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Guure C, Dery S, Baptista da Silva C, Asamoah-Adu C, Ayisi-Addo S, Diaba K, Loglo MG, Mohammed A, Sarpong YA, Hanu S, Torpey K. Situational assessment and epidemiology of HIV, HBV and HCV among people who use and inject drugs in Ghana. PLoS One 2024; 19:e0305923. [PMID: 39186757 PMCID: PMC11346957 DOI: 10.1371/journal.pone.0305923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/06/2024] [Indexed: 08/28/2024] Open
Abstract
INTRODUCTION People who inject drugs (PWID) and people who use drugs (PWUD) are an important population group that remain under-served in Ghana. Though PWID and PWUD are among the key populations most-at-risk to acquire sexually transmitted or blood-borne diseases, they are among those with the least access to human immunodeficiency (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses' prevention, care and treatment services in Ghana due to lack of data on them. We provide a rapid assessment of the PWUD and PWID situation in Ghana. METHODS This rapid cross-sectional design undertook consultative meetings between the study team and relevant stakeholders, including Civil Society Organizations (CSO) working with PWUD/PWID. The assessment considered a representative sample of PWID and PWUD. It was conducted in four (4) selected regions of Ghana (Greater Accra, Ashanti, Western, and Northern). Overall, 323 participants were interviewed using respondent-driven sampling (RDS) approach. Information obtained from participants were demographics, HIV risk behaviors, human immunodeficiency (HIV) and sexually transmitted infections (STI)-related knowledge HIV/HCV/HBV screening, attitude, and practices among others. Analyses were conducted using Stata version 17 and RDSAT version 7.1.46 software. FINDINGS Drug use was found to be more prevalent among the youth with a median age of 37 years. Majority of the respondents were males (86%). About 28% of the female respondents identified themselves as sex workers, while about 74% have been involved in transactional sex. The median age at which respondents started using and injecting drugs was 20 and 22 years respectively. Majority (68%) of the respondents consume drugs through smoking, with 20% through snorting, inhaling or swallowing and 12% through injection. The drug mostly used among the respondents was heroin (52%). The most commonly injected drug was cocaine (55%). About 64.7% of respondents reported mixing two or more drugs. HIV prevalence among respondents was 2.5%, 12.3% among women and 17.7% among women engaged in sex work, highlighting the overlap vulnerability. The prevalence of hepatitis C was 6.0%, and Hepatitis B was 4.5%. Access to care is limited, with 63% of the respondents never been tested for HIV. CONCLUSION These rapid assessment findings reveal the challenging conditions for people who use and inject drugs coupled with a relatively high prevalence of HIV and Hepatitis C compared to the general population. However, it also reveals that Ghana has a window of opportunity to prevent an exponential spread of HIV and Hepatitis in this population. Therefore, there is the need to implement prevention and treatment programs for HIV and hepatitis among people who use and inject drugs including essential strategies for an enabling environment in Ghana.
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Affiliation(s)
- Chris Guure
- Department of Biostatistics, School of Public Health, University of Ghana, Legon-Accra, Ghana
| | - Samuel Dery
- Department of Biostatistics, School of Public Health, University of Ghana, Legon-Accra, Ghana
| | | | | | | | - Kofi Diaba
- West Africa Program to Combat AIDS, Accra, Ghana
| | | | - Adamu Mohammed
- West Africa Behavioural Health Addictions and Recovery Management, Accra, Ghana
| | | | | | - Kwasi Torpey
- Department of Population Family and Reproductive Health, School of Public Health, University of Ghana, Legon-Accra, Ghana
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Gonçalves JS, Oliveira JLD, Almeida JCPD, Morero JAP, Pegoraro NPJ, Zanetti MOB, Souza JD. Effect of an Online Intervention on Nursing Students' Alcohol Consumption and Social Support. J Addict Nurs 2024; 35:51-58. [PMID: 38829994 DOI: 10.1097/jan.0000000000000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
OBJECTIVE This research aimed to evaluate the impact of custom-developed software on nursing students' alcohol consumption and perception of social support. METHOD A quasi-experimental study was conducted with 88 students in the early years of nursing courses at a Brazilian public university. The members of the intervention group (n = 40) participated in a lecture delivered by a nurse and used online software developed based on cognitive behavioral techniques and social skills training. The members of the control group (n = 48) participated only in the lecture. Data on alcohol consumption profiles and social support characteristics were collected. Descriptive statistics, an analysis of variance test, and the Dunnett's test were utilized for data analysis. RESULTS Alcohol consumption decreased in both groups without significant differences between them. However, in terms of frequency of use, binge drinking, and the number of drinks consumed, a significant decrease occurred among participants in the intervention group. Regarding social support, both groups showed an increase in satisfaction with support and a decrease in the number of supporters. This reduction was less pronounced in the intervention group than in the control group. CONCLUSION This investigation presents relevant results that suggest the potential of using online technologies as supplemental materials for promoting students' mental health.
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Tomko RL, Gex KS, Davis CN, Schick MR, Kirkland AE, Squeglia LM, Flanagan JC, Gray KM, McRae-Clark AL. Sex and Gender Differences in Simultaneous Alcohol and Cannabis Use: a Narrative Review. CURRENT ADDICTION REPORTS 2023; 10:628-637. [PMID: 38264339 PMCID: PMC10803059 DOI: 10.1007/s40429-023-00513-3] [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] [Accepted: 07/28/2023] [Indexed: 01/25/2024]
Abstract
Purpose of Review The aim is to review recent literature on sex and gender differences in patterns of use, motives, pharmacological effects, and consequences of simultaneous alcohol and cannabis use (SAC). Recent Findings Men engage in SAC more frequently than women. Women may have more substance-specific motives for use, while men tend to consistently endorse social/enhancement motives for both alcohol and cannabis. Regarding pharmacological effects, women experience the same subjective effects as men do at lower levels of use, with some evidence that women modulate cannabis use during simultaneous use episodes to avoid greater subjective intoxication. Finally, women appear more vulnerable to experiencing a range of positive and negative consequences from SAC relative to men. Summary Research has identified several important sex/gender differences in SAC and its correlates and consequences. However, research has primarily focused on white and cisgender populations, with a need for more research among racial/ethnic and gender minorities.
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Affiliation(s)
- Rachel L. Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Kathryn S. Gex
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Christal N. Davis
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | | | - Anna E. Kirkland
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Julianne C. Flanagan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
| | - Aimee L. McRae-Clark
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, MSC 864, 67 President Street, Charleston, SC 29425-8610, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Jelagat J, Budambula NLM, Ngari M, Budambula V. Polydrug Use among Students in a Public University in a Lower Middle-Income Country. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8085588. [PMID: 37560202 PMCID: PMC10409583 DOI: 10.1155/2023/8085588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023]
Abstract
Recreational drug use among students in tertiary institutions remains a public health concern. Despite documentation of drug use in Kenyan universities, most of the studies are based on self-reported history which is prone to social desirability bias. It is in this context that we sought to establish lifetime and current drug use among university students. The study investigated self-reported and confirmed drug use. Using proportionate to size and snowball sampling methods, 380 respondents were enrolled from three university campuses. Actual drug use was confirmed qualitatively using a 6 panel plus alcohol saliva test kit. The study participants' median (IQR) age was 22 (20-23) years, and 262 (69%) were male; 328 (86%) were degree-level students, while 127 (33%) were in their fourth year and above. A total of 221 (58%) students reported a lifetime ever use of drugs, while 193 (51%) tested positive for at least one drug. Alcohol, tobacco products (cotinine), marijuana, and amphetamine or khat were the most preferred drugs. The usage was either solely, concurrently, or simultaneously. Having multiple sexual partners compared to students with no sexual partner (adjusted risk ratio (aRR) of 2.33 (95% CI 1.45, 3.76)) and residing in Mishomoroni and Kisauni (aRR 1.50 (95% CI 1.08, 2.09)) were associated with risk of testing positive for any drug. Having one (aRR of 1.54 (95% CI 1.05, 2.26)) and multiple sexual partners (aRR 2.03 (95% CI 1.27, 3.25) and residing in Mishomoroni and Kisauni (aRR 1.48 (95% CI 1.05, 2.08)) were associated with self-reported drug use. One out of two students was currently using drugs. Irrespective of the method used to record data, alcohol, tobacco products, marijuana, and amphetamine or khat were the most preferred drugs. The usage was solely, concurrently, or simultaneously. Future interventions should focus on continuing students, students' residences, and those who are sexually active.
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Affiliation(s)
- Joan Jelagat
- Department of Environment and Health Sciences, Technical University of Mombasa, Kenya
| | | | - Moses Ngari
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kenya
| | - Valentine Budambula
- Department of Environment and Health Sciences, Technical University of Mombasa, Kenya
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Daldegan-Bueno D, Lindner SR, Kovaleski D, Fischer B. Cannabis use, risk behaviours and harms in Brazil: A comprehensive review of available data indicators. Drug Alcohol Rev 2023; 42:318-336. [PMID: 36443987 DOI: 10.1111/dar.13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 12/02/2022]
Abstract
ISSUES Cannabis use and related health/social outcome indicator data for Brazil-where non-medical cannabis is generally illegal-are limited. APPROACH Towards a comprehensive overview of relevant indicators, we searched primary databases by combining MeSH-index terms related to cannabis, geographic location and subtopic terms (e.g., use, health, mortality) focusing on cannabis use and key outcome indicators in Brazil since 2010. In addition, relevant 'grey literature' (e.g., survey reports) was identified. Key indicator data were mainly narratively summarised. KEY FINDINGS Overall, cannabis use has increased somewhat since pre-2010, with (past-year) use rates measured at 2-3% for general population adults, yet 5% or higher among youth and/or (e.g., post-secondary) student populations. For key risk behaviours, the presence of tetrahydrocannabinol-positivity among motor-vehicle drivers has been measured at <2%. While the prevalence of cannabis use disorder appears to have decreased, the relative proportion of treatment provided for cannabis-related problems increased. National- and local-based studies indicated an association of cannabis use with mental health harms, including depression and suicidality. Although some non-representative and/or local studies contain information, other monitoring data, including cannabis-related risks and harms (e.g., cannabis-related driving, mortality, hospitalisations), are limited in availability. IMPLICATIONS AND CONCLUSION The prevalence of cannabis use in Brazil is comparably low (e.g., relative to elsewhere in the Americas). Data on numerous key cannabis-related indicators is absent, or limited in scope for Brazil. Considering ongoing evolutions in cannabis control and its status as the most common illicit drug, more comprehensive surveillance of cannabis use and related outcomes is advised.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Sheila R Lindner
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Douglas Kovaleski
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
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Garcia-Cerde R, Valente JY, Sanchez ZM. Effects on secondary outcomes of the Brazilian version of the European unplugged drug use prevention program: drug knowledge, intention predictors, and life skill competencies. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2022.2161347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Rodrigo Garcia-Cerde
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Juliana Y. Valente
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Zila M. Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brasil
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Adham D, Afrashteh S, Alimohamadi Y, Maghsodlou-Nejad V, Khodadost B, Abbasi-Ghahramanloo A. Patterns of substance use and predictors of class membership among university male students: a latent class analysis. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2077253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Davoud Adham
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Yousef Alimohamadi
- Health Research Center, Life Style Institute, Baqiyatollah University of Medical Sciences, Tehran, Iran
| | | | - Behnam Khodadost
- Department of Epidemiology, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
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Fasanella NA, Custódio CG, do Cabo JS, Andrade GS, de Almeida FA, Pavan MV. Use of prescribed psychotropic drugs among medical students and associated factors: a cross-sectional study. SAO PAULO MED J 2022; 140:697-704. [PMID: 35976367 PMCID: PMC9514864 DOI: 10.1590/1516-3180.2021.0566.r2.05012022] [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] [Received: 06/26/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The worldwide prevalences of anxiety and depressive disorders are 3.6% and 4.4%, respectively. Among medical students, many studies have indicated that the prevalences of these mental disorders vary between 19.7% and 47.1%, but there is a lack of information on psychotropic drug usage in this group of students. OBJECTIVE To evaluate the prevalence of psychotropic drug use, adherence to therapy and main clinical and diagnostic indications relating to psychotropic drug use among medical students. DESIGN AND SETTING Cross-sectional study at a Brazilian private university in the city of Sorocaba, state of São Paulo. METHODS Observational analytical cross-sectional study, conducted during the second semester of 2019, through a semi-structured online questionnaire, answered by first to sixth-year medical students. RESULTS Among the 263 participants (41.7% of the 630 enrolled students), the current prevalence of psychotropic drug usage was 30.4%. This prevalence increased over the course and 90.7% of the drugs were prescribed at regular medical consultations (85.5% by psychiatrists). The main indications for psychotropic drug usage were anxiety (30.0%), depression (22.8%), insomnia (7.2%), panic (5.3%) and attention deficit hyperactivity disorder (3.8%). Women were more likely to present diagnoses of depression and panic. Most of the participants used antidepressants and had good adherence to medications. Adequate sleep and regular physical activity were identified as protective factors against mental disorders. CONCLUSION The prevalence of mental disorders among medical students is high, which justifies the use of psychotropic drugs. This study provides valuable information and recommendations for institutional educational actions to improve students' mental health.
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Affiliation(s)
- Nicoli Abrão Fasanella
- MD. Professor, Department of Public Health, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | - Clarissa Garcia Custódio
- Undergraduate Medicine Student, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | - Júlia Santos do Cabo
- Undergraduate Medicine Student, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | | | - Fernando Antônio de Almeida
- MD, PhD. Full Professor, Department of Clinics, Faculdade de Ciências Médicas e da Saúde (FCMS), Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
| | - Maria Valéria Pavan
- MD, MSc, PhD. Professor, Department of Public Health, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba (SP), Brazil
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McCabe SE, Engstrom CW, Kcomt L, Evans-Polce R, West BT. Trends in binge drinking, marijuana use, illicit drug use, and polysubstance use by sexual identity in the United States (2006-2017). Subst Abuse 2022; 43:194-203. [PMID: 34344281 PMCID: PMC8770527 DOI: 10.1080/08897077.2021.1913696] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: National studies often examine associations between sexual identity and substance use at a single point in time and neglect to examine whether these associations change over time. The present study examines U.S. trends in the past-year prevalence of binge drinking, marijuana use, illicit drug use, and polysubstance use across sexual identity subgroups (gay, lesbian, bisexual and heterosexual). Methods: The data come from four independent, cross-sectional samples measured by the National Survey of Family Growth (2006-2010, 2011-2013, 2013-2015, and 2015-2017). Based on the consistency in the sampling procedures used over time, merging the four data sets was possible. The target population is men and women 15-44 years of age. Results: Lesbian women had the sharpest decline in past-year binge drinking over time, followed by heterosexual women. The prevalence of binge drinking for bisexual women did not change significantly over time and was higher in 2015-2017 than for any sexual identity subgroup. In contrast, there were no significant differences in the prevalence of binge drinking among men by sexual identity subgroup. Past-year abstinence from substance use was consistently lower among lesbian women, gay men, and bisexual women relative to other sexual identity subgroups. Polysubstance use was consistently more prevalent among bisexual women (e.g., 32.3% in 2015-2017) as compared to other sexual identity subgroups. Conclusion: This is the first study to examine U.S. national trends in alcohol, marijuana, illicit drug, and polysubstance use across sexual identity subgroups, and demonstrates that sexual identity subgroup differences were robust with relatively few changes in trends over time. The consistently high rates of binge drinking and polysubstance use among bisexual women deserve much closer attention based on the related health consequences.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Curtiss W. Engstrom
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Brady T. West
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Lee CM, Calhoun BH, Abdallah DA, Blayney JA, Schultz NR, Brunner M, Patrick ME. Simultaneous Alcohol and Marijuana Use Among Young Adults: A Scoping Review of Prevalence, Patterns, Psychosocial Correlates, and Consequences. Alcohol Res 2022; 42:08. [PMID: 35548267 PMCID: PMC9059839 DOI: 10.35946/arcr.v42.1.08] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Alcohol and marijuana are commonly used by young adults, and use of both substances, particularly at the same time, is prevalent among this population. Understanding the prevalence, patterns, correlates, and consequences of simultaneous alcohol and marijuana (SAM) use is important to inform interventions. However, this literature is complicated by myriad terms used to describe SAM use, including use with overlapping effects and same-day co-use. OBJECTIVES This scoping review identifies and describes the peer-reviewed literature focused on SAM use by young adults and distinguishes simultaneous use from same-day co-use of alcohol and marijuana. This review also provides a narrative summary of the prevalence of SAM use, patterns of SAM and other substance use, psychosocial correlates, and consequences of SAM use. ELIGIBILITY CRITERIA This review is limited to papers written in English and published in peer-reviewed journals between January 2000 and August 2021. It includes papers assessing simultaneous use or same-day co-use of alcohol and marijuana among young adults ages 18 to 30. Review papers, qualitative interviews, experimental lab studies, policy work, toxicology or medical reports, and papers focused on neurological outcomes are excluded. SOURCES OF EVIDENCE PubMed, PsycINFO, and Web of Science databases were searched. Databases were selected and the search strategy developed in consultation with an information specialist. CHARTING METHODS A data charting form was utilized to specify which information would be extracted from included papers. Eight categories of data were extracted: (1) research questions and hypotheses; (2) sample characteristics; (3) study procedures; (4) definition of SAM use; (5) prevalence of SAM use; (6) patterns of SAM and other substance use; (7) psychosocial correlates of SAM use; and (8) consequences of SAM use. RESULTS A total of 1,282 papers were identified through initial search terms. Through double-blind title/abstract screening and full-text review, the review was narrowed to 74 papers that met review inclusion criteria. Review of these papers demonstrated that SAM use was prevalent among young adults, particularly among those who reported heavier quantities and more frequent use of alcohol and marijuana. Enhancement-related motives for use were consistently positively associated with SAM use. SAM use was associated with greater perceived positive and negative consequences of alcohol and/or marijuana use. Inconsistencies in prevalence, patterns, correlates, and consequences were found between studies, which may be due to large variations in measurement of SAM use, populations studied, methodological design (e.g., cross-sectional vs. intensive longitudinal), and the covariates included in models. CONCLUSIONS The literature on simultaneous use and same-day co-use of alcohol and marijuana has expanded rapidly. Of the 74 included papers (61 on SAM use; 13 on same-day co-use), 60 papers (47 on SAM use; 13 on same-day co-use) were published within the last 5 years. Future research focusing on the ways in which SAM use confers acute risk, above and beyond the risks associated with separate consumption of alcohol and marijuana, is needed for understanding potential targets for intervention.
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Affiliation(s)
- Christine M. Lee
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Brian H. Calhoun
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Devon Alisa Abdallah
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Jessica A. Blayney
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Nicole R. Schultz
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Meg Brunner
- Addictions, Drug, and Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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Salguero A, Pilatti A, Michelini Y, Rivarola Montejano G, Pautassi RM. Factors Associated with Simultaneous or Concurrent Use of Alcohol and Marijuana in Argentina. Subst Use Misuse 2022; 57:1062-1071. [PMID: 35437102 DOI: 10.1080/10826084.2022.2063895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: The identification of factors promoting simultaneous alcohol and marijuana (SAM) use is important to promote early intervention efforts. The associations between impulsivity facets and SAM (or concurrent alcohol and marijuana, CAM) use have been analyzed in North American samples. These topics, however, remain unexplored in South American samples. This study assessed if internalizing symptoms, five impulsivity dimensions, and emotional regulation strategies differentiate between participants who reported last 2-month SAM use, CAM use, alcohol, or marijuana only use, or that reported no substance use. Methods: A sample of 1057 Argentinian citizens answered an online survey. A multinominal logistic regression was conducted on drug use membership. Results: Circa 25% of the sample reported SAM use. Higher sensation seeking differentiated between SAM use versus no substance use, and those with lower sensation seeking were more likely to be classified into the alcohol-only group or into the nonuse group, than into the SAM use group. Stress scores uniquely predicted membership into the alcohol-only category. Those with lower use of emotional suppression were more likely than nonusers to be classified in all drug use categories, except CAM use. Higher emotional suppression scores were associated with membership into the nonuse group or the alcohol-only group, when compared to the SAM use group. Hazardous drinking was significantly greater in SAM than in alcohol-only users. Conclusions: The study highlights the relevance of sensation seeking as a predictor of SAM use and pinpoints emotional suppression as common factor modulating hazardous drug use behaviors.
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Affiliation(s)
- Agustín Salguero
- Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina.,Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Angelina Pilatti
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto de Investigaciones Psicológicas, IIPsi-CONICET-UNC, Córdoba, Argentina
| | - Yanina Michelini
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto de Investigaciones Psicológicas, IIPsi-CONICET-UNC, Córdoba, Argentina
| | - Gabriela Rivarola Montejano
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.,Instituto de Investigaciones Psicológicas, IIPsi-CONICET-UNC, Córdoba, Argentina
| | - Ricardo Marcos Pautassi
- Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina.,Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
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12
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Krawczyk N, da Mota JC, Coutinho C, Bertoni N, de Vasconcellos MTL, Silva PLN, De Boni RB, Cerdá M, Bastos FI. Polysubstance use in a Brazilian national sample: Correlates of co-use of alcohol and prescription drugs. Subst Abus 2021; 43:520-526. [PMID: 34283709 DOI: 10.1080/08897077.2021.1949666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: Responses to problem substance use have largely focused on illicit drugs, but reports on rising prescription drug misuse worldwide raise questions about their combined use with alcohol and potential consequences. The current study assessed prevalence of alcohol in conjunction with nonmedical opioid and benzodiazepine use across a nationally representative sample of adults in Brazil. Methods: Cross-sectional data on prevalence were estimated from the 2015 Brazilian Household Survey on Substance Use. We estimated past month nonmedical use of benzodiazepines and alcohol and past month nonmedical use of opioids and alcohol among adults who reported any past-year alcohol use. Zero-inflated Poisson models assessed independent correlates of alcohol and nonmedical opioid use, and alcohol and nonmedical benzodiazepine use. Results: Among adults who reported past year alcohol use, 0.4% (N = 257,051) reported past month alcohol and non-medical benzodiazepine use, and 0.5% (N = 337,333) reported past month alcohol and non-medical opioid use. Factors independently associated with co-use of alcohol and benzodiazepines included having depression (adjusted prevalence ratio (aPR):4.61 (95%CI 1.76-12.08)), anxiety (aPR:4.21 (95%CI 1.59-11.16)) and tobacco use (aPR: 5.48 (95%CI 2.26-13.27)). Factors associated with past-month alcohol and opioid use included having experienced physical or a threat of violence (aPR: 4.59 (95%CI 1.89-11.14)), and tobacco use (aPR:2.81(95%CI:1.29-6.12)). Conclusions: Co-use of prescription drugs with alcohol remains relatively rare among Brazilians, but findings point to a unique profile of persons at risk. Results of this study are important in light of changing dynamics and international markets of prescription drugs and the need for more research on use of these substances on a global scale.
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Affiliation(s)
- Noa Krawczyk
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Jurema C da Mota
- Institute of Scientific and Technological Communication and Information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
| | - Carolina Coutinho
- São Paulo School of Business Administration, Getúlio Vargas Foundation, Sao Paulo, Brazil
| | - Neilane Bertoni
- Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil
| | | | | | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
| | - Magdalena Cerdá
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Francisco Inácio Bastos
- Institute of Scientific and Technological Communication and Information in Health (ICICT), FIOCRUZ, Rio de Janeiro, Brazil
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13
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Aly SM, Omran A, Gaulier JM, Allorge D. Substance abuse among children. Arch Pediatr 2020; 27:480-484. [PMID: 33011026 DOI: 10.1016/j.arcped.2020.09.006] [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: 04/04/2020] [Revised: 07/21/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
Substance abuse (SA) among children is a recognized challenge for policymakers and law enforcement and has life-threatening consequences owing to the impact on the children's development and the consequent increase in vulnerability. This work outlines several important issues related to SA among children: (1) SA prevalence including onset, common examples, extent, and spectrum of SA; (2) the presence of new psychoactive substances, which are rapidly spreading worldwide with limitations regarding their prevalence, detection, and interventions; (3) street children and their recruitment in drug supply; (4) SA and substance use disorder pathways, risk and protective factors for the development of SA; (5) SA consequences in the case of early initiation, including deaths; and (6) current preventive interventions for the pediatric population. In conclusion, this challenge requires consistent and unremitting attention in order to execute effective prevention programs with continuous re-evaluation of the situation.
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Affiliation(s)
- Sanaa M Aly
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France.
| | - Ahmed Omran
- Pediatrics and Neonatology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt(d)
| | - Jean-Michel Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France; Université de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Delphine Allorge
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France; Université de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
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14
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Gender Differences in Clinical and Sociodemographic Patterns of Substance Use Disorder. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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15
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Demenech LM, Dumith SC, Paludo SDS, Neiva-Silva L. Academic migration and marijuana use among undergraduate students: evidences from a sample in southern Brazil. CIENCIA & SAUDE COLETIVA 2019; 24:3107-3116. [PMID: 31389557 DOI: 10.1590/1413-81232018248.27292017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/20/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to measure the prevalence of marijuana use in the last month, its associated factors and its relationship with academic migration among undergraduate students of a federal university in southern Brazil. This was a cross-sectional study and data were collected through self-administered questionnaire. A systematic sampling process was conducted. To data analyses, it was used Poisson regression with robust adjust for variance. Overall, 1,423 students participated. The prevalence of marijuana use in the last month was 16.8% (95%CI 14.8% to 18.8%). Data showed that the greater the distance of the city prior to university entry, the higher the prevalence of marijuana use in the last month. Being male, having less age, being single, not having religious practices, having relatives and friends who have used any illicit drug, and having tobacco use in the last month were also risk factors. We understand that academic migration within the country tends to decrease students contact with family and increase vulnerability to peer influence, which may lead to a higher probability of marijuana use in this sample. The results highlights the importance to develop projects of illicit drug use prevention focused on this risky subgroup.
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Affiliation(s)
- Lauro Miranda Demenech
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Itália km 8, Carreiros. 96201-900 Rio Grande RS Brasil.
| | - Samuel C Dumith
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Itália km 8, Carreiros. 96201-900 Rio Grande RS Brasil.
| | - Simone Dos Santos Paludo
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Itália km 8, Carreiros. 96201-900 Rio Grande RS Brasil.
| | - Lucas Neiva-Silva
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal do Rio Grande. Av. Itália km 8, Carreiros. 96201-900 Rio Grande RS Brasil.
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16
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Zanetti ACG, Cumsille F, Mann R. THE ASSOCIATION BETWEEN THE USE OF ALCOHOL, MARIJUANA AND COCAINE AND THE SOCIODEMOGRAPHIC CHARACTERISTICS OF UNIVERSITY STUDENTS OF RIBEIRÃO PRETO, BRAZIL. TEXTO & CONTEXTO ENFERMAGEM 2019. [DOI: 10.1590/1980-265x-tce-cicad-1-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to determine the prevalence of use in life and in the last three months of alcohol, marijuana and cocaine among university students from the social and health Sciences areas of Ribeirão Preto, Brazil and to evaluate the association between use in life and in the last three months of alcohol, marijuana and cocaine and the variables gender, area of the course, with whom the student lives, importance of religion, age and year of study. Method: a cross-sectional study, carried out with a convenience sample of 275 students from a public university in Ribeirão Preto-SP. For data collection, two instruments were used, containing sociodemographic, training and psychoactive substances. For the analysis, the following tests were used: Fisher's exact test, Chi-square test of Person and Mann-Whitney test. Results: As for sociodemographic factors, there was a significant association between the gender of the participants among the use of marijuana and cocaine in life (p=0.024 and p=0.005, respectively) and the last three months (p=0.013 and p=0.009, respectively), among the importance of religion and the lifetime use of alcohol, marijuana and cocaine (p <0.001, p <0.001 and p = 0.024, respectively) and the use of only marijuana in the last three months (p <0.001) and among the use of marijuana in the last three months and the year of graduation (p=0.003). Regarding age, the results showed a significant difference only between the groups that reported not to use alcohol in life (p=0.037). Conclusion: the investigated university students presented a prevalence of use in their lifetime and in the last three months of marijuana and cocaine greater among men, but not for alcohol. The importance of religion was negatively associated with the use of investigated drugs. The results can provide important subsidies for the structuring of preventive measures for abuse of psychoactive substances between university students and the need for new investigations that cover the subject.
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Affiliation(s)
| | - Francisco Cumsille
- Inter-American Observatory on Drugs, Inter-American Drug Abuse Control Commission, Estados Unidos
| | - Robert Mann
- University of Toronto, Canada; Centre for Addiction and Mental Health, Canada
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17
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Hernández-Serrano O, Gras ME, Font-Mayolas S. Concurrent and Simultaneous Use of Cannabis and Tobacco and Its Relationship with Academic Achievement amongst University Students. Behav Sci (Basel) 2018; 8:E31. [PMID: 29494479 PMCID: PMC5867484 DOI: 10.3390/bs8030031] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/23/2018] [Indexed: 11/16/2022] Open
Abstract
The combined use of cannabis and tobacco is frequent in Europe. Few studies have nonetheless explored this pattern of consumption and its relationship with academic achievement in Spanish population. The aim of the present study was to analyze (1) the frequency of four patterns of polydrug use the last year (non-dual users of cannabis and tobacco; concurrent users: cannabis and tobacco separately; simultaneous users: tobacco in cannabis "joints"; simultaneous users: tobacco in cannabis joints alongside alcohol) by gender and age; (2) grade point average (GPA) by gender and age; (3) the association between the frequency of the four patterns of use and the GPA amongst a sample of 477 Spanish university students. The use of cannabis and tobacco (concurrent and simultaneous) and GPA were assessed by means of self-reported questionnaires. Statistically significant differences were found for the GPA with respect to gender. The GPA by the non-dual users of cannabis and tobacco was significantly higher than the GPA corresponding to the concurrent and simultaneous users. The combined use of cannabis and tobacco, regardless of the type of use (concurrent or simultaneous), is moderately related to poor academic achievement amongst university students.
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Affiliation(s)
- Olga Hernández-Serrano
- Departament of Physical Therapy, Campus of Salt, EUSES-University of Girona (UdG), Carrer Francesc Macià, 65, 17190 Salt, Girona, Spain.
| | - Maria E Gras
- Department of Psychology, University of Girona (UdG), Plaça Sant Domènec, 9, 17004 Girona, Spain.
| | - Sílvia Font-Mayolas
- Department of Psychology, University of Girona (UdG), Plaça Sant Domènec, 9, 17004 Girona, Spain.
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18
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Likhitsathian S, Jiraporncharoen W, Aramrattana A, Angkurawaranon C, Srisurapanont M, Thaikla K, Assanangkornchai S, Kanato M, Perngparn U, Jarubenja R. Polydrug use among kratom users: Findings from the 2011 Thailand National Household Survey. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1436599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Apinun Aramrattana
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Northern Substance Abuse Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanitta Thaikla
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Manop Kanato
- Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Usaneya Perngparn
- Public Health Science College, Chulalongkorn University, Chiang Mai, Bangkok, Thailand
| | - Ratana Jarubenja
- Social Research Institute, Chulalongkorn University, Bangkok, Thailand
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19
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Lipperman-Kreda S, Paschall MJ, Saltz R, Morrison C. Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. Drug Alcohol Rev 2018; 37:188-195. [PMID: 28422352 PMCID: PMC5648641 DOI: 10.1111/dar.12537] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/20/2016] [Accepted: 12/29/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND AIMS Little is known about social-ecological correlates of simultaneous use of alcohol with other substances. This study examined places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. DESIGN AND METHODS We used survey data obtained from 1538 young adult recent alcohol drinkers (49% male; 18-30 years old) in 24 non-contiguous cities in California. Event-level measures included alcohol, tobacco and marijuana use, drinking places and social characteristics of the event. Individual-level measures included alcohol expectancies, depression and demographics. RESULTS Bars and restaurants had less alcohol and marijuana use (odds ratio = 0.34; 95% confidence interval 0.18, 0.62; P < 0.001) and alcohol, marijuana and tobacco use (odds ratio = 0.27; 95% confidence interval 0.14, 0.54; P < 0.001) compared with alcohol use only. Perceived percent of intoxicated people at an event was associated with greater likelihood of using alcohol with tobacco and marijuana at the event. At the individual level, greater age was generally associated with increased odds of simultaneous use. Participants who were male, less educated, more depressed and had positive alcohol expectancies were more likely to simultaneously co-use alcohol with tobacco and marijuana. Those with negative expectancies were less likely to simultaneously use these substances. DISCUSSION AND CONCLUSIONS Social events in private settings with a high percentage of people who are intoxicated had increased likelihood of simultaneous use of alcohol, tobacco and marijuana. Prevention efforts in these settings may reduce simultaneous use of these substances and related harms. [Lipperman-Kreda S, Paschall MJ, Saltz RF, Morrison CN. Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. Drug Alcohol Rev 2017;00:000-000].
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Affiliation(s)
| | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, USA
| | - Robert Saltz
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, USA
| | - Christopher Morrison
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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20
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Kataja K, Hakkarainen P, Väyrynen S. Risk-taking, control and social identities in narratives of Finnish polydrug users. DRUGS: EDUCATION, PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1335285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kati Kataja
- National Institute for Health and Welfare, Helsinki, Finland, and
| | | | - Sanna Väyrynen
- Faculty of Social Sciences, University of Lapland, Rovaniemi, Finland
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21
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McCabe SE, West BT. The 3-Year Course of Multiple Substance Use Disorders in the United States: A National Longitudinal Study. J Clin Psychiatry 2017; 78:e537-e544. [PMID: 28406266 PMCID: PMC5453813 DOI: 10.4088/jcp.16m10657] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 08/15/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the 3-year course of multiple co-occurring substance use disorders (SUDs) based on longitudinal survey data from a large, nationally representative sample. METHODS National estimates of the prevalence of DSM-IV SUDs were derived by analyzing data from structured, face-to-face diagnostic interviews as part of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), which collected data from a large, nationally representative sample of noninstitutionalized US adults at 2 waves (2001-2002 and 2004-2005; N = 34,653). RESULTS US adults with multiple past-year SUDs at Wave 1 were substantially more likely than those with an individual past-year SUD or no SUD at Wave 1 to report at least 1 past-year SUD at Wave 2 (66.3% vs 46.0% vs 6.9%, respectively). There were several sociodemographic characteristics and psychiatric disorders (ie, male, younger age, never married, sexual minority identity, nicotine dependence, mood disorder, and personality disorder) associated with increased odds of developing multiple SUDs and having 3-year persistence of multiple SUDs. The majority of adults with multiple past-year SUDs had a lifetime personality disorder and did not utilize substance abuse treatment or other help-seeking. CONCLUSIONS Multiple SUDs are associated with a more persistent 3-year course of disease over time relative to individual SUDs. Despite a more severe 3-year course and higher rates of comorbidity with other psychiatric disorders, the majority of US adults with multiple SUDs do not utilize substance abuse treatment or other help-seeking. Clinical assessments and the substance abuse literature tend to focus on drug-specific individual SUDs rather than considering the more complex multiple SUDs, which can be more challenging to treat.
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Affiliation(s)
- Sean Esteban McCabe
- University of Michigan Institute for Research on Women, 204 S State St, Ann Arbor, MI 48109. .,University of Michigan Institute for Research on Women and Gender, Ann Arbor, Michigan, USA
| | - Brady T. West
- University of Michigan Institute for Social Research, Survey Research Center, P.O. Box 1248, Ann Arbor, MI, USA 48016-1248
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22
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Karjalainen K, Kuussaari K, Kataja K, Tigerstedt C, Hakkarainen P. Measuring Concurrent Polydrug Use in General Populations: A Critical Assessment. Eur Addict Res 2017. [PMID: 28641293 DOI: 10.1159/000477802] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Polydrug use is a complicated phenomenon that is measured in a wide variety of different ways. Using Finland as an example, we aimed to demonstrate how the prevalence and prevalence trends of concurrent polydrug use (CPU) varied in the general population based on the different measurements used. METHODS Population-based Drug Surveys conducted every 4 years during 1998-2014 were used. CPU was measured with different measurements: strict, medial and loose definition of CPU, which were based on different combinations of alcohol, illicit drugs, pharmaceutical drugs and cigarettes used during the last 12 months/30 days. Logistic regression was used to estimate the p values for assessing trends. RESULTS Depending on the measurements used, the prevalence of CPU in 2014 varied between 2.0 and 18.7%. Different definitions also produced contradictory trends of CPU: there was a modest increase in prevalence if it was measured with a medial (p < 0.001) or strict (p = 0.054) definition, but when measured with the loose definition (only measure that included smoking), there was a decrease in prevalence (p < 0.001). CONCLUSIONS The prevalence of CPU varies greatly depending on the measurement used, as does the course of the prevalence trends. The concept of simultaneous polydrug use may capture the phenomenon better compared to the concept of CPU.
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23
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Tzilos GK, Reddy MK, Caviness CM, Anderson BJ, Stein MD. Mostly Smokers: Identifying Subtypes of Emerging Adult Substance Users. Subst Use Misuse 2016; 51:1587-1592. [PMID: 27484392 PMCID: PMC5055451 DOI: 10.1080/10826084.2016.1188956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The concurrent use of marijuana and other substances among emerging adults (ages 18-25) is a major public health problem. This study examined if there are distinct subtypes of emerging adult marijuana users and if these are associated with demographic and substance use variables. METHODS The design was a cross-sectional interview with a community sample of 1,503 emerging adults in the northeastern U.S. who reported last month marijuana use. We used latent class analysis (LCA) to identify distinct subtypes of emerging adults who used additional substances and examined predictors of the latent classes. RESULTS We identified three distinct classes of emerging adults who use substances: "mostly smokers" (those who primarily use marijuana and nicotine), "moderate users" (those who primarily use marijuana and/or heavy episodic alcohol), and "polysubstance users." Polysubstance users had higher probabilities of use of all assessed substances (e.g. cocaine, opiates, sleep medications, stimulants, synthetic marijuana, and inhalants) than the other two groups. Not being currently enrolled in school and male gender were associated with mostly smokers and polysubstance users group status. CONCLUSIONS We identified a distinct group of emerging adult marijuana users who primarily smoke marijuana and cigarettes, suggesting that there could be a shared vulnerability for risk of co-occurrence.
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Affiliation(s)
- Golfo K Tzilos
- a General Medicine Research Unit , Butler Hospital , Providence , Rhode Island , USA.,b Department of Psychiatry and Human Behavior , Brown University , Providence , Rhode Island , USA.,c Department of Family Medicine , University of Michigan , Ann Arbor , Michigan , USA
| | - Madhavi K Reddy
- b Department of Psychiatry and Human Behavior , Brown University , Providence , Rhode Island , USA.,d Department of Psychiatry and Behavioral Sciences , The University of Texas Health Science Center at Houston , Houston , Texas , USA
| | - Celeste M Caviness
- a General Medicine Research Unit , Butler Hospital , Providence , Rhode Island , USA
| | - Bradley J Anderson
- a General Medicine Research Unit , Butler Hospital , Providence , Rhode Island , USA
| | - Michael D Stein
- a General Medicine Research Unit , Butler Hospital , Providence , Rhode Island , USA.,e Department of Medicine , Brown University , Providence , Rhode Island , USA
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24
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Harker Burnhams N, Laubscher R, Howell S, Shaw M, Erasmus J, Townsend L. Using respondent-driven sampling (RDS) to recruit illegal poly-substance users in Cape Town, South Africa: implications and future directions. Subst Abuse Treat Prev Policy 2016; 11:31. [PMID: 27586507 PMCID: PMC5007993 DOI: 10.1186/s13011-016-0074-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 08/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa continues to witness an increase in illicit poly-substance use, although a precise measurement continues to be compounded by difficulties in accessing users. In a pilot attempt to use respondent-driven sampling (RDS)-a chain referral sampling method used to access populations of individuals who are 'hard-to-reach'-this article documents the feasibility of the method as recorded in a simultaneously run, multisite, poly-substance study in Cape Town. Here we aim to a) document the piloting of RDS among poly-substance users in the three socio-economic disparate communities targeted; b) briefly document the results; and c) review the utility of RDS as a research tool. METHODS Three cross-sectional surveys using standard RDS procedures were used to recruit active poly-substance users and were concurrently deployed in three sites. Formative research was initially conducted to assess the feasibility of the survey. To determine whether RDS could be used to successfully recruit poly-substance users, social network characteristics, such as network size was determined. RESULTS A 42.5 % coupon return rate was recorded in total from 12 initial seeds. There were vast differences in the recruitment chains of individual seeds-two generated more than 90 recruits, and 2 of the 10 recruitment chains showing a length of more than 10 waves. Findings include evidence of the use of 3 or more substances in all three sites, high levels of unemployment among users, with more than a third of participants in two sites reporting arrest for drug use in the past 12 months. CONCLUSIONS Our results indicate that RDS was a feasible and acceptable sampling method for recruiting participants who may not otherwise be accessible. Future studies can use RDS to recruit such cohorts, and the method could form part of broader efforts to document vulnerable populations.
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Affiliation(s)
- Nadine Harker Burnhams
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg, 7505 Cape Town, South Africa
- School of Public Health and Family Medicine, Falmouth Building, Faculty of Health Sciences University of Cape Town, 7701 Cape Town, South Africa
| | - Ria Laubscher
- Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town, 7505 South Africa
| | - Simon Howell
- Centre for Criminology, University of Cape Town Rondebosch, Private Bag x3, Cape Town, 7701 South Africa
- Centre of Criminology, Private Bag x3, Cape Town, 7701 South Africa
| | - Mark Shaw
- Centre for Criminology, University of Cape Town Rondebosch, Private Bag x3, Cape Town, 7701 South Africa
- Centre of Criminology, Private Bag x3, Cape Town, 7701 South Africa
| | - Jodilee Erasmus
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg, 7505 Cape Town, South Africa
| | - Loraine Townsend
- Health Systems Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town, 7505 South Africa
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25
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Haardörfer R, Berg CJ, Lewis M, Payne J, Pillai D, McDonald B, Windle M. Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis. Addict Behav 2016; 59:58-64. [PMID: 27074202 DOI: 10.1016/j.addbeh.2016.03.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 02/11/2016] [Accepted: 03/29/2016] [Indexed: 11/19/2022]
Abstract
Limited research has examined polysubstance use profiles among young adults focusing on the various tobacco products currently available. We examined use patterns of various tobacco products, marijuana, and alcohol using data from the baseline survey of a multiwave longitudinal study of 3418 students aged 18-25 recruited from seven U.S. college campuses. We assessed sociodemographics, individual-level factors (depression; perceptions of harm and addictiveness,), and sociocontextual factors (parental/friend use). We conducted a latent class analysis and multivariable logistic regression to examine correlates of class membership (Abstainers were referent group). Results indicated five classes: Abstainers (26.1% per past 4-month use), Alcohol only users (38.9%), Heavy polytobacco users (7.3%), Light polytobacco users (17.3%), and little cigar and cigarillo (LCC)/hookah/marijuana co-users (10.4%). The most stable was LCC/hookah/marijuana co-users (77.3% classified as such in past 30-day and 4-month timeframes), followed by Heavy polytobacco users (53.2% classified consistently). Relative to Abstainers, Heavy polytobacco users were less likely to be Black and have no friends using alcohol and perceived harm of tobacco and marijuana use lower. Light polytobacco users were older, more likely to have parents using tobacco, and less likely to have friends using tobacco. LCC/hookah/marijuana co-users were older and more likely to have parents using tobacco. Alcohol only users perceived tobacco and marijuana use to be less socially acceptable, were more likely to have parents using alcohol and friends using marijuana, but less likely to have friends using tobacco. These findings may inform substance use prevention and recovery programs by better characterizing polysubstance use patterns.
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Affiliation(s)
- Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Michael Lewis
- Department of Marketing, Goizueta Business School, Emory University, 1300 Clifton Road, Atlanta, GA 30322, United States
| | - Jackelyn Payne
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Drishti Pillai
- Deparment of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Bennett McDonald
- Deparment of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
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Leopoldo K, Leyton V, Oliveira LGD. [Alcohol use alone and in combination with other drugs among truck drivers on highways in São Paulo State, Brazil: a cross-sectional study]. CAD SAUDE PUBLICA 2016; 31:1916-28. [PMID: 26578016 DOI: 10.1590/0102-311x00047214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 03/02/2015] [Indexed: 11/21/2022] Open
Abstract
Traffic accidents cause more than a million deaths per year worldwide. Brazil is one of the leading countries in traffic accidents. Since alcohol is a known etiological factor for traffic accidents, the pattern of alcohol use alone and in combination with other drugs was assessed in a convenience sample of 684 truck drivers in São Paulo State, Brazil. 67.3% of participants reported alcohol use in the previous 30 days, 34.6% reported heavy drinking, 26% binge drinking, and 9.2% were at risk of developing alcohol addiction. Furthermore, 54.6% reported multiple drug use, mostly alcohol with tobacco and energy drinks. Truck drivers that reported multiple drug use showed heavier alcohol use than those who consumed only alcohol. Drinking and driving is problematic and can be aggravated by multiple drug use. The authors thus suggest monitoring the issue, which creates serious problems for users and society as a whole.
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Affiliation(s)
- Kae Leopoldo
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Vilma Leyton
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
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da Cruz TA, da Cunha GN, de Moraes VPM, Massarini R, Yoshida CMK, Tenguam PT, Garcia MV, Varoto DA, de Oliveira MB, de Andrade AG, de Azevedo-Marques Périco C, do Nascimento VB, Castaldelli-Maia JM. ICD-10 mental and behavioural disorders due to use of crack and powder cocaine as treated at a public psychiatric emergency service: an analysis of visit predictors. Int Rev Psychiatry 2014; 26:508-14. [PMID: 25137118 DOI: 10.3109/09540261.2014.928271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The present study investigated the predictors of an increased number of visits from individuals with some of the diagnoses noted in chapter F14 of ICD-10, from calls to the emergency psychiatric unit of a general hospital in São Paulo state, Brazil, in the period 2011-2012. Poisson regression models were carried out for the outcome variable, accounting for number of subsequent visits to the psychiatric emergency unit. For the analysis of this outcome we took into account the exposure time of each individual in the study. Our findings point to a population at risk for frequent psychiatric emergency service visits: individuals over 25 years. This population should be targeted for interventions on entry into public healthcare due to increased psychiatric morbidity and greater clinical morbidity already confirmed by previous studies. We discussed the need of these individuals for special attention during the clinical or psychiatric emergency consultation which, unfortunately, may be the access point for the public health system. None of the other variables were related to the outcome of interest, such as those related to the level of individual entry into the care network before and after treatment, and other variables related to medical acts during the visit.
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Abstract
PURPOSE OF REVIEW Polysubstance use is common, particularly amongst some age groups and subcultures. It is also associated with elevated risk of psychiatric and physical health problems. We review the recent research findings, comment on changes to polysubstance diagnoses, report on contemporary clinical and epidemiological polysubstance trends, and examine the efficacy of preventive and treatment approaches. RECENT FINDINGS Approaches to describing polysubstance use profiles are becoming more sophisticated. Models over the last 18 months that employ latent class analysis typically report a no use or limited-range cluster (alcohol, tobacco and marijuana), a moderate-range cluster (limited range and amphetamine derivatives), and an extended-range cluster (moderate range, and nonmedical use of prescription drugs and other illicit drugs). Prevalence rates vary as a function of the population surveyed. Wide-ranging polysubstance users carry higher risk of comorbid psychopathology, health problems, and deficits in cognitive functioning. SUMMARY Wide-ranging polysubstance use is more prevalent in subcultures such as 'ravers' (dance club attendees) and those already dependent on substances. Health risks are elevated in these groups. Research into the prevention and treatment of polysubstance use is underdeveloped. There may be benefit in targeting specific polysubstance use and risk profiles in prevention and clinical research.
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