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Schutz C, Smout MF. Effects of Positive versus Negative Framing on Stigma toward Individuals Recovering from Methamphetamine Use Disorder during Randomized Brief Video Exposure. J Psychoactive Drugs 2024; 56:88-96. [PMID: 36417295 DOI: 10.1080/02791072.2022.2149436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/24/2022] [Accepted: 10/07/2022] [Indexed: 11/24/2022]
Abstract
Eighty-two Australians (mean age = 30.07; 61% female) were blindly randomized to view either a video edited to depict a positive or negative presentation of individuals in recovery from methamphetamine use disorder. Participants completed the Social Distance Scale for Substance Users, Dangerousness Scale for Substance Users and Affect Scale for Substance Users before and after video exposure. Following video exposure, those exposed to the positive video portrayal reported lower desire for social distance (p < .001), lower perceptions of dangerousness (p = .011), and more favorable affective reactions (p < .001). Participants' previous level of contact with the target group did not predict baseline stigma or moderate the experimental effect. Participants' qualitative responses to the experiment were assessed via content analysis and indicated mainly positive or ambivalent attitudes, unchanged by the video; however, 18% of those receiving the positive video reported attitudes becoming more sympathetic/favorable. Findings suggest that media depictions which include people with methamphetamine use disorder displaying friendliness and recovery narratives may improve community perceptions of people recovering from methamphetamine use disorder, and conversely, unsmiling portrayals focusing on harm done to others increases desire for social distance and perceived dangerousness.
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Affiliation(s)
- C Schutz
- Justice and Society, University of South Australia, Adelaide, Australia
| | - M F Smout
- Justice and Society, University of South Australia, Adelaide, Australia
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2
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Hersi M, Corace K, Hamel C, Esmaeilisaraji L, Rice D, Dryburgh N, Skidmore B, Garber G, Porath A, Willows M, MacPherson P, Sproule B, Flores-Aranda J, Dickey C, Hutton B. Psychosocial and pharmacologic interventions for problematic methamphetamine use: Findings from a scoping review of the literature. PLoS One 2023; 18:e0292745. [PMID: 37819931 PMCID: PMC10566716 DOI: 10.1371/journal.pone.0292745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023] Open
Abstract
RATIONALE Methamphetamine use and related harms have risen at alarming rates. While several psychosocial and pharmacologic interventions have been described in the literature, there is uncertainty regarding the best approach for the management of methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU). We conducted a scoping review of recent systematic reviews (SR), clinical practice guidelines (CPG), and primary controlled studies of psychosocial and pharmacologic treatments for MUD/PMU. METHODS Guided by an a priori protocol, electronic database search updates (e.g., MEDLINE, Embase) were performed in February 2022. Screening was performed following a two-stage process, leveraging artificial intelligence to increase efficiency of title and abstract screening. Studies involving individuals who use methamphetamine, including key subgroups (e.g. those with mental health comorbidities; adolescents/youths; gay, bisexual, and other men who have sex with men) were sought. We examined evidence related to methamphetamine use, relapse, use of other substances, risk behaviors, mental health, harms, and retention. Figures, tables and descriptive synthesis were used to present findings from the identified literature. RESULTS We identified 2 SRs, one CPG, and 54 primary studies reported in 69 publications that met our eligibility criteria. Amongst SRs, one concluded that psychostimulants had no effect on methamphetamine abstinence or treatment retention while the other reported no effect of topiramate on cravings. The CPG strongly recommended psychosocial interventions as well as self-help and family support groups for post-acute management of methamphetamine-related disorders. Amongst primary studies, many interventions were assessed by only single studies; contingency management was the therapy most commonly associated with evidence of potential effectiveness, while bupropion and modafinil were analogously the most common pharmacologic interventions. Nearly all interventions showed signs of potential benefit on at least one methamphetamine-related outcome measure. DISCUSSION This scoping review provides an overview of available interventions for the treatment of MUD/PMU. As most interventions were reported by a single study, the effectiveness of available interventions remains uncertain. Primary studies with longer durations of treatment and follow-up, larger sample sizes, and of special populations are required for conclusive recommendations of best approaches for the treatment of MUD/PMU.
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Affiliation(s)
- Mona Hersi
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kim Corace
- Ottawa Hospital Research Institute, Ottawa, Canada
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Danielle Rice
- Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Nicole Dryburgh
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | | | - Gary Garber
- Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
- Division of Infectious Diseases, The Ottawa Hospital, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Amy Porath
- Knowledge Institute on Child and Youth Mental Health and Addictions, Ottawa, Canada
| | - Melanie Willows
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Paul MacPherson
- Division of Infectious Diseases, The Ottawa Hospital, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Beth Sproule
- Department of Pharmacy, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Chandlee Dickey
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Brian Hutton
- Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
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3
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He J, Wang R, Li J, Jiang X, Zhou C, Liu J. Effect of transcranial direct current stimulation over the left dorsolateral prefrontal cortex on the aggressive behavior in methamphetamine addicts. J Psychiatr Res 2023; 164:364-371. [PMID: 37406500 DOI: 10.1016/j.jpsychires.2023.06.038] [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] [Received: 02/20/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
Aggressive behavior of drug addicts threatens human security and social stability, and Methamphetamine (MA) addicts show especially aggressive behavior. Researches showed that the decreased activity of dorsolateral prefrontal cortex (DLPFC) is closely related to violence and aggression, and continuous transcranial direct current stimulation (tDCS) on DLPFC can increase the activity of this position. So, the purpose of this study was to investigate the effect of tDCS on DLPFC for the aggressive behavior of MA addicts. Ninety MA addicts were recruited and randomly divided into anodal tDCS group, cathode tDCS group and sham tDCS group (current intensity was set as 2 mA, 2 mA and 0 mA, respectively). The tDCS intervention was conducted twice a day for five consecutive days. Taylor Aggression Paradigm (TAP) was used to measure the proactive aggressiveness and reactive aggressiveness of MA addicts at different time points (Pretest, Day 1, and Day 5). At the same time, we also recruited 30 healthy adult males as healthy controls, and measured their aggressiveness through TAP for comparative analysis. The results showed that the aggressiveness of MA addicts was significantly higher than that of healthy controls. The aggressiveness of MA addicts was effectively reduced by the anode intervention of tDCS on the left DLPFC, especially when they were subjected to high-intensity provocation, the 2-way interaction between time and tDCS group was statistically significant (F4,164 = 2.939, P = 0.022, ηp2 = 0.067). This study can provide a reference for how to correct the aggressive behavior of MA addicts.
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Affiliation(s)
- Jingzhen He
- College of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rufang Wang
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Jiaoyang Li
- College of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoyu Jiang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | | | - Jun Liu
- Drug Rehabilitation Administration of Sichuan Province, Chengdu, China
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O'Malley KY, Hart CL, Casey S, Downey LA. Methamphetamine, amphetamine, and aggression in humans: A systematic review of drug administration studies. Neurosci Biobehav Rev 2022; 141:104805. [PMID: 35926727 DOI: 10.1016/j.neubiorev.2022.104805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/24/2022] [Accepted: 07/30/2022] [Indexed: 10/16/2022]
Abstract
The relationship between amphetamine use and aggressive or violent behaviour is unclear. This review examined laboratory data collected in humans, who were administered an acute dose of amphetamine or methamphetamine, in order to investigate the link between amphetamines and aggression. It is registered with PROSPERO (CRD42019127711). Included in the analysis are data from twenty-eight studies. Behavioural and/or subjective measures of aggression were assessed in one thousand and sixty-nine research participants, with limited amphetamine-use histories, following a single amphetamine dose (0-35mg). The available published evidence indicates that neither amphetamine nor methamphetamine acutely increased aggression as assessed by traditional laboratory measures. Future research should assess supratherapeutic amphetamine doses as well as include a broader range of multiple aggression measures, facilitating simultaneous assessment of the various components that comprise this complex, multifaceted construct.
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Affiliation(s)
- Kate Y O'Malley
- Centre for Human Psychopharmacology, Swinburne University, 427-451 Burwood Road Hawthorn, Victoria, Australia 3122; Department of Psychology, Columbia University, 1190 Amsterdam Avenue, 406 Schermerhorn, MC 5501, New York, NY 10027.
| | - Carl L Hart
- Department of Psychology, Columbia University, 1190 Amsterdam Avenue, 406 Schermerhorn, MC 5501, New York, NY 10027; Division on Substance Use, New York State Psychiatric Institute, and Department of Psychiatry, 1051 Riverside Drive, MC 120, New York, NY 10032
| | - Sharon Casey
- Centre for Human Psychopharmacology, Swinburne University, 427-451 Burwood Road Hawthorn, Victoria, Australia 3122; Centre for Investigative Interviewing, Griffith, 176 Messines Ridge Road, Mount Gravatt, QLD, 4122
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University, 427-451 Burwood Road Hawthorn, Victoria, Australia 3122; Institute for Breathing and Sleep, Austin Hospital, 145 Studley Road Heidelberg, Victoria, Australia 3084
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Pino EC, Fontin F, James TL, Dugan E. Mechanism of penetrating injury mediates the risk of long-term adverse outcomes for survivors of violent trauma. J Trauma Acute Care Surg 2022; 92:511-519. [PMID: 34284465 DOI: 10.1097/ta.0000000000003364] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND While hospital-based violence intervention programs are primarily designed to aid youth victims of gun violence at high risk for reinjury, the root causes and complex outcomes of community violence are varied. In this study, we examined the risk factors for violent penetrating injury and how the risk of adverse outcomes for survivors differs by injury type (stabbing vs. gunshot wound). METHODS This retrospective study was performed using a cohort of patients presenting to the Boston Medical Center emergency department for a penetrating injury due to community violence between 2006 and 2016. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the risk of all-cause mortality and violent reinjury within 3 years after surviving a penetrating injury. RESULTS Of the 4,280 survivors of the initial violent penetrating injury, there were 88 deaths (2.1%) and 568 violent reinjuries (13.3%) within 3 years. Compared with gunshot wound victims, stab wound victims were 31% less likely to be reinjured with a gunshot wound (HR, 0.69; 95% CI, 0.51-0.93), 72% more likely to be reinjured with a stab wound (HR, 1.72; 95% CI, 1.21-2.43), and 49% more likely to be reinjured by assault (HR, 1.49; 95% CI, 1.14-1.94). While survivors of stabbing and firearm injuries were equally at risk for 3-year all-cause mortality, stab wound victims were 3.75 times more likely to die by a drug/alcohol overdose (HR, 3.75; 95% CI, 1.11-20.65). CONCLUSION Patients surviving a stab wound have a significantly higher risk of violent reinjury by stabbing or assault, and risk of death by drug/alcohol overdose. Hospital-based violence intervention programs with similar patient populations should explore options to expand partnerships with drug treatment programs. These results illustrate two distinct populations of victims of violence-gunshot victims and stabbing/assault victims-with separate risk factors and outcomes, mediated by substance use disorder. LEVEL OF EVIDENCE Prognostic and Epidemiologic; level III.
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Affiliation(s)
- Elizabeth C Pino
- From the Boston Violence Intervention Advocacy Program, Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts
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6
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Gooden JR, Petersen V, Bolt GL, Curtis A, Manning V, Cox CA, Lubman DI, Arunogiri S. Maybe It's Not the Meth: Considering Biopsychosocial Contributors to Cognitive Impairment in Methamphetamine Polydrug Use. Front Psychiatry 2022; 13:795400. [PMID: 35237189 PMCID: PMC8882579 DOI: 10.3389/fpsyt.2022.795400] [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: 10/15/2021] [Accepted: 01/19/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE In considering the cognitive harms of methamphetamine (MA) use, there is currently a limited appreciation of the profile of pre-existing, comorbid, or modifiable risk factors for cognitive impairment in individuals with MA-polydrug use who present to clinical services. This is in contrast to the well-recognized evidence in alcohol use groups. The aim of this study was to investigate the biopsychosocial and neuropsychological profiles of MA-polysubstance using individuals reporting cognitive impairment in comparison to an alcohol-using group. METHODS A retrospective file audit was undertaken of individuals who presented for assessment to a specialist addiction neuropsychology service and reported either more than 1 year of heavy MA use as part of a polydrug use history (n = 40) or having only used alcohol (n = 27). Clinical histories including demographic, medical, mental health, substance use, and neuropsychological assessment results were extracted from medical records. Between group comparisons were conducted to explore differences in the MA-polydrug vs. the alcohol group. RESULTS Individuals in the MA-polydrug group were significantly younger, commenced substance use at an earlier age, were more likely to have an offending history, and experienced an overdose than those in the alcohol group. No differences in comorbid neurodevelopmental, psychiatric or acquired brain injury diagnoses were observed between groups. For neuropsychological functioning, significant group differences were observed in overall IQ, semantic verbal fluency, and psychomotor tracking, where individuals in the alcohol group performed significantly worse. CONCLUSIONS Neuropsychological profiles were largely equivalent between groups across cognitive domains, with minor differences in favor of the MA-polydrug group. Relative to the general population, cognitive functioning was reduced for both groups across a range of domains. High rates of comorbid mental health concerns were common across both groups, however, individuals in the MA-polydrug group presented with a higher risk of overall harm from substance use at a significantly younger age which is a unique concern for this group. These findings highlight the importance of considering the biopsychosocial factors, such as age of first use, emotional distress, indirect substance related harms including overdose and blood born virus infection that may be relevant to experiences of cognitive difficulty in MA-polydrug users.
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Affiliation(s)
- James R Gooden
- Turning Point, Eastern Health, Richmond, VIC, Australia.,The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | | | | | - Ashlee Curtis
- Centre for Drug Use, Addictive and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | | | - Dan I Lubman
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Shalini Arunogiri
- Turning Point, Eastern Health, Richmond, VIC, Australia.,Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
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7
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Liu Y, Guo X, Yang B. Age at onset of drug use and aggressive behavior: The role of internal and environmental factors. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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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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9
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Hamel C, Corace K, Hersi M, Rice D, Willows M, Macpherson P, Sproule B, Flores-Aranda J, Garber G, Esmaeilisaraji L, Skidmore B, Porath A, Ortiz Nunez R, Hutton B. Psychosocial and pharmacologic interventions for methamphetamine addiction: protocol for a scoping review of the literature. Syst Rev 2020; 9:245. [PMID: 33099314 PMCID: PMC7585172 DOI: 10.1186/s13643-020-01499-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/04/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Methamphetamine use and harms are rising rapidly. Management of patients with methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU) is challenging, with no clearly established best approach; both psychosocial and pharmacologic interventions have been described. Furthermore, given the diversity of individuals that use methamphetamines, there is a need to assess evidence for treatments for subgroups including youths; gay, bisexual, and other men who have sex with men; individuals with mental health comorbidities; and individuals in correction services. Establishing awareness of the messages regarding treatment from recent clinical practice guidelines (CPG) in the field is also of value. The first study objective will be to establish a greater understanding of the methods, populations, and findings of controlled studies for psychosocial and pharmacologic treatments for MUD and PMU. Investigation of this information can help establish the potential for advanced syntheses of the evidence (such as network meta-analysis) to compare therapies for this condition and to identify gaps related to key populations where more primary research is needed. Summarizing the recommendations regarding treatment of MUD/PMU from recent CPGs and systematic reviews will be an important secondary objective. METHODS A scoping review will be performed. Using the OVID platform, MEDLINE, Embase, PsycINFO, and relevant Cochrane databases from EBM Reviews will be searched (from databases' inception onwards). Eligibility criteria will include individuals described as having MUD or PMU, with designs of interest including randomized trials, non-randomized trials, and controlled cohort studies with three or more months of follow-up; systematic reviews and CPGs will also be sought. Two reviewers (with support from automation tools) will independently screen all citations, full-text articles, and chart data. Different approaches to handling and summarizing the data will be implemented for each type of study design. Tables and graphics will be used to map evidence sources and identify evidence gaps. DISCUSSION This research will enhance awareness of evidence addressing the effects of psychosocial and pharmacologic interventions for MUD/PMU overall and in sub-populations, both in terms of recent CPGs/reviews and primary studies; inspection of the latter will also help establish the feasibility of future syntheses to compare treatments, such as network meta-analysis. SYSTEMATIC REVIEW PROTOCOL REGISTRATION: Open Science Framework ( https://osf.io/9wy8p ).
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Affiliation(s)
- C Hamel
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada
| | - K Corace
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada.,Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - M Hersi
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada
| | - D Rice
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - M Willows
- Substance Use and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.,Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - P Macpherson
- Division of Infectious Diseases, The Ottawa Hospital, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - B Sproule
- Department of Pharmacy, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - G Garber
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.,Public Health Ontario, Toronto, ON, Canada
| | - L Esmaeilisaraji
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada
| | - B Skidmore
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada
| | - A Porath
- Canadian Center on Substance Use and Addiction, Ottawa, ON, Canada
| | | | - B Hutton
- Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada. .,Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada. .,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
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10
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Ronsley C, Nolan S, Knight R, Hayashi K, Klimas J, Walley A, Wood E, Fairbairn N. Treatment of stimulant use disorder: A systematic review of reviews. PLoS One 2020; 15:e0234809. [PMID: 32555667 PMCID: PMC7302911 DOI: 10.1371/journal.pone.0234809] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. METHODS A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as 'core' or 'supplementary' reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. RESULTS Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. CONCLUSIONS The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed.
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Affiliation(s)
- Claire Ronsley
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Seonaid Nolan
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Jano Klimas
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Alex Walley
- Department of General Internal Medicine, Boston Medical Center, Boston, MA, United States of America
- Boston University School of Medicine, Boston, MA, United States of America
| | - Evan Wood
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Nadia Fairbairn
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada
- * E-mail:
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11
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Farrell M, Martin NK, Stockings E, Bórquez A, Cepeda JA, Degenhardt L, Ali R, Tran LT, Rehm J, Torrens M, Shoptaw S, McKetin R. Responding to global stimulant use: challenges and opportunities. Lancet 2019; 394:1652-1667. [PMID: 31668409 PMCID: PMC6924572 DOI: 10.1016/s0140-6736(19)32230-5] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 07/31/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
We did a global review to synthesise data on the prevalence, harms, and interventions for stimulant use, focusing specifically on the use of cocaine and amphetamines. Modelling estimated the effect of cocaine and amphetamine use on mortality, suicidality, and blood borne virus incidence. The estimated global prevalence of cocaine use was 0·4% and amphetamine use was 0·7%, with dependence affecting 16% of people who used cocaine and 11% of those who used amphetamine. Stimulant use was associated with elevated mortality, increased incidence of HIV and hepatitis C infection, poor mental health (suicidality, psychosis, depression, and violence), and increased risk of cardiovascular events. No effective pharmacotherapies are available that reduce stimulant use, and the available psychosocial interventions (except for contingency management) had a weak overall effect. Generic approaches can address mental health and blood borne virus infection risk if better tailored to mitigate the harms associated with stimulant use. Substantial and sustained investment is needed to develop more effective interventions to reduce stimulant use.
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Affiliation(s)
- Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia.
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Population Health Sciences, University of Bristol, Bristol, UK
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Annick Bórquez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Javier A Cepeda
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Robert Ali
- Discipline of Pharmacology, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Lucy Thi Tran
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Jürgen Rehm
- Institute Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, IM Sechenov First Moscow State Medical University, Moscow, Russia
| | - Marta Torrens
- Addiction Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions, Barcelona, Spain
| | - Steve Shoptaw
- Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
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12
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Shahraki G, Sedaghat Z, Fararouei M. Family and social predictors of substance use disorder in Iran: a case-control study. Subst Abuse Treat Prev Policy 2019; 14:17. [PMID: 31060577 PMCID: PMC6501311 DOI: 10.1186/s13011-019-0201-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The problem of substance use disorder in Iran is of great national concern. The aim of this study was to measure the association between substance use disorder and demographic, social and behavioral factors in Yasuj city, located at southwest of Iran. METHODS As the second phase of a previously published study, this case-control study was conducted in 2015-2016 on 362 addicted participants and 207 controls (with no history of substance use disorder). The control group was selected from male hospital visitors in Yasuj city during the same period of selection of the case group. The required information was collected via a self-administered questionnaire. RESULTS Based on the results of multivariate analysis, significant associations were found between the number of sisters (OR = 0.82, 95%CI = 0.68 to 0.99, P = 0.04), history of smoking (ORyes/no = 19.89, 95%CI = 10.02 to 39.49, P < 0.001), leisure time activity (ORwith friends/home = 8.98, 95%CI = 3.99 to 20.19, P < 0.001) and substance use disorder. CONCLUSION This study introduced smoking, number of sisters, education and way of spending leisure time as predictors of substance use disorder. Among these factors, smoking was the most powerful risk factor and spending leisure time with family and having sister were the most powerful preventive factors for substance use disorder.
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Affiliation(s)
- Gholamhossein Shahraki
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Zahra Sedaghat
- Research Center for Health Sciences, Department Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- HIV/AIDs Research Center, Shiraz University of Medical Sciences, Zand Street, Shiraz, 7143854188 Iran
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13
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Wang L, Xu B, Gu Y, Zhu J, Liang Y. The mediating and moderating effects of resilience on the relationship between perceived stress and depression in heroin addicts. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:495-503. [PMID: 30345512 DOI: 10.1002/jcop.22133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/26/2018] [Accepted: 08/26/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to examine the mediating and moderating roles of resilience on the relationship between perceived stress and depression among heroin addicts. A total of 138 heroin addicts completed the measures of perceived stress, resilience, and depression. Correlation analysis indicated that perceived stress was positively associated with depression. Resilience was negatively correlated with perceived stress and depression. Mediation analysis revealed that resilience partially mediated the relationship between perceived stress and depression. However, resilience did not moderate the influence of perceived stress on depression. These findings might provide a better understanding of the mental health among heroin addicts.
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Affiliation(s)
| | - Banghua Xu
- NanJing Normal University
- Shenzhen Polytechnic
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14
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Darke S, Kaye S, Duflou J, Lappin J. Completed Suicide Among Methamphetamine Users: A National Study. Suicide Life Threat Behav 2019; 49:328-337. [PMID: 29444345 DOI: 10.1111/sltb.12442] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Abstract
All Australian cases of methamphetamine-related suicide (2009-2015) retrieved from the National Coronial Information System were examined to determine crude mortality rates, characteristics and circumstances of death, and blood toxicology. There were 300 cases, 18.2% of all methamphetamine-related deaths, and 1.6% of all completed suicides. The mean age was 33.1 years, and 77.0% were male. The crude mortality rate was 1.9 per 106 , with males having a significantly higher rate than females (2.9 vs. 0.9 per 106 ). A quarter were known to have previous suicide attempts, and a history of psychosis was noted in 12.3%. In 40.7% of cases, witnesses described the decedent as having been agitated and/or aggressive immediately prior to the incident. The vast majority (85.3%), and of both sexes (males 87.0%, females 79.7%), used violent methods. Hanging (70.3%) was overwhelmingly the most frequent method among both males (70.1%) and females (71.0%). Prescription medications were frequently present: hypnosedatives (23.6%), antidepressants (19.5%), and antipsychotics (8.4%). Self-poisoning cases were significantly more likely to have antidepressants (odds ratio: 4.2) and opioids (4.9) present, but less likely to have cannabis (0.3). Methamphetamine-related suicide makes a large contribution to methamphetamine-related death and represents a substantial clinical and public health problem.
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Affiliation(s)
- Shane Darke
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Sharlene Kaye
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, NSW Health, Sydney, NSW, Australia
| | - Johan Duflou
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Julia Lappin
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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15
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Hoffmann L, Buchenauer L, Schumann N, Schröder SL, Martin O, Richter M. Improving Rehabilitative Care of Methamphetamine Users in Germany: The Expert's Perspective. QUALITATIVE HEALTH RESEARCH 2019; 29:248-259. [PMID: 30129874 DOI: 10.1177/1049732318792504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Methamphetamine is one of the most frequently used drugs worldwide. In Germany, methamphetamine use has greatly increased in recent years, presenting the rehabilitative treatment system with new challenges. In this study, we identified deficits and possibilities for optimization in the field of medical rehabilitation. A total of 39 interviews and two focus groups with experts along the treatment course of methamphetamine users were conducted. Our analyses indicate that methamphetamine users are more difficult to treat compared with patients who consume other drugs. They are more likely to be associated with problematic characteristics and behaviors than other rehabilitants. Several health care deficits were revealed: too short rehabilitation treatment, no specific or differentiated therapy concepts, lack of capacity for education and vocational training, lack of outpatient options, and insufficient facilities for parents and children. Findings indicate that inadequate rehabilitation is being provided for methamphetamine users in Germany, indicating a need to adapt treatment for this group.
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Affiliation(s)
- Laura Hoffmann
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Lisa Buchenauer
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Nadine Schumann
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | | | - Olaf Martin
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Richter
- 1 Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
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16
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Lee NK, Jenner L, Harney A, Cameron J. Pharmacotherapy for amphetamine dependence: A systematic review. Drug Alcohol Depend 2018; 191:309-337. [PMID: 30173086 DOI: 10.1016/j.drugalcdep.2018.06.038] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Demand for treatment for amphetamine use is increasing internationally. Establishing effective pharmacotherapy provides broader treatment options for people who are dependent on amphetamine and may encourage engagement in evidence-based behavioral treatment. This study aimed to identify medicines that have potential in improving treatment outcomes for people who are dependent on amphetamines. METHODS Medline, PsycINFO, Embase and the Cochrane Database of Systematic Reviews were searched from 1997 to 2012 and again from 2013 to 2016. Studies on medications for amphetamine/methamphetamine dependence treatment were selected and assessed by two independent researchers. A meta-narrative review approach was used to synthesize results. RESULTS A total of 49 studies investigating 20 potential pharmacotherapies were eligible for inclusion. Of these, 35 studies related to 33 level II quality randomized controlled trials (RCTs). Five medications were subject to multiple RCTs. Four of these medicines demonstrated some limited evidence of benefit for reducing amphetamine use: methylphenidate (as reported in three studies), bupropion (in three studies), modafinil (two studies), and naltrexone (one study). Four RCTs of dexamphetamine suggest its benefit on secondary outcomes such as treatment retention, but not for reducing amphetamine use. Six other medicines indicate the potential for efficacy, but the number of studies is too small to draw conclusions. CONCLUSIONS No medicine has as yet demonstrated sufficient, consistent evidence of effectiveness to support its use in routine treatment. High study drop-out and poor medication adherence limits the strength of evidence and raises important clinical questions about how to improve treatment engagement and outcomes.
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Affiliation(s)
- Nicole K Lee
- National Drug Research Institute, Curtin University, 7 Parker Place, Bentley, WA, 6102, Australia; 360Edge Consulting, P.O. Box 359, Elwood, 3184, Victoria, Australia.
| | - Linda Jenner
- 360Edge Consulting, P.O. Box 359, Elwood, 3184, Victoria, Australia
| | - Angela Harney
- 360Edge Consulting, P.O. Box 359, Elwood, 3184, Victoria, Australia
| | - Jacqui Cameron
- 360Edge Consulting, P.O. Box 359, Elwood, 3184, Victoria, Australia; Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Victoria, 3053, Australia
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17
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Ergelen M, Yalçın M, Bilici R. The comparison of violence, and the relationship with childhood trauma in Turkish men with alcohol, opiate, and synthetic cannabinoid use disorder. Neuropsychiatr Dis Treat 2018; 14:3169-3178. [PMID: 30538474 PMCID: PMC6260182 DOI: 10.2147/ndt.s173604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The objectives of this study are, first, to explore the prevalence of lifetime violent and criminal behaviors among alcohol, opioid, and synthetic cannabinoid (SC) users in the treatment program; second, to examine and compare sociodemographic characteristics, childhood traumatic experiences, and impulsivity of these groups. PATIENTS AND METHOD This cross-sectional cohort study includes 110 male patients who received inpatient treatment in AMATEM (Alcohol and Substance Addiction Treatment Center) Clinic of Erenköy Training and Research Hospital for Psychiatry and Neurology between October 2014 and May 2015, diagnosed with alcohol, opioid, SC use disorder. The patients who were included in the study were given Data Collection Form, APIsoft (Addiction Profile Index), Childhood Trauma Questionnaire (CTQ-28), and Barratt Impulsiveness Scale (BIS-11). Statistical analysis was performed with SPSS 15.0 statistic software package. RESULTS We found that resorting to verbal and physical violence was more frequent in SC group in comparison with alcohol and opiate groups (for verbal violence 88.5%, 60%, 70%; P = 0.02; for physical violence (82%, 40%, 60%; P = 0.001). Criminal involvement was also higher for SC users than alcohol and opioid users (94%, 85%, 68.5%; P = 0.01). The average CTQ-28 scores for SC group (P = 0.017) were high whereas there was no difference in the average BIS-11 scores (P = 0.073) between groups. There was no difference between the groups in terms of severity of addiction (P = 0.2). Our study ascertained that the patients exhibited mild and moderate addiction. CONCLUSION Although creating a treatment for addiction, we think that a holistic treatment that will take into consideration the used substance and the individual's childhood traumatic events along with his/her impulsive and aggressive behaviors could make a significant contribution to the prevention of the patient's possible violent and criminal behaviors in the future.
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Affiliation(s)
- Mine Ergelen
- Practise and Research Center for Fight Againist Addiction, University of Health Sciences,
| | - Murat Yalçın
- The Psychotheraphy Center, Erenköy Training and Research Hospital for Psychiatry and Neurology, Istanbul, Turkey
| | - Rabia Bilici
- Practise and Research Center for Fight Againist Addiction, University of Health Sciences,
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18
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Darke S, Kaye S, Duflou J. Rates, characteristics and circumstances of methamphetamine-related death in Australia: a national 7-year study. Addiction 2017; 112:2191-2201. [PMID: 28603836 DOI: 10.1111/add.13897] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/10/2017] [Accepted: 06/06/2017] [Indexed: 11/28/2022]
Abstract
AIMS To (1) assess trends in the number and mortality rates of methamphetamine-related death in Australia, 2009-15; (2) assess the characteristics and the cause, manner and circumstances of death; and (3) assess the blood methamphetamine concentrations and the presence of other drugs in methamphetamine-related death. DESIGN Analysis of cases of methamphetamine-related death retrieved from the National Coronial Information System (NCIS). SETTING Australia. CASES All cases in which methamphetamine was coded in the NCIS database as a mechanism contributing to death (n = 1649). MEASUREMENTS Information was collected on cause and manner of death, demographics, location, circumstances of death and toxicology. FINDINGS The mean age of cases was 36.9 years, and 78.4% were male. The crude mortality rate was 1.03 per 100 000. The rate increased significantly over time (P < 0.001), and at 2015 the mortality rate was 1.8 [confidence interval (CI) = 1.2-2.4] times that of 2009. Deaths were due to accidental drug toxicity (43.2%), natural disease (22.3%), suicide (18.2%), other accident (14.9%) and homicide (1.5%). In 40.8% of cases, death occurred outside the major capital cities. The median blood methamphetamine concentration was 0.17 mg/l, and cases in which only methamphetamine was detected had higher concentrations than other cases (0.30 versus 0.15 mg/l, P < 0.001). The median blood methamphetamine concentration varied within a narrow range (0.15-0.20 mg/l) across manner of death. In the majority (82.8%) of cases, substances other than methamphetamine were detected, most frequently opioids (43.1%) and hypnosedatives (38.0%). CONCLUSIONS Methamphetamine death rates doubled in Australia from 2009 to 2015. While toxicity was the most frequent cause, natural disease, suicide and accident comprised more than half of deaths.
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Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia.,Justice Health and Forensic Mental Health Network, NSW Health, NSW, Australia
| | - Johan Duflou
- National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia.,Sydney Medical School, University of Sydney, NSW, Australia
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Leslie EM, Smirnov A, Cherney A, Wells H, Legosz M, Kemp R, Najman JM. Simultaneous use of alcohol with methamphetamine but not ecstasy linked with aggression among young adult stimulant users. Addict Behav 2017; 70:27-34. [PMID: 28182965 DOI: 10.1016/j.addbeh.2017.01.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/27/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Illicit stimulants are often combined with alcohol in nightlife entertainment districts, an environment where aggressive behaviour commonly occurs. While alcohol and methamphetamine use are each associated with aggressive behaviour, relatively little is known about the impact of the combined use of alcohol and amphetamine-type stimulants (i.e., ecstasy [MDMA] and methamphetamine) on aggression. METHOD Analysis of longitudinal data from a population-based sample of Australian young adult amphetamine-type stimulant users (n=248) to examine: (a) prevalence and timing of simultaneous alcohol and amphetamine-type stimulant use and (b) predictors of ecstasy- and methamphetamine-related aggression and hostility. Prediction models of ecstasy- and methamphetamine-related aggression and hostility were developed using multivariate logistic regression. RESULTS Simultaneous alcohol consumption and amphetamine-type stimulant use was prevalent, with drinking generally occurring before consuming amphetamine-type stimulants and while 'high'. Methamphetamine-related aggression and hostility was significantly associated with recurrent risky simultaneous methamphetamine and alcohol use (Adjusted Odds Ratio [AOR] 2.74, 95% CI 1.09-6.89), a high frequency and increasing use methamphetamine trajectory (AOR 7.23, 95% CI 1.27-41.03), and high trait aggression (AOR 5.78, 95% CI 2.53-13.20). In contrast, only trait aggression (moderate: AOR 3.01, 95% CI 1.55-5.84; high: AOR 5.02, 95% CI 2.38-10.61) was associated with ecstasy-related aggression and hostility. CONCLUSIONS These findings indicate a link between risky patterns of simultaneous alcohol and methamphetamine use and methamphetamine-related aggression and hostility, independent of separate use of alcohol, methamphetamine and cannabis, trait aggression, psychosis, and gender. The policy challenges of amphetamine-type stimulant and alcohol use require a targeted, multidisciplinary approach.
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20
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Arribas-Ibar E, Suelves JM, Sanchez-Niubò A, Domingo-Salvany A, T. Brugal M. Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities. GACETA SANITARIA 2017; 31:292-298. [DOI: 10.1016/j.gaceta.2016.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/14/2016] [Accepted: 11/20/2016] [Indexed: 11/28/2022]
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Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders. Psychiatry Res 2017; 251:349-354. [PMID: 28282630 DOI: 10.1016/j.psychres.2017.02.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/13/2017] [Accepted: 02/12/2017] [Indexed: 11/21/2022]
Abstract
We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine.
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22
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Liu Y, Hao B, Shi Y, Xue L, Wang X, Chen Y, Zhao H. Violent offences of methamphetamine users and dilemmas of forensic psychiatric assessment. Forensic Sci Res 2017; 2:11-17. [PMID: 30483614 PMCID: PMC6197090 DOI: 10.1080/20961790.2017.1287155] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/23/2017] [Indexed: 11/03/2022] Open
Abstract
Methamphetamine (MA), an extremely addictive synthetic stimulant, has quickly spread to become the most frequently used illicit drug in China. People with a history of chronic and heavy MA use have a high possibility of exhibiting schizophrenia-like psychotic symptoms, mainly delusions of reference, auditory hallucinations and cognitive deficits. These emerging findings suggest MA use increases aggression and violence and that there is a correlation between MA use and violence. However, it is unclear how to assess the capacity of criminal responsibility in "MA-induced" psychosis and how to set clear boundaries between schizophrenia and MA-induced psychosis when only limited and inconsistent evidence is available. Furthermore, a final persuasive differential diagnostic method based on improved understanding of schizophrenia and MA-induced psychotic disorders has yet to be developed. This paper will evaluate the epidemiology, social harm, and forensic psychiatric assessment of MA users, propose a future direction for the differential diagnosis between MA-induced psychotic disorders and schizophrenia, and put forward some practical solutions to assess the capacity of criminal responsibility of defendants with drug-induced psychotic disorder.
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Affiliation(s)
- Yi Liu
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Bo Hao
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Yanwei Shi
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Li Xue
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoguang Wang
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Yefei Chen
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Hu Zhao
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
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23
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Gayman C, Pietras C. Laboratory Measures of Aggression in Methadone Patients Pre- and Postdose. PSYCHOLOGICAL RECORD 2016. [DOI: 10.1007/s40732-016-0206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Fairbairn N, Hayashi K, Milloy MJ, Nolan S, Nguyen P, Wood E, Kerr T. Hazardous Alcohol Use Associated with Increased Sexual Risk Behaviors Among People Who Inject Drugs. Alcohol Clin Exp Res 2016; 40:2394-2400. [PMID: 27638501 DOI: 10.1111/acer.13216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 08/10/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Alcohol is associated with a multitude of severe health consequences. While risk behaviors related to illicit drug use are commonly studied among people who inject drugs (PWID), the role of alcohol use has received substantially less attention in this population. We explored whether drug and sexual risk behaviors as well as experiences of violence were associated with hazardous alcohol use in a cohort of PWID. METHODS Analyses were conducted using observational data from a prospective cohort of community-recruited HIV-negative PWID in Vancouver, Canada. We used the U.S. National Institute on Alcohol Abuse and Alcoholism definition of hazardous alcohol use (i.e., >14 drinks/wk or >4 drinks on 1 occasion for men, and >7 drinks/wk or >3 drinks on 1 occasion for women). We used multivariable generalized estimating equations (GEE) to identify the factors associated with hazardous alcohol use. RESULTS Between 2006 and 2012, 1,114 HIV-negative individuals were recruited, and 186 (16.7%) reported hazardous alcohol use in the previous 6 months at baseline. In multivariable GEE analyses, having multiple sex partners (adjusted odds ratio [AOR] = 1.25), history of sexually transmitted infection (AOR = 1.50), experiencing violence (AOR = 1.36), and incarceration (AOR = 1.29) were each independently associated with hazardous alcohol use. Caucasian ethnicity (AOR = 0.56), ≥ daily heroin injection (AOR = 0.81), and engagement in addiction treatment (AOR = 0.84) were negatively associated with hazardous alcohol use (all p < 0.05). CONCLUSIONS A considerable proportion of PWID reported hazardous alcohol use, which was independently associated with reporting sexual, but not drug-related, HIV risk behaviors and experiencing recent violence. Findings suggest a need to integrate regular screening and evidence-based alcohol interventions into treatment efforts for PWID.
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Affiliation(s)
- Nadia Fairbairn
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kanna Hayashi
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M-J Milloy
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Seonaid Nolan
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Nguyen
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Evan Wood
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Thomas Kerr
- Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada. .,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Torok M, Darke S, Shand F, Kaye S. Investigating heterogeneity in violent offending liability among injection drug users from a developmental perspective. Addict Behav 2016; 60:165-70. [PMID: 27155243 DOI: 10.1016/j.addbeh.2016.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/08/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Violence is a major burden of harm among injecting drug users (IDU), however, the liability to violent offending is not well understood. The current study aimed to better understand differences in the liability to violence by determining whether IDU could be disaggregated into distinct violent offending classes, and determining the correlates of class membership. METHODS A total of 300 IDU from Sydney, Australia were administered a structured interview examining the prevalence and severity of drug use and violent offending histories, as well as early life risk factors (maltreatment, childhood mental disorder, trait personality). RESULTS IDU were disaggregated into four distinct latent classes, comprising a non-violent class (24%), an adolescent-onset persistent class (33%), an adult-onset transient class (24%) and an early-onset, chronic class (19%). Pairwise and group comparisons of classes on predispositional and substance use risks showed that the EARLY class had the poorest psychosocial risk profile, while the NON class had the most favourable. Multinomial logistic regression revealed that higher trait impulsivity and aggression scores, having a history of conduct disorder, frequent childhood abuse, and more problematic alcohol use, were independently associated with more temporally stable and severe violent offending. The model explained 67% of variance in class membership (χ(2)=207.7, df=51, p<0.001). CONCLUSIONS IDU can be meaningfully disaggregated into distinct violent offending classes using developmental criteria. The age of onset of violence was indicative of class membership insomuch as that the extent of early life risk exposure was differentially associated with greater long-term liability to violence and drug use.
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Harvey-Vera AY, González-Zúñiga P, Vargas-Ojeda AC, Medina-Mora ME, Magis-Rodríguez CL, Wagner K, Strathdee SA, Werb D. Risk of violence in drug rehabilitation centers: perceptions of people who inject drugs in Tijuana, Mexico. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:5. [PMID: 26812913 PMCID: PMC4728769 DOI: 10.1186/s13011-015-0044-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 12/03/2015] [Indexed: 11/10/2022]
Abstract
Background In 2009, Mexico reformed its health law to partially decriminalize drug possession considered for personal use and to increase mandatory referrals to certified drug rehabilitation centers in lieu of incarceration. Concurrently, news media reported violent attacks perpetrated by drug cartels against Mexican drug rehabilitation centers and instances of human rights violations by staff against people who inject drugs (PWID) in treatment. In many cases, these violent situations took place at “Peer Support” (Ayuda Mutua) drug rehabilitation centers that house a large number of drug-dependent PWID. In an effort to understand barriers to treatment uptake, we examined prevalence and correlates of perceived risk of violence at drug rehabilitation centers among PWID in Tijuana, Mexico. Methods Secondary analysis of baseline data collected between March 2011 and May 2013 of PWID recruited into a prospective cohort study in Tijuana. Interviewer-administered surveys measured perceived risk of violence at drug rehabilitation centers by asking participants to indicate their level of agreement with the statement “going to rehabilitation puts me at risk of violence”. Logistic regression was used to examine factors associated with perceived risk of violence. Results Of 733 PWID, 34.5 % perceived risk of violence at drug rehabilitation centers. In multivariate analysis, reporting ever having used crystal methamphetamine and cocaine (separately), having a great or urgent need to get help for drug use, and ever receiving professional help for drug/alcohol use were negatively associated with perceived risk of violence at drug rehabilitation centers, while having been told by law enforcement that drug rehabilitation attendance is mandatory was positively associated with perceived risk of violence. All associations were significant at a 0.05 alpha level. Conclusion The perception of violence at drug rehabilitation centers among PWID does not represent the lived experience of those PWID who attended professionalized services, reported a great or urgent need to get help for their drug use and had a history of using crystal and cocaine. Professionalizing service delivery and engaging law enforcement in their new role of decriminalization and service referral for PWID could address the perceptions of violence at drug rehabilitation centers. Similarly, health authorities should expand periodic inspections at drug rehabilitation centers to guarantee quality service provision and minimize PWIDs’ concerns about violence. Electronic supplementary material The online version of this article (doi:10.1186/s13011-015-0044-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alicia Yolanda Harvey-Vera
- Division of Global Public Health, University of California, San Diego, School of Medicine, San Diego, California, USA. .,Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Baja California, Mexico.
| | - Patricia González-Zúñiga
- Division of Global Public Health, University of California, San Diego, School of Medicine, San Diego, California, USA.
| | | | | | | | - Karla Wagner
- Division of Global Public Health, University of California, San Diego, School of Medicine, San Diego, California, USA.
| | - Steffanie Anne Strathdee
- Division of Global Public Health, University of California, San Diego, School of Medicine, San Diego, California, USA.
| | - Daniel Werb
- Division of Global Public Health, University of California, San Diego, School of Medicine, San Diego, California, USA.
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Lipinska G, Timol R, Thomas KGF. The implications of sleep disruption for cognitive and affective processing in methamphetamine abuse. Med Hypotheses 2015; 85:914-21. [PMID: 26384529 DOI: 10.1016/j.mehy.2015.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 11/25/2022]
Abstract
Sleep is disrupted during active use of methamphetamine (MA), during withdrawal from the drug, and during abstinence from its use. However, relatively little is known about possible mediatory functions of disrupted sleep in the emergence, manifestation, and maintenance of cognitive and affective symptoms of MA abuse. We hypothesise that sleep functions as a mediator for stimulant drug effects. Specifically, we propose that objectively-measured sleep parameters can be used to explain some of the variability in the experience and presentation of memory deficits and emotion dysregulation in MA abusers. After describing how important healthy sleep is to unimpaired cognitive and affective functioning, we review literature describing how sleep is disrupted in MA abuse. Then, we provide a conceptual framework for our hypothesis by explaining the relationship between MA abuse, sleep disruption, memory deficits, emotion dysregulation, and changes in reward-related brain networks. We conclude by discussing implications of the hypothesis for research and treatment.
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Affiliation(s)
- Gosia Lipinska
- ACSENT Laboratory, Department of Psychology, University of Cape Town, South Africa
| | - Ridwana Timol
- ACSENT Laboratory, Department of Psychology, University of Cape Town, South Africa
| | - Kevin G F Thomas
- ACSENT Laboratory, Department of Psychology, University of Cape Town, South Africa.
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Chen IM, Huang CLC, Yeh BJ, Chien YL. Health service utilization of heroin abusers: a retrospective cohort study. Addict Behav 2015; 45:281-6. [PMID: 25747796 DOI: 10.1016/j.addbeh.2015.01.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 11/28/2014] [Accepted: 01/14/2015] [Indexed: 11/15/2022]
Abstract
AIMS This study aimed to determine the patterns of medical service utilization among heroin users and to identify the factors associated with the frequency of utilization. METHODS We conducted a retrospective/prospective cohort study of 789 heroin-using adults in a catchment area, collecting data on their usage of medical care, including inpatient care, emergency visits, and outpatient care, in a 2-year observation period. We interviewed and reviewed the medical records of 789 heroin users in a methadone clinic of a general hospital in a rural area of Taiwan. The demographic data, records of service use, diagnoses, and information on viral infection status from Jan. 1, 2007 to Dec. 31, 2008 were collected. Most patients were middle-aged and unemployed, had a basic educational level, and began their first heroin use in their twenties. RESULTS The health service utilization of heroin users was mostly for infectious diseases, orthopedic conditions, and gastroenterological disorders mainly due to blood-borne or local infections and traumatic injury. Heroin users utilize fewer outpatient or inpatient services, but more emergency care than the general public. The major correlates of inpatient and emergency service utilization were HIV status and education level. CONCLUSIONS Our findings suggest that integrated outpatient services may help to enhance medical service accessibility and adherence, and also imply the necessity of putting more effort into promoting health management and safe behaviors in heroin users, particularly the lower-educated addicts.
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Affiliation(s)
- I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan
| | - Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Medical Center, Taiwan; Department of Social Worker, Chia Nan University of Pharmacy and Science, Taiwan
| | - Bao-Juan Yeh
- (e)Department of Psychiatry, National Taiwan University Hospital Yun-Lin Branch, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taiwan; (f)Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan.
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Bride BE, Choi YJ, Olin IW, Roman PM. Patient Violence Towards Counselors in Substance Use Disorder Treatment Programs: Prevalence, Predictors, and Responses. J Subst Abuse Treat 2015; 57:9-17. [PMID: 26025921 DOI: 10.1016/j.jsat.2015.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 03/18/2015] [Accepted: 04/08/2015] [Indexed: 11/16/2022]
Abstract
Workplace violence disproportionately impacts healthcare and social service providers. Given that substance use and abuse are documented risk factors for the perpetration of violence, SUD treatment personnel are at risk for patient-initiated violence. However, little research has addressed SUD treatment settings. Using data nationally representative of the U. S., the present study explores SUD counselors' experiences of violent behaviors perpetrated by patients. More than half (53%) of counselors personally experienced violence, 44% witnessed violence, and 61% had knowledge of violence directed at a colleague. Counselors reported that exposure to violence led to an increased concern for personal safety (29%), impacted their treatment of patients (15%), and impaired job performance (12%). In terms of organizational responses to patient violence, 70% of organizations increased training on de-escalation of violent situations, and 58% increased security measures. Exposure to verbal assault was associated with age, minority, tenure, recovery status, 12-step philosophy, training in MI/MET, and higher caseloads of patients with co-occurring disorders. Exposure to physical threats was associated with age gender, minority, tenure, recovery status, and higher caseloads of patients with co-occurring disorders. Exposure to physical assault was associated with age, gender, and sample. Implications of these findings for organizations and individuals are discussed.
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Affiliation(s)
- Brian E Bride
- School of Social Work, Georgia State University, Atlanta, Georgia.
| | - Y Joon Choi
- School of Social Work, University of Georgia, Athens, Georgia
| | - Ilana W Olin
- School of Social Work, University of Georgia, Athens, Georgia
| | - Paul M Roman
- Owens Institute for Behavioral Research, University of Georgia, Athens, Georgia, Athens, Georgia; Department of Sociology, University of Georgia, Athens, Georgia
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Nyamathi A, Salem BE, Farabee D, Hall E, Zhang S, Marfisee M, Khalilifard F, Musto S, Leake B. Correlates of Heroin and Methamphetamine Use among Homeless Male Ex-Jail and Prison Offenders. ADDICTION RESEARCH & THEORY 2014; 22:463-473. [PMID: 25489295 PMCID: PMC4257470 DOI: 10.3109/16066359.2013.877453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Homeless men exiting California State jails and prisons are a heterogeneous community with varied childhood, incarceration and drug use histories. This cross-sectional study assessed whether homeless men who were discharged from either jail or prison into a residential substance abuse treatment program, differed in terms of methamphetamine and heroin use. This study utilized baseline data collected on 540 recently paroled men randomized to one of three programs that assessed the impact of a peer coaching intervention on subsequent drug use and re-incarceration. We found that younger ex-offenders exiting prisons and jails were more likely to have used methamphetamine alone, whereas African American ex-offenders were less likely to have used methamphetamine alone when compared to other ethnic groups. Further, ex-offenders exiting jails and self-reporting use of heroin only at baseline were significantly more likely than their counterparts to have been removed from home before age 18. For men exiting jails, there was an association between lower self-esteem and having used methamphetamine but not heroin. However, having used both heroin and methamphetamine was associated with both violent crime and cognitive problems in both jail and prison samples. Our findings showcase the need to understand unique correlates of both heroin and methamphetamine as they relate to jail and prison populations.
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Affiliation(s)
| | | | - David Farabee
- University of California, Los Angeles, Integrated Substance Abuse Program
| | - Elizabeth Hall
- University of California, Los Angeles, Integrated Substance Abuse Program
| | - Sheldon Zhang
- San Diego State University, San Diego, Department of Sociology
| | - Mary Marfisee
- University of California, Los Angeles, School of Nursing
| | | | - Stefanie Musto
- University of Albany, Mark Faucette, RAS, CSAC, Amity Foundation
| | - Barbara Leake
- University of California, Los Angeles, School of Nursing
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Torok M, Darke S, Shand F, Kaye S. Violent offending severity among injecting drug users: examining risk factors and issues around classification. Addict Behav 2014; 39:1773-8. [PMID: 25123345 DOI: 10.1016/j.addbeh.2014.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 06/02/2014] [Accepted: 07/02/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE There is a paucity of research as to how injecting drug users (IDU) might be differentiated in the severity of their violent offending. This paper reported on the risks associated with severity, as well as issues around severity classification and the impact on observed relationships with known major risk factors. METHOD A cross-sectional survey administered to 300 IDU, who had injected drugs weekly or more in the past 12months. A structured questionnaire addresses potential substance use and early-life risk factors for violent offending. RESULTS Four severity groups were identified: non-violent (24%), low (34%), moderate (22%) and high (20%) level offenders. Higher severity groups had more prevalent and more severe histories of childhood maltreatment, child psychopathology and dysfunctional trait personalities, as well as more severe substance use problems than low-level and non-violent IDU. Regression analyses found that only two of 15 risk factors remained uniformly associated with violent offending across the four classification schemes tested: (1) having committed violence under the influence and (2) having more impulsive trait personalities. CONCLUSIONS Disaggregating IDU into distinct subgroups showed that the extent and severity of predispositional and substance use risk exposure corresponded to the severity of violent offending. There is a need to establish a systematic method for classifying severity given that there were clinically meaningful differences between groups which require further exploration and replication, and because there was extensive variation in the risks associated with severity across schemes.
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Affiliation(s)
- Michelle Torok
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Horyniak D, Dietze P, Degenhardt L, Agius P, Higgs P, Bruno R, Alati R, Burns L. Age-related differences in patterns of criminal activity among a large sample of polydrug injectors in Australia. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.950700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Danielle Horyniak
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia,
- School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia,
| | - Paul Agius
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
- National Drug Research Institute (Melbourne Office), Curtin University, Victoria, Australia,
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia,
- School of Psychology, University of Tasmania, Hobart, Tasmania, Australia,
| | - Rosa Alati
- Queensland Alcohol and Drug Research and Education Centre, School of Population Health, University of Queensland, Herston, Queensland, Australia, and
- Centre for Youth Substance Abuse Research, University of Queensland, Queensland, Australia
| | - Lucy Burns
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia,
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McKetin R, Lubman DI, Najman JM, Dawe S, Butterworth P, Baker AL. Does methamphetamine use increase violent behaviour? Evidence from a prospective longitudinal study. Addiction 2014; 109:798-806. [PMID: 24400972 DOI: 10.1111/add.12474] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/15/2013] [Accepted: 12/19/2013] [Indexed: 12/12/2022]
Abstract
AIMS To determine whether violent behaviour increases during periods of methamphetamine use and whether this is due to methamphetamine-induced psychotic symptoms. DESIGN A fixed-effects (within-subject) analysis of four non-contiguous 1-month observation periods from a longitudinal prospective cohort study. SETTING Sydney and Brisbane, Australia. PARTICIPANTS A total of 278 participants aged 16 years or older who met DSM-IV criteria for methamphetamine dependence on entry to the study but who did not meet DSM-IV criteria for life-time schizophrenia or mania. MEASUREMENTS Violent behaviour was defined as severe hostility in the past month on the Brief Psychiatric Rating Scale (BPRS) (corresponding to assault/damage to property). Days of methamphetamine and other substance use in the past month were assessed using the Opiate Treatment Index. Positive psychotic symptoms in the past month were identified using the BPRS. FINDINGS There was a dose-related increase in violent behaviour when an individual was using methamphetamine compared with when they were not after adjusting for other substance use and socio-demographics [cf. no use in the past month: 1-15 days of use odds ratio (OR) = 2.8, 95% confidence interval (CI) =1.6-4.9; 16+ days of use OR = 9.5, 95% CI = 4.8-19.1]. The odds of violent behaviour were further increased by psychotic symptoms (OR = 2.0, 95% CI = 1.1-3.6), which accounted for 22-30% of violent behaviour related to methamphetamine use. Heavy alcohol consumption also increased the risk of violent behaviour (OR = 3.1, 95% CI = 1.4-7.0) and accounted for 12-18% of the violence risk related to methamphetamine use. CONCLUSIONS There is a dose-related increase in violent behaviour during periods of methamphetamine use that is largely independent of the violence risk associated with psychotic symptoms.
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Affiliation(s)
- Rebecca McKetin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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Miller P, Droste N, Martino F, Palmer D, Tindall J, Gillham K, Wiggers J. Illicit drug use and experience of harm in the night-time economy. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.911974] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Torok M, Darke S, Kaye S, Shand F. The association of early-life and substance use risks to violent offending among injecting drug users. Drug Alcohol Rev 2014; 34:10-7. [PMID: 24602098 DOI: 10.1111/dar.12126] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 02/04/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS It remains unclear whether violent offending among injecting drug users (IDU) is the direct result of drug use factors or whether they are predisposed to violent behaviour from childhood. The current study sought to identify substance use and early-life correlates of lifetime violent offending among IDUs and to determine what risks contributed to recent violent offending. DESIGN AND METHODS Three hundred community-based regular IDUs were administered a face-to-face cross-sectional structured interview examining correlates of violent offending. RESULTS One-third (34%) of IDUs had committed violence in the past 12 months, 42% more than 12 months ago and 24% had never been violent. Predispositional and substance use risk profiles were poorer among IDUs who had been violent, but many of these risks were even more prevalent and severe among those who had been violent in the past 12 months. Multinomial logistic regression found that IDUs who had been violent in the past 12 months had greater polysubstance and higher trait aggressive personalities than the other IDUs, whereas they were further differentiated from non-recent violent IDUs in having more involvement in drug dealing and more likely to screen positive for conduct disorder. DISCUSSION AND CONCLUSIONS Drug use factors alone did not adequately explain the likelihood of violent offending among IDUs. Instead, there appeared to be complex interactions between early-life risks and substance use which created a liability to violent offending, and the level of exposure to these risks appeared to explain differences in violent offending patterns.
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Affiliation(s)
- Michelle Torok
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Darke S, Torok M, Duflou J. Sudden or Unnatural Deaths Involving Anabolic-androgenic Steroids. J Forensic Sci 2014; 59:1025-8. [DOI: 10.1111/1556-4029.12424] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 04/25/2013] [Accepted: 05/24/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney NSW 2052 Australia
| | - Michelle Torok
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney NSW 2052 Australia
| | - Johan Duflou
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney NSW 2052 Australia
- Department of Forensic Medicine; South Western Sydney Local Health District; PO Box 90 Glebe NSW 2037 Australia
- School of Medical Sciences; University of New South Wales; Sydney NSW 2052 Australia
- Sydney Medical School; University of Sydney; NSW 2008 Australia
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Gordon MS, Kinlock TW, Schwartz RP, Couvillion KA, O’Grady KE. The Severity, Frequency, and Variety of Crime in Heroin-Dependent Prisoners Enrolled in a Buprenorphine Clinical Trial. THE PRISON JOURNAL 2013; 93:390-410. [PMID: 25392564 PMCID: PMC4225709 DOI: 10.1177/0032885513500753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Data were obtained on four dimensions of criminal activity (frequency, variety, severity, and income) from male and female prisoners (N = 200) with preincarceration heroin dependence who participated in a randomized clinical trial of buprenorphine treatment. The article examines the above-mentioned dimensions of crime and their relationships with demographic characteristics, substance use, legitimate employment, drug treatment episodes, and psychological problems. Results largely show several important similarities to results on previous prison inmate cohorts with histories of heroin addiction, although the present sample may have more of a tendency toward violent crime than earlier cohorts of heroin-dependent offenders. This study's findings may have implications for the design of appropriate treatment interventions for prisoners with preincarceration heroin dependence that address not only substance use but also criminal activity.
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Affiliation(s)
- Michael S. Gordon
- Friends Research Institute, Baltimore, MD, USA
- Stevenson University, MD, USA
| | - Timothy W. Kinlock
- Friends Research Institute, Baltimore, MD, USA
- University of Baltimore, MD, USA
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Methamphetamine dependent individuals show attenuated brain response to pleasant interoceptive stimuli. Drug Alcohol Depend 2013; 131:238-46. [PMID: 23806873 PMCID: PMC3760794 DOI: 10.1016/j.drugalcdep.2013.05.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 05/14/2013] [Accepted: 05/17/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mechano-receptive C-fiber (MR-CF) stimulation via slow stroking of C-fiber rich skin areas can be used to probe the relationship between reward and interoception. Individuals with substance use disorders show impaired reward processing, and dysfunctional interoceptive processing of MR-CF may contribute to this dysfunction. This study predicted that methamphetamine dependent (MD) individuals would exhibit altered responses to MR-CF stimulation in brain regions important for interoception. METHODS Recently abstinent MD (n=25) and comparison (CTL, n=17) subjects received a pleasant interoceptive stimulus ("Soft Touch" consisting of a slow brush stroke) to the palm or forearm during functional magnetic resonance imaging. Subjects were provided with cues signaling stimulation to examine anticipatory and stimulus-related processing. Subjective responses were measured using visual analog scales (VAS). RESULTS Groups were similar on behavioral performance and ratings of the interoceptive stimuli, yet MD exhibited lower anterior insula, dorsal striatum, and thalamus activation than CTL, across anticipation and soft touch conditions. The lower the anterior insula activation, the faster the reaction time across conditions in MD, whereas the opposite pattern was evident in CTL. Striatal activation in MD was greater than CTL during anticipation, but lower during soft touch. Greater striatal attenuation was associated with higher VAS pleasantness ratings of soft touch. CONCLUSIONS MD expend fewer brain processing resources during soft touch, a form of positively-valenced interoceptive stimuli, in brain areas that are important for both interoception and reward. Future studies will ascertain if sustained abstinence from methamphetamine use can normalize aberrant neural interoceptive processing.
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Abstract
UNLABELLED The purpose of this review is to discuss the incidence, risks, pregnancy complications, and maintenance options for treatment of opioid addiction in pregnancy. SUMMARY Opioid dependence in pregnancy carries clear identifiable maternal and fetal risk. Providing care for patients with dependence is best done in a multidisciplinary care model addressing the particular needs of this population. There are limited data on maternal detoxification, with data still emerging surrounding the safety profile of this practice. Historically, methadone has been the recommended maintenance treatment; however, recent data on buprenorphine identify this as a safe and effective option. The majority of births from women with opioid dependence result in neonatal abstinence syndrome requiring prolonged neonatal hospitalization. Intrapartum pain management should not differ from the general obstetric population. Postpartum pain is magnified in this population, and particular attention should be focused on this issue. Breast-feeding is recommended regardless of maintenance dose, unless other conditions restricting breast-feeding are present. Comprehensive postpartum care and transition of care to addiction specialists are highly recommended. TARGET AUDIENCE Obstetricians and gynecologists, family physicians, addiction specialists. LEARNING OBJECTIVES After completing this CME activity, physicians should be better able to assess the treatment options available to patients with opioid addiction during pregnancy, compare the risk/safety profiles of methadone and buprenorphine, and evaluate the recommendations and current data surrounding breast-feeding while on opioid maintenance treatment.
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Darke S, Torok M. Attitudes of regular injecting drug users towards the legal status of the major illicit drugs. Drug Alcohol Rev 2013; 32:483-8. [PMID: 23647529 DOI: 10.1111/dar.12050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 04/09/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS The study aimed to determine injecting drug users' (IDU) attitudes, and correlates of attitudes, towards continued prohibition, decriminalisation or legalisation of the major illicit drugs. DESIGN AND METHODS This study used structured interview with 300 IDUs who had injected on at least a weekly basis over the preceding 12 months. RESULTS Methamphetamine was rated the most harmful of the five illicit substances and cannabis the lowest. By far the highest level of support for legislative change was for cannabis, with only 8.7% supporting continued prohibition. While there was majority support for change to the legal status of heroin, the modal position was for decriminalisation. Support for changing the status of the three illicit psychostimulants was low, with the majority believing that methamphetamine (63.3%), cocaine (53.3%) and 3,4-methylenedioxy-N-methylamphetamine (53.3%) should remain illegal. Demographic characteristics were largely unrelated to attitudes. Lower levels of perceived harm were associated with increased likelihood of support for legalisation of all substances. Recent use was positively related to support for both decriminalisation and legality of heroin, but was not associated with views on other substances. Higher lifetime polydrug use was associated with support for the legalisation of heroin, methamphetamine, cocaine and 3,4-methylenedioxy-N-methylamphetamine. DISCUSSION AND CONCLUSIONS IDUs expressed nuanced views on different substances. In policy debates, care should be taken not to speak for IDUs by imputing their beliefs. It is clear that the fact that a group uses illegal drugs does not necessarily imply that they support changes to their legal status.
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Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Tsai J, Rosenheck RA, Decker SE, Desai RA, Harpaz-Rotem I. Trauma experience among homeless female veterans: correlates and impact on housing, clinical, and psychosocial outcomes. J Trauma Stress 2012; 25:624-32. [PMID: 23225030 DOI: 10.1002/jts.21750] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 05/24/2012] [Accepted: 06/18/2012] [Indexed: 11/05/2022]
Abstract
This study examined lifetime exposure to traumatic events as reported by 581 homeless female veterans enrolled in a Homeless Women Veterans Program across 11 sites to characterize the types of trauma they experienced; their correlation with baseline characteristics; and their association with housing, clinical outcomes, and psychosocial functioning over a 1-year treatment period. Almost all participants endorsed multiple types and episodes of traumatic events. Among the most common were having someone close experience a serious or life-threatening illness (82%) and rape (67%). Exploratory factor analysis revealed 6 potential trauma categories: being robbed, experiencing accident or disasters, illness or death of others, combat, sexual assault, and physical assault. At baseline, trauma from sexual assault was associated with more days homeless (β = .18, p < .001), trauma from accidents or disasters was associated with poorer physical health (β = -.23, p < .001), and trauma from being robbed was related to greater use of drugs (β = .22, p < .001). Trauma reported at baseline, however, was not predictive of 1-year outcomes, suggesting type and frequency of trauma does not negatively affect the housing gains homeless women veterans can achieve through homeless services.
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Affiliation(s)
- Jack Tsai
- Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA.
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Latkin CA, Yang C, Tobin KE, German D. Injection drug users' and their risk networks' experiences of and attitudes towards drug dealer violence in Baltimore, Maryland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2012; 24:135-41. [PMID: 22959117 DOI: 10.1016/j.drugpo.2012.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 07/13/2012] [Accepted: 07/16/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND A large portion of violence associated with drug use is due to drug dealing. These analyses sought to examine injection drug users' attitudes and experiences of drug dealer violence. METHODS The current study used the 18-month follow up data of STEP into Action (STEP) study, an HIV prevention intervention among drug injectors and their risk network members conducted in Baltimore, Maryland. Four scales assessed acceptability of drug dealer violence, willingness to talk to drug users about avoiding drug dealer violence, social norms about reporting drug dealer violence and intentions to report drug dealer violence to the police. RESULTS Many (44%) of the 373 participants reported witnessing drug dealers' acts of violence within the prior 6 months. Although the majority of participants disagreed with statements on the acceptability of dealers using violence, only a minority indicated that they would call the police if they observed dealer violence. Most participants indicated that they would be interested in talking to drug users about how to avoid violent dealers. Males were more likely to report that violence was acceptable, whereas African Americans were less likely to condone violence. Those who were homeless and had higher incomes were more likely to report witnessing drug dealer violence. CONCLUSIONS These results suggest that it may be feasible to train current and former drug users and their risk network members in methods to promote violence reduction among drug dealers.
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Affiliation(s)
- Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Havnes I, Bukten A, Gossop M, Waal H, Stangeland P, Clausen T. Reductions in convictions for violent crime during opioid maintenance treatment: a longitudinal national cohort study. Drug Alcohol Depend 2012; 124:307-10. [PMID: 22382045 DOI: 10.1016/j.drugalcdep.2012.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 01/29/2012] [Accepted: 02/01/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although opioid maintenance treatment (OMT) has been found to reduce crime, less is known about its associations with violent crime. This study investigates changes in violent crime convictions prior to, during, and after OMT, and examines the relationship between violent crime convictions prior to OMT with the risk of violent and non-violent crime convictions during treatment. METHODS The cohort comprised all who started OMT (n=3221) in Norway between 1997 and 2003. Treatment data were cross linked with the national Crime Registry. Convictions for violent crime 3 years prior to, during, and after treatment were studied. RESULTS Violent crime rates were significantly reduced during OMT compared with before treatment, for both men and women. The rate of convictions for violent crime during OMT was halved amongst those who remained in treatment. The reduction was less pronounced for those who left treatment: for this group, the rate of violent convictions after OMT was higher than before treatment. The risk of convictions for violent and non-violent crime during OMT was highest for those with violent convictions prior to treatment. CONCLUSIONS Violent crime is reduced during OMT. Screening for violent behaviour and violence risk assessment should be implemented in the treatment system.
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Affiliation(s)
- Ingrid Havnes
- SERAF-Norwegian Centre for Addiction Research, University of Oslo, Kirkevn 166, N-0407 Oslo, Norway.
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Darke S, Kaye S, Torok M. Age-related patterns of drug use initiation among polydrug using regular psychostimulant users. Drug Alcohol Rev 2012; 31:784-9. [PMID: 22449025 DOI: 10.1111/j.1465-3362.2012.00436.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS To determine age-related patterns of drug use initiation, drug sequencing and treatment entry among regular psychostimulant users. DESIGN AND METHODS Cross-sectional study of 269 regular psychostimulant users, administered a structured interview examining onset of use for major licit and illicit drugs. RESULTS The mean age at first intoxication was not associated with age or gender. In contrast, younger age was associated with earlier ages of onset for all of the illicit drug classes. Each additional year of age was associated with a 4 month increase in onset age for methamphetamine, and 3 months for heroin. By the age of 17, those born prior to 1961 had, on average, used only tobacco and alcohol, whereas those born between 1986 and 1990 had used nine different drug classes. The period between initial use and the transition to regular use, however, was stable. Age was also negatively correlated with both age at initial injection and regular injecting. Onset sequences, however, remained stable. Consistent with the age-related patterns of drug use, each additional year of age associated with a 0.47 year increase in the age at first treatment. DISCUSSION AND CONCLUSIONS While the age at first intoxication appeared stable, the trajectory through illicit drug use was substantially truncated. The data indicate that, at least among those who progress to regular illicit drug use, younger users are likely to be exposed to far broader polydrug use in their teens than has previously been the case.
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Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Abstract
Drug users have very high rates of lifetime exposure to traumatic events, leading to significant psychiatric complications. In spite of the high rate of lifetime exposure, very little is known about the rate of ongoing re-exposure to new traumatic events in drug users. We investigated the rate of traumatic event re-exposure in male and female injecting drug users using syringe exchange services in Baltimore (N = 197). Participants were assessed monthly for traumatic event re-exposure for 16 months. Averaged over the entire follow-up period, 27% of participants were re-exposed to a traumatic event each month and 72% were re-exposed over the 16-month study period. Women were over twice as likely to report any traumatic event re-exposure as men (adjusted odds ratio [AOR] = 2.48; 95% CI = 1.54-3.99), with the specific events of life-threatening illness, death of a loved one, and injury or illness of a loved one being more common in women than men. Traumatic event re-exposure occurs far more often than previously reported, with women injecting drug users at the highest risk. Reassessment of traumatic events may help to identify people most in need and encourage entry into treatment.
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Brecht ML, Urada D. Treatment outcomes for methamphetamine users: California Proposition 36 and comparison clients. J Psychoactive Drugs 2012; Suppl 7:68-76. [PMID: 22185041 DOI: 10.1080/02791072.2011.602279] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Methamphetamine (meth) is a major drug of abuse in California and several other states, particularly among criminal offender populations. Over the past decade, substance abuse treatment systems have had to adapt to and accommodate the increasing needs of meth users and, in California, deal with the impact of Proposition 36, which has resulted in a greater number of criminal offenders entering the treatment system. This study examines selected treatment performance and outcome indicators for California Proposition 36 offenders entering substance abuse treatment for meth use and compares their performance and outcomes to other subgroups of California treatment clients differentiated by whether or not they were admitted to treatment through Proposition 36 and whether or not their primary substance was meth. Significant improvements in all outcome domains were seen across the populations, and treatment performance and outcomes were not substantively inferior for the offender or meth-using groups.
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Affiliation(s)
- Mary-Lynn Brecht
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90025, USA.
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Nyamathi A, Marlow E, Zhang S, Hall E, Farabee D, Marfisee M, Khalilifard F, Faucette M, Leake B. Correlates of serious violent crime for recently released parolees with a history of homelessness. VIOLENCE AND VICTIMS 2012; 27:793-810. [PMID: 23155727 PMCID: PMC3629810 DOI: 10.1891/0886-6708.27.5.793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study used baseline data on recently released paroled men who are homeless (N=157), residing in a residential drug treatment program, and enrolled in a longitudinal study to examine personal, developmental, and social correlates of parolees who are homeless and who have committed serious violent offenses. Having experienced childhood sexual abuse, poor parental relationships, and early-onset incarceration (prior to 21 years of age) were important correlates of serious violent crimes. These findings highlight the need for interventions that address offenders' prior adult and childhood victimization and suggest that policies for reentering violent offenders should encompass an understanding of the broader family contexts in which these patterns of maltreatment often occur.
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Affiliation(s)
- Adeline Nyamathi
- University of California, Los Angeles, School of Nursing, CA 90095-1702, USA.
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Bukten A, Skurtveit S, Stangeland P, Gossop M, Willersrud AB, Waal H, Havnes I, Clausen T. Criminal convictions among dependent heroin users during a 3-year period prior to opioid maintenance treatment: A longitudinal national cohort study. J Subst Abuse Treat 2011; 41:407-14. [DOI: 10.1016/j.jsat.2011.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 03/21/2011] [Accepted: 06/22/2011] [Indexed: 12/18/2022]
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TOROK MICHELLE, DARKE SHANE, KAYE SHARLENE. Predisposed violent drug users versus drug users who commit violence: Does the order of onset translate to differences in the severity of violent offending? Drug Alcohol Rev 2011; 31:558-65. [DOI: 10.1111/j.1465-3362.2011.00332.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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50
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Abstract
Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or psychiatric disorders. A comprehensive patient evaluation is needed. Treatment options include pharmacotherapy as well as nonpharmacologic interventions, both of which need to be individualized to the patient.
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Affiliation(s)
- Scott D Lane
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Road Houston, TX 77054, USA
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