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Jiang H, Zhang X, Zhang C, Lu R, Zhou C, Ouyang L, Xing H, Vermund SH, Shao Y, Ruan Y, Wu G, Qian HZ. Trends of HIV, hepatitis C virus and syphilis seroprevalence among injection and non-injection drug users in southwestern China, 2010-2017. AIDS Care 2024; 36:612-617. [PMID: 33345591 PMCID: PMC10767711 DOI: 10.1080/09540121.2020.1856320] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 11/17/2020] [Indexed: 01/26/2023]
Abstract
Background: The primary risk of HIV transmission in China has shifted from injecting drug use (IDU) to sexual contact since 2006. We evaluated the prevalence trends of HIV, hepatitis C virus (HCV), syphilis, and sexual and drug use behaviors among drug users. Methods: People who use drugs participated in any of four rounds of cross-sectional surveys during 2010-2017 in Chongqing. Participants were tested for HIV, HCV, and syphilis. Questionnaire interviewing was conducted to collect behavioral information. Chi-square and trend tests were employed to assess the changes in diseases and behaviors over time. Results: A total of 8,171 people who inject drugs (PWID) and 5,495 non-injection drug users (NIDU) were included in the analyses. HIV prevalence among PWID in four rounds of the survey in 2010-11, 2012-13, 2014-15, and 2016-17 was 11.5%, 9.7%, 6.5%, and 6.9%, and among NIDU, 2.4%, 1.4%, 2.1% and 2.6%, respectively. HCV prevalence among PWID was 83.5%, 85.2%, 67.1% and 79.7% (P < 0.001), and among NIDU, 22.2%, 10.8%, 13.4% and 14.8%, (P < 0.001). Conclusions: The declining HIV and HCV prevalence among PWID is coincident with declining risky drug use behaviors. Tailored disease prevention and interventions targeting PWID and NIDU are needed.
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Affiliation(s)
- Hehong Jiang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Xiangjun Zhang
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA
| | - Chen Zhang
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - Rongrong Lu
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Chao Zhou
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Lin Ouyang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Hui Xing
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, People’s Republic of China
| | - Sten H. Vermund
- School of Public Health, Yale University, New Haven, CT, USA
| | - Yiming Shao
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, People’s Republic of China
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, People’s Republic of China
| | - Guohui Wu
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Han-Zhu Qian
- School of Public Health, Yale University, New Haven, CT, USA
- Xiangya Nursing School, Central South University, Changsha, People’s Republic of China
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Yan P, Ma H, Tian W, Liu J, Yan X, Ma L, Wei S, Zhu J, Zhu Y, Lai J. Methadone maintenance treatment is more effective than compulsory detoxification in addressing gut microbiota dysbiosis caused by heroin abuse. Front Microbiol 2023; 14:1283276. [PMID: 37954240 PMCID: PMC10635210 DOI: 10.3389/fmicb.2023.1283276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Heroin use disorder (HUD) is commonly accompanied by gut dysbiosis, but the roles of gut microbiota in HUD treatment, such as compulsory detoxification and methadone maintenance treatment (MMT), remain poorly understood. Methods In this study, we performed 16 s rDNA and whole metagenome sequencing to analyze the gut microbial profiles of HUD patients undergoing heroin addiction, heroin withdrawal (compulsory detoxification), and MMT. Results Our findings revealed that, compared to healthy controls, microbial diversity was significantly decreased in HUD patients who were in a state of heroin addiction and withdrawal, but not in those receiving MMT. We observed significant alterations in 10 bacterial phyla and 20 bacterial families in HUD patients, while MMT partially restored these changes. Whole metagenome sequencing indicated gut microbiota functions were significantly disrupted in HUD patients experiencing heroin addiction and withdrawal, but MMT was found to almost reverse these dysfunctions. In addition, we identified 24 featured bacteria at the genus level that could be used to effectively distinguish between healthy individuals and those with heroin addiction, heroin withdrawal, or receiving MMT. Furthermore, we found the relative abundance of Actinomyces, Turicibacter and Weissella were positively associated with the Hamilton Depression Scale score in different states of HUD patients. Discussion This study provides evidence from the gut microbiota perspective that MMT is a more effective approach than compulsory detoxification for HUD treatment.
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Affiliation(s)
- Peng Yan
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Haotian Ma
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Wenrong Tian
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Jincen Liu
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Xinyue Yan
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Lei Ma
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Shuguang Wei
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Jie Zhu
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Yongsheng Zhu
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
| | - Jianghua Lai
- NHC Key Laboratory of Forensic Science, College of Forensic Science, Xi’an Jiaotong University, Xi’an, China
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, China
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Zhang J, Lu Y, Jia M, Bai Y, Sun L, Dong Z, Tian W, Yin F, Wei S, Wang Y. Kappa opioid receptor in nucleus accumbens regulates depressive-like behaviors following prolonged morphine withdrawal in mice. iScience 2023; 26:107536. [PMID: 37636073 PMCID: PMC10448166 DOI: 10.1016/j.isci.2023.107536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/12/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Prolonged withdrawal from opioids leads to negative emotions. Kappa opioid receptor (KOR) plays an important role in opioid addiction and affective disorders. However, the underlying mechanism of KOR in withdrawal-related depression is still lacking. We found that escitalopram treatment had a limited effect in improving depression symptoms in heroin-dependent patients. In mice, we demonstrated prolonged (4 weeks) but not acute (24 h) withdrawal from morphine induced depressive-like behaviors. The number of c-Fos positive cells and the expression of KOR in the nucleus accumbens (NAc), were significantly increased in the prolonged morphine withdrawal mice. Conditional KOR knockdown in NAc significantly improved depressive-like behaviors. Repeated but not acute treatment with the KOR antagonist norBNI improved depressive-like behaviors and reversed PSD95, synaptophysin, p-ERK, p-CREB, and BDNF in NAc. This study demonstrated the important role of striatal KOR in morphine withdrawal-related depressive-like behaviors and offered therapeutic potential for the treatment of withdrawal-related depression.
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Affiliation(s)
- Jinyu Zhang
- Department of Psychiatry and Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Ye Lu
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Min Jia
- Department of Psychiatry and Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Yuying Bai
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Lulu Sun
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Ziqing Dong
- Department of Psychiatry and Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
- Shaanxi Belt and Road Joint Laboratory of Precision Medicine in Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Wenrong Tian
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Fangyuan Yin
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Shuguang Wei
- College of Forensic Science, School of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Yunpeng Wang
- Department of Psychiatry and Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
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Luo T, Lin Z, Wu Z, Cen P, Nong A, Huang R, Che J, Liang F, Yang Y, Liu J, Huang L, Cai J, Ou Y, Ye L, Bao L, Liang B, Liang H. Trends and associated factors of HIV, HCV and syphilis infection among different drug users in the China-Vietnam border area: an 11-year cross-sectional study (2010-2020). BMC Infect Dis 2023; 23:575. [PMID: 37667212 PMCID: PMC10478360 DOI: 10.1186/s12879-023-08239-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/10/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Data on recent human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis prevalence among drug users in the Southwest China are sparse despite the high burden of drug use. This study aims at assessing the prevalence trends and related factors of HIV, HCV and syphilis infection among different drug users in the China-Vietnam border area. METHODS A continuous cross-sectional survey was conducted among drug users from 2010 to 2020 in the China-Vietnam border area. Chi-square trend tests were used to assess the trend of HIV, HCV and syphilis prevalence and the proportion for drug type used by drug users. Multivariate logistic regression was used to identify associated factors of HIV, HCV and syphilis infection in different drug users. RESULTS In this study, a total of 28,951 drug users were included, of which 27,893 (96.45%) male, 15,660 (54.09%) aged 13-34 years, 24,543 (84.77%) heroin-only users, 2062 (7.12%) synthetic drug-only (SD-only) users and 2346 (8.10%) poly-drug users. From 2010 to 2020, the proportion of heroin-only users decreased from 87.79% to 75.46%, whereas SD-only users and poly-drug users increased from 5.16% to 16.03%, and from 7.05% to 8.52%, respectively. The prevalence of HIV, HCV, and syphilis during the study period declined from 12.76%, 60.37% and 5.72% to 4.35%, 53.29% and 4.53%, respectively, among heroin-only users and declined from 18.30%, 66.67% and 15.69% to 6.95%, 27.81% and 5.35%, respectively, among poly-drug users; however, the prevalence of HIV and HCV among SD-only users increased from 0.89% and 8.93% to 2.84% and 18.75%, respectively. Having ever injected drugs and needle sharing were common associated factors for both HIV and HCV infection among poly-drug users and heroin-only users. Aged ≥ 35 years old was an associated factor for HIV, HCV and syphilis infection among the SD-only users. Female drug users were at high risk of contracting syphilis among three different drug users. CONCLUSIONS The prevalence of HIV, HCV and syphilis among heroin-only users and poly-drug users decreased during the study period. However, the prevalence of HIV and HCV among SD-only users increased. Comprehensive intervention strategies, particularly focusing on the SD-only users are needed in order to bring down the disease burden in this population in the China-Vietnam border areas.
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Affiliation(s)
- Tong Luo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bioresource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Zhaosen Lin
- Qinzhou Center for Disease Control and Prevention, Qinzhou, 535000, Guangxi, China
| | - Zhenxian Wu
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China
| | - Ping Cen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Aidan Nong
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China
| | - Rongye Huang
- Qinzhou Center for Disease Control and Prevention, Qinzhou, 535000, Guangxi, China
| | - Jianhua Che
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China
| | - Fengfeng Liang
- Qinzhou Center for Disease Control and Prevention, Qinzhou, 535000, Guangxi, China
| | - Yuan Yang
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bioresource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jie Liu
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bioresource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Li Huang
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China
| | - Jie Cai
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China
| | - Yanyun Ou
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bioresource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lijuan Bao
- Chongzuo Center for Disease Control and Prevention, Chongzuo, 532200, Guangxi, China.
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bioresource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Collaborative Innovation Centre of Regenerative Medicine and Medical Bioresource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Li DX, Zhou XY, Lin QQ, Wu Y, Hu C, Shen ZH, Wang YG. Increased EEG gamma power under exposure to drug-related cues: a translational index for cue-elicited craving in METH-dependent individuals. BMC Psychiatry 2023; 23:367. [PMID: 37231397 DOI: 10.1186/s12888-023-04892-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/20/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study explored the feasibility of using EEG gamma-band (30-49 Hz) power as an index of cue-elicited craving in METH-dependent individuals. METHODS Twenty-nine participants dependent on methamphetamine (METH) and 30 healthy participants were instructed to experience a METH-related virtual reality (VR) social environment. RESULTS Individuals with METH dependence showed significantly stronger self-reported craving and higher gamma power in a VR environment than healthy individuals. In the METH group, the VR environment elicited a significant increase in gamma power compared with the resting state. The METH group then received a VR counterconditioning procedure (VRCP), which was deemed useful in suppressing cue-induced reactivity. After VRCP, participants showed significantly lower self-reported craving scores and gamma power when exposed to drug-related cues than the first time. CONCLUSIONS These findings suggest that the EEG gamma-band power may be a marker of cue-induced reactivity in patients with METH dependence.
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Affiliation(s)
- Dong-Xu Li
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China
| | - Xiang-Yi Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China
| | - Qian-Qian Lin
- Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, 305 Tianmushan Road, Hangzhou, Zhejiang Province, China
| | - Yue Wu
- The Fifth Hospital of Ruian, Ruian, Zhejiang Province, China
| | - Cheng Hu
- Shiliping Compulsory Rehabilitation Center, Zhejiang, China
| | - Zhi-Hua Shen
- Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, 305 Tianmushan Road, Hangzhou, Zhejiang Province, China
| | - Yong-Guang Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, China.
- Affiliated Mental Health Center, Hangzhou Seventh People's Hospital, 305 Tianmushan Road, Hangzhou, Zhejiang Province, China.
- The Fifth Hospital of Ruian, Ruian, Zhejiang Province, China.
- Zhejiang Provincial Institute of Drug Abuse Research, Hangzhou, Zhejiang Province, China.
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Zhu Y, Yan P, Wang R, Lai J, Tang H, Xiao X, Yu R, Bao X, Zhu F, Wang K, Lu Y, Dang J, Zhu C, Zhang R, Dang W, Zhang B, Fu Q, Zhang Q, Kang C, Chen Y, Chen X, Liang Q, Wang K. Opioid-induced fragile-like regulatory T cells contribute to withdrawal. Cell 2023; 186:591-606.e23. [PMID: 36669483 DOI: 10.1016/j.cell.2022.12.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/04/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
Dysregulation of the immune system is a cardinal feature of opioid addiction. Here, we characterize the landscape of peripheral immune cells from patients with opioid use disorder and from healthy controls. Opioid-associated blood exhibited an abnormal distribution of immune cells characterized by a significant expansion of fragile-like regulatory T cells (Tregs), which was positively correlated with the withdrawal score. Analogously, opioid-treated mice also showed enhanced Treg-derived interferon-γ (IFN-γ) expression. IFN-γ signaling reshaped synaptic morphology in nucleus accumbens (NAc) neurons, modulating subsequent withdrawal symptoms. We demonstrate that opioids increase the expression of neuron-derived C-C motif chemokine ligand 2 (Ccl2) and disrupted blood-brain barrier (BBB) integrity through the downregulation of astrocyte-derived fatty-acid-binding protein 7 (Fabp7), which both triggered peripheral Treg infiltration into NAc. Our study demonstrates that opioids drive the expansion of fragile-like Tregs and favor peripheral Treg diapedesis across the BBB, which leads to IFN-γ-mediated synaptic instability and subsequent withdrawal symptoms.
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Affiliation(s)
- Yongsheng Zhu
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, Shaanxi 710115, China
| | - Peng Yan
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, Shaanxi 710115, China
| | - Rui Wang
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; School of Informatics, Xiamen University, Xiamen, Fujian 361005, China
| | - Jianghua Lai
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, Shaanxi 710115, China
| | - Hua Tang
- Xi'an International Medical Center Hospital, Xi'an, Shaanxi 710117, China
| | - Xu Xiao
- National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; School of Informatics, Xiamen University, Xiamen, Fujian 361005, China
| | - Rongshan Yu
- National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; School of Informatics, Xiamen University, Xiamen, Fujian 361005, China
| | - Xiaorui Bao
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Feng Zhu
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Kena Wang
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, Shaanxi 710115, China
| | - Ye Lu
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, Shaanxi 710115, China
| | - Jie Dang
- School of Basic Medicine, Ningxia Medical University, Yinchuan, Ningxia 750004, China
| | - Chao Zhu
- Department of Nephrology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Rui Zhang
- Department of Emergency Medicine, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Wei Dang
- The Sixth Ward, Xi'an Mental Health Center, Xi'an, Shannxi 710100, China
| | - Bao Zhang
- National Biosafety Evidence Foundation, Bio-evidence Sciences Academy, Western China Science and Technology Innovation Harbor, Xi'an Jiaotong University, Xi'an, Shaanxi 710115, China
| | - Quanze Fu
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Qian Zhang
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Chongao Kang
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Yujie Chen
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Xiaoyu Chen
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China
| | - Qing Liang
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China.
| | - Kejia Wang
- Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Xiamen Key Laboratory of Regeneration Medicine, Organ Transplantation Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China; National Institute for Data Science in Health and Medicine, School of Medicine, Xiamen University, Xiamen, Fujian 361102, China.
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Zhang M, Li J, Fan J, Feng D, Li Q, Tang S, Li J. Cross-border Activities Associated With Pattern of Amphetamine-type Stimulants Usage Among Drug Users in Southwest of China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231206608. [PMID: 37902428 PMCID: PMC10617300 DOI: 10.1177/00469580231206608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 10/31/2023]
Abstract
Cross-border activities are possibly associated with the use of amphetamine-type stimulants (ATS), this study was to explore poly-substance of ATS use and influencing factors among ATS use populations in southwest China. A cross-sectional study was conducted by response driven and continuous samplings from January to July 2021. Descriptive, univariate and logistic regression were carried out. ATS users accounted for 95.6% of the target population, of whom one-third had cross-border experiences with 4.1% of the cross-border purchase of drugs. ATS users were mainly over 31 years old (53.9%), male (98.7%), minority (79.1%), and unmarried (72.7%). Cross-border users consumed more ketamine (8%) and methamphetamine (40%) (P < .05). After adjusting for socioeconomic-demographic factors, cross-border activity [OR: 0.336 (0.141, 0.799)], occupation [OR: 0.273 (0.080, 0.929)], injecting drug behavior [OR: 6.239 (1. 087, 35.811)], frequency [OR: 0.251 (0.073, 0.859)], and ATS use location [OR: 2.915 (1.040, 8.168)] were possible factors influencing ATS use patterns (P < .05). Cross-border activity may be associated with polydrug use, especially predominantly methamphetamine use, among ATS users along the Southwest border. It implied that the focus of drug prevention and control in border areas should be on cross-border populations.
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Affiliation(s)
- Mingmei Zhang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
| | - Jiashuang Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jianhua Fan
- Centre for Disease Control and Prevention, Xishuangbanna Dai Autonomous Prefecture, Jinghong, Yunnan, China
| | - Dongli Feng
- The Centre for Disease Control and Prevention in Jinghong, Jinghong, Yunnan, China
| | - Qun Li
- Department of Clinical Skills Centre, Kunming Medical University, Kunming, Yunnan, China
| | - Songyuan Tang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jing Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
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Huang G, Cheng W, Xu Y, Yang J, Jiang J, Pan X, Zhou X, Jiang J, Chai C. Development and Validation of a Risk Prediction Tool to Identify People at Greater Risk of Having Hepatitis C among Drug Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15677. [PMID: 36497751 PMCID: PMC9738321 DOI: 10.3390/ijerph192315677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/14/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND People who use drugs (PWUD) are among those with the highest risk for hepatitis C virus (HCV) infection. Highly effective direct-acting antiviral agents offer an opportunity to eliminate HCV. A simple tool for the prediction of HCV infection risk in PWUD is urgently needed. This study aimed to develop and validate a risk prediction tool to identify people at greater risk of having hepatitis C among PWUD that is applicable in resource-limited settings. METHODS We extracted data from national HIV/AIDS sentinel surveillance in PWUD (Zhejiang Province, 2016-2021) and developed and validated a risk score to improve HCV testing in PWUD. This risk score consists of seven risk factors identified using multivariable logistic regression modeling (2016-2020, exploratory group). We validated this score using surveillance data for 2021 (validation group). The accuracy of the model was determined using C-statistics. RESULTS We identified seven risk factors, including sex, age, marital status, educational attainment, and the use of heroin, morphine, and methamphetamine. In the exploratory group, the positive rates of detecting the HCV antibody in the low-risk (0-9 points), intermediate-risk (10-16 points), and high-risk (≥17 points) groups were 6.72%, 17.24%, and 38.02%, respectively (Ptrend < 0.001). In the validation group, the positive rates in the low-, medium-, and high-risk groups were 4.46%, 12.23%, and 38.99%, respectively (Ptrend < 0.001). CONCLUSIONS We developed and validated a drug-specific risk prediction tool for identifying PWUD at increased risk of HCV infection. This tool can complement and integrate the screening strategy for the purpose of early diagnosis and treatment.
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Affiliation(s)
- Gang Huang
- Medical School of Ningbo University, Ningbo University, Ningbo 315211, China
| | - Wei Cheng
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Yun Xu
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jiezhe Yang
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jun Jiang
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Xiaohong Pan
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Xin Zhou
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jianmin Jiang
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
- Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou 310051, China
| | - Chengliang Chai
- Department of AIDS and STDs Prevention and Control, Zhejiang Province Center for Disease Control and Prevention, Hangzhou 310051, China
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Zhang Y, Lu S. Effects of traditional Chinese exercises on mental health in individuals with drug rehabilitee: A systematic review and meta-analysis. Front Public Health 2022; 10:944636. [PMID: 35991075 PMCID: PMC9386426 DOI: 10.3389/fpubh.2022.944636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThe intent of this systematic review and meta-analysis was to examine the effects of Traditional Chinese Exercise (TCE) on mental health and drug cravings in drug rehabilitees.MethodsSix electronic databases (PubMed, Web of Science, MEDLINE, CINAHL, PsycArticles, and CNKI) were searched to identify the potential literature from inception to March 2022. The controlled studies with a pro-posttest design that investigated the effects of TCE on mental health (depression, anxiety, drug craving, and sleep quality) were included. The effect sizes were calculated using the random-effect models with a 95% confidence interval. The Physiotherapy Evidence Database (PEDro) scale was employed to evaluate study quality.ResultsA total of 10 studies (740 participants, mean age 35 years old) were included in this study. The pooled results showed that TCE produced significant improvements in depression (SMD = 0.65, 95% CI 0.29 to 1.02, p < 0.01), anxiety (SMD = 0.98, 95% CI 0.44 to 1.53, p < 0.01), and drug craving (SMD = 0.87, 95% CI 0.54 to 1.21, p < 0.01) compared to the control group. The subgroup analysis results showed that TCE resulted in significant improvements in depression compared to active intervention (SMD = 0.33, 95% CI 0.07 to 0.60) or passive intervention (SMD = 1.07, 95% CI 0.40 to 1.74). A significant improvement in depression was observed in both male and female drug rehabilitee (p < 0.05). Moreover, Tai Chi (SMD = 0.69, 95% CI 0.19 to 1.18) or Qigong (SMD = 0.49, 95% CI 0.24 to 0.74) exercise, 3–4 times per week (SMD = 1.06, 95% CI 0.39 to 1.74) or ≥5 times (SMD = 0.39, 95% CI 0.12 to 0.66), >45 min (SMD = 0.62, 95% CI 0.09 to 1.15) or ≤ 45 min (SMD = 0.68, 95% CI 0.10 to 1.27), and for a duration of 12 weeks (SMD = 0.84, 95% CI 0.15 to 1.54) produced significant improvement in depression.ConclusionThis current study suggests that TCE (Tai Chi, Qigong) may have benefits in alleviating depression, anxiety, and drug cravings in drug rehabilitees. Further studies are required to verify our results through the implementation of well-designed experimental protocols.
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Affiliation(s)
- Yulong Zhang
- Hunan Judicial Police Vocational College, Changsha, China
| | - Shenghua Lu
- College of Sports Science, Jishou University, Jishou, China
- Hunan Academy of Education Sciences, Changsha, China
- *Correspondence: Shenghua Lu
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Zeng Y, Han L, Cheng Y, Jia CX. How Anti-Substance Abuse Campaigns Influence Substance Abusers' Psychological Health in Chinese Communities: The Mediating Role of Perceived Stigma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116687. [PMID: 35682271 PMCID: PMC9180135 DOI: 10.3390/ijerph19116687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 02/04/2023]
Abstract
The current study explored how anti-substance abuse campaigns influence substance abusers' psychological health through the perception of stigma. The study is based on a sample of substance abusers who received community-based treatments (n = 3457) and used structural equation modeling to estimate the role of perceived stigma in mediating between perceptions of overstatement of harm conveyed in anti-substance abuse campaigns and psychological outcomes. The results revealed that substance abusers' perception of overstatement of the harm caused by the substances and substance abusers enhanced their perceived stigma and impaired their psychological health in terms of anxiety, depression, and somatization, through both direct and indirect pathways. The results advocate for proper strategies in the design of anti-substance abuse campaigns. Possible initiatives to reduce substance abusers' perceived stigma are recommended.
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Affiliation(s)
- Yonghui Zeng
- School of Economics and Statistics, Guangzhou University, Guangzhou 510006, China;
- Department of Social Work, School of Public Administration, South China Agricultural University, Guangzhou 510640, China;
| | - Li Han
- Department of Social Work, School of Public Administration, South China Agricultural University, Guangzhou 510640, China;
| | - Yu Cheng
- School of Education Science and Law, Xiangnan University, Chenzhou 423043, China
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou 510275, China
- Correspondence: (Y.C.); (C.X.J.)
| | - Cindy Xinshan Jia
- Department of Social Work, School of Public Administration, South China Agricultural University, Guangzhou 510640, China;
- Correspondence: (Y.C.); (C.X.J.)
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Zhang B, Yan X, Li Y, Zhu H, Lu Z, Jia Z. Trends in Methamphetamine Use in the Mainland of China, 2006-2015. Front Public Health 2022; 10:852837. [PMID: 35570894 PMCID: PMC9096246 DOI: 10.3389/fpubh.2022.852837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Methamphetamine is the most prevalent drug in the mainland of China, yet few studies on the non-medical use of methamphetamine nationwide have been conducted. This study aimed to examine the trends in the prevalence of non-medical methamphetamine use and to explore the flow pattern of internal migrant methamphetamine users in the mainland of China. Methods Data were extracted from the National Dynamic Management and Control Database for Drug Users (NDMCD). Joinpoint regressions were used to examine trends in the prevalence and population size of methamphetamine use. Results A total of 1,821,468 methamphetamine use cases registered in NDMCD from 2006 to 2015 were identified. The number of methamphetamine use cases presented an increasing trend in all age subgroups, and among them, the elderly increased the fastest [annual percent change (APC2006−2015), 122.9; 95% CI, 113.0–133.3; p < 0.001]. The prevalence of methamphetamine use increased from 4.69 per 100,000 population in 2008 to 45.38 per 100,000 population in 2015 (APC2008−2015, 36.1; 95% CI, 31.9–40.6; p < 0.001). The regions of the Pearl River Delta, Yangtze River Delta, and Beijing-Tianjin-Hebei Urban Agglomeration absorbed over 96% of all internal migrant methamphetamine use cases, and the number of migrant methamphetamine use cases presented increased trends in these three regions. Conclusions The increasing trends in methamphetamine use have become a threat to all age groups in China. Substance use prevention programs should focus on internal migrant drug users, especially in economically developed regions.
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Affiliation(s)
- Bo Zhang
- School of Public Health, Peking University, Beijing, China
| | - Xiangyu Yan
- School of Public Health, Peking University, Beijing, China
| | - Yongjie Li
- School of Public Health, Peking University, Beijing, China
| | - He Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Zuhong Lu
- State Key Laboratory for Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Zhongwei Jia
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
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Han Y, Cao L, Yuan K, Shi J, Yan W, Lu L. Unique Pharmacology, Brain Dysfunction, and Therapeutic Advancements for Fentanyl Misuse and Abuse. Neurosci Bull 2022; 38:1365-1382. [PMID: 35570233 PMCID: PMC9107910 DOI: 10.1007/s12264-022-00872-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/13/2022] [Indexed: 11/20/2022] Open
Abstract
Fentanyl is a fully synthetic opioid with analgesic and anesthetic properties. It has become a primary driver of the deadliest opioid crisis in the United States and elsewhere, consequently imposing devastating social, economic, and health burdens worldwide. However, the neural mechanisms that underlie the behavioral effects of fentanyl and its analogs are largely unknown, and approaches to prevent fentanyl abuse and fentanyl-related overdose deaths are scarce. This review presents the abuse potential and unique pharmacology of fentanyl and elucidates its potential mechanisms of action, including neural circuit dysfunction and neuroinflammation. We discuss recent progress in the development of pharmacological interventions, anti-fentanyl vaccines, anti-fentanyl/heroin conjugate vaccines, and monoclonal antibodies to attenuate fentanyl-seeking and prevent fentanyl-induced respiratory depression. However, translational studies and clinical trials are still lacking. Considering the present opioid crisis, the development of effective pharmacological and immunological strategies to prevent fentanyl abuse and overdose are urgently needed.
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Dynamics and correlations in multiplex immune profiling reveal persistent immune inflammation in male drug users after withdrawal. Int Immunopharmacol 2022; 107:108696. [PMID: 35303506 DOI: 10.1016/j.intimp.2022.108696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 11/05/2022]
Abstract
Drug withdrawal elicits immune responses that contribute to the development of withdrawal symptoms and relapse. The understanding of the immunologic dynamics after drug withdrawal is limited, precluding the finding of promising immune intervention measures. Here, we performed cytokine and multiplex immune profiling in heroin, methamphetamine (METH) and ephedrine users after withdrawal and identified the correlation between cytokines and other immune parameters. We showed that broad and strong inflammatory responses occurred at the early stage after drug withdrawal, and the inflammatory responses showed a downtrend with the extension of withdrawal time. Notably, immune dysregulation remained through and may last longer than 12 months after withdrawal in heroin and METH users. Our findings suggest that cytokines, immune cells, complement and immunoglobulin form a complex immune network that regulates immune responses after withdrawal. These data provide a reference for future scientific research and drug research and development.
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Relation of substance use disorders to mortality, accident and emergency department attendances, and hospital admissions: A 13-year population-based cohort study in Hong Kong. Drug Alcohol Depend 2021; 229:109119. [PMID: 34717115 DOI: 10.1016/j.drugalcdep.2021.109119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The impact of substance use disorders (SUD) in an Asian population has not been fully explored. We aimed to assess the risk of mortality, accident and emergency (A&E) department attendances, and hospital admissions associated with SUD in a population-based cohort study. METHOD Patients diagnosed with SUD in public A&E departments from 2004 to 2016 (N = 8,423) were identified in the Clinical Database Analysis and Reporting System of the Hong Kong Hospital Authority and 1:1 matched to patients without SUD by propensity score (N = 6,074 in each group). Relative risks of mortality, A&E attendances and hospital admissions were assessed using Cox regression and Hurdle negative binomial regression. RESULTS Patients with SUD had higher mortality (hazard ratio=1.43; 95% confidence interval [CI]=1.26-1.62) and more often died from poisoning or toxicity and injuries. The odds ratio (OR) for A&E attendances and all-cause hospital admissions associated with SUD were 2.80 (95% CI=2.58-3.04) and 3.54 (95% CI=3.26-3.83), respectively. The impact of SUD on the above outcomes was greatest among school-aged individuals (≤ 21 years) and decreased with age. The relative risk of mental disorder-related hospital admissions was much higher than that for infections, respiratory diseases, and cardiovascular diseases. In patients with SUD, ketamine and amphetamine use were associated with increased A&E attendances than opioid use. CONCLUSIONS SUD was associated with increased mortality, A&E attendances and hospital admissions, especially in school-aged individuals. Our findings suggest prioritising early treatment and preventive interventions for school-aged individuals and focusing on the management of comorbid mental disorders and the use of ketamine and amphetamine.
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Al-Waheeb S, Al-Omair N, Mahdi A. Patterns of drug overdose deaths in Kuwait from 2014 to 2018. PUBLIC HEALTH IN PRACTICE 2021; 2:100181. [PMID: 36101572 PMCID: PMC9461498 DOI: 10.1016/j.puhip.2021.100181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 07/15/2021] [Accepted: 07/30/2021] [Indexed: 12/18/2022] Open
Abstract
Background Kuwait is an Arabian Gulf couFntry with a population of around 4.4 million as of 2020. In recent years, government based news agencies have commonly exposed drug smuggling plots that were foiled by local authorities. We attempted to study the patterns of drug overdose deaths in Kuwait, which we believe is a good method to address the effect of illicit drug use in the country. Methodology All cases that were signed out as drug overdose death were collected from the General department of criminal evidence. The relationship between demographic factors and drug types were analyzed using various statistical methodologies. Results 344 victims were identified from 2014 to 2018. The majority of whom were Kuwaiti nationals (67%) and the average age of death was 38. Hawalli governorate had the highest number of cases, while Jahra governorate had the least. Morphine appeared to be the most common drug found in the victims post mortem (79.9%) followed by benzodiazepines (43%). Our study has an extremely low female number of victims (2.6%). Some substances that are commonly abused globally eg heroin and cocaine were rarely recovered in our study. The number of cases have had an increase over the study period with the highest number of cases in 2018. Conclusion The current study is the first of its kind in Kuwait and one of the first in the middle east region. It is evident that illicit drug use and subsequent drug overdose deaths are on a rise in Kuwait and government agencies need to put a strategic plan to address and reduce this problem.
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Yu J, Wu Q, Wu Y, Li J, Wu Q, Cao H, Wang Z. Prevalence of and Factors Associated with Club Drug Use among Secondary Vocational Students in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10408. [PMID: 34639708 PMCID: PMC8507794 DOI: 10.3390/ijerph181910408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Abstract
To understand the prevalence of and factors associated with club drug use among Chinese secondary vocational students, a nationally representative survey was conducted. The multistage cluster sampling strategy was employed to select participants. A total of 9469 students from eleven secondary vocational schools in five cities completed self-reported questionnaires, which included information on club drug use, sociodemographic variables, individual factors, as well as peer and family related factors. The data were separately analyzed with Poisson regression models for female and male students. The overall lifetime prevalence of club drug use was 2.7% (258/9469), and male students had higher prevalence than female students (3.5% vs. 1.9%, p < 0.001). Female and male students shared four risk factors (i.e., having ever smoked, perceiving social benefit expectancies, peer drug using and perceiving peer's approval of drug use) and one protective factor (i.e., having medium or high levels of refusal skills) for club drug use. Moreover, family drug using and having a part-time job were two additionally independent risk factors for club drug use among male students. These findings indicate that the problem of club drug use among Chinese secondary vocational students is worthy of attention. The prevention of club drug use should address multiple risks and protective factors on individual, peer and family levels.
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Affiliation(s)
- Jincong Yu
- Psychological Health Education and Counseling Center, Zhongnan University of Economics and Law, Wuhan 430073, China;
| | - Qingfeng Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China;
| | - Yuqin Wu
- School of Foreign Languages, Zhongnan University of Economics and Law, Wuhan 430073, China;
| | - Jiang Li
- Chongqing Health Statistics Information Center, Chongqing 401120, China;
| | - Qinxuan Wu
- Guangdong Province Technician College of Light Industry, Guangzhou 510315, China;
| | - Huiping Cao
- Zhaoqing Secondary Vocational School of Science and Technology, Zhaoqing 526020, China;
| | - Zengzhen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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The Effect of Crystal Dependence on Brain Activity Related to the Perception of Pleasure Using fMRI. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Addiction is currently one of the problems of human society. Drug abuse is one of the most important issues in the field of addiction. Methamphetamine (crystal) is one of the drugs that has been abused in recent decades. Methods: In this case-control study, 10 individuals aged 20 to 40 years old with at least 2 years of experience of methamphetamine consumption without any history of drug use or other stimulants from clients and drug withdrawal centers in Tehran City, and 10 healthy volunteers were selected. Age, social status, and economic status of addicts were included in the fMRI apparatus, and 90 selected pleasurable, non-pleasurable, and neutral images (IAPS) were displayed by the projector through an event-related method. The playback time of each photo was 3 s, and after this process, the person outside the device, without the time limit selected the enjoyable and unpleasant images. Results: The results showed that there was no significant difference between the groups in terms of age, alcohol use, and smoking history (P < 0.05). There was no significant difference in terms of the age at first use between members of the methamphetamine-dependent group. Also, the methamphetamine-dependent group showed more brain activity in their pre-center and post-center gyrus than the normal (control) group. Conclusions: According to the results obtained in this study, in general, it can be concluded that there are some areas in the brain of addicts that are activated when watching pleasant photos, while these areas are not active in the brains of normal people.
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Zhuo R, Chen Z, Shen X, Yang H, Luo S, Wu Y, Zhu Y, Wu T, Feng Z, Cai H. The Mediating Roles of Impulsiveness and Maladjustment in the Association of Psychological Resilience with Drug Addiction during Isolated Detoxification. Subst Use Misuse 2021; 56:1457-1466. [PMID: 34139949 DOI: 10.1080/10826084.2021.1936048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Studies have shown that psychological resilience is a key factor in drug rehabilitation. To explore the feasibility of developing psychological resilience as an addiction treatment intervention, it is essential to explore the role that it plays in drug addiction. Objectives: This study aimed to investigate the relationship between psychological resilience and drug addiction, as well as to examine the underlying mediational roles of maladjustment and impulsiveness in this association. Methods: We used a cross-sectional design that included a sample of 140 male drug addicts in compulsory isolation centers and used questionnaires and scales to ascertain their level of drug addiction, psychological resilience, maladjustment, impulsiveness, social support, and loneliness. Correlation and mediation effect analyses were performed to determine the roles of impulsiveness and maladjustment in the association of psychological resilience with drug addiction. Results: Psychological resilience was an inverse predictor of drug addiction. The results of the mediation effect analysis showed that maladjustment acted as a mediator between resilience and drug addiction and between impulsiveness and drug addiction. Furthermore, impulsiveness and maladjustment jointly mediated the relationship between psychological resilience and drug addiction. Conclusion: These findings highlight the importance of psychological resilience in maladjustment and impulsiveness for drug addicts and suggest that the role of psychological resilience in drug addiction needs to be further explored.
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Affiliation(s)
- Ruirui Zhuo
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Zhencai Chen
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Xunbing Shen
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Hechen Yang
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Shuilian Luo
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Yuanqiang Wu
- Jiangxi University of Chinese Medicine, Nanchang, China
| | - Yuxiang Zhu
- Nanchang Compulsory Isolated Detoxification Center, Nanchang, China
| | - Tingyun Wu
- Nanchang Compulsory Isolated Detoxification Center, Nanchang, China
| | - Zhenjun Feng
- Nanchang Compulsory Isolated Detoxification Center, Nanchang, China
| | - Hengbin Cai
- Nanchang Compulsory Isolated Detoxification Center, Nanchang, China
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Luo T, Xiao M, Qi C, Wu Q, Tang J, Liao Y. Features of Psychotic Symptoms in Methamphetamine Use Disorder Patients and Ketamine Use Disorder Patients: A Cross-Sectional Study. Front Psychiatry 2021; 12:786622. [PMID: 35115964 PMCID: PMC8804087 DOI: 10.3389/fpsyt.2021.786622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Methamphetamine and ketamine are commonly used club drugs. Both of them have been reported to mimic psychotic symptoms of schizophrenia. However, the prevalence and detailed features of psychotic symptoms among methamphetamine use disorder (MUD) and ketamine use disorder (KUD) patients are largely unknown. This study aimed to measure psychotic symptoms among patients with MUD and KUD. METHODS A total sample of 842 patients from voluntary drug rehabilitation centers, including 462 MUD patients and 380 KUD patients, were invited to this study. The Positive and Negative Syndrome Scale (PANSS) was applied to assess psychotic symptoms in these two groups of patients. RESULTS The prevalence of psychotic symptoms was significantly higher among MUD patients than KUD patients (75.1 vs. 50.5%, 95% CI: 3.532 - 11.858, p < 0.001). Compared with KUD patients, MUD patients were more likely to experience positive symptoms (PANSS positive scores: 11.5 ± 6.07 vs. 15.1 ± 8.22, P < 0.001) and negative symptoms (PANSS negative scores: 12.4 ± 6.60 vs. 14.5 ± 8.63, P < 0.001), but not general symptoms (PANSS general scores: 31.2 ± 13.90 vs. 32.2 ± 15.13, P < 0.001). CONCLUSIONS The current study found that more than half of MUD and KUD patients experienced psychotic symptoms, and that patients with MUD are more likely to experience positive and negative symptoms than patients with KUD. The findings provide a new perspective for exploring the neuropathological mechanism of psychotic symptoms of schizophrenia.
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Affiliation(s)
- Tao Luo
- Department of Psychology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meng Xiao
- The Fourth People's Hospital of Urumqi, Urumqi, China
| | - Chang Qi
- Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Qiuxia Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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20
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Yang J, Giummarra MJ. Compulsory and voluntary drug treatment models in China: A need for improved evidence-based policy and practice to reduce the loaded burden of substance use disorders. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 92:103063. [PMID: 33303344 DOI: 10.1016/j.drugpo.2020.103063] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023]
Abstract
In China, the majority of people who use drugs (PWUD) identified by authorities are admitted to compulsory isolated detoxification centers in which their treatment is administered by administrative and judicial systems that restrict their freedom. China's compulsory isolated detoxification centers have been criticized as an abuse of human rights. The two other primary models of drug treatment in China include community-based treatment and medically-oriented voluntary treatment. This article presents an overview of the three primary treatment models for PWUD currently practiced in China. The existing compulsory and voluntary treatment models predominantly operate separately from each other, and lack evidence-based guidelines. A drug treatment system that embraces social support, psychosocial interventions and well-qualified health-based workforce is currently lacking. We propose that China needs to employ a localized model that is composed of well-facilitated and evidence-based treatment methods for both compulsory and voluntary treatment for PWUD to reduce the burden of illicit drug use. The implementation of these models of care, however, need to be tailored to the country's historical background, large population of PWUD and cultural settings in order to succeed. Urgent changes in drug treatment policies and practices are needed by the Chinese governments at different levels, organizations and front-line practitioners if we are to see a reduction in the incidence and impact of harms related to substance use in China.
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Affiliation(s)
- Jie Yang
- Director of Shenzhen Bohou Social Work Service Center, China.
| | - Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia
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21
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Liu X, Chen MG, Chen Y, Shi L, Chen Y, Zhang Z, Xu X, Huan X, Fu G, McFarland W. Changing trends in the types of drug used and infectious disease prevalence among drug users in jiangsu province, china. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 88:103034. [PMID: 33232884 DOI: 10.1016/j.drugpo.2020.103034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND In recent years, a boom of synthetic drugs, especially methamphetamine has been documented in China, however, the situation in Jiangsu was unclear. The objective of this study was to evaluate the changing trends in types of drug used, examine the prevalence trends of HIV, syphilis and HCV over time and compare the demographic, drug and sexual behaviors among different types of people who use drugs (PWD) in Jiangsu Province, China. METHODS Consecutive cross-sectional studies were conducted from 2011 to 2015 in nine compulsory detoxification centers, which were HIV sentinel surveillance sites, in Jiangsu Province, China. A structured questionnaire was administered in a face-to-face interview with each participant to collect demographic, behavioral and laboratory information. Participants were classified into three types: opioids PWD (using heroin, opium, morphine and dolantin); stimulant PWD (using cocaine, methamphetamine, methylene dioxymetham-phetamine and Magu); poly-drug PWD (using opioids and stimulant drugs simultaneously). RESULTS Among a total of 16,164 PWD recruited from 2011 to 2015, the proportion of opioids PWD declined from 40.1% in 2011 to 11.8% in 2015, while the proportion of stimulant PWD increased from 53.6% to 84.3%. Overall HIV, syphilis, and HCV prevalence for the period was 0.3%, 9.6% and 31.6%, respectively. As types of drugs used shifted from opioids to stimulants, HIV prevalence increased (P = 0.031) while HCV decreased (P<0.001). HIV, syphilis and HCV prevalence trends varied across the three subgroups. Injection and needle-sharing behaviors differed between opioids and stimulant PWD, whereas unsafe sexual behaviors were similar. Poly-drug PWD might have higher risks for these infections due to combinations of unsafe sexual and injection behaviors. CONCLUSION Although the trend of drugs used have changed over time, HIV, syphilis and HCV infection risk behaviors among PWD still exist. Therefore, traditional intervention strategies should seek to address the challenge of increasing stimulant PWD. Access to convenient testing services, as well as pre- and post-exposure prophylaxis for HIV risk reduction should be improved among PWD. Antiviral treatment for HCV should be added to medical insurance coverage as soon as possible in Jiangsu Province.
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Affiliation(s)
- Xiaoyan Liu
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Master Guohong Chen
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China.
| | - Yuheng Chen
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Lingen Shi
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Yunting Chen
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Zhi Zhang
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Xiaoqin Xu
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Xiping Huan
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Gengfeng Fu
- Department of STD and HIV/AIDS control and prevention, Jiangsu Provincial Center for Disease Prevention and Control, No. 172 Jiangsu Road, Nanjing, Jiangsu Province, China
| | - Willi McFarland
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 710, San Francisco, California, USA
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Yan X, Su H, Zhang B, Li Y, Zhang L, Jia Z. Adherence of HIV Self-Testing Among Men Who Have Sex With Men in China: Longitudinal Study. J Med Internet Res 2020; 22:e19627. [PMID: 32940619 PMCID: PMC7530689 DOI: 10.2196/19627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/06/2020] [Accepted: 07/26/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The World Health Organization recommended HIV self-testing (HIVST) for individuals practicing unsafe sexual behaviors; however, the adherence to HIV testing has not been reported. OBJECTIVE In this study, we attempted to determine the adherence to HIVST among men who have sex with men (MSM), as well as the impact factors and potential effects of their adherence. METHODS We conducted a longitudinal study among MSM in Harbin, Heilongjiang province, China from July 1, 2017 to June 30, 2018. A mobile app system was used to provide the "Mailing rapid test reagent kit" for the HIVST service. The proportion of those who adhered to HIV testing every 3 months was calculated. Logistic regression was used to explore the impact factors related to adherence to HIVST. Rates of HIV infection between MSM who adhered to HIVST and those who did not were compared using Cox proportional hazards regression. Changes of condom use behaviors between the two groups were also compared using the chi-square test. RESULTS A total of 1315 MSM who received the HIVST service through the app were included in the study. Overall, 10% of the MSM adhered to HIVST, and the proportion of adhering tests was only 34.9%. Adherence of HIVST was associated with marital status (adjusted odds ratio [OR]unmarried vs married 2.31, 95% CI 1.13-4.71) and the number of HIV tests they received (adjusted OR3 times vs 2 times or below 3.36, 95% CI 2.01-5.63; adjusted OR4 times or above vs 2 times or below 7.30, 95% CI 4.67-11.42). Twenty HIV seroconversions were observed during 1-year follow up. The rate of HIV infection in the adherence group (17.10 per 100 person years, 95% CI 8.80-30.84) was significantly higher than that in the nonadherence group (4.80 per 100 person years, 95% CI 2.77-7.88; adjusted hazard ratio 3.33, 95% CI 1.35-8.20). Those who adhered to HIV testing were more likely to improve condom use behaviors, although the difference was not statistically significant. CONCLUSIONS Regular HIV testing is necessary for early detection of HIV infection among MSM. Given the poor adherence, a new internet-based management paradigm for MSM is needed to raise their health awareness to optimize the implementation of HIVST.
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Affiliation(s)
- Xiangyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Hexuan Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Bo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Yongjie Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lingling Zhang
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Zhongwei Jia
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
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Epidemics of HIV Infection among Heavy Drug Users of Depressants Only, Stimulants Only, and Both Depressants and Stimulants in Mainland China: A Series, Cross-Sectional Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155483. [PMID: 32751337 PMCID: PMC7431999 DOI: 10.3390/ijerph17155483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/31/2022]
Abstract
Background: Heavy drug users was a global consensus high-risk population of HIV infection. However, the specific impact of drug on HIV infection has not yet been established. Depressants and stimulants were most widely used drugs in mainland China, and mix use of the two drugs was also serious. We assessed the HIV infection rate and trends in heavy drug users by analyzing data from the National Dynamic Management and Control Database for Drug Users (NDMCDDU). Methods: All heavy drug users with HIV test results in NDMCDDU from 2008 to 2016 were grouped into depressants only group (DOG), stimulants only group (SOG), and both depressants and stimulants group (DSG). We used joinpoint regression to examine trends of HIV infection rates. Multivariable logistic regression was used to examine factors related to HIV infection. Results: A total of 466,033 heavy drug users with 9522 cases of HIV infection were included in this analysis. HIV infection rate was estimated at 2.97% (95% CI 2.91–3.04%) of 265,774 users in DOG, 0.45% (95% CI 0.42–0.49%) of 140,895 users in SOG, and 1.65% (95% CI 1.55–1.76%) of 59,364 users in DSG. In DOG, a U-shaped curve of HIV infection rate decreased from 3.85% in 2008 to 2.19% in 2010 (annual percent change (APC) −12.9, 95% CI −19.3–−6.0, p < 0.05), then increased to 4.64% in 2016 (APC 8.3, 95% CI 6.1–10.4, p < 0.05) was observed. However, SOG and DSG showed consistent increases from 0.15% in 2008 to 0.54% in 2016 (APC 8.2, 95% CI 4.8–11.8, p < 0.05) and from 0.78% in 2008 to 2.72% in 2016 (APC 13.5, 95% CI 10.7–16.4, p < 0.05), respectively. HIV infection rate of DOG in the southwest region presented a U-shaped trend. All groups showed significant increases in HIV infection in east and central regions. Conclusions: The U-shaped curve for HIV infection rate among DOG users and consistent increases among SOG and DSG users implies drug abuse is still a critical focus of HIV infection in China. It is urgently needed to reassess the effectiveness of current strategies on HIV prevention and control among drug users.
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Gao H, Liu M, Luo X, Zhang J, Cai T. Application of the Chinese version of the addiction profile index (API) in drug users: an analysis of validity and measurement invariance across genders. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:28. [PMID: 32272937 PMCID: PMC7146950 DOI: 10.1186/s13011-020-00263-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/28/2020] [Indexed: 02/03/2023]
Abstract
Background In China, substance use disorders represent a significant burden on public health and the economy. However, while the range of drugs and drug markets expands and diversifies, the instruments available to evaluate users’ dependence statuses from multiple dimensions have become insufficient. Accordingly, the present study presents the Chinese version of the Addiction Profile Index (API), explores its reliability and validity, and investigates the measurement invariance between males and females with substance use disorders. Methods The API, a self-report questionnaire, was administered to 2252 people with substance use disorders who were undergoing treatment in compulsory detoxification institutions located in five provinces in China (943 females; mean age = 33.5 years old, SD = 8.6). Additionally, to ensure the authenticity of the collected data, the study’s volunteers completed the Drug Use Disorders Identification Test (DUDIT), DUDIT-Extended (DUDIT-E), and the Health Scale for Drug Abusers (HSDA). Results The revised API, with its updated substance list, featured 34 items. The new four-factor model, incorporating behavioral symptoms of dependence, impact on social life, cravings, and motivations for detoxification, explained 55.30% of the total variance, indicating a good fit. Moreover, Cronbach’s α and mean item coefficient values showed good internal consistency reliability. Regarding criterion validity, the revised factors were moderately to highly correlated with their corresponding subscales in the DUDIT, DUDIT-E, and HSDA. In addition, the multigroup confirmatory factor analysis demonstrated that a measurement invariance of the revised four-factor model across genders was supported, fully assuming different degrees of invariance. The three factors of symptoms, social life, and motivation exhibited significant differences between male and female participants in the t test results (p < 0.01). Conclusions The Chinese version of the API shows good psychometric properties in terms of reliability and validity, and exhibits measurement equivalence across the genders. Therefore, it could be used to comprehensively assess the severity of drug dependence in people with substance use disorders.
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Affiliation(s)
- Huiyuan Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.,Medical Psychological Institute of Central South University, Changsha, Hunan, 410011, China.,National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Meizhu Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.,Medical Psychological Institute of Central South University, Changsha, Hunan, 410011, China.,National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
| | - Xu Luo
- Hunan Judicial Police Vocational College, Changsha, China
| | - Jun Zhang
- Hunan Judicial Police Vocational College, Changsha, China.
| | - Taisheng Cai
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China. .,Medical Psychological Institute of Central South University, Changsha, Hunan, 410011, China. .,National Clinical Research Center for Mental Disorders, Changsha, Hunan, China.
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25
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Shao XT, Liu YS, Tan DQ, Wang Z, Zheng XY, Wang DG. Methamphetamine use in typical Chinese cities evaluated by wastewater-based epidemiology. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:8157-8165. [PMID: 31900768 DOI: 10.1007/s11356-019-07504-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/22/2019] [Indexed: 06/10/2023]
Abstract
Methamphetamine has become one of the most widely used illicit drugs in China. To understand the current situation in China, the prevalence and consumption of methamphetamine were estimated through wastewater-based epidemiology (WBE) in the present study. Methamphetamine concentrations ranged from 42.6 ng/L (Harbin) to 700 ng/L (Xi'an) in influent wastewater samples collected from 27 wastewater treatment plants (WWTPs) in 22 Chinese cities. The estimated consumption of methamphetamine was 23.0 (Dingxi) to 376 (Xi'an) mg/day/1000 inhabitants with a mean value of 157 mg/day/1000 inhabitants. The annual consumption in 2018 was estimated to be 84 tons (95% confidence interval, 44-136), which was 26% lower than that in 2014. The prevalence of methamphetamine use was 0.64% (95% confidence interval, 0.18-1.25), indicating that more than five million people used methamphetamine in 2018. Although drug abuse is common in the country, the consumption showed a different spatial pattern, with the highest values in Central China and the lowest use in Northeast China, so drug use is still considered a geographic and culture-dependent behaviour. The results indicated that WBE can not only be used to assess the trends of illicit drug use, but also to analyse the spatial differences in the whole country, which will provide complementary evidence for the prevention and control of methamphetamine use.
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Affiliation(s)
- Xue-Ting Shao
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, 116026, China
| | - Yue-Shan Liu
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, 116026, China
| | - Dong-Qin Tan
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, 116026, China
| | - Zhuang Wang
- Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, No. 219 Ningliu Road, Nanjing, 210044, China
| | - Xiao-Yu Zheng
- Institute of Forensic Science, Ministry of Public Security, Beijing, China
| | - De-Gao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian, 116026, China.
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26
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Zhang Q, Shi M, Tang H, Zhong H, Lu X. κ Opioid Receptor 1 Single Nucleotide Polymorphisms were Associated with the Methadone Dosage. Genet Test Mol Biomarkers 2020; 24:17-23. [PMID: 31940240 DOI: 10.1089/gtmb.2019.0159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Heroin use disorder (HUD) is a complex brain disease that includes multiple phenotypes. Heroin acts primarily as a mu-opioid receptor (OPRM1) agonist. The κ opioid receptor 1 (OPRK1) is critically involved in abstinence and remission. Multiple studies confirm that the OPRM1 and OPRK1 genes are associated with HUD. However, their relationship with the addictive phenotype is still unclear. This study was designed to identify the genetic polymorphisms within OPRM1 and OPRK1 with six HUD phenotypes. Methods: A total of 801 patients with HUD were recruited from the Methadone Maintenance Treatment Program in Xi'an. We identified eight potential functional single nucleotide polymorphisms (SNPs) in the two genes that were genotyped using SNaPshot SNP technology. We then performed a case-control association analysis, investigated particular disease phenotypes, and assessed the extent of epistasis among the variants of the two genes. Results: The OPRK1 rs3802279, rs3802281, and rs963549 genotypes were significantly associated with methadone dosage analyzed by Pearson's chi-square test or binary logistic regression to correct for covariates. The rs3802279 CC, rs3802281 TT, and rs963549 CC genotype carriers required a lower methadone maintenance dose per day. Multifactor dimensionality reduction analysis indicated strong interactions between sex and OPRK1 rs963549. The results of the OPRM1 genotyping did not reveal any associations with the various HUD phenotypes. Conclusion: These findings support an important role of the OPRK1 polymorphism in determining the daily methadone dose and may guide future studies in identifying additional genetic risk factors for HUD.
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Affiliation(s)
- Qian Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Minghai Shi
- Department of Radiology, Affiliated Hospital of Ningxia Medical University, Yinchuan, China
| | - Hua Tang
- Department of Gastroenterology, Tangdou Hospital, Air Force Medical University, Xi'an, China
| | - Huijun Zhong
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Xiaohong Lu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
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27
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Liu S, Tu D, Cai Y. Development and Validation of an Item Bank for Drug Dependence Measurement Using Computer Adaptive Testing. Subst Use Misuse 2020; 55:2291-2304. [PMID: 32772651 DOI: 10.1080/10826084.2020.1801743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Currently, measurement tools to assess patient-reported outcomes for drug dependence are limited in their latent trait to adapt to the needs of individual patients while also maintaining comparability of scores across patients. Purpose/Objectives: To develop an item bank for computer adaptive testing (CAT) to measure severity of drug dependence. Methods: There were four phases: (1) review the literature of drug dependence measurement; (2) formulate an item list to be assessed by experts; (3) pretest our item list in two substance dependence treatment centers; and (4) field-test and conduct psychometric performance analysis with the final item bank. Additionally, based on our response data, a CAT simulation was used to validate the item bank, Drug Dependence CAT (DD-CAT). Results: The final drug dependence item bank - with a unidimensional configuration - contained 56 items with good item-fit, high discrimination, no differential item functioning, and covered all symptoms of diagnostic criteria for drug dependence. These results revealed that the final item bank was of good quality. Additionally, the results of a simulation CAT procedure with real response data indicated that the DD-CAT item bank exhibited acceptable and reasonable test reliability, content validity, and criterion-related validity. Conclusions/Importance: The proposed item bank for DD-CAT contained acceptable reliability and validity, and exhibited a shorter but efficient assessment of drug dependence. These psychometric properties can result in shorter test times, less information loss, and a reduction in the testing burden of patients.
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Affiliation(s)
- Siyang Liu
- School of Psychology, Jiangxi Normal University, Nanchang, Jiangxi, China
| | - Dongbo Tu
- School of Psychology, Jiangxi Normal University, Nanchang, Jiangxi, China
| | - Yan Cai
- School of Psychology, Jiangxi Normal University, Nanchang, Jiangxi, China
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28
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Wang Y, Yan KJ, Fan CX, Luo XN, Zhou Y. Altered functional connectivity of the nucleus accumbens subdivisions in amphetamine-type stimulant abusers: a resting-state fMRI study. BMC Neurosci 2019; 20:66. [PMID: 31888484 PMCID: PMC6937793 DOI: 10.1186/s12868-019-0548-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022] Open
Abstract
Background The growing abuse of amphetamine-type stimulants leads to new challenges to human health. A possible addiction mechanism has been proposed by altered functional architecture of the nucleus accumbens (NAc) during resting state. NAc contains different subdivisions and they may play different roles in addiction. The aim of the present study was to examine whether there are common or distinct patterns of functional connectivity of the NAc subdivisions in amphetamine-type stimulant abusers (ATSAs). Methods The present study recruited 17 male ATSAs and 22 healthy male controls. All the subjects underwent resting-state functional magnetic resonance imaging (fMRI) with their eyes closed. The NAc was divided into core-like and shell-like subdivisions. We used seed-based resting-state functional connectivity (RSFC) analyses to identify differences in brain functional architecture between ATSAs and healthy controls (HCs). Results ATSAs had lower positive RSFCs with all of the NAc subdivisions over the left orbital part of superior frontal gyrus and higher positive RSFCs with the NAc subdivisions over the left opercular part of inferior frontal gyrus than HCs, which indicates common abnormalities across the NAc subdivisions in ATSAs. In addition, the RSFCs between the NAc subdivisions and the left orbital part of superior frontal gyrus were negatively correlated with the addiction severity in ATSAs. Conclusion These results provide evidence that there are common RSFC patterns of the NAc subdivisions in ATSAs. The abnormality indicated by disrupted functional connectivity between the NAc subdivisions and prefrontal cortex suggests abnormal interaction between the rewarding process and cognitive control in ATSAs. Our results shed insight on the neurobiological mechanisms of ATSA and suggest potential novel therapeutic targets for treatment and intervention of ATSAs.
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Affiliation(s)
- Yun Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Kai-Juan Yan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chen-Xiao Fan
- The Second Hospital of Jinhua City, Jinhua, Zhejiang, China
| | - Xiao-Nian Luo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing, China. .,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. .,Key Laboratory of Behavioral Science & Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Jiang W, Zhuo L, Wu X, Shen J, Ye X, Wang Y, Xia X, Chen H, Yu R, Yang S, Huang P. Association of rs2111485 and rs1990760 Polymorphisms of Interferon Induced with Helicase C Domain 1 Gene with Hepatitis C Virus Clearance in Chinese Han Population. Viral Immunol 2019; 32:341-347. [PMID: 31539314 DOI: 10.1089/vim.2019.0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Interferon induced with helicase C domain 1 (IFIH1), which is a type of cytological RNA helicase protein and an important initiator of innate immune response to RNA virus infection, may play an important role in hepatitis C virus (HCV) infection outcomes. This study was conducted to investigate the association of IFIH1 gene polymorphisms with HCV clearance in Chinese Han population. A total of 1,527 subjects positive for anti-HCV and 357 chronic hepatitis C (CHC) patients were enrolled in this study. Two single nucleotide polymorphisms in IFIH1 gene (rs2111485 and rs1990760) were selected and genotyped by TaqMan real-time polymerase chain reaction. Haplotypes analysis was further performed by HaploView software and PHASE software. Our results demonstrated that the mutant alleles of rs2111485 (dominant model: odds ratio [OR] = 1.41, 95% confidence interval [CI] = 1.11-1.79) and rs1990760 (dominant model: OR = 1.63, 95% CI = 1.30-2.06) decreased the possibility of spontaneous HCV clearance, but it had no association with HCV clearance induced by interferon-alfa (IFN-α). And, CHC risk increased with the increasing number of unfavorable alleles (ptrend < 0.001). In addition, haplotype analysis also showed that the A-C protective haplotype (rs2111485-rs1997060) promoted spontaneous HCV clearance (p < 0.001). Variants of rs2111485 and rs1990760 at IFIH1 may be associated with spontaneous HCV clearance in Chinese Han population, but have no effect on HCV clearance induced by IFN-α.
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Affiliation(s)
- Wei Jiang
- Department of Clinical Medicine, School of Basic Medical, Nanjing Medical University, Nanjing, China
| | - Lingyun Zhuo
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xinyu Wu
- Department of Clinical Medicine, School of Basic Medical, Nanjing Medical University, Nanjing, China
| | - Jia Shen
- Department of Preventive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiangyu Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xueshan Xia
- Department of Bioengineering, Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Hongbo Chen
- Department of Infectious Disease, Jurong Hospital Affiliated to Jiangsu University, Jurong, China
| | - Rongbin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.,Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Sheng Yang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Peng Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.,Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University, Nanjing, China
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Wang YG, Liu MH, Shen ZH. A virtual reality counterconditioning procedure to reduce methamphetamine cue-induced craving. J Psychiatr Res 2019; 116:88-94. [PMID: 31226580 DOI: 10.1016/j.jpsychires.2019.06.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/29/2019] [Accepted: 06/13/2019] [Indexed: 01/19/2023]
Abstract
The present work developed a virtual reality (VR) counterconditioning procedure (VRCP), and investigated its efficacy in treatment of cue-induced craving in individuals with methamphetamine (METH) dependence. In study 1, thirty-one patients diagnosed with METH dependence received VRCP, while twenty-nine METH-dependent patients in waiting-list group did not. In study 2, the VRCP was computerized as a VR treatment system. Six-hundred and twelve abstinent individuals with a history of METH dependence received the computerized VRCP, while two-hundred seventy-six abstinent individuals with a history of METH dependence in waiting-list group did not. Patients with METH dependence who received VRCP showed a significantly larger decrease on the score of METH-craving and METH-liking from baseline to follow-up assessments, compared to those who did not received VRCP. Participants received VRCP showed a significantly larger decrease in HRV indexes on time domain and non-linear domain from baseline to follow-up assessments during exposure to VR cues, compared to those in waiting-list group. These findings indicate that the counterconditioning procedure under VR environment may be a useful strategy in suppressing cue-induced reactivity for patients with METH dependence.
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Affiliation(s)
- Yong-Guang Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China; Anhui Psychiatric Medical Center, Anhui Medical University, Hefei, Anhui Province, China; Zhejiang Provincial Institute of Drug Abuse Research, Hangzhou, Zhejiang Province, China.
| | - Meng-Hui Liu
- Anhui Psychiatric Medical Center, Anhui Medical University, Hefei, Anhui Province, China
| | - Zhi-Hua Shen
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, 310013, Zhejiang Province, China
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Su S, Fairley CK, Mao L, Medland NA, Jing J, Cheng F, Zhang L. Estimates of the national trend of drugs use during 2000-2030 in China: A population-based mathematical model. Addict Behav 2019; 93:65-71. [PMID: 30685570 DOI: 10.1016/j.addbeh.2019.01.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND The use of synthetic drugs has exceeded heroin to become a major public health concern in China. We aimed to estimate the trend of heroin-only, synthetic drug-only and poly-drug (heroin and synthetic drug) use during 2000-2030 period in China using existing data. METHODS We used data from the Annual Report on Drug Control in China and peer-reviewed publications. We constructed a mathematical model to estimate the drug use trend based on Monte Carlo simulations. RESULTS The best calibrated model estimated that the number of drug users would increase from 0.86 million to 3,120,059 (95% CI 2,669,214-3,570,904) during 2000-2030 period. The proportion of heroin-only users among the total drug users will decrease from 96.8% (95% CI, 96.6-97.1%) in 2000 to 36.9% (30.1-40.8%) in 2030, while the proportion of synthetic drug-only users will increase from 1.1% (0.9-1.3%) in 2000 to 57.7% (51.7-65.6%) in 2030. In contrast, the proportion of poly-drug users shared an increasing trend during 2000-2016 (from 2.1% (1.5-2.8%) to 15.1 (13.8-17.1%)) but declined to 5.5% (3.4-7.2%) in 2030. Estimated 46,370 (41,634-51,106) heroin-only users and 3767 (3481-4053) synthetic drug only users initiated poly-drug use in 2000. We observed a cross-over in 2012 where more synthetic drug-only users were initiating heroin use than heroin-only users initiating synthetic drug use. There will be estimated 2,094,052 (1,819,830-2,368,274) synthetic drug-only users and poly-drug users 211,407 (177,150-245,664) in 2030. CONCLUSIONS Synthetic drug use will become dominant in drug users in China, but poly-drug use of both heroin and synthetic drugs will remain substantial.
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Pan M, Wang X, Zhao Y, Liu W, Xiang P. A retrospective analysis of data from forensic toxicology at the Academy of Forensic Science in 2017. Forensic Sci Int 2019; 298:39-47. [DOI: 10.1016/j.forsciint.2019.02.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/18/2019] [Accepted: 02/23/2019] [Indexed: 12/28/2022]
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Wang YG, Shen ZH, Wu XC. Detection of patients with methamphetamine dependence with cue-elicited heart rate variability in a virtual social environment. Psychiatry Res 2018; 270:382-388. [PMID: 30300868 DOI: 10.1016/j.psychres.2018.10.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 09/24/2018] [Accepted: 10/01/2018] [Indexed: 01/05/2023]
Abstract
In the present study, we developed a methamphetamine (METH)-related virtual social environment to elicit subjective craving and physiological reactivity. Sixty-one male patients who were abstinent from METH use and 45 age-matched healthy males (i.e., normal controls) were recruited. The physiological electrocardiogram (ECG) signals were recorded before (resting-state condition) and during viewing of a METH-cue video in the virtual environment (cue-induced condition). The cue-induced subjective craving was measured with a visual analogue scale (VAS) for patients with METH dependence. The results indicated that the cue-induced condition elicited significant differences in heart rate variability (HRV) between patients with METH dependence and normal controls. The changes of HRV indexes on time domain and non-linear domain from the resting-state condition to the cue-induced condition were positively correlated with the score on VAS of METH craving. Using a supervised machine learning algorithm with the features extracted from HRV changes, our results showed that the discriminant model provided a high predictive power for distinguishing patients with METH dependence from normal controls. Our findings support that immersing subjects with METH dependence in a METH-related virtual social environment can successfully induce physiological reactivity, and cue-induced physiological signal changes may have a potential implication in clinical practice.
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Affiliation(s)
- Yong-Guang Wang
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, Zhejiang Province 310013, China; Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang Province, China; Zhejiang provincial Institute of Detoxification Research, Hangzhou, Zhejiang Province, China.
| | - Zhi-Hua Shen
- Department of Brain Functioning Research, The Seventh Hospital of Hangzhou, 305 Tianmushan Road, Hangzhou, Zhejiang Province 310013, China; Clinical Institute of Mental Health in Hangzhou, Anhui Medical University, Hangzhou, Zhejiang Province, China; Zhejiang provincial Institute of Detoxification Research, Hangzhou, Zhejiang Province, China
| | - Xuan-Chen Wu
- Hangzhou Seventh Science and Technology Co., Ltd, Hangzhou, Zhejiang Province, China
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Liu L, Chui WH, Chai X. A qualitative study of methamphetamine initiation among Chinese male users: Patterns and policy implications. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 62:37-42. [DOI: 10.1016/j.drugpo.2018.08.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 07/29/2018] [Accepted: 08/10/2018] [Indexed: 11/28/2022]
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Su S, Zhang L, Cheng F, Li S, Li S, Jing J, Fairley CK, Chen L, Zhao J, Mao L. Association between recreational drug use and sexual practices among people who inject drugs in Southwest China: a cross-sectional study. BMJ Open 2018; 8:e019730. [PMID: 29961003 PMCID: PMC6042564 DOI: 10.1136/bmjopen-2017-019730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To describe the differences in sexual practices among individuals with various drug administration patterns. SETTING A detoxification centre in Southwest China, a part of the Chinese national sentential surveillance network for hepatitis C virus (HCV), HIV and syphilis infections, was recruited. PARTICIPANTS A total of 610 newly enrolled injection drug users (IDUs) from detoxification centre were included during 2015. PRIMARY AND SECONDARY OUTCOME MEASURES Self-reported sexual activities, drug-related practices and laboratory-confirmed HCV, HIV and syphilis infection status were collected. RESULTS Of the 610 IDU, 295 (48.4%) used heroin only, 277 (45.4%) poly-drug users reported the mixed use of synthetic drugs (SDs) with heroin and 38 (6.2%) used SDs only. The average daily drug injection frequency for poly-drug users (3.3±1.2 times) was the highest, followed by heroin-only (2.2±0.8 times) and SD-only users (1.2±0.4 time). SD-only drug users reported the highest proportion (86.8%) of engaging in sexual activities in the previous month, with more than half (54.5%) reporting any condomless sex. A higher frequency of daily injecting in heroin-only users was significantly correlated with the less likelihood of sex, condomless sex in the past month, having sex with fixed partners, condomless commercial sex in the previous 12 months (all p<0.01). In poly-drug users, who injected drugs two times per day was associated with the highest proportion of people who engaged in sex and commercial sex (p<0.05). For SD-only users, increased drug use was not associated with reducing sexual risk (p>0.05). Different patterns of HCV, HIV and syphilis infections prevalence rates were shown among the IDU depending on the roles and length of exposure. CONCLUSIONS The daily drug injecting frequency of heroin-only and poly-drug users was negatively associated with sexual activities, but SD-only users kept a high frequent engagement in sex. The interventions for relevant diseases should adapt to characteristics of IDU.
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Affiliation(s)
- Shu Su
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Lei Zhang
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Research Center for Public Health, Tsinghua University, Beijing, China
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Feng Cheng
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Shunxiang Li
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Shifu Li
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Jun Jing
- Research Center for Public Health, Tsinghua University, Beijing, China
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Christopher Kincaid Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Liang Chen
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Jinxian Zhao
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Limin Mao
- Center for Social Research in Health, Faculty of Arts and Social Science, University of New South Wales, Sydney, New South Wales, Australia
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Zhang S, Hu Q, Tang T, Liu C, Li C, Zang YY, Cai WX. Changes in Gray Matter Density, Regional Homogeneity, and Functional Connectivity in Methamphetamine-Associated Psychosis: A Resting-State Functional Magnetic Resonance Imaging (fMRI) Study. Med Sci Monit 2018; 24:4020-4030. [PMID: 29897049 PMCID: PMC6030991 DOI: 10.12659/msm.905354] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Using regional homogeneity (ReHo) blood oxygen level-dependent functional MR (BOLD-fMRI), we investigated the structural and functional alterations of brain regions among patients with methamphetamine-associated psychosis (MAP). Material/Methods This retrospective study included 17 MAP patients, 16 schizophrenia (SCZ) patients, and 18 healthy controls. Informed consent was obtained from all patients before the clinical assessment, the severity of clinical symptoms was evaluated prior to the fMRI scanning, and then images were acquired and preprocessed after each participant received 6-min fRMI scanning. The participants all underwent BOLD-fMRI scanning. Voxel-based morphometry was used to measure gray matter density (GMD). Resting-state fMRI (rs-fMRI) was conducted to analyze functional MR, ReHo, and functional connectivity (FC). Results GMD analysis results suggest that MAP patients, SCZ patients, and healthy volunteers show different GMDs within different brain regions. Similarly, the ReHo analysis results suggest that MAP patients, SCZ patients, and healthy volunteers have different GMDs within different brain regions. Negative correlations were found between ReHo- and the PANSS-positive scores within the left orbital interior frontal gyrus (L-orb-IFG) of MAP patients. ReHo- and PANSS-negative scores of R-SFG were negatively correlated among SCZ patients. The abnormal FC of R-MFG showed a negative correlation with the PANSS score among MAP patients. Conclusions The abnormalities in brain structure and FC were associated with the development of MAP.
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Affiliation(s)
- Shengyu Zhang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, Shanghai, China (mainland)
| | - Qiang Hu
- Department of Psychology, Qiqihar Mental Health Center, Qiqihar, Heilongjiang, China (mainland)
| | - Tao Tang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, Shanghai, China (mainland)
| | - Chao Liu
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, Shanghai, China (mainland)
| | - Chengchong Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, China (mainland)
| | - Yin-Yin Zang
- Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, PA, USA
| | - Wei-Xiong Cai
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, Shanghai, China (mainland)
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Zang F, Yue M, Zhuo L, Wu J, Liu M, Yao Y, Wang J, Feng Y, Xia X, Huang P, Yu R. Association of CXCR2 genotype variations with HCV clearance in a Chinese population. Arch Virol 2018; 163:2711-2718. [PMID: 29948377 DOI: 10.1007/s00705-018-3872-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 03/12/2018] [Indexed: 12/21/2022]
Abstract
Chemokines are known to play a vital role in guiding and regulating the immune response to viral infections. The chemokine CXC subfamily is a major subfamily in the chemokine family. Outcomes of hepatitis C virus (HCV) infection, as well as the response to treatment, depend on virus and host factors. Here we recruited chronic hepatitis C (CHC) patients to perform an association study between three single nucleotide polymorphisms (SNPs) (CXCR2 rs1126579, CXCL10 rs8878 and CXCL10 rs3921) and HCV infection outcomes and treatment responses among a Chinese population, using primarily a TaqMan assay. Multivariate logistic regression analysis was performed to identify the influencing factors on HCV infection outcome and treatment response. The results showed that subjects with the CXCR2 rs1126579 TT genotype had a significantly increased possibility of HCV spontaneous clearance (Dominant model: adjusted OR = 1.32, 95% CI = 1.06-1.64; P = 0.013). Additionally, CHC patients carrying the CXCR2 rs1126579 TT genotype were also more likely to achieve a sustained virological response (SVR) (Dominant model: adjusted OR = 0.49, 95% CI = 0.29-0.84; P = 0.010). We also established a predictive model for HCV treatment response including the CXCR2 rs1126579 SNP status, albumin (ALB) levels and baseline HCV RNA levels, which produced an area under the curve (AUC) of about 0.660. These findings highlight that variant CXCR2 rs1126579 genotypes are associated with HCV clearance within the Chinese population.
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Affiliation(s)
- Feng Zang
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Ming Yue
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Lingyun Zhuo
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Jingjing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Mei Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Yinan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Jie Wang
- Department of Basic and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Peng Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China.
| | - Rongbin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Key Laboratory of Infectious Diseases, Nanjing Medical University, Nanjing, 211166, China.
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Zhang J, Yan P, Li Y, Cai X, Yang Z, Miao X, Chen B, Li S, Dang W, Jia W, Zhu Y. A 35.8 kilobases haplotype spanning ANKK1 and DRD2 is associated with heroin dependence in Han Chinese males. Brain Res 2018; 1688:54-64. [DOI: 10.1016/j.brainres.2018.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/07/2018] [Accepted: 03/13/2018] [Indexed: 02/07/2023]
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Ma J, Li XD, Wang TY, Li SX, Meng SQ, Blow FC, Ilgen M, Degenhardt L, Lappin J, Wu P, Shi J, Bao YP, Lu L. Relationship between the duration of methamphetamine use and psychotic symptoms: A two-year prospective cohort study. Drug Alcohol Depend 2018; 187:363-369. [PMID: 29715654 DOI: 10.1016/j.drugalcdep.2018.03.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/22/2018] [Accepted: 03/25/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Psychosis is a key harm associated with methamphetamine (MA) use. This study examined the relationship between the duration of MA use and risk of psychotic symptoms. METHODS A cohort of 528 individuals with chronic MA use was followed for two years after leaving treatment center in Guangdong, China. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale at baseline and four follow-up visits (6, 12, 18 and 24 months after baseline). MA use during the past six months was investigated at each assessment. Generalized Estimating Equations for longitudinal panel data were developed to examine the risk of MA-associated psychotic symptoms among individuals with different durations of MA use. 340 MA users who completed at least one follow-up were included in the analysis. RESULTS During 6-month intervals, participants who reported MA use showed a two-fold increase in the risk of psychotic symptoms compared to those with no MA use (odds ratio [OR] = 2.15, 95% confidence interval [CI] = 1.33-3.49). A dose-response effect was found between the duration of MA use and the risk of psychotic symptoms (continued 12-month MA use vs. no use: OR = 2.84, 95% CI = 1.39-5.77; continued 18-month MA use vs. no use: OR = 9.93, 95% CI = 3.58-27.57). There was no assessment for 24-month intervals due to a small sample size of the continuous use group. CONCLUSIONS Longer periods of MA use predicted a higher risk of experiencing psychotic symptoms. Early prevention of MA use could help reduce the risk of psychosis in MA users.
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Affiliation(s)
- Jun Ma
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China; School of Public Health, Peking University, Beijing, 100191, China
| | - Xiao-Dong Li
- Zhuhai Jinding Vocabulary Rehabilitation Hospital, Zhuhai, Guangdong, 519085, China
| | - Tong-Yu Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China; School of Public Health, Peking University, Beijing, 100191, China
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Frederic C Blow
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Mark Ilgen
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Julia Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China; Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing, 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100191, China.
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Li Z, Yang J, Wu Y, Pan Z, He X, Li B, Zhang L. Challenges for the surgical capacity building of township hospitals among the Central China: a retrospective study. Int J Equity Health 2018; 17:55. [PMID: 29720175 PMCID: PMC5932883 DOI: 10.1186/s12939-018-0766-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/16/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND China's rapid transition in healthcare service system has posed considerable challenges for the primary care system. Little is known regarding the capacity of township hospitals (THs) to deliver surgical care in rural China with over 600 million lives. We aimed to ascertain its current performance, barriers, and summary lessons for its re-building in central China. METHODS This study was conducted in four counties from two provinces in central China. The New Rural Cooperative Medical System (NRCMS) claim data from two counties in Hubei province was analyzed to describe the current situation of surgical care provision. Based on previous studies, self-administered questionnaire was established to collect key indicators from 60 THs from 2011 to 2015, and social and economic statuses of the sampling townships were collected from the local statistical yearbook. Semi-structured interviews were conducted among seven key administrators in the THs that did not provide appendectomy care in 2015. Determinants of appendectomy care provision were examined using a negative binominal regression model. RESULTS First, with the rapid increase in inpatient services provided by the THs, their proportion of surgical service provision has been nibbled by out-of-county facilities. Second, although DY achieved a stable performance, the total amount of appendectomy provided by the 60 THs decreased to 589 in 2015 from 1389 in 2011. Moreover, their proportion reduced to 26.77% in 2015 from 41.84% in 2012. Third, an increasing number of THs did not provide appendectomy in 2015, with the shortage of anesthesiologists and equipment as the most mentioned reasons (46.43%). Estimation results from the negative binomial model indicated that the annual average per capita disposable income and tightly integrated delivery networks (IDNs) negatively affected the amount of appendectomy provided by THs. By contrast, the probability of appendectomy provision by THs was increased by performance-related payment (PRP). Out-of-pocket (OOP) cost gap of appendectomy services between the two different levels of facilities, payment method, and the size of THs presented no observable improvement to the likelihood of appendectomy care in THs. CONCLUSION The county-level health system did not effectively respond to the continuously increasing surgical care need. The surgical capacity of THs declined with the surgical patterns' simplistic and quantity reduction. Deficits and critical challenges for surgical capacity building in central China were identified, including shortage of human resources and medical equipment and increasing income. Moreover, tight IDNs do not temporarily achieve capacity building. Therefore, the reimbursement rate should be further ranged, and physicians should be incentivized appropriately. The administrators, policy makers, and medical staff of THs should be aware of these findings owing to the potential benefits for the capacity building of the rural healthcare system.
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Affiliation(s)
- Zhong Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
| | - Jian Yang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
- Department of Medical Affairs, Guangdong General Hospital, Guangzhou, 510080 Guangdong China
| | - Yue Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
| | - Zijin Pan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
| | - Xiaoqun He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
| | - Boyang Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District Wuhan, Hubei, 430030 China
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Su S, Mao L, Zhao J, Chen L, Jing J, Cheng F, Zhang L. Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China. Sci Rep 2018; 8:6615. [PMID: 29700352 PMCID: PMC5919913 DOI: 10.1038/s41598-018-25038-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/28/2018] [Indexed: 11/18/2022] Open
Abstract
The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8–3.4]; 2.3, [1.6–3.1]) and syphilis infection (AOR = 4.1, [2.1–6.9]; 3.9, [1.8–5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.
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Affiliation(s)
- Shu Su
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Limin Mao
- Center for Social Research in Health, Arts and Social Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Jinxian Zhao
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Liang Chen
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Jun Jing
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Feng Cheng
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
| | - Lei Zhang
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China. .,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
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Ma J, Sun XJ, Wang RJ, Wang TY, Su MF, Liu MX, Li SX, Han Y, Meng SQ, Wu P, Shi J, Bao YP, Lu L. Profile of psychiatric symptoms in methamphetamine users in China: Greater risk of psychiatric symptoms with a longer duration of use. Psychiatry Res 2018; 262:184-192. [PMID: 29453037 DOI: 10.1016/j.psychres.2018.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/31/2017] [Accepted: 02/02/2018] [Indexed: 11/17/2022]
Abstract
Chronic methamphetamine (MA) use is associated with psychiatric symptoms. This study explored pattern of co-occurring psychiatric symptoms in MA users and their relationship to duration of MA use. A cross-sectional study was conducted among MA users at the Shenzhen Compulsory Drug Detoxification Center from April 2012 to October 2015. The Positive and Negative Syndrome Scale, Hamilton Anxiety Scale, and Beck Depression Inventory were used to assess psychiatric symptoms. Among 1277 MA users, 57.6% participants had any type of psychiatric symptoms including depressive, anxiety and psychotic symptoms. A dose-response relationship was found between duration of MA use and risk of psychiatric symptoms. The odds ratios (OR) of depressive symptoms increased with the duration of MA use (1-5 years vs. < 1 year: 1.74 [95% CI, 1.24-2.42]; ≥ 5 years vs. < 1 year: 2.07 [1.19-3.61]), so did the ORs of co-occurring anxiety and depressive symptoms (1-5 years: 1.74 [1.20-2.51]; ≥ 5 years: 3.09 [1.76-5.40]). Methamphetamine-dependent individuals were four-times more likely to experience any type of psychiatric symptoms than non-dependent users. The prevalence of psychiatric symptoms was high in chronic MA users and increased with MA use duration. Early prevention and treatment strategies targeting both MA use and associated psychiatric symptoms are needed.
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Affiliation(s)
- Jun Ma
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Xin-Jun Sun
- Shenzhen Compulsory Drug Rehabilitation Center, Shenzhen, Guangdong 518019, China
| | - Ru-Jia Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Tong-Yu Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Meng-Fan Su
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Mo-Xuan Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, 2052, Australia.
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China.
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Chen WT, Shiu C, Yang JP, Li CSR, Wang K, Zhang L, Zhang J, Bao M, Aung MN, Chen LC, Zhao H, Lu H. Substance use, anxiety, and self-management efficacy in HIV-positive individuals: A mediation analysis. JOURNAL OF SUBSTANCE USE 2018; 23:408-414. [PMID: 30906222 DOI: 10.1080/14659891.2018.1436603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Context In China, the social stigma of both substance use and HIV remains major barriers. HIV+ individuals have been demonstrated to have higher psychosocial distress in the literature. To ensure quality of life among HIV+ Chinese individuals, self-efficacy in HIV-related management including substance use and anxiety is the key to suppress viral load and maintain healthy lives. Objectives We examine the mediation relationship among substance use, anxiety, and self-management efficacy. Method A cross-sectional study design was used. 137 HIV+ individuals were recruited from two premier Chinese hospitals: Beijing's Ditan Hospital and Shanghai's Public Health Clinic Center (SPHCC). Results HIV+ substance users had significantly lower HIV-management efficacy and higher anxiety scores. About a third of the relations between substance use and anxiety was mediated by HIV-management self-efficacy. Those who used substances in the previous week had higher anxiety levels suggesting the presence of a recent effect. Their higher levels of anxiety could be largely explained by their lower HIV-management efficacy. Conclusion It is useful for healthcare providers to assess substance use behaviors in HIV+ individuals as well as provide support in managing anxiety in this population. Meanwhile, enhancing self-management efficacy to ensure healthy lifestyles may support achieving optimal lives with HIV.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA
| | - Chengshi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA
| | - Joyce P Yang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Chiang-Shan Ray Li
- Psychiatry and of Neuroscience, School of Medicine, Yale University, New Haven, CT
| | - Kerong Wang
- Ditan Hospital, Capital Medical University, Beijing, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jing Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Meijuan Bao
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | | | - Li-Chen Chen
- National Cheng Kung University, School of Nursing, Tainan, Taiwan
| | - Hongxin Zhao
- Ditan Hospital, Capital Medical University, Beijing, China
| | - Hongzhou Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Gray matter volume showed dynamic alterations in methamphetamine users at 6 and 12months abstinence: A longitudinal voxel-based morphometry study. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:350-355. [PMID: 28887180 DOI: 10.1016/j.pnpbp.2017.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/01/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Previous studies have demonstrated brain gray matter reduction in methamphetamine (MA) users; however, little is known about longitudinal brain structural alternations during abstinence. METHOD Brain volumes were compared among 30 MA-dependent patients (average 6.3years of drug use) at 6months' abstinence and 27 drug-naïve controls by voxel-based morphometry. A longitudinal analysis of MA subjects was performed from 6 to 12months' abstinence, and multiple regression analyses were performed between drug use patterns and gray matter volumes (GMV) at 6months' abstinence. RESULTS Compared with drug-naïve subjects, subjects with 6months' abstinent of MA showed significantly lower GMV in the precentral gyrus, caudate head, fusiform gyrus, and cerebellum. Compared to 6months' abstinence, GMV was greater in the cerebellum and lower in the cingulate gyrus at 12months' abstinence. Accumulated years of MA use negatively correlated with GMV in the right superior frontal gyrus, the right superior temporal cortex, and the right caudate nucleus (significant at the whole brain level, p<0.001; FWE cluster-corrected p<0.05). CONCLUSION The present study suggested that heavy MA users' GMV could show dynamic alterations in different brain regions at different time lengths of abstinence.
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Duan C, Wei L, Cai Y, Chen L, Yang Z, Tan W, Gan Y, Au WW, Zhao J. Recreational drug use and risk of HIV infection among men who have sex with men: A cross-sectional study in Shenzhen, China. Drug Alcohol Depend 2017; 181:30-36. [PMID: 29031090 DOI: 10.1016/j.drugalcdep.2017.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/03/2017] [Accepted: 09/06/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recreational drug use has increased in recent years, especially among MSM, and has been found to be associated with higher risk of HIV infection. However, there is limited information about current recreational drug use among MSM in Shenzhen which is an international gateway city to China with a rapidly expanding MSM population. METHODS A cross-sectional survey among MSM in Shenzhen was conducted and was used to collected information on demographics, sexual behavior and drug use via questionnaires. Serologic results on HIV and syphilis were obtained from laboratory assays. We performed logistic regression analysis to evaluate correlates with drug use. RESULTS Among the 1935 MSM surveyed, 12.7% reported use of recreational drugs in the past six months. Rush poppers had become the most frequently used drug (10.6%). Risk factors associated with the use of recreational drugs included being unmarried, non-Han ethnicity, having high education level, seeking male sex partners via the internet, having multiple male sex partners, performing receptive role during anal sex, and having unprotected anal intercourse. Recreational drug use was significantly associated with higher risk of both HIV and syphilis infections (aOR:1.89, 95% CI:1.28-2.79; aOR:1.79, 95% CI:1.25-2.60, respectively). CONCLUSIONS Recreational drug use is associated with increased risk of HIV and syphilis infections among MSM in Shenzhen. Rush poppers were the most popular recreational drug. This finding suggests the need for targeted prevention and behavioral intervention programs to control the recreational drug use, and to reduce HIV and other sexually transmitted diseases among MSM in Shenzhen and internationally.
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Affiliation(s)
- Chenlin Duan
- Department of Preventive Medicine and MPH Education Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Lan Wei
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Yitian Cai
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Lin Chen
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Zhengrong Yang
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Wei Tan
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - Yongxia Gan
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
| | - William W Au
- Department of Preventive Medicine and MPH Education Center, Shantou University Medical College, Shantou, Guangdong, China; University of Medicine and Pharmacy, Tirgu Mures, Romania
| | - Jin Zhao
- Shenzhen Center for Disease Control and Prevention, Guangdong, China
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Liu C, Liu PL, Dong QL, Luo L, Xu J, Zhou W, Wang X. Social-demographic shift in drug users at the first-ever- methadone maintenance treatment in Wuhan, China. Sci Rep 2017; 7:11446. [PMID: 28904357 PMCID: PMC5597614 DOI: 10.1038/s41598-017-11888-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 08/31/2017] [Indexed: 11/09/2022] Open
Abstract
The methadone maintenance treatment (MMT) has been initiated in Wuhan, China since early 2006. To understand the social-demographic, behavioral, and infectious diseases characteristics of drug users enrolled in their first-ever-MMT between 2006 and 2015, a retrospective observational study was implemented to also provide evidence for health policy-decisions to reduce harm and control disease. Pearson chi-square tests and t-tests were used to assess significant differences between two 5-year periods, 2006-2010 and 2011-2015. We observed increases in the mean age (38.65 vs. 42.43 years, P < 0.001), mean age of initial opioid drug use (28.18 vs. 31.07 years, P < 0.001), employment (11.9% vs. 30.7%, P < 0.001), married/co-habiting (42.4% vs. 47.8%, P < 0.001), and declines in higher education level (93.6% vs. 84.8%, P < 0.001), injection (82.3% vs. 75.1%, P < 0.001), syringe sharing (27.7% vs. 9.9%, P < 0.001), HCV infection rates (72.9% vs. 70.5%, P = 0.017). The number of drug users enrolling each year reduced following a continuous rapid growth in the first 3 years. The findings imply for adjusting in treatment services and allocation of resources to respond to emerging trends. In addition, the data will also be helpful for identifying needs and getting a baseline insight of the social-demographic and behavioral characteristics of the opioid abusers in the area.
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Affiliation(s)
- Cong Liu
- Wuhan centers for disease prevention and control, Hubei province, China
| | - Pu-Lin Liu
- Wuhan centers for disease prevention and control, Hubei province, China
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College,, Huazhong University of Science and Technology, Hubei province, China
| | - Quan-Lin Dong
- Wuhan centers for disease prevention and control, Hubei province, China
| | - Li Luo
- Wuhan centers for disease prevention and control, Hubei province, China
| | - Jun Xu
- Wuhan centers for disease prevention and control, Hubei province, China
| | - Wang Zhou
- Wuhan centers for disease prevention and control, Hubei province, China
| | - Xia Wang
- Wuhan centers for disease prevention and control, Hubei province, China.
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Sun Y, Guo W, Li G, He S, Lu H. Increased synthetic drug abuse and trends in HIV and syphilis prevalence among female drug users from 2010-2014 from Beijing, China. Int J STD AIDS 2017; 29:30-37. [PMID: 28697679 DOI: 10.1177/0956462417715174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to monitor the trend of addiction drug use and its relationship with sexually transmitted infections (STIs) among female drug users (FDUs). Serial cross-sectional surveys were conducted during 2010-2014 among FDUs in Beijing to collect information on addiction drug usage, sexual behaviors, and STI prevalence. Characteristics were analyzed and compared between traditional and synthetic drug users among FDUs by logistic regression method. A total of 3859 FDUs were surveyed during 2010-2014, with the median age being 32.7 years old. The proportion of synthetic drug users among FDUs increased from 43.7% in 2010 to 70.7% in 2014. Compared with traditional drug users, synthetic drug users were younger (P < 0.001), lacked education (P < 0.001), were unmarried (P < 0.001), and were non-local residents (P < 0.001). No significant difference was found with condom usage during sexual activity between traditional and synthetic drug FDUs. However, the engagement of commercial sexual activities (P < 0.001) and syphilis prevalence (P < 0.001) among synthetic drug users were significantly higher than traditional drug users. Synthetic drug abuse appears to be correlated with commercial sex behavior and higher syphilis prevalence among FDUs. Tailored strategies on health education to curb the prevalence of synthetic drug abuse are urgently needed in Beijing.
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Affiliation(s)
- Yanming Sun
- 1 Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Wei Guo
- 2 Division of Epidemiology, 196543 National Center for AIDS/STD Control and Prevention , Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guiying Li
- 1 Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Shufang He
- 1 Beijing Center for Diseases Prevention and Control, Beijing, China
| | - Hongyan Lu
- 1 Beijing Center for Diseases Prevention and Control, Beijing, China
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Mdege ND, Meader N, Lloyd C, Parrott S, McCambridge J. The Novel Psychoactive Substances in the UK Project: empirical and conceptual review work to produce research recommendations. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundAlthough illegal drug use has largely been declining in the UK over the past decade, this period has witnessed the emergence of a range of novel psychoactive substances (NPS) (‘legal highs’). These are new, mostly synthetic, substances that mimic the effects of existing drugs). Despite there being many causes for concern in relation to NPS, there has been little prior study of the burden associated with their use in public health terms. Clarity is lacking on research priorities in this rapidly developing literature.ObjectivesTo inform the development of public health intervention research on NPS by reviewing existing data on their use, associated problems and potential responses to such problems.DesignA scoping review and narrative synthesis of selected bodies of evidence was undertaken to summarise and evaluate what is known about NPS use and the related harms of, and responses to, such use. Relevant literature was identified from electronic databases (covering January 2006 to June 2016 inclusive), Google (Google Inc., Mountain View, CA, USA), relevant websites and online drug forums and by contacting experts. Articles were included if they were primary studies, secondary studies involving the analysis and interpretation of primary research or discussion papers. A conceptual framework postulating an evidence-informed public health approach to NPS use in the UK was developed through a pragmatic literature review, the iterative development of concepts and finalisation in light of the results from the empirical review work. The process also involved feedback from various stakeholders. Research recommendations were developed from both strands of work.ResultsA total of 995 articles were included in the scoping review, the majority of which related to individual-level health-related adverse effects attributable to NPS use. The prevalence of lifetime NPS use varied widely between (e.g. with higher prevalence in young males) and within population subgroups. The most commonly reported adverse effects were psychiatric/other neurological, cardiovascular, renal and gastrointestinal manifestations, and there is limited evidence available on responses. In these and other respects, available evidence is at an early stage of development. Initial evidence challenges the view that NPS should be treated differently from other illicit drugs. The conceptual framework indicated that much of the evidence that would be useful to inform public health responses does not yet exist. We propose a systems-based prevention approach that develops existing responses, is multilevel and life course informed in character, and emphasises commonalities between NPS and other legal and illegal drug use. We make 20 recommendations for research, including nine key recommendations.LimitationsScoping reviews do not interrogate evidence in depth, and the disjunction between the scoping review and the conceptual framework findings is worthy of careful attention.ConclusionsKey research recommendations build on those that have previously been made and offer more evidence-based justification and detail, as previous recommendations have not yet been acted on. The case for decision-making on commissioning new research based on these recommendations is both strong and urgent.Future workThe validity of recommendations generated through this project could be enhanced via further work with research commissioners, policy-makers, researchers and the public.Study registrationThe systematic review element of this study is registered as PROSPERO CRD42016026415.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
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Lin C, Cao X, Li L. Psychoactive Substance Use among Methadone Maintenance Therapy Clients in China. Int J Ment Health Addict 2017; 15:801-811. [PMID: 28761409 DOI: 10.1007/s11469-017-9758-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
A proportion of methadone maintenance therapy (MMT) clients in China shifted their substance use habit from opiate to psychoactive substances. The objective of this study was to examine the pattern and associated factors of psychoactive substance use among MMT clients. The study was conducted among 2,448 clients from 68 MMT clinics of China. The type and frequency of psychoactive substance use were self-reported. About 38.1% (N=933) of the participants reported psychoactive substance use in lifetime, and 6.5% (N=158) in the previous 30 days. The most commonly used psychoactive substances were sedative/hypnotic/antidiarrheal agent and amphetamine. Psychoactive substance use in the past 30 days was correlated with younger age, recent heroin use, having psychoactive substance using friend(s), and depressive symptoms. The finding suggested that urinalysis of psychoactive substances should be routinely administered in the MMT clinics. Young clients, concurrent heroin users, and clients with depressive symptoms deserve more screening and intervention efforts.
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Affiliation(s)
- Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, U.S.A
| | - Xiaobin Cao
- National Center for AIDS Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Li
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, U.S.A
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Using Monte Carlo simulation to assess uncertainty and variability of methamphetamine use and prevalence from wastewater analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 36:1-7. [DOI: 10.1016/j.drugpo.2016.06.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/27/2016] [Accepted: 06/13/2016] [Indexed: 01/30/2023]
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