Double trouble? A mixed methods study exploring experiences with combined use of anabolic-androgenic steroids and psychoactive substances among women

Socio-economic changes that occured in the wake of dismemberment of former Yugoslavia resulted in the appearance of social pathology, one of which was the increase in the use of psychoactive substances. The overwhole epidemiological research in the use of psychoactive substances has not been conducted so far. The aim of this study was to establish the type and form of the use of psychoactive substances considering sex and age, as well as risk factors for the use of psychoactive substances among the children and adolescents. The research was carried out among 1011 elementary school children (seventh and eighth grades) and secondary school children (all four grades) in the area of Belgrade from October 2003 to January 2004. Out of the total number 457 (45.2%) were elementary school pupils and 554 (54.8%) secondary school pupils. There were 524 (51.8%) boys and 487 (48.2%) girls, aged from 12 to 18 years (the average age being 15.3 years). The method used was the European School Survey Project on Alcohol and Other Drugs Questionaire. Chi-square test, Mann-Whitney, Student's t test and Logistic Regression test were used in statistical processing of the data. Totally 14.2% examinees tried psychoactive substances. The most frequent drug used at the first contact was marijuana (10.8%) at the age of 15 tried by 12.7% examinees, inhalants (4.4%), amphetamines (4.1%), sedatives (3.7%), alcohol combined with marijuana (3.9%), then cocaine (2.8%), heroine (2.3%), alcohol combined with sedatives (2.2%), and ecstasy (1.6%), followed by anabolic steroids, heroin, diethilamid lisergic acid (LSD) and magic mushrooms. It was determined that going out in the evening, smoking and binge form drinking were directly connected with the use of psychoactive substances. Totally 14.2% of the exameneers used psychoactive substances, mostly marijuana, followed by amphetamines and others. New tendencies of use characterized by the increase in the use are of synthetic substances, simultaneous use of more psychoactive substances and younger age. The risk factors are going out in the evening, smoking, binge drinking and use of synthetic substances among peers. Our research indicates the neccessity of primary prevention.

BackgroundThe aims of this study were to assess: 1) the associations among sexual activity, alcohol consumption, use of other psychoactive substances and mental health during the COVID-19 pandemic; and 2) the associations between COVID-19 preventive measures, alcohol consumption and use of psychoactive substances.MethodsThis was a secondary analysis of data collected from adults in Nigeria between July and December 2020. The variables extracted included change in sexual activity, alcohol consumption and use of other psychoactive substances, COVID-19 preventive behaviors (wearing face masks, washing hands, physical distancing), anxiety, depression, post-traumatic stress disorder (PTSD) and sociodemographic variables (age, sex, education, HIV status, employment status). Multivariable logistic regressions were conducted. A model was run to regress depression, anxiety, PTSD, increased alcohol consumption, and increased use of other psychoactive substances, on increased sexual activity. In separate models, anxiety, depression, and PTSD were regressed on increased alcohol consumption and on increased use of other psychoactive substances. Finally, three models were constructed to determine the associations between increased alcohol consumption and increased use of other psychoactive substances on three separate COVID-19 preventive behaviors. All models were adjusted for sociodemographic variables.ResultsIncreased alcohol consumption (AOR:2.19) and increased use of other psychoactive substances (AOR: 3.71) were significantly associated with higher odds of increased sexual activity. Depression was associated with significantly higher odds of increased alcohol consumption (AOR:1.71) and increased use of other psychoactive substances (AOR:3.21). Increased alcohol consumption was associated with significantly lower odds of physical distancing (AOR:0.59).ConclusionThere was a complex inter-relationship between mental health, sexual health, increased use of psychoactive substances. The consumption of alcohol also affected compliance with physical distancing. Further studies are needed to understand the observed relationships.

Use of Psychoactive Substances and Health Care in Response to Anxiety and Depressive Disorders

Psychoactive substance use is frequently encountered in hospitals' emergency departments (EDs). It accounts for major health-care problems frequently leading to accident and ED admissions, yet it is frequently unidentified. The aim of this study was to determine the prevalence and pattern of psychoactive substance use among patients presenting in the Accident and EDs and to compare the case detection rate of psychoactive substance use between self-report questionnaire and biochemical markers (e.g., urine toxicology). To achieve this, 200 consenting participants attending the accident and emergency unit of a tertiary hospital were consecutively enlisted into the study within 2 weeks. They were screened for psychoactive substance use with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the urine drug test (UDT). The lifetime prevalence of psychoactive substance use was 45.5%, while the past 3 months (recent use) prevalence was 27.0%. The pattern of psychoactive substance use revealed that alcohol was the predominant psychoactive substance use with a lifetime prevalence of 13.0% and recent use of 12.0%. The UDT significantly detected more patients who used psychoactive substance compared to self-report (P < 0.001). The prevalence of drug use recorded among attendees of the accident and emergency unit was high in this study. The UDT significantly detected more patients who used psychoactive substances compared to self-report (P < 0.001). Several patients with major health problems as a result of psychoactive substance use were identified with the aid of these screening tools.

Psychoactive substance use is a major global public health issue. Use of psychoactive substances has been associated with negative consequences among students. The study assessed the prevalence and socio-demographic correlates of psychoactive substance use among undergraduate students in a Nigerian university. This was a cross-sectional descriptive study of 763 undergraduate students of Imo State University, Owerri, Nigeria, recruited using multi-stage sampling technique. Data on the socio-demographic characteristics and pattern of psychoactive substance use were collected using a structured questionnaire. The lifetime rate of psychoactive substance use was 84.5%. Alcohol had the highest rate of lifetime (82.5%) and 12-month (61.1%) use. There was a similar rate of lifetime use of psychoactive substances among males (86.1%) and females (83.4%). Age (p<0.05) and place of residence (p<0.05) were significantly associated with lifetime psychoactive substance use. Catholics (OR:1.43; 1.03 - 1.99), whose friend (OR:1.94; 1.39 - 2.71), roommate (OR:3.06; (1.62 - 5.78) or brother (OR:1.22; 0.77 - 1.93) uses psychoactive substances were significantly more likely to have used substances in the past 12-months. There is a high rate of psychoactive substance use among the students. Age, religion, place of residence, family and peer use of substances are important determinants of psychoactive substance use.

The purpose of this study was to determine the extent of comorbid substance use disorders in patients referred for treatment of personality disorders. Two hundred inpatients and outpatients were assessed by semistructured interviews for substance use and personality disorders. Univariate odds ratios were calculated for groups of substance use disorders and each DSM-III-R axis II disorder; comorbidity among axis II disorders was controlled in multivariate models predicting current or lifetime substance use disorder groups. The impact of personality disorder on chronicity and overall impairment associated with substance use disorders was evaluated. Close to 60% of subjects with substance use disorders had personality disorders. Borderline personality disorder was significantly associated with current substance use disorders, excluding alcohol and cannabis, and with lifetime alcohol, stimulant, and other substance use disorders, excluding cannabis. Antisocial personality disorder was associated with lifetime substance use disorders other than alcohol, cannabis, and stimulants. These relationships remained significant after controlling for the presence of all other personality disorders. There was no evidence that personality disorders increased the chronicity of substance use disorders, but comorbid personality disorders were associated with greater global impairment. Borderline personality disorder may be associated with a wide variety of substance use disorders, especially among patients seeking treatment for personality problems.

The purpose of this study was to assess the psychiatric effects of anabolic-androgenic steroid (AAS) use and assess the frequency of other psychoactive substance use in a population of AAS users compared with non-AAS-using weight-lifter controls. One hundred sixty-four subjects were administered a demographic survey, including psychiatric history, substance use history, AAS use history, and medical history. Psychiatric diagnoses were made and psychological testing was performed. User categories were determined by history and urine testing. The user categories did not differ significantly on psychological testing. Past AAS users had a higher incidence of psychiatric diagnosis than the nonuser and current user groups. Hypomania was correlated with AAS use, and major depression with AAS discontinuation. Present psychoactive substance abuse or dependence was relatively low across all user categories. AAS dependence was seen in 12.9% of current users and 15.2% of past users of AAS. In conclusion, AAS use may lead to psychiatric disorders in certain individuals. Concurrent use of psychoactive drugs other than AAS does not appear to be common in intensively training weight lifters and bodybuilders.

Background: Prevalence and underlying reasons of psychoactive substance use vary across different age, gender and societal groups. It is an important concern among females as female physiology and psychology makes them more vulnerable to substance dependence. The primary objective of study was to find prevalence, pattern and factors affecting psychoactive substance use among female students (18-25 years).Methods: In a cross-sectional survey, 250 female students were recruited from a university in Chandigarh using multistage cluster random sampling. Survey tool developed by World Health Organization was used in a self administrated format using paper based survey method. Associations among various factors leading to psychoactive substance use were tested using logistic regression model.Results: Lifetime prevalence of psychoactive substance use was 13.6% [95% CI 9.3-17.8, n=34]. Participants reported their use out of curiosity, for having fun, personal problems, easy availability, familial use, etc. 52.9% (18/250) students reported their use within last 3 months; out of them health problems were faced by two. Association of psychoactive substance use was significant for age, socioeconomic status and family history of psychoactive substance use.Conclusions: Due to sensitive nature of reporting substance use, the lifetime prevalence of 13.6% among female young students may be an underestimation. Familial psychoactive substance use exposes their wards to its use, especially under psychological stress. Qualitative research should be performed to understand why some female students use psychoactive substances while others abstain themselves from using these at all or abstain from their use for a long time after first exposure.

Anabolic androgenic steroids (AAS) and associated drug use is now recognised as a significant concern and an emerging public health issue. Once restricted to the elite sporting arena, recent decades have seen AAS diffuse through bodybuilding and gym culture to an increasingly image conscious general population. This portfolio of research contributes to our understanding of this phenomenon in relation to our understanding of the extent and characteristics of AAS use, emerging harms and the policy response to the issue, as summarised below. While specific prevalence is unknown, data from needle and syringe programmes (NSPs) indicate growing numbers of people who inject AAS and associated drugs. Often portrayed in the media as a homogenous group of young male, working class men, a growing body of research indicates a much more diverse population in relation to demographic characteristics and motivations for use. Further research indicates that this is by no means confined to the United Kingdom (UK) but is a global public health issue although barely recognised in some countries such as the Republic of Ireland. Changes in the specific drugs of use and the regimes employed have been identified, with a growing pharmacopeia of easily accessible and affordable peptide hormones being used as a direct result of the rise of the Internet, coupled with developments in manufacturing and transportation. Opinion, anecdote and targeted marketing on the Internet fill the void of a lack of empirical evidence in the field of AAS, image and performance enhancing drugs (IPEDs) influencing a trend towards higher dosages, multiple drugs and prolonged use. Drug use is not confined to IPEDs, with psychoactive drug use identified in populations in UK and Internationally. Our understanding of the chronic health harms associated with AAS has increased over the last 25 years, in particular cardiovascular damage, psychological harms and the potential for dependence. However, this research has made a significant contribution to the recognition and understanding of the harms associated with the administration of these drugs through injection and the impact of adulterated products as a result of the illicit market. The extent of localised infection and soft tissue injury is a cause for concern, an issue previously neglected. Of further concern is the prevalence of blood borne virus (BBV) infection within the population of AAS users. In the first studies of their kind, HIV amongst AAS injectors has been shown to be at a similar level as that in psychoactive drug injectors in the UK. Hepatitis B and hepatitis C levels were identified as being higher than in the general population, and of key concern is the low levels of awareness of hepatitis C positive status amongst AAS injectors. The UK has operated a comprehensive NSP system since the 1980s, which has seen increasing numbers of AAS injectors however, there remains barriers to engagement with this population of people who inject drugs. Data from interviews and surveys submitted here identify a level of mistrust and lack of confidence among AAS users when it comes to engaging with health professionals. The following thesis, submitted in partial fulfilment of the requirements of Liverpool John Moores University for the degree of Doctor of Philosophy spans over twenty years of academic work within the specific field of AAS use. The research provides the groundwork for the development of meaningful and successful policies and interventions to reduce harm and promote health based on the need of this population. The submission includes a brief critical reflection on the undertaken research and the engagement with the research population, drawing on my experiences, positionality and evolution of knowledge and understanding. This further informs the concluding remarks and suggestions for future research.

A community based study of patterns of psychoactive substance use among street children in a local government area of Nigeria

Актуальность. Статья посвящена проблеме причинно-следственных связей между воздействием социальных факторов риска в виде чрезмерного потребления психоактивных веществ на медицинские факторы риска, последствиями чего являются формирование и распространение аддиктивных расстройств здоровья. Цель исследования: установка и обработки причинно-следственных связей между социальными и медицинскими факторами риска при формировании аддиктивных расстройств здоровья на примере Днепропетровской области путем корреляционного анализа с позиции судебной фармации. Материалы и методы. При проведении исследования использовали действующие законодательные, нормативно-правовые и инструктивно-методические документы; Интернет-ресурсы. Применяли документальный, судебно-фармацевтический, статистический, корреляционный, сравнительный и графический методы анализа. Результаты. В статье приведены результаты судебно-фармацевтических исследований, обоснована их актуальность, сформулированы цель, разработан дизайн, описано материалы и методы исследования. Установление причинно-следственных связей между социальными и медицинскими факторами риска при формировании аддиктивных расстройств здоровья проводилось на примере наиболее типичной для Приднепровского региона Украины Днепропетровской области путем корреляционного анализа в течении 2014-2018 годов. Сбор, анализ и обработка императивных данных проводились с учетом 5 показателей социальных факторов риска: оборот психоактивного вещества I уровня крепости этанола (пиво); оборот психоактивного вещества II уровня крепости этанола (ликеры); оборот психоактивного вещества III уровня крепости этанола (водка); индекс потребительских цен; оборот совместного употребления психоактивных веществ (в частности, алкогольные напитки + табак). Сбор, анализ и обработка данных по показателям медицинских факторов риска проводились с учетом 4 факторов: количество впервые зарегистрированных случаев аддиктивных расстройств здоровья; количество случаев болезней нервной системы; количество случаев аддиктивных расстройств здоровья из-за употребления психоактивного вещества алкоголя; количество случаев аддиктивных расстройств здоровья вследствие совместного употребления психоактивных веществ. По результатам исследования было установлено, что показатели социальных факторов риска оборота психоактивных веществ III уровня крепости этанола (водка) причинно влияют на показатели медицинских факторов риска, следствием чего является рост количества случаев болезней нервной системы. Определена структура нормированного t-критерия социальных и медицинских факторов риска при формировании аддиктивных расстройств здоровья. Выводы. Установлено, что на формирование аддиктивных расстройств здоровья первопричиною выступают социальные факторы риска (чрезмерное и неконтролируемое употребление психоактивных веществ в виде алкогольных напитков различного уровня крепости или сочетанное применение психоактивных веществ различных классификационно-правовых групп, например алкогольные напитки + табак). Социальные факторы риска влияют на медицинские факторы риска, следствием чего является рост количества впервые зарегистрированных случаев аддиктивных расстройств здоровья и количества случаев болезней нервной системы. Полученные данные являются основанием для планирования дальнейших судебно-фармацевтических исследований в этом направлении и акцентируют внимание государственных органов власти на необходимость разработки социально ориентированных профилактических мероприятий, направленных на совершенствование оборота алкогольных напитков I, II и III уровней крепости (пиво, ликеры, водка), неумеренное потребление которых приводит к формированию аддиктивных расстройств здоровья.

INTRODUCTION: Psychoactive substances are chemicals that affect the nervous system and alter the activity in the brain. Such substances include alcohol and other illicit drugs. This research study is aimed to determine the prevalence and pattern of psychoactive substance use among students at a government secondary school in Ilorin, Kwara State, Nigeria. METHODS: this study adopts a cross-sectional descriptive survey design. A simple random sampling technique was used to select 104 students for an invitation to fill a semi-structured questionnaire after consenting to the informed consent. Correlational analyses were performed between social characteristics and the knowledge of the effects and prevalence of substance use. RESULTS: thirty three point seven percent of students reported to use psychoactive substances, with alcohol and tramadol being the most consumed. Those ageed 15-19 years were found to have a higher prevalence of substances use than other ages. There was an important knowledge of the social perspective and health effects of using such substances, but they persisted in their consumption. Age and school level were observed to have a statistically significant correlation with the knowledge of the effects of drug use. CONCLUSION: our study shows that the prevalence and pattern of psychoactive substance use among the students are high considering their level and age. The majority of the students knew about psychoactive substance use and its social and health effects. We, therefore, recommend a multi-stakeholder effort within the community to curtail drug use among young people.

Introduction: The use of anabolic androgenic steroids (AAS) and other image- and performance-enhancing drugs is a growing public health concern. AAS use is associated with various physical and mental harms, including cardiovascular risks, cognitive deficiencies, and dependence. The aim of this study was to determine whether patterns of AAS use and other variables are associated with the presence of an AAS use disorder (AASUD). Methods: An online survey was completed by 103 male AAS consumers visiting gyms. The association of different patterns of AAS consumption (cycling vs. continuous forms of AAS use), psychoactive substance use, mental health disorders, and sociodemographic variables with moderate-severe AASUD (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ≥4 criteria) was investigated. The associations between duration of AAS use and the AAS dose with moderate-severe AASUD were investigated using logistic regression analysis with moderate-severe AASUD as the dependent variable. Results: Moderate-severe AASUD was present in 25 (24.3%) of the participants. AAS consumers meeting criteria for moderate-severe AASUD, compared to those that did not, in the last 12 months reported a longer duration of AAS use (in weeks), a higher average AAS dose (mg/week), and a greater number of AAS side effects. Duration of AAS use and the AAS dose were the only independent predictors, with an increase of 3.4% in the probability of moderate-severe AASUD with every week increase of the duration of AAS use in the last year (p < 0.05) and an increase in moderate-severe AASUD of 0.1% with every 10 mg increase in the average AAS dose per week (p < 0.05), respectively. Conclusion: Our findings show that moderate-severe AASUD is relatively frequent among male AAS consumers and is positively associated with the duration and average dose of AAS use in the last 12 months.

Background: Concerns over the use of psychoactive substances by students in health sciences is growing. This study evaluated the prevalence and patterns of these substances among the learners in the college of health sciences, Osun State University, Osogbo.Methods: A multistage sampling technique was used to obtain 252 respondents for a descriptive cross-sectional study design. Data were collected using a publicly accessible, and standardized questionnaire. Descriptive and inferential statistics were employed in SPSS 27 with p&lt;0.05.Results: The majority of the participants were between18 to 24 years with a mean age of 21.3 ± 0.92 years. The prevalence of psychoactive substance use was 17%, with alcohol being the most commonly consumed substance (17.9%). Majority of the respondentsnever abused psychoactive substances, a substantial proportion occasionally consumed alcohol (28.5%) and prescription drugs (37.3%), through different routes of administration (12.7%). The most identified factors influencing substance use were: curiosity 71(28.2%), stress (23.8%), and media influence (23.8%). Findings show a statistically significant association between the age of respondents and the prevalence of psychoactive substance use (X2=60.79; p=0.00). Additionally, a statistically significant association was found between the pattern of usage and prevalence of psychoactive substance use (X2=38.77; p=0.03).Conclusion: Psychoactive substance use among health sciences students was found to be of moderate prevalence, influenced by peer pressure, stress, media exposure, and age. These findings underscore the need for age-specific preventive interventions and targeted policies to safeguard students' academic performance and mental health. Universities should integrate structured counseling, mentorship and awareness programs into students support services to address psychoactive substance use and promote healthier coping strategies among health sciences undergraduate students.

Background:Anabolic androgenic steroid (AAS) use is associated with serious mental and physical health problems. Evidence indicates that AAS use among people who use psychoactive substances is higher than in the general population. This study aims to estimate lifetime AAS use among patients in substance use disorder (SUD) treatment, compare characteristics of AAS and non-AAS users and identify whether AAS use was addressed during treatment.Methods:This cross-sectional survey included 563 (142 women, 24.2%) patients in 38 SUD treatment facilities in Norway. Respondents reported on AAS and substance use, and treatment experiences.Results:Lifetime AAS use was reported by 156 (28.3%) SUD patients, thereof 35.6% of the men and 8.0% of the women. Lifetime AAS use was highest among men with stimulants (55.8%) as preferred substance, and lowest among men who preferred alcohol (14.6%). Initiation of AAS use due to getting thinner following substance use was reported by 44.5% of the AAS using men. AAS users reported more severe substance use than non-AAS users. More than half (58%) of all patients had not been asked about AAS use, and 42.4% of those who were asked, experienced that treatment providers lacked expertise about AAS.Conclusion:Lifetime AAS use in this sample of SUD patients is common practice and comprise an underrecognized problem in SUD treatment. Given the deleterious implications to the individual and society that concomitant use of AAS may cause, it would be essential to raise the awareness about AAS use among SUD patients, and the level of competence among health professionals.