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BACKGROUND AND AIMS: Urban green space has many health benefits, but it is still unclear how much actually is needed for better health. Recently a new 3-30-300 rule of thumb for urban forestry and urban greening has been proposed, but this rule has not been evaluated for benefits on health. The rule requires that every citizen should be able to see at least three trees from their home, have 30 percent tree canopy cover in their neighbourhood and not live more than 300 m away from the nearest park or green space. The aim of this study was to evaluate the relationship between the 3-30-300 green space rule and its components in relation to mental health. METHODS: We conducted a cross-sectional study based on a population-based sample of 3145 individuals aged 15-97 years from in Barcelona, Spain who participated in the Barcelona Health Survey (2016-2017). We created 3-30-300 green space indicators using questionnaire data, GIS, remote sensing and land cover maps. Mental health status was assessed with the 12-item General Health Questionnaire (GHQ-12) and also the use of tranquilizer/sedatives or antidepressants and psychiatrist or psychologist visits. Analyses were conducted using mixed effects logistic regression models with districts as the random effect, adjusted for relevant covariates. RESULTS: We found that people in Barcelona had relatively little exposure to green space, whether through window view, living in an area with sufficient greenness, or access to a major green space, and only 4.7% met a surrogate 3-30-300 green space rule. Residential surrounding greenness, but not tree window view or access to major green space, was significantly associated with better mental health, less medication use, and fewer psychologist or psychiatrist visits. Meeting the full surrogate 3-30-300 green space rule was associated with better mental health, less medication use, and fewer psychologist or psychiatrist visits, but only for the latter combined the association was statistically significant (Odds ratio = 0.31, 95% CI: 0.11, 0.91). CONCLUSION: Few people achieved the 3-30-300 green space in Barcelona and we used a surrogate measure. We observed health benefits when the full surrogate rule was met.
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Saúde Mental , Parques Recreativos , Estudos Transversais , Humanos , Hipnóticos e Sedativos , Características de Residência , ÁrvoresRESUMO
OBJECTIVE: To examine prevalence of past-month prescription drug misuse (PDM) and alcohol co-ingestion and its correlates in adults age 50 or older. METHODS: Data were from the 2015-2018 US National Survey on Drug Use and Health (n = 35,190). PDM-alcohol co-ingestion was defined as prescription opioid, tranquilizer/sedative, or stimulant misuse while "drinking alcohol or within a couple of hours of drinking." Co-ingestion prevalence was estimated, and logistic and negative binomial regressions examined the sociodemographic, physical health, mental health, substance use, and substance use disorder (SUD) correlates of co-ingestion. RESULTS: Over 344,000 adults aged 50 years or older (0.3%) engaged in past-month PDM-alcohol co-ingestion, or 27.4% of those with past-month PDM. Past-month co-ingestion was linked to greater past-month alcohol use frequency and elevated adjusted odds ratios (aORs) for all examined substance use outcomes (e.g., non-PDM SUD aOR = 21.8; 49.7% prevalence rate). The aOR for suicidal ideation was 506% higher in those with co-ingestion than those without past-year PDM. CONCLUSIONS: US adults aged 50 years or older with past-month PDM-alcohol co-ingestion are at high risk for SUD and concerning mental health symptoms. Screening for mental health and substance use treatment is warranted among aging adults with signs of PDM, especially involving co-ingestion.
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Uso Indevido de Medicamentos sob Prescrição , Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Adulto , Ingestão de Alimentos , Humanos , Pessoa de Meia-Idade , Uso Indevido de Medicamentos sob Prescrição/psicologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Estados Unidos/epidemiologiaRESUMO
Background: Older adult prescription tranquilizer/sedative misuse is understudied, despite evidence of increased misuse prevalence and significant associated consequences (e.g., suicidal ideation). Identification of misuse sources could limit such misuse by offering policymakers and clinicians targets to limit diverted tranquilizer/sedative medication. Objective: To establish the prevalence of tranquilizer/sedative misuse sources in older adults and investigate associated poor outcomes. Methods: Data were from the 2009-14 National Survey on Drug Use and Health, including participants endorsing one or more past-month tranquilizer/sedative misuse sources (n = 3,162) with older adult (50-64 and 65 and older; n =160) tranquilizer/sedative source prevalence estimated and compared to younger cohorts. Results: Adults 65 and older had the greatest physician source use (38.2%) across ages. Physician source use in those 50 and older, relative to those obtaining medication from friends/family for free, was linked to a higher prevalence of both past-year prescription opioid misuse (58.6% versus 34.9%) and serious psychological distress (50.1% versus 11.6%). Conclusions/Importance: Physician source use is particularly prevalent in adults 65 and older, and adults 50 and older using physician sources appear at elevated risk of consequences. Careful monitoring of psychiatric symptoms in older adults receiving tranquilizers/sedatives appears warranted. Older adults use a unique pattern of tranquilizer/sedative misuse sources, as compared to younger groups, further signaling that older adult misuse processes differ from those in younger groups.
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Hipnóticos e Sedativos/efeitos adversos , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Tranquilizantes/efeitos adversos , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Médicos , Prevalência , Estados Unidos/epidemiologiaRESUMO
This article discusses a rare case of isolated xylazine overdose in a human, treated successfully with naloxone. Xylazine, typically used as a veterinary tranquilizer, acts as a potent α2 adrenergic agonist, leading to sedation, muscle relaxation, and potential respiratory depression. In this case, a female mistakenly injected herself with xylazine mistaking it for a different medication. The report discusses naloxone's role beyond opioid overdose, especially regarding substances causing central nervous system (CNS) depression via mechanisms similar to those of opioids. While naloxone is traditionally associated with opioid receptor antagonism, its successful application here suggests potential benefits against non-opioid substances such as xylazine. The report emphasizes the need for higher naloxone dosages than those used for opioid toxicity and suggests more research into its use for treating xylazine intoxication, reflecting on the growing trend of xylazine as a recreational drug adulterant and the resulting health risks.
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Research about the association of knowledge and attitudes with practices (KAP) of non-medical tranquilizer use is scarce. We compared findings from cross-sectional and longitudinal approaches in a KAP-based study on non-medical tranquilizer use in Spain using data collected from the same population. Eight-hundred forty-seven participants completed a validated KAP questionnaire at baseline and were then followed-up bimonthly for one year for episodes of non-medical tranquilizer use. Non-medical use was defined as unprescribed use, non-adherence to treatment, storage/sharing of tranquilizers, or a combination of those practices. Adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using logistic regression from cross-sectional data and generalized linear mixed models for repeated measures in the longitudinal approach. Only the longitudinal approach showed that limited knowledge about the effect of tranquilizers on behaviour [OR: 3.24 (95% CI: 1.12-9.38)] and about the negative effect of their excessive consumption [OR: 4.12 (95% CI: 1.5-11.33)] is associated with storing/sharing tranquilizers. Both cross-sectional and longitudinal analyses indicated that personal attitudes towards tranquilizers and attitudes towards healthcare providers are associated with non-medical tranquilizer use, yet with different magnitude of associations. Differences between the two approaches were also observed for individual types of non-medical use. Certain discrepancies exist between findings from longitudinal and cross-sectional approaches on KAP of non-medical tranquilizer use. KAP studies are the backbone for designing and evaluating prevention programs on non-medical tranquilizer use, and hence choosing a proper study design, scrutinizing the associated biases, and carefully interpreting findings from those studies are required.
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BACKGROUND: Benzodiazepine overdose rates have increased in the US, largely from concomitant use of other drugs such as opioids. Studies are needed to examine trends in prescription tranquilizer (e.g., benzodiazepine) use-with a particular focus on use of other drugs such as opioids-to continue to inform prevention efforts. METHODS: We conducted a secondary analysis of the 2005-2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample. Trends in past-year nonmedical tranquilizer use and trends in demographic and other past-year substance use characteristics among nonmedical users were examined (N = 560,099). RESULTS: Prevalence of nonmedical tranquilizer use remained stable from 2005/06 through 2013/14 at 2%. Prevalence of past-year heroin use and heroin use disorder both more than doubled among nonmedical tranquilizer users between 2005/06 and 2013/14 (Ps<.001). Nonmedical opioid use decreased between 2005/06 and 2013/14 (P < .001); however, opioid use disorder increased from 13.4% to 16.7% (P = .019). Prevalence doubled among those age >50 between 2005/06 and 2013/14 from 7.9% to 16.5% (P < .001), and nonmedical tranquilizer use among racial minorities also increased (Ps<.01). Prevalence of nonmedical use also increased among those with health insurance (Pâ¯=â¯.031), and this increase appeared to be driven by a 190.6% increase in nonmedical use among those with Medicare (from 2.6% to 7.4%; P = .002). CONCLUSIONS: Characteristics of nonmedical tranquilizer users are shifting, and many shifts are related to past-year nonmedical prescription opioid use and heroin use. Prevention needs to be geared in particular towards older individuals and to those who use opioids nonmedically.
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Hipnóticos e Sedativos/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tranquilizantes/efeitos adversos , Adolescente , Adulto , Analgésicos Opioides/efeitos adversos , Benzodiazepinas/efeitos adversos , Criança , Estudos Transversais , Overdose de Drogas/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Prescrições , Prevalência , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Adolescent controlled prescription drug misuse (PDM) co-occurs with significant consequences, including lower educational achievement, substance use disorder (SUD) symptoms, and psychopathology. Nonetheless, adolescent PDM sources and the prevalence of other substance use, SUD, and mental health outcomes associated with sources remain poorly understood. METHOD: Data were from the 2009 to 2014 National Survey on Drug Use and Health, including 103,920 adolescents (12-17 years of age). Six mutually exclusive sources were used: physician source only, theft/fake prescription only, friend/relative for free only, purchases only, other source only, or multiple sources. Analyses occurred separately for prescription opioids, stimulants, and tranquilizer/sedatives. PDM source prevalence across adolescents and by sex and school enrollment/engagement were estimated. Adjusted odds of past-year DSM-IV substance-specific SUD, marijuana use, any SUD, major depressive disorder (MDD), anxiety diagnosis, mental health treatment, and past-month binge drinking were estimated by source. RESULTS: Friends/relatives, for free, was the most common source (29.0%-33.2%), followed by physician sources for opioids (23.9%), purchases for stimulants (23.5%), and tranquilizer/sedatives (22.7%). Few school enrollment/engagement differences existed, but female adolescents were more likely to use multiple sources. Over 70% of adolescents using multiple sources had a past-year SUD. Multiple sources, purchases, and theft/fake prescription were more strongly associated with other substance use than physician source use, and multiple source use was linked with MDD. CONCLUSION: Adolescents using multiple sources, purchases and theft/fake prescriptions have elevated rates of other substance use, SUD and MDD and particularly warrant intervention. Also, adolescents with other SUD and MDD should be screened for PDM and misuse sources.
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Transtorno Depressivo Maior/epidemiologia , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Evasão Escolar/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Analgésicos Opioides , Estimulantes do Sistema Nervoso Central , Criança , Feminino , Inquéritos Epidemiológicos , Humanos , Hipnóticos e Sedativos , Modelos Logísticos , Masculino , Medicamentos sob Prescrição/classificação , Tranquilizantes , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Olanzapine (OLZ) has become well-known for its antiemetic effects on chemotherapy-induced nausea and vomiting. However, it remains unclear whether OLZ also has efficacy for treating cancer-related anorexia. This study, therefore, retrospectively examined whether or not OLZ administration affects the food intake in anorexic cancer patients who exhibit neither nausea nor vomiting. METHODS: Eighty patients prescribed OLZ were extracted from 951 inpatients who consulted with our palliative care team at Chiba University Hospital from April 2008 to March 2016. Their food intake described on a nursing record was compared before and after OLZ administration. The observation period was 3 days before and after the start of OLZ treatment, because most inpatients whose food intake increased were discharged in 3 days. RESULTS: In those 80 patients, the average dose of OLZ for 3 days was 2.28±0.87 (mean±SD) mg/day. First, the food intake in 80 patients was significantly higher after than before starting OLZ, and the relative change in food intake was 149% on average (P<0.0001, Student's paired t-test). Second, OLZ increased the food intake even in 40 out of 80 patients without nausea or vomiting, and the relative change in food intake was 143% on average (P<0.001, Student's paired t-test). Third, the average food intake increased in 13 out of 40 patients who were prescribed 1.5 mg/day of OLZ, and the relative change in food intake was 124% on average (P<0.01, Student's paired t-test). There was no significant difference in food intake between a dose of 1.5 mg/day and a dose of >1.5 mg/day of OLZ (P=0.18, Welch's unpaired t-test). CONCLUSION: We have herein reported OLZ's ameliorating efficacy in cancer-related anorexia at the low dose of 1.5 mg/day. Although our study has many limitations, low-dose OLZ can be a promising treatment for cancer-related anorexia.
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To assess potential seasonal differences in responses to immobilization, we sedated eight orphaned yearling black bears ( Ursus americanus) being held for rehabilitation at a wildlife facility in Colorado, US, using a premixed combination of nalbuphine (40 mg/mL), azaperone (10 mg/mL), and medetomidine (10 mg/mL; NalMed-A) in October (autumn) prior to hibernation and again after emergence in May (spring) prior to their release. We dosed all bears at 1 mL NalMed-A per estimated 45 kg body mass (1 mL NalMed-A/45 kg), delivered by intramuscular injection using a pole syringe, to facilitate routine examination and ear tagging. Arterial blood gases were measured to assess oxygenation and acid-base status of bears both pre and post oxygen supplementation. The mean (SE) dose calculated post hoc was 0.9 (0.04) mg nalbuphine/kg, 0.2 (0.01) mg azaperone/kg, and 0.2 (0.01) mg medetomidine/kg. The mean induction time was 8 (1) min for six of the bears in October and 6 (1) min for eight bears in May. The NalMed-A combination provided good sedation in captive yearling black bears in autumn and spring and was effectively antagonized with a combination of naltrexone and atipamezole. Mild hypoxemia (PaO2: 53.5-54.4 mmHg) was the most significant side effect and was corrected (PaO2: 68.4-150.1 mmHg) with supplemental oxygen administered at 2-5 L/min for 5 min (point of sampling).
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Azaperona/farmacologia , Imobilização/veterinária , Medetomidina/farmacologia , Nalbufina/farmacologia , Ursidae , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/farmacologia , Animais , Azaperona/administração & dosagem , Azaperona/efeitos adversos , Combinação de Medicamentos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/farmacologia , Hipóxia/induzido quimicamente , Hipóxia/terapia , Hipóxia/veterinária , Medetomidina/administração & dosagem , Medetomidina/efeitos adversos , Nalbufina/administração & dosagem , Nalbufina/efeitos adversos , Oxigênio/administração & dosagem , Oxigênio/uso terapêuticoRESUMO
PURPOSE: Almost a third of opioid overdose deaths also involve benzodiazepines, but few representative studies have examined misuse of benzodiazepines and other tranquilizers by adults who misuse opioids. This study estimated the prevalence and frequency of tranquilizer misuse among adults who misuse opioids and examined characteristics associated with tranquilizer misuse. METHODS: A sample of adults who misused opioids in the past year (n = 36,043) were identified in the National Surveys on Drug Use and Health 2002-2014. Tranquilizer misuse prevalence was estimated for each year from 2002 to 2014. Data were then pooled for all years. Multiple logistic and Poisson regression was used to identify characteristics independently associated with the prevalence and frequency tranquilizer misuse respectively. RESULTS: Twenty-eight percent of adults who misused illicit opioids in the past year also reported tranquilizer misuse. This prevalence did not change notably over the 13-year period examined. Among those who misused opioids, meeting criteria for opioid abuse or dependence was associated with a 134% increase in the odds of misusing tranquilizers during the same year. Other characteristics associated with increased odds of tranquilizer misuse included being aged 18-25 years, non-Hispanic white, uninsured, unemployed, and having used heroin. CONCLUSIONS: Tranquilizer misuse is common among adults who misuse opioids and has not changed substantially over the past decade. Meeting criteria for abuse or dependence of opioids is associated with more than double the odds of tranquilizer misuse among adults who misuse opioids.
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Benzodiazepinas/efeitos adversos , Overdose de Drogas/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Tranquilizantes/efeitos adversos , Adolescente , Adulto , Overdose de Drogas/etiologia , Feminino , Heroína , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/etiologia , Prevalência , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Little is known about recent nonmedical prescription tranquilizer and stimulant use trends in Latin America. We tested whether recent trends among students in three South American countries differed by sex over time. METHODS: Three countries independently collected National School Students Survey on Drugs. Students in 8th, 10th, and 12th grades were sampled in Argentina (2007-2014, Nâ¯=â¯328,202), Chile (2007-2015, Nâ¯=â¯136,379), and Uruguay (2007-2016, Nâ¯=â¯32,371). Weighted linear regression models predicted the prevalences and trends over time of past-year nonmedical tranquilizer and stimulant use by country, and tested whether trends differed by sex, adjusting for school type and grade. RESULTS: In Argentina from 2007 to 2014, past-year nonmedical prescription tranquilizer (girls: 2.8 to 2.6%, boys: 2.5 to 2.3%) and stimulant (girls: 1.7 to 1.3%, boys: 1.9 to 1.5%) use trends did not differ by sex. In Chile from 2007 to 2015, nonmedical prescription tranquilizer use trends significantly differed comparing girls (3.9 to 10%) with boys (3.2 to 6.9%); stimulant use trends did not differ comparing girls (1.6 to 2.0%) with boys (2.0 to 1.3%). In Uruguay from 2007 to 2014 and 2014-2016, past-year nonmedical prescription tranquilizer (girls: 5.1 to 6.6%; boys: 2.8 to 4.2%) and stimulant (girls: 1.8 to 0.7%; boys: 1.8 to 0.7%) use trends did not differ by sex. CONCLUSIONS: Trends of nonmedical prescription tranquilizer use recently increased in Chile and Uruguay, widening by sex over time in Chile only. The drivers of increasing tranquilizer use among girls in Chile and Uruguay merit further investigation.
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Estimulantes do Sistema Nervoso Central/efeitos adversos , Instituições Acadêmicas/tendências , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tranquilizantes/efeitos adversos , Adolescente , Argentina/epidemiologia , Criança , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipnóticos e Sedativos/efeitos adversos , Masculino , Autorrelato , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Uruguai/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Prescription tranquilizer/sedative (e.g., alprazolam, zolpidem) misuse (i.e., use in ways not intended by the prescriber or without a prescription) is understudied, with little research identifying misuse correlates. Identification of key correlates could identify subgroups more likely to engage in misuse, allowing for targeted treatment. This work examines tranquilizer/sedative use and misuse prevalence rates and misuse correlates across U.S. age cohorts, using nationally representative data. METHODS: Data were from the 2015-16 National Survey on Drug Use and Health (nâ¯=â¯114,043). Analyses used design-based logistic regression for past-year tranquilizer/sedative misuse correlates across participants or those engaged in past-year use; past-month misuse correlates were also examined in those with past-year misuse. RESULTS: Young adults (18-25â¯years) had the highest prevalence of past-year and past-month tranquilizer/sedative misuse, with 42.8% of those with past-year use also engaged in misuse. Mental health correlates were associated with past-year misuse, while substance use, particularly opioid misuse, was associated with both past-year and past-month misuse. Substance use correlate strength was most likely to vary by age group, with older adults (65â¯years and older) having fewer significant correlates overall. CONCLUSIONS: This work highlighted young adults and those with other substance use as most likely to engage in tranquilizer/sedative misuse. In particular, those endorsing suicidality and reporting opioid misuse are a subgroup of concern, given their especially elevated rates of misuse and the increased risk for overdose imparted by tranquilizer/sedative medication. Workplace-based interventions for young adults and school-based universal prevention may be warranted to limit tranquilizer/sedative misuse in these groups.
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Hipnóticos e Sedativos , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tranquilizantes , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Ideação Suicida , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Physical inactivity is a major public health problem associated with an increased risk of several psychiatric and physical conditions. This study investigated the association between leisure time physical activity (PA) and incident use of prescription tranquilizers in a regionally representative and prospective cohort. METHODS: A total of 4043 men and women (mean age: 61.3 years; 57% women) from the Tromsø Study were followed for six years. Leisure time PA was captured at baseline. Psychiatric morbidity was measured by use of prescription tranquilizers, captured at both baseline and follow-up. Leisure time PA at baseline was used as a predictor of subsequent (incident) use of prescription tranquilizers. We used multinomial regression models and Poisson regression models to estimate relative risk-ratios (RRRs), and relative risks (RRs), respectively, and their corresponding 95% confidence intervals (CIs). RESULTS: In the fully-adjusted model, accounting for socio-demographic factors, parental history of psychopathology, years of education, smoking, respondent's psychopathology at baseline, and occupational PA, a lower leisure time PA conferred a 41% increased risk of incident use of prescription tranquilizers at follow-up (RRâ¯=â¯1.41, 95% CI: 1.09, 1.83; pâ¯=â¯0.010). CONCLUSIONS: These findings suggest that physical inactivity increases the risk of psychiatric morbidity (albeit, measured via use of prescription tranquilizers). Future regionally representative and longitudinal research is required to confirm/refute our findings and explore underlying mechanisms.
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Exercício Físico/psicologia , Comportamento Sedentário , Tranquilizantes/uso terapêutico , Adulto , Estudos de Coortes , Feminino , Humanos , Atividades de Lazer/psicologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Análise de Regressão , Fumar/epidemiologiaRESUMO
OBJECTIVES: We used two waves of National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data and examined whether the misuse of prescription tranquilizers or sedatives at Wave 1 was associated with either continued misuse, tranquilizer/sedative use disorder, or other substance use disorder (SUD) at Wave 2. METHODS: Prospective data were analyzed from structured diagnostic interviews using the Alcohol Use disorders and Associated Disabilities Interview Schedule: DSM-IV Version (AUDADIS-DSM-IV). A nationally representative sample of 34,653 of U.S. adults, 18years or older at Wave 1 (2001-2002), were re-interviewed at Wave 2 (2004-2005). After applying the survey weights, the sample represented a population that was 52% female, 71% White, 12% Hispanic, 11% African American, 4% Asian and 2% Native American or other. RESULTS: An estimated 79% of adults who engaged in tranquilizer or sedative misuse at Wave 1 had stopped using these drugs at Wave 2. Only a small percentage (4.3%) of misusers at Wave 1 had a tranquilizer or sedative use disorder at Wave 2. However, 45% (45.0%) of misusers at Wave 1 had at least one other SUD at Wave 2. Among those in remission from a sedative or tranquilizer use disorder at Wave 1, 4.8% had a tranquilizer or sedative use disorder while 34.7% had at least one other SUD at Wave 2. CONCLUSIONS: Most adults who engaged in the misuse of prescription tranquilizers or sedatives ceased using within 3years; however, their prior misuse was associated with higher prevalence of having a SUD three years later.
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Hipnóticos e Sedativos , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tranquilizantes , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Based on projections of increasing older adult nonmedical prescription drug use (NMPDU) prevalence, we investigated whether increases had occurred in opioid, tranquilizer and stimulant NMPDU in older adults from 2002-2003 to 2012-2013, using the National Survey on Drug Use and Health (NSDUH). METHODS: The NSDUH is a nationally representative survey of the US population, with assessments of lifetime, past-year and past 30-day NMPDU from opioids, tranquilizers and stimulants. Weighted cross-tabulations were used to compute prevalence rates, and design-based logistic regressions were used to examine change in NMPDU. Regressions controlled for gender, race/ethnicity and population density of respondent residence. RESULTS: Across medication classes, lifetime NMPDU rates increased in all older adults and two sub-groups: those aged 50 to 64 and those 65years and older. Rates of past year opioid NMPDU also increased from 2002-2003 to 2012-2013 in all examined age ranges. Trend-level results were also found for the past-30day opioid NMPDU and past-year tranquilizer NMPDU in adults aged 50years and older. CONCLUSIONS: The results support projections of increasing older adult NMPDU rates. As NMPDU in older adults may impart greater risk for adverse events, public health efforts are needed to reverse the increases in older adult NMPDU.
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Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Inquéritos Epidemiológicos/métodos , Inquéritos Epidemiológicos/estatística & dados numéricos , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados UnidosRESUMO
BACKGROUND: Non-medical prescription drug use (NMPDU) has been a growing concern due to increased prevalence and severity of consequences. Epidemiological research has identified alcohol, cannabis, and cigarette use to be associated with NMPDU and initiation. However, studies have not examined stages of NMPDU in relation to other substances, which can highlight salient factors associated with high risk stages of NMPDU, such as reinitiation and persistence. METHODS: This study used an adult sample from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 1 (2001-2002) and Wave 2 (2004-2005) data. We examined non-users, prior users, and current users of opioids and sedatives/tranquilizers at risk of initiation, reinitiation, and persistence between Wave 1 and Wave 2 in relation to early-onset and frequency of cannabis, cigarette, and alcohol use, controlling for sociodemographics. RESULTS: Early-onset of cigarette and alcohol use increased the odds of opioid use initiation; early-onset of cannabis, cigarette, and alcohol use increased the odds of sedative/tranquilizer use initiation and opioid reinitiation, persistence, while early-onset cannabis increased the odds of sedative/tranquilizer reinitiation and persistence. Frequency of cannabis and cigarette use predicted all three stages of opioid use, initiation/reinitiation of sedatives/tranquilizers, and frequency of cannabis use alone predicted sedative/tranquilizer persistence. CONCLUSIONS: This study provided evidence that differentiating among those who have experienced initiation, reinitiation, or persistence of NMPDU via early-onset and frequency of alcohol, cigarettes, and cannabis is vital, as there are specific aspects that influence risk. Therefore, tailoring interventions at different stages to reduce NMPDU is crucial.
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Consumo de Bebidas Alcoólicas/epidemiologia , Analgésicos Opioides/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem , Fumar Maconha/epidemiologia , Automedicação/estatística & dados numéricos , Fumar/epidemiologia , Tranquilizantes/administração & dosagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologiaRESUMO
Introducción: Existen plantas que se usan desde tiempos ancestrales con efecto alucinógeno y alteraciones al sistema nervioso central, debido a la presencia principalmente de mezcalina son usadas para cumplir objetivos tradicionales asociados a la adivinación, curandería, divinidad y otros. Objetivos: Determinar el efecto del extracto acuoso de Trichocereus pachanoi a dosis de 10 por ciento, 20 por ciento y 30 por ciento sobre el comportamiento exploratorio de carácter depresivo en Rattus rattus var. albinus. Material y métodos: El presente estudio experimental es de carácter exploratorio aplicado, constructivo y prospectivo, se formaron 4 grupos de 10 ratas cada uno a las que se les administró extracto acuoso de Trichocereus pachanoi en dosis creciente, luego fueron sometidas a natación forzada con entrenamiento previo de 15 minutos. Resultados: El grupo que no recibió tratamiento alguno posee la más baja respuesta en gasto de tiempo para el escalamiento, comparado con los grupos B, C y D que presentan 13,5 min. 17,17 min. y 24,37 min. respectivamente. También en la evaluación de la movilidad, el grupo A posee en valor más bajo, comparado con los grupos B, C y D que presentan 13,42 min. 17,62 min. y 23,12 min., respectivamente. Conclusiones: El tratamiento en ratas con extracto acuoso de Trichocereus pachanoi a concentraciones de 10 por ciento, 20 por ciento y 30 por ciento ha sido eficaz en producir un efecto tranquilizante en el comportamiento exploratorio de carácter depresivo en el sujeto(AU)
Introduction: Since ancient times, some mescaline containing plants that have hallucinogen effects and cause alterations in the central nervous system have been used to fulfill traditional objectives associated with divination, healing, spirituality and others. Objective: To determine the effect of the aqueous extract of Trichocereus pachanoi at doses of 10 %, 20 % and 30 % solution on depression-like exploratory behavior in Rattus rattus var. albinus. Material and Methods: The present experimental study, which is exploratory, constructive and prospective in nature, was conducted in 4 groups of 10 rats. The rats were administered increasing doses of aqueous extract of Trichocereus pachanoi; then, they underwent forced swimming with a previous 15-minute training. Results: The group that did not receive any treatment had the lowest response to the duration of time spent at scaling compared to groups B, C and D that spent 13.5 min., 17.17 min., and 24.37 min., respectively. Also, in the evaluation of mobility, group A showed the lowest value compared to groups B, C and D that recorded 13.42 min., 17.62 min., and 23.12 min., respectively. Conclusions: The treatment with aqueous extract of Trichocereus pachanoi at concentrations of 10 percent, 20 percent and 30 percent applied to rats has been effective in producing a tranquilizer effect on the depression-like exploratory behavior in rats(AU)
Assuntos
Ratos , Tranquilizantes , Sistema Nervoso Central , Comportamento Exploratório , Alucinógenos , MescalinaRESUMO
The present study evaluated the effects of acepromazine combined with midazolam and morphine on sedation and cardiovascular variables as well as the propofol dose required for induction of anesthesia in dogs compared with acepromazine-morphine or midazolam-morphine. Dogs were randomly assigned to receive an intramuscular administration of (1) acepromazine (0.05 mg/kg) with 0.5mg/kg of morphine (group AM, n=10), (2) midazolam (0.5mg/kg) with 0.5mg/kg of morphine (group MM, n=9), or (3) acepromazine with midazolam and morphine at the same doses (group AMM, n=10). After 30 min, sedation was assessed by a numeric descriptive scale (NDS, range 0-3) and a simple numerical scale (SNS, range 0-10). Dogs were then administered IV propofol to allow endotracheal intubation. NDS and SNS scores were significantly higher in the AMM than in the MM group (P<0.05). There was a trend towards more dogs presenting with intense sedation (NDS=3) in AMM (6/10 dogs) compared with AM (1/10 dogs) and MM (1/9 dogs) (P=0.057). The propofol dose required for induction of anesthesia was significantly lower in AMM (4.0mg/kg) compared with MM (6.0mg/kg, P<0.01) but not AM (4.6 mg/kg). Heart rate decreased in AM after treatment and after intubation. Blood pressure decreased in groups AM and AMM following treatment and in all groups after intubation. The combination AMM resulted in intense sedation more frequently than AM and MM, and provided the greatest sparing effect in the propofol dose. Administration of AM and AMM but not MM decreased blood pressure although hypotension was not recorded in healthy dogs.
Assuntos
Analgésicos/farmacologia , Anestésicos Intravenosos/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Hipnóticos e Sedativos/farmacologia , Acepromazina/farmacologia , Animais , Cães , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Midazolam/farmacologia , Morfina/farmacologia , Propofol/farmacologiaRESUMO
BACKGROUND: Nonmedical use of prescription medication (NUPM) is associated cross-sectionally with a host of medical and psychosocial consequences. Few studies, however, have examined longitudinal outcomes based on NUPM indicators. This study aimed to address this gap by examining change in health-related quality of life as a function of NUPM status. METHODS: Data are from waves 1 and 2 of the National Epidemiological Survey on Alcoholism and Related Conditions (NESARC) a household-based, nationally-representative survey of the US population. 34,653 participants who completed both NESARC waves were included in analyses. The primary outcome measure was the 12-item Short Form Health Survey (SF-12), with history of NUPM of opioids, tranquilizer/sedatives and stimulants (examined separately) at wave 1 and any NUPM between waves 1 and 2 used to group participants. Sociodemographic characteristics were used as control variables. RESULTS: Across medication classes, results indicated that individuals who initiated NUPM between waves (initiators) had greater declines or smaller increases on many SF-12 scales, when compared to other groups. Individuals with a history of NUPM at wave 1 but no use between waves (quitters) and never users generally had the best outcomes in terms of change in SF-12 scales, with quitters making larger gains (or smaller losses) in mental health-related quality of life. Persistent users were generally intermediate between initiators and quitters or never users. CONCLUSIONS: These data reinforce the importance of preventing NUPM initiation and of promoting NUPM cessation, highlighting the need for greater use of NUPM-related public health interventions.
Assuntos
Uso Indevido de Medicamentos sob Prescrição/psicologia , Qualidade de Vida/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto JovemRESUMO
Foi realizado um estudo para investigar a tranquilização de cães com subdose de acepromazina no acuponto yin tang, localizado no ponto médio de uma linha traçada entre os cantos laterais dos olhos. O estudo foi delineado em quatro protocolos, utilizando-se oito cães. No primeiro protocolo (P1) foi administrada acepromazina no yin tang em subdose (0,01mg/ kg). No segundo protocolo (P2) foi administrada a mesma dose utilizada em P1 por via intramuscular (IM). No terceiro protocolo (P3) foi administrada dose terapêutica (0,1mg/kg) IM. No quarto protocolo (P4) foi colocada uma agulha de acupuntura no yin tang. Durante as etapas foram aferidos: frequência cardíaca (FC), frequência respiratória (FR) e temperatura retal (TR). Tais aferições foram realizadas antes dos tratamentos, quinze minutos após a administração do fármaco e de quinze em quinze minutos até duas horas. Nos mesmos momentos foi pesquisada a presença ou ausência de decúbito, sonolência, ptose palpebral e outros sinais de tranquilização. Os dados foram analisados estatisticamente. No tratamento experimental (P1) dois cães apresentaram tranquilização satisfatória e um moderada, sem diferença significativa com o grupo no qual se administrou acepromazina em dose terapêutica IM. Concluiu-se que a administração de acepromazina em subdose no acuponto Yin Tang pode ser usada com segurança na rotina clínica nas mais diversas manipulações nas quais haja necessidade de tranquilização de cães...
A study was conducted to investigate the tranquilization of dogs using a subdose of acepromazine in the yin tang acupoint located in the medium point of a line drawn between the lateral corners of the eyes. The study was designed in four protocols using eight dogs. In the first protocol (P1), acepromazine was administered in yin tang in subdose (0.01mg/kg). In the second protocol (P2), the same dose as in P1 was administered by intramuscular route (IM). In the third protocol (P3), a therapeutic dose (0.1 mg/kg) was administered IM. In the fourth protocol (P4), an acupuncture needle was placed in the yin tang point. During the steps, heart rate (HR), respiratory rate (RR) and rectal temperature (RT) were measured. These evaluations were performed before treatment, fifteen minutes after drug administration, and every fifteen minutes for two hours. At the same moments, the presence or absence of decubitus, drowsiness, ptosis and other signs of tranquilization were observed. Data were statistically analyzed. In the experimental treatment (P1), one dog showed moderate tranquilization, and two dogs showed satisfactory tranquilization, without statistical difference from the group in which acepromazine was administered IM in the therapeutic dose. It can be concluded that the administration of acepromazine in subdose in the yin tang acupoint can be safely used in clinical practice, in various manipulations in which the need of tranquilization of dogs is necessary...
Se ha realizado un estudio para investigar como tranquilizar perros con acepromacina en subdosis en el punto de acupuntura yin tang, que se encuentra en el punto medio de una línea trazada entre las bordas laterales de los ojos. El estudio ha sido diseñado en cuatro protocolos utilizando ocho perros. En el primer protocolo (P1) se administró acepromacina en el punto yin tang en subdosis (0,01 mg / kg). En el segundo protocolo (P2), se administró la misma dosis usada en P1 por vía intramuscular (IM). En el tercer protocolo (P3), se administró dosis terapéutica (0,1 mg / kg) IM. En el cuarto protocolo (P4), se ha puesto una aguja de acupuntura en el punto yin tang. Durante las etapas se midieron: frecuencia cardíaca (FC), frecuencia respiratoria (FR) y la temperatura rectal (TR). Estas evaluaciones se realizaron antes del tratamiento, quince minutos después de la administración del fármaco, y a cada quince minutos durante dos horas. En los mismos momentos se ha investigado la presencia o ausencia de decúbito, somnolencia, ptosis de pálpebra y otras señales de tranquilidad. Los datos han sido analizados estadísticamente. En el tratamiento experimental (P1), dos perros mostraron tranquilidad satisfactoria y un perro moderada, lo que no fue significativamente diferente del grupo donde se administró dosis terapéutica de acepromacina por vía intramuscular. Se concluyó que la administración de acepromacina en subdosis en el punto yin tang puede ser utilizado con seguridad en la práctica clínica en las más diversas manipulaciones en las que hay la necesidad de tranquilizar perros...