Trends In Drug Use Research Articles

Emerging psychoactive drugs and the common life events among adolescents in a Nigerian rehabilitation centre

ABSTRACT Adolescence is characterised by intense experimentation. This study examined the prevalence and pattern of psychoactive substance use and common life events among adolescents abusing psychoactive substances in a Nigerian Hospital. The study employed cross-sectional descriptive method of 385 patients admitted for drug rehabilitation in the ABUAD Multisystem Hospital Ado Ekiti, Ekiti State Nigeria. Smoking and eating Marijuana (47.6%), eating Datura stramonium leaf (32.2%) and drinking alcohol (11.4%) were psychoactive substances commonly used among the respondents. The predominant life events among respondents included: heavy load of study (34.3%), study pressure from family (26.5%), family member serious illness (23.5%), scolding by parents (21.1%), and tired of learning (20.8%). Datura stramonium leaf abuse is an emerging psychoactive substance among the respondents. Relevant stakeholders should be aware of the new trend in drug use among adolescents and coordinated effort should be made to stop the trend.

The Prevalence of and Trend in Drug Use among Adolescents in Mississippi and the United States: Youth Risk Behavior Surveillance System (YRBSS) 2001-2021.

Mississippi youth are demographically unique compared to those of the nation. The aim of the study was to examine the drug use among adolescents in Mississippi compared to that in the US, which included determining prevalence and trends in drug use as well as drugs on school property and estimating the differences in drug use prevalence by gender and by race. National and Mississippi Youth Risk Behavior Surveillance System (YRBSS) data from 2001 to 2021 were obtained for analysis. Summary statistics, prevalence ratio, and survey Chi-squared tests of independence statistics were generated for the comparison for all students, and by gender and race separately. Trend analysis was conducted using logistic regression combined with joinpoint regression. The six survey questions being studied were the following: have you ever used marijuana, an inhalant, heroin, methamphetamines, or injected drugs, and were you offered, sold, or given an illegal drug on school property during the last 12 months. Survey packages in R were used to account for the complex sampling design of YRBSS data. On the national level, all six drug-related risk behaviors being studied showed a significant decrease from 2001 to 2021. In Mississippi, however, only "ever used marijuana" showed a decrease trend, while three remain unchanged, and two increased. The 2021 YRBSS data show that Mississippi adolescents exhibited a significantly higher prevalence of drug use, and are more likely to be offered, sold or given an illegal drug on school property. This research showed detailed findings on drug use-related issues in Mississippi, which is alarming. This poses an important challenge for public health in Mississippi and sounds an urgent call for drug use intervention among Mississippi adolescents. More concerted actions at the community, school and government level are needed for reducing youth drug use and controlling the drug traffic on school property.

Comprehensive Urine Drug Screen by Liquid Chromatography-Quadrupole Time of Flight Mass Spectrometry.

Current trends in drug use include polydrug use as well as an ever-changing landscape of novel psychoactive substances. Immunoassay-based urine drug screens limited to classic drugs of abuse do not have the scope necessary to identify patients with drug intoxications or drug misuse. Mass spectrometry is an alternative method that is both sensitive and specific. In this chapter, we present a liquid chromatography-quadrupole mass spectrometry-based method for qualitative comprehensive urine drug screening. The method runs in positive mode and encompasses over 1000 basic compounds, including pharmaceutical, illicit, and novel drugs. Retention time, MS and MS/MS spectra, mass error, and isotope confidence are parameters used for compound identification. New compounds are readily added as new recreational drugs emerge.

Ten-year clinical characteristics of patients with early-onset type 2 diabetes: A single-center experience in China.

The incidence of type 2 diabetes in China has exhibited an increasing trend, including younger individuals, over the past years. Early-onset type 2 diabetes (EOT2D) refers to diabetes diagnosed before 40 years of age. These patients have poor metabolic control and are highly susceptible to diabetic complications, which poses challenges for treatment. However, few studies have reported on the treatment of EOT2D. We determined clinical features and trends in drug use in patients with type 2 diabetes mellitus (T2DM). This retrospective study was performed at the Endocrinology Ward, Peking Union Medical College Hospital (PUMCH). "Diabetes" was used when searching PUMCH's Electronic Medical Record Analytical Database to obtain clinical data of patients between January 2013 and May 2022. The analysis included 1590 patients with T2DM. Among them, 609 (38.3%) had EOT2D. Compared with late-onset type 2 diabetes (LOT2D) patients, EOT2D patients exhibited worse glycemic control and higher body weight and lipid levels despite significant age differences. EOT2D patients also had a higher risk of diabetic retinopathy and nephropathy. Under the general trend of increasing use of dipeptidylpeptidase-4 inhibitors, sodium-glucose cotransporter-2 inhibitors, and glucagon-like peptide-1 agonists, patients with EOT2D were more likely to use organ-protective drugs. Compared with LOT2D patients, EOT2D patients have a longer course of diabetes, worse metabolic control, and a higher rate of developingmicrovascular complications. The administration of combined therapy, including new agents, may require consideration when selecting hypoglycemic agents for treating EOT2D.

The trends in death of primary liver cancer caused by specific etiologies worldwide: results from the Global Burden of Disease Study 2019 and implications for liver cancer management

BackgroundOver past decades, epidemiological patterns of liver cancer (LC) have changed dramatically. The Global Burden of Disease (GBD) study provides an opportunity for tracking the progress in cancer control with its annual updated reports at national, regional and global level, which can facilitate the health decision-making and the allocation of health resources. Therefore, we aim to estimate the global, regional and national trends of death caused by liver cancer due to specific etiologies and attributable risks from 1990 to 2019.Materials and methodsData was collected from the GBD study 2019. Estimated annual percentage changes (EAPC) were used to quantify the trends of age-standardized death rate (ASDR). We applied a linear regression for the calculation of estimated annual percentage change in ASDR.ResultsFrom 1990 to 2019, the ASDR of liver cancer decreased globally (EAPC = − 2.23, 95% confidence interval [CI]: − 2.61 to − 1.84). Meanwhile, declining trends were observed in both sexes, socio-demographic index (SDI) areas, and geographies, particularly East Asia (EAPC = − 4.98, 95% CI: − 5.73 to − 4.22). The ASDR for each of the four major etiologies fell globally, while liver cancer caused by hepatitis B had the largest drop (EPAC = − 3.46, 95% CI: − 4.01 to − 2.89). China has had dramatic decreases in death rates on a national scale, particularly when it comes to the hepatitis B etiology (EAPC = − 5.17, 95% CI: − 5.96 to − 4.37). However, certain nations, such as Armenia and Uzbekistan, saw a rise in liver cancer mortality. Controlling smoking, alcohol, and drug use contributed to a drop in LC-related mortality in the majority of socio-demographic index areas. Nevertheless, the excessive body mass index (BMI) was portrayed as the underlying cause for LC fatalities.ConclusionFrom 1990 to 2019, there was a worldwide decrease in deaths caused by liver cancer and its underlying causes. However, rising tendencies have been observed in low-resource regions and countries. The trends in drug use- and high BMI-related death from liver cancer and its underlying etiologies were concerning. The findings indicated that efforts should be increased to prevent liver cancer deaths through improved etiology control and risk management.

Trends in drug use among nightclub and festival attendees in New York City, 2017-2022.

Drug use is prevalent among people who attend electronic dance music (EDM) parties at nightclubs or festivals. This population can serve as a sentinel population to monitor trends in use of party drugs and new psychoactive substances (NPS) that may diffuse through larger segments of the population. We surveyed adults entering randomly selected EDM parties at nightclubs and dance festivals in New York City about their drug use in 2017 (n=954), 2018 (n=1,029), 2019 (n=606), 2021 (n=229), and 2022 (n=419). We estimated trends in past-year and past-month use of 22 drugs or drug classes based on self-report from 2017-2022 and examined whether there were shifts pre- vs. post-COVID (2017-2019 vs. 2021-2022). Between 2017 and 2022, there were increases in past-year and past-month use of shrooms (psilocybin), ketamine, poppers (amyl/butyl nitrites), synthetic cathinones ("bath salts"), and novel psychedelics (lysergamides and DOx series), increases in past-year cannabis use, and increases in past-month use of 2C series drugs. Between 2017 and 2022, there were decreases in past-year heroin use and decreases in past-month cocaine use, novel stimulant use, and nonmedical benzodiazepine use. The odds of use of shrooms, poppers, and 2C series drugs significantly increased after COVID, and the odds of use of cocaine, ecstasy, heroin, methamphetamine, novel stimulants, and prescription opioids (nonmedical use) decreased post-COVID. We estimate shifts in prevalence of various drugs among this sentinel population, which can inform ongoing surveillance efforts and public health response in this and the general populations.

Fatal drug use in the COVID-19 pandemic response: Changing trends in drug-involved deaths before and after stay-at-home orders in Louisiana.

The effect of disaster events on increasing drug-involved deaths has been clearly shown in previous literature. As the COVID-19 pandemic led to stay-at-home orders throughout the United States, there was a simultaneous spike in drug-involved deaths around the country. The landscape of a preexisting epidemic of drug-involved deaths in the United States is one which is not geographically homogenous. Given this unequal distribution of mortality, state-specific analysis of changing trends in drug use and drug-involved deaths is vital to inform both care for people who use drugs and local policy. An analysis of public health surveillance data from the state of Louisiana, both before and after the initial stay-at-home order of the COVID-19 pandemic, was used to determine the effect the pandemic may have had on the drug-involved deaths within this state. Using the linear regression analysis of total drug-involved deaths, as well as drug-specific subgroups, trends were measured based on quarterly (Qly) deaths. With the initial stay-at-home order as the change point, trends measured through quarter 1 (Q1) of 2020 were compared to trends measured from quarter 2 (Q2) of 2020 through quarter 3 (Q3) of 2021. The significantly increased rate of change in Qly drug-involved deaths, synthetic opioid-involved deaths, stimulant-involved deaths, and psychostimulant-involved deaths indicates a long-term change following the initial response to the COVID-19 pandemic. Changes in the delivery of mental health services, harm reduction services, medication for opioid use disorder (MOUD), treatment services, withdrawal management services, addiction counseling, shelters, housing, and food supplies further limited drug-involved prevention support, all of which were exacerbated by the new stress of living in a pandemic and economic uncertainty.

Long-term wastewater-based surveillance and impacts of the COVID-19 pandemic on drug use trends in a U.S. Northeast rural town

Herein we discuss the findings of a two-year wastewater-based drug use surveillance from September 2018 to August 2020 and present objective evidence on the impacts of the COVID-19 pandemic on drug use in a rural community. 24-h composite wastewater samples were collected twice each month from a university town in Northeastern United States and were analyzed for ten priority opioids and stimulants: morphine, codeine, hydrocodone, methadone, fentanyl cocaine, methamphetamine, amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), and 3,4-methylenedioxy-N-ethylamphetamine (MDEA). All target drugs were detected at 100 % frequency in wastewater samples. On a mass basis, the average estimated per capita drug consumption were highest for cocaine, morphine, and amphetamine, and lowest for MDMA, MDEA, and hydrocodone. Furthermore, the estimated per capita consumption of fentanyl was higher than previous reports from rural and university settings in the U.S. Generally, drug consumption was higher during the spring semesters, with year-on-year semester increases also noted over the 2-y study period. Except for methadone and cocaine, the estimated average per capita consumption of drugs increased over the pandemic period, with the highest increase noted for MDMA (286 % increase compared to baseline, p = 0.016). Estimated average consumption of methadone and cocaine decreased slightly by 6 % and 7 %, respectively. These results demonstrate the utility and strength of wastewater-based approaches in capturing long-term and evolving trends in drug use within communities. Our study findings reflect the regionwide problem with opioid-related overdoses and increasing stimulant prescription rates. Our findings also provide objective data and insights for health policymakers on the effects of the pandemic period on community drug use in a rural U.S. town.

1147. Regional Trends in Favipiravir and Steroid Use in the Treatment of COVID-19

Abstract Background Two years have passed since the global outbreak of COVID-19 began. Vaccines and many therapeutic agents have now been developed, and treatment is being conducted in accordance with guidelines. In general, it takes a long time for guidelines to be established, as a large amount of clinical data is required. Therefore, in the early and middle stages of an epidemic, treatment is often based on experience at individual centers. This study focuses on two drugs, Favipiravir and Steroid, and investigates how trends in drug use changed in different regions. Methods We compared the proportion of drug administered patients in the COVID-19 Registry Japan (COVIREGI-JP). Data from four COVID-19 epidemic waves, from January 2020 to June 2021, were included for the analysis. To compare regional trends, 10 categories were used based on existing classifications. In addition, Tokyo and Osaka were accounted for separately, for a total of 12 regions. Severity of each case was divided into mild, moderate 1, moderate 2 and severe based on the condition on admission, and the proportion of Favipiravir or Steroid administered cases was calculated for moderate 2 and severe cases. Results Favipiravir was administered to more than 50-100% of patients in the first wave. Thereafter, it declined nationwide, with sharp falls in Tokyo (34.9%, 16.5% and 4.3%) and Osaka (48.8%, 41.8% and 8.0%). In Hokkaido, on the other hand, 82.4%, 53.7% and 59.8% of the cases still continued to receive Favipiravir. In the first wave, Steroid was administered to 20-40% of cases. The proportion gradually increased, with 50-80% in the second wave, and 85.5% in Tokyo, 93.4% in Osaka and 90.2% in Hokkaido in the fourth wave, the majority of cases. Changes over time in the proportions of cases treated with Favipiravir and Steroid in each region. The top four and middle four panels show the proportion of cases treated with Favipiravir and Steroid, respectively. The lower epi-curve shows the number of COVID-19 cases in Japan. Conclusion We confirmed that the more effective treatment was rapidly spreading throughout the country. More information is available in areas with a large number of cases, such as Tokyo and Osaka, and in facilities that see a large number of cases. On the other hand, it may be difficult for smaller facilities or facilities that do not see many COVID-19 cases. Information from registry studies would be useful in making more effective treatments available earlier and more widely. We believe that further use of COVIREGI-JP would promote standardization of treatment. Disclosures All Authors: No reported disclosures.

Exploring Potential Bellwethers for Drug-Related Mortality in the General Population: A Case for Sentinel Surveillance of Trends in Drug Use among Nightclub/Festival Attendees

Background : Drug-related deaths in the US continue to increase. Sentinel surveillance of high-risk populations can provide early warning for shifts in trends. Nightclub/festival attendees have high levels of drug use, so we explored whether use among this population can serve as a potential bellwether or indicator for use-related mortality in the general population. Methods : Trends in past-year cocaine and methamphetamine use were estimated from nightclub/festival attendees in New York City (NYC) and among NY residents, and trends were estimated for related death rates in NYC (2014/15–2019/20). Using national data from England and Wales (2010–2019), trends in past-year cocaine and ecstasy use (among the full population and among nightclub attendees) and related deaths were also estimated. Results : In NY/NYC, cocaine use remained stable in the general population, but use among nightclub/festival attendees and cocaine-related deaths doubled. Methamphetamine use among nightclub/festival attendees and death rates also more than doubled while use among the general population remained stable. In UK countries, increases in cocaine and ecstasy use were larger for infrequent/frequent nightclub attendees than in the general population, with 3.6- and 8-fold increases in related deaths, respectively. In UK countries, the association between nightclub attendance and death rates increased in a dose-response-like manner with larger associations detected when death rates were lagged by one year. Conclusions : Patterns of use among nightclub/festival attendees, more so than patterns in the general population, were similar to patterns of drug-related deaths. Use among this subpopulation could possibly serve as a bellwether for use-related outcomes. Continued surveillance is recommended.

Wastewater-based epidemiology combined with forensic toxicological information: trends in drug use and impact of law enforcement activities

Wastewater-based epidemiology (WBE) has recently become one of the most rapidly evolving disciplines engaged in the measurement of population-level illicit drug use. Still, limited evidence has been presented how population-level WBE data correlates to forensic toxicological statistics and law enforcement activities. Objective was to study (1) how WBE methodology can efficiently give early-warning type of information on drug use and its trends, (2) how WBE findings compared to number of drivers under influence of drugs (DUID), and (3) how (exceptionally large) law enforcement operation affected actual drug use. Wastewater analysis: 24-h wastewater influent composite samples ( n = 190) were collected during 04/2013–03/2022 from Helsinki wastewater treatment plant (WWTP) serving approximately 860,000 inhabitants. Furthermore, several national sampling campaigns up to 28 WWTPs covering approximately 60% of all Finnish population (3.2 million out of 5.5 million) during 2012–2022 were performed. All samples were analysed by validated UHPLC-MS/MS. For comparison, traffic cases: Prevalence of different drugs was studied in all suspected DUID cases in Finland (from 2013 to 2021). All cases (whole blood) were systematically analysed by chromatographic mass spectrometric techniques. Law enforcement operation of illicit drugs: Information on Operation Greenlight (Trojan Shield), which was an exceptional operation in size together with Finnish and several international law enforcement authorities worldwide starting in February 2021 in Finland. Both wastewater analysis data and suspected DUID cases confirm the significant rise of amphetamine and cocaine use between 2013 to early 2021 in Finland. Based on WBE, amphetamine use peaked at record-high level from mid-2020 (after COVID-19 lockdown) to spring 2021 in the capital area of Finland. Mean amphetamine mass loads were 92 mg/1000 persons/day in 2013, 335 in 2020, 322 in H1/2021, 234 in H2/2021 and 162 in Q1/2022 at the wastewater of Helsinki WWTP. The use of amphetamine significantly decreased in 2021 after the start of Operation Greenlight, while for cocaine effects on population-level use were more temporary. The number of amphetamine positive DUID in Finland showed similar trend: 2064 cases in 2013 (45.9% of all suspected DUID cases), 7913 (65.8%) in 2020 and 6228 (63.6%) in 2021 for amphetamine. For cocaine, the similar figures in wastewater were 18 (2013), 119 (2020), 110 (H1/2021), 144 (H2/2021) and 141 mg/1000 persons/day (Q1/2022), respectively. The number of cocaine-related DUID increased from 81 (2013) to 501 (2021). Cocaine use is still highly concentrated in the capital area of Finland and there has been 6-8-fold increase in cocaine use at population-level during the last eight years. Based on WBE, the use of amphetamine was partially replaced by methamphetamine and synthetic cathinones, such as alfa-PHP, at the end of 2021, but not close to the same extent as amphetamine use was reduced. The results show in detail how use of various illicit drugs has changed during the last decade in Finland. WBE and DUID results have strongly correlated with each other concerning drug use and its trends: increase/decrease in population-level drug use has also increased/decreased harmful societal phenomena of illicit drugs, such as DUID. The results obtained during the last year indicate that unexceptionally large and successful law enforcement operations may affect drug supply, reduce actual drug use and diminish harmful societal effects, such as DUID. Extensive 10-year data and experience on WBE approach shows that objective, novel and early-warning type of information on drug use and its trends for various illicit drugs can be obtained. More comprehensive picture and unique perspectives on drug use and drug markets are further obtained when combining different indicators and information, as exemplified here with WBE and DUID data linked to law enforcement activities.

Trends in drug use among young adult females: a 22-year retrospective analysis

Louisiana State University Health Sciences Center at Shreveport (LSUHSC-S) serves a largely minority-based, urban population. This study aims to identify trends in urine drug screen (UDS) results among females aged 18–35 visiting State University during 1998–2011 and 2012–2019. Using two databases extracted from the electronic medical record system, we performed statistical analysis of demographics and UDS results. Young females aged 18–35 mostly tested positive for cannabinoids and opiates during both periods, 1998–2011 and 2012–2019. African-American females had a higher percentage of positive UDS for illicit drugs, such as cannabinoids and cocaine, while Caucasian females had a higher rate for prescription drugs such as opiates, benzodiazepines, and amphetamine. Between 1998–2011 and 2012–2019, trends in drug screen results changed in both populations, with Caucasian females showing a drastic increase in amphetamines and African-American females showing increase in opiates and cannabinoids during 2012–2019. GatewayNet analysis (sequential-rule mining for inducing causation) for 2012–2019 indicated that a positive screen for amphetamines is likely preceded by a positive screen for cannabinoids, and benzodiazepines may be preceded by opiates. Our results emphasize the importance of drug use monitoring among young females of childbearing age. GatewayNet analysis implies a sequential nature to drug positivity on urine drug screening in this population.

Definitive urine drug test findings in patients prescribed opioids for pain from a large national database.

Clinicians and policymakers have been wrestling with the appropriateness and safety of opioid therapy during the opioid crisis. Policy and clinical decisions have often been made without much current data on trends in drug use in patients with pain. Thus, we evaluated definitive urine drug test (UDT) results in patients being treated for pain to see if those taking their prescribed opioids were less likely to be positive for the primary illicit drugs currently driving overdose deaths: cocaine, heroin, fentanyl, and methamphetamine. A cross-sectional study of UDT results from January 1, 2015 to September 30, 2021, from 600,000 patient specimens submitted for testing by pain management specialists. UDT by liquid chromatography-tandem mass spectrometry as ordered by the treating clinician. Presence of other substances stratified by whether a patient's prescribed opioid was found. The presence of cocaine, heroin, fentanyl, and methamphetamine for the total population was low (<5 percent). Of the 347,092 patients prescribed opioids, 76 percent (n = 264,961) were positive on UDT for their prescribed opioid ("consistent"). Compared to patients without their prescribed opioid present ("inconsistent"), patients consistent with therapy were 54 percent (incidence rate ratio (IRR) 1.54, 95 percent confidence interval (CI) 1.47-1.59) less likely to be positive for cocaine, 47 percent [IRR 1.47, 95 percent CI 1.34-1.57] less likely to be positive for heroin, and 35 percent [IRR 1.35, 95 percent CI 1.24-1.45] less likely to be positive for methamphetamine, p < 0.001. Differences between the groups for fentanyl were not significant. Overall positivity rates for cocaine, heroin, fentanyl, and methamphetamine were low. Patients with prescribed opioid present were less likely to be positive for cocaine, heroin, or methamphetamine. Patterns of substance use within this pain management population should be used to inform ongoing policy decisions.

Glucose-lowering drug use, glycemic outcomes, and severe hypoglycemia: 18-Year trends in 0·9 million adults with Diabetes in Hong Kong (2002–2019)

SummaryBackgroundImprovements in glycemic outcomes have stalled since 2010 in several international surveys. We previously reported improvements in glycemic control in 2007-2014 in Hong Kong coinciding with primary care reforms, use of dipeptidyl-peptidase 4 inhibitors (DPP-4is) and metformin. The aim of this study was to estimate more recent trends in drug use and glycemic outcomes following introduction of newer classes of glucose-lowering drugs (GLDs).MethodsUsing population-based data from the Hong Kong Diabetes Surveillance Database, we explored age-specific trends in proportion of patients reaching glycemic targets and incidence rates of severe hypoglycemia (SH) in 963,612 adults with diabetes in 2002-2019. We further assessed patterns of GLDs utilisation by presence of atherosclerotic-cardiovascular disease (ASCVD), heart failure, and estimated-glomerular filtration rate (eGFR).FindingsFollowing rapid decline in HbA1c from 7·7% to 7·2% in 2005-2014 (annual percentage change [APC]= -0·8, 95% CI:-1·0,-0·6), standardized mean HbA1c plateaued since 2014 (HbA1c 7·2% in 2019, APC=0·0, 95% CI:-0·2, 0·2). The incidence rates of SH declined from 3·4 to 0·7 events per 100-person years, but improvements levelled off since 2014. Use of metformin steadily increased (41·1 to 58·7%), sulfonylureas decreased (52·2 to 31·1%) while insulin remained static in 2002-2019. Adoption of DPP-4is slowed following initial rapid uptake in 2007-2011. DPP-4is remained the most widely prescribed newer GLD in all ages (14·3% in 2019). Use of glucagon-like-peptide 1 receptor agonists (GLP1-RAs) and sodium glucose co-transporter-2 inhibitors (SGLT2is) increased rapidly in 2015-2019 with 0·5% and 6% of users respectively in 2019.InterpretationFollowing rapid improvement in 2007-2014, glycemic control and SH rates had plateaued despite changing patterns of newer GLDs use in Hong Kong.FundingDr. Aimin Yang was supported by a CUHK Impact Research Fellowship Scheme.

New indicators of illegal drug use to compare drug user populations for policy evaluation

&#x0D; Background: New trends in drug consumption show a trend towards higher poly-use. Epidemiological indicators presently used are mostly based on the prevalence of users of the “main” substances and the ranking of harm caused by drug use is based on a single substance analysis.&#x0D; Methods: In this paper new indicators are proposed; the approach consider the segmentation of the population with respect to the frequency of use in the last 30 days and the harm score of the various substances used by a poly-user. Scoring is based on single substance score table reported in recent papers and principal component analysis is applied to reduce dimensionality. Any user ischaracterized by the two new scores: frequency of use score and poly-use score.&#x0D; Results: The method is applied to the drug user populations interviewed in Communities and Low Threshold Services within the Problem Drug Use 2012 survey in four different European countries. The comparison of the poly-use score cumulative distributions gives insight about behavioural trends of drug use and also evaluate the efficacy of the intervention services. Furthermore, the application of this method to School Population Survey 2011 data allows a definition of the expected behaviour of the poly-drug score for the General Population Survey to be representative.&#x0D; Conclusions: In general, the method is simply and intuitive, and could be applied to surveys containing questions about drug use. A possible limitations could be that the median is chosen for calculating the frequency of use score in questionnaires containing the frequency of drug use in classes.&#x0D;

934-P: Real-World Evidence of Glucose Lowering Drug Use, Glycemic Outcomes, and Severe Hypoglycemia in Hong Kong: Eighteen-Year Trends in 0.9 Million Adults with Diabetes

Introduction: Improvements in glycemic outcomes have stalled since 20in some international surveys. We examined the latest trends in drug use and glycemic outcomes following recent introduction of newer classes of glucose lowering drugs (GLDs) in a territory-wide analysis. Methods: Using data from the Hong Kong Diabetes Surveillance Database, we estimated age-specific trends in the proportion of patients reaching different glycemic targets, and rates of severe hypoglycemia (SH) in 963,612 patients between 2002-2019. We assessed patterns of GLDs use by age, sex, presence of atherosclerotic cardiovascular disease (ASCVD) and estimated glomerular filtration rate (eGFR) . Results: HbA1c improved most markedly between 2007-2014 but plateaued since 2014, with 53.1% patients achieving HbA1c &amp;lt;7% in 2019. The 20-44 age group had the highest proportion with HbA1c ≥9% (22.1% in 2002 and 16.8% in 2019) compared with the ≥75 age-group (14.9% in 2002 and 5.5% in 2019) . SH rates declined between 2002-20 and further in 2010-2014. Between 2002-2019, metformin use increased steadily from 41.1% to 58.7%, sulfonylurea use decreased from 52.2% to 31.1% while insulin use remained static. Use of dipeptidyl-peptidase 4 inhibitors (DPP4i) experienced rapid growth between 2007-20equally in all age groups, with a slower rise between 2011-2019. DPP4i remains the most widely prescribed newer oral GLDs (14.3%) compared with sodium glucose co-transporter 2 inhibitors (SGLT2is) (4.2%) and glucagon like peptide-1 receptor agonists (GLP1-RAs) (0.6%) in 2019. Compared with over 75s, higher proportions of the 20-44 age-group were treated with SGLT2is (6.4% versus 1.7%) and GLP-1RAs (1.5% versus 0.1%) and thiazolidinediones (8.1% versus 3.4%) in 2019, irrespective of ASCVD status. Conclusions: Following rapid improvement in 2007-2014, glycemic control and SH rates had plateaued despite the increasing use of SGLT2is and GLP-1RA in Hong Kong. Disclosure A.Yang: None. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer AG, Boehringer Ingelheim International GmbH, Celltrion, Merck Sharp &amp; Dohme Corp., Roche Diabetes Care, Viatris Inc., Research Support; Applied Therapeutics, AstraZeneca, Eli Lilly and Company, Hua Medicine, Servier Laboratories, Stock/Shareholder; GemVCare Ltd. E.Chow: Research Support; Hua Medicine, Medtronic, Powder Pharmaceuticals Inc., Speaker's Bureau; Novartis AG, Sanofi. H.Wu: None. E.S.H.Lau: None. X.Zhang: None. M.Shi: None. B.Fan: None. A.P.Kong: Advisory Panel; Abbott, Kyowa Kirin Co., Ltd., Other Relationship; AstraZeneca, Novo Nordisk, Research Support; Boehringer Ingelheim, Speaker's Bureau; AstraZeneca, Bayer, Eli Lilly and Company, Sanofi, Stock/Shareholder; Aptorum Group Limited. A.Luk: None. R.C.Ma: Other Relationship; Bayer AG, Boehringer Ingelheim International GmbH, Research Support; AstraZeneca, Bayer AG, Novo Nordisk A/S, Pfizer Inc., Tricida, Inc.

Intoxication related to substances use in patients presenting to Ain Shams University Poisoning Treatment Center, Cairo, Egypt (2015–2019)

Illicit drug use may result in several emergencies. Hospital emergency data can help to detect new patterns of substance use and high-risk trends of drug use. This epidemiological study aimed to investigate the pattern and outcome of cases with substance use intoxication who presented to Ain Shams University Poisoning Treatment Centre, Cairo, Egypt. This retrospective study included all cases of acute intoxication due to use/misuse of substances who presented to the centre during the period (2015-2019). The study included 11 281 cases; young adults (aged 20-40 years) represented the greatest proportion of cases (6519, 57.8%). Males were the predominant gender in all age groups (representing 79.2% of the cases). Tramadol was the most common substance of exposure in all age groups except for children and adolescents where cannabis was the most common one. There were 162 fatalities (1.4% of all cases) and opioids had the greatest case fatality rate. Tramadol was the most used drug that resulted in acute intoxication, followed by cannabis. A total of 43.6% of the cases of acute intoxications were due to recreational use/misuse of prescription drugs.

ADOLESCENT DRUG ADDICTION IN UKRAINE: SOCIAL AND PSYCHOLOGICAL ASPECTS. Review

Relevance. The relevance is determined by the danger of drug addiction among Ukrainian adolescents, and the lack of attention by parents to the study of this problem, and the lack of proper attention to this issue in most Ukrainian schools. Currently, the main social and psychological aspects that motivate modern Ukrainian adolescents to use drugs have not been sufficiently identified and studied.&#x0D; Objective: to identify the dominant psychological and social factors that motivate Ukrainian adolescents to start using drugs.&#x0D; Methods. Analysis of publications from scientometric electronic databases by keywords. Search depth - 18 years (2001-2018).&#x0D; Results. The social factors that influence the spread of adolescent drug addiction in Ukraine include the decline in the general standard of living in the country over the past 25-30 years; mass unemployment among the population, lack of life prospects for a large part of the country's population; the spread of the AIDS epidemic among the population (the number of drug addicts among HIV-infected reaches 80%); the growth of crime in modern Ukrainian society and the associated availability of drugs. Also, the indifference of modern Ukrainian society to the existing problem; the absence of a state program to prevent the spread of drugs among adolescents with the mandatory registration of new drug addicts, and the presence in the high school curriculum of special lessons that explain the essence of the problem and ways to solve it.&#x0D; Factors of a psychological nature that affect the spread of adolescent drug addiction in Ukraine include: inattention of parents to this problem, lack of preventive work in families to reverse trends in drug use by adolescents; bad microclimate in the families of adolescent drug addicts, the indifference of parents to children's problems; alcoholism of parents in the families of young drug addicts; the example of friends who started using drugs at a young age; the desire of adolescents to try new sensations; the inability of adolescents to understand for themselves the harm that drugs can potentially do to them and their organism.&#x0D; Conclusions. Problems in families are a major reason for modern children to use drugs.

Identification of the Effect of Drug Use Trends on Senior High School in Banda Aceh City: Multiple Logistic Regression Analysis

Introduce. “The problem of abuse in Indonesia has entered an alarming stage, where drugs are not only abused by adults but also by students. There are 6.4% are Senior High School. Research Objectives To identify trends in drug use among Senior High School in Banda Aceh City”. Method. “Analytical research design with a sample of 256 students with multiple logistic regression analysis”. Result. “Hereditary factors sig (0.198), parent factors sig (0.018), individual factors sig (0.013), peer risk factors 2.354 times, availability sig (0.007), the cultural factors risk level of 2.420 times”. Conclusion. “Based on the identification that has been done, it can be concluded that of the six factors analyzed, the Hereditary factor does not have a significant effect on drug abuse, while other factors show a significant effect on drug abuse”.

Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis

ObjectivesIt is unclear what is driving rising colorectal cancer (CRC) treatment costs in China, whether an adjustment in drug prices changes use and total cost. This study aims to estimate...