Abuse Screening Research Articles

Motives for cannabis use in a sample of portuguese users

ABSTRACT Cannabis is the most commonly used illicit substance worldwide. Given the increasing trends of its use and the impression of its harmlessness, it is important to understand the user’s motivation to adjust prevention and intervention strategies. Thus, the present study sought to explore the psychometric properties of the motives to use cannabis among Portuguese cannabis users, describing the main motives for cannabis use and their associated factors. A sample of Portuguese adolescent and youth users (N = 212) were administered a sociodemographic questionnaire; a set of questions from the European School Survey Project on Alcohol and Other Drugs regarding lifetime, annual, monthly and weekly use; the Cannabis Abuse Screening Test; and the Comprehensive Marijuana Motives Questionnaire. The results allowed us to identify an adequate structure and reliability of the measure, with internal consistency ranging from .719 to .907. The main motives for using cannabis were to celebrate, enjoy and experiment, with some gender and age differences. Moderate correlations were found between cannabis use and sleep, altered perception and experimentation, explaining 46.5% of the variance in cannabis use. The results are discussed, and future directions are presented.

Clinical characteristics and outcomes of methamphetamine-associated versus non-methamphetamine intracerebral hemorrhage

Methamphetamine use has emerged as a risk factor for intracerebral hemorrhage (ICH). We aim to investigate the clinical characteristics and outcomes of methamphetamine-associated ICH (Meth-ICH) versus Non-Meth-ICH. Patients with ICH between January 2011 and December 2017 were studied. Meth-ICH and Non-Meth-ICH were defined by history of abuse and urine drug screen (UDS). The clinical features of the 2 groups were explored. Among the 677 consecutive patients, 61 (9.0%) were identified as Meth-ICH and 350 as Non-Meth ICH. Meth-ICH was more common in Hispanics (14.6%) and Whites (10.1%) as compared to Asians (1.2%). Patients with Meth-ICH were more often younger (51.2 vs. 62.2 years, p < 0.001), male (77.0% vs. 61.4.0%, p < 0.05), and smokers (44.3% vs. 13.4%, p < 0.001). Non-Meth-ICH was more likely to have history of hypertension (72.61% v. 59%, p < 0.05) or antithrombotic use (10.9% vs. 1.6%, p < 0.05). There was no significant difference in clinical severity, hospital length of stay (LOS), rate of functional independence (29.5% vs. 25.7%, p = 0.534), or mortality (18.0% vs. 24.6%, p = 0.267) between the 2 groups. Methamphetamine use was not an independent predictor of poor outcome. Despite difference in demographics, Meth-ICH is similar to Non-Meth ICH in hospital course and outcome.

Coping Strategies and Factors Related to Problematic Substance Use and Behavioral Addictions Among Adolescents and Young Adults with Cancer.

Purpose: This study aimed to explore and identify the factors associated with problematic substance use (alcohol, tobacco, and cannabis) and behavioral addictions (internet and eating disorders) over time in adolescents and young adults (AYAs) treated for cancer. Methods: AYAs newly diagnosed with cancer, 15-25 years of age, completed a questionnaire during their hospitalization (T1), assessing their consumption of alcohol, tobacco, and cannabis (The Alcohol Use Disorders Identification Test; The Smoking Behavior Questionnaire; and The Cannabis Abuse Screening Test), their internet use (The Internet Addiction Test), their body preoccupations (The Eating Attitudes Test), as well as their coping strategies (Brief COPE) and emotional adjustment (The Hospital Anxiety and Depression Scale). Questionnaires were completed again 6 months later (T2). Results: Seventy-three AYAs were included at T1 and 21 AYAs at T2. Nearly one out of two (46.58%) AYAs had a problematic substance use or behavioral addiction after cancer diagnosis (T1). Problematic use of internet was frequently reported (23.29%), as well as harmful alcohol consumption or addiction (16.44%) and cannabis dependence (12.33%). The main factor related to problematic substance use was being older, while the main factor related to behavioral addiction was having a higher anxiety score. Substance use as a coping strategy was used more frequently by AYAs with problematic substance use and emotional support as a coping strategy was used more frequently by AYAs with a behavioral addiction. Conclusions: High rates of problematic substance use and behavioral addiction were reported in our sample. AYAs surveyed had high problematic use of cannabis and high internet use. Attention to substance use and addictive behaviors is recommended to ensure optimal care.

Elder abuse and its predictors: a cross-sectional study in a rural area of West Bengal, eastern part of India.

Elder abuse is an important public health problem hidden from public view in spite of its detrimental effect on physical and mental health. In the last three decades, there is responsiveness toward abuse of children and spouses worldwide but even today abuse and neglect of aged people seem to be the matter of least concern. This study aims to reveal the magnitude of elder abuse and its predictors. This is a cross-sectional study carried out in a community setting among elderly people (60 years and older) from October 2015 to September 2017 in a rural area of West Bengal, eastern part of India. Elder abuse was elicited by questions adapted from the Actual Abuse Tool. Data were analysed using SPSS (version 16.0). Logistic regression analysis was performed to reveal the factors associated with elder abuse. The study found that 25.6% of the respondents had experienced abuse, psychological abuse being the commonest type. Disability was the most common perceived risk for abuse. Univariate logistic regression showed higher age (70 years and older), female gender, who were Scheduled caste, living in a nuclear family, having more than three children, financially and functionally dependent, who was suffering from depression and multimorbidity had increased odds of being abused. In multivariable logistic regression, people aged above 70 years, living in a nuclear family and dependent for instrumental activities of daily living remained significant predictors of abuse. Around one in four of the respondents was abused in a 1 year duration which implies the urgent need for action. Routine screening for elder abuse at ground level and abuse prevention campaigns can be an important measure to alleviate this hidden problem. Also, there is a need to explore culturally specific forms of elder abuse to provide an age-friendly environment.

Trihexyphenidyl abuse in psychiatric outpatient clinic of a general hospital in Northern Nigeria

Background: Concomitant prescription of anticholinergics with first generation antipsychotic medications is widely practiced in psychiatry to avert or abort extrapyramidal side effect resulting from the latter. Trihexyphenidyl (Benzhexol) is the most commonly prescribed and the most likely to be abused amidst the anticholinergics in Nigeria. Objectives: To explore the prevalence and the associated factors for Trihexyphenidyl abuse among psychiatric outpatients in Nigeria. Methodology: 64 stable outpatients who met the inclusion criteria were interviewed with a sociodemographic questionnaire and a ten items Drug Abuse Screening Test (DAST-10), other relevant data were obtained from their case notes at the psychiatric clinic of Sarkin Maska Shehu (SMASH) Hospital, Funtua, Katsina State. Data were tabulated and analysed with Microsoft Excel and version 11.65 of Window Program for Epidemiologist (WINPEPI).

A role for metabolomics in the antidoping toolbox?

Evidence of the continuous rise of novel doping agents and novel doping strategies calls for the development of more accurate multi-target screening methods. Direct multi-target screening approaches are restricted to the targeted substances and their turnover. The development of effective "indirect" screening methods requires a priori a deep understanding of the metabolism of the substance. The biological passport has been demonstrated to be very effective, but it is limited to about 20 indirect parameters. The standard antidoping analytical methods are hence targeted and do not aim directly to identify unknown substances. Also, the detection of doping agents is limited by the excretion of the substance. This study considers metabolomics for the screening of performance enhancing hormone abuse by athletes, based on the following pieces of evidence: (1) hormones have a strong influence on human metabolism, changing several parameters in many tissues, organs, and bio-fluids; (2) metabolomics has been demonstrated to be a very accurate tool to depict the metabolic status of several organisms, tissues, and for several human diseases, including hormone deficiencies; (3) metabolomics has been demonstrated to be able to distinguish hormone-treated animals from controls in many species, without the need for a priori knowledge of the metabolism for the specific substance. The literature shows that metabolomics could be an appropriate tool to detect hormone abuse, keeping in mind the strength and the limitation of such an approach.

Marital Violence affecting female nurses and its physical and mental health consequences.

To investigate the relationship between marital violence and Jordanian nurses' physical and mental health. Despite the negative impact of marital violence on female nurses' health, few studies have investigated its physical and mental aspects. A descriptive correlational design was used to investigate the relationship between marital violence and the physical and mental health of female Jordanian nurses. One hundred ninety-eight female Jordanian nurses from five governmental hospitals were recruited. The Women Abuse Screening Test was used to measure forms of violence, and the SF-36 V2 instrument was used to examine physical and mental health. The prevalence of violence was calculated, and the linear relationship between violence and physical and mental health was measured using Pearson correlation. Female nurses reported a high percentage of different forms of violence. The study results revealed a negative relationship between violence and mental health and physical health. Jordanian female nurses suffered hazardous physical and mental health consequences of violence that adversely affect their entire life. Nursing educators should establish clear guidelines and training policies on marital violence for nurses through creation of an effective and cooperative networking and resources. Also, nursing/health policymakers should create responsive healthcare environment through raising the awareness on marital violence against nurses and providing counselling services for emergency and concurrent cases.

Success Factors for and Barriers to Integration of Electronic Mental Health Screening in Primary Care.

Currently, only a third of primary care providers screen for substance use, which is a growing epidemic. This quality improvement study aimed to improve the screening process by integrating the Drug Abuse Screening Test without information systems support into the electronic health record to increase completed screenings and provider interventions for positive screenings in adult patients at an urban primary care clinic. Electronic drug abuse screening should include a prescreen followed by the Drug Abuse Screening Test, interprofessional approach, comprehensive education, and utilization of generic tools to create new screening forms. Staff participated in a new drug abuse screening process, and chart audits and staff interviews were conducted. There was a 9% increase in completed screenings by medical assistants with electronic versus paper screening (30% vs 21%, respectively; P < .001). There was a 33.4% increase in provider intervention for positive screenings with electronic versus paper screening (55% vs 21%, respectively; P = .1081). Primary care providers can play an increased role in drug abuse treatment by using available technology to overcome barriers to screening independent of information systems support. By adopting the new electronic screening documentation process, this clinic was able to increase its screening outcomes.

RETRACTED: Distributions of alcohol use biomarkers including ethanol, phosphatidylethanol, ethyl glucuronide and ethyl sulfate in clinical and forensic testing

Laboratory tests vary widely in their utility and each test has unique advantages and disadvantages. For the detection of ethanol use and abuse, a variety of direct and indirect markers are available. Alcohol biomarkers provide objective measures for numerous areas of testing including clinical trials, alcohol abuse, postmortem assessment, and drugs of abuse screening. Because the utility of alcohol biomarkers vary depending on the context in which the results will be used, knowing the analogous distribution of results is of value. Herein we report distributions of ethanol in blood, phosphatidylethanol in blood, ethyl glucuronide in urine, and ethyl sulfate in urine for results reported in the last twelve months by our laboratory. Positivity rates were higher for directed analyses when compared to broad screening or panel tests with the highest overall positivity for ethyl glucuronide and ethyl sulfate. The distribution of results for ethyl glucuronide and ethyl sulfate were higher in clinical testing scenarios compared to forensic and a significant correlation between ethyl glucuronide and ethyl sulfate was found consistent with previous reports. Phosphatidylethanol was rarely ordered for forensic use while distributions between routine clinical and clinical trial use were similar. Approximately 21% of all phosphatidylethanol results were in the moderate to chronic alcohol use category. These results provide a summary of four commonly used direct markers for alcohol use with positivity rates and overall quantitative distributions. These data supply insights broken out by various disciplines where applicable providing a concise comparison of results for these markers.

Effect of urine adulterants on commercial drug abuse screening test strip results.

Immunochromatographic strips for urine drug screening tests (UDSTs) are common and very suitable for drug abuse monitoring, but are also highly susceptible to adulterants kept in the household, which can significantly alter test results. The aim of this study was to see how some of these common adulterants affect UDST results in practice and whether they can be detected by sample validity tests with pH and URIT 11G test strips. To this end we added household chemicals (acids, alkalis, oxidizing agents, surfactants, and miscellaneous substances) to urine samples positive for amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), tetrahydrocannabinol, heroin, cocaine, or benzodiazepines (diazepam or alprazolam) and tested them with one-component immunochromatographic UDST strips. The UDST for cocaine resisted adulteration the most, while the cannabis test produced the most false negative results. The most potent adulterant that barely changed the physiological properties of urine specimens and therefore escaped adulteration detection was vinegar. Besides lemon juice, it produced the most false negative test results. In conclusion, some urine adulterants, such as vinegar, could pass urine specimen validity test and remain undetected by laboratory testing. Our findings raise concern about this issue of preventing urine tampering and call for better control at sampling, privacy concerns notwithstanding, and better sample validity tests.

Primary Care Recognition and Treatment of Methamphetamine Use Disorder

Methamphetamine addiction remains one of the most common substance use disorders encountered by physicians and is often unrecognized in the current opioid epidemic. Methamphetamine remains widely available in the United States despite laws designed to limit illicit production. Physical signs of methamphetamine abuse are not always recognized in the primary care setting. The utilization of the Drug Abuse Screening Test (DAST) has helped in identification of drug abusers in this setting. The mainstay of treatment remains cognitive behavioral therapy. Though various medications have been tried, none have gained FDA approval because of lack of proven efficacy. The most promising treatment modality on the horizon appears to be immunotherapy. Treatment, while not necessarily efficacious in the long term, is widely available today.

Guided web-based treatment program for reducing cannabis use: a randomized controlled trial

BackgroundThe aim of this study was to investigate the effects of a web-based treatment program with therapist guidance for adults and adolescents with regular cannabis use from the general population.MethodsA double blinded randomized controlled trial with a parallel group design was conducted (intervention group n = 151, wait-list control group n = 152). Follow-up 12 weeks from treatment commencement of a 13-module intervention. The primary outcome was frequency of cannabis use. Time by group interaction effects were modeled using generalized estimated equations and the instrumental variable approach was used to estimate the effect of intervention adherence.ResultsAt follow-up, the intention to treat (ITT) analyses did not show any significant time by group effects. A significant association between intervention adherence and scores on the cannabis abuse screening test (CAST) was found. Secondary analysis excluding participants who had received other professional help revealed time by group effects for secondary outcomes gram cannabis consumed past week, number of dependency criteria and CAST score. Due to methodological limitations, these latter results should be interpreted with caution.ConclusionsIn this study we did not find a web-based treatment program with therapist guidance to be more effective than a waiting-list in reducing frequency of cannabis use.Trial registration The trial was pre-registered at ClinicalTrials.gov (NCT02408640) April 3, 2015

Substance Use and Exposure to Adverse Childhood Experiences in Undergraduate and Graduate Nursing Students

BACKGROUND: Substance misuse remains a public health crisis and contributor to morbidity and mortality. The nursing workforce is not immune to the impacts of substance misuse as rates are thought to mirror those of the general population. Additionally, as substance misuse often begins in adolescence or early adulthood, prevalence of misuse among practicing nurses highlights the fact that students are also at risk. OBJECTIVES: The purpose of this study was to examine rates and patterns of substance use and adverse childhood experience (ACE) exposure among nursing students while also examining associations between substance use and ACE exposure. METHOD: This study utilizes a cross-sectional and descriptive design through the provision of email surveys to nursing students. Email surveys consisting of the Alcohol Use Disorders Identification Test, the Drug Abuse Screening Tool 10-item survey, the ACE Questionnaire, and a demographic inquiry were distributed via Qualtrics survey software. RESULTS: A total of 662 individuals participated in the survey, the majority of whom self-identified as female, were undergraduate students, and were between 18 and 21 years. Moderate- to high-risk alcohol use was identified in 20% of students, while moderate- to high-risk drug use was identified in 3.6% of students. More than half of students endorsed exposure to at least one ACE. Significant associations were found between the Drug Abuse Screening Tool 10-item survey and the ACE Questionnaire. CONCLUSIONS: The results of this study have significant implications for nursing educators and must inform groundwork for the development of policies and interventions that are evidence based, nonpunitive, and trauma informed.

Sensation seeking, sexual orientation, and drug abuse symptoms in a community sample of emerging adults.

Increased use of drugs is associated with a number of factors including high sensation seeking and sexual minority status (through group-specific minority stress). We sought to examine how personality traits like sensation seeking may influence drug abuse among sexual minority individuals. Participants were 217 emerging adults (Mage = 20.23, SD = 0.85) recruited from Amazon Mechanical Turk (MTurk). Of these participants, 67.7% identified as heterosexual, 9.7% as gay or lesbian, 21.2% as bisexual, and 1.4% indicated other sexual orientations. Sensation seeking and drug abuse were self-reported using the Brief Sensation Seeking Scale and the Drug Abuse Screening Test, respectively. A preliminary multiple analysis of variance indicated no significant mean differences for these variables as a function of sex or sexual orientation. Next, sexual minority status, Brief Sensation Seeking Scale scores, sex and their interactions were entered into a linear regression predicting Drug Abuse Screening Test scores. Results revealed a significant moderation, such that the positive relationship between Brief Sensation Seeking Scale total scores and Drug Abuse Screening Test total scores was stronger for sexual minorities (β = 0.14, P = 0.00) compared to heterosexuals (β = 0.04, P = 0.04), controlling for sex. These results demonstrate, while sensation seeking and sexual minority status may selectively indicate risk for drug use, sexual minorities high in sensation seeking may be at especially high risk for problems related to drug abuse. More research examining the addiction etiology of sexual minority individuals would inform targeted interventions for this population.

Alcohol and drug use disorders in patients with cancer and caregivers: effects on caregiver burden

BackgroundThe estimated prevalence of alcohol use disorders in patients with advanced cancer is reported as 4%–38%. There are limited data regarding alcohol and drug use disorders in caregivers of patients...

Suicide ideation among pregnant women: The role of different experiences of childhood abuse

BackgroundChildhood abuse has a negative effect on mental health during pregnancy; however, the association between childhood abuse and suicide ideation has received relatively little attention. MethodWomen at 28 weeks or more into their pregnancy were recruited from a prenatal clinic in Shandong province, China. Suicide ideation was measured using item 9 of the Patient Health Questionnaire-9. Childhood abuse was measured using childhood abuse subscales of the Childhood Trauma Questionnaire. ResultsWomen with any experience of childhood abuse had high risk of suicide ideation (OR = 2.44, 95%CI: 1.31–4.55). The association of continuous childhood abuse scores with suicide ideation was consistent with the finding using dichotomous childhood abuse (OR = 1.07, 95%CI: 1.02–1.12). After adjustment for depression, pregnant women with only physical abuse experience had high risk of suicide ideation (OR = 3.63, 95%CI: 1.32–10.03). Pregnant women with both childhood abuse and depression had increased risk of suicide ideation compared to those with neither risk factor (OR = 17.78, 95%CI 7.20–43.92). LimitationsUsing a self-report measure to assess childhood abuse is susceptible to recall bias. Using a single item to measure suicide ideation and assessing only suicide ideation were limitations of the study. ConclusionsPregnant women who experienced childhood abuse, especially physical abuse, had a high risk of suicide ideation during pregnancy. Screening for both childhood abuse and antenatal depression may be an effective way to identify high-risk groups with suicide ideation.

Gratitude and suicide risk among college students: Substantiating the protective benefits of being thankful

Objective Gratitude, or thankfulness for positive aspects of life, is related to psychosocial well-being and decreased psychopathology, and may reduce suicide risk. We explored four potential hypotheses purported to explain the beneficial outcomes of gratitude (schematic, positive affect, broaden-and-build, and coping), hypothesizing that hopelessness (schematic), depression (positive affect), social support (broaden-and-build), and substance use (coping) would mediate the gratitude-suicide linkage. Participants: 913 undergraduate students from a mid-size, southeastern U.S. university. Methods: Respondents completed online self-report questionnaires including the Suicidal Behaviors Questionnaire-Revised, Gratitude Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory, Duke Social Support Index, Alcohol Use Disorders Identification Test, and Drug Abuse Screening Test. Results: Supporting theory and hypotheses, gratitude was related to less suicide risk via beneficial associations with hopelessness, depression, social support, and substance misuse. Conclusions: The linkage between gratitude and suicide risk appears to be predicated on the beneficial association of gratitude to negative mood and interpersonal functioning.

A cross-sectional study of psychopathy and khat abuse among prisoners in the correctional institution in Jimma, Ethiopia.

BackgroundKhat abuse and psychopathy are both strongly related to criminal activity. Higher rates of substance use in people with psychopathy are hypothesized to be related to psychopathic personality traits, which include high sensation seeking, low conscientiousness and neuroticism, impulsivity, and irresponsibility. Little is known, however, about the association between psychopathy and khat abuse among prisoners in Ethiopia. Therefore, we evaluated the presence of these two factors in prisoners in the correctional institution in Jimma, Southwest Ethiopia.Materials and methodsWe used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected by a systematic random sampling technique. Khat abuse was assessed with the Drug Abuse Screening Tool and psychopathy with the Psychopathy Checklist: Screening Version. We also assessed nicotine dependence with the Fagerstrom Test for Nicotine Dependence; alcohol use disorder, with the alcohol use disorder identification test; adverse traumatic life events, with the Life Events Checklist; and social support, with the Oslo 3-Item Social Support Scale. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models. Variables with a P value < 0.05 in the final fitted model were declared to be significantly associated with the outcome variable.ResultsThe overall prevalence of lifetime khat use was 59.9%, and the prevalence of khat abuse in prisoners with psychopathy was 78.0%. Prisoners with psychopathy had a three times higher odds ratio of abusing khat than those without psychopathy (AOR = 3.00 [1.17–7.67]). Among the confounders, a family history of substance use (AOR = 2.50 [1.45–4.31]), poor support (AOR = 2.28 [1.11–4.67]), alcohol use disorder (AOR = 7.78 [4.16–14.53]), and suicidal ideation and suicide attempts (AOR = 2.26 [1.45–4.31]) were also positively associated with khat abuse.ConclusionsThe prevalence of khat abuse was higher in prisoners with possible or probable psychopathy.

287. Association Between Interpersonal Violence and Dual Protection Use Among Adolescent Females in Atlanta: Implications for Abuse Screening and Expanding Dual Protection Messages to Include PREP/PEP

287. Association Between Interpersonal Violence and Dual Protection Use Among Adolescent Females in Atlanta: Implications for Abuse Screening and Expanding Dual Protection Messages to Include PREP/PEP

Screening for elder abuse in geriatric outpatients: reliability and validity of the Iranian version Hwalek–Sengstock Elder Abuse Screening Test (H-S/EAST)

ABSTRACTThe present research seeks the notion of the appropriateness of “Hwalek-Sengstock Elder Abuse Screening Test (H-S/East)”, and psychometric properties to analyses cultural aspects of elder abuse in the Iranian community dwellers referred to clinics. In this cross-sectional validation study 364 participants, 60 years and over were selected from outpatient’ clinics. The SF-36, GDS-15, and AMT scores were used for concurrent validity. The Brief Abuse Screen for the Elderly (BASE) scale was examined to determine the sensitivity and specificity of the Iranian version H-S/East. The elder abuse rate in participants was 29.4% based on cutoff ≥4, while a significant correlation was found in Iranian version H-S/EAST with depression and SF-36 subscale MCS at P < .01, and four factors observed. Optimal cutoff ≥4 obtained with 82.8% sensitivity and 84.5% specificity. It seems the Iranian version of H-S/East demonstrates concurrent validity and fair reliability in elderly outpatients, while construct validity should be carried out in the Iranian elder illiterate population and other languages/cultures.