Days of heroin use predict poor self-reported health in hospitalized heroin users

Association between psychological and self-assessed health status and smartphone overuse among Korean college students

BACKGROUND

Several studies suggest that subjective health status is closely related to various behavioral addictions, but there are few studies on smartphone overuse.

AIM

This study investigated the associations between psychological and subjective health conditions and smartphone overuse in Korean college students.

METHOD

A total of 608 college students participated in this study. We investigated the perceived psychological factors, such as stress, depression symptoms and suicidal ideation. Overall health status was evaluated with self-assessed items, including usual health condition and EuroQol-visual analog scales (EQ-VAS) score. Smartphone overuse was evaluated as the Korean Smartphone Addiction Proneness Scale.

RESULTS

Students with psychotic anxiety (i.e. stress, depression and suicidal ideation) showed significant associations with smartphone overuse, indicating an approximately twofold increased risk compared to those without psychological anxiety (all p < 0.05). Students who reported feeling that their usual health is not good were more likely to overuse smartphones than those who are in good health (OR = 1.98; 95% CI = 1.22-3.21). The EQ-VAS score, which indicates current self-assessed health status, also showed a similar result with general health status (OR = 2.14; 95% CI = 1.14-4.02).

CONCLUSION

Negative conditions in self-perceived emotional or overall health condition are associated with the increased likelihood of smartphone overuse in Korean college students.

Perceived need for depression treatment among persons entering inpatient opioid detoxification

BACKGROUND AND OBJECTIVES

Depression is common among persons with opioid use disorder. We examined the perceived need for depression treatment (PNDT) among opioid-dependent patients and the relationship of PNDT to depression screening result.

METHODS

Between May and December 2015, we surveyed consecutive persons (n = 440) seeking inpatient opioid detoxification. We used the Patient Health Questionnaire-2 (PHQ-2) to screen for depression. To assess perceived need for depression services, participants were asked, "Do you believe you should be treated for depression?" Response options were recorded into four categories: "Not Depressed (ND)," "Perceive Need for Depression Treatment (PNDT)," "Depressed/Don't Want Treatment," and "Currently Treated."

RESULTS

Participants' mean age was 32.3 (±8.7) years; 70.7% were male. Nearly two out of three persons screened positive for depression yet only 8.2% were being treated for depression prior to admission. Screening positive for depression was associated with a 2.95 (95%CI 1.82-4.81, p < .005) fold increase in the expected odds of PNDT. But nearly half of those depressed (48%) did not perceive the need for treatment. Approximately 40% of the participants (n = 177) perceived that they were not depressed; of these persons, 52% screened positive for depression.

DISCUSSION AND CONCLUSIONS

Detoxification program staff should screen patients for depression, and if a clinical diagnosis is confirmed, discuss treatment options, exploring the level of interest in mental health treatment for depression.

SCIENTIFIC SIGNIFICANCE

Screening for and addressing depression, including patients' interest in treatment, should be central to post-detoxification aftercare planning. (Am J Addict 2017;26:395-399).

The spectrum of unhealthy drug use and quality of care for hypertension and diabetes: a longitudinal cohort study

OBJECTIVES

Although it is well known that addiction is associated with adverse medical consequences, the effects of the spectrum of unhealthy drug use (illicit drug or prescription misuse) on chronic conditions such as hypertension and diabetes are understudied. This study evaluated the associations between measures of drug use (ie, frequency, severity and type) and standard quality metrics for inadequate blood pressure (BP) and blood glucose (BG) control.

DESIGN

Longitudinal cohort study.

PARTICIPANTS

Adult primary care patients with unhealthy drug use and hypertension or diabetes.

SETTING

Urban hospital-based primary care practice.

MEASUREMENTS

Outcomes were (1) inadequate BP (systolic BP ≥ 140 or diastolic BP ≥ 90) and (2) inadequate BG (glycated haemoglobin ≥ 8%) control (Healthcare Effectiveness Data and Information Set criteria). Drug use was characterised by a primary independent variable, drug use frequency, and two secondary variables, severity of use and drug type. We fit separate regression models for each drug use measure and outcome.

RESULTS

Overall, 40% (65/164) of the sample with hypertension had inadequate BP control and 44% (24/54) of those with diabetes had inadequate BG control. More frequent drug use was not significantly associated with inadequate BP control (adjusted OR (AOR) 0.67; 95% CI 0.31 to 1.46, highest vs lowest tertile; AOR 0.72; 95% CI 0.36 to 1.41, middle vs lowest tertile) or BG control (AOR 0.27; 95% CI 0.07 to 1.10, highest vs lowest tertile; AOR 1.01; 95% CI 0.38 to 2.69, middle vs lowest tertile). Drug use severity was also not associated with BP or BG control. Cocaine use was associated with inadequate BG control compared to marijuana use (AOR 8.82; 95% CI1.86 to 41.90).

CONCLUSIONS

Among primary care patients with recent drug use and hypertension or diabetes, drug type was significantly associated with inadequate BG, but not BP control. Frequency and severity of use were not significant predictors of either outcome.

Health, perceived quality of life and health services use among homeless illicit drug users

INTRODUCTION

Drug misuse has been identified as a significant problem in homeless populations. This study examines aspects of physical and mental health, perceived quality of life and health service use among homeless illicit drug users and compares these to non-drug users.

METHODS

Participants were recruited through health clinics across Dublin. A questionnaire assessed participants' drug use, health and well-being, health behaviours and use of health services. Descriptive statistics are presented for the entire cohort and drug users separately. Logistic regression analysis was used to examine the relationship between drug use and (i) multimorbidity, (ii) anxiety and/or depression, (iii) perceived quality of life and (iv) use of health services.

RESULTS

Of 105 participants recruited, 35 (33%) were current drug users. Current and previous drug users were significantly more likely to have multimorbidity than those who had never taken drugs (OR 4.86, 95% CI 1.00-23.66). There was no significant difference between drug users and non-drug users in the prevalence of anxiety and/or depression. Drug users were five times more likely than non-drug users to have a low perceived quality of life (OR 5.2, 95% CI 1.7-16.0). Health service utilization was high, although some services were used less by drug users (e.g., dentist and psychiatric outpatient services) while others were used more often (e.g., phoneline services and day care centres).

CONCLUSION

This study highlights the high levels of drug use in this population and the negative impact of drug use on health and perceived quality of life of a homeless population in Dublin.