drugs and the risk of cutaneous melanoma and non-melanoma skin cancer (NMSC). We searched PubMed, EMBASE, Google Scholar and the Cochrane Library, and included observational and experimental epidemiological studies published until February 28th, 2017. We calculated summary relative risk (SRR) and 95% confidence intervals (95% CI) through random effect models to estimate the risk of skin malignancies among users of the following classes of anti-hypertensive drugs: thiazide diuretics, angiotensin converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and β-blockers. We conducted sub-group and sensitivity analysis to explore causes of between-studies heterogeneity, and assessed publication bias using a funnel-plot based approach. Nineteen independent studies were included in the meta-analysis. CCB users were at increased skin cancer risk (SRR 1.14, 95% CI 1.07-1.21), and β-blockers users were at increased risk of developing cutaneous melanoma (SRR 1.21, 95% CI 1.05-1.40), with acceptable between-studies heterogeneity (I 2  < 50%). There was no association between thiazide diuretics, ACEi or ARB use and skin cancer risk. We found no evidence of publication bias affecting the results. Family doctors and clinicians should inform their patients about the increased risk of skin cancer associated with the use of CCB and β-blockers and instruct them to perform periodic skin self-examination. Further studies are warranted to elucidate the observed associations. Copyright © 2017 Elsevier B.V. All rights reserved.

Current trends in illegal drug use and drug related health problems in Switzerland.

PubMed

De Preux, Elisabeth; Dubois-Arber, Françoise; Zobel, Frank

2004-05-29

As part of the evaluation of the Confederation's measures to reduce drug related problems, a review of available data on drug use and drug related problems in Switzerland has been conducted. Source of data included: population surveys (adults and teenagers), surveys among drug users, health statistics (drug related and AIDS related deaths, HIV case reporting, drug treatments) police statistics (denunciations for consumption). The aims of reducing the number of dependent hard drug users have been achieved where heroin is concerned. In particular, there seems to have been a decrease in the number of people becoming addicted to this substance. For all other illegal substances, especially cannabis, the trend is towards an increased use, as in many European countries. As regards dependent drug users, especially injecting drug users, progress has been made in the area of harm reduction and treatment coverage. This epidemiological assessment can be used in the discussions currently engaged about the revision of the Law governing narcotics and will be a baseline for future follow up of the situation.

Association of opioid agonist therapy with lower incidence of hepatitis C virus infection in young adult injection drug users.

PubMed

Tsui, Judith I; Evans, Jennifer L; Lum, Paula J; Hahn, Judith A; Page, Kimberly

2014-12-01

Injection drug use is the primary mode of transmission for hepatitis C virus (HCV) infection. Prior studies suggest opioid agonist therapy may reduce the incidence of HCV infection among injection drug users; however, little is known about the effects of this therapy in younger users. To evaluate whether opioid agonist therapy was associated with a lower incidence of HCV infection in a cohort of young adult injection drug users. Observational cohort study conducted from January 3, 2000, through August 21, 2013, with quarterly interviews and blood sampling. We recruited young adult (younger than 30 years) injection drug users who were negative for anti-HCV antibody and/or HCV RNA. Substance use treatment within the past 3 months, including non-opioid agonist forms of treatment, opioid agonist (methadone hydrochloride or buprenorphine hydrochloride) detoxification or maintenance therapy, or no treatment. Incident HCV infection documented with a new positive result for HCV RNA and/or HCV antibodies. Cumulative incidence rates (95% CI) of HCV infection were calculated assuming a Poisson distribution. Cox proportional hazards regression models were fit adjusting for age, sex, race, years of injection drug use, homelessness, and incarceration. Baseline characteristics of the sample (n = 552) included median age of 23 (interquartile range, 20-26) years; 31.9% female; 73.1% white; 39.7% who did not graduate from high school; and 69.2% who were homeless. During the observation period of 680 person-years, 171 incident cases of HCV infection occurred (incidence rate, 25.1 [95% CI, 21.6-29.2] per 100 person-years). The rate ratio was significantly lower for participants who reported recent maintenance opioid agonist therapy (0.31 [95% CI, 0.14-0.65]; P = .001) but not for those who reported recent non-opioid agonist forms of treatment (0.63 [95% CI, 0.37-1.08]; P = .09) or opioid agonist detoxification (1.45 [95% CI, 0.80-2.69]; P = .23). After adjustment for other covariates, maintenance opioid agonist therapy was associated with lower relative hazards for acquiring HCV infection over time (adjusted hazard ratio, 0.39 [95% CI, 0.18-0.87]; P = .02). In this cohort of young adult injection drug users, recent maintenance opioid agonist therapy was associated with a lower incidence of HCV infection. Maintenance treatment with methadone or buprenorphine for opioid use disorders may be an important strategy to prevent the spread of HCV infection among young injection drug users.

Chronic cocaine but not chronic amphetamine use is associated with perseverative responding in humans

PubMed Central

Roiser, Jonathan P.; Robbins, Trevor W.; Sahakian, Barbara J.

2013-01-01

Rationale Chronic drug use has been associated with increased impulsivity and maladaptive behaviour, but the underlying mechanisms of this impairment remain unclear. We investigated the ability to adapt behaviour according to changes in reward contingencies, using a probabilistic reversal-learning task, in chronic drug users and controls. Materials and methods Five groups were compared: chronic amphetamine users (n = 30); chronic cocaine users (n = 27); chronic opiate users (n = 42); former drug users of psychostimulants and opiates (n = 26); and healthy non-drug-taking control volunteers (n = 25). Participants had to make a forced choice between two alternative stimuli on each trial to acquire a stimulus–reward association on the basis of degraded feedback and subsequently to reverse their responses when the reward contingencies changed. Results Chronic cocaine users demonstrated little behavioural change in response to the change in reward contingencies, as reflected by perseverative responding to the previously rewarded stimulus. Perseverative responding was observed in cocaine users regardless of whether they completed the reversal stage successfully. Task performance in chronic users of amphetamines and opiates, as well as in former drug users, was not measurably impaired. Conclusion Our findings provide convincing evidence for response perseveration in cocaine users during probabilistic reversal-learning. Pharmacological differences between amphetamine and cocaine, in particular their respective effects on the 5-HT system, may account for the divergent task performance between the two psychostimulant user groups. The inability to reverse responses according to changes in reinforcement contingencies may underlie the maladaptive behaviour patterns observed in chronic cocaine users but not in chronic users of amphetamines or opiates. PMID:18214445

Memory for Drug Related Visual Stimuli in Young Adult, Cocaine Dependent Polydrug Users

PubMed Central

Ray, Suchismita; Pandina, Robert; Bates, Marsha E.

2015-01-01

Background and Objectives Implicit (unconscious) and explicit (conscious) memory associations with drugs have been examined primarily using verbal cues. However, drug seeking, drug use behaviors, and relapse in chronic cocaine and other drug users are frequently triggered by viewing substance related visual cues in the environment. We thus examined implicit and explicit memory for drug picture cues to understand the relative extent to which conscious and unconscious memory facilitation of visual drug cues occurs during cocaine dependence. Methods Memory for drug related and neutral picture cues was assessed in 14 inpatient cocaine dependent polydrug users and a comparison group of 21 young adults with limited drug experience (N = 35). Participants completed picture cue exposure, free recall and recognition tasks to assess explicit memory, and a repetition priming task to assess implicit memory. Results Drug cues, compared to neutral cues were better explicitly recalled and implicitly primed, and especially so in the cocaine group. In contrast, neutral cues were better explicitly recognized, and especially in the control group. Conclusion Certain forms of explicit and implicit memory for drug cues were enhanced in cocaine users compared to controls when memory was tested a short time following cue exposure. Enhanced unconscious memory processing of drug cues in chronic cocaine users may be a behavioral manifestation of heightened drug cue salience that supports drug seeking and taking. There may be value in expanding intervention techniques to utilize cocaine users’ implicit memory system. PMID:24588421

The diverse reasons for using Novel Psychoactive Substances - A qualitative study of the users' own perspectives.

PubMed

Soussan, Christophe; Andersson, Martin; Kjellgren, Anette

2018-02-01

The increasing number of legally ambiguous and precarious Novel Psychoactive Substances (NPS) constitutes a challenge for policy makers and public health. Scientific and more in-depth knowledge about the motivations for using NPS is scarce and often consist of predetermined, non-systematic, or poorly described reasons deduced from top-down approaches. Therefore, the aim of the present study was to explore and characterize the users' self-reported reasons for NPS use inductively and more comprehensively. The self-reported reasons of a self-selected sample of 613 international NPS users were collected via an online survey promoted at the international drug discussion forum bluelight.org and later analyzed qualitatively using inductive thematic analysis. The analysis showed that the participants used NPS because these compounds reportedly: 1) enabled safer and more convenient drug use, 2) satisfied a curiosity and interest about the effects, 3) facilitated a novel and exciting adventure, 4) promoted self-exploration and personal growth, 5) functioned as coping agents, 6) enhanced abilities and performance, 7) fostered social bonding and belonging, and 8) acted as a means for recreation and pleasure. The consumption of NPS was also driven by 9) problematic and unintentional use. The present study contributed to a more comprehensive understanding of the users' own and self-reported reasons for using NPS, which needs to be acknowledged not only in order to minimize drug related harm and drug user alienation but also to improve prevention efforts and reduce the potentially counter-intuitive effects of strictly prohibitive policies. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0196] Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice, request for comments. SUMMARY: The Food and...

Exploring the Link among State of Mind Concerning Childhood Attachment, Attachment in Close Relationships, Parental Bonding, and Psychopathological Symptoms in Substance Users.

PubMed

Musetti, Alessandro; Terrone, Grazia; Corsano, Paola; Magnani, Barbara; Salvatore, Sergio

2016-01-01

In the present study, we have explored the link among styles of attachment and psychopathology in drug users. We know that insecure attachment predisposes the individuals the development of drug-addiction and psychopathological symptoms. However, we do not know which attachment is more frequent in drug users and which is related to particular psychopathological symptoms. The aim of the present work is to explore the relationship between childhood attachment state of mind, attachment in close relationships, parental bonding and psychopathology in sample of Italian substance users. We explored, in a sample of 70 drug users and drug-addicted patients, the childhood attachment state of mind measured by the Adult Attachment Interview, the attachment in close relationships by the Relationship Questionnaire and parental bonding measured by the Parental Bonding Instrument. The Symptom Check-List-90-R (SCL-90-R) measured psychopathological symptoms. We found that parental bonding, rather than state of mind concerning childhood attachment or attachment in close relationships, is related to the psychopathological manifestation of anxiety, hostility, depression, and paranoid ideation in the sample. The latter occurs frequently in our sample, independent of state of mind concerning child attachment, attachment in close relationships, and parental bonding, suggesting its role either as a factor that favors a bad image of the participants' own relationships or as a direct effect of consuming drugs. These results have clinical implications on suggesting ways of interventions that prevent drug-addiction, which should include the evaluation of attachment in the prodromic phases of substance use onset or rehabilitation programs to prevent and manage psychotic-like symptoms.

A qualitative exploration of perceived gender differences in methamphetamine use among women who use methamphetamine on the Mexico-U.S. border.

PubMed

Loza, Oralia; Ramos, Rebeca; Ferreira-Pinto, João; Hernandez, Maria Teresa; Villalobos, Susana A

2016-01-01

The purpose of this study is to extend the research on contextual factors that influence the initiation and continued use of methamphetamine (meth) by women on the U.S.-Mexico border. At present, a minimal body of literature exists that explores meth use on the Mexico-U.S. border. A purposeful sample of 20 women who were active meth users aged ≥18 years was recruited by trained outreach workers from a variety of meth-user networks in Ciudad Juárez, Mexico, the city bordering El Paso, Texas. Respondents participated in in-depth, semi-structured interviews including questions on users' perceived familial, social, and environmental influences of meth use. Gender-based themes emerged from the analysis: (1) patterns of meth use; (2) places where drugs were used; (3) effects of relationship networks on meth use; (4) differential access to drugs; (5) trading sex for drugs; (6) perceived class differences; and (7) long-term drug use and its consequences. Respondents reported a preference for using meth as powder or pills as opposed to smoking or injecting the drug. They reported being introduced to meth by men they trust and relying on men for drug acquisition in spaces less accessible and more dangerous to women. They described how the drug changed their lifestyle and their behavior towards family members and friends, including instances of physical and psychological violence. Interventions for women on the Mexico-U.S. border should be developed based on users' social networks to target social processes to prevent initiation and to bring active meth users into treatment.

Exploring the Link among State of Mind Concerning Childhood Attachment, Attachment in Close Relationships, Parental Bonding, and Psychopathological Symptoms in Substance Users

PubMed Central

Musetti, Alessandro; Terrone, Grazia; Corsano, Paola; Magnani, Barbara; Salvatore, Sergio

2016-01-01

Background: In the present study, we have explored the link among styles of attachment and psychopathology in drug users. We know that insecure attachment predisposes the individuals the development of drug-addiction and psychopathological symptoms. However, we do not know which attachment is more frequent in drug users and which is related to particular psychopathological symptoms. The aim of the present work is to explore the relationship between childhood attachment state of mind, attachment in close relationships, parental bonding and psychopathology in sample of Italian substance users. Methods: We explored, in a sample of 70 drug users and drug-addicted patients, the childhood attachment state of mind measured by the Adult Attachment Interview, the attachment in close relationships by the Relationship Questionnaire and parental bonding measured by the Parental Bonding Instrument. The Symptom Check-List-90-R (SCL-90-R) measured psychopathological symptoms. Results: We found that parental bonding, rather than state of mind concerning childhood attachment or attachment in close relationships, is related to the psychopathological manifestation of anxiety, hostility, depression, and paranoid ideation in the sample. The latter occurs frequently in our sample, independent of state of mind concerning child attachment, attachment in close relationships, and parental bonding, suggesting its role either as a factor that favors a bad image of the participants’ own relationships or as a direct effect of consuming drugs. Conclusion: These results have clinical implications on suggesting ways of interventions that prevent drug-addiction, which should include the evaluation of attachment in the prodromic phases of substance use onset or rehabilitation programs to prevent and manage psychotic-like symptoms. PMID:27555832

HIV Testing, Care, and Treatment Among Women Who Use Drugs From a Global Perspective: Progress and Challenges.

PubMed

Metsch, Lisa; Philbin, Morgan M; Parish, Carrigan; Shiu, Karen; Frimpong, Jemima A; Giang, Le Minh

2015-06-01

The article reviews data on HIV testing, treatment, and care outcomes for women who use drugs in 5 countries across 5 continents. We chose countries in which the HIV epidemic has, either currently or historically, been fueled by injection and non-injection drug use and that have considerable variation in social structural and drug policies: Argentina, Vietnam, Australia, Ukraine, and the United States. There is a dearth of available HIV care continuum outcome data [ie, testing, linkage, retention, antiretroviral therapy (ART) provision, viral suppression] among women drug users, particularly among noninjectors. Although some progress has been made in increasing HIV testing in this population, HIV-positive women drug users in 4 of the 5 countries have not fully benefitted from ART nor are they regularly engaged in HIV care. Issues such as the criminalization of drug users, HIV-specific criminal laws, and the lack of integration between substance use treatment and HIV primary care play a major role. Strategies that effectively address the pervasive factors that prevent women drug users from engaging in HIV care and benefitting from ART and other prevention services are critical. Future success in enhancing the HIV continuum for women drug users should consider structural and contextual level barriers and promote social, economic, and legal policies that overhaul the many years of discrimination and stigmatization faced by women drug users worldwide. Such efforts must emphasis the translation of policies into practice and approaches to implementation that can help HIV-infected women who use drugs engage at all points of the HIV care continuum.

From ecstasy to MDMA: Recreational drug use, symbolic boundaries, and drug trends.

PubMed

Edland-Gryt, Marit; Sandberg, Sveinung; Pedersen, Willy

2017-12-01

Ecstasy pills with MDMA as the main ingredient were introduced in many European countries in the 1980s, and were often linked to the rave and club scenes. However, use gradually levelled off, in part as a response to increased concerns about possible mental health consequences and fatalities. Extensive use of MDMA now seems to be re-emerging in many countries. In this study, we investigated the cultural and social meaning associated with MDMA use in Oslo, Norway, with an emphasis on how users distinguish MDMA crystals and powder from "old ecstasy pills". Qualitative in-depth interviews (n=31, 61,3% males) were conducted with young adult party-goers and recreational MDMA/ecstasy users (20-34 years old, mean age 26.2 years). Research participants emphasised three important perceived differences between the MDMA crystals and ecstasy pills: (i) The effects of MDMA were described as better than ecstasy; (ii) MDMA was regarded as a safer drug; (iii) Users of MDMA crystals were described as more distinct from and less anchored in out-of-fashion rave culture than those using ecstasy. These differences were an important part of the symbolic boundary work MDMA users engaged in when justifying their drug use. MDMA has re-emerged as an important psychoactive substance in Oslo's club scene. One important reason for this re-emergence seems to be its perceived differentiation from ecstasy pills, even though the active ingredient in both drugs is MDMA. This perceived distinction between MDMA and ecstasy reveals the importance of social and symbolic meanings in relation to psychoactive substance use. Insights from this study can be important in terms of understanding how trends in drug use develop and how certain drugs gain or lose popularity. Copyright © 2017 Elsevier B.V. All rights reserved.

77 FR 51814 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... costs to industry. GDUFA enables FDA to assess user fees to support critical and measurable enhancements... critical and measurable enhancements to FDA's generic drugs program. GDUFA establishes fees for abbreviated... current thinking on generic drug user fee amendments of 2012. It does not create or confer any rights for...

78 FR 55261 - Draft Guidance for Industry on Generic Drug User Fee Amendments of 2012: Questions and Answers...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

... public and reduce costs to industry. GDUFA enables FDA to assess user fees to support critical and... assess user fees to support critical and measurable enhancements to FDA's generic drugs program. GDUFA...). The draft guidance, when finalized, will represent the Agency's current thinking on ``Generic Drug...

A study of the effects of long-term use on individual sensitivity to temazepam and lorazepam in a clinical population.

PubMed

van Steveninck, A L; Wallnöfer, A E; Schoemaker, R C; Pieters, M S; Danhof, M; van Gerven, J M; Cohen, A F

1997-09-01

The central effects of benzodiazepines may be attenuated after chronic use by changes in pharmacokinetics, pharmacodynamics or both. This attenuation may be influenced by the dosing pattern and the characteristics of the user population. The objectives of this study were to evaluate drug sensitivity in long-term users of temazepam and lorazepam in a clinical population. The sensitivity to benzodiazepine effects in chronic users (1-20 years) of lorazepam (n = 14) or temazepam (n = 13) was evaluated in comparison with age and sex matched controls. Drug sensitivity was evaluated by plasma concentration in relation to saccadic eye movement parameters, postural stability and visual analogue scales. Pharmacokinetics of lorazepam and temazepam did not differ between patients and control subjects. Chronic users of lorazepam showed clear evidence of reduced sensitivity, indicated by lack of any pharmacodynamic difference between patients and controls at baseline, when drug concentrations were similar to the peak values attained in the control subjects after administration of 1-2.5 mg of lorazepam. In addition, there was a two- to four fold reduction in the slopes of concentration-effect plots for measures of saccadic eye movements and body sway (all; P < or = 0.01). By contrast, sensitivity in chronic users of temazepam was not different from controls. The difference between the temazepam and the lorazepam group appears to be associated with a more continuous drug exposure in the latter, due to the longer half-life and a more frequent intake of lorazepam. This pattern of use may be partly related to the more anxious personality traits that were observed in the chronic users of lorazepam. Chronic users of lorazepam show evidence of tolerance to sedative effects in comparison with healthy controls. Tolerance does not occur in chronic users of temazepam. The difference may be related to pharmacological properties, in addition to different patterns of use, associated with psychological factors.

Alterations to global but not local motion processing in long-term ecstasy (MDMA) users.

PubMed

White, Claire; Brown, John; Edwards, Mark

2014-07-01

Growing evidence indicates that the main psychoactive ingredient in the illegal drug "ecstasy" (methylendioxymethamphetamine) causes reduced activity in the serotonin and gamma-aminobutyric acid (GABA) systems in humans. On the basis of substantial serotonin input to the occipital lobe, recent research investigated visual processing in long-term users and found a larger magnitude of the tilt aftereffect, interpreted to reflect broadened orientation tuning bandwidths. Further research found higher orientation discrimination thresholds and reduced long-range interactions in the primary visual area of ecstasy users. The aim of the present research was to investigate whether serotonin-mediated V1 visual processing deficits in ecstasy users extend to motion processing mechanisms. Forty-five participants (21 controls, 24 drug users) completed two psychophysical studies: A direction discrimination study directly measured local motion processing in V1, while a motion coherence task tested global motion processing in area V5/MT. "Primary" ecstasy users (n = 18), those without substantial polydrug use, had significantly lower global motion thresholds than controls [p = 0.027, Cohen's d = 0.78 (large)], indicating increased sensitivity to global motion stimuli, but no difference in local motion processing (p = 0.365). These results extend on previous research investigating the long-term effects of illicit drugs on visual processing. Two possible explanations are explored: defuse attentional processes may be facilitating spatial pooling of motion signals in users. Alternatively, it may be that a GABA-mediated disruption to V5/MT processing is reducing spatial suppression and therefore improving global motion perception in ecstasy users.

[War on Drugs or War against Health? The pitfalls for public health of Puerto Rican drug policy].

PubMed

Santiago-Negrón, Salvador; Albizu-García, Carmen E

2003-03-01

Puerto Rico has followed the United States in adopting drug policy sustained on a criminal justice model that limits the opportunities to address problematic drug use through public health interventions. Demand for illegal drugs is controlled by criminalizing drug use and applying jail sentences for drug offenses. These strategies marginalize drug users and reduce opportunities to minimize health risks applying public health measures. Production and sale of illegal drugs is criminalized with the intent of dissuading drug use, with adverse unintended health effects that impact both drug users and non-drug users in the community. The present work reviews the assumptions of the punitive prohibitionist model and its outcomes that present themselves as public health challenges in Puerto Rico. It also presents those principles that should sustain pragmatic drug policy to address problematic drug use from a health and social perspective.

Affective dysregulation predicts incident nonmedical prescription analgesic use among college students.

PubMed

Morioka, Christine K; Howard, Donna E; Caldeira, Kimberly M; Wang, Min Qi; Arria, Amelia M

2018-01-01

This study investigated the relationship between four suspected risk factors-affective dysregulation, conduct problems, depressive symptoms, and psychological distress-and incident nonmedical prescription analgesic (NPA) use among college students. The sample was derived from 929 college students from a large, mid-Atlantic university who completed the third annual College Life Study assessment (Y 3 ) and were NPA use naïve at baseline (Y 1 ). A series of logistic regression analyses were conducted to evaluate the predictors of incident NPA use by Y 3 . Separate models were developed to evaluate the association between the suspected risk factors and (a) NPA use relative to non-use of other drugs, including nonmedical use of other drug classes, (b) NPA use relative to other drug use, and (c) other drug use relative to non-use. All models included gender, parental education level, and race/ethnicity. Affective dysregulation was significantly associated with becoming an incident NPA user relative to both drug users without NPA use as well as non-users, after statistically controlling for demographic characteristics and other factors. Conduct problems in early childhood were positively related to both incident NPA use and other drug use without NPA use relative to non-users, after statistically controlling for demographic characteristics and other factors. Depressive symptoms were associated with NPA incidence at the bivariate level only. These findings extend previous research suggesting that NPA use might be related to deficits in regulating negative emotional states, and highlight possible markers for screening and intervention to prevent NPA use. Copyright © 2017 Elsevier Ltd. All rights reserved.

Risk Profile of Male College Athletes Who Use Performance-Enhancing Substances*

PubMed Central

Buckman, Jennifer F.; Yusko, David A.; White, Helene R.; Pandina, Robert J.

2009-01-01

Objective: There is a general perception that use of performance-enhancing substances (PESs) does not fit the standard profile of substance use. This study sought to determine whether users of PESs report high-risk patterns of alcohol and other drug use and demonstrate risk behaviors associated with problematic substance use. Method: Anonymous self-report questionnaires were administered to a sample of 234 male student athletes. PES users were defined as college athletes who reported past-year use of a broad array of PESs (including stimulants, hormone precursors, and nutritional supplements). Results: Male athlete PES users (n = 73) compared with nonusers (n = 160) reported more problematic alcohol-use behaviors and more alcohol- and drug-use-related problems. The former compared with the latter was also more likely to report past-year use of tobacco products, marijuana, cocaine, psychedelics, and prescription drugs without a prescription. In addition, PES users demonstrated higher sensation seeking, and greater coping and enhancement motivations for drinking and marijuana use than non-PES users. Conclusions: Although banned PESs are not typically viewed as having a high addiction potential, male athletes who use these drugs may be more likely to participate in other problematic substance-use behaviors. Importantly, the male athletes in this study who reported PES use also participated in substance-use behaviors that can have profound negative effects on athletic performance. More research on the use of PESs in college athletes is needed. PMID:19895768

Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand.

PubMed

Fairbairn, Nadia; Kaplan, Karyn; Hayashi, Kanna; Suwannawong, Paisan; Lai, Calvin; Wood, Evan; Kerr, Thomas

2009-10-07

Drug policy in Thailand has relied heavily on law enforcement-based approaches. Qualitative reports indicate that police in Thailand have resorted to planting drugs on suspected drug users to extort money or provide grounds for arrest. The present study sought to describe the prevalence and factors associated with this form of evidence planting by police among injection drug users (IDU) in Bangkok. Multivariate logistic regression was used to identify factors associated with evidence planting of drugs by police among a community-based sample of IDU in Bangkok. We also examined the prevalence and average amount of money paid by IDU to police in order to avoid arrest. 252 IDU were recruited between July and August, 2008, among whom 66 (26.2%) were female and the median age was 36.5 years. In total, 122 (48.4%) participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11), recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66), syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66), and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36). Among those who reported having drugs planted on them, 59 (48.3%) paid police a bribe in order to avoid arrest. A high proportion of community-recruited IDU participating in this study reported having drugs planted on them by police. Drug planting was found to be associated with numerous risk factors including syringe sharing and participation in government-run drug treatment programs. Immediate action should be taken to address this form of abuse of power reportedly used by police.

If I Didn't Have HIV I'd Be Dead Now: Illness Narratives of Drug Users Living with HIV/AIDS

PubMed Central

Mosack, Katie E.; Abbott, Maryann; Singer, Merrill; Weeks, Margaret R.; Lucy, Rohena

2010-01-01

The purpose of this study was to illuminate the experiences of poor, urban HIV-positive drug users. Sixty participants were asked about HIV risk behaviors, the impact of HIV on their lives, religious beliefs, life plans, relationships, and work-related issues both prior to and since diagnosis. A theoretical framework was developed using Frank's (1995; 1998) Illness Narratives and Boss and Couden's (2002) Ambiguous Loss theories. Themes pertaining to both physical and emotional or spiritual dimensions were located within Benefit, Loss, or Status Quo orientations. The findings contribute to researchers' understanding of the HIV/AIDS illness experiences among the very marginalized and they have important implications for physical and mental health care professionals working with HIV-positive drug users. PMID:15802537

Social network members' roles and use of mental health services among drug users in New York City.

PubMed

Sapra, Katherine J; Crawford, Natalie D; Rudolph, Abby E; Jones, Kandice C; Benjamin, Ebele O; Fuller, Crystal M

2013-10-01

Depression is more common among drug users (15-63 %) than the general population (5-16 %). Lack of social support network members may be associated with low mental health service (MHS) use rates observed among drug users. We investigated the relationship between social network members' roles and MHS use among frequent drug users using Social Ties Associated with Risk of Transition into Injection Drug Use data (NYC 2006-2009). Surveys assessed depression, MHS use, demographics, drug use and treatment, and social network members' roles. Participants reporting lifetime depressive episode with start/end dates and information on social/risk network members were included (n = 152). Adjusting for emotional support and HIV status, having one or more informational support network members remained associated with MHS use at last depressive episode (adjusted odds ratio (AOR) 3.37, 95 % confidence interval (CI) 1.38-8.19), as did history of drug treatment (AOR 2.75, 95 % CI 1.02-7.41) and no legal income (AOR 0.23, 95 % CI 0.08-0.64). These data suggest that informational support is associated with MHS utilization among depressed drug users.

Anxiety sensitivity and self-reported reasons for drug use.

PubMed

Stewart, S H; Karp, J; Pihl, R O; Peterson, R A

1997-01-01

Two studies examined the relationships between anxiety sensitivity (AS), drug use, and reasons for drug use. In Study 1, 229 university students (57% F) completed the Anxiety Sensitivity Index (ASI) and a drug use survey, assessing use of a variety of drugs within the last month, and coping reasons for drug use. Consistent with a modified tension-reduction hypothesis, ASI scores were positively correlated with the number of both anxiety- and depression-related reasons for drug use endorsed. In Study 2, 219 university students (74% F) completed the ASI and a drug use survey, assessing use of several drugs (e.g., alcohol, cigarettes, caffeine, and marijuana/hashish) within the last year, and primary reasons (coping, affiliative, or enhancement) for the use of each drug. Marijuana/hashish users reported lower ASI scores than non-users supporting a negative relation between AS and the use of cannabis. ASI scores were positively correlated with the use of alcohol primarily to cope, and negatively correlated with the use of alcohol primarily to affiliate, among both gender groups, and ASI scores were positively correlated with the use of nicotine primarily to cope among the females. Implications of these findings for understanding risk for abuse of stress-response-dampening drugs by high AS individuals are discussed.

An Ambient Intelligence Framework for End-User Service Provisioning in a Hospital Pharmacy: a Case Study.

PubMed

Martín, Diego; Alcarria, Ramón; Sánchez-Picot, Álvaro; Robles, Tomás

2015-10-01

End-user development is a new trend to provide tailored services to dynamic environments such as hospitals. These services not only facilitate daily work for pharmacy personnel but also improve self-care in elder people that are still related to hospital, such as discharged patients. This paper presents an ambient intelligence (AmI) environment for End-user service provisioning in the pharmacy department of Gregorio Marañón Hospital in Madrid, composed of a drug traceability infrastructure (DP-TraIN) and a ubiquitous application for enabling the pharmacy staff to create and execute their own services for facilitating drug management and dispensing. The authors carried out a case study with various experiments where different roles from the pharmacy department of Gregorio Marañón Hospital were involved in activities such as drug identification, dispensing and medication administering. The authors analyzed the effort required to create services by pharmacy staff, the discharged patients' perception of the AmI environment and the quantifiable benefits in reducing patient waiting time for drug dispensing.

Pharmacotherapeutic profile of users and expenditure on high-cost drugs in São Leopoldo, Rio Grande do Sul State, Brazil, 2014.

PubMed

Sopelsa, Mariani; Motter, Fabiane Raquel; Barcellos, Nêmora Tregnago; Leite, Heloísa Marquardt; Paniz, Vera Maria Vieira

2017-01-01

to describe the pharmacotherapeutic profile of users of the Specialized Program for Pharmaceutical Assistance, and to measure the expenditure on the most prevalent and the most expensive medications. descriptive study conducted in São Leopoldo-RS, Brazil, with secondary data regarding information about requests accepted in 2014, through administrative proceedings; delivery notes of the State Health Department/RS were used to assess the costs. 1,528 users were included in the study, mostly women (56.7%), and the average age was 52 years (standard deviation=17.9); the most frequent diagnoses were allergic asthma (17.1%), chronic kidney disease (11.5%) and rheumatoid arthritis (8.4%); the most prevalent drug was budesonide+formoterol fumarate (18.3%); among the most prevalent drugs, the highest total monthly expense was with epoetin alfa (BRL37,922.34) and among the most expensive drugs, infliximab (BRL72,503.28). the data show the importance of the Specialized Program for Pharmaceutical Assistance in the high-cost treatment of highly prevalent.

77 FR 51814 - Generic Drug User Fee Amendments of 2012; Public Meeting; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0882] Generic Drug User Fee Amendments of 2012; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public meeting; request for comments. SUMMARY: The Food and Drug...

Polydrug use among club-going young adults recruited through time-space sampling

PubMed Central

Grov, Christian; Kelly, Brian C.; Parsons, Jeffrey T.

2009-01-01

Though some researchers have indicated club drug users are more likely to be polydrug users, there remains little known about the prevalence and specific combinations of the substances they use. Between 2004-2006, and using time-space sampling, a stratified sample of 400 18-29 year old New York City club-going drug-using young adults were recruited into the Club Drugs and Health Project. Most participants (91.7%) had engaged in polydrug use and 1,670 combinations of drugs were reported. Ecstasy (86.6% of users) and cocaine (85.7% of users) were the two most frequently reported club drugs used in combination with other substances. In terms of poly-club-drug combinations, ecstasy appeared to be the “universal compliment” as this drug was most often cited in combinations with other club drugs (specifically ecstasy + ketamine, ecstasy + cocaine, ecstasy + GHB). Other frequently cited drug combinations included cocaine and marijuana, ecstasy and marijuana, LSD and marijuana, and cocaine and alcohol. These data highlight the need to develop drug health education and prevention messages targeted at polydrug use. PMID:19444726

Hepatitis B virus sero-profiles and genotypes in HIV-1 infected and uninfected injection and Non-injection drug users from coastal Kenya.

PubMed

Webale, Mark K; Kilongosi, Mark W; Budambula, Valentine; Lihana, Raphael; Musumba, Francis O; Nyamache, Anthony K; Budambula, Nancy L M; Ahmed, Aabid A; Ouma, Collins; Were, Tom

2015-07-30

Information about HBV sero-markers, infection stages and genotypes in HIV-1 infected and uninfected injection and non-injection drug users (IDUs) in Kenya remains elusive. A cross-sectional study examining HBV sero-marker, infection stages and genotypes was conducted among HIV-1 infected and uninfected, respectively, IDUs (n = 157 and n = 214) and non-IDUs (n = 139 and n = 48), and HIV-1 uninfected non-drug using controls (n = 194) from coastal, Kenya. HBV sero-marker and infection stages were based on HBV 5-panel rapid test plasma sero-reactivity. DNA was extracted from acute and chronic plasma samples and genotypes established by nested-PCR and direct sequencing. HBsAg positivity was higher in HIV-1 infected IDUs (9.6%) relative to HIV-1 uninfected IDUs (2.3%), HIV-1 infected non-IDUs (3.6%), HIV-1 uninfected non-IDUs (0.0%) and non-drug users (2.6%; P = 0.002). Contrastingly, HBsAb positivity was higher in HIV-1 uninfected IDUs (14.6%) and non-IDUs (16.8) in comparison to HIV-1 infected IDUs (8.3%), and non-IDUs (8.6%), and non-drug users (8.2%; P = 0.023). HBcAb positivity was higher in HIV-1 infected IDUs (10.2%) compared to HIV-1 uninfected IDUs (3.3%), HIV-1 infected non-IDUs (6.5%), HIV-1 uninfected non-IDUs (2.1%) and non-drug users (4.6%; P = 0.038). Acute (5.7%, 1.4%, 0.0%, 0.0% and 1.5%) and chronic (5.1%, 0.9%, 3.6%, 0.0% and 1.5%) stages were higher in HIV-1 infected IDUs, compared to HIV-1 uninfected IDUs, HIV-1 infected and uninfected non-IDUs and non-drug users, respectively. However, vaccine type response stage was higher in HIV-1 uninfected IDUs (15.4%) relative to HIV-1 infected IDUs (6.4%), and HIV-1 infected (6.5%), and uninfected (10.4%) non-IDUs, and non-drug users (5.7%; P = 0.003). Higher resolved infection rates were also recorded in HIV-1 uninfected IDUs (11.2%) compared to HIV-1 infected IDUs (8.3%), and HIV-1 infected (7.2%), uninfected (6.3%) non-IDUs, and non-drug users (6.7%; P = 0.479), respectively. Only A1 genotype showing minimal diversity was detected among the study participants. HBV sero-markers and infection staging are valuable in diagnosis and genotyping of HBV infections. Among IDUs, higher HBsAg and HBcAb positivity in HIV-1 infected and higher HBsAb positivity in HIV-1 negative IDUs suggests frequent exposure. Additionally, HBV genotype A is the dominant circulating genotype in both high and low risk populations of Kenya.

Do adolescent Ecstasy users have different attitudes towards drugs when compared to Marijuana users?

PubMed Central

Martins, Silvia S.; Storr, Carla L.; Alexandre, Pierre K.; Chilcoat, Howard D.

2008-01-01

Background Perceived risk and attitudes about the consequences of drug use, perceptions of others expectations and self-efficacy influence the intent to try drugs and continue drug use once use has started. We examine associations between adolescents’ attitudes and beliefs towards ecstasy use; because most ecstasy users have a history of marijuana use, we estimate the association for three groups of adolescents: non-marijuana/ecstasy users, marijuana users (used marijuana at least once but never used ecstasy) and ecstasy users (used ecstasy at least once). Methods Data from 5,049 adolescents aged 12–18 years old who had complete weighted data information in Round 2 of the Restricted Use Files (RUF) of the National Survey of Parents and Youth (NSPY). Data were analyzed using jackknife weighted multinomial logistic regression models. Results Adolescent marijuana and ecstasy users were more likely to approve of marijuana and ecstasy use as compared to non-drug using youth. Adolescent marijuana and ecstasy users were more likely to have close friends who approved of ecstasy as compared to non-drug using youth. The magnitudes of these two associations were stronger for ecstasy use than for marijuana use in the final adjusted model. Our final adjusted model shows that approval of marijuana and ecstasy use was more strongly associated with marijuana and ecstasy use in adolescence than perceived risk in using both drugs. Conclusion Information about the risks and consequences of ecstasy use need to be presented to adolescents in order to attempt to reduce adolescents’ approval of ecstasy use as well as ecstasy experimentation. PMID:18068314

Antiproteinuric effects of renin-angiotensin inhibitors in lung cancer patients receiving bevacizumab.

PubMed

Nihei, Satoru; Sato, Junya; Harada, Toshiyuki; Kuyama, Shoichi; Suzuki, Toshiro; Waga, Nobutsugu; Saito, Yoshitaka; Kisara, Shigeki; Yokota, Atsuko; Okada, Kouji; Tsuchiya, Masami; Terui, Kazufumi; Tadokoro, Yumiko; Chiba, Takeshi; Kudo, Kenzo; Oizumi, Satoshi; Inoue, Akira; Morikawa, Naoto

2018-06-01

The objective of this study was to investigate the effect of renin-angiotensin system inhibitors (RASIs) on bevacizumab (BV)-induced proteinuria in non-small cell lung cancer (NSCLC) patients. We retrospectively reviewed the medical records of NSCLC patients receiving BV between 2008 and 2014 at 11 hospitals. The patients were categorized into three groups according to their antihypertensive drug use: RASI user, non-RASI user, and non-user groups. The primary outcome was a proteinuria event of any grade during the first 6 cycles of BV treatment. A total of 211 patients were included, 89 of whom received antihypertensive drugs. Of these 89 patients, 49 were in the RASI user group, and 40 were in the non-RASI user group. The non-user group comprised 122 patients. The occurrence of proteinuria in the RASI user group was significantly lower than that in the non-RASI user group (P = 0.037) but was not significantly lower than that in the non-user group (P = 0.287). Patients using RASIs had a lower rate of proteinuria than those who did not use RASIs according to multivariate analysis (odds ratio 0.32; 95% confidence interval 0.12-0.86; P = 0.024). Our study suggests that RASI administration reduces the risk of proteinuria in patients receiving BV.

Perforated peptic ulcer and short-term mortality among tramadol users.

PubMed

Tørring, Marie L; Riis, Anders; Christensen, Steffen; Thomsen, Reimar W; Jepsen, Peter; Søndergaard, Jens; Sørensen, Henrik T

2008-04-01

* Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a strong risk and prognostic factor for peptic ulcer perforation, and alternative analgesics are needed for high-risk patients. * Pain management guidelines propose tramadol as a treatment option for mild-to-moderate pain in patients at high risk of gastrointestinal side-effects, including peptic ulcer disease. * Tramadol may mask symptoms of peptic ulcer complications, yet tramadol's effect on peptic ulcer prognosis is unknown. * In this population-based study of 1271 patients hospitalized with peptic ulcer perforation, tramadol appeared to increase mortality at least as much as NSAIDs. * Among users of tramadol, alone or in combination with NSAIDs, adjusted 30-day mortality rate ratios were 2.02 [95% confidence interval (CI) 1.17, 3.48] and 1.32 (95% CI 0.89, 1.95), compared with patients who used neither tramadol nor NSAIDs. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown. The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users. The study was based on data on reimbursed prescriptions and hospital discharge diagnoses for the 1993-2004 period, extracted from population-based healthcare databases. All patients with a first-time diagnosis of perforated peptic ulcer were identified, excluding those with previous ulcer diagnoses or antiulcer drug use. Cox regression was used to estimate 30-day mortality rate ratios for tramadol and NSAID users compared with non-users, adjusting for use of other drugs and comorbidity. Of 1271 patients with perforated peptic ulcers included in the study, 2.4% used tramadol only, 38.9% used NSAIDs and 7.9% used both. Thirty-day mortality was 28.7% overall and 48.4% among users of tramadol alone. Compared with the 645 patients who used neither tramadol nor NSAIDs, the adjusted mortality rate in the 30 days following hospitalization was 2.02-fold [95% confidence interval (CI) 1.17, 3.48] higher for the 31 'tramadol only' users, 1.41-fold (95% CI 1.12, 1.78) higher for the 495 NSAID users and 1.32-fold (95% CI 0.89, 1.95) higher for the 100 patients who used both drugs. Among patients hospitalized for perforated peptic ulcer, tramadol appears to increase mortality at a level comparable to NSAIDs.

[Rational use of drugs. Viewpoint of the users in the 3d Health Area of Saragossa].

PubMed

Astier Peña, M P; Pueyo Usón, M J; Aza Pascual-Salcedo, M; Vicente Barra, A

1995-10-15

To know the role of drugs and their use from the point of view of the National Health System users. Development of a qualitative method: focal groups of discussion. SITE: Health Area 3 of Zaragoza (Spain) which belongs to the Spanish National Health System. Groups of eight people who are representative of the rural and urban population. MAIN MEASUREMENT AND RESULTS: There were different meeting of one hour and a half for each. All of them started with the same question: What utility, use, and functions have drugs for all of you? All the session were recorded on video-tape and cassette to facilitate its typewriting. The general opinion was that users did not like to take drugs, nevertheless, it was a tool to solve easily and fast a health problem. At the same time, it was a cheap resource comparing to others as massage, health resort, diets... Drugs are seen as interchange currency in the medical bureau. There were critical opinions against abusive consumption of drugs. There is a lack of information concerning the utility and actions of drugs. The speech of user groups shows opposing points of view related to health professional opinions concerning drugs request from users and the role of drugs in the relationship doctor-patient.

Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: Social organization and systemic violence

PubMed Central

Small, Will; Maher, Lisa; Lawlor, Jeff; Wood, Evan; Shannon, Kate; Kerr, Thomas

2014-01-01

Background Illicit drug markets are a key component of the risk environment surrounding injection drug use. However, relatively few studies have explored how injection drug users’ (IDUs) involvement in drug dealing shapes their experiences of drug market-related harm. This exploratory qualitative study aims to understand IDUs’ dealing activities and roles, as well as the perceived benefits and risks related to participation in illicit drug markets, including experiences of drug market violence. Methods Ten IDUs with extensive involvement in drug dealing activities were recruited from the Vancouver Injection Drug User Study (VIDUS) and participated in semi-structured qualitative interviews, which elicited discussion of experiences dealing drugs, perceived benefits and hazards related to dealing, and understandings of drug market violence. Results Participant's involvement in drug market activities included corporate sales, freelance or independent sales, and opportunistic sales termed “middling” as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. Participants primarily dealt drugs to support their own illicit drug use, and we found that arrest and criminal justice involvement, hazards stemming from drug debts, and drug market-related violence were key risks related to dealing activities. Conclusion The challenges of managing personal consumption while selling drugs exacerbates the hazards associated with drug dealing. Efforts to address drug dealing among IDUs should consider both drug dependency and the material conditions that propel drug users towards dealing activities. Interventions should explore the potential of combining enhanced drug treatment programs with low threshold employment and alternative income generation opportunities. PMID:23664788

Shooting gallery operation in the context of establishing a medically supervised injecting center: Sydney, Australia.

PubMed

Kimber, Jo; Dolan, Kate

2007-03-01

Shooting galleries (SGs) are illicit off-street spaces close to drug markets used for drug injection. Supervised injecting facilities (SIFs) are low threshold health services where injecting drug users (IDUs) can inject pre-obtained drugs under supervision. This study describes SG use in Kings Cross, Sydney before and after the opening of the Sydney Medically Supervised Injecting Centre (MSIC), Australia's first SIF. Operational and environmental characteristics of SGs, reasons for SG use, and willingness to use MSIC were also examined. An exploratory survey of SG users (n = 31), interviews with SG users (n = 17), and drug workers (n = 8), and counts of used needles routinely collected from SGs (6 months before and after MSIC) and visits to the MSIC (6 months after MSIC) were triangulated. We found five SGs operated during the study period. Key operational characteristics were 24-h operation, AUS $10 entry fee, 30-min time limit, and dual use for sex work. Key reasons for SG use were to avoid police, a preference not to inject in public, and assistance from SG operators in case of overdose. SG users reported high levels of willingness to use the MSIC. The number of used needles collected from SGs decreased by 69% (41,819 vs. 12,935) in the 6 months after MSIC opened, while MSIC visits increased incrementally. We conclude that injections were transferred from SGs to the MSIC, but SGs continued to accommodate injections and harm reduction outreach should be maintained.

77 FR 20825 - Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

...] Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information... Administration (FDA) is announcing the availability of the guidance entitled ``Guidance for Industry and Food and... ``Guidance for Industry and Food and Drug Administration Staff; User Fees for 513(g) Requests for Information...

Perceived risk for severe outcomes and drinking status among drug users with HIV and Hepatitis C Virus (HCV).

PubMed

Elliott, Jennifer C; Hasin, Deborah S; Des Jarlais, Don C

2016-12-01

Among drug users with HIV and Hepatitis C Virus (HCV) infections, heavy drinking can pose significant risks to health. Yet many drug users with HIV and HCV drink heavily. Clarifying the relationship of drug-using patients' understanding of their illnesses to their drinking behavior could facilitate more effective intervention with these high-risk groups. Among samples of drug users infected with HIV (n=476; 70% male) and HCV (n=1145; 81% male) recruited from drug treatment clinics, we investigated whether patients' perceptions of the risk for severe outcomes related to HIV and HCV were associated with their personal drinking behavior, using generalized logit models. Interactions with co-infection status were also explored. HIV-infected drug users who believed that HIV held highest risk for serious outcomes were the most likely to be risky drinkers, when compared with those with less severe perceptions, X(2)(6)=14.19, p<0.05. In contrast, HCV-infected drug users who believed that HCV held moderate risk for serious outcomes were the most likely to be risky drinkers, X(2)(6)=12.98, p<0.05. In this sample of drug users, risky drinking was most common among those with HIV who believed that severe outcomes were inevitable, suggesting that conveying the message that HIV always leads to severe outcomes may be counterproductive in decreasing risky drinking in this group. However, risky drinking was most common among those with HCV who believed that severe outcomes were somewhat likely. Further research is needed to understand the mechanisms of these associations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Factors associated with history of drug use among female sex workers (FSW) in a high HIV prevalence state of India.

PubMed

Medhi, Gajendra Kumar; Mahanta, Jagadish; Kermode, Michelle; Paranjape, Ramesh S; Adhikary, Rajatashuvra; Phukan, Sanjib Kumar; Ngully, P

2012-04-05

The intersection between illicit drug use and female commercial sex work has been identified as an important factor responsible for rising HIV prevalence among female sex workers (FSW) in several northeastern states of India. But, little is know about the factors associated with the use of drugs among FSWs in this region. The objective of the paper was to describe the factors associated with history of drug use among FSWs in Dimapur, an important commercial hub of Nagaland, which is a high HIV prevalence state of India. FSWs were recruited using respondent driven sampling (RDS), and were interviewed to collect data on socio-demographic characteristics and HIV risk behaviours. Biological samples were tested for HIV, syphilis gonorrhea and Chlamydia. Logistic regression analysis was performed to identify factors associated with drug use. Among the 426 FSWs in the study, about 25% (n = 107) reported having ever used illicit drugs. Among 107 illicit drug users, 83 (77.6%) were non-injecting and 24 (22.4%) were injecting drug users. Drug-using FSWs were significantly more likely to test positive for one or more STIs (59% vs. 33.5%), active syphilis (27.1% vs. 11.4%) and Chlamydia infection (30% vs. 19.9%) compared to their non-drug using peers. Drug-using FSWs were also significantly more likely to be currently married, widowed or separated compared with non-drug-using FSWs. In multiple logistic regression analysis, being an alcohol user, being married, having a larger volume of clients, and having sexual partners who have ever used or shared injecting drugs were found to be independently associated with illicit drug use. Drug-using FSWs were more vulnerable to STIs including HIV compared to their non-drug using peers. Several important factors associated with being an FSW who uses drugs were identified in this study and this knowledge can be used to plan more effectively targeted harm reduction strategies and programs.

Retrieving Online Information on Drugs: An Analysis of Four Databases.

ERIC Educational Resources Information Center

Lavengood, Kathryn A.

This study examines the indexing of drugs in the literature and compares actual drug indexing to stated indexing policies in selected databases. The goal is to aid health science information specialists, end-users, and/or non-subject experts to improve recall and comprehensiveness when searching for drug information by identifying the most useful…

Marijuana and tobacco co-use among a nationally representative sample of US pregnant and non-pregnant women: 2005-2014 National Survey on Drug Use and Health findings.

PubMed

Coleman-Cowger, Victoria H; Schauer, Gillian L; Peters, Erica N

2017-08-01

Marijuana and tobacco are the most commonly used illicit and licit drugs during pregnancy. This study aimed to examine a nationally representative sample of US pregnant women and to: (1) determine the prevalence of past month marijuana and tobacco co-use, (2) identify characteristics that distinguish marijuana and tobacco co-users from users of marijuana only, tobacco only, or neither, and (3) compare characteristics that differ between pregnant and non-pregnant co-users of marijuana and tobacco. Data were obtained from 497,218 US women (8721 pregnant) ages 12-49 who participated in the 2005-2014 National Survey on Drug Use and Health. Prevalence and demographic and substance use characteristics were compared across groups using weighted estimates and chi-squared tests. Multinomial logistic regression identified demographic and substance use correlates of co-use. Co-use among pregnant and non-pregnant women was significantly more prevalent than marijuana-only use but was less common than tobacco-only use. In unadjusted frequencies, pregnant co-users significantly differed from non-pregnant co-users across several domains. Among pregnant women, multivariate correlates of co-use of tobacco and marijuana vs. tobacco-only use were ages 12-17, non-Hispanic black race, Hispanic ethnicity, and past month polytobacco, any alcohol, and other drug use (all adjusted odds ratios≥2.0). In this first examination of the prevalence and correlates of co-use of marijuana and tobacco among a nationally representative group of pregnant women, pregnant co-users were more likely to report other high risk behaviors compared with non-pregnant co-users and users of a single substance, suggesting disparities worthy of further investigation. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparing subjective well-being and health-related quality of life of Australian drug users in treatment in regional and rural Victoria.

PubMed

Miller, Peter G; Hyder, Shannon; Zinkiewicz, Lucy; Droste, Nicolas; Harris, Jane B

2014-11-01

The aim of this study is to examine the self-reported subjective well-being and health-related quality of life (HRQOL) of alcohol and other drug users and to examine whether subjective well-being in this sample would be predicted by either HRQOL and/or severity of dependence. A cross-sectional survey was conducted of 201 Victorian substance users in individual targeted outpatient treatment for a variety of types of substance use. Participants were administered an interview, including the personal well-being index, the SF-8 health survey and the severity of dependence scale, in order to assess subjective well-being, the mental health component of HRQOL and severity of drug dependence respectively. Subjective well-being was predicted by mental health aspects of HRQOL (sr(2)  = 0.03) and by employment (sr(2)  = 0.05), rather than by severity of dependence [F(5, 146) = 5.60, P < 0.001, R(2)  = 0.14]. The current sample of urban and regional substance users in outpatient treatment shows poorer levels of subjective well-being than do the general population. Subjective well-being was predicted by mental aspects of HRQOL and not by severity of drug dependence or by physical aspects of HRQOL. Treatment which aims to improve substance users' well-being should include mental health interventions and pathways to employment. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Outreach-based HIV prevention for injecting drug users: a review of published outcome data.

PubMed Central

Coyle, S L; Needle, R H; Normand, J

1998-01-01

OBJECTIVE: Over the past decade, a body of observational research has accrued about the effects of outreach-based human immunodeficiency virus (HIV) interventions for drug users. The authors reviewed the findings related to postintervention behavior changes and integrated findings across studies to provide the best estimate of program impact. METHODS: The authors conducted a computerized literature search to locate published accounts of HIV intervention effects on drug users. Thirty-six publications covered outreach-based HIV risk reduction interventions for out-of-treatment injecting drug users (IDUs) and reported intervention effects on HIV-related behaviors or HIV seroincidence. Two-thirds of the publications reported that participation in street-based outreach interventions was followed with office-based HIV testing and counseling. The authors described the theoretical underpinnings of outreach intervention components, the content of the interventions, and the outcome measures that investigators used most frequently. The authors also described and critiqued the evaluation study designs that were in place. Because most of the evaluations were based on pretest and posttest measures of behavior rather than on controlled studies, results were examined with respect to accepted criteria for attributing intervention causality, that is, the plausibility of cause and effect, correct temporal sequence, consistency of findings across reports, strength of associations observed, specifically of associations, and dose-response relationships between interventions and observed outcomes. RESULTS: The majority of the published evaluations showed that IDUs in a variety of places and time periods changed their baseline drug-related and sex-related risk behaviors following their participation in a outreach-based HIV risk reduction intervention. More specifically, the publications indicated that IDUs regularly reported significant follow-up reductions in drug injection, multiperson reuse of syringes and needles, multiperson reuse of other injection equipment (cookers, cotton, rinse water), and crack use. The studies also showed significant intervention effects in promoting entry into drug treatment and increasing needle disinfection. Although drug users also significantly reduced sex-related risks and increased condom use, the majority still practiced unsafe sex. One quasi-experimental study found that reductions in injection risk led to significantly reduced HIV seroincidence among outreach participants. Few investigators looked at dosage effects, but two reports suggested that the longer the exposure to outreach-based interventions, the greater the reductions in drug injection frequency. CONCLUSIONS: Accumulated evidence from observational and quasi-experimental studies strongly indicate that outreach-based interventions have been effective in reaching out-of-treatment IDUs, providing the means for behavior changes and inducing behavior change in the desired direction. The findings provide sound evidence that participation in outreach-based prevention programs can lead to lower HIV incidence rates among program participants. PMID:9722807

User input in iterative design for prevention product development: leveraging interdisciplinary methods to optimize effectiveness.

PubMed

Guthrie, Kate M; Rosen, Rochelle K; Vargas, Sara E; Guillen, Melissa; Steger, Arielle L; Getz, Melissa L; Smith, Kelley A; Ramirez, Jaime J; Kojic, Erna M

2017-10-01

The development of HIV-preventive topical vaginal microbicides has been challenged by a lack of sufficient adherence in later stage clinical trials to confidently evaluate effectiveness. This dilemma has highlighted the need to integrate translational research earlier in the drug development process, essentially applying behavioral science to facilitate the advances of basic science with respect to the uptake and use of biomedical prevention technologies. In the last several years, there has been an increasing recognition that the user experience, specifically the sensory experience, as well as the role of meaning-making elicited by those sensations, may play a more substantive role than previously thought. Importantly, the role of the user-their sensory perceptions, their judgements of those experiences, and their willingness to use a product-is critical in product uptake and consistent use post-marketing, ultimately realizing gains in global public health. Specifically, a successful prevention product requires an efficacious drug, an efficient drug delivery system, and an effective user. We present an integrated iterative drug development and user experience evaluation method to illustrate how user-centered formulation design can be iterated from the early stages of preclinical development to leverage the user experience. Integrating the user and their product experiences into the formulation design process may help optimize both the efficiency of drug delivery and the effectiveness of the user.

Illicit drug use in seven Latin American countries: critical perspectives of families and familiars.

PubMed

Silva, Jaqueline da; Ventura, Carla Aparecida Arena; Vargens, Octavio Muniz da Costa; Loyola, Cristina Maria Douat; Albarracín, Daniel Gonzalo Eslava; Diaz, Jorge; Funes, Gladys Magdalena Rodríguez; Hernández, Mabell Granados; Torres, Ruth Magdalena Gallegos; Rodriguez, Ruth Jakeline Oviedo

2009-01-01

This cross-sectional multi-centre study explored how family members and friends of illicit drug users perceived protective and risk factors, treatment facilities and policies and laws regarding illicit drug use. Family members and friends of illicit drug users were recruited in 10 urban health care outpatient units in 7 Latin American countries (Brazil, Colombia, Costa Rica, Ecuador, Guatemala, Honduras and Mexico) to complete a questionnaire. The majority of the respondents chose psycho-social factors over genetic or biological explanations as causes of drug problems. Respondents felt that families and governments were responsible for preventing drug problems. Church/religious institutions were most often mentioned in the context of accessible treatment. When asked about access to treatment facilities, the majority said that there were not enough. Shame about drug use, cost, and limited treatment options were most often cited as barriers to treatment.

Severity of club drug dependence and perceived need for treatment among a sample of adult club drug users in Shanghai, China

PubMed Central

Ding, Yingying; He, Na; Shoptaw, Steven; Gao, Meiyang; Detels, Roger

2013-01-01

Purpose Examine the severity of club drug dependence and perceived need for treatment, and further identify their determinants among a sample of club drug users in Shanghai, China. Methods 276 club drug users were recruited using respondent-driven sampling (RDS). Severity of dependence on club drugs was measured using the Severity of Dependence Scale (SDS). Results 69.9% reported dependence on club drugs (i.e., SDS≥4) and 36.6% reported severe dependence (i.e., SDS≥6). One eighth (12.7%) perceived need for drug treatment. Severe dependence on club drugs was more likely among those who reported recent use of ecstasy and those who had more depressive symptoms, but less likely among those reporting recent use of methamphetamine. Perceived need for treatment was more likely among those who lived with a spouse or boy/girlfriend, but less likely among those had prior drug treatment experience and more severe club drug dependence. Conclusions Our findings suggest that educational activities should be implemented to raise public awareness about the powerful addictive properties of club drugs, along with efforts to reduce stigma towards drug abuse and psychiatric disorders. Programs to motivate drug users to seek treatment and encourage treatment linkage are urgently needed. PMID:23715971

Social-psychological correlates of drug use among Colombian university students.

PubMed

Marin, G

1976-01-01

This paper reports the results of a large-scale study conducted among Colombian college students directed at finding patterns of use of legal and illegal drugs. The subjects reported reasons for use and nonuse of the different substances, use on the part of parents, parent's attitudes toward use, effects, attitudes toward drug use, and a series of sociodemographic variables. The results were later analyzed in relation to social learning variables that could differentiate marijuana users and nonusers. Results are also reported on personality differences between users and nonusers as measured by the Maudsley Personality Inventory.

A successful strategy for estimating the consumption of needles and syringes by injecting drug users in the Czech Republic.

PubMed

Gabrhelík, Roman; Vacek, Jaroslav; Mista, Jan

2014-01-01

The objectives were to: (i) estimate the extent of the injecting equipment (IE) provided by needle exchange programs (NEPs) to injecting drug users (IDUs) in the Czech Republic in 2010; (ii) subsequently validate the recent methodology used for data collection by the Czech National Monitoring Centre for Drugs and Drug Addiction (CMC), and (iii) estimate the number of syringes provided to Czech IDUs. A simple document analysis was performed in order to collect data on the production, sale, and consumption of injecting equipment in the Czech Republic in combination with questionnaire screening in the NEPs and 21 brief interviews with key informants. Ten types of IE most commonly used for drug injecting by the Czech drug users were identified. Approximately 5,038,000 pieces of sterile IE were marketed in the Czech Republic in 2010. According to four manufacturers (with a market share of 96%) and with reference to the year 2010, 5,430,694 pieces of sterile IE were provided to Czech injecting drug users (487,694 pieces of IE were sold to IDUs in pharmacies and 5,038,000 pieces of IE were distributed by NEPs in 2010). We compared the amount of IE provided to IDUs as reported to the CMC National registry by NEPs (4,943,000) with that of IE distributed by manufacturers and distributors (5,038,000) in the country in 2010 and found a difference of less than two percent using two different methodologies. This study confirms the accuracy of the data on the amount of IE exchanged as collected by the CMC monitoring system. This study opens up important public health practice and policy-making issues. The methodology of this study may be used in regions where no data collection system is present or where confirmation of the data related to IE is needed.

Cannabis as a substitute for prescription drugs – a cross-sectional study

PubMed Central

Corroon, James M; Mischley, Laurie K; Sexton, Michelle

2017-01-01

Background The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs. Methods A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days. Subjects were surveyed via an online anonymous questionnaire on cannabis substitution effects. Participants were recruited through social media and cannabis dispensaries in Washington State. Results A total of 1,248 (46%) respondents reported using cannabis as a substitute for prescription drugs. The most common classes of drugs substituted were narcotics/opioids (35.8%), anxiolytics/benzodiazepines (13.6%) and antidepressants (12.7%). A total of 2,473 substitutions were reported or approximately two drug substitutions per affirmative respondent. The odds of reporting substituting were 4.59 (95% confidence interval [CI], 3.87–5.43) greater among medical cannabis users compared with non-medical users and 1.66 (95% CI, 1.27–2.16) greater among those reporting use for managing the comorbidities of pain, anxiety and depression. A slightly higher percentage of those who reported substituting resided in states where medical cannabis was legal at the time of the survey (47% vs. 45%, p=0.58), but this difference was not statistically significant. Discussion These patient-reported outcomes support prior research that individuals are using cannabis as a substitute for prescription drugs, particularly, narcotics/opioids, and independent of whether they identify themselves as medical or non-medical users. This is especially true if they suffer from pain, anxiety and depression. Additionally, this study suggests that state laws allowing access to, and use of, medical cannabis may not be influencing individual decision-making in this area. PMID:28496355

From "herbal highs" to the "heroin of cannabis": Exploring the evolving discourse on synthetic cannabinoid use in a Norwegian Internet drug forum.

PubMed

Bilgrei, Ola Røed

2016-03-01

In the early 2000s, online vendors began selling an array of so-called "legal highs"--apparently organic produce made from exotic herbs. Simultaneously, members of online drug discussion forums began to debate the alleged effects of the new drugs, creating an enormous base of user-derived information based on personal experiences. This study combines the historical data spanning a seven-year period derived from a Norwegian drug discussion forum about synthetic cannabinoids and interviews with 14 male forum members who all had experience with the drug. By combining the two sources, this study reveals not only the evolving discourse on synthetic cannabinoid use but also how forum members related to the online information that they gathered and co-produced. Analysis of the evolving online discourse revealed three distinct phases. The first was an enthusiastic phase, with users embracing the new drugs. The second was a phase characterized by growing ambivalence and scepticism towards use of the drugs. The third was one in which members of the community rejected the new drugs based on negative reviews from users. The analysis displays the communal process whereby members co-operate in the exchange of an extensive body of knowledge accumulated about synthetic cannabinoids, and the way in which this evolving discourse influences members of the forum in their views and representations of the drugs. Paradoxically, the online discussions of synthetic cannabinoids, which had great significance for their proliferation when they were initially introduced to the market, now seem to be a deterrent. The role of online drug communities in the development of new drug trends should receive renewed attention. Copyright © 2016 Elsevier B.V. All rights reserved.

Participatory design for drug-drug interaction alerts.

PubMed

Luna, Daniel; Otero, Carlos; Almerares, Alfredo; Stanziola, Enrique; Risk, Marcelo; González Bernaldo de Quirós, Fernán

2015-01-01

The utilization of decision support systems, in the point of care, to alert drug-drug interactions has been shown to improve quality of care. Still, the use of these systems has not been as expected, it is believed, because of the difficulties in their knowledge databases; errors in the generation of the alerts and the lack of a suitable design. This study expands on the development of alerts using participatory design techniques based on user centered design process. This work was undertaken in three stages (inquiry, participatory design and usability testing) it showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction in the system.

Willingness to Provide a Hair Sample for Drug Testing among Electronic Dance Music Party Attendees.

PubMed

Palamar, Joseph J; Salomone, Alberto; Cleland, Charles M; Sherman, Scott

2018-04-25

Non-disclosure of drug use on surveys is common and many drug users unknowingly ingest adulterant or replacement drugs, which leads to underreporting of use of these drugs. Biological testing can complement survey research, and hair-testing is an appealing method as many drugs are detectable for months post-use. We examined willingness to donate a hair sample to be tested among those surveyed in a population at high risk for consuming adulterated drugs-electronic dance music (EDM) party attendees. We surveyed 933 adults entering EDM parties in New York City in 2017. Hair donation response rates and reasons for refusal were examined from this cross-sectional study. A third (n = 312; 33.4%) provided a hair sample. Lack of interest (21.0%), lack of time (19.8%), not wanting a lock of hair cut (17.7%), and disinterest in having hair cut in public (13.8%) were the main reported reasons for refusal. 4.7% refused because they could not receive results. Past-year drug users were more likely to fear identification than non-users (p<.001). Asian participants were at lower odds of providing a hair sample (aOR = 0.53, 95% CI = 0.32-0.87), and those reporting past-year use of LSD (aOR = 1.62, 95% CI = 1.11-2.35), opioids (nonmedical; aOR = 1.93, 95% CI = 1.25-2.99), and/or methamphetamine (aOR = 3.43, 95% CI = 1.36-8.62) were at higher odds of providing a sample than non-users of these drugs. Only a third of participants provided a hair sample and we found individual-level differences regarding willingness to provide a sample. Factors contributing to refusal should be considered to increase response rates and generalizability of results.

Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study.

PubMed

Carroll, Jennifer J; Marshall, Brandon D L; Rich, Josiah D; Green, Traci C

2017-08-01

Illicit fentanyl use has become wide spread in the US, causing high rates of overdose deaths among people who use drugs. This study describes patterns and perceptions of fentanyl exposure among opioid users in Rhode Island. A mixed methods study was conducted via questionnaire with a convenience sample of 149 individuals using illicit opioids or misusing prescription opioids in Rhode Island between January and November 2016. Of these, 121 knew of fentanyl and reported known or suspected exposure to fentanyl in the past year. Semi-structured interviews were conducted with the first 47 participants. Study participants were predominantly male (64%) and white (61%). Demographic variables were similar across sample strata. Heroin was the most frequently reported drug of choice (72%). Self-reported exposure to illicit fentanyl in the past year was common (50.4%, n=61). In multivariate models, regular (at least weekly) heroin use was independently associated with known or suspected fentanyl exposure in the past year (adjusted prevalence ratio (APR)=4.07, 95% CI: 1.24-13.3, p=0.020). In interviews, users described fentanyl as unpleasant, potentially deadly, and to be avoided. Participants reporting fentanyl exposure routinely experienced or encountered non-fatal overdose. Heroin users reported limited ability to identify fentanyl in their drugs. Harm reduction strategies used to protect themselves from fentanyl exposure and overdose, included test hits, seeking prescription opioids in lieu of heroin, and seeking treatment with combination buprenorphine/naloxone. Participants were often unsuccessful in accessing structured treatment programs. Among illicit opioid users in Rhode Island, known or suspected fentanyl exposure is common, yet demand for fentanyl is low. Fentanyl-contaminated drugs are generating user interest in effective risk mitigation strategies, including treatment. Responses to the fentanyl epidemic should be informed by the perceptions and experiences of local users. The rapid scale-up of buprenorphine/naloxone provision may slow the rate of fentanyl-involved overdose deaths. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

The Place of Drugs in the Religion of the Counter Culture.

ERIC Educational Resources Information Center

Clark, Walter Houston

The thesis of this paper is that the main catalyst of religious interest of the counter culture has been the use of psychedelic drugs along with marijuana. The author determined, through investigating subjective experiences of an unselected population of 100 users of LSD type drugs and 20 users of cannabis drugs, that psychedelic drugs are…

76 FR 45814 - Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0547] Animal Generic Drug User Fee Rates and Payment Procedures for Fiscal Year 2012 AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the rates and...

Concurrent crack and powder cocaine users from Sao Paulo: Do they represent a different group?

PubMed Central

Guindalini, Camila; Vallada, Homero; Breen, Gerome; Laranjeira, Ronaldo

2006-01-01

Background Cocaine abuse is a serious and socially damaging illegal drug problem. Different routes of administration are associated with a specific progression of use, different degrees of abuse liability, propensity for dependence and treatment response. There have been relatively few studies comparing different cocaine users groups and no studies into the characterization of the group of individuals reporting concurrent use of powder cocaine and crack cocaine. Methods Six hundred and ninety-nine cocaine users were assessed during the period August 1997 to October 1998 in one outpatient and six inpatient clinics located in the São Paulo, Brazil. Patients were interviewed using a structured questionnaire schedule in Portuguese, designed specifically for the Brazilian population. The statistical analyses were performed using either ANOVA or a chi-squared test and focusing on their preferred form of use/route of administration and other variables. Results For 83% of the variables tested in this study, the Dual Users subgroup (using both powder and crack cocaine) demonstrated statistical differences from the single drug user subgroups. Those differences include the initiation of cocaine, the abuse of other illicit drugs, and rates of criminal history. Conclusion These data suggest cocaine-dependent individuals who report use of both powder and crack cocaine are an at least partially, distinct subgroup. However, further studies will be necessary to confirm this and to determine if they also show a different treatment response. PMID:16426451

Bone Mineral Density Changes Among Women Initiating Blood Pressure Lowering Drugs: A SWAN Cohort Study

PubMed Central

Solomon, Daniel H.; Ruppert, Kristine; Zhao, Zhenping; Lian, YinJuan; Kuo, I-Hsin; Greendale, Gail A.; Finkelstein, Joel S.

2016-01-01

Purpose Several blood pressure lowering drugs may affect bone mineral density (BMD), leading to altered fracture risk. We examined the effect of blood pressure lowering drugs on BMD using data from the Study of Women’s Health Across the Nation. Methods We conducted a propensity score matched cohort study. Women were initiators of ACE inhibitors (ACEi), beta-blockers (BB), or thiazide diuretics (THZD). Their annualized BMD changes during the 14-years of observation were compared with non-users. Results Among the 2312 eligible women, we found 69 ACEi, 71 BB, and 74 THZD users who were matched by a propensity score with the same number of non-users. THZD users had a slower annual percent decline in BMD compared to nonusers at the femoral neck (FN) (−0.28% vs −0.88%; p = 0.008) and the spine (−0.74% vs −1.0%; p = 0.34), albeit not statistically significant. Annual percent changes in BMD among ACEi and BB users were similar to rates in non-users. In comparison with BB, THZD use was associated with a trend toward less annualized BMD loss at the spine (−0.35% vs −0.60%; p = 0.08) and a similar trend at the FN (−0.39% vs −0.64%; p = 0.08); in comparisons with ACEi, THZD was also associated with less loss at the FN (−0.48% vs −0.82%; p = 0.02), but not at the spine (−0.40% vs −0.56%; p = 0.23). Conclusions Neither ACEi nor BB were associated with improvements in BMD. THZD use was associated with less annualized loss of BMD compared with non-users, as well as compared with ACEi and BB. PMID:26449354

The Impact of Illicit Use of Amphetamine on Male Sexual Functions.

PubMed

Chou, Nan-Hua; Huang, Yung-Jui; Jiann, Bang-Ping

2015-08-01

Data concerning the impact of amphetamine on male sexual functions are limited, although amphetamine has been used as an aphrodisiac. This cross-sectional study was to assess the impact of illicit use of amphetamine on male sexual functions. Male illicit drug users in a Drug Abstention and Treatment Center were recruited to complete a self-administered questionnaire, and data were compared with age-matched controls. The International Index of Erectile Function (IIEF) and global assessment questions were used to assess sexual functions. Of 1,159 amphetamine mono-illicit drug users, the mean age was 31.9 ± 7.5 (18-57) years, and mean duration of drug use was 30.7 ± 52.2 (median 9, range 0.1-252) months. Half of them reported that drug use had no impact on their sexual functions. The other half reported drug impacts as reduced erectile rigidity and sexual life satisfaction, enhanced orgasmic intensity, and prolonged ejaculation latency time more often than the opposite effects, while they reported enhanced or reduced effect equally on sexual desire. Dosing frequency of amphetamine was associated with its impact on sexual functions, but duration of its use had little association with that. Compared with 211 age-matched controls, the amphetamine mono-illicit drug users had lower IIEF scores in the domains of erectile function, orgasmic function, and overall satisfaction, but there are no significant differences in intercourse satisfaction and sexual desire scores. The prevalence of erectile dysfunction (ED) was significantly higher in the drug users than in the controls (29.3% vs. 11.9%). The odds ratio of ED for amphetamine use was 2.1 (95% confidence interval 1.2-3.6) after adjustment for other risk factors. The impact of illicit use of amphetamine on male sexual functions varied among users, and their ED prevalence was higher than the controls. © 2015 International Society for Sexual Medicine.

Memory deficits in abstinent MDMA (ecstasy) users: neuropsychological evidence of frontal dysfunction.

PubMed

Quednow, Boris B; Jessen, Frank; Kuhn, Kai-Uwe; Maier, Wolfgang; Daum, Irene; Wagner, Michael

2006-05-01

Chronic administration of the common club drug 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is associated with long-term depletion of serotonin (5-HT) and loss of 5-HT axons in the brains of rodents and non-human primates, and evidence suggests that recreational MDMA consumption may also affect the human serotonergic system. Moreover, it was consistently shown that abstinent MDMA users have memory deficits. Recently, it was supposed that these deficits are an expression of a temporal or rather hippocampal dysfunction caused by the serotonergic neurotoxicity of MDMA. The aim of this study is to examine the memory deficits of MDMA users neuropsychologically in order to evaluate the role of different brain regions. Nineteen male abstinent MDMA users, 19 male abstinent cannabis users and 19 male drug-naive control subjects were examined with a German version of the Rey Auditory Verbal Learning Test (RAVLT). MDMA users showed widespread and marked verbal memory deficits, compared to drug-naive controls as well as compared to cannabis users, whereas cannabis users did not differ from control subjects in their memory performance. MDMA users revealed impairments in learning, consolidation, recall and recognition. In addition, they also showed a worse recall consistency and strong retroactive interference whereby both measures were previously associated with frontal lobe function. There was a significant correlation between memory performance and the amount of MDMA taken. These results suggest that the memory deficits of MDMA users are not only the result of a temporal or hippocampal dysfunction, but also of a dysfunction of regions within the frontal cortex.

The Impact of Trauma on Drug Users' Identities

ERIC Educational Resources Information Center

Etherington, Kim

2007-01-01

This article addresses drug users' identity construction, and invites counsellors, psychotherapists, researchers and others who work with drug misusers to notice how cultural and societal discourses can shape drug misusers' stories, and the positions from which helpers listen and respond to them. By representing and analysing parts of two life…

An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs

ERIC Educational Resources Information Center

Lamonica, Aukje K.; Boeri, Miriam

2012-01-01

This study examines patterns of use of prescription drugs and methamphetamine. We drew our sample from a study about 130 active and inactive methamphetamine users and focused on 16 participants with a recent history of methamphetamine and prescription drug use. We collected in-depth interviews to explore relationships in use trajectory patterns.…

Substance use and its implications for the critical care nurses: a literature review.

PubMed

Brotto, Vanessa; Lee, Geraldine

2007-04-01

Illicit drug use in Australia has been increasing and studies indicate that illicit drug users have a higher risk of accidents which may result in the user needing critical care. However, there is a significant gap in the literature specifically pertaining to the implications of drug use in critical care. The primary objective was to examine the literature for the physiological effects of methylenedioxymethamphetamine (MDMA), cocaine and amphetamines in critically ill patients. A comprehensive literature review was undertaken and a body systems framework was used to categorise the effects of these illicit drugs. The illicit substances addressed have potentially fatal and long-term side effects. For those users involved in accidents or trauma requiring intensive or critical care nursing, the mortality and co-morbidity risks are increased significantly. It is, therefore, important that nurses are able to recognise the specific physiological effects and possible complications that can occur with the use of each illicit drug. Both nursing and medical staff need to have a thorough understanding of how illicit substances work and how they can affect the critical care patient and the care they are given.

Predicting drug court outcome among amphetamine-using participants.

PubMed

Wu, Lora J; Altshuler, Sandra J; Short, Robert A; Roll, John M

2012-06-01

Amphetamine use and abuse carry with it substantial social costs. Although there is a perception that amphetamine users are more difficult to treat than other substance users, drug courts have been used to effectively address drug-related crimes and hold the potential to lessen the impact of amphetamine abuse through efficacious treatment and rehabilitation. The objective of this study was to identify predictors of drug court outcome among amphetamine-using participants. A drug court database was obtained (N = 540) and amphetamine-using participants (n= 341) identified. Multivariate binary regression models run for the amphetamine-using participants identified being employed and being a parent as predictive of successful completion of the program, whereas being sanctioned to jail during the program was inversely related to program completion. Copyright © 2012 Elsevier Inc. All rights reserved.

Color it Black: The Failure of Drug Abuse Policy

ERIC Educational Resources Information Center

Lewis, David L.

1976-01-01

Notes that those who know drugs and users first hand see the law enforcement-medical/maintenance system which has evolved in America as ineffective, hypocritical, and cruel. The drug user remains the archetypal pariah. (Author/AM)

Perforated peptic ulcer and short-term mortality among tramadol users

PubMed Central

Tørring, Marie L; Riis, Anders; Christensen, Steffen; Thomsen, Reimar W; Jepsen, Peter; Søndergaard, Jens; Sørensen, Henrik T

2008-01-01

Aim Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown. The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users. Methods The study was based on data on reimbursed prescriptions and hospital discharge diagnoses for the 1993–2004 period, extracted from population-based healthcare databases. All patients with a first-time diagnosis of perforated peptic ulcer were identified, excluding those with previous ulcer diagnoses or antiulcer drug use. Cox regression was used to estimate 30-day mortality rate ratios for tramadol and NSAID users compared with non-users, adjusting for use of other drugs and comorbidity. Results Of 1271 patients with perforated peptic ulcers included in the study, 2.4% used tramadol only, 38.9% used NSAIDs and 7.9% used both. Thirty-day mortality was 28.7% overall and 48.4% among users of tramadol alone. Compared with the 645 patients who used neither tramadol nor NSAIDs, the adjusted mortality rate in the 30 days following hospitalization was 2.02-fold [95% confidence interval (CI) 1.17, 3.48] higher for the 31 ‘tramadol only’ users, 1.41-fold (95% CI 1.12, 1.78) higher for the 495 NSAID users and 1.32-fold (95% CI 0.89, 1.95) higher for the 100 patients who used both drugs. Conclusion Among patients hospitalized for perforated peptic ulcer, tramadol appears to increase mortality at a level comparable to NSAIDs. What is already known about this subject Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a strong risk and prognostic factor for peptic ulcer perforation, and alternative analgesics are needed for high-risk patients.Pain management guidelines propose tramadol as a treatment option for mild-to-moderate pain in patients at high risk of gastrointestinal side-effects, including peptic ulcer disease.Tramadol may mask symptoms of peptic ulcer complications, yet tramadol's effect on peptic ulcer prognosis is unknown. What this study adds In this population-based study of 1271 patients hospitalized with peptic ulcer perforation, tramadol appeared to increase mortality at least as much as NSAIDs.Among users of tramadol, alone or in combination with NSAIDs, adjusted 30-day mortality rate ratios were 2.02 [95% confidence interval (CI) 1.17, 3.48] and 1.32 (95% CI 0.89, 1.95), compared with patients who used neither tramadol nor NSAIDs. PMID:17922882

Active-comparator design and new-user design in observational studies

PubMed Central

Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

2015-01-01

SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

Pattern of Drug Use and Associated Behaviors Among Female Injecting Drug Users From Northeast India: A Multi-Centric, Cross-Sectional, Comparative Study.

PubMed

Ambekar, Atul; Rao, Ravindra; Agrawal, Alok; Goyal, Shrigopal; Mishra, Ashwani; Kishore, Kunal; Mukherjee, Debashis; Albertin, Cristina

2015-01-01

Studies from developed countries document the presence of injecting drug use among females and significantly higher vulnerabilities and risks as compared with male injecting drug users (IDUs). Studies comparing vulnerabilities and drug use patterns between female and male IDUs are not available for developing countries. The aim of the study was to assess the drug use pattern and related HIV vulnerabilities among female IDUs and compare these findings with those from male IDUs from four states of Northeast India. The study used data collected as part of a nationwide study of drug use pattern and related HIV vulnerabilities among IDUs. Ninety-eight female and 202 male IDUs accessing services from harm reduction sites across the four states of Northeast region of India were chosen through random sampling methodology. Drug use pattern, injecting practices, and knowledge of HIV were assessed using a structured questionnaire. Significantly higher proportion of female IDUs was uneducated, unemployed, reported their occupation as sex workers, and switched to injecting drug use faster as compared with male IDUs. Female IDUs practicing sex work differed significantly from those who did not with respect to frequency of daily injections, choice of drugs injected, and concomitant use of non-injecting drugs. More than half of female IDUs initiated sharing within the first month of injecting. The study demonstrates that female IDUs differ from male IDUs in their drug use pattern, initiation into injection as well as injecting behavior, which would be an important consideration during designing of female-specific interventions.

HIV vaccine trials: will intravenous drug users enroll?

PubMed Central

Meyers, K; Metzger, D S; Navaline, H; Woody, G E; McLellan, A T

1994-01-01

OBJECTIVES. The purpose of this study was to assess the willingness of intravenous drug users to participate in a preventive human immunodeficiency virus (HIV) vaccine efficacy trial. METHODS. Of the 347 intravenous drug users in methadone treatment who were approached for participation, 257 completed a battery of self-administered questionnaires assessing risk behaviors, interest in vaccine trials, and other vaccine-related information. Data from 16 known seropositives and 1 inconsistent responder were dropped from analyses (n = 240). RESULTS. Fifty-two percent of the subjects expressed a willingness to be one of the first individuals to participate in a preventive HIV vaccine efficacy trial. Subjects who had recently shared needles or works and subjects who trusted the government to ensure vaccine safety were both twice as likely to report interest in participation. Twenty-two percent of subjects reported that they would increase needle sharing if vaccinated. Thirty percent did not know what a vaccine was. CONCLUSIONS. These findings suggest that some in-treatment intravenous drug users would volunteer for a preventive HIV vaccine efficacy trial. Education and counseling will be required to ensure that subjects fully understand the trial's purposes, methods, risks and benefits. PMID:8179045

Object relations and differential treatment response to methadone maintenance.

PubMed

Nicholson, B; Treece, C

1981-07-01

The authors report results from a psychiatric study of narcotic addicts in which the relationship between specified aspects of object relations development and treatment response to methadone maintenance was examined. Two groups were defined as high and low drug users (in addition to the prescribed methadone dose) depending upon the frequency and intensity of additional drug use; a middle group was excluded. Thirty subjects participated. The dimensions of separation/individuation, narcissistic development, and self and object representations were measured by 12 scaled variables; scores of the high and low drug users were compared by t-test. In all cases, the high use group was found to be more impaired than the low use group. However, the dimensions differed greatly in their ability to differentiate the groups. The strongest group differences were found in the area of narcissistic development, with the high user group significantly more impaired than the low user group. The strength of these findings lends empirical support to the notion that an addict population can be differentiated on diagnostic and ego psychological measures. This has important implications for methadone maintenance treatment programs, and, possibly, for drug programs in general.

Developmental Factors in Adolescent Drug Use: A Study of Psychedelic Drug Users

ERIC Educational Resources Information Center

Pittel, Stephen M.; And Others

1971-01-01

This paper is concrned with the backgrounds and developmental histories of a group of approximately 250 volunteer subjects who identify themselves with the hippie community of San Francisco. (Authors)

Hepatitis C virus infection among illicit drug users in an archipelago of the Amazon.

PubMed

Silva, Fabricio Q; Santos, Francisco J A; Andrade, Andreia P; Pacheco, Suzy D B; Fischer, Benedikt; Pinho, João Renato R; Lemos, José Alexandre R; Oliveira-Filho, Aldemir B

2018-03-01

Hepatitis C virus (HCV) infection causes acute and chronic liver disease and may lead to cirrhosis, liver failure or hepatocellular carcinoma. The behavior of illicit drug users (DUs) typically exposes them to risks of viral infection. In the Brazilian Amazon region, a number of studies have identified high rates of drug use among adolescents, and a high prevalence of HBV infection in DUs, disseminated by sexual and parenteral activities. However, the epidemiological scenario of HCV infection in the region is still poorly understood. This study determined the prevalence, genotypes, and risk factors for HCV infection among DUs of the Marajó Archipelago. This cross-sectional study collected samples and epidemiological information from DUs in 11 municipalities. The diagnosis was established by EIA and real-time PCR, and the samples were genotyped by multiplex real time PCR. The data were analyzed by simple and multiple logistical regression. In 466 DUs, 28.3% had anti-HCV antibodies, and 25.5% had HCV-RNA. In 92 injecting drug users, 88.0% had anti-HCV antibodies, and 80.4% had HCV-RNA. Genotypes 1 and 3 were detected, with three cases of mixed infections. The multivariate analysis indicated associations of HCV infection with age (≥ 35 years), tattoos, intravenous drug use, shared use of injection equipment, and the daily and long-term (> 3 years) use of illicit drugs. These findings will contribute to the development of effective measures for the prevention of HCV infection among Brazilian DUs, as well as its general population.

Adolescent tramadol use and abuse in Egypt.

PubMed

Bassiony, Medhat M; Salah El-Deen, Ghada M; Yousef, Usama; Raya, Yasser; Abdel-Ghani, Mohamed M; El-Gohari, Hayam; Atwa, Samar A

2015-05-01

Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has not been well studied in Egypt. The aim of this study was to estimate the prevalence and associated correlates of tramadol use and abuse among school students in Egypt. A total of 204 students, aged 13-18 years, from six schools in Zagazig, Egypt, were screened for tramadol use using The Drug Use Disorders Identification Test and a urine screen for tramadol. The prevalence of tramadol use was 8.8% among school students and the average age at onset of tramadol use was 16.5 ± 1.1. Some 83% of the users were using tramadol alone while the rest (17%) were using a combination of tramadol, alcohol, and cannabis. Two-thirds of these students started with tramadol as the first drug after the onset of tobacco smoking. Over one third of tramadol users had drug-related problems and 6% had dependence. There was a significant association between tramadol use and older age, male gender, and smoking. Drug-related problems were negatively correlated with age at onset of tramadol use. Tramadol use was common among adolescents and over one third of tramadol users had drug-related problems. Population-based longitudinal studies are needed to investigate tramadol use and the possible role of tramadol as a gateway drug in the development of substance abuse in Egypt.

What happened to the HIV epidemic among non-injecting drug users in New York City?

PubMed

Des Jarlais, Don C; Arasteh, Kamyar; McKnight, Courtney; Feelemyer, Jonathan; Campbell, Aimee N C; Tross, Susan; Cooper, Hannah L F; Hagan, Holly; Perlman, David C

2017-02-01

HIV has reached high prevalence in many non-injecting drug user (NIDU) populations. The aims of this study were to (1) examine the trend in HIV prevalence among non-injecting cocaine and heroin NIDUs in New York City, (2) identify factors potentially associated with the trend and (3) estimate HIV incidence among NIDUs. Serial-cross sectional surveys of people entering drug treatment programs. People were permitted to participate only once per year, but could participate in multiple years. Mount Sinai Beth Israel drug treatment programs in New York City, USA. We recruited 3298 non-injecting cocaine and heroin users from 2005 to 2014. Participants were 78.7% male, 6.1% white, 25.7% Hispanic and 65.8% African American. Smoking crack cocaine was the most common non-injecting drug practice. Trend tests were used to examine HIV prevalence, demographics, drug use, sexual behavior and use of antiretroviral treatment (ART) by calendar year; χ 2 and multivariable logistic regression were used to compare 2005-10 versus 2011-14. HIV prevalence declined approximately 1% per year (P < 0.001), with a decline from 16% in 2005-10 to 8% in 2011-14 (P < 0.001). The percentages of participants smoking crack and having multiple sexual partners declined and the percentage of HIV-positive people on ART increased. HIV incidence among repeat participants was 1.2 per 1000 person-years (95% confidence interval = 0.03/1000-7/1000). HIV prevalence has declined and a high percentage of HIV-positive non-injecting drug users (NIDUs) are receiving antiretroviral treatment, suggesting an end to the HIV epidemic among NIDUs in New York City. These results can be considered a proof of concept that it is possible to control non-injecting drug use related sexual transmission HIV epidemics. © 2016 Society for the Study of Addiction.

Pill content, dose and resulting plasma concentrations of 3,4-methylendioxymethamphetamine (MDMA) in recreational 'ecstasy' users.

PubMed

Morefield, Kate M; Keane, Michael; Felgate, Peter; White, Jason M; Irvine, Rodney J

2011-07-01

To improve our understanding of the pharmacology of 'ecstasy' in recreational environments; in particular, to describe the composition of ecstasy pills, patterns of ecstasy use and the relationship between dose of 3,4-methylendioxymethamphetamine (MDMA) and resulting plasma concentrations. A naturalistic observational study of 56 experienced 'ecstasy' users in recreational settings in Australia. Drug use patterns (number of pills consumed, other drugs consumed). drug content of pills and resultant plasma concentrations of MDMA and related drugs were assessed by gas chromatography/mass spectrometry (GC/MS). Ecstasy pills generally contained MDMA, but this was often combined with other drugs such as 3,4-ethylendioxyethylamphetamine (MDEA) and methamphetamine. The dose of MDMA per pill ranged from 0 to 245 mg and users consumed from one-half to five pills, with the total dose consumed ranging up to 280 mg. Plasma concentrations of MDMA increased with number of pills consumed and cumulative MDMA dose. Use of larger numbers of pills was associated with extended exposure to the drug. MDMA is the major active drug in ecstasy pills, but there is a high degree of variation in doses. Use of multiple pills over the course of one session is common and results in a sustained increase in MDMA plasma concentrations over a number of hours. This is likely to lead to a much greater exposure of the brain to MDMA than would be predicted from controlled single-dose pharmacokinetic studies. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

75 FR 45641 - Medical Device User Fee Rates for Fiscal Year 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

...] Medical Device User Fee Rates for Fiscal Year 2011 AGENCY: Food and Drug Administration, HHS. ACTION... payment procedures for medical device user fees for fiscal year (FY) 2011. The Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device User Fee Amendments of 2007 (title II of the Food...

Reconceptualizing Early and Late Onset: A Life Course Analysis of Older Heroin Users

ERIC Educational Resources Information Center

Boeri, Miriam Williams; Sterk, Claire E.; Elifson, Kirk W.

2008-01-01

Purpose: Researchers' knowledge regarding older users of illicit drugs is limited despite the increasing numbers of users. In this article, we apply a life course perspective to gain a further understanding of older adult drug use, specifically contrasting early- and late-onset heroin users. Design and Methods: We collected qualitative data from…

[Cohort study of HIV infection among drug users in Ruili City and Longchuan County, Yunnan Province, China].

PubMed

Zheng, X

1993-02-01

In March 1992, KAP investigation and HIV blood test were carried out for 860 drug users and 82 spouses in Ruili, Luxi, Longchuan of Yunnan Province, China. The results show that there were 285 IDUs (33.1%) among 860 drug users. Among 282 blood samples of IDUs, the HIV infection rate was 49.0%, highest in Ruili (81.8%, 63/77), then Longchuan (44.6%, 77/166), lowest in Luxi County (5.1%, 2/36). Twelve new HIV+ were found from 75 persons, who had been tested as HIV- in recent two years. Sixty-two blood samples were collected among 82 spouses of IDUs with HIV+, 6 were HIV+ (9.8%), with an increase of 6.7% comparing with results of the investigation two-years ago (3.1%, 2/64).

A national study of substance use behaviors among NCAA male athletes who use banned performance enhancing substances

PubMed Central

Buckman, Jennifer F.; Farris, Samantha G.; Yusko, David A.

2013-01-01

Background Reports of illicit substance use by college athletes have become commonplace in recent years, yet comparatively little effort has been put forth by the research community to understand these behaviors. Methods Data for this study came from a large, national dataset collected by the National Collegiate Athletic Association (NCAA). This study compared substance use behaviors of male undergraduate student athletes who reported using ergogenic performance enhancing substances (e.g., anabolic steroids and peptide hormones) during college (PES users) to those who did not (PES non-users). Results A consistent pattern of higher substance use rates was observed among PES users compared to non-users, including heavier drinking, higher prevalence rates of cigarettes, marijuana, amphetamines, narcotics, and a variety of permissible and impermissible dietary supplements. An unexpected finding was that there were large discrepancies in reported prevalence rates between similar or overlapping survey items (e.g., past year use of “narcotics” versus “I have taken Vicodin, Oxycontin or Percocet with/without a prescription”). Conclusions These findings suggest that male college athletes who use PES while in college demonstrate a general tendency to engage in alcohol and drug use behaviors, regardless of whether these behaviors improve or impede athletic performance. The results further suggest that college athletes may not fully appreciate drug categorizations that are commonly employed to gauge substance use behaviors. Changes to drug education and prevention programs may be needed to enhance understanding of drug properties and actions. PMID:23688842

A national study of substance use behaviors among NCAA male athletes who use banned performance enhancing substances.

PubMed

Buckman, Jennifer F; Farris, Samantha G; Yusko, David A

2013-07-01

Reports of illicit substance use by college athletes have become commonplace in recent years, yet comparatively little effort has been put forth by the research community to understand these behaviors. Data for this study came from a large, national dataset collected by the National Collegiate Athletic Association (NCAA). This study compared substance use behaviors of male undergraduate student athletes who reported using ergogenic performance enhancing substances (e.g., anabolic steroids and peptide hormones) during college (PES users) to those who did not (PES non-users). A consistent pattern of higher substance use rates was observed among PES users compared to non-users, including heavier drinking, higher prevalence rates of cigarettes, marijuana, amphetamines, narcotics, and a variety of permissible and impermissible dietary supplements. An unexpected finding was that there were large discrepancies in reported prevalence rates between similar or overlapping survey items (e.g., past year use of "narcotics" versus "I have taken Vicodin, Oxycontin or Percocet with/without a prescription"). These findings suggest that male college athletes who use PES while in college demonstrate a general tendency to engage in alcohol and drug use behaviors, regardless of whether these behaviors improve or impede athletic performance. The results further suggest that college athletes may not fully appreciate drug categorizations that are commonly employed to gauge substance use behaviors. Changes to drug education and prevention programs may be needed to enhance understanding of drug properties and actions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Falls-Related Drug Use and Risk of Falls Among Older Adults: A Study in a US Medicare Population.

PubMed

Musich, Shirley; Wang, Shaohung S; Ruiz, Joann; Hawkins, Kevin; Wicker, Ellen

2017-07-01

Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. A 10% random sample, insured in AARP ® Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users. New users had a 12-month pre-period without FRD use, whereas continuing users had at least one FRD in the pre-period. Both groups had 12-month follow-up after initiating or continuing FRD use. Characteristics associated with the risk of falls for new and continuing users were determined using multivariate logistic regression models. Among insureds, 44% used at least one of the FRD classes. Of these, 29% were new users (N = 35,340) and 71% were continuing users (N = 121,488). Fall rates for the two subgroups were similar at 7 and 8%, respectively. Characteristics associated with the risk of falls were previous injurious fall, use of two or more classes of FRDs, older age, poorer health, and being female. New users were at higher risk than continuing users. New users of FRDs were at highest risk of falls, and continuing users were at increased risk, especially with higher numbers of FRD classes. Both groups could benefit from falls awareness and prevention programs.

High-Cost Users of Prescription Drugs: A Population-Based Analysis from British Columbia, Canada.

PubMed

Weymann, Deirdre; Smolina, Kate; Gladstone, Emilie J; Morgan, Steven G

2017-04-01

To examine variation in pharmaceutical spending and patient characteristics across prescription drug user groups. British Columbia's population-based linked administrative health and sociodemographic databases (N = 3,460,763). We classified individuals into empirically derived prescription drug user groups based on pharmaceutical spending patterns outside hospitals from 2007 to 2011. We examined variation in patient characteristics, mortality, and health services usage and applied hierarchical clustering to determine patterns of concurrent drug use identifying high-cost patients. Approximately 1 in 20 British Columbians had persistently high prescription costs for 5 consecutive years, accounting for 42 percent of 2011 province-wide pharmaceutical spending. Less than 1 percent of the population experienced discrete episodes of high prescription costs; an additional 2.8 percent transitioned to or from high-cost episodes of unknown duration. Persistent high-cost users were more likely to concurrently use multiple chronic medications; episodic and transitory users spent more on specialized medicines, including outpatient cancer drugs. Cluster analyses revealed heterogeneity in concurrent medicine use within high-cost groups. Whether low, moderate, or high, costs of prescription drugs for most individuals are persistent over time. Policies controlling high-cost use should focus on reducing polypharmacy and encouraging price competition in drug classes used by ordinary and high-cost users alike. © 2016 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust.

Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study

PubMed Central

2014-01-01

Background The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes. Methods The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users. Results The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions. Conclusion The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction. PMID:24986546

Economic Impacts of the Generic Drug User Fee Act Fee Structure.

PubMed

Dong, Ke; Boehm, Garth; Zheng, Qiang

2017-06-01

A Food and Drug Administration (FDA) Generic Drug User system, Generic Drug User Fee Amendment of 2012 (GDUFA), started October 1, 2012, and has been in place for over 3 years. There is controversy about the GDUFA fee structure but no analysis of GDUFA data that we could find. To look at the economic impact of the GDUFA fee structure. We compared the structure of GDUFA with that of other FDA Human Drug User fees. We then, using FDA-published information, analyzed where GDUFA facility and Drug Master File fees are coming from. We used the Orange Book to identify the sponsors of all approved Abbreviated New Drug Applications (ANDAs) and the S&P Capital IQ database to find the ultimate parent companies of sponsors of approved ANDAs. The key differences between the previous structure for Human Drug User fees and the GDUFA are as follows: GDUFA has no approved product fee and no first-time or small business fee exemptions and GDUFA charges facility fees from the time of filing and charges a foreign facility levy. Most GDUFA fees are paid by or on behalf of foreign entities. The top 10 companies hold nearly 50% of all approved ANDAs but pay about 14% of GDUFA facility fees. We conclude that the regressive nature of the GDUFA fee structure penalizes small, new, and foreign firms while benefiting the large established firms. A progressive fee structure in line with other human drug user fees is needed to ensure a healthy generic drug industry. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Rapid assessment response (RAR) study: drug use and health risk - Pretoria, South Africa

PubMed Central

2011-01-01

Background Within a ten year period South Africa has developed a substantial illicit drug market. Data on HIV risk among drug using populations clearly indicate high levels of HIV risk behaviour due to the sharing of injecting equipment and/or drug-related unprotected sex. While there is international evidence on and experience with adequate responses, limited responses addressing drug use and drug-use-related HIV and other health risks are witnessed in South Africa. This study aimed to explore the emerging problem of drug-related HIV transmission and to stimulate the development of adequate health services for the drug users, by linking international expertise and local research. Methods A Rapid Assessment and Response (RAR) methodology was adopted for the study. For individual and focus group interviews a semi-structured questionnaire was utilised that addressed key issues. Interviews were conducted with a total of 84 key informant (KI) participants, 63 drug user KI participants (49 males, 14 females) and 21 KI service providers (8 male, 13 female). Results and Discussion Adverse living conditions and poor education levels were cited as making access to treatment harder, especially for those living in disadvantaged areas. Heroin was found to be the substance most available and used in a problematic way within the Pretoria area. Participants were not fully aware of the concrete health risks involved in drug use, and the vague ideas held appear not to allow for concrete measures to protect themselves. Knowledge with regards to substance related HIV/AIDS transmission is not yet widespread, with some information sources disseminating incorrect or unspecific information. Conclusions The implementation of pragmatic harm-reduction and other evidence-based public health care policies that are designed to reduce the harmful consequences associated with substance use and HIV/AIDS should be considered. HIV testing and treatment services also need to be made available in places accessed by drug users. PMID:21631928

Effects of police confiscation of illicit drugs and syringes among injection drug users in Vancouver.

PubMed

Werb, Daniel; Wood, Evan; Small, Will; Strathdee, Steffanie; Li, Kathy; Montaner, Julio; Kerr, Thomas

2008-08-01

Drug market policing has been associated with various harms among injection drug users (IDU). However, little is known about instances in which drugs and injecting equipment are confiscated from IDU in the absence of a formal arrest. We examined factors associated with being stopped, searched, or detained by police among participants in the Vancouver Injection Drug Users Study (VIDUS) using logistic regression. We also examined actions taken by study participants immediately following instances in which drugs or syringes were confiscated by police. Among 465 active IDU, 130 (28.0%) reported being detained by police in the last 6 months without being arrested. In multivariate logistic regression analysis, factors associated with being stopped, searched or detained by police included homelessness (Adjusted Odds Ratio [AOR]=3.96, 95% CI: 1.86-8.45), recent incarceration (AOR=3.52, 95% CI: 1.75-7.10), frequent crack use (AOR=2.24, 95% CI: 1.34-3.74), requiring help injecting (AOR=5.20, 95% CI: 1.21-22.39), and lending syringes (AOR=3.18, 95% CI: 1.09-9.30). Of those who reported being detained, 34% participants reported having had drugs confiscated, and 70% of these reported that they immediately acquired more drugs. Fifty-one percent of participants who reported being detained also reported having had syringes confiscated, and of this group, 6% reported immediately borrowing used syringes. Our study demonstrates that the IDU most affected by street-level policing tend to possess various characteristics, such as homelessness, that place them at heightened risk for various adverse health outcomes. Our findings also suggest that the confiscation of drugs and/or needles and syringes through discretionary policing practices have the potential to exacerbate drug market activity or prompt increased syringe borrowing. These findings indicate the need for ongoing evaluation of the public health impacts of discretionary policing approaches.

[Methamphetamine Use in Central Germany: A Qualitative Study on Consumer Groups and Motives from the Experts' Perspective].

PubMed

Hoffmann, Laura; Schumann, Nadine; Richter, Matthias

2017-09-11

Background Methamphetamine is one of the most consumed illegal drugs worldwide. In Germany, Methamphetamine shows the highest rates of growth in comparison to other illegal substances in recent years. Particularly Central Germany has been struck by a high rise in consumption. International studies indicate that there is no specific group of people that can be identified as Methamphetamine users. Different consumption patterns in terms of Methamphetamine use can be identified within various social groups. This qualitative study will explore different consumer groups among methamphetamine users, their motives, and how they differ by drug addiction type. Methods The empirical data collection was carried out in a consecutive 2-stage process. Initially, 39 semi-structured individual interviews with experts from different clinical areas were carried out about their experience and perspectives on Methamphetamine use. The results of the individual interviews were subsequently discussed and validated within 2 interdisciplinary focus groups. All interviews and focus groups were digitally recorded, transcribed and analyzed according to the method of Meuser & Nagel. Results Altogether, 3 consumer groups were identified: (1) Young parents, women and pregnant women, (2) young drug users and early adapters and (3) older drug users or late entrants. The guiding motive in terms of Methamphetamine use described by the experts was improved efficiency. Further motives are for instance overcoming stressful situations, enablement and improvement of sexual experiences, self-esteem enhancement, coping with crisis or trauma, curiosity and drug use as leisure time activity. Discussion/conclusion The results in terms of consumer groups and consumption motives are consistent with international findings and we were able to verify and expand them for Central Germany. The outcomes illustrated that there are different consumer groups among methamphetamine users that differ from consumer groups of other drug addiction types. Treatment and consultation have to anticipate these challenges and adapt their strategies to different needs. Finally, further improvement of accessibility for those affected persons is an imperative to the German healthcare system. © Georg Thieme Verlag KG Stuttgart · New York.

User evaluations offer promise for pod-intravaginal ring as a drug delivery platform: A mixed methods study of acceptability and use experiences

PubMed Central

Rosen, Rochelle K.; Getz, Melissa L.; Dawson, Lauren; Guillen, Melissa; Ramirez, Jaime J.

2018-01-01

Background Effective HIV prevention requires efficient delivery of safe and efficacious drugs and optimization of user adherence. The user’s experiences with the drug, delivery system, and use parameters are critical to product acceptability and adherence. Prevention product developers have the opportunity to directly control a drug delivery system and its impact on acceptability and adherence, as well as product efficacy. Involvement of potential users during preclinical design and development can facilitate this process. We embedded a mixed methods user evaluation study into a safety and pharmacokinetics (PK) trial of a pod-intravaginal ring delivering antiretroviral agents. Methodology Women enrolled in two cohorts, ultimately evaluating the safety/PK of a pod-IVRs delivering TDF-alone, TDF-FTC, and/or TDF-FTC-MVC. A 7-day use period was targeted for each pod-IVR, regardless of drug or drug combination. During the clinical study, participants provided both quantitative (i.e., survey) and qualitative (i.e., in-depth interview) data capturing acceptability, perceptibility, and adherence behaviors. Initial sexual and reproductive health history surveys, daily diaries, a final acceptability and willingness to use survey, and a qualitative in-depth interview comprised the user evaluation data for each pod-IVR experienced by the participants. Findings Overall, the majority of participants (N = 10) reported being willing to use the pod-IVR platform for HIV prevention should it advance to market. Confidence to use the pod-IVR (e.g., insertion, removal) was high. There were no differences noted in the user experience of the pod-IVR platform; that is, whether the ring delivered TDF-alone, TDF-FTC, or TDF-FTC-MVC, users’ experiences of the ring were similar and acceptable. Participants did report specific experiences, both sensory and behavioral, that impacted their use behaviors with respect to the ring, and which could ultimately impact acceptability and adherence. These experiences, and user evaluations elicited by them, could both challenge use or be used to leverage use in future trials and product rollout once fully articulated. Conclusions High willingness-to-use data and lack of salient differences in user experiences related to use of the pod-IVR platform (regardless of agents delivered) suggests that the pod-IVR is a feasible and acceptable drug delivery device in and of itself. This finding holds promise both for an anti-HIV pod-IVR and, potentially, a multipurpose prevention pod-IVR that could deliver both prevention for sexually transmitted infections (STIs) including HIV and contraception. Given the very early clinical trial context, further acceptability, perceptibility, and adherence data should continue to be explored, in the context of longer use periods (e.g., 28-day ring use), and in the contexts of sexual activity and menses. Using early design and development contexts to gain insights into potential challenges and facilitators of drug delivery systems such as the pod-IVR could save valuable resources and time as a potential biomedical technology moves through the clinical trial pipeline and into real-world use. PMID:29758049

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.

Prescription drugs purchased through the internet: who are the end users?

PubMed

Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Rosenblum, Andrew; Ahwah, Candice; Bailey, J Elise; Dart, Richard C; Burke, John J

2010-07-01

Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of "end users" of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

78 FR 46977 - Generic Drug User Fee-Abbreviated New Drug Application, Prior Approval Supplement, Drug Master...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... costs to total FDA costs of the review of human generic drug activities for the first 3 of the preceding... review of human generic drug activities. Since the first year of the Generic Drug User Fee Program has... activities other than PC&B (see section 744B(c)(1)(C) of the FD&C Act). Table 3 of this document provides the...

The therapeutic workplace to promote treatment engagement and drug abstinence in out-of-treatment injection drug users: a randomized controlled trial.

PubMed

Holtyn, August F; Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Strain, Eric C; Schwartz, Robert P; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

2014-11-01

Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. This study was conducted from 2008 to 2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. Clinical trial registration number: NCT01416584. Copyright © 2014 Elsevier Inc. All rights reserved.

Nonnatural deaths among users of illicit drugs: pathological findings and illicit drug abuse stigmata.

PubMed

Delaveris, Gerd Jorunn Møller; Hoff-Olsen, Per; Rogde, Sidsel

2015-03-01

The aim of the study was to provide information on illicit drug abuse stigmata and general pathological findings among an adult narcotic drug-using population aged 20 to 59 years whose death was nonnatural. A total of 1603 medicolegal autopsy reports from 2000 to 2009 concerning cases positive for morphine, heroin, amphetamines, ecstasy, cannabis, LSD (lysergic acid diethylamide), PCP (phencyclidine), and high levels of GHB (γ-hydroxybutyric acid) in addition to methadone and buprenorphine were investigated. Reported findings of hepatitis, portal lymphadenopathy, recent injection marks, drug user's equipment, and numbers of significant pathological conditions were registered and analyzed according to cases positive for opiates, opioids (OPs), and central nervous system (CNS)-stimulating illicit drugs, respectively. Of the selected cases, 1305 were positive for one or more opiate or OP. Cases positive for OPs had significantly more findings of noninfectious pathological conditions. Hepatitis, portal lymphadenopathy, recent injections marks findings of drug user's equipment were all findings found more frequently among the opiate OP-positive individuals. Portal lymphadenopathy was significantly more often found in cases with hepatitis than in cases with other or no infection. In the population positive for CNS stimulants, hepatitis recent injection marks were more frequent findings than in the CNS stimulant-negative group, irrespective of whether they were opiate OP positive or negative.

The Therapeutic Workplace to Promote Treatment Engagement and Drug Abstinence in Out-of-Treatment Injection Drug Users: A Randomized Controlled Trial

PubMed Central

Holtyn, August F.; Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Strain, Eric C.; Schwartz, Robert P.; Leoutsakos, Jeannie-Marie S.; Silverman, Kenneth

2014-01-01

Objective Determine if employment-based reinforcement can increase methadone treatment engagement and drug abstinence in out-of-treatment injection drug users. Method This study was conducted from 2008–2012 in a therapeutic workplace in Baltimore, MD. After a 4-week induction, participants (N=98) could work and earn pay for 26 weeks and were randomly assigned to Work Reinforcement, Methadone & Work Reinforcement, and Abstinence, Methadone & Work Reinforcement conditions. Work Reinforcement participants had to work to earn pay. Methadone & Work Reinforcement, and Abstinence, Methadone, & Work Reinforcement participants had to enroll in methadone treatment to work and maximize pay. Abstinence, Methadone, & Work Reinforcement participants had to provide opiate- and cocaine-negative urine samples to maximize pay. Results Most participants (92%) enrolled in methadone treatment during induction. Drug abstinence increased as a graded function of the addition of the methadone and abstinence contingencies. Abstinence, Methadone & Work Reinforcement participants provided significantly more urine samples negative for opiates (75% versus 54%) and cocaine (57% versus 32%) than Work Reinforcement participants. Methadone & Work Reinforcement participants provided significantly more cocaine-negative samples than Work Reinforcement participants (55% versus 32%). Conclusion The therapeutic workplace can promote drug abstinence in out-of-treatment injection drug users. PMID:24607365

Oral health effects, brushing habits and management of methamphetamine users for the general dental practitioner.

PubMed

Smit, D A; Naidoo, S

2015-05-08

Methamphetamine is a synthetic drug commonly abused in South Africa and is highly addictive. Users have a higher prevalence of dental caries compared to non-users and the classical caries pattern found in methamphetamine users is termed 'meth mouth'. The increased consumption of soft drinks and the absence of saliva are the main risk factors for 'meth mouth'. To determine the oral health status of individuals using methamphetamine. A cross-sectional study was conducted on a convenience sample of 308 self-reported methamphetamine users at 22 specialised substance addiction treatment centres in the Western Cape, South Africa. There was a significant difference in tooth brushing frequency when using methamphetamine (p = 0.0000022; χ(2) = 23.84; OR = 3.25). The mean decayed, missing and filled teeth score was ten and there was an association between the mean number of decayed teeth and the duration of drug addiction (p = 0.0071; χ(2) = 12.07). Users who were using methamphetamine for less than four years had fewer missing teeth compared to those who were using methamphetamine for more than four years. When methamphetamine abuse is detected, the dentist can play a key role in early management of drug addiction by referring the patient to specialised substance addiction treatment centres. In addition, by restoring the dental appearance, users may regain their self-esteem and improve their oral health quality of life.

Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs

PubMed Central

Altice, Frederick L; Kamarulzaman, Adeeba; Soriano, Vincent V; Schechter, Mauro; Friedland, Gerald H

2016-01-01

HIV-infected drug users have increased age-matched morbidity and mortality compared with HIV-infected people who do not use drugs. Substance-use disorders negatively affect the health of HIV-infected drug users, who also have frequent medical and psychiatric comorbidities that complicate HIV treatment and prevention. Evidence-based treatments are available for the management of substance-use disorders, mental illness, HIV and other infectious complications such as viral hepatitis and tuberculosis, and many non-HIV-associated comorbidities. Tuberculosis co-infection in HIV-infected drug users, including disease caused by drug-resistant strains, is acquired and transmitted as a consequence of inadequate prescription of antiretroviral therapy, poor adherence, and repeated interfaces with congregate settings such as prisons. Medication-assisted therapies provide the strongest evidence for HIV treatment and prevention efforts, yet are often not available where they are needed most. Antiretroviral therapy, when prescribed and adherence is at an optimum, improves health-related outcomes for HIV infection and many of its comorbidities, including tuberculosis, viral hepatitis, and renal and cardiovascular disease. Simultaneous clinical management of multiple comorbidities in HIV-infected drug users might result in complex pharmacokinetic drug interactions that must be adequately addressed. Moreover, interventions to improve adherence to treatment, including integration of health services delivery, are needed. Multifaceted, interdisciplinary approaches are urgently needed to achieve parity in health outcomes in HIV-infected drug users. PMID:20650518

Satisfaction with nursing care in drug users: the evolution of a scale.

PubMed

Seabra, Paulo Rosário Carvalho; Sá, Luis Octávio; Amendoeira, José Joaquim Penedos; Ribeiro, Ana Leonor

2017-07-13

To identify the degree of satisfaction with nursing care, the significant variables and contribute to the evolution of the scale. Descriptive, correlational, cross study, with 180 drug users. Data collected using the scale called "Satisfaction of users with the Nursing Health Center26", between February and December 2012 in three treatment units in the region of Lisbon and Vale do Tejo, Portugal. Users indicated 83.3% satisfaction. The dimension "Information individualization" was the most marked (98.5%). The more stability in the programs, abstinence from stimulants and benzodiazepines and more nursing interventions, the greater the satisfaction. Better working conditions, specializing in mental health, younger ages and less experience of nurses also contributed to satisfaction. Four items of the scale were extracted, assuming new SUCECS22 designation. Satisfaction was high, influenced by structural variables of users, nurses and working conditions. The scale has proved suitable for assessment in this population.

Digoxin and prostate cancer survival in the Finnish Randomized Study of Screening for Prostate Cancer.

PubMed

Kaapu, Kalle J; Murtola, Teemu J; Talala, Kirsi; Taari, Kimmo; Tammela, Teuvo Lj; Auvinen, Anssi

2016-11-22

Protective effects have been suggested for digoxin against prostate cancer risk. However, few studies have evaluated the possible effects on prostate cancer-specific survival. We studied the association between use of digoxin or beta-blocker sotalol and prostate cancer-specific survival as compared with users of other antiarrhythmic drugs in a retrospective cohort study. Our study population consisted of 6537 prostate cancer cases from the Finnish Randomized Study of Screening for Prostate Cancer diagnosed during 1996-2009 (485 digoxin users). The median exposure for digoxin was 480 DDDs (interquartile range 100-1400 DDDs). During a median follow-up of 7.5 years after diagnosis, 617 men (48 digoxin users) died of prostate cancer. We collected information on antiarrhythmic drug purchases from the national prescription database. Both prediagnostic and postdiagnostic drug usages were analysed using the Cox regression method. No association was found for prostate cancer death with digoxin usage before (HR 1.00, 95% CI 0.56-1.80) or after (HR 0.81, 95% CI 0.43-1.51) prostate cancer diagnosis. The results were also comparable for sotalol and antiarrhythmic drugs in general. Among men not receiving hormonal therapy, prediagnostic digoxin usage was associated with prolonged prostate cancer survival (HR 0.20, 95% CI 0.05-0.86). No general protective effects against prostate cancer were observed for digoxin or sotalol usage.

A qualitative view of drug use behaviors of Mexican male injection drug users deported from the United States.

PubMed

Ojeda, Victoria D; Robertson, Angela M; Hiller, Sarah P; Lozada, Remedios; Cornelius, Wayne; Palinkas, Lawrence A; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

2011-02-01

Deportees are a hidden yet highly vulnerable and numerous population. Significantly, little data exists about the substance use and deportation experiences of Mexicans deported from the United States. This pilot qualitative study describes illicit drug use behaviors among 24 Mexico-born male injection drug users (IDUs), ≥ 18 years old, residing in Tijuana, Mexico who self-identified as deportees from the United States. In-person interviews were conducted in Tijuana, Mexico in 2008. Content analysis of interview transcripts identified major themes in participants' experiences. Few participants had personal or family exposures to illicit drugs prior to their first U.S. migration. Participants reported numerous deportations. Social (i.e., friends/family, post-migration stressors) and environmental factors (e.g., drug availability) were perceived to contribute to substance use initiation in the U.S. Drugs consumed in the United States included marijuana, heroin, cocaine, methamphetamine, and crack. More than half of men were IDUs prior to deportation. Addiction and justice system experiences reportedly contributed to deportation. After deportation, several men injected new drugs, primarily heroin or methamphetamine, or a combination of both drugs. Many men perceived an increase in their substance use after deportation and reported shame and loss of familial social and economic support. Early intervention is needed to stem illicit drug use in Mexican migrant youths. Binational cooperation around migrant health issues is warranted. Migrant-oriented programs may expand components that address mental health and drug use behaviors in an effort to reduce transmission of blood-borne infections. Special considerations are merited for substance users in correctional systems in the United States and Mexico, as well as substance users in United States immigration detention centers. The health status and health behaviors of deportees are likely to impact receiving Mexican communities. Programs that address health, social, and economic issues may aid deportees in resettling in Mexico.

21 CFR 801.430 - User labeling for menstrual tampons.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false User labeling for menstrual tampons. 801.430 Section 801.430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... label of menstrual tampons in conformance with section 502(c) of the Federal Food, Drug, and Cosmetic...

21 CFR 801.430 - User labeling for menstrual tampons.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false User labeling for menstrual tampons. 801.430 Section 801.430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... label of menstrual tampons in conformance with section 502(c) of the Federal Food, Drug, and Cosmetic...

21 CFR 801.430 - User labeling for menstrual tampons.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false User labeling for menstrual tampons. 801.430 Section 801.430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... label of menstrual tampons in conformance with section 502(c) of the Federal Food, Drug, and Cosmetic...

21 CFR 801.430 - User labeling for menstrual tampons.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false User labeling for menstrual tampons. 801.430 Section 801.430 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... label of menstrual tampons in conformance with section 502(c) of the Federal Food, Drug, and Cosmetic...

Results of an international drug testing service for cryptomarket users.

PubMed

Caudevilla, Fernando; Ventura, Mireia; Fornís, Iván; Barratt, Monica J; Vidal, Claudio; Lladanosa, Cristina Gil; Quintana, Pol; Muñoz, Ana; Calzada, Nuria

2016-09-01

User surveys indicate that expectations of higher drug purity are a key reason for cryptomarket use. In 2014-2015, Spain's NGO Energy Control conducted a 1-year pilot project to provide a testing service to cryptomarket drug users using the Transnational European Drug Information (TEDI) guidelines. In this paper, we present content and purity data from the trial. 219 samples were analyzed by gas chromatography associated with mass spectrometry (GC/MS). Users were asked to report what substance they allegedly purchased. 40 different advertised substances were reported, although 77.6% were common recreational drugs (cocaine, MDMA, amphetamines, LSD, ketamine, cannabis). In 200 samples (91.3%), the main result of analysis matched the advertised substance. Where the advertised compound was detected, purity levels (m±SD) were: cocaine 71.6±19.4%; MDMA (crystal) 88.3±1.4%; MDMA (pills) 133.3±38.4mg; Amphetamine (speed) 51.3±33.9%; LSD 123.6±40.5μg; Cannabis resin THC: 16.5±7.5% CBD: 3.4±1.5%; Ketamine 71.3±38.4%. 39.8% of cocaine samples contained the adulterant levamisole (11.6±8%). No adulterants were found in MDMA and LSD samples. The largest collection of test results from drug samples delivered from cryptomarkets are reported in this study. Most substances contained the advertised ingredient and most samples were of high purity. The representativeness of these results is unknown. Copyright © 2016 Elsevier B.V. All rights reserved.

Examination of Synthetic Cannabinoid and Cathinone Use among a Drug-Using Offender Sample, 2013-2015.

PubMed

Smith, Kirsten Elin; Bunting, Amanda M; Staton, Michele; Walker, Robert; Shalash, Sara; Winston, Erin; Pangburn, Kevin

2017-01-01

Use of novel psychoactive substances (NPS) such as synthetic cannabinoids (e.g., "Spice," "Serenity") and cathinones (e.g., "bath salts") has proliferated in recent years; however, there is a gap in research examining prevalence among offender samples. This study examined demographics, drug use, mental health characteristics, and criminal histories of NPS users compared to non-NPS users within an offender sample entering drug treatment. Using logistic regression analysis, combined 2013-2015 assessment data were examined (N = 8,791). NPS users offended more often (x̄ = 10.3), were more likely to have experienced homelessness (12.2%), and to have lived in a metro area (59.0%). NPS users reported significantly more past-year drug use, including substances not readily detected by standard urine analysis (e.g., hallucinogens, alcohol, and inhalants). Individuals with higher anxiety symptom counts (OR = 1.07; p < .001) and those who reported drinking to intoxication (OR = 1.30; p < .001) had an increased likelihood of NPS use. Older individuals (OR = 0.95; p < .001) and those who began using drugs at an older age (OR = 0.95; p < .001) were less likely to report NPS use. NPS use may be a marker of more severe using patterns in an offender sample. Future investigation should focus on NPS use as a possible method for bypassing drug testing measures.

Hepatitis C infection among intravenous drug users attending therapy programs in Cyprus.

PubMed

Demetriou, Victoria L; van de Vijver, David A M C; Hezka, Johana; Kostrikis, Leondios G; Kostrikis, Leondios G

2010-02-01

The most high-risk population for HCV transmission worldwide today are intravenous drug users. HCV genotypes in the general population in Cyprus demonstrate a polyphyletic infection and include subtypes associated with intravenous drug users. The prevalence of HCV, HBV, and HIV infection, HCV genotypes and risk factors among intravenous drug users in Cyprus were investigated here for the first time. Blood samples and interviews were obtained from 40 consenting users in treatment centers, and were tested for HCV, HBV, and HIV antibodies. On the HCV-positive samples, viral RNA extraction, RT-PCR and sequencing were performed. Phylogenetic analysis determined subtype and any relationships with database sequences and statistical analysis determined any correlation of risk factors with HCV infection. The prevalence of HCV infection was 50%, but no HBV or HIV infections were found. Of the PCR-positive samples, eight (57%) were genotype 3a, and six (43%) were 1b. No other subtypes, recombinant strains or mixed infections were observed. The phylogenetic analysis of the injecting drug users' strains against database sequences observed no clustering, which does not allow determination of transmission route, possibly due to a limitation of sequences in the database. However, three clusters were discovered among the drug users' sequences, revealing small groups who possibly share injecting equipment. Statistical analysis showed the risk factor associated with HCV infection is drug use duration. Overall, the polyphyletic nature of HCV infection in Cyprus is confirmed, but the transmission route remains unknown. These findings highlight the need for harm-reduction strategies to reduce HCV transmission. (c) 2009 Wiley-Liss, Inc.

'Heads held high': an exploratory study of legal highs in pre-legislation Ireland.

PubMed

Van Hout, Marie Claire; Brennan, Rebekah

2011-01-01

The research aimed to present a unique 'snapshot' of legal psychoactive drug use prior to legislative control in Ireland, in relation to the types of products used; sourcings; consumptive practices and particular social settings for use; gauging of dosage; licit and illicit drug transitions, individualisation of drug decision-making and experiences; and future intentions regarding drug switching post legislation. Semi-structured in depth interviews (n = 32) were conducted with adults aged 18-33 years who had used legal highs in the 6 months prior to fieldwork. The findings indicate some support for 'differentiated' displacement consumptive patterns between illegal and legal drugs, with user pathways grounded in 'legal high' availability; perceived user effect, safety, legality, quality and price. Mephedrone emerged as most popular drug of choice. Internet sales, stockpiling and diversion of previously 'legal highs' onto the illegal street drug market remain of concern, against a background of emerging new designer drugs in Ireland.

Meth Mouth, White Trash, and the Pseudo-Racialization of Methamphetamine Use in the U.S.

PubMed

Peterson, Jeffery Chaichana; Gubrium, Aline; Fiddian-Green, Alice

2018-05-07

Drug scares have historically been created for a range of purposes and with a variety of effects in the United States. Moral panics evoked by these drug scares either support or challenge dominant American ideas about race, economics, and society. In the present study, we examined newspaper accounts of methamphetamine use in the Inland Pacific Northwest of the United States in an effort to understand how the "reality" of the "meth epidemic" is socially constructed in a "meth hotspot," and reflect upon the ways that the discourse of Whiteness intersects with this construction. For our analysis, we are cognizant of the "slipperiness" of the logic of Whiteness as a concept, and the ways that an alternative logic is articulated - one that strategically embraces or distances White drug users to support notions of White dominance. We focus on the possibility that individual meth users could then be portrayed pseudo-racially as "White trash," and thus rendered outside the logic of White racial order. Our findings center on two main themes: (1) the use of fear in the construction of the meth drug scare through the sensationalization of meth, its anthropomorphization, and the depiction of the threat of the White drug user; and (2) how the logic of Whiteness is discursively reconciled within this construction. Given current mediated discourses about drug use and health in the United States that center on the emergence of the White drug user as the face of the opioid crisis, we are well served to carefully consider the recent historical precedence of the "meth epidemic" in which the public was faced with reconciling their views about drug use and the intersection of race, class, and mainstream American identity.

Marathon Group Therapy with Former Drug Users.

ERIC Educational Resources Information Center

Page, Richard C.; Mannion, John

1980-01-01

Discusses the effects of marathon group therapy on attitudes of former drug users in a residential drug treatment center. Experimental group members responded higher on the group counseling evaluative subscale and lower on the guilt evaluative subscale than control members. (Author)

[Follow-up of alcohol and/or cocaine dependents after their discharge from a therapeutic community: a pilot study].

PubMed

Lopez-Fernandez, Olatz; Ferrer-Pérez, Xavier; Lafarga-Lebey, Sandra; Honrubia-Serrano, María Luisa; Tudela-Marí, Maite

2011-01-01

In Spain, the Therapeutic Community (TC) constitutes a common model of treatment in the field of addictions, although there hardly exists any investigation about its efficiency and the persistence of its attainments. To evaluate the short, half and long term effects of treatment of addiction to alcohol or cocaine in the TC run by "Fundacion Salud y Comunidad" (Foundation Health and Community). descriptive pilot study, with a sequential design of cohort. 91 users completed a survey specifically designed to know their evolution at different follow-up periods (1, 3, 5 or 10 years after their exit from the TC): socio-demographic, psychoactive substance use, other variables related to the stay at the TC. Changes between before the TC and the present time regarding variables such as academic, labour, drug consumption, health, family and social adaptation and their criminal behaviour are described. the cohorts showed a relatively common previous socio-demographic pattern having received a similar treatment. The users reported to have diminished the frequent consumption of the main drug, having 48.9% never relapsed even through an occasional consumption of the drug/s. Also they perceived to have improved their health and family relations, as well as their aggressive behaviour and legal problems linked with their consumption of drug/s. after their rehabilitation in a TC, the users report a global decrease of the consumption of drugs and perceive an improvement of their health, family relations, violence and other problems linked to their former drug use.

Syphilis in Drug Users in Low and Middle Income Countries

PubMed Central

Coffin, Lara S.; Newberry, Ashley; Hagan, Holly; Cleland, Charles M.; Des Jarlais, Don C.; Perlman, David C.

2009-01-01

Background Genital ulcer disease (GUD), including syphilis, is an important cause of morbidity in low and middle income (LMI) countries and syphilis transmission is associated with HIV transmission. Methods We conducted a literature review to evaluate syphilis infection among drug users in LMI countries for the period 1995–2007. Countries were categorized using the World Bank Atlas method (The World Bank, 2007) according to 2006 gross national income per capita. Results Thirty-two studies were included (N=13,848 subjects), mostly from Southeast Asia with some from Latin America, Eastern Europe, Central and East Asia, North Africa and the Middle East but none from regions such as Sub-Saharan Africa. The median prevalence of overall lifetime syphilis (N=32 studies) was 11.1% (interquartile range: 6.3% to 15.3%) and of HIV (N=31 studies) was 1.1% (interquartile range: 0.22% to 5.50%). There was a modest relation (r=0.27) between HIV and syphilis prevalence. Median syphilis prevalence by gender was 4.0% (interquartile range: 3.4% to 6.6%) among males (N=11 studies) and 19.9% (interquartile range: 11.4% to 36.0%) among females (N=6 studies). There was a strong relation (r= 0.68) between syphilis prevalence and female gender that may be related to female sex work. Conclusion Drug users in LMI countries have a high prevalence of syphilis but data are limited and, in some regions, entirely lacking. Further data are needed, including studies targeting the risks of women. Interventions to promote safer sex, testing, counseling and education, as well as health care worker awareness, should be integrated in harm reduction programs and health care settings to prevent new syphilis infections and reduce HIV transmission among drug users and their partners in LMI countries. PMID:19361976

Illicit drug use and HIV risk in the Dominican Republic: tourism areas create drug use opportunities.

PubMed

Guilamo-Ramos, Vincent; Lee, Jane J; Ruiz, Yumary; Hagan, Holly; Delva, Marlyn; Quiñones, Zahira; Kamler, Alexandra; Robles, Gabriel

2015-01-01

While the Caribbean has the second highest global human immunodeficiency virus (HIV) prevalence, insufficient attention has been paid to contributing factors of the region's elevated risk. Largely neglected is the potential role of drugs in shaping the Caribbean HIV/acquired immune deficiency syndrome epidemic. Caribbean studies have almost exclusively focused on drug transportation and seldom acknowledged local user economies and drug-related health and social welfare consequences. While tourism is consistently implicated within the Caribbean HIV epidemic, less is known about the intersection of drugs and tourism. Tourism areas represent distinct ecologies of risk often characterised by sex work, alcohol consumption and population mixing between lower and higher risk groups. Limited understanding of availability and usage of drugs in countries such as the Dominican Republic (DR), the Caribbean country with the greatest tourist rates, presents barriers to HIV prevention. This study addresses this gap by conducting in-depth interviews with 30 drug users in Sosúa, a major sex tourism destination of the DR. A two-step qualitative data analysis process was utilised and interview transcripts were systematically coded using a well-defined thematic codebook. Results suggest three themes: (1) local demand shifts drug routes to tourism areas, (2) drugs shape local economies and (3) drug use facilitates HIV risk behaviours in tourism areas.

With God's Help I Can Do It: Crack Users' Formal and Informal Recovery Experiences in El Salvador

PubMed Central

Dickson-Gomez, Julia; Bodnar, Gloria; Guevara, Carmen Eugenia; Rodriguez, Karla; De Mendoza, Lorena Rivas; Corbett, A. Michelle

2013-01-01

Crack use has increased dramatically in El Salvador in the last few decades. As with other developing countries with sudden onsets of drug problems, El Salvador has few medical staff trained in addictions treatment. Little research has examined drug users' attempts to reduce or abstain from drug use in countries where government-regulated formal medical treatment for drug addiction is scarce. This paper uses qualitative and quantitative data gathered from active crack users to explore their formal and informal strategies to reduce or abstain from drugs, and compares these with components of informal and formal treatment in developed countries. PMID:20735191

Cotton Fever: Does the Patient Know Best?

PubMed

Xie, Yingda; Pope, Bailey A; Hunter, Alan J

2016-04-01

Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls. While this syndrome is commonly recognized amongst the injection drug user population, there is a paucity of data in the medical literature. We review the case presentation and available literature related to cotton fever.

Functional changes of the reward system underlie blunted response to social gaze in cocaine users

PubMed Central

Preller, Katrin H.; Herdener, Marcus; Schilbach, Leonhard; Stämpfli, Philipp; Hulka, Lea M.; Vonmoos, Matthias; Ingold, Nina; Vogeley, Kai; Tobler, Philippe N.; Seifritz, Erich; Quednow, Boris B.

2014-01-01

Social interaction deficits in drug users likely impede treatment, increase the burden of the affected families, and consequently contribute to the high costs for society associated with addiction. Despite its significance, the neural basis of altered social interaction in drug users is currently unknown. Therefore, we investigated basal social gaze behavior in cocaine users by applying behavioral, psychophysiological, and functional brain-imaging methods. In study I, 80 regular cocaine users and 63 healthy controls completed an interactive paradigm in which the participants’ gaze was recorded by an eye-tracking device that controlled the gaze of an anthropomorphic virtual character. Valence ratings of different eye-contact conditions revealed that cocaine users show diminished emotional engagement in social interaction, which was also supported by reduced pupil responses. Study II investigated the neural underpinnings of changes in social reward processing observed in study I. Sixteen cocaine users and 16 controls completed a similar interaction paradigm as used in study I while undergoing functional magnetic resonance imaging. In response to social interaction, cocaine users displayed decreased activation of the medial orbitofrontal cortex, a key region of reward processing. Moreover, blunted activation of the medial orbitofrontal cortex was significantly correlated with a decreased social network size, reflecting problems in real-life social behavior because of reduced social reward. In conclusion, basic social interaction deficits in cocaine users as observed here may arise from altered social reward processing. Consequently, these results point to the importance of reinstatement of social reward in the treatment of stimulant addiction. PMID:24449854

MDMA effects consistent across laboratories

PubMed Central

Kirkpatrick, Matthew G.; Baggott, Matthew J.; Mendelson, John E.; Galloway, Gantt P.; Liechti, Matthias E.; Hysek, Cédric M.; de Wit, Harriet

2014-01-01

Rationale Several laboratories have conducted placebo-controlled drug challenge studies with MDMA, providing a unique source of data to examine the reliability of the acute effects of the drug across subject samples and settings. We examined the subjective and physiological responses to the drug across three different laboratories, and investigated the influence of prior MDMA use. Methods Overall, 220 healthy volunteers with varying levels of previous MDMA experience participated in laboratory-based studies in which they received placebo or oral MDMA (1.5 mg/kg or 125 mg fixed dose) under double blind conditions. Cardiovascular and subjective effects were assessed before and repeatedly after drug administration. The studies were conducted independently by investigators in Basel, San Francisco and Chicago. Results Despite methodological differences between the studies and differences in the subjects' drug use histories, MDMA produced very similar cardiovascular and subjective effects across the sites. The participants' prior use of MDMA was inversely related to feeling `Any Drug Effect' only at sites testing more experienced users. Conclusions These data indicate that the pharmacological effects of MDMA are robust and highly reproducible across settings. There was also modest evidence for tolerance to the effects of MDMA in regular users. PMID:24633447

Shooting Gallery Operation in the Context of Establishing a Medically Supervised Injecting Center: Sydney, Australia

PubMed Central

Dolan, Kate

2007-01-01

Shooting galleries (SGs) are illicit off-street spaces close to drug markets used for drug injection. Supervised injecting facilities (SIFs) are low threshold health services where injecting drug users (IDUs) can inject pre-obtained drugs under supervision. This study describes SG use in Kings Cross, Sydney before and after the opening of the Sydney Medically Supervised Injecting Centre (MSIC), Australia’s first SIF. Operational and environmental characteristics of SGs, reasons for SG use, and willingness to use MSIC were also examined. An exploratory survey of SG users (n = 31), interviews with SG users (n = 17), and drug workers (n = 8), and counts of used needles routinely collected from SGs (6 months before and after MSIC) and visits to the MSIC (6 months after MSIC) were triangulated. We found five SGs operated during the study period. Key operational characteristics were 24-h operation, AUS$10 entry fee, 30-min time limit, and dual use for sex work. Key reasons for SG use were to avoid police, a preference not to inject in public, and assistance from SG operators in case of overdose. SG users reported high levels of willingness to use the MSIC. The number of used needles collected from SGs decreased by 69% (41,819 vs. 12,935) in the 6 months after MSIC opened, while MSIC visits increased incrementally. We conclude that injections were transferred from SGs to the MSIC, but SGs continued to accommodate injections and harm reduction outreach should be maintained. PMID:17273925

Sexual behavior differences between amphetamine-type stimulants users and heroin users.

PubMed

Jia, Zhen-jun; Yan, Shi-yan; Bao, Yan-ping; Lian, Zhi; Zhang, Hao-ran; Liu, Zhi-min

2013-01-01

To explore the sexual behavior of amphetamine-type stimulant (ATS) users and heroin users, and to find out the dangerous sexual behaviors, even related risk factors among them. Four hundred thirty-eight ATS users and 524 heroin users were recruited in 10 compulsory detoxification treatment centers and voluntary detoxification centers in Beijing, Shenzhen, Guangzhou, Xi'an, and Taiyuan. Their sociodemographic characteristics, history of drug taking, and sexual behaviors were surveyed. Many variables of sociodemographic characteristics and sexual behaviors were significantly different between ATS users and heroin users (P < 0.05). Dangerous sexual behaviors among ATS users include sexual intercourse often or each time after taking drug (30.1%), multiple sexual intercourse (16.5%), casual sex partners (34.0%), homosexual partners (2.5%), and never or occasionally using condom with a steady sex partner (79.3%) or with casual sex partners (39.1%). The rate of ever-infecting sexually transmitted disease (STD) was high in both the groups (ATS, 20.5%; heroin, 30.9%). Sexual behavior is the main way to transmit STD and human immunodeficiency virus among ATS users. The study results will promote the government's awareness of the issue and take necessary steps to slow the spread of STD and human immunodeficiency virus among the ATS users.

Social and structural aspects of the overdose risk environment in St. Petersburg, Russia

PubMed Central

Grau, Lauretta E.; Blinnikova, Ksenia N.; Torban, Mikhail; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei; Heimer, Robert

2009-01-01

Background While overdose is a common cause of mortality among opioid injectors worldwide, little information exists on opioid overdoses or how context may influence overdose risk in Russia. This study sought to uncover social and structural aspects contributing to fatal overdose risk in St. Petersburg and assess prevention intervention feasibility. Methods Twenty-one key informant interviews were conducted with drug users, treatment providers, toxicologists, police, and ambulance staff. Thematic coding of interview content was conducted to elucidate elements of the overdose risk environment. Results Several factors within St. Petersburg’s environment were identified as shaping illicit drug users’ risk behaviors and contributing to conditions of suboptimal response to overdose in the community. Most drug users live and experience overdoses at home, where family and home environment may mediate or moderate risk behaviors. The overdose risk environment is also worsened by inefficient emergency response infrastructure, insufficient cardiopulmonary or naloxone training resources, and the preponderance of abstinence-based treatment approaches to the exclusion of other treatment modalities. However, attitudes of drug users and law enforcement officials generally support overdose prevention intervention feasibility. Modifiable aspects of the risk environment suggest community-based and structural interventions, including overdose response training for drug users and professionals that encompasses naloxone distribution to the users and equipping more ambulances with naloxone. Conclusion Local social and structural elements influence risk environments for overdose. Interventions at the community and structural levels to prevent and respond to opioid overdoses are needed for and integral to reducing overdose mortality in St. Petersburg. PMID:18774283

Topical Antimycotics for Oral Candidiasis in Warfarin Users.

PubMed

Hellfritzsch, Maja; Pottegård, Anton; Pedersen, Andreas James Thestrup; Burghle, Alaa; Mouaanaki, Fatima; Hallas, Jesper; Grove, Erik Lerkevang; Damkier, Per

2017-04-01

Treatment for oral candidiasis in warfarin users may be complicated by drug-drug interactions (DDIs) between warfarin and topically applied antimycotics. However, current knowledge of these putative DDIs is merely based on case series. We therefore performed a cohort cross-over study with the objective to evaluate the potential DDIs between warfarin and miconazole oral gel or nystatin oral solution. The cohort consisted of individuals using warfarin in the period of 1998-2012 (n ≈ 7400). We collected data on cohort members' measurements of the international normalized ratio (INR) from a clinical database, and obtained information on their use of topically applied miconazole and nystatin from a regional prescription register. Potential DDIs were assessed by comparing INR values before and after initiation of an antimycotic drug. Among 17 warfarin users exposed to miconazole oral gel, the mean INR increased from 2.5 (95% CI: 2.1-2.8) to 3.8 (95% CI: 2.8-4.8) after exposure, corresponding to a mean INR increase of 1.4 (95% CI: 0.3-2.4). Among 30 warfarin users exposed to nystatin oral solution, the mean INR was 2.7 (95% CI: 2.3-3.1) before and 2.5 (95% CI: 2.2-2.9) after exposure. In conclusion, we found evidence supporting a clinically relevant drug-drug interaction between warfarin and miconazole oral gel. In contrast, we did not find any indication of an interaction between warfarin and nystatin oral solution. Nystatin rather than miconazole should be preferred when treating warfarin users for oral candidiasis. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Detecting cocaine use? The autobiographical implicit association test (aIAT) produces false positives in a real-world setting

PubMed Central

2013-01-01

Background The autobiographical Implicit Association Test (aIAT) is a novel application of the implicit association concept for detecting life events. It has been used to reveal concealed knowledge in clinical and forensic settings, including detecting drug use. In this study, we aimed to explore the functionality of the aIAT to identify drug use in real-world settings. Methods The study used mixed methodology with known groups of drug users and nonusers. Recreational cocaine users (n = 23) and non-users (n = 23) were recruited through ethnographic methodology and assessed using a bespoke brief aIAT for cocaine use. An identical aIAT test for heroin detection was also administered to a sub-sample of 10 cocaine users and 13 nonusers. The accuracy of the cocaine aIAT was measured through ROC analysis. Paradoxical aIAT results were explored by integrating craving, consumption measures and life-story interviews into the analysis. Results Whilst the two brief aIATs showed good concurrent validity for cocaine users by accurately detecting drug using status for 18 of the 23 users (78.3%), the test falsely reported 61% cocaine users in the non-user comparison group. The average D-scores were 0.257±0.246 for the cocaine users and 0.134±0.367 for the non-users, showing no discriminatory power (t(44) = 1.339, p = 0.187; AUC = 0.605, p = 0.223). Results were independent from craving and recent cocaine use. The comparison group’s cocaine and heroin aIAT scores correlated significantly (r(13) = 0.776, p = 0.002) whilst an accurate absence of such relationship was evidenced in the cocaine using sample (r(10) = 0.061, p = 0.866). Triangulation with life-story interviews suggests that in the absence of an autobiographical event, this test may measure an alternative cognitive construct linked to the Self-concept. Conclusion The aIAT is a variant of an attitude measure and can be better rationalized if propositional thinking is implied to explain outcomes. The Relational Frame and Social Knowledge Structure theories can perhaps provide a more plausible theoretical background. Further work is required to clarify which factors underlie this testing technique’s functioning. Reappraisal is advised before further forensic use of the instrument to ensure that general associations not related to autobiographical memory do not confound results. PMID:23767665

The dynamics of injection drug users' personal networks and HIV risk behaviors.

PubMed

Costenbader, Elizabeth C; Astone, Nan M; Latkin, Carl A

2006-07-01

While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time. Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%. The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

Building skills of recovering women drug users to reduce heterosexual AIDS transmission.

PubMed Central

Schilling, R F; el-Bassel, N; Schinke, S P; Gordon, K; Nichols, S

1991-01-01

Although most women infected with HIV are intravenous drug users, some contact the virus through sexual contact with IV drug users. To reach at-risk women, public health officials must develop a range of prevention strategies. One approach, skills training, holds promise as a means of altering risk-related sexual behavior. In this study, 91 women methadone patients were pretested and randomly assigned to an information-only control control group or a skills-building intervention group. Skills-building intervention consisted of five sessions of small groups in which participants identified their own high risk sexual behaviors, discussed their negative associations with condoms, and practiced skills which involved asking partners to use condoms. Compared with members of the control group, respondents in the intervention group reported that they initiated discussion of sexual issues with their partners more frequently, felt more comfortable talking with them about safer sex, and reported using and carrying condoms more frequently. The high rates of attendance and program retention by skills-building participants suggest that such groups may be supportive and useful in the design of risk reduction and drug abuse treatment programs. The modest outcomes of this study underscore the difficulty of altering risk behavior but also serve as a basis for future AIDS prevention studies. PMID:1905051

Motivations for Using MDMA (Ecstasy/Molly) among African Americans: Implications for Prevention and Harm-Reduction Programs.

PubMed

Rigg, Khary K

2017-01-01

Despite the growing popularity of MDMA (ecstasy/molly) among African Americans, their motives for using the drug are still largely unknown. The purpose of this study was to identify and describe the most salient motivations for using MDMA among this understudied population. In-depth interviews (n = 15) were conducted with a sample of African American young adults in Southwest Florida between August 2014 and November 2015. The primary motivations for using MDMA included: (1) altering the effects of marijuana and alcohol; (2) lasting longer sexually; (3) enhancing sexual pleasure; and (4) facilitating "freaky" sexual experiences. This is the first study to directly examine MDMA motivations specifically among African American drug users, and findings shed light on why some African Americans use MDMA. A better understanding of why African Americans use this drug should help to inform prevention and harm-reduction efforts. Study findings show the need for health messages that include the potential consequences of mixing MDMA with other drugs, and engaging in high-risk sexual behaviors after taking MDMA. These data contrast with motivations (e.g., introspection, self-enlightenment, getting into the music) commonly reported among groups of largely White MDMA users, suggesting that interventions tailored specifically for African American users are needed.

Adaptation of the European Commission-recommended user testing method to patient medication information leaflets in Japan.

PubMed

Yamamoto, Michiko; Doi, Hirohisa; Yamamoto, Ken; Watanabe, Kazuhiro; Sato, Tsugumichi; Suka, Machi; Nakayama, Takeo; Sugimori, Hiroki

2017-01-01

The safe use of drugs relies on providing accurate drug information to patients. In Japan, patient leaflets called Drug Guide for Patients are officially available; however, their utility has never been verified. This is the first attempt to improve Drug Guide for Patients via user testing in Japan. To test and improve communication of drug information to minimize risk for patients via user testing of the current and revised versions of Drug Guide for Patients, and to demonstrate that this method is effective for improving Drug Guide for Patients in Japan. We prepared current and revised versions of the Drug Guide for Patients and performed user testing via semi-structured interviews with consumers to compare these versions for two guides for Mercazole and Strattera. We evenly divided 54 participants into two groups with similar distributions of sex, age, and literacy level to test the differing versions of the Mercazole guide. Another group of 30 participants were divided evenly to test the versions of the Strattera guide. After completing user testing, the participants evaluated both guides in terms of amount of information, readability, usefulness of information, and layout and appearance. Participants were also asked for their opinions on the leaflets. Response rates were 100% for both Mercazole and Strattera. The revised versions of both Guides were superior or equal to the current versions in terms of accessibility and understandability. The revised version of the Mercazole guide showed better ratings for readability, usefulness of information, and layout ( p <0.01) than did the current version, while that for Strattera showed superior readability and layout ( p <0.01). User testing was effective for evaluating the utility of Drug Guide for Patients. Additionally, the revised version had superior accessibility and understandability.

Barriers associated with the treatment of hepatitis C virus infection among illicit drug users.

PubMed

Grebely, Jason; Genoway, Krista A; Raffa, Jesse D; Dhadwal, Gurbir; Rajan, Tasleem; Showler, Grey; Kalousek, Kate; Duncan, Fiona; Tyndall, Mark W; Fraser, Chris; Conway, Brian; Fischer, Benedikt

2008-01-11

Illicit drug users account for the majority of cases of HCV infection in the developed world, but few have received treatment. We evaluated barriers to initiating HCV treatment -- including general treatment willingness -- and factors associated with these among HCV infected illicit drug users. Participants were recruited via convenience sampling from two community clinics in Canada. Individuals age >18 years with a history of illicit drug use completed interviewer-administered surveys. Those reporting positive HCV testing underwent additional questioning on willingness, uptake and barriers to treatment for HCV. Of 188 HCV positive illicit drug users, 16% (n=30) had received treatment for HCV. Factors associated with a decreased treatment uptake included current heroin use and HIV/HCV co-infection. Among those not having received therapy, 77% (117/153) indicated a willingness to receive HCV treatment. Factors associated with treatment willingness included not being infected with HIV, having not recently used drugs by injection and having reported physical health problems. Among those not having sought HCV treatment (n=107), the major reasons for not doing so were: lack of information about HCV or knowledge that treatment was available (23%), the absence of symptoms (20%) and the perceived side effects of treatment (14%). Among illicit drug users attending inner city clinics, we have observed a low uptake of HCV treatment, but a high willingness to receive therapy. An increased focus on improving education about the long-term consequences of HCV and the availability of effective treatment are important components for expanding HCV treatment among illicit drug users.

Perspectives on Health among Adult Users of Illicit Stimulant Drugs in Rural Ohio

ERIC Educational Resources Information Center

Siegal, Harvey A.; Draus, Paul J.; Carlson, Robert G.; Falck, Russel S.; Wang, Jichuan

2006-01-01

Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may…