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Scant evidence exists to support the association of opium use with head and neck cancer, limited to the larynx and oral cavity. In a multicenter case‐control study—Iran Opium and Cancer study, we recruited 633 cases of head and neck squamous cell carcinoma (HNSCC) (254 lip and oral cavity, 54 pharynx, 327 larynx and 28 other subsites within the head and neck) and 3065 frequency‐matched controls from April 2016 to April 2019. Odds ratios (ORs) for opium use and 95% confidence intervals (95% CIs) were obtained using mixed‐effects logistic regression because of heterogeneity among centers. The adjusted OR (95% CI) for regular opium use was 3.76 (2.96‐4.79) for all HNSCC combined. Strong dose‐response effects were observed by frequency or amount of use, and duration of use. Regular opium uses significantly increased the risk of HNSCC of the pharynx, larynx and other subsites within the head and neck with OR (95% CI) of 2.90 (1.40‐6.02), 6.55 (4.69‐9.13) and 5.95 (2.41‐14.71), respectively. The observed associations were significant even among never tobacco smokers (including cigarette and water‐pipe smoking). Moreover, by the multiplicative interaction scale, the effect of opium use could be varied by cigarette smoking on HNSCC, 8.16 (6.20‐10.74). For the first time, the current study showed opium users have an increased risk of several anatomic subsites of HNSCC. What's new? Opium use has been associated with the risks of several cancers, but there is little data on whether opium contributes to head and neck cancer risk. Here, the authors conducted a multicenter case‐control study, the Iran Opium and Cancer study (IROPICAN). They recruited 633 cases of head and neck squamous cell carcinoma and 3065 controls. The study drew from 10 provinces in Iran where opium use is most prevalent. They found that regular opium users have an elevated overall risk of HNSCC, and laryngeal cancer in particular. [ABSTRACT FROM AUTHOR]

The perception of children of drug-dependent parents on family functioning and affectionate relationships with their parents is described. Current qualitative study has been conducted with four children, children of drug addicts. Data were collected through family genogram and semi-structured interview. The statements were submitted to content analysis. Family functioning was classified as careless, entangled in border strengthening, or non- classified. Attachment types were safe and preventive. Family functioning is related to the forms of interaction between members and not to the use of psychoactive substances. Dependency is not the triggering factor of the system´s rigidity, but a consequence of the predominant style of attachment. It hinders positive interactions and the search for alternative patterns of functioning, being an important risk factor for healthy development of its members. [ABSTRACT FROM AUTHOR]

Current descriptive and qualitative study described feelings and codependent behavior in relatives of illicit drug users. Data were collected between March and April 2012 by an open interview with eight family members of illicit drugs-dependent individuals and subjected to theme-mode content analysis. Results were classified into two categories which showed intense suffering coupled to feelings of guilt, fear, shame, sadness, shame and manifestation of codependent behaviors such as denial and control of the one´s situation and that of others. Professionals should know the situation in which the families of drug addicts live to assist them in a different way. They should also identify codependent relatives, since they also need care so that their behavior does not worsen the symptoms and behavior of the drug user and prevents a possible medical or psychiatric diagnosis.

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Over the past decade, the amount and variety of addiction research around the world has increased substantially. Researchers in Australia, Canada, United Kingdom, United States, and western Europe have significantly contributed to knowledge about addiction and its treatment. However, the nature and context of substance use disorders and the populations using drugs are far more diverse than is reflected in studies done in Western cultures. To stimulate new research from a diverse set of cultural perspectives, the National Institute on Drug Abuse (NIDA) has promoted the development of addiction research capacity and skills around the world for over 25 years. This review will describe the programs NIDA has developed to sponsor international research and research fellows and will provide some examples of the work NIDA has supported. NIDA fellowships have allowed 496 individuals from 96 countries to be trained in addiction research. The United Arab Emirates and Saudi Arabia have recently developed funding to support addiction research to study, with advice from NIDA, the substance use disorder problems that affect their societies. Examples from Malaysia, Tanzania, Brazil, Russian Federation, Ukraine, Republic of Georgia, Iceland, China, and Vietnam are used to illustrate research being conducted with NIDA support. Health services research, collaboratively funded by the U.S. National Institutes of Health and Department of State, addresses a range of addiction service development questions in low- and middle-income countries. Findings have expanded the understanding of addiction and its treatment, and are enhancing the ability of practitioners and policy makers to address substance use disorders. [ABSTRACT FROM AUTHOR]

Community hospital stays in 12 states during 2008-2009 were analyzed to determine predictors of 12-month hospital readmission and emergency department (EDs) revisits among persons with a mental health or substance abuse diagnosis. Probabilities of hospital readmission and of ED revisits were modeled as functions of patient demographics, insurance type, number of prior-year hospital stays, diagnoses and other characteristics of the initial stay, and hospital characteristics. Alcohol or drug dependence, dementias, psychotic disorders, autism, impulse control disorders, and personality disorders were most strongly associated with future inpatient admission or ED revisits within 12 months of initial encounter. Insurance type, including uninsured status, were highly significant ( p < .01) predictors of both readmission and ED revisits. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to clarify the clinical features of designer-drug-abusing patients through comparisons with methamphetamine-abusing patients and hypnotics/anxiolytics-abusing patients. Methods Information on 126 designer-drug-abusing patients, 138 methamphetamine-abusing patients, and 87 hypnotics/anxiolytics-abusing patients was extracted from the 2012 database of 'The Nationwide Mental Hospital Survey on Drug-related Psychiatric Disorders' and the clinical variables of designer-drug-abusing patients compared with those of the other two groups. Results Multivariate analysis indicated the following significant differences between designer-drug-abusing patients and the other two types of patients: designer-drug-abusing patients were younger, included more men, had higher education and fewer relationships with antisocial groups, and included more patients meeting ICD-10 F1 sub-classification categories of 'Harmful use' and 'Psychotic disorders' than methamphetamine-abusing patients. Compared with hypnotics/anxiolytics-abusing patients, designer-drug-abusing patients were younger, included more men and more patients meeting criteria for 'Psychotic disorders', and more frequently cited 'peer pressure', 'unable to refuse', and 'seeking stimulation' as reasons for using the drug. Conclusion The advent of designer drugs has created a new class of drug abuse, and abuse of designer drugs may carry a strong psychosis-inducing risk, exceeding that of methamphetamine. [ABSTRACT FROM AUTHOR]

Abstract: Persons with a substance use disorder (SUD) are less likely to be insured and may have limited access to appropriate care, thereby increasing their reliance on emergency departments (EDs). We investigated whether health conditions and insurance status are significant predictors of admission to a community hospital directly from an ED visit with an SUD diagnosis. We analyzed the 2008 Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project. Lack of health insurance was disproportionately likely in ED visits that carried an SUD diagnosis, whether alcohol- or drug-related. Using regression analysis, most SUD and non-SUD diagnostic categories and many procedure categories were significantly related to subsequent hospital admission. Controlling for clinical characteristics, SUD-related ED visits covered by public or private insurance had substantially higher odds of leading to hospital admission than did uninsured visits. Policies that broaden insurance coverage may improve access to inpatient care for persons with SUDs. [Copyright &y& Elsevier]

Abstract: Background: The empirical evidence of effectiveness of many school-based programs against substance abuse is rather weak. The EU-Dap study is a multicenter cluster randomized community trial (CRCT) designed to evaluate such a program. This paper presents study design and baseline characteristics of the study population. Methods: 170 schools from 9 centers from seven countries (Austria, Belgium, Germany, Greece, Italy, Spain, Sweden), stratified according to average social status in the catchment area, were randomized to either three variants of the active intervention (basic curriculum, basic with peer involvement, and basic with parent involvement) or to a control group. The program under evaluation is based on a comprehensive social influence approach, and was delivered during the scholar year 2004–2005 to a population of 12- to 14-year-old students attending junior high school. An anonymous questionnaire administered before and after the intervention was used to track behavioral and attitudinal changes. Results: All in all, we included in the study 143 schools and 7079 students, of which 3547 in the intervention groups and 3532 in the control group. At baseline, 34.9% of students had smoked cigarettes, 24.7% had been drunk, and 8.9% had used cannabis at least once in life. Discussion: EU-Dap is the first European multicenter randomized study to evaluate the effectiveness of a school program targeting tobacco, alcohol and drug use. The baseline assessment showed high prevalence and wide geographical variations of substance use. [Copyright &y& Elsevier]