Risk Factors For Substance Abuse Research Articles

Parent-child conflict: A risk factor for substance abuse among adolescents

Parent-child conflict: A risk factor for substance abuse among adolescents

Motor impulsivity but not risk-related impulsive choice is associated to drug intake and drug-primed relapse.

Motor impulsivity and risk-related impulsive choice have been proposed as vulnerability factors for drug abuse, due to their high prevalence in drug abusers. However, how these two facets of impulsivity are associated to drug abuse remains unclear. Here, we investigated the predictive value of both motor impulsivity and risk-related impulsive choice on characteristics of drug abuse including initiation and maintenance of drug use, motivation for the drug, extinction of drug-seeking behavior following drug discontinuation and, finally, propensity to relapse. We used the Roman High- (RHA) and Low- Avoidance (RLA) rat lines, which display innate phenotypical differences in motor impulsivity, risk-related impulsive choice, and propensity to self-administer drugs. Individual levels of motor impulsivity and risk-related impulsive choice were measured using the rat Gambling task. Then, rats were allowed to self-administer cocaine (0.3 mg/kg/infusion; 14 days) to evaluate acquisition and maintenance of cocaine self-administration, after which motivation for cocaine was assessed using a progressive ratio schedule of reinforcement. Subsequently, rats were tested for their resistance to extinction, followed by cue-induced and drug-primed reinstatement sessions to evaluate relapse. Finally, we evaluated the effect of the dopamine stabilizer aripiprazole on reinstatement of drug-seeking behaviors. We found that motor impulsivity and risk-related impulsive choice were positively correlated at baseline. Furthermore, innate high levels of motor impulsivity were associated with higher drug use and increased vulnerability to cocaine-primed reinstatement of drug-seeking. However, no relationships were observed between motor impulsivity and the motivation for the drug, extinction or cue-induced reinstatement of drug-seeking. High levels of risk-related impulsive choice were not associated to any aspects of drug abuse measured in our study. Additionally, aripiprazole similarly blocked cocaine-primed reinstatement of drug-seeking in both high- and low-impulsive animals, suggesting that aripiprazole acts as a D2/3R antagonist to prevent relapse independently of the levels of impulsivity and propensity to self-administer drugs. Altogether, our study highlights motor impulsivity as an important predictive factor for drug abuse and drug-primed relapse. On the other hand, the involvement of risk-related impulsive choice as a risk factor for drug abuse appears to be limited.

An approach for studying the contributions of childhood sexual abuse and HPA axis dysregulation to substance use disorders

An environmental risk factor for substance abuse and dependence is childhood sexual abuse (CSA). We piloted an approach we developed to test the hypothesis that hypothalamic-pituitary-adrenal (HPA) axis dysregulation from the stress of CSA is a biological mediator. We based our hypothesis on the allostasis model. New admissions to residential treatment for substance use disorders (N = 41) were evaluated for CSA history and two HPA axis regulation measures at baseline, one month, and two months. The two HPA axis regulation measures were morning cortisol level and the dexamethasone suppression test. Five potential covariates were also measured to increase reliability of the findings. Feasibility outcomes were mostly favorable, and included rates of participation (57 %), attrition (46 % at one month and 71 % at two months), and compliance with data collection procedures (87 % for morning cortisol level and 84 % for the dexamethasone suppression test). High attrition rates at one and two months were entirely attributable to high rates of leaving treatment, an important consideration for future studies. Baseline correlations among variables showed a significant negative correlation between dexamethasone suppression and perceived stress, a potential covariate (rho = −0.458). This finding suggests that individuals with lower stress levels have better negative feedback regulation of the HPA axis, which results in the benefit of lower cortisol exposure—a finding congruent with the allostasis model.

A Comparison of the Efficacy of Different Forensic Methods in Detection of Narcotic Substances from Blood and Urine Samples by Rapid Antigen Test Kit

Introduction: Bangladesh is the most vulnerable country for narcotic drug addiction which is rising at alarming rate and spreading all over the country. These drugs cause serious health injuries to our young generation and child abusers. Our society is facing adverse effects due to drug addiction such as killing, hijacking, raping, western party celebrations etc. Department of narcotic drug control agency seized them every month which includes Heroin, Phensedyl (Codeine preparations), intravenous Morphine, Pethidine, Diazepam, Bromazepam, Yaba (Methamphetamine, Amphetamine with caffeine) and energy drinks containing sildenafil citrate and tadalafil citrate substances. Most of the addicted people are multiple drug users. So these substances should be detected by a rapid, reliable and cost effective method. The aim of the study was to understand the cause and risk factors of drug abuse. Methods: This cross-sectional analytical study was conducted at the outpatient department of Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the period from July 2019 to july 2020 with a responsive sample size of 36. Data was analyzed using Microsoft Excel. During study the ethical clearance was obtained from proper authority. Clearance regarding handling of narcotic samples was also taken from the Ministry of Home Affairs. Result: This study was conducted with a responsive sample size of 36. Of the total 36 samples, 34 were cases and 2 were controls. Post analysis of the used drugs pattern showed that 8.33% of cases used Benzodiazepine+Opioid+PCP, 8.33% of cases used Cocaine+Opioid+THC, 25% of the cases used Opioid+THC, 8.33% cases used BZD+Cocaine+Opioid+THC, 25% cases used BZD+Opioid+THC, 8.33% of cases used Cocaine+Opioid and the rest 16.67% were control and tested negative at the time of data collection. Conclusion: Sources at the department of narcotics control intelligence wing also said that around 10,000 cases are filed and 9,000 people are arrested every year in connection with drug-related violence and crimes. In the present, people are using multiple drugs rather than a single substance. For the rapid detection of drug of abuse the method of priority should be rapid blood sample test by kit to avoid unwanted tempering and a reliable result

Opioid for in-hospital admitted patient analgesics; which demographics and psychiatric profiles need more pain drugs?

Introduction: The prevalence of substance use disorders is higher in patients receiving opioid analgesics, and pain management in these patients is more challenging. This study aimed to investigate the pattern of analgesic drug administration and evaluate the associated factors. Method: The cross-sectional study was performed on 230 patients admitted to General Hospital ( internal medicine, surgery, and cancer wards). Result: The most used analgesic drug was morphine (59.4%), and a mean dose of 27 mg, then pethidine and methadone. Most pain control methods were intravenous (68.1%) and PRN pattern (61.1%). Using analgesics in patients who do not have risk factors for drug abuse, or addiction, can be considered safe. In our subjects, 95.6% of analgesic users did not become addicted or had any misuse. Discussion and Conclusion: For effective and low-risk treatment of these patients, there is a need for clinical skills, knowledge of opioid administration, assessment, and risk management of substance abuse and addiction. In patients with substance abuse, analgesics should be prescribed in a particular setting, under supervision, and with careful monitoring. Structured and planned administration of opioid agonists (such as methadone or buprenorphine) seems appropriate according to a structured schedule. These plans are recommended: · Increasing the awareness of clinicians about prescribing narcotic analgesics. · Prescribing narcotic analgesics with a regular pattern against PRN. · Evaluating patients for a history of substance abuse. · Closely monitoring them, and if necessary. · Counseling. Identifying high-risk groups such as women, youth, and psychiatric patients are also recommended, and performing early interventions.

1.L. Workshop: Assessment of substance abuse in different populations

Abstract Substance abuse is a growing public mental health issue. Recent data from Global Burden of Disease study demonstrate that age standardized DALYs rate attributed to drug use disorders has increased by 25% in age group of 25-49 years during 1990-2019 (Lancet 2020; 396 1204-22). Standardized DALY rate due to alcohol use disorders reduced by 1/5 in this age group during the last 30 years, however it remains among the top 20 causes leading to greatest losses of DALYs in this age group. European countries persist to have high burden of diseases due to substance abuse. Social ecological model enables to structure individual, family, community and broader societal risk factors for substance abuse in specific groups within society. Some European countries (e.g. Germany) face increased migration especially from the war affected countries like Syria. Respective refugees and migrants may demonstrate higher substance abuse (alcohol and drug abuse) prevalence as an outcome of traumatic exposures and reflect the attempts to escape past and present experiences. In other countries (e.g. Lithuania), who still reflect transitional societies, substance abuse rates remain high due to psychosocial stress and structural barriers to implement effective prevention. Identification of risk factors may alleviate targeted and tailored prevention. The aim of the workshop is to systematize substance abuse risk factors in specific population groups based on socio-ecological framework applying different methodological approaches. There is a knowledge gap in culturally sensitive and translated into different languages instruments which assess substance use in refugee populations, especially from the Arabic countries. Therefore, a systematic review results on culturally sensitive substance abuse screening and assessment instruments among refugee populations will be presented. The qualitative study conducted in Germany will provide findings and insights on substance abuse perceptions among Syrian migrants and refugees. Understanding the explanatory model of Syrian refugees could inform future interventions to prevent substance abuse and design tailored interventions. Assessment of the behavioral risk factors related to injecting dug use in Lithuanian population using respondent driven sampling technique will be presented. Identifying individual and social risk factors may lead to targeted and effective prevention. Key messages Context specific knowledge of substance use is necessary for prevention including past and present factors. As refugee populations continue to grow, adequate screening instruments for substance abuse/dependence are needed.

Risk factors for adolescents’ substance abuse

Background Substance abuse is a rising community health problem especially among adolescents throughout the world. Studies for substance abuse including risk factors need to be frequently updated, to refurbish the prevention and management treatments on a scientific basis. Aim To assess the risk factors for adolescents’ substance abuse. Patients and methods A descriptive research design was used. Setting The study was conducted at the outpatient clinic of Helwan Mental Health Hospital (Adolescent Addiction Clinic). Sample A convenience sample of adolescents (N=83) who attended the previously mentioned setting was included. Tools A questionnaire for adolescents about risk factors for substance abuse was used. It consists of 85 questions and includes two parts: part A − demographic characteristics and adolescents’ experiences with substances and part B − risk factors for substance abuse among adolescents. Results The current study revealed that 92.8% of the adolescents were males whereas 7.2% were females. Overall, 79.5% of adolescents were aged from 16 to 18 years, with a mean age±SD of 16.33±1.24 years. Regarding the age of starting substance abuse, 43.4 % of the adolescents started at 14 to less than 16 years, with a mean age±SD of 13.63±1.76. In addition, 71.1% of the adolescents had a smoker among their families, whereas 33.7% had a substance abuser among their families. Moreover, 100% of the adolescents had smoker friends, and 97.6% of their friends were substance abusers. Conclusion The study concluded that many factors can lead to substance abuse among adolescents. The most important factors were having substance abusers among family members and friends. Recommendation Educational programs about risk factors for substance abuse should be given to both parents and adolescents at schools, family health centers, and any family reunion places.

Childhood risk factors for substance abuse in a clinical sample of adults with attention-deficit / hyperactivity disorder (ADHD) symptoms in an addiction outpatient clinic

IntroductionSubstance use disorder (SUD) in patients with ADHD symptoms is associated with a poorer treatment prognosis. The study is aimed to investigate psychosocial risks factors for developing SUD in patients with ADHD.ObjectivesTo examine the associations between self-reported weak academic performance, repetition of a grade, single – parent family, self-reported quality of parent – child relationship, conduct problems in childhood and SUD in adulthood in a sample of outpatients with ADHD symptoms of an addiction medicine clinic in Riga, Latvia.MethodsSelf-report surveys, containing Adult ADHD Self-Report Scale (ASRS-v I.I), were completed by outpatients of addiction clinic, including healthy control subjects (adults without addiction, formally assessed for fitness to drive, firearms licensing etc.). Patients then were examined in relation to childhood risk factors.ResultsSurvey was compleated by 341 outpatients – 98 (28,7%) healthy controls and 243 (71,3%) patients with SUD (mean age, 36,8 and 37,7, respectively; 76,4% males). 62 (18,1%) patients were tested positive for ADHD, of whom 12 (19,4%) were healthy subjects and 50 (80,6%) were with SUD. Data shows connection between conduct problems in childhood (p=0,010), single - parent family (p=0,010), repetition of a grade (p=0,026) and SUD in adults with ADHD symptoms. Comparing patients with and without ADHD symptoms, there was found no significant association between these factors, except for conduct problems (p=0,015).ConclusionsThe study found preliminary evidence that adults with ADHD symptoms who experienced single – parenthood in childhood, had conduct problems or repeated a grade are more likely to develop SUD. Futher investigation is required.

Comorbidity with substance abuse and its influence in a forensic population: A retrospective study

IntroductionThe criminality associated with psychiatric disorders has been extensively studied with some studies showing a greater risk of violence in these patients. Substance abuse has been long linked to criminal and antisocial behaviours, but what happens when is in comorbidity with other psychiatric disorders.ObjectivesThe authors aim to study the impact of substance abuse comorbidity in type of crime and other characteristics in a forensic ward population.MethodsA retrospective study was designed, including patients admitted in the Forensic ward of Coimbra Hospital and University Center between 2018 and 2020.ResultsOur study included 110 patients, 39 of which had comorbidity with substance abuse. Although the authors couldn’t find differences in the type of crime committed regarding the patient’s primary diagnosis, substance abuse was significantly associated with non-violent crimes. The prevalence of homicide was significantly inferior in psychoactive substance users and the prevalence of domestic violence was significantly greater. However, the prevalence of a criminal history was significantly higher in patients with comorbidity with substance abuse. Patients with substance abuse had significantly higher childhood adverse events reports.ConclusionsInterestingly, criminal behaviors prior to admission were more frequent in patients with substance abuse, which is understandable. However, the type of crimes were significantly less serious in this patients, which can mean that, although these consumptions are a risk factor for criminal behavior, the association in less important in crimes like murder. The exposition to childhood adverse events is a well-known risk factor for substance abuse in adulthood.DisclosureNo significant relationships.

Studying Sex Differences in Rodent Models of Addictive Behavior.

Animal models of addictive behaviors are useful for uncovering neural mechanisms involved in the development of dependence and for identifying risk factors for drug abuse. One such risk factor is biological sex, which strongly moderates drug self-administration behavior in rodents. Female rodents are more likely to acquire drug self-administration behaviors, consume higher amounts of drug, and reinstate drug-seeking behavior more readily. Despite this female vulnerability, preclinical addiction research has largely been done in male animals. The study of sex differences in rodent models of addictive behavior is increasing, however, as more investigators are choosing to include both male and female animals in experiments. This commentary is meant to serve as an introductory guide for preclinical investigators new to the study of sex differences in addiction. We provide an overview of self-administration models, a broad view of female versus male self-administration behaviors, and suggestions for study design and implementation. Inclusion of female subjects in preclinical addiction research is timely, as problem drug and alcohol use in women is increasing. With proper attention, design, and analysis, the study of sex differences in addiction has the potential to uncover novel neural mechanisms and lead to greater translational success for addiction research. © 2021 Wiley Periodicals LLC.

Assessment of risk factors for substance abuse among adolescents in urban slums of Belagavi - A cross sectional study

Assessment of risk factors for substance abuse among adolescents in urban slums of Belagavi - A cross sectional study

Prevention and intervention for victims of violence in occupational therapy

ABSTRACT South Africa has one of the highest rates of violent crime in the world resulting in a significant public health concern. The adverse effects are not limited to death and physical injury, but also include numerous other issues which are of immediate concern to occupational therapists, such as depression, anxiety and occupational disabilities. These are risk factors for substance abuse, relationship difficulties and unsafe sexual practices. Intergenerational effects occur when children witness or experience violence and a cycle of violence is established. Yet, occupational therapists contributing to the South African Journal of Occupational Therapy, South African Society of Hand Therapists and the 2018 World Federation of Occupational Therapy congress do not appear to have prioritised this topic. Occupational therapists have been called to address the social determinants of health, to rethink their roles, to become activists and to promote justice. This opinion piece serves as a stepping-stone to further encourage South African occupational therapists to consider a turnaround (pivot) and to face the challenge of becoming leaders in the Prevention and Intervention for victims of Violence in Occupational Therapy (PIVOT).

Chronic pain and substance abuse disorders: Preoperative assessment and optimization strategies.

There is an ever-increasing number of opioid users among chronic pain patients and safely managing them can be challenging for surgeons, anesthesiologists, pain experts, and addiction specialists. Healthcare providers must be familiar with phenomena typical of opioid users and abusers, including tolerance, physical dependence, hyperalgesia, and addiction. Insufficient pain management is very common in these patients. Patient-centered preoperative communication is integral to setting realistic expectations for postoperative pain, developing successful nonopioid analgesic regimens, minimizing opioid consumption during the postoperative period, and decreasing the number of opioid pills at the risk of diversion. Preoperative evaluation should identify comorbidities and identify risk factors for substance abuse and withdrawal. Intraoperative and postoperative strategies can ensure safe and effective pain management and minimize the potential for morbidity and mortality in this high-risk patient population.

Meta-analysis of risk factors for substance abuse in the US military

ABSTRACTThis article describes the results from a meta-analytic review of 55 studies and 78 independent samples containing information about the demographic, contextual, and psychological factors associated with alcohol and drug abuse among United States military personnel. In terms of demographics, results from this analysis reveal higher levels of substance abuse among personnel who are male, younger, have less education, are unmarried, and who are of a lower military rank (E1-E3). In terms of the military context, rates of substance abuse are greater for personnel with combat exposure and a recent or lengthy deployment. Finally, rates of substance abuse are higher among personnel reporting specific psychological symptoms, including negative emotionality, impulsivity, and symptoms associated with depression, posttraumatic stress disorder (PTSD), and traumatic brain injuries (TBI). This study suggests that a number of sociodemographic, psychological, and contextual factors are related to the odds that a military service member engages in high levels of substance abuse. The results provide a strong foundation for the development of interventions aimed toward vulnerable populations in the US military.

Ethanol pre-exposure does not increase delay discounting in P rats, but does impair the ability to dynamically adapt behavioral allocation to changing reinforcer contingencies

Increased subjective discounting of delayed rewards is associated with substance abuse, and individuals tend to discount their drug of choice at a greater rate compared to monetary rewards. While there is evidence indicating that increased delay discounting (DD) is a risk factor for substance abuse, some results suggest that exposure to drugs of abuse also increases DD, but effects are mixed. The current study examined whether ethanol pre-exposure increases DD and if an ethanol reinforcer would be discounted at a greater rate than sucrose. Alcohol preferring (P) rats were pre-exposed to either ethanol or sucrose using an intermittent access protocol (IAP) for 8 weeks. Then animals completed an operant fixed choice procedure where each pre-exposure group was split into either an ethanol or sucrose reinforcer group. Afterwards, animals completed an adjusting delay DD task using the same groups as the fixed choice task. Animals that received access to ethanol in the IAP showed increased delayed reward preference in a delay and session dependent manner. Specifically, ethanol pre-exposed animals took more sessions to decrease their preference for the delayed reward at longer delays. In the adjusting delay task, no differences in mean adjusting delays were seen, but ethanol pre-exposure impaired animals' ability to reach stability criteria. The observed results are not consistent with ethanol pre-exposure causing a change in DD. Rather they indicate ethanol pre-exposure impaired animals' ability to reallocate their behavior in response to a change in reinforcer contingencies. The current findings extend prior results showing alcohol naïve P rats exhibit both increased DD and decreased response inhibition (Beckwith and Czachowski 2014, 2016) by demonstrating that after alcohol exposure they exhibit a form of behavioral inflexibility. Hence, a “two-hit” genetic vulnerability/environmental acceleration of addictive behavior is supported.

Managing risk factors for substance abuse among employees in the waste management sector: Perspectives from an Africa-based public waste management organization

The unique case of substance abuse among employees in the waste management sector seems inadequately described. Based on the perspectives of employees recently released from treatment centers for substance abuse, and their supervisors at a public waste management organization in South Africa, this study explored and described the risk factors for substance abuse in the waste management sector. As part of a collective case study, data were collected through semistructured interviews with employees (n = 10) and a focus group discussion with supervisors (n = 8). Recommendations are offered to manage the risk factors for substance abuse in the waste management sector.

"The drug issue really isn't the main problem"- A photovoice study on community perceptions of place, health, and substance abuse.

Substance abuse is a complex and challenging public health problem. In order to better address substance abuse, it is vital to understand the perspectives of people whose communities are disproportionately impacted by it. This photovoice study aimed to understand how community members perceive the relationship between place, health, and substance abuse in Hartford, Connecticut, one city grappling with substance abuse and its related challenges. Findings revealed three themes: perceived place-based environmental risk factors for substance abuse; coping strategies to maintain sobriety in this challenging environmental context; and participants' recommendations for addressing substance abuse. Implications are discussed.

The prevalence of substance use in child welfare and general population eighth graders in the United States

Background: Early substance use is an established risk factor for substance abuse and dependence. Objective: The current study sought to examine whether child welfare-involved eighth graders have higher rates of early substance use than general population eighth graders. Data from the first National Survey of Child and Adolescent Well-Being (NSCAW) were analyzed to assess the prevalence of self-reported substance use, including alcohol, marijuana, and inhalant use in child welfare-involved eighth graders (N = 896). These figures were compared to general eighth grade student population estimates from the Monitoring the Future Study (N = 16,900) using 95% confidence intervals (CIs). Finally, regression analyses were conducted to examine demographic predictors (i.e., age, gender, race/ethnicity, and out-of-home placement) of substance use among child welfare eighth graders. Results: Results indicated comparable or lower incidence of substances among child welfare eighth graders relative to the general population, but higher past 30-day inhalant use among child welfare youth in out-of-home placement (17.1%, 95% CI: 6.0%, 40.2%) than the general population (4.2%, 95% CI: 3.7%, 4.7%). Out-of-home placement was associated with higher inhalant use (lifetime β = .659, p = .034; 30-day β = .763, p = .040) and alcohol use (lifetime β = .415, p = .028). Conclusions/Importance: These findings imply the need for screening and prevention education about substance use in child welfare populations, particularly in regards to inhalant use.

Chronic Pain Experience and Management among People Who Use Illicit Drugs: A Qualitative Study in Montreal (QC)

POSTER ABSTRACTIntroduction/Aim: Chronic non-cancer pain (CNCP) is both highly prevalent and undertreated among people who use illicit drugs (PWUD). To address the current opioid crisis, several health authorities have produced guidelines recommending not to prescribe opioid painkillers to patients with substance abuse risk factors. This could jeopardize pain relief for PWUD suffering from CNCP. This study aims to describe: (1) PWUD’s daily CNCP experiences; (2) barriers of access to adequate CNCP management for PWUD in the opioid crisis context; (3) PWUD’s stated needs for improving their CNCP and healthcare experiences.Methods: This was a qualitative study. In-depth semi-structured interviews were conducted with 25 PWUD (illicit opioids and/or cocaine) suffering from CNCP (≥ 3 months) recruited in downtown Montreal (2017/07 to 2018/05). Interviews were analyzed using Grounded Theory method.Results: Participants faced multiple health problems (e.g. HIV, hepatitis C) and social issues (e.g. homelessness, precarious employment) concomitantly with CNCP and substance use. These problems contributed to heighten their pain intensity. Physicians’ increased defiance against PWUD in the opioid crisis context led to major barriers for participants’ pain management. Participants experienced stigma and discrimination in the healthcare system. They wished they could access non-pharmacological therapies (e.g. physiotherapy) as alternatives to opioids, but these therapies were unaffordable. Some participants reported self-medicating their CNCP with street drugs when no other solution was available.Discussion/Conclusions: PWUD suffering from CNCP are a population with several comorbidities and high health care needs. Public policies should be revisited to improve access to appropriate CNCP management for this population.

Drug Abuse in Zagazig University Students, Egypt: Cross Sectional Study

Background: Drug addiction is a major public health and socioeconomic problem worldwide that annoys the Egyptian government, as it deals with youth within the age of productivity. Aim of the Work: To determine the prevalence of drug abuse among Zagazig University students. Subjects and Methods: A cross-sectional study conducted on 750 students in Zagazig University from the beginning of November 2015 to the end of November 2016, after an informed verbal consent. Data were collected through a self-administrated questionnaire and the results of screening urine samples. Results: The prevalence of drug abuse in general was 7.41%. The prevalence of drug abuse in descending order was tetrahydrocannabinol (3.9%) followed by tramadol (1.9%) then benzodiazepines (0.67%), while, opium and barbiturates each one of them (0.47%). 18% of them were Polydrug users and were only males. Tramadol was the commonest drug to use in polydrug users. The prevalence of smoking was 16.81% and strongly related to gender as in males 26.1% were current smokers while in females only 1.4%. The prevalence of abusing alcohols was 6%, and all of them were males. Conclusion: The prevalence of drug abuse in Zagazig university students is considered high and a very serious problem damaging the youth and the community. Recommendation: Future longitudinal studies should be conducted to investigate the risk factors of drug abuse and suggest the use of urine analysis for drugs of abuse for all students before joining the university.