Higher Rates Of Substance Use Research Articles

A Focused Screening and Clinical Intervention with Streamlined Outpatient Linkage for Hospitalized Patients with Opioid Use Disorder Experiencing Homelessness.

Patients experiencing homelessness have higher rates of substance use and related mortality, often driven by opioid overdose. Conversely, opioid use disorder (OUD) is a leading risk factor for homelessness. Our goal was to test the efficacy of an electronic health record (EHR) screen in identifying this vulnerable population during hospitalization and to assess the feasibility of a bundled intervention in improving opioid safety. We assessed patients' housing status, substance use, previous MOUD treatment, barriers to MOUD treatment and readiness to take MOUD in and out of the hospital. For each post discharge follow up call, patients were asked about their MOUD status, barriers accessing treatment, current substance use, and housing status. We also assessed team members perceptions and experiences of the study. We enrolled 32 patients with housing insecurity and OUD. The mean age was 44, the majority self-identified as male (78%), and mostly as White (56%) or Black (38%). At each follow up within the 6-months post-discharge, reach rates were low: 40% of enrollees answered at least 1 call and the highest reach rate (31% of patients) occurred at week 4. At the third and sixth-month follow ups, >50% of subjects still taking MOUD were also using opioids. Our clinician augmented EHR screen accurately identified inpatients experiencing OUD and PEH. This intervention showed high rates of attrition among enrolled patients, even after providing cellphones. The majority of patients who were reached remained adherent to MOUD though they reported significant barriers.

State Laws on Substance Use Treatment for Incarcerated Pregnant and Postpartum People.

Incarcerated perinatal populations report high rates of substance use in the United States (US). Despite this, substance use disorder (SUD) treatment is not routinely available in carceral settings and state policies related to the provision of substance use screening and treatment are unknown. We conducted a systematic search in WestLaw through the end of the 2020 legislative session combining the terms "pregnant" and "postpartum" with terms for incarceration and related terms. The search returned 453 statutes from 43 states. A deductive codebook of various maternal health topics was developed. Legislative texts related to SUD screening and treatment were extracted for textual analysis. Of the 43 states identified as having at least 1 state statute pertaining to pregnant or postpartum incarcerated people, 7 states had statutes relevant to SUD screening and treatment. Statutes related to substance use screening, education, treatment and diversion programs, program eligibility, aftercare and release planning, and funding appropriations. The majority of states across the U.S. lack legislation that address SUD screening and treatment among incarcerated perinatal populations. Given the known limited access to SUD treatment for perinatal populations in custody, increasing legislative statutes could increase access to essential care.

Existential isolation and well-being in justice-involved populations.

Much work in psychology has focused on feelings of social isolation and/or loneliness. Only recently have psychologists begun to explore the concept of existential isolation (EI). EI is the subjective sense that persons are alone in their experience and that others are unable to understand their perspective. EI thus occurs when people feel that they have a unique worldview unshared by others. Measured as either a state or trait, empirical studies have shown EI undermines life meaning and decreases well-being; people scoring high on EI report lower levels of need satisfaction, purpose in life, and meaningfulness and increased death-related concerns. There is also a positive correlation between EI and anxiety, depression, and suicidal ideation. The purpose of this perspective paper is to review literature on EI and discuss its relevance to people who have been involved with the justice system. Given their higher rates of substance use, mental health difficulties, and trauma, this traditionally underserved population is particularly susceptible to compromised well-being. We theorize that EI may impede the impact of therapeutic interventions in justice settings as more isolated individuals may feel disjointed from their counselors and peers, thereby decreasing levels of treatment engagement, participation, satisfaction, and perceived social support. Professionals may be able to mitigate issues related to EI by an enhanced focus on establishing authenticity within the therapist-client relationship (e.g., empathy, perspective taking, compassion), connecting with clients via I-sharing [i.e., matching on a shared experience(s)], and/or encouraging active participation in client's behavioral healthcare needs (e.g., self-reflection).

Impairment, Disability, and Substance Use Disorder

According to the social model of disability, it is not individuals’ impairments, but societal barriers that cause these impairments to be disabling. Impairment refers to the “loss or abnormality of psychological, physiological, or anatomical structure or function,” whereas disability is socially constructed and refers to the inability to independently complete one or more everyday tasks at a “normal” level of functioning. Existing research finds that disability serves as a chronic stressor, and those with disabilities report higher rates of substance use than their able-bodied counterparts. Therefore, this research will be among the first to combine the social model of disability with the stress process framework. It will examine the relationship between impairment and substance use and how disability, as a measure of chronic stress, may affect this relationship. More specifically, using data from the 2019 National Survey on Drug Use and Health (N = 42,739), this article examines the following two research questions: (1) What is the relationship between impairment and substance use disorder? and (2) Does disability, as a measure of chronic stress, mediate the relationship between impairment and substance use disorder? Findings reveal that those with an impairment have significantly greater odds of having a substance use disorder. However, the relationship between impairment and substance use disorder is fully mediated by disability. These findings indicate that disability or the chronic stress one faces living in an inaccessible society, not one’s impairments, are what accounts for the increased likelihood of substance use disorder among individuals with disabilities.

Collaborative approach to harm reduction by managed care pharmacy team for populations with substance use disorder

BackgroundOregon has one of the highest rates of substance use and substance use disorders (SUDs) in the nation. To improve access to SUD treatment in Oregon, CareOregon clinical pharmacists in collaboration with the behavioral health team have implemented these best practices to support members with SUD. ObjectiveThe primary objective of this article is to describe the various harm reduction programs and interventions implemented by managed care clinical pharmacists at CareOregon to prevent overdose and ensure improved health outcomes for populations with SUD. Practice descriptionThe CareOregon team of managed care clinical pharmacists acts as a liaison with provider networks by providing pharmacy benefit knowledge and implementing several interventions and best practices to improve health outcomes for populations with SUD. Practice innovationThe managed care clinical pharmacist team implemented a medication education (MEDS Ed) program to provide educational support to the CareOregon provider network on harm reduction, supported medication for opioid use disorder (MOUD) program initiatives to increase buprenorphine prescribing, and used programs to increase naloxone access for populations at high risk of overdose. Evaluation methodsA mixed-method approach was applied to evaluate the impact of the practice innovations implemented. A qualitative self-assessment questionnaire was used to evaluate the impact of the harm reduction MEDS Ed. Quantitative data accessed via CareOregon’s claims data were used to evaluate the effect of initiatives to expand naloxone access and increase buprenorphine prescribing. ResultsThe CareOregon provider network reported an increase in knowledge about harm reduction by attending the MEDS Ed training. From the first quarter of 2019 to the second quarter of 2022, the number of naloxone prescriptions filled increased by 346%. From the third quarter of 2017 to the first quarter of 2022, the number of Drug Addiction Treatment Act–waivered providers prescribing buprenorphine increased by 331%. As a result, the number of prescriptions for MOUD doubled during this period. ConclusionThe harm reduction interventions implemented by the managed care clinical pharmacist team at CareOregon were successful in improving knowledge on harm reduction and increasing naloxone access and buprenorphine prescribing for populations at risk of opioid use disorder.

Trauma recidivism is pervasive and is associated with mental and social health opportunities

IntroductionRecidivism after orthopedic trauma results in greater morbidity and costs. Prior studies explored the effects of social and medical factors affecting the frequency of return to the hospital with new, unrelated injury. Identification of mental, social and other risk factors for trauma recidivism may provide opportunities for mitigation. The purposes of this study are to determine the rates of subsequent, unrelated injury noted among orthopedic trauma patients at a large urban trauma center and to evaluate what patient and injury features are associated with greater rates of trauma recidivism. We hypothesize higher rates of new injuries will be related to ballistic trauma and other forms of assault, alcohol and recreational drug use, unemployment, and unmarried status among our trauma patients. MethodsA series of 954 skeletally mature patients at a level 1 trauma center over a 5 year period were included in the study. All were treated operatively for thoracolumbar, pelvic ring, acetabulum, and/or proximal or shaft femoral fractures from a high energy mechanism. Retrospective review of demographic, injury, medical, and social factors, and subsequent care was performed. Trauma recidivism was defined as returning to the emergency department for treatment of any new injury. A backward stepwise logistic regression statistical analysis was used to identify independent predictors of recidivism. ResultsMean age of all patients was 41.2 years, and 73.2% were male. 136 patients (14.3%) returned with a new injury within a mean of 21 months. These trauma recidivists were more likely to sustain a GSW (22.1% vs 11.4%, p = 0.001). They had higher rates of substance use, including tobacco (57.4% vs 41.8%, p = 0.001) and recreational drugs (50.7% vs 34.4%, p = 0.001), and were less likely to be married (10% vs 25.9%, p<0.001). Mental illness was pervasive, noted in 56.6% of patients with new injury (vs 32.8%, p<0.001). Medicaid insurance was most common in the trauma recidivist population (58.1% vs 35.0%, p = 0.001), and 12.5% were uninsured. Completing high school or more education was protective (93% non-recidivist (vs 79%, p = 0.001). Sixty-nine patients (50.7%) were repeat trauma recidivists within the study period. Independent predictors of new injury included recreational drug use (OR 1.64, p = 0.05) and history of assault due to GSW or other means (OR 1.67, p = 0.05). History of pre-existing mental illness represented the greatest risk factor for trauma recidivism (OR 2.55, p<0.001). DiscussionNew injuries resulting in emergency department presentation after prior orthopedic trauma occurred in 14.3% and were associated with history of assault, lower education, Medicaid insurance, tobacco smoking and recreational drug use. Mental illness was the greatest risk factor. Over half of patients with these additional injuries were repeat trauma recidivists, returning for another new injury within less than 2 years. Awareness of risk factors may promote focused education and other interventions to mitigate this burden. Level of EvidenceLevel 3 retrospective, prognostic

Investing in Community Care Is an Important Goal and Need for Eliminating Hepatitis C in the United States: An Abolitionist Perspective.

Recent nationwide racial justice uprisings following ongoing police violence against Black communities juxtaposed with the COVID-19 pandemic have increased the urgency for a reckoning around the ineffectiveness and harm caused by the carceral apparatus. It is well documented that the correctional system was founded upon and continues the legacy of slavery and white supremacy. Research has shown that incarceration directly contributes to many negative health outcomes, including increased risk and spread of hepatitis C virus (HCV) infections, especially among people who inject drugs. This high burden of HCV disproportionately impacts low-income communities of color, who not only report higher rates of substance use due to pervasive discrimination but are also over-incarcerated as a result of structural racism and the War on Drugs. The COVID-19 pandemic further underscores that correctional facilities are fundamentally structured to promote health inequities. Minoritized communities who are overrepresented in corrections continue to be put at increased risk of COVID-19 in overcrowded facilities, are isolated from social support and medical care, and have been ignored in vaccination strategies. In this perspective, we argue that HCV interventions within the carceral apparatus will remain largely ineffective due to the negative health impacts of incarceration. Instead, we propose adopting abolitionist principles for HCV elimination-divesting from the carceral apparatus to prioritize community-based efforts on promoting HCV screening, treatment, and prevention. In doing so, the nation will have not only the capacity to meaningfully eliminate HCV but also the potential to improve overall societal outcomes.

Housing and supportive services for substance use and self-efficacy among young mothers experiencing homelessness: A randomized controlled trial

AimsHomeless mothers with young children in their care contend with high rates of substance use and low self-efficacy. However, a limited number of studies have examined these outcomes associated with housing and supportive services. DesignParticipants were randomly assigned to: (1) housing + support services (n = 80), (2) housing-only (n = 80), or (3) services as usual (SAU) (n = 80) and were re-assessed at 3-, 6-, 9- and 12-months postbaseline. SettingsThe study recruited a community-based sample from homeless service agencies and advertisements in a large Midwestern city. ParticipantsThe study recruited two hundred forty (N = 240) women between the ages of 18 to 24 years, experiencing homelessness and with a substance use disorder (SUD) who also had a biological child under the age of 6 years in their care. MeasurementsWe measured frequency of alcohol and drug use using the Form 90 semi-structured interview, and self-efficacy using Pearlin and Schooler's (1978) 7-item Mastery Scale. FindingsOverall, mothers showed significant improvement in substance use and self-efficacy over time in each condition. However, as expected, patterns of change differentiated intervention groups with more mothers showing better substance use and self-efficacy outcomes in housing + supportive services than in SAU. Unexpectedly, more mothers in SAU showed better outcomes than those in housing-only. ConclusionsSubstance use decreased and self-efficacy increased over time, but patterns of change characterized the intervention groups. In particular, findings suggest that when providing housing to this population, supportive services should also be offered.

Primary Care: A Critical Stopgap of Mental Health Services During the COVID-19 Pandemic.

The COVID-19 pandemic resulted in a worsening mental health crisis, while also dramatically reducing access to in-person primary care services. Primary care, an essential provider of mental health services, rapidly adopted telemedicine to address behavioral health needs. Here we examine the provision of mental health services by primary care during the pandemic, including the essential use of telemedicine. METHODS: Data were collected via a series of national, cross-sectional surveys of primary care clinicians in November 2020 by the Larry A. Green Center. The survey was distributed through a network of partner organizations and subscribers. Descriptive and chi squared analysis were utilized. RESULTS: Among 1,472 respondents, 88% reported increased mental health needs and 37% reported higher rates of substance use among patients. Most (65%) clinicians became more involved in providing mental health support, and 64% reported using telemedicine to provide behavioral health services. Phone-based care was more common for care delivery among patients who were uninsured (60% vs 42%, P < .01), Medicare beneficiaries (45% vs 36%, P < .05), non-English speaking (67% vs 40%, P < .001), and racial and ethnic minorities (58% vs 34%, P < .001). CONCLUSIONS: Primary care is a leading provider of mental health services and has played a critical role during the pandemic. Primary care clinicians have strong relationships with their patients as well as outreach within communities that may otherwise struggle to access mental health services. The use of telemedicine in primary care, and specifically phone-based services, has been an essential tool to providing equitable access to mental health services.

Substance use and sentiment and topical tendencies: a study using social media conversations of youth experiencing homelessness

PurposeThis study investigates associations between Facebook (FB) conversations and self-reports of substance use among youth experiencing homelessness (YEH). YEH engage in high rates of substance use and are often difficult to reach, for both research and interventions. Social media sites provide rich digital trace data for observing the social context of YEH's health behaviors. The authors aim to investigate the feasibility of using these big data and text mining techniques as a supplement to self-report surveys in detecting and understanding YEH attitudes and engagement in substance use.Design/methodology/approachParticipants took a self-report survey in addition to providing consent for researchers to download their Facebook feed data retrospectively. The authors collected survey responses from 92 participants and retrieved 33,204 textual Facebook conversations. The authors performed text mining analysis and statistical analysis including ANOVA and logistic regression to examine the relationship between YEH's Facebook conversations and their substance use.FindingsFacebook posts of YEH have a moderately positive sentiment. YEH substance users and non-users differed in their Facebook posts regarding: (1) overall sentiment and (2) topics discussed. Logistic regressions show that more positive sentiment in a respondent's FB conversation suggests a lower likelihood of marijuana usage. On the other hand, discussing money-related topics in the conversation increases YEH's likelihood of marijuana use.Originality/valueDigital trace data on social media sites represent a vast source of ecological data. This study demonstrates the feasibility of using such data from a hard-to-reach population to gain unique insights into YEH's health behaviors. The authors provide a text-mining-based toolkit for analyzing social media data for interpretation by experts from a variety of domains.

Family Connect: The Pilot Test of a Cross-Systems Behavioral Health Treatment Referral and Linkage Intervention for Youth on Probation

Despite high rates of substance use, youth involved in the juvenile justice system are unlikely to be linked to the treatment services they need. Family Connect is a flexible, family-focused, linkage intervention developed to address multilevel barriers and increase youth engagement in care through the introduction of a linkage specialist. We describe the components of Family Connect and present findings from the intervention pilot test comparing 18 youth–caregiver dyads to 95 historical controls on referral, attending intake and initiating treatment. Results indicated preliminary support for Family Connect as an approach to increase cross-systems linkage and access to behavioral health care. Findings also suggested support for the feasibility of the intervention and indicated that justice-involved youth and their caregivers found the intervention to be acceptable. In addition to discussing our findings in the context of recent justice reforms, and the importance of improving access to treatment, we make recommendations to inform a future trial of Family Connect.

Mental distress and substance use among rural Black South African youth who are not in employment, education or training (NEET).

South Africa (SA) has one of the highest rates of youth unemployment and youth who are not in employment, education or training (NEET), even higher among Black South Africans. SA's NEET rates are 3 times those of UK; 5.4 times of Germany; 1.3 times of Brazil; and 2.5 times of Malaysia. Given that youths between 15 and 24 years of age make up 24% of the total population, these are significant challenges for the economy and further fuel the cyclical, pervasive and enduring nature of poverty. We hypothesised that rural youth who are NEET would have a greater prevalence of mental disorders and higher rates of substance use compared to their non-NEET counterparts. The objective of the study is to determine the differences in rates of psychological distress and substance use between NEET and non-NEET rural African 14- to 24-year-old young men. The study took place in a remote and rural district municipality in KwaZulu-Natal, South Africa. We divided the district's five sub-municipalities into two clusters (large and small) and randomly selected one from each cluster for inclusion in the study. We further randomly selected wards from each sub-municipality and then rural settlements from each ward, for inclusion in the study. We recruited young men as part of a larger study to explore sociocultural factors important in gender-based violence in rural SA. We compared 15- to 19-year old and 20- to 24-year old youth NEET and non-NEET on rates of psychological distress symptoms (depression, anxiety, suicidal thoughts, hopelessness and worthlessness) and substance misuse (including alcohol, cannabis, other recreational drugs) using a Multivariate Analysis of Variance (MANOVA) statistics at p < .005 level of significance level. About 23% of the 355 male participants were NEET. There were no statistically significant differences in psychological distress or substance use between youth NEET and non-NEET, controlling for age. The study highlights difficult transitions to post-secondary education and work for Black youth in rural SA where opportunities for employment are limited. Education, training and employment appear to offer limited benefit.

Social norms and club drug use of young adult college students during Music Week

Background: Young adult college students have high rates of substance use, theoretically related to social norms. Behavioral norms refer to the quantity of substances that students think others use, and attitudes refer to how much students or others approve of substance use. Prior research has shown a relationship between behavioral norms, student attitudes, and perceived parental attitudes and alcohol and marijuana use. However, the relationship between social norms and use of club drugs (e.g., MDMA) has not been studied.Objective: The purpose of this cross-sectional study was to expand knowledge about young adult college student social norms and club drug use.Methods: 200 young adult undergraduates (Women = 97, 49%) were recruited from a campus recreational facility on a large private Southeastern university in April 2019. Students self-reported behavioral norms, student attitudes, parental perceived attitudes, club drug use during a typical week and during music week, and substance use consequences.Results: Logistic and negative binomial regressions showed that student attitudes were significantly related to club drug use in a typical week (OR = 2.07, p = .005), during music week (OR = 2.08, p = .001), and consequences of use (RR = 1.23, p < .001), but behavioral norms and perceived parental attitudes were not.Conclusions: Findings build on social norms research with alcohol and marijuana use. Attitudes may be more important to consider than behavioral norms or perceived parental attitudes for interventions to reduce club drug use. Young adults (18-25 years old) have a high risk for substance use; both alcohol and drug use increase throughout adolescence and peak in young adulthood. 1–3 Young adults have high heavy episodic drinking (35% past month) and illicit drug use (25% past month), with greater MDMA use (10% vs 7%) and marijuana use (35% vs. 15%) than other adults. 4 Alcohol and marijuana use has been linked to many negative consequences, such as blackouts, physical injuries, unprotected sex, and even death. 5 , 6 Club drug use is also linked to negative consequences, such as memory lapse, headaches, loss of energy, trouble sleeping, depression, confusion, anxiety, irritability, nausea, and changes in heart rate and blood pressure. 7 , 8

Types of criminal legal system exposure and polysubstance use: Prevalence and correlates among U.S. adults in the National Survey on Drug Use and Health, 2015–2019

IntroductionCriminal legal system (CLS) exposed adults experience higher rates of substance use, substance use disorder (SUD), and overdose. As most CLS exposed adults are not incarcerated, it is important to focus on CLS exposure across the carceral continuum. MethodsThis research used pooled data from adult respondents (N = 206,314) in the National Survey on Drug Use and Health (2015–2019). Survey weighted descriptive statistics and Poisson regression were used to estimate prevalence of polysubstance use (i.e., concurrent use) across CLS exposure types (i.e., arrest, probation, parole), identifying relevant correlates. ResultsThe prevalence of polysubstance use was higher among CLS exposed adults, and nearly two-thirds of CLS exposed adults who used multiple types of substances indicated having an SUD. Comparing CLS exposure types, polysubstance use was less likely among adults on probation (IRR=0.89, 95%CI=0.84,0.94) or parole (IRR=0.82, 95%CI=0.76,0.87) compared to those arrested. Polysubstance use was also more likely among adults on probation (IRR=1.09, 95%CI =1.01,1.17) compared to those on parole. While some characteristics (i.e., age, ethnicity, SUD) were consistently associated with polysubstance use across types of CLS exposure, other characteristics (i.e., sexual identity, marital status, suicidal ideation) were not. ConclusionsThere is heterogeneity in health risks as a function of CLS exposure type. Further research is needed to identify causal mechanisms and differences based on demographic characteristics. Given high levels of polysubstance use across CLS exposure types, a shift towards a more comprehensive approach in substance use epidemiology may facilitate building an evidence-base to maximize treatment related interventions to reduce polysubstance-involved overdoses.

Discrimination, Substance Use, and Mental Health among Sexual and Gender Minority Adults Accessing Day Shelter Services

Background Sexual and gender minority (SGM) adults are overrepresented in the population of individuals experiencing homelessness, and high rates of substance use are common in this group. Plausibly, poor mental health and discrimination may contribute to substance use among SGM adults experiencing homelessness. This study described participant characteristics, and the interrelations among sociodemographic variables, substance use, mental health, and discrimination experiences among 87 SGM adults seeking services at a day shelter in Oklahoma City, OK. Discrimination experiences were characterized by race (White vs. non-White), sex (female vs. male), sexual identity (heterosexual vs. sexual minority), and gender identity (gender conforming vs. gender minority). Methods Participants reported their past 30-day tobacco (cigarette/cigarillos, alternative tobacco products [ATP]), alcohol, and marijuana use, as well as everyday and lifetime major discrimination experiences, substance use problems, depression, anxiety, and post-traumatic stress disorder (PTSD). Independent samples t-tests examined differences in discrimination based on substance use and mental health. Results Participants had high rates of tobacco and marijuana use, substance use problems, depression, anxiety, and PTSD. Over 80% reported experiencing everyday or lifetime major discrimination. Depression and PTSD were associated with ATP use, and anxiety was associated with alcohol use. All mental health variables were associated with substance use problems and everyday discrimination. Depression was associated with lifetime major discrimination. Conclusions SGM adults accessing shelter services frequently experienced discrimination and poor mental health, and substance use was common. Future research should examine the causal impact of discrimination on mental health and substance use among SGM adults experiencing homelessness.

Mental Health and Addiction Services Exclusive to LGBTQ2S+ during COVID-19: An Environmental Scan.

Background: Youth who are lesbian, gay, bisexual, trans, queer, 2-spirit, and of other identities (LGBTQ2S+) experience mental health disparities and higher rates of substance use when compared to their cisgender and heterosexual peers and yet also experience more barriers to access to services. The purpose of this paper is to determine the types of mental health and substance use programs and services exclusive to LGBTQ2S+ youth in Ontario during the pandemic. Methods: An environmental scan was conducted to identify existing programs and services in Ontario, Canada that offered exclusive mental health and addiction services to LGBTQ2S+ individuals aged 16–29, either by offering services to all or subgroups within the population. Organizations, services and programs were classified by the geographical distribution of services, populations served, types of programming or services, methods of service delivery, and program criteria. Results: In total, 113 organizations and 240 programs and services were identified as providing mental health and substance use services exclusively to LGBTQ2S+ youth. Identified adaptations for the COVID-19 pandemic included cancelling in-person services, increasing online and telephone services, and expansion to province wide from local availability. Conclusions: The findings highlight the importance of offering services that provide culturally inclusive care for LGBTQ2S+ youth, and these results can also be used by policy makers to inform policies. In particular, there was a lack of culturally relevant clinical services for youth requiring a greater intensity of treatment.

Prevalence, Sociodemograhic Characteristics and Substance Abuse among Young Persons in Edo State, Nigeria

Substance Abuse among youths is a major public health challenge globally. Complications associated with drug abuse include psychiatric disorders, sexual violence, drug dependence and criminal tendencies. The study set out to determine the prevalence and sociodemographic characteristics associated with Substance abuse among the young in Edo State, Nigeria. A descriptive cross-sectional study design and multi-stage sampling technique was used with a structured interviewer administered questionnaire among 412 study respondents who gave informed consent. All relevant data such as socio-demographic information, substance abuse was collected and analyzed using SPSS 23. The mean age (SD) of the study subjects was 19.03(3.09) years. The age group with the highest use of drugs was 19-22 years. Among drug abusers, male subjects (10.8%) had a higher rate of substance use compared to females (6.2%). In all, 29(8.3%) of the respondents satisfied the criteria for defining substance abuse. Cannabis was the most named substance abused accounting for 86 (20.9%) followed by alcohol and tramadol respectively (19.7% and 11.2%). Alcohol was the most commonly abused substance accounting for 17(58.6%). This was closely followed by Tramadol 41.4%. 52.4% of the respondents had no knowledge about the definition of substance abuse. About 32.3% of the subjects got information about Substance abuse from friends. The commonest reason for illegal drug use was peer influence which accounted for 50% of the respondents. Majority of the substance abusers (62.5%) who continued to abuse drugs did so because of the euphoric feeling they got from its use. Alcohol is still the most commonly abused substance among young persons in our environment as shown in this study and all effort be made the relevance authorities to control the illicit use of this substance in our society.

Substance Use, Financial Stress, Employment Disruptions, and Anxiety among Veterans during the COVID-19 Pandemic.

The COVID-19 pandemic has resulted in financial, employment, and mental health challenges. In general, American veterans report high rates of substance use, which may be influenced by the COVID-19 pandemic. Those with pre-existing mental health problems, employment disruptions, or financial stress may be particularly vulnerable. We examined the relationships between pre-existing self-report screens for a probable anxiety disorder, COVID-19-related financial stress, employment disruption (e.g., lost job, reduced hours), and alcohol, cannabis, and cigarette use during the pandemic among 1230 veterans (Mage = 34.5; 89% male). Participants were recruited through various social media sites and completed an online survey 1 month prior to implementation of the nationwide physical distancing guidelines in the United States (February 2020). Six months later (August 2020), they completed a follow-up survey. Compared to veterans who screened negative for anxiety prior to the pandemic, veterans who screened positive reported consuming more drinks per week (b = 3.05), were more likely to use cannabis (OR = 6.53), and smoked more cigarettes (b = 2.06) during the first 6 months of the pandemic. Financial stress was positively associated with alcohol (b = 1.09) and cannabis use (OR = 1.90). Alcohol use was heaviest among veterans with a positive pre-existing anxiety screen and high financial stress. Moreover, veterans who experienced employment disruption due to the pandemic consumed less alcohol but were more likely to use cannabis during the pandemic. Veterans with pre-pandemic anxiety and pandemic-related financial stress may be using substances at higher rates and may benefit from intervention to mitigate negative substance use-related outcomes. Findings also enhance our understanding of veteran substance use behaviors following disruptions in employment due to the pandemic.

Gender differences in use of suicide crisis hotlines: a scoping review of current literature

PurposeLittle is known about the gender profile of callers to crisis hotlines, despite distinct gender differences in suicide risk and behavior. The authors assessed current knowledge of the role of caller gender in the use of crisis hotlines for suicide, specifically whether there are differences in frequency, reason for call and caller outcomes by gender.Design/methodology/approachThe authors conducted a scoping literature review of peer-reviewed studies published since 2000 in Medline, PubMed and PsychInfo, examining a total of 18 articles based on 16 studies.FindingsOverall, women represent a higher percentage of calls to crisis hotlines worldwide, despite men having higher rates of suicide. Primary reasons for calling hotlines were the same for men and women, regardless of geography or culture. When gender differences in reason for call were reported, they were consistent with literature documenting gender differences in the prevalence of risk factors for suicide, including higher rates of substance use among men and higher instances of domestic violence/abuse among women.Research limitations/implicationsThere was variability in the studies the authors examined. This review was limited to research on crisis telephone hotlines and did not include text or chat services. Due to data reporting, the findings are constrained to reporting on a male/female gender binary.Originality/valueFindings on gender differences in crisis line use suggest a need for continued research in this area to determine how to best meet the needs of callers of all genders.

Substance use and misuse patterns and disability status in the 2020 US National Alcohol Survey: A contributing role for chronic pain

BackgroundEvidence about substance use and misuse among adults with disabilities is still emerging, despite increased risk of chronic pain and mental health problems, which are in turn risk factors for substance use and misuse. ObjectiveWe examined substance use and misuse among adults with selected self-reported disability (versus without), controlling for sociodemographics, depression/anxiety, physical health, and chronic pain, and assessed whether associations could be attributed to chronic pain. MethodsData are from the nationally representative 2020 US National Alcohol Survey. Disability indicators included sensory or mobility impairment, receiving Medicare before age 65, and/or unemployment due to disability. Regression analyses determined associations of disability with past-year substance use and misuse. Mediation analyses examined the role of chronic pain. ResultsApproximately 18% met 1+ disability criterion, representing 42.8 million adults. Disability was associated with reduced odds of current drinking (OR = 0.77, p < 0.01), but greater odds of daily nicotine use (OR = 1.43, p < 0.01), any drug use (OR = 1.32 p < 0.01), prescription drug misuse (OR = 1.99, p < 0.001), and other drug use (OR = 2.02, p < 0.001). Disability was not associated with high-intensity drinking or marijuana use. Chronic pain accounted for 17–38% of the association between disability and nicotine use, any drug use, prescription drug misuse, and other drug use. ConclusionsFindings indicated higher rates of substance use and misuse among people with disabilities, accounting for depression/anxiety, physical health, and chronic pain, with pain being a significant mediator. Substance use screening, brief intervention, and treatment should include appropriate accommodations for disabilities, inclusive of comprehensive pain management options.