Onset Of Illicit Drug Use Research Articles

A Retrospective Survey of Buprenorphine Substitute Treatment With Minimal Dosage in Heroin Use Disorder.

Objectives: It is widely accepted that buprenorphine maintenance treatment (BMT) with dosages above 8 mg daily is effective for patients with heroin use disorder. In this study, the authors evaluated the effectiveness of long-term BMT for heroin users in China, with dosages kept on a much smaller level.Methods: This is a retrospective observational study of 72 patients who had undergone detoxification and continued with buprenorphine maintenance between 2007 and 2016. Measurements such as self-reported relapse status, buprenorphine doses, protracted symptoms, general health condition, and self-reported side effects were included.Results: At the time of interview, 51 patients had remained abstinent at follow-up (including 13 who were opioid-free). The dosages of buprenorphine were 1.33 ± 0.88 (ranging 0.3–3.5) mg/day when maintenance treatment was initiated and 1.2 ± 0.8 (ranging 0.2–3.2) mg/day at the last follow-up. The remaining patients had either relapsed on heroin (n = 11) or switched to compulsory treatment (n=10). In general, abstinent patients had minimal protracted symptoms, especially in physical symptoms. Opioid-free abstainers were more likely to report good physical health than patients on buprenorphine. Predictors of worse outcomes (relapsed or switched to compulsory treatment) were lower education levels, younger age, and younger onset of illicit drug use.Conclusions: This study shows promising results of minimal-dosage BMT in treating heroin use disorder. We recommend further studies applying minimal-dosage BMT in China and worldwide.

Associations of childhood maltreatment with subsequent illicit drug use among Chinese adolescents: The moderating role of the child's sex

Adolescence is a critical period for the onset of illicit drug use. This study aimed to estimate the prevalence of illicit drug use among Chinese adolescents, to assess the associations between different forms of childhood maltreatment and subsequent illicit drug use and to test whether the child's sex plays a moderating role in the associations. A secondary analysis was made of cross-sectional data collected from 10th to 12th graders from China who were sampled in the 2015 School-based Chinese Adolescents Health Survey. A total of 59,518 questionnaires were included in the final analysis. The prevalence estimates and logistic regression analyses were weighted to account for the complex survey design. If the interaction term (between childhood maltreatment and sex) was significantly associated with illicit drug use, we would perform stratification analyses across sex. Of the total sample, 45.2% were boys, and the mean (SD) age was 17.0 (0.9) years. The results of stratification analyses demonstrated that among boys, physical abuse and sexual abuse were independently associated with an increased risk of use during their lifetime of MDMA, methamphetamine, ketamine, and mephedrone; among girls, only emotional abuse and sexual abuse were associated with MDMA use, methamphetamine use, ketamine use, and mephedrone use.

The social exigencies of the gateway progression to the use of illicit drugs from adolescence into adulthood

BackgroundThere is limited empirical integration between peer clustering theory and the Gateway framework. The goal of the present study was to test the hypothesis that friendship associations partly predict gateway escalations in the use of drugs from adolescence to adulthood. MethodThis longitudinal study analyzed 3 waves of data from a community sample of 711 male and female participants without a history of illicit drug use reporting drug use at age 17, 22, and 27. Substance use assessments including tobacco, alcohol, cannabis, onset and abuse/dependence tendency of illicit drugs other than cannabis (i.e., cocaine, methamphetamine, and opiates), and friends' reported use of illicit drugs. Structural equation modeling was used to test the hypothesized model. ResultsParticipants' cannabis use level at age 17 was positively associated with perceived friends' drug use at age 22, which in turn predicted participants' onset of illicit drug use between ages 22 and 27. Moreover, progression of tobacco use throughout age 17 to 22 was associated with an increased onset of illicit drug use between ages 22 and 27. Apart for an effect of cannabis use at age 22 on abuse and dependence tendency to various drugs at age 28, results were similar. ConclusionsDuring this period of development, the availability and selection of drug-using friends contributes to the progression to potentially more rewarding and damaging illicit drugs. These findings suggest the need to attend to the peer ecology in prevention and support the common practice of using abstaining peers in treatment for drug dependence.

Opiate- and Cocaine-Related Fatal Overdoses in Luxembourg from 1985 to 2011: A Study on Gender Differences

Background/Aim: We analysed gender differences in national fatal overdose (FOD) cases related to opiates and cocaine use between 1985 and 2011 (n = 340). Methods: Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence. Bivariate and logistic regression analysis of male/female differences according to sociodemographics, forensic evidence and drug use trajectories. Results: The burden of deaths caused by FOD on the general national mortality was higher for men (PMR^/100 = 0.55) compared with women (PMR^/100 = 0.34). Compared with their male peers, women were younger at the time of death (t = 3.274; p = 0.001) and showed shorter drug use careers (t = 2.228; p = 0.028). Heroin use was recorded more frequently in first drug offences of female victims (AOR = 6.59; 95% CI 2.97-14.63) and according to forensic evidence, psychotropic prescription drugs were detected to a higher degree in females (AOR = 2.019; 95% CI 1.065-3.827). Conclusion: The time window between the onset of illicit drug use and its fatal outcome revealed to be shorter for women versus men included in our study. Early intervention in female drug users, routine involvement of first-line healthcare providers and increased attention to use of poly- and psychotropic prescription drugs might contribute to prevent premature drug-related death and reduce gender differences.

Predisposed violent drug users versus drug users who commit violence: Does the order of onset translate to differences in the severity of violent offending?

To determine whether there were differences in drug use profiles, psychopathology, and severity of violence among regular illicit drug users in respect to the order of onset of drug use and violence. A cross-sectional survey utilising self-report data was administered to 327 regular illicit drug users in Sydney, Australia. Those who first committed violent crime prior to illicit drug use were found to have more serious offending patterns (greater frequency, arrest for more serious violence, earlier age of onset, and more weapon use). Being male, having a history of child abuse and greater severity of conduct disorder were independent predictors of committing violence before drug use. Whilst the nature of the data does not permit causative conclusions, it appears that the order of onset of illicit drug use and violent crime is associated with heterogeneous offending patterns. Early onset violence was associated with more severe violent crimes in later adulthood, whereas violence which proceeded drug use was more strongly linked to systemic risks. The findings have implications for early intervention among children with conduct disorder and also for using drug and alcohol treatment services to reduce specific risks associated with violence.

Oxycodone Abuse in New York City: Characteristics of Intravenous and Intranasal Users

This pilot study sought to characterize typical nonmedical oxycodone use in the New York Metropolitan area. Accordingly, a clinical interview was administered to 25 intranasal (IN) and 25 intravenous (IV) oxycodone abusers to capture demographics and patterns of use within the region. IN and IV abusers shared a number of similar characteristics including age, proportion of men and women, criminal history, drug use history, and current recreational drug use. However, the two populations also differed in a number of aspects. IV oxycodone users had lower rates of employment, earlier onset of illicit drug use, and more current heroin use. Although IN users reported somewhat more frequent use of oxycodone weekly, IV users were more likely to supplement their oxycodone use with other opioid drugs, most notably heroin. Additional research is needed to confirm these observed differences, yet these data may assist treatment efforts by providing information to guide targeted treatment and population-specific interventions.

A mixture-model approach to linking ADHD to adolescent onset of illicit drug use.

Prior research findings have been mixed as to whether attention-deficit/hyperactivity disorder (ADHD) is related to illicit drug use independent of conduct problems (CP). With the current study, the authors add to this literature by investigating the association between trajectories of ADHD symptoms across childhood and adolescence and onset of illicit drug use, with and without controlling for CP. In a longitudinal panel study of a community sample of 754 girls and boys recruited in kindergarten, this research question was examined with a combination of growth mixture modeling (to model parent-reported ADHD symptom trajectories) and survival analysis (to model youth-reported initiation of illicit drug use). Results revealed a 3-class model of ADHD trajectories, with 1 class exhibiting no or minimal symptoms throughout childhood and adolescence, another class showing a convex shape (an increase, then a decrease in symptoms) across time, and a third class showing a concave shape (a decrease, then a slight increase in symptoms) over time. The concave-trajectory class demonstrated significantly earlier onset of illicit drug use than the minimal-problem class, with the convex-trajectory class falling between (but not significantly different from either of the other two classes). These results did not change when the authors added CP to the model as a covariate. Implications of findings for theory and practice are discussed.

Psychiatric comorbidity and gender difference among treatment‐seeking heroin abusers in Taiwan

The objectives of the present study were to estimate the psychiatric comorbidity of Taiwanese heroin users seeking treatment and to identify the gender differences in psychiatric comorbidity and drug use behavior. Subjects were interviewed using a structured questionnaire on drug use behavior and the Mini International Neuropsychiatric Interview for psychiatric disorders. Of the subjects, 58.5% of the male and 62.5% of the female subjects had at least one non-substance-use axis I psychiatric disorder or antisocial personality disorder. Compared to male subjects, female subjects were younger, were less educated, had higher rates of unemployment and had earlier onset of illicit drug use. Female subjects were 11-fold more likely than male subjects to exhibit suicidal behavior. Among heroin abusers in the present study, female subjects were more widely exposed to unfavorable social factors and had substantially higher incidence of suicidal behavior than male subjects. Drug treatment centers should be aware of these gender differences and pay particular attention to comorbid depressive disorders and suicidal behavior of female heroin abusers.

Illicit drug use and offending histories: A study of male incarcerated offenders in Australia

Utilizing the self-reported offending and drug use histories of over 2000 incarcerated male prisoners from four Australian jurisdictions, offenders were categorized into different offending typologies based on lifetime criminal behaviour. Eight different crime types were developed and offenders’ reported use of four drugs - cannabis, amphetamines, heroin and cocaine - was examined. The analysis found that the type and level of illicit drug use varied across the different types of offenders. Of those who had used drugs, the rates of poly-drug use were high. Furthermore, most drug using offenders, regardless of crime type, were on average more likely to commit minor offending prior to the onset of illicit drug use. The extent to which offenders attributed drug use to their criminal careers also varied. This article highlights that interventions aimed at drug use alone will have only a limited impact on reducing the likelihood of re-offending.

Screening for HIV, HBV and HCV markers among drug users in treatment in rural south-east England.

This study was designed as an opportunistic screening to estimate the prevalence of blood-borne viral infection among drug users in treatment in the rural population and to investigate related risk factors and use of general health services. A total of 102 patients aged 18 years and over (78 male, 24 female) with problematic self-reported drug use, recruited between 1 February 1996 and 31 January 1997, in a mixed urban-rural population in south-east England, were interviewed for information on socio-demographic status, drug use history, HIV-related risk behaviours, hepatitis B vaccination, general practice consultations, and use of A&E departments and medical out-patient clinics. Diagnostic testing was offered to all patients for anti-HIV-1, anti-HBc, HBsAg and anti-HCV. The mean age at onset of illicit drug use for the entire sample was 15.33 (SD 3.36) years; 3.7 per cent (1/27), 20.4 per cent (18/88), and 55.8 per cent (48/86) had antibodies to HIV-1, HBc and HCV, respectively; 1.1 per cent (1/88) tested positive for HBsAg indicative of a carrier state. All 18 patients anti-HBc seropositive were male (p = 0.009). There was no gender difference for anti-HCV serological status. The proportion of town residents and village dwellers seropositive for anti-HBc and anti-HCV did not differ significantly. Patient's age at interview, age at onset of opioid use and duration of opioid use showed a significant association with anti-HBc and anti-HCV serological status. The proportion directly sharing injecting equipment was too small for rigorous statistical analysis; however, indirect sharing involving cooking equipment and frontloading rituals achieved statistical significance. Anti-HBc serological status showed a significant association with vaginal intercourse without a condom (p = 0.03); none of the sexual risk behaviour variables revealed any significant association with HCV infection. Although only one-third of the sample consented to HIV antibody test, consenting and non-consenting groups did not differ significantly except on one variable: having a drug-using sexual partner (chi2 = 5.6167; p = 0.017). Serum aspartate amino transferase and gamma-glutamyl transpeptidase concentrations were raised above the upper limit in 23 (25.7 per cent) of the 89 patients who gave blood specimens; 41.2 per cent (42/102) were referred to treatment by their general practitioners. There was no significant relationship between HBV and HCV serological status and general practice consultations. Only eight (7.8 per cent) had received hepatitis B vaccination, and although 48 (47.1 per cent) had in the preceding 12 months used A&E departments, only seven (6.2 per cent) had been seen in medical out-patient clinics. In this study the prevalence of HIV, HBV and HCV in the rural population is as high as has been reported for inner cities. The poor uptake of hepatitis B vaccination among drug users, their poor response to HIV antibody test and poor health service utilization suggest the need for an urgent appraisal of service provision and a review of prevention and treatment strategies.

The Relationship between Physical Abuse, Sexual Victimization, and Adolescent Illicit Drug Use

Researchers have typically relied on clinically or legally involved persons to assess the influence of childhood maltreatment on illicit drug use, limiting the generalizability of findings. A few studies have sampled from the general population to explore this relationship, although these studies tended to focus on a particular type of maltreatment (sexual assault vs. physical abuse vs. neglect). The present study attempted to elucidate the role of various measures of maltreatment, namely sexual victimization, physical abuse, and the co-occurrence of both types of abuse, in adolescent illicit drug use and age of onset of drug use. Using a sample of Mexican-American and non-Hispanic White adolescents, the current research addressed (1) whether the three measures of abuse were related to self-reported measures of illicit drug use, (2) the relative effects of the three measures of abuse on illicit drug use, and (3) whether, among drug users, the three measures of abuse were related to self-reported age of onset of illicit drug use. Findings indicated that physical abuse and sexual victimization, as well as the co-occurrence of both, were significantly associated with frequency of various types of illicit drug use, but that among drug users, no measure was a particularly robust predictor of mean age of onset of drug use. Results also suggested that physical abuse was generally more strongly related to illicit drug use than sexual victimization or the co-occurrence of both. implications of these findings for future research are discussed.

Drug Use Amongst Peers: peer pressure or peer preference?

The importance of peer ‘pressure’ as a major causal factor in the onset of illicit drug use is reviewed. Most of the data adduced in support of this hypothesis are associational and therefore no basis for the inference of causality. While there is evidence to show that peer factors are associated with illicit drug use this evidence has, in many cases, been inappropriately interpreted or cited as support for peer pressure when it should have been more appropriately interpreted as evidence for peer preference. The operational definition of peer pressure or peer influence in many research reports is such that it is clear the researchers were only addressing one factor, amongst others, in a dynamic and reciprocal relationship between individuals and peers. There is a need to reassert the role of the individual in their own development, with a particular need to reassert the role of choice and motivation in relation to drug use and social interaction with peers, without assuming that motivation for drug use arises solely out of personal or social inadequacy. Some implications for educational interventions and health promotion are discussed.

Alcohol, other drugs, and criminality: a structural analysis.

The authors examine a model which specifies the relationships among criminality and the use of alcohol and other drugs. A pattern is hypothesized: The initiation of alcohol/drug use tends to progress from legal to illicit drugs; the early initiation of drugs increases the current use of drugs; and criminality is affected by the initiation/use patterns. Analyses based on data collected from individuals in jails, drinking driver programs, alcoholism treatment centers, and on probation indicate that the early onset of legal drug use induces the onset of illicit drug use. Criminality is affected by the current use of alcohol and cocaine. Comparison and contrast of findings from the four groups are provided.