Influence Of Illicit Drugs Research Articles

The Role of Parenting Behaviors and Their Influence on Adolescent Drunk and Drugged Driving: 2016-2019, USA.

Drugged driving, the act of driving a vehicle under the influence of illicit drugs, by adolescents is a serious public health concern. Many factors contribute to this risk behavior, but much less is known regarding the role of parenting behaviors in this phenomenon. The purpose of this study was to examine specific parenting behaviors and their influence among a nationally representative sample of adolescents. Pooled data from the 2016-2019 National Survey on Drug Use and Health (NSDUH) among 17,520 adolescents ages 16-17 years old were analyzed. Differences were found in specific parenting behaviors and adolescent drugged/drunk driving, with parents not checking homework and not telling their children they are proud of them being the most influential. Findings from the present study may inform drugged driving prevention programs for parents and adolescents and enhance road safety interventions.

Should men who have ever had sex with men be allowed to donate blood in Brazil?

Many countries have modified their policies on banning or deferring blood donation by men who have sex with men (MSM) in light of ethical concerns and new evidence about transfusion risks. In Brazil, MSM were not eligible to donate blood unless they had been celibate for the previous 12 months. However, in May 2020, the Brazilian Federal Supreme Court overturned this restriction. Many authors have attempted to stress possible risks of transfusion-transmitted infection under various scenarios of changes in bans or restrictions on donations by MSM using mathematical models, but we consider that it is a difficult task due to the wide variety of sexual behaviors, attitudes, and practices. Among these factors, we highlight sex under the influence of illicit drugs, and the fact that people with an undetectable human immunodeficiency virus viral load have the potential to transmit should their blood be transfused. Despite these possible risks, we believe that some MSM can donate blood regardless of the time elapsed since their last sexual contact, especially because blood donations by MSM were occurring even when there were time-based deferral rules. Blood banks should always seek to use screening algorithms to identify high-risk sexual behaviors using gender-neutral criteria, and education about transfusion risks should be offered to healthcare workers and MSM.

Fatal Oedipism: A Case Report and Literature Review.

To describe a unique case of a fatal self-enucleation and review previously published cases. The authors describe a unique case of a complete unilateral self-enucleation while under the influence of drugs, which resulted in severe intracranial hemorrhages, right internal carotid artery opacification, and death. A literature review was performed by searching articles published before January 2023 in the Pubmed/MEDLINE database using the keywords "auto-enucleation or self-enucleation." Cases of self-inflicted damage to the globe without severing any connections were excluded. A literature review identified a total of 54 articles and 75 patients who had self-enucleated at least one globe completely (84.0%). Their average age was 37 years and 50.7% were male. At the time of auto-enucleation, 64.0% of these patients had known psychiatric disorders, and 28.0% were found to be under the influence of illicit drugs or alcohol. Auto-enucleation resulted in intracranial complications in 26.7% of cases. There has been 1 prior case, which, like the authors' case, resulted in death due to intracranial complications. However, this occurred in a patient who partially enucleated one eye after a self-inflicted injury to the fellow eye. The current case is unique as these complications resulted from a complete unilateral auto-enucleation. The severity of this case's presentation and outcome highlights the importance of prompt neuroimaging and a thorough assessment. Prompt psychiatric assessment and treatment are also required.

Mitochondrial DNA methylation profiling of the human prefrontal cortex and nucleus accumbens: correlations with aging and drug use

BackgroundDespite the brain’s high demand for energy, research on its epigenetics focuses on nuclear methylation, and much of the mitochondrial DNA methylation remains seldom investigated. With a focus on the nucleus accumbens (NAcc) and the prefrontal cortex (PFC), we aimed to identify the mitochondrial methylation signatures for (1) distinguishing the two brain areas, (2) correlating with aging, and (3) reflecting the influence of illicit drugs on the brain.ResultWe collected the brain tissue in the NAcc and the PFC from the deceased individuals without (n = 39) and with (n = 14) drug use and used whole-genome bisulfite sequencing to cover cytosine sites in the mitochondrial genome. We first detected differential methylations between the NAcc and the PFC in the nonusers group (P = 3.89 × 10–9). These function-related methylation differences diminished in the drug use group due to the selective alteration in the NAcc. Then, we found the correlation between the methylation levels and the chronological ages in the nonusers group (R2 = 0.34 in the NAcc and 0.37 in the PFC). The epigenetic clocks in illicit drug users, especially in the ketamine users, were accelerated in both brain regions by comparison with the nonusers. Finally, we summarized the effect of the illicit drugs on the methylation, which could significantly differentiate the drug users from the nonusers (AUC = 0.88 in the NAcc, AUC = 0.94 in the PFC).ConclusionThe mitochondrial methylations were different between different brain areas, generally accumulated with aging, and sensitive to the effects of illicit drugs. We believed this is the first report to elucidate comprehensively the importance of mitochondrial DNA methylation in human brain.

Influence of Child Protection Benchmark on Management Outcomes in Child Friendly Schools of Makueni County, Kenya

The influence of child protection as a child-friendly school benchmark on the management outcome in public primary schools has been of interest. Schools in Makueni County (Kenya) have had their share of reported cases of child insecurity with children having been physically violated within the school community, sometimes with corporal punishment cases by teachers to an alarming level. The sought to answer the question: what is the influence level of the child protection internal school benchmark on the management outcome in Child Friendly Schools (CFS) of Makueni County? To answer the question, a mixed-method triangulation design was applied with a convergent model that inculcates regression and correlation models. The study findings establish that schools partially put in place and managed child protection measures as an important benchmark to strengthen management outcomes in CFS. Results from the study determined that there were established rules for visitors to identify themselves (82.1%), rules not to allow people under the influence of illicit drugs at school (85.5%), rules against bullying and corporal punishment (91.8%), not to allow pits in the school compound (65.5%), and buildings at school to be earthquake resistant (27.9%). School management used UNICEF’s child-friendly school child protection model as a benchmark on which to provide protection as a child right, thus making the schools more child-friendly.

Drugged Driving among Sexual Minority Older Adults in the United States, 2015-2019

Racial and ethnic minority older adults—especially non-Latino Black and Latino older adults—continue to have a higher prevalence of dementia with longer delays in formal diagnosis compared to non-Latino Whites. Few studies have estimated racial/ethnic differences in trajectories of dementia onset using nationally representative data with representation from the three largest racial/ethnic groups in the U.S.: non-Latino White, non-Latino Black, and Latino older adults. Additionally, given the delays in formal diagnosis we rely on a measure of probable dementia that takes into account both formal diagnosis and cognitive function. Data from the National Health and Aging Trend Study (NHATS, 2011–2019) reveals three trajectories of dementia onset (early, late, and dementia-free) and we find that Latino and Black older adults are at greater risk for early dementia onset compared to non-Latino Whites. Our next step is to explore the role of social function for dementia disparities.

Older sexual minority adults and driving under the influence, 2015–2019, USA

IntroductionOlder lesbian, gay, and bisexual (LGB) adults are often neglected in healthcare settings, despite increases in risk behaviors and substance use. The present study assessed drugged driving among older adults in the United States and investigated differences by sexual orientation. MethodsThe 2015–2019 National Survey on Drug Use and Health data were analyzed among 43,238 adults aged 50 years or older. Associations between drugged driving and demographic information were examined using weighted logistic regression models. ResultsAn estimated 4.82% (n = 2,120) of older adults drove under the influence of alcohol in the past year, 1.33% (n = 619) drove under the influence of marijuana in the past year, and 1.48% (n = 683) drove under the influence of illicit drugs in the past year. Compared to heterosexual counterparts, individuals who identified as a sexual minority were at increased risk for driving under the influence, with individuals who identified as bisexual nearly 4 times more likely to drive under the influence of marijuana (95% CI = 2.39, 6.51) and 4.5 times more likely to drive under the influence of illicit drugs (95% CI = 2.84, 7.08) within the past year. ConclusionsOlder LGB adults are at increased risk for drugged driving. Harm reduction efforts and behavioral interventions are currently warranted for healthcare improvement.

An age-period-cohort study of completed suicides in Greece: Patterns and implications for suicide prevention

Suicide is a dynamic phenomenon. Psychiatric medication intake, illicit drug and alcohol use or the preference for particular suicide methods shift continuously over time. To capture such variations –and their potential implications for suicide prevention-, we researched the forensic records of suicide cases for the period 1992–2016 at a large department of forensic medicine and conducted age-period-cohort (APC) analyses of our sample (1162 suicides, 77.45% males, 22.25% females). We primarily investigated socio-demographic and toxicological parameters. Benzodiazepine, alcohol and illicit drug use increased considerably towards the younger cohorts. The segment of individuals of foreign nationality raised significantly too; likewise, the proportion of prison suicides. Hanging appears increasingly preferred by the younger APCs (the opposite is true for jumping). Hanging seems more popular among males, prisoners, and those under the influence of illicit drugs; jumping by females and those less likely to have consumed alcohol or illicit drugs. Given that the method of a prior attempt, if a highly lethal one, usually gets repeated in the completed suicide, a history of an attempt by hanging should never be underestimated. The mental health needs of immigrants and prisoners look inadequately addressed. Young-middle aged immigrant prisoners appear a group at high suicide risk.

To What Extent Does Illicit Drug Use Predispose to Facial Injury? An Institutional Investigation for an Emergent Problem.

There are potential substantive linkages between illicit drug use and the occurrence of injury. The purpose of our study was to determine the prevalence, class of illicit drugs abused, and demographics in relation to a cohort of patients who sustained facial injury. The authors undertook a retrospective observational study of a prospectively accessioned cohort of patients who had sustained a facial injury and presented to the John Hunter Hospital (Newcastle, NSW, Australia). The primary predictor variable was the presentation of a facial injury and the secondary outcome variables included illicit drug use, alcohol use, and socioeconomic factors. The study was carried out over a 12-month period. A descriptive analysis was undertaken on the assembled data. Of the 465 patient medical records that were accessed for the study, 348 were male and 117 were female. Their average age was 42.6 years: 5.8% (n = 27) were under the influence of illicit drugs at the time of their presentation and 13.1% (n = 61) admitted to an intercurrent illicit drug habit. Those who were under the combined influence of alcohol and drugs comprised of 2.8% (n = 13). Our study found that illicit drug use plays a small, but nonetheless, demonstrable role in the presentation of maxillofacial trauma patients to an urban level I trauma center. Illicit drug users are an emergent sociodemographic group of patients who can sustain facial trauma and their presentation needs to be appropriately considered, assessed, and managed collectively.

Driving Under the Influence of Marijuana and Illicit Drugs Among Persons Aged ≥16 Years - United States, 2018.

In the United States, driving while impaired is illegal. Nonetheless, an estimated 10,511 alcohol-impaired driving deaths occurred in 2018.* The contribution of marijuana and other illicit drugs to these and other impaired driving deaths remains unknown. Data from the Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health (NSDUH) indicated that in the United States during 2014, 12.4% of all persons aged 16-25 years reported driving under the influence of alcohol, and 3.2% reported driving under the influence of marijuana (1). The impairing effects of alcohol are well established, but less is known about the effects of illicit substances or other psychoactive drugs (e.g., marijuana, cocaine, methamphetamines, and opioids, including heroin). This report provides the most recent national estimates of self-reported driving under the influence of marijuana and illicit drugs among persons aged ≥16 years, using 2018 public-use data from NSDUH. Prevalences of driving under the influence of marijuana and illicit drugs other than marijuana were assessed for persons aged ≥16 years by age group, sex, and race/ethnicity. During 2018, 12 million (4.7%) U.S. residents reported driving under the influence of marijuana in the past 12 months; 2.3 million (0.9%) reported driving under the influence of illicit drugs other than marijuana. Driving under the influence was more prevalent among males and among persons aged 16-34 years. Effective measures that deter driving under the influence of drugs are limited (2). Development, evaluation, and further implementation of strategies to prevent alcohol-impaired,† drug-impaired, and polysubstance-impaired driving, coupled with standardized testing of impaired drivers and drivers involved in fatal crashes, could advance understanding of drug- and polysubstance-impaired driving and support prevention efforts.

Driving under the influence of drugs: Prevalence in road traffic accidents in Italy and considerations on per se limits legislation

Objective: The objective of this study was to present the prevalence and concentrations of drugs in blood samples of drivers involved in road traffic accidents (RTAs) and to discuss the effects of adopting different concentration cutoff values proposed or applied in other European countries on the number of driving under the influence of drugs (DUID) offenses.Methods: Blood samples from drivers involved in RTAs in Padova province from 2014 to 2017 were analyzed for the presence of alcohol and drugs. The prevalence of positive subjects was reported for each substance adopting the limits of quantification (LOQs) of our laboratory and the concentration cutoff values proposed and/or used in other European countries. The reduction of cases of driving under the influence of illicit drugs in applying different cutoffs was calculated.Results: Four thousand four hundred forty-three blood samples were analyzed: 23.7% were positive for alcohol and 19.9% for psychoactive drugs, with prevalences of polydrug and alcohol–drug abuse of 4.5 and 6%, respectively.The most frequently detected drugs were cannabinoids (9.7%) and cocaine (7.2%), followed by benzodiazepines (4.1%), opiates (1.9%), and other opioids (1.7%). Barbiturates, amphetamines, and ketamine were identified in a much smaller number of cases. The overall decrease in DUID cases when adopting different cutoffs with respect to cases above the LOQs was between 8 and 84%. The adoption of high LOQs such as those used in the European Union’s research project on Driving Under the Influence of Drugs, Alcohol and Medicines (DRUID) decreases the hypothetical number of DUID offenses by a quarter, and per se limits proposed as broadly equivalent to a blood alcohol concentration (BAC) between 0.2 and 0.8 g/L dramatically reduce the cases of DUID (cocaine −81%, cannabis −79%, opioids −97%, opiates −96%, and amphetamines −77%); no ketamine-positive samples were above the cutoff.Conclusions: The implementation of high analytical limits or per se limits based on impairing concentrations in the Italian legislation could result in the prosecution of a much lower number of drugged drivers involved in RTAs, with a decrease from 25% to more than 80% depending on the limits.

The Role of Gay-Related Stigma in HIV-Risk Behavior Among Sexual Minority Men in Europe.

Sexual orientation stigma stems from discriminatory social contexts and may ultimately impact the behavioral health of stigmatized individuals through stress-related pathways. Sexual minority stigma is of particular concern in Europe given the diversity of social contexts on the continent and sexual minority men's rapidly increasing risk of HIV infection, especially in Central and Eastern Europe, potentially rooted in stigma. This study assesses whether stigma in the ubiquitous social contexts surrounding sexual minority men (e.g., family, workplace, government) may place them at higher risk for HIV contraction across six countries. We utilized a large cross-sectional survey sample of HIV-negative sexual minority men (N = 2087; mean age = 31.6, SD = 9.7) from six European countries to test whether those who reported sexual orientation stigma also engaged in more HIV risk-related behaviors, including condomless sex with casual partners (in the absence of PrEP) and substance use before and during sex. Regression analyses were performed in Mplus. We found that a one standard deviation increase in reported sexual orientation stigma was significantly associated with the following during the last sexual encounter: a 19% increase in odds of sex under the influence of alcohol, 27% increase in odds of sex under the influence of cannabis, 49% increase in odds of sex under the influence of illicit drugs, an 11% increase in odds of condomless sex with casual partners in the past 6months, and a 26% increase in odds of knowing where to receive an HIV test. Sexual minority men who reported perceiving greater sexual orientation-related stigma within their ubiquitous social contexts were significantly more likely to report sexual risk and alcohol and drug use during their last sexual encounter, yet reported more knowledge of preventive services. Contextual stigma might serve as a precursor to behavioral risks of HIV infection, generating maladaptive stress responses capable of being modified through individually-focused interventions. Structural interventions are also needed to ultimately reduce stigma at its source.

Complex systems modeling for evaluating potential impact of traffic safety policies: a case on drug-involved fatal crashes

Driving under the influence of illicit drugs is a critical road safety and public health concern. The U.S. National Drug Control Strategy has set a goal in 2010 to lower drugged driving significantly. In this study we presented a complex systems approach and developed a system dynamics (SD) model of drugged driving for assessing the impact of drugged driving per se law on the crash fatalities over time. The experimental analyses presented the behavioral change on the trend of number of annual drug-related fatally injured drivers when per se law is implemented with certain effect and investigated on the impact of drugged driving per se law on the number drug-related fatally injured drivers. By considering multiple interrelated factors that may influence drugged driving behaviors, the SD model was helpful in analyzing the potential “real world” impact of policy interventions on improving roadway safety and the behavior of drivers given the road infrastructure. Analyses showed that per se law would have negative exponential effect on the drugged driving fatalities over time and the policy effect would require time to be visible. In addition, combining policies of drugged driving and investing on public transportation would cause a higher change over time on reversing the trend of number of drugged driving-related crashes, however, cost effectiveness of policies still need further investigation.

Predictors of Aggressive Behavior While under the Influence of Illicit Drugs among Young Adult Methamphetamine Users

ABSTRACTBackground: Prior research indicates that patterns of combined alcohol and methamphetamine use may be associated with experiencing subjective feelings of aggression or hostility during methamphetamine use episodes. Objectives: This study examines whether subjective effects of methamphetamine use (i.e., aggression or hostility and paranoia) are associated with aggressive behavior while under the influence of any illicit drugs, controlling for combined alcohol and methamphetamine use and a number of other potential predictors. Methods: Data from a population-based sample of Australian young adult methamphetamine users (n = 101) collected in 2010 was analyzed. A prediction model of aggressive behavior under the influence of illicit drugs was developed using penalized maximum likelihood logistic regression. Results: Over one-third (34.7%) of methamphetamine users had engaged in verbal and/or physical aggression under the influence of illicit drugs in the last 12 months. In the prediction model, recurrent feelings of aggression or hostility attributed to methamphetamine use (≥3 times in the last 12 months) were associated with aggressive behavior (adjusted odds ratio 4.95, 95% confidence interval 1.67, 14.69). This association was independent of methamphetamine-attributed paranoia, combined alcohol and methamphetamine use, methamphetamine, ecstasy, cocaine, and cannabis use patterns, heavy episodic drinking, gender, and age. No association was found for combined alcohol and methamphetamine use. Conclusions: These findings indicate a link between methamphetamine-related subjective feelings of aggression or hostility and self-reported aggressive behavior while under the influence of illicit drugs. This suggests that subjective feelings of aggression or hostility may distinguish those who are involved in aggression from other methamphetamine users.

Toxicological investigation in blood samples from suspected impaired driving cases in the Milan area: Possible loss of evidence due to late blood sampling

Driving under the influence of illicit drugs (DUID) represents a significant menace to public safety and is therefore sanctioned with severe fines and penalties such as driving disqualification or even arrest in case the accident has caused serious injury or death. In Italy, DUID is regulated by the article 187 of the National Street Code, however, the list of the substances to be searched and their threshold concentrations are left to the 20 Italian regional authorities. A further lack of legislative standardization concerns the type of detection methods and moreover the time gap between the car accident and blood sampling. This interval can be as high as 5h, enough to significantly reduce the concentration of drugs with fast pharmacokinetic. By analyzing 1258 blood tests performed on drivers involved in road traffic crashes in the Milan area between 2012 and 2016 we show that approximately 75% of such drivers who tested positive for THC and 15% of the drivers who tested positive for cocaine are at risk of misjudgment. Considering the severe sanctions associated with DUID, we emphasize the urgency of introducing a corrective factor that takes into account the time elapsed between the accident and blood sampling in order to avoid unfair treatment, including the unjust application of sanctions.

Registered Dietitian Nutritionists in Substance Use Disorder Treatment Centers

Registered Dietitian Nutritionists in Substance Use Disorder Treatment Centers

In vitro elucidation of the metabolic profile of the synthetic cannabinoid receptor agonists JWH-175 and JWH-176

The continuing rise of synthetic cannabinoids consumption remains an analytical challenge. Proof of the intake of these substances is crucial when it comes to driving under the influence of illicit drugs, proof of abstinence after revocation of a driving license, mandatory workplace drug screenings, or judgement of legal culpability of a criminal suspect. Furthermore, in clinical cases of intoxication, the identification of the responsible substance is essential. Because of the short half-life time and the extensive metabolism of synthetic cannabinoids, blood is not the optimal matrix for the verification of elapsed consumption. The parent substance appears in urine only for a very short time period after intake. Therefore, it is crucial to include the metabolites of such substances in the analytical screening strategies. In this work we elucidated the in vitro metabolism of synthetic cannabinoids belonging to the naphthylmethylindole- and the naphthylmethylindene family. Low- and high-resolution mass spectrometry experiments have been performed to identify the formed metabolites. In total, 27 phase I metabolites of JWH-175 and eight of JWH-176 were identified. The obtained metabolic pattern of JWH-175 and JWH-176 can be used to supplement existing screening methods to be able to prove the intake of the investigated synthetic cannabinoids. To our knowledge this is the first report describing the metabolites of JWH-175 and JWH-176.

Abscess infections and malnutrition – a cross-sectional study of polydrug addicts in Oslo, Norway

Background. Injection drug use and malnutrition are widespread among polydrug addicts in Oslo, Norway, but little is known about the frequency of abscess infections and possible relations to malnutrition. Objectives. To assess the prevalence of abscess infections, and differences in nutritional status between drug addicts with or without abscess infections. Design. A cross-sectional study of 195 polydrug addicts encompassing interview of demographics, dietary recall, anthropometric measurements and biochemical analyses. All respondents were under the influence of illicit drugs and were not participating in any drug treatment or rehabilitation program at the time of investigation. Results. Abscess infections were reported by 25% of the respondents, 19% of the men and 33% of the women (p = 0.025). Underweight (BMI < 18.5 kg/m2) was significantly more prevalent in the abscess infected than in the non-abscess-infected group (p = 0.001). The abscess-infected addicts reported fewer meals, lower intakes of fruits and vegetables, lower energy percentage (E%) from protein and higher E% from sugar. They also had lower total intakes of vitamins D, B1, B6, B12, folic acid and vitamin C than the non-abscess-infected group. The two groups differed significantly with respect to S-C-peptide (p = 0.042) and B-HbA1c (p = 0.012), and the prevalence of hyperhomocysteinemia (P-tHCY > 15 μmol/L) was 73% in the abscess-infected group and 41% in the non-abscess-infected group (p = 0.001). The concentrations of S-25-hydroxy-vitamin D3 was very low. Conclusion. The prevalence of abscess infections was 25% among the examined polydrug addicts. Dietary, anthropometric and biochemical assessment indicated a relation between abscess infections and malnutrition.

Driving After Drug or Alcohol Use by US High School Seniors, 2001–2011

We examined prevalence, trends, and correlates of driving or riding after use of drugs or alcohol among US high school seniors from 2001 to 2011. Data come from Monitoring the Future, an annual survey of nationally representative samples of high school seniors. We used logistic regressions with data from more than 22,000 respondents to examine multivariate associations with demographic and lifestyle factors. Large numbers of US high school seniors put themselves and others at great risk of harm by driving after using marijuana or other illicit drugs or drinking alcohol or by riding in a vehicle whose driver had used marijuana, other illicit drugs, or alcohol. Driving after drinking has declined in recent years, but driving after use of marijuana has increased. A higher percentage of students reported driving after using marijuana than after having 5 or more alcoholic drinks. Risky driving and riding behaviors differed little between demographic subgroups but considerably according to lifestyle factors. Stronger efforts are needed to combat adolescent driving under the influence of illicit drugs.

RELATIVE AND ATTRIBUTABLE RISKS OF FATAL CRASHES ASSOCIATED WITH DRUG USE

BackgroundWhile alcohol-related motor vehicle crashes have declined in recent years, driving under the influence of illicit drugs and prescription drugs has become a major safety concern. The influence of drugs...