Nightclub Attendance and Substance Use: Findings From the General Population Survey

Background Prevalence rates of adolescent substance use have shifted over time, although potential changes in nuanced patterns of substance use remain unexplored. We examined patterns of adolescent substance use in Sweden and changes in these patterns between 1988 and 2011. Furthermore, we investigated whether gender and internalizing problems were associated with substance use and whether these associations changed over time. Methods The sample included all 15-16-year-old students in Värmland County, Sweden (N = 20,057). Survey data were collected eight times between 1988 and 2011 and analyzed as four cohorts (1988/1991, 1995/1998, 2002/2005, 2008/2011). We measured alcohol, tobacco and inhalant use and internalizing problems. Results A latent class analysis showed that a three-class model fit the data best (i.e. non/low use, experimental use, and polysubstance use classes). Class- and item-response probabilities changed over time: fewer adolescents exhibited riskier substance use patterns in the later cohorts. Boys were more likely than girls to be in the polysubstance use class compared to the non/low use class across all cohorts (all ps < .001). Gender differences in experimental use differed across the cohorts. Adolescents who reported more internalizing problems were more likely to be included in the experimental and polysubstance use classes compared to the non/low use class (all ps < .001) and this effect did not change over the study period. Conclusions We extended the research on trends in rates of substance use by mapping how patterns of substance use changed over time as well as how the effects of gender and internalizing problems shifted. While fewer adolescents exhibited riskier patterns of substance use in the later cohorts, these patterns were associated with experiencing more internalizing problems across the study period. Prevention efforts could be more effective by targeting patterns of substance use rather than prevalence rates. Key messages We tested whether patterns of adolescent substance use changed from 1988 to 2011 in Sweden. Fewer adolescents showed riskier substance use patterns in the late 2000s than in the earlier study years. Gender differences shifted over time for experimental use but not polysubstance use. Internalizing problems were consistently associated with riskier substance use patterns across the study period.

Patterns of substance use and associations with mental health and interpersonal violence among adolescents.

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.

This practice parameter describes the assessment and treatment of children and adolescents with substance use disorders and is based on scientific evidence and clinical consensus regarding diagnosis and effective treatment as well as on the current state of clinical practice. This parameter considers risk factors for substance use and related problems, normative use of substances by adolescents, the comorbidity of substance use disorders with other psychiatric disorders, and treatment settings and modalities. (Reprinted with permission from the Journal of the American Academy of Child and Adolescent Psychiatry 2005; 44(6):609–621)

The dearth of population-based data on polysubstance use, especially in young emerging adults, presents a critical gap in understanding public health challenges, particularly in rural India, where tobacco use and oral cancer are prevalent. This study addresses this gap by investigating the prevalence and patterns of substance use, with a focus on young emerging adults (18-29 years) within a high-risk cohort for oral cancer in Varanasi, India. The study involved a cross-sectional analysis of baseline data from 10 101 participants within a high-risk cohort in rural settings of the Varanasi district between December 2020 and June 2023. This region has high rates of tobacco use and oral cancer. Polysubstance use was defined as the lifetime concurrent use of two or more substances for at least a year. The study examined the prevalence of any substance use, polysubstance use, and associated sociodemographic factors. Univariable and multivariable analyses were employed to identify significant predictors. The prevalence of any substance use in the study population was 55.7%. Tobacco use was most prevalent (94.3%), followed by areca nut (44.8%), alcohol (6.6%), and cannabis (0.8%). Among young emerging adult substance users, the prevalence of polysubstance use was 42.6%. Predictors of polysubstance use included age, male gender, employment status, and income. This study offers vital insights into substance use among rural Indian communities, particularly among young adults who are at a critical juncture in their lives. The findings underscore the urgent need for evidence-based strategies to address this region's multifaceted public health challenge of polysubstance use. Literature is scarce on population-based data for the prevalence and pattern of polysubstance (tobacco and other substances) use in India, both for the young and adult population. We studied the prevalence and pattern of substance use in a predominantly rural district of India, which reportedly has the second-highest burden of oral cancer among all Indian population-based cancer registries. We found that more than half (55.7%) of the study population used at least one substance; among them, nearly half (42.4%) used two or more substances. Tobacco use was the most prevalent form (94.3%), followed by areca nut use (44.8%), alcohol (6.6%), and cannabis (0.8%). Polysubstance use was prevalent among young emerging adult substance users. Age, male gender, employment, and income were predictors of polysubstance use. Distinct sociocultural factors shaping substance use in India necessitate research.

Background Substance use, and pattern of consumption varies across population and may, within a particular population, show temporal variations in accordance with changing fads. Understanding the pattern of substance use in a population is key to any programme of demand reduction. Thus, we studied a consecutive series of patients with substance use disorders in our facility, aiming to determine the patient profile and pattern of substance use. Methods Hospital’s digital register was consulted and data of patients who were seen over a 16-months period, and who had diagnosis of ‘alcohol and substance use disorder’ were retrieved and analyzed. Results Seven hundred and nineteen patients were treated for substance use disorder over a 16-months period. Age of patients ranged from 16 to 69 years with mean age (SD) of 28.7(9.2) years. Majority were males (91%), single (87%) and had been to secondary or tertiary school with or without graduation. Fifty nine percent (421/719) of the patients admitted being on ‘Kush’, 49% on alcohol, 47% on cannabis, 11% on tramadol and 5.6% on cocaine. About 71% of the patients were poly-substance users while 29 percent were on one agent. Alcohol, ‘Kush’ and cannabis were the most common preferences of those who use more than one agent. Conclusions Substance use disorder in Freetown was most prevalent in young, adult, secondary school educated males. ‘Kush’ was the most common agent of abuse and frequency of polysubstance use is high. Understanding the factors responsible for low substance use among females in the population might point to some preventive control measures.

International audience

Substance use is a major obstacle to preventing and managing HIV among adolescents, who account for 30% of new infections in many parts of the world, including Botswana. Unfortunately, there is a paucity of data on adolescent substance use, especially in the region. Therefore, this study aimed to determine the pattern of psychoactive substance use in adolescents living with HIV (ALWHIV). It also aimed to compare and explore the pattern of substance use disorders and associated factors between congenitally infected adolescents (CIAs) and behaviorally infected adolescents (BIAs). Six hundred and thirty-four ALWHIV were interviewed using a sociodemographic questionnaire, the WHO drug questionnaire, and DSM-5 criteria for substance use disorder. The participants' mean age (SD) was 17.69 (1.6) years, with a male predominance (n = 336, 53%), and the majority (n = 411, 64.8%) were CIAs. Alcohol was the most used substance among the participants, with 15.8% admitting to its current use. The BIAs were more likely to have SUD (χ2 = 17.2, P < .01), use more than one substance (χ2 = 20.3, P < .01), and more likely to use all psychoactive substances except for inhalants. In the CIAs, regular participation in religious activities was negatively associated with SUD (AOR = 0.36; 95% CI: 0.17-0.77), while struggling with HIV status acceptance was positively associated with SUD (AOR = 2.54; 95% CI: 1.15-5.61) in the BIAs. This study showed a huge burden and similar pattern of substance use disorders among the ALWHIV in Botswana, as reported elsewhere. It also identified the dissimilarities between the BIAs and CIAs regarding substance-related issues and suggested the need for differentiated care.

ABSTRACTBackground: This study is the first to explore how child supervisory neglect influences patterns of substance use among young adults. This study investigated patterns of substance use among males and females, 18 to 24 years old, after controlling for adolescent parental drinking, living with parents, relationship status, delinquency, and depression. Methods: The study sample (N = 10,618) included individuals who participated in Waves I (1994–1995) and III (2001–2002) of the National Longitudinal Study of Adolescent Health (Add Health). The study used latent class analysis to ascertain how patterns of substance use emerged as distinct classes. Results: For both males and females, we identified the following 4 classes of substance use: (1) heavy polysubstance use, (2) moderate polysubstance use, (3) alcohol and marijuana, and (4) low-use substance use patterns. Multinomial logistic regression indicated that, for both males and females 18 to 24 years old, experiencing supervisory neglect, being depressed, being single, and engaging in adolescent delinquency serve as risk factors for heavy polysubstance use class membership. Conversely, being black or Hispanic lowered the likelihood of polysubstance use for males and females. For females only, living with parents served as a protective factor that reduced the risk of membership in heavy polysubstance use, moderate polysubstance use, and alcohol and marijuana classes. For males only, being less educated increased the risk of heavy polysubstance use class membership. Conclusions: Results from this exploratory study underscore the enduring effect of supervisory neglect on substance use among male and female young adults. Future studies should explore whether these relationships hold over time.

Background: While data on prevalence of psychoactive substance use and trends among adolescents are available in Serbia, less is known about patterns of use, including concurrent use of illicit and licit psychoactive substances. Methods and Objectives: The purpose of this study is to explore patterns of substance use among students in Serbia and correlation with sociodemographic and other factors using latent class and chi square test to examine demographic factors and other correlates of the defined groups. Data were obtained from ESPAD survey conducted in Serbia in 2019 on representative sample of 3529 16 years old students. Results: Six latent class solution with the lowest BIC value was selected: Class1 (38.4%) characterized by low probability of any psychoactive substance use; Class 2 (3.8%) high probability of only cigarette use; Class 3 (47.8%) high probability of alcohol use and low probability of any other substance; Class 4 (4.4%) high probability of alcohol and sedatives use; Class 5 ( 4.1%) high probabilities of concurrent use of alcohol, cigarettes and cannabis and Class 6 ( 3.8%) high probability of concurrent use of all explored substances. Results show alcohol, the most popular psychoactive substances is used either as only substance or concurrently, with girls having higher probability using it concurrently with sedatives. Class 6 students are more likely to be from more affluent families and those in classes with high probability of concurrent substance use (Classes 4, 5 and 6) were more likely to skip school five or more days in the last 30 days (6.5%; 13.7% and 10.8% respectively) compared to Classes 1, 2 and 3 (0.5%;1.4% and 2.2%) Conclusion: Concurrent substance use is associated with skipping school, not being engaged in sports activities and lower grades. Variations in substance use patterns have implications for monitoring, prevention and treatment.

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.

To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11). The sample included all 15-16-year-olds in Värmland County, Sweden (n=20 057). Binary-coded substance use measures included life-time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight-item scale was used to assess psychosomatic problems. A three-class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use classes rather than the non/low use class than in the earlier cohorts (all Ps<0.001). Males had higher odds than females of being in the polysubstance use class rather than the non/low use class among the first three cohorts (all Ps<0.001) but not the last. Sex was not associated with inclusion in the alcohol use class rather than the non/low use class. Adolescents who reported more psychosomatic problems had higher odds of being included in the alcohol and polysubstance use classes rather than the non/low use class (all Ps<0.001). The associations of sex and psychosomatic problems with class inclusion did not change during the study period. Between 1988 and 2011, patterns of substance use among adolescents in Sweden shifted away from polysubstance use and alcohol use to non-use or low use. Associations between patterns of substance use and sex and psychosomatic problems remained largely consistent across the study period.

Men who have sex with men (MSM) remain disproportionately infected with HIV. MSM accounted for 53% of the 56,300 new HIV infections in the US in 2006, despite representing only 4% of the national male population [1, 2]. This high HIV disease burden coincides with high prevalence of non-injection substance use and alcohol consumption among US MSM. A national MSM sample found a 42% previous year prevalence for any non-injection substance use [3]. The recently released United States National HIV/AIDS strategy highlights the need to address substance use among MSM as a critical component of reducing HIV incidence in the United States [4]. To advance this goal, it is imperative to: (1) redress the knowledge gaps on patterns of non-injection substance use among substance using MSM (SUMSM); (2) improve upon existing interventions; (3) develop effective, scalable interventions for the spectrum of users; and (4) determine how to best identify and address the structural and cultural factors that may contribute to non-injection substance use in the MSM population. Non-injection substance use may increase susceptibility to HIV infection in multiple ways [5, 6]. Many epidemiological studies document the association between these substances and sexual risk behaviors [7–24]. These sexual risks are paralleled by high rates of incident and prevalent HIV cases and sexually transmitted infections among SUMSM. Most notably, methamphetamine, cocaine, poppers, and alcohol use have each been associated with an increased risk for HIV and other STD infections [9, 12, 24–30]. The contribution of polysubstance use may also be considerable [9, 28, 31]. Patterns of Substance Use among MSM Drug use among MSM is not an all or nothing phenomenon. There needs to be more emphasis on addressing the specific patterns of non-injection substance use among SUMSM, and what implications these patterns have for intervention approaches. Most SUMSM are not drug-dependent, but rather use episodically (i.e., using substances less than weekly). National HIV Behavioral Surveillance (NHBS) data show that 69–86% of SUMSM report less than weekly substance use [32–35]. Episodic binge drinking is also common among high-risk MSM [36, 37]. Importantly, episodic patterns are associated with high-risk sexual behaviors, suggesting that while perhaps less concerning from a drug-dependence perspective, they may nonetheless contribute substantially to HIV transmission rates among SUMSM [24, 38]. Polysubstance use patterns (i.e., taking more than one substance concurrently, or periodically over a period of time) are often the norm among SUMSM. For example, exclusive of alcohol use, 93% of non-injection methamphetamine using MSM in the San Francisco NHBS sample reported polysubstance use during the prior 12 months before interview; similarly, 94% of cocaine and 90% of poppers users reported using other substances [39]. In a sample of HIV-positive methamphetamine using MSM, 95% of respondents were polysubstance users [40]. Similar findings were reported among samples of MSM club drug users and African American MSM [41–43]. Among various MSM samples, 11–44% of participants reported recent use of three or more substances [44–48]. We need to better understand how to address the wide spectrum of non-injection substance use patterns among MSM. At one extreme are the substance-dependent MSM for whom risk behavior and substance use morbidity may be especially high. Yet, there is also the larger population of MSM whose substance use is infrequent, but for whom it is associated with harmful use and HIV risk. It is unclear where on the substance use spectrum interventions should be invested to have the maximum effectiveness. There is also little understanding as to why, with overall substance use being so prevalent among MSM, only a small proportion develops dependence. Similarly, there is a paucity of understanding as to why some MSM do not use substances, and what factors confer protective effects or relative resiliency with regard to substance use [49]. Finally, how substance use patterns vary across the life trajectories of MSM and how those variations coincide with major life milestones (e.g., sexual debut, coming out, dating, aging, etc.), remains largely unexplored.

Background:Substance use in patients with psychiatric disorder is an every-day seen. Detection of this comorbidity can significantly affect the treatment of these disorders, as well as substance use.Objectives:This study has been conducted to determine the prevalence and pattern of substance use in hospitalized psychiatric patients.Patients and Methods:In this cross-sectional study, 210 hospitalized psychiatric patients were selected by simple randomization from all records of hospitalized patients. The instrument of gathering data was a demographic checklist including age, gender, marital status, education, type of disorder and substance abuse and duration of psychiatric disorder. Data were analyzed by SPSS version 16 using Fisher exact and Chi square tests.Results:The mean age of patients was 37.9 years. Most of the patients were male, married and unemployed. The Prevalence of substance use was 36.7%. The most prevalent pattern of substance use was opium, opioid, methamphetamines and other substances (poly substance). The prevalence of substance use in patients with mood disorders was more than the other disorders and the most prevalent substance use in these patients was opium and opioid. Poly substance use was the most prevalent pattern of use (80 %) in psychotic and mood disorders due to substance. Significant difference was seen between genders, marital status, occupation, duration of illness and frequency of substance use (P < 0.05 ), however no significant difference was seen between educational levels, age and substance use.Conclusions:The patients with mood disorders had the highest comorbidity with substance use and concurrent use of poly substance was the most prevalent pattern of use in these patients. Therefore, successful treatment of psychiatric disorders and substance use needs multimodal and more serious interventions. Regarding to the pattern of poly substance use in these patients, careful screening should be performed at admission.

BACKGROUND: Substance use disorders (SUDs) are a major contributor to global disease burden, premature mortality, and social disruption.While international data demonstrate shifting trends in polysubstance use, evidence from the United Arab Emirates (UAE) remains limited, particularly among individuals engaged in specialized treatment.OBJECTIVE: To describe the epidemiological profile, initiation factors, and current patterns of psychoactive substance use among patients diagnosed with SUDs in a rehabilitation and treatment facility in Dubai.METHODS: A descriptive, cross-sectional study was conducted among 103 patients meeting DSM-5 diagnostic criteria for SUDs who attended Erada Center for Treatment and Rehabilitation between May and August 2021.Data were collected using structured, interviewer-administered questionnaires addressing sociodemographic characteristics, substance use history, routes of administration, frequency of use, and psychosocial comorbidities.Descriptive and correlational analyses were performed using SPSS v27. RESULTS:The mean age at first substance exposure was 16.4 years (SD = 3.7).Curiosity (67%), peer or familial influence (28.2%), and hedonic motivation (21.4%) were primary initiating factors.Methamphetamine (50.5%), opioids (48%), and amphetamines (45.6%) were the most commonly reported substances.Intravenous administration predominated (68.9%), and 74% reported daily use.Frequent comorbidities included legal problems (63.7%),financial instability (50%), bereavement (41.2%), and exposure to violence (38.2%).Correlation analyses indicated distinct co-use clusters involving opioids, stimulants, and prescription medications.CONCLUSION: The study reveals early onset, high frequency polysubstance use with considerable health and psychosocial risks.Findings highlight the urgent need for culturally tailored evidencebased interventions and regional surveillance to guide treatment and public health strategies in the UAE.