Stimulant Use Research Articles

Positron Emission Tomography: Updates on Imaging of Addiction.

Positron Emission Tomography: Updates on Imaging of Addiction.

Risky driving behaviours among stimulant drug users and the role of aggression: findings from a national survey.

Stimulant drug users have a greater prevalence of risky driving behaviour. This study aimed to assess how far this association remains after adjusting for aggressiveness. Cross-sectional interview study assessing associations between measures of risky driving behaviours as outcomes, measures of stimulant drug use as predictors and a measure of aggressiveness as a covariate. United States. Data were drawn from wave 3 (2012-13) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III) (n=36 309 aged ≥18years). Stimulant drug use, past-year DSM-5 stimulant use disorder, aggression and measures of risky driving were assessed using face-to-face interviews conducted using the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Overall, 2714 (8.3%) respondents indicated life-time stimulant use, and 112 (0.3%) met criteria for past-year DSM-5 stimulant use disorder. More than 10% of ongoing stimulant users and one-third of respondents with DSM-5 stimulant use disorder reported stimulant-specific driving under the influence of drugs (DUID) in the past-year (both P<0.0001). Adjusted for demographics and independent of aggression, life-time stimulant users reported increased likelihood of driving [adjusted odds ratio (aOR)=3.00, 95% confidence interval (CI)=2.63-3.42] or speeding under the influence of drugs (aOR=3.39, 95% CI=3.01-3.82) and licence revocation (aOR=2.16, 95% CI=1.87-2.50) (all P<0.0001). Past-year DSM-5 stimulant use disorder was associated with all outcomes (aOR=5.48, 95% CI=2.95-10.18 and aOR=3.87, 95% CI=2.23-6.70, respectively, all P<0.0001), except licence revocation (aOR=1.72). Stimulant use appears to be positively associated with risky driving behaviours after adjusting for aggressiveness.

Effects of stimulant drug use on the dopaminergic system: A systematic review and meta-analysis of in vivo neuroimaging studies

BackgroundStimulant drugs can cause persistent changes in the brain. Imaging studies show that these changes are most apparent in dopamine transporter (DAT) or receptor availability within the striatum. MethodsThis work focuses on influences of stimulant use on dopaminergic function assessed using nuclear-medicine imaging (PET/SPECT). Included are 39 studies on 655 cocaine, amphetamine, methamphetamine or nicotine users, as well as 690 healthy controls. Metaanalyses were conducted separately for D2/D3 receptors and dopamine transporters of the entire striatum, its subregions caudate and putamen respectively. ResultsMeta-analyses results regarding nicotine did not show significant effects between smokers and nonsmokers. In cocaine users there was a significant decrease in dopamine receptor availability in all regions. The striatal DAT availability was significantly increased in cocaine users. Methamphetamine users showed a significantly decreased dopamine receptor and transporter density in all regions. Significant results also indicate a lower transporter availability in all regions. Amphetamine users showed reduced DAT availability in the striatum, as well as in the sub regions. ConclusionThis meta-analysis provides evidence that there are ongoing changes in the dopaminergic system associated with the use of stimulants. Especially the results of cocaine, methamphetamine and amphetamine use mainly showed a downregulation. In addition, this meta-analysis is the first to include nicotine. This subset of studies showed evidence for a decreased receptor and DAT availability but no significant results were found in the metaanalyses.

Substance Use Among College Students.

U.S. college campuses have witnessed a national increase of cannabis, stimulant, and illicit drug use among students over the past decade. Substance use among college students is associated with numerous negative outcomes including lower academic performance, a higher probability of unemployment after graduation, and an increased risk of committing and experiencing sexual assault. Several risk factors for substance use are specific to this population, including an affiliation with Greek life, perception of high academic pressure, and peer pressure. Students with problematic substance use also face unique challenges in planning treatment, including aspects of confidentiality, financial constraints, and potential university oversight and involvement. This article highlights the prevalence of substance use on college campuses and describes some of the specific challenges and approaches to treatment in this population, including screening tests and interventions for specific substances used on college campuses and evidence-based substance use programming for college students.

BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP) 2018.

We aim to provide evidence-based guidance on best clinical practice in the provision, monitoring and support of pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition. The guidelines include: (i) Guidance on risk assessment prior to PrEP; (ii) Baseline assessment; (iii) Dosing schedules; (iv) Monitoring; (v) Supporting adherence; (vi) Buying generic PrEP; and (vii) Cost-effectiveness. The guidelines are aimed at clinical professionals directly involved in, and responsible for, HIV prevention, and at community advocates and organisations responsible for supporting HIV prevention strategies in those at risk of HIV acquisition. A detailed review of the evidence base is included in Section 4. Sections 5 to 7 are intended to offer practical guidance in risk assessment, starting PrEP, ongoing management while on PrEP and stopping PrEP.

Vulnerable Periods: Characterizing Patterns of Sexual Risk and Substance Use During Lapses in Adherence to HIV Pre-exposure Prophylaxis Among Men Who Have Sex With Men.

Pre-exposure prophylaxis (PrEP) is highly efficacious, but some groups of men who have sex with men may have difficulty adhering to daily dosing. Prevention-effective adherence suggests that PrEP's efficacy depends on adherence at the time of HIV exposure; yet, few studies have examined how exposures (ie, high-risk sex) overlap with periods of consecutive missed PrEP doses. Substance use may also play a role in these vulnerable periods. We used digital pill bottles to monitor the daily adherence of 40 PrEP-experienced patients recruited from an outpatient clinic in the Northeastern US over a six-month period. Participants also completed detailed online diaries every 2 weeks during this time that surveyed their sexual behavior and substance use each day. Daily adherence was high overall (M = 83.9%, SD = 18.0%), but 53% (N = 21) had a lapse of > 3 consecutive daily PrEP doses over 6 months. Participants' rate of engaging in high-risk condomless anal sex (CAS) did not differ across lapse days versus continuously adherent days. Alcohol use was not associated with engaging in CAS during a PrEP lapse. However, participants reported engaging in CAS significantly more often during a PrEP adherence lapse on days when they also used stimulant drugs. Men who have sex with men may have periodic difficulty adhering to PrEP at the specific times when they are at risk. Stimulant drug use could play an important role in increasing HIV risk specifically during adherence lapses.

Ketamine for Acute Agitation

This review describes the use of ketamine for acutely agitated patients in the emergency care setting. Evidence for its efficacy will be reviewed and practical suggestions for using ketamine in this scenario will be presented. The available observational literature on the topic of ketamine for agitation was recently summarized in a systematic review. This review found that ketamine effectively and quickly sedates acutely agitated patients. However, it did raise some concerns about an increased intubation rate in patients administered ketamine. In severely agitated patients, particularly those presumed to be caused by stimulant drug use, who need immediate sedation to ensure the safety of the patient and staff, ketamine is a reasonable and safe choice. Emergency practitioners can consider giving ketamine 4-6 mg/kg IM (500 mg for most adults). Once given, it is important to closely monitor the patient for adverse effects and that the examination continue to determine the etiology of the patient’s agitation.

Effects of familial risk and stimulant drug use on the anticipation of monetary reward: an fMRI study

The association between stimulant drug use and aberrant reward processing is well-documented in the literature, but the nature of these abnormalities remains elusive. The present study aims to disentangle the separate and interacting effects of stimulant drug use and pre-existing familial risk on abnormal reward processing associated with stimulant drug addiction. We used the Monetary Incentive Delay task, a well-validated measure of reward processing, during fMRI scanning in four distinct groups: individuals with familial risk who were either stimulant drug-dependent (N = 41) or had never used stimulant drugs (N = 46); and individuals without familial risk who were either using stimulant drugs (N = 25) or not (N = 48). We first examined task-related whole-brain activation followed by a psychophysiological interaction analysis to further explore brain functional connectivity. For analyses, we used a univariate model with two fixed factors (familial risk and stimulant drug use). Our results showed increased task-related activation in the putamen and motor cortex of stimulant-using participants. We also found altered task-related functional connectivity between the putamen and frontal regions in participants with a familial risk (irrespective of whether they were using stimulant drugs or not). Additionally, we identified an interaction between stimulant drug use and familial risk in task-related functional connectivity between the putamen and motor-related cortical regions in potentially at-risk individuals. Our findings suggest that abnormal task-related activation in motor brain systems is associated with regular stimulant drug use, whereas abnormal task-related functional connectivity in frontostriatal brain systems, in individuals with familial risk, may indicate pre-existing neural vulnerability for developing addiction.

Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men.

The HIV epidemic among black men who have sex with men (BMSM) demands urgent public health attention. Pre-exposure prophylaxis (PrEP) is a highly efficacious option for preventing HIV, but characteristics of PrEP use among community samples of BMSM are not well-understood. A serial cross-sectional survey assessment (N = 4184 BMSM reporting HIV-negative/unsure status) and HIV testing were conducted at Black Gay Pride events in 6 US cities in 2014, 2015, 2016, and 2017. HIV prevalence was higher among BMSM self-reporting current PrEP use (1 of 3 participants) than BMSM not self-reporting current PrEP use (1 of 5 participants) [32.3%, N = 103/319 vs. 20.0%, N = 639/3,193, adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI): 1.31 to 2.15]. BMSM reporting current PrEP use (N = 380) were more likely to report having a greater number of male sex partners (aOR = 1.02, 95% CI: 1.01 to 1.03), a sexually transmitted infection diagnosis (aOR = 2.44, 95% CI: 1.88 to 3.16), and stimulant drug use (aOR = 2.05, 95% CI, 1.21 to 3.47) when compared with BMSM not reporting current PrEP use (N = 3804). PrEP use increased from 4.7% (2014) to 15.5% (2017) (aOR = 1.19, 95% CI: 1.13 to 1.25). Among PrEP users, inability to afford health care coverage was associated with testing HIV-positive (aOR = 2.10, 95% CI: 1.24 to 3.56). The high prevalence of HIV infection among BMSM reporting PrEP use is concerning. It does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, sexually transmitted infection treatment, and medication adherence counseling. Further research to understand barriers to fully effective PrEP is needed to guide operational and behavioral interventions that close the gap on incident infection.

Prevalence and determinants of anal human papillomavirus infection in men who have sex with men and transgender women.

Human papillomavirus (HPV) prevalence varies by population. This study investigated anal HPV type detection risk by country in a population of men who have sex with men (MSM) and transgender women (TW) at risk of HIV. Sexually active HIV-1-uninfected MSM and TW were enrolled at eight sites: four in the United States (US), two in Thailand, one in Peru, and one in South Africa. Baseline anal HPV swabs were collected, and DNA typing was performed. One hundred and ninety-five participants, 76 (42%) from the US, had a mean age of 30.9 years (range 18-64). In 182 participants with results available, anal HPV infection was common with 169 (93%) with ≥1 type, 132 (73%) with ≥1 nine-valent vaccine types, and 66 (36%) with HPV 16. Participants in the US had a higher prevalence of HPV 16 (56%, p = 0.004) and HPV 6 (69%, p < 0.001) compared to the other regions. Stimulant drug use was significantly associated with HPV 6 detection. Anal HPV is highly prevalent in this population of MSM and TW sampled from four countries, with HPV 16 the most commonly detected type. The nine-valent HPV vaccine has the potential to provide significant protection if given prior to exposure.

Prevalence and correlates of stimulant and depressant pharmacological cognitive enhancement among Norwegian students.

Aims:To assess the prevalence and factors associated with stimulant and depressant pharmacological cognitive enhancement (PCE) drug use among Norwegian students.Design:In the first wave (T1), 28,553 students were invited to participate, of whom 9370 (32.8%) responded and completed the survey (mean age = 24.9 years, 63.5% female). One year later (T2) those who had responded to some items at T1 were invited to participate in a follow-up survey, where 4783 (47.2%) responded and completed the survey (mean age = 24.8 years, 64.8% female).Results:Lifetime prevalence of stimulant PCE drug use was 2.1% at T1 and 3.6% at T2. The lifetime prevalence of depressant PCE drug use was 1.5% at T1 and 3.3% at T2. Stimulant PCE drug use at T2 was predicted by low scores on agreeableness and anxiety, high scores on intellect/openness, and alcohol use, and stimulant and depressant PCE drug use at T1; while depressant PCE drug use at T2 was predicted by low scores on extroversion, high scores on conscientiousness, intellect/openness, and anxiety, and stimulant and depressant PCE drug use at T1.Conclusions:The rates of stimulant and depressant PCE drug use increased from T1 to T2. Pharmacological cognitive enhancement drug use may be explained by a combination of a motivation for improving academic achievements and a general inclination towards substance use. The current results may suggest that stimulant PCE drug users are more antisocial and indifferent to rules, while depressant PCE drug users are more motivated by coping with stress.

BFGF expression is differentially regulated by cocaine seeking versus extinction in learning-related brain regions.

In cocaine use disorder, relapse can be elicited by drug-associated cues despite long periods of abstinence. The persistence of drug-associated cues in eliciting drug seeking suggests enduring changes in structural and functional plasticity, which may be mediated by basic fibroblast growth factor (bFGF, FGF2). Stimulant drug use increases bFGF expression in reward- and learning-related brain regions, such as the infralimbic medial-prefrontal cortex (IL-mPFC), and we previously found that this increase was reversed by extinction. However, whether bFGF expression is similarly modified in other brain regions is unknown. Therefore, we used the conditioned place preference (CPP) paradigm to assess bFGF expression following cocaine-associated CPP or extinction of that CPP within the mPFC, nucleus accumbens (NAc), hippocampus (Hipp), and basolateral amygdala (BLA). bFGF expression was increased in IL-mPFC and NAc-Core and -Shell following a cocaine-associated CPP, an effect reversed by extinction. Conversely, bFGF expression was increased in BLA following extinction, but no significant changes were observed in PL-mPFC or either dorsal or ventral Hipp. These results demonstrate differential regulation of bFGF following cocaine-associated CPP or extinction of that CPP in discrete brain regions. Changes in bFGF expression may regulate long-lasting drug-induced plasticity that underlies persistent drug-associated memories, and therefore present potential prophylactic targets.

Intracerebral Hemorrhage in Women: A Review with Special Attention to Pregnancy and the Post-Partum Period

Non-traumatic intracranial hemorrhage includes subarachnoid hemorrhage, subdural hemorrhage, and intracerebral hemorrhage (ICH), which can be classified as primary or secondary. Primary ICH is due to arterial hypertension or cerebral amyloid angiopathy, and secondary ICH is due to cerebral vascular malformations, coagulopathies, infectious complications, brain tumors, and illicit stimulant drug use. This review explores the epidemiology and management of non-traumatic ICH in women, with a focus on pregnancy and the post-partum period, defined as 6weeks post-delivery.

EXPERIENCE OF CYCLOFERON THERAPY IN THE COMPLEX THERAPY OF RECURRENT RESPIRATORY INFECTIONS IN CHILDREN

The article contains materials on the use of antiviral and immune stimulating drugs for treatment of infectious processes of viral aetiology. The potential of using Cycloferon in children with recurrent infections are shown. Prescription of nonspecific immune modulators of the topical (derinat) and systemic (cycloferon) effect as etiotropic and immune modulating therapy for sickly children was justified from the pathogenetical point of view. The findings of our studies on the efficacy of the latter in children with different states of the pharyngeal lymphoid ring and complicated course of acute respiratory infection are presented. It is shown that the frequency of acute respiratory infections in children depends on the child’s age, immune status, and not on the state of the pharyngeal lymphoid ring.

Methylphenidate Consumption Behaviors among Students of Ardabil University of Medical Sciences, 2017

Introduction: Methylphenidate is a derivative of the amphetamines group, which is prescribed to improve efficacy, reduce sleep, develop euphoria and treat depression. It also serves as an enhancement of memory and facilitates learning by students during examinations. The aim of this study was to investigate the Methylphenidate consumption behaviors among students of Ardabil University of Medical Sciences, 2017. Methods: This is a cross-sectional descriptive study that has been done on 150 university students who selected randomly from all medical fields. Data collected by a questionnaire included demographic data and questions about behavior and motivation of Methylphenidate abuse. Collected data analyzed by statistical methods in SPSS version 16. Results: Of all students, 52.6% were female and rest of them was male with mean age of 22.2±6 years. Of all students, 38 (25.3%) had Methylphenidate abuse. Most and least abuse of Methylphenidate was among medicine and hygiene students with 30.4% and 5%, respectively. In terms of Methylphenidate consumers, impairment in thinking and memory with 81.6% and increasing the self confidence with 63.2% was the least and most motivation for Methylphenidate abuse. 65.8% of them, known the consumers as people with high self confidence and 39.5% known them inexpert people. Conclusion: Results showed that Use of non-prescriptive stimulant drugs among students specially males were prevalent and is considered as a high-risk behavior that should be monitored and controlled in the future with the necessary planning.

Pharmacological cognitive enhancement among non-ADHD individuals—A cross-sectional study in 15 countries

BackgroundPsychoactive substance use aiming at increased performance at work or while studying, usually referred to as pharmacological cognitive enhancement (PCE), has been extensively researched in recent years. While large scale national studies have tried to assess the prevalence of PCE among the general population, cross-cultural comparisons have been hampered by the different definitions and designs included. In addition, the non-medical use of prescription drugs indicated to treat the symptoms of the Attention Deficit Hyperactivity Disorder (ADHD) has been the focus of discussion, yet no study has addressed the association between ADHD rates, prescribing behaviour and PCE yet. MethodsThe Global Drug Survey is an annually conducted anonymous web survey on substance use. Two data sets from male and female Global Drug Survey (GDS) participants aged 16 to 65 years with no previous ADHD diagnosis were analysed to assess12-month PCE in 15 countries. GDS2015 (n = 79,640) examined the patterns of and motives for stimulant PCE, while GDS2017 (n = 29,758) focused on both the use of stimulant and sedative drugs for PCE ResultsWhen comparing the study samples 2015 and 2017, PCE with prescription and illegal stimulants and modafinil increased across all countries. People who used stimulant drugs and modafinil for PCE rated the perceived effect on cognitive performance most beneficial, while alcohol was the substance with the most adverse effect. ConclusionThe analysis of data on stimulant use for PCE in the largest global sample highlights relatively low-risk PCE use patterns except for participants with illegal stimulant use for PCE. The globalisation of ADHD, physicians’ prescribing behaviour and changes in drug policy are likely to influence the country-specific rate of PCE among non-ADHD individuals what calls for further investigation.

The Stimulating Nature of Gambling Behaviors: Relationships Between Stimulant Use and Gambling Among Adolescents.

Adolescence represents a significant developmental period during which experimentation with high-risk behaviors including substance use and gambling often occurs. These high-risk behaviors have been associated with multiple negative measures of social, academic and psychological functioning. Although associations have been established between alcohol use, marijuana use, mental health problems, and problem gambling in youth, research investigating possible associations between stimulant drug use and gambling is scarce. Questionnaire responses were collected from 6542 high-school students aged 12-19years. Relationships between types and patterns of gambling with stimulant drugs [including cocaine, methamphetamine, non-medical use of stimulants, and 3,4-methylenedioxymethamphetamine (MDMA)] were examined. Chi square analyses with odds ratio calculations revealed the use of any stimulant was associated with an increased odds of gambling frequency and problem gambling among both males and females. Self-reported use of crack cocaine was associated with a higher risk of frequent gambling and use of methamphetamines was associated with a higher risk of at-risk/problem gambling. Individuals using stimulants six or more times in the past year had high likelihoods of frequent and at-risk/problem gambling behaviors. The results contribute to our understanding of stimulant drug use and its associations with gambling behaviors among high-school youth.

1085 US Healthcare Claims Analysis of Obstructive Sleep Apnea Comorbidities and Their Association with Stimulant Drug Use

1085 US Healthcare Claims Analysis of Obstructive Sleep Apnea Comorbidities and Their Association with Stimulant Drug Use

Sex, Drugs, and Female Agency: Why Siramori Diabaté’s Song “Nanyuman” Was Such a Success in Mali and Guinea

Abstract This article presents the lyrics of the song “Nanyuman” by Mali’s legendary female griot (bard) Siramori (Sira Mory) Diabaté (c. 1925–1989). It will demonstrate how a female griot integrates into her songs topical moral discussions on the position of married women in the socialist-inspired nations of Guinea and Mali in the 1960s and 1970s. Through the voice of “Nanyuman,” the protagonist of the song, Siramori, comments in ways a male griot never could, discussing marriage, sex, men’s roles as husbands, motherhood, and even the use of stimulant drugs. This source publication shows that the remarkable rise of female griots in West Africa from the 1960s onwards can be explained by new topical debates on West African society, and not only by technological innovations and new aesthetic appreciations of female voices that have received scholarly attention. The performance of “Nanyuman” also reveals Siramori’s artistic and comedic talents as an entertainer, thus evidencing why she was elevated to the highest ranks of musicians in Mali.

CLINICAL OUTCOMES OF β-BLOCKER THERAPY IN COCAINE-ASSOCIATED HEART FAILURE

Cardiovascular disease is found in 70% of cocaine users. Illicit stimulant drug use is associated with 5% of all cases of acutely decompensated heart failure. The use of β-blockers has been discouraged in cocaine users who have heart failure with a reduced ejection fraction (HFrEF). We performed a