Addiction Center Research Articles

The mediating role of coping strategies in the relationship between illness perception and quality of life among hashish users

Purpose Hashish consumption is one of the most widespread public health concerns due to its extensive use and high prevalence. This study aims to investigate the association between illness perception and quality of life among hashish users, while also assessing the mediating role of coping strategies. Design/methodology/approach Male hashish users’ with a mean age of 37.9 years (SD = 12.3) were screened from public and private addiction and rehabilitation centers in Districts Peshawar, Kohat and Karak. Data were collected through the Brief Illness Perception Questionnaire, the World Health Organization Quality of Life scale and the Brief Cope scale to assess illness perception, quality of life and coping strategies. Stepwise regression and mediation analysis were performed. Findings The findings suggest that illness perception has a significant reverse association with quality of life (r = −0.16, p < 0.01). However, coping strategies have a significantly positive association with quality of life (r = 0.51, p < 0.01) while subcategories, that is, problem-focused, emotion-focused and active avoidance coping were not significantly associated with quality of life. Practical implications Lower quality of life increases vulnerability to illness perception, and effective coping strategies improve quality of life. This study emphasizes the importance of addressing illness perception and enhancing coping strategies in interventions aimed at improving the quality of life for hashish users. Originality/value This novel view provide valuable insights for developing targeted interventions that enhance the well-being of hashish users by addressing both their psychological and behavioral aspects.

Impact of COVID-19 on Substance Use Disorder Treatment: Examining the Influence of In-Person and Telehealth Intervention on Outcomes Using Real-World Data.

Background: The COVID-19 health crisis challenged healthcare systems around the world, leading to restrictions in access to face-to-face healthcare services, and forcing rapid adaptation to telehealth services. At present, there is a gap in the functioning of this adaptation in drug-dependence centres. The present study analyses, over four years, care indicators on the care modality (face-to-face vs. hybrid), the patient profile and the impact on retention in treatment. Methods: Retrospective observational study with data collected between 14 March 2019 and 21 June 2023. The electronic health records of 44,930 patients were analysed according to different moments and selected based on the different health measures imposed by the COVID-19 pandemic. Patients were classified according to whether they received an in-person or hybrid intervention. Bivariate statistics and logistic regression analysis were applied. Results: The trend over time shows an increase in the number of patients seen in addiction centres. However, no notable changes within the in-person care modality and a modest increase in telehealth services are observed. Telehealth is primarily used among patients with opiate addiction, as well as with those with comorbid mental disorders. Logistic regression analysis shows that patients in a hybrid modality are more likely to remain in treatment. Conclusions: Results show that hybrid care is associated with higher patient retention rates. Despite this, different profiles are mostly treated with in-person interventions rather than hybrid modalities. Future studies should explore how to generalise personalised hybrid care among SUD patients considering factors such as patients' educational level, employment status or accessibility to mental health services.

How Has the COVID-19 Pandemic Impacted Addiction Services? A Study of the Different Periods of the Pandemic and Patient Treatment Follow-up Over 1 Year.

Various studies have provided evidence of the impact of COVID-19 and the measures adopted by governments on drug use and its treatment. After 4 years, a more precise assessment of the evolution of patients and addiction treatment services can be made. The objective of this study is to compare different periods during the COVID-19 pandemic to identify changes in patient profiles and the care activity of addiction treatment centres. A retrospective observational study was conducted using data from March 14, 2019 to June 22, 2022, from addiction centres of Andalusia (Spain). Information related to the treatment of each patient was collected during 1 year after the initiation of treatment (until June 22, 2023). Electronic health records of 29 740 outpatients were analysed and divided into 4 periods (pre-pandemic, lockdown, return to normal and post-lockdown). Differences were found across the analysed periods. Admissions declined during the lockdown period but subsequently increased, without reaching pre-pandemic levels. Admission to treatment due to opioid dependence increased during the lockdown. In contrast, the percentage of patients with dual pathology decreased. An increase in the dropout rate of patients from treatment was observed compared to the pre-pandemic period. The results revealed a similar patient profile across the different analysed periods. The most notable changes are observed in healthcare activity, which appears to have decreased. Therefore, a greater investment is likely required for the reformulation of addiction centres and increased funding to provide adequate assistance to these patients.

Sociodemographic and clinical characteristics of patients admitted to an addiction center with methamphetamine use

Sociodemographic and clinical characteristics of patients admitted to an addiction center with methamphetamine use

Prevalence of anxio-depressive disorders, insomnia and self-esteem in a Moroccan population addicted to cannabis and/or alcohol: a cross-sectional study

ABSTRACT Background Addiction to cannabis and alcohol is a global public health concern, linked to significant mental health impairments such as anxiety, depression, insomnia, and low self-esteem. This study, conducted in Marrakech’s addiction treatment centers, aims to assess the prevalence of mental health disorders, insomnia, and self-esteem among individuals seeking treatment for alcohol and/or cannabis addiction. Methods This cross-sectional study was conducted from January 1 2023 to January 1 2024. Depression, anxiety, insomnia, and self-esteem were assessed using the HADS, ISI, and Rosenberg scale. Results Anxiety prevalence for cannabis, alcohol, and both substances was 57.9%, 55.2%, and 59.2%, respectively. Depression prevalence was 71.7% (cannabis), 73.1% (alcohol), and 75% (both substances). Sub-clinical insomnia (mild) prevalence for the three groups was 65.4%, 71.6%, and 77.6%. Low self-esteem was observed at 59.1%, 64.2%, and 60.5% for cannabis, alcohol, and both substances, respectively. No significant association has been found between the type of product consumed (cannabis, alcohol, cannabis and alcohol) and anxiety, depression, insomnia and self-esteem. Conclusions These findings highlight prevalent mental health disorders in cannabis and alcohol addiction, underscoring the need for comprehensive, multidisciplinary treatments, including regular mental health screenings, quarterly follow-ups, and family involvement in group therapies at Moroccan addiction centers.

Use Of Passiflora Incarnata L. Herba In The Treatment Of Cocaine Use Disorders: The Experience Of An Addiction Center In Monza, Italy.

The authors report a real-world experience on the treatment of cocaine use disorders (craving) in outpatient treatment subjects at the addiction centre in Monza (MB, Italy). 38 patients with Substance Use Disorder (Cocaine) were enrolled over one year for substance craving treatment with Passiflora Incarnata L Herba at a dose of 600 mg/day for a period of two months.

Etienne Sibille: Investigating the cellular and molecular bases of depression and aging for innovative therapeutics

Etienne Sibille, a pioneering figure in neuropsychiatric research, has yet to follow conventional paths. From his early days as a photojournalist editor in New York to becoming one of neuroscience's most innovative voices, his journey reflects the same creative thinking that drives his groundbreaking research at the University of Toronto. As a Professor of Psychiatry, Pharmacology & Toxicology, he brings a fresh perspective to understanding how our brains age and why we get depressed. At the Center for Addiction and Mental Health (CAMH), where he directs the Neurobiology of Depression and Aging research program, his team is turning fascinating discoveries about brain chemistry into potential new treatments. Building on his influential work at Columbia University and the University of Pittsburgh, Sibille has challenged traditional views of brain disorders, particularly through his insights into the GABAergic system and aging. While serving as CAMH's Campbell Chair (2014–2024) and Deputy Director of the Campbell Institute (2017–2020), he has pushed the boundaries between basic research and real-world treatments, recently diving into biopharma development to help bridge this gap. In this Genomic Press Interview, he shares the winding road that led him from behind a camera lens to the forefront of psychiatric research, offering a candid look at what drives his passion for unraveling the brain's mysteries.

Externalized nurse-led model for hepatitis C virus microelimination and impact of drug use profile

Background and objectiveDirect-acting antivirals have greatly simplified the treatment of hepatitis C virus (HCV), yet circuits that bring diagnosis and treatment closer to people who inject drugs (PWID) are needed to achieve the elimination targets of the WHO. With this purpose we have established an externalized nurse-driven circuit among former and active PWID in an addiction centre (AC) and a harm reduction centre (HRC). Methods and settingsThe nursing staff offered HCV screening, diagnosis and treatment to the AC and HRC users, administered medication after the hepatologist's remote prescription to those with an active infection who accepted being treated, and implemented educational and harm reduction interventions. Participants and resultsBetween October 2018 and March 2021, 566 users accepted screening. 134 (24%) had an active infection, with a higher prevalence among HRC users (42% vs 17%; p<0.001), who were more frequently foreigners, homeless and reported active drug use and syringe sharing. Treatment initiation was similar between groups. Overall sustained viral response (SVR) for intention-to-treat (ITT) and per protocol (PP) was 70% and 88% respectively. Overall adherence was good in both groups; however, SVR was higher in AC users compared to HRC users (ITT-SVR 81% vs 55%). All reinfections (6% by ITT) occurred in the HRC group. Overall loss to follow-up rate was 21%. ConclusionsThis patient-centred nurse-driven circuit demonstrates that HCV treatment can be successfully delivered to PWID even with active drug use and socio-economic complexity. User-specific characteristics need to be considered when setting up these interventions to maximize success.

Effective Strategies for Managing Substance Use Disorders in Older Adults in Nursing Homes

Substance use disorder is very prevalent in nursing home (NH) residents due to aging, the number of prescription drugs that are being used to manage their physical and psychological pain, and several discharges with the diagnosis of substance use disorder from hospitals to NH for aftercare support. However, many nursing homes are not equipped to provide adequate care for residents with a diagnosis of substance use. The staff is not well-trained to care for this type of population, which is becoming a challenge for the staff to manage residents in-house, leading to overdose, recurrent hospitalization, and unsuccessful discharges to communities due to relapses and an increase in the number of frequent flyers. Substance use disorder has become a significant public health concern in the United States, especially in the older population from the past couple of decades, which tends to increase. Discharging older adults with substance use disorders into nursing homes without ensuring established resources in the long-term care setting raises safety and quality concerns, emphasizing a pressing need for innovative preventive and management approaches for substance use disorders to meet unique needs of older adults in nursing homes. Purpose: The purpose of the study is to explore and identify the interventions, treatments and care models to effectively manage substance use disorders in older residents who are living in nursing homes. The study further focuses on the unique challenges that are faced by older adults and staff in nursing homes to understand the need for integrating addiction treatments in Long-term care settings to assess the need to enhance care strategies to improve resident outcomes, which includes handling overdose emergencies, prevention, rehabilitation and relapse management of substance use disorders (SUDs). Scope: Provides valuable insights for future researchers and points out the need for collaborative models among the rehabilitation, addiction centers, and LTC and the need for virtual health platforms to improve access to care, interdisciplinary approaches, and policy innovation on resident retention and optimum resource allocation to reduce the health care cost of frequent flyers or unnecessary hospitalizations, therefore, improve patient outcomes.

Collaborative work processes in establishing a MiniMaria treatment center for youth substance addiction: a qualitative inquiry of county council healthcare and municipal efforts

BackgroundThis article is part of a larger study exploring the collaborative dynamics between key stakeholders in providing care to youths suffering from alcohol or substance use and their families in formulating policies and operational practices for county and country-wide application in similar settings. The focus of this article is to describe the collaborative processes between two stakeholders, a municipality, and a county council, in establishing a MiniMaria treatment center. While collaborative efforts between municipalities and county councils in health service provision are often acknowledged, little is known about how communication and decision-making processes between these entities shape the success of such initiatives. This study aims to fill this gap by providing insights into the communicative processes that foster organizational cohesion, agility, and innovation. The guiding research question is: What communicative processes occur between the county council and municipal stakeholders during the planning phase of the MiniMaria treatment center?MethodsThe municipality and county council were selected based on purposive sampling, owing to the proximity and accessibility of the field. An exploratory and descriptive design, incorporating a participatory research approach, was employed for this qualitative investigation.ResultsTwo central themes, each underpinned by specific subthemes sum up the essence of our findings. The first theme underscores the collaborative dynamics and shared objectives that have emerged through the project, thus showing the importance of a unified vision and mutual understanding in driving the initiative forward. The second theme points to the practical aspects of implementing the project, including recruitment strategies, and the significance of interpersonal communication.ConclusionsThis article sheds light on the establishment of a MiniMaria treatment center through collaboration between a municipality and county council, using the Four Flows Model to interpret communicative processes. Membership negotiation was crucial for defining roles and building a unified team identity, while activity coordination ensured aligned stakeholder efforts. Self-structuring facilitated internal organization and operational clarity, and institutional positioning aligned the initiative with broader healthcare norms, enhancing its credibility and impact. These communicative practices were central to get a grip on inter-organizational complexities, emphasizing communication’s constitutive role in organizational development and innovation.

Does Topiramate Add-On Enhance the Response to the MATRIX Program in Individuals with Methamphetamine Use Disorder? A Double-Blinded Randomized Placebo-Controlled Trial

Background: Methamphetamine dependence significantly impacts individuals and society. Treating methamphetamine use disorder is challenging due to limited evidence on effective pharmacotherapies and their interaction with nonpharmacologic interventions. This study evaluated the efficacy of topiramate compared to placebo in treating methamphetamine use disorder among participants in a Matrix program. Methods: Participants were recruited from the Addiction Center of Iran Psychiatric Hospital between January 2020 and June 2023 and randomly assigned to receive either topiramate or a placebo for 12 weeks, alongside Matrix program sessions. Blinding was maintained for participants, personnel, outcome assessors, and statisticians. Main outcomes included craving, desire to use, positive urine amphetamine toxicology rates, and depression severity. Craving was assessed using the Visual Analog Scale (VAS) and the Substance Craving Questionnaire–brief (SCQ-B). The desire to use was evaluated with the Addiction Severity Index (ASI), while depression severity was measured using the Beck Depression Inventory. Data analysis utilized IBM SPSS Statistics® 20.0, employing various statistical tests for comparison. Results: Both groups exhibited improvement in craving as per VAS scores (p=0.007), with greater reduction in the topiramate group; however, no significant difference was found between groups (p=0.06). The negative urine toxicology rates showed no significant difference (Hazard ratio=1.15, 95% CI: 0.75, 1.78). Depression scores decreased in both groups without significant between-group differences (p=0.78). Conclusion: The findings do not support the efficacy of topiramate in enhancing outcomes within a Matrix program for individuals with methamphetamine use disorder.

Characteristics of patients who are initiated on long-acting buprenorphine (Buvidal®) in France: A retrospective cross-sectional study

The long-acting buprenorphine Buvidal® is a recent type of opioid agonist treatment (OAT) used for opioid use disorder (OUD). It was initially suggested to preferentially use Buvidal® for specific OUD populations, including people in prison, or patients in recovery and on sublingual buprenorphine. We conducted a national study to examine whether the profile of patients treated with Buvidal® in France matched these initial recommendations. A retrospective cross-sectional study was conducted in 13 national addiction centers (outside prison), using the individual medical records of patients initiated on Buvidal®. Baseline characteristics were collected and described, including sociodemographic features, comorbid medical conditions, concurrent substance use and prescription drug misuse, and OAT features before Buvidal® initiation, respectively. In total 101 patients (72.3% males, mean age 43.9±11.3years) were identified, which corresponded to one sixth of all patients treated with Buvidal® in France at the time of the study. Of them, 36 (36.4%) of them were professionally active, 35 (35.4%) were durably inactive, and the rest in an intermediary situation. Furthermore, 90 (90.0%) patients had at least one medical comorbidity (all types), and 83 (83.0%) at least one psychiatric comorbidity. Most frequent non-psychiatric comorbidities were chronic pain (n=20, 20.0%) and chronic viral infection (n=16, 17.8%). Current use of psychoactive substances included cocaine and crack (n=43, 42.6%), heroin (n=19, 18.8%), but also misuse of prescription drugs (n=20, 20%), mainly opioid analgesics. Moreover, 99 (98.0%) patients had an OAT before Buvidal® initiation, including 7 (8.1%) patients on methadone. The profile of patients initiated on Buvidal® in France was extremely similar to that of patients treated for OUD in France, either in terms of social or clinical features. While initial recommendations essentially underlined the interest of Buvidal® for some niche populations, the on-the-ground practice reveals a more widespread use, including for unrecovered patients, or patients treated with methadone.

Effectiveness of self enhancement programme on self esteem and quality of life among patients with alcohol dependence syndrome

The present study investigates the Effectiveness of self enhancement programme on self esteem and quality of life among patients with alcohol dependence syndrome. The research design selected for this study was quasi experimental pre-test post-test control group design and the samples were selected by non-probability purposive sampling technique. The theoretical frame work of the study was based on Betty Neuman’s System model. The tools used were Socio personal and clinical data sheet, Rosenberg’s self esteem scale, WHOQOL BREF26. For the study, the researcher selected thirty patients with Alcohol dependence syndrome as control group and thirty clients with Alcohol dependence syndrome as experimental group who met the inclusion criteria. The data were tabulated and analyzed by using descriptive and inferential statistics. Socio personal and clinical data, self esteem and quality of life were analysed using frequency distribution and percentage. Computation of Mann Whitney U value were used to determine the effectiveness of self enhancement programme. The inter correlation between self esteem and quality of life were analysed using Spearman’s rank correlation coefficient. Association of self esteem and quality of life with selected variables were analysed by using Chi-square test. The findings revealed that patients with Alcohol dependence syndrome had low self esteem and poor quality of life. The study also revealed that self enhancement programme was effective in improving self esteem (p&lt;0.001) and quality of life (p&lt;0.001) among patients with ADS. It also revealed that there was a strong positive correlation (p&lt;0.01) between self esteem and quality of life among patients with ADS and there was a significant association between self esteem and age of patients with ADS, quality of life and age of patients with ADS. The researchers suggest that self enhancement programme can be used regularly for patient with ADS in de addiction centres and community setting.

Perceived severity and Barriers to Health Promotion of Male addicts in Early Recovery from Drug Use Disorder

Background: Drug addiction remains a significant public health issue globally, with substantial personal and societal impacts. Effective treatment and health promotion behaviors are crucial for recovery. Specific Background: In Iraq, the context of addiction treatment and the factors influencing health promotion behaviors among male addicts are underexplored. Knowledge Gap: There is limited understanding of the perceived severity and barriers to health promotion behaviors among male addicts in drug addiction centers in Iraq. Aims: Aims to assess the perceived severity and barriers to health promotion behavior among male addicts with a drug use disorder. Methods: A descriptive study design was utilized, with a convenience sample of 100 male individuals aged 15 to 45 from the Al-Ataa Hospital for Addiction and Psychological Rehabilitation. Data were collected via a questionnaire comprising socio-demographic characteristics and scales measuring beliefs regarding addiction. Cronbach's alpha for the perceived barriers and severity scales were 0.789 and 0.881, respectively. Results: The average participant age was 28 years, with 49% single, 71% living in lower-class neighborhoods, and 72% voluntary admissions. A significant relationship was found between educational level and health beliefs (p=0.00). The study revealed a high-level assessment of perceived severity and a moderate-level assessment of perceived barriers. Novelty: This study highlights the significant impact of educational level on health beliefs among male addicts, a relatively unexplored area in the region. Implications: The findings suggest that increasing awareness among patients and their families, establishing specialized hospitals, developing targeted policies, and leveraging media can enhance addiction treatment. This research underscores the need for comprehensive approaches involving various stakeholders to address drug addiction effectively. Highlights: High Perceived Severity: Addicts show high severity awareness. Education Impact: Significant link between education and health beliefs. Policy Recommendations: Establish specialized hospitals, targeted policies, media involvement. Keywords: drug addiction, health promotion, perceived barriers, perceived severity, Iraq

Readmission and Dropout in Outpatient Centers: An Analysis of Real-World Data in Patients with Dual-Diagnosis

AbstractSubstance use disorder treatment faces challenges such as dropout, relapse, and readmission. This study aims to identify factors associated with readmission and those influencing dropout among dual diagnosis (DD) patients (those with both a substance use disorder and another psychiatric disorder) attending outpatient addiction centers. Retrospective cohort study using the electronic health records of 8383 outpatients diagnosed with DD. Bivariate analysis and regression analysis were applied to control for the variables. Age, incarceration for 30 days prior to admission, and specific patterns of consumption increased the likelihood of readmission. Specifically, individuals who reported no substance use in the 30 days before admission or those diagnosed with an opioid or cocaine use disorder were particularly susceptible to readmission. Of the dual diagnoses, patients with personality disorders were more likely to be readmitted. In relation to dropout, opioid dependence and frequency of use were associated with a higher probability of dropout. Patients with poorer adherence to treatment and previous readmissions were also more likely to drop out. Enhancing treatment adherence and reducing dropout and readmission rates poses a challenge in managing patients with DD. Leveraging electronic health records offers enhanced ecological validity concerning the outpatient treatment requirements for such patients. Therapeutic adherence, alongside specific sociodemographic variables and consumption patterns, emerges as pivotal factors in this context. Identifying and understanding these variables facilitates the customization of outpatient treatment strategies to better meet the needs of patients with comorbidities.

Study on the efficiency of virtual reality in the treatment of alcohol use disorder: study protocol for a randomized controlled trial

ContextAccording to the World Health Organization, alcohol is a major global public health problem, leading to a significant increase in illness and death. To treat alcohol use disorders, new therapeutic tools are being promoted, among which virtual reality (VR) shows promise. Previous research has demonstrated the efficacy of VR in reducing alcohol cravings in patients, but there is a lack of data on its effectiveness in maintaining abstinence or reducing consumption in recently abstinent individuals.The E-Reva study aims to compare the efficacy of a treatment strategy combining virtual reality cue exposure therapy (VR-CET) and cognitive behavioral therapy (CBT) with conventional CBT in reducing alcohol consumption and craving in patients with alcohol use disorder (AUD). In addition to this primary objective, the study will compare the effects of VR-CET combined with CBT on anxiety, depression, rumination, and feelings of self-efficacy versus conventional CBT.MethodsThis prospective randomized controlled trial will be conducted over 8 months in four addiction departments in France. It includes two parallel groups: i) the VR-CET + CBT group, and ii) the CBT-only group, which serves as a control group.Participants will be recruited by the investigating doctor in the addiction centers. The sample will consist of 156 patients diagnosed with AUD and abstinent for at least 15 days.Both treatment groups will participate in four group CBT sessions followed by four individual sessions: i) the VR-CET group will be exposed to virtual environments associated with alcohol-related stimuli, ii) the CBT-only group will receive traditional CBT sessions. After completion of the 8 sessions, patients will be followed up for 6 months. The primary outcome is the cumulative number of standard drinks consumed at 8 months, assessed using the TLFB method.DiscussionDespite the promise of VR-CET to reduce the desire to drink, the effect on alcohol consumption remains uncertain in the existing literature. Our protocol aims to address the limitations of previous research by increasing sample size, targeting consumption reduction, and incorporating neutral environments. E-Reva aims to enrich the literature on the use of VR in the treatment of AUD and open new perspectives for future interventions.Trial registrationClinicalTrials.gov ID NCT06104176, Registered 2023/11/13 (https://clinicaltrials.gov/study/NCT06104176?id=NCT06104176&rank=1).N° IDRCB: 2022-A02797-36.Protocol version 1.0, 12/05/2023.

Frequency of Methamphetamine Use in Patients Admitted to an Addiction Center and Clinical Factors Associated With Methamphetamine Use

We aimed to determine the frequency of methamphetamine (METH) use and the clinical factors associated with METH use. Face-to-face interviews were conducted with 788 patients who applied to an addiction treatment center in Turkey. Patients diagnosed with primary psychotic disorder and/or bipolar disorder were excluded from the study. It was found that 48.9% of patients ( n = 385) used METH, and 24.4% of them ( n = 94) used it every day. Visual hallucinations were present in 34.3% of METH users, auditory hallucinations in 38.2%, paranoid delusions in 55.6%, and agitation in 39.7%. Additionally, 40.8% of patients had spontaneous skin wounds unrelated to scratching after METH use. Oral mucosa and dental lesions (METH mouth) were detected in 37.1% of patients. The incidence of these conditions increased with the frequency of METH use ( p &lt; .001 for all). Regression analysis revealed that the use of pregabalin and poly-substance use independently predicted METH use.

Seroprevalence of HIV, HCV, and HBV: The Associated Psychiatric Co-morbidities Among Injection Drug Users in Kashmir- A Hospital-Based Cross-sectional Study.

Injection drug use remains a significant public health concern globally, with injection drug users (IDUs) facing elevated risks of contracting blood-borne infections such as hepatitis C (HCV), hepatitis B (HBV), and acquired immune deficiency syndrome caused by the human immunodeficiency virus (HIV). This study delves into the seroprevalence of these disorders among IDUs in Kashmir and extends further to explore the relationship between injection drug use and psychiatric co-morbidities. A cross-sectional study was conducted among IDUs recruited from tertiary care drug addiction centers. Those who agreed to participate underwent serological testing for HCV, HBV, and HIV. The presence of psychiatric disorders was assessed using the Mini International Neuropsychiatric Interview, a standardized instrument for diagnosing mental health conditions. The results showed that the prevalence rate of HCV, HBV, and HIV was 73%, 12%, and 1%, respectively. Genotype 3a was the predominant genotype in 71 (51.5%) participants with detectable HCV-RNA. A total of 151 (50.3%) participants had a comorbid psychiatric illness with attention-deficit hyperactivity disorder and major depressive disorder in 63 (21%) and 36 (12%), respectively. Sharing of paraphernalia was the most common high-risk behavior in 234 (78%). Early initiation of opioid use, a history of sharing of paraphernalia, and the presence of comorbid psychiatric illness were found to be significantly associated with positive serology results, indicating a higher risk of contracting infection (χ2 = 24.55, p < .01; χ2 = 121.56, p < .01; and χ2 = 4.534, p <.01, respectively). IDUs have an elevated prevalence of HCV, substantial rates of infection with HBV and HIV, and a considerable burden of psychiatric morbidities. Considering the high seroprevalence of hepatitis infections and alarming rates of psychiatric morbidity in IDUs, this calls for a comprehensive and integrated approach to address the interconnected challenges faced by IDUs in Kashmir.

Substance Use Disorder Admission Rates Before and After the Lockdown in a Large Addiction Center in Saudi Arabia: A Retrospective Cohort Study

Objective: This study aimed to examine the potential changes in substance use disorder (SUD) admission rates before and after the lockdown in a major addiction center in Saudi Arabia. Method: This retrospective cohort study extracted data from Al-Amal Hospital Electronic Health Record in the city of Dammam, Eastern region of Saudi Arabia. A total of 2,426 cases included in the analysis for patients who received services from the SUD treatment programs from 1/1/2015 to 31/12/2021. Results: Before the pandemic, there was a consistent increase in the admission rates for patients with substance use disorder. The highest proportion of increase were among unemployed, young, newly admitted patients. During lockdown, there was nearly a 70% reduction in SUDs-related admission rate. The age group 18–25 was seven-times more likely to be admitted for SUD after the lockdown. Amphetamine-related admissions were two times more likely to be admitted after the lockdown (Odds ratio (OR) 2.04; confidence interval (CI) 95%[1.64, 2.54]). Conclusions: There was nearly 70% reduction in SUDs admission rates during the lockdown. After the lockdown, a significant proportional increase in amphetamine use disorder admissions was observed mostly among the patients age group 18–24 with a history of a previous admissions. Determining populations at risk for high health care utilization is crucial in building a comprehensive and effective prevention strategy. Therefore, the need to adopt coordinated strategies and innovative, comprehensive approaches to benefit individuals with SUD is imperative to face the increased rate of SUD related admissions.

Perinatal women in substance use disorder treatment: Interest in partnering with family and friends to support recovery needs

Background Perinatal women treated for substance use disorder (SUD) face considerable barriers to recovery that might be ameliorated through activation of community support. Objectives This descriptive study evaluated the presence of drug-free family and friends in the social networks of perinatal women treated for SUD. It also assessed the interest of these women to partner with network members to mobilize support across several recovery needs. Methods Social network interviews were conducted with 40 pre- and post-partum women treated at the Center for Addiction and Pregnancy (CAP) in Baltimore, Maryland. These interviews also prompted participants to consider which network members to invite to the program to support recovery efforts. Results Study participants reported that their personal social networks included 4.4 drug-free adults. An overwhelming majority (80%) of participants reported a willingness to invite at least one person to the CAP program. Participants also endorsed several opportunities for collaboration between the program and community support. Conclusions These findings suggest that treatment program guided activation of network support offers a testable strategy to help perinatal women reduce barriers to recovery and improve treatment outcomes.