Substance Abuse Research Articles

Wastewater-Based Surveillance of Substances of Potential Abuse

ObjectiveAmid a drug poisoning epidemic, UCalgary adapted its comprehensive wastewater monitoring program to track illicit drug use. The joint initiative between the academic community and Alberta municipalities aims to provide early warning information on changes in the drug supply to healthcare workers, policymakers, and people with substance use disorders (pwSUD). ApproachThe logistic network, first used for SARS-CoV-2 monitoring, has evolved to track 48 substances linked to substance use. These include the parent drugs (e.g., cocaine, methamphetamines, various opiates) and their metabolites. The comprehensive nature of this tracking provides a nuanced understanding of trends. Collected up to 3X-weekly across various locations in Alberta including municipal wastewater treatment plants, entire neighbourhoods, and shelters, the data reveals geographical and temporal patterns in substance use. Findings were cross validated with Alberta’s substance use surveillance system to predict trends in wastewater, correlating with emergency and inpatient admissions and overdose deaths. ResultsThe research uncovered noteworthy trends. Intermittent, alarming, spikes in carfentanyl, benzodiazepines, and xylazine in wastewater were observed during periods of elevated Emergency Medical Services (EMS) responses to opioid-related incidents in the year 2023. This correlation underscores the real-world impact of the identified substance trends, emphasizing the urgency for targeted interventions to address the escalating opioid crisis. Further work to create a dashboard with additional data sources has begun. ConclusionsTimely data on the dynamic drug supply is crucial in addressing the ongoing drug poisoning crisis. The team is exploring ways to share information with emergency responders, healthcare providers, government officials, and pwSUD.

Pasienter innlagt ved en medisinsk intensivavdeling etter henging 2010–21

Hanging is one of the most common causes of death among young adults in Norway. Our aim was to study the hospital course and cerebral function on discharge in patients admitted to our Medical Intensive Care Unit after hanging without skeletal injury. Retrospective study based on the medical records of patients admitted to the Medical Intensive Care Unit at Oslo University Hospital (OUS), Ullevål after hanging, from January 2010 to December 2021. Cerebral function on discharge was classified according to Cerebral Performance Category (CPC) from grade 1 (normal cerebral function) to 5 (brain death). 135 patients were admitted to OUS after hanging during the period; 60 of these were admitted to the Medical Intensive Care Unit and were included in this study. There were 35 men and 25 women. Mental illness was documented in the medical records of 43 patients, somatic illness in 24, previous substance abuse in 19, and previous suicide attempts in 19. Upon admission, 34 patients had suffered cardiac arrest, and 39 had a Glasgow Coma Scale (GCS) score of 3. The most common complication was pneumonia (n=42). Twenty-seven patients (45%) died, all with a GCS score of 3 on admission, of which 25 had pre-hospital cardiac arrest. Ten became organ donors. Among the 33 survivors, 28 had a CPC score of 1 and five had a CPC score of 2 on discharge. The median lactate concentration at admission was 8.1 mmol/L among those who died versus 3.8 mmol/L among survivors. Hanging has a high mortality rate. Cardiac arrest, a GCS score of 3, and lactic acidosis were more common among those who died than among the survivors. The organ donation rate was high, and most survivors had a good cerebral function, assessed by CPC score.

Characteristics of drug-related deaths where individuals are found submerged in a bath or hot tub in the United Kingdom, 1997-2023.

Recent media reports highlight that drug-related fatalities can occur while individuals are immersed in water in domestic settings. We aimed to determine the case characteristics, circumstances of death and type of implicated drugs among individuals dying due to unintentional drug-related causes found immersed in a bath or hot tub. Retrospective cohort study in the United Kingdom using coronial records from the National Programme on Substance Abuse Deaths, 1997-2023. Information was available on decedent socio-demographics, characteristics of death and drugs implicated in death. One hundred fifty-six decedents were found immersed in the bath and six in a hot tub, a mean of 6.4 deaths per year (SD 3.7; range 1-13). Overall decedents were predominantly male (n = 94, 58.0%), of White ethnicity (n = 98, 60.5%) with a mean age of 40 years (SD 13; range 19-74). Only 12 decedents had any physical contributory factor to death other than poisoning or drowning. The median number of drugs detected at post-mortem was 3 (interquartile range 2, 5) with multiple drug toxicity implicated in the majority of cases (n = 90, 55.6%). The most common implicated drugs were heroin (n = 53, 32.7%), alcohol (n = 46, 28.4%) and cocaine (n = 33, 20.4%). Over the last two decades in the United Kingdom there have been consistent numbers of unintentional drug-related deaths each year where individuals were found in a bath or hot tub. Polysubstance, opioid and alcohol use are overrepresented. Targeted advice to avoid bathing while intoxicated would appear to be an appropriate harm reduction message.

Mathematical Modeling of the Dynamics of Psychoactive Drug Abuse with Intervention of Control Agencies

Drug abuse continues to pose a significant threat to both developed and developing countries. This paper examines the dynamics of psychoactive drug abuse with intervention of control agencies. The study established that the drug abuse model remains positively invariant over time, as indicated by the positivity of the solutions to the model equations. The study identified both drug abuse endemic and drug abuse free equilibrium states. Basic reproduction number was obtained using the method of next generation matrix. The local stability of the drug abuse free equilibrium state was analyzed using Jacobian method and the analysis showed that the drug abuse free equilibrium state is locally asymptotically stable since all the Eigen values are negative. Similarly, the global stability analysis of the drug abuse free equilibrium state confirmed that the system is globally asymptotically stable. The sensitivity index was computed. The results indicate that parameters with positive sensitivity indices increase the prevalence, while those with negative sensitivity indices decrease it. This suggests that these parameters have the ability to either increase or decrease the persistence of drug abuse in the population. The numerical simulation of the model was performed using MATLAB R2015a software and results show that enlightenment and law enforcement agencies play a vital role in reducing the spread of drug abuse. This research recommends intensification of early enlightenment to curtail the spread of drug abuse. Also making more policies, enactment and enforcement of more laws that will check the use of hard drugs

Overcrowding, Drugs Abuse and Violence vs. Rehabilitation Interviews and Perceptions of a Sample of Prisoners

Based on the interviews collected and conducted during the data gathering process for the documentary "11 days: within the prison walls”, some inmates from the prison of Nerio Fischione based in Brescia (Italy) decide to share their stories to a microphone and storytellers. The voices provide a sincere look, suitable for investigating the subjective perceptions that inmates have regarding the prison environment, exploring the complexities of their experiences. What emerges from the stories is a place that is far away from the rehabilitation purpose that it should have. The enormous issue of overcrowding, drug pills treatment abuse, and, above all, the pervasive violence within the corridors of the facility. The punitive function seems to prevail and is doubly enacted: firstly, through the nature of the prison itself, and secondly, through the prison conditions that prevent from any possibility to start a positive path. This article aims to contribute to the existing academic debate providing an insight from the prisoners’ perception about their personal experience, focusing on the issues that most frequently emerge from their testimonies: the lack of significance that they experience on a daily basis.

Rights-based policies for role-bearing people: Are geo-cultural norms a hindrance to cultivating safer sport?

Many (inter)national governments and sports organisations are implementing standardised Safe Sport policies and guidelines. However, the Western-born, rights-based norm that underlies Safe Sport can collide with pre-existing geo-sociocultural norms of local contexts. Drawing from a case study of South Korea's elite sport pathway where tightened regulations on abuse challenge the long-lasting relational hierarchy based on Confucianism, this paper examines how athletes and coaches manoeuvre within the fast-changing social order shaped by the new safeguarding policies and practices. Analysing data from semi-structured interviews with 48 participants around two Elite Sports Schools, the paper shows that the rights-based norm integral to Safe Sport is sifted through the Confucian hierarchy, generating two main shifts respectively in coaches’ roles (from caring disciplinarians to professional service providers) and senior athletes’ (from potential abusers to benevolent superiors). That is, individual actors re-script their relational template by negotiating between the familiar and new relational ethics. From this, the paper suggests that Safe Sport is not a straightforward process of modernising less advanced practices up to a certain standard; it requires understanding how individuals make sense of the process in their own socio-cultural contexts.

Islamic Spiritual Guidance to Restructure the Cognitive of Drug Abuse Assisted Citizens in Prison Class II A Pamekasan

Drug abuse is currently a concern for many people and is continuously discussed because the consequences of consuming drugs will make a person lose personality and easily influence their minds and thoughts, resulting in negative actions. The problem raised in this research is Islamic spiritual guidance to restructure the cognition of inmates for drug abuse in class IIA Pamekasan prisons which is explained in two focuses, namely: 1. How to implement Islamic spiritual guidance to restructure the cognition of inmates for drug abuse in class IIA prison Pamekasan, 2. What are the results of Islamic spiritual guidance services to restructure the cognition of inmates in class IIA Pamekasan prisons. This research uses a qualitative approach and collects data using observations, interviews and documentation. The data analysis techniques used are condensation, presentation of data and drawing conclusions. The results of the research conducted by the author at Class IIA Pamekasan Prison, namely based on data obtained by researchers, conclusions can be drawn based on the research focus that the implementation of guidance at Class IIA Pamekasan Prison through several strategies including religious studies, Istighotsah activities, congregational prayer as well as through learning tartil al-Qur'an and Islamic spiritual guidance which is carried out at Class IIA Pamekasan Prison has produced results in restructuring the cognition of inmates, including increasing awareness of religion, reducing the stress of inmates in drug abuse, the peace of mind felt by inmates and reducing drug dependence.

The Impediments in Implementing Inclusive Education in Two Special Schools in Dr Kenneth Kaunda District Impediments and Recommendations

Background: The implementation of successful inclusive education our special schools is still a challenge as there are numerous impediments that hinders such implementation.  Objectives: To explore impediments in the implementation of inclusive education in two special schools in Dr Kenneth Kaunda District.  Method: To archive stipulated objectives, a qualitative research approach was employed. The population of the study was made up of two special schools in Dr Kenneth Kaunda District. Data was collected using semi- structured interviewed. Data was collected through interviews that were collected from learners who are identified with learning barriers and request for placement in special schools. The data was gathered from the participants and analysed in thematic manner.  Results: The study revealed that there are numerous impediments that hinders the implementation of inclusive education, inter alia, safety and security in schools, lack of parental involvement, learner’s drug abuse, shortage of therapists, teacher’s qualification, overage learners and shortage of special schools. The study also outlined factors curbing the implementation of inclusive education.  Conclusion: The study concluded that indeed the stipulated impediments hinders the successful implementation inclusive education.  Contribution: The suggested strategies will enhance the successful implementation of inclusive education in schools.

Aged mice exhibit faster acquisition of intravenous opioid self-administration with variable effects on intake.

Although opioid abuse is more prevalent in young individuals, opioid use, overdose, and use disorders continue to climb at a rapid rate among the elderly. Little is known about abuse potential in a healthy aged population, in part due to technical and logistical difficulties testing intravenous self-administration in aged rodents. The goal of this study was to address the critical gap in the literature regarding age-dependent differences in opioid (remifentanil and fentanyl) self-administration between old and young mice. Male and female mice were grouped into young (mean: 19 weeks) and old (mean: 101 weeks), and were trained to self-administer intravenous fentanyl or remifentanil in daily sessions. In both old and young mice, acquisition, intake, and cue-responding after forced abstinence were measured for both drugs, and a dose-response curve (remifentanil) and dose-escalation (fentanyl) were conducted. Surprisingly, old mice learned to self-administer both remifentanil and fentanyl faster and more accurately than young mice. Baseline intake of remifentanil was also substantially greater in old mice compared to their young counterparts; however, we did not see increased intake of fentanyl with age at either dose tested. Further, compared to young mice, the old mice showed a greater incubation of responding for cues previously associated with remifentanil after a forced abstinence, but again this was not observed with fentanyl. Together these data suggest that an aged population may have an increased drug-abuse vulnerability for opioids compared to young counterparts and underscore the importance of future work on mechanisms responsible for this increased vulnerability.

Lifetime exposure to smoking and substance abuse may be associated with late-onset multiple sclerosis: a population-based case-control study

BackgroundLate-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS.MethodsThis population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23.ResultsTotally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44–4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05–15.7), wine (AOR: 3.30, 95% CI: 1.41–7.71), and beer (AOR: 3.12, 95% CI: 1.45–6.69) were found to pose the greatest risk of LOMS, respectively.ConclusionFor the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention.

A real-world pharmacovigilance study of esketamine nasal spray.

Mining and updating the post-marketing safety signals of esketamine nasal spray for better identification of adverse drug event (ADE) signals and medication monitoring during clinical use to ensure patient medication safety. Downloading data from the US Food and Drug Administration Adverse Event Reporting System from Q1 2019 to Q2 2023, the reporting odds ratio, proportional reporting ratio, Multi-item Gamma Poisson Shrinker, and Bayesian Confidence Propagation Neural Network methods of the disproportionality method were used to mine and analyze ADEs, and finally to screen for signals of ADEs with esketamine nasal spray as the primary suspected drug. The Preferred Terminology of the Medical Dictionary of Regulatory Activities (version 26.0) was used to standardize the description of ADEs and to attribute ADEs to the System Organ Classification. A total of 5132 ADEs reports of esketamine nasal spray as the primary suspected drug were obtained from the Food and Drug Administration Adverse Event Reporting System. The most frequently observed ADEs are dissociation, sedation, and hypertension, while some new rare signals have been detected, such as interstitial cystitis, substance abuse, and drug diversion. The present study identified significant new ADEs signals for esketamine nasal spray, which may provide a source for healthcare professionals to assess patients' symptoms and risk identification.

Social-emotional competence, social adequacy, and self-regulation among Iranian female high school students

The research aimed to investigate the association between social-emotional competence and social adequacy with the self-regulation of female high school students in Tehran. The sample of the current study consisted of 250 female participants from the student community in different educational areas of Tehran, who were selected using the multi-stage cluster sampling method. The measurement tools were: The social-emotional competence scale, the social adequacy scale and the self-regulation questionnaire. The findings revealed a positive association between social-emotional competence, social adequacy, and self-regulation among Iranian female students. Resulted of regression analysis showed that self-regulation was positively predicted by social-emotional competence and social adequacy. Enhancing social competence, particularly in emotional and psychological aspects, can improve students’ adaptation and well-being. This can help prevent issues such as social rejection, substance abuse, and depression in both their school environment and future personal and professional lives. Additionally, it is important to implement various intervention programs targeting parents and teachers to raise awareness about social-emotional competence and social adequacy in adolescent girls, as well as strategies for fostering these skills. This will improve their mental health and help prevent the development of various addictive behaviors

Pendidikan Kesehatan tentang Pencegahan Infeksi Menular Seksual pada Remaja

Sexually Transmitted Infections (STIs) are diseases transmitted through sexual activity, whether vaginal, oral, or anal. However, these infections can also be transmitted outside of sexual contact, such as from mother to child (e.g., during birth or through breastfeeding) or through shared needles among drug users, as well as due to poor hygiene of the reproductive organs (http://dewibest.blogspot.com/2014/11/sap-kespro-pada-remaja.htm). STIs can be caused by bacteria, fungi, viruses, and protozoa. STIs are a significant public health issue globally, affecting both developed and developing countries. The actual incidence and prevalence of these infections are not precisely known in various countries (Fauziah Husna, 2020). According to the Centers for Disease Control (CDC) in 2022, the most frequently reported STIs worldwide include syphilis (including congenital syphilis), gonorrhea, chlamydia, chancroid, and HIV (Human Immunodeficiency Virus) (Niforatos, J.D., & Rothman, 2021).

Incidence and pattern of neurological emergencies in Ramadan

ABSTRACT Background The impact of Ramadan fasting on various neurological emergencies remains relatively unexplored. This study aimed to clarify the incidence and pattern of the different neurological emergencies in Ramadan compared to Shaaban. Methods In this cross-sectional study, all adult patients attending the emergency room at two Egyptian centers with neurological emergencies during Shaaban and Ramadan were evaluated. Clinical, laboratory, and radiological assessments were made on an individual basis upon which the diagnosis of neurological disorder was made. IBM SPSS Version 25 was used to analyze the data. Results Seventy-twenty patients were included, 382 during Shaaban and 338 during Ramadan. Among causes of delirium, the frequency of dehydration was significantly higher, and the frequency of illicit drug abuse was significantly lower during Ramadan compared to Shaaban (P = 0.004, 0.030, respectively). The incidence of ICH was significantly reduced during Ramadan compared to Shaaban (10.8% vs 19.7%, P = 0.031). The incidence of cardioembolic strokes significantly increased during Ramadan than Shaaban (40.5% vs 26.4%, P = 0.014), whereas the incidence of small vessel disease (SVD) significantly decreased during Ramadan than Shaaban (21.6% vs. 42.1%, P < 0.001). The incidence of a single seizure was significantly higher in Ramadan than in Shaaban (69.4% vs. 34.6%, P = 0.007). The incidence of functional neurological disorders was significantly reduced in Ramadan than in Shaaban (P < 0.001). Conclusion The incidence of delirium caused by illicit drug abuse, ICH, SVD, and functional neurological disorders declined during Ramadan, while the incidence of delirium triggered by dehydration, cardioembolic strokes, and a single seizure increased during Ramadan.

Slot Blot- and Electrospray Ionization-Mass Spectrometry/Matrix-Assisted Laser Desorption/Ionization-Mass Spectrometry-Based Novel Analysis Methods for the Identification and Quantification of Advanced Glycation End-Products in the Urine.

Proteins, saccharides, and low molecular organic compounds in the blood, urine, and saliva could potentially serve as biomarkers for diseases related to diet, lifestyle, and the use of illegal drugs. Lifestyle-related diseases (LSRDs) such as diabetes mellitus (DM), non-alcoholic steatohepatitis, cardiovascular disease, hypertension, kidney disease, and osteoporosis could develop into life-threatening conditions. Therefore, there is an urgent need to develop biomarkers for their early diagnosis. Advanced glycation end-products (AGEs) are associated with LSRDs and may induce/promote LSRDs. The presence of AGEs in body fluids could represent a biomarker of LSRDs. Urine samples could potentially be used for detecting AGEs, as urine collection is convenient and non-invasive. However, the detection and identification of AGE-modified proteins in the urine could be challenging, as their concentrations in the urine might be extremely low. To address this issue, we propose a new analytical approach. This strategy employs a method previously introduced by us, which combines slot blotting, our unique lysis buffer named Takata's lysis buffer, and a polyvinylidene difluoride membrane, in conjunction with electrospray ionization-mass spectrometry (ESI)/matrix-assisted laser desorption/ionization-mass spectrometry (MALDI-MS). This novel strategy could be used to detect AGE-modified proteins, AGE-modified peptides, and free-type AGEs in urine samples.

Crack lung: a difficult differential diagnosis of ground glass opacities in the emergency setting

BackgroundThe term 'Crack lung' refers to an acute syndrome of diffuse alveolar damage and hemorrhagic alveolitis that occurs within 48 hours of smoking freebase cocaine. Crack lung induces a variety of pulmonary complications, both acute and chronic, including pulmonary edema, alveolar hemorrhage, eosinophilic pneumonia, pneumothorax, and pulmonary thromboembolism. Ischaemia of pneumocytes because of crack use is induced by the following phenomena: thermal damage to the airways, direct toxicity, inflammatory damage, barotrauma and vasospasm. Diffuse alveolar damage and alveolar hemorrhage with eosinophilic cell infiltration and IgE deposits are found in the lung tissue.PurposeWe present two clinical cases of patients admitted to the emergency department of our university hospital with respiratory failure. HRCT scans showed bilaterally, subpleural, and peri-hilar lung parenchyma, extensive areas of parenchymal ground-glass hyperdensity, crazy paving aspects, and relative sparing of the apices. The temporal relationship between the appearance of the bilateral opacities, the history documenting drug use, and the onset of hypoxemia suggests the diagnosis of "Crack lung".ConclusionsIt is important to include drug abuse and crack lung in the differential diagnosis of acute respiratory symptoms with ground-glass opacities, as they are not uncommon in emergency departments and may rapidly progress to ARDS. CT findings are not specific, but it is important to accurately collect anamnestic data and collaborate with the clinician to achieve a diagnosis and establish proper therapy.

Step-By-Step Procedure to Identify Previously Unknown Compounds by LC-QTOF-MS Exemplified by an Intoxication With the Methaqualone Analog SL-164.

In September 2019, a 22-year-old man with a history of drug abuse presented to the hospital with altered mental status. Due to a suspected drug overdose, a blood sample taken on admission and a urine sample collected 30 h thereafter were submitted to our laboratory to test for illegal drugs, pharmaceutical substances, and designer drugs. During the routine toxicological analysis of the serum sample, morphine and phenobarbital were identified by liquid chromatography-quadrupole-time-of-flight mass spectrometry (LC-QTOF-MS). Additionally, two compounds showing identical accurate masses and isotope ratios as the designer benzodiazepine diclazepam and the benzodiazepine lormetazepam were found. However, retention times differed significantly from the expected values, and the acquired MS/MS spectra did not match the library entries of the two compounds, indicating the presence of two previously unknown substances. After further investigation, SL-164 (5-chloro-3-(4-chloro-2-methylphenyl)-2-methyl-4(3H)-quinazolinone), a methaqualone analog, which has recently emerged on the research chemical market, and its hydroxy metabolite were tentatively identified by accurate mass, isotope matching, and plausible fragmentation. However, for unequivocal confirmation and quantification, a reference standard is required. As no reference material was available by the end of 2019, SL-164 was obtained from an online shop, and its identity and purity (97.8%) were confirmed by nuclear magnetic resonance spectroscopy. The subsequent quantitative analysis revealed a concentration of 390 ng/mL SL-164 in serum. In the urine sample, the parent compound was not detected, but three suspected monohydroxylated metabolites were found. This example shows that LC-QTOF-MS is a powerful approach for the (tentative) identification of unknown compounds in biological matrices.

Parenting style of parents undergoing substance abuse treatment having adolescent children (12–20 years old) referring to addiction treatment clinics in Bojnurd

BackgroundConsidering the adverse effect of drug abuse on Parenting, this study was conducted to determine the parenting style of parents undergoing substance abuse treatment who were referred to addiction treatment clinics in Bojnurd in 2021. MethodsThe type of cross-sectional study was descriptive-analytical. The sample size was 360 parents with adolescent children (12–20 years old) undergoing substance abuse treatment who were included in the study by simple random sampling. A two-part questionnaire, including personal characteristics questions and Bamrind's parenting style questionnaire, was used to collect information. Data analysis was done using SPSS 23 software with parametric T-test, ANOVA, and non-parametric equivalent tests of Spearman's correlation at a significance level of 0.05. ResultsThe average score of permissive, authoritarian, and authoritative parenting styles was (16.15±5.92), (18±6.34) and (24.89±7.09) respectively. Men used permissive and authoritarian parenting styles significantly more than women. The people living in the village, compared to the city residents, and the people in the Turkish and Kurdish ethnicities, compared to Fars, significantly used authoritarian parenting style more. People using opioids significantly less preferred the permissive method and the authoritarian method compared to stimulant drug users and simultaneous users of stimulant and opioid drugs. ConclusionChildren of parents with substance abuse disorders are at risk of various adverse consequences, and it seems that inconsistent behavior of parents is an essential cause of this risk; therefore, the need for public education regarding Parenting, especially in addicted parents, is raised.

Integrating nutrition and culinary medicine into preclinical medical training

BackgroundPoor nutrition is a leading cause of preventable death, but is inconsistently taught in medical education and inadequately discussed in medical care. To overcome this problem, we developed a hybrid nutrition team-based learning/culinary medicine approach to integrate practical nutrition knowledge and basic cooking skills into the training of future health professionals.MethodsNutrition was integrated into the systems-based courses at a college of osteopathic medicine, complemented by culinary medicine sessions based on the Health meets Food curriculum (HmF; culinarymedicine.org). Students participated in the program for one year and two cohorts of students were included in this analysis. Outcomes were measured via online food frequency questionnaire (FFQ, Vioscreen, Viocare, Inc) and surveys administered via Qualtrics online survey software. Diet quality was measured using the Healthy Eating Index (HEI)-2015. Data were analyzed using SAS 9.4.ResultsOne hundred and ninety-five first year students completed a baseline FFQ (97.5% response rate). Mean age of students was 26 years, 47% were female (n = 92/195). The average BMI of participants was 24.8 kg/m2 (range 17-45.4) and the majority of participants reported being active. Seventy-five students (38%) completed an end of year FFQ. Diet quality was poor among students at baseline (n = 195; 67.59 (SD 10.54)) and improved slightly but significantly at the end of year 1 (n = 75, 69.63 (SD: 12.42), p = 0.04). The survey was administered to the second cohort only; 63 students responded (53% response rate). Talking to patients about nutrition was seen as more relevant to future practice among respondents than talking to patients about safe sex, weight, tobacco, alcohol, other substance abuse and domestic violence.ConclusionsThis study evaluated the nutrition and culinary medicine curriculum at a new college of osteopathic medicine. Students rated the program highly and attendance was excellent, even though not required. Student diet quality did not decline over the first year of medical school. Students rated talking to patients about nutrition as highly relevant, providing encouragement that they will do so in future practice. We believe our work shows that nutrition can be integrated into the training of future physicians and that it may pay dividends, particularly with the increasing awareness of the importance of preventive care.

Rewarding properties of L-Dopa in experimental parkinsonism are mediated by sensitized dopamine D1 receptors in the dorsal striatum.

Treatment of Parkinson's disease (PD) is based on the use of dopaminergic drugs, such as L-Dopa and dopamine receptor agonists. These substances counteract motor symptoms, but their administration is accompanied by motor and non-motor complications. Among these latter conditions a neurobehavioral disorder similar to drug abuse, known as dopamine dysregulation syndrome (DDS), is attracting increasing interest because of its profound negative impact on the patients' quality of life. Here we replicate DDS in a PD mouse model based on a bilateral injection of 6-hydroxydopamine (6-OHDA) into the dorsal striatum. Administration of L-Dopa induced locomotor sensitization and conditioned place preference in 6-OHDA lesion, but not in control mice, indicative of the acquisition of addictive-like properties following nigrostriatal dopamine depletion. These behavioral effects were accompanied by abnormal dopamine D1 receptor (D1R) signaling in the medium spiny neurons of the dorsal striatum, leading to hyperactivation of multiple signaling cascades and increased expression of ΔFosB, a stable transcription factor involved in addictive behavior. Systemic administration of the D1R antagonist, SCH23390, abolished these effects and the development of place preference, thereby counteracting the psychostimulant-like effect of L-Dopa. The rewarding properties of L-Dopa were also prevented by chemogenetic inactivation of D1R-expressing neurons in the dorsal striatum. Our results indicate the association between abnormal D1R-mediated transmission and DDS in PD and identify potential approaches for the treatment of this disorder.