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Aim: Young people who are socially engaged with people who inject drugs are at higher risk of transitioning to injecting drug use. We aimed to examine rates of exposure to injecting among young people in an online survey, and whether exposure to injecting was related to hepatitis C(HCV) knowledge. Methods: A cross-sectional, online survey was completed by 827 young people (aged 16-26 years) in New South Wales, Australia. Exposure to injecting in the preceding 12 months was measured by asking participants whether close friends and romantic/sexual partners had injected, and whether somebody had offered them an injection. HCV knowledge was measured using items adapted from a survey of Australian secondary school students. Findings: Eleven percent of participants reported recent exposure to injecting.Participants exposed to injecting were significantly more likely than other participants to report use of injectable drugs. Some aspects of HCV transmission were poorly understood, and exposure to injecting was not significantly associated with higher HCV knowledge. Conclusions: While online methods were only moderately successful in recruiting people exposed to injecting, higher rates of use of injectable drugs and HCV knowledge deficits in this group suggests that they are an important target for HCV education and prevention.

Background: Negative attitudes towards substance use and Substance Use Disorders (SUDs) are among the commonly cited barriers to screening and treating these disorders by physicians. These negative attitudes have also been reported in medical students. The aim of this study was to examine attitudes of medical students in Israel towards nicotine, alcohol and drug use and SUDs based on their stage of training and personal experience. Methods: A sample of 329 medical students responded to the Attitudes Towards Substance Use questionnaire, which includes 50 questions regarding substance use and SUDs, as well as specific questions focusing on nicotine, alcohol, cannabis and heroin use. Results: Students at the clinical phase of their training had higher rates of moralism and lower rates of self-reported competency in treating SUDs compared to those in the pre-clinical phase of training. Personal experience with nicotine or alcohol use, as well as having a friend who suffers from addiction, were associated with lower rates of moralism. Across substances, the lowest ratings of treatment efficacy and of self-reported competence, were directed towards alcohol dependence. Conclusions: Medical education programs should include training in addiction medicine throughout all phases of medical school. This may have a significant role in future physicians' attitudes towards individuals with substance use and SUDs, and eventually in the treatment these patients receive.

The progression from prescription opioid (RXO) abuse to RXO addiction is not well understood in adolescents, nor is the progression from RXO addiction to heroin abuse. The purpose of this pilot study was to characterize the development of RXO drug abuse, RXO drug addiction, and heroin abuse in a small cohort of adolescents recovering from opioid addiction at Massachusetts Recovery High Schools (RHS). A self-report questionnaire was administered to 31 adolescent, former RXO abusers across two Massachusetts RHS. RXO abuse was primarily initiated due to curiosity; RXOs were initially obtained through illicit and licit methods. Fifty-eight percent (N = 18) of the RXO abusers became addicted to RXOs. Many addicted adolescents initiated RXO abuse under the influence of marijuana, yet believed that they became addicted due to the stress from difficult life situations. A subgroup indicated they abused and became addicted to RXOs that had been obtained from legitimate prescriptions due to their pain. Sixteen percent (N = 5) of the sample abused heroin. Most heroin abusers (4/5) were addicted to RXOs prior to onset of heroin use. Heroin abusers indicated that they considered using heroin after they began tampering with RXOs. A portion of the sample felt that abuse deterrent formulations (ADFs) would have reduced their RXO use. This pilot study discovered areas where further research could be targeted, such as drug combinations, adolescent coping mechanisms, adolescent pain management, and the use of ADFs to disrupt the transition from RXO addiction to heroin use.

Using current research and real-life scenarios to motivate students to understand chemistry principles is a key strategy in learning and teaching. An illustration of psychoactive drugs referred to as "legal highs" used in the U.K. and Europe is presented to highlight key chemistry principles and relate the importance of chemistry research in healthcare. Specific topics include stereochemistry, 1 H NMR characterization, organic synthesis, and functional groups, which can be used in chemistry curricula for high school students and also in higher education programs. A contextualized example focused on mephedrone is used during an interpretative spectroscopy exercise in a second-year bioscience program. Student evaluations on the use of this case study approach were very positive. This topic on psychoactive drugs integrates chemistry in social and legal issues relating to patient safety. It highlights public awareness of "legal highs" and the generalized perception that "natural products" are safe and nontoxic.

Aims: Scotland was the first country to adopt take-home naloxone (THN) as a funded public health policy. We summarise the background and rigorous set-up for before/after monitoring to assess the impact on high-risk opiate-fatalities. Methods: Evidence-synthesis of prospectively monitored small-scale THN schemes led to a performance indicator for distribution of THN-kits relative to opiate-related deaths. Next, we explain the primary outcome and statistical power for Scotland's before/after monitoring. Results: Fatality-rate at opiate overdoses witnessed by THN-trainees was 6% (9/153, 95% CI: 2-11%). National THN-schemes should aim to issue 20 times as many THN-kits as there are opiate-related deaths per annum; and at least nine times as many. Primary outcome for evaluating Scotland's THN policy is reduction in the percentage of all opiate-related deaths with prison-release as a 4-week antecedent. Scotland's baseline period is 2006-10, giving a denominator of 1970 opiate-related deaths. "A priori" plausible effectiveness was 20-30% reduction, relative to baseline, in the proportion of opiate-related deaths that had prison-release as a 4-week antecedent. A secondary outcome was also defined. Conclusion: If Scotland's THN evaluation shifts the policy ground seismically, our new performance measure may prove useful on how many THN-kits nations should provide annually.

Epidemiological data in Vietnam shows high HIV prevalence rates among injection drug users, especially in urban centres. However, there are limited data on specific practices used to prepare and inject drugs or on sexual practices among Vietnamese injectors. A street-based cross-sectional interview was conducted with 862 heroin injectors in Hanoi, Vietnam, to collect such data. Variability was seen in both injection and sexual risk, with 12.9% of current injectors reporting at least one unsafe method of drug sharing and 57.1% reporting unsafe sex in the past 30 days. These risks were strongly associated with those who engaged in unsafe injection significantly more likely to engage in unsafe sex (69.4% vs. 55.3%) and those engaging in unsafe sex significantly more likely to engage in unsafe injection (15.7% vs. 9.2%). These findings highlight the overlap of injection and sexual risk practices among Vietnamese heroin users and suggest the need for strong, broadly targeted HIV prevention activities among this population.

This grounded theory study explores how women with histories of addiction perceive stigma while in treatment. In-depth interviews were conducted with 30 women participating in a residential drug treatment centre. Previous research has found that support from peers during recovery can be critical to managing illnesses. In fact, researchers have postulated that peers can be a more effective form of support than even family. This study extends existing literature indicating that peer support systems can be supportive, however they can also can be perceived as negative support that impose stigmas. Findings reveal that women perceive stigmas due to how various types of drug use violate societal expectations and conflict with notions of deservingness. Specifically, the ''hard users'' (i.e. women who use heroin or crack cocaine) perceive stigmas regarding how their drug use violates norms of womanhood. Moreover, the ''soft users'' (i.e. those who use alcohol or marijuana) perceive stigmas that their drug use is considered undeserving of support. This article explores the factors that contribute to stigma amongst populations who potentially face marginalisation from larger society. Implications for treatment and group work are discussed.

Objective: Hepatitis C virus (HCV) incidence has been increasing among young injection drug users (IDUs). This analysis examined whether the emerging practice of prescription opioid (PO) injection is associated with self-reported HCV among young IDUs. Methods: Young IDUs (n = 162) aged 18-25-years-old who indicated recent misuse of prescription drugs were sampled in New York and Los Angeles during 2009--2011. Participants reported lifetime PO injection history and results from their most recent HCV test as well as demographic characteristics and lifetime drug use. Bivariate analyses examined relationships between covariates and both lifetime PO injection and HCV positivity. Poisson regression examined the associations between lifetime PO injection, HCV positivity, and significant covariates. Results: A majority reported lifetime PO injection (72.2%) and 30.9% self-reported being HCV positive. Lifetime PO injectors were nearly three times more likely to report being HCV positive than non-PO injectors (adjusted incidence rate ratio (AIRR): 2.69, p < 0.05) after controlling for socio-demographic and other drug use variable. Additionally, substituting POs for heroin (AIRR: 2.27, p < 0.05), growing up in a lower social class (AIRR: 1.67, p < 0.05), age (AIRR: 1.12, p < 0.05), age of injection initiation (AIRR: 0.87, p < 0.001), and history of being prescribed stimulants (AIRR: 0.64, p < 0.05) were independently associated with HCV positivity. Conclusions: Findings suggest that PO injection should be given further consideration as a contributing factor to rising HCV infection among young adults in the US.

The study purpose is to examine the impact of early substance use on lifetime and past year contraction of sexually transmitted diseases (STDs), including chlamydia, gonorrhea, herpes, and syphilis. A secondary analysis of the 2012 National Survey on Drug Use and Health (N = 52,529) was conducted to determine if lifetime or past year STD contraction differed based on demographic differences. Lifetime and past year contraction based on first use of substance before age 21 differed based on sex, race/ethnicity, age, alcohol, marijuana, crack, and sedatives. Recommendations for future studies are included.

Safety signals provide "relief" through predicting the absence of an aversive event. At issue is whether these signals also act as instrumental reinforcers. Four experiments were conducted using a free-operant lever-press avoidance paradigm in which each press avoided shock and was followed by the presentation of a 5-sec auditory safety signal. When given a choice between two levers in Experiment 1, both avoiding shock, rats preferentially responded on the lever that produced the safety signal as feedback, even when footshock was omitted. Following avoidance training with a single lever in Experiment 2, removal of the signal led to a decrease in avoidance responses and an increase in responses during the safety period normally denoted by the signal. These behavioral changes demonstrate the dual conditioned reinforcing and fear inhibiting properties of the safety signal. The associative processes that support the reinforcing properties of a safety signal were tested using a novel revaluation procedure. Prior experience of systemic morphine during safety signal presentations resulted in an increased rate of avoidance responses to produce the safety signal during a drug-free extinction test, a finding not seen with d-amphetamine in Experiment 3. Morphine revaluation of the safety signal was repeated in Experiment 4 followed by a drug-free extinction test in which responses did not produce the signal for the first 10 min of the session. Instrumental avoidance in the absence of the signal was shown to be insensitive to prior signal revaluation, suggesting that the signal reinforces free-operant avoidance behavior through a habit-like mechanism.

The social, economic, and cultural changes that occurred in Russia following the collapse of the Soviet Union have combined to impose severe damage on the population, and not the least on Russia's young people. The provision of new forms of social and economic support are needed, as well as new youth programs, if further damage is to be avoided.

Learner-centered molecular modeling exercises in college science courses can be especially challenging for nonchemistry majors as students typically have a higher degree of anxiety and may not appreciate the relevance of the work. This article describes a learner-centered project given to allied health majors in a Biochemistry course. The project involved building molecular models of imagined protein binding sites for the drug thalidomide. By designing their own sites, students should have a better understanding of how proteins interact with other molecules and that small changes in the three-dimensional structure of the molecule have the potential to reduce interactions with the protein. Surveys suggested that students understood the purpose of the project and its relevance to their careers beyond the Biochemistry course. There was slightly less agreement as to whether this type of project made the material more comprehensible. Nevertheless, there was a significant improvement of final exam scores over previous classes. In addition, students expressed some anxiety over the project prior to and on its initiation. Anxiety was reduced and enthusiasm was greatly improved as the project progressed. Together these findings suggest that a molecular modeling exercise can be successfully introduced to allied health majors to provide spatial reasoning and critical thinking skills.

Research on narcotics use among students in Russia shows that many are under pressure become involved, and that knowledge of and willingness to participate in clinics and other sources of help are not widespread.

Survey data on the problem of drug abuse in Russia show a high level of awareness of the issue among young people. To reduce the level of drug use in Russia, a comprehensive, focused, and coordinated program involving representatives of official state and social institutions, as well as institutions of civil society, is needed. Combining their efforts will require an integrated state program to fight against narcotics abuse in all spheres where it is manifested. (Contains 3 tables, 2 figures, and 1 note.)

Driving under the influence of drugs poses risks for traffic safety. Most research attention has been focused on the most prevalent drugs of abuse, such as alcohol, illegal drugs, and prescription drugs with high abuse potential. The objectives of this study were to determine the types of drugs used by convicted DUI offenders on the day of their arrest, prevalence of poly-substance use, and offender characteristics associated with different drug use patterns. Data were collected from 6,339 individuals enrolled in the court-mandated Mississippi Alcohol Safety Education Program. After alcohol, cannabis was the most frequently used substance, followed by sedative medications and prescription analgesics. Among poly-substance users, 78.4% reported combining alcohol with other drugs. Findings could be used to inform public education campaigns, law enforcement training, and highway safety policies about the prevalence of combining alcohol with other drugs, as well as how poly-substance use further impairs traffic-related risks.

Objective: To examine the influence of conduct disorder (CD) on substance use initiation. Method: Community adolescents without CD (n = 1,165, mean baseline age = 14.6 years), with CD (n = 194, mean baseline age = 15.3 years), and youth with CD recruited from treatment (n = 268, mean baseline age = 15.7 years) were prospectively followed and re-interviewed during young adulthood (mean ages at follow-up respectively: 20, 20.8, and 24). Young adult retrospective reports of age of substance initiation for 10 substance classes were analyzed using Cox regression analyses. Hazard ratios of initiation for the CD cohorts (community without CD as the reference) at ages 15, 18, and 21 were calculated, adjusting for baseline age, gender, and race/ethnicity. Results: Among community subjects, CD was associated with elevated adjusted hazards for initiation of all substances, with comparatively greater hazard ratios of initiating illicit substances at age 15 years. By age 18, the adjusted hazard ratios remained significant except for alcohol. At age 21, the adjusted hazard ratios were significant only for cocaine, amphetamines, inhalants, and club drugs. A substantial portion of community subjects without CD never initiated illicit substance use. Clinical youth with CD demonstrated similar patterns, with comparatively larger adjusted hazard ratios. Conclusions: CD confers increased risk for substance use initiation across all substance classes at age 15 years, with greater relative risk for illicit substances compared to licit substances. This effect continues until age 18 years, with the weakest effect for alcohol. It further diminishes for other substances by age 21, However, the likelihood of initiating cocaine, amphetamines, inhalants and club drug use among those who have not initiated yet continues to be highly elevated by age 21. (Contains 4 tables and 4 figures.)

This article examines the relationship between gun possession and the nature of an offender's involvement in drug markets. The analyses are based on data obtained from drug offenders who participated in the 1997 Survey of Inmates of State and Federal Correctional Facilities. The authors find that participants in crack-cocaine markets are more likely to possess guns than participants in powdered-cocaine, opiate, and marijuana markets, particularly if they are street-level crack dealers. However, participants in barbiturates and amphetamine markets also have high rates of gun possession. The authors also find relatively high levels of gun possession among traffickers who handle stashes of moderately large market value, who have central roles in the trade, and who are members of drug organizations. Finally, offenders who are young, female, African American, and from lower economic status are more likely to traffic in crack cocaine than in other drugs. (Contains 3 tables, 1 figure, and 9 notes.)

The prevention of teen dating violence is a major public health priority. However, the dearth of longitudinal studies makes it difficult to develop programs that effectively target salient risk factors. Using a school-based sample of ethnically diverse adolescents, this longitudinal study examined whether substance use (alcohol, marijuana, and hard drugs) and exposure to parental violence predicted the perpetration of physical dating violence over time. 1,042 9th and 10th grade high schools students were recruited and assessed in the spring of 2010, and 93 % of the original sample completed the 1-year follow-up in the spring of 2011. Participants who had begun dating at the initial assessment and who self-identified as African American (n = 263; 32 %), Caucasian (n = 272; 33 %), or Hispanic (n = 293; 35 %) were included in the current analyses (n = 828; 55 % female). Slightly more than half of the adolescents who perpetrated dating violence at baseline reported past year dating violence at follow-up, relative to only 11 % of adolescents who did not report perpetrating dating violence at baseline. Structural equation modeling revealed that the use of alcohol and hard drugs at baseline predicted the future perpetration of physical dating violence, even after accounting for the effects of baseline dating violence and exposure to interparental violence. Despite differences in the prevalence of key variables between males and females, the longitudinal associations did not vary by gender. With respect to race, exposure to mother-to-father violence predicted the perpetration of dating violence among Caucasian adolescents. Findings from the current study indicate that targeting substance use, and potentially youth from violent households, may be viable approaches to preventing the perpetration of teen dating violence.

Prior research has identified a link between schools (particularly high schools) and neighborhood crime rates. However, it remains unclear whether the relationship between schools and crime is a reflection of other criminogenic dynamics at the neighborhood level or whether schools influence neighborhood crime patterns independently of other established structural predictors. We address this question by investigating the relationship between schools and serious crime at the block group level while controlling for the potentially criminogenic effects of neighborhood instability and structural disadvantage. We find that, net of other structural correlates, neighborhoods with high schools and middle schools experience more violent, property, and narcotics crimes than those without middle or high schools. Conversely, neighborhoods with elementary schools exhibit less property crime than those not containing elementary schools. These results, which are consistent with prior research and with explanations derived from the routine activities and social disorganization perspectives, suggest some strategies for police deployment and community involvement to control crime. (Contains 3 tables and 5 notes.)

Objective: To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R])) System. Method: Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. Results: A total of 16,209 intentional adolescent exposures to prescription drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD[plus or minus]1.7 years). Slightly more than half (52.4%) of drug mentions involved females. The five most frequently misused or abused drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38% were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to prescription drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Conclusions: Prescription drug misuse and abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent prescription drug abuse and misuse by adolescents. (Contains 2 figures and 3 tables.)

Objective: Relapse is a major problem in drug addiction treatment. Both drug craving and drug-related cognitions (e.g., attentional bias and implicit attitudes to drugs) may contribute to relapse. Using ecological momentary assessments, we examined whether craving and cognitions assessed during drug detoxification treatment were associated with relapse. Method: Participants were 68 heroin-dependent inpatients undergoing clinical detoxification at an addiction treatment center. Participants carried around a personal digital assistant for 1 week. Participants completed up to 4 random assessments (RAs) per day. They also completed an assessment when they experienced a temptation to use drugs (TA). At each assessment, participants reported their craving and attitudes to drugs. Implicit cognitions were assessed with a drug Stroop task (attentional bias) and an Implicit Association Test (implicit attitudes). Results: Individuals who relapsed during the study week exhibited a larger attentional bias and more positive implicit attitudes to drugs than did nonrelapsers at TAs (but not RAs). In addition, compared to nonrelapsers, relapsers reported higher levels of craving and more positive explicit attitudes to drugs at TAs than at RAs. Additional within-subject analyses revealed that attentional bias for drugs at TAs increased before relapse. Conclusions: Drug-related cognitive processes assessed with ecological momentary assessments were associated with relapse during drug detoxification. Real-time assessment of craving and cognitions may help to identify which individuals are at risk of relapse and when they are at risk of relapse. (Contains 5 tables, 2 figures and 2 footnotes.)

Narp knockout (KO) mice demonstrate an impaired extinction of morphine conditioned place preference (CPP). Because the medial prefrontal cortex (mPFC) has been implicated in extinction learning, we tested whether Narp cells in this region play a role in the extinction of morphine CPP. We found that intracranial injections of adenoassociated virus (AAV) expressing wild-type (WT) Narp into the mPFC of Narp KO mice rescued the extinction and the injection of AAV expressing a dominant negative form of Narp (NarpN) into the mPFC of WT mice impaired the extinction of morphine CPP. These findings suggest that Narp in the mPFC mediates the extinction of morphine CPP.

Racial/ethnic disparities in HIV infection, with minority groups typically having higher rates of infection, are a formidable public health challenge. In the United States, among both men and women who inject drugs, HIV infection rates are elevated among Hispanics and non-Hispanic Blacks. A meta-analysis of international research concluded that among persons who inject drugs, racial and ethnic minorities were twice as likely to acquire an HIV infection, though there was great variation across the individual studies. To examine strategies to reduce racial/ethnic disparities among persons who inject drugs, we reviewed studies on injection drug use and its role in HIV transmission. We identified four sets of evidence-based interventions that may reduce racial/ethnic disparities among persons who inject drugs: HIV counseling and testing, risk reduction services, access to antiretroviral therapy, and drug abuse treatment. Implementation of these services, however, is insufficient in many countries, including the United States. Persons who inject drugs appear to be changing drug use norms and rituals to reduce their risks. The challenges are to (a) develop a validated model of how racial/ethnic disparities in HIV infection arise, persist, and are reduced or eliminated over time and (b) implement evidence-based services on a sufficient scale to eliminate HIV transmission among all persons who inject drugs.

Aims: This article reports on findings to emerge from a project examining YouTube "drug videos" in the light of an emerging literature on the relationship between YouTube and health education. The aim of this article is to describe the variety of discourses circulated by the "drug videos" available on YouTube and to consider the implications of these for mediated drugs education. Method: The method used is a content analysis of a sample of 750 "drug videos" in which both video text and loader comments are used to code "drug discourses". Findings: The findings point to the circulation of a variety of "drug videos" of which official drugs education materials represent only a small proportion. The "drug videos" created by YouTube users circulate a variety of "drug discourses" including the "celebratory" or hedonistic but also "cautionary" videos intended to "warn" or "discipline" but others offer an "amateur" or "vernacular drugs education" while still others develop "consumer discourses" which evaluate substances and technologies of intoxication as commodities. Conclusions: The findings suggest that in the symbolic environment of YouTube drugs education strategies based upon "old media" assumptions become highly problematic. This is firstly, because official drugs education material now has to compete with a variety of alternative discourses circulated in the "drug videos" created by YouTube users. Secondly, some of these videos offer an alternative "vernacular drugs education", or offer alternative understandings of drug use. But thirdly, in the era of Web 2.0 technologies such as YouTube, lines of communication are no longer characterized by simple linearity but multiple directionality, which mean that official drugs agencies are now even less assured of communicative control than in the past. (Contains 3 tables and 17 notes.)

Ethnographic and qualitative research were utilized to examine how the effects of geographic place can be related to heroin abuse and collective identity in non-metropolitan areas (NMAs) in the mid-Hudson region of New York State, U.S. The socio-geographic consequences of this interrelationship are explored. In-depth interviews were conducted with 237 recent admissions to drug treatment at 28 facilities in the seven mid-Hudson region counties. The effects of geographic place and collective identity emerged in interviews through narratives relating to heroin experimentation, subsequent dependence, and the lure of New York City. Heroin experimentation and the New York City lifestyle are collectively constructed by many respondents as "cool." They are both oriented toward city life and in conflict with what respondents believe to be a lack of community and caring among city dwellers and the dehumanizing effects of the city. The idea that heroin use is cool serves as tacit permission to experiment with heroin.

Prescription drugs for many indications are labeled with warnings for potential risk of suicidal ideation or behavior. Exposures to prescription drugs labeled for adverse effects of suicidal behavior or ideation among 100 Air Force personnel who died by suicide between 2006 and 2009 are described. Air Force registry data were linked to administrative prescription data. Descriptive statistics illustrate utilization: 89 personnel had a prescription history, 35 filled at least one prescription labeled with a warning, 26 had antidepressants on hand at death, and 2 died by drug overdose. Most airmen were not exposed to any prescriptions labeled for risk of suicidal ideation or behavior prior to death by suicide. (Contains 2 tables.)

There is a persistent opinion that the spread of narcotics abuse is taking in more and more young people and having an impact on the economic, political, and cultural development of society. Data obtained by sociologists and criminologists make it possible to single out the factors, conditions, and channels of the spread of psychoactive substances [PAS]. Until recently, the Republic of Sakha (Yakutia) was not counted among the regions where narcotics abuse was mounting. At the same time, the crime situation is characterized by the same tendencies that are prevalent in the country as a whole: a rise in registered crimes, basically as the result of the increase in violations of the laws stemming from greed, and crimes linked to the illegal circulation of narcotics. Data from a study of substance abuse among young people in the Republic of Sakha (Yakutia) show that it increases when social and economic opportunities are lacking, and when supplies of drugs increase. Programs to combat this need to be more comprehensive and more coordinated on both local and national levels.

The increase in the use of narcotics in Russia has been complicated by the spread of new kinds of drugs that are less visible than more traditional kinds. A worsening of the situation must be prevented. This requires studying the accumulation of world experience, searching for up-to-date approaches to prevention, combining the efforts of science and practice, and coordinating actions on the part of all preventive agencies.

A recent paper (Zald & Andreotti, 2010) reviewed neuropsychological tasks that assess the function of the orbital and ventromedial portions of the prefrontal cortex (OMPFC). Neuropathological studies have shown that the function of the OMPFC should be preserved in the early stages of Parkinson's disease (PD) but becomes affected in the advanced stages of PD. This pattern has also been suggested by studies that have shown that dopaminergic drugs impair the performance of early PD patients in OMPFC tasks that involve reinforcement learning but enhance the performance of advanced PD patients. Based on these empirical findings, we reviewed the neuropsychological evidence of OMPFC functions in PD patients to test two hypotheses regarding the following: (1) OMPFC functions at different stages of PD; (2) different effects of dopaminergic drugs on OMPFC functions based on PD stage and task demand. We focused our review only on the neuropsychological tasks that were specific and sensitive to the functions of the OMPFC and that were adopted at different stages of PD, such as reversal learning tasks, the Iowa Gambling Task and the affective Theory of Mind task. We found robust empirical evidence that in early PD, OMPFC functions are preserved and dopaminergic drugs result in a detrimental effect when the task involves reinforcement learning. Further studies are needed to verify the status of OMPFC functions in non-demented, advanced PD and to describe the longitudinal course of OMPFC functions in this clinical population. (Contains 3 tables and 1 figure.)

Background: Illicit drug use by school-aged teens can adversely affect their health and academic achievement. This study used a survey administered in schools to assess the prevalence of problematic drug use among teenagers in a Midwestern community. Methods: Self-report data were collected from 11th- and 12th-grade students (N = 3974) in 16 school districts in the Dayton, Ohio, area. Students responded to a drug use survey that also included CRAFFT, a brief substance abuse screening instrument. Binomial and zero-inflated Poisson regressions were used to examine the association between CRAFFT scores and drug use practices, including abstinence. Results: More than one third of students had CRAFFT scores suggestive of problematic use. Of these, 14.1% had scores suggesting drug dependence. Although alcohol, marijuana, and tobacco were the drugs most commonly used, an array of other drugs including opioids, benzodiazepines, stimulants, hallucinogens, and dextromethorphan were also commonly used. Higher CRAFFT scores were associated with a greater number of drugs used (p less than 0.0001). Proportionately more 12th graders than 11th graders had CRAFFT scores indicating problems (p less than 0.0001). Among 12th graders, boys were more likely than girls to have CRAFFT scores indicating dependence (p = 0.01). Conclusions: The results suggest that problematic drug use among high school students is more prevalent than has been recognized previously. CRAFFT can be used easily to assess the prevalence of problematic drug use among teenagers in school settings. CRAFFT results can also inform prevention and intervention activities, particularly if the CRAFFT instrument is paired with a drug use survey. (Contains 3 tables and 1 figure.)

Gamma-hydroxybutyrate (GHB) is a drug with significant abuse potential. The present study aimed to assess the relative value of escalating doses of GHB to current GHB users via the Multiple Choice Procedure (MCP), and to validate that the dose rated highest with the MCP would be self-administered at a greater rate than placebo. Participants were 5 current GHB users who were not currently trying to stop using GHB. To examine the value of escalating doses of GHB, the following doses of GHB were used: 0 (placebo), 12.5, 25, 37.5, and 50 mg/kg. Participants typically assigned higher doses of GHB had higher crossover points on the MCP. During choice sessions, participants made repeated choices between administering GHB, placebo or nothing. All participants selected GHB exclusively (5 out of 5 instances) except for one participant who selected GHB on 4 out of 5 instances, thus 96% (i.e., 24/25) of choices were for active GHB. Based on these data, GHB appears likely to function as a dose-dependent reinforcer for humans based on our sample. (Contains 2 figures.)

Objective: Although the majority of poisonings in young children are due to exploratory ingestions and might be prevented through improved caregiver supervision, the circumstances that warrant evaluation for suspected maltreatment and referral to Child Protective Services (CPS) are unclear. Therefore the objective of this study was to determine the percentage and characteristics of young poisoning victims who were evaluated for child maltreatment by the hospital team (social work and/or child protection team) and/or referred to CPS. Methods: Retrospective study of poisoning victims less than 6 years old seen at an urban children's hospital from 2006 to 2008. Logistic regression was performed to evaluate the associations between the outcomes (evaluation for maltreatment by hospital team and/or referral to CPS) and predictor variables (demographics and circumstances, type and severity of poisoning). Results: Among 928 poisonings, 41% were from household products, 20% from over-the-counter drugs, 7% from prescription narcotics/sedatives, 29% from other prescription drugs, and [less than or equal to]1% each from ethanol, illicit drugs, or other substances. Most children were asymptomatic (69%) or stable (28%); 3% were critically ill. Only 13% were evaluated by the hospital team and 4% were referred to CPS. Demographic characteristics were not associated with referral to CPS. Higher clinical severity was associated with increased referral (p less than 0.001). Compared to poisonings with over-the-counter drugs, referrals were more likely for poisonings with ethanol and prescription narcotics/sedatives, but not other prescription drugs or household products (p less than 0.001). All illicit drug poisonings and 44% of ethanol poisonings were referred. The majority of referrals to CPS were for concerns for illicit drugs, poor supervision or multiple forms of maltreatment; 6% were secondary to concerns for intentional poisoning. Conclusions: Evaluations and referrals to CPS for maltreatment are uncommon in young poisoning victims. Referrals occurred consistently for illicit drugs but not ethanol. Although referrals were more likely for higher severity poisonings, it is unclear if the severity of poisoning is associated with the level of supervisory neglect or a marker of ongoing risk to the child. These findings suggest the need to identify risk factors for ongoing harm and the development of clinical guidelines used to determine which poisoning victims should be referred to Child Protective Services. (Contains 3 tables.)

In the past 10 to 15 years, the wide prevalence of various forms of negative behavior among young people in college has become one of the main causes of their deteriorating health. Traditionally classified among such forms are the excessive consumption of alcohol, smoking, and narcotics abuse. Issues relating to the protection of students' health in the framework of the educational process in higher education have taken on special urgency for society. The topic of the dissemination and consumption of psychoactive substances among college students and the factors that influence their health has become the object of study by the scientific community as well. A substantial number of studies have come out in recent years relating to these problems. One example is the survey "College Students' Health," conducted by the Social Problems of Health sector of the Institute of Sociology, Russian Academy of Sciences, in 2009. A questionnaire survey was carried out in eight cities of the Russian Federation (Moscow, Briansk, Murmansk, Nizhnii Novgorod, Ufa, Ul'ianovsk, Khabarovsk, and Groznyi) and in two cities of Belarus (Minsk and Grodno). A scientific-methodological feature of that sociological survey is the comparative analysis of sample sets in the two allied countries of Russia and Belarus. The purpose of the present article is to analyze the empirical data base of the "College Students' Health" survey reflecting the prevalence of harmful habits among students in higher educational institutions of Russia and Belarus. The article suggests that the lack of an adequate system of antinarcotics education and propaganda and a state system of treatment and rehabilitation for narcotics addicts is leading to the expansion of the black market in narcotics and an increase in demand for them. (Contains 1 note.) [This article was translated by Kim Braithwaite.]

Some side effects (SEs) of increasingly prescribed psychotropic medications can impact student performance in school. SE risk varies, even among drugs from the same class (e.g., antidepressants). Knowing which SEs occur significantly more often than others may enable school psychologists to enhance collaborative risk-benefit analysis, medication monitoring, data-based decision-making, and inform mitigation efforts. SE data from Full Prescribing Information (PI) on the FDA website for ADHD drugs, atypical antipsychotics, and antidepressants with pediatric indications were analyzed. Risk ratios (RR) are reported for each drug within a category compared with placebo. RR tables and graphs inform the reader about SE incidence differences for each drug and provide clear evidence of the wide variability in SE incidence in the FDA data. Breslow-Day and Cochran Mantel-Haenszel methods were used to test for drug-placebo SE differences and to test for significance across drugs within each category based on odds ratios (ORs). Significant drug-placebo differences were found for each drug compared with placebo, when odds were pooled across all drugs in a category compared with placebo, and between some drugs within categories. Unexpectedly, many large RR differences did not reach significance. Potential explanations are offered, including limitations of the FDA data sets and statistical and methodological issues. Future research directions are offered. The potential impact of certain SEs on school performance, mitigation strategies, and the potential role of the school psychologist is discussed, with consideration for ethical and legal limitations. (Contains 4 tables and 3 figures.)

Is sniffing at the front door of a private home by a trained narcotics detection dog a Fourth Amendment search requiring probable cause? Is a "drug dog" somehow like a manmade technology, such as a thermal imaging device? These were a couple of the questions recently presented to the U.S. Supreme Court during arguments in "Florida v. Jardines." The case provides an engaging kickstarter for classroom discussion about current issues related to the Fourth Amendment. A teaching activity included in this article will provide students with an opportunity to learn about historic Supreme Court decisions around some important Fourth Amendment issues, and equip them with information to discuss the possibilities in "Florida v. Jardines." (Contains 3 notes.)

Drug use is an alarming issue in Bangladesh. Most drug users return to drugs after treatment, in what becomes a vicious cycle of treatment and relapse. This study explored why they return and what pathways they follow. We carried out 5 key informant interviews, 10 in-depth interviews, 2 focus group discussions, 3 case studies, 8 observations, and more than 22 informal discussions with male drug users and others. We found a number of factors at individual, familial, societal, and treatment provider-levels that worked in an interactive way. Some initiated, while others facilitated, several pathways that led to relapse. Our findings will be of help in formulating and implementing effective interventions to reduce the number of users returning to drugs. (Contains 1 figure.)

The present report is an intent-to-treat analysis involving secondary data drawn from the first randomized clinical trial of prison-initiated methadone in the United States. This study examined predictors of treatment entry and completion in prison. A sample of 211 adult male prerelease inmates with preincarceration heroin dependence were randomly assigned to one of three treatment conditions: counseling only (counseling in prison; n = 70); counseling plus transfer (counseling in prison with transfer to methadone maintenance treatment upon release; n = 70); and counseling plus methadone (methadone maintenance in prison, continued in a community-based methadone maintenance program upon release; n = 71). Entered prison treatment (p less than 0.01), and completed prison treatment (p less than 0.001) were significantly predicted by the set of 10 explanatory variables and favored the treatment conditions receiving methadone. The present results indicate that individuals who are older in age and have longer prison sentences may have better outcomes than younger individuals with shorter sentences, meaning they are more likely to enter and complete prison-based treatment. Furthermore, implications for the treatment of prisoners with prior heroin dependence and for conducting clinical trials may indicate the importance of examining individual characteristics and the possibility of the examination of patient preference. (Contains 2 tables.)

This study examined posttreatment patterns of polysubstance use and heroin relapse in a sample of 43 adolescents (ages 14-20) entering short-term residential treatment for primary heroin use. At 12-month follow-up, youths that achieved heroin abstinence (N = 19) were significantly less likely than youths that relapsed to heroin (N = 24) to endorse polysubstance use and cannabis, cocaine, or benzodiazepine use. Furthermore, heroin-abstinent youths significantly reduced their cannabis and cocaine use across the study period while youths that relapsed made initial reductions before returning to their pretreatment levels of use for these drugs. Clinical implications for heroin-using youths and areas for future research are discussed. (Contains 2 figures, 2 tables and 2 notes.)

While previous studies have investigated the relationship between substance use and violent behaviors among youths, the individual influence of specific drugs among males and females is poorly understood. Using the Nevada 2005 Youth Risk Behavior Surveillance (YRBS) Survey (N = 1,556), weighted logistic regression was used to assess the independent substance use correlates of physical fighting among males and females. Final models controlled for sociodemographics, gang membership, parental monitoring, and other drugs. Our data suggest that there are gender differences in the individual drugs that are correlated with fighting among high school students. For males, binge drinking was independently associated with fighting, while for females, marijuana and methamphetamine were independent correlates. (Contains 3 tables.)

This study used data from six neuropsychological measures of executive function (EF) and general intellectual functioning (GIF) administered to 303 regular users of heroin and/or cocaine as indicators in a latent profile analysis (LPA). Results indicated the presence of three profiles: impaired GIF and EF profile (30.8%), intact GIF and EF profile (58.8%), and high GIF/intact EF profile (10.4%). Using a multinomial logistic regression, it was determined that individuals who reported being diagnosed with either a learning disability (LD) and/or attention-deficit/hyperactivity disorder (ADHD) were more likely to be in the impaired GIF and EF profile than other profiles. Results from a logistic regression indicated that the impaired GIF and EF profile was associated with a greater prevalence of past hepatitis B and/or C infection. Implication for harm reduction and treatment programs and the need to take into account individuals with LD and ADHD are discussed. (Contains 4 tables and 1 figure.)

Aims: This article presents an overview of the strategies and measures used in the context of school-based prevention in Slovenia, both on a declaratory and on a practical level. Methods: A review of the Resolution on the National Programme on Drugs in the Republic of Slovenia [ReNPPD (2004). Resolucija o nacionalnem programu na podrocju drog 2004-2009 [Resolution on the 2004-2009 National Programme on Drugs Control], OG. RS, Vol. 28, pp. 3125-3139] is given and followed by a comparison with the guidelines of the European Drug Strategy [EU Drugs Strategy 2005-2012 (2005). Retrieved from http://www.emcdda.europa.eu] and three other national strategies from three eastern European countries. An analysis of the key problems that emerge in practice is made on the basis of data collected in individual interviews and in focus group interviews. Findings: On the declaratory level, drug prevention activities in Slovenian schools are mostly in line with the EU guidelines and similar to those in Poland, Czech Republic, and Slovakia. In practice, some discrepancies emerge, since there is neither a national database of programmes nor any programme evaluations in Slovenia; therefore, schools are left to their own judgement in choosing which programme is suitable for them. Conclusions: The deficiencies create an urgent need to establish a database of programmes and introduce community prevention strategies in schools on the national level. (Contains 6 notes.)

Aims: To determine the prevalence and nature of prescription drug misuse among university staff and students in the UK. Methods: In 2009, an online questionnaire regarding non-medical use of prescription drugs was completed by 1614 students and 489 staff registered at a large university in Wales. The sample data were weighted to match the population of students and staff and were analysed using SPSS. Findings: The lifetime prevalence of prescription drug misuse (using prescription drugs not prescribed to the person) was 33% among students and 24% among staff. The main medications misused were pain relievers, followed by sedatives and sleeping aids. The main motives for misusing prescription drugs were to gain therapeutic benefit and "to get high". Conclusions: The study shows that a notable proportion of staff and students at the university used prescription drugs in a way that was not intended. The discussion draws attention to a debate about whether all forms of non-medical drug use should be regarded as misuse. The implications of non-medical use include health risks to the user as well as hidden social and economic costs. More research should be done to generate a more in-depth understanding of prescription drug misuse. (Contains 4 tables.)

Introduction: Process research in psychotherapy is important to understand how treatment works. The National Institute of Clinical Excellence guidelines suggest that in methadone maintenance treatment (MMT) for opioid dependence, drug key-working should be based on cognitive behavioural therapy (CBT) principles. This article reports the findings of process research component of a larger study investigating the effectiveness and cost-effectiveness of CBT in MMT in the UK (UKCBTMM project). Method: This was a multicentre randomized controlled trial comparing MMT plus CBT with MMT alone. The following concepts have been measured as part of the process research: (i) coping skills, (ii) self-efficacy and (iii) outcome expectancies. Results: CBT group has gained coping skills over time (as predicted) at 6 months, which were sustained at 12 months. Self-efficacy showed delayed greater increase in the CBT group at 12 months (as predicted). Positive outcome expectancies from reduction of drug use were reduced for the CBT group both at 6 and 12 months whereas negative expectancies had increased (against prediction). Conclusions: As this is the first trial in which the process changes in CBT in opioid dependence have been explored, the reported limited findings are of importance for further development in the field. (Contains 1 table.)