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Vauhkonen P, Oura P, Kriikku P, Mäyränpää MI, Lindroos K. Association of anabolic androgenic steroid use with perimortem polypharmacy, antemortem prescription drug use, and utilization of health care services - A Finnish triple register study of forensic autopsy cases. Forensic Sci Int 2024; 356:111947. [PMID: 38290417 DOI: 10.1016/j.forsciint.2024.111947] [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: 11/22/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
Anabolic androgenic steroid (AAS) use has previously been associated with complex polysubstance use that may increase morbidity and mortality among these individuals. In this study we aimed to further describe the features of perimortem polysubstance use, antemortem central nervous system (CNS) drug use and health care service utilization of AAS using males that suffer premature death. The main sample included all cases that were screened for AAS in connection with forensic autopsy between 2016-2019 and tested positive (n = 16). The control samples included autopsy cases that were screened for AAS but tested negative (n = 30) and randomly selected, age and sex matched autopsy cases not suspected of having used AAS but were otherwise fully toxicologically investigated (n = 43). Postmortem toxicological results were used for perimortem polysubstance use prevalence and severity estimation. Antemortem CNS drug use was calculated from a national register of reimbursed prescription medicines, and health care utilization from public health care registers, covering the last five years of life. Perimortem polysubstance use was prevalent in all groups, but the AAS positive had a tendency for greater CNS drug polypharmacy and the highest number of antemortem CNS drug purchases during the last five years of life, with a median of 14.5 purchases/person, vs. 1/person in the AAS negative and 0/person in the random group (Kruskal-Wallis H test, p < .001). Yearly medical contacts increased in all groups as death approached. Our findings suggest that prescription CNS drug use may play a significant role in polysubstance use disorders of AAS using males that suffer premature death.
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Affiliation(s)
- Paula Vauhkonen
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30 (Mannerheimintie 166), FI-00271 Helsinki, Finland; Faculty of Medicine, University of Helsinki, P.O. Box 63 (Haartmaninkatu 3), FI-00014 Helsinki, Finland.
| | - Petteri Oura
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30 (Mannerheimintie 166), FI-00271 Helsinki, Finland; Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21 (Haartmaninkatu 3), FI-00014 Helsinki, Finland
| | - Pirkko Kriikku
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, P.O. Box 21 (Haartmaninkatu 3), FI-00014 Helsinki, Finland; Forensic Toxicology Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland
| | - Mikko Ilari Mäyränpää
- Department of Pathology, University of Helsinki, P.O. Box 21 (Haartmaninkatu 3), FI-00014 Helsinki, Finland; Helsinki University Hospital, P.O. Box 340, FI-00029 Helsinki, Finland
| | - Katarina Lindroos
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30 (Mannerheimintie 166), FI-00271 Helsinki, Finland
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Jones AA, Strong-Jones S, Apsley HB. The role of polysubstance use on criminal justice involvement in the United States. Curr Opin Psychiatry 2023; 36:290-300. [PMID: 37191661 PMCID: PMC10280570 DOI: 10.1097/yco.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW Polysubstance use, broadly defined as using more than one type of substance, disproportionately impacts those involved in the criminal justice system (CJS). This review synthesizes recent findings on polysubstance use among those involved in the CJS and highlights areas of particular concern and interventions. RECENT FINDINGS We use 18 recent articles to identify the prevalence and types of criminal justice involvement and correlates of polysubstance use and criminal justice involvement. We highlight latent patterns of polysubstance use among various criminal justice populations (adults, pregnant women, and youth) and differential associations with adverse substance use and criminal justice outcomes. Lastly, we discuss substance use treatment in the justice system, the role of polysubstance use in treatment access and outcomes, and substance use-related services for previously incarcerated individuals reentering society. SUMMARY Current research provides further evidence of the syndemic nature of polysubstance use, criminal justice involvement, and adverse outcomes, which are complicated by significant barriers to accessing evidence-based treatment in justice settings. Yet, current research is limited due to methodological inconsistency and limited focus on the social determinants of health, racial/ethnic disparities, and interventions to increase treatment and reentry services.
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Affiliation(s)
- Abenaa A Jones
- Department of Human Development and Family Studies, Pennsylvania State University
- Consortium on Substance Use and Addiction, Pennsylvania State University
| | - Sienna Strong-Jones
- Department of Human Development and Family Studies, Pennsylvania State University
| | - Hannah B Apsley
- Department of Human Development and Family Studies, Pennsylvania State University
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Mellner C, Dahlen M, Simonsson O. Association between Lifetime Classic Psychedelic Use and Sick Leave in a Population-Based Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11353. [PMID: 36141631 PMCID: PMC9517576 DOI: 10.3390/ijerph191811353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Absenteeism from work due to illness, and related costs, has increased steadily during the past decades. In recent years, there has been a reemergence of research on the therapeutic effects of classic psychedelics showing associations with both physical and mental health. However, the association between classic psychedelics and sick leave remains unknown. The aim of this study is to investigate the association between lifetime classic psychedelic use and sick leave in the past 30 days among adults in the United States (N = 407,717), using data from the National Survey on Drug Use and Health (2005-2019), weighted to be representative of the US adult population. METHODS The primary analysis was conducted using multiple linear regression, controlling for sociodemographic characteristics, risky behavior, and use of other substances. RESULTS There was a significant and negative association between lifetime classic psychedelic use and sick leave in the past 30 days (B = -0.09, p < 0.01) when adjusting for all control variables. CONCLUSION These findings suggest that classic psychedelics could potentially lead to reduced sick leave and associated costs in the general population, but more research is needed to investigate potential causal pathways of classic psychedelics on sick leave and evaluate possible mechanisms.
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Affiliation(s)
- Christin Mellner
- Department of Psychology, Stockholm University, 114 19 Stockholm, Sweden
| | - Micael Dahlen
- Stockholm School of Economics, 114 19 Stockholm, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Sociology, University of Oxford, Oxford OX1 1JD, UK
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Savonen J, Kataja K, Sakki I. Distancing from the worst or facing the inescapable? Social representations and positioning of people in marginalised groups. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2022. [DOI: 10.1002/casp.2603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jenni Savonen
- Faculty of Social Sciences University of Helsinki Helsinki Finland
| | - Kati Kataja
- Department of Social Sciences University of Eastern Finland Kuopio Finland
| | - Inari Sakki
- Department of Social Sciences University of Eastern Finland Kuopio Finland
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Armoon B, Bayani A, Griffiths MD, Bayat AH, Mohammadi R, Fattah Moghaddam L, Ahounbar E. Prevalence and high-risk behaviors associated with non-fatal overdose among people who use illicit opioids: A systematic review and meta-analysis. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1978112] [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]
Affiliation(s)
- Bahram Armoon
- Research Center, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, Qc, Canada
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Amir-Hossein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Rasool Mohammadi
- Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Elahe Ahounbar
- Substance Abuse and Dependence Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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McQuoid J, Thrul J, Lopez-Paguyo K, Ling PM. Exploring multiple drug use by integrating mobile health and qualitative mapping methods - An individual case study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 97:103325. [PMID: 34175527 DOI: 10.1016/j.drugpo.2021.103325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple drug use involves particular pleasures and risks, and is disproportionately practiced by some minority and socially marginalized groups. The unique patterns, intentions, and social contexts of multiple drug use for these groups are poorly understood. METHODS Our mixed method integrates geo-enabled smartphone survey data collection with a qualitative mapping interview method. This brief report presents data from one study participant to demonstrate this method's potential contributions to multiple drug use research for priority groups in different settings. RESULTS 'Jason's' data revealed the interrelated dynamics within his drug use repertoire and links between his substance use to rural life as a transgender person with autism spectrum disorder (ASD). Cigarettes played a role in coping with acute stress from repeatedly being misgendered. Cannabis intoxication helped manage social interactions as a person with ASD, while 'chasing' with cigarettes calibrated cannabis intoxication. Methamphetamine use related to managing body dysmorphia in a rural context with poor access to transgender health services. CONCLUSION This mixed method can integrate reliable and ecologically valid assessments of multiple drug use repertoires and combination patterns with the place-embedded experiences, intersecting identities, structural barriers, and intentions related to multiple drug use for different priority groups.
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Affiliation(s)
- Julia McQuoid
- TSET Health Promotion Research Center, Department of Preventive and Family Medicine, University of Oklahoma Health Sciences Center and 2 Center for Tobacco Control Research and Education, University of California, San Francisco; Center for Tobacco Control Research and Education, University of California, San Francisco; TSET Health Promotion Research Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center.
| | - Johannes Thrul
- Department of Mental Health Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland, USA; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Kekoa Lopez-Paguyo
- Center for Tobacco Control Research and Education, Department of Medicine, University of California, San Francisco and School of Public Health, University of California, Berkeley; School of Public Health, University of California, Berkeley; Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Pamela M Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California, San Francisco; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco; Center for Tobacco Control Research and Education, University of California, San Francisco
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Johann Willmann T. Improving the treatment of patients with dual diagnosis in emergency departments. Emerg Nurse 2021; 29:28-33. [PMID: 33205637 DOI: 10.7748/en.2020.e2055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/09/2022]
Abstract
Dual diagnosis involves the co-occurrence of severe mental illness and substance misuse. Recent guidance has sought to improve the initial identification of dual diagnosis and the ongoing management of patients with confirmed dual diagnoses. However, service provision between mental health teams and emergency departments (EDs) can be disjointed, resulting in suboptimal care. This article explores the care of patients who present at EDs with symptoms arising from a combination of severe mental illness and substance misuse. The author aims to alter the approach of multidisciplinary teams by applying change management theory, resulting in patients being treated by multiple healthcare disciplines in a more coordinated way. This will be demonstrated through a case study that follows a patient with dual diagnosis on the journey through an emergency department. Guidelines identifying best practice will be referred to and care failings in the patient's journey will be analysed. The author also provides an overview of how change management theory can be used to implement a new protocol for managing the treatment of patients with a dual diagnosis.
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Vera BDV, Carmona-Marquez J, Vidal-Giné C, Fernández-Calderón F. Harm Reduction Strategies and Drug-Related Negative Consequences in the Dance Music Scene: The Moderating Role of Polysubstance Use. Subst Use Misuse 2021; 56:777-781. [PMID: 33663340 DOI: 10.1080/10826084.2021.1892144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although simultaneous polysubstance use (SPU) is associated with greater harms than concurrent polysubstance use (CPU), no previous research has examined the effectiveness of harm reduction strategies in reducing drug-related harms in people who use drugs simultaneously and whether these strategies have a differential impact on drug-related negative consequences according to SPU patterns. Objectives: to examine the relationship between SPU patterns, harm reduction strategies and drug-related consequences experienced among people who attend dance music settings, and to examine the moderating role of SPU patterns in the relationship between harm reduction strategies and drug-related negative consequences Methods: a web-based survey was used to gather data from 649 substance-using attendees at dance music settings (mean age = 26.2, 68% male). The survey collected data on: settings of last party attended, drug use, harm reduction strategies used and drug-related negative consequences experienced during last party attended. Results: Latent class analysis identified two SPU profiles: Moderate SPU and Severe SPU. Participants in the severe SPU class experienced more drug-related negative consequences at their last party in comparison with those in the moderate SPU class. Regardless of SPU pattern, avoiding binge drinking was related to fewer drug-related negative consequences, whilst avoiding mixing stimulants was related to fewer drug-related negative consequences only among those participants in the severe simultaneous polysubstance use class. Conclusions: These findings could help to inform the design of messages and tailored interventions aimed at minimizing drug-related negative consequences among people who use multiple substances in the dance music scene.
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Affiliation(s)
- Belén Del Valle Vera
- Faculty of Psychology, National University of Córdoba, Córdoba, Argentina.,Institute of Psychological Research, IIPSI, UNC-CONICET, Córdoba, Argentina
| | - José Carmona-Marquez
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain.,Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Claudio Vidal-Giné
- Non-Governmental Organization Welfare and Development, Energy Control, Antequera, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain.,Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
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Noroozi M, Higgs P, Bayani A, Armoon B, Astaneh AN, Moghaddam LF, Askari M. Non -fatal overdose among people who inject drugs in Tehran, Iran. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:80. [PMID: 33054806 PMCID: PMC7559998 DOI: 10.1186/s13011-020-00323-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND With increasing frequencies of non-fatal overdose in people who inject drugs (PWID), it is essential to improve our knowledge about associated risk factors for overdose to inform overdose prevention and assistance programs. The aim of present study was to determine the prevalence of non-fatal overdose and the associated risk factors among PWID in Tehran, Iran. METHODS Snowball sampling was used to collect data from 465 participants in Tehran using a cross-sectional survey. Consenting participants who reported drug injecting in the past month and were able to speak and comprehend Farsi enough to respond to survey questions were interviewed. The endpoint of interest was non-fatal overdose in the previous 6 months, or answering "Yes" to the question: "In the last six months, have you ever overdosed by accident? (at least once)". We used STATA v. 14 for this analysis. Statistical significance was defined as p < 0.05 for all analyses. RESULTS Of 465 PWIDs who participated in this study, all were male, and about half had less than a high school education. The prevalence of self-reported non-fatal overdose in the past 6 months was 38% (CI95%: 34, 43%). Our findings indicate that characteristics and behaviors that were associated with an increased risk of experiencing an overdose in the past 6 months were drug use initiation under 22 years (AOR =2.2, P < 0.05), using methamphetamine (AOR =2.8, P < 0.05), and using multiple drugs at the same time (AOR =2.1, P < 0.05). Also, more recent initiates to injecting (< 2 years) had an increased risk of experiencing an overdose in the past 6 months. The odds of experiencing a non-fatal overdose among PWIDs who regularly attended NSP were 0.6 times less than for those who did not attend regularly (OR = 0.6,95% CI: 0.2-0.9). CONCLUSION Methamphetamine and alcohol use were the most significant association for non-fatal overdose among PWIDs. Our results indicate that intervention and prevention initiatives seeking to reduce overdoses among PWIDs should not only be focused on the primary drug used but also the use of alcohol and poly-drug use.
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Affiliation(s)
- Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Ali Nazeri Astaneh
- Department of Psychiatry, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Dumbili EW, Ezekwe E, Odeigah OW. From “Codeine Diet” to “Gutter Water”: polydrug use among Nigerian young adults. DRUGS AND ALCOHOL TODAY 2020. [DOI: 10.1108/dat-02-2020-0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore polydrug use and the factors that motivate the use of multiple substances among selected young adults.
Design/methodology/approach
A total of 23 male and female participants (aged 23-29 years) who use illicit drugs and prescription pharmaceuticals for non-medical purposes were recruited through snowball sampling. Qualitative interviews were conducted, and the data were analysed thematically.
Findings
The use of drug “concoctions” and cocktails was widespread among the participants. Some used what they called Codeine Diet (codeine-based cough syrup mixed with a Coca-Cola® product or malt drink), while others took Gutter Water (a cocktail of cannabis, codeine, tramadol, vodka and juice or water). The use of Monkey Tail (a mixture of local gin, cannabis leaves, stems, roots and seeds) and petrol mixed with glue and La Casera® (carbonated soft drink) combined with Tom-Tom® (menthol-flavoured candy) was also revealed. Pleasure, better highs, the need to experience prolonged intoxication and the use of one drug to douse the effects of another substance motivated polysubstance use.
Social implications
The findings revealed that the reasons why codeine-based cough syrups are mixed with soft drinks (Codeine Diet) include avoiding social discrimination and evading law enforcement agencies. Results suggest that these drug use practices require specifically tailored public health interventions. Social stigmatization against substance users and the use of extra-legal measures by the police should be discouraged to facilitate harm reduction.
Originality/value
This study represents the first qualitative research to explore polydrug use among an understudied Nigerian population.
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