Role Of Substance Abuse Research Articles

Role of substance abuse in requirement of physical restraint of psychiatric patients in emergency setting

Background The practice of physical restraint in psychiatric emergency practice is rather frequent. Patients with substance abuse more often present aggressive behavior requiring physical restraint in such settings. The legal frame for such practice in our country is defined in the Law for the protection of persons with mental disturbances. Patients admitted to a psychiatric emergency ward were analyzed prospectively according to their need of physical restraint.

The Role of Substance Abuse in HIV Disease Progression: Reconciling Differences from Laboratory and Epidemiologic Investigations

From the onset of the HIV/AIDS epidemic, the use of licit and illicit drugs has been investigated for its potential impact on HIV disease progression. Findings from a large number of laboratory-based studies indicate that drug abuse may exacerbate HIV disease progression; however, epidemiological studies have shown mixed results. This article presents a review of findings from both laboratory-based and epidemiologic investigations. In addition, we provide a careful evaluation of methodological strengths and limitations inherent to both study designs in order to provide a more nuanced understanding of how these findings may complement one another.

Emerging linkages between substance abuse and HIV infection in St. Croix, US Virgin Islands

In the US Virgin Islands 575 cases of AIDS had been reported to the Centers for Disease Control and Prevention through mid-2003. Although males continue to be most affected by HIV/AIDS, the feminization of the epidemic is evidenced by recent data showing rates of infection increasing rapidly among women. This paper focuses on the role of substance abuse and the socially and culturally based gender issues that influence risk and vulnerability to HIV in this setting. 254 chronically drug- or alcohol-involved men and women were recruited and interviewed using targeted sampling strategies. Crack use was overwhelmingly reported by females when compared to males (84.7% vs. 48.8%). Women also reported a significantly higher number of sexual partners in the past month (5.6 vs. 2.3) and significantly more occasions of unprotected vaginal sexual contact (11.2 vs. 6.5). Rates of self-reported HIV infection were elevated among women as well (8.8% vs. 1.4%). Women's precarious economic position and lack of access to legitimate income-generating activities tended to drive them into ‘survival sex’ to support their subsistence and drug needs. As such, it would appear that substance abuse has an emerging role in the spread of the epidemic in St. Croix, particularly among women.

Substance Abuse in HIV-Positive Women

Early in the U.S. HIV/AIDS pandemic, the role of substance abuse in the spread of AIDS was clearly established. However, the relationship of HIV and substance abuse is more complex than simply noting that injection drug use is a mode of transmission for the virus. HIV infection and substance abuse disorders interact in a complex fashion, with each acting as a potential catalyst or obstacle in the treatment of the other. In this article, we report the results of a qualitative metasynthesis of studies containing information on substance abuse among HIV-positive women, using 74 published and unpublished reports. The data on 1,548 women, who were primarily mothers from minority groups, allowed us to construct a trajectory that describes the events of their lives with regard to substance abuse and its intersection with HIV infection.

A spatial analysis of social disorganization, alcohol access, and rates of child maltreatment in neighborhoods

Parental substance abuse is a major contributing factor to increasing child welfare caseloads. Previous research on the role of substance abuse in child maltreatment has focused almost exclusively on the efficacy of substance abuse treatment programs for parents in reducing the reoccurrence of child abuse. Little attention has been given to the role of neighborhood characteristics or alcohol access on rates of child maltreatment. This study examines the relationship between alcohol access and neighborhood rates of child maltreatment. Using substantiated reports of child maltreatment for 940 census tracts in three counties in California, this study examines the role of neighborhood social disorganization and alcohol access on child abuse and neglect. Spatial regression models show that neighborhoods with higher percentages of poverty, female-headed households, Hispanic residents, population loss, and greater densities of bars have higher rates of child maltreatment. Neighborhoods provide an ideal mechanism for developing preventive interventions of child abuse and neglect because individual families or parents are not targeted for services. Instead, neighborhood characteristics that contribute to potentially harmful living situations for children can be identified and altered. These results suggest that efforts to prevent child maltreatment should focus on neighborhood disadvantage and alcohol outlet densities.

Adolescent substance abuse and suicide

Rates of adolescent suicide have increased significantly in the last five decades as have rates of adolescent substance abuse. However, the relationship between substance abuse and adolescent suicide is unclear. To better understand this relationship, a literature review that focused on the role of substance abuse in adolescent suicide was performed. The results of this review are discussed in this article. The most important risk factors for completed and attempted suicide are mental disorders (mood disorders and disruptive behavior disorders) and substance abuse [Brent, 1995: Suicide Life-Threatening Behav 25:52-63]. Furthermore, family history, social factors, and the presence of firearms in the home may contribute significantly to the risk for suicide. More research is needed in this area particularly with regard to cultural issues, substance abuse, and suicide.

The Role of Substance Abuse Among Rural Youth by Race, Culture and Gender

ABSTRACT Analysis of responses of 468 rural Caucasian, African American, Mexican-American, Mexican, and Navajo adolescents to the 10-item Problem-Oriented Screening Instrument (POSIT) showed interesting results among these groups according to race, culture and gender. Compared to the POSIT's minimum mean score for pathology, Navajo adolescent females scored the highest followed by Navajo adolescent males, Caucasian adolescent males, African American adolescent males, African American adolescent females, Mexican adolescent females, Mexican-American adolescent males, Mexican adolescent males, Caucasian adolescent females, and Mexican-American adolescent females. Of the 10 POSIT items, peer relations, substance use/abuse, mental health, educational status and social respectively exceeded the minimum mean score for pathology for the sample overall.

Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment.

Co-morbid substance use and abuse is common in schizophrenic patients, and the role of substance abuse in initiating and maintaining psychosis has important definitional and aetiological implications. We investigated the issue in a cohort of 131 schizophrenic patients. We found non-users (N = 67) were similar to pathological users (N = 64) in current symptomatology and clinical history. The pathological users did, however, have better pre-morbid adjustment levels. Only alcohol use and to some extent cannabis use contributed to this effect; use of stimulants or hallucinogens did not. These results indicate the importance of evaluating the various types of substance used when attempting to explore the significance of co-morbidity. The results also suggest that co-morbidity of substance abuse and schizophrenia may be explained by a common factor antecedent to both: better pre-morbid adjustment. A two-stage model is proposed to explain these findings: increased sociability increases exposure to opportunities of substance use in a subset of patients; subsequent onset of psychotic illness accelerates the use to a pathological level as the individual attempts to cope with the stress of the developing mental illness.

AIDS and chemical dependency: special issues and treatment barriers for gay and bisexual men.

Because gay and bisexual men continue to be the largest at-risk group for human immunodeficiency virus (HIV) related conditions, the special role of substance abuse, and not just intravenous drug abuse, must be understood in order to provide adequate services and prevention. Gay men and women appear to have a higher incidence of substance abuse than the general population. Genetic, biochemical, societal, and cultural factors may all contribute to this increase, especially the overwhelming impact of societal homophobia. To address the treatment barriers to gay and bisexual men seeking or needing treatment for HIV-related conditions, chemical dependence or both, the gay community should be seen like any other minority community. The social and cultural norms of this widely varied community should be studied: the socialization of being gay in mainstream society, including the awareness of being different; the coming-out process; and dealing with internalized homophobia need to be understood. In addition, the resistance or anxiety health care providers may feel in working with gay or bisexual men or with HIV-related conditions should be addressed.

Post-traumatic stress disorder and substance abuse in Vietnam combat veterans: Treatment problems, strategies and recommendations

Post-Traumatic Stress Disorder (PTSD) rarely presents as a discrete diagnostic entity. Frequently, PTSD is accompanied by substance abuse, somatoform, and/or affective disorders. This article focuses on the interplay of PTSD and substance abuse in Vietnam combat veterans. PTSD symptoms, assessment and diagnostic difficulties, treatment strategies and recommendations are discussed. The role of substance abuse should be determined before initiating treatment. Substance abuse may suppress, exacerbate or perpetuate PTSD symptoms. Substance-free combat veterans, veterans who use substances to self-medicate PTSD symptoms, and chronic substance abusers can be differentiated. Treatment goals and strategies differ for each group. Case histories, intake procedures and treatment recommendations conclude this article. To conform with APA guidelines (1983) for non-sexist language and to avoid ambiguity of reference, it should be stated that all of the information in this paper came from or relates to male Vietnam combat veterans. It is truly unfortunate that so little is known about the role of females in the Vietnam conflict. The authors, who are themselves Vietnam veterans, have interviewed or treated more than 2,000 combat veterans and their families and have found that 80% of the veterans seen have had alcohol related problems. The information in this paper is largely drawn from the authors' personal experiences, that of co-professionals with whom they have worked, and from the direct experiences of patients who have been treated by the authors.