Age Of First Drug Use Research Articles

Sexual Orientation and Age of First Drug Use Among Adults in the United States

Background Early onset of drug use could lead to long-term impairments, and research suggests that substance use and substance use disorders are more common among lesbian, gay, and bisexual (LGB) individuals. We sought to determine whether adults of different sexual identities were at differential risk for an earlier onset of drug use. Methods We examined data from adults participating in the five waves (2015–2019) of the National Survey on Drug Use and Health, a nationally representative sample of noninstitutionalized adults in the United States. We determined whether current sexual identity was associated with retrospectively reported age of the first use of marijuana, cocaine, inhalants, ecstasy, and methamphetamine. Results Compared to heterosexual individuals of the same sex, gay men had a later age of onset of use of all five drugs examined (marijuana, cocaine, inhalants, ecstasy, and methamphetamine) and bisexual men had a later onset of marijuana and inhalant use. Bisexual women had earlier age of onset for marijuana, cocaine, and ecstasy use. When examining early initiation (prior to age 15), both lesbian and bisexual women had greater odds of early initiation for marijuana, cocaine, and ecstasy; bisexual men had greater odds of early initiation for cocaine. Gay men had lower odds of initiation prior to age 15 for marijuana, inhalants, and methamphetamine. Conclusions Current sexual identity is a correlate of earlier onset drug use. Longitudinal research is needed to further examine such associations as sexual identity can shift over time. Results are discussed in relation to prevention efforts aiming younger LGB persons.

Setting the policy agenda for the treatment of substance use disorders in Iran

BackgroundDrug use is one of the most common public health problems globally. This study was done to analyze the agenda-setting of policies related to substance use disorder treatment in Iran since 1979.MethodsThe current qualitative study was done through document review and interviews with policymakers and executives. Purposive sampling with snowball strategy was considered for sampling. Semi-structured interviews were done. A total of 22 documents were examined, and the data were saturated with 32 interviews. Kingdon's Multiple Streams Framework was used to analyze the data.ResultsThe results indicated the intersection of problem stream, policy stream, political stream, and opening the opportunity window. In the problem stream, the rapid growth of AIDS among people who inject drugs (PWID), the decrease in the average age of first drug use, the increase in the prevalence of substance use disorder in women, the ineffectiveness of compulsive treatment, and criminological perspectives played key roles. The policy stream included criminological perspective and war on drugs, and harm reduction. The political stream included announcing general anti-narcotics policies by the Supreme Leader of Iran and understanding the need for treatment, rehabilitation, harm reduction, and social support for substance use disorder by officials and policymakers.ConclusionsFor a long time in Iran, policies based on the war on drugs were the dominant approach, and then, policies based on harm reduction and patient-centeredness were considered. The ideology and political parties influenced the executive apparatus's policy stream in this area. In countries with an ideological approach, the political stream plays a critical role in setting issues on the agenda. Therefore, policy entrepreneurs can put the points on the agenda by attracting the attention of political forces to the issue.

International Multicenter Study on Drug Consumption in Nursing Students.

Background: The prevalence of illicit drug use among young people is high, with many being highly vulnerable to substance abuse. The nursing profession is not immune to the impacts of substance misuse. Knowing the current levels of consumption of illicit drugs in nursing students will allow for the introduction of preventive actions. Methods: Multi-center, descriptive, and cross-sectional study involving nursing schools from four different countries (Spain, Belgium, France, and Brazil). A total of seven centers participated. An adapted version of the Global School-based Student Health Survey (GSHS) was used as a tool, which selected only the module on illicit drugs. Standard logistic regression analysis was performed. Results: A total of 496 nursing students participated in the study. Illicit drug shows positive representation among nursing students. A significant difference was observed between the gender and the age of first drug use, illicit drug consumption, cannabis use, and cocaine use ever in life, with higher use of illicit drugs by male, although at later ages than girls. The bivariate analysis, gender, problems as result of drugs, and nationality were significantly associated with the consumption of illicit drugs, cannabis, cocaine, and ecstasy ever in life. Conclusions: High rates of illicit drug use were found among nursing students, as well as factors that can influence consumption such as nationality or gender. These results can serve as a basis for the development of educational and policy interventions within nursing schools that are based on evidence, with significant implications for nurse educators, academic administrators, and practice.

Profil dan Pengalaman Menggunakan Dadah dan Keterlibatan Jenayah Dalam Kalangan Banduan Melayu di Malaysia

The problem of drug use and crime worries many people as it threatens the well-being, harmony and security of the country and society. Over the years, this problem has been often associated with Malays compared to other ethnics. This study aims to identify the profiles and experiences of drug use and crime among Malay offenders. The study was conducted using a quantitative cross-sectional survey. A total of 301 Malay offenders who were charged for drug-related offences and serving their sentences in the Malaysian Prison Department were selected to participate in the study. The study has found that the majority of offenders involved in drug use and crime offences are young people aged 21-39 years old, unmarried, attained at least lower and/or upper secondary education SRP/SPM, employed prior to custody, and had income below than RM3,850 per month (B40). Based on their experiences of drug use, most offenders reported that they obtain drugs from the dealers and the average age of first drug use is between 30 to 35 years old. Methamphetamine is a popular drug used by majority of Malay offenders, and it is due to incredible enjoyment and peer pressure. The study also reported offenders spent between RM50 and RM100 to buy drugs in a day. Based on the experiences of crime, most of offenders reported to commit crimes at least twice a week and preferred to commit crime alone than in groups. The type of crime offences reported by most of Malay offenders are drug dealing, theft and burglary instead of drug use. Findings of this study have implications for the implementation of effective intervention and management offenders in terms of providing counseling services, skills, education, prevention, treatment and rehabilitation among offenders.

The determinants of methadone maintenance treatment in opioids dependence users: A survival analysis study.

Background: Staying in treatment is one of the basic principles in maintenance treatment with methadone and it is considered as a success criterion in the treatment procedure. This study aimed at analyzing effective determinants on staying in treatment in methadone treatment procedure. Methods: This was a retrospective cohort study, in which 6 MMT centers were randomly selected to be studied. The data were collected using the patients' medical records. Therefore, 1008 medical record files belonging to the patients who received methadone treatment from April 2013 to August 2017 were investigated. Proportional hazard Cox regression (extended) was used to specify the determinants of the methadone maintenance treatment and STATA 11 was used for data analysis. Results: The patients' mean age was 38.8 years (±1.08), and 75.8% were married and only 39.1% had full-time jobs. The mean age for the first substance abuse was at 24.31years (±7.93). The average time of staying in the treatment was 28.8 months. The results of the adjusted Cox proportional hazards regression showed among the 14 variables entered into the model, in the 1-12-month interval age of first drug use (HR=0.945, 95 % CI=0.908-0.983, p=0.005), specific drug use (HR=1.14, 95 % CI=1.026-1.268, p=0.014), and the frequency of treatment (HR=0.974, 95 % CI=0.959-0.990, p=0.002) were significantly correlated with survival status. The 13-36- month interval drug use (HR=0.931, 95 % CI=0.886-0.978, p=0.005) was significantly correlated with survival status. Also, the range of 37-53 month drug use (HR=1.058, 95 % CI=1.001-1.119, p= .044) had a significant relationship with survival status. Conclusion: This study showed age of first drug use, specific drug use, the frequency of treatment and drug use were correlated with a decrease in staying duration in treatment. Therefore, taking these factors into consideration in designing and administering various interventions in addiction treatment and consulting centers is of paramount importance.

The determinants of methadone maintenance treatment in opioids dependence users: A survival analysis study.

Background: Staying in treatment is one of the basic principles in maintenance treatment with methadone and it is considered as a success criterion in the treatment procedure. This study aimed at analyzing effective determinants on staying in treatment in methadone treatment procedure. Methods: This was a retrospective cohort study, in which 6 MMT centers were randomly selected to be studied. The data were collected using the patients’ medical records. Therefore, 1008 medical record files belonging to the patients who received methadone treatment from April 2013 to August 2017 were investigated. Proportional hazard Cox regression (extended) was used to specify the determinants of the methadone maintenance treatment and STATA 11 was used for data analysis. Results: The patients’ mean age was 38.8 years (±1.08), and 75.8% were married and only 39.1% had full-time jobs. The mean age for the first substance abuse was at 24.31years (±7.93). The average time of staying in the treatment was 28.8 months. The results of the adjusted Cox proportional hazards regression showed among the 14 variables entered into the model, in the 1-12-month interval age of first drug use (HR=0.945, 95 % CI=0.908-0.983, p=0.005), specific drug use (HR=1.14, 95 % CI=1.026-1.268, p=0.014), and the frequency of treatment (HR=0.974, 95 % CI=0.959-0.990, p=0.002) were significantly correlated with survival status. The 13-36- month interval drug use (HR=0.931, 95 % CI=0.886-0.978, p=0.005) was significantly correlated with survival status. Also, the range of 37-53 month drug use (HR=1.058, 95 % CI=1.001-1.119, p= .044) had a significant relationship with survival status. Conclusion: This study showed age of first drug use, specific drug use, the frequency of treatment and drug use were correlated with a decrease in staying duration in treatment. Therefore, taking these factors into consideration in designing and administering various interventions in addiction treatment and consulting centers is of paramount importance.

Addiction is a brain disease, and it doesn’t matter: Prior choice in drug use blocks leniency in criminal punishment.

Our aim was to explore how (neuro)scientific understanding of addiction as a brain-disease impacts criminal sentencing decisions in courts in England and Wales, where legal rules concerning intoxication, prior-fault and mental disease conflict, and sentencing guidelines lack clarity. We hypothesized that despite significant neuropsychiatric overlap of addiction and other brain-disorders, variables in relation to etiology would moderate magistrates’ sentencing decisions in cases involving addicted offenders. Using a questionnaire-based, quantitative design, and combining frequentist and Bayesian analysis approaches, we probed court magistrates’ sentencing decisions, and underlying rationale, for defendants presenting with brain damage resulting from a (fictional) disease, addiction to heroin, or more complex, mixed etiologies. When identical neuropsychiatric profiles resulted from disease, but not heroin addiction, prison sentences were significantly reduced. Study 1 (N=109) found the pivotal factor preventing addiction from mitigating sentences was perceived choice in its acquisition; removing choice from addiction increased the odds of sentence reduction (~20- fold) and attaching choice to disease aggravated or reversed earlier leniency. Study 2 (N=276) replicated these results and found that when heroin use led to disease or vice versa, magistrates found middle ground. These differences were independent of the age of first drug use. Finally, evidence of addiction was more likely to evoke punishment considerations by magistrates, rather than rehabilitation. Consistent with legal rules relating to intoxication but running counter to norms around mental-illness and choice, our results demonstrate the need for greater clarity in sentencing guidance on addiction specifically, and mental disorders more generally.

Факторы вовлечения в проституцию в несовершеннолетнем возрасте: результаты эмпирического исследования взрослых женщин

Проституция рассматривается исследователями с позиций одной из основных парадигм: как девиация, как секс-работа или как насилие. Однако если речь идет о несовершеннолетних, то международные нормативные документы однозначно трактуют проституцию как форму сексуальной эксплуатации. На материалах эмпирического исследования взрослых женщин, занимающихся проституцией в Санкт-Петербурге и Оренбурге (N = 654), мы изучили обстоятельства начала занятия проституцией в зависимости от возраста начала – до 18 лет или старше. В исследование были включены взрослые женщины, занимающиеся проституцией на улицах, в гостиницах, салонах, на вокзалах и индивидуально. Влияние различных факторов на начало занятия проституцией в возрасте до 18 лет оценивалось с помощью критерия согласия χ2 Пирсона и бинарного логистического регрессионного анализа. Каждая десятая женщина в выборке начала заниматься проституцией до наступления совершеннолетия. Первый опыт оказания сексуальных услуг за деньги респонденты, независимо от возраста начала занятия проституцией, в половине случаев оценивают как недобровольный (из-за уговоров, давления или применения силы). Основными факторами вовлечения в проституцию в возрасте до 18 лет являются семейное неблагополучие, ранний возраст пробы наркотиков и др. Мы заключаем, что группа женщин, занимающихся проституцией, неоднородна. Жизненные траектории, приводящие в проституцию детей и взрослых, могут существенно различаться. Жесткая теоретическая позиция, основанная на обобщении всех женщин, занимающихся проституцией, как жертв, «девиантов» или работниц, неминуемо игнорирует потребности и интересы части из них. В современной российской социальной политике проституция рассматривается как девиация, которая запрещена и влечет за собой административную ответственность. Общественно-политические дискуссии о мерах контроля проституции включают в себя обсуждение как легализации, так и ужесточения контроля и наказания за проституцию, однако вопросы профилактики вовлечения, а также помощи на этапе «выхода» из проституции незаслуженно исключены из этой дискуссии.

Gang Involvement and Drug Use Histories Among People Who Inject Drugs in California: A Retrospective Analysis

We examined whether gang membership history was associated with earlier age of first drug use, first drug injection, and shorter time to injection (TTI) drug use among people who inject drugs (PWID). PWID ( N = 438) were interviewed in California (2011-2013). Surveys addressed demographics, current/former drug use practices, gang membership, and parental drug use. Multivariate analyses were conducted to identify whether gang membership history was associated with age at first drug use, first injection drug use, and TTI. Gang membership was reported by 23% of sample. Gang membership history was associated with earlier ages of first drug use (–1.35 years; 95% confidence interval [CI]= [−0.50, −2.20]), age at first injection (–1.89 years; 95% CI = [0.00, −3.78]), but not TTI. Gang involvement facilitates drug use including earlier age of first injection drug use.

The Current Substance Abuse Trends in Russia and the West

This paper selects and analyzes the key trends of current substance abuse that are most widespread in western European countries, the USA, Canada, and Russia, while also reviewing their differences and similarities. Foreign case studies, along with the results of analyzing the most prominent trends of substance abuse, must be accounted for when designing the optimal and most efficient measures for impacting the current drug abuse situation and eliminating its negative consequences. This paper examines the motivations and factors that encourage substance abuse; the phenomenon of substance abuse normalization; and the problems with identifying modern drug addicts that may arise as they try to adapt their behavior. The paper is based on a secondary analysis of several surveys among the working-age population (2013, 2016, 2017), as well as a college youth survey, entitled “The Student Lifestyle: Behavior Risks” (Ivanovo, Krasnodar, Moscow, Rybinsk, Chita, Yaroslavl). All of the above studies were conducted by the deviant behavior sociology sector of the RAS Federal Sociology Research Center. In addition, we considered surveys of college students in the USA and students in higher education in Canada. The analysis shows that: the age of first drug use is shifting upwards, which signifies that people are consciously deciding to consume addictive substances as mature individuals; there is an emerging trend of people aged 50 and over being introduced to addictive substances; the most popular motivation for consuming such substances is hedonism, i.e. the desire for pleasure; the attitude towards substance abuse is growing more and more tolerant, as introduction to recreational psychoactive drugs is becoming a fact of life and drug use is being integrated into society; modern substance abuse patterns still remain largely latent. We also consider foreign researchers’ insights, which warrant attention as we analyze the situation regarding substance abuse in Russian society and work on an effective anti-drug and addiction prevention policy.

Methadone Dosage and Plasma Levels, SNPs of OPRM1 Gene and Age of First Drug Use Were Associated With Outcomes of Methadone Maintenance Treatment.

Objective: To explore the association between methadone dosage, plasma drug concentration, SNPs of μ-opioid receptor gene (OPRM1), ATP-binding cassette subfamily B member 1 gene (ABCB1), and methadone maintenance treatment (MMT) response.Method: A total of 240 Chinese Han participants receiving MMT were recruited from Shanghai. Nine single nucleotide polymorphisms (SNPs) of the OPRM1 gene and three SNPs of the ABCB1 gene were genotyped, plasma methadone concentration was detected, and a morphine urine test was taken from all subjects.Results: Methadone dosage, plasma methadone concentration, and negative rate of morphine urine test of retention participants were significantly higher, although the addiction severity index (ASI) was not significantly different between the two groups. A allele and AA genotype carriers of rs562859 (OPRM1 gene) had better compliance of MMT, and AA genotype carriers had a higher negative rate of morphine urine test. However, the difference was not significant after adjusting influence factors (age, sex, and methadone dosage). GG genotype carriers of rs3192723 (OPRM1 gene) had a significantly lower negative rate of morphine urine test, and the difference was still significant after adjusting influence factors. Logistic regression analysis showed that methadone-free trough concentration (OR = 0.910, p = 0.023) and AA genotype of rs526859 (OR = 0.580, p = 0.037) were associated with better compliance of MMT. After Bonferroni correction, only free trough concentration of methadone was negatively correlated with MMT compliance. The SNPs rs6912029 (OR = 0.021, p = 0.066) and rs6902403 (OR = 0.910, p = 0.007) of the OPRM1 gene, age at first use (OR = 1.118, p = 0.005), and average methadone dosage (OR = 1.033, p = 0.045) were associated with MMT effect. After Bonferroni correction, average methadone dosage was no longer correlated with MMT effect.Conclusion: Dosage of methadone, plasma methadone concentration, several SNPs (rs3192723, rs6912029, rs6902403) of the OPRM1 gene, and age of first drug use were associated with better MMT outcomes.

Modelling opportunity: An examination of quadratic effects of adolescent Venezuelan substance use.

Numerous studies have found a linear relationship between an exposure opportunity and age of first drug use. This study further tests this relationship by exploring whether a quadratic exposure opportunity best fits the data on age of first use and whether gender moderates this relationship. That is, is there a peak age in which the transition to use occurs for male compared to female adolescents? A sample of 1716 adolescents from 14 public and private schools, representative of two school districts in Caracas, Venezuela, was examined using a zero-inflated Poisson modelling approach to test for quadratic effects. A series of models were tested for each set of substances (alcohol, tobacco and other drugs) to assess whether a quadratic model has better predictive ability than linear models and to test whether gender moderates the quadratic relationship. After controlling for common covariates, the quadratic models for alcohol indicated the peak age of transition from an exposure opportunity to use was 10-years of age in this Venezuelan sample. Gender did not moderate these models suggesting an important move toward gender equality in substance use. Focused efforts on preventing exposure to alcohol use during these windows of rapid transition is likely to have the greatest impact on delaying age of onset, which will reduce the overall prevalence of alcohol related problems among adolescents.

Transition from First Drug Use to Regular Injection among People Who Inject Drugs in Iran.

BackgroundThe study aimed to evaluate the interval between first drug use and regular injection and factors associated with transition from first injection into premature regular injection among people who inject drugs (PWIDs).MethodsIn a multicenter cross-sectional study, we recruited 400 PWIDs using snowball sampling. Age of first drug use, age of initiation of regular injection, and demographic and behavioral data were collected using face to face interview. Premature transition to regular injection was defined as initiation of regular injection within the five years of first injection. Data were analyzed using bivariate and multivariate logistic regression survey analysis.FindingsThe mean age of first drug use and age of initiation of regular injection was 29.87 ± 6.54 years, respectively. Having history of sexual abuse in childhood [adjusted odds ratio (AOR) = 3.1], history of imprisonment (AOR = 3.4), use of heroin as the first drug (AOR = 4.3), and doing the first injection at friends’ houses (AOR = 2.2) or in ruins (AOR = 2.2) significantly increased the chance of premature transition to regular injection, while being a female decreased the chance of premature transition to regular injection (AOR = 0.4). Compared to curiosity, being friend with a drug user (AOR = 0.4), having withdrawal symptoms (AOR = 0.2), and low cost of injection (AOR = 0.3) at the first occasion of drug injection reduced the chance of premature transition to regular injection.ConclusionNew interventions to prevent injection initiation among drug users are needed and should be integrated in harm reduction programs.

Associations Between Family History of Substance Use, Childhood Trauma, and Age of First Drug Use in Persons With Methamphetamine Dependence.

The current study examined the association among family history of substance use problems, childhood maltreatment, and age of first drug use in a sample of men and women seeking treatment for methamphetamine dependence. Various forms of childhood maltreatment were considered as mediators of the association between family history of substance use problems and age of first drug use. Participants (N = 99, 40% women, mean age 33) who were under treatment for methamphetamine dependence completed a baseline interview that obtained demographic information, past substance use by participants, history of drug/alcohol problems in their family of origin, and age at first use of any drug (excluding alcohol and tobacco). The Early Trauma Inventory Self-Report-Short Form was used to assess child maltreatment experiences before the age of 18. Family history of substance use problems and childhood physical (but not emotional or sexual) trauma significantly predicted age of first drug use. Further, childhood physical trauma mediated the association between family history of substance use problems and age of first drug use. These findings suggest that the experience of childhood physical abuse may be an important mechanism through which family history of substance use is associated with an earlier age of first drug use.

Using Client's Routine Urinalysis Records From Multiple Treatment Systems to Model Five-Year Opioid Substitution Treatment Outcomes

ABSTRACT Background: At global, national, and local level, the need for ongoing, timely and cost efficient, comprehensive drug treatment monitoring, and evaluation systems have clearly been well recognized. Objectives: To test the feasibility of linking laboratory data and client intake data and its usefulness for modeling retrospectively, for the first time, 5-year longitudinal drug treatment outcomes in an Irish opiate treatment setting. Methods: A multisite, retrospective, longitudinal cohort study was implemented to evaluate outcomes for opiate users based on 1.7 million routine urinalysis results collected from 4,518 individuals presenting for opioid substitution treatment in Ireland from January 2006 to December 2010. Results: Analysis of opiates, cocaine, benzodiazepine, and cannabis use at treatment intake, 6 months and at 1–5 year follow-ups revealed differences in urinalysis protocols; significant differences in age of first drug use between those using and not using opiates at 5 years; significant decreases in opiate use; increases in benzodiazepine use and significant increasing effects of concurrent cocaine and benzodiazepine use on the odds of using opiates. Time series analysis of weekly proportions opiate positive predicted 16% (95% confidence interval: 7%–25%) of clients would be opiate positive 5 years postinitial intake. ConclusionsImportance: Underutilized urinalysis data can be used to address the need for cost effective, efficient evidence of drug-treatment outcomes across time, place, and systems. Linking and matching the cross-sectional data across sites and times also revealed where improvements in electronic records could be made.

Gaze time as a sensitive measure of cocaine-related attentional bias

imum prescribed daily dose, and average daily equivalent dose received (total dose received per patient/number of days of treatment episode) for 8811 patients who had at least one dose of methadone in one of Wuhan’s 20 MMT programs in 2010. For patientswhohadoneormorenewtreatment episodesduring2010, we calculated initial methadone dose for new treatment episodes. Results: Over 1.3 million doses of methadone were administered to 8811patients. Patient characteristics at entry:mean age 41 years (SD 7.3); 70.6% male; 43.3% married; 73.2% live with family; 69.8%with ‘middle school’ or less education;modal age of first drug use 28 (SD 7.4) and mean duration of drug use 13.2 years (SD 5.5); 62.5% had injection drug use in the pastmonth. 74%wereHCVpositive and 0.28%wereHIV positive. 83% had only 1 treatment episode in 2010, 12.2% had 2 and 1.3% had 4 or more episodes within the year (range 1–7 episodes); 7% of treatment episodes lasted only one day. The modal maximum dose was 80mg of methadone per day, with themeanmaximumdoseof77mg(range5–235mg), anddaily equivalent dose per treatment episode was 39.6mg methadone (SD 24.1). For those who had a new treatment episode in 2010 (1475/8811), the mean starting dose for a new treatment episode was 65.5mg (SD 25.8). Conclusions: The rapid expansion of MMT in China has attracted a large number of admissions, but provision of safe and effective methadone dosages and optimizing treatment outcomes (e.g., retention) are identified as priority areas for improving treatment. Financial support: Supported by NIDA DA026797 & CMHC/DMHAS/State of Connecticut.

A Randomized Trial of Extended Buprenorphine Detoxification for Opioid Dependency

: The objective of this study was to determine whether additional "take-home" medication after inpatient opioid detoxification would lead to improved rates of subsequent treatment initiation and abstinence. : We randomly assigned 60 inpatients to a 7-day or 37-day extension of sublingual buprenorphine/naloxone after hospitalization. Follow-up telephone interviews were conducted approximately 5 weeks after discharge. The primary outcomes were abstinence, initiation of aftercare outpatient counseling, and initiation of self-help meeting attendance. : Of the 30 participants in each group, outcome data were obtained for 25 (83%) in the 7-day extension group and 27 (90%) in the 37-day extension group. There was not a significant difference in the rates of abstinence (53% versus 41%) or initiation of self-help (57% versus 54%) between the 7-day and 37-day groups, respectively. Of those in the 7-day group, 15 (65%) initiated outpatient treatment compared with 21 (88%) of those assigned to the 37-day group. Although not significant in unadjusted analysis (P = 0.093), this difference was significant in regression analysis when controlling for a history of intravenous drug use (P = 0.034). Among all participants, individual characteristics at the time of hospital admission (eg, age of first drug use, previous history of intravenous drug, type of health insurance) were predictive of outcomes. : In this preliminary study, additional medication beyond a week after inpatient detoxification was not associated with clinically important improvements in rates of abstinence or treatment initiation. Baseline patient characteristics seem to affect these clinical outcomes after hospitalization.

Patterns of drug use among a sample of drug users and injecting drug users attending a General Practice in Iran

AimThis study aimed to examine drug use, drug treatment history and risk behaviour among a sample of Iranian drug users seeking treatment through a general practice clinic in Iran.MethodsReview of medical records and an intake questionnaire at a large general practice in Marvdasht, Iran, with a special interest in drug dependence treatment. Records from a random sample of injecting drug users (IDU), non-injecting drug users (DU) and non-drug using patients were examined.Results292 records were reviewed (34% IDU, 31% DU and 35% non-drug users). Eighty-three percent were males; all females were non-drug users. The mean age of the sample was 30 years. Of the IDU sample, 67% reported sharing a needle or syringe, 19% of these had done so in prison. Of those who had ever used drugs, being 'tired' of drug use was the most common reason for seeking help (34%). Mean age of first drug use was 20 years. The first drugs most commonly used were opium (72%), heroin (13%) and hashish/ other cannabinoids (13%). Three quarters reported having previously attempted to cease their drug use. IDU were more likely than DU to report having ever been imprisoned (41% vs 7%) and 41% to have used drugs in prison.ConclusionThis study has shown that there is a need for general practice clinics in Iran to treat drug users including those who inject and that a substantial proportion of those who inject have shared needles and syringes, placing them at risk of BBVI such as HIV and hepatitis C. The expansion of services for drug users in Iran such as needle and syringe programs and pharmacotherapies are likely to be effective in reducing the harms associated with opium use and heroin injection.

Substance Abuse among Rural and Very Rural Drug Users at Treatment Entry

Historically, researchers and policymakers concerned with the problems of substance abuse have focused their attention almost exclusively on urban America. However, this focus now includes the special needs of rural areas. In the past, rural areas were more sheltered from the problems of mainstream America, but now, mass communication has decreased the isolation of rural areas. The purpose of this study is to examine rural and very rural drug users; including:demographic and other selected background characteristics of rural and very rural drug users admitted to substance abuse treatment,lifetime drug use patterns,current drug use,age of first drug use,recognition of drug abuse as a problem, andcorrelates of drug use behavior to identify potential predisposing factors.It was hypothesized that drug users from very rural areas would be more sheltered and the severity of their involvement with drug use would be less than that of drug users from rural areas. Between November 15, 1999 and January 31, 2001, face-to-face interviews were conducted in three geographic regions of Kentucky (N = 604); eastern Kentucky (n = 206), south central Kentucky (n = 165)—both frequently are considered rural (n = 371)—and Western Kentucky, which is considered more urban (N = 233). Over half of the participants were admitted to outpatient treatment (57%). The majority of participants were male (75%), White (94%), had no religious preference (51%), had been referred to by the criminal justice system (64%), and had a history of prior substance abuse treatment (55%). Findings indicate that being from very rural areas may be somewhat protective with lower current drug use and older age at drug use initiation. While alcohol remains the most used substance in terms of lifetime and current use, cocaine use was three times higher in rural areas than in very rural areas. Implications are discussed and recommendations are presented for substance abuse treatment providers and policymakers.

Drug problems and "at risk" women's involvement in HIV risk behaviors.

This paper focuses on two research questions: is there a relationship between women's number of drug problems and the extent to which they engage in HIV risk behaviors? What factors influence the extent to which women experience drug-related problems? This study is based on 250 adult "at risk" women (predominantly African American) in the Atlanta, Georgia metropolitan area. Street outreach efforts, targeted sampling, and ethnographic mapping procedures were used to identify potential study participants. The more drug problems women experienced, the greater their involvement in HIV risk behaviors was. The number of drug problems experienced was a significant contributor to the model predicting women's HIV risk involvement, along with religiosity, living with substance abusers, and age of first drug use. Depression, optimism, coping with stress, and number of different drugs used predicted the extent to which women experienced drug problems. Drug problems are an important predictor of women's involvement in HIV risk behaviors. Programs wishing to reduce their risk for contracting HIV should target drug-involved women and help them to stop using drugs.