Suicide deaths and substance use in the Galician provinces between 2006 and 2020.

Background: Suicide is a serious public health problem that affects our entire country, including the Galician provinces. The aim of this research was to study the variation in completed suicide rates, between 2006 and 2020, in the different Galician provinces and their relationship with the consumption of addictive substances. Methods: Completed suicide data from the Spanish Office for National Statistics and the Institute of Legal Medicine of Galicia were analyzed with a Joinpoint regression model to determine time trends. The relationship between the variation in completed suicide rates with sociodemographic variables obtained from the Spanish Office for National Statistics and variables related to the consumption of substances obtained from the survey on alcohol and other drugs in Spain (EDADES) of the Government Delegation for the National Plan on Drugs was also analyzed. Results: The Joinpoint regression model did not reveal any point of significant change in the period studied for any Galician province. The following variables correlated positively with the variation in completed suicide rates in the Galician provinces: masculinity ratio, average age, daily alcohol consumption and daily illegal substance consumption. Conclusion: Applying preventive strategies on the daily consumption of alcohol and illegal substances would help reduce the rates of completed suicide in the Galician provinces.

Prevalence of drug use before and during imprisonment in seven European countries (2014-2018).

Substance use is a global phenomenon that is particularly affecting the prison population. This study aimed to describe the prevalence of drug use among people in prison before and during incarceration in seven European countries and to compare it with the prevalence in the general population. Individual data collection was carried out between 2014 and 2018 with a model European Questionnaire on Drug Use among people in prison. A total of 12,918 people living in prison filled in the survey. People in prison report higher level of drug use when compared with the general population and the use of drug inside prison exist, although at lower levels when compared with predetention. Prisons can represent a point of access to engage individuals who use drugs in interventions that address drug use and risk factors related to both drug use and imprisonment.

Estimating the Prevalence of Recreational Opioid Use in Spain Using a Multiplier Method.

Acknowledgement of the prevalence of recreational opioid use (PROU) is key to the planning and evaluation of care services. However, in Spain, the prevalence of PROU in recent years is unknown. The objective of this study was to estimate the PROU between 2005 and 2019 in the general populations of six Spanish cities. A benchmark-multiplier methodology was used to estimate the PROU population size. The benchmark used was overdose deaths from recreational opioid use in Spain's six most populated cities. The multiplier was the overdose death rate in a cohort of heroin users. Linear regression was used to estimate the trend of the PROU estimate over the set period of years. In 2005, the PROU was 4.78 (95%CI 3.16-7.91) per 1000 people. The estimated trend decreased, with the two lowest values being 2.35 per 1000 in 2015 and 2.29 in 2018. In 2019 the PROU was 2.60 per 1000 (95%CI 1.72-4.31), 45% lower than in 2005. While the decline in the PROU continues, its deceleration over the last four years calls for increased vigilance, especially in light of the opioid crisis in North America that has occurred over the last few years.

[COVID-19 impact on substance use and behaviors with addictive potential: Spanish Observatory on Drugs and Addictions survey.] / Impacto COVID-19 en el consumo de sustancias y comportamientos con potencial adictivo: encuesta del Observatorio Español de las Drogas y Adicciones.

The Covid-19 pandemic and the measures adopted for its control have had a significant impact, both in and at health, social and personal levels. The Spanish Observatory of Drugs and Addictions designed a survey to study the change in the pattern of consumption of psychoactive substances and other behaviors with addictive potential, such as the use of the Internet and gambling with money, in the Spanish population during the pandemic COVID-19. A random sample of 7,886 people aged 15 to 64 was interviewed by a telephone survey. The results show a decrease in the consumption of alcohol, tobacco and cannabis and non-internet gambling, along with an increase in the use of non-prescription hypnosedatives and the number of hours spent using the internet for recreational purposes, while online gambling remained unchanged. This overall decline in use occurs in a context of reduced access to illicit drugs, a consequence of the control measures adopted in the COVID-19 pandemic in Spain. The control measures also affected leisure environments, and this has possibly contributed to the changes observed, especially in heavy episodic alcohol consumption among young people, showing the impact of environmental prevention in tackling this problem.

La pandemia por Covid-19 y las medidas adoptadas para su control han supuesto un importante impacto, tanto sanitario como social y personal, a todos los niveles. El Observatorio Español de las Drogas y las Adicciones diseñó una encuesta para estudiar el cambio en el patrón de consumo de sustancias psicoactivas y otras conductas con potencial adictivo, como el uso de internet y el juego con dinero, en la población española durante la pandemia por Covid-19. Se realizó una encuesta telefónica sobre una muestra de 7.886 personas de 15 a 64 años representativa a nivel nacional. Los resultados muestran un descenso del consumo de alcohol, tabaco, cannabis y juego con dinero presencial, que contrasta con un aumento del consumo de hipnosedantes sin receta y del número de horas dedicado al uso de internet por diversión, mientras que el juego online permaneció sin cambios. El descenso generalizado de los consumos se ha producido en un contexto de diminución del acceso a las drogas ilegales, consecuencia de las medidas adoptadas para el control de la pandemia por COVID-19. Estas afectaron a los entornos de ocio lo que, posiblemente, ha contribuido a los cambios observados, en especial en los consumos intensivos de alcohol en jóvenes, sugiriendo la relevancia de las medidas de prevención ambiental en el abordaje de este problema.

Cocaine treatment demands in 10 western European countries: observed trends between 2011 and 2018.

AIMS: To describe cocaine treatment demand in 10 western European countries and to examine the size, direction and temporality of recent trends in the proportion of cocaine users among all clients entering treatment. DESIGN: Aggregated data collected through the European Union standardized treatment demand monitoring system (TDI) between 2011 and 2018 were used. SETTING: Belgium, England, France, Germany, Ireland, Italy, Luxembourg, Spain, Switzerland and the Netherlands. PARTICIPANTS: In total, more than 700 000 cocaine treatment records were analysed. Clients in treatment for cocaine as primary drug were predominantly male (85%), with an average age of 35 years. MEASUREMENTS: Number of treatment episodes for substance use and for cocaine as primary or secondary drug were collected year- and country-wise. When available, powder cocaine and crack and patients with and without previous treatment were differentiated. FINDINGS: Among the participating countries the share of cocaine as primary drug in treatment demand ranged between 4.7% [95% confidence interval (CI) = 4.6-4.9%] in Germany and 43.1% in Spain (95% CI = 42.6-43.5%). The general trend analysis showed a decreasing proportion of cocaine-related treatment entrants between 2011 and 2014 among all subgroups followed by a strong increase in 2015. The increase appeared stronger than for powder cocaine. Seven of 10 countries observed a recent significant increase in the proportion of treatment entrants reporting cocaine as the primary substance: Belgium [annual percentage change (APC) = 9.6%, P < 0.01], England (APC = 14.9%, P < 0.05), France (APC = 21.8%, P < 0.01), Ireland (APC = 28.2%, P < 0.01), Italy (APC = 7.8%, P < 0.01), Spain (APC = 7.0%, P < 0.05) and Switzerland (APC = 12.0%, P < 0.05). Trends were similar when looking at cocaine reported as primary or adjunctive substance. CONCLUSIONS: Despite substantial country-specific variation regarding cocaine prevalence and treatment demand, there has been an overall significant increase since 2015 in the share of cocaine-related treatment demand in western Europe.

Cocaine-related health emergencies in Europe: a review of sources of information, trends and implications for service development.

BACKGROUND: Cocaine-related health consequences are difficult to observe. Data on drug users in health-emergency settings may be a useful source of information on consequences that are not visible via other information sources. METHODS: Thirty European countries submit an annual national report on the drug situation to the EMCDDA. All reports for the period 2007-2010 were analyzed, with particular attention given to auditing cocaine-related mentions. Analysis was also performed in order to identify sources and case definitions, assess coverage, audit cases and, where possible, to identify long-term trends. RESULTS: Considerable heterogeneity existed between countries in their approach to recording drug-related emergencies, with only Spain and the Netherlands having established formal indicators. The highest annual numbers of cocaine-related episodes were reported by the UK (3,502), Spain (2,845) and the Netherlands (1,211). A considerable (2- to 3-fold) increase in the numbers of cocaine-related episodes has been reported since the end of the 1990s in these countries; these increases peaked in Spain and England around 2007/08. CONCLUSIONS: The analysis reported here suggests the need to develop more standardized approaches to monitoring drug-related emergencies. It points to the potential value of developing effective referral links between the emergency and specialized drug services working with cocaine users.

Effects of socialization and family factors on adolescent excessive drinking in Spain.

Adolescent drinking has an important health and social impact in many countries. In Spain, this behavior often takes place in groups and in open areas (known as "botellón"). The aim of this study is to describe the prevalence of excessive drinking among Spanish adolescents and its association with socialization and family factors. A national school survey was conducted in 2006 among 26,454 students aged 14-18 years who were selected by two-stage cluster sampling (schools and classrooms). The questionnaire was self-completed with paper and pencil. The outcomes were: habitual excessive drinking or HED (average consumption ≥30 g/day of alcohol among men, and ≥20 g/day among women), binge drinking (drinking 5 or more standard alcohol units in a 2-hour interval), and drunkenness. Logistic regression models were used to estimate the effect of socialization and family factors. Monthly prevalence of HED, binge drinking and drunkenness was 11.2%, 30.9% and 25.6%, respectively. The main factors positively associated with HED were: frequently going out for fun in the evenings, high proportion of friends who drink or get drunk, early onset of alcohol use, low perceived risk of drinking, truancy, illegal drug use, and amount of money spent for personal needs. Family factors were weakly associated with outcomes. Socialization in leisure environments with friends who drink excessively is an important predictor of adolescent excessive drinking in Spain. Thus, prevention must also focus on the community level, limiting alcohol access, building socialization environments without alcohol, and increasing adolescents' risk perception of drinking.

Perception and consumption of alcohol among the immigrant population from Latin America in Valencia region (Spain).

This study examines patterns of alcohol consumption among the Hispanic immigrant population in Valencia (Spain), and also whether the length of immigrants' residence in our country and perceived degree of discrimination have any influence on such patterns. A total of 610 Spanish-speaking immigrants (314 women, 296 men) over 15 years of age, from six Hispano-American countries were interviewed in 2006; 76.8% had consumed alcohol in the previous 12 months; 37.6% drink more alcohol in Spain than in their country of origin. This study shows the need to develop specific programs for the immigrant population, with special consideration for the young, males, and smokers. The study's limitations are noted.

Methadone maintenance treatment: a protective factor for cocaine injection in a street-recruited cohort of heroin users.

OBJECTIVE: To evaluate the effect of methadone maintenance treatment (MMT) on cocaine use and cocaine injection among heroin users. METHODS: Generalized estimating equations (GEE) were used to examine the association between MMT enrollment (0, <12, ≥12 months) and changes in frequency of cocaine use or injection in two consecutive follow-up visits among heroin users in the Itinere cohort, and to determine whether these changes were independent of equivalent changes in heroin use or injection. Seven multivariate models were constructed, one for each outcome variable on drug use changes. RESULTS: Of the 992 participants recruited in 2001-2003, 628 (63.3%) had at least one follow-up visit. Of these, 55.8% were enrolled in MMT at baseline and an additional 23.2% initiated MMT during follow-up. In multivariate GEE, changes significantly and positively associated with MMT enrollment were: less cocaine use [MMT<12 months (OR=1.70, 95% CI=1.17-2.48)] and less cocaine injection [MMT≥12 months (OR=2.98, 95% CI=1.51-5.89)]. Being on MMT≥12 months was negatively associated with more cocaine use (OR=0.62, 95% CI=0.38-0.99) and with more cocaine injection (OR=0.52, 95% CI=0.28-0.98). When equivalent changes in heroin were used as a covariate, the MMT effect on less cocaine use was hardly modified (OR=1.69, 95% CI=1.07-2.65), and the effect on changes in cocaine injection disappeared. CONCLUSION: MMT enrollment is a protective factor against both cocaine use and injection among heroin users. The effect of MMT on cocaine injection appears to be mediated by heroin injection, whereas its effect on cocaine use is more direct.

El cielo revuelto del cannabis: ¿hay nueces para tanto ruido? / The cannabis epidemic in perspective: can a solution be found?

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Occupational safety and health in Spain.

Occupational Health and Safety in Spain has improved considerably over the last decade, most likely due to a new concept where an overall concept of safety culture is defined. Important changes in industrial safety, hygiene, and psychosocial factors present an optimistic panorama for the future of Spain. Despite this general improvement, according to the European Convergence Program, Spanish statistics still offer far from good safety results. In fact, according to 1997 official statistics, Spain had the highest incidence rate for nonfatal occupational accidents of all European Union (EU) countries, and occupied third place for fatal accidents. This paper summarizes the organizational structure of the Spanish National System of Health & Safety at Work, its effective health and safety laws, and statistics on the Spanish work environment obtained from III Spanish National Survey on Work Conditions (1997). The researchers hope that the findings of this work will have an impact on Spanish industry that will subsequently bring about improvements in work conditions and develop assessment and intervention models in occupational health and safety, from a theoretical position integrating environmental, human, and organizational factors.