Substance Abuse Research Articles

B/F/TAF forgiveness to non-adherence

BackgroundART forgiveness is the ability of a regimen to maintain HIV-RNA suppression despite a documented imperfect adherence. We explored forgiveness of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF).MethodsIn this retrospective cohort study pharmacy drug...

Police mental health in small and rural areas of Pennsylvania

PurposeThe nature of policework is uniquely challenging to officers’ mental health, producing detrimental outcomes such as higher rates of suicide, substance abuse and divorce compared to other occupations. This is especially true in small and rural police departments, where officers often have broader responsibilities and cover a larger geographic area than their counterparts who work in large urban departments. Given the limited resources available to small and rural police, the purpose of this study is to explore the mental health services available to officers in small and rural police departments.Design/methodology/approachWe used a mixed methods approach. First, we surveyed 349 small and rural Pennsylvania police chiefs about the mental health services in their department. Of these chiefs, 53 participated in subsequent in-depth qualitative interviews about officer awareness of the mental health services available to them, what resources they thought would be helpful to officers and what barriers exist to prevent officers from seeking help.FindingsQuantitative results indicated that 22% of small and rural police departments had no mental health programs available to officers; Critical Incident Stress Management and Employee Assistance Programs were most commonly available. Budget size and the presence of a union influenced whether a department had mental health programs available to officers. Qualitative interviews found that although most departments provided some mental health services, officers were unlikely to use them. Chiefs expressed a need for improved services that officers might be more likely to use.Practical implicationsGiven the lack of resources available in small and rural police departments and the lack of adoption of some resources, we recommend peer assistance, general wellness programs and telehealth as feasible options for officer mental health.Originality/valueSmall and rural police comprise the bulk of policing in the USA, yet remain understudied. This study focuses on small and rural police.

Editorial: Mental illness and neuropsychiatry of the homeless: psychosis, personality, drug abuse, and other brain disorders

Editorial: Mental illness and neuropsychiatry of the homeless: psychosis, personality, drug abuse, and other brain disorders

Exploring the Impact of Recreational Drugs on Suicidal Behavior: A Narrative Review

Substance use/abuse and suicide are two closely related phenomena, mostly due to neurobiological, psychological, and social impairments. In the present narrative review, the relationship between suicidal behavior (SB) and the use and abuse of common recreational drugs, such as alcohol, cannabis, cocaine, methamphetamine, heroin, nicotine, ketamine, psilocybin, MDMA, and LSD, has been explored. Furthermore, potential mechanisms linking the two have also been examined. According to current research, all substances appear to have a deleterious effect on SB except for ketamine and psilocybin, which could potentially confer a protective effect. Further studies are needed to understand the relationship between MDMA, LSD, and suicide.

Coup d’états in Africa: A cure or prophylactic for good governance?

Military Coups in Africa share a “cause-and-effect” relationship with civilian mal-administration, by way of the military auditing, disrupting and helping to arrest or capture, and re-organize defective governance system in politically sick-nations. This aim appears consistent with the mandate of the Military to serve, protect and defend the national interests, therefore, turning coups into constitutional cure and prophylactic? The analysis in this paper is conducted under the concept of Military-Coup-Symbiosis: consisting of mutualism, commensalism and parasitism. Military-Coup-Symbiosis espouses the cyclical nature of military-takeovers, and the beneficial effects on democracy in general. It also rationalizes the justification why coups are bound to co-exist with civilian governments, for as long as political leaders continue to support and engage in De-democratization processes, exhibiting inimical conducts such as neopatrimonialism, and non-meritorious job recruitment and promotions. This paper investigates the possible curative qualities of military coups on good governance by posing as perpetual threat caution to democracy, and the normative values as political prophylactic to arrest and prevent potential leadership abuses. The ultimate question is how military interventions in politics can be harnessed to clean up mal-administration in politically sick-nations?

Elevance Health Foundation awards additional $13.1 million for substance abuse treatment programs.

Elevance Health Foundation awards additional $13.1 million for substance abuse treatment programs.

Psychometric properties of the modified Drug Abuse Screening Test Sinhala version (DAST-SL): evaluation of reliability and validity in Sri Lanka

BackgroundPsychoactive drug use is an important public health issue in Sri Lanka as it causes substantial health, social and economic burden to the country. Screening for substance use disorders in people who use drugs is vital in preventive health care, as it can help to identify problematic use early. Screening can aid in referring those in need, for the most appropriate treatment and care. Thus, preventing them from developing severe substance use disorders with complications. The Drug Abuse Screening Test (DAST-10) is an evidence-based tool widely used to assess the severity of psychoactive drug use. This study aimed to culturally adapt and evaluate the validity and reliability of the Drug Abuse Screening Test (DAST-10) in Sri Lanka.MethodsThe DAST-10 was culturally adapted, and the nine-item Sinhala version (DAST-SL) was validated using exploratory and confirmatory factor analysis. The validation study was conducted in the Kandy district among people who use drugs, recruited using respondent-driven sampling. Criterion validity of the questionnaire was assessed by taking the diagnosis by a psychiatrist as the gold standard. Cut-off values for the modified questionnaire were developed by constructing Receiver Operating Characteristic (ROC) curves. The reliability of the DAST-SL was assessed by measuring its internal consistency and test re-test reliability.ResultsThe validated DAST-SL demonstrated a one-factor model. A cut-off value of ≥ 2 demonstrated the presence of substance use disorder and had a sensitivity of 98.7%, specificity of 91.7%, a positive predictive value of 98.8% and a negative predictive value of 91.3%. The area under the curve of the ROC curve was 0.98. A cut-off score of ≤ 1 was considered a low level of problems associated with drug use. The DAST-SL score of 2–3 demonstrated a moderate level of problem severity, a score of 4–6 demonstrated a substantial level of problems, and a score of ≥ 7 demonstrated a severe level of drug-related problems. The questionnaire demonstrated high reliability with an internal consistency of 0.80 determined by Kuder–Richardson Formula-20 and an inter-class correlation coefficient of 0.97 for test re-test reliability.ConclusionThe DAST-SL questionnaire is a valid and reliable tool to screen for drug use problem severity in people who use drugs in Sri Lanka.

Gender differences in sleep quality among Iranian traditional and industrial drug users

Gender differences in sleep quality among Iranian traditional and industrial drug users

Assessment of the Prevalence and Factors Contributing to Drug and Alcohol Use Among Young People in South-South, Nigeria

Background: Adolescent substance abuse is a major public health concern in Nigeria, having far-reaching effects on both individuals and society. The susceptibility of Nigerian youth to substance abuse is influenced by numerous factors including socioeconomic factors like poverty, unemployment, and limited access to education. Method: The research employed a cross-sectional descriptive design. Four hundred and fifty individuals were interviewed using interviewer-administered, structured questions through a multi-stage sampling procedure. After manual data analysis, a chi-square test statistic was employed to determine whether there was a significant relationship between the categorical variables, with a p-value of less than 0.05. Results: Out of the 450 responders, 241 (53.6%) male and 209 (46.4%) female were questioned. More than half of the respondents (54.5%) were between the ages of 19-21 years old. According to the survey, 182 people (or 40.4% of the sample) use one or more substances. The most popular ones are Alcohol, which is followed by paracetamol and cigarettes. About 93.1% and 87.3% of the respondents identified negative peer influence and lack of parental care as factors that influence drug and alcohol abuse respectively. The study also reveals a statistically significant relationship between Age, gender, and substance use. Conclusion: Adolescents actively use illegal substances, making drug misuse a pervasive social issue that disproportionately impacts young people. It also highlights how crucial peer and family pressure is to the development and maintenance of prescription medication abuse. Keywords: Adolescent, Drug misuse, Drug abuse, Alcohol

Innovative disposable pipette extraction for concurrent analysis of fourteen psychoactive substances in drug users’ sweat

Widespread consumption of drugs of abuse worldwide has caused concern: it adversely affects public health, individual safety, and social structures. Experts are particularly alarmed because new psychoactive substances have been increasingly detected in biological samples. In recent years, several studies have focused on developing methods to identify psychoactive substances in alternative biological matrices, such as sweat. This approach holds promise for monitoring substance use, especially in individuals undergoing rehabilitation. Among the commonly employed analytical procedures, extraction using disposable DPX tips stands out as a novel, miniaturized, and promising technique. This study aimed to validate and to apply a method to analyze various substances, including amphetamine, methamphetamine, MDMA, MDA, MDEA, cocaine, cocaethylene, anhydroecgonine methyl ester, dibutylone, N-ethylpentylone, 25E-NBOMe, 25CNBOMe, 2CC, 2C-E, fentanyl, and carfentanil, in sweat samples simultaneously. In this method, sweat is collected by using laboratory-developed patches, and extraction is conducted with DPX-SCX tips. Gas chromatography coupled to mass spectrometry is employed to separate, to identify, and to quantify the analytes. Validation results indicated that the quantification limit ranged from 2 to 30 ng of analyte/patch, and that the method was linear for analyte concentrations ranging from 2 to 1100 ng/patch. The validated method was applied to analyze 30 sweat samples collected from volunteers drug users and processed by using both the selected ion mode (SIM) and full scan. The method was able to detect and to quantify substances such as cocaine, cocaethylene, anhydroecgonine methyl ester, MDMA, MDA, nicotine, cotinine, caffeine, procaine, lidocaine, and ethylamphetamine simultaneously. The recovery rates ranged from 72.4 % to 97.1 %. The analytes were stable in the biological matrix. In conclusion, the validated method proved effective and allowed the target analytes to be quantified in sweat samples, highlighting that sweat is a viable matrix for analyzing drugs of abuse.

“He’s used drugs - he’s biased! He’s not a drug user - what would he know!”: A Cross-sectional, Online Study of Drug Researchers’ Experiential Knowledge of Drug Use and Disclosure

“He’s used drugs - he’s biased! He’s not a drug user - what would he know!”: A Cross-sectional, Online Study of Drug Researchers’ Experiential Knowledge of Drug Use and Disclosure

Telehealth Availability for Mental Health Care During and After the COVID-19 Public Health Emergency.

Telehealth services expanded rapidly during the COVID-19 public health emergency (PHE). To evaluate changes in availability of telehealth services at outpatient mental health treatment facilities (MHTFs) throughout the US during and after the COVID-19 PHE. In this cohort study, callers posing as prospective clients contacted a random sample of 1404 MHTFs drawn from the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Locator from December 2022 to March 2023 (wave 1 [W1]; during PHE). From September to November 2023 (wave 2 [W2]; after PHE), callers recontacted W1 participants. Analyses were conducted in January 2024. Callers inquired whether MHTFs offered telehealth (yes vs no), and, if yes, whether they offered (1) audio-only telehealth (vs audio and video); (2) telehealth for therapy, medication management, and/or diagnostic services; and (3) telehealth for comorbid alcohol use disorder (AUD). Sustainers (offered telehealth in both waves), late adopters (did not offer telehealth in W1 but did in W2), nonadopters (did not offer telehealth in W1 or W2), and discontinuers (offered telehealth in W1 but not W2) were all compared. During W2, 1001 MHTFs (86.1%) were successfully recontacted. A total of 713 (71.2%) were located in a metropolitan county, 151 (15.1%) were publicly operated, and 935 (93.4%) accepted Medicaid as payment. The percentage offering telehealth declined from 799 (81.6%) to 765 (79.0%) (odds ratio [OR], 0.84; 95% CI, 0.72-1.00; P < .05). Among MHTFs offering telehealth, a smaller percentage in W2 offered audio-only telehealth (369 [49.3%] vs 244 [34.1%]; OR, 0.53; 95% CI, 0.44-0.64; P < .001) and telehealth for comorbid AUD (559 [76.3%] vs 457 [66.5%]; OR, 0.62; 95% CI, 0.50-0.76; P < .001) compared with W1. In W2, MHTFs were more likely to report telehealth was only available under certain conditions for therapy (141 facilities [18.0%] vs 276 [36.4%]; OR, 2.62; 95% CI, 1.10-3.26; P < .001) and medication management (216 facilities [28.0%] vs 304 [41.3%]; OR, 1.81; 95% CI, 1.48-2.21; P < .001). A total of 684 MHTFs (72.0%) constituted sustainers, 94 (9.9%) were discontinuers, 106 (11.2%) were nonadopters, and 66 (7.0%) were late adopters. Compared with sustainers, discontinuers were less likely to be private for-profit (adjusted OR [aOR], 0.28; 95% CI, 0.11-0.68) or private not-for-profit (aOR, 0.26; 95% CI, 0.14-0.48) after adjustment for facility and area characteristics. Based on this longitudinal cohort study of 1001 MHTFs, telehealth availability has declined since the PHE end with respect to scope and modality of services, suggesting targeted policies may be necessary to sustain telehealth access.

Structure-Activity Relationship and Functional Evaluation of Cannabinoid Type-1 Receptor.

The type-1 cannabinoid receptor (CB1R) is a potential therapeutic target in several pathological conditions, including neuropsychological disorders and neurodegenerative diseases. Owing to their structural diversity, it is not easy to derive general structure-activity relationships (SARs) for CB1R ligands. In this study, CB1R ligands were classified into six structural families, and the corresponding SAR was determined for their affinities for CB1R. In addition, we determined their functional activities for the activation of extracellular signal-regulated kinases (ERKs). Among derivatives of indol-3-yl-methanone, the highest ligand affinity was observed when a pentyl and a naphthalenyl group were attached to the N1 position of the indole ring and the carbon site of the methanone moiety, respectively. In the case of adamantane indazole-3-carboxamide derivatives, the presence of fluorine in the pentyl group, the substituent at the N1 position of the indazole ring, strongly increased the affinity for CB1R. For (naphthalen-1-yl) methanone derivatives, the presence of 4-alkoxynaphthalene in the methanone moiety was more beneficial for the affinity to CB1R than that of a heterocyclic ring. The functional activities of the tested compounds, evaluated through ERK assay, were correlated with their affinity for CB1R, suggesting their agonistic nature. In conclusion, this study provides valuable insight for designing novel ligands for CB1R, which can be used to control psychiatric disorders and drug abuse.

The Renaissance of Secondary Syphilis: A Case Series

Abstract Sexually transmitted diseases/infections (STDs/STIs) are one of major public health concern, and syphilis in today’s era is not an uncommon diagnosis. The rising trend of syphilis cases can be attributed to changes in sexual practices such as individuals being engaged in oro-genital or anogenital sex, having multiple sexual partners, increase in men having sex with men, HIV co-infection, and drug abuse. Syphilis mimics many other diseases, and diagnosis can be delayed if the clinician is not aware of varied presentations. Often, unusual mucocutaneous manifestations have fascinated dermatologists, leading to diagnostic difficulties. In today’s era, cases of secondary and latent syphilis are being more commonly encountered than those of primary syphilis. Herein, we emphasize on varied mucocutaneous manifestations of secondary syphilis among young individuals. We would like to highlight the need for the implementation of sex education among adolescents/young adults to prevent STDs/STIs.

Loperamide positive deaths in Sweden 2012–2022 and Finland 2017–2022: Fatal loperamide intoxication exclusively for Sweden

Loperamide, a potent μ-opioid receptor agonist used as an antidiarrheal drug, exhibits increased bioavailability at supratherapeutic doses, causing potential central nervous system effects. Its misuse for opioid withdrawal relief and euphoria can lead to dangerously elevated blood levels, causing severe cardiac dysrhythmias and death. This study aimed to compare loperamide positive autopsy cases in Sweden and Finland after the introduction of postmortem toxicological analysis of loperamide, focusing on loperamide’s role in fatalities and identifying common characteristics among those affected. All cases with detected loperamide in femoral blood at forensic autopsies in Sweden (2012–2022) and Finland (2017–2022) were included. In Sweden, loperamide was detected in 126 individuals, and in Finland, in 111 individuals. The incidence of individuals positive for loperamide in postmortem femoral blood increased steadily over the study duration in both Sweden and Finland. Loperamide related fatalities were observed exclusively in Sweden (n=80), predominantly involving younger males with histories of substance abuse, typically classified as accidental deaths. The group of loperamide nonrelated deaths in Sweden mirrored the entirety of cases in Finland. The concentration of loperamide in postmortem femoral blood was significantly higher in cases where loperamide was considered the cause of death (median 0.140 μg/g) compared to cases where loperamide contributed (median 0.080 μg/g), as well as in deaths unrelated to loperamide in both countries (Sweden: median 0.029 μg/g; Finland: median 0.010 μg/ml). The high limit of quantification for loperamide in Sweden may underestimate therapeutic users in epidemiological assessments. This study underscores the absence of loperamide misuse in Finland and indicates a rising trend of loperamide abuse in Sweden.

Onset of Prolonged High-Potency Benzodiazepine Use Among ICU Survivors: A Nationwide Cohort Study.

Exposure to critical illness and intensive care may lead to long-term psychologic and physical impairments. To what extent ICU survivors become prolonged users of benzodiazepines after exposure to critical care is not fully explored. This study aimed to describe the extent of onset of prolonged high-potency benzodiazepine use among ICU survivors not using these drugs before admission, identify factors associated with this use, and analyze whether such usage is associated with increased mortality. Retrospective cohort study. Sweden, including all registered ICU admissions between 2010 and 2017. ICU patients surviving for at least 3 months, not using high-potency benzodiazepine before admission, were eligible for inclusion. Admission to intensive care. A total of 237,904 patients were screened and 137,647 were included. Of these 5338 (3.9%) became prolonged users of high-potency benzodiazepines after ICU discharge. A peak in high-potency benzodiazepine prescriptions was observed during the first 3 months, followed by sustained usage throughout the follow-up period of 18 months. Prolonged usage was associated with older age, female sex, and a history of both somatic and psychiatric comorbidities, including substance abuse. Additionally, a longer ICU stay, a high estimated mortality rate, and prior consumption of low-potency benzodiazepines were associated with prolonged use. The risk of death between 6 and 18 months post-ICU admission was significantly higher among high-potency benzodiazepine users, with an adjusted hazard ratio of 1.8 (95% CI, 1.7-2.0; p < 0.001). No differences were noted in causes of death between users and nonusers. Despite the lack of evidence supporting long-term treatment, prolonged usage of high-potency benzodiazepines 18 months following ICU care was notable and associated with an increased risk of death. Considering the substantial number of ICU admissions, prevention of benzodiazepine misuse may improve long-term outcomes following critical care.

A commercial tobacco and alcohol use intervention for urban Native American youth

ObjectiveWesternized alcohol and commercial tobacco use prevention approaches for Native Americans have not been effective, or sustainable. The overall objective of this study examined the effect of the culturally based Urban Talking Circle (UTC) intervention versus standard education (SE) program for the prevention of alcohol and commercial tobacco use among urban Native American youth. DesignThe study employed a 2-condition quasi-experimental design and utilized convenience and snowball sampling methods for recruiting 100 urban Native American youth participants in two urban Native American community program locations in Florida. Study participants were randomized by their urban Native American community program location to one of the 2-conditions. These included the standard education (SE) program used within United States school systems (drug abuse resistance education) and the Urban Talking Circle (UTC) intervention, culturally tailored and developed for urban Native American youth from the culturally based Talking Circle Intervention for rural Native American Youth. The Native American Alcohol Measure for Youth (NAAMY) and Native Reliance Questionnaire were utilized to collect participants' data. Participants' data was analyzed using multivariate variance analysis to determine differences between the scores on all measures at pre/post-intervention for the 2-conditions. ResultsStudy findings indicate that a culturally based intervention was more effective for the reduction of commercial tobacco and alcohol use than a non-culturally based intervention for urban Native American youth. ConclusionThe study findings emphasized that the utilization of the culturally tailored UTC intervention reduced involvement associated with alcohol and commercial tobacco use.

A valid and reliable self-peace scale with indicators of love, care and fearlessness for adolescent drug users

Self-peace is a crucial component for individuals/teenagers/students to live happily and recover from drug use. However, self-peace isn't wholly owned by individuals affected by drug use or recovering from drugs. Peace counsellors measure self-peace as a form of the addiction counsellor's role in the growth of self-peace due to drug use. This research aims to develop a valid and reliable self-peace scale. The research method uses a sequential exploratory mixed method from the qualitative data analysis process supported by quantitative data. The research targets were three expert validators and N=151 subjects among students/individuals/adolescents. Qualitative descriptive analysis compiles grids and statement items and provides expert input in developing the self-peace scale. Quantitative data analysis from the expert assessment with Aikan-V and instrument testing with confirmatory factor analysis will be used to determine the validity and reliability of the self-peace scale. The results of the data analysis compiled a blueprint of the peace scale (sub-aspects of caring, courage and love) and 12 statement items that were included in the very feasible category (Aikan-V ≥0.888). Validity of statement items with 12 valid statement items with factor loading ≥0.5, KMO=0.793 ≥0.50, reliability score 0.842 (high criteria). School counsellors can use student problem assessments to analyze student problems and needs. Counsellors, psychologists and researchers can use the self-peace scale to determine the development of an individual's self-peace to recover from drug use with four answer choices. The analysis results can be applied to further intervention in peace counselling. Keywords: self-peace, scale, validity, reliability

Viral Hepatitis and HIV Screening in Seasonal Mountain Workers: Feasibility and Results of a First French Experiment

Viral Hepatitis and HIV Screening in Seasonal Mountain Workers: Feasibility and Results of a First French Experiment

Socialization and Counseling to Enhance Teenagers' Understanding of the Dangers of Addictive Substances for Students of Harapan Tiga Private High School

Community Service aims to enhance students' understanding of Harapan Tiga Private High School's dangers of addictive substances and their impact on physical and mental health. Additionally, community service strives to encourage positive attitudes and behaviors so that students can face pressures and temptations without resorting to addictive substances. Adolescence is a critical period where teenagers undergo various developmental tasks and social pressures, including the risk of drug abuse. Through a comprehensive program of socialization and counseling, students are provided with information about types of addictive substances, their negative impacts, and strategies to combat peer pressure. The implementation method involves a collaborative approach with the school, preparation stages, activity planning, and partner participation. The results of these activities show an increase in students' understanding of the dangers of addictive substances, positive attitude changes, and the establishment of cooperation between the school, parents, and the community in preventing drug abuse among teenagers. Teaching knowledge about addictive substances and their misuse from an early age, through both formal and informal education, plays an important role in shaping teenagers' understanding of the dangers of addictive substances. By increasing understanding and awareness among teenagers, it is expected that the risk of drug abuse will decrease and their quality of life will improve. In conclusion, the results of community service show a significant increase in students' understanding of the dangers of addictive substances and the formation of positive attitudes, thereby preventing drug abuse among teenagers.