Prevalence, consequences and factors associated with drug use among individuals over 50 years of age in the family perspective

OBJECTIVES

The aim of this study was to investigate the prevalence, consequences and factors associated with drug use among individuals over 50 years of age, from the perspective of their families, with particularly reference to cocaine use.

METHODS

Cross-sectional study based on secondary data with 624 family members of substance users who sought family support in 14 units of the Recomeço Família Program in São Paulo, Brazil.

RESULTS

The participants were predominately men, aged 50 to 59 years (68%); cocaine users (inhaled and/ or smoked); living alone; with a low level of education and were unemployed. They were likely to use family money to pay for their substance use, with a history of theft and aggression against strangers, and were not in treatment. Unlike other participants [≥ 60 years (31.1%)]; who were better educated and retired. In this latter group, 32.8% are alcohol users, 14.8% cocaine users (inhaled and smoked), 32.6% has physically assaulted their family, 39.7% had assaulted someone else and 18.3% had stolen objects or money from home.

CONCLUSIONS

The population has peculiar characteristics of vulnerability (cocaine use and violence) that remain under investigated; not only do routes into treatment for older adults (≥ 60) but appropriate treatment packages need to be developed too.

eSubmission of Promotional Labeling and Advertising Materials via the eCTD FDA Gateway : The Time Has Come for Advertising and Promotion to Submit in Module One

In June 2019, the Food and Drug Administration (FDA) issued its final Guidance on submission of advertising and promotional materials to the Office of Prescription Drug Promotion (OPDP) in eCTD format through the electronic gateway. Our goal was to put in place a stepwise plan and clear process to submit these materials in advance of June 2021 when electronic submissions become mandatory. The first step was to test every submission type and every possible iteration, therefore, as issues arose, problems could be easily addressed and resolved. This helped build confidence and achieve a level of comfort in preparing for the first eSubmission. To accomplish this, testing was performed through the gateway including: Form FDA 2253 (and accompanying promotional materials), advisory comments (launch and non-launch), enforcement actions, multiproduct submissions (grouped and ungrouped), and information request responses. The second step was to obtain internal alignment between involved functional areas to pilot a single brand. Finally, after a successful pilot program, eCTD submissions were expanded across all other brands. This paper discusses the stepwise approach taken, considerations for electronic submissions and results for improved efficiencies and cost savings. Implementing a well, laid-out plan, and starting the conversion early, allowed us to be thoughtful in our approach. The steps taken, and the successful outcomes achieved, demonstrate that there is no reason to wait for submitting promotional materials via the FDA gateway.

Anatomy of Risk Evaluation and Mitigation Strategies (REMS)

This Chapter provides an introduction and overview of the U.S. FDA REMS program and applicable regulatory aspects. Topics covered include the 2015 Draft Guidance, organization structure and functions, a discussion on pharmacovigilance and adverse event reports, and a discussion of the applicability of REMS in oncology.