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1. A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic

Author

Ali Farhoudian, Seyed Ramin Radfar, Hossein Mohaddes Ardabili, Parnian Rafei, Mohsen Ebrahimi, Arash Khojasteh Zonoozi, Cornelis A. J. De Jong, Mehrnoosh Vahidi, Masud Yunesian, Christos Kouimtsidis, Shalini Arunogiri, Helena Hansen, Kathleen T. Brady, ISAM Global Survey Consortium (ISAM-GSC), Adrian Octavian Abagiu, Franck David Noel Abouna, Mohamed Hassan Ahmed, Basma Al-ansari, Feda Mahmmoud Abu Al-khair, Mandhar Humaid Almaqbali, Atul Ambekar, Sidharth Arya, Victor Olufolahan Asebikan, Murad Ali Ayasreh, Debasish Basu, Zoubir Benmebarek, Roshan Bhad, Mario Blaise, Nicolas Bonnet, Jennifer Brasch, Barbara Broers, Anja Busse, Jenna L. Butner, Moses Camilleri, Giovanna Campello, Giuseppe Carra, Ivan Celic, Fatemeh Chalabianloo, Abhishek Chaturvedi, José de Jesús Eduardo Noyola Cherpitel, Kelly J. Clark, Melissa Anne Cyders, Ernesto de Bernardis, Abbas Deilamizade, John Edward Derry, Naveen Kumar Dhagudu, Pavla Dolezalova, Geert Dom, Adrian John Dunlop, Mahmoud Mamdouh Elhabiby, Hussein Elkholy, Nsidibe Francis Essien, Ghandi Ilias Farah, Marica Ferri, Georgios D Floros, Catherine Friedman, Clara Hidalgo Fuderanan, Gilberto Gerra, Abhishek Ghosh, Maka Gogia, Ilias A. Grammatikopoulos, Paolo Grandinetti, Amira Guirguis, David Gutnisky, Paul Steven Haber, Peyman Hassani-Abharian, Zahra Hooshyari, Islam Ibrahim Mokhtar Ibrahim, Hada Fong-ha Ieong, Regina Nova Indradewi, Shelly Iskandar, Thahir Noorul Isra, Shobhit Jain, Sandi James, Seyyed Mohammad hossein Javadi, Keun Ho Joe, Darius Jokubonis, Acka Tushevska Jovanova, Rama Mohamed Kamal, Alexander Ivanov Kantchelov, Preethy Kathiresan, Gary Katzman, Paul Kawale, Audrey Margaret Kern, Felix Henrique Paim Kessler, Sung-Gon Sue Kim, Ann Marie Kimball, Zeljko Kljucevic, Kristiana Siste Kurniasanti, Roneet Lev, Hae Kook Lee, Aiste Lengvenyte, Shaul Lev-ran, Geni Seseja Mabelya, Mohamed Ali El Mahi, J. Maphisa Maphisa, Icro Maremmani, Laura Masferrer, Omid Massah, Orlagh McCambridge, Garrett Gregory McGovern, Aung Kyi Min, Amir Moghanibashi-Mansourieh, Jazman Mora-Rios, Indika Udaya Kumara Mudalige, Diptadhi Mukherjee, Pejic Munira Munira, Bronwyn Myers, Jayakrishnan Menon T. N., Venkata Lakshmi Narasimha, Nkemakolam Ndionuka, Ali-Akbar Nejatisafa, Kamran Niaz, Asad Tamizuddin Nizami, Jan H. Nuijens, Laura Orsolini, Vantheara Oum, Adegboyega Adekunle Oyemade, Irena Rojnia Palavra, Sagun Ballav Pant, Joselyn Paredes, Eric Peyron, Randall Alberto Quirós, Rouhollah Qurishi, Noor ul Zaman Rafiq, Ranjini Raghavendra Rao, Woraphat Ratta-apha, Karren-Lee Raymond, Jens Reimer, Eduardo Renaldo, Tara Rezapour, James Roy Robertson, Carlos Roncero, Fazle Roub, Elizabeth Jane Rubenstein, Claudia Ines Rupp, Elizabeth Saenz, Mohammad Salehi, Lampros Samartzis, Laura Beatriz Sarubbo, Nusa Segrec, Bigya Shah, Hongxian Shen, Tomohiro Shirasaka, Steve Shoptaw, Fransiskus Muronga Sintango, Veronica Andrea Sosa, Emilis Subata, Norberto Sztycberg, Fatemeh Taghizadeh, Joseph Brian Tay Wee Teck, Christian Tjagvad, Marta Torrens, Judith Meme Twala, Ramyadarshni Vadivel, Joseph Robert Volpicelli, Jelmer Weijs, Steven Michael Wintoniw, Apisak Wittayanookulluk, Marcin Wojnar, Sadia Yasir, Yimenu Yitayih, and Min Zhao

Subjects
COVID-19, addiction, substance use disorder, global survey, behavioral addiction, illicit drug market, Psychiatry, RC435-571
Abstract

Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and “lockdown” measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic.Design: Cross-sectional survey.Setting: Worldwide.Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries.Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic.Findings: Participants reported (among who answered “decreased” or “increased”) a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall.Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.

Published
2021
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2. Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

Author

Seyed Ramin Radfar, Cornelis A. J. De Jong, Ali Farhoudian, Mohsen Ebrahimi, Parnian Rafei, Mehrnoosh Vahidi, Masud Yunesian, Christos Kouimtsidis, Shalini Arunogiri, Omid Massah, Abbas Deylamizadeh, Kathleen T. Brady, Anja Busse, ISAM-PPIG Global Survey Consortium, Marc N. Potenza, Hamed Ekhtiari, Alexander Mario Baldacchino, Adrian Octavian Abagiu, Franck David Noel Abouna, Mohamed Hassan Ahmed, Basma Al-ansari, Feda Mahmmoud Abu Al-khair, Mandhar Humaid Almaqbali, Atul Ambekar, Hossein Mohaddes Ardabili, Sidharth Arya, Victor Olufolahan Lasebikan, Murad Ali Ayasreh, Debasish Basu, Zoubir Benmebarek, Roshan Bhad, Mario Blaise, Nicolas Bonnet, Jennifer Brasch, Barbara Broers, Jenna L. Butner, Moses Camilleri, Giovanna Campello, Giuseppe Carra, Ivan Celic, Fatemeh Chalabianloo, Abhishek Chaturvedi, José de Jesús Eduardo Noyola Cherpitel, Kelly J. Clark, Melissa Anne Cyders, Ernesto de Bernardis, John Edward Derry, Naveen Kumar Dhagudu, Pavla Dolezalova, Geert Dom, Adrian John Dunlop, Mahmoud Mamdouh Elhabiby, Hussien Elkholy, Nsidibe Francis Essien, Ghandi Ilias Farah, Marica Ferri, Georgios D Floros, Catherine Friedman, Clara Hidalgo Fuderanan, Gilberto Gerra, Abhishek Ghosh, Maka Gogia, Ilias A. Grammatikopoulos, Paolo Grandinetti, Amira Guirguis, David Gutnisky, Paul Steven Haber, Peyman Hassani-Abharian, Zahra Hooshyari, Islam Ibrahim Mokhtar Ibrahim, Hada Fong-ha Ieong, Regina Nova Indradewi, Shelly Iskandar, Shobhit Jain, Sandi James, Seyyed Mohammad hossein Javadi, Keun Ho Joe, Darius Jokubonis, Acka Tushevska Jovanova, Rama Mohamed Kamal, Alexander Ivanov Kantchelov, Preethy Kathiresan, Gary Katzman, Paul Kawale, Audrey Margaret Kern, Felix Henrique Paim Kessler, Sung-Gon Sue Kim, Ann Marie Kimball, Zeljko Kljucevic, Kristiana Siste, Roneet Lev, Hae Kook Lee, Aiste Lengvenyte, Shaul Lev-ran, Geni Seseja Mabelya, Mohamed Ali El Mahi, J. Maphisa Maphisa, Icro Maremmani, Laura Masferrer, Orlagh McCambridge, Garrett Gregory McGovern, Aung Kyi Min, Amir Moghanibashi-Mansourieh, Jazman Mora-Rios, Indika Udaya Kumara Mudalige, Diptadhi Mukherjee, Pejic Munira Munira, Bronwyn Myers, Jayakrishnan Menon T N, Venkata Lakshmi Narasimha, Nkemakolam Ndionuka, Ali-Akbar Nejatisafa, Kamran Niaz, Asad Tamizuddin Nizami, Jan H. Nuijens, Laura Orsolini, Vantheara Oum, Adegboyega Adekunle Oyemade, Irena Rojnia Palavra, Sagun Ballav Pant, Joselyn Paredes, Eric Peyron, Randall Alberto Quirós, Rouhollah Qurishi, Noor ul Zaman Rafiq, Ranjini Raghavendra Rao, Woraphat Ratta-apha, Karren-Lee Raymond, Jens Reimer, Eduardo Renaldo, Tara Rezapour, James Roy Robertson, Carlos Roncero, Fazle Roub, Elizabeth Jane Rubenstein, Claudia Ines Rupp, Elizabeth Saenz, Mohammad Salehi, Lampros Samartzis, Laura Beatriz Sarubbo, Nusa Segrec, Bigya Shah, Hongxian Shen, Tomohiro Shirasaka, Steve Shoptaw, Fransiskus Muronga Sintango, Veronica Andrea Sosa, Emilis Subata, Norberto Sztycberg, Fatemeh Taghizadeh, Joseph Brian Tay Wee Teck, Christian Tjagvad, Marta Torrens, Judith Meme Twala, Ramyadarshni Vadivel, Joseph Robert Volpicelli, Jelmer Weijs, Steven Michael Wintoniw, Apisak Wittayanookulluk, Marcin Wojnar, Sadia Yasir, Yimenu Yitayih, Min Zhao, and Arash Khojasteh Zonoozi

Subjects
COVID-19 pandemic, substance use disorder, public health, drug policy, opioid agonist treatment, addiction services, Psychiatry, RC435-571
Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

Published
2021
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3. The influence of blood storage time and general anaesthesia on chromosomal radiosensitivity assessment

Author

Ans Baeyens, Mike Morford, Marshall Murdoch, Jacobus Slabbert, Olivia Herd, A. Cairns, Dineshree Padiachy, Gary Katzman, Anne Vral, and Flavia Zita Francies

Subjects
0301 basic medicine, Adult, Time Factors, Health, Toxicology and Mutagenesis, Binucleated cells, Breast Neoplasms, Biology, Anesthesia, General, Toxicology, medicine.disease_cause, Radiation Tolerance, Specimen Handling, Andrology, 03 medical and health sciences, Young Adult, Genetics, medicine, Humans, Blood culture, Radiosensitivity, Genetics (clinical), Micronuclei, Chromosome-Defective, Chromosome Aberrations, Micronucleus Tests, medicine.diagnostic_test, Middle Aged, Comet assay, 030104 developmental biology, Blood, Immunology, Micronucleus test, Female, Micronucleus, Genotoxicity, Blood sampling
Abstract

The micronucleus assay (MN assay) is a well-established assay in genetic toxicology, biomonitoring of mutagen-exposed populations and chromosomal radiosensitivity testing. To evaluate the effect of storage time on the chromosomal radiosensitivity assessment in lymphocytes, micronuclei (MN) yields in blood samples received and processed on the same day were compared with MN yields obtained when blood cultures were set up 24 and 48h after blood sampling. Furthermore, the influence of general anaesthesia on MN and binucleated cells (BN) yields in the MN assay was considered. Blood samples of 10 healthy donors were irradiated and blood cultures were set up during the same day of blood sampling or with a delay of 24 or 48h. The MN assay was also performed on two blood samples from 60 women undergoing breast surgery. The first blood sample was taken before general anaesthesia and the second sample, 2h after anaesthesia induction. Fifty percent of the blood samples were transported to the cytogenetics lab within 2h while the other 50% reached the lab after 24h. The results of this study show a decrease in BN and an increase in MN yields with increasing storage time before irradiation and setting up of the MN assay for both healthy controls and patients. The administration of general anaesthesia in patients resulted in lower BN yields, higher spontaneous MN yields but no differences in radiation-induced MN yields. In conclusion, this study indicates that the time between blood sampling and the in vitro irradiation of the samples for the MN assay influences the MN yields. Delays of more than 24h should be avoided. To assess chromosomal radiosensitivity in patients, blood samples should be taken before induction of general anaesthesia as anaesthesia can have an impact on the reliability of the MN results.

Published
2015

4. Combination Pharmacotherapy and Psychotherapy for the Treatment of Major Depressive and Anxiety Disorders

Author

Cindy J. Aaronson, Gary Katzman, and Rachel L. Moster

Subjects
humanities
Abstract

Clinical wisdom and intuition suggest that when treating major depression and/or anxiety disorders, combining two documented efficacious treatments such as antidepressants and psychotherapy would improve outcome. However, the data do not completely support this conclusion. This chapter reviews randomized clinical trials comparing combined pharmacotherapy and psychotherapy with monotherapy for the treatment of major depressive disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder in adults. Although DSM-V no longer categorizes posttraumatic stress disorder and obsessive-compulsive disorder as anxiety disorders, the authors continue to include them in this chapter.

Published
2015
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