1
|
AlOtaibi SD, Elsisi HA, AlShammary MJ, AlQader SA, AlHarbi HA, AlOlaiyan BR, Alanazi AO, AlMendeel FS, AlHarbi YN, AlKhalaf I, Alhowail AH, Elwy AM, Emara AM. Evaluation of the Psychiatric Disorders among Amphetamine Addicts in Rehabilitation Centers: A Cross-Sectional Analysis. J Toxicol 2024; 2024:1643693. [PMID: 39139980 PMCID: PMC11321892 DOI: 10.1155/2024/1643693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/20/2024] [Accepted: 06/07/2024] [Indexed: 08/15/2024] Open
Abstract
Background People who are addicted to amphetamines have a much greater chance of developing psychosis compared to those who are not. It is essential to study the behavioral and psychological effects of amphetamines. Therefore, this research aimed to examine conditions such as depression, anxiety, mood, cognitive abilities at the workplace, and social responsibilities by using sociodemographic factors as useful tools in determining effective strategies for preventing, managing, and treating amphetamine addiction. Methods A cross-sectional study among addicts hospitalized at two rehabilitation centers across Saudi Arabia between May and October 2023. A validated questionnaire consisting of psychiatric disorders assessment tools was distributed to healthcare professionals to start an interview with addicts to assess the abnormalities. The results were compared with healthy people (control). The assessment tools used are Hamilton Anxiety and Depression Rating Scale, Young Mania Rating Scale, and Work and Social Adjustment Scale. The data were analyzed using SPSS version 22.0. Pearson correlation coefficients (r) were employed. Results A total of 60 subjects participated in this study. The participants were divided into two groups (n = 60): group I was control (n = 25) healthy volunteers and group II was amphetamine abusers (n = 35), who were hospitalized for detoxification. The ages ranged from 18 to 60 years old with mean ages of 38.68 (±8.14) and 37.77 (±10.95) years in the control and amphetamine groups, respectively. Among the addicts, the mean severity dependence scale value was 10.46 (±1.82), which denotes high dependency on the illicit drug. The prevalence of high levels of anxiety, depression, and bipolar disorder was significantly higher among addicts when they were compared to healthy people (control). The assessment of the Work and Social Adjustment Scale (WSAS) reflected a higher impairment that minimized their ability to perform the work requirements, home management, social leisure, and relationships. Conclusions The addiction to amphetamines was associated with high impairment of work performance and social obligations and a negative impact on the addict's mental health. The risk of suffering anxiety, depression, and bipolar is higher than in nonaddict people. These effects are attributed to brain damage, neurotoxicity, and neuronal inflammation, particularly when these substances are abused over extended periods and at higher doses.
Collapse
Affiliation(s)
- Saud D. AlOtaibi
- Department of Pharmacology and ToxicologyCollege of PharmacyQassim University, Buraydah 51452, Qassim, Saudi Arabia
- Pharmaceutical Care ServicesKing Saud Medical CityMinistry of Health, Riyadh 12746, Saudi Arabia
- Qassim Health ClusterMinistry of Health, Qassim, Saudi Arabia
| | - Hossam A. Elsisi
- Department of Pharmacology and ToxicologyCollege of PharmacyQassim University, Buraydah 51452, Qassim, Saudi Arabia
- Department of Clinical PharmacologyFaculty of MedicineZagazig University, Zagazig 44519, Egypt
| | | | - Saud A. AlQader
- Mental Health HospitalERADAH, Sakaka 72385, Jouf, Saudi Arabia
| | | | | | | | | | | | | | - Ahmad H. Alhowail
- Department of Pharmacology and ToxicologyCollege of PharmacyQassim University, Buraydah 51452, Qassim, Saudi Arabia
| | - Abdelhamid Mohamed Elwy
- Department of Forensic Medicine and Clinical ToxicologyFaculty of MedicineTanta University, Tanta, Egypt
| | - Ashraf M. Emara
- Department of Pharmacology and ToxicologyCollege of PharmacyQassim University, Buraydah 51452, Qassim, Saudi Arabia
- Department of Forensic Medicine and Clinical ToxicologyFaculty of MedicineTanta University, Tanta, Egypt
| |
Collapse
|
2
|
Rezaianzadeh A, Niazkar HR, Rezaeianzadeh R, Jafari F, Rahimikazerooni S, Ghoddusi Johari M, Zare M, Hosseini SV. Kharameh cohort study (KHCS) on non-communicable diseases and preliminary findings of 3-year follow-up. BMJ Open 2024; 14:e077116. [PMID: 38331866 PMCID: PMC10860034 DOI: 10.1136/bmjopen-2023-077116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
PURPOSE The Kharameh cohort study (KHCS) is one branch of the 'Prospective Epidemiological Research Studies in Iran', located in the south of Iran. The enrolment phase of KHCS spanned from April 2015 to March 2017, during which urban and rural residents of Kharameh were enrolled in the study. KHCS aims to investigate the incidence of non-communicable diseases (NCDs) such as hypertension, diabetes mellitus, cardiovascular diseases and cancer, and its related risk factors in a 15-year follow-up. PARTICIPANTS KHCS was designed to recruit 10 000 individuals aged 40-70 years old from both urban and rural areas of Kharameh. Thus, a total of 10 800 individuals aged 40-70 years of age were invited and, finally, 10 663 subjects were accepted to participate, with a participation rate of 98.7%. FINDINGS TO DATE Of the 10 663 participants, 5944 (55.7%) were women, and 6801 (63.7%) were rural residents. The mean age of the participants was 51.9±8.2 years. 41.8% of the participants were aged 40-49, 35.2% were aged 50-59 and the remaining 23% were 60-70 years old. Until March 2020 (first 3 years of follow-up), the total number of patients diagnosed with NCDs was 1565. Hypertension, type 2 diabetes and acute ischaemic heart disease were the most common NCDs. Furthermore, the total number of deaths during the first 3 years of follow-up was 312, with cardiovascular diseases (38.7%) as the most common cause of death, followed by cerebrovascular diseases (11.8%) and cancer (16.2%). FUTURE PLANS The remaining 12 years of follow-up will inevitably shed light on the genetic, lifestyle/socioeconomic status, and environmental risk and protective factors of NCDs.
Collapse
Affiliation(s)
- Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Hamid Reza Niazkar
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Ramin Rezaeianzadeh
- Department of Medicine, British Columbia Open University, Kamloops, British Columbia, Canada
| | - Fatemeh Jafari
- Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Salar Rahimikazerooni
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Masoumeh Ghoddusi Johari
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Marjan Zare
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Seyed Vahid Hosseini
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| |
Collapse
|
3
|
Oh TK, Song IA. Association between socioeconomic status and treatment in patients with low back or neck pain: a population-based cross-sectional study in South Korea. Reg Anesth Pain Med 2023; 48:561-566. [PMID: 37045556 DOI: 10.1136/rapm-2022-104246] [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: 12/05/2022] [Accepted: 03/25/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Socioeconomic status affects the treatment of patients with low back pain and/or neck pain. We examined the relationship between socioeconomic status (occupation and household income level) and treatments such as chronic opioid use and interventional procedures among these patients. METHODS Data from the National Health Insurance Service database in South Korea were used in this population-based cross-sectional study. Approximately 2.5% of adult patients diagnosed with low back pain and/or neck pain between 2010 and 2019 were selected using a stratified random sampling technique and included in the analysis. RESULTS We analyzed the data of 5,861,007 patients with low back pain and/or neck pain in total. Among them, 4.9% were chronic opioid users and 17.7% underwent interventional procedures. Healthcare workers and unemployed individuals had 18% lower and 6% higher likelihood of chronic opioid use compared with office workers, respectively. Those with a very low household income had 18% higher likelihood of chronic opioid use than those with a poor household income. Other workers and unemployed individuals had 4% and 8% higher likelihood of undergoing interventional procedures than office workers, respectively. Healthcare workers had 5% lower likelihood of undergoing interventional procedures than office workers. Patients with middle, high, and very poor household incomes had a higher likelihood of undergoing interventional procedures, while those in the very high household income group had a lower likelihood of undergoing interventional procedures than those with poor household incomes. CONCLUSIONS Socioeconomic status factors are associated with treatment in patients with low back pain and/or neck pain.
Collapse
Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| |
Collapse
|
4
|
Ma CF, Luo H, Leung SF, Wong GHY, Lam RPK, Bastiampillai T, Chen EYH, Chan SKW. Impact of community mental health services on the adult psychiatric admission through the emergency unit: a 20-year population-based study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 39:100814. [PMID: 37927999 PMCID: PMC10625018 DOI: 10.1016/j.lanwpc.2023.100814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 11/07/2023]
Abstract
Background There is a lack of real-life population-based study examining the effect of community mental health services on psychiatric emergency admission. In Hong Kong, Integrated Community Center for Mental Wellness (ICCMW) and telecare service were introduced in 2009 and 2012, respectively. We examined the real-life impact of these services on psychiatric emergency admissions over 20 years. Methods Number of psychiatric emergency admissions between 2001 and 2020 was retrieved from the Hong Kong Clinical Data Analysis & Reporting System. We used an interrupted time series analysis to examine monthly psychiatric admission trend before and after service implementation, considering socioeconomic and environmental covariates. Findings A total of 108,492 psychiatric emergency admissions (47.8% males; 64.9% aged 18-44 years) were identified from the study period, of which 56,858, 12,506, 12,295, 11,791, and 15,051 were that for schizophrenia-spectrum disorders, bipolar affective disorders, unipolar mood disorders, neuroses, and substance use disorders. ICCMW introduction has an immediate effect on psychiatric emergency admission (adjusted estimate per 100,000: -10.576; 95% CI, -16.635 to -4.518, p < 0.001), particularly among adults aged 18-44 years (-8.543; 95% CI, -13.209 to -3.877, p < 0.001), females (-5.843; 95% CI, -9.647 to -2.039, p = 0.003), and with neuroses (-3.373; 95% CI, -5.187 to -1.560, p < 0.001), without a significant long-term effect. Unemployment, seasonality, and infectious disease outbreak were significant covariates. Interpretation ICCMW reduced psychiatric emergency admission, but no further reduction following full implementation. Community mental health services should be dynamically tailored for different populations and socioeconomic variations over time. Funding None.
Collapse
Affiliation(s)
- Chak Fai Ma
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sau Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Gloria Hoi Yan Wong
- Department of Social Work and Social Administration, Faculty of Social Science, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rex Pui Kin Lam
- Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tarun Bastiampillai
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| |
Collapse
|
5
|
Conway A, Krawczyk N, McGaffey F, Doyle S, Baaklini V, Marshall AD, Treloar C, Davis CS, Colledge-Frisby S, Grebely J, Cerdá M. Typology of laws restricting access to methadone treatment in the United States: A latent class analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104141. [PMID: 37540917 DOI: 10.1016/j.drugpo.2023.104141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/09/2023] [Accepted: 07/14/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND In the United States, methadone treatment for opioid use disorder is only available at opioid treatment programs (OTPs). In addition to federal regulations, states can enact laws which shape access to OTPs. We aimed to define classes of states according to restrictiveness of state OTP laws and examine population characteristics associated with class membership. METHODS A set of laws was extracted from a database of statutes and regulations governing OTPs in 49 states and the District of Columbia as of June 2021. Latent class analysis of laws was used to estimate the probability of class membership for each state. Class-weighted multinomial logistic regression analysis assessed state-level correlates of class membership and adjusted Relative Risk Ratio (aRRR) and 95% confidence intervals (95%CI) were generated. RESULTS States (n = 50) were assigned to three classes; Class 1) High restrictiveness on patient experience, low restrictiveness on access to service (n = 13); Class 2) Medium restrictiveness on patient experience, high restrictiveness on access to service (n = 14); Class 3) Low restrictiveness on patient experience, low restrictiveness on access to service (n = 23). States with a higher probability of membership in Classes with higher restrictiveness had higher rates of unemployment (Class 1 vs Class 3, aRRR:1.24; 95%CI:1.06-1.45), and Black residents (Class 2 vs Class 3, aRRR:1.10; 95%CI:1.04-1.15), and lower likelihood of Medicaid coverage of methadone (Class 1 vs Class 3, aRRR:0.25; 95%CI:0.07-0.88). States with a higher probability of membership in Classes with higher restrictiveness also had higher rates of potential indicators for opioid use disorder treatment need, including rates of opioid dispensing (Class 1 vs Class 3, aRRR:1.06; 95%CI:1.02-1.10, Class 2 vs Class 3, aRRR:1.07; 95%CI:1.03-1.11) and HIV diagnoses attributed to injection (Class 1 vs Class 3, aRRR:3.92; 95%CI:1.25-12.22). CONCLUSIONS States with indicators of greater potential need for opioid use disorder treatment have the most restrictions, raising concerns about unmet treatment need.
Collapse
Affiliation(s)
- Anna Conway
- The Kirby Institute, UNSW, Sydney, Australia; Centre for Social Research in Health, UNSW, Sydney, Australia.
| | - Noa Krawczyk
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Sheri Doyle
- The Pew Charitable Trusts, Philadelphia, United States
| | | | - Alison D Marshall
- The Kirby Institute, UNSW, Sydney, Australia; Centre for Social Research in Health, UNSW, Sydney, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW, Sydney, Australia
| | - Corey S Davis
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States; Network for Public Health Law, Los Angeles, United States
| | - Samantha Colledge-Frisby
- National Drug Research Institute, Curtin University, Melbourne, Australia; National Drug and Alcohol Research Centre, Burnet Institute, Melbourne, Australia
| | | | - Magdalena Cerdá
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| |
Collapse
|
6
|
Jeong S, Fox AM. Enhanced unemployment benefits, mental health, and substance use among low-income households during the COVID-19 pandemic. Soc Sci Med 2023; 328:115973. [PMID: 37257269 DOI: 10.1016/j.socscimed.2023.115973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 03/17/2023] [Accepted: 05/15/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To buffer the economic impacts of the pandemic-induced economic downturns, the U.S. government passed major economic stimulus bills that provided cash payments to affected citizens and a large boost to unemployment benefits. We ask what impact these enhanced safety-net policies have had on mental health and stress-induced substance use among low-income Americans, especially enhanced unemployment insurance (UI) benefits, which constituted a large economic transfer to those eligible. METHODS Using individual fixed effects analysis of a panel of nearly 900 low-income Americans since the start of the pandemic from the Understanding America Survey, we examine how receipt of enhanced unemployment benefits has impacted the mental health burden and substance use behaviors of low-income Americans. We additionally examine the buffering effect of a set of other safety-net measures (Stimulus, Medicaid, SNAP, TANF, housing assistance, EITC, WIC, and CHIP). RESULTS We found that job loss, regardless of benefit receipt, was associated with increased stress and decreased average substance use, driven by reduced smoking when compared with those were employed. Yet, when factoring in UI receipt we see that receiving UI was associated with reduced stress, but no impact on depression or substance use. In contrast, those who did not receive UI experienced greater stress compared with those who were employed. Overall, we found that people who remained employed used substances more than people who were unemployed regardless of UI receipt with the exception of drinking. CONCLUSIONS We conclude that enhanced unemployment offset some of the negative mental health effects of the pandemic and did not increase routine substance use among the unemployed.
Collapse
Affiliation(s)
- Soyun Jeong
- Department of Public Administration and Policy, Rockefeller College of Public Affairs & Policy, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA.
| | - Ashley M Fox
- Department of Public Administration and Policy, Rockefeller College of Public Affairs & Policy, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| |
Collapse
|
7
|
Karabulut S. A 6-Month Follow-Up Study: Cognitive Impairment May Predict More Frequent Use of Methamphetamine. Subst Abuse 2023; 17:11782218231175811. [PMID: 37216038 PMCID: PMC10192674 DOI: 10.1177/11782218231175811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
Objectives Methamphetamine (METH) use has been associated with impairments in a variety of cognitive functions. In this study, it was aimed to assess the relation between cognitive measures and frequency of METH use. Methods Ninety-eight participants with methamphetamine use disorder were assessed with Wisconsin Card Sorting Test (WCST), Victoria-Stroop Word Color Test (SWCT), Trail Making Test (TMT) A and B. Participants were followed up during 6-month period with multiple urine toxicology tests (at baseline, month 1, month 2, month 3 and month 6). Results Participants who had their prescriptions regularly were more likely to have higher rates of METH-negative urine results (P = .003). Participants who had more correct numbers, completed more categories and had more conceptual level responses on WCST were more likely to use lower frequency of METH (OR = 0.006, P < .01; OR = 0.171, P < .001; OR = 0.024, P < .001; respectively). The higher error numbers and perseverative error rates on WCST were associated with more frequent METH use (OR = 0.023, P < .001; OR = 0.076, P < .001). Interference factor on SWCT was related with lower frequency of METH use whereas color naming factor on SWCT was related with higher rates of urine results (OR = 0.012, P < .001; OR = 3.628, P < .001; respectively). Higher TMT B-A score was related with more frequent METH use, although the significance disappeared after adjustment (OR = 0.002, P < .001). Having psychotic symptoms predicted less frequent use, but after adjustment for other significant variables, there was no significance. Conclusion Lower frequency of METH use in the follow-up could be predicted by neurocognitive assessments. Deficits in executive functions, attention, set-shifting and mental flexibility seems to be the most effected domains and this effect may be independent from the severity of psychotic symptoms.
Collapse
Affiliation(s)
- Sercan Karabulut
- Sercan Karabulut, Centre of Alcohol and
Substance Addiction Treatment, Ataturk State Hospital, Nebiler, 7192 Sok.,
Kepez/Döşemealtı/Antalya 07192, Turkey.
| |
Collapse
|
8
|
Nolte-Troha C, Roser P, Henkel D, Scherbaum N, Koller G, Franke AG. Unemployment and Substance Use: An Updated Review of Studies from North America and Europe. Healthcare (Basel) 2023; 11:healthcare11081182. [PMID: 37108016 PMCID: PMC10137824 DOI: 10.3390/healthcare11081182] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 04/29/2023] Open
Abstract
Since the industrial revolution, the relationship between unemployment and psychiatric disorders has been a subject of high interest. Currently, regarding the correlation between unemployment and substance-use disorders (SUDs), only older, often isolated and fragmented research results are available in the literature. This review was based on an extensive literature search of the European and North American literature in most relevant databases for "unemployment" and "substance use" related to "drugs", "alcohol", "nicotine", and "tobacco" between November 2022 and January 2023, according to the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) guidelines. A total of 59,117 papers were identified, of which only 33 articles were identified as relevant to the research objective. The literature showed significantly higher prevalence rates of SUDs involving divergent psychotropic substances among unemployed people. Unemployment was found to be a risk factor for SUD, and vice versa. However, the correlation between unemployment and relapses or smoking cessation was inconsistent. In addition, there appeared to be a mild effect of business cycles on SUD. The results showed significant multifaceted correlations between unemployment and SUD, indicating that prevention and early intervention are required to prevent harmful psychosocial consequences, such as social disintegration and severe psychiatric disorders.
Collapse
Affiliation(s)
- Carina Nolte-Troha
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Ludwig-Maximilians-University Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Patrik Roser
- Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Dieter Henkel
- Main Institute of Addiction Research (ISFF), University of Applied Sciences Frankfurt, Nibelungenplatz 1, 60318 Frankfurt am Main, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Ludwig-Maximilians-University Munich, Nußbaumstr. 7, 80336 Munich, Germany
| | - Andreas G Franke
- University of Applied Labour Studies, Seckenheimer Landstr. 16, 68163 Mannheim, Germany
| |
Collapse
|
9
|
Gutkind S, Askari MS, Perlmutter AS, Nesoff ED, Mauro PM, Martins SS. Associations between relative deprivation with opioid use among working-age adults during the great recession. J Psychiatr Res 2023; 160:101-109. [PMID: 36796291 PMCID: PMC10023414 DOI: 10.1016/j.jpsychires.2023.02.010] [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] [Received: 09/23/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Recessions, poverty, and unemployment have been associated with opioid use. However, these measures of financial hardship may be imprecise, limiting our ability to understand this relationship. We tested associations between relative deprivation and non-medical prescription opioid use (NMPOU) and heroin use among working-age adults (ages 18-64) during the Great Recession. Our sample included working-age adults in the 2005-2013 United States National Survey of Drug Use and Health (n = 320,186). Relative deprivation compared the lowest limit of participants' income category to the national 25th percentile individual income for people with similar socio-demographic characteristics (race and ethnicity, gender, year). We distinguished the period before (1/2005-11/2007), during (12/2007-06/2009), and after (07/2007-12/2013) the Great Recession. We estimated odds of past-year NMPOU and heroin use for each past-year exposure (i.e., relative deprivation, poverty, unemployment) using separate logistic regressions adjusting for individual-level covariates (gender, age, race/ethnicity, marital status, and education) and national-level annual Gini coefficient. Our results show that NMPOU was higher among people experiencing relative deprivation (aOR = 1.13, 95% CI = 1.06-1.20), poverty (aOR = 1.22, 95% CI = 1.16-1.29), and unemployment (aOR = 1.42, 95% CI = 1.32-1.53) between 2005 and 2013, as was heroin use (aORs = 2.54, 2.09, 3.55, respectively). The association between relative deprivation and NMPOU was modified by recession timing, and was significantly higher after the Recession (aOR = 1.21, 95% CI = 1.11-1.33). Relative deprivation was associated with higher odds of NMPOU and heroin use, and higher odds of NMPOU after the Great Recession. Our findings suggest contextual-level factors may modify the relationship between relative deprivation and opioid use, and support the need for new measures of financial hardship.
Collapse
Affiliation(s)
- Sarah Gutkind
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
| | - Melanie S Askari
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
| | - Alexander S Perlmutter
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
| | - Elizabeth D Nesoff
- Department of Biostatistics, Epidemiology & Informatics at University of Pennsylvania Perelman School of Medicine, 423 Guardian Dr, Philadelphia, PA, USA.
| | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, USA.
| |
Collapse
|
10
|
Ramadan M, Alharbi A, Ahmad RG, Alkhalaf A, Alhusseini N, Algarni AS, Mohamed IS. Evaluation of Substance Use Disorder Readmission and Length of Hospital Stay in a Major Rehabilitation Center in the Gulf States: a Retrospective Cohort Study. Int J Ment Health Addict 2022:1-16. [PMID: 36196061 PMCID: PMC9521855 DOI: 10.1007/s11469-022-00920-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Substance use disorders (SUDs) patients have longer lengths of hospital stay, and more unplanned readmissions than other hospitalized patients. We aim to evaluate SUD-related rehospitalization and length of hospital stay in a major rehabilitation center that serves countries of the Gulf States. In a retrospective cohort study for 16-year data set in Al-Amal Hospital Electronic Health Record in the city of Dammam, Eastern region of Saudi Arabia, patients received services from the SUD treatment programs in the period of January 1, 2005, to December 31, 2021. We used cause-specific Cox proportional hazards regression model to estimate risk of readmission, and general linear model to examine the association between substance use disorders and length of hospital stay. Of the total cohort, 4398 (30.17%) were readmitted within 1 year of discharge date. More than half of the cohort were unemployed patients (52.93%). Patients diagnosed with amphetamine use disorder were 1.36 higher risk of readmission compared to no amphetamine disorder (HR = 1.36; CI (1.04, 1.78) P.02). Patients diagnosed with mental disorder had 7.25 times higher risk of longer hospital stay compared to no mental health disorder (coefficient = 7.25; P < .0001). Amphetamine use disorder increased the risk of readmission. A secondary diagnosis of mental disorders among SUD patients increased length of hospital stay. As a targeted region of amphetamine smuggling in the world, policy and clinical decision-makers in Saudi Arabia and the Gulf States should consider taking proactive steps to minimize the future anticipated high demand for addiction treatment in the region.
Collapse
Affiliation(s)
- Majed Ramadan
- Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah, 21423 Kingdom of Saudi Arabia
| | - Aysha Alharbi
- Ministry of Health, Prince Abdulrahman Bin Abdulaziz St., Riyadh, Kingdom of Saudi Arabia
| | - Rami Ghazi Ahmad
- Psychiatry Section, Medicine Department, Ministry of National Guard - Health Affairs, Abdullah International Medical Research Center, Jeddah, 21423 Saudi Arabia
| | - Ahmed Alkhalaf
- Psychiatry & Mental Health Services, Johns Hopkins Aramco Healthcare, Dhahran, Kingdom of Saudi Arabia
| | - Noara Alhusseini
- Department of Biostatistics and Epidemiology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Alanood S. Algarni
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Mecca, Saudi Arabia
| | | |
Collapse
|
11
|
Kim M, Byrne AM, Jeon J. The Effect of Vocational Counseling Interventions for Adults with Substance Use Disorders: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4674. [PMID: 35457542 PMCID: PMC9027488 DOI: 10.3390/ijerph19084674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
The authors reviewed the research literature evaluating the effectiveness of vocational counseling interventions focused on employment for consumers with substance use disorders. This review included 11 articles related to vocational counseling interventions, which are either incorporated with substance use treatment or not. The results of this review revealed that vocational counseling services have been highly efficacious in resulting in part-time and full-time jobs. The study designs had some limitations, and few studies employed randomized control trials (RCT).
Collapse
Affiliation(s)
- Min Kim
- Department of Social Welfare, Incheon National University, Incheon 22012, Korea;
| | - Andrew M. Byrne
- School of Education, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Jihye Jeon
- Department of Social Welfare, Incheon National University, Incheon 22012, Korea;
| |
Collapse
|
12
|
Azagba S, Shan L, Wolfson M, Hall M, Chaloupka F. Problem drinking as intentional risky behavior: Examining the association between state health insurance coverage and excessive alcohol consumption. Prev Med Rep 2021; 24:101556. [PMID: 34976624 PMCID: PMC8683933 DOI: 10.1016/j.pmedr.2021.101556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/27/2021] [Accepted: 09/04/2021] [Indexed: 11/26/2022] Open
Abstract
The moral hazard theory asserts that having health insurance may increase individual risk-taking behaviors. We examined the association between state health insurance coverage and excessive alcohol use among U.S. adults. We used 2001-2017 Behavioral Risk Factor Surveillance System data to estimate annual binge and heavy drinking rates for each state. In a multivariable regression analysis, we used difference-in-difference (DID) models to assess the association between state-level insurance coverage and binge and heavy drinking. Additionally, we assess the potential asymmetric effect and whether economic recessions (2001, 2008-09) had a moderation effect. In the multivariable DID analysis, aggregate state insurance coverage was not significantly associated with binge drinking rates in baseline analysis with state-fixed effects (Model 1), and in the analysis that extends the baseline model to include state unique time trend (Model 2). A similar result was found for heavy drinking in Model 1. In contrast, the result showed a significant association between health insurance coverage and heavy drinking rates in Model 2. However, we found no significant association for binge and heavy drinking rates in both models in the analyses restricting data to periods before the methodological change in the BRFSS sampling frame. The results did not show asymmetric effects, and the association between health insurance and excessive alcohol use did not differ during economic recessions. These findings largely do not support assertions that health insurance may lead to moral hazards (risk-taking behaviors), especially binge drinking.
Collapse
Affiliation(s)
- Sunday Azagba
- Ross and Carol Nese College of Nursing, Penn State, University Park, PA 16802, USA
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, Riverside, CA 92501, USA
| | - Mark Wolfson
- Department of Social Medicine, Population and Public Health, University of California Riverside School of Medicine, Riverside, CA 92501, USA
| | - Mark Hall
- Department of Social Science and Health Policy, Wake Forest School of Medicine, USA
| | - Frank Chaloupka
- School of Public Health, The University of Illinois at Chicago, USA
| |
Collapse
|
13
|
Dumonceau RG, Soeiro T, Lacroix C, Giocanti A, Frauger É, Mezaache S, Micallef J. Antidepressants abuse in subjects with opioid use disorders: A 10-year study in the French OPPIDUM program. Fundam Clin Pharmacol 2021; 36:436-442. [PMID: 34837277 DOI: 10.1111/fcp.12738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/22/2023]
Abstract
Accumulating evidence shows that some antidepressants are abused for their psychostimulant effects, but the extent of antidepressants abuse is unknown in subjects with opioid use disorders (OUD). The objective of this work is to assess the prevalence of antidepressant abuse and its correlates in subjects with OUD. Subjects ≥18 year-old in an opiate maintenance treatment (OMT) program who reported using an antidepressant were selected from the OPPIDUM program from 2011 to 2020. The outcome was antidepressant abuse. Antidepressant abusers were identified as subjects reporting at least one of the following behaviors: "drug abuse," "concomitant use of alcohol," "illegal obtaining," and "dose higher than recommended in the Summary of Product Characteristics." Among the 83 040 observations of subjects ≥18 year-old in an OMT program included in the OPPIDUM program from 2011 to 2020, 2708 (3.3%) subjects reported using an antidepressant in monotherapy. Among them, there were 385 (14.2%) abusers. The proportion of abusers was the highest for amitriptyline (n = 31, 25.0%). In multivariate analysis, antidepressant abuse was positively associated with amitriptyline (OR 2.07, 95% CI [1.16, 3.73]; p = 0.015), unemployment (OR 1.52, 95% CI [1.16, 2.01]; p = 0.003), the use of intravenous route of administration (OR 1.77, 95% CI [1.12, 2.80]; p = 0.014), and the use of benzodiazepines (OR 1.53, 95% CI [1.21, 1.94]; p < 0.001). Clinicians should be aware of the risk of antidepressant abuse when prescribing in subjects with OUD, accounting for their heterogeneous pharmacological properties that may account for their abuse potential.
Collapse
Affiliation(s)
- Robinson Gravier Dumonceau
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Thomas Soeiro
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France.,Aix-Marseille Université, Inserm, UMR 1106, Marseille, France
| | - Clémence Lacroix
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France.,Aix-Marseille Université, Inserm, UMR 1106, Marseille, France
| | - Adeline Giocanti
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Élisabeth Frauger
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Salim Mezaache
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France
| | - Joëlle Micallef
- Assistance publique - Hôpitaux de Marseille, Service de pharmacologie clinique, Centre d'Évaluation et d'information sur la pharmacodépendance - Addictovigilance PACA Corse, Marseille, France.,Aix-Marseille Université, Inserm, UMR 1106, Marseille, France
| |
Collapse
|
14
|
Asilkalkan A, Zhu X. Matrix‐variate time series modelling with hidden Markov models. Stat (Int Stat Inst) 2021. [DOI: 10.1002/sta4.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Abdullah Asilkalkan
- Department of Information Systems, Statistics, and Management Science The University of Alabama Tuscaloosa AL 35487 USA
| | - Xuwen Zhu
- Department of Information Systems, Statistics, and Management Science The University of Alabama Tuscaloosa AL 35487 USA
| |
Collapse
|