Substance use disorders among young adults in North-Western Nigeria: descriptive survey of patterns of use.

Substance Use Among Older Adults: Ethical Issues.

Substance use disorders (SUDs) in nursing have individual well-being, patient safety, and licensure/regulatory implications. Literature is scarce related to predicting SUDs in registered nurses; this study included specific items surrounding nurses' psychological trauma. An online survey, consisting of validated scales and investigator-generated items was distributed to 4,000 registered nurses in Indiana with a yield of 1,478 surveys. The World Health Organization: Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used as the dependent variable to assess risk of SUDs. Three multivariate regression models with predictive variables for risk of tobacco (R2 = 0.08), alcohol (R2 = 0.09), and other substances (R2 = 0.10) use were found. Of concern, nurses are at moderate risk for tobacco use at 11.6%; alcohol use at 11.6% and for other substances at 10.4%. Each regression model contained distinct predictor variables; however, variables occurring in all three models were: depression, anxiety, and items surrounding psychological trauma (adverse childhood experiences, life events, lateral workplace violence).

Substance use disorder (SUD) among women of reproductive age is a complex public health problem affecting a diverse spectrum of women and their families, with potential consequences across generations. The goals of this study were 1) to describe and compare the prevalence of patterns of injury requiring emergency department (ED) visits among SUD-positive and SUD-negative women and 2) among SUD-positive women, to investigate the association of specific categories of injury with type of substance used. This study was a secondary analysis of a large, multisource health care utilization data set developed to analyze SUD prevalence, and health and substance abuse treatment outcomes, for women of reproductive age in Massachusetts, 2002 through 2008. Sources for this linked data set included diagnostic codes for ED, inpatient, and outpatient stay discharges; SUD facility treatment records; and vital records for women and for their neonates. Injury data (ICD-9-CM E-codes) were available for 127,227 SUD-positive women. Almost two-thirds of SUD-positive women had any type of injury, compared to 44.8% of SUD-negative women. The mean (±SD) number of events also differed (2.27 ± 4.1 for SUD-positive women vs. 0.73 ± 1.3 for SUD-negative women, p < 0.0001). For four specific injury types, the proportion injured was almost double for SUD-positive women (49.3% vs 23.4%), and the mean (±SD) number of events was more than double (0.72 ± 0.9 vs. 0.26 ± 0.5, p < 0.0001). The numbers and proportions of motor vehicle incidents and falls were significantly higher in SUD-positive women (22.5% vs. 12.5% and 26.6% vs. 11.0%, respectively), but the greatest differences were in self-inflicted injury (11.5% vs. 0.8%; mean ± SD events = 0.19 ± 0.9 vs. 0.009 ± 0.2, p < 0.0001) and purposefully inflicted injury (11.5% vs 1.9%, mean ± SD events = 0.18 ± 0.1 vs. 0.02 ± 0.2, p < 0.0001). In each of the injury categories that we examined, injury rates among SUD-positive women were lowest for alcohol disorders only and highest for alcohol and drug disorders combined. Among 33,600 women identified as using opioids, 2,132 (6.3%) presented to the ED with overdose. Multiple overdose visits were common (mean ± SD = 3.67 ± 6.70 visits). After adjustment for sociodemographic characteristics, psychiatric history, and complex/chronic illness, SUD remained a significant risk factor for all types of injury, but for the suicide/self-inflicted injury category, psychiatric history was by far the stronger predictor. The presence of SUD increases the likelihood that women in the 15- to 49-year age group will present to the ED with injury. Conversely, women with injury may be more likely to be involved in alcohol abuse or other substance use. The high rates of injury that we identified among women with SUD suggest the utility of including a brief, validated screen for substance use as part of an ED injury treatment protocol and referring injured women for assessment and/or treatment when scores indicate the likelihood of SUD.

While there is broad recognition of the high societal costs of substance use disorders (SUD), treatment rates are low. We examined whether, in the United States, participants with substance or alcohol use disorder would report a greater willingness to enter SUD treatment located in a primary care setting (primary care) or more commonly found specialty care setting in the United States (usual care). Randomized survey-embedded experiment. US web-based research panel in which participants were randomized to read one-paragraph vignettes describing treatment in usual care (specialty drug or alcohol treatment center), primary care or collaborative care within a primary care setting. A total of 42451 panelists aged 18+ were screened for substance or alcohol use disorder using validated diagnostic criteria. Participants included 344 with a substance use disorder and 634 with an alcohol use disorder not in treatment with no prior treatment history. Willingness to enter treatment across vignettes by condition. Among participants with a substance use disorder, 24.6% of those randomized to usual care reported being willing to enter drug treatment compared with 37.2% for primary care [12.6 percentage point difference; 95% confidence interval (CI)=0.8, 24.4) and 34.0% for collaborative care (9.4 percentage point difference; 95% CI=-2.0, 20.8). Among participants with an alcohol use disorder, 17.6% of those randomized to usual care reported being willing to enter alcohol treatment compared with 20.3% for primary care (2.6 percentage point difference; 95% CI=-4.9, 10.1) and 20.8% for collaborative care (3.1 percentage point difference; 95% CI=-4.3, 10.6). The most common reason for not being willing to enter drug (63%) and alcohol (78%) treatment was the belief that treatment was not needed. In the United States, people diagnosed with substance or alcohol use disorders appear to be more willing to enter treatment in a primary care setting than in a specialty drug treatment center. Expanding availability of primary care-based substance use disorder treatment could increase treatment rates in the United States.

The epidemic within the pandemic: Behavioral health and substance use in the face of COVID-19

Background: Substance use problems impact both physical and mental health, spreading to many areas, including military forts, which represent the strength and stability of the nation. Objective: This study aimed to investigate the prevalence, behavior, attitudes, and factors related to substance use among the conscripts affiliated with the Fort Ratchaburi Province. Methods: A cross-sectional study collected data from 400 conscripts between July - September 2023 using questionnaires through individual interviews. The questionnaires included: 1) demographic information; 2) attitudes towards substance use; 3) The alcohol, smoking and substance involvement screening test; 4) The Thai substance use disorder screening test. A urine toxicology test was conducted for cannabis, opioid, and methamphetamine. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of substance use, at least once in the lifetime and in the past three months, was 86.7% (n = 347) and 71.5% (n = 286), respectively. The five substances with the highest usage in the past three months were alcohol (54.0%), tobacco (53.3%), kratom leaves (33.3%), cannabis (30.8%), and mixtures of kratom leaf decoction (22.0%). Of 254 conscripts who used tobacco, 210 (82.7%) and 6 (2.4%) were found to be at moderate and high risk, respectively, of having tobacco problem. Substance use disorder (SUD) was found in 76.8%, 37.4%, 37.4%, 34.1%, 27.3, 26.7% of conscripts who used tobacco, alcohol, cannabis, kratom leaves, mixtures of kratom leaf decoction and amphetamine-type stimulants, respectively. The attitudes of the conscripts are mostly not aligned with substance use. Low educational level and income sufficiency were identified as factors associated with and predictors of substance use (P &lt; 0.05). Conclusion: Most conscripts used substances. Although the majority of substances used in this study are legal, high prevalence of SUD was found, especially tobacco use disorder in conscripts who smoked cigarettes. Factors related to substance use include low level of education and income sufficiency.

BackgroundSubstance use related health and social problems are on the rise in sub-Saharan Africa. Currently, substance abuse is one of the most burning public health problems in Ethiopia. Although it has been known that this public health problem is an urgent issue, the real extent and magnitude of substance abuse is not yet properly explored. The purpose of this study was to assess substance use and associated factors among Gumuz people in Mandura Woreda, northwest Ethiopia.MethodsA community based cross sectional study was conducted involving 1588 adults, recruited using multi stage stratified simple random sampling technique. The data were collected at the household level by using pre tested Standardized questionnaire of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Oslo social support scale and substance use questionnaire. The data was entered and cleaned using Epi Data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 22 statistical package. Descriptive statistics and logistic regression were performed to examine the prevalence and predictors of substance use. An Adjusted odds ratio with 95% confidence interval was computed to determine the level of significance.ResultThe overall life time substance use prevalence in the current study was 25.9% (95% CI = 23.7, 28.0). The three-month prevalence of Alcohol and tobacco use was 48.4 and 15.8% respectively. The three-month prevalence of hazardous alcohol and tobacco use were 25.8 and 7.8% respectively. Able to read and write (AOR = 3.79; 95%CI 2.34–6.15) in educational status and Strong social support (AOR = 0.39; 95%CI 0.27–0.58) were significantly associated with substance use.ConclusionHigh level of substance use was detected in the current study setting. This high prevalence (three-month) of substance use affects the productive age groups which influence on the family and cause the rise of major public health and socio economic problems. The finding informed the need to integrate services for hazardous substance use such as brief intervention at different levels of primary care services in the district. Public health interventions to reduce hazardous substance especially on alcohol and smoking use also need to be initiate.

People With SUDs at Higher Risk of Breakthrough COVID-19 Infection

Prior research has found bidirectional associations between psychotic experiences (PEs) and selected substance use disorders. We aimed to extend this research by examining the bidirectional association between PEs and various types of substance use (SU) and substance use disorders (SUDs), and the influence of antecedent mental disorders on these associations. We used data from the World Health Organization World Mental Health surveys. A total of 30 902 adult respondents across 18 countries were assessed for (a) six types of life-time PEs, (b) a range of types of SU and DSM-IV SUDs and (c) mental disorders using the Composite International Diagnostic Interview. Discrete-time survival analyses based on retrospective age-at-onset reports examined the bidirectional associations between PEs and SU/SUDs controlling for antecedent mental disorders. After adjusting for demographics, comorbid SU/SUDs and antecedent mental disorders, those with prior alcohol use disorders [odds ratio (OR)=1.6, 95% confidence interval (CI)=1.2-2.0], extra-medical prescription drug use (OR=1.5, 95% CI=1.1-1.9), alcohol use (OR=1.4, 95% CI=1.1-1.7) and tobacco use (OR=1.3, 95% CI=1.0-1.8) had increased odds of subsequent first onset of PEs. In contrast, those with temporally prior PEs had increased odds of subsequent onset of tobacco use (OR=1.5, 95% CI=1.2-1.9), alcohol use (OR=1.3, 95% CI=1.1-1.6) or cannabis use (OR=1.3, 95% CI=1.0-1.5) as well as of all substance use disorders (ORs ranged between 1.4 and 1.5). There was a dose response relationship between both count and frequency of PEs and increased subsequent odds of selected SU/SUDs. Associations between psychotic experiences (PEs) and substance use/substance use disorders (SU/SUDs) are often bidirectional, but not all types of SU/SUDs are associated with PEs. These findings suggest that it is important to be aware of the presence of PEs within those with SUDs or at risk of SUDs, given the plausibility that they may each impact upon the other.

Adverse childhood experiences (ACEs), peer victimization, and substance use among adolescents

Accuracy of the Audio Computer Assisted Self Interview version of the Alcohol, Smoking and Substance Involvement Screening Test (ACASI ASSIST) for identifying unhealthy substance use and substance use disorders in primary care patients

Management of Mental Health Disorders, Substance Use Disorders, and Suicide in Adults with Spinal Cord Injury: Clinical Practice Guideline for Healthcare Providers.

Background: Proactive and reactive functions of aggression have been found to be differentially associated with substance use; however, the pattern of associations differs across substance and outcome assessed. Methods: The current study extends extant literature by examining associations between proactive and reactive functions of aggression and frequency of substance use (tobacco, alcohol, marijuana, e-cigarettes, and prescription drugs) 30 days prior to detainment among a sample of justice-involved youth. Further, the moderating effect of behavioral dysregulation on these associations was evaluated. Results: While proactive aggression was positively correlated with past 30-day marijuana and prescription drug use for non-medical purposes, reactive aggression was positively correlated with tobacco, alcohol, marijuana, and prescription drug use. However, only reactive aggression was uniquely associated with past 30-day use, specifically marijuana and prescription drug use. Further behavioral dysregulation moderated associations, such that reactive aggression was positively associated with frequency of tobacco use and marijuana use, but only at low levels of behavioral dysregulation. Conclusions: Reactive aggression appears to be associated with more frequent substance use than proactive aggression during adolescence. Implications for findings are discussed.

Substance use disorders (SUDs) have increased substantially across the globe, and has become one of the world's most significant public health and socioeconomic challenge. This study examined the prevalence and patterns of substance use disorders among patients admitted to the main psychiatric hospital in Botswana, the Sbrana Psychiatric Hospital. This was a cross-sectional study of patients admitted to a major psychiatric hospital in Botswana. SUDs were assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v13.0. Bivariate analysis was conducted to determine the association between socio-demographic characteristics and SUDs. Multivariate logistic regression was used to control for confounders. The final analysis involved 101 patients. Participants ranged in age from 18-60 years, and over half (59.4%) were male. The majority of participants (85.1%) had used potentially addicting substances at least once during their lifetime, with 63.4% having current substance use disorders. The most frequently used substances were tobacco, cannabis, alcohol, and cocaine at 58.4%, 42.6%, 34.7% and 12.8% respectively. SUDs were more common among participants who were male, ages 18-35 years, single, had a tertiary education, or were unemployed. There is a high prevalence of substance use and SUDs among psychiatric patients in Botswana. Screening for and interventions to manage SUDs should be part of routine care at psychiatric health care facilities in this country. Consideration should be given to the screening of all patients admitted to psychiatric hospitals in Botswana for SUDs using the ASSIST.

AimIndividuals with anorexia nervosa (AN) often present with substance use and substance use disorders (SUDs). However, the prevalence of substance use and SUDs in AN has not been studied in-depth, especially the differences in the prevalence of SUDs between AN types [e.g., AN-R (restrictive type) and AN-BP (binge-eating/purge type]. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of SUDs and substance use in AN samples.MethodSystematic database searches of the peer-reviewed literature were conducted in the following online databases: MEDLINE, PsycINFO, Embase, and CINAHL from inception to January 2021. We restricted review eligibility to peer-reviewed research studies reporting the prevalence for either SUDs or substance use in individuals with AN. Random-effects meta-analyses using Freeman–Tukey double arcsine transformations were performed on eligible studies to estimate pooled proportions and 95% confidence intervals (CIs).ResultsFifty-two studies met the inclusion criteria, including 14,695 individuals identified as having AN (mean age: 22.82 years). Random pooled estimates showed that substance use disorders had a 16% prevalence in those with AN (AN-BP = 18% vs. AN-R = 7%). Drug abuse/dependence disorders had a prevalence of 7% in AN (AN-BP = 9% vs. AN-R = 5%). In studies that looked at specific abuse/dependence disorders, there was a 10% prevalence of alcohol abuse/dependence in AN (AN-BP = 15% vs. AN-R = 3%) and a 6% prevalence of cannabis abuse/dependence (AN-BP = 4% vs. AN-R = 0%). In addition, in terms of substance use, there was a 37% prevalence for caffeine use, 29% prevalence for alcohol use, 25% for tobacco use, and 14% for cannabis use in individuals with AN.ConclusionThis is the most comprehensive meta-analysis on the comorbid prevalence of SUDs and substance use in persons with AN, with an overall pooled prevalence of 16%. Comorbid SUDs, including drugs, alcohol, and cannabis, were all more common in AN-BP compared to AN-R throughout. Therefore, clinicians should be aware of the high prevalence of SUD comorbidity and substance use in individuals with AN. Finally, clinicians should consider screening for SUDs and integrating treatments that target SUDs in individuals with AN.Plain English SummaryIndividuals with anorexia nervosa (AN) may also present with substance use or have a substance use disorder (SUDs). Thus, we conducted a systematic review and meta-analysis to determine the prevalence of substance use and substance use disorders in individuals with AN. We examined published studies that reported the prevalence of either substance use or SUDs in individuals with AN. We found that substance use disorders had a 16% prevalence and that drug abuse/dependence disorders had a prevalence of 7% in those with AN. These rates were much higher in individuals with binge-eating/purging type compared to the restrictive AN. However, many specific substance use disorders and substance use types were low in individuals with AN. Nonetheless, clinicians should be aware of the high prevalence of SUD comorbidity and substance use in individuals with AN.