Effects Of Substance Use Research Articles

Substance use trajectories among emerging adult Black men: Risk factors and consequences.

Young, Black American men experience greater social, legal and economic consequences of substance use compared with White men for comparable levels of consumption. The development of tailored interventions requires prospective information on their substance use patterns, risk factors and consequences. We identified longitudinal substance use profiles and examined their links to childhood adversity, racial discrimination and young adult problem substance use and mental health. Emerging adult Black men (n = 504, mean age = 20.26, SD = 1.08) provided fours waves of data between January 2012 and March 2021. We conducted a parallel process latent class growth analysis for three substances to explore conjoint longitudinal use patterns and investigated the risk factors and consequences of each pattern. Three trajectory classes emerged: non-using (n = 201, 39.9%), cannabis using (n = 202, 40.1%) and poly-substance using (n = 101, 20%) groups. Threat-based childhood adversity and racial discrimination were associated with higher odds of being members of cannabis or poly-substance groups than non-using group. Deprivation-based adversity was associated with higher odds for membership in poly-substance than non-using group. At Wave 4, elevated depressive symptoms were more prevalent among poly-substance compared with cannabis using group. Heterogeneous substance use patterns emerged among Black American men and each pattern has distinct risk factors and outcomes in young adulthood. For prevention, more attention is needed for cannabis use patterns and psychosocial adversities that are unique to Black population.

COVID-19 vaccine uptake in mental healthcare users: Czech nationwide register study

BackgroundThe excessive covid-related mortality of psychiatric patients was reduced by vaccination. The vaccine uptake in patients diagnosed with different mental health disorders is, however, not fully described. AimsA nationwide, record-based retrospective cross-sectional study examines the effect of substance use, psychotic, affective, anxiety, and personality disorders on COVID-19 vaccination rates in August and December 2021. Further, it quantifies the effect of receiving mental healthcare on vaccine uptake. MethodsThe COVID-19 vaccine rates of mental healthcare users in August and December 2021 were examined using logistic regression models adjusted for sex and age on a sample of 7,235,690 adult inhabitants of the Czech Republic. The probability of vaccine uptake in the week following mental healthcare appointment or hospitalization on any day in the fall 2021 was compared to the general probability of getting vaccinated during that week. ResultsThe vaccination rate in August 2021 was related to history of hospitalization due to substance use (OR = 0.71), personality (OR = 0.87), psychotic (OR = 0.92), and anxiety (OR = 1.15) disorders, while mood disorders had no effect (OR = 1.00). Compared to general population, mental healthcare users were undervaccinated in August but not in December 2021. Vaccine uptake was low in those with history of psychiatric hospitalizations but higher in those utilizing inpatient or outpatient mental healthcare recently, predominantly for affective disorders. Increased vaccine uptake was observed following utilization of mental healthcare as well as in those with repeated psychiatric hospitalizations. ConclusionsThe vaccination rates of mental healthcare users relative to general population largely differ across nosological categories and during the vaccination campaign. Psychiatrists were successful in promoting vaccination against COVID-19.

The utility of the MMPI-3 in predicting substance use related problems in a clinical neuropsychology sample

Assessing for problematic substance use in neuropsychological assessments is crucial for differential diagnosis and attribution of symptom causes. The current investigation examines the utility of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3 in predicting such substance use in a clinical neuropsychology sample. Participants included 208 outpatient neuropsychological examinees. Correlations and risk ratios were calculated for externalizing-psychopathology-related scales and external substance use criteria. Hierarchical regressions examined the incremental prediction of criteria by MMPI-3 externalizing scales above the Substance Abuse (SUB) scale. Results indicate that MMPI-3 externalizing scales are associated with substance-use-related criteria as conceptually expected. Additionally, we report significantly increased risk of experiencing substance-use-related problems at various T score elevations on multiple externalizing scales. Finally, SUB served as the primary predictor of substance-use-related criteria. These findings support the ability of the MMPI-3 to assess for past or current substance use and negative consequences of substance use in a clinical neuropsychology setting.

Effects of Substance Use and Antisocial Personality on Neuroimaging-Based Machine Learning Prediction of Schizophrenia.

Neuroimaging-based machine learning (ML) algorithms have the potential to aid the clinical diagnosis of schizophrenia. However, literature on the effect of prevalent comorbidities such as substance use disorder (SUD) and antisocial personality (ASPD) on these models' performance has remained unexplored. We investigated whether the presence of SUD or ASPD affects the performance of neuroimaging-based ML models trained to discern patients with schizophrenia (SCH) from controls. We trained an ML model on structural MRI data from public datasets to distinguish between SCH and controls (SCH = 347, controls = 341). We then investigated the model's performance in two independent samples of individuals undergoing forensic psychiatric examination: sample 1 was used for sensitivity analysis to discern ASPD (N = 52) from SCH (N = 66), and sample 2 was used for specificity analysis to discern ASPD (N = 26) from controls (N = 25). Both samples included individuals with SUD. In sample 1, 94.4% of SCH with comorbid ASPD and SUD were classified as SCH, followed by patients with SCH + SUD (78.8% classified as SCH) and patients with SCH (60.0% classified as SCH). The model failed to discern SCH without comorbidities from ASPD + SUD (AUC = 0.562, 95%CI = 0.400-0.723). In sample 2, the model's specificity to predict controls was 84.0%. In both samples, about half of the ASPD + SUD were misclassified as SCH. Data-driven functional characterization revealed associations between the classification as SCH and cognition-related brain regions. Altogether, ASPD and SUD appear to have effects on ML prediction performance, which potentially results from converging cognition-related brain abnormalities between SCH, ASPD, and SUD.

Pattern of Substance Use among Patients Attending De-Addiction Unit in a Nigerian Tertiary Hospital

Substance use is a growing public health problem and the consequences of substance use disorder are costly to the community. The absence of data on the pattern of substance-use among drug using patients attending the University of Benin Teaching Hospital (UBTH) and other hospitals in south-south Nigeria and the negative consequences of substance use justified the study. Thus, the objectives of the study were to investigate the pattern of substance use, the socio-demographic characteristics and clinical indices associated with drug use among the patients attending the De-Addiction Unit in UBTH. It was a cross-sectional study that obtained data from casefiles of 48 patients. Cannabis was the most frequently used substance (52.1%), followed by alcohol (18.8%), tobacco (16.7%), tramadol (14.6%) and pentazocine (12.5%). Majority of the respondents were males 38 (79.2%), age group 18 to 27 years (75%), singles 38 (79.2%), multiple substance users 34 (70.8%), reported peer pressure influence 35 (72.9%) and reported ‘smoking’ as route of substance use 32 (66.7%). It was observed that prevalence of use of drugs among females was rising. The commonest psychiatric co-morbidity among them was depression 19 (39.6%), followed by bipolar affective disorder 10 (20.8%) and schizophrenia 7 (14.6%). Substance use prevention, treatment and control measures need to pay attention to males and female users, since the prevalence of substance use among female is rising. Such programs must bear in mind the adolescent and young adult age groups and measures to mitigate the use of common substances such as alcohol and cannabis must continue to enjoy priority. During screening/assessment for substance use, a high index of suspicion for comorbidities especially depression is important. Peer group influence and curiosity, which are identified reasons for initiating substance use, may be checked by targeted health education.

Dissociating the Link of Neural Correlates of Inhibition to the Degree of Substance Use and Substance-Related Problems: A Preregistered, Multimodal, Combined Cross-sectional and Longitudinal Study

BackgroundFrontal hypoactivation during inhibition is a promising phenotype for substance use disorders (SUDs), but studies comparing individuals with SUDs with unaffected individuals have reported inconsistent results. This may result from distinctive associations of neural correlates of inhibition with the degree of substance use and the severity of substance-related problems—two correlated but distinct facets of SUDs—reflecting a potentially disregarded confounding effect. This preregistered study tested whether frontal hypoactivation during inhibition is specifically linked to substance-related problems in SUDs beyond the degree of substance use. MethodsA stop signal task during functional magnetic resonance imaging, trait self-control, substance use, and substance-related problems in the past 12 months were assessed in 121 (poly)substance users. One hundred seven participants completed a 1-year follow-up. We examined the association between multimodal indicators of inhibition (neural activation in regions of interest, inhibitory performance, trait self-control) and substance-related problems while controlling for the degree of substance use. ResultsRight inferior frontal gyrus hypoactivation explained variance in substance-related problems beyond the degree of substance use, while hyperactivation in the same region explained variance in the degree of substance use beyond the effects of substance-related problems, both cross-sectionally (problems: Bonferroni-Holm–corrected p = .048; use: p < .01) and prospectively (problems at trend level: p = .096; use: p = .01). Trait and behavioral inhibition were unrelated to problems beyond the effects of substance use (ps > .05). ConclusionsWe demonstrated that frontal hypoactivation during inhibition specifically relates to substance-related problems. Interestingly, increased activity may even represent a resilience factor in substance use without SUDs. Future studies should distinguish between processes linked to the degree of substance use and substance-related problems to advance understanding of why some substance users develop SUDs and others do not.

Co-occurring pain and addiction: prognostic implications for healthcare professionals in residential treatment for substance use disorder

Objectives : Chronic pain is both an important antecedent and consequence of substance use. Although evidence suggests healthcare professionals may be uniquely vulnerable to chronic pain, this vulnerability remains largely unexamined in the context of recovery from substance use disorders (SUDs). We characterized pain in a sample of treatment-seeking individuals, examined potential differences in pain trajectories between healthcare professionals and non-healthcare patients, and interrogated potential pain-related vulnerabilities in treatment outcomes between these groups. Methods : Patients with SUDs (n = 663; 251 women) completed questionnaires indexing pain intensity, craving, and abstinence self-efficacy (including self-efficacy in pain-related contexts). Assessments were conducted at treatment entry, 30 days, and discharge. Analyses included chi-square and longitudinal mixed models. Results : The proportion of healthcare and non-healthcare patients endorsing recent pain was equivalent (χ2=1.78, p=.18). Healthcare professionals reported lower pain intensity (p = 0.02) and higher abstinence self-efficacy (p < 0.001). Profession by pain interactions (ps <.040) revealed that among medical professionals, associations between pain and all three treatment outcomes of interest were more robust relative to the non-healthcare group. Conclusions : Results suggest that although healthcare professionals endorse similar rates of pain and lower average pain intensity, they may be uniquely vulnerable to pain-related disruptions in craving and abstinence self-efficacy.

Implementation of the “unplugged” school-based prevention programme in Nigeria: Results of process evaluation

Process evaluation can improve the quality of program implementation and the achievement of program outcomes. This paper aims to describe the fidelity of implementation of the school-based prevention program 'Unplugged' in Nigeria, i.e., the degree to which the intervention was delivered as intended, and the satisfaction of teachers and students. The program aims to prevent tobacco, alcohol, and substance use and consists of 12 standardized units, one-hour each, delivered by class teachers. Sixteen schools implemented the program. Eleven schools, 33 classes, 27 teachers, 993 students provided process evaluation data. Eighty-two percent of classes implemented the entire program, with lower rates of activities implementation at the beginning and at the end of the program. Each unit took on average 55 minutes. More than 90% of teachers perceived high students' interest for units 1, 4, 5, 8, and 9, high interactivity for units 1, 2, 8, and 9, and declared high comfort in implementing most units. About 80% of teachers reported an improvement in knowledge, teaching skills, and relationships with students due to the program. More than 75% of students declared the program changed their way of seeing themselves, was helpful to answer questions about themselves, and improved their relationships with mates and teachers. About 95% of students reported an increase in knowledge of the consequences of substance use. Students declared Unplugged educative, informative, helpful, impacting on change, interesting and suggested the program should be spread to other schools.

Intimate Partner Violence Survivors' Daily Experiences of Social Disconnection, Substance Use, and Sex with Secondary Partners.

Women who have experienced intimate partner violence (IPV) are disproportionately likely to engage in sexual risk behavior, including sex with a secondary partner (i.e., sex partners outside their primary relationship). Social disconnection has been identified as a social determinant of health that may enhance understanding of sex with a secondary partner. This study extends past research by using an intensive longitudinal design consisting of multiple daily assessments to examine event-level associations between women IPV survivors' social disconnection and sex with a secondary partner concurrently (i.e., during the same aggregated assessment) and temporally (i.e., social disconnection during one assessment predicting sex with a secondary partner in a subsequent assessment) over a 14-day period, in consideration of physical, psychological, and sexual IPV, and alcohol and drug use. Participants (N = 244) were recruited from New England through 2017. Results from multilevel logistic regression models indicate that women who experienced greater social disconnection on average were more likely to report sex with a secondary partner. However, after including IPV and substance use in the model, the strength of this relationship was attenuated. Sexual IPV emerged as a between-person predictor of sex with a secondary partner in temporally lagged models. Results provide insight into the relationships between daily social disconnection and sex with a secondary partner among IPV survivors, particularly regarding the effects of substance use and IPV both concurrently and temporally. Taken together, findings emphasize the importance of social connection for women's well-being and highlight the need for interventions that enhance interpersonal connectedness.

Serum irisin and caspase-9 levels in adolescents with substance use disorder: a case-control study

ABSTRACT Background During adolescence, individuals experience rapid changes in physical, cognitive, emotional, behavioral, and social aspects of their life. Due to certain risks which arise during the developmental period of adolescence, substance use and addiction are encountered as a public health problem. Studies on biochemical parameters and puberty are limited. In this study, adolescents with substance use disorder were compared to healthy individuals in terms of sociodemographic characteristics and serum irisin and caspase-9 levels. Methods The study group consisted of 32 adolescents with substance use disorder and the control group was comprised of 29 healthy adolescents. The sociodemographic characteristics and serum irisin and caspase-9 levels of the groups were compared. Results The study group performed lower than the control group in terms of duration of education and continuing education. Serum caspase-9 levels were found to be significantly higher in the study group compared to the control group. There was no difference in irisin levels of the groups. Conclusions It was determined that substance use negatively affects educational aspects and may also lead to certain destructive biological effects in adolescents. In order to reveal the effect of substance use on adolescents in more detail, studies with larger samples are needed.

Substance use and solid organ transplantation in adolescents and young adults: Current findings and implications.

Understanding the role of substance use is important in the equitable allocation of solid organs and may present an opportunity for improving outcomes among substance users who receive transplants. This scoping review presents findings related to substance use among pediatric and young adult transplant populations and suggests future directions. A scoping review was conducted seeking studies related to substance use in pediatric and young adult transplant populations under the age of 39 years. Studies were deemed eligible if they collected data or addressed policy concerns and participants' mean age was below 39 years. Twenty-nine studies were identified as eligible for this review. Overall, policies around substance use are largely inconsistent throughout both pediatric and adult transplant centers. Findings indicated that substance use among pediatric and young adult transplant recipients is similar to or lower than healthy peers. Few studies addressed marijuana use and opioid misuse, among other substances. There is a general dearth of research on substance use in this population. The current findings suggest that substance use, although relatively less common, affects eligibility for transplant, may lead to poor outcomes, and affects medication adherence. Inconsistent substance use policies in transplant centers have the potential to result in bias. However, more research is needed on the effects of substance use among pediatric and young adult transplant candidates and recipients as well as on equitable policies for organ allocation for individuals who use substances.

Driving under the influence of substances and motor vehicle fatalities among older adults in the United States

Objective This study examines contribution of substance use (including alcohol, cannabinoids, stimulants, narcotics, depressants, and hallucinogens) on the probability of drivers being at-fault for a crash on U.S. public roads, with specific emphasis on older adult drivers. Methods Data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS) for the years 2010–2018 were employed for 87,060 drivers (43,530 two-vehicle crash pairs) involved in two moving vehicle crashes. The quasi-induced exposure (QIE) method was used to compute the relative crash involvement ratios (CIRs) for each relevant substance and illicit drug. Mixed-effect generalized linear regression models were fit to examine the effect of substance use on the probability of a driver being at-fault for a crash. Results There were 75.51% males and 73.88% Non-Hispanic Whites in our sample. The CIR for those aged 70–79 years was 1.17, and more than double (2.56) for the ≥80 years old drivers, while being relatively low among drivers of ages 20 to 69. Substance use, in general, disproportionately increased the probability of being at-fault during a crash, regardless of driver’s age. Though older drivers are less likely than other age groups to report substance use, presence of substances among older drivers increased the probability of their being at-fault two to four times during a crash across almost all substances. The regression models, after adjusting for driver’s sex, road grade, weather, light conditions, distraction, and speeding at time of crash, revealed that older drug-impaired drivers were twice as likely to be at fault in a fatal crash (aOR = 1.947; 95% CI = 1.821, 2.082; <0.0001) compared to their middle-aged counterparts. Similarly, most substance use categories were responsible for the probabilities of higher CIRs among the drivers. Conclusion These findings necessitate continued efforts to bring awareness to the deadly consequences of “drugged driving,” especially among older adult drivers.

Ayahuasca in Western society and the metacognitive counselling approach

AbstractAyahuasca is a hallucinogenic plant used throughout South America for religious, cultural and healing ceremonies. Previous studies have analysed it as a therapy method from either the microperspective, such as physiological and psychological effects of substance use, or the macroperspective, such as legal issues or cultural appropriation of ayahuasca by Westerners. There is a need to combine those two aspects to fully understand the effects of ayahuasca for therapists and clients in Western communities. By utilising an autoethnographic instrumental case study, we discuss the possible risk of ayahuasca gaining popularity in Western societies without an understanding of how the social context plays a tremendous part in healing using this method. We also discuss the risk of intrapsychic experiences brought about by ayahuasca that may deter individuals from seeking appropriate treatment. It is not our intention to present ayahuasca as an illegitimate or invalid method of healing; rather, we emphasise the importance of integrating micro‐ and macroperspectives in psychotherapy practice. We suggest that the metacognitive counselling approach be taken by both clients and therapists when adopting indigenous methods of therapy which may add a significantly positive effect. Although we hope this study offers realistic and lived experiences to generate pragmatic solutions for therapists and clients, we recognise that it is necessary to collect data from a larger number of both clients and therapists to better support our suggestion of the metacognitive counselling approach.

Examining the influence of substance use on mental health rating during COVID-19: A Canadian perspective.

Substance use and mental health symptoms (e.g., depression and anxiety) have increased during the COVID-19 pandemic, partly due to implementation of physical distancing measures aimed at containing the spread of the SARS-CoV-2 virus. However, there is limited pandemic-specific research that has examined the relationship between substance use and mental health with other correlates of well-being, including life satisfaction and social confidants. In the current study, we used ordered logistic regression analyses to examine whether a greater frequency of substance use (e.g., alcohol, cannabis, and opioids) during the pandemic predicted poorer ratings of self-reported mental health in a large sample of Canadians aged 15 to 64 years. We further considered whether life satisfaction and number of social confidants interacted with substance use to influence mental health, and stratified the models by sex and personal feelings of shame surrounding the use of substances (i.e., high and low shame). Findings indicated that frequency of substance use was significantly associated with increased odds of reporting poorer mental health for males and females exhibiting both low and high shame. In females reporting low shame, we found that as frequency of cannabis use increased, life satisfaction has a much greater positive association with mental health. Whereas, in females disclosing high shame, maintaining social relations was particularly important to benefit the mental health of current users of opioids, relative to past and non-users. No such interaction was found in males. Overall, the findings of the current study showed the negative mental health consequences of substance use during COVID-19 in a large Canadian sample, and most importantly revealed a critical sex difference in the way in which social determinants interact with substance use to influence mental health.

Predictors of polysubstance vaping in emerging adults

BackgroundPolysubstance use, which increases the risk for negative consequences of substance use, is common among emerging adults who regularly consume substances by vaping. Examining predictors of polysubstance vaping is crucial for understanding whether this novel form of substance consumption lends itself equally efficaciously to established forms of intervention for smoked substances. ObjectiveThe current study aimed to examine whether modifiable cognitive risk factors for increased vaping in the form of attitudes, expectancies and norms can predict co-use of nicotine and cannabis among vapers over and above the effect of demographics, personality risk factors and anxiety, depression symptoms. MethodsRegular nicotine and cannabis vapers between 18 and 30 years were recruited online in Canada via a Qualtrics panel. Hierarchical binary logistic regression was used to predict membership in a polysubstance or a single substance vaping group. Demographics, personality risk factors, depression and anxiety symptoms were included as predictors in block 1; attitudes, expectancies and perceived norms of vaping were added in block 2. ResultsAttitudes, expectancies and norms predicted polysubstance use over and above the effect of demographics, personality risk factors and anxiety, depression symptoms. Positive expectancies played a uniquely significant role in the prediction of polysubstance vaping. ConclusionsCognitive interventions targeting attitudes, expectancies and norms may be effective in prevention of polysubstance vaping, although positive expectancies appear to be the main unique factor that has an influence above and beyond all other cognitive factors related to vaping. Treatment and prevention programs should put special focus on lowering positive expectancies.

What factors matter in the amount of alcohol consumed? An analysis among Brazilian adolescents.

Alcohol consumption in the under-18 age group has been growing in recent years, leading to various health risks. Considering the problems this habit brings, the present study contributes to the literature dedicated to categorizing different types of drinkers. The study objective is to verify the factors associated with the intensity of alcohol use among elementary school students in the year 2015. The dataset came from the National Adolescent School-based Health Survey (PeNSE). The applied methodology was a logit model of sequential response (continuation ratio). The main results are as follows. It was found that being female is associated with a lesser chance of having consumed alcohol in the reference period, however, with a greater chance of consuming five or more doses. Economic condition and formal paid employment are positively associated with alcohol consumption, which increases with the progression of the student's age. The number of friends who drink alcohol and consumption of products originating from tobacco and illicit drugs, are good predictors of alcohol use by students. The time spent practicing physical activities increased the chance of male students consuming alcohol. The results showed that, in general, the characteristics associated with different alcohol consumption profiles remain similar but differ between genders. Intervention strategies aimed at preventing alcohol consumption by minors are suggested in order to reduce the negative effects of substance use and abuse.

Lower-risk substance use guidelines accessible by youth

BackgroundLower-risk substance use guidelines (LRSUGs) are an evidence-based harm reduction strategy used to provide information to people who use drugs so they can reduce harms associated with substance use.ObjectivesThis study aimed to identify LRSUGs accessible to youth and to characterize the recommendations within these guidelines. The overall goal is to identify gaps in current LRSUGs and to inform researchers and policymakers of the kinds of health information youth can access.MethodsWe conducted a digital assessment using the Google search engine to identify LRSUGs that could be identified by youth when searching for official sources of information related to commonly used substances, including cannabis, caffeine, alcohol, hallucinogens, prescription opioids, nicotine, and/or prescription stimulants. LRSUGs were coded and data were extracted from them to identify gaps.ResultsOne hundred thirty LRSUGs were identified; most focused on alcohol (n = 40, 31%), cannabis (n = 30, 23%), and caffeine (n = 21, 16%). LRSUGs provided recommendations about dosing (n = 108, 83%), frequency of use (n = 72, 55%), and when to use (n = 86, 66%). Most LRSUGs were published by health (n = 51, 39%) and third-sector organizations (n = 41, 32%), followed by provincial/state (n = 18, 14%), government (n = 14, 11%), municipal (n = 4, 3%), and academic (n = 2, 2%) sources. Only 16% (n = 21) of LRSUGs were youth-specific and one-quarter (n = 32, 25%) of LRSUGs provided gender-specific recommendations. Most guidelines featured information on short (n = 76, 58%) and long-term (n = 69, 53%) negative effectives and positive effects of substances (n = 56, 43%). Less than half (n = 50, 38%) of LRSUGs cited evidence in support of the information they provided.ConclusionsWe identified several areas in the current LRSUGs for youth that need to be addressed. Among the gaps are a lack of LRSUGs developed specifically for youth, a lack of youth engagement in developing harm reduction strategies centered around them, and a lack of evidence-based LRSUGs. Youth-oriented, evidence-based LRSUGs are needed to better support youth who use substances and help them manage the negative effects of substance use.

Characteristics and circumstances of cocaine-related completed suicide in Australia, 2000–2021

BackgroundThere has been a substantial global increase in cocaine use and associated harms. The current study aimed to: 1. Determine the case characteristics and circumstances of death of cocaine-related suicide in Australia 2000–2021; and 2. Determine the toxicological profiles of cases. MethodsRetrospective study of cocaine-related death in Australia, 2000–2021, retrieved from the National Coronial Information System (NCIS). Suicide intent was based upon the NCIS code for “Intentional Self-harm”, derived from case circumstances and coroners’ conclusions. Sex comparisons were made for all major variables. ResultsA total of 157 cases were identified, 82.2% male, 79.5% employed, with a mean age of 32.3 years. Concerns for mental health were documented in 65.6%, a previous suicide attempt in 21.0%, a history of substance use treatment and/or negative consequences of substance use in 45.9% and injecting drug use in 14.6%. Manner of death amongst both sexes was predominantly by physical means (82.8%). Written intent was documented in 29.3%. Intense agitation prior to the incident was noted in 28.0% and conflict in 24.8%. The median blood cocaine concentration was 0.060 mg/L (range 0.007–5.500). Other drugs were present in 95.5%, most commonly alcohol (63.1%) with a median concentration of 0.140 g/100 ml. Psychostimulants other than cocaine were present in 31.2%. ConclusionsThe ‘typical’ cocaine-related suicide case was a male, aged in their early thirties, who was highly likely to be employed. The majority of cases used physical means, and a substantial minority were highly agitated and engaged in conflict prior to the fatal incident.

Impacts of intergenerational substance use and trauma among black women involved in the criminal justice system: A longitudinal analysis

IntroductionIntergenerational substance use and trauma disproportionately impact racialized women. Yet, how these factors impact outcomes in women involved in the criminal justice system is understudied. MethodsUsing data from 443 participants in the Black Women in a Study of Epidemics, we assessed the impact of intergenerational substance use and trauma on participant drug use and open Child Protective Services (CPS) cases over 18 months. In repeated-measures logistic regression, intergenerational substance and trauma were independent variables, while participants' drug use at each follow-up and any open CPS case (s) served as separate dependent variables. Models were adjusted for criminal justice involvement, age, marital status, education, childhood guardian, number of children, and prior year homelessness. ResultsOn average, participants were aged 35 years, 64 % had never married, and 44 % were raised by both parents. Two-thirds of women (67 %) reported intergenerational substance use (≥1 parent and/or grandparent with alcohol/drug problems), while only 13 % reported intergenerational trauma. Each increase in the number of parents/grandparents with drug/alcohol problems was associated with 30 % increased odds of participants' drug use (aOR 1.30, 95 % CI: 1.07,1.57) and 40 % increased odds of having an open CPS case (aOR 1.40, 95 % CI: 1.11, 1.78). The association of intergenerational trauma and CPS cases was attenuated with sociodemographic/contextualizing factors. ConclusionsIntergenerational substance use and trauma are associated with negative outcomes. Our findings highlight the need for substance use treatment to address the pervasive generational effects of substance use and trauma faced by racialized women in the criminal justice system.

Characterizing the Development of Research Landscapes in Substance Use and HIV/AIDS During 1990 to 2021.

Mitigating the impacts of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and substance use requires comprehensive and systematic thinking in designing interventions and developing policies. This study describes the growth of research publications from 1991 to 2021 in the Web of Science database and points out current research landscapes in the fields of HIV/AIDS and substance use. Latent Dirichlet Allocation was used for classifying 21 359 papers into corresponding topics. The most common topics were HIV transmission, HIV infection, quality of life and mental health of substance users, and the biomedical effect of substance use. Emerging research landscapes include vulnerabilities of people who inject drugs to HIV transmission and related health problems. This study found a lack of research on health services, interdisciplinary and inter-sectoral in combination with clinical evaluation and treatment services. Future investment and implementation of HIV/AIDS and substance use programs should focus on research of health services and clinical evaluation, especially context-specific interventions.