Alcohol Involvement Research Articles

Mapping prescription drug monitoring program data to self-report measures of non-medical prescription opioid use in community pharmacy settings

BackgroundCommunity pharmacists are well-positioned to identify patients engaged in non-medical prescription opioid use (NMPOU) through Prescription Drug Monitoring Program (PDMP) databases. Integrating patient-reported outcomes with PDMP data may improve the interpretability of PDMP information to support clinical decision-making. ObjectiveThis study linked patient-reported clinical measures of substance use with PDMP data to examine relationships between average daily opioid dose in morphine milligram equivalents (MME) and visits to multiple pharmacies/prescribers with self-reported NMPOU. MethodsData from a cross-sectional health assessment given to patients aged ≥18 years filling opioid prescriptions were linked to PDMP records. NMPOU in the past three months was assessed on a continuous scale (range 0–39) using an adapted version of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). PDMP measures included average daily MME and number of distinct pharmacies/prescribers visited in the past 180 days. Univariable and multivariable zero-inflated negative binomial models estimated associations between PDMP measures and any NMPOU and severity of use. ResultsThe sample included 1421 participants. In multivariable models adjusted for sociodemographic, mental health, and physical health characteristics, any NMPOU was associated with higher average daily MME (adjusted OR = 1.22, 95% CI = 1.05–1.39) and number of distinct prescribers visited (adjusted OR = 1.15, 95% CI = 1.01–1.30). Higher average daily MME (adjusted mean ratio (MR) = 1.12, 95% CI = 1.08–1.15), number of distinct pharmacies visited (adjusted MR = 1.11, 95% CI = 1.04–1.18), and number of distinct prescribers visited (adjusted MR = 1.07, 95% CI = 1.02–1.11) were associated with increased NMPOU severity. ConclusionsWe observed significant, positive associations between average daily MME and visits to multiple pharmacies/prescribers with any NMPOU and severity of use. This study demonstrates self-report clinical measures of substance use can be cross-walked to PDMP data and translated into clinically interpretable information.

Bayesian Network for Motorcycle Crash Severity Analysis

Given the lack of protective structural barriers and advanced restraints, motorcyclists are vulnerable road users. In 2020 in the United States, motorcycle-involved fatalities occurred 28 times more frequently per vehicle mile traveled than passenger car occupant fatalities, causing 5,579 motorcycle-related fatalities—the highest number of motorcyclists killed since 1975. By identifying patterns and relationships between key contributing factors, strategies for reducing motorcycle crashes can be developed. In addition to current efforts, additional research must be conducted using innovative avenues, with increased funding. Bayesian networks can better discover the relationships between potential speed compliance variables. This study used six years (2014 to 2019) of motorcycle crash data in Louisiana to determine the conditional probabilities of the influential factors. In addition to the high contribution of alcohol involvement, two-way undivided roadways, 35 to 44 year-old drivers involved in improper driving behaviors, and crash types are the underlying factors associated with a considerable increase in motorcycle crash severity. The findings of this study can also be used for decision making and strategy development for motorcycle safety.

Pre-pandemic circadian phase predicts pandemic alcohol use among adolescents.

Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depression and alcohol. We used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing showed improvements in sleep, depression and alcohol involvement. Participants were 42 adolescents reporting alcohol use. We assessed circadian phase via dim light melatonin onset prior to the pandemic, then conducted remote assessments of sleep, depressive symptoms and alcohol use during the pandemic. Mixed-effects models were used to test for pandemic effects, covarying for age, sex, time since baseline evaluation, and current school/work status. Adolescents with later circadian timing reported less sleep than other teens on school nights, both before and during the pandemic. Although school night sleep increased during the pandemic (F = 28.36, p < 0.001), those increases were not greater for individuals with later circadian timing. Individuals with later circadian timing reported larger increases in alcohol use than other teens during the pandemic (X2 = 36.03, p < 0.001). Depressive symptoms increased during the pandemic (X2 = 46.51, p < 0.001) but did not differ based on circadian timing. Consistent with prior reports, adolescents with later circadian timing obtained less sleep, and later school schedules facilitated increased sleep duration. Nonetheless, individuals with later circadian timing reported the sharpest increases in alcohol use, suggesting that circadian timing contributes to risk for alcohol use beyond the effects of insufficient sleep.

A Cross Sectional Study into Drug Abuse among Youth and Its Association with Socio-demographic and Risk Factors in District Kangra of Himachal Pradesh, India.

Aim: Substance abuse has a detrimental impact on an individual, families and communities posing major public health challenges. Therefore, the present study has been designed to study the level of prevalence of drug abuse among youth and its association with socio demographic and various risk factors.&#x0D; Methodology: The present research was conducted among 500 students in the age range of 12-25 years. The study was conducted in district Kangra of Himachal Pradesh, India. Out of total 15 blocks from Kangra, five blocks were randomly selected. From these selected blocks five schools and five colleges (one school and one college from each block) were selected for data collection. “The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)” and self-structured questionnaire were administered to the sample to collect data.&#x0D; Results: It was revealed that tobacco was the most abused substance (29.2%) followed by alcohol (28.2%) and inhalants (11.8%). Less than 10 per cent of sample used other substances at least once in their lifetime. Moderate level of drug prevalence of drugs was found among study subjects. A highly significant association was observed between factors like age, type of educational institutes, mother’s occupation, bad company, peer pressure, curiosity, and use of drugs by parents with prevalent drug abuse among youth.&#x0D; Conclusion: It was concluded from the results that use of varied drugs like tobacco, alcohol, inhalants was found to be prevalent among youth. Moderate level of prevalence was reported for drugs like tobacco, cannabis, sedatives, opioids, inhalants and amphetamines. It is a matter of concern for them as they are at risk of health and other problems from their current pattern of substance use. A brief intervention has to be provided for them in terms of awareness and treatment from health professionals or by a specialist in drug and alcohol treatment service.

Factors Associated with Work Zone Crashes

Nationally, the annual number of fatal crashes in work zones over the past decade (2010–2019) increased from 521 to 762, which led to rising fatalities from 546 in 2010 to 842 in 2019. Traffic safety in work zones with the aim of reducing fatal and serious injury crashes has been under investigation by researchers and related agencies for decades. The main objective of this study was to investigate the factors associated with work zone crashes to recommend policies targeted at addressing them. Data collected by the Kansas Department of Transportation on crashes that occurred between 2016 and 2020 were used for this research. For the statistical model, binary logistic regression was used in which the dichotomous response variable was defined as either crashes in work zones or crashes outside work zones. According to the model’s results, several significant factors were associated with work zone crashes. Those that had a reasonable expectation of improvement through state policies included the following: alcohol involvement; driver distraction; large commercial vehicle involvement; pedestrian involvement; single-vehicle crashes; speed limits, and speeding. Although these may already be areas targeted in a state’s strategic highway safety plan, special consideration of the overrepresentation of these factors in work zones can provide additional policy options for consideration. Existing countermeasures can be explored, or new countermeasures can be developed based on the needs of the existing conditions.

Cannabis use and psychotic disorders in diverse settings in the Global South: findings from INTREPID II.

Cannabis use has been linked to psychotic disorders but this association has been primarily observed in the Global North. This study investigates patterns of cannabis use and associations with psychoses in three Global South (regions within Latin America, Asia, Africa and Oceania) settings. Case-control study within the International Programme of Research on Psychotic Disorders (INTREPID) II conducted between May 2018 and September 2020. In each setting, we recruited over 200 individuals with an untreated psychosis and individually-matched controls (Kancheepuram India; Ibadan, Nigeria; northern Trinidad). Controls, with no past or current psychotic disorder, were individually-matched to cases by 5-year age group, sex and neighbourhood. Presence of psychotic disorder assessed using the Schedules for Clinical Assessment in Neuropsychiatry and cannabis exposure measured by the World Health Organisation Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Cases reported higher lifetime and frequent cannabis use than controls in each setting. In Trinidad, cannabis use was associated with increased odds of psychotic disorder: lifetime cannabis use (adj. OR 1.58, 95% CI 0.99-2.53); frequent cannabis use (adj. OR 1.99, 95% CI 1.10-3.60); cannabis dependency (as measured by high ASSIST score) (adj. OR 4.70, 95% CI 1.77-12.47), early age of first use (adj. OR 1.83, 95% CI 1.03-3.27). Cannabis use in the other two settings was too rare to examine associations. In line with previous studies, we found associations between cannabis use and the occurrence and age of onset of psychoses in Trinidad. These findings have implications for strategies for prevention of psychosis.

The health needs of people leaving prison with a history of methamphetamine and/or opioid use.

Methamphetamine use is more common than opioid use among prison entrants in some countries, including Australia, yet most research and policy focuses on opioid use. This suggests that traditional opioid-focused interventions are no longer appropriate for the majority of this group in countries such as Australia. To inform policy and practice, we compared socio-demographic characteristics and health needs of people leaving prison with a history of methamphetamine use and/or opioid use. A cross-sectional survey of incarcerated adults administered the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test was used to identify moderate-/high-risk methamphetamine use (n=909), opioid use (n=115) or combined methamphetamine/opioid use (n=356) before incarceration. We compared groups using modified log-linked Poisson regression with robust error variance. Compared to the opioid-only group, the methamphetamine-only group were: significantly more often aged <25 years; significantly more likely to identify as Indigenous; significantly less likely to have a history of prior incarceration, drug injection or overdose. A significantly lower proportion of methamphetamine-only and methamphetamine-and-opioid participants self-reported current hepatitis C infection compared to opioid-only participants. A majority of participants in all groups screened positive for current psychological distress according to the K10. People leaving prison with a history of methamphetamine use differ from opioid users with respect to demographics, patterns of substance use and related health concerns. Treatment and harm reduction efforts for people who experience incarceration must respond to patterns of drug use in this population, and invest at scale in coordinated, continuous services for co-occurring substance use and mental health problems.

Alcohol, tobacco and drug use among adults experiencing homelessness in Accra, Ghana: A cross-sectional study of risk levels and associated factors.

Substance use contributes to poor health and increases the risk of mortality in the homeless population. This study assessed the prevalence and risk levels of substance use and associated factors among adults experiencing homelessness in Accra, Ghana. 305 adults currently experiencing sheltered and unsheltered homelessness in Accra aged ≥ 18 years were recruited. The World Health Organization's (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess substance use risk levels. Association of high-risk substance use with sociodemographic, migration, homelessness, and health characteristics were assessed using logistic regression. Nearly three-quarters (71%, n = 216) of the sample had ever used a substance, almost all of whom engaged in ASSIST-defined moderate-risk (55%) or high-risk (40%) use. Survivors of physical or emotional violence (AOR = 3.54; 95% confidence interval [CI] 1.89-6.65, p<.001) and sexual violence (AOR = 3.94; 95%CI 1.85-8.39, p<.001) had significantly higher odds of engaging in high-risk substance use, particularly alcohol, cocaine, and cannabis. The likelihood of engaging in high-risk substance use was higher for men than women (AOR = 4.09; 95%CI 2.06-8.12, p<.001) but lower for those in the middle-income group compared to low-income (AOR = 3.94; 95%CI 1.85-8.39, p<.001). Risky substance use was common among adults experiencing homelessness in Accra, and strongly associated with violent victimisation, gender, and income levels. The findings highlight the urgent need for effective and targeted preventive and health-risk reduction strategies to address risky substance use in the homeless population in Accra and similar cities within Ghana and sub-Sahara Africa with a high burden of homelessness.

Digital screening and brief intervention for illicit drug misuse in college students: A mixed methods, pilot, cluster, randomized trial from India

Adolescence and early adulthood are vulnerable periods for substance use-related disorders later in life. The use of internet-enabled interventions can be useful, especially in low-resource settings. To examine the feasibility, acceptability, and preliminary effectiveness of single-session digital screening and brief intervention (d-SBI) for illicit drug misuse in college students and explore barriers and facilitators of d-SBI. Design: Mixed-methods, pilot cluster randomized trial. Four conveniently selected colleges were randomized into intervention and control groups. 219 students were screened, and 37 fulfilled eligibility. Twenty-four completed follow-ups. In-depth interviews were done with ten students. Intervention and Comparator: Following a digital screening, Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) based brief intervention was provided in the d-SBI group. The control group received brief education. Acceptability was assessed by direct questions and usage statistics. ASSIST scores of groups were assessed at baseline and 3 months. Inductive coding of the interview transcript was done. More than 50% of participants found d-SBI user-friendly, appropriate, and useful. Eighty percent of users, who logged in, completed screening. Per-protocol analysis showed a reduction in cannabis-ASSIST score over 3 months. The mean ASSIST score for other drugs combined did not differ significantly between groups. The difference in risk transition (moderate to low) was not significant. Qualitative analysis revealed three overarching themes- recruitment, engagement, and behavior change. Digital SBI for drug misuse is feasible among college students. d-SBI might be effective in reducing cannabis use.

Identifying Aboriginal and Torres Strait Islander offenders and victims in judicial sentencing remarks

Judicial Sentencing Remarks (JSRs) have been utilised by several researchers, as a publicly available data source, to explore topics such as alcohol and other drug involvement in intimate partner homicide; the use of therapeutic jurisprudence; narratives of mitigation for Aboriginal offenders; and the identification and impact of trauma in the sentencing of homicide offenders (to name a few). There is inconsistency in the existing literature regarding the methodology for identifying offenders as Aboriginal and/or Torres Strait Islander. Appropriate and correct identification of Aboriginal and Torres Strait Islander peoples in the criminal justice system is important because of the distinct differences in how Aboriginal and Torres Strait Islander peoples experience the criminal justice system, including sentencing and punishment. We retrospectively developed a manual algorithm to identify offenders and victims as “Aboriginal and/or Torres Strait Islander”, “non-Aboriginal and/or Torres Strait Islander” or “Unknown”. This paper provides an overview of the development and the application of the algorithm and discusses the importance of transparency in Aboriginal and Torres Strait Islander identification processes when using JSRs as a data source.

The prevalence of substance use disorders and associated characteristics among patients admitted to a psychiatric hospital in Botswana.

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

Do Dimensional Measures of Mental Health Symptoms Predict Level of Alcohol Involvement in the General Population?

Background: There is a limited understanding of what specific mental health symptoms are associated to alcohol involvement. It is important to understand how the severity of different mental health dimensions may differ, and distinguish between, levels of alcohol involvement. Objectives: (a) explore for differences in severity of mental health symptoms between those with lower, and moderate/high alcohol involvement, (b) assess the degree to which mental health dimensions can distinguish between those with lower, and moderate/high alcohol involvement, and (c) examine what mental health dimensions are related to the highest risk of moderate/high alcohol involvement. Results: 400 participants representative of the general population in the USA were recruited online through Prolific and completed the Alcohol, Smoking and Substance Involvement Screening Test and Brief Symptom Inventory. Each of the nine mental health symptom dimensions significantly differed between lower and moderate/high alcohol involvement, with the moderate/high alcohol involvement group reporting greater severity symptoms. The nine symptom dimensions in combination also significantly distinguished lower and moderate/high alcohol involvement, however only somatization offered unique predictive utility. Lastly, global distress was also able to significantly distinguish the alcohol involvement groups, albeit to a lesser accuracy compared to the collection of individual symptom dimensions. Conclusions: These findings suggest that overall mental health distress may be important to understanding alcohol involvement, however individual symptom dimensions can add further explanatory variance. In particular, somatic symptoms may offer unique utility in understanding the relationship between mental health and alcohol involvement.

The predictive validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for moderate- to high-risk cannabis, methamphetamine and opioid use after release from prison.

Illicit substance use is common among people entering prisons, as is returning to substance use after release from prison. We aimed to assess the predictive validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for returning to substance use after release from prison. A longitudinal design with baseline survey conducted between 2008 and 2010 in the 6weeks before expected prison release and up to three follow-up surveys in the 6months after release. Prisons in Queensland, Australia. A total of 1054 adults within 6 weeks of expected release from prison. The ASSIST was used to assess problematic use of cannabis, methamphetamine, heroin and other non-prescribed opioids in the 3months before incarceration. Post-incarceration substance use was measured at 1, 3 and 6months after release. We calculated the area under the receiver operating characteristic curve (AUROC) and the optimal ASSIST cut-off score for each substance, using Youden's index (J). Forty-one per cent (n = 434) of the cohort reported any substance use during follow-up: 33% (n = 344) used cannabis, 20% (n = 209) methamphetamine, 10% (n = 109) heroin and 9% (n = 97) illicit other opioids. The optimal ASSIST cut-off score was ≥ 4 for heroin, methamphetamine and cannabis and ≥ 1 for other opioids. Using these cut-offs, the AUROC was highest for heroin in predicting both any use (AUROC = 0.82) and weekly use (AUROC = 0.88) in the past 4weeks. AUROCs for other drugs ranged from 0.73 to 0.79. The ASSIST shows promise as an accurate and potentially scalable tool that may be useful for predicting a return to substance use after release from prison and could inform service delivery. The substantial rates of returning to substance use after release from prison suggest that prison serves to interrupt rather than cease substance use.

Prevalence of alcohol and drugs among drivers killed in road traffic crashes in Norway during 2011–2020

Objective Driving under the influence of alcohol or drugs is one of the main contributing causes of serious road traffic crashes (RTCs). This study aimed to investigate the involvement of alcohol and drugs in driver fatalities in Norway during 2011–2020 and compare the findings with data from the previous decade. Methods We linked the results of forensic toxicology testing for alcohol and the 17 most commonly used drugs assigned with legal limits with data on fatal road traffic crashes obtained from Statistics Norway and the Norwegian Public Roads Administration. Results The number of fatalities had decreased significantly since the previous decade, while the proportion of drivers and riders tested for alcohol and drug use increased. Blood alcohol concentrations at the legal limit or higher were found in 14.4% and psychoactive drugs were detected in 15.8% of the cases; 10.7% tested positive for illicit drugs, and 10.1% for medicinal drugs. The most prevalent illicit drugs were tetrahydrocannabinol (7.9%) and amphetamine/methamphetamine (4.7%), whereas the most prevalent medicinal drugs were clonazepam (3.7%) and diazepam (2.2%). Conclusions There was a marked reduction in the number of motor vehicle drivers killed in RTCs compared with the previous decade, and also a reduction in the prevalence of alcohol. For other substances, there were no marked changes in the prevalence.

Development and evaluation of a risk algorithm predicting alcohol dependence after early onset of regular alcohol use.

Likelihood of alcohol dependence (AD) is increased among people who transition to greater levels of alcohol involvement at a younger age. Indicated interventions delivered early may be effective in reducing risk, but could be costly. One way to increase cost-effectiveness would be to develop a prediction model that targeted interventions to the subset of youth with early alcohol use who are at highest risk of subsequent AD. A prediction model was developed for DSM-IV AD onset by age 25 years using an ensemble machine-learning algorithm known as 'Super Learner'. Shapley additive explanations (SHAP) assessed variable importance. Respondents reporting early onset of regular alcohol use (i.e. by 17 years of age) who were aged 25 years or older at interview from 14 representative community surveys conducted in 13 countries as part of WHO's World Mental Health Surveys. The primary outcome to be predicted was onset of life-time DSM-IV AD by age 25 as measured using the Composite International Diagnostic Interview, a fully structured diagnostic interview. AD prevalence by age 25 was 5.1% among the 10 687 individuals who reported drinking alcohol regularly by age 17. The prediction model achieved an external area under the curve [0.78; 95% confidence interval (CI) = 0.74-0.81] higher than any individual candidate risk model (0.73-0.77) and an area under the precision-recall curve of 0.22. Overall calibration was good [integrated calibration index (ICI) = 1.05%]; however, miscalibration was observed at the extreme ends of the distribution of predicted probabilities. Interventions provided to the 20% of people with highest risk would identify 49% of AD cases and require treating four people without AD to reach one with AD. Important predictors of increased risk included younger onset of alcohol use, males, higher cohort alcohol use and more mental disorders. A risk algorithm can be created using data collected at the onset of regular alcohol use to target youth at highest risk of alcohol dependence by early adulthood. Important considerations remain for advancing the development and practical implementation of such models.

Drug addiction among high school students in Toamasina I Madagascar in 2020

Introduction: The problematic use of psychoactive substances by high school students is currently more and more widespread social phenomenon. The dangerousness of these misuses is cognitive decline and behavioral disorders with legal consequences. The objectives of the study is to show a screening of the socio-demographic and clinical profile of high school students taking psychoactive substances in the Region of Toamasina I Madagascar. Research methods: This is a cross-sectional study carried out on a sample of population made by high school students from the Region of Toamasina I Madagascar, from the class of Second to Terminale, among 6 high schools establishments, obtained after a draw, from October 01st to November 30th, 2020. Students were asked to fill out questionnaires and submitting them immediately. The content of the questionnaires was made up of the standardized assessment items ASSIST Version 3.0 (Alcohol, Smoking, and Substance Involvement Screening Test). It was studied the social and demographic parameters with the clinical symptoms presented by high school students who reported a notion of taking or using psychoactive substances and finaly, the level of dependence on these substances. Conclusion: Almost of high school students are classified as occasional users who, during a meeting with their classmates or during a trip, would allow themselves to be convinced of the need to accept drug use as symbol of sharing and brotherhood. Sensitizations must be initiated to aware of the imminence of this dangerous health problem.

Virtual reality consumer product injuries: An analysis of national emergency department data

IntroductionThe growing popularity of virtual reality devices and increasingly widespread distribution of VR products into the home exposes users to risk of bodily harm. Safety features are integrated into the devices themselves, but the burden of cautious use rests upon the end user. The purpose of this study is to quantify and describe the array of injuries and demographics effected by the burgeoning VR industry to inform and encourage mitigation strategies. Materials and methodsThe National Electronic Injury Surveillance System (NEISS) data was used to examine a nationwide sample of emergency department records from 2013 – 2021. Inverse probability sample weights for cases were applied to arrive at national estimates. NEISS data included consumer product injuries, patient age, sex, race and ethnicity, drug and alcohol involvement, diagnoses, injury descriptions, and emergency department disposition. ResultsThe first VR-related injury was reported in the NEISS data in 2017, and injuries were estimated to number 125. Incidents of VR-related injuries amplified as increased VR units sold, and by 2021, there was a 352% increase in VR injuries totaling a weighted estimate of 1,336 ED visits. The most common VR-related injury diagnosis is fracture (30.3%), followed by laceration (18.6%), contusion (13.9%), other (11.8%), and strain / sprain (10.0%). VR-related injuries involve the hand (12.1%), face (11.5%), finger (10.6%), and knee (9.0%), head (7.0%) and upper trunk (7.0%). Patients age 0–5 most commonly experienced injuries to the face (62.3%). Injuries in patients 6–18 were mostly to the hand (22.3%) and face (12.8%). Patients 19–54 experienced primarily injuries to the knee (15.3%), finger (13.5%), and wrist (13.3%). Patients aged 55 and older disproportionately experienced injuries in the upper trunk (49.1%) and upper arm (25.2%). ConclusionsThis is the first study to describe the incidence, demographics and characteristics of injuries from VR device use. Sales of home VR units continue to increase annually and the rapid increase in VR consumer injuries is being managed by emergency departments across the country. An understanding of these injuries will inform VR manufacturers, application developers, and users to promote safe product development and operation.

Urban drinking and driving: comparison of electric scooter and bicycle related accidents in facial fracture patients.

In recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention. This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries. Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients. Compared with patients in bicycle accidents, facial fracture patients injured in e-scooter accidents are younger, are more likely under the influence of alcohol, and sustain more severe craniofacial skeleton fractures. Our results for both groups of patients advocate stricter adherence to helmet and road safety legislation as well as public education for injury prevention.

Substance use and associated factors among high school students in Northwest Ethiopia.

substance abuse is the use of a drug that affects both the function and the structure of the brain by altering the activity neurotransmitters of particular pathways in the central nervous system that affect the mood, perception, and consciousness of the person. a cross-sectional study design was employed among 422 high school students. Study participants were selected by simple random sampling from all five high school students. A self-reported questionnaire was used that included alcohol, smoking, and substance involvement screening test, Oslo-3 social support, and other instruments. Data were checked, coded, and entered into Epi-Data version 4.6.2 then exported to the statistical package for social sciences version 20 for analysis. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with substance use. Adjusted odds ratios with 95% confidence intervals were determined and predictors with a p-value of <0.05 were counted as significantly associated. a total of 406 students have participated with an overall response rate of 96.2% (n=406). Of the participants 235 were female and 171 were male. The mean age was 17.51 with a standard deviation of ±1.42. The prevalence of substance use among study participants was 52.5%. Being male aOR: 1.77, 95% CI 1.11-2.77, family history of substance use aOR: 3.07, 95% CI 1.57-6.01, and having close friends´ pressure aOR: 5.77, 95% CI 2.39-13.89 were significantly associated with substances use among high school students. the prevalence of substance use among high school students was high. Being male, family history of substance use, and having peer pressures were strongly associated with substance use.

A cross-sectional study of sociodemographic profile, availability, pattern of use, and service utilization by opioid users in a tertiary care hospital

Background: The menace of substance abuse is not only socially unacceptable but also emerging as a major public health challenge in many States of India, including Rajasthan. Aims: The aim of this study is to study the sociodemographic profile, pattern of use, availability of opioids, and process of seeking treatment services for opioid dependence. Subjects and Methods: After ethical clearance, a cross-sectional observational study was carried out among those who fulfilled the screening criteria at a tertiary care hospital. A self-designed pro forma was used, which included a sociodemographic profile, drug use profile and pattern, behaviors and practices, service access, and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Results were analyzed using SPSS version 22. Results: The mean age of the participants was 41.25 (±12.4) years. The majority (98.3%) were males, married (91.7%), illiterate (33.3%), farmers (61.7%), 45.7% lived in Bikaner District, and 83.3% lived in rural areas. Crude opium was the most common drug used in the lifetime of 98% of users. The most common comorbid substance used was tobacco, used by 75% of them. In 85% of cases, opioid drugs were purchased with their own legal earnings. The major reasons for starting opioid drugs were peer pressure (38.3%), to relieve pain/stress (25%), and to increase physical stamina for work (33.3%). The majority (73.3%) of them had utilized services for deaddiction purposes earlier. Conclusion: The rural population in Western Rajasthan was highly affected by opium dependence. Participants were mainly low-potency opioid users without significant impairment in socio-occupational functioning, and their use was mainly to relieve stress and pain and to increase work capacity.