Changes In Drug Use Research Articles

“Create in Me a Clean Heart”: The Role of Spirituality in Desistance From Substance Use

Although the impact of religion on behavior is robust and well-examined in many areas, the role spirituality plays in changes in drug use over time has received relatively little attention. Using a life-course theoretical framework, this relationship is examined through growth curve modeling techniques. Specifically, multilevel analyses are estimated testing within-person relationships between substance use desistance and spirituality. The Pathways to Desistance longitudinal data are analyzed and leading criminological predictors are included, to determine if spirituality has a unique impact on substance use net of these criminological factors, and if these impacts vary across gender. Results from these analyses suggest that the impact of spirituality on desistance varies by gender, with spirituality significantly increasing the odds of desistance from marijuana use for females, but not males.

Revisiting long-access versus short-access cocaine self-administration in rats: intermittent intake promotes addiction symptoms independent of session length.

In rats, continuous cocaine access during long self-administration sessions (6 versus 1-2hours) promotes the development of behavioral symptoms of addiction. This has led to the assumption that taking large amounts of drug during extended daily bouts is necessary to develop an addiction phenotype. Recent work shows that within-session intermittent access (IntA) to cocaine produces much less drug intake than continuous-access procedures (i.e. long-access sessions) but evokes addiction symptoms more effectively. IntA-sessions are also long, typically lasting 6hours. It is not known whether IntA-sessions must be extended to promote addiction-relevant changes in drug use over time. Here, we determined the influence of IntA-session length on patterns of cocaine use relevant to addiction. Two groups of male Wistar rats self-administered cocaine (0.25mg/kg/injection, injected over 5seconds) during 18 daily IntA-sessions. One group had long 6-hour sessions (Long-IntA), the other group had shorter, 2-hour sessions (Short-IntA). Only Long-IntA rats escalated their cocaine intake over sessions, but both groups developed a burst-like pattern of drug use over time and similar levels of psychomotor sensitization. The two groups also showed robust and similar levels of both responding for cocaine under a progressive ratio schedule of reinforcement and cocaine-induced reinstatement of extinguished drug-seeking behavior. In summary, long IntA-sessions lead to greater cocaine intake than shorter IntA-sessions, but the two conditions are equally effective in evoking the patterns of drug-taking and drug-seeking that define addiction. This suggests that chronic intermittent cocaine use, even during short daily bouts, is sufficient to promote addiction symptoms.

Alcohol, Diet and Drug Use Preceding Alcoholic Hepatitis

Background: Alcoholic hepatitis (AH) is a severe manifestation of alcohol-related liver disease characterised by jaundice and liver failure. It is not known what might trigger an episode of AH. We interviewed patients to investigate changes in behaviour before the onset of AH. Methods: Structured interviews were performed with patients with AH to examine their alcohol use, diet, drug use and smoking habit. Clinical and laboratory results were noted. Patients were followed up for 12 months after interview. Results: Data from 39 patients was analysed. No single behavioural change occurred before the onset of jaundice, although reductions in alcohol and/or dietary intake were common. Reduction in alcohol use was seen to occur approximately 14 days before the onset of jaundice. Increased alcohol intake was not common. Clinical and laboratory data varied between types of behaviour changes, although these were not statistically significant. No changes in drug use or tobacco were reported before AH. Those who had not reduced alcohol intake or had increased their drinking had better survival. Conclusions: No single type of behaviour change is associated with AH. Contrary to previous assertions, increased alcohol intake was not common; in fact, participants were much more likely to have reduced their alcohol intake.

Opioid substitution treatment and heroin dependent adolescents: reductions in heroin use and treatment retention over twelve months

BackgroundOpioid dependence is a major health concern across the world and does also occur in adolescents. While opioid substitution treatment (OST) has been thoroughly evaluated in adult populations, very few studies have examined its use in adolescents. There are concerns that OST is underutilised in adolescents with heroin dependence. We sought to measure changes in drug use among adolescents receiving OST and also to examine treatment attrition during the first 12 months of this treatment.MethodsWe included all heroin dependent patients aged under 18.5 years commencing OST at one outpatient multidisciplinary adolescent addiction treatment service in Dublin, Ireland. Psycho-social needs were also addressed during treatment. Drug use was monitored by twice weekly urine drugs screens (UDS). Change in the proportion of UDS negative for heroin was examined using the Wilcoxon signed rank test. Attrition was explored via a Cox Regression multivariate analysis.ResultsOST was commenced by 120 patients (51% female and mean age 17.3 years). Among the 39 patients who persisted with OST until month 12, heroin abstinence was 21% (95% confidence interval [CI] = 9–36%) at month three and it was 46% (95% CI = 30–63%) at month 12. Heroin use declined significantly from baseline to month three (p < 0.001) and from month three to month 12 (p = 0.01). Use of other drugs did not change significantly. People using cocaine during month 12 were more likely to be also using heroin (p = 0.02). Unplanned exit occurred in 25% patients by 120 days. The independent predictors of attrition were having children, single parent family of origin, not being in an intimate relationship with another heroin user and evidence of cocaine use just before treatment entry.ConclusionsWe found that heroin dependent adolescent patients achieved significant reductions in heroin use within three months of starting OST and this improved further after a year of treatment, about half being heroin abstinent at that stage. Patient drop out from treatment remains a challenge, as it is in adults. Cocaine use before and during treatment may be a negative prognostic factor.

Intergenerational Mobility and Changes in Drug Use Across the Life Course

The consequences of “falling from grace”—or experiencing downward intergenerational mobility—are indeed becoming an abrupt reality for many entering the labor force. Scholars of social mobility speculate that such life course trajectories can result in antisocial behavior, but few have examined whether these trajectories lead to drug use. Thus, with the United States in the midst of a drug epidemic, as well as recovering from an economic recession, the study of social mobility may contribute to a better understanding of what causes individuals to turn to drugs. Using data from The National Longitudinal Study of Adolescent to Adult Health (Add Health) and a series of logistic diagonal reference models, this study examines the association between intergenerational social mobility and drug use. Overall, I find evidence that downward mobility is associated with increases in drug use, with the relationship strongest among those experiencing the greatest loss in status.

Erectile Dysfunction Medications and Treatment for Cardiometabolic Risk Factors: A Pharmacoepidemiologic Study

BackgroundErectile dysfunction (ED) can be a sentinel marker for future cardiovascular disease and has been described as providing a “window of curability” for men to receive targeted cardiovascular risk assessment. AimTo determine whether the prescription of phosphodiesterase type 5 inhibitors (PDE5is) for ED leads to the detection and treatment of previously undiagnosed cardiometabolic risk factors. MethodsWe performed a retrospective population-based cohort study of residents of British Columbia, Canada using linked health care databases from 2004 to 2011. An individual-level time series analysis with switching replications was used to determine changes in drug use for hypertension, hypercholesterolemia, and diabetes in men 40 to 59 years old. The observation window for each patient was 720 days before and 360 days after the index date. OutcomesThe primary outcome was changes in prescriptions for antihypertensive, statin, and oral antidiabetic drugs, with secondary outcomes being laboratory tests for plasma cholesterol and glucose. Results5,858 men 40 to 59 years old newly prescribed a PDE5i were included in the analysis. We found a sudden increase in prescriptions for antihypertensive drugs (40 per 1,000; P < .001), statins (10 per 1,000; P = .001), and antidiabetic drugs (17 per 1,000; P = .002) in the 90 days after a new prescription for a PDE5i. For hypercholesterolemia and diabetes, most of this change was observed in men with relevant screening tests performed in the 30 days after their PDE5i prescription. Only 15% and 17% of men who did not have a screening test for cholesterol and glucose, respectively, in the year before their PDE5i prescription went on to have one in the subsequent 30 days. Clinical ImplicationsThe paucity of screening tests observed in our study after PDE5i prescriptions suggests that physicians should be educated on the recommended screening guidelines for men newly diagnosed with ED. Strengths and LimitationsThe number of men who were ordered a laboratory test or written a prescription but chose not to complete or fill it, respectively, is unknown. ConclusionTreatment for ED with PDE5is can be a trigger or “gateway drug” for the early detection and treatment of cardiometabolic risk factors provided physicians perform the requisite screening investigations.Skeldon SC, Cheng L, Morgan SG, et al. Erectile Dysfunction Medications and Treatment for Cardiometabolic Risk Factors: A Pharmacoepidemiologic Study. J Sex Med 2017;14:1597–1605.

High and escalating levels of cocaine intake are dissociable from subsequent incentive motivation for the drug in rats.

Taking high and increasing amounts of cocaine is thought to be necessary for the development of addiction. Consequently, a widely used animal model of drug self-administration involves giving animals continuous drug access during long sessions (LgA), as this produces high and escalating levels of intake. However, human cocaine addicts likely use the drug with an intermittent rather than continuous pattern, producing spiking brain cocaine levels. Using an intermittent-access (IntA) cocaine self-administration procedure in rats, we studied the relationship between escalation of cocaine intake and later incentive motivation for the drug, as measured by responding under a progressive ratio schedule of cocaine reinforcement. First, under IntA, rats escalated their cocaine use both within and between sessions. However, escalation did not predict later incentive motivation for the drug. Second, incentive motivation for cocaine was similar in IntA-rats limited to low- and non-escalating levels of drug intake (IntA-Lim) and in IntA-rats that took high and escalating levels of drug. Finally, IntA-Lim rats took much less cocaine than rats given continuous drug access during each self-administration session (LgA-rats). However, IntA-Lim rats later responded more for cocaine under a progressive ratio schedule of reinforcement. Taking large and escalating quantities of cocaine does not appear necessary to increase incentive motivation for the drug. Taking cocaine in an intermittent pattern-even in small amounts-is more effective in producing this addiction-relevant change. Thus, beyond the amount of drug taken, the temporal kinetics of drug use predict change in drug use over time.

Pattern of in-hospital changes in drug use in the older people from 2010 to 2016.

To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. People aged 65years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy). To assess whether or not prevalence of patients in relation to drug use distribution changed overtime, adjusted prevalence ratios (PRs) was estimated with log-binomial regression models. Among 2120 patients recruited in 27 wards continuously participating to data collection, 1882 were discharged alive and included in this analysis. The proportion of patients with very low drug use (0-1 drug) at hospital discharge increased overtime, from 2.7% in 2010 to 9.2% in 2016. Results from a log-logistic adjusted model confirmed the increasing PR of these very low drug users overtime (particularly in 2014 vs 2012, PR 1.83 95% CI 1.14-2.95). Moreover, from 2010 to 2016, there was an increasing number of patients who, on polypharmacy at hospital admission, abandoned it at hospital discharge, switching to the very low drug use group. This study shows that in internal medicine and geriatric wards continuously participating to the REgistro POliterapie Società Italiana di Medicina Interna register, the proportion of patients with a very low drug use at hospital discharge increased overtime, thus reducing the therapeutic burden in this at risk population.

Comprehensive genomic profiling (CGP) versus conventional molecular diagnostic testing of patients with advanced non-small cell lung cancer (NSCLC): Overall survival (OS) and cost in a U.S. health plan population.

6599 Background: Molecular diagnostic testing options in NSCLC include conventional testing (specific alterations in single genes or multi-gene panels), and CGP (all classes of genomic alterations—base pair substitutions, copy number, insertions/deletions, and rearrangements in multi-gene panels). Guidelines recommend broad molecular profiling to enable genomic matching with available compendia-based and investigational treatment options. This study estimated the incremental benefits and costs of CGP versus conventional testing of patients with advanced NSCLC. Methods: The impacts of increased use of CGP (via FoundationOne) versus conventional molecular testing on OS and on a commercial US health plan budget were estimated using a decision-analytic model. The number of patients needed to test with CGP to add 1 life year was also estimated. Model inputs were based on published literature (incidence rates, OS associated with drugs indicated for advanced NSCLC), real-world data (testing rates, and biopsy, conventional testing, and medical service costs from administrative claims data analyses), list price of FoundationOne, and assumptions for clinical trial participation. Results: Among 2 million covered lives, an estimated 532 had advanced NSCLC and 266 received molecular diagnostic testing. An increase in CGP use from 2% to 10% (+21 patients receiving CGP) was associated with +2 years in population OS and a budget impact of $0.018 per member per month (PMPM). The budget impact was primarily attributable to changes in drug use, longer treatment, and longer survival (collectively $0.013 PMPM) with the remainder due to CGP cost ($0.005 PMPM). Approximately 11 patients need to be tested with CGP versus conventional molecular diagnostic testing to add 1 life year. Conclusions: An increase in molecular diagnostic testing with CGP versus conventional testing to inform treatment decisions in patients with advanced NSCLC was associated with a gain in OS and a modest health plan budget impact, with most of the added costs attributable to increased use of effective treatments and prolonged survival.

Drug involvement during and after college: Estimates of opportunity and use given opportunity

BackgroundCollege students perceive widespread availability of drugs and prescription medications for non-medical use on campus, but less is known about the relationship between opportunity to use, use, and use given opportunity of these drugs during and after college. The current study describes annual trends in (1) opportunity to use, (2) use, and (3) use given opportunity of eight drugs and three prescription medications used non-medically over seven years. MethodsData were derived from a longitudinal cohort study of 1253 first-year college students (52% female, 72% non-Hispanic white) at one large, public university. Annually, past-year opportunity to use and use were assessed for marijuana, hallucinogens, inhalants, cocaine, ecstasy, amphetamines, methamphetamine, heroin, and non-medical use of prescription stimulants, analgesics, and tranquilizers. Binary variables were created to represent opportunity to use, use, and use given opportunity for each drug. ResultsParticipants had the greatest opportunity to use marijuana compared with other drugs during the study period, but there was a significant decline in the opportunity to use marijuana over time. Notably, opportunity for both drugs other than marijuana and prescription medications used non-medically consistently declined, while use given opportunity remained relatively stable over time. ConclusionsThese findings suggest that changes in drug use are driven by changes in opportunity to use, even during the post-college years. Greater opportunity to use and use of all drugs during the college years in comparison with the post-college years confirms the high-risk nature of the college environment.

Benefits and unintended consequences of antimicrobial de-escalation: Implications for stewardship programs.

Sequential antimicrobial de-escalation aims to minimize resistance to high-value broad-spectrum empiric antimicrobials by switching to alternative drugs when testing confirms susceptibility. Though widely practiced, the effects de-escalation are not well understood. Definitions of interventions and outcomes differ among studies. We use mathematical models of the transmission and evolution of Pseudomonas aeruginosa in an intensive care unit to assess the effect of de-escalation on a broad range of outcomes, and clarify expectations. In these models, de-escalation reduces the use of high-value drugs and preserves the effectiveness of empiric therapy, while also selecting for multidrug-resistant strains and leaving patients vulnerable to colonization and superinfection. The net effect of de-escalation in our models is to increase infection prevalence while also increasing the probability of effective treatment. Changes in mortality are small, and can be either positive or negative. The clinical significance of small changes in outcomes such as infection prevalence and death may exceed more easily detectable changes in drug use and resistance. Integrating harms and benefits into ranked outcomes for each patient may provide a way forward in the analysis of these tradeoffs. Our models provide a conceptual framework for the collection and interpretation of evidence needed to inform antimicrobial stewardship.

Vital Signs: Trends in HIV Diagnoses, Risk Behaviors, and Prevention Among Persons Who Inject Drugs - United States.

Persons who inject drugs (PWID) are at increased risk for poor health outcomes and bloodborne infections, including human immunodeficiency virus (HIV), hepatitis C virus and hepatitis B virus infections. Although substantial progress has been made in reducing HIV infections among PWID, recent changes in drug use could challenge this success. CDC used National HIV Surveillance System data to analyze trends in HIV diagnoses. Further, National HIV Behavioral Surveillance interviews of PWID in 22 cities were analyzed to describe risk behaviors and use of prevention services among all PWID and among PWID who first injected drugs during the 5 years before their interview (new PWID). During 2008-2014, HIV diagnoses among PWID declined in urban and nonurban areas, but have leveled off in recent years. Among PWID in 22 cities, during 2005-2015, syringe sharing decreased by 34% among blacks/African Americans (blacks) and by 12% among Hispanics/Latinos (Hispanics), but remained unchanged among whites. The racial composition of new PWID changed during 2005-2015: the percentage who were black decreased from 38% to 19%, the percentage who were white increased from 38% to 54%, and the percentage who were Hispanic remained stable. Among new PWID interviewed in 2015, whites engaged in riskier injection behaviors than blacks. Decreases in HIV diagnoses among PWID indicate success in HIV prevention. However, emerging behavioral and demographic trends could reverse this success. Access to comprehensive prevention services is essential for all PWID. Syringe services programs reduce syringe sharing and can help PWID access prevention and treatment services for HIV and other bloodborne diseases, such as hepatitis C and hepatitis B.

Changes in Drug Use and Polypharmacy After the Age of 90: A Longitudinal Study of the Danish 1905 Cohort.

To determine the longitudinal development of drug use in very old adults. Longitudinal cohort study with waves in 1998, 2000, 2002, and 2005. Nationwide study in Denmark. All living Danes born in 1905 were approached in 1998; 2,262 responded at baseline. Self-reported use of regularly taken drugs. Mean and median number of drugs and growth curve models were used to identify the change in number of drugs as the cohort aged from 92 to 100. The within-person use of drugs increased with age for women (0.19 per year; 95% confidence interval (CI) = 0.15-0.24) and men (0.15 per year; 95% CI = 0.06-0.24). Persons leaving the study prematurely had higher baseline values and a steeper increase in their annual use of drugs. The population-level mean number of drugs increased from baseline (3.6 drugs) to the first follow-up (4.1 drugs) but thereafter remained stable at approximately 4 drugs. Women used more drugs than men at all waves. In this first longitudinal study of drug use in nonagenarians, individuals used an increasing number of drugs as they aged. This increase is difficult to detect in cross-sectional analyses of the population-level mean. More efforts to understand what is reasonable prescribing at these older ages are needed.

Early Adverse Experiences and Health: The Transition to College.

This study cross-sectionally and prospectively examined the impact of adversity experienced prior to college on the health and well-being of students adjusting to their first college semester. Two-hundred sixteen (216) first-year students completed measures of adverse life experiences, perceived stress, physical symptoms, and health-related behaviors during the first 2 weeks of college entry and again at the end of the first semester. Reported adversity prior to college predicted greater perceived stress and physical symptoms at college entry and an increase in physical symptoms over the semester; perceived stress mediated the prospective changes. Early adversity predicted smoking, alcohol use problems, and risky sexual behavior at college entry, but was unrelated to the change in smoking, alcohol use problems, or risky sexual behavior. Adversity was not related to drug use at college entry but did predict change in drug use over the semester. Some risk factors associated with early adversity are present when students matriculate, but adversity also may impact mental and physical health prospectively during the transition to college. Interventions directed at reducing distress may prevent negative developmental consequences.

Incidence and time trends of drug-induced parkinsonism: A 30-year population-based study.

ABSTRACTBackgroundEpidemiological studies of drug‐induced parkinsonism remain limited.ObjectivesTo investigate the incidence and time trends of drug‐induced parkinsonism over 30 years in a geographically defined American population.MethodsWe used the medical records‐linkage system of the Rochester Epidemiology Project to identify all persons in Olmsted County, Minnesota, who received a screening diagnostic code for parkinsonism from 1976 through 2005. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of drug‐induced parkinsonism associated with dopamine‐blocking or dopamine‐depleting medications.ResultsAmong 906 incident cases of parkinsonism from 1976 to 2005, 108 persons had drug‐induced parkinsonism (11.9%). The average annual incidence rate of drug‐induced parkinsonism was 3.3 per 100,000 person‐years, was higher in women, and increased with older age. Drug‐induced parkinsonism was the fifth‐most common type of parkinsonism overall; however, it was the most common type among persons younger than age 40 years. Typical antipsychotic drugs were the most common class of drugs associated with parkinsonism, whereas atypical antipsychotic drugs were rarely involved. The incidence rate of drug‐induced parkinsonism decreased 32.0% per decade (relative risk = 0.68; 95% confidence interval: 0.49–0.94) and 68.6% over the 30 years of the study. The decrease was similar in men (65.2%) and women (69.4%); however, the trend was significant only in women.ConclusionsThe incidence of drug‐induced parkinsonism increased with older age and was higher in women at all ages. Typical antipsychotic drugs were the most common cause. The incidence of drug‐induced parkinsonism decreased over the 30 years of the study because of changes in drug use. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Proximal Predictors of Long-Term Discontinuance with Noninsulin Antihyperglycemic Agents.

Noninsulin antihyperglycemic agents (NAAs) are the mainstay of treatment for type 2 diabetes, yet persistence in NAA use is suboptimal in many diabetes patients. Most of the research on NAA discontinuance has focused on sociodemographic characteristics and general health status, but such factors are inherently limited in explaining dynamic events such as discontinuance. To assess the relative importance of static and proximal dynamic factors in explaining long-term NAA discontinuance among Medicare beneficiaries with diabetes. Two sets of probability models were estimated to predict NAA discontinuance as a function of static variables (age, sex, race, original reason for Medicare entitlement, low-income subsidy and dual Medicare/Medicaid eligibility status, and disease burden) and 21 dynamic factors capturing month-by-month changes in drug use, health status, and use of medical services leading up to discontinuance (defined as month 0) and the previous 4 months (designated months -1 to -4) among 71,619 patients with diabetes enrolled in Medicare Part D plans in 2006-2008. Static variables explained just 1.2% of the variance in probability of NAA discontinuance compared with 14% for all variables combined. Key time-related predictors of NAA discontinuance included discontinuation with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) and statins, hypoglycemia, NAA usage gaps, insulin use, and discharge from hospitals and skilled nursing facilities (SNFs). The strongest significant predictors (P < 0.05) of NAA discontinuance were discontinuation with statins and ACEIs/ARBs in month 0 (predicted probabilities of 37% and 34%, respectively). Other variables that significantly increased the probability of NAA discontinuance by 10% or more were hypoglycemia in month 0 (14%) and month -1 (17%), discontinuance with ACEIs/ARBs in months -1 (15%) and -2 (10%), discontinuance with statins in month -1 (13%), and insulin use in month 0 (12%). Experiencing a previous gap in NAA therapy was associated with higher likelihood of discontinuance if the gap occurred in month -2 (10%) or month -4 (6%), but a gap in therapy in month -1 actually reduced the likelihood of discontinuance by 13%. Discharge from a hospital or SNF was consistently associated with higher probabilities of NAA discontinuance ranging between 4% and 10%, with higher probabilities occurring closer to month 0. A cascade of dynamic changes preceding discontinuance with NAA therapy among Medicare Part D enrollees with diabetes was observed between 2006 and 2008. Understanding that lack of persistence in drug use is a dynamic rather than a static phenomenon opens up new avenues for investigating and ultimately improving adherence behavior in the elderly. This study was funded by Merck & Co. Huang and Raipathak are employees of Merck & Co. Brandt reports consultancy and speaker fees from Catapult, Omnicare, RAND, HRSA, CMS, and AGS Beers Criteria. Loh is currently employed at Touro College of Pharmacy. All other authors have no relevant potential conflicts of interest to disclose. Study concept and design were primarily contributed by Stuart, Quinn, and Brandt, along with Shen, Roberto, Hendrick, Huang, and Rajpathak. Shen, Loh, Hendrick, and Kim collected the data, and data interpretation was performed primarily by Stuart, Shen, and Roberto, assisted by Quinn, Brandt, Hendrick, Huang, and Rajpathak. The manuscript was written primarily by Stuart, with assistance from the other authors, and revised by Huang, Rajpathak, and Stuart, with assistance from the other authors.

Social factors associated with drug use in the Mexican school-age population: A comparison of two national surveys

Objectives: This study analyses changes in drug use in Mexican junior high and high-school students and identifies differences over two decades in the social factors (availability of drugs, perceptions of risk and social tolerance) associated with such use. Method: Data from two national surveys, conducted in 1991 and 2014, were analysed. Results: Data show that the proportion of students who had tried drugs doubled in 2014. In both surveys, substance use was significantly associated with a high perception of availability and use by friends and older siblings; in 2014, there was a decrease in the perception of risk for marijuana use and an increase in social tolerance toward illegal drugs. Conclusions: It can be inferred from this analysis that public policy to prevent drug use has not had the expected impact, at least not on the social factors considered here.

Changes in Drug Use Among Belgian Higher Education Students: A Comparison Between 2005, 2009, and 2013

ABSTRACTBackground: Most drug users initiate illicit drug use during adolescence and young adulthood. Although in the general population a trend towards a decrease in drug use can be seen, patterns of drug use among students are unclear. Objectives: The objective of the study was to look at drug use patterns among students in higher education in Belgium. Methods: A survey study in Antwerp (Belgium) was conducted on three occasions (2005, 2009, and 2013) at several institutes for higher education. Students (total sample size 24,478; 29,210, and 31,950, respectively) were asked if they had used legal or illicit drugs in the past year. To compare whether drug use differed between the separate years, χ2-tests were performed on past-year drug use for all three time points. If significant, χ2-tests between pairs were performed. Gender and age differences were also analyzed. Results: The use of nondistilled alcohol, spirits, and cannabis decreased during this period but no change in student's use patterns was seen for beer, wine, sedative hypnotics, stimulating medication, XTC, cocaine, or amphetamines. Tobacco use decreased initially, but increased in 2013. More men indicated having used drugs in the past year than women. Only for cannabis did more younger students indicate having used in the past year. Conclusions/Importance: The data from this study could provide valuable insights for academic and governmental bodies and health care professionals into the use of drugs by higher education students since this subgroup shows specific use patterns.

Commentary: A Gene-Based Association Method for Mapping Traits Using Reference Transcriptome Data.

Commentary: A Gene-Based Association Method for Mapping Traits Using Reference Transcriptome Data.

Changes in psychiatric symptoms among persons with methamphetamine dependence predicts changes in severity of drug problems but not frequency of use

ABSTRACTBackground: Few studies have examined how changes in psychiatric symptoms over time are associated with changes in drug use and severity of drug problems. No studies have examined these relationships among methamphetamine (MA)-dependent persons receiving motivational interviewing within the context of standard outpatient treatment. Methods: Two hundred seventeen individuals with MA dependence were randomly assigned to a standard single session of motivational interviewing (MI) or an intensive 9-session model of MI. Both groups received standard outpatient group treatment. The Addiction Severity Index (ASI) and timeline follow-back (TLFB) for MA use were administered at treatment entry and 2-, 4-, and 6-month follow-ups. Results: Changes in ASI psychiatric severity between baseline and 2 months predicted changes in ASI drug severity during the same time period, but not changes on measures of MA use. Item analysis of the ASI drug scale showed that psychiatric severity predicted how troubled or bothered participants were by their drug us, how important they felt it was for them to get treatment, and the number of days they experienced drug problems. However, it did not predict the number days they used drugs in the past 30 days. These associations did not differ between study conditions, and they persisted when psychiatric severity and outcomes were compared across 4- and 6-month time periods. Conclusions: Results are among the first to track how changes in psychiatric severity over time are associated with changes in MA use and severity of drug problems. Treatment efforts targeting reduction of psychiatric symptoms among MA-dependent persons might be helpful in reducing the level of distress and problems associated with MA use but not how often it is used. There is a need for additional research describing the circumstances under which the experiences and perceptions of drug-related problems diverge from frequency of consumption.