Family History Of Substance Abuse Research Articles

Household Exposure to Substance Abuse and the Risk of New Persistent Opioid Use After Cancer Surgery.

Household-level factors may also influence the risk of new persistent opioid use (NPOU). We sought to assess the risk of NPOU among individuals with household exposure to substance abuse. Opioid-naïve individuals who underwent oncological procedures were identified using the IBM MarketScan database. Multivariable regression equations were used to assess the association between household exposure to substance abuse and NPOU. Among 10 557 individuals 4.9% (n = 520) had a family history of substance abuse. Patients with a family history of substance abuse were more likely to use opioids during the perioperative (85.0% vs. 78.8%) and postoperative periods (40.2% vs. 34.1%) (both p < 0.05). Moreover, perioperative (300 MME [IQR: 450-200] vs. 250 MME [IQR: 150-435]) and postoperative (525 MME [IQR: 1348-225] vs. 350 MME [IQR: 150-850]) opioid dose was also higher among patients with a family history of substance abuse (both p < 0.001). On multivariate analysis, patients with family history of substance abuse had 37% (OR 1.37, 95% CI 1.07-1.75) higher odds of NPOU. Among opioid-naïve individuals undergoing oncological procedures, a family history of substance abuse is associated with NPOU. Patients should be screened for household-level factors before prescribing opioids for perioperative use.

The magnitude of parental physical harms: a descriptive report of 76 abusive children in Isfahan.

Victimization of parents by their children is a widespread phenomenon. However, there is a shortage of literature regarding the abusive behavior of children in Iranian society. The primary focus of this study was to highlight the magnitude and nature of the abusive behavior of a handful of Iranian children toward their parents. The sample study comprised 76 cases referred to the Isfahan Forensic Department (IFD) from September 2015 to October 2016. Data were computer analyzed using SPSS-21 by running a couple of descriptive-analytical tests. Most of the victims were elderly mothers above 60 years old. The victims were mostly injured in the neck and head. The majority of the offenders were between 20 to 30 years old, unemployed, with a family history of substance abuse. Significant differences (p less than 0.05) were observed in some variables: gender (women), age (over 60 years), harassment in the residence, having financial authority, 4 children or more (in victims group) and unemployment, single, age between 21-30 years (in offenders group). Children's abusive behavior towards their parents is a multifactorial phenomenon. Family constitution and background appeared to play a pivotal role in shaping the offenders' social behavior and reaction to their parents. Nonetheless, there is a need to explore further the possible causes of parental victimization.

Affective neuroscience personality traits in opioid use disorder patients: The relationship with earlier onset of substance use, the severity of addiction, and motivational factors to quit opiate use.

This study aims to explore the relationship between affective personality traits and opioid use disorder (OUD), including factors such as motivation to quit, addiction severity, and age of onset of drug use. This study included 141 patients with opioid addiction (OAP) and 160 age- and sex-matched healthy controls (HC). OAP were interviewed and diagnosed according to DSM-5 criteria. HC were screened for past or current drug use. Participants completed sociodemographic forms and the Affective Neuroscience Personality Scale (ANPS), and the OAP group also completed the Addiction Profile Index (API). SEEK, PLAY, and SADNESS were identified as different affective personality traits between OAP and HC groups. Addiction severity was positively correlated with SADNESS and ANGER, while the age of onset of drug use was correlated with ANGER. Risk factors for OA include family history of substance abuse, low education, and low PLAY scores, whereas risk factors for earlier substance use onset are childhood trauma and high ANGER scores. This study highlights the importance of understanding affective personality traits in OUD. These findings may deepen our understanding of the underlying mechanisms of OUD. The identification of these affective systems may have implications for the development of personalized prevention and treatment strategies.

Substance Abuse and Sleep Quality in University Students.

Substance abuse remains a challenging public health issue, especially among young people. It has been shown that poor sleep and substance abuse may have mutual intensifying effects. This study aimed to evaluate the rates of substance abuse, cigarette smoking, and alcohol consumption and their association with sleep disturbances among university students in 2021. The participants were the students of the Faculty of Sciences, University of Guilan, Iran in 2021. Data were collected through a researcher-made demographic questionnaire, the first two questions of the translated version of the World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and the Pittsburgh Sleep Quality Index (PSQI). A total of 222 students entered the study from March to August 2021. The rates of substance abuse in the past three months and lifetime were 35.6% and 45.5%, respectively. The most common type of substance abuse was related to the 'other substances' category. Substance abuse was significantly higher in students living in dormitories and those with a family history of substance abuse. Poor sleep was found in 34.2% of the students, and substance abuse and alcohol consumption both in the past three months and lifetime were significantly associated with lower sleep quality. This study showed that substance abuse was significantly associated with sleep disturbances. The study results also illustrated an upward trend of substance abuse in recent years among students in Rasht, which may be related to economic issues in the country and/or the effects of the COVID-19 pandemic. Considering the rising prevalence of substance abuse and its impacts on society, policymakers are highly recommended to pay special attention to its risk factors.

Substance use patterns in an adolescent psychiatric unit in Johannesburg, South Africa.

Substance use among adolescents carries a significant public health and socioeconomic burden with potential long-term consequences for the adolescent substance user (SU). Adolescents with mental health challenges are vulnerable to substance use and substance use worsens outcomes in this population. This study aimed to describe the substance use patterns among inpatients admitted to a specialised tertiary adolescent inpatient unit in Johannesburg over a 4-year period. This study was conducted at the Tara H. Moross Centre (Tara Hospital), in Johannesburg in the Gauteng province of South Africa. This was a retrospective comparative record review of all patients admitted to the adolescent unit over the 4 years. A lifetime history of substance use was documented in 44.1% (n = 52) of the 118 patient's records included in the final analysis. Cannabis was the most frequently used substance (n = 36, 69.2%). There were significant differences between the SU and substance nonuser groups regarding family structure (p = 0.012), family history of substance abuse (p = 0.046) and conflict within the family (p < 0.001). The high prevalence of substance use in this sample demonstrates the dual burden of mental health disorders and substance use in an adolescent treatment programme in Johannesburg. Primary caregiver burden and relational difficulties within the family unit should be observed for planned multidisciplinary interventions. The findings of this review provide an update on the pattern and prevalence of substance use among this adolescent mental healthcare user group, highlighting potential therapeutic targets.

Gender differences in the young-onset persistent delusional disorder.

We conducted a retrospective chart review to examine the gender differences in young onset Persistent Delusional Disorder (PDD) subjects (N=236) with onset of illness before the age of 30 years. Gender differences in marital and employment status were significant (p-0.001). Delusion of infidelity and erotomania were more common in females, while males had more body dysmorphic and persecutory delusions (X2-20.45, p-0.009). Males had more substance dependence (X2-21.31, p<0.001), as well as a family history of substance abuse and PDD (X2-18.5, p<0.01). To conclude, gender differences in PDD comprised some psychopathology, co-morbidity, and family history among those with young onset PDD.

Socio-Demographic Correlates and Patterns of Use Among Patients Visiting Addiction Services of Almadinah Specialized Psychiatric Hospital in Saudi Arabia

Background: Substance use disorders are on the increase worldwide with negative consequences on individuals, their family and the community. Our objective is to study the socio-demographic and patterns of use in those requesting addiction treatment in Addiction treatment services of Almadinah Specialist Psychiatrist Hospital (ASPH). Methods: A descriptive chart review study of 622 patients requesting treatment between the first January 2019 and 31 December 2012. Information was taken from patients’ records and if necessary, completed by a direct interview with the patient. Data collected were analysed using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: The majority were male (96.6%) with a mean age of 32.1 ± 9.2 years. More than half had less than a bachelor’s degree, while 23.5% were highly educated. The majority of patients were single (70.7%), 53.1% reported difficulty keeping a job, 17.8% a high income, 90% a negative family history of substance abuse and 94.7% a negative family history of psychiatric illness. The most frequent substances used, in descendant order, were captagon (69.8%), cannabis (63%) and alcohol (30.7%). The mean age of initiation was around 21 years for the three main substances. The prevalence of co-occurring disorders was at 14%. Two thirds of patients were from the outpatient department (67.7%) and 32.2% from the emergency department (ED). Around a third of our sample visited the emergency room at least once during the month prior to their evaluation and overall, 32.3% needed hospital admission. Conclusions: The fact that 90% of our sample reported a negative history of substance abuse with about 4 out of 5 having an early age of initiation to substance use emphasizes the urgent need for psychoeducational preventive efforts on substance abuse and dependence targeting our youths and their families, in multiple areas particularly in school and neighbourhoods.

Mood regulation, alexithymia, and personality disorders in female patients with opioid use disorders

BackgroundOpioid use disorders are rising among females. So, there is a need for more recognition of the various factors contributing to this trend in women, to help us to plan effective interventions to this group of patients. Hence, we conducted this research to identify risk factors associated with opioid use in females including mood regulation, alexithymia, and personality disorders. The study included 60 females ranging from 18 to 45 years [30 females diagnosed with opioid use disorder according DSM-IV (case group), and 30 females with no mental illness diagnosis according to general health questionnaire (control group)]. The subjects were recruited from inpatients and outpatient clinic of Al-Abbassia Hospital, Cairo, Egypt. Both groups were assessed by the Structured Clinical Interview for DSM-IV axis II disorders (SCID II) for personality, Trait Meta-Mood Scale (TMMS) for emotional regulation and Toronto Alexithymia Scale-20 (TAS-20) for alexithymia.ResultsRegarding sociodemographic data, cases were significantly different from controls as they are less educated (P < 0.001), more 73% (22) unemployed (P <0.001) and 56.7% (17) of cases had positive family history of first degree relatives with drug use (P = 0.001).SCID II showed more significant personality disorders diagnosis among cases as (borderline, antisocial, paranoid, schizotypal, and schizoid personality disorder) (P < 0.001, < 0.001, 0.01, 0.003, and 0.005, respectively) and also multiple personality disorders (P < 0.001) diagnosis. As regards alexithymia all cases were classified as having alexithymia 100% versus 56.7% among controls. Meanwhile, cases showed more difficulty in identifying (P < 0.001) and describing feelings (P = 0.001) and more externally oriented thinking (P = 0.010). Results of TMMS showed cases had lower total score on TMMS (p = 0.016). Signifying their inability to regulate their emotions in comparison to controls. There was no significant association between alexithymia, sociodemographic data, TMMS, and SCID II among cases group.ConclusionsThe present study found that females with opioid use disorders tend to be less educated, unemployed with positive family history of substance abuse, and diagnosed mainly with cluster A and B personality disorders. Moreover, had difficulty in identifying, describing, and regulating their emotions.

A study to eveluate the outcome of psychosocial intervention on motivation and readiness to change among individuals with alcohol use disorder at Dharwad institute of mental health and neurosciences (DIMHANS) Dharwad

Background of the study and objectives: The aim of the study was to evaluate the outcome of psychosocial intervention on Motivation and Readiness to change among individuals with Alcohol use disorder at DIMHANS, Dharwad. The study was conducted with following objectives: (1) To assess the motivation and readiness to change among individuals with Alcohol Use Disorder. (2) To evaluate the effectiveness of psychosocial intervention by comparing post-intervention motivation and readiness to change scores of experimental and control group subjects. (3) To find out the correlation between motivation and readiness to change (4) To find out association between motivation and readiness to change with selected demographic and clinical characteristics of individuals with alcohol use disorder.Research methodology: For the present study, quasi experimental non-equivalent control group pre-test post-test design was adopted. The independent variable was psychosocial intervention and dependent variable was Motivation and Readiness to change scores of alcohol use disorder patients. By using convenient sampling technique 60 alcohol use disorder patients were selected from psychiatric wards of DIMHANS Dharwad, based on the convenience first 30 subjects were taken to control group and next 30 subjects were taken to experimental group.The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) and University of Rhode Island Change Assessment Scale – URICA was used to collect the data on assessing Motivation and Readiness to change among individuals with alcohol use disorder. The pre-test was conducted for both experimental and control group subjects. Psychosocial intervention was administered to experimental group subjects in 4 sessions for 10 days. Post-test was conducted on 11th day after the intervention for both the groups.Results: Majority (70%) were in the age group 18-40yrs. 60% of the subjects were having secondary education. 28.33% of the subjects were farmers and private workers. 81.67% of the subjects were married. Largest proportions of participants were residing in rural area. In terms of clinical characteristics, 93.33% of the subjects were having the family history of substance abuse, 63.33% of the subjects were started to consume alcohol above the age of 18 years, among them 80% of the subjects were having peer pressure.Subjects in experimental group improved in motivation and readiness to change scores compared to control group subjects at post-tests level. There was a significant positive correlation between motivation and readiness to change scores among alcohol subjects.Interpretation and conclusion: The present study implies that nurse should involve in conducting psycho social intervention programme to improve the Motivation and readiness to change behaviour of alcohol dependents and help them to have a balanced lifestyle.

Factors Associated With Safe Prescription Opioid Disposal After Surgery in Adolescents

IntroductionUnused prescription opioids contribute to diversion, unintended exposure, and poisonings in adolescents. Factors associated with safe prescription opioid disposal for adolescents undergoing surgery are unknown. MethodsParents of adolescents (13-20 y) undergoing surgery associated with an opioid prescription were enrolled preoperatively. Parents completed a baseline survey measuring sociodemographics and family history of substance abuse and two postoperative surveys capturing opioid use and disposal at 30 and 90 d. Safe disposal was defined as returning opioids to a healthcare facility, pharmacy, take-back event, or a police station. Factors associated with safe opioid disposal were assessed using bivariate analysis. ResultsOf 119 parent-adolescent dyads, 90 (76%) reported unused opioids after surgery. The majority of parents reporting unused opioids completed the surveys in English (80%), although many (44%) spoke another language at home. Most reported income levels <$60,000 (54%), did not attend college (69%), and had adequate health literacy (66%). Most parents (78%) did not report safe opioid disposal. Safe opioid disposal was associated with younger patient age, (median 14 y, IQR 13-16.5 versus median 15.5 y, IQR 14-17, P = 0.031), fewer days taking opioids (median 5, IQR 2-6 versus median 7, IQR 4-14, P = 0.048), and more leftover pills (median 20, IQR 10-35 versus median 10, IQR 5-22, P = 0.008). ConclusionsMost parents fail to safely dispose of unused opioids after their adolescent’s surgery. Younger patient age, shorter duration of opioid use, and higher number of unused pills were associated with safe disposal. Interventions to optimize prescribing and educate parents about safe opioid disposal are warranted.

English

BACKGROUND Substance abuse is a cause of deaths, global burden of disease and injury. Increasing trends of underage substance abuse have shown to be associated with future substance dependency. Understanding various factors associated with it will help mitigate the severity and extent of use. In this study, we wanted to find out the pattern of substance abuse in patients at a de-addiction centre in Bangalore. METHODS This cross-sectional study was conducted on 500 male patients admitted to a deaddiction centre in Bangalore. Information was collected using pre-tested and structured questionnaire forms and the collected data was analyzed using statistical package for social sciences (SPSS) v 16.0 software. RESULTS The majority of the participants abused alcohol (92.4 %) and nicotine (74.2 %). 40.5 % of the participants initiated alcohol abuse in age groups of 12 – 18 (Years). Peer pressure (40.4 %) and curiosity (19 %) were observed as the most common reason for substance abuse. The common reason to seek de-addiction services was family pressure (22.4 %), physical health problems (14.2 %), family responsibility (12.4 %) fear of being a social outcast in the community (12 %) and psychiatric problems (10.6 %). Among the participants, 39.4 % had a family history of substance abuse and 41 % had a history of psychiatric illness. 47.4 % reported a history of child abuse. CONCLUSIONS Most participants initiated abuse before age of 25 mainly due to peer pressure. Proper enforcement of rules concerning under-aged substance abuse, proper peer and familial support, addressing concerns of psychiatric comorbidity and child abuse can decrease the chances of future dependency and thus lessen the burden of the problem. KEYWORDS De-Addiction Centre, Under-Aged Substance Abuse, Family History, Psychiatric Illness

Transition of Care Model for Pediatric Patients With Nonalcoholic Fatty Liver Disease.

Transition of Care Model for Pediatric Patients With Nonalcoholic Fatty Liver Disease.

Reduced Opioid Prescription After Anterior Cruciate Ligament Reconstruction Does Not Affect Postoperative Pain or Prescription Refills: A Prospective, Surgeon-Blinded, Randomized, Controlled Trial

PurposeTo investigate opioid utilization after anterior cruciate ligament (ACL) reconstruction in the setting of a multimodal pain regimen and assess the feasibility of prescribing fewer opioids to achieve adequate postoperative pain control.MethodsPatients undergoing ACL reconstruction in conjunction with a multimodal approach to pain control were randomized to receive either 30 or 60 tablets of hydrocodone (10 mg)–acetaminophen (325 mg). Patients were contacted at multiple time points up to 21 days after surgery to assess opioid utilization and medication side effects. We compared the mean number of tablets used between groups as the primary outcome. Preoperative variables associated with an increased risk of higher opioid pain medication requirements were also assessed.ResultsThe final analysis included 43 patients in the 30-tablet group and 42 in the 60-tablet group. There was no significant difference between groups in the number of tablets consumed (9.5 vs 12.2, P = .22), number of days opioids were required (4.5 vs 6.2, P = .14), 3-month opioid refill rates (12% vs 7%, P = .48), or postoperative pain control at any point up to 21 days after surgery. The 30-tablet group had a significantly smaller proportion of unused tablets compared with the 60-tablet group (69% of prescribed tablets [910 tablets] vs 80% of prescribed tablets [2,027 tablets], P < .001). Opioids were required after surgery by 91% of patients (n = 77), and 81% could have had their pain medication requirements met with a prescription for 15 tablets. Risk factors for increased postoperative opioid use included a family history of substance abuse (β = 14.1; 95% confidence interval, 5.7-22.4; P = .0014) and increased pain score at 2 hours after surgery (β = 1.07; 95% confidence interval, 0.064-2.07; P = .037).ConclusionsOrthopaedic surgeons may significantly reduce the number opioid tablets prescribed after ACL reconstruction without affecting postoperative pain control or refill rates.Level of EvidenceLevel I, randomized controlled trial.

Differential predictors for alcohol use in adolescents as a function of familial risk

Traditional models of future alcohol use in adolescents have used variable-centered approaches, predicting alcohol use from a set of variables across entire samples or populations. Following the proposition that predictive factors may vary in adolescents as a function of family history, we used a two-pronged approach by first defining clusters of familial risk, followed by prediction analyses within each cluster. Thus, for the first time in adolescents, we tested whether adolescents with a family history of drug abuse exhibit a set of predictors different from adolescents without a family history. We apply this approach to a genetic risk score and individual differences in personality, cognition, behavior (risk-taking and discounting) substance use behavior at age 14, life events, and functional brain imaging, to predict scores on the alcohol use disorders identification test (AUDIT) at age 14 and 16 in a sample of adolescents (N = 1659 at baseline, N = 1327 at follow-up) from the IMAGEN cohort, a longitudinal community-based cohort of adolescents. In the absence of familial risk (n = 616), individual differences in baseline drinking, personality measures (extraversion, negative thinking), discounting behaviors, life events, and ventral striatal activation during reward anticipation were significantly associated with future AUDIT scores, while the overall model explained 22% of the variance in future AUDIT. In the presence of familial risk (n = 711), drinking behavior at age 14, personality measures (extraversion, impulsivity), behavioral risk-taking, and life events were significantly associated with future AUDIT scores, explaining 20.1% of the overall variance. Results suggest that individual differences in personality, cognition, life events, brain function, and drinking behavior contribute differentially to the prediction of future alcohol misuse. This approach may inform more individualized preventive interventions.

Predictors of change in suicidal ideation across treatment phases of major depressive disorder: analysis of the STAR*D data.

The effects of common antidepressants on suicidal ideation (SI) is unclear. In the landmark STAR*D trial antidepressants were effective for Major Depressive Disorder (MDD) in early treatment phases, but less effective in later phases. The effects of antidepressants on SI across the entire sample of the STAR*D trial has never been investigated. We performed a secondary analysis of the STAR*D data with the primary outcome of change in score on the suicide item (item three) of the Hamilton Rating Scale for Depression (HRSD17) across all four study levels. We used descriptive statistics and logistic regression analyses. Pearson correlation was used for change in SI versus change in depression (HRSD16). Reduction in mean (SD) SI was greater in levels one: 0.29 (±0.78) (p < 0.001) and two: 0.26 (±0.88) (p < 0.001) than in levels three: 0.16 (±0.92) (p = 0.005) and four: 0.18 (±0.93) (p = 0.094). A history of past suicide attempts (OR 1.72, p = 0.007), comorbid medical illness (OR 2.23, p = 0.005), and a family history of drug abuse (OR 1.69, p = 0.008) were correlated with worsening of SI across level one. Treatment with bupropion (OR 0.24, p < 0.001) or buspirone (OR 0.24, p = 0.001) were correlated with lowering of SI across level two. Improvement in SI was correlated with improvement in overall depression (HRSD16) at level one: r(3756) = 0.48; level two: r(1027) = 0.38; level three: r(249) = 0.31; and level four: r(75) = 0.42 (p < 0.001 for all levels). Improvement in SI is limited with pharmacotherapy in patients with treatment-resistant depression. Treatments with known anti-suicidal effects in MDD, such as ECT, should be considered in these patients.

Socio Demographic Profile of Late Childhood and Adolescence Abusing Cannabis

Adolescence is a transition period from childhood to adulthood. Along with many other conflicts, students atthis age group are likely to encounter drug abuse for the first time. Identifying the socio demographic profilewill help in prevention of substance use disorder to some extent. Objective: Identify the socio demographicprofile of adolescents abusing cannabis. Methods: Data were collected from 100 patients from two deaddiction centres using a survey questionnaire after getting consent. Results: The demographic findingsrevealed that the majority 63% belonged to the age group of 15-20 years and the highest 64% of the sampleswere hailing from the urban area. Significantly, the prevalence of substance use is high among children froma nuclear family. Majority (42%) were belonging to high income family group (>30,000/month). Analysisof the family status revealed that among 100 samples, fathers of 62 patients were working abroad. In 92%of the cases there was family history of substance abuse. All these findings suggest that an in-depth study isneeded to identify the role of demographic factors in cannabis abuse.

Relative accuracy of social and medical determinants of suicide in electronic health records.

ObjectiveThis paper compares the accuracy of predicting suicide from Social Determinants of Health (SDoH) or history of illness.Population Studied5 313 965 Veterans who at least had two primary care visits between 2008 and 2016.Study DesignThe dependent variable was suicide or intentional self‐injury. The independent variables were 10 495 International Classification of Disease (ICD) Version 9 codes, age, and gender. The ICD codes included 40 V‐codes used for measuring SDoH, such as family disruption, family history of substance abuse, lack of education, legal impediments, social isolation, unemployment, and homelessness. The sample was randomly divided into training (90 percent) and validation (10 percent) sets. Area under the receiver operating characteristic (AROC) was used to measure accuracy of predictions in the validation set.Principal FindingsSeparate analyses were done for inpatient and outpatient codes; the results were similar. In the hospitalized group, the mean age was 67.2 years, and 92.1 percent were male. The mean number of medical diagnostic codes during the study period was 37; and 12.9 percent had at least one SDoH V‐code. At least one episode of suicide or intentional self‐injury occurred in 1.89 percent of cases. SDoH V‐codes, on average, elevated the risk of suicide or intentional self‐injury by 24‐fold (ranging from 4‐ to 86‐fold). An index of 40 SDoH codes predicted suicide or intentional self‐injury with an AROC of 0.64. An index of 10 445 medical diagnoses, without SDoH V‐codes, had AROC of 0.77. The combined SDoH and medical diagnoses codes also had AROC of 0.77.ConclusionIn predicting suicide or intentional self‐harm, SDoH V‐codes add negligible information beyond what is already available in medical diagnosis codes.Implications for PracticePolicies that affect SDoH (eg, housing policies, resilience training) may not have an impact on suicide rates, if they do not change the underlying medical causes of SDoH.

Socio-demographic Characteristics of Drug Abusers Attending a De-addiction Center in Dhaka

Introduction: Drug addiction is a social curse involving all classes of people for ages. Not only it increases individuals morbidity and mortality but also creates social unrest and reduces the national productivity frequent assessment surveys have provided insights into the pattern and required responses.&#x0D; Objectives: To assess the sociodemographic profile of drug addicts admitted in a prominent drugs deaddiction centre of Dhaka, Bangladesh.&#x0D; Materials and Methods: This cross-sectional descriptive study carried out on 158 admitted patients in Thikana Psychiatric/ Drug de-addiction clinic, from October 2014 to September 2015. A predesigned questionnaire used in evaluating the patients by two or more sittings face-to-face interviews.&#x0D; Results: Amongst 158 patients, 94.30% were male and 62.0% were in the age group of 21-30 years with a mean age of 26.46 + 6.168 years. Majority (60.8%) patients were married and 48.7% had education up to higher secondary level, 29.1% were unemployed and 27.2% students. About 36.7% were spending between 101- 500 Taka/day and 65.8% arrange money for drugs by themselves. The reason behind starting drug abuse was mainly peer pressure (49.4%) followed by curiosity (26.6%). The mean age of starting drug was 19.42 + 7.68 years and 68.35% were addicted to the drug for the period between 1-5 years. Only 4.4% had positive family history of drug abuse. Regarding route of drug abuse, ingestion was most popular (55.1%) and only 8.9% participants were using injectable route. Amongst abused drugs, Amphetamine (Yaba) was most popular among the female (77.7%) and students (21.5%).&#x0D; Conclusion: Drug abuse cripples the individual, the family, the society and finally the nation. Since younger generations most affected by the drug abuse, it is prudent to evolve and apply preventive, curative and rehabilitative strategies before it is too late.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 113-115

Implementation and Evaluation of an Opioid Risk Questionnaire in the Outpatient Plastic Surgery Setting.

Most patients undergoing plastic and cosmetic surgery are prescribed an opioid for postoperative pain control. With the advent of the opioid epidemic in our country, screening for opioid risk has become a topic of many health care discussions. However, there has been little mention of using an opioid risk questionnaire specific to the outpatient plastic surgery setting. This project consisted of distribution of an opioid risk questionnaire to adult patients undergoing outpatient plastic surgery. Data were collected at preoperative appointments from participating patients (n = 27). Although the sample size was small, two patients (7%) were identified as having a history of substance abuse, and both of those patients reported they had also received treatment for their substance abuse. In addition, six patients (22%) reported having a family history of substance abuse. Such findings suggest that clinicians working in outpatient plastic surgery should screen their patients for substance abuse and misuse.

Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy.

The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.