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Background and aims: Journal metrics assess impact upon the research literature, and are now used to assess individual researchers in hiring and promotion decisions. This study compared the ranking of addiction journals according to eight widely used metrics; assessed the correlations between journal rankings; and assessed changes over time in metric scores. Methods: Data pertaining to the 2020 scores on eight metrics for 43 journals were obtained and the top 20 ranking in each compared and the correlations between rankings assessed. The Impact Factor was employed to assess changes over time. Results: Ignoring the two categorization systems used by some metrics, 31 journals appeared in at least one metric top 20 and 11 in all eight. The top rank in each was occupied by one of three journals. Threequarters of the correlations between rankings were above 6.0. The number of journals with an Impact Factor rose from 23 in 1997 to 38 in 2020, and the journals added tended to focus on addictions other than alcohol and drugs or have a specific focus. Conclusions and discussion: The results indicate a concentration of journals at the top of the metrics and moderate to strong agreement between them, but almost three-quarters of journals appeared in at least one metric. The longitudinal data reflect both a broadening and specialization of the addiction field. The study limitations include exclusion of some journals and metrics. [ABSTRACT FROM AUTHOR]

Abstract: Objective: In this study of newly incident drinkers (NIDs), we (a) investigate and calibrate measurement equivalence of 7 clinical features of an alcohol dependence syndrome (ADS) across sex and age‐of‐onset subgroups and (b) estimate female–male differences in ADS levels soon after taking the first full drink, with focus on those with first full drink before the 24th birthday. Methods: The study population is 12‐ to 23‐year‐old NIDs living in the United States (n = 33,561). Calibrated for measurement equivalence, male–female differences in levels of newly incident ADS are estimated for 6 age‐of‐onset subgroups. Results: Measurement equivalence is achieved by dropping the “difficulty cutting down” item. Then, among early‐adolescent‐onset NID, females have higher ADS levels (for 12‐ to 13‐year‐old NID: β = .25; 95% CI [0.05, 0.45]). In contrast, when drinking onset is delayed to adulthood, males have higher ADS levels (e.g., for 18‐ to 19‐year‐old NID: β = −.27; 95% CI [−0.52, −0.02]; for 20‐ to 21‐year‐old NID: β = −.38; 95% CI [−0.65, −0.12]). Conclusions: In the United States, there is female excess in ADS levels measured soon after drinking onset in early adolescence. The traditional male excess is seen when drinking onset occurs after mid‐adolescence. Evidence from other countries will be useful. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Substance use may influence study results in human subjects research. This study aims to report the concordance between self‐report and biochemical assessments of substance use and test the effect of methods to reduce false reports of abstinence in trauma‐exposed women participating in a research study. Methods: In this pilot study, substance use was assessed during telephone prescreening and via self‐report and biochemical verification (i.e., urine toxicology and alcohol breathalyzer tests) at an in‐person evaluation. Due to the high number of participants who tested positive for substances despite self‐reporting abstinence during prescreening, study procedures were modified to disincentivize false self‐reports of substance use two thirds of the way through recruitment. New potential participants were explicitly informed during prescreening and informed consent that a positive drug or alcohol test during screening would result in exclusion from the study and withholding of payment. Results: Prior to modifying study methods, 20% of participants who had reported abstinence during the telephone prescreen had a positive substance use test at the in‐person visit. Modifying study procedures resulted in an 81% decrease in positive substance use assessments. Conclusions: Adoption of this methodology may decrease inadvertent confounding of clinical research outcomes by undetected and/or misreported substance use. [ABSTRACT FROM AUTHOR]

A biography is presented of substance abuse researcher and professor Dennis McCarty. It mentions his research in alcohol and drug abuse in Massachusetts, his work with Massachusetts social services to help drug abuses and develop policies, and his teaching at Brandeis University and Oregon Health and Science University.

Abstract: Established in 2006, the Centre for Alcohol Policy Research (CAPR) is Australia's only research centre with a primary focus on alcohol policy. CAPR has four main areas of research: alcohol policy impacts; alcohol policy formation and regulatory processes involved in implementing alcohol policies; patterns and trends in drinking and alcohol problems in the population; and the influence of drinking norms, cultural practices and social contexts, particularly in interaction with alcohol policies. In this paper, we give examples of key publications in each area. During the past decade, the number of staff employed at CAPR has increased steadily and now hovers at approximately 10. CAPR has supported the development of independent researchers who collaborate on a number of international projects, such as the Alcohol's Harm to Others study which is now replicated in approximately 30 countries. CAPR receives core funding from the Foundation for Alcohol Research and Education, and staff have been highly successful in securing additional competitive research funding. In 2016, CAPR moved to a new institutional setting at La Trobe University and celebrated 10 years of operation. [ABSTRACT FROM AUTHOR]

Background: We compare self-reported prevalence of drug use and indicators of data quality from two different response modes (with and without an independent answer sheet for recording responses) in a survey conducted in 2015 among secondary school students.Methods: Stratified cluster-randomized study conducted among students in grades 8-12 from public, private and subsidized schools in Chile (N=2317 students in 122 classes). Measurements included were: percentage reporting substance use (tobacco, alcohol, marijuana, cocaine, ecstasy); number of inconsistent responses; number of item nonresponses; percentage of extreme reports of drug use; percentage reporting using the nonexistent drug, relevón; and completion times.Results: Compared with those who responded directly in the questionnaire booklet, students who used a separate answer sheet took 17.6 more minutes (95% confidence interval [CI]: 14.4-20.8) to complete the survey and had on average 1.5 more inconsistent responses (95%CI: 0.91-2.14). The prevalence and variance of drug use was higher among those who used an answer sheet for all substances except tobacco; the prevalence ratio (PR) of reported substance use for low-prevalence substances during the past year were: cocaine PR=2.5 (95%CI: 1.6-4.1); ecstasy PR=5.0 (95%CI: 2.4-10.5); relevón PR=4.8 (95%CI: 2.5-9.3).Conclusions: Using an answer sheet for a self-administered paper-and-pencil survey of drug use among students result in lower quality data and higher reports of drug use. International comparison of adolescent drug use from school-based surveys should be done with caution. The relative ranking of a country could be misleading if different mode of recording answers are used. [ABSTRACT FROM AUTHOR]

Background and aims Few data exist on changes to substance use patterns before and after hepatitis C virus (HCV) treatment. We used longitudinal data of HIV-HCV co-infected individuals to examine whether receiving pegylated interferon (Peg-IFN)-based therapy irrespective of HCV clearance could modify tobacco, cannabis and alcohol use. Design A prospective cohort of HIV-HCV co-infected individuals was enrolled from 2006. Participants' clinical data were retrieved from medical records and socio-demographic and behavioural characteristics were collected by yearly self-administered questionnaires. Setting Data were collected across 17 hospitals in France. Participants All HIV-HCV co-infected patients who initiated HCV treatment during follow-up and answered items regarding substance use in at least one yearly questionnaire (258 patients, 671 visits). Intervention HCV treatment consisted of Peg-IFN-based regimens. Measurements Four time-varying outcomes: hazardous alcohol use (Alcohol Use Disorders Identification Test-C > 3/4 for women/men), number of alcohol units/month, binge drinking, cannabis and tobacco use. Mixed models assessed the effect of HCV treatment status (not yet treated, treated and HCV-cleared, treated and HCV-chronic) on each outcome. Findings A significant decrease (more than 60% reduction) in both hazardous alcohol use and binge drinking and a reduction of 10 alcohol units/month was observed after HCV treatment (irrespective of HCV clearance). No significant effect of HCV treatment status was found on tobacco use and regular cannabis use, but HCV 'clearers' reported less non-regular use of cannabis. Conclusions Hepatitis C virus (HCV) treatment appears to help HIV-HCV co-infected patients reduce alcohol use. [ABSTRACT FROM AUTHOR]

Background: Missing data in substance use disorder (SUD) research pose a significant threat to internal validity. Participants terminate involvement or become less likely to attend intervention and research visits for many reasons, which should be addressed prior to becoming problematic. During a 9-month study targeting stimulant abuse, early dropouts and participant reported attendance barriers led to implementing a structured, pre-randomization protocol with participants about retention and solution-focused strategies (the "Fireside Chat"). Our aim is to outline this approach and present data on intervention participation and research visit attendance after implementation.Methods/design: STimulant Reduction using Dosed Exercise (STRIDE) was a two-arm, multisite randomized clinical trial testing treatment-as-usual for stimulant abuse/dependence augmented by Exercise or Health Education. For both groups, study intervention visits at the site were scheduled 3/week for 12weeks followed by 1/week for 24weeks. During The Chat, research staff thoroughly reviewed participants' expectations, and barriers and solutions to retention. Fifteen participants were randomized (to Exercise or Health Education) prior to and fourteen were randomized after Chat implementation. Intervention and monthly follow-up attendance (before and after implementation) were compared at the site (N=29) that developed and rigorously implemented The Chat.Results: Individuals who participated in The Chat (n=14) attended significantly more intervention visits during weeks 1-12 (p<0.001) and weeks 13-36 (p<0.05) and attended more research visits (p<0.001).Discussion: Proactive discussion of expectations and barriers prior to randomization was associated with greater study attendance. SUD researchers should consider tailoring this approach to suit their needs. Further investigation is warranted. [ABSTRACT FROM AUTHOR]

This study examined predictors of physical and psychological integration in homeless adults with problematic substance use. Homeless adults with problematic substance use ( n = 115) in Ottawa, Canada, completed questionnaires regarding their demographics (age, gender, Aboriginal ethnicity), health and social functioning (physical health, mental health, alcohol use problems, drug use problems, social skills), environmental factors (satisfaction with personal safety, social support), physical integration, and psychological integration. Participants reported low physical integration (i.e., participation in activities in the community) and did not feel strongly psychologically integrated (i.e., sense of belonging). The final models accounted for 36% and 19% of the variance in physical and psychological integration, respectively. Higher levels of social skills and social support were associated with greater physical integration. Higher levels of mental health functioning and satisfaction with safety were related to greater psychological integration. Implications of the findings for community support services are discussed. [ABSTRACT FROM AUTHOR]

Aims To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. Methods Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates and gambling) were identified via PubMed, MEDLINE and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random-effects meta-analysis was conducted using Pearson's r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger's tests, meta-regression of publication year and effect size and imputation of missing studies. Results The primary meta-analysis revealed a small magnitude effect size that was highly significant ( r = 0.14, P < 10−14). Significantly larger effect sizes were observed for studies examining severity compared with QF ( P = 0.01), but not between the type of addictive behavior ( P = 0.30) or DRD assessment ( P = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. Conclusions Delayed reward discounting is associated robustly with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality. [ABSTRACT FROM AUTHOR]

Background: Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address.Aims: This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment.Methods: A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies.Results: Smartphones are being used to collect large amounts of sensitive information, including personal information, geo-location, physiological activity, self-reports of mood and cravings, and the consumption of illicit drugs, alcohol and nicotine. Given that detailed information is being collected about potentially illegal behaviour, we identified the following ethical considerations: protecting user privacy, maximising equity in access, ensuring informed consent, providing participants with adequate clinical resources, communicating clinically relevant results to individuals, and the urgent need to demonstrate evidence of safety and efficacy of the technologies.Conclusions: mHealth technology offers the possibility to collect large amounts of valuable personal information that may enhance research and treatment of substance abuse and addiction. To realise this potential researchers, clinicians and app-developers must address these ethical concerns to maximise the benefits and minimise risks of harm to users. [ABSTRACT FROM AUTHOR]

The Philippines is one of seven countries in which HIV incidence has recently increased-much of this increase has been among men who have sex with men. Despite this trend, knowledge on sexuality and same-sex behaviors in the Philippines is limited. This study examines same-sex behavior, sexual outcomes, substance use, and psychological distress among young adults participating in the 2005 Cebu Longitudinal Health and Nutrition Survey (CLHNS). We use gender-stratified, multivariate models to compare young adults who reported same-sex behaviors and those who did not. Among a cohort of 1,912 Filipino young adults (ages 20-22), 58.2 % were sexually experienced and 15.1 % of them reported same-sex sexual contacts or romantic relationships. Compared to females, more males reported same-sex sexual contact (19.4 vs. 2.3 %) or same-sex romantic relationships (9.2 vs. 4.1 %). Young adults reporting same-sex behavior had higher odds of smoking, drug use, perceived stress, and more sexual partners as compared to their peers. Males who reported same-sex behavior initiated sex earlier than those males who did not report same-sex behaviors. There were no significant differences in depressive distress. Earlier sexual initiation and higher levels of substance use among Filipino young adults engaging in same-sex behavior highlight the need to address unique health issues within this population. Mixed findings for depressive distress and perceived stress indicate that further investigation is needed to explore the potential impacts of same-sex status on mental health outcomes, particularly in lower- and middle-income countries such as the Philippines. [ABSTRACT FROM AUTHOR]

Pennsylvania’s Board of Probation & Parole recently developed a reentry program that provides intensive supervision and oversight to offenders during their reintegration back into the community. The present analysis examined findings gathered from 261 surveys and 226 interviews with program participants across four counties in Pennsylvania. Participants discussed topics related to substance abuse, program characteristics, and perceptions of program staff. Findings highlight program benefits and recidivism outcomes. Results indicate short-term effectiveness with diminished returns overtime. Improvements to the program are needed to ensure better long-term outcomes. Policy implications for offender reentry in Pennsylvania will be discussed. [ABSTRACT FROM PUBLISHER]

The article discusses the handling of substance use disorders (SUD) among pilots. Topics include the need for empirical research on the prevalence of SUD among pilots, the need for prevention programmes to assist pilots, and the accessibility of psychotherapy and psychiatric care in relation to mental health concerns.

Objective: Medication nonadherence is a serious issue in clinical trials, especially in studies of substance abuse disorders. Measuring and confirming adherence is critical to ensuring that collected data is accurate and interpretable. This study evaluated the feasibility and success of a smartphone-based approach (Cellphone Assisted Remote Observation of Medication Adherence [CAROMA]) to visually confirm medication adherence in a clinical trial.Method: Medication adherence was confirmed visually via smartphones provided to participants in a double-blind, randomized, placebo-controlled trial for cannabis dependence. Every morning, subjects (n=20) were video-called by staff who observed consumption of study medication. Adherence was also assessed with weekly face-to-face visits, pill counts and plasma drug levels. Subjects were paid for completing daily CAROMA visits, and for returning the smartphone at study completion.Results: CAROMA confirmed 96.04% adherence to medication. Concordance between expected and actual remaining study medication counted at weekly study visits was 87.69%. Subjects assigned to active study medication had detectable plasma drug levels, while those assigned to placebo did not. CAROMA was estimated to cost approximately $100 per subject per week - a total of $300.24 per subject for the 3-week outpatient portion of the trial.Conclusion: This pilot study demonstrates the feasibility, success and cost-effectiveness of CAROMA to facilitate and confirm medication adherence in a clinical trial. Preliminary findings support larger and longer studies, and possibly applying this approach to clinical care - especially in other populations with high rates of medication nonadherence. [ABSTRACT FROM AUTHOR]

Background: Substance use disorder (SUD) is a global problem with no boundaries, which also afflicts individuals from countries of the Arabian Peninsula. Data from this region is limited. In an effort to develop targeted prevention and intervention initiatives in the United Arab Emirates (UAE), it was necessary to identify the nature of substance use by describing the characteristics of those using different substances. Consequently, this study in the UAE was conceived to describe the pattern of SUD in a first-ever cohort that was systematically recruited from the country's National Rehabilitation Centre (NRC) in Abu Dhabi.Methods: Two hundred and fifty male patients were recruited from the NRC. Information on substance use was collected using a questionnaire that was completed at an interview with patients who consented to participate. The questionnaire was based on information that the study was designed to capture. It was reviewed by members of institutional ethics committees and approved prior to use. Two hundred and fifty male subjects from the Emirates Family Registry (EFR) were used as a comparison group.Results: In the cohort studied, SUD correlated with smoking and marital status. Poly-substance users formed the majority of the cohort (84.4 %) with various combinations of substances identified across different age groups. Opioid and alcohol were the most common substances used. The use of pharmaceutical opioids, primarily Tramadol (67.2 % of opioid users), was higher among the youngest age group studied (<30 years old), while older opioid users (≥30 years old) commonly used illicit opioids (Heroin). The use of prescribed medication for non-medical use also included Pregabalin (mean of 8.3 capsules ± 0.5 per day), Procyclidin (6.1 tablets + 0.6 per day) and Carisoprodol (4.2 tablets ± 0.4 per day) and was again highest in the age group below 30 years.Conclusion: This 2015 study highlights the importance of examining the pattern of poly-substance use in a population in order to develop targeted prevention programs to arrest the prevailing trends. It has drawn attention to the rise in use of prescription medication in the UAE, in particular among younger patients (<30 years), and continuing use of illicit opioid amongst males above 30 years. Specific prevention and intervention strategies, targeting differences between these distinct demographic profiles will capture a large subset of sufferers. [ABSTRACT FROM AUTHOR]

Background: The perioperative management of human immunodeficiency virus (HIV) infected patients undergoing neurosurgery is challenging due to the presence of HIV-related multi-system derangements, opportunistic infections and malignancies, history of substance abuse, and adverse effects of anti-retroviral therapy (ART), together with the inherent risks of neurosurgery. The possible adverse impact of HIV disease on the anesthetic outcome due to the associated co-morbidities, and conversely, the role of surgery and anesthesia in HIV disease progression due to their immunosuppressive effects, and also, the fear of HIV transmission among the attending medical personnel are the important perioperative concerns in such surgeries. Aim: To present our experience in the perioperative management of HIV-infected patients who underwent neurosurgery at our institute in the past 5 years and highlight the relevant perioperative issues. Materials and Methods: A retrospective analysis of the records of HIV-infected neurosurgical patients was undertaken to determine their HIV status and ART, anesthesia and surgery details, perioperative complications, and instances of postoperative worsening of HIV disease or its transmission, if any. Results: Seven HIV infected patients with variable severity of HIV infection and systemic disease underwent neurosurgery for different indications. Their perioperative management was modified in accordance with the co-morbidities and the type of neurosurgery. There was no obvious adverse impact of the HIV disease on the anesthetic outcome, no obvious clinical evidence of post-surgery worsening of the HIV disease, and no instance of HIV transmission in our patients. Conclusion: A good understanding of the HIV disease and its perioperative implications during neurosurgery helps in better patient management and enables a safe outcome. [ABSTRACT FROM AUTHOR]

The effectiveness of juvenile drug courts is mixed, and several factors could account for these findings. The present study examines whether and why youth with co-occurring mental health problems may have worse outcomes in juvenile drug court than youth who only have issues with substance use. In a sample of youth in juvenile drug court, 328 youth with co-occurring mental and substance use disorders were compared with 336 youth with only substance use disorders. Youth with co-occurring mental health problems had significantly worse criminal justice outcomes than youth without mental health problems. These outcomes were explained, in part, by more frequent violations of the drug court requirements, and in particular, violations surrounding treatment noncompliance. Results suggest that juvenile drug courts—as they currently operate—may be unsuccessfully managing youth who present with co-occurring mental health and substance use problems. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Background: The DSM uses one set of abuse and dependence criteria to assess multiple substance use disorders (SUDs). Most SUD research aggregates across these symptoms to study the behavior of SUD as a static construct. We use an alternative approach that conceptualizes symptoms as directly interacting variables in psychopathological networks. We apply network models to symptom-level data to investigate the unique roles of individual symptoms and their interactions in SUD.Methods: We analyzed 11 DSM III-R/IV abuse and dependence criteria in a sample of 2405 adult twins who reported use of at least one illicit substance six or more times from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD). We estimated a symptom network for each substance class as well as a global network collapsed across all substance classes. We examined similarities and differences across the 6 networks in terms of symptom-to-symptom connections and symptom centrality.Results: The global network model revealed several interesting symptom connections, such as a strong predictive relation between tolerance and more-than-planned substance use. The most central symptom was using a drug more than planned. In addition, several interesting differences across substances emerged, both in the strength of symptom connections as well as the centrality of symptoms to each network.Conclusions: When analyzed as networks, abuse and dependence symptoms do not function equivalently across illicit substance classes. These findings suggest the value of analyzing individual symptoms and their associations to gain new insight into the mechanisms of SUD. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Wastewater analysis is a new approach developed to estimate illicit drug (ID) consumption in large communities, such as a city. We tested the ability of this approach to detect differences in consumption in different districts of a city.Design and Methods: Consumption of cocaine, heroin, tetrahydrocannabinol (THC) (cannabis active principle), amphetamine, methamphetamine and ecstasy was estimated by analysis of selected drug excretion residues in composite 24 h samples of untreated urban wastewater by liquid chromatography-tandem mass spectrometry. Samples were collected from the inlet of the three main Milan wastewater treatment plants (WWTP), each serving a district of the city (west, center and east). In each WWTP, samples were taken daily for seven consecutive days in November 2010 and March 2011.Results: We observed significant differences of ID consumption (expressed as mg/day/1000 inhabitants) among districts: consumption of some ID was significantly higher in the eastern district (P < 0.01 for THC, P < 0.001 for cocaine and P < 0.0001 for heroin by one-way analysis of variance), while consumption of methamphetamine and amphetamine was higher in the central area (P < 0.0001). Overall, from 2010 to 2011, ID consumption decreased in all the districts, in line with a recent population survey showing decreases from 25 to 55% in the annual prevalence of ID users in Italy.Discussion and Conclusions: This approach may help to detect ID consumption in different districts of a city and may be useful for planning interventions aimed at specific city areas and substances. [ABSTRACT FROM AUTHOR]

Introduction and Aims: To assess the prevalence of use and subjective effect profile of methoxetamine among a group of polydrug users. Design and Methods: Cross-sectional, anonymous, online survey of UK-based polydrug users was conducted. Prevalence of lifetime, last year and last month use, sourcing of the drugs, motivations for use, and subjective effect and risk profile compared with that of ketamine were measured. Results: There were 7700 UK-based polydrug users, of whom 326 reported recent use of methoxetamine. Of the whole sample, 4.2% reported last 12 month use of methoxetamine compared with 24.5% for ketamine. The most common route of use was intranasal and the predominate effect described as psychedelic. Of the 15.5% of last year users of ketamine reporting last year use of methoxetamine, only 18.7% reported that they thought methoxetamine was less damaging to their kidneys or bladder than ketamine. Its broad effect profile, based on participants' first experience of use, was very similar to that of ketamine. Almost one-third of users reported that they did not intend to try the drug again. Discussion and Conclusions: Methoxetamine appears to have a broadly similar effect profile to that of ketamine. Only a minority of participants were motivated to use it because they believed it was less damaging to their kidneys or bladder than ketamine. The impact of the recent temporary banning order on availability and use of both methoxetamine and ketamine should be monitored carefully. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Wastewater analysis (WWA) is intended to be a direct and objective method of measuring substance use in large urban populations. It has also been used to measure prison substance use in two previous studies. The application of WWA in this context has raised questions as to how best it might be used to measure illicit drug use in prisons, and whether it can also be used to measure prescription misuse. We applied WWA to a small regional prison to measure the use of 12 licit and illicit substances. We attempted to measure the non-medical use of methadone and buprenorphine and to compare our findings with the results of the prison's mandatory drug testing (MDT).Design and Methods: Representative daily composite samples were collected for two periods of 12 consecutive days in May to July 2013 and analysed for 18 drug metabolites. Prescription data and MDT results were obtained from the prison and compared with the substance use estimates calculated from WWA data.Results: Daily use of methamphetamine, methadone, buprenorphine and codeine was detected, while sporadic detection of ketamine and methylone was also observed. Overall buprenorphine misuse appeared to be greater than methadone misuse.Discussion and Conclusions: Compared with MDT, WWA provides a more comprehensive picture of prison substance use. WWA also has the potential to measure the misuse of medically prescribed substances. However, a great deal of care must be exercised in quantifying the usage of any substance in small populations, such as in prisons. [ABSTRACT FROM AUTHOR]

Purpose: The goal of calcaneal fracture surgery is to restore its anatomy and good foot function. However, loss of height of the subtalar joint can occur post-operatively, as expressed by a decrease in Böhler's angle (BA). The aim of this study was to identify potential factors associated with a post-operative decrease in BA.Methods: All consecutive adult patients treated with open reduction and internal fixation (ORIF) by an extended lateral approach (ELA) between 2000 and 2013 were retrospectively included. Primary outcome was the occurrence of a calcaneal collapse, defined as a postoperative decrease of ≥10° in BA. The BA was measured pre-operatively, directly following surgery and at one year follow-up. Patient characteristics (body mass index, diabetes mellitus, smoking/alcohol/substance abuse, American Society of Anaesthesiologist classification), fracture classification and treatment characteristics: per-operative increase in BA and occurrence of post-operative wound infection (POWI) were collected.Results: A total of 262 patients with 276 calcaneal fractures were included. A calcaneal collapse occurred in 46 cases (17%). The median preoperative BA, per-operative increase in BA and post-operative decrease in BA were, respectively, 2°, 27° and 4°. A calcaneal collapse was seen more often following a per-operative increase of >25° in BA, but no significant association was found (p = 0.056). Uni- and multivariate analysis showed that patients with substance abuse and those with POWI had significantly more calcaneal collapse (p < 0.05). No association was found between substance abuse and the occurrence of POWI (p = 0.293).Conclusions: In nearly one in six patients with an intra-articular calcaneal fracture treated with ORIF by an ELA, a post-operative collapse of ≥10° was found during follow-up. Calcaneal collapse was correlated with the occurrence of a POWI and substance abuse. [ABSTRACT FROM AUTHOR]

Background: Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os.Purpose: The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables.Methods: We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder.Results: Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome.Conclusions: Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity. [ABSTRACT FROM AUTHOR]

Aim A central task for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is to produce an annual report of the latest data available on drug demand and drug supply in Europe. This paper is intended to facilitate a better understanding of, and easier access to, the main quantitative European level data sets available in 2015. Methods The European reporting system formally covers all 28 European Union (EU) Member States, Norway and Turkey and incorporates multiple indicators alongside an early warning system (EWS) on uncontrolled new psychoactive substances (NPS). While epidemiological information is based largely on registries, surveys and other routine data reported annually, the EWS collects case-based data on an ongoing basis. The 2015 reporting exercise is centred primarily on a set of standardized reporting tools. Results The most recent data provided by European countries are presented, including data on drug use, drug-related morbidity and mortality, treatment demand, drug markets and new psychoactive substances, with data tables provided and methodological information. A number of key results are highlighted for illustrative purposes. Drug prevalence estimates from national surveys since 2012 (last year prevalence of use among the 15-34 age band) range from 0.4% in Turkey to 22.1% in France for cannabis, from 0.2% in Greece and Romania to 4.2% in the United Kingdom for cocaine, from 0.1% in Italy and Turkey to 3% in the Czech Republic and the United Kingdom for ecstasy, and from 0.1% or less in Romania, Italy and Portugal to 2.5% in Estonia for amphetamine. Declining trends in new HIV detections among people who inject drugs are illustrated, in addition to presentation of a breakdown of NPS reported to the EU early warning system, which have risen exponentially from fewer than 20 a year between 2005 and 2008, to 101 reported in 2014. Conclusions Structured information is now available on patterns and trends in drug consumption in Europe, which permits triangulation of data from different sources and consideration of methodological limitations. Opioid drugs continue to place a burden on the drug treatment system, although both new heroin entrants and injecting show declines. More than 450 new psychoactive substances are now monitored by the European early warning system with 31 new synthetic cathinones and 30 new synthetic cannabinoid receptor agonists notified in 2014. [ABSTRACT FROM AUTHOR]

Introduction: Heat Shock Protein (HSP) expression is observed in central nerve system at different stressful condition like hypothermia, hypoxia, trauma, status epilepticus, and drug abuse. Also, HSP is suggested as a molecular protection for cellular damaged proteins. The aim of this review was to evaluate and summarize the studies about the role of HSP in psychotic caused by substance abuse. Materials and Methods: In this review article, all the articles published up to December 2014 in both Persian and English language about the relationship between heat shock protein and drug abuse had been evaluated. These studies were searched in database of SID, IranMedex, IranDoc, Margiran, Science Direct, Ovid, Google Scholar, PubMed, CINAHL and using key words of HSP27 AND drug abuse. The used keywords were selected based on MeSH Database. To collect data, Data Extraction Form was used that it was designed based on the objective of the study. The result of this search was to obtain 11 related articles that 5 articles were excluded due to lack of inclusion criteria and ultimately 6 articles entered to the study. Results: The oldest performed study was related to 2001 and the most recent was in 2014. 3 studies (50%) were performed on rat and 3 (50%) on mice. 4 articles was about morphine abuse, 1 about amphetamine abuse, and 1 about phenobarbital. Conclusion: All the researches showed that HSP27 increases after substance withdrawal, and it seems that it has damage protective effect. [ABSTRACT FROM AUTHOR]

Background: Millions of children across North America and Europe live in families with alcohol or drug abusing parents. These children are at risk for a number of negative social, emotional and developmental outcomes, including an increased likelihood of developing a substance use disorder later in life. Family-based intervention programs for children with substance abusing parents can yield positive outcomes. This study is a realist review of evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents (COSAPs). The primary objectives were to uncover patterns of contextual factors and mechanisms that generate program outcomes, and advance program theory in this field. Methods: Realist review methodology was chosen as the most appropriate method of systematic review because it is a theory-driven approach that seeks to explore mechanisms underlying program effectiveness (or lack thereof). A systematic and comprehensive search of academic and grey literature uncovered 32 documents spanning 7 different intervention programs. Data was extracted from the included documents using abstraction templates designed to code for contexts, mechanisms and outcomes of each program. Two candidate program theories of family addiction were used to guide data analysis: the family disease model and the family prevention model. Data analysis was undertaken by a research team using an iterative process of comparison and checking with original documents to determine patterns within the data. Results: Programs originating in both the family disease model and the family prevention model were uncovered, along with hybrid programs that successfully included components from each candidate program theory. Four demi-regularities were found to account for the effectiveness of programs included in this review: (1) opportunities for positive parent-child interactions, (2) supportive peer-to-peer relationships, (3) the power of knowledge, and (4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. Conclusions: This review yielded new findings that had not otherwise been explored in COSAP program research and are discussed in order to help expand program theory. Implications for practice and evaluation are further discussed. [ABSTRACT FROM AUTHOR]

Background: Most studies on offending heterogeneity have been conducted with general population samples. It is not clear to what extent these can inform such outcomes for individuals with substance use disorders specifically.Aims: The aim of this study is to compare the offending trajectories of individuals treated for substance use disorders in adolescence with a matched general population sample, and to test for gender differences in this respect.Method: Growth mixture models were applied to identify offending trajectories from age 15 to 33 of 1568 individuals treated for substance use disorders in adolescence, and in a matched population-based sample of 1500 individuals.Results: Several parallel trajectories for men and for women were identified in both samples. The substance misuse treatment sample, however, had higher levels of offending, larger offender classes, longer careers and two additional, distinct trajectories. Although there were similarities between the men and women, the men were more heterogeneous offenders. There were two distinct offending trajectories among male substance misusers-decreasing high level and decreasing low level offending.Conclusions: Differences between substance using and general population samples indicate that results from the latter could underestimate the severity, heterogeneity, and persistence of offending trajectories if merely generalised to individuals with substance use disorders. Our results also indicated that population--based samples might be underpowered for detecting female offending heterogeneity. [ABSTRACT FROM AUTHOR]

The Simple Screening Instrument for Substance Abuse (SSI-SA) is gaining widespread use as a self-report measure of substance abuse; yet, little information exists regarding the instrument's psychometric properties. This study examined the SSI's psychometric properties within a population of 6,664 adult Medicaid enrollees in Florida, who responded to a survey conducted as part of a statewide evaluation of Medicaid services. The SSI-SA had excellent internal consistency (.85). Evidence of the SSI's validity was strong; SSI-SA scores distinguished among individuals with and without substance abuse needs and were significantly correlated with a measure of functioning in daily living. Using the recommended SSI-SA cutoff score of 4 or higher to indicate the presence of a substance abuse problem, the SSI-SA had respectable sensitivity (.82) and specificity (.90). [ABSTRACT FROM AUTHOR]

Substance abuse has an enormous impact on economic and quality of life measures throughout the world. In more developed countries, overutilization of the most common forms of substances of abuse, alcohol and tobacco, is addressed primarily through prevention of substance use initiation and secondarily through the treatment of those with substance abuse or dependence. In general, these therapeutic approaches to substance abuse are deemed effective. However, there is a broad consensus that the development of additional tools to aid diagnosis, prioritize treatment selection and monitor treatment response could have substantial impact on the effectiveness of both substance use prevention and treatment. The recent demonstrations by a number of groups that substance use exposure is associated with robust changes in DNA methylation signatures of peripheral blood cells suggests the possibility that methylation assessments of blood or saliva could find broad clinical applications. In this article, we review recent progress in epigenetic approaches to substance use assessment with a particular emphasis on smoking (and alcohol) related applications. In addition, we highlight areas, such as the epigenetics of psychostimulant, opioid and cannabis abuse, which are markedly understudied and could benefit from intensified collaborative efforts to define epigenetic biomarkers of abuse and dependence. [ABSTRACT FROM AUTHOR]

Distinct environmental and conditioned stimuli influencing ethanol-associated appetitive and consummatory behaviors may jointly contribute to alcohol addiction. To develop an effective translational animal model that illuminates this interaction, daily seeking responses, maintained by alcohol-associated conditioned stimuli (CSs), need to be dissociated from alcohol drinking behavior. For this, we established a procedure whereby alcohol seeking maintained by alcohol-associated CSs is followed by a period during which rats have the opportunity to drink alcohol. This cue-controlled alcohol-seeking procedure was used to compare the effects of naltrexone and GSK1521498, a novel selective μ-opioid receptor antagonist, on both voluntary alcohol-intake and alcohol-seeking behaviors. Rederived alcohol-preferring, alcohol-nonpreferring, and high-alcohol-drinking replicate 1 line of rats (Indiana University) first received 18 sessions of 24 h home cage access to 10% alcohol and water under a 2-bottle choice procedure. They were trained subsequently to respond instrumentally for access to 15% alcohol under a second-order schedule of reinforcement, in which a prolonged period of alcohol-seeking behavior was maintained by contingent presentations of an alcohol-associated CS acting as a conditioned reinforcer. This seeking period was terminated by 20 min of free alcohol drinking access that achieved significant blood alcohol concentrations. The influence of pretreatment with either naltrexone (0.1−1−3 mg/kg) or GSK1521498 (0.1-1-3 mg/kg) before instrumental sessions was measured on both seeking and drinking behaviors, as well as on drinking in the 2-bottle choice procedure. Naltrexone and GSK1521498 dose-dependently reduced both cue-controlled alcohol seeking and alcohol intake in the instrumental context as well as alcohol intake in the choice procedure. However, GSK1521498 showed significantly greater effectiveness than naltrexone, supporting its potential use for promoting abstinence and preventing relapse in alcohol addiction. [ABSTRACT FROM AUTHOR]

The research agenda for global mental health and substance-use disorders has been largely driven by the exigencies of high health burdens and associated unmet needs in low- and middle-income countries. Implementation research focused on context-driven adaptation and innovation in service delivery has begun to yield promising results that are improving the quality of, and access to, care in low-resource settings. Importantly, these efforts have also resulted in the development and augmentation of local, in-country research capacities. Given the complex interplay between mental health and substance-use disorders, medical conditions, and biological and social vulnerabilities, a revitalized research agenda must encompass both local variation and global commonalities in the impact of adversities, multi-morbidities and their consequences across the life course. We recommend priorities for research - as well as guiding principles for context-driven, intersectoral, integrative approaches - that will advance knowledge and answer the most pressing local and global mental health questions and needs, while also promoting a health equity agenda and extending the quality, reach and impact of scientific enquiry.This article has not been written or reviewed by Nature editors. Nature accepts no responsibility for the accuracy of the information provided. [ABSTRACT FROM AUTHOR]

No abstract available [ABSTRACT FROM AUTHOR]

Aim To examine the experience of developing and living with mental health and substance use disorders among young people living in urban-deprived areas in Ireland to inform primary care interventions. Method Semi-structured qualitative interviews with 20 young adults attending health and social care agencies in two deprived urban areas, and analysed using thematic analysis. Results Five themes were identified: experiencing symptoms, symptom progression, delay accessing help, loss of control/crisis point, and consequences of mental health and substance use disorders. As young people delayed help, symptoms disrupted normal life progression and they found themselves unable to engage in everyday activities, and living with reduced potential. Living in deprived areas influenced the development of problems: many had added stressors, less familial support and early exposure to violence, addiction and bereavement. Conclusion Young people in urban-deprived areas are especially vulnerable to mental health and substance use disorders. Early identification in primary care appears necessary in halting symptom and illness progression, improving young people's chances of achieving their potential. [ABSTRACT FROM AUTHOR]

This study examines the effect of dynamic and structural community characteristics on school misconduct. Data include over 45,000 students in the eighth, tenth, or twelfth grade in 237 schools. Hierarchical linear models tested the direct and interactive effects of community measures, while accounting for student and school characteristics. Community substance abuse norms as well as perceptions of community crime and disorder mediated the influence of concentrated disadvantage on school misconduct. Interaction effects demonstrated that community substance abuse norms were more influential for students enrolled in schools that had a less positive school climate although individual and school characteristics remained robust predictors of school misconduct. School misconduct is influenced by the characteristics of the surrounding community and school context, as well as the interaction between those contexts. Research relying on census data measures of community characteristics may underestimate community influence on school misconduct, and omit proximal community influences on school misconduct. [ABSTRACT FROM PUBLISHER]

Background: Adolescents with substance use disorder (SUD) and conduct problems exhibit high levels of impulsivity and poor self-control. Limited work to date tests for brain cortical thickness differences in these youths. Objectives: To investigate differences in cortical thickness between adolescents with substance use and conduct problems and controls. Methods: We recruited 25 male adolescents with SUD, and 19 male adolescent controls, and completed structural 3T magnetic resonance brain imaging. Using the surface-based morphometry software FreeSurfer, we completed region-of-interest (ROI) analyses for group cortical thickness differences in left, and separately right, inferior frontal gyrus (IFG), orbitofrontal cortex (OFC) and insula. Using FreeSurfer, we completed whole-cerebrum analyses of group differences in cortical thickness. Results: Versus controls, the SUD group showed no cortical thickness differences in ROI analyses. Controlling for age and IQ, no regions with cortical thickness differences were found using whole-cerebrum analyses (though secondary analyses co-varying IQ and whole-cerebrum cortical thickness yielded a between-group cortical thickness difference in the left posterior cingulate/precuneus). Secondary findings showed that the SUD group, relative to controls, demonstrated significantly less right > left asymmetry in IFG, had weaker insular-to-whole-cerebrum cortical thickness correlations, and showed a positive association between conduct disorder symptom count and cortical thickness in a superior temporal gyrus cluster. Conclusion: Functional group differences may reflect a more nuanced cortical morphometric difference than ROI cortical thickness. Further investigation of morphometric differences is needed. If replicable findings can be established, they may aid in developing improved diagnostic or more targeted treatment approaches. [ABSTRACT FROM AUTHOR]

Men’s and women’s drinking tend to elicit different societal reactions, which may be attributed to different perceptions of masculinity and femininity. This study analyzes addiction care practitioners’ constructions of substance use and treatment needs in relation to gender. Data were collected by means of six focus group interviews with 30 addiction care practitioners. An interpretative repertoire of difference emerged, whereby women were constructed as being different from men in psychological, social, and biological respects. The practitioners related to gender in addiction care as an ideological dilemma resulting from the contradictory ideals of on the one hand treating everybody equally and on the other giving special attention to what is regarded as women’s needs. Reflections emerged regarding the need to be aware of one’s own stereotyped assumptions, and also to be attentive toward men’s specific problems, thus constituting a reflective repertoire. In order to avoid potentially stereotyped treatment, the application of a gender-sensitive approach should acknowledge the variety of ways in which femininity and masculinity may be performed. [ABSTRACT FROM AUTHOR]

Adolescence encompasses a sensitive developmental period of enhanced clinical vulnerability to nicotine, tobacco, and e-cigarettes. While there are sociocultural influences, data at preclinical and clinical levels indicate that this adolescent sensitivity has strong neurobiological underpinnings. Although definitions of adolescence vary, the hallmark of this period is a profound reorganization of brain regions necessary for mature cognitive and executive function, working memory, reward processing, emotional regulation, and motivated behavior. Regulating critical facets of brain maturation are nicotinic acetylcholine receptors (nAChRs). However, perturbations of cholinergic systems during this time with nicotine, via tobacco or e-cigarettes, have unique consequences on adolescent development. In this review, we highlight recent clinical and preclinical data examining the adolescent brain's distinct neurobiology and unique sensitivity to nicotine. First, we discuss what defines adolescence before reviewing normative structural and neurochemical alterations that persist until early adulthood, with an emphasis on dopaminergic systems. We review how acute exposure to nicotine impacts brain development and how drug responses differ from those seen in adults. Finally, we discuss the persistent alterations in neuronal signaling and cognitive function that result from chronic nicotine exposure, while highlighting a low dose, semi-chronic exposure paradigm that may better model adolescent tobacco use. We argue that nicotine exposure, increasingly occurring as a result of e-cigarette use, may induce epigenetic changes that sensitize the brain to other drugs and prime it for future substance abuse. [ABSTRACT FROM AUTHOR]

The present study aimed to find out the prevalence of substance use and its relationship with selected socio-demographic factors as well as its educational impacts. Halaba public secondary school was selected purposefully due to its strategic importance. Out of a total of 5,518 students 311 female and 500 male students were selected to take part in the study by using proportionate stratified random sampling technique . A survey questionnaire was used to collect data by the help of 11 secondary school teachers. Three FGDs were conducted with 24 key informants. According to the present study 29.8% of the students were found to be current substance users. Chi-Square Test indicated that gender and substance use were highly significantly associated (p< .001). On the other hand, one way ANOVA indicated that Muslims were more involved in khat chewing compared to other religious groups. Also grades 9 & 10 students were more involved compared to their seniors. The more the parents' were educated the trend observed was that the lesser is the involvement of their children in substance use. Children of vocational level educated parents were less involved in substance use. Likewise, compared to other professional groups farmers' children were more involved in substance use (p<.001). Furthermore, an indication that pointed out negative impacts of substance use on academics was found. In order to control and prevent substance use in schools, an integrated approach that involves Parent Teacher Association, Student Council, Community and Religious leaders and the Government should be employed. [ABSTRACT FROM AUTHOR]

Objectives: Studies show that illicit cannabis (marijuana) use is related to use of other illicit drugs and that reasons for use are related to frequency of marijuana use. However, research is needed to examine whether specific reasons for marijuana use are associated with use of other illicit drugs.Methods: Data from recent marijuana-using high school seniors were examined from 12 cohorts of Monitoring the Future (Weightedn = 6481) to examine whether reasons for recent marijuana use are associated with use of eight other illicit drugs.Results: Using “to experiment” decreased odds of reporting use of each drug and using to decrease effects of other drugs increased odds of reporting use of each drug. In multivariable models, using marijuana “to experiment” decreased the odds for reporting use of hallucinogens other than LSD and narcotics other than heroin. Using marijuana for “insight” increased the odds for use of hallucinogens other than LSD, and use due to “boredom” increased the odds for reporting use of powder cocaine and hallucinogens other than LSD. Using marijuana to increase effects of other drugs increased odds of reporting use of each of the eight drugs, and using it to decrease other drug effects increased odds of reporting use of crack, hallucinogens other than LSD, and amphetamine/stimulants.Conclusions: This study helped identify illicit marijuana users who are more likely to report use of other illicit drugs. Prevention efforts need to focus on students who report certain reasons for marijuana use as they may be at risk for use of other illicit drugs. [ABSTRACT FROM PUBLISHER]

Background: Research assessments can confound the results of treatment outcome studies and can be themselves an intervention or form of aftercare.Objective: To determine the trajectory of substance use and substance severity in a sample of African American cocaine users participating in a community-based sexual risk reduction trial.Methods: Out-of-treatment participants were recruited using Respondent-Driven Sampling in two African American majority counties in rural Arkansas. They participated in either the sexual risk reduction condition or an active control focused on access to social services. They were interviewed at baseline, post-intervention, and 6 and 12 months post-intervention. Substance use outcome measures were use of crack cocaine, powder cocaine, marijuana, alcohol, and the Addiction Severity Index Alcohol and Drug Severity composites. A random sample of participants completed qualitative interviews post-12-month interview.Results: 251 were enrolled. Substance use outcomes did not differ among the two conditions at any point in the study. Use of measured substances and the ASI composites significantly decreased between baseline and post-intervention (p < 0.01), decreases that persisted at the 12-month assessment period compared to baseline. Qualitative findings suggested that many participants identified increased awareness of their drug use and need to control it through the programs. Participants also noted strong bonding with interviewers.Conclusion: Clinical trials may have positive unexpected outcomes in terms of reduced substance use even though the trial is not substance use focused. Behavioral interventions for drug users that are not focused specifically on reducing drug use may nonetheless have unanticipated positive associations with reductions in drug use. [ABSTRACT FROM PUBLISHER]

Special attention needs to be paid to the attitudes of psychiatry residents toward individuals diagnosed with substance use disorders. The attitudes of trainees may be worse toward these individuals than toward individuals with other diagnoses, and these attitudesmay worsen over time. While psychiatry residencies are increasingly teaching residents about how to diagnosis and treat individuals diagnosed with substance use disorders, more attention needs to be paid to educating residents about common attitudes toward these individuals. We recommend that psychiatry residency programs start with basic educational didactics and reflection exercises on attitudes toward individuals diagnosed with substance use disorders and that programs try to form a positive "hidden curriculum" in their institutions. [ABSTRACT FROM AUTHOR]

Officers in law enforcement agencies (LEAs) experience long-term health morbidity and mortality at rates exceeding other occupations and the general population. The purpose of this study was to pilot a survey of officer safety and wellness to demonstrate feasibility, assess the need for further research, and lay the groundwork for policies and additional support for officer wellbeing. A random sample of 184 officers from 11 participating LEAs responded to a survey regarding physical activity patterns, job characteristics, substance use, critical incidents, job-related stress, personal health, and health-care usage. Officers reported physical health outcomes at rates similar to the general population but screened positive for elevated rates of posttraumatic stress disorder, common mental disorders, and alcohol misuse. These data support the need for research at the regional and national levels to inform LEA policies and programs. [ABSTRACT FROM PUBLISHER]

ObjectiveThe aim of the present study was to analyse demographic and clinical characteristics, as well as psychiatric diagnoses to identify gender differences in patients with attempted suicide in a Mexican population.MethodsBetween September 2010 and September 2012, 140 suicide attempts were documented in the Department of Psychiatry at the General Hospital of Comalcalco (Hospital General de Comalcalco in Spanish) in Tabasco, Mexico. Diagnoses were established using the DSM-IV questionnaire in which Axis I and II were considered. The Suicide Intent Scale was also applied.ResultsIn our sample, 63.6% were females and 36.4% males. With regard to socio-demographic characteristics, the predominant marital status in males was single, and in females married (χ2=5.93, df=2, p=0.05). In occupation the male group was mainly unemployed and housewife in females (χ2=55.51, df=4, p<0.001). Male subjects were more likely to consume alcohol (χ2=20.40, df=1, p≤0.001), cannabis (χ2=16.62, df=1, p≤0.001) or tobacco. The prevalence of psychiatric diagnosis was significantly different because, the male group was mainly diagnosed with substance-related disorders, whereas female participants showed a prevalence of stress-related disorders (χ2=34.17, gl=4, p=0.0001).ConclusionOur results provide evidence that the characteristics of suicide attempt are different by gender in the Mexican population. Interventions are necessary for the development of prevention strategies that may lead to a reduction in suicidal behaviour. These preventive activities should consider the occupation for the female group and consumption of alcohol, cannabis or tobacco in the male group. [ABSTRACT FROM PUBLISHER]

Borderline personality disorder (BPD) and substance use disorders (SUDs) often co-occur, partly because they share risk factors. In this international multicenter study, risk factors for BPD were examined for SUD patients. In total, 1,205 patients were comprehensively examined by standardized interviews and questionnaires on psychiatric diagnosis and risk factors, and it was found that 1,033 (85.7%) had SUDs without BPD (SUD) and 172 (14.3%) had SUD with BPD (SUD + BPD). SUD + BPD patients were significantly younger, more often females and more often diagnosed with comorbid adult attention deficit/hyperactivity disorder. SUD + BPD patients did not differ from SUD patients on most risk factors typical for SUD such as maternal use of drugs during pregnancy or parents having any SUD. However, SUD + BPD patients did have a higher risk of having experienced emotional and physical abuse, neglect, or family violence in childhood compared to SUD patients, suggesting that child abuse and family violence are BPD-specific risk factors in patients with SUDs. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In the late 1960s and 1970s, countercultural entrepreneurs in the United States sold paraphernalia for enhancing LSD trips or for smoking marijuana at small stores called head shops. These accessories of alternative lifestyles provided hippies with a totemic material culture they could call their own. Head shop owners hoped their countercultural wares and atmosphere would provide hippies with desperately needed public spaces where they could gather in peace without being harassed. More importantly, these entrepreneurs believed their products allowed people to alter their minds – and even their societies – through meaningful drug use. In addition, many head shops made vital contributions to the movement to undermine, reform, and eradicate America’s drug laws. While these businesses were not opposed to turning a profit, their communitarian idealism and political engagement contradict the common charge that so-called hip capitalists were little more than apolitical sell-outs and dupes. Both head shops and the marijuana legalization movement helped each other achieve remarkable levels of financial and political success in the middle of the 1970s. In contrast to their predecessors of the late 1960s, many head shops of the late 1970s embraced profit and financial growth and deemphasized radical politics and counterculture. By the end of the decade, head shops numbered an estimated 30,000 and organized their own trade groups and meetings. Eleven states even decriminalized minor personal possession of marijuana in the 1970s. Although head shops had always faced scrutiny from police and concerned private citizens, it was only at the end of the 1970s that parents’ groups and legislators began to coordinate a national campaign against the so-called “commercialized drug culture” they attributed to these countercultural entrepreneurs. Consequently, the crusade against head shops represented one of the first salvos in the cultural and legislative War on Drugs of the 1980s. [ABSTRACT FROM PUBLISHER]

Background Despite evidence that many people engage in solitary drinking and that it might be associated with negative consequences, to date, little research has focused on this form of drinking behaviour. This study examined the prevalence and factors associated with solitary drinking, and assessed whether it is linked with hazardous alcohol use among males in nine countries of the former Soviet Union (fSU). Methods Data came from a cross-sectional population-based survey undertaken in 2010/11 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. Information was obtained on the frequency of solitary drinking among male regular drinkers (i.e., those consuming alcoholic drinks at least once a month), and on problem drinking (CAGE) and heavy episodic drinking (HED). Logistic regression analysis was used to examine associations between the variables. Results The prevalence of occasional and frequent solitary drinking ranged from 8.4% (Georgia) to 42.4% (Azerbaijan), and 3.1% (Kazakhstan) to 8.2% (Armenia), respectively. Solitary drinking was associated with being older, divorced/widowed, living alone, having a bad/very bad household financial situation, lower levels of social support, and poor self-rated health. Occasional solitary drinking was linked to problem drinking and HED, while frequent solitary alcohol use was related to problem drinking. Conclusions Solitary drinking is relatively common among male regular drinkers in the fSU and is linked to older age, social and economic disadvantage, and hazardous alcohol use. [ABSTRACT FROM AUTHOR]

Background: Cocaine-dependent individuals (CDI) display increased impulsivity. However, despite its multifactorial nature most studies in CDI have treated impulsivity monolithically. Moreover, the impact of attention-deficit/hyperactivity disorder (ADHD) has often not been taken into account. This study investigates whether CDI with ADHD (CDI+ADHD) differ from CDI without an ADHD diagnosis and healthy controls (HC) on several impulsivity measures. Methods: Thirty-four CDI, 25 CDI+ADHD and 28 HC participated in this study. Trait impulsivity was assessed with the motor, attentional and non-planning subscales of the Barratt Impulsiveness Scale (BIS-11). Neurocognitive dimensions of impulsivity were examined with the stop signal task (SST), delay discounting task (DDT) and information sampling task (IST). Results: Relative to HC, both CDI and CDI+ADHD scored higher on all BIS-11 subscales, required more time to inhibit their responses (SST) and sampled less information before making a decision (IST). Greater discounting of delayed rewards (DDT) was only found among CDI+ADHD. Compared to CDI without ADHD, CDI+ADHD scored higher on the BIS-11 non-planning and total scale and showed higher discounting rates. Conclusion: CDI score higher on several indices of impulsivity relative to HC, regardless of whether they have concomitant ADHD or not. CDI+ADHD are specifically characterized by a lack of future orientation compared to CDI without ADHD. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. Methods: Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). Results: A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. 'Legal problems' and 'desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7% higher than with DSM-IV. Conclusions: Results support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]