urban drug users: Topics by Science.gov

Sample records for urban drug users

RURAL/URBAN RESIDENCE, ACCESS, AND PERCEIVED NEED FOR TREATMENT AMONG AFRICAN AMERICAN COCAINE USERS

PubMed Central

BORDERS, TYRONE F.; BOOTH, BRENDA M.; STEWART, KATHARINE E.; CHENEY, ANN M.; CURRAN, GEOFFREY M.

2014-01-01

Objective To examine how rural/urban residence, perceived access, and other factors impede or facilitate perceived need for drug use treatment, a concept closely linked to treatment utilization. Study Design Two hundred rural and 200 urban African American cocaine users who were not receiving treatment were recruited via Respondent-Driven Sampling and completed a structured in-person interview. Bivariate and multivariate analyses were conducted to test the associations between perceived need and rural/urban residence, perceived access, and other predisposing (eg, demographics), enabling (eg, insurance), and health factors (eg, psychiatric distress). Principal Findings In bivariate analyses, rural relative to urban cocaine users reported lower perceived treatment need (37% vs 48%), availability, affordability, overall ease of access, and effectiveness, as well as lower perceived acceptability of residential, outpatient, self-help, and hospital-based services. In multivariate analyses, there was a significant interaction between rural/urban residence and the acceptability of religious counseling. At the highest level of acceptability, rural users had lower odds of perceived need (OR=.23); at the lowest level, rural users had higher odds of perceived need (OR=2.74) than urban users. Among rural users, the acceptability of religious counseling was negatively associated with perceived need (OR=.64). Ease of access was negatively associated (OR=.71) whereas local treatment effectiveness (OR=1.47) and the acceptability of hospital-based treatment (OR=1.29) were positively associated with perceived need among all users. Conclusions Our findings suggest rural/urban disparities in perceived need and access to drug use treatment. Among rural and urban cocaine users, improving perceptions of treatment effectiveness and expanding hospital-based services could promote treatment seeking. PMID:25213603
Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya

PubMed Central

Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

2016-01-01

ABSTRACT Background: The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Methods: Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. Results: In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Conclusions: Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. PMID:28031299
Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya.

PubMed

Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

2016-12-23

The Family Planning 2020 initiative aims to reach 120 million new family planning users by 2020. Drug shops and pharmacies are important private-sector sources of contraception in many contexts but are less well understood than public-sector sources, especially in urban environments. This article explores the role that drug shops and pharmacies play in the provision of contraceptive methods in selected urban areas of Nigeria and Kenya as well as factors associated with women's choice of where to obtain these methods. Using data collected in 2010/2011 from representative samples of women in selected urban areas of Nigeria and Kenya as well as a census of pharmacies and drug shops audited in 2011, we examine the role of drug shops and pharmacies in the provision of short-acting contraceptive methods and factors associated with a women's choice of family planning source. In urban Nigeria and Kenya, drug shops and pharmacies were the major source for the family planning methods of oral contraceptive pills, emergency contraceptives, and condoms. The majority of injectable users obtained their method from public facilities in both countries, but 14% of women in Nigeria and 6% in Kenya obtained injectables from drug shops or pharmacies. Harder-to-reach populations were the most likely to choose these outlets to obtain their short-acting methods. For example, among users of these methods in Nigeria, younger women (<25 years old) were significantly more likely to obtain their method from a drug shop or pharmacy than another type of facility. In both countries, family planning users who had never been married were significantly more likely than married users to obtain these methods from a drug shop or a pharmacy than from a public-sector health facility. Low levels of family planning-related training (57% of providers in Kenya and 41% in Nigeria had received training) and lack of family planning promotional activities in pharmacies and drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. © Corroon et al.
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.
The prevalence and correlates of single cigarette selling among urban disadvantaged drug users in Baltimore, Maryland.

PubMed

Latkin, Carl A; Murray, Laura I; Clegg Smith, Katherine; Cohen, Joanna E; Knowlton, Amy R

2013-10-01

Selling of single cigarettes, also known as loosies, is a public health concern. Loosies allow for those with fewer resources to buy cigarettes without having to purchase a pack. Selling of loosies may cue smoking behaviors. In the US, socioeconomically disadvantaged populations have high rates of smoking and illicit drug use and the selling of loosies appears to be linked to the urban informal economy. We examined the proportion and frequency of cigarette selling and roles in the informal economy associated with selling loosies among a sample of urban drug users. There were 801 participants, recruited by community outreach, assessed at baseline, who were enrolled in an HIV prevention intervention for drug users. Most (89%) smoked cigarettes in the prior 30 days, of whom 92% smoked daily. Self-reported selling of cigarettes was common with 58% reporting that they had sold cigarettes within the last six months; 20.4% reported selling cigarettes a few times a week and 7.4% reported daily selling of cigarettes. In a stepwise regression model, four sources of income were associated with frequent cigarette selling: providing street security (OR=2.214, 95% CI 1.177-4.164), selling food stamps (OR=1.461, 95% CI 1.003-2.126), pawning items (OR=2.15, 95% CI 1.475-3.135), and selling drugs (OR=1.634, 95% CI 1.008-2.648). There is a high rate of selling loosies among urban substance users. The wide availability of loosies may promote smoking. Smoking cessation programs with drug treatment and economic development programs may help to reduce economic pressures to sell loosies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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.
The diffusion of ecstasy through urban youth networks.

PubMed

Schensul, Jean J; Diamond, Sarah; Disch, William; Bermudez, Rey; Eiserman, Julie

2005-01-01

Ecstasy is a drug commonly associated with all-night, or all-weekend electronic dance events known as raves. Upper- and middle-class clubs, gay bars and clubs, and party venues are other common public settings where ecstasy use occurs. During the mid to late 1990s its use was reported in locations as distant as Australia and New Zealand, England and Scotland, and North America. In the United States, use increased dramatically at the end of the millennium, and drug monitoring systems began to report its presence among urban youth. Using social influence, social marketing and diffusion theory, this paper outlines the micro-level processes through which ecstasy traveled from downtown clubs catering to suburban young adults through urban youth networks through distributors and users. The paper is based on participant observation, and in-depth interviews with dealers and users collected during the period of peak diffusion 1999-2001, and survey data collected from 401 poly-drug users between the ages of 16 and 24 and collected at two time points from 1999-2002.
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…
Boredom, depressive symptoms, and HIV risk behaviors among urban injection drug users.

PubMed

German, Danielle; Latkin, Carl A

2012-11-01

Boredom is closely aligned with depression, but is understood to be conceptually distinct. Little is known about boredom among active drug users and the potential association with depression and HIV risk. Current IDUs (n = 845) completed a baseline behavioral survey including socio-demographic characteristics, self-reported boredom, depressive symptoms (CESD score), and HIV risk behaviors. One-third of the sample reported high boredom in the past week. In multivariate analysis, those who reported boredom were less likely to be older, African-American, have a main partner, and to be employed at least part-time. Controlling for covariates, those with high boredom were almost five times as likely to report high depressive symptoms. Co-occurrence of boredom and depressive symptoms (28 %) was strongly and independently associated with a range of injection risk behaviors and sex exchange. This study demonstrates the need for more thorough understanding of mental health and HIV risk among urban drug users.
Patterns and Correlates of Drug Use Among Urban High School Students

ERIC Educational Resources Information Center

Mc Killip, Jack; And Others

1973-01-01

A drug-use survey was administered in a large metropolitan, middle class high school to test two hypotheses: a. drug users can be divided according to the types of drugs used (tobacco, alcohol, and marijuana vs. opiates, LSD, amphetamines, etc.); and, b. respondents' drug use is significantly related to their peers drug use. Both hypotheses were…
The Criminal Justice Experience of African American Cocaine Users in Arkansas.

PubMed

Zaller, Nickolas; Cheney, Ann M; Curran, Geoffrey M; Booth, Brenda M; Borders, Tyrone F

2016-10-14

African Americans are incarcerated at rates much higher than other racial and ethnic groups in the United States. We sought to qualitatively explore the relationships between ongoing involvement in the criminal justice system and continued drug use in a population of urban and rural African American cocaine users in a southern state. Semi-structured qualitative interviews were conducted among African American cocaine users in Arkansas between 2010 and 2012. Participants resided in both rural (two counties located in the eastern Arkansas Mississippi delta region) and urban (the county including the capital city of Little Rock) areas. Numerous important themes emerged from participants' narratives, including chronic involvement with the criminal justice system (being a "career criminal"), continued access to drugs while incarcerated, relapse, and reincarceration and lack of access to effective drug treatment. Conclusion/Importance: The themes which emerged from our data speak to the collective experience that many substance using populations in the United States face in dealing with the criminal justice system. Our findings highlight the need to better, more holistic ways of engaging African American substance users in community based substance use treatment and supportive services.
Boredom, depressive symptoms, and HIV risk behaviors among urban injection drug users

PubMed Central

German, Danielle; Latkin, Carl A.

2013-01-01

Boredom is closely aligned with depression, but is understood to be conceptually distinct. Little is known about boredom among active drug users and the potential association with depression and HIV risk. Current IDUs (n=845) completed a baseline behavioral survey including socio-demographic characteristics, self-reported boredom, depressive symptoms (CESD score), and HIV risk behaviors. One-third of the sample reported high boredom in the past week. In multivariate analysis, those who reported boredom were less likely to be older, African-American, have a main partner, and to be employed at least part-time. Controlling for covariates, those with high boredom were almost five times as likely to report high depressive symptoms. Co-occurrence of boredom and depressive symptoms (28%) was strongly and independently associated with a range of injection risk behaviors and sex exchange. This study demonstrates the need for more thorough understanding of mental health and HIV risk among urban drug users. PMID:22760741
The Criminal Justice Experience of African American Cocaine Users in Arkansas

PubMed Central

Zaller, Nickolas; Cheney, Ann M.; Curran, Geoffrey M.; Booth, Brenda M.; Borders, Tyrone F.

2018-01-01

Background African Americans are incarcerated at rates much higher than other racial and ethnic groups in the United States. Objectives We sought to qualitatively explore the relationships between ongoing involvement in the criminal justice system and continued drug use in a population of urban and rural African American cocaine users in a southern state. Methods Semi-structured qualitative interviews were conducted among African American cocaine users in Arkansas between 2010 and 2012. Participants resided in both rural (two counties located in the eastern Arkansas Mississippi delta region) and urban (the county including the capital city of Little Rock) areas. Results Numerous important themes emerged from participants’ narratives, including chronic involvement with the criminal justice system (being a “career criminal”), continued access to drugs while incarcerated, relapse, and reincarceration and lack of access to effective drug treatment. Conclusion/Importance The themes which emerged from our data speak to the collective experience that many substance using populations in the United States face in dealing with the criminal justice system. Our findings highlight the need to better, more holistic ways of engaging African American substance users in community based substance use treatment and supportive services. PMID:27486889
Medical and Nonmedical Users of Prescription Drugs among College Students

ERIC Educational Resources Information Center

Rozenbroek, Katelyn; Rothstein, William G.

2011-01-01

Objectives: To examine medical and nonmedical users of prescription opioids, central nervous system depressants, and stimulants taken individually and in combination. Participants: Undergraduates at an urban mid-Atlantic university with 12,000 students. Methods: A questionnaire administered in classes provided 413 responses, with a usable response…
[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.
Understanding the Subjective Experience of Medication Adherence for Older Urban African Americans With Type 2 Diabetes and a History of Illicit Drug Addiction.

PubMed

Wallace, Brandy Harris; Reese, Ashante M; Chard, Sarah; Roth, Erin G; Quinn, Charlene; Eckert, J Kevin

2017-04-01

African Americans experience high rates of type 2 diabetes mellitus (T2D). Self-management strategies, such as medication adherence, are key to mitigating negative T2D outcomes. This article addresses a gap in the literature by examining the intersections of drug abuse histories and medication adherence among urban, older African Americans with T2D. In-depth interview data were collected as part of a larger ethnographic study examining the subjective experience of T2D among urban older adults. Two representative focal cases were selected and thematic analysis performed to illustrate how former illicit drug addicts perceive prescription medication usage. Narratives reveal that participants are displeased about having to take prescription drugs and are making lifestyle changes to reduce medication usage and maintain sobriety. Previous drug abuse not only complicates medication adherence but is also a significant part of how older African Americans who are former drug users frame their understanding of T2D more broadly.
Substance Use Profiles of Urban American Indian Adolescents: A Latent Class Analysis.

PubMed

Kulis, Stephen S; Jager, Justin; Ayers, Stephanie L; Lateef, Husain; Kiehne, Elizabeth

2016-07-28

A growing majority of American Indian adolescents now live in cities and are at high risk of early and problematic substance use and its negative health effects. This study used latent class analysis to empirically derive heterogeneous patterns of substance use among urban American Indian adolescents, examined demographic correlates of the resulting latent classes, and tested for differences among the latent classes in other risk behavior and prosocial outcomes. The study employed a representative sample of 8th, 10th, and 12th grade American Indian adolescents (n = 2,407) in public or charter schools in metropolitan areas of Arizona in 2012. Latent class analysis examined eight types of last 30 day substance use. Four latent classes emerged: a large group of "nonusers" (69%); a substantial minority using alcohol, tobacco, and/or marijuana [ATM] (17%); a smaller group of polysubstance users consuming, alcohol, tobacco, marijuana, other illicit drugs, and prescription or OTC drugs in combination (6%); and a "not alcohol" group reporting combinations of tobacco, marijuana, and prescription drug use, but rarely alcohol use (4%). The latent classes varied by age and grade level, but not by other demographic characteristics, and aligned in highly consistent patterns on other non-substance use outcomes. Polysubstance users reported the most problematic and nonusers the least problematic outcomes, with ATM and "not alcohol" users in the middle. Urban AI adolescent substance use occurs in three somewhat distinctive patterns of combinations of recent alcohol and drug consumption, covarying in systematic ways with other problematic risk behaviors and attitudes.
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
“Everything that looks good ain’t good!”: Perspectives on Urban Redevelopment among Persons with a History of Injection Drug Use in Baltimore, Maryland

PubMed Central

Linton, Sabriya L.; Kennedy, Caitlin E.; Latkin, Carl A.; Celentano, David D.; Kirk, Gregory D.; Mehta, Shruti H.

2013-01-01

Background While urban redevelopment is intended to ameliorate urban decay, some studies demonstrate that it can negatively impact some residents. Few studies have considered its impact on persons with a history of drug use. Methods A convenience sample of 25 current or former injection drug users from Baltimore, Maryland, enrolled in the AIDS Linked to the Intravenous Experience study, and reporting residence in or bordering a redeveloping neighborhood participated in 1-2 semi-structured in-depth interviews from July, 2011-February, 2012. Interviews explored personal experiences with redevelopment and perceptions of community-wide impact. Data were analyzed using the constant comparison method. Results Respondents rarely described urban redevelopment as solely negative or positive. Revitalization and increased security in the redeveloping area were reported as positive consequences. Negative consequences included the lack of redevelopment-related employment opportunities, disruption of social ties, and housing instability among relocated residents. Respondents also said that urban redevelopment led to the displacement of drug markets to adjacent neighborhoods and outlying counties. Residential relocation and displacement of drug markets were reported as beneficial for persons in contemplative and later stages of recovery. Conclusion These findings support a holistic approach to urban redevelopment that increases access to employment opportunities and affordable housing and ensures equitable coverage of public services such as law enforcement. PMID:23647924
Urban vs. rural differences in prescription opioid misuse among adults in the United States: informing region specific drug policies and interventions.

PubMed

Rigg, Khary K; Monnat, Shannon M

2015-05-01

In the United States, prescription opioid misuse (POM) has increased dramatically over the past two decades. However, there are still questions regarding whether rural/urban differences in adult POM exist, and more important, which factors might be driving these differences. Using data from the 2011 and 2012 National Survey on Drug Use and Health, we conducted unadjusted and adjusted binary logistic regression analyses to determine the association between metropolitan status and POM. We found that urban adults were more likely to engage in POM compared to rural adults because of their higher use of other substances, including alcohol, cannabis, and other illicit and prescription drugs, and because of their greater use of these substances as children. This study fills an important gap in the literature by not only identifying urban/rural differences in POM, but by also pointing out factors that mediate those differences. Because patterns and predictors of POM can be unique to geographic region, this research is critical to informing tailored interventions and drug policy decisions. Specifically, these findings suggest that interventions should be aimed at urban illicit drug users and adults in manual labor occupations. Copyright © 2014 Elsevier B.V. All rights reserved.

Intra-Urban Mobility and its Potential Impact on the Spread of Blood-Borne Infections among Drug Injectors in Tijuana, Mexico

PubMed Central

Brouwer, Kimberly C.; Lozada, Remedios; Weeks, John R.; Magis-Rodríguez, Carlos; Firestone-Cruz, Michelle; Strathdee, Steffanie A.

2013-01-01

We explored intra-urban mobility of Tijuana, Mexico injection drug users (IDUs). In 2005, 222 IDUs underwent behavioral surveys and infectious disease testing. Participants resided in 58 neighborhoods, but regularly injected in 30. From logistic regression, “mobile” IDUs (injecting ≥3 km from their residence) were more likely to cross the Mexico/U.S. border, share needles, and get arrested for carrying syringes - but less likely to identify hepatitis as an injection risk. Mobile participants lived in neighborhoods with less drug activity, treatment centers, or migrants, but higher marriage and home ownership rates. Mobile IDUs should be targeted for outreach and further investigation. PMID:22136446
The War on Drugs That Wasn't: Wasted Whiteness, “Dirty Doctors,” and Race in Media Coverage of Prescription Opioid Misuse

PubMed Central

Netherland, Julie; Hansen, Helena B.

2016-01-01

The past decade in the U.S. has been marked by a media fascination with the white prescription opioid cum heroin user. In this paper, we contrast media coverage of white non-medical opioid users with that of black and brown heroin users to show how divergent representations lead to different public and policy responses. A content analysis of 100 popular press articles from 2001 and 2011 in which half describe heroin users and half describe prescription opioid users revealed a consistent contrast between criminalized urban black and Latino heroin injectors with sympathetic portrayals of suburban white prescription opioid users. Media coverage of the suburban and rural opioid “epidemic” of the 2000s helped draw a symbolic, and then legal, distinction between (urban) heroin addiction and (suburban and rural) prescription opioid addiction that is reminiscent of the legal distinction between crack cocaine and powder cocaine of the 1980s and 90s. This distinction reinforces the racialized deployment of the War on Drugs and is sustained by the lack of explicit discussion of race in the service of “color blind ideology.” We suggest potential correctives to these racially divergent patterns, in the form of socially responsible media practices and of clinical engagement with public policy. PMID:27272904
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.
Drug-Intake Methods and Social Identity: The Use of Marijuana in Blunts among Southeast Asian Adolescents and Emerging Adults

ERIC Educational Resources Information Center

Soller, Brian; Lee, Juliet P.

2010-01-01

This article examines why Southeast Asian American adolescents and emerging adults in two urban settings prefer to use "blunts," or hollowed-out cigars filled with marijuana, over other methods of drug intake. Rationales for preferring blunts were both instrumental and social. Blunts allowed users to more easily share marijuana, the preferred drug…
Stated preferences for anti-malarial drug characteristics in Zomba, a malaria endemic area of Malawi

PubMed Central

2014-01-01

Background The evidence on determinants of individuals’ choices for anti-malarial drug treatments is scarce. This study sought to measure the strength of preference for adult antimalarial drug treatment attributes of heads of urban, rural and peri-urban households in a resource-limited malaria-endemic area of sub-Saharan Africa. Methods Discrete choice experiments were conducted with 508 heads of household interviewed face-to-face for a household population survey of health-seeking behavior in Zomba District, Malawi. The interviews were held in Chichewa and the choice experiment questions were presented with cartoon aids. The anti-malarial drug attributes included in the stated preference experiment were: speed of fever resolution, side effects (pruritus) risk, protection (duration of prophylactic effect), price, duration of treatment course and recommendation by a health professional. Sixteen treatment profiles from a fractional factorial design by orthogonal array were paired into choice scenarios, and scenarios were randomly assigned to participants so that each participant was presented with a series of eight pairwise choice scenarios. Respondents had the option to state indifference between the two profiles or decline to choose. Data were analysed in a mixed logit model, with normally distributed coefficients for all six attributes. Results The sex ratio was balanced in urban areas, whereas 63% of participants in rural areas were male. The proportion of individuals with no education was considerably higher in the rural group (25%) than in the urban (5%) and peri-urban (6%) groups. All attributes investigated had the expected influence, and traded-off in most respondents’ choices. There were heterogeneous effects of price, pruritus risk, treatment recommendation by a professional, and duration of prophylaxis across respondents, only partly explained by their differences in education, household per capita expenditure, sex and age. Individuals´ demand elasticity (simulated median, inter-quartile range) was highest (most responsive) to speed of symptom resolution (0.88, 0.80-0.89) and pruritus risk (0.25, 0.08-0.62). Conclusions Most adult antimalarial users are willing to use treatments without recommendation from health professional, and may be influenced by price. Future studies should investigate the magnitude of differences in price and treatment attribute sensitivity between adult anti-malarial drug users in rural, peri-urban and urban areas in order to determine optimal price subsidies. PMID:25005466
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.
[Family and acquaintances of illicit drug users: community perspectives on laws and public policies in Western Rio de Janeiro, Brazil].

PubMed

Silva, Jaqueline da; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

This article is part of the study 'Illicit Drug Use in Seven Latin American Countries and Canada: Critical Perspectives of Family and Familiars' (7LACC), which investigated four domains: protective and risk factors; preventive initiatives; treatment facilities; and laws and policies. The article presents a section of the results based on four items of the laws and policies domain--as perceived by the family and acquaintances of illicit drug users living in the community. Participants were recruited in urban primary health care units located in Western Rio de Janeiro (city), Brazil. This multi-method, cross-temporal study performed interviews with 100 adults (18 years of age or older), all cognitively healthy. Results and key conclusions included non-compliance with the fundamental principles of the Unique Health System Legislation / Law 8.080/90 and the erroneous implementation of laws and public policies on illicit drug.
Opioid Overdose Experience, Risk Behaviors, and Knowledge in Drug Users from a Rural versus an Urban Setting.

PubMed

Dunn, Kelly E; Barrett, Frederick S; Yepez-Laubach, Claudia; Meyer, Andrew C; Hruska, Bryce J; Petrush, Kathy; Berman, Suzan; Sigmon, Stacey C; Fingerhood, Michael; Bigelow, George E

2016-12-01

Opioid use is highly prevalent in the United States and there has been an increased incidence in the rate of opioid-related overdose. While evidence suggests there are substantial differences in opioid use among rural versus urban settings, the rate of overdose and corresponding frequency of opioid overdose risk behaviors and overdose knowledge between rural and urban settings have not been examined. Individuals with opioid use disorder from rural (N=98) and urban (N=247) settings completed a self-report survey regarding their lifetime history of overdose and overdose risk behaviors. Participants also completed the Brief Opioid Overdose Knowledge (BOOK) questionnaire, a 12-item self-report measure of opioid overdose knowledge. Overall, 35.6% of participants had experienced an overdose, and prevalence of overdose was significantly higher (p<.01) among rural (45.9%) vs. urban (31.6%) participants, though fewer rural participants reported past 30-day risk behaviors. There were few differences observed between the subset of rural and urban participants who had experienced an overdose, and fewer rural participants with a history of overdose reported past 30-day risk behaviors. Both rural and urban participants performed poorly on the BOOK, though the percent of correct responses was lowest among rural participants with a history of overdose. Results demonstrate higher rates of overdose among rural opioid users, though rural participants were less likely to report recent risk behaviors. Results also suggest that knowledge regarding key factors related to opioid overdose is severely lacking, particularly among rural opioid users, which could be a potential target for future intervention efforts.
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.
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.
High risk behavior for HIV transmission among former injecting drug users: a survey from Indonesia.

PubMed

Iskandar, Shelly; Basar, Diba; Hidayat, Teddy; Siregar, Ike M P; Pinxten, Lucas; van Crevel, Reinout; Van der Ven, Andre J A M; De Jong, Cor A J

2010-08-10

Injecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs) are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs) in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use. Current and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test. Ninety-two out of 210 participants (44%) were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66%) and current (60%) IDUs. Former IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.
Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999-2014.

PubMed

Maurer, Laurie A; Bass, Sarah Bauerle; Ye, Du; Benitez, José; Mazzella, Silvana; Krafty, Robert

2016-12-01

This study examines trends of injection drug users' (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia's SEP registration data were analyzed using linear regression, Pearson's Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.
"It was fun, it was dangerous": Heroin, young urbanities and opening reforms in China's borderlands.

PubMed

Zoccatelli, Giulia

2014-07-01

An unprecedented flow of opiates flooded China's southern regions in the wake of the country's opening reforms in the 1980s. After the Maoist war on drugs had turned the People's Republic of China into an almost entirely drug-free area for three decades, heroin reappeared to become the most widely used illicit substance in the country. As the number of users rose by 1200% between 1988 and 1998, a generation of young people found themselves facing the consequences of addiction. Based on ethnographic data collected during 13 months of field research among a community of heroin users in the county-level city of Qilin in Yunnan Province, this paper explores the interplay of historical and social factors that led southern China's young urbanities to turn to heroin in the 1980s and 1990s. Towards this end, it draws on a broad array of research methods including the collection of life histories, extensive participant observation, and focus groups among the members of Qilin's local community of heroin users. I argue that the spread of heroin among southern China's young urbanities should be read as the aggregate outcome of such seemingly disparate factors as the opening of new global routes for the trafficking of opiates, the almost complete lack of Chinese public discourse around drugs in the immediate post-Mao period, the increased individualization of young people's ambitions, desires and forms of socialization, and the rise of a consumerist market economy in the country. Based on the data collected, I claim that the boom in the diffusion of heroin use in post-reform China cannot be described exclusively as a matter of deviant individual behaviours. Rather, it has to be interpreted as a complex social act, which is only understandable when framed within the social and historical context in which it was performed. Copyright © 2014 Elsevier B.V. All rights reserved.
Motivations for sexual risk behavior across commercial and casual partners among male urban drug users: contextual features and clinical correlates.

PubMed

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

2010-05-01

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 of childhood trauma, as well as current symptoms of depression, posttraumatic stress disorder (PTSD), and borderline personality disorder (BPD). Exploratory factor analysis indicated a 5-factor solution for commercial partner type, and a 4-factor solution for casual partner type, including the motivations of sexual sensation-seeking, intimacy seeking, reassurance-seeking, emotional avoidance, and emotional expressivity. Emotional avoidance and emotional expressivity were strongly related to childhood trauma and PTSD and BPD symptoms. These results provide initial results for mechanisms underlying the relationship between SRB and a history of trauma and psychopathology.
Negotiating ecstasy risk, reward, and control: a qualitative analysis of drug management patterns among ecstasy-using urban young adults.

PubMed

Singer, Elyse Ona; Schensul, Jean J

2011-01-01

This paper is based on qualitative in-depth interviews conducted from 2008 to 2009 with 118 ethnically diverse Ecstasy users from the greater Hartford area, CT, USA. Participants were urban, primarily Black and Hispanic, aged 18 to 36, and had limited higher education compared with samples in previous Ecstasy research. Interviews focused on personal background, history of Ecstasy and other drug use, and recent sexual events. In this paper, we examine: participants' negotiation of perceived risks and benefits of Ecstasy use, behavioral strategies employed to minimize risks, and the relationship of risk-benefit analysis, motivation for use, frequency of use, and polydrug use to participants' sense of control over their Ecstasy use. We conclude with recommendations for intervention approaches and suggestions for future 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.
Serving women who use drugs in Delhi, India: challenges and achievements.

PubMed

Sarin, Enisha; Selhore, Elizabeth

2008-04-01

Sharan and Sahara, two NGOs working in Delhi, India, in the field of drug use and HIV/AIDS, present some key challenges as well as lessons learned in working with women who use drugs. Although there is no official estimate of the number of women drug users in Delhi, outreach reports indicate a hidden population of women users in the slums and streets of Delhi. A rapid situation assessment (RSA) conducted in 2000 by Sharan found urban poor women using drugs in Delhi with multiple issues related to their health, livelihoods, and relationships that put them at risk of severe health problems including HIV. The findings of the RSA led to intensified and focused intervention for women users by Sahara and Sharan. This is a discussion on a gender specific intervention ongoing in Delhi by delineating the particular achievements and challenges faced in working with women who use drugs. The article also looks at broader challenges that are outside the scope of this particular intervention but which nevertheless affect the well being of women who use drugs. Out of the 3700 women who have been rehabilitated in Sahara, 40% have found employment, while another 10% have been reintegrated into their families. There is however, an overdependence on its services that impedes their successful transition to mainstream life. One of the biggest limitations in the design of drug treatment interventions in Delhi is that there is a lack of diverse treatment options for women users. Only indoor detoxification and rehabilitation facilities are available for women; even these not offering a quality of care commensurate with the needs of the women. Lack of mental health care in drug treatment centres is felt to be a huge gap in services. Finally, NGOs like Sharan and Sahara are obliged to take up the entire continuum of care services which limits their ability to provide optimal care and services to women who use drugs. Lack of funds and lack of understanding among funding agencies about issues of women users are additional limitations in service provision. A multi-sectoral response is a viable response to the multi-dimensional problem of women drug use.
Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa.

PubMed

Lion, Ryan R; Watt, Melissa H; Wechsberg, Wendee M; Meade, Christina S

2017-05-12

South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence. This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa. Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women. In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex. Conclusions/importance: The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior.
Beliefs and attitudes regarding drug treatment: application of the theory of planned behavior in African-American cocaine users.

PubMed

Booth, Brenda M; Stewart, Katharine E; Curran, Geoffrey M; Cheney, Ann M; Borders, Tyrone F

2014-10-01

The Theory of Planned Behavior (TPB) can provide insights into perceived need for cocaine treatment among African American cocaine users. A cross-sectional community sample of 400 (50% rural) not-in-treatment African-American cocaine users was identified through respondent-driven sampling in one urban and two rural counties in Arkansas. Measures included self-reports of attitudes and beliefs about cocaine treatment, perceived need and perceived effectiveness of treatment, and positive and negative cocaine expectancies. Normative beliefs were measured by perceived stigma and consequences of stigma regarding drug use and drug treatment. Perceived control was measured by readiness for treatment, prior drug treatment, and perceived ability to cut down on cocaine use without treatment. Multiple regression analysis found that older age (standardized regression coefficient β=0.15, P<0.001), rural residence (β=-0.09, P=0.025), effectiveness of treatment (β=0.39, P<0.001), negative cocaine expectancies (β=0.138, P=0.003), experiences of rejection (β=0.18, P<0.001), need for secrecy (β=0.12, P=0.002), and readiness for treatment (β=0.15, P<0.001) were independently associated with perceived need for cocaine treatment. TPB is a relevant model for understanding perceived need for treatment among African-American cocaine users. Research has shown perceived need to be a major correlate of treatment participation. Study results should be applicable for designing interventions to encourage treatment participation. Copyright © 2014. Published by Elsevier Ltd.

Reaching out and reaching up - developing a low cost drug treatment system in Cambodia

PubMed Central

2012-01-01

Cambodia, confronted by the spread of drug misuse among young people, requested support from international agencies to develop a drug treatment programme in 2000. The initial plan developed by the United Nations Office on Drugs and Crime was to set up a number of conventional drug treatment centres in urban areas. During the planning phase, however, the project was redesigned as a community based outreach programme. Ten Community Counselling Teams have been formed and trained in pilot areas, and within the first year of operation 462 drug and alcohol users contacted. Comprising former drug users, family members affected by drug use and health care staff, they have drug scene credibility, local knowledge and connectivity, and a rudimentary level of medical competence. Crucially, they enjoy the support of village elders, who are involved in the planning and reporting stages. While the Community Counselling Teams with their basic training in addiction counselling are in no position as yet to either provide or refer clients to treatment, they can provide brief interventions, organise self help groups, and most importantly provide an alternative to law enforcement. By taking a development centred approach, with emphasis on community, empowerment and inclusion, it provides a constructive and inclusive alternative to medical approaches and the compulsory drug treatment centres. The paper is based on an evaluation involving interviews with a range of stakeholders and a review of project documents. PMID:22410105
Heroin mismatch in the Motor City: addiction, segregation, and the geography of opportunity.

PubMed

Draus, Paul; Roddy, Juliette; Greenwald, Mark

2012-01-01

In this article, the authors used data from economic and ethnographic interviews with heroin users from Detroit, Michigan, as well as other sources, to illustrate the relationship between heroin users' mobility patterns and urban and suburban environments, especially in terms of drug acquisition and the geography of opportunity. The authors found that although geographic location and social networks associated with segregation provided central city residents and African Americans with a strategic advantage over White suburbanites in locating and purchasing heroin easily and efficiently, this same segregation effectively focuses the negative externalities of heroin markets in central city neighborhoods. Finally, the authors consider how the heroin trade reflects and reproduces the segregated post-industrial landscape and discuss directions for future research about the relationship between ethnic and economic ghettos and regional drug markets.
HIV vaccine trial willingness among injection and non-injection drug users in two urban centres, Barcelona and San Francisco.

PubMed

Etcheverry, M Florencia; Lum, Paula J; Evans, Jennifer L; Sanchez, Emilia; de Lazzari, Elisa; Mendez-Arancibia, Eva; Sierra, Ernesto; Gatell, José M; Page, Kimberly; Joseph, Joan

2011-02-24

Being able to recruit high-risk volunteers who are also willing to consider future participation in vaccine trials are critical features of vaccine preparedness studies. We described data from two cohorts of injection- and non-injection drug users in Barcelona, Spain [Red Cross centre] and in San Francisco, USA, [UFO-VAX study] at high risk of HIV/HCV infection to assess behaviour risk exposure and willingness to participate in future preventive HIV vaccine trials. We successfully identified drug-using populations that would be eligible for future HIV vaccine efficacy trials, based on reported levels of risk during screening and high levels of willingness to participate. In both groups, Red Cross and UFO-VAX respectively, HCV infection was highly prevalent at baseline (41% and 34%), HIV baseline seroprevalence was 4.2% and 1.5%, and high levels of willingness were seen (83% and 78%). Copyright © 2011 Elsevier Ltd. All rights reserved.
Dental Disease Prevalence among Methamphetamine and Poly-drug Users in an Urban Setting: A Pilot Study

PubMed Central

Brown, Carolyn; Krishnan, Sumathi; Hursh, Kevin; Yu, Michelle; Johnson, Paul; Page, Kimberly; Shiboski, Caroline H.

2013-01-01

Background/Objectives Rampant tooth decay has been reported among methamphetamine users. We investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared to heroin users. Methods This pilot project is a cross-sectional study of an on-going cohort of young adult injection-drug users (IDUs) in San Francisco. An oral health questionnaire was administered by a research-assistant, and two dentists performed clinical examinations to record the Decayed-Missing-Filled-Surfaces (DMFS) index, presence of residual roots, the Simplified Oral Hygiene Index, and salivary hypofunction. Results The prevalence of dental disease among 58 young adult IDUs was strikingly high compared to the U.S. general population, however, there was no difference in the level of dental disease between the methamphetamine and heroin users in this study. The mean DMFS and number of decayed surfaces exceeded 28 in both groups. Conclusions While no difference in dental disease between methamphetamine and heroin users was detected, we found a high prevalence of caries and caries-associated behaviors in this sample of young adult IDUs. Clinical Implications Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventative measures (e.g., distribution of chlorhexidine rinses, xylitol gum, application of fluoride varnishes) through outreach workers. PMID:22942146
Drug addicts seeking treatment after the Iranian Revolution: a clinic-based study.

PubMed

Dalvand, S; Agahi, C; Spencer, C

1984-09-01

A sample survey of 200 addicts attending the Rehabilitation Centre at Shiraz was conducted after the 1979 Iranian Revolution had disrupted both drug supply and addict treatment programmes. The study showed that clinics were, after the revolution, seeing a broader social range of addicts than before; and that action by the authorities was bringing many recently-addicted individuals to clinics. Heroin use predominated among those who were urban residents, whilst villagers were more likely to be opium users. The survey also sought the addicts' perceptions of the reasons for their initiation and addiction.
Bullying Victimization, Social Network Usage, and Delinquent Coping in a Sample of Urban Youth: Examining the Predictions of General Strain Theory.

PubMed

Baker, Thomas; Pelfrey, William V

2016-12-01

Guided by the propositions of general strain theory, this study examines the impact of experienced and anticipated strains on the delinquent coping of adolescents while accounting for the usage of social networking sites. Specifically, this study uses self-report survey data collected from 3,195 middle and high school students in a single Midwest city in the United States to explore the effect of experiencing the strains of traditional bullying victimization and cyberbullying victimization on adolescents self-reported soft drug use, hard drug use, and weapon carrying behavior. These relationships are explored among both frequent and infrequent users of social networking sites. Results indicate that cyberbullying victimization and the anticipated strain of feeling unsafe at or on the way to or from school are significantly and positively associated with all three mechanisms of delinquent coping among both frequent and infrequent social network users.
Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa

PubMed Central

Watt, Melissa H.; Wechsberg, Wendee M.; Meade, Christina S.

2017-01-01

Background South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence. Objectives This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa. Methods Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women. Results In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex. Conclusions/importance The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior. PMID:28379107
Prevalence of Sexual Violence and its Association with Depression among Male and Female Patients with Risky Drug Use in Urban Federally Qualified Health Centers.

PubMed

Bone, Curtis W; Goodfellow, Amelia M; Vahidi, Mani; Gelberg, Lillian

2018-02-01

Sexual violence (SV) is common; however, the prevalence of SV and its long term sequela vary geographically and among subpopulations within the USA. As such, the aims of this study are the following: (1) to determine the prevalence of SV, (2) to identify correlates of SV, and (3) to determine if SV is associated with depression among male and female risky drug users in urban Federally Qualified Health Centers (FQHCs) in Los Angeles. This study includes adult patients of five urban FQHCs who self-reported risky drug use. We identified survivors of SV and those experiencing depression through survey questions that queried, before or after age 18, "Were you ever sexually assaulted, molested or raped?" and with the RAND Mental Health Index (MHI-5). We utilized Pearson's chi-square tests to assess predictors of SV and logistic regression to assess for an association between SV and depression. Data collection took place from February 2011 to November 2012. Of the 334 study patients, 49% of females and 25% of males reported surviving SV. Exposure to SV, (both before 18 years of age and after 18 years of age) was the strongest predictor of depression among men and women in this study (OR 4.7, p < 0.05). These data demonstrate that sexual violence is prevalent in this urban FQHC population and is strongly associated with depression. Providers should consider screening both men and women with risky drug use for SV while health systems should continue to align mental health and primary care services to appropriately care for these extremely vulnerable patients. Trial Registration Clinical Trials. gov ID NCT01942876, Protocol ID DESPR DA022445, http://www.clinicaltrials.gov.
Teledermatology: quality assessment by user satisfaction and clinical efficiency.

PubMed

Klaz, Itay; Wohl, Yonit; Nathansohn, Nir; Yerushalmi, Nir; Sharvit, Sharon; Kochba, Ilan; Brenner, Sarah

2005-08-01

The Israel Defense Forces implemented a pilot teledermatology service in primary clinics. To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units. A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction. Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments. CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.
Illicit drug use is a significant risk factor for loss to follow up in patients with HIV-1 infection at a large urban HIV clinic in Tokyo.

PubMed

Nishijima, Takeshi; Gatanaga, Hiroyuki; Komatsu, Hirokazu; Takano, Misao; Ogane, Miwa; Ikeda, Kazuko; Oka, Shinichi

2013-01-01

Loss to follow up (LTFU) is an important prognostic factor in patients with HIV-1 infection. The impact of illicit drug use on LTFU of patients with HIV-1 infection is unknown in Japan. A single center observational study was conducted to elucidate the impact of illicit drug use on LTFU at a large HIV clinic in Tokyo. LTFU was defined as those who discontinued their visits to the clinic for at least 12 months and were not known to be under the care of other facilities or have died within 12 months of their last visit. Patients who first visited the clinic between January 2005 and August 2010 were enrolled. Information on illicit drug use was collected in a structured interview and medical charts. Comparison of the effects of illicit drug use and no use on LTFU was conducted by uni- and multi-variate Cox hazards models as the primary exposure. The study subjects were 1,208 patients, mostly Japanese men, of relatively young age, and infected through homosexual contact. A total of 111 patients (9.2%) were LTFU (incidence: 24.9 per 1,000 person-years). Among illicit drug users and non users, 55 (13.3%) and 56 (7.1%) patients, respectively, were LTFU, with incidence of 35.7 and 19.2 per 1,000 person-years, respectively. Uni- and multi-variate analyses showed that illicit drug use was a significant risk for LTFU (HR=1.860; 95% CI, 1.282-2.699; p=0.001) (adjusted HR=1.544; 95% CI, 1.028-2.318; p=0.036). Multivariate analysis also identified young age, high CD4 count, no antiretroviral therapy, and no health insurance as risk factors for LTFU. The incidence of LTFU among illicit drug users was almost twice higher than that among non users. Effective intervention for illicit drug use in this population is warranted to ensure proper treatment and prevent the spread of HIV.
Injection drug use and HIV/AIDS in China: Review of current situation, prevention and policy implications

PubMed Central

Qian, Han-Zhu; Schumacher, Joseph E; Chen, Huey T; Ruan, Yu-Hua

2006-01-01

Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem. PMID:16451717
Heterosexual Transmission of HIV in China

PubMed Central

YANG, HONGMEI; LI, XIAOMING; STANTON, BONITA; LIU, HONGJIE; LIU, HUI; WANG, NING; FANG, XIAOYI; LIN, DANHUA; CHEN, XINGUANG

2006-01-01

Objective: The objective of this study was to address the role of heterosexual transmission of HIV in China. Goal: The goal of this study was to explore the prevalence of unsafe sex and the likelihood of HIV spread heterosexually from core populations to others. Study: The authors conducted a review of behavioral studies. Results: Drug users were more likely to be involved in higher-risk sexual behaviors than were those who abstained from using drugs. Most female drug users (52-98%) reported having engaged in commercial sex. Most female sex workers (FSWs) and individuals with sexually transmitted diseases (STDs) had concurrent sexual partners. Many continued to have unprotected sex after noticing STD symptoms in themselves or their sexual partners. From 5% to 26% of rural-to-urban migrants had multiple sexual partners and 10% of males patronized FSWs during migration. Conclusions: Factors such as high rates of FSW patronage, low rates of condom use during commercial sex, having sex with both commercial and noncommercial sexual partners, and high rates of STD infection may promote a heterosexual epidemic in China. PMID:15849527
Cohort study of HIV-positive and -negative methamphetamine users.

PubMed

Spolsky, Vladimir W; Clague, Jason; Shetty, Vivek

2018-04-20

The effects of methamphetamine (MA) on caries have been well documented. Little, however, is known about its effects on the periodontium. The authors conducted this study to determine the prevalence and severity of periodontal disease in an urban population of HIV-positive MA users. This cross-sectional survey was conducted in one of the most populous urban areas of Los Angeles County, California, beset with high rates of MA use. Participants were recruited by a combination of street outreach methods, referral from drug treatment centers, and word of mouth. Participants were eligible if they were older than 18 years, spoke English or Spanish, used MA in the past 30 days, were willing to undergo a dental examination and psychosocial assessments, and were willing to provide a urine sample. Periodontal assessments were completed for 541 participants by 3 trained and calibrated dentists. The prevalence and severity of periodontal disease were high in this population of HIV-positive and -negative MA users. Cigarette smoking and age were identified as risk factors. The HIV-positive and -negative cohorts were remarkably similar, suggesting that their lifestyles contributed more to their destructive periodontal disease than their MA use. MA users are at high risk of developing destructive periodontal disease and badly broken-down teeth. Clinicians should plan accordingly for timely management of the patients' care, knowing that MA users have extensive periodontal and restorative treatment needs. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.
Factors associated with nicotine dependence during methadone maintenance treatment: findings from a multisite survey in Vietnam

PubMed Central

Do, Huyen Phuc; Nguyen, Long Hoang; Thi Nguyen, Nhung Phuong; Ngo, Chau; Thi Nguyen, Huong Lan; Le, Giang Tong; Nguyen, Linh Khanh; Nguyen, Cuong Tat; Tran, Bach Xuan; Le, Huong Thi; Vu, Thuc Minh Thi; Phan, Huong Thu Thi; Tran, Tho Dinh; Latkin, Carl A; Dunne, Michael P

2017-01-01

Objectives Smoking is associated with adverse health outcomes among drug users, including those in treatment. To date, however, there has been little evidence about smoking patterns among people receiving opioid-dependence treatment in developing countries. We examined self-reported nicotine dependence and associated factors in a large sample of opioid-dependent patients receiving methadone maintenance treatment (MMT) in northern Vietnam. Setting Five clinics in Hanoi (urban area) and Nam Dinh (rural area). Participants Patients receiving MMT in the settings during the study period. Primary and secondary outcome measures We collected data about smoking patterns, levels of nicotine dependence and other covariates such as socioeconomic status, health status, alcohol use and drug use. The Fagerström test was used to measure nicotine dependence (FTND). Logistic regression and Tobit regression were employed to examine relationships between the smoking rate, nicotine dependence and potentially associated variables. Results Among 1016 drug users undergoing MMT (98.7% male), 87.2% were current smokers. The mean FTND score was 4.5 (SD 2.4). Longer duration of MMT (OR 0.98, 95% CI 0.96 to 0.99) and being HIV-positive (OR 0.46, 95% CI 0.24 to 0.88) were associated with lower likelihood of smoking. Being employed, older age at first drug injection and having long duration of MMT were inversely related with FTND scores. Higher age and continuing drug and alcohol use were significantly associated with higher FTND scores. Conclusion Smoking prevalence is high among methadone maintenance drug users. Enhanced smoking cessation support should be integrated into MMT programmes in order to reduce risk factors for cigarette smoking and improve the health and well-being of people recovering from opiate dependence. PMID:28716791
Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

PubMed Central

Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

1997-01-01

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004
Cold Cook Methods: An Ethnographic Exploration on the Myths of Methamphetamine Production and Policy Implications

PubMed Central

Boeri, Miriam W.; Gibson, David; Harbry, Liam

2011-01-01

Background Urban legends and myths are prevalent in drug-use environments. However, the distinction between myth and fact is not always clear. We found contradictory claims regarding the emergence of cold cook methods for producing methamphetamine when contrasting user-generated reports with official reports repudiating such methods as myths. Our aim is to open the topic for more academic discussion. Methods We examine cold cook methods of methamphetamine production revealed in our ethnographic study and interviews with former (n=50) and current (n=48) methamphetamine users. Data were collected in the suburbs of a large southeastern city in the United States. We compare the data with reports from law enforcement professionals and public health officials. Results Official reports claim the cold cook method described by users in our study is a myth and does not produce methamphetamine. Small-scale producers sell it as methamphetamine and users claim it has the same effect as methamphetamine. They are charged for possession and distribution of methamphetamine when caught with this drug. It appears the unintended consequences of recent policy aimed to reduce production and use of methamphetamine may be a user-friendly production method. We do not know the health implications at this time. Conclusion We do not make any definitive conclusions on the legitimacy of the stories or myths discussed here but instead suggest that labeling drug stories as myths might lead to dismissing facts that hold partial truth. The subsequent dismissal of cold cook methods among policy and public health officials risks a range of unintended consequences among vulnerable populations. We present our case for more research attention on the myths of methamphetamine production. PMID:19195870
Cold cook methods: an ethnographic exploration on the myths of methamphetamine production and policy implications.

PubMed

Boeri, Miriam W; Gibson, David; Harbry, Liam

2009-09-01

Urban legends and myths are prevalent in drug-use environments. However, the distinction between myth and fact is not always clear. We found contradictory claims regarding the emergence of cold cook methods for producing methamphetamine when contrasting user-generated reports with official reports repudiating such methods as myths. Our aim is to open the topic for more academic discussion. We examine cold cook methods of methamphetamine production revealed in our ethnographic study and interviews with former (n=50) and current (n=48) methamphetamine users. Data were collected in the suburbs of a large southeastern city in the United States. We compare the data with reports from law enforcement professionals and public health officials. Official reports claim the cold cook method described by users in our study is a myth and does not produce methamphetamine. Small-scale producers sell it as methamphetamine and users claim it has the same effect as methamphetamine. They are charged for possession and distribution of methamphetamine when caught with this drug. It appears the unintended consequences of recent policy aimed to reduce production and use of methamphetamine may be a user-friendly production method. We do not know the health implications at this time. We do not make any definitive conclusions on the legitimacy of the stories or myths discussed here but instead suggest that labelling drug stories as myths might lead to dismissing facts that hold partial truth. The subsequent dismissal of cold cook methods among policy and public health officials risks a range of unintended consequences among vulnerable populations. We present our case for more research attention on the myths of methamphetamine production.
A comparison of the use of smokeless tobacco in rural and urban teenagers.

PubMed

Poulson, T C; Lindenmuth, J E; Greer, R O

1984-01-01

This paper compared the use of smokeless tobacco and its effects in rural and urban teenagers. A random sample of 445 subjects from rural Colorado were examined: 82.9 percent of the total sample were Caucasian, and 94.6 percent of those who used smokeless tobacco were Caucasian. This percentage supports the findings of an earlier urban study that the habit is predominantly one of male Caucasians. The average age of the users was 16.7 years, slightly older than in the urban study. Of the rural users, 62.5 percent had lesions of the oral tissues, compared with 48.7 percent lesional incidence in urban users. In both studies, those subjects with lesions had longer daily contact with smokeless tobacco, as well as a longer history of use than those without lesions. These are numerical averages that reflect great individual variations in susceptibility. The average duration of use for rural and urban users with lesions was almost the same; the development of lesions appears to be related to the length of daily exposure, which, on the average, was greater among rural users than urban users. Additionally, more than twice as many degree 3 lesions were found among users in the rural study. The habituating effects of nicotine and the influence of this substance on the future tobacco-usage patterns of youngsters who presently use smokeless tobacco are areas of concern. It is hoped that additional research will further delineate the scope of this current health problem.
Heroin Mismatch in the Motor City: Addiction, Segregation and the Geography of Opportunity

PubMed Central

Draus, Paul; Roddy, Juliette; Greenwald, Mark

2012-01-01

In this paper, we employ data drawn from economic and ethnographic interviews with Detroit heroin users, as well as other sources, to illustrate the relationship between heroin users’ mobility patterns and urban and suburban environments, especially in terms of drug acquisition and the geography of opportunity. We explore how the “spatial mismatch” (Kain 1968; 1992) between legal work opportunities and central city residents is seemingly reversed in the case of heroin users. We find that while both geographic location and social networks associated with segregation provide central city residents and African Americans with a strategic advantage over white suburbanites in locating and purchasing heroin easily and efficiently, this same segregation effectively focuses the negative externalities of heroin markets in central city neighborhoods. Finally, we consider how the heroin trade reflects and reproduces the segregated post-industrial landscape, and we discuss directions for potential future research on the relationship between ethnic and economic ghettos and regional drug markets. PMID:22679895
Outcomes from a large 10 year hepatitis C treatment programme in people who inject drugs: No effect of recent or former injecting drug use on treatment adherence or therapeutic response.

PubMed

Elsherif, Omar; Bannan, Ciaran; Keating, Shay; McKiernan, Susan; Bergin, Colm; Norris, Suzanne

2017-01-01

People who inject drugs (PWID) are historically viewed as having "difficult to treat" hepatitis C disease, with perceived inferior treatment adherence and outcomes, and concerns regarding reinfection risk. We evaluated for differences in treatment adherence and response to Peginterferon-alfa-2a/Ribavirin (Peg-IFNα/RBV) in a large urban cohort with and without a history of remote or recent injection drug use. Patient data was retrospectively reviewed for 1000 consecutive patients-608 former (no injecting drug use for 6 months of therapy), 85 recent (injecting drug use within 6 months) PWID, and 307 non-drug users who were treated for chronic hepatitis C with Peg-IFNα/RBV. The groups were compared for baseline characteristics, treatment adherence, and outcome. There was no significant difference in treatment non-adherence between the groups (8.4% in PWID vs 6.8% in non-PWIDs; RR = 1.23, CI 0.76-1.99). The overall SVR rate in PWID (64.2%) was not different from non-PWIDs (60.9%) [RR = 1.05, 95% CI 0.95-1.17]. There was no significant difference in SVR rates between the groups controlling for genotype (48.4% vs 48.4% for genotype 1; 74.9 vs 73.3% for genotype 3). Former and recent PWID had similar adherence rates. PWID have comparable treatment adherence and SVR rates when compared to non-drug users treated with Peg-IFNα/RBV. These data support a public health strategy of HCV treatment and eradication in PWID in the DAA era.

Exploring Association between Morphology of Tree Planting and User Activities in Urban Public Space; An opportunity of Urban Public Space Revitalisation

NASA Astrophysics Data System (ADS)

Shen, Qi; Liu, Yan

2018-03-01

This paper discusses the association between the morphology of tree planting in urban riverside brown field and user activities. With the growth of popularity, the revitalisation of urban public space is also promising. This research used drone photography and mapping to systematically surveys sample sites. An original observation study of user activities proceed in four sample public spaces in Sheffield. The study results found there are huge popularity and duration difference of user activities between various tree planting morphologies and typologies. The public space with lawn and rounded by mature trees attracted most users with the most activity types; the neat and silent public space is the favourite choice of lunch and reading, meanwhile it got the longest activity duration; but the space with sparse morphology and small trees are more likely be forgotten and abandoned. This finding offered a great opportunity for urban public space revitalisation in post-industrial cities.
Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China.

PubMed

Su, Shu; Mao, Limin; Zhao, Jinxian; Chen, Liang; Jing, Jun; Cheng, Feng; Zhang, Lei

2018-04-26

The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8-3.4]; 2.3, [1.6-3.1]) and syphilis infection (AOR = 4.1, [2.1-6.9]; 3.9, [1.8-5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.
Patterns, determinants and barriers of health and social service utilization among young urban crack users in Brazil

PubMed Central

2013-01-01

Background Crack use is prevalent across the Americas, and specifically among marginalized urban street drug users in Brazil. Crack users commonly feature multiple physical and mental health problems, while low rates of and distinct barriers to help service use have been observed in these populations. This study examined profiles and determinants of social and health service utilization, and unmet service needs, in a two-city sample of young (18–24 years), marginalized crack users in Brazil. Methods N = 160 study participants were recruited by community-based methods from impoverished neighborhoods in the cities of Rio de Janeiro (n = 81) and Salvador (n = 79). A mixed methods protocol was used. Participants’ drug use, health, and social and health service utilization characteristics were assessed by an anonymous interviewer-administered questionnaire completed in a community setting; descriptive statistics on variables of interest were computed. Service needs and barriers were further assessed by way of several focus groups with the study population; narrative data were qualitatively analyzed. The study protocol was approved by institutional ethics review boards; data were collected between November 2010 and June 2011. Results The majority of the sample was male, without stable housing, and used other drugs (e.g., alcohol, marijuana). About half the sample reported physical and mental health problems, yet most had not received medical attention for these problems. Only small minorities had utilized locally available social or health services; utilization appeared to be influenced by sex, race and housing characteristics in both sites. Participants cited limited service resources, lack of needs-specific professional skills, bureaucratic barriers and stigma as obstacles to better service access. However, most respondents stated strong interest and need for general social, health and treatment services designed for the study population, for which various key features were emphasized as important. Conclusions The study contributes substantive evidence to current discussions about the development and utilization of health and treatment interventions for crack use in Brazil. Based on our data, crack users’ social, service needs are largely unmet; these gaps appear to partly root in systemic barriers of access to existing services, while improved targeted service offers for the target population seem to be needed also. PMID:24373346
Profile of inhalant users seeking treatment at a de-addiction centre in north India.

PubMed

Gupta, Sunil; Nebhinani, Naresh; Basu, Debasish; Mattoo, Surendra Kumar

2014-05-01

Inhalants are substances whose chemical vapors are inhaled to produce euphoric, disinhibiting, and exciting effects. Data on inhalant abuse in India are relatively scarce. We report the demographic and clinical profile of inhalant users among the treatment seekers at a Drug De-addiction and Treatment Centre in north India. The records of treatment seekers at the Drug De-addiction and Treatment Centre, over 10 years (2002-2011) were scanned to identify 92 cases reporting inhalant use. Of these 92 cases, the complete record files were available for 87 (94.6%) cases. These case files were reviewed and the relevant data were collected and analyzed. Over the study period of 10 years, the number of cases with inhalant abuse per year rose steadily to peak at 20 cases (4.08% of new cases) in 2006 and then stabilized at 1-3 per cent of new cases annually. Of the 87 cases studied, all were males with a mean age of 18.9±4.12 yr, mean education of 9.8±3.42 yr and mean family income of Rs. 7676±7343.15 (median: Rs. 5000). Majority of subjects were unmarried (89.7%), urban resident (79.3%), and from a nuclear family (78.2%). About half of the subjects were students (50.6%). The most common inhalant used was typewriter correction fluid (73.6%) followed by typewriter diluent fluid (19.5%) and glue (6.9%). The most common reason for initiation was curiosity. The mean age of onset of inhalant use was 16.3±4.22 yr. Most subjects fulfilled the criteria for inhalant dependence (85.1%). Psychiatric co-morbidity and the family history of substance dependence were present in 26.4 and 32.9 per cent subjects, respectively. Majority of the subjects reported drug related problems, occupation and finance being the worst affected. Interpretations & conclusions: Our results showed that the inhalant users were mostly urban youth belonging to middle socio-economic class families. The principal sources of inhalant abuse were the commonly available substances like typewriter correction fluids and majority of the subjects initiated it out of curiosity. Nearly three-fourth of the subjects used some other substance of abuse in addition, tobacco being the most common. In view of associated drug related problems, there is a need for strategies to prevent this emerging health care problem.
The relationship between social desirability bias and self-reports of health, substance use, and social network factors among urban substance users in Baltimore, Maryland.

PubMed

Latkin, Carl A; Edwards, Catie; Davey-Rothwell, Melissa A; Tobin, Karin E

2017-10-01

Social desirability response bias may lead to inaccurate self-reports and erroneous study conclusions. The present study examined the relationship between social desirability response bias and self-reports of mental health, substance use, and social network factors among a community sample of inner-city substance users. The study was conducted in a sample of 591 opiate and cocaine users in Baltimore, Maryland from 2009 to 2013. Modified items from the Marlowe-Crowne Social Desirability Scale were included in the survey, which was conducted face-to-face and using Audio Computer Self Administering Interview (ACASI) methods. There were highly statistically significant differences in levels of social desirability response bias by levels of depressive symptoms, drug use stigma, physical health status, recent opiate and cocaine use, Alcohol Use Disorders Identification Test (AUDIT) scores, and size of social networks. There were no associations between health service utilization measures and social desirability bias. In multiple logistic regression models, even after including the Center for Epidemiologic Studies Depression Scale (CES-D) as a measure of depressive symptomology, social desirability bias was associated with recent drug use and drug user stigma. Social desirability bias was not associated with enrollment in prior research studies. These findings suggest that social desirability bias is associated with key health measures and that the associations are not primarily due to depressive symptoms. Methods are needed to reduce social desirability bias. Such methods may include the wording and prefacing of questions, clearly defining the role of "study participant," and assessing and addressing motivations for socially desirable responses. Copyright © 2017 Elsevier Ltd. All rights reserved.
Sociodemographic factors influence use of proton pump inhibitors among users of nonsteroidal anti-inflammatory drugs.

PubMed

van Boxel, Ofke S; Hagenaars, Matthijs P; Smout, André J P M; Siersema, Peter D

2009-08-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs. Although adequate gastroprotection is indicated in individuals at high risk for upper gastrointestinal complications, underutilization of preventive strategies has been demonstrated. We investigated the utilization of proton pump inhibitors (PPIs) in high risk, short term users of NSAIDs and assessed the association between sociodemographic factors and the rates at which PPIs are prescribed. A retrospective study was conducted using data from 2.8 million individuals. Short term use was defined as an isolated period of NSAID use between 7 to 30 days. Logistic regression was performed to determine sociodemographic factors associated with PPI inhibitor use. A total of 155,825 short term users of NSAID were identified. Of these, 52,842 subjects (33.9%) had 1 or more risk factors; 56.1% of these subjects did not receive PPIs. Utilization was associated with sociodemographic factors of patients (such as older age [odds ratio (OR), 1.80; 95% confidence interval (CI), 1.64-1.99], female gender [OR, 1.14; 95% CI, 1.10-1.18], risk factors for upper gastrointestinal complications [OR, 3.72; 95% CI, 3.45-4.00]) and physicians (such as female gender [OR, 1.09; 95% CI, 1.03-1.14], practice in a deprived area [OR, 0.57; 95% CI, 0.53-0.61], or an urban area [OR, 0.86; 95% CI, 0.82-0.90]). Adequate gastroprotection is not provided to more than 50% of short term users of NSAIDs who are at an increased risk for upper gastrointestinal complications. Utilization is associated with sociodemographic factors of patients and physicians.
Factors associated with nicotine dependence during methadone maintenance treatment: findings from a multisite survey in Vietnam.

PubMed

Do, Huyen Phuc; Nguyen, Long Hoang; Thi Nguyen, Nhung Phuong; Ngo, Chau; Thi Nguyen, Huong Lan; Le, Giang Tong; Nguyen, Linh Khanh; Nguyen, Cuong Tat; Tran, Bach Xuan; Le, Huong Thi; Vu, Thuc Minh Thi; Phan, Huong Thu Thi; Tran, Tho Dinh; Latkin, Carl A; Dunne, Michael P

2017-07-17

Smoking is associated with adverse health outcomes among drug users, including those in treatment. To date, however, there has been little evidence about smoking patterns among people receiving opioid-dependence treatment in developing countries. We examined self-reported nicotine dependence and associated factors in a large sample of opioid-dependent patients receiving methadone maintenance treatment (MMT) in northern Vietnam. Five clinics in Hanoi (urban area) and Nam Dinh (rural area). Patients receiving MMT in the settings during the study period. We collected data about smoking patterns, levels of nicotine dependence and other covariates such as socioeconomic status, health status, alcohol use and drug use. The Fagerström test was used to measure nicotine dependence (FTND). Logistic regression and Tobit regression were employed to examine relationships between the smoking rate, nicotine dependence and potentially associated variables. Among 1016 drug users undergoing MMT (98.7% male), 87.2% were current smokers. The mean FTND score was 4.5 (SD 2.4). Longer duration of MMT (OR 0.98, 95% CI 0.96 to 0.99) and being HIV-positive (OR 0.46, 95% CI 0.24 to 0.88) were associated with lower likelihood of smoking. Being employed, older age at first drug injection and having long duration of MMT were inversely related with FTND scores. Higher age and continuing drug and alcohol use were significantly associated with higher FTND scores. Smoking prevalence is high among methadone maintenance drug users. Enhanced smoking cessation support should be integrated into MMT programmes in order to reduce risk factors for cigarette smoking and improve the health and well-being of people recovering from opiate dependence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Association between traditional systemic antipsoriatic drugs and tuberculosis risk in patients with psoriasis with or without psoriatic arthritis: results of a nationwide cohort study from Taiwan.

PubMed

Chen, Yi-Ju; Wu, Chun-Ying; Shen, Jui-Lung; Chen, Tzu-Ting; Chang, Yun-Ting

2013-07-01

Although the link between tuberculosis (TB) and biologics use is well established, the risk of TB among patients with psoriasis exposed to traditional systemic therapies remains elusive. The aim is to investigate the association between traditional systemic therapies and TB among patients with psoriasis. We conducted a retrospective cohort study on the risk of active TB among patients with psoriasis and psoriatic arthritis, using the National Health Insurance Research Database of Taiwan, 1996 through 2008. Standardized incidence ratios of TB were analyzed in comparison with age- and gender-matched general population. Logistic regression was used in a nested case-control analysis to estimate the odds ratios of TB related to exposure to traditional systemic agents during the year before TB development. Among the 81,266 patients in the psoriasis cohort, 497 new active TB cases were identified. The incidence rate of TB was 102 cases per 100,000 person-years among patients with psoriasis (standardized incidence ratio 1.22, 95% confidence interval 1.18-1.33). The risk of TB was higher in patients with severe disease (standardized incidence ratio 1.52, 95% confidence interval 1.46-1.74). To facilitate comparisons with the 497 active TB cases, a total of 1988 matched control subjects were selected for a nested case-control study. Patients taking systemic corticosteroids and nonsteroidal anti-inflammatory drugs were associated with higher incidence of TB, especially frequent users, after adjustment for multiple TB risk factors, drug exposures, hospital visits, and level of urbanization. Stratified analyses of current users and new users of these drugs revealed similar results. Finally, traditional systemic antipsoriatic treatment was not associated with TB on any of the analyses. The National Health Insurance Research Database did not contain information regarding severity of psoriasis, smoking status, alcohol use, diet, laboratory parameters, chest radiograph, or history of recent contact with an individual with TB. Misclassification of disease cannot be ruled out in a registry-based database. The accessibility of health care may be associated with the level of urbanization, which could confound the effect of drugs in multivariate analyses. Severe psoriasis may be associated with an elevated TB risk. Traditional systemic therapies do not seem to be strongly associated with TB occurrence. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
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...
Alterations in taste perception due to recreational drug use are due to smoking a substance rather than ingesting it.

PubMed

Dovey, Terence M; Boyland, Emma J; Trayner, Penelope; Miller, Jo; Rarmoul-Bouhadjar, Amin; Cole, Jon; Halford, Jason C G

2016-12-01

Two studies explored the differences in tastant (salt, sour, bitter, sweet and spicy) concentration preference between recreational drug users and abstainers. In study 1, 250 opportunistically recruited abstainers, cannabis only users and multiple-drug users completed psychometric questionnaires and a concentration preference tastant test. In study 2, 76 participants purposefully recruited abstainers, daily tobacco users, recreational cannabis users and daily cannabis users completed the same protocol as study 1. Study 1 demonstrated that both multiple drug users and cannabis users had a higher preference for salt and sour tastants than abstainers. Study 2 showed that daily cannabis and tobacco users had a higher preference for sweet and spicy tastants than recreational cannabis users and abstainers. As predicted, recreational drug users scored higher on both sensation-seeking and impulsivity compared to abstainers. Participants who habitually smoke tobacco or cannabis daily have different concentration preference for specific tastants. The aim of the current study was to provide an explanation for the inconsistency in published results on taste preferences in recreational drug users. The data offered in this paper indicate that variation in recruitment strategy, definition of 'drug users', and mode of drug delivery, as well as multiple drug use, may explain the preference for stronger tastants in habitual drug users. Future research exploring the psychobiological underpinnings of the impact of drug use on food preferences should carefully define recreational drug user groups. Copyright © 2016 Elsevier Ltd. All rights reserved.
American Indians with substance use disorders: treatment needs and comorbid conditions.

PubMed

Rieckmann, Traci; McCarty, Dennis; Kovas, Anne; Spicer, Paul; Bray, Joe; Gilbert, Steve; Mercer, Jacqueline

2012-09-01

American Indians and Alaska Natives (AI/ANs) experience significant disparities in health status and access to care. Furthermore, only limited data are available on substance use, mental health disorders, and treatment needs for this population. Addressing such disparities and developing culturally relevant, effective interventions for AI/AN communities require participatory research. The Western States Node of the National Institute on Drug Abuse Clinical Trials Network partnered with two American Indian substance abuse treatment programs: an urban health center and a reservation-based program to assess client characteristics, drug use patterns, and treatment needs. Data collected by staff members at the respective programs from urban (n = 74) and reservation (n = 121) clients were compared. Additional sub-analysis examined patients reporting regular opioid use and mood disorders. Findings indicate that urban clients were more likely to report employment problems, polysubstance use, and a history of abuse. Reservation-based clients reported having more severe medical problems and a greater prevalence of psychiatric problems. Clients who were regular opioid users were more likely to report having a chronic medical condition, suicidal thoughts, suicide attempts, polysubstance abuse, and IV drug use. Clients who reported a history of depression had twice as many lifetime hospitalizations and more than five times as many days with medical problems. Findings from this project provide information about the patterns of substance abuse and the importance of comprehensive assessments of trauma and comorbid conditions. Results point to the need for integrative coordinated care and auxiliary services for AI/AN clients seeking treatment for substance use disorders.
24 CFR 1000.46 - Do drug-free workplace requirements apply?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Do drug-free workplace requirements apply? 1000.46 Section 1000.46 Housing and Urban Development Regulations Relating to Housing and Urban... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES General § 1000.46 Do drug-free workplace...
Cognitive function and mood in MDMA/THC users, THC users and non-drug using controls.

PubMed

Lamers, C T J; Bechara, A; Rizzo, M; Ramaekers, J G

2006-03-01

Repeated ecstasy (MDMA) use is reported to impair cognition and cause increased feelings of depression and anxiety. Yet, many relevant studies have failed to control for use of drugs other than MDMA, especially marijuana (THC). To address these confounding effects we compared behavioural performance of 11 MDMA/THC users, 15 THC users and 15 non-drug users matched for age and intellect. We tested the hypothesis that reported feelings of depression and anxiety and cognitive impairment (memory, executive function and decision making) are more severe in MDMA/THC users than in THC users. MDMA/THC users reported more intense feelings of depression and anxiety than THC users and non-drug users. Memory function was impaired in both groups of drug users. MDMA/THC users showed slower psychomotor speed and less mental flexibility than non-drug users. THC users exhibited less mental flexibility and performed worse on the decision making task compared to non-drug users but these functions were similar to those in MDMA/THC users. It was concluded that MDMA use is associated with increased feelings of depression and anxiety compared to THC users and non-drug users. THC users were impaired in some cognitive abilities to the same degree as MDMA/THC users, suggesting that some cognitive impairment attributed to MDMA is more likely due to concurrent THC use.
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...
Establishing the Melbourne injecting drug user cohort study (MIX): rationale, methods, and baseline and twelve-month follow-up results

PubMed Central

2013-01-01

Background Cohort studies provide an excellent opportunity to monitor changes in behaviour and disease transmission over time. In Australia, cohort studies of people who inject drugs (PWID) have generally focused on older, in-treatment injectors, with only limited outcome measure data collected. In this study we specifically sought to recruit a sample of younger, largely out-of-treatment PWID, in order to study the trajectories of their drug use over time. Methods Respondent driven sampling, traditional snowball sampling and street outreach methods were used to recruit heroin and amphetamine injectors from one outer-urban and two inner-urban regions of Melbourne, Australia. Information was collected on participants’ demographic and social characteristics, drug use characteristics, drug market access patterns, health and social functioning, and health service utilisation. Participants are followed-up on an annual basis. Results 688 PWID were recruited into the study. At baseline, the median age of participants was 27.6 years (IQR: 24.4 years – 29.6 years) and two-thirds (67%) were male. Participants reported injecting for a median of 10.2 years (range: 1.5 months – 21.2 years), with 11% having injected for three years or less. Limited education, unemployment and previous incarceration were common. The majority of participants (82%) reported recent heroin injection, and one third reported being enrolled in Opioid Substitution Therapy (OST) at recruitment. At 12 months follow-up 458 participants (71% of eligible participants) were retained in the study. There were few differences in demographic and drug-use characteristics of those lost to follow-up compared with those retained in the study, with attrition significantly associated with recruitment at an inner-urban location, male gender, and providing incomplete contact information at baseline. Conclusions Our efforts to recruit a sample of largely out-of-treatment PWID were limited by drug market characteristics at the time, where fluctuating heroin availability has led to large numbers of PWID accessing low-threshold OST. Nevertheless, this study of Australian injectors will provide valuable data on the natural history of drug use, along with risk and protective factors for adverse health outcomes associated with injecting drug use. Comprehensive follow-up procedures have led to good participant retention and limited attrition bias. PMID:23786848
Characteristics and drug utilization patterns for heavy users of prescription drugs among the elderly: a Danish register-based drug utilization study.

PubMed

Øymoen, Anita; Pottegård, Anton; Almarsdóttir, Anna Birna

2015-06-01

The objectives of this study were to (1) identify and characterize heavy users of prescription drugs among persons aged 60 years and above; (2) investigate the association of demographic, socioeconomic, and health-related variables with being a heavy drug user; and (3) study the most frequently used drugs among heavy drug users and development in use over time. This is a descriptive study. Heavy drug users were defined as the accumulated top 1 percentile who accounted for the largest share of prescription drug use measured in number of dispensed defined daily doses (DDDs). The nationwide Danish registers were used to obtain data. Multivariable logistic binary regression was used to determine which factors were associated with being a heavy drug user. Heavy drug users among persons aged 60 years and above accounted for 6.8, 6.0, and 5.5% of prescription drug use in 2002, 2007, and 2012, respectively. Male gender, those aged 60-69 years, being divorced, shorter education, low annual income, and recent hospitalization were all significantly associated with being in the top 1 percentile group of drug users (p < 0.05). The ten most frequently used drug classes among heavy drug users accounted for 75.4% of their use in 2012, and five of these were cardiovascular drugs. The development over time for the ten most used drug classes followed the same pattern among heavy drug users and in the general population. There is a skewed utilization of prescription drugs. Contrary to earlier findings, being male was associated with heavy prescription drug use both with respect to number of drugs used and drug expenditure.
Nonmedical use of sedatives in urban Bengaluru.

PubMed

Nattala, Prasanthi; Murthy, Pratima; Thennarasu, K; Cottler, Linda B

2014-07-01

Nonmedical sedative use is emerging as a serious problem in India. However, there is paucity of literature on the patterns of use in the population. The aim of the present analysis was to explore sedative use patterns in an urban metropolis. Data for the present analysis come from the parent study on nonmedical prescription drug use in Bengaluru, India. Participants (n = 717) were recruited using a mall-intercept approach, wherein they were intercepted in five randomly selected shopping malls, and administered an interview on their use of prescription drugs. Past 12-month nonmedical sedative use was reported by 12%, benzodiazepines being the commonest. Reasons cited for nonmedical use included "sleeplessness, pain relief, stress." A majority (73%) reported sedative use "in ways other than as prescribed," compared to "use without prescription" (27%). All prescriptions were issued by general physicians in private hospitals. About 11% among those who used "in ways other than as prescribed," and 100% of nonprescribed users, reported irregular use (skipping doses/stopping/restarting). Among those who used "in ways other than prescribed," pharmacy stores were the source of obtaining the sedatives. Among "nonprescribed users," family/friends were the main source. Three-percent reported using sedatives and alcohol together in the same use episode. In multivariate logistic regression analyses, nonmedical sedative use was significantly associated with graduation-level education or above (adjusted odds ratio [aOR]: 2.53, 95% confidence interval [CI]: 1.30-4.91), and married status (aOR: 2.32, 95% CI: 1.04-5.18). Findings underscore the need for considering various contextual factors in tailoring preventive interventions for reducing nonmedical sedative use.
Motivations for Prescription Drug Misuse among Young Adults: Considering Social and Developmental Contexts.

PubMed

LeClair, Amy; Kelly, Brian C; Pawson, Mark; Wells, Brooke E; Parsons, Jeffrey T

As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants' motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. We identified experimentation and a "work hard, play hard" ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants' social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of "recreation" and "self-medication" presently established in the research, policies targeting young adults may want to tailor intervention efforts based on motivations.
Violent and Non-Violent Criminal Behavior among Young Chinese Drug Users: A Mixed Methods Study.

PubMed

Liu, Liu; Chui, Wing Hong; Chen, Ye

2018-03-02

Young drug users are found to be increasingly involved in criminal justice issues. This exploratory and descriptive study aims to analyze the criminal behaviors among young Chinese drug users through a mixed methods research design. Quantitative analysis indicates that young drug users with and without a history of criminality show significant differences in terms of several features. Male drug users, particularly, those who are older, with religious beliefs, and initiated into drug use at younger age were most likely to commit crimes. Among drug users with criminal experiences, those who committed crimes prior to drug initiation have a greater likelihood of committing violent crimes. Furthermore, young drug users with severe depression are more likely to commit crimes, especially violent ones. Qualitative analysis further illustrates that young male drug users often get involved in criminal conduct of the youth gang nature with propensity for engaging in violent crimes as compared to their female counterparts who are more likely to turn into drug dealers and traffickers, in addition to engaging in larceny. The research findings are consistent with developmental theories and "victim to offender cycle". Integrated mental health and substance use services are suggested for crime prevention among young Chinese drug users.
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

Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space.

PubMed

Knight, Kelly R; Lopez, Andrea M; Comfort, Megan; Shumway, Martha; Cohen, Jennifer; Riley, Elise D

2014-05-01

Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women. We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs. Women in the study lived in a range of SRO built environments, from publicly funded, newly built SROs to privately owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.'s framework of socio-structural vulnerability, we explore how SROs can operate as "mental health risk environments" in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women's mental health. The degree to which SRO built environments were "trauma-sensitive" at the macro level significantly influenced women's mental health at meso- and micro-levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro-level to manage their mental health symptoms. Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women. Copyright © 2013 Elsevier B.V. All rights reserved.
Single Room Occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space

PubMed Central

Knight, Knight R.; Lopez, Andrea M.; Comfort, Megan; Shumway, Martha; Cohen, Jennifer; Riley, Elise

2014-01-01

Due to the significantly high levels of comorbid substance use and mental health diagnosis among urban poor populations, examining the intersection of drug policy and place requires a consideration of the role of housing in drug user mental health. In San Francisco, geographic boundedness and progressive health and housing polices have coalesced to make single room occupancy hotels (SROs) a key urban built environment used to house poor populations with co-occurring drug use and mental health issues. Unstably housed women who use illicit drugs have high rates of lifetime and current trauma, which manifests in disproportionately high rates of post-traumatic stress disorder (PTSD), anxiety, and depression when compared to stably housed women. We report data from a qualitative interview study (n=30) and four years of ethnography conducted with housing policy makers and unstably housed women who use drugs and live in SROs. Women in the study lived in a range of SRO built environments, from publicly-funded, newly built SROs to privately-owned, dilapidated buildings, which presented a rich opportunity for ethnographic comparison. Applying Rhodes et al.’s framework of socio-structural vulnerability, we explore how SROs can operate as “mental health risk environments” in which macro-structural factors (housing policies shaping the built environment) interact with meso-level factors (social relations within SROs) and micro-level, behavioral coping strategies to impact women’s mental health. The degree to which SRO built environments were “trauma-sensitive” at the macro level significantly influenced women’s mental health at meso- and micro- levels. Women who were living in SROs which exacerbated fear and anxiety attempted, with limited success, to deploy strategies on the meso- and micro- level to manage their mental health symptoms. Study findings underscore the importance of housing polices which consider substance use in the context of current and cumulative trauma experiences in order to improve quality of life and mental health for unstably housed women. PMID:24411945
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.
Similarity and Difference in Drug Addiction Process Between Heroin- and Methamphetamine-Dependent Users.

PubMed

Wang, Ziyun; Li, Wei-Xiu; Zhi-Min, Liu

2017-03-21

This study aimed to compare the drug addiction process between Chinese heroin- and methamphetamine (MA)-dependent users via a modified 4-stage addiction model (experimentation, occasional use, regular use, and compulsive use). A descriptive study was conducted among 683 eligible participants. In the statistical analysis, we selected 340 heroin- and 295 MA-dependent users without illicit drug use prior to onset of heroin or MA use. The addiction process of heroin-dependent users was shorter than that of MA-dependent users, with shorter transitions from the onset of drug-use to the first drug craving (19.5 vs. 50.0 days), regular use (30.0 vs. 60.0 days), and compulsive use (50.0 vs. 85.0 days). However, no significant differences in the addiction process were observed in frequency of drug administration, except that heroin users reported more administrations of the drug (20.0 vs. 15.0) before progressing to the stage of compulsive drug use. A larger proportion of regular heroin users progressed to use illicit drugs recklessly than did MA users. Most heroin and MA users reported psychological dependence as their primary motivation for compulsive drug use, but more heroin users selected uncomfortable symptoms upon ceasing drug use as further reason to continue. Our results suggest that typical heroin and MA users may experience a similar four-stage addiction process, but MA users might undergo a longer addiction process (in days). More research is necessary to further explore factors influencing the drug addiction process.
Young people who use drugs engaged in harm reduction programs in New York City: Overdose and other risks.

PubMed

Calvo, Michele; MacFarlane, Jessica; Zaccaro, Heather; Curtis, Matthew; Cabán, María; Favaro, Jamie; Passannante, Marian R; Frost, Taeko

2017-09-01

Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey. We investigated differences in socio-demographics, service utilization, and risk behaviors between young (aged 18-30) and older participants and examined factors associated with overdose among young participants. The study included 257 young participants. They were significantly more likely than older participants to be white, educated, uninsured, unstably housed or homeless, and have a history of incarceration and residential drug treatment. They were more likely to report recent overdose but less likely to report knowledge of naloxone. Young participants also had higher rates of alcohol, marijuana, benzodiazepine, and injection drug use, and related risk behaviors such as public injection. Factors associated with past year overdose among young participants included experiencing symptoms of psychological distress (AOR=9.71), being unstably housed or homeless (AOR=4.39), and utilizing detox (AOR=4.20). Young PWUD who access services at HRPs in NYC differ significantly from their older counterparts. New York City and other urban centers that attract young PWUD should consider implementing harm reduction oriented services tailored to the unique needs of young people. Copyright © 2017. Published by Elsevier B.V.
Violent and Non-Violent Criminal Behavior among Young Chinese Drug Users: A Mixed Methods Study

PubMed Central

Liu, Liu; Chen, Ye

2018-01-01

Young drug users are found to be increasingly involved in criminal justice issues. This exploratory and descriptive study aims to analyze the criminal behaviors among young Chinese drug users through a mixed methods research design. Quantitative analysis indicates that young drug users with and without a history of criminality show significant differences in terms of several features. Male drug users, particularly, those who are older, with religious beliefs, and initiated into drug use at younger age were most likely to commit crimes. Among drug users with criminal experiences, those who committed crimes prior to drug initiation have a greater likelihood of committing violent crimes. Furthermore, young drug users with severe depression are more likely to commit crimes, especially violent ones. Qualitative analysis further illustrates that young male drug users often get involved in criminal conduct of the youth gang nature with propensity for engaging in violent crimes as compared to their female counterparts who are more likely to turn into drug dealers and traffickers, in addition to engaging in larceny. The research findings are consistent with developmental theories and “victim to offender cycle”. Integrated mental health and substance use services are suggested for crime prevention among young Chinese drug users. PMID:29498649
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.
Seroprevalence of Hepatitis B Infection and Associated Risk Factors among Drug Users in Drop-in Centers of Isfahan, Iran.

PubMed

Taleban, Roya; Moafi, Mohammad; Ataei, Behrooz; Yaran, Majid; Nokhodian, Zary; Kassaian, Nazila; Adibi, Peyman; Javadi, Abbasali

2018-01-01

Scientists perceive drug users (DUs) as a high-risk population for hepatitis B virus (HBV) infection. Effective strategies aiming at the reduction of HBV infection can be depicted when its epidemiological status is clearly defined. The present study provides new insight into associated risk factors of HBV infection and its seroepidemiological status among DUs attending drop-in centers (DICs). This was a cross-sectional study, which was implemented in 7 DICs of Isfahan province. The sample size included 539 participants. Demographic data and risk factors for HBV infection were obtained by a trained social worker using a self-made structured questionnaire. Venous blood sample was obtained and tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody, and total hepatitis B core antibody (HBcAb) using enzyme-linked immunosorbent assay. Mean age of the participants was 31.76 ± 8.4 years. They were generally male, Iranian, urban, with an education level of high school or less. The prevalence of HBV infection (HBsAg and/or HBcAb) was 18% (88.490). Regression analysis showed that age, bloodletting, and drug injection, being the sexual partner of injecting DU (IDU), as well as frequency and duration of imprisonment positively correlated with HBV infection. Drug injection bloodletting, and being the sexual partner of IDU, as well as frequency and duration of imprisonment could be considered as contributing factors in HBV infection.
Comparing the Trend of Physical Activity and Caloric Intake between Lipid-Lowering Drug Users and Nonusers among Adults with Dyslipidemia: Korean National Health and Nutrition Examination Surveys (2010-2013).

PubMed

Oh, Jin-Young; Chekal, Lan; Kim, Se-Won; Lee, Jee-Yon; Lee, Duk-Chul

2016-03-01

The purpose of this study was to compare the physical activity and caloric intake trends of lipid-lowering drug users with those of non-users among Korean adults with dyslipidemia. This study was a repeated cross-sectional study with a nationally representative sample of 2,635 Korean adults with dyslipidemia based on the 2010-2013 Korea National Health and Nutrition Examination Survey. Physical activity was assessed using the International Physical Activity Questionnaire, and caloric intake was estimated through 24-hour dietary recall. All statistical analyses were conducted using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The changes in physical activity and caloric intake were investigated for lipid-lowering drug users and non-users using generalized linear models. The proportion of lipid-lowering drug users in the 2010-2013 survey population increased from 3.5% to 5.0% (P<0.001). Among adults of dyslipidemia, total of 1,562 participants (56.6%) reported taking lipid-lowering drugs, and 1,073 (43.4%) reported not taking lipid-lowering drugs. Drug users were more likely to be older and less educated and to have a diagnosis of diabetes, higher body mass index, and lower low density lipoprotein cholesterol level. Physical activity trends were tested separately for the lipid-lowering drug users and non-users, and a significant decrease was found among the drug users during the study period. Physical activity among the drug users in 2013 was 38% lower (1,357.3±382.7 metabolic equivalent [MET]; P for trend=0.002) than in 2010 (2,201.4±442.6 MET). In contrast, there was no statistically significant difference between drug users and non-users in the trend of caloric intake during the same period. Physical activity significantly decreased among lipid-lowering drug users between 2010 and 2013, which was not observed among non-users. The importance of physical activity may need to be re-emphasized for lipid-lowering drug users.
Streets, drugs, and the economy of sex in the age of AIDS.

PubMed

Weeks, M R; Grier, M; Romero-Daza, N; Puglisi-Vasquez, M J; Singer, M

1998-01-01

Drug addicted women whose economic and social base is urban streets face limited options for income generation and multiple dangers of predation, assault, arrest, and illness. Exchanging sex for money or drugs offers one important source of income in this context. Yet the legal, social, and safety risks associated with these exchanges reduce the likelihood of regular safer sex practices during these encounters, thereby increasing the risk of HIV infection. Such conditions lead women engaged in sexual exchanges for money to varied and complex responses influenced by multiple and often contradictory pressures, both personal and contextual. Street-recruited women drug users in an AIDS prevention program in Hart-ford, Connecticut reported a range of condom use when engaging in sex for money exchanges. This paper explores their differences by ethnicity, economic resources, and drug use, and analyzes these and other factors that impact on street risks through sexual income generation. Surveys and in-depth interviews with drug-addicted women sex workers describe their various approaches to addressing multiple risks on the streets and suggest significant effort by women in these contexts to avoid the many risks, including HIV infection.
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
Are Physician Assistants Needed in Guatemala? A Survey of Potential Urban and Rural Users.

PubMed

Luna-Asturias, Claudia; Apple, Jennifer; Bolaños, Guillermo A; Bowser, Jonathan M; Asturias, Edwin J

2017-09-01

The shortage of trained health care personnel has been increasing worldwide. With the physician assistant (PA) profession, created in the United States in the 1960s, expanding globally, this study sought to ascertain whether PAs can be an innovative solution to this crisis. We conducted a convenience sample survey to assess the need for and acceptability of future PA professionals in Guatemala. Eighty-nine doctors, nurses, and community members from rural and urban areas of Guatemala participated in the survey. More urban (70%) than rural (58%) respondents found it difficult to access a doctor, with cost being the major reason (34%). Access in rural areas was reportedly limited by lack of doctors and inaccessible office hours. Most survey respondents considered PAs to be suitable and potentially helpful providers for Guatemala, with a preference for competencies in the diagnosis of serious illnesses, drug prescription, labor and delivery attendance, and care for injuries and fractures, especially in rural locations. Belonging to the community was deemed very important for a PA who would practice in the country.
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...
Values and beliefs of psychedelic drug users: a cross-cultural study.

PubMed

Lerner, Michael; Lyvers, Michael

2006-06-01

Psychedelic drugs such as LSD and psilocybin are often claimed to be capable of inducing life-changing experiences described as mystical or transcendental, especially if high doses are taken. The present study examined possible enduring effects of such experiences by comparing users of psychedelic drugs (n = 88), users of nonpsychedelic illegal drugs (e.g., marijuana, amphetamines) (n = 29) and non illicit drug-using social drinkers (n = 66) on questionnaire measures of values, beliefs and emotional empathy. Samples were obtained from Israel (n = 110) and Australia (n = 73) in a cross-cultural comparison to see if values associated with psychedelic drug use transcended culture of origin. Psychedelic users scored significantly higher on mystical beliefs (e.g., oneness with God and the universe) and life values of spirituality and concern for others than the other groups, and lower on the value of financial prosperity, irrespective of culture of origin. Users of nonpsychedelic illegal drugs scored significantly lower on a measure of coping ability than both psychedelic users and non illicit drug users. Both groups of illegal drug users scored significantly higher on empathy than non illicit drug users. Results are discussed in the context of earlier findings from Pahnke (1966) and Doblin (1991) of the transformative effect of psychedelic experiences, although the possibility remains that present findings reflect predrug characteristics of those who chose to take psychedelic drugs rather than effects of the drugs themselves.
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
[Laws and policies on illicit drugs in Brazil and the perspective of drug users' family members and acquaintances: a study in the City of Ribeirão Preto, São Paulo, Brazil].

PubMed

Ventura, Carla Aparecida Arena; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto; Ferreira, Paulo Sérgio

2009-01-01

Brazilian drugs legislation has evolved from a prohibitionist system to a less repressive one in terms of drug users. The objective of this study was to identify the perception of relatives and acquaintances of drug users living in Ribeirão Preto, São Paulo, Brazil, about the country's laws and policies on drugs. Data collection was performed using a structured questionnaire. The sample consisted of 100 drug users' relatives or acquaintances, selected at a public health service. Respondents' relationships with the drug user were as follows: 31% friend, 23% sibling, 15% child and 7% spouse. Most users (78%) were men, with an average age of 26 years. Results confirm that national laws and policies have a direct effect on individuals' attitude and behaviors. There is a lack of trust in the police and a general perception that, despite recent chances that favor user rehabilitation, the laws on drugs do not respect users' human rights.
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.
Dental disease prevalence among methamphetamine and heroin users in an urban setting: a pilot study.

PubMed

Brown, Carolyn; Krishnan, Sumathi; Hursh, Kevin; Yu, Michelle; Johnson, Paul; Page, Kimberly; Shiboski, Caroline H

2012-09-01

Researchers have reported rampant caries among methamphetamine users. The authors investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared with those in heroin users. This pilot project was a cross-sectional study of an ongoing cohort of young adult injection-drug users (IDUs) in San Francisco. Participants completed an oral health questionnaire administered by a research assistant, and dentists performed clinical examinations to record the participants' data in terms of scores on the decayed-missing-filled surfaces (DMFS) index, presence of residual roots, scores on an oral hygiene index and whether any salivary hypofunction was observed. The prevalence of dental disease among 58 young adult IDUs was strikingly high compared with that in the U.S. general population; however, the authors found no difference in the level of dental disease between users of methamphetamine and users of heroin. The mean DMFS score and number of decayed surfaces exceeded 28 in both groups. Although the authors detected no difference in dental disease between methamphetamine and heroin users, they found a high prevalence of caries and caries-associated behaviors in the sample of young adult IDUs. Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventive measures (such as distribution of chlorhexidine rinses or xylitol gum or application of fluoride varnishes) through outreach workers.
Lifetime influences for cannabis cessation in male incarcerated indigenous australians.

PubMed

Jacups, Susan; Rogerson, Bernadette

2015-01-01

Urban non-indigenous populations report life events (marriages, employment) as influences for self-initiated cannabis cessation. However, this hasn't been investigated in remote indigenous populations with different social paradigms. We investigate cannabis use, harms, and poly-substance misuse in 101 consenting male incarcerated indigenous Australians. Interviews applied quantitative and qualitative questions assessing demographic characteristics, criminal history, drug use, the Marijuana Problems Inventory (MPI), and cannabis-cessation influences. Comparisons used Chi Square, Analysis of Variance, and Nvivo software. Cannabis use groups (current users, ex-users, and never users) were demographically similar except that current users reported more juvenile legal problems, younger school departure, and lower school achievement (p < 0.05). Mean cannabis consumption was 12.3 cones/day. Incarceration and family responsibilities were the strongest cessation influences. Employment responsibilities and negative self-image were rarely cited as influences. High cannabis use, with its associated problems, is concerning. These identified influences indicate incarceration should be used for substance reduction programs, plus post-release follow-up. Community-based programs focusing on positive influences, such as family responsibilities and social cohesion, may be successful within indigenous populations with strong kinship responsibilities, rather than programs that focus solely on substance harms.

Thermal Adaptation Methods of Urban Plaza Users in Asia's Hot-Humid Regions: A Taiwan Case Study.

PubMed

Wu, Chen-Fa; Hsieh, Yen-Fen; Ou, Sheng-Jung

2015-10-27

Thermal adaptation studies provide researchers great insight to help understand how people respond to thermal discomfort. This research aims to assess outdoor urban plaza conditions in hot and humid regions of Asia by conducting an evaluation of thermal adaptation. We also propose that questionnaire items are appropriate for determining thermal adaptation strategies adopted by urban plaza users. A literature review was conducted and first hand data collected by field observations and interviews used to collect information on thermal adaptation strategies. Item analysis--Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA)--were applied to refine the questionnaire items and determine the reliability of the questionnaire evaluation procedure. The reliability and validity of items and constructing process were also analyzed. Then, researchers facilitated an evaluation procedure for assessing the thermal adaptation strategies of urban plaza users in hot and humid regions of Asia and formulated a questionnaire survey that was distributed in Taichung's Municipal Plaza in Taiwan. Results showed that most users responded with behavioral adaptation when experiencing thermal discomfort. However, if the thermal discomfort could not be alleviated, they then adopted psychological strategies. In conclusion, the evaluation procedure for assessing thermal adaptation strategies and the questionnaire developed in this study can be applied to future research on thermal adaptation strategies adopted by urban plaza users in hot and humid regions of Asia.
Thermal Adaptation Methods of Urban Plaza Users in Asia’s Hot-Humid Regions: A Taiwan Case Study

PubMed Central

Wu, Chen-Fa; Hsieh, Yen-Fen; Ou, Sheng-Jung

2015-01-01

Thermal adaptation studies provide researchers great insight to help understand how people respond to thermal discomfort. This research aims to assess outdoor urban plaza conditions in hot and humid regions of Asia by conducting an evaluation of thermal adaptation. We also propose that questionnaire items are appropriate for determining thermal adaptation strategies adopted by urban plaza users. A literature review was conducted and first hand data collected by field observations and interviews used to collect information on thermal adaptation strategies. Item analysis—Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA)—were applied to refine the questionnaire items and determine the reliability of the questionnaire evaluation procedure. The reliability and validity of items and constructing process were also analyzed. Then, researchers facilitated an evaluation procedure for assessing the thermal adaptation strategies of urban plaza users in hot and humid regions of Asia and formulated a questionnaire survey that was distributed in Taichung’s Municipal Plaza in Taiwan. Results showed that most users responded with behavioral adaptation when experiencing thermal discomfort. However, if the thermal discomfort could not be alleviated, they then adopted psychological strategies. In conclusion, the evaluation procedure for assessing thermal adaptation strategies and the questionnaire developed in this study can be applied to future research on thermal adaptation strategies adopted by urban plaza users in hot and humid regions of Asia. PMID:26516881
Other drug use does not impact cognitive impairments in chronic ketamine users.

PubMed

Zhang, Chenxi; Tang, Wai Kwong; Liang, Hua Jun; Ungvari, Gabor Sandor; Lin, Shih-Ku

2018-05-01

Ketamine abuse causes cognitive impairments, which negatively impact on users' abstinence, prognosis, and quality of life. of cognitive impairments in chronic ketamine users have been inconsistent across studies, possibly due to the small sample sizes and the confounding effects of concomitant use of other illicit drugs. This study investigated the cognitive impairment and its related factors in chronic ketamine users with a large sample size and explored the impact of another drug use on cognitive functions. Cognitive functions, including working, verbal and visual memory and executive functions were assessed in ketamine users: 286 non-heavy other drug users and 279 heavy other drug users, and 261 healthy controls. Correlations between cognitive impairment and patterns of ketamine use were analysed. Verbal and visual memory were impaired, but working memory and executive functions were intact for all ketamine users. No significant cognitive differences were found between the two ketamine groups. Greater number of days of ketamine use in the past month was associated with worse visual memory performance in non-heavy other drug users. Higher dose of ketamine use was associated with worse short-term verbal memory in heavy other drug users. Verbal and visual memory are impaired in chronic ketamine users. Other drug use appears to have no impact on ketamine users' cognitive performance. Copyright © 2018. Published by Elsevier B.V.
The phenomenon of low-frequency heroin injection among street-based urban poor: drug user strategies and contexts of use

PubMed Central

Wenger, Lynn D.; Lopez, Andrea M.; Comfort, Megan; Kral, Alex H.

2014-01-01

Background Dominant public health and medical discourse has relied on a pharmacocentric conception of heroin use—that is, the notion that heroin users inject compulsively to stave off physical and psychological withdrawal. Previous research disputes this claim suggesting that other patterns of heroin use, such as occasional, recreational, or controlled use are possible. In our previous cross-sectional epidemiological research, we identified the phenomenon of low frequency heroin injection (low-FHI), among street-based drug users. The goal of the current study was to qualitatively assess and contextualize this phenomenon over time among a sample of street-based low-FHI. Methods 29 low-FHI and 25 high frequency heroin injectors (high-FHI) were followed for two years, during which they participated in a series of in-depth interviews. Qualitative data were coded using an inductive analysis approach. As similarities and differences between participants were discovered, transcripts were queried for supportive quotations as well as negative cases. Results We found the social context among low-FHI and high-FHI to be similar with the exception of their patterns of heroin use. Thus, we focused this analysis on understanding motivations for and management of low-FHI. Two major categories of low-FHI emerged from the data: maintenance and transitioning low-FHI. Maintenance low-FHI sustained low-FHI over time. Some of these heroin users were circumstantial low-FHI, who maintained low-FHI as a result of their social networks or life events, and others maintained low-FHI purposefully. Transitioning low-FHI did not sustain low use throughout the study. We found that heroin use patterns frequently shift over time and these categories help identify factors impacting drug use within particular moments in an individual’s life. Conclusions Given the various patterns of heroin use that were identified in this study, when working with IDUs, one must assess the specifics of heroin use patterns including drug preferences, desire for substance abuse treatment, as well as basic physical and mental health care needs. PMID:24690452
HIV testing experience of drug users in Bali, Indonesia.

PubMed

Sagung Sawitri, A A; Sumantera, G M; Wirawan, D N; Ford, K; Lehman, E

2006-08-01

Recently, large increases have been noted in injection drug use and HIV prevalence among drug users in Indonesia. The objective of this study was to examine the experience of drug users with HIV testing in Bali, Indonesia. In-depth interviews were conducted with a sample of 40 drug users who had injected heroin in the Denpasar, Bali area. The users' experience with testing highlighted the importance of pre- and post-test counselling that provides clear information, confidentiality and assistance in developing social support.
Nonmedical use of sedatives in urban Bengaluru

PubMed Central

Nattala, Prasanthi; Murthy, Pratima; Thennarasu, K.; Cottler, Linda B.

2014-01-01

Background: Nonmedical sedative use is emerging as a serious problem in India. However, there is paucity of literature on the patterns of use in the population. Aim: The aim of the present analysis was to explore sedative use patterns in an urban metropolis. Materials and Methods: Data for the present analysis come from the parent study on nonmedical prescription drug use in Bengaluru, India. Participants (n = 717) were recruited using a mall-intercept approach, wherein they were intercepted in five randomly selected shopping malls, and administered an interview on their use of prescription drugs. Results: Past 12-month nonmedical sedative use was reported by 12%, benzodiazepines being the commonest. Reasons cited for nonmedical use included “sleeplessness, pain relief, stress.” A majority (73%) reported sedative use “in ways other than as prescribed,” compared to “use without prescription” (27%). All prescriptions were issued by general physicians in private hospitals. About 11% among those who used “in ways other than as prescribed,” and 100% of nonprescribed users, reported irregular use (skipping doses/stopping/restarting). Among those who used “in ways other than prescribed,” pharmacy stores were the source of obtaining the sedatives. Among “nonprescribed users,” family/friends were the main source. Three-percent reported using sedatives and alcohol together in the same use episode. In multivariate logistic regression analyses, nonmedical sedative use was significantly associated with graduation-level education or above (adjusted odds ratio [aOR]: 2.53, 95% confidence interval [CI]: 1.30-4.91), and married status (aOR: 2.32, 95% CI: 1.04-5.18). Conclusions: Findings underscore the need for considering various contextual factors in tailoring preventive interventions for reducing nonmedical sedative use. PMID:25316935
Echocardiogram Utilization among Rural and Urban Veterans

ERIC Educational Resources Information Center

Okrah, Kingston; Vaughan-Sarrazin, Mary; Kaboli, Peter; Cram, Peter

2012-01-01

Purpose: To compare echocardiography use among urban and rural veterans and whether differences could be accounted for by distance. Methods: We used Veterans Administration (VA) administrative data from 1999 to 2007 to identify regular users of the VA Healthcare System (VA users) who did and did not receive echocardiography. Each veteran was…
The intersection of urban form and mileage fees : findings from the Oregon road user fee pilot program

DOT National Transportation Integrated Search

2011-03-01

This report analyzes data from the 2006-2007 Oregon Road User Fee Pilot Program to assess if and how urban form variables correlate with travel behavior changes that participants made in response to the mileage fee program. The study tested the impac...
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...
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
Distress tolerance interacts with circumstances, motivation, and readiness to predict substance abuse treatment retention.

PubMed

Ali, Bina; Green, Kerry M; Daughters, Stacey B; Lejuez, C W

2017-10-01

Our understanding of the conditions that influence substance abuse treatment retention in urban African American substance users is limited. This study examined the interacting effect of circumstances, motivation, and readiness (CMR) with distress tolerance to predict substance abuse treatment retention in a sample of urban African American treatment-seeking substance users. Data were collected from 81 African American substance users entering residential substance abuse treatment facility in an urban setting. Participants completed self-reported measures on CMR and distress tolerance. In addition, participants were assessed on psychiatric comorbidities, substance use severity, number of previous treatments, and demographic characteristics. Data on substance abuse treatment retention were obtained using administrative records of the treatment center. Logistic regression analysis found that the interaction of CMR and distress tolerance was significant in predicting substance abuse treatment retention. Higher score on CMR was significantly associated with increased likelihood of treatment retention in substance users with higher distress tolerance, but not in substance users with lower distress tolerance. Findings of the study indicate that at higher level of distress tolerance, favorable external circumstances, higher internal motivation, and greater readiness to treatment are important indicators of substance abuse treatment retention. The study highlights the need for assessing CMR and distress tolerance levels among substance users entering treatment, and providing targeted interventions to increase substance abuse treatment retention and subsequent recovery from substance abuse among urban African American substance users. Copyright © 2017 Elsevier Ltd. All rights reserved.
Crack Cocaine Use and its Relationship with Violence and Hiv

PubMed Central

de Carvalho, Heraclito Barbosa; Seibel, Sergio Dario

2009-01-01

OBJECTIVES To evaluate crack cocaine use practices, risk behaviors associated with HIV infection among drug users, and their involvement with violence. INTRODUCTION HIV infections are frequent among drug users due to risky sexual behavior. It is generally accepted that crack cocaine use is related to increased levels of violence. Several reports point to an increase in violence from those involved in drug trafficking. Although HIV infections and risky sexual behavior among drug users have been quite well studied, there are few studies that evaluate violence as it relates to drugs, particularly crack. METHODS A total of 350 drug users attending drug abuse treatment clinics in São Paulo, Brazil were interviewed about their risky behaviors. Each patient had a serological HIV test done. RESULTS HIV prevalence was 6.6% (4.0 to 10.2). Violence was reported by 97% (94.7 to 99.1) of the subjects (including cases without personal involvement). Acts of violence such as verbal arguments, physical fights, threats, death threats, theft, and drug trafficking were significantly higher among crack users. A decrease in frequency of sexual intercourse was observed among users of injected drugs, though prostitution was observed as a means of obtaining drugs. A high number of crack cocaine users had a history of previous imprisonment, many for drug-related infractions. DISCUSSION The data presented are in accordance with other reports in the literature, and they show a correlation between drug use, imprisonment, violence, and drug trafficking. CONCLUSION A high HIV prevalence and associated risky sexual behaviors were observed among crack cocaine users. The society and the authorities that deal with violence related to crack users and drug trafficking should be aware of these problems. PMID:19759879
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.
Motivations for Prescription Drug Misuse among Young Adults: Considering Social and Developmental Contexts

PubMed Central

LeClair, Amy; Kelly, Brian C.; Pawson, Mark; Wells, Brooke E.; Parsons, Jeffrey T.

2015-01-01

Aims As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants’ motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. Methods Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. Findings We identified experimentation and a “work hard, play hard” ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants’ social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. Conclusion Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of “recreation” and “self-medication” presently established in the research, policies targeting young adults may want to tailor intervention efforts based on motivations. PMID:26709337
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.
Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men

PubMed Central

Hatfield, Laura A.; Horvath, Keith J.; Jacoby, Scott M.; Rosser, B. R. Simon

2012-01-01

Aims To measure substance use across racial and ethnic subgroups of HIV-positive men who have sex with men (MSM), model associations between drug use and unsafe sex, and characterize users of the substances most strongly associated with risky sexual behavior. Design Cross-sectional survey at the pre-intervention time point of the Positive Connections behavioral intervention trial. Setting HIV-positive men of color who have sex with men living in six US cities. Participants 675 trial participants. Measurements Self-reported drug and alcohol use and sexual behaviors. Findings We found high prevalence of substance use in this sample, with differences across racial and ethnic groups. Compared to Hispanic, African America, and men of other or mixed races/ethnicities, Caucasian men were most likely to report use of stimulants (30%), methamphetamines (27%), and amyl nitrite inhalants (“poppers”, 46%) with anal sex. African American men reported crack/cocaine use in the highest proportion (38%) among the four groups. While many drugs were individually associated with serodiscordant unprotected anal intercourse (SDUAI), only alcohol quantity and poppers with sex were retained in a multivariate model. More frequent poppers use was associated with more reported instances of SDUAI, adjusted for increased anal sex. Men who used poppers were more likely to be white, have completed more education, and have slightly higher income than non-users. Poppers users also reported lower peer norms and self-efficacy for condom use. In a multiple logistic regression model including these psychosocial factors, only poppers use (vs non-use OR = 2.46, CI: 1.55, 3.94) and condom self-efficacy (1 sd increase on scale OR = .58, CI: .46, .73) were significantly associated with SDUAI. Conclusion These results, from a large sample of HIV-positive MSM of color, highlight the HIV transmission importance of drugs used specifically in conjunction with sex. PMID:20155589
Substance use and homelessness among emergency department patients.

PubMed

Doran, Kelly M; Rahai, Neloufar; McCormack, Ryan P; Milian, Jacqueline; Shelley, Donna; Rotrosen, John; Gelberg, Lillian

2018-05-22

Homelessness and substance use often coexist, resulting in high morbidity. Emergency department (ED) patients have disproportionate rates of both homelessness and substance use, yet little research has examined the overlap of these issues in the ED setting. We aimed to characterize alcohol and drug use in a sample of homeless vs. non-homeless ED patients. A random sample of urban hospital ED patients were invited to complete an interview regarding housing, substance use, and other health and social factors. We compared substance use characteristics among patients who did vs. did not report current literal (streets/shelter) homelessness. Additional analyses were performed using a broader definition of homelessness in the past 12-months. Patients who were currently homeless (n = 316, 13.7%) versus non-homeless (n = 1,993, 86.3%) had higher rates of past year unhealthy alcohol use (44.4% vs. 30.5%, p < .0001), any drug use (40.8% vs. 18.8%, p < .0001), heroin use (16.7% vs. 3.8%, p < .0001), prescription opioid use (12.5% vs. 4.4%, p < .0001), and lifetime opioid overdose (15.8% vs. 3.7%, p < .0001). In multivariable analyses, current homelessness remained significantly associated with unhealthy alcohol use, AUDIT scores among unhealthy alcohol users, any drug use, heroin use, and opioid overdose; past 12-month homelessness was additionally associated with DAST-10 scores among drug users and prescription opioid use. Patients experiencing homelessness have higher rates and greater severity of alcohol and drug use than other ED patients across a range of measures. These findings have implications for planning services for patients with concurrent substance use and housing problems. Copyright © 2018 Elsevier B.V. All rights reserved.
Feasibility of mileage-based user fees : application in rural/small urban areas of northeast Texas, final report, October 31, 2008.

DOT National Transportation Integrated Search

2008-10-31

This study explores the application of mileage-based user fees, or vehicle-miles traveled (VMT) fees, as an : alternative to the fuel tax in rural and small urban areas. The purpose of the study is to identify the issues : associated with implementat...
Electrophysiological evidence of early attentional bias to drug-related pictures in chronic cannabis users.

PubMed

Asmaro, Deyar; Carolan, Patrick L; Liotti, Mario

2014-01-01

Behavioral and electrophysiological correlates of attentional bias to cannabis-related cues were investigated in a marijuana dependent group and a non-user group employing a drug Stroop task in which cannabis-related, negative and neutral images were presented. Behaviorally, cannabis users were less accurate during drug-containing blocks than non-users. Electrophysiologically, in chronic marijuana-users, an early positive ERP enhancement over left frontal scalp (EAP, 200-350ms) was present in response to drug-containing blocks relative to negative blocks. This effect was absent in the non-user group. Furthermore, drug-containing blocks gave rise to enhanced voltage of a posterior P300 (300-400ms), and a posterior sustained slow wave (LPP, 400-700ms) relative to negative blocks. However, such effects were similar between cannabis users and non-users. Brain source imaging in cannabis users revealed a generator for the EAP effect to drug stimuli in left ventromedial prefrontal cortex/medial orbitofrontal cortex, a region active in fMRI studies of drug cue-reactivity and a target of the core dopaminergic mesolimbic pathway involved in the processing of substances of abuse. This study identifies the timing and brain localization of an ERP correlate of early attentional capture to drug-related pictures in chronic marijuana users. The EAP to drug cues may identify a new electrophysiological marker with clinical implications for predicting abstinence versus relapse or to evaluate treatment interventions. © 2013.
[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.

Converging risk factors but no association between HIV infection and multidrug-resistant tuberculosis in Kazakhstan.

PubMed

van den Hof, S; Tursynbayeva, A; Abildaev, T; Adenov, M; Pak, S; Bekembayeva, G; Ismailov, S

2013-04-01

Kazakhstan is a country with a low HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) burden, but a high prevalence of multidrug-resistant tuberculosis (MDR-TB). We describe the epidemiology of multidrug resistance and HIV among TB patients, using the 2007-2011 national electronic TB register. HIV test results were available for 97.2% of TB patients. HIV prevalence among TB patients increased from 0.6% in 2007 to 1.5% in 2011. Overall, 41.6% of patients had a positive smear at diagnosis, 38.6% a positive culture and 51.7% either a positive smear or culture. Drug susceptibility testing (DST) results were available for 92.7% of culture-positive cases. Socio-economic factors independently associated with both HIV and MDR-TB were urban residency, drug use, homelessness and a history of incarceration. In adjusted analysis, HIV positivity was not associated with MDR-TB (OR 1.0, 95%CI 0.86-1.2). Overall, among TB patients with DST and HIV test results available, 65.0% were positive for neither HIV nor MDR-TB, 33.5% only for MDR-TB, 0.9% only for HIV and 0.6% for both HIV and MDR-TB. Among injection drug users, 12.5% were positive for HIV and MDR-TB. We showed increasing HIV prevalence among TB patients in Kazakhstan. HIV was not an independent risk factor for MDR-TB, but risk factors were largely overlapping and we did identify subgroups at particular risk of HIV-MDR-TB co-infection, notably drug users. Enhanced efforts are necessary to provide care to these socially vulnerable populations.
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.
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
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
Pathways to HIV risk and vulnerability among lesbian, gay, bisexual, and transgendered methamphetamine users: a multi-cohort gender-based analysis

PubMed Central

2011-01-01

Background Methamphetamine (MA) use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered) drug users. Methods Beginning in 2005 and ending in 2008, 2109 drug users were enroled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sexual minority participants (n = 248). Logistic regression using generalized estimating equations (GEE) was used to examine the independent correlates of MA use over time. All analyses were stratified by biological sex at birth. Results At baseline, 104 (7.5%) males and 144 (20.4%) females reported sexual minority status, among whom 64 (62.1%) and 58 (40.3%) reported MA use in the past six months, respectively. Compared to heterosexual participants, sexual minority males (odds ratio [OR] = 3.74, p < 0.001) and females (OR = 1.80, p = 0.003) were more likely to report recent MA use. In multivariate analysis, MA use among sexual minority males was associated with younger age (adjusted odds ratio [AOR] = 0.93 per year older, p = 0.011), Aboriginal ancestry (AOR = 2.59, p = 0.019), injection drug use (AOR = 3.98, p < 0.001), having a legal order or area restriction (i.e., "no-go zone") impact access to services or influence where drugs are used or purchased (AOR = 4.18, p = 0.008), unprotected intercourse (AOR = 1.62, p = 0.048), and increased depressive symptoms (AOR = 1.67, p = 0.044). Among females, MA use was associated with injection drug use (AOR = 2.49, p = 0.002), Downtown South residency (i.e., an area known for drug use) (AOR = 1.60, p = 0.047), and unprotected intercourse with sex trade clients (AOR = 2.62, p = 0.027). Conclusions Methamphetamine use was more prevalent among sexual minority males and females and was associated with different sets of HIV risks and vulnerabilities. Our findings suggest that interventions addressing MA-related harms may need to be informed by more nuanced understandings of the intersection between drug use patterns, social and structural HIV vulnerabilities, and gender/sexual identities. In particular, MA-focused prevention and treatment programs tailored to disenfranchised male and female sexual minority youth are recommended. PMID:21214930
"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…
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...
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.
An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India.

PubMed

Phukan, Sanjib Kumar; Medhi, Gajendra Kumar; Mahanta, Jagadish; Adhikary, Rajatashuvra; Thongamba, Gay; Paranjape, Ramesh S; Akoijam, Brogen S

2017-07-03

Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur. A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes. The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors. Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users for enriching the HIV prevention in this region.
Wastewater-based assessment of regional and temporal consumption patterns of illicit drugs and therapeutic opioids in Croatia.

PubMed

Krizman, Ivona; Senta, Ivan; Ahel, Marijan; Terzic, Senka

2016-10-01

A comprehensive study of spatial and temporal consumption patterns of the selected illicit drugs (heroin, cocaine, amphetamine, MDMA, methamphetamine, cannabis) and therapeutic opioids (codeine, methadone) has been performed in six Croatian cities by applying wastewater-based epidemiology. The investigated cities (Bjelovar, Vinkovci, Varazdin, Karlovac, Zadar and Zagreb) varied widely in the population size (27,000-688,000 inhabitants) as well as in the number of registered drug consumers included in compulsory and voluntary medical treatment and rehabilitation programs (30-513 persons/100,000 inhabitants of age 15-64). The most consumed illicit drugs were cannabis (10-70doses/day/1000 inhabitants), heroin (<0.2-10doses/day/1000 inhabitants) and cocaine (0.2-8.7doses/day/1000 inhabitants), while the consumption of amphetamine-type drugs was much lower (<0.01-4.4doses/day/1000 inhabitants). Enhanced consumption of illegal drugs was generally associated with larger urban centers (Zagreb and Zadar) however comparatively high consumption rate of cocaine, MDMA and methadone was determined in some smaller cities as well. The overall average dose number of 3 major illegal stimulants (cocaine, MDMA, amphetamine) was rather similar to the number of corresponding heroin doses, which is in disagreement with a comparatively much higher proportion of heroin users in the total number of registered drug users in Croatia. Furthermore, the illicit drug consumption pattern in the large continental city (Zagreb) was characterized by a significant enhancement of the consumption of all stimulants during the weekend, which could not be confirmed neither for the coastal city of Zadar nor for the remaining small continental cities. On the other hand, the city of Zadar exhibited a significant increase of stimulant drug usage during summer vacation period, as a result of pronounced seasonal changes of the population composition and lifestyle in coastal tourist centers. The obtained results represent a valuable complementary data source for the optimisation and implementation of strategies to combat drug abuse in Croatia. Copyright © 2016. Published by Elsevier B.V.
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)
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...
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.
Social sensing of urban land use based on analysis of Twitter users' mobility patterns.

PubMed

Soliman, Aiman; Soltani, Kiumars; Yin, Junjun; Padmanabhan, Anand; Wang, Shaowen

2017-01-01

A number of recent studies showed that digital footprints around built environments, such as geo-located tweets, are promising data sources for characterizing urban land use. However, challenges for achieving this purpose exist due to the volume and unstructured nature of geo-located social media. Previous studies focused on analyzing Twitter data collectively resulting in coarse resolution maps of urban land use. We argue that the complex spatial structure of a large collection of tweets, when viewed through the lens of individual-level human mobility patterns, can be simplified to a series of key locations for each user, which could be used to characterize urban land use at a higher spatial resolution. Contingent issues that could affect our approach, such as Twitter users' biases and tendencies at locations where they tweet the most, were systematically investigated using 39 million geo-located Tweets and two independent datasets of the City of Chicago: 1) travel survey and 2) parcel-level land use map. Our results support that the majority of Twitter users show a preferential return, where their digital traces are clustered around a few key locations. However, we did not find a general relation among users between the ranks of locations for an individual-based on the density of tweets-and their land use types. On the contrary, temporal patterns of tweeting at key locations were found to be coherent among the majority of users and significantly associated with land use types of these locations. Furthermore, we used these temporal patterns to classify key locations into generic land use types with an overall classification accuracy of 0.78. The contribution of our research is twofold: a novel approach to resolving land use types at a higher resolution, and in-depth understanding of Twitter users' location-related and temporal biases, promising to benefit human mobility and urban studies in general.
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.
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
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.
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
Relationship between ecstasy use and depression: a study controlling for poly-drug use

PubMed Central

Roiser, Jonathan P.; Sahakian, Barbara J.

2008-01-01

Rationale 3,4-Methylenedioxymethamphetamine (MDMA or “ecstasy”) causes serotonin neuron damage in laboratory animals. The serotonin system is known to be important in the regulation of mood. Previous research has shown that MDMA users score higher on self-report ratings of depression than controls. However, MDMA users commonly take other illicit substances and many studies do not fully control for poly-drug use. Objectives The aim of this study was to examine the relationship between MDMA use and affective disturbance, while fully controlling for poly-drug use. Methods Participants were 30 current MDMA users, 30 poly-drug controls who had never used MDMA, 30 drug-naïve controls with no history of illicit drug use and 20 ex-MDMA users. The current MDMA users and poly-drug controls were well matched on all indices of non-MDMA drug use. All participants were administered the Beck Depression Inventory (BDI) and the Affective Go/No-go task, which has been shown to be sensitive to depression. Results The current and ex-MDMA users scored significantly higher on the BDI than the drug-naive controls, but were not significantly different from the poly-drug controls. There were no differences between the groups in terms of affective bias scores on the Affective Go/No-go task. Conclusions Increased scores on self-report depression scales in MDMA users are not entirely attributable to MDMA use. MDMA users do not show the same attentional bias towards negatively toned material as depressed patients. PMID:14652710
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…

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.
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.
Drugs and personality: comparison of drug users, nonusers, and other clinical groups on the 16PF.

PubMed

Spotts, J V; Shontz, F C

1991-10-01

This article reviews published 16PF research on drug users. It also compares the 16PF scores of a new sample of nonusers with scores of matched groups of heavy, chronic users of cocaine, amphetamine, opiates, and barbiturates/sedative hypnotics, as well as combined groups of stimulant users, depressant users, and a combined group of users of all substances. No significant differences were found among drug user groups, but the profile of the nonuser group was distinctive. K-Means Cluster Analyses, as well as Cattell's Similarity and Pearson Product Moment Correlation Coefficients, were used to compare profiles of these new samples with the 19 groups described in an earlier meta-analysis of published 16PF studies. Data from the new samples did not cluster with data from other published research, although certain specific similarities appeared in more detailed correlational analyses. Methodological problems are discussed, and it is recommended that in future studies drug user groups be more carefully selected and defined, sample descriptions be more thorough and complete, complete profile information be routinely provided, and efforts be made to explore the utility of the Cattell CAQ in studies of drug users/misusers.
Prevalent new-user cohort designs for comparative drug effect studies by time-conditional propensity scores.

PubMed

Suissa, Samy; Moodie, Erica E M; Dell'Aniello, Sophie

2017-04-01

Studies of the real-world comparative effectiveness of drugs conducted using computerized healthcare databases typically involve an incident new-user cohort design for head-to-head comparisons between two medications, using exclusively treatment-naïve patients. However, the desired contrast often involves one new drug compared with an older drug, of which many users of the new drug may have switched from, seriously restricting the scope of incident new-user studies. We introduce prevalent new-user cohort designs for head-to-head comparative drug effect studies, where incident new users are scarce. We define time-based and prescription-based exposure sets to compute time-conditional propensity scores of initiating the newer drug and to identify matched subjects receiving the comparator drug. We illustrate this approach using data from the UK's Clinical Practice Research Datalink to evaluate whether the newer glucagon-like peptide-1 receptor agonists (GLP-1 analogs) used to treat type 2 diabetes increase the risk of heart failure, in comparison with the older similarly indicated sulfonylureas. Of the 170 031 users of antidiabetic agents from 2000 onwards, 79 682 used sulfonylureas (first use 2000), while 6196 used GLP-1 analogs (first use 2007), 75% of which had previously used a sulfonylurea. After matching each GLP-1 analog user to a sulfonylurea user on the time-conditional propensity scores from prescription-based exposure sets, the hazard ratio of heart failure with GLP-1 use was 0.73 (95%CI: 0.57-0.93). The proposed prevalent new-user cohort design for comparative drug effects studies allows the use of all or most patients exposed to the newer drug, thus permitting a more comprehensive assessment of a new drug's safety. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
The Urbis Project: Identification and Characterization of Potential Urban Development Areas as a Web-Based Service

NASA Astrophysics Data System (ADS)

Manzke, Nina; Kada, Martin; Kastler, Thomas; Xu, Shaojuan; de Lange, Norbert; Ehlers, Manfred

2016-06-01

Urban sprawl and the related landscape fragmentation is a Europe-wide challenge in the context of sustainable urban planning. The URBan land recycling Information services for Sustainable cities (URBIS) project aims for the development, implementation, and validation of web-based information services for urban vacant land in European functional urban areas in order to provide end-users with site specific characteristics and to facilitate the identification and evaluation of potential development areas. The URBIS services are developed based on open geospatial data. In particular, the Copernicus Urban Atlas thematic layers serve as the main data source for an initial inventory of sites. In combination with remotely sensed data like SPOT5 images and ancillary datasets like OpenStreetMap, detailed site specific information is extracted. Services are defined for three main categories: i) baseline services, which comprise an initial inventory and typology of urban land, ii) update services, which provide a regular inventory update as well as an analysis of urban land use dynamics and changes, and iii) thematic services, which deliver specific information tailored to end-users' needs.
The changing face of heroin use in the United States: a retrospective analysis of the past 50 years.

PubMed

Cicero, Theodore J; Ellis, Matthew S; Surratt, Hilary L; Kurtz, Steven P

2014-07-01

Over the past several years, there have been a number of mainstream media reports that the abuse of heroin has migrated from low-income urban areas with large minority populations to more affluent suburban and rural areas with primarily white populations. To examine the veracity of these anecdotal reports and define the relationship between the abuse of prescription opioids and the abuse of heroin. Using a mixed-methods approach, we analyzed (1) data from an ongoing study that uses structured, self-administered surveys to gather retrospective data on past drug use patterns among patients entering substance abuse treatment programs across the country who received a primary (DSM-IV) diagnosis of heroin use/dependence (n = 2797) and (2) data from unstructured qualitative interviews with a subset of patients (n = 54) who completed the structured interview. In addition to data on population demographics and current residential location, we used cross-tabulations to assess prevalence rates as a function of the decade of the initiation of abuse for (1) first opioid used (prescription opioid or heroin), (2) sex, (3) race/ethnicity, and (4) age at first use. Respondents indicated in an open-ended format why they chose heroin as their primary drug and the interrelationship between their use of heroin and their use of prescription opioids. Approximately 85% of treatment-seeking patients approached to complete the Survey of Key Informants' Patients Program did so. Respondents who began using heroin in the 1960s were predominantly young men (82.8%; mean age, 16.5 years) whose first opioid of abuse was heroin (80%). However, more recent users were older (mean age, 22.9 years) men and women living in less urban areas (75.2%) who were introduced to opioids through prescription drugs (75.0%). Whites and nonwhites were equally represented in those initiating use prior to the 1980s, but nearly 90% of respondents who began use in the last decade were white. Although the "high" produced by heroin was described as a significant factor in its selection, it was often used because it was more readily accessible and much less expensive than prescription opioids. Our data show that the demographic composition of heroin users entering treatment has shifted over the last 50 years such that heroin use has changed from an inner-city, minority-centered problem to one that has a more widespread geographical distribution, involving primarily white men and women in their late 20s living outside of large urban areas.
Social psychological determinants of the use of performance-enhancing drugs by gym users.

PubMed

Wiefferink, C H; Detmar, S B; Coumans, B; Vogels, T; Paulussen, T G W

2008-02-01

The aim of this study is to identify the social psychological determinants of the use of performance-enhancing drugs by gym users who practice bodybuilding, fitness, powerlifting or combat sports. In this questionnaire-based study, 144 respondents answered questions on their actual use and intention to use such drugs and also on their background characteristics and beliefs, such as their attitudes, social influences and self-efficacy. While all social psychological determinants correlated with intention to use these drugs, the most important predictors were personal norms, beliefs about performance outcomes and the perceived behavior of others. Non-users held more restrictive norms about using performance-enhancing drugs, were less optimistic about the performance-enhancing outcomes and believed that fewer significant others used performance-enhancing drugs than users and ex-users. The results of this study indicate that users attribute advantages to performance-enhancing drugs and are inclined to overlook the risks of using them. Preventive interventions should focus on influencing personal norms and social processes.
Urban and Rural Differences in Sedentary Behavior among American and Canadian Youth

PubMed Central

Carson, Valerie; Iannotti, Ronald J.; Pickett, William; Janssen, Ian

2011-01-01

We examined relationships between urban-rural status and three screen time behaviors (television, computer, video games), and the potential mediating effect of parent and peer support on these relationships. Findings are based on American (n=8563) and Canadian (n=8990) youth in grades 6–10 from the 2005/06 Health Behaviour in School-Aged Children Survey. Weekly hours of individual screen time behaviors were calculated. Urban-rural status was defined using the Beale coding system. Parent and peer support variables were derived from principal component analysis. In comparison to the referent group (non-metro adjacent), American youth in the most rural areas were more likely to be high television users and less likely to be high computer users. Conversely, Canadian youth in medium and large metropolitan areas were less likely to be high television users and more likely to be high computer users. Parent and peer support did not strongly mediate the relationships between urban-rural status and screen time. These findings suggest that interventions aiming to reduce screen time may be most effective if they consider residential location and the specific screen time behavior. PMID:21565545
Urban and rural differences in sedentary behavior among American and Canadian youth.

PubMed

Carson, Valerie; Iannotti, Ronald J; Pickett, William; Janssen, Ian

2011-07-01

We examined relationships between urban-rural status and three screen time behaviors (television, computer, video games), and the potential mediating effect of parent and peer support on these relationships. Findings are based on American (n = 8563) and Canadian (n = 8990) youth in grades 6-10 from the 2005/06 Health Behavior in School-Aged Children Survey. Weekly hours of individual screen time behaviors were calculated. Urban-rural status was defined using the Beale coding system. Parent and peer support variables were derived from principal component analysis. In comparison to the referent group (non-metro adjacent), American youth in the most rural areas were more likely to be high television users and less likely to be high computer users. Conversely, Canadian youth in medium and large metropolitan areas were less likely to be high television users and more likely to be high computer users. Parent and peer support did not strongly mediate the relationships between urban-rural status and screen time. These findings suggest that interventions aiming to reduce screen time may be most effective if they consider residential location and the specific screen time behavior. Copyright © 2011 Elsevier Ltd. All rights reserved.
A research agenda for a people-centred approach to energy access in the urbanizing global south

NASA Astrophysics Data System (ADS)

Broto, Vanesa Castán; Stevens, Lucy; Ackom, Emmanuel; Tomei, Julia; Parikh, Priti; Bisaga, Iwona; To, Long Seng; Kirshner, Joshua; Mulugetta, Yacob

2017-10-01

Energy access is typically viewed as a problem for rural areas, but people living in urban settings also face energy challenges that have not received sufficient attention. A revised agenda in research and practice that puts the user and local planning complexities centre stage is needed to change the way we look at energy access in urban areas, to understand the implications of the concentration of vulnerable people in slums and to identify opportunities for planned management and innovation that can deliver urban energy transitions while leaving no one behind. Here, we propose a research agenda focused on three key issues: understanding the needs of urban energy users; enabling the use of context-specific, disaggregated data; and engaging with effective modes of energy and urban governance. This agenda requires interdisciplinary scholarship across the social and physical sciences to support local action and deliver large-scale, inclusive transformations.
Spatial Analysis of HIV Positive Injection Drug Users in San Francisco, 1987 to 2005

PubMed Central

Martinez, Alexis N.; Mobley, Lee R.; Lorvick, Jennifer; Novak, Scott P.; Lopez, Andrea M.; Kral, Alex H.

2014-01-01

Spatial analyses of HIV/AIDS related outcomes are growing in popularity as a tool to understand geographic changes in the epidemic and inform the effectiveness of community-based prevention and treatment programs. The Urban Health Study was a serial, cross-sectional epidemiological study of injection drug users (IDUs) in San Francisco between 1987 and 2005 (N = 29,914). HIV testing was conducted for every participant. Participant residence was geocoded to the level of the United States Census tract for every observation in dataset. Local indicator of spatial autocorrelation (LISA) tests were used to identify univariate and bivariate Census tract clusters of HIV positive IDUs in two time periods. We further compared three tract level characteristics (% poverty, % African Americans, and % unemployment) across areas of clustered and non-clustered tracts. We identified significant spatial clustering of high numbers of HIV positive IDUs in the early period (1987–1995) and late period (1996–2005). We found significant bivariate clusters of Census tracts where HIV positive IDUs and tract level poverty were above average compared to the surrounding areas. Our data suggest that poverty, rather than race, was an important neighborhood characteristic associated with the spatial distribution of HIV in SF and its spatial diffusion over time. PMID:24722543
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 Â© 2011 Elsevier B.V. All rights reserved.
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.
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...
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
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.…
Assessment of prescribing practices among urban and rural general practitioners in Tamil Nadu.

PubMed

Gopalakrishnan, Sekharan; Ganeshkumar, Parasuraman; Katta, Ajitha

2013-01-01

Studying drug use pattern among medical practitioners is of vital importance in the present scenario where irrational drug use and development of drug resistance is becoming rampant. To assess, the pattern of prescribing practices among the general practitioners in a defined rural and urban area of Tamil Nadu. A community based descriptive study was conducted to collect 600 prescriptions from the catchment areas of rural and urban health training centers of a medical college using prescribing indicators as per the WHO "How to investigate drug use in health facilities" tool. This prescription study revealed that multivitamins (19.5%), antibiotics (19.3%), drugs for gastro-intestinal tract (GIT) (18%), analgesic non-steroidal anti-inflammatory drugs/ (NSAID's) (15.1%), and antihistaminic (12.5%) were prescribed frequently. Among the antibiotics, amoxicillin (49.2%) was the most commonly prescribed followed by gentamicin (31.7%). Percentage of prescriptions with an antibiotic was 55% and nearly 62% of the practitioners prescribed drugs by their generic names. As a practice of poly-pharmacy, it was observed that the average number of drugs prescribed in urban and rural area was nearly 5 and 4, respectively. Nearly 80% of the urban and rural practitioners were prescribing at least one injection. Study of the quality of prescriptions revealed that there was poor legibility, high usage of abbreviations, inadequate details of the drugs, and absence of signature by practitioners in the prescriptions. This study clearly highlights the practice of poly-pharmacy, low usage of generic drugs, injudicious usage of antibiotics and injections and low usage of drugs prescribed from essential drugs list.
Consistency of Use and Effectiveness of Household Water Treatment Practices among Urban and Rural Populations Claiming to Treat Their Drinking Water at Home: A Case Study in Zambia

PubMed Central

Rosa, Ghislaine; Kelly, Paul; Clasen, Thomas

2016-01-01

Household water treatment (HWT) can improve drinking water quality and prevent disease, if used correctly and consistently. While international monitoring suggests that 1.8 billion people practice HWT, these estimates are based on household surveys that may overstate the level of consistent use and do not address microbiological effectiveness. We sought to examine how HWT is practiced among households identified as HWT users according to international monitoring standards. Case studies were conducted in urban and rural Zambia. After a baseline survey (urban: 203 households, rural: 276 households) to identify HWT users, 95 urban and 82 rural households were followed up for 6 weeks. Consistency of HWT reporting was low; only 72.6% of urban and 50.0% of rural households reported to be HWT users in the subsequent visit. Similarly, availability of treated water was low, only 23.3% and 4.2% of urban and rural households, respectively, had treated water on all visits. Drinking water was significantly worse than source water in both settings. Only 19.6% of urban and 2.4% of rural households had drinking water free of thermotolerant coliforms on all visits. Our findings raise questions about the value of the data gathered through the international monitoring of HWT practices as predictors of water quality in the home. PMID:26572868
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.
Drug Use Patterns and Trends in Rural Communities

ERIC Educational Resources Information Center

Gfroerer, Joseph C.; Larson, Sharon L.; Colliver, James D.

2007-01-01

Context and Purpose: This study examines the prevalence of tobacco, alcohol, and illicit drug use among adolescents and adults in 3 types of counties: "rural" (nonmetropolitan counties with urban population less than 20,000), "urbanized nonmetropolitan" (nonmetropolitan counties with urban population 20,000 or higher), and…

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.
The expertise of participation: mass housing and urban planning in post-war France.

PubMed

Cupers, Kenny

2011-01-01

This article analyses the advent of participation in French planning as the historical touchstone of a larger shift in urban thinking. It investigates how the interactions between inhabitants, developers, state officials and social scientific experts in the production of large-scale modern housing areas and new towns helped bring about user participation as a category of action and discourse. The article argues that the transformation of inhabitants into active participants entails the development of legitimate 'user knowledge' and therefore - perhaps paradoxically - the continuing involvement of experts. The first part of the article examines how the turn towards mass housing production during the 1950s prompted the question of the user and established the ground for debates about participation. The second part of the article explores the relationship between inhabitant contestation and changing urban planning and policy-making during the 1960s. The focus here is on Sarcelles, which served both as a national urban model, a key object of sociological study, and the main target of national public outcry, and helps to reveal relations between local contestation, national policy and shifts in urban thinking. The last part of the article looks at the concrete influence of ideas of participation on subsequent urban policies during the 1970s.
EPA RESEARCH IN URBAN STORMWATER POLLUTION CONTROL

EPA Science Inventory

This state-of-the-art on the Environmental Protection Agency' s research in urban stormwater and combined sewer overflow pollution control describes the major elements of the Urban Runoff Pollution Control Program. roblem definition, users assistance tools, management alternative...
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
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.
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
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
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
Urban-rural inequality regarding drug prescriptions in primary care facilities - a pre-post comparison of the National Essential Medicines Scheme of China.

PubMed

Yao, Qiang; Liu, Chaojie; Ferrier, J Adamm; Liu, Zhiyong; Sun, Ju

2015-07-30

To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities. A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions. The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%). NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.
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.
75 FR 5847 - Section 5309 Bus and Bus Facilities Livability Initiative and Urban Circulator Program Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

... Livability Initiative and Urban Circulator Program Grants AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice to Extend Application Deadline for the Bus and Bus Facilities and Urban Circulator..., Transportation Equity Act: A Legacy for Users (SAFETEA-LU), Public Law 109-59, August 10, 2005. The Urban...
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
Designing a New Urban Internet.

ERIC Educational Resources Information Center

Burke, Lauren

2002-01-01

Discusses Web site design and information architecture in light of principles of New Urbanism that are being applied in urban planning situations. Topics include networked electronic environment design; user-centered network design; multidisciplinary approaches; knowledge access and collaboration; and the Global Information Infrastructure…
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.
Use of illicit drugs by adolescents and young adults of an urban settlement in Brazil.

PubMed

Guimarães, Rafael Alves; Souza, Márcia Maria de; Caetano, Karlla Antonieta Amorim; Teles, Sheila Araujo; Matos, Marcos André de

2018-02-01

To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Of the total participants (n=105), 27.6% (95CI 20.0-36.9%) had used illicit drugs such as marijuana, cocaine, crack, LSD and inhalants. The consumption of these substances was associated with male gender, use of body piercing and/or tattoos, licit drug use and self-report of signs and/or symptoms of sexually transmitted infections. High prevalence of illicit drug use was found in the individuals investigated, ratifying the presence of risk factors to the vulnerability of the settlers to use these substances in the urban settlement population.
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.
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.
Exploring the impact of wheelchair design on user function in a rural South African setting.

PubMed

Visagie, Surona; Duffield, Svenje; Unger, Mariaan

2015-01-01

Wheelchairs provide mobility that can enhance function and community integration. Function in a wheelchair is influenced by wheelchair design. To explore the impact of wheelchair design on user function and the variables that guided wheelchair prescription in the study setting. A mixed-method, descriptive design using convenience sampling was implemented. Quantitative data were collected from 30 wheelchair users using the functioning every day with a Wheelchair Scale and a Wheelchair Specification Checklist. Qualitative data were collected from ten therapists who prescribed wheelchairs to these users, through interviews. The Kruskal-Wallis test was used to identify relationships, and content analysis was undertaken to identify emerging themes in qualitative data. Wheelchairs with urban designs were issued to 25 (83%) participants. Wheelchair size, fit, support and functional features created challenges concerning transport, operating the wheelchair, performing personal tasks, and indoor and outdoor mobility. Users using wheelchairs designed for use in semi-rural environments achieved significantly better scores regarding the appropriateness of the prescribed wheelchair than those using wheelchairs designed for urban use ( p = <0.01). Therapists prescribed the basic, four-wheel folding frame design most often because of a lack of funding, lack of assessment, lack of skills and user choice. Issuing urban type wheelchairs to users living in rural settings might have a negative effect on users' functional outcomes. Comprehensive assessments, further training and research, on long term cost and quality of life implications, regarding provision of a suitable wheelchair versus a cheaper less suitable option is recommended.
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…
Methamphetamine Users in a Community-Based Drug Court: Does Gender Matter?

ERIC Educational Resources Information Center

Hartman, Jennifer L.; Listwan, Shelley Johnson; Shaffer, Deborah Koetzle

2007-01-01

This paper examines men and women methamphetamine (meth) users who participated in a community-based drug court. The treatment of female drug users is a particularly salient issue because of the concerns with relapse and recidivism. For the current study, we studied the impact of the drug court by gender on a group of high-risk/high-need meth…

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...
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.
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.
Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study

PubMed Central

2014-01-01

Background The irrational overuse of antibiotics should be minimized as it drives the development of antibiotic resistance, but changing these practices is challenging. A better understanding is needed of practices and economic incentives for antibiotic dispensing in order to design effective interventions to reduce inappropriate antibiotic use. Here we report on both quantitative and qualitative aspects of antibiotic sales in private pharmacies in northern Vietnam. Method A cross-sectional study was conducted in which all drug sales were observed and recorded for three consecutive days at thirty private pharmacies, 15 urban and 15 rural, in the Hanoi region in 2010. The proportion of antibiotics to total drug sales was assessed and the revenue was calculated for rural and urban settings. Pharmacists and drug sellers were interviewed by a semi-structured questionnaire and in-depth interviews to understand the incentive structure of antibiotic dispensing. Results In total 2953 drug sale transactions (2083 urban and 870 rural) were observed. Antibiotics contributed 24% and 18% to the total revenue of pharmacies in urban and rural, respectively. Most antibiotics were sold without a prescription: 88% in urban and 91% in rural pharmacies. The most frequent reported reason for buying antibiotics was cough in the urban setting (32%) and fever in the rural area (22%). Consumers commonly requested antibiotics without having a prescription: 50% in urban and 28% in rural area. The qualitative data revealed that drug sellers and customer’s knowledge of antibiotics and antibiotic resistance were low, particularly in rural area. Conclusion Over the counter sales of antibiotic without a prescription remains a major problem in Vietnam. Suggested areas of improvement are enforcement of regulations and pricing policies and educational programs to increase the knowledge of drug sellers as well as to increase community awareness to reduce demand-side pressure for drug sellers to dispense antibiotics inappropriately. PMID:24555709
Research investigations in and demonstrations of remote sensing applications to urban environmental problems

NASA Technical Reports Server (NTRS)

Hidalgo, J. U.

1975-01-01

The applicability of remote sensing to transportation and traffic analysis, urban quality, and land use problems is discussed. Other topics discussed include preliminary user analysis, potential uses, traffic study by remote sensing, and urban condition analysis using ERTS.
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.
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
Automated Drug Identification for Urban Hospitals

NASA Technical Reports Server (NTRS)

Shirley, Donna L.

1971-01-01

Many urban hospitals are becoming overloaded with drug abuse cases requiring chemical analysis for identification of drugs. In this paper, the requirements for chemical analysis of body fluids for drugs are determined and a system model for automated drug analysis is selected. The system as modeled, would perform chemical preparation of samples, gas-liquid chromatographic separation of drugs in the chemically prepared samples, infrared spectrophotometric analysis of the drugs, and would utilize automatic data processing and control for drug identification. Requirements of cost, maintainability, reliability, flexibility, and operability are considered.
Policing and risk of overdose mortality in urban neighborhoods

PubMed Central

Bohnert, Amy S.B.; Nandi, Arijit; Tracy, Melissa; Cerdá, Magdalena; Tardiff, Kenneth J; Vlahov, David; Galea, Sandro

2010-01-01

Background Accidental drug overdose is a major cause of mortality among drug users. Fears of police arrest may deter witnesses of drug overdose from calling for medical help and may be a determinant of drug overdose mortality. To our knowledge, no studies have empirically assessed the relation between levels of policing and drug overdose mortality. We hypothesized that levels of police activity, congruent with fears of police arrest, are positively associated with drug overdose mortality. Methods We assembled cross-sectional time-series data for 74 New York City (NYC) police precincts over the period 1990–1999 using data collected from the Office of the Chief Medical Examiner of NYC, the NYC Police Department, and the US Census Bureau. Misdemeanor arrest rate—reflecting police activity—was our primary independent variable of interest, and overdose rate our primary dependent variable of interest. Results The mean overdose rate per 100,000 among police precincts in NYC between 1990 and 1999 was 10.8 (standard deviation = 10.0). In a Bayesian hierarchical model that included random spatial and temporal effects and a space-time interaction, the misdemeanor arrest rate per 1,000 was associated with higher overdose mortality (posterior median = 0.003, 95% Credible Interval = 0.001, 0.005) after adjustment for overall drug use in the precinct and demographic characteristics. Conclusions Levels of police activity in a precinct are associated with accidental drug overdose mortality. Future research should examine aspects of police-community interactions that contribute to higher overdose mortality. PMID:20727684
Consistency of Use and Effectiveness of Household Water Treatment Practices Among Urban and Rural Populations Claiming to Treat Their Drinking Water at Home: A Case Study in Zambia.

PubMed

Rosa, Ghislaine; Kelly, Paul; Clasen, Thomas

2016-02-01

Household water treatment (HWT) can improve drinking water quality and prevent disease, if used correctly and consistently. While international monitoring suggests that 1.8 billion people practice HWT, these estimates are based on household surveys that may overstate the level of consistent use and do not address microbiological effectiveness. We sought to examine how HWT is practiced among households identified as HWT users according to international monitoring standards. Case studies were conducted in urban and rural Zambia. After a baseline survey (urban: 203 households, rural: 276 households) to identify HWT users, 95 urban and 82 rural households were followed up for 6 weeks. Consistency of HWT reporting was low; only 72.6% of urban and 50.0% of rural households reported to be HWT users in the subsequent visit. Similarly, availability of treated water was low, only 23.3% and 4.2% of urban and rural households, respectively, had treated water on all visits. Drinking water was significantly worse than source water in both settings. Only 19.6% of urban and 2.4% of rural households had drinking water free of thermotolerant coliforms on all visits. Our findings raise questions about the value of the data gathered through the international monitoring of HWT practices as predictors of water quality in the home. © The American Society of Tropical Medicine and Hygiene.
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.
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.
Hydroeconomic optimization of integrated water management and transfers under stochastic surface water supply

NASA Astrophysics Data System (ADS)

Zhu, Tingju; Marques, Guilherme Fernandes; Lund, Jay R.

2015-05-01

Efficient reallocation and conjunctive operation of existing water supplies is gaining importance as demands grow, competitions among users intensify, and new supplies become more costly. This paper analyzes the roles and benefits of conjunctive use of surface water and groundwater and market-based water transfers in an integrated regional water system where agricultural and urban water users coordinate supply and demand management based on supply reliability and economic values of water. Agricultural users optimize land and water use for annual and perennial crops to maximize farm income, while urban users choose short-term and long-term water conservation actions to maintain reliability and minimize costs. The temporal order of these decisions is represented in a two-stage optimization that maximizes the net expected benefits of crop production, urban conservation and water management including conjunctive use and water transfers. Long-term decisions are in the first stage and short-term decisions are in a second stage based on probabilities of water availability events. Analytical and numerical analyses are made. Results show that conjunctive use and water transfers can substantially stabilize farmer's income and reduce system costs by reducing expensive urban water conservation or construction. Water transfers can equalize marginal values of water across users, while conjunctive use minimizes water marginal value differences in time. Model results are useful for exploring the integration of different water demands and supplies through water transfers, conjunctive use, and conservation, providing valuable insights for improving system management.
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)
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
[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.

STUDY ON SUPPORTING FOR DRAWING UP THE BCP FOR URBAN EXPRESSWAY NETWORK USING BY TRAFFIC SIMULATION SYSTEM

NASA Astrophysics Data System (ADS)

Yamawaki, Masashi; Shiraki, Wataru; Inomo, Hitoshi; Yasuda, Keiichi

The urban expressway network is an important infrastructure to execute a disaster restoration. Therefore, it is necessary to draw up the BCP (Business Continuity Plan) to enable securing of road user's safety and restoration of facilities, etc. It is important that each urban expressway manager execute decision and improvement of effective BCP countermeasures when disaster occurs by assuming various disaster situations. Then, in this study, we develop the traffic simulation system that can reproduce various disaster situations and traffic actions, and examine some methods supporting for drawing up the BCP for an urban expressway network. For disaster outside assumption such as tsunami generated by a huge earthquake, we examine some approaches securing safety of users and cars on the Hanshin Expressway Network as well as on general roads. And, we aim to propose a tsunami countermeasure not considered in the current urban expressway BCP.
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.
Pins and posters: Paradigms for content publication on situated displays.

PubMed

José, Rui; Pinto, Hélder; Silva, Bruno; Melro, Ana

2013-01-01

Public-display systems are still far from being a medium for meeting people's diverse communication goals. Moving toward open displays will require publication paradigms that can overcome the challenges of meaningful engagement and enable users to fully understand and control the publication process. The metaphors of pins and posters have inspired two complementary paradigms for public displays. Researchers implemented these paradigms in the Instant Places system, which they deployed on 10 displays in diverse urban locations for six months. They collected user and system data regarding the users' practices. The findings improve the understanding of what might drive user-generated content in networks of urban displays. Such knowledge can inform the design of tools and procedures for situated publication in public displays.
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.
Preferred Drug Resistance Strategies of Urban American Indian Youth of the Southwest

ERIC Educational Resources Information Center

Kulis, Stephen; Brown, Eddie F.

2011-01-01

This study explored the drug resistance strategies that urban American Indian adolescents consider the best and worst ways to respond to offers of alcohol, cigarettes, and marijuana. Focus group data were collected from 11 female and 9 male American Indian adolescents attending urban middle schools in the southwest. The youth were presented with…
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.
Adherence to a web-based intervention program for traumatized persons in mainland China.

PubMed

Wang, Zhiyun

2014-01-01

This paper investigated adherence to a self-help web-based intervention for PTSD (Chinese My Trauma Recovery, CMTR) in mainland China and evaluated the association between adherence measures and potential predictors, for example, traumatic symptoms and self-efficacy. Data from 56 urban and 90 rural trauma survivors were reported who used at least one of the seven recovery modules of CMTR. The results showed that 80% urban users visited CMTR four or less days and 87% rural users visited CMTR for 5 or 6 days. On average, urban users visited 2.54 (SD=1.99) modules on the first visiting day and less from the second day; rural users visited 1.10 (SD=0.54) modules on the first visiting day, and it became stable in the following days. In both samples, depression scores at pre-test were significantly or trend significantly associated with the number of visited web pages in the relaxation and professional help modules (r=0.20-0.26, all p<0.14); traumatic symptom scores at pre-test significantly or trend significantly correlated to the number of visited web pages in the relaxation, professional help, and mastery tools modules (r=0.20-0.26, all p<0.10). Moreover, urban users' coping self-efficacy scores at pre-test significantly or trend significantly related to the number of visited web pages in the relaxation, professional help, social support, and mastery tool modules (r=0.20-0.33, all p<0.16). These findings suggest that individuals tend to focus on one or two recovery modules when they visit CMTR, and the number of web pages visited during the intervention period relates to users' traumatic and depressive symptoms and self-efficacy before intervention.
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.
Is the New Heroin Epidemic Really New? Racializing Heroin.

PubMed

Bowser, Benjamin; Fullilove, Robert; Word, Carl

2017-01-01

Heroin abuse as an outcome of the prior use of painkillers increased rapidly over the past decade. This "new epidemic" is unique because the new heroin users are primarily young White Americans in rural areas of virtually every state. This commentary argues that the painkiller-to-heroin transition could not be the only cause of heroin use on such a scale and that the new and old heroin epidemics are linked. The social marketing that so successfully drove the old heroin epidemic has innovated and expanded due to the use of cell-phones, text messaging and the "dark web" which requires a Tor browser, and software that allows one to communicate with encrypted sites without detection. Central city gentrification has forced traffickers to take advantage of larger and more lucrative markets. A second outcome is that urban black and Latino communities are no longer needed as heroin stages areas for suburban and exurban illicit drug distribution. Drug dealing can be done directly in predominantly white suburbs and rural areas without the accompanying violence associated with the old epidemic. Denial of the link between the new and old heroin epidemics racially segregates heroin users and more proactive prevention and treatment in the new epidemic than in the old. It also cuts off a half-century of knowledge about the supply-side of heroin drug dealing and the inevitable public policy measures that will have to be implemented to effectively slow and stop both the old and new epidemic. Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.
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…
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.
Injecting risk behavior among traveling young injection drug users: travel partner and city characteristics.

PubMed

Montgomery, Martha E; Fatch, Robin S; Evans, Jennifer L; Yu, Michelle; Davidson, Peter J; Page, Kimberly; Hahn, Judith A

2013-06-01

Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004-2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000-1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56-8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25-22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11-27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46-5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42-7.68; AOR = 3.03; 95 % CI, 1.32-6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.
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...
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
24 CFR 21.205 - What must I include in my drug-free workplace statement?

Code of Federal Regulations, 2010 CFR

2010-04-01

... workplace statement? 21.205 Section 21.205 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) Requirements for Recipients Other Than Individuals § 21.205 What must I include in my drug-free workplace...
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.
Impact of Presence of Children on Indoor Tobacco Restrictions in Households of Urban and Rural Adult Tobacco Users.

PubMed

Kopp, Benjamin T; Hinton, Alice; Lu, Rong; Cooper, Sarah; Nagaraja, Haikady; Wewers, Mary Ellen

2018-04-10

Secondhand smoke exposure in children is changing as a result of new public policy and electronic nicotine products (e-cigarettes). We examined factors related to self-imposed indoor household tobacco restrictions, with emphasis on children in the household and associations with combustible and noncombustible product use. A cross-sectional survey of urban and rural Ohio adult tobacco users classified participants as exclusive combustible users, smokeless tobacco (SLT) users, e-cigarette users, or dual users. They were further stratified according to combustible or noncombustible product use and the presence of indoor tobacco use restrictions. Multiple logistic regression determined factors associated with indoor tobacco restrictions. A total of 1210 tobacco users participated, including 25.7% with children living in the home. Half allowed combustible and two thirds allowed noncombustible tobacco use indoors. Urban location (odds ratio [OR] = 1.58), younger age (OR = 0.88 per 5 year), male sex (OR = 1.40), college education (OR = 1.40), household income of more than $15,000 (OR = 1.78), and being married (OR = 2.43) were associated with a higher likelihood of banning combustible products indoors. SLT (OR = 8.12) and e-cigarette (OR = 5.85) users were more likely to have indoor bans compared to combustible users. Children in the household (OR = 1.89), older age (OR = 1.12 per 5 years), and nonwhite race (OR = 1.68) were associated with a higher likelihood of banning noncombustible products indoors. Combustible (OR = 4.54) and e-cigarette (OR = 3.04) users were more likely than SLT users to have indoor bans. Indoor restrictions on tobacco use remain infrequent in homes with children and are associated with user type and socioeconomic factors. Public policy should target modifiable risk factors for in-home secondhand smoke exposure. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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...

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.
Scientific approaches to AIDS prevention and control in China.

PubMed

Teng, T; Shao, Y

2011-04-01

The HIV epidemic in China started among intravenous drug users in the late 1980s. The second wave of the epidemic was caused by an outbreak in the paid plasma donors in central China in the mid-1990s. Sexually transmitted HIV cases have steadily increased and comprised more than half the reported HIV/AIDS infections since 2007. In the last 5 years, there has been a sharp increase of HIV infection in men who have sex with men. The HIV epidemic in China has expanded from high-risk groups to the general population and from rural regions to urban areas. This brief article discusses the history of HIV epidemics in China and the challenges facing the current AIDS control efforts in the country. It explains that only scientific approaches can sustain the national AIDS control programs and introduce the type of research needed to address those challenges. The selected research areas include molecular epidemiology, drug resistance surveillance, and the Chinese HIV vaccine research.
AIDS and behavioral change to reduce risk: a review.

PubMed Central

Becker, M H; Joseph, J G

1988-01-01

Published reports describing behavioral changes in response to the threat of AIDS (acquired immunodeficiency syndrome) are reviewed. These studies demonstrate rapid, profound, but expectably incomplete alterations in the behavior of both homosexual/bisexual males and intravenous drug users. This is true in the highest risk metropolitan areas such as New York City and in areas with lower AIDS incidence. Risk reduction is occurring more frequently through the modification of sexual or drug-use behavior than through its elimination. In contrast to aggregate data, longitudinal descriptions of individual behavior demonstrate considerable instability or recidivism. Behavioral change in the potentially vulnerable heterosexual adolescent and young adult populations is less common, as is risk reduction among urban minorities. Reports of AIDS-related knowledge and attitudes generally parallel the pattern of behavioral changes. Nonetheless, few studies investigate the relationship of knowledge and attitudes to risk reduction. Future studies should provide much-needed information about the determinants as well as the magnitude of behavioral changes required to reduce the further spread of AIDS. PMID:3279837
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.
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
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.
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.
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...
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.
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.
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.
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...
[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.
From Information to Urban Sustainability through Innovations in Citizen Centered Transparency Mechanism

NASA Astrophysics Data System (ADS)

Tiwari, A.

2017-12-01

Current urban information mechanisms in developing countries operate only through linear exchanges between institutions and users and therefore reinforce hierarchical relationships. Coupled with conflicting interests and perspectives of stakeholders in multilevel climate-governance and absence of grassroots information-networking for adaptation decision-making, there are therefore, existing information gaps. Central to urban sustainability is the need for citizen centered transparency (CCT) mechanisms that encompass and address the needs of the marginalized and vulnerable communities in developing countries especially. The study discloses the existing information gaps through information-needs assessment of stakeholders, and attempts to chart the desired course for responsible action within frame-work of Citizen Centered Transparency (CCT) mechanism. This involved analysis of several urban development projects for Indian metropolitans that mainly involved end-user association, and the parameters considered for breaking complexity for assessment included: a. Feedback: Ends-user feedback to improve resource consumption literacy and consequently urban behaviour and sustainable lifestyles(feedback technology, consumption displays, eco-labeling, billing, advisory services, sensor technology), and b. Administrative Traditions and Institutional Policy: Rewarding-punishing to enforce desired action(subsidies, taxation). The research thus answered: 1.Who gets the information whereas who requires it (Equity in Information Distribution)? and 2. How can information translate to responsible action in future (Transparency of Execution)? Findings suggested that, how, by using the CCT innovations it is practically possible to embed responsibilities in urban development planning, and manifesting environmental goals in municipal policies so that they bear clear potential short-term benefits, short-term costs, and have maximum compliance with the objectives of sustainable urban development.
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.
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.
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
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
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
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
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.
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
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.
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...
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…
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.
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.
[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.
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.
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.
Explorations of Public Participation Approach to the Framing of Resilient Urbanism

NASA Astrophysics Data System (ADS)

Liu, Wei-Kuang; Liu, Li-Wei; Shiu, Yi-Shiang; Shen, Yang-Ting; Lin, Feng-Cheng; Hsieh, Hua-Hsuan

2017-08-01

Under the framework of developing resilient and livable cities, this study was aimed at engaging local communities to achieve the goal of public participation. Given the prevalence of smart mobile devices, an interactive app called “Citizen Probe” was designed to guide users to participate in building resilient and livable urban spaces by enabling users to report the condition of their living environment. The app collects feedback from users regarding the perceived condition of the urban environment, and this information is used to further develop an open online index system. The index system serves as a guide for the public to actively transform their city into a resilient and livable urban environment. The app was designed for the reporting of flood incidents with the objective of resilient disaster prevention, which can be achieved by enabling users to identify disaster conditions in order to develop a database for basic disaster information. The database can be used in the prevention and mitigation of disasters and to provide a foundation for developing indices for assessing the resilience and livability of urban areas. Three communities in Taichung, Taiwan, participated in the study. Residents of these communities were requested to use the app and identify local environmental conditions to obtain spatial data according to four stages in disaster response: assessment, readiness, response, and recovery. A volunteered geographic information database was developed to display maps for providing users with current reports of predisaster risk assessment, disaster response capacity, real-time disaster conditions, and overall disaster recovery. In addition, the database can be used as a useful tool for researchers to conduct GIS analyses and initiate related discussions. The interactive app raises public awareness on disaster prevention and makes disaster prevention a daily norm. Further discussion between the public and experts will be initiated to assist in policy management pertaining to the ongoing development of cities in addition to improving disaster prevention and response measures.
Technology and Economics, Inc. Technology Application Team

NASA Technical Reports Server (NTRS)

Ballard, T.; Macfadyen, D. J.

1981-01-01

Technology + Economics, Inc. (T+E), under contract to the NASA Headquarters Technology Transfer Division, operates a Technology Applications Team (TATeam) to assist in the transfer of NASA-developed aerospace technology. T+E's specific areas of interest are selected urban needs at the local, county, and state levels. T+E contacts users and user agencies at the local, state, and county levels to assist in identifying significant urban needs amenable to potential applications of aerospace technology. Once viable urban needs have been identified in this manner, or through independent research, T+E searches the NASA technology database for technology and/or expertise applicable to the problem. Activities currently under way concerning potential aerospace applications are discussed.
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…
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.

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
Towards a framework for geospatial tangible user interfaces in collaborative urban planning

NASA Astrophysics Data System (ADS)

Maquil, Valérie; Leopold, Ulrich; De Sousa, Luís Moreira; Schwartz, Lou; Tobias, Eric

2018-04-01

The increasing complexity of urban planning projects today requires new approaches to better integrate stakeholders with different professional backgrounds throughout a city. Traditional tools used in urban planning are designed for experts and offer little opportunity for participation and collaborative design. This paper introduces the concept of geospatial tangible user interfaces (GTUI) and reports on the design and implementation as well as the usability of such a GTUI to support stakeholder participation in collaborative urban planning. The proposed system uses physical objects to interact with large digital maps and geospatial data projected onto a tabletop. It is implemented using a PostGIS database, a web map server providing OGC web services, the computer vision framework reacTIVision, a Java-based TUIO client, and GeoTools. We describe how a GTUI has be instantiated and evaluated within the scope of two case studies related to real world collaborative urban planning scenarios. Our results confirm the feasibility of our proposed GTUI solutions to (a) instantiate different urban planning scenarios, (b) support collaboration, and (c) ensure an acceptable usability.
Towards a framework for geospatial tangible user interfaces in collaborative urban planning

NASA Astrophysics Data System (ADS)

Maquil, Valérie; Leopold, Ulrich; De Sousa, Luís Moreira; Schwartz, Lou; Tobias, Eric

2018-03-01

The increasing complexity of urban planning projects today requires new approaches to better integrate stakeholders with different professional backgrounds throughout a city. Traditional tools used in urban planning are designed for experts and offer little opportunity for participation and collaborative design. This paper introduces the concept of geospatial tangible user interfaces (GTUI) and reports on the design and implementation as well as the usability of such a GTUI to support stakeholder participation in collaborative urban planning. The proposed system uses physical objects to interact with large digital maps and geospatial data projected onto a tabletop. It is implemented using a PostGIS database, a web map server providing OGC web services, the computer vision framework reacTIVision, a Java-based TUIO client, and GeoTools. We describe how a GTUI has be instantiated and evaluated within the scope of two case studies related to real world collaborative urban planning scenarios. Our results confirm the feasibility of our proposed GTUI solutions to (a) instantiate different urban planning scenarios, (b) support collaboration, and (c) ensure an acceptable usability.
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
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...
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 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.
"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.
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
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.
Education for Healthy Urban Transport.

ERIC Educational Resources Information Center

Ross, Andrew

1996-01-01

Describes the attempts of a bicycle-user group in Brisbane to generate a framework for action to bring about transport change. The framework integrates the theory of ecological public health with the practice of urban environmental education. (DDR)
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.…
Design of Urban Public Spaces: Intent vs. Reality

PubMed Central

Martin, W. Mike; Stewart, Tom; Troelsen, Jens

2018-01-01

This study investigated how two public spaces for sport and recreation were utilized by different user groups, and how this aligned with the initial design objectives for these spaces. Two newly built urban spaces situated in Copenhagen, Denmark, provided the context for this investigation. The System for Observing Play and Recreation in Communities (SOPARC) was used to examine the physical activity of users in these two urban spaces. The architects responsible for designing each space were interviewed to ascertain the intended target group of each space and to unravel the reasons behind the design decisions. The SOPARC observations revealed that males were more vigorously active than females when using the recreation facilities, and the observed users did not align with the intended target groups. The interviews suggested that design decisions were based on minimal interdisciplinary knowledge, and that expert knowledge was chosen randomly. These findings point to a systematic lack of evidence-based practice when designing sport and recreational facilities. This article has implications for landscape architects and urban planners; a new method must be developed to embed interdisciplinary knowledge in the planning process of future sport and recreation projects. This must be done in a systematic way to make the design process transparent. PMID:29690509
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…
The prevalence of traditional herbal medicine use among hypertensives living in South African communities.

PubMed

Hughes, Gail D; Aboyade, Oluwaseyi M; Clark, Bobby L; Puoane, Thandi R

2013-02-18

In South Africa, over 6 million people are hypertensive and the burden of disease shows that cardiovascular diseases (CVDs) are the leading cause of death among adults. Although treatments exist, few people comply or adhere to recommended treatment due to side effects or costs of the drugs, hence the reliance on alternative forms of treatment. Traditional herbal medicines (THM) are used for the management of hypertension but the prevalence of its use among hypertensive patients living in South African communities is not sufficiently known. This was a cross-sectional descriptive study to determine the prevalence of THM use for hypertension, among 135 purposefully selected South African participants of the Prospective Urban and Rural Epidemiological (PURE) study, who are THM users. Data on THM use were collected by way of face to face interviews using structured questionnaires administered by trained field workers. Standard descriptive measures were used to characterize the study sample and responses to the questionnaire. Chi-square test was used when making comparisons between groups. There were 135 THM users, 21% of whom used THM to treat hypertension. Majority (82.1%) of the hypertensive THM users were females, only 29% were married or co-habitating, virtually all (96%) were unemployed and 86% were Christians. More than half (56%) of the respondents were aged between 55 and 64 years. THM was occasionally used (51.9%) as a combination of tea and other mixtures (63%) and prescribed by family/ friends/self-administered. There was a significant difference in the age, marital and employment status, as well as the form and frequency of THM use of hypertensive THM users compared to other THM users. The study gives an insight into the prevalence of THM use by hypertensive patients in selected South African communities. The practice of self-medication was also observed which raises concern regarding the safety of medications taken by the participants. Health care providers should however be more aware of THM use and counsel patients regarding the combination of prescribed treatment regimen and herbal medicines and the potential of herb-drug interactions.
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)
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.
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

Tobacco Smoking and Its Association with Illicit Drug Use among Young Men Aged 15-24 Years Living in Urban Slums of Bangladesh

PubMed Central

Kabir, Mohammad Alamgir; Goh, Kim-Leng; Kamal, Sunny Mohammad Mostafa; Khan, Md. Mobarak Hossain

2013-01-01

Background Tobacco smoking (TS) and illicit drug use (IDU) are of public health concerns especially in developing countries, including Bangladesh. This paper aims to (i) identify the determinants of TS and IDU, and (ii) examine the association of TS with IDU among young slum dwellers in Bangladesh. Methodology/Principal Findings Data on a total of 1,576 young slum dwellers aged 15–24 years were extracted for analysis from the 2006 Urban Health Survey (UHS), which covered a nationally representative sample of 13,819 adult men aged 15–59 years from slums, non-slums and district municipalities of six administrative regions in Bangladesh. Methods used include frequency run, Chi-square test of association and multivariable logistic regression. The overall prevalence of TS in the target group was 42.3%, of which 41.4% smoked cigarettes and 3.1% smoked bidis. The regression model for TS showed that age, marital status, education, duration of living in slums, and those with sexually transmitted infections were significantly (p<0.001 to p<0.05) associated with TS. The overall prevalence of IDU was 9.1%, dominated by those who had drug injections (3.2%), and smoked ganja (2.8%) and tari (1.6%). In the regression model for IDU, the significant (p<0.01 to p<0.10) predictors were education, duration of living in slums, and whether infected by sexually transmitted diseases. The multivariable logistic regression (controlling for other variables) revealed significantly (p<0.001) higher likelihood of IDU (OR = 9.59, 95% CI = 5.81–15.82) among users of any form of TS. The likelihood of IDU increased significantly (p<0.001) with increased use of cigarettes. Conclusions/Significance Certain groups of youth are more vulnerable to TS and IDU. Therefore, tobacco and drug control efforts should target these groups to reduce the consequences of risky lifestyles through information, education and communication (IEC) programs. PMID:23935885
Bioclimatic comfort and the thermal perceptions and preferences of beach tourists

NASA Astrophysics Data System (ADS)

Rutty, Michelle; Scott, Daniel

2015-01-01

The largest market segment of global tourism is coastal tourism, which is strongly dependent on the destination's thermal climate. To date, outdoor bioclimatic comfort assessments have focused exclusively on local residents in open urban areas, making it unclear whether outdoor comfort is perceived differently in non-urban environments or by non-residents (i.e. tourists) with different weather expectations and activity patterns. This study provides needed insight into the perception of outdoor microclimatic conditions in a coastal environment while simultaneously identifying important psychological factors that differentiate tourists from everyday users of urban spaces. Concurrent micrometeorological measurements were taken on several Caribbean beaches in the islands of Barbados, Saint Lucia and Tobago, while a questionnaire survey was used to examine the thermal comfort of subjects ( n = 472). Universal Thermal Climate Index (UTCI) conditions of 32 to 39 °C were recorded, which were perceived as being "slightly warm" or "warm" by respondents. Most beach users (48 to 77 %) would not change the thermal conditions, with some (4 to 15 %) preferring even warmer conditions. Even at UTCI of 39 °C, 62 % of respondents voted for no change to current thermal conditions, with an additional 10 % stating that they would like to feel even warmer. These results indicate that beach users' thermal preferences are up to 18 °C warmer than the preferred thermal conditions identified in existing outdoor bioclimatic studies from urban park settings. This indicates that beach users hold fundamentally different comfort perceptions and preferences compared to people using urban spaces. Statistically significant differences ( p ≤ .05) were also recorded for demographic groups (gender, age) and place of origin (climatic region).
Bioclimatic comfort and the thermal perceptions and preferences of beach tourists.

PubMed

Rutty, Michelle; Scott, Daniel

2015-01-01

The largest market segment of global tourism is coastal tourism, which is strongly dependent on the destination's thermal climate. To date, outdoor bioclimatic comfort assessments have focused exclusively on local residents in open urban areas, making it unclear whether outdoor comfort is perceived differently in non-urban environments or by non-residents (i.e. tourists) with different weather expectations and activity patterns. This study provides needed insight into the perception of outdoor microclimatic conditions in a coastal environment while simultaneously identifying important psychological factors that differentiate tourists from everyday users of urban spaces. Concurrent micrometeorological measurements were taken on several Caribbean beaches in the islands of Barbados, Saint Lucia and Tobago, while a questionnaire survey was used to examine the thermal comfort of subjects (n = 472). Universal Thermal Climate Index (UTCI) conditions of 32 to 39 °C were recorded, which were perceived as being "slightly warm" or "warm" by respondents. Most beach users (48 to 77 %) would not change the thermal conditions, with some (4 to 15 %) preferring even warmer conditions. Even at UTCI of 39 °C, 62 % of respondents voted for no change to current thermal conditions, with an additional 10 % stating that they would like to feel even warmer. These results indicate that beach users' thermal preferences are up to 18 °C warmer than the preferred thermal conditions identified in existing outdoor bioclimatic studies from urban park settings. This indicates that beach users hold fundamentally different comfort perceptions and preferences compared to people using urban spaces. Statistically significant differences (p ≤ .05) were also recorded for demographic groups (gender, age) and place of origin (climatic region).
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…
Consistency of Use and Effectiveness of Household Water Treatment among Indian Households Claiming to Treat Their Water.

PubMed

Rosa, Ghislaine; Clasen, Thomas

2017-07-01

Household water treatment (HWT) can improve drinking water quality and prevent disease if used correctly and consistently by populations at risk. Current international monitoring estimates by the Joint Monitoring Programme for water and sanitation suggest that at least 1.1 billion people practice HWT. These estimates, however, are based on surveys that may overstate the level of consistent use and do not address microbial effectiveness. We sought to assess how HWT is practiced among households identified as HWT users according to these monitoring standards. After a baseline survey (urban: 189 households, rural: 210 households) to identify HWT users, 83 urban and 90 rural households were followed up for 6 weeks. Consistency of reported HWT practices was high in both urban (100%) and rural (93.3%) settings, as was availability of treated water (based on self-report) in all three sampling points (urban: 98.8%, rural: 76.0%). Nevertheless, only 13.7% of urban and 25.8% of rural households identified at baseline as users of adequate HWT had water free of thermotolerant coliforms at all three water sampling points. Our findings raise questions about the value of the data gathered through the international monitoring of HWT as predictors of water quality in the home, as well as questioning the ability of HWT, as actually practiced by vulnerable populations, to reduce exposure to waterborne diseases.
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.
Understanding urban green space as a health resource: a qualitative comparison of visit motivation and derived effects among park users in Sheffield, UK.

PubMed

Irvine, Katherine N; Warber, Sara L; Devine-Wright, Patrick; Gaston, Kevin J

2013-01-22

With increasing interest in the use of urban green space to promote human health, there is a need to understand the extent to which park users conceptualize these places as a resource for health and well-being. This study sought to examine park users' own reasons for and benefits from green space usage and compare these with concepts and constructs in existing person-environment-health theories and models of health. Conducted in 13 public green spaces in Sheffield, UK, we undertook a qualitative content analysis of 312 park users' responses to open-ended interview questions and identified a breadth, depth and salience of visit motivators and derived effects. Findings highlight a discrepancy between reasons for visiting and derived effects from the use of urban green space. Motivations emphasized walking, green space qualities, and children. Derived effects highlighted relaxation, positive emotions within the self and towards the place, and spiritual well-being. We generate a taxonomy of motivations and derived effects that could facilitate operationalization within empirical research and articulate a conceptual framework linking motivators to outcomes for investigating green space as a resource for human health and well-being.
[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.
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
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
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.
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.
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.
IMPROVEMENT OF BUSINESS EFFICIENCY USING A MULTI-AGENT SIMULATION FOR HIGHWAY PATROL ON URBAN EXPRESSWAY

NASA Astrophysics Data System (ADS)

Okamoto, Taro; Taniguchi, Eiichi; Yamada, Tadashi

In Japan, the network of urban expressway has been expanding with the development of urban areas. However, the patrol systems in the urban expressway has not been operated on the basis of scientific evidence, but of conformity and experience. It is therefore crucial to efficiently operate such systems, not only to facilitate the rapid recovery of decreased expressway functionality, but also to acquire the income that supports the operation of privatized expressway companies. Therefore, we develop a multiagent simulation model consisting of the decision-making of four agents, including expressway company, highway patol company, road network users and road authority. These agents determines their schemes depending on their profit obtained. Results of the simulation identyfies the schemes that could offer the profits to the expressway companies in terms of the convenience of the users and the improvement of their operation.
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...
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.
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
Ethnic Identity, Neighborhood Risk, and Adolescent Drug and Sex Attitudes and Refusal Efficacy: The Urban African American Girls' Experience

ERIC Educational Resources Information Center

Corneille, Maya A.; Belgrave, Faye Z.

2007-01-01

This study examined the impact of ethnic identity and neighborhood risk on drug and sex attitudes and refusal efficacy among early adolescent urban African American females (n = 175). The model also predicted a moderating relationship of ethnic identity on neighborhood risk for drug and sex attitudes and refusal efficacy. Data were collected as…
Expanding Urban American Indian Youths' Repertoire of Drug Resistance Skills: Pilot Results from a Culturally Adapted Prevention Program

ERIC Educational Resources Information Center

Kulis, Stephen; Dustman, Patricia A.; Brown, Eddie F.; Martinez, Marcos

2013-01-01

This article examines changes in the drug resistance strategies used by urban American Indian (UAI) middle school students during a pilot test of a substance use prevention curriculum designed specifically for UAI youth, "Living in 2 Worlds" (L2W). L2W teaches four drug resistance strategies (refuse, explain, avoid, leave [R-E-A-L]) in…

Residents and urban greenways: Modeling support for the Atlanta BeltLine

Treesearch

Nathan P. Palardy; B. Bynum Boley; Cassandra Johnson Gaither

2018-01-01

Urban greenways have received significant attention due to their many publicized benefits and costs that make them contentious recreational developments. Most prior studies have approached urban greenways from a demand-side perspective solely focused on their users. This study adds to the literature by taking a supply-side approach to assessing resident attitudes...
'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.
Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India.

PubMed

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-07-01

In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively-with a focus, for example, on rural areas and urban slum areas-in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated.
Strategies for coping with the costs of inpatient care: a mixed methods study of urban and rural poor in Vadodara District, Gujarat, India

PubMed Central

Ranson, Michael Kent; Jayaswal, Rupal; Mills, Anne J

2012-01-01

Background In India, coping mechanisms for inpatient care costs have been explored in rural areas, but seldom among urbanites. This study aims to explore and compare mechanisms employed by the urban and rural poor for coping with inpatient expenditures, in order to help identify formal mechanisms and policies to provide improved social protection for health care. Methods A three-step methodology was used: (1) six focus-group discussions; (2) 800 exit survey interviews with users of public and private facilities in both urban and rural areas; and (3) 18 in-depth interviews with poor (below 30th percentile of socio-economic status) hospital users, to explore coping mechanisms in greater depth. Results Users of public hospitals, in both urban and rural areas, were poor relative to users of private hospitals. Median expenditures per day were much higher at private than at public facilities. Most respondents using public facilities (in both urban and rural areas) were able to pay out of their savings or income; or by borrowing from friends, family or employer. Those using private facilities were more likely to report selling land or other assets as the primary source of coping (particularly in rural areas) and they were more likely to have to borrow money at interest (particularly in urban areas). Poor individuals who used private facilities cited as reasons their closer proximity and higher perceived quality of care. Conclusions In India, national and state governments should invest in improving the quality and access of public first-referral hospitals. This should be done selectively—with a focus, for example, on rural areas and urban slum areas—in order to promote a more equitable distribution of resources. Policy makers should continue to explore and support efforts to provide financial protection through insurance mechanisms. Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and the quality and quantity of health care provided must be monitored and regulated. PMID:21653545
Capture-recapture estimates of drug misuse in urban and non-urban settings in the north east of Scotland.

PubMed

Hay, G

2000-12-01

To estimate the prevalence of opiate or benzodiazepine misuse in the Grampian Health Board area, Scotland and illustrate the use of the capture-recapture method in both rural and urban settings. Capture-recapture analyses on six distinct sources of data with unequal coverage of the geographical area. Grampian Health Board area, including the City of Aberdeen. Data were collated from the Police, Social Work Departments, GPs contributing to the Scottish Drug Misuse Database, statutory drug agencies, a voluntary sector drug agency and a needle/syringe exchange. In total 1770 individuals were identified as misusing opiates or benzodiazepines and residing in the Grampian Health Board area; 1129 individuals were resident in the City of Aberdeen. The total number of opiate or benzodiazepine misusers in the City of Aberdeen was estimated to be 2519 (95% CI 2048-3200). This figure corresponds to 2.0% (1.6-2.5%) of the population aged 15-54 years. In a town to the north of Aberdeenshire where high levels of heroin use had previously been reported in the media, 2.5% of the population aged 15-54 (1.8-3.8%) were estimated to be misusing opiates or benzodiazepines. Although there may be difficulties in applying capture-recapture methods in all settings, the methodology can give valuable information on the extent of drug misuse in both urban and non-urban areas. This information is particularly important to assess the spread of drug misuse from cities to rural areas.
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.
Substance use among high-school students: relationships with temperament, personality traits, and parental care perception.

PubMed

Gerra, G; Angioni, L; Zaimovic, A; Moi, G; Bussandri, M; Bertacca, S; Santoro, G; Gardini, S; Caccavari, R; Nicoli, M A

2004-01-01

Alcohol use, "alcohol abuse," and illicit drug use were investigated in a representative sample of 1076 urban, northern Italian high school students aged 14 to 19 years in 2001. In addition to questions on substance use, the participants were asked about school achievements and perceived substance use among friends. All the students were submitted to Zuckerman Sensation Seeking Scale (SSS) scale, Eysenck Personality Questionnaire (EPQ), Buss-Durkee Hostility Inventory (BDHI), and Parental Bonding Instrument (PBI). Lifetime alcohol use was found in 80.5%, "alcohol abuse" in 37.7%, cannabis use in 26.2%, ecstasy in 2.8%, heroin in 3.8%, and cocaine in 8.3% of the students: gender differences were significant for alcohol use, "alcohol abuse" and ecstasy use, with male subjects outnumbering females, but not for reported cannabis, heroin, and cocaine use. Early substance use onset among adolescents aged 14-16 years was detected. Higher sensation seeking on SSS, social coping impairment on EPQ, direct aggressiveness on BDHI, poor school achievements, and lower parental care on PBI were found associated with illicit drug use and "alcohol abuse" (multiple drugs users). Increased levels of aggressiveness and sensation seeking were evidenced both in minimal experimenters (ME) and habitual users (HU), without any significant difference, in comparison with abstinent students. Similarly, ME scored higher than abstinent subjects on EPQ for social coping impairment, but lower than HU. Parental care perception was lower in HU, but not in ME with, respect to abstinent subjects. Pearson inverse correlation was demonstrated between PBI scores and EPQ maladaptation and BDHI aggressiveness. Data from this preliminary pilot study suggest that temperamental traits and personality changes may be associated to early substance use "proneness" and reduced perception of parental care.
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...
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.
The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater.

PubMed

Banta-Green, Caleb J; Field, Jennifer A; Chiaia, Aurea C; Sudakin, Daniel L; Power, Laura; de Montigny, Luc

2009-11-01

To determine the utility of community-wide drug testing with wastewater samples as a population measure of community drug use and to test the hypothesis that the association with urbanicity would vary for three different stimulant drugs of abuse. Single-day samples were obtained from a convenience sample of 96 municipalities representing 65% of the population of the State of Oregon. Chemical analysis of 24-hour composite influent samples for benzoylecgonine (BZE, a cocaine metabolite), methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA). The distribution of community index drug loads accounting for total wastewater flow (i.e. dilution) and population are reported. The distribution of wastewater-derived drug index loads was found to correspond with expected epidemiological drug patterns. Index loads of BZE were significantly higher in urban areas and below detection in many rural areas. Conversely, methamphetamine was present in all municipalities, with no significant differences in index loads by urbanicity. MDMA was at quantifiable levels in fewer than half the communities, with a significant trend towards higher index loads in more urban areas. CONCLUSION; This demonstration provides the first evidence of the utility of wastewater-derived community drug loads for spatial analyses. Such data have the potential to improve dramatically the measurement of the true level and distribution of a range of drugs. Drug index load data provide information for all people in a community and are potentially applicable to a much larger proportion of the total population than existing measures.
Use of herbal medicine during pregnancy among women with access to public healthcare in Nairobi, Kenya: a cross-sectional survey.

PubMed

Mothupi, Mamothena Carol

2014-11-04

Maternal health is a public health priority in many African countries, but little is known about herbal medicine use in pregnancy. This study aimed to determine the pattern of use of herbal medicine in an urban setting, where women have relatively high access to public healthcare. This cross-sectional study included 333 women attending a childcare clinic in a district public health hospital in Nairobi, Kenya, during January and February, 2012, and who had delivered a baby within the past 9 months. Qualitative and quantitative data on herbal medicine use during their latest pregnancy were collected through an interviewer-administered questionnaire. Data was analysed descriptively and the Chi square test and Fishers' exact test used to analyse relationships among variables. About 12% of women used herbal medicine during their most recent pregnancy. The use of herbal medicine was associated with a lower level of education (p = 0.007) and use before the index pregnancy (p <0.001). Only 12.5% of users disclosed such use to healthcare professionals, and about 20% used herbal medicine concomitantly with Western medicine for the same illness/condition. Women used herbal medicine for back pain, toothache, indigestion and infectious diseases, such as respiratory tract infections and malaria. A proportion of users took herbal medicine only to boost or maintain health. There were high rates of self-prescribing, as well as sourcing from family and friends. Beliefs about safety and efficacy were consistent with patterns of use or non-use, although both users and non-users were unsure about the safety and contraindications of Western medicine during pregnancy compared with that of herbal medicine. Herbal medicine is used by 12% of pregnant women with access to healthcare in an urban context in Kenya, and often occurs without the knowledge of healthcare practitioners. Healthcare professionals should play a role in rational use of both herbal and Western medicine, by discussing contraindications and the potential for drug-herb interactions with patients. More studies are needed into the use of herbal medicines during pregnancy, labour and the postpartum period in different geographical areas, and into the health outcomes associated with their use.
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
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)
Research on water management system based on Android

NASA Astrophysics Data System (ADS)

Li, Dongjiang; Hu, Songlin

2018-04-01

With the rapid development of Smart city, Smart water is an important part of Smart city, which is paid more and more attention. It obtains and deals with urban water information through information technology. It can effectively manage urban water supply, The sale of water and other processes. At the same time, due to the popularity of Smartphones, Smartphone applications have covered every aspect of life and become an indispensable part of people's daily life. Through the Smartphone applications, the user can achieve online mobile water purchase, query the water situation, water quality and other basic situation, greatly facilitate the use of the user, for wisdom water construction is of great significance. In this paper, the water management system based on Android is designed and implemented according to the user's needs. It includes intelligent water meter terminal, monitoring center server, Smartphone application and wireless communication network. The user can use the Smartphone at any time and at any place to view the user's water information in real time providing great convenience for users. So its application prospect is very broad as an important part of smart city.
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.
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.
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.
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
'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.
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.
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.
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…
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…
Impact of HIV prevention programs on drug users in Malaysia.

PubMed

Kamarulzaman, Adeeba

2009-11-01

Faced with a rising HIV epidemic among injecting drug users, harm reduction policies and programs were introduced in Malaysia in 2005. The positive impact seen since the introduction of these programs comprise the inclusion of the health aspects of illicit drug use in the country's drug policies; better access to antiretroviral therapy for injecting drug users who are HIV infected; reduction in HIV-risk behavior; and greater social benefits, including increased employment. Despite these achievements, tension between law enforcement and public health persists, as harm reduction exists alongside an overall drug policy that is based on abstinence and zero tolerance. Unless there is harmonization of this policy, sustainability and scale-up of harm reduction programs will remain a challenge.
Do painkillers serve as "hillbilly heroin" for rural adults with high levels of psychosocial stress?

PubMed

Black, Pamela; Hendy, Helen M

2017-07-05

Nonmedical use of painkillers has increased in recent years, with some authors suggesting that painkillers serve as "hillbilly heroin": a drug chosen by rural adults to cope with psychosocial stresses in their lives. The present study compared rural and urban adults for their reported use of 5 drugs during the past year (painkillers, marijuana, cocaine, methamphetamine, heroin) and for associations between these 5 drugs and their reported psychosocial stressors. This study conducted secondary analyses of anonymous survey data provided by the 2014 National Survey on Drug Use and Health with responses from 8,699 rural and 18,481 urban adults. The survey included demographics (gender, age, race, education, marital status, family income), reports of whether participants had used each of 5 illicit drugs during the past year, and measures of psychological distress and social functioning problems. Controlling for demographics, rural adults showed no greater prevalence of painkiller use than urban adults, but rural adults were more likely than urban adults to use methamphetamine and less likely to use marijuana, cocaine, and heroin. Controlling for demographics, rural adults showed no associations between psychological or social stressors and the use of painkillers, but such stressors were significantly associated with the use of marijuana, methamphetamine, and heroin. Urban adults showed significant associations of psychological and social stressors with the use of painkillers, as well as with the use of marijuana, cocaine, and heroin. Results suggest that painkillers are unlikely to serve as "hillbilly heroin" for rural adults, but they may serve as "big-city heroin" for urban adults.
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.
Drug policy, intravenous drug use, and heroin addiction in the UK.

PubMed

Geraghty, Jemell

In order to fully understand and appreciate today's drug problem in the UK, the foundations of drug legislation and the history of drug evolution require exploration. This paper critically examines the history of drug policy and the growth of heroin addiction from the perspective of a novice researcher who works closely with intravenous drug users in relation to leg ulceration and wound care in the acute setting. Today's drug policy has come a long way in understanding the problems of heroin addiction and establishing services to meet intravenous drug users' needs and the needs of society. This paper highlights the early warning signs of drug addiction and growth within the UK from an early stage with key areas such as who the early users were and how addiction grew so rapidly between 1920 and 1960. Current policy and decision makers as well as clinicians and researchers in this field must understand the impacts of past policy and embed it within their decisions surrounding drug policy today.
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.
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.
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
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.
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.
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.
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.
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.

The application of a Web-geographic information system for improving urban water cycle modelling.

PubMed

Mair, M; Mikovits, C; Sengthaler, M; Schöpf, M; Kinzel, H; Urich, C; Kleidorfer, M; Sitzenfrei, R; Rauch, W

2014-01-01

Research in urban water management has experienced a transition from traditional model applications to modelling water cycles as an integrated part of urban areas. This includes the interlinking of models of many research areas (e.g. urban development, socio-economy, urban water management). The integration and simulation is realized in newly developed frameworks (e.g. DynaMind and OpenMI) and often assumes a high knowledge in programming. This work presents a Web based urban water management modelling platform which simplifies the setup and usage of complex integrated models. The platform is demonstrated with a small application example on a case study within the Alpine region. The used model is a DynaMind model benchmarking the impact of newly connected catchments on the flooding behaviour of an existing combined sewer system. As a result the workflow of the user within a Web browser is demonstrated and benchmark results are shown. The presented platform hides implementation specific aspects behind Web services based technologies such that the user can focus on his main aim, which is urban water management modelling and benchmarking. Moreover, this platform offers a centralized data management, automatic software updates and access to high performance computers accessible with desktop computers and mobile devices.
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
International epidemiology of HIV and AIDS among injecting drug users.

PubMed

Des Jarlais, D C; Friedman, S R; Choopanya, K; Vanichseni, S; Ward, T P

1992-10-01

HIV/AIDS and iv drug use (IVDU) are of significant multinational scope and growing. Supporting increased IVDU in many countries are countries' geographical proximity to illicit drug trafficking distribution routes, law enforcement efforts which increase the demand for more efficient drug distribution and consumption, and countries' infrastructural and social modernization. Given the failures of intensified law enforcement efforts to thwart the use and proliferation of illegal drugs, countries with substantial IVDU should look away from preventing use to preventing HIV transmission within drug user populations. With HIV seroprevalence rates rapidly reaching 40-50% in some developing country IVDU groups, a variety of prevention programs is warranted. Such programs should be supported and implemented while prevention remains feasible. This paper examines the variation in HIV seroprevalence among IVD users, rapid HIV spread among users, HIV among IVDUs in Bangkok, emerging issues in HIV transmission among IVDUs, non-AIDS manifestations of HIV infection among IVDUs, prevention programs and effectiveness, and harm reduction.
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.
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
Rural Adolescents' Nonmedical Prescription Drug Use: Implications for Intervention

ERIC Educational Resources Information Center

Young, April M.; Glover, Natalie; Havens, Jennifer R.

2012-01-01

Rural communities often have distinct contextual factors that impact residents' substance abuse behavior. However, most studies to date have focused either exclusively on urban populations or neglected to analyze data in a way that allows any rural/urban comparison. This is especially true for research examining nonmedical prescription drug use…
HIV/AIDS and African American men: urban-rural differentials in sexual behavior, HIV knowledge, and attitude towards condoms use.

PubMed

Williams, Patrick Bassey; Sallar, Anthony M

2010-12-01

We assessed the differences and similarities in knowledge, attitude, beliefs, myths, and misconceptions; and the various high-risk behavioral factors that influence the rate of infectivity of human immunodeficiency virus (HIV)/AIDS among African American men in urban and rural communities of Mississippi. A cross-sectional sample survey was conducted on 466 African American men in 2 sites between 2005 and 2007. With the main outcome variables of knowledge, attitude/feelings, behavior/practices, and potentials for behavior change, we administered a 64-item, ethnically sensitive, gender-specific instrument to the subjects via a person-to-person interview. Of the 466 respondents (urban, 33%; rural, 67%), 70%, 14.4%, and 16.6%, respectively, were heterosexual, bisexual, and men who have sex with men (MSM). The number of the respondents' sexual partners in the previous 12 months were: 1 to 2 (54%), 3 to 4 (25.7%), and 5 or more (20.2%). Statistically significant differences were observed between the 2 populations on HIV knowledge (p < .001), HIV/sexually transmitted infection testing history (p < .001), sexual partners (p = .038), unprotected sexual intercourse with drug users (p < .001), unprotected casual sex (p < .001), intercourse in an open relationship or marriage (p < .001), and communication with potential sex partners regarding sexual limits prior to intercourse (p = .027). Although the level of HIV/AIDS knowledge and education were lower among urban than rural respondents, subjects' negative overall beliefs, attitude/feelings, behavior and potentials for behavioral change did not differ significantly among the African American men in the 2 communities.
Drugs of abuse in urban groundwater. A case study: Barcelona.

NASA Astrophysics Data System (ADS)

Jurado, A.; Mastroianni, N.; Vazquez-Suñe, E.; Carrera, J.; Tubau, I.; Pujades, E.; Postigo, C.; Lopez de Alda, M.; Barceló, D.

2012-04-01

This study is concerned with drugs of abuse (DAs) and their metabolites in urban groundwater at field scale in relation to (1) the spatial distribution of the groundwater samples, (2) the depth of the groundwater sample, (3) the presence of DAs in recharge sources, and (4) the identification of processes affecting the fate of DAs in groundwater. To this end, urban groundwater samples were collected in the city of Barcelona and a total of 21 drugs were analyzed including cocainics, amphetamine-like compounds, opioids, lysergics and cannabinoids and the prescribed drugs benzodiazepines. Overall, the highest groundwater concentrations and the largest number of detected DAs were found in zones basically recharged by a river that receives large amounts of effluents from waste water treatment plants (WWTPs). In contrast, the urbanized areas yielded not only lower concentrations but also a much smaller number of drugs, which suggests a local origin. In fact, cocaine and its metabolite were dominant in more prosperous neighbourhoods, whereas the cheaper (MDMA) was the dominant DA in poorer districts. Concentrations of DAs estimated mainly from the waste water fraction in groundwater samples were consistently higher than the measured ones, suggesting that DAs undergo removal processes in both reducing and oxidizing conditions.
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.
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
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
Plasmodium falciparum: Differential Selection of Drug Resistance Alleles in Contiguous Urban and Peri-Urban Areas of Brazzaville, Republic of Congo

PubMed Central

Tsumori, Yoko; Ndounga, Mathieu; Sunahara, Toshihiko; Hayashida, Nozomi; Inoue, Megumi; Nakazawa, Shusuke; Casimiro, Prisca; Isozumi, Rie; Uemura, Haruki; Tanabe, Kazuyuki; Kaneko, Osamu; Culleton, Richard

2011-01-01

The African continent is currently experiencing rapid population growth, with rising urbanization increasing the percentage of the population living in large towns and cities. We studied the impact of the degree of urbanization on the population genetics of Plasmodium falciparum in urban and peri-urban areas in and around the city of Brazzaville, Republic of Congo. This field setting, which incorporates local health centers situated in areas of varying urbanization, is of interest as it allows the characterization of malaria parasites from areas where the human, parasite, and mosquito populations are shared, but where differences in the degree of urbanization (leading to dramatic differences in transmission intensity) cause the pattern of malaria transmission to differ greatly. We have investigated how these differences in transmission intensity affect parasite genetic diversity, including the amount of genetic polymorphism in each area, the degree of linkage disequilibrium within the populations, and the prevalence and frequency of drug resistance markers. To determine parasite population structure, heterozygosity and linkage disequilibrium, we typed eight microsatellite markers and performed haplotype analysis of the msp1 gene by PCR. Mutations known to be associated with resistance to the antimalarial drugs chloroquine and pyrimethamine were determined by sequencing the relevant portions of the crt and dhfr genes, respectively. We found that parasite genetic diversity was comparable between the two sites, with high levels of polymorphism being maintained in both areas despite dramatic differences in transmission intensity. Crucially, we found that the frequencies of genetic markers of drug resistance against pyrimethamine and chloroquine differed significantly between the sites, indicative of differing selection pressures in the two areas. PMID:21858115
Injection Drug Users’ Involvement In Drug Economy: Dynamics of Sociometric and Egocentric Social Networks

PubMed Central

Yang, Cui; Latkin, Carl; Muth, Stephen Q.; Rudolph, Abby

2014-01-01

The purpose of this analysis was to examine the effect of social network cohesiveness on drug economy involvement, and to test whether this relationship is mediated by drug support network size in a sample of active injection drug users. Involvement in the drug economy was defined by self-report of participation in at least one of the following activities: selling drugs, holding drugs or money for drugs, providing street security for drug sellers, cutting/packaging/cooking drugs, selling or renting drug paraphernalia (e.g., pipes, tools, rigs), and injecting drugs in others’ veins. The sample consists of 273 active injection drug users in Baltimore, Maryland who reported having injected drugs in the last 6 months and were recruited through either street outreach or by their network members. Egocentric drug support networks were assessed through a social network inventory at baseline. Sociometric networks were built upon the linkages by selected matching characteristics, and k-plex rank was used to characterize the level of cohesiveness of the individual to others in the social network. Although no direct effect was observed, structural equation modeling indicated k-plex rank was indirectly associated with drug economy involvement through drug support network size. These findings suggest the effects of large-scale sociometric networks on injectors’ drug economy involvement may occur through their immediate egocentric networks. Future harm reduction programs for injection drug users (IDUs) should consider providing programs coupled with economic opportunities to those drug users within a cohesive network subgroup. Moreover, individuals with a high connectivity to others in their network may be optimal individuals to train for diffusing HIV prevention messages. PMID:25309015
Places and patterns of drug use in the Scottish dance scene.

PubMed

Forsyth, A J

1996-04-01

Interviews were conducted with 135 participants in the Glasgow dance (rave) scene. Drug use in this group was varied and not merely restricted to drugs associated with dance events, such as MDMA (Ecstasy). The setting in which each drug was used varied greatly. Amphetamine, nitrites and Ecstasy were the drugs most commonly used at dance events. Pharmaceuticals were least likely to be used in such settings. However, some drugs, such as Temazepam, were sometimes used prior to or after attending rave events. It is suggested that dance drug users are polydrug users who use drugs in a setting specific fashion. As such it would be wrong to classify such users solely on the grounds of their very visible behaviour in the public arena (at dance events). Other forms of substance use engaged in by this group may have a greater potential for harm than that seen at raves. The implications of these findings are discussed.
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.
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.
Worldwide Prevalence and Trends in Unintentional Drug Overdose: A Systematic Review of the Literature.

PubMed

Martins, Silvia S; Sampson, Laura; Cerdá, Magdalena; Galea, Sandro

2015-11-01

Drug overdose is an important, yet an inadequately understood, public health problem. Global attention to unintentional drug overdose has been limited by comparison with the scope of the problem. There has been a substantial increase in drug overdose incidence and prevalence in several countries worldwide over the past decade, contributing to both increased costs and mortality. The aim of this study was to systematically synthesize the peer-reviewed literature to document the global epidemiological profile of unintentional drug overdoses and the prevalence, time trends, mortality rates, and correlates of drug overdoses. We searched different combinations of Medical Subject Headings (MeSH) terms in PubMed for articles published from 1980 until July 2013, and we organized these results in tabular spreadsheets and compared them. We restricted the search to English-language articles that deal with unintentional overdose, focusing on 1 or more of the following key constructs: prevalence, time trends, mortality rates, and correlates. The term "overdose" as a MeSH major topic yielded 1076 publications. In addition, we searched the following combinations of nonmajor MeSH terms: "street drugs" and "overdose" yielded 180, "death" and "overdose" yielded 114, and "poisoning" and "drug users" yielded 17. There was some overlap among the searches. Based on the search and inclusion and exclusion criteria, we selected a total of 169 relevant articles for this article based on a close review of abstracts. We found wide variability in lifetime prevalence of experiencing a nonfatal overdose or witnessing an overdose, and in mortality rates attributable to overdose. Lifetime prevalence of witnessed overdose among drug users (n = 17 samples) ranged from 50% to 96%, with a mean of 73.3%, a median of 70%, and a standard deviation of 14.1%. Lifetime prevalence of drug users personally experiencing a nonfatal overdose (n = 27 samples), ranged from 16.6% to 68.0% with a mean of 45.4%, a median of 47%, and a standard deviation of 14.4%. Population-based crude overdose mortality rates (n = 28 samples) ranged from 0.04 to 46.6 per 100 000 person-years. This range is likely attributable to the diversity in regions, time periods, and samples. Most studies on longitudinal trends of overdose death rates or overdose-related hospitalization rates showed increases in overdose death rates and in overdose-related hospitalization rates across time, which have led to peaks in these rates at the present time. An overall trend of increasing deaths from prescription opioid use and decreasing deaths from illicit drug use in the past several years has been noted across most of the literature. With the increase in prescription opioid overdose deaths, drug overdose is not just an urban problem: rural areas have seen an important increase in overdose deaths. Lastly, cocaine, prescription opioids, and heroin are the drugs most commonly associated with unintentional drug overdoses worldwide and the demographic and psychiatric correlates associated with unintentional drug overdoses are similar globally. There is a need to invest in research to understand the distinct determinants of prescription drug overdose worldwide. Several other countries need to collect in a systematic and continuous fashion such data on sales of prescription opioids and other prescription drugs, nonmedical use of prescription drugs, and hospitalization secondary to overdoses on prescription drugs. The sparse evidence on the environmental determinants of overdose suggests a need for research that will inform the types of environmental interventions we can use to prevent drug overdose. Methodological issues for future studies include enhancing data collection methods on unintentional fatal and nonfatal overdoses, and collecting more detailed information on drug use history, source of drug use (for prescription drugs), and demographic and psychiatric history characteristics of the individual who overdosed.

Associations between injection risk and community disadvantage among suburban injection drug users in southwestern Connecticut, USA.

PubMed

Heimer, Robert; Barbour, Russell; Palacios, Wilson R; Nichols, Lisa G; Grau, Lauretta E

2014-03-01

Increases in drug abuse, injection, and opioid overdoses in suburban communities led us to study injectors residing in suburban communities in southwestern Connecticut, US. We sought to understand the influence of residence on risk and injection-associated diseases. Injectors were recruited by respondent-driven sampling and interviewed about sociodemographics, somatic and mental health, injection risk, and interactions with healthcare, harm reduction, substance abuse treatment, and criminal justice systems. HIV, hepatitis B and C (HBV and HCV) serological testing was also conducted. Our sample was consistent in geographic distribution and age to the general population and to the patterns of heroin-associated overdose deaths in the suburban towns. High rates of interaction with drug abuse treatment and criminal justice systems contrasted with scant use of harm reduction services. The only factors associated with both dependent variables-residence in less disadvantaged census tracts and more injection risk-were younger age and injecting in one's own residence. This contrasts with the common association among urban injectors of injection-associated risk behaviors and residence in disadvantaged communities. Poor social support and moderate/severe depression were associated with risky injection practices (but not residence in specific classes of census tracts), suggesting that a region-wide dual diagnosis approach to the expansion of harm reduction services could be effective at reducing the negative consequences of injection drug use.
[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.
Quantitative Authorship Attribution of Users of Mexican Drug Dealing Related Online Forums

ERIC Educational Resources Information Center

Rico Sulayes, Antonio

2012-01-01

As the violence in the Mexican drug war escalates, a proliferation of social media sites about drug trafficking in Mexico was followed by the murder of some of their users, and the eventual disappearance of many of those sites. Despite these events, there still exist a number of drug-dealing related social media outlets in this country with a…
Concepts of illicit drug quality among darknet market users: Purity, embodied experience, craft and chemical knowledge.

PubMed

Bancroft, Angus; Scott Reid, Peter

2016-09-01

Users of darknet markets refer to product quality as one of the motivations for buying drugs there, and vendors present quality as a selling point. However, what users understand by quality and how they evaluate it is not clear. This article investigates how users established and compared drug quality. We used a two-stage method for investigating users' assessments. The user forum of a darknet market that we called 'Merkat' was analysed to develop emergent themes. Qualitative interviews with darknet users were conducted, then forum data was analysed again. To enhance the applicability of the findings, the forum was sampled for users who presented as dependent as well as recreational. Quality could mean reliability, purity, potency, and predictability of effect. We focused on the different kinds of knowledge users drew on to assess quality. These were: embodied; craft; and chemical. Users' evaluations of quality depended on their experience, the purpose of use, and its context. Market forums are a case of indigenous harm reduction where users share advise and experiences and can be usefully engaged with on these terms. Copyright © 2015 Elsevier B.V. All rights reserved.
Implicit processing of heroin and emotional cues in abstinent heroin users: early and late event-related potential effects.

PubMed

Yang, Ling; Zhang, Jianxun; Zhao, Xin

2015-05-01

The abnormal cognitive processing of drug cues is a core characteristic of drug dependence. Previous research has suggested that the late positive potential (LPP) of heroin users is increased by heroin-related stimuli because of the attention-grabbing nature of such stimuli. The present research used a modified emotional Stroop (eStroop) task to examine whether there was an early posterior negativity (EPN) modulation to heroin cues compared with emotional or neutral stimuli in heroin dependent subjects. Fifteen former heroin users and 15 matched controls performed the eStroop task, which was composed of positive, negative, heroin-related, and neutral pictures with superimposed color squares. Participants responded to the color of the square and not to the picture while behavioral data and event-related potentials were recorded. There were no significant differences of EPN amplitudes to emotional and neutral stimuli between heroin users and controls. However, heroin users displayed increased EPN modulation for heroin cues, whereas this modulation was absent in controls. Drug-related cues acquire motivational salience and automatically capture the attention of heroin users at early processing stages, even when engaged in a non-drug-related task. The EPN to heroin cues could represent a novel electrophysiological index with clinical implications for selecting abstinent drug users who are at increased risk of relapse or to evaluate treatment interventions.
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.
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
Assessment of the Crashworthiness of Existing Urban Rail Vehicles. Volume 3. Train-Collision Model Users Manual.

DOT National Transportation Integrated Search

1975-11-01

The crashworthiness of existing urban rail vehicles (passenger cars) and the feasibility of improvements in this area were investigated. Both rail-car structural configurations and impact absorption devices were studied. This final report issued unde...
UPDATE ON EPA'S URBAN WATERSHED MANAGEMENT BRANCH MODELING ACTIVITIES

EPA Science Inventory

This paper provides the Stormwater Management Model (SWMM) user community with a description of the Environmental Protection Agency (EPA's) Office of Research and Development (ORD) approach to urban watershed modeling research and provides an update on current ORD SWMM-related pr...
Low Striatal Dopamine D2-type Receptor Availability is Linked to Simulated Drug Choice in Methamphetamine Users.

PubMed

Moeller, Scott J; Okita, Kyoji; Robertson, Chelsea L; Ballard, Michael E; Konova, Anna B; Goldstein, Rita Z; Mandelkern, Mark A; London, Edythe D

2018-03-01

Individuals with drug use disorders seek drugs over other rewarding activities, and exhibit neurochemical deficits related to dopamine, which is involved in value-based learning and decision-making. Thus, a dopaminergic disturbance may underpin drug-biased choice in addiction. Classical drug-choice assessments, which offer drug-consumption opportunities, are inappropriate for addicted individuals seeking treatment or abstaining. Fifteen recently abstinent methamphetamine users and 15 healthy controls completed two laboratory paradigms of 'simulated' drug choice (choice for drug-related vs affectively pleasant, unpleasant, and neutral images), and underwent positron emission tomography measurements of dopamine D2-type receptor availability, indicated by binding potential (BP ND ) for [ 18 F]fallypride. Thirteen of the methamphetamine users and 10 controls also underwent [ 11 C]NNC112 PET scans to measure dopamine D1-type receptor availability. Group analyses showed that, compared with controls, methamphetamine users chose to view more methamphetamine-related images on one task, with a similar trend on the second task. Regression analyses showed that, on both tasks, the more methamphetamine users chose to view methamphetamine images, specifically vs pleasant images (the most frequently chosen images across all participants), the lower was their D2-type BP ND in the lateral orbitofrontal cortex, an important region in value-based choice. No associations were observed with D2-type BP ND in striatal regions, or with D1-type BP ND in any region. These results identify a neurochemical correlate for a laboratory drug-seeking paradigm that can be administered to treatment-seeking and abstaining drug-addicted individuals. More broadly, these results refine the central hypothesis that dopamine-system deficits contribute to drug-biased decision-making in addiction, here showing a role for the orbitofrontal cortex.
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
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.
The Marihuana Dilemma: Challenge to Commanders.

DTIC Science & Technology

The marihuana dilemma poses a major challenge to commanders in the US Army today. The problem was analyzed as to the characteristics of the drug...available to commanders to meet the challenge. The essay concludes that marihuana should not be legalized; drug users or former drug users should not be
76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

...] Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration, HHS. ACTION... information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to achieve... Information Technology Plan.'' This plan will meet one of the performance goals agreed to under the 2007...
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
Predictors of incident and recurrent participation in the sale or delivery of drugs for profit amongst young methamphetamine users in Chiang Mai Province, Thailand, 2005-2006.

PubMed

Latimore, Amanda D; Rudolph, Abby; German, Danielle; Sherman, Susan G; Srirojn, Bangorn; Aramrattana, Apinun; Celentano, David D

2011-07-01

Despite Thailand's war on drugs, methamphetamine ("yaba" in Thai) use and the drug economy both thrive. This analysis identifies predictors of incident and recurrent involvement in the sale or delivery of drugs for profit amongst young Thai yaba users. Between April 2005 and June 2006, 983 yaba users, ages 18-25, were enrolled in a randomized behavioural intervention in Chiang Mai Province (415 index and 568 of their drug network members). Questionnaires administered at baseline, 3-, 6-, 9-, and 12-month follow-up visits assessed socio-demographic factors, current and prior drug use, social network characteristics, sexual risk behaviours and drug use norms. Exposures were lagged by three months (prior visit). Outcomes included incident and recurrent drug economy involvement. Generalized linear mixed models were fit using GLIMMIX (SASv9.1). Incident drug economy involvement was predicted by yaba use frequency (adjusted odds ratio [AOR]: 1.05; 95% confidence interval [CI]: 1.01, 1.10), recent incarceration (AOR: 2.37; 95% CI: 1.07, 5.25) and the proportion of yaba-using networks who quit recently (AOR: .34; 95% CI: .15, .78). Recurrent drug economy involvement was predicted by age (AOR: 0.81; 95% CI: 0.68, 0.96), frequency of yaba use (AOR: 1.06; 95% CI: 1.02, 1.09), drug economy involvement at the previous visit (AOR: 2.61; CI: 1.59, 4.28), incarceration in the prior three months (AOR: 2.29; 95% CI: 1.07, 4.86), and the proportion of yaba-users in his/her network who quit recently (AOR: .38; 95% CI: .20, .71). Individual drug use, drug use in social networks and recent incarceration were predictors of incident and recurrent involvement in the drug economy. These results suggest that interrupting drug use and/or minimizing the influence of drug-using networks may help prevent further involvement in the drug economy. The emergence of recent incarceration as a predictor for both models highlights the need for more appropriate drug rehabilitation programmes and demonstrates that continued criminalization of drug users may fuel Thailand's yaba epidemic. Copyright © 2011 Elsevier B.V. All rights reserved.
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

Children of female sex workers and drug users: a review of vulnerability, resilience and family-centred models of care.

PubMed

Beard, Jennifer; Biemba, Godfrey; Brooks, Mohamad I; Costello, Jill; Ommerborn, Mark; Bresnahan, Megan; Flynn, David; Simon, Jonathon L

2010-06-23

Injection drug users and female sex workers are two of the populations most at risk for becoming infected with HIV in countries with concentrated epidemics. Many of the adults who fall into these categories are also parents, but little is known about the vulnerabilities faced by their children, their children's sources of resilience, or programmes providing services to these often fragile families. This review synthesizes evidence from disparate sources describing the vulnerabilities and resilience of the children of female sex workers and drug users, and documents some models of care that have been put in place to assist them. A large literature assessing the vulnerability and resilience of children of drug users and alcoholics in developed countries was found. Research on the situation of the children of sex workers is extremely limited. Children of drug users and sex workers can face unique risks, stigma and discrimination, but both child vulnerability and resilience are associated in the drug use literature with the physical and mental health of parents and family context. Family-centred interventions have been implemented in low- and middle-income contexts, but they tend to be small, piecemeal and struggling to meet demand; they are poorly documented, and most have not been formally evaluated. We present preliminary descriptive data from an organization working with pregnant and new mothers who are drug users in Ukraine and from an organization providing services to sex workers and their families in Zambia. Because parents' drug use or sex work is often illegal and hidden, identifying their children can be difficult and may increase children's vulnerability and marginalization. Researchers and service providers, therefore, need to proceed with caution when attempting to reach these populations, but documentation and evaluation of current programmes should be prioritized.
ARTVAL user guide : user guide for the ARTerial eVALuation computational engine.

DOT National Transportation Integrated Search

2015-06-01

This document provides guidance on the use of the ARTVAL (Arterial Evaluation) computational : engine. The engine implements the Quick Estimation Method for Urban Streets (QEM-US) : described in Highway Capacity Manual (HCM2010) as the core computati...
An Appreciative Inquiry into an Urban Drug Court: Cultural Transformation

ERIC Educational Resources Information Center

Calabrese, Raymond; Cohen, Erik

2013-01-01

The purpose of this study was to use an appreciative inquiry (AI) theoretical research perspective and change methodology to transform the working relationships and cultural expectations of members through the discovery of their positive core leading to an optimistic and confidence-based future for an urban drug court. This study describes how…
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
Illicit and prescription drug problems among urban Aboriginal adults in Canada: the role of traditional culture in protection and resilience.

PubMed

Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul

2013-07-01

Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. Mainstream acculturation was also examined. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Associations were analysed using two sets of bootstrapped linear regression models adjusted for confounders with continuous illicit and prescription drug problem scores as outcomes. Psychological mechanisms that may explain why traditional culture is protective for Aboriginal peoples were examined using the cross-products of coefficients mediation method. The extent to which culture served as a resilience factor was examined via interaction testing. Results indicate Aboriginal enculturation was a protective factor associated with reduced 12-month illicit drug problems and 12-month prescription drug problems among Aboriginal adults in an urban setting. Increased self-esteem partially explained why cultural participation was protective. Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal cultural practices and beliefs may promote and protect Aboriginal health in an urban environment. Copyright © 2013 Elsevier Ltd. All rights reserved.
Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia.

PubMed

Bryant, Joanne; Ward, James; Wand, Handan; Byron, Kat; Bamblett, Andrew; Waples-Crowe, Peter; Betts, Sarah; Coburn, Tony; Delaney-Thiele, Dea; Worth, Heather; Kaldor, John; Pitts, Marian

2016-07-01

To examine patterns of illicit drug use among Australian Indigenous young people, identify correlates of frequent use separately in urban, regional and remote settings and characterise those who inject. Cross-sectional design at 40 Indigenous events. Self-complete surveys were administered to Indigenous people aged 16-29 years using mobile devices. 2,877 participants completed the survey. One in five reported using cannabis at least weekly in the previous year, but the use of other drugs was less prevalent. Patterns of drug use were largely similar across regions, although more participants in urban and regional areas reported using ecstasy (12% vs 11% vs 5%) and cocaine (6% vs 3% vs 1%) and more reported weekly cannabis use (18% vs 22% vs 14%). Injecting was rare (3%) but those who did inject reported a high incidence of needle sharing (37%). Methamphetamine (37%), heroin (36%) and methadone (26%) were the most commonly injected drugs, and injecting was related to prison experience (AOR 5.3 95% CI 2.8-10.0). Attention is needed in relation to cannabis use, particularly among those Indigenous young people living in regional and urban settings. Also, although injecting is uncommon, it is associated with prison involvement. Priority must be given to reducing the numbers of Indigenous youth entering justice settings, delaying the age at first entry to justice settings, and reducing the risk of BBV acquisition while in custody through, for example, prison-based NSP, BBV education, and Indigenous-specific treatment that emphasises connection to country and culture. [Bryant J, Ward J, Wand H, Byron K, Bamblett A, Waples-Crowe P, Betts S, Coburn T, Delaney-Thiele D, Worth H, Kaldor J, Pitts M. Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug Alcohol Rev 2016;35:447-455]. © 2015 Australasian Professional Society on Alcohol and other Drugs.
Factors associated with drug use among male motorbike taxi drivers in urban Vietnam.

PubMed

Nguyen, Huy Van; Vu, Thinh Toan; Pham, Ha Nguyen

2014-08-01

A cross-sectional study was conducted on a sample of 291 male motorbike taxi drivers (MMTDs) recruited through social mapping technique in Hanoi, Vietnam, for face-to-face interviews to examine factors associated with drug use among MMTDs using Information-Motivation-Behavioral skills (IMB) model. Among 291 MMTDs, 17.18% reported drug use sometime in their lives, 96% of whom were drug injectors. Being depressed, being originally borne in urban cities, currently residing in rural areas, having a longer time living apart from their wives/lovers, using alcohol, following Buddhism, and reporting lower motivation of HIV prevention predict significantly higher odds of uptaking drugs.
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
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.
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.
Drug use and social control: The negotiation of moral ambivalence.

PubMed

Shiner, Michael; Winstock, Adam

2015-08-01

Illicit drugs occupy an ambivalent position in late modern society; one that revolves around the twin themes of pleasure and disapproval. Drawing on Freudian psychoanalysis and Eliasian sociology this article considers how people, particularly those who use drugs, negotiate such ambivalence. Patterns of drug use and associated attitudes are examined on the basis of the Crime Survey for England and Wales and a specialist survey of largely recreational drug users in the United Kingdom. Although illicit drugs have become increasingly familiar, their use is still widely thought to be harmful and morally dubious, creating a series of challenges for those who engage in such behaviour. Ambivalence among drug users is evident in an awareness of potential costs as well as benefits; a tendency to avoid more harmful substances; a general emphasis on moderation; and a desire to use less. Building on previous work, which highlights the role of neutralisations in sustaining drug using behaviour, particular attention is paid to users' judgements about how their levels of consumption compare with other users. The analysis identifies a tendency among users to downplay their relative levels of use, which, it is argued, serves to shield them from some of the imperatives that may lead to decisions to cut down. As such, normalisation is said to be an intra-personal as well inter-personal process. The article concludes by discussing the potential of web-based personalised feedback as a harm reduction approach. Copyright © 2015 Elsevier Ltd. All rights reserved.
Building and evaluating sensor-based Citizens' Observatories for improving quality of life in cities

NASA Astrophysics Data System (ADS)

Castell, Nuria; Lahoz, William; Schneider, Philipp; Høiskar, Britt Ann; Grossberndt, Sonja; Naderer, Clemens; Robinson, Johanna; Kocman, David; Horvat, Milena; Bartonova, Alena

2014-05-01

Urban air quality, the environmental quality of public spaces and indoor areas such as schools, are areas of great concern to citizens and policymakers. However, access to information addressing these areas is not always available in a user-friendly manner. In particular, the quality and quantity of this information is not consistent across these areas, and does not reflect differences in needs among users. The EU-funded CITI-SENSE project will build on the concept of the Citizens' Observatories to empower citizens to contribute to and participate in environmental governance, and enable them to support and influence decision making by policymakers. To achieve this goal, CITI-SENSE will develop, test, demonstrate and validate a community-based environmental monitoring and information system using low-cost sensors and Earth Observation applications. Key to achieving this goal is the chain "sensors-platforms-products-users" linking providers of technology to users: (i) technologies for distributed monitoring (sensors); (ii) information and communication technologies (platform); (iii) information products and services (products); (iv) and citizen involvement in both monitoring and societal decisions (users). The CITI-SENSE observatories cover three empowerment initiatives: urban air quality; public spaces; and school indoor quality. The empowerment initiatives are being performed at nine locations across Europe. Each location has adapted the generic case study to their local circumstances and has contacted the urban stakeholders needed to run the study. The empowerment initiatives are divided into two phases: a first phase (Pilot Study), and a second phase (Full Implementation). The main goal of the Pilot Study is to test and evaluate the chain "sensors-platform-products-users". To assess the results of the empowerment initiatives, key performance indicators (KPIs) are being developed; these include questionnaires for users. The KPIs will be used to design the full implementation phase of the project. First results from the Pilot Study will be presented for three participating cities: Ljubljana (Slovenia), Vienna (Austria) and Oslo (Norway), which differ in size, environmental conditions and social perception on local air quality. Ljubljana and Oslo empowerment initiatives include urban air quality, and school indoor air quality, while Vienna only includes urban air quality. For the area of urban air quality, the three cities will deploy a wireless network of five static sensor nodes and distribute five personal sensors among people to be carried while performing daily activities in the pilot study. The data will be accessible to users through mobile phones, web services and other devices. For the full implementation phase the sensor network will comprise a total of 20 to 40 static nodes, depending on the size of the city, and 20 personal nodes. For the school indoor air quality three sensors will be allocated inside the school and one outside. The data will be visible provided in school classrooms giving the students a unique and innovative approach to learn about air quality by being involved. Acknowledgements: CITI-SENSE is a Collaborative Project partly funded by the EU FP7-ENV-2012 under grant agreement no 308524. www.citi-sense.eu.
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.
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.
49 CFR 40.159 - What does the MRO do when a drug test result is invalid?

Code of Federal Regulations, 2010 CFR

2010-10-01

....160 for determining if there is clinical evidence that the individual is an illicit drug user. (5) If... is clinical evidence that the individual is an illicit drug user. (5) If the recollection was not... 49 Transportation 1 2010-10-01 2010-10-01 false What does the MRO do when a drug test result is...
Improving the roadside environment through integrating air quality and traffic-related data.

DOT National Transportation Integrated Search

2016-12-01

Urban arterial corridors are landscapes that give rise to short and long-term : exposures to transportation-related pollution. With high traffic volumes, congestion, and : a wide mix of road users and land uses at the road edge, urban arterial enviro...
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 u-Service Model Based on a Smart Phone for Urban Computing Environments

NASA Astrophysics Data System (ADS)

Cho, Yongyun; Yoe, Hyun

In urban computing environments, all of services should be based on the interaction between humans and environments around them, which frequently and ordinarily in home and office. This paper propose an u-service model based on a smart phone for urban computing environments. The suggested service model includes a context-aware and personalized service scenario development environment that can instantly describe user's u-service demand or situation information with smart devices. To do this, the architecture of the suggested service model consists of a graphical service editing environment for smart devices, an u-service platform, and an infrastructure with sensors and WSN/USN. The graphic editor expresses contexts as execution conditions of a new service through a context model based on ontology. The service platform deals with the service scenario according to contexts. With the suggested service model, an user in urban computing environments can quickly and easily make u-service or new service using smart devices.
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.
Urban users of wildland areas as forest fire risks

Treesearch

William S. Folkman

1979-01-01

A telephone survey of 1500 households in metropolitan Los Angeles and San Francisco was made to (1) determine extent of wildland use by residents of the two metropolitan areas, reasons for non-use, and the characteristics of users; (2) describe and analyze activities, knowledge, and attitudes of users which may contribute to their fire risk; and (3) assess selected...

A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China.

PubMed

Qi, Chang; Kelly, Brian C; Liao, Yanhui; He, Haoyu; Luo, Tao; Deng, Huiqiong; Liu, Tieqiao; Hao, Wei; Wang, Jichuan

2015-03-01

Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target. A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC). Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status. Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Problem drug use the public health imperative: what some of the literature says.

PubMed

Bevan, Gez

2009-12-16

With more than 200,000 problem drug users is contact with structured treatment services in England the public health imperative behind drug treatment is great. Problem drug use for many is a chronic and relapsing condition, where "cure" is often neither a reasonable or appropriate expectation and it can further be argued that in these circumstances problem drug use is no different from any number of chronic and enduring health conditions that are managed in the health care system and therefore should be conceptualised as such. A public health approach to drug treatment emphasises the need for drug users in or accessing treatment, to reduce their harmful drug use, reduce drug use related risks such as sepsis and overdose and stay alive for longer. However a public health perspective in relation to problem drug use isn't always either apparent or readily understood and to that end there is still a significant need to continue the arguments and debate that treatment and interventions for problem and dependent drug users need to extend beyond an individualistic approach. For the purposes of discussion in this article public and population health will be used interchangeably. A recognition and acceptance that a public and population health approach to the management of problem drug users is sound public health policy also then requires a long term commitment in terms of staffing and resources where service delivery mirrors that of chronic condition management.
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
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 Â© 2016 Elsevier Ltd. All rights reserved.
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.
Impacts of a Temporary Urban Pop-Up Park on Physical Activity and Other Individual- and Community-Level Outcomes.

PubMed

Salvo, Deborah; Banda, Jorge A; Sheats, Jylana L; Winter, Sandra J; Lopes Dos Santos, Daniela; King, Abby C

2017-08-01

Physical inactivity is a known risk factor for obesity and a number of chronic diseases. Modifying the physical features of neighborhoods to provide residents with equitable and convenient access to spaces for physical activity (PA) is a promising strategy for promoting PA. Public urban recreation spaces (e.g., parks) play an important role in promoting PA and are potentially an important neighborhood element for optimizing social capital and liveability in cities. Most studies examining the effects of park availability and use on PA have focused on traditional, permanent parks. The aims of this study were to (1) document patterns of park use and park-based PA at a temporary urban pop-up park implemented in the downtown business district of Los Altos, California during July-August 2013 and May-June 2014, (2) identify factors associated with park-based PA in 2014, and (3) examine the effects of the 2014 pop-up park on additional outcomes of potential benefit for park users and the Los Altos community at large. Park use remained high during most hours of the day in 2013 and 2014. Although the park attracted a multigenerational group of users, children and adolescents were most likely to engage in walking or more vigorous PA at the park. Park presence was significantly associated with potentially beneficial changes in time-allocation patterns among users, including a reduction in screen-time and an increase in overall park-time and time spent outdoors. Park implementation resulted in notable use among people who would otherwise not be spending time at a park (85% of surveyed users would not be spending time at any other park if the pop-up park was not there-2014 data analysis). Our results (significantly higher odds of spending time in downtown Los Altos due to park presence) suggest that urban pop-up parks may also have broader community benefits, such as attracting people to visit downtown business districts. Pending larger, confirmatory studies, our results suggest that temporary urban pop-up parks may contribute to solving the limited access to public physical activity recreation spaces many urban residents face.
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.
Cotton Fever: A Condition Self-Diagnosed by IV Drug Users.

PubMed

Zerr, Ashley Michelle; Ku, Kimberly; Kara, Areeba

2016-01-01

The presentation of fever in an intravenous drug user prompts diagnostic testing targeted at identifying infectious etiologies. However, an alternate diagnosis exists in "cotton fever." While few reports describe this phenomenon in the peer-reviewed literature, the diagnosis is well recognized among the intravenous drug user community. Although its etiology is not well understood, cotton fever seems to be a self-limited, febrile response to the intravenous administration of a drug filtered through cotton. Educating clinicians regarding cotton fever may limit unnecessary hospital admissions and improve our ability to care for this population. © Copyright 2016 by the American Board of Family Medicine.
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.
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).
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.
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
Heroin shortage in Coastal Kenya: A rapid assessment and qualitative analysis of heroin users' experiences.

PubMed

Mital, Sasha; Miles, Gillian; McLellan-Lemal, Eleanor; Muthui, Mercy; Needle, Richard

2016-04-01

While relatively rare events, abrupt disruptions in heroin availability have a significant impact on morbidity and mortality risk among those who are heroin dependent. A heroin shortage occurred in Coast Province, Kenya from December 2010 to March 2011. This qualitative analysis describes the shortage events and consequences from the perspective of heroin users, along with implications for health and other public sectors. As part of a rapid assessment, 66 key informant interviews and 15 focus groups among heroin users in Coast Province, Kenya were conducted. A qualitative thematic analysis was undertaken in Atlas.ti. to identify salient themes related to the shortage. Overall, participant accounts were rooted in a theme of desperation and uncertainty, with emphasis on six sub-themes: (1) withdrawal and strategies for alleviating withdrawal, including use of medical intervention and other detoxification attempts; (2) challenges of dealing with unpredictable drug availability, cost, and purity; (3) changes in drug use patterns, and actions taken to procure heroin and other drugs; (4) modifications in drug user relationship dynamics and networks, including introduction of risky group-level injection practices; (5) family and community response; and (6) new challenges with the heroin market resurgence. The heroin shortage led to a series of consequences for drug users, including increased risk of morbidity, mortality and disenfranchisement at social and structural levels. Availability of evidence-based services for drug users and emergency preparedness plans could have mitigated this impact. Published by Elsevier B.V.
[Drug information for patients (Package Leaflets), and user testing in EU].

PubMed

Yamamoto, Michiko; Doi, Hirohisa; Furukawa, Aya

2015-01-01

Patients and consumers have desired high quality drug information in their pharmacotherapy, and are entitled to receive it. It is desirable that the information should be aimed at shared decision-making between patients and healthcare professionals about medications. The quality of drug information available to patients should also be assured. With an aim to improve the quality of "Drug Guide for Patients", we investigated Patient Information Leaflets (PILs) which are approved by the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom (UK) with regard to the criteria of development and user testing for assuring the quality of the PILs. In the European Union (EU), these are called Package Leaflets (PLs). PILs have been a legal requirement in the UK since 1999 for all medications. The user testing of PILs has been implemented as evidence since 2005 so that people can rely on the information provided in the leaflet. Execution of PILs which follow the guidance of the user testing, according to the guidance of this user testing, would reflect the views of patients. Here, we introduce the development process and implementation of user testing of PILs. In terms of readability, accessibility and understandability of drug information for patients, we need to discuss involving the public in decisions on how its quality should be assured and how it can be made easily be comprehensible for patients, in order to make effective use of "Drug Guide for Patients" in the future in Japan.
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.
75 FR 53702 - Medical Device User Fee Act; Public Meeting; Request for Comments; Amendment of Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. 2010-N-0389] Medical Device User Fee Act; Public Meeting; Request for Comments; Amendment of Notice AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing...
78 FR 46970 - Medical Device User Fee Rates for Fiscal Year 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

...] Medical Device User Fee Rates for Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS. ACTION... procedures for medical device user fees for fiscal year (FY) 2014. The Federal Food, Drug, and Cosmetic Act.... The FY 2014 fee rates are provided in this document. These fees apply from October 1, 2013, through...
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.
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.

Social sensing of urban land use based on analysis of Twitter users’ mobility patterns

PubMed Central

Soltani, Kiumars; Yin, Junjun; Padmanabhan, Anand; Wang, Shaowen

2017-01-01

A number of recent studies showed that digital footprints around built environments, such as geo-located tweets, are promising data sources for characterizing urban land use. However, challenges for achieving this purpose exist due to the volume and unstructured nature of geo-located social media. Previous studies focused on analyzing Twitter data collectively resulting in coarse resolution maps of urban land use. We argue that the complex spatial structure of a large collection of tweets, when viewed through the lens of individual-level human mobility patterns, can be simplified to a series of key locations for each user, which could be used to characterize urban land use at a higher spatial resolution. Contingent issues that could affect our approach, such as Twitter users’ biases and tendencies at locations where they tweet the most, were systematically investigated using 39 million geo-located Tweets and two independent datasets of the City of Chicago: 1) travel survey and 2) parcel-level land use map. Our results support that the majority of Twitter users show a preferential return, where their digital traces are clustered around a few key locations. However, we did not find a general relation among users between the ranks of locations for an individual—based on the density of tweets—and their land use types. On the contrary, temporal patterns of tweeting at key locations were found to be coherent among the majority of users and significantly associated with land use types of these locations. Furthermore, we used these temporal patterns to classify key locations into generic land use types with an overall classification accuracy of 0.78. The contribution of our research is twofold: a novel approach to resolving land use types at a higher resolution, and in-depth understanding of Twitter users’ location-related and temporal biases, promising to benefit human mobility and urban studies in general. PMID:28723936
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.
Exploring motivations to stop injecting in English prisons: qualitative research with former male prisoners.

PubMed

Tompkins, Charlotte N E

2013-01-01

This paper aims to explore the cessation of injecting amongst male drug users when in prison in England and uncovers what influenced this behaviour and why. Qualitative interviews were conducted with 30 male drug users on release from prison to explore what happened to their injecting drug use in prison. The research was conducted from a pragmatic harm reduction approach using grounded theory. Not injecting in prison was identified as a pertinent finding and nine overarching themes accounted for this decline. The themes often overlapped with one another, highlighting how the decision not to inject when last in prison was multi-factorial. Running throughout the themes were participants' concerns regarding the health and social risks attributed to injecting in prison, alongside an appreciation of some of the rehabilitative measures and opportunities offered to injecting drug users when in prison. This qualitative research offers an updated perspective on illicit drug injecting in prison in England from the view of drug users since health and prison policy changes in prescribing and practice. It contributes to evidence suggesting that prisons can be used as a time of reprieve and recovery from injecting drug use.
Predisposition to and effects of methamphetamine use on the adolescent brain

PubMed Central

Lyoo, IK; Yoon, S; Kim, TS; Lim, SM; Choi, Y; Kim, JE; Hwang, J; Jeong, HS; Cho, HB; Chung, YA; Renshaw, PF

2017-01-01

Adolescence is a period of heightened vulnerability both to addictive behaviors and drug-induced brain damage. Yet, only limited information exists on the brain mechanisms underlying these adolescent-specific characteristics. Moreover, distinctions in brain correlates between predisposition to drug use and effects of drugs in adolescents are unclear. Using cortical thickness and diffusion tensor image analyses, we found greater and more widespread gray and white matter alterations, particularly affecting the frontostriatal system, in adolescent methamphetamine (MA) users compared with adult users. Among adolescent-specific gray matter alterations related to MA use, smaller cortical thickness in the orbitofrontal cortex was associated with family history of drug use. Our findings highlight that the adolescent brain, which undergoes active myelination and maturation, is more vulnerable to MA-related alterations than the adult brain. Furthermore, MA-use-related executive dysfunction was greater in adolescent MA users than in adult users. These findings may provide explanation for the severe behavioral complications and relapses that are common in adolescent-onset drug addiction. Additionally, these results may provide insights into distinguishing the neural mechanisms that underlie the predisposition to drug addiction from effects of drugs in adolescents. PMID:25666756
Predisposition to and effects of methamphetamine use on the adolescent brain.

PubMed

Lyoo, I K; Yoon, S; Kim, T S; Lim, S M; Choi, Y; Kim, J E; Hwang, J; Jeong, H S; Cho, H B; Chung, Y A; Renshaw, P F

2015-12-01

Adolescence is a period of heightened vulnerability both to addictive behaviors and drug-induced brain damage. Yet, only limited information exists on the brain mechanisms underlying these adolescent-specific characteristics. Moreover, distinctions in brain correlates between predisposition to drug use and effects of drugs in adolescents are unclear. Using cortical thickness and diffusion tensor image analyses, we found greater and more widespread gray and white matter alterations, particularly affecting the frontostriatal system, in adolescent methamphetamine (MA) users compared with adult users. Among adolescent-specific gray matter alterations related to MA use, smaller cortical thickness in the orbitofrontal cortex was associated with family history of drug use. Our findings highlight that the adolescent brain, which undergoes active myelination and maturation, is more vulnerable to MA-related alterations than the adult brain. Furthermore, MA-use-related executive dysfunction was greater in adolescent MA users than in adult users. These findings may provide explanation for the severe behavioral complications and relapses that are common in adolescent-onset drug addiction. Additionally, these results may provide insights into distinguishing the neural mechanisms that underlie the predisposition to drug addiction from effects of drugs in adolescents.
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.
[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.
"Damaging what wasn't damaged already": psychological tension and antiretroviral adherence among HIV-infected methadone-maintained drug users.

PubMed

Batchelder, A W; Brisbane, M; Litwin, A H; Nahvi, S; Berg, K M; Arnsten, J H

2013-01-01

Active drug use among HIV-infected persons is associated with poor adherence to highly active antiretroviral therapy (HAART) and suboptimal treatment outcomes. To understand adherence experiences among HIV-infected drug users, we conducted semistructured interviews with 15 participants in a randomized controlled trial evaluating the efficacy of directly observed HAART delivered in methadone maintenance clinics. Interviews were recorded, transcribed, and thematically analyzed. We identified negative and positive psychological themes associated with both drug use and adherence. Participants described tension between negative feelings (denial, shame, and perceived isolation) and positive feelings (acceptance, motivation, empowerment, and perceived connectedness), and they associated this tension with their own drug using and adherence behaviors. Sustained antiretroviral therapy adherence may require increased emphasis on understanding the psychological experience of HIV-infected drug users.
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.
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.
An Alternative Curriculum Model for Urban Education and Community Affairs Programs in Higher Education. Working Paper No. 103.

ERIC Educational Resources Information Center

Simmons, Ron

This document describes the urban education program at William Paterson College of New Jersey. Urban education is defined as educating people for living and in coping with an urban environment, including politics, crime and drug prevention, and delivery of services to cities. Some problems in urban education are identified as weak…
Impact of Land Use/Land Cover Conditions on WRF Model Evaluation for Heat Island Assessment

NASA Astrophysics Data System (ADS)

Bhati, S.; Mohan, M.

2017-12-01

Urban heat island effect has been assessed using Weather Research and Forecasting model (WRF v3.5) focusing on air temperature and surface skin temperature in the sub-tropical urban Indian megacity of Delhi. Impact of urbanization related changes in land use/land cover (LULC) on model outputs has been analyzed. Four simulations have been carried out with different types of LULC data viz. (1) USGS , (2) MODIS, (3) user-modified USGS and (4) user modified land use data coupled with urban canopy model (UCM) for incorporation of canopy features. Heat island intensities have been estimated based on these simulations and subsequently compared with those derived from in-situ and satellite observations. There is a significant improvement in model performance with modification of LULC and inclusion of UCM. Overall, RMSEs for near surface temperature improved from 6.3°C to 3.9°C and index of agreement for mean urban heat island intensities (UHI) improved from 0.4 to 0.7 with modified land use coupled with UCM. In general, model is able to capture the magnitude of UHI as well as high UHI zones well. The study highlights the importance of appropriate and updated representation of landuse-landcover and urban canopies for improving predictive capabilities of the mesoscale models.
Assessing the urban water balance: the Urban Water Flow Model and its application in Cyprus.

PubMed

Charalambous, Katerina; Bruggeman, Adriana; Lange, Manfred A

2012-01-01

Modelling the urban water balance enables the understanding of the interactions of water within an urban area and allows for better management of water resources. However, few models today provide a comprehensive overview of all water sources and uses. The objective of the current paper was to develop a user-friendly tool that quantifies and visualizes all water flows, losses and inefficiencies in urban environments. The Urban Water Flow Model was implemented in a spreadsheet and includes a water-savings application that computes the contributions of user-selected saving options to the overall water balance. The model was applied to the coastal town of Limassol, Cyprus, for the hydrologic years 2003/04-2008/09. Data were collected from the different authorities and hydrologic equations and estimations were added to complete the balance. Average precipitation was 363 mm/yr, amounting to 25.4 × 10(6)m(3)/yr, more than double the annual potable water supply to the town. Surface runoff constituted 29.6% of all outflows, while evapotranspiration from impervious areas was 21.6%. Possible potable water savings for 2008/09 were estimated at 5.3 × 10(3) m(3), which is 50% of the total potable water provided to the area. This saving would also result in a 6% reduction of surface runoff.
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
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…
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.
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.
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.
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.
DockingApp: a user friendly interface for facilitated docking simulations with AutoDock Vina.

PubMed

Di Muzio, Elena; Toti, Daniele; Polticelli, Fabio

2017-02-01

Molecular docking is a powerful technique that helps uncover the structural and energetic bases of the interaction between macromolecules and substrates, endogenous and exogenous ligands, and inhibitors. Moreover, this technique plays a pivotal role in accelerating the screening of large libraries of compounds for drug development purposes. The need to promote community-driven drug development efforts, especially as far as neglected diseases are concerned, calls for user-friendly tools to allow non-expert users to exploit the full potential of molecular docking. Along this path, here is described the implementation of DockingApp, a freely available, extremely user-friendly, platform-independent application for performing docking simulations and virtual screening tasks using AutoDock Vina. DockingApp sports an intuitive graphical user interface which greatly facilitates both the input phase and the analysis of the results, which can be visualized in graphical form using the embedded JMol applet. The application comes with the DrugBank set of more than 1400 ready-to-dock, FDA-approved drugs, to facilitate virtual screening and drug repurposing initiatives. Furthermore, other databases of compounds such as ZINC, available also in AutoDock format, can be readily and easily plugged in.

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.
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.
DockingApp: a user friendly interface for facilitated docking simulations with AutoDock Vina

NASA Astrophysics Data System (ADS)

Di Muzio, Elena; Toti, Daniele; Polticelli, Fabio

2017-02-01

Molecular docking is a powerful technique that helps uncover the structural and energetic bases of the interaction between macromolecules and substrates, endogenous and exogenous ligands, and inhibitors. Moreover, this technique plays a pivotal role in accelerating the screening of large libraries of compounds for drug development purposes. The need to promote community-driven drug development efforts, especially as far as neglected diseases are concerned, calls for user-friendly tools to allow non-expert users to exploit the full potential of molecular docking. Along this path, here is described the implementation of DockingApp, a freely available, extremely user-friendly, platform-independent application for performing docking simulations and virtual screening tasks using AutoDock Vina. DockingApp sports an intuitive graphical user interface which greatly facilitates both the input phase and the analysis of the results, which can be visualized in graphical form using the embedded JMol applet. The application comes with the DrugBank set of more than 1400 ready-to-dock, FDA-approved drugs, to facilitate virtual screening and drug repurposing initiatives. Furthermore, other databases of compounds such as ZINC, available also in AutoDock format, can be readily and easily plugged in.
Harm reduction theory: Users culture, micro-social indigenous harm reduction, and the self-organization and outside-organizing of users’ groups

PubMed Central

Friedman, Samuel R.; de Jong, Wouter; Rossi, Diana; Touzé, Graciela; Rockwell, Russell; Jarlais, Don C Des; Elovich, Richard

2007-01-01

This paper discusses the user side of harm reduction, focusing to some extent on the early responses to the HIV/AIDS epidemic in each of four sets of localities—New York City, Rotterdam, Buenos Aires, and sites in Central Asia. Using available qualitative and quantitative information, we present a series of vignettes about user activities in four different localities in behalf of reducing drug-related harm. Some of these activities have been micro-social (small group) activities; others have been conducted by formal organizations of users that the users organised at their own initiative. In spite of the limitations of the methodology, the data suggest that users’ activities have helped limit HIV spread. These activities are shaped by broader social contexts, such as the extent to which drug scenes are integrated with broader social networks and the way the political and economic systems impinge on drug users’ lives. Drug users are active agents in their own individual and collective behalf, and in helping to protect wider communities. Harm reduction activities and research should take note of and draw upon both the micro-social and formal organizations of users. Finally, both researchers and policy makers should help develop ways to enable and support both micro-social and formally organized action by users PMID:17689353
Building a Web-based drug ordering system for hospitals: from requirements engineering to prototyping.

PubMed

Hübner, U; Klein, F; Hofstetter, J; Kammeyer, G; Seete, H

2000-01-01

Web-based drug ordering allows a growing number of hospitals without pharmacy to communicate seamlessly with their external pharmacy. Business process analysis and object oriented modelling performed together with the users at a pilot hospital resulted in a comprehensive picture of the user and business requirements for electronic drug ordering. The user requirements were further validated with the help of a software prototype. In order to capture the needs of a large number of users CAP10, a new method making use of pre-built models, is proposed. Solutions for coping with the technical requirements (interfacing the business software at the pharmacy) and with the legal requirements (signing the orders) are presented.
Examining Rural/Urban Differences in Prescription Opioid Misuse Among U.S. Adolescents

PubMed Central

Monnat, Shannon M.; Rigg, Khary K.

2015-01-01

Purpose This study examines differences in prescription opioid misuse (POM) among adolescents in rural, small urban and large urban areas of the US and identifies several individual, social, and community risk factors contributing to those differences. Methods We used nationally representative data from the 2011 and 2012 National Survey on Drug Use and Health (NSDUH) and estimated binary logistic regression and formal mediation models to assess past-year POM among 32,036 adolescents aged 12–17. Results Among adolescents, 6.8% of rural, 6.0% of small urban, and 5.3% of large urban engaged in past-year POM. Net of multiple risk and protective factors, rural adolescents have 35% greater odds and small urban adolescents have 21% greater odds of past-year POM compared to large urban adolescents. The difference between rural and small urban adolescents was not significant. Criminal activity, lower perceived substance use risk, and greater use of emergency medical treatment partially contribute to higher odds among rural adolescents, but they are also partially buffered by less peer substance use, less illicit drug access, and stronger religious beliefs. Conclusions Researchers, policy makers, and treatment providers must consider the complex array of individual, social, and community risk and protective factors to understand rural/urban differences in adolescent POM. Potential points of intervention to prevent POM in general and reduce rural disparities include early education about addiction risks, use of family drug courts to link criminal offenders to treatment, and access to non-emergency medical services to reduce rural residents’ reliance on emergency departments where opioid prescribing is more likely. PMID:26344571
Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia.

PubMed

Lim, Li Min; McStea, Megan; Chung, Wen Wei; Nor Azmi, Nuruljannah; Abdul Aziz, Siti Azdiah; Alwi, Syireen; Kamarulzaman, Adeeba; Kamaruzzaman, Shahrul Bahyah; Chua, Siew Siang; Rajasuriar, Reena

2017-01-01

Polypharmacy has been associated with increased morbidity and mortality in the older population. The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.
Optical properties of drug metabolites in latent fingermarks

PubMed Central

Shen, Yao; Ai, Qing

2016-01-01

Drug metabolites usually have structures of split-ring resonators (SRRs), which might lead to negative permittivity and permeability in electromagnetic field. As a result, in the UV-vis region, the latent fingermarks images of drug addicts and non drug users are inverse. The optical properties of latent fingermarks are quite different between drug addicts and non-drug users. This is a technic superiority for crime scene investigation to distinguish them. In this paper, we calculate the permittivity and permeability of drug metabolites using tight-binding model. The latent fingermarks of smokers and non-smokers are given as an example. PMID:26838730
The influence of neighborhood characteristics on the relationship between discrimination and increased drug-using social ties among illicit drug users.

PubMed

Crawford, Natalie D; Borrell, Luisa N; Galea, Sandro; Ford, Chandra; Latkin, Carl; Fuller, Crystal M

2013-04-01

Social discrimination may isolate drug users into higher risk relationships, particularly in disadvantaged neighborhood environments where drug trade occurs. We used negative binomial regression accounting for clustering of individuals within their recruitment neighborhood to investigate the relationship between high-risk drug ties with various forms of social discrimination, neighborhood minority composition, poverty and education. Results show that experiencing discrimination due to drug use is significantly associated with more drug ties in neighborhoods with fewer blacks. Future social network and discrimination research should assess the role of neighborhood social cohesion.
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.
Perception of Urban Environmental Risks and the Effects of Urban Green Infrastructures (UGIs) on Human Well-being in Four Public Green Spaces of Guangzhou, China.

PubMed

Duan, Junya; Wang, Yafei; Fan, Chen; Xia, Beicheng; de Groot, Rudolf

2018-05-28

Cities face many challenging environmental problems that affect human well-being. Environmental risks can be reduced by Urban Green Infrastructures (UGIs). The effects of UGIs on the urban environment have been widely studied, but less attention has been given to the public perception of these effects. This paper presents the results of a study in Guangzhou, China, on UGI users' perceptions of these effects and their relationship with sociodemographic variables. A questionnaire survey was conducted in four public green spaces. Descriptive statistics, a binary logistic regression model and cross-tabulation analysis were applied on the data from 396 valid questionnaires. The results show that UGI users were more concerned about poor air quality and high temperature than about flooding events. Their awareness of environmental risks was partly in accordance with official records. Regarding the perception of the impacts of environmental risks on human well-being, elderly and female respondents with higher education levels were the most sensitive to these impacts. The respondents' perceptions of these impacts differed among the different green spaces. The effects of UGIs were well perceived and directly observed by the UGI users, but were not significantly influenced by most sociodemographic variables. Moreover, tourists had a lower perception of the impacts of environmental risks and the effects of UGI than residents did. This study provides strong support for UGIs as an effective tool to mitigate environmental risks. Local governments should consider the role of UGIs in environmental risk mitigation and human well-being with regard to urban planning and policy making.
[Sex workers and public health: intersections, vulnerabilities and resistance].

PubMed

Oliveira, Alexandra; Fernandes, Luís

2017-01-01

Since the 19th century with syphilis and most recently with AIDS, sex workers have been seen as a means for disease transmission and a public health problem that requires intervention. However, researchers have shown that in Western countries, HIV rates in people involved in commercial sex are low, except for in specific groups, such as intravenous drug users. Moreover, the risks faced by sex workers due to stigmatization and other forms of violence have been put into evidence. Based on an urban ethnography with street sex workers carried out in Porto (Portugal), between 2004 and 2005, this article discusses the social, labor, and legal vulnerabilities affecting people involved in commercial sex and how these interfere with their health. Focus is placed on the strategies used by sex workers to minimize health risks and their discourses of resistance in fighting vulnerabilities.
An Analysis of Contraceptive Discontinuation among Female, Reversible Method Users in Urban Honduras

PubMed Central

Barden-O’Fallon, Janine; Speizer, Ilene S.; Cálix, Javier; Rodriguez, Francisco

2013-01-01

A panel study examining the effects of individual characteristics, side effects experienced, and service quality on contraceptive discontinuation was undertaken in four urban areas of Honduras. Data were collected from October 2006 to December 2007. The baseline population included 800 women aged 15–44 who were new or continuing users of the injectable, IUD, or oral contraceptive pill. A total of 671 women (84%) were re-interviewed after one year. Life tables and Cox proportional hazards models are used to present discontinuation rates and factors associated with contraceptive discontinuation. Among new users, discontinuation of the baseline method at 12 months was high (45%); especially for users of the injectable (50%). In the hazards model, service quality had little effect on discontinuation, while individual characteristics and the experience of specific side effects showed significant effects. The results suggest that programs should emphasize continuous contraceptive coverage rather than continuous use of a particular method. PMID:21500697
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
Physicians' approaches to the use of gastroprotective strategies in low-risk non-steroidal anti-inflammatory drug users.

PubMed

Murthy, S K; Kauldher, S; Targownik, L E

2006-05-01

Many doctors unnecessarily prescribe gastroprotective strategies to non-steroidal anti-inflammatory drugs users at low risk of non-steroidal anti-inflammatory drug-related gastrointestinal complications. To identify factors that predict the overuse of gastroprotective strategies in low-risk non-steroidal anti-inflammatory drug users. We distributed a questionnaire to family doctors and general internists consisting of a clinical vignette describing a low-risk hypothetical patient with osteoarthritis who was a candidate for non-steroidal anti-inflammatory drug therapy. Respondents were asked whether they would prescribe this patient a gastroprotective strategy and to estimate the annual risk of that patient developing a gastrointestinal complication with non-steroidal anti-inflammatory drug use. Respondents inappropriately recommending a gastroprotective strategy were compared with respondents who opted not to use gastroprotection. We received 340 responses (response rate of 28.3%), of which 278 supplied analysable data. Thirty-five percent of respondents inappropriately recommended a gastroprotective strategy for the low-risk subject. Inappropriate prescribers were significantly more likely to overestimate the risk of gastrointestinal complications with traditional non-steroidal anti-inflammatory drugs and this was strongly predictive of gastroprotective strategy recommendation in logistic regression. Many doctors inappropriately recommend gastroprotective strategies in low-risk non-steroidal anti-inflammatory drug users. Improving doctors' awareness of non-steroidal anti-inflammatory drug-associated gastrointestinal risks may lead to a decrease in inappropriate utilization of gastroprotective strategies in low-risk patients.
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.
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.
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.
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.

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
Sexual Risk Taking among HIV-Positive Injection Drug Users: Contexts, Characteristics, and Implications for Prevention

ERIC Educational Resources Information Center

Knight, Kelly R.; Purcell, David; Dawson-Rose, Carol; Halkitis, Perry N.; Gomez, Cynthia A.

2005-01-01

HIV-positive injection drug users (IDUs) (N = 161) were recruited to complete a qualitative interview and a quantitative survey about sexual behavior and transmission risk. We identified two contexts in which exposure encounters occurred most commonly for HIV-positive IDUs: in intimate serodiscordant relationships and in the drug/sex economy.…
The Parents' Experience: Coping with Drug Use in the Family

ERIC Educational Resources Information Center

Butler, Rachael; Bauld, Linda

2005-01-01

The families of drug users are often overlooked in the planning and delivery of services. This paper is based on interviews with parents of heroin users and staff from a support agency that worked with families affected by drug use. Findings highlight the devastation parents experienced in learning that their child was using heroin, and the…
Patterns and correlates of new psychoactive substance use in a sample of Australian high school students.

PubMed

Champion, Katrina E; Teesson, Maree; Newton, Nicola C

2016-05-01

In recent years there has been growing concern about new psychoactive substances (NPS) designed to mimic the effects of established illicit drugs. This paper explores the patterns and correlates of NPS use in a sample of Australian students. A cross-sectional survey was conducted in Australia in 2014. Data were collected from 1126 students (mean age: 14.9 years) from 11 secondary schools. Students completed a self-report questionnaire assessing NPS use and knowledge, beliefs and intentions to use these substances. NPS users were compared with non-users and illicit drug users, who had not used NPS, in terms of gender, binge drinking, tobacco use, psychological distress and self-efficacy to resist peer pressure. Of the 1126 students, 3% reported having ever tried NPS, 2.4% had used synthetic cannabis and 0.4% had used a synthetic stimulant. Analyses revealed that NPS users were more likely to have had an episode of binge drinking in the past 6 months, tried tobacco and had higher levels of psychological distress and lower perceived self-efficacy to resist peer pressure than non-users, but did not significantly differ from users of other illicit drugs. NPS use appears to be uncommon among Australian school students. Although adolescents that do use these substances did not differ from students that had used traditional illicit drugs, both appear to be higher-risk groups of students than non-users. Our findings suggest that universal education about NPS be incorporated into existing drug prevention programmes, and that targeted NPS prevention may also be warranted among high-risk adolescents. [Champion KE, Teesson M, Newton NC. Patterns and correlates of new psychoactive substance use in a sample of Australian high school students. Drug Alcohol Rev 2016;35:338-344]. © 2015 Australasian Professional Society on Alcohol and other Drugs.
Urban Space as the Commons - New Modes for Urban Space Management

NASA Astrophysics Data System (ADS)

Ondrejicka, Vladimir; Finka, Maros; Husar, Milan; Jamecny, Lubomir

2017-12-01

The significant growing of urban population, globalization of social-ecological systems, fuzzification of spatial structures, the diversity of actors in spatial development, their power and interest in using the resources including space, especially in high-density urban areas. Spatial development is connected with a high concentration of economic activities and population in urban systems. In many cases very rapid processes of urbanization and suburbanization approach natural spatial/territorial limits, such as carrying capacity of land, transport and infrastructural systems, absorption capacities of recipients and others [1]. Growing shortage of space and problems in their accessibility (physical, functional, etc.) leads to growing tension and conflicts among the actors/users of urban spaces and represent the initial phase of space deprivations processes. There is a parallel with “tragedy of commons” as defined by Hardin [2] and was reinterpreted by many other academics and researchers. Urban space can be clearly interpreted as the commons or commons good for their community of users and relevant actors, so innovative governance modes overlapping defined “tragedy of commons” representing a possible approach for a new concept of urban public spaces management. This paper presents a possible new approach to the management of urban spaces reflecting the current challenges in spatial development based on the theory of commons and innovative governance modes. The new approach is built on innovations in institutional regimes, the algorithm of decision-making and economic expression and interpretation of quality of the space. The theory of the commons as the base source for this approach has been broadly proved in practice and Elinor Ostrom as the author of this theory [3-5] was awarded by Nobel Prize in 2009.
Collaboration-Centred Cities through Urban Apps Based on Open and User-Generated Data

PubMed Central

Aguilera, Unai; López-de-Ipiña, Diego; Pérez, Jorge

2016-01-01

This paper describes the IES Cities platform conceived to streamline the development of urban apps that combine heterogeneous datasets provided by diverse entities, namely, government, citizens, sensor infrastructure and other information data sources. This work pursues the challenge of achieving effective citizen collaboration by empowering them to prosume urban data across time. Particularly, this paper focuses on the query mapper; a key component of the IES Cities platform devised to democratize the development of open data-based mobile urban apps. This component allows developers not only to use available data, but also to contribute to existing datasets with the execution of SQL sentences. In addition, the component allows developers to create ad hoc storages for their applications, publishable as new datasets accessible by other consumers. As multiple users could be contributing and using a dataset, our solution also provides a data level permission mechanism to control how the platform manages the access to its datasets. We have evaluated the advantages brought forward by IES Cities from the developers’ perspective by describing an exemplary urban app created on top of it. In addition, we include an evaluation of the main functionalities of the query mapper. PMID:27376300
Collaboration-Centred Cities through Urban Apps Based on Open and User-Generated Data.

PubMed

Aguilera, Unai; López-de-Ipiña, Diego; Pérez, Jorge

2016-07-01

This paper describes the IES Cities platform conceived to streamline the development of urban apps that combine heterogeneous datasets provided by diverse entities, namely, government, citizens, sensor infrastructure and other information data sources. This work pursues the challenge of achieving effective citizen collaboration by empowering them to prosume urban data across time. Particularly, this paper focuses on the query mapper; a key component of the IES Cities platform devised to democratize the development of open data-based mobile urban apps. This component allows developers not only to use available data, but also to contribute to existing datasets with the execution of SQL sentences. In addition, the component allows developers to create ad hoc storages for their applications, publishable as new datasets accessible by other consumers. As multiple users could be contributing and using a dataset, our solution also provides a data level permission mechanism to control how the platform manages the access to its datasets. We have evaluated the advantages brought forward by IES Cities from the developers' perspective by describing an exemplary urban app created on top of it. In addition, we include an evaluation of the main functionalities of the query mapper.
Comparison of Liveable City of Three Cities in Indonesia through Index of Happiness Data from Social Media and Urban Structure

NASA Astrophysics Data System (ADS)

Munawir; Dewancker, B. J.; Koerniawan, M. D.

2018-05-01

Social media has contributed to providing information from the users. Users can expressing and sharing their thoughts and opinions on all kinds of topics and events freely. Twitter offers organizations fast and effective way to monitor the users’ feelings towards their mood in the cities. In twitter there are the big information data that be able to download freely, this study collected data from twitter and make the classification based on users’ tweets to categorize the index of happiness of the city. The urban structure data are collected from the urban guideline development from each city. The index of happiness becomes the prosperity level paradigm of a city, it becomes a tool to assess and compare how the city is liveable. This study will analyse from the users’ tweets on a regular basis in three cities of Indonesia, to the parameters of happiness that will be compared with the urban structure development. Based on data of the index of happiness from social media can offer better information for city planners and developers that can be used to improve planning and quality of life in the city and future of urban development.
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.
The generic drug user fee amendments: an economic perspective

PubMed Central

Berndt, Ernst R; Murphy, Stephen J

2018-01-01

Abstract Since the vast majority of prescription drugs consumed by Americans are off patent (‘generic’), their regulation and supply is of wide interest. We describe events leading up to the US Congress's 2012 passage of the Generic Drug User Fee Amendments (GDUFA I) as part of the Food and Drug Administration Safety and Innovation Act (FDASIA). Under GDUFA I, generic manufacturers agreed to pay approximately $300 million in fees each year of the five-year program. In exchange, the US Food and Drug Administration (FDA) committed to performance goals. We describe GDUFA I’s FDA commitments, provisions, goals, and annual fee structure and compare it to that entailed in the authorization and implementation of GDUFA II on October 1, 2017. We explain how user fees required under GDUFA I erected barriers to entry and created scale and scope economies for incumbent manufacturers. Congress changed user fees under GDUFA II in part to lessen these incentives. In order to initiate and sustain user fees under GDUFA legislation, FDA requires the submission of self-reported data on generic manufacturers including domestic and foreign facilities. These data are public and our examination of them provides an unprecedented window into the recent organization of generic drug manufacturers supplying the US market. Our results suggest that generic drug manufacturing is increasingly concentrated and foreign. We discuss the implications of this observed market structure for GDUFA II’s implementation among other outcomes. PMID:29707218
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.
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.
Phyt'Eaux Cités: application and validation of a programme to reduce surface water contamination with urban pesticides.

PubMed

Botta, Fabrizio; Fauchon, Nils; Blanchoud, Hélène; Chevreuil, Marc; Guery, Bénédicte

2012-01-01

This paper presents first results of Phyt'Eaux Cités, a program put in place by the local water supply agency, the SEDIF (Syndicat des Eaux d'Ile-de-France), in collaboration with 73 local authorities, private societies and institutional offices (365 km(2)). The challenges included: measurement of the previous surface water contamination, control of urban pesticide applications, prevention of pesticide hazard on users and finally a overall reduction of surface water contamination. An inquiry on urban total pesticide amount was coupled with a surface water bi-weekly monitoring to establish the impact of more than 200 molecules upon the Orge River. For 2007, at least 4400 kg and 92 type of pesticides (essentially herbicides) were quantified for all urban users in the Phyt'Eaux Cités perimeter. At the outlet of the Orge River (bi-weekly sampling in 2007), 11 molecules were always detected above 0.1 μg L(-1). They displayed the mainly urban origin of pesticide surface water contamination. Amitrole, AMPA (Aminomethyl Phosphonic Acid), demethyldiuron, diuron, glyphosate and atrazine were quantified with a 100% of frequency in 2007 and 2008 at the Orge River outlet. During the year, peaks of contamination were also registered for MCCP, 2,4 MCPA, 2,4 D, triclopyr, dichlorprop, diflufènican, active substances used in large amount in the urban area. However, some other urban molecules, such as isoxaben or flazasulfuron, were detected with low frequency. During late spring and summer, contamination patterns and load were dominated by glyphosate, amitrole and diuron, essentially applied by cities and urban users. Both isoproturon and chlortoluron were quantified during autumn and winter months according to upstream agricultural practices. In conclusion, 3 years after the beginning of this programme, the cities reduced the use of 68% of the total pesticide amount. An improvement on surface water quality was found from 2008 and during 2009 for all pesticides. In particular, glyphosate showed a decrease of the load above 60% in 2008, partly related to the Phyt'Eaux Cités action. Copyright © 2011 Elsevier Ltd. All rights reserved.
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.
Substance Abuse and the HIV Situation in Malaysia

PubMed Central

Singh, Darshan; Chawarski, Marek C.; Schottenfeld, Richard; Vicknasingam, Balasingam

2014-01-01

Heroin continues to be the main drug used in Malaysia, while amphetamine-type stimulants (ATS) have been recently identified as a growing problem. A cumulative total of 300,241 drug users were detected between 1988 and 2006. It is also estimated that Malaysia has 170,000 injecting drug users. HIV prevalence among drug users in the country ranges from 25% to 45%. Currently, there are approximately 380 general medical practice offices that offer agonist maintenance treatments for approximately 10,000 patients. There are 27,756 active patients in 333 general medical practice offices and government-run methadone maintenance treatment (MMT) centers. The Needle Syringe Exchange Program (NSEP) reached out to 34,244 injection drug users (IDUs) in 2011. In the last 2 years (2011 and 2012) the number of detected drug addicts decreased from 11,194 to 9015. The arrests made by the police related to opiate and cannabis use increased from 41,363 to 63,466 between the years 2008 and 2010, but decreased since 2010. An almost four-fold increase in the number of ATS and ketamine users was detected from 2006 (21,653 users) 2012 (76,812). Between 2004 and 2010, the yearly seizures for heroin ranged between 156 to 270 kg. However, in 2010 and 2011, heroin seizures showed a significant increase of 445kg and 410.02 kg, respectively. There has been a seizure of between 600 to 1000kg of syabu yearly from 2009 to 2012. Similar to heroin, increased seizures for Yaba have also been observed over the last 2 years. A significant increase has also been recorded for the seizures of ecstasy pills from 2011 (47,761 pills) to 2012 (634,573 pills). The cumulative number of reported HIV infections since 1986 is 94,841. In 2011, sexual activity superseded injection drug use as the main transmission factor for the epidemic. HIV in the country mainly involves males, as they constitute 90% of cumulative HIV cases and a majority of those individuals are IDUs. However, HIV infection trends are shifting from males to females. There are 37,306 people living with HIV (PLHIV) who are eligible for treatment, and 14,002 PLHIV were receiving antiretroviral treatment (ART) in 2011. The decreasing trend of heroin users who have been detected and arrested could be due to the introduction of medical treatments and harm reduction approaches for drug users, resulting in fewer drug users being arrested. However, we are unable to say with certainty why there has been an increase in heroin seizures in the country. There has been an increasing trend in both ATS users and seizures. A new trend of co-occurring opiate dependence and ATS underscores the need to develop and implement effective treatments for ATS, co-occurring opiate and ATS, and polysubstance abuse disorders. The low numbers of NSEP clients being tested for HIV underscores our caution in interpreting the decline of HIV infections among drug users and the importance of focusing on providing education, prevention, treatment, and outreach to those who are not in treatment. PMID:25278737
Substance Abuse and the HIV Situation in Malaysia.

PubMed

Singh, Darshan; Chawarski, Marek C; Schottenfeld, Richard; Vicknasingam, Balasingam

2013-12-01

Heroin continues to be the main drug used in Malaysia, while amphetamine-type stimulants (ATS) have been recently identified as a growing problem. A cumulative total of 300,241 drug users were detected between 1988 and 2006. It is also estimated that Malaysia has 170,000 injecting drug users. HIV prevalence among drug users in the country ranges from 25% to 45%. Currently, there are approximately 380 general medical practice offices that offer agonist maintenance treatments for approximately 10,000 patients. There are 27,756 active patients in 333 general medical practice offices and government-run methadone maintenance treatment (MMT) centers. The Needle Syringe Exchange Program (NSEP) reached out to 34,244 injection drug users (IDUs) in 2011. In the last 2 years (2011 and 2012) the number of detected drug addicts decreased from 11,194 to 9015. The arrests made by the police related to opiate and cannabis use increased from 41,363 to 63,466 between the years 2008 and 2010, but decreased since 2010. An almost four-fold increase in the number of ATS and ketamine users was detected from 2006 (21,653 users) 2012 (76,812). Between 2004 and 2010, the yearly seizures for heroin ranged between 156 to 270 kg. However, in 2010 and 2011, heroin seizures showed a significant increase of 445kg and 410.02 kg, respectively. There has been a seizure of between 600 to 1000kg of syabu yearly from 2009 to 2012. Similar to heroin, increased seizures for Yaba have also been observed over the last 2 years. A significant increase has also been recorded for the seizures of ecstasy pills from 2011 (47,761 pills) to 2012 (634,573 pills). The cumulative number of reported HIV infections since 1986 is 94,841. In 2011, sexual activity superseded injection drug use as the main transmission factor for the epidemic. HIV in the country mainly involves males, as they constitute 90% of cumulative HIV cases and a majority of those individuals are IDUs. However, HIV infection trends are shifting from males to females. There are 37,306 people living with HIV (PLHIV) who are eligible for treatment, and 14,002 PLHIV were receiving antiretroviral treatment (ART) in 2011. The decreasing trend of heroin users who have been detected and arrested could be due to the introduction of medical treatments and harm reduction approaches for drug users, resulting in fewer drug users being arrested. However, we are unable to say with certainty why there has been an increase in heroin seizures in the country. There has been an increasing trend in both ATS users and seizures. A new trend of co-occurring opiate dependence and ATS underscores the need to develop and implement effective treatments for ATS, co-occurring opiate and ATS, and polysubstance abuse disorders. The low numbers of NSEP clients being tested for HIV underscores our caution in interpreting the decline of HIV infections among drug users and the importance of focusing on providing education, prevention, treatment, and outreach to those who are not in treatment.
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.
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.

Regional variation in drug purchase opportunity among youths in the United States, 1996-1997.

PubMed

James, Kirk E; Wagner, Fernando A; Anthony, James C

2002-03-01

This study was designed to examine geographic variation in illegal drug purchase opportunity among young people living in the United States; there was a subfocus on age, sex, and urban/rural residence. Data from the 1996-1997 National Household Surveys on Drug Abuse were analyzed; the nationally representative sample of community residents included 21,531 participants aged 12-24 years old. Respondents were asked if someone had approached them to sell them an illegal drug during the past 30 days. To protect respondents' confidentiality, there is no finegrained geographical coding of data in the National Household Surveys on Drug Abuse public use data files, but nine geographical divisional indicators are provided (i.e., West North Central, New England, etc.). Results indicated males were an estimated 1.8 times more likely than females to have had a recent illicit drug purchase opportunity, and urban residents were 1.5 times more likely than rural residents to have had a recent drug purchase opportunity. As for geographic divisions, the Pacific division surpassed all other divisions: Its residents were 1.5 times more likely to have recent drug purchase opportunities than the West North Central division (used here as a reference category). After controlling statistically for age, sex, and urban/rural residence, residence in four divisions was found to be associated with greater likelihood of an illicit drug purchase opportunity. The observed patterns of drug purchase opportunity add new features to our understanding of illicit drug involvement across the United States.
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.
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.
The efficacy of interviewing young drug users through online chat.

PubMed

Barratt, Monica J

2012-06-01

Despite the fact that most young people who use 'party drugs' also use the Internet, accounts of drugs research involving qualitative interviewing using real-time instant messaging or online chat are yet to be published. This paper assesses the efficacy of conducting qualitative research interviews with young party drug users through instant messaging. In 2007-2008, 837 Australian residents who reported recent use of psychostimulants and/or hallucinogens and participated in online drug discussion completed a web survey and a subsample of 27 completed online interviews (median age 21, range 17-37, 59% male). Experienced drug users were more likely to volunteer to be interviewed than novices. The time and space flexibility provided by the online interviews was convenient; however, interviews were more prone to interruption. Establishing legitimacy, personal disclosure, appropriate linguistic style and humour facilitated the development of rapport and enabled the production of more detailed and in-depth data. These strategies were not successful in all cases and when unsuccessful, interviewees were more easily able to exit the interview by choosing not to respond. Young drug users already using the Internet to chat about drugs find online interviewing an acceptable and convenient way to contribute to research. With adequate preparation to develop technical and cultural competencies, online interviewing offers an effective way of engaging with young people that is worthy of consideration by researchers in the alcohol and other drug field. © 2011 Australasian Professional Society on Alcohol and other Drugs.
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.
Tracking the Evolution of HIV/AIDS in China from 1989–2009 to Inform Future Prevention and Control Efforts

PubMed Central

Chen, Ray Y.; Li, Dongmin; Wang, Lan; Qin, Qianqian; Ding, Zhengwei; Ding, Guowei; Zang, Chunpeng; Wang, Ning

2011-01-01

Background To determine policy implications, this analysis tracks the evolution of HIV/AIDS infection across China to understand current trends and potential risk factors. Methods and Principal Findings A retrospective study with spatial analytical model and multilevel spatial models was conducted among 326,157 HIV/AIDS cases reported from 1989–2009. The results indicate that the distribution of HIV/AIDS was clustered at the county level with different directional distributions across China from 2003 to 2009. Compared to 2003, by 2009 there was a 122% increase in HIV cases among rural residents, 294% increase among urban residents, 211% increase among migrants, and 237% increase among permanent residents. The overall proportion of HIV by different routes of transmission showed dramatic changes with a 504% increase in sexual transmission of HIV, 90% decrease in blood/plasma transmission, and 35% decrease in injecting drug user transmission. Sexual transmission was the major transmission route among women (44%) and the elderly (59% in men, 44% in women) as well as among permanent (36%) and urban residents (33%). Among those <65 years old, women increased more than men, but among those ≥65 years, men increased more than women. Migrants contributed to the variance of HIV infection between counties but not within counties. The length of highway and urbanization combined with illiteracy were risk factors for HIV/AIDS. Conclusions/Significance Rates of HIV/AIDS among permanent urban residents, particularly women and elderly men, have increased significantly in recent years. To prevent HIV from spreading further among the general population, additional attention should be paid to these populations as well as to migrants. PMID:21998679
Advertising of OTC products in a Nigerian urban setting: content analysis for indications, targets, and advertising appeal.

PubMed

Yusuff, Kazeem B; Yusuf, Akeem

2009-01-01

To identify the indications for which treatments were promoted, the segments of population targeted, and the type and extent of advertising appeal used for over-the-counter (OTC) products in a Nigerian urban setting. Using a cross-sectional design, the content of advertisements for OTC products on radio, television, and billboards in a city in southwestern Nigeria were assessed during a 3-month period. Two coders independently assessed 1,492 advertisements for 49 brands of OTC products (interrater reliability [Cohen's kappa] = 0.83 [95% CI 0.80-0.90]). The most frequent indications for OTC products were aches and pain (42.9%), anemia/malnutrition (34.8%), and malaria (22.2%). Of advertisements, 92% were targeted at the primary end user. Use of appeal related to efficacy (100%), psychosocial enhancement (80%), and ease of use (40%) in visual, written, and audio messages was highest in ads on billboards. Efficacy appeal had the highest frequency across the three advertising media (100%); ease-of-use and safety appeal had the lowest frequency (40% and 7.4%, respectively). Nigerian movie stars were used as brand icons in advertisements of OTC products on radio (59.5%), television (52.9%), and billboards (49.6%). The majority of advertisements for OTC products in a Nigerian urban setting used advertising appeal related to efficacy and psychosocial enhancement. Promotional efforts by pharmaceutical manufacturers appear to focus on positive emotional appeal to influence drug purchase and use decisions.
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.
Thematic accuracy assessment of the 2011 National Land Cover Database (NLCD)

USGS Publications Warehouse

Wickham, James; Stehman, Stephen V.; Gass, Leila; Dewitz, Jon; Sorenson, Daniel G.; Granneman, Brian J.; Poss, Richard V.; Baer, Lori Anne

2017-01-01

Accuracy assessment is a standard protocol of National Land Cover Database (NLCD) mapping. Here we report agreement statistics between map and reference labels for NLCD 2011, which includes land cover for ca. 2001, ca. 2006, and ca. 2011. The two main objectives were assessment of agreement between map and reference labels for the three, single-date NLCD land cover products at Level II and Level I of the classification hierarchy, and agreement for 17 land cover change reporting themes based on Level I classes (e.g., forest loss; forest gain; forest, no change) for three change periods (2001–2006, 2006–2011, and 2001–2011). The single-date overall accuracies were 82%, 83%, and 83% at Level II and 88%, 89%, and 89% at Level I for 2011, 2006, and 2001, respectively. Many class-specific user's accuracies met or exceeded a previously established nominal accuracy benchmark of 85%. Overall accuracies for 2006 and 2001 land cover components of NLCD 2011 were approximately 4% higher (at Level II and Level I) than the overall accuracies for the same components of NLCD 2006. The high Level I overall, user's, and producer's accuracies for the single-date eras in NLCD 2011 did not translate into high class-specific user's and producer's accuracies for many of the 17 change reporting themes. User's accuracies were high for the no change reporting themes, commonly exceeding 85%, but were typically much lower for the reporting themes that represented change. Only forest loss, forest gain, and urban gain had user's accuracies that exceeded 70%. Lower user's accuracies for the other change reporting themes may be attributable to the difficulty in determining the context of grass (e.g., open urban, grassland, agriculture) and between the components of the forest-shrubland-grassland gradient at either the mapping phase, reference label assignment phase, or both. NLCD 2011 user's accuracies for forest loss, forest gain, and urban gain compare favorably with results from other land cover change accuracy assessments.
Using the Rural-Urban Continuum to Explore Adolescent Alcohol, Tobacco, and Other Drug Use in Montana

ERIC Educational Resources Information Center

Hanson, Carl L.; Novilla, M. Lelinneth L. B.; Barnes, Michael D.; Eggett, Dennis; McKell, Chelsea; Reichman, Peter; Havens, Mike

2009-01-01

The purpose of the study was to compare 30-day prevalence of alcohol, tobacco, and other drug use among twelfth-grade students in Montana across a rural-urban continuum during 2000, 2002, and 2004. The methods include an analysis of the Montana Prevention Needs Assessment (N = 15,372) using multivariable logistic regression adjusting for risk…
MONITORING POTENTIAL DRUG INTERACTIONS AND REACTIONS VIA NETWORK ANALYSIS OF INSTAGRAM USER TIMELINES

PubMed Central

CORREIA, RION BRATTIG; LI, LANG; ROCHA, LUIS M.

2015-01-01

Much recent research aims to identify evidence for Drug-Drug Interactions (DDI) and Adverse Drug reactions (ADR) from the biomedical scientific literature. In addition to this “Bibliome”, the universe of social media provides a very promising source of large-scale data that can help identify DDI and ADR in ways that have not been hitherto possible. Given the large number of users, analysis of social media data may be useful to identify under-reported, population-level pathology associated with DDI, thus further contributing to improvements in population health. Moreover, tapping into this data allows us to infer drug interactions with natural products—including cannabis—which constitute an array of DDI very poorly explored by biomedical research thus far. Our goal is to determine the potential of Instagram for public health monitoring and surveillance for DDI, ADR, and behavioral pathology at large. Most social media analysis focuses on Twitter and Facebook, but Instagram is an increasingly important platform, especially among teens, with unrestricted access of public posts, high availability of posts with geolocation coordinates, and images to supplement textual analysis. Using drug, symptom, and natural product dictionaries for identification of the various types of DDI and ADR evidence, we have collected close to 7000 user timelines spanning from October 2010 to June 2015. We report on 1) the development of a monitoring tool to easily observe user-level timelines associated with drug and symptom terms of interest, and 2) population-level behavior via the analysis of co-occurrence networks computed from user timelines at three different scales: monthly, weekly, and daily occurrences. Analysis of these networks further reveals 3) drug and symptom direct and indirect associations with greater support in user timelines, as well as 4) clusters of symptoms and drugs revealed by the collective behavior of the observed population. This demonstrates that Instagram contains much drug- and pathology specific data for public health monitoring of DDI and ADR, and that complex network analysis provides an important toolbox to extract health-related associations and their support from large-scale social media data. PMID:26776212
MONITORING POTENTIAL DRUG INTERACTIONS AND REACTIONS VIA NETWORK ANALYSIS OF INSTAGRAM USER TIMELINES.

PubMed

Correia, Rion Brattig; Li, Lang; Rocha, Luis M

2016-01-01

Much recent research aims to identify evidence for Drug-Drug Interactions (DDI) and Adverse Drug reactions (ADR) from the biomedical scientific literature. In addition to this "Bibliome", the universe of social media provides a very promising source of large-scale data that can help identify DDI and ADR in ways that have not been hitherto possible. Given the large number of users, analysis of social media data may be useful to identify under-reported, population-level pathology associated with DDI, thus further contributing to improvements in population health. Moreover, tapping into this data allows us to infer drug interactions with natural products-including cannabis-which constitute an array of DDI very poorly explored by biomedical research thus far. Our goal is to determine the potential of Instagram for public health monitoring and surveillance for DDI, ADR, and behavioral pathology at large. Most social media analysis focuses on Twitter and Facebook, but Instagram is an increasingly important platform, especially among teens, with unrestricted access of public posts, high availability of posts with geolocation coordinates, and images to supplement textual analysis. Using drug, symptom, and natural product dictionaries for identification of the various types of DDI and ADR evidence, we have collected close to 7000 user timelines spanning from October 2010 to June 2015.We report on 1) the development of a monitoring tool to easily observe user-level timelines associated with drug and symptom terms of interest, and 2) population-level behavior via the analysis of co-occurrence networks computed from user timelines at three different scales: monthly, weekly, and daily occurrences. Analysis of these networks further reveals 3) drug and symptom direct and indirect associations with greater support in user timelines, as well as 4) clusters of symptoms and drugs revealed by the collective behavior of the observed population. This demonstrates that Instagram contains much drug- and pathology specific data for public health monitoring of DDI and ADR, and that complex network analysis provides an important toolbox to extract health-related associations and their support from large-scale social media data.
MDMA in humans: factors which affect the neuropsychobiological profiles of recreational ecstasy users, the integrative role of bioenergetic stress.

PubMed

Parrott, Andy C

2006-03-01

Many recreational ecstasy/MDMA users display neuropsychobiological deficits, whereas others remain problem free. This review will investigate some of the drug and non-drug factors which influence the occurrence of these deficits. Acute and chronic MDMA usage are both important. Intensive use within a session is often associated with more problems. In term of lifetime usage, novice users generally remain unimpaired, whereas most heavy users report memory or other psychobiological problems which they attribute to ecstasy. These complaints are confirmed by objective deficits in working memory, attention, frontal-executive, and episodic memory tasks. Psychobiological deficits include disturbed sleep, sexual dysfunction, reduced immuno-competence, and increased oxidative stress. Further MDMA-related factors which may contribute to these changes, include acute and chronic tolerance, and drug dependence. Around 90ñ95% of ecstasy/MDMA users also take cannabis, and this can independently contribute to the adverse neuropsychobiological pro.les; although in some situations the acute co-use of these two drugs may be interactive rather than additive, since cannabis has relaxant and hypothermic properties. Alcohol, nicotine, amphetamine, and other drugs, can also affect the psychobiological pro.les of ecstasy polydrug users in complex ways. Pure MDMA users are rare but they have been shown to display significant neurocognitive deficits. Psychiatric aspects are debated in the context of the diathesis-stress model. Here the stressor of ecstasy polydrug drug use, interacts with various predisposition factors (genetic, neurochemical, personality), to determine the psychiatric outcome. Recreational MDMA is typically taken in hot and crowded dances/raves. Prolonged dancing, feeling hot, and raised body temperature, can also be associated with more psychobiological problems. This is consistent with the animal literature, where high ambient temperature and other metabolic stimulants boost the acute effects of MDMA, and cause greater serotonergic neurotoxicity. In conclusion, the neuropsychobiological effects of MDMA are modulated by a wide range of drug and non-drug factors. These multiple influences are integrated within a bioenergetic stress model, where factors which heighten acute metabolic distress lead to more neuropsychobiological problems.
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
Intimate partner violence among men and women who use methamphetamine: A mixed-methods study in South Africa.

PubMed

Watt, Melissa H; Guidera, Kathryn E; Hobkirk, Andréa L; Skinner, Donald; Meade, Christina S

2017-01-01

The prevalence of methamphetamine use has risen dramatically in parts of South Africa. Globally, methamphetamine has been linked to intimate partner violence (IPV) and other forms of aggression. The aim of this mixed-methods study was to examine the experiences of physical IPV and its contextual factors among methamphetamine users in an urban community in Cape Town, South Africa. Active methamphetamine users were recruited using respondent driven sampling. All participants (n = 360) completed structured surveys, and a subset (n = 30) completed in-depth interviews with discussions of personal IPV experiences. Quantitative data were examined separately by gender, and regression models were used to identify factors that were associated with physical IPV victimisation and perpetration. Qualitative data were analysed to provide contextual understanding. In the past 3 months, 47% of women and 31% of men reported being a victim of IPV, and 30% of women and 28% men reported being a perpetrator of IPV. Victimisation and perpetration were highly correlated, and both were significantly associated with histories of other traumas. Although the survey data suggests gender equivalence in IPV, the qualitative data provides a more nuanced context, with female victimisation by male partners being particularly frequent and intense. In narratives, IPV was a product of male aggression while using methamphetamine, norms around sex trading and gender-based attitudes endorsing violence against women. Addiction to methamphetamine creates heightened risks of IPV, especially among those with previous traumas. The findings emphasise the importance of identifying and addressing IPV among methamphetamine users in South Africa. [Watt MH, Guidera KE, Hobkirk AL, Skinner D, Meade CS. Intimate partner violence among men and women who use methamphetamine: A mixed-methods study in South Africa. Drug Alcohol Rev 2017;36:97-106]. © 2016 Australasian Professional Society on Alcohol and other Drugs.
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.
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
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;…
Urban Environment Development based on Universal Design Principles

NASA Astrophysics Data System (ADS)

Harsritanto, Bangun Ir

2018-02-01

Universal Design is a design which facilitated full range of human diversity. By applying Universal design principles, urban environment can be more functional and more user-friendly for everyone. This study examined five urban streets of South Korea as a country experienced on developing various urban street designs based on universal design. This study aimed to examine and compare the South Korea cases using seven principles of universal design. The research methods of this study are literature study, case study, and site observation. The results of this study are: South Korea cases are good practices, urgency of implementing the direction into local regulations; and change of urban development paradigm.
Permissive Attitude Towards Drug Use, Life Satisfaction, and Continuous Drug Use Among Psychoactive Drug Users in Hong Kong.

PubMed

Cheung, N Wt; Cheung, Y W; Chen, X

2016-06-01

To examine the effects of a permissive attitude towards regular and occasional drug use, life satisfaction, self-esteem, depression, and other psychosocial variables in the drug use of psychoactive drug users. Psychosocial factors that might affect a permissive attitude towards regular / occasional drug use and life satisfaction were further explored. We analysed data of a sample of psychoactive drug users from a longitudinal survey of psychoactive drug abusers in Hong Kong who were interviewed at 6 time points at 6-month intervals between January 2009 and December 2011. Data of the second to the sixth time points were stacked into an individual time point structure. Random-effects probit regression analysis was performed to estimate the relative contribution of the independent variables to the binary dependent variable of drug use in the last 30 days. A permissive attitude towards drug use, life satisfaction, and depression at the concurrent time point, and self-esteem at the previous time point had direct effects on drug use in the last 30 days. Interestingly, permissiveness to occasional drug use was a stronger predictor of drug use than permissiveness to regular drug use. These 2 permissive attitude variables were affected by the belief that doing extreme things shows the vitality of young people (at concurrent time point), life satisfaction (at concurrent time point), and self-esteem (at concurrent and previous time points). Life satisfaction was affected by sense of uncertainty about the future (at concurrent time point), self-esteem (at concurrent time point), depression (at both concurrent and previous time points), and being stricken by stressful events (at previous time point). A number of psychosocial factors could affect the continuation or discontinuation of drug use, as well as the permissive attitude towards regular and occasional drug use, and life satisfaction. Implications of the findings for prevention and intervention work targeted at psychoactive drug users are discussed.

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