Levels Of Drug Use Research Articles

A randomized trial of brief assessment interventions for young adults who use drugs in the club scene

BackgroundEfficacious interventions to reduce drug use and its consequences for club drug using populations are not apparent in the literature. We tested interviewer- (CAPI) and self-administered (ACASI) comprehensive health and social risk assessments as distinct interventions compared to waitlist control. Methods750 men and women ages 18–39 with multidrug use and heterosexual behavior were randomized in equal proportions to the three conditions. Instrumentation included well-tested measures of drug use, risky sex, mental distress and substance dependence. ResultsThe sample was 56% male; mean age=25. Reported risk behaviors and health consequences did not differ by assessment modality. Adjusted HLM analyses showed a significant main effect of assigned condition on all outcomes. CAPI participants had greater reductions in drug use, risky sex, mental distress and substance dependence symptoms, and greater increases in abstinence, compared to ACASI intervention or control participants at 12months, except that the CAPI and ACASI conditions had similar efficacy for reductions in drug use. Effect sizes for CAPI versus ACASI participants were d=0.2–0.3, and between CAPI and controls d=0.2–0.4. Effect sizes for improved outcomes between ACASI compared to controls were small to non-significant. ConclusionsThe study established the therapeutic benefit of interviewer interaction in reducing risky behavior among this young drug using population. The study demonstrated the efficacy and acceptability of a low threshold intervention in reducing drug use, sexual risk and related co-morbidities among a not-in-treatment young adult population that exhibits severe and complex levels of drug use, but that is also highly resistant to intervention.

Patterns of drug use and HIV infection among adults in a nationally representative sample

BackgroundLittle is known about drug use patterns among people living with HIV in comparison to an uninfected group in the general population. The aim of this study was to investigate the association between legal and illegal drug use and HIV infection in a nationally representative sample of adults in the United States. MethodsPublic use data files (2005–2014) from the National Survey on Drug Use and Health (NSDUH) were used. Respondents were asked whether a medical professional had ever told them that they had HIV/AIDS. Ever (lifetime), past-year, and past month use of cigarettes, alcohol, marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of psychotherapeutics was assessed. Logistic regression was used to estimate adjusted odds ratios (aOR) of the relationship between drug use and HIV infection, adjusting for demographics. ResultsOf 377,787 respondents age 18 and older, 548 (0.19%) were categorized as HIV-infected. Ever use of cigarettes, tobacco, marijuana, cocaine, heroin, hallucinogens, inhalants, and psychotherapeutics was higher in HIV-infected individuals compared to HIV-uninfected individuals after adjustment for sex, age, race/ethnicity, education, total family income, and marital status. Past year and past month use was also higher for HIV-infected individuals for all substances aside from alcohol. ConclusionsIn a nationally representative sample, there are higher levels of drug use and DSM-IV dependence among the HIV-infected population compared to the HIV-uninfected population. This is of concern because drug use and dependence can impede engagement in HIV care and adherence to antiretroviral therapy.

A Brief Assessment for HIV Risk: The TCU HVHP Form.

Targeted HIV screens may help identify some risk-related concerns of drug-using offenders. The present study describes the Texas Christian University HIV/Hepatitis Risk Assessment (TCU HVHP) form, a 19-item self-report instrument measuring HIV and hepatitis risks based on a sample (N = 1,056) of offenders in eight prisons. Principal components analysis indicated four scales (Injection Risk, Condom Attitudes, Sex Risk, and AIDS Concern) with reliable psychometric properties with coefficient α reliabilities ranging from .72 to .88. Concurrent validities indicated the four scales were related to motivation for treatment, level of drug use, psychosocial functioning, and criminal thinking, although the patterns varied by gender. The TCU HVHP Form should be attractive to programs needing a brief assessment measuring HIV risk behaviors, attitudes toward condom use, and concerns about acquiring and transmitting HIV.

The influence of psychopharmacological treatment in the long-term outcome in patients suffering ADH with comorbid drug use

ADH is one of mental disease with a higher prevalence of alcohol and drug abuse. ADH is a risk factor for drug use, and that's true in the reverse sense. The mutual influence in both disorders is clear and the presence of both disorders together could be a real challenge for a clincial professional.The main objective of the study is to evaluate the influence of the psychopharmacological treatment in the longterm outcome of this sample, using a measurement drug use, adherence to the treatment and impulsivity.We make a study that includes a group of patients with both disorders. We select a sample from the Centro de Día Zuría. The patients complete a battery of scales (SCL-90, BArratt, SF-36) before and after the beginning of psychopharmacological treatment.Our results shows a better prognosis in the patients with a good adherence to treatment, with a decrease in frequency and levels of drug use and a decrease in impulsivity, with a low level of behavioral disorders and violence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Do police arrestees substitute legal highs for other drugs?

BackgroundSome commentators have suggested legal highs (LH) might reduce existing illegal drug use and contribute to lower drug-related harm. However, no studies have specifically investigated substitution between LH and other drugs. AimsTo explore the extent to which police detainees substitute LH for illegal drugs. MethodA total of 848 detainees at four central police stations were interviewed about their drug and LH use. Detainees were asked what impact their LH use had on their other drug use (i.e., ‘no change’, ‘more’, ‘less’ or ‘stopped’). The detainees were placed into four groups: (i) no LH use; (ii) LH use and ‘no change’ in drug use; (iii) LH use and ‘more’ drug use; (iv) LH use and ‘less’ or ‘stopped’ drug use. Demographics and levels of drug use in the past month were compared between groups. ResultsNinety-six percent of the LH using detainees had used synthetic cannabinoids (SC), and, of those who reported substituting a drug, 94% had substituted (natural) cannabis. Overall, 54% of the detainee sample had not used SC, 34% had used SC but not changed their cannabis use, 9% had used SC and used ‘less’ or ‘stopped’ cannabis use, and 3% had used SC and used ‘more’ cannabis. The SC users were more likely to have recently been in drug treatment. All those who used SC had higher cannabis consumption regardless of substitution behaviour. The SC users who used ‘more’ cannabis also used more methamphetamine and ecstasy. ConclusionTwenty percent of those who used SC and cannabis reported reducing or stopping their cannabis use while 6% increased their cannabis use, suggesting a modest overall reduction in cannabis use. Further research is required to quantify the magnitude of substitution changes, the impact on drug-related harm, and extent to which substitution occurs for other LH and other populations.

Sexual Initiation and Complex Recent Polydrug Use Patterns Among Male Sex Workers in Vietnam: A Preliminary Epidemiological Trajectory.

Little is known about the age of onset of sexual and drug risk and their association with complex patterns of recent drug use among male sex workers (MSW) in a developing country, such as Vietnam. The aim of this study was to determine whether latent class analysis (LCA) would aid in the detection of current individual and polydrug use combinations to predict how different trajectories of sexual and drug initiation contribute to different patterns of current illicit drug use. Data were collected from a cross-sectional survey administered to young MSWs between 2010 and 2011 in Vietnam (N=710). LCA clustered participants into recent drug use groups, incorporating both the specific types and overall count of different drugs used. Men reported drug use within a 1 month period from an 11-item drug use list. LCA identified three distinct drug use classes: (1) alcohol use, (2) alcohol and tobacco use, and (3) high polydrug use. The current drug use classes are associated with sex worker status, housing stability, income level, educational attainment, marital status, sexual identity, and sexual preferences. High levels of drug use are strongly associated with being a recent sex worker, not having recent stable housing, higher than median income, more than a high school education, less likely to be currently in school and more likely to have non-homosexual preferences and heterosexual partners. An event history analysis approach (time-event displays) examined the timing of the age of onset of drug and sexual risks. Early ages of drug and sexual initiation are seen for all three classes. High current drug users show earlier onset of these risks, which are significantly delayed for moderate and low current drug users. LCA incorporating an overall count of different drugs detected three distinct current drug use classes. The data illustrates that the complexity of drug factors that must be accounted for, both in advancing our epidemiological understanding of the complexity of drug use and the use of drug and sexual risk initiation data to predict current drug use subtypes among high-risk populations.

Six-year follow-up study of combined type ADHD from childhood to young adulthood: Predictors of functional impairment and comorbid symptoms

BackgroundADHD in childhood is associated with development of negative psychosocial and behavioural outcomes in adults. Yet, relatively little is known about which childhood and adulthood factors are predictive of these outcomes and could be targets for effective interventions. To date follow-up studies have largely used clinical samples from the United States with children ascertained at baseline using broad criteria for ADHD including all clinical subtypes or the use of DSM III criteria. AimsTo identify child and adult predictors of comorbid and psychosocial comorbid outcomes in ADHD in a UK sample of children with DSM-IV combined type ADHD. MethodOne hundred and eighteen adolescents and young adults diagnosed with DSM-IV combined type ADHD in childhood were followed for an average of 6years. Comorbid mental health problems, drug and alcohol use and police contact were compared for those with persistent ADHD, sub-threshold ADHD and population norms taken from the Adult Psychiatric Morbidity Study 2007. Predictors included ADHD symptomology and gender. ResultsPersistent ADHD was associated with greater levels of anger, fatigue, sleep problems and anxiety compared to sub-threshold ADHD. Comorbid mental health problems were predicted by current symptoms of hyperactivity-impulsivity, but not by childhood ADHD severity. Both persistent and sub-threshold ADHD was associated with higher levels of drug use and police contact compared to population norms. ConclusionsYoung adults with a childhood diagnosis of ADHD showed increased rates of comorbid mental health problems, which were predicted by current levels of ADHD symptoms. This suggests the importance of the continuing treatment of ADHD throughout the transitional years and into adulthood. Drug use and police contact were more common in ADHD but were not predicted by ADHD severity in this sample.

Can persons with a history of multiple addiction treatment episodes and chronic relapse benefit from technology-delivered behavior therapy?

Drug misuse has been identified as a significant problem in homeless populations. This study examines aspects of physical and mental health, perceived quality of life and health service use among homeless illicit drug users and compares these to non-drug users.Participants were recruited through health clinics across Dublin. A questionnaire assessed participants’ drug use, health and well-being, health behaviours and use of health services. Descriptive statistics are presented for the entire cohort and drug users separately. Logistic regression analysis was used to examine the relationship between drug use and (i) multimorbidity, (ii) anxiety and/or depression, (iii) perceived quality of life and (iv) use of health services.Of 105 participants recruited, 35 (33%) were current drug users. Current and previous drug users were significantly more likely to have multimorbidity than those who had never taken drugs (OR 4.86, 95% CI 1.00–23.66). There was no significant difference between drug users and non-drug users in the prevalence of anxiety and/or depression. Drug users were five times more likely than non-drug users to have a low perceived quality of life (OR 5.2, 95% CI 1.7–16.0). Health service utilization was high, although some services were used less by drug users (e.g., dentist and psychiatric outpatient services) while others were used more often (e.g., phoneline services and day care centres).This study highlights the high levels of drug use in this population and the negative impact of drug use on health and perceived quality of life of a homeless population in Dublin.

Measuring windows of selection for anti-malarial drug treatments.

BackgroundThe long half-lives of malaria ‘partner’ drugs are a potent force selecting for drug resistance. Clinical trials can quantify this effect by estimating a window of selection (WoS), defined as the amount of time post-treatment when drug levels are sufficiently high that resistant parasites can re-establish an infection while preventing drug-sensitive parasites from establishing viable infections.MethodsThe ability of clinical data to accurately estimate the true WoS was investigated using standard pharmacokinetic–pharmacodynamic models for three widely used malaria drugs: artemether–lumefantrine (AR-LF), artesunate–mefloquine (AS-MQ) and dihydroartemisinin–piperaquine (DHA-PPQ). Estimates of the clinical WoS either (1) ignored all new infections occurring after the 63-day follow-up period, as is currently done in clinical trials, or, (2) recognized that all individuals would eventually be re-infected and arbitrarily assigned them a new infection day.ResultsThe results suggest current methods of estimating the clinical WoS underestimate the true WoS by as much as 9 days for AR-LF, 33 days for AS-MQ and 7 days for DHA-PPQ. The new method of estimating clinical WoS (i.e., retaining all individuals in the analysis) was significantly better at estimating the true WoS for AR-LF and AS-MQ.ConclusionsPrevious studies, based on clinically observed WoS, have probably underestimated the ‘true’ WoS and hence the role of drugs with long half-lives in driving resistance. This has important policy implications: high levels of drug use are inevitable in mass drug administration programmes and intermittent preventative treatment programmes and the analysis herein suggests these policies will be far more potent drivers of resistance than previously thought.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0810-4) contains supplementary material, which is available to authorized users.

Foster youth and drug use: Exploring risk and protective factors

Substance use and misuse experiences of foster youth remain an under-researched area. Given that early use of drugs is said to be a common factor among 90% of those who develop substance misuse problems in their lifetime, this is an important area of academic study (Dennis, White, & Ives, 2009). By drawing upon primary empirical data from a mixed-methods study, this paper addresses an important gap in the literature and seeks to provide an improved understanding of foster youth, drug use and vulnerability. A total of 261 foster youth, who had exited care, contributed to a quantitative survey, and a further 35 provided qualitative narratives of their lived experience. Key risk factors including experience of homelessness, school exclusion and living setting are identified as strong influences that predict high levels of drug use among foster youth. Targeted social support and interventions in the form of pre-leaving care in the context of a strong practitioner/youth relationship are suggested to help ameliorate poor outcomes to obviate the problem of substance misuse among foster youth.

Health, perceived quality of life and health services use among homeless illicit drug users

IntroductionDrug misuse has been identified as a significant problem in homeless populations. This study examines aspects of physical and mental health, perceived quality of life and health service use among homeless illicit drug users and compares these to non-drug users. MethodsParticipants were recruited through health clinics across Dublin. A questionnaire assessed participants’ drug use, health and well-being, health behaviours and use of health services. Descriptive statistics are presented for the entire cohort and drug users separately. Logistic regression analysis was used to examine the relationship between drug use and (i) multimorbidity, (ii) anxiety and/or depression, (iii) perceived quality of life and (iv) use of health services. ResultsOf 105 participants recruited, 35 (33%) were current drug users. Current and previous drug users were significantly more likely to have multimorbidity than those who had never taken drugs (OR 4.86, 95% CI 1.00–23.66). There was no significant difference between drug users and non-drug users in the prevalence of anxiety and/or depression. Drug users were five times more likely than non-drug users to have a low perceived quality of life (OR 5.2, 95% CI 1.7–16.0). Health service utilization was high, although some services were used less by drug users (e.g., dentist and psychiatric outpatient services) while others were used more often (e.g., phoneline services and day care centres). ConclusionThis study highlights the high levels of drug use in this population and the negative impact of drug use on health and perceived quality of life of a homeless population in Dublin.

The effect of paracetamol on the level of drug use during and after orthopedic surgery of the upper limb

The effect of paracetamol on the level of drug use during and after orthopedic surgery of the upper limb

Personality psychopathology, drug use and psychological symptoms in adolescents with substance use disorders and community controls.

Substance use is a risk behavior that tends to increase during adolescence, a time when part of the personality is still in development. Traditionally, personality psychopathology has been measured in terms of categories, although dimensional models have demonstrated better consistency. This study aimed to analyze differences in personality profiles between adolescents with substance use disorders (SUD n = 74) and matched community controls (MCC n = 74) using the Personality Psychopathology Five (PSY-5) dimensional model. Additionally, we compared age at first drug use, level of drug use and internalizing and externalizing symptoms between the groups. In this study, the PSY-5 model has proved to be useful for differentiating specific personality disturbances in adolescents with SUD and community adolescents. The Disconstraint scale was particularly useful for discriminating adolescents with substance use problems and the Delinquent Attitudes facet offered the best differentiation.

Examining Problematic Gambling and Mental Health in a LGBTI community: A preliminary study

This preliminary study explored gambling in the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community, recognising this as an under researched area. Several factors were considered alongside gambling, namely mental health, substance use, alcohol use and self-control. Participants were recruited to take part in an online survey, with a final sample of 69 obtained. Findings revealed that gambling activities such as pub slot machines/games (58%) were the most common form of gambling, followed by scratch cards (43.5%). The most common motive for engaging in gambling was for ‘fun’, followed by ‘because you like the feeling’. Twenty percent of participants appeared to meet the criteria for gambling disorder, as defined by the DSM–V. Mental health variables, namely depression and anxiety, did not distinguish between problematic and non-problematic gambling whereas alcohol, drug use and self-control did; higher levels of alcohol and higher levels of drug use were present in the problematic gambling group which appeared to confirm gambling as a difficulty best placed within the addiction spectrum. Self-control was also lower in the problematic gambling group and represented a significant predictor of problematic gambling.

Community attitudes towards harm reduction services and a newly established needle and syringe automatic dispensing machine in an inner-city area of Sydney, Australia

BackgroundAutomatic dispensing machines (ADMs) are an inexpensive method of increasing needle and syringe distribution to people who inject drugs but widespread implementation has been limited. The operation of ADMs in Australia has been met with apparent community opposition despite national data indicating support for harm reduction. Key community concerns include perceived increases in crime and drug use. This study aimed to examine community-level support for a newly implemented ADM in an inner-city Sydney area known for high levels of drug use. MethodsAttitudes to harm reduction and ADMs were assessed via a brief face-to-face survey of local residents (n=118) and businesses (n=35) located within the vicinity of needle and syringe program (NSP) services including the ADM. Participation was voluntary and no reimbursement was provided. Univariate analysis assessed statistically significant differences between residents’ and businesses’ knowledge of, and support for, a range of harm reduction initiatives, both generally and in the local area. Univariate logistic regression models were used to determine factors associated with indicating support for an ADM locally. ResultsThe response rate was higher among businesses (60%) compared to residents living in street-accessible dwellings (42%). Participants indicated support for fixed-site NSPs in general (83%) and locally (77%). Support for ADMs was slightly lower – 67% indicated support for ADMs generally and 60% locally. Negative opinions regarding ADMs (believing that they encourage drug use, attract drug users to the area and increase drug-related crime) were found to be significantly associated with a lower likelihood of indicating support for ADMs locally. ConclusionDespite media reports suggesting widespread community concern, there was general community support for harm reduction, including ADMs. While it is important that harm reduction services are aware of community concerns and respond appropriately, such responses should be considered and interpreted against a broader backdrop of support.

P145 Introduction and trial of a “chemsex” support service in a south west london gu clinic

Background/introduction Since 2013 our centre has recognised a problem of recreational use drug associated with sex amongst MSM. Aim(s)/objectives A joint survey with the local commissioners was set up to establish the extent of the problem in the borough and to identify a need for further services. Methods 100 HIV negative MSM and 50 HIV positive MSM completed a patient survey with questions regarding recreational drug use related to “chemsex”. Results Results indicated a high level of drug use with 60% (90/150) reporting any drug use and 21% (32/150) specifically using party drugs in the last 6 months. Clients were asked where they would like to have a specialist drug service and the majority preferred the sexual health clinic as an acceptable venue 37% (56/150). A weekly “in-reach” service was set up with the local Drug Service to run alongside the MSM evening clinic. From August to December 2014, there were 15 clinics in total with 21 visits (max capacity 30 visits). 25% of those seen were from the local borough; the rest of the clients were from neighbouring boroughs. Discussion/conclusion The service to date has been a clinical and operational success. A patient satisfaction questionnaire completed by 13 clients noted 92% were happy to be seen at this venue, 85% felt the provision of this service was worthwhile and 85% would recommend this service to others. Further work in this area with a targeted MSM history proforma, chemsex leaflet and needle exchange schemes are also being developed.

Co-occurrence between mental distress and poly-drug use: A ten year prospective study of patients from substance abuse treatment

IntroductionLongitudinal research investigating psychiatric trajectories among patients with poly-drug use patterns remains relatively scant, even though this specific population is at elevated risk for multiple negative outcomes. The present study examined temporal associations between poly-drug use (i.e. heroin, cannabis, tranquilizers, and amphetamines) and mental distress over a 10-year period. MethodsA clinical cohort of 481 patients was recruited from substance use treatment facilities in Norway, and prospectively interviewed 1, 2, 7 and 10years after the initial data collection at treatment admission. At each assessment participants completed a questionnaire addressing their substance use and mental distress. Longitudinal growth models were used to examine whether, and if so, how, levels of drug use were associated with the level and rate of change in mental distress over time. ResultsResults from the longitudinal growth models showed a co-occurrence between active poly-drug use and mental distress, such that there was a dose–response effect where mental distress increased both in magnitude and over time with the number of drugs used. Reduction in mental distress during the 10-year study period was evident only in the no-drug use condition. Use of multiple drugs and mental distress appear strongly co-related over time. ConclusionsPre-treatment assessment should carefully identify individuals manifesting poly-drug use and mental disorders. Treatment and follow-up services should be tailored to their specific needs.

Drug Use Among Immigrant and Non‐immigrant Adolescents: Immigrant Paradox, Family and Peer Influences

AbstractThe present study compared immigrant and Italian native adolescents with regard to drug use. Additionally, we analysed the role of family and peer risk and protective factors for drug use. Participants included 2533 Italian native and immigrant adolescents (mean age = 17.19, SD = 1.6; 66.7% male). Results showed that immigrant adolescents reported lower levels of marijuana and pharmaceutical drug abuse than non‐immigrant adolescents. These results confirm the so‐called immigrant paradox phenomenon: the counterintuitive finding that although immigrants often live under challenging conditions and reported lower economic affluence compared with nationals, some health outcomes have not always corresponded to their relative disadvantage. Immigrant adolescents also reported higher level of parental control and lower levels of affiliation with deviant peers, but lower levels of child disclosure, parental solicitation and parental knowledge. Socio‐economic status and parental monitoring showed equivalent effects on drug use for immigrant and non‐immigrant adolescents. Results have implications for preventive interventions for immigrant adolescents and families, including the need to develop programmes that leverage the benefits of the immigrant paradox for immigrant communities. Future research should analyse the processes that lead to lower levels of drug use in immigrant adolescents and investigate the influence of friendship networks on immigrant adolescent drug use behaviour. Copyright © 2015 John Wiley & Sons, Ltd.

Depression and Substance Use: A Temporal-Ordered Model

Background and Objectives: This study sought empirical evidence for the self-medication hypothesis. It asked whether diagnosis of depression, together with the use of mental-health care, leads to substance use. Methods: Data came from the 5-wave, longitudinal Fragile Families and Child Wellbeing (FFCW) Study, an investigation of a cohort of nearly 5,000 births, which oversampled non-marital births. FFCW examined newborns’ biological mothers and fathers, all of whom lived in the United States. The adults were initially interviewed between 1998 and 2000 (the period of the cohort's births); they were then re-interviewed for four times over 10 years. FFCW measured mental health-related variables, level of drug use, and social structural and demographic factors, all of which are also measured by the present study. Respondents in our study's two final subsamples had responded to every FFCW interview item we would use in constructing our final model's variables. Our subsample of mothers totaled 3,477 women, from whom 5,987 person-waves were derived. Our subsample of fathers totaled 2,096 men, yielding 3,543 person-waves. Results: We used STATA generalized estimating equations for panel data, and found some evidence to support the self-medication hypothesis. In addition, our results indicated that the relationship of substance use to the use of mental-health care was gender-specific. Conclusions/Importance: Empirical evidence from this study only partially supported the self-medication hypothesis; the co-occurrence of depression and substance abuse in our sample was also reflective of social structural and demographic variables and of prior substance use variables.

Trajetória de Adolescentes em Conflito com a Lei Após Cumprimento de Medida Socioeducativa em Meio Fechado

This research investigated trajectories of adolescents after a socio-educational measure through a quantitative and longitudinal study. Participants were 143 young offenders aged between 14 and 20 years old. The instruments used were a data socio-demographic and a risk and protective factors questionnaire, besides conducting telephone contacts for a period of two and half years. Participants were divided into four groups: G1: recidivists (n=22), G2: socially reintegrated (n=24), G3: maintaining the status (n=38) and G4: other situations (n=59). The results indicated that the contextual variables were not associated with the type of trajectory. As to personal variables, we found significant differences, G2 presented higher levels in relation to self-esteem while G1 had higher levels of drug use. Therefore, proposals for intervention with this population should consider both contextual and personal variables.