Influence Drug Use Research Articles

Neuropsychological functioning in methadone maintenance patients with HIV

Although highly active antiretroviral therapy (HAART) has improved survival rates of HIV patients, HIV-associated neurocognitive disorders (HAND) still exist in a highly prevalent group of persons with this disease. In this study we seek to evaluate the influence of drug use in the neuropsychological performance of seropositive drug users. We carried out an extensive neuropsychological evaluation and compared the performance of seropositive drug users (n=90) with that of a control group of seronegative drug users (n=48). The results reveal that methadone maintenance programmes can make the seropositive subject neuropsychologically vulnerable. Likewise, we found that giving up drugs have a protective effect in the presence of neuropsychological alterations associated with HIV. These findings lead us to suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users, noting that these alterations are multifactorial.

The influence of potentially traumatic household characteristics on blunt use among Black youth

ABSTRACTThe residential status of mothers and fathers in the household has been shown to influence drug use and other health outcomes among adolescents. However, no studies have examined if these household characteristics influence blunt use (marijuana mixed with or replacing tobacco in cigar paper), specifically among Black adolescents. Using data from the 2012 National Survey on Drug Use and Health, this study was designed to examine the relationship between household characteristics (non-residential mother vs. residential mother and non-residential father vs. residential father) and blunt use among Black male and female adolescents. Findings revealed that Black males with non-residential fathers were more likely to have smoked blunts in their lifetime than Black males with residential fathers, illustrating the importance of fathers in the lives of Black males.

Rational use of medicine in some family health centers in Manisa

Objective: In our study, over 18 people in two different locations in Manisa is intended to rational use of medicine and the factors that influence drug use. Methods: 550 people, living in two family health center in Manisa participated to this descriptive study. Data were collected by using questionnaire. The questionnaire consisted of 56 questions about the demographic char¬acteristics and the attitudes of the applicants drug use. Descriptive statistics were used for summarizing the data and the chi-square test was used to compare the categor¬ical variables. Result: The mean age of the participants was 39.47±13.85. Of the total participants, 51.6% were ¬male, 28.4% were university graduated, 81.6% have Social Security Ýnsurance. Participants 76% stated that they use medicines without consulting medical doctors. In the elementary families, in still working people, in which more than expenses even, in his own and his wife secondar and higher education, in well general health status, in medicine with attention to using prescriptions in by storage conditions were found to be the use of more rational drug Totally, 85.5% of the participants had drugs at home without using. Analgesics were the most frequently drugs held at home. Conclusion: Most participants of this study had the be¬havior of irrational drug use. Key words: Rational use of medicine, physician, patient, prescription

Alcohol Use Disorders: Translational Utility of DSM-IV Liabilities to the DSM-5 System.

Young adults have some of the highest rates of problem drinking and alcohol use disorders (AUDs) relative to any other age. However, recent evidence suggests that the DSM-IV hierarchical classification system of AUDs does not validly represent symptoms in the population; instead, it evinces a unitary, dimensional classification scheme. The DSM-5 has been altered to fit this changing, evidence-based conceptualization. Nevertheless, little is understood about the degree to which known risk factors for DSM-IV AUD diagnoses will transfer to the new DSM-5 guidelines in this group of high-risk drinkers. The current study built a coherent model of liabilities for DSM-IV AUDs in young adults and tested for transferability to DSM-5. N = 496 college students (51.10% male) were assessed on a variety of factors related to AUD risk, including demographics, substance use (past 90-days), and drinking motives. Liability models were created using all variables in Structural Equation Modeling to test direct and indirect effects on DSM diagnostic status. The best model under the DSM-IV was chosen based on fit and parsimony. This model was then applied to the DSM-5 system to test for transferability. The best the fitting model for DSM-IV included direct influences of drug use, quantity-frequency of alcohol consumption, and social and coping drinking motives. Improved model fit was found when the DSM-5 system was the outcome. Knowledge of risk factors for AUDs appear to transfer well to the new diagnostic system.

Entangled in Big Events: Rise of Heroin Use Among Children of Ex-Gurkhas in Hong Kong

Big event models have been developed to demonstrate the relationships between wars and socioeconomic political transitions, and between rise of drug use and HIV epidemic outbreaks. This ethnographic interview-based study of a Nepali, Hong Kong community, carried out between 2009 and 2011, explored increased heroin use among the children of Hong Kong's Nepali ex-Gurkhas since its political transition in 1997. Data from its 59 informants were coded and analyzed using the grounded-theory approach. Three derived themes influencing drug use among ex-Gurkha children were identified: (1) reorganization of social networks, (2) redefinition of social norms, and (3) renegotiation of self-identity. Their associated processes crossed the boundaries of time and space. These findings document that big event modeling variables can and do overlap, are interconnected in many different ways, and their relationships are dialectical and are culturally shaped even as individuals may and do influence these processes and outcomes. Study's limitations are noted.

Patterns of Drug Use, Risky Behavior, and Health Status Among Persons Who Inject Drugs Living in San Diego, California: A Latent Class Analysis

Background: Among persons who inject drugs (PWID), polydrug use (the practice of mixing multiple drugs/alcohol sequentially or simultaneously) increases risk for HIV transmission and unintentional overdose deaths. Research has shown local drug markets influence drug use practices. However, little is known about the impact of drug mixing in markets dominated by black tar heroin and methamphetamine, such as the western United States. Methods: Data were collected through an ongoing longitudinal study examining drug use, risk behavior, and health status among PWID. Latent class analysis (LCA) was used to identify patterns of substance use (heroin, methamphetamine, prescription drugs, alcohol, and marijuana) via multiple administration routes (injecting, smoking, and swallowing). Logistic regression was used to identify behaviors and health indicators associated with drug use class. Results: The sample included 511 mostly white (51.5%) males (73.8%), with mean age of 43.5 years. Two distinct classes of drug users predominated: methamphetamine by multiple routes (51%) and heroin by injection (49%). In multivariable logistic regression, class membership was associated with age, race, and housing status. PWID who were HIV-seropositive and reported prior sexually transmitted infections had increased odds of belonging to the methamphetamine class. Those who were HCV positive and reported previous opioid overdose had an increased odds of being in the primarily heroin injection class (all P-values < .05). Conclusion: Risk behaviors and health outcomes differed between PWID who primarily inject heroin vs. those who use methamphetamine. The findings suggest that in a region where PWID mainly use black tar heroin or methamphetamine, interventions tailored to sub-populations of PWID could improve effectiveness.

Influence of noninjecting and injecting drug use on mortality, retention in the cohort, and antiretroviral therapy, in participants in the Swiss HIV Cohort Study.

We studied the influence of noninjecting and injecting drug use on mortality, dropout rate, and the course of antiretroviral therapy (ART), in the Swiss HIV Cohort Study (SHCS). Cohort participants, registered prior to April 2007 and with at least one drug use questionnaire completed until May 2013, were categorized according to their self-reported drug use behaviour. The probabilities of death and dropout were separately analysed using multivariable competing risks proportional hazards regression models with mutual correction for the other endpoint. Furthermore, we describe the influence of drug use on the course of ART. A total of 6529 participants (including 31% women) were followed during 31 215 person-years; 5.1% participants died; 10.5% were lost to follow-up. Among persons with homosexual or heterosexual HIV transmission, noninjecting drug use was associated with higher all-cause mortality [subhazard rate (SHR) 1.73; 95% confidence interval (CI) 1.07-2.83], compared with no drug use. Also, mortality was increased among former injecting drug users (IDUs) who reported noninjecting drug use (SHR 2.34; 95% CI 1.49-3.69). Noninjecting drug use was associated with higher dropout rates. The mean proportion of time with suppressed viral replication was 82.2% in all participants, irrespective of ART status, and 91.2% in those on ART. Drug use lowered adherence, and increased rates of ART change and ART interruptions. Virological failure on ART was more frequent in participants who reported concomitant drug injections while on opiate substitution, and in current IDUs, but not among noninjecting drug users. Noninjecting drug use and injecting drug use are modifiable risks for death, and they lower retention in a cohort and complicate ART.

The Social Contexts of Drug Offers and Their Relationship to Drug Use of Rural Hawaiian Youths

This article examines the differences in drug offers and recent drug use between Hawaiian and non-Hawaiian youths residing in rural communities, and the relationship between drug offers and drug use of Hawaiian youths in these communities. Two hundred forty-nine youths (194 Hawaiian youths) from 7 different middle or intermediate schools completed a survey focused on the social context of drug offers. Hawaiian youths in the study received significantly more offers from peers and family, and had significantly higher rates of recent alcohol and marijuana use, compared with non-Hawaiian youths. Logistic regression analysis indicated that the social context differentially influenced drug use of Hawaiian youths, with family drug offers and context influencing overall drug use and the use of the widest variety of substances. Implications for prevention practices are discussed.

From “Kickeando las malias” (Kicking the Withdrawals) to “Staying clean”: The Impact of Cultural Values on Cessation of Injection Drug Use in Aging Mexican-American Men

Drug use among older adults is a growing concern, particularly for the burgeoning Hispanic population. Older adults seeking drug treatment will double over the next decade to almost 6 million. Cultural factors influence drug use, and more specifically, Hispanic cultural values influence heroin use. This study explored Mexican-American injection drug users’ adherence to traditional Hispanic cultural values and their impact on cessation. Ethnographic interviews endorsed contextualized influences of values on heroin use. Cultural values functioned dichotomously, influencing both initiation and cessation. Understanding the impact of cultural values on substance abuse is critical given the changing demographics in American society.

The effects of social contact on drug use: Behavioral mechanisms controlling drug intake.

The social environment plays a critical role in determining the likelihood that an individual will use drugs or will develop a drug use disorder. Recent evidence obtained from preclinical studies reveals that proximal social factors (i.e., those factors that are immediately present at the time of drug exposure) exert a particularly strong influence on both drug-seeking and drug-taking behavior. These studies are advancing our understanding of the role of the social environment in drug use by showing that the rewarding and reinforcing effects of drugs depend on (a) whether other individuals are immediately present and (b) whether those individuals are also using drugs. Furthermore, the preclinical literature examining the role of social learning in behavior maintained by nondrug reinforcers reveals a number of behavioral mechanisms by which social contact may influence drug use, as well as potential ways the social environment may be modified to prevent or reduce drug use. Additional research is needed to determine potential age and sex differences in the effects of social contact on drug use, to determine the generality of the current findings across different pharmacological classes of drugs, and to determine the role of social contact on drug intake during different transitional stages of drug use disorders; however, enough evidence now exists to begin implementing social interventions in clinical and at-risk populations.

Explaining Homeless Youths’ Criminal Justice Interactions: Childhood Trauma or Surviving Life on the Streets?

Homeless youth are at increased risk for involvement in the criminal justice system. This study investigated childhood trauma as a risk factor for arrest or jail among a sample of youth seeking services at drop in, shelter, and transitional housing settings, while controlling for more established risk factors including: substance use, peer deviance, and engagement in survival behaviors. Standardized and researcher developed measures collected quantitative data through face-to-face interviews with youth (N = 202). Two sequential logic regression models identified significant predictors of arrest and jail, with a particular interest in the effects of childhood maltreatment. Youth with a history of physical abuse were nearly twice as likely to be arrested and to be jailed compared to non-abused youth, controlling for the significant influence of drug use and survival behaviors. These findings suggest the need for trauma screening and trauma-informed services for homeless youth at risk of illegal behavior.

Legal and illegal drug use among female sex workers in bar and club prostitution in Belgium: A quantitative and qualitative study

Aims: This study describes the amounts and effects of drug use in bar and club sex work, and the use of healthcare for the drug-related needs of sex workers (SW).Methods: A cross-sectional study was carried out in Belgium. In a quantitative component, 120 bar and club SW were interviewed face-to-face by means of a semi-structured questionnaire. In a qualitative component, 25 SW were interviewed face-to-face and 5 focus group discussions with key actors professionally involved with the study's subject were conducted.Findings: Many bar and club SW drink frequently alcohol and engage in heavy drinking. Illegal drugs such as cannabis, cocaine and benzodiazepines are also frequently used. The drug use often involves poly or combined drug use. More than one-third experienced a certain degree of dependence on a product and many experienced effects from drug use on their sex work. The study shows that SW have difficulties accessing drug-related healthcare.Conclusions: SW use often legal and illegal drugs. The prevalence and influence of drug use among bar and club SW illustrates the need for drug and sex work related healthcare. Distribution of more information about the risks of drug use, the possible negative effects, and the available drug-related healthcare is needed.

Drug trajectories among youth undergoing treatment: The influence of psychological problems and delinquency

Previous research has documented associations of addiction with delinquency and psychological problems. However, few studies have evaluated their influence on adolescent's drug use trajectories. The current study aims to examine the influence of these factors on the recovery trajectories of 199 youths aged 15.6 years on average admitted to inpatient and outpatient addiction treatment centers, followed up three and six months later. Results indicate that youth who show higher severity of drug abuse exhibit greater improvement than youth with a lower severity of drug abuse at the onset of treatment. Although psychological problems were associated with baseline drug use, they did not influence drug use trajectory over time. Only delinquency influenced the recovery trajectories of these youth. Results suggest that a high level of delinquency can have a significant effect on the drug recovery process of adolescents and that interventions should attempt to reduce both drug use and delinquency.

Media campaigns for the prevention of illicit drug use in young people

Substance-specific mass media campaigns which address young people are widely used to prevent illicit drug use. They aim to reduce use and raise awareness of the problem. To assess the effectiveness of mass media campaigns in preventing or reducing the use of or intention to use illicit drugs amongst young people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 1), including the Cochrane Drugs and Alcohol Group's Specialised Register; MEDLINE through PubMed (from 1966 to 29 January 2013); EMBASE (from 1974 to 30 January 2013) and ProQuest Dissertations & Theses A&I (from 1861 to 3 February 2013). Cluster-randomised controlled trials, prospective and retrospective cohort studies, interrupted time series and controlled before and after studies evaluating the effectiveness of mass media campaigns in influencing drug use, intention to use or the attitude of young people under the age of 26 towards illicit drugs. We used the standard methodological procedures of The Cochrane Collaboration. We included 23 studies involving 188,934 young people, conducted in the USA, Canada and Australia between 1991 and 2012. Twelve studies were randomised controlled trials (RCT), two were prospective cohort studies (PCS), one study was both a RCT and a PCS, six were interrupted time series and two were controlled before and after (CBA) studies. The RCTs had an overall low risk of bias, along with the ITS (apart from the dimension 'formal test of trend'), and the PCS had overall good quality, apart from the description of loss to follow-up by exposure.Self reported or biomarker-assessed illicit drug use was measured with an array of published and unpublished scales making comparisons difficult. Pooled results of five RCTs (N = 5470) show no effect of media campaign intervention (standardised mean difference (SMD) -0.02; 95% confidence interval (CI) -0.15 to 0.12).We also pooled five ITS studies (N = 26,405) focusing specifically on methamphetamine use. Out of four pooled estimates (two endpoints measured in two age groups), there was evidence of a reduction only in past-year prevalence of methamphetamine use among 12 to 17 years old.A further five studies (designs = one RCT with PCS, two PCS, two ITS, one CBA, N = 151,508), which could not be included in meta-analyses, reported a drug use outcome with varied results including a clear iatrogenic effect in one case and reduction of use in another. Overall the available evidence does not allow conclusions about the effect of media campaigns on illicit drug use among young people. We conclude that further studies are needed.

Screening for substance use disorders in first-episode psychosis: Implications for readmission

IntroductionScreening of substance use may prove useful to prevent readmission after the first episode of psychosis. The aim of the present study was to evaluate the influence of drug use on readmission risk in a first-episode psychosis sample, and to determine whether the cannabis/cocaine subscale of the Dartmouth Assessment of Lifestyle Inventory (DALI) is a better predictive instrument than urinary analysis. MethodsAfter admission, first-episode psychotic patients were interviewed for substance use and assessed with the DALI scale. They also underwent blood and urine sampling. Time to readmission was studied as a dependent outcome. The Kaplan–Meier estimator was applied to estimate the survival curves for bivariate analysis. The Cox proportional hazards model for multivariate analysis was assessed in order to control for potential confounders. ROC curve and validity parameters were used to assess validity to detect readmission. ResultsFifty-eight patients were included. The DALI cannabis/cocaine subscale and urinalysis were associated with increased readmission risk in survival curves, mainly the first five years of follow-up. After controlling for potential confounding variables for readmission, only the DALI cannabis/cocaine subscale remained as a significant risk factor. In terms of validity, the DALI cannabis/cocaine subscale was more sensitive than urinalysis. Alcohol assessments were not related to readmission. ConclusionsThe findings demonstrated that a quick screening self-report scale for cannabis/cocaine use disorders is superior to urinary analysis for predicting readmission. Future research should consider longitudinal assessments of brief validated screening tests in order to evaluate their benefits in preventing early readmission in first-episode psychosis.

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

To investigate the influence of hospital drug choices on pharmaceutical consumption for nine competitive classes in the surrounding community. Ecological study. Data from the national survey on drugs in hospitals were used to extract quantities purchased by 25 French university hospitals for three 'hospital classes' (EPOs, LMWHs and setrons) and six 'ambulatory classes' (PPIs, ACEIs and ARBs, statins, α-adrenoreceptor antagonists (AAAs) and selective serotonin re-uptake inhibitors SSRIs). Re-imbursed quantities for patients living in the hospital's catchment area were extracted from the national health insurance database. The relationship between the use of a brand in hospitals and their catchment areas was assessed using multivariate linear regressions with instrumental variables. An increase of 1 day of treatment with one brand in the hospital was associated with a significant increase of 2.8 days of treatment with the same brand in the catchment area. However, results strongly varied according to classes. An increase of 1 day of treatment in the hospital was significantly associated with an increase of 0.21 day for 'hospital classes' and 21.8 days for 'ambulatory classes' in the catchment area. Strong variations were seen across 'ambulatory classes'. The effect was maximal for cardiovascular classes and not significant for AAAs and SSRIs. The size of the effect also varied with hospital characteristics: small and proximity university hospitals exerted the greatest influence. Hospital consumption influences the use of drugs in the community. A significant effect was found, especially for competitive classes used on a long-term basis. The economic consequences of these findings need to be addressed.

National-level drug policy and young people's illicit drug use: A multilevel analysis of the European Union

IntroductionRecent research has called upon investigators to exploit cross-national differences to uncover the cultural and structural factors influencing drug use. While the individual-level correlates are well-established, little is known about the association between cross-national variation in drug policies and young people's substance use. This study examines, net of individual-level predictors, the association between national-level drug policy and use of an illicit drug other than cannabis. MethodsThe study uses Eurobarometer repeated cross-sectional surveys in 2002 and 2004 of adolescents aged 15–24 drawn in multistage, random probability samples proportional to population size and density within regions of their country (N=15,191). Participants completed self-reported measures of last month drug use, attitudes toward drugs, school and work participation, and demographics. Gathered from several international bodies, national-level policy measures include drug offense levels, possession decriminalization, and presence and usage of harm reduction strategies. ResultsHierarchical logistic regression models demonstrate that, while controlling for important individual-level predictors, in countries where there is no restriction on possession of drugs for personal use, the odds of drug use in the last month are 79% lower (p<0.05). On the other hand, higher usage of treatment and drug substitution are associated with higher levels of drug use. These results are robust to several alternate specifications. ConclusionsAmong the strongest and most consistent findings, eliminating punishments for possession for personal use is not associated with higher drug use. The results indicate that researchers should take national-level context into account in individual-level studies of drug use.

Risk Behaviors Among HIV-Positive Gay and Bisexual Men at Party-Oriented Vacations

This study examined substance use (intended and actual), unprotected sex, and HIV disclosure practices (disclosure and questioning) among HIV-positive men who have sex with men (MSM) at two party-oriented vacations, where substance use and sexual risk may be heightened. A random sample of 489 MSM attending one of two party-oriented vacations participated in PartyIntents, a short-term longitudinal survey. Nearly half (47%) completed a follow-up assessment at the event or online for up to 2 weeks after the event. We examined rates of baseline intentions to use substances, actual substance use, and unprotected intercourse among HIV-positive men in attendance.Rates among HIV-negative men were estimated for comparison. Multiple logistic regression was used to assess the impact of illegal drug use and HIV status on unprotected anal intercourse (UAI). HIV-positive attendees (17%) were significantly more likely than HIV-negative attendees to use nitrite inhalants (or "poppers") (24.3% vs. 10.7%). HIV-positive attendees were also significantly more likely to have insertive UAI (64.3% vs. 34.1%) and receptive UAI (68.8% vs. 22.2%). Multivariate models showed associations between HIV status and illegal drug use with UAI (for HIV status, odds ratio [OR] = 4.5, p = .001; for any illegal drug use, OR = 16.4, p < .001). There was no evidence that the influence of drug use moderated risk by HIV status. Rates of HIV disclosure and questioning did not differ by HIV status. HIV-positive men attending these events engaged in higher rates of illegal drug use and sexual risk than HIV-negative men. Prevention campaigns targeting MSM at high-risk events should include messages geared toward HIV-positive men.

Pre-encoding administration of amphetamine or THC preferentially modulates emotional memory in humans

Many addictive drugs are known to have effects on learning and memory, and these effects could motivate future drug use. Specifically, addictive drugs may affect memory of emotional events and experiences in ways that are attractive to some users. However, few studies have investigated the effects of addictive drugs on emotional memory in humans. This study examined the effects of the memory-enhancing drug dextroamphetamine (AMP) and the memory-impairing drug Δ(9)-tetrahydrocannabinol (THC) on emotional memory in healthy volunteers. Participants completed three experimental sessions across which they received capsules containing placebo and two doses of either AMP (10 and 20 mg; N = 25) or THC (7.5 and 15 mg; N = 25) before viewing pictures of positive (pleasant), neutral, and negative (unpleasant) scenes. Memory for the pictures was assessed 2 days later, under drug-free conditions. Relative to placebo, memory for emotional pictures was improved by AMP and impaired by THC, but neither drug significantly affected memory for unemotional pictures. Positive memory biases were not observed with either drug, and there was no indication that the drugs' memory effects were directly related to their subjective or physiological effects alone. This study provides the first clear evidence that stimulant drugs can preferentially strengthen, and cannabinoids can preferentially impair, memory for emotional events in humans. Although addictive drugs do not appear to positively bias memory, the possibility remains that these drugs' effects on emotional memory could influence drug use among certain individuals.

Timing of Stroke in Patients Undergoing Total Hip Replacement and Matched Controls

Stroke is a potentially fatal complication of total hip replacements (THR). However, timing of stroke in THR patients compared with matched controls and influence of drug use remain unknown. The objective of this study was to determine timing of stroke in patients with THR compared with matched control subjects. A nationwide cohort study was conducted within the Danish registers (1998-2007). Included patients were those with a primary THR in the study period (n=66,583) and were matched by age, sex, and region to three referent subjects without THR or total knee replacements. Time-dependent Cox models were used to derive hazard ratios and were adjusted for disease history and drug use. A 4.7-fold increased risk of ischemic stroke (adjusted hazard ratio, 4.69; 95% CI, 3.12-7.06), and a 4.4-fold increased risk of hemorrhagic stroke (adjusted hazard ratio, 4.40; 95% CI, 2.01-9.62) were found within 2 weeks following THR, compared with matched controls. The risk remained elevated during the first 6 postoperative weeks for ischemic stroke, and the first 12 weeks for hemorrhagic stroke. Outpatient antiplatelet drug use lowered the 6-week hazard ratios for ischemic stroke by 70%, although not affecting risk of hemorrhagic stroke. This study shows, that THR patients have a 4.7-fold increased risk of ischemic stroke, and a 4.4-fold increased risk of hemorrhagic stroke during the first 2 weeks postsurgery. Risk assessment of stroke in individual patients undergoing THR (ie, evaluate other risk factors for stroke) should be considered during the first 6 to 12 weeks.