Interpreting fibrosis markers in psychoactive substance use disorders: Key confounders to consider.

Concurrent use of anabolic-androgenic steroids (AAS) and psychoactive substances (illicit drugs and alcohol) is found common in studies among men and involves a higher risk of adverse events than AAS use alone. However, women who use AAS represent an understudied group, and little is known about their pattern of psychoactive substance use and possible links to AAS use. The aim of this mixed methods paper is to a) examine lifetime and problem use of psychoactive substances and AAS, and b) explore experiences of AAS and psychoactive substance use including understandings of how these substances may be related among women with current or previous AAS use.Among sixteen women with current or previous AAS use, lifetime psychoactive substance and AAS use, AAS dependence and problem drug and alcohol use were assessed. In-depth semi-structured interviews were conducted, audio-recorded, transcribed verbatim and analyzed thematically within a biopsychosocial framework applying pharmacological agency; the concept of bodily surveillance of effect and the ability to handle substances instrumentally to feel oneselves/ones bodies better.Twelve participants reported lifetime substance use, where cannabis, cocaine and amphetamines were most commonly used. Substance use problems were found among eight participants; five had lifetime AAS-dependence and clinically significant drug and/or alcohol dependence scores, two had lifetime AAS dependence, and one had clinically significant drug dependence scores. Psychoactive substance use was experienced as unrelated to AAS use or it could be used to counteract side effects of AAS. On the contrary, AAS was used to cope with the bodily and emotional change following withdrawal from psychoactive substances and to counteract bodily effects of long-term substance use. Being in substance use disorder (SUD) treatment after detoxification with affected mental health, a passive lifestyle and experiencing a transition from having an emaciated body, gaining weight and becoming unfit, was experienced to motivate AAS initiation during treatment.The polysubstance nature of AAS use including use of psychoactive substances and risk of developing SUDs poses a significant health risk. Health professionals need to understand motivations for combined use of AAS and psychoactive substances among women to be able to prevent harms and address individual treatment needs.

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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.

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.

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.

Background Road traffic accidents (RTAs) remain an important public health issue worldwide. Psychoactive substance use is one of the main contributors to the occurrence of traffic accidents, and its use by truck drivers is a global problem. Also, psychoactive substance use is a commonly observed behavior among truck drivers. To the best of our knowledge, no evidence shows the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia. Therefore, this study was aimed at assessing the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia. Methods A cross-sectional study was conducted among 400 systematically selected truck drivers at Modjo dry port in Ethiopia, from February 1 to March 1, 2018. The data were collected through face-to-face individual interviews using a structured questionnaire. The collected data were entered into EpiData version 4.2.0.0 and analyzed using SPSS version 20. Binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at p value < 0.05 in the multivariable binary logistic regression analysis. Results Of the 400 truck drivers interviewed, the overall one-month self-reported prevalence of psychoactive substance use was 70% (n = 280). In the multivariable binary logistic regression analysis, aged 38 years and above (AOR = 0.40, 95% CI [0.23-0.69]), Christianity religion (AOR = 0.52, 95% CI [0.28-0.97]), college and university education (AOR = 3.47, 95% CI [1.27-9.47]), having a family size of 3 or more (AOR = 0.34, 95% CI [0.20-0.60]), having 6 or more hours spent sleeping at night (AOR = 0.46, 95% CI [0.28-0.75]), and rest breaks between driving (AOR = 2.13, 95% CI [1.14-3.97]) were significantly associated with psychoactive substance use. Conclusion The one-month prevalence of psychoactive substance use among truck drivers was remarkably high. We can conclude that psychoactive substance use is a public health problem among truck drivers, which is a major threat to themselves and others on the road. The sociodemographic and occupational factors are the factors associated with drivers' psychoactive substance use. Therefore, devising health education and counseling program for drivers to tackle the problem plays paramount importance.

Background Bullying and the use of psychoactive substances are both prevalent among adolescents and appear to be interconnected. However, the literature has yet to reach a consensus regarding the association between being a victim of bullying and the use of psychoactive substances. In this cross-sectional study, the authors investigated the relationship between psychoactive substance use and involvement in bullying among Brazilian adolescents. Methods Data were analyzed from the 2019 National School Health Survey (“Pesquisa Nacional de Saúde do Escolar, PeNSE 2019”), which included responses from 123,261 students aged 13 to 17 years. The survey assessed experiences of bullying (both as victim and perpetrator), as well as lifetime and recent (past 30 days) use of various psychoactive substances. Multivariate logistic regression models were employed to examine associations, with odds ratios (ORs) calculated to estimate the likelihood of substance use across different bullying involvement profiles. Results Adolescents involved in bullying—whether as victims or perpetrators—had higher odds of using tobacco cigarettes, hookahs, e-cigarettes, clove cigarettes, straw cigarettes, alcohol, illicit drugs, marijuana, and crack. Those not involved in bullying had the lowest likelihood of substance use, followed by those who were only victims. The highest odds were observed among individuals who perpetrated bullying exclusively, followed by those involved as both perpetrators and victims. Conclusions In Brazil, being a victim of bullying is associated with increased use of various psychoactive substances. These findings align with studies conducted in other Latin American countries, yet diverge in part from patterns observed in high-income countries—highlighting the influence of geographic and sociocultural contexts on these risk associations.

BackgroundThere is a high prevalence of psychoactive substance use among patients with mental health disorders. The optimal treatment of patients with mental health disorders requires an awareness of their history pertaining substance use. Several methods are used to assess the use of substance. Each of them embodies its limitations. This study aimed at assessing the diagnostic capability of a self-report psychoactive substance use among patients at the National Psychiatric University Hospital of Cotonou, Benin.MethodsA cross-sectional survey was conducted from August 1, 2021 to November 24, 2021. A total of 157 consenting patients admitted to psychiatric consultations were successively enrolled in the ongoing study. They were screened for the use of psychoactive substance with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), followed by urine test using the NarcoCheck® kit for qualitative detection of substances or its metabolites. To assess the diagnostic capability, the participants’ self-responses were compared with their urine test results. The sensitivity, specificity, positive and negative predictive values, and kappa coefficient were also calculated.ResultsThe frequency of lifetime psychoactive substance use according to self-report was 81.5% (95% CI: 0.746–0.873), while over the past three months (recent use) was 52.2% (95% CI: 0.441–0.603) and 58.6% based on the urine test. Alcohol, tobacco and cannabis were the most prevalent psychoactive substance used. The overall concordance between self-reported psychoactive substance use and the urine test (gold standard) was moderate (sensitivity = 66%; kappa = 0.46). Self-report cocaine use compared with urine test showed the highest concordance (sensitivity = 100%; kappa = 79%), followed by tobacco (sensitivity = 58%, kappa = 41%). On an average 70% of urine test results were consistent with self-report (VPP). Participants’ were more accurate when they were reporting no psychoactive substance use as suggested by the high negative predictive value (NPV).ConclusionDiagnostic capability of self-reporting of psychoactive substance use among patients admitted to psychiatric consultations was moderate. Therefore self-reporting may not estimate the exact prevalence of psychoactive substance use. Optimal identification of psychoactive substances use in psychiatric patients requires both history and urine testing. The integration of these two approaches is an excellent method to find out the level, frequency and nature of drug used.

Background: Psychoactive substance use is a major public health concern globally. Though youth attending higher education institutions are considered particularly vulnerable to psychoactive substances, there is a paucity of evidence in Ethiopia. We aimed to determine the prevalence of psychoactive substance use, factors associated with psychoactive substance use and level of dependence among Mekelle University undergraduate students in Ethiopia. Methods: An institution-based quantitative cross-sectional survey was used to randomly (using multistage sampling) invite 1220 undergraduate students in April and May 2017 to participate. Multinomial logistic regression was used to identify factors associated with psychoactive substance use. Level of dependence was determined using the WHO’s Alcohol, Smoking and Substance Involvement Screening Test classification. Results: Among the eligible students approached, 1214 participants completed the survey, which yields a 99.5% response rate. The lifetime prevalence of psychoactive substance use was 66.5% (95% Confidence Interval (CI) = 64% to 69%) while the current prevalence was 49% (95% CI = 46% to 52%). A history of, but not current, psychoactive substance use was reported by 18%, while 33.5% reported never having used psychoactive substances. The current prevalence of alcohol use was 35.5%, tobacco 7.8% and khat 5.7%. Of the current users, 17% (95% CI = 14% to 20%) were at a moderate to high risk of dependency. Being over 21 years of age (adjusted odds ratio (AOR) = 1.6, 95% CI = 1.37 to 2.25), male (AOR = 3.13; 95% CI = 2.26 to 4.34), living in urban areas (AOR = 2.39, 95% CI = 1.77 to 3.23), an Orthodox Christian (AOR = 7.55, 95% CI = 4.56 to 12.48), and being in their 3rd year (AOR = 2.3, 95% CI = 1.49 to 3.55), 4th year (AOR = 2.0, 95% CI = 1.2 to 3.51) and 5th year (AOR = 4.0, 95% CI = 2.81 to 7.67) at university were associated with currently using psychoactive substances. Being male and Orthodox Christian was associated with being an ex-smoker. Conclusions: Approximately half of Mekelle University undergraduate students were using psychoactive substances with almost one in five at risk of dependency. The likelihood of use increased with seniority. Evidence-based strategies are needed to prevent school-aged children from using psychoactive substances and university students becoming dependent on substances. Interventions designed to stop current psychoactive substance use may also have promise for reducing dependency.

Objective: To understand the use of psychoactive substances and its related factors in men who have sex with men (MSM) in Tianjin. Methods: A cross-sectional survey was conducted in MSM recruited in Tianjin by snowball sampling from September 2017 to December 2020, the information about their social demographic information, use of psychoactive substances and behavioral characteristics were collected, meanwhile the blood samples were taken from them for HIV/syphilis detections. Multivariate logistic regression was used to explore related factors about psychoactive substances use. Results: A total of 9 218 MSM were included in the study, in whom 43.5% (4 013/9 218) had ever used psychoactive substances, including 92.6% (3 718/4 013)who used Rush and 17.2% (692/4 013) who used multi substances. Multivariate analysis showed that, the OR of psychoactive substances use in MSM who were in Han ethnic group was 0.68 (95%CI:0.51-0.91) compared with those who were in minor ethnic group; the OR of psychoactive substances use in MSM who were married or cohabited, divorced or widowed were 0.65 (95%CI: 0.57-0.71), 0.80 (95%CI: 0.65-0.97) respectively compared with those who were unmarried; the OR of psychoactive substances use in MSM who had the first homosexual sex at age of ≥30 years was 0.57 (95%CI: 0.44-0.74) compared with those who had the first homosexual sex at age of <30 years; the OR of psychoactive substances use in local MSM in Tianjin was 1.12 (95%CI: 1.03-1.23) compared with those who were not local residents in Tianjin; the OR of psychoactive substances use in MSM with education level of college or above was 1.29 (95%CI: 1.12-1.49) compared with those with education level of junior middle school or below; the OR of psychoactive substances use in MSM who had anal sex in the past six months was 1.93 (95%CI: 1.34-2.77) compared with those who had no anal sex; the OR of psychoactive substances use in MSM who had >2 homosexual partners in the last week was 1.62 (95%CI: 1.41-1.87) compared with those who had ≤2 homosexual partners; the OR of psychoactive substances use in MSM who had homosexual commercial sex in the past six months was 1.99 (95%CI: 1.62-2.45) compared with those who had no homosexual commercial sex; the OR of psychoactive substances use in MSM who had sexually transmitted diseases in the last year was 2.39 (95%CI: 1.82-3.12) compared with those who had no sexually transmitted diseases and the OR of psychoactive substances use in MSM who received peer education services in the last year was 1.63 (95%CI: 1.50-1.78) compared with those who received no peer education services. Conclusion: The prevalence of psychoactive substances use is high in MSM in Tianjin, and there are many influencing factors. It is necessary to conduct targeted interventions according to the influencing factors.

Psychoactive Substance Use Among Individuals With Chronic Spinal Cord Injury: Patterns and Characteristics

The aim of this study was to assess the associations between HIV status, SARS-CoV-2 infection, increase in use of psychoactive substances and oral ulcers among people who use psychoactive substances. This was a secondary analysis of the data of 1087 people who used psychoactive substances collected during the first wave of the COVID-19 pandemic. The data extracted were confounding (age, sex, the highest level of education attained, employment status, emotional distress status), dependent (oral ulcers) and independent (SARS-CoV-2 infection, increase in alcohol consumption, smoking and use of other psychoactive substances, living with HIV) variables. A multivariate logistic regression model was constructed to determine the associations between the dependent and independent variables after adjusting for the confounding variables. Participants who had a history of SARS-CoV-2 infection (AOR:10.37) and people living with HIV (AOR:1.91) had higher odds of reporting oral ulcers. The finding suggests that people who used psychoactive substances, had COVID-19 and lived with HIV were at increased risk for oral ulcers during the first wave of the COVID-19 pandemic. Increased use of psychoactive substances was not associated with a significant increase in the risk for oral ulcers. Further research is needed to better understand the reasons for these findings.

Background: The use and abuse of psychoactive substances among adolescents pose serious health problems in society. It is crucial to ascertain the factors predisposing adolescents to this in order to enable action by stakeholders. This study was conducted to determine the prevalence and factors associated with psychoactive substance use among in-school adolescents in Zaria Local Government Area (LGA) of Kaduna State, Nigeria. Methods: A descriptive cross-sectional study was conducted in nine secondary schools selected by balloting with a sample size of 639 students. A semi-structured, self-administered questionnaire was used to obtain information on socio-demographics and lifetime/current use of psychoactive substances. Data were analyzed by descriptive statistics, chi-square test, and logistic regression at P=0.05. Results: The mean age of respondents was 15.98±1.52 years, 51% were male, and 54.6% were aged 14-16 years. The lifetime and current prevalence of psychoactive substances were 69.3% and 46%, respectively. Kolanut was the most widely used substance with a lifetime and current use prevalence rates of 56% and 37.6%, followed by 14.4%, 12.8%, and 11% of respondents with lifetime use of sedatives, alcohol, and tobacco, respectively. Respondents’ age (OR 2.493 95% CI=1.670-5.185; P=0.001), mothers’ educational level (OR 1.703 95% CI=4.201-5.057; P=0.001), family (OR 3.428 95% CI=9.778–8.856; P=0.023) and friends’ (OR 2.252 95% CI=1.315–3.856; P=0.003) use of psychoactive substances were predictors of substance use. Conclusions: The study revealed that both lifetime and current use of psychoactive substances among the adolescents were high, especially among the males. Kolanut was the most used psychoactive substance among in-school adolescents, followed by sedatives and alcohol. Age, mothers’ educational level, and parents’ occupation were predisposing factors to psychoactive substance use.

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.

Background: Adolescence is a critical developmental stage during which health behaviours with long-term consequences are often established. Psychoactive substance (PAS) use commonly begins during this period, necessitating continuous monitoring and understanding of associated risk factors. Objective: To compare the prevalence, perceptions, and social determinants of PAS use among adolescents in public and private secondary schools in Uyo, Nigeria. Methods: A comparative cross-sectional mixed-methods study was conducted among 844 adolescents selected through multistage sampling from public and private secondary schools. Data were collected using a pretested, interviewer-administered questionnaire adapted from the WHO Global Assessment Programme. Quantitative data were analysed using SPSS version 25, with descriptive and inferential statistics applied. Statistical significance was set at p&lt;0.05. Qualitative data were thematically analysed. Ethical approval was obtained from the University of Uyo Teaching Hospital Ethics Committee. Results: A total of 416 private-school and 428 public-school students participated. Mean ages were 13.1 ± 2.0 years (private) and 13.7 ± 2.2 years (public). Lifetime alcohol use was significantly higher in public schools (4.7%) than private schools (2.2%) (p&lt;0.05). Other PAS use was low and occurred only among students with prior alcohol use. Key predictors of PAS use included family substance use and peer influence in both school types. Conclusion: PAS use was generally low but higher among public-school students. Alcohol appears to act as a gateway substance. Family and peer influences are significant determinants, highlighting the need for targeted school-based and community interventions.