Illegal Substance Use Research Articles

Effect of Abandoned Housing Interventions on Gun Violence, Perceptions of Safety, and Substance Use in Black Neighborhoods

Structural racism has resulted in long-standing disinvestment and dilapidated environmental conditions in Black neighborhoods. Abandoned houses signal neglect and foster stress and fear for residents, weakening social ties and potentially contributing to poor health and safety. To determine whether abandoned house remediation reduces gun violence and substance-related outcomes and increases perceptions of safety and use of outdoor space. This cluster randomized trial was conducted from January 2017 to August 2020, with interventions occurring between August 2018 and March 2019. The study included abandoned houses across Philadelphia, Pennsylvania, and surveys completed by participants living nearby preintervention and postintervention. Data analysis was performed from March 2021 to September 2022. The study consisted of 3 arms: (1) full remediation (installing working windows and doors, cleaning trash, weeding); (2) trash cleanup and weeding only; and (3) a no-intervention control. Difference-in-differences mixed-effects regression models were used to estimate the effect of the interventions on multiple primary outcomes: gun violence (weapons violations, gun assaults, and shootings), illegal substance trafficking and use, public drunkenness, and perceptions of safety and time outside for nearby residents. A master list of 3265 abandoned houses was randomly sorted. From the top of this randomly sorted list, a total of 63 clusters containing 258 abandoned houses were formed and then randomly allocated to 3 study arms. Of the 301 participants interviewed during the preintervention period, 172 (57.1%) were interviewed during the postintervention period and were included in this analysis; participants were predominantly Black, and most were employed. Study neighborhoods were predominantly Black with high percentages of low-income households. Gun violence outcomes increased in all study arms, but increased the least in the full remediation arm. The full housing remediation arm, compared with the control condition, showed reduced weapons violations by -8.43% (95% CI, -14.68% to -1.19%), reduced gun assaults by -13.12% (95% CI, -21.32% to -3.01%), and reduced shootings by a nonsignificant -6.96% (95% CI, -15.32% to 3.03%). The trash cleanup arm was not associated with a significant differential change in any gun violence outcome. Instances of illegal substance trafficking and use and public drunkenness outcomes were not significantly affected by the housing remediation or trash cleanup treatment. Perceptions of neighborhood safety and time spent outside were unaffected by the intervention. The study arms did differ in a baseline characteristic and some preintervention trends, which raises questions regarding other potential nonmeasured differences between study arms that could have influenced estimates. No evidence of displacement of gun violence outcomes was found. In this cluster randomized controlled trial among low-income, predominantly Black neighborhoods, inexpensive, straightforward abandoned housing remediation was directly linked to significant relative reductions in weapons violations and gun assaults, and suggestive reductions in shootings. isrctn.org Identifier: ISRCTN14973997.

SEROPREVALENCE OF HBsAg, Anti-HBs, Anti-HCV, and Anti-HIV IN PATIENTS WITH ALCOHOL AND SUBSTANCE ABUSE IN AN AMATEM CLINIC IN EASTERN TURKIYE: A SIX-YEAR RETROSPECTIVE EVALUATION

Aim
 Substance abuse and concomitant infections are important causes of morbidity and mortality. Yet, the number of epidemiological studies regarding infectious diseases in people with substance abuse are limited in our country. In this study, the aim was to investigate the frequency of illegal alcohol and substance use in an Alcohol and Drug Research, Treatment and Training Centres (AMATEM) clinic in Turkey as well as the HBsAg, anti-HBs, anti-HCV, and anti-HIV parameters between the years of 2016-2021. 
 Material and Method
 HBsAg, anti-HBs, anti-HCV, and anti-HIV tests were conducted using the ELISA technique in 6881 alcohol and substance use disorder (ASUD). Urine samples from ASUD’s were analyzed for alcohol, cannabis, and cocaine metabolites. The results were evaluated retrospectively. 
 Results
 All of the 6881 ASUD’s were male with a mean age of 32.18±9.66 years. Of the 6881 ASUD’s included in the study, 4107 (59.7%) were opioid addicts; 1479 (21.5%) were mixed drug addicts; 897 (13%) were alcohol addicts; and the rest were addicts with other types of substance use. The mean age of the alcohol users was 45.33±13.03 and the mean age of opioid users was 29.90±7.13. The percentage of opioid addiction in 2016 was 71.2% which dropped to 28.7% in 2021. Meanwhile, the percentage of alcohol addiction was 13.6% in 2016 and increased to 21.4% in 2021; and the percentage of mixed drug use was 8.7% in 2016 and increased to 36.8% in 2021. HBsAg-positivity in opioid users (56.7%) was higher compared to cannabis users (2.6%) and mixed drug users (22.3%). Anti-HCV positivity of opioid users (69.4%) was found to be higher compared to alcohol (9.4%), cannabis (2%), and mixed drug (16.2%) users, and this finding was statistically significant (p=0.0001). Anti-HBs positivity of opioid users (63.1%) was found to be higher compared to alcohol (9.9%), cannabis (3%), and mixed drug (21%) users, and this finding was statistically significant (p=0.0001). Anti-HIV was determined negative in all ASUD’s. The highest rates of HBsAg, anti-HCV and anti-HBs positivity were found in the 26-30 years of age. 
 Conclusion
 These findings indicate a high prevalence of intravenous substance abuse in the 26-30 years age group in our region as well as the high HBV and HCV rates in this patient group.

RF12 | PSUN103 Wireless Mobile Device Overuse and Obesity: Understanding the Neuroscience, Implications and Interventions

Abstract Background While wireless mobile device (WMD) overuse might be perceived as normal behavior in people of all ages, the pathophysiology of WMD addiction is similar to that of substance addiction. Increasing prevalence of disorders related to screentime/sedentary lifestyle such as obesity, dyslipidemia, prediabetes, and type 2 diabetes mellitus calls for comprehensive and cost-effective interventions. Objectives We aimed to synthesize existing data on the neuroscience that underlies WMD addiction, its adverse health outcomes and suggest practical strategies to achieve life-technology balance at home and work. Methods Comprehensive search of databases (PubMed and MEDLINE) was conducted until May 2021, for smartphone, screentime and phone addiction. The data were collected as part of a population-based educational initiative, Phreedom (Freedom from smartPhone), to inspire individuals to achieve life-technology balance. Results From the initial 655 citations, 234 were included. The addictive use of WMDs was linked to the 'incentive sensitization theory of addiction': repeated exposure to potentially addictive stimuli (i.e., notifications) can cause persistent structural and functional brain changes in the prefrontal cortex. As a result, an individual's executive functions and cue-reactivity could be impaired. The hyper-reactive dopamine system could also drive this compulsive behavior in the form of a habit-loop of cue, craving, response, and reward. Each hour/day increase in screentime was associated with 0.05-0.07 increase in body mass index (BMI) (p < 0.001), likely due to food marketing, distracted eating, reduced satiety, and procrastination of physical activity. Overuse of WMDs was associated with insufficient and low-quality sleep, daytime tiredness, daytime sleepiness, depression, and daily cognitive failures. Nine of 10 Americans reported using a technological device in the hour before bed. The more interactive the device, the higher the difficulty falling asleep and unrefreshing sleep (p < 0.05). The younger the age at initial exposure and the longer the duration of exposure, the higher the odds of adverse health outcomes, such as illegal substance use. High users of screens were more likely to have been diagnosed with anxiety or depression, requiring medication. Practical strategies to disrupt the addictive dopamine habit-loop included WMD triage and uncluttering, eliminating redundant notifications, deleting time-consuming applications, modifying the digital environment at home and work, and replacing screentime with greentime. Other tactics could include using an alarm clock, wearing a wristwatch, specifying times to check emails and social media, refocusing teams to decrease reliance on text messages and lowering expectations of immediate responses. Conclusions While it would be irrational to suggest complete avoidance of all WMDs, moderation, balance, and real-life engagement together with strategies aimed at disrupting the dopamine habit loop will be critical components of any intervention plan. Educating patients about the neuroscience of WMD addiction and empowering them with tips to curb WMD use might impact their behavior substantially. Presentation: Saturday, June 11, 2022 1:30 p.m. - 1:35 p.m., Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Illegal drugs and periodontal conditions.

In recent years, the practice of dentistry and periodontology has become complicated by several risk factors, including the treatment of an increasing number of patients with substance use disorder. This review presents an update in the current literature of the impact of illegal drug use on periodontal conditions and their possible effect as risk factors or indicators. The main illegal drugs that may have an impact on periodontal health and conditions are described, including their effect, medical manifestations, risks, and the overall effect on oral health and on the periodontium. Where available, data from epidemiologic studies are analyzed and summarized. The clinical management of periodontal patients using illegal drugs is reported in a comprehensive approach inclusive of the detection of illicit drug users, screening, interviewing and counseling, the referral to treatment, and the dental and periodontal management. With regard to the impact of illegal substance use on periodontal conditions, there is moderate evidence that regular long-term use of cannabis is a risk factor for periodontal disease, manifesting as a loss of periodontal attachment, deep pockets, recessions, and gingival enlargements. Limited evidence also shows that the use of cocaine can cause a series of gingival conditions that mostly presents as chemical induced-traumatic lesions (application of cocaine on the gingiva) or necrotizing ulcerative lesions. There is a scarcity of data regarding the impact of other drug use on periodontal health. There is evidence to suggest that regular long-term use of cannabis is a risk factor for periodontal disease and that the use of cocaine can cause a series of periodontal conditions. The dental treatment of subjects that use illegal substances is becoming more common in the daily clinical practice of periodontists and other dental clinicians. When the clinicians encounter such patients, it is essential to manage their addiction properly taking into consideration the impact of it on comprehensive dental treatment. Further studies and clinical observations are required to obtain sound and definitive information.

Use of Illegal Foreign Substances for Cosmetic Purposes. An Increasing Global Problem.

Use of Illegal Foreign Substances for Cosmetic Purposes. An Increasing Global Problem.

Risk factors for substance use in Swedish adolescents: A study across substances and time points.

Aim: The public health model for prevention of disease and disorder has been influential in informing interventions regarding substance use. While a number of risk factors within this model have been found to predict substance use, few studies have explored the associations across substances, at different time points and in the same individuals. The aim of this study was to test this model across legal and illegal substance use among adolescents, and to identify potential changes in associations over time. Methods: Data from two waves of a nationally representative cohort study among Swedish adolescents were used. Baseline data were collected in 2017 (9th grade) with a follow-up in 2019 (11th grade). Using modified Poisson regression analyses, we explored cross-sectional associations between factors from different domains and prevalence of cigarette use, binge-drinking and illegal drug use at both baseline and follow-up. Results: The results in part supported the public health model. Substance use was predicted by factors within the family, school and the individual/peer domain, but several associations were not statistically significant. The only consistent risk factors across substances and time points were lack of parental monitoring, truancy and minor criminal activities. Conclusion: Despite widely different prevalence rates across substances, some risk factors were consistently associated with adolescent substance use. Nonetheless, the findings challenge the assumption that risk factors are stable over adolescence. They suggest a need for flexible prevention interventions spanning across substances and legal boundaries of substances, but also over domains to reflect the heterogenous needs of adolescents.

Public health approaches to substance use: a scoping review protocol

The aim of this scoping review is to describe how a public health approach to legal and illegal psychoactive substance use has been previously defined, and to identify its core values, concepts, activities, and goals. Jurisdictions globally are increasingly endorsing a public health approach to addressing psychoactive substance use. However, there is currently no agreed definition of this approach, and this term has been applied inconsistently in the literature, policy, and practice. A critical first step toward advancing a public health approach to substance use is identifying and articulating its core components. This review will consider all peer-reviewed and gray literature in English focused on conceptualizing, defining, or describing a public health approach to substance use. Our review does not place limitations on populations, psychoactive substance types, or other contextual factors. We will search PROSPERO, MEDLINE, Embase, PsycINFO, Cochrane Library, CINAHL, and Scopus, as well as health and social science databases; websites of prominent nonprofit, civil society, and government agencies/organizations in public health and substance use fields; and reference lists of included articles. Two independent reviewers will screen titles/abstracts of peer-reviewed literature, and 1 reviewer will screen titles/abstracts of gray literature. Two independent reviewers will conduct the full-text screening. A data extraction sheet will be pilot tested through double extraction. Findings will be presented as a narrative summary supported by tables and diagrams and, if feasible, a conceptual framework for understanding and applying a public health approach to substance use. Open Science Framework https://osf.io/sv25e.

Cops and drugs: Illicit drug abuse by police personnel

Aim: Patterns and prevalence of psychoactive drug use are unique in the professions and vary by profession as well as by type of practice (e.g., private/public), gender, and career stage. In this study, we attempt to summarise the results of research over the past decades on the use of illegal substances by law enforcement officers.Methodology: A literature search was performed in PubMed, HeinOnline, GoogleScholar and other relavant database (such as US Department of Justice) from their inception through April 2022.Findings: In total, 26 studies met the search criteria. Research data clearly indicates that, in addition to alcohol and smoking, the use of illegal drugs is also prevalent among police officers. Our review shows that the prevalence of illcit drug use ranges widely (0,22% – 21,6%). Results suggest that estimates of the prevalence of illegal substance abuse by police are influenced by a number of factors, such as: research methodology. deliberate distortion of data; social differences.Value: Studies on substance abuse by police officers focus on legal drug consumption (alcohol and smoking) and mostly do not address illicit drug use. However, limited results show that, in addition to alcohol consumption and smoking, police officers also use illegal drugs. There are many consequences of drug use by police officers.

Predictors of Workplace Substance Reuse among Patients with Alcohol or Illegal Substance Use Disorder in the Workplace

Substance and alcohol use in the workplace have become a global health burden; however, the etiologies have seldom been explored. The aims of this study were to develop a Workplace Substance Reuse Questionnaire (WSRQ) to measure the multidimensional factors associated with the reuse of alcohol or illegal substances in the workplace. The predictors of reuse were also investigated. The WSRQs for alcohol (WSRQ-Alc) and illegal substances (WSRQ-Sub) were composed of 15 and 13 items, respectively. Factors associated with workplace substance reuse included workplace environment, workload, social interaction in the workplace and other cues. Construct validity and reliability were performed to verify the questionnaires. Multivariate linear regression was conducted to estimate the associations between the factors and WSRQ score. A total of 90 patients with substance or alcohol use disorder were recruited. The results demonstrated that the WSRQ-Alc and WSRQ-Sub had acceptable reliability, with variance of 76.4% and 75.4%, respectively. The confirmatory factor analysis fit indices also indicated the adequacy of the model. A longer duration of alcohol use (β = 0.44; p = 0.002) and higher frequencies of changing job (β = 0.32; p = 0.027) and working part time (β = 0.32; p = 0.028) were significantly associated with higher WSRQ-Alc score. Our results highlight the importance of abstinence treatment and job referral for individuals with alcohol or substance use. Further studies are warranted to help extend the applicability and generalizability of the WSRQ.

Assessment of Low Patient Social Support and its Associated Factors among Hospitalized Medical-Surgical Adult in Patients in Addis Ababa Public Hospitals, Addis Ababa, Ethiopia, 2020. Multicenter Cross-Sectional Study

Background: Research is focused on cardiovascular disease (CVD). CVD is the leading cause of death in the Background: Patient social support is a network or web of social relationships that each individual keeps including the closest people, such as family, close friends, and other neighborhood or community individuals in the hospital as well as out of the hospital. Patient psychosocial support influences the health status and treatment effectiveness, enhancing the quality of care in a hospitalized medical-surgical inpatient setting. Therefore, it should be practiced in a hospital setting than a community setting. Methods: Institutional based cross-sectional study was conducted with 380 study subjects from March 1-30, 2020. A systematic random sampling technique was used and data were collected using interviewer-administered questionnaires. Trained nursing students collected data, which were entered into Epi-data 3.1 and exported to SPSS version 26 for analysis, and then binary and multiple logistic regression was performed to check the association between dependent and independent variables. Results: In this study, the low level of patient social support was 61.9%, while 38.1% of them have high levels of patient social support. Variables being housewives [AOR=3.41; 95%CI (1.145-10.153)], chat chewing [AOR=2.596; 95%CI (1.072-6.288)], psychosocial counseling [AOR=4.149; 95 %CI (0.075-0.771) and previous history of hospitalization [AOR=1.673; 95%CI (1.019-2.746) were found to be significantly associated with low patient social support. While age, sex, ethnicity, religion, income, alcohol drinking, smoking, other illegal substance use, family history of mental health problems, having a mental illness, type of case, and length of hospital stay were not significantly associated. Conclusions: The overall level of patient social support in hospitalized patients was low and being housewives, khat chewing, psychosocial counseling, and previous history of hospitalization were significantly associated with low levels of patient social support among adult inpatients, therefore health care providers should provide special consideration to those group of patients admitted to hospitals.

Problem drinking among university students in Berlin

Objective Problem-drinking among university students is common and poses serious health-related risks. Therefore, identifying and addressing associated factors is important. Participants and methods A large cross-sectional online-survey with 12,914 university students from Berlin was conducted from November 2016 to August 2017. Relative-risk- and correlation-analysis was used to identify factors associated with problem-drinking and regular heavy-drinking. Independent t-tests compared impulsivity and personality traits, chi-square-tests compared drinking motives between risk- and non-risk-drinkers. Results Male gender, tobacco-smoking, illegal substance use, impulsivity and various sociodemographic and psychosocial variables were significantly related to problem/heavy-drinking. Extraversion was a risk, conscientiousness and agreeableness were protective factors. Drinking-motives did not differ significantly between risk- and non-risk-drinkers. Generally, the main drinking-motives were to feel elated, relax and social purposes. Conclusion The identified markers and related problem behaviors may serve as a tool to enhance the identification of student subgroups at risk for problem/heavy-drinking, and hence improve targeted health-intervention-programs.

Utilizing a combined hospital and criminal justice database to identify risk factors for repeat firearm injury or violent-crime arrest among firearm victims.

Introduction: Identifying firearm victims with the greatest risk of repeat-firearm exposure and offering interventions has the potential to disrupt recurrent violence. This study explored risk factors associated with repeat violence among survivors of intentional firearm injury in a unique clinical and criminal justice (CJ) dataset. Methods: This study analyzed a retrospective cohort (n = 4058) of persons injured by nonfatal intentional firearm violence from 2013 to 2016 in one metropolitan area. Data were collected from a single level I trauma center, city police records, and state CJ databases from 1948 to 2019. The primary outcome of interest was another firearm injury or violent-crime arrest (defined as a violent or firearm felony offense). Results: Among 4058 nonfatal intentional firearm victims, 1202 (29.6%) individuals had a repeat-firearm injury or violent-crime arrest. In a bivariate analysis, history of mental, physical, and/or emotional abuse (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.40-1.86), mental health diagnosis (OR, 1.88; 95% CI, 1.51-2.35), or illegal substance use (OR, 2.87; 95% CI, 2.48-3.32) was associated with increased risk of repeat-firearm injury or violent-crime arrest. Prior felony arrest (OR, 3.68; 95% CI, 3.19-4.24), prior incarceration (OR, 3.72; 95% CI, 3.04-4.56), prior firearm charge (OR, 4.06; 95% CI, 3.33-4.96), and suspected gang membership (OR, 8.69; 95% CI, 6.14-12.32) demonstrated the greatest association with significant repeat violence. Conclusions: Thirty percent of those who experienced an intentional firearm injury were found to have a repeat-firearm injury or violent-crime arrest multi-disciplinary interventions that address the complex needs of a CJ-involved population are needed to mitigate significant repeat violence.

Mental Health in Young Detainees Predicts Perpetration of and Desistance From Serious, Violent and Chronic Offending.

Mental health problems are common among young offenders but their role in predicting criminal recidivism is still not clear. Early identification and treatment of young offenders at risk of serious, violent, and chronic (SVC) offending is of major importance to increase their chances to develop into a healthy and non-criminal future and protect society from further crime. In the present study, we assessed mental health among 106 young offenders while incarcerated and analyzed their criminal careers up to 15 years after release. We found high rates of mental health issues, especially externalizing problems, but also concerning illegal substance and alcohol use patterns as well as personality disorders. Rule-breaking behavior and internalizing problems were negatively related to incarceration time until study assessment, but withdrawal and internalizing problems were positively associated with remaining time to release. Whereas, SVC status before assessment and after release were not statistically dependent, mental health issues predicted perpetration of and desistance from SVC offending after release. Alarming alcohol use appeared to be of specific importance in this regard. Findings indicate that young offenders at risk of future SVC offending may benefit from mental health treatment with specific focus on problematic alcohol consumption to prevent ongoing crime perpetration.

'I Was Present but I Was Absent': Perceptions and Experiences of the Non-Medical Use of Prescription or over the Counter Medication among Employed South African Women.

Background: The need for workplace substance use prevention programmes globally and in South Africa is driven by the growing problem of substance use and the associated burden on the health and welfare of employees, their families and organizations. Substance use, which include the non-medical use of medications (both prescription and over-the counter), remains widespread and is a major cause of mortality and a risk factor for non-communicable diseases (NCDs). Method: Twenty in-depth semi-structured qualitative interviews were conducted with employed women in treatment or shortly out of treatment for the non-medically indicated use of over the counter or/and prescription medications (NMIU). These interviews were conducted face-to face with women residing in the Western and Eastern Cape provinces of South Africa. Thematic analysis using NVIVO was used to analyse data collected. Results: The findings from this study suggest that previous use of legal or illegal substances and challenging life experiences underpin pathways to the non-medical use of over-the-counter and prescription medications among employed women. Factors found to contribute to misuse relate to a lack of understanding on risks, and health professional prescribing practices, while mitigators to harmful use were related to increased awareness and understanding harmful practices, the need for improved access and referral to specialist treatment as well as prevention programmes for women. Conclusion: With the improved understanding of the issues surrounding the NMIU of over-the-counter and prescription medications among employed women, the need for interventions to prevent misuse and inadvertently dependency is highlighted.

Prevalence and Correlates of Prescription Drug Misuse Among Spanish Adolescents.

Prescription drug (PD) misuse among adolescents constitutes a growing health concern worldwide. This study aimed to provide up-to-date prevalence and correlates of PD misuse (i.e., tranquilizers, opioids and stimulants) among a national representative sample of high-school adolescents in Spain. We used nationwide data from 36,788 adolescents (51.93% females) aged between 14 and 18 who completed the 2018-2019 Survey on Drug Use in Secondary Education in Spain (ESTUDES). Lifetime misuse of the following PD was assessed: tranquilizers without prescription, opioids to get high, and prescription stimulants to improve academic performance. Other substance use, sociodemographic characteristics, academic performance related variables, and the quality of parental relationship were assessed. Lifetime prevalence of PD misuse was 8.50% for tranquilizers, 2.34% for stimulants, and 2.20% for opioids. Past-month tobacco use and lifetime illegal substance use were the only correlates associated with all PD categories (ORs between 1.419 and 6.788). The remaining sociodemographic, academic and family correlates were PD category-specific. This information may help in the development of empirically-based preventive interventions.

Practitioners\u2019 perspectives on family-based intervention for illicit drug-using adolescents in Taiwan: a qualitative study

BackgroundDrug-related psychiatric comorbidity or death among adolescents has grown to become a public health threat in Taiwan. In an atmosphere of abstinence, few alternatives or rehabilitative options for troubled young people have caused many juveniles to be driven away from home and placed in closed institutions. The intersectionality of illegal substance use, deviant behaviours, and criminal offences among adjudicated adolescents is a challenge for the development of adolescent users’ harm reduction strategies. In addition, the relationships among the adolescents, their families, and practitioners might be undermined by coercive and mandatory court measures. As developing a harm reduction approach includes minimizing the negative effects on not only adolescents and also their families, this study aims to explore Taiwanese practitioners’ perspectives of family-based programmes for drug-using adolescents.MethodsThis study adopted a qualitative approach. Through face-to-face interviews and a focus group, accounts were collected from 28 key informants working in youth delinquency. The interviews were transcribed for analysis using qualitative analysis software, namely NVivo10.ResultsPractitioners tend to refer to an “adolescent-centred model” when describing their work with drug-using young people. From the frontline practitioners’ descriptions, the families of those youth needing treatment services are often vulnerable and disadvantaged. These families are seldom onboard because of low readiness and scarce resources. Although a legal framework is in place, resources, workforce, and programmes to engage and involve parents in the intervention are lacking. Despite the obstacles, practitioners have utilized a variety of strategies to obtain limited success, such as parent meetings, resources referrals, parent counselling, court support, voluntary parenting courses, illicit substance information sharing, and home visits. Practitioners also pointed out that therapeutic interventions are more effective than coercive or mandatory interventions for adolescents and also for their families.ConclusionsSince most practitioners have an adolescent-centred work principle, their work with parents falls into professional-centred or family-allied work models. It is therefore suggested that resources be reallocated to involve parent counselling and intense treatment instead of mandatory parental education.

Factor Structure, Measurement Invariance, and Abbreviated Versions of The Adolescent Dissociative Experiences Scale (A-DES)

ABSTRACT The purpose of this study was to examine the factor structure of the Adolescent Dissociative Experiences Scale (A-DES) questionnaire with item response theory (IRT) methods, including an assessment of measurement invariance with differential item functioning (DIF) analysis. Three abbreviated versions of the A-DES (with 20, 10, and 5 items) were constructed based on the IRT and DIF statistics. The respondents in this population-based study (N = 4,072) were 12- to 19-year-old Finnish junior and senior high school students. A one-factor model of the A-DES was best supported, and the original theoretical four-factor model showed poor fit. The A-DES turned out to have high measurement invariance with respect to age, gender, transgender tendencies, having multiple friends, the use of illegal substances, and experience of being bullied. Compared to the full 30-item A-DES, abbreviated versions of the questionnaire retained acceptable information value and empirical reliability in the clinically relevant range of symptomatology. Further psychometric studies are needed especially with regards to clinical use.

Use of Legal and Illegal Substances and Their Impact on the Academic Performance of Medical University Students

Objective: This study will analyze the effects of the most common substances in medical students and their impact on their academic performance. Method: 328 medical students were interviewed between April 2019 to March 2020 for this study. In this cross-sectional study, information regarding substance use habits among medical students was obtained through a survey. The information was obtained through a questionnaire that is made up of 6 pages with the following sections: Registration, consumption of alcohol, marijuana, cocaine, medication to improve academic performance and energy drinks. Results: The results in this investigation were the following: the use of alcohol showed that it has a low relevance in influencing the performance of the students (p=0.702), the use of marijuana showed that it has a low relevance in the performance (p= 0.527), the use of cocaine showed that it has a low relevance in influencing academic performance (p=0.560), the use of medications showed that they have a high relevance in influencing academic performance (p=0.001), the use of energy drinks showed that they have a low relevance in influencing the performance of medical students (p=0.346). Conclusions: The use of substances among university students has been increasing over the years, the importance of understanding this phenomenon and its repercussions on students can help prevent addictions, school dropouts and even deaths from overdoses, as described in various literatures.

Use of Legal and Illegal Substances and Their Impact on the Academic Performance of Medical University Students

Use of Legal and Illegal Substances and Their Impact on the Academic Performance of Medical University Students

Thinking of Harm Reduction and Reducing Harm in a Chinese Therapeutic Community for Drug Users.

Harm is a concept that permeates behavioral and public health discourses on addiction. Examining addiction recovery services in settings beyond the OECD led me to the question: What does harm mean in an un-urban, un-Western, and un-democratic space? While some emphasize the human rights potential of reducing harm, others speak to the violence of cure. My ethnographic research in a Therapeutic Community (TC) for drug treatment in Southwest China pushed me to consider how the potential for reducing the harms of illegalsubstance use balance with the complex psychological demands of cure. The alliance linking Sunlight Therapeutic Community with the provincial drug abuse institute and a foreign NGO was fragile. At the TC, they had difficulty weaving the Western psychological construct of the singular self through the Chinese scaffolding of institutional and cultural practices around the group. In thinking with the concepts of harm and reducing harm, I move across time and space to consider how current tensions link to and reflect: 1) the historical harms of opium imperialism; 2) reducing harm in translation; and, 3) reducing harm in the recent psycho-boom.