High Drug Use Research Articles

Prevalence of drugs used for chronic conditions after diagnosis of thyroid cancer: a register-based cohort study.

Little is known about thyroid cancer survivors' risk of chronic conditions. We, therefore, investigated the prevalence of drugs used for chronic conditions among thyroid cancer patients using population-wide register data. We linked data from the Cancer Registry of Norway to the Norwegian Prescription Database and other databases for a study population of 3.52 million individuals, including 3486 individuals with thyroid cancer diagnosed during 2005-2019. Prevalence ratios (PRs) with 95% CIs of reimbursed prescribed drugs in thyroid cancer patients up to 15 years after thyroid cancer diagnosis were estimated by log-binomial regression, with the cancer-free population as reference. Individuals (both males and females) with thyroid cancer had higher use of drugs for several chronic conditions in the years after diagnosis; eg, 5 years after thyroid cancer diagnosis, there was elevated use of drugs for hypoparathyroidism (PRmales = 35.4, 95% CI, 25.2-49.7; PRfemales = 42.8, 95% CI, 34.2-53.6), hypertension (PRfemales = 1.20, 95% CI, 1.12-1.28), anxiety and tension (PRmales = 4.01, 95% CI, 1.80-8.92; PRfemales = 2.01, 95% CI, 1.15-3.52), gastric acid disorders (PRmales = 1.52, 95% CI, 1.22-1.91; PRfemales = 1.45, 95% CI, 1.27-1.66), and pain (PRmales = 1.48, 95% CI, 1.11-1.97; PRfemales = 1.24, 95% CI, 1.08-1.42) as compared with the cancer-free population. In addition, males with thyroid cancer had long-term elevated use of drugs for depression (eg, year 10+, PRmales = 1.66, 95% CI, 1.06-2.59). Individuals with thyroid cancer also had higher use of drugs for several conditions prior to the thyroid cancer diagnosis, eg, hypertension, gastric acid disorders, and pain. Individuals diagnosed with thyroid cancer had elevated long-term use of drugs for several chronic conditions, as compared with the cancer-free population.

Trends in socio-demographic characteristics and substance use among high school learners in a selected district in Limpopo Province, South Africa.

Substance use is an escalating public health problem in South Africa resulting in risky behaviours and poor educational attainment among adolescents. There is a huge battle to overcome substance use among learners as more drugs become easily available with the mean age of drug experimentation reported to be at 12 years of age. It is important to continuously understand the trends in substance use in order to assess if there are positive changes and provide evidence for the development of context-specific effective interventions. This paper outlines the prevalence of substance use among selected high schools in a district in Limpopo province. To determine the prevalence of substance use among selected high school learners in a district in Limpopo Province, a cross-sectional school survey of 768 learners was conducted. Data was analysed using SPSS v 26. Descriptive analysis was used to describe the independent and dependent variables and Chi-Square test was used to investigate associations between demographic characteristics and substance use among high school learners. The most abused substances by learners were alcohol (49%), cigarettes (20.8%) and marijuana (dagga/cannabis) (16.8%). In a lifetime, there was a significant difference (P < 0.05) in cigarette smoking with gender, school, and grade; with more use in males (14.2%) than females (7.6%); in urban schools (14.6) than peri-urban (6.7%) and more in Grade 12 (6.4%). There was a significant difference (P < 0.05) in alcohol use with more use in Grade 10 (12.6%) and varied use among male and female learners but cumulatively more alcohol use in females (27.7%). Drug use varied, with an overall high drug use in urban schools (20.7%). Substance use is rife among high school learners in the district and health promotion initiatives need to be tailored within the context of socio-demographic characteristics of learners including the multiple levels of influence such as peer pressure, poverty, unemployment and child headed families. Additional research is required to investigate the factors leading to a notable gradual increase in use among female learners and into the environmental and family settings of learners in influencing substance use.

Personality traits explain the relationship between psychedelic use and less depression in a comparative study

Interest in psychedelics is increasing due to the potential for improved mental health and quality of life. However, adverse effects on mental health are still a concern. Personality traits have been suggested to both influence the psychedelic experience and mental health, and even be changed by psychedelic use. The present study describes for the first time a national sample of Swedish psychedelic users (n = 400) compared to a sex and age-matched control-group of non-users (n = 400) regarding mental health variables (depression, insomnia, problematic alcohol and drug use, and dissociation) and personality (Big Five). Data was collected in an online survey including individuals from 16 years of age who had at least one psychedelic experience. The main results reported psychedelic users as less depressed (Patient Health Questionnaire-9; PHQ-9) (d = − 0.29) and having more use of drugs (Drug Use Disorders Identification Test; DUDIT) (d = 1.27). In the Big Five personality traits, openness differed notably (d = 1.72), and the between-group effects in PHQ-9 were explained by lower neuroticism. Our findings reveal that psychedelic users report less depression and higher drug use, and this is partly due to personality traits. These results have implications on how we view psychedelic users and the use of psychedelic drugs.

Consumo de drogas sintéticas por estudiantes universitarios de una universidad pública: prevalencia y factores asociados

Objective: to present the prevalence of synthetic drug use (lysergic acid diethylamide – LSD, andecstasy) and associated factors among university students. Methodology: a quantitative and crosssectionalstudy, part of a research on sociodemographic profile, university life, mental health andpsychosocial identity. An anonymous, face-to-face questionnaire was applied to undergraduate studentsat a Brazilian public university. Use of synthetics in the past year was analyzed in relation to gender,sexuality, socioeconomic status, academic performance, interpersonal/sexual violence, mental health,use of psychoactive substances and quality of life. Bivariate and multivariate analysis methods wereused, employing the Statistical Package for the Social Sciences and R software packages. Results:6,906 students participated in the study, of whom 8.3% used LSD, 7.9% ecstasy, and 10.8% LSD and/or ecstasy in the past year. Synthetic drug use was associated with cocaine use (OR 4.90), frequentmarijuana use (OR 6.83) and solvent use (OR 8.11). There was an association with belonging tosexual minority groups, higher socioeconomic status, poorer academic performance, sexual violencewhile intoxicated and higher scores on the quality of life scale. There was a weaker association withmale gender and poorer mental health. Conclusion: high synthetic drug use rates were observedin this population, and the associated factors may assist in the development of targeted interventionstrategies within the university context.

DETERMINATION OF MALNUTRITION, FRAILTY, POLYPHARMACY, MULTIMORBIDITY, AND MORTALITY RISK IN HOSPITALIZED ELDERLY COVID-19 PNEUMONIA CASES WITH AND WITHOUT POSSIBLE SARCOPENIA

Introduction: To evaluate elderly COVID-19 pneumonia hospitalizations via the presence of possible sarcopenia, hand grip strength measurements, malnutrition, frailty, polypharmacy, multimorbidity, mortality risk and 30th-day mortality after discharge. Materials and Method: This observational study included geriatric patients in the COVID ward of Gaziosmanpasa Training and Research Hospital between March 1, 2022, and April 30, 2022. SARC-F screening test, hand grip strength measurement, CALL score for mortality risk, KATZ Index of Independence in activities of daily living, Mini Nutritional Assessment-Short Form, BORG dyspnea scale, and Frail scale were administered. 30th-day mortality after discharge was recorded during follow-up using phone calls. Results: Distribution of 75 cases aged 76.6±8.2 years was as follows: 65.3% (n =49) possible sarcopenia, 49.3% (n =37) malnutrition, 49.3% (n =37) polypharmacy,70.7% (n =53) multimorbidities. 30th-day after-discharge mortality was 24.0% (n =18). The length of hospital stay, activities of daily living, frailty, D-dimer level, albumin, and oxygen requirement were significant in the possible sarcopenia group compared to non-sarcopenia group (p =0.003, p = 0.012, p =0.012, p =0.007, p =0.004, and p =0.015, respectively). Impaired hand grip strength was related to a higher CALL risk score (r =-0.343; p =0.003), higher drug use and disease counts (r =-0.387, p =0.001 and r =-0.321; p =0.005), prolonged length of hospital stay (r=-0.315; p=0.006), and higher oxygen requirement (r =-0.240, p =0.038). Conclusion: COVID-19 pneumonia hospitalizations of geriatric patients are significantly accompanied by possible sarcopenia. The measurement of hand grip strength was emphasized to determine associations with the length of hospital stay, malnutrition, and 30th-day discharge mortality of hospitalized COVID-19 pneumonia in the elderly. Keywords: Pneumonia; COVID-19; Sarcopenia; Frail Elderly; Malnutrition; Mortality.

Latent Class Groups of Concurrent Substance Use Among Adolescents in an Urban Community: Correlates With Mental Health, Access to Drugs and Alcohol, and Risk Perception.

Concurrent substance use among adolescents has been associated with an increase in physical and mental health problems. These outcomes tend to be exacerbated among adolescents of color in underserved urban settings. The purpose of this study was to understand alcohol and concurrent drug use patterns among adolescents in an underserved urban community to provide targeted prevention and treatment recommendations. This study examined data among adolescents in an underserved urban community (N = 1789; 56.90% female; 70.86% Hispanic/Latino/a; meanage = 15.96 ± 1.56). Using latent class analysis (LCA) and multinomial logistic regression modeling, analyses identified independent correlates of latent class membership. Five latent classes (LC) were identified including LC group 1: Predominant alcohol use and limited to no concurrent-drug use (n = 213; 11.9%); LC group 2: Concurrent drug and alcohol use including methamphetamine, marijuana and synthetic marijuana use, and alcohol use (n = 74; 4.2%); LC group 3: Concurrent drug and alcohol use, with no marijuana use (n = 204; 11.39%); LC group 4: High Concurrent drug use and alcohol use (n = 204; 11.40%); and LC group 5: Concurrent drug use without alcohol use (n = 1101; 61.52%). Significant between group differences were noted between latent class groups and sociodemographic characteristics. Multinomial logistic regression models identified the associations between sociodemographic characteristics and corollary clinical features of substance use on latent class groupings of alcohol and concurrent drug use. Understanding concurrent substance use LC groups among adolescents is essential to providing targeted interventions and treatment programs, as well as early intervention programs that may help reduce substance use during adolescence.

Development and performance of the c4c national clinical trial networks for optimizing pediatric trial facilitation.

The high failure rate of industry-driven pediatric clinical trials leads to insufficient timely labeling of drugs in children and a lack of scientific evidence, resulting in the persistently high off-label drug use. National clinical trial networks can facilitate collaboration between sites, investigators, and experts, increasing the likelihood of successful trials. Within the conect4children (c4c) network, an Innovative Medicines Initiative 2-funded project, National Hubs hosted by National Clinical Trials Networks were set up across 21 European countries to facilitate the setup and execution of pediatric clinical trials. In this paper, we aim to present the performance metrics of the trial feasibility process as well as learnings and challenges encountered by the Belgian and Dutch Networks in working within the European c4c project. The c4c National Hubs streamline pediatric clinical trials by initiating early country outreach, identifying overlapping studies, recommending quality trial sites, and supporting trial budgeting for both industry and academic settings. To show the impact of Pedmed-NL and Belgian Pediatric Clinical Research Network (BPCRN), internal metrics were collected from 2019 to 2022 on four industry-sponsored and three academic trials performed within the c4c network. Timelines and outcomes of the site identification were collected and analyzed for industry trials. A qualitative analysis was conducted through c4c platforms, sponsor interactions, and stakeholder engagement to evaluate the added value of a research network. In industry-sponsored trials, full feasibility questionnaires were completed within 2 weeks (n = 48), and inclusion rates were up to 80% of clinical sites. Before committing to c4c, 14% of sites were contacted by industry, leading to communication burdens. Utilizing national infrastructure knowledge and therapeutic environment insights helped optimize trial timelines and address feasibility challenges. In addition, national adaptations, such as bilingual staff and site development, played a role in streamlining trial operations in both academic and industry settings. Performance and experiences were similar for both networks. The early-facilitation examples from the c4c trials demonstrated promising metrics for two National Hubs, including optimized start-up timelines and aiding site selection quality. The learnings and challenges of the Belgian and Dutch Networks provided insights for the development of clinical research networks.

Substance use typologies among young people experiencing homelessness in seven cities across the United States: A latent class analysis

BackgroundSubstance use and other health-risk risk factors, including mental health, trauma, and sexual-risk behaviors, often co-occur among youth experiencing homelessness (YEH). The present study aimed to identify subgroups of YEH based on polysubstance use and the linkages to sociodemographic and health-risk characteristics. MethodsFrom June 2016 to July 2017, 1,426 YEH (aged 18–26 years) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information via a self-administered electronic survey on substance use, mental health, trauma, sexual risk behaviors, and sociodemographic characteristics. The majority of YEH identified as Black (37.3%), cisgender (92.8%), and heterosexual (69.2%). On average, YEH were 20.9 years (SD = 2.1). This study employed latent class analysis (LCA) to identify subgroups of YEH according to their substance use. Multinomial logistic regression analyses were conducted to identify sociodemographic and health-risk characteristics associated with class-membership. ResultsFour latent classes of YEH substance use were identified: (1) high polysubstance use; (2) moderate stimulant and high marijuana, alcohol, and prescription drug use; (3) high marijuana, alcohol, and prescription drug use; (4) low/moderate marijuana and alcohol use. Multinomial logistic regression models indicated that geographic location, gender, race/ethnicity, mental health, trauma history, and sexual risk behaviors were significant correlates of substance use class membership among YEH. ConclusionsThese findings offer important implications for the prevention and treatment of substance use among YEH. Screening protocols should consider co-occurring risk factors such as traumatic experiences, sexual risk behaviors, and mental health history as indicators of polysubstance use.

Adherence to riluzole therapy in patients with amyotrophic lateral sclerosis in three Italian regions-The CAESAR study.

Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease. Riluzole may increase survival and delay the need for mechanical ventilation. The CAESAR project ('Comparative evaluation of the efficacy and safety of drugs used in rare neuromuscular and neurodegenerative diseases', FV AIFA project 2012-2013-2014) involves evaluating prescribing patterns, and analysing effectiveness and comparative safety of drugs, in patients with neurodegenerative diseases. The aim of this study is to evaluate adherence to riluzole in patients with ALS during the first year of use, identifying adherence clusters. A retrospective cohort study was conducted using administrative data from Latium, Tuscany, and Umbria. We identified subjects with a new diagnosis of ALS between 2014 and 2019, with the first dispensation of riluzole within 180 days of diagnosis. We considered a two-year look-back period for the characterization of patients, and we followed them from the date of first dispensing of riluzole for 1 year. We calculated 12 monthly adherence measures, through a modified version of the Medication Possession Ratio, estimating drug coverage with Defined Daily Dose. Adherence trajectories were identified using a three-step method: (1) calculation of statistical measures; (2) principal component analysis; (3) cluster analysis. Patient characteristics at baseline and during follow-up were described and compared between adherence groups identified. We included 264 ALS patients as new users of riluzole in Latium, 344 in Tuscany, and 63 in Umbria. We observed a higher frequency of males (56.2%) and a mean age of 67.4 (standard deviation, SD, 10.4) in the overall population. We identified two clusters in all regions: one more numerous, including adherent patients (60%, 74%, 88%, respectively), and another one including patients who discontinued therapy (40%, 26%, 12%, respectively). In Tuscany patients discontinuing riluzole more frequently died (28.6% vs. 15.4%, p-value <0.01). Additionally, low-adherers had a higher frequency of central nervous system disorders (69.0% vs. 52.5%, p-value 0.01), and a greater use of non-pharmacological treatments (p-values ≤0.01 for invasive ventilation and tracheostomy). We did not observe any differences in Lazio, whereas in Umbria we observed a higher use of drugs for dementia-related psychiatric problems among low-adherers (57.1% vs. 7.8%, respectively, p-value <0.01), although with small numbers. Most ALS patients who start riluzole adhere to therapy during the first year. Patients who discontinue therapy early show greater fragility and mortality.

Patterns of Polydrug Use Classes Among a Subset of Latino Male Seasonal Workers in South Florida: A Latent Class Analysis

ABSTRACT Background Little is known about polydrug use among Latino seasonal farmworkers. This cross-sectional study with male Latino seasonal workers (LSWs) living in South Florida categorized distinct classes of drug use and then characterized each drug use typology by demographic, structural, and psychological factors. Methods One hundred and twenty-five male LSWs were recruited during community events using convenience sampling between July 2019-March 2020. Latent class analysis was conducted by leveraging measures of self-reported use of nine drugs in the past year (sedatives, cannabis, stimulants, heroin, opioids, cocaine, PCP, hallucinogens, and inhalants). Correlates of latent class membership were examined using 3-step categorical latent variable logistic regression. Analyses were performed using Mplus version 8 and SAS 9.4. Results Four drug use classes were identified, male LSWs who exhibited: 1) use of illegal opioids only (n = 32); 2) concurrent cannabis and cocaine use (n = 75); 3) concurrent sedative and cannabis use (n = 13); and 4) high concurrent drug use (n = 5). About 84.7% of the sample reported use of at least one drug in the past 12 months. LSWs who identified as White and were married or in a stable relationship were likely to only use illegal opioids. LSWs with less than high school education and self-reported good to excellent health were more likely to use cannabis and cocaine. Men with moderate to severe anxiety and self-reported bad health were classified as engaging in sedative and cannabis co-use. Survivors of physical abuse were more commonly classified as people using high concurrent substances relative to non-abused men among the four classes. Conclusions This pilot study suggests the presence of heterogeneity in polydrug use classes among LSWs in South Florida.

Characterization of patients receiving surgical versus non-surgical treatment for infective endocarditis in West Virginia.

Infective endocarditis (IE) has increased in rural states such as West Virginia (WV) with high injection drug use. IE is medically managed with antimicrobial treatment alone or combined with surgical treatment. This study aimed to characterize the predictors associated with surgical treatment and rates of inpatient mortality and readmission among IE patients in WV's rural centers. This retrospective review of electronic health records includes all adults hospitalized for IE at major rural tertiary cardiovascular centers in WV during 2014-2018. Descriptive statistics were presented on demographics, history of injection drug use, clinical characteristics, and hospital utilization by surgery status, and multivariable logistic regression examined the association of surgery with key predictor variables, generating odds ratios (OR). Of the 780 patients with IE, 38% had surgery, with a 26-fold increase in patients undergoing surgery between 2014-2018. Comparing surgery and non-surgery patients revealed significant differences. Surgery patients were significantly younger (median age 35.6 vs. 40.5 years; p<0.001); had higher rates of drug use history (80% vs. 65%; p<0.001), psychiatric disorders (57% vs. 31%; p<0.001), and readmissions (18% vs.12%; p = 0.015). Surgery patients had lower rates of discharge against medical advice (11% vs.17%; p = 0.028) and in-hospital mortality (5% vs.12%; p<0.001). In the multivariable logistic regression, surgery was associated with injection drug use (OR: 1.9; 95% CI:1.09-3. 3), indications for surgery (OR: 1.68; 95% CI:1.48-1.91), left-sided IE (OR: 2.14; 95%CI:1.43-3.19) and later years (OR:3.75; 95%CI:2.5-5.72). This study characterizes the predictors associated with surgical treatment and rates of inpatient mortality and readmission among IE patients across rural WV. The decision to perform cardiac surgery on IE patients is complex. Results with increased injection drug use-associated IE emphasize the importance of comprehensive care by a multidisciplinary team for optimal management of patients with IE.

Periodontal Disease, Tooth Loss, and Systemic Conditions: An Exploratory Study

Although systemic medical conditions are associated with periodontitis and tooth loss, large-scale studies that include less prevalent systemic conditions are needed. The purpose of the study was to investigate the link between periodontal disease and tooth loss with systemic medical conditions in a large and diverse population. Dental charts of adult patients who had attended the dental clinics seeking dental therapy of the universities contributing data to the BigMouth network and accepted the protocol of the study were included. Dental Procedure Codes and Current Procedural Terminology procedures were utilised to identify patients with and without periodontitis. Data were extracted from patients' electronic health records including demographic characteristics, dental procedural codes, and self-reported medical conditions as well as the number of missing teeth. A total of 108,307 records were ultimately included in the analysis; 42,377 of them included a diagnosis of periodontitis. The median age of the included population was 47.0 years, and 55.2% were female. Older and male individuals were significantly more likely to be in the periodontitis group and have higher number of missing teeth. A number of systemic conditions are associated with periodontitis and a higher number of missing teeth. High blood pressure, smoking, drug use, and diabetes were all found to be significant. Other significant conditions were anaemia, lymphoma, glaucoma, dialysis, bronchitis, sinusitis hepatitis, and asthma. Within the limitations of this retrospective study that utilised the BigMouth dental data repository, the association of a number of systemic conditions such as smoking, diabetes, and hypertension with periodontitis and tooth loss has been confirmed. Additional connections have been highlighted for conditions that are not commonly reported in the literature.

Attitudes and prevention towards malaria in the context of COVID-19 pandemic in urban community in Benin, West Africa

BackgroundThe COVID-19 pandemic and its damages have severely impacted the global healthcare system even in countries with the best systems. In sub-Saharan Africa (SSA), it could worsen the malaria situation in endemic countries such as Benin. This study was conducted to describe the potential effects of the pandemic on urban dwellers attitudes, prevention and treatment against malaria in four major cities of Benin.MethodsA cross-sectional questionnaire survey was conducted in Cotonou, Bohicon, Parakou and Natitingou, four urban cities of Benin. A total of 800 randomly selected households were interviewed. The questionnaire consisted of four parts: sociodemographic characteristics, knowledge, attitude, and practice. Descriptive statistics and binomial logistic regression analysis were used in the statistical analysis.ResultsMore than 90% of the participants interviewed had a good level of knowledge about the transmission and prevention of malaria in the cities surveyed. In contrast, low proportions of participants reported visiting health-care facilities when they suspected malaria. Compared to the proportions observed at Parakou and Natitingou, the low proportion of participants was statistically significant at Cotonou (Parakou: X2 = 31.345, df = 1, P < 0.0001; Natitingou: X2 = 17.471, df = 1, P < 0.0001). Among the reasons for not seeking care, these related to COVID-19 were the most mentioned. Moreover, the good education level of the participants was one of the factors associated with the non-use of healthcare facilities due to over-knowledgeable about Covid-19, which might have increased the fear to go to the health facilities. Finally, high proportions of self-medication practice were mentioned with high use of malaria drugs to treat both malaria and to protect against COVID-19.ConclusionsThe data show a negative impact of COVID-19 on visits to healthcare facilities for malarial treatment and malaria drugs usage by the population. It is, therefore, necessary to rebuild malaria programmes by integrating measures adapted to health crises such as the COVID-19 pandemic.

Toward a Typology of Counterproductive Employees: A Person-Oriented Investigation of Counterproductive Work Behavior.

The study of counterproductive work behavior (CWB), intentional actions by employees that are deleterious to the organization and/or its stakeholders, has produced research on the dimensionality of CWB, as well as its situational and dispositional antecedents. Absent from these advancements have been investigations into the potential utility of a taxonomy of counterproductive employee types-a "person-oriented" approach. Our latent profile analysis (N = 522) suggested a four-profile solution which included one profile with uniformly low rates across CWBs (here termed "Angels;" 14% of the sample), and three profiles with higher CWB rates but which were distinguishable by different CWBs being most frequent in each group. Specifically, one profile was distinguished from the Angels group by higher rates of less severe CWBs (misuse of time/resources and poor attendance; 33% of the sample). The other two of the three counterproductive profiles were similar to each other except that one was characterized by higher drug use than the other (14% of the sample). The profiles also differed significantly on narcissism, psychopathy, and Machiavellianism, and on self-reports of prior arrest and censure by employers. Provided these distinctions among profiles, the treatment and assumptions of employee counterproductivity in research and practice should be revisited, particularly when using models assuming a homogenous, monotonic relationship between counterproductive behaviors across employees. Implications for our conceptual understanding of counterproductivity and applied interventions aimed at reducing CWBs are discussed, alongside recommendations for future person-oriented research on CWB.

Telephone monitoring and 15-month outcomes for patients with co-occurring substance use and mental health disorders: Moderating effects of high-risk patient characteristics

IntroductionTelephone monitoring interventions for substance use disorders are an important component of continuing care to reduce relapse and connect patients to services. However, a knowledge gap still exists as to which patient groups benefit most from them. This secondary analysis of a randomized controlled trial examined moderators of associations between telephone monitoring and 15-month substance use outcomes among patients with co-occurring substance use and mental health disorders. High-risk patient characteristics at baseline were examined as potential moderators of the effectivness of telephone monitoring, including history of incarceration, severity of depression symptoms, and suicide risk. MethodsParticipants were 406 psychiatry inpatients with documented substance use and mental health disorders who were randomized to treatment as usual (TAU; n = 199) or TAU plus telephone monitoring (TM; n = 207). Outcomes included abstinence self-efficacy (Brief Situational Confidence Questionnaire) and alcohol and drug use severity (Addiction Severity Index composites) at 15-month follow-up. Analyses examined main effects of treatment condition and moderators, and interactions between treatment condition and moderators. ResultsThe study found five significant main effects, three of which were qualified by significant interactions. Incarceration history was associated with higher drug use severity; higher suicide risk was associated with higher abstinence self-efficacy. Regarding interaction effects, among participants with an incarceration history, TM compared to TAU was associated with significantly lower alcohol use severity at 15-month follow-up; this finding did not hold for never-incarcerated participants. For participants with less severe depression symptoms, TM compared to TAU was associated with significantly lower alcohol use severity and higher abstinence self-efficacy at follow-up; this did not hold for participants with more severe depression symptoms. Suicide risk was not a significant moderator of any outcome. ConclusionsResults indicate that TM is effective in improving alcohol use severity and abstinence self-efficacy for some subgroups of patients, including patients with an incarceration history or less severe depression. Results inform the clinical provision of substance use disorder care by means of telehealth, which increased due to the COVID-19 pandemic.

Motor impulsivity but not risk-related impulsive choice is associated to drug intake and drug-primed relapse.

Motor impulsivity and risk-related impulsive choice have been proposed as vulnerability factors for drug abuse, due to their high prevalence in drug abusers. However, how these two facets of impulsivity are associated to drug abuse remains unclear. Here, we investigated the predictive value of both motor impulsivity and risk-related impulsive choice on characteristics of drug abuse including initiation and maintenance of drug use, motivation for the drug, extinction of drug-seeking behavior following drug discontinuation and, finally, propensity to relapse. We used the Roman High- (RHA) and Low- Avoidance (RLA) rat lines, which display innate phenotypical differences in motor impulsivity, risk-related impulsive choice, and propensity to self-administer drugs. Individual levels of motor impulsivity and risk-related impulsive choice were measured using the rat Gambling task. Then, rats were allowed to self-administer cocaine (0.3 mg/kg/infusion; 14 days) to evaluate acquisition and maintenance of cocaine self-administration, after which motivation for cocaine was assessed using a progressive ratio schedule of reinforcement. Subsequently, rats were tested for their resistance to extinction, followed by cue-induced and drug-primed reinstatement sessions to evaluate relapse. Finally, we evaluated the effect of the dopamine stabilizer aripiprazole on reinstatement of drug-seeking behaviors. We found that motor impulsivity and risk-related impulsive choice were positively correlated at baseline. Furthermore, innate high levels of motor impulsivity were associated with higher drug use and increased vulnerability to cocaine-primed reinstatement of drug-seeking. However, no relationships were observed between motor impulsivity and the motivation for the drug, extinction or cue-induced reinstatement of drug-seeking. High levels of risk-related impulsive choice were not associated to any aspects of drug abuse measured in our study. Additionally, aripiprazole similarly blocked cocaine-primed reinstatement of drug-seeking in both high- and low-impulsive animals, suggesting that aripiprazole acts as a D2/3R antagonist to prevent relapse independently of the levels of impulsivity and propensity to self-administer drugs. Altogether, our study highlights motor impulsivity as an important predictive factor for drug abuse and drug-primed relapse. On the other hand, the involvement of risk-related impulsive choice as a risk factor for drug abuse appears to be limited.

EVALUASI PERSEDIAAN OBAT COVID-19 PADA MASA PANDEMI DAN FAKTOR YANG MEMPENGARUHI DI RUMAH SAKIT PEMERINTAH DAN RUMAH SAKIT SWASTA DI KOTA MAKASSAR

Background: Drug management realizes the availability of drugs needed to be effective and efficient, especially during the COVID-19 pandemic. The high use of COVID-19 drugs makes several types of drugs needed to experience vacancies, and due to changes in government regulations make some COVID-19 drugs stagnant.Objectives: To evaluate the supply of COVID-19 drugs during the pandemic and the factors that influence it in government and private hospitals in Makassar CityMethods: This study is a mixed-method study with a sequential explanatory design. Quantitative data were obtained retrospectively from January to December 2021 by searching drug management documents. Qualitative data was obtained through in-depth interviews with 12 informants.Results: The availability of COVID-19 drugs in government hospitals is 19.3 months, while in private hospitals, it is 13.6 months. Factors that affect drug supply are the method of planning drug needs, Lead Time, and several changes in guidelines.Conclusions: The supply of COVID-19 drugs is still excessive at that Public Hospital, and the factor that most influenced the supply of COVID-19 drugs was changes in guidelines.

Understanding the relationship between the spatial configuration and the crime rate of Downtown Eastside in Vancouver, Canada

As one of Vancouver's oldest neighbourhoods and the historical heart of the city, Downtown Eastside (DTES) has been home to many low-income residents and has been challenged by factors such as high crime rates, drug use, unemployment, housing issues, and loss of businesses in the community. Although a variety of studies have explored the causes and effects of DTES's social dilemma and indicated that crimes are closely related to the spatial configuration of the underlying street network, how DTES's underlying street network affects the spatial distribution of different types of crime remains unclear. Focusing on the relationship between the street network and the crime rate of DTES, the authors make three hypotheses regarding the connections between the street network of DTES and the distribution patterns of crimes, and employ the space syntax methods to analyse the street network of DTES and test the hypotheses. The results indicate that the spatial configuration of street network can be helpful in explaining where different crimes may occur, thus providing a spatial perspective to figure out approaches to addressing DTES's social issues. At last, this paper, combining spatial and social perspectives, puts forward strategies for making DTES a more liveable place, and is likely to work as a reference for academics and practitioners to further understand gentrification and urbanisation related issues.

High risk injection drug use and uptake of HIV prevention and treatment services among people who inject drugs in KwaZulu-Natal, South Africa.

We conducted a mixed-methods study to understand current drug use practices and access to healthcare services for people who use injection drugs in KwaZulu-Natal, South Africa. We used respondent-driven sampling to recruit 45 people who used injection drugs within the past 6 months from KwaZulu-Natal, South Africa. We found high rates of practices that increase HIV/viral hepatitis risk including the use of shared needles (43%) and direct blood injections (bluetoothing) (18%). Despite 35% living with HIV, only 40% accessed antiretroviral therapy within the past year, and one accessed PrEP. None of the participants ever tested for Hepatitis C.

Differential influence from family and best friend on adolescent drug use: a prospective cohort study with latent classes

We aimed to analyze the association between latent classes of drug use of the ‘closest psychosocial network’ (CPN) (i.e. parents, siblings, and best friend) of adolescents, and adolescents’ lifetime drug use practices (tobacco, alcohol, and binge drinking). A prospective cohort study, nested in a randomized controlled trial, was performed among public school students in six Brazilian cities (N = 3,148; 51.4% girls; M age=12.6 years), for 21 months. Latent class analyses and multilevel mixed-effect logistic regressions were performed. Regressions were clustered at the school and individual levels and adjusted for sex, age, socioeconomic status, and relatives with whom the adolescents lived. The three-class model was the best solution for the three drug use practices, ranging from minimum to high exposure of drug use influence. Those adolescents with high exposure were more likely to use tobacco and practice binge drinking. In the alcohol model, a gradient of association was observed as the exposure increased. CPN’s drug use may predict substance use in adolescents. It was observed that if the mother’s drug use is similar to that of the father, it may predict higher drug use in the other CPN characters. Our results support the idea that preventive actions in adolescence should be comprehensive, i.e. including components targeting the family (e.g. parenting and communication skills) and peers (e.g. refusal skills and perception of use). Mainly, integrating family-based components in the curriculum of school-based prevention programs is recommended.