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Siddiqui M, Sanduka O, Tom A, Sinha P, Appel G, Avery J, Weber A. A Medical Student-Led Stigma Awareness Initiative in the Middle East and North Africa (MENA) Region. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:102-103. [PMID: 37735343 DOI: 10.1007/s40596-023-01855-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Affiliation(s)
| | - Omar Sanduka
- Al-Khalidi Hospital and Medical Center, Amman, Jordan
| | | | | | | | | | - Alan Weber
- Weill Cornell Medicine-Qatar, Doha, Qatar
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Dabbagh R, Alsulimani A, Alshamrani S, Abuhaimed A, Alzaid W, Aldofyan M, Alqahtani S, Alsharqi A, Rawson R. Prescription opioid misuse in relation to addiction susceptibility among women at a Saudi university. Saudi Pharm J 2023; 31:101764. [PMID: 37693733 PMCID: PMC10491761 DOI: 10.1016/j.jsps.2023.101764] [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: 05/08/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives The trends of prescription opioid misuse are understudied in Arab populations, let alone among university students. Additionally, little is known about the psychological traits that increase susceptibility for such behaviors in this region. Thus, this study aimed to assess the prevalence of prescription opioid misuse and its association with addiction susceptibility, as measured by the Substance Abuse Risk Profile Scale (SURPS). Methods We sampled university students from King Saud University's women's campus. Data on prescription opioid misuse, SURPS traits, and demographic characteristics were collected using an electronic self-administered survey. Results Lifetime prescription opioid misuse was 48.5%, while past-month misuse was 28.9%. On average, SURPS subscale scores for impulsivity (mean = 11.6; SD = 2.8) hopelessness (mean = 12.3; SD = 3.5), sensation seeking (mean = 16.4; SD = 3.8), and anxiety sensitivity (mean = 14.6; SD = 2.6). Anxiety sensitivity composite scores significantly differed between students reporting misuse and those who did not. Moreover, the odds for prescription opioid misuse increased by 7% for every 1 unit increase in anxiety sensitivity (AOR = 1.07; 95% CI = 1.00, 1.14), when controlling for other SURPS measures and student characteristics. Conclusion The prevalence of prescription opioid misuse in our study is higher than what is reported in global student populations. This may reflect unmonitored availability of controlled substances and unsupervised medical prescriptions. Additionally, high levels of anxiety sensitivity may be driving such misuse. Further surveillance of prescription drug misuse among university students and motivators for such behavior is needed for planning prevention and control interventions.
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Affiliation(s)
- Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Wejdan Alzaid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Samar Alqahtani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Richard Rawson
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, United States
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False Positive Tramadol Urine Testing in Patients Taking Fexofenadine: A Tale of Two Consecutive Cases. Case Rep Psychiatry 2023; 2023:4370648. [PMID: 36643013 PMCID: PMC9836806 DOI: 10.1155/2023/4370648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023] Open
Abstract
Urine drug screen immunoassays have been widely used as point-of-care testing for detection of various drug classes in substance use disorders. However, these immunoassays frequently result in false positive results. We report two patients that used 180 mg daily dose of fexofenadine hydrochloride for treatment of skin allergy and, falsely, tested positive for use of tramadol during urine drug screening. We recommend caution when interpreting positive tramadol urine screening among patients on fexofenadine treatment.
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Polysubstance Use in Adults With Opioid Use Disorder Receiving Buprenorphine Maintenance. J Addict Med 2023; 17:74-78. [PMID: 35793664 DOI: 10.1097/adm.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Studying polysubstance use is a public health recommendation. In the United Arab Emirates, more than 80% of adults with opioid use disorder (OUD) use 2 or more nonopioid substances. This secondary analysis contrasts the characteristics of polysubstance users (OUD + ≥1 nonopioid) with OUD, explores the correlates and predictors of nonfatal overdose, and examines the impact of polysubstance use on OUD treatment outcomes using buprenorphine (BUP). METHODS This analysis uses data from a 16-week outpatient randomized controlled trial of 141 adults with OUD allocated to BUP + incentivized adherence and abstinence monitoring (n = 70) and BUP in usual care (control, n = 71). Outcomes were nonfatal overdose events over the preceding 12 months, positive drug screens, and treatment retention. Participant characteristics were contrasted, and bivariate statistical tests were conducted for simple associations followed by logistic regression. RESULTS Polysubstance use was reported by 117 participants (82.9%), the majority of whom used pregabalin 72.1% (n = 75). Compared with OUD, polysubstance users observed higher arrests (median, 1.0 [interquartile range, 0.0-3.0] vs 0.5 [interquartile range, 0.0-2.0]; P = 0.04]) and nonfatal overdose events (n = 33 [31.8%] vs 2 [10.8%], P = 0.003). Carisoprodol and injecting drug use independently predicted nonfatal overdose (adjusted odds ratio, 4.519 [95% confidence interval, 1.81-11.22] and 2.74 [95% confidence interval, 1.15-6.51], respectively). No significant difference was observed in opioid use and retention in treatment outcomes between groups. CONCLUSION Carisoprodol and injecting drug use increase the likelihood of nonfatal overdose in adults with OUD. Polysubstance use does not impact response to BUP treatment compared with OUD.
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Zenbaba D, Yassin A, Abdulkadir A, Mama M. Geographical variation and correlates of substance use among married men in Ethiopia: spatial and multilevel analysis from Ethiopian Demographic and Health Survey 2016. BMJ Open 2022; 12:e062060. [PMID: 36153037 PMCID: PMC9511580 DOI: 10.1136/bmjopen-2022-062060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The use of substances has become one of the world's most serious public health and socioeconomic issues. Most nations in sub-Saharan Africa, including Ethiopia, are undergoing significant economic transitions, creating a favourable environment for socially destructive substance use. This study aimed to determine the geographical variation, prevalence and correlates of substance use among ever-married men in Ethiopia. DESIGN A community-based cross-sectional survey was undertaken from 18 January 2016 to 27 June 2016. DATA SOURCE Data were used from the 2016 Ethiopian Demographic and Health Survey (EDHS). DATA EXTRACTION AND ANALYSIS Data from the 2016 EDHS was used, and a total of 7793 ever-married men were involved in the analysis. The spatial autocorrelation statistic (Global Moran's I) was used to determine whether substance use was dispersed, clustered or randomly distributed. A multilevel logistic regression model was used to identify the correlates with substance use, and statistical significance was declared at p<0.05 and 95% CI. RESULTS Of all ever-married men, 72.5% (95% CI 71.5% to 73.4%) were currently using at least one of the three substances (alcohol, cigarettes and chat). The highest hotspot areas of substance use were observed in Ahmara and Tigray regions. The age (adjusted OR, AOR 1.80; 95% CI 1.32 to 2.45), educational status (AOR 0.64; 95% CI 0.51 to 0.82), occupation (AOR 1.36; 95% CI 1.05 to 1.76), watching television (AOR 1.50; 95% CI 1.25 to 1.81) and living in the city (AOR 2.25; 95% CI to 1.36 to 3.74) were individual and community-level correlates found to have a statistically significant association with substance use. CONCLUSION In this study, nearly three-fourths of married men used one of the three substances. Given these findings, it is critical to reducing the problem by improving modifiable individual-level variables such as educational status and reducing substance advertising.
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Affiliation(s)
- Demisu Zenbaba
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
| | - Ahmed Yassin
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
| | - Adem Abdulkadir
- Public Health, Madda Walabu University, Goba, Oromia, Ethiopia
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Alodhayani AA, Almutairi KM, Vinluan JM, Alonazi WB, Alzahrani HG, Batais MA, Kaki FM, Almigbal TH, Alsaad S. A retrospective analysis of substance use among female psychiatric patients in Saudi Arabia. Front Psychol 2022; 13:843785. [PMID: 36072054 PMCID: PMC9443957 DOI: 10.3389/fpsyg.2022.843785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This study investigated the prevalence of substance use (SU), and its risk factors, among women attending psychiatric outpatients center in Saudi Arabia. Design A retrospective cross-sectional design. Materials and methods We reviewed outpatients' records of 200 female patients with a history of SU from a psychiatric unit in Jeddah, Saudi Arabia from December 2018 to February 2019. The researchers developed the pro forma, and 2 psychiatrists and a family medicine physician validated the form. Results The most common and widely used were psychoactive substances (58%), followed by central nervous system (CNS) depressants (22%), and finally cannabinols (9.5%). Overall, the highest substance use was the amphetamine-cannabis-nicotine (ACN) representing nearly half of the illicit items (46.6%), followed by heroine-alcohol-benzodiazepine (16.4%), and with the lowest being benzodiazepine-nicotine (1.7%). There was a significant difference between the single substance and multiple substance use in terms of age (p = 0.001), smoking behavior (p = 0.001), patients past history (p = 0.005), and age of the patient at the start of drug use (p = 0.005). Conclusion Although the prevalence of substance use among women is low in Saudi Arabia, screening of substance use disorders risks and building a rehabilitation program to control drug dependence are needed.
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Affiliation(s)
- Abdulaziz A. Alodhayani
- Department of Family Medicine and Community, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M. Almutairi
- Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Jason M. Vinluan
- Department of Family Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Wadi B. Alonazi
- College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | | | - Mohammed Ali Batais
- Department of Family Medicine and Community, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Turky H. Almigbal
- Department of Family Medicine and Community, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alsaad
- Department of Family Medicine and Community, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Prevalence, and associated factors of tobacco smoking among adults in the United Arab Emirates; results from national health survey. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01571-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Althunian TA, Alomran MI, Alsagri GM, Alrasheed MM, Alshammari TM. The Impact of Regulatory Restrictions on Pregabalin use in Saudi Arabia: An Interrupted Time series Analysis. Pharmacoepidemiol Drug Saf 2022; 31:577-582. [PMID: 35049110 DOI: 10.1002/pds.5408] [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: 05/25/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The Saudi Food and Drug Authority (SFDA) added pregabalin to the list of controlled substances in December 2017 to minimize the risk of its possible abuse and misuse. This study was aimed at assessing the impact of this decision on the overall use of pregabalin in Saudi Arabia and in comparison, with drugs prescribed to treat neuropathic pain therapy (i.e. vs. gabapentin, tramadol, duloxetine, and amitriptyline). METHODS This was an interrupted time-series analysis of the Saudi quarterly sale data of the study drugs from October/2015 to September/2020. These data were obtained from IQVIA and were converted into use estimates (defined daily dose per 1000 inhabitant-days [DDD/TID]). Segmented regression models were conducted to assess the direct (level) and prolonged (trend) changes in use data after the decision. All analyses were completed using RStudio Version 1.4.1103. RESULTS Before the SFDA's decision, there was an increased quarter-to-quarter use of pregabalin (DDD/TID: 0.16; 95% confidence interval [CI] 0.04 to 0.28). Pregabalin overall use dropped sharply by -1.85 DDD/TID (95%CI -2.71 to -0.99) directly after the decision with a prolonged quarter-to-quarter declining effect (DDD/TID: -0.22, CI to -0.37 to -0.05). The decision was associated with a direct increase in the use of gabapentin by 0.62 DDD/TID (95%CI 0.52 to 0.72) without any impact on the use of other drugs. CONCLUSIONS The results of our study showed that the SFDA decision was associated with a decrease in the overall use of pregabalin, which may help minimize the risk of its abuse and misuse. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Turki A Althunian
- Executive Directorate for Research and Studies, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Maha I Alomran
- Executive Directorate for Research and Studies, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Ghada M Alsagri
- Executive Directorate for Research and Studies, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Meshael M Alrasheed
- Executive Directorate for Research and Studies, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Thamir M Alshammari
- Executive Directorate for Research and Studies, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
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Mohaddes Ardabili H, Akbari A, Rafei P, Butner J, Khan R, Khazaal Y, Arab AZ, Qazizada MR, Al-Ansari B, Baldacchino AM. Tramadol, captagon and khat use in the Eastern Mediterranean Region: opening Pandora's box. BJPsych Int 2021; 19:58-62. [PMID: 36287793 PMCID: PMC9540563 DOI: 10.1192/bji.2021.53] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/05/2021] [Accepted: 08/15/2021] [Indexed: 12/12/2022] Open
Abstract
As defined by the World Health Organization, the Eastern Mediterranean Region (EMR), given its special geopolitical situation and internal/external conflicts, faces an increase in illegal activities such as drug production and trafficking, highlighting the need for a comprehensive understanding of the substance use situation. On the basis of a review of published papers between 2015 and 2021 we briefly review substance use in the EMR with special focus on the emerging drugs pertinent to this region, namely tramadol, captagon and khat.
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Bassiony MM, Mahdy RS, Haggag N, Salah Eldeen G. Current attention-deficit/hyperactivity disorder and nonmedical prescription opioid use attributed to tramadol among male adolescents without conduct disorder in Egypt. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:623-629. [PMID: 34280063 DOI: 10.1080/00952990.2021.1944172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: Evidence for the association between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) is common. However, little research has investigated this relationship among adolescents using nonmedical prescription opioids, particularly tramadol.Objective: To estimate the prevalence and correlates of ADHD among adolescents with tramadol misuse and without conduct disorder (CD).Methods: This study included 122 Egyptian adolescents (100% male) with opioid use disorders attributed to tramadol. The diagnosis of SUDs, ADHD, and CD (to exclude) was based on the SCID-I criteria of the DSM-IV-TR. Drug-related problems were assessed using the Drug Use Disorders Identification Test (DUDIT). All adolescents were screened for drugs by urinalysis.Results: Thirty-eight percent of adolescents with tramadol misuse had ADHD. Adolescents with tramadol misuse and ADHD were more likely to have a younger age of onset of smoking, substance use, and tramadol misuse than adolescents without ADHD.Conclusions: ADHD is common among adolescents with tramadol misuse. There is an association between ADHD and young age of onset of tramadol misuse and drug-related problems.
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Affiliation(s)
- Medhat M Bassiony
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rehab S Mahdy
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Noha Haggag
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ghada Salah Eldeen
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Abraham O, Thakur T, Brasel K, Norton D, Rosenberger CA. Development of the Adolescent Opioid Safety and Learning (AOSL) scale using exploratory factor analysis. Res Social Adm Pharm 2021; 18:2796-2803. [PMID: 34144900 PMCID: PMC9536461 DOI: 10.1016/j.sapharm.2021.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND While adolescents in the United States are one of the most affected groups by the opioid crisis, their perceptions on opioid misuse and preferences for education are rarely studied. Although it is critical to educate adolescents on proper opioid use and storage, many educational tools need easy measurement scales to systematically document learning of targeted programs. It is essential to understand adolescents' knowledge about opioid risks and perceptions about the opioid crisis to design effective preventive interventions. OBJECTIVE The purpose of this study was to develop an effective scale that measures adolescents' knowledge about opioid misuse and interest in learning about prescription opioid safety. METHODS Using survey data from 188 high school students in the Midwest, exploratory factor analysis (EFA) was used to examine the underlying structure of an initial 68 items. Items were adapted from a statewide survey previously designed to document awareness of prescription drug misuse and abuse in the state of Wisconsin. Refinement of the scale used factor analysis iterations and internal consistency measures. Cronbach's alpha was used to determine internal consistency among the items. RESULTS Three exploratory factor analysis iterations resulted in a 16-item four-factor structure describing adolescents' knowledge of misuse and harm, their interest in learning about prescription opioids, and their tendency to practice misuse behaviors. Internal consistency and the correlation among factors were examined and strong (Cronbach's α > 0.8). The final 16-item instrument was termed the Adolescent Opioid Safety and Learning (AOSL) Scale. CONCLUSIONS When combined with adolescent opioid education tools, the AOSL Scale can help assess and document medication safety learning. The four subscales could support researchers and practitioners in measuring adolescents' orientation towards prescription opioid misuse. The AOSL Scale may also be used in developing targeted educational materials on prevention of opioid misuse for adolescents.
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Affiliation(s)
- Olufunmilola Abraham
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, Madison, WI, USA.
| | - Tanvee Thakur
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, Madison, WI, USA
| | - Kelsey Brasel
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, Madison, WI, USA
| | - Derek Norton
- University of Wisconsin-Madison, Department of Biostatistics and Medical Informatics, Madison, WI, USA
| | - Claire A Rosenberger
- University of Wisconsin-Madison School of Pharmacy, Social and Administrative Sciences Division, Madison, WI, USA
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Sweileh WM. Contribution of researchers in the Arab region to peer-reviewed literature on mental health and well-being of university students. Int J Ment Health Syst 2021; 15:50. [PMID: 34039394 PMCID: PMC8153525 DOI: 10.1186/s13033-021-00477-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/21/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The current study aimed at investigating the contribution of researchers in the Arab region to the field of mental health and well-being of university students using bibliometric tools. METHOD Relevant literature was obtained from the Scopus database for the period from 2001-2020. Examples of keywords used in the query included "college student", "university student", and undergraduate student" combined with keywords such as wellbeing, wellness, suicide, and anxiety. No language restriction was used. Only research articles were considered. The search query was validated. Bibliometric indicators and mappings such as active countries, institutions, authors, highly cited documents, and the most frequently encountered topics were identified and discussed to shed light on research gaps in the Arab region. Research gaps were also identified. The analysis was carried out on February 12, 2021. RESULTS The search query returned 309 research articles published by authors from 17 different Arab countries. Less than one-third (n = 97, 31.4%) of the retrieved articles were carried out in collaboration with authors from 39 non-Arab countries, mainly from the United Kingdom and the United States. The overall contribution of researchers from the Arab region to global research in the field was 5.6%. In total, 1212 authors from 791 different institutions participated in publishing the retrieved research articles. At the country level, Saudi Arabia (n = 125, 40.5%) ranked first, followed by Jordan, Egypt, and Lebanon. At the institutional level, The University of Jordan (n = 25, 8.1%) ranked first, followed by King Saud University, and Kuwait University. The retrieved articles included 132 (42.7%) articles on stress/distress, 95 (30.7%) on anxiety, 61 (19.7%) on depression. Knowledge gaps on suicide, eating disorders, substance use, and happiness were identified. The retrieved articles appeared in 193 different journals and approximately two-thirds of the active journal were in general medicine, public health, and education. CONCLUSIONS The contribution of researchers in the Arab region to the field showed a noticeable increase with time. However, important research gaps were identified. The contribution was confined to authors from a limited number of Arab countries. Funding and international research collaboration for the mental health and well-being of students need to be strengthened.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Al-Matrouk A, Al-Hasan M, Naqi H, Al-Abkal N, Mohammed H, Haider M, Al-Shammeri D, Bojbarah H. Snapshot of narcotic drugs and psychoactive substances in Kuwait: analysis of illicit drugs use in Kuwait from 2015 to 2018. BMC Public Health 2021; 21:671. [PMID: 33827491 PMCID: PMC8028837 DOI: 10.1186/s12889-021-10705-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] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background The misuse of illicit substances is associated with increased morbidity and mortality; thus, substance abuse is a global health concern. The Arabian Gulf region is considered a crossing point and a consumer of illicit drugs. However, a lack of laboratory-based research has limited the scientific assessment of drug misuse in the Arabian Gulf region. Thus, an up-to-date analytical representation of the drug situation is warranted. Methods We investigated the type and quantity of detained narcotic drugs and psychotropic substances from 2015 to 2018, representing a population of approximately 4 million people, in addition to the number of abusers and mortality among abusers. In total, 6220 cases from the Narcotic and Psychotropic Laboratory and 17,755 cases from the Forensic Toxicology Laboratory were reviewed and analyzed. Substances were identified and documented using gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry. Results Cannabis, including marijuana, was the most seized substance, followed by heroin, opium, and cocaine. Amphetamines, including methamphetamine, in the form of powder or pills, were seized in larger quantities than other psychoactive substances. The most consumed substances were, in order, amphetamines (including methamphetamine), benzodiazepines, cannabis, and heroin. We identify the common drugs in postmortem specimens, according to sex, from suspected drug-related deaths. The most common single drug identified were heroin, benzodiazepines, and methamphetamine. Similarly, the multiple-drug cocktail of heroin–benzodiazepines, cannabis–benzodiazepines, and cannabis–amphetamines, were detected frequently. Conclusions The data shows that cannabis is the leading type of illicit substance seized. Deaths resulting from benzodiazepines and heroin abuse were the highest in the single drug category, while heroin-benzodiazepines combination deaths were the highest in the multiple-drug category. Methamphetamine was the most abused illicit drug in Kuwait. These findings revealed the illicit drug abuse situation in the State of Kuwait, in a region that suffers from the scarcity of information regarding illicit substances. Thus, providing valuable information for drug enforcement, forensic analyst, health workers on national and international levels. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10705-z.
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Affiliation(s)
- Abdullah Al-Matrouk
- Narcotic and Psychotropic Laboratory, General Department of Criminal Evidence, Ministry of Interior, Al-Dhajeej, Block 1, Al-Farwaniya City, Kuwait.
| | - Mohammed Al-Hasan
- Toxicology Laboratory, Department of Criminal Evidence, Ministry of Interior, Farwaniya city, Kuwait
| | - Husain Naqi
- Kuwait Police Academy for Security Sciences, Ministry of Interior, Al-Farwaniya City, Kuwait
| | - Neamat Al-Abkal
- Narcotic and Psychotropic Laboratory, General Department of Criminal Evidence, Ministry of Interior, Al-Dhajeej, Block 1, Al-Farwaniya City, Kuwait
| | - Hanan Mohammed
- Narcotic and Psychotropic Laboratory, General Department of Criminal Evidence, Ministry of Interior, Al-Dhajeej, Block 1, Al-Farwaniya City, Kuwait
| | - Meshaal Haider
- Toxicology Laboratory, Department of Criminal Evidence, Ministry of Interior, Farwaniya city, Kuwait
| | - Dalal Al-Shammeri
- Narcotic and Psychotropic Laboratory, General Department of Criminal Evidence, Ministry of Interior, Al-Dhajeej, Block 1, Al-Farwaniya City, Kuwait
| | - Haider Bojbarah
- Narcotic and Psychotropic Laboratory, General Department of Criminal Evidence, Ministry of Interior, Al-Dhajeej, Block 1, Al-Farwaniya City, Kuwait
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Bargel S, Becam J, Chanu L, Lanot T, Martin M, Vaucel J, Willeman T, Fabresse N. Les gabapentinoïdes : une revue de la littérature. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2021. [DOI: 10.1016/j.toxac.2020.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Peltokorpi J, Hakko H, Riipinen P, Riala K. Profile of Substance Misuse among Adolescent and Young Adult Gabapentinoid Users: A Register-Based Follow-up Study of Former Adolescent Psychiatric Inpatients. Subst Use Misuse 2021; 56:598-605. [PMID: 33663338 DOI: 10.1080/10826084.2021.1883662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Our study examined characteristics of adolescent and young adult study participants using gabapentinoids (gabapentin, pregabalin), with previous history of adolescent psychiatric inpatient hospitalization. Particular focus was on temporal association of age, at first prescription for gabapentinoids, to age at tobacco smoking initiation, regular alcohol use, diagnosis of substance dependence and prescriptions for benzodiazepines and opioids. Methods: The initial study population contained 508 adolescents (300 females, 208 males) admitted to psychiatric inpatient care in Oulu University hospital between the ages 13-17 years. Register-based follow-up information on prescriptions for gabapentinoids, benzodiazepines and opioids, as well as ICD-10 diagnosis for hospital-treated substance dependence, was obtained from the Finnish national health care registers. Results: The users of gabapentinoids accounted for 9.1% of the initial study population. Of adolescence-related characteristics, suicidal ideation, suicide attempts and non-suicidal self-injury was emphasized in females using gabapentinoids. The majority of participants using gabapentinoids had benzodiazepines (80.4%) and opioids (71.7%) as comorbid drugs. Initiation of tobacco smoking and alcohol use and first prescriptions for of benzodiazepines and opioids, and a diagnosis of substance dependence commonly predated first prescriptions for gabapentinoids. Conclusions: In clinical practice, the decision to prescribe gabapentinoids to adolescents or young adults must be made with caution, particularly for those with substance use problems and/or without a clinically approved indication.
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Affiliation(s)
- Juuso Peltokorpi
- Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Pirkko Riipinen
- Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, Oulu, Finland
| | - Kaisa Riala
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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16
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Dabbagh R, Aldofyan M, Alzaid W, Alsulimani A, Alshamrani S, Alqahtani S, Abuhaimed A. Prescription and over-the-counter drug misuse among female students at a Saudi university. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1856210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Wejdan Alzaid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Samar Alqahtani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
This review summarizes current evidence on the abuse and misuse of the gabapentinoids pregabalin and gabapentin. Pharmacovigilance studies, register-based studies, surveys, clinical toxicology studies, and forensic toxicology studies were identified and scrutinized with the goal to define the problem, identify risk factors, and discuss possible methods to reduce the potential for abuse and misuse. Studies found that gabapentinoids are abused and misused and that individuals with a history of psychiatric disorders or substance use disorder seem to be at high risk. Moreover, some evidence supports the notion that patients with opioid use disorders may be at an increased risk of abusing gabapentinoids. Available evidence also suggests that abuse and misuse are more frequent in users of pregabalin compared with users of gabapentin. Health professionals and prescribers should be aware of the risk for misuse of pregabalin and gabapentin, which eventually could lead to abuse, substance dependence, and intoxications. Prescribing to patients belonging to risk populations such as those with psychiatric disorders or substance use disorder should be avoided if possible and, if prescribed, signs of misuse and abuse should be monitored.
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Affiliation(s)
- Staffan Hägg
- Futurum, Jönköping, Region Jönköping County and Department of Biomedicine and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Futurum, Hus B4, Ryhov Hospital, S-551 85, Jönköping, Sweden.
| | - Anna K Jönsson
- Division of Drug Research, Department of Biomedicine and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Department of Forensic Genetics and Forensic Chemistry, National Board of Forensic Medicine, Linköping, Sweden
| | - Johan Ahlner
- Division of Drug Research, Department of Biomedicine and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Department of Forensic Genetics and Forensic Chemistry, National Board of Forensic Medicine, Linköping, Sweden
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18
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Rostam-Abadi Y, Gholami J, Amin-Esmaeili M, Safarcherati A, Mojtabai R, Ghadirzadeh MR, Rahimi H, Rahimi-Movaghar A. Tramadol use and public health consequences in Iran: a systematic review and meta-analysis. Addiction 2020; 115:2213-2242. [PMID: 32196801 DOI: 10.1111/add.15059] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/04/2019] [Accepted: 03/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Misuse of tramadol, an opioid prescription analgesic, is known as a public health challenge globally. We aimed to systematically review studies on the prevalence of non-prescribed use, regular tramadol use and dependence, tramadol-induced poisoning and mortality in Iran. METHODS Consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, international (Medline, Scopus, Web of Science) and Persian (SID) databases were systematically searched up to June 2019. Other relevant data were collected through personal contacts and review of reference lists. Pooled estimates of prevalence of tramadol use in subgroups of males and females, percentage of tramadol poisoning among admitted poisoning cases, tramadol-associated seizures and mortality among tramadol poisonings and percentage of tramadol as a cause of death among fatal drug-poisoning records were estimated through a random-effects model. RESULTS A total of 84 records were included. Pooled estimates of last 12-month use of tramadol in the Iranian general population were 4.9% [95% confidence interval (CI) = 4.1-5.9] and 0.8% (95% CI = 0.2-1.8) among males and females, respectively. The estimates for last 12-month use among Iranian male and female university students were 4.8% (95% CI = 1.9-8.9) and 0.7% (95% CI = 0.3-1.1), respectively. Six heterogeneous reports indicated the existence of regular use of tramadol and dependence in Iran. Sixty-two studies provided data on tramadol-induced poisoning, seizures and mortality. The pooled estimate of the percentage of tramadol poisoning among all drug-poisoning patients was 13.1% (95% CI = 5.7-22.9). The overall estimates of seizures and mortality among tramadol-poisoning patients were 34.6% (95% CI = 29.6-39.8) and 0.7% (95% CI = 0.0-1.9), respectively. The pooled percentage of tramadol-related fatalities among drug-poisoned cases was 5.7% (95% CI = 0.5-15.4). CONCLUSION Despite control policies, tramadol use is as prevalent as the use of illicit opioids in Iran. Numerous cases of tramadol abuse, dependence, poisonings, seizures and hundreds of tramadol-related deaths have been reported in recent years.
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Affiliation(s)
- Yasna Rostam-Abadi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Jaleh Gholami
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Amin-Esmaeili
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Anousheh Safarcherati
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mojtabai
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Hosein Rahimi
- Division of Pharmaceuticals and Narcotics Affairs, Ministry of Health, Tehran, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
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Al Abri MZ, Farag MA, Al Mosawi AS, Al Awaidy ST. Socio-Demographic Characteristics and Patterns of Substance Use Disorder in Oman: A retrospective study of the National Registry Surveillance Programme between 2004 and 2018. Sultan Qaboos Univ Med J 2020; 20:e296-e303. [PMID: 33414933 PMCID: PMC7757916 DOI: 10.18295/squmj.2020.20.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/09/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Substance use disorder is a global challenge. Therefore, this study aimed to provide an updated view of socio-demographic characteristics and patterns of substance use in Oman. METHODS This retrospective descriptive study was conducted between 2004 and 2018. Data were retrieved from Oman's National Drug Addict Registry. The data collected included the socio-demographic characteristics of registered cases, the proportion of various psychoactive substances' consumption and their routes of administration, the associated sociodemographic determinants as well as comorbid conditions. RESULTS A total of 6,453 cases were registered during the study's timeframe. The majority of which were Omani (97.9%), male (98.7%), single (57.9%), unemployed (50.2%), had an education level below university (81.0%) and were adolescents and young adults (77.0%). Opiates were the most common substance used (66.6%) and more than half of the sample were polydrug users (51.0%). Injecting-drug users constituted 53.4% of the total registered cases. The proportion of people with hepatitis virus C, hepatits virus B and HIV among the registered cases were 46.9%, 5.1% and 3.7%, respectively. CONCLUSION The findings are in favour of rapidly escalating the introduction of a substance use preventive programme at all school levels as well as making opioid substitution therapy and other harm reduction programmes available in Oman.
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Amini Pozveh Z, Saleh Z. The Role of Social Skills in the Prevention of Drug Addiction in Adolescents. Adv Biomed Res 2020; 9:41. [PMID: 33072653 PMCID: PMC7532813 DOI: 10.4103/abr.abr_99_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/10/2020] [Accepted: 06/20/2020] [Indexed: 01/28/2023] Open
Abstract
Background: Substance abuse has turned into a great problem in the worldwide. Considering the increased prevalence of addiction in this study, we tried to assess the role of social skills aspects in tendency to addiction among the adolescents. Materials and Methods: This cross-sectional study was conducted on 600 high school students studying in the Isfahan City, Iran, from 2016 to 2018. The studied population was assessed using addiction tendency questionnaire and Matson's social skills questionnaire. Data were analyzed by Statistical Package for the Social Sciences software and independent t-test, Pearson and Spearman correlation, and linear regression test. Results: Social behavior (P = 0.002, r = −0.124), high self-esteem (P < 0.001, r = −0.381), and peer-communication (P < 0.001, r = −0.361) were inversely associated with a tendency to addiction and were independent predictors of it (P < 0.05). Aggression was associated with increased tendency to the addiction (P = 0.01, r = 0.103) but not a predictor. Conclusion: We found that appropriate social behaviors, inappropriate assertiveness, and functional communication were factors associated with less tendency to substance abuse in the adolescent.
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Affiliation(s)
- Zahra Amini Pozveh
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Saleh
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Razzak HA, Harbi A, Ahli S. Tobacco Smoking Prevalence, Health Risk, and Cessation in the UAE. Oman Med J 2020; 35:e165. [PMID: 32904941 PMCID: PMC7462068 DOI: 10.5001/omj.2020.107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/17/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives Tobacco smoking is a major public health concern and a leading cause of preventable death. We sought to review epidemiological studies available on the prevalence of tobacco use, the associated health effects, and interventions that have undergone evaluation concerning smoking cessation and prevention in the UAE. Methods An electronic search of the PubMed and Scopus databases was conducted using appropriate keywords for articles published between 2007 and 2017. We included all English-language articles in addition to research articles on the UAE populations (including both citizens and expatriates). Results Fourteen articles were included, of which 11 were cross-sectional studies, one was a cohort longitudinal study, one was quasi-experimental, and one case-control study. Our results suggest that current smoking prevalence estimates vary widely. This is the first study in the region to review the smoking prevalence, health risk, and interventions in the UAE. Conclusions UAE Government demonstrated excellent efforts by raising the cost of smoking through taxation, mounting sustained social marketing campaigns, and ensuring that health professionals routinely advise smokers to stop smoking accompanied by behavioral and pharmacological support for cessation. Hence, future research should be more focused on evaluating the outcome and impact of current anti-smoking campaigns.
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Affiliation(s)
- Hira Abdul Razzak
- Statistics and Research Centre, Ministry of Health and Prevention, Dubai, UAE
| | - Alya Harbi
- Statistics and Research Centre, Ministry of Health and Prevention, Dubai, UAE
| | - Shaima Ahli
- Statistics and Research Centre, Ministry of Health and Prevention, Dubai, UAE
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22
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Jones NS, Comparin JH. Interpol review of controlled substances 2016-2019. Forensic Sci Int Synerg 2020; 2:608-669. [PMID: 33385148 PMCID: PMC7770462 DOI: 10.1016/j.fsisyn.2020.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.
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Affiliation(s)
- Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA
| | - Jeffrey H. Comparin
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
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23
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Alblooshi H, Al Safar H, El Kashef A, Al Ghaferi H, Shawky M, Hulse GK, Tay GK. Stratified analyses of genome wide association study data reveal haplotypes for a candidate gene on chromosome 2 (KIAA1211L) is associated with opioid use in patients of Arabian descent. BMC Psychiatry 2020; 20:41. [PMID: 32005204 PMCID: PMC6995052 DOI: 10.1186/s12888-019-2425-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 12/30/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Genome Wide Association Studies (GWAS) have been conducted to identify genes and pathways involved in development of opioid use disorder. This study extends the first GWAS of substance use disorder (SUD) patients from the United Arab Emirates (UAE) by stratifying the study group based on opioid use, which is the most common substance of use in this cohort. METHODS The GWAS cohort consisted of 512 (262 case, 250 controls) male participants from the UAE. The samples were genotyped using the Illumina Omni5 Exome system. Data was stratified according to opioid use using PLINK. Haplotype analysis was conducted using Haploview 4.2. RESULTS Two main associations were identified in this study. Firstly, two SNPs on chromosome 7 were associated with opioid use disorder, rs118129027 (p-value = 1.23 × 10 - 8) and rs74477937 (p-value = 1.48 × 10 - 8). This has been reported in Alblooshi et al. (Am J Med Genet B Neuropsychiatr Genet 180(1):68-79, 2019). Secondly, haplotypes on chromosome 2 which mapped to the KIAA1211L locus were identified in association with opioid use. Five SNPs in high linkage disequilibrium (LD) (rs2280142, rs6542837, rs12712037, rs10175560, rs11900524) were arranged into haplotypes. Two haplotypes GAGCG and AGTTA were associated with opioid use disorders (p-value 3.26 × 10- 8 and 7.16 × 10- 7, respectively). CONCLUSION This is the first GWAS to identify candidate genes associated with opioid use disorder in participants from the UAE. The lack of other genetic data of Arabian descent opioid use patients has hindered replication of the findings. Nevertheless, the outcomes implicate new pathways in opioid use disorder that requires further research to assess the role of the identified genes in the development of opioid use disorder.
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Affiliation(s)
- Hiba Alblooshi
- 0000 0004 1936 7910grid.1012.2Division of Psychiatry, the University of Western Australia, Crawley, Western Australia Australia ,0000 0004 1936 7910grid.1012.2School of Human Science, The University of Western Australia, Crawley, Western Australia Australia ,0000 0001 2193 6666grid.43519.3aCollege of Medicine and Health Science, The United Arab Emirates University, Al Ain, United Arab Emirates
| | - Habiba Al Safar
- 0000 0004 1762 9729grid.440568.bCenter of Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates ,0000 0004 1762 9729grid.440568.bDepartment of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ahmed El Kashef
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | | | - Mansour Shawky
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Gary K. Hulse
- 0000 0004 1936 7910grid.1012.2Division of Psychiatry, the University of Western Australia, Crawley, Western Australia Australia ,0000 0004 0389 4302grid.1038.aSchool of Health and Medical Science, Edith Cowan University, Joondalup, Western Australia Australia
| | - Guan K. Tay
- 0000 0004 1936 7910grid.1012.2Division of Psychiatry, the University of Western Australia, Crawley, Western Australia Australia ,0000 0004 1762 9729grid.440568.bCenter of Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates ,0000 0004 1762 9729grid.440568.bDepartment of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates ,0000 0004 0389 4302grid.1038.aSchool of Health and Medical Science, Edith Cowan University, Joondalup, Western Australia Australia
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Alaryan T, Hasan TA, Eshelli M, Alzeer S. The Misuse of Prescribed Drugs During the Syrian Crisis: a Cross-sectional Study. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00180-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Cairns R, Schaffer AL, Ryan N, Pearson SA, Buckley NA. Rising pregabalin use and misuse in Australia: trends in utilization and intentional poisonings. Addiction 2019; 114:1026-1034. [PMID: 30098227 DOI: 10.1111/add.14412] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/25/2018] [Accepted: 08/01/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Pregabalin is a gamma-aminobutyric acid (GABA) analogue, used to treat neuropathic pain and epilepsy. Pregabalin was registered in Australia in 2005, and subsidized publically in 2013. We aimed to describe Australian patterns of pregabalin use and intentional poisoning, and identify people potentially at high risk of misuse. DESIGN AND SETTING Population-based retrospective cohort study of dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme (July 2012-February 2017); intentional poisoning calls to New South Wales Poisons Information Centre (NSWPIC) (2004-2016); intentional poisonings in two Australian toxicology service databases; and poisoning fatalities in NSW coronial records (2005-2016). PARTICIPANTS A total of 122 572 people dispensed pregabalin, people with intentional pregabalin overdoses managed by NSWPIC and the toxicology services and pregabalin-associated deaths referred to the NSW coroner. MEASUREMENTS Trends in dispensing, poisoning, death; demographics and patient characteristics, proportion of users at high risk of misuse (latent class analysis, LCA) and characteristics of high-risk users. FINDINGS Pregabalin dispensing increased by 73 424 per year [95% confidence interval (CI) = 61726-85 121 P < 0.001] between 2013 and 2016. NSWPIC received 1158 reports of intentional pregabalin poisonings, with a 53.8% increase per year, 2005-2016 (95% CI = 44.0-64.2%, P < 0.001). We identified 88 pregabalin-associated deaths, 57.8% yearly increase (95% CI = 30.0-91.6%, P < 0.001). Patients overdosing on pregabalin commonly co-ingested opioids, benzodiazepines and illicit drugs, and had high rates of psychiatric and substance use comorbidities; 14.7% of pregabalin users were classed by the LCA as at high risk of misuse, and were more likely to be younger, male, co-prescribed benzodiazepines or opioids, have more individual prescribers and higher pregabalin strengths dispensed. CONCLUSIONS There has been a dramatic increase in pregabalin use, poisonings and deaths in Australia since it became subsidized publicly in 2013. One in seven Australians dispensed pregabalin appears to be at high risk of misuse.
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Affiliation(s)
- Rose Cairns
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, School of Medical Sciences, Sydney Medical School, University of Sydney, NSW, Australia
| | - Andrea L Schaffer
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Nicole Ryan
- Clinical Toxicology Research Group, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Sallie-Anne Pearson
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Nicholas A Buckley
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Westmead, NSW, Australia.,Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, School of Medical Sciences, Sydney Medical School, University of Sydney, NSW, Australia
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Elarabi H, Elrasheed A, Ali A, Shawky M, Hasan N, Gawad TA, Adem A, Marsden J. Suboxone Treatment and Recovery Trial (STAR-T): Study Protocol for a Randomised Controlled Trial of Opioid Medication Assisted Treatment with Adjunctive Medication Management Using Therapeutic Drug Monitoring and Contingency Management. JOURNAL OF ADDICTION 2019; 2019:2491063. [PMID: 30956839 PMCID: PMC6425325 DOI: 10.1155/2019/2491063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/10/2018] [Accepted: 02/18/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Opioid assisted treatment (OAT) with buprenorphine (BUP) is front-line medical maintenance intervention for illicit and prescription opioid use disorder (OUD). In many clinics, opioid medication is dispensed for several days for self-administration. This provides flexibility to the patient but may compromise the effectiveness of OAT because of nonadherence or medication diversion. OAT can be delivered as an entirely supervised intervention, but many patients discontinue treatment under this arrangement and dispensing costs may be prohibitive. An alternative is to enable patients to receive take-home doses contingent on OAT adherence guided by a medication management framework using Therapeutic Drug Monitoring (TDM) alongside negative urine drug screens (UDS) to provide evidence of abstinence. TDM is recommended to monitor adherence with BUP but it has not been applied in OAT programs and evaluation research to date. METHODS The Suboxone Treatment and Recovery Trial (STAR-T) is a single site, 16-week, parallel-group, randomised controlled trial. The aim of the study is to determine the effectiveness of a medication management framework including TDM and UDS to enable patients enrolled on outpatient OAT (with buprenorphine/naloxone [sublingual film formulation; BUP/NX-F; Suboxone™]) to receive stepped take-home doses. Following stabilisation during inpatient care, adult participants with illicit or prescription OUD were allocated (1:1) to receive (1) BUP/NX-F plus medication management for take-home doses based on TDM, UDS, and contingency management protocol (the experimental group) or (2) BUP/NX-F plus UDS only (treatment-as-usual, the control group). The primary outcome is the mean percentage of negative UDS over 16 weeks. The secondary outcome is treatment retention defined as completion of 16 weeks of OAT without interruption. There will be an exploratory analysis of the association between participant characteristics, clinical data, and outcomes. CONCLUSIONS Providing BUP/NX-F take-home doses contingent on adherence and opioid abstinence may enable OAT to be delivered flexibly and effectively. TRIAL REGISTRATION ISRCTN41645723 is retrospectively registered on 15/11/2015.
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Affiliation(s)
- Hesham Elarabi
- Addictions Department, Institute of Psychiatry, Psychology and Neurosciences, King's College London, 4-Windsor Walk, ASB, Denmark Hill, SE5 8BB, London, UK
- National Rehabilitation Centre, UAE, P.O. Box 55001, Abu Dhabi, Shakhboot City, UAE
| | - Abuelgasim Elrasheed
- National Rehabilitation Centre, UAE, P.O. Box 55001, Abu Dhabi, Shakhboot City, UAE
| | - Ahmed Ali
- National Rehabilitation Centre, UAE, P.O. Box 55001, Abu Dhabi, Shakhboot City, UAE
| | - Mansour Shawky
- National Rehabilitation Centre, UAE, P.O. Box 55001, Abu Dhabi, Shakhboot City, UAE
| | - Nael Hasan
- National Rehabilitation Centre, UAE, P.O. Box 55001, Abu Dhabi, Shakhboot City, UAE
| | - Tarek A. Gawad
- National Rehabilitation Centre, UAE, P.O. Box 55001, Abu Dhabi, Shakhboot City, UAE
| | - Abdu Adem
- College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Alain, AD, UAE
| | - John Marsden
- Addictions Department, Institute of Psychiatry, Psychology and Neurosciences, King's College London, Addiction Sciences Building, 4 Windsor Walk, Demark Hill, London, Denmark Hill, SE5 8AF, UK
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27
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Al Wahaibi N, Al Lawati A, Al Ruqeishy F, Al Khatri A, Al-Farsi Y, Juma TMA, Al Hinai F, Al-Sibani N, Mahadevan S, Al-Adawi S. The characteristics and patterns of utilization of healthcare services among Omanis with substance use disorders attending therapy for cessation. PLoS One 2019; 14:e0210532. [PMID: 30703131 PMCID: PMC6354979 DOI: 10.1371/journal.pone.0210532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 12/27/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND It is indicated that Oman is witnessing an increase in issues pertinent to alcohol and psychoactive substance use. AIM The aim of this study was to identify the characteristics of Omanis with substance use disorder attending a specialized hospital in Oman and the pattern of their utilization of healthcare services. A related aim was to ascertain the age group most vulnerable to alcohol and substance use in Oman. METHOD A cross-sectional study was conducted in a tertiary care center specialized for treatment of those engaging in substance use in Oman. The participants in the study were selected from a convenience sample among patients seeking consultation at the center for alcohol and substance use. A six-part questionnaire was designed to obtain information regarding socio-demographic background, clinical history, healthcare utilization and perceived hurdles to access. Chi-square analyses were used to evaluate the significance of differences among categorical data. Logistic regression modelling was used to obtain measures of association after adjusting for confounding factors. RESULTS Among the patients (n = 293) seeking cessation therapy, 99% were male and less than 30 years of age. Peer influences on the initiation of substance use were significant. Most patients had a history of polysubstance use, including intravenous substance use. Cannabis and alcohol were the first substances consumed by most patients and Hepatitis C and psychiatric disorders were found to be the most common co-morbidities. The participants that reported use of cannabis and benzodiazepines were more likely to perceive "improvement" upon receiving treatment. CONCLUSION This study indicated that males below 30 years of age with a history of polysubstance use were likely to attend a hospital specialized in treating substance use disorder in Oman. This study identified information regarding socio-demographic background, risk factors and perceived hurdles to healthcare that could serve as groundwork for further studies conducted on newly emerging issues of substance use in Oman.
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Affiliation(s)
- Nabila Al Wahaibi
- Wadi Kabir Health Centre, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Anwaar Al Lawati
- Ruwi Health Centre, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Falaah Al Ruqeishy
- Muscat Health Centre, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | | | - Yahya Al-Farsi
- Department of Family Medicine and Public Health, Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, Oman
| | - Tahira M. A. Juma
- Directorate of Health Services, Muttrah, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Fatma Al Hinai
- Directorate of Health Services, Muttrah, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Nasser Al-Sibani
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Sangeetha Mahadevan
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Alblooshi H, Al Safar H, Fisher HF, Cordell HJ, El Kashef A, Al Ghaferi H, Shawky M, Reece S, Hulse GK, Tay GK. A case-control genome wide association study of substance use disorder (SUD) identifies novel variants on chromosome 7p14.1 in patients from the United Arab Emirates (UAE). Am J Med Genet B Neuropsychiatr Genet 2019; 180:68-79. [PMID: 30556296 DOI: 10.1002/ajmg.b.32708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/17/2018] [Accepted: 11/21/2018] [Indexed: 12/11/2022]
Abstract
Genome wide association studies (GWASs) have provided insights into the molecular basis of the disorder in different population. This study presents the first GWAS of substance use disorder (SUD) in patients from the United Arab Emirates (UAE). The aim was to identify genetic association(s) that may provide insights into the molecular basis of the disorder. The GWAS discovery cohort consisted of 512 (250 cases and 262 controls) male participants from the UAE. Controls with no prior history of SUD were available from the Emirates family registry. The replication cohort consisted of 520 (415 cases and 105 controls) Australian male Caucasian participants. The GWAS discovery samples were genotyped for 4.6 million single nucleotide polymorphism (SNP). The replication cohort was genotyped using TaqMan assay. The GWAS association analysis identified three potential SNPs rs118129027 (p-value = 6.24 × 10-8 ), rs74477937 (p-value = 8.56 × 10-8 ) and rs78707086 (p-value = 8.55 × 10-8 ) on ch7p14.1, that did not meet the GWAS significance threshold but were highly suggestive. In the replication cohort, the association of the three top SNPs did not reach statistical significance. In a meta-analysis of the discovery and the replication cohorts, there were no strengthen evidence for association of the three SNPs. The top identified rs118129027 overlaps with a regulatory factor (enhancer) region that targets three neighboring genes LOC105375237, LOC105375240, and YAE1D1. The YAE1D1, which represents a potential locus that is involved in regulating translation initiation pathway. Novel associations that require further confirmation were identified, suggesting a new insight to the genetic basis of SUD.
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Affiliation(s)
- Hiba Alblooshi
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia.,School of Human Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Habiba Al Safar
- Center of Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.,Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Holly F Fisher
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Heather J Cordell
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Ahmed El Kashef
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | | | - Mansour Shawky
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Stuart Reece
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Gary K Hulse
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia.,School of Medical Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Guan K Tay
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia.,Center of Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.,Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.,School of Medical Science, Edith Cowan University, Joondalup, Western Australia, Australia
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Reports of gabapentin and pregabalin abuse, misuse, dependence, or overdose: An analysis of the Food And Drug Administration Adverse Events Reporting System (FAERS). Res Social Adm Pharm 2018; 15:953-958. [PMID: 31303196 DOI: 10.1016/j.sapharm.2018.06.018] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 04/10/2018] [Accepted: 06/27/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Reports of gabapentinoid (gabapentin and pregabalin) misuse have increased in recent years. Pharmacovigilance data from the Food and Drug Administration Adverse Event Reporting System (FAERS) provides a useful examination of adverse drug event (ADE) reporting for safety signal detection. OBJECTIVE This study was conducted to analyze epidemiological information on the nature and extent of gabapentin/pregabalin abuse utilizing the FAERS database. METHODS A query was designed utilizing SafeRx, an indexed, searchable database of FAERS data from October 2012-December 2016. All-cause and abuse-related (including abuse/misuse/dependence/overdose events) ADE reports for gabapentin and pregabalin were isolated, as well as limited demographic data. The proportional reporting ratio (PRR) was calculated to compare signal detection. RESULTS A total of 10,038 all-cause ADEs were reported to FAERS for gabapentin, including 576 (5.7%) abuse-related events. For pregabalin, 571 all-cause ADEs were identified, including 58 (10.2%) related to abuse. Compared to all-cause ADEs, those involved in abuse-related events were younger and more likely to be male. The PRR of pregabalin versus gabapentin abuse-related events was 1.77. CONCLUSION Though not traditionally thought of as drugs of abuse, over 600 cases of gabapentinoid abuse were reported in the time frame analyzed, prompting the need for further study and regulatory investigation.
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Alblooshi H, Hulse G, Osman W, El Kashef A, Shawky M, Al Ghaferi H, Al Safar H, Tay GK. The frequency of DRD2 rs1076560 and OPRM1 rs1799971 in substance use disorder patients from the United Arab Emirates. Ann Gen Psychiatry 2018; 17:22. [PMID: 29881439 PMCID: PMC5984335 DOI: 10.1186/s12991-018-0192-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 05/25/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Dopaminergic and opioid systems are involved in mediating drug reward and reinforcement of various types of substances including psychoactive compounds. Genes of both systems have been candidate for investigation for associations with substance use disorder (SUD) in various populations. This study is the first study to determine the allele frequency and the genetic association of the DRD2 rs1076560 SNP and OPRM1 rs1799971 SNP variants in clinically diagnosed patients with SUD from the United Arab Emirates (UAE). METHODS A cross-sectional case-control cohort that consisted of 512 male subjects was studied. Two hundred and fifty patients with SUD receiving treatment at the UAE National Rehabilitation Center were compared to 262 controls with no prior history of mental health and SUD. DNA from each subject was extracted and genotyped using the TaqMan ® SNP genotyping assay. RESULTS There were no significant associations observed for DRD2 rs1076560 SNP, OPRM1 rs1799971 SNP, and combined genotypes of both SNPs in the SUD group. CONCLUSION Further research is required with refinements to the criteria of the clinical phenotypes. Genetic studies have to be expanded to include other variants of the gene, the interaction with other genes, and possible epigenetic relationships.
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Affiliation(s)
- Hiba Alblooshi
- 1School of Human Sciences, The University of Western Australia, Crawley, WA Australia.,2School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA Australia
| | - Gary Hulse
- 2School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA Australia.,3School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Wael Osman
- 4Center of Biotechnology, Khalifa University of Science, Technology and Research, PO Box 1227788, Abu Dhabi, United Arab Emirates
| | - Ahmed El Kashef
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Mansour Shawky
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Hamad Al Ghaferi
- United Arab Emirates National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Habiba Al Safar
- 4Center of Biotechnology, Khalifa University of Science, Technology and Research, PO Box 1227788, Abu Dhabi, United Arab Emirates.,6Faculty of Biomedical Engineering, Khalifa University of Science, Technology and Research, Abu Dhabi, United Arab Emirates
| | - Guan K Tay
- 2School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA Australia.,3School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia.,4Center of Biotechnology, Khalifa University of Science, Technology and Research, PO Box 1227788, Abu Dhabi, United Arab Emirates.,6Faculty of Biomedical Engineering, Khalifa University of Science, Technology and Research, Abu Dhabi, United Arab Emirates
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High Rates of Tramadol Use among Treatment-Seeking Adolescents in Malmö, Sweden: A Study of Hair Analysis of Nonmedical Prescription Opioid Use. JOURNAL OF ADDICTION 2017; 2017:6716929. [PMID: 29435382 PMCID: PMC5757138 DOI: 10.1155/2017/6716929] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/06/2017] [Indexed: 11/17/2022]
Abstract
Background Nonmedical prescription opioid use (NMPOU) is a growing problem and tramadol has been suggested as an emerging problem in young treatment-seeking individuals. The aim of the present study was to investigate, through hair analysis, NMPOU in this group and, specifically, tramadol use. Methods In a study including 73 treatment-seeking adolescents and young adults at an outpatient facility for young substance users, hair specimens could be obtained from 59 subjects. Data were extracted on sociodemographic background variables and psychiatric diagnoses through MINI interviews. Results In hair analysis, tramadol was by far the most prevalent opioid detected. Thirty-two percent screened positive for opioids, and of those, all but one were positive for tramadol. Ninety-eight percent reported problematic cannabis use. Significantly more opioid-positive patients also screened positive for other (noncannabis) drugs, compared to nonopioid users. Sixty-four percent fulfilled criteria of DSM-IV psychiatric disorders, other than substance use disorders according to MINI. Fifty-three percent met the symptom criteria count of ADHD above cut-off level. Conclusion In the present setting, tramadol, along with high rates of cannabis use, may represent a novel pattern of substance use among young treatment-seeking subjects with problematic substance use and high rates of concurrent psychiatric problems.
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Bonnet U, Scherbaum N. How addictive are gabapentin and pregabalin? A systematic review. Eur Neuropsychopharmacol 2017; 27:1185-1215. [PMID: 28988943 DOI: 10.1016/j.euroneuro.2017.08.430] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 07/16/2017] [Accepted: 08/20/2017] [Indexed: 12/21/2022]
Abstract
In the last ten years, gabapentin and pregabalin have been becoming dispensed broadly and sold on black markets, thereby, exposing millions to potential side-effects. Meanwhile, several pharmacovigilance-databases have warned for potential abuse liabilities and overdose fatalities in association with both gabapentinoids. To evaluate their addiction risk in more detail, we conducted a systematic review on PubMed/Scopus and included 106 studies. We did not find convincing evidence of a vigorous addictive power of gabapentinoids which is primarily suggested from their limited rewarding properties, marginal notes on relapses, and the very few cases with gabapentinoid-related behavioral dependence symptoms (ICD-10) in patients without a prior abuse history (N=4). In support, there was no publication about people who sought treatment for the use of gabapentinoids. Pregabalin appeared to be somewhat more addictive than gabapentin regarding the magnitude of behavioral dependence symptoms, transitions from prescription to self-administration, and the durability of the self-administrations. The principal population at risk for addiction of gabapentinoids consists of patients with other current or past substance use disorders (SUD), mostly opioid and multi-drug users, who preferred pregabalin. Pure overdoses of gabapentinoids appeared to be relative safe but can become lethal (pregabalin > gabapentin) in mixture with other psychoactive drugs, especially opioids again and sedatives. Based upon these results, we compared the addiction risks of gabapentin and pregabalin with those of traditional psychoactive substances and recommend that in patients with a history of SUD, gabapentinoids should be avoided or if indispensable, administered with caution by using a strict therapeutic and prescription monitoring.
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Affiliation(s)
- U Bonnet
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, Grutholzallee 21, D-44577 Castrop-Rauxel, Germany; LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, D-45147 Essen, Germany.
| | - N Scherbaum
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, D-45147 Essen, Germany
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Al Ghaferi HA, Ali AY, Gawad TA, Wanigaratne S. Developing substance misuse services in United Arab Emirates: the National Rehabilitation Centre experience. BJPsych Int 2017; 14:92-96. [PMID: 29093960 PMCID: PMC5663023 DOI: 10.1192/s2056474000002105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
In 2001 a directive was issued to establish the National Rehabilitation Centre (NRC) to deal with the growing problem of substance misuse in the United Arab Emirates. The NRC has achieved many goals as a treatment and rehabilitation facility as well as a drug and alcohol demand reduction response centre. It is now working towards being an international centre of excellence.
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Affiliation(s)
| | | | | | - Shamil Wanigaratne
- National Rehabilitation Centre, Abu Dhabi; United Arab Emirates University; King's College London, UK, email
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Abstract
BACKGROUND The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs). OBJECTIVE Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population. METHODS We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013. We used an extensive questionnaire, part of the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) Axis I Disorders (SCID-I) and urine samples. RESULTS Of the 253 participating patients, 56% had used pregabalin at least once. Of these, 92% had acquired it at least in part from illegal sources. The main motives for the use of pregabalin were the attenuation of opioid withdrawal symptoms, the augmentation of other psychotropic substances, and the psychotropic effects of pregabalin itself. Predictors for pregabalin use were opioid and sedative use as well as younger age. The criteria of dependency according to DSM-IV was met by 11% of pregabalin users and 13% of urine samples were positive for pregabalin. CONCLUSIONS Use of pregabalin is common among users of illicit drugs in large parts of southern Germany, with motives for use, acquisition, and mode of use suggesting misuse. The mode of use, especially intake of high doses and concomitant use of other drugs, poses a serious risk to this population, including the development of dependency.
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