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This study explored the prevalence of violent behaviors in patients who are addicted to drugs. A sample of 252 addicted patients (203 male and 49 female) who sought outpatient treatment was assessed. Information on violent behaviors, sociodemographic factors, consumption factors (assessed by the European version of the Addiction Severity Index [EuropASI]), psychopathology's factors (assessed by Symptom Checklist-90-Revised [CL-90-R]), and personality variables (assessed by Millon Clinical Multiaxial Inventory [MCMI-II]) was collected. Drug-addicted patients who were associated with violent behaviors were compared on all variables with patients who were not associated with violent behaviors. The rate of drug-addicted patients with violent behaviors in this sample was 39.68% (n = 100). There were significant differences between the numbers of patients who did and did not demonstrate violence on some variables. Patients with violence problems were younger than those without violence problems and were more likely to report having been a victim of abuse. Moreover, they were significantly more likely to have experienced an overdose and showed a significantly higher score on several EuropASI, SCL-90-R and MCMI-II variables. According to these results, patients with violence control problems present with both a more severe addiction and several comorbid problems. The implications of these results for further research and clinical practice are discussed. (Contains 4 tables.)

This study analyzed the viability of financing a voucher program for cocaine addicts in Spain through public and private donations. Of the 136 companies contacted, 52 (38%) provided donations. The difference between the benefits (15,670[euros]/$20,371) and the costs (3,734[euros]/$4,854) was 11,936[euros]/$15,517. The type of reinforcer a company can offer, the size of the company, and the time elapsed before responding may be determining variables in a company's decision whether to collaborate. (Contains 1 table.)

In a study to evaluate the drug treatment and aftercare efforts sponsored by the State Department's International Narcotics and Law Enforcement Affairs Bureau, residential Therapeutic Community (TC) treatment programs in four European countries-Poland, Spain, Slovenia, and Italy-were examined to identify promising practices and to assess lessons learned. Based on field visits, in-person interviews, focus groups, and document analyses, the authors recommend the following promising practices for replication: (1) structured programs with individualized treatment objectives throughout each stage of therapy; (2) integration of the family into every dimension of treatment; (3) emphasis on meeting the individual needs of each client; (4) extensive involvement of volunteers in the delivery of services; and (5) integration of prevention programs for children and adolescents.

Introduction: The use of emerging tobacco and nicotine products affects tobacco use behaviors among college students. Thus, we aimed to examine transitions in tobacco use patterns and identify their predictors among smokers in a cohort of nursing students in Catalonia (Spain). Methods: We conducted a prospective longitudinal study of Catalan nursing students between 2015–2016 and 2018–2019. We examined transitions in tobacco use patterns between baseline and follow-up among smokers from: 1) daily to nondaily smoking, 2) non-daily to daily smoking, 3) cigarette-only use to polytobacco use, 4) poly-tobacco use to cigarette-only use, 5) between products, 6) reducing consumption by ≥5 cigarettes per day (CPD); and 7) quitting smoking. We applied a Generalized Linear Model with a log link (Poisson regression) and robust variance to identify predictors of reducing cigarette consumption by ≥5 CPD and quitting smoking, obtaining both crude and adjusted (APR) prevalence ratios and their 95% confidence intervals (CIs). Results: Among daily smokers at baseline, 12.1% transitioned to non-daily smoking at follow-up, while 36.2% of non-daily smokers shifted to daily smoking. Among cigarette-only users, 14.2% transitioned to poly-tobacco use, while 48.4% of polytobacco users switched to exclusive cigarette use. Among all smokers (daily and non-daily smokers), 60.8% reduced their cigarette consumption by ≥5 CPD and 28.3% quit smoking. Being a non-daily smoker (APR=0.33; 95% CI 0.19–0.55) and having lower nicotine dependence (APR=0.78; 95% CI 0.64–0.96) were inversely associated with reducing cigarette consumption, while being a non-daily smoker (APR=1.19; 95% CI: 1.08–1.31) was directly associated with quitting smoking. Conclusions: Nursing students who smoked experienced diverse transitions in tobacco use patterns over time. Evidence-based tobacco use preventive and cessation interventions are needed to tackle tobacco use among future nurses. [ABSTRACT FROM AUTHOR]

The co-occurrence of substance use disorders (SUD) and other mental disorders (OMD) is assumed to be high, but the details are uncertain in Spain. The objective of the present study was to know the prevalence of this comorbidity, as well as the pharmacological treatment, both in specific addiction treatment networks and in mental health networks, with a gender perspective. Observational, multicenter study, with a randomized sample, of patients under treatment for SUD or OMD in Spain (N = 1783). A specific questionnaire, collecting sociodemographic and clinical variables, diagnosed SUD and OMD, and prescribed psychotropic drugs, was completed by treating clinicians. Differences between females and males were searched. A high prevalence of OMD was found in those patients treated for their SUD (71%), and also of diagnoses of SUD (59%) in people treated for OMD. Significant relationships between addiction to certain substances and specific mental disorders were found (with no main differences between women and men). The treatments for OMD were very common in the addiction treatment networks, but that of SUDs in those patients treated in the mental health networks was less than expected. A high prescription of benzodiazepines was found. Women were less frequently diagnosed with cannabis, opioid, and especially cocaine use disorders, and they had fewer psychotic disorders and more affective, anxiety, sleep, and eating disorders, with the rest being the same, including personality disorders. Women had fewer treatments with agonists and more with antagonists, and more prescriptions of anxiolytics and antidepressants. This study provides preliminary information on the coexistence in routine clinical practice of addictive disorders and other mental disorders in Spain, and on the treatment provided, and shows differences in prevalence and clinical characteristics, and especially in treatment approaches between women and men. Thus, should be useful to adapt the treatment response with greater precision, and with a gender perspective. [ABSTRACT FROM AUTHOR]

BACKGROUND: Drug dependence is a public health problem that requires trained professionals to effectively address this issue. The aim of this study was to analyze postgraduate university training programs specializing in addictions in Spain. METHODS: An exhaustive review of the scientific literature was conducted, and information was collected on university training programs specializing in addictions in Spain. A descriptive documentary analysis of the curricula of Master's and other postgraduate degrees at Spanish universities was performed. Postgraduate and continuing education programs were considered. The inclusion criteria encompassed academic relevance and the availability of publicly accessible information pertaining to those programs. RESULTS: Thirteen active university specialized training programs in addictions were identified across the country. These programs were offered in different universities and focused on theoretical and practical aspects related to addiction prevention, treatment and rehabilitation. Some of them focused on specific areas, such as clinical or preventive approaches, or both. In addition, a variety of methodological approaches were observed, including face-to-face, online or blended learning; courses that included clinical placements and practical experience in specialized centers and others that did not. CONCLUSIONS: This study provided an overview of specialized postgraduate university training programs in addictions in Spain. The results indicated that there are a variety of training options in the country, providing opportunities to acquire knowledge and skills in the field of addictions. However, it is important to further research and evaluate these programs to ensure their quality and effectiveness in preparing specialists in the treatment of drug dependence. It is recommended that universities, along with relevant subsidiary agencies such as ministries of health, public health organizations, research agencies linked to universities, specialized international organizations, and professional entities, continue to collaborate, and update training programs. This ongoing effort is essential to address current and future challenges in the field of addiction. [ABSTRACT FROM AUTHOR]

There is a high prevalence of drug use in female prisoners in Spain. Studies on incarcerated women are scarce, and research on drug addiction in the prison context tends to ignore the gender dimension. Objective: To understand the female prisoners' perception on the incarceration of women with drug addiction problems in prisons in Andalucía (Spain). Methodology: Qualitative, exploratory, and inductive methodology without previous hypotheses, following the Grounded Theory and supported by the Family Categorization process. In-depth semi-structured interviews are conducted with 10 women with drug addiction problems who are serving or have served a prison sentence. Results: The results show the women's perceptions in relation to life trajectories, adaptive strategies, female image and identity and organization of centers. The current center organization model facilitates certain practices that violate psychosocial health as a fundamental right. Conclusions: Interviewees perceive that their imprisonment accentuates the double stigmatization already suffered. Furthermore, the organization of the centers does not favor re-education, social reintegration and, therefore, the psychosocial health of women with drug addiction problems. [ABSTRACT FROM AUTHOR]

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Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article analyzes the treatment of cannabis in the Spanish newspapers La Razón, El Mundo, El País, and ABC during the year 2019. The sources used, the authorship of the texts, and the dominant thematic areas are identified. The results show a predominance of informative genres and topics related to criminal actions, as well as the lack of institutional information on addiction prevention campaigns. Companies and organizations related to research, production, and sale of medicinal cannabis in Spain and other countries are also mentioned. In addition, the social debate and legislative changes regarding cannabis in Spain are discussed, as well as the role of the media in shaping public perception of cannabis. [Extracted from the article]

BACKGROUND: The two-year, multidisciplinary Master's in Drug Dependence (MDD) at the University of Barcelona was created in 1986, after some years of offering shorter seminars. It was a response to the heroin crisis of the 80s and 90s and Spain's longstanding alcohol and smoking problems. Addressing the situation required specialised professionals, and a specific curriculum for drug dependence did not exist. As far as we know, the MDD is the longest-running programme of its kind in Europe. AIMS: To describe briefly the conceptualization and development of this master's programme. RESULTS: The context of design and creation of the MDD, the historical perspective, and the current context are described. Then its structure and distinctive features are analysed. Next, qualitative and quantitative data are furnished to explain the relevance of the MDD throughout its more than 30 years of existence. Finally, future challenges and the need to respond to new societal demands are discussed. [ABSTRACT FROM AUTHOR]

Drug dependence is a neuropsychiatric condition that involves genetic, epigenetic and environmental factors. Allele-specific methylation (ASM) is a common and stable epigenetic mechanism that involves genetic variants correlating with differential levels of methylation at CpG sites. We selected 182 single-nucleotide polymorphisms (SNPs) described to influence cis ASM in human brain regions to evaluate their possible contribution to drug dependence susceptibility. We performed a case-control association study in a discovery sample of 578 drug-dependent patients (including 428 cocaine-dependent subjects) and 656 controls from Spain, and then, we followed-up the significant associations in an independent sample of 1119 cases (including 589 cocaine-dependent subjects) and 1092 controls. In the discovery sample, we identified five nominal associations, one of them replicated in the follow-up sample (rs6020251). The pooled analysis revealed an association between drug dependence and rs6020251 but also rs11585570, both overcoming the Bonferroni correction for multiple testing. We performed the same analysis considering only cocaine-dependent patients and obtained similar results. The rs6020251 variant correlates with differential methylation levels of cg17974185 and lies in the first intron of the CTNNBL1 gene, in a genomic region with multiple histone marks related to enhancer and promoter regions in brain. Rs11585570 is an eQTL in brain and blood for the SCP2 and ECHDC2 genes and correlates with differential methylation of cg27535305 and cg13461509, located in the promoter regions of both genes. To conclude, using an approach that combines genetic and epigenetic data, we highlighted the CTNNBL1, SCP2 and ECHDC2 genes as potential contributors to drug dependence susceptibility. • We inspected the role of ASM in drug dependence through a case-control study. • Rs6020251 was associated with drug dependence in two independent samples. • Rs11585570 was associated with drug dependence in the discovery and pooled analysis. • The same associations were obtained for cocaine dependence. • We highlighted the CTNNBL1 , SCP2 and ECHDC2 genes as contributors to drug dependence. [ABSTRACT FROM AUTHOR]

This investigation measures the effectiveness of media relations in campaigns on road safety and drugs. Spain is among the European countries with the highest rates of road accidents due to drug use (Instituto Nacional de Toxicología y Ciencias Forenses, 2017) and, as a result, several organizations carry out prevention campaigns. Xifra (2011) links this type of social campaigns to public relations, since media relations (Wilcox, Cameron & Xifra, 2012) are fundamental to their effect, as they amplify messages (Castillo, 2009) and influence the public agenda (McCombs & Shaw, 1972). Previous studies on this subject did not focus on television and radio campaigns that address drug addiction and road safety, thus justifying this work. To carry out this investigation, a qualitative and quantitative methodology was used, which combined semistructured interviews with leaders of organizations responsible for the creation of road safety campaigns (General Traffic Directorate, Foundation for Aid against Drug Addiction and Mapfre Foundation), with the purpose of measuring exposure to the message (Castillo & Álvarez, 2015), which includes the analysis of the coverage, economic impact and content of ten campaigns run between 2011 and 2015. The results showed that the campaigns aimed at knowledge, awareness and education, by betting on combined strategies. For this, they used mass media, in particular television. Education, deterrence and health predominated in the frameworks of the campaigns, which favoured cannabis and alcohol as dangerous substances. Regarding the media coverage of these announcements, 375 pieces of information were disseminated in four months. From the analysis of its content, the predominance of informative messages (93%), its broadcasting in news (56,2% on television and 50,6% on radio) and the news in terms of events can be highlighted. The most treated substance is alcohol (90%). Despite the interviews evidencing the use of mass media, in particular television, the low coverage and the low continuity does not make the topic present in the media or public agenda. In addition, the framework and thematization that were generated did not meet the objectives desired by the organizations that created the campaigns. [ABSTRACT FROM AUTHOR]

Objective: to know the dependence on nicotine and the motivation to quit smoking in Nursing and Physiotherapy students of a university in the South of Spain, and to evaluate the impact of an intervention based on the use of information technologies on the motivation to quit smoking. Method: a pilot study in two phases: the first being cross-sectional and the second, a before-and-after intervention. The motivation to quit smoking was assessed by means of the Richmond questionnaire, and the dependence on nicotine through the Fagerström questionnaire; additionally, an intervention was performed based on the use of a web platform to increase motivation to quit smoking. Descriptive and inferential statistics were applied. Results: the prevalence in the use of tobacco was 4.33% (n=29). 3.45% of the participants had a high level of dependence; and 6.90%, a high level of motivation. The level of motivation did not change after the intervention (p=0.10). Conclusion: most of the students have low levels of motivation to quit smoking and of physical dependence to nicotine. The level of motivation to quit smoking does not change after performing the intervention. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aim: Cocaine consumption may result in irreversible structural changes in the brain. The long‐term effects of cocaine are related to a wide range of deteriorated cognitive functions. This study aimed to examine the fine motor control and hand‐function in cocaine users compared to healthy controls. Methods: An observational study was conducted. Sociodemographic variables, substance consumption, the Purdue Pegboard and the Jebsen–Taylor Hand‐function Test were evaluated bilaterally in 35 participants who were cocaine users and in 35 healthy participants. Differences between sides (dominant and non‐dominant hands) and groups were analysed with analysis of variance (ANOVA). Results: The ANOVA revealed significant differences between groups (P < 0.001) and between sides (dominant and non‐dominant hands) (P = 0.005) for the one‐hand pin placement subtest of the Purdue Pegboard Test. Also, ANOVA tests showed significant differences between sides, but not groups, for the simulated feeding (P < 0.001) and stacking checkers (P < 0.001) Jebsen–Taylor subtests. Cocaine user participants exhibited significantly lower scores in bilateral pin placement and required more time for the Jebsen–Taylor subtests compared to healthy participants. Conclusions: Cocaine user participants display deficits of fine motor control and some aspects of manual dexterity when compared to healthy controls. These findings show the convenience of incorporating functional rehabilitation by occupational therapists as a key component within the treatment of cocaine users. This study therefore opens a new field of practice for occupational therapy based on the assessment and treatment of motor deficits in the hand and the upper limb of people who consume cocaine. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacological treatment of insomnia in patients with addictions has been hardly investigated and there are few researches about it in an inpatient detoxification. The aim of this study was to describe the outcomes of the pharmacological treatment of insomnia in SUD patients admitted to a detoxification unit in Spain, with a focus on the primary substance of abuse and co-occurring mental disorders. Methods: A quasi-experimental study was conducted in 481 addicted in patients, who were admitted for substances detoxification in Vall d´Hebron University Hospital, Barcelona, Spain, from 2010 to 2015. The patients underwent systematic evaluation of axes I and II psychiatric disorders (SCID-I, SCID-II, and CAADID). Insomnia was evaluated using a night time sleep log. Substance-dependent patients, who had insomnia during hospital detoxification, received a psychotropic medication with hypnotic effect, keeping the regular clinical practice without randomization. Results: At discharge, insomnia was considered to have been alleviated in 63.8% (n = 204) of patients while 36.2% (n = 116) of patients remained with insomnia disturbances. Comparing hypnotic treatments it was observed that mirtazapine and clotiapine were the treatment that corrected the insomnia more frequently. Discussion: Since insomnia is not corrected in all patients, it should be further investigated in medications with hypnotic purpose. Based on the results of this work, randomized clinical trials might be proposed. [ABSTRACT FROM AUTHOR]

INTRODUCTION A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. METHODS Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. RESULTS In all, 20.5% (95% CI: 18.1-23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88-11.43), young age groups (18-64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44-5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. CONCLUSIONS Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban. [ABSTRACT FROM AUTHOR]

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The main aim of this study was to objectify the treatment assignment criteria used in a clinical centre for addiction treatment in Spain. A sample of 162 patients (87 inpatients and 75 outpatients) who sought treatment between 2010 and 2012 was assessed. Clinical characteristics (addiction severity, psychopathological symptoms, impulsiveness and maladjustment) of the two treatment groups (inpatient and outpatient) into which patients were assigned according to the clinical criteria of therapists were analysed to identify which variables were more relevant for patient placement. Moreover, the therapeutic progression of patients who met and did not meet the assignment criteria received was studied. According to the results, a score above 4 in the family/social support area of the European Addiction Severity Index (EuropASI), or, in cases of a score between 2 and 4 in the family/social area of EuropASI, a score above 2 in the partner subscale of the Maladjustment Scale correctly classified 73.5% of cases (96.6% of inpatients and 46.7% of outpatients). Comparisons of therapeutic results depending on matching or mismatching these assignment criteria showed a larger effect size in mismatching patient assignment criteria for outpatient treatment. The results obtained in this study provide an objective criterion for addicted patient placement. Moreover, from a cost-effective perspective, they question the necessity of inpatient treatment in most cases, demonstrating that outpatient treatment is a sufficient level of care. This study addresses the approach to assigning patients to the treatment modality that best fits them, implementing the least expensive level of care needed to achieve treatment success. [ABSTRACT FROM AUTHOR]

Background: The prevalence of depressive disorder in opioid-dependent patients in methadone treatment has been found to be between 19 to 74.3%. Beck Depression Inventory (BDI) is commonly used as a screening for depressive symptoms. The objective of this study is assessing BDI in opiate-dependent patients. Methods: A total of 415 patients over 18 years old in a methadone maintenance program that is part of an outpatient drug clinic treated with stable doses of methadone in the last month were assessed using Structured Clinical Interview for Axis I Disorders of the DSM-IV (SCID-I) and BDI. Results: A sample of 118 patients completed the evaluation; 77.96% showed depressive symptoms (N: 92) (BDI scores ≥ 10). Patients who met criteria for depression with SCID-I and BDI (6.7%) showed a higher score in BDI which did not reach significance. Statistical differences were found in the depressive group. Predictive value of BDI was 6.61% with a cut-off point of BDI ≥ 10, growing to 11.7% with a cut-off point of BDI > 30. Conclusions: BDI is not effective for diagnosing depressive disorder. An adequate psychometric tool is needed to improve the detection of depressive symptoms and depressive diagnosis in opiate-dependent patients in order to reduce risk of relapse and improve treatment strategies. [ABSTRACT FROM PUBLISHER]

Evidence on the prevalence of symptoms related to distress, anxiety/depression or substance abuse/dependence, - typically referred to as symptoms of common mental disorders (CMD) -is lacking in European professional football (soccer). The aims of the present study were to investigate the prevalence of symptoms related to CMD (distress, anxiety/depression, sleeping disturbance, adverse alcohol behaviour, and adverse nutrition behaviour) in professional footballers from five European countries, and to explore associations of the outcome measures under study with life events and career dissatisfaction. A cross-sectional design was used. Questionnaires were distributed among professional footballers by the national players' unions in Finland, France, Norway, Spain and Sweden. The highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway). In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour. Results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team. [ABSTRACT FROM AUTHOR]

Copyright of Pedagogía Social is the property of Pedagogia Social and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There has been an increase in adolescent substance use that has led to the development and implementation of prevention programs. New evidence is needed in order to improve them and optimize the resources. The aim of this paper is to use a meta-analysis to analyze the effectiveness of school drug prevention programs in Spain. Method: Twenty-one studies that evaluated drug abuse prevention programs in schools, were published between 2002 and 2013, and that met the selection criteria were identified. Results: Preventive program effectiveness was low (d= 0.16), although it was higher at the follow-up (d= 0.30). The programs were most effective in changing attitudes (d= 0.44) towards drugs. The models of health education (d= 0.48) and social learning (d= 0.20) were also very effective, especially in combination with oral, written, and audiovisual support material (d= 0.21) and the implementation of joint programs by health education professionals and faculty members (d= 0.25). Conclusions: Is possible to determine the need for more rigorous evaluations of interventions to establish useful programs. [ABSTRACT FROM AUTHOR]

The present study examined whether personality disorders (PDs) are associated with cigarette smoking, and the possible influence of nicotine dependence, sociodemographic variables, and the presence of any lifetime Axis I mental disorder in these relationships. The sample was made up of 1,081 adult participants from the Spanish general population and was stratified by smoking status (519 smokers and 562 non-smokers). PDs were assessed by means of the International Personality Disorder Examination Questionnaire, Module DSM-TV. Results indicated that participants with a paranoid, a narcissistic, a borderline, an antisocial, or an obsessive-compulsive PD had a higher probability for being smokers and for being nicotine-dependent. The only exception was the schizoid PD, because participants with this Axis II disorder had a lower probability for being nicotine-dependent smokers. The association between PDs and smoking was maintained even after adjusting for all covariates. Findings are discussed in relation to the influence of Axis II disorders on smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Problem During the 1980s, Spain had very strict laws limiting access to opioid agonist maintenance treatment (OAMT). Because of this, mortality among people who used illicit opioids and other illicit drugs was high. Spain was also the European country with the highest number of cases of acquired immunodeficiency syndrome transmitted through illicit drug injection. Approach The rapid spread of human immunodeficiency virus (HIV) infection among people using heroin led to a shift from a drug-free approach to the treatment of opioid dependence to one focused on harm reduction. A substantial change in legislation made it possible to meet public health needs and offer OAMT as part of harm reduction programmes in the public health system, including prisons. Local setting Legislative changes were made throughout the country, although at a different pace in different regions. Relevant changes Legal changes facilitated the expansion of OAMT, which has achieved a coverage of 60%. A parallel reduction in the annual incidence of HIV infection has been reported. Reductions in morbidity and mortality and improved health-related quality of life have been described in patients undergoing OAMT. Lessons learnt The treatment of opioid dependence has been more heavily influenced by moral concepts and prejudices that hinder legislation and interfere with the implementation of OAMT than by scientific evidence. To fulfil public health needs, OAMT should be integrated in harm reduction programmes offered primarily in public facilities, including prisons. Longitudinal studies are needed to detect unmet needs and evaluate programme impact and suitability. [ABSTRACT FROM AUTHOR]

Accessible summary For some heron addicts, heroin-assisted treatment is more efficacious than methadone treatment., Seven European countries have implemented outpatient centres where patients self-administer pharmaceutical heroin under close supervision., Nurses deliver pharmaceutical heroin and supervise administration. The two main concerns are overdosing and smuggling., Nurses are convinced of the utility of this treatment for severe heroin addicts., Abstract Heroin-assisted treatment (HAT) is a solution for improving the condition of treatment-resistant heroin addicts. Since 1994, six randomized controlled trials have concluded that HAT is more efficacious than oral methadone for severe heroin addicts. We visited seven HAT treatment centres in four countries in order to observe diacetylmorphine (DAM) administration and to study the main concerns of the staff. Nurses were concerned by the risk taken if a previously intoxicated patient received his dose of DAM. Another concern was the smuggling of DAM doses. The HAT centres face a dilemma: treating patients while at the same time allowing their risky street habits in the centre. [ABSTRACT FROM AUTHOR]

Purpose -- This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in Barcelona, Spain. Design/methodology/approach -- Secondary analysis of a cross-sectional study of the psychiatric, behavioural and social risk factors for HIV. DSM-IV disorders were assessed using the Spanish Psychiatric Research Interview for Substance and Mental Disorders; the Composite Abuse Scale assessed intimate partner violence and the Child Maltreatment History Self-Report assessed childhood physical and sexual abuse. Findings -- The odds of experiencing intimate partner violence were 2.42 times greater among those with any depressive disorder (95 per cent CI 1.13, 5.20), over three times greater for those who reported ever attempting suicide (OR 3.20; 95 per cent CI 1.29, 7.94), met criteria for borderline personality disorder (OR 3.05; 95 per cent CI 1.31, 7.11), had been abused in childhood (OR 3.38; 95 per cent CI 1.45, 7.85) or currently lived with a substance user (OR 3.74; 95 per cent CI 1.29, 10.84). In multiple logistic regression, only living with a substance user (OR 3.42; 95 per cent CI 1.08, 10.86) and a history of childhood abuse (OR 2.87; 95 per cent CI 1.05, 7.86) remained significant in the model examining intimate partner violence victimisation. Research limitations/implications -- The small sample size, together with the fact that the study was not originally powered to examine differences in intimate partner violence may have increased the possibility of type II errors. Originality/value -- Histories of psychiatric disorders, intimate partner violence and childhood abuse are common in female substance users in treatment. Research suggests that such histories result in poorer treatment outcomes. Histories of intimate partner violence and childhood abuse should be identified and addressed in substance abuse treatment to enhance treatment outcomes. [ABSTRACT FROM AUTHOR]

The objective of the present research was to examine the contribution of two intervention components, social skills training and problem solving training, to alcohol- and drug-related outcomes in a school-based substance use prevention program. Participants included 341 Spanish students from age 12 to 15 who received the prevention program Saluda in one of four experimental conditions: full program, social skills condition, problem solving condition, and a wait-list control group. Students completed self-report surveys at the pretest, posttest and 12-month follow-up assessments. Compared to the wait-list control group, the three intervention conditions produced reductions in alcohol use and intentions to use other substances. The intervention effect size for alcohol use was greatest in magnitude for the full program with all components. Problem-solving skills measured at the follow-up were strongest in the condition that received the full program with all components. We discuss the implications of these findings, including the advantages and disadvantages of implementing tailored interventions to students by selecting intervention components after a skills-based needs assessment. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Derecho UNED is the property of Editorial UNED and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The psychological approach followed by a Drug Addict Public Assistance Center, belonging to the Antidrug Agency of the Health Regional Ministry of the County of Madrid, to treat a subject with cocaine addiction and alcohol abuse, is presented. The treatment, based on the radical behavioral paradigm, is an exception rather than a common approach in the drug addict field. The case presented in this paper intends to show the usefulness of third generation behavior treatments when dealing with this population. [ABSTRACT FROM AUTHOR]

The association between criminal and addictive conduct has been debated in many studies, without today a causal direction could be established. The behavior turned aside from the individuals is a product of the interrelationship of several elements of risk that make his appearance more probable. One of these factors is the consumption of drugs, which in turn is going to be related to the history of life of the person. Therefore, this study centres on knowing the use and abuse that a sample of penitentiary boarders does of some substances, both legal and illegal, and the difference in relation with the level of criminal repetition, having in it counts the factors of the age of his first revenue in prison and the type of committed crime, indicating the associate motive of revenue in the Penitentiary establishment. The participants were 157 prisoners of Villabona's penitentiary establishment (Asturias), in the main males (94,9 %), whose ages include the range between 19 and 49 years. By virtue of the results, there has been verified that the repetition associates positively with the heroine's consumption in those crimes related to the public health and the property, being in the latter significantly the income in the Penitentiary Establishment to an earlier age. The implications of the results are discussed to achieve a competent adjustment looking for a reduction of the criminal activity and his repetition. [ABSTRACT FROM AUTHOR]

At present we have the perception that the preventive policies on drugs issues are something relatively recent. Nevertheless, between 1926 and 1931, Barcelona had the Asociación contra la Toxicomanía (Association against Drug Addiction) which was a pioneer in claiming the prevention from the private area background though narrowly linked to the public power. Although many professionals today dealing with addictions complain that the mass media do no pay enough attention to their work, the people in charge of this association never complained about this matter. The existence of the Asociación contra la Toxicomanía (Association against Drug Addiction), whose composition, history and achievements are presented in this article, may constitute an invitation to approach a reserch of perspective compared to some of the existing associations nowadays. [ABSTRACT FROM AUTHOR]

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The article examines the role of heroin in the "movida madrileña," or the urban culture of a Spain recently liberated from decades of dictatorship, in the 1980s through an analysis of the song "Princesa" by Spanish singer and poet Joaquín Sabina. It explains that the song, about a drug addict who robs a pharmacy in search of any substance that will alleviate her chronic heroin habit, shows that love is not enough to overcome drug addiction. The article notes that allusions to the libertine urban life of this period appear in other Spanish artistic genres as well, including the writings of Spanish author Luis Antonio de Villena and Spanish filmmaker Pedro Almodóvar.

In this study, the prevalence of psychoactive substance use and dependence was estimated among students at a Spanish university, together with associated factors, polyconsumption, and comorbidity with depression, using a 554-member sample stratified by sex, degree year, and discipline. 86.5% had consumed some potentially addictive psychoactive substance in the past month, and 10.5% satisfied DSM-IV criteria for dependence on nicotine, alcohol, caffeine, or cannabis. Polyconsumers (90.4%) consumed an average 3.2 different substances. Current depression implied increased likelihood of having consumed tobacco or psychoactive pharmaceutical drugs in the past month, and DSM-lV symptoms of major depressive episode were shown by 8.6% of 58 substance-dependent participants, 8.7% of 540 past-month legal substance consumers, and 12.1% of 140 past-month illegal substance consumers. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article examines the status of evidence-based interventions for preventing drug dependence in Spain. The evolution of the perception that the Spanish have of the problem and how this has influenced prevention efforts is described. An analysis is made of how programs designed to prevent drug use have been translated from the field of experimental research to implementation. The characteristics of evidence-based programs developed in Spain are outlined, analyzing their efficacy and the adaptations of programs from other countries to the Spanish context. Most have been school based, although some family and leisure-time based programs also have been developed. The processes for translation and cultural adaptation of evidence-based programs are described. Finally, pending aspects of the adaptation of research in drug dependence within Spain are discussed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between four polymorphisms of the 5-HT2A receptor and 5-HT transporter genes and heroin dependence. Methods: 113 heroin- dependent patients (DSM-IV criteria) and 420 unrelated healthy controls from Asturias (Northern Spain) were genotyped using standard methods. Results: There was an apparent difference in the distribution of genotypes for A-1438G polymorphisms (p = 0.024, not significant after Bonferroni correction). The 5-HT2A -1438A allele was significantly more common in patients than controls [0.55 and 0.45, respectively; corrected p = 0.042, OR = 1.51 (95% CI = 1.13–2.03)]. An interaction was observed between A-1438G of 5-HT2A and 5-HTT polymorphisms. The association between the -1438AA vs. AG/GG genotypes and heroin dependence was enhanced in the presence of 12-repeat 5-HTT VNTR and short 5-HTTLPR alleles [24.8% in heroin-dependent patients vs. 12.6% in controls; corrected p = 0.045, OR = 2.28 (95% CI = 1.36–3.82)]. Conclusions: Our findings support a contribution of the 5-HT2A gene to susceptibility to heroin dependence, as well as a possible synergistic effect of 5-HT2A and 5-HTT genes on susceptibility to heroin dependence. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Our aim is to describe the current situation regarding the diagnosis and treatment of addiction in a variety of settings in Spain. Four-hundred and twenty-seven physicians known to treat addicted patients in non-private settings were recruited and agreed to participate. Each physician provided clinical and anonymous information on the first 6 consecutive patients who attended on a scheduled day. A total of 2361 patients were interviewed (92.1%) and data were obtained concerning gender, age, work, educational level, civil status, addiction diagnosis, type of treatment and psychiatric comorbidity. Seven-hundred and ninety-eight out of 2361 addicts (33.8%) presented with a dual diagnosis. Depression was the most prevalent disorder (21.6%), followed by anxiety disorders (11.7%). Comorbidity was found to be related to age, female gender, divorce and widowhood, and higher educational levels. Alcoholics who abused other drugs showed the highest rates of comorbidity (48.5%), while opiate addicts were at the lower end of the spectrum (27.4%). No differences were found related to the treatment setting, the doctor's medical specialty, or the geographical area. Finally, doctors tended to perceive that dual diagnosis was related to a worse psychiatric prognosis but not to higher relapse rates. Antidepressants were the most commonly prescribed drugs (62.4% of co-morbid patients) and anticraving agents were prescribed equally to comorbid and non-comorbid patients. Within the limitations of a descriptive study, our data show that comorbidity is a common clinical problem in patients who access addiction treatment. Affective and anxiety disorders are the most common comorbid diseases, and comorbidity rates seem to be unrelated to regional differences, medical settings or doctor's professional background. Dual diagnosis patients thus account for one third of the clinical workload of addiction specialists in Spain. [Gual A. Dual diagnosis in Spain. Drug Alcohol Rev 2007;26:65 - 71] [ABSTRACT FROM AUTHOR]

Introduction: The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. A 12 workshop sexual health program was made in two Drug Dependence Clinics in Madrid. Shame, stigma, homophobia or ignorance of drug services assistance have been describe as barriers by chemsex drug users to accessing services. Facilitators such as creating a safe environment are necessary. Objectives: The objective of this study was to identify barriers and facilitators to the implementation of a sexual health program for chemsex users in two Drug Dependence Clinics in Madrid. Methods: The study is based on a qualitative research approach. We analyze an anonymous on-line survey with chemsex users with open answer questions about barriers and facilitators for implementing the sexual health program. Data analysis was based on thematic analysis of content. Results: Facilitators included: motivated stuff with LGBT cultural competence, close interaction between stuff and the patients, a nonjudgemental and multidisciplinary approach which includes sexual health and mental health. Barriers included: stigma related to attending drug dependence clinics, psychopathology in acute state (psychosis, anxiety), lack of perceived support from public institutions facing the mental and sexual health problems associated with chemsex. Conclusions: Chemsex, a public health problem in some Spanish communities, is a phenomenon that needs a collaborative approach between users and mental and sexual health professionals and other medical stuff. The described program is a pioneering initiative in Spain. [ABSTRACT FROM AUTHOR]

The relationship between humanity and illegal drugs has always existed in different cultures and epochs, though with different shades in regards to their use, meaning, types of used substances. The research's objective is, among others, to come closer to the relationship between Spanish Youth Culture and the behaviour related with drug consumption. This project was carried out by the Research Group HUM 739 of the University of Granada. From Social Education perspective, the analyzed data in this article investigates the initial motivations to approach addictive drugs (alcohol, tobacco and cannabis), including which consumption factors are the most influential and where these diverse situations take place. The target population are individuals between 12 and 26 years old. A total of 28 interviews and 1,030 questionnaires were applied both in Spanish urban and rural areas. [ABSTRACT FROM AUTHOR]

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Introduction. Substance dependence, especially heroin dependence, has become one of the most prevalent psychiatric diseases during recent years. In spite of the numerous related publications, very few articles offer a heroin users profile based on an extensive sample and a broad range of variables of opiate dependent patients in Spain, thus limiting the possibility of generalizing the different findings published. Objective. Present a description of an opiate dependence user profile, based on the analysis of a broad range of variables in an extensive population sample. Methodology. An observational retrospective study, with treatment group (n = 11 "y^) and no control group was established. Descriptive and survival techniques were used to analyse different variables (sociodemograpbic data, medical and psychiatric history, drug consumption record, risk behavior in regards to HIV infection, previous dehabituations, legal situation, treatment carried out for addiction, etc.). Results. We describe a heroine dependent user pattern that coincides in the different variables with the data offered by previous reviews in Spain. Conclusions. The profile defined can be considered as representative of opiate users in Spain, and it may be used as a reference for future articles. [ABSTRACT FROM AUTHOR]

In this paper, the effectiveness of the treatment program developed by Proyecto Hombre ('Project Mankind') in Asturias, Spain, is evaluated. In a long-term follow-up (range from 73 days to 8 years) with a sample of 249 subjects, the results obtained by subjects completing the treatment (194) were compared with pre-treatment results and with those of the group that dropped out (55). The measurements used were relapses in illegal drugs, alcohol, changes in family situation, educational level, employment, criminal involvement and state of health. External validation of self-report measures given in the questionnaire was carried out. Findings support the effectiveness of the treatment in all measures and the validity of self-report items. Relapse rate in 'treatment-completed' group was 10.3%, whilst in the non-completers group it reached 63.6% (significant difference, p < 0.001). Relapses of non-completers were more severe, occurred sooner after leaving the program (they stayed abstinent for shorter periods) and lasted longer than those of subjects completing the treatment. [ABSTRACT FROM AUTHOR]

Drug addiction is a neuropsychiatric disorder where long-lasting changes in gene expression within particular regions of the brain play an important role. Work over the past decade has demonstrated a crucial role for epigenetic mechanisms in driving stable changes in gene expression in several tissues, including the brain. Allele-specific methylation (ASM) is a common epigenetic mechanism consisting on SNPs that correlate with differential levels of methylation at CpG sites. The aim of our study is to assess the possible contribution of ASM in different brain regions to drug dependence susceptibility. We performed a SNP selection based on two previous studies that reported thousands of ASM SNPs in different brain regions of post-mortem human samples. By combining both studies, we obtained a total of 43,132 SNPs CpG pairs that include 33,944 SNPs and 5,036 CpG islands. From those, we obtained a sub-list of 184 SNPs using the following selection criteria: cis associations between SNPs and CpG sites, correlation (R2) of DNA methylation with gene expression ≥0.5 and selection of only one SNP per CpG site, the one showing the best correlation (R2). Subsequently, we evaluated the possible contribution of these SNPs to drug dependence predisposition through a case-control association study in a sample of 577 drug-dependent patients and 655 sex-matched controls from Spain, and then we followed-up the significant associations in an independent sample of 1,192 cases and 1,256 sex-matched controls. In the discovery sample, we obtained five associations (p<0.05) under the additive model after correcting by age. One of them was replicated in the follow-up sample. To conclude, we detected a potential association between drug dependence and a SNP that correlates with differential levels of methylation at one CpG site. Both the SNP and the CpG site are located in the first intron of a gene encoding an integral protein of the spliceosome. Further research is needed to understand its potential role in the susceptibility to drug dependence. [ABSTRACT FROM AUTHOR]

Background and Aims: Patients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the specific risk characteristics for suicidal attempts in patients with addiction problems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and to explore the differential characteristics for suicide ideators with and without suicide attempts., Methods: A sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed., Measurements: Information concerning socio-demographic characteristics, addiction severity, and psychopathological symptoms was obtained., Results: In total, 39.6% of the patients had attempted suicide (95% Confidence Interval: 32.1%-47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction profile and more maladjustment to everyday life than patients with only suicidal ideation. Specifically, three psychopathological variables were related to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium., Conclusions: According to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

This study explored the prevalence of victims of abuse and the therapeutic progression among women who sought treatment for drug addiction. A sample of 180 addicted Spanish women was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual), socio-demographic factors, consumption variables, and psychological symptoms. Of the total sample, 74.4% ( n = 134) of the addicted women had been victims of abuse. Psychological abuse affected 66.1% ( n = 119) of the patients, followed by physical abuse (51.7%; n = 93) and sexual abuse (31.7%; n = 57). Compared with patients who had not been abused, the addicted women with histories of victimization scored significantly higher on several European version of the Addiction Severity Index (EuropASI) and psychological variables. Specifically, physical abuse and sexual abuse were related to higher levels of severity of addiction. Regarding therapeutic progression, the highest rate of dropout was observed among victims of sexual abuse (63.5%; n = 33), followed by victims of physical abuse (48.9%; n = 23). Multivariate analysis showed that medical and family areas of the EuropASI, as well as violence problems and suicide ideation, were the main variables related to physical and/or sexual abuse. Moreover, women without abuse and with fewer family problems presented the higher probability of treatment completion. The implications of these results for further research and clinical practice are discussed.