Non-prescribed Drugs Research Articles

Acceptability and further potential of an app for maternal notes, the eMutterPass: A patient-centered online survey at the University Hospital Zurich

ObjectivesWe wanted to characterize the acceptability of and women’s satisfaction with the eMutterPass application. Particular attention was placed on concerns about data confidentiality and on willingness to use the app in an interactive way to share information about medication consumption. Study designThe present analysis is based on self-reported data from obstetric patients participating in an anonymous online survey between April 6th 2021 and April 20th 2021. ResultsDuring the 2-week timeframe, 1123 questionnaires were completed. The eMutterPass application was widely appreciated by our survey population and almost all participants would recommend the application to other pregnant women. A subpopulation analysis indicates that concerns about data confidentiality were higher among younger, multigravid and non-German-speaking pregnant women. The majority of women would be willing to report their medication use by taking pictures, filling in medication dosages or submitting assessments of perceived drug effectiveness. ConclusionThe development of our eMutterPass application meets the spirit of the times and gives pregnant women uncomplicated access to their own data. Concerns about data confidentiality can be adequately countered with additional information about the system structure. The largely positive adherence to the idea of reporting medication use on the app lays the groundwork for potential use of the eMutterPass for documentation of non-prescribed drugs.

Psychological, Physical and Behavioral Health of Adults, 3 Years After Exposure to a Train Derailment.

In July 2013, a train derailment profoundly disrupted the tranquility of the population of Lac-Mégantic for months and even years. In 2016, we conducted a representative population-based survey among 387 people from Lac-Mégantic and 413 from other municipalities with the aim to document psychological and physical health of adults exposed to the disaster. This article examines differences between 3 groups of respondents: those who were highly, moderately or not exposed to the train accident. Khi Square analyses, odds ratios and logistic regressions were used to examine differences between the 3 groups of respondents (high, moderate and no exposure). Results show that the level of exposure to this technological disaster is strongly associated with psychological suffering, post-traumatic growth, physical heath, drinking patterns, and use of prescribed and non-prescribed drugs. We can explain these results by the nature and cause of the event as well as its consequences.

Management of Psychiatric Disorders in Patients with Respiratory Diseases.

Management of Psychiatric Disorders in Patients with Respiratory Diseases.

Analisis Mutu Pengelolaan Obat di Puskesmas Kota Tegal

Primary health centers is a facility that organizes health efforts at the first level to achieve health degrees, but in its implementation is still constrained in realizing standard pharmaceutical services. The purpose of the research is to find out the quality of drug management in Tegal City primary Health Center. This study is a non-experimental descriptive study. The study was conducted throughout the primary health center in Tegal City. Data collection is prospective and retrospective by tracing documents to obtain secondary data and direct observations, interviews of pharmaceutical personnel, heads of primary health centers, and heads of the pharmaceutical section to obtain primary data. The next drug management indicator is done descriptive data analysis by calculating the value of the indicator with the formula then compared to the standard and inter primary health care. Indicators of drug management used 28 and those that meet standard 10. Indicator results include conformity of items with disease patterns 76.39%, planning accuracy 321.10%, the accuracy of the number of requests 169.84%, the storage of narcotics 72.92%, the storage of drugs without contamination 98.97%, the storage of high alert drugs 68.15%, the storage of LASA drugs 87.5%, ITOR 1.87 times /year, the availability of drugs 36.08 months, drug items less than 14.01%, safe drug items 37.94%, excess stock items 41.76%, non-prescribed drugs 4.59% and drug value ED 3.85%. These results show that drug management indicators in Tegal City primary health centers have not been efficient and need improvements ranging from the planning stage to control. Indicators that still need improvement include ITOR and all indicators of drug availability. Things that need to be done to improve indicators that have not been efficient include increasing the number and quality of pharmaceutical human resources in primary health centers, increasing supervision of drug use and control, building communication, and a good organizing culture in primary health centers.

Comparison of non -Prescribed use of Tranquilizer with Stimulants Drugs among Medical Students

Objective: The goal of this study to look at the patterns of drug use among medical students. Methodology: All medical students enrolled in the Bakhtawer Amin Medical & Dental College Multan, from first to fifth year were included in this study. The sample size was calculated using a single population proportion formula. The sample consisted of 200 students drawn from various batches and chosen using a stratified random selection procedure Results: The total study participants were 200 medical students of different years in which 139(70%) were males and 61(30%) were females. The participants having age range 18-25 years and maximum number of students were fall in age group 21-25 [117(58.5%)]. The results of the study showed that 76% used tranquilizer and 68% of the students used Stimulants without prescription as p-value 0.004 showing statistical significant difference in the use of both types of drugs. Student used tranquilizer and stimulants once a month as 32% vs 37% with significant p-value 0.034. Conclusion: The fourth-year students had the highest rate of drug usage. During the evaluation, the majority of students were drug users; there was no sign of physical dependency. The topic of non-prescribed drug usage among medical students is examined in this study. More research is needed to investigate national trends of drug addiction among medical students, as well as to find and reinforce protective variables. Supporting children with a non-prescription usage necessitates the development of strategies. Keywords:Nonmedical prescription drug use; Nonmedical prescription stimulant use; Nonmedical prescription tranquilizer use; Trends.

Health-Related Quality of Life and Undergraduate Nursing Students: A Narrative Review

Background: Undergraduate nursing students are vulnerable to stressful university learning environments and poor working conditions in clinical rotations. This can result in students leaving nursing programs or abandoning the profession following graduation. As a result, the health-related quality of life of nursing students is an important indicator to monitor student quality of life adequacy. Preventing premature student nurses' departure from the profession is necessary to reduce the nursing shortage. Objective: To describe the body of knowledge about the health-related quality of life for undergraduate nursing students during their qualification process. Methods: This was a narrative review through a six-database search, including Cochrane, CINAHL, Pubmed, Medline, PsycINFO and Livivio, from between January 1990 and June 2018, with updates in the search followed until November 2019. To assess study quality, the STROBE checklist was used. Results: Eight studies were included in a narrative synthesis. All studies were of cross-sectional design, and none included follow-up procedures. Most of the studies recruited participants from nursing courses and only one study recruited students from a national register. Sample sizes ranged from 110 individuals to 4,033 participants in the register-based study. Common health-related dimensions evaluated included stress, social support, mental health, fatigue, quality of life, and drug abuse. Stress, the most commonly studied dimension, was associated with clinical placements, final exams, and non-prescribed drugs. Social support networks were positively associated with coping abilities and self-esteem. Conclusion: There is low-quality evidence of the impact of nursing courses upon student health-related dimensions (stress, self-esteem, health-related behaviors). Nurse educators should be aware of these associations and support routine screening of students and their health-related dimensions. Interventions, such as consultation and study redesign, might increase the level of health-related dimensions. Nursing schools should further collaborate to investigate these associations and tailored interventions to positively affect health-related dimensions in nursing students.

Fabrication of paper-based analytical devices using a PLA 3D-printed stencil for electrochemical determination of chloroquine and escitalopram.

In recent years, the use of prescribed and non-prescribed drugs has increased. Therefore, advances in new technologies and sensors for detecting molecules in natural environments are required. In this work, a 3D-printed polylactic acid stencil is used to fabricate paper-based analytical devices (ePADs). Herein, we report the use of carbon-based lab-manufactured conductive ink for the fabrication of sensors towards the detection of chloroquine and escitalopram. For each batch, eight ePADs were successfully fabricated. Firstly, the fabricated sensors were evaluated morphologically by scanning electron microscopy and electrochemically by cyclic voltammetry and electrochemical impedance spectroscopy experiments. The sensors displayed a well-defined voltammetric profile in the presence of the redox couple, when compared to a commercial carbon screen-printed electrode. Differential pulse voltammetry conducted the detection of chloroquine and escitalopram with detection limits of 4.0 and 0.5 µmol L−1, respectively. The ePADs fabricated using the 3D stencil are here presented as alternatives for the fabrication of electrochemical analytical devices.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10008-021-05075-w.

Characterization of Bodily Pain and Use of Both Prescription and Non-Prescription Opioids in Tenants of Precarious Housing

Background opioid use, which includes both prescribed and non-prescribed drugs, is relatively common amongst marginalized populations. Past research has shown that among those who use non-prescribed or diverted opioids recreationally, many were first exposed to the drug as prescribed pain medication. Objective: to better understand the relationship between pain and opioid use in tenants of precarious housing. Methods: in the present study, 440 individuals from a cohort living in homeless or precariously housed conditions in a neighborhood with high rates of poverty and drug use were interviewed for their bodily pain and opioid use. We examined the relationship between bodily pain levels, assessed using the Maudsley Addiction Profile questionnaire, and prescribed, non-prescribed and combined self-reported opioid use in the prior 28 days assessed using the Timeline Followback and Doctor-Prescribed Medication Timeline Followback questionnaires. Results: Analysis of the results indicated that sex (female), age (younger) and early exposure to opioids (≤ age 18) predicted current opioid use, but there was no association between current bodily pain levels and opioid use. Conclusions: these unexpected findings indicate the complex nature of the relationship between pain and opioid use in this population.

Patterns of self-medication in Qassim Province, Saudi Arabia: A cross-sectional study

BackgroundSelling medicines in pharmacies without a prescription is a common practice in the Kingdom of Saudi Arabia. The aim of this study was to determine the attitudes about and prevalence of non-prescribed medication for those attending community pharmacies in Qassim Province, Saudi Arabia. MethodsThis is a cross-sectional survey based study that was designed and administered to individuals attending four community pharmacies in the main cites of Qassim Province, Saudi Arabia to obtain Over The Counter (OTC) drug use, exposure to health education, awareness of risks, important causes, and side-effects. ResultsApproximately 75% of 109 individuals attending the studied pharmacies purchased non-prescribed medicines. Most participants (80%) had read the drug pamphlets and followed the instructions for use. The most common reasons for buying non-prescribed medicines were repetition of a previous prescription by a healthcare provider (30.3%), belief that the disease was minor (26.6%), convenience of pharmacist prescription (19.3%), and the low cost and shortness of time to attend health services. The most commonly used drugs were analgesics (18.3%) followed by anti-allergic medications and antibiotics, and the least commonly used drugs were laxatives and anti-diarrheal medications. There were no significant differences in the purchase of non-prescribed drugs with respect to age, gender, and educational level. Only 9% of respondents were opposed to buying non-prescribed drugs and 34% were willing to use them only when necessary. ConclusionsThere was a high prevalence of non-prescribed medicine purchase from community pharmacies in the study area. Education efforts are needed to change this behavior.

The Opioid Epidemic Within the COVID-19 Pandemic: Drug Testing in 2020.

The convergence of the opioid epidemic and the coronavirus disease 2019 (COVID-19) pandemic has created new health care challenges. The authors analyzed changes in clinical drug testing patterns and results at a national clinical laboratory, comparing data obtained before and during the pandemic. Testing for prescription and illicit drugs declined rapidly during the pandemic, with weekly test volumes falling by approximately 70% from the baseline period to the trough (the week beginning March 29) before rising in subsequent weeks. Among individuals tested, positivity increased by 35% for non-prescribed fentanyl and 44% for heroin during the pandemic. Positivity for non-prescribed fentanyl increased significantly among patients positive for other drugs: by 89% for specimens positive for amphetamines; 48% for benzodiazepines; 34% for cocaine; and 39% for opiates (P < 0.01 for all comparisons). These findings suggest significant increases in dangerous drug combinations. Positivity for non-prescribed use of many other drugs remained consistent or declined for some drugs, relative to pre-pandemic patterns. Models adjusting for potential confounding variables, including medication-assisted treatment and treatment at a substance use disorder facility indicated that the risk for non-prescribed fentanyl positivity rose by more than 50% during the pandemic. In summary, these findings demonstrate decreased drug testing overall, with increased positivity for high-risk drugs and dangerous drug combinations. The convergence of the drug abuse epidemic and COVID-19 pandemic has led to an increased need for health care and public health resources dedicated to supporting vulnerable patients and addressing the underlying causes of these disturbing trends.

Taking drugs for exams: an investigation with social work students

ABSTRACT The present study carried out in Germany is concerned with social work students’ consumption of either non-prescribed medicine (e.g. amphetamine) or illegal drugs (such as cocaine) to improve their cognitive performance (neuroenhancement) during examinations. In the main study (n = 257), 16% reported to have consumed such substances, including more men than women and more older than younger students. The use of drugs was neither influenced by study-related variables (e.g. performance pressure) nor parent-related factors (e.g. high-performance expectations). However, as expected by the Theory of Planned Behavior, there were impacts of (1) students’ belief in the supposed effectiveness of neuroenhancers, (2) their affiliation to a ‘doping’ student minority group, and (3) the possibility and situational ease of procurement of such substances. The conclusions were supported by a replication study (n = 444). Finally, implications of these results for social work education are discussed.

E-cigarette Use and Risk Behaviors among Lesbian, Gay, Bisexual, and Transgender Adults: The Behavioral Risk Factor Surveillance System (BRFSS) Survey

IntroductionThe prevalence of e-cigarette use among lesbian, gay, bisexual, and transgender (LGBT) individuals and its association with risk behaviors was studied.MethodsUsing data from the Behavioral Risk Factor Surveillance System (BRFSS) survey, self-reported sexual orientation, e-cigarette use, cigarettes, marijuana, smokeless tobacco, and high-risk behavior (using non-prescribed drugs, treatment for sexually transmitted disease, or receiving monetary or drug compensation in exchange for sex in the previous year) were assessed. Multivariable-adjusted logistic regression models were used to study the association between LGBT and risk behaviors.ResultsThe prevalence of e-cigarette use among LGBT adults was 13%, nearly twice that of heterosexual adults. LGBT adults were more likely [Odds Ratio (95% Confidence Interval)] to report current use of e-cigarettes 1.84 (1.64, 2.06), cigarettes 1.61 (1.49, 1.73), marijuana 2.37 (1.99, 2.82), and high-risk behavior 3.69 (3.40, 4.01) compared to heterosexual adults. Results for smokeless tobacco were not significant.ConclusionThere are disparities in e-cigarette and other risk behaviors among LGBT adults, which may increase risk of adverse health effects in this vulnerable population.

Non-prescribed drug use and predictors among pregnant women in Ethiopia: systematic review and meta-analysis

Background The use of non-prescribed drugs are common to pregnant women. It may lead to undesirable effects, such as birth defects. Study results on the occurrence and predictor of non-prescribed drug use among pregnant women throughout Ethiopia are highly variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled prevalence of non-prescribed drug use and predictors among pregnant women in Ethiopia. Methods We systematically searched studies from the international databases, including PubMed, EMBASE, Web of Science, Science Direct, Google Scholar, the Cochrane Library and others. The meta-analysis was conducted using Stata15. I2 test and Egger’s test were used to assess the heterogeneity and publication bias respectively. The random-effect model was used to estimate the pooled prevalence of non-prescribed drug use at a 95% CI. Results Eleven studies with a total of 4492 pregnant women fulfilled the inclusion criteria and were included. The pooled national level non-prescribed drug use among pregnant women was 30.38% (95% CI: 20.28, 40.48). The highest use of non-prescribed drug among pregnant women was observed in Amhara region 36.71%, while the lowest was in Tigray region 9.67%, respectively. The most frequently consumed non prescribed drugs by pregnant mothers were paracetamol 34.38%, amoxicillin 14.73%, aspirin 4.25%, metronidazole 2.81% and ciprofloxacin 2.80%. Maternal previous history of self-medication, maternal illness during pregnancy and maternal marital status were significantly associated with women non-prescribed drug use during pregnancy. Conclusions The overall prevalence of non- prescribed drug use among pregnant women in Ethiopia is relatively high, and varies across different regions. The most frequently consumed non- prescribed drug by pregnant mothers was paracetamol. Maternal; previous history of self-medication, illness during pregnancy and marital status were significantly associated with pregnant women non-prescribed drug use. Awareness of the possible side effects of taking non-prescribed drugs for all pregnant women is very relevant in the media and in the maternity ward. In particular, it is important to make clear to mothers who have a history of self-medication, to those who have a history of illness during pregnancy and to those who are pregnant, unmarried or divorced.

Assessment of Knowledge, Attitudes and Practices Relating to Parasitic Diseases and Anthelmintic Resistance Among Livestock Farmers in Hamedan, Iran.

Iranian studies have shown a high prevalence of broad spectrum anthelmintic resistance (AR) in gastrointestinal helminths of ruminants. However, there is a lack of information about levels of knowledge, attitudes and practices among livestock farmers in Iran regarding the concept of parasite control and AR. This study aimed to evaluate the knowledge, attitudes and practices of livestock farmers of Hamedan, Iran, regarding parasitic diseases and AR by interviewing 150 farmers using a structured questionnaire. Most of farmers had some knowledge of the clinical signs associated with helminth parasitism, but more than half were unaware of the existence of zoonotic parasites. More than half of the participants had never heard about AR, but were interested to learn about it through their veterinarians. Those who were aware of the problem considered non-prescribed anthelmintic drugs to play a role in its emergence, while several of the participants believed that “more expensive” and “foreign-branded” drugs worked best. Almost all of the farmers reported that they frequently consulted with a veterinarian about anthelmintic treatments, but very few adhered to recognized principles of responsible and sustainable drug use. About half of the participating farmers treated their sheepdogs for helminth parasites, despite the common practice of regularly feeding likely infected livestock offal. Education had a significantly positive association with farmers' knowledge, attitudes, and best practice scores, while knowledge was significantly associated with both attitudes and practices. Based on these results, we recommend that regular country-wide classes should be held to educate farmers on the evidence-based principles of sustainable helminth control and prevention of zoonotic helminth diseases.

Opioid initiation and injection transition in rural northern New England: A mixed-methods approach

BackgroundIn rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England. MethodsThis mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England. ResultsMedian age of first injection was 22 years (interquartile range 18–28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in families and communities, experiencing trauma, and abrupt discontinuation of an opioid prescription. Other factors that led to a transition to injecting included lower cost, increased effect/ rush, greater availability of heroin/ fentanyl, and faster relief of withdrawal symptoms with injection. ConclusionsTrauma, normalization of drug use, over-prescribing of opioids, and abrupt discontinuation challenge people who use drugs in rural northern New England communities. Inadequate opioid tapering may increase transition to non-prescribed drug use. The extent and severity of traumatic experiences described highlights the importance of enhancing trauma-informed care in rural areas.

The Use of Non-Prescribed Prescription Drugs and Substance Use Among College Students: A 9-Year Follow-Up Cohort Study.

The use of non-prescribed prescription drugs (NPPD) is common in post-modern societies and a significant proportion of youth consume NPPD concomitantly to other drugs. We studied the prevalence of this consumption among university students in Spain, and its relationship to different patterns of alcohol, tobacco, and cannabis use. A cohort study among university students (n=1,380) (2005–2015) was carried out. Students completed self-administered questionnaires at initial (n=1,363, 98.7%), at 2 years (n=875, 75%) and 9 years of follow-up (n=415, 30.5%). Consumption of medicines (last 15 days), risky alcohol consumption (RC), heavy episodic drinking (HED), and tobacco and cannabis use were measured. Multilevel logistic regressions for repeated measures were generated using consumption of medicines with or without medical prescription as dependent variables. Prevalence of RC, HED, tobacco and cannabis had significant reductions during the follow-up. The use of NPPD increased over time, from 35.5% and 33.3% at 18 and 22 years old, respectively, to 49.6% at 27 years old. The highest rates were found among cannabis, tobacco, RC and HED users. For females, cannabis and RC constitute signitifant risk factors for use of NPPD. Conversely, for males, tobacco and cannabis were risk factors for such use of medicines. Later onset of alcohol consumption constitutes a protective factor for females. Our results reveal high prevalence of NPDD among university students. Those who consume NPPD are -at the same time- more likely to be alcohol, tobacco, and cannabis users than those who take medication under prescription. Preventive strategies should be reinforced and focused on this target population to decrease these high levels of poly-consumption.

Factors influencing knowledge levels among hypertensive patients receiving treatment at the Komfo Anokye Teaching Hospital in Kumasi, Ghana: a cross-sectional study.

Background&#x0D; Basic knowledge about hypertension and its treatment can have a positive impact on high blood pressure control reducing cardiovascular morbidity and mortality. This study aimed at assessing the knowledge levels and to determine the factors that influenced knowledge levels among hypertensive patients receiving treatment at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana.&#x0D; Methods&#x0D; A cross-sectional study was conducted at the outpatient hypertensive clinic of KATH between April and May 2019. Three hundred and ninety-seven (397) hypertensive patients aged 18 years and above who had been diagnosed with hypertension for at least six months and currently taking at least one antihypertensive drug completed a self-administered questionnaire. The questionnaire consisted of basic socio-demographic profile, patient-related information on hypertension and its treatment and knowledge on hypertension. The Hypertension Knowledge-Level Scale (HK-L) was used to determine the level of knowledge among patients receiving treatment at the Komfo Anokye Teaching Hospital (KATH), Kumasi.&#x0D; Results&#x0D; Out of the 397 patients, 199 (50.1%) had high knowledge level on hypertension and its treatment. Binary logistic regression analysis was conducted for hypertension knowledge level. Respondents with a junior level of education, paid for their antihypertensive drugs by themselves, had asthma as a comorbidity and took non-prescribed drugs had a significant association with knowledge level on hypertension and its treatment.&#x0D; Conclusion&#x0D; Knowledge about hypertension in hypertensive patients is moderate and therefore much effort should be made in educating and involving them in the condition to help them gain control over the disease and improve adherence rates.

Electronic Cigarettes Associated With Incident and Polysubstance Use Among Youth

PurposeElectronic cigarette (e-cigarette) use has increased exponentially among the youth in the United States and may increase the incidence of substance use. MethodsYouth participants (12–17 years) were surveyed through the Population Assessment of Tobacco and Health study over a three-year time period. Youth with any baseline substance use or diagnosis of an attention deficit disorder were excluded from the analysis. Multivariable logistic regressions were used to assess the association between e-cigarette use at Wave 1 and incident substance use (marijuana, painkillers, sedatives, or tranquilizers and Ritalin/Adderall) and polysubstance use at Wave 2 or 3, and marijuana use in the electronic nicotine device at Wave 3. ResultsBaseline ever e-cigarette users who had no history of marijuana, nonprescribed drugs and illicit substance use in Wave 1 had increased odds of reporting incident use of marijuana (odds ratio 2.59, 95% confidence interval: 1.90–3.52), nonprescribed Ritalin/Adderall use (1.89, 1.09–3.28), or polysubstance use (2.09, 1.43–3.05) in Wave 2 or 3 compared to never e-cigarette users. They were also more likely to report use of marijuana in the electronic nicotine product (2.26, 1.56–3.27) in Wave 3 compared to never e-cigarette users. There was no statistically significant association between baseline e-cigarette use and incident use of painkillers, sedatives, or tranquilizers in Wave 2 or 3 (1.21, .79–1.87). ConclusionsE-cigarette use is associated with incident use of marijuana, marijuana in electronic nicotine devices, Ritalin/Adderall, and polysubstance use but not painkillers, sedatives, or tranquilizers. Results indicate that e-cigarettes are associated with subsequent additional risky health behaviors in youth.

Prevalence and disparities in opioid overdose response training among people who inject drugs, San Francisco: Naloxone training among injectors in San Francisco

BackgroundExpanding naloxone training stands to reduce opioid-related overdose deaths. The current study assessed the prevalence of overdose response training and use of naloxone among people who inject drugs (PWID). MethodsData were from a survey of PWID in San Francisco in 2018, recruited by respondent-driven sampling (RDS). Eligibility criteria were age over 18 years, injected non-prescribed drugs in the last year, San Francisco residence, and referral by another participant. Interviews collected demographic characteristics and injection-related behavior. ResultsThe sample (N=458) was majority male (67.5%) and over 45.5 years. Over three-fourths (76.0%) injected primarily opioids. Overall, 62.9% received overdose response training and 68.8% owned a naloxone kit. A majority (77.9%) had witnessed an overdose in the past year, of whom 55.8% used naloxone the last time they witnessed an overdose. Receiving overdose response training was significantly lower among persons of non-white race/ethnicity compared to whites (adjusted odds ratio [AOR] 0.43, 95% CI 0.27, 0.69) and higher among those who owned naloxone (AOR 6.29, 95% confidence interval [CI] 3.95, 10.02) and used syringe exchange programs (AOR 3.51, 95% CI 1.41, 8.79). ConclusionWhile the majority of PWID have had overdose response training, gaps and disparities persist in promotion of naloxone use.

An Insight into Gabapentin and Pregabalin in Scottish Prisoners.

The aim of this study was to evaluate the prevalence and abuse potential of antiepileptic drugs (AEDs) among prison populations in Scotland, UK. Participants consisted of all admitted and released prisoners over a 1month period who consented to provide samples. Urine samples were collected and analyzed by liquid chromatography coupled with triple quadrupole tandem mass spectrometry using a method validated for the simultaneous quantification of 21 AEDs in urine. A total of 904 samples were collected. The samples were also screened for drugs of abuse by using point-of-care testing kits. A total of 18% of the samples were positive for AEDs. Gabapentin (GBP) was identified in 118 samples (13%) and pregabalin (PRG) in 32 samples (3.5%). Interestingly, 12 samples contained both drugs (1.3%). The concentrations ranged from 0.5 to 1,100mg/L (median, 15mg/L) for GBP and from 0.5 to 440mg/L (median, 7.3mg/L) for PRG. Four samples were found to have concentrations >400mg/L, two samples for GBP and two samples for PRG. These concentrations are at least 20 times above the median concentrations. Other AEDs detected were levetiracetam (four samples), vigabatrin (four samples), lamotrigine (three samples), valproic acid (three samples), carbamazepine (two samples) and topiramate (one sample). Illicit or non-prescribed drugs were detected in 81% of urine samples of which 80% were from admitted prisoners and 20% from released prisoners. Benzodiazepines, opiates and cannabis were the most frequently detected drugs. Other drugs found in positive AED samples were methadone (26%), cocaine (18%), buprenorphine (17%), amphetamines (4%), methamphetamines (4%) and barbiturates (4%). This study shows a high prevalence of AEDs within the Scottish prison system, primarily due to GBP and PRG; however, due to the anonymity of the sample collection, it is unknown if these are prescribed or illicit drug ingestions.