Reasons For Use Research Articles

Medical marijuana in pediatric oncology: What your patients are thinking.

Medical marijuana in pediatric oncology: What your patients are thinking.

Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey

Cannabidiol (CBD) is widely advertised as helpful for chronic pain management but research is limited. Using a cross-sectional, anonymous survey, we examined patterns of naturalistic CBD use among individuals with fibromyalgia (FM) and other chronic pain conditions. Our objective was to better understand rates of CBD use, reasons for use and discontinuation, communication with healthcare professionals about CBD, and perceptions of CBD effectiveness and safety among people with FM. After excluding incomplete surveys, our study population consisted of N = 2,701 participants with fibromyalgia, primarily in the United States. Overall, 38.1% reported never using CBD, 29.4% reported past CBD use, and 32.4% reported current CBD use. Past-year cannabis use was strongly associated with past or current CBD use. Those using CBD typically did so due to inadequate symptom relief, while those not using CBD typically cited safety concerns as their reason for not using CBD. Two-thirds of participants disclosed CBD use to their physician, although only 33% asked for physician advice on using CBD. Participants used CBD for numerous FM-related symptoms (most commonly pain), and generally reported slight to much improvement across symptom domains. Around half of participants reported side effects, which were typically minor. Our findings are limited by selection bias and our cross-sectional design, which prevents causal associations. In conclusion, CBD use is common among individuals with FM and many individuals using CBD report improvements across numerous FM-related symptoms. Our findings highlight the need for additional rigorous studies to better understand CBD's potential for FM management. PerspectiveThis article indicates that CBD use is common among people with fibromyalgia, and the results suggest that many derive benefit from using CBD across multiple symptoms domains. Clinicians should discuss CBD use with fibromyalgia patients, and future studies are needed to rigorously assess CBD's therapeutic value for fibromyalgia symptoms.

Knowledge & Utilization of Long Lasting Impregnated Nets among Housewives in Al Moneera City and Al Koozi Villages, Hodieda Governorate, Republic of Yemen 2007

Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable groups to malaria infection (pregnant women and children under 5 years). After one year of distribution, there is a need to measure the use rate among vulnerable groups and explore factors affecting their use. The aim of the study was to investigate the use rate of long lasting impregnated nets among children under five years and pregnant women in Al Moneera city and Al Koozi villages of Hodieda governorate. Methodology: Cross section study with multistage sample, Random selection of one urban and one rural locality. 768 housewives were interviewed, proportionally allocated sample according to the number of vulnerable groups in each locality. Systematic random sample to select households. Results: The use rate of LLINs for vulnerable groups was 74.3% CI (71.2 - 77.4). There was no statistically significant association between the use of LLINs and residence, also with ages of housewives, occupation, type of house, but there is strong statistically significant association between use of LLINs and having correct information about how to use and to take care of them P value < 0.001, also with educational status of housewives; P value 0.03 and educational status of fathers; P value 0.01. (84%) have correct information about how to use and take care of LLINs and the main source of information was health workers who distributed them. Only 13.4% realized pregnant women as a vulnerable group to malaria infection while about 77.9% realized children as a vulnerable group to malaria infection. The main reason of LLINs use (84.8%) was protection from nuisance of insects. Conclusion and recommendations: There is shortage in the information about the protective effect of LLINs from malaria infection and the main reason of using them is protection from nuisance of insects. There is a need to increase health awareness about the role of LLINs in malaria prevention.

Students’ use of caffeine, alcohol, dietary supplements, and illegal substances for improving academic performance in a New Zealand university

ABSTRACT This study aimed to describe patterns of use and attitudes towards a broad variety of substances for improving academic performance at a New Zealand university. 685 students (from 1800 invited) completed an online questionnaire (38% response rate). They were asked about their lifetime and current substance use for improving academic performance, as well as their reasons for use, attitudes and perceptions of: caffeine, alcohol, dietary supplements, prescription stimulants, other prescription substances, and illicit substances. 80% (95% CI: 76.3, 82.5) reported ever using any substance to help improve academic performance, mainly to stay awake and improve concentration. Caffeine (70%, 95% CI: 66.3, 73.3) and dietary supplements (32%, 95% CI: 28.3, 35.5) were most commonly used. 4% (95% CI: 2.7, 5.9) reported use of prescription stimulants, mostly methylphenidate, and another 4% (95% CI: 2.7, 5.9) reported using illicit substances for improving academic performance. Users of prescription stimulants were more likely than non-users to believe that they were safe, morally acceptable, and that they should be available legally for enhancing academic performance. We close with discussions on broadening the focus of substances for improving academic performance in public health debates. Further qualitative research from small countries is also needed to move towards a place-based approach for clarifying ethical implications, inform policy in universities, and understand how injustices are created through the use of and ability to purchase different substances.

Prevalence and reasons behind use of injectable contraceptive among the women of reproductive age group: A cross-sectional survey in rural areas of Nadia District, West Bengal

Context:Estimated 42 million reproductive age group women currently use injectable contraceptive, fourth most prevalent contraceptive worldwide.Aims:To find out the prevalence, reasons and the associated factors for using injectable contraceptive among the women of reproductive age group.Settings and Design:A sub-centre-based observational, cross sectional survey was conducted among 212 reproductive age group women living in the rural areas of a district, West Bengal.Methods and Material:A multi-stage cluster random sampling technique was done considering villages as the cluster to get the required sample. Totally, 212 reproductive age group women were chosen from a total of 16 villages, selected by simple random sampling. Information regarding study variables was collected by direct interview of the respondents by visiting individual houses with help of a pre-designed, semi-structured proforma. Strict confidentiality and anonimousity were maintained throughout the study.Statistical Analysis Used:Data were analysed with SPSS 22.0 (licensed). Mean, median, proportion were used for quantitative variables whereas qualitative attributes were presented by proportion. Associations between dependent and independent variables were tested by Chi-square test.Results:The proportion of teenage marriage was unexpectedly high. More than half mothers were unwilling to have babies in future. One-third of study population used injectable contraceptive, ASHA was the main suggestion provider in choosing the method. The major reasons of use were discomfort in previous method and suggestion of service provider. Irregular menstrual problem and easy maintenance was the commonest cause of dissatisfaction and satisfaction, respectively.Conclusions:Use of injectable contraceptive must be sincerely promoted through social marketing and the front line health workers should motivate the women to use it by providing correct information.

1268. Dalbavancin for the Treatment of Infections due to Staphylococcus aureus

BackgroundDalbavancin is a lipoglycopeptide antibiotic active against gram-positive organisms. Its extended half-life allows for weekly dosing that can last 4 to 6 weeks with 2 doses. Although approved for treating skin and soft tissue infections, use for more complicated infections is appealing, particularly when daily intravenous antibiotics are impractical. S aureus is the most common cause of complex infections for which dalbavancin is considered at our institution, so we sought to better understand its use.MethodsWe conducted a retrospective study to describe dalbavancin use at our institution for infections caused by Staphylococcus aureus. We identified all patients ≥18 years who received ≥1 dose of dalbavancin. Infectious disease faculty reviewed charts for clinical characteristics and outcomes of the infections.ResultsFifty-two patients with S. aureus infections (60% MRSA) were treated with at least a partial course of dalbavancin. Twenty-seven (52%) had a history of IV drug use (IDU) and the most common infections were bone and joint infection in 51% and bacteremia in 40% (Table 1). The most common dosing regimen was 1500 mg x 1 in 55% or 1500 mg weekly x 2 in 25% (Table 2). The most common reasons for use of dalbavancin were history of IDU in 48% and lack of a safe home environment in 21%. Suppressive oral antibiotics for the primary infection were prescribed to 3 patients after completing dalbavancin (2 received for other indications). Clinical outcomes include 15% of patients lost to follow-up, readmission due to infection recurrence or dalbavancin adverse effects in 12%, and overall infection recurrence or relapse by day 90 in 31% (Table 3). There were no severe dalbavancin-related adverse drug events.Table 1. Patient and Disease Characteristics Table 2. Dalbavancin Use Characteristics Table 3. Clinical Endpoints ConclusionWhile our results suggest dalbavancin is well tolerated, questions about relapse rates in the treatment of complicated S. aureus infections remain. Further research is needed to evaluate clinical outcomes for dalbavancin compared to standard of care antibiotics and to better elucidate whether relapses were related to true antibiotic failure versus other complexities of the S. aureus infections.Disclosures All Authors: No reported disclosures

A Latent Transition Analysis of Self-Reported Reasons for Marijuana Use During Young Adulthood.

Individuals' reasons for marijuana use have been linked to their risk for continued use and development of disordered use. Although individuals tend to have multiple reasons for use, co-occurrence of reasons is not always accounted for in analytic approaches. Latent transition analysis (LTA) is ideal for modeling transitions in co-occurring reasons. Using longitudinal panel data from Monitoring the Future, LTA was used to identify profiles of self-reported reasons for marijuana use among young adults, examine transitions between profiles, and determine whether cohort, gender, race/ethnicity, parent education, grade of first marijuana use, and 4-year college attendance predicted transitions between profiles. Data included senior year cohorts from 1976-2009 and were collected at ages 19/20, 21/22, and 23/24 (weighted n = 7,294; 55.9% female; 79.3% White). Five latent classes were identified: Non-Users and individuals with Experimental, Typical, Get High + Relax, and Escape + Coping Reasons. Transitions among Non-Users, Experimental Reasons, and Typical Reasons were common; generally, those with earlier cohort membership, early initiation, college non-attending parents, and college attendance were more likely to make transitions to higher-risk classes. As the legalization of recreational marijuana use continues to expand, change over time in reasons for use should be considered carefully as interventions are developed and implemented.

Students’ use of GCSE access arrangements

Access arrangements (AAs) in GCSE and GCE examinations are the reasonable adjustments made for students with special educational needs and disabilities (SEND) under the Equality Act 2010. The Joint Council for Qualifications (JCQ) sets out evidence requirements for allowing AAs on behalf of awarding bodies, although there is a lack of research into the efficacy of AAs in enabling students with SEND to demonstrate their attainment. This article reports findings from research in a school for 11‐ to 16‐year‐olds, which gathered feedback from 60 students on their use of AAs in GCSE examinations. Outcomes for those allowed AAs are compared with those who had none. Use of extra time and students’ reasons for use or non‐use are also reported. The researchers recommend research into the predictive utility of AA evidence requirements for allowing extra time, and time sufficiency in exams for all students.

Driving After Cannabis Use Among Young Adults in Michigan.

Introduction: Driving after cannabis use is associated with a number of risks. Examination of driving after cannabis use among young adults is particularly important, as young adults have the highest rates of cannabis use and among the highest rates of traffic crashes. The current study examines rates and correlates of driving after cannabis use among young adults (aged 18-25) who reported past month cannabis use. Methods: Participants were from Michigan and recruited through paid Facebook and Instagram advertisements between February and March 2018 (n=461). Results: Nearly a third (31.9%) of the sample reported driving after cannabis use in the past month. Young adults who were employed (aOR=1.872, p=0.045), had medical cannabis cards (aOR=2.877, p<0.001), endorsed coping reasons for use (aOR=2.992, p=0.007), and endorsed social/recreational reasons for use (aOR=1.861, p=0.034) had greater odds of driving after cannabis use. Students had lower odds of driving after use (aOR=0.573, p=0.011). Conclusions: Employment and having a medical cannabis card may be important risk markers for identifying individuals more likely to drive after use of cannabis. Prevention efforts could provide psychoeducation at dispensaries to individuals with medical cannabis cards about the risks of driving after use. Coping motives for cannabis use may also be useful in identifying young adults at the greatest risk of driving after use of cannabis.

Exercise Recovery Practices of Wheelchair Court Sports Athletes

Murphy, CJ, Mason, BS, and Goosey-Tolfrey, VL. Exercise recovery practices of wheelchair court sports athletes. J Strength Cond Res 35(2): 366-372, 2021-Research that describes the recovery practices of Para-athletes around training and competition is limited. This study investigated if and why athletes in wheelchair court sports (basketball, rugby, and tennis) use recovery strategies, what type of strategies are used, and whether the period of the season influences the prevalence of use. A cross-sectional questionnaire was developed to acquire data pertaining to individual characteristics, recovery habits, reasons for use/nonuse, the use of specific recovery strategies, and lifestyle habits. One hundred forty-four athletes (92 = international and 52 = national/club) completed the questionnaire online. In total, 85% (n = 122) of athletes reported using at least one type of recovery strategy, yet most specific types of recovery strategies were not popular (<34% of recovery strategy users). The most commonly used type of recovery strategy was stretching (n = 117), whereas both stretching and heat-related recovery were the most highly rated types of recovery strategies (μ = 4.2/5). The 3 most prevalent reasons for use across all strategies were "reduces muscle soreness," "reduces muscle tightness," and "reduces muscle spasms." The prevalence of sleep complaints was apparent with 38% (n = 55) of respondents reporting difficulties sleeping. This study highlights that although the frequent use of well-known recovery practices is positive, the lack of diversity in strategies implemented may have implications due to the specific requirements of exercise recovery. Therefore, strength and conditioning professionals should educate wheelchair athletes further around this area and increase the range of recovery-specific and impairment-specific strategies used.

Ingestion of herbal medication during pregnancy and adverse perinatal outcomes

Background. Pregnant women in South Africa (SA) traditionally use herbal medicines even though the potential risk or benefit is not fully elucidated. Objectives. To determine the prevalence of the use of herbal medicines in pregnant women in our setting, as well as explore the reasons for use. Methods. This cross-sectional study was conducted at King Edward VIII Hospital, from 1 September 2014 to 31 December 2014. Women were interviewed using a structured questionnaire during the post-delivery period, irrespective of outcome. The questionnaires enquired about women’s demographic data, social and previous obstetric history and herbal medication use during current pregnancy. Results. Two hundred and ninety-nine women were interviewed. The prevalence of herbal medication use was 33.7% ( n =101), mainly via the oral route. Fifty-eight (57.4%) of these women used herbal medication throughout their pregnancy. Reasons given for herbal ingestion included general well-being, or to make labour easier or come sooner. There was a high rate of caesarean delivery among pregnant women who used herbal medication compared with those who did not (79.2% v. 52.8%; p =0.001). One hundred and eighteen women had meconium-stained liquor; 59% of the herbal medication users compared with 29.6% of the non-users ( p &lt;0.001) comprised this group.The perinatal mortality rate was also higher among users ( p &lt;0.04). There were no maternal deaths. Conclusion. Herbal medicine was used by a third of black South African pregnant women in this study and was associated with significant adverse obstetric and perinatal outcomes.

Self-medication practices during the COVID-19 pandemic among the adult population in Peru: A cross-sectional survey

Self-medication impacts both negatively and positively the health of people, which has become evident during the COVID-19 pandemic. The study aimed to assess the prevalence of self-medicated drugs used for respiratory symptoms, as COVID-19 preventive, for its symptoms or once tested positive. To determine the perception of symptom relief and demographic variables that promote self-medication in Peru. We performed a cross-sectional, analytical, multicenter study in 3792 study respondents on the use, the reason for use, and perception of relief after the use of six drugs during the quarantine period. An online questionnaire was developed, pretested and submitted to the general public. Multivariable logistic regression was used to ascertain factors that influence an individual’s desire to self-medicate, associations were considered significant at p < 0.05 and using region (coast, mountain and jungle) as cluster group. The majority of respondents self-medicated with acetaminophen for respiratory symptoms and mainly because they had a cold or flu. It was observed that all the surveyed drugs (acetaminophen, ibuprofen, azithromycin, penicillin, antiretrovirals and hydroxychloroquine) were consumed for various symptoms including: fever, fatigue, cough, sneezing, muscle pain, nasal congestion, sore throat, headache and breathing difficulty. Over 90% of respondents perceived relief of at least one symptom. Multivariable logistic regression showed that older people have a higher frequency of antiretroviral self-medication, respondents who currently have a job had a higher frequency of penicillin self-medication, and that respondents from the Andes consumed less acetaminophen, while the ones from the rainforest consumed it more. There were significant percentages of self-medication, including drugs without sufficient scientific evidence. Age, region where one lived and job status were variables associated with self-medication frequency. Continuous awareness and sensitization about the risks of self-medication are warranted.

A neglected source of household air pollution: a preliminary, mixed methods study of purposely produced household smoke in Wollo, Ethiopia.

Ill health associated with household air pollution (HAP) is increasingly recognized as a public health problem in sub-Saharan Africa. To date, attempts to reduce HAP have focussed on smoke from cooking fires and have ignored traditional cultural practices which generate purposely produced smoke (PPS). This study aimed to investigate PPS prevalence, reasons for use and safety perceptions. The study was conducted in Wollo, Ethiopia, and used a mixed methods approach of quantitative surveys (analysed descriptively) and qualitative interviews with householders and healthcare workers (analysed thematically). PPS use was reported by 99% of survey respondents and it was considered a fundamental part of life. Although reasons for use included housekeeping, culture/religion and well-being, coffee ceremony was most commonly cited (44% of respondents). Both householders and healthcare workers appeared to assume PPS is safe, except for people with certain underlying conditions. Healthcare workers felt the lack of evidence of harm from PPS meant there was no justification for intervention. This study, the first in-depth study of PPS, has shown its use to be widespread, with many perceived benefits and thus a very important part of local culture in this sample Ethiopian community. Consequently, any public health interventions aimed at reducing HAP in this setting need to consider PPS.

A point prevalence survey to assess antibiotic prescribing in patients hospitalized with confirmed and suspected coronavirus disease 2019 (COVID-19)

BackgroundEarlier studies have reported high antibiotic use in patients hospitalised for coronavirus disease 2019 (COVID-19), resulting in concerns of increasing antimicrobial resistance with increase antibiotic use in this pandemic. Point prevalence survey (PPS) can be a quick tool to provide antibiotic prescribing information to aid antimicrobial stewardship (AMS) activities. ObjectivesTo describe antibiotic utilization and evaluate antibiotic appropriateness in COVID-19 patients using PPS. MethodsAdapting Global-PPS on antimicrobial use, the survey was conducted in COVID-19 wards at 2 centres in Singapore on 22 April 2020 at 0800h. Patients on systemic antibiotics were included and evaluated for antibiotic appropriateness. ResultsFive hundred and seventy-seven patients were screened. Thirty-six (6.2%) patients were on antibiotics and which were started at median of 7 days (inter-quartile rate (IQR), 4, 11) from symptom onset. Fifty-one antibiotics were prescribed in these patients. Overall, co-amoxiclav (26/51, 51.0%) was the most often prescribed antibiotic. Thirty-one out of 51 (60.8%) antibiotic prescriptions were appropriate. Among 20 inappropriate prescriptions, 18 (90.0%) were initiated in patients with low likelihood of bacterial infections. Antibiotic prescriptions were more appropriate when reviewed by infectious diseases physicians (13/31 [41.9%] versus 2/20 [10.0%], p=0.015), and if reasons for use were stated in notes (31/31 [100.0%] versus 16/20 [80.0%], p=0.019). ConclusionsDespite low prevalence of antibiotic use among confirmed and suspected COVID-19 patients at 2 centres in Singapore, there was significant proportion of inappropriate antibiotics use where bacterial infections were unlikely. AMS teams can tailor stewardship strategies using PPS results.

Internet Users in Damanhur’s Town, Characteristics, Problems, and Spatial Variability.

Abstract The aim of the study was to identify the factors influencing the use of internet in Damanhur town, analyzing population demographic, economic and social characteristics, and identifying levels of satisfaction with the network and its positive and negative aspects. The study adopted the analytical inductive approach which detailing and clarifying the phenomenon of internet users to reach the desired results, it also relied on SPSS for many statistical and cartographic methods. The study resulted in several results, which were: - Age group (15, less than 30 years old) has the highest internet penetration rate in town. - High percentage of low-income network users. - The use of the network through social networking sites at the top of the reasons for use. - Most users were satisfied with the cost and efficiency of internet, despite the multitude of problems. - Continuation of the sample of the study in the use of internet, despite the problems that may be. Key Words: Internet users, population satisfaction, Damanhur town.

African indigenous contraception: A review.

In Africa, indigenous methods of contraception continue to play a significant role in preventing unwanted pregnancies despite the introduction and popularity of modern contraceptives. The current review identified the common techniques and practices of African indigenous contraception, and examined their mechanisms and reasons for use. We searched data bases such as Google Scholar, Scopus, Web of Science, EBSCohost, African Journals, Science Direct, textbooks, thesis and dissertations for research articles on African indigenous contraception. The six common techniques of African indigenous contraception included periodic abstinence, withdrawal, breastfeeding, use of herbs, postpartum abstinence and waist bands, whilst practices relate to child (birth) spacing, postponement of first birth (virginity), stopping of reproduction and indigenous emergency contraception. Mother and infant health was stated as one of the reasons for using African indigenous contraception. African indigenous contraception continues to play a critical reproductive role in preventing unwanted pregnancies. However, there is lack of clarity regarding mechanisms, the safety, and efficacy of some techniques.

Women's cannabis use before, during, and after pregnancy in New Hampshire.

Cannabis use in the United States has been steadily increasing. Much more is known about cannabis users in states where recreational cannabis is legal, compared to states yet to legalize. Further, there is little information known about reasons for cannabis use during critical maternal and child health periods. To address this gap, we examined cannabis use among New Hampshire women during the preconception, prenatal, and postpartum periods, and explored reasons for use. We analyzed data from the 2016-2017 Pregnancy Risk Assessment Monitoring System (PRAMS) in the Spring of 2020. For women delivering a live-born infant, PRAMS collects behavior and experience data before, during, and after pregnancy. Using data from New Hampshire, we estimated the weighted prevalence of self-reported cannabis use during the preconception, prenatal, and postpartum periods, and reasons for use during each period. Of the 1147 women included in the analysis, 16.8% (unweighted n=186) reported preconception cannabis use, 5.5% (unweighted n=68) reported prenatal cannabis use, and 6.6% (unweighted n=73) reported postpartum cannabis use. About one-fifth (20.3%) of women who reported cannabis use reported use during all three periods. The top reason for cannabis use during preconception and postpartum was for stress or anxiety relief (64.88% and 73.06, respectively), and during the prenatal period was for its' antiemetic properties (84.1%). Our findings support that women's healthcare providers should screen patients for cannabis use, addressing underlying reasons (e.g., mental health issues, nausea/vomiting) for use as part of the screening process.

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

ObjectivesTo determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe.MethodsA literature search was performed on Pubmed, ScienceDirect and EMBASE. Keywords: ‘herbal medicine’ OR ‘herbal and dietary supplement’ OR ‘complementary and alternative medicine’ AND ‘reason’ OR ‘attitude’. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a ‘risk of bias’ assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage.Results231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05).ConclusionsDissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.

Characterizing Trends in Synthetic Cannabinoid Receptor Agonist Use from Patient Clinical Evaluations during Medical Toxicology Consultation

ABSTRACT Synthetic cannabinoid receptor agonists (SCRAs) are a new class of compounds with profound psychoactive effects and potential toxicity. This study characterizes patterns in SCRA abuse using qualitative interviews with individuals receiving medical toxicology consultation. Patients with suspected exposure to a new psychoactive substance were interviewed by medical toxicologists upon presentation for acute care. Investigators collected clinical and qualitative data including knowledge, attitudes, beliefs, and practices related to psychoactive substance use. Responses were categorized by identifying themes, and statistics were generated to describe patterns of use. Overall, 69% (86) of the 124 cases of novel psychoactive substance use entered into the registry were associated with exposure to SCRAs. Most patients (68.8%) had used SCRAs at least once before the presenting episode. 47.7% considered SCRAs to be very easy to obtain, and 44.2% reported paying for the substances while 32.6% acquired it for free. Nearly half (48.8%) of patients reported their primary reason for use was to get high; a small proportion used SCRAs to avoid testing positive on drug screening (6.9%) or as an alternative to marijuana (4.6%). Findings suggest an independent and stable culture is developing around the use of SCRAs separate from their appeal as an “undetectable” alternative to marijuana.

The non-steroidal anti-inflammatory drug salsalate provides safe and effective control of mucositis-unrelated pain during autologous and allogeneic hematopoietic stem cell transplantation.

Pain is a serious adverse event which frequently accompanies hematopoietic stem cell transplantation (HSCT). The safety and efficacy of NSAIDS during HSCT is currently unknown. Salsalate is a platelet-sparing NSAID with a favorable toxicity profile compared with other NSAIDS. We report the safety and efficacy of salsalate for different types of pain during SCT. We conducted a retrospective study of SCT recipients empirically treated with salsalate for > 48h. Pain scores were assessed using the verbal rating scale for pain. A subset analysis of patients who received > 7days of salsalate during periods of pancytopenia, mucositis, and other end-organ toxicities is included. Sixty-four patients, 42 auto- and 22 allografts, were identified. Reason for use: vertebral-related pain (30%), musculoskeletal (30%), and cytokine inflammatory pain syndromes (24%). Median dose 1500mg/day, number of treatment days = 5, started on day+5 post-HSCT. Pain resolved/improved to pain score < 4 in 76% and stable in 15%. Forty-four patients (28-auto and 16 allografts) received > 7-day salsalate. Median WBC and platelet nadir were < 0.1 and 10,000 cells/ml respectively. pain was improved or eradicated in 64% and stable in 32%. LFT elevation (n = 2), elevated serum creatinine (n = 2), and minor bleed (n = 5-nose, gums, and urine). Salsalate discontinuation (n = 6): ineffective (n = 1), the liver (n = 1), the kidney (n = 1), > 5 platelet transfusions (n = 1), and vomiting (n = 2). There was no treatment related mortality. Salsalate was well tolerated, safe, and beneficial for several different types of pain during HSCT.