Genotoxicity of Marijuana in Mono-Users.

Marijuana (Cannabis sp.) is among the most recurred controlled substances in the world, and there is a growing tendency to legalize its possession and use; however, the genotoxic effects of marijuana remain under debate. A clear definition of marijuana's genotoxic effects remains obscure by the simultaneous consumption of tobacco and other recreational substances. In order to assess the genotoxic effects of marijuana and to prevent the bias caused by the use of substances other than cannabis, we recruited marijuana users that were sub-divided into three categories: (1) users of marijuana-only (M), (2) users of marijuana and tobacco (M+T), and (3) users of marijuana plus other recreative substances or illicit drugs (M+O), all the groups were compared against a non-user control group. We quantified DNA damage by detection of γH2AX levels and quantification of micronuclei (MN), one of the best-established methods for measuring chromosomal DNA damage. We found increased levels of γH2AX in peripheral blood lymphocytes from the M and M+T groups, and increased levels of MNs in cultures from M+T group. Our results suggest a DNA damage increment for M and M+T groups but the extent of chromosomal damage (revealed here by the presence of MNs and NBuds) might be related to the compounds found in tobacco. We also observed an elevated nuclear division index in all marijuana users in comparison to the control group suggesting a cytostatic dysregulation caused by cannabis use. Our study is the first in Mexico to assess the genotoxicity of marijuana in mono-users and in combination with other illicit drugs.

Characterization of dual disorders in addiction treatment-seekers at mexican outpatient centers.

In Mexico, very few studies have been published on dual disorders (DD) at specialized treatment centers describing actual treatment needs and even fewer have been undertaken at addiction treatment centers in the public system. The objective of this study was therefore to analyze DD and other clinical characteristics in people seeking treatment at outpatient addiction centers in the public system.

Caracterización de la patología dual en personas que buscan tratamiento de adicciones en centros ambulatorios mexicanos / Characterization of dual disorders in addiction treatment-seekers at mexican outpatient centers

INTRODUCCIÓN: En México son pocos los estudios publicados sobre la patología dual (PD) en centros de tratamiento espe­cializados que describan las necesidades reales de tratamiento y menos aún que se hayan realizado en centros de tratamiento de adicciones del sistema público. Por esto, el objetivo de pre­sente estudio fue analizar la PD y otras características clínicas en personas que buscan tratamiento en centros ambulatorios de adicciones del sistema público. MÉTODO: Estudio transversal multisede. Se analizó una muestra de 148 pacientes de cen­tros de tratamiento. Se evaluaron trastornos psiquiátricos con la Mini Entrevista Neuropsiquiátrica Internacional, conductas sexuales de riesgo con la Escala de Comportamiento de Riesgo de VIH, consumo de drogas inyectables, y la calidad de vida con el Cuestionario de Calidad de Vida. Se realizaron análisis univariados mediante chi cuadrado para determinar diferen­cias estadísticas entre personas con y sin PD, así como regre­sión lineal para calidad de vida y regresión logística binomial para determinar el riesgo para presentar consumo de drogas inyectables, uso de condón y conducta suicida. RESULTADOS: La cocaína fue la droga de impacto con mayor prevalencia (33.8%). El grupo de personas con trastorno por consumo de alcohol + trastorno por consumo de drogas presentó mayor comorbilidad con el trastorno depresivo mayor (25.7%), tras­torno antisocial (27.7%), déficit de atención (11.5%) e intento suicida (17.6%). El grupo con PD presentó mayor consumo de drogas inyectables (OR= 1.67), no uso de condón con pareja primaria (OR= 3.66), más intentos de suicidio (OR= 4.2) y una menor calidad de vida en comparación con aquellos sin PD. CONCLUSIÓN: Caracterizar a los pacientes con PD, permite iden­tificar con precisión sus necesidades de tratamiento y desarro­llar programas de mejora continua para optimizar los recursos y mejorar el éxito de la atención

INTRODUCTION: In Mexico, very few studies have been published on dual disorders (DD) at specialized treatment centers describing actual treatment needs and even few­er have been undertaken at addiction treatment centers in the public system. The objective of this study was therefore to analyze DD and other clinical characteristics in people seeking treatment at outpatient addiction centers in the public system. Method. Cross-sectional multi-site study. A sample of 148 patients from treatment centers was analyzed. Psychi­atric disorders were evaluated with the Mini International Neuropsychiatric Interview, risky sexual behaviors with the HIV Risk Behavior Scale, injection drug use, and quality of life with the Quality of Life Questionnaire. Univariate chi-square analyses were performed to determine statistical dif­ferences between subjects with and without DD, while linear regression was used to calculate quality of life and binomial logistic regression to determine the risk of injection drug use, condom use, and suicidal behavior. RESULTS: Cocaine was the impact drug with the highest prevalence (33.8%). The group of subjects with alcohol use disorder + drug use disorder presented greater comorbidi­ty with major depressive disorder (25.7%), antisocial disor­der (27.7%), attention deficit (11.5%) and suicide attempt (17.6%). The group with DD presented higher injection drug use (OR = 1.67), non-use of condoms with a primary part­ner (OR = 3.66), more suicide attempts (OR = 4.2) and lower quality of life than those without DD. CONCLUSION: Characterizing patients with DD enables the accurate identification of their treatment needs and the development of continuous improvement programs to opti­mize resources and improve the success of care

Mental Health Problems among COVID-19 Frontline Healthcare Workers and the Other Country-Level Epidemics: The Case of Mexico.

COVID-19 frontline healthcare workers (FHCW) are struggling to cope with challenges that threaten their wellbeing. We examine the frequency and predictors of the most frequent mental health problems (MHP) among FHCW during the first COVID-19 peak in Mexico, one of the most severely affected countries in terms of FHCW's COVID-19 mortality. A cross-sectional survey was conducted between May 8 and August 18, 2020. A total of 47.5% of the sample (n = 2218) were FHCW. The most frequent MHP were insomnia, depression, posttraumatic stress symptoms, and health anxiety/somatization (whole sample: 45.7, 37.4, 33.9, and 21.3%; FHCW: 52.4, 43.4, 40.3 and 26.1, respectively). As compared to during the initial COVID-19 phase, depression and health anxiety/somatization symptoms as well as experiences of grieving due to COVID-19, personal COVID-19 status, and having relatives and close friends with COVID-19 were more frequent during the COVID-19 peak. Obesity, domestic violence, personal COVID-19 status, and grieving because of COVID-19 were included in regression models for main FHCW's MHP during the COVID-19 peak. In conclusion, measures to decrease other country-level epidemics contributing to the likelihood of COVID-19 complications (obesity) and MHP (domestic violence) as well as FHCW´s probability of COVID-19 infection could safeguard not only their physical but also mental health.

Psychosocial reintegration process in patients who receive maintenance treatment with methadone: A qualitative analysis / Proceso de reintegración psicosocial en pacientes que reciben tratamiento de mantenimiento con metadona: un análisis cualitativo

Abstract Introduction The evaluation of methadone maintenance programs reports generally positive outcomes. Objective To explore the psychosocial factors that contribute to achieve treatment goals even when patients live in conditions of precariousness and exclusion. Method Qualitative study of multiple cases, with a sample of 12 interviews with patients participating in a maintenance and detoxification program with methadone; a thematic and discursive-narrative analysis was undertaken. Results We identified the predominance of a typical discursive scheme composed of clearly differentiated narrative segments: previous conditions, establishment of a relationship with the therapeutic system, process of adjustment as a part of treatment and social reintegration. Two main themes were also identified: addiction and dealing with substances, and the problem of normative integration; there was also an experience of acceptance and recognition that constitutes a central factor for treatment. Discussion and conclusion These findings are discussed in light of the disaffiliated conditions of people using injected heroin and the need to consider psychosocial and normative adjustment as a relevant factor for treatment and social reintegration, which leads to the suggestion to include psychotherapeutic interventions to accompany and reinforce the process.

Resumen Introducción La evaluación de los programas de mantenimiento con metadona reporta, en general, resultados positivos. Objetivo Explorar factores psicosociales que contribuyan al logro de los objetivos del tratamiento, incluso cuando los pacientes se encuentran en condiciones de precariedad y exclusión. Método Estudio cualitativo de casos múltiples, con una muestra de 12 entrevistas con pacientes participantes en un programa de mantenimiento y deshabituación con metadona; se realizó un análisis discursivo-narrativo y temático. Resultados Identificamos el predominio de un esquema discursivo típico compuesto de segmentos narrativos claramente diferenciados: condiciones previas, vinculación con el sistema terapéutico, proceso de ajuste al interior del tratamiento y proceso de reintegración social. También se identificaron dos ejes de articulación temática: la adicción y el manejo de sustancias, y el problema de la integración normativa; hubo además una experiencia de aceptación y reconocimiento que constituye un factor central en el tratamiento. Discusión y conclusión Estos hallazgos se discuten a la luz de las condiciones de desafiliación del usuario de heroína y de la necesidad de considerar el ajuste psicosocial y normativo como un factor relevante para el tratamiento y la reintegración social, lo que lleva a sugerir que los programas incluyan componentes psicoterapéuticos con el objeto de acompañar y reforzar efectivamente el proceso.

Diagnosis of macrosocial risks of drug use in Mexican municipalities / Diagnóstico de riesgos macrosociales del consumo de drogas en municipios de la República Mexicana

Abstract Introduction Factors associated with drug use are defined in terms of their proximity to the phenomenon and can be classified as individual, microsocial, and macrosocial. Macrosocial factors include variables of a geographic, economic, demographic, and social nature, which can be compiled from population censuses and surveys. Objective To determine the levels of risk for drug use in municipalities in Mexico based on macro-social indicators. Method Retrospective cross-sectional study, based on the analysis of population data, weighted by the Delphi method. Results Sixty-four municipalities with a high or very high risk of drug use were identified. Factors such as the volume of drug seizures, prevalence of student use, alcohol supply, and inequality among the population were weighted as the factors with greatest risk for drug use. Discussion and conclusion These data serve as a benchmark for guiding the efficient, rational administration of resources assigned for dealing with the problem of addictions, since they make it possible to identify localities with a greater need for care services.

Resumen Introducción Los factores asociados al consumo de drogas se definen en función de su proximidad con el fenómeno y pueden clasificarse en individuales, microsociales y macrosociales. Entre los factores macrosociales se incluyen variables de tipo geográfico, económico, demográfico y social, que es posible integrar a partir de censos y encuestas poblacionales. Objetivo Determinar niveles de riesgo del consumo de drogas en municipios de la República Mexicana con base en indicadores macrosociales. Método Estudio transversal retrospectivo, basado en el análisis de datos poblacionales, ponderados mediante el método Delphi. Resultados Se identificaron 64 municipios con alto o muy alto riesgo de consumo de drogas. Factores como el volumen de decomisos de drogas, prevalencia de consumo en estudiantes, oferta de alcohol y desigualdad entre la población fueron ponderadas como los factores de mayor riesgo para el consumo de drogas. Discusión y conclusión Estos datos representan un referente para orientar la administración eficiente y racional de los recursos destinados a atender el problema de las adicciones en tanto permiten identificar localidades que requieren servicios de atención con mayor prioridad.

Trends and patterns of marijuana use in men and women seeking drug treatment / Tendencias y patrones de consumo de mariguana en hombres y mujeres solicitantes de tratamiento

Abstract Introduction Marijuana is the world's most widely used illegal drug. In Mexico, it is the drug of choice for both male and female users of all ages, and there has been a recent increase in its use. Objective To describe drug use trends in people seeking treatment by sex and age range, and to explore different patterns. Method To provide a description of trends and rates of increase for the population attended between 2005 and 2016 and to make a comparative analysis of patterns of use in a sample of 11 595 marijuana users who received treatment in 2016. Results In general, there has been a greater increase in use in the group ages twelve to seventeen. The greatest increase in lifetime use was reported among women in this age range. The greatest increase in marijuana use in the past month was found among women aged eighteen to thirty-five. Women use a greater variety of substances, and a higher number of younger women report using cocaine, methamphetamines, benzodiazepines and hallucinogens than men. Discussion and conclusion Significant increases in marijuana use have been registered among girls under 18 and women in recent years. The differences in trends and patterns of use for men and women are being reduced and reconfigured.

Resumen Introducción La mariguana es la droga de mayor consumo en el mundo. En México, es la droga preferida por ambos sexos y en todos los grupos de edad, y en su consumo ha habido un incremento desde hace varios años. Objetivo Describir las tendencias del uso de mariguana en solicitantes de tratamiento, por sexo y rango de edad, y explorar diferencias en el patrón de consumo, según sexo. Método Se describieron tendencias y tasas de crecimiento en población atendida entre 2005 y 2016 y se realizó un análisis comparativo del patrón de consumo con una muestra de 11 595 usuarios de mariguana recibidos para tratamiento en 2016. Resultados En general, se registran mayores tasas de crecimiento en el grupo de 12 a 17 años. El mayor incremento del uso alguna vez en la vida corresponde a las mujeres de este rango; el del uso en el último mes y como droga de mayor impacto, a las de 18 a 35 años. Las mujeres consumen un mayor número de sustancias. Las de menor edad refieren el uso de cocaína, metanfetaminas, éxtasis, benzodiacepinas y alucinógenos en mayor proporción que los hombres. Discusión y conclusión Los menores de edad y las mujeres tienen un mayor peso en el aumento del uso de mariguana registrado en los últimos años. Las diferencias en las tendencias y el patrón de consumo entre sexos se están reduciendo y reconfigurando.

Comparación de Tres Modelos de Riesgo de Uso Nocivo de Alcohol en Estudiantes Mexicanos / Comparison of Three Risk Models of Harmful Use of Alcohol in Mexican Students

Resumen: El presente estudio se planteó como objetivo identificar correlatos psicosociales del consumo nocivo de alcohol en estudiantes mexicanos, así como probar comparativamente la validez y capacidad explicativa de tres modelos teóricos y de medición de estos factores, a fin de apoyar la investigación del problema y dar pauta al desarrollo de acciones preventivas teórica y empíricamente sustentadas. Estos tres modelos son: la teoría de las expectativas, la teoría del aprendizaje social de R. Akers y la teoría de la conducta planificada. Los hallazgos indican que los tres modelos tienen una buena capacidad predictiva del consumo nocivo de alcohol en la población de estudio. El mayor peso corresponde a las expectativas positivas asociadas a los efectos del alcohol, seguidas por el uso de alcohol entre pares, una baja percepción de riesgo y, como factor protector, la capacidad percibida para controlar la cantidad que se bebe. Los hallazgos reflejan la conveniencia de aplicar un modelo multivariado compuesto por variables provenientes de los tres modelos.

Abstract: The aim of this study was to identify psychosocial correlates of harmful alcohol use among young Mexican students, and to comparatively prove the predictive validity of three theoretical models, each one capable to support the research of the problem and to guide the design of theoretically and empirically grounded preventive and treatment programs: a) the alcohol expectancies theory, b) the social learning theory by R. Akers, and c) the planned behavior theory. Findings indícate that these three models are appropriate predictive models for harmful alcohol use in the studied group. The highest predictive weight belongs to positive expectancies associated to the effects of alcohol, followed by alcohol use among friends, low risk perception, and self-control of alcohol drinking as a protective factor. Findings suggest the convenience of the application of a composed multi-varied algorithm, integrated by factors and variables extracted from the three models.