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1.
Int J Mol Sci ; 22(10)2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-34067981

RESUMO

Pseudoephedrine (PSE) is a drug with a long history of medical use; it is helpful in treating symptoms of the common cold and flu, sinusitis, asthma, and bronchitis. Due to its central nervous system (CNS) stimulant properties and structural similarity to amphetamine, it is also used for non-medical purposes. The substance is taken as an appetite reducer, an agent which eliminates drowsiness and fatigue, to improve concentration and as a doping agent. Due to its easier availability, it is sometimes used as a substitute for amphetamine or methamphetamine. Pseudoephedrine is also a substrate (precursor) used in the production of these drugs. Time will tell whether legal restrictions on the sale of this drug will reduce the scale of the problem associated with its misuse.


Assuntos
Broncodilatadores/uso terapêutico , Metanfetamina/efeitos adversos , Pseudoefedrina/uso terapêutico , Medição de Risco/métodos , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Humanos , Metanfetamina/química , Transtornos Relacionados ao Uso de Substâncias/etiologia
2.
Rev Med Suisse ; 17(742): 1115-1117, 2021 06 09.
Artigo em Francês | MEDLINE | ID: mdl-34106536

RESUMO

Use of benzodiazepine and Z-drug is common in Switzerland, also for prolonged periods of time. Physical dependence, psychological dependence and a syndrome of dependence may ensue. Related to a lack of well-established medical guidelines, current clinical practices are subject to debate. Also controversial is the need to request an authorization from the cantonal health authorities before starting treatment with these controlled substances. The present article describes the limited circumstances in which such prior authorization is required.


Assuntos
Comportamento Aditivo , Transtornos Relacionados ao Uso de Substâncias , Benzodiazepinas , Humanos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Suíça
3.
Tidsskr Nor Laegeforen ; 141(9)2021 06 08.
Artigo em Norueguês | MEDLINE | ID: mdl-34107659

RESUMO

BACKGROUND: The purpose of the study was to investigate health-related help-seeking behaviour among illegal substance users. MATERIAL AND METHOD: Data were collected on the website Rusopplysningen.no. Questions were asked about use of illegal substances and openness with healthcare personnel regarding this use. Only respondents who reported having used illegal substances were included, and missing responses to particular questions were excluded from the percentage calculations. RESULTS: Altogether 2 485 respondents had used illegal substances. A total of 880 (39 %) had told healthcare/social care personnel about their substance use, of which 506 (68 %) reported that they had no need of help. Altogether 802 (36 %) had avoided telling healthcare/social care personnel about their use of illegal substances in relevant situations, while 309 (14 %) believed that they needed treatment for substance use, and 202 of these (65 %) had avoided or postponed seeking such treatment. Among the 815 who had been in an acute medical situation related to substance use, 82 (10 %) had delayed calling an ambulance, and 330 (41 %) had avoided calling an ambulance altogether. Among these, fear of being reported to the police was the most frequently reported reason (n = 280, 71 %), while 216 (55 %) reported that they had considered an ambulance to be unnecessary. INTERPRETATION: Many users of illegal substances do not reveal this to healthcare personnel. Some also avoid calling an ambulance in acute substance-related situations. Fear of police sanctions appears to be a plausible contributory factor.


Assuntos
Usuários de Drogas , Comportamento de Busca de Ajuda , Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Inquéritos e Questionários
4.
BMJ Open ; 11(6): e048353, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108170

RESUMO

INTRODUCTION: The COVID-19 pandemic was preceded by an ongoing overdose crisis and linked to escalating drug overdose deaths in British Columbia (BC). At the outset of these dual public health emergencies, the BC government announced interim Risk Mitigation Guidance (RMG) that permitted prescribing medication alternatives to substances, including opioids, alcohol, stimulants and benzodiazepines, an intervention sometimes referred to as 'safe supply'. This protocol outlines the approach for a study of the implementation of RMG and its impacts on COVID-19 infection, drug-related and systemic harms, continuity of care for people with substance use disorder (SUD), as well as their behavioural, psychosocial and well-being outcomes. METHODS AND ANALYSIS: We conducted a parallel mixed-method study that involved both analysis of population-level administrative health data and primary data collection, including a 10-week longitudinal observational study (target n=200), a cross-sectional survey (target n=200) and qualitative interviews (target n=60). We implemented a participatory approach to this evaluation, partnering with people with lived or living expertise of drug use, and researchers and public health decision-makers across the province. Linked population-level administrative databases will analyse data from a cohort of BC residents with an indication of SUD between 1996 and 2020. We will execute high-dimensional propensity score matching and marginal structural modelling to construct a control group and to assess the impact of RMG dispensation receipt on a collaboratively determined set of primary and secondary outcomes. ETHICS AND DISSEMINATION: Study activities were developed to adhere to the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, recommended COVID-19 research practices, and guided by the Truth and Reconciliation Commission's Calls to Action for public health, data governance and research ethics related to Indigenous people. Results will be disseminated incrementally, on an ongoing basis, through the consortium established for this study, then published in peer-reviewed journals.


Assuntos
COVID-19 , Overdose de Drogas , Transtornos Relacionados ao Uso de Substâncias , Colúmbia Britânica , Estudos Transversais , Overdose de Drogas/epidemiologia , Overdose de Drogas/prevenção & controle , Humanos , Estudos Observacionais como Assunto , Pandemias , Saúde Pública , SARS-CoV-2
5.
BMC Public Health ; 21(1): 1026, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059021

RESUMO

BACKGROUND: Young gay, bisexual, and other men who have sex with men (YMSM) are vulnerable to the risks associated with sexualized substance use. This is a novel study in Singapore that aims to classify patterns of sexualized substance use among YMSM, and investigate its association with sexual and mental health outcomes. METHODS: In this cross-sectional study among 570 YMSM aged 18 to 25 years old, latent class analysis (LCA) conducted to identify classes with similar patterns of sexualized substance use, across which measures of inconsistent condom use, recent STI diagnoses, past suicide ideation and depression severity were compared. RESULTS: LCA revealed three classes of YMSM based on types of substances ever used in sexualized contexts, which we labelled as 'substance-naive', 'substance-novice', and 'chemsex'. Substance-naive participants (n = 404) had only ever used alcohol, while substance-novice participants (n = 143) were primarily amyl nitrite users with a small proportion who reported using chemsex-related drugs. Chemsex participants (n = 23) comprised individuals who had mostly used such drugs. Those in the chemsex group were more likely to report recent unprotected anal sex with casual partners (aPR = 3.28, 95%CI [1.85, 5.79]), depression severity (aß = 3.69, 95%CI [0.87, 6.51]) and a history of suicide ideation (aPR = 1.64, 95%CI [1.33, 2.03]). CONCLUSIONS: Findings of this study highlight how the use of varying substances in sexualized contexts may be classified and characterized by different sexual and mental health outcomes. Health promotion efforts should be differentiated accordingly to address the risks associated with sexualized substance use among YMSM.


Assuntos
Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Estudos Transversais , Homossexualidade Masculina , Humanos , Análise de Classes Latentes , Masculino , Avaliação de Resultados em Cuidados de Saúde , Assunção de Riscos , Comportamento Sexual , Singapura/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
6.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 29-36, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201546

RESUMO

Drugs are sold on both dark web services and on social media, but research investigating these drug purchases online is still emerging. The aim of this study is to analyze risk factors associated with buying drugs online. Utilizing theories of criminology and addiction research, it was hypothesized that social bonds, low levels of self-control, and poor mental health are associated with buying drugs online. Additionally, it was predicted that purchases of drugs online would mediate the relationship between low self-control and regular drug use. Participants of this nationwide study were 15 to 25 years old living in the United States (N = 1,212) and Spain (N = 1,212). Measures of impulsivity, a sense of mastery, social belonging, psychological distress, excessive behaviors (drinking, gambling and internet use) were utilized to predict purchasing drugs online. Two percent of the U.S. and Spanish respondents reported buying drugs online with 77% of them utilizing social media services to buy drugs. Results from multinomial logistic regression, penalized maximum-likelihood logistic regression, and binary mediation regression models indicated that buying drugs online was associated with lower self-control, higher psychological distress, and excessive gambling behavior and excessive Internet use. Having online friends was not a risk factor, but having strong social bonds with offline friends served as a protective factor. Additionally, buying drugs online mediated the relationship between low self-control and regular use of drugs. Results indicate that more focus should be placed on mainstream social media services as sources of drug acquisition as online drug buyers have multiple self-control and mental health problems


Las drogas se venden en páginas web oscuras y en las redes sociales, aunque la investigación de estas adquisiciones online está aún en sus comienzos. Este estudio tiene como objetivo examinar los factores de riesgo vinculados a la compra de drogas online. De acuerdo con las teorías de la criminología y la investigación sobre adicciones, se planteó la hipótesis de que los vínculos sociales, el bajo nivel de autocontrol y los problemas de salud mental están relacionados con la compra online de drogas. Además, se postuló que la adquisición online de drogas estaría mediada por la relación entre el bajo autocontrol y el consumo frecuente de drogas. Participaron en el estudio un total de 2,424 jóvenes residentes en Estados Unidos (N = 1,212) y en España (N = 1,212), que fueron evaluados en impulsividad, sensación de dominio, pertenencia social, malestar psicológico, comportamientos abusivos (bebida, juego y utilización de internet) , con el objetivo de predecir la compra online de drogas. El 2% de los participantes de EE UU y España dijeron que compraban drogas online, de los cuales el 77% utilizaba servicios de redes sociales para tal fin. Los resultados de una regresión logística multinomial, regresión logística de máxima verosimilitud penalizada y modelos de regresión de mediación binaria mostraron que la adquisición online de drogas se relaciona con un menor autocontrol y un mayor malestar emocional y abuso del juego, y del uso de internet. El hecho de tener amigos por internet no constituía un factor de riesgo y tener vínculos sociales estrechos con amigos fuera de internet constituía un factor protector. A su vez, la compra online de drogas es un factor que media la relación entre bajo autocontrol y uso habitual de drogas. Los resultados sugieren que debería prestarse mayor atención a las redes sociales como medio habitual de adquisición de drogas, dado que los compradores online de drogas tienen múltiples problemas de salud mental y autocontrol


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Tráfico de Drogas/tendências , Comércio Eletrônico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Rede Social , Estados Unidos/epidemiologia , Espanha/epidemiologia , Controle de Medicamentos e Entorpecentes/tendências
8.
Cogn Behav Ther ; 50(3): 179-184, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34018469

RESUMO

The novel 2019 SARS-2-CoV causing COVID-19 has had a devastating impact on the entire world. COVID-19 is a broad-based stressor, and research to date has documented increases in mental health problems, including anxiety, depression, and substance use, since the onset of COVID-19. By taking a transdiagnostic approach, scholars can help elucidate mechanisms and vulnerability as well as resiliency related to behavioral health problems in the context of COVID-19. The aim of the current special issue of Cognitive Behaviour Therapy was to showcase ongoing research focused on transdiagnostic factors in the context of COVID-19. The purpose of this issue is to highlight the significance of this work in the pandemic for research and practice; illustrate some of the many domains currently being explored via innovative approaches; and explicate fruitful areas for programmatic study. We hope that readers will recognize the important role of transdiagnostic models and their potential to offset the mental, addictive, and physical health disease burden of COVID-19.


Assuntos
Transtornos de Ansiedade/diagnóstico , Ansiedade/diagnóstico , Comportamento Aditivo/diagnóstico , COVID-19/psicologia , Depressão/diagnóstico , Transtorno Depressivo/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Comportamento Aditivo/psicologia , Depressão/psicologia , Transtorno Depressivo/psicologia , Humanos , Pandemias , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/psicologia
9.
Exp Clin Psychopharmacol ; 29(2): 210-215, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34043402

RESUMO

Given high relapse rates and the prevalence of overdose deaths, novel treatments for substance use disorder (SUD) are desperately needed for those who are treatment refractory. The objective of this study was to evaluate the safety of deep brain stimulation (DBS) for SUD and the effects of DBS on substance use, substance craving, emotional symptoms, and frontal/executive functions. DBS electrodes were implanted bilaterally within the Nucleus Accumbens/Ventral anterior internal capsule (NAc/VC) of a man in his early 30s with >10-year history of severe treatment refractory opioid and benzodiazepine use disorders. DBS of the NAc/VC was found to be safe with no serious adverse events noted and the participant remained abstinent and engaged in comprehensive treatment at the 12-week endpoint (and 12-month extended follow-up). Using a 0-100 visual analog scale, substance cravings decreased post-DBS implantation; most substantially in benzodiazepine craving following the final DBS titration (1.0 ± 2.2) compared to baseline (53.4 ± 29.5; p < .001). A trend toward improvement in frontal/executive function was observed on the balloon analog risk task performance following the final titration (217.7 ± 76.2) compared to baseline (131.3 ± 28.1, p = .066). FDG PET demonstrated an increase in glucose metabolism in the dorsolateral prefrontal and medial premotor cortices at the 12-week endpoint compared to post-surgery/pre-DBS titration. Heart Rate Variability (HRV) improved following the final titration (rMSSD = 56.0 ± 11.7) compared to baseline (19.2 ± 8.2; p < .001). In a participant with severe, treatment refractory opioid and benzodiazepine use disorder, DBS of the NAc/VC was safe, reduced substance use and craving, and improved frontal and executive functions. Confirmation of these findings with future studies is needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Benzodiazepinas , Estimulação Encefálica Profunda , Núcleo Accumbens , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Analgésicos Opioides/efeitos adversos , Benzodiazepinas/efeitos adversos , Humanos , Cápsula Interna , Masculino , Projetos Piloto
10.
Psychol Addict Behav ; 35(4): 391-401, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34014686

RESUMO

OBJECTIVE: Guided by accounts of adjustment in daily life as a key indicator of health, the current study examined prospective changes in young adults' emotions and substance behaviors assessed during a normative baseline period and during the acute COVID-19 disruption period in late March/early April 2020. The COVID-19 assessment also collected psychosocial risk factors expected to moderate changes in adjustment across time. METHOD: Participants included 295 young adults (70.8% female; ages 18-21 at baseline), drawn from an ongoing study of daily behaviors and health in college life that oversampled for recent substance behaviors, who completed both the baseline and COVID-19 assessments. Hypotheses were tested using analyses of repeated-measures data that included covariates of length of time between assessments and sampling group status. RESULTS: Direct tests in support of hypotheses indicated an increase in negative affect (d = .67, p < .001), and greater alcohol use (d = .75, p < .001) and marijuana use (d = .58, p < .001), in daily life across time. Levels of positive affect (d = .08, p > .05), nicotine use (d = .01, p > .05), and prescription drug misuse (d = .003, p > .05) did not reliably change in tests of direct models. Moderation tests indicated several risk factors for experiencing steeper increases in negative affect, and increased likelihood of marijuana and nicotine use, in daily life across time. CONCLUSIONS: Findings offer implications for future research and clinical efforts to improve young adult adjustment in response to the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Afeto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , COVID-19 , Uso da Maconha/epidemiologia , Uso da Maconha/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Nicotina , Uso Indevido de Medicamentos sob Prescrição/psicologia , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologia , Fumar/psicologia , Universidades , Adulto Jovem
11.
J Psychiatr Res ; 139: 47-53, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34029833

RESUMO

BACKGROUND: Individuals with Substance Use Disorders (SUD), are vulnerable to the psychological consequences of the COVID-19 pandemic. This is the first study to assess risk factors of adverse mental health outcomes during lockdown in a SUD population. METHODS: This was a cross-sectional study, conducted through an online survey that was completed by 303 individuals with SUD, attended in the Addiction Unit of University of Barcelona Clínic Hospital. Sociodemographic and clinical data were collected and descriptive analyses were carried out. Depending on whether individuals reported a worsening or no change/improvement in anxiety and depression symptoms during lockdown, the sample was divided in two groups. A logistic regression was then carried out to identify risk factors associated with adverse mental health outcomes. RESULTS: Overall, frequency of use for the majority of individuals with SUD remained stable during lockdown in comparison to the pre-lockdown era, although a reduction was found in frequency of tobacco, alcohol, cannabis and cocaine use in a small fraction of individuals with SUD. Symptoms of clinical anxiety were found in 58.7% of the sample while 48.2% of participants scored above the clinical threshold for depression. In addition, 50.3% of the sample reported a deterioration in depression and anxiety symptoms during lockdown that was associated with the following risk factors: previous trauma-exposure, female gender, distress and isolation, income reduction and alcohol use. CONCLUSION: A high percentage of patients with SUD experienced adverse mental health outcomes during lockdown that were associated with several risk factors, which should be taken into account in policy making and prevention strategies, as well as in clinical practice, in order to provide personalized care to SUD patients during the time of the pandemic.


Assuntos
COVID-19 , Transtornos Relacionados ao Uso de Substâncias , Ansiedade/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Fatores de Risco , SARS-CoV-2 , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
12.
MEDICC Rev ; 23(2): 55, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33974609

RESUMO

Cuba implemented policies mandating social distancing on March 11, 2020, which were still in place at the time of this study. During such periods of isolation, people with psychoactive substance-related disorders and other addictions may be tempted to reduce tension, stress, uncertainty and possible distress by increasing the use of substances or practices they have abused. This can mean relapses and setbacks for patients undergoing treatment. A multidisciplinary team of health professionals specializing in addiction at the Center for Academic Development in Drug Addiction, in Havana, Cuba, cares for people with these disorders and followed their evolution during the initial period of COVID-19 social isolation. With the aim of characterizing strategies employed by patients undergoing treatment for substance abuse and addictions, we conducted a qualitative study from April 2020 through May 2020, using a convenience sample of 37 patients (all students) who had been progressing towards recovery from addictive behaviors when face-to-face encounters were suspended due to COVID-19 restrictions. Contact was maintained through information and communication technologies. The research used telepsychology and focused on understanding patient life experiences. Patients were interviewed using a semi-structured survey, which was then transcribed and coded thematically using a grounded-theory approach. We found that patients' ability to cope successfully with challenges presented by COVID-19 were influenced by: 1) the individual's own methods for maintaining self-control (commitment to studies, projects, and work with therapists) that aided them in their goals concerning abstinence; 2) difficulties faced in addressing specific events and situations (doubts, uncertainties, disagreements, isolation and time use); 3) perpetuation and revivification of myths related to substances and addictive activities (exacerbation of supposed benefits of tobacco, alcohol, marijuana, overuse of social networks); and 4) tendencies toward irrationality and lack of emotional control (fear, sadness, anger, constant worry and self-imposed demands). Our findings suggest that despite the potential negative psychological impact of preventive social isolation during the COVID-19 pandemic, individual coping mechanisms developed by these patients, aiming at improved self-control, allowed most to avoid setbacks that could have affected their recovery. Nevertheless, patients faced challenges to their recovery that were compounded by difficulties in specific situations, myths related to substances and addictive activities, and tendencies toward irrationality or lack of emotional control.


Assuntos
Adaptação Psicológica , Comportamento Aditivo/psicologia , COVID-19/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/reabilitação , COVID-19/epidemiologia , Cuba/epidemiologia , Feminino , Teoria Fundamentada , Humanos , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/reabilitação
13.
BMC Public Health ; 21(1): 971, 2021 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022843

RESUMO

BACKGROUND: Gay, bisexual and queer (GBQ) men are frequently subjected to minority stressors that have negative impacts on their health. Milestones that include the acceptance and disclosure of sexual identity amongst GBQ men are hence key instruments in understanding the prevalence of internalised homophobia and predicting health outcomes. As such, this work takes a novel approach to deduce the correlates of delayed acceptance of sexual orientation in young GBQ men as a measure of internalised homophobia through retrospective self-reporting and age-based analysis. METHODS: Participants were recruited as part of a cohort study exploring the syndemic risks associated with HIV acquisition among young GBQ men in Singapore. We examined their levels of internalised, perceived, experienced homophobia, as well as their health behaviours and suicidal tendencies. Two separate variables were also self-reported by the participants - the age of questioning of sexual orientation and the age of acceptance of sexual orientation. We subsequently recoded a new variable, delayed acceptance of sexual orientation, by taking the difference between these two variables, regressing it as an independent and dependent variable to deduce its psychosocial correlates, as well as its association with other measured instruments of health. RESULTS: As a dependent variable, delayed acceptance of sexual orientation is positively associated with an increase of age and internalised homophobia, while being negatively associated with reporting as being gay, compared to being bisexual or queer. As an independent variable, delayed acceptance of sexual orientation was associated with a delayed age of coming out to siblings and parents, suicide ideation, historical use of substances including smoking tobacco cigarettes and consuming marijuana, as well as reporting higher levels of experienced, internalised and perceived homophobia. CONCLUSION: Greater levels of early intervention and efforts are required to reduce the heightened experience of minority stress resulting from communal and institutional hostilities. Areas of improvement may include community-based counselling and psychological support for GBQ men, while not forsaking greater education of the social and healthcare sectors. Most importantly, disrupting the stigma narrative of a GBQ 'lifestyle' is paramount in establishing an accepting social environment that reduces the health disparity faced by GBQ men.


Assuntos
Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Bissexualidade , Estudos de Coortes , Feminino , Pisos e Cobertura de Pisos , Homofobia , Homossexualidade Masculina , Humanos , Masculino , Estudos Retrospectivos , Comportamento Sexual , Singapura/epidemiologia , Ideação Suicida
14.
BMC Public Health ; 21(1): 980, 2021 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034690

RESUMO

BACKGROUND: Substance use is a risk factor for intimate partner abuse (IPA) perpetration. Delivering perpetrator interventions concurrently with substance use treatment shows promise. METHODS: The feasibility of conducting an efficacy and cost-effectiveness trial of the ADVANCE 16-week intervention to reduce IPA by men in substance use treatment was explored. A multicentre, parallel group individually randomised controlled feasibility trial and formative evaluation was conducted. Over three temporal cycles, 104 men who had perpetrated IPA towards a female (ex) partner in the past year were randomly allocated to receive the ADVANCE intervention + substance use treatment as usual (TAU) (n = 54) or TAU only (n = 50) and assessed 16-weeks post-randomisation. Participants' (ex) partners were offered support and 27 provided outcome data. Thirty-one staff and 12 men who attended the intervention participated in focus groups or interviews that were analysed using the framework approach. Pre-specified criteria assessed the feasibility of progression to a definitive trial: 1) ≥ 60% of eligible male participants recruited; 2) intervention acceptable to staff and male participants; 3) ≥ 70% of participants followed-up and 4) levels of substance use and 5) IPA perpetrated by men in the intervention arm did not increase from average baseline level at 16-weeks post-randomisation. RESULTS: 70.7% (104/147) of eligible men were recruited. The formative evaluation confirmed the intervention's acceptability. Therapeutic alliance and session satisfaction were rated highly. The overall median rate of intervention session attendance (of 14 compulsory sessions) was 28.6% (range 14.3-64.3% by the third cycle). 49.0% (51/104) of men and 63.0% (17/27) of their (ex) partners were followed-up 16-weeks post-randomisation. This increased to 100% of men and women by cycle three. At follow-up, neither substance use nor IPA perpetration had worsened for men in the intervention arm. CONCLUSIONS: It was feasible to deliver the ADVANCE intervention in substance use treatment services, although it proved difficult to collect data from female (ex)partners. While some progression criteria were met, others were not, although improvements were demonstrated by the third cycle. Lessons learned will be implemented into the study design for a definitive trial of the ADVANCE intervention. TRIAL REGISTRATION: ISRCTN79435190 prospectively registered 22nd May 2018.


Assuntos
Violência por Parceiro Íntimo , Transtornos Relacionados ao Uso de Substâncias , Análise Custo-Benefício , Estudos de Viabilidade , Feminino , Humanos , Violência por Parceiro Íntimo/prevenção & controle , Masculino , Transtornos Relacionados ao Uso de Substâncias/terapia
15.
BMC Public Health ; 21(1): 997, 2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-34044802

RESUMO

BACKGROUND: From a secondary prevention perspective, it is useful to know who is at greatest risk of progressing from substance initiation to riskier patterns of future use. Therefore, the aim of this study was to determine relationships between age at first use of alcohol, tobacco and cannabis and patterns of cannabis use, frequency of use and whether age of substance use onset is related to having a cannabis use disorder (CUD). METHODS: We analysed data from Ireland's 2010/11 and 2014/15 National Drug Prevalence Surveys, which recruited 5134 and 7005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported lifetime cannabis use. Multinomial, linear and binary logistic regression analyses were used to determine relationships between age of substance use onset and patterns of cannabis use, frequency of use and having a CUD. RESULTS: When compared to former users, the odds of being a current cannabis user were found to be reduced by 11% (OR = 0.89; 95% CI: 0.83, 0.95) and 4% (OR = 0.96; 95% CI: 0.92, 1.00) for each year of delayed alcohol and cannabis use onset, respectively. Among current users, significant inverse linear relationships were noted, with increasing age of first use of tobacco (ß = - 0.547; P < .001) and cannabis (ß = - 0.634; P < .001) being associated with a decreased frequency of cannabis use within the last 30 days. The odds of having a CUD were found to be reduced by 14% (OR = 0.86; 95% CI: 0.78, 0.94) and 11% (OR = 0.89; 95% CI: 0.82, 0.98) for each year of delayed tobacco and cannabis use onset respectively in analyses which examined survey participants aged 15-34 years. CONCLUSIONS: Among people who report past cannabis use, it is those with a more precocious pattern of early use of substances, including alcohol, and especially tobacco and cannabis, who are more likely to report ongoing, heavy and problematic cannabis use. Secondary prevention initiatives should prioritise people with a pattern of very early onset substance use.


Assuntos
Cannabis , Abuso de Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estudos Longitudinais , Abuso de Maconha/epidemiologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
16.
BMC Psychiatry ; 21(1): 242, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33962614

RESUMO

BACKGROUND: Substance use disorders are reliably associated with high impulsivity and sensation seeking. Importantly, both precede problematic substance use, implicating them as risk factors. Individuals with substance use disorders show variable degrees of substance use (combined quantity and frequency) and substance-related problems and differ in both aspects from healthy controls. Dimensional research has indicated differential associations of impulsivity-related traits as well as sensation seeking with the degree of substance use and substance-related problems. The current study aimed to clarify whether impulsivity-related traits and sensation seeking predict substance-related problems above and beyond the degree of substance use and are thus specifically linked to problems, the dimension that characterizes substance use disorders. METHOD: We assessed impulsivity-related traits and sensation seeking using self-report, as well as delay discounting, a behavioral indicator of impulsivity, in a sample of 258 substance-using adults. RESULTS: Sensation seeking and impulsivity-related traits significantly predicted the degree of substance use, with sensation seeking explaining the largest portion of variance. In contrast, self-reported impulsivity, in particular when experiencing negative emotions (urgency), but not sensation seeking or delay discounting, predicted substance-related problems when controlling for the degree of substance use. CONCLUSIONS: This suggests that urgency, but not sensation seeking, may be specifically linked to substance-related problems and thus especially relevant for substance use disorders. Taken together, this study underlines the necessity to assess and control for the degree of substance use in risk factor research concerning substance-related problems. Thus, it may inform future research improving targeted prevention and therapy.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , Comportamento Impulsivo , Fatores de Risco , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
17.
BMC Psychiatry ; 21(1): 244, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33975577

RESUMO

BACKGROUND: Smoking is still prevalent among people with substance use disorders. The objective of this study was to investigate the prevalence of smoking among patients in treatment for substance use disorders and to analyze the effect of smoking both at baseline and follow-up on drop-out, mental health and quality of life. METHODS: One hundred and twenty-eight inpatients (26% female), mainly with alcohol use disorder, staying at three different rehabilitation clinics in Eastern Norway, were interviewed at admission, and at 6 weeks and 6 months follow-up. The interview contained mental health-related problems, trauma, questions on alcohol and other substances and quality of life. Non-parametric tests were used to test group differences and unadjusted and adjusted linear regression to test the associations between smoking and the main outcome variables, while logistic regression was used to test the association between smoking and drop-out. RESULTS: At admission, 75% were daily smokers. Compared to non-smokers at baseline, the smokers had higher drop-out rates (37% vs. 13%), more mental distress, and lower quality of life from baseline up to 6 months follow-up. Those quitting smoking while admitted improved in mental distress and quality of life at the same rate as non-smokers. Alcohol-related factors did not differ between smokers and non-smokers. CONCLUSIONS: Smoking was associated with mental distress, quality of life and treatment drop-out among patients in primary alcohol use disorder treatment. The results indicate that smoking cessation should be recommended as an integral part of alcohol use treatment both before and during inpatient treatment to reduce drop-out.


Assuntos
Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Feminino , Humanos , Pacientes Internados , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Noruega/epidemiologia , Prevalência , Qualidade de Vida , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
18.
Health Promot Pract ; 22(1_suppl): 44S-52S, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33942641

RESUMO

In October 2017, the U.S. Department of Health & Human Services declared the opioid crisis a national public health emergency and prioritized identifying effective, evidence-based strategies for pain management and the prevention and treatment of substance use disorder (SUD). Increasingly, the arts have become more widely established and accepted as health-promoting practices in the United States and around the world. As the U.S. health care system moves toward greater integration of physical and behavioral health, arts-based interventions should be considered among potential complementary approaches for managing pain and preventing and treating SUD. We conducted an integrative literature review to summarize and synthesize the evidence on the role of the arts in the management of pain and in the prevention and treatment of SUD, including opioid use disorder. The available evidence suggests that music interventions may reduce participants' pain, reduce the amount of pain medication they take, improve their SUD treatment readiness and motivation, and reduce craving. Few studies examined art forms other than music, limiting the ability to draw conclusions for those art forms. Given the critical need to identify effective strategies for managing pain and preventing and treating SUD, future research on arts-based interventions should examine maintenance of pain management and SUD treatment benefits over time and outcomes related to SUD prevention.


Assuntos
Transtornos Relacionados ao Uso de Opioides , Transtornos Relacionados ao Uso de Substâncias , Humanos , Epidemia de Opioides , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Dor , Saúde Pública , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Estados Unidos
20.
Tidsskr Nor Laegeforen ; 141(7)2021 05 04.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-33950661

RESUMO

BACKGROUND: Poisonings by substances of abuse are potentially dangerous and indicate risky substance use behaviour. To be prepared to handle patients with poisonings by substances of abuse, we need updated knowledge about the kinds of substances we can be expected to encounter. Most substance use-related poisonings in Oslo are treated at the OAEOC, and we describe the poisonings observed there in the period 2014-2018. MATERIAL AND METHOD: We included all patients treated for poisoning by substances of abuse at the OAEOC in the years 2014-18, with the exception of lone ethanol poisonings. For 2018, these were also included. The patients were identified retrospectively by a review of the patient registration lists in the clinic's electronic records system. The diagnosis of the substances involved was based on the clinical assessment made by the doctor responsible for treatment. RESULTS: In the period 2014-18, altogether 8 116 cases of poisoning by a substance of abuse were treated at OAEOC, lone ethanol poisonings not included. The most frequently occurring intoxicants were heroin (3 237 cases), benzodiazepines (2 196), amphetamine/methamphetamine (1 827), cannabis (1 081), gamma-hydroxybutyrate (GHB) (904), cocaine (569) and unspecified opioids (546). There was an increasing trend in number of cases per year for central stimulants, cannabis and GHB, and a decreasing one for benzodiazepines. The number of heroin poisonings fell until 2017, but rose again in 2018. In 2018 there were 4 021 poisonings by substances of abuse, of which 2 022 were lone ethanol poisonings. INTERPRETATION: The number of poisonings increased for most substances in 2014-18, but fell for heroin and benzodiazepines.


Assuntos
Envenenamento , Transtornos Relacionados ao Uso de Substâncias , Acidentes , Instituições de Assistência Ambulatorial , Serviço Hospitalar de Emergência , Humanos , Envenenamento/epidemiologia , Envenenamento/etiologia , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
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