1
|
Lokko H, Avor WMK. On the pathway to health equity: Creating a harm reduction strategy for a large academic acute care hospital. Healthc Manage Forum 2024:8404704241264243. [PMID: 39037245 DOI: 10.1177/08404704241264243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
An urban centre in southwestern Ontario continues to be faced with the extensive impacts of high rates of substance use. To more effectively meet the quintuple aim, in a way that authentically considers patients who use substances, the need for a cohesive, comprehensive organizational harm reduction strategy at the large academic acute care hospital providing community and regional healthcare services was clear. Community-based harm reduction expertise was leveraged to support the development work. Information gathered through literature review and interviews with patients, internal staff and leaders, partner healthcare agencies, and Canadian hospitals leading in harm reduction work provided key insights and supported the formulation of emerging recommendations that will be used to shape the acute care hospital's formal organizational harm reduction strategy.
Collapse
Affiliation(s)
- Heather Lokko
- London Health Sciences Centre, London, Ontario, Canada
- Western University, London, Ontario, Canada
| | | |
Collapse
|
2
|
Dhinsa J, Roman-Urrestarazu A, van Kessel R, Humphreys K. Understanding predictors of mental health and substance use treatment utilization among US adults: A repeated cross-sectional study. GLOBAL EPIDEMIOLOGY 2023; 5:100109. [PMID: 37638373 PMCID: PMC10445987 DOI: 10.1016/j.gloepi.2023.100109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 08/29/2023] Open
Abstract
Background Understanding discrepancies in mental health and substance use treatment utilization can help identify inequities in access to health services. We investigate mental health and substance use treatment utilization as function of demographic and social determinants, as well as pre-existing mental health and substance use disorders. Methods In this repeated cross-sectional study, we used the 2017-2019 National Survey on Drug Use and Health data on US adults above age 18. Two logistic regression models were conducted, using predictors of age, gender, race/Hispanicity, sexual identity, education, insurance, family income, and past year mental health and substance use disorders, with outcomes of mental health or substance use treatment utilization. Weighted estimates of substance use disorders and insurance types and Pearson's correlation tests of vulnerability among age, gender, and treatment type were reported. Findings Racial minorities, uninsured populations, sexual minorities, and females had lower odds of receiving mental health treatment, while older populations, lower income groups, and dual eligible enrollees had higher odds. Individuals with substance use disorders but no mental illness had higher odds of receiving mental health treatment. Those utilizing mental health treatment were mostly of high income, privately insured, and using cannabis, cocaine, and opioids. Older populations, men, and Medicaid only enrollees had higher odds of receiving substance use disorder treatment, whereas racial minorities had lower odds. Distribution of income, insurance type, and substance use were more widespread than mental health treatment. Interpretation Mental health treatment can be used as an avenue for substance use treatment, particularly opioid use disorders. It is important to target vulnerable populations, like racial minorities and uninsured populations to improve access to mental health and substance use treatment.
Collapse
Affiliation(s)
- Jaskiran Dhinsa
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Andres Roman-Urrestarazu
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Keith Humphreys
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| |
Collapse
|
3
|
Holborn T, Schifano F, Deluca P. No prescription? No problem: A qualitative study investigating self-medication with novel psychoactive substances (NPS). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104109. [PMID: 37422986 DOI: 10.1016/j.drugpo.2023.104109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The proliferation of Novel Psychoactive Substances (NPS) presents a challenge for global drug policy. The ease of online drug purchase and the emergence of the dark web have created new avenues for the growth of NPS. Despite the global nature of this issue, limited research has examined motivations of use. These include perceived safety or convenience, an interest in novel pharmacology and self-exploration. Recent evidence has suggested individuals may be self-medicating with NPS, however this phenomenon has yet to be thoroughly explored. This study aims to investigate the occurrence of NPS self-medication, identify the specific NPS involved, and understand the motivations behind their use. METHODS Discussions surrounding self-medication using NPS were collected between October 2022 and February 2023 via a content analysis of a Reddit community. Ninety-three threads, comprising 182,490 words and 5023 comments, were collected and cleaned. A frequency analysis was conducted to identify the NPS discussed, and data was analysed systematically through the process of iterative categorization (IC). RESULTS Our study revealed frequent discussions about the self-medication with several NPS, notably etizolam, clonazolam, diclazepam, flualprazolam, 2-FMA, 4F-MPH, 3-FPM and 3-MeO-PCP. Individuals were mainly self-treating ADHD, anxiety and depression. Motivations for choosing NPS included access, cost, legality and a dissatisfaction with conventional healthcare. Substances were often chosen based on a profile of "Functionality" and outcomes varied. The use of clonazolam was highlighted as particularly problematic. CONCLUSION The current study provides insight into the phenomenon of self-medication with NPS within an internet demographic, exploring the motivations behind why individuals choose NPS for a variety of disorders. The easy access to NPS and lack of scientific data pose a significant challenge for drug policy. Future policies should focus on improving healthcare providers knowledge of NPS use, removing barriers to adult ADHD diagnosis and rebuilding trust between individuals and addiction services.
Collapse
Affiliation(s)
- Tayler Holborn
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| |
Collapse
|
4
|
Sisco E, Urbas A. A Collaborative Platform for Novel Compound Identification - Characterization of Designer Phencyclidines (PCPs) POXP, PTHP, and P2AP. Forensic Chem 2023; 34:10.1016/j.forc.2023.100505. [PMID: 38716063 PMCID: PMC11070955 DOI: 10.1016/j.forc.2023.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
With the sustained prevalence and introduction of new emerging drugs throughout the world there is a need for continued development and maintenance of platforms that enable rapid identification and characterization of unknown compounds. To complement existing efforts, a collaborative platform between the National Institute of Standards and Technology (NIST) and practicing forensic agencies is being deployed which enables laboratories to leverage techniques and expertise that may not exist at their facilities. Using this approach, unknown compounds are identified and characterized using a suite of analytical tools to obtain (1) a rapid preliminary identification followed by (2) a more complete characterization and confirmation of the preliminary identification. To demonstrate this platform, the characterization of three previously unreported analogs of phencyclidine (PCP) - POXP, PTHP, and P2AP - are described. A preliminary identification of the three substances was obtained using direct analysis in real time mass spectrometry (DART-MS) with confirmation by nuclear magnetic resonance (NMR) spectroscopy, gas chromatography mass spectrometry (GC-MS) and gas chromatography flame ionization detection (GC-FID).
Collapse
Affiliation(s)
- Edward Sisco
- National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Aaron Urbas
- National Institute of Standards and Technology, Gaithersburg, MD, USA
| |
Collapse
|
5
|
Hulme MC, Hayatbakhsh A, Brignall RM, Gilbert N, Costello A, Schofield CJ, Williamson DC, Kemsley EK, Sutcliffe OB, Mewis RE. Detection, discrimination and quantification of amphetamine, cathinone and nor-ephedrine regioisomers using benchtop 1 H and 19 F nuclear magnetic resonance spectroscopy. MAGNETIC RESONANCE IN CHEMISTRY : MRC 2023; 61:73-82. [PMID: 33786881 DOI: 10.1002/mrc.5156] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Amphetamine and cathinone derivatives are abused recreationally due to the sense of euphoria they provide to the user. Methodologies for the rapid detection of the drug derivative present in a seized sample, or an indication of the drug class, are beneficial to law enforcement and healthcare providers. Identifying the drug class is prudent because derivatisation of these drugs, to produce regioisomers, for example, occurs frequently to circumvent global and local drug laws. Thus, newly encountered derivatives might not be present in a spectral library. Employment of benchtop nuclear magnetic resonance (NMR) could be used to provide rapid analysis of seized samples as well as identifying the class of drug present. Discrimination of individual amphetamine-, methcathinone-, N-ethylcathinone and nor-ephedrine-derived fluorinated and methylated regioisomers is achieved herein using qualitative automated 1 H NMR analysis and compared to gas chromatography-mass spectrometry (GC-MS) data. Two seized drug samples, SS1 and SS2, were identified to contain 4-fluoroamphetamine by 1 H NMR (match score median = 0.9933) and GC-MS (RRt = 5.42-5.43 min). The amount of 4-fluoroamphetamine present was 42.8%-43.4% w/w and 48.7%-49.2% w/w for SS1 and SS2, respectively, from quantitative 19 F NMR analysis, which is in agreement with the amount determined by GC-MS (39.9%-41.4% w/w and 49.0%-49.3% w/w). The total time for the qualitative 1 H NMR and quantitative 19 F NMR analysis is ~10 min. This contrasts to ~40 min for the GC-MS method. The NMR method also benefits from minimal sample preparation. Thus, benchtop NMR affords rapid, and discriminatory, analysis of the drug present in a seized sample.
Collapse
Affiliation(s)
- Matthew C Hulme
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, Manchester, UK
| | - Armita Hayatbakhsh
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | | | - Nicolas Gilbert
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, Manchester, UK
| | - Andrew Costello
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, Manchester, UK
- Greater Manchester Police, Openshaw Complex, Manchester, UK
| | - Christopher J Schofield
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, Manchester, UK
- Greater Manchester Police, Openshaw Complex, Manchester, UK
| | | | - E Kate Kemsley
- Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
| | - Oliver B Sutcliffe
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, Manchester, UK
| | - Ryan E Mewis
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
- MANchester DRug Analysis and Knowledge Exchange (MANDRAKE), Manchester Metropolitan University, Manchester, UK
| |
Collapse
|
6
|
Mijatović Jovin V, Dickov I, Ratković D, Dickov A, Tomas A. Synthetic cannabinoids awareness among patients with opioid use disorder in Serbia - A survey based cross-sectional pilot study. Front Psychiatry 2023; 14:987726. [PMID: 36960457 PMCID: PMC10028092 DOI: 10.3389/fpsyt.2023.987726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/18/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction There is limited data on the awareness and use of synthetic cannabinoids (SCs) in high-risk population in Serbia, despite SCs becoming more and more common at illicit drug market. Aim This pilot study aimed to examine the awareness and prevalence of use of SCs in patients with an opioid-use disorder and to identify patient characteristics and other factors associated with SCs use. Patients and methods This cross-sectional study was conducted at the Clinic for Psychiatry, Clinical Center Vojvodina, Serbia, the largest tertiary health care institution in this region of the country. All patients hospitalized due to the treatment of opioid dependence during November and December 2017 were included (response rate 100%), and filled-out an anonymous questionnaire specifically developed for the purpose of this study. Differences between patients reporting SCs use and those who did not were compared using chi-square test with values of p < 0.05 were considered significant. Results Out of 64 patients (median age 36.37 years), one third (32.81%) reported using SCs. Socio-demographic characteristics of the subjects were not associated with SCs use. There were differences in the most common sources of information reported between the SCs users and non-users. Majority of SCs users (76.0%) were informed about SCs through friends, compared with just 26.0% of non-users (<0.001). Nearly all study participants (93.8%) were daily tobacco users. The share of respondents reporting alcohol and marihuana use was significantly higher among the SCs users (52.0% vs. 20.9%, p = 0.011 and 15.6% vs. 12.5%, p = 0.015), respectively. Higher share of SCs users used multiple psychoactive substances (38.1% vs. 16.3%), and this difference was statistically significant (p = 0.047). The most commonly reported adverse effect of SCs among users included dry mouth (81.0%), trouble thinking clearly (52.4%) and panic attacks (52.4%). Conclusion Understanding the awareness and use of SCs among high-risk drug users, as well as associated factors can help improve substance-use disorder treatment in our setting. Educational activities targeting public are urgently needed to raise awareness on SCs, considering that social contacts are the main sources of information on SC for this vulnerable population. Users of SCs have also reported using other psychoactive substances more often, and this calls for a holistic approach addressing multiple factors to improve substance-use treatment in our setting.
Collapse
Affiliation(s)
- Vesna Mijatović Jovin
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- *Correspondence: Vesna Mijatović Jovin,
| | - Isidora Dickov
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Dragana Ratković
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Aleksandra Dickov
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Ana Tomas
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| |
Collapse
|
7
|
Onaolapo OJ, Olofinnade AT, Ojo FO, Adeleye O, Falade J, Onaolapo AY. Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature. World J Psychiatry 2022; 12:1268-1286. [PMID: 36389088 PMCID: PMC9641378 DOI: 10.5498/wjp.v12.i10.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/01/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023] Open
Abstract
The relationship between man and substances that have abuse potentials, and whose use has been associated with the development or progression of substance use disorders has continued to evolve in terms of geography, economic implications, and time. History shows that local plants with psychoactive constituents can get exported worldwide through global travel, commerce, or even conquest. Time and globalization also change people’s relationship with substances of abuse; hence, an area that was initially alien to certain substances might evolve to becoming a trafficking hub, and then a destination. A case in point is Africa where a rapidly increasing prevalence of substance use/abuse and substance use disorder among adolescents and young adults is putting enormous strain on the economy, healthcare system, and society at large. However, there appears to be a paucity of scientific literature and data on the epidemiology, risk assessment, and contributing factors to substance use and the development of substance use disorders across Africa. In this narrative review, we examine extant literature (PubMed, Google scholar, Medline) for information on the prevalence, trends, and influencers of substance use and the development of substance use disorders. This is with a view of understanding the determinants of substance use and factors that influence the development of substance use disorders in the region, and how this information can be channeled towards developing a comprehensive intervention and treatment program.
Collapse
Affiliation(s)
- Olakunle James Onaolapo
- Behavioral Neuroscience Unit, Neuropharmacology Subdivision, Department of Pharmacology, Ladoke Akintola University of Technology, Ogbomoso 210214 Oyo, Nigeria
| | - Anthony Tope Olofinnade
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University, Ikeja 100001, Lagos, Nigeria
| | - Foluso Olamide Ojo
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| | - Olufunto Adeleye
- Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| | - Joshua Falade
- Department of Mental Health, Afe Babalola University, Ado-Ekiti 360282, Ekiti, Nigeria
| | - Adejoke Yetunde Onaolapo
- Behavioral Neuroscience Unit, Neurobiology Subdivision, Department of Anatomy, Ladoke Akintola University of Technology, Ogbomoso 210214, Oyo, Nigeria
| |
Collapse
|
8
|
Mallaroni P, Mason NL, Vinckenbosch FRJ, Ramaekers JG. The use patterns of novel psychedelics: experiential fingerprints of substituted phenethylamines, tryptamines and lysergamides. Psychopharmacology (Berl) 2022; 239:1783-1796. [PMID: 35487983 PMCID: PMC9166850 DOI: 10.1007/s00213-022-06142-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Novel psychedelics (NPs) are an expanding set of compounds, presenting new challenges for drug policy and opportunities for clinical research. Unlike their classical derivatives, little is known regarding their use profiles or their subjective effects. AIMS The purpose of this study was to compile usage patterns and adverse event rates for individual NPs belonging to each of three main psychedelic structural families. Targeting the most widely used representatives for each class, we expanded on their phenomenological distinctions. METHODS A two-part survey was employed. We investigated the prevalence of novel phenethylamines, tryptamine and lysergamides in NP users (N = 1180), contrasting the type and incidence of adverse events (AEs) using a set of logistic regressions. Honing in on 2-4-Bromo-2,5-dimethoxyphenyl)ethanamine (2C-B) (48.6%), 1-propionyl-lysergic acid diethylamide (1P-LSD) (34.2%) and 4-Acetoxy-N,N-dimethyltryptamine (4-AcO-DMT) (23.1%), we examined their phenomenological separability using a gradient boosting (XGBoost) supervised classifier. RESULTS Novel phenethylamines had the highest prevalence of use (61.5%) seconded by tryptamines (43.8%) and lysergamides (42.9%). Usage patterns were identified for 32 different compounds, demonstrating variable dosages, durations and a common oral route of administration. Compared to phenethylamines, the odds for tryptamines and lysergamides users were significantly less for overall physical AEs. No significant differences in overall psychological AEs were found. Overall model area under the curve (AUC) stood at 0.79 with sensitivity (50.0%) and specificity (60.0%) for 2C-B ranking lowest. CONCLUSION NP classes may hold distinct AE rates and phenomenology, the latter potentially clouded by the subjective nature of these experiences. Further targeted research is warranted.
Collapse
Affiliation(s)
- P Mallaroni
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| | - N L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - F R J Vinckenbosch
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| |
Collapse
|
9
|
Haslacher D, Novkovic N, Buthut M, Heinz A, Soekadar SR. Pathological Delta Oscillations in Hallucinogen Persisting Perception Disorder: A Case Report. Front Psychiatry 2022; 13:867314. [PMID: 35401281 PMCID: PMC8987195 DOI: 10.3389/fpsyt.2022.867314] [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] [Received: 01/31/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hallucinogen persisting perception disorder (HPPD) is characterized by spontaneous recurrence of visual hallucinations or disturbances after previous consumption of hallucinogens, such as lysergic acid diethylamide (LSD). The underlying physiological mechanisms are unknown and there is no standardized treatment strategy available. CASE PRESENTATION A 33-year-old male patient presented with persistent visual distortions (halos around objects, intensified colors, positive after images, and trails following moving objects) that developed after repeated use of hallucinogenic drugs at the age of 18. Symptoms developed gradually and worsened several months later, resulting in various pharmacological and psychosocial treatment attempts that remained unsuccessful, however. At presentation, 32-channel electroencephalography (EEG) showed increased delta activity over the occipital brain regions, reminiscent of occipital intermittent rhythmic delta activity (OIRDA) usually seen in children. Two sessions of cathodal (inhibitory) transcranial direct current stimulation (tDCS) over 30 min attenuated visual hallucinations and occipital delta activity by approximately 60%. The response persisted for over four weeks. CONCLUSION Pathological delta activity over occipital brain regions may play an important role in the development and perpetuation of HPPD and can be attenuated by non-invasive brain stimulation.
Collapse
Affiliation(s)
- David Haslacher
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nikolina Novkovic
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Buthut
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Surjo R Soekadar
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
10
|
Zangani C, Ostinelli EG, Giordano B, D’Agostino A, Martinotti G, Clerici M, Gambini O, Schifano F. Knowledge and Use of Novel Psychoactive Substances in Italy: a Survey-Based Study in the General Population. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00683-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
11
|
Neicun J, Yang JC, Shih H, Nadella P, van Kessel R, Negri A, Czabanowska K, Brayne C, Roman-Urrestarazu A. Correction: Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007-2014. PLoS One 2021; 16:e0251006. [PMID: 33905461 PMCID: PMC8078782 DOI: 10.1371/journal.pone.0251006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
|
12
|
Rosner B, Neicun J, Yang JC, Roman-Urrestarazu A. Substance use among sexual minorities in the US - Linked to inequalities and unmet need for mental health treatment? Results from the National Survey on Drug Use and Health (NSDUH). J Psychiatr Res 2021; 135:107-118. [PMID: 33472121 DOI: 10.1016/j.jpsychires.2020.12.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/30/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Sexual minorities (SM) have specific substance use patterns and show elevated rates of substance use and substance use disorders. We investigated the potential association between substance use - including chemsex drug use - among SM adults in the United States (US) and social inequality, with an additional focus on disparities in unmet need for mental health treatment. METHODS A secondary cross-sectional data analysis was performed using National Survey on Drug Use and Health (NSDUH) data from 2015 to 2017 and including 126,463 individuals with 8241 identifying as SM. Multivariable logistic regression models were implemented to quantify disparities in substance use, to calculate the effect of sociodemographic variables on substance use, and to examine associations with socioeconomic vulnerability. FINDINGS SM showed higher odds of past-year substance use and lifetime chemsex drug use. All SM except for bisexual men exhibited higher odds of past-month binge drinking relative to heterosexuals. Bisexual women had higher odds for use of all analysed substances relative to heterosexual women. Being older and being a woman were shown to be protective factors. Urbanity, being uninsured, and unmet need for mental health treatment were associated with significantly higher odds of substance use, chemsex drug use and binge drinking. A link was established between drug use and health indicators, with higher odds of drug use for lower health ratings. SM experienced significantly higher levels of socioeconomic vulnerability. Higher vulnerability indices were associated with increased odds for drug use. INTERPRETATION This study is among the first nationally representative samples that analysed the link between sociodemographic factors and unmet need for mental health treatment and substance use in SM. It emphasises the multifactorial aetiology of substance use exposure, highlights the underlying mechanisms for substance use among SM while underscoring disparities among them. Approaches tailored to SM subgroups may be needed to address comorbidities and negative health outcomes of substance use in the long-term. However, critical gaps in the literature remain and large-scale studies inclusive of SM individuals are needed to present causal links. FUNDING Gillings Fellowship SYOG054 to ARU.
Collapse
Affiliation(s)
- Bastian Rosner
- Department of Anaesthesia/Intensive Care/Emergency Medicine/Pain Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany; Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, United Kingdom
| | - Jessica Neicun
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Justin Christopher Yang
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom; Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, United Kingdom
| | - Andres Roman-Urrestarazu
- Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, United Kingdom; Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| |
Collapse
|