Problematic Use Of Psychoactive Substances Research Articles

Machiavellianism as a crucial Dark Tetrad trait for the prediction of life-course criminal behavior

The Dark Tetrad (Machiavellianism, psychopathy, narcissism, and sadism) is a taxonomy of personality dispositions toward immoral, antisocial, and antagonistic behavior; still, its predictive power in the domain of criminal behavior is rarely tested. In the present research, we analyzed the associations between the Dark Tetrad and several indicators of criminal behavior (onset of criminal behavior, juvenile correctional measures, problematic use of psychoactive substances [PUPS], penal recidivism, number of convictions, violent offences, and the risk of future recidivism) in a sample of Serbian prisoners (N = 471). While all dark traits were positively associated with criminal behavior indicators on a zero-order level (except violent offences), regression analyses identified Machiavellianism as the most prominent predictor. Psychopathy positively predicted PUPS, while narcissism had a negative contribution to PUPS and penal recidivism. Interactions with the participants’ sex showed that sadism represents a risk factor for females regarding early offences and PUPS, while Machiavellianism elevates the chance of repeated prison sentences for men. Finally, the structural model showed that juvenile offending mediates the association between Machiavellianism and general criminal recidivism. Findings showed the fruitfulness of assessing the Dark Tetrad traits in order to predict various aspects of criminal behavior.

Ideación suicida, uso de sustancias psicoactivas y sufrimiento mental entre la población sin hogar de un municipio brasileño

Objective: to characterize the presence of suicidal ideation, use of psychoactive substances and mental distress among homeless people. Methodology: a cross sectional study carried out with 127 participants. Data were collected through the application of a questionnaire containing sociodemographic data, economic information related to living and health conditions and the Self-Reporting Questionnaire; the Alcohol, Smoking and Substance Involvement Screening Test; and the Alcohol Use Disorders Identification Test. Data analysis was carried out descriptively. Results: 37% of the sample reported suicidal ideation, with predominance of the female gender (52.6%), adults (from 30 to 39 years old) (36.3%), non-white skin color (35.2%), low schooling level (39.7%), without a partner (36.4%) and earning no income (36.7%). Problematic consumption of alcohol, tobacco, marijuana and cocaine was observed among the participants with suicidal ideation. More than half of the sample that presented suicidal ideation was experiencing mental distress. Conclusion: suicidal ideation was identified in a significant portion of the sample. Problematic use of psychoactive substances and mental distress were also prevalent in those with suicidal ideation.

Personality disorders and addiction A study of 54 patients

IntroductionPersonality disorders are very often comorbid with addictions and are known to have a negative impact on the development of substance use disorder.ObjectivesEvaluate the prevalence of personality disorder in patients with problematic use of psychoactive substances followed at Ar Razi hospital Determine the relationship between different personality disorders and the clinical aspects of psychoactive substance useMethodsThis is a descriptive and analytical cross-sectional study carried out among 54 patients followed at Ar-Razi hospital Salé in Morocco for problematic use of psychoactive substances from June 1 to September 15, 2023 (Diagnosis assessed by DSM 5) Data collection was done using a questionnaire including clinical and socio-demographic characteristics and data on addiction to psychoactive and behavioral substances. The psychometric scale used to assess personality disorder: Personality Disorder Questionnaire (PDQ-4+)ResultsWe recruited 54 patients with age ranges from 18 to 45 years, with a male predominance. The average age at the start of psychoactive substance use was 15 years. Tobacco is the most used substance followed by cannabis Antisocial, histrionic and borderline personality disorders were the most common in our population. There was a statistically significant difference between specific personality disorder and the presence of severe psychoactive substance use disorderConclusionsThe frequency of personality disorders is high among subjects with problematic use of psychoactive substances. It is necessary to take care of them simultaneously (integrated care) in order to improve the prognosisDisclosure of InterestNone Declared

Psychiatric comorbidities among patients hospitalized in the addictology department of Ar Razi hospital in Morocco

IntroductionComorbidity between psychiatric disorders and disorders linked to psychoactive substance use is common and represent a real public health problem.The association of a psychiatric disorder can, in certain cases, modify the treatment methods and also the evolution of the addictive behavior.ObjectivesDetermining the prevalence of psychiatric comorbidities in patients with substance use disorder Identify the sociodemographic and clinical characteristics of patients hospitalized in the addictology department.MethodsWe conducted a cross-sectional study with descriptive and analytical aims, in order to study psychiatric comorbidities in 150 patients with substance use disorder hospitalized in the addictology department of Ar Razi hospital in Salé over a period from June 1, 2022 to August 30, 2023.Data collection was done using a questionnaire including clinical and socio-demographic characteristics, the prevalence of problematic use of psychoactive substances and the comorbidity of psychiatric disorders (diagnoses assessed by DSM 5 criteria).ResultsA male predominance was noted (80%). The main substances consumed in the last 12 months were tobacco (98%), cannabis (74%), alcohol and benzodiazepines.The majority of patients presented at least one psychiatric comorbidity (80%), with a predominance of depressive disorder and anxiety disorders.Personal history of suicide attempts was found in 30% of the sample Substance dependency that prompted initially the consultation was higher in patients with psychiatric comorbidity (p < 0.05)Post-traumatic stress disorder was significantly associated with the presence of problematic cocaine and alcohol use. Social phobia is associated with the absence of a criminal record.ConclusionsAddictive behaviors are often associated with psychiatric disorders. The most common psychiatric comorbidities are depression, anxiety and personality disorders, hence the need for simultaneous treatment of psychiatric pathologies and addictive behaviorDisclosure of InterestNone Declared

Epidemiological, clinical, and forensic approach to a series of defendants examined in criminal psychiatric expertise

Introduction The transgression of the law can be a deliberate act by a lucid adult, but it can also be the result of a deficiency in judgment and discernment due to lack of age or insanity. Psychiatric expertises are more and more solicited in the penal field with the objective of identifying the causal link between mental illness and the criminal act.ObjectivesThe objective of this work was to give an overview of the subjects expertised, the offences and the pathologies encountered through the report of a psychiatric expertise activity in criminal law.MethodsIt is a retrospective descriptive study carried out on the criminal psychiatric expertises made for a forensic act in the psychiatric department of Mahdia during the period from January 1, 2003 to March 30, 2022.Results In total, we collected 101 defendants. The average age of our study population was 35±12.07 years. The majority of our study sample was male (98%), from an urban area (50%). 46.6% had primary education and only 11.2% had higher education. The defendants were single in 57.8% of the cases, and almost half (45.7%) had no occupation. Two-thirds of the accused (61.2%) had experienced emotional deprivation at a young age. The problematic use of psychoactive substances was found in 10.3%, as well as alcohol consumption in 46.6%. Moreover, 39.7% of the patients had a personal psychiatric history and 19% had been incarcerated at least once. The forensic acts were mostly against people (62.9%) dominated by physical aggression (33.6%) followed by homicide or its attempt in 19% of the cases. The majority of patients were not related to their victims (62.1%). The nosographic diagnosis found was a personality disorder in 32.75% of cases, followed by schizophrenic disorders in 22.4% of cases.ConclusionsPsychiatric expertise is a useful, complex and noble clinical act. Determining the predictive factors of a possible acting out allows to specify the objectives of interventions aiming at limiting the acts of violence, hospitalizations and incarcerations of patients suffering from mental disorders.Disclosure of InterestNone Declared

Epidemiological, clinical, and forensic approach to a series of defendants examined in criminal psychiatric expertise

IntroductionThe transgression of the law can be a deliberate act by a lucid adult, but it can also be the result of a deficiency in judgment and discernment due to lack of age or insanity. Psychiatric expertises are more and more solicited in the penal field with the objective of identifying the causal link between mental illness and the criminal act.ObjectivesThe objective of this work was to give an overview of the subjects expertised, the offences and the pathologies encountered through the report of a psychiatric expertise activity in criminal law.MethodsIt is a retrospective descriptive study carried out on the criminal psychiatric expertises made for a forensic act in the psychiatric department of Mahdia during the period from January 1, 2003 to March 30, 2022.ResultsIn total, we collected 101 defendants. The average age of our study population was 35±12.07 years. The majority of our study sample was male (98%), from an urban area (50%). 46.6% had primary education and only 11.2% had higher education.The defendants were single in 57.8% of the cases, and almost half (45.7%) had no occupation. Two-thirds of the accused (61.2%) had experienced emotional deprivation at a young age. The problematic use of psychoactive substances was found in 10.3%, as well as alcohol consumption in 46.6%. Moreover, 39.7% of the patients had a personal psychiatric history and 19% had been incarcerated at least once. The forensic acts were mostly against people (62.9%) dominated by physical aggression (33.6%) followed by homicide or its attempt in 19% of the cases. The majority of patients were not related to their victims (62.1%). The nosographic diagnosis found was a personality disorder in 32.75% of cases, followed by schizophrenic disorders in 22.4% of cases.ConclusionsPsychiatric expertise is a useful, complex and noble clinical act. Determining the predictive factors of a possible acting out allows to specify the objectives of interventions aiming at limiting the acts of violence, hospitalizations and incarcerations of patients suffering from mental disorders.Disclosure of InterestNone Declared

Who has a problem with chemsex? Identity as a missing link in support services for men who engage in problematic use of psychoactive substances for sexual purposes.

As the social consent for seeking help in the area of psychosexual health increases, specialists observe the current socio-cultural changes and the new phenomena they give rise to be reflected in their patients. One of these relatively new phenomena is chemsex. It is a distinct form of combining highly specific psychoactive substances and sexual activity, practised almost exclusively by men. Due to the heightened health risks, connected both with the drugs used and the frequent lack of protection during sexual activity, international public health institutions consider chemsex a health problem of men who have sex with men (MSM). Although the introduction of MSM as a category in the 1990s - mainly in the context of HIV - was based on important epidemiological premises (the behaviour, not the identification, is what is important in the context of risk), it is neglecting sexual identity that may be one of the missing links in the intersectional understanding and appropriate addressing of problematic chemsex. The article is addressed especially to psychiatrists, psychologists, psychotherapists, addiction and sexologists working with this group of patients.

Drug addiction among high school students in Toamasina I Madagascar in 2020

Introduction: The problematic use of psychoactive substances by high school students is currently more and more widespread social phenomenon. The dangerousness of these misuses is cognitive decline and behavioral disorders with legal consequences. The objectives of the study is to show a screening of the socio-demographic and clinical profile of high school students taking psychoactive substances in the Region of Toamasina I Madagascar. Research methods: This is a cross-sectional study carried out on a sample of population made by high school students from the Region of Toamasina I Madagascar, from the class of Second to Terminale, among 6 high schools establishments, obtained after a draw, from October 01st to November 30th, 2020. Students were asked to fill out questionnaires and submitting them immediately. The content of the questionnaires was made up of the standardized assessment items ASSIST Version 3.0 (Alcohol, Smoking, and Substance Involvement Screening Test). It was studied the social and demographic parameters with the clinical symptoms presented by high school students who reported a notion of taking or using psychoactive substances and finaly, the level of dependence on these substances. Conclusion: Almost of high school students are classified as occasional users who, during a meeting with their classmates or during a trip, would allow themselves to be convinced of the need to accept drug use as symbol of sharing and brotherhood. Sensitizations must be initiated to aware of the imminence of this dangerous health problem.

Designing a Nurse-Led Program for Self-Management of Substance Addiction Consequences: A Modified e-Delphi Study.

Therapeutic interventions for people with problematic use of psychoactive substances can help tackle specific needs related to substance addiction consequences. This modified e-Delphi study aimed to establish consensus on a training program for self-management of substance addiction consequences. The study was conducted between February and April 2022, with an experts' sample of 28 participants in the first round and 24 in the second. A priori consensus criteria were defined for each round. The results revealed a very strong consensus was achieved on the structure of the program and on clinical areas, such as the problematic use of substances, general health knowledge, health-seeking behavior and adherence, self-knowledge and well-being, social role and personal dignity, and family process. Additionally, over 80% participant consensus was achieved on an extensive number of interventions categorized as psychoeducational, psychotherapeutic, socio therapeutic, brief interventions, social skills training, problem solving techniques, relaxation techniques, and counseling. These findings may be able to fulfill a gap concerning structured treatment approaches for people with problematic use of psychoactive substances. Supporting self-management of the consequences of substance addiction and its application can change nurses' interventions.

Factors affecting problematic use of psychoactive substances among Bachelor level students: A mixed methods study from Hill and Terai of Nepal

Introduction: Adolescents start experimenting with licit substances which later worsen to use of more addictive illicit substances. Genetic and environmental vulnerabilities affect use of psychoactive substances with family support, competence, and psychological well-being acting as protective factors. This study aimed to identify the prevalence of problematic use of psychoactive substances among Bachelor level students and factors affecting the problematic use.
 Method: A cross-sectional study was conducted among 50 Bachelor level students selected purposively from a private college of Kathmandu metropolitan city and five In-depth and Key Informant interviews of Bachelor level students, guardian, and teachers from Kohalpur municipality. Cronbach’s alpha was calculated for each of the tools used and prevalence of problematic use of psychoactive substances was assessed.
 Result: Prevalence of problematic use of psychoactive substances among lifetime users was 51.4%. The factors significantly associated with problematic use of psychoactive substances were sex and social discrediting by peers. Qualitative analysis identified many risk and protective factors at individual, interpersonal, and socio-cultural level.
 Conclusion: High prevalence of lifetime psychoactive substance use and high percentage of problematic use of psychoactive substances among substance users requires intervention at different socio-ecological level.

A critical scoping review about the impact of music in the lives of young adults who use drugs.

Music is among the most frequently used medium to promote young adults' well-being. To that aim, the efficiency of music is explained by its capacity to modulate emotions through its effect on the brain's reward pathways. Hence, music could help individuals suffering from dysregulations in these pathways, whose experience of positive emotions is often inhibited. Such dysregulations are particularly present in individuals with problematic psychoactive substance (PAS) use, who are overrepresented in the context of homelessness. While few of them initiate treatment, they successfully rely on their own resources to promote their well-being, including music, though its impact in this context remains under-studied. This scoping review describes the impact of music on the well-being, PAS use and addictive trajectory of young housed and homeless individuals with problematic PAS use. Eleven French and English databases were screened for peer-reviewed articles using concepts and keywords related to music, PAS and well-being. From the 3697 results, 39 were reviewed. Results were organised according to the observed impact of music and analysed critically. Literature shows that PAS users value the impact of music in meeting emotional, psychological and social needs, especially when they experience homelessness. Yet, research has been highly limited to the harmful consequences of music, limiting our knowledge of its potential benefits. To deepen our understanding about the impact of music, future research should endorse a broader perspective and consider the personal and contextual experiences accompanying the involvement in music, factors that were traditionally overlooked.

O Estado brasileiro e os cuidados em saúde para as pessoas em situação de rua

Analisamos as estratégias de cuidado em saúde às pessoas em situação de rua no Brasil entre a década de 1970 e 2009. Buscamos identificar como o Estado brasileiro assumiu o cuidado em saúde a esse segmento social e desenvolveu as primeiras estratégias de assistência. Efetivamos estudo socio-histórico com revisão de literatura e entrevistas em profundidade. Ações voltadas ao controle da população em casos de inadequação social e ao tratamento ao uso de drogas foram as primeiras iniciativas a esse público. O Ministério do Desenvolvimento Social foi o primeiro setor a debater o tema estimulado por pessoas com trajetória de vida vinculada à atuação junto essa população. O Ministério da Saúde propôs inicialmente ações ao uso problemático de substâncias psicoativas para esse público.

Consequences associated with the use of psychoactive substances among female adolescents placed in residential care: the role of sexual exploitation

ABSTRACT Sexual exploitation is a major burden among female adolescents placed in residential care centers. Moreover, problematic psychoactive substance use is a concern because of its prevalence and various associated consequences. However, little is known about the consequences resulting specifically from the use of psychoactive substances among sexually exploited female adolescents. This study explored the association between sexual exploitation and the various consequences associated with substance use among adolescent female (15.3–17.1 years old) living in Quebec’s residential care centers during 2008–2009. To better understand this association, 83 sexually exploited female adolescents and 66 non-sexually exploited female adolescents responded to self-reported questionnaires. As expected, even controlling for age of onset and frequency of substance use, an ANCOVA showed that sexually exploited female adolescents experience more consequences associated with their use of psychoactive substances (F (4, 148) = 24.79, p <.001, d = 0.83). The associations between sexual exploitation and the consequences of psychoactive substance use were particularly strong for risk-taking (OR = 7.99; p <.001) and delinquency (OR = 4.27; p <.001). Such results highlight the importance of not dissociating the use of psychoactive substances from sexual exploitation when working with female adolescents in rehabilitation centers.

Diabetes and Addictive Disorders

AbstractPrevalence of addictive disorders among persons with diabetes mellitus (DM) (type 1 and type 2) ranges from 9.6 to 29%. Excessive and problematic use of psychoactive substances in persons with diabetes results in poor glycemic control with frequent hyperglycemic crisis. Tobacco, alcohol, cannabis, benzodiazepines, inhalants, and stimulants are common psychoactive substances used among persons with diabetes in India. The daily use of alcohol by men and women with DM should not exceed 15 and 30 g of ethanol, respectively. Use of other psychoactive substances is not recommended for persons with DM. Various screening tools exist for assessing substance abuse like WHO-ASSIST, Alcohol Use Disorders Identification Test (AUDIT), Fagerström Test for Nicotine Dependence (FTND), and Opioid Risk Tool. Integrated management of co-occurring addictive disorder and DM is recommended. Psychosocial treatments for substances include brief interventions (BIs), motivational interviewing, contingency management, relapse prevention, and cognitive behavior therapy

Consumo de sustancias: factores psicosociales intervinientes en consultas a centros públicos de atención

La familia, las redes sociales de apoyo y los espacios de pertenencia son factores de importancia en el entendimiento de la etiología del consumo problemático de sustancias psicoactivas (CPSP). El objetivo general del trabajo fue identificar y analizar factores psicosociales relacionados con CPSP en pacientes atendidos en Centros de Atención de las Adicciones (CPA) de la Provincia de Buenos Aires (BA), Argentina. Se diseñó un estudio descriptivo transversal. Se obtuvieron registros centralizados por el Observatorio sobre el Uso de Sustancias Psicoactivas sobre variables sociodemográficas y psicosociales de la población usuaria de la red de atención. Principalmente, se hallaron la debilidad de redes sociales de contención y apoyo, la falta de proyección a futuro en pacientes con edad promedio de 28 años, y escenarios familiares con dificultades en desempeño de las funciones socioafectivas. Aquellos pacientes con proyección a futuro presentaron mayor presencia de redes sociales de apoyo y de intereses.

The Experience and Meaning of Problematic ‘G’ (GHB/GBL) Use in an Irish Context: an Interpretative Phenomenological Analysis

The problematic use of psychoactive substances has adverse consequences for people’s lives and requires on-going investigation of experiences of onset, course and resolution in order to better inform theoretical understanding, particularly with regard to the use of club drugs and novel psychoactive substances. In turn, this may influence treatment approaches. GHB/GBL, frequently termed ‘G’, is one such substance, with problematic use resulting in increased presentations at AE (2) daily use: “It’s like insidious; it just weaves into your everyday life”; and (3) early recovery: “my priorities are changing”. This study supports the interactive role of community, self-identity, personal vulnerability and substance effects in the development, maintenance and recovery from problematic G use. Findings are discussed in the context of gay community health, the role of chemsex in problematic substance use and the need for public health providers to engage with novel psychoactive substance use and the health and well-being effects of chemsex.

Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

Early Life Stress as Factor for Use of Psychoactive Substances: Integrative Review

Purpose: To identify, analyze and synthetize the scientific evidences that support Early Life Stress (ELS) diagnosis using the Childhood Trauma Questionnaire (CTQ), since it assumes the use of psychoactive substances later in adolescence and adulthood. Individuals that experienced some form of childhood stress may present, in adulthood, consequences that manifest into mental disorders such as problematic use of psychoactive substances. Methods: An integrative review of the literature on the subject in the databases: PubMed, Web of Science, LILACS and Psycinfo, regards studies that have been indexed in the last ten years (2003-2014). Combination of controlled and uncontrolled factors in the use and abuse of psychoactive substances, CTQ and ELS adapted to each database. Findings: The alcohol was the most used drug by the participating subjects of these research; mostly, the use of psychoactive drugs, started when they were still in adolescence; ELS and the later use of psychoactive drugs can be found more frequently in female; the lack of internal resources for dealing with stress in adulthood after ELS occurrence may have as a consequence the use of psychoactive drugs as a coping mechanism. Conclusions: It was possible to identify scientific evidences that support the ELS diagnosis, measured by the CTQ, as a determining factor for the use and abuse of alcohol and/or other psychoactive drugs in adolescence and adulthood. Implications: Investigate the ELS as a strategy to improve the therapeutic project of patients in nursing care, which will be built based on scientific evidence, so it can be more effective.

Problematic use of psychoactive substances in undergraduates: a comparison of four patterns of substance use

The aim of the study was to examine the difference between alcohol-related and illicit drug-related negative consequences in a sample of undergraduates. The survey study was conducted on a sample of 458 lifetime drug users among second-year students, aged between 19 and 25 years (M = 21.24, SD = 1.15). The Chi-square test of independence revealed a significant dominance of alcohol-related consequences, in comparison to drug-related ones. Separate repeated measures analyses of variance (ANOVAs) were performed to examine mean differences between substance-related consequences (alcohol-related and illicit drug-related) among the groups of current substance users in four patterns: (1) frequency of alcohol use (non-users, occasional, regular), (2) quantity of alcohol use (non-users, moderate, binge), (3) frequency of illicit drug use (non-users, occasional, regular) and (4) concurrent alcohol and illicit substance use (non-user, alcohol only user, concurrent alcohol and drug user). The strongest association was found between regular illicit drug users and substance-related consequences, when comparing four models of multivariate analysis of variances (MANOVAs). Collectively, these results extend previous findings that identification of regular illicit drug users among undergraduates may be a powerful tool for predicting both alcohol-related and drug-related negative consequences and a potential target for clinical intervention and prevention efforts at universities.

Practical tools to detect, counsel and treat patients with problematic psycho-active substance use in primary care

Practical tools to detect, counsel and treat patients with problematic psycho-active substance use in primary care