Addiction profile in probation practices in Turkey: 5-year data analysis

Examination of childhood trauma and self-esteem of individuals who applied to the probation office due to substance use

Substance use is increasing worldwide, and this creates serious social, economic and psychological problems. This study aims to examine the sociodemographic, childhood trauma (CT), self-esteem level and clinical data of individuals diagnosed with substance use disorder (SUD) who applied to the Probation Unit and the control group and it also aims to compare these data. In this prospective cohort study, 73 individuals diagnosed with SUD, and a control group consisting of 73 simple randomly selected healthy individuals. It was determined that the participants in the SUD group had extremely significantly lower self-esteem and had a high level of CT exposure compared to the control group. When all the cases were examined in the study, it was observed that as the level of self-esteem decreased, the rate of exposure of CT was significantly higher. Participants with SUD were more exposed to emotional abuse, physical abuse, physical neglect, and physical abuse compared to control group. It was determined that those with substance use had a high rate of childhood trauma and low self-esteem. In effective fight against substance abuse, it was thought that sociocultural programs should be implemented, and accessibility of these programs should be expanded in order to increase individuals' self-esteem levels.

Substance use-related factors and psychosocial characteristics among Turkish adults with early- and late-onset substance use disorder

The onset of substance use is a strong predictor of substance use disorders and related problems. This study examined the differences between early- and late-onset substance use in personality and substance use characteristics, traumatic experiences, and social support with a sample of 100 Turkish adults with substance use disorders. Early onset (<18 years) was associated with more traumatic experiences, increased risk of developing posttraumatic stress disorder (PTSD), and higher levels of depressive symptoms compared to late onset (≥18 years). Also, depressive symptoms, living, and working status were predictors of substance use onset. The study addresses the groups at risk of initiating substance use.

Investigation of hand functions in individuals with cannabis and its derivatives use disorder

BACKGROUND

The present study was aimed to compare the grip/pinch strengths and manual dexterity of individuals with and without the use of cannabis and its derivatives.

METHODS

A cross-sectional prospective study was conducted with 66 individuals, including 33 cases with the use of cannabis (and its derivatives) and 33 age- and sex-matched controls. Grip and pinch strengths were evaluated with a dynamometer. The Nine-Hole Peg Test (9HPT), Minnesota Manual Dexterity Test (MMDT), and Michigan Hand Outcomes Questionnaire (MHQ) were used to assess the hand function.

RESULTS

The hand grip strength and dominant hand 2-point pinch (2PP) grip strength were less in individuals with substance use disorder (SUD) (p < 0.05). The 9HPT duration of the SUD patients was higher (p < 0.05). On the other hand, the MMDT insertion and rotation test results were different between the groups (p < 0.05). Grip strength was related with the MMDT insertion and rotation tests (r =  -0.411 to -0.480). There was significant correlation between grip strength with dominant hand 9HPT (r =  -0.370) and between dominant hand 3-point pinch (3PP) strength with MMDT insertion (r =  -0.378). In addition, dominant hand 2PP strength was correlated with overall hand function of MHQ (r = 0.382).

CONCLUSION

The individuals with cannabis use disorder showed reduced grip strength on both sides and decreased 2PP strength on the dominant side compared to healthy individuals. In addition, there is a decrease in the hand skills of individuals with cannabis use disorder. Decreased grip strength of individuals with cannabis use disorder affected their hand skills negatively.

The relationship between expressed emotion, personality traits and prognosis of alcohol and substance addiction: 6-month follow-up study

AIM

Preventing relapses in addiction and related factors are still being investigated. There is inadequate data, specifically, on the effects of expressed emotion (EE) among key relatives of patients with alcohol and substance use disorder (ASUD), the personality traits of patients, and the clinical features of addiction on relapses.

MATERIAL AND METHOD

This study was conducted with patients with ASUD (n = 102, 98 male) and their relatives (n = 102, 44 male). The Dependency Profile Index, and the Temperament and Character Inventory were applied to the patients, while the EE scale was applied to key relatives. Relapse rates were evaluated six months later.

RESULTS

EE levels among key relatives of patients were found to be associated with early relapse rates (p = 0.002). In addition, the individuals the patients lived with (p = 0.041), income level (p = 0.048), working status (p = 0.039), time spent in profession (p = 0.007), and severity of addiction (p = 0.016) were all found to be significantly associated with relapses. The personality traits of patients were not related to early relapses. In logistic regression analysis, EE and time spent in a profession were found to be significantly associated with relapses (p = 0.014, 0.043 respectively), while other variables were not significant.

CONCLUSION

The relationship between relapse in the early period of abstaining from substance use and EE levels of key relatives seems to be a greater determinant for ongoing success than several other variables in patients with ASUD, including addiction severity. The research suggests that families be involved in programs that help prevent relapses.

Klotho, BDNF, NGF, GDNF Levels and Related Factors in Withdrawal Period in Chronic Cannabinoid Users

Klotho and neurotropic factors have recently been shown to be related to some psychiatric disorders and neurocognitive disorders, but there is no study on this issue within substance users. In this study, brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial derived neurotrophic factor (GDNF) and klotho serum levels of a patient group consisting of 27 chronic cannabis users according to the DSM-V and 27 healthy volunteers were compared, and their relationships with other the clinical features of other patients were evaluated. Clinical scales, the Buss-Perry Aggression Scale, and the Substance Craving Scale were repeated on the first day of hospitalisation and on the seventh day of withdrawal. BDNF, GDNF, NGF and klotho levels were analysed using the ELISA method. There was no differences between the cannabinoid use disorder group and the control group regarding their klotho and other neurotrophic levels, but initiation age of cannabis use was negatively correlated with these levels. In addition, there was a relationship between verbal aggression scores and BDNF and NGF levels. There was a positive correlation between klotho and neurotrophic factors in all groups (patient group Day 1, patient group Day 7, control group) (p < 0.01). When comparing the difference between the correlations using the cocor (a comprehensive solution for the statistical comparison of correlations), the klotho-GDNF and klotho-NGF correlations for the first day of the patient group and the control group were different. In this study, rather than a difference in klotho levels and neurotropic factors, a significant relationship between these markers and each other and clinical parameters was demonstrated; further studies are needed to understand the exact mechanism.

Delirium and High Creatine Kinase and Myoglobin Levels Related to Synthetic Cannabinoid Withdrawal

Synthetic cannabinoids (SCs) are included in a group of drugs called new psychoactive substances. Effects of SCs on the central nervous system are similar to other cannabinoids, but 2-100 times more potent than marijuana. Thus, addiction and withdrawal symptoms are more severe than natural cannabinoids. Withdrawal symptoms of SCs were reported in the literature previously. But there is no report about SC withdrawal delirium and its treatment. Several studies reported that agonists of CB1 receptors play a role in GABA and glutamatergic neurotransmission, which is similar to the effects of alcohol on GABA and glutamatergic receptors. Previous studies on alcohol delirium cases suggested that elevated creatine kinase (CK) can be a marker of progress. This study reports delirium and high serum CK levels related to SC withdrawal and offers a treatment with benzodiazepine for them. We described two cases treated in our inpatient clinic about SC withdrawal with increase of serum CK level and other laboratory parameters. One of them demonstrated delirium symptoms and the other did not with early rapid treatment.

Alterations of the hematologic cells in synthetic cannabinoid users

BACKGROUND

Functions, morphology, distributions, and index of the circulating cells are the most useful parameters that indicate various inflammatory and toxic conditions. The aim of this study was to investigate the clinical significance of these parameters in patients diagnosed with (synthetic) cannabis use disorder.

METHODS

This study included a total of 40 patients in the study group (SG) with synthetic cannabis use; and 40 healthy individuals as the control group (CG). Participants, who had hematological disorders and other chronic diseases, were excluded from the study. All hematological parameters of SG were compared with CG. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) values were calculated and compared between groups.

RESULTS

There were statistically significant differences between the groups in terms of WBC, MCH, RDW, MCV, MPV, and NEU, LYM%, MONO% parameters (P<.05). MPW and LYM% were significantly lower in SG compared to CG. WBC, MCH, RDW, MCV, MPV, MONO, and NEU parameters were significantly higher in SG compared to CG (P<.05). UIBC and TIBC levels were significantly higher in SG compared to CG (P<.001). Although there was statistically significant difference between groups in terms of NLR, there was no significant difference for PLR values.

CONCLUSION

Our data suggested that chronic use of cannabinoids can lead to deterioration of hematopoietic cells. Chronic use of cannabinoids was consistent with subthreshold/subclinical megaloblastic anemia with iron deficiency. Inflammatory cells, especially neutrophil and monocyte counts were higher in SG compared to CG. Thus, recovery of subclinical hematological parameters should be considered in cannabis use disorder patients.