Stimulant Use Research Articles

Cosmetic Neurocognitive Enhancement and Healthcare Providers

I.INTRODUCTION 730 II. NEUROCOGNITIVE ENHANCEMENT IN HEALTH CARE ..... 732 III.REQUESTS 737 A. Neuromyths Facilitating Requests 737 B. Direct-to-Consumer Advertising as a Driver of Patient Requests 739 C. So What Is It That People Do (and Do Not) Want To Alter? 741 IV. RESPONSES: PROVIDER ISSUES 745 A. Models of Provider-Patient Interactions 746 B. Provider Attitudes About Enhancement 749 C. Availability of Enhancing Drugs (Off-Label Prescribing) 751 D. Currently Available Enhancing Drugs 753 1. Schedule II Drugs 753 2. Schedule IV Drugs 756 3. OTC Drugs 758 4. Other Considerations 761 V. RECOMMENDATIONS FOR PROVIDERS AND SYSTEMS ....... 763 VI. CONCLUSION 767

Repeat HIV-testing is associated with an increase in behavioral risk among men who have sex with men: a cohort study.

BackgroundThe Center for Disease Control and Prevention recommends that high-risk groups, like sexually active men who have sex with men (MSM), receive HIV testing and counseling at least annually. The objective of this study was to investigate the relationship between voluntary repeat HIV testing and sexual risk behavior in MSM receiving rapid serologic and nucleic acid amplification testing.MethodsWe performed a cohort study to analyze reported risk behavior among MSM receiving the “Early Test”, a community-based, confidential acute and early HIV infection screening program in San Diego, California, between April 2008 and July 2014. The study included 8,935 MSM receiving 17,333 “Early Tests”. A previously published risk behavior score for HIV acquisition in MSM (i.e. Menza score) was chosen as an outcome to assess associations between risk behaviors and number of repeated tests.ResultsAt baseline, repeat-testers (n = 3,202) reported more male partners and more condomless receptive anal intercourse (CRAI) when compared to single-testers (n = 5,405, all P <0.001). In 2,457 repeat testers there was a strong association observed between repeated HIV tests obtained and increased risk behavior, with number of male partners, CRAI with high risk persons, non-injection stimulant drug use, and sexually transmitted infections all increasing between the first and last test. There was also a linear increase of risk (i.e. high Menza scores) with number of tests up to the 17th test. In the multivariable mixed effects model, more HIV tests (OR = 1.18 for each doubling of the number of tests, P <0.001) and younger age (OR = 0.95 per 5-year increase, P = 0.006) had significant associations with high Menza scores.ConclusionsThis study found that the highest risk individuals for acquiring HIV (e.g. candidates for antiretroviral pre-exposure prophylaxis) can be identified by their testing patterns. Future studies should delineate causation versus association to improve prevention messages delivered to repeat testers during HIV testing and counseling sessions.

One day access to a running wheel reduces self-administration of d-methamphetamine, MDMA and methylone

BackgroundExercise influences drug craving and consumption in humans and drug self-administration in laboratory animals, but the effects can be variable. Improved understanding of how exercise affects drug intake or craving would enhance applications of exercise programs to human drug users attempting cessation. MethodsRats were trained in the intravenous self-administration (IVSA) of d-methamphetamine (METH; 0.05mg/kg/inf), 3,4-methylenedioxymethamphetamine (MDMA; 0.5mg/kg/inf) or methylone (0.5mg/kg/inf). Once IVSA was established, the effect of ∼22h of wheel access in the home cage on subsequent drug taking was assessed in a two cohort crossover design. ResultsProvision of home cage wheel access during the day prior to IVSA sessions significantly decreased the self-administration of METH, MDMA and methylone. At the individual level, there was no correlation between the amount a rat used the wheel and the size of the individual's decrease in drug intake. ConclusionsWheel access can reduce self-administration of a variety of psychomotor stimulants. It does so immediately, i.e., without a need for weeks of exercise prior to drug access. This study therefore indicates that future mechanistic investigations should focus on acute effects of exercise. In sum, the results predict that exercise programs can be used to decrease stimulant drug use in individuals even with no exercise history and an established drug taking pattern.

Hand function is altered in individuals with a history of illicit stimulant use.

Use of illicit stimulant drugs such as methamphetamine, cocaine, and ecstasy are a significant worldwide problem. However, little is known about the effect of these drugs on movement. The aim of the current study was to investigate hand function in adults with a history of illicit stimulant use. We hypothesized that prior use of illicit stimulant drugs is associated with abnormal manipulation of objects. The study involved 22 subjects with a history of illicit stimulant use (aged 29±8 yrs; time since last use: 1.8±4.0 yrs) and two control groups comprising 27 non-drug users (aged 25±8 yrs) and 17 cannabis users with no history of stimulant use (aged 22±5 yrs). Each subject completed screening tests (neuropsychological assessment, medical history questionnaire, lifetime drug history questionnaire, and urine drug screen) prior to gripping and lifting a light-weight object with the dominant right hand. Horizontal grip force, vertical lift force, acceleration, and first dorsal interosseus electromyographic (EMG) activity were recorded during three trials. In trial one, peak grip force was significantly greater in the stimulant group (12.8±3.9 N) than in the control groups (non-drug: 10.3±4.6 N; cannabis: 9.4±2.9 N, P<0.022). However, peak grip force did not differ between groups in trials two and three. The results suggest that individuals with a history of stimulant use overestimate the grip force required to manipulate a novel object but, are able to adapt grip force in subsequent lifts. The results suggest that movement dysfunction may be an unrecognized consequence of illicit stimulant use.

Stimulant use disorders in people with psychosis: a meta-analysis of rate and factors affecting variation.

Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This study systematically reviews the prevalence estimates reported for stimulant abuse and dependence in people with psychotic disorders, and examines personal, clinical, regional and methodological factors which explain variation in these rates. PsychINFO, EMBASE and MEDLINE (1946-2013) were searched systematically for studies reporting on stimulant drug use disorders in representative samples of people with psychotic disorders. Random effects models estimated the pooled rate of a stimulant use disorder, defined to include stimulant abuse and stimulant dependence. Study characteristics associated with heterogeneity in rates of stimulant use disorder were examined by subgroup analyses for categorical variables, by meta-regression for continuous independent variables and by multiple meta-regression. Sixty-four studies provided 68 estimates of lifetime or recent stimulant use disorders in 22,500 people with psychosis. The pooled rate of stimulant use disorder was 8.9% (95% CI 7.4%, 10.5%). Higher rates of stimulant use disorders were reported in studies of affective psychosis, studies from inpatient settings, studies from the USA and Australia, and studies with higher rates of cannabis disorder; in multiple meta-regression analysis these factors explained 68% of between-study variance. Rates of stimulant use disorder were stable over time, and unrelated to age, sex, stage of psychosis, type of stimulant drug or study methodology factors. Reported rates of stimulant use disorder in people with psychosis are much higher than in the general population but vary widely and are associated with regional, service setting and clinical differences between studies. It is likely that stimulants contribute to the overall burden of psychosis, and that social and environmental factors combine with drug and illness-related factors to influence stimulant use in psychosis.

Substance Use and Experienced Stigmatization Among Ethnic Minority Men Who Have Sex with Men in the United States

Research has documented deleterious effects of racism among ethnic minorities and of homophobia among men who have sex with men (MSM). Less is known about the impact of multiple forms of stigmatization on ethnic minority MSM. This study examined substance use by African American, Asian/Pacific Islander and Latino MSM, and the associations of experienced racism and homophobia from various sources with polydrug use and stimulant drug use. Experienced racism within the general community was associated with higher levels of use; other forms of discrimination were either not associated with polydrug or stimulant use or had more complex relationships with use. Implications for further research and interventions are discussed.

Correlates of selling sex among male injection drug users in New York City

BackgroundCompared to female IDUs, the correlates of receiving money, drugs, or other things in exchange for sex (“selling sex”) among male IDUs are not well understood. MethodsIn 2012, IDUs were sampled in New York City for the National HIV Behavioral Surveillance cross-sectional study using respondent driven sampling. Analyses were limited to male participants. Logistic regression was used to calculate crude and adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) to determine the correlates of selling sex to (1) men and (2) women in the past 12 months. ResultsOf 394 males, 35 (8.9%) sold sex to men and 66 (16.8%) sold sex to women. Correlates of selling sex to men included bisexual/gay identity (aOR: 31.0; 95% CI: 8.1, 119.1), Bronx residence (vs. Manhattan) (aOR: 38.1; 95% CI: 6.2, 235.5), and in the past 12 months, being homeless (aOR: 9.9; 95% CI: 2.0, 49.6), ≥3 sex partners (aOR: 26.2; 95% CI: 4.7, 147.6), non-injection cocaine use (aOR: 5.4; 95% CI: 1.6, 18.2), and injecting methamphetamine (aOR: 36.9; 95% CI: 5.7, 240.0). Correlates of selling sex to women included, in the past 12 months, ≥3 sex partners (aOR: 14.6; 95% CI: 6.6, 31.9), binge drinking at least once a week (aOR: 3.1; 95% CI: 1.6, 6.1), non-injection crack use (aOR: 3.3; 95% CI: 1.6, 6.7), most frequently injected “speedball” (vs. heroin) (aOR: 2.1; 95% CI: 1.1, 4.2), and receptively shared syringes (aOR: 2.4; 95%CI: 1.2, 4.8). ConclusionsAmong male IDUs, those who sold sex had more sex partners, which may facilitate the sexual spread of HIV among IDUs and to non-IDU male and female sex partners. HIV prevention interventions aimed at male IDUs who sell sex should consider both their sexual and parenteral risks and the greater risk of engaging in exchange sex associated with the use of injection and non-injection stimulant drugs.

Substance use and PTSD among smokers with serious mental illness

Aims: Epidemiological studies indicate Posttraumatic Stress Disorder (PTSD) frequently co-occurs with substance use and abuse, particularly among women. This study examined the PTSDsubstance use relation in a sample of men and women smokers with serious mental illness. Methods: 733 adult smokers (51% male) aged 18–73, were recruited from 5 acute inpatient psychiatry units. The e-MINI measured PTSD. Past 30-day substance use and readiness to change were assessed for heavy alcohol use (ALC), stimulants (STIM), sedatives (SED), hallucinogens (HAL), opiates (OP), and marijuana (MJ). The SF-12 assessed physical and mental health functioning. Logistic regression analyses tested for women and men separately the relation of PTSD with substance use and readiness to change. Results: 44% of women and 36% of men had PTSD. Past 30 day use of ALC, STIM, SED, OP and MJ was high (women range: 21.5–39.6%, men range: 24.9–47.1%). HAL use was lower (women: 3.9%, men: 5.9%). On average, women used 1.6 (sd =1.2) and men used 1.7 (sd =1.2) substances, during the past 30 days. Adjusting for covariates, use of OP (OR=2.1, p= .01), SED (OR=1.8, p= .02), and MJ (OR=1.9, p= .01) predicted PTSD in women. Use of STIM (OR=1.8, p= .04) and MJ (OR=1.7, p= .04) predicted PTSD in men. Number of substances used predicted PTSD in women (OR=1.5, p< .01), but not men. PTSD was unrelated to motivation to quit ALC/drugs. PTSD and # of substances used were associated with poorermental health functioning, anda significant interaction indicated mental health functioning was the worst among those with both PTSD and greater substance use (b=2.1, p= .03). Conclusions: Among smokers with serious mental illness, recent heavy alcohol, illicit drug use, and PTSD were common, found to co-occur, and predictive of worse mental health functioning. Integrative treatments for PTSD and substance abuse, with attention to sex-specific drugs of abuse, appear warranted. Financial support: Funding: K23MH083684, K05DA01869, P50DA09253, TRDRP#23BT-0018, T32HL007034.

The impact of engagement in street-based income generation activities on stimulant drug use cessation among people who inject drugs

BackgroundDespite the growing prevalence of illicit stimulant drug use internationally, and the widespread involvement of people who inject drugs (IDU) within street-based drug markets, little is known about the impact of different types of street-based income generation activities on the cessation of stimulant use among IDU. MethodsData were derived from an open prospective cohort of IDU in Vancouver, Canada. We used Kaplan–Meier methods and Cox proportional hazards regression to examine the effect of different types of street-based income generation activities (e.g., sex work, drug dealing, and scavenging) on time to cessation of stimulant use. ResultsBetween December, 2005 and November, 2012, 887 IDU who use stimulant drugs (cocaine, crack cocaine, or crystal methamphetamine) were prospectively followed-up for a median duration of 47 months. In Kaplan–Meier analyses, compared to those who did not engage in street-based income generation activities, participants who reported sex work, drug dealing, scavenging, or more than one of these activities were significantly less likely to report stimulant drug use cessation (all p<0.001). When considered as time-updated variables and adjusted for potential confounders in a multivariable model, each type of street-based income generation activity remained significantly associated with a slower time to stimulant drug cessation (all p<0.005). ConclusionsOur findings highlight the urgent need for strategies to address stimulant dependence, including novel pharmacotherapies. Also important, structural interventions, such as low-threshold employment opportunities, availability of supportive housing, legal reforms regarding drug use, and evidence-based approaches that reduce harm among IDU are urgently required.

We Cannot Say Whether Attention Deficit Hyperactivity Disorder Exists, but We Can Find Its Molecular Mechanisms

The irony of predictions such as “attention deficit hyperactivity disorder (ADHD) does not exist” is that once knowledge has advanced enough to settle the question, it is no longer clear what the question meant in the first place. “ADHD Does Not Exist” is the title of a recent book by neurologist Richard Saul,1 which gives a detailed differential diagnosis of attention deficit, with the noble goal of reducing the indiscriminant use of stimulant drugs. Similar questions have also been raised in scientific journals, notably by Warren Weinberg and Roger Brumback in their 1992 article “The myth of attention deficithyperactivity disorder: symptoms resulting from multiple causes”.2 Everyone agrees on the basics. Everyone agrees that there is a finding that we term “attention deficit.” Everyone agrees that many diseases, as well as states such as sleep deprivation, have the finding “attention deficit.” The controversy boils down to whether there is at least one disease entity that we would consider to be primary attention deficit, with no other obvious abnormal findings. I am convinced that this is true, within current definitions. The uncertainty in my mind is what we will decide that “obvious” and “abnormal” mean once we have enough knowledge to answer the question. This perspective comes from the study of families with no obvious findings other than attention deficit, apparently inherited in an autosomal dominant fashion. However, the affected individuals also have a biological marker, one typically not tested, but suggestive of a channelopathy: reduced effectiveness of lidocaine. This is most conveniently demonstrated using lidocaine gel on the tongue, but most convincingly demonstrated by injection of lidocaine in a nondental area and observing negligible loss of sensation.

Life context of pharmacological academic performance enhancement among university students – a qualitative approach

BackgroundAcademic performance enhancement or cognitive enhancement (CE) via stimulant drug use has received increasing attention. The question remains, however, whether CE solely represents the use of drugs for achieving better academic or workplace results or whether CE also serves various other purposes. The aim of this study was to put the phenomenon of pharmacological academic performance enhancement via prescription and illicit (psycho-) stimulant use (Amphetamines, Methylphenidate) among university students into a broader context. Specifically, we wanted to further understand students’ experiences, the effects of use on students and other factors, such as pressure to perform in their academic and private lives.MethodsA sample of 18 healthy university students reporting the non-medical use of prescription and illicit stimulants for academic performance enhancement was interviewed in a face-to-face setting. The leading questions were related to the situations and context in which the students considered the non-medical use of stimulants.ResultsBased on the resultant transcript, two independent raters identified six categories relating to the life context of stimulant use for academic performance enhancement: Context of stimulant use beyond academic performance enhancement, Subjective experience of enhancement, Timing of consumption, Objective academic results, Side effects, Pressure to perform.ConclusionsThe answers reveal that academic performance enhancement through the use of stimulants is not an isolated phenomenon that solely aims at enhancing cognition to achieve better academic results but that the multifaceted life context in which it is embedded is of crucial relevance. The participants not only considered the stimulants advantageous for enhancing academic performance, but also for leading an active life with a suitable balance between studying and time off. The most common reasons given for stimulant use were to maximize time, to increase motivation and to cope with memorizing. According to the interviews, there is a considerable discrepancy between subjective experiences and objective academic results achieved.

The culpability of drivers killed in New Zealand road crashes and their use of alcohol and other drugs

Over a period of five years, blood samples were taken from 1046 drivers killed as a result of a motor vehicle crash on New Zealand roads. These were analysed for the presence of alcohol and a range of both illicit drugs and psychoactive medicinal drugs. Driver culpability was determined for all crashes. The control group of drug- and alcohol-free drivers comprised 52.2% of the study population. Drivers positive for psychoactive drugs were more likely to be culpable (odds ratio (OR) 3.5, confidence interval (CI) 95% 2.4–5.2) than the control group. Driver culpability exhibited the expected positive association with alcohol use (OR 13.7, 95% CI 4.3–44) and with combined alcohol and cannabis use (OR 6.9, 95% CI 3.0–16). There was only a weak positive association between cannabis use (with no other drug) and culpability (OR 1.3, CI 95% 0.8–2.3). Furthermore, the OR for drivers with blood tetrahydrocannabinol (THC) concentrations greater than 5ng/mL was lower (OR 1.0, CI 95% 0.4–2.4) than drivers with blood THC concentrations less than 2ng/mL (OR 3.1, CI 95% 0.9–10). This is inconsistent with results reported by other studies where a significant increase in crash risk was found with blood THC levels greater than 5ng/mL. In this study, there were very few drivers who had used a single drug, other than cannabis or alcohol. Therefore, from this study, it is not possible to comment on any relationship between opioid, stimulant or sedative drug use and an increased risk of being killed in a crash for the drivers using these drugs. The results from a multivariate analysis indicate that driver gender, age group and licence status, (P=0.022, P=0.016, P=0.026, respectively), the type of vehicle being driven (P=0.013), the number of vehicles in the crash (P<0.001), the blood alcohol concentration of the driver (P<0.001) and the use of any drug other than alcohol and cannabis (P=0.044), are all independently associated with culpability.

Gabapentin: Can It Be Misused?

Gabapentin, a gamma-aminobutyric acid analog drug, appears to be safe and efficacious for the treatment of alcohol dependence. Gabapentin is not a controlled drug, but there are anecdotal reports of its misuse and abuse as well as reports of withdrawal symptoms associated with abrupt discontinuation. The risk of gabapentin misuse is inconsistent, the magnitude of the risk is small, and the risk is not comparable to the much higher risks associated with alcohol use; benzodiazepine, opioid, and stimulant drug use; or illicit drug use. Reports of gabapentin misuse are not unique to this drug, as misuse of prescription medications not typically considered "drugs of abuse" can also occur.

Sedative Drug Use among King Saud University Medical Students: A Cross-Sectional Sampling Study

Introduction. Medical students experience significant psychological stress and are therefore at higher risk of using sedatives. There are currently no studies describing the prevalence of sedative drug use among medical students in Saudi Arabia. The aim of this study was to evaluate the prevalence and factors associated with sedative drug use among medical students in Saudi Arabia. Materials and Methods. A cross-sectional convenience sampling study gathered data by anonymous questionnaire from students enrolled at the King Saud University College of Medicine in 2011. The questionnaires collected data regarding social and demographic variables, sleep patterns, and the use of stimulant and sedative drugs since enrollment. Sedatives were defined as any pharmaceutical preparations that induce sleep. Results and Discussion. Of the 729 students who returned questionnaires, 17.0% reported sedative drug use at some time since enrollment. Higher academic year, lower grade point average, regular exercise, fewer hours of sleep per day, poorer quality of sleep, and the presence of sleeping disorders were found to be significantly associated with sedative drug use. Conclusions. Further study is required to increase our understanding of sedative drug use patterns in this relatively high-risk group, as such understanding will help in the development of early intervention programs.

Use of illicit stimulant drugs in Finland: A wastewater study in ten major cities

Estimations of drug use at the national level are generally based on various sources of information, such as drug seizures, socio-scientific studies, toxicological data and hospital records. Nevertheless, all of these approaches have limitations that cannot be overcome, even if conclusions are drawn from combined data retrieved from different sources. Drug epidemiology through wastewater analysis has the potential to provide unique perspectives, internationally comparable data, and up-to-date information on the use of both traditional illicit drugs and new psychoactive substances (NPSs). In Finland, no large-scale studies on regional illicit drug consumption, based on a wastewater approach, have been reported. In this study, 24-h influent composite samples were collected during two 1-week study periods from ten different wastewater treatment plants in May and November–December 2012. The cities included in the study represent the geographical areas throughout Finland and cover 40% of the Finnish population. The samples were analyzed with an in-house validated, ultra high-performance liquid–chromatography mass spectrometric (UHPLC–MS/MS) method for various common illicit drugs and some NPS type stimulant drugs. The results were also compared with available statistics, information on drug seizures and laboratory-confirmed toxicological data, as well as other studies available based on wastewater analysis. The data show that illicit stimulant drug use is more common in the larger cities of Southern Finland. Amphetamine was the most commonly used drug in all 10 cities during both collection periods (excluding the collection period in May in Lappeenranta). Cocaine consumption remains very low in Finland in comparison to other European countries; it was concentrated in the biggest cities in Southern Finland. This study shows interesting temporal and spatial differences in drug use in Finland, as well as the possibilities of using wastewater analytics to reveal local hotspots of NPS consumption.

Electroconvulsive Therapy Improves Persistent Psychosis After Repeated Use of Methylenedioxypyrovalerone (“Bath Salts”)

The use of synthetic cathinone drugs, known popularly as "bath salts," may lead to persistent visual hallucinations and paranoia with repeated use. This is the first case report known to the authors suggesting that such symptoms may persist despite discontinuing the use of psychoactive bath salts. As is the case with other such symptoms associated with use of stimulant drugs of abuse, these symptoms are resistant to pharmacologic treatment, and electroconvulsive therapy can be a useful treatment modality in such situations. This report adds to evidence for efficacy of electroconvulsive therapy in the management of stimulant-induced persistent psychotic symptoms.

Increased cortisol levels in hair of recent Ecstasy/MDMA users

Previous research has revealed an acute 8-fold increase in salivary cortisol following self-administrated Ecstasy/MDMA in dance clubbers. It is currently not known to what extent repeated usage impacts upon activity of the hypothalamic–pituitary–adrenal axis over a more prolonged period of time. This study investigated the integrated cortisol levels in 3-month hair samples from recent Ecstasy/MDMA users and non-user controls. One hundred and one unpaid participants (53 males, 48 females; mean age 21.75 years) completed the University of East London recreational drug use questionnaire, modified to cover the past 3-months of usage. They comprised 32 light recent Ecstasy/MDMA users (1–4 times in last 3 months), 23 recent heavy MDMA users (+5 times in last 3 months), and 54 non-user controls. Volunteers provided 3cm hair samples for cortisol analysis. Hair cortisol levels were observed to be significantly higher in recent heavy MDMA users (mean= 55.0±80.1pg/mg), compared to recent light MDMA users (19.4±16.0pg/mg; p=0.015), and to non-users (13.8±6.1pg/mg; p<0.001). Hence the regular use of Ecstasy/MDMA was associated with almost 4-fold raised hair cortisol levels, in comparison with non-user controls. The present results are consistent with the bio-energetic stress model for Ecstasy/MDMA, which predicts that repeated stimulant drug use may increase cortisol production acutely, and result in greater deposits of the hormone in hair. These data may also help explain the neurocognitive, psychiatric, and other psychobiological problems of some abstinent users. Future study design and directions for research concerning the psychoneuroendocrinological impact of MDMA are also discussed.

Pediatric neuroenhancement: Ethical, legal, social, and neurodevelopmental implications

The recent article on pediatric neuroenhancement is an excellent review of the ethical aspects of stimulant drug use.1 However, the authors may be off point. Most children initially receive stimulant medications from general pediatricians and family physicians who believe that they are treating attention deficit disorder (ADD). These physicians do not believe that they are prescribing drugs for neuroenhancement. It is rare for children taking these drugs to have received psychometric testing and these drugs are frequently started in elementary …

Detecting Alcohol and Illicit Drugs in Oral Fluid Samples Collected from Truck Drivers in the State of São Paulo, Brazil

Objective: Alcohol and drug use by truck drivers is a current problem in Brazil. Though there is evidence that alcohol consumption is occurring in higher proportions, the use of stimulant drugs to avoid fatigue and to maintain the work schedule has also been reported. The purpose of this study was to estimate the incidence of alcohol and illicit drug use among truck drivers on São Paulo state roads. São Paulo is the most populous state in Brazil and has the largest industrial park and economic production in the country. Methods: Data were assessed not only using a questionnaire but also, and more reliably, through toxicological analysis of oral fluid samples. Between the years 2002 and 2008, 1250 oral fluid samples were collected from truck drivers on the roads during morning hours. The samples were tested for the presence of alcohol, cocaine, tetrahydrocannabinol (THC), and amphetamine/methamphetamine. A previously published, validated gas chromatographic (gas chromatography–flame ionization detection and gas chromatography–mass spectrometry) method was applied to the samples for alcohol and drug detection. Results: Of the total analyzed samples, 3.1 percent (n = 39) were positive: 1.44 percent (n = 18) were positive for alcohol, 0.64 percent (n = 8) for amphetamines, 0.56 percent (n = 7) for cocaine, and 0.40 percent (n = 5) for THC. In one case, cocaine and THC were detected. The results are indicative of the extent of alcohol and drug use by truck drivers in the state of São Paulo, Brazil. Conclusions: This research provides evidence that not only alcohol but also illicit drug use is a real problem among professional drivers. The use of these substances should be controlled to better promote safe driving conditions on Brazilian roads.

Factors Contributing to Staff’s Susceptibility to HIV in Oromia Agricultural Research Institute: A Case Study from Zeway Fisheries Resources Research Center

This case study was conducted during the year of 2012 on the staffs of Zeway fisheries resources research centre, Oromia. It mainly focused on identifying factors contributing to staffs susceptibility to HIV. Susceptibility refers to the likelihood of being infected by HIV. Qualitative analysis has been widely used. Data has been presented and analysed by use of the following: Discussions, tables, responses were organized together according to their types. The study identified the following as factors that contributed to susceptibility to HIV. These factors were knowledge of staffs on HIV transmission and methods of HIV prevention, decision making, and culture of silence on HIV/AIDS aspects, religious practices and beliefs, long absence from home, use of field allowance and use of stimulant drugs. The study indicated that the likelihood of staffs susceptibility to HIV with regard to their knowledge about HIV transmission and methods of HIV prevention is less likely and with regards to use of stimulant drugs, use of field allowance, long absence from home and culture of silence on HIV and AIDS aspects, the staffs were more likely to be susceptible to HIV infection. Organization need to encourage behavioural change or change from high risk to more responsible sexual behaviour. Due to having disposable field allowances and absence of better recreation centres during field work, men staffs tend to show high susceptibility by spending part of their allowances to drink alcohols. However, no way to reduce their field allowances. Therefore, organization should deal with those identified as a high susceptibility group of men to bring behavioural change. One way of dealing with this is through providing managerial level consultation.