Severity Of Dependence Scale Research Articles

Bridge Nodes between Personality Traits and Alcohol-Use Disorder Criteria: The Relevance of Externalizing Traits of Risk Taking, Callousness, and Irresponsibility.

Background: Personality disorders show strong comorbidities with alcohol-use disorder (AUD), and several personality traits have been found to be more frequent in people with AUD. This study analyzes which personality facets of those proposed in the Alternative Model of Personality Disorder (AMPD) of DSM-5 are associated with the diagnostic criteria of AUD. Methods: The sample was composed of 742 participants randomly selected from the Spanish population, and 243 patients attending mental health services. All participants were of legal age and signed an informed consent form. The instruments were administered to the community sample in an online format, and a psychologist conducted individual face-to-face interviews with the patients. AMPD facets were assessed through the Personality Inventory of DSM-5 Short-Form, and the AUD criteria through the Substance Dependence Severity Scale. A network analysis was applied to identify the personality facets mostly associated with the AUD criteria. Results: The network analysis showed the existence of three communities, grouping the AUD criteria, externalizing spectrum facets, and internalizing spectrum facets, respectively. Risk taking, callousness, and irresponsibility facets showed the strongest association with the AUD criteria, bridging externalizing personality traits with AUD criteria. Conclusions: The facets of risk taking, callousness, and irresponsibility should be accurately assessed in patients with AUD to differentiate between a possible primary personality disorder and a syndrome induced by alcohol addiction.

Cocaine use disorder criteria in a clinical sample: an analysis using item response theory, factor and network analysis

ABSTRACT Background The conceptualization of substance use disorders (SUDs) was modified in successive editions of the DSM. Dimensionality and inclusion/exclusion of several criteria was studied using various analytic approaches. Objective The study aimed to deepen our knowledge of the interrelationships between the diagnostic criteria for cocaine use disorder (CUD), applying three different analytical techniques: factor analysis, Item Response Theory (IRT) models, and network analysis. Methods 425 (85.4% male) outpatients were evaluated for CUD using the Substance Dependence Severity Scale. Confirmatory Factor Analysis, 2-parameter logistic model (IRT) and network analysis were applied to analyze the relationships between the diagnostic criteria. Results The results show that “legal problems” criterion is not congruent with the CUD measure on three analyses. Also, network analysis suggests the usefulness of the “craving” criterion. The criterion “quit/control” is the one that presents the best centrality indices and expected influence, showing strong relationships with the criteria of “craving,” “tolerance,” “neglect roles” and “activities given up.” Conclusions Network analysis appears to be a useful and complementary technique to factor analysis and IRT for understanding CUD. The “quit/control” criterion emerges as a central criterion to understand CUD.

Dual Disorders in the Consultation Liaison Addiction Service: Gender Perspective and Quality of Life.

Dual disorders (DD) and gender differences comprise an area of considerable concern in patients with substance use disorder (SUD). This study aims to describe the presence of DD among patients with SUD admitted to a general hospital and attended by a consultation liaison addiction service (CLAS), in addition to assessing its association with addiction severity and quality of life from a gender perspective, between 1 January and 30 September 2020. The dual diagnosis screening interview (DDSI), the severity of dependence scale (SDS), and the WHO well-being index were used to evaluate the patients. In the overall sample, DD prevalence was 36.8%, (women: 53.8% vs. men: 32.7%, NS). In both genders the most prevalent DD was depression (33.8%, women: 46.2% vs. men: 30.9%, p = 0.296). Women presented more panic disorders (46.2% vs. 12.7%, p = 0.019) and generalized anxiety (38.5% vs. 10.9%, p = 0.049) than men. When DD was present, women had worse quality of life than men (21.7 vs. 50 points, p = 0.02). During lockdown period 77 patients were attended to and 13 had COVID-19 infection, with no differences in relation to sociodemographic and consumption history variables. The study confirms a high prevalence of DD among patients with SUD admitted to a general hospital for any pathology, and its being associated with worse quality of life, particularly in women.

Feasibility of a Mobile Health App for Routine Outcome Monitoring and Feedback in SMART Recovery Mutual Support Groups: Stage 1 Mixed Methods Pilot Study.

BackgroundMutual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategies). Trained facilitators lead all SMART Recovery groups, providing an opportunity to implement ROM.ObjectiveThe aim of this stage 1 pilot study is to explore the feasibility, acceptability, and preliminary outcomes of a novel, purpose-built mobile health ROM and feedback app (SMART Track) in mutual support groups coordinated by SMART Recovery Australia (SRAU) over 8 weeks.MethodsSMART Track was developed during phase 1 of this study using participatory design methods and an iterative development process. During phase 2, 72 SRAU group participants were recruited to a nonrandomized, prospective, single-arm trial of the SMART Track app. Four modes of data collection were used: ROM data directly entered by participants into the app; app data analytics captured by Amplitude Analytics (number of visits, number of unique users, visit duration, time of visit, and user retention); baseline, 2-, and 8-week follow-up assessments conducted through telephone; and qualitative telephone interviews with a convenience sample of study participants (20/72, 28%) and facilitators (n=8).ResultsOf the 72 study participants, 68 (94%) created a SMART Track account, 64 (88%) used SMART Track at least once, and 42 (58%) used the app for more than 5 weeks. During week 1, 83% (60/72) of participants entered ROM data for one or more outcomes, decreasing to 31% (22/72) by the end of 8 weeks. The two main screens designed to provide personal feedback data (Urges screen and Overall Progress screen) were the most frequently visited sections of the app. Qualitative feedback from participants and facilitators supported the acceptability of SMART Track and the need for improved integration into the SRAU groups. Participants reported significant reductions between the baseline and 8- week scores on the Severity of Dependence Scale (mean difference 1.93, SD 3.02; 95% CI 1.12-2.73) and the Kessler Psychological Distress Scale-10 (mean difference 3.96, SD 8.31; 95% CI 1.75-6.17), but no change on the Substance Use Recovery Evaluator (mean difference 0.11, SD 7.97; 95% CI –2.02 to 2.24) was reported.ConclusionsFindings support the feasibility, acceptability, and utility of SMART Track. Given that sustained engagement with mobile health apps is notoriously difficult to achieve, our findings are promising. SMART Track offers a potential solution for ROM and personal feedback, particularly for people with substance use disorders who attend mutual support groups.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12619000686101; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336International Registered Report Identifier (IRRID)RR2-10.2196/15113

Neurological Soft Signs in Cannabis Use Disorder with or without Psychosis: A Comparative Study from India

Objective The purpose of this study was to assess and compare neurological soft signs in patients of cannabis use disorder (CUD) with and without co-occurring psychosis in a treatment-seeking sample. Methods: We included 30 right-handed male subjects aged 18–65 years diagnosed with CUD (as per DSM-5) without any co-occurring psychiatric disorder in group I and those with co-occurring non-affective psychosis in group II. Group III consisted of 30 age and sex-matched, right-handed, healthy subjects with no psychiatric or medical conditions. Neurological Evaluation Scale (NES) was applied to measure neurological soft signs across the groups. We also used the Severity of Dependence Scale (in CUD with or without co-occurring non-affective psychosis groups) and Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Barnes Akathisia Rating Scale, Abnormal Involuntary Movements Scale, and Simpson Angus Scale (in CUD with co-occurring non-affective psychosis group). Results: Our data suggested higher total NES mean scores in CUD with (20.53 ± 13.77) or without co-occurring non-affective psychosis groups (15.93 ± 9.86) as compared to healthy controls (6.20 ± 5.40) (χ 2 = 23.12; p < .001). However, there were no differences between cannabis use disorder with or without co-occurring non-affective psychosis groups. The mean of subdomain scores of motor incoordination, sequencing of complex motor tasks, sensory integration, and others was significantly higher in CUD with or without co-occurring non-affective psychosis groups compared to healthy controls. Conclusion: Impairment in neurological soft signs is present in patients with CUD regardless of a co-occurring psychosis. Cannabinoids might be interacting with the brain circuits known to be involved in schizophrenia.

Validation of the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) in acute psychiatric inpatients.

The aims of this study were to examine the psychometric properties of The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in psychiatric inpatients, due to the scarcity of screening instruments validated in this population. Patients from Hospital Clínic's psychiatric ward (n=202) completed: ASSIST, Addiction Severity Index (ASI), MINI-International Neuropsychiatric Interview (MINI), Alcohol Use Disorders Identification Test (AUDIT), Fagerström Test for Nicotine Dependence (FTND), Severity of Dependence Scale (SDS), and Drug Abuse Screening Test (DAST). Reliability and validity evidences based on internal structure (Exploratory and Confirmatory Factor Analyses) and on the relation to other variables were obtained. Excellent internal consistency was found for Total Substance Involvement (TSI) (α = .92 and ω = .93) and for Specific Substance Involvement (SSI) scores (α = .88 - .96 and ω = .89 - .95). Analysis of internal structure for tobacco, alcohol and cannabis subscales resulted in unidimensional models with adequate goodness-of-fit indices. ASSIST scores were significantly correlated with those of ASI (r = .795 to r = .953), AUDIT (r = .864), FTND (r = .808), DAST (r = .831), SDS (r = .519) and with "number of diagnoses of abuse/dependence" in MINI-Plus (TSI: r = .857 to r = .862; SSI: r = .646 to r = .834). Receiver operating characteristic analysis (ROC) and Mann-Whitney's U test found good discriminative validity evidences. ASSIST scores showed good reliability and there were validity evidences that support its use for identifying risk levels of tobacco, alcohol and other substance use in psychiatric patients.

A discriminant analysis model of psychosocial predictors of problematic Internet use and cannabis use disorder in university students

Researchers have found similarities and differences between behavioral and drug addictions. The present study was designed to explore which of a series of psychosocial predictors of addictive behaviors could differentiate problematic Internet use (PIU) and Cannabis Use Disorder (CUD) in a sample of University students. A total of 144 participants (76 males, mean age = 23.03 years ± 2.83) were separated into three groups: those presenting with PIU (18 females, Mean age = 22.27 years), those presenting with CUD (22 female, Mean age = 22.73 years), and a control group (28 female, Mean age = 24.04 years). Participants completed the Internet Abusive Use Questionnaire (IAUQ), the Severity of Dependence Scale (SDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Barratt Impulsiveness Scale-11 (BIS-11), the Multidimensional Distress Tolerance Scale (MDTS), the Emotion Regulation Questionnaire (ERQ), the Metacognitions Questionnaire-30 (MCQ-30), and the Repetitive Thinking Questionnaire-10 (RTQ-10). The classification analysis results showed that 68.8% of the control group, 70.8% of the PIU group, and 81.3% of the CUD group were correctly classified in their respective groups. In addition, the results of the discriminant function analysis showed that there was a significant difference between members of the PIU and CUD groups in the degree of family support (0.45), significant other (0.33), tolerance of physical discomfort (0.30), reappraisal (0.42), and cognitive confidence (0.35). The findings provide evidence that specific psychosocial predictors can discriminate PIU from CUD.

The Severity of Dependence Scale (SDS) for Codeine: Preliminary Investigation of the Psychometric Properties of the SDS in an Online Sample of Codeine Users From the UK.

Objective: Investigate the psychometric properties of the Severity of Dependence Scale (SDS) for codeine and its association with aberrant codeine related behaviors.Design: A voluntary and uncompensated cross-sectional online survey.Setting: Online population (≥18 years).Respondents: Two hundred and eighty-six respondents (66% women) who had used codeine containing medicines in the last 3 months and were living in the UK.Results: Of the respondents (mean age = 35.4 years, SD = 12.5), more than half were employed. Only 3.5% respondents reported no income. The majority of respondents (45.1%) primarily obtained prescription-only codeine from a consultation with a health professional, whilst 40.9% mainly purchased “over-the-counter” codeine containing medicines in a pharmacy without a medical prescription. Principal component analysis indicated a single factor solution accounting for 75% of the variance. Factor loadings ranged from 0.83 to 0.89. Cronbach's Alpha was high (α = 0.92). Several behaviors relating to codeine use were found to significantly predict probable codeine dependence. These included: daily codeine use in the last 3 months (OR = 66.89, 95% CI = 15.8–283.18); tolerance to codeine (OR = 32.14, 95% CI = 13.82–74.75); problems with role responsibility due to intoxication (OR = 9.89, 95% CI = 4.95–19.78); having sought advice on the internet to manage codeine use (OR = 9.56, 95% CI = 4.5–20.31); history of alcohol or drug treatment (OR = 3.73, 95% CI = 1.88–7.43).Conclusions: The SDS was acceptable and feasible to use to assess probable psychological codeine dependence in an online sample of people using codeine containing medicines. SDS scores were associated with behaviors known to be indicators of codeine dependence. Studies are needed in well-defined populations of people who use codeine to test the different aspects of psychometry of the scale compared against “gold standard” criterion [a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)].

Factors associated with methamphetamine dependency among men who have sex with men engaging in chemsex: Findings from the COMeT study in Taiwan.

Sexualized drug use or "chemsex" in Taiwan commonly incorporates the use of methamphetamine. Our study aimed to assess the extent of severity of dependence of methamphetamine among MSM in Taiwan as well as motivations for engagement in chemsex. Direct messages were sent to users of a large MSM social networking application in Taiwan between November 2018 and January 2019. MSM who had at least one experience of using drugs during sex in the preceding 12 months were invited to complete an online survey that assessed their sexual behavior, substance use and motivations for engaging in chemsex. The Severity of Dependence Scale was used to assess methamphetamine dependency. Multivariable logistic regression was used to determine the factors associated with methamphetamine dependency. From a total of 1906 responses, 517 had used methamphetamine in their lifetime and were included in the analysis. The majority (87.2%) used more than one substance when engaging in chemsex in the past six months, while a quarter reported injection of methamphetamine within the last six months. The most commonly reported motivations for participants to engage in chemsex were to have fun, for relaxation, and to increase the intensity of the sexual experience. Nearly half (46.0%) exhibited signs of methamphetamine dependency. Lower monthly income, injection of methamphetamine, ever feeling lonely in the past 3 months and concerns about their substance use expressed by others were significantly associated with methamphetamine dependency. A high proportion of MSM population who engaged in chemsex were at risk of developing methamphetamine dependency. While motivations for engaging in chemsex were diverse and suggest potential for enhanced sexual experience for some, community health organization for gay men's health and healthcare providers should be vigilant at identifying the risk of methamphetamine dependency and provide in-time, brief intervention or referrals when needed.

Dependence-like behaviour in patients treated for medication overuse headache: A prospective open-label randomized controlled trial.

Dependence-like behaviour may complicate withdrawal and increase risk of relapse of medication overuse headache (MOH). The most effective treatment for reducing dependence-like behaviour is unknown. To compare patient-reported outcomes among three treatment strategies for MOH. The primary outcome was change in Severity of Dependence Scale (SDS) score from baseline to 6months. Patients with MOH were randomized to (1) withdrawal combined with preventive medication from start (W+P), (2) preventive medication without withdrawal (P), or (3) withdrawal with optional preventive medication 2months after withdrawal (W). At baseline, 2, and 6months, patients filled out SDS (used for measurements of dependence-like behaviour and treatment feasibility), Headache Under-Response of Treatment (HURT) and WHO Quality of Life BREF questionnaires. Out of 120 patients with MOH, 100 completed the 6-month follow-up and filled out questionnaires. The W+P arm was the most effective in treating MOH. After 6months, the SDS score was reduced by 3.69 (95% CI 3.23-4.49) in the W+P arm, by 3.19 (95% CI 2.43-3.96) in the W arm, and by 1.65 (95% CI 0.96-2.33) in the P arm (p=0.04). At baseline and after 2months, the P arm was considered the most feasible treatment, but at 6-month follow-up, there was no difference in feasibility score, change in HURT score, or quality of life. Dependence-like behaviour was reduced most in the two withdrawal arms. Withdrawal combined with preventive medication is recommended for the treatment of MOH. Withdrawal combined with preventive medication from start is the treatment strategy that reduces dependence-like behaviour the most in MOH patients. Patients initially considered preventive treatment without withdrawal as the most feasible treatment. However, no difference in feasibility between the three arms was found at 6-month follow-up. Withdrawal combined with preventive medication is recommended for treatment of MOH.

Application of Dialectical Behavior Therapy in patients with opioid dependence- a pilot study

Background: Opioid dependency is a serious public health concern. India is one of the largest legal producers of opium and has an established pattern of use of opioid group of drugs. Opioid substitution therapy (OST) has displayed better outcomes compared with other existing treatment strategies. Dialectical Behavior Therapy (DBT) is a fast growing treatment modality used more and more to help individuals overcome addiction and maintain recovery. DBT incorporates concepts and modalities designed to promote abstinence and to reduce the length and adverse impact of relapses. DBT serves to improve patient motivation to change, enhance patient capabilities, generalize new behaviors, and restructure the individual’s environment. Aim: Present study was aimed to explore the effect of Dialectical Behavior Therapy (DBT) on level of severity of opioid dependence, distress tolerance, emotion regulation and interpersonal competence skills in patients with opioid dependence. Methods: This study consisted of 40 patients diagnosed with opioid dependence syndrome .The selected patients completed their individual baseline assessment. Afterward the patients were randomly assigned to the Experimental and control groups equally. The patients in experimental group attended 13 twice a week – 90 minutes’ individual DBT sessions focusing on Distress tolerance, Emotion regulation and inter-personal competence along with their TAU. The patients in control group were only on their TAU. Base line assessment scores were obtained using Severity of dependence scale (SDS), Brief-Cope Questionnaire, Emotional Regulation Questionnaire (ERQ) and Interpersonal Competence Questionaaire-15 (ICQ-15). Analysis was done using SPSS v 25.0 software and Wilcoxon Singed Rank Test was applied. A p value of

Poor Quality of Sleep Among HIV-Positive Persons in Ethiopia.

BackgroundIn comparison to the general population, persons living with HIV show a higher prevalence of poor quality of sleep, with estimates from 24.1–100% vs in the normal population 10–40%. There are not enough data on the poor quality of sleep among HIV-infected persons in Ethiopia.MethodsHospital-based cross-sectional study design was conducted among 336 HIV-infected persons in Mettu Karl Referral Hospital. Pittsburgh sleep quality index (PSQI), social phobia inventory (SPIN), changes in sexual functioning questionnaire short-form (CSFQ-14), Fagerstrom test for nicotine dependence (FTND), severity of dependence scale (SDS), and CAGE questionnaire (cut down, annoyed, guilty, eye opener) was used. Data were analyzed by SPSS 20 version. Bivariate and multivariable regressions were computed, and a significance level was declared at a point P-value of <0.05.ResultsA total of 336 respondents completed all questionnaires with response rate 98.53%. A total of 192 participants (57.1%) had poor sleep quality. Concerning associated factors; positive for social phobia, sexual dysfunction, living alone, poor antiretroviral (ARV) treatment adherence, and drunken alcohol had a positive association with poor sleep quality.ConclusionOf the persons living with HIV (PLWH) in Mettu Karl Referral Hospital, 57.1% experienced poor sleep quality. Social phobia, living arrangement, sexual dysfunction, poor ARV treatment adherence, and use of alcohol showed a significant association with poor quality of sleep. The findings suggest that a longitudinal study will be needed to elucidate the causal relationship of variables, and routine screening of poor sleep quality among PLWH is highly recommended. Furthermore, integrating and launching mental health services at ART clinic is greatly important.

Survey methods and characteristics of a sample of Aboriginal and Torres Strait Islander and non-Indigenous people who have recently used methamphetamine: the NIMAC survey.

There is a need for detailed information on methamphetamine use in Aboriginal and Torres Strait Islander communities. We describe a national survey on methamphetamine use among Aboriginal and Torres Strait Islander people and non-Indigenous people. Participants aged 16 years or older who reported using methamphetamine in the past year were recruited for a cross-sectional survey through 10 Aboriginal Community Controlled Organisations. Surveys were completed anonymously on electronic tablets. Measures included the Australian Treatment Outcomes Profile, the Severity of Dependence Scale, subscales from Opiate Treatment Index and the Kessler 10. A Chronic Stress Scale was used to assess culturally situated chronic stress factors. Of the 734 participants, 416 (59%) were Aboriginal or Torres Strait Islander and 331 (45%) were female. In the previous year, most participants reported smoking (48.7%) or injecting (34%) methamphetamine and 17.4% reported daily use. Aboriginal and Torres Strait Islander people did not differ significantly from non-Indigenous participants on methamphetamine use patterns (age at first use, frequency of use, main mode of use, injecting risk, poly drug use). Aboriginal and Torres Strait Islander participants felt less able to access health care (32% vs. 48%, P < 0.001), including mental health services (19% vs. 29%, P < 0.002), were less likely to report a mental health diagnosis (50% vs. 60%, P < 0.002) and were more likely to turn to family for support (52% vs. 34%, P < 0.001). We recruited and surveyed a large sample of Aboriginal and Torres Strait Islander people from which we can derive detailed comparative data on methamphetamine use and related health service needs for Aboriginal and Torres Strait Islander and non-Indigenous Australians.

Risk factors for risky cannabis use : Aretrospective cohort study of 7671 cannabis users

Cannabis use is widespread in Germany. So far little is known about which factors are predictive for the development of risky cannabis use. Aretrospective cohort study was conducted. Via social networks 7671 cannabis users (mean age = 21.8 years, standard deviation (SD) = 4.5years) were recruited (59.3% male). The end point of the online study was risky cannabis use, which was assumed with a cut-off >3 of the Severity of Dependence Scale (SDS). Predictors were gender, age, migration status, sensation seeking, a diagnosis of attention deficit hyperactivity disorder (ADHD), the age of first use and the prevalence of cannabis use in school time. In addition, characteristics of the parental home were surveyed, such as socioeconomic status, parenting style, the relationship with the parents, and mental health of the parents. Risky cannabis use was reported by 29.7% of the sample. The following risk factors predicted risky cannabis use: male gender (adjusted risk ratio, ARR: 1.25), higher age (ARR: 1.01), migration status (ARR: 1.13), higher sensation seeking (ARR: 1.08), earlier onset of cannabis use (ARR: 0.94), more frequent cannabis use among peers during school time (ARR: 1.21), unstable relationship with parents (ARR: 0.97), and lower parental mental health (father: ARR: 0.98; mother: ARR: 0.96). No associations could be found for a diagnosis of ADHD, parental socioeconomic status and parenting style. Potentially influenceable risk factors for risky cannabis use are relationship quality in the parental home and early onset of cannabis use.

Once-Monthly Long-Acting Injectable Aripiprazole for the Treatment of Patients with Schizophrenia and Co-occurring Substance Use Disorders: A Multicentre, Observational Study.

AimTo evaluate the efficacy and impact of long-acting injectable (LAI) aripiprazole in patients with schizophrenia with a coexisting substance use disorder (SUD).Patients and methodsA multicenter, observational, descriptive and retrospective study was conducted in patients with a DSM-5 diagnosis of schizophrenia who had a coexisting SUD and were treated with LAI-aripiprazole. Disease severity was evaluated with the Clinical Global Impression (CGI) severity scale for schizophrenia, daily functioning and disability were evaluated with the World Health Organisation Disability Assessment Scale (WHODAS-2.0), and the severity of the addiction was evaluated with the Severity of Dependence Scale (SDS).ResultsThe sample included 40 patients. Overall, after 6 months of treatment with LAI-aripiprazole at a dose of 400 mg/4 weeks in 77.5% of the patients, we observed significant improvement in the psychopathological symptoms, with a reduction of over 30% in the scores of the five CGI-severity scales. The WHODAS-2.0 mean (standard deviation) score was also significantly reduced from 57.6 (8.2) to 42.3 (4.3) points (p < 0.001). Regarding SUDs, after 6 months of treatment, substance use was stopped in 5 of the 9 patients with cocaine use disorder and in 3 of the 16 patients with alcohol abuse disorder. A significant reduction in the severity of the dependence was observed only in the subgroups of participants with cocaine and alcohol use disorders.ConclusionOur study suggests that once-monthly LAI-aripiprazole retains its antipsychotic efficacy in patients with schizophrenia and a coexisting SUD and could be useful for the management of cocaine or alcohol use disorders in this population.

Patterns of Substance Use among Patients in Addiction Rehabilitation in Jordan.

Background: This study aimed to identify pattern of substance use among patients at two public addiction rehabilitation centers in Amman. It provided a description of substance use career and assessment of addiction severity, quality of life and quality of sleep among participants.Methods: A quantitative cross-sectional study using a structured data collection form consisting of 4 parts: 1. General data including the demographic characteristics, medical history and career of drug abuse. 2. Severity of addiction using the severity of dependence scale (SDS). 3. Quality of life measured by the EQ-5D and 4. Quality of sleep measured by the insomnia severity index (ISI) scale.Results: A total of 93 patients from 2 treatment settings were recruited over 5 months. The total number of actively used substances was 196, with an average of 2 substances per patient. Alcohol and synthetic cannabinoids were the two most commonly used substances (39.8% and 38.7% respectively) followed by benzodiazepines (33.4%). A notable drop in heroin use was observed (5.4%, 5 out of 23 opioid user) compared to the years 2007-2009. The mean SDS score among patients was 11.43 (SD ± 3.48) indicating high dependence. Sleep problems were reported by 45% of patients. Data showed a significant role of community pharmacies in supplying drugs of abuse for users.Conclusion: Pattern of substance use changed significantly in Jordan with synthetic cannabinoids being of the top substances used and heroin use dropping. Actions should be taken to reframe the legalization of dispensing certain drugs by pharmacists without a prescription.

Influence of Early Life Stress on Alcohol and Crack Dependents

Background: Early life stress is a significant public health problem associated with increased rates of psychiatric disorders, especially those related to drug abuse. Objective: To identify the prevalence of early life stress in drug users, to compare the intensity of trauma in alcohol and crack users, and to relate the power of injury to the severity of drug dependence. Method: Cross-sectional analytical study with a sample of 105 alcohol and crack users treated by an outpatient service. The instruments for data collection were sociodemographic data questionnaire, the Mini-International Neuropsychiatric Interview, and the Severity of Dependence Scale. The categorical variables association was analyzed using the Chi-squared test, considering p < 0.05 significance. ANOVA was used to verify the variance. To assess the difference between sociographic and dependent variables, we used the Mann-Whitney and Kruskal-Wallis tests. Results: High prevalence of early stress and severity of dependence were identified, with higher rates among crack users. The early stress revealed in the Alcohol group high rates of emotional (88.7%) and physical (94.3%) neglect and in the Crack group significant frequency of physical (61.5%) emotional abuse (51.9%), sexual (46.2%), and emotional (78.8%) and physical (90.4%) neglect. Crack users are 2.6 times more likely to have been emotionally abused, and 2.1 times more likely to have been sexually abused during childhood when compared to the alcohol group. Conclusion: Early stress was prevalent with significant intensity in drug users, and evaluation of this problem is essential for a better understanding of these disorders.

An exploratory research: factor structure and reliability of the Arabic version of the Assessment and Screening of Assistance Needs – Drugs (ASAN-Drugs)

ABSTRACT Background: Assessment and Screening of Assistance Needs (ASAN-Drugs) has its objective to identify the severity of drug consumption through 28 items. This instrument allows for the matching of severity levels of the degree of care needed to allow the orientation of the person in the service that corresponds to his/her case and needs. The aim of this research is to assess the factorial validity and reliability of the Arabic version of the ASAN-D. Methods: The study included a sample of 53 participants; all of them were males (100%). Participants' age ranged from 18 to 50 with a mean age (SD) of 31.5 (6.27). Results: The results of the exploratory factor analysis demonstrated a one-factor solution which explained 61% of the total sample. Through confirmatory factor analysis, this model can be considered as satisfactory. Reliability was good in the total sample (α = .84). Conclusions: According to these results, the factorial validity of the Arabic version of the ASAN-D appears as a helpful assessment instrument to detect the degree of assistance needed and to better orient the individual in the appropriate service in Saudi Arabia. Abbreviations: SDS: Severity of Dependence Scale; ASAN-D: Assessment and Screening of Assistance Needs – Drugs; DUIS: Drug Use Impact Scale; EFA: exploratory factor analysis

Characterising heterogeneity in the use of different cannabis products: latent class analysis with 55 000 people who use cannabis and associations with severity of cannabis dependence.

As new cannabis products and administration methods proliferate, patterns of use are becoming increasingly heterogeneous. However, few studies have explored different profiles of cannabis use and their association with problematic use. Latent class analysis (LCA) was used to identify subgroups of past-year cannabis users endorsing distinct patterns of use from a large international sample (n = 55 240). Past-12-months use of six different cannabis types (sinsemilla, herbal, hashish, concentrates, kief, edibles) were used as latent class indicators. Participants also reported the frequency and amount of cannabis used, whether they had ever received a mental health disorder diagnosis and their cannabis dependence severity via the Severity of Dependence Scale (SDS). LCA identified seven distinct classes of cannabis use, characterised by high probabilities of using: sinsemilla & herbal (30.3% of the sample); sinsemilla, herbal & hashish (20.4%); herbal (18.4%); hashish & herbal (18.8%); all types (5.7%); edibles & herbal (4.6%) and concentrates & sinsemilla (1.7%). Relative to the herbal class, classes characterised by sinsemilla and/or hashish use had increased dependence severity. By contrast, the classes characterised by concentrates use did not show strong associations with cannabis dependence but reported greater rates of ever receiving a mental health disorder diagnosis. The identification of these distinct classes underscores heterogeneity among cannabis use behaviours and provides novel insight into their different associations with addiction and mental health.

Risks of psychosis in methamphetamine users: cross-sectional study in Thailand

ObjectiveTo determine factors related to recent methamphetamine-associated psychosis (MAP) among individuals recently using methamphetamine (MA).DesignCross-sectional study carried out between July 2015 and June 2017.SettingFour mental health hospitals and one substance...