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2.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artículo en Español | IBECS | ID: ibc-193593

RESUMEN

OBJETIVOS: Evaluar la efectividad de una intervención comunitaria de formación profesional para jóvenes en riesgo de exclusión social, en la salud autopercibida, la autoestima y el consumo de sustancias (alcohol, tabaco y cannabis). Evaluar la satisfacción de los participantes. MÉTODOS: Diseño: estudio de intervención pre-post. Emplazamiento: tres barrios de renta baja de Barcelona durante 2013-2017. Participantes: 185 participantes, de 21 años de media y predominio masculino (65,5%). Intervención: programa de 4 meses de formación profesional de diferentes disciplinas e itinerarios orientados a la inserción laboral. Mediciones principales: análisis bivariado (McNemar) para datos apareados, comparando la salud autopercibida, autoestima y consumos pre-post intervención. Modelos de regresión de Poisson para las variables resultado, ajustando por variables explicativas. Además, se evaluó la satisfacción con el programa a través de un cuestionario y una discusión grupal. RESULTADOS: la salud autopercibida era elevada antes de la intervención (87,7% hombres y 82,1% mujeres) y se mantuvo tras ella (90,6% y 83,9% respectivamente). Los niveles elevados de autoestima previos a la intervención (92,8% en hombres y 92,9% mujeres) aumentaron tras ella (95,5% y 100% respectivamente), de forma significativa en las mujeres (p < 0,05). El consumo de sustancias no varió tras la intervención. La satisfacción con el programa fue elevada. CONCLUSIÓN: la intervención parece haber mejorado la autoestima en las mujeres, un colectivo con elevado desempleo y normalmente infrarrepresentado en los programas formativos. Esta intervención no incidió en el consumo de sustancias. Los programas de inserción laboral para jóvenes pueden promover factores beneficiosos para la salud mental


OBJECTIVES: To evaluate the effectiveness of a community occupational training intervention for young people at risk of social exclusion on self-perceived health, self-esteem and substance use (alcohol, tobacco and cannabis). To assess participant's satisfaction. METHODS: Design: Quasi-experimental before-after study. Setting: Three low-income neighbourhoods in Barcelona during 2013-2017. Participants: 185 participants with an average age of 21 years and mainly males (65.5%). Intervention: Four-month programme on specific occupational skills and itineraries oriented towards occupational integration. Most important measurements: Bivariate analysis (McNemar test) for paired data to compare self-rated health and self-esteem pre-intervention and post-intervention. Poisson regression models for result variables, adjusting for explanatory variables. In addition, satisfaction with the programme was evaluated by means of a questionnaire and group discussion. RESULTS: Pre-intervention self-rating was good (87.7% men and 82.1% women) and remained good post-intervention (90.6% and 83.9% respectively). Pre-intervention self-esteem was good (92.8% in men and 92.9% in women) and increased after the intervention (95.5% and 100% respectively). This was statistically significant in women (P<0.05). Substance use was unaltered after the intervention. Satisfaction with the programme was high. CONCLUSION: The intervention appears to have improved self-esteem among young women, who are an important group among the unemployed, as they are usually underrepresented in training and professional programmes. Programmes that foster young people moving into working life may also promote factors beneficial to mental health


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Participación de la Comunidad , Capacitación Profesional , Poblaciones Vulnerables/psicología , Autoimagen , Trastornos Relacionados con Sustancias/psicología , Consumidores de Drogas/psicología
3.
An. psicol ; 36(3): 443-450, oct. 2020.
Artículo en Español | IBECS | ID: ibc-195660

RESUMEN

El propósito de este estudio es presentar el perfil psicopatológico y las diferencias entre hombres y mujeres que inician tratamiento residencial para las adicciones. La muestra se compuso de 142 pacientes (116 hombres y 26 mujeres), que cumplimentaron el EuropASI y MMCMI-III. Se analizan variables socio-demográficas, patrón de consumo y otras características, así como patrones, trastornos de personalidad y síndromes clínicos. El grupo de hombres presenta alta prevalencia en el patrón de personalidad antisocial (31%). Las mujeres, en el depresivo (23,1%), dependiente (26,9%) y antisocial (26,9%), solo en el dependiente las diferencias son estadísticamente significativas. En los síndromes clínicos los hombres presentan prevalencia en dependencia de sustancias (86,2%), trastorno de ansiedad (60,3%) y dependencia de alcohol (45,7%), las mujeres en el trastorno de ansiedad (76,9%), dependencia de alcohol (69,2%), sustancias (53,8%) y distímico (46,2%). Aparecen diferencias significativas estadísticamente en el trastorno ansioso, distímico y dependencia de alcohol, donde las mujeres se muestran más afectadas. En el síndrome clínico trastorno de pensamiento los hombres puntúan más alto y las mujeres más altas en depresión, en ambos casos las diferencias son estadísticamente significativas. Se comentan las implicaciones que estos resultados tienen en la evaluación y mejora de los tratamientos


The aim of this study is to present the psychopathological profile and the differences between men and women who start an addition residential treatment. The sample included 142 patients (116 were men and 26 women). We analysed socio-demographic variables, consumption pattern as well as personality disorders and clinical syndromes using EuropASI and MCMI-III as evaluating instruments. Men group showed a high prevalence at antisocial personality disorder (31%). On the other hand, women did so at depressive (23,1%), dependent (26,9%) and antisocial (26,9%) patterns, finding statistically significant differences only at the dependent disorder. At clinical syndromes men showed a relevant prevalence when analysing substances dependence (86,2%), anxiety disorder (60,3%) and alcohol dependence (45,7%), and women group at anxiety disorder (76,9%), alcohol dependence (69,2%), substances (53,8%) and dysthymic (46,2%). We found statistically significant differences at anxiety disorder, dystymic and alcohol dependence where women appeared to be more affected. At thought clinical syndrome men raised higher scores, and women did so at depression, being both differences statistically significant. The results are discussed and their clinical implications analysed


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Salud Mental , Trastornos Mentales/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Consumidores de Drogas/psicología , Trastornos Mentales/inducido químicamente , Trastornos Relacionados con Sustancias/complicaciones , Escalas de Valoración Psiquiátrica , Estadísticas no Paramétricas , Distribución por Sexo , Factores Socioeconómicos , Factores Sexuales , España/epidemiología
4.
BMC Infect Dis ; 20(1): 702, 2020 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-32972393

RESUMEN

BACKGROUND: Hepatitis C virus (HCV) infections in people who inject drugs (PWID) can now be treated and cured. However, the impact that HCV treatment has on drug-user health, practices and wellbeing is not known. The aim of this research was to understand the non-clinical impact that HCV treatment has in PWID and their reasons for accessing and completing treatment. METHODS: Participants aged 25-67 years who had injected opioids or stimulants (currently or in the past) and had completed direct-acting antiviral treatment were recruited from seven European countries. Participants completed a 30-min online survey administered face-to-face between September 2018 and April 2019. The questionnaire responses were used to assess the mental and physical impact of having completed treatment. RESULTS: Of the 124 participants who completed the survey questionnaire, 75% were male, 69% were over 45 years old and 65% were using opioids and/or stimulants at the start of HCV treatment. Participants reported improvements in the following areas after completing HCV treatment: outlook for the future (79%); self-esteem (73%); ability to plan for the future (69%); belief in their abilities (68%); confidence (67%); empowerment (62%); energy levels (59%); and ability to look after themselves (58%). The most common reasons for starting HCV treatment were: becoming aware of treatments that were well tolerated (77%) and effective (75%); and understanding the potentially severe consequences of HCV (75%). CONCLUSIONS: The benefits of HCV treatment go beyond clinical outcomes and are linked to improved drug-user health and wellbeing. Sharing information about well-tolerated and effective HCV treatments, and raising awareness about the potentially severe consequences of untreated HCV are likely to increase the number of PWID who are motivated to access and complete HCV treatment in future.


Asunto(s)
Consumidores de Drogas , Hepatitis C/tratamiento farmacológico , Abuso de Sustancias por Vía Intravenosa , Adolescente , Adulto , Anciano , Antivirales/uso terapéutico , Actitud Frente a la Salud , Consumidores de Drogas/psicología , Consumidores de Drogas/estadística & datos numéricos , Emociones , Empleo , Europa (Continente) , Femenino , Hepatitis C/psicología , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
5.
Artículo en Inglés | MEDLINE | ID: mdl-32867216

RESUMEN

Owing to the increasing prevalence of hidden drug abuse in Hong Kong, yet scarce relevant current local research, this study seeks to carry out an in-depth investigation into the experience of hidden drug abusers, paying particular attention to their relevance to social capital and social networks. Seventy-three abusers attending drug treatment programs were interviewed, and a thematic analysis was performed. The results indicate hidden drug abuse is popular in Hong Kong. Apart from the decline of public, large-scale discos and the change of the types of drugs abused to date, one important contributing factor is the drug supply and transaction networks, which are extensive and multilocused, but secretive, with high closure levels. This kind of network is supported by bonding, bridging, and linking social capital as well as by providing convenient supply modes and offering drug abusers psychological comfort and safety. These factors encourage the hidden drug abuse to prevail and allow drug abusers to remain unidentifiable.


Asunto(s)
Consumidores de Drogas/psicología , Capital Social , Red Social , Trastornos Relacionados con Sustancias , Hong Kong/epidemiología , Humanos , Drogas Ilícitas/provisión & distribución , Prevalencia , Trastornos Relacionados con Sustancias/epidemiología
6.
Rev. esp. drogodepend ; 45(3): 55-71, jul.-sept. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-198233

RESUMEN

Esta investigación estudia las posibles diferencias de género en una muestra de 176 chicos y chicas adolescentes con consumo abusivo de drogas que recibían tratamiento en un Centro de Tratamiento Ambulatorio, para ello analiza distintos factores psicosociales (personales, familiares y sociales) que pueden estar influyendo de forma diferencial en el consumo de drogas. Las pruebas de efectos inter-sujetos realizadas indicaron que las chicas adolescentes consumidoras de drogas presentan mayor nivel de empatía, más sintomatología depresiva, mayor comunicación ofensiva con padres y madres, menor comunicación abierta con padres, mayor comunicación evitativa con padres, poco sentimiento de cohesión familiar, mayor percepción de conflictividad familiar y menor participación comunitaria en comparación con chicos consumidores de drogas. Estos resultados facilitan parte de la comprensión del fenómeno de las drogodependencias en la adolescencia y de sus diferencias en cuanto al género, y por tanto este conocimiento puede ser válido para que los y las profesionales implicados en la intervención con adolescentes con problemas de consumo de drogas puedan innovar en actuaciones diferenciales, y puedan adaptarse a las necesidades de las personas según su género


This research studies the possible gender differences in a case study of 176 adolescent boys and girls with abusive drug use who were treated in an Outpatient Treatment Centre; it analyses different psychosocial factors (personal resources, family variables and social variables) that can influence drug use differently. The inter-subject effect tests indicate that the teen girls who use illegal drugs have a higher level of empathy, more depressive symptoms, a greater offensive, less open communication with both parents, a greater avoidant communication with fathers, misunderstanding of family cohesiveness, a greater perception of family conflict and less community participation compared to adolescent boys who abuse illegal drugs. These results facilitate part of the understanding of the problem of drug addiction in adolescence and its differences of gender; therefore, the conclusion drawn can be useful so that the professionals involved in the intervention with adolescents with drug use problems can innovate in differential actions and can adapt to the needs of people according to their gender


Asunto(s)
Humanos , Masculino , Femenino , Consumidores de Drogas/psicología , Relaciones Familiares/psicología , Conducta del Adolescente , Factores Sexuales , Factores de Riesgo
7.
BMC Public Health ; 20(1): 1220, 2020 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-32778084

RESUMEN

BACKGROUND: While previous research has identified how criminalization of HIV non-disclosure can have deleterious effects on those living with HIV, the perspectives of people who use drugs - a population disproportionately affected by HIV- should be more meaningfully considered in these discussions. METHODS: Using constant comparative techniques, data from 60 interviews with men and women living with and without HIV and who use drugs in Vancouver were analyzed to explore their perceptions about Canada's HIV non-disclosure legal framework. RESULTS: Participants' perspectives on the framework involved three themes: understandings of HIV risk; HIV-related stigma; and their own experiences with HIV. While several participants favored the punitive character of the legal framework, these arguments were premised on misinformed and stigmatized assumptions regarding HIV. CONCLUSIONS: The paper concludes by discussing the challenges and opportunities for resisting HIV stigma and misconceptions about HIV within the context of personal accounts that, at times, support criminalization of non-disclosure.


Asunto(s)
Revelación/legislación & jurisprudencia , Consumidores de Drogas/psicología , Infecciones por VIH/epidemiología , Adulto , Anciano , Canadá/epidemiología , Consumidores de Drogas/estadística & datos numéricos , Femenino , Infecciones por VIH/psicología , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Estigma Social
8.
PLoS One ; 15(7): e0236243, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32722721

RESUMEN

BACKGROUND: Cannabis is one of the most widely used substances among vulnerable young people (<26 years of age) experiencing street entrenchment. Although previous research has documented the role cannabis can play in harm reduction, substance use and mental health treatment and pain management, this research has predominantly been quantitative and focused on adult drug-using populations. Little qualitative work has examined how young people who use drugs understand, experience, and engage with cannabis in the context of street entrenchment and drug use trajectories that include the use of other substances such as alcohol, opioids and crystal methamphetamine (meth). METHODS: Semi-structured, in-depth qualitative interviews were conducted between 2017 and 2019 with 56 young people recruited from a cohort of street-involved youth in Vancouver, Canada. We also conducted 13 interviews with 12 youth-focused care providers across the same time period. Interview data were triangulated by drawing on the findings of a program of anthropological research conducted by the senior author since 2008. Interviews were transcribed verbatim and thematic analysis was conducted. RESULTS: The vast majority of study participants engaged in daily, intensive cannabis use at the same time as they cycled on and off other substances that were perceived as much more harmful (primarily alcohol, fentanyl, heroin and meth). While most participants derived significant pleasure from the use of cannabis, no participants in our study described using cannabis for purely recreational purposes. A number of participants explicitly framed cannabis as a form of mental health and substance use treatment that was more effective and "healthier" than the long-term use of psychopharmaceuticals and medication-assisted substance use treatment (e.g., opioid agonist therapies). Cannabis use was also understood to ameliorate some of the harms of, or even facilitate transitions out of, periods of street-based homelessness. While the majority of our participants highlighted the positive effects of regular cannabis consumption, some described how intensive cannabis use could generate significant harms. CONCLUSION: In the context of the recent legalization of non-medical cannabis use in Canada and amid ongoing overdose and housing crises, it is imperative that future policy and programming interventions and provider education and training be responsive to the ways in which vulnerable youth in our setting are actively using cannabis to navigate their everyday lives and healthcare needs.


Asunto(s)
Consumidores de Drogas/psicología , Adolescente , Analgésicos Opioides/administración & dosificación , Femenino , Reducción del Daño , Personas sin Hogar/psicología , Humanos , Entrevistas como Asunto , Masculino , Salud Mental , Trastornos Relacionados con Sustancias/etiología , Adulto Joven
9.
BMC Public Health ; 20(1): 1081, 2020 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-32646390

RESUMEN

BACKGROUND: As research on HIV vaccines continues to advance, studies exploring the feasibility of this intervention are necessary to inform uptake and dissemination strategies with key populations, including people who use drugs (PWUD). METHODS: We conducted 25 in-depth qualitative interviews examining HIV vaccine acceptability among PWUD in Vancouver, Canada. Participants were recruited from an ongoing prospective cohort of HIV-negative PWUD. Data were coded using NVivo, and analyzed thematically. RESULTS: Acceptability was framed by practical considerations such as cost and side effects, and was influenced by broader trust of government bodies and health care professionals. While an HIV vaccine was perceived as an important prevention tool, willingness to be vaccinated was low. Results suggest that future vaccine implementation must consider how to minimize the burden an HIV vaccine may place on PWUD. Centering the role of health care providers in information dissemination and delivery may assist with uptake. CONCLUSIONS: Our findings suggest improvements in care and improved patient-provider relationships would increase the acceptability of a potential HIV vaccine among this population.


Asunto(s)
Vacunas contra el SIDA/administración & dosificación , Consumidores de Drogas/psicología , Infecciones por VIH/prevención & control , Aceptación de la Atención de Salud/psicología , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adulto , Anciano , Canadá/epidemiología , Estudios de Cohortes , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Relaciones Profesional-Paciente , Estudios Prospectivos , Abuso de Sustancias por Vía Intravenosa/epidemiología , Confianza
10.
Ann Agric Environ Med ; 27(2): 260-268, 2020 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-32588603

RESUMEN

INTRODUCTION: Marijuana is one of the most widely used psychoactive substance. There is evidence of genetic predisposition for addiction. OBJECTIVE: The aim of the study is to evaluate personality traits measured by the NEO Five-Factor Inventory and State-Trait Anxiety Inventory, combined with analysis of Tag1B rs1079597 and Tag1D rs1800498 located in the DRD2 gene. MATERIAL AND METHODS: The study group consisted of 214 rural cannabinoid users and 301 controls. The same psychometric test and real-time PCR genotyping were performed in both studied groups. RESULTS: The values of Anxiety state, Anxiety trait, NEO FFI: Neuroticism and Openness in the rural cannabis using group were significantly higher than in the control group. On the other hand, lower values were observed among rural people using cannabis compared to the control group for NEO FFI: Extraversion, Agreeability and Conscientiousness. In the Anxiety trait subscale, a 2% association with the polymorphism DRD2 Tag1B rs1079597 was detected in subjects using cannabis. However, for the DRD2 Tag1D rs1800498, there was no effect on the differences in personality traits between rural cannabis users and the control group. CONCLUSIONS: The study shows differences in personality traits between the cannabis using group and controls. Interaction between genetic factors and personality traits was also detected. The association showing the combination of psychological characteristics and genetic variants can bring us closer to the overall picture of the issue of marijuana addiction.


Asunto(s)
Cannabis , Consumidores de Drogas/psicología , Personalidad/genética , Polimorfismo Genético , Receptores de Dopamina D2/genética , Población Rural/estadística & datos numéricos , Adulto , Humanos , Masculino , Pruebas de Personalidad , Polonia , Receptores de Dopamina D2/metabolismo , Adulto Joven
11.
BMC Public Health ; 20(1): 851, 2020 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-32493347

RESUMEN

BACKGROUND: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID. METHODS: The first Bio-Behavioral Surveillance Survey was conducted in 2013-2014 among persons who self-reported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited in two cross-sectional samples in Maputo and Nampula/Nacala, two large urban centers of Mozambique. Rapid screening of HIV, HBV (HBsAg) and HCV was performed on site. Data from participants in both cities were pooled to conduct RDS-weighted bivariate analyses with HIV/HBV and HIV/HCV co-infections as separate outcomes. Unweighted bivariate and multivariate logistic regression analyses were conducted to assess correlates of co-infection. RESULTS: Among 492 eligible PWID, 93.3% were male and median age was 32 years [IQR: 27-36]. HIV, HBV and HCV prevalence were respectively 44.9% (95% CI:37.6-52.3), 32.8% (95% CI:26.3-39.5) and 38.3 (95% CI:30.6-45.9). Co-infections of HIV/HBV, HIV/HCV and HIV/HBV/HCV were identified in 13.1% (95% CI:7.2-18.9), 29.5% (95% CI:22.2-36.8) and 9.2% (95% CI:3.7-14.7) of PWID, respectively. Older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HBV co-infection. Living in Maputo city, have older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HCV co-infection. CONCLUSION: There is a high burden of HBV and HCV among HIV-infected PWID in Mozambique. Our results highlight the need for targeted harm reduction interventions that include needle exchange programs and integrated services for the diagnosis and treatment of HIV, HBV and HCV to address these epidemics among PWID. Efforts should be made to strengthen ART coverage in the population as an important treatment strategy for both viruses.


Asunto(s)
Coinfección/epidemiología , Infecciones por VIH/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Abuso de Sustancias por Vía Intravenosa/epidemiología , Adolescente , Adulto , Anciano , Coinfección/psicología , Coinfección/virología , Estudios Transversales , Consumidores de Drogas/psicología , Consumidores de Drogas/estadística & datos numéricos , Epidemias , Femenino , VIH , Infecciones por VIH/psicología , Infecciones por VIH/virología , Hepacivirus , Hepatitis B/psicología , Hepatitis B/virología , Virus de la Hepatitis B , Hepatitis C/psicología , Hepatitis C/virología , Humanos , Masculino , Persona de Mediana Edad , Mozambique/epidemiología , Compartición de Agujas/estadística & datos numéricos , Prevalencia , Factores de Riesgo , Asunción de Riesgos , Abuso de Sustancias por Vía Intravenosa/psicología , Abuso de Sustancias por Vía Intravenosa/virología , Adulto Joven
12.
Psychopharmacology (Berl) ; 237(7): 1893-1908, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32363438

RESUMEN

BACKGROUND: This review aims to identify whether risky decision-making is increased in substance users, and the impact of substance type, polysubstance use status, abstinence period, and treatment status on risky decision-making. METHODS: A literature search with no date restrictions was conducted to identify case-control studies or cross-sectional studies that used behavioral tasks to measure risky decision-making in substance users. A random-effects model was performed. GRADE criteria was used to assess the quality of evidence. RESULTS: 52 studies were enrolled. The result showed that the difference in risky decision-making performance between user groups and control groups was significant (SMD = - 0.590; 95%CI = - 0.849 to - 0.330; p < 0.001; I2 = 93.4%; Pheterogeneity < 0.001). Subgroup analysis showed that users in the subgroups of alcohol (p < 0.001), tobacco (p < 0.01), cocaine (p < 0.001), opioid (p < 0.001), mixed group (p < 0.01), adult users (p < 0.001), small sample size (p < 0.001), large sample size (p < 0.01), low education (p < 0.001), high education (p < 0.001), short-abstinence period (p < 0.001), long-abstinence period (p < 0.001), without current polysubstance dependence (p < 0.001), and with treatment (p < 0.001) had increased risky decision-making when compared to the controls. On the other hand, elderly substance users with short-abstinence period showed increased risky decision-making. Moreover, current treatment status and polysubstance use may not influence the level of decision-making in substance users. CONCLUSIONS: The results show that substance use is associated with impaired risky decision-making, indicating that interventions targeting risky decision-making in substance users should be developed for relapse prevention and rehabilitation.


Asunto(s)
Toma de Decisiones , Asunción de Riesgos , Trastornos Relacionados con Sustancias/diagnóstico por imagen , Trastornos Relacionados con Sustancias/psicología , Estudios de Casos y Controles , Estudios Transversales , Toma de Decisiones/fisiología , Consumidores de Drogas/psicología , Humanos , Análisis de Regresión
13.
PLoS One ; 15(5): e0233463, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32437443

RESUMEN

BACKGROUND: Cannabis use is common among marginalized people who use illicit drugs (PWUD) but reasons for use remain poorly investigated. We sought to explore how different intentions for cannabis use relate to social, structural, and behavioural factors among PWUD in Vancouver, Canada. METHODS: We used data from cannabis-using participants in two community-recruited prospective cohort studies of PWUD. Using latent class analysis, we identified discrete cannabis-using groups based on self-reported intentions for use. Generalized estimating equations were used to examine correlates of class membership. RESULTS: Between June 2016 and December 2018, 2,686 observations from 897 participants cannabis-using PWUD were analyzed. Four latent classes of cannabis use emerged: Class 1 (31.6%), characterized by non-medical purposes; Class 2 (37.5%), characterized by non-pain therapeutic use (e.g., stress, nausea/loss of appetite, and insomnia); characterized by Class 3 (21.9%) predominantly pain relief; and Class 4 (9.0%), characterized by a wide range of therapeutic uses in addition to pain management, including insomnia, stress, nausea/loss of appetite, and harm reduction. Class-specific structural, substance-, and health-related differences were observed, including indicators of better physical and mental health among the "recreational" class, despite evidence of more structural vulnerabilities (e.g., homelessness, incarceration). CONCLUSIONS: Our findings demonstrate a wide spectrum of motivations for cannabis use among PWUD. We observed important health-related differences between latent classes, demonstrating possible unmet healthcare needs among PWUD reporting therapeutic cannabis use. These findings inform ongoing policy surrounding access to cannabis for harm reduction purposes and applications of medical cannabis for PWUD.


Asunto(s)
Consumidores de Drogas/psicología , Uso de la Marihuana/psicología , Motivación , Adulto , Canadá , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Fumar Marihuana/psicología , Persona de Mediana Edad , Manejo del Dolor
14.
PLoS One ; 15(4): e0231424, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32298320

RESUMEN

BACKGROUND: People who inject drugs (PWID) are at an increased risk for HIV infection due to injection and sexual risk behaviors. This study aims to examine PrEP knowledge, awareness, and willingness to be linked to PrEP services at a syringe services program (SSP), and examine the relationship between substance use and interest in PrEP linkage. METHODS: Data were collected using a cross-sectional survey of IDEA SSP clients in Miami, FL (N = 157). Based on reported substance injected, participants were classified into opioid-only injection or polysubstance injection. Socio-demographics and HIV risk were examined using Pearson's Chi-Squared analysis. Bivariate and multivariable logistic regression models were used to test for significant correlates of interest in PrEP linkage. RESULTS: Only 28.3% of PWID surveyed had previously heard of PrEP. However, 57.2% were interested in receiving more information about PrEP. In the adjusted model, people with opioid-only use were significantly less likely to report interest in being linked to PrEP. CONCLUSION: Knowledge, awareness, and interest in being linked to PrEP were low among PWID surveyed. No participants of the study were successfully linked to PrEP services through direct referrals. Further research is needed to examine low threshold service delivery of PrEP to PWID at SSPs.


Asunto(s)
Consumidores de Drogas/psicología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Profilaxis Pre-Exposición/métodos , Abuso de Sustancias por Vía Intravenosa/psicología , Adulto , Consumidores de Drogas/estadística & datos numéricos , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Femenino , Florida , Infecciones por VIH/etiología , Infecciones por VIH/psicología , Humanos , Masculino , Persona de Mediana Edad , Programas de Intercambio de Agujas/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Abuso de Sustancias por Vía Intravenosa/complicaciones
15.
PLoS One ; 15(4): e0231726, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32298337

RESUMEN

OBJECTIVES: Mental health is a largely neglected issue among in Sub-Saharan Africa, especially among key populations at risk for HIV. The aim of this study was to estimate the prevalence of psychological distress (PD) and to assess the factors associated among males who have sex with males (MSM), female sex workers (FSW) and drug users (DU) in Togo in 2017. STUDY DESIGN: A cross-sectional bio-behavioral study was conducted in August and September 2017 using a respondent-driven sampling (RDS) method, in eight cities in Togo. METHODS: A standardized questionnaire was used to record sociodemographic characteristics and sexual behaviors. The Alcohol Use Disorders Identification Test (AUDIT) and a subset of questions from the Tobacco Questions for Survey were used to assess alcohol and tobacco consumption respectively. PD was assessed with the Kessler Psychological Distress Scale. A blood sample was taken to test for HIV. Descriptive statistics, univariable and multivariable ordinal regression models were used for analysis. RESULTS: A total of 2044 key populations including 449 DU, 952 FSW and 643 MSM with a median age of 25 years, interquartile range (IQR) [21-32] were recruited. The overall prevalence of mild PD among the three populations was 19.9% (95%CI = [18.3-21.8]) and was 19.2% (95%CI = [17.5-20.9]) for severe/moderate PD. HIV prevalence was 13.7% (95%CI = [12.2-15.2]). High age (≥ 25 years) [aOR = 1.24 (95% CI: 1.02-1.50)], being HIV positive [aOR = 1.80 (95% CI: 1.31-2.48)] and hazardous alcohol consumption [aOR = 1.52 (95% CI: 1.22-1.87)] were risk factors for PD. Secondary [aOR = 0.52 (95% CI: 0.42-0.64)] or higher [aOR = 0.46 (95% CI: 0.32-0.64)] education levels were protective factors associated with PD. FSW [OR = 0.55 (95% CI: 0.43-0.68)] and MSM [OR = 0.33 (95% CI: 0.24-0.44)] were less likely to report PD compared with DU. CONCLUSION AND RECOMMENDATIONS: This is the first study conducted among a large, nationally representative sample of key populations in Togo. The prevalence of PD is high among these populations in Togo and was associated to HIV infection. The present study indicates that mental health care must be integrated within health programs in Togo with a special focus to key populations through interventions such as social support groups.


Asunto(s)
Consumidores de Drogas/psicología , Infecciones por VIH/epidemiología , Homosexualidad Masculina/psicología , Distrés Psicológico , Trabajadores Sexuales/psicología , Adulto , Estudios Transversales , Demografía , Consumidores de Drogas/estadística & datos numéricos , Femenino , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Prevalencia , Factores de Riesgo , Trabajadores Sexuales/estadística & datos numéricos , Factores Sociológicos , Encuestas y Cuestionarios , Togo/epidemiología , Adulto Joven
16.
BMC Womens Health ; 20(1): 77, 2020 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-32321495

RESUMEN

BACKGROUND: According to recent studies, the number of women drug users is dramatically increasing. However, the information on the issue of drug rehab in women is not sufficient, and there are numerous traditional, organizational, political and cultural barriers to the provision of relevant information in this regard in Iran. This study, thus, aimed to explain the factors influencing the decision of these women to stop drug use. METHODS: This qualitative study was conducted in two rehab camps of Isfahan (in Iran) on July to October 2017. Thirty participants (women drug users) were selected through purposive and theoretical sampling until data saturation was reached. Data collection was conducted through semi-structured interviews. The transcribed interviews were analyzed using conventional content analysis. RESULTS: Based on the analysis of the obtained results, the women's experience of the ups and downs of stopping drug use yielded two themes and nine sub-themes. The themes were "the need for emancipation (the deviated path, being abused, compulsive drug use, acquaintance with God, a supportive family)" and "Sinking factors (non-assisting mates, pro-addictive family, unawareness of assisting official organization and non-government organization, woman's lack of authority, ineffective opportunities)". CONCLUSIONS: It was concluded that addiction rehab strategies can lead to a brighter life for women drug users only when they are coupled with open-hearted assistance of the families and women specific rehab centers are established to help them meet their specific needs.


Asunto(s)
Consumidores de Drogas/psicología , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Femenino , Humanos , Entrevistas como Asunto , Irán , Investigación Cualitativa , Trastornos Relacionados con Sustancias/psicología , Salud de la Mujer
17.
Public Health Rep ; 135(3): 393-400, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32264789

RESUMEN

OBJECTIVES: Delivering and receiving prompt medical care during an overdose are imperative to ensure survival. Good Samaritan laws encourage people to call 911 during an overdose by providing immunity from selected drug arrests (eg, low-level possession). However, it is unclear whether persons who inject drugs (PWID) are aware of and understand these laws and their implications. We examined awareness among PWID of the 2015 Good Samaritan law in Maryland and their beliefs about whether they could be arrested for calling 911 or having an overdose. METHODS: We surveyed 298 PWID in Baltimore, Maryland. We estimated the proportion who knew what the Good Samaritan law addressed and who believed they could be arrested for calling 911 or overdosing. We used a multivariate model to assess the association between harm-reduction services and knowledge of the Good Samaritan law or beliefs about getting arrested for calling 911 or overdosing. RESULTS: Of PWID, 56 of 298 (18.8%) knew what the Good Samaritan law addressed, 43 of 267 (16.1%) believed they could be arrested for calling 911, and 32 of 272 (11.8%) believed they could be arrested for having an overdose. After adjusting for demographic characteristics, accessing the syringe services program was associated with accurate knowledge and the belief that PWID could be arrested for calling 911; however, training in overdose reversal was not associated. CONCLUSIONS: Most PWID were unaware of the Good Samaritan law; this lack of awareness is a barrier to preventing overdose deaths. Educating PWID about Good Samaritan laws is essential, and such education should include police to ensure that law enforcement is congruent with Good Samaritan laws and does not perpetuate mistrust between police and PWID.


Asunto(s)
Sobredosis de Droga/psicología , Consumidores de Drogas/legislación & jurisprudencia , Consumidores de Drogas/psicología , Aplicación de la Ley , Trastornos Relacionados con Opioides/psicología , Adolescente , Adulto , Baltimore/epidemiología , Sobredosis de Droga/epidemiología , Femenino , Reducción del Daño , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Trastornos Relacionados con Opioides/epidemiología , Abuso de Sustancias por Vía Intravenosa , Adulto Joven
18.
East Mediterr Health J ; 26(2): 212-218, 2020 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-32141600

RESUMEN

Background: Parenting approach and early childhood experiences are thought to be two important factors in the initiation of substance use. Aims: We aimed to explore the nurse's role in the prevention of childhood addiction. Methods: In this qualitative study we conducted in-depth interviews with young men and women who were either in treatment for their addiction or were active drug users as well as with family members and nurses. The data analysis followed Strauss and Corbin's constant comparison method. Results: The data analysis revealed six categories: traumatic events during childhood, inappropriate parenting approach, Lack of knowledge and a tolerant attitude toward drug use, turning a blind eye on the threat of drug use, nurses' poor experience of drug use prevention, and the lack of a clear definition of the nurse's role in prevention of drug use. Conclusions: Nurses who work with young people and their families have a special opportunity for prevention, early detection and timely intervention for drug dependency.


Asunto(s)
Consumidores de Drogas/psicología , Rol de la Enfermera , Trastornos Relacionados con Sustancias/enfermería , Adolescente , Adulto , Conducta Adictiva/enfermería , Conducta Adictiva/prevención & control , Conducta Adictiva/psicología , Niño , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Investigación Cualitativa , Estrés Psicológico/psicología , Trastornos Relacionados con Sustancias/prevención & control , Trastornos Relacionados con Sustancias/psicología
19.
JAMA Netw Open ; 3(1): e1919792, 2020 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-31977062

RESUMEN

Importance: While a diverse array of cannabis products that may appeal to youth is currently available, it is unknown whether the risk of persistent cannabis use and progression to higher frequency of use after experimentation differs among cannabis products. Objective: To estimate the comparative relative risk of experimental use of 5 cannabis products on use status and frequency of use among adolescents during 12 months of follow-up. Design, Setting, and Participants: In this cohort study, data were collected from 3065 adolescents at 10 high schools in southern California, with baseline data collected in spring 2016, when students were in 11th grade, and 6-month and 12-month follow-up surveys collected in fall 2016 and spring 2017, when students were in 12th grade. Analyses, conducted from April to June 2019, were restricted to 2685 participants who were light or nonusers of any cannabis product (ie, ≤2 days in the past 30 days) at baseline. Exposures: Number of days of use of each cannabis product (ie, combustible, blunts, vaporized, edible, or concentrated) in the past 30 days at baseline (ie, 1-2 vs 0 days). Main Outcomes and Measures: Past 6-month use (ie, yes vs no) and number of days of use in the past 30 days at 6-month and 12-month follow-ups for each product. Results: Of 2685 individuals in the analytic sample, 1477 (55.0%) were young women, the mean (SD) age was 17.1 (0.4) years, and a plurality (1231 [46.6%]) were Hispanic individuals. Among them, 158 (5.9%) reported combustible cannabis use on 1 to 2 days of the past 30 days at baseline, 90 (3.4%) reported blunt use, 78 (2.9%) reported edible cannabis use, 17 (0.6%) reported vaping cannabis, and 15 (0.6%) reported using cannabis concentrates. In regression models adjusting for demographic characteristics and poly-cannabis product use, statistically stronger associations of baseline use with subsequent past 6-month use at the 6-month and 12-month follow-ups were observed for combustible cannabis use (odds ratio, 6.01; 95% CI, 3.66-9.85) and cannabis concentrate use (odds ratio, 5.87; 95% CI, 1.18-23.80) compared with use of blunts (OR, 2.77; 95% CI, 1.45-5.29) or edible cannabis (OR, 3.32; 95% CI, 1.86-5.95) (P for comparison < .05); vaporized cannabis use (OR, 5.34; 95% CI, 1.51-11.20) was not significantly different from the other products. In similarly adjusted models, we found the association of cannabis use at baseline with mean days of use at the 6-month and 12-month follow-ups was significantly stronger for cannabis concentrate than for other cannabis products; participants who had used cannabis concentrate on 1 to 2 of the past 30 days at baseline (vs 0 days) used cannabis concentrate a mean of 9.42 (95% CI, 2.02-35.50) more days in the past 30 days at the 6-month and 12-month follow-ups (P for comparison < .05). Conclusions and Relevance: Cannabis control efforts should consider targeting specific cannabis products, including combustible cannabis and cannabis concentrate, for maximum public health consequences.


Asunto(s)
Conducta del Adolescente/psicología , Cannabis/efectos adversos , Consumidores de Drogas/psicología , Fumar Marihuana/psicología , Estudiantes/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Consumidores de Drogas/estadística & datos numéricos , Femenino , Humanos , Masculino , Oportunidad Relativa , Factores de Riesgo , Autoinforme/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos
20.
Int J Occup Med Environ Health ; 33(2): 125-136, 2020 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-31942874

RESUMEN

OBJECTIVES: This study analyzed the prevalence of new psychoactive substance (NPS) use in the analyzed group and compared demographic features and psychoactive substance profiles between the 2 subgroups (NPS users, non-NPS users). The secondary measure was used to determine the prevalence of psychiatric comorbidities in study group and to compare demographic features and psychoactive substance profiles between 2 subgroups (the F11-19 only diagnosed group and the F11-19 group with psychiatric comorbidities according to ICD-10). MATERIAL AND METHODS: A 12-month retrospective cross-sectional analysis of medical records compiled for adult psychiatric patients who had been admitted to the Regional Psychiatric Hospital in Olsztyn, Poland, in October 1, 2016 - September 30, 2017 was conducted. After analyzing the available medical records, 157 cases were included and analyzed. Data for the study were collected in a specially designed monitoring card from discharge reports, including data from psychiatric examinations, especially anamnesis. RESULTS: The most commonly declared psychoactive substances were amphetamine (AMF) - 54% and cannabinoids - 46%. The prevalence of NPS use in the study group was 34%. Inpatients taking NPS, as compared with non-NPS users, were younger and more often admitted to hospital through the Emergency Department. It was also found that NPS users more often took AMF or cannabinoids, and less frequently benzodiazepines (BDZ) or opioids. However, the taking of AMF, cannabinoids and BDZ was also age-dependent. CONCLUSIONS: The prevalence of psychiatric comorbidities in the study group was 9%. Inpatients with psychiatric comorbidities were older and took BDZ significantly more often than AMF. In addition, NPS use affects different groups, including a specific group as the analyzed sample, which shows a similar NPS use profile as different groups described in the literature. Int J Occup Med Environ Health. 2020;33(2):125-36.


Asunto(s)
Pacientes Internos/psicología , Pacientes Internos/estadística & datos numéricos , Trastornos Mentales/inducido químicamente , Psicotrópicos , Trastornos Relacionados con Sustancias/psicología , Adulto , Comorbilidad , Estudios Transversales , Consumidores de Drogas/psicología , Consumidores de Drogas/estadística & datos numéricos , Femenino , Hospitales Psiquiátricos , Humanos , Masculino , Trastornos Mentales/epidemiología , Polonia/epidemiología , Prevalencia , Estudios Retrospectivos , Trastornos Relacionados con Sustancias/epidemiología
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