Rates Of Drug Use Research Articles

Past-year substance use behaviors among university admission test-takers: insights from Bangladesh

University entrance test-takers are a vulnerable group of students transitioning from adolescence to youth, a peak time for adopting unhealthy behaviors. However, limited studies investigate substance use behaviors among this group. This study aimed to investigate the current (past 12 months) prevalence, associated risk factors, and geographic distribution of substance use behaviors, employing spatial analysis to identify regional disparities. A cross-sectional study was conducted utilizing convenience sampling in February 2024 among university entrance test-takers at Jahangirnagar University, Dhaka, Bangladesh (N = 1485). Participants provided information on socio-demographics, admission-related, depression (PHQ-9), anxiety (GAD-7), and substance use. Chi-square tests and logistic regression were employed to explore significant associations, with spatial analysis using ArcGIS to map substance use across districts. About 20.8% reported smoking, 10.1% reported drug use, and 9.9% reported alcohol consumption over the past 12 months. Males exhibited higher rates of smoking (23.1% vs. 17.6%) and alcohol consumption (10% vs. 9.7%), while females reported slightly higher rates of drug use (10.2% vs. 10%). Being female (AOR = 0.56; 95% CI: 0.40–0.79; p = 0.001), living in rural areas (AOR = 0.68; 95% CI: 0.49–0.94; p = 0.020), having a higher monthly family income (AOR = 1.72; 95% CI: 1.01–2.91; p = 0.042), a history of physical illness (AOR = 2.65; 95% CI: 1.87–3.76; p < 0.001), being a repeat test-taker (AOR = 1.49; 95% CI: 1.08–2.05; p = 0.014), and satisfaction with previous mock tests (AOR = 1.66; 95% CI: 1.20–2.28; p = 0.002) were significant risk factors for smoking. For drug use, belonging to a joint family (AOR = 1.71; 95% CI: 1.08–2.71; p = 0.021), having a history of physical illness (AOR = 2.57; 95% CI: 1.64–4.02; p < 0.001), and satisfaction with previous mock tests (AOR = 1.84; 95% CI: 1.20–2.83; p = 0.005) increased the risk. Additionally, a history of physical illness (AOR = 5.12; 95% CI: 3.27–8.02; p < 0.001) and satisfaction with previous mock tests (AOR = 1.78; 95% CI: 1.13–2.80; p = 0.013) were contributing factors to alcohol consumption. Spatial analyses indicated higher rates of substance use in border districts. The findings warrant targeted interventions, such as mental health support and substance use prevention programs, particularly in high-risk regions. By understanding the factors driving substance use, tailored strategies can be developed to reduce risk behaviors among university entrance test-takers, ultimately enhancing public health outcome in this vulnerable population.

Response-contingent cocaine increases the reinforcing effectiveness of social contact.

Epidemiological studies report a high concordance rate of drug use within groups, suggesting an interplay between drug reinforcement and social cohesion. Preclinical studies reveal that (a) contingent access to a social partner increases cocaine intake and (b) experimenter-delivered cocaine increases the reinforcing effects of social contact. The purpose of this study was to determine if response-contingent cocaine increases the reinforcing effectiveness of social contact. Male rats were implanted with intravenous catheters and trained on a fixed ratio (FR1) schedule for 30-s access to a social partner. The reinforcing effectiveness of social contact was then determined using a progressive ratio (PR) schedule. After the PR test, rats were divided into two groups in which each response on an FR1 schedule produced social access and either response-contingent cocaine (0.5 mg/kg/infusion) or saline. After 9 days, the reinforcing effectiveness of social contact in the absence of infusions was determined again on the PR schedule. The cocaine and saline reinforcers were then switched between groups and the latter procedures were repeated. Recent exposure to response-contingent cocaine increased the reinforcing effectiveness of social contact on the PR schedule. This effect was transient, and the reinforcing effectiveness of social contact returned to baseline levels once response-contingent cocaine was replaced with saline. These data indicate that recent exposure to response-contingent cocaine transiently increases the reinforcing effectiveness of social contact and suggest that cocaine use may strengthen social cohesion by increasing the reinforcing effects of social contact with other individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Bayesian spatial mapping of rates of substance use among high-school students in Florida

ABSTRACT Objective In adolescent substance use research, more work has been done in identifying risk factors at individual level while little work was done at community level. The objective of this study is to examine the possible risk factors associated with substance use by high-school students at county level. Methods Data on the percentages of county-level substance use by adolescents and county-level risk factors were obtained from the Florida Department of Health, Division of Public Health Statistics & Performance Management (DPHSM). Spatial beta models were used to examine the associations between risk factors and rates of substance use. Results Geographic variation in rates of substance use by adolescents was observed in Florida, ranging from 6.5% to 28.6% for drug use, and from 14.8% to 36.3% for alcohol. It was found that percentages of black population and individual below poverty level were inversely associated with rates of drug use by adolescents. There were no significant associations between percentages of drug use by adolescents and median income, adult drug use, school suspension, and student emotional/behavioral disability per county. Conclusion Interventions for reducing rates of adolescent substance use may focus on involving parents to monitor financial resources for their children.

Responding to ‘wicked problems’: policy and governance on drug-related deaths in English and Welsh prisons, 2015-2021

BackgroundPrison settings have been neglected in the growing literature on drug-related deaths. This paper explores policy and practice issues regarding the governance of drug-related deaths in prisons in England and Wales from 2015-2021. MethodsThematic documentary analysis was conducted on national level policy documents published between 2015-2021 (e.g. drug strategies, prison policy documents, Her Majesty's Inspectorate of Prisons and Prison and Probation Ombudsman (PPO) annual reports and guidance for staff). At the local (prison) level, all of the PPO fatal investigation reports and their associated action plans relating to 171 drug-related deaths from 2015-2021 were analysed thematically. Various modes of governance were identified using Head's ‘wicked problems’ conceptual framework including avoidance and denial, coercive controls, compartmentalised micro-management, incremental and pragmatic adjustment and technocratic problem-solving. ResultsThere was strong evidence of the dominance of denial of the problem of drug-related deaths, coercive controls, micro-management and reliance on technological solutions in the early years (2015-2018). In some prisons, there developed a move towards the adoption of more pragmatic and incremental policies and push towards comprehensive policies over time. In others, remnants of denial and coercion remained. In our analysis, the focus on new psychoactive substances came to dominate attention, to the relative neglect of other substances and of the contribution of mental and physical illness to these deaths. Staff are not equipped, supported or resourced adequately to deal with the two ‘wicked problems’ of increasing rates of drug use and mental illness which collide in the prison setting. ConclusionThe PPO investigations repeatedly recommend reducing supply and improving monitoring and surveillance and the emergency response. There is less focus on prevention and reducing demand or improving the wider environmental context and culture in which the deaths occur. Policy needs to pay more attention to the fundamental issues driving the current deterioration in conditions in prisons.

A feasibility (pilot) mixed methods study of an innovative non-pharmacological breath-based yoga and social-emotional intervention program in an at-risk youth sample in London, Canada

BackgroundVarious service provision models for youth at risk of homelessness have been researched and implemented, including access to housing and physical and mental health resources. However, even with these interventions, we remain unaware of how best to manage symptoms of depression and anxiety and the rate of drug use in these populations primarily because of a lack of feasibility data.MethodsThis paper presents the results of a mixed-methods study in London, Canada, that examined the feasibility of implementing a biopsychosocial intervention, SKY Schools, in at-risk youth aged between 16 and 25 (n = 49). The study also recorded qualitative responses about the program’s usefulness from the perspective of the service users. The SKY Schools intervention consisted of social-emotional learning combined with Sudarshan Kriya Yoga, a standardized yoga-based breathing exercise routine. The intervention program was divided into two phases: an active learning phase and a reinforcement phase. The following feasibility outcome measures were collected: (1) the number of potential participants approached per month, (2) number (proportion) who were successfully screened, (3) the proportion of screened participants who enrolled, (4) the rate of retention in the study, (5) rate of adherence to study protocol, (6) proportion of planned ratings that were completed, (7) intervention cost per case, (8) completeness of final data for analysis, (9) length of time to collect all data, (10) quality of all collected data, (11) determining if partnering community organizations were willing to conduct the study as per study protocol, (12) determining if there were any capacity issues with partners providing intervention and investigators being able to perform the tasks that they were committed to doing, (13) determining if there were any problems of entering the data into a computer, (14) preliminary data about the safety of the intervention, and (15) preliminary estimate of treatment effects.ResultsAll feasibility outcome measures were collectible. In the city of London, Canada it was feasible to conduct a pilot study in this population of youth at risk of homelessness. Foremost among the findings was a high retention rate (61.2%) and overall positive qualitative feedback with a number of potential suggestions to improve the delivery and quality of the intervention. However, we had a significantly low recruitment rate (0.27 participants per week) suggesting that multiple sites will be needed to achieve an adequate sample size for a subsequent definitive trial.ConclusionsFuture researchers may consider the findings of this feasibility study when designing a randomized control trial to further assess the efficacy and tolerability of SKY Schools.Trial registrationTrial registration: Clinicaltrials.gov, identifier NCT02749240. Registered April 22, 2016, https://clinicaltrials.gov/ct2/show/NCT02749240.

A Call for Help: A Retrospective National Study of Self-Inflicted Trauma Among American Indians and Alaskan Natives.

Background Self-inflicted injury accounts for approximately 312,000 emergency department visits annually. American Indians/Alaskan Natives (AIAN) have significantly higher rates of suicide. The National Trauma Data Bank (NTDB) was analyzed for the incidence of self-inflicted trauma. Methods Data were obtained from the NTDB 2012-2017. Patients were selected using ICD codes for self-inflicted trauma. Categorical and continuous variables were tested for significance. Results AIAN patients accounted for 1,176 of the 78,668 patients. The AIAN patients were younger, had lower injury severity score (ISS) scores, were more female, utilized Medicaid more frequently, were more likely to present with a cut or piercing injury, and had higher rates of positive alcohol and drug tests. AIAN patients had shorter lengths of stay in the ICU and overall hospital stay. Conclusion Despite a higher rate of suicide completion, the AIAN population had lower rates of presentation to the hospital and lower ISS scores. AIAN patients were younger, had higher rates of drug use, and utilized cutting/stabbing. This discrepancy could indicate a physical manifestation of a "call for help".

Investigation of the treatment and follow-up approaches of pregnant with asthma

Aims: Uncontrolled asthma during pregnancy can lead to complications for both the mother and the fetus. In this study; It was aimed to evaluate the follow-up and treatment of pregnant women with asthma, their knowledge about asthma triggers, their use of inhaler therapy, and their compliance with pulmonologist controls for asthma. Methods: In this study; 64 pregnant patients with asthma who applied to our clinic between 01.01.2022 and 31.07.2022 were reviewed. Demographic patients (mean age, age groups, smoking history, comorbidities), recommended treatment information, and birth information, whether they used asthma treatment or not, were recorded and evaluated according to patient groups. Results: There was a statistically significant difference between drug use during pregnancy according to the age groups of pregnant women with asthma (Chi-square test; χ²=6.684; p=0.035). As the age of the pregnant women increased, the rate of drug use during the pregnancy increased, and there was a correlation between drug use during pregnancy and whether the patients were regularly checked by a pulmonologist (Chi-square test; χ²=12.835; p=0.0001). While 68% of those who were not under the control of a pulmonologist did not use medication, 60.8% of those under the control of a pulmonologist used medication during their pregnancy. Conclusion: Pregnant women with asthma must be followed by a gynecologist and a pulmonologist. Using inhaler therapy in asthma treatment in pregnant women can keep asthma under control and reduce the number and severity of exacerbations.

Mediating Effect of Stress Recognition on the Effect of Generalized Anxiety Disorder on Smartphone Dependence

The widespread adoption of the smartphone has led to both positive and negative consequences for adolescents’ mental health. This study examines the interplay between smartphone dependence (SPD), generalized anxiety disorder (GAD), and various mental health outcomes among Korean adolescents. Data from the 16th Adolescence Health Behavior Survey (2020), including 54,948 middle and high school students, were analyzed. Adolescents were categorized into three groups based on SPD severity. The GAD-7 scale assessed anxiety, and other factors such as subjective health recognition, happiness, weight control efforts, and body mass index (BMI) were considered. Adolescents with higher SPD exhibited lower academic performance, decreased happiness, and increased perception of stress. GAD levels were positively correlated with SPD, with higher SPD linked to more severe GAD symptoms. Additionally, higher SPD was associated with increased loneliness, sadness, and suicidal thoughts, plans, and attempts as well as a greater likelihood of habitual drug use. Gender differences revealed that females were more prone to sadness, hopelessness, and suicidal thoughts, while males exhibited higher rates of drug use. This study highlights the complex relationship between SPD, GAD, and mental health outcomes among Korean adolescents. Stress recognition was found to mediate the association between GAD and SPD. The process-macro result of the total effect between SPD on GAD and the direct effect of the SPD pathway on GAD was significant; thus, the stress recognition was mediated. Effective interventions should target stress management, especially among adolescents with high smartphone dependence, to mitigate the risk of mental health issues. These findings underscore the importance of addressing smartphone dependence and its impact on the mental well-being of adolescents.

Turning gold into lead: The troubling fate of the police drug diversion initiative.

This paper explores the fate of South Australia's highly regarded Police Drug Diversion Initiative over the past 10 years. The paper uses historical and legal analysis, including publicly available data as to rates of drug use, arrests and diversions, media reports, legislation and Hansard debates. In the mid-2010s, amidst growing anxiety about levels of amphetamine-type stimulants use in Adelaide, a coroner's report became the poster child for what was seen by the Liberal opposition as the excessive leniency and 'waste of resources' of the Police Drug Diversion Initiative. Despite being universally praised for its efficacy, the Liberal government, when elected, passed amendments to the legislation which 'capped' diversions at two. This ended the period in which diversions from criminal to social justice systems was mandatory for all persons charged with simple drug possession. But since then, the diversion rate in South Australia has plummeted in ways that cannot be explained merely because of these amendments. The most highly regarded scheme for diversion of minor drug offenders to treatment is no longer effective. Indeed, the best scheme in the country may now be the worst. The essay draws attention to a catastrophe whose extent is not yet fully appreciated and suggests ways in which we can begin to explain why such a small change has had such dramatic and unforeseen consequences. Like some sort of perverse alchemy, Australia's gold standard for drug diversion has been turned into lead.

Adverse Drug Events by Sex After Adjusting for Baseline Rates of Drug Use

This cross-sectional study examines adverse drug events reported by sex in the US Food and Drug Administration (FDA) database after adjusting for drug use by males and females.

Exploring the Relationship between Drug Addiction and Quality of Life in Herat, Afghanistan: A Cross-sectional Study.

Addiction is a global public health problem, with over 36 million people suffering from drug-use disorders. Afghanistan, the world's leading opium producer, has high rates of drug use owing to the easy access to drugs in this country. This study aimed to investigate drug users' quality of life in Herat, Afghanistan, and identify the factors affecting it. This cross-sectional study examined health-related quality of life at six rehabilitation camps in Herat, Afghanistan, from March to July 2019, using the short form-36 questionnaire (SF-36). Data collected through interviews were analyzed using SPSS software (version 25). A total of 240 participants from six rehabilitation camps in Herat, Afghanistan participated in this study. The majority of participants (80%) rated their overall health as "good" or "very good". Men had higher average scores for mental health and vitality than women and those aged 30-39 had the highest quality of life. Statistically significant differences were found in bodily pain (P=0.038), vitality (P=0.042), and social functioning (P=0.046) among users of different types of drugs. Opium abusers had the highest scores for the physical and mental components, followed by heroin, methamphetamine, hashish, and crack abusers. This study explored the relationship between drug addiction and quality of life in Herat, Afghanistan. The findings showed that young adults were more vulnerable to drug use and male addicts and opium users had the highest quality of life. This study can inform the development of effective rehabilitation programs but more research is needed for addiction treatment strategies.

Longitudinal trends in meconium drug detection in 46 US states between the years 2015-2020.

Maternal drug use during pregnancy has significant health and socio-legal implications. The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes self-reported rates of drug use during pregnancy; however, comprehensive long-term laboratory data on neonatal drug exposure are lacking. Over 175,000 meconium specimens originating from 46 US states were analyzed at ARUP laboratories between the years 2015 and 2020. A retrospective investigation of drug positivity rates, multidrug detection, and median drug concentrations was conducted for 28 compounds in 6 drug classes. The overall meconium drug positivity rate was lowest in 2015 (47.3%), which increased over six years, reaching a peak in 2020 (53.4%). 11-Nor-9-carboxy-Tetrahydrocannabinol (THC-COOH) was the most frequently detected compound across all six years. The second most frequently detected analyte was morphine in 2015-2016 and amphetamines in 2017-2020. THC-COOH positivity rate rose from 29.7% in 2015 to 38.2% in 2020. The positivity rates for stimulants also increased in the range of 0.4-2.9% in 2020 compared to 2015. Conversely, opioid positivity rates declined in the range of 1.6-2.3% in 2020 as compared to 2015. The most common two-drug combination was THC-COOH¯opioids (2.4%) in 2015-2016, which was replaced by THC-COOH‒amphetam‒ines (2.6%) in 2017-2020. The most common three-drug combination was THC-COOH¯opioids¯amphetamines throughout all six years. Neonatal drug exposure positivity rates have increased over the past six years based on retrospective data analysis from the patient population submitted for testing at ARUP Laboratories.

“It's no foundation, there's no stabilization, you're just scattered”: A qualitative study of the institutional circuit of recently-evicted people who use drugs

People who use drugs (PWUD) commonly experience housing instability due to intersecting structural vulnerabilities (e.g., drug prohibition, discriminatory housing policies), and prejudicial or illegal evictions are common. In Vancouver, Canada, evictions have proliferated in the Downtown Eastside, a historically low-income neighbourhood with high rates of drug use and housing instability, resulting in many PWUD being evicted into homelessness. This study characterizes housing trajectories of recently-evicted PWUD through the lens of the institutional circuit of homelessness, and explores how wider contexts of structural vulnerability shape experiences within this. Qualitative interviews were conducted with PWUD recently evicted in the Downtown Eastside (<60 days). Peer research assistants recruited 58 PWUD through outreach activities. All PWUD participated in baseline interviews on the causes and contexts of evictions. Follow-up interviews were completed with 41 participants 3–6 months later, focusing on longer-term impacts of eviction, including housing trajectories. Most participants were evicted into homelessness, remaining so at follow-up. Participants described patterns of residential instability consisting of frequent cycling between shelters, streets, and kin-based networks. While participants normalized this cycling as characteristic of their marginalized social positions, narratives revealed how the demands of the institutional circuit deepened vulnerabilities and prolonged experiences of homelessness. Experiences were framed by participants' (in)ability to navigate survival needs (e.g., shelter, drug use), with tensions and trade-offs between needs increasing participants' and their peers' risks of harms. Constructions of agency further shaped experiences; accounts highlighted tensions between the control inherent to indoor spaces and participants’ need for autonomy. Findings demonstrate how the demands of the institutional circuit foregrounded structural vulnerabilities to perpetuate cycles of instability. Interventions that address survival needs and preserve agency will be necessary to mitigate risks within the institutional circuit, in tandem with upstream interventions that target housing vulnerability and broader social-structural conditions (e.g., poverty, affordability) that entrap recently-evicted PWUD in the institutional circuit.

Cardiovascular benefits of air purifier in patients with stable coronary artery disease: A randomized single-blind crossover study.

Exposure to PM2.5 will accelerate the progression of cardiovascular diseases. Air purifier can reduce the PM2.5 exposure and theoretically alleviate the influence of PM2.5 on patients with stable coronary artery disease (SCAD). However, few studies of the protective effect showed significant results because the interferent effects of routine medication had not been taken into account. In order to explore the actual effect on patients with SCAD, we conducted a randomized single-blind crossover air purifier intervention trial. Levels of PM2.5 exposure during intervention and cardiovascular indicators (inflammation, coagulation, plaque stability, and blood lipids) after intervention were detected, meanwhile the information of drug use was obtained by questionnaire. The kinds of drug used by more than 20% of the subjects were sorted out. And the influence of these drugs on cardiovascular indicators was summarized through literature review. Based on that, the drug use was included as a variable in linear mixed effects models that used to analyze the associations between PM2.5 exposure reduction by air purifier and cardiovascular indicators. The result revealed that the interpretation contribution rate of drug use was more than that of PM2.5 exposure. The level of C-reactive protein significantly decreased by 20.93% (95%CI: 6.56%, 33.10%), 23.44% (95%CI: 2.77%, 39.39%) and 24.11% (95%CI: 4.21%, 39.69%) on lag1, lag01 and lag02 respectively, while the level of high-density lipoprotein cholesterol significantly increased by 5.10% (95%CI: 0.69%, 9.05%), 3.71% (95%CI: 0.92%, 6.60%) and 6.48% (95%CI: 2.58%, 10.24%) respectively on lag0, lag1 and lag01 associated with an interquartile range decrease of 22.51 μg/m3 in PM2.5 exposure. The study shows positive effects of air purifier on SCAD, and also provides methodological reference for future related research.

Examining racial differences in substance use and HCV among birthing women in a midwestern prison

Given limited data in incarcerated pregnant people, our study aimed to examine the rates of substance use in pregnancy, medications for opioid use disorder, mood disorders, and HCV of Black and White incarcerated women. We conducted a retrospective chart review of women from Michigan’s state prison who had a live hospital birth from January 1st, 2010 through May 31st, 2019. Trinity Health provides all delivery care for incarcerated women in Michigan. Rates of maternal substance use and HCV were determined. Comparisons were completed using Fisher’s exact test. Two hundred and eight women delivered in the study period. Racial distribution was Black (n=77) and White (n=131). Rates of drug use in pregnancy were higher among White women (35.1% vs 16.9%, p < 0.01), as was opioid use (24.4% vs 9.1%, p< 0.05) and medications for opioid use disorder (MOUD) (14.5% vs 2.6%, p < 0.05). Of the 21 women who received MOUD, 17 received methadone and four received buprenorphine. All patients who received buprenorphine were White. White women also had higher rates of HCV (23.7% vs 2.6, p< 0.001). Sixty-four (30.8%) and eleven (5.3%) women used tobacco and alcohol respectively in pregnancy, with no statistical difference by race. Among those who gave birth while incarcerated in Michigan, White women had higher rates of drug and opioid use, MOUD, and HCV than Black women. Additionally, no Black women received buprenorphine. Further research investigating the impact of societal-level conditions including racism, poverty, and geographical sentencing patterns on pregnant people is needed. Targeted interventions must be anti-racist and address pre-incarceration factors as well as justice in care.

Panniculus retractor use during scheduled cesarean section: potential neonatal impact

Use of a disposable panniculus retractor (DPR) during cesarean section (CS) improves surgical site visualization in obese women. However, whether this redistribution of weight onto the uterus and abdominal vasculature just prior to delivery impacts neonatal outcomes is unclear. To assess the potential downstream effect of DPR, we investigated neonatal outcomes after scheduled CS for deliveries using DPR. A retrospective cohort study of term pregnant patients with body mass index (BMI) ≥ 40.00 kg/m2 who underwent a scheduled CS at a tertiary care center from June, 2018 to May, 2019. CS using a DPR were compared to those without. Exclusion criteria included multiple gestation, fetal anomalies and general anesthesia. Universal umbilical artery (UA) cord gas collection is performed at our institution. The primary outcome was UA pH. Secondary outcomes were UA pH< 7.1, APGAR scores at 1 min and 5 min, neonatal intensive care (NICU) admission, and other UA gas parameters. Descriptive statistics and univariate analysis were performed. Multivariable logistic regression was used to adjust for potential confounders. 91 patients met inclusion criteria, including 23 (25.3%) with intraoperative DPR use and 68 (74.7%) without. Patients in the DPR group had a higher BMI (49.4 kg/m2 ±7.8 vs 45.9 kg/m2±6.1 [p=0.03]), and higher rates of drug use (47.8% vs 16.2% [p< 0.01]). UA pH was similar between groups (7.21±0.09 vs 7.24±0.06 [p=0.13]) as was UA pH < 7.1 (4.3% vs 1.5% [p=0.56]). UA lactate was significantly higher in the DPR group (4.0mmol/l±1.9 vs 3.2mmol/l±1.2 [p=0.02]). However, the risk of UA lactate > 4 mmol/l and NICU admission were similar between groups (aRR 2.52 [0.81, 3.53] and aRR 1.92 [0.31, 8.59], respectively). Intraoperative use of DPR did not significantly impact rates of neonatal acidemia at time of delivery. However, as elevated UA lactate represents early hypoxemia, more research is needed to assess the impact of increased lactate and whether this indicates an emerging trend.

Understanding the longitudinal relationship between substance use and violent victimization among street-based women who exchange sex in Baltimore, Maryland.

Women who exchange sex (WES) experience extensive interpersonal violence from multiple perpetrators. Violence towards WES contributes to poor mental and behavioral health outcomes, including high rates of drug use. However, it is difficult to disentangle the temporal relationship between drug use and violence among WES. We used data from 251 WES, who completed baseline and 6-month follow up surveys. WES reported baseline sociodemographic characteristics, including homelessness and hunger. Participants reported their drug use by type and violent experiences by perpetrator at each time point. We conducted a path analysis examining the associations between drug use and violent victimization over time. Participants were on average 37.8 years old, non-Hispanic White (57.4%) and experiencing high levels of structural vulnerability (59.4% homelessness; 58.6% weekly hunger). Drug use and violence were significantly correlated within each time point. Prospectively, baseline violent victimization was significantly associated with drug use (ß (SE)=0.13 (0.06)) and violence (ß (SE)=0.47 (0.05)) at follow up. Baseline drug use was associated with drug use at follow up (ß (SE)=0.45 (0.05)) but was not significantly associated with violence at follow up (ß (SE)=0.10 (0.06)). Violence and drug use are closely linked in this population; and violence appears to facilitate sustained drug use. Interventions to address the dual epidemics of violence and substance use in this population should address underlying trauma as well as socio-structural drivers of violence as well as tailored harm reduction services for this population.

Prevalence of injected drug use and access to OAT in prison: survey in 7 EU countries, 2014-2018

Abstract Background People in prison report high rates of drug use and drug-related problems and people who use or inject drugs (PWUD) have higher rates of offending and an increased likelihood of spending part of their lives in prison. They represent a vulnerable population with high burden of diseases, socio-economic disadvantages and limited access to healthcare. In this study, we aimed to describe the lifetime prevalence (LTP) of heroin use, injected drug use and opioid agonist therapy (OAT) among people living in prison. Methods Individual data collection was carried out in seven European countries (Czech Republic, Latvia, Lithuania, Poland, Portugal, Slovenia, Spain) between 2014 and 2018 with a model European Questionnaire on Drug use among people in Prison. Risk factors analysis was carried out using multivariate logistic regression model. Results The analysis of EQDP data found that the LTP of heroin use was overall 22.4% (ranged from 7.3% in Poland to 27.5% in Spain). Female, recidivist offenders, individuals aged below 44 and with an history of mental health condition had a higher likelihood of being heroin user (p-value&amp;lt;0.05). The LTP of injected drug use was overall 20.6%(2176/10,587), while the prevalence of injected drug use in prison was 8.1%(745/9273) (with higher prevalence in countries that did not allow OAT initiation in prison: 17.5% in Latvia, 22.1% in Lithuania and 26.7% in Czech Republic). Among those who used heroin, 44.5%(772/1735) had access to OAT and among them 95.8(566/591) had access to OAT in prison. Conclusions Despite the heterogeneity of the results, there is a clear evidence that people in prison have a high prevalence of heroin and injected drug use. Prisons are an important point of access to OAT, and where treatment is available there is a reduction in risk behaviour. It is also important to implement tailored preventive interventions among vulnerable social groups at the community level. Key messages • People in prison in Europe have a high prevalence of heroin and injected drug use. Prisons can represent a point of access to integrated prison-community healthcare and social services for PWUD. • In order to plan adequate healthcare interventions, there is an urgent need to assess and monitor the prevalence of drug use also in other European countries.

SAĞLIK ÇALIŞANLARININ COVID-19 PANDEMİSİ DÖNEMİNDE UYKU KALİTESİNİN ARAŞTIRILMASI

Amaç&#x0D; Bu çalışma, hastane çalışanlarında, pandemi döneminde&#x0D; yoğun iş temposu ile uyku kalitesi arasındaki&#x0D; ilişkinin araştırılması amacıyla yapıldı.&#x0D; Gereç ve Yöntem&#x0D; Kesitsel tipteki araştırmamıza hastanede çalışan sağlık&#x0D; çalışanları dahil edildi. Veriler hastanede pandemi&#x0D; sürecinde aktif olarak görev alan personele; Tanıtıcı&#x0D; Anket Formu, Pandemi Değerlendirme Anketi ve Pittsburg&#x0D; Uyku Kalitesi İndeksi kullanılarak elde edildi.&#x0D; Verilerin değerlendirilmesinde; tanımlayıcı istatistik,&#x0D; ki-kare, korelasyon, t testi ve tek yönlü varyans analizi&#x0D; (ANOVA) kullanıldı.&#x0D; Bulgular&#x0D; Çalışmamıza hemşire, sağlık teknisyeni, doktor, idari&#x0D; personel ve temizlik personelinden oluşan toplam 103&#x0D; sağlık çalışanı (Erkek: 36 (%35), Kadın: 67 (%65)) katıldı.&#x0D; Çalışanların görev süresi ortalaması 14,12±9,73&#x0D; yıl olarak saptandı. Sağlık profesyonellerinin vücut&#x0D; kitle indeksi (VKİ) erkek: 26,33±3,13 kg/m2, kadın:&#x0D; 24,07±3,70 kg/m2 olarak bulundu. Çalışmamıza katılan&#x0D; sağlık profesyonellerinin çoğunluğu cerrahi Bölümde&#x0D; (25 (%24,3)), yoğun Bakımda (19 (%18,4), acil&#x0D; serviste (15 (%14,6)) ve idari kısımda (13 (%12,6)) çalışmaktaydı.&#x0D; Geri kalanları laboratuvarda (9 (%8,7)),&#x0D; COVID-19 polikliniğinde (7 (%6,8)), ve diyalizde (5&#x0D; (%4,9)) çalışmaktaydı. Pandemi öncesi uyku bozukluğu&#x0D; ve buna bağlı olarak ilaç kullanım oranı düşüktü.&#x0D; Pandemi sürecinde; sağlık profesyonellerinde Hemşire&#x0D; ve Temizlik Personeli arasında istatistiksel olarak&#x0D; anlamlı farklılık vardı ve PUKİ puanları Hemşirelerde&#x0D; yüksek bulundu (p=0,002).&#x0D; Sonuç&#x0D; Pandemi döneminde hastane çalışanlarında uyku&#x0D; kalitesinin artan iş yükü ile beraber azaldığı ve artan&#x0D; kaygı düzeyleri ile beraber sağlık çalışanlarının yaşamını&#x0D; olumsuz etkilediği saptandı.

The Meaning of Religion in Drug Rehabilitation Patients

There is a religious problem in today's modern life, such as a shift in religious values, which is indicated by the high rate of drug use among youths. In reality, these teens' primary motivation for doing drugs is to fulfill their curiosity about the drugs because adolescence is a psychologically curious enough stage of life. As a result, several measures try to reduce drug usage, one of which is to conduct rehabilitation based on religion, as was done at Inabah XX. This article will define religiosity in terms of belief, rituals, intellectual, experience, and consequence dimensions for drug rehabilitation patients. This study uses a qualitative methodology to gather data through observation, documentation, and interviewing procedures. Based on the collected data, the researchers discovered that drug rehabilitation patients fully believe in Islamic religious doctrines, including the presence of God, angels, prophets, sacred books, heaven, and hell. The Inabah program demonstrates a rise in diversity in religious practices, including fasting, prayer, and Qur’anic recitation. The inner serenity that rehabilitation patients experience is influenced by how obediently they perform dhikr and prayers. However, this ran contrary to how strictly they fast. Most of them are pretty ignorant regarding religion, but others are well-informed since they have studied religion since they were young. In terms of practice, the majority of them have managed to avoid drinking and thieving. Nevertheless, a few people still find it impossible to stop doing these forbidden acts.